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20 February 2021, Volume 35 Issue 2 Previous Issue    Next Issue

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Analysis of incidence and risk factors of delirium in hospitalized elderly medical patients with visual impairment QIN Ling, CHEN Xing-yi, ZHAO Yan-li, GAO Lang-li, YUE Ji-rong 2021, 35 (2):  122-125.  doi: 10.3969/j.issn.1003-9198.2021.02.004 Abstract ( 164 )   PDF (1058KB) ( 1528 )   Save Objective To learn the incidence and risk factors of delirium in hospitalized elderly medical patients with visual impairment. Methods In this prospective cochort study, elderly patients with visual impairment admitted to the Geriatrics Department of West China Hospital of Sichuan University from March 2016 to January 2017 were included. Visual acuity and risk factors of delirium were assessed within 48 h after admission. Delirium screening was performed within 48 h of admission and every 48 h thereafter until discharge or for a maximum of 13 days. Results A total of 243 elderly inpatients with visual impairment were included, of whom 53 (21. 8%) developed delirium. Multivariate Logistic regression analysis showed that age, severe comorbidity index, and cognitive impairment were independent risk factors for delirium. Conclusions We should actively prevent the development of delirium for hospitalized elderly patients with visual impairment, especially for those with advanced age, severe comorbidities and cognitive impairment. References | Related Articles | Metrics

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Relevant factors influencing the accuracy of IWPC prediction model in Chinese Han elderly patients with oral warfarin YANG Hai-yan, LI Man, PAN Feng-hui, CUI Wen-xia, SHI Xiao-ting, GAO Lei, WANG Chun 2021, 35 (2):  126-131.  doi: 10.3969/j.issn.1003-9198.2021.02.005 Abstract ( 195 )   PDF (1093KB) ( 1587 )   Save Objective To explore the related factors that affect the accuracy of international warfarin phamacogenetics consortium (IWPC) prediction model in the patients aged ≥75 years old receiving warfarin, and to provide a reference for reasonable usage of warfarin. Methods The clinical data of the patients aged ≥75 years old receiving warfarin were collected. According to the difference rate between the predicted dose and the actual dose, the patients were divided into mild difference group (42 cases), moderate difference group (21 cases), significant difference group (10 cases). The clinical indicators of each group, including gender, age, body mass index, blood pressure, heart rate, comorbidities and concomitant medication were compared, and the influencing factors were analyzed. Results There were no significant differences in sex, age, liver function index and genotype distribution among the three groups (P>0. 05). The history of heart failure and the proportion of diuretics used in the mild difference group were significantly lower than those in the significant difference group, and the serum creatinine of mild difference group was significantly lower and the estimated glomerular filtration rate(eGFR) was significantly higher than that in the moderate difference group and the significant difference group (P<0. 05). History of heart failure and diuretics showed no significant effects on the dosage of warfarin (P>0. 05). According to the quartile, eGFR was divided into low level [<59. 5 mL/(min·1. 73m2)],middle-low level[59. 5~76. 3 mL/(min·1. 73m2)] , middle-high level [76. 4~96. 5 mL/(min·1. 73m2)] and high level[>96. 5 mL/(min·1. 73m2)] group. The difference between the actual and predicted dose of warfarin caused by the low level of eGFR was 4. 455 times of that of the high level of eGFR; The difference between the actual and predicted dose of warfarin caused by the middle-low level of eGFR was 5. 135 times higher than that of the high level of eGFR. Conclusions The average actual stable dose of warfarin in the patients aged≥75 years old of Han Chinese is less than 2. 5 mg/d, the lower of the actual dose, the greater of the difference with the predicted dose by IWPC model formula, and there is a significant correlation between eGFR and dose difference. References | Related Articles | Metrics

