[Study on the reliability and validity of the Chinese Criteria of Health Scale for the elderly people].

Objective: To evaluate the reliability and validity of the Chinese Criteria of Health Scale for the elderly people. Methods: A cross-sectional study was performed among older adults of Meiyuan Community in Haidian District, Beijing and Nanwangkong Village in Qingzhou City,Shandong Province during July 2021. Using a cluster sampling method, totally 667 elderly people were investigated by face-to-face interview, using the scale which was formulated after two rounds of the Delphi method and pilot study. The overall scale includes physical health, mental health and social health subscales, including 9, 52 and 15 items, respectively. Four weeks after the survey, 56 elderly people were randomly selected and repeated the survey with the same method. The test-retest reliability, split-half reliability and internal consistency reliability of the scale were evaluated, and the validity was evaluated at the same time, including construct validity and content validity. Results: A total of 710 questionnaires were distributed and 667 valid questionnaires were obtained, with a total effective rate of 93.94%. The score of the overall scale was 79.79±16.22, the scores of the physical health, mental health, social health sub-scores were 41.64±9.76, 26.82±3.92 and 11.34±5.19, respectively. The scale had excellent reliability. In the test-retest reliability, the intraclass correlation coefficient (ICC) of the overall scale and each subscale were 0.766-0.861, and the weighted Kappa values were 0.762-0.817. The Spearman-Brown coefficient of the overall scale and each subscale in the split-half reliability were 0.722-0.855 (all P<0.001). The Cronbach's α coefficients of the overall scale of internal consistency reliability and each subscale were 0.748-0.899, and the Cronbach's α coefficients of each dimension were from 0.709 to 0.963(all P<0.001). At the same time, the scale had good construct validity and content validity. The correlation coefficients between the score of each dimension and its sub-scale were larger, from 0.641 to 0.873 (all P<0.05). The cumulative variance contribution rates of the scale and three subscales were all more than 50% of the approved standard. A total of 11 common factors were extracted, and all the load values of each item on the corresponding factors were ≥0.04. Conclusion: The Chinese Criteria of Health Scale for the elderly people has good validity and excellent reliability. It can be used as a basis for the scientific division of the health status of the elderly, the formulation of relevant policies by the government and the provision of appropriate health services for the elderly.

[The gender disparity and relevant factors of frailty in the elderly of communities in Beijing based on Fairlie decomposition analysis].

Objective: To analyze the gender disparity and relevant factors of frailty in the elderly of communities in Beijing. Methods: From November 2015 to January 2016, 1 557 participants aged 60 and older in four communities of Dongcheng district in Beijing were recruited by cluster sampling. The information of demographic characteristics, social support, economic status, health status, prevalence situation, cognitive function, emotion and comprehensive assessment of the elderly were collected by a self-made questionnaire. The frailty index (FI) model was used to evaluate the frailty of the elderly. Multivariate nonconditional logistic regression model and Fairlie decomposition method were applied to analyze the relevant factors and their contribution rate to the difference between males and females. Results: The age of subjects was (74.5±8.5) years old, ranging from 60-102 years old, among which 641 were males, accounting for 41.2%. The M (Q1, Q3) of FI was 0.09 (0.06, 0.14), among which the value in males was 0.08 (0.05, 0.13), lower than females [0.10 (0.06, 0.15)] (P<0.001).The frail proportion in female was 14.9% (137/916), higher than that of male [8.4% (54/641)] (P<0.001). Multivariate nonconditional logistic regression model analysis demonstrated that common relevant factors associated with frailty in older women and men include: age ≥80 years old, marital status as not married (unmarried, separated, divorced, or widowed), living alone increased the risk of frailty; participating in group activities ≥3 times/week and exercising regularly decreased the risk of frailty (all P<0.05). Fairlie decomposition method showed that the contribution rate of life style, family support, marital status and social support were 32.21%, 15.26%, 8.23% and 4.34%, respectively (all P<0.05). Conclusions: The frailty degree and frailty proportion of elderly women in communities in Beijing were higher than those of men of the same age. The frailty gender difference was related to lifestyle, family support, marital status and social support.

[Relationship between frailty status and risk of death in the elderly based on frailty index analysis].

