Objective:To study the best extraction technology of Qishan sugar-free granule. Methods:The effects of boiling dura-tion, boiling times and water addition ratio on the extraction process were investigated by using L9 (34 ) orthogonal design, and the con-tents of total flavonoids, baicalin and berberine were taken as the indices. Results:The optimum conditions were as follows:10-fold a-mount of water for 2 cycles, and every extracting time was 1 hour. Conclusion: The best extraction technology of Qishan sugar-free granule is obtained, and the process is stable and feasible, and the contents of active components are high.

Supported by various departments concerned of the district government, medical workers in Luwan District of Shanghai started in 1994 to set up in the whole district community based social help network for the medical care of SCGFD. In the last 4 years, the annual outpatient volume of SCGFD averaged 3.9 times and the annual visits received by SCGFD averaged 2.2 times. The conditions of 78.1% of SCGFD suffering from an illness turned for the better or became stable. The annual hospitalization utilization ratio averaged 5.4%. After hospitalization, 89.5% of SCGFD suffering from a serious illness fully recovered from their illness or were discharged after turning for the better. The average outpatient expenses per time, hospitalization expenses per day and per time of SCGFD respectively dropped 32.1%, 21.5% and 30.4%, as compared with the group of senior citizens enjoying free medical care. The authors hold that the social help network for the medical care of SCGFD in Luwan District is an easy to operate and effective community based medical security system for SCGFD. It has produced sound social repercussions after being put into practice. The controlled use of medical funds has ensured the normal operation of the network.

Objective To study the influence of different dialysis frequence on infection and prognosis of maintenance hemedialysis patients. Methods Fifty-three maintenance hemodialysis patients with chronic kidney disease were divided into 3 groups. Groups A, B, C dialysed thrice per week (19 cases),twice per week (15 cases) and thrice per two weeks (19 cases), respectively. All the patients were dialysed for 1 year. The rate of infection, death number and death reason were recorded. Results All the cases were infected 62 times (17 times in group A, 18 times in group B and 27 times in group C). Pulmonary infection,blood vessels infection, urinary tract infection and digestive tract infection happened 35 times(56.45% ), 14 times (22.58%), 8 times (12.90%) and 5 times (8.06%) respectively. Eight cases died in three groups,and the total death rate was 15.09%, with 1 case in group A,1 case in group B and 6 cases in group C.There was significant difference in prognosis among three groups (χ2 =6.293,P <0.05). Conclusions Patients who dialysis less than twice per week have higher rate of infection and death. Dialysis program should be adjusted and dialysis frequence should be increased.

The population of the very elderly is growing steeply with prolonged life expectancy.Age is an independent risk factor for stroke.Naturally,the very elderly become the high risky population.Hypertension is the most common and modifiable risk factor of stoke in the very elderly.Results of studies conducted during these 20 years have been reported to explore and investigate the relationship between stroke primary prevention and antihypertensive treatment,some of which are regarded as landmarks trials,providing essential evidences for blood pressure management in the very elderly.

Objective To study the effects and safety of levocarnitine and shuxuetong in treatment of the patients with chronic renal failure.Methods 94 patients with chronic renal failure were selected as research object,and they were randomly divided into group A(levocarnitine and shuxuetong group) 47 cases and group B(shuxuetong group) 47 cases.Group A were treated with levocarnitine oral solution and shuxuetong,and group B were treated with shuxuetong,then the percentage of effectiveness,incidence of adverse reactions of group A and group B and serum BUN,Scr,Hcy were analyzed.Results The percentage of effectiveness of group A was higher than that of group B,but the incidence of adverse reactions of the two groups had no difference,and the serum BUN,Scr,Hcy of group A and group B before the treatment had no differences(P＞0.05),those of group A and group B after treatment were compared there were significant differences(all P＜0.05).Conclusion The effects of levocarnitine oral solution and shuxuetong in treatment of patients with chronic renal failure were better.

