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Objective@#To investigate the relationship between insomnia and cognitive function in middle-aged and elderly patients.@*Methods@#Patients aged ≥ 45 years visiting outpatient clinic of You′anmen Community Health Center from October 2016 to December 2016 were enrolled in the study. Among 850 participants there were 159 patients with persistent insomnia, 188 with paroxysmal insomnia (insomnia group) and 503 with normal sleep (normal sleep group) according to DSM-5 diagnostic criteria. The sleep quality and cognition were evaluated using Pittsburgh Sleep Quality Index(PSQI) and Montreal Cognitive Assessment(MoCA) and compared among 3 groups. Relationship between sleep quality and cognition, influencing factors of cognition were explored in this study.@*Results@#The total score and all sub-scores of PSQI in persistent insomnia group were higher than those in the normal sleep group. The total score of PSQI and all sub-scores (except hypnotic drugs and daytime dysfunction) of paroxysmal insomnia group were higher than those of normal sleep group. The total PSQI score and all sub-scores (except sleep disorders) of the persistent insomnia group were higher than those of the paroxysmal insomnia group. The total score of MoCA and the sub-scores of naming, attention, language, abstract thinking, delayed recall and orientation ability of the persistent insomnia group were lower than those of the normal sleep group (P<0.05). The language ability of paroxysmal insomnia group was lower than that of normal sleep group (P<0.05). The language ability of persistent insomnia group was lower than that of paroxysmal insomnia group (P<0.05). The total score of MoCA was negatively correlated with the total score of PSQI and sub-scores of sleep time and sleep efficiency (r=-0.162, -0.131, -0.190; P<0.05). Logistic regression analysis showed that age was a risk factor for cognitive impairment (β=0.038, P=0.000) and sleep efficiency was a protective factor for cognitive function (β=0.260, P=0.000).@*Conclusion@#The overall cognitive function of middle-aged and elderly patients with persistent insomnia is poor, the abilities of naming, attention, language, abstract thinking, delayed recall and orientation are decreased; and the cognitive function is associated with age and sleep efficiency.
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Objective To examine the association between child-supporting from their folks and elder abuse in China so as to provide evidence for prevention and control of elder abuse.Methods Based on the third survey on the Status of Chinese women,organized by the All-China Women's Federation and the National Bureau of Statistics,7 159 residents aged 65 and older were included and general information on supporting child and elder abuse were gathered.Chi-square test and logistic regression were used to investigate the association between supporting child from elderly and elder abuse.Results The overall prevalence of elder abuse was 6.71％.Risks of elder people being abused by family numbers varied from different supporting child situations.After adjusting for potential confounding factors,ORs for the elderly appeared as follows:OR=1.99 (95％CI:1.56-2.54) for those who only providing support to male children;OR=2.07 (95％CI:1.51-3.79) for those only providing support to the female offspring and OR=2.32 (95％CI:1.72-3.13) for those who did not support their children regardless of their sex identity.Elderly who provided support to their children on both sexes were exposed to lower risk of being abused than those who only supporting their male offspring.There was no significant difference appearing on the risk of elder abuse between those elderly who only supporting the male (OR=1.00) or the female offspring (OR=1.04,95％ CI:0.63-1.71),among all the participants in our study.However,such associations were different in urban and rural areas.Conclusions High prevalence of abuse was seen in China.The pattem of supporting child was associated with risk of elder abuse.Elderly who showed poor support to their children were under higher risk of being abused by their family members.
ABSTRACT
Objective To examine the association between child-supporting from their folks and elder abuse in China so as to provide evidence for prevention and control of elder abuse.Methods Based on the third survey on the Status of Chinese women,organized by the All-China Women's Federation and the National Bureau of Statistics,7 159 residents aged 65 and older were included and general information on supporting child and elder abuse were gathered.Chi-square test and logistic regression were used to investigate the association between supporting child from elderly and elder abuse.Results The overall prevalence of elder abuse was 6.71％.Risks of elder people being abused by family numbers varied from different supporting child situations.After adjusting for potential confounding factors,ORs for the elderly appeared as follows:OR=1.99 (95％CI:1.56-2.54) for those who only providing support to male children;OR=2.07 (95％CI:1.51-3.79) for those only providing support to the female offspring and OR=2.32 (95％CI:1.72-3.13) for those who did not support their children regardless of their sex identity.Elderly who provided support to their children on both sexes were exposed to lower risk of being abused than those who only supporting their male offspring.There was no significant difference appearing on the risk of elder abuse between those elderly who only supporting the male (OR=1.00) or the female offspring (OR=1.04,95％ CI:0.63-1.71),among all the participants in our study.However,such associations were different in urban and rural areas.Conclusions High prevalence of abuse was seen in China.The pattem of supporting child was associated with risk of elder abuse.Elderly who showed poor support to their children were under higher risk of being abused by their family members.
