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Abstracts from the Second Chinese Congress on Gerontology and Health Industry P1 Establishing a Rat Model of Aging with Pseudomonas aeruginosa Pneumonia J. Wen, S. J. Yin. Department of Geriatric Medicince, the 10th People’s Hospital of Tongji University, Shanghai, China Supported By: Scientific Research Project Funded by Department of Health of Shanghai (2010082). BACKGROUND: Elderly patients are susceptible to Pseudomonas aeruginosa (PA) infections including pneumonia. PA pneumonia shows no specific clinical manifestations while causes high mortality. Establishment a proper animal model is important to investigate its mechanism and treatment. METHODS: Sixty SD rats were divided into two groups: the infected group aged 20–22 months and the control group aged 20–22 months. The animal model was established through tracheotomy. Bacterial load in the lung tissue was quantified and pathological changes were determined at 2, 6, 9, 12 and 24 hours after inoculation. RESULTS: The control rats had no detectable PA in the lung tissue while PA was detected in infected rats. Bacterial load was more than 105 cfu/g at 2, 6, 9 and 12 hours and more than 103 cfu/g at 24 hours post-inoculation. Pathological changes observed in the infected rats at 2, 6, 9, 12 and 24 hour time points include, edema, congestion and fibrosis. Meanwhile, no significant morphological change was observed in the control rats except a mild congestion and inflammatory reaction at 2 and 4 hours after inoculation. CONCLUSIONS: The animal model of aged rat with pulmonary infection can be established by inoculating Pseudomonas aeruginosa through tracheotomy. Further investigations including PAinduced inflammatory responses and therapeutic evaluation will be conducted in this model.

P2 Clinical Features of 85 Elderly Patients with Pyogenic Liver Abscess F. Cao, F. Li, Q. Liu, J. F. Liu, D. B. Liu, Y. H. Wang. Department of General Surgery, Xuanwu Hospital of Capital Medical University, Beijing, China BACKGROUND: Pyogenic liver abscess is one of the most common inflammatory diseases. The optimal treatment for this condition is yet to be determined, especially for the elderly. This study aimed to investigate the clinical manifestations of pyogenic liver abscess in the elderly. METHODS: Two hundred and six patients with pyogenic liver abscess were enrolled from January 1989 to February 2009 and were divided into older group (60–90 years old, mean age 71.0  10.5 years, n = 85) and young group (18–59 years old, mean age 42.0  12.1 years, n = 121). The data of the clinical features, laboratory examination, imaging and microbiological examinations, treatment and outcome were analyzed between the two groups. RESULTS: Compared with the young group, the incidence of associated diseases and the levels of serum creatinine (115.1  44.2 vs 88.5  37.3 mmol/L, p < 0.01) and APACHE II score (8.7  4.1 vs 6.2  4.0, p < 0.05) in elderly group were higher. Multiple abscess and bilobar abscess were more often found in the elderly group than in younger group (32.9% vs 20.7%, 18.8% vs 8.3%, p < 0.05). There were no significant differences in the length of

hospital stay, overall complication or hospital mortality between the two groups. CONCLUSIONS: Elderly patients with pyogenic liver abscess had characteristic clinical and laboratory presentations. Active management was tolerated well in these patients and they had similar prognosis compared to young controls.

P3 Role of Clinical Presentation Combined with Risk Factors in Diagnosis of Coronary Heart Disease in Elderly or Non-Elderly Women of Different Races X. M. Cai,1 L. J. Wang,1 Y. P. Peng,1 X. M. Cheng,1 S. Q. He,1 J. B. Gong,1 S. S. Jiang,1 Z. G. Wu2. 1. Department of Cardiology, General Hospital of Nanjing Military Command PLA, Nanjing, China; 2. Department of Cardiology, Changzheng Hospital, the Second Military Medical University, Shanghai, China BACKGROUND: Coronary heart disease (CHD) is often misdiagnosed in the female for atypical symptoms and fewer opportunities to accept diagnostic interventional examination. Whether there are differences in the clinical manifestation and risk factors between Chinese female and Caucasian female is still unknown. METHODS: Female patients (n = 2395) who underwent coronary angiography (CAG) were divided into four groups according to race (Chinese or Caucasian) and age ( 1.8 mmol/L, HDL-C < 1.0 mmol/L, hypertension, diabetes, smoking, and non-traditional factors included triglycerides > 1.7 mmol/L, CRP > 2 mg/L, glucose intolerance (fasting glucose 5.6–7.0 mmol/L or HbA1c > 6%), overweight (BMI > 25 kg/m2). RESULTS: Compared with the young group, the number of risk factors was higher in the elderly group (6.12 vs 3.43, p < 0.05), and the ratio of patients with LDL-C > 1.8 mmol/L, HDLC < 1.0 mmol/L, hypertension, diabetes, CRP > 2 mg/L, glucose intolerance were higher in the elderly group (p < 0.05). While the ratio of smoking, triglycerides > 1.7 mmol/L and overweight was higher in non-elderly group (p < 0.05). The incidence of major adverse cardiac and cerebrovascular events (MACCE) in 6 months in patients with ACS increased gradually with the number of the risk factors. CONCLUSIONS: Elderly patients with ACS have more risk factors, and the distribution characteristics of the risk factors is different from young patients; As the number of risk factors increases, the risk of cardiovascular events in elderly patients increases.

P7 Application of Analgesia Percutaneous Endoscopic Gastrostomy or Jejunum Through Derma at Bedside in Older Patients F. Huang, N. Wu, X. M. Qian. First Department of Geriatrics, Nanjing General Hospital of Nanjing Military Command, PLA, Nanjing, China Supported By: Science and Technology Innovation Project of Nanjing Military Region (11MA097). BACKGROUND: Patients aged more than 80 years old with Parkinson’s disease, Alzheimer’s disease or cerebral ischemic diseases usually accept long-term nasogastric feeding, which often induce mucosal injury, infection and aspiration pneumonia. This study aimed to investigate the safety and clinical value of analgesia percutaneous endoscopic gastrostomy or jejunum (PEG/J). METHODS: The complications of 32 cases of aged patients (83–97 years old) who underwent PEG through nasogastric tube feeding under intravenous anesthesia were evaluated. Twenty-six patients underwent PEJ at the same time. The comfort levels, snout infection, pulmonary infection among the patients were analyzed before and after operation. RESULTS: The average time taken during placing tube was 14.10  3.26 minutes. The successful rate of placing tube was 100%. Five cases suffered from superficial skin infection after

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placing tube. The skin infections recovered after treatment. There were no complications associated with the procedure. CONCLUSIONS: The analgesia PEG/PEJ through derma at bedside in aged patients is a brief, safe operation. The operation improves comfort of the patients, and decreases injury and infections of mouth and nose.

P8 Analysis of Clinical Features of Hepatitis E Infection in the Elderly Y. Zhang, G. Q. Zang, Z. H. Tang, H. Jiang, M. Xi, Y. S. Yu. Shanghai Sixth People’s Hospital, Shanghai Jiaotong University, Shanghai, China BACKGROUND: Compared with other types of hepatitis, the mortality of hepatitis E infection (HE) is higher. In recent years, the incidence of HE in the elderly population increases continuously. This study aimed to investigate the clinical characteristics of HE in the elderly. METHODS: The clinical data of 59 elderly patients with HE (the elderly group, aged 60–89 years old, mean age 68.5  7.3 years) and 46 young patients with HE (the non-elderly group, 20–59 years old, mean age 47.2  8.6 years) were analyzed retrospectively. Comparisons were performed to investigate the differences between the two groups. RESULTS: Incidence of severe hepatitis in the elderly group was significantly higher than that in the non-elderly group (16.9% vs 2.2%, p < 0.05). Serum albumin (ALB) concentration in the elderly group was significantly lower than that in the non-elderly group (31.8  6.3 vs 35.7  5.2 g/L, p < 0.01), whereas levels of total bilirubin (TBIL) and prothrombin time (PT) in the elderly group were significantly higher than those in the non-elderly group (187.3  83.2 vs 154.9  72.8 lmol/L, respectively, p < 0.05). Incidence of combined diseases in the elderly group was significantly higher than that in the non-elderly group (81.4% vs 39.1%, p < 0.01). The length of hospitalization in the elderly group was significantly longer than that in the non-elderly group (31.2  10.8 vs 21.7  9.1 days, p < 0.01). CONCLUSIONS: With a high incidence, HE in the elderly results in more severe liver dysfunction and longer course of disease.

P9 Effects of Angiotensin II on Human Umbilical Vein Endothelial Cells Senescence and Release of Inflammatory Factors M. S. Zou, L. Liu, Z. Liu, L. N. Wang, J. Wu, W. Wang, J. X. Feng. The Fifth Division of Cadres Ward, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, China BACKGROUND: Inflammatory factors play important role in the development of inflamm-aging. We hypothesized that angiotensin ΙΙ (Ang II) could induce the aging of human umbilical vein endothelial cells (HUVECs) in vitro and increase the expression of interleukin-6 (IL-6) and tumor necrosis factor-a (TNF-a). METHODS: HUVECs were cultured in vitro and the cell viability was determined by CCK-8. HUVECs were intervened by Ang II and divided into two groups: the control group, Ang II group (stimulated with Ang II 10 6 mol/L for 48 hours). Senescence- associated b-galactosidase (SA-b-Gal) activity and cell proliferation were selected as two age-related markers. They were evaluated by immunocytochemistry and flowcytometry, respectively. The levels of IL-6 and TNF-a in the cell culture were determined by ELISA.

RESULTS: The cell viability of Ang II group was (77.15  6.83) % of that of the control group. The positive rate of SA-b-Gal staining was significantly higher (81.80  0.92)% in comparison to that of control group. The G0/G1 phase showed a (68.4  3.4)% distribution. Which indicated phenotypes of cellular senescence. Meanwhile, Ang II induced an elevated level of IL-6 and TNF-a (178  28 vs 75  31, 58  23 vs 32  19, p < 0.01). CONCLUSIONS: Ang II may induce HUVECs cellular senescence and this induction may be mediated by up-regulation of inflammatory factors.

P10 Evaluation of Serum CA19-9 Level in Patients with Diabetes Mellitus and Impaired Glucose Metabolism W. Yang, H. Y. Huang. The Internal Medicine Department of Geriatrics, Navy General Hospital, Beijing, China BACKGROUND: Serum level of CA19-9 is increased in the patients with acute or chronic pancreatitis. This study aimed to test the hypothesis that the serum level of CA19-9 might be changed in the patients with impaired fasting glucose or diabetes. METHODS: A total of 140 patients were enrolled in this study and divided into three groups, control group with normal glucose metabolism (48–98 years old, n = 77), impaired glucose metabolism group (53–98 years old, n = 32), diabetes mellitus group (50– 95 years old, n = 34). Age, body mass index (BMI), CA19-9, fasting blood glucose, total plasma cholesterol, plasma triglyceride, plasma creatinine concentration and blood urinary nitrogen were observed in 34 cases with diabetes mellitus, 32 cases with impaired fasting glucose and 77 healthy controls. RESULTS: CA19-9 level was significantly higher in diabetes mellitus group than that in control group and impaired glucose metabolism group (19.18  11.63 vs 11.55  9.62, 12.46  7.59 U/ ml, respectively, p < 0.01). Linear regression analysis showed that fasting blood glucose and plasma triglyceride were identified as significant and independent risk factors for CA19-9 (B = 17.78, p < 0.01; B = 2.39, p < 0.05, respectively) in impaired glucose metabolism group. Fasting blood glucose and total plasma cholesterol were identified as significant and independent risk factors for CA19-9 (B = 3.72, p < 0.01; B = 5.58, p < 0.05, respectively) in diabetes mellitus group. CONCLUSIONS: The CA19-9 is increased in patients with diabetes mellitus. The elevations of CA19-9 in diabetics should be considered as an indication of exocrine pancreatic dysfunction.

P11 Effects of Allopurinol on Cardiac Function in Elderly Patients with Chronic Heart Failure Complicated with Hyperuricemia T. Y. Xu, B. Chang, H. S. Peng, X. Y. He, J. Y. Zhong, G. J. Liang, T. Zhao. Department of Geriatrics, Chengdu Military General Hospital, Chengdu, China BACKGROUND: Xanthine oxidase inhibitor could inhibit series of adverse reactions, such as apoptosis, endothelial dysfunctions induced by superoxide anion produced in the metabolic process of xanthine. This study aimed to test the hypothesis that allopurinol could improve cardiac function of patients with chronic heart failure. METHODS: Ninety-four elderly patients (75–87 years old) with chronic heart failure complicated with hyperuricemia were randomly divided into conventional treatment group (control group) and allopurinol group (treatment group). The control group received the standard anti-heart failure therapy while the treatment group received allopurinol in addition to conventional treatment

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for 4 months. Echocardiography was used to measure left ventricular end-diastolic diameter (EDD) and left ventricular end-systolic diameter (ESD) before and after treatment. Ejection fraction (EF) was calculated. Levels of serum uric acid and forebrain-type natriuretic peptide (NT-proBNP) were also measured. RESULTS: Serum uric acid and NT-proBNP levels and the level of EDD, ESD were significantly lower in the treatment group (324.09  84.39 lmol/L, 312.49  55.31 pg/ml, 58.58  3.54, 40.82  3.14 mm) than those in control group (382.60  106.14, 438.15  63.64 lmol/L, 64.36  3.53, 46.79  3.07 mm, all p < 0.05) and EF was significantly higher in the treatment group [(45.31  5.44)%] than that in control group [(40.41  4.45) %, p < 0.05]. CONCLUSIONS: Allopurinol treatment can reduce serum uric acid level, inhibit oxidative stress and improve cardiac function and prognosis of the patients with chronic heart failure complicated with hyperuricemic.

P12 Clinical Implications of the Changes of Ankle Brachial Index in Elderly Patients with Masked Hypertension Q. Lu, S. F. Ding, J. Q. Jiang, Z. N. Chen, Z. G. Gong, Z. G. Li, R. X. Wang. Department of Cardiology, Wuhan General Hospital of Guangzhou Military Command, Wuhan, China BACKGROUND: Ankle brachial index (ABI) is an independent risk factor of cerebral and cardiac events. ABI will be decreased in the patients with hypertension. Masked hypertension (MH) is defined as that clinical blood pressure is normal (1 g/24 h were randomly divided into two groups: control group (mean age 58.6  13.5 years, n = 30), treated with fosinopril 10 mg/day for 4 weeks; treatment group (59.9  10.4 years, n = 30), treated with fosinopril 10 mg/day plus calcitriol 0.25 lg/ day for 4 weeks. Urine albumin, 24 hours urine protein, and peripheral blood T cell subsets were measured before and after treatment in all patients. RESULTS: After 4 weeks of treatment, compared with the control group, the level of 24 hours urinary protein, urinary albumin decline, CD4+ T cells and CD4+/CD8+ were significantly decreased [1.51  0.45 vs 2.04  0.47 g, 70.20  7.90 vs 105.30  8.10 mg/dl, (32.3  5.2)% vs (41.8  1.7)%, 1.69  0.62 vs 2.42  0.21, respectively, p < 0.05], and the level of peripheral blood CD3+ T cells and CD8 + T cells were significantly increased [(66.9  8.4)% vs (53.9  5.2)%, (22.1  3.1)% vs (18.2  2.4)%, respectively, p < 0.05] in the treatment group. CONCLUSIONS: Calcitriol combined with fosinopril can effectively reduce the level of proteinuria in patients with type 2 DN, and may play a role in T-cell phenotype immunomodulation.

P17 Effects of Dexmedetomidine Combined with Remifentanil on the Hemodynamics in Elderly Patients Undergoing Abdominal Surgery Under Total Intravenous Anesthesia D. D. Feng, W. Zhang, Z. L. Ma, J. Hao, X. P. Gu. Department of Anesthesiology, Nanjing Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, China BACKGROUND: Aging is associated with degenerative changes of multiple organ systems. The metabolism of anesthetic agents is retarded, which induces lower anesthetic tolerance and higher risk. How to choose anesthetic agents with satisfactory quality and low effects on physiological function is very important to the elderly patients. METHODS: Forty ASA I or II elderly patients undergoing abdominal surgery were randomly divided into two groups, dexmedetomidine group (group D, 60–80 years old, mean age 64.1  4.8 years, n = 20) and propofol group (group C, 60–80 years old, mean age 61.2  2.1 years, n = 20), with 20 patients in each group. Dexmedetomidine [a loading dose of 0.6 lg/kg over 10 minutes followed by an infusion of 2.0 lg/(kg/h) was administered in group D while propofol was started at 100 lg/(kg/min) after 1 mg/ kg induction dose in group C], and they were both adjusted to maintain a constant depth of anesthesia as measured by a BIS of 40–60. In both groups vecuronium bromide was infused at 0.1 mg/ (kg/min) and remifentanil was infused at 0.25 lg/(kg/min). Blood pressure (BP), heart rate (HR), central vein pressure (CVP), cardiac outcome (CO), cardiac ejection index (CI), stroke volume (SV), stroke volume index (SVI), stroke volume variation (SVV) were determined before induction (T0), before intubation (T1), instant time after intubation (T2), when the abdominal cavity was opened, washed, closed (T3–T6) in all the patients. During the operation, the consumption of vasoactive agents was monitored. RESULTS: Compared with T0, all the indicators except HR decreased significantly (SBP: 106.1  16.7 vs 148.3  22.2 mmHg, p < 0.05) in group C. CO decreased significantly (5.0  0.4, 5.2  1.2, 5.2  1.0, 4.7  0.8 vs 6.0  1.2 L/min, respectively, p < 0.05) at T3–T6. SVI decreased significantly (44.1  7.7, 41.8  9.0 vs 51.9  9.2, respectively, p < 0.05) at T5, T6, while group D showed no significant change. In group C, compared with T1, all the indicators except HR increased significantly (SBP: 146.4  22.6 vs 132.6  25.5, 131.4  18.7 vs 106.1  16.7 mmHg, respectively, p < 0.05) at T2–T4. DBP, CO, SV, SVI increased significantly (p < 0.05) at T5. No significant changes were found in HR between two groups at T2–T6. Patients’ consumption of phenylephrine in group C was significantly more than that in group D (133.3  17.7 mg vs 0) while the consumption of nitroglycerin in group D was significantly more than that in group C (0.18  0.07 mg vs 0.05, p < 0.05). CONCLUSIONS: Total intravenous anesthesia with dexmedetomidine-remifentanil provided sufficient sedative effect for elderly patients undergoing abdominal surgery. It was associated with more stable hemodynamic parameters compared to propofol.

P18 Clinical Study of Irbesartan Combined with Amlodipine in the Treatment of Elderly Patients with Morning Hypertension Q. Wang. Department of Cardiology, Shanghai Songjiang Central Hospital, Shanghai, China BACKGROUND: Blood pressure variability especially morning blood pressure surge (MBPS), is associated with target-organ damage and cardiac events in patients with hypertension. Therefore, it is important to decrease MBPS in hypertensive patients. METHODS: Elderly patients with MBPS (n = 205) were enrolled and randomly assigned into two groups, treatment group

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ABSTRACTS (mean age 67.9  3.3, range 65–80 years) and control group (mean age 68.3  3.6, range 65–80 years). In treatment group, 103 patients received a combination therapy of 150 mg irbesartan and 5 mg amlodipine once every morning; in control group, 102 patients received 150 mg irbesartan and 12.5 mg HCTZ once every morning. At baseline and after 8 weeks of treatment, 24-hour average systolic blood pressure (SBP), 24-hour average diastolic blood pressure (DBP), morning SBP, daytime SBP, evening SBP, morning DBP, daytime DBP, evening DBP, systolic blood pressure variability (SBPV) and diastolic blood pressure variability (DBPV) were determined through 24-hour ambulatory blood pressure. RESULTS: In two groups, after 8 weeks of administration, SBP, DBP, morning SBP, daytime SBP, evening SBP, morning DBP, daytime DBP, evening DBP, SBPV were reduced significantly (p < 0.05), and the reductions were greater in treatment group than control group (SBP: 22.1  2.9 vs 17.1  2.2 mmHg; DBP: 11.9 vs 8.0 mmHg, p < 0.05). There was significant decline of DBPV in treatment group (2.0  0.5 vs 0.4  0.3 mmHg, p < 0.05). In treatment group, higher proportion of patients reaching blood pressure target and morning blood pressure target was observed when compared with the control group (87.4% vs 80.4%, p < 0.05). CONCLUSIONS: Both irbesartan/amlodipine combination and irbesartan/HCTZ combination are able to effectively manage elderly patients with MBPS. However, irbesartan/amlodipine combination is superior to irbesartan/HCTZ combination in improving the achievement rate, controlling MBPS and narrowing SBPV and DBPV, and is more suitable for elderly patients with MBPS.

P19 Effects of Acupoint Catgut-Embedding Therapy Combined with Infrared Sauna Room in Patients with Simple Obesity W. Ge, G. Ouyang, X. M. Gu. Department of Rehabilitation, Jiangsu Provincial Official Hospital, Nanjing, China BACKGROUND: Obesity with no identifiable cause is an independent risk factor of diabetes, cardiovascular diseases and stroke. We hypothesized that the combination therapy of acupoint catgut-embedding with infrared sauna room could improve the obese physical condition. METHODS: Patients with obesity (n = 130) were randomly divided into three groups. Sixty patients with obesity in group A (48–63 years old, mean age 56.3  6.8 years) received the treatment of acupoint catgut-embedding per 2 weeks and infrared sauna room per week for 12 weeks. Forty patients in group B (mean age 56.8  5.7, range 50–62 years) were treated with acupoint catgutembedding per 2 weeks. Thirty patients in group C (mean age 55.2  5.9, range 49–62 years) were treated with infrared sauna room per week. Body weight (BW), waist circumference (WC), hip circumference (HC) and body mass index (BMI), the level of percentage of body fat (PBF) and lipid were assessed before and after the whole treatment. RESULTS: The levels of WC, HC, BMI and PBF were decreased significantly after treatment in all three groups (BMI: 23.98  4.16 vs 29.85  3.07 in group A, 25.12  3.95 vs 29.64  3.34 in group B, 25.61  4.22 vs 29.68  3.76 in group C, all p < 0.05). The total effective rate of group A was 85%, compared with 72.5% and 66.7% in group B and group C, respectively, and there were significant differences between the three groups (p < 0.05). CONCLUSIONS: Acupoint catgut-embedding therapy combined with infrared sauna room treatment could be helpful to improve the obese physical condition.

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P20 Comparative Analysis of Therapeutic Effect and Safety of Locally Advanced Non-Small Cell Lung Cancer in the Elderly by Sequential and Concurrent Chemoradiotherapy X. J. Wu,1 W. Wang,1 H. B. Dong,1 C. L. Sang,1 S. M. Feng,1 Y. Y. Mi,2 A. K. Hu,2 Y. M. Yin3. 1. Department of Radiotherapy, Xuzhou No. 1 Hospital, Xuzhou, China; 2. Xuzhou Medical College, Xuzhou, China; 3. The First Affiliated Hospital of Nanjing Medical University, Nanjing, China BACKGROUND: Chemotherapy and radiotherapy are the main treatment methods for advanced non-small cell lung cancer. This study aimed to analyze the different of efficacy and safety between sequential chemotherapy and concurrent chemotherapy. METHODS: Elderly patients with non-small cell lung cancer (n = 158) who received the treatment in our hospital from December 2007 to November 2012 were observed. Patients were divided into two groups (A and B) randomly. Group A (mean age 62.09  5.11 years, n = 79) was treated with sequential therapy, and group B (mean age 61.85  4.86 years, n = 79) was treated with concurrent therapy. After the treatment, the efficacy according the standard of the WHO of the two groups as well as the occurrence of adverse reactions were analyzed. RESULTS: After the treatment, the efficacy of group A was 44.30%, compared with 66.67% in group B (p < 0.05). On the other hand, group A had less adverse reactions such as nausea, vomiting, neutropenia and thrombocytopenia than group B (p < 0.05). CONCLUSIONS: The concurrent chemoradiotherapy was more effective than the sequential therapy in treating stage III nonsmall cell lung cancer, but the sequential chemoradiotherapy was associated with fewer side effects, so it may be more suitable for elderly patients.