Objective To describe the prevalence of hyperuricemia of centenarians in longevity areas of China and the risk factors were analyzed. Methods All centenarians in 7 longevity areas were selected,and people aged 40 ～, 60 ～, 80 ～ and 90 ～ were selected randomly in the same 7 areas. The data of demographic data, dieting habits and diseases history were collected by questionnaire survey. Hyperuricemia and associated risk factors, physical examination and biochemical tests were collected. Logistic regression was used to analyze the hypemricemia and its relevant factors. Results The highest prevalence of hyperuricemia was found in centenarian men, which was 12.73％, the highest prevalence of hyperuricemia among 90～ women was 18.75％. The hyperuricemia group were more prone to have hypertension, diabetes, renal function decreased, hypercholesterolemia, hypertriglyceridemia, high density lipoprotein. Logistic regression analysis showed that renal function declined, high TG, high density lipoprotein hyperlipidemia, blood urea nitrogen increased, drinking were risk factors for hyperuricemia. Conclusion The prevalence of hyperuricemia in people older than 90 years and above in longevity areas is high. The results suggest that the treatment strategy for hyperuricemia should be a comprehensive one that combines preventive measures with medication interventions.

Objective To explore the effect of repetitive transcranial magnetic stimulation(rTMS) treatment on the brain derived neurotrophic factor(BDNF) serum levels in depressive patients.Methods Sixty-eight unipolar depressions treated with venlafaxine were randomly assigned to the real rTMS group(n =34)and the sham rTMS group(n =34),which were accepted the real or the shame rTMS treatment on the left dorsolateral prefrontal lobes respectively.The Hamilton Rating Scale for Depression (HAMD) and BDNF serum was assayed before and after 4 weeks' treatment.Results 1) A significant increase of serum BDNF((12.2 ± 1.3) μg/L vs (5.6 ± 0.8) μg/L,t=-9.167,P=0.000;(11.4 ± 1.5)μg/L vs (6.0± 1.0)μg/L,t=-7.421,P=0.000)and a significant decline of HAMD((11.6 ± 1.7) score vs (32.6 ± 2.5) score,t =14.654,P =0.000 ; (4.2 ± 2.8) score vs (31.8 ± 3.2)score,t=12.089,P =0.000) were found after the treatment in the real and the shame group,and the real group changed more significantly than the shame group ((6.7 ± 0.8) μg/L vs (5.1 ± l.2) μg/L,t =2.690,P =0.009 ; (21.0 ± 2.1) score vs (17.6 ± 2.6) score,t =2.693,P =0.000).2) A negative correlation was found between the serum BDNF levels and the HAM D scores before the treatment(r =-0.530,P=0.003; r =-0.490,P =0.004),and a positive correlation between changes of BDNF levels and HAMD scores changes(r =0.439,P =0.006 ; r =0.454,P =0.005).Conclusion The rTMS treatment can increase serum BDNF levels in depressive patients.

ObjectiveTo investigate the clinical characteristics,3-month outcome and predictive factors in the very elderly patients with ischemic stroke.MethodsA total of 305 acute ischemic patients aged 65 years and over were enrolled in the study.They were divided into two subgroups by age:80 years old and over(n =78),65-79 years old(n =227).The clinical outcome was assessed by the modified Rankin Scale (mRS) on (90 ± 7 ) days after stroke,and categorized as good ( scoring 0-2 ) or poor( scoring 3-6) outcome.Results Significantly lower BMI [ ( 23.62 ± 4.92 ) kg/m2 vs ( 25.08 ± 3.69 ) kg/m2,P =0.005],lower frequency of dyslipidemia(56.41％ vs 71.13％,P =0.006) and alcohol intake (0％ vs 6.61％,P =0.043 )were found in the very elderly group.The rates of poor functional outcome in the ≥ 80years group and the 65-79 years old group were 56.41％ (44/76) and 41.40％ (94/224) respectively,with a P value of 0.015.Multivariate logistic regression analysis showed that higher National Institute of Health stroke scale (NItISS) total score (OR 1.48,95％ CI 1.19-1.83 ) and lower albumin level (OR 0.73,95 ％ CI 0.55 -0.95 ) were associated with poor outcome in ≥ 80 year old,whereas higher NIHSS total score ( OR 1.38,95％ CI 1.24-1.53) and complications during hospital stay ( OR 2.58,95％ CI 1.07-6.19 ) were predictive factors in the 65-79 years old group.ConclusionOur study suggests that NIHSS scores,albumin level and complications during hospitalization are useful predictive factors for the short-term poor functional outcome in the patients of ≥65 years old and ≥80 years old patients have a worse prognosis.

