Objective To explore whether the patients aged over 65 years with obstructive sleep apnea hypopnea syndrome (OSAHS) are able to tolerate continuous positive airway pressure (CPAP)while compared with patients aged less than 65 years.And to investigate the factors that affect compliance to CPAP in OSAHS patients.Methods A total of 147 OSAHS patients diagnosed with overnight polysomnography (PSG) were divided into two groups:≥65 years old group (n=46),<65 years old group (n = 101 ).Clinical data and PSG parameters were included in a computerized database.The pressure level of CPAP,the duration of respirator use were followed up.Results Compared with <65 years old group,there were higher prevalences of COPD (16% vs.4%,P=0.02),cardiovascular disease (23% vs.10%,P=0.04),apnea (43% vs.26%,P=0.03),regular alcohol consumption (61% vs.38%,P=0.007) and lower incidence of snoring (31% vs.54%,P= 0.03),shorter total sleeping time (378 min vs.423 min,P=0.001),longer wake after sleep onset periods (162 min vs.115 min,P=0.004),lower sleep efficiency (69% vs.77%,P<0.001),higher percentage of stage 1 sleep (29% vs.20%,P=0.001),lower percentage of stage 3-4 sleep (6% vs.9%,P=0.016) and rapid eye movement (REM) sleep (12% vs.15%,P=0.001) in ≥65 years old group.The percentages of acceptance to CPAP at 3 months,6 months,1 year,2 years and 3 years were 91%,89%,84%,82% and 82% respectively in ≥65 years old group,and were 92%,86%,81%,72% and 67% in <65 years old group.Average use time of CPAP were (5.1±1.5) h/night in ≥65 years old group,and were (3.9±1.2) h/night in <65 years old group (P=0.022).By analysis of multivariate logistic regression,a high pressure CPAP was associated with higher objective CPAP compliance in OSAHS patients.Conclusions Compliance to CPAP in older OSAHS patients is not decreased when compared to younger adults.A high CPAP pressure is the only significant independent predictor of better CPAP compliance.

Objective To explore the characteristics of clinical features,diagnosis,treatment and prognosis in acute fibrinous and organizing pneumonia (AFOP) patients.Methods We described an 80-year-old woman who was diagnosed with AFOP and got better after treatment with glucocorticoids.Clinical data of 51 patients which have been published in literatures in China and abroad were retrospectively analyzed.The differences in characteristics of clinical features were compared between the elderly and non-elderly patients.Results The case reported herein,who was a 80-year-old female with latent autoimmune diabetes in adults (LADA),presented with fever,dry cough and progressive dyspnea.Chest CT scan showed bilateral multiple patchy consolidation.CT-guided needle aspiration was performed and the pathological examination finding was consistent with AFOP.The patient was treated with oral methylprednisolone and experienced a significant improvement in symptoms and imaging manifestations.But she presented with deterioration with relapsing clinical symptoms when she discontinued corticosteroid treatment by herself,and the clinical symptoms were improved by retreatment.Clinical data of 51 reported cases with AFOP including 27 males and 24 females aged 38 d to 80 years were enrolled and analyzed in the study.Patients aged 60 years and over accounted for 47.1％ (24 cases).No risk or predisposing factor was found in most of cases.Autoimmune diseases were the most common combined diseases in AFOP patients.The top three symptoms were dyspnea (80.4％,41 cases),cough (64.7％,33 cases) and fever (52.9％,27 cases).The incidence of dyspnea was lower in elderly patients than in non-elderly patients [66.7％ (16/24) vs.92.6％ (25/27),P＜0.05],and ground glass opacity in the chest image was also less in elderly patients than in non-elderly patients (P＜0.05).15 patients (29.4％) got definitive diagnosis by minimally invasive procedures including percutaneous lung puncture biopsy or transbronchial lung biopsy.Corticosteroids were the main drug treatment,and 39 cases (76.5 ％) received antibacterial drugs.The mortality rate of AFOP was 37.3％ (15 cases).The average time from symptom onset to final diagnosis was shorter in dead cases than in recovered patients (19 days vs.40 days,P＜0.05).The rate of using mechanical ventilation was higher in dead cases than in recovered patients [57.9 ％ (11/19) vs.9.4％ (3/32),P＜0.05].Conclusions There are no specific clinical and imaging features in AFOP,which is easily misdiagnosed as infectious diseases.AFOP is more common in elderly patients.Dyspnea and other symptoms can easily be ignored,and minimally invasive biopsy and pathological examination findings is helpful for diagnosis.The mortality rate of AFOP is high,and insufficient course of therapy is associated with the increased risk of AFOP relapse.Rapid progression of disease and the invasive mechanical ventilation predispose poor outcomes.

