Falls in an elderly require a comprehensive bio-psycho-social approach to evaluate for the root causes. These may be multi-factorial, and we need to deal with most of them, if not all, in order to effectively reduce the risk for falls. Frailty is a marker of poor functional outcomes. Sarcopenia is a major modifiable risk factor for frailty. There are various community programmes providing a comprehensive range of services to keep the elderly physically, mentally, and socially active. Communication with primary care physicians is important to ensure smooth transition back into the community, optimal management of chronic diseases and minimal re-admission.

BACKGROUND:For patients in intensive care unit (ICU), mechanical ventilation is an effective treatment to survive from acute illness and improve survival rates. However, long periods of bed rest and restricted physical activity can result in side effects. This study aimed to investigate the feasibility of early rehabilitation therapy in patients with mechanical ventilation. METHODS:A randomized controlled trial was carried out. Sixty patients, with tracheal intubation or tracheostomy more than 48 hours and less than 72 hours, were admitted to the ICU of the Affiliated Hospital of Medical College, Qingdao University, from May 2010 to May 2012. These patients were randomly divided into a rehabilitation group and a control group. In the rehabilitation group, rehabilitation therapy was performed twice daily, and the training time and intensity were adjusted according to the condition of the patients. Early rehabilitation therapy included heading up actively, transferring from the supine position to sitting position, sitting at the edge of the bed, sitting in chair, transferring from sitting to standing, and ambulating bedside. The patient's body mass index, days to first out of bed, duration of mechanical ventilation, length of ICU stay, APACHE Ⅱ score, highest FiO2, lowest PaO2/FiO2 and hospital mortality of patients were all compared between the rehabilitation group and the control group. The differences between the two groups were compared using Student's t test. RESULTS:There was no significant difference in body mass index, APACHE Ⅱ score, highest FiO2, lowest PaO2/FiO2 and hospital mortality between the rehabilitation group and the control group (P>0.05). Patients in the rehabilitation group had shorter days to first out of bed (3.8±1.2 d vs. 7.3±2.8 d; P=0.00), duration of mechanical ventilation (5.6±2.1 d vs. 12.7±4.1 d; P=0.005) and length of ICU stay (12.7±4.1 d vs. 15.2±4.5 d; P=0.01) compared with the control group. CONCLUSION:Early rehabilitation therapy was feasible and effective in improving the outcomes of patients with mechanical ventilation.

OBJECTIVETo explore the feasibility of IGF2 imprinting system in target gene therapy for tumors.

METHODSThe mouse H19 enhancer, DMD and promoter H19 were amplified by PCR from mouse genomic DNA and then cloned into the plasmid pDC312. The EGFP and DT-A fragments were amplified by PCR and cloned into the recombinant plasmid, and then the shuttle plasmid were transfected into HEK293 cells together with the adenoviral vector Ad5, namely, Ad-EGFP and Ad-DT-A. Adenovirus hexon gene expression was applied to confirm the presence of adenovirus infections. The effect of the IGF2 imprinting system was tested by fluorescence microscopy. RT-PCR and Western blotting after transfection of the recombinant adenoviral vectors into cancer cells were used to show loss of IGF2 imprinting (LOI) and maintenance of IGF2 imprinting (MOI), respectively. The anti-tumor effect was assessed by MTT and flow cytometry after the HCT-8 (LOI). Human breast cancer cell line MCF-7 (MOI) and human normal gastric epithelial GES-1 (MOI) cell line were transfected with Ad-DT-A in vitro. The anti-tumor effect was detected by injecting the Ad-DT-A in nude mice carrying HCT-8 tumors.

RESULTSThe expression of EGFP protein, DT-A mRNA and DT-A protein were seen to be positive only in the HCT-8 tumor cell line. Infection with Ad-DT-A resulted in obviously growth inhibition in HCT-8 cells (75.4 ± 6.4)% compared with that in the control group, and increased the percentage of apoptosis in the HCT-8 cells (20.8 ± 5.9)%. The anti-tumor effect was further confirmed by injecting the recombinant adenoviruses in HCT-8 tumor-bearing nude mice, and the results showed that the Ad-DT-A inhibited the tumor growth, with on inhibition rate of 36.4%.

