: ObjectiveTo explore the clinical features of senile hypertension.MethodsThe clinical manifestations of 296 cases with senile hypertension admitted from January 2001 to September 2004 were analyzed retrospectively.ResultsThere were 16 cases in stage 1 (5.4%), 100 cases in stage 2 (33.8%), 180 cases in stage 3 (60.8%). came on with Hypertension had been found before 60 years old in 143 cases (48.3%), after 60 years old in other 153 cases (51.7%). 63 cases presented systolic hypertension(21.3%), other 233 were mixed type hypertension (78.7%). Comparing the type of senile hypertension came on before 60 years with the type of senile hypertension came on after 60 years, The ratio of different type of senile hypertension was significant difference between the patients who were found to have hypertension before or after 60 years old(χ2=18.87,P<0.01).ConclusionSome of senile hypertension happened in middle age. Most of them were in stage 2～3. The type of senile hypertension was related to pathogenic time.

Objective To explore the clinical feature of multiple organ dysfunction syndrome in the elderly (MODSE) induced by pulmonary infection. Methods The clinical sign of 169 cases with MODSE induced by pulmonary infection admitted from January 2001 to September 2006 were reviewed. Results All cases complicated more than one chronic disease. 82.9% cases complicated more than 4 chronic diseases. The first failure organ of MODSE induced by pulmonary infection included lung, heart, kidney or gastrointestinal tract, and the respiratory failure was the most commonly. The incidence of primary failure in organs dysfunction group was significantly higher than those in organs normal function group (P<0.001). Binary Logistic stepwise regression showed that clinical stage of MODSE, renal failure and circulatory failure were the high risk factors for mortality （P＜0.05）. Conclusion Lung or other dysfunction organs is the first failure organ in MODSE induced by pulmonary infection in most cases. Clinical stage of MODSE, renal failure and circulatory failure were the high risk factors for mortality. The mortality of MODSE may be reduced by preventing renal failure and circulatory failure.

Objective To establish the scoring system for early prediction of multiple organ dysfunction syndrome (MODSE) induced by pulmonary infection in the elderly. Methods A total of 393 inpatients with pulmonary infection, aged 60 years and over, were enrolled in this study and the data of them from January 2001 to December 2006 were analyzed retrospectively. All patients were divided into MODSE group and non-MODSE group. The effects of age, chronic disease and blood test items of healthy examination on the pathogenesis of MODSE were explored. The early prediction indexes which were selected from age, 21 chronic diseases and 15 blood test items of healthy examination were scored to establish the scoring system for early predicting MODSE. Results The age, chronic obstructive pulmonary disease, chronic respiratory failure, pulmonary fibrosis, chronic cardiac insufficiency, cerebrovascular disease, diabetes, chronic renal failure, hemoglobin, albumin,urea nitrogen and fasting blood glucose were selected to establish the scoring system for early predicting MODSE. Conclusions The scoreing system for early predicting MODSE may be used to screen the high risk population of MODSE induced by pulmonary infection, which is valuable in early prediction of MODSE.

Objective To evaluate the early prediction score system for multiple organ dysfunction syndrome in the elderly (MODSE) induced by pulmonary infection. Methods A total of 316 patients with pulmonary infection aged over 60 were admitted from 2007 Jun to 2009 Jun. All patients were scored by the early prediction score system for MODSE and then classified as high-risk group and non high-risk group. χ2 test was used to analyze the difference in morbidity of MODSE between high-risk group and non high-risk group. Receiver operating characteristic (ROC) curve was drawn, and the area under the curve, sensitivity and specificity was calculated. Results The morbidity of MODSE in high-risk group was higher than that in non high-risk group(χ2=87.569,P＜0.01).The area under the ROC curve was 0.864(P＜0.01).The sensitivity and specificity of the early prediction score system of MODSE were 84.2% and 72. 1%, respectively. Conclusion The early prediction score system for MODSE can be used to predict MODSE induced by pulmonary infection and to screen for the high risk population.