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Prevention and treatment of pulmonary infection in elderly comatose patients by early continuousbronchial lavage JIANG Dao-ming, TENG Xiao-hua, YANG Bin, WANG Guang-hua 2021, 35 (2):  132-136.  doi: 10.3969/j.issn.1003-9198.2021.02.006 Abstract ( 182 )   PDF (1068KB) ( 1282 )   Save Objective To investigate the effect of early continuous bronchial lavage on pulmonary infection in senile comatose patients. Methods A total of 95 elderly comatose inpatients were selected from January 2016 to December 2019. The patients were divided into two groups according to the time sequence of routine and early bronchial lavage. The early lavage group consisted of 28 patients receiving early lavage who had no signs of pulmonary infection within 48 hours after admission. The other 67 were non-early lavage group. In the non-early lavage group, 25 patients who underwent intermittent bronchial lavage after diagnosis of pulmonary infection were lavage group, and 42 patients without lavage were non lavage group. All the groups were treated with aspiration of sputum, extracorporeal vibration expectoration, atomization, anti-infection and other preventive measures. Occurrence and control of pulmonary infection, pulmonary ventilation function and inflammatory response after treatment, bacterial count of secretion were compared among the three groups. Results The occurrence time of pulmonary infection in early lavage group was longer, CPIS value on the 1st, 3rd and 7th day after treatment, average antibiotic DDD value and infection control time were decreased than those in lavage group and non lavage group (P<0. 05); After pulmonary infection, arterial partical pressure of carbon dioxide, plasma concentrations of tumor necrosis factor-α and interleukin-6 were lower and arterial partial pressure of oxygen was higher in early lavage group than those in lavage group and non lavage group (P<0. 05); The third day, the bacterial count of secretion and the levels of C-reactive protein and procalcitonin in early lavage group were lower than those in lavage group and non lavage group (P<0. 05). Conclusions Early continuous bronchial lavage can reduce the severity of pulmonary infection in comatose patients and shorten the infection control time, which may be related to the inhibition of inflammatory response and the reduction of bacterial count. References | Related Articles | Metrics

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Clinical study of catheter balloon dilatation combined with forced swallowing in elderly patients with cricopharyngeus muscle dysfunction LI Yi-xian, SUN Yan-dong, WANG Jing, ZHANG Yan,ZHU Hai-xia, BAI Xiao-yan, YIN Hua 2021, 35 (2):  137-140.  doi: 10.3969/j.issn.1003-9198.2021.02.007 Abstract ( 210 )   PDF (1047KB) ( 1549 )   Save Objective To investigate the curative effect of catheter balloon dilatation combined with forced swallowing in the elderly patients with cricopharyngeus muscle dysfunction. Methods A total of 32 elderly patients with cricopharyngeus muscle dysfunction diagnosed by video swallowing angiography (VFSS) were divided into study group and control group according to the hospitalization order, with 16 cases in each group. The study group was treated with catheter balloon dilatation combined with forced swallowing, while the control group was treated with routine swallowing rehabilitation. Both groups received neuromuscular electrical stimulation. Before treatment and after 6 weeks of oral feeding or treatment, the clinical evaluation criteria and VFSS were used to evaluate dysphagia, and the changes of swallowing function were analyzed and compared. Results The effective rate of study group was 93. 75%,which was significantly higher than that of the control group(75. 0%). After treatment, the VFSS examination showed the opening, leakage and aspiration of annular pharynx muscle in the two groups were significantly improved, especially in the study group (P<0. 05). Conclusions Balloon dilatation combined with forced swallowing is superior to conventional swallowing rehabilitation in improving the cricopharyngeus muscle dysfunction in the elderly. References | Related Articles | Metrics

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Consistency of two methods in screening COPD among residents over 60 years old in Yibin City DU Ming-ming, DONG Li, LV Jun 2021, 35 (2):  141-144.  doi: 10.3969/j.issn.1003-9198.2021.02.008 Abstract ( 202 )   PDF (1046KB) ( 2084 )   Save Objective To compare the consistency of symptom-based questionnaire for identifying chronic obstructive pulmonary disease (COPD) and Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017 standard in screening COPD among the residents over 60 years old in Yibin. Methods From January to December 2019, 744 residents over 60 years old were selected from Yibin by multi-stage sampling, and they were diagnosed by symptom-based questionnaire for identifying COPD and pulmonary function test respectively. The consistency of two methods was compared in diagnosing COPD. Results With a score of symptom-based questionnaire for identifying COPD of 16. 5 or 19. 5, a total of 127 or 86 residents were diagnosed as COPD with a detection rate of 17. 1% or 11. 6% respectively. There was significant difference in the detection rate of COPD among the residents with different age, body mass index (BMI) or smoking state(P<0. 05). Eighty-one cases were diagnosed as COPD by pulmonary function according to GOLD 2017 with a prevalence of 10. 9%, and significant differences were observed among the residents with different age and smoking (P<0. 05). With GOLD 2017 as the golden standard, symptom-based questionnaire for identifying COPD score with 16. 5 or 19. 5 as cut-off showed a kappa of 0. 512 and 0. 791, sensitivity of 74. 1% and 84. 0%, specificity of 89. 9% and 97. 3%, respectively. Conclusions Symptom-based questionnaire for identifying COPD is suitable for COPD screening among the residents over 60 years old. Taking 19. 5 as cut-off for diagnosing COPD can accurately reflect the lung function of individuals, with high consistency, sensitivity and specificity. References | Related Articles | Metrics

