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.     

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.     

含灯盏花中成药DNA提取及其分子鉴定

目的:优选适用于含灯盏花中成药的DNA提取方法和聚合酶链式反应(PCR)扩增引物,并通过测序和系统发育分析实现对其原料灯盏花的分子鉴定。方法:采用4种十六烷基三甲基溴化铵(CTAB)改良方法对3种含灯盏花的中成药进行DNA提取,测定DNA的纯度和浓度。采用内转录间隔区(ITS)、matK、psbA-trnH、rbcL位点通用引物对提取的中成药DNA进行PCR扩增,并对PCR扩增最佳位点进行测序,通过构建系统发育树进行分子鉴定。结果:4种CTAB改良方法均能获得含灯盏花中成药DNA,其中CTAB改良方法一提取的DNA质量浓度显著高于其他改良方法;PCR扩增中以matK位点2对引物(matKXF/matK5R或matK3F/matK1R)最佳,可通过1次PCR成功获得具有单一条带且浓度较高的PCR产物,序列与灯盏花对照药材同源性为100%,系统发育树显示可与同属其他植物区分。结论:通过CTAB改良方法一可以有效提取含灯盏花中成药样品的DNA,采用matK位点引物matKXF/matK5R或matK3F/matK1R进行1次PCR扩增并对产物进行测序,通过序列比对可完成其原料灯盏花的鉴定。     

Regurgitation and aspiration

Regurgitation and aspiration remains one of the major complications of general anaesthesia. Aspiration is defined as oropharyngeal or gastric content entering the airway below the level of the vocal cords. This can cause morbidity and mortality by direct effects of the particulate, acid-related damage and bacterial pneumonia. It occurs largely in patients with risk factors although occasionally in patients that are low risk. Anaesthetic technique should be adjusted depending on the patient's risk of aspiration with rapid sequence induction considered in high-risk patients. Recognition and appropriate management of aspiration is essential.     

用二核苷酸简单串联重复顺序多态位点进行中国人个体鉴别

为建立二核苷酸简单串联重复顺序（ＳＴＲ）多态位点个体鉴别技术系统，应用６个位于不同染色体呈共显性传递的二核苷酸ＳＴＥ多态位点进行中国汉族人个体鉴别研究，这６个位点是Ｄ１Ｓ１０３、Ｄ４Ｓ１７５、Ｄ５Ｓ１０７、Ｄ１９Ｓ４９、Ｄ６Ｓ８９及Ｄ９Ｓ５８。结果显示：（１）６个ＳＴＲ位点基因型数１４～３９个，等位片段数０～２０个；（２）杂合度观察值及估测值分别为０．６５～０．９１及０．６３～０．９３．多态信息含量０．５９～０．９０；（３）６个位点均符合Ｈａｒｄｙ－Ｗｅｉｎｂｅｒｇ平衡；（４）６个位点１５次配对分析中，未见非随机关联；（５）６个位点的亲子关系排除概率０．９９；（６）普通群体中两个无亲缘关系随机个体间６个位点基因型完全一致的概率在１．７×１０－１２～９．２×１０－３３间。结果表明，应用这六个二核苷酸ＳＴＲ位点适于亦足以在中国汉族人中进行个体鉴别．故将此检测及数据处理系统，命名为ＤＮＡ身份号码。     

用双剂量实验数据分析药物的米氏消除参数的识别问题

本文分析了给药剂量对按一级过程吸收，米氏过程消除药物的血药浓度的峰值与达峰时间的影响。并据此讨论了利用较少的双剂量实验数据改善识别米氏参数的方法。     

中药地榆的性状及显微鉴定

研究国内来源于地榆属8个不同种、变种与变型的地榆及2种混淆品的生药性状、组织构造及其粉末的鉴别特征,并分别列出生药性状、组织构造及粉末特征的检索表。     

分清五淋丸的薄层色谱鉴别

目的寻找控制分清五淋丸质量的方法。方法利用薄层色谱对其中大黄、黄柏、黄芩和栀子4种主药进行检出研究。结果样品不仅与黄连素、黄芩素和栀子甙对照品有一致的层析斑点,且与对照药材有一致或基本一致的层析斑点。结论薄层色谱方法是控制分清五淋丸质量的有效方法。     

香青藤的生药鉴定

利用药材性状、显微特征、紫外吸收光谱和薄层层析等鉴别方法对香青藤进行生药鉴定研究 ,为该药材的鉴别和开发利用提供科学依据