Falls in an elderly require a comprehensive bio-psycho-social approach to evaluate for the root causes. These may be multi-factorial, and we need to deal with most of them, if not all, in order to effectively reduce the risk for falls. Frailty is a marker of poor functional outcomes. Sarcopenia is a major modifiable risk factor for frailty. There are various community programmes providing a comprehensive range of services to keep the elderly physically, mentally, and socially active. Communication with primary care physicians is important to ensure smooth transition back into the community, optimal management of chronic diseases and minimal re-admission.

BACKGROUND:For patients in intensive care unit (ICU), mechanical ventilation is an effective treatment to survive from acute illness and improve survival rates. However, long periods of bed rest and restricted physical activity can result in side effects. This study aimed to investigate the feasibility of early rehabilitation therapy in patients with mechanical ventilation. METHODS:A randomized controlled trial was carried out. Sixty patients, with tracheal intubation or tracheostomy more than 48 hours and less than 72 hours, were admitted to the ICU of the Affiliated Hospital of Medical College, Qingdao University, from May 2010 to May 2012. These patients were randomly divided into a rehabilitation group and a control group. In the rehabilitation group, rehabilitation therapy was performed twice daily, and the training time and intensity were adjusted according to the condition of the patients. Early rehabilitation therapy included heading up actively, transferring from the supine position to sitting position, sitting at the edge of the bed, sitting in chair, transferring from sitting to standing, and ambulating bedside. The patient's body mass index, days to first out of bed, duration of mechanical ventilation, length of ICU stay, APACHE Ⅱ score, highest FiO2, lowest PaO2/FiO2 and hospital mortality of patients were all compared between the rehabilitation group and the control group. The differences between the two groups were compared using Student's t test. RESULTS:There was no significant difference in body mass index, APACHE Ⅱ score, highest FiO2, lowest PaO2/FiO2 and hospital mortality between the rehabilitation group and the control group (P>0.05). Patients in the rehabilitation group had shorter days to first out of bed (3.8±1.2 d vs. 7.3±2.8 d; P=0.00), duration of mechanical ventilation (5.6±2.1 d vs. 12.7±4.1 d; P=0.005) and length of ICU stay (12.7±4.1 d vs. 15.2±4.5 d; P=0.01) compared with the control group. CONCLUSION:Early rehabilitation therapy was feasible and effective in improving the outcomes of patients with mechanical ventilation.

OBJECTIVETo explore the feasibility of IGF2 imprinting system in target gene therapy for tumors.

METHODSThe mouse H19 enhancer, DMD and promoter H19 were amplified by PCR from mouse genomic DNA and then cloned into the plasmid pDC312. The EGFP and DT-A fragments were amplified by PCR and cloned into the recombinant plasmid, and then the shuttle plasmid were transfected into HEK293 cells together with the adenoviral vector Ad5, namely, Ad-EGFP and Ad-DT-A. Adenovirus hexon gene expression was applied to confirm the presence of adenovirus infections. The effect of the IGF2 imprinting system was tested by fluorescence microscopy. RT-PCR and Western blotting after transfection of the recombinant adenoviral vectors into cancer cells were used to show loss of IGF2 imprinting (LOI) and maintenance of IGF2 imprinting (MOI), respectively. The anti-tumor effect was assessed by MTT and flow cytometry after the HCT-8 (LOI). Human breast cancer cell line MCF-7 (MOI) and human normal gastric epithelial GES-1 (MOI) cell line were transfected with Ad-DT-A in vitro. The anti-tumor effect was detected by injecting the Ad-DT-A in nude mice carrying HCT-8 tumors.

RESULTSThe expression of EGFP protein, DT-A mRNA and DT-A protein were seen to be positive only in the HCT-8 tumor cell line. Infection with Ad-DT-A resulted in obviously growth inhibition in HCT-8 cells (75.4 ± 6.4)% compared with that in the control group, and increased the percentage of apoptosis in the HCT-8 cells (20.8 ± 5.9)%. The anti-tumor effect was further confirmed by injecting the recombinant adenoviruses in HCT-8 tumor-bearing nude mice, and the results showed that the Ad-DT-A inhibited the tumor growth, with on inhibition rate of 36.4%.

