Objective To investigate the kidney function changes and the risk factors in elderly patients aged 80 years and over.Methods A total of 1054 hospitalized patients aged ≥80 years in our hospital were selected.Serum levels of creatinine,urea,uric acid and urinate were tested.Cockcroft-Gault equation was used to estimate glomerular filtrate rate (GFR).Results The renal function in 87.1 ％ of the patients was reduced.The percentage of patients with 30≤eGFR ＜60 ml · min-1 · 1.73 m-2 was 66.2％.The percentage of patients with 15≤eGFR ＜30 ml · min-1 · 1.73 · m-2had a gender difference (P＜0.05).Serum creatinine level was not an ideal indicator for early renal dysfunction in the elderly,especially in emaciated elderly people.Multivariate logistic regression analysis showed that gender,hypertension,coronary heart disease and hyperuricemia were independent risk factors for the decline of renal function (OR=1.937,1.602,1.842,7.020,respectively,all P＜0.05).Conclusions The rate of renal dysfunction is high in very old people.Many risk factors affect renal dysfunction.

Objective To explore the influence of family function on health behaviors of stroke patients and the mediating effects of depression.Methods From September 2011 to April 2012,101 stroke survivors from a certain hospital in Guangzhou were investigated with Health Promoting Lifestyle Profile Ⅱ (HPLP Ⅱ),Family Assessment Device (FAD) and Self-Rating Depression Scale (SDS).Results The mean score of overall health behavior was (2.27±0.36).The mean score of overall family function was (2.18±0.25).The score of overall depression was (37.39±7.94),which was higher than normal people.And the incidence of the stroke survivors' depression state was 29.5％.There was a correlation between family function,depression and health behavior.The depression totally mediated the influence of problem solving on health behaviors.The depression partially mediated the influence of communication,affective responsiveness,behavior control on health behaviors,and their mediating effects were 32.1％,37.4％,26.1％.Conclusions The promotion of family function and the reducing of depression can be regarded as the in-tervention to improve their health behavior.

Background Evaluation of intra-retinal layer thickness plays an important role in the diagnosis and monitor of various eye diseases,and spectral domain optical coherence tomography (OCT) is a frequently used tool.Software analysis method was used to measure the retinal thickness in previous study,but the study on the reliability of automatic layered software is lack.Objective This study was to evaluate the repeatability and reproducibility of thickness profile measurement of intra-retinal layers determined by an automated algorithm applied to OCT images from RTVue100 OCT instrument.Methods In this prospective cross-sectional study,retinal thickness images at 6 mm around fovea were obtained from 18 right eyes of 18 normal subjects with RTVue100 OCT instrument.The retinal images were segmented into retinal nerve fiber layer (RNFL),ganglion cell layer and inner plexiform layer(GCL+IPL),inner nuclear layer (INL),outer plexiform layer (OPL),outer nuclear layer (ONL),inner segment (IS),outer segment (OS) and retinal pigment epithelial (RPE) layer using automated algorithm method.Then Matlab software was used to analyze the measuring outcome.Interclass correlation coefficient (ICC) and coefficients of reproducibility (COR) were calculated from the results of two-time examination by the same examiner to evaluate the repeatability and from the results of two different examiners to assess the reproducibility.Written informed consent was obtained from each subject prior to any medical procedure.Results The entire retinal thickness measured by RTVue-OCT was (303.22± 14.10) μm in the horizontal meridian and (306.68 ± 13.32) μm in the vertical meridian,with the maximum values of retinal thickness in the GCL+ IPL and ONL.Whether in the horizontal meridian or in the vertical meridian,the ICC and COR were ＜0.60 in the OPL,IS and OS;while those in the RNFL,GCL+IPL,INL,ONL and RPE layer were ＞0.70.Conclusions RTVue OCT with automated algorithm is a useful and reliable approach to the measurement of intra-retinal layer thickness.Automated segmentation can offer accurate and repeatable thickness profile of OCT retinal image.This method may improve the diagnosis and monitoring of retinal diseases.

