Objective To investigate the relationship between advanced glycosylation end products (AGEs) and cognitive functional impairment in the elderly. Methods The present investigation enrolled 270 outpatients aged 60 years and above who had presented to the Department of Neurology or Health Check-up Center,Zhujiang Hospital.They were divided into a normal cognition group (n=139) and a cognitive impairment group (n=131) according to Montreal Cognitive Assessment (MoCA) scores. Their fasting serum was collected to measure AGEs content by fluorimetry in both groups.Associations between their MoCA scores and their age,gender,education and AGEs content were analyzed. Results The AGEs contents were not significantly different between the 2 groups (P＞0.05).The MoCA scores or the detectable rates of cognitive impairment were significantly different among different age groups (P＜0.05),but not between genders (P＞0.05).The detectable rates of cognitive impairment were significantly different among subjects with different educational levels (P＜0.05).Conclusions Age and educational level are significant factors associated with cognitive impairment in the elderly population.Since the serum AGEs level is not linked to the impaired cognitive function in the elderly,it cannot be used as a laboratory index in early diagnosis of Alzheimer disease.

Objective To study the effects of human uriilary kallikrein(HUK)on the number of apoptotic cells and the expressions of Bcl-2 and Bax proteins in rats after focal cerebral ischemia and reperfusion(FCIR) injury. Methods Eighty-four Spmque-Dawley(SD)male rats were randomly divided into sham-operated group(n=12),ischemia-reperfusion group(n=36),and HUK-treated group (n=36). Transient focal cerebml ischemia models were established by middle cerebml artery occlusion.Six rats were chosen from sham-operated group,ischemia-reperfusion group,and HUK-treated group for measuring infarct sizes.The rest were used to evaluate neurologic fhnction impaiment and measure the nunlber of apoptotic cells and Bcl-2 or BaX protein positive cells in cerebral cortex with TUNEL and immunohistochemistry.The latter 2 groups were subdivided into 6,12,24,72,168 h reperfusio groups (each n=6). Results The neurologic function impairmlent score,the infarct sizes,the apoptotic cells and the expression of Bax protein of HUK-treated group at different time points (except 168 h group)significantly decreased compared wilh those of ischemia-reperfsion group (p＜0.05).The expression of Bcl-2 protein of HUK-treated group at different time points(except 168 h group) remarkably increased compared with that of ischemia-reperfusion group(P＜0.05). Conclusions HUK can excrt a protection against FCIR injury, maybe through up-regulating Bcl-2 and down-regulating Bax protein in the initial 3 d of FCIR injury to decrease the number of apoptotic cells

Objective To investigate the relationship between CYP19 gene polymorphism and Alzheimer disease. Methods Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to analyze the allele frequency distribution at the Mfe Ⅰ site of CYP19 gene in 102 patients with Alzheimer disease and 121 healthy control subjects. Results The frequencies of CYP19 ml and m2 alleles showed significant differences between the patient group and the control group (66.2% vs 81.0% and 33.8% vs 19.0%, respectively, X2=12.696, P<0.05). In patients with Alzheimer disease, the frequencies ofm1/m1, m1/m2, m2/m2 genotypes of CYP19 gene were 44.1%, 44.1%, and 11.8%, respectively, showing significant differences from the frequencies in the control subjects (65.3%, 31.4%, and 3.3%, respectively, X2=12.384, P<0.05). Conclusion CYP19 gene polymorphism at the Mfe Ⅰ site is associated with the genetic susceptibility to Alzheimer disease.

Objective To explore the effect of continuous venovenous hemofiltration (CVVH)combined with intravenous injection of mannitol in the treatment of intracranial hypertensive patients with renal failure. Methods Nine intracranial hypertensive patients with renal failure from ICU of our hospital were treated with 2-3 times of CVVH combined with intravenous injection of mannitol; their non-invasive intracranial pressure, serum creatinine and cystatin concentrations before and after the treatments were monitored. Results The difference of intracranial pressure was statistically significant before and after CVVH (P＜0.05), so were the values of serum creatinine and cystatin before and after CVVH (P＜0.05). One patient with brain stem hemorrhage died fiom multiple organ failure 2 d after the treatment, and the other 8 patients all smoothed out the rush hours of brain edema without cerebral hernia.Conclusion CVVH combined with intravenous injection of mannitol is a kind of effective treatment for intraeranial hypertensive patients with renal failure.

