BACKGROUND:At present,the treatment of infected bone defects has the problems of long course of disease,poor treatment effect and high cost.The osteogenic effect of personalized bone replacement materials in clinical treatment is limited.Therefore,a 3D-printed bone graft material with both good osteogenic effect and antibacterial effect is urgently needed for clinical treatment. OBJECTIVE:To summarize the research status of 3D-printed scaffolds loaded with antimicrobial agents for the treatment of infected bone defects. METHODS:PubMed,Web of Science,Elsevier,and CNKI databases from January 2010 to June 2022 were searched for related articles.The Chinese search terms were"bone defect,3D printing,scaffold material,antibacterial,animal experiments,in vitro experiments".English search terms were"bone defect,3D printing,scaffold,antibiosis,animal experiment,in vitro".Finally,60 articles were included for review and analysis. RESULTS AND CONCLUSION:The 3D scaffolds made of titanium,magnesium,tantalum and other metals and their alloys have certain osteogenic properties,but do not have antibacterial function.Hydroxyapatite and other bioceramic materials have good biocompatibility and are prone to be degraded,whereas due to the lack of strength,they are usually combined with artificial polymer materials to form composite materials,which respectively mimic the inorganic and organic components in natural bone,and play their respective excellent functions.Antibiotics,silver/copper nanoparticles,antimicrobial peptides,gallium and other antibacterial agents play an antibacterial role by destroying bacterial cell membrane,producing reactive oxygen species to interfere with bacterial DNA replication,inhibiting iron absorption and other mechanisms.As a result,the 3D-printed scaffold has both antibacterial and osteogenic effects.However,there are still some problems such as drug resistance and difficult to control effective concentrations.3D-printed scaffolds are often loaded with antibacterial agents by loading drug-loaded microspheres on scaffolds,preparing antibacterial coating on the scaffold surface,and participating in joint 3D printing with drugs.The loading mode of antibacterial coating prepared on the scaffold surface is the most widely used,and its antibacterial effect is more stable.Nonetheless,the selection of the most suitable loading mode for antibacterial agents needs to be further discussed and summarized.It is a future research prospect to optimize the mechanical properties of composite scaffolds and prepare biomimetic bone scaffolds so that the degradation rate is consistent with the bone reconstruction rate in infected bone defects.The ideal antibacterial agents may play a role through a variety of antibacterial mechanisms,thus being expected to play a good antibacterial effect through low antibacterial concentration,which should be a hot spot of anti-bone infection research.After loading antibacterial agents on the surface of the scaffold,antibacterial agents can"intelligently"react to the local microenvironment,achieving controlled release,and regulating the osteogenesis,vascularization and immune response of the microenvironment,which is the focus of current research.

Objective:The study aimed to assess the scientific rigor, transparency, and practicality of Chinese geriatric medicine guidelines and consensus published in academic journals.Methods:A systematic search was conducted across 8 major Chinese and English databases to identify guidelines and consensus documents from Chinese scholars in 2022.Results:The selected documents were evaluated using the STAR rating tool, resulting in the inclusion of 2 guidelines and 19 expert consensuses.The total scores ranged from 9.0 to 50.6 points, with an average score of 29.6±13.1 points.The highest score rate in the'Consensus Methods’category of expert consensuses was 47.4%, while the lowest score rate in the'Registration’category was 0.For guidelines, the highest score rate in the'Consensus Methods’category was 42.9%, while the lowest score rates were observed in the'Registration’, 'Plan’, and'Others’categories at 0.Conclusions:The overall quality of geriatric medicine guidelines and consensus in China requires enhancement.There is a need to improve training in guideline consensus development, involve methodologists, elevate the standards for journal publication, and strive to enhance the scientific rigor, transparency, and practicality of guidelines and consensus documents.