CONCLUSIONSThe recombinant adenoviruses carrying IGF2 imprinting system and DT-A gene have been successfully constructed, while Ad-DT-A can effectively kill the tumor cells showing loss of IGF2 imprinting. It might play an important role in future target gene therapy against malignant tumors based on loss of IGF2 imprinting.

Adenoviridae ; genetics ; Animals ; Apoptosis ; Breast Neoplasms ; genetics ; pathology ; Colonic Neoplasms ; genetics ; pathology ; therapy ; Diphtheria Toxin ; biosynthesis ; genetics ; Female ; Genetic Therapy ; methods ; Genetic Vectors ; Genomic Imprinting ; Green Fluorescent Proteins ; biosynthesis ; genetics ; Humans ; Insulin-Like Growth Factor II ; genetics ; metabolism ; MCF-7 Cells ; Mice ; Mice, Nude ; Neoplasm Transplantation ; Peptide Fragments ; biosynthesis ; genetics ; Plasmids ; RNA, Messenger ; metabolism ; Random Allocation ; Recombinant Fusion Proteins ; biosynthesis ; genetics ; Transfection

To study the constituents from the chloroform extract of the roots of Lasianthus acuminatissimus Merr., various chromatographic techniques were used to separate and purify the constituents. The structure was established on the basis of ID, 2D NMR and HRMS spectroscopic analysis. A new compound was isolated and identified, which was 3, 8-dihydroxy-1-methoxy-2-methoxymethyl-9,10-anthraquinone (I). Compound I is a new anthraquinone, namely lasianthurin.
Anthraquinones ; chemistry ; isolation & purification ; Chromatography, Thin Layer ; Magnetic Resonance Spectroscopy ; Molecular Conformation ; Molecular Structure ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Rubiaceae ; chemistry ; Spectrometry, Mass, Electrospray Ionization

OBJECTIVE: To observe the changes of cardiac functional indicators in spontaneously hypertension rats (SHR) suffered by struck injuries of soft tissues, form which to discuss the significance in relationship between injury and disease. METHODS: SHRs were divided into four groups according to the degree, and whose thigh was struck with the homemade hit instrument. Then the blood pressure, heart rate as well as serum biochemical indicators (CK, CK-Mb, LDH, Cr, BUN, HBDH and AST) were examined. In addition, the morphological changes of heart, brain and kidney were also observed. RESULTS: The observe values of heart rate and blood pressure of SHRs seemed have relation to the degree of damage, but there were no statistically significance between different hit degree groups. In terms of serum biochemical indicators, all seven indicators of the hit group had significant difference with that of the control group, and the AST CK, CK-MB levels were difference between the group of different strike degree. CONCLUSIONS Struck injuries of soft tissues can result in forepart damage of cardiac muscle. The biochemical indicators reflect the degree of injury, and they could be used as a type of objective enzymology indicators for analysis of the relationship between injury and disease in forensic practice.
Animals ; Aspartate Aminotransferases/blood* ; Biomarkers/blood* ; Blood Pressure ; Creatine Kinase/blood* ; Female ; Heart/physiopathology* ; Heart Rate ; Hindlimb/injuries* ; Hypertension/physiopathology* ; Kidney/physiopathology* ; Male ; Myocardium/pathology* ; Random Allocation ; Rats

OBJECTIVETo investigate body weight and the body mass index (BMI) in girls with adolescent idiopathic scoliosis (AIS).

METHODSSix hundred and thirteen AIS female patients admitted from January 2005 to January 2007 and 449 healthy girls were recruited for this study with a range of age from 12 to 16 years old. The direct indexes included body height, body weight and date of birth. The indirect indexes included corrected body height, BMI and corrected BMI. The corrected body heights of AIS patients were adjusted by using the greatest Cobb angle to correct for spinal deformity according to Bjure's formula. Two-tailed Student's test was used for group comparison.

