Research progress on issues concerning the definition of cognitive frailty / 中华老年医学杂志

Since the first operational definition of cognitive frailty was proposed by the expert consensus group of the International Academy of Nutrition and Aging and the International Association of Gerontology and Geriatrics in 2013, frailty and neurocognitive assessment has become the standard diagnostic tool.Since then, the reported prevalence in the literature for cognitive frailty in community-dwelling elderly people vary by dozens of times, as a result of different scales and diagnostic cut-off points, seriously affecting health decision-making.This article reviewed the current literature with a focus on the re-recognition of the clinical significance of cognitive frailty, the limitations of existing assessment tools for diagnosis, and possible solutions in the future.

Frailty progress and related factors in the elderly living in community: a prospective study / 中华流行病学杂志

Objective: To investigate frailty progress status and related factors in the elderly living in communities. Methods: A cohort of elderly people aged 65 and over in Pingyi community of Dujiangyan, Sichuan province, was established. Face-to-face questionnaire survey was conducted by trained interviewers. The frailty status, cognitive function, nutrition status and other functions of the subjects surveyed were evaluated at baseline survey and during follow-up. The socio-demographic and clinical characteristics of the subjects surveyed were assessed at baseline survey. Binary logistic regressions were used to identify factors associated with frailty progress. Results: A total of 653 elderly people were surveyed in January 2014, and 507 elderly people were followed up while 146 elderly people terminated further follow-up in January 2017. The prevalence rates of frailty and pre-frailty at baseline survey were 11.2% (n=57) and 26.2% (n=133), respectively. After 3 years, 205 subjects (40.4%) surveyed experienced frailty progress, 276 (54.5%) remained to be in frailty state at baseline survey, and 26 (5.1%) had improvement. Disability (OR=8.27, 95%CI: 1.62-42.26), visual problem (OR=2.02, 95%CI: 1.27-3.22), cognitive impairment (OR=1.94, 95%CI: 1.08-3.48), poor self-rated health (OR=1.89, 95%CI: 1.07-3.31), chronic pain (OR=1.57, 95%CI: 1.03-2.40) and older age (OR=1.12, 95%CI: 1.08-1.17) were independently associated with the progress of frailty. In contract, overweight was a protective factor (OR=0.54, 95%CI: 0.34-0.85). Conclusions: Frailty is a dynamic syndrome affected by several socio-demographic factors and geriatric factors. The results of the study can be used in the prevention of frailty progress in the elderly in communities.

Frailty progress and related factors in the elderly living in community: a prospective study / 中华流行病学杂志

Objective To investigate frailty progress status and related factors in the elderly living in communities.Methods A cohort of elderly people aged 65 and over in Pingyi community of Dujiangyan,Sichuan province,was established.Face-to-face questionnaire survey was conducted by trained interviewers.The frailty status,cognitive function,nutrition status and other functions of the subjects surveyed were evaluated at baseline survey and during follow-up.The socio-demographic and clinical characteristics of the subjects surveyed were assessed at baseline survey.Binary logistic regressions were used to identify factors associated with frailty progress.Results A total of 653 elderly people were surveyed in January 2014,and 507 elderly people were followed up while 146 elderly people terminated further follow-up in January 2017.The prevalence rates of frailty and pre-frailty at baseline survey were 11.2％ (n=57) and 26.2％ (n=133),respectively.After 3 years,205 subjects (40.4％) surveyed experienced frailty progress,276 (54.5％) remained to be in frailty state at baseline survey,and 26 (5.1％) had improvement.Disability (OR=8.27,95％CI:1.62-42.26),visual problem (OR=2.02,95％CI:1.27-3.22),cognitive impairment (OR=1.94,95％CI:1.08-3.48),poor self-rated health (OR=1.89,95％ CI:1.07-3.31),chronic pain (OR=1.57,95％ CI:1.03-2.40) and older age (OR =1.12,95％CI:1.08-1.17) were independently associated with the progress of frailty.In contract,overweight was a protective factor (OR=0.54,95％CI:0.34-0.85).Conclusions Frailty is a dynamic syndrome affected by several socio-demographic factors and geriatric factors.The results of the study can be used in the prevention of frailty progress in the elderly in communities.

Artificial intelligence and machine learning in plastic and aesthetic surgery / 中华整形外科杂志

With the emergence of artificial intelligence and application of Watson Health (International Business Machines Corp, Armonk, N. Y.), more and more medical physicians and researchers attempt to contact with this technology. The purpose of this article is to introduce the modern plastic surgeon to machine learning, a subfield of artificial intelligence. This article provides a brief introduction to background of machine learning and current research and potential projects in the field of plastic and aesthetic surgery.

