Sarcopenia is closely related with age-related loss of muscle fiber, reduced physical activity, hormone level decline and nutrition deficiency. Though torque generation in knee extension, relative skeletal muscle index, lean body weight, electromyogram, gait analysis, grasp force, nuclear magnetic resonance and B ultrasonic examination are generally accepted as diagnostic method, there is not an unified standard in diagnosis. Through the physical activity and diet can prevent and reverse the tendency of sarcopenia, which also improve the activity of the hypothalamic-GH-insulin-like growth factor-1 axis. In future, the characteristic therapy of Chinese medicine science can be added into resistance exercise and nutrition method, or combined compound hormones with nutrition intervention to design orthogonal test for seeking the best interaction, and explore the long-term safety and effectivity by follow-up observation.

AIM:To investigate the effect of liraglutide ( LG) on the expression of fibronectin type Ⅲdomain-containing protein 5 (FNDC5) in the C2C12 myotubes.METHODS:The C2C12 mouse myoblast cell line was induced to differentiation.Differentiated cells were stimulated with gradient concentrations (1 ~1000 nmol/L) of LG for different time (0 ~24 h).The effects of LG on the expression of FNDC5 and the activation of adenosine 5'-monophosphate ( AMP)-activated protein kinase ( AMPK) signaling pathway were determined .After pretreated with glucagon-like peptide-1 ( GLP-1 ) receptor antagonist exendin 9-39 , the inhibitor of Ca 2+/calmodulin-dependent protein kinase kinase 2 (CAMKK2), STO609, or the inhibitor of AMPK, Compound C, the LG-induced FNDC5 expression in C2C12 myotubes was examined.The expression of FNDC5 and the activation of AMPK were determined by Western blot .RESULTS: In C2C12 myotubes, LG promoted the expression of FNDC5 in a dose-and time-dependent manner .LG also activated AMPK signaling pathway .These effects of LG were partly abolished by exendin 9-39 , STO609 and Compound C .CONCLUSION:LG promotes the expression of FNDC5 via GLP-1 receptor in the C2C12 myotubes possibly through activation of the CAMKK2/AMPK signaling pathways .

Objective We evaluated the role of a quality improvement initiative in improving clinical outcomes in peritoneal di-alysis ( PD) . Methods In a retrospective analysis of 6 years of data from a hospital registry, the period between 1 July 2005 and 30 June 2008 ( control group) provided baseline data from before implementation of systemic outcomes monitoring, and the period between 1 July 2008 and 30 June 2011 [continuous quality improvement (CQI) group] represented the time when a CQI program was in place.Per-itonitis incidence, patient and technique survival, cardiovascular status, causes of death, and drop-out were compared between the groups. Results In the 370 patients of the CQI group and the 249 patients of the control group, the predominant underlying kidney diseases were chronic glomerulonephritis and diabetic nephropathy.After implementation of the CQI initiative, the peritonitis rate de-clined to 1 episode in 77.3 patient-months from 1 episode in 22.6 patient-months.In the CQI group, the complicance of blood pressure was more significantly improved than the control group ( 67.8% vs 47.4%,P<0.05).During the 3 years of follow-up,cardiothoracic ratio and IVST were significantly increased in the control group [0.55 ± 0.08 vs 0.51 ±0.05,P<0.05,11.07 ±1.66 mm vs 10.25 ±1.38 mm, P<0.05〗.The difference of LVID between the two groups was signifi-cant at the 2nd and 3rd year of follow-up(P<0.05).Patient survival at 1, 2, and 3 years was significantly higher in the CQI group (97.3%, 96.3%, and 96.3%respectively) than in the control group (92.6%, 82.4%, and 67.3%respectively, P<0.001).Imple-mentation of the CQI initiative also appeared to significantly improve technique survival rates:95.6%, 92.6%, and 92.6%in the CQI group compared with 89.6%, 79.2%, and 76.8%in the control group (P<0.001) after 1, 2, and 3 years respectively. Conclusion Integration of a CQI process into a PD program can significantly improve the quality of therapy and its outcomes.

