As one of the major geriatric syndromes,frailty exerts adverse effects on life expectancy and quality of life of the elderly.Because of its importance,a number of methods and tools have been introduced for the assessment of frailty.Malnutrition,as an independent risk factor,interacts with frailty and is involved in its progression.This article reviews recent studies on frailty and malnutrition.

Objective To study the association between clinical symptoms,psychosomatic factors and autonomic nervous function in patients with gastroesophageal reflux disease (GERD).Methods Thirty-four patients with GERD diagnosed by reflux disease questionnaire (RDQ) and endoscopy and 15 healthy control subjects were enrolled in this study.All the subjects were divided into two groups,one with normal scores of Zung's self-rating anxiety scale (SAS) and Zung's depression scale (SDS) as GERD (-) and the other with abnormal scores of SAS and SDS as GERD (+).Reflux symptom score was recorded for both groups at the same time.Autonomic nervous function was assessed by their heart rate variability (HRV) on dynamic electrocardiogram (DCG).The time domain parameters analyzed included standard deviation (SD) of average R-R interval during 24 hours (SDNN),SD of average 5-minute sinus heart rate (SDANN),mean square root of the difference of adjoining two R-R interval (rMSSD),and proportion of the heart beats with difference of R-R interval more than 50 ms from the total heart beats (PNN 50),and the frequency domain parameters analyzed included low-frequency (LF),high-frequency (HF) and ratio of LF to HF.Results Average scores of SAS and SDS were significantly higher in patients with GERD than those in healthy controls (48?9 vs 38?6 and 48?11 vs 41?6,respectively,P

AIM: To explore the probable mechanisms of diabetes-induced arrhythmias. METHODS: Diabetes was induced in male SD rats,using a single injection of alloxan into tail vein. Untreated age-matched animals were used as controls. All animals were observed by 2,4,6 and 8 weeks,respectively. Transmembrane potentials were recorded with conventional glass microelectrodes. RESULTS: Action potential duration(APD) at all level (APD10,APD20,APD30,APD50,APD70,APD90) was significantly lengthened in right ventricular papillary muscle from week 2 of diabetes. At week 8,APD was more lengthened at any level of repolarization than that at week 2. No differences were observed in the maximum rate of depolarization(V_ max ),overshoot(OS) and action potential amplitude(APA) as well as the resting membrane potential(RP) from the 2th to 8th week of diabetes. CONCLUSION: The results indicate that prolongation of APD may be prominently responsible for the increased incidence of cardiac re-entry-arrhythmias and sudden death,especially at late stages of diabetes.

Objective To evaluate the differential diagnosis value of enhanced multi-slice spiral CT (MSCT) scan on adrenal adenoma and metastases in patients with malignant tumor.Methods Thirty-nine malignant tumor patients complicated with adrenal nodules were chosen, and all patients underwent MSCT plain scan and enhanced scan.Features of adrenal adenomas and metastases of MSCT enhanced were analyzed.Results Forty-nine adrenal gland nodules were found in 39 patients, and 35 adrenal metastasis were found in 25 patients.They were shown quasi-circular, oval or irregular shaped nodules.The average diameter was (2.6 ± 0.7) cm.Part of them were uneven density, and the CT value of the solid part was (32.8 ± 6.1) Hu.The solid part of tumor in enhancement scanning arterial phase was underwent mild to moderate strengthening, and the CT value was (49.5 ±6.9)Hu.The solid part of tumor was underwent further strengthen scanning in the venous phase, and the CT value was (74.9 ±8.0)Hu.The average CT value of solid part in after 3 min scanning tumor was (72.4 ± 7.6) Hu.Fourteen adrenal adenomas were found in 14 patients.CT value was (19.6 ± 4.5) Hu, and tumor diameter was (1.8 ± 0.4) cm.Enhanced scanning the tumors showed mild to moderate homogeneous enhancement in arterial phase, the CT value was (43.8 ± 8.1) Hu.Venous phase enhanced obviously, the average of CT value was (67.7 ±9.2)Hu.The strong degree in the delay period was decreased significantly, the average value of CT was (55.9 ± 8.8) Hu.The adrenal metastasis tumor diameter (t =4.006, P ＜ 0.001), CT value of plain scan (t =7.320, P ＜ 0.001), CT value of arterial phase enhanced scan (t =2.486, P =0.017) , venous phase enhanced scan (t =2.727, P =0.009) and CT value of the delay period (t =6.653, P ＜ 0.001) were higher than those in adrenal adenoma.Conclusion Enhanced MSCT scan can reflect the hemodynamic changes of adrenal lesions, and provide the bases for the differential diagnosis of enhanced MSCT scan on adrenal adenoma and metastases in patients with malignant tumor.