RESULTSIn the AIS patients, the maximum Cobb angle was (31 +/- 11) degrees (11 degrees to 77 degrees). The corrected body height were significantly higher in AIS patients than in the normal controls from 12 to 16 years old (P < 0.05). The body weight were significantly lower in AIS girls than in normal controls from 12 to 16 years of age (P < 0.01). From 12 to 16 years of age, the BMI were (17.6 +/- 1.9), (17.9 +/- 2.5), (17.9 +/- 2.1), (18.6 +/- 2.3) and (19.0 +/- 1.9) kg/m2 in AIS patients; while the BMI were (19.5 +/- 3.4), (19.8 +/- 3.0), (20.4 +/- 2.9), (20.4 +/- 2.8) and (20.2 +/- 2.2) kg/m2 in normal controls. The BMI were significantly lower in AIS girls than the normal controls from 12 to 16 years of age (P < 0.001).

CONCLUSIONSAfter the onset of puberty, significantly longer corrected height, lower body weight and lower BMI were found in AIS patients. Results of this large-scale study revealed the presence of abnormal growth in AIS patients during peripubertal development.

Adolescent ; Body Height ; Body Mass Index ; Body Weight ; Child ; Female ; Humans ; Kyphosis ; physiopathology ; Scoliosis ; physiopathology

OBJECTIVETo investigate the expression and relationship between HSP70 and caspase-3 in knee osteoarthritis.

METHODSForty adult SD rats were divided into experimental group and control group. Thirty rats in experimental group, anterior cruciate ligament transaction (ACLT) was cut off and partial meniscectomy of 1/3 inside incision were performed to reproduce knee osteoarthritis (KOA) model according to Hulth methos, and the other 10 rats was treated with nothing as control group. The rats were sent to the cage and free to move. At 1, 2 and 4 weeks later, the arthritis cartilage of femoral and tibial end were observed through immunohistochemistry staining and light microscope. Meanwhile, Mankin scale system was adopted for histomorphology evaluation.

RESULTSChanges of KOA such as hyperplastic synovium,erosion on the surface of cartilage and so on were found in experiment group, the expression of HSP70 was augmentation all the time, but the expression of caspase-3 was reduction 1 week later; no similar changes were found in control group. Mankin scale system showed that there were significant differences in the first week as compared with the second week and 4th week (both P < 0.01).

CONCLUSIONHeat shock protein inhibit the apoptosis of cartilage cells and protect the cartilage cells in knee osteoarthritis, the conservative treatment for clinical provide objective scientific basis.

Animals ; Apoptosis ; Cartilage ; pathology ; Caspase 3 ; physiology ; Chondrocytes ; pathology ; Female ; HSP70 Heat-Shock Proteins ; physiology ; Male ; Osteoarthritis, Knee ; pathology ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo investigate the effect of potential spinal growth on the posterior-only spinal instrumentation of adolescent idiopathic scoliosis (AIS).

METHODSFrom June 2003 to October 2007, 40 patients received posterior-only spinal instrumentation. Group of open triradiate cartilage (Group A) included 16 female AIS patients with mean age of 11.8, and group of closed triradiate cartilages (Group B) covered 24 female AIS patients with mean age of 13.7. The mean preoperative Cobb angles of Group A and B were 53.3° and 49.6° respectively, and the mean kyphosis in the sagittal plane was 27.7° and 27.8° respectively.

RESULTSThe post-operative Cobb angles were 22.2° (Group A) vs. 20.7° (Group B) (P = 0.34) with correction rate of 58.3% (Group A) vs. 57.7% (Group B) (P = 0.83). The mean Cobb angles at final follow-up were 24.8° (Group A) vs. 21.1° (Group B) (P = 0.05) with the correction loss of 5.3% (Group A) vs. 1.0% (Group B) (P = 0.01). In the sagittal plane, the average post-operative kyphosis was 22.5° (Group A) vs. 23.9° (Group B) (P = 0.49) with correction of 5.2° (Group A) vs. 3.9°(Group B) (P = 0.63). The mean kyphosis at final follow-up was 20.8°(Group A) vs. 24.7°(Group B) (P = 0.04) with the correction loss of -1.7° (Group A) vs. 0.8°(Group B) (P = 0.01). Group A showed obvious correction loss in the coronal plane and decrease of kyphosis in the sagittal plane. Adding on phenomenon was found in 2 cases with Lenke type I with selected fusion in Group A, but not in Group B.

