OBJECTIVE:To optimize the ethanol mixed-extraction technology of Red ginseng and Salvia miltiorrhiza in Xin-likang granules. METHODS:L9(34)orthogonal test was adopted to optimize ethanol mixed-extraction technology with ethanol vol-ume fraction,amount of ethanol and extraction times as factors using weighting coefficient comprehensive score of the contents of ginsenoside Rg1,Re and Rb1 in R. ginseng and the contents of tanshinone ⅡA and salvianolic acid B in S. miltiorrhiza as index;and the verification test was detected. RESULTS:Optimal mixed-ethanol extraction technology was as follows as 6-fold 70% etha-nol,reflux extracting for 3 times,2 h each time. In verification test,average contents of ginsenosides Rg1,Re,Rb1 in R. ginseng and those of tanshinone ⅡA and salvianolic acid B in S. miltiorrhiza were 3.963 8,0.757 3,4.986 2,0.964 7,27.662 5 mg/g,re-spectively,and comprehensive score was 0.96 (RSD=1.26%,n=3). CONCLUSIONS:Ethanol extraction technology of R. gin-seng and S. miltiorrhiza in Xinlikang granules optimized by multiple indexes comprehensive score combined with orthogonal test is stable,reasonable and feasible.

Objective:To explore the diagnostic value of the serial position effect combined with delayed recall of auditory verbal learning test in diagnosing the elderly patients with different levels of cognitive impairment.Methods:A total of 310 subjects were enrolled and divided into three groups: the normal control group(NC group, n=128), the mild cognitive impairment group(MCI group, n=133)and the mild Alzheimer's disease group(mild AD group, n=149)matched for gender, age and education level.Comprehensive neuro-psychological tests were performed on all subjects, and the Auditory Verbal Learning Test-Huashan version(AVLT-H)was used to analyze the serial position effect.Results:There were significant differences in the primacy effect of the second and third time of immediate recall, short-term and long-term delayed recall among the three groups( P<0.05), but no difference was found in the recency effect between the MCI and mild AD groups( P>0.05). The long-term delayed primacy effect combined with the short-term delayed recall showed a better validity to distinguish those elderly subjects with different levels of cognitive impairment than other memorial indexes, and the correlative sensitivity and specificity were 83.21% and 71.43%(NC group vs.MCI group), 85.71% and 92.86%(NC group vs.mild AD group), 66.67% and 75.57%(MCI group vs.mild AD group), respectively. Conclusions:The long-term delayed primacy effect combined with the short-term delayed recall can assist in distinguishing elderly patients with different levels of cognitive impairment.

Objective To evaluate the clinical effect of CEREC chairside on atypical porcelain inlay restoring class [[cavity.Methods 30 patients that required re-treatment because of resin restoration failure and early posterior proximal caries were selected randomly.The original fillings,secondary carious tissues and undercut parts were removed.The clear and round edge lines were prepared.With Sirona CEREC Blocs,35 atypical ceramic inlays were produced in accordance with CEREC AC CAD/CAM standard procedures.After clinical trial and modification,the inlays were bonded with 3M Veneer resin adhesive cement.Evaluation was done immediately and 3,6,12 and 24 months after restoration.Two senior prosthodontists did the evaluation according to the modified USPHS criteria.Results The evaluation results were all A when estimated immediately after restoration.None inlay falled off during the first two years.However,3 inlay were found to be damaged when reviewed at the 24th month.There exsited two patients having mild symptoms of dentine hypersensitivity which appeared at the beginning and died out gradually.Generally speaking,more than 90％ of inlay restorations had reached the USPHS criteria A.Color match and retention represented better effects.Conclusions CEREC atypical ceramic inlays can effectively restore Class Ⅱ cavity,short-term effect is good,but long-term effect still needs further observations.

Distal radius fractures often occur in the elderly.At present,there has not yet reached a consensus on how to take effective measures for the treatment of such fractures in clinical.There are many different therapeutic methods for this fracture with different effect.Based on the summary of the relevant literature,the epidemiological characteristics of fractures of the distal radius,treatment,implant selection,surgical procedure,complications and prevention were summarized,in order to provide references for clinical treatment.

