Objective:To examine factors that may have impact on the Mini-Mental State Examination ( MMSE) screening validity, which could lead to further establishing the general model of the MMSE score in Chinese health elderly and to improve the screening accuracy of the existing MMSE reference. Methods:Based on the data of the Chinese Longitudinal Healthy Longevity Survey ( CLHLS ) , the MMSE scores of 19 117 normal elderly and 137 dementia patients who met the inclusion criteria were used for the analysis. The area under the curve ( AUC) and validity indexes were used to compare the screening accuracy of various criteria. Multiple linear regression was used to identify factors that had impact on the MMSE score for both the normal and dementia elderly. Descriptive analysis was performed for differences in the MMSE scores by age trends and gender between the normal and dementia elderly. Results:The AUC of MMSE was≥0 . 75 ( P<0 . 05 ) . The MMSE score of the normal elderly declined nonlinearly as the age grew older(male:R2 =0. 924, P<0. 05; female: R2 =0. 951, P<0. 05), and increased nonlinearly as the education level rose(male: R2 =0. 948, P <0. 05; female: R2 =0. 859, P<0. 05). The females had significantly lower MMSE scores than the males, with a faster decline trend with age than the males (95%CI of female partial regression coefficient was not overlapped with 95%CI of male partial regression coefficient) . The dementia elderly showed a much lower MMSE score ( male:difference of Z score:-1 . 573 , P<0 . 05;female:difference of Z score:-1 . 222 , P<0 . 05 ) and ten-ded to with a faster decline speed than that of the normal elderly (95%CI of dementia partial regression coefficient included 95%CI of normal partial regression coefficient) . Conclusion:The screening validity of MMSE in CLHLS is not affected by educational level. The analysis of factors that may impact on the MMSE screening validity are gender, age, vision and residence which with validity identification. These four fac-tors can be used as assist tool of MMSE in the screening of dementia to improve the screening accuracy.

Objective To comparative study the effect on colorectal cleansing of CT colonography with gulping down 10 mg bisacodyl before or 1 h after oral taking 2 liter polyethylene glycol .Methods Forty participants with informed consent were appor‐tioned to group A ,group B randomly ,20 cases in each group .On the day before CT colonography ,participants in group A oral took 20 mL of 40% W/V barium sulfate prior to 3 mealtime ,and 20 mL of 60% diatrizoate meglumine diluted in 250 mL of water after supper ,then gulped down 10 mg bisacodyl enteric‐coated tablets 1 hour before oral taking 2 liter polyethylene glycol electrolyte so‐lution .Participants in group B were the same as that in group A ,with the exception of gulping down 10 mg bisacodyl enteric‐coated tablets 1 hour after oral taking 2 liter polyethylene glycol electrolyte solution .Cleansing efficacy of stool and fluid ,and attenuation value of remainder fluid between the two groups were analyzed statistically .Results In group A ,score of cleansing efficacy of stool (1 .96 ± 0 .11) was lower than that in group B (2 .01 ± 0 .12) ,segments with good cleansing efficacy of stool (87/120 segments , 72 .50% ) was higher than that in group B (83/120 segments ,69 .17% ) ,the difference was not statistically significant (P>0 .05) .In group A ,score of cleansing efficacy of fluid (1 .50 ± 0 .06) was lower than that in group B (1 .53 ± 0 .06) ,segments with good cleansing efficacy of fluid(113/120 segments ,94 .17% ) was higher than that in group B (111/120 segments ,92 .50% ) ,the differ‐ence was not statistically significant (P>0 .05) .Attenuation value of remainder fluid [(729 ± 29)HU ] in group A was higher than that in group B[(653 ± 25)HU] ,the difference was statistically significant(P<0 .05) .Conclusion Gulping down 10 mg Bisacodyl before or after oral taking 2 liter polyethylene glycol has no effect on cleansing of stool and fluid ,with good cleansing efficacy .The former has better cleansing efficacy of fluid ,is beneficial to detecting polyps for CT colonography .

Objective To study the compliance of examinees,and effectiveness of colorectal distension with partially automated and individualized insufflation of air for dual-energy CT colonography.Methods Forty-six healthy adult volunteers without history of conditions affecting gastrointestinal motor function were enrolled in this study.One day before CT examination,volunteers were asked to orally administered 60 mL 4% diatrizoate meglumine five times for fecal tagging.Air was insufflated by using an inflator in a partially automated and individualized manner.The volunteers were initially asked to assume the right lateral decubitus position,then slowly turn to the supine position.Insufflation rate began at 1.5 L/min,and decreased to 0.5 L/min at later stage.The necessity and volume of air insufflation were decided according to effectiveness of colorectal distension on CT scout images,self-reported sensation of volunteers,and intestinal pressure.Dual-energy CT scanning was performed,and dual-energy blended images were acquired.Compliance of volunteers was statistically analyzed.The effectiveness of colorectal segments distension was statistically analyzed by using Kruskal-Wallis H test.Results No abdominal pain,bloating,nausea or vomiting were noted in the 46 volunteers.All volunteers easily accepted colorectal insufflation of air,with grade 1 compliance.The effectiveness of colorectal distension of grades 1,2,3 and 4 were 0%,2.1%,5.1% and 92.8%,respectively.The difference of effectiveness of colorectal segments distension had no statistical significance(χ2=6.19,P=0.288).The effectiveness of insufflation was poor in 6 colorectal segments,including 2 in sigmoid colon and 2 in rectum.Effectiveness of insufflation was suboptimal in 14 colorectal segments,including 4 in descending colon,4 in sigmoid colon,and 3 in rectum.Conclusion Compliance of examinees with partially automated and individualized insufflation of air for dual-energy CT colonography is excellent,with good effectiveness of colorectal distension.

