Screening Tool of Older Person's Prescriptions(STOPP)in Frail old patients(STOPP Frail)with limited life expectancy is a list of explicit criteria for potentially inappropriate medication (PIM)using in frail older adults.STOPP Frail criteria were initially created by the experts from Cork university hospital based on the clinical experience and literature appraisal and released in 2017 by an expert panel of Cork university hospital,Ireland.Using Delphi consensus methodology,the panelists ranked their agreement with each criterion on a 5-point Likert scale and provided a written feedback.Twenty-seven criteria with a median Likert response of 4/5 (agree/strongly agree)and a 25th centile of ≥4 scores were included in the final list.STOPP Frail may assist physicians in deprescribing medications to reduce the PIM use in frail older adults.

Objective:To analyze the genetic characteristics of varicella-zoster virus (VZV) in Liaoning province in 2019.Methods:Vesicle fluid samples were collected from 32 individuals with suspected VZV infection in Liaoning province from 2019. Nucleic acids were extracted, the suspected samples were screened by real-time fluorescent quantitative PCR. Single nucleotide polymorphisms (SNP) sites on ORF22, ORF38 and ORF62 were detected and analyzed in three open reading frames (ORFS) of positive samples. The samples and sequence data were collected and the gene sequences were compared to determine the genotype of the virus strain, and the vaccine strain was identified from the wild strain.Results:In the 32 suspected samples, VZV-positive strains were detected in 27 samples, all belonged to wild-type strain of Clade 2. Compared with Clade 2 referenced strains, the homology of nucleotide and amino acid for all 10 samples were 98.85%-100% and 96.9%-100%, respectively. There was a synonymous mutation (A→G) in position 37990 of LN-14 strain. The nucleotide homology of ORF22 showed that all 27 samples were on the same branch with the Clade 2 referenced strains and had a vaccine breakthrough cases.Conclusions:This study reveals that the VZV strains circulating in Liaoning province in 2019 were all wild-type strains belonging to Clade 2.

Objective To clarify the genotype of wild-type strains of varicella zoster virus (VZV) in Jilin province in 2014,and to discriminate between v-Oka vaccine strains and wild-type strains.Methods Vesicle fluid and throat swab samples were collected from 13 individuals with suspected VZV in Jilin province from January to December 2014.Viral DNA was extracted,the fragments of 15 open reading fragments (ORFs) were amplified by polymerase chain reaction (PCR),and viral genotypes were determined by single nucleotide polymorphisms (SNP).PCR restriction fragment length polymorphism (RFLP) was used to distinguish between wild-type strains and v-Oka vaccine strains.The results were analyzed with MEGA5 software,using the VZV reference strain sequences from GenBank.Results The 13 suspected samples included 5 males and 8 females,aged 11-27 years (mean:(16.69±5.48) years).Sampling was performed on days 0 to 3 of suspected infection.VZV strains were detected in 8 samples,all belonging to Clade 2.There was a synonymous mutation (T＞C) in SNP18082 compared with the v-Oka vaccine strain.Analysis of PCR-RFLPs showed that all 8 positive samples were wild-type strains (Pst Ⅰ +Bgl Ⅰ +Sma Ⅰ-).Conclusions The study revealed that the VZV strains circulating in Jilin province in 2014 were wild-type strains belonging to Clade 2.

Objective To clarify the genotype of wild-type strains of varicella zoster virus (VZV) in Jilin province in 2014,and to discriminate between v-Oka vaccine strains and wild-type strains.Methods Vesicle fluid and throat swab samples were collected from 13 individuals with suspected VZV in Jilin province from January to December 2014.Viral DNA was extracted,the fragments of 15 open reading fragments (ORFs) were amplified by polymerase chain reaction (PCR),and viral genotypes were determined by single nucleotide polymorphisms (SNP).PCR restriction fragment length polymorphism (RFLP) was used to distinguish between wild-type strains and v-Oka vaccine strains.The results were analyzed with MEGA5 software,using the VZV reference strain sequences from GenBank.Results The 13 suspected samples included 5 males and 8 females,aged 11-27 years (mean:(16.69±5.48) years).Sampling was performed on days 0 to 3 of suspected infection.VZV strains were detected in 8 samples,all belonging to Clade 2.There was a synonymous mutation (T＞C) in SNP18082 compared with the v-Oka vaccine strain.Analysis of PCR-RFLPs showed that all 8 positive samples were wild-type strains (Pst Ⅰ +Bgl Ⅰ +Sma Ⅰ-).Conclusions The study revealed that the VZV strains circulating in Jilin province in 2014 were wild-type strains belonging to Clade 2.

