Sarcopenia is a syndrome characterized by progressive and generalised loss of skeletal muscle mass and strength with a risk of adverse outcomes such as physical disability, poor quality of life and increasing risk of infection and mortality. Inadequate intake of nutrients (especially protein) might block muscle protein synthesis, and accelerate age-related sarcopenia progress. Age-related decline in skeletal muscle mass as well as muscle functions has been regarded as major health issues in elderly people. The domestic and foreign literature related to impact of nutritional intervention on muscle protein synthesis and muscle functions in elderly people were retrieved to evaluate the effect of nutritional intervention on muscle protein synthesis and muscle functions in elderly people.

[Summary] Traumatic brain injury ( TBI ) constitutes a major health and socioeconomic problem throughout the world . Increasing traffic accidents and aging of population promote the incidence of TBI .In patients with severe TBI mortality and disability rates are higher .And survivors may suffer physical activity , cognitive and psychological problems due to trauma , leading to shortened life span and higher risk of death than general population .They are also facing with long-term care and rehabilitation .This article reviewed the status and limitations on treatment of severe traumatic brain injury and its clinical significance .

Objective To investigate effect of standardized nutritional assessment, intervention, and monitoring on nutritional status of patients with cystic fibrosis (CF).Methods We recruited 6 consecutive patients with CF diagnosed from June 2005 to June 2015 in Peking Union Medical College Hospital, all given nutritional assessment and intervention.The clinical data and nutritional status of the patients were analyzed.Four cases were followed up, and their compliance and effect of nutritional intervention on their nutritional status were evaluated.Results The mean age of diagnosis of the patients was (19 ± 6) years.All the patients had recurrent onset of pulmonary infection and hypoxemia with varying degrees.The nutritional status was impaired in all the cases to different extent, with body mass index (BMI) of 3 patients under 20 years of age being lower than the third percentile of the standard growth curve for adolescents of the same age and sex.Mild microcytic hypochromic anemia existed in 2 cases, hypoalbuminemia in 2 cases (serum albumin ＜ 35 g/L in absence of liver or renal dysfunction), and decreased prealbumin level in 4 patients.The serum concentrations of Na, Cl, K, and Ca were approximately normal in all the 6 cases.Vitamin D level was detected in only 2 cases, all revealing vitamin D deficiency.High energy and high protein diet was suggested to all the patients, plus prescription of oral nutritional supplements for 5 patients.Diagnostic pancreatic enzyme replacement therapy (PERT) was performed in 3 patients who were suspected with exocrine pancreatic insufficiency (PI), together with fatsoluble vitamins supplementation including vitamin D3.Four CF patients were followed up for 11 to 39 months, of whom 1 was lost to follow-up after 11 months.During the follow-up period, 3 patients had progressive weight loss or growth retardation, and the other one patient failed to increase body weight.Dietary review of the 3 patients with available follow-up data revealed that actual energy intake and protein intake were only 46.1％-65.9％ and 44.1％-63.2％ of recommendation levels, respectively.By enhancing dietary education and guidance in follow-up, nutritional status of the patients was improved.Conclusion Intensive nutrition management, standardized nutritional intervention and monitoring, dietary guidance or enteral nutrition adjustment may constitute critical measures for improving nutritional status of CF patients.

Objective:To the effects of testosterone replacement therapy on muscle strength and function among the elderly (≥65 years old).Methods:We searched English and Chinese databases of PubMed, SinoMed, etc, upto July 4, 2020. All retrieved literatures were reviewed according to inclusion and exclusion criteria in accordance with PICOS principles. The Cochrane risk bias assessment tool was used for quality evaluation. Two researchers extracted data and evaluated literature quality independently. The outcomes included muscle strength (assessed by handgrip strength, leg extension strength, etc) and function (assessed by walking speed according to 6-minute walking test, 6MWT). Review Manager 5.3 software was used for statistical analysis. The fixed or random effects model was used to merge data of upper-and lower-extremity strength or 6MWT to produce forest plot and funnel plot. The subgroup analyses were conducted based on the characteristics of included studies. The sensitivity analyses were conducted for excluding literatures with small sample size, etc.Results:A total of 15 relatively high quality researches (14 English literatures and 1 Chinese literature) were included. The results of this meta analyses showed TRT could improve upper-extremity (0.21[0.11, 0.32]) and lower-extremity (0.34[0.12, 0.55]) muscle strength while not physical function (17.62[-13.06, 48.31]) among the elderly men. Subgroup analyses showed that region, source of participants, administration route and intervention period, while not the baseline testosterone level had effect on the pooled effect size. Funnel plot suggested a certain degree of publication bias. Sensitivity analyses revealed that the meta analyses were robust.Conclusion:TRT can improve muscle strength while not physical function among elderly men.