Objective To investigate the association of serum dehydroepiandrosterone sulfate( DHEA-S) with the cognition in male type 2 diabetes mellitus(T2DM)patients. Methods 99 male patients cared at Tangshan Gongren Hospital and another 97 male healthy controls without T2DM from the medical examination center were recruited. Data on demographic characteristics and clinical parameters were collected, DHEA-S was measured by radioimmunologic assay. Cognitive performance was assessed by the Repeatable Battery for the Assessment of Neuropsychological Status(RBANS). Results (1) Serum DHEA-S levels were lower in male T2DM patients than that of controls[(2. 66 ± 0. 78 vs 4. 02 ± 1. 24) μmol/ L, P<0. 01];(2) Compared with controls, RBANS scores including immediate memory(79. 24 ± 17. 47 vs 86. 25 ± 15. 21, P<0. 01), visuospatial/ constructional(83. 98 ± 17. 98 vs 97. 24 ± 11. 51, P<0. 01), attention(96. 04 ± 14. 65 vs 101. 45 ± 13. 93, P<0. 01), delayed memory (89. 28 ± 11. 74 vs 97. 41 ± 9. 41, P<0. 01), and total scores(85. 85 ± 11. 46 vs 94. 60 ± 10. 91, P<0. 01)were all lower in male T2DM patients;(3) RBANS scores including delayed memory(84. 53 ± 12. 23 vs 93. 94 ± 9. 18, P<0. 01)and total scores(80. 33 ± 10. 91 vs 91. 26 ± 9. 25, P<0. 01)in T2DM patients with low-level DHEA-S(DHEA-S-L)were all lower than those of patients with high-level DHEA-S;(4)Male T2DM patients with cognitive impairment had lower levels of DHEA-S than patients without cognitive impairment(2. 31 ±0. 79 对 2. 90 ±0. 67, P<0. 01);(5) In male T2DM patients, DHEA-S was positively correlated with delayed memory(r = 0. 252, P = 0. 019) and total scores(r=0. 258, P= 0. 016). Conclusion Male T2DM patients are with lower serum DHEA-S levels and worse cognitive performance, and serum DHEA-S was positively correlated with their cognitive performance, suggesting that serum DHEA-S may be involved in the cognitive deficits of male T2DM patients.

Objective To analyze the efficacy and safety of losartan in the treatment of massive proteinuria in kidney transplant recipients.Methods All of the 82 patients were randomized in two groups:losartan group and control group(amlodipine group).Both of the groups were divided into two different subsets according to blood pressure control Twenty-four-hour proteinuria,serum creatinine,blood pressure and adverse effects were observed.Results Losartan and amlodipine had the similar effects on blood pressure control The 24-h proteinuria in losartan group at the end of the study was significantly lower than that at the baseline,and there was significant difference between the losartan blood pressure control subset and the losartan blood pressure un-control subseL The effective rate and significant effective rate in losartan group for massive proteinuria were higher than in control group.Conclusion T Losartan can be effectively and safely used for the treatment of massive proteinuria in renal transplant recipients independent of blood pressure.

Objective To investigate the effect of cyclosporine blood level at first year after kidney transplantation on patients with a survival time over 10 years. Methods 380 patients with functional allograft, a survival time over 10 years and long-term administration of cyclosporine A (CsA) were studied, and received CsA-based treatments. According to the blood CsA level at the first year after kidney transplantation, patients were divided into five groups: group 1, blood CsA level was above 0. 208 μmol/L (1 μmol/L = 1201.9 μg/L), group 2, blood CsA level between 0. 166-0. 208μmol/L; group 3, blood CsA blood level between 0. 125-0. 166 μmol/L; group 4, blood CsA blood level between 0. 083-0. 125 μmol/L; group 5, blood CsA level less than 0. 083 μmol/L. Systolic blood pressure (SBP), diastolic blood pressure (DBP), serum creatinine(SCr), uric acid (UA), cholesterol (CH), triglyceride (TG), alanine aminotransferase (ALT), direct bilirubin (DBil) and total bilibubin (TBil), albumin (Alb), hemoglobin (Hb), count of white blood cells and positive rate of proteinuria in 5 groups at the 1st, 5th and 10th year after kidney transplantation were analyzed. Results At the 5th year SBP in groups 1 and 2 was higher than in groups 3, 4 and 5. UA level in group 5 was lower than other groups, and Alb level in group 5 was higher than other 4 groups. Proteinuria positive rate in groups 4 and group was lower than other groups. At the 10th year after kidney transplantation,indexes among 5 groups had no statistically significant difference, except for SBP, DBP, DBil and CH in some groups. There was also no significant difference in SCr level among 5 groups at the 5th or 10th year after transplantation. Conclusion Blood CsA levels at the first year after kidney transplantation has no significant effect on long-term allograft function. But higher level of CsA (＞0. 166μmol/L) at the first year maybe predict high rate of hypertension, high blood UA and proteinuria at the 5th and 10th year after transplantation.