Objective: To analyze the relationship between frailty status and the risk of death in the elderly based on the frailty index (FI). Methods: Data from a prospective cohort study conducted between 2005 and 2015 in elderly people of an urban community in Beijing were analyzed. The variables related to health and frailty status based on the 2005 baseline survey and death as outcome variables collected in 2015 were used. A FI model was used to evaluate the correlation between FI and mortality in the elderly people in different age groups was analyzed. Cox regression was applied to evaluate the influence of FI on the risk of death, and Kaplan-Meier curves was used to show the survival rate of different frailty levels in the elderly adults. Results: Of the 1 301 elderly people included in the analysis, 403 died during 2005-2015, with the 10-year mortality rate of 31.0%(403/1 301). The mortality rate of the elderly increased with the increase of FI, but, with the increase of FI value, the rate of mortality increased slowly. The limit value of FI causing death was around 0.70, indicating any new health problem might cause death at this value. Cox regression analysis showed that higher FI was associated with higher risk for death (HR=1.143, 95%CI: 1.034-1.248, P=0.000), and FI was more significantly associated with death than age (HR=1.143 vs. HR=1.048, t=5.827, P=0.000). With the increase of age, the effect of frailty on the risk of death decreased (HR=1.179 to HR=1.120). Kaplan-Meier curves showed that the survival rate of the elderly in all age groups decreased with the increase of frailty (Log-rank=317.812, 354.203, 247.258, all P=0.000). The survival time between different frailty levels in the elderly were significantly different, except for the elderly adults aged ≥80 years with severe frailty level (0.4≤FI<0.5, FI≥0.5, P=0.368). Conclusions: Compared with other evaluation tools of frailty, FI model can better reflect the frailty status of the elderly in communities in Beijing and has a high sensitivity in predicting adverse outcomes such as mortality. In the intervention of frailty in the elderly, focusing on relatively young elderly might be more effective in reducing the adverse outcomes caused by frailty.

[Relationship between fall and frailty index in elderly adults of urban community in Beijing].

Objective: To evaluate the frailty status and understand the relationship between the incidence of fall and frailty status in the elderly in Beijing. Methods: A cross-sectional study was conducted in old people aged ≥60 years in Longtan community of Dongcheng district in Beijing from November 2015 to January 2016. The information about any fall during the past year and frailty status of the elderly were collected with a standardized structured questionnaire in face-to-face interviews. The frailty status of elderly people was assessed with frailty index (FI) method. Logistic regression analysis was used to explore the relationship between fall and frailty status among the elderly. Results: Among 1 557 old people surveyed, the incidence of fall was 17.8% (277/1 557) during the past year. The incidence of fall in women (21.0%, 192/277) was statistically higher than that in men (13.3%, 85/277) (χ(2)=15.288, P=0.000). The median (quartile) value of FI of the elderly surveyed was 0.09 (0.08); and women had a higher FI median value than men [0.10 (0.08) versus 0.08 (0.07)](Z=5.376, P=0.000). The median FI value (quartile range) of 277 old people with history of fall in previous year was 0.12 (0.11), which was higher than the median FI value of 0.08 (0.07) of 1 280 old people without fall history (Z=7.501, P=0.000). Logistic regression analysis showed that higher FI value was associated with more risks for fall; and FI value showed the greatest impact on the incidence and frequency of fall (OR=1.093, 2.234) compared with other related factors of fall, such as age and gender. Conclusion: Frailty status has a greater impact on both incidence and frequency of fall compared with other factors in elderly people in Beijing; more attention should be paid to weak and old adults in the prevention of fall.

lncRNA HOXA11-AS is involved in fracture healing through regulating mir-124-3p.