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Analysis of the influencing path of optimism on psychological toughness in elderly patients with gastric cancer WANG Lei, LI Yan-fei, XU Li 2021, 35 (2):  145-148.  doi: 10.3969/j.issn.1003-9198.2021.02.009 Abstract ( 164 )   PDF (1061KB) ( 1287 )   Save Objective To explore the effect of optimism on the psychological toughness of the elderly patients with gastric cancer. Methods A questionnaire survey was performed on 138 elderly patients with gastric cancer treated in Jiangsu Province Hospital from March 2017 to October 2019. The effective questionnaire recovery rate was 95. 65% (132/138). The general information of the patients was collected through questionnaires, and the psychological resilience was assessed with Chinese version of Psychological Resilience Scale (CD-RISC), optimism was assessed with life-oriented test revised version (LOT-R), social support was assessed with adopted social Support scale (SSQ) assessment, self-efficacy was assessed with General Self-Efficacy Scale (GSES). Pearson correlation was used to analyze the correlation between psychological toughness and optimism, social support, and self-efficacy. Multivariate regression analysis was used to analyze the factors affecting psychological toughness. Path analysis was used to analyze the effects of optimism on psychological toughness. Results The psychological toughness was positively correlated with optimism, social support, and self-efficacy in the elderly patients with gastric cancer. The results of multiple stepwise regression analysis showed that LOT-R score, SSQ score, and GSES score were the influencing factors of self-resilience. The influencing path model of self-resilience showed that social support and self-efficacy had a direct effect on mental toughness, while optimism had both direct and indirect effects on mental toughness. Conclusions Optimism has a direct impact on the psychological resilience in the elderly patients with gastric cancer. References | Related Articles | Metrics

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Study of muscle mass prediction models through simple muscle strength in community-dwelling elderly LIU Min-jing, ZHOU Si-mei, LI Meng-li, WANG Li 2021, 35 (2):  149-154.  doi: 10.3969/j.issn.1003-9198.2021.02.010 Abstract ( 174 )   PDF (1088KB) ( 1425 )   Save Objective To construct prediction models for muscle mass based on single or multiple indexes of muscle strength in the community-dwelling elderly. Methods A total of 140 elderly residents were recruited from the communities between September and December 2019. Simple muscle strengths, including hand-grip strength, biceps curl test, 30 s chair stand test and maximal isometric strength of the quadriceps and hamstring muscles based on the Micro FET3 handheld ergometer were tested. Muscle mass was measured with body composition analyzer (TANITA, Japanese). The correlation between muscle strength and muscle mass were analyzed, and the regression equation was established. Results All indexes of muscle strength (hand-grip strength, biceps curl test, 30 s chair stand test and maximal isometric strength of the quadriceps and hamstring muscles) were positively correlated with muscle mass (r=0. 207-0. 720, P＜0. 001). The multiple regression analysis showed that the muscle mass prediction models based on each index of muscle strength were statistically significant (r2=0. 702-0. 761,P＜0. 001), except the result of 30 s chair stand test. The prediction model of muscle mass based on multiple indexes including sex, body mass index (BMI), non-dominant hand grip strength, result of 30 s chair stand test, maximal isometric strength of the quadriceps was statistically significant (r2=0. 786, P<0. 001). Conclusions All indexes of the simple muscle strengths are positively correlated with muscle mass. Each single muscle strength index and combined multiple muscle strengths can effectively predict muscle mass and the prediction effect is slightly better in the latter. These models provide simple screening methods for assessing muscle mass in the community-dwelling elderly, which is beneficial for subsequent examination and treatment. References | Related Articles | Metrics

