Frailty is an age-related non-specificity status caused by a decline of physiological reservation,which leads to an increase of vulnerability in body and decrease of ability in stress resistance.The pathophysiology of frailty involves multiple systems including neuromuscular system,metabolism and immune system.Studies have showed that frailty is closely related with negative events of elder people.People with frailty are subject to higher risks for fall,hospitalization,and mortality.However,the development of frailty can be delayed if early prevention or interventions are performed.Prospective cohort studies have showed that the risk factors for frailty include age,gender,family history of obesity,BMI,waist circumference,blood pressure,hyperglycemia,smoking and lack of exercise.Among them,nutrition,exercise and therapeutic drugs are hot spots in prevention study.Here,we reviewed the intervention studies by focusing on nutrition,exercise and therapeutic drugs in frail population.

ObjectiveTo determine whether simvastatin alleviates lower urinary tract symptoms (LUTS) in patients with metabolic syndrome (MS) coexisting with benign prostate hyperplasia (BPH) and explore an optimized scheme of treatment. MethodsFrom February to June in 2011,30 male subjects with MS and LUTS caused by BPH in out-patients and in-patients from geriatric department were recruited.The patients were randomly assigned to receive orally simvastatin (40 mg) and tamsulosin (0.2 mg) quaque noete as combination treatment group or only tamsulosin (0.2 mg,quaque nocte) as single treatment group for 8 weeks.International prostate symptoms score (IPSS),quality of life (QOL),maximum flow rate (MFR) and prostate volume (PV),liver enzymes,creatinine and routine urine test were monitored to evaluate the effectiveness and safety before and after the treatment.Results In the two groups,the significant differences were found in the levels of IPSS,QOL and MFR,while there was no difference in PV between pre-treatment and post-treatment.The scores of IPSS after treatment were (6.4 ± 4.4) in combination treatment group and(4.2±3.3)in single treatment group (P＜0.05),and there were significant difference in scores of IPSS before and after the treatment between two groups (P＜0.05),suggesting better improvement in combination treatment group than in single treatment group.In two groups,there were no adverse events,and no changes were found in liver and kidney function,muscle enzymes and routine urine test.Conclusions Combined tamsulosin and simvastatin treatment may alleviate LUTS caused by BPH and are well tolerated with no adverse events.

Objective To investigate the relationship between lipid abnormality and benign prostatic hyperplasia (BPH) in men receiving physical examination. MethodsFour hundred and one people who participated health examination in our hospital in May 2008 were included in the study. They were divided into two groups according to history of disease, IPSS score, the results of digital rectal examination and transrectal ultrasound: BPH group (192 cases) and no BPH group (209 cases). The blood lipid level and risk factors were compared in two groups. ResultsThere were no statistical differences in blood lipid level and risk stratification of cardiovascular disease between the two groups (TG:P=0. 698;TC:P=0. 654;LDL-C:P=0. 880; HDL-C:P=0. 531; risk stratification: P= 0. 251). IPSS score had no obvious correlation with blood lipid level (TG: P = 0. 054 ; TC: P =0. 149; LDL-C: P = 0. 427; HDL-C:P=0. 193) .Conclusions BPH complicated with lipid abnormality is common in the clinics, but the correlation between BPH and lipid abnormality in patients with light BPH is not so clear as that in patients with mild or severe BPH.

The Nano ultra-high performance liquid chromatography-electrospray ionization mass spectrometry tandem mass spectrometry(UPLC-ESI-MS/MS) was used to characterize the primary protein. Samples were digested by trypsin, followed by liquid chromatography-tandem mass spectrometry analysis and database search. Five peptides matched with tumor necrosis factor receptor and seven peptides matched with human IgG1 fragment of the Fc. Further analysis demonstrated that seven peptides all matched with the IgG1 Fc but only partly peptides matched with the other subtypes. RhTNFR:Fc is fused by IgG1 Fc but not other subtypes.

ObjectiveTo investigate the predictive value of heart rate turbulence(HRT) in patients with diabetes mellitus (DM) after acute myocardial infarction (AMI).MethodsNinety-two AMI patients combined with DM (DM group) and 120 AMI patients without DM (non-DM group) were selected.Turbulence onset (TO) and turbulence slope (TS) were two indexes of HRT.HRT was considered positive when TO was ≥0 and TS was ≤2.5 ms/R-R.The differences in clinical data between HRT-positive and HRT-negative patients were compared.And the related risk factors after AMI were analyzed.ResultsAge,left ventricular ejection fraction (LVEF) level,renal insufficiency,LVEF＜40％,standard deviation of sinus cardiac cycle (R-R interval)(SDNN),heart rate variability (HRV) positiveand HRT indexes (TO,TS) between HRT-positive and HRT-negative patients in DM group had significant differences (P ＜ 0.05 ).Age,LVEF level,SDNN and HRT indexes(TO,TS) between HRT-positive and HRT-negative patients in non-DM group had significant differences(P ＜ 0.05).Multivariate Cox regression analysis showed that renal insufficiency (OR=4.8,95％ CI:1.8 - 10.7,P=0.008) and HRT positive (OR=3.7,95％ CI:1.5 - 8.6,P=0.070) in DM group had statistical significance.And HRT positive in non-DM group had statisticalsignificance(OR=23.0,95％ CI:5.2 ～ 86.0,P ＜ 0.01 ).ConclusionsHRT,an index of dynamic electrocardiogram,can predict the risk in patients with DM or without DM after AMI.

