Abstract:Objective To evaluate the association between adiponectin ADIPOQ +276G/T (rs1501299) single nucleotide polymorphisms and type 2 diabetes mellitus (T2DM) in the Chinese Han population via a meta-analysis. Methods A search, supplemented by literature traceability, was conducted for the case-control studies about the association between adiponectin gene rs1501299 (+276G/T) and T2DM in Chinese Han population from PubMed, Ovid, CBM, Springer, CNKI and WanFang Data from Jan. 1,2000 to Nov. 25,2018. The meta-analysis was performed using Review Manager 5.3. Results A total of 13 studies were included with 3384 T2DM patients and 3187 healthy people as controls. The meta-analysis showed that the difference between the two groups was statistically significant [OR=1.29,95%CI (1.13,1.49), P<0.05]. Gene polymorphism at this locus was less biased with large samples and high accuracy, all the study groups having good representativeness. Conclusion Polymorphism of adiponectin +276G/T locus in Chinese Han population may be correlated to T2DM.

Abstract:Objective To investigate the relationship of polymorphisms of CYP1A2 and CYP2C19 with prognosis of stable coronary heart disease in elderly patients receiving primary or secondary prevention. Methods A total of 241 men aged ≥ 60 years were enrolled, who was on long-term oral clopidogrel and received their annual health examination in Chinese PLA General Hospital between April and July 2017. The patients were divided, based on diagnosis of coronary heart disease, into primary prevention group (n=123) and secondary prevention group (n=118). For all patients, blood samples were collected on admission, platelet aggregation was measured, polymorphisms of CYP1A2 and CYP2C19 were assayed, and major adverse cardiovascular and cerebrovascular events (MACCE) were recorded during the follow-up as of before April 2019. The data were processed by SPSS statistics 23.0. t test and Pearson chi-square test were performed to compare the data between groups, and multivariate Cox proportional hazard model was used to compare the outcomes. Results According to polymorphisms of CYP1A2 and CYP2C19, all patients were divided into fast metabolism group and medium/slow metabolism group, and platelet aggregations induced by ADP and AA of the two groups were not significantly different (P>0.05). Multivariate Cox survival analysis showed that only age [hazard ratio (HR)=1.074,95% confidence interval (CI):1.003-1.150] was independent risk factor in primary prevention group, and that, after adjusting for baseline characteristics, age (HR=1.036,95%CI:1.000-1.075) and diabetes (HR=1.990,95%CI:071-3.696) were independent risk factors in secondary prevention group. However, the phenotypes of CYP2C19 and CYP1A2 had no effects on the prognosis (P>0.05). Conclusions The phenotypes of CYP1A2 and CYP2C19 had no significant effect on the platelet aggregation function and the risk of MACCE in the elderly patients receiving primary or secondary prevention with stable coronary heart disease.

Abstract:Objective To investigate the effect of β-amyloid (Aβ) deposition on cognitive function in patients with mild cognitive impairment (MCI). Methods A total of 37 MCI patients admitted in our hospital from June 2014 to June 2017 were enrolled in the study. They were 15 males and 22 females, and aged (70.51±6.57) years. ¹¹C-Pittsburgh compound B (¹¹C-PIB) positron emission tomography/computed tomography (PET/CT) was performed to calculate the standardized uptake value ratio (SUVR). With 1.5 as the cut-off value, these patients were divided into Aβ deposition (Aβ⁺) and non-deposition (Aβ-) groups. Neuropsychological assessment and plasma Aβ level test were carried out on all subjects. SPSS statistics 18.0 was used to analyze the data. Results The patients of Aβ⁺ group had poorer general cognitive ability, memory function and executive function. The SUVR obtained by ¹¹C-PIB PET-CT was negatively correlated with the score of mini-mental state examination (MMSE) and memory function (r=-0.362, P<0.05; r=-0.403, P<0.05), but had no association with executive function, visuospatial ability or language function (P>0.05). Linear regression analysis showed that Aβ deposition exerted its effect on cognitive function in aspects of general cognitive ability and memory function (P<0.05). Conclusion Aβ deposition is associated with cognitive decline in MCI patients.

