Objective To test the reliability and validity of the self-assessed questionnaire of the elderly health care needs.Methods Based on the Zuluaga-Raysmith model, the initial questionnaire was formulated by literature reviewing and interviews.Through Delphi experts consultation, a questionnaire containing 12 factors, 61 items was constructed.A total of 750 elderly residents were investigated to test the reliability and validity of the questionnaire.Results The effective rate of questionnaires was 88.67％ (665/750).The total Cronbach α was 0.871.The test-retest reliability of all the items were all greater than 0.75.The item-level content validity index were all greater than 0.80.The scale-level content validity index was 0.95.14 factors were extracted by exploratory factor analysis, explaining 66.653％ of the total variance.Conclusions The elderly health care needs self-assessed questionnaire is comprehensive with good stability, which can be used in a multi-center, large sample research.The research may help to get a deep understanding of health care needs of the elderly as well as influencing factors.

Objective To study cutaneous ultrastructural changes and FERMT1 gene mutations in a patient with Kindler syndrome. Methods Clinical data were collected, and tissue samples obtained from the lesions of poikiloderma were observed by using transmission electron microscopy. Fifteen coding exons and their flanking sequences of the FERMT1 gene were amplified by PCR and DNA sequencing was followed.Results Reduplication of lamina densa was seen between the dermal-epidermal junctions of the lesional skin. The patient was found to be homozygous for a novel splice-site mutation (IVS9 + 1G ＞ A) in FERMT1 gene, and his parents were heterozygous for it. The mutation was undetected in fifty normal control individuals.Conclusions Transmission electron microscopy may serve as an ancillary examination for the diagnosis of Kindler syndrome. The IVS9+1G＞A mutation of FERMT1 gene may contribute to the clinical phenotype of Kindler syndrome in this patient.

Objective To analyze the correlation of preoperative serum vascular endothelial growth factor(VEGF)level with serum CA125 level in patients with epithelial ovarian cancer(EOC),and to evaluate the prognostic value of preoperative serum VEGF in these patients.Methods Forty-one patients with EOC were included as study group,while 20 healthy women were selected as control group.Enzymelinked immunosorbent assay(ELISA)and chemiluminescence assay were used to measure serum VEGF and CA125 level respectively.The correlations of serum VEGF with CA125 level,postoperative recurrence rate and survival time were analyzed retrospectively.Resuits Serum VEGF levels in patients with EOC were higher than those in healthy women,with the median of 415 and 165 ng/L,range 110-2120 and 100-735 ng/L respectively(P＜0.01).No correlation was found between preoperative serum VEGF and CA125 level (Spearman test,P=0.989).High preoperative serum VEGF was positively correlated with postoperative recurrence.Serum VEGF level in patients with postoperative recurrence was higher than that in patients without recurrence,with the median of 490 and 315 ng/L respectively(P=0.035).Univariate analysis showed that higher serum level was reversely correlated with shorter survival.Median overall survival time in patients with higher serum VEGF level and lower serum VEGF level was 18 months and＞35 months respectively(P=0.010).Multivariate Cox model analysis showed that high VEGF level was an independentfactor for the prognosis of EOC(P=0.042).Conclusion Preoperative serum VEGF level is not correlated with CA125 concentration in patients with EOC,and it is an independent risk factor for prognosis.

OBJECTIVE:To study the improvement effects of citalopram combined with huperzine A in aged depression model rats. METHODS:Aged rats were randomly divided into blank control group,model group,huperzine A group(0.3 mg/kg),citalo-pram group(5 mg/kg),and combination group(huperzine A 0.3 mg/kg+citalopram 5 mg/kg),10 in each group. Except for blank control group,rats in other groups received chronic unpredictable mild stress to reduce depression model. After modeling,rats were intragastrically administrated relevant drugs once a day,for 2 weeks. The depression,learning and memory behavior changes of rats in each group were observed by using open-field test,sucrose consumption test,tail suspension test,forced swimming test and Morris water maze test. RESULTS:Compared with blank control group,the horizontal crossing number,uprightness number,su-crose preference rate,crossing number in platform,percentages of target quadrant distance and time of rats in model group were ob-viously decreased (P<0.05 or P<0.01);immobility time of tail suspension and swimming,escape latency were obviously pro-longed(P<0.05 or P<0.01). Compared with model group,the depression-related indexes of rats in citalopram group and combina-tion group were obviously improved(P<0.05 or P<0.01),and combination group had better effects;the learning and memory-re-lated indexes in combination group were obviously improved(P<0.05 or P<0.01),only crossing time in platform in huperzine A group and citalopram group were obviously increased (P<0.05 or P<0.01),and other learning and memory-related indexes had no obvious changes(P>0.05). CONCLUSIONS:Citalopram combined with huperzine A can obviously improve the depression be-havior,learning and memory ability of aged rats with depression,showing better effects than citalopram alone.

