Self-Reported Frailty Screening Tools: Comparing Construct Validity of the Frailty Phenotype Questionnaire and FRAIL

ObjectivesWe examined the construct validity of 2 self-reported frailty questionnaires, the Frailty Phenotype Questionnaire (FPQ) and FRAIL, against the Cardiovascular Health Study frailty phenotype (CHS-FP).DesignCross-sectional data analysis of longitudinal prospective cohort study.Settings and ParticipantsWe included data from 230 older adults (mean age: 67.2 ± 7.4 years) from the “Longitudinal Assessment of Biomarkers for characterization of early Sarcopenia and Osteosarcopenic Obesity in predicting frailty and functional decline in community-dwelling Asian older adults Study” (GeriLABS 2) recruited between December 2017 and March 2019.MethodsWe compared area under receiver operating characteristic curves (AUC), agreement, correlation, and predictive validity against outcome measures [Short Physical Performance Battery, 5 times repeat chair stand (RCS-5), Frenchay activities index, International Physical Activity Questionnaire, life-space assessment, Social Functioning Scale 8 (SFS-8), EuroQol-5 dimensions (utility value)] using logistic regression adjusted for age, gender, and vascular risk factors. We examined concurrent validity across robust versus prefrail/frail for inflammatory blood biomarkers [tumor necrosis factor receptor 1 and C-reactive protein (CRP)] and dual-energy x-ray absorptiometry body composition [bone mineral density (BMD); appendicular lean mass index (ALMI), and fat mass index (FMI)].ResultsPrevalence of prefrail/frail was 25.7%, 14.8%, and 48.3% for FPQ, FRAIL, and CHS-FP, respectively. Compared with FRAIL, FPQ had better diagnostic performance (AUC = 0.617 vs 0.531, P = .002; sensitivity = 37.8% vs 18.0%; specificity = 85.6% vs 88.2%) and agreement (AC1-Stat = 0.303 vs 0.197). FPQ showed good predictive validity [RCS-5: odds ratio (OR) 2.38; 95% CI: 1.17–4.86; International Physical Activity Questionnaire: OR 3.62; 95% CI:1.78–7.34; SFS-8: OR 2.11; 95% CI: 1.64–5.89 vs FRAIL: all P > .05]. Only FRAIL showed concurrent validity for CRP, compared with both FPQ and FRAIL for TNF-R1. FRAIL showed better concurrent validity for BMD, FMI, and possibly ALMI, unlike FPQ (all P > .05).Conclusions and ImplicationsOur results support complementary validity of FPQ and FRAIL in independent community-dwelling older adults. FPQ has increased case detection sensitivity with good predictive validity, whereas FRAIL demonstrates concurrent validity for inflammation and body composition. With better diagnostic performance and validity for blood biomarkers and clinical outcomes, FPQ has utility for early frailty detection in the community setting.     

促细菌快速生长繁殖因子的研究

目的 通过对促细菌快速生长繁殖因子即细菌培养基成分进行科学配比研究,促使细菌能快速生长繁殖,并在同一体系内同时对细菌进行鉴定防止耐药菌株泛滥作了初步探讨^[1,2]。方法 采用V型板体系内培养,并同时进行鉴定和药敏试验。结果 细菌鉴定报告时间缩短至4～8小时,与常规方法对比其中标准菌株符合率为100%,临床分离株符合率为98%。结论 初步建立了细菌检验的快速常规程序,使临床细菌学检验更好的为临床提供正确,及时的诊断依据。     

藿香正气片增强镇静催眠药的镇静与催眠作用的研究

目的研究藿香正气片增强镇静催眠药对小鼠的镇静催眠作用.为临床增添了一个中西药结合的镇静催眠合剂提供药理依据.方法应用抖笼换能器法观察藿香正气片对小鼠的自发活动的影响.由此观察藿香正气片与镇静催眠药的协同作用.测定藿香正气片与镇静催眠药对小鼠的入睡时间及睡眠持续时间的作用.两个实验均分成四组,生理水组、藿香正气片组、安定组、安定+藿香正气片组.结果1.对小鼠自发活动的影响.(1)藿香正气片组与生理盐水组比较,具有极显著性差异(P＜0.01).(2)安定组与安定+藿香正气片组比较具有显著性差异(P＜0.05).2.藿香正气片增强镇静催眠药对小鼠的睡眠作用.(1)藿香正气片组与生理盐水组比较具有显著性差异(P＜0.05).(2)藿香正气片+安定组与安定组比较具有极显著性差异(P＜0.01).结论藿香正气片与安定合用对镇静及催眠确有协同作用.     

蒙药材夏至草的生药鉴定

目的:研究蒙药材夏至草的生药鉴定特征,方法,应用来源,性状,显微及薄层鉴别方法.结果:蒙药材夏至草为唇形科植物夏至草Lagopsis supina(Steph),Ik-Gal ex Knorr,的合草,详细描述了其生药鉴别特征.结论:实验结果为鉴别`开发利用该药材提供了鉴定依据.     