Abstract:Objective To investigate the relationship between the changes of regional cerebral oxygen saturation (rSO₂) and postoperative delirium in the elderly after general anesthesia. Methods A total of 76 elderly patients receiving spinal surgery under general anesthesia in our hospital from January 2017 to January 2018 were enrolled in this study. After entering the operation room, the patients were monitored for rSO₂ continuously. rSO₂, heart rate (HR) and mean arterial pressure (MAP) were recorded before anesthesia induction (T0), after tracheal intubation (T1), at the beginning of (T2), in 1h(T3) and 3h(T4) after, and at the end of operation (T5). With the rSO₂ value at T0 as the baseline value, the mean (rSO₂), minimum (rSO_2min) and maximum descendence (ΔrSO_2max) of rSO₂ from T0 to T5 were calculated. Consciousness disorder test (CAM) was applied for the cognitive status of postoperative patients, and they were divided into postoperative delirium group (POD group, n=14) and non-postoperative delirium group (NPOD group, n=62). SPSS statistics 18.0 was used to analyze the data. t test, the analysis of variance of repeated measurement or pairwise comparison was employed for comparison. Results The incidence of POD was 18.4%(14/76) in this study. There were no significant differences in MAP and HR at T0 to T5 between the 2 groups (P>0.05). Though no obvious differences were seen in rSO₂ at T0-T3 between the 2 groups (P>0.05), the value was significantly decreased in the POD group than the NPOD group at T4 and T5 (P<0.05). The POD group had significantly higher ΔrSO_2max [(0.09±0.04)% vs (0.05±0.02)%], and lower rSO₂ [(73.29±1.69)% vs (75.49±1.89)%], but no obviously difference in rSO_2min [(65.00±3.40)% vs (67.47±5.10)%, P>0.05] and baseline [(71.14±0.77)% vs (70.95±0.89)%, P>0.05] when compared with the NPOD group. Conclusion There is a significant correlation between the decrease of intraoperative rSO₂ and occurrence of POD. The monitoring of rSO₂ during operation can be used as an auxiliary means to predict the occurrence.

Abstract:Objective To investigate, using different criteria of potentially inappropriate medication (PIM), status quo of PIM and to analyze the relationship between PIM and doctors′ prescriptions, patients′ diseases, cognitive dysfunction and other factors with a view of improving rationality in clinical drug use for the elderly outpatients in townships. Methods A cross-sectional study was conducted of 264 elderly patients who received long-term treatment in Zhaitang Community Health Service Center in Mentougou District, Beijing. Data were collected on their age, comorbidity [number of diseases, Charson comorbidity index (CCI)], oral medications and cognitive function. The PIM was identified by the Chinese Criteria for Potentially Inappropriate Drug Use in Elderly People 2017 (criteria 1), the Beers Criteria 2019 (criteria 2) and the combined criteria of the Chinese and the Beers (criteria 3). Patients were divided into PIM group and non-PIM group by three criteria. PIM rate was explored, and the two groups were compared in age, multimorbidity, cognitive function status and other factors. Statistical analysis was performed using SPSS statistics 23.0. Data were analyzed with χ² test, independent sample t test, non-parametric test, Pearson correlation analysis, and Spearman correlation analysis. Results A total of 264 patients were included in the study, aged (71.7±5.9) years. PIM detected by the three criteria were increased gradually, 28.4% for criteria 1,39.0% for criteria 2 and 50.8% criteria 3. PIM with criteria 3 was found to be associated with male gender (OR=1.941,95%CI 1.110-3.394, P=0.020), CCI (OR=1.470,95%CI 1.115-1,939, P=0.006), types of oral medication (OR=1.241,95%CI 1.056-1.459, P=0.009) and cognitive dysfunction (OR=3.686,95%CI 1.448-9.382,P=0.006), but not with age.Conclusions The incidence of PIM is high among the elderly outpatients in the township, and the combined Chinese and American PIM criteria can improve its PIM detection. PIM is associated with the types of oral medication, the severity of the diseases and cognitive dysfunction. Doctors should use both Chinese and foreign criteria to strengthen screening for the reasonable drug use among the elderly with multimorbidity and cognitive dysfunction, thus reducing PIM among the elderly in the township.

