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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.
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In order to make the shared traditional Chinese medicine (TCM) pharmacy develop more efficiently and normatively at the grass-roots level, using the “shared TCM pharmacy” as the retrieval word, this paper uses the literature research method to retrieve the reports, documents and policies from CNKI, the websites of people’s governments at all levels, the official websites of the State Administration of Traditional Chinese Medicine, people.com, China News Network, Xinhua News and other platforms before May 20, 2022, sort out the development mode and history of two “Internet plus” TCM pharmacies, namely “shared TCM pharmacies” and “smart TCM pharmacies”, and compare them with each other. Combined with the actual work of community hospitals and community service centers (stations), the necessity and advantages (such as reducing the costs of the intermediate links of drug circulation and standardizing the grass-roots drug use process) of the development of “shared TCM pharmacy” are obtained from the perspective of primary medical care. Combined with the current situation of the promotion and application of shared TCM pharmacy in county medical communities, it is concluded that the shared TCM pharmacy should be further constructed from four aspects: improving the work process of drug centralized procurement under the background of normalization, improving the compatibility and synchronization of the whole process dispensing information system module, unifying pharmaceutical services and personnel training, defining the authority of data query and clarifying the boundaries of patient privacy to further build a shared TCM pharmacy. Finally, it integrates information technology, summarizes the definition of shared TCM pharmacy and its future construction direction, and provides reference for the next development of shared TCM pharmacy at the grass-roots level.
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【Objective】 To explore the status of confidential unit exclusion(CUE) status among voluntary blood donors in Hefei, so as to provide scientific basis for blood safety. 【Methods】 From 2012 to 2021, 57 out of the 1 158 272 voluntary blood donors in Anhui Blood Center, who requested CUE, were analyzed for population characteristics and their motives in asking for CUE. 【Results】 There were 57(0.004 9%) voluntary blood donors asking for CUE after donation, including 42 males (73.69%) and 15 females (26.32%). All the blood samples were negative in transfusion-transmitted viral marker testing except one positive in syphilis (TP) antibody. The reasons for CUE were as follows: high-risk behaviors (including multiple sexual partners, male-to-male homosexual behaviors, intravenous drug use, etc.) in 23 cases (40.35%), diseases unsuitable for blood donation in 7 cases (12.28%), and other reasons in 14 cases (24.56%). 【Conclusion】 Effective consultation before blood donation is particularly important to ensure blood safety and avoid the waste of blood.
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This study firstly introduced the mechanism, benefits and applications of irreversible electroporation(IRE) for tumor ablation. In addition, this study also introduced the most advanced IRE systems cleared by FDA or CFDA and IRE research equipment. The clinically licensed IRE systems include the Nanoknife 3.0 of Angiodynamics, the Dophi
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Humans , Electricity , Electroporation , Heart Rate , Neoplasms/therapyABSTRACT
Objective:To observe the effects of salvianolic acid B on migration and tube formation of the retinal vascular endothelial cell (RVEC) in high glucose, and explore its mechanism with network pharmacology.Methods:The cells were divided into normal group, model group and 1.0, 0.5, 0.1 μg/ml salvianolic acid B group according to the random number table method. The cells of each group were added with 5.5 mmol/L glucose for intervention, and the salvianolic acid B group was added with 1.0, 0.5, and 0.1 μg/ml salvianolic acid B for intervention. After 72 h, the cell viability of each group was detected by the CCK-8 method. The cells were divided into normal group, model group and low-, medium-, and high-dose salvianolic acid B group according to the random number table method. Then the cells of the normal group were added with 5.5 mmol/L glucose; the model group was added with 25 mmol/L glucose; the low-, medium-, and high-dose salvianolic acid B group was added with 25 mmol/L glucose and 0.062 5, 0.1250, 0.250 0 μg/ml salvianolic acid B. Then by taking Transwell test to detect the number of cell migration, and Matrigel test to analyze the total length of cells tubes. The active targets of Salvianolic acid B were screened by SuperTarget and Swiss TargetPrediction. Then, the targets of diabetic retinopathy were obtained by searching the GAD database, pharmGkb database, TTD database, DiGSeE database and OMIM database. The effective targets of drug-disease interaction were screened, and the component-target-disease interaction network was constructed by Cytoscape. Finally, the effective targets were analyzed by DAVID for GO analysis and KEGG pathway enrichment analysis. Molecular docking was performed by using Accelrys Discovery Studio Client 2.5 software.Results:The CCK-8 method showed that the cell absorbance values of 0.5 and 0.1 μg/ml salvianolic acid B group were not significantly different from those of the normal group ( P>0.05). The results of Transwell experiment and Matrigel experiment showed that compared with the model group, the relative number of migrating cells and the total length of tubule formation in each dose group of salvianolic acid B decreased ( P<0.05 or P<0.01). The interaction network revealed that salvianolic acid B acted on 46 targets and 8 signaling pathways. Conclusions:Salvianolic acid B could inhibit the migrating and tube forming ability of RVEC cultivated by high glucose. The results suggest that salvianolic acid B may play roles in preventing diabetic retinopathy.
