It is important to explore the fundamental medical concepts which can enhance the overall quality of medical students in the department of geriatrics during clinical practice. These funda-mental medical concepts include medical humanistic spirit,holistic medicine,health management and patient-physician communication. Specific measures include improving emotional communication of clini-cal interns in department of geriatrics with elderly patients,training student's thinking as a whole towards multiple system disease in the elderly,training students to assess and manage elderly patients from a vari-ety of perspectives and improving doctor-patient communication skills by routine clinical teaching and teaching ward round. All these concepts will help improve the working ability and medical ethics of clini-cal interns and enable them to adapt to the clinical work quickly. So they can become qualified doctors.

Objective:To explore the correlation between serum cystatin C (Cys C)content and renal function in aged patients with benign prostatic hyperplasia (BPH).Methods:Clinical data of 237 aged BPH patients were retro-spectively analyzed.According to international prostate symptom score (IPSS),they were divided into mild group (n=25),moderate group (n=67)and severe group (n= 145);another 110 patients without prostatic hyperplasia were enrolled as normal control group in the same period.Levels of serum Cys C,blood urea nitrogen (BUN),ser-um creatinine (Scr),fasting blood glucose (FBG),blood lipids and prostate-specific antigen (PSA)were measured in all groups,and prostate volume (PV)was calculated.Results:Compared with normal control group,PV signifi-cantly rose [(18.94±4.62)ml vs.(40.09±12.72)ml],maximum urinary flow rate (Qmax)significantly reduced [(18.67±4.60)ml/s vs.(9.93±3.54)ml/s],and serum Cys C level significantly increased [(1.03±0.23)mg/L vs.(1.53±0.61)mg/L]in BPH group,P <0.01 all.Subgroup analysis indicated that serum Cys C levels in mild, moderate and severe group [(1.32±0.45)mg/L,(1.42±0.32)mg/L,(1.61 ±0.64)mg/L]were significantly higher than that of normal control group,P <0.01 all;and that of severe group was significantly higher than those of mild group and moderate group (P <0.01 or P <0.05).Pearson correlation analysis indicated that serum Cys C level was positively correlated with of age,SBP,DBP,FBG,BUN,Scr,PV and IPSS (r=0.179~0.580,P <0.05 or P <0.01),and inversely correlated with Qmax (r=-0.243,P <0.05)in BPH patients.Conclusion:Serum Cys C level significantly rise,and related with BPH degree,correlated with renal function in aged BPH patients,which can be used to predict renal function of these patients.

Objective To evaluate the accuracy of the patient positioning in prostate cancer therapy with the kilo-volt X-ray imaging system. Methods From June to August in 2014,14 patients with prostate cancer were treated by carbon ion beam with the Siemens proton and carbon ion equipment. X-ray orthogonal images was made twice by the imaging system before treatment. All the images were fused with the planning digitally reconstructed radiograph ones by automatic and manual method. We got positioning error data in six directions:lateral, longitudinal, vertical, isocentre, roll and pitch. The data were analyzed to study the situation. Results A total of 644 pairs of images from 14 patients were obtained during treatment. The average error in six directions is 0. 34 cm,0. 30 cm,0. 79 cm,0. 3°,1. 1° and 0. 5°.The patients′positioning error had no obvious change in all directions with fractions. There was no significant deviation between the two groups of images,either. But error in pitch and vertical direction is much larger. Conclusions The bony landmarks of the orthogonal filed images are clear. Photography lasts short time by the imaging system. DRR images are 3D and we can get images in six directions,but the development of soft tissue is weak. Positioning error we get cannot be match with the one of actual situation.

