Abstract: Objective　To compare the different effects of body mass index (BMI) and lean body mass index (LBMI) on the risk of all-cause death among elderly Chinese individuals. For the more scientific, accurate and convenient measurement of the elderly physique, analysis and evaluation of the health risk factors of the elderly in China. Methods　This study is based on follow-up data from 2014 to 2018, involving 5 990 participants who met the inclusion criteria in the Chinese Longitudinal Healthy Longevity Survey. Participants were grouped according to their BMI and LBMI, and both univariate and multivariate Cox proportional hazard models were established to compare the effects of BMI and LBMI on the risk of death in the elderly. According to gender, age, activities of daily living, and comorbidities, subgroup analysis was conducted to study the influence of LBMI in different subgroups. Results　The study population predominantly comprised females (52.9%, 3 167/5 990), with an average age of (84.7 ± 10.1) years, and most participants lived in rural areas (55.1%, 3 298/5 990). A majority were non-smokers (82.7%, 4 952/5 990) and non-drinkers (84.3%, 5 050/5 990). The prevalence of hypertension was 32.8% (1 966/ 5 990), diabetes 5.6% (334/5 990), and heart disease 12.9% (774/5 990). In the analysis of the impact of BMI on all-cause death in the elderly, univariate analysis showed that an increase in BMI was associated with a reduced risk of mortality. After adjusted by multiple factors (age, gender, living environment, marital status, average arterial pressure, number of children, smoking, drinking, hypertension, diabetes, heart disease, cerebrovascular disease, tumor, ADL/IADL, number of complications), compared to the normal group, the emaciated group (BMI<18.5 kg/m2) had the highest risk of death (HR=1.15,95%CI: 1.01-1.30); the overweight group (24.0 kg/m2≤BMI<28.0 kg/m2) had a lower risk of death (HR=0.78, 95%CI: 0.67-0.91). In the analysis of the impact of LBMI on the risk of death in the elderly, compared to moderate LBMI, lower LBMI was associated with a higher risk of death. Multivariate analysis showed that compared with moderate LBMI, a decrease in LBMI increased the risk of death, whereas an increase in LBMI did not show statistically significant differences in mortality risk in the elderly. Conclusion　In measuring fitness and quality of life in the elderly, LBMI has better representativeness and practical value.

AIM:To study the effect of acyl coenzyme A:cholesteryl acyltransferase 1(ACAT1)antisense oligonucleotides on the formation of foam cells(FC).METHODS:THP-1 cells were cultured and differentiated into macrophages(MP)by phorbol myristate acetate(PMA).Over-expressing ACAT1 gene THP-1 cells were constructed.The ACAT1 antisense and missense oligonucleotides conducted by LipofectamineTM 2000 were incubated with above cells.Ac-LDL was added 6 h later and incubated for 24 h.The expression of ACAT1 protein was detected by Western blotting.The ACAT activity was measured by quantifying the incorporation of 1-14C oleoyl CoA into cholesteryl esters.The formation of foam cells was detected by oil red O staining.RESULTS:The ACAT1 antisense oligonucleotides inhibited the activity of ACAT in macrophages and over-expressing ACAT1 gene THP-1 cells.It also inhibited the formation of foam cell in macrophages and over-expressing ACAT1 gene THP-1 cells with lipid loading.The missense oligonucleotides did not show the inhibitory effects.CONCLUSION:The ACAT1 antisense oligonucleotides inhibit the activity of ACAT and the formation of foam cells.

Objective To study the distribution of body constitutions of CHD patients with blood stasis syndrome;To explore the relationship between different body constitutions and their blood lipid levels.Methods WANG’s Constitutional Classification was used to diagnose body constitutions of 600 CHD patients with blood stasis syndrome, and analyze the relationship between the different body constitutions and triglyceride (TG) level, low density cholesterol (LDL-C) level, high density cholesterol (HDL-C) level.Results The four most common body constitutions of CHD patients with blood stasis syndrome in Taiyuan area were the constitutions of blood stasis, yang deficiency, qi deficiency and yin deficiency. The TG levels of the four body constitutions were higher than those of healthy people (P<0.01), but there was no obvious difference among TG levels of different body constitutions. The LDL-C level of the patients with the body constitution of blood stasis was higher than that of patients with other body constitutions and healthy people (P<0.01). Compared with healthy people, there was no obvious difference among HDL-C levels of different body constitutions (P>0.05).Conclusion There is a certain difference among the blood lipid levels in different body constitutions of CHD patients with blood stasis syndrome, and the patients of blood stasis syndrome with high LDL-C level are more dangerous than patients with other body costitutions.

