Falls occurring in populations of elder people are prevalent as dangerous public health events that can result in the considerable institutionalization or even postfall morbidity and mortality. The prevention and intervention of falls in the elderly are the important fields of geriatric rehabilitation medicine. This paper reviewed the literature related to the falls in the elderly, involving the conception, incidence, evaluation and identification of risk factors, and multiple-risk-factor intervention strategy, and indicates the further research direction.

ObjectiveTo investigate the test-retest reliability about the lower extremities static joint position sense which was tested with the Tetrax balance-test-training system, and the dynamic joint position sense which was tested with the Functional Squat System; and to investigate the relationship between the static and the dynamic joint position sense of lower extremities of the patients with knee osteoarthritis. Methods30 patients with knee osteoarthritis were tested with the lower extremities static and dynamic joint position sense twice within 7 d with the Tetrax balance-test-training system and the Functional Squat System. ResultsThe intraclass correlation coefficient (ICC) of the sum of the coefficient of medium-to-high-frequency in postural sway was 0.95 (P<0.001). The ICC of the reposition accuracy error mean of the unaffected/mild or affected/severe extremity were respectively 0.59 and 0.60 (P<0.001). The Pearson correlation coefficients of the sum of the coefficient of medium-to-high-frequency in postural sway and the reposition accuracy error mean of the unaffected/mild or affected/severe extremity were respectively 0.40 and 0.54 (P<0.05). ConclusionThe lower extremities static joint position sense test of the Tetrax balance-test-training system is well reliable, as well as the dynamic joint position sense of the Functional Squat System. They can be used together to evaluate the lower extremities proprioception in the patients with knee osteoarthritis.

Objective To further improve the awareness of the clinical feature of acute fibrinous and organizing pneumonia (AFOP).Methods One case of AFOP treated in our department was described in details.The relevant cases were searched in Wanfang database using key words acute fibrinous and organizing pneumonia [in Chinese].Results Four reports containing 9 cases were identified from published literature.A total of 10 cases (including this one) were analyzed.The patients included 7 males and 3 females (43 to 78 years of age).Eight patients presented with cough.Chest tightness and dyspnea were reported in 8 cases,and fever in 9 cases.Velcro crackles were heard in 4 patients.Laboratory tests showed WBC increased in 2 cases,increased neutrophil count in 6 cases,elevated C-reactive protein in 9 cases,and faster erythrocyte sedimentation rate in 8 cases.The partial oxygen pressure (PO2) ranged from 54 mmHg to 69 mmHg.Chest CT scan showed unilateral lesions in 3 cases and bilateral lesions in 7 cases initially.The main CT findings were patchy,consolidation and ground-glass opacities,sometimes associated with air bronchogram.The diagnosis was confirmed by lung biopsy in all the 10 cases.Bronchoscopy biopsy was conducted in 6 cases,and percutaneous lung biopsy in 3 cases.One patient received both bronchoscopy biopsy and percutaneous lung biopsy.Methylprednisolone was used in all cases.No patient received mechanical ventilation.One patient died.Conclusions AFOP is a new type of interstitial lung disease,the etiology of which is unknown.AFOP often occurs in middle-and old-aged patients.AFOP is easily misdiagnosed due to its unspecific clinical manifestations,which are similar to common pneumonia.The confirmation of AFOP diagnosis depends on pathological biopsy.Corticosteroids treatment is appropriate,but the dosage,duration,and long term effect of corticosteroids are not established.

Objective To assess the test-retest reliability of Tetrax posturographic balance assessment system in determining the balance function in elderly individuals. Methods 22 elderly subjects (66~84 years old) were measured with the stability index (ST), the spectrum analysis of postural sway and the weight distribution harmony between two foots or heels and toe parts in standing on solid surface with eyes open using Tetrax balance system. All tests were repeated 1 week after the initial test and each subject underwent the test under the same instructions and conditions. The intraclass correlation coefficients (ICC) were used to determine the test-retest reliability. Results ICC of all balance functional parameters ranged from 0.797~0.882 (P<0.01). Conclusion The posturographic balance assessment system has good test-retest reliability for determining the balance function in elderly people.

