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.

To reveal the underlying mechanism of doxorubicin induced hepatotoxicity, an NMR-based metabolomic approach combined with multivariate statistical analysis was used to observe its metabolic alternations of rat liver. Sixteen differential metabolites between model rats and normal rats were characterized as potential pathological biomarkers related to doxorubicin induced hepatotoxicity. Six pathways, including phenylalanine, tyrosine and tryptophan biosynthesis, valine, leucine and isoleucine biosynthesis, phenylalanine metabolism, glycine, serine and threonine metabolism, alanine, aspartate and glutamate metabolism, and tyrosine metabolism were regarded as the targeted metabolic pathways according to Metabolic Pathway Analysis (MetPA). The results suggested that the metabolic perturbations in rats with doxorubicin induced hepatotoxicity were mainly involved in amino acid metabolism, lipid pathways, purine metabolism, energy metabolism, dysfunction of biotransformation and oxidative stress. The investigation revealed the effects of doxorubicin on liver in a holistic metabolic way, which laid a foundation for further studies on its toxicity mechanism.

Objective: To study the effects of propafenone on action potential (AP) of rabbit ventricular myocytes with the tonic block and use-dependent block of transient sodium current (INa-T). Methods: A total of 10 adult New Zealand white rabbits were sacriifced and 10 individual ventricular myocytes were isolated by enzyme digestion method. Microelectrode technologies were used to record AP-related parameters: maximum diastolic potential (MDP), maximum rate of rise of the action potential upstroke (Vmax), action potential amplitude (APA) and action potential duration at 20%, 50% and 90% (APD20, APD50 and APD90).INa-T was measured, I-V curves and peak currents at different frequencies were detected by whole cell patch clamp before and after propafenone perfusion at 10 μmol/L. Results: There was no statistical difference in MDP at before and after propafenone perfusion as (-80 ± 6) mV vs (-82 ± 5) mV,P>0.05. After perfusion, APA was signiifcantly decreased as (95 ± 12) mV vs ( 125 ± 10) mV,P<0.05, the Vmax slowed down as (330 ± 43) V/s vs (420 ± 54) V/s,P<0.05, while APD20, APD50 and APD90 were unchanged as (8 ± 2) ms vs (6 ± 2) ms,P>0.05, (16 ± 3) ms vs (12 ± 3) ms,P>0.05 and (86 ± 14) ms vs (85 ± 12) ms,P>0.05. After propafenone perfusion, I-V curve ofINa-T was shifted upward and the peak current was decreased as (3001 ± 383) pA vs (4193 ± 378) pA, P<0.05. Before perfusion, when stimulated at 0.06 Hz, 1 Hz, 2 Hz, 5 Hz and 10 Hz, there were no signiifcant use-dependent block inINa-T , and no real difference inINa-T between the 10th and 1st pulse,P>0.05. After perfusion, no significant use-dependent block was observed when stimulated at 0.06 Hz and 1 Hz,P>0.05, while at 2 Hz, 5 Hz and 10 Hz, propafenone perfusion demonstrated signiifcant use-dependent block uponINa-T with the inhibition fractions of (22 ± 11)%, (38 ± 14)% and (52 ± 17)% respectively, those were signiifcantly different from the inhibition fractions at either 0.06 Hz or 1Hz,P<0.05. When the inhibition fractions were compared by each 2 conditions, allP<0.05. Conclusion: Propafenone may slow down the Vmax of AP, reduce APA and without the impact on APD; the effects onINa-T is not only in tonic block, but also more obviously in use-dependent block in isolated ventricular myocytes of New Zealand rabbit. Such inlfuences minimized the impact on QT interval and meanwhile, decreased the incidence of brad arrhythmia.