Effect of frailty syndrome on falls in Chinese elderly diabetics in the communities: a prospective cohort study / 中华流行病学杂志

Objective: To explore the relationship between frailty syndrome and falls in the elderly diabetics, in the communities. Methods: A three-year cohort study involving 653 community-dwelling adults who were over 65 years of age and participated in the Survey of Disease, Psychological and Social Needs in Dujiangyan Pingyi Community. Diabetic patients would include those who self-reported as having histories of diabetes or on anti-hyperglycemic therapies. Frailty, functional and other geriatric status were assessed respectively. Falls was defined as having had multiple falls or at least one event but with injury. Results: The highest prevalence of falls was found in the group of frail diabetic group (62.5%). Data showed that baseline frailty was associated with falls in both diabetic and non-diabetic groups but the odds ratio in the diabetic group was higher than that of the non-diabetic group (OR=3.87, 95%CI: 1.45-10.28 vs. OR=6.68, 95%CI: 1.14-38.99). Conclusion: Frailty could be used as a strong clinical predictor to prevent falls, for the elderly diabetic Chinese living in the communities.

Effect of frailty syndrome on falls in Chinese elderly diabetics in the communities: a prospective cohort study / 中华流行病学杂志

Objective To explore the relationship between frailty syndrome and falls in the elderly diabetics,in the communities.Methods A three-year cohort study involving 653 community-dwelling adults who were over 65 years of age and participated in the Survey of Disease,Psychological and Social Needs in Dujiangyan Pingyi Community.Diabetic patients would include those who self-reported as having histories of diabetes or on anti-hyperglycemic therapies.Frailty,functional and other geriatric status were assessed respectively.Falls was defined as having had multiple falls or at least one event but with injury.Results The highest prevalence of falls was found in the group of frail diabetic group (62.5％).Data showed that baseline frailty was associated with falls in both diabetic and non-diabetic groups but the odds ratio in the diabetic group was higher than that of the non-diabetic group (OR=3.87,95％ CI:1.45-10.28 vs.OR=6.68,95％ CI:1.14-38.99).Conclusion Frailty could be used as a strong clinical predictor to prevent falls,for the elderly diabetic Chinese living in the communities.

Clinical analysis of six cases of neonatal hand-foot-mouth disease / 中国新生儿科杂志

Objective To study the clinical features of hand-foot-mouth disease(HFMD) in neonates.Method From April 2015 to May 2016,the clinical manifestations,laboratory examinations,treatments and prognosis of neonates with HFMD in our hospital were retrospectively analyzed.Result A total of 6 cases of neonatal HFMD were included,with 4 males and 2 females.The ages of 2 patients were ≤7 days and the other 4 patients 8 ～ 28 days.5 patients developed this disease during April to July,while the other one in January.2 cases had a definite contract history of HFMD.4 cases presented with fever and rashes in hand and foot,one case with fever,rash and oral ulcer,and one case with rash in hip and oral ulcer without fever.The nucleic acid test of enterovirus were positive in 4 cases.The symptoms of these neonatal HFMD were mild and recovered after symptom-relieving treatment.Conclusion HFMD in neonates with fever and/or rash should be considered during the HFMD epidemic period.

The clinical significance of predicting the contrast-induced nephropathy after PCI by the ratio of contrast ;medium volume and glomerular filtration rate / 实用医学杂志

Objective To evaluate the significance of contrast medium (CM) volume and estimated glomerular filtration rate (CM/eGFR) in predicting contrast-induced nephropathy (CIN) after PCI. Methods A total of 307 patients after PCI were enrolled from Nanfang Hospital from May 2014 to October 2015. The patients were divided into the CIN group(n = 29) and the non-CIN group(n = 278) according to whether CIN within 72 hours after PCI. The baseline renal function was assessed by the sCr and CyC, respectively. Results Twenty-nine patients (9.4%, 29/307) developed CIN. There were significant differences in Age, CM、NTpro-BNP、IABP、 Periprocedural Hypotension、Preprocedural sCr/CyC between two groups (P < 0.05, respectively). The result of multivariate logistic regression analysis showed that Age, Cardiac function ≥Ⅲ level, IABP, use CCB, CM/eGFRMDRD, CM/eGFRCyC were independent risk predictors for CIN, respectively. Receiver Operating Characteristic (ROC) curve analysis showed that the area under the curve of CM/eGFRMDRD(AUC = 0.838) was superior to CM/eGFRCyC (AUC = 0.805) without significant difference. The sensitivity and specificity were 79.3%and 76.3%(Cut-off Point = 2.094), respectively. Conclusion Both the CM/eGFRMDRD and CM/eGFRCyC may be good methods to determine maximum CM before PCI and to predict CIN after PCI currently, without significant differences between these two predictors.