P21 Effect of Electro-Acupuncture Pretreatment on Glutamate and c-Amino Butyric Acid in Rats Following Middle Cerebral Artery Occlusion Z. Z. Guo, Y. Wu, J. Jia, Z. Y. Wu, M. F. Li. Department of Rehabilitation Medicine, Hua Shan Hospital, Fudan University, Shanghai, China BACKGROUND: Electro-acupuncture could reduce the apoptosis of cerebral neurons in the ischemic areas and improve the neurological impairment. Glutamate (Glu) is the main excitatory amino acid and c-amino butyric acid (GABA) is the main inhibitory amino acid in brain. We hypothesized that the protective mechanism of electro-acupuncture to cerebral ischemia-reperfusion injury was associated with the expression of Glu and GABA. METHODS: SD rats (2–3 months old) were randomly divided into three groups: sham group, ischemic group and pretreatment group. The rats in the electro-acupuncture pretreatment group received electro-acupuncture at Baihui acupoint and Dazhui acupoint for 30 minutes per day, 5 days at the awake station. After electro-acupuncture pretreatment, middle artery was occluded for 120 minutes, followed by reperfusion. Dialysate was collected from the striatum in vivo before occlusion and 40, 80, 120 minutes after occlusion as well as 40, 80, 120, 160, 200, 240 minutes after reperfusion. The changes of neurological deficit scores were evaluated 24 hours after reperfusion, while the infarct volumes of brains was then measured with TTC staining immediately after the neurological outcome evaluation. RESULTS: The level of Glu and GABA in the ischemic group and the electro-acupuncture group increased significantly 40, 80, 120 minutes after occlusion (Glu: 28.23  5.85, 34.02  7.03, 32.41  5.87 vs 3.62  0.80 lmol/L in ischemic group;

ABSTRACTS 22.66  5.13, 17.83  3.87, 19.12  3.95 vs 3.60  0.71 lmol/L in electro-acupuncture group; GABA: 7.56  2.51, 25.69  5.45, 39.01  6.18 vs 2.86  0.56 lmol/L in ischemic group; 11.55  2.61, 35.87  7.78, 53.41  11.03 vs 2.81  0.56 lmol/L, in electro-acupuncture group, all p < 0.01) and 40, 120, 160, 200 minutes after reperfusion (p < 0.01); The level of Glu in the electroacupuncture group was significantly lower than that in the ischemic group 40, 80, 120 minutes after occlusion and 120, 160 minutes after reperfusion (p < 0.01). The level of GABA in the electro-acupuncture group was significantly higher during ischemia and reperfusion (p < 0.01). The level of GABA in the electro-acupuncture group was significantly higher than that in the ischemic group 40, 80, 120 minutes after occlusion and 160, 200 minutes after reperfusion. The neurological deficit scores in the electro-acupuncture group were significantly lower than those in the ischemic group (2.17  0.41 vs 3.17  0.41, p < 0.01). Meanwhile, infarct volume changes at ischemia-reperfusion 24 hours between different groups also had a significant difference (158.83  12.86 mm3 in ischemic group vs 118.83  26.77 mm3 in electro-acupuncture group, p < 0.01). CONCLUSIONS: Electro-acupuncture pretreatment can in a certain degree inhibit the excessive release of Glu and up-regulate the expression of GABA in striatum in the process of subsequent ischemic-reperfusion brain injury, which may be one of the protection mechanisms for the early ischemic brain injury.

P22 Effects of Thymosin a1 on Prognosis of Very Elderly Patients with Severe Hospital Acquired Pneumonia Y. Q. Qi, X. H. Zhang, W. H. Wan, N. Wu, F. Huang, X. M. Qian. Geriatrics Disease Research Center of Nanjing Military Command, Nanjing, China BACKGROUND: Immunomodulatory treatment is important for the elderly patients aged more than 80 years with severe hospital acquired pneumonia, as well as the anti-inflammatory therapy. This study aimed to investigate the immunomodulatory effects of thymosin a1 on patients with severe pneumonia. METHODS: Forty-two very elderly cases (80–101 years old, mean age 88.36  4.25 years) were randomly divided into treatment group and control group. Both groups were given conventional treatment (antibiotics, nutritional support, and symptomatic treatment). Meanwhile treatment group was additionally treated with thymosin a1 for 14 days. In two groups, peripheral blood samples were collected before and after treatment, and the percents of CD3+, CD4+, CD8+, the ratio of CD4+/CD8+, the level of CRP in peripheral blood, and APACHE II scores were observed. RESULTS: After 14-day treatment of thymosin a1, the level of CRP and the score of APACHE II decreased more significantly (58.08  10.15 vs 78.76  15.38 mg/L, p < 0.01), and the percents of CD3+, CD4+ and the ratio of CD4+/CD8+ increased more significantly in treatment group than those in the control group (65.68  7.36 vs 56.27  6.28; 35.24  5.78 vs 24.47  3.47; 2.23  1.23 vs 1.32  1.20; all p < 0.01). CONCLUSIONS: The very elderly individuals manifested impaired immune parameters, and thymosin a1 might improve their immune function and enhance resistance to infection, leading to better clinical outcomes.

P23 Effects of Oteracil Combined with Oxaliplatin as First-Line Treatment in Elderly Patients with Advanced Gastric Cancer W. F. Fan, J. Wang, L. J. Meng, F. Y. Liu, X. L. Pu, M. Yang. Department of Oncology, Jiangsu Province Geriatric Institute, Nanjing, China BACKGROUND: The combination therapy of oteracil and cisplatin is the recommended scheme for advanced gastric cancer. Renal toxicity is the main adverse reaction of cisplatin. We hypothesized that oteracil combined with cisplatin might have well effects and less renal toxicity in the treatment for advanced gastric cancer in elderly patients. METHODS: Clinical data from 61 patients with previously untreated AGC, who were histologically confirmed diagnosis of gastric adenocarcinoma and treated with oteracil/oxaliplatin (therapy group) or oteracil (control group), were reviewed. Thirty-one patients (mean age 66.9  3.7 years) received the treatment of oteracil/oxaliplatin and 30 patients (mean age 67.5  3.1 years) receiving oteracil regimens, respectively. The patients received oteracil at 40 mg [body surface area (BSA) < 1.25 m2] or 50 mg (BSA > 1.5 m2) twice a day for 14 days, followed by a 7-day rest period, and oxaliplatin 130 mg/m2 was administered on the 1st day in the therapy group. In the control group, the usage of oteracil was the same as the treatment group. Chemotherapy cycle was 3 weeks in both groups. Treatment was continued until disease progression or the development of unacceptable toxicity. RESULTS: The treatment group had a response rate (RR) of 48.3%, a tumor growth control rate (TGCR) of 74.2%, a median progression-free-time (PFS) of 6.1 months and a median overall survival (OS) of 11.6 months. The control group had a RR of 23.3%, a TGCR of 50.0%, a median PFS of 4.3 months and a median OS of 7.9 months. The treatment group had better effect. In two groups, quality of life was improved and the treatment group had a higher improvement. The treatment was well tolerated. The most frequent grade 3 or 4 toxicities were neutropenia (16.1%) and thrombocytopenia (12.9%) in the treatment group. A similar incidence of grade 3 or 4 anemia in both groups was recorded. No neutropenic fever occurred. None of the patients in both groups experienced grade 3 or 4 nonhematological toxicities. No treatment-related death occurred during the study period. CONCLUSIONS: Elderly patients with untreated AGC could benefit from oteracil/oxaliplatin or oteracil regimens. Qteracil/oxaliplatin protocol had a higher activity. The treatment was well tolerated.

P24 Comparison of the Effects of 3.5 mm Incision Manual Nucleofragmentation and Phacoemulsification on Hard Nuclear Cataracts S. H. Lu, Q. Qin, Y. Z. Li. Ninyi Eye Center, Affiliated DrumTower Hospital of Medical College of Nanjing University, Nanjing, China BACKGROUND: Phacoemulsification is the most common method of operation for cataract with the advantages of a small incision and rapid recovery. It is difficult to carry out phacoemulsification in patients with grade IV or higher of hard nuclear cataracts. METHODS: A total of 106 cases with hard nuclear cataract were randomly divided into two groups, phacoemulsification group (65–87 years old, mean age 72.42  5.24 years, n = 53) receiving phacoemulsification operation, and 3.5 mm incision group (62– 95 years old, mean age 75.42  7.37 years, n = 53) receiving 3.5 mm incision namual nuclefragmentation. The average best corrected visual acuity, the corneal astigmatism, corneal endothelial cell and the corneal edema degree pre-operation and post-operation were determined and compared using t-test between the two groups.

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RESULTS: There was a significant difference between the two groups in average best-corrected visual acuity on 1st day after operation (0.63  0.23 vs 0.51  0.18, p < 0.01), but there was no significant difference between the two groups 1 week and 3 months after operation. There was no statistical difference in the loss rate of corneal endothelial cell. The incidences of corneal edema of the two groups were significantly different on 1st day after the surgery (27.4% inphacoemulsification group vs 11.1% in 3.5 mm incision group, p < 0.05). The corneal astigmatism 1 week and 3 months after operation was significantly decreased (1.32  0.54, 1.25  0.53 vs 0.96  0.59, p < 0.05) in phacoemulsification group. CONCLUSIONS: In this study, the two operation methods are both effectively implemented for hard nuclear cataracts.

P25 Effect of Oral Bisphosphonate on Postoperative Bone Resorption After Cementless Total Hip Arthroplasty in Elderly Patients W. J. Gu, H. S. Wu. Department of Orthopedics, Affiliated Changzheng Hospital of the Second Military Medical University, Shanghai, China BACKGROUND: Postoperative bone resorption in the patients receiving cementless total hip arthroplasty (THA) could induce loose prosthesis. We hypothesized that oral bisphosphonate could reduce postoperative bone resorption. METHODS: Forty-six elderly patients (64–79 years old, mean age 72.2  3.2 years) with cementless THA who met the inclusion criteria were randomly divided into alendronate group (n = 22) and control group (n = 24). The alendronate group was treated with alendmnate for 1 week postoperatively, and control group with caltrate D. The bone density of the periprosthetic bone mineral density of each area was measured by DEXA 3 weeks and 6 months after operation, and was compared between two groups using t-test. RESULTS: A total of 46 patients completed the follow-up. A continuing downward trend was presented in bone mineral density in the district. At the 6th month after surgery, BMD in the alendronate group was significantly higher than that in the control group in zones 1, 2, 3, 6, and 7 (zone 3: 1.81  0.24 vs 1.68  0.14, p < 0.05), The two groups showed no significant differences in the zones of 4, 5 (zone 4: 1.01  0.19 vs 1.04  0.23). CONCLUSIONS: Bisphosphonates may reduce the periprosthetic bone resorption after cementless THA in elderly patients.

P26 Influence of Enteral Nutrition on Cardiac Function and Inflammatory Factors in Elderly Patients with Chronic Pulmonary Heart Failure R. P. Wang, J. Deng, L. Yang. Deparment of Cadres, Yan’an Hospital, Kunming, China BACKGROUND: In the elderly patients with chronic pulmonary heart failure, there are obvious congestion of systemic and pulmonary circulation. The patients are likely to suffer from inefficient digestion. Enteral nutrition might play an important role in improve the level of inflammatory factors and the cardiac function. METHODS: Seventy-one elderly patients (68–90 years old, mean age 74.8  7.5 years) with chronic pulmonary heart failure, including 30 cases of cardiac cachexia, were enrolled in this study. The patients were randomly divided into two groups, group A (n = 36) and group B (n = 35). Both groups received conventional treatment for heart failure, and at the same time group B received enteral nutrition, group A received free diet. Nutritional status was evaluated by nutritional index (name of the instrument used), serum tumor necrosis factor-a (TNF- a) and interleukin-6 (IL-6)

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levels were measured by ELISA, and left ventricular ejection fraction were determined by echocardiography, both before and after the treatment. T-test and ANOVA were used to compare the data between the groups. RESULTS: The nutritional index, TNF-a, IL-6, and left ventricular ejection fraction (LVEF) were significantly improved after enteral nutrition (BMI: 19.68  1.92 vs 17.65  1.88; TNF-a: 60.23  35.22 vs 76.11  37.56 pg/ml; IL-6: 327.87  82.99 vs 515.93  87.92 pg/ml; LVEF: 46.88  6.24 vs 35.46  6.87, p < 0.05), particularly in patients with cardiac cachexia (p < 0.01). There was no significant improvement in free diet group. CONCLUSIONS: Enternal nutrition on the basis of conventional treatment for heart failure could improve the immune function, regulate the levels of inflammation and improve cardiac function in the elderly patients with chronic pulmonary heart failure and cardiac cachexia.

P27 Association Between the Urinary Microalbumin and Lipoprotein (a) Among Elderly Type 2 Diabetic Patients P. Yu, M. Zhu. Department of Geriatrics, Huashan Hospital, Fudan University, Shanghai, China OBJECTIVES: To analyze the relationship between the urinary microalbumin/creatinine ratio (UACR) and Lipoprotein (a) [Lp (a)] in elderly type 2 diabetic patients. METHODS: A total of 100 elderly patients with type 2 diabetes (T2DM) were divided into diabetic nephropathy group (50 cases) and non-diabetic nephropathy group (50 cases), while 30 cases of elderly nondiabetic healthy people were as the normal control group. Lp (a), UACR were compared among the three group. RESULTS: (1) Lp (a) level in diabetic group was significantly higher than that in non-diabetic group, meanwhile Lp (a) level was higher in diabetic nephropathy group than that in non-nephrotic group; (2) Lp (a) and UACR had no significant correlation between the normal control group and non-diabetic nephropathy group, while Lp (a) and UACR had positive correlation in diabetic nephropathy group(r = 0.363, p < 0.01); (3) In elderly patients with type 2 diabetes, Lp (a), fasting C-peptide(FCP), course of diseaseas the independent factors associated with UACR. CONCLUSIONS: Lp (a) and UACR had positive correlation in diabetic nephropathy group, and Lp (a) was one of the independent factors affecting UACR level, so Lp (a) level can indirectly reveal the kidney damage in type 2 diabetic patients.

P28 Correlation of Pulse Pressure Index with Serum Cystatin C and Urine Trace Protein in Elderly Patients with Hypertension J. Feng, Z. M. Yu, X. G. Dong. Department of Geriatrics, Shanghai Second People’s Hospital, Shanghai, China BACKGROUND: Kidney is one of the most common involved target organs of hypertension. Pulse pressure is significantly associated with the target organ injury. We hypothesized that pulse pressure might be associated early renal injury. METHODS: One hundred and thirty-nine elderly hypertensive patients (65–87 years old, mean age 75.9  6.3 years) were divided into three groups according to pulse pressure index (PPI): group A (n = 46) with a PPI < 0.40, group B (n = 49) with a PPI 0.40~0.55, group C (n = 44) with a PPI > 0.55. Serum urea nitrogen, creatinine, cystatin C, urine trace protein were measured in all patients. ANOVA and SNK test were used to compare the data between the groups. Pearson linear analysis was used to analyze the correlation between the parameters.

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RESULTS: There were significant differences in the levels of blood CysC, urine mAlb, urine IgG, urine NAG enzyme and urine a1-MG between group C and group A (1.52  0.43 vs 1.27  0.42, 39.3  9.9 vs 16.95  3.6, 18.7  7.9 vs 5.5  2.1 mg/L, 13.1  4.6 vs 9.8  3.5 U/L, 26.9  11.1 vs 12.2  5.0 mg/L, respectively, p < 0.01). Compared with group B, the excretion of urine mAlb and NAG enzyme, the levels of urine IgG and urine a1-MG of group C were increased significantly (39.3  9.9 vs 22.4  4.3, 18.7  7.9 vs 10.3  4.0 mg/L, respectively, p < 0.01; 13.1  4.6 vs 10.9  4.2 U/L, p < 0.05; 26.9  11.1 vs 17.7  6.9 mg/L, respectively, p < 0.01). Compared with group A, the excretion of urine mAlb, the levels of urine IgG and urine a1-MG of group B were increased significantly (p < 0.01). There was positive correlation of PPI with the levels of blood CysC, urine mAlb in elderly hypertensive patients (r = 0.204, 0.201, p < 0.05). CONCLUSIONS: Early kidney damage in elderly hypertensive patients is related to PPI suggesting that PPI is an important risk factor.

P29 Hidden Blood Loss in Perioperative Period of Femoral Intertrochanteric Fractures Treated with Gamma Nail and Dynamic Hip Screws S. Li, W. Sun, H. Ma, B. Ye, Y. Y. Lu, L. L. Chen, F. Y. Hong. Department of Orthopedics, Geriatric Hospital of Shanghai, Yangpu District, Shanghai, China BACKGROUND: The patients with intertrochanteric fractures usually present with continuous decrease of hemoglobin, which might be associated with hidden blood loss. This study aimed to investigate the hidden blood loss after Gamma nail operation or dynamic hips crew (DHS) operation. METHODS: A retrospective analysis of 38 elderly patients with intertrochanteric fracture treated with Gamma nail and 32 elderly patients with intertrochanteric fracture treated with dynamic hip crews was conducted to compare the mean operative time, intraoperative and postoperative blood loss, blood transfusion, the dominant and hidden blood loss. RESULTS: The mean operative time was (60.82  9.24) minutes in the Gamma nail group. The total dominant blood loss during operation and drainage was 100 ml. The mean operative time was (78.19  8.03) minutes in the dynamic hip screws group. The dominant blood loss during operation and drainage was 179 ml. The difference of dominant blood loss was significant between the two groups (p < 0.01). The hidden blood loss was (418.05  35.69) ml in Gamma nail group and (666.13  73.15) ml in dynamic hip screws group, which accounted for 80.7% and 78.8% of total amount of bleeding, respectively. CONCLUSIONS: The incision of the Gamma nail group is smaller than that in dynamic hips crew group. However, the total blood loss of the Gamma nail group is more. The hidden blood loss in perioperative period of femoral intertrochanteric fractures with Gamma nail should be taken into consideration.

P30 Characteristics and Clinical Significance of Blood Glucose Fluctuations in Elderly Diabetic Patients Hospitalized for Acute Myocardial Infarction T. S. Liu, Y. T. Chen, S. S. Jiang, J. B. Gong. Department of Cardiology, Nanjing General Hospital of Nanjing Military Command, Nanjing, China

Blood glucose fluctuation might play an important role in this process. This study aimed to investigate blood glucose fluctuation in the early stage of hospitalization for myocardial infarction. METHODS: Elderly diabetic patients (elderly group, n = 98, mean age 69.72  6.28, range 63–76 years) hospitalized for AMI underwent continuous glucose measurement via continuous glucose monitoring system (CGMS). Non-elderly diabetic patients (n = 108, mean age 51.4  7.9, range 42–59 years) with AMI were enrolled as control group. Blood glucose fluctuation in elderly group was investigated and compared with the control group. RESULTS: No significant difference was found in terms of administration of hypoglycemic agents. Elderly patients had a marked blood glucose fluctuations compared with non-elderly patients. There were significant difference between two group in four CGMS parameters: standard deviation of blood glucose: 2.88  0.68 vs 0.85  0.38 mmol/L, p < 0.01; maximum blood glucose fluctuation: 8.2  2.8 versus 3.9  1.2 mmol/L, p < 0.01; mean blood glucose fluctuation: 5.5  2.1 versus 2.8  1.2 mmol/L, p < 0.01; mean deviation of day time blood glucose: 2.6  1.1 versus 1.2  0.7 mmol/L, p < 0.01. Compared with non-elderly patients and elderly patients with mild blood glucose fluctuations, elderly patients with severe blood glucose fluctuations were more likely to suffer from malignant arrhythmia (28.8% vs 13.0%, 11.1%, respectively, p < 0.01) and cardiogenic shock (25.0% vs 10.9%, 9.3%, respectively, p < 0.01) during hospital stay. CONCLUSIONS: Elderly diabetic patients have marked blood glucose fluctuations during the early phase of AMI, which is associated with poorer in-hospital prognosis.

P31 Risk Factors for Mild Cognitive Impairment in Retired Male Chinese Veterans B. H. Zhang,1 J. Wang,1 H. L. Sun,1 H. Wu,1 G. H. Ye,2 S. Song,3 X. Li,4 C. Y. Li,5 R. Q. Zhang,6 F. Z. Zhang,7 L. N. Wan,8 J. P. Tan8. 1. Cadre Department of Health Care, Navy General Hospital, Beijing, China; 2. Navy Xiangshan Sanatorium, Beijin, China; 3. Navy Wanshoulu Sanatorium, Beijing, China; 4. Navy Fuxinglu Sanatorium, Beijing, China; 5. Navy Fuchenglu Sanatorium, Beijing, China; 6. Navy Fengtai Sanatorium, Beijing, China; 7. Navy Xiaojing Sanatorium, Beijing, China; 8. Department of Neurology, South Building, Chinese PLA General Hospital, Beijing, China BACKGROUND: Mild cognitive impairment (MCI) is a cognitive dysfunction state between aging and dementia. Patients with MCI are likely to develop dementia. It is important to monitor the prevalence of MCI to prevent its progression to dementia. METHODS: Retired male elderly Chinese veterans (n = 321, mean age 81.6  4.1, range 60–91 years) from six military sanatorium in Beijing were evaluated. Mini mental state examination (MMSE), Montreal cognitive assessment (MoCA), global deterioration scale (GDS), clinical dementia rating scale (CDR), activity of daily living (ADL), Hachinski ischemic scale (HIS), Hamilton depression scale and the risk factors were determined and analyzed using chi-square test and logistic regression. RESULTS: Prevalence of MCI was 25.7% in the study population. Histories of smoking, drinking, and advanced age were associated with MCI (OR = 0.608, 0.865, p < 0.05). Exercise in last year, education level, hypoperfusion, insomnia, and exposure to electromagnetic wave, or history of mental disturbances in the past were not associated with MCI. CONCLUSIONS: Aging and history of smoking, hypertension, and diabetes may be important risk factors for MCI in the elderly male Chinese veterans.

BACKGROUND: Elderly patients with diabetes mellitus are likely to suffer from cardiac events, such as myocardial infarction.

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P32 Effect of Bronchoalveolar Lavage on Pneumonia in Critically Ill Elderly Patients J. Zhou, M. Huang, D. M. Zhu, L. Q. Bi, Q. Zhang, S. M. Zhou. Department of Geriatrics, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China BACKGROUND: Cough reflex in the elderly patients with severe pneumonia weakens. Deep sputum cannot expectorated easily even after mechanical positive pressure ventilation. METHODS: Sixty-eight critically ill elderly patients with pneumonia receiving mechanical ventilation were divided into BAL group (n = 36) and control group (n = 32). In addition to the routine therapy of antibiotics, nutritional support, acid-base balance and organ function support, the BAL group received bronchoalveolar lavage (twice a week), and the control group received sputum aspiration and postural drainage. The therapeutic effects, 28-day mortality, secondary organ dysfunction and the improvement of clinical pulmonary infection score (CPIS) in the two groups were evaluated and compared. In the BAL group, oxygenation index and CPIS changes were also determined before and after BAL. The data were compared between the two groups using t-test or chi-square test. RESULTS: The percentage of improvement rate in the BAL group (91.6%) was significantly higher than that (68.7%) in the control group (p < 0.05). The level of CPIS was improved significantly in the BAL group compared to the control group (p < 0.01). Twenty-eight-day mortality and secondary organ dysfunction in BAL group was significantly lower than that in the control group (13.9% vs 34.3%, p < 0.05; 1.81  0.98 vs 2.66  1.21, p < 0.01). In the BAL group, the oxygenation indexes after BAL was significantly increased (268.88  91.24 vs 238.28  95.48 mmHg, p < 0.01), and CPIS after BAL was significantly decreased (6.58  1.45 vs 7.25  1.31, p < 0.01). CONCLUSIONS: BAL may be an effective and safe method for treatment of severe pneumonia in the elderly. BAL may improve oxygenation and promote lesion absorption in the short term. At the same time, it may reduce secondary organ failure in the elderly patients.

P33 Therapeutic Efficacy of Kanglaite Injection Combined with Pemetrexed as First-Line Treatment in Elderly Patients with Advanced Non-Small Cell Lung Cancer L. J. Meng, W. F. Fan, M. Yang, F. Y. Liu, X. L. Pu, J. Wang. Department of Oncology, Jiangsu Provincial Geriatric Hospital, Nanjing, China BACKGROUND: Platinum based combination chemotherapy is the standard first-line treatment of non-small cell lung cancer (NSCLC). The elderly patients usually have a variety of concomitant diseases, which increase the adverse effects of platinum. METHODS: Elderly patients (n = 47, 65–82 years old) with advanced NSCLC were divided into treatment group (67.3  3.8 years old) and control group (68.3  3.3 years old) randomly. In treatment group, 24 cases received pemetrexed at a dose of 500 mg/m2 on day 1, repeated every 3–4 weeks as one cycle; in the same time, Kanglaite Injection (10 g) was given intravenously on day 1–15. In control group, 23 cases were treated with pemetrexed alone. The data were compared between the two groups using Fisher’s exact probability or chi-square test. RESULTS: In treatment group and control group, the effective rate was 41.6% and 39.1% respectively, and the disease control rate was 70.8% and 69.6% respectively (p > 0.05). In both groups, the toxicities were tolerable; treatment group showed less toxicity and enjoyed better quality of life (20.8% vs 34.8% p < 0.05).

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CONCLUSIONS: Elderly patients with NSCLC can benefit from pemetrexed as first-line treatment. Pemetrexed combined with Kanglaite Injection can reduce toxicity of chemotherapy and improve quality of life in elderly patients.