CONCLUSIONSThe recombinant adenoviruses carrying IGF2 imprinting system and DT-A gene have been successfully constructed, while Ad-DT-A can effectively kill the tumor cells showing loss of IGF2 imprinting. It might play an important role in future target gene therapy against malignant tumors based on loss of IGF2 imprinting.

Adenoviridae ; genetics ; Animals ; Apoptosis ; Breast Neoplasms ; genetics ; pathology ; Colonic Neoplasms ; genetics ; pathology ; therapy ; Diphtheria Toxin ; biosynthesis ; genetics ; Female ; Genetic Therapy ; methods ; Genetic Vectors ; Genomic Imprinting ; Green Fluorescent Proteins ; biosynthesis ; genetics ; Humans ; Insulin-Like Growth Factor II ; genetics ; metabolism ; MCF-7 Cells ; Mice ; Mice, Nude ; Neoplasm Transplantation ; Peptide Fragments ; biosynthesis ; genetics ; Plasmids ; RNA, Messenger ; metabolism ; Random Allocation ; Recombinant Fusion Proteins ; biosynthesis ; genetics ; Transfection

To study the constituents from the chloroform extract of the roots of Lasianthus acuminatissimus Merr., various chromatographic techniques were used to separate and purify the constituents. The structure was established on the basis of ID, 2D NMR and HRMS spectroscopic analysis. A new compound was isolated and identified, which was 3, 8-dihydroxy-1-methoxy-2-methoxymethyl-9,10-anthraquinone (I). Compound I is a new anthraquinone, namely lasianthurin.
Anthraquinones ; chemistry ; isolation & purification ; Chromatography, Thin Layer ; Magnetic Resonance Spectroscopy ; Molecular Conformation ; Molecular Structure ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Rubiaceae ; chemistry ; Spectrometry, Mass, Electrospray Ionization

OBJECTIVE: To observe the changes of cardiac functional indicators in spontaneously hypertension rats (SHR) suffered by struck injuries of soft tissues, form which to discuss the significance in relationship between injury and disease. METHODS: SHRs were divided into four groups according to the degree, and whose thigh was struck with the homemade hit instrument. Then the blood pressure, heart rate as well as serum biochemical indicators (CK, CK-Mb, LDH, Cr, BUN, HBDH and AST) were examined. In addition, the morphological changes of heart, brain and kidney were also observed. RESULTS: The observe values of heart rate and blood pressure of SHRs seemed have relation to the degree of damage, but there were no statistically significance between different hit degree groups. In terms of serum biochemical indicators, all seven indicators of the hit group had significant difference with that of the control group, and the AST CK, CK-MB levels were difference between the group of different strike degree. CONCLUSIONS Struck injuries of soft tissues can result in forepart damage of cardiac muscle. The biochemical indicators reflect the degree of injury, and they could be used as a type of objective enzymology indicators for analysis of the relationship between injury and disease in forensic practice.
Animals ; Aspartate Aminotransferases/blood* ; Biomarkers/blood* ; Blood Pressure ; Creatine Kinase/blood* ; Female ; Heart/physiopathology* ; Heart Rate ; Hindlimb/injuries* ; Hypertension/physiopathology* ; Kidney/physiopathology* ; Male ; Myocardium/pathology* ; Random Allocation ; Rats

OBJECTIVETo investigate the expression and relationship between HSP70 and caspase-3 in knee osteoarthritis.

METHODSForty adult SD rats were divided into experimental group and control group. Thirty rats in experimental group, anterior cruciate ligament transaction (ACLT) was cut off and partial meniscectomy of 1/3 inside incision were performed to reproduce knee osteoarthritis (KOA) model according to Hulth methos, and the other 10 rats was treated with nothing as control group. The rats were sent to the cage and free to move. At 1, 2 and 4 weeks later, the arthritis cartilage of femoral and tibial end were observed through immunohistochemistry staining and light microscope. Meanwhile, Mankin scale system was adopted for histomorphology evaluation.

RESULTSChanges of KOA such as hyperplastic synovium,erosion on the surface of cartilage and so on were found in experiment group, the expression of HSP70 was augmentation all the time, but the expression of caspase-3 was reduction 1 week later; no similar changes were found in control group. Mankin scale system showed that there were significant differences in the first week as compared with the second week and 4th week (both P < 0.01).