Objective To investigate the clinical application of measurements of neutrophil gelatinase associated lipocalin in serum (sN-GAL) and urine(uNGAL),cystatin C(CysC) and serum creatinine(sCr) in diagnosis of acute kidney injury(AKI) patients secondary to liver cirrhosis (LC).Methods A total of 260 liver cirrhosis patients without AKI (LC group),207 liver cirrhosis patients with AKI (AKI group)and 106 healthy controls(HC group)were included in the study.The levels of sNGAL,uNGAL,serum creatinine(sCr) and cystatin C (CysC) were determined,respectively.The estimated glomerular filtration rate (eGFR) were calculated base on sCr and CysC,named as c-aGFR and CysC-eGFR.The differences and correlation of each observed parameters among the various groups were statistically analyzed,and the effectiveness of these parameters as biomarkers for predicting the development of AKI in these patients with liver cirrhosis were assessed.Results Compared with LC group and healthy control group,the levels of sNGAL,uNGAL,sCr and CysC in AKI group were significantly increased(all P ＜0.01),while the levels of c-aGFR and CysC-eGFR were significantly decreased(all P ＜ 0.01).Along with the progression of AKI stages,the levels of sNGAL,uNGAL,sCr and CysC in the patients were increasing(all P ＜ 0.01),while the levels of c-aGFR and CysC-eGFR were decreasing(all P ＜0.01).Correlation analysis showed that the levels of sNGAL,uNGAL and CysC were positively correlated with sCr(r =0.662,0.672,0.726,all P ＜0.01)and negatively correlated with c-aGFR(r =-0.639,-0.661,-0.732,all P ＜ 0.01).On the contrary,CysC was negatively correlated with sCr (r =-0.711,P ＜ 0.01)and positively correlated with c-aGFR (r =0.736,P ＜ 0.01).ROC curve analysis showed that the area under the curve (AUC) of uNGAL was maximum (0.995) which were significantly higher than that of sNGAL,sCr,c-aGFR,CysC and CysCeGFR(all P ＜ 0.01).The AUC of sNGAL did not present marked difference with that of sCr and CysC (P ＞ 0.05),but-was barely higher than that of c-aGFR and CysC-eGFR (P ＜ 0.05).The diagnostic effectiveness of uNGAL was maximum (0.962),followed by sNGAL(0.920).Conclusion For diagnosis of the development of AKI in the patients with liver cirrhosis,NGAL may be more reliable marker than sCr and CysC,and the detection of uNGAL could be more effective than sNGAL for the diagnosis.

OBJECTIVETo explore the molecular and epidemic characteristics of rifampin (RFP) and isoniazid (INH) resistance of mycobacterium tuberculosis (MTB) in Sichuan.

METHODSGenoType reg; MTBDRplus Assay GTplus was used to examine 68 clinical isolates of MTB and 105 clinical specimens for mutations in rpoB, katG and inhA genes related to RFP and INH resistance.

RESULTSOf the 151 valid tests obtained, 44 (29.14%) and 26 (17.22%) showed drug resistance and multidrug resistance, respectively. Resistance to RFP and INH was found in 21.85% (33/151) and 24.50% (37/151) of the samples, respectively. The most prevalent mutations were rpoB S531L, katG S315T1 and inhA C-15T. The multidrug resistance rate in the sputum specimens was significantly higher than that in the non-respiratory samples (19.35% vs 7.41%).

CONCLUSIONDrug-resistant, especially multidrug-resistant tuberculosis is highly prevalent in Sichuan. The multidrug-resistant bacteria most frequently show rpoB S531L combined with katG S315T1 mutations, suggesting the necessity of developing rapid clinical identification methods for drug-resistant MTB to control the spread of the resistant strains.

DNA, Bacterial ; analysis ; Drug Resistance, Multiple, Bacterial ; Genotype ; Humans ; Isoniazid ; pharmacology ; Mycobacterium tuberculosis ; drug effects ; isolation & purification ; Reagent Kits, Diagnostic ; Rifampin ; pharmacology ; Sputum ; microbiology ; Tuberculosis, Multidrug-Resistant ; diagnosis ; microbiology

OBJECTIVETo present the clinical application of composite graft of acellular allo-dermis matrix (ADM) with thin auto-microskin on burn wound.

