The management of frailty in elderly patients with chronic kidney disease (CKD) has been receiving increasing attention.Frailty in elderly patients with CKD has a high incidence and is used for risk prediction of adverse outcomes,including death,hospitalization,falls,dialysis and so on.A range of pathophysiological changes caused by CKD,aging and multimorbidity work together to promote the development of frailty.Treatment for CKD patients with frailty includes mainly nutritional support,exercise,drug therapy and comprehensive intervention.This article reviews recent research progress concerning frailty in elderly CKD patients.

DREEM inventory developed by Dundee University in England was used to measure medical education environment of Medical University of China. It was found that the total perception of educational environment and the perception of teachers and learning of female students were higher than those of male students, but female students' confidence was lower than male students'. In this article the authors will express their own opinions on these problems and propose appropriate countermeasures.

Disability insurance is one of main component of isurance. This paper made comparison of disability standard of insurance among some countries and regions and drawn serveal chracteristics. With the review of Chinese Disability Standard for Insurance (1998 version),implications and strategies had been proposed for further revision.

Recent reports have indicated that Statins could remarkably improve the prognosis of patients suffered from coronary artery disease.And this effect is not only due to Statin's lipid-regulating function,but also correlated to its non-lipid-regulating action.Atorvastatin is the latest kind of statins.In this article,we specified the non-lipid-regulating effect of Atorvastatin in the prevention and therapy to coronary artery disease.Furthermore,we summarized its corresponding clinical evaluation or security.

AIM:To compare the efficacy of three types of eye care (artificial tear, moist chamber and polyethylene covers) for preventing exposure keratopathy in intensive care patients.METHODS: Intensive Care Unit (ICU) patients were randomly divided to three treatment groups, including artificial tear group(29 cases), moist chamber group (27 cases) and polyethylene covers group (28 cases). Patients in artificial tear group received two drops of carboxymethylcellulose dropped to each eye every 2 hours. The moist chamber and polyethylene covers groups were changed every 12 hours or as needed if they became unclean or torn. Corneal fluorescein stain was performed daily.RESULTS:No one in the polyethylene covers group and one case(4%) in the moist chamber group had exposure keratopathy compared to 8 cases (28%) in the artificial tear group. There were statistical significance differences between both artificial tear group and moist chamber group (P=0.02), artificial tear group and polyethylene covers group (P=0.003). Everyday time of eye care in the artificial tear group, the moist chamber group and the polyethylene covers group was respectively 26.69±2.39, 35.33±2.63 and 7.48±0.87 minutes. Everyday time of eye care in the polyethylene covers group was statistically more time-saving than that in the artificial tear group (P<0.01) and the moist chamber group (P<0.01). CONCLUSION: Polyethylene covers are more effective and time-saving in reducing the incidence of corneal damage in intensive care patients.

Objective To study the effect of cellular glutathione (GSH) in relieving the cytotoxicity induced by arsenic on HaCaT. Methods The HaCaT cells were pre-treated with N-acetylcysteine (NAC) and L-buthionine-[S'R]-sulfoximine (BSO) for 24 h, then treated with sodium arsenite (NaAsO2) by adding it into the medium for 24 h. Alarmarblue assay was used to detect the proliferation of the cells. Results The reduction rate of Alarmarblue increased when the HaCaT cells were treated with 0.001-10.000 ?mol/L of NaAsO2 alone (P