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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.
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Aged , Aged, 80 and over , Humans , China/epidemiology , Frail Elderly/statistics & numerical data , Frailty , Geriatric Assessment/statistics & numerical data , Prospective Studies , Quality of Life/psychology , Surveys and QuestionnairesABSTRACT
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.
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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.
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Aged , Humans , Accidental Falls/statistics & numerical data , Cohort Studies , Frail Elderly/statistics & numerical data , Frailty/epidemiology , Geriatric Assessment/methods , Independent Living , Odds Ratio , Prevalence , Prospective Studies , Risk Assessment/methods , Surveys and Questionnaires , SyndromeABSTRACT
Objective To isolate and identify 3 flavonoids (taxifolin, orobol and quercetin) from Cudrania tricuspidata, and develop a method for determining 3 flavonoid constituents in Cudrania tricuspidata. Methods Three flavonoids was isolated from ethanol extract of Cudrania tricuspidata by chromatography, and its structure was identified by nuclear magnetic resonance. The analysis was conducted on an Aglient C18 column (4.6 mm ×250 mm, 5 μm) eluted with 1% acetic acid and methanol as mobile phases in gradient mode. The flow rate was 1 ml/min and the detection wavelength was set at 310 nm. The column temperature was 25 ℃. Results Taxifolin, orobol and quercetin were isolated from ethanol extract of Cudrania tricuspidata by chromatography. The content of taxifolin, orobol and quercetin were 0.850 mg/g, 0.518 mg/g, 0.103 mg/g. Conclusion The method can be used for the quality control of Cudrania tricuspidata as a reference.
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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.
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Objective To improve the quality of the management of the elderly patients with cancer in Sichuan province,and to understand the attitudes and perspectives of elderly surgeons and oncologists for the management and treatment of elderly patients with cancer.Methods A face-toface questionnaire interview was conducted with oncologists (n 64) and geriatricians (n =64).128 physicians were involved in this study.Results The cancer management and therapeutics were deemed appropriate at present by 9.38% (6/64)of the geriatricians and 25.00% (16/64)of the oncologists.The 39.06% (25/64) of geriatricians used to notice geriatric syndromes,while 81.25% (52/64)of oncologists never concerned about the geriatric syndrome(P=0.011).As for the causes of the therapy-associated toxicity,oncologist versus geriatrician payed an attention to malnutrition (100.00% vs.100.00% in both groups),to mobility disorders(65.63% vs.65.63%,84/128 in both groups),to cognitive impairment/mood disorder (89.06% in geriatrician group vs.75.00% in oncologist group,P=0.038).For the factors affecting treatment decisions,a physical ability attention (oncologists vs geriatricians:70.31% vs.92.19%;P =0.002),and comorbidity (oncologists vs geriatricians:62.50% vs.79.69%,P =0.032) had statistically significant difference.In addition,lack of geriatrics knowledge was also reported by more oncologists.However,one hundred percent of participants wanted very much to cooperate with each other in their clinical work.When responding to the clinical scenario,the 10.94% (7/64)of geriatricians and 32.81% (21/64)of oncologists chose modified treatment for 65-74 years old patient with cancer(P =0.003).When the age of the patients was 75-84 years old,only 12.50 % (8/64) of geriatricians prefer end-of-life care,while 31.25 % (20/64) of oncologists chose it (P =0.010).Conclusions Selection of treatment decisions in the elderly patients with cancer affect by ageing.Both oncologists and geriatricians are concerned with the elderly patients with cancer,ageing syndrome,total sickness and functional status.And these doctors support an establishment of a multi disciplinary team cooperation for the elderly patients with cancer.Therefore,the establishment of mutual cooperation between the two professionals is necessary and feasible.