Objective To analyze the prevalence rate and risk factors for aspiration pneumonia in elderly inpatients,and to identify a high-risk population for aspiration pneumonia.Methods Totally 398 inpatients aged ≥ 60 years in Beijing Hospital from April 2014 to April 2015 were selected.A questionnaire survey was performed for aspiration risk factors,including gender,age,smoking and drinking history,swallowing function,basal diseases,medication history,activities of daily living(ADL),occurrence of aspiration pneumonia over the past year.The patients were divided into aspiration pneumonia group and non-aspiration pneumonia group,and the prevalence rate and risk factors for aspiration pneumonia were studied.Results 364 cases with complete data were collected,and 14.3％ (52/364)were identified definitively as aspiration pneumonia over the past year.The ADL score was (77.0± 33.9) scales in aspiration pneumonia group,and (88.0 ± 22.2) scales in non-aspiration pneumonia group,with statistically significant difference (P＜ 0.05).The incidence rate of aspiration pneumonia was increased along with the increase of the age of patients.Risk factors for aspiration pneumonia were different in different age group.The proportion of patients aged 60-69,70-79 and over 80 years were 23.1％ (12 cases),36.5％ (19 cases),40.4％ (23 cases)in the aspiration pneumonia group,respectively.Under the condition of a propensity score-matched case-control pair design on 104 subjects with versus without aspiration pneumonia,the logistic regression analysis showed that smoking history,coronary heart disease,Parkinson's disease,dementia,chronic obstructive pulmonary disease(COPD),gastro-esophageal reflux disease(GERD),long-term uses of theophylline,calcium antagonists,nitrates,diazepam,antidepressants,anti-Parkinson drugs were the risk factors for aspiration pneumonia in elderly(all P＜0.05).Conclusions Smoking history,basal diseases and medication history are associated with the incidence rate of aspiration pneumonia in elderly.Assessment of these risk factors for aspiration pneumonia should be emphasized,and preventive measures should be considered conscientiously to lower the incidence rate of aspiration pneumonia in elderly.

Objective To investigate the clinical characteristics,distribution and drug sensitivity of pathogens causing intravenous catheter-related bloodstream infections (CRBSIs) in pediatric intensive care unit (PICU) so as to use antibiotics reasonably.Methods All patients with CRBSIs in PICU of Guangdong General Hospital from September 2009 to September 2014 were investigated and the drug resistance profiles of pathogens causing CRBSIs were also analyzed retrospectively.Results Between 2009 and 2014,there were totally 10 834 catheter days and 23 episodes of CRBSIs with an incidence of 2.1 infections per 1 000 catheter days.Catheter indwell time ＜ 7 days in 9 cases (39.1％),8 to 14 days in 10 cases (43.5％),14 to 21 days in 4 cases (17.4％).There were 13 strains (56.6％) of gram-positive bacteria,5 strains (21.7％) of gram-negative bacteria and 5 strains (21.7％) of fungi.The main pathogens causing CRBSIs were coagulase negative Staphylococci (7 strains,30.4％),Staphylococcus aureus (3 strains,13.0％),Candida albicans(3 strains,13.0％),Candida parapsilosis(2 strains,8.7％),and Enterobacter cloacae (2 strains,8.7 ％).The susceptibility to Vancomycin,Linezolid and Teicoplanin of coagulase negative Staphylococ cus such as S.epidermidis and to Imipenem,Piperacillin/Tazobactam,Cefoperazone/ Sulbactam and Amikacin of gram-positive bacteria arrived at 100.0％,respectively.The candida were 100％ susceptible to Amphotericin B,5-Flucytosine,Fluconazole and Voriconazole.Twenty-one cases (91.3％) received antibiotic treatment versus no antibiotic in 2 cases (8.7％).The average number of antibiotic kinds administered on the patients with fungal infection was 4.4,bacteria were 1.4.Ten cases (43.5％) treatment with 1 kind of antibiotic,4 cases (17.4％) with 2,4 cases (17.4％) with 3,5 cases (21.7％) with more than 3.Twenty-two cases (95.7％) cured and 1 case died (4.3％).Conclusions The major species of pathogen causing CRBSIs was coagulase negative staphylococci in PICU.It is critical for clinicians to guard against fungal infection because of prolonged catheter indwelling time and more antibiotics administered before indwelling catheter.It is effective way to prevent the CRBSIs by reasonably using antibiotics and shortening the time of catheter indwelling.Monitoring CRBSIs pathogenic bacteria distribution and drug susceptibility helps reasonable administration of antibiotics in the earlier time.