ObjectiveTo determine the static equilibrium of elderly individuals over the age of 60 and the correlation to the age. Methods142 elderly subjects (60～95 years old) were divided into 7 groups: 60～65 years old group, 66～70 years old group, 71～75 years old group, 76～80 years old group, 81～85 years old group, 86～90 years group, and >90 years old group, 24 cases 18～30 years old as the control. The static equilibrium was examined by measuring the stability index （ST） and the spectrum analysis of postural sway under following 4 conditions: standing on solid surface with eyes open （NO），standing on solid surface with eyes closed （NC）， standing on pillows with eyes open （PO）， and standing on pillows with eyes closed （PC） using Tetrax Balance System. ResultsThe ST and the intensity of postural sway increased in the elderly group compared with the control group. NO: there were significant differences (P<0.01) in ST, F1, F4, F6, F8 among the 81～85 years group, 86～90 years old group, >90 years old group and the control group. NC: there were significant differences (P<0.01) in ST, F1, F4 among all the elderly groups and the control group, and in F6, F8 among the >66 years groups and the control group（P<0.05）. PO: there were significant differences (P<0.01) in ST, F4, F6 among the >66 years old groups and the control group, and in F1, F8 among the >71 years old groups and the control group（P<0.05）. PC: there were significant differences (P<0.01) in ST, F4 among all the elderly groups and the control group, in F6 among the >66 years groups and the control group, in F8 among the >76 years old groups and the control group, and in F1 among the >80 years old groups and the control group（P<0.05）. The ST distributed as NOP<0.01）. There were similar changes in the intensity of postural sway of F1, F4, F6, F8 bands. ConclusionThere is the significant decline of the static equilibrium in the subjects aged 80 or over and no significant decline of the static equilibrium in the subjects aged 60～80 whose compensation in the static balance may decrease.

AIMTo determine the effect of piperazinyl estrone, a new estrogen derivative, on bone turnover, bone mass and uteri in ovariectomized rats.

METHODSFemale Sprague-Dawley rats were ovariectomized (OVX) or sham operated (sham) at the age of 3 months and treated with estrone (E) at 0.75 mg.kg-1.d-1, or with piperazinyl estrone (P-E) at 1 or 10 mg.kg-1.d-1, orally, for 3 months. At the time of death, the uterine weight was measured. Bone histomorphometric analysis of proximal tibial metaphyses (PTM) was performed in undecalcified sections.

RESULTSBone histomorphometric data showed that the percent trabecular area (% Tb.Ar) of OVX rats with bone high turnover was significantly decreased. The uteri were atrophied. The percent trabecular area (% Tb.Ar) of estrone treated group was increased in decreasing bone turnover manner. But the size and weight of uteri in this group were increased vs OVX group. The bone loss induced by OVX was preserved by P-E treatment, but the mechanism of maintaining bone is different from that of E-treated rats. P-E treatment in low dose did not decrease any bone formation indices, such as percent labeling perimeter, bone formation rate per bone volume (BFR/BV), except bone mineral apposition rate (MAR) compared with E-treated group, and maintained them at OVX level. The uteri were found to be in atrophy compared with the match dose (0.75 mg) of E-treated OVX rats. But rats treated with high dose of P-E showed the same change like E-treated group.

CONCLUSIONThe finding of this study shows that lower dosage of piperazinyl estrone has effect on preventing the bone losses in OVX rats, while the bone formation and the uterus are not affected, thus supporting the hypothesis that piperazinyl estrone has the potential to prevent postmenopausal bone loss in women with less side effects.

Animals ; Atrophy ; prevention & control ; Bone Density ; Estradiol Congeners ; pharmacology ; therapeutic use ; Estrone ; analogs & derivatives ; pharmacology ; therapeutic use ; Female ; Organ Size ; drug effects ; Osteogenesis ; drug effects ; Osteoporosis ; prevention & control ; Ovariectomy ; Rats ; Rats, Sprague-Dawley ; Uterus ; pathology

To explore novel histone deacetylase (HDACs) inhibitors with anti-tumor activity, MS-275, a HDACs inhibitor, was prepared and used as a lead compound to design new N-substituted benzamide derivatives. MS-275 and eleven target compounds were obtained, and their structures were confirmed by 1H NMR and HR-MS individually. The results showed that the activity of compound 9d was equal to MS-275 in HDACs inhibition tests in vitro and worthy of further investigation. Compound 5c, 5d and 9c displayed obvious dose-effect relationship, which possessed moderate HDACs inhibitory activities. Ten compounds except 9e had selective inhibitory activities on Hut78.
Antineoplastic Agents ; chemical synthesis ; chemistry ; pharmacology ; Benzamides ; chemical synthesis ; chemistry ; pharmacology ; Cell Line, Tumor ; Humans

Aged ; Endoscopy ; methods ; Female ; Humans ; Laparoscopy ; Lymph Node Excision ; methods ; Video-Assisted Surgery ; methods ; Vulvar Neoplasms ; surgery

OBJECTIVETo study the association of positive expression of nucleotide excision repair cross complementary group 1 (ERCC1) in the tumor tissues with platinum resistance of the tumor cells and the clinical outcomes of neo-adjuvant chemotherapy in elderly patients with non-small cell lung cancer (NSCLC).