OBJECTIVETo observe the effect of puerarin on infarction size, fatty acids metabolism, inflammatory response and atherosclerotic plaque stability in patients with acute myocardial infarction (AMI).

METHODSSixty-one patients with AMI were randomly divided into two groups, the control group (n = 30) and the treated group (n = 31). All were treated with conventional treatment, but to the treated group, puerarin injection was given additionally by injecting 500 mg per day for 2 weeks. Before and after treatment, blood levels of free fatty acids (FFA), matrix metalloproteinases-9 (MMP-9) and C-reactive protein (CRP) were assayed, and the size of infarction was determined by Ideker QRS scoring method.

RESULTSBefore treatment, the size of infarction was positively correlated to the levels of FFA, MMP-9 and CRP (r = 0.43, 0.42 and 0.39, respectively, all P<0.01). As compared with those before treatment, after treatment, the three parameters lowered by 30%, 41% and 23%, respectively and the size of infarction significantly reduced in the treated group (P<0.01), while in the control group, no significant change was found (P>0.05).

CONCLUSIONPuerarin treatment could significantly reduce the size of infarction in patients with AMI, the mechanism is possibly related with its effects in lowering plasma levels of FFA, inhibiting inflammation and stabilizing atherosclerotic plaque.

Aged ; Biomarkers ; C-Reactive Protein ; metabolism ; Fatty Acids ; metabolism ; Female ; Humans ; Isoflavones ; therapeutic use ; Male ; Matrix Metalloproteinase 9 ; metabolism ; Middle Aged ; Myocardial Infarction ; drug therapy ; pathology ; Vasodilator Agents ; therapeutic use

Objective:To investigate the post-traumatic stress response in women with unintended pregnancy termination and analyze its related factors.Methods:Totally 388 women with unintended pregnancy termination from two public hospitals in Fujian were selected as the research subjects.They were assessed with the Impact of E-vent Scale-Revised(IES-R),Hospital Anxiety and Depression Scale(HADS),Connor-Davidson Resilience Scale(CD-RISC)and Perinatal Grief Scale(PGS).The total score of IES-R ≥35 was positive for post-traumatic stress disorder screening.Results:The total score of IES-R was(20.6±12.4),and the positive rate of post-traumatic stress disorder screening was 16.5％.Multiple linear regression analysis showed that the IES-R total scores were higher in those who thought pregnancy timing was appropriate than those who thought pregnancy timing was wrong(β=0.13),and lower in women with moderate pain during termination than in those with severe pain(β=-0.09).The IES-R total scores were positively correlated with gestational weeks,depression scores of the HADS and grief scores of the PGS(β=0.18,0.27,0.16),and negatively correlated with optimism scores of the CD-RISC(β=-0.12).Conclusion:The post-traumatic stress response of unintended termination of pregnancy is at a moder-ate level.Post-traumatic stress symptoms are more likely to occur in women who thought pregnancy timing is ap-propriate,and those with severe pain during pregnancy termination,large gestational weeks,high level of depression during pregnancy,and high level of grief after pregnancy termination.

Objective To investigate the association of frailty with serum inflammatory biomarkers and geriatric parameters.Methods A total of 299 elderly people aged 60 and over were recruited,received frailty and comprehensive geriatric assessment,and were tested on serum levels of interleukin-10 (IL-10),interleukin-1β (IL-1β),monocyte chemoattractant protein-1 (MCP-1),monocyte chemoattractant protein-3 (MCP-3),macrophage inflammatory protein 1a (MIP-1α),macrophage inflammatory protein-1β (MIP-1β),tumor necrosis factor α (TNF-α),nuclear factor-κB (NF-κB) and sirtuin-1 (SIRT-1).Potential association of frailty with these biomarkers and several geriatric parameters was analyzed.Results Statistical differences in serum levels of MCP-1,MIP-1α and MIP-1β were detected between the frailty group and the non-frailty group (H=10.766,10.766 and 8.217,respectively;P =0.005,0.043 and 0.016,respectively).Logistic regression analyses showed that MCP-1 and MIP-1β were associated with frailty after adjustment for age,sex,body mass index (BMI),smoking,drinking,comorbidity and comprehensive geriatric assessment (OR=2.493,2.531,both F＜0.05).Conclusions MCP-1 and MIP-1β are risk factors for frailty.