Nowadays,the incidence of intellectual disabilities(ID) increased in the elder,and they would meet the following problems:life transitions,future life planning and understanding emotions,etc.This paper discusses the measures to be made for ageing person with ID from three aspects:assessing and managing illness,caregiving stress and the role of psychologists.

Objective To investigate the role of endothelial progenitor cells ( EPCs ) transplantation in rats with sepsis induced by endotoxin ( lipopolysaccharides, LPS ). Methods Sixty clean grade Sprague-Dawley ( SD ) rats with genetic background were divided into three groups according to random number table method:control group, model group, and EPCs transplantation group, with 20 rats in each group. The sepsis model was reproduced by intravenous delivery of LPS 5 mg/kg. Rats in control group were injected with the same amount of normal saline. EPCs were isolated, and cultured and identified were fluorescently labeled with the green fluorescent protein ( GFP ) adenoviral transfection method. The EPC transplantation group was injected with LPS, then a fluorescently labeled EPCs suspension was injected via the tail vein 1 hour later. The expression of fluorescent markers of EPCs was detected with both small animal in vivo imaging instrument and frozen section. Seven days after transplantation, abdominal aorta blood was collected to determine interleukins ( IL-6 and IL-10 ) in peripheral blood with enzyme linked immunosorbent assay ( ELISA ), and the lung, liver, and kidney tissues were harvested, the wet/dry ratio of the lung ( W/D ) was calculated, and hematoxylin and eosin ( HE ) staining was performed to observe, the change in histopathology. Toll-like receptor 4 ( TLR4 ) mRNA expression in lung, liver, and kidney tissues was determined with real-time reverse transcription-polymerase chain reaction ( RT-PCR ). Results The positive rate of EPCs cells with double marking of CD133 and CD34 was 99.0% at the 5th generation of subculture by using flow cytometry. After the transplantation of EPCs labeled with the green fluorescent protein, the appearance of fluorescence indicated that EPCs were mainly localized in the chest, and a stronger fluorescence was observed near the blood vessels. EPCs transplantation could significantly reduce the inflammatory cell infiltration and cell damage in lung, liver, and kidney tissue in septic rats. Compared with control group, the expression of IL-6 and IL-10 in the peripheral blood, W/D ratio, and TLR4 mRNA in lung, liver, and kidney were increased significantly in the model group. Compared with model group, the expressions of IL-6 and IL-10 in the peripheral blood were significantly reduced after EPCs transplantation [ IL-6 (μg/L ):2.127±0.118 vs. 2.664±0.438, IL-10 ( ng/L ): 24.5±3.9 vs. 31.5±3.8, both P < 0.01 ]. EPCs transplantation reduced the W/D ratio of lung, liver and kidney tissues ( lung: 4.68±0.24 vs. 5.48±0.15, liver: 3.33±0.11 vs. 3.94±0.09, kidney: 4.08±0.20 vs. 4.84±0.21, all P < 0.05 ], and down-regulated the expression of TLR4 mRNA ( ×103, lung: 782±131 vs. 1 136±126, liver: 39.1±14.0 vs. 69.2±8.7, kidney: 52.2±15.2 vs. 83.5±17.1, all P < 0.01 ). Conclusions EPCs can enter the lung, liver and kidney tissues of the rat successfully after transplantation of EPCs via vein. EPCs transplantation can down-regulate pro-inflammatory process, help to recover the balance of pro-and anti-inflammatory processes, alleviate the damage to the lung, liver, and kidney tissue significantly.

Objective The purpose of this study was to observe the effects of bumetanide on elderly type 2 diabetic patients with middle and advanced stages nephropathy. Methods Forty cases with diabetic nephropathy (DN) were divided into two groups:control group (20 cases) and treatment group (20 cases) . The control group accepted furosemide (20 mg, once a day) and the bumetanide was orally administrated at the dose of 1.0 mg, twice a day to the treatment group for 3 months. The assessment of transferrin (TRF) and urine microalbumin (UALB) was performed at the time points at the end of 1, 4, 8, 12 weeks after treatment. Results (1) The levels of BUN, SCr and UA after treatment were lower than before treatment, but there were no significant differences. (2) In the treatment group, the levels of TRF and UALB have decreased after treatment for 1 week, with no statistically significant. But at the end of 4, 8 and 12 weeks,the differences were statistically significant ( <0.05) . Especially, during the three months follow-up,the levels of TRF and UALB at 12 weeks have decreased obviously. Conclusion The therapeutic effect of bumetanide on DN might be better than that of furosemide.

