Objective:To evaluate the clinical efficacy and safety of fecal microbiota transplantation(FMT)for the treatment of chronic functional constipation in the elderly.Methods:A total of 33 elderly patients with chronic functional constipation were included and given three sessions of FMT.Changes in fecal characteristics, constipation, mood and quality of life in these patients were evaluated using the Bristol stool form scale(BSFS), the constipation assessment scale(CAS), patient assessment of constipation symptoms(PAC-SYM), the Zung self-rating anxiety scale(SAS), the Zung self-rating depression scale(SDS), and the patient assessment of constipation quality of life(PAC-QOL)before and 12 weeks after treatment.The clinical efficacy was based on comparison between pre-and post-treatment results for each patient.Results:Clear improvement was achieved in 33 patients 12 weeks after treatment, compared with before transplantation.Post-treatment scores of the constipation assessment scale and symptom self-assessment questionnaire for patients with constipation were(8.9±1.2)scores and(26.5±2.4)scores, respectively, significantly lower than pre-transplantation scores of(12.2±1.1)scores and(32.4±2.4)scores( t=15.034, 13.904, both P<0.001). Similarly, post-treatment scores were also lower than pre-transplantation levels for the self-rating anxiety scale[(50.4±8.4)scores vs.(57.5±9.0)scores, t=10.333, P<0.001], the self-rating depression scale[(50.6±8.4)% vs.(55.0±10.5)%, t=5.301, P<0.001], and self-assessment questionnaire for quality of life[(88.2±7.3)scores vs.(103.7±7.3)scores, t=23.300, P<0.001]. Conclusions:FMT can improve fecal characteristics and constipation symptoms, relieve anxiety and depression, improve the quality of life, and provide a new option for the treatment for elderly patients with chronic functional constipation.

Objective:To explore the clinical value of the geriatric potentially inappropriate medication(PIM)evaluation system in elderly inpatients.Methods:As a prospective cohort study, 203 elderly inpatients with polypharmacy were randomly divided into the control group and experimental group.Geriatric PIM evaluation system(based on the criteria for judging potential inappropriate drug use in Chinese elderly 2017 edition)on wechat platform was applied to patients of experimental group.During the 6 months, the number of elderly syndromes, types of drugs, the days in hospitalization, readmission rates and all-cause mortality were compared between two groups.Results:The age of 203 elderly inpatients ranged from 60 to 94(77.30±10.34)years, including 121 males and 82 females.The morbidity proportion of top five diseases were 69.95%(142/203)in cerebral infarction(non-acute phase), 62.07%(126/203)in hypertension, 24.14%(49/203)in coronary heart disease, 9.85%(20/203)in atrial fibrillation, and 6.40%(13/203)in cardiac insufficiency.The 97.53%(198/203)of elderly hospitalized patients had at least one senile syndrome, the average was 4.3±2.0.Insomnia, fall and frailty accounted for 32.87%(15/198), 28.45%(56/198)and 13.66%(27/198)respectively.Compared with the control group, the average length of stay in hospital in the experimental group significantly decreased[(16.38±4.29) vs.(21.32±6.10)d, t=2.438、 P=0.025], the number of senile syndrome, the score of fall, weakness and the re-admission rate were also decreased significantly(3.11±2.14 vs.4.32±1.50, t=0.854、 P=0.032; 6.19±1.35 vs.8.61±3.22, t=4.078、 P=0.044; 3.94±1.92 vs.5.65±1.34, t=2.843、 P=0.038; 9.81%(10/102) vs.1.98%(2/101), χ2=4.772、 P=0.029), and the frequency of PIM was significantly different between two groups(417.36±49.21 vs.210.25±38.23, t=2.136、 P=0.034). Conclusions:After making the drug adjustment on the elderly inpatients with multiple drugs, PIM evaluation system for the elderly are able to reduce the incidence of geriatric syndrome, shorten the length of stay in hospital, improve the rational use of drugs, and enhance the quality of life of the elderly patients.