P34 Characteristics and Risk Factors of Post-Transplantation Diabetes Mellitus After Kidney Transplantation C. Y. He, H. M. Bi. People’s Hospital of Wuhan University, Wuhan, China BACKGROUND: Post-transplantation diabetes mellitus (PTDM) is a severe complication of kidney transplantation with complex induction factors and mechanism. This study aimed to investigate the clinical characteristics and risk factors of 18 cases of PTDM. METHODS: From January 2004 to December 2009, 183 patients undergoing cadaveric kidney transplantation were retrospectively analyzed. The patients were randomly divided into PTDM group (n = 19) and non-PTDM group (n = 164). Age, sex, family history of diabetes mellitus, pre-transplanting BMI, renal function, steroid dose and baseline immunosuppressive agents were compared between the two groups. RESULTS: The incidence of PTDM was 10.4% (19/183). Compared to non-PTDM group, the PTDM group was older and had higher pre-transplanting BMI and steroid dosage, renal dysfunction and more common family history of diabetes mellitus (45  14 vs 32  11 years, 23.3  2.3 vs 20.6  2.8, 36.2  18.3 vs 24.9  13.6 mg/day, (42.1  2.8) % vs (8.3  2.1) %, 42.7% vs 3.8%, respectively, all p < 0.05). There was no difference between the two groups in terms of sex and baseline immunosuppressive agents. CONCLUSIONS: The age, pre-transplanting BMI, steroid dosage, renal function and family history of diabetes mellitus are likely the risk factors for PTDM.

P35 Effect of Shensongyangxin Capsules on Heart Rate Variability in the Elderly with Frequent Premature Ventricular Contraction J. J. Huang. Department of Geriatrics, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, China BACKGROUND: Premature ventricular contraction is the most common arrhythmia, especially in the elderly. Heart rate variability (HRV) is a prognostic indicator for acute myocardial infarction. Choosing an effective drug with less adverse effects in improving HRV is our research focus. METHODS: Forty-two patients over 60 years with frequent ventricular premature contractions were randomly selected. On the basis of conventional treatment, oral Shensongyangxin capsules were taken, four capsules per time, three times per day. Twentyfour hours electrocardiogram and HRV were analyzed before and after 4 weeks’ treatment. RESULTS: After treatment, standard deviation of normal-tonormal RR intervals (SDNN), standard deviation of 5 minutes average normal-to-normal RR intervals (SDANN), square root of the mean of the squared differences between adjacent normal RR intervals (rMSSD) were increased (90  21 vs 62  14, 92  22 vs 54  10, 35  16 vs 16  10 ms, respectively, p < 0.01). CONCLUSIONS: After the treatment of Shensongyangxin capsules, the indexes of HRV are increased significantly in the elderly with frequent ventricular premature contractions.

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P36 Effect of Atorvastatin on Expression of Lysyl Oxidase (LOX) in Myocardial Tissue of Old Mice with Chronic Heart Failure and Its Mechanism H. Liu, J. D. Rong, G. J. Yuan, S. Y. Zhang. Department of Cardiology, Guizhou Provincial People’s Hospital, Guiyang, China OBJECTIVE: To investigate the effect of atorvastatin on expression of LOX in myocardial tissues of old mice with chronic heart failure (CHF) and its mechanism. METHODS: A CHF model of C57BL/6 mice was reproduced. Forty C57BL/6 mice were randomly divided into CHF group (n = 10), atorvastatin treatment group (n = 11), b-aminopropionitrile treatment group (n = 10), and control group (n = 9). The animals were sacrificed at the end of week 4. Expression of LOX and MMP-9 mRNA as well as phosphorated P38 and P38 protein in myocardial tissues were measured by RT-PCR and Western blot, respectively. RESULTS: The expression of LOX and MMP-9 mRNA was significantly higher in the CHF group than that in the control group (0.76  0.09 vs 0.48  0.03 and 0.24  0.05 vs 0.11  0.01, respectively, both p < 0.01). The expression of LOX and phosphorated p38 was significantly higher in the CHF group than that in the control group (0.931  0.163 vs 0.686  0.069 and 0.971  0.089 vs 0.692  0.275, respectively, both p < 0.01), while atorvastatin and b-aminopropionitrile treatment significantly reversed this elevation in CHF mice (0.696  0.085, 0.866  0.189 by atorvastation and 0.417  0.081, 0.533  0.060 by b-aminopropionitrilee, respectively, all p < 0.01). CONCLUSIONS: Atorvastatin down-regulates the expression of LOX in myocardial tissue of CHF mice and LOX inhibits cardiac remodeling by regulating the MMP-9 expression, which may be an important mechanism in delaying the progress of CHF.

P37 Apolipoprotein E Polymorphism in Patients with Cerebral Hemorrhage H. L. Huang, K. Q. Zhou, Q. S. Wang, H. J. Liu, X. C. Liu, Y. M. Guan, W. Wang. Chinese PLA Clinical College, Anhui Medical University, Hefei, China OBJECTIVE: To investigate the distribution characteristics of apolipoproteinE (apoE) polymorphism and the relationship of apoE genotypes with neurologic defect and serum hs-CRP level in cerebral hemorrhage patients. METHODS: Seventy-eight cerebral hemorrhage patients (age ranges from 32 to 87, mean age 62  10 years) served as a cerebral hemorrhage group and 91 subjects (mean age 63  9 years, age ranges from 25 to 85) undergoing health check served as a control group in this study. Their apoE genotype was detected by PCRRFLP, their serum levels of TC, TG, HDL-C, LDL-C, blood glucose and hs-CRP were measured with an automatic biochemical analyzer, and their neurologic defect was scored at admission according to the NIHSS. RESULTS: As shown in Tables 1 and 2, The frequency of apoEe4 genotype and the serum TC, TG, LDL-C and blood glucose levels were significantly higher while the frequency of apoEe2 genotype and serum HDL-C level were significantly lower in cerebral hemorrhage group than in control group (see tables below). NIHSS score was significantly higher in cerebral hemorrhage group with apoEe4 than in that without apoEe4 (p < 0.05). Serum hsCRP level was significantly higher in patient group with apoEe2 and apoEe4 than that in the group without these genotypes (p < 0.05).

CONCLUSIONS: Apolipoprotein Ee2 and Ee4 may be significant risk factors for cerebral hemorrhage and increased inflammatory reactions with worse neurological deficits in both young and old patients.

P38 Value of Los Angeles Pre-Hospital Stroke Scale and its Modified Version in Pre-Hospital Diagnosis of Ischemic Stroke Y. F. Ma, Y. N. Lei. Emergency Department, Affiliated Beijing Ditan Hospital of Capital Medical University, Beijing, China OBJECTIVE: To assess the value of Los Angeles pre-hospital stroke scale (LAPSS) and it’s modified version in pre-hospital diagnosis of ischemic stroke. METHODS: Four hundred and twelve ED patients were included in this study with mean age of 63.8  15.3 years. The LAPSS and its modified version were completed by their first-aid physicians. The patients were diagnosed according to the LAPSS and its modified version. RESULTS: The sensitivity and specificity of the LAPSS and its modified version were 84.8% and 86.5%, and over 90% and 85.8%, respectively for the diagnosis of ischemic stroke. CONCLUSIONS: The LAPSS is more accurate and promptly for pre-hospital diagnosis of ischemic stroke, which supports its use in the pre-hospital first-aid system. However, larger scale clinical trial is needed for its modified version.

P39 Value of Serum NT-Probing Elevation in Predicting Risk of Atrial Fibrillation in Elderly Male Patients with Normal Heart Function X. Huo, N. Li, S. J. LI. Department of Cardiology in South Building, Chinese PLA General Hospital, Beijing, China OBJECTIVE: To assess the value of serum NT-proBNP elevation in predicting the risk of atrial fibrillation in elderly male patients with normal heart function. METHODS: Elderly male patients with normal heart function (n = 197) were divided into non-atrial fibrillation group (n = 166, mean age 84.3  10.1 years) and atrial fibrillation group (n = 31, mean age 86.5  7.6 years). Their left ventricular long axis crosssection and LVEF were measured by echocardiography. Their serum NT-proBNP level was measured by electrochemiluminescence immunoassay. RESULTS: The serum NT-proBNP level was significantly higher in atrial fibrillation group than in non-atrial fibrillation

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ABSTRACTS group (1940.69  386.48 vs 742.36  106.10 pg/ml, p < 0.0001). Pearson correlation analysis showed that the serum NT-proBNP level was closely correlated with the cardiac ultrasonography parameters such as left artial diameter (r = 0.359, p < 0.0001), right ventricular diameter (r = 0.241, p = 0.003), right artial diameter (r = 0.358, p < 0.0001) and LVEF (r = 0.329, p < 0.0001). ROC curve analysis displayed that the area under the ROC curve was 0.754. The optimal critical value of serum NT-proBNP was >4779.3 pg/ml for the diagnosis of atrial fibrillation with a specificity of 98.5%, and a sensitivity of 11.1% according to the Youden index. CONCLUSIONS: Serum NT-proBNP level is elevated in elderly male patients with atrial fibrillation. The sensitivity of elevated serum NT-proBNP level is low when it is used in predicting the risk of atrial fibrillation and can exclude the risk of atrial fibrillation when it is 0.05). The frequencies of CAS and multiple CAS tended to increase gradually with the severity of extracranial artery stenosis, but no significant difference was observed (28.6%, 40.0%, 58.4%, vs 16.7%, 20.3%, 33.3%, p > 0.05). CONCLUSIONS: The frequencies of coronary sclerosis and asymptomatic CAS were high in ischemic stroke patients even in the absence of severe cerebral artery stenosis. Intracranial or extracranial artery stenosis was not significantly correlated with asymptomatic CAS.

P41 Correlation Between NT-proBNP and Heart Function in Elderly Patients with Chronic Heart Failure S. S. Xing, F. Wei, Z. D. Liu, F. H. Lu, Y. X. Zhao. Institute of Preclinical Medicine, Institute of Medical and Life Sciences, Shandong Academy of Medical Sciences, Jinan, China OBJECTIVE: To study the correlation between NT-proBNP and heart function in elderly patients with chronic heart failure (CHF).

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METHODS: One hundred and thirty-three elderly CHF patients served as a CHF group (mean age 68.3  5.8 years, age ranges from 61 to 79, 56% male) and 116 subjects undergoing routine physical examination served as a control group in this study (mean age 69.2  6.5, age ranges from 61 to 80, 56% male). Cardiac function was evaluated by echocardiography and serum NTproBNP was measured by ELISA. RESULTS: The left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD), Tei index and NT-proBNP level were significantly higher whereas the left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS) and E/A were significantly lower in CHF group than in control group, p < 0.05 for all: LVEDD was 44.96  3.04 mm in control group and 47.32  4.57 mm in CHF group. LVESD was 24.81  2.41 mm in control group and 28.24  2.96 in CHF group. Tei index was 0.35  0.09 in control group and 0.54  0.10 in CHF group. NT-proBNP was 101  18 in control group and 1182  367 ng/L in CHF group. LVEF was 60.17  4.26% in control group and 46.74  5.09% in CHF group. LVFS was 43.01  4.11% in control group and 37.39  6.57% in CHF group. E/A was 1.18  0.22 in control group and 0.88  0.29 in CHF group. The LVEDD, LVESD, Tei index and NT-proBNP level increased significantly while the LVEF, LVFS and E/A decreased significantly with increased severity of heart failure according to the HYHA classification (from grade I to IV, respectively, p < 0.05 for all: LVEDDs were 45.33  3.16, 46.87  3.58, 48.05  4.71, and 49.43  5.13 mm, LVESDs were 25.57  2.38, 27.42  2.91, 29.45  2.02, and 30.88  2.45 mm, Tei indexes were 0.41  0.09, 0.52  0.11, 0.61  0.10, and 0.74  0.07, NT-proBNPs were 403  89, 995  204, 2196  397, and 4894  569 ng/L; LVEFs were 58.66  4.64%, 0.35  5.01%, 45.02  4.93%, and 36.31  3.37%, LVFSs were 42.02  4.32%, 39.74  3.94%, 36.53  4.33%, and 32.71  4.02%, and E/As were 1.04  0.28, 0.89  0.23, 0.81  0.26, and 0.73  0.21, respectively. Serum NTproBNP level was negatively correlated with the LVEF, LVFS and E/A, positively correlated with Tei index, LVEDD and LVESD. Multivariate linear regression analysis showed that the LVEF, LVFS, HYHA classification and Tei index were major factors for elevated NT-proBNP level. CONCLUSION: Elevated NT-proBNP level is correlated with the severity of heart failure in elderly CHF patients.

P42 Analysis of Risk Factors in Patients with Recurrent Cerebral Infarction H. M. Zhao, W. H. Liu, X. M. Wang, X. Y. Fan, W. S. Zhu, X. F. Liu, G. L. Xu. Department of Neurology, Nanjing University School of Medicine, Jinling Hospital, Nanjing, China Supported By: Nature Science foundation of Jiangsu Province (BK2010067). OBJECTIVE: To evaluate risk factors of recurrent cerebral infarction (RCI). METHODS: Patients with recurrent cerebral infarction (n = 110) from Nanjing Stroke Registry Program were enrolled as RCI group (mean age 61.1  14.3, 71.8% male), and 317 patients with first-ever cerebral infarction (FCI) were enrolled as the control group (mean age 56.9  13.0, 75.7% male). The clinical data were reviewed and recorded. All patients were classified into five major ischemic stroke subtypes according to the TOAST criteria. The occurrence and distribution of cerebral arterial stenosis or occlusion were analyzed by digital subtraction angiography (DSA) or CTA, MRA. RESULTS: Hypertension was the most common concomitant disease in both RCI and FCI group (68.2% and 60.9%, respectively). The prevalence of hyperlipidemia (27.3% vs 15.1%) and

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TIA (11.8% vs 4.4%) in RCI group was higher than that in FCI group (p < 0.05). Large vessel disease was the most common type in both RCI and FCI group (46.4% and 54.9%, respectively). The rate of stroke of undetermined etiology was higher in RCI group (10% vs 3.1%, p < 0.01). The patients with negative vessels finding decreased in the RCI group (9.8% vs 20.4%, p < 0.05). CONCLUSIONS: Hypertension was the most common concomitant disease in both RCI and FCI group. The prevalence of hyperlipidemia and TIA in RCI group was higher than that in FCI group. The pattern of TOAST subtypes differed between the RCI and FCI group. Undetermined stroke was more common in the RCI group. RCI group had fewer patients without obvious vessel lesion.

P43 Relation Between Na+, K (+)-ATPase Activities and I/R Injury in Ischemic Penumbra Tissues in Old Rats X. J. Lin, L. X. Zhang, Y. J. Luo, J. D. Xiao, Y. Chen, S. T. Tang, H. Huang, L. L. Li. Department of Neurology, People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi Zhuang Autonomous Region, China Supported By: Nature Science foundation of Guangxi Province (0991212). OBJECTIVE: To study the relationship between Na+, K (+)-ATPase activities and I/R injury in ischemic penumbra tissues. METHODS: Old male Wistar rats (n = 75) were randomly divided into sham operation group (n = 15) and model group (n = 60). The model group was further divided into 6, 24, 48 and 72 hours I/R groups (15 in each group). An I/R model was established with thread method. Brain tissue was taken out from the rats at 6, 24, 48 and 72 hours after reperfusion. The Na+, K (+)-ATPase activities, neurological symptoms, brain edema and cerebral infarction size were observed. RESULTS: The Na+, K (+)-ATPase activities, neurological symptom scores, brain water content and cerebral infarction size were significantly higher in the I/R model group compared with the sham operation group (see table, p < 0.05). The neurological symptom scores and brain water content reached their peak at 48 hours, the Na+, K (+)-ATPase activities reached their minimum at 48 hours, and the cerebral infarction size reached its peak at 72 hours after I/R injury.

CONCLUSIONS: The Na+, K (+)-ATPase may play an important role in rat penumbra tissue I/R injury.

P44 Study of the Hippocampal MR T2 Signal Intensity in Mild Alzheimer’s Disease Y. F. Luo, Z. H. Cao, D. Q. Wang, L. W. Wu, Y. P. Zhao, W. C. Xie, Y. F. Li. Department of Medical Imaging, the Affiliated Yixing People’s Hospital of Jiangsu University, Wuxi, China OBJECTIVE: To evaluate clinical value of hippocampal MRI T2 signal intensity in early diagnosis of mild Alzheimer’s disease. METHODS: Twenty mild AD patients (mean age 68.3  12.2 years) and 20 normal controls (mean age 67.0  11.3 years) were scanned by MRI using FSE-T2 sequence, the margin of hippocampal subfields were outlined manually for each side to measure the T2 signal intensity. The relationship between hippocampal T2 signal intensity and the scores of MMSE was analyzed. By ROC (receiver operating characteristic curve) method, the cut-off point of the hippocampal T2 signal intensity was calculated as an early diagnostic marker for mild AD and its values were estimated. RESULTS: There was significant difference of the T2 signal intensity in the bilateral hippocampal head, while the body and tail were not between the two groups, but the numerical value of the left tail was bigger than the control group. There was inverse correlation between bilateral hippocampal head’s T2 signal intensity and the scores of MMSE (r = 0.53, 0.47 for left and right respectively, p < 0.05). The best cut-off point of hippocampal T2 signal intensity, as a diagnostic marker, was left head: 563.0 with the sensitivity of 87% and specificity of 94%; right head: 562.2 with the sensitivity of 89% and specificity of 93%. CONCLUSIONS: The abnormality of the bilateral hippocampal head’s T2 signal intensity could be regarded as a valuable marker in making clinical diagnosis of AD in its early stage.

P45 Relation Between Carotid Atherosclerotic Plaque Stability and Red Blood Cell Distribution Width in Elderly Patients with Cerebral Infarction P. Wang, W. H. Lu, H. J. Liu, Q. Wang. Department of Geriatrics, Affiliated Fuxing Hospital of Capital Medical University, Beijing, China OBJECTIVE: To study the relation between carotid atherosclerotic plaque stability and red blood cell distribution width (RDW) in elderly cerebral infarction patients. METHODS: Elderly patients with acute cerebral infarction (ACI) patients with carotid plaques (n = 165, mean age 81.18  5.90 years, range 63–93, 71% male) were divided into stable plaque group (n = 45, mean age of 75.41  10 years) and unstable plaque group (n = 120, mean age of 85.85  6 years) according to their color Doppler ultrasonography. Their clinical data and risk factors for cardiovascular diseases were collected, their serum levels of lipid, hemoglobin, A1c, createnine, plasma fibrinogen (Fib), hs-CRP and mean corpuscular volume were measured, and their body mass index (BMI), ankle brachial index, white blood cells and RDW were evaluated. RESULTS: The RDW, serum levels of hs-CRP, and Fib were significantly higher in unstable plaque group than in stable plaque group (11.7  1.25%, 3.50  12.00 mg/L, 3.07  0.89 g/L vs 11.40  0.75%, 1.10  1.00 mg/L, 2.78  0.45 g/L, p < 0.05). Spearman correlation analysis showed that the incidence of unstable carotid plaques was positively correlated with RDW (r = 0.244, p < 0.01), hs-CRP (r = 0.323, p < 0.01), and Fib (r = 0.164, p < 0.05). Logistic regression analysis demonstrated that RDW was the risk factor for unstable plaques after adjustment for age, sex and other traditional cardiovascular risk factors (OR = 2.020, 95% CI: 1.191–3.426, p < 0.01).

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CONCLUSION: RDW is related to instability of carotid atherosclerotic plaques and a risk factor for plaque rupture in elderly ACI patients.

P46 Cross-Sectional Study of Carotid Intima-Media Thickness in Senior Male Patients with Metabolic Syndrome H. Wang, J. Cao, B. P. Zhu, T. Tao, X. N. Zhao, H. J. Wang. Department of Geriatric Cardiology of Chinese PLA General Hospital, Beijing, China OBJECTIVE: To study carotid intima-media thickness (IMT) cross-sectionally in senior male patients in order to assess the severity of atherosclerosis and the relationship between IMT and metabolic syndrome (MS). METHODS: A total of 132 senior male patients with MS were recruited between Jan 2010 and Jun 2012 – 65 patients with MS in MS group (mean age 77.43  10.28 years) and 67 patients without MS as controls (mean age 75.93  9.20 years). Demographic information was collected and all patients received carotid artery echography. RESULTS: Compared with controls, BMI, waist, WHR, systolic blood pressure, diastolic blood pressure, TG, fasting serum blood sugar, hs-CRP, and IMT in MS group were significantly higher, while HDL-c in MS group was much lower (see table below). IMT were correlated with DBP (r = 0.306, p < 0.0001), BMI (r = 0.917, p < 0.0001), and HDL-C (r = 0.813, p < 0.04). Regression analysis showed that only BMI and diagnosis of MS remained statistically significant.

RESULTS: The NIHSS and MRS scores and the carotid IMT were significantly higher in Hcy group than those in control group on day 90 after admission than at admission (4 vs 0–2, p < 0.05). Logistic analysis showed that Hcy was an independent risk factor for the poor prognosis in elderly ACI patients (OR = 1.473, 95% CI: 0.878–3.246, p < 0.04). CONCLUSIONS: Hcy may predict severe neurological deficit and poor prognosis in elderly ACI patients.

P48 Mild Cognitive Impairment (MCI) in Elderly Type 2 Diabetic Patients with Hyperhomocysteinaemia X. N. Wang, X. J. Bai, C. L. Wang. Departments of Geriatrics, First Affiliated Hospital of China Medical University, Shenyang, China OBJECTIVE: To evaluate relationship between and hyperhomocysteinaemia in elderly type 2 diabetic patients. METHODS: Elderly type 2 diabetic patients (n = 120) admitted to our hospital from August 2011 to July 2012 were divided into three groups according to their plasma homocysteine (Hcy) levels. Group A: 29 lmol/L (n = 40 in each group). Their cognitive function was assessed and compared according to the MMSE and ADL. RESULTS: MCI was detected more frequently in groups B (MMSE score: 26.5  1.8) and C (MMSE score: 25.2  2.1) than in group A (MMSE score: 27.3  1.4) (all p < 0.05) and in group C than in group B (p < 0.05). CONCLUSIONS: There was a significant association between MCI and hyperhomocysteinaemia in elderly type 2 DM patients.

P49 Relationship of Resting Heart Rate with Ambulatory Blood Pressure and Left Ventricular Hypertrophy in Elderly Hypertensive Patients H. Wang, X. L. Wang, S. F. Wang, J. M. Zhang. Department of Geriatrics, First Affiliated Hospital of Liaoning Medical College, Jinzhou, China

CONCLUSIONS: Our data indicate that BMI and MS are significantly correlated with IMT in senior male patients.

P47 Prognostic Value of Hyperhomocysteinemia in Elderly Patients with Acute Cerebral Infarction J. Wang, J. F. Liu, Z. H. Guo, J. Sun, Y. M. Qu. Department of Neurology, Harbin No. 1 Hospital, Harbin, Heilongjiang, China OBJECTIVE: To study prognostic value of hyperhomocysteine (Hcy) in elderly acute cerebral infarction (ACI) patients. METHODS: Elderly patients with ACI (n = 377) were divided into Hcy group (n = 251, mean age of 70.2  10.6 years) and control group (n = 126, mean age of 69.5  11.0 years) according to their Hcy level at admission. Their clinical manifestations were recorded, and their neural function and disability were assessed according to the NIHSS and modified Rankin scale (mRS). Patients were followed up for 90 days during which their prognoses were compared.

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OBJECTIVE: To investigate the relationship of resting heart rate (RHR) with ambulatory blood pressure (ABP) and left ventricular hypertrophy (LVH) in elderly hypertensive patients. METHODS: Elderly hypertensive patients (n = 103) were divided into RHR1 group (RHR < 70/min n = 31, mean age 69.59  5.76 years), RHR2 group: (RHR 70–80/min, n = 39, mean age 67.39  5.69 years) and RHR3 group (RHR ≥ 80/min, n = 33, mean age 68.01  5.31 years). All patients underwent resting electrocardiography and carotid ultrasonography. Their ABP, serum FPG, TC, TG, LDL-C, HDL-C, UA, Cr levels and MBI were measured. RESULTS: As shown in tables below, the serum FBG, TC, TG, LDL-C, UA, Cr levels, BMI, and the average 24 hours, daytime and nighttime SBP and PP were significantly higher in RHR3 group than in RHR1 group and RHR2 group. A significant difference was found in BMI and posterior wall thickness of left ventricle, interventricular septum thickness, diameter of left ventricle at end-diastolic phase, and LVEF among the three groups. The RHR was positively related with the serum FPG, TC, TG, LDL-C levels, 24 hours SBP and PP (r = 0.608, r = 0.528, r = 0.385, r = 0.615, r = 0.509, r = 0.407, p < 0.01 for all) and negatively related with the serum HDL-C level and LVEF (r = 0.374, r = 0.522, p < 0.01 for both).

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CONCLUSIONS: MSC reduce unstable plaques by down-regulating inflammatory reactions and up-regulating anti-inflammatory cytokine level.

CONCLUSIONS: Since RHR is closely related with SBP, PP and LVH in elderly hypertensive patients, their RHR should be controlled by blood pressure.