BACKGROUND: In recent years, the effects of cytokines on osteoporosis have Received much attention, and of these cytokines, interleukin-6(IL-6) is considered to play an important role in the regulation of bone absorption.OBJECTIVE: To observe the changes of bone mineral density(BMD) and serum IL-6 rats with in senile osteoporosis after reperfusion with kidney and spleen-tonifying and blood flow-promoting prescription of traditional Chinese medicine.DESIGN: A randomized controlled experimental study based on the experimental animals.SETTING: Second Department of Cadre, Bethune International Peace Hospital of Chinese PLA; department of regimen and rehabilitation in a college of traditional Chinese medicine.MATERIALS: The experiment was conducted in the Center of Experimental Animals, Hubei College of Traditional Chinese Medicine between May and August 2003. Thirty 15-month-old Wistar rats(15 males and 15 females) were provided by the Experimental Animal Center of Tongji Medical College,Huazhong University of Science and Technology.METHODS: According to random number table method, 30 rats were divided into normal control group, pathological control group and traditional Chinese prescription treatment group. Rat models of senile osteoporosis were established in the latter two groups by injection with 2.5 mg/kg dexamethasone given twice a weeks for 6 consecutive weeks. Rats in normal control group and pathological control group were given oral administration of saline,and those in the treatment group were treated with the traditional Chinese prescription. After 6 weeks of treatment, blood samples were obtained from all rats by removing the eyeballs and the serum was separated by centrifugation,followed by truncation of the right hindlimb for dissection of the femoral bone. Serum IL-6 was measured by radioimmunoassay and BMD determined by means of displacement of acetone.MAIN OU TCOME MEASURES: BMD of the femoral bone and serum IL-6 level.RESULTS: The BMD of the pathological control group was significantly lower ( P < 0.01), but the serum IL-6 level was significantly higher( P < 0.01 ) than those of the normal control group. The BMD of the treatment group was significantly higher but serum IL-6 level significantly lower than those of the pathological control group ( P < 0.01 for both comparisons).CONCLUSION: The traditional Chinese prescription can decrease the production of IL-6 and lower serum IL-6 level to reduce the bone loss in senile rats.

Multiple organ dysfunction syndrome in the elderly (MODSE) is an important research topic of geriatrics. This article would review the advance of study in MODSE.

Objective To evaluate the prediction value of the early prediction score system of multiple organ dysfunction syndrome in the elderly (MODSE). Method A total of 393 patients with pulmonary infection, who were above60 years old, were divided into non MODSE(n =224) and MODSE group(n = 169) and were scored by the early prediction score system of MODSE. Independent-samples t Test was used to analyze the difference of forecast score between MODSE and non MODSE group. Receiver operating characteristic (ROC) curve was drawn,and the area under the curve was calculated. The prediction accuracy of scores for MODSE was assessed using sen-sitivity and specificity, and the optimal forecast point for MODSE was found. Results The score of MODSE group was higber than that of non MODSE[(19.38±12.049) vs. (45.78±20.257), P <0.001]. The area under the ROC curve was 0.889 (P <0.001) ond 95% (0.857～0.920). As the value of forecast score was 27.5, the sensitivity of the early prediction score system of MODSE was 82.8 %, the specificity of the early prediction score system of MODSE was 80.3 %. Conclusions The early prediction score system of MODSE is valuable in predic-tion of MODSE, which may be used to forecast MODSE and find the high risk population of MODSE.

Objective To evaluate the clinical value of fasting blood glucose (FBG) in the diagnosis of multiple organ dysfunction syndrome (MODS) caused by pulmonary infection in elderly patients with diabetes. Methods Patients over 65 years old with diabetic pulmonary infection admitted to Department of Cadres Ward of Bethune International Peace Hospital of PLA from July 2015 to December 2016 were enrolled. According to the patient's highest FBG level during pulmonary infection, all patients were divided in two groups. The cases whose FBG ≥8.83 mmol/L were served as suspicious multiple organ dysfunction syndrome in the elderly (MODSE) group, and those had FBG < 8.83 mmol/L were served as suspicious non-MODSE group. The incidence of MODSE in suspicious MODSE group and suspicious non-MODSE group was compared. The receiver operating characteristic curve (ROC) was drawn, and the clinical value of highest FBG in the diagnosis of MODSE caused by pulmonary infection in elderly patients with diabetes was assessed. Results 119 elderly patients with diabetes and pulmonary infection were enrolled in the analysis. All patients were male, with age of 76-105 years with an average of (89.41±4.16) years. Among 119 patients, 55 of them with suspected MODSE, 64 of them with suspected non-MODSE. The incidence of MODSE in suspicious MODSE group was significantly higher than that in suspicious non-MODSE group (78.2% vs. 12.5%), with statistically significant difference (χ2 = 52.108, P = 0.000). The area under the ROC curve of the highest FBG for diagnosis of MODSE was 0.895, and 95% confidence interval (95%CI) was 0.839-0.951 (P < 0.001). When using FBG ≥ 8.83 mmol/L to diagnose MODSE induced by pulmonary infection in elderly patients with diabetes, the sensitivity was 84.3% and the specificity was 82.4%. Conclusion FBG ≥ 8.83 mmol/L, as an indicator reflecting the changes of metabolic function, have a diagnostic value for MODSE caused by pulmonary infection in elderly patients with diabetes.