OBJECTIVE: Long noncoding RNAs (lncRNAs) have been reported to participate in many diseases. Fracture healing is one of these ordinary diseases. This study aims to identify how lncRNA HOXA11-AS affects the progression of fracture healing. MATERIALS AND METHODS: RT-qPCR was performed to detect the level of HOXA11-AS. Moreover, function assays including cell growth assay and cell apoptosis assay were performed to explore how HOXA11-AS functions in fracture healing. Furthermore, the interaction between HOXA11-AS and mir-124-3p was studied by RT-qPCR, luciferase assay, and RNA immunoprecipitation assay. Rescue experiments were performed to verify the interaction between HOXA11-AS and mir-124-3p in vitro. RESULTS: In the research, function assays revealed that HOXA11-AS overexpression inhibited cell proliferation, while HOXA11-AS knockdown promoted cell proliferation in vitro. Moreover, HOXA11-AS overexpression promoted cell apoptosis, while HOXA11-AS knockdown inhibited cell apoptosis in vitro. Furthermore, mechanism assays demonstrated that HOXA11-AS acts a ceRNA via sponging mir-124-3p. Rescue assay demonstrated that HOXA11-AS suppressed cell proliferation and promoted cell apoptosis via targeting mir-124-3p. CONCLUSIONS: These results indicate that HOXA11-AS could inhibit cell proliferation and promote cell apoptosis of osteoblast via sponging mir-124-3p, which may offer a new vision for interpreting the mechanism of fracture healing.

[Application of frailty index for comprehensive geriatric assessment in the elderly in China].

OBJECTIVE: To discuss the suitability of frailty index for comprehensive geriatric assessment(FI-CGA)in the elderly in China, and evaluate the application of FI-CGA in China. METHODS: A comprehensive geriatric assessment was conducted among 118 old adults receiving health examination, and frailty index was calculated. Clinical frailty scale(CFS)was also used to evaluate the frail status of the old adults. The correlation between FI-CGA value and CFS level of the old adults was analyzed. RESULTS: The mean value of FI-CGA was 0.19 ± 0.07, and the average level of CFS was 3.11 ± 1.46. Women had higher mean value of FI-CGA and higher CFS level than men(FI-CGA= 0.20 ± 0.02 for women, 0.19 ± 0.07 for men; CFS =3.40 ± 0.55 for women, 3.10 ± 1.48 for men), but the differences had no significance(t=0.270, 0.452, P=0.788, 0.652). The FI-CGA value and CFS level increased with age(F=10.437, 5.651, P=0.000, 0.001); and there was a positive correlation between FI-CGA value and CFS level(r=0.615, P=0.000). CONCLUSION: FI-CGA is an effective model for the quantitative evaluation of the frail status of the elderly, and can be used in the clinical practice of geriatric medicine.

Laser Cooling of a Micromechanical Membrane to the Quantum Backaction Limit.

The radiation pressure of light can act to damp and cool the vibrational motion of a mechanical resonator, but even if the light field has no thermal component, shot noise still sets a limit on the minimum phonon occupation. In optomechanical sideband cooling in a cavity, the finite off-resonant Stokes scattering defined by the cavity linewidth combined with shot noise fluctuations dictates a quantum backaction limit, analogous to the Doppler limit of atomic laser cooling. In our work, we sideband cool a micromechanical membrane resonator to the quantum backaction limit. Monitoring the optical sidebands allows us to directly observe the mechanical object come to thermal equilibrium with the optical bath. This level of optomechanical coupling that overwhelms the intrinsic thermal decoherence was not reached in previous ground-state cooling demonstrations.

Determination of the mode of action of enterolysin A, produced by Enterococcus faecalis B9510.

AIM: The current study aimed to visualize the damage caused by enterolysin A to the cells of sensitive strains and to find out cleavage site within the peptidoglycan moiety of bacterial cell walls. METHODS AND RESULTS: Enterolysin A produced by a local isolate, Enterococcus faecalis B9510 was found to rapidly kill cells of the sensitive strain Lactococcus lactis ssp. cremoris 2144 during 120 min of treatment as compared to the untreated control where no such effect was observed. Transmission electron microscopy of the enterolysin A-treated cells revealed leaking of the cytoplasmic contents ultimately resulting in complete lysis of cell walls. To find the cleavage site, purified cell walls of L. lactis ssp. cremoris 2144, Pediococcus pentosaceus 43201 and Lactobacillus delbrueckii ssp. bulgaricus ATCC 11842 were treated with enterolysin A, and liberated amino acids were derivatized for N and C terminals and analysed using thin layer chromatography on silica gel with isopropanol as solvent. The results showed that enterolysin A cleaves the peptide bonds at two locations within peptidoglycan subunits. The first location is between L-alanine and D-glutamic acid of the stem peptide and the other location is between L-lysine of the stem peptide and D-aspartic acid of the interpeptide bridge. CONCLUSIONS: Enterolysin A cleaves the peptide bonds within the stem peptide as well as in the interpeptide bridge of Gram-positive bacterial cell walls. This gives a possible reason for the broad spectrum of enterolysin A activity. SIGNIFICANCE AND IMPACT OF THE STUDY: This is the first report identifying the cleavage site of enterolysin A within the cell walls of sensitive bacteria. This will help in identifying potential applications for enterolysin A.