P50 Effect of Intravenous Mesenchymal Stem Cell Infusion on Vulnerable Plaques in Carotid of Rabbits S. S. Wang, S. H. Yang, G. X. Kong, F. Xue, W. He, Z. X. Jiang. Postgraduate School, Southern Medical University, Guangzhou, China Supported By: National Science Foundation (30971235). OBJECTIVE: To study the effect of intravenous bone marrow mesenchymal stem cell (MSC) infusion on vulnerable plaques (VP) in atherosclerotic rabbits. METHODS: Thirty healthy male New Zealand white rabbits were randomly divided into MSC group, VP group, stable plaque (SP) group (10 in each group). Serum was collected at 3rd day, 1 and 2 weeks after MSC transplantation. Serum levels of hs-CRP, TNF-a, IL-6, IL-10 were measured by ELISA. The animals were sacrificed at week 10. Lesions in right common carotid were observed with HE staining. The fibrous cap/lipid core ratio of atherosclerotic plaques was calculated. RESULTS: The following were observed in VP group, including intact morphological structure of atherosclerotic plaques, thick fibrous cap, a small number of inflammatory cells, no ruptured plaques, massive lipid cores in the center of plaques covered by thin fibrous cap, residual foam cells with infiltration of a large number of inflammatory cells in the shoulder with ruptured plaques and/or thrombosis. The fibrous cap/lipid core ratio of atherosclerotic plaques was higher in MSC group and SP group than in VP group (p < 0.01). The serum levels of hs-CRP, TNF-a, and IL-6 were significantly lower whereas the serum IL-10 level was significantly higher in MSC group and SP group than in VP group, and in MSC group and SP group than in VP group at different time points (see table below, p < 0.05, p < 0.01).

P51 Effect of Stenting and Medical Treatment on Symptomatic Intracranial Arterial Stenosis and its Intermediate and Long-Term Effect Follow-Up X. H. Pan, G. R. Liu, C. C. Jiang, Y. C. Li, B. J. Wang. Department of Neurology, Baotou Central Hospital, Baotou, China OBJECTIVE: To analyze the effect of stenting and medical treatment on symptomatic intracranial arterial stenosis and its intermediate and long-term effect follow-up. METHODS: Clinical data from 86 patients (mean age 63.17  10.41 years, 67% male) with digital angiography-confirmed intracranial arterial stenosis >50% were retrospectively analyzed. Patients were divided into stenting group (n = 34) and medical treatment group (n = 52). Clinical and imaging findings were recorded during 30-day, 6-, 12-, 24-month, and over 24-month follow-up periods. RESULTS: The success rate of stenting was 94.74% in stenting group. The stenosis decreased from 87.15  7.43% before stenting to 11.32  17.72% after stenting (p < 0.05). No significant difference was found in the incidence of homolateral ischemic stroke and total vascular events between the two groups after a follow-up period ≥12 months (5.88% vs 5.77%, p > 0.05). CONCLUSIONS: Stenting is a safe procedure for intracranial arterial stenosis and more effective than simple medical treatment. However, it does not seem to provide more benefit than medical therapy in preventing homolateral ischemic stroke and vascular events after 12-month follow-up.

P52 Sensitivity and Specificity of Transcranial Doppler Ultrasound in the Diagnosis of Posterior Circulation Artery Stenosis or Occlusion Y. H. Yin, W. H. Liu, F. Yu, H. Wang, F. L. Gao, X. Lu, J. Chen, M. L. He. Department of Neurology, Beijing Shijitan Hospital of Capital Medical University, Beijing, China OBJECTIVE: To investigate the sensitivity and specificity of transcranial Doppler ultrasound (TCD) in diagnosis of posterior circulation artery stenosis or occlusion. METHODS: Ninety-eight patients (mean age 66.05  11.00 years, 65.3% male) with acute posterior circulation cerebral stroke were included in this study. The findings in TCD examination, neck angiography, head MRA, CTA and DSA were compared and analyzed.

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RESULTS: TCD examination showed lesions of 67 arteries and the MRA/CTA/DSA revealed lesions of 107 arteries in 26 patients. The sensitivity and specificity of TCD were 55.14% and 97.91% for the diagnosis of posterior circulation artery stenosis, 88.89% and 97.63% for the diagnosis of vertebral artery stenosis, 46.43% and 94.29% for the diagnosis of basal artery stenosis, 41.51% and 100% for the diagnosis of posterior cerebral artery stenosis. CONCLUSIONS: The specificity of TCD is high for the diagnosis of posterior circulation artery stenosis or occlusion and may be used in screening posterior circulation artery stenosis or occlusion and diagnosing posterior circulation stroke.

P53 Energy Expenditure at Different Periods in Myocardium of Patients with Myocardial Infarction and its Significance J. Q. Liang, S. C. Bai, C. Li, D. L. Xu. Department of Cardiology, Affiliated Southern Hospital of Southern Medical University, Guangzhou, China OBJECTIVE: To study the energy expenditure at different periods in myocardium of patients with myocardial infarction and its clinical significance. METHODS: Fifty-five patients with myocardial infarction but without heart failure were divided into acute myocardial infarction (AMI) group (n = 28, mean age of 59.7  5.5 years, 57% male) and old myocardial infarction (OMI) group (n = 23, mean age of 61.4  7.0 years, 56% male). Thirty patients with normal coronary angiography served as a normal control group. Their circumferential end-systolic wall stress (cESS) and energy expenditure in myocardium were detected by Doppler ultrasonography and their plasma NT-BNP level was measured. Correlation of cESS and energy expenditure in myocardium with plasma NT-BNP level was analyzed. RESULTS: The cESS, energy expenditure in myocardium and plasma NT-probing level were significantly higher in AMI group and OMI group than in normal control group and in AMI group than in OMI group (table 1). The energy expenditure in myocardium was positively related with the plasma NT-BNP level (r = 0.605, p = 0.0001) and negatively related with the LVFS and LVEF (r = 0.393, 0.376, p = 0.0001).

CONCLUSIONS: Energy expenditure in myocardium may be useful for assessing cardiac function in patients with myocardial infarction and is correlated with plasma NT-BNP levels.

P54 Cerebrovascular Reserve in Patients with Internal Carotid Artery Stenosis Y. Lin, L. Kong, J. F. Dai, H. B. Liu, M. Li, R. B. Guo, G. H. Chen, L. Liu, F. Yang. Department of Neurology, Nanjing General Hospital of Nanjing Military Area Command, PLA, Nanjing, China Supported by: National Science Foundation of China (81070923, 81100870). OBJECTIVE: To evaluate the relationship between cerebrovascular reserve (CVR) and unilateral internal carotid artery (ICA) stenosis.

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METHODS: Elderly patients with cerebral infarction (n = 85 including 59 patients with ICA stenosis) served as an ICA stenosis group and 26 patients without ICA stenosis served as a control group in this study. Hypercapnia was induced by inhaling 5% CO2 and 95% O2 mixed gas. The blood flow rate in middle cerebral artery (MCA) was measured. RESULTS: The CVR was significantly lower in ICA stenosis group than in control group (22.47  12.45% vs 37.25  11.77%, p < 0.01). The CVR was positively correlated with the severity of ICA stenosis (95% CI = 0.6587, p < 0.01), indicating that ICA stenosis is an independent factor for the reduced CRV (OR = 5.149, 95% CI: 2.682–9.858, p < 0.01). CONCLUSIONS: ICA stenosis is an independent factor for CVR and detection of CVR can predict the severity of ICA stenosis.

P55 Application of ABCD2 Score in Predicting Risk of Cerebral Ischemic Stroke After Transient Cerebral Ischemia (TIA) W. Y. Li, X. H. Qian. Department of Geriatrics, Yunnan Provincial First People’s Hospital, Kunming, China OBJECTIVE: To explore the application of ABCD2 score in predicting the risk of cerebral ischemic stroke 7 days after TIA. METHODS: Patients with TIA (n = 114, mean age 63.5  12.9, range: 50–88 years) were divided into cerebral infarction group (n = 28) and non-cerebral infarction group (n = 86). The patients were further divided into high-risk group (n = 13) with an ABCD2 score of 6–7, medium risk group (n = 69) with an ABCD2 score of 4–5, and low risk group (n = 32) with an ABCD2 score of 0–3. The incidence of cerebral infarction was observed in different groups within 7 days after transient cerebral ischemia. RESULTS: The number of seniors (age ≥ 60 years), rate of hypertension (BP ≥140/90 mmHg), and the persistent time of limb weakness ≥60 minutes in cerebral infarction group were significantly higher than those in non-cerebral infarction group (78.6%, 85.7%, 92.8%, vs 31.4%, 32.5%, 39.5%, p < 0.05). The incidence of cerebral infarction was 3.1%, 28.9%, and 53.8%, respectively, in low, medium and high-risk groups within 7 days after transient cerebral ischemia (p < 0.05). CONCLUSIONS: ABCD2 score may predict post-TIA cerebral ischemic stroke.

P56 Clinical Symptoms of the Nervous System in Elderly Aortic Dissection Patients G. F. Cao, Q. Bi, L. Cao. Department of Neurology, Affiliated Beijing Anzhen Hospital of Capital Medical University, Beijing, China OBJECTIVE: To evaluate the nervous system symptoms in elderly patients with aortic dissection. METHODS: Clinical data (including symptoms, signs and imaging) from 189 elderly patients with aortic dissection (mean age 65.02  4.52 years, 66.7% male) were retrospectively analyzed. RESULTS: Of the 189 aortic dissection patients, 54 (28.6%) presented with the nervous system symptoms. Dizziness was the most common symptom which developed in 16 (8.5%), followed by syncope which developed in 14 (7.4%), coma which developed in 7 (3.7%), single lower limb sensory disturbance which developed in 6 (3.1%). Three patients were diagnosed with paraplegia and 12 patients were diagnosed with ischemic stroke. Patients with type A aortic dissection were more prone to nervous system symptoms than those with type B aortic dissection (40.9% vs 13.1%,

ABSTRACTS p < 0.01). The incidence of syncope was significantly higher than that of type B aortic dissection (p = 0.001). CONCLUSIONS: Nervous system symptoms are common in elderly patients with aortic dissection, especially in those with type A aortic dissection, which may be related to cerebral ischemia.

P57 Nutritional Risk Screening in Elderly Patients with Cerebrovascular Disease S. J. Zhang, W. Wu, F. Zhai, C. Hu, R. Xue. Department of Neurology, General Hospital of Tianjin Medical University, Tianjin, China OBJECTIVE: To assess the nutrition status in elderly patients with cerebrovascular disease according to the NRS2002. METHODS: A total of 321 old patients (mean age 75.22  6.88 years, ranges from 65 to 97, 56.7% male) with cerebrovascular disease (201 with cerebral infarction, 18 with cerebral hemorrhage and 102 with other cerebrovascular diseases) admitted to our hospital were divided into 65–74 years old group (n = 152), 75–84 years old group (n = 139), and ≥85 years old group (n = 30). Their nutrition status was assessed according to the NRS2002 and scored according to the NIHSS. Different cerebrovascular disease classifications and NIHSS scores in different age groups were comparatively analyzed in this cross-sectional study. RESULTS: The prevalence of nutritional risk was 70.4%. Nutritional status was significantly poorer in patients with cerebral infarction and hemorrhage than in those with other cerebrovascular diseases (77.6%, 88.9%, and 55.2% respectively, p < 0.01). The prevalence of nutritional risk was significantly higher in 75–84 years old group and ≥85 years old group than in 65–74 years old group (80.6%, 83.3%, and 58.6% respectively, p < 0.01). The nutrition was poorer in patients with their NIHSS score >8 than in those with their NIHSS score ≤8 (94.5% vs 59%, p < 0.01). CONCLUSIONS: The prevalence of nutritional risk is high in elderly cerebrovascular disease patients according to the NRS2002, especially in those with advanced age and ischemic stroke and severe nerve defect. The nutrition of cerebrovascular disease patients should be assessed as early as possible according to the NRS2002 and effectively intervened.

P58 Relation Between Two-Dimensional Echocardiography Myocardial Strain and Infarction Size in Patients with Myocardial Infarction (MI) M. Q. Zhang, Q. S. Wang, D. S. Huang, L. W. Zhang, Q. H. Ouyang, Y. Z. Wang, X. Z. An. Department of Cardiology, First Affiliated Hospital of General Hospital of PLA, Beijing, China OBJECTIVE: To assess the relationship between two-dimensional echocardiography strained myocardial infarct size in patients with MI. METHODS: Fifty-one patients 3–6 months post-MI underwent routine echocardiography 2D-STI and SPECT. According to the myocardial infarct size assessed by SPECT, MI group was divided into group A (infarct size 75 years old group (n = 506) and ≤75 years old group (n = 1570). Patients were treated with intravenous salvianolatedrip at the dose of 200 mg/d for 10–14 days, and the efficacy and safety of salvianolate were analyzed. RESULTS: The frequency of angina pectoris attack decreased from 5.5  5.2 times per week before treatment to 1.6  2.8 times per week after treatment (p < 0.05). The number of nitroglycerin tablets used by the patients decreased from 3.2  3.4 per week before treatment to 1.7  2.8 per week after treatment (p < 0.05). Canadian angina pectoris staging decreased one level or more in 59% of the patients. Twenty-five adverse events occurred during the treatment, including seven symptomatic adverse events and 18 adverse events detected in laboratory test (adverse reaction rate: 1%). CONCLUSION: Salvianolate injection for 14 days may safely reduce frequency of angina pectoris attack in elderly patients with coronary heart disease.

P64 Effect of Chronic Heart Failure on Longitudinal Cognitive Function in Elderly Subjects G. Q. Zhou, B. Yan, F. Sun, Y. He, Y. T. Wang, L. H. Duan. Department of Geriatric Neurology, Nanjing General Hospital of Nanjing Military Area Command, Nanjing, China OBJECTIVE: To investigate effect of chronic heart failure (CHF) on longitudinal cognitive function in elderly subjects and its mechanism. METHODS: Eighty-eight CHF patients served as a CHF group (mean age 79.9  1.7 years) and 93 healthy elderly subjects

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ABSTRACTS served as a control group (mean age 80.8  1.5 years) in this prospective control study. Baseline cognitive function and general clinical condition were assessed according to the MMSE, word learning and delayed recall, animal fluency, symbol and digit transformation tests. All patients were followed up for 2 years, during which their cognitive function was assessed. Effect of CHF on baseline cognitive function and its changing speed was analyzed according to the random effect model. RESULTS: As shown in Table 1, the incidence of hypertension was significantly higher whereas the percentages of word learning and delayed recall, animal fluency, symbol and digit transformation were significantly lower in CHF group than in control group. The annual decline rates on the MMSE, word learning, delayed recall, animal fluency, symbol and digit transformation scores were significantly higher in CHF group than in control group after adjustment for hypertension (0.453, 0.487, 0.229, 0.463, 0.622 vs 0.236, 0.264, 0.153, 0.236, 0.353, all p < 0.01).

genes. Nse and nne expression levels were significantly higher whereas the gfap expression level was significantly lower at 24 h in differentiated gene. Nse expression level was significantly higher whereas the gfap expression level was significantly lower at 48 h in differentiated genes.

CONCLUSIONS: Hypoxia can lead to differentiation of neural stem cells to neural glial cells and BDNF can induce differentiation of neural stem cells to neurons.

CONCLUSIONS: The cognitive function impairment appears to develop faster in CHF patients than in controls.

P65 Role of Brain Derived Neurotrophic Factor in Inducing Differentiation of Hypoxia Neural Stem Cells J. J. Wu, X. Su. Department of Medicine, Tianjin Huanhu Hospital, Tianjin, China OBJECTIVE: To investigate the role of brain derived neurotrophic factor (BDNF) in inducing differentiation of hypoxia neural stem cells. METHODS: Neural stem cells cultured in vitro to the second generation were divided into control group (normal culture), hypoxia group (hypoxia culture) and BDNF group (hypoxia culture into which BDNF was added). After cultured for 36 h, the culture condition was changed to induce differentiation of the cells at 24, 48 and 72 h. Expression levels of Bcl-2, bax, nse, nne and gfap mRNA in each group were measured by RT-PCR and Western blot, respectively, at 48 h after culture. RESULTS: Bcl-2 expression level was significantly higher in BDNF group than in hypoxia group at 48 h whereas the bax expression level was significantly lower at 48 and 72 h in apoptotic

P66 Characteristics of Metabolic Risk Factors in Elderly Patients with Coronary Heart Disease (CHD) after Coronary Artery Bypass Grafting B. N. Bao, X. Q. Sun, Y. Zhao, H. Tao, Y. S. Zhou. Department of Endocrinology, Affiliated Beijing Anzhen Hospital of Capital Medical University, Beijing, China OBJECTIVE: To study the characteristics of metabolic risk factors in elderly patients with CHD after coronary artery bypass grafting (CABG). METHODS: Elderly CHD patients (n = 398, mean age 70.7  4.1 years) were divided into male patients group (n = 272, mean age 70.7  4.2 years) and female patients group (n = 126, mean age 70.8  3.8 years). The characteristics of metabolic risk factors in the two groups were compared. RESULTS: BMI, SBP, and serum TC, HDL-C, LDL-C and TG levels were significantly higher whereas the serum uric acid (UA) level was significantly lower in female patients group than in male patients group (see Table 1 below). No significant difference was found in age, DBP, and fasting blood glucose and HbA1c levels between the two groups. The percentage of dyslipidemia was higher whereas that of smoking was lower in female patients group than in male patients group (77.8% vs 51.8%, 26.2% vs 59.2% p < 0.0001). No significant difference was observed in the incidence of diabetes mellitus, hypertension and multi-vessel lesion between the two groups (47.4% vs 50.8%, 68.4% vs 71.4%, 63.2% vs 69.0% p > 0.05).

CONCLUSIONS: Elderly female patients with CHD had higher post-CABG dyslipidemia and HTN, but lower smoking and UA level than their male counterparts.

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P67 Characteristics of Cardiac Collagen Lesions in Elderly Patients with Hypertensive Left Ventricular Hypertrophy L. Y. Guan, X. Y. Li, X. D. Liu, S. R. Li. Department of Cardiology, Handan Central Hospital, Handan, China OBJECTIVE: To observe the characteristics of cardiac collagen lesions in elderly patients with hypertensive left ventricular hypertrophy (LVH). METHODS: Cardiac tissue samples (n = 126) taken from patients aged ≥65 years were selected from 3520 consecutive autopsy samples (1954–2001) in Chinese PLA General Hospital and divided into hypertension group [n = 105, which were further divided into hypertensive LVH 0 group (n = 15), hypertensive LVH I group (n = 36), hypertensive LVH II group (n = 28), and hypertensive LVH III group (n = 22)] and control group (n = 25). The samples were stained with HE, Sirius Red F3B and immunohistochemistry, respectively. Distribution of collagen was observed under light microscope and polariscope, respectively. Myocardial collagen volume fraction (CVF), CVF of collagen I, III, and their ratio were measured by videodensitometry. RESULTS: The myocardial CVF, and CVF I were significantly higher in hypertensive LVH I-III group than in control group and hypertensive LVH0 group (p < 0.01).

CONCLUSIONS: CVF increases significantly with the severity of hypertensive LVH, which indicates that cardiac diastolic function is severely impaired.

P68 D-Dimer Cut-Off Value for Prediction of Deep Venous Thrombosis (DVT) in Elderly Patients M. Q. Yu, J. L. Li, X. L. Cao, J. Bai, S. X. Zhang, X. Liu, Q. Lin, D. F. Song, J. Wang. Department of Ultrasound and Clinical Laboratory, Chinese PLA General Hospital, Beijing, China OBJECTIVE: To explore the applicable D-Dimer cut-off value for low extremity DVT in elderly patients. METHODS: A total of 394 consecutive older than 60 years hospitalized patients (mean age 81.393  0.99 years, 60–103) from January 2005 to May 2012 is divided into older age-group (60– 79 years old) and advanced age-group (older than 80 years). Each of the two groups was further divided into DVT and non-DVT groups. D-Dimer was tested at the intervals of about 1–2 weeks, the patients whose D-dimer value increase to 0.5 mg/L, should be carried out ultrasonic testing and reexamined at intervals of about 3–5 days with D-Dimer testing interval also being increased to every 3–5 days. RESULTS: For each D-dimer cut-off between older age group and advanced age group, all values including sensitivity, specificity, positive predictive value, negative predictive value have big differences (see Table 1).

CONCLUSIONS: For 60–79 years old patients, D-Dimer cutoff value of 0.5 mg/L is still applicable for clinic diagnosis guidance of ruling out low extremity DVT, while for more than 80-year-old patients; the D-Dimer cut-off value should be increased to 2.0 mg/L.

P69 Curative Effect of Balloon Dilatation Therapy on Cricopharyngeal Achalasia in Elderly Cerebral Stroke Patients Y. Yu, Y. J. Guo, L. Y. Zhang. Department of Rehabilitation, Tianjin Huanhu Hospital, Tianjin, China OBJECTIVE: To observe the curative effect of balloon dilatation therapy on cricopharyngeal achalasia in elderly cerebral stroke patients. METHODS: Cerebral stroke patients (n = 32, mean age 69.7  6.3 years, ranges 60–80, 62.5% male) with cricopharyngeal achalasia were divided into treatment group (n = 18) and control group (n = 14). Patients in treatment group underwent balloon dilatation therapy and routine swallowing rehabilitation treatment, those in control group received only routine swallowing rehabilitation treatment. Their swallowing function was assessed according to water drinking test and VFSS before and after treatment. RESULTS: Water-drinking test showed that swallowing function was significantly improved both in treatment group and in control group after treatment. Total efficacy of balloon dilatation therapy was significantly higher in treatment group than in control group (66.7% vs 35.7%, p < 0.05). The opening amplitude of cricopharyngeal muscle was greater in treatment group than in control group (1 vs 4, 14 vs 9, 3 vs 1, p < 0.05). The mean time for the bolus to pass pharynx was significantly shorter after treatment than before treatment (0.16  0.08 vs 0.22  0.04 s, p = 0.018). CONCLUSIONS: Balloon dilatation therapy in combination with routine swallowing rehabilitation treatment appears to be effective for cricopharyngeal achalasia in elderly cerebral stroke patients and can reduce complications.

P70 Chronic Constipation, Sleep Disturbances and Olfactory Disorders Among Chinese Older Adults: A Population Analysis Across China Z. H. Wang, L. H. Wang, S. G. Qi, Y. C. Li, L. M. Wang. The National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China OBJECTIVE: To investigate the current status and distribution characteristics of chronic constipation, sleep disturbances and olfactory disorders in Chinese elderly.

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METHODS: In 2010, the 3rd Chronic Non-communicable Disease & Risk Factor Surveillance in China was conducted in 31 provinces plus Xinjiang Production & Construction Corps. Of 142,668 individuals over 60 years old in 98,548 households were randomly selected from 162 National Disease Surveillance Points (DSPs) by a stratified multistage cluster sampling design. All subjects received a set of standardized questionnaire and interview. After a complex weighted, the differences in the prevalence of constipation, sleep disturbances and olfactory disorders were investigated among the residents with different genders, ages, urban or rural regions. RESULTS: In all subjects aged over 60 years, the general prevalence of self-reported constipation was 5.06%, which increased with age. The general prevalence of self-reported constipation was higher in females than in males (5.80% vs 4.27%, v2 = 21.78, p < 0.05), higher in urban areas than in the rural areas (6.04% vs 4.58%, v2 = 5.66, p < 0.05), and there were no significant differences among residents in eastern, central, and western regions. The general prevalence of self-reported sleep disturbances was 14.19%, which increased with age. The general prevalence of self-reported sleep disturbances was higher in females than in males (17.27% vs 10.94%, v2 = 165.53, p < 0.05), and there were no significant differences among residents in urban and rural areas or in different regions. The general prevalence of self-reported olfactory disorders was 8.49%, which increased with age. The general prevalence of self-reported olfactory disorders was higher in females than in males (9.36% vs 7.58%, v2 = 22.32, p < 0.05). There were significant differences in the prevalence of self-reported olfactory disorders among residents in eastern, central and western regions (6.98%, 8.28% and 11.00%, v2 = 6.66, respectively, all p < 0.05), and no significant differences were found between residents in urban and rural areas. CONCLUSIONS: The prevalence of self-reported constipation sleep disturbances and olfactory disorders are increased with age and significantly more common among women in Chinese elderly residents.

P71 CD4+CD25+CD127low Treg Cells in Elderly Patients with Acute Myeloid Leukemia H. P. Wang, Y. Y. Shen, S. D. Xiong, T. P. Chen, Q. S. Tao, R. Zhang, Z. M. Zhai. The Second Affiliated Hospital of Anhui Medicial University, Hefei, China OBJECTIVE: To investigate the phenotype and clinical significance of Treg cells in elderly patients with newly diagnosed acute myeloid leukemia. METHODS: Patients with newly diagnosed acute myeloid leukemia (AML group, n = 65) and 72 healthy volunteers (control group) were divided into the elderly group (age over 60 years) and the young group. CD4+CD25+ regulatory T cells were detected by CD4, CD25 and CD127 multiparameter flow cytometry analysis. Their phenotype and clinical significance were examined. RESULT: After gated on CD4+ lymphocytes, more CD4+CD25+CD127low regulatory T cells was detected in AML group as compared to control group [(7.06  2.60)% vs (5.61  1.06)%, t = 4.188, p = 0.0001]. This was also true in both elderly AML patients and elderly controls [(7.55  2.78)% vs (5.98  1.08)%, t = 3.419, p = 0.001) and young AML and control groups [(6.09  1.91)% vs (5.14  0.82)%, t = 2.206, p < 0.04]. in addition, more CD4+CD25+CD127low regulatory T cells was detected in the elderly AML patients than young AML patients [(7.55  2.78)% vs (6.09  1.91)%, t = 2.195, p < 0.04]. CONCLUSIONS: Elderly patients with newly diagnosed AML appear to have excessive CD4+CD25+CD127low regulatory T cells. The dual roles of immunosenescence and tumor may cause

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the excessive accumulation of CD4+CD25+ regulatory T cells in elderly patients with newly diagnosed acute myeloid leukemia.