Objective To explore the relationship between high sensitive C-reactive protein (hsCRP) and renal function among people aged 90 years and over in longevity regions in China.Methods Totally 506 subjects aged 90 years and over in 5 longevity areas from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) 2008-2009 were included in the study.Demographic,behavioral and lifestyle parameters and self-reported chronic diseases were collected by general health-related questionnaire.We conducted the physical examination and also measured serum hsCRP and other indicators of renal function.Logistic regression was used to analyze the relationship between hsCRP and renal function.Results The prevalence of elevated hsCRP was 36.6％ in people aged 90 years and over,43.0％ in male and 34.8％ in female.No significant gender difference was observed among them (x2 =2.4184,P=0.1199).The prevalence of elevated hsCRP were 34.4％ in 90-99 years group and 39.2％ in the centenarian group,and there was no significant difference between the two groups (x2 =1.2425,P =0.2650).We found significant statistical difference in prevalence of elevated hsCRP between declined renal function group (42.0％) and normal group (33.3％) (t=3.8450,P=0.0499).The level of serum creatinine were (89.5±37.4) μmol/L in elevated hsCRP group and (81.5±31.4) μmol/L in the normal hsCRP group among the people aged 90 years and over.Significant difference was found between the elevated and normal hsCRP group (x23.8450,P=0.0161).In the multivariate logistic regression analysis,the risk factors of renal function decline were female,smoking,hypertension,hyperuricemia and elevated hsCRPCOR=1.676 (95％CI:1.091-2.573)].Conclusions Elevated hsCRP increases the risk of renal function decline among people aged 90 years and over in China.

Objective To analyze the relationship between thyroid function and grades of diabetic nephropa-thy (DN).Methods One hundred and twenty patients with definite DN were classified into the four groups,and forty patients with non-DN diabetic was NDN group.Their serum albumin,blood hemoglobin,serum potassium,functional parameters of thyroid and dependability to DN were analyzed.Results The plasma albumin ofⅢ,Ⅳ and Ⅴ group were (41.3 ±3.6)g/L,(30.5 ±4.8)g/L and (28.3 ±5.9)g/L,which were lower than those of NDN group (F=11.36,P<0.05).24h urine protein ofⅢ,Ⅳ and Ⅴ were (0.48 ±0.29)g,(1.86 ±0.54)g and (1.69 ±0.67)g, which were higher than those of group NDN (F=7.12,P<0.05).Triiodothyronine(T3)ofⅢ,ⅣandⅤgroup were (0.98 ±0.38)nmol/L,(0.75 ±0.41)nmol/L and (0.60 ±0.28)nmol/L,which were lower than those of NDN group (F=7.64,P<0.05).Tetraiodothyronine(T4)of III,IV and V group were (6.06 ±1.76)nmol/L,(5.31 ±1.98)nmol/L and (4.65 ±1.87)nmol/L,which were lower than those of NDN group (F=6.83,P<0.05 ).Free Triiodothyronine (FT3)ofⅢ,Ⅳ and Ⅴ group were (4.37 ±2.12)pmol/L,(3.33 ±2.30)pmol/L and (2.91 ±1.82)pmol/L, which were lower than those of NDN group (F=7.14,P<0.05 ).Correlation analysis indicated that FT3 was an independent predictor for the severity of diabetic nephropathy.Conclusion In the patients with DN Ⅳ and Ⅴ,DN has attained a very severe status and the treatment of DN should be intensive.