Background Ultra-long scan depth OCT can achieve imaging of full range of human ocular anterior segment.However,the measurement of the dimension of anterior segment from the OCT image with high speed and precision is a challenge at present.The software of automatic data processing is still lack in analyzing spectral domain OCT.Objective This study was to perform the automatic biometry and data processing of human ocular anterior segment OCT image by using self-developed automatic detection software and evaluate the accuracy and repeatability of this method.Methods Twenty eyes of 10 normal subjects were included in Eye Hospital of Wenzhou Medical University from June to July 2013.The OCT image of anterior eye segments were obtained with custom-made ultra-long scan depth OCT under the informed consent.Anautomatic software algorithm was developed for the biometric measurement on these OCT images,including boundary segmentation,image registration and optical correction of OCT images.The boundary segmentation algorithm utilized the axial gradient information of OCT images and the shortest path search principal based on the dynamic programming to optimize edge finding.Central corneal thickness (CCT),anterior chamber depth (ACD),pupil diameter (PD),lens thickness (LT),radius of lens anterior curvatures (LAC) and radius of lens of posterior curvatures (LPC) were automatically and manually measured,and the validity of automatic detection algorithm was assessed by calculating the intraclass correlation coefficient (ICC) between the automatic and manual measurements,and the repeatability was validated by calculating the coefficient of repeatability (COR) between repeated measurement.This study was approved by the Ethic Committee of Wenzhou Medical University and informed consent was obtained from all subjects.Results There were no significant differences in the results of CCT,ACD,PD,LT,LAC and LPC between the automatic and manual measurements (P =0.205,0.167,0.285,0.127,0.102,0.074).The results were consistent between automatic and manual measurements (all at ICC＞0.75).The repeated measurement values were consistent in CCT,ACD and LT in both automatic and manual modes (all at ICC＞0.75).The reproducibilities of automatic biometry in PD and LAC (ICC =0.793,0.872;COR =2.90,5.79) were better than those of manual mode (ICC =0.631,0.579;COR =5.62,10.46);while the reproducibility of automatic biometry in LPC (ICC =0.663;COR =6.17) was lower than that of manual mode (ICC =0.794,COR =4.79).Conclusions Self-developed automatic detection software appears to be accurate and repeatable in measuring dimension of spectral domain OCT images.This automatic software algorithm can be used for the biometry and monitor of human ocular anterior segment.

[ ABSTRACT ] AIM: To investigate the protect effect of Chinese herbal preparation, Qing Yi TangⅡgranule (QYT), on acute pancreatitis (AP) mice and its mechanism.METHODS:Adult male and female C57BL/6 mice (n=24) were randomly divided into control group, AP group and AP+QYT group.Severe AP was induced by combined intra-peritoneal injection of caerulein (50μg/kg) and lipopolysaccharide (LPS;10 mg/kg).Drinking water or 24%QYT solu-tion was given to the mice in AP group or AP+QYT group by oral gavage.The mice in control group were intraperitoneally injected with equivalent volume of normal saline and gavaged with water.The mice were sacrificed 3 h after the last injec-tion.Severity of AP was assessed by biochemical markers and histology.The plasma level of IL-6 and MCP-1, and lung myeloperoxidase ( MPO) levels were determined for assessing the extent of systemic inflammatory response.The intestinal microflora, T lymphocytes and T-lymphocyte subgroups were examined for assessing the function of the intestinal barrier. RESULTS:Compared with control group, the mice in AP group presented significant increases in pathological histological scores, plasma amylase activity and IL-6 and MCP-1 levels, as well as the MPO activity in the lung and pancreatic tissues. QYT attenuated these changes to some extent.Furthermore, the increased intestinal microflora was significantly reversed by QYT.No difference of the numbers of Peyer’ s patches in small intestine in the 3 groups was observed, but the percentage of CD3 +T lymphocytes decreased significantly in AP group, and increased percentage of CD4 +and CD4 +/CD8 +ratio were found in AP group and AP+QYT group.CONCLUSION: QYT protects against cearulein and LPS-induced acute pancreatitis in mice.The mechanisms may be related to the suppression of the inflammatory response, promoting intestinal bacteria removal, and regulating the functions of T lymphocytes in the intestinal barrier.