This study was aimed to observe the regulating effect of Shen-Xiong Hua-Y u (SXHY) capsule precondi-tioning on the expression of subtypes of nitric oxide synthase (NOS), including endothelial nitric oxide synthase (eNOS), nervous nitric oxide synthase (nNOS), inducible nitric oxide synthase (iNOS), in cerebral ischemia-reperfu-sion injury (CIRI) among rats, and to further clarify the mechanism of protective effect by SXHY capsule on acute CIRI rats. Rats were randomly divided into the sham operation group, CIRI group, and SXHY capsule of high-, medium-, and low-dose preconditioning group (480, 240, 120 mg·kg-1). Each group was further randomly divided into different subgroups, which were the 3, 6, 12, 24, 48, 72 h group after 2 h CIRI (n=6). Intragastric administration was given once a day for 7 days. The middle cerebral artery occlusion (MCAO) and reperfusion model was repro-duced by an intraluminal filament method on the 7th day. The protein expressions of eNOS, nNOS and iNOS were measured by immunhistochemical method. The results showed that compared with the sham operation group, expres-sions of eNOS, nNOS and iNOS in the CIRI group were increased at different time points (i.e., 3, 6, 12, 24, 48, 72 h, P< 0.05 or P< 0.01). Compared with the CIRI group, eNOS expression increased at different time points in SX-HY capsule group (P< 0.05 or P< 0.01). The nNOS and iNOS expression decreased at different time points (P<0.05 or P < 0.01). Among them, the high-dose group was the group with the most obvious effect. It was concluded that SXHY capsule preconditioning had protective effect on CIRI. Its mechanism may be related to the regulation on protein expression of NOS subtypes.

Objective To explore the relationship of different body mass index, waist circumference and serum lipid levels with essential hypertension among residents of Ningbo. And to explore the predictive value of BMI and WC (Waist Cir-cumference) for hypertension. Methods Adopting cluster sampling, 2 303 people (1 081 cases of hypertension and 1 222 people with normal blood pressure) were collected in the four townships of Ningbo City. We conducted questionnaires, physi-cal examination and blood lipid testing for all of subjects. WC group:WC≥85 cm in male or WC≥80 cm in female is central obesity, and the others are normal. BMI groups:BMI≥24 kg/m2 is overweight, and BMI<24 kg/m2 is normal. The relationship of BMI, WC and serum lipid levels with hypertension was analyzed by multivariate unconditional logistic regression model. The predictive value of BMI and WC for hypertension was analyzed by receiver operating characteristic (ROC) curve. Results WC, BMI, total cholesterol (TC), triglyceride (TG) and low density lipoprotein cholesterol (LDL-C) in hypertension group were higher than those in control group (P<0.01). And WC, BMI, TG, LDL-C is the impact factor for hypertension. The overweight rate and central obesity rate in hypertension group were higher than control group (P<0.01). TG and LDL-C level abnormality, overweight and central obesity were the risk factors of hypertension. As a risk factor of hypertension, over-weight with central obesity group is higher than overweight with normal waistline group, simple central obesity group and nor-mal group. In the area under the ROC curve, BMI is higher than WC in both male and female population. Conclusion WC, BMI, TG and LDL-C abnormalities were risk factors for hypertension, and BMI was a better predictive factor for hyper-tension than WC.

