Anorexia of aging is one of the common clinical geriatric syndrome in clinic, characterized by the persistent and significant decreasing of appetite and/or by reducing a food intake in the elderly, which can cause various adverse consequences and increase the morbidity and mortality.However, clinicians have insufficient understanding of anorexia in the elderly, and often regard the anorexia of aging as the normal phenomenon of aging and might ignore it.This article reviews the domestic and foreign relevant literatures on anorexia of aging.

Gastrointestinal motility disorders are commonly seen digestive system diseases in elderly subjects. During the process of normal aging,digestive tract experiences a series of degenerative changes,which is the foundation of many gastrointestinal motility disorders. Further study on gastrointestinal dysmotility and its mechanisms is of great significance for the diagnosis and treatment of related diseases in aging population. In this article,the advances in studies on effects of aging on motility of digestive tract( including oropharynx,esophagus,stomach,small bowel,colon and anorectum)and its mechanism researches were reviewed.

ObjectiveTo compare the results of Verme ul en calculation and the enzyme immunoassay in the determination of serum free tes tosterone (FT)concentration in aging males.Methods129 healthy males over 45 years of age who have no disease or medicine that can infl uence the secretion of hormone were enrolled in the study. They were divided int o 4 age groups. The serum specimens were prepared and kept under -40 ℃ until as saying. All the samples were divided into two parts, one measured by enzyme immu noassay and the other calculated with the Vermeulen formula after determining th e total testosterone(T)and sex-hormone-binding globulin(SHBG):FT=T- 23.43FTSHBG-(T-23.43FT)?10 -9 mol/L.The data were analyzed by S PSS.ResultsThe results of FT in the 129 males were (46 .69?21.79)pmol/L by enzyme immunoassay and (396.30?317.04)pmol/L by calculatio n.Pairing test suggested that " t " was 13.01 and the difference of FT w as remarkably significant ( P

Objective To observe the effects of aging on liver and heat shock protein (HSP)70 expression in rats,and explore the role of HSP 70 in the changes of aging liver. Methods 24 healthy Sprague Dawley rats were divided into 4 groups according to age:21-day-old group,3-monthold group,12-month-old group and 18-month-old group (n=6 per group).Routine blood tests and biochemical tests were tested. Liver tissues were observed under light microscopy. The mRNA expression of HSP70 was detected by real-time PCR. Results The ratios of liver weight to body weight were decreased gradually with aging in 4 groups (0.073,0.050,0.025,0.019,respectively,t=78.016,P =0.000).Compared with those of young rats (21-day-old and 3-month-old),serum albumin levels of aged rats (12-months and 18-months) were declined [(35.0±2.7) g/L and (39.8±3.5) g/L vs.(27.3±9.3) g/L and (20.6± 1.7) g/L,t=12.233,P=0.000].Nevertheless serum alkaline phosphatase (ALP) levels were increased with aging [(68.8± 23.3) U/L,(71.6 ± 19.2)U/L,( 185.9 ± 41.5) U/L,(418.6 ± 140.6) U/L,respectively,t =35.454,P=0.000].The differences in other routine biochemical indexes were not found among the age groups (P＞0.05).Liver histological changes including hepatocytes disordered and vacuolization or fatty changes were detected with aging,especially in 18 month-old rats. Real-time PCR results indicated that the expression level of HSP70 mRNA was much lower in 18-month-old rats than in 12-month-old and 3-month-old rats (0.218 vs.0.220 and 0.230,P=0.000). Conclusions HSP70,as a stress protein,may play an important role in the procedure of injury and senescence of liver cell,and then can serve liver aging as one of the influential markers.