Objective To study the association of prevalence of cardio-cerebro vascular diseases (CCVD) with metabolic syndrome (MS) defined by different criteria in middle and aged people.Methods A cross-section survey was conducted among 1458 people aged 55 years and over in urban and rural areas of Beijing in 2009.MS definitions by World Health Organization (WHO),National Cholesterol Education Program-Adult Treatment Panel Ⅲ (NCEP-ATP Ⅲ ) revised,international diabetes mellitus (IDF) and Chinese Diabetes Society (CDS) were applied to analyze the association MS with the prevalence of CCVD.Results The risks of CCVD were all significantly higher in patients with MS than with non-MS using 4 definitions of MS.The definitions of WHO and CDS showed well agreement with the prevalence of CCVD.OR values of MS for CCVD were 2.14 folds (95％ CI:1.59-2.87) for WHO definition and 1.91 folds (95％ CI:1.43-2.55) for CDS definition,while OR values of MS for CCVD were 1.68 folds (95％ CI:1.32-2.15) for NCEP-ATPⅢ definition and 1.64 folds (95％ CI:1.26-2.13) for IDF definition as compared to non-MS,respectively.After adjustment for age,sex,region,history of smoking and alcohol drinking,the OR values in above four definitions were 1.91,1.88,1.67 and 1.80,respectively.The OR value of MS was highest for stroke by CDS definition and highest for coronary heart disease by WHO definition.Conclusions MS values defined by WHO and CDS are the optimal index of prevalence for CCVD in middle and aged people.

Objective To analyze the effect of stroke duration on the cognitive function in the elderly population in Beijing.Methods Based on the Research Project of Beijing Chronic Disease Combined with Common Elderly Syndrome Community Management Practices,a cross-sectional study was used.From July 2013 to December 2014,the old population in 4 districts and a county (Xicheng District,Fangshan District,Tongzhou District and Yanqing County) in Beijing were sampled with the multi-stage,randomized and stratified sampling.A total of 3 024 subjects were enrolled in the study.The data were obtained from the questionnaires and clinical examinations.Mini-Mental State Examination (MMSE) was used as the evaluation index of cognitive function.The subjects were divided into either a normal cognitive function group (MMSE>26,n=1 878) or a cognitive impairment group (MMSE≤26,n=1 146) according to the MMSE scores.A multiple logistic regression model was used to analyze the effects of hemorrhagic stroke,ischemic stroke,and asymptomatic stroke,as well as disease duration on cognitive function.Results After adjusting for the confounding factors,such as sex,age,educational level,marriage,smoking,and alcohol consumption,the risks of occurring cognitive impairment in patients with hemorrhagic stroke in stroke duration for 1-3,4-10 and >10 years were OR 3.019 (95％CI 0.974-9.361,P=0.056),8.652 (95％CI 2.924-25.601,P<0.01) and 1.104 (95％CI 0.311-3.920,P=0.879) times of those without occurring stroke population;the risks of occurring cognitive impairment in patients with ischemic stroke in stroke duration for 1-3,4-10 and >10 years were 1.000 (95％CI 0.636-1.571,P=1.000),1.874 (95％CI 1.231-2.853,P=0.003),2.439 (95％CI 1.386-4.291,P=0.002) times of those without occurring stroke population.Stroke duration for 4-10 years in patients with hemorrhagic stroke and stroke duration for 4-10 and >10 years in patients with ischemic stroke were all the risk factors for occurring cognitive dysfunction.Conclusion For patients with stroke,stroke duration or long-term effects has a certain impact on cognitive function.

Objective To investigate the prevalence and risk factors of H-type hypertension among middle-aged and elderly people in Beijing community. Methods A cross-sectional study by recruiting 1 458 middle-aged and elderly people from a cohort of the "Beijing Longitudinal Study of Aging" in 2009 was conducted. All participants were asked to complete a standardized questionnaire, physical examination and laboratory examinations. Hyperhomocysteinemia was defined as homocysteine (Hcy) > 15 μmol/L, and H- type hypertension was defined as having hypertension and hyperhomocysteinemia simultaneously. The prevalence of H-type hypertension was estimated by using the results of 2000 Beijing population census to weight the data. Multivariate Logistic regression analysis was preformed to estimate the associated factors of H-type hypertension. Results The age was (69.48 ± 8.09) years, and the distribution of Hcy was skewed with the median of 16.56 μmol/L. After weight, the prevalence of hyperhomocysteinemia was 57.20% (834/1 458), and the prevalence of H-type hypertension was 35.32% (515/1 458), accounting for 59.47% (515/866) in patients with hypertension. The ageing, male, hyperuricemia, estimated glomerular filtration rate (eGFR) and insufficiency of fishes/ shrimps were independent risk factors of H-type hypertension ( OR = 2.30, 1.04, 1.02, 0.95 and 0.67; 95% CI 1.54-3.44, 1.02-1.06, 1.04-1.06, 0.94-0.97 and 0.46-0.97; P＜0.01 or＜0.05). Conclusions The proportion of H-type hypertension is high in the middle-aged and elderly people in Beijing community. Lowering uric acid, protection of renal function and intake sufficient fishes and shrimps might prevent and control H-type hypertension.