Objective To retrospectively analyze the treatments of nonvalvular atrial fibrillation (nvAF) in elderly patients aged 80 years and over,and to investigate the influencing factors for occurrence of stroke and transient ischemic attack(TIA)and relationships between antithrombotic therapy and stroke or TIA.Methods 101 elderly patients with nvAF were enrolled and grouped according to the occurrence of stroke/TIA and antithrombotic-correlated bleeding.The influencing factors were retrospectively analyzed and antithrombotic schemes were compared.Results Incidence rate of stroke/TIA was 28.7％ (29/101).Among all patients,70 cases were treated with antiplatelet therapy,19 cases were treated with anticoagulation therapy,while 12 cases received no antithrombotic (antiplatelet or anticoagulation) therapy before stroke.Both the nvAF time course and the antithrombotic strategy were significantly different between post-AF stroke/TIA group and non-postAF stroke/TIA group(both P＜0.05).The difference was reflected in ratios of antiplatelet therapy/anticoagulation therapy.The proportion of anticoagulation therapy was higher in non stroke/TIA group(x2 =5.778,P =0.016).Different antiplatelet therapy scheme significantly affected occurrence of stroke/TIA(P＜0.05).There was no significant effect of antithrombotic schemes on hemorrhagic events(x2=0.708,P =0.702).Multiple logistic regression analysis showed that hypertension,coronary heart disease,cancer,diabetes and previous stroke history,as well as nvAF duration were the independent risk factors for post-AF stroke/TIA(OR=1.351,95 ％CI:1.129-1.617).Conclusions Currently,the proportion using anticoagulation therapy is low,and single antiplatelet therapy is the main regimen in the elderly patients with nvAF.For elderly patients with nvAF,anticoagulation therapy has a protective effect against the occurrence of post-nvAF stroke/TIA,meanwhile there is no significantly increased risk of bleeding,which makes anticoagulation therapy advisable in the elderly.The nvAF time course is one of the risk factors,which is worth experts' attention in risk evaluation of thrombus in elderly patients.

[ ABSTRACT] AIM:To investigate the effects of transplantation of bone marrow mesenchymal stem cells ( BMSCs) modified by bcl-2 gene on myocardial cell apoptosis, angiogenesis and cardiac function in the rabbit after acute myocardial in-farction ( MI) .METHODS:The rabbit BMSCs were isolated, cultured and purified in vitro.The BMSCs were transfected with adenovirus or adenovirus-Bcl-2.The rabbit model of MI was established by ligation of left anterior descending branch. The rabbits were injected with Ad-Bcl-2-BMSCs ( MI+Bcl-2-BMSCs group) , Ad-BMSCs ( MI+BMSCs group) and DMEM ( MI group) in infarction marginal zone 2 weeks after ligation.The cardiac function was evaluated by echocardiography.The apoptosis of myocardial cells was measured by TUNEL.The mRNA expression of VEGF was detected by real-time PCR.The expression of CD31 was examined by immunohistochemical staining, and new blood capillaries were counted at 4 weeks after BMSCs transplantation.The correlation of the above values with cardiac function was analyzed.RESULTS: The cardiac function was better, the apoptotic rate was lower, the mRNA expression of VEGF and the capillary density were higher in both MI+Bcl-2-BMSCs group and the MI+BMSCs group than those in MI group, and those in MI+Bcl-2-BMSCs group in-creased more obviously .The left ventricular ejection fraction ( LVEF) had a negative correlation with the myocardial cell ap-optosis rate.A positive correlation with the mRNA expression level of VEGF and the capillary density was also observed. CONCLUSION:The transplantation of BMSCs modified by bcl-2 gene significantly reduces the myocardial cell apoptosis, promotes angiogenesis, improves heart function of the rabbits with MI.

Objective:To investigate the correlation between serum uric acid level and symptomatic intracranial hemorrhage (sICH) and outcomes after endovascular therapy (EVT) in elderly patients with anterior circulation acute ischemic stroke (AIS).Methods:Elderly patients with AIS (aged ≥65 years) received EVT in Beijing Geriatric Hospital and Xuanwu Hospital from December 2017 to December 2020 were retrospectively enrolled. sICH was defined as cerebral parenchymal hemorrhage revealed by CT within 72 h after admission and the Naitonal Institutes of Health Stroke Scale score increased by ≥4 compared with the baseline. At 90 d after onset, the clinical outcome was evaluated by the modified Rankin Scale. 0-2 was a good outcome and 3-6 was a poor outcome. The clinical data of the sICH group and non-sICH group, as well as the good outcome group and poor outcome group were compared. Multivariate logistic regression analysis was used to determine the independent correlation between serum uric acid level and sICH and poor outcomes. Results:A total of 122 patients were enrolled, their age was 73.89±6.24 years, and 73 (59.8%) were male. Fifty-two patients (42.6%) had hemorrhagic transformation, 27 (22.1%) had sICH, and 28 (23.8%) had a good outcome at 90 d after onset. The serum uric acid in the sICH group was significantly lower than that in the non-sICH group ( P=0.002), while the serum uric acid in the good outcome group was similar to that in the poor outcome group ( P=0.510). Multivariate logistic analysis showed that the lower serum uric acid was an independent risk factor for sICH (odds ratio 0.994, 95% confidence interval 0.990-0.998; P=0.011). Conclusion:The lower serum uric acid level was an independent risk factor for sICH after EVT in elderly patients with AIS, but it was not associated with the outcomes.