Objective:To explore the role of commensal microbiota in the regulation of long non-coding RNA(LncRNA)expression in mouse alveolar macrophages(AMs).Methods:AMs were separated from antibiotics-treated mice and normal mice and then were purified.LncRNA microarray technology was used to screen differentially expressed LncRNAs and conduct bioinformatics analysis.Fluorescence in situ hybridization(FISH)was used to detect the subcellular localization of LncRNA-30162.RNA interference technology was used to knock out the expression of LncRNA-30162 in RAW264.7 cells, and reverse transcription polymerase chain reation(RT-PCR) was used to detect the regulation of gene expression by LncRNA-30162 in RAW264.7 cells.Results:The purity of the separated AMs was greater than 95%.Compared with normal mice, there were 634 differentially expressed LncRNAs with changes greater than 2 folds in the AMs from antibiotics-treated mice, 363 of which were upregulated and 271 were downregulated.The target genes of differentially expressed LncRNAs were closely associated with immune system regulation, cell differentiation and chemotaxis.The expression levels of CCL24 and Arg1 in RAW264.7 macrophages were decreased after interference with LncRNA-30162 expression[(218.70±31.45) μg/L vs.(420.23±56.25) μg/L, (1.24±0.21)×10 3 U/L vs.(2.63±0.31)×10 3 U/L, t=5.416 and 6.409, P=0.006 and 0.003]. Conclusions:Commensal microbiota can regulate the expression of LncRNAs in AMs.Differentially expressed LncRNAs are associated with a variety of gene ontology(GO)biological processes and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathways.LncRNA-30162 can regulate the expression levels of CCL24 and ARG1 in RAW264.7 cells.

Objective: To investigate the correlation between frailty status and anticoagulation therapy in elderly patients with atrial fibrillation. Methods: A total of 131 atrial fibrillation inpatients in our hospital aged 70 years and over with a mean age of(77.4±6.4)years were enrolled from January 2017 to June 2018 in this retrospective study.According to the state of anticoagulation therapy at discharge, patients were divided into the anticoagulation group(n=67)and the non-anticoagulation group(n=64). Data including gender, age, N-terminal pro-brain natriuretic peptide(NT-proBNP), glomerular filtration rate(eGFR), the type of medication, HAS-BLED(Hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile international normalized ratio, elderly, drugs/alcohol concomitantly), CHA2DS2-VASc scores, Charlson comorbidity index and clinical frailty scores(CFS)were recorded and compared between the two groups.Spearman correlation was used to analyze the correlation between frailty degrees and program of anticoagulant therapy.Two-class Logistic regression models were used to analyze the related factors for programs of anticoagulant therapy. Results: The incidence of the frailty syndrome was 56.49% in 131 elderly patients with atrial fibrillation.Compared with the anticoagulation group, non-anticoagulation group showed that the CFS score[(5.73±1.85)vs.(3.69±2.07), P<0.05], the incidence of the frailty syndrome(67.19% vs.46.27%, P<0.05)and Charlson index[(6.09±2.80)vs.(4.98±2.61), P<0.05]were increased.While, there was no significant difference in HAB-BLED score and CHA2DS2-VASc score between the two groups(P>0.05). The correlation analysis showed that there was a negative correlation between the application of anticoagulants and CFS grade in elderly patients with atrial fibrillation(r=-0.138, P<0.05). Multivariate Logistic regression analysis showed that age, CFS score and the incidence of frailty state were risk factors in elderly atrial fibrillation patients without the anticoagulant therapy(P<0.05). Conclusions The incidence of frailty state in elderly patients with atrial fibrillation is high, and the proportion of patients receiving the anticoagulant therapy is low.Age and frailty may be the most important influencing factors for anticoagulant therapy.Therefore, it is of great significance to incorporate frailty assessment into the management of anticoagulant therapy in elderly patients with atrial fibrillation.

Objective: To establish the culture technique for culturing γδ T cells in vitro and evaluate the basic characteristics, security and anti-tumor effect of the cultured γδ T cells. Methods: Phytohemagglutinin, zoledronic acid, interleukin-2 and interleukin -7 were used to induce the abundant expansion of peripheral blood mononuclear cells in vitro. Flow cytometry assay, in vitro killing assay and mouse model of human lung cancer were also adopted to assess the characteristics and the anti-tumor effect of cultured γδ T cells. Additionally, the contamination of exogenous agents and the acute toxicity of γδ T cells were determined. Results: After culturing 14-16 days in vitro, the total number of γδ T cells was more than 1.0×10¹⁰. Among these γδ T cells, CD3⁺ γδ TCR⁺ cells accounted for more than 90%. None of contaminations of bacteria, fungi, mycoplasma and virus were observed. At effect target ratio (E/T ratio) of 50/1, killing efficiency of γδ T cells cultured in vitro to SK-MES-1, Ho8910, A549 and K562 reached more than 65%. In vivo experiments showed that the tumor volume of γδ T-treated mice was (828.99±61.05) mm^3, significantly lower than (1 723.51±84.30) mm³ of the control mice (P<0.05). Meanwhile, no acute toxicity effect was observed in γδ T cells treated mice. Conclusion The number, purity and activity of γδT cells cultured in our institute can reach the requirement of clinical application, and the γδT cells also display strong cytotoxic activity against tumor cells such as lung cancer, ovarian cancer and leukemia.