Objective To investigate the changes of liver histology and ultrastructure in aged Beagles dogs.Methods A total of fifteen healthy Beagles,1 .5 to 10.6 years old,were divided into middle-aged group (n=8,average (2.21 ±0.94)years old)and aged group (n=7,average (8.26±1 .52) years old)according to age.After intravenous anesthesia,the liver tissues of dogs were taken to compare number and morphology of hepatocytes and extra cellular matrix (ECM)of two groups under light microscope with hematoxylin-eosin staining.The number density, morphology and area fraction of mitochondria,the morphology and area fraction of endoplasmic reticulum,the changes of number density and morphology of microbody,the thickness of hepatic sinusoidal endothelial cell as well as the density and the diameter of fenestrae,the changes of morphology and number of lipofuscin in two groups were compared under electron microscope.Independent sample t-test was performed for comparison between two groups.Results Under light microscope,hepatocytes were arranged radially around the central veins,especially obvious in the middle aged group. Hepatocytes were circular or oval,most were mononuclear or binuclear.The cytoplasma of hepatocyte in middle-aged group was dense eosinophilic pink.Vacuolar lipid droplets were small and scanty.The cell boundary was clear.In aged group, cytoplasmic vacuolization of hepatocyte was more obvious,bigger vacuolated lipid droplets were observed, eosinophillic granules were scattered in the cytoplasma,cellular boundary was blurry and the number of hepatocytes significantly decreased when compared with middle-aged group ((75 .80 ±5 .76 )/high power field (HPF)vs (97.80 ±6.45 )/HPF,t = -2.510,P =0.026 ).There were no obvious infiltration of inflammatory cells in the liver tissue of Beagles dogs in both middle-aged group and aged group.Compared with middle aged group, cell gap and ECM increased in aged group. Under electron microscope, mitochondria of normal hepatocyte was oval,round or horseshoe-shaped with double membranes,ridge was observed inside and distributed around nucleus.Compared with middle-aged group,the shape of hepatocyte mitochondria in aged group was varied,the number density of mitochondria significantly decreased (0.202±0.021 vs 0.248 ±0.040,t = -2.683,P =0.020)and the area fraction remarkably reduced (0.136 ±0.015 vs 0.202 ±0.019,t = -6.083,P <0.01 ).Endoplasmic reticulum was mesh laminated arranged,scattered flake distributed and was mostly seen around nucleus in flat or stacked shape.Compared with middle aged group,the area fraction of endoplasmic reticulum of hepatocyte in aged group was obviously reduced (0.006±0.001 vs 0.011 ±0.004,t=-3.338,P =0.005).Lipofuscin was shaped as round or irregular structure without membrane and pigment unevenly distributed inside.The number of lipofuscin in aged group was significantly higher than that in middle-aged group (0.028±0.025 vs 0.001 ±0.000,t=2.880,P =0.014).The number of microbody in aged group was slightly less than that of middle aged group and the difference was not statistically significant (P =0.603).The thickness of the liver sinusoidal endothelium in aged group significantly increased compared with that in middle-aged group ((0.242±0.047)μm vs (0.114±0.075)μm,t=3.881 ,P =0.002).The diameter and density of endothelial fenestration in aged group ((1 .895 ± 0.439 )μm and (0.260 ± 0.120 )/μm)obviously decreased compared with those in middle-aged group ((3.186±0.332)μm and (0.723±0.184)/μm,t=6.345 and -4.511 ,both P <0.01).Conclusions There were significant degradations of liver in quality and quantity among aged individuals.These degradations were the structure basis of decreased hepatic reserve function and involved directly or indirectly in high prevelance of hepatic diseases among elders.

Background:It has been demonstrated that H + -K + -ATPase expression in human parietal cells had a tendency to increase with aging. However,the effect of aging on activity of H + -K + -ATPase is still unclear. Aims:To investigate effect of aging on activity of H + -K + -ATPase. Methods:Fifteen male Sprague-Dawley(SD)rats were divided into 4,21,24, 27 and 30 months group,and 19 healthy beagle dogs were divided into younger group,junior elderly group and senior elderly group. The activity of H + -K + -ATPase in gastric fundal mucosa was assessed. Results:The activity of H + -K + -ATPase in gastric fundal mucosa in 4,21,24,27 and 30 months old rats were(4. 850 ± 0. 312)μmol·mg - 1 ·h - 1 , (5. 466 ± 0. 379)μmol·mg - 1 ·h - 1 ,(6. 068 ± 0. 228)μmol·mg - 1 ·h - 1 ,(5. 733 ± 0. 767)μmol·mg - 1 ·h - 1 and (6. 223 ± 0. 428)μmol · mg - 1 · h - 1 ,respectively. With aging,H + -K + -ATPase activity in rats had a tendency to increase(F = 4. 519,P = 0. 031). The activity of H + -K + -ATPase in beagle dogs in younger group,junior elderly group and senior elderly group were(11. 087 ± 4. 320)μmol·mg - 1 ·h - 1 ,(8. 549 ± 3. 250)μmol·mg - 1 ·h - 1 ,(12. 071 ± 2. 820)μmol·mg - 1 ·h - 1 ,respectively. There was no statistically significant difference among the three groups(F =1. 339,P = 0. 290). Conclusions:With aging,the activity of H + -K + -ATPase in rats and beagle dogs does not decline, but even has a tendency to increase.