Osteoarthritis (OA)is a chronic degenerative joint disease and one of the most common causes of pain and disability in the elderly.Frailty is a physiological state characterized by the deregulation of multiple physiologic systems in an aging organism,leading to the loss of homeostatic capacity that exposes the elderly to disability,disease,and eventual death.Prefrailty occurs at an earlier stage of the frailty spectrum and is closely associated with later development of frailty.A large number of studies,using various diagnostic criteria,have addressed the interrelationship between OA and frailty during their disease development processes.Identifying prefrailty and frailty is necessary for the choice of intervention measures and the prevention or delay of disability occurrence in elderly OA patients.Frailty can be considered as a new prognostic factor for mortality,especially in individuals with OA.

Objective To investigate the association between interleukin-17 A (IL-17 A) gene promoter polymorphism and blood lipid and inflammatory factors in coronary heart disease.Methods A total of 241 patients with coronary heart disease who were admitted to hospital from April 2010 to December 2016 were enrolled in this study.68 cases of healthy subjects were collected.IL-17 gene promoter rs8193036 genotype,blood lipid and inflammatory factors were detected and compared.Results Compared with the control group,the genotype CC,CT and TT of the rs8193036 genotype in the coronary heart disease group were significantly different (P＜0.05),and the frequency of C allele in the coronary heart disease group was significantly higher than that in the control group (P＜0.05).The levels of triglyceride,low-density lipoproteinCholesterol,high density lipoprotein cholesterol,interleukin-17a,interleukin-6,interleukin-8 and tumor necrosis factor alpha in CC genotype of tumor necrosis factor alpha group were significantly higher than those in tumor necrosis factor alpha group (P＜0.05),high density lipoprotein cholesterol decreased significantly (P＜0.05).Total cholesterol and low-density lipoprotein cholesterol had no significant differences (P ＞ 0.05).Conclusion The rs8193036 polymorphism of IL-17A gene promoter is associated with the pathogenesis of coronary heart disease.The C allele is an important genetic marker of coronary heart disease.The polymorphism of IL-17A promoter rs8193036 might affect coronary heart disease by increasing blood lipids and inflammation factors.

Rift Valley fever (RVF) is an acute, febrile zoonotic disease that is caused by the RVF virus (RVFV). RVF is mainly prevalent on the Arabian Peninsula, the African continent, and several islands in the Indian Ocean near southeast Africa. RVFV has been classified by the World Organisation for Animal Health (OIE) as a category A pathogen. To avoid biological safety concerns associated with use of the pathogen in RVFV neutralization assays, the present study investigated and established an RVFV pseudovirus-based neutralization assay. This study used the human immunodeficiency virus (HIV) lentiviral packaging system and RVFV structural proteins to successfully construct RVFV pseudoviruses. Electron microscopy observation and western blotting indicated that the size, structure, and shape of the packaged pseudoviruses were notably similar to those of HIV lentiviral vectors. Infection inhibition assay results showed that an antibody against RVFV inhibited the infective ability of the RVFV pseudoviruses, and an antibody neutralization assay for RVFV detection was then established. This study has successfully established a neutralization assay based on RVFV pseudoviruses and demonstrated that this method can be used to effectively evaluate antibody neutralization.
Africa ; Animals ; Blotting, Western ; HIV ; Indian Ocean ; Islands ; Methods ; Microscopy, Electron ; Product Packaging ; Rift Valley fever virus ; Rift Valley Fever ; Zoonoses