Research progress of β2 microglobulin / 中国临床药理学与治疗学

β2 microglobulin (β2-MG) is a key component I molecule of the major histocompatibility complex class that assists in the cytotoxic T lymphocyte (CTL) immune response. Serum β2-MG content is dynamically correlated with many diseases. Most studies on β2-MG mainly focus on the pathogenesis of kidney disease, tumor and amyloid fibrils. In recent years, some studies have found that β2-MG is also involved in the adverse prognosis of cardiovascular system, cognitive impairment of aging and antibacterial effects. This paper summarized the domestic and foreign studies on β2-MG in recent years, and proposed the possible role of β2-MG in multi-system human body and its potential application prospect of drug molecular targeting.

Thermoregulatory disorders and their significance in the elderly.

Our treatise is aimed at providing a brief survey on ethiology, pathogenesis, risks of inception, clinical picture, treatment pitfalls and prognosis of hypothermia and hyperthermia and possible interactions of these thermoregulation disorders with some other co-morbidities. It deals also with drugs and medicines including their potential unwanted side effects in these thermally abnormal conditions. The problems of hypothermia and hyperthermia in the senium (especially the late one) will be closely connected with labile homeostasis and the occurence of frailty syndrome which increases with the age. Permanently growing number of patients with polymorbidity of higher age tending to suffer from thermoregulation disorders and relatively small awareness of this issue in wider specialist (including medical) community have led us to come out with this topic in the form of survey treatise. Key words: drugs - hyperthermia - hypothermia - interactions - polymorbidity - senium - thermoregulation disorders.

[Morphological features of structural organization of cerebellar cortex in old age].

In this science work there were conducted such researches as organometric, histological, immunomorphologic and morphometric of cerebellar cortex of 219 corpses of people (108 man and 111 woman) of young and old age. A comparative analysis of the parameters of bulb-shaped neurons in these ages revealed decrease of their height and width. It is found that distance between interval nerve cell bodies of ganglionic layer increases with age that obviously associated with progressing disorganization and death of bulb-shaped neurons. It is marked an increment in the number of immunopositive for glial fibrillary acidic protein, protide S-100 and vimentin astrocytes in granular layer and molecular layer of cerebellar cortex, and decline in the number of immunopositive for neuron-specific enolase and immunonegative for protide S-100 and vimentin bulb-shaped neurons that can be regarded as manifestation of neurodegeneration. Using immunohistochemical methods in research allows approaching more differentially to the issues of morphological assessment cerebellar cortex of elderly people and gives an opportunity to receive more objective and full information of postnatal morphogenesis.

Clinical analysis of effect of Dexmedetomidine on postoperative cognitive function and preoperative inflammation in the elderly patients undergoing general anesthesia / 实用医学杂志

Objective To study the effect of dexmedetomidine (DEX) on postoperative cognitive function and preoperative inflammation in the elderly patients undergoing general anesthesia. Methods 70 elderly patients undergoing general anesthesia operation were chosen and divided into observation group and control group randomly. DEX and physiological saline were applied in observation group on the basis of routine general anesthesia. The cognitive function of patients in both groups were tested by mini-mental state examination (MMSE) and the incidence rate of cognitive dysfunction (POCD) were measured at 1 day before surgery, 1 day, 3 days, 5 days, and 7 days after surgery. The level of interleukin-6 (IL-6) and tumor necrosis factor-α(TNF-α) were tested before anesthesia, during skin incision, rightly after operation and 1h after operation. Results MMSE scores were significantly higher and the incident rates of POCD were lower in observation group than those in control group at 1 day and 3 days after surgery (P<0.05). The levels of IL-6 and TNF-αincreased obviously during skin incision and postoperative period, and they were significantly lower in observation group (P<0.05). The levels of IL-6 and TNF-αdecreased to the levels before anesthesia in observation group, and were still much higher in control group than that of preanesthesia (P < 0.05). Conclusions DEX infusion intraoperatively may effectively decrease the incidence of early POCD, whose mechanism could be reducing inflammation response.