P72 Efficacy and Safety of Tirofiban with Low-Dose Heparin in the Treatment of Progressing Stroke F. Q. MU, T. Chen, S. Liu. Department of Neurology, Tangshan Workers Hospital, Tangshan, China OBJECTIVE: To investigate the efficacy and safety of tirofiban with low-dose heparin for treating progressing stroke combined with intracranial vessel stenosis, to analyze the clinical value of tirofiban in the treatment of ischemic stroke. METHODS: Clinical data of 26 patients with tirofiban and low-dose heparin for treating progressing stroke were retrospectively collected with NIHSS increased ≥3 with 6 h–7 day as the diagnosis standard of progressing stroke. The degree of intracranial vessel stenosis was checked by CT angiography (CTA). The efficacy of tirofiban for treating progressing stroke and the correlation between the degree of intracranial vessel stenosis and the prognosis of progressing stroke were observed. RESULTS: The percentage of progressing stroke patients with intracranial vessel stenosis/lesion was higher than that of progressing stroke patients without intracranial vessel stenosis/lesion (88.5% vs 11.5%, v2 = 14.786, p = 0.0001). There was a significant difference in NIHSS between progressing stroke patients with and without intracranial vessel stenosis/lesion before treatment (t = 2.271, p < 0.05). NIHSS were significantly decreased in both two groups after treatment and had a statistical difference between groups (t = 3.591, p = 0.02). MRS was lower in progressing stroke patients without intracranial vessel stenosis/lesion than in progressing stroke patients with intracranial vessel stenosis/lesion after treatment (t = 6.79, p = 0.001). The efficacy of tirofiban was higher in progressing stroke patients without intracranial vessel stenosis/ lesion than in progressing stroke patients with intracranial vessel stenosis/lesion (60.2% vs 30.8%, p < 0.05). CONCLUSIONS: Tirofiban with low-dose heparin is safe and effective in the treatment of progressing stroke. The degree of intracranial vessel stenosis is correlated with worse stroke prognosis.

P73 Clinical Evaluation of Asian Proximal Femoral Nail Antirotation in Treatment of Intertrochanteric Fractures in the Elderly M. H. Li, H. Peng, Y. Liu. Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, China OBJECTIVE: To investigate the clinical efficacy of Asian proximal femur intramedullary nail antirotation (PFNA-II) in the treatment of intertrochanteric fractures in elderly people. METHODS: From July 2009 to December 2011, 127 elderly patients with intertrochanteric fracture were treated by PFNA-II. Patients were classified by modified Evans: I type (n = 37 cases), II type (n = 42 cases), III types (n = 26 cases), IV type (n = 15 cases), V type (n = 7 cases). We make the statistics on the intraoperative bleeding volume, operation time, incision length, X-ray exposure times were recorded. The efficacy and complications were evaluated by the Harris hip score after the postoperative follow-up. RESULTS: Average operation time was 42.5 min (35– 90 min), average intraoperative blood loss was 107.5 ml (65– 410 ml), X-ray exposure times were (2.5  1.4) times (2–4 times), and average total incision length was (6.5  1.8) cm (5.5–11.0 cm). No serious complications or worsening complications were found during perioperative period. All patients received a 6–24-month

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follow-up (12.5 months in average). X-ray examination showed that the average neck shaft angle was (134  13°) (120–150°). Average fracture healing time was (14  2.5) weeks (11–19 weeks). Average hip Harris score was (86.5  19.5) points (65–100 points). Among them, 29 cases (22.83%) were excellent, 76 cases (59.8%) were good, 20 cases (15.7%) were moderate, two cases (1.6%) were poor, and the excellent and good rate was 82.7%. No complications including hip varus deformity, screw cut-out, or femoral shaft fractures were found. Thigh pain occurred in 14 patients (11.0%), inner thigh pain occurred in five cases (3.9%), and the heavier pain in four patients were improved by physical therapy. CONCLUSIONS: Asian PFNA-II has certain advantages (simple operation, fewer complications, and better clinical efficacy). Its long-term efficacy needs to be further evaluated by multi-center studies with a large sample size.

P74 Association Between Nocturia and Age: A Large Population Study in China u, J. S. Li, X. P. Shang, C. W. Lu, Z. M. Wang, J. G. Wen, Y. T. L€ X. Huang, G. J. Qin, Z. S. Liu, Z. Z. Zhao. Urodynamic Center and Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China OBJECTIVE: To investigate the prevalence and risk factors of nocturia in middle-aged and elderly people. METHODS: From June 2010 to February 2011, a randomized, community-based, cross-sectional study was performed on 10,160 Chinese inhabitants (living over 5 years) aged over 40 years in Zhengzhou. All subjects were assessed by questionnaires. Subjects were divided into nocturia group and non-nocturia group. The risk factors for nocturia including age, sex, and diabetes mellitus (DM) were analyzed, and the international prostate symptom score (IPSS) were compared between groups. RESULT: Among 10,160 people receiving questionnaires, 9880 (96.5%) pepole were qualified to enter the final statistical analysis. Mean age was 57.9  9.7 (range 40–92). The prevalence of nocturia was 31.5% (3117/9880). It increased with age (OR = 1.05, 95% CI = 1.04–1.05, p < 0.01), and it reached to 48.9% (642/1311) in people over 70 years. Nocturia was more prevalent in DM subjects than non-DM subjects (43.1% vs 29.7%, OR = 1.514, 95% CI = 1.34–1.71, p < 0.01). IPSS was higher in nocturia group than in non-nocturia group [(5.1  5.3) vs (1.7  2.7), p < 0.01]. CONCLUSIONS: Nocturia is significantly associated with age, diabetes and benign prostatic hyperplasia (BPH) in people over 40 years in Mainland China. It should be strengthen the evaluation and treatment of nocturia in order to reduce the impact of nocturia on quality of life in middle-aged and elderly people.

P75 Diagnostic Value of Sputum Smear Test with Gram-Staining in Elderly Patients with Ventilator-Associated Lower Respiratory Tract Infection L. L. Zhi, W. Feng, Y. H. Liu. Department of Intensive Care Unit, The Fourth People’s Hospital of Shenyang, Shenyang, China OBJECTIVE: To explore the diagnostic value of gram-stained sputum smears in elderly patients with ventilator-associated lower respiratory tract infection (VALRI). METHODS: Among 368 elderly patients undergoing mechanical ventilation over 48 h in ICU were retrospectively analyzed from June 2009 to 2011, 42 fulfilled the inclusion criteria (with goodquality sputum samples and presence of the same microorganism in

sputum and blood cultures). Fifty-eight gram-stained smears and sputum cultures were obtained and analyzed. RESULT: The diagnostic sensitivity and specificity of Grampositive bacteria and Gram-negative bacteria by gram-stained smears were 82.35% and 78.05%, 80.49% and 82.35%, respectively. The positive and negative predictive value of Gram-positive bacteria and Gram-negative bacteria were 63.64% and 91.43%, 91.67% and 60.87%, respectively. Coincidence rates in diagnosing Grampositive bacteria and Gram-negative bacteria were 81.03% and 79.31%, respectively. CONCLUSIONS: Gram-stained sputum smear is reliable in diagnosing ventilator-associated lower respiratory infection in elderly patients, and has a certain clinical significance in guiding to the selection of antibiotics.

P76 Correlation Between Low Diastolic Blood Pressure and Coronary Disease in Elderly Persons with Isolated Systolic Hypertension J. Zhang, W. Wang, M. Y. Chen, R. Liang. Department of Cardiology, Tianjin Chest Hospital, Tianjin, China OBJECTIVE: To investigate the correlation of low diastolic blood pressure (DBP) 20% and 60 ml/min
1.73/m2 in the elderly. A cut-off value of GFR 45 ml/min
1.73/m2 for the diagnosis of CKD may be appropriate in the elderly.

P88 Effect of Auxiliary Therapy with Microbial Probiotic Agents for Elderly Patients with Acute Pancreatitis M. Chen, Z. W. Cao. Department of Gastroenterology, Tianjin Nankai Hospital, Tianjin, China OBJECTIVE: To explore Effect of auxiliary therapy with microbial probiotic agents for elderly patients with acute pancreatitis.

ABSTRACTS METHODS: Elderly patients with acute pancreatitis (n = 144) were selected and randomly divided into the study group and control groups (n = 72, each group). All patients received regular treatment and enteral nutrition. Microbial probiotic agents were added in enteral nutrition in the study group. The levels of endotoxin (ET), tumor necrosis factor (TNF-a), interleukin (IL)-6, Creactive protein (CRP) in peripheral blood were measured by ELISA and compared between the two groups. Clinical index and occurrence of adverse reactions were evaluated. RESULTS: Pre- and post-treatment comparison showed that levels of ET, TNF-a, IL-6, CRP were significantly reduced in both two groups after treatment (data not shown). The levels of ET, IL6, TNF-a, CRP were lower in the study group than in the control group [(0.14  0.07) vs (0.31  0.12) EU/ml, (44.77  17.82) vs (63.25  14.26) pg/ml, (0.15  0.05) vs (0.29  0.14) lg/L, (108.33  11.84) vs (135.41  21.45) mg/L, respectively, all p < 0.05]. Time to resolution of symptoms and signs, anal exsufflation time, and length of hospital stay were shorter in the study group than in the control group [(25.8  4.8) vs (36.4  6.2) h, (30.9  6.7) vs (44.4  7.3) h, (24.9  3.2) vs (37.6  3.4) h, (6.9  0.4) vs (13.1  1.2) day, respectively, all p < 0.05]. There were no statistically significant differences in death rate and the occurrence of adverse reactions between the two groups. CONCLUSION: Microbial probiotic agents may be safe and effective as an adjuvant therapy for elderly patients with acute pancreatitis.

P89 Clinical Observation of Simultaneous Coronary Artery Bypass Surgery and Carotid Endarterectomy for the Treatment of Combined Coronary and Carotid Artery Severe Stenosis in Elderly Patients S. Y. Qian, P. Liu, Z. D. Ye, S. Y. Ren, F. Wang, F. Lin, Y. G. Yang, X. Q. Fan, Y. N. Zhen, F. L. Wang. Department of Cardiac and Vascular Surgery, China-Japan Friendship Hospital, Beijing, China OBJECTIVE: To evaluate clinical safety and efficacy of simultaneous coronary artery bypass grafting (CABG) and carotid endarterectomy (CEA) in patients with combined coronary and carotid artery severe stenosis. METHODS: From January 2000 to September 2012, 31 patients [19 males, 12 females, aged 54–80 years, average aged (67  12) years] underwent combined CABG and CEA. Preoperative coronary and carotid artery angiography revealed that left main trunk stenosis occurred in six cases; triple-vessel disease occurred in 15 cases; and two-vessel disease occurred in 10 cases. CEA was performed followed by CABG in 30 patients, and one patient had them in reverse order. Majority of patients (n = 24) underwent CABG without cardiopulmonary bypass (CPB). An intraluminal coronary shunt tube and patch repair was used in CEA procedure. RESULTS: No operative mortality and perioperative cardiocerebral vascular accidents were observed in this study. One patient received right femo-popliteal artificial graft bypass for lower extremity atherosclerotic occlusive disease 1 month after the simultaneous CABG and CEA. No cardiovascular events were observed during the 6- to 84-month follow-up period. CONCLUSIONS: The simultaneous CABG and CEA is an effective and safe treatment for combined coronary and carotid artery severe stenosis. It can prevent postoperative cardio-cerebral vascular complications with good follow-up results.

P90 Investigation of Treatment for Cervical Intraepithelial Neoplasia (CIN) in Women Aged Over 65 years S. Zhong, L. Y. Pan. Department of OB/Gyn, Peiking Union Medical College Hospital, Beijing, China OBJECTIVE: To evaluate clinical characteristics of cervical intraepithelial neoplasia (CIN) in women over 65 years. METHODS: From July 2002 to December 2011, 51 postmenopausal women over 65 years with CIN were admitted to our hospital. The diagnosis and treatment were summarized in this retrospective analysis, and CIN related literature was reviewed. RESULTS: Thirty-one patients had colposcopy and punch biopsy. Squamo-columnar junction (SCJ) CIN was found in 18 patients (58.1%). Among 21 patients who had conization after biopsy, CIN diagnosis was missed by biopsy in nine patients (four had SCJ CIN and five had non-SCJ CIN). In all patients, 26 had conization and 20 had hysterectomy directly. Fourteen patients had hysterectomy after conization, and among them four were diagnosed CINII-III with negative margin and three CINII-III with positive margin. CONCLUSIONS AND DISCUSSION: For women over 65 years, it is important to evaluate for SCJ through colpscopy or direct punch biopsy. It is better to do conization if possible. Patients with conization specimen diagnosed CINII-III and negative margin needn’t subsequent hysterectomy. Patients with positive margin but with bad general conditions or complications can continue to be monitored if they have good follow-up. If patients are diagnosed as carcinoma by conization, total hysterectomy or radical hysterectomy is recommended.

P91 Effect of Propofol or Sevoflurane on the Quality of Neuromuscular Blockade with Cisatracurium During Comparable Depth of Anesthesia in Elderly Patients J. J. Shao, L. L€ u, Z. H. Ren, J. Y. L€ u. Department of Anesthesia, Dongyang People’s Hospital Affiliated to Wenzhou Medical College, Dongyang, China OBJECTIVE: To evaluate effect of propofol or sevoflurane on quality of neuromuscular blockade with cisatracurium at comparable depth of anesthesia in elderly patients. METHODS: A total of 70 elderly patients [classified as American Society of Anesthesiologists (ASA) physical status I–II] were included in this study. Patients were randomized into two groups: propofol group (induction of anesthesia with propofol) and sevoflurane group (n = 35, each). Neuromuscular blocking effect was monitored by muscle response to ulnar nerve stimulation. Rates of cisatracurium injection at different time points, time of loss of consciousness and the onset time of cisatracurium neuromuscular block were compared between the two groups. RESULTS: The rate of cisatracurium injection significantly decreased after 60 min in sevoflurane group, and the onset time of cisatracurium neuromuscular block was significantly shorter in sevoflurane group than in propofol group (p < 0.05). CONCLUSIONS: Compared with propofol, sevoflurane can shorten the onset time of cisatracurium and enhance the effect of cisatracurium neuromuscular block with stable hemodynamics.

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Interphalangeal Joint Replacement Arthroplasty for the Treatment of Traumatic Arthritis in Elderly Patients H. Luo, Q. J. Pang. Department of orthopedics, Ningbo Second Hospital, Ningbo, China

Relationship Between Osteoporosis and Chronic Vascular Complications in Elderly Male Patients with Type 2 Diabetes F. Cheng, M. Zhao, K. Kang. Department of Endocrinology, Beijing ShiJiTan Hospital, Capital Medical University, Beijing, China

OBJECTIVE: To examine clinical effects and surgical technique of interphalangeal joint replacement arthroplasty for the treatment of traumatic arthritis. METHODS: From March 2005 to December 2010, five elderly patients with post-traumatic arthritis underwent interphalangeal joint replacement arthroplasty in our hospital. Operation indications, intraoperative flexor and extensor tendon lesion treatment and postoperative rehabilitation were evaluated. RESULTS: Operative incisions of five cases were primary healing in class I grade A. Stitches were taken out 2 weeks after the operation. Patients were followed up for 1.5 years. The range of interphalangeal joint motion was 0–90° (extension/flexion) with no pain at end of follow-up. The hand function of patients was excellent in three cases and good in two cases according to total active motion (TAM) hand function evaluation. CONCLUSIONS: Interphalangeal joint replacement arthroplasty is an effective treatment for traumatic arthritis. Preoperative evaluation for indication and postoperative rehabilitation should be focused on in the treatment.

P93 Analysis of Clinical Efficacy of Single Span Video-Assisted Thoracoscope Surgery for Spontaneous Pneumothorax in Elderly Patients X. Y. Zhang, J. M. Ye, X. R. Bao. Department of Thoracic surgery, Jinhua People’s Hospital of Zhejiang Province, Jinhua, China OBJECTIVE: To compare clinical efficacy of single span video-assisted thoracoscope (VATS) surgery and traditional VATS surgery for spontaneous pneumothorax in elderly patients. METHODS: A total of 88 elderly patients diagnosed with spontaneous pneumothorax by chest X-ray and CT were selected and randomly divided into single span VATS group and traditional VATS group (n = 44, each group). Blood loss, duration of operation, hospitalization, time of postoperative analgesic use, chest tube indwelling time, postoperative complications and adverse reactions were evaluated. All patients were follow-up for 1–2 years to record the recurrence and mortality. RESULTS: VATS surgery was completed successfully in all patients. Their clinical symptoms resolved and resolution of pneumothorax was confirmed by chest X-ray. There were significant differences in blood loss, time of postoperative analgesic use, hospitalization between single span VATS group and traditional VATS group [(16.7  10.2) vs (46.7  18.8) ml, (1.7  0.9) vs (2.4  1.7) day, (6.3  1.7) vs (9.1  2.1) day, respectively, all p < 0.05]. The duration of operation and chest tube indwelling time were shorter in single span VATS group than in traditional VATS group (both p < 0.05). Number of patients with chest pain and incision numbness after operation were less in single span VATS group than in traditional VATS group (11 cases vs 26 cases, seven cases vs 21 cases, both p < 0.05). There were no significant differences in recurrence rate or mortality between the two groups. CONCLUSIONS: Single span VATS surgery is a safe and effective treatment for spontaneous pneumothorax in elderly patients with better postoperative recovery and fewer adverse reactions.

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OBJECTIVE: To explore the relationship between osteoporosis and chronic vascular complications in elderly male patients with type 2 diabetes and to evaluate its related risk factors. METHODS: A retrospective study was conducted in 428 elderly type 2 diabetic patients. The bone mineral density (BMD) of lumbar spines (L2–L4), femoral neck, Ward’s triangle were measured by dual X-ray absorptiometry, and chronic vascular complications in patients were evaluated. The correlation between BMD and chronic vascular complications were analyzed. RESULTS: Diabetic history was longer in osteoporosis group than in non-osteoporosis group (p < 0.05). Levels of fasting blood glucose (FBG) and postprandial blood glucose (PBG) were significantly higher in osteoporosis group than in non-osteoporosis group (p < 0.05). Prevalence of diabetic nephropathy, diabetic retinopathy, diabetic neuropathy and hypertension was significantly higher in osteoporosis group than in non-osteoporosis group (59.8% vs 12.0%, 41.8% vs 22.3%, 33.6% vs 24.5%, and 35.7% vs 26.1%, respectively, all p < 0.05). Logistic analysis showed that diabetic course, FBG and diabetic nephropathy were significantly correlated with diabetic osteoporosis (OR = 1.055, 1.168, 7.401, 95% CI: 1.015–1.096, 1.073–1.273, 4.303–12.727, p = 0.007, 0.001, 0.001 respectively). CONCLUSIONS: Osteoporosis is associated with diabetic microvascular complications in elderly diabetic male patients. Diabetic nephropathy may play an important role in the development of osteoporosis in these elderly patients.

P95 Expression and Clinical Significance of Oct4 in Prostate Cancer M. J. Jiang, M. F. Wan, L. Feng, J. H. Mei, Z. L. Hong. Department of Urinary Surgery, First People’s Hospital of TongLu, Tonglu, China OBJECTIVE: To evaluate Oct4 expression in prostate cancer and clinical relevance. METHODS: Oct4 mRNA expression levels in two normal prostate (NP) samples and eight prostate cancer (PCa) samples were determined by reverse transcription polymerase chain reaction (RT-PCR) analysis. Oct4 protein expression levels in 10 NP samples, 10 benign prostate hyperplasia (BPH) samples and 45 PCa samples were detected by immunohisochemical analysis. RESULTS: Relative expression levels of Oct4 mRNA were 0.91, 0.76, 0.66, 0.63, 0.55, 0.50, 0.48, 0.42 in eight Pca samples and 0 in 2 NP samples, respectively. The positive rates of Oct4 protein expression was higher in Pca tissues than in NP and BPH tissues (91.1% vs 0%, 91.1% vs 0%, respectively, both p < 0.05). Higher levels of Oct4 protein were correlated with worse histological grade and more advanced clinical stage of prostate cancer. The strong positive rates of Oct4 expression were 72.7% and 30.0% in Pca tissues with and without lymph node metastasis, respectively (p < 0.05). CONCLUSION: Differential expression of Oct4 expression among PCa, NP and BPH tissues suggests potential self-renewal and differentiation of tumor cells in the PCa tissues. Oct4 expression was closely related to the differentiation and invasion of tumor. Oct4 might be an important index for prognosis of prostate cancer.

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P96 Efficacy Analysis of Ezetimibe on Lipid Management in Elderly Patients with Coronary Heart Disease after Coronary Intervention M. Q. Duan, G. R. Huang, X. J. Xu, X. C. Cao, Y. S. Huang. Department of Geriatric Cardiology, Henan Provincial People’s Hospital, Zhengzhou, China OBJECTIVE: To evaluate clinical efficacy of ezetimibe combined with atorvastatin calcium on hyperlipidemia and lipid management in elderly patients with coronary heart disease (CHD) after coronary intervention. METHODS: A total of 150 elderly CHD patients with hyperlipidemia undergoing coronary intervention in our hospital were included in this study. Patients were randomly divided into control and study groups (n = 75, each group). Patients in control group were treated with atorvastatin calcium tablets and patients in the experimental group were treated with ezetimibe tablets combined with atorvastatin calcium tablets. Cholesterol levels and adverse reactions were monitored and compared between the two groups 1 month after the treatment. RESULTS: Patients with normal total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL-C) were much more in the study group than in the control group after treatment [68 cases (90.7%) vs 50 cases (66.7%), 62 cases (82.7%) vs 44 cases (58.7%), 56 cases (74.7%) vs 38 cases (50.7%), v2 = 12.87, 10.42, 9.23, respectively, all p < 0.01]. There was no significant difference in rates of adverse reactions between the two groups [5.3% (four case) vs 2.7% (two cases)]. CONCLUSIONS: Compared with atorvastatin calcium treatment, ezetimibe combined with atorvastatin calcium treatment has a better clinical efficacy on hyperlipidemia with no increase in adverse reactions in elderly CHD patients.

P97 Utility of Neuropsychological Scales and Single-Item Tools in the Diagnosis of Mild Cognitive Impairment X. Z. Liang, Y. B. Wu, J. Shi, Y. Teng, J. Z. Tian. Graduate Team, Chinese PLA Medical School, Beijing, China OBJECTIVE: To evaluate the utility of neuropsychological single-item scales in the diagnosis of mild cognitive impairment (MCI) and Alzheimer′s disease (AD). METHODS: A total of 676 elderly people living in Dongzhimen district in Beijing were recruited using multistage sampling method. Cognitive function was assessed by minimum mental state examination (MMSE) and other scales. MCI was diagnosed based on the criteria proposed by Petersen (1999), and AD was diagnosed based on the NINCDS-ADRDA published by McKhann et al. (1984). Subjects were divided into normal cognitive (NC) group (n = 213, 31.5%), Alzheimer′s disease (AD) group (n = 167, 24.7%), amnestic mild cognitive impairment (aMCI) group (n = 186, 27.5%) and non-AD dementia group (110, 16.3%). RESULTS: The mean MMSE scores in AD, aMCI and NC groups were (23.0  5.9), (25.9  2.6), (8.1  1.7) respectively. There were significant differences in mean MMSE scores between AD, aMCI and NC groups separately (all p < 0.01). Compared with MCI and NC group, mean scores of time orientation, attention, calculation and immediate recall and delayed recall were significantly decreased in AD group (all p < 0.01). Comparing with NC group, mean scores of attention and calculation were decreased in aMCI groups (both p < 0.01). The mean delayed story recall (DSR) scores in AD, aMCI and NC groups were (15.7  11.7), (7.6  4.9), (26.5  9.3) respectively. There were significant differences in mean DSR scores between AD, aMCI and NC groups separately (all p < 0.01). Compared with NC group, the clinical dementia rating (CDR) scores were higher and the mean clock

drawing task (CDT) scores were lower in AD and aMCI groups (both p < 0.01). CONCLUSIONS: Neuropsychological assessment scales such as MMSE and single-item tools such as delayed story recall may be useful in the diagnosis of MCI and AD.