0.05).There was a negative correlation between the EGFR expression with the expression of SSTR2A and SSTR5 in NSCLC tissues.The 3-year survival rates were 64.5% and 65.9% in patients positive of SSTR5 and SSTR2A,respectively;and were 45.2% and 22.2% for those negative of SSTR5 and SSTR2A,respectively(P

Objective:To study the changes of left atrial volume and function in patients with acute myocardial infarction (AMI) by three-dimensional echocardiography (3DE) and magnetic resonance imaging (MRI).Methods:Thirty-one patients with AMI in Henan People′s Hospital from March to October 2020 were selected as AMI group and 30 healthy subjects were selected as control group.The left atrial maximum volume (LAVmax), minimum volume (LAVmin), presystolic volume (LAVpre), volume index(LAVI), emptying volume (LAEV), ejection fraction (LAEF), long axis and circumferential strain (LASr, LASr-c; LAScd, LAScd-c; LASct, LASct-c) were measured by two-dimensional echocardiography (2DE), 3DE left atrial automatic quantitative technique and CMR.The differences of left atrial indices between two groups and among 2DE, 3DE left atrial automatic quantitative and CMR techniques were compared. Pearson correlation coefficient and Bland-Altman analysis were used to compare 2DE, 3DE left atrial automatic quantitative and CMR. Intra-observer and inter-observer repeatability of 2DE, 3DE left atrial automatic quantitative technique and CMR were evaluated by intra-group correlation coefficient (ICC).Results:①Compared with the control group: LAVmax, LAVmin, LAVpre, LAVI, LASct and LASct-c by 3DE left atrial automatic quantitative increased, while LAEV, LAEF, LASr, LASr-c, LAScd and LAScd-c by 3DE left atrial automatic quantitative technique decreased in AMI group (all P<0.05). ②LAVmax, LAVmin, LAVpre, LASr, LAScd, LASct measured by 3DE left atrial automatic quantitative were more strongly related to CMR than that measured by 2DE(all P<0.05). Compared with CMR, 2DE underestimated LAVmax, LAVmin, LAVpre, LASr, LAScd, LASct by (8.01±4.01)ml, (9.03±4.15)ml, (7.26±2.09 )ml, (7.26±1.23)%, (5.02±1.08)%, (6.24±0.43)%(all P<0.05); 3DE left atrial automatic quantitative technique underestimated LAVmax, LAVmin, LAVpre, LASr, LAScd, LASct by (1.67±0.62)ml, (1.95±0.90)ml, (2.52±0.76)ml, (1.97±0.59)%, (2.03±0.39)%, (1.02±0.30)% (all P>0.05); The time-consuming of 2DE and 3DE left atrial automatic quantitative technique was reduced, and the time-consuming of 3DE left atrial automatic quantitative technique was less than 2DE [(12.18±3.24)s vs (73.34±10.37)s]. ③The reproducibility of 2DE, 3DE left atrial automatic quantitative technique and CMR measurement within and between observers were good. Conclusions:3DE left atrial automatic quantitative technique can effectively evaluate the changes of left atrial volume and function in patients with AMI. Compared with 2DE and CMR, it is simple, rapid, accurate and repeatable, which provides a new and effective method for clinical study of cardiovascular diseases.

