Multiple organ dysfunction syndrome in the elderly (MODSE) is an important research topic of geriatrics. This article would review the advance of study in MODSE.

Objective To evaluate the early prediction score system for multiple organ dysfunction syndrome in the elderly (MODSE) induced by pulmonary infection. Methods A total of 316 patients with pulmonary infection aged over 60 were admitted from 2007 Jun to 2009 Jun. All patients were scored by the early prediction score system for MODSE and then classified as high-risk group and non high-risk group. χ2 test was used to analyze the difference in morbidity of MODSE between high-risk group and non high-risk group. Receiver operating characteristic (ROC) curve was drawn, and the area under the curve, sensitivity and specificity was calculated. Results The morbidity of MODSE in high-risk group was higher than that in non high-risk group(χ2=87.569,P＜0.01).The area under the ROC curve was 0.864(P＜0.01).The sensitivity and specificity of the early prediction score system of MODSE were 84.2% and 72. 1%, respectively. Conclusion The early prediction score system for MODSE can be used to predict MODSE induced by pulmonary infection and to screen for the high risk population.

Objective To establish the scoring system for early prediction of multiple organ dysfunction syndrome (MODSE) induced by pulmonary infection in the elderly. Methods A total of 393 inpatients with pulmonary infection, aged 60 years and over, were enrolled in this study and the data of them from January 2001 to December 2006 were analyzed retrospectively. All patients were divided into MODSE group and non-MODSE group. The effects of age, chronic disease and blood test items of healthy examination on the pathogenesis of MODSE were explored. The early prediction indexes which were selected from age, 21 chronic diseases and 15 blood test items of healthy examination were scored to establish the scoring system for early predicting MODSE. Results The age, chronic obstructive pulmonary disease, chronic respiratory failure, pulmonary fibrosis, chronic cardiac insufficiency, cerebrovascular disease, diabetes, chronic renal failure, hemoglobin, albumin,urea nitrogen and fasting blood glucose were selected to establish the scoring system for early predicting MODSE. Conclusions The scoreing system for early predicting MODSE may be used to screen the high risk population of MODSE induced by pulmonary infection, which is valuable in early prediction of MODSE.

Objective To compare oligoneucleotide arrays with sequence specific primer polymerase chain reaction (PCR-SSP) for HLA-DR genotyping in order to develop a new technique of genotyping for donors and recipients in kidney transplantation. Methods Sixty DNA samples of donors and recipients were subjected to HLA-DR typing by oligoneucleotide arrays and PCR-SSP simultaneously. The results of the two typing techniques were analyzed.Results Of 60 samples using the two above-mentioned typing techniques, the results in 56 samples were identical with the accordance rate being 93 %, and in the remaining 4 unidentified samples verified by the other laboratory, oligoneucleotide arrays made 1 allele miss typing for 2 samples , 1 allele mistaking for 1 and PCR-SSP made 1 allele miss typing for 1 sample. Among the total, 20 samples retyping was made and its reproduction rate was 96 %. Conclusion The oligoneucleotide arrays technique for HLA genotyping has advantage of high sensitivity, high efficiency, high level standard and it is incomparable.

Objective To investigate which is better for gastroduodenal endoscopic ultrasound (EUS) between right lateral position and left lateral position of patients guided by nurses. Methods A total of 79 patients were randomly assigned to the left and right lateral position groups. Each patient received EUS examination in three parts, which were sinuses ventriculi, duodenal bulb and descendant duodenum. The operating time and the water volume of each patient were recorded in the procedure of EUS. Results Operating time in sinuses ventriculi, duodenal bulb and descendant duodenum of left lateral position group was (9.0±4.0) min, (6.5±3.2) min and (13.6±10.9) min, while (5.7±3.0) min, (3.6± 1.7) min and ( 6.6±5.7) min in right lateral position group, the differences were significant (t=3.098, 2.190, 3.210, P<0.05) . In the meantime, water volume was (892.0±169.5) ml, (898.6±145.9) ml and (1 012.0± 333.2) ml in sinuses ventriculi, duodenal bulb and descendant duodenum of left lateral position group, while (327.1±79.3) ml, (260.6±30.4) ml and (263.8±17.7) ml in three parts of right lateral position group, respectively. Significant differences were found in water volume among subgroups (t=13.798, 11.290, 4.930, P<0.01 or 0.05). Conclusions In the process of EUS for submucosal lesions at gastric antrum and duodenum, right lateral position instructed by nurses can shorten the operating time and make the procedure easier. This might reduce risks of regurgitation, aspiration, and other related complications.

Objective To study the effect of direct cover vitrification (DCV ) on the morphology of follicles from human o‐varian tissue .Methods Biopsies of ovarian tissue was cryopreserved by DCV and some of them was cultured for 7 days .The rates of primordial follicles ,primary follicles and secondary follicles were counted .Results Compared to the fresh group and frozen group ,the percent of primordial follicle of fresh‐cultured group ,frozen group decreased ,primary follicle significantly increased(P<0 .05) .The percent of primordial follicle ,primary follicle ,secondary follicles of fresh‐cultured group were lower than those of fresh group(P<0 .01) .In frozen group ,the rates of the primary and secondary follicles with normal morphology were lower than those of fresh cultured group(P<0 .05) .The rate of normal morphology of secondary follicles of frozen‐cultured group was demonstrably lower than that of fresh‐cultured group(P<0 .05) .Conclusion Partial follicles might be injured in cryopreserved human ovarian tissues by direct cover vitrification .A period of post‐thaw culture may enhance follicle recovery .