Objective To investigate the prevalence characters of peripheral artery disease (PAD) and associated factors among people aged 35 and above in Beijing. Methods This was a cross?sectional study. A total of 5 208 community?based individuals aged equal and above 35 in Beijing were chosen with stratified multistage random sampling method. Structure questionnaire was used to collected the information of demographic factors, habits and chronic disease history. Ankle brachial blood pressure was detected and ankle brachial index (ABI) was calculated. ABI was used to diagnose PAD (ABI≤0.90). Based on the 2010 Beijing Municipal Population Census, the age?and gender?specific weight?adjusted sample was acquired to estimate the prevalence of PAD and corresponding 95% confidence intervals ( CI ). Multivariate logistic regression analysis was performed to estimate the associated factors of PAD. Results The age?and sex?standardized prevalence of PAD was 3.84% (200/5 208, 95%CI 3.32%-4.36%). There was no significant difference between male and female (3.83%(102/2 664 ,95%CI 3.10%-4.56%) vs. 3.85% (98/2 544,95% CI 3.10%-4.60%), P=0.965). The prevalence of PAD in urban was higher than that in rural (4.34% (163/3 755,95%CI 3.69%-4.99%) vs. 2.55% (37/1 453,95%CI 1.74%-3.36%), P=0.001). Furthermore, the prevalence of PAD increased with age (Ptrend<0.01), and the difference between genders did not change with ageing (all P>0.05). In addition, age (OR=1.03, 95%CI 1.01-1.04), urban (OR=1.52, 95%CI 1.08-2.12), smoking ( OR=1.83, 95%CI 1.29-2.59), hypertension ( OR=1.61, 95%CI 1.17-2.22) and diabetes (OR=1.44, 95%CI 1.08-1.93) were related with increased risk of PAD in logistic regression analysis models. Conclusions The prevalence of PAD increases with age in Beijing and there are significant difference between urban and rural on prevalence of PAD. Age, urban, smoking, hypertension and diabetes are related with increased risk of PAD.

[Abstract] Objective: To investigate the expression and clinical significance of PD-1/PD-L1 in gastric cancer (GC) tissues. Methods: Paraffin embedded tumor tissues and clinical data of 82 GC patients who had undergone operation at the Fourth Hospital of Hebei Medical University from January 2007 to December 2007 were collected, and their survival status was followed. The protein expressions of PD-1 and PD-L1 in tumor tissues were detected by immunohistochemistry. Kaplan-Meier analysis and Log-Rank test were adopted to analyze the survival of GC patients, and the ROC curve was plotted. Results: The positive rate of PD-L1 protein expression was 42.68% while the positive rate of PD-1 expression was 13.41% in GC tissues. The positive rate of PD-1 and PD-L1 expression in GC tissues of patients without pre-operative distant metastasis was significantly lower than those patients with pre-operative metastasis (PD1： 3.28% vs 42.86%; PD-L1： 13.11% vs 90.48%; all P<0.01). The positive rate of PD-L1 expression in tumor stroma of patients without pre-operative distant metastasis was significantly lower than those with metastasis (PD-L1: 13.11% v s 47.62%, P<0.01). The resection range of stomach, PD-L1 over-expression and the presence of pre-operative distant metastasis were the adverse factors affecting the prognosis of patients with GC (P<0.05). Conclusion: PD-1 and PD-L1 expressions in GC tissues were closely related to the presence of pre-operative distant metastasis and the depth of tumor infiltration. The postoperative survival of patients who were PD-L1 positive was shorter than the negative ones.

Objective To find out the prevalence of urinary incontinence(UI),as well as its impact on self assessed life quality in community dwelling elderly Beijing residents.Methods A total of 2 878 local elderly residents(≥ 65 years)were enrolled through stratified cluster random sampling from July 2013 to December 2014 in Beijing.A face-to-face questionnaire survey and physical examination were conducted by trained investigators.UI was screened using ICIQ SF.Prevalence of UI was adjusted by the standard population of Beijing and the number of elderly people with UI was estimated.Results The overall prevalence of UI was 24.6％.The morbidity of UI was 18.5％ in male and 29.8％ in female participants.The estimated number of elderly UI patients in Beijing was about 445 thousands,with 153 thousand male and 292 female patients.After adjustment for potential confounding demographic,lifestyle and chronic disease factors,logistic regression analysis revealed that UI was negatively correlated with several self-assessed measures,including quality of life,health,sleep quality,activities of daily life,sexual life and relationship with other people(all P＜0.05).Moreover,negative emotions in the last four weeks increased in the elderly with UI.Conclusions Nearly one quarter of the aged population,especially among aged women,in Beijing suffer from UI.UI severely affects the quality of life and emotions in aged persons.It is necessary to take early interventions to improve quality of life and promote healthy aging.