Development of a chemically defined medium for the production of enterolysin A from Enterococcus faecalis B9510.

AIM: This study aimed to develop a simplified chemically defined medium that could sustain the growth and bacteriocin (enterolysin A) production by Enterococcus faecalis B9510. METHODS AND RESULTS: The nutritional requirements of E. faecalis B9510 in a chemically defined medium were determined by single omission experiments. It was observed that eight amino acids (arginine, glycine, histidine, isoleucine, leucine, methionine, tryptophan and valine), three B vitamins (nicotinic acid, Ca-pantothenic acid and pyridoxal) and magnesium sulphate were essential for growth. Based on this information, a Simplified Defined Medium (SDM) was formed consisting of 26 components. Comparison of SDM with M-17 showed that growth and bacteriocin production in SDM was similar to that in M-17. The bacteriocin from SDM was then purified by ultrafiltration. The retentate of ultrafiltration step was analysed by SDS-PAGE and the results showed a single active band in the gel, which was excised and analysed by mass spectrometry, which indicated that the active band was enterolysin A, a cell wall degrading bacteriocin. CONCLUSIONS: A simplified defined medium can be formulated for the growth and bacteriocin production by Enterococcus faecalis, whose efficiency is comparable with that of a complex commercial medium. SIGNIFICANCE AND IMPACT OF THE STUDY: The development of such a medium can be useful for bacteriocin production and subsequent purification in a simplified manner and, therefore, helpful in the identification of novel bacteriocins.

Control of material damping in high-Q membrane microresonators.

We study the mechanical quality factors of bilayer aluminum-silicon-nitride membranes. By coating ultrahigh-Q Si(3)N(4) membranes with a more lossy metal, we can precisely measure the effect of material loss on Q's of tensioned resonator modes over a large range of frequencies. We develop a theoretical model that interprets our results and predicts the damping can be reduced significantly by patterning the metal film. Using such patterning, we fabricate Al-Si(3)N(4) membranes with ultrahigh Q at room temperature. Our work elucidates the role of material loss in the Q of membrane resonators and informs the design of hybrid mechanical oscillators for optical-electrical-mechanical quantum interfaces.

Avian cathelicidins: paradigms for the development of anti-infectives.

The broad-spectrum defense system based on host defense peptides (HDPs) is evolutionary very old and many invertebrates rely on this system for protection from bacterial infections. However, in vertebrates the system remained important in spite of the superposition of a very sophisticated adaptive immune system. The cathelicidins comprise a major group of HDPs in mammals. About six years ago it was first described that cathelicidins are also present in birds. Here we review the properties and biological activities of the recently discovered avian cathelicidins and their potential to be used as a paradigm for the development of anti-infectives. Like the mammalian cathelicidins, avian cathelicidins exert direct antimicrobial activities but can also selectively boost host immune responses by regulation of cytokine production and recruitment of immune cells. In addition, it was found that chicken cathelicidins bind endotoxins and dampen the endotoxin-mediated inflammatory response. Molecular dissection has allowed identification of different structural elements involved in bacterial killing and immunomodulation. These studies have enabled the design of small HDP-based antibiotics with specific functions, i.e. having primarily immunomodulatory or antimicrobial activities. Since the immunomodulatory effects may, to a certain degree, be species-specific, we hypothesize that poultry-specific antibiotics can be developed based on avian cathelicidins.

Predicting potential drop-out and future commitment for first-time donors based on first 1.5-year donation patterns: the case in Hong Kong Chinese donors.