Objective To explore the effects of amlodipine,perindopril and valsartan on plasma adiponectin and retinol binding protein 4 in elderly patients with essential hypertension.Methods From March 2007 to July 2010,238 elderly patients with essential hypertension were selected and 193 cases completed this study.Patients were randomly divided into 3 groups:amlodipine group (n=68),perindoprilgroup (n=60) and valsartan group (n=65).Patients in each group were treated with amlodipine,perindopril and valsartan respectively for at least 12 weeks.The changes in blood pressure,heart rate,body height,body mass index (BMI),abdominal circumference,waist circumference (WC),levels of blood lipids,plasma adiponection and retinol binding protein 4 were observed before and after treatment.Results Compared with pre-treatment,systolic blood pressure in 3 groups were significantly decreased after treatment (all P＜0.01).There were no significant differences in blood pressure among 3 groups after treatment (all P＞0.05).Compared with pre treatment,plasma adiponectin level was significantly increased in perindopril group and valsartan group after treatment [(7.4±1.8) μg/L vs.(8.3± 1.8) μg/L,(7.5±1.7) μg/L vs.(8.4±1.9)μg/L,both P＜0.01].Plasma adiponectin level was higher in perindopril group and valsartan group than in amlodipine group after treatment [(8.3±1.8) μg/L vs.(7.6±1.8) μg/L,(8.4±1.9) μg/Lvs.(7.6±1.8) μg/L,both P＜0.05].Compared with pretreatment,plasma retinol binding protein 4 level in 3 groups were all decreased after treatment,and the decrements had significant differences in perindopril group and valsartan group (both P＜0.01) but had no difference in amlodipine group (P＞0.05).Plasma adiponectin retinol binding protein 4 levels were lower in perindopril group and valsartan group than in amlodipine group after treatment[(36.6± 14.2) μg/L vs.(42.7± 13.8) μg/L,(36.3±14.1) μg/L vs.(42.7±13.8) μg/L,respectively,both P＜0.01].Conclusions Perindopril and valsartan play important roles in cardiovascular protection beyond the antihypertensive effects by increasing plasma adiponection level and decreasing plasma retinol binding protein 4 level in elderly patients with hypertension.

Objective To explore the significance of serum cystatin C (Cys C)and β2-microglobulin (β2-MG) levels in blood and urine samples in hypertension grading and risk stratifying. Methods One hundred and thirty six cases with primary hypertension were enrolled into the study and classified into three grades and four risk stratifications. The serum Cys C levels were determined by ELISA assay. The blood and urine β2-MG were measured by radioimmunoassay. The serum BUN, Cr concentration were measured by the automatic biochemical analyzer. Results The positive rates of urine β2-MG were the highest index in patients with grade 1 (32%) and low risk hypertension( 8% ) ,followed by serum Cys C levels( grade 1 hypertension 24% ) ,compared with other indices( Ps ＜ 0. 05 ). With the blood pressure elevating, as well as the risk stratification increasing,serum Cys C level and the blood, urine β2-MG levels increased gradually by grading and stratifications (Ps ＜0. 05 or Ps ＜0. 01 ). We also found linear regression relationship between serum Cys C ,urine β2-MG levels and the risk stratifications of hypertension( r =0. 851 and r =0. 469 respectively,Ps ＜0. 01 ). The significant changes of serum BUN,Cr were only found in patients with grade 3 or very high-risk hypertension. Conclusion Joint detection of serum Cys C and urine β2-MG may help to detect early glomerular and tubular dysfunction in primary hypertension patients. Serum Cys C and blood, urine β2-MG levels are also related with the occurrence and development of hypertension,which show clinical significance in hypertension prognosis.

Objective To retrospectively analyze the relationship of the classification and risk stratification in senile hypertension with benign prostatic byperplasia (BPH).Methods Totally 376 male senior patients,including 233 senile hypertensive patients and 143 non-hypertensive patients as a control,were enrolled in this study.There were 35 cases of hypertension at level 1,82 cases at level 2,116 cases at level 3.Based on risk stratification of hypertension,there were 3 cases of low-risk,28 cases of medium risk,75 cases of high-risk,127 cases of very high risk.All candidates accepted the International Prostatic Symptom Score (IPSS) assessment before the treatment.Fasting blood glucose (FBG),total cholesterol (TC),triglycerides (TG),low density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol (HDL-C) and prostate specific antigen (PSA) were determined.Body mass index (BMI) and prostate volume (PV) were calculated.Relationship of classification and risk stratification in hypertension with BPH were analyzed.Results The levels of systolic blood pressurc (SBP),diastolic blood pressure (DBP),body weight,BMI,FBG and TC were higher (t=3.883,2.498,2.161,3.399,2.200,2.370,P＜0.05 or P＜0.01),while serum HDL-C were lower (t=2.036,P＜0.05) in hypertensive patients than in control group.Compared with the control group,IPSS and PV was increased (t =3.432,3.381,both P＜0.01) in hypertension group.Risk rate of hypertensive patients with BPH was 2.03 times (95％CI:1.33-3.11,P＜0.01) as compared with control group.In hypertensive patients,PV and IPSS were higher in level 2 or 3 grade group than in level 1 group (F=6.890,7.576,all P＜0.01).PV and IPSS in high risk and very high risk groups were enhanced as compared with those in low-medium risk group (F=30.608,19.804,all P＜0.01).Pearson analysis showed that PV was positively correlated with SBP,FBG and TC(r=0.223,0.251,0.305,all P＜0.05),while negatively correlated with HDL-C(r =-0.235,P＜0.05).Similarly,IPSS was positively correlated with SBP,DBP and FBG (r=0.396,0.273,0.224,all P＜0.01),while negatively correlated with HDL-C (r =-0.288,P＜ 0.01).Conclusions High incidence of BPH appears in the elderly men with hypertension.The increased PV and IPSS coexist with conventional risk factors of essential hypertension.Development of BPH is closely related to higher blood pressure and risk stratifications of hypertension.