Objective To elucidate intracellular transcription factor activation of C_7～T_5 dorsal root ganglia in rats recurrently infected with respiratory syncytial virus (RSV). Methods Eighty 1～2 weeks old Sprague-Dawley rats were randomly divided into 2 groups: a control group and a RSV-infection group. The rats in the RSV-infection group were infected with 5 ×10~5 U/mL RSV once a week and the rats in the control group were treated with culture medium without RSV. Airway response was measured after 8 weeks. Lung tissue was submitted for HE staining and in situ hybridization. The C_7～T_5 dorsal root ganglia were obtained for the preliminary screening of the intracellular transcription factors by TranSignal~(TM) protein/DNA combo array. Nuclear protein of C_7～T_5 dorsal root ganglia were extracted and submitted to Western blot. Results Airway response in the RSV-infection group was higher than that in the control group (P＜0.05). HE staining showed inflammatory cell infiltration, and in situ hybridization demonstrated positive RSV RNA in the RSV-infection rat lung which was not present in the control group, thus validating the efficacy of our model. TranSignalTM protein/DNA combo array screening showed that 55 transcription factors increased by at least 2 folds in the C_7～T_5 DRG cells of the RSV-infection group. The transcription factors Smad and interferon regulatory factor (1 or 2) were the 2 most upregulated transcription factors identified by combo array screening (59 and 43 fold increase compared with the control, respectively). Western blot confirmed Smad(1/2/3) and IRF-1 upregulate while IRF-2 remained unchanged. Conclusion Respiratory syncytial virus infection results in airway hyperresponsiveness and transcription factor activation in C7～T5 spinal adorsal root ganglia in rats, which may contribute to airway nerve network dysfunction and airway hyperresponsiveness.

Objective To determine the persistence time of genotype 4 hepatitis E (HE) viremia after the onset of clinical symptoms in HE patients and provide essential data for study on HE epidemiologieal transmission, so that to evaluate potential contagiousness of HE patients after clinical stage. Methods The first serum samples from 162 HE patients after hospitalized in Eastern China were collected and tested for hepatitis E virus (HEV) RNA by nested reversed transcription- polymerase chain reaction (RT-PCR). The persistence time of HEV viremia after the onset of clinical symptoms was estimated with Kaplan-Meier survival analysis. Results HEV RNA was detectable in 101 out of 162 serum samples with positive rate of 62.35%, which was all grouped to genotype 4 by homology analysis. Furthermore, HEV RNA was detectable in 74 (64.91%) out of 114 male and 27 (56.25%) out of 48 female, which was not significantly different (χ2 = 1.08, P=0. 30). Kaplan-Meier survival analysis showed that the median persistence time of HEV genotype 4 viremia was 24 days after the onset of clinical symptoms (95% CI: 18-30 days), which meant that the viremia of 50% HE patients remaining detectable up to 24 days after the onset. The 75% and 25% percentiles were 14 days and 31 days, respectively. There was no significant difference of viremia persistence time between male and female (Breslow test: P=0.98, Tarone-Ware test: P=0.91). Conclusions The viremia of 75% patients with HEV genotype 4 infection could persistent until 2 weeks after the onset of clinical symptoms and that of some patients could persistent over 1 month. It is indicated that the viremia is still persistent and HE patient could be a reservoir even after the clinical symptoms disappeared and biochemical marks normalized.