Abstract:Objective To investigate the effects of resting heart rate (RHR) on cardiocerebral vascular diseases (CVD) and all-cause death in the elderly (≥60 years old). Methods This prospective cohort study was performed in 101 510 employees of Kailuan Group who received their first physical examination in 2006 and 2007. Included in the study were 18924 participants aged ≥60 years without arrhythmia, a history of CVD, and use of β-receptor blockers. According to the RHR quartile value, they were divided into four groups:<67 group, 68-71 group, 72-79 group, and ≥80 group (times/min). Data were collected of CVD and all-cause mortality events during follow-up period. Cox regression model was used to assess the association of RHR with all-cause mortality and CVD events. Results (1)During a median follow-up period of 11.18 years, the number and cumulative incidence of CVD events in the 4 groups were 536(11.32%) in <67 group, 479(12.38%) in 68-71 group, 686(12.53%) in 72-79 group, and 618(12.76%)≥80 group, with no statistical significance (P>0.05). The number of all-cause deaths and cumulative all-cause mortality in the 4 groups were 1086(22.93%), 940(24.30%), 1330(24.28%) and 1462(30.19%), respectively, with statistically significant differences (P<0.01). (2) In multivariate analysis adjusted for major conventional cardiovascular risk factors, compared with the lowest quartile group, CVD events and all-cause death in the highest quartile group were 1.06(95%CI:0.93-1.20), 1.07(95%CI:0.95-1.20), 1.07(95%CI:0.94-1.21); 1.14(95%CI:1.04-1.25), 1.12(95%CI:1.03-1.22), 1.37(95%CI:1.26-1.49), respectively. Conclusion Elevated RHR is a risk factor for all-cause mortality in the cohort of the elderly subjects of Kailuan Group.

Abstract:Objective To investigate the effect of nutritional status on the severity and clinical prognosis of community acquired pneumonia (CAP) in the elderly. Methods One hundred and fifty elderly CAP patients hospitalized in our department from January 2018 to September 2018 were selected. The severity of pneumonia was assessed with pneumonia severity index (PSI) within 24h after admission, and according to the severity of pneumonia, the patients were divided into non-high-risk pneumonia group (n=99) and high-risk pneumonia group (n=51). The nutritional status was evaluated with nutritional risk screening 2002 (NRS2002) scale within 72h. Their basic data, laboratory indices and clinical prognosis were recorded and compared between the 2 groups. SPSS statistics 22.0 was used for statistical analysis. According to the data type, Student′s t test, rank sum test or Chi-square test was used for comparison between groups. Multivariate logistic stepwise regression analysis was used to investigate the influencing factors of high-risk pneumonia in CAP patients. Results Multiple logistic regression analysis showed that increased nutritional risk score (OR=0.481,95%CI 0.231-0.999, P=0.049) and red blood cell volume distribution width (OR=2.400,95%CI 1.302-4.425, P=0.005), heart failure (OR=7.854,95%CI 1.086-56.784, P=0.041), oral missing teeth/denture (OR=19.84,95%CI 1.366-288.219, P=0.029), blood urea (OR=2.050,95%CI 1.219-3.446, P=0.007) and lower Barthel score for ability of daily life score (OR=0.452, 95%CI 0.237-0.862, P=0.016) were influencing factors for high-risk pneumonia in elderly CAP patients (P<0.05). In all these patients, there were significant differences in 30-day clinical prognosis (P=0.016) and discharge outcome (P=0.012) between those with nutritional risk and those with normal nutrition. The prognosis of those with nutritional risk was worse. Conclusion The elderly CAP patients are prone to high-risk pneumonia and poor prognosis. Therefore, special attention should be paid to the elderly with nutrition risk, cardiac insufficiency, oral hygiene and decline of daily living ability.

Abstract:Objective To investigate the efficacy of double dose of clopidogrel in the treatment of acute myocardial infarction (AMI) in the elderly patients with ticagrelor CYP2C19 intermediate metabolism. Methods A total of 196 elderly patients with acute myocardial infarction were enrolled, who were admitted to the Cardiology Department in Beijing Shijitan Hospital from August 2016 to August 2018. All patients were found to be of CYP2C19 intermediate metabolism and randomized into the study group and control group (98 in each group). The two groups underwent percutaneous coronary intervention (PCI). The study group took oral clopidogrel at 300mg for the first time after surgery, then at 150mg once for three months before shifted to 75mg once. The control group took oral clopidogrel at 300mg for the first time after surgery and then at 75mg once. Both groups took medication once daily for 1 year. The two groups were compared in cardiac function related indicators and inflammatory factors interleukin-8 (IL-8) and C-reactive protein (CRP) levels before and after treatment as well as clinical efficacy, adverse reaction rate and recurrence rate. SPSS statistics 22.0 was used to analyze the data. Student′s t test or Chi-square test was employed for intergroup comparison. Results Compared with the control group after treatment, the study group had lower QRS [(4.74±0.81) vs (5.68±0.63) score], myocardial infarction [(13.86±2.47)% vs (17.23±3.02)%], cardiac troponin [(1.08±0.25) vs (3.12±0.77)μg/L], creatine kinase isoenzyme-MB[(45.82±8.45) vs (55.83±10.26)U/L], IL-8 [(39.54±8.22) vs (55.28±11.64)μg/L] and CRP[(5.22±0.86) vs(7.13±0.92) mg/L], but higher left ventricular ejection fraction [(52.90±5.83)% vs (44.93±5.46)%], the difference beingstatistically significant. The total effective rate was significantly higher in the study group than the control group [89.80%(88/98) vs78.57%(77/98)], but the incidence of adverse reactions [4.08%(4/98) vs 11.22%(11/98)] and recurrence rate [2.04%(2/98) vs 8.16%(8/98)] in the former was significantly lower than the latter, the differences being statistically significant. Conclusion Double dose of clopidogrel has a good clinical efficacy in the treatment of acute myocardial infarction in the elderly patients with ticagrelor CYP2C19 intermediate metabolism with low incidence of adverse reactions and recurrence rate.