Objective To investigate the relationship between alteration of gene in cyclic adenosine monophosphate(cAMP) signal transduction system in rats after myocardial damage and changes of cardiac function and ventricular remodeling. Methods Twenty eight male Wistar rats weighing 220 g to 250 g were randomly divided into three groups: acute myocardial damage group(AMD, n = 10), chronic myocardial damage group (CMD,n = 9 ) and sham-operation group (control, n = 9). Animal model of acute myocardial damage was established by ligation of rats left coronary artery in the AMD and the CMD groups. Rats in control group were treated similarly, except that the coronary suture was not tied. Hemodynamics and echocardiography were measured before rats were sacrificed 24 hours after operation in control and AMD groups but those in CMD groups were sacrificed 8 weeks later. Cadiocyte apoptosis were estimated by TUNEL method, cAMP levels in heart were tested by radioimmunity and the mRNA expressions for inducible cAMP early repressor (ICER), cAMP response element binding protein (CREB), phosphodiesterase 3A (PDE3A) and bcl-2 were assayed by real-time quantitative reverse transcriptase polymerase chain reaction (RT-PCR). Results The difference of left ventricular end diastolic diameter (LVEDD), left ventricular end diastolic pressure(LVEDP), maximal rising and falling rate of ventricular pressure,left ventricular systolic pressure (LVSP), eject fraction (EF) and fraction shortening (FS) were statistically significant among the three groups(F = 285.9, 196.8, 83.2, 80.4, 54.9, 196.6, 95.2, all P ＜ 0.01). LVEDD[(7.03 ±0.28), (8.20 ± 0.27)mm] and LVEDP[(11.19 ± 2.89), (19.76 ± 3.34)mmHg] in AMD and CMD groups were significantly increased, compared with those in control group[ (5.05 ± 0.30)mm, (- 5.62 ± 3.01 )mmHg, all P ＜0.01 ]. While maximal rising rate[ (2964 ± 449), (2214 ± 434)mmHg/s] and falling rate[(- 2617 ± 441),(- 1891± 424)mmHg/s] of left ventricular pressure, LVSP[ (94.19 ± 4.03), (85.85 ± 6.39)mmHg], EF[ (41.6 ±5.9)%, (35.9 ± 4.1 )%] and FS[ (36.9 ± 4.6)%, (23.1 ± 4.9)%] of left ventricular in the two groups were lower than those in control[(4759 ± 406)mmHg/s, (- 4327 ± 388)mmHg/s, (116.29 ± 8.25)mmHg, (80.9 ± 5.6)%,(53.1 ± 4.3)%, all P ＜ 0.01 ]. These changes in CMD group were more significant than those in AMD groups(P ＜0.05 or P ＜ 0.01 ). The difference of apoptotic index, cAMP and expression of ICER, CREB, PDE3A mRNA and bcl-2 mRNA were statistically significant among the three groups(F= 172.5, 141.0, 540.8, 246.8, 165.1, 563.9,all P＜ 0.01 ). Apoptotic index[ (32.8 ± 4.2)‰, (18.4 ± 3.9)‰] and cAMP in heart[ (9.95 ± 0.30), (5.60 ± 0.25)nmol/kg] in AMD and CMD groups were increased compared to control group[ (3.9 ± 1.7)‰, (2.48 ± 0.29)nmol/kg,all P ＜ 0.01 ], and those in CMD group were lower than in AMD group(all P ＜ 0.01 ). Expression of ICER mRNA (1.434 ± 0.093, 0.942 ± 0.076) and CREB mRNA(5.70 ± 0.50, 2.64 ± 0.51) in AMD and CMD groups were higher, and expression of PDE3A mRNA(48.98 ± 8.14, 16.68 ± 8.46) were lower than those in control group (0.154 ± 0.063, 1.08 ± 0.35, 105.94 ± 12.61, all P ＜ 0.01 ). The three genes in CMD group were fewer than those in AMD group(all P ＜ 0.01 ). bcl-2 mRNA was up regulated in AMD group(4.55 ± 0.27) and was down regulated in CMD group(0.35 ± 0.15) compared to control(2.18 ± 0.30, all P＜ 0.01). Conclusions There is PDE3A-ICER positive-feedback loop leading to myocyte apoptosis and heart failure after myocardial damage. The downregulation of PDE3A mRNA observed in chronic myocardial damage may play a causative role in the progression of ventricular remodeling and heart failure, in part, by inducing ICER mRNA and promoting cardiac myocyte dysfunction.

