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.

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.

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.

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 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 study the directly injury effects of lipopolysaccharide(LPS) on human vascular endothelial cells(HVEC).Methods Lipopolysaccharide with different concentrations added into cultured vascular endothelial cells of human umbilical vein,at different phase after lipopolysaccharide being added,the concentrations of nitric oxide(NO),lactic acid dehydrogenase(LDH) were measured,and the adhesion of HVEC to polymorphonuclear leucocytes(PMN) were observed,the morphological changes of HVEC were detected by phase-contrast microscope.Results The NO content,LDH activity were obviously elevated with increase of LPS concentration(P

Objective Prepare biomimetic muitilayered scaffold which has similar structure of natural cartilage.Method By lyophilizing the scaffolds which were prefrozen at-20℃ and in liquid nitrogen successively,we prepared double-layered spongy scaffolds.By partially thawing the prefrozen samples and refreezing them in liquid nitrogen before the final liyophilization,we prepared biomimetic multilayered scaffolds with about 2mm thickness.XRD and FT-IR were used to confirm the interaction between collagen and chitosan.SEM was used to observe the morphologies of the scaffolds.The mechanical properties of pure chitosan scaffolds,pure collagen scaffolds,composite single-layered scaffolds and biomimetic multilayered scaffolds were compared both in dry and wet conditions.Results There was chemical interaction between collagen and chitosan.Composite materials will form better pore structure.The biomimetic multilayered scaffolds have upright pores,round pores and a dense layer from bottom to top of the scaffolds.The scaffolds have quite different mechanical properties between dry and wet state.Under wet state,the different layers of the biomimetic muitilayered scaffold have different mechanical properties.Results The biomimetic structure of the multilayered scaffold is very close to that of the natural articular cartilage,and the different layers of the biomimetic muitilayered scaffold had different mechanical properties under wet state.These are hopefully beneficial to help maintain the phenotypes of chondrocytes and promote the repairing effect of cartilage defects.