The rapid development of big data and artificial intelligence technologies has propelled the large-scale, multi-center, and diverse forms of clinical research, and how to efficiently integrate and utilize clinical research data resources has become an urgent problem to be solved. Based on the U. S. geological survey(USGS) scientific data life cycle model, the National Clinical Research Center for Geriatrics has devised the " S-C-V-C-R-A" data management platform framework, which determined six data management principles: Standardization, Controllability, Visibility, Credibility, Reliability, and Availability. By solving three key technologies: data aggregation, data standardization, and data sharing, an integrated clinical research data platform was built to realize standardized data management plans, controllable data acquisition, visible data processing, credible data analysis, reliable data storage, and accessible data publication and sharing. As of July 2023, the platform has aggregated data from 487 096 elderly patients, carried out more than 10 scientific research projects, supported over 200 collaborative innovation network units, and established four cohorts of elderly populations with distinct characteristics. The platform has achieved a one-stop, comprehensive service of data management planning, acquisition, processing, analysis, storage, publication, and sharing, thus achieving the objectives of enhancing research efficiency, promoting collaborative research, and facilitating data sharing.

Open fund projects play an important role in strengthening discipline construction and enhancing research capabilities. The National Clinical Research Center for Geriatrics of West China Hospital, Sichuan University (hereinafter referred to as the Center) initiated the establishment of open fund projects in 2018. However, due to their strong disciplinary and autonomous nature, as well as the presence of uncertainty, these projects posed new challenges to project management. Therefore, based on the theory of project integration management, the Center has established an integrated management system for open fund projects. This system was achieved by identifying the construction objectives of open fund projects, defining their scope of application, and integrating the four essential elements of project management: execution, processes, control, and support. It ensured standardized execution through organizational and institutional measures, optimized management processes, implemented control through the development of milestone lists, risk registration lists, superior funding lists, and non-performing lists, and integrated technology and platforms as support. The system was implemented since 2020, realizing comprehensive and holistic management of open fund projects across all stages and elements, thereby effectively enhancing management efficiency and quality. As of December 2023, 112 open fund projects have been approved, with a total funding of 31.943 million yuan. These projects have yielded a series of achievements in cohort study and platform construction, academic output, and have demonstrated remarkable effectiveness in projects and talents cultivation. The construction and application of this system can provide reference for medical institutions in managing open fund projects.

Male ; Humans ; Aged ; Sleep Duration ; Aging ; Testosterone ; China ; Sleep

This study aimed to investigate the effect of curcumin (Cur) against human cytomegalovirus (HCMV) in vitro. Human embryonic lung fibroblasts were cultured in vitro. The tetrazolium salt (MTS) method was used to detect the effects of Cur on cell viability. The cells were divided into control group, HCMV group, HCMV + (PFA) group and HCMV + Cur group in this study. The cytopathic effect (CPE) of each group was observed by plaque test, then the copy number of HCMV DNA in each group was detected by quantitative polymerase chain reaction (qPCR), and the expression of HCMV proteins in different sequence was detected by Western blot. The results showed that when the concentration of Cur was not higher than 15 μmol/L, there was no significant change in cell growth and viability in the Cur group compared with the control group (P>0.05). After the cells were infected by HCMV for 5 d, the cells began to show CPE, and the number of plaques increased with time. Pretreatment with Cur significantly reduced CPE in a dose-dependent manner. After the cells were infected by HCMV, the DNA copy number and protein expression gradually increased in a time-dependent manner. Pretreatment with Cur significantly inhibited HCMV DNA copies and downregulate HCMV protein expression levels in a concentration-dependent manner, and the difference was statistically significant (P<0.05). In conclusion, Cur may exert anti-HCMV activity by inhibiting the replication of HCMV DNA and down-regulating the expression levels of different sequence proteins of HCMV. This study provides a new experimental basis for the development of anti-HCMV infectious drugs.
Humans ; Curcumin/therapeutic use* ; Cytomegalovirus/genetics* ; Cytomegalovirus Infections/drug therapy* ; Plaque, Atherosclerotic