Recent studies showed that gastric mucosa was more susceptible to injury by invasion factors with aging, however,the studies were mainly on gastric antral mucosa,fundic mucosa was rarely studied.Aims:To investigate the effect of aging on related biological activity factors in gastric fundic mucosa in beagle dogs.Methods:Nineteen beagle dogs were assigned into younger group (aged 1-5 years),junior elderly group (aged 6-8 years)and senior elderly group (aged≥9 years).The contents of MDA,LPO,MPO in gastric fundic mucosa were determined by TBA method.The contents of PTEN,TE,survivin,caspase-3,caspase-9,ZO-1,CGRP,VEGF,COX-1 and COX-2 were assessed by ELISA.Results:Compared with younger group and junior elderly group,contents of MDA,LPO,MPO,PTEN,TE,ZO-1 ,CGRP,VEGF, COX-1 and COX-2 were significantly increased in senior elderly group (P<0.05),no significant differences in contents of caspase-3 and caspase-9 were found among the three groups (P>0.05 ).The content of survivin in junior elderly group and senior elderly group was significantly decreased when compared with younger group (P =0.000 ).Conclusions:Disadvantaging changes of biological activity factors are found in gastric fundic mucosa in elderly beagles dogs,however, gastric mucosal blood flow, mucosa regeneration and epithelial tight junction related biological activity factors are significantly increased in senior elderly beagle dogs,which may be a phenomenon of degeneration-compensation.

Objective To review the clinical features of drug-induced liver injury (DILI) in elderly Chinese patients.Methods A literature search was conducted with the key wordsdrug-induced liver injury ordrug-induced liver disease andelderly; four Chinese medical databases were used:including Chinese Biomedical Literature Database (CBM),Chinese Science and Technology Periodical Database (VIP),Wanfang Database and China National Knowledge Infrastructure (CNKI),from when the bases established to December 2011.Data from retrieved literatures of retrospective controlled studies of DILI were analyzed by SPSS 14.0 software.Results Five studies met the inclusion criteria,including 275 elderly patients (aged group) and 602 non-elderly patients (non-aged group) with DILL There was no significant difference in gender between the two groups (P ＞ 0.05).Clinical manifestations of jaundice,fatigue,anorexia,and skin itching were more commonly seen in the aged group (P ＜ 0.01).Cholestatic hepatic injury occurred more frequently in the aged group than in the non-aged group [24.9％ (61/245) vs.18.8％ (102/245),P ＜ 0.05],while hepatocellular type occurred more frequently in the non-aged group [64.3％ (350/544) vs.55.1％ (135/245),P ＜ 0.05].More DILI were induced by Chinese herb medicine and cardiovascular drugs in the aged group than in the non-aged group [47.0％ (79/168) vs.35.9％ (93/254) and 8.3％ (14/168) vs 1.2％ (3/259) respectively,P ＜ 0.05].As for the prognosis,there was no significant difference in clinical cure and improvement rate between the two groups [84.4％ (141/167) vs.81.5％ (291/357),P ＞0.05].Conclusion The elderly are more sensitive to the drugs and have a high risk of DILI.Prevention and timely diagnosis and treatment of DILI are particularly important for elderly patients.

Objective To investigate the age-associated changes of ultrastructure,mRNA and protein expressions of H+-K+-ATPase in elderly gastric parietal cell. Methods Fifty patients with relative normal stomach without gastroduodenal diseases were enrolled,including younger group (aged 20-59 years,n=19) and elderly group (aged≥60 years,n=31).Furthermore,the elderly group was divided into 3 subgroups:60-69 years old (n =11 ),70-79 years old (n=10 ),above 80 years old (n =10).The ultrastructure of gastric parietal cell was observed under electron microscope.The expression of H+-K+-ATPase α subunit mRNA and H+-K+-ATPase β subunit protein were assessed by quantitative real-time PCR and Western-blot,respectively.The ageing-associated changes of all these data were respectively compared. Results No significant difference was showed in the morphology of gastric parietal cell and acid-secretion-associated organelles among all the groups.The average ratio Am to Ac (Am means the area of mitochondria,Ac means the area of cytoplasm) of gastric parietal cell and the average At to Ac ratio (At means the area of secretory canaliculi and tubulovesicular system )between younger group and elderly group had no significant difference[(48.4±7.5) ％ vs.(50.6±7.6) ％,t=-0.775,P=0.444; (13.8±4.1) ％ vs.(12.2±4.7) ％,t=0.984,P=0.332].Meanwhile,there were no distinctions in the expression of H+-K+ -ATPase α subunit mRNA and H+-K+-ATPase protein among all elderly subgroups(F=1.522,2.32,P=0.24,0.114).However,the mRNA expression of H+-K+-ATPase a subunit was higher in the elderly group than in the younger group(t=-3.682,P=0.001).Furthermore,the expression of H+ -K+ -ATPase protein in the elderly group was increased as compared with younger group(t=-3.389,P=0.004). Conclusions Acidsecretion-associated organelles of human gastric parietal cell have no degeneration and the expression of H + -K+-ATPase is in trend of increase with aging,indicating that healthy elderly people have the basis of ultrastructure and molecular biology to maintain well function of acid secretion.