Objective To evaluate the prediction value of the early prediction score system of multiple organ dysfunction syndrome in the elderly (MODSE). Method A total of 393 patients with pulmonary infection, who were above60 years old, were divided into non MODSE(n =224) and MODSE group(n = 169) and were scored by the early prediction score system of MODSE. Independent-samples t Test was used to analyze the difference of forecast score between MODSE and non MODSE group. Receiver operating characteristic (ROC) curve was drawn,and the area under the curve was calculated. The prediction accuracy of scores for MODSE was assessed using sen-sitivity and specificity, and the optimal forecast point for MODSE was found. Results The score of MODSE group was higber than that of non MODSE[(19.38±12.049) vs. (45.78±20.257), P <0.001]. The area under the ROC curve was 0.889 (P <0.001) ond 95% (0.857～0.920). As the value of forecast score was 27.5, the sensitivity of the early prediction score system of MODSE was 82.8 %, the specificity of the early prediction score system of MODSE was 80.3 %. Conclusions The early prediction score system of MODSE is valuable in predic-tion of MODSE, which may be used to forecast MODSE and find the high risk population of MODSE.

Objective To study change of insulin resistance and beta-cell function of the patients in hyper-tension with normal glucose tolerance(NGT) to phthogonesis of type 2 diabetes mellitus(T2DM). Methods 84 pa-tients with hypertension were divided into NGT group,and groups of impaired glucose tolerance(IGT) with groups of T2DM. The blood pressure, height, weight, waist circumference, hip circumference, high-density lipoproteins (HDL-C)and total cholesterol(TC) ,fasting plasma glucose(FPG) and fasting plasma insulin(FINS) were measured to deter-mine the body mass index(BMI) ,waist/hip ratio(WHR) ,insulin secretion function[ including Homa β-cell function index(HBCI) and fasting β-cell function index(FBCI)] and insulin resistance level [ including Homa model insulin resistance index(IR) and insulin action index(IAI)] ,statistic comparison were measured between the groups of dif-ferent glucose tolerances. Results The BMI, WHR, diastolic blood pressure ( DBP), TC in IGT group and T2DM group were bigger or higher than those in NGT group ( P<0.05, P<0.01 ), the IAI, HOMA-IS and FBCI in T2DM group were lower than those in NGT group with these in NGT group were lower than those in NGT group( P<0.05 ,P<0.01 ). The HOMA-IR in IGT group and T2DM group were higher than those in NGT group with these in T2DM group were higher than those in NGT group. Conclusion T2DM group and IGT group had more insulin resistance level,sensitivity of insulin and islet β-cell function decrease than those in IGT group,the IGT group and T2DM group are analogous at the body weight is heavier, with waist/hips ratio, triglyceride level and DBP are higher than those in the NGT group in clinic.

Objective:To investigate the optimal administration approach of using aspirin by observing the effects of the rats in-testinal mucosal barrier and somatostatin receptors level with different administration approaches of using non-steroid anti-inflammatory drugs-aspirin.Methods:32 SD rats were randomly divided into 4 groups:oral intake group,enema group,intraperitoneal injection group and control group.Every group had 8 rats.The ileum mucosal injury was scored.The level and distribution of SSTRs in every group was detected by ELISA and immunohistochemistry, respectively, The IOD score in each group was measured by image analysis.Results:(1) The scores of ileum mucosal injury in aspirin experimental groups were significantly higher than that in control group (P<0.05), but there were no difference among aspirin experimental groups.( 2 ) All subtypes of SSTR were expressed in rat intestinal mucosa.However,SSRT1 and SSTR2 were expressed mainly ( P<0.05 ).( 3 ) The expressions of SSTR1-5 on intestinal mucosa in aspirin experimental groups were significantly less than that in control group (P<0.05).(4) There was incompletely no same effects of SSTR1-5 in intestinal mucosa by different approaches ( P<0.05 ).( 5 ) There were no significant difference of SST concentration and IOD score among all groups ( P>0.05).Conclusion:Aspirin can damage the rat intestinal mucosa.Aspirin could lead to the decrease of SSTR1-5 expression in the intestinal mucosa.All subtypes of SSTR in rat small intestine mucosa were expressed, suggesting that aspirin could affect the barrier function of the intestine.There were different influences on SSTR1-5 expression by different administration approaches,suggesting aspirin by parenteral approach may reduce the intestinal damage.

Objective:To investigate the changes of somatostatin ,epidermal growth factor receptor ,prostaglandin E2 and mucus of ileum in SD rats injected aspirin.Methods:32 SD rats were randomly divided into 4 groups:oral intake group ,coloclyster group ,in-traperitoneal injection group and normal control group.Ileal tissue sections were stained by Alcian blue.The positive area and IOD of Alcian blue was counted by image analysis in each group.The concentration of SST ,EGFR and PGE2 were detected by ELISA immuno-histochemistry ,and the IOD of each index was measured by image analysis in each group.Results:The score of ileum mucosal injury were highest in aspirin treatment groups ( P<0.05 ) ,but the score was no difference among aspirin treatment groups.The area and IOD of mucus in aspirin treatment groups were less than normal control group .The Area ( 602.17 ±158.03 ) and level of IOD ( 249.54 ± 113.19) in intraperitoneal injection group was the lowest (P<0.05).There were no differences of level of SST ,EGFR was observed among all groups .The concentration and IOD of PGE2 in normal control group was the highest (P<0.05).However,his discrepancy was not obvious among three groups of aspirin.Conclusion: Aspirin, in the four routes of administration , can cause damage to the mucosa of the rat small intestine in two weeks.The integrity of the small intestinal mucosa and mucus secretion were damaged significantly ,and it was the worst in intraperitoneal injection group.These changes might be correlated with the reduction of PGE 2.No clear results showed that the SST and EGFR were involved in the pathophysiology of the NSAIDs .