The surface electromyography (sEMG) is the noninvasive method which can record and measure the changes of local muscle activities. The sEMG's amplitude and frequence signal will change with muscular movement. sEMG application in present study on muscle fatigue is a reliable predictor of muscle functional level. The researches on the sEMG signals changes of limb muscles of hemiplegic patients will take a important role in providing scientific evidence for the neural rehabilitation training after stroke.

Immunosenescence is a process characterized by alterations and progressive deterioration of the structure and function of the immune system.Manifestations of immunosenescence include damage to both innate and adaptive immunity,reduction of immune responses to antigen stimulation,quantitative and functional changes of immune cells and alterations of cytokine activities,all of which may result in attenuated responses to vaccines,enhanced chronic inflammatory reactions,an elevated risk of infections and an increased susceptibility to cancer among old individuals.In recent years,it has been increasingly recognized that oxidative stress plays a vital role in immunosenescence.This review is focused on the influences of oxidative stress on the structure,function and generation of immunecells and the major mechanisms underlying immunosenescence.

TLR2 activity plays an important role in the pathogenesis of autoimmune diseases, tumor carcinogenesis and cardio-cerebrovascular diseases. To establish a TLR2 receptor-based cell screening model, NF-kappaB promoter-driven luciferase reporter plasmids were transfected into human embryonic kidney cells (HEK293) stably expressing human TLR2 and co-receptors CD14, TLR1 and TLR6. Single clones were then isolated and characterized. Using this screening system, a human TLR2-binding peptide C8 was obtained from the Ph.D.-7 Phage Display Peptide Library through biopanning and rapid analysis of selective interactive ligands (BRASIL). The binding characteristic of C8 with human TLR2 was evaluated by ELISA, flow cytometry and immunofluorescence. The NF-kappaB luciferase activity assay showed that C8 could activate the TLR2/TLR1 signaling pathway and induce the production of cytokines TNF-alpha and IL-6. In conclusion, the TLR2 receptor-based cell screening system is successfully established and a new TLR2-binding peptide is identified by using this system.

ObjectiveTo examine the effects of proprioceptive neuromuscular facilitation(PNF) techniques on lower limb motor function of strokes and its mechanism.MethodsWe used simple random sampling and cross-section survey design. PNF Contract Relax Agonist Contract(PNF-CRAC) techniques were applied to 44 stroke patients. Surface electromyography values(sEMG) was recorded from rectus femoris and hamstring of stroke patients with both low limbs. ResultsPNF-CRAC techniques not only caused the irradiation of muscles activities in the contralateral extremity during unilateral exercise, but also increased agonist EMG activities and the motor control of knee joint in strokes.ConclusionPNF-CRAC techniques can improve the knee stability and enhance the recovery of motor function in paretic lower limb.

Autophagy is an important homeostatic cellular recycling mechanism responsible for degrading injured or dysfunctional cellular organelles and proteins in all living cells. Aging is a universal phenomenon characterized by progressive deterioration of cells and organs due to accumulation of macromolecular and organelle damage. Growing evidences indicate that the rate of autophagosome formation and maturation and the efficiency of autophagosome/lysosome fusion decline with age. Dysfunctional autophagy has also been observed in age-related diseases. Autophagy disruption resulted accumulation of mutated or misfolded proteins is the essential feature of neurodegenerative disorders. However, in cancers, fibroproliferative diseases or cardiovascular diseases, autophagy can play either a protective or destructive role in different types of disease, and even in different stages of the same disease. The review will discuss the cellular and molecular mechanisms of autophagy and its important role in the pathogenesis of aging and age-related diseases, and the ongoing drug discovery strategies for therapeutic intervention.

Objective To investigate the mechanism of hypedipidemia on pancreas of rats by comparative proteomic analysis.Methods Ten male SD rats were randomly divided into two groups,the experimental group Was fed with high lipid forage and the control group Was fed with normal food.Pancreatic samples from the two groups were harvested six weeks later.Differential protein analysis Was performed using differential in-gel electrophoresis(DIGE),and characterizing the protein biomarkers using tandem mass spectrometry.Western blot Was used to confirm the expression of significantly changed proteins.Results Compared to the normal pancreas tissue,a total of 3 protein spot-features were found to be significantly increased and 11 significantly decreased in pancreatic samples with hyperlipidemia.Significantly increased proteins in hyperlipidemia pancreatic samples were arginaseⅡ,ribonuclease inhibitor and glyeine amidinotransferase,which increased by 2.19,1.82 and 1.12 fold,respectively.Significantly decreased proteins in hyperlipidemia group were tyrosyl-tRNA synthetase,alpha-amylase,triacylglycerol lipase,DJ-1protein,Cu,Zn superoxide dismutase,which dicreased by 2.48,2.37,1.85,1.73 and 1.65 folds,respectively.Western blot analysis revealed increased arginase Ⅱ levels and decreased alpha-amylase in pancreatic samples with hyperlipidemia.Conclusions Pancreas wag possibly injured by hyperlipidemia via increase of arginase Ⅱ.Decreased amylase and lipase may be the protection mechanism of pancreas.