METHODS8 inpatients with 18 full thickness skin burn wounds were transplanted with allo-ADM after eschar was excised, then the auto-microskin and allo-human skin were covered on the area of the matrix, the wound where no allo-ADM grafting were covered as control groups only with auto-microskin and allo-human skin. The area of donor to wound is 1:5 - 1:8.

RESULTSSurvived rate of 18 pieces composite skin that allo-ADM with auto-microskin were grafted were 94%. After following up for 3 to 13 months, the skins of complex grifting had well elastic and smooth texture compared to auto-microskin grafted, they appeared less cicatrisation and ulceration. 3 months after operation, it was indicated by histological examination that tightknit the epithelial-dermal conjunction and epidermal papilla structure could be identified in the allo-ADM skin and there were orderly collagenous fibres, but scar skin structure was observed in that auto-microskin grifted area.

CONCLUSIONThe graft effectiveness of allo-ADM and auto-microskin was better than that of auto-microskin, and this method could be used on major deep burn wound healing.

Adult ; Burns ; surgery ; Female ; Humans ; Male ; Middle Aged ; Skin Transplantation ; methods ; Tissue Donors ; Transplantation, Autologous ; Transplantation, Homologous ; Treatment Outcome

Background/Aims: To determine the value of salivary pepsin in discriminating sub-types of gastroesophageal reflux disease (GERD) and GERD-related disorders. Methods: Overall, 322 patients with different sub-types of GERD and 45 healthy controls (HC) were studied. All patients took Gastroesophageal Reflux Disease Questionnaire (GerdQ) and underwent endoscopy and 24-hour esophageal pH monitoring and manometry. Salivary pepsin concentration (SPC) was detected by using colloidal gold double-antibody immunological sandwich assay. Oral esomeprazole treatment was administrated in the patients with non-erosive reflux disease (NERD) and extra-esophageal symptoms (EES). Results: Compared to HC, patients with erosive esophagitis, NERD, EES, EES plus typical GERD symptoms, or Barrett’s esophagus had a higher prevalence of saliva and SPC (all P < 0.001). There was no significant difference in the positive rate for pepsin in patients with functional heartburn or GERD with anxiety and depression, compared to HC. After esomeprazole treatment, the positive rate and SPC were significantly reduced in NERD (both P < 0.001) and in EES (P = 0.001 and P = 0.002, respectively). Of the 64 NERD patients, 71.9% (n = 46) were positive for salivary pepsin, which was significantly higher than the rate (43.8%, n = 28) of pathological acid reflux as detected by 24-hour esophageal pH monitoring (P = 0.002). Conclusions Salivary pepsin has an important significance for the diagnosis of GERD and GERD-related disorders. Salivary pepsin and 24-hour esophageal pH monitoring may complement with each other to improve the diagnostic efficiency.

Chronic pancreatitis (CP) is a progressive and irreversible fibroinflammatory disorder, accompanied by pancreatic exocrine insufficiency and dysregulated gut microbiota. Recently, accumulating evidence has supported a correlation between gut dysbiosis and CP development. However, whether gut microbiota dysbiosis contributes to CP pathogenesis remains unclear. Herein, an experimental CP was induced by repeated high-dose caerulein injections. The broad-spectrum antibiotics (ABX) and ABX targeting Gram-positive (G⁺) or Gram-negative bacteria (G^-) were applied to explore the specific roles of these bacteria. Gut dysbiosis was observed in both mice and in CP patients, which was accompanied by a sharply reduced abundance for short-chain fatty acids (SCFAs)-producers, especially G⁺ bacteria. Broad-spectrum ABX exacerbated the severity of CP, as evidenced by aggravated pancreatic fibrosis and gut dysbiosis, especially the depletion of SCFAs-producing G⁺ bacteria. Additionally, depletion of SCFAs-producing G⁺ bacteria rather than G^- bacteria intensified CP progression independent of TLR4, which was attenuated by supplementation with exogenous SCFAs. Finally, SCFAs modulated pancreatic fibrosis through inhibition of macrophage infiltration and M2 phenotype switching. The study supports a critical role for SCFAs-producing G⁺ bacteria in CP. Therefore, modulation of dietary-derived SCFAs or G⁺ SCFAs-producing bacteria may be considered a novel interventive approach for the management of CP.