METHODSERCC1 expression was detected immunohistochemically in the tumor tissues from 113 elderly patients with NSCLC, of which 58 patients received platinum-containing neo-adjuvant chemotherapy, and the impact of ERCC1 expression on the outcomes of neo-adjuvant chemotherapy was analyzed.

RESULTSThe total positivity rate of ERCC1 expression was 35% in these patients. The positivity rates was significantly higher in the patients receiving neo-adjuvant chemotherapy than in the control group (46.7% vs 21.05%, χ² = 3.770, P = 0.048). In the 39 patients positive for ERCC1, the response rate to treatment was 53.85%, as compared to the rate of 51.35% in the 74 ERCC1-negative patients. After neoadjuvant chemotherapy, the median survival time (MST) was 53 months in ERCC1-negative patients, as compared to 37 months in the positive patients. The ERCC1-negative and ERCC1-postivie patients showed similar 3- and 5-year survival rates (48.3% vs 44.4%, χ² = 0.033, P = 0.856; 22.5% vs 18.5%, χ² = 0.096, P = 0.757). Multivariate COX regression analysis showed that ERCC1 expression level in the tumor tissue and TNM stages were independent factors that affected the prognosis of the patients (P < 0.05).

CONCLUSIONNeoadjuvant chemotherapy can induce ERCC1 expression in the tumor, and the objective response rate of neoadjuant chemotherapy can be low in NSCLC patients with high ERCC1 expression. ERCC1 expression is an independent factor affecting the prognosis of elderly patients with NSCLC receiving neoadjuant chemotherapy.

Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; metabolism ; Chemotherapy, Adjuvant ; methods ; DNA-Binding Proteins ; genetics ; metabolism ; Endonucleases ; genetics ; metabolism ; Female ; Humans ; Lung Neoplasms ; drug therapy ; metabolism ; Male ; Middle Aged ; Treatment Outcome

OBJECTIVEFor clarifying the situation of the natural infection of rodents having hemorrhagic fever with renal syndrome (HFRS) virus and to type Hantavirus (HV) using molecular technique in Shenzhen city in 2005, and offering guidance for prevention and control of HFRS.

METHODSData on the host animals was collected from the city of Shenzhen. ELISA and indirect immunofluorscent antibody(IFA) test were applied to the specific antibodies against HV in the sera of captured rats. Direct immunofluorscece assay was adopted to determine HFRS antigens and the lung tissues of the HV infected rats were inoculated into Meriones unguiculata to isolate HV. The whole viral RNA was extracted from the lung tissues of the HV infected rats and amplified the partial M fragments with RT-nested-PCR, using the HV genotype specific primers. The amplified genes were then sequenced, and subjected to genotyping and homology analysis.

RESULTS472 rodents were captured from Shenzhen in 2005. Surveillance on rats demonstrated 9.96% rats carrying HV (with a density of 8.25%) and the main host was Rattus norvegicus. In the blood samples of rats, anti-HV IgG antibodies were detectable in 56 cases by IFA, and proved to be positive in 76 cases by ELISA. We successfully isolated a HV strain designated as SZ2083 from Rattus norvegicus for the first time in Shenzhen and was identified to SEO type by RT-nested-PCR. Compared with the coding region of the M gene of HV L99 virus strain, the homologies of nucleotide among them were 97%, but the homology was 76% of the SZ2083 with HTN 76-118 virus strain.

CONCLUSIONResults showed the existence of natural epidemic areas of HFRS in Shenzhen city. Based on the results of sequencing, it is possible that the Seoul strain of HV might be the predominant serotype of virus harbored.

Animals ; China ; epidemiology ; Cities ; Data Collection ; Enzyme-Linked Immunosorbent Assay ; Fluorescent Antibody Technique, Indirect ; Genotype ; Hantavirus ; classification ; genetics ; isolation & purification ; Hantavirus Infections ; epidemiology ; veterinary ; Rats ; virology ; Rodentia ; virology