Objective To investigate the geriatric syndromes in the very elderly people in Beijing community,in order to provide the basis for management of geriatric syndromes and rational use of medical resources.Methods All community-dwelling residents aged 95 years and over living in Haidian district and some residents aged 85 years and over living in Haidian,Chaoyang and Xicheng districts were investigated in household in Beijing.The survey included the general condition,functional status and geriatric syndromes such as falls,senile urinary incontinence,chronic pain syndrome,chronic constipation and malnutrition occurrence.Results 336 seniors with the mean age of (96.0± 3.0) years were investigated.The percentage of people who had falls within 1 year,chronic pain,and chronic constipation was 27.2％ (88/324),37.3％ (122/327) and 47.6％ (160/336) respectively.The incidence of urinary incontinence was 37.1％ (118/318),with 33.3 ％ (46/138) in males and 40.0％ (72/180) in females,and there was no significant gender difference in the incidence of urinary incontinence (P=0.220).The incidences of malnutrition and malnutrition risks was 10.4％ (31/299) and 50.5％ (151/299).37.2％ of subjects could walk outdoor with a better physical function.The self-rated health satisfaction was lower in elderly people with malnutrition and urinary incontinence than in subjects without those diseases (40.0％ vs.70.4％,34.0％ vs.64.6％,x2 =25.20,25.30,both P＜0.001).26％ of them had never heard of geriatrics.Conclusions Geriatric syndromes are common in community-dwelling older seniors.It is urgent to spread the geriatric knowledge and set a reasonable goal for diagnosis and treatment in the seniors.

Palliative and hospice care for patients suffering severe or end-stage illness with projected short life expectancy.Such services aim to improve patients' quality of life through prognosticating,prevention and treatment of their ailment.The main components include evaluation and treatment of symptoms,pain control,family care,alleviating and treating patients' psychological burden and depression,and offering comfort and dignity.Hospice and palliative care are different from euthanasia,because they neither hasten nor delay the dying process.Instead,they focus on patients'physical and psychological needs and helping patients to maintain their independence and make their own choice.As a new medical subspecialty,palliative and hospice care are considered one of the important frontier in modern medicine.They employ a multi-disciplinary team approach,and the team members require special skill sets including those in communication and symptom management.

Objective To explore the protective effect of pre-operation administration of nicorandil on myocardial injury and recurrent angina in patients with unstable angina pectoris who underwent percutaneous coronary intervention (PCI). Methods A total of 91 patients with unstable angina pectoris were admitted for PCI and randomly divided into 2 groups who either received nicorandil(5 mg tid)or not for 7 days prior to the procedure and routine dose of nicorandil (5mg tid) after it. The concentrations of creatine kinase MB (CK-MB) and cardiac troponin I(cTnI) were compared between two groups before PCI and 6 hours, 18 hours and 24 hours after PCI;Recurent angina and major adverse cardiac events,includ-ing death,re-infarction and stroke at 6 months after the procedure were also chased and compared. Results In total, 75 pa-tients who were successfully undergone elective PC1 were finally enrolled,among whom 37 cases were in nicorandil group and 38 cases were in routine group. Post-procedural levels of CK-MB and cTnI significantly reduced in the nicorandil group between 6~24 h (P<0.05) compared those in routine group.At 6 months follow-up,symptoms of recurrent angina after PCI were significantly relieved in the nicorandil group compared with that in routine group (P < 0.05).Conclusion nicorandil can limit the PCI-induced myocardial injury and relieve the symptoms of recurrent angina after PCI in patients with unstable angina.

Objective To analyze Mycoplasma detection and drug sensitivity test of 3 127 urogenital tract infection women ,and to provides important basis for clinical diagnosis and treatment .Methods Mycoplasma detection and drug sensitivity of 3 127 uro-genital tract infection women were detected .Results Among 3 127 cases ,1 800 patients were detected Mycoplasma ,and the posi-tivity was 57 .6% .The infection rates of Ureaplasma urealyticum(Uu) ,Mycoplasma hominis(Mh) and Uu+ Mh mixed infection were 46 .2% ,1 .2% ,10 .1% .Uu was sensitive to minocycline ,doxycycline and clarithromycin .Mh was sensitive to minocycline , doxycycline and josamycin .Uu+ Mh mixed infection was sensitive to minocycline ,doxycycline and josamycin .Conclusion Myco-p lasma infections have been the major pathogen of urogenital tract diseases ,the clinical treatment should be based on drug sensitivity test .