According to the training requirement of the biological-psycho-social medical model to the clinical medical students,in order to promote the comprehensive improvement of medical students' professional knowledge,hands-on ability and human qualities,we design the course of introduction to clinical medicine.Through six major functional modules such as basic professional quality,clinical diagnosis basic technology,basic skills related to the operation,the new progress in clinical medicine and technology,clinical nursing and medical relationship,and medical information management,we build up the core content of integrated course of introduction to clinical medical.In this way,the clinical and related basic knowledge and skills are integrated,the clinical course is closely connected with the basic curriculum,the medical and the humanities exchanges.Through this design,the foundation is laid out for the collaborative efforts of the organ-system of integrated curriculum reform.

OBJECTIVETo explore the molecular mechanism via which the chemotherapeutic drug hydroxyurea (HU) enhances K562 cell apoptosis induced by tumor necrosis factor-related apoptosis-inducing ligand (TRAIL).

METHODSChronic myelogenous leukemia-derived K562 and SVT-35 cells were treated with recombinant soluble TRAIL (rsTRAIL) alone or combined with HU for a time course, and the cell viability was determined by 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-4-sulfophenyl-2H-tetrazolium-phenazine methosulphate assay. Western blot was performed to analyze the activation of apoptosis-related protein kinases and the expression of apoptosis inhibitor molecules.

RESULTSThe survival rates of SVT-35 and K562 cells treated with 1 μg/ml rsTRAIL for 24 hours were 32% and 93%, respectively. HU significantly increased the sensitivity of K562 cells to rsTRAIL cytotoxicity. Combination of rsTRAIL and HU resulted in the phosphorylation of rat sarcoma (RAS), mitogen-activated protein kinase/extracellular signal-regulated kinase kinase (MEK), extracellular signal-regulated kinase (ERK), and c-Jun N-terminal kinase and in the significant reduction of apoptosis-inhibited molecule Fas associated death domain protein-like interleukin-1 beta-convening enzyme inhibitory protein and cellular inhibitor of apoptosis protein-1 in K562 cells.

CONCLUSIONSHU enhanced K562 cell sensitivity to rsTRAIL is mediated by Ras-MEK-ERK signaling pathway. Expression of antiapoptotic proteins cellular Fas associated death domain protein-like interleukin-1 beta-convening enzyme inhibitory protein and cellular inhibitor of apoptosis protein-1 is also down-regulated during this process. These results may through light on the therapeutic study of human chronic myelogenous leukemia.

Apoptosis ; drug effects ; physiology ; CASP8 and FADD-Like Apoptosis Regulating Protein ; metabolism ; Humans ; Hydroxyurea ; pharmacology ; Inhibitor of Apoptosis Proteins ; metabolism ; K562 Cells ; MAP Kinase Signaling System ; TNF-Related Apoptosis-Inducing Ligand ; pharmacology

To study the clinical significance of the detection of inv(16) (p13 q22) by FISH in the diagnosis and prognosis for M(4), the metaphase bone marrow cells of 6 cases M(4) which had already diagnosed by morphology were detected for CBFbeta-MYH(11) fusion gene by MYH 11 probe including dual labelled sequences and the results were compared with that of conventional cytogenetic analysis. The results showed that 4 cases inv(16) (two M(4) EO and two M(4)) were found by G banding kanyotyping test. One case M(4) had trisomy (+22) in addition to inv(16); one case M(4) had hypodiploid in addition to inv(16), which relapsed after CR 8 months. All 6 cases had inv(16) abnormal fluorescence signal. Among them case No 2 had the deletion of 16p13 showed by red fluorescence signal in addition to inv(16). It is concluded that the detection of inv(16) by FISH is of sensitivity and specificity. It is the important supplement to the conventional cytogenetic analysis. It possesses the important clinical significance in the diagnosis and prognosis of M(4) patients.
Adolescent ; Adult ; Chromosome Inversion ; Chromosomes, Human, Pair 16 ; genetics ; Female ; Humans ; In Situ Hybridization, Fluorescence ; methods ; Leukemia, Myelomonocytic, Acute ; genetics ; pathology ; Male ; Middle Aged ; Reproducibility of Results