Objective To investigate the relationship between cerebral white matter fractional anisotropy(FA)and metabolite con-centrations measured by 1 H magnetic resonance spectroscopy(1 H-MRS)in healthy adults.Methods Diffusion tensor imaging(DTI) and 1 H-MRS were acquired from thirty-one healthy adults at 3.0 T MR system.The concentrations of N-acetylaspartate(NAA), choline(Cho),creatine(Cr),the ratios of NAA/Cr and FA values of DTI were measured in 353 voxels,covering the bilateral medium corona radiata.According to the age,all voxels were divided into two groups:the senior group (mean age=29 years),and the senior group(mean age=5 6 years).The correlations between FA values and age were analyzed using Pearson’s correlation coefficients.The correlations between FA values and metabolite concentrations were estimated using partial correlations test controlling for the age re-lated bias.Results Pearson’s correlation analysis revealed a negative correlation between FA values and age in 353 voxels(r=-0.146,P<0.05),senior group(r=-0.204,P<0.05)and senior group(r=-0.162,P<0.05).Only the correlation between NAA and FA values were significant(r=0.339,P<0.05;r=0.213,P<0.05;r=0.430,P<0.05).There were positive relation-ships between FA values and NAA/Cr among 353 voxels (r=0.166,P<0.05)and senior group(r=0.305,P<0.05).Conclusion There are correlations between cerebral white matter FA values and metabolite concentrations measured by 1 H-MRS .Combining 1 H-MRS with DTI can reveal the relationship between microscopic white matter integrity and metabolic characteristics of the white matter.

Objective To explore the change in anatomical volume during intensity?modulated radiotherapy (IMRT) for different stages of nasopharyngeal carcinoma (NPC) and its influence on dose distribution, and to assess the necessity to modify the IMRT plan. Methods Twenty?four patients with newly diagnosed NPC who received IMRT and chemotherapy were enrolled in the study, and were divided into early?intermediate group ( 12 cases ) and locally advanced group ( 12 cases ) according to the 2008 staging system for NPC. Each patient had a repeated CT scan at week 5 of radiotherapy, and target volume and organs at risk ( OAR) were contoured. The dose distribution of the original plan shown on CT was calculated. Changes in target volume, OAR anatomical volume, and dose distribution were analyzed, and paired t?test and Spearman correlation analysis were performed. Results In the early?intermediate group, gross target volume of neck positive lymph nodes (GTVnd) was reduced during radiotherapy (P=0. 059), and gross target volume of nasopharynx ( GTVnx ) , high?risk clinical target volume ( CTV1 ) , and parotid volume were reduced significantly during radiotherapy ( P= 0. 001, 0. 012, 0. 002, and 0. 000, respectively) . In locally advanced group, GTVnx , GTVnd , CTV1 , and parotid volume were significantly reduced during IMRT (P=0. 000, 0. 000, 0. 003, 0. 003, and 0. 000, respectively). Compared with the values before radiotherapy, the parotid dose increased significantly in the two groups during IMRT ( P=0. 044, 0. 026, 0. 033, and 0. 026, respectively;P=0. 024, 0. 016, 0. 030, and 0. 015, respectively) , and the increase in GTVnd dose was observed in the locally advanced group ( P= 0. 029 and 0. 049 ) . Conclusions It is recommended to perform another CT scan for patients with locally advanced NPC at week 5 of radiotherapy and formulate a new IMRT plan to maintain target volume dose and guarantee a safe parotid dose.