Objective:To explore the relationship between the expressions of P21,P27 and proliferating cell nuclear antigen(PCNA)in glomerular mesangial tissue and poor renal prognosis in patients with immunoglobulin A(IgA)nephropathy.Methods:A total of 145 patients with IgA nephropathy treated in Xiaogan Central Hospital from April 2017 to August 2019 were selected as the research object.The expressions of P21,P27 and PCNA in glomerular mesangial tissue were detected by immunohistochemistry.All patients were followed up for 24 months,and the prognosis were counted.The expressions of P21,P27 and PCNA in glomerular mesangial tissue of patients with different prognosis were compared and the influencing factors of poor prognosis in patients with IgA nephropathy were analyzed by Logistic regression analysis.Results:The expression rates of P21,P27 and PCNA positive cells in glomerular mesangial tissue of patients with IgA nephropathy were(38.69±6.83)%,(55.94±8.08)%,(33.47±5.72)%,respectively.The incidence rete of poor prognosis in patients with IgA nephropathy was 17.24%,and the expression rates of P21 and PCNA positive cells in glomerular mesangial tissue of patients with poor prognosis were higher than those in good prognosis group(P<0.05),while the expression rate of P27 positive cells was lower than that in good prognosis group(P<0.05).Logistic multiple regression analysis showed that elevated diastolic blood pressure,increased 24 h proteinuria,mesangial cell proliferation,segmental glomerulosclerosis,renal tubular atrophy/interstitial fibrosis,crescentic body,increased expression rates of P21 and PCNA positive cells and decreased expression rate of P27 positive cells were all risk factors affecting the poor prognosis of patients with IgA nephropathy(P<0.05).Conclusion:There are positive expressions of P21,P27 and PCNA in glomerular mesangial tissue of IgA nephropathy.The expression rates of P21 and PCNA positive cells in glomerular mesangial tissue of of patients with poor prognosis of IgA nephropathy are higher than those with good prognosis,while the expression rate of P27 protein positive cells is lower than those with good prognosis,which are risk factors for poor prognosis of patients with IgA nephropathy.

Objective: To clarify the genotype of varicella-zoster virus (VZV) in Jilin province in 2017, and to discriminate between vaccine strain and wild-type strain. Methods: Vesicle fluid and throat swab samples were collected from 10 individuals with suspected VZV in Jilin province from January to March of 2017. Real-time fluorescent quantitative PCR was used to detect viral nucleic acid. Specific regions of ORF22, ORF38 and ORF62 of VZV were amplified by PCR. Viral genotype was determined by five SNPs of ORF 22 and vaccine strain or wild-type strain was distinguished by four SNPs of ORF 38 and ORF 62. The results were analyzed with MEGA5 and BioEdit software, using the VZV reference strain sequences from GenBank. Results: VZV-positive strains were detected in 10 samples, all belonged to Clade 2. There was a synonymous mutation (C→T) in position 38 048 of JL17-7 strain. The nucleotide homology of ORF22 showed that all 10 samples were on the same branch with the Clade 2 referenced strains. Compared with Clade 2 referenced strains, the homology of nucleotide and amino acid for all 10 samples were 99.5%-100% and 99.3%-100%, respectively. The four specific SNPs of ORF38 and ORF62 in 10 samples were A-T-T-T, which were consistent with wild-type strain. Conclusions This study reveals that the VZV strains circulating in Jilin province in 2017 were all wild-type strains belonging to Clade 2.