This article was aimed to study the distribution and effects of apolipoprotein E (ApoE) gene polymorphism of different constitutional types among coronary heart disease (CHD) patients with blood stasis syndrome on vascular endothelial cell (VEC) function. The whole gene sequencing method was used to identify genotypes of ApoE gene among 556 CHD patients with blood stasis syndrome, in order to analyze the relationship between polymorphism of ApoE gene and the level of VEC function. The results showed that the frequency of E3/3 genotype of each physical group was significantly lower than that of the healthy group; and the frequency of E3/4 genotype was significantly higher than that of the healthy group. In addition, the frequency of E3/3 genotype in qi deficiency constitution group was higher than that of blood stasis constitution group and yang deficiency constitution group; but the frequency of E3/4 genotype in blood stasis constitution group and yang deficiency constitution group was higher than that of the qi deficiency constitution group. The levels of ET and ET/NO in each of genotype groups of blood stasis constitution, yang deficiency constitution, qi deficiency constitution of CHD patients with blood stasis syndrome were higher than that of the healthy group (P < 0.05). In the genotype group of blood stasis constitution of CHD patients with blood stasis syndrome, the frequency of E3/4+E4/4 genotype ET was higher than that of other genotypes (P < 0.01). The levels of ET, NO, ET/NO in genotype groups of yang deficiency constitution and qi deficiency constitution of CHD patients with blood stasis syndrome were not significantly different. It was concluded that ApoE genotype E3/4, E3/3 may be the susceptible genotypes of blood stasis syndrome in CHD. There is a certain difference among different constitutional types. CHD with blood stasis syndrome patients, who are the constitution of blood stasis, carrying the ApoE gene polymorphism of E4 allele may have the function of increasing the ET level.

Three-parent test tube baby technology is important to solve the mitochondrial genetic disease.Once available,it raises greatly ethical controversy such as breaking traditional family values,hitting the religious belief,existing unknown risks,correctly handling the failed embryo,as well as the influence on the social status of the babies.Regarding these controversy,we can discuss it from several aspects.Because the development of ethics is behind the progress of science and technology,we should affirm the value of three-parent test tube baby technology and balance the development of science and technology with respecting the religious beliefs.Strict supervision system and standard application system reflect our respect for life.Incomprehension to the unknown things should become the motivation of our inquiry.We should face up to our fear of three-parent test tube baby technology,and thus to strengthen research and deepen understanding.Based on the above argument,this paper puts forward the ethical principles that should be followed in the development of three-parent test tube baby technology,namely respect,benefit,no harm and justice.

Objective To examine the effect and mechanism of different targets of glucose control on liver damage in rats with sepsis .Methods The rat sepsis model was established by cecal ligation and puncture (CLP) .Forty Sprague‐Dawley rats were randomly divided into five groups (eight rats to each group):sham operation (sham group) ,sepsis (CLP group) ,glycemic control A group (glucose target 4 .6‐6 .1 mmol/L ) ,glycemic control B group (glucose target 6 .2‐8 .3 mmol/L ) and glycemic control C group (glucose target 8 .4‐10 .0 mmol/L) .The animals were sacrificed 12 hours after CLP .Venous blood was sampled for testing alanine transaminase (ALT ) , aspartate transaminase (AST ) and free fatty acid (FFA ) . Peroxisome proliferator activated receptor‐α (PPAR‐α) and liver carnitine palmitoyltransferase 1 (CPT‐1 ) protein were determined by immunohistochemistry .The pathological changes of liver tissue was observed under an optical microscope .Results The levels of ALT ,AST and FFA in venous blood and the pathological tissue injury score in sepsis groups were higher than those in sham group and all glycemic control groups (P<0 .05) .However ,the level of these markers significantly decreased in group A than those in group B or group C (P<0 .05) ,and lower in group B than those in group C (P< 0 .05) .PPARα and liver CPT‐1 expression levels were lower in sepsis group than those in sham group and all glycemic control groups except group C (P>0 .05) .The levels of PPARαand liver CPT‐1 were significantly higher in group A than in group B or group C (P<0 .05) ,and lower in group C than in group B(P<0 .05) .Conclusions The lowest target of glucose control(4 .6‐6 .1 mmol/L)shows better protective effects on liver damage in rats with sepsis ,the mechanism of which may be related to upregulation of PPARα and liver CPT‐1 expression .

