As one of the major geriatric syndromes,frailty exerts adverse effects on life expectancy and quality of life of the elderly.Because of its importance,a number of methods and tools have been introduced for the assessment of frailty.Malnutrition,as an independent risk factor,interacts with frailty and is involved in its progression.This article reviews recent studies on frailty and malnutrition.

In order to study the analgesic effect of Shaoyao Gancao Decoction, this paper discussed material basis and mechanism from the perspective of macromolecules in traditional Chinese medicine. Inspired by the phenomenon of turbidity after boiling Chinese medicine, this experiment took Shaoyao Gancao Decoction as the research object to study the formation process of precipitation during boiling. The results showed that aggregates with a certain shape were formed in the solvent during the boiling process, and the precipitate was obtained by standing and centrifuging. Analysis found that the precipitation was mainly composed of small molecules such as paeoniflorin, albiflorin, liquiritin, glycyrrhizic acid, isoliquiritin and gallic acid, and macromolecules such as protein and polysaccharide. The composition of precipitate was consistent with that of Shaoyao Gancao Decoction, but the analgesic effect of Shaoyao Gancao Decoction after removing the precipitate was significantly reduced. Based on these results, we isolated small molecular compounds, polysaccharides and protein from Shaoyao Gancao Decoction and their contents are 60.4, 700.7 and 207.2 mg·g^-1 respectively. We get the ratio, polysaccharide: small molecule = 11.6∶1, protein: small molecule = 3.4∶1, the precipitate is prepared in the state of boiling. The characterization results showed that the particle size of the precipitate will change significantly after co-heating, and the content determination results showed that the content of the six small molecular compounds which was free in solvent was significantly reduced after the formation of the precipitate. The acetic acid writhing experiment proved that the precipitate has a good analgesic effect, and effectively reduced the levels of inflammatory factors prostaglandin E2 and nitric oxide, and increased the level of anti-inflammatory factor interleukin-10. These results proved that the precipitate in Shaoyao Gancao Decoction is an important material basis for analgesic effect, and macromolecules such as protein and polysaccharide are the main components of the precipitate. The study of macromolecules in the precipitate of Shaoyao Gancao Decoction not only provides new ideas and methods for elucidating the pharmacodynamic material basis of Shaoyao Gancao Decoction, but also provides a reference for analyzing the scientificity of traditional decoction.

Adenocarcinoma, Mucinous ; pathology ; Aged ; Appendectomy ; methods ; Appendiceal Neoplasms ; pathology ; surgery ; Appendicitis ; pathology ; Appendix ; pathology ; Carcinoid Tumor ; pathology ; surgery ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Male

Aged ; Female ; Hodgkin Disease ; diagnosis ; pathology ; Humans ; Reed-Sternberg Cells ; pathology

AIMTo research the spontaneous firing activities during different-frequency stimulation of subthalamic nucleus and microelectrophoresis GABA, Glu and their antagons respectively, approaching the mechanism of DBS in the treatment of Parkinson's disease further.

METHODSUsing extracellular recording to investigate the effect of different-frequency stimulation of STN and microelectrophoresis several drugs on the spontaneous firing activities of the SNr neurons.

RESULTSFor STN stimulation at low frequency, there was no difference on the spontaneous firing activities of SNr neurons between pro-stimulation and meta-stimulation (P > 0.05). With the increasing of stimulation frequency, most of the SNr neurons were inhibited. While during the STN stimulation frequency at high-frequency, the firing rates of inhibited SNr neurons were changed (P < 0.05). Glu had catatonic excitement effect on the SNr neurons, whereas GABA had tonic inhibition effect. 80% of SNr neurons which were inhibited by STN-HFS were not inhibited by STN-HFS on the basis of excitatory effect of BIC.

CONCLUSIONTo treat the motor symptoms of PD, when SIN is selected as the target nucleus, the electrical stimulation with high-frequency should be chosen. It is possible that SIN-HFS modulate the activity of SNr by inhibitory effect of GABA predominantly.

Action Potentials ; physiology ; Animals ; Electric Stimulation ; Electrophoresis ; methods ; Glutamic Acid ; administration & dosage ; pharmacology ; Male ; Neurons ; physiology ; Parkinson Disease ; physiopathology ; therapy ; Rats ; Rats, Sprague-Dawley ; Substantia Nigra ; physiology ; Subthalamic Nucleus ; physiology ; gamma-Aminobutyric Acid ; administration & dosage ; pharmacology

Objective To understand health seeking behavior and its influential factors to reproductive tract infections (RTIs) on women at reproductive age in the rural areas. Methods 54 540 fertile women aged 15-49 were surveyed by a stratified-cluster-random sampling method and gynecological examination were conducted in two steps: converging at the clinics, and then visiting their households, later, 31 624 women who had at least one RTI symptom were chosen. Results Among all the women at reproductive age, the rate of having at least one RTI symptom was 59.8% with the means of RTI symptom as 1.66±0.89. 15 989 women went to see doctors out of the 31 624 women who had RTI symptoms, with a proportion of 50.6 %. The results of logistic regressy showed that those women whose husbands having higher education level, higher income, more RTI symptoms and better knowledge on RTI were more easily to go to the hospitals. However, those women whose husbands working out of the county, having older first bearing age and more numbers of pregnancy were less likely to go to the hospitals. Reasons that refrained them from going to see a doctor would include: 2137(13.7%) did not know that RTI was a disease; 7443(47.6%) of them thought that every woman were bound to have at least one symptom and it did not matter; 1629 (10.4%) of them felt shameful; 349 (2.2%) learned that the diseases were incurable; 975 (6.2 % ) felt the cost of treatment was too expensive; 2101 (13.4 %) had no time; 1001 (6.4 %) would treat themselves through buying medicines over the counter. Conclusion RTI symptoms were quite prevalent among women at reproductive age but the rate of seeing a doctor was low and caused by multi-factors. Health education and gynecological census in increasing the curable rate of RTIs should to be strengthened.