BACKGROUND AND OBJECTIVES: Adequate blood supply is crucial to the health-care system. To maintain a stable donor pool, donation-promotion strategies should not only be targeted in recruitment but also focus on retaining donors to give blood regularly. A study using statistical modelling is conducted to understand the first 4-year donation patterns for drop-out and committed first-time blood donors and to build model for the donor-type identification based on their first 1.5-year donation patterns. SUBJECTS AND METHODS: First-time whole blood (n= 20 631) adult donors recruited in year 2000 and 2001 in Hong Kong were observed for more than 4 years. Cluster analysis was first applied to group donor type by their similarities in donation behaviour under the surveillance period. A decision tree model based on a shorter surveillance period (1.5 years) is then built to predict the donor type. RESULTS: Three donation patterns - one-time, drop-out, and committed donor behaviour - were identified in cluster analysis. Three variables - donation frequencies in the first-year and in the half-year period after first year, and the number of donation centre visits in the following half year after first year, were able to predict drop-out donors with potential to become committed and committed donors with relatively lower donation frequency. CONCLUSIONS: The present statistical modelling is able to identify those donors with potential to become committed donors and those committed donors who can donate more frequently. This information is useful for development of targeted donor retention strategies.

A device for feline head positioning and stabilization during magnetic resonance imaging.

Minimization of head movement and reproduction of standard head positions are essential for reliable brain functional magnetic resonance imaging. Devices for stabilization and alignment of feline preparations are not available currently. We describe a system that involves minimal surgery, allows for both acute and chronic atraumatic positioning, and has the potential to be used for unanesthetized animals. The device uses non-metallic materials and stabilizes the head by means of an apparatus that fixes the head with nylon screws and dental cement in the frontal sinuses. Application of the head-stabilizing device decreases head movements by more than a factor of ten. Anatomical images show that this device provides 3 dimensional head placement at a precision comparable to that of a stereotactic frame, i.e. within 1 mm.

Mechanisms in regulating the release of serotonin from the perfused rat stomach.

The mechanisms regulating the release of serotonin into the portal circulation as well as into the gastric lumen were studied in the isolated vascularly and luminally perfused rat stomach. Immunohistochemical study of the rat stomach showed that serotonin-containing enterochromaffin (EC) cells were densely packed in the antral mucosa, sparsely scattered in the corpus, and not found in the fundus. Such morphological findings suggest that serotonin detected in this study may have originated from antral EC cells. Luminal acidification stimulated the vascular release of serotonin but did not affect the luminal release of serotonin. The basal release of serotonin into the vasculature was 10 times higher than that into the gastric lumen at intragastric pH 2. The vascular release of serotonin is regulated by stimulation from cholinergic nicotinic mechanisms, whereas inhibitory neurotransmitters such as vasoactive intestinal peptide and NO are probably not involved. Somatostatin and peptide YY originating from endocrine cells may exert direct inhibitory effects, possibly via somatostatin and peptide YY receptors on the EC cells, and a cholinergic muscarinic mechanism may exert indirect effects on the vascular release of serotonin via the muscarinic receptor on the endocrine cells.

Fluid therapy of acute brain edema in children.

The clinical experience with a new fluid therapy in children with acute brain edema complicated by infectious disease is reported. The clinical data of a retrospective group of 192 patients and a prospective study of 1,302 and 2,279 patients is summarized. One method of fluid therapy for children with acute brain edema is traditional; fluid intake is restricted to less than 1,200 mL/m(2) daily (60 mL/kg daily). Another method is the new fluid therapy regimen used in our prospective study, in which dehydration and fluid replenishment are individualized. On the first day the fluid intake of patients who survived varied from 40 to 208 mL/kg daily. The mortality rate in the two prospective groups was 19.66% in 1,302 patients and 17.2% in 2,279 patients, significantly lower than the 63.5% in the retrospective group (192 patients) (P <0.001). This result indicates that a wide range of fluid intake for children with acute brain edema is allowable during the first days of treatment. The appropriate dehydration and fluid replenishment should be individualized based on close observation of the patient's condition.

Immunohistochemical localization of tryptophan hydroxylase in the human and rat gastrointestinal tracts.

