A new physical-cognitive scale for assessment of frailty in Chinese Han elderly

ABSTRACT

Objective: To develop a physical- cognitive scale for assessment of frailty and compare the clinical features between the new scale and the conventional Fried criteria.

Methods: 1757 individuals aged 70–84 were analyzed. Participants reporting three or more Fried phenotypes were grouped as frail patients (FP) whereas others as non-frail (NF). A score of Hasegawa’s dementia scale (HDS-R) higher than 21.5 were classified as non-cognitive impairment group (NCI) group. By combining the cognitive and frailty criteria, participants manifesting three or more positive components out of the six were categorized into the Physical-cognitive frailty group (Pc-F) while others into non- Pc-F (Pc-NF).

Results: Of all the participants, 46.7% (820) were males and 53.3% (937) were females. The mean age was 75.33 ± 3.90. 10.1% (178/1757) were evaluated as FP patients. The prevalence of CI was 53.2%; CI was much higher in the frail group (77.0%) than in the non-frail group (50.5%). Based on the new Pc-F scale, 163 out of 1579 NF participants were identified as Pc-F, and the prevalence of Pc-F reached 19.4% (341/1757). In the Pc-F group, there are more females, patients of advanced age, diabetes, stroke, CHD, CKD, metabolic syndrome, and high hs-CRP. Within the Pc-F group, patients with CI showed a higher incidence of exhaustion, low activity, weakness, and slowness than those without CI.

Conclusions: Our study revealed a significantly worse status in frail participants with CI than without. Our new scale shows a stronger correlation between frailty and complications than the classic phenotype.     

Long-term Clinical Significance of Tacrolimus Trough Level at the Early Period After Kidney Transplantation

BackgroundThe stable immunosuppressant level at the early period after kidney transplantation (KT) is one of the most important factors for the prognosis of KT. However, the extent of immunosuppression varies according to the policies of each KT center. We investigated the relationship between the clinical outcome and tacrolimus trough level (TTL) at the early post-transplant period.Materials and MethodsWe retrospectively analyzed medical records of patients who underwent KT between July 2007 and June 2016. We investigated TTLs at 3 months after KT. We evaluated the incidence of biopsy-proven acute rejection (BPAR), cytomegalovirus infection, and graft survival according to the TTLs.ResultsA total of 426 patients who received KT during the study period were enrolled. The mean age of KT recipients was 46.3 ± 11.5 years, and 55.5% of patients were men. The incidence of BPAR within 1 year after KT was significantly higher when TTLs at 3 months were less than 4.0 ng/mL (P = .020). Death-censored graft survival rates were significantly lower in KT recipients with BPAR and TTL less than 4.0 ng/mL (P < .001, P < .001, respectively). In multivariate analysis, BPAR and TTL less than 4.0 ng/mL at 3 months after KT were independent risk factors for graft failure.ConclusionBPAR and TTL less than 4.0 ng/mL at 3 months after KT are important risk factors for allograft failure. Therefore, TTL should be kept at least 4.0 ng/mL or more at 3 months after KT to reduce the incidence of BPAR within 1 year after KT.     

新疆维吾尔族、汉族抗结核药物性肝损伤患者IL-10分泌水平的研究

目的 探讨汉族、维吾尔族抗结核药物诱导的肝损伤（ATDLI）患者IL-10分泌量，比较两民族之间存在的差异。方法 选取新疆维吾尔自治区胸科医院、石河子大学医学院第一附属医院确诊的ATDLI患者。采用双抗体夹心ELISA测定患者IL-10的分泌量。比较两个民族以及两个民族不同性别、不同肝损伤程度的患者血清IL-10的表达量。结果 共收集ATDLI汉族组患者100例，维吾尔族组患者135例。维吾尔族组ATDLI患者IL-10分泌量[（56.30±17.24）pg/mL]高于汉族组[（45.81±11.04）pg/mL]，差异有统计学意义（P<0.0001）。汉族轻度、中度及重度肝损伤组患者血清IL-10水平分别为（44.73±9.10）、（47.39±10.58）、（49.52±13.21）pg/mL；维吾尔族轻度、中度及重度肝损伤组患者血清IL-10水平分别为（52.30±15.24）、（56.84±13.71）、（58.62±14.38）pg/mL。组间比较显示，IL-10的分泌量汉族、维吾尔族中重度肝损伤组患者均高于轻度肝损伤组患者（均P<0.05）。结论 ATDLI患者IL-10分泌量随肝损伤程度的加重而升高。ATDLI患者IL-10分泌量维吾尔族高于汉族。     