P98 Minimally Invasive Technique with Long Proximal Humeral Locking Plate for Treatment of Osteoporotic Humeral Shaft Fractures in Elderly Patients L. H. Yang, R. Wang, W. Liu, L. K. An, X. C. Kong, J. Li, G. Hong, W. Y. Zhu, Z. C. Guo. Department of Orthopaedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China OBJECTIVE: To evaluate clinical effect of minimally invasive technique with long proximal humeral locking plate for the treatment of osteoporotic middle-proximal humeral shaft fractures. METHODS: From February 2010 to January 2012, a total of 13 patients with osteoporotic middle-proximal humeral shaft fractures were treated with internal fixation by using long proximal humeral locking plate. According to AO/OTA classification, five cases were B type and eight were C type. The operation time and blood loss were recorded. Contralateral and ipsilateral shoulder function was assessed by Constant-Murley shoulder assessment score and percentage of ipsilateral shoulder assessment scores on contralateral shoulder assessment scores was calculated. RESULTS: Mean operative time was (96.1  13.1) min and blood loss was (153.4  45.8) ml. All patients were followed up for (10.5  3.1) months. The mean fracture healing time was (11.7  1.8) weeks. No complications such as hardware displacement, screw loose or pullout, broken nails and necrosis of the humeral head were found. At the last follow-up, the mean rang of motion (ROM) in ipsilateral shoulders was (155.7  9.7) and the average of Constant-Murley scores in ipsilateral shoulders were (81  6.0). The percentage of ipsilateral shoulder assessment scores on contralateral shoulder assessment scores was 89.3  5.8%. Twelve patients had excellent or good shoulder function and one had satisfactory function after treatment. CONCLUSION: Internal fixation using long proximal humeral locking plate can provide stable fixation with minimal invasion and high rate of fracture repair, and has advantage in early functional exercise for the treatment of osteoporotic middle-proximal humeral shaft fractures.

P99 A Survey of Statins Application and Correlation Factor Analysis in Elderly Patients with Ischemic Stroke Y. Yang, X. M. Huang, L. Cheng, X. P. Chen, F. Li. Shanghai Yangpu District Jiangpu Community Primary Healthcare Center, Shanghai, China OBJECTIVE: To investigate the clinical application of statins for secondary prevention and correlation factor analysis in patients with ischemic stroke. METHODS: A total of 300 patients with ischemic stroke were divided into statins group (n = 91) and control group (n = 209) according to whether receiving statins. Serum lipid parameters, liver and kidney function, carotid artery intima-media thickness (IMT) and plaque area were compared between the two groups. RESULTS: In 209 patients not taking statins, 68 cases (32.5%) were not advised by physicians; 55 cases (27.8%) were reluctant to take statins for fear of adverse reactions; 77 cases (36.8%) were discontinued stains when serum lipids were normal; three cases (1.4%) developed skin allergic reaction and the skin

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rash disappeared after stains was discontinued; three cases (1.4%) had elevated liver enzyme levels which was resolved after stain discontinued. The levels of total cholesterol (TC), triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C) were significantly lower in statin group than in control group [(4.93  0.45) vs (5.87  0.38) mmol/L, (1.68  0.61) vs (2.01  0.58) mmol/L, (2.49  0.57) vs (3.76  0.44) mmol/L, t = 18.60, 4.46, 20.94, p = 0.0001, 0.007, 0.0001, respectively]. High-density lipoprotein (HDL) level was significantly higher in stain group than in control group [(1.36  0.31) vs (1.03  0.25) mmol/L, t = 9.75, p = 0.001]. There were no significant differences in liver and kidney function parameters such as alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, serum total bilirubin, direct bilirubin, indirect bilirubin, glutamyl transferase, blood urea nitrogen and serum creatinine between the two groups. Carotid IMT and carotid atherosclerotic plaque area were significantly lower in stain group than in control group [(1.62  0.23) vs (1.74  0.31) mm, (0.57  0.12) vs (0.65  0.18) cm2, p = 0.008, 0.002, respectively]. CONCLUSION: In this study, many patients with ischemic stroke are still not taking statins for secondary prevention. Statins can significantly improve blood lipid levels and carotid arteriosclerosis status with minimal adverse reactions.

P100 Relative Performance of the CKD-EPI Equation and MDRD Equations for Estimation of Glomerular Filtration Rate (GFR) in the Elderly: A Systemic Review and Meta-Analysis X. S. Ye, W. H. Zhao. Division of Nephrology, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China BACKGROUND: Various studies of elderly people reveal that the prevalence of chronic kidney disease was influenced by the method used to estimate the glomerular rate. We performed the systemic review and meta-analysis to evaluate the performance of glomerular filtration rate (eGFR) calculated by MDRD and CKDEPI equations in the elderly in contrast to a standard reference material. METHODS: Studies were assessed in PUBMED by a systematic search, with no language restriction, between 5 May 2009 and 2 October 2012. We also performed an update search in 31 December 2012. The studies were selected by the title and abstract review first, and then the full-text review, and a detailed evaluation eventually. Quality of included studies was accessed by a version of QUADAS. RESULTS: A total number of 509 articles were retrieved, but only eleven were finally included with an identified population or subpopulation aged 60 or older. The linear correlation analysis revealed that the GFR estimated by CKD-EPI equation correlate closer with the mGFR than the MDRD equation. The area under the ROC curves (at GFR cut-off values of 60 ml/min/1.73 m2) of CKD-EPI equation, which represents diagnostic accuracy, was higher than that of the MDRD equation. And the bias of the CKD-EPI equation was significantly less than that of the MDRD equation both in the elderly [ 1.08 (95%CI 2.07, 0.08), p = 0.03] and in the very old [ 2.05 (95%CI 3.53, 0.57), p = 0.007], while no significant differences of p30 were found neither in the elderly [0.32 (95%CI 2.52, 3.16)] nor in the very old [1.96 (95%CI 4.80, 8.72)]. CONCLUSIONS: Although no sufficient evidence proved the CKD-EPI equation to be optimal in the elderly, the CKD-EPI equation did show some extent advantages than the MDRD equation. The CKD-EPI equation could be recommended in the clinical routine in the elderly.

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P101 Effects of Human Umbilical Cord Mesenchymal Stem Cell Therapy on CD61, CD62P and CD54 in Elderly Patients with Old Myocardial Infarction X. Li, Y. Guo, Y. D. Hu, Y. Chen, D. X. Guo, H. L. Zhou, H. C. Yang, X. Li. Department of Geriatrics, Huaian Hospital Affiliated to Xuzhou Medical College, Huaian, China OBJECTIVE: To investigate effects of human umbilical cord mesenchymal stem cells (hUCM-SCs) therapy on peripheral blood CD61, CD62P and CD54 in elderly patients with old myocardial infarction. METHODS: From July 2010 to August 2012, 30 elderly patients (mean age 85.9  4.23 years) with old myocardial infarction were randomly recruited. Patients were divided into control group (n = 15, treated with percutaneous coronary intervention (PCI) and stent implantation) and the study group (n = 15, treated with PCI, stent implantation and hUC-MSCs transplantation). Peripheral blood CD61, CD62P and CD54 expression was measured by flow cytometry. Correlations between their expression levels and infarct size, left ventricular ejection fraction (LVEF) were evaluated. RESULTS: After 8 weeks of treatment, there were significant differences in infarct size and LVEF between the control group and the experimental group [(26.6  3.4)% vs (24.2  3.9)%, (38.4  2.8)% vs (47.3  4.1)%, respectively, both p < 0.05]. The CD61 level was significantly higher in the experimental group than in the control group [(28.3  0.9)% vs (23. 6  0.6)%, p < 0.05]. The levels of CD62P and CD54 were significantly lower in the study group than in the control group [(10.5  1.2)% vs (14.2  2.8)%, (11.2  0.8)% vs (15.3  1.3)%, respectively, both p < 0.05]. CONCLUSIONS: The changes in CD61, CD62P, and CD54 expression are correlated with decrease of myocardial infarction size and improvement of LVEF in elderly patients with old myocardial infarction.

P102 Effects of Three Antihypertensive Drugs on Plasma Adiponection and Retinol Binding Protein 4 in Elderly Patients with Essential Hypertension (HTN) P. Cao, D. Sheng, Y. Zhong, R. Li. Department of Geriatrics, Zhongnan Hospitial, Wuhan University, Wuhan, China OBJECTIVE: To evaluate the effects of amlodipine, perindopril and valsartan on plasma adiponectin and retinol binding protein 4 in elderly patients with HTN. METHODS: Elderly patients with HTN (n = 238) were recruited and 193 cases completed this study. Patients were randomly divided into three groups: amlodipine group (n = 68), perindopril group (n = 60) and valsartan group (n = 65). Patients in each group were treated with amlodipine, perindopril and valsartan respectively for at least 12 weeks. Changes in blood pressure, heart rate, body height, body mass index (BMI), abdominal circumference, waist circumference (WC), lipid levels, as well as plasma adiponection and retinol binding protein 4 concentrations were evaluated before and after treatment. RESULTS: Compared with pre-treatment measurement, systolic blood pressure in three groups was significantly decreased after treatment (all p < 0.01). There were no significant differences in blood pressure between groups after treatment. Compared with before treatment, plasma adiponectin level was significantly increased in perindopril group and valsartan group after treatment [(7.4  1.8) vs (8.3  1.8) lg/L, (7.5  1.7) vs (8.4  1.9) lg/L, respectively, both p < 0.01]. Plasma adiponectin levels were higher

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in perindopril group and valsartan group than in amlodipine group after treatment [(8.3  1.8) vs (7.6  1.8) lg/L, (8.4  1.9) vs (7.6  1.8) lg/L, respectively, both p < 0.05]. Compared with before treatment, plasma retinol binding protein 4 level in three groups were all decreased after treatment, and the decreases had significant differences in perindopril group and valsartan group (both p < 0.01) but had no differences in amlodipine group. Plasma adiponectin retinol binding protein 4 level were lower in perindopril group and valsartan group than in amlodipine group after treatment [(36.6  14.2) vs (42.7  13.8) lg/L, (36.3  14.1) vs (42.7  13.8) lg/L, respectively, both p < 0.01], and there was no significant difference between perindopril group and valsartan group. CONCLUSIONS: Perindopril and valsartan may offer cardiovascular protection beyond antihypertensive effects by increasing plasma adiponection and decreasing retinol binding protein 4 in elderly patients with hypertension.

P103 Effect of Diabetes on Short-Term Prognosis of Transient Ischemic Attack in Elderly Patients P. Y. Zhan, L. H. Zhang, W. P. Xu, P. Jing. Department of Neurology, Central Hospital of Wuhan, Wuhan, China OBJECTIVE: To investigate the effect of diabetes on shortterm prognosis of transient ischemic attack (TIA) in elderly patients. METHODS: From January 2006 to June 2010, 126 patients with TIA aged over 60 years were recruited. Patients were divided into diabetic group and non-diabetic group according to past history, blood glucose and glycosylated hemoglobin levels. The cumulative ischemic stroke incidences were analyzed by Kaplan–Meier survival analysis 30 and 90 days after the first TIA respectively. The risk factors for short-term stroke after TIA were analyzed by Cox regression analysis. RESULTS: Among 126 patients with TIA, 31 cases (24.6%) had diabetes. The cumulative ischemic stroke incidences were significantly higher in diabetic group than in non-diabetic group 30 and 90 days after the first TIA respectively (54.8% vs 22.1%, 61.3% vs 28.4%, both p < 0.01). Cox regression analysis revealed that diabetes and cerebral arterial stenosis were significant risk factors for recurrent stroke within 90 days. CONCLUSIONS: The short-term stroke incidence is significantly higher in elderly diabetic patients than in elderly non-diabetic patients. Diabetes is an independent risk factor for recurrent stroke after TIA. The short-term prognosis of TIA can be improved by preventing diabetes.

P104 Clinical and Pathological Study of Wegener’s Granulomatosis in Middle-Aged and Elderly Patients F. Fang, X. B. Qiao, C. Pu, J. X. Pang, D. G. Liu. Department of Pathology, Beijing Hospital of Ministry of Health, Beijing, China OBJECTIVE: To study the clinical and pathological features of Wegener’s granulomatosis (WG) in middle-aged and elderly patients. METHODS: From February 1999 to July 2012, 21 patients with WG (11 males, 10 females, aged 45–76 years, mean age 58.1 years) were recruited. Clinical and pathological data were retrospectively analyzed. Biopsies (n = 34) including two autopsies from different organs were paraffin embedded and stained by hematoxylin and eosin and histochemistry. Renal biopsies (n = 13) were all examined by immunofluorescence and electron microscope.

RESULTS: The average time from the onset of clinical symptoms to diagnosis was 5.3 months (from 24 days to 11.0 months). Eyes, nose and salivary glands were the most commonly involved parts at the beginning of Wegener’s granulomatosis (52.4%, 11 cases). The percentages of the skin, lung and renal involvement were 14.3% (three cases), 81.0% (17 cases) and 71.4% (15 cases) respectively. Among 21 patients, 18 patients were examined antineutrophil cytoplasmic antibody (ANCA). c-ANCA was positive in 72.2% patients (13 cases, 13/18), pANCA was positive in 16. Seven percent patients (three cases, 3/ 18), and ANCA was negative in 11.1% patients (two cases, 2/18). Three major pathological manifestations were observed: seven kinds of vasculitis, including capillaritis, acute vasculitis, chronic vasculitis, fibrinoid necrosis in vasculitis, necrotizing granulomatous vasculitis, non-necrotizing granulomatous vasculitis and cicatricial vascular changes; four kinds of granulomatous inflammation, including scattered giant cells, palisading histiocytes, poorly formed granulomas and microabscess surrounded by granulomatous inflammation; two kinds of parenchymal necrosis, including geographic necrosis and microabscess. Many histopathologic features in three major manifestations were found from two autopsies, but various kinds histopathologic features presented in small biopsy samples. Rare manifestations such as diffuse pulmonary hemorrhage were found at the periphery of WG. CONCLUSIONS: The wide variation and broad spectrum of pathologic features can occur in WG. Vasculitis, granulomatous inflammation and parenchymal necrosis are the most important histopathological features. Careful correlation of pathology with complicated clinical features is required to achieve accurate diagnosis of WG.

P105 Clinical Research of Pulse Wave Velocity and Arterial Compliance in Elderly Patients with Type 2 Diabetes Mellitus H. Zhang, H. Y. Zhang, J. Qiu, Y. Wang, C. M. Liu, Y. H. Chu, R. X. Zhou, Y. Zhang, H. Q. Gao. Department of Geriatrics, Qilu Hospital of Shandong University, Jinan, China OBJECTIVE: To examine clinical characteristics of pulse wave velocity, arterial compliance and cardiovascular risk factors in elderly patients with type 2 diabetes. METHODS: A total of 363 patients were selected and divided into four groups: diabetic group, diabetic- hypertensive group, hypertensive group and healthy control group. Carotid-femoral pulse wave velocity (CF-PWV) was measured by using a validated Complior automatic device. Capacitive arterial compliance (C1) and oscillatory arterial compliance (C2) were measured by using CVProfilor DO-2020. RESULTS: CF-PWV were higher in diabetic group and diabetic-hypertensive group than in healthy control group (t = 3.24, 5.38, p < 0.05, 0.01, respectively). C2 were lower in diabetic group and diabetic-hypertensive group than in healthy control group (t = 6.88, 3.96, p < 0.05, 0.01, respectively). CF-PWV had positive correlations with age, waist to hip ratio, fasting blood glucose (FBG), systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP) and mean artery pressure (MAP) (r = 0.34, 0.13, 0.18, 0.45, 0.13, 0.48, 0.29, all p < 0.05). C2 had negative correlations with age, FBG, SBP, DBP, PP and MAP (r = 0.29, 0.15, 0.35, 0.17, 0.31, 0.28, all p < 0.05), and had a positive correlation with BMI (r = 0.16, p < 0.05). CF-PWV had a negative correlation with C2 (r = 0.19, p < 0.05). CONCLUSIONS: Arterial compliance is impaired in elderly patients with diabetes mellitus, and age, blood glucose and blood pressure are significant risk factors. CF-PWV and C2 measurements are noninvasive and sensitive indicators for abnormalities in arterial compliance in patients with diabetes mellitus.

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P106 Multivariate Logistic Analysis of Post-Operative Severe Complications in Elderly Paients with Gastric Cancer Y. Zhang, Q. Zhang, X. Z. Ye, X. We, H. S. Qiu. Department of Gastrointestinal Surgery, First Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China OBJECTIVE: To determine risk factors of post-operative severe complications in elderly patients with gastric cancer, and to establish the logistic regression discriminant model. METHODS: From January 2006 to June 2011, a total of 236 elderly patients undergoing gastrectomy for gastric carcinoma were retrospectively evaluated in this case–control study. Factors related to post-operative severe complications were analyzed by multivariate logistic regression analysis. RESULTS: Younger age was associated with less post-operative complications [No complication group vs complication group: (72.9  5.8) vs (80.6  6.7) years, t = 9.194, p < 0.0001]. Higher levels of hemoglobin and albumin were associated with less postoperative complications (109.94  18.72) vs (98.75  18.82) g/L, (38.37  5.52) vs (33.69  3.35) g/L, t = 4.391, 7.080, respectively, both p < 0.0001] Operation time was shorter in patients without post-operative complications than in patients with post-operative complications [(3.1  1.0) vs (3.6  1.1) hours, t = 3.507, p = 0.001)]. Intraoperative blood transfusion volume was less in patients without post-operative complications than in patients with post-operative complications [(2.5  4.4) vs (2.8  5.5) L, t = 4.901, p < 0.0001)]. The long diameter of tumor was shorter in patients without post-operative complications than in patients with post-operative complications [(4.5  2.8) vs (5.3  2.7) cm, t = 2.111, p < 0.04)]. Logistic regression analysis revealed that chronic obstructive pulmonary disease (COPD), serum albumin level, age, operation time and blood transfusion volume were associated with postoperative severe complications. CONCLUSIONS: COPD, operation time, blood transfusion volume, serum albumin level and age are significant independent risk factors for post-operative severe complications in elderly patients with gastric cancer.

P107 Clinical Efficacy of Mucosolvan on Acute Stroke-Associated Pneumonia Y. Zhang, J. C. He, A. M. Xing, L. Y. Li. Department of Respiratory, Tianjin 4th Centre Hospital, Tianjin Medical University, Tianjin, China OBJECTIVE: To evaluate effects of mucosolvan on acute stroke-associated pneumonia (SAP). METHODS: From July 2011 to December 2012, a total of 82 patients with SAP admitted to our hospital were selected and randomly divided into mucosolvan group (n = 43, treated with mucosolvan in combination with antibiotic therapy) and control group (n = 39, treated with antibiotic therapy). Defervescence time, duration of hospitalization and antibiotic use, C-reactive protein (CRP) level, oxygen pressure, effective bacterial clearance rates were compared between the two groups. RESULTS: Defervescence time and duration of hospitalization and antibiotic use were shorter in mucosolvan group than in control group [(3.1  0.8) vs (3.8  1.1) day, (11.7  3.7) vs (13.6  4.9) day, (5.4  1.7) vs (6.6  2.1) day, t = 18.60, 22.80, 23.50, p = 0.014, 0.008, 0.011, respectively]. Bacterial clearance rate and the total effective rate were higher in mucosolvan group than in control group [90.7% vs 74.4%, 93.0% vs 74.4%, v2 = 3.86, 5.34, p = 0.05, 0.02, respectively]. There were no significant differences in changes in CRP level and blood oxygen partial pressure between two groups before and after treatment.

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CONCLUSIONS: Mucosolvan is an effective treatment for pneumonia associated with acute stroke, which can remove bacteria effectively and shorten the duration of antibiotic use and recovery.

P108 Evaluation of the Efficacy of Rosuvastatin Calcium in Elderly Patients with Hyperlipidemia and Hypertension (HTN) F. Y. Shou, Z. H. Zhao, F. F. Yang, H. M. Wang, L. Y. Hu. Shaoxing People’s Hospital, Shaoxing, China OBJECTIVE: To evaluate the efficacy of rosuvastatin calcium in elderly patients with hyperlipidemia and HTN. METHODS: From March 2011 to June 2012, 112 elderly patients with hyperlipidemia and HTN were enrolled into this study. They were randomly divided into treatment group and control group (n = 56, each group). Patients in control group were treated with oral amlodipine 5 mg/d. Patients in treatment group were treated with oral rosuvastain 10 mg/d and oral amlodipine 5 mg/d. One month after the treatment, the levels of blood pressure, total cholesterol (TC), tryglyceride (TG), low-density liporotein cholesyerol (LDL-C), high-density lipoprotein (HDL-C), highsensitivity C-reactive protein (hsCRP) were determined. The occurrence of adverse effects was observed. RESULTS: One month after treatment, systolic blood pressure and diastolic blood pressure were decreased significantly in both two groups compared with before treatment [control group: (135.2  9.51) vs (59.2  7.3) mmHg, (88.8  5.2) vs (99.5  8.3) mmHg, t = 4.95, 2.87, respectively, both p < 0.01; treatment group: (130.2  5.5) vs (160.3  9.3) mmHg, (86.7  10.2) vs (99.7  8.3) mmHg, t = 5.03, 2.94, respectively, both p < 0.01), but more declines were observed in treatment group than in control group (t = 3.96, 3.42 respectively, both p < 0.001). The levels of LDL-C, TG and TC were significantly decreased in both two groups compared with before treatment [control group: (2.64  0.72) vs (3.97  0.84) mmol/L, (1.89  0.25) vs (2.56  0.45) mmol/L, (4.23  0.56) vs (7.36  0.48) mmol/L, t = 2.58, 3.03, 2.36, p = 0.013, 0.004, 0.022, respectively; treatment group: (1.75  0.68) vs (3.85  0.79) mmol/L, (1.71  0.18) vs (2.63  0.42) mmol/L, (3.18  0.47) vs (7.20  0.56) mmol/L, t = 2.77, 3.16, 2.59, p = 0.008, 0.003, 0.012, respectively), but more declines were observed in treatment group than in control group (t = 6.73, 4.37, 10.70 respectively, all p < 0.05). The HDL-C concentration were increased in both two groups compared with before treatment [control group: (0.97  0.26) vs (0.75  0.31) mmol/L, t = 2.89, p = 0.006; treatment group: (1.09  0.23) vs (0.72  0.24) mmol/L, t = 3.01, p = 0.004], but more increases were observed in treatment group than in control group (t = 2.59, p < 0.05). The hsCRP concentration was significantly decreased in treatment group compared with before treatment [(1.32  0.17) vs (4.97  0.13) mg/L, t = 4.40, p < 0.001]. There were no significant differences in liver and kidney function between the two groups. Serious adverse effects were not observed. CONCLUSIONS: Rosuvastatin calcium combined with routine therapy can effectively lower the levels of serum LDL-C, TG, hsCRP and increase serum HDL-C concentration. Blood pressure can also be effectively controlled by this therapy.

P109 Analysis of International Literatures on Geriatrics and Gerontology from Mainland China B. Y. Zhou, C. B. Duan, J. Shi, X. Tan, P. L. Yu. Department of Editorial, Beijing Hospital, Ministry of Health, Beijing, China OBJECTIVE: To evaluate international literatures on geriatrics and gerontology from mainland China.

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METHODS: Research articles on geriatrics and gerontology written by scholars in mainland Chinese as first authors were selected from Thomson Scientific database in 1979–2011 period. Researches on basic research, summary reports of clinical practice, and scientific reviews were collected. The quantity of published articles, article types, international cooperation research and funding programs, hospital rankings, as well as the 2011 geriatrics professional journals, thesis topic disciplines distribution analysis and high-performance papers were analyzed by Thomson Data Analyzer software. RESULTS: From 1979 to 2011, a total of 1927 articles were written by Chinese scholars as the lead authors (not including Hong Kong, Macao and Taiwan regions) including 1769 research articles, 86 reviews, 18 editorials, 54 letters. Average paper was cited 7.63 times and the average number of citation were 30.6. International cooperation research articles were 379 (19.7%). Articles with research sponsorship were 734 (38.1%), most of which were geriatric and gerontology. CONCLUSIONS: The development of geriatric medicine in China is rapid. Its international scientific and technological cooperation grows fast. It is important to further promote such research collaboration, leading the development of aging research in China to the next level that is systematic, cooperative, comprehensive, interdisciplinary, and interagency. Large prospective, multicenter, and cooperative studies should be organized. English version of Chinese journals of geriatrics should be established in order to increase their international influence.

P110 Effects of Lentiviral-Mediated p38 Mitogen-Activated Protein Kinase Short Hair-Pin RNA on Cardiac Function after Myocardial Infarction in Aldosterone Overload Rats Y. Zhou, J. Wei, Y. H. Liang, J. Chen, Q. Z. Tang. Deparment of Cardiology, Renmin Hospital, Wuhan University, Wuhan, China OBJECTIVE: To investigate the effects of p38 mitogen-activated protein kinase (MAPK) short hair RNA (shRNA) delivered by lentiviral vectors (pGLV) on cardiac function after myocardial infarction (MI) in aldosterone overload rats and to explore the mechanism. METHODS: Aldosterone overload rat myocardial infarction model was obtained by ligating the left anterior descending coronary artery. The pGLV-shRNA was constructed, sequenced and injected into rats via tail vein. Rats were divided into three groups: pGLV-shRNA group (n = 6), pGLV-shRNA-NC group (n = 6, contained a nonsense shRNA) and the sham-operation group (n = 6). Cardiac function was measured by cardiac ultrasound. Apoptosis was assessed by transferase (TdT)-mediated biotin-16dUTP nick-end labeling (TUNEL). The p38 MAPK mRNA expression was analyzed by RT-PCR. The protein expressions of p38 MAPK and caspase-3 were detected by Western blot. RESULTS: Compared with the sham-operation group, cardiac systolic function was significantly reduced and myocardial apoptosis index was significantly increased [(31.26  4.45)% vs (15.20  2.18)%, p < 0.01] in pGLV-shRNA-NC group. The mRNA and protein expression of p38MAPK and caspase-3 protein expression were significantly increased in pGLV-shRNA-NC group (all p < 0.01). Compared with pGLV-shRNA-nc group, cardiac function was significantly improved, myocardial cell apoptosis index was reduced [(22.35  3.59)% vs (31.26  4.45)%, p < 0.05], and the mRNA and protein expression of p38MAPK and caspase-3 protein expression were decreased in pGLV-shRNA group (all p < 0.05). CONCLUSIONS: Cardiac dysfunction is associated with p38MAPK-mediated myocardial apoptosis in aldosterone overload MI rats. pGLV-shRNA may inhibit myocyte apoptosis and improve post-MI cardiac function.