White matter hyperintensities (WMHs) are one of the main imaging biomarkers of cerebral small vessel disease (CSVD). With the development of neuroimaging technology, the WMH penumbra (WMH-P) has gradually become a research hotspot. WMH-P refers to the area of brain tissue microstructural integrity destruction or reduced blood flow perfusion around WMH lesions, which is not visible on conventional MRI sequences. It is not only a risk factor for the progression of WMHs, but also associated with clinical symptoms such as cognitive impairment and gait abnormalities in patients with CSVD, and is considered a new potential and reversible therapeutic target.

The occurrence of sudden cardiac death(SCD)in children is a rare but devastating event.Children′ SCD occurs mostly outside the hospital, with its strong suddenness and low success rate of treatment, causing serious consequences to both the families and society.Compared with other fatal incidents in children(such as car accidents, drowning), SCD incidents in children attracted more attention.Children′ SCD has been regarded as an unsolved major problem in clinical cardiology, emergency medicine and public health.The key to reducing the incidence of SCD in children is early detection and early prevention.With the continuous progress in the field of inspection technology, the understanding of electrocardiogram T-wave is getting deeper and deeper, and T-wave has become an important indicator for predicting SCD.This paper will review the research progress of T-wave and SCD in children.

The P wave of electrocardiogram is the atrial depolarization wave, which represents the atrial excitement.P waves are associated with many diseases, which can be used as diagnostic standard and prognostic index, and may have significant clinical value.Neurally-mediated syncope(NMS)is primarily mediated by autonomic abnormalities or autonomic dysfunction.NMS is also the most common type of syncope in children and adolescents.Many studies have shown that P waves can provide a lot of information related to NMS.In patients with NMS, P wave duration, P wave dispersion and P wave amplitude are statistically significant.Therefore, P wave of electrocardiogram may become an important ECG indicator for the prognosis of NMS in children and adolescents.Here we review the relationship between P wave of electrocardiogram and prognosis of NMS in children and adolescents.

Objective:To discuss the protective effect of sodium butyrate(NaB)on acute liver injury in the mice induced by lipopolysaccharide(LPS)combined with D-galactosamine(D-Gal),and to clarify its mechanism.Methods:Thirty male Kunming mice were randomly divided into control group,model group,and NaB group,and there were 10 mice in each group.The mice in NaB group were given 200 mg·kg-1·d-1 NaB,while the mice in control group and model group were given an equal volume of sterile water.The mice in model group and NaB group were intraperitoneally injected with 20 μg·kg-1 LPS and 600 mg·kg-1 D-Gal to induce the acute liver injury models.The body weights and liver weights of the mice in various groups were detcted,and the liver index was calculated.HE staining was used to observe the pathomorphology of liver tissue of the mice in various groups;kits were used to detect the activities of alanine aminotransferase(ALT)and aspartate aminotransferase(AST)in serum,and the activities of total superoxide dismutase(T-SOD)and catalase(CAT),and the levels of malondialdehyde(MDA)in liver tissue of the mice in various groups;Western blotting method was used to detect the expression levels of nuclear factor E2-related factor 2(Nrf2)and heme oxygenase-1(HO-1)proteins in liver tissue of the mice in various groups.Results:There were no significant differences in body weights of the mice among various groups(P>0.05).Compared with control group,the liver index of the mice in model group was significantly increased(P<0.01).Compared with model group,the liver index of the mice in NaB group was significantly decreased(P<0.01).The HE staining results showed that the liver tissue of the mice in control group exhibited normal structure,with clear boundaries of hepatocytes,consistent size,radially arranged around the central vein,and the nucleus located in the center of the cells;in model group,the arrangement of hepatocytes was disordered,the cells were swollen,there were multiple foci of hepatocellular necrosis,inflammatory cell infiltration,and hemorrhage;compared with model group,the cells in NaB group showed improved hepatocellular structure and reduced inflammatory infiltration.Compared with control group,the activities of ALT and AST in serum of the mice in model group were significantly increased(P<0.01);compared with model group,the activities of ALT and AST in serum of the mice in NaB group were significantly decreased(P<0.05 or P<0.01).Compared with control group,the activities of T-SOD and CAT in liver tissue of the mice in model group were significantly decreased(P<0.01),and the level of MDA was significantly increased(P<0.01);compared with model group,the activities of T-SOD and CAT in liver tissue of the mice in NaB group were significantly increased(P<0.05 or P<0.01),and the level of MDA was significantly decreased(P<0.01).The Western blotting results showed that compared with control group,the expression levels of Nrf2 and HO-1 proteins in liver tissue of the mice in model group were significantly decreased(P<0.05);compared with model group,the expression levels of Nrf2 and HO-1 proteins in liver tissue of the mice in NaB group were significantly increased(P<0.01).Conclusion:NaB has a protective effect on LPS/D-Gal induced acute liver injury in the mice,and its mechanism may be related to the upregulation of the expressions of Nrf2 and HO-1 proteins and the increas of the activity of oxidant enzyme in liver tissue by NaB,thereby reduces the liver oxidative stress level of liver.