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Background Graft rejection is a primary cause of corneal transplantation failure,especially in high-risk keratoplasty.How to extend the survival time of graft is a problem to be solved.Objective This study was to investigate the influence of immune tolerance on high-risk rat keratoplasty induced by donor bone marrowderived immature dendritic cells (imDCs) transfected by chemokine receptor 7 (CCR7) recombinant adenovirus (Ad).Methods Bone marrow-derived imDCs were isolated and cultured from femur marrow of one male Wistar donor rat.The cells were transfected using recombinant Ad vector with rat CCR7 gene and resuspended in 500 μl PBS containing 1％ fetal bovine serum with the cells 1 × 107.High-risk corneal transplantaion models were established using monolateral corneal alkali-burn method in 60 SD rat recipients, and then allograft keratoplasty was performed with the 30 Wistar rats as donors.The models were randomized into the PBS group,imDCs group,imDCs with blank Ad vector group and imDCs with Ad-CCR7 group following the corresponding solution injection via caudal vein on preoperative day 7 and postoperative day 3 respectively.The survival time of graft was evaluated under the slit lamp microscope once per day.On the 14th day after operation, corneal sections were prepared from 6 eyes of each group for the pathological examination,and the relative expression levels of T helper cell 1 (Th1)-related factors,interleukin-2 (IL-2) mRNA and interferon-γ(IFN-γ) mRNA,as well as Th2-related factors, IL-4 mRNA and IL-10 mRNA, were detected by reverse transcription PCR (RT-PCR).The use and care of animals complied with the ARVO statement Results The mean survival time of grafts was (10.44±1.88) , (16.00±2.18) , (15.11±2.03) and(23.67±2.83) days in the PBS group,imDCs group,imDCs with blank Ad group and imDCs with Ad-CCR7 group, respectively, with a significant difference among the 4 groups (F =53.005, P =0.000).Compared with the PBS group, the mean survival time of grafts was considerably extended in the imDCs group,imDCs with blank Ad group and imDCs with Ad-CCR7 group (t=5.220,4.385,12.423 ,all at P=0.000) ,and a remarkble prolongation of graft survival duration was seen in the imDCs with Ad-CCR7 group in comparison with the imDCs group and the imDCs with blank Ad group (t =7.204,8.039,both at P=0.000).The relative expression levels of IFN-γ mRNA and IL-2 mRNA in the grafts were significantly lower,but the relative expression levels of IL-4 mRNA and IL-10 mRNA were significantly higher in the imDCs group,imDCs with blank Ad group and the imDCs with Ad-CCR7 group than those in the PBS group (all at P＜0.05).Compared with the imDCs group and the imDCs with blank Ad group, the relative expression levels of IFN-γ mRNA and IL-2 mRNA in the grafts were remarkably delined,but the relative expression levels of IL-4 mRNA and IL-10 mRNA were remarkably elevated in the imDCs with Ad-CCR7 group (all at P =0.000).Conclusions Application of imDCs transfected with CCR7 recombinant Ad via vena caudalis can prolong the survival time of grafts after keratoplasty of SD rats probably by affecting the balance of Th1/Th2 cytokines.
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Background To maintain corneal transparency is important for good visual function.A new treatment concept and the selection of surgical techniques and timing of surgery are critical for stopping the infringement of cornea tissue after alkali burning and other chemical warfare agents.Objective This study was to investigative the ultrastructure and histopathological status following the femtosecond laser-assisted deep lamellar keratoplasty (DLK) for acute alkali burn of cornea.Methods Acute corneal alkali burn models were established in 12 New Zealand rabbits by putting the 6 mm filter paper with 1 mol/L NaOH at the central cornea for 30 seconds.The rabbits were randomly allocated to femtosecond laser-assisted DLK group and model control group according to the randomized number table method.Femtosecond laser-assisted DLK was performed to transplant the corneal grafts of domestic rabbits to the model rabbits 24 hours after burning.The rabbits were sacrificed 1 week,2 weeks and 4 weeks after modeling,and the corneas were extracted for the preparation of corneal section.The cornea were performed with hematoxylin and eosin staining to assess the histopathological status under the optical microscope,and the ultrastructure of grafts and corneas was examined under the transmission electron microscope (TEM).Results Acute corneal alkali bourn models were successfully eatablished.In the fourth week after surgery,corneal graft was clear in the femtosecond laser-assisted DLK group.However,corneal swelling,conjunctival congestion and neovascularization were found in the model control group.Histopathological examination revealed the defect of corneal epithelium,edema of stroma,loose arrangement of collagen fibers,much vacuoles,few neovascularization and infiltration of a large number of inflammatory cells in the model control group,but in the femtosecond laser-assisted DLK group,the inflammatory response was slight.More desmosomes among the endothelial cells were seen,and the nuclei were intact in the grafts.In the fourth week after surgery,the transplanted corneas were transparent with the regular arrangement of collagen fibers and entire fibroblasts in the femtosecond laser-assisted DLK group under the TEM.However,flat surface corneal epithelial cells and shedding of some epithelial cells were exhibited in the modelcontrol group.Conclusions Femtosecond laser-assisted DLK can effectively alleviate the inflammatory response,promote epithelial healing and enhance intercellular tight junction in the cornea with acute alkali burn.