Objective To investigate the effects of exercise on expression of microtube associated protein-2 (MAP-2) and MAP-2 mRNA in neuronal cells after intracerebral hemorrhage (ICH) in rats. Methods Ninety-six male Sprague-Dawley rats (weighing 270 to 300 g) were divided into 3 groups, a trial group (ICH-induction and ex-ercise, n=32), a control group (ICH-induction only, n=32) and a sham-operated group (no ICH and no exercise, n=32). The brains of the rats were sampled at 7, 14, 21, and 28 days after the operation for establishing ICH mod-el. Another 64 rats were divided into 8 groups (6 h, 12 h, 24 h, 48 h, 72 h, 7 d after ICH, no ICH group and nor-mal group). MAP-2 and MAP-2 mRNA activity were measured by immunohistochemical methods and RT-PCR. The rats in the trial group began cage-running exercise 72 h after the operation. The others were reared in the standard ca-ges. Results ①MAP-2-positive cells appeared around the hematoma in the cortex. The number of MAP-2-positive cells was very small in the sham-operation group. There was an up-regulation of MAP-2 from 24 h to 7 d after ICH, and significant difference was found between the non-ICH group and the normal group. The expression of MAP-2 showed an up-regulation trend in the trial and control groups. There was a significant difference compared with the sham operated group, and the trial group had significantly higher expression levels than the control group. ②RT-PCR showed up-ragulation of MAP-2 mRNA 12 to 24 h after ICH. There was a significant difference between the no ICH and normal groups. The trial and control groups showed up-regulation of MAP-2 mRNA at 14 to 28 d after ICH, with was significantly different from that of the sham group, and the trial group had significantly higher levels than the con-trol group. Conclusion MAP-2 might participated in neural cells plasticity after ICH, and exercise training (cage-running) can up-regulate MAP-2 and MAP-2-mRNA expression.

Objective: To study the relationship between insulin resistance (IR) and coronary collateral circulation in patients with impaired glucose tolerance (IGT). Methods: A total of 227 patients with coronary angiography (CAG) were studied. There were 131 patients with male gender and the average patient’s age was (53.2 ± 11.0) years. IR (HOMA2-IR) index was measured by HOMA2 method, the severity level of coronary stenosis was assessed by Gensini scoring system, collateral circulation condition was determined by Rentrop classiifcation. 187 IGT patients were divided into 4 groups: Rentrop 0 group,n=55, Rentrop 1 group,n=42, Rentrop 2 group,n=39 and Rentrop 3 group,n=51; in addition, Control group,n=40 patients with normal glucose tolerance and coronary stenosis<50%. Results: Compared with Control group, all patients in 4 Rentrop groups had increased 2h-PBG, HbA1c, HOMA2-IR and Gensini score, while decreased fasting insulin (FINS), allP<0.05. Compared with Rentrop 3 group and Rentrop 2 group, the patients in Rentrop 1 group and Rentrop 0 group had elevated 2h-PBG, HbA1c, HOMA2-IR and Gensini score, while Rentrop 0 group had reduced FINS, allP<0.05. Multivariable regression analysis showed that HOMA2-IR index (R=0.518,P<0.05), HbA1c (R=1.916, P<0.05), 2h-PBG (R=2.130,P<0.05) and FINS (R=1.547,P<0.05) might be related to the severity of coronary stenosis. Binary regression analysis indicated that poor collateral circulation (the patients in Rentrop 0 group and Rentrop 1 group) was related to HOMA2-IR index (OR=1.679, 95% CI 1.101-2.558,P=0.016). Conclusion: HOMA2-IR index could be signiifcantly higher in patients with IGT combining chronic coronary occlusion. IR was the independent risk factor for the severity of coronary stenosis and coronary collateral formation.