This study is to determine six chlorogenic acids (chlorogenic acid, 5-O-caffeoylquinic acid, 4-O-caffeoylquinic acid, 3,4-di-O-caffeoylquinic acid, 3,5-di-O-caffeoylquinic acid and 4,5-di-O-caffeoylquinic acid) by quantitative analysis of multi-components with a single marker (QAMS). Chlorogeinc acid was used as internal reference to calculate the relative correction factors (RCF) of five compounds. Then the ruggedness of relative correction factors was tested on different instruments and columns. Meanwhile, a total of 4 batches of Lonicerae Flos and 20 batches of Lonicerae Flos extract with five different processing procedures were analyzed by external standard method (ESM) and QAMS, respectively. The ruggedness of relative correction factors was good. And the analytical results calculated by ESM and QAMS showed no difference. The quantitative method established was suitable for the quality evaluation of Lonicerae Flos extract.
Biomarkers ; analysis ; Chlorogenic Acid ; analysis ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; analysis ; Flowers ; chemistry ; Lonicera ; chemistry

According to the designed specific primers of gene fragment based on the Salvia miltiorrhiza transcriptome data, a full-length cDNA sequence of SQS2 from S. miltiorrhiza f. alba was cloned by the method of reverse transcription polymerase chain reaction (RT-PCR). The SmSQS2 cDNA sequence was obtained, this sequence is named SmSQS2 and its GenBank registration number is KM244731. The full length of SmSQS2 cDNA was 1245 bp, encoding 414 amino acids including 5'UTR 115 bp and 3'UTR 237 bp. Sequence alignment and phylogenetic analysis demonstrated that SmSQS2 had relative close relationship to the SQS2 of S. miltiorrhiza. The induction of E. coli [pET28-SQS2] in different temperature, induction time, IPTG concentrations and density of inducing host bacterium (A600) were performed, Shaking the culture at 30 degrees C until the A600 is approximately 0.6 and add IPTG to final concentration of 0.2 mmol x L(-1), and then the optimal expression of SmSQS2 recombinant protein were accumulated after the induction time of 20 h. The research provided important base for the study of sterol and terpene biosynthesis of SQS2 in S. miltiorrhiza f. alba.
Cloning, Molecular ; Farnesyl-Diphosphate Farnesyltransferase ; chemistry ; genetics ; metabolism ; Models, Molecular ; Molecular Sequence Data ; Phylogeny ; Plant Proteins ; chemistry ; genetics ; metabolism ; Salvia miltiorrhiza ; chemistry ; classification ; enzymology ; genetics ; Sequence Alignment

AIMTo study the protective effect and mechanism of osthol on learning and memory impairment of mice with acute senile model induced by AlCl3.

METHODSAfter s.c. AlCl3 60 mg.kg-1 for 7 d and i.p. osthol 15 and 7.5 mg.kg-1 for 12 d, using step-through test and step-down test, the effect of osthol on learning and memory was observed and the glutathione peroxidase (GSH-PX) activities in blood and superoxide dismutase (SOD) activities in plasma and cerebrum were measured.

RESULTSOsthol 15 and 7.5 mg.kg-1 significantly improved the capability of memory and enhanced the activities of GSH-PX and SOD in AlCl3 treated mice.

CONCLUSIONOsthol shows protective effect on brain memory impairment of mice in acute senile model induced by AlCl3. Perhaps the mechanism is involved in enhancing the activities of GSH-PX and SOD, clearing away the free radical, protecting the brain neuron from the harm of lipoperoxide.

Acute-Phase Reaction ; Aging ; drug effects ; metabolism ; Aluminum Compounds ; pharmacology ; Animals ; Avoidance Learning ; drug effects ; Brain ; enzymology ; Chlorides ; pharmacology ; Cnidium ; chemistry ; Coumarins ; isolation & purification ; pharmacology ; therapeutic use ; Female ; Glutathione Peroxidase ; blood ; Male ; Memory Disorders ; chemically induced ; enzymology ; prevention & control ; Mice ; Plants, Medicinal ; chemistry ; Random Allocation ; Superoxide Dismutase ; metabolism