Employing resveratrol as template molecule, acrylamide as functional monomer and ethyleneglycol dimethacrylate as cross-linkers, a core-shell resveratrol imprinted microspheres was prepared based on the surface of SiO_2 with a surface imprinting technique.The molecularly imprinted microsphere was characterized by infrared spectroscopy and scanning electron microscopy, and the results showed that the surface grafting of molecularly imprinted polymer-shell particle on SiO_2 was successful and the particles were evenly distributed.High performance liquid chromatography was also used to investigate the imprinted microsphere adsorption per formance, and the results showed that the imprinted microsphere exhibited good recognition performance.The maximum adsorption capacities were Q_(maxl)=9.087 mg/g and Q_(max2)= 13.80 mg/g by the model of Scatchard analysis.The imprinted micospheres was applied to separate resveratrol from the extraction of rhizoma polygoni cuspidate successfully.

Objective: To explore the effect of trimetazidine (TMZ) on T-peak (Tp) to T-end (Te) interval of resting ECG in patients with unstable angina pectoris (UAP) after percutaneous coronary intervention (PCI). Methods: We investigated 94 UAP patients with PCI and 76 of them ifnished the study as 2 groups. Control group,n=42, the patients received conventional treatment, and TMZ group,n=34, in addition to conventional treatment, the patients received TMZ 60 mg at 0.5 to 1 hour before PCI. The changes of Tp to Te interval before and after PCI were calculated, serum levels of creatine kinase (CK), creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) at before and at 6, 24 hours after PCI were compared between 2 groups. Ventricular arrhythmia was recorded during PCI. Results: Both groups had shortened Tp to Te intervals after PCI, and TMZ group had more shortened Tp to Te interval, bothP<0.05, while the Tp to Te intervals were similar between 2 group before PCI,P>0.05. The occurrence rate of ventricular arrhythmia in Control group was higher than that in TMZ group (12.52% vs 5.16%) during PCI,P<0.05. Compared with Control group, TMZ group had lower levels of CK, CK-MB and cTnI at 6, 24 hours after PCI, allP<0.05. Conclusion: TMZ could decrease Tp to Te interval of resting ECG, prevent ventricular arrhythmia and reduce the relevant myocardial injury in UAP patients after PCI.

Objective To prospectively analyze the impact of frailty on the short-term outcomes of coronary heart disease (CHD) and its related factors.Methods A total of 505 patients aged ≥65 years,with diagnosis of CHD in Cardiology Department and Geriatrics Department in our hospital were selected.Clinical data including geriatrics syndromes were collected by using Comprehensive Geriatrics Assessment (CGA).Frailty was defined according to the Clinical Frailty Scale (CFS).The impact of the comorbid conditions on the risk was quantified by the coronary artery disease-specific index.Patients were followed up by clinic visit or telephone consultation.Following-up items included recurrence of all-cause mortality,recurrence of cardiovascular events,and unscheduled returned visit.The impact of frailty on the prognosis of coronary heart disease was analyzed by Cox regression.Results Of the 505 patients,221 patients (43.76％) were considered to be frail elderly,in whom 126 patients (24.95％) were assessed as moderately to severely frail elderly.The incidences of comorbidities and geriatrics syndrome including incontinence,fall history,visual impairment,hearing impairment,constipation,chronic pain,sleeping disorder,dental problems,anxiety or depression,and delirium were higher in frail patients than in non-frail patients[51.1％ (113/221) vs.30.6％ (87/ 284),31.2％ (69/221) vs.19.0％ (54/284),43.9％ (97/221) vs.29.9％ (85/284),49.3％ (109/221) vs.29.6％ (84/284),60.2％ (133/221) vs.33.8％ (96/284),62.0％ (137/221) vs.46.8％ (133/284),49.3％ (109/221) vs.37.7％ (107/284),79.2％ (175/221) vs.55.6％ (158/284),11.3％ (25/221) vs.6.0％ (17/284),2.7％ (6/221) vs.0 (0/284),x2=21.831,10.053,10.510,20.519,34.894,11.481,6.886,30.695,4.624,7.803,respectively,all P＜0.05].After adjusting for sex,age,severity of illness and other coexist factors,the Cox survival analysis showed that frailty was the independent risk predictor for the all-cause mortality and unscheduled return visit in CHD patients (HR=2.881 and 1.835,95％CI:1.591-5.215 and 1.458-2.311,both P＜0.001).Conclusions Comprehensive Geriatrics Assessment and Clinical Frail Scale are useful to evaluate the clinical features in elderly CHD patients.Frailty is the independent risk predictor for the short-term prognosis including all-cause mortality and unscheduled return visit in elderly CHD patients.