Aim To investigate the effects of ghrelin on alcohol-induced liver injury. Methods The alcoholic liver injury mouse model was induced by chronic etha-nol feeding ( 4-week ad libitum oral feeding with the ethanol liquid diet) plus a single binge ethanol (5 g· kg-1 ) feeding. The level of alanine aminotransferase (ALT), aspartate aminotransferase (AST) in serum, malondiadehyde ( MDA ) content, superoxide dis-mutase (SOD) and glutathione peroxidase (GSH-Px) activities in liver homogenate were assayed by spectro-photometer. Hepatic pathological examination was ob-served by HE staining. The mRNA expression of proin-flammatory cytokines including TNF-α, IL-1β, IFN-γ, IL-6 and MCP-1 in the liver was measured by real-time PCR method. Results This chronic-plus-single-binge high dose ethanol feeding synergistically induced liver injury, inflammation and fatty liver change. Treatment with Ghrelin ( 5 , 10 , 20 μg · kg-1 ) significantly de-creased the enhanced level of transaminase ( ALT, AST) in serum, improved the pathologic change in liv-er, and reduced the infiltration of inflammatory cells induced by alcohol administration. Ghrelin also de-creased MDA content and increased the reduced SOD and GSH-Px level in liver homogenate. Furthermore, ghrelin decreased inflammatory cytokines mRNA ex-pression including TNF-α, IL-1β, IFN-γ, IL-6 and MCP-1 in the liver. Conclusion Ghrelin has protec-tive effects against alcoholic liver injury in mice via in-hibiting inflammation and suppressing oxidative stress.

Aim To establish a mouse breast cancer model stab-ly expressing HER2. Methods 4T1-Luc mouse breast cancer cell line was transfected with the full-length human HER2 gene and selected with G418. The HER2 expression in 4T1-Luc stable cells was detected by fluorescence-activated cell sorting ( FACS) and Western blot. 4T1-Luc/HER2 cells were implanted into the mammary fat pads of BALB/c or nude mice. After tumor stabili-zation, mice were randomly assigned into 4 groups for treatment with PBS control, chA21, Trastuzumab, or chA21 plus Trastu-zumab. Tumor volumes were measured and tumor growth inhibi-tion ratios were calculated twice a week. At the end of experi-ment, tumor metastasis in mice was detected by bioluminescence imaging technology. Results Several 4T1-Luc/HER2 stable cell clones were obtained after G418 selection. FACS and West-ern blot analysis showed that all clones expressed HER2 protein at high levels. These 4T1-Luc/HER2 clones showed good tumor-igenicity in mice with steady tumor growth after one week of cell implantation. After 2-3 weeks, metastatic tumor cells were seen in the lung, cheek and groin areas. In BALB/c mice, the tumor growth inhibition ratio was 43. 3% in chA21 plus Trastuzumab group (P<0. 05 vs PBS control), which was higher than chA21 group (11. 1%) or Trastuzumab group (23%). In addition, the luminescence number and density of tumor metastases in lungs were significantly reduced in the antibody combination group. Conclusions The mouse model of spontaneously metastasizing breast cancer with HER2 overexpression is successfully estab-lished. The preliminary study suggests that anti-HER2 antibody combination of chA21 and Trastuzumab has excellent inhibitory effects on tumor growth and metastasis.