Seven compounds were isolated from the leaves of Panax japonicus var. major by chromatographic methods including silica gel, Sephadex LH-20, ODS and semi-preparative HPLC. Their structures were elucidated by their physical and chemical properties and spectral data analysis as 5, 7-dihydroxy-8-methoxyl flavone (1), ginsenoside Rs2 (2), quinquenoside R1 (3), ginsenoside Rs1 (4), notoginsenoside Fe (5), ginsenoside Rd2 (6) and gypenosiden IX (7). Among them, compound 1 was obtained from the Panax genus for the first time, and compounds 2-7 were isolated from this plant for the first time.
Chromatography, High Pressure Liquid ; Flavones ; analysis ; chemistry ; isolation & purification ; Ginsenosides ; analysis ; chemistry ; isolation & purification ; Magnetic Resonance Spectroscopy ; Panax ; chemistry ; Plant Leaves ; chemistry ; Spectrometry, Mass, Electrospray Ionization

Objective To understand the perceived stigma and discrimination and received stigma and discrimination as well as the differences and reasons of them among people living with HIV/AIDS and their family members. Methods 307 people were investigated and 117 of which were HIV/AIDS and the others were their family members. Face to face interview was carried out. Results HIV/AIDS and their family were living in the social environment rounded by stigma and discrimination. Stigma and discrimination could be divided into perceived stigma and discrimination and received stigma and discrimination, and these two kinds of stigma and discrimination were statistically significant different between HIV/AIDS and their family members (t=-12.540, P=0.000) , and the perceived stigma and discrimination was more serious than received stigma and discrimination. The perceived stigma and discrimination were related to their self-efficacy (OR=0.558, P=0.041 ), family APGAR (OR= 0.650, P=0.027), infected with HIV or not (OR= 2.116,P=0.004). The received stigma and discrimination were related to their self-efficacy (OR=0.468,P=0.028), family APGAR (OR=0.427, P=0.000) whether infected by HIV (OR=3.412, P=0.001 ). Conclusion Stigma and discrimination did exist in the environment where HIV/AIDS and their family lived, suggesting that it was necessary to develop a series of policies and measures to fight against stigma and discrimination.

Objective To observe the changes in tear quantity and tear break-up time(BUT) before and after wearing overnight orthokeratology (OK),and investigate the influence of OK on tear film in young adolescents.Methods Prospective clinic study was conducted in 60 adolescents,aged 8-16 years,who met the inclusion criteria during November 2016 and May 2017 in the Second Hospital of Dalian Medical University were chosen and fitted with OK (OK group).At the same time,60 adolescents who met the same requirement were fitted with spectacle (spectacle group).The two groups were both divided into three subgroups according to the age (subgroup of 8-10 years old,11-13 years old,and 14-16 years old).The BUT,Schirmer' s I test score,and corneal fluorescent (FL) were measured and recorded before wearing and 1 week,1 month,3 months,6 months and 12 months after wearing.Results Totally 57 patients in the OK group (114 eyes) and 59 patients in the spectacle group (118 eyes) completed the follow-up study.No significant difference in Schirmer' s Ⅰ test scores was observed between the OK group and spectacle group (all P＞0.05).The BUT in OK group was significantly lower than that in the spectacle group at all the time points (all P ＜ 0.05).Of all subgroups,the subgroup aged from 8-10 years exhibited the sharpest and most rapid reduction in BUT.Conclusion Based on our findings,long-term OK wearing has no effect on tear volume but reduces the stability of tear film.The results suggest that OK should be considered to be a good alternative for children and adolescents with spectacle;however,it may influence the quality of tear film.In addition,special attention should be paid to younger adolescents,and regular follow-up is needed.

Objective To explore the impact of diagnosis related groups (DRGs) payment and drug zero plus on the management of intensive care medicine department. Methods The clinical data of patients in one year from 2016 to 2017 admitted into the Department of ICU in Liuzhou Worker's Hospital concerning their numbers of discharged patients, transferred patients, bed utilization rate, number of bed turnover, average length of stay of discharged patients, cure and improvement rates, admission and discharge diagnostic coincidence rate, 3-day definite diagnosis rate, clinicopathological diagnosis coincidence rate, rescue success rate, total income, drug proportion, consumable proportion, DRGs payment and settlement data, etc were retrospectively analyzed to explore the dual challenges, DRGs payment and drug zero plus, facing the department and how to respond and deal with them. Results In 2016 and 2017, the total incomes of the department of critical care medicine in our hospital were 42.107 0 million yuan and 41.371 3 million yuan respectively, and the medical insurance incomes were 15.03 million yuan and 16.69 million yuan respectively;in 2016 and 2017, 2 693 patients and 2 922 patients were admitted and treated respectively; 595 patients and 577 patients were discharged respectively, with 2 071 patients and 2 334 patients transferred respectively; the balances of the department were 15.48 million yuan and 29.11 million yuan, respectively. From July to December 2017, the medical insurance DRGs payment data suggested that the proportion of loss of the department be 7.02%. Accelerating the Grade 6 electronic medical records and informationization construction, adopting the severe disease information solution program and fine quality control management in the department of critical care medicine can reduce the cost of manpower. Conclusion Our future development direction in the Department of Intensive Care Medicine includes the following aspects: Open source and reduce expenditure, strictly control the proportions of drugs and consumables, improve the balance of the department, and actively respond and deal with the medical insurance DRGs payment.