Objective To study the distinct clinical phenotype of chronic airway diseases by hierarchical cluster analysis and two-step cluster analysis.Methods A population sample of adult patients in Donghuamen community,Dongcheng district and Qinghe community,Haidian district,Beijing from April 2012 to January 2015,who had wheeze within the last 12 months,underwent detailed investigation,including a clinical questionnaire,pulmonary function tests,total serum IgE levels,blood eosinophil level and a peak flow diary.Nine variables were chosen as evaluating parameters,including pre-salbutamol forced expired volume in one second(FEV1)/forced vital capacity (FVC) ratio,pre-salbutamol FEV1,percentage of post-salbutamol change in FEV1,residual capacity,diffusing capacity of the lung for carbon monoxide/alveolar volume adjusted for haemoglobin level,peak expiratory flow (PEF) variability,serum IgE level,cumulative tobacco cigarette consumption (pack-years) and respiratory symptoms (cough and expectoration).Subjects' different clinical phenotype by hierarchical cluster analysis and two-step cluster analysis was identified.Results (1) Four clusters were identified by hierarchical cluster analysis.Cluster 1 was chronic bronchitis in smokers with normal pulmonary function.Cluster 2 was chronic bronchitis or mild chronic obstructive pulmonary disease (COPD) patients with mild airflow limitation.Cluster 3 included COPD patients with heavy smoking,poor quality of life and severe airflow limitation.Cluster 4 recognized atopic patients with mild airflow limitation,elevated serum IgE and clinical features of asthma.Significant differences were revealed regarding pre-salbutamol FEV1/FVC％,pre-salbutamol FEV1％ pred,postsalbutamol change in FEV1 ％,maximal mid-expiratory flow curve (MMEF)％ pred,carbon monoxide diffusing capacity per liter of alveolar(DLCO)/(VA)％ pred,residual volume(RV)％ pred,total serum IgE level,smoking history (pack-years),St.George' s respiratory questionnaire (SGRQ) score,acute exacerbation in the past one year,PEF variability and allergic dermatitis (P ＜ 0.05).(2) Four clusters were also identified by two-step cluster analysis as followings,cluster 1,COPD patients with moderate to severe airflow limitation;cluster 2,asthma and COPD patients with heavy smoking,airflow limitation and increased airways reversibility;cluster 3,patients having less smoking and normal pulmonary function with wheezing but no chronic cough;cluster 4,chronic bronchitis patients with normal pulmonary function and chronic cough.Significant differences were revealed regarding gender distribution,respiratory symptoms,pre-salbutamol FEV1/FVC％,pre-salbutamol FEV1 ％ pred,post-salbutamol change in FEV1 ％,MMEF％ pred,DLCO/VA％ pred,RV％ pred,PEF variability,total serum IgE level,cumulative tobacco cigarette consumption (pack-years),and SGRQ score (P ＜ 0.05).Conclusion By different cluster analyses,distinct clinical phenotypes of chronic airway diseases are identified.Thus,individualized treatments may guide doctors to provide based on different phenotypes.

Objective To explore the clinical phenotype of airways disease in elderly patients using hierarchical cluster analysis.Methods A total of 67 elderly patients with respiratory symptoms were enrolled in a prospective study.Demographic and clinical data,such as respiratory symptoms,cumulative tobacco cigarette consumption,acute exacerbation,atopic symptoms and peak flow diary were collected.Pulmonary function tests,blood tests (total serum IgE level and blood eosinophil level) were performed in each patient during the stable stage.Then patients with different clinical phenotype were identified by hierarchical cluster analysis.Results Four clusters were identified with the following characteristics by hierarchical cluster analysis:cluster 1,atopic patients with no smoking,normal lung function,but increased total serum IgE levels and asthma symptom;cluster 2,patients with no smoking and normal pulmonary function with wheezing but without chronic cough;cluster 3,patients with chronic obstructive pulmonary disease and smoking,severe airflow limitation and poor quality of life;cluster 4,patients with asthma-chronic obstructive pulmonary disease overlap syndrome and smoking,airflow limitation and increased total serum IgE levels.The forced expiratory volume in 1 second (FEV1) / forced vital capacity (FVC) ratio,FEV1/predicted value,rate of FEV1 change,maximal mid-expiratory flow (MMEF)/ predicted value,the diffusion lung capacity for carbon monoxide (DLCO)/alveolar volume (VA)/predicted value,residual volume (RV)/ predicted value,total serum Ig E levels,cumulative tobacco cigarette consumption,the St.George's Respiratory Questionnaire (SGRQ) score had significant differences in patients before versus after treatment (all P＜0.05 or P＜0.01).Conclusions Based on hierarchical cluster analysis,distinct clinical phenotypes of airways disease in elderly patients can be identified.Conclusions With patients having asthma or COPD alone,patients with Asthma-COPD overlap syndrome (ACOS) always experience a more rapid decline in lung function and frequent exacerbations,having poor health-related quality-of-life (HRQOL) outcomes,which deserve our high attention.