Objective To establish mild cognitive dysfunction (MCI) models in elderly rats,and to investigate the pathophysiological features.Methods Totally 40 SD rats (14 to 18-month-old) were randomly divided into 2 groups:the model group (n=20) and the sham operation group (n=20).Bilateral carotid artery stenosis was prepared in the model group while bilateral carotid artery was seperated with no bilateral narrowing in the sham operation group.30 days after the operation,Morris water maze test was performed,pathomorphological and electron microscopic observations of the cerebral tissue were examined and the expression of G protein-coupled receptor kinase 2(GRK2) in hippocampus tissue w detected by reverse transcription polymerase chain reaction (RT-PCR) and Western blottin.Results The mortality in model group was only 10％.Pathological morphology and ultrastructure showed that hippocampal tissue structure was almost normal in sham operated group,but in model group group,hippocampal CA1 pyramidal cells were in ischemic demyelination,arranged loose,and part of the cells showed nucleus pyknosis,deeply stained; there was no obvious infarct in white matter,part of the white matter fiher hecame thinner and disorder,nucleolus became smaller and steped aside,cytoplasmic electron density increased,lipofuscin appeared occasionally.Rough endoplasmic reticulum and Golgi were expanded,cytosolic free ribosomes increased,part of mitochondria became swelled,vacuolated.Morris water maze test results showed that the average escape latency in model group was longer than in sham group (P＜0.05).In spatial probe test,the average time of crossing the first original platform in model rats was significantly longer than the sham operated group [(36.80±7.68) s vs.(20.87±6.16)s,P＜0.05].The average number of crossing the original platform in 60 seconds in model group was significantly less than in sham group(1.43±0.51 vs.3.10±1.45,P＜0.05).The expressiones of GRK2 mRNA and protein in the hippocampus were significantly increased in model group rats than in sham group (P＜0.05).Conclusions The model of severe CCA stenosis in elderly rats can be applied for MCI animal models with good stability and repeatability.Compared with sham group,the cells morphology and ultrastructure in model group appeare more obvious pathological changes and mild impairments in cognitive function.GRK2 may play an important role in the development of MCI.

Objective To investigate the effects of testosterone (T) replacement therapy (TRT) on carotid artery intima-media thickness (IMT) in middle aged and elderly male patients.Methods A total of 80 middle-aged and elderly male patients with testosterone deficiency and increased carotid artery IMT were selected and randomly divided into two groups:the treatment group (n=38,treated with testosterone for 1 year) and the control group (n=42,without any treatment).The serum T level,IMT and prostate-specific antigen (PSA) before and after treatment were determined.The correlation between the testosterone level and carotid artery IMT was analyzed.Results There were no significant differences in the serum T level and IMT between the control group and the treatment group before treatment [(10.39 ± 1.44) nmol/L vs.(10.88 ± 1.87) nmol/L,(1.25 ±0.11) mm vs.(1.24±0.13) mm,t=1.32,-0.26,P=0.191,0.794].Compared with pretreatment,the serum T level was significantly increased and the IMT was significantly decreased in the treatment group afterTRT [(10.88±1.87) nmol/L vs.(22.83±1.56) nmol/L,(1.24±0.13) mmvs.(1.18±0.16) mm,t=-29.14,2.55,P=0.000,0.015],while no significant differences in the serum T level and IMT were found in the control group before and after treatment [(10.39± 1.44)nmol/L vs.(9.99±1.72) nmol/L,(1.25±0.11) mm vs.(1.27±0.11) mm,t=1.24,-1.00,P =0.219,0.323].Linear correlation analysis showed that the serum T level was negatively correlated with IMT (r-0.605,P=0.000) and multiple regression analysis showed that the T level was an independent factor for IMT.Conclusions Testosterone replacement therapy is an effective treatment to alleviate IMT in middle-aged and elderly male patients,which may play an important role in preventing cardiovascular diseases in middle-aged and elderly male patients.

Objective To investigate the effects of aging and the decreased glomerular filtration rate on the prevalence of anemia in elder receiving body check from urban area of Hefei, China.Methods A total of 4547 >60 years subjects received healthy examination in Healthy Center of Anhui Provincial Hospital from January 2005 to December 2007 were enrolled in this study.Anemia was defined as hemoglobin < 120 g/L in men or < 110 g/L in women.Results The prevalence of anemia in the subjects was 4.40% (95% CI: 3.83% -5.05% ) and significantly increased with the aging process and the decline of estimated glomerular filtration rate ( eGFR) .With logistic analyses, increasing age, female, decreased eGFR were major risk factors for anemia Conclusions The morbidity of anemia is 4.40% in old population receiving body check from urban area of Hefei, China.Aging and the decline of eGFR are the independent risk factors of anemia.