This paper addressed the volume measurement of 3D ultrasound imaging system. Two different phantoms used in the measurement of volume of the 3D ultrasound imaging system were built, i.e., water phantom and agar phantom. The experiments demonstrated that as the increase of scan depth, the volume measurement accuracy is varied from 4% to 7% in water and 6% to 10% in agar. The phantoms and the volume measurement of the 3D ultrasound imaging system provides a basis for the establishment of testing standard and clinical application of 3D ultrasound imaging system.
Imaging, Three-Dimensional ; Phantoms, Imaging ; Ultrasonography ; instrumentation ; methods

To evaluate the correlation of the serum uric acid and free fatty acid (FFA) levels in Shandong coastal residents. To investigate the correlation between serum uric acid and FFA based on 3860 individuals who have been long staying in Qingdao, Yantai, Weihai, Rizhao with a randomized, stratified cluster sampling method. According to FFA quartile, subjects were divided into four groups: group Q1 of 908, group Q21016, group Q3958, and group Q4978 cases. The prevalence of hyperuricemia and serum uric acid levels increased with the increasing FFA quartile. Compared with Q1, Q2, and Q3 groups, the prevalence of hyperuricemia in Q4 group and the increase of serum uric acid were statistically significant(P<0. 05). And in the group Q4, hyperuricemia prevalence is twice as the group A. According to the serum uric acid level, subjects were divided into the normal uric acid group(n=3331) and the hyperuricemia group ( n = 529). In the hyperuricemia group, their systolic blood pressure, diastolic blood pressure, waist circumference, hip circumference, triglycerides, total cholesterol, low density lipoprotein-cholesterol (LDL-C), glucose, uric acid, FFA, body mass index etc. were significantly higher than those of the normal uric acid group (all P<0. 01), while the high density lipoprotein-cholesterol ( HDL-C), cystatin, glomerular filtration rate (eGFR) are significantly lower than those of the normal uric acid group( all P<0. 01). Serum uric acid levels are positively correlated with systolic and diastolic blood pressures, waist and hip circumferences, triglycerides, total cholesterol, LDL-C, FFA, blood glucose, body mass index (all P<0. 01); and negatively correlated with eGFR (P<0. 01). Multiple regression analysis showed that systolic blood pressure, FFA, total cholesterol, triglycerides, LDL-C, blood glucose, body mass index, eGFR were factors influencing serum uric acid independently. Multivariate binary logistic regression analysis showed that systolic blood pressure, waist circumference, total cholesterol, blood glucose, and FFA are independent risk factors to predict hyperuricemia onset while eGFR is a protective factor. Serum uric acid level is closely related to the free fatty acid, and FFA seems to be involved in the development and progression of hyperuricemia.

Osteoporosis （OP） is a skeletal metabolic disease characterized by bone loss and destruction of bone microstructure. Changes in estrogen levels are not the only pathogenic factors for the occurrence and development of OP. MicroRNA （miRNA） plays an important regulatory role in cells. The complementary sequences of miRNA and targeted mRNA combine to inhibit the expression of targeted mRNA through post-transcriptional regulation， forming a complex regulatory network. Research suggests that miRNA is closely related to the occurrence and development of various diseases， including inflammatory diseases， metabolic diseases， and cancer. Targeted mRNA participates in post-transcriptional gene expression regulation in OP， mainly regulating the balance among bone construction， bone resorption， and osteoblast differentiation. Therefore， miRNA-based gene therapy is a rapidly developing disease treatment strategy. Traditional Chinese medicine can improve bone metabolism by intervening in miRNA differential expression to target and regulate osteogenic/osteoclast differentiation. This article summarized the targeting effects of miRNAs in physiological and developmental processes such as bone cell proliferation， differentiation， survival， and apoptosis， reviewed and classified their mechanisms of action and targets， and sorted out the current treatment methods of traditional Chinese medicine for preventing and treating OP and drugs that exert bone protective functions through miRNAs. This review is expected to provide theoretical reference and research guidance for future research on OP treatment by regulating miRNA.