Resveratrol regulates serum lipid and antioxidant enzymes level in an atherosclerotic rabbit model / 重庆医学

Objective This study was designed to investigate influence of resveratrol on serum lipid and antioxidant enzyme lev‐els in atherosclerotic rabbit model ,and to explore its influence on NF‐κB and MAPKs signal pathway .Methods Rabbits were as‐signed to five groups :control (group A) ,high fat diet group (group B) ,resveratrol group (group C ,D and E) .The contents of lip‐ids level (TC ,TG ,LDL‐C ,HDL‐C) and antioxidant enzyme (GSH ,GSH‐PX ,GST ,γ‐GCS ,CAT ,SOD ,MDA) levels in the serum were measured respectively and the difference was studied .Phosphorylation levels of MAPKs cascades ,NF‐κB were measured by Western blot .Results Compared with group A ,group B had elevated levels of blood lipids ,antioxidant enzymes were on the de‐cline ,the MDA content increased ,MAPKs and the NF‐κB protein phosphorylation enhanced .C ,D ,E group can reduce levels of blood lipids ,increases HDL‐C ,improve antioxidant enzyme activity and reduce MDA content ,inhibit MAPKs ,NF‐κB protein phos‐phorylation .Conclusion Resveratrol could reduce the atherosclerotic rabbit blood lipid levels ,increase antioxidant enzyme activity , reduce the MDA level and this effect is likely to inhibit NF‐κB and MAPKs signaling pathway activation .

Expression of pituitary tumor transforming gene and p53 protein in large intestinal adenoma and large intestinal carcinoma tissues / 中国医师进修杂志

ObjectiveTo investigate the expression and relationship of pituitary tumor transforming gene (PTTG) and p53 protein in large intestinal adenoma,large intestinal carcinoma and normal large intestinal mucosa tissues.MethodsImmunohistochemistry was employed to determine the expression of PTTG and p53 protein in 50 cases with large intestinal adenoma tissues,42 cases with large intestinal carcinoma tissues and normal large intestinal mucosa tissues.The relationship of the expression of PTTG and p53 protein with the clinicopathological characteristics was analyzed.ResultsThere was no positive expression of p53 protein in normal large intestinal mucosa tissues,while the positive rate of PTTG expression was 7.14％(3/42).The positive rates of PTTG and p53 protein expression were 82.00％(41/50) and 90.00％(45/50) in large intestinal adenoma tissues,88.10％ (37/42) and 95.24％ (40/42) in large intestinal carcinoma tissues.The positive rates of PTTG and p53 protein over expression were 45.24％(19/42) and 69.05％(29/42) in large intestinal carcinoma tissues.The positive rates of PTTG and p53 protein expression in large intestinal carcinoma tissues were higher than those in large intestinal adenoma tissues and normal large intestinal mucosa tissues,the positive rates of PTTG and p53 protein expression in large intestinal adenoma tissues were higher than those in normal large intestinal mucosa tissues,and there were significant differences(P ＜ 0.05).The expression of PTTG was not correlated with p53 protein in large intestinal carcinoma tissues(P＞ 0.05 ),while the positive relationship was found between the expression of PTTG and p53 protein in large intestinal adenoma tissues (P ＜ 0.05 ).The over expression of PTTG was significantly correlated with lymph node metastasis (P ＜ 0.01 ),but the over expression of p53 protein was not correlated with lymph node metastasis(P ＞ 0.05) in large intestinal carcinoma tissues.Conclusions The expression of PTTG is significantly correlated with p53 protein in large intestinal adenoma tissues,and their co-expression may be used as markers for carcinogenesis of large intestinal adenoma tissues.The over expression of PTTG and p53protein is found in large intestinal carcinoma,and the over expression of PTTG is correlated with lymph node metastasis.The over expression of PTTG may be used as a marker for lymph node metastasis of large intestinal carcinoma.

The change of plasma N-terminal pro-brain natriuretic peptide levels in patients with acute myocardial infarction / 中国基层医药

Objective To investigated the changes of plasma NT-proBNP levels in patients with acute myocardial infarction(AMI),unstable angina pectoris(UAP)and non-insulin-dependent diabetes(NIDD).Methods Plasma NT-proBNP levels were determined with RIA in 32 patients with AMI,27 patients with UAP,12 patients with NIDD and 20 controls.Moreover,16 of the 32 AMI patients underwent precutancous transluminal coronary angioplasty(PTCA)and plasma NT-proBNP levels were again determined 12h before and 12h after the procedure.Results The plasma NT-proBNP levels in controls were(360.8±57.3)pg/ml with no significant difference between the sexes.In patients with AMI,UAP and NIDD,NT-proBNP levels were(554.1±195 9)pg/ml,(525.7±199.1)pg/ml and(552.6±141.9)pg/ml respectively;all of them were significantly higher than those in controls.AMI patients increased from(563.1±190.1)pg/ml to(774.7±238.9)pg/ml(P＜0.05).12 hours after PTCA.However,NT-proBNP levels did not differ statistically among AMI,UAP and NIDD patients(P＞0.05).Conclusion The plasma NT-proBNP levels in patients with AMI,UAP and NIDD were increased significantly and the result suggested that NT-proBNP might beauseful risk marker for these diseases.