CONCLUSIONHeat shock protein inhibit the apoptosis of cartilage cells and protect the cartilage cells in knee osteoarthritis, the conservative treatment for clinical provide objective scientific basis.

Animals ; Apoptosis ; Cartilage ; pathology ; Caspase 3 ; physiology ; Chondrocytes ; pathology ; Female ; HSP70 Heat-Shock Proteins ; physiology ; Male ; Osteoarthritis, Knee ; pathology ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo investigate body weight and the body mass index (BMI) in girls with adolescent idiopathic scoliosis (AIS).

METHODSSix hundred and thirteen AIS female patients admitted from January 2005 to January 2007 and 449 healthy girls were recruited for this study with a range of age from 12 to 16 years old. The direct indexes included body height, body weight and date of birth. The indirect indexes included corrected body height, BMI and corrected BMI. The corrected body heights of AIS patients were adjusted by using the greatest Cobb angle to correct for spinal deformity according to Bjure's formula. Two-tailed Student's test was used for group comparison.

RESULTSIn the AIS patients, the maximum Cobb angle was (31 +/- 11) degrees (11 degrees to 77 degrees). The corrected body height were significantly higher in AIS patients than in the normal controls from 12 to 16 years old (P < 0.05). The body weight were significantly lower in AIS girls than in normal controls from 12 to 16 years of age (P < 0.01). From 12 to 16 years of age, the BMI were (17.6 +/- 1.9), (17.9 +/- 2.5), (17.9 +/- 2.1), (18.6 +/- 2.3) and (19.0 +/- 1.9) kg/m2 in AIS patients; while the BMI were (19.5 +/- 3.4), (19.8 +/- 3.0), (20.4 +/- 2.9), (20.4 +/- 2.8) and (20.2 +/- 2.2) kg/m2 in normal controls. The BMI were significantly lower in AIS girls than the normal controls from 12 to 16 years of age (P < 0.001).

CONCLUSIONSAfter the onset of puberty, significantly longer corrected height, lower body weight and lower BMI were found in AIS patients. Results of this large-scale study revealed the presence of abnormal growth in AIS patients during peripubertal development.

Adolescent ; Body Height ; Body Mass Index ; Body Weight ; Child ; Female ; Humans ; Kyphosis ; physiopathology ; Scoliosis ; physiopathology

OBJECTIVETo evaluate the early outcomes of children with congenital scoliosis treated by one-stage transpedicular hemi-vertebra resection.

METHODSFrom July 2005 to June 2006, 27 consecutive cases of congenital scoliosis managed by one-stage transpedicular hemi-vertebra resection with instrumentation were investigated retrospectively. There were 11 girls and 16 boys, with a mean age of 5.5 years at surgery (range 1.3 - 10.0 years). Location of the hemi-vertebra was in the thoracic spine in 12 cases and in the lumbar spine in 15 cases. Radiographic evaluations were performed on the preoperative, postoperative, and latest follow-up standing posteroanterior and lateral radiographs.

RESULTSThe average operation time was 4 hours (range 3-6 hours), and the mean blood loss during operation was 750 ml (range 300 - 2200 ml). The mean fusion level was 2 to 7 segments, average 4.4 segments. The average follow-up period was 16 months (range 12 - 34 months). Mean Cobb angle of the total main curve was 40.0° before surgery, 12.6° after surgery, and 15.2° at latest follow-up. Mean Cobb angle of the segmental main curve was 35.6° before surgery, 11.6° after surgery, and 12.1° at latest follow-up. The trunk shift was improved from 16.5 mm before operation to that of 7.5 mm after the operation and 7.6 mm at the latest follow-up. Compensatory cranial curve improved from 19.4° before surgery to 8.9° after surgery, and compensatory caudal curve improved from 26.3° to 12.8°. The angle of segmental kyphosis was 26.4° before surgery and 14.6° after surgery in cases with thoracic hemivertebrae, and averaged 11.2° before surgery and 3.9° after surgery in cases with lumbar hemivertebrae. Peri-operative complications included two pedicle screws malpositioning and one case with pelvic tilt. There was no neurological complication.