Clinical research of pemetrexed combination with carboplatin as the therapy in advanced non-small cell lung cancer of senium / 中国基层医药

Objective To evaluate the curative effect and toxic reaction of pemetrexed combination with carboplatin as the therapy in advanced non-small cell lung cancer(NSCLC) of senium.Methods A total of 49 chemotherapy naive patients with ⅢB or Ⅳ NSCLC were enrolled in this study.Pemetrexed was given at a dose of 500mg/m2.Carboplatin dosed to an area under the time-concentration curve( AUC ) of 5.The chemotherapy was repeated every 21 days.Each patient was given at least 2 cycles.Results The curative effects of all the patients were evaluated.Among the 49 patients, the symptoms of 23 had been partially response ,21 stabilized and 5 progressed.The total effective rate was 46.9% ( 23/49 ).The efficiency of 68.2% in NSCLC with ⅢB phase were significantly higher than,29.6% in NSCLC with IV phase( X2 = 3.879, P < 0.05 ), Median time to progression (TIP) was 5.3 months.Median survival duration was 11.2 months( 3～ 21 months), and one year survival rate was 54.3%.The major toxicity included neutropenia, nausea, vomiting and diarrhea, impaired liver function, febrile neutropenia, etc.The severity of these side effect was in grade Ⅰ-Ⅱ and well tolerated.Among 49 cases,23 cases of leukopenia(46.9% ) was significantly higher than that of nausea in 11 cases (22.4%), vomiting in 5 cases ( 10.0% ), abnormal liver function in 4 cases( 8.0% ).Fever in 1 case ( 2.0% ) ( X2 = 3.879, P < 0.05 ; X2 = 8.451,8.778,9.123,9.741, all P < 0.01 ).Conclusion Pemetrexed combination with carboplatin was effective in the first line treatment of advanced non-small cell lung cancer,with mild to moderate side effect and safety in clinical practice.

An analysis of the sleep condition and its influence factors in old patients with hypertension / 中国实用护理杂志

Objective To investigate the sleep condition and its influence factors in old patients with hypertension. Methods A total of 100 old patients with hypertension were investigated by Pitts-burgh sleep quality index (PSQI) and serf-designed questionnaire of influence factors. Results 76 per-cents of the old patients with hypertension had sleep disorders.The total score of PSQI,sleep quality,time take to fall asleep,hours of sleep,sleep effficiency,sleep disorders,hypnotic drugs and every score of daytime dysfunction were significantly higher than domestic norm(P<0.01).Surroundings(strange circumstances or noisiness), physio-pathology (disease distress or high frequency of going to toilet during nighttime),psycho-logical situations(the fear to the disease or worrying about medical fees) and drags(use of diuretics or the adverse effects of some antihypertensive agents) were the important factors affecting sleep quality. Con-clusions Old patients with hypertension have poor sleep quality,which relates with multiple factors.Valid nursing interventions should be adopted in order to control the various factors which affect sleep quality to improve patients' sleep quality.

Correlation between HDL-C/TG ratio and cardiovascular risk in elderly patients with hypertension / 解放军医学杂志

Objective To investigate the correlation between HDL-C/TG ratio and cardiovascular risk in elderly patients with hypertension, in order to set up an evaluation criterion which may objectively assess the cardiovascular risk in elderly population. Methods A survey was carried out among 2011 subjects aged 60 or over, who received health examination in the General Hospital of PLA in May 2008. Hypertension was diagnosed by using the definition recommended by WHO/ISH. The subjects were divided into 4 groups (male hypertesion group, male control group, female hypertension group and female control group) according to their gender and with or without hypertension. The parameters of hematology (systolic pressure, diastolic pressure, pulse pressure and mean arterial pressure) and the indicators of lipidemia [total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C)] were measured, and HDL-C/TG ratio was calculated. Logistic regression analysis was used to analyze the correlation between the indicators of lipidemia and cardiovascular risk. Results In both male and female hypertension groups, systolic pressure, diastolic pressure, pulse pressure and mean arterial pressure showed significant differences compared with those of the control groups gender-wise (P0.05). Other indicators of lipidemia showed no significant differences between hypertension group and control group. Logistic regression analysis showed that HDL-C/TG ratio was significantly correlated to the cardiovascular risk (P