Objective To evaluate the plasma level of miR-21 in hepatocellular carcinoma (HCC) patients and its clinical diagnostic significance .Methods Case-control study was used .The plasma level of miR-21 was measured by real-time quantitative PCR.The relative expressions of miR-21 were calculated. This study included 60 cases of patients with HCC , 71 patients with liver cirrhosis ( LC ) , 52 healthy volunteers ( HV) from January to June in 2014 in Henan Province People′s Hospital.The receiver operating characteristic ( ROC) curves were analyzed to determine the sensitivity and specificity of miR-21 expression levels in HCC diagnosis. Differences between groups were assessed by the t-test.Results Plasma microRNA-21 level in the 60 patients with hepatocellular carcinoma ( 2.6 ±1.1 ) was significantly higher than in patients with chronic hepatitis (1.6 ±0.9) and healthy volunteers (1.0 ±0.6) (t=5.322,P=0.004;t =8.349, P =0.000 3, respectively ) .Plasma microRNA-21 level in the HCC patients were positively correlated with tumor size and differentiation (tdif=3.366,P=0.019;tsize =3.490,P=0.012). ROC analysis of plasma microRNA-21 yielded an AUC of 0.796 with 70.0% sensitivity and 65.3%specificity when differentiating hepatocellular carcinoma from chronic hepatitis , and an AUC of 0.934 with 89.5% sensitivity and 81.8% specificity when differentiating hepatocellular carcinoma from healthy volunteers.Conclusion The plasma level of miR-21 in HCC patients has high specificity , and maybe help to diagnose of HCC.

Objective To explore the expression feature of long non-coding RNA (lncRNA) 1010001N08Rik in hyperoxia-induced bronchopulmonary dysplasia (BPD) and predict the mechanism that 1010001N08Rik might be involved in the occurrence and development of BPD by a series of bioinformatics analysis.Method The sequence,genomic position and structure characteristics of 1010001N08Rik were acquired from UCSC genome browser,and its target gene was predicted by Ensemble database.We successfully established the animal model of BPD by making newborn C57BL/6J mice exposed to 95％ concentrations of ambient oxygen for seven days.The expression of 1010001N08Rik and Gata 6 were detected using real-time quantitative polymerase chain reaction (PCR).Student's t test was used to compare their expression levels during the BPD process.Result The relative expression of 1010001N08Rik in BPD process at d1,d3,d5,d7 was 1.21 ± 0.33,2.02 ± 0.41,2.95 ± 0.45,4.20-± 0.48 respectively,and there were significant difference between adjacent time points (P ＜ 0.05).The relative expression of Gata 6 mRNA was 0.92 ±0.30,1.10 ± 0.31,0.86 ± 0.24,0.45-± 0.08 respectively,and there was significant difference between d5 and d7 (P ＜0.05).1010001N08Rik had highly conserved property among different species.The chromosomal regions of 1010001N08Rik existed transcriptional factors binding locations and epigenetic regulation clues,and its possible candidate target gene was Gata 6.Conclusion The expression of 1010001N08Rik increased during the formation process of BPD.Bioinformatics analysis and preliminary experiment results suggested that 1010001N08Rik might participate in the process of BPD by down-regulating Gata 6 expression.

Objective To investigate the role of toll-like receptor 4 (TLR4) of endothelium or bone marrow derived cells in the acute lung injury (ALI) induced by lipopolyscccharide (LPS) in mice with reciprocal bone marrow transplantation. Method Chimeric mice were produced by reciprocal bone marrow transplantation between TLR4mut/mut and TLR4+/+ mice and divided into 4 groups: WT/WT (recipient/donor),WT/Mutant, Mutant/WT and Mutant/Mutant group. Six to eight weeks following transplantation, LPS was injected inot mice's tail vein in order to produce ALI model,and mice were sacrificed five hours later on.Samples of lung tissues were taken for the following analysis of wet/dry weight (W/D), lung permeabifity index (LPI), myeloperoxidase (MPO),levels of cytokines (TNF-α, IL-1β) and adhesion molecules (ICAM-1). Results Lung injury in the Mutant/Mutant mice was the mildest in the 4 groups. And lung injury in WT/Mutant mice was more serious than that in Mutant/WT mice. levels of MPO and ICAM-1 in WT/Mutant mice were much higher than those of Mutant/WT. In addition,the expression of ICAM-1 in WT/Mutant mice is comarable to that in WT/WT mice. Mutant/WT mice expressed higher levels of TNF-α and IL-1β than WT/Mutant mice. Conclusions Endothelial cell derived TLR4 plays ker-nel role in ALI induced by LPS via lung PMN recruitment,although bone marrow cells derived TLR4 are more im-portant for the release of cytokines.