This study aims to investigate the preventive role and potential mechanisms of blocking extracellular HMGB1 function on doxorubicin induced cardiac injury. Mice were treated with HMGB1 blocker glycyrrhizin 1 h before and one time every day (intraperitoneal, 10 mg per mouse) after doxorubicin injection, and sacrificed on the day 14 after doxorubicin challenge. Cardiac function was evaluated by echocardiography and hemodynamic measurement. Myocardial inflammation and collagen deposition were analyzed by immunohistochemistry and picrosirius red staining. The interaction of HMGB1 and TLR2 was assessed by co-immunoprecipitation and confocal microscopy. The protein contents of HMGB1, MyD88, p65NF-kappaB and phospho-p65NF-kappaB were measured by Immunoblot. Compared with mice treated with saline, doxorubicin treatment led to an upregulation in HMGB1 expression. Blocking HMGB1 activity with glycyrrhizin protected mice against cardiac dysfunction, inflammatory response, and cardiac fibrosis induced by doxorubicin challenge. Glycyrrhizin inhibited the interaction of HMGB1 and TLR2, and blocked the downstream signaling of TLR2. In conclusion, blocking HMGB1 protected against doxorubicin induced cardiac injury by inhibiting TLR2 signaling pathway.

Objective To investigate the relative percentage of normal cognitive function (NCF),age associated memory impairment (AAMI),mild cognitive impairment (MCI) and Alzheimer's disease (AD) in the elderly,and the correlation between cognitive function and ApoE genotypes.Methods A total of 2666 elderly people aged ≥65 years (2132 males and 534 females)were divided into 3 groups according age:65-74-year age group (925 cases),75-84 year age group (1054 cases) and 85-100-year age group (687 cases).ApoE genotypes were determined in the controls and patients with AAMI and MCI.The degrees of fundus arteriosclerosis were detected in all subjects except for patients with AD.Results There were 867 cases with NCF,860 cases with AAMI and 782 cases with MCI.The incidence of AAMI was higher in 65-74-year age group than in the other two groups (42.0％ vs.31.1,20.96).The incidences of MCI and AD were higher in 85-100-year age group than in the other groups (42.5％,13.3％).The major degrees of fundus arteriosclerosis were Ⅰ+,Ⅰ-Ⅱ°,Ⅱ in subjects with AAMI (34.7％,x2=10.02,P＜0.01) and were Ⅱ °/ Ⅱ + / Ⅲ° in subjects with MCI (34.9 ％,x2 =23.39,P＜0.001).The APOEε4 allele frequency was significantly higher in patients with MCI than in the controls (x2=8.31,P＜0.05).However,no significant differences in APOEε4 allele frequency were found between patients with AAMI and the controls.Conclusions The incidence of AAMI is highest in 65-74-year age group,while the incidences of MCI and AD are highest in 85-100-year age group.Compared to patients with AAMI,the more serious fundus arteriosclerosis and higher allele frequency of APOEε4 appear in patients with MCI.

Objective To evaluate the efficacy and application value of retroperitoneal laparoscopic nephroureterectomy for localized and poor differentiated renal pelvic carcinoma by comparing with open nephroureterectomy.Methods Thirty-three pelvic carcinoma patients underwent radical nephroureterectomy were retrospeetively analyzed.All tumors were confirmed to be localized,stage T1-T3 and grade 3.Retroperitoneal laparoscopic nephroureterectomy was performed in 12 patients,the ureteral orifice was resected in traditional way through a small incision in lower abdomen.Open radical nephroureterectomy was performed in 21 cases.Clinical outcomes of the patients were compared between the 2 surgery groups.Results Mean operative time was 232 vs 212 min(P=0.100)and blood loss volume was 162 vs 233 ml(P=0.001)in the laparoscopic and open nephroureterectomy groups.Mean postoperative hospitalization was 7.6 vs 9.8 d(P＜0.001)for the laparoscopic and open groups.During the followup for 7-67 months,all the 33 patients survived.There was no recurrence or metastasis in laparoscopic group.While there was 1 retroperitoneal recurrence,and 3 cases suffering from superficial bladder cancer in open surgery group.Conclnsion Retroperitoneal laparoscopic nephroureterectomy may be performed safely in local renal pelvic carcinoma patients with poor differentiated tumors,with less intraoperative blood loss and early recovery.

Objective To learn the needs of family physicians for tertiary hospital support in the hierarchical medical system. Methods In July 2017 cluster sampling was made to 135 family physicians of Changning district of Shanghai for a " Family physicians needs questionnaire" . It covered such aspects as their demographic characteristics and their needs. The data so acquired were subject to descriptive and logical analysis. Results 99.3% of them need preferential appointment of specialists at tertiary hospitals;93.3% of them need preferential appointment of examinations; 82.2% of them need preferential outpatient visits; while 83.7% of them need preferential hospitalization and surgery scheduling. In terms of the approaches for preferential appointment of specialists, 84.4% of them prefer specialist appointment at short notice, and 73.3% of them need direct online appointment for large-scale device examinations at tertiary hospitals. In terms of mentoring scenarios, 62.2% of them prefer mentoring during outpatient rounds at fixed schedules of specialists in their community. Conclusions Tertiary hospitals are recommended to establish green pathways for referrals and priority measures in order to improve capabilities of family physicians and the shared platform in the hierarchical medical network. They are also expected to guide family physicians in their research paper writing, thus fully supporting the hierarchical medical system.