Objective To explore the effects of reconstruction and shaping of thumb or finger defects by free second-toe transfer and one stage appearance remodeling.Methods From October,2007 to August,2013,128 thumb or finger Ⅴ degree defect of 109 cases were reconstruct with free second-toe transfer,and one stage shape remodeling at the same time.Among them,20 fingers by nail bed expand one stage; 23 fingers were nail bed expand added on toe pulp splayed resection on both sides; 29 fingers were added on embedded the philp island flap of great toe to the section of plantar side narrow part in the second digit,19 fingers were added on embedded the abdominal phil chamfered-edge-shape flap to that narrow part in the second digit,and 37 fingers added on toe pulp resection and embedded the philp island flap of great toe to that narrow part.Results All reconstructed thumb or fingers survived and appearance were good.The nail shape of reconstructed thumb or fingers were improved obviously,the shape of narrow part in middle segment was recovered satisfactorily.Seventy-nine cases (72.5％) were followed-up from 3 months to 5 years,and the other 30 cases (27.5％) were lost.The function of the reconstructed thumb or finger and hand feeling was ideal recovered.There were no claudication,no pain and no other sequelaes for donor foot.According to the Standard on Approval of Reconstructed Thumb and Finger Functional Assessment of Chinese Medical Association,43 cases excellent,26 cases good,10 cases approve.The rate of excellent and good was 87％.Conclusion Second-toe transfer and shape remodeling is a good method of thumb or finger reconstructing.The appearance of the thumb reconstruction can be improved obviously.Preoperative carefully design and the combination of the above several kinds of operation,for draw up an personalized surgical program is necessary.

Objective To retrospectively analyze the result of hemoglobin(Hb)test by using full-automatic Hb electrophoresis and evaluate the its significance in hemoglobinopathy.Methods The data of patients who underwent Hb electrophoresis test and regular blood tests in the hospital from January 2011 to December 2013 were included in the study.The test results were recorded including mean corpuscular volume(MCV),mean corpuscular hemoglobin(MCH)and results of Hb electrophoresis test.Final diag-nosis were made for suspected patients by using genetic testing,then disease detection rates and gene coincidence rates and constitu-ent ratios were calculated.Results 12 898 cases were included in the study,after statistical analysis the MCV was(85.32±13.61) fL,MCH was(29.87±6.44)pg.By using automatic hemoglobin electrophoresis,1 315 cases were found to be positive,in which 568 were male,747 were female,the detection rate was 10.19%.In the 1 315 patients,there were 761 cases suspectedα-thalassemia,ac-counted for 5.90%.There were 495 cases of suspectedβ-thalassemia,accounted for 3.84%,11 patients with HbJ(0.08%),15 pa-tients with HbK(0.12%),9 patients with HbG(0.07%),3 patients with HbD(0.02%),21 patients with HbE(0.16%).The sus-pected case′s final diagnosis were made by using genetic testing,α-thalassemia gene′s coincidence rate was 80.55%,β-thalassemia gene′s coincidence rate was 96.77%.Conclusion Automatic hemoglobin electrophoresis detection is of great significance for the di-agnosis of hemoglobinopathy.

Objective To observe the effect of pulsed electromagnetic fields(PEMFs)of different daily treatment durations on biomechanical properties of femur in ovariectomized rats,so as to find out the optimal daily treatment time.Methods Fifty female Sprague-Dawley rats were randomly divided into five groups:(1)SHAM control(no PEMFs treatment),(2)OVX control(no PEMFs treatment),(3)OVX I(PEMFs treatment at 8Hz fre- quency with 3.8 mT intensity,20 min daily for 30 days),(4)OVX 11(PEMFs treatment at 8 Hz frequency with 3.8 mT intensity,40 min daily for 30 days),and(5)OVXⅢ(PEMFs treatment at 8Hz frequency with 3.8 mT in- tensity,60 rain daily for 30 days).All the rats were subject to bilateral overiectomy except those in the SHAM control group.The biomechanical properties of the femur were assessed after 30 days of PEMFs treatment.Results The values of the parameters of the biomechanical properties obtained with the OVX control group were significantly lower than those of the other 4 groups(P0.05).Conclusion PEMFs of the three different daily treatment durations can maintain the biomechanical properties of the femur in ovariectomized rats.Under certain in- tensity(3.8 mT)and frequency(8 Hz),PEMFs of the three different treatment durations can significantly maintain biomechanical properties of femur in ovariectomized rats approximately to the nomal level,but among the three groups,the difference is not significant.It was shown that exposure to PEMFs for 20 to 60 minutes daily had similar effect of maintaining biomechanical properties of the femur in ovariectomized rats.