AIM:Using Toll-like receptor 4 gene knockout (tlr4-/-) mice and the wild-type (WT) mice with the same C57BL/10J genetic background, the effects of HU210, a cannabis preparation, on caerulein (CAE)-induced acute pancreatitis (AP) and the potential mechanisms were investigated.METHODS:WT or tlr4-/-mice were randomly divided into AP group, AP+HU210 group and control group.AP was induced by intraperitoneal injection of CAE (50 μg·kg-1·h-1) for a total of 6 times and lipopolysaccharide (LPS) at 10 mg/kg 6 h after the first injection of CAE.HU210 (50 μg/kg) was given 30 min before and 4 h after the first injection of CAE in AP+HU210 group.The animals in control group were given normal saline instead of CAE and LPS in the same way.The mice were sacrificed 3 h after the last injection.The blood, the pancreas, the lungs and the intestinal Peyer's patches were harvested.RESULTS:Compared with control group, the pancreatic pathological score and P38 protein expression, plasma amylase activity and inflammatory mediator levels, and lung MPO activity were significant increased (P<0.05) in both WT and tlr4-/-mice with AP.Compared with the WT mice with AP, the tlr4-/-mice with AP showed significantly low levels of IL-6, TNF-α and MCP-1 in the plasma, low expression levels of pancreatic P38 and p-P38 protein (P<0.05), and mild alterations of CD3+ T-lymphocytes, CD4+ T-lymphocytes and the ratio of CD4+/CD8+ (P<0.05).The administration of HU210 attenuated the pancreatic pathological changes and the lung MPO activity in both stains of mice with AP (P<0.05).However, the inhi-bitory effects of HU210 on the increased amylase activity in the plasma and the increased protein levels of pancreatic P38 and p-P38 were remarkable (P<0.05) in WT mice instead of in tlr4-/-mice.CONCLUSION:TLR4 is mainly involved in AP-related systemic inflammatory response and its mechanism may be dependent on TLR4-P38 MAPK signaling pathway.The intervention of HU210 in AP plays a protective role mainly by inhibiting the infiltration of inflammatory cells, and the relationship with TLR4 signaling pathway is not obvious.

For rapid and accurate screening of recombinant modified vaccinia virus Ankara (rMVA) that satisfied the quality standards of clinical trials, a novel shuttle vector that can delete the marker gene automatically during virus propagation was construted: pZL-EGFP. To construct the pZL-EGFP, the original shuttle vector pSC11 was modified by replacing the LacZ marker gene with enhanced green fluorescent protein (EGFP) and then inserting homologous sequences of TKL into the flank regions of EGFP. Baby hamster kidney (BHK)-21 cells were cotransfected with pZL-EGFP and MVA, and underwent ten passages and one plaque screening to obtain the EGFP-free rMVA carrying the exogenous gene. Resulting rMVA was tested by polymerase chain reaction and western blotting to verify pZL-EGFP function. A novel shuttle vector pZL-EGFP containing an EGFP marker gene which could be deleted automatically was constructed. This gene deletion had no effect on the activities of rMVA, and the exogenous gene could be expressed stably. These results suggest that rMVA can be packaged efficiently by homologous recombination between pZL-EGFP and MVA in BHK-21 cells, and that the carried EGFP gene can be removed automatically by intramolecular homologous recombination during virus passage. Meanwhile, the gene deletion had no influence on the activities of rMVA and the expression of exogenous target gene. This study lays a solid foundation for the future research.
Animals ; Biomarkers ; Cricetinae ; Epithelial Cells ; virology ; Gene Deletion ; Genetic Engineering ; methods ; Genetic Vectors ; genetics ; metabolism ; Green Fluorescent Proteins ; genetics ; metabolism ; Humans ; Recombination, Genetic ; Vaccinia ; virology ; Vaccinia virus ; genetics ; physiology ; Virus Replication