Abstract:Objective To observe the efficacy and safety of apatinib in the treatment of the elderly patients with advanced hepatocellular cancer (HCC). Methods From January 2018 to June 2018, a total of 49 elderly patients were retrieved for the study, who were treated with apatinib for advanced hepatocellular cancer. Clinical efficacy was evaluated by RECIST 1.1 and side effects by NCI-CTCAE 3.0. Progression-free survival (PFS) was also observed. Kaplan-Meier survival analysis and Cox multivariate regression analysis were performed. Results The sum of maximum diameters of the lesion and alpha-fetoprotein levels were significantly reduced at 4 weeks of treatment as compared with those before the treatment (P<0.05). At 12 weeks of the treatment, the objective response rate, complete remission (CR) and partial remission (PR), was 8.16%(4/49), and disease control rate [CR, PR, and stable disease (SD)] was 77.55%(38/49). The median PFS of 49 patients was 7.75 months (P<0.05). Cox multivariate analysis showed that the sum of maximum diameters was an independent influencing factor [HR:1.866,95%CI(2.470-16.916), P=0.000]. The incidence of adverse reactions was 100%, mainly of grade 1-2. Conclusion Apatinib is effective for advanced HCC among the elderly patients with controllable adverse reactions and may serve as an option for those who have failed with multi-line treatment.

Abstract:Objective To explore the relationship between serum lactate dehydrogenase (LDH) and insulin resistance in patients with type 2 diabetes mellitus (T2DM). Methods A total of 138 T2DM inpatients admitted in our department from October 2016 to December 2017 were enrolled in this study. After admission, the patients received oral glucose tolerance test (OGTT), i.e. 75g of glucose was taken orally in the early morning under fasting condition. The blood glucose and insulin levels were measured before and 30,60 and 120min after oral taking. According to homeostasis model assessment of insulin resistance (HOMA-IR), the patients were divided into HOMA-IR＜2.5 group (n=50) and HOMA-IR≥2.5 group (n=88). Their general data, related biochemical indices, LDH and Matsuda insulin sensitivity index (ISI) were collected and compared between the 2 groups. According to LDH level, they were divided into 3 subgroups (<172,172-197, and >197IU/L). The related indices of β cell function (HOMA-IR and Matsuda ISI) and other indices were compared among the 3 subgroups. SPSS statistics 24.0 was used for data analysis. According to the type of data, independent sample t test, Mann-Whitney U test, Chi-square test, one-way ANOVA or Kruskal-Wallis H test was employed for the comparison in the groups. Spearman nonparametric correlation analysis was applied for index correlation. Multivariate logisticregression analysis was performed to evaluate the risk factors for insulin resistance. Results Compared with the HOMA-IR<2.5 group, the levels of LDH, fasting blood glucose, and insulin at every time point were significantly higher, while Matsuda ISI was obviously lower in the HOMA-IR≥2.5 group (all P<0.05). The percentage of the patients with HOMA-IR≥2.5 accounted for 50.00%(23/46), 52.17%(24/46) and 89.13%(41/46), respectively, in the 3 subgroups of LDH levels in order. With the increase of LDH levels, HOMA-IR was notably increased, Matsuda ISI was markedly decreased, and the insulin levels were different at different time points in the 3 subgroups (P<0.05). Correlation analysis showed that LDH was positively correlated with HOMA-IR (r=0.289,P<0.05), and negatively with Matsuda ISI (r=-0.314, P<0.001). After adjustment for age and other related factors, multivariate logistic regression analysis showed that LDH was one of the independent predictors of insulin resistance (OR=2.99,95%CI 1.83-4.67; P<0.001). Conclusion LDH has significant correlations with HOMA-IR and Matsuda ISI, which can be used as a simple index to evaluate the severity of insulin resistance in T2DM patients and help to adjust the treatment regimen.