OBJECTIVE: To evaluate the role of total glucosides of peony (TGP) as adjuvant therapy for prevention of cardiac allograft rejection in rats. METHODS: Rats with cardiac allograft were randomly divided into control group, tacrolimus-treated group, TGP-treated group and tacrolimus plus TGP-treated group. Graft survival time was observed. Allografts in some cases were examined by histological study seven days after transplantation. At the same time, the levels of CD4(+) and CD8(+) T cell subsets in peripheral blood were examined by using flow cytometry; the hepatic function and renal function of recipients were also tested. RESULTS: The graft survival time of the tacrolimus-treated group and tacrolimus plus TGP-treated group was (11.14+/-1.57) d and (13.57+/-1.99) d, respectively. The graft survival time of the tacrolimus plus TGP-treated group was longer than that of the tacrolimus-treated group (P<0.05). The histological study showed that the rejection of the tacrolimus plus TGP-treated group was slighter than that of the tacrolimus-treated group. The levels of CD4(+) T cell subset in the peripheral blood of the tacrolimus-treated and tacrolimus plus TGP-treated groups were (38.71+/-5.15)% and (32.43+/-4.39)% respectively 7 days after transplantation. The level of CD4(+) T cell subset in the tacrolimus plus TGP-treated group was lower than that in the tacrolimus-treated group (P<0.05). The level of CD8(+) T cell subset and the hepatic and renal function had no significant differences between the tacrolimus-treated group and the tacrolimus plus TGP-treated group. CONCLUSION: Effects of tacrolimus plus TGP in prevention of rejection are better than tacrolimus monotherapy in rats with cardiac allograft and without increasing side effects.

Objective:To construct NBS1 microRNA expressing eukaryotic recombinants,and identify biological activity of recombinants in Hela cell after transfection.Methods:According to sequence of NBS1mRNA,the NBS1 pre-microRNA was designed and synthesized,then cloned into the GFP reporter pcDNA6.2-GW/EmGFP-miR vector and transfected into Hela cell line.To detect integrity of inset fragment through colony PCR and sequencing analysis.The biological activity of recombinants through identify interference efficiency of NBS1 microRNA recombinants by way of Real-Time PCR and Western blot were determined.Results:Sequences of inset fragment in four microRNA expressing recombinants were correct.NBS1 mRNA and protein expression of four microRNA recombinants were decrease,which is the lowest in the NBS1mi-2 group.Conclusion:Four NBS1-targeting microRNA expressing recombinants all have biological activity in Hela cell line,and NBS1mi-2 recombinant has the most interference efficiency.The microRNA expressing plasmid which were successfully constructed and lay foundation for the studies on the tumor gene therapy of microrna targeting NBS1.

[Objective]To investagate the anatomic features in the approach to the brachial plexus in neck in order to make the exposure of brachial plexus more convenience and safer.[Method]Neck of six embalmed adult cadavers were made serial sectional specimens,which was observed to identify the border,composition and anatomic relation of fat layer between the superficial and deep layer of cervical fascia in the posterior triangle of neck with the brachial plexus.[Result]There was no branches of superficial cervical plexus in the fat layer between the superficial layer and deep layer of cervical fascia below the middle neck,in which there was no important structures except omohyoid muscle and transverse cervical artery.The deep layer of cervical fascia was dense and was directly superficial to the brachial plexus.[Conclusion]Exposure of brachial plexus in the neck would be more safe and convenience upon the understanding of anatomic relatiowship between cervical fascia and brachial plexus.

Objective To develop a method for the determination of berberine hydrochloride,palmatine hydrochloride and jatrorrhizine hydrochloride in Yiqi Zhixue Granules. Methods The samples were extracted by ultrasonication with methanol for 30 min,and an ion pair RP-HPLC method was applied to determine three kinds of alkaloids.The column of C18 with temperature at 30 ℃ was used to separate the target components,the mobile phase consisted of the mixed solution of 0.01 mol/L sodium-heptanesulfonate solution and equal volume of 0.01 mol/L potassium dihydrogen phosphate solution(pH being adjusted at 3.1 with phosphoric acid) combined with acetonitrile(70 ∶ 30),the flow rate was 1.0 mL/min,and the detection wavelength was at 345 nm. Results Three kinds of alkaloids were separated perfectly,the average recoveries(n=6)were 100.95 %(RSD=2.10 % ) for berberine chloride,102.14 %(RSD=2.29 % ) for palmatine chloride,and 100.71 %(RSD=2.65 % ) for jatrorrhizine chloride. Conclusion The developed method is demonstrated to be simple,specific and accurate,which can be used to determine the contents of berberine chloride,palmatine chloride and jatrorrhizine chloride in Yiqi Zhixue Granula,and to control the quality of Folium Mahoniae in Yiqi Zhixue Granules.