P111 Comparison of Arteriosclerosis Severity in Middle-Aged and Elderly Patients with Chronic Kidney Disease H. M. Ye, W. L. Chen, X. F. Dai. Department of Nephrology, Taizhou Hospital of Zhejiang Province, Taizhou, China OBJECTIVE: To compare the degree of atherosclerosis in middle-aged and elderly patients with chronic kidney disease (CKD), and to explore the relationship between serum inflammatory molecules and atherosclerosis. METHODS: Elderly (n = 87) and middle-aged (n = 64) patients with CKD were selected. Venous blood samples were taken fasting in the morning. Serum levels of interleukin (IL)-18, IL-6, tumor necrosis factor (TNF-a), high-sensitivity C-reactive protein (hs-CRP) were measured by enzyme-linked immunosorbent assay (ELISA) and ankle-brachial pulse wave conduction velocity (baPWV) were measured. RESULTS: Inflammatory molecules such as IL-18, IL-6, TNFa and hs-CRP levels in venous blood were increased with the severity of CKD in both two groups, and the levels of inflammatory molecules were significantly higher in elderly group than in middleaged group. There was a significant difference in the number of patients with baPWV > 1400 cm/s between elderly group and middle-aged group [30 cases (34.5%) vs 11 cases (17.2%), v2 = 5.58, p < 0.05]. The ratio of PWV > 1400 cm/s in patients with hyperlipidemia and hypertension was significantly higher than in patients with diabetes or heart disease (elderly group: 100%, 100% vs 45.5%, 40%, respectively; middle-aged group: 80%, 100% vs 28.6%, 33.3%, respectively; p < 0.05). Levels of IL-18, IL-6, TNF-a and hs-CRP were significantly higher in patients with baPWV > 1400 cm/s than in patients with baPWV 0.05). (2) Histopathological examination showed no characteristic AD senile plaques in brains of rats in the experimental group. Immunohistochemical pathology showed no obvious Ab-42 immu-

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nohistochemical reactions in the blank group, mild Ab-42 immunohistochemical reactions in the control group and significant Ab-42 immunohistochemical reactions in the experimental group. (3) OD values and mRNA expression levels of BACE1 determined by ELISA, Western blot method and fluorescence quantitative RTPCR showed that BACE1 significantly increased in the experimental group as compared to the levels in the control group and the blank group (p < 0.01), and no statistical difference was found between the control group and the blank group. CONCLUSIONS: The significant increase of BACE1 expression in cerebral tissue of IR rats indicates that IR results in excessive deposition of Ab by up-regulating BACE1 expression. This is possibly one of the action mechanisms of IR participating in pathogenesis of AD.

P122 Development of an Aspirin Resistance Incident Prediction Model for Old Patients with Chronic Coronary Heart Disease (CHD) J. Cao, L. G. Gao, L. Fan. The First Geriatric Cardiology Department, Chinese PLA General Hospital, Beijing, China SUPPORTED BY: Military Healthcare Fund of China (12BJZ39) and the clinical fund from Chinese PLA General Hospital (2012FC-TSYS-2019). BACKGROUND: CHD is one of the leading causes of mortality in women and men in the world. Aspirin use for the primary and secondary prevention of coronary heart disease reduces the risk of cardiovascular events. However, it appears that aspirin’s antiplatelet effect may not be uniform in all patients. Clinical aspirin resistance has included patients who, despite being on therapeutic doses of aspirin, experience thrombotic or embolic vascular events. Therefore, it is very important to identify high-risk population who are more likely to develop aspirin resistance and then to conduct interventions at early stage. METHODS: To establish prediction models, 1130 patients with stable angina who take aspirin (75–100 mg) for more than 2 months were included. Platelet aggregation was measured by light transmission aggregometry (LTA) and thrombelastography platelet mapping assay (TEG). And ROC approach of the interviewees to define the best cut point of the model with its sensitivity and specificity was applied. RESULTS: Seven risk factors were included in the model. Risk score was finally set up according to the coefficient B and rank of variables in logistic regression model (logit = exp (B 0 + B1X1 + B2X2 + …+BnXn). Risk model showed good calibration and discriminative power in which Hosmer-Lemeshow test’s p value were >0.05 and the area under the ROC curve were >0.70. Results in our risk score: serum creatinine >110 lmol/L: 1 score; fasting blood glucose >7.0 mmol/L: 1 score; hyperlipidemia: 1 score; number of coronary artery lesion (2 branches: 2 score; ≥3 branches: 4 score); Body mass index: (20–25 kg/m2: 2 score; >25 kg/m2: 4 score); PCI: 2 score; smoking: 3 score. CONCLUSIONS: High levels of serum creatinine, fasting blood glucose and blood lipid, number of coronary artery lesion (2 branches: 2 score, ≥3 branches; 4 score), high body mass index and PCI history are risk factors for aspirin resistance. The incidence prediction model of aspirin resistance is effective to identify highrisk patient population.

P123 Protective Effect of N-Acetylcysteine Against Contrast AgentInduced Renal Injury in Elderly Patients with Coronary Heart Disease (CHD) H. P. Hui,1 K. L. Li,1 Z. B. Li,2 J. J. Wang,2 Q. Q. Meng,1 X. M. Han,1 P. Zhu1. 1. Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China; 2. Department of Cardiology, Chinese PLA General Hospital, Beijing, China OBJECTIVES: To evaluate the protective effect of N-acetylcysteine against contrast agent-induced renal injury in elderly patients with coronary heart disease. METHODS: Elderly patients (n = 182) with CHD undergoing coronary artery angiography were randomized to treatment or control group (n = 91 each). Participants in treatment group took Nacetylcysteine (NAC) orally for 2 days starting from 24 hour before contrast agent administration. Controls took placebo. At 24 hour, 48 hour and 5 days after contrast agent administration, the renal glomerular and tubular function were measured using serum cystatin C, urea nitrogen, creatinine, creatinine clearance rate, urine b2microglobulin, and urine N-acetyl-b-glucosaminidase (NAG). RESULTS: The contrast agents affected renal functions of all patients (p < 0.05). The incidence of contrast agent-induced nephropathy was significantly lower in NAC group than in control group (4/ 92 vs 10/ 90, p < 0.05). 24 hours after contrast administration, the levels of serum cystatin C, urine b2-microglobulin and urine NAG were significantly lower in NAC group than in control group, but the other functional parameters showed no significant difference. At 48 hour, the glomerular and tubular functional parameters in NAC group were all superior to controls (p < 0.05). At 5 days, the treatment group had better iglomerular and tubular functional parameters such as urea nitrogen, creatinine, creatinine clearance rate, urine b2-microglobulin, and urine NAG (p < 0.05), while there was no significant difference in serum cystatin C levels. CONCLUSIONS: N-acetylcysteine offers protection against contrast agent-induced renal injury in elderly patients with coronary heart disease.

P124 Xuezhikang Reduces Arterial Stiffness in Patients with Essential Hypertension (HTN), Independent of Lipid Lowering Effects J. Zheng, P. Ye, L. M. Luo, D. M. Miao, H. M. Wu. Second Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China OBJECTIVE: Increased arterial stiffness occurs early in hypertension and is considered to play an important role in cardiovascular events. Xuezhikang, an extract of Cholestin, contains statin-like components. We hypothesized that Xuezhikang can reduce arterial stiffness in patients with essential hypertension. METHODS: Patients with HTN (n = 100) were prospectively enrolled into Xuezhikang group (1200 mg/day) and placebo group. Physical examination, lipid profiles, high sensitivity C reactive protein (hs-CRP), matrix metalloproteinases-9 (MMP-9), arterial stiffness parameters, including b, Ep, AC, AI and PWVb measured by Echo Tracking technique, were measured at baseline and 6 months after enrollment in all subjects. RESULTS: Ninety patients completed the study. Xuezhikang group (n = 46; mean age 58.4  10.0 years) and placebo group (n = 44; mean age 57.1  10.4 years) had similar clinical characteristics, medications, lipid profiles and arterial stiffness parameters. Levels of b, Ep and PWVb decreased significantly (8.4  3.1 vs 6.8  2.1, p < 0.01; 122.8  43.9 vs 100.7  33.2, p < 0.01; 6.7  1.2 vs 6.1  1.0, p = 0.01) after 6 months treatment of Xuezhikang, while placebo did not show influence on these parameters. There were significant reductions of total cholesterol and LDL cholesterol in Xuezhikang group (5.5  0.7 vs 5.1  0.6, p = 0.01;

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ABSTRACTS 3.4  0.6 vs 2.9  0.5, p = 0.001), but not in placebo group. Xuezhikang therapy also significantly reduced hs-CRP and MMP-9 from baseline [2.1 (0.4–10.0) vs 1.4 (0.3–4.1), p < 0.01; 17.2  2.4 vs 12.7  3.8, p = 0.001], but placebo group didn’t. Of interest, in Xuezhikang group, the improvement of b, Ep and PWVb was significantly correlated with the decrease of hs-CRP or MMP-9 (r = 0.125, p < 0.04; r = 0.297, p < 0.04; r = 0.278, p = 0.03, respectively), but not with their lipid profiles. CONCLUSIONS: In HTN patients, 6-month treatment of Xuezhikang can reduce arterial stiffness. These improvements were independent of lipid lowering. It seems that several statins’ cholesterol-independent effects, such as anti-inflammation and reducing extracellular matrix degeneration, might play a role in improving arterial stiffness in patients with HTN.

P125 Fasudil, a Rho-kinase Inhibitor, Triggers Differentiation of Bone Marrow Mesenchymal Stem Cells into Neuron-like Cells in Rats Y. H. Hu,1 X. Li,1 G. W. Huang,2 J. Z. Wang,1 W. Lu1. 1. Department of Neurology, the Second Hospital of Tianjin Medical University, Tianjin, China; 2. Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China OBJECTIVES: To investigate whether fasudil, a selective Rho kinase inhibitor promotes bone marrow mesenchymal stem cells (BMMSCs) differentiation into neuron-like cells in vitro. METHODS: BMMSCs were harvested from 4 to 6-week-old Sprague Dawley rats, and the 3rd passage cells were pre-induced with 10 ng/ml basic fibroblast growth factor for 24 hours, followed by induction with fasudil. Morphological changes in BMMSCs prior to and following fasudil induction were monitored using inverted phase-contrast microscopy. Growth kinetics and cell cycle analysis of the cultured BMMSCs were evaluated by MTT assays and flow cytometry, respectively. Different haematopoietic and stem cell markers were detected by flow cytometry to identify BMMSCs. Expression of neurocyte-specific markers (neuron-specific enolase (NSE), nestin, neurofilament protein (NF), and glial fibrillary acidic protein (GFAP) following induction was analysed by immunocytochemistry. Significant differences in their expression between the groups were determined using statistical analyses. RESULTS: At 6 hours following fasudil induction, cells were shrunken; refractile; round with long, bipolar, slender processes; and presented the shapes of neuron-like cells. More neuron-like cells were observed at 24 hours, wherein filamentous structures of various shapes appeared to connect the cells in the form of a network. Expressions of NSE, nestin, NF and GFAP in neuron-like cells were positive. Immunopositivity increased with the increase in time period following induction. Notably, the difference between the groups (6, 24, 48 hours) was statistically significant (p < 0.01). CONCLUSIONS: Our study highlights that fasudil efficiently induces BMMSCs differentiation into neuron-like cells in vitro. Fasudil might represent a promising therapeutic perspective by inducing the neuronal differentiation of MSCs, thus laying the foundation for the transplantation BMMSCs in the treatment of CNS damage and neurodegenerative diseases.

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P126 Protective Effect of Bone Morphogenetic Protein 4 (BMP4) on Oxidative Stress Induced Cardiomyocyte Death X. P. Wu,1,2 F. Haugen,2 G. Valen2. 1. The First Division of Cardiovascular Medicine, Chinese PLA General Hospital, Beijing, China; 2. Department of Physiology, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway BACKGROUND: Bone morphogenetic proteins (BMP) may have multiple actions on cardiac cells. The aim of our study is to investigate the effect of BMP4 on oxidative stress -induced cardiomyocyte cell death and the possible signaling pathway. METHODS: All experiments were conducted using the immortalized cardiomyocyte-like HL-1 cells. (1) Oxidative stress was induced by hydrogen peroxide (H2O2). HL-1cells were stimulated with incremental concentrations of H2O2 (10, 50, 100, 200, 300, 400, 500 lmol/L) for 4 hours, and cell viability was evaluated to establish the optimal model of H2O2-induced injury. (2) To study the effect of BMP4 on cell viability, HL-1 cells were seeded on 96-well plates and pretreated for 24 hours with different concentrations of human recombinant BMP4 (0,10, 50, 100 ng/ml) prior to the application of optimal concentrated H2O2 For 4 hours. (3) To define the signalling mechanism downstream to BMP4 effects, proteins were isolated from cells 30 minutes and 24 hours after treatment of BMP4, and subjected to western blotting with antibodies against phosphorylated Smad1/5/8 and the downstream protein-inhibitor of differentiation-1 (ID-1). The western blot analysis expression value was calculated relative to that of actin. Cell viability was detected by using Lactate dehydrogenase (LDH) cytotoxicity detection kit. RESULTS: H2O2 at 300 lmol/L induces 57.8  5.1% death of HL-1 cells, and was selected for further experiments. HL-1 cells pretreated with 100 ng/ml recombinant BMP4 had a significiant reduction of H2O2-mediated cell death (38.4  2.1%, p < 0.05), while the other concentrations did not protect. Western blot analysis showed that BMP4 increased phosphorylation of Smad1/5/8 after 30 minutes incubation, while ID1 protein expression increased after 24 hours. CONCLUSIONS: Recombinant BMP4 protect HL-1 cells from oxidative stress. Smad1/5/8 and ID-1 may be involved in the protective BMP4 signalling pathway.

P127 Influence Factors of Outcomes of Intra-Aortic Balloon Counterpulsation in Elderly Patients X. P. Wu, H. W. Liu, X. N. Zhao, J. Cao, P. Zhu. The Chinese PLA General Hospital, Medical School of PLA, Beijing, China BACKGROUND: Intra-aortic balloon counterpulsation (IABP) is a mechanical cardiac-assist device that is used for cardiac support. There are no published reports about the use of IABP in elderly Chinese patients, especially for those over 80 years old. The aim of this study was to describe the clinical outcomes, influencing factors, and complications in patients ≥80 years and requiring IABP. METHODS: We performed a retrospective study on 134 consecutive patients who received IABP therapy. We defined all patients into elder and younger groups based on age at treatment (≥80 or 10, UA levels were positively associated with CACS in both total (p = 0.001) and female (p = 0.002). As the UA increases in female, the proportion of mixed plaques increased significantly (p = 0.022). After adjusting for other risk factors, UA was the significant predictor of significant stenosis (OR: 1.124, 95% CI (1.101–1.369), p = 0.015), multivessel disease (OR: 1.023, 95% CI (1.001–1.026), p < 0.001) and mixed plaque (OR: 1.002, 95% CI (1.001–1.005), p = 0.013) in female subgroup; in total population, UA was the only strongest risk factor for mixed plaques (OR: 1.223, 95% CI (1.121–1.315), p = 0.035). CONCLUSIONS: UA was predictive of significant stenosis, multivessel disease and mixed plaques in old female subgroup; UA was the strongest risk factor for mixed plaques in total population. However, UA was not an independent risk factor for coronary atherosclerosis in old male subgroup.

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P154 Differential Diagnosis of Parkinson Disease from Multiple System Atrophy: Clinical Diagnosis, MRI and 18F-FDG PET P. Zhao,1,2 B. S. Zhang,2,3 S. Gao4. 1. Department of Neurology, the Second Hospital of Tianjin Medical University, Tianjin, China; 2. Tianjin Neurological Institute, Tianjin, China; 3. Department of Neurology, the General Hospital of Tianjin Medical University, Tianjin, China; 4. Department of Nuclear Medicine, the General Hospital of Tianjin Medical University, Tianjin, China OBJECTIVES: The differential diagnosis between Parkinson’s disease (PD) and multiple system atrophy (MSA) is often difficult at the early disease stages, largely because of the extensive overlap in signs and symptoms of these diseases. In this study, we aimed to characterize the differences in clinical features, MRI abnormality and glucose metabolism on 18F FDG PET for differential diagnosis among PD, MSA-P and MSA-C. METHODS: PD patients (n = 30), 22 MSA-P patients and 28 MSA-C patients underwent MRI, and 20 PD patients, 11 MSA-P patients and 13 MSA-C patients underwent 18F-FDG PET. RESULTS: Clinical data showed that tremor at rest, bradykinesia, and postural instability predominated in PD, MSA-P, and MSAC patients, respectively. MRI findings indicated that putaminal atrophy and hyperintensive rim (T2WI) are characteristic features in MSA-P, and cerebellar atrophy, ‘hot cross bun’ sign and signal increase in the middle cerebellar peduncle are more prominent in MSA-C. The 18F-FDG PET images demonstrated that a reduction in glucose metabolism occurred in parietal area for PD, in bilateral putamen for MSA-P, and in bilateral cerebellum for MSA-C. CONCLUSIONS: This study identifies characteristic features of clinic symptoms, MRI abnormality and glucose metabolism on 18 F-FDG PET, which are indispensable for differential diagnosis among PD, MSA-P, and MSA-C.

P155 Structure-Function Relationship of Chitosan-GraftPolyethyleneimine as Gene Vector L. H. Duan,1,2 Q. J. Zheng,2 D. P. Quan,2 Z. Z. Wu,1 L. G. Chen3. 1. The Second Clinical Medical College of Jinan University, Shenzhen, China; 2. Institute of Polymer Science of Sun Yat–Sen University, Guangzhou, China; 3. School of Medicine of Jinan University, Guangzhou, China BACKGROUND: A gene-based therapy is a new approach for treating neurological disease. The success of gene therapy is mainly dependent on the development of a gene delivery vector. Polyethylenimine (PEI) is regarded to be the most effective cationic polymer for gene delivery. However, efficient PEI of high molecular weight is serious toxic and non-biodegradable. In order to make up of these shortages, CS-g-PEI was simply prepared by reaction between PEI of low molecular weight and periodate-oxidized chitosan (CSO). METHODS: The impact of various experimental factors on grafting degree of PEI was studied to improve the grafting efficiency of PEI and the effects of grafting degree of PEI on transfection efficiency of the CS-g-PEI as gene or siRNA vector. RESULTS: The most appropriate value of molar ratio of reagent is 1:1. The higher degree of aldehyde of chitosan (CS) was, the higher the grafting degree (GD) of PEI was. The GD increased along with decreasing molecular weight value of CS from 120*103 g/mol to 42*103 g/mol or 8.8*103 g/mol. CONCLUSION: Such experimental approach is effective with many factors to be considered.

P156 Age-Associated Changes in the Histology and Ultrastructure of Pyloric Glands M. M. Chen, S. B. Zheng, D. S. Kumar. Department of Geriatrics, Huadong Hospital, Fudan University, Shanghai, China OBJECTIVES: To investigate age-associated changes in the histology and ultrastructure of pyloric glands. METHODS: Sixty subjects with a relatively normal stomach were enrolled, with 20 subjects in the younger group (20–59 years) and 40 subjects in the elderly group (≥60 years). The latter group included 15 subjects aged from 60 to 69, 13 subjects from 70 to 79 and 12 subjects from 80 to 89. Under light microscopy, the histology and morphology of pyloric glands were observed to determine the thickness of the lamina propria and the Ap:Al ratio (Ap: area of the parenchyma, Al: the area of gastric mucosa lamina proprias). The ultrastructure of pyloric gland cells was examined under electron microscope. RESULTS: Among all groups no significant difference in the morphology of pyloric glands was found. Interstitial hyperplasia of the lamina propria and sparse arrangement of pyloric glands were clearly seen in the elderly group. By quantitative estimation, the thickness of the lamina propria in the elderly group was lower than that in the younger group [(630.7  95.8) lm vs (649.8  127.9) lm], but there was no significant difference. The average ratio Ap: Al in the elderly group was significantly lower than that in the younger group [(31.6  5.9)% vs (37.6  6.5)%, p = 0.003]. There was no significant difference in the ultrastructure of pyloric gland cells among each group. The average ratio Am:Ac (Am: the area of mucous granule, Ac: the area of cytoplasm of pyloric gland cell) of the elderly group was significantly lower compared to the younger group [(25.68  4.62)% vs (34.66  4.34) %, p = 0.0001]. It was also significant among all groups. CONCLUSIONS: With aging, the density of pyloric glands gradually decreased, while the connective tissue between the glands increased. The density of mucous granules in pyloric cells associated with mucus secretion is also decreased. Hence, in the elderly, gastric antral mucosa and its functioning glands have deteriorated performance and morphology.

P157 Relationship Between Life Satisfaction and Social Sustain and Coping Style Among Residents in Minhang District M. Q. Wei,1 F. Yu,1 J. Wang,1 X. Y. Qi,2 J. M. Dai2. 1. Minhang Center for Disease Control and Prevention, Shanghai, China; 2. School of Public Health, Fudan University, Shanghai, China OBJECTIVES: To evaluate the residents’ statuses of life satisfaction, social sustain and coping style and their relationship through an investigation in Minhang District and provide evidence for their mental health work. METHODS: By random sampling, residents aged 18 or over were surveyed with The Short Form Version of The Quality of Life Enjoyment and Satisfaction Questionnaire, Social Support Questionnaire and Simplified Coping Style Questionnaire. RESULTS: Among 1440 residents surveyed, the score of life satisfaction was 51.16  6.62, overall social sustain 41.02  7.30, active coping styles 1.57  0.63, and passive coping styles 1.05  0.55. Positive correlations were found between the score of life satisfaction and every domain score of social sustain and coping style. CONCLUSIONS: The statuses of life satisfaction and social sustain were quiet well, but that of coping style was insufficient. More attention should be paid to the subjective support to the residents. Provide them as much health knowledge as possible, and improve their self-efficacy.

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P158 Epidemiological Analysis of 1266 Hip Fracture Patients Y. M. Yin, W. L. Lin, H. M. Shen, S. B. Zheng, S. K. Dewan. Department of Geriatrics, Huadong Hospital, Fudan University, Shanghai, China OBJECTIVES: To evaluate clinical characteristics of patients with hip fractures. METHODS: Data of 1266 patients who were hospitalized for the primary diagnosis of hip fracture at Huadong hospital from January 2008 to December 2012 were analyzed. Variables such as age, sex, cause of fracture, seasonal variation, fracture type, complication, treatment approach, outcome, length of hospital stay and costs were included in the statistical analysis. RESULTS: The mean age of patients with hip fractures was 76.77  12.26 years. The mean age of female patients (78.83  10.20) was significantly higher than male patients (72.60  14.75) (p < 0.001). Most patients were elderly (89.42% of total patients) with a peak in age 80–89 years (42.1%). Male to female ratio was 1:2.01. Hip fracture occurred more frequently in winter. Fall was the leading cause of hip fracture in the elderly group (91.08%). From our study population, incidence of femoral neck, intertrochanteric and femoral head fracture were 48.34%, 51.03% and 0.63% respectively. The average age of intertrochanteric fracture patients (78.69  11.39) was significantly higher than for femoral neck fracture patients (74.77  12.83) (p < 0.001). Majority of patients (1089 or 86%) had undergone surgical treatment. Efficiency of surgery in the younger group (complete or partial recovery) was 100% and in the elderly group it was 98.8%. Inhospital postoperative mortality of the elderly group was 1.2%. The average length of hospital stay for the elderly group (20.5  9.5 days) was longer than that of the younger group (16.9  7.7 days). The average inpatient cost for elderly patients who had undergone surgery (51.6  18.2 thousand RMB) was more than for younger patients (39.8  27.0 thousand RMB), and the inpatient costs increased gradually from 2008 to 2012. CONCLUSIONS: Almost of hip patients were elderly. Fall and osteoporosis were the leading causes of hip fracture. Although for elderly patients with hip fractures, surgical risk is relatively high it remains the treatment of choice. The average length of hospital stay and inpatient cost of elderly patients with hip fractures are longer and higher than those of younger ones which increases the economic burden on society and the patients’ relatives.