Objective To investigate the relationship between body mass index (BMI),total body fat (TBF),body fat distribution,and dyslipidemia in the elderly.Methods A total of 395 healthy elderly people who had annual examination at Peking Union Medical College Hospital were consecutively enrolled from October 2013 to March 2014.Body weight (BW),TBF,abdominal fat (AF),visceral fat (VF),visceral fat area (VFA) and waist-to-hip ratio (WHR) were measured with multi-frequency bioelectric impedance analysis.Serum triglyceride (TG),total cholesterol (TC),high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were measured at the same time.The relationship between BMI,TBF,body fat distribution,and dyslipidemia were analyzed.Results The incidences of obesity (17.8％ vs.9.6％,P=0.036),overweight (49.6％ vs.30.4％,P=0.000) and dyslipidemia (67.0％ vs.44.8％,P =0.000) in male were significantly higher than those in female;while female showed a significantly higher percentage of TBF (60.0％ vs.41.1％,P =0.001).TC was positively correlated with TBF (P =0.020),AF (P =0.018),VF (P =0.015) and VFA (P =0.017);TG was positively correlated with BMI (P =0.000),TBF (P=0.000),WHR (P=0.000),AF (P=0.000),VF (P=0.000) and VFA (P=0.000);LDL-C was positively correlated with BMI (P =0.049),TBF (P =0.005),AF (P =0.004),VF (P =0.003) and VFA (P =0.004);while HDL-C was negatively correlated with BMI (P =0.000),TBF (P=0.020),WHR (P=0.000),AF (P=0.021),VF (P=0.024) and VFA (P=0.022).Receiver operating characteristic curve analysis showed that the predictive curves of BMI,TBF,WHR,AF,VF and VFA were above the reference line.TBF (P =0.000),WHR (P =0.000),AF (P =0.000),VF (P =0.000),VFA (P =0.000),TG (P =0.000) and LDL-C (female:P =0.021) in obesity/overweight group were significantly higher than those in normal weight group.Conclusion Obesity/overweight,high TBF and large WHR may increase the risk of dyslipidemia in the elderly.

Objective To develop medical equipment suited for medical care.Methods The secondary auxiliary wings were added inside the original intravenous infusion dressing clips on the left and right,and then a new stereo magnetic infusion dressing came into being with the medical 3M sticking membrane and glutinous magnetic woundplast.Results The Stereo Magnetic Intravenous Infusion Dressing was gifted with the functions of observing,supporting,and fixing the sting area.The model successfully passed the animal experiments.Conclusion The new stereo magnetic infusion dressing,easy to use,can satisfy the requirements of medical care.

Objective: To explore the association of the serum levels of cytokine IL-10 with the occurrence of cachexia from patients with low-third gastric cancer. Methods: Radioimmunoassay was used to examine the serum levels of IL-10 in 150 patients with low-third gastric cancer and 135 healthy controls. Results: The serum levels of IL-10 were significantly higher in patients with low-third gastric cancer than controls(Z=-11.862, P<0.01). The serum levels of IL-10 were significantly higher in patients with low-third gastric cancer of clinical stageⅢ/Ⅳ than those with clinical stageⅠ/Ⅱ(Z=-10.028, P<0.01). The serum levels of IL-10 were significantly higher in patients with cachexia than those without(Z=-10.369, P<0.01). Logistic regression analysis showed that IL-10 was associated with odds ratios of 1.599 (95%CI:1.299-1.870, P<0.01) for cachexia. Conclusion: The serum levels of IL-10 are possibly associated with the occurrence of cachexia from patients with low-third gastric cancer.