CONCLUSIONSAlthough similar post-operative correction is found in AIS patients with OTRC or CTRC, the loss of correction and "adding on phenomenon" are more likely to happen in patients with OTRC.

Adolescent ; Child ; Female ; Follow-Up Studies ; Humans ; Postoperative Complications ; Retrospective Studies ; Scoliosis ; surgery ; Spinal Fusion ; adverse effects ; methods ; Treatment Outcome

OBJECTIVETo investigate the position of the conus medullaris in adolescent idioppathic scoliosis (AIS) with a greater curve and the relationship of that with age, sex, curve severity and curve pattern.

METHODSIn this study, 202 AIS patients with a Cobb angle greater than 40 degrees on coronal plane were included. And 52 age-matched healthy adolescents were recruited to serve as controls. Both of them displayed neurologically normal upon physical examinations. The T1-weighted, sagittal, spino-echo magnetic resonance imaging (MRI) of lumbar spine was performed on both of AIS patients and healthy controls. According to a standard method described previously, the position of the conus medullaris relative to lumbar vertebrae and intervertebral disc space was measured.

RESULTSThere was no significant difference in the distributions of the positions of the conus medullaris in AIS patients and healthy controls. In both groups, the mean position of the conus medullaris located at the same level, the lower 1/3 of L(1) (range: the middle 1/3 of T(12) to L(2 - 3) disc space). No significant correlations were found between the position of the conus medullaris and age or sex in AIS and control subjects. It was shown that the positions of the conus medullaris were not significantly different among AIS patients with different curve severity and curve patterns.

CONCLUSIONSThe distribution of the conus location in AIS patients is shown to be ranged from the middle 1/3 of T(12) to L(2 - 3) disc space, with no significant difference when compared to controls. No significant associations are found between the conus position with curve severity and curve patterns, indicating the conus location might be of no significant relevance of research on AIS pathogenesis and curve progression.

Adolescent ; Case-Control Studies ; Child ; Female ; Humans ; Lumbar Vertebrae ; Magnetic Resonance Imaging ; Male ; Scoliosis ; pathology ; Spinal Cord ; pathology

OBJECTIVETo investigate whether initial bone mineral status acts as a predictor factor in evaluating the early outcome of brace treatment in adolescent idiopathic scoliosis (AIS) girls.

METHODSSeventy-seven girls with AIS, aged 10 - 15 years old, were included in this study. A standardized bracing protocol was performed in these girls, and the early outcomes of brace treatment were evaluated at over-1-year follow-up. Girls with a progressed scoliosis and those with a non-progressed scoliosis were identified. The associations between the outcome and the indices before bracing, including age, menstrual status, Risser grade, bone mineral density (BMD) status, curve magnitude and curve pattern were assessed using univariate analysis. A multiple Logistic stepwise regression was used to determine the risk factors in curve progression in AIS girls treated with brace treatment.

RESULTSThere were 16 girls (21%) with a progressed scoliosis and 61 girls (79%) with a non-progressed scoliosis, respectively. In the girls with a progressed scoliosis, higher ratios of subjects were found with pre-menarchal status (chi(2) = 9.628, P = 0.004), lower Risser grade (chi(2) = 4.565, P = 0.037), main thoracic scoliosis (chi(2) = 4.009, P = 0.045), a larger curve (chi(2) = 1.685, P = 0.194), as well as osteopenia (chi(2) = 3.828, P = 0.050), as compared with those with a non-progressed scoliosis. During brace treatment, besides pre-menarchal status, a larger Cobb angle, and a main thoracic scoliosis, osteopenia (OR = 5.362, P = 0.022) was identified as the risk factor in curve progression in AIS girls, as revealed by the multiple Logistic regression analysis.

CONCLUSIONSOsteopenia might be an independent risk factor in the curve progression during brace treatment. The analysis of initial BMD status before bracing may help to predict the outcome of brace treatment.

Adolescent ; Bone Density ; Braces ; Child ; Female ; Humans ; Prognosis ; Retrospective Studies ; Scoliosis ; physiopathology ; therapy ; Treatment Outcome