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Comparisons of curative effect of three kinds of surgical treatment in elderly patients with gallstone complicated with extrahepatic bile duct stone JIA Mei, LI Meng, GUO Ai-hua, GONG Cui-li, FAN Yan-yan, WANG Liu-man, JIANG Zheng 2021, 35 (2):  155-158.  doi: 10.3969/j.issn.1003-9198.2021.02.011 Abstract ( 174 )   PDF (1049KB) ( 1437 )   Save Objective To compare the curative effect and the complications of three kinds of surgical treatment in the elderly patients with gallstone complicated with extrahepatic bile duct stone. Methods A total of 178 cases of elderly patients with gallbladder stones complicated with extrahepatic bile duct stones treated in our hospital from July 2016 to June 2019 were selected. Out of them 63 cases were treated by the laparoscopic cholecystectomy combined with laparoscopic common bile duct exploration (LC+LCBDE), 61 cases were treated by endoscopic retrograde cholangiopancreatography combined with laparoscopic cholecystectomy (ERCP+LC), and 54 cases were treated by open cholecystectomy combined with open common bile duct exploration (OC+OCBDE). The liver function indexes before and after surgery, operation conditions and the complications after surgery were compared between the three groups. Results The levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and total bilirubin in the three groups 5 d after surgery were significantly lower than those before surgery(P<0. 05). There were no significant differences in the levels of AST and ALT between the three groups before and 5 d after surgery (P>0. 05). The operation time in the OC+OCBDE group was significantly shorter than that in the LC+LCBDE group and the ERCP+LC group (P＜0. 05). The intraoperative blood loss, anal exhaust time and hospital stay in the OC+OCBDE group were increased significantly than those in the LC+LCBDE group and ERCP+LC group(P<0. 05). The incidence rate of postoperative complications in the LC+LCBDE group, ERCP+LC and OC+OCBDE group was 7. 94%, 21. 31% and 25. 93% respectively with statistical difference (P<0. 05). Conclusions The three surgical treatments for gallbladder stones and extrahepatic bile duct stones can effectively remove the stones and improve the liver function. Among them, OC+OCBDE has certain advantages in shortening the operation time, and LC+LCBDE surgery has minimal risk of postoperative complications. References | Related Articles | Metrics

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Observation of the efficacy of sacral neuromagnetic stimulation combined with totrodine in the treatment of mixed urinary incontinence in elderly women ZHANG Jie-hui 2021, 35 (2):  159-162.  doi: 10.3969/j.issn.1003-9198.2021.02.012 Abstract ( 149 )   PDF (1059KB) ( 1351 )   Save Objective To investigate the clinical effect of sacral neuromagnetic stimulation combined with totrodine in the treatment of mixed urinary incontinence in the elderly women. Methods A total of 61 elderly female patients with mixed urinary incontinence were randomly divided into control group and observation group according to the registration order. The control group (n=30) was given toterodine tartrate sustained release tablets for 2 months. The observation group (n=31) received toterodine combined with sacral neuromagnetic stimulation for 2 months. The questionnaire for urinary incontinence (ICI-Q-SF), quality of life for urinary incontinence (I-QOL), visual analogue scale (VAS) for urinary incontinence, bladder hyperactivity disorder (OABSS), pelvic floor strength assessment score (Glazer) and residual urine volume were recorded before treatment, 1 and 2 months after treatment. The clinical efficacy of the two groups was evaluated 2 months later. Results After 2 months of treatment, the scores of ICI-Q-SF, I-QOL, VAS, OABSS and pelvic floor muscle strength in the two groups were significantly improved compared with those before treatment (P<0. 05). The residual urine volume in the control group was increased compared with that before treatment (P<0. 05). Compared with the control group, the indicators in the observation group at each time point were improved more significantly than those in the control group (P<0. 05). After 2 months of treatment, the total effective rate of observation group and treatment group was 87. 10% (27/31) and 56. 67% (17/30) respectively, with statistically significant difference(P<0. 05). Conclusions Sacral neuromagnetic stimulation combined with tortrodine can effectively improve the clinical symptoms of mixed urinary incontinence in the elderly women and improve the quality of life. It has the advantages of quick onset, non-invasiveness, and less drug complications, which is worthy of clinical application. References | Related Articles | Metrics

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Effect of enhanced recovery after surgery in the treatment of elderly patients with early non-small cell lung cancer XU Zhi-yun, GAO Xiang, ZHANG Zhi, REN Bin-hui, XU Lin 2021, 35 (2):  163-165.  doi: 10.3969/j.issn.1003-9198.2021.02.013 Abstract ( 204 )   PDF (1001KB) ( 1388 )   Save Objective To evaluate the effect of enhanced recovery after surgery(ERAS) in the elderly patients with early non-small cell lung cancer. Methods A total of 248 patients undergoing thoracoscopic pulmonary lobectomy for early non-small cell lung cancer from June 2018 to May 2019 in the Department of Thoracic Surgery of Jiangsu Cancer Hospital were selected. All the patients were divided into group A (99 cases receiving ERAS) and group B (149 cases without ERAS). The postoperative complications, including atelectasis, pleural effusion, pneumonia, atrial fibrillation and 90-day mortality were observed and compared between the two groups. Results The incidence rate of postoperative pleural effusion in group B was significantly higher than that in group A (P=0. 045). During the follow-up, there were no deaths. There were no significant differences in other postoperative complications between the two groups. Conclusions Elderly patients with early non-small cell lung cancer undergoing ERAS have significantly greater prognosis. References | Related Articles | Metrics