Leaf senescence is considered as one of important factors to decrease ornamental values of foliage plants. In the attempt to study and understand the molecular mechanism of leaf senescence, a senescent leaf cDNA library of Coleus blumei was constructed and a small EST library was obtained. According to the sequence of an EST fragment with a cystathionine beta synthase (CBS) domain, a novel leaf senescenceassociated gene (SAG) full-length cDNA encoding a CBS-domain-containing protein, denoted Cbcbs, was rapidly cloned using a strategy of RACE combined with cDNA library. The full length of the Cbcbs gene was 859 bp long (accession No. EF076754) and contained a 609 bp open reading frame (ORF) encoding a 202amino acid protein. One stop codon (TAA) was found in 5' UTR and one possible polyadenylation signal,AATAAA, and a pentanucleotide motif, ATTTA, were found in 3' UTR. The CbCBS contained a predicted mitochondrial targeting peptide in the N-terminal region, two conserved and intact CBS domains, four casein kinase Ⅱ (CK Ⅱ) phosphorylation sites, three protein kinase c (PKC) phosphorylation sites and one tyrosine sulfation (TS) site. Sequence comparisons and phylogenetic analysis showed that CbCBS was a novel senescence or stress-associated protein. The prediction analysis of secondary structure and three dimensional structure of CbCBS suggested that the chief function of the protein was decided by the CBS domain pair. The expression pattern of Cbcbs in leaves was analyzed by RT-PCR. It was demonstrated that Cbcbs gene was a senescence-associated gene (SAG) and expressed in all leaf stages, young stage (Y) being the lowest and terminal senescence stage (S3) being the highest, and was upregulated along with the leaf senescence.Function analysis showed that the mature CbCBS maybe acts as a sensor of cellular energy status and directly or indirectly regulates cellular energy levels to increase ATP content in mitochondria during periods of metabolic stress of senescent leaves.

Using RACE with a Fagopyrum dibotrys callus cDNA library, one clone, named FdMYBP1, encoding a putative R2R3 MYB protein was identified. FdMYBP1 appeared to be a full-length cDNA of 1159 bp encoding a protein of 265 amino acids. Through structure and property analysis of FdMYBPI with bioinformational methods, it was found that the amino acid sequence of FdMYBP1 showed great homology to other MYBP with the R2R3 repeat region in the N-terminus. Southern blot analysis indicated that FdMYBP1 belongs to a single copy gene in F. dibotrys genomes. The FdMYBP1 gene has the same classic characters with other MYBP and probably involved in the pathway of flavonoid metabolisms.
Cloning, Molecular ; Fagopyrum ; genetics ; metabolism ; Gene Expression Regulation, Plant ; Molecular Sequence Data ; Plant Proteins ; genetics ; metabolism ; Proto-Oncogene Proteins c-myb ; genetics ; metabolism

Objective:To investigate the mechanism of depression between social capital and cognitive function of the elderly in nursing institutions, and provide new ideas for improving the cognitive function of the elderly.Methods:This study was a cross-sectional survey. Using the convenient sampling method to collect the general information questionnaire, the Geriatric Depression Scale (GDS), Social Capital Scale and Montreal Cognitive Assessment Scale (MoCA) of 218 elderly people from three elderly nursing institutions including Shenyang Health Care Centre, Songpu Nursing Home and Colourful Sunshine City Pension Service Centre in Shenyang from July 2020 to January 2021.Results:A total of 218 questionnaires were distributed and 202 valid questionnaires were recovered. The effective recovery rate was 92.7%. The scores of the cognitive function, depression and social capital of the elderly were (23.60 ± 4.25), (6.38 ± 4.35) and (75.41 ± 8.61). Depression scores were negatively correlated with social capital scores and cognitive function scores ( r = - 0.401, - 0.481, both P<0.05); there was a positive correlation between social capital scores with cognitive function scores ( r = 0.338, P<0.05). There was a mediating effect of depression between social capital and cognitive function, accounting for 42.1%. Conclusions:While improving the cognitive function of the elderly in nursing institutions by improving the level of social capital, it is necessary to pay attention to the mediatingeffect of depression, strengthen the psychological counseling of the elderly, promote mental health, and further reduce the occurrence and development of cognitive decline in the elderly.