Objective To explore the establishment of skin photoaging model and the protective effects of nitroxide tempol on skin in guinea pig. Methods The guinea pig skin photoageing model was established by using solar-simulaten radiation (SSR). Dermal structure was observed with hematoxylin-eosin staining. The structure and expression of elastic fiber were analyzed by Weigert's staining. The uhrastructure of dermal fibroblasts and elastic fiber were observed by electron microscopy. Tempol was used before each exposure at the concentration of 5 mg/ml or 0. 5 mg/ml, and the protective effects of tempol on skin were assessed. Results After seventeen weeks' exposure, there was typical "solar elastosis" damage in the upper dermis. Mature elastic fibers were severely degraded and there was large amount of elastotic material accumulated in the upper dermis. Dermal fibroblasts appeared metabolically hyperactive and mitochondria in the cells were damaged. Some cells even broke up. Tempol at the concentration of 5 mg/ml or 0. 5 mg/ml could prevent photodamage of the photoageing model in the dermis, and Tempol at the concentration of 5 mg/ml had stronger protective effects. Conclusions Guinea pig can be applied as an useful animal model of skin photoageing. Antioxidant tempol has photoprotective effects on photodamage of the photoageing model in guinea pig and can be used as an anti-photoageing agent.

Objective To investigate the efficacy and safety of repeated botulinum toxin type A (BTX-A) treatment for Meige's syndrome in senile people. Methods Forty-eight senile patients with Meige's syndrome received BTX-A treatment for twelve times or over. The improvements of spasm were evaluated before and after the first, the sixth and the twelfth treatment according to Cohen's criteria. The onset time, effective duration and side effects were studied and compared among the three times treatments. Results The obvious effective rate of the three times treatment were all 100%. The average onset time of the three times treatments were (3.5± 1.7)days,(3.2±1.8)days and (3.3±1.9)days, and the average effective duration were (25.4±2.1)weeks,(24.6±2.3)weeks and (25.4±1.8)weeks, respectively. The incidences of side effects were 8. 3% (4/48), 6.3(3/48)%and 8.3%(4/48), respectively. All the differences were not statistically significant(P>0.05). Conclusions Repeated BTX-A treatment is an effective and safe method for Meige's syndrome in senile people.

Objective To evaluate the efficacy and safety of low-dose dexamethasone pretreatment regimen in prevention of hypersensitive reaction (HR) related to docetaxel in elderly tumor patients. Methods According to the order for admission and the ratio of 3:2, 91 elderly patients with docetaxel weekly therapy were randomly divided into two groups: experimental group and control group. All patients aged from 65 to 82 years with a median age of 68 years old. There were 54 patients in the experimental group and 37 patients in the control group. In the experimental group, patients received oral dexamethasone 4. 5 mg once daily on 1 day before treatment, the day of treatment and continuing for 3 days after treatment, while patients received 8 mg twice daily in the control group. All patients were scored according to MCIRS by the physician. The side effects were evaluated by NCI-CTCAE3.0. Results Four cases in the experimental group (7.4 %) and three cases in the control group (8. 1%) occurred HR, and there was no significant statistical difference (P=1. 000). Conclusions The low dose dexamethasone is efficient and safe compared with the conventional dose dexamethasone, and there is no significant difference in HR incidence between two groups.

Objective To investigate the relationship of lacunar infarction (LI) and white matter lesion with cognitive impairment in patients with subcortical ischemic vascular disease (SIVD) Methods Fifty-three patients were diagnosed as SIVD according to the criteria of Erkinjuntti. The symptoms and signs were recorded by an interview and examination, and neuropsychological assessment and magnetic resonance imaging (MRI) were performed. A semi-automated MRI quantitative method was used to measure the volume of white matter hyperintensity (WMH) and the number of LI was counted. Correlation and the partial correlation analysis were performed to examine the relationship of general cognitive function with the volume of WMH and the number of LI. Results The pseudobulbar paralysis symptom and the upper motoneuron injury sign were the most common in these patients (18.9% and 37.7%). Correlation analysis showed that there was positive correlation between the volume of WMH and age (r = 0. 518, P < 0. 05), and there was negative correlcction between mini-metal state examination (MMSE) scures and the volume of WMH (r=-0.514, P<0. 05), After controlling confounding factors, only age was positively correlated with the volume of WMH (r=0. 400, P=0. 004). There were negative correlation between the number of LI, the volume of WMH and MMSE scores(r=-0. 456,-0. 514,-0. 385,-0. 382;all P<0. 05), and the years of education was positively correlated with MMSE scores (r= 0. 518, P< 0. 001). Conclusions Age may not be the main risk factor for cognitive impairment in patients with SIVD. The volume of WMH and the number of LI are independent risk factors for cognitive impairment in patients with SIVD. Patients with severer SIVD or more LI show poorer performance on cognitive function.