CD44基因多态性与宫颈癌及非小细胞肺癌的相关性

背景与目的：CD44分子是众多肿瘤细胞的标志分子，其表达水平与肿瘤细胞的恶性程度有关。该研究探讨CD44基因中的单核苷酸多态性（single nucleotide polymorphism，SNP）位点与云南汉族人群宫颈癌和非小细胞肺癌（nonsmall cell lung cancer，NSCLC）易感性的相关性。方法：选取了CD44基因中的两个SNP位点rs13347和rs8193，采用TagMan基因分型的方法，分析这两个多态性位点在497例宫颈癌患者和500例健康对照个体以及483例NSCLC患者和471例健康对照个体中的分布特征，并分析CD44基因中的多态性位点与云南汉族人群宫颈癌和NSCLC的相关性。结果：rs13347和rs8193位点等位基因和基因型在宫颈癌组和对照组中的分布频率的差异无统计学意义（P>0.05）。而在NSCLC组和对照组的比较中：rs13347和rs8193位点等位基因在NSCLC组和对照组中的分布频率的差异有统计学意义（P=0.020和P=0.004）；这两个位点基因型在NSCLC组和对照组中分布频率的差异有统计学意义（P=0.027和P=0.020）；其中rs13347位点等位基因C在NSCLC组中的分布频率显著高于对照组，可能是NSCLC发生的风险因素（OR=1.250，95% CI：1.035～1.509），rs8193位点等位基因C在对照组中的分布频率显著高于NSCLC组，可能是NSCLC发生的保护性因素（OR=0.768，95%CI：0.641～0.921）。单倍型分析结果显示，rs13347C-rs8193T和rs13347T-rs8193C在NSCLC组和对照组中的分布频率差异有统计学意义（P=0.003和0.022）；该结果说明单倍型rs13347C-rs8193T可能是云南汉族人群NSCLC发生的风险性因素（OR=1.316，95%CI：1.096～1.579）。结论：CD44基因中的两个SNP位点rs13347和rs8193可能与云南汉族人群宫颈癌发病风险无关，而可能与云南汉族人群NSCLC具有相关性。     

The Gene Polymorphism of VMAT2 Is Associated with Risk of Schizophrenia in Male Han Chinese

ObjectiveTo investigate the association between gene polymorphism of vesicular monoamine transporter type 2(VMAT2) and schizophrenia in Han Chinese population. Methods430 patients with schizophrenia and 470 age-sex matched controls were recruited from four mental health centers. All patients were diagnosed by two psychiatrists based on the Structured Clinical Interview for DSM Disorders (SCID). The ligase detection reactions (LDR) method was used to assess the polymorphism of the two SNPs (rs363371 and rs363324) of VMAT2. ResultsNo associations of two SNPs with schizophrenia was found. When we stratified males and females for the analysis, we found that that in the recessive model of rs363371, there was an obvious significant association between rs363371 and schizophrenia in males (OR=0.564, 95% CI=0.357–0.892, p=0.014) but not females. For the association between rs363324 and schizophrenia, no association was found in either males or females. No association was found when stratifying early-onset schizophrenia and late-onset schizophrenia. ConclusionOur findings indicate that both rs363371 and rs363324 were not associated with schizophrenia, while it seemed that the AA genotype of rs363371 plays a protective effect in male Chinese in developing schizophrenia.     

汉族人拉莫三嗪相关过敏反应与HLA-B*1502的相关性

目的研究在汉族人中拉莫三嗪相关过敏反应是否与HLA-B*1502有相关性。方法对在郑州人民医院诊断为癫痫的患者在服用拉莫三嗪前进行HLA-B*1502测定,将服用拉莫三嗪12周后出现过敏反应者作为实验组,未出现过敏反应者作为对照组1,服用其他非芳香族抗癫痫药物出现过敏反应者为对照组2,检测对照组2的HLA-B*1502阳性率,对3组间HLA-B*1502的阳性率进行比较。结果实验组HLA-B*1502的阳性率为41.86%,对照组1为14.02%,对照组2为13.33%.实验组阳性率高于对照组1(χ2=13.86,P<0.05)及对照组2(χ2=6.83,P=0.009),对照组1与对照组2比较差异无统计学意义(χ2=0.009,P=0.924)。结论HLA-B*1502可能与汉族人拉莫三嗪相关过敏反应相关。     

基于仝小林院士脏腑风湿理论探讨新型冠状病毒肺炎康复期的中药治疗

仝小林院士将新型冠状病毒肺炎定名为"寒湿疫"，并以此理论为基础制定了初期、中期、重症期及恢复期的中医治疗方案，同时基于仝院士学术理论体系中的"脏腑风湿"理论，根据恢复期 "余毒未清，正虚邪恋"的病机特点，探讨其符合具备脏腑风湿行成3个基本要素：即外受寒湿裹挟戾气为必要外因；脏腑内虚为重要基础；邪疫伏留胶着，正邪交争为致病关键。故在辨证施治中可应用脏腑风湿理论以调理脾胃，化湿透邪，补益肺脾，顾护阳气，养阴生津。     

参芪润肠通便汤治疗小儿便秘的临床疗效

目的观察参芪润肠通便汤治疗小儿便秘的临床疗效。方法选定麻城市人民医院中医儿科门诊治疗的小儿便秘患儿80例,研究时段自2017年2月—2019年1月,按照治疗方式进行分组,分对照组(40例,常规药物治疗)、试验组(40例,参芪润肠通便汤治疗),回顾分析患儿临床资料,比较临床疗效、症状积分。结果试验组临床总有效率(95.00%)显著较对照组(77.50%)高,P<0.05;试验组治疗前1 d大便全程干燥、腹部胀满、胃纳减退评分与对照组相比存在差异,但P<0.05,治疗2周后两组上述评分均降低,且试验组较对照组低,P<0.05。结论针对小儿便秘患儿,参芪润肠通便汤可改善患者症状,促进其病情恢复,患儿整体状态得以改善,值得借鉴。