Objective To investigate the characteristics of the objective sleep disturbances in Parkinson' s disease (PD) and the factors related to it.Methods One hundred and one PD patients and 90 age- and sex- matched controls underwent a video-polysomnography.The sleep parameters and its related factors in two groups were analyzed.Results Sleep latency was not statistically different in comparing two groups.PD patients had a higher percentage of non-rapid eye movement( non-REM ) sleep stage 1 and a lower percentage of non-REM sleep stage 2 compared with controls ( 27.9 ± 1 7.8 vs 21.2 ± 11.7,t =3.034,P =0.003 ;47.8 ± 17.4 vs 54.7 + 12.9,t =- 3.043,P =0.003 ).Reduced sleep efficiency,decreased the proportion of slow wave sleep and REM sleep,increased awake time and longer REM sleep latency occurred in PD patients.There were no significant differences of these above parameters.Some sleep parameters in PD patients were correlated with advancing age,the severity of PD,and the degree of depression.The index of periodic leg movements in sleep (PLMSI) of 41 PD patients (40.6％ ) was more than 15.These PD patients didn' t complain corresponding symptoms about their legs.The PLMSI in PD patients were significantly higher than the controls.PLMSI increased with aging in the PD group( r =0.261,P ＜0.01 ).PD patients didn' t suffer significantly lower apnea- hypopnea index and oxygen desaturation index.The lowest SPO2 ( L-SPO2 ) increased in the PD group.REM sleep without atonia occurred in 83 patients (82.2％) with PD.Thirty-eight patients (37.6％) were diagnosed with REM sleep behavior disorder (RBD).The incidences of REM without atonia and RBD in the PD group were significantly higher than in the control s(0 and 8 patients (8.9％),x2 =42.271,102.480; both P ＜ 0.01 ).Conclusions The sleep parameters in PD patients are changed.For PD patients,there is no difficulty in falling asleep.The PD patients also have sleep structure disorder and difficulty in maintaining sleep.The sleep parameters are correlated with advancing age,the severity of PD,and the degree of depression in PD.PLMS don' t lead to sleep disturbances in PD patients.The blood oxygen saturation don' t decrease severely when PD patients suffer apnea or hypopnea.RBD occur more frequently in PD patients.

AIM: To explore the expression and significance of receptor tyrosine kinase anexelekto (Axl) in nasopharyngeal carcinoma (NPC).METHODS: Immunohistochemistry was used to detect the Axl protein expression of 78 patients with NPC and 32 patients with nasopharyngeal chronic inflammation (NPI).The correlations between the Axl protein levels and the clinical parameters of NPC patients were analyzed.NPC cells were cultured in vitro, and the expression of Axl in well differentiated CNE1 cells, poorly-differentiated CNE2Z cells and undifferentiated C666-1 cells was detected by immunofluorescence staining.After treatment of the CNE1and C666-1 cells with Axl specific inhibitor TP-0903, CCK-8 assay was used to detect cell viability, flow cytometry was adopted to analyze the cell cycle distribution, qPCR was used to examine the mRNA levels of Axl and proliferating cell nuclear antigen (PCNA), and Western blot was used to examine the protein expression of Axl and p-Axl.RESULTS: Axl protein was localized in the cell membrane and cytoplasm.The rate of high expression of Axl in NPC was significantly higher than that in NPI (P<0.01).High Axl expression showed no correlations with NPC patients'' age, gender and M stage, while positively correlated with the clinical stage, T stage and N stage (P<0.05).Axl protein showed a low level in the CNE1 cells, but showed a high level in CNE2Z and C666-1 cells.TP-0903 inhibited cell viability in concentration and time dependent manners.TP-0903 at 2 nmol/L showed significant inhibitory effects, as evidenced by arresting the cell cycle at G0 phase and reducing Axl activity and PCNA expression.CONCLUSION: High expression of Axl promotes the clinical progress of NPC.TP-0903 significantly inhibits the viability of NPC cells, suggesting that Axl may be a valuable target in the NPC treatment.

Objective:Through literature search,this paper aims to understand the current situation of social trust mechanism and the research progress of trust evaluation methods,and thus to provide theoretical reference for further researches.Methods:Using the literature search method,this paper sorted out,analyzed and concluded the domestic and foreign literatures and information about social trust mechanism and trust evaluation.Results:The domestic research on social trust mechanism could be mainly divided into two parts,while the foreign research path was different and mainly related to the field of electronic commerce,government departments,medical behavior,and so on.Evaluation methods in doctor-patient trust mainly included trust scale evaluation and trust model.Conclusion:There is a certain development of the domestic researches on social trust mechanism and evaluation,but still need further improvement.The limitation of doctor-patient trust evaluation is prominent and efforts should be made to research on the improvement measures of medical social trust mechanism.