Objective To explore the correlation between adiponectin/leptin(A/L) ratio and metabolic syndrome diagnosis in elderly men. Methods A total of 256 elderly men (≥60 years) were enrolled and divided into metabolic syndrome group(n= 109) and non metabolic syndrome group (n= 147). Serum levels of adiponectin and leptin were measured by radioimmunoassay (RIA) and the A/L ratio was calculated. Metabolic syndrome diagnosis is based on the definition provided by China Diabetes Society (CDS) in 2004. Results (1) In metabolic syndrome group versus non metabolic syndrome group, the serum levels of leptin and adiponectin were (10. 3±7.0) vs (6.8±4.9)μg/L and(7.8±5.6)g/L vs (9.5±5.9)g/L, and A/L ratio was 0. 94±0. 78 vs 2.15±2.13 respectively. (2) A/L ratio was positively correlated with high density lipoprotein cholesterol (HDL-C) and negatively correlated with body mass index (BMI), triacylglycerol (TG) and serum uric acid(P< 0. 001). (3) The higher value of A/L ratio, the lower possibility of metabolic syndrome. When the A/L ratio was more than 5, the incidence of metabolic syndrome was decreased to O(X2 =34. 891 ,P< 0.001). (4) The more components of metabolic abnormality, the lower value of A/L ratio(F= 10. 876,P<0. 001). Conclusions The A/L ratio may be useful in evaluating the extent of metabolic disorder and diagnosing metabolic syndrome in elderly men.

Objective To explore the key points of the diagnosis and treatment of severe pneumonia following renal transplantation in the elderly. Methods The clinical data of 28 patients with severe pneumonia following renal transplantation were retrospectively analyzed, including 20 cases aged <60 years (<60 years old group) and 8 cases aged ≥60 years (≥60 years old group). Results In <60 years old group, the severe pneumonia occurred during 1-13 months after the renal transplantation. All the patients had fever. 10 cases coughed and 8 cases had expectoration. 6 cases had type I respiratory failure (RF) and 3 cases experienced type 11 RF. 6 cases had lobar pneumonia and 13 cases occurred interstitial pneumonia. One case experienced lung consolidation. The pathogens of 16 cases in <60 years old group were identified, including 4 cases with bacterial pneumonia, 4 cases with cytomegalovirus (CMV) pneumonia, 2 cases with pneumocystis carinii pneumonia, Ⅰ case with mycoplasma infection, Ⅰ case with tuberculosis infection, and 4 cases with mixed infection (2 cases infected by bacteria plus CMV, 1 case by bacteria plus fungi and 1 case by bacteria plus tuberculosis). Combined drugs (broad-spectrum antibiotic, antivirus and antifungal agent) were administered on the initial stage and sensitive drugs were used later according to the pathogens. Hormone or immunoglobulin was used when other drugs were useless. 17 cases were cured and 3 cases died. In ≥60 years old group, the severe pneumonia occurred during 1-9 months after renal transplantation. All 8 patients had fever, too. 5 cases coughed and 3 cases had expectoration. 3 cases experienced type ⅠRF and 1 case experienced type Ⅱ RF. 3 cases had lobar pneumonia and 5 casesoccurred interstitial pneumonia. The pathogens of 5 eases were identified. Among them, 2 cases were affected by bacterial pneumonia, 1 case by CMV pneumonia and 2 cases by mixed pneumonia (one by bacteria plus CMV, one by bacteria plus fungi). Similar modality was applied, and 5 cases were cured and 3 cases died. Conclusions Most of severe pneumonia occur during 1-9 months after renal transplantation in the elderly. The main pathogens are bacteria and CMV. Medications for all of the most common pathogens and assisted ventilation should be used early. Specific narrow-spectrum antibiotic or antiviral drugs could be used quickly after pathogens were identified, and hormone or immunoglobulin could be administered to patients when the infection is severe or the pathogens are uncertain.

Objective To investigate the relationship between lipid abnormality and benign prostatic hyperplasia (BPH) in men receiving physical examination. MethodsFour hundred and one people who participated health examination in our hospital in May 2008 were included in the study. They were divided into two groups according to history of disease, IPSS score, the results of digital rectal examination and transrectal ultrasound: BPH group (192 cases) and no BPH group (209 cases). The blood lipid level and risk factors were compared in two groups. ResultsThere were no statistical differences in blood lipid level and risk stratification of cardiovascular disease between the two groups (TG:P=0. 698;TC:P=0. 654;LDL-C:P=0. 880; HDL-C:P=0. 531; risk stratification: P= 0. 251). IPSS score had no obvious correlation with blood lipid level (TG: P = 0. 054 ; TC: P =0. 149; LDL-C: P = 0. 427; HDL-C:P=0. 193) .Conclusions BPH complicated with lipid abnormality is common in the clinics, but the correlation between BPH and lipid abnormality in patients with light BPH is not so clear as that in patients with mild or severe BPH.