CONCLUSIONOne-stage transpedicular hemi-vertebra resection with instrumentation has a good capability of correcting deformity on the frontal and sagittal planes, which is available in children with middle or lower thoracic or lumbar hemivertebrae.

Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Infant ; Lumbar Vertebrae ; abnormalities ; surgery ; Male ; Retrospective Studies ; Scoliosis ; congenital ; surgery ; Thoracic Vertebrae ; abnormalities ; surgery ; Treatment Outcome

OBJECTIVETo evaluate the efficacy of preoperative Halo-femoral traction in the treatment of rigid idiopathic scoliosis.

METHODSSixteen patients with rigid idiopathic scoliosis treated with Halo-femoral traction before posterior spine fusion from July 2003 through May 2006 were studied retrospectively. There were 4 male and 12 female, with a mean age of 16 years (range, 12-20 years). The coronal Cobb angles of coronal major curve and the thoracic kyphosis (T(5)-T(12)) were 111 degrees and 64 degrees, respectively. All the patients underwent preoperative Halo-femoral traction. After the maximum weight traction for 2-3 weeks, a posterior instrumentation and fusion was performed. The correction rate of coronal major curve on preoperative side bending film, on supine film after Halo-femoral traction and after surgery was compared.

RESULTSThe maximum traction weight averaged 19 kg. All patients had an at least 12-month follow-up. One patient experienced transient brachial plexus palsy and complete recovery was achieved after reducing the traction weight. No neurologic complication, death and respiratory failure occurred after surgery. In comparison to the correction rate of 18.7% on preoperative side bending film, the correction rate of coronal major curve after Halo-femoral traction increased by 13.2% (P < 0.05). The postoperative correction rate of coronal major curve and thoracic kyphosis was 48.6% and 51.9%, respectively. At the final follow-up, the coronal and sagittal correction loss averaged 2.0% and 5.8%, respectively.

CONCLUSIONSPreoperative Halo-femoral traction combined with intraoperative posterior spinal release can significantly enhance the correction rate for rigid idiopathic scoliosis. However, the traction complications should be worthy of vigilance.

Adolescent ; Child ; Female ; Follow-Up Studies ; Humans ; Male ; Retrospective Studies ; Scoliosis ; surgery ; Spinal Fusion ; Traction ; methods ; Young Adult

OBJECTIVETo investigate the impairment pattern and the influencing factors of pulmonary function in patients with Marfan and Marfanoid syndrome associated scoliosis (MS).

METHODSIn this retrospective study, totally 25 MS patients (aged 11 - 20 years, 11 boys and 14 girls) who received posterior instrumentation and fusion (Group A) and 38 adolescent idiopathic scoliosis (AIS) patients (Group B) (aged 10 - 19 years, 11 boys and 27 girls) were included from February 1998 to September 2007. The curve pattern was matched in both groups. The preoperative pulmonary function test (PFTs) were compared in two groups. And the parameters influencing the preoperative pulmonary function were analyzed in group A.

RESULTSIn Group A, the Cobb angle of thoracic curve was negatively correlated with the percentage of predicted pulmonary volumes (VC%, FVC% and FEV1%) (r = -0.514, -0.503, -0.464, P < 0.05). And the reduction of lung function parameters (VC%, FVC%, FEV1% and MMEF%) was more severe in Group A than in Group B with compared magnitude of thoracic curve (P < 0.05). In Group A, the extent of impairment of pulmonary function in patients with the number of vertebrae involved ≥ 8 were more severe than those involved < 8 vertebrae (P < 0.05). However, there was no significant difference of deterioration of lung function between the higher apex (T₄₋₈) subgroup and lower apex (T₉₋₁₂) subgroup. And no correlation was found between thoracic kyphosis and the degrees of impairment of respiration function.

CONCLUSIONSPatients with MS have mixed ventilation dysfunction, which is more severe than AIS patients with matched age and Cobb angle. The pulmonary dysfunction in MS patients can be influenced by the severity of thoracic curve and the number of involved vertebrae.

Adolescent ; Child ; Female ; Humans ; Lung ; physiopathology ; Male ; Marfan Syndrome ; complications ; physiopathology ; Respiratory Function Tests ; Retrospective Studies ; Scoliosis ; complications ; physiopathology ; Young Adult