Assessment of Psychological Factors in Short-Stay Total Hip Arthroplasty Protocol

BackgroundSeveral variables are known to correlate with the successful completion of short-stay total hip arthroplasty (THA) protocols. The role of psychological factors remains unclear. We investigated the interaction between patient-reported measures of psychological fitness and successful completion of a short-stay THA protocol.MethodsWe performed a prospective cohort study of patients undergoing elective anterior total hip arthroplasty enrolled in a short-stay protocol (success defined as LOS ≤1 midnight versus failed, LOS >1 midnight). Psychological fitness was measured using the Patient-Reported Outcomes Measurement Information System (PROMIS) domains for self-efficacy, depression, anxiety, emotional support, and the ability to participate in social roles. PROMIS scores, patient demographics, and surgical factors were assessed for a relationship with failure to complete short-stay protocol.ResultsPatients that failed to complete the short-stay protocol had higher mean pre-operative PROMIS depression scores (50.8 vs 47.1, P = .025) and anxiety scores (53.6 vs 49.2, P = .008) and higher postoperative PROMIS depression (48.19 vs 43.49, P = .003) and anxiety scores (51.7 vs 47.1, P = .01). Demographic and surgical variables did not correlate with the successful completion of the short-stay protocol. That seventy-six percent of the patients did not adhere to the short-stay protocol was due to the inability to complete a physical therapy standardized safety assessment.ConclusionHigher levels of preoperative and postoperative anxiety and depression in otherwise psychologically healthy patients, is associated with an increased risk of failure to complete a short-stay protocol following THA. Targeted interventions are needed to facilitate rapid recovery in patients with psychological barriers to early mobilization.     

远志地上部分正丁醇部位化学成分研究

目的 研究远志Polygala tenuifolia Wild.地上部分的化学成分。方法 远志地上部分70%乙醇提取物的正丁醇萃取部位采用硅胶、中压十八烷基键合硅胶（ODS）色谱柱和高效液相色谱法（HPLC）进行分离纯化,根据理化性质和核磁共振波谱数据鉴定化合物的结构。结果 从远志地上部分70%乙醇提取物的正丁醇萃取部位中分离得到13个化合物,分别为顺式丁香苷（1）、长春花苷Ⅱ（2）、2-苯乙醇-β-D-葡萄糖苷（3）、吐叶醇（4）、4-C-[β-D-呋喃芹菜糖基-(1→6)-β-D-吡喃葡萄糖基]-1,3,6-三羟基-7-甲氧基氧杂蒽酮苷（5）、蚱蜢酮（6）、3-羟基-1-(4-羟基-3-甲氧基苯基)丙烷-1-酮（7）、polygalatenoside A（8）、刺槐林素（9）、3′,5′-二甲氧基双苯基-4-醇（10）、拟茎点霉内酯A（11）、莽吉柿酮D（12）和玫红穗状霉胺A（13）。结论 化合物2、4、6、7、9~13均为首次从远志科植物中分离得到。     

广藿香药材及饮片质量标准提升研究

目的 修订和完善广藿香药材和饮片质量标准,为合理控制广藿香药材和饮片质量提供科学依据。方法 分别收集23批广藿香药材和32批饮片代表性样品,参照《中华人民共和国药典》2020年版广藿香项下标准修订叶片粉末的显微鉴别方法;简化薄层色谱鉴别前处理方法,建立以广藿香对照药材和百秋李醇对照品为对照的薄层色谱鉴别方法;改进含量测定项下供试品制备方法,修订药材指标性成分限度;新增广藿香饮片标准检查、浸出物和含量测定项。结果 建议显微鉴别中腺鳞头部细胞描述为“细胞壁多破裂而呈裂隙状”;薄层色谱方法中用石油醚超声提取、乙酸乙酯复溶代替原标准中提取挥发油的前处理方式,以5%茴香醛浓硫酸溶液为显色剂,所有样品与广藿香对照药材和百秋李醇对照品在同一位置显相同颜色的斑点,改进后方法前处理简单、展开效果好、斑点清晰;建议适当提高药材醇溶性浸出物限度,用乙醇作溶剂时不低于4.0%;采用无水乙醇替换毒性较大的三氯甲烷作为含量测定提取溶剂,方法学考察符合要求,23批广藿香药材百秋李醇质量分数和平均值分别为0.34%~0.92%、0.58%,建议药材标准中提高百秋李醇质量分数限度为0.22%;新增饮片检查项目,其中水分不得过14.0%,总灰分不得过11.0%,酸不溶性灰分不得过4.0%;新增饮片浸出物项目,限度同药材标准;新增饮片含量测定项,32批饮片中百秋李醇质量分数和平均值分别为0.12%~0.46%、0.29%,建议饮片中百秋李醇质量分数不低于0.20%。结论 所建立的方法操作简便可行、准确可靠、重复性好,新增项目和制订的标准限度合理,可用于广藿香药材和饮片的质量控制。     

基于ITS2序列的翻白草与委陵菜分子鉴定

目的 应用DNA条形码技术对翻白草及易混品委陵菜进行分子鉴定,保障药材质量和临床用药安全。方法 提取翻白草及委陵菜的基因组DNA,扩增内转录间隔区2（ITS2）序列并双向测序,所得序列用SeqMan软件校对、拼接;在线双序列比对翻白草对照药材（F_R）及委陵菜对照药材（W_R）的ITS2序列,并预测其二级结构;从GenBank下载部分相关序列,运用MEGA X软件进行多序列比对,分析序列变异位点,计算种内、种间遗传距离,采用邻接法（NJ）构建系统进化树。结果 所有样品均成功扩增出ITS2序列,翻白草和委陵菜的ITS2序列长度均为210 bp。双序列比对结果表明,F_R与W_R的ITS2序列相似性为92.9%,二级结构存在明显差异。多序列分析结果表明,翻白草ITS2序列平均鸟嘌呤（G）+胞嘧啶（C）占比为63.0%,存在2个变异位点,种内遗传距离为0~0.009 6;委陵菜ITS2序列平均G+C占比为64.4%,存在5个变异位点,种内遗传距离为0~0.019 3;种间遗传距离为0.054 8~0.075 8。NJ树结果显示,翻白草、委陵菜聚为不同分支,可明显区分。结论 利用ITS2序列可以准确鉴别翻白草与委陵菜,为保障其安全用药提供了新的技术手段。