Objective To observe the effects of gossypol on expressions of transforming growth factor-β1 (TGF-β1), fibronectin (FN) and 11β-hydroxysteroid dehydrogenase (11β-HSD) in nephridial tissue in rats with diabetes mellitus. Methods Thirty male Sprague-Dawley rats were randomly divided into three groups: normal control, type 2 diabetes and gossypol treatment group . After high-fat feeding for 4 weeks, the later two groups were injected with low dosage strepozotocin (30 mg/kg) intraperitoneally to induce type 2 diabetic rat model. The rats in gossypol treated group were given gossypol at the dosage of 15 mg/kg once per day for 4 weeks by gavage. And since the 5th week, the times of gavages had been changed into once per week at the same dosage and lasted to the 12th week . The levels of blood glucose, total cholesterol (TC), low density lipoprotein-cholesterol (LDL-c) were measured. Additionally, the morphological changes of the kidney were studied by light microscopy and transmission electron microscopy respectively. The mRNA expressions of TGF-β1, FN, 11β-HSD and 11β-HSD2 in nephridial tissue were assayed by semi-quantity RT-PCR. The protein expressions of TGF-β1 and FN in nephridial tissue were determined by immunohistochemistry. Results The blood levels of glucose, TC and LDL- c were increased significantly in type 2 diabetic group compared with normal control group(P<0. 01). The volume of glomerulus and the deposition of PAS positive substance in the glomerular interstitium were increased under light microscopy, and the glomerular basal membrane was thicker in type 2 diabetic group than those in normal control group under transmission electron microscopy. The mRNA and protein expressions of TGF-β1 and FN were increased(P<0. 01), and the mRNA expression of 11β-HSD2 was decreased(P<0. 05), while the mRNA expression of 11β-HSD1 was unchanged in type 2 diabetic group compared with normal control group. After the treatment of gossypol, the level of the blood glucose was significantly decreased(P< 0. 01), and the levels of TC, LDL-c showed a trend of decrease but had no statistical differences compared with type 2 diabetic group. The morphology of nephridial tissue was ameliorated in gossypol treatment group. The mRNA and protein expressions of TGF-β1 and FN were decreased(0. 16± 0. 02,0. 22±0. 05 ; 0. 24±0. 06,0. 33±0. 07, P< 0. 05), while the mRNA expressions of 11β-HSD1 and 11β-HSD2 were unchanged compared with type 2 diabetic group. Conclusions Gossypol can relieve the pathologic changes of nephridial tissue, inhibit the expressions of TGF-β1 and FN through decreasing blood glucose of rats with diabetes mellitus.

Objective To retrospectively analyze clinicopathological features and prognosis effect of progesterone therapy in elderly patients with endometrial carcinoma. Methods Two hundred and thirty-five patients were divided into three groups according to age: 30-49 years old group (n=54), 50-59 years old group (n= 102) and 60-82 years old group (n= 79). The relationship between age and clinicopathological features was analyzed, and the prognosis effect of progesterone therapy in patients of 60-82 years old was assesed. Results The incidences of special pathological type of endometrial cancer (serous eystadenocarcinoma, clear cell carcinoma and squamous cell carcinoma) , operation-pathological stage ≥Ⅲ and low differentiation were increased with advancing age. The incidences of the above mentioned special pathological type of endometrial cancer were 20.4% (11/54), 38. 2%(39/63), 48.1%(38/79) in the three groups, respectively, and there were statistical significances among the three groups (χ<'2> = 10.039, P<0.01). The positive rate of progesterone receptor was significantly decreased in the three groups (57.4% (31/54)vs. 45.1% (46/ 102) vs. 25.3%(20/79), P<0. 01]. The remission rate of progesterone therapy was higher (18/23) than that of radiotherapy and (or) chemotherapy (4/8) (78.3% vs. 50%, Z= 1.46, P<0. 05). Conclusions The incidence of clinical pathological factors of endometrial cancer is increased with advancing age, and the prognosis of progesterone therapy is better than treatment with radiotherapy and (or) chemotherapy.

Objective To explore the risk factors for falls in patients with dementia. Methods Totally 118 patients diagnosed with dementia were divided into fails group and no fails group. The scores of mini-mental state examination (MMSE), clinical dementia rating (CDR) , activity of daily living scale (ADL), neuropsychiatric inventory (NPI) and unified Parkinson's disease rating scale (UPDRS) were compared between the two groups. The relationship between falls and their risk factors were analyzed by logistic regression model. Results The NPI and UPDRS scores were higher in falls group than in no falls group(t=2. 237,2. 213; both P<0.05). Multivariate analysis showed that dyskinesia and behavior disorders were significantly associated with an increased risk of falls (β=0.77 and 0.86, both P<0.05). Conclusions Dyskinesia and behavior disorders may be related to fails in patients with dementia and intervention measures of these risk factors are very essential.