Objective To explore the effect of calories supplement or protein supplement on the skeletal muscle in the elderly.Methods The ambulatory elderly (≥65 yrs) with reduced handgrip strength and/or gait speed were enrolled,who did not suffer from any neurological or arthritic disease impairing mobility,or any severe pulmonary or heart disease,or chronic kidney failure.The subjects were recruited with their written informed consent from clinical practices in five hospitals in China.The subjects were randomized to control group(n=26),nutrition supplementation (Nutren 400 kcal/ d) group (n=27) or protein supplementation(Biopro Protein 20 g/d) group (n=21).All the subjects were given healthy lifestyle education.The physical performances i.e.gait speed and handgrip strength were measured at baseline and at 2 and 3 months of followed up.Lean soft tissue mass (muscle mass) was measured by BIA at baseline and at 3 months of follow-up.Results A total of 74 subjects completed the trial,including 26 in controls,27 in Nutren,and 21 in protein group.At the end of the trial,the changes from baseline in appendicular muscle mass were-490.0 g (95％CI:-801.9--245.5,P=0.001)in control group,90.0 g (95％CI:-346.8--442.0,P=0.241) in Nutren group,and 290.0 g (95％CI:-746.6-20.1,P=0.007) in protein group.There were no significant difference in above indices among the three groups (P=0.051),except between Nutren group and control group (P=0.020).The handgrip strength and gait speed in the three groups were improved obviously as compared with those at baseline,but not statistically significant between different groups.Conclusions Caloric supplementation group may have greater effect in maintaining muscle mass than the protein supplement group in the elderly.Both the caloric supplement and the protein supplement produce no additional effect on muscular function as compared with healthy lifestyle education.

Objective To analyze the clinical characteristics and prognosis of the overlap syndrome of dementia,depression and delirium coexistence in two or three of them (the 2D's or 3D's) in elderly patients,in order to raise awareness.Methods Clinical data of 16 patients aged ＞65 years diagnosed with the 2D's or 3D's admitted to Peking Union Medical College Hospital from 2010 to 2014 were analyzed and relevant literatures were reviewed.Results Patients with the 2D's or 3D' s accounted for 10％ of the elderly demented patients and 3％ of the elderly depressive patients.16 patients [11 females and 5 males,median age 82 years and mean age (80±6) years] were enrolled,with 7 cases of dementia with depression,6 cases of delirium superimposed on dementia,2 cases of the 3D's,and 1 case of coexisting depression and incident delirium.The Charlson comorbidity index of the 16 patients was (3.0± 1.5).(4.0± 1.6) kinds of geriatric syndromes were found,and the most common were falls (62％),sleep disorders (56％),frailty (50％),polypharmacy (43 ％),and malnutrition (37％).Disability was identified in 14 (88％) patients on admission.Delirium was observed in 9 patients (56 ％),with 7 cases of hyperactive delirium and 2 cases of hypoactive delirium.Coexisting underlying dementia was identified after episodes of delirium in 6 cases.16 patients all received corresponding intervention during hospitalization period.During a mean follow-up period of (15±13) months,62 ％ of the patients had more impaired physical function (ADL score reduction≥ 1),and 43％ of the patients had more impaired cognitive function (MMSE score reduction≥3).Two patients were transferred to long-term care facilities and one patient died during follow-up.The readmission rate was 50％ within 1 year after discharge.Conclusions The domestic report of overlap syndrome of dementia,depression and delirium is rare.Patients with the coexistence of the 2D's or 3D's are more commonly combined with geriatric syndromes,which results in further cognitive and physical function impairment with a higher re-admission rate.We should pay attention to the follow-up in elderly patients with delirium for screening dementia.

BACKGROUND:Until now, it is stil unclear whether the stem cel transplantation triggersadverse effects on the myocardial electrical activity, resulting in the emergence of arrhythmia.
OBJECTIVE:To explore the effect of intracoronary transplantation of umbilical cord blood stem cels on arrhythmia score and incidence of ventricular arrhythmia.
METHODS:According to therapeutic strategies, 73patients with coronary heart disease were assigned to receive drug therapy in control group (n=38) and umbilical cord blood stem cel transplantation in observation group (n=35). Arrhythmia score, incidence of ventricular arrhythmia and adverse reactions were recorded and analyzed before and 1, 4, 8 weeks after transplantation.
RESULTS AND CONCLUSION:After treatment, arrhythmia scores were significantly reduced in the two groups, especialy in the observation group, to exhibit a continuous decline trend (P< 0.05). Compared with the control group, the incidence of ventricular arrhythmia was significantly lower in the observation (P< 0.05). However, there were no significant changes in the blood pressure, heart rate and blood oxygen saturation before and after transplantation, and no acute heart failure and death occurred in thetwo groups. These results suggest that the intracoronary transplantation of umbilical cord blood stem cels exhibits superiorities in the treatment of coronary artery disease, significantly reducing the arrhythmia score, reducing the incidence of ventricular arrhythmia, and resulting in less adverse reactions.