Objective This study aimed to explore the clinical value of human papilloma virus ( HPV) E6/E7 mRNA tests in identifying precancerous lesions of the uterine cervix-cervical intraepithelial neoplasia 2 or more CIN2+( CINⅡand CINⅢ).Methods This study is a cross-sectional survey design , between December 2011 to December 2013.The specimens were collected from the First People′s Hospital of Huizhou and the Third People′s Hospital of Huizhou in Department of Obstetrics and Gynecology outpatient and inpatient of cervical disease suspected patients , with thin-prep cytologic test ( TCT ) and histopathological results as reference , detected 345 patients of exfoliated cervical epithelial cells by using the branched DNA (b-DNA) technology to evaluate the application value of high risk HPV E 6 /E7mRNA in the clinical diagnosis of CIN.Using spss 19.0 software for data analysis.Results (1)Compared with TCT, the positive rate of E6/E7 mRNA in 325 samples were grading by cytology as follows: no intraepithelial lesion cells (NILM) 21.1%(40/190), atypical squamous cells (ASC) 38.5%(15/39 ), low-grade squamous intraepithelial lesions ( LSIL ) 76.9% ( 30/39 ) , atypical squamous cells can not exclude high-grade intraepithelial lesions (ASC-H) (8/10), high-grade squamous intraepithelial lesions (HSIL) 72.3%(34/47), TCT grades and HPV E6/E7 mRNA positive rate showed linear association (χ2 =67.654,P<0.01;r=0.497, P<0.01 ); and with HPV E6/E7 mRNA copy number was also relevant ( r =0.511, P <0.01).(2) Compared with pathological results , the positive rate of E6/E7 mRNA in 164 women samples were grading by pathology as follows:with NILM was 27.8%(10/36), with CIN Ⅰwas 65.9%(29/44), with CINⅡwas 80.6%(54/67), and with CINⅢwas 82.4%(14/17), pathological grades and HPV E6/E7 mRNA positive rate showed a linear correlation (χ2 =26.426, P<0.01; r=0.438, P<0.01); and the number of copies correlated with the increase of pathological grades too (r=0.543, P<0.01).(3) Screening effectiveness analysis results showed , the sensitivity of HPV E6 /E7mRNA was 84.6% while TCT was 47.7%.The sensitivity and specificity were 40.0% and 91.1% respectively when HPV E6/E7 mRNA and TCT processed as sequential detection test.The CIN2 +( CINⅡand CIN Ⅲ) best diagnostic critical point of 890.26 copies/ml,was established using receiver operating characteristic ( ROC) curve.The sensitivity and specificity were 58.5% and 93.7%, respectively.Conclusions The sensitivity of HPV E6/E7 mRNA test is better than TCT, the specificity is high in HPV E6/E7 mRNA and TCT processed as sequential detection test.Using the optimal cut-off value of ROC curve to detect CIN 2+has high sensitivity and specificity, so the detection of HPV E6/E7 mRNA may have some clinical value in screening and risk assessment of precancerous lesions of the uterine cervix.

OBJECTIVETo investigate the effect of noise on the antioxidant capacity in different regions of brain tissue in guinea pigs.

METHODSThirty male white red-eye guinea pigs were equally and randomly divided into five groups: 1-, 3-, 7-, and 14-day groups after noise exposure and control group. The guinea pigs of the experimental groups were exposed to steady white noise with a sound pressure level at 100 dB for 8 h per day and for 2 consecutive days. The auditory brainstem response (ABR) of guinea pigs, as well as the glutathione (GSH) level, methane dicarboxylic aldehyde (MDA) level, and superoxide dismutase (SOD) activity in the cerebrum, cerebellum, and hippocampus, was determined prior to and 1, 3, 7, and 14 days after noise exposure.

RESULTSAfter noise exposure, the shifts in ABR threshold of the experimental groups were significantly higher than that of the control group (P<0.05). Compared with those in the control group, the SOD activity and GSH level both significantly decreased in the cerebrum tissue of each experimental group after noise exposure (P<0.05) and MDA content significantly increased in the 1-day group (P<0.05). As for cerebellum tissue, the SOD activity and GSH level in the 7-day group were significantly lower than those in the control group (P<0.05), but there was no difference in MDA level between each experimental group and the control group (P>0.05). In comparison with those in the control group, the GSH and MDA levels in the 1-day group after noise exposure were significantly higher, and the GSH and MDA levels in the 3-day group and the MDA level in the 7-day group after noise exposure were significantly lower (all P<0.05).

CONCLUSIONNoise exposure can lead to hearing loss and affect the antioxidant capacity of brain tissue, which indicates that the improvement in antioxidant levels may alleviate noise-induced damage.

Animals ; Antioxidants ; chemistry ; Brain ; metabolism ; Brain Chemistry ; Evoked Potentials, Auditory, Brain Stem ; Glutathione ; chemistry ; Guinea Pigs ; Male ; Malondialdehyde ; chemistry ; Noise ; adverse effects ; Superoxide Dismutase ; chemistry