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<p><b>OBJECTIVE</b>To assess the impact of natural selection and genetic background on the polymorphisms of HLA-G 3-untranslated regions (UTR) among five ethnic Chinese populations.</p><p><b>METHODS</b>PCR and DNA sequencing were used to determine the polymorphisms among 432 individuals from the five ethnic populations. Their genetic background was determined by genotyping of 10 short tandem repeats (STRs).</p><p><b>RESULTS</b>Eight variations were identified among Gelao, Mongolian and Kirgiz populations, while only 7 were found in Shui and Dai people. For all 3 southern populations (Gelao, Shui, and Dai), the observed heterozygosites (Ho) was higher than expected heterozygosities (He). But this was reversed for the 2 northern populations (Mongolian and Kirgiz). The Ho and He of the 10 neutral STRs were in random distribution. Ewens-Watterson testing based on haplotypes of the HLA-G 3'UTR has suggested that a natural selection had occurred in the region where Dai and Shui had inhabited, but not in the northern region where Mongolian and Kirgiz population inhabited. Polygenetic trees based on the HLA and STRs were also different.</p><p><b>CONCLUSION</b>The HLA-G 3'UTR of Dai and Shui people who lived in southern China may have subjected to a selection pressure. Based on current knowledge, this pressure may have been driven by a pathogenic selection.</p>
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Female , Humans , Male , 3' Untranslated Regions , Genetics , China , Ethnology , HLA-G Antigens , Genetics , Microsatellite Repeats , Polymorphism, Genetic , Selection, GeneticABSTRACT
Objective To introduce the competing risk model into outcome prediction of mild cognitive impairment (MCI) of seniors and to explore influencing factors for the prognosis of MCI to Alzheimer' s disease (AD).Methods Data were collected from six follow-up visits to 600 seniors from communities in Taiyuan city,which were conducted at an interval of six months from October 2010 to May 2013.MCI state was defined as the transient state,AD and death before AD as two absorbing states (death before AD in which was regarded as a competing risk event),building the competing risk model to identify the model parameters,and to explore influencing factors on MCI prognosis to AD.In the meantime,the 3-year MCI-AD transition probability was estimated based on the multi-state Markov model.Results Based on screening with the multivariate competing risk model analysis,factors such as higher age (estimate HR=1.56,95%CI:1.01-2.39),female gender (HR=1.72,95%CI:1.02-2.92),higher education(HR=0.64,95%CI:0.41-1.00),reading frequently (HR=0.57,95%CI:0.32-0.99),hypertension (HR=3.43,95%CI:1.08-10.85) and high SBP(HR=1.67,95%CI:1.04-2.66),were statistically significant for transition from MCI to AD in three years.3-year MCI-AD transition probability was 10.7%(95%CI:8.6%-13.2%).Conclusion Age,gender,education,reading and blood pressure were the influencing factors for the prognosis of MCI to AD.Competing risk model was advantageous in studying longitudinal data with multiple potential outcomes.
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Mediator is a highly conserved large protein complex (25 proteins, >1000 kDa) and preeminently responsible for eukaryotic transcription, which contains a dissociable 'Cdk8 module'. Although increasing evidence demonstrates that Cdk8 module plays both positive and negative roles in transcription regulation, the detailed structure, and subunit organization, molecular mechanism how it regulates transcription remain elusive. Here we used single-particle electron microscopy to characterize the structure and subunit organization of the Cdk8 module and illuminated the substantial mobility of the Med13 subunit results in the structural flexibility. The Cdk8 module interaction with core Mediator is concurrent with active transcription in vivo. An interaction with the Cdk8 module induces core Mediator into very extended conformation in vitro, which is presumed to be an active functional state of Mediator. Taken together, our results illuminated the detailed architecture of Cdk8 module, and suggested the Cdk8 module could positively regulate transcription by modulating Mediator conformation.
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Humans , Cyclin-Dependent Kinase 8 , Chemistry , Mediator Complex , Chemistry , Models, Molecular , Protein Conformation , Protein Subunits , Chemistry , Saccharomyces cerevisiae Proteins , ChemistryABSTRACT
Objective To explore the relationship between infant feeding practices and infants growth,especially the weight gain for length in the first 6 months of life. Methods Two-hundred healthy full-term singlet normal birth weight 5 - 6 months old infants and their main care givers were recruited in Kongjiang community health service center in Shanghai. The questionnaires included infants feeding pattern, feeding environment and care givers feeding behaviors, and were completed on-site by investigators. The birth weight was obtained. The weight and length of infants at 6 months were measured. Results There were 70/200 (35.0%) infants overweight (BMI for age Z score>+1) at 6 months. There were more overweight boys than girls (40.0% vs. 30.9%, x2 = 1.798, P = 0.180). Compared with normal weight infants, the overweight infants had same birth weight (3.30 ± 0.35 kg vs. 3.35 ± 0.32 kg, t =1.010, P = 0.314) and same length at 6 months (67.64 ± 2.10 cm vs. 67.91 ± 1.97 cm, t=- 0.896, P = 0.371). However, the overweight infants gained much more weight for length in the first six months of life. At 6 months, the weight and BMI of overweight infants was significantly higher than that of normal weight infants (9.16 ± 0.67 vs. 7.94 ±0.64, t = 12.324, P 0.05). The grandparents played an important role in infants feeding in Shanghai. There were 39.0% infants fed only by grandparents, and 23.0% infants fed jointly by grandparents and parents (x2 = 0.175, P > 0.05).The care givers' educational level and knowledge of feeding skill were similar in overweight and normal weight infants (x2 = 0.446, t = 0.949, P > 0.05). However, the overweight infants were fed more quickly than normal weight infants (Z = 2.753, P < 0.01), and there was less language communication between care givers and overweight infants during feeding (Z = 2.932, P < 0.01). In overweight infants, the overfeeding behaviors of care givers were positively correlated with BAZ (r = 0.281, P < 0.05). Conclusions Overweight in early life is associated with some particular infants feeding behaviors of care givers in Shanghai. The long term effect of more rapid weight gain for length in the first 6 months of life on the risk of childhood obesity warranted to be further followed and researched.