Abstract:Objective To investigate the effect and mechanism of aging on cardiac morphological changes in rats by observing the changes of cardiac fibrosis and activation of inflammatory bodies. Methods A total of 10 SD rats were divided into young group (8 weeks old) and old group (20 months old), with 5 rats in each group. The rats were sacrificed at corresponding time, and the cardiac tissue was harvested respectively. The collagen deposition was detected by Masson staining. The expression of aging markers p16 and p21 was evaluated by immunohistochemical assay. The expression of inflammasome associated proteins Caspase-1 and interleukin-1 (IL-1β) was evaluated by immunohistochemistry and immunofluorescence assays. Image-pro plus 6.0 software was used to analyze the image. SPSS statistics 13.0 was employed to analyze the data, and one-way ANOVA was applied for the comparison between groups. Results Compared with the young group, the collagen deposition was increased [(12.54±2.8)% vs (45.12±7.63)%], the expression of p16 [(21.45±5.21)% vs (38.71±6.89)%] and p21 [(19.23±7.32)% vs (41.01±10.21)%] was enhanced, and the levels of Caspase-1 [(10.23±7.12)% vs (42.01±8.91)%] and IL-1β [(5.27±1.02)% vs (14.62±3.87)%] were elevated in the old group (all P<0.05). Conclusion The occurrence of cardiac fibrosis in aged rats is closely related to the activation of inflammasome signaling pathway.

Abstract:Parkinson disease (PD), as the second most common neurodegenerative disease, its pathogenesis is still unclear. Both genetic and environmental factors play important roles in its incidence and development. The main pathological features of the disease are degeneration of substantia nigra and formation of Lewy bodies. As well known, statins are commonly used as cholesterol-lowering drugs, and can alleviate oxidative stress and neuroinflammatory damage in neurodegenerative diseases to some extents. In this review, we focus on the neuroprotective effect of statins in order to provide a reference for the future diagnosis and treatment of PD.

Abstract:Despite a good number available, cardiovascular diseases have become one of the diseases threatening human health with high morbidity and mortality, which warrants new drugs to be developed. Sacubitril-valsartan is a novel neuroendocrine inhibitor with a dual inhibition of angiotensin receptor and neprilysin, and is one of great breakthroughs in the management of cardiovascular diseases in the past decade. In this review, we summarize the role of sacubitril-valsartan in the treatment of cardiovascular diseases.

Abstract:Ischemic stroke has become a major worldwide health problem due to its high recurrence and high disability and is getting increasing attention. Recent studies have shown that immune inflammation plays an important role in all aspects of stroke. This article reviews the progress in the research about the interaction between stroke and inflammatory cells and related antibodies, and the new target to prevent the progression of stroke with a view of providing more efficacious treatment for ischemic stroke.

Abstract:With the acceleration of population aging and the increasing economic burden of aging related diseases, the research on aging has received unprecedented attention. However, although many achievements have been made in molecular biology, clinical medicine and epidemiology, there are still many difficulties in aging assessment due to the complex forms, various contents, different standards and lack of sensitive biological markers. Therefore, in this paper, we summarize the methods of aging assessment and the research progress of common and emerging biomarkers in the assessment.

Abstract:Hydrogen sulfide (H₂S) is ranked after carbon monoxide and nitric oxide as the third largest endogenous gas signaling molecule. It can be synthesized in mammalian tissues and can freely pass through cell membrane. It can exerted a variety of biological effects in multiple systems including the cardiovascular system. Cardiovascular diseases are the leading cause of death worldwide, and its specific pathogenesis is not fully understood. In recent years, more and more studies have supported the protective effects of endogenous H₂S and exogenous H₂S donor compounds on such cardiovascular diseases as atherosclerosis, myocardial hypertrophy, heart failure and ischemia/reperfusion injury. In this paper, we review the research progress in this area, highlighting the potential of H₂S and various exogenous H₂S donors in the treatment of cardiovascular diseases.