Objective To study the effects of coal burning related endemic fluorosis on body development and intelligence levels of fluorosic children in Zhijin county.Methods One hundred and seventy-six fluorosic children and 50 healthy(without fluorostic teeth) children aging 7-12 years who were sampled in cluster sampling were examined for urine fluorosis,physical examination and intelligence tests in Zhijin county,with coal burning pollution related fluorosis.Results Physical development of sick children and the children in control group were in low levels. The intelligence levels and the leves of urine fluorosis in study group were lower than those in control group and there was a significant difference(P

Objective To explore the relationship between -262C/T and -21A/T polymorphisms of catalase(CAT) gene and coal-burning borne fluorosis. Methods In 2007, 150 villagers were taken as a nonintervention group in Bijie city from the village of coal-burning borne fluorosis areas with unchanged cooking stoves;150 villagers were taken as the intervention group from the town of Changchun county where cooking stoves changed; 150 villagers were taken as control from non-endemic fluorosis areas in Baiyun town of Changshun county.PCR-restriction fragment length polymorphism were employed to detect genotypes of CAT-262C/T and CAT-21A/T polymorphism of CAT gene. Results The genotypic frequencies of CAT-262C/T and CAT-21A/T in nonintervention group,intervention group and control group were in line with Hardy-Weinberg equilibrium law (P＞ 0.05 ).The genotypes of CC and CT were detected while no TT were detected for CAT-262C/T polymorphism; the genotypes of AA, AT and TT were detected for CAT-21A/T. The genotype frequencies of CAT-262 CC, CT in control group, intervention group and non-intervention group were (89.33%(134/150), 10.67%(16/150); 88.67%(133/150), 11.33% (17/150),93.33% (140/150),6.67% (10/150), respectively. The gene frequency of C in control group, intervention group and non-intervention group were (94.67% (284/300), 94.33% (283/300),96.67%(290/300), respectively. The gene frequency of T in control group, intervention group and non-intervention group were 5.33%(16/300), 5.67%(17/300), 3.33%(10/300), respectively. The genotype frequencies of CAT-21 AA,AT and TT in control group, intervention group and non-intervention group were 48.67%(73/150),46.00%(69/150),5.33%(8/150) ,52.67%(79/150) ,38.00%(57/150) ,9.33% (14/150) ,51.33%(77/150) ,38.00%(57/150), 10.67%(16/150), respectively. The gene frequency of A in control group, intervention group and non-intervention group were 71.67%(215/300),71.67%(215/300),70.33%(211/300), respectively. The gene frequency of T in control group, intervention group and non-intervention group were 28.33% (85/300),28.33% (85/300),29.67% (89/300),respectively. CAT-262C/T and CAT-21A/T genotype and allele frequencies in the control group, the intervention group and non-intervention group showed no significant differences in the distribution(x2= 0.331,0.336, all P ＞0.05 ). Conclusion CAT-262C/T and CAT-21A/T polymorphism is not associated with coal-burning borne fluorosis.

Objective To study the influence on the tumor after percutaneous intra-tumor injection of ~(32)P-GMS in liver cancer as well as its suitable dose.Methods 24 New Zealand rabbits were used to establish the animal model of VX-2 liver cancer,and divided into A,B,C and D groups with individually 37,74,111 and 148 MBq of ~(32)P-GMS being injected,respectively;and then pathological changes of tumor were observed by light and electron microscope respectively.Result The dose of ~(32)P-GMS was obviously correlated with the radioactivity damage of tumor cells.In the A and B groups,the tumor cells were not observed to disappear completely after injection of ~(32)P-GMS,but in C group,tumor cells were almost completely disappeared and surrounded by a lot of connective tissue.Although the tumor cells were found to disappear completely in D group,normal liver tissues were also involved.Conclusion Percutaneous intra-tumor injection of ~(32)P-GMS with suitable dose that may induce the tumor tissue to be maximally damaged and may also provide some significances to prevent the tumor metastasis.