BACKGROUND:Isoflurane cannot only induce a wide range of large neuronal apoptosis, but also inhibit hippocampal neurogenesis in neonatal rats, thereby resulting in hippocampus-dependent learning and memory defects.
OBJECTIVE:To investigate the isoflurane effect on proliferation and differentiation of the hippocampal neural stem cels.
METHODS:Twenty-six Sprague-Dawley rats were randomly divided into air group and isoflurane group (n=13 per group). Rats in the isoflurane group were subjected to 2.5% isoflurane inhalation for 3 minutes folowed by 1.5% isoflurane inhalation for 4 hours. Rats in the air group only breathed in air. After the intervention, blood glucose and arterial blood gas changes were detected in the two groups. Additionaly, rats in the two groups were given intraperitoneal injection of 5-bromodeoxyuridine before and after intervention. At 24 hours after the last injection of 5-bromodeoxyuridine, brain tissues were taken to make frozen sections for immunofluorescence staining.
RESULTS AND CONCLUSION:There were no significant difference in pH, PaO2, PaCO2, HCO3, BE and SaO2 levels between the two groups (P> 0.05). Compared with the air group, the number of BrdU+ cels was significantly less in the isoflurane group (P < 0.05), while the number of NeuroD+/BrdU+ cels was significantly higher in the isoflurane group (P < 0.05). The incidence of adverse reactions was 23% in the isoflurane group, which was significantly higher than that in the air group (7.7%;P < 0.05). These findings indicate that isoflurane can inhibit the proliferation of neural stem cels in the hippocampal dentate gyrus, and promote their differentiation into neurons.

Objective To investigate the clinical diagnostic significance of detecting T in peripheral blood lymphocyte subsets (CD4+,CD8+ and the ratio of pulmonary tuberculosis with diabetes) and explore drug therapy of the five thymus peptide combined anti-tuberculosis on the diabetes complicated with pulmonary tuberculosis.Methods Eighty cases of pulmonary tuberculosis complicated with diabetes mellitus were selected as our treatment subject,who were treated with anti-tuberculosis drug treatment and five thymus peptide regulating immunity treatment.T lymphocyte subsets (CD4 +,CD8 + and their ratio) were detected.Meanwhile acid-fast bacilli and image detection were performed.Another 80 cases were as our control group that treated with anti-tuberculosis drug.Results Following the thymus peptide five treatment for 1,2,and 6 months,T lymphocyte subsets were (CD4+:(34.34 ± 7.32) ％,(39.23 ± 6.62) ％,(41.06 ± 7.13) ％),(CD8+:(31.42 ±8.91)％,(32.52 ±8.58)％,(32.12 ±8.59)％),(CD4+/CD8+:(1.23 ±0.31),(1.34 ±0.30),(1.36 ± 0.32),higher than that of before treatment (30.26 ± 8.25) ％,(30.36 ± 9.86) ％,(1.13 ± 0.42) CD4 +.Through 2 months treatment,CD4+,CD4+/CD8+ of patient in treatment groups were different with that of control group (P ＜ 0.01 or P ＜ 0.05).80 patients after anti-TB plus application thymopentin regulating immunity for 2 months,normal sputum negative conversion rate of CD4+ was 97.2％ and improvement rate was 98.0％.However cases with high CD4+ T lymphocyte subsets showed 78.6％ negative rate of acid-fast bacilli and 88.0 ％ cured rate,and there was significant difference (x2 =4.764,7.680,respectively,P ＜ 0.05).Conclusion Thymic peptide five might have the ability of improving the cellular immune function in patients with pulmonary tuberculosis and diabetes.The prognosis is better when T lymphocyte subsets CD4+ of patient was back to normal through treatment.

To improve the oral medical students' entrepreneurial ability, in accordance with the requirements of national innovation and entrepreneurship training plan for the college students,Zhaoqing Medical College launches the entrepreneurship training project-establishing and managing private dental clinics, aiming at the development trend of China medical industry and professional characteristics. The project fully mobilizes students' initiative, enables them to learn how to establish, operate and manage the community oral clinic, stimulates students' entrepreneurial spirit and improves their ability.