P159 Relationship of Glycated Hemoglobin and Left Ventricular Function in Elderly Patients with Type 2 Diabetes Mellitus and Hypertension (HTN) J. Song, M. Zhu. Department of Gereology, Huashan Hospital, Fudan University, Shanghai, China OBJECTIVES: To evaluate relationship between glycated hemoglobin and left ventricular cardiac function in elderly patients with type 2 diabetes mellitus and HTN. METHODS: Elderly patients with type 2 diabetes mellitus and HTN (n = 153, 86 male, 67 female) admitted to our hospital from 2008 to 2013 were included in this study. They were divided into two groups: group I (HbAlc 10) were relatively common, but the prevalence of severe depression (HDRS >17) was only 7.0%. Patients with depressive symptoms were more likely to be female (v2 = 4.01, p = 0.04), have a family history of depression (v2 = 3.87, p = 0.04), and a poor functional status (MMAS, t = 2.18 and p = 0.02; BI, t = 3.74 and p = 0.009). There was a significantly negative relationship between depressive symptoms and functional status (rMMAS = 0.33, rBI = 0.38, respectively, p < 0.01). CONCLUSIONS: Our findings indicate that depressive symptoms occurred in about one third of post stroke patients. Important risk factors found for PSD included gender, family history of depression and functional impairment. There is a negative correlation between depressive symptoms and functional status of these patients.

P169 Current Status of Community Health Management Bases in China S. P. Wang, Y. Bao. School of Medicine, Shanghai Jiao Tong University, Shanghai, China OBJECTIVES: To analyze the satisfaction, reactive, trust of the citizens towards the community health management bases, which were founded by Chinese Medical Association and were in charge of monitoring chronic diseases. METHODS: Questionnaires including the prevalence, awareness rate, management rate, behavior correcting rate, control rate

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and drug intake rate were used as the main method in our work and were delivered and finished by professional staff of the bases. RESULTS: A total of 1,189,456 individuals were enrolled and among which the prevalence of hypertension and diabetes was 10.7% and 6.57% respectively. When comparing between the individuals from Shanghai and Jilin province in six aspects including prevalence, awareness rate, management rate, behavior correcting rate, control rate and drug intake rate, except the behavior correcting rate, individuals from Shanghai possess higher rate in other five aspects. As for the satisfaction, reactive and trust, 2268 individuals were surveyed and the result shows that the satisfaction towards process of service and overall were 93.43% and 93.78%, the reactive towards the privacy protection and infrastructure were 94.41% and 90.45% and the trust towards the treatment service, expense and overall were 92.59%, 93.98% and 92.76%, respectively. CONCLUSIONS: The prevention and control of chronic disease should be emphasized by government and meanwhile the establishment of health management base is also a indispensable measure to enhance and unify the surveillance system. On the other hand, in order to improve the current situation of chronic disease prevention and control, more endeavors should also be devoted to the systemic culture of general physician, professional skill and the upgrading of citizens’ self-health management ability.

P170 Evaluation of the Route and Effect of GP System in Hypertension (HTN) Control M. Xu, L. Jin, L. L. Tan. Long Bai Community Healthcare Center, Shanghai, China OBJECTIVES: Explore the route of HTN control for general practitioner (GP) system and evaluate its effect of HTN control after the system was implemented in half a year. METHODS: This is a retrospective analysis in a large dataset collected from 1,189,456 participating. Parameters included in this analysis were information of HTN control, medication compliance, follow-up visits before and after the implementation of the GP system. RESULTS: GP system having been implemented, hypertension record ratio rose from 71.6% to 77.5%, management ratio rose from 58.4% to 66.6%, standard management ratio rose from 44.0% to 53.6%, effective HTN control ratio rose from 30.2% to 45.5%, identification ratio was increased from 71.3% to 80.1%, follow up ratio was increased from 93.4% to 99.6%, and medicine-taking ratio was increased from 69.7% to 80.8%. All of seven indicators obviously went upward. The difference of identification ratio, follow up ratio and medicine-taking ratio are of statistical significance. CONCLUSIONS: HTN control under the GP system is apparently conductive to increasing the effect of hypertension control so that it is worthy of wide introduction and application.

P171 Study on Student Health Management Mode Based on General Practitioner in Minhang District, Shanghai D. D. He,1 H. L. Su,1 Y. P. Zhao,1 Q. R. Bai,1 X. Y. Zhang,2 S. J. Ying,1 Z. M. Gong,1 Q. K. Zhao,1 G. Z. Jin,1 M. Q. Wei,1 Y. Bao3. 1. Center for Disease Control and Prevention, Minhang District, Shanghai, China; 2. Municipal Center for Disease Control and Prevention, Shanghai, China; 3. Public Health College, Shanghai Jiaotong University, Shanghai, China OBJECTIVES: To establish the model of student health management by campus general practitioners and explore its impact with the following sub-aims: (1) To develop student health manage-

ment mechanisms and quality control indicators. (2) To establish of the student electronic health records and health management information network platform. (3) To survey on the rate of health literacy knowledge awareness. (4) To assess health management effectiveness. RESULTS: The numbers of primary and secondary school students are 1202221. 94.72% of students have health cards and electronic health records. 23,674 disease cards have been established and managed by general practitioners. Primary health intervention cure rate is higher than the junior middle school and high school students. The management efficiency of overweight, obesity, amblyopic and malnutrition is higher, the cure rate is low; at the intervention time, cure rate is improved (chi-square = 46.86, p < 0.0001); average knowledge awareness and health literacy rate of junior middle school students is highest. CONCLUSIONS: To improve campus GP network and to determine the job duties can effectively promote the work of student health management. P172 Prospective Study of Falls and Fall Risk Factors in Communitydwelling Elderly People in Beijing J. Shi, P. L. Yu. The Beijing Hospital, Beijing, China OBJECTIVES: To investigate the incidence of falls, and explore the risk factors for falls and subsequent falls in communitydwelling elderly. METHODS: A cross-sectional study was conducted in the Longtan community of Dongcheng district in Beijing in 2005. People aged 60 years and over were selected with stratified cluster sampling. A follow-up survey was conducted in the same community in 2009. Information about any falls during the past year was collected with a standardized structured questionnaire by face-toface interview. Binary logistic regression analysis was used to explore related factors for falls and subsequent falls in the elderly. RESULTS: Among 1512 interviewees at baseline, the incidence of falls was 18.0% (272) during the past year; the incidence was higher among women than among men (20.1% vs 14.9%, p = 0.006). In follow-up survey, the incidence of falls among 472 interviewees was 17.8% (84) within the past 12 months. Among the 170 persons with a fall history in the baseline survey, 49 fell in 2009, with the incidence rate of subsequent falls 28.8%. Risk factors for falls were female gender (OR = 1.56), higher family monthly income (OR = 1.28), living alone (OR = 1.68), negative emotion (OR = 1.41), fear of falls (OR = 1.72), abnormal dynamic balance (OR = 1.50), impaired vision (OR = 1.24) and poor ability of daily life (OR = 1.74); Risk factors for subsequent falls included higher family monthly income (OR = 2.17), fear of falls (OR = 2.20) and living alone (OR = 4.67), while protective factors included easy access to daily necessities (OR = 0.41) and good lighting in surrounding environment (OR = 0.35). CONCLUSIONS: The incidence of falls is higher among older community-dwellers in Beijing. Falls in the elderly might have been influenced by various factors suggesting the intervention strategy should be targeted at those related factors as well as focusing on primary prevention.

P173 Prospective Study of Recurrent Falls in Elderly People of Urban Community in Beijing J. Shi, P. L. Yu. The Beijing Hospital, Beijing, China OBJECTIVES: To investigate the incidence of recurrent falls (i.e., ≥2 falls), and explore the risk factors for recurrent falls and its frequency in community-dwelling elderly in Beijing.

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METHODS: A cross-sectional study was conducted in the Longtan community of Dongcheng district in Beijing in 2005. People aged 60 years and over were selected using a stratified cluster sampling method. A follow–up survey was conducted in 2009, and 75% of the people who had falls history and 25% of the people who had no falls history in 2005 were interviewed in this survey. Data on falls within the past 12 months were collected through face-to-face interview, and logistic regression analysis was used to explore the related factors for recurrent falls and its frequency in the elderly. RESULTS: In the baseline survey, the incidence of recurrent falls among 1512 interviewees was 4.0% (61) during the past year. Among people aged 80 or above, the incidence of recurrent falls was 7.2%, which was higher than that among people younger than 80 years of age (7.2% vs 3.7%, v2 = 4.38, p < 0.05). In the followup survey, the incidence of recurrent falls among 472 older adults was 6.1% (29) within the past 12 months. Among the 170 persons with a fall history in the baseline survey, 23 fell two times or more in follow-up survey. Logistic regression analysis showed that retire (OR = 0.12) and being widowed (OR = 0.78) were protective factors, while higher family monthly income (OR = 1.45), negative emotion (OR = 1.87), abnormal dynamic balance (OR = 2.52) and often riding a bike (OR = 3.19) were risk factors for recurrent falls; Risk factors for frequency of recurrent falls were higher family monthly income (OR = 1.85), fear of falls (OR = 1.95) and living alone (OR = 4.34), while the protective factors included proper bench height in surrounding environment (OR = 0.45). CONCLUSIONS: The incidence of recurrent falls in the elderly living in community in Beijing is high. Falls was the result caused by various factors, suggesting the intervention should target multiple risk factors.

P174 Relationship Between Resistin Level in Serum and Acute Coronary Syndrome or Stable Angina Pectoris X. Z. Qiao, Y. M. Yang, Z. R. Xu, L. A. Yang. Department of Very Important Person, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China Supported By: Science and Technology Department of Zhejiang Province, China (No. 2003C33031). OBJECTIVES: To investigate the relationship between serum resistin level and acute coronary syndrome (ACS) or stable angina pectoris (SAP). METHODS: Sixty-five patients, with coronary artery disease, were enrolled and divided into three subgroups: acute myocardial infarction (AMI), unstable angina pectoris (UAP) and SAP, and 26 healthy people were recruited as controls in the cross-sectional study. Serum resistin levels were determined by ELISA (enzymelinked immunosorbent assay), and WBC (white blood cell count), hsCRP (high sensitive C-reaction protein), CKmax (maximum of creatinkinase), CK-MBmax (maximum of isozyme of creatinkinase) and cTnImax (maximum of troponin) were measured by standard laboratory methods. RESULTS: The serum resistin levels were 4 folds higher in AMI patients, 2.43 folds in UAP patients and 1.12 folds in SAP patients than in the healthy controls (p < 0.05). The resistin levels were also significantly different between AMI [(8.16  0.79)ng/ml], UAP [(5.59  0.75) ng/ml] and SAP [(3.45  0.56) ng/ml] groups (p < 0.01); WBC, hsCRP, CKmax, CK-MBmax and cTnImax were significantly increased in AMI patients over UAP and SAP patients. Spearman analysis showed that serum resistin levels were positively correlated with WBC (r = 0.412, p = 0.046), hsCRP (r = 0.427, p = 0.03), CKmax, CK-MBmax and cTnImax (r = 0.731, 0.678, 0.656 respectively; p < 0.01).

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CONCLUSIONS: Serum resistin levels increased with inflammatory factors and myocardial impairment. The results suggest that human resistin might play an important role in the pathogenesis of atherosclerosis and AMI.

P175 Plasma B-type Natriuretic Peptide Levels Reflect the Presence and Severity of Stable Coronary Artery Disease (CAD) in Elderly Patients X. X. Dai, H. Y. Wang, N. Y. Fang. Geriatric Department, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China OBJECTIVES: Coronary artery disease (CAD) is one of the leading causes of morbidity and mortality in elderly patients. We examined the relationship between plasma B-type natriuretic peptide (BNP) levels and the presence and severity of coronary artery disease based on coronary angiography (CAG) in elderly patients. METHODS: The study included 73 patients undergoing coronary angiography at Renji hospital affiliated to shanghai Jiao Tong University School of Medicine. According to the result of coronary angiography, patients were divided into two groups: non-coronary artery disease (non-CAD) patients and coronary artery disease (CAD) patients with significant lesions in coronary artery (≥70% diameter narrowing). Plasma BNP and troponin-I levels were measured, and the severity of coronary artery stenosis was quantified with the Gensini scoring system. All patients had an echocardiographic examination to exclude left ventricular systolic dysfunction. RESULTS: There were 45 (61.6%) CAD patients and 28 (38.4%) non-CAD patients totally. The plasma levels of BNP in CAD were significantly higher than that in non-CAD (75.62  150.09 pg/ml vs 17.68  15.96 pg/ml, p = 0.014). There is a significant relationship between the plasma levels of BNP and Genisi scores (r = 0.505, p < 0.01). CONCLUSIONS: BNP may be a useful marker for the evaluation of coronary lesions.

P176 Elevated Peripheral Inflammatory Factors IL-6 and RANTES in Parkinson’s Disease P. Tang, X. Q. Li, Y. Liu, P. Liu, C. Li, R. Li. Department of Geriatric Neurology, Shaanxi Provincial People’s Hospital, Xi’an, China OBJECTIVES: To investigate the correlation between peripheral serum inflammatory markers interleukin-6 (IL-6), regulated on activation normal T cell expressed and secreted (RANTES) and Parkinson’s disease. METHODS: PD patients (n = 78) fulfilled the diagnosis of United Kindom Parkinson’s Disease Society Brain Bank Clinical Diagnostic Criteria were consecutively registered from October 2008 to May 2011. Age and sex matched healthy volunteers as the control group (n = 80) were recruited from Physical Examination Center of Shaanxi Provincial People’s Hospital. Serum levels of IL6 and RANTES were measured by Enzyme-linked immunosorbent assay (ELISA). PD patients were evaluated with UPDRS and Hoehn-Yahr scale. The correlation between serum inflammatory markers and clinical features were analysed. RESULTS: 1. The serum levels of IL-6 and RANTES in PD patients were significantly higher than controls (4.67  3.64 pg/ml vs 2.66  1.91 pg/ml and 36.7  16.6 ng/ml vs 31.1  10.6 ng/ml, p = 0.00002, p = 0.013, respectively). 2. There were no associations between IL-6 serum levels and Hoehn-Yahr scales, UPDRS part I,

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II, III in PD patients. 3. There was a mild positive correlation between RANTES serum levels and disease duration, Hoehn-Yahr scales in PD patients (p = 0.015 and 0.001, respectively), but no associations were found between RANTES serum levels and UPDRS I, II, III in PD patients. CONCLUSIONS: These data indicated that patients with PD have an on-going systemic inflammatory state where the elevated peripheral production of RANTES may play a role in the neurodegenerative process.

P177 Effects of Atorvastatin on Bone Metabolism and Bone Mineral Density in Old Male Patients with Osteopenia and Mild Dyslipidemia: A 1-year Randomized Trial Z. G. Chen, J. H. Lu, H. J. Cai, X. Jin, N. Y. Fang. Department of Geriatrics, RenJi Hospital, Shanghai, China OBJECTIVES: Osteoporosis (OP), known as a systemic disease with reduced bone mass and degeneration of bone micro-structure, is easy to cause fracture due to increased fragility of bone. Dyslipidemia, widely accepted as a risk factor of cardiovascular diseases, has been reported to have association with bone mass changes. Some lipid-lowering agents, such as statins, were suggested as a potential treatment for improvement of bone mass in some researches. However, the detailed evidence was still far from enough, especially in elderly male subjects. The purpose of our study was to explore the effects of atorvastatin on bone mineral density (BMD) and bone metabolism with a 1-year perspective randomized controlled study, so as to reveal the link between relevant factors of osteoporosis and risk factors of cardiovascular disease in elderly man. METHODS: 60 male patients (mean age 80.20  6.68 years) with osteopenia and mild dyslipidemia were recruited from persons accepting regular health examination, and were randomized to atorvastatin treated (10 mg/night) group and control group. BMD of hip and lumbar spine were measured with DXA (dual-energy Xray absorptionmetry); Bone metabolic markers including resorption markers b-C-terminal telopeptide of type I collagen (CTx), formative markers osteocalcin (OC), 25-hydroxyvitamin D (25 (OH) D3) and intact parathyroid hormone (iPTH) were measured with electrochemiluminescence immunoassay (ECLIA); levels of serum lipid and biochemical parameters were measured with automatic biochemical analyzer. All the parameters mentioned above were recorded at baseline, month 6, month 12, respectively. All subjects were asked for questionnaire and took detailed physical examination, including height, weight etc. RESULTS: All the 60 men completed the 1-year follow-up with the study procedure without adverse drug reaction. In comparison to control group, Atorvastatin treatment group caused significant reduction of Triglyceride (TG, p < 0.01) and low-density lipoprotein (LDL, p < 0.01). Similarly, CTx significantly declined in month 6 (p = 0.03) and month 12 (p < 0.01) compared with baseline in atorvastatin group. However, OC, 25 (OH) D3 and iPTH did not change significantly (p > 0.05). Atorvastatin caused significant increment of BMD at total hip (p < 0.01), while there was no change at femoral neck and lumbar spine (p = 0.48, 0.53 respectively). In addition, there were no significant correlation of CTx and BMD changes with lipid lowering. CONCLUSIONS: Our findings suggested that in the elderly male patients with osteopenia and mild dyslipidemia, therapeutic doses of atorvastatin might exert positive effects on bone mineral density of total hip by suppressing bone resorption. In addition, the effects mentioned above were not likely to depend on the extent of lipid lowering.

P178 A Proposal for a New Training Pattern and Policies of Medical Students Based on the Needs of General Practitioners S. P. Wang, Y. Bao. School of Public Health, Shanghai Jiaotong University, Shanghai, China OBJECTIVES: To offer practical advices about the training of medical students and explore a systemized training pattern for general practitioners. It is inspired by Shanghai’s attempt to build a family doctor system and the real needs in the training of general practitioners. METHODS: We carried out a questionnaire survey in 1300 general practitioners and 400 medical students all over Shanghai to evaluate their basic information, understanding of the family doctor system, career goals, and the needs for a practical training of general practitioners. RESULTS: An analysis of the basic info reveals that certain needs for basic knowledge and ability are indicated by general practitioners. However, job description is poorly understood by the medical students who generally wish to become specialists. The existing medical education is also inadequate in the training of relevant knowledge and skills. CONCLUSIONS: Despite its leading role in the training of general practitioners, Shanghai has a number of challenges that require immediate solutions. Such as stronger image building effort, a higher degree of social recognition and respect, a more standardized system of training, more specific sets of security measures, a more systemized curriculum, more capable teaching crews and a more advanced training pattern.

P179 PP/MAP Reflect the Presence and Severity of Coronary Artery Disease (CAD) in Elderly Patients with Cardiovascular Risk Factors L. Wang, X. X. Dai, H. Y. Wang. Geriatric Department, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China OBJECTIVES: The pulse pressure (PP) and mean artery pressure (MAP) have been proposed as novel makers of atherosclerosis. The present study evaluated the correlation of PP/MAP and the severity of coronary atherosclerosis in high cardiovascular risk patients. METHODS: In the present randomized prospective study, a total of 90 patients with cardiovascular risk factors were assigned to those with significant coronary artery stenosis group [(+)stenosis] (n = 56; age: 68.71  5.47 years) or those without significant coronary artery stenosis [( )stenosis] group (n = 34; age: 67.03  6.12 years). Baseline characteristics, such as body height, weight, serum cholesterols, triglycerides, high density lipoprotein, low density lipoprotein, Fasting plasma glucose, Creatinine, Uric acid were quantitatively determined in each patient at the beginning the study. In each patient, the PP and MAP were calculated; the severity of coronary atherosclerosis was evaluated using the Gensini score. RESULTS: There were no significant differences in age, sex ratio, body mass index, lipid profiles, Creatinine and Uric acid level between the two groups (p > 0.01). The brachial MAP was lower in the (+) stenosis group than it was in the ( ) stenosis group (p < 0.005). A positive relationship was found between the Gensini score and the PP/MPA after adjustment for age and low-density lipoprotein in patients with coronary stenosis (r = 0.301, p = 0.004). CONCLUSIONS: Our observations suggest that PP/MAP may become a marker for the severity of coronary atherosclerosis in elderly subjects with high cardiovascular risk.

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P180 Molecular Profiling of Bacteroides and Bifidobacterium spp. in Feces from Patients with Type 2 diabetes W. Z. Wu, S. J. Li, H. F. Lu, Z. R. Xu, Q. Zhang, Y. M. Yang. Department of Special Care, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China BACKGROUND: Type 2 diabetes is a metabolic disease and its prevalence has increased substantially worldwide over recent decades. Recent studies have highlighted that gut microbiota may shape the host metabolic and immune network activity and ultimately contribute to the development of metabolic disorders such as type 2 diabetes. In this study, PCR-DGGE fingerprint and qualitative clone library were used to analyze the structural features of the predominant intestinal bacteria of patients with type 2 diabetes compared with healthy individuals as control, and study the influences of diabetes on the structure of intestinal bacteria. METHODS: Bacterial DNAs from type 2 diabetes patients (n = 21) and healthy volunteers (n = 13) were extracted from fecal samples, and then subjected to community fingerprinting of Bacteroides and Bifidobacterium using PCR/denaturing gradient gel electrophoresis with genus- and group-specific primers, as well as sequencing excised gel bands. RESULTS: The mean numbers of gel bands in the diabetic and control groups were 6.3  1.4 and 5.2  2.0 for Bacteroides; 2.5  1.1 and 3.0  1.4 for Bifidobacterium. The mean similarity index of Bacteroides for the diabetic group was 57.0  12.7%, and 76.9  5.06% in the control group, and 85.9  17.4% and 86.2  16.1%, respectively for Bifidobacterium. The results showed that there were common bands for Bacteroides and Bifidobacterium between the two groups, but also two distinct bands for Bifidobacterium (Bifidobacterium saeculare/pullorum/subtile, and Bifidobacterium ruminantium /adolescentis) appeared only in the diabetic group. CONCLUSIONS: The results showed that the composition of Bacteroides and Bifidobacterium in the human gut microflora was different between the diabetic group and the control group. There may be relationship between intestinal microflora and type 2 diabetes, suggesting that compositional changes of intestinal microflora might be a risk factor for type 2 diabetes, or type 2 diabetes itself could affect intestinal microflora.

P181 Comparison of Gb-ACT and Anti-Xa Activity for Bedside Monitoring of Anticoagulation in Elderly Patients P. A. Peng, M. Z. Qin, Y. W. Ghen, J. Q. Wang, X. B. Shi, J. Zhuo. Beijing Tongren Hospital, Capital Medical University, Beijing, China OBJECTIVES: To provide a convenient point-of-care method for monitoring the effects of low-molecular-weight heparins (LMWH) in elderly patients by comparing the glass bead-activated clotting time (gb-ACT) and anti-Xa activity. METHODS: In this prospective study, a total of 84 consecutive hospitalized patients (≥60 years) were enrolled, who suffering from an acute coronary syndrome (ACS group) or were prone to

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developing a venous thromboembolism (VTE group) to receive LMWH subcutaneously. The ACS group received a dose of 1 mg/ kg twice a day, and a half dose was given when the serum creatinine ≥177 lmol/L, while the VTE group received a dose of 40 mg once daily. Plasma anti-factor Xa activity and the gb-ACT were obtained separately and the correlation between them was analyzed by different characters. RESULTS: The gb-ACT was correlated with the anti-Xa activity in both the ACS group and the VTE group (r = 0.409, p = 0.005 vs r = 0.219, p = 0.05, respectively). It was also in both the enoxaparin group and the nadroparin group (r = 0.576, p = 0.01 vs r = 0.307, p = 0.001, respectively). The relationship only existed in the group of patients ≥80 years (r = 0.526, p < 0.001) and in those with GFR of 30–60 ml/min (r = 0.407, p = 0.005). CONCLUSIONS: The correlation between the anti-Xa and gb-ACT probably exist, especially in the patients ≥80 years with a GFR of 30–60 ml/min undergoing VTE prophylaxis.

P182 Expression Profiling of Glucocorticoid-target MicroRNA in Human Subcutaneous and Omental Adipogenesis J. Yu, G. X. Ding. The Jiangsu Provincial People’s Hospital, Nanjing, Jiangsu, China OBJECTIVES: Glucocorticoids (GCs) cause visceral obesity, but reduce fat accumulation adipose accumulation in the peripheral regions. Very little is known about the molecular mechanisms that mediate depot differences in the effects of GCs on adipocyte function. MicroRNAs (miRNAs) are small non-coding RNAs, that play important regulatory roles in a variety of biological processes, including development, differentiation, apoptosis, and metabolism. We aimed to elucidate the differential expression of miRNAs between human subcutaneous and visceral adipogenesis regulated by GCs. METHODS: Human preadipocytes were isolated from human subcutaneous and visceral adipose tissues of subjects and cultured with dexamethasone – a kind of synthetic long-term glucocorticoid. We tested more than 1891 human and viral microRNAs using miRNA microarrays (miRCURY™ LNA Array v.16.0) in human subcutaneous and omental differentiating adipocytes treated with dexamethasone (10 8 or 10 6 mol/L) for 24 hours. Then we validated 21 of these miRNAs, predicted target genes of them and used pathway analysis for research of target genes. RESULTS: There were 21 miRNAs expressed differently in human subcutaneous and omental differentiating adipocytes and the levels of these miRNAs would be changed oppositely by the stimulation of dexamethasone. 10 miRNAs in subcutaneous differentiating adipocytes expressed higher than in visceral adipocytes, and 11 miRNAs changed in opposite trend. Target genes prediction and pathway analysis indicated that these miRNAs were related to adipogenesis, lipid metabolism and insulin signaling pathway. CONCLUSIONS: There is an association between visceral obesity and miRNA differential expression. Differences in miRNA expression might contribute to different responses to glucocorticoids between omental and subcutaneous depots.

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