Objective:To investigate the nutritional status of elderly inpatients in China, and to assess its relationship with clinical outcomes.Methods:A prospective, multicenter, parallel investigation was organized and conducted by the Chinese Medical Association's Group of Geriatric Nutrition Support.Patients aged ≥65 years from 30 major hospitals of 14 cities in China were evaluated by the Nutritional Risk Screening 2002(NRS2002)and the Mini-Nutritional Assessment-Short Form(MNA-SF), in order to understand the nutritional status and nutritional risk of elderly inpatients in China.The indicators of clinical outcomes were summarized, and the correlation between nutritional status and clinical outcomes was analyzed.Results:A total of 10 184 elderly patients who met the inclusion criteria were enrolled in this study, aged 65-112(74.81±7.01)years, with a body mass index(BMI)of 17.80-35.50(23.32±3.83)kg/m 2.Grip strength of the dominant hand was(16.95±18.42)kg, upper arm circumference was(25.68±3.70)cm, and calf circumference was(32.07±3.89)cm.BMI, grip strength, upper arm circumference and calf circumference decreased significantly with age( F=13.74, 97.47, 28.31 and 88.68, all P<0.001). NRS2002 was conducted on 10 182 patients.Of them, 10.14%(895/10 182)suffered malnutrition(BMI≤18.5 kg/m 2), and 46.42%(4 726/10 182)were at nutritional risk(NRS2002 score≥3). Nutrition deficiency and nutritional risk showed upward trends with age( F=43.41 and 177.05, both P<0.001). A total of 9 755 patients(95.79%, 9 755/10 182)completed the MNA-SF.Of them, 14.67%(1 431/9 755)had malnutrition, 35.04%(3 418/9 755)were at risk of malnutrition, and 50.29%(4 906/9 755)had normal nutritional status.The incidence of malnutrition and the risk of malnutrition significantly increased with age( F=172.79, 12.10 and 152.42, all P<0.05). Nutritional risk(NRS2002 score≥3)was related to age, BMI, mortality, infectious complications, length of hospital stay and total hospital cost(all P<0.05). Conclusions:The incidence of malnutrition and the risk of malnutrition are high in elderly inpatients in China.Nutritional risk is an influencing factor for adverse clinical outcomes.

Older patients often experience a loss of physical,cognitive and social functioning during an acute illness-caused hospitalization.The loss of function could be due to a traditional model of hospital care,which focuses only on diagnosis and treatment of acute disease.Restoration of elderly patients' lost functions is important for better prognosis of hospitalized elderly patients and would reduce the cost of additional medical treatment.Acute care for the elderly (ACE) is a new model of care aiming at function restoration by practicing a geriatric assessment in the special ACE unit of hospital.The ACE intervention includes interdisciplinary team rounds,discharge planning of hospital,medical care review,a prepared environment,and patient-centered care.Multiple randomized control trials have demonstrated that ACE unit can improve the functional status and prognosis of old patients,reduce the cost of hospitalization,and improve patients' satisfaction.Currently,ACE care model is poorly known by Chinese hospitals and doctors.This article introduces the concepts of ACE unit,technical elements and the clinical evidence of its effectiveness.

Objective To investigate the association of frailty with serum inflammatory biomarkers and geriatric parameters.Methods A total of 299 elderly people aged 60 and over were recruited,received frailty and comprehensive geriatric assessment,and were tested on serum levels of interleukin-10 (IL-10),interleukin-1β (IL-1β),monocyte chemoattractant protein-1 (MCP-1),monocyte chemoattractant protein-3 (MCP-3),macrophage inflammatory protein 1a (MIP-1α),macrophage inflammatory protein-1β (MIP-1β),tumor necrosis factor α (TNF-α),nuclear factor-κB (NF-κB) and sirtuin-1 (SIRT-1).Potential association of frailty with these biomarkers and several geriatric parameters was analyzed.Results Statistical differences in serum levels of MCP-1,MIP-1α and MIP-1β were detected between the frailty group and the non-frailty group (H=10.766,10.766 and 8.217,respectively;P =0.005,0.043 and 0.016,respectively).Logistic regression analyses showed that MCP-1 and MIP-1β were associated with frailty after adjustment for age,sex,body mass index (BMI),smoking,drinking,comorbidity and comprehensive geriatric assessment (OR=2.493,2.531,both F＜0.05).Conclusions MCP-1 and MIP-1β are risk factors for frailty.