Because few previous studies have shown the immunohistochemical localization of tryptophan 5-hydroxylase (TPH) in the gastrointestinal tract, we developed a specific antibody against TPH purified from mouse mastocytoma P-815 and stained human and rat gastrointestinal tracts. The specificity of the antibody was examined by Western blotting and by immunohistochemistry in brain sections. Human ileum and colon specimens, rat stomach, duodenum, jejunum, ileum and colon specimens, with and without colchicine treatment were prepared for immunohistochemistry. Immunoelectron microscopic double staining of TPH and serotonin/chromogranin A and immunofluorescence double staining of TPH and serotonin were performed to identify the cell types. Epithelial enterochromaffin (EC) cells, mast cells in the lamina propria and submucosa, and varicose fibers in the submucosa and muscle layer showed positive immunoreactivity in all segments examined from human and normal rat specimens. In colchicine-treated rat specimens, nerve cell bodies in the myenteric plexus were stained. Because the antibody does not cross react with tyrosine hydroxylase as defined in Western blotting or brain sections, these positive structures may contain TPH. The present results show evidence that EC cells, mast cells, and nerve cell bodies and fibers in the gastrointestinal tracts of both the human and the rat contain TPH and therefore may have the ability to synthesize serotonin from tryptophan.

Regression estimator in ranked set sampling.

Ranked set sampling (RSS) utilizes inexpensive auxiliary information about the ranking of the units in a sample to provide a more precise estimator of the population mean of the variable of interest Y, which is either difficult or expensive to measure. However, the ranking may not be perfect in most situations. In this paper, we assume that the ranking is done on the basis of a concomitant variable X. Regression-type RSS estimators of the population mean of Y will be proposed by utilizing this concomitant variable X in both the ranking process of the units and the estimation process when the population mean of X is known. When X has unknown mean, double sampling will be used to obtain an estimate for the population mean of X. It is found that when X and Y jointly follow a bivariate normal distribution, our proposed RSS regression estimator is more efficient than RSS and simple random sampling (SRS) naive estimators unless the correlation between X and Y is low (/rho/ < 0.4). Moreover, it is always superior to the regression estimator under SRS for all rho. When normality does not hold, this approach could still perform reasonably well as long as the shape of the distribution of the concomitant variable X is only slightly departed from symmetry. For heavily skewed distributions, a remedial measure will be suggested. An example of estimating the mean plutonium concentration in surface soil on the Nevada Test Site, Nevada, U.S.A., will be considered.

[Multifactor analysis on proliferative retinopathy in elderly patients with type II diabetes].

UNLABELLED: To evaluate the importance of different risk factors and their mutual interactions in the occurrence of proliferative diabetic retinopathy (PDR) in the elderly patients with type II diabetes, an investigation was carried out on the relationship between PDR and various risk factors in 98 elderly cases of type II diabetes by way of stepwise regression analysis method. Results showed: (1) the average course of PDR was longer than that of diabetic patients without diabetic retinopathy (P < 0.01). Patients with PDR had higher values of BUN (P < 0.01), Cr(P < 0.05), GHbA1c(P < 0.01) and TC(P < 0.01) than those without retinopathy. Patients with PDR had higher coincidences of hypertension, coronary artery disease, proteinuria and urine microalbumin than those without retionpathy (P < 0.01) respectively, (2) multifactor analysis showed that BUN was one of the most important variables positively correlated with PDR, second to it in orders were the course of diabetes militus, GHbA1c, hypertention, proteinuria and urine microalbumin and TC. CONCLUSION: To prevent the occurrence and progress of PDR in the elderly patients with type II diabetes, it is important not only to control blood sugar, but to control blood pressure and relieve renal damage.

Functional expression of the dihydrofolate reductase domain of Leishmania major dihydrofolate reductase-thymidylate synthase bifunctional protein.

The dihydrofolate reductase (DHFR) domain of the bifunctional dihydrofolate reductase-thymidylate synthase from Leishmania major has been subcloned and expressed as a soluble protein in Escherichia coli strain PA414 harboring plasmid pLMDHFR. Homogeneous L. major DHFR was obtained by chromatography on methotrexate-Sepharose followed by DE52. The purified enzyme migrated as a single 25-kDa protein on SDS-PAGE. The native molecular weight was determined to be 26 kDa, indicating that the isolated domain is a monomer. N-terminal sequence analysis revealed that serine, the second amino acid in the coding sequence, was the N-terminal amino acid of the protein. The enzyme showed a pH optimum similar to that of the bifunctional protein. For purified DHFR, the Km values were <1.0 microM for H2folate and <1.0 microM for NADPH. The kcat of the most active DHFR preparation was 5 s-1. The Km and kcat values were similar to those of the bifunctional enzyme.