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A comparative study on the clinical effect of OCM approach and posterolateral approach femoral head replacement in the treatment of elderly patients with femoral neck fracture under multi-disciplinary team mode WANG Bo-yao, WANG Yun-hua, HE Bin, FAN Lei, QIN Hu, SHEN Ya-jun, XU Nuo, ZHUANG Zhi-jie 2021, 35 (2):  166-168.  doi: 10.3969/j.issn.1003-9198.2021.02.014 Abstract ( 197 )   PDF (1031KB) ( 1465 )   Save Objective To compare the clinical effect of OCM approach and posterolateral approach in the treatment of femoral neck fracture under multi-disciplinary team (MDT) mode. Methods A total of 42 elderly patients receiving MDT were divided into experimental group (n=20) and control group (n=22) according to the different treatment methods. The experimental group was treated with OCM approach and the control group received posterolateral approach. The operative time, intraoperative bleeding volume, hospitalization time, the Harris scores 3 days or 3 months after operation were compared between the two groups. Results There was no significant difference in the operation time between the experimental group and the control group (P>0. 05). The levels of intraoperative bleeding, shorter hospital stay, and high rate of better Harris score 3 days or 3 months after operation in the experimental group were significantly than those in the control group. Conclusions Under MDT mode, OCM approach is better than posterolateral approach in the treatment of femoral neck fracture in the elderly patients. References | Related Articles | Metrics

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Effects of different enteral nutrition on blood glucose, nutrition and prognosis in elderly patients with severe pneumonia SHI Xiao-lan, SHEN Xiao-xing, HU Jian, QIN Hui 2021, 35 (2):  169-172.  doi: 10.3969/j.issn.1003-9198.2021.02.015 Abstract ( 158 )   PDF (1050KB) ( 1264 )   Save Objective To investigate the effects of enteral nutrition on blood glucose, nutrition and prognosis in the elderly patients with severe pneumonia. Methods Sixty elderly patients with severe pneumonia who were treated in our hospital from January 2016 to October 2019 were selected as research subjects. They were randomly divided into TPF-D group and TPF group, with 30 cases in each group. The blood glucose related indexes, nutritional status, clinical pulmonary infection scores (CPIS), 28 d mortality, days in ICU and the incidence of adverse reactions of the two groups were recorded and compared. Results After treatment, the blood glucose related indexes in TPF-D group were significantly lower than those in TPF group (P<0. 05). The serum levels of prealbumin(PAB) and albumin(ALB) in the two groups were significantly higher than those before treatment, especially in the TPF-D group. CPIS scores of the two groups were lower than those before treatment (P<0. 05), especially in the TPF-D group. In addition, the incidence rate of adverse reactions such as diarrhea, bloating, and nausea in TPF-D group and TPF group was 6. 67% and 20. 00% (P>0. 05), respectively. Conclusions TPF-D can contribute to stabilizing blood glucose levels, reducing inflammation,improving nutritional status, relieving clinical symptoms in the elderly patients with severe pneumonia. References | Related Articles | Metrics

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Application of ultrasound-guided intercostal nerve block combined with general anesthesia in postoperative analgesia of elderly patients with primary lung cancer WANG Mei-qing, YIN Fei, LEI Jun, ZHAO Wei-shan, SUN Yang, LIU Zheng-cheng 2021, 35 (2):  173-176.  doi: 10.3969/j.issn.1003-9198.2021.02.016 Abstract ( 183 )   PDF (1047KB) ( 1363 )   Save Objective To investigate the application of ultrasound-guided intercostal nerve block combined with general anesthesia in postoperative analgesia of elderly patients with lung cancer and its influence on visual analogue scale (VAS) score. Methods A total of 132 elderly patients with primary lung cancer from February 2018 to March 2020 were selected and divided into the control group (n= 66) and the observation group (n=66) according to different anesthesia methods. The control group was given general anesthesia, while the observation group was given ultrasound-guided intercostal nerve block combined with general anesthesia. The vital signs related indexes before induction and after extubation, VAS score at different time points after operation, comfort degree and sedation at different time points after operation were compared between the two groups. Results After extubation, the levels of diastolic blood pressure, systolic blood pressure and heart rate in the observation group were lower than those in the control group (P<0. 05), and the blood oxygen saturation after operation was higher than that in the control group (P<0. 05); The VAS scores in the observation group 2, 8, 24, 48 h after operation were lower than those in the control group (P<0. 05 or P<0. 01). The sedation scores in the observation group 1 and 2 h after operation were lower, and the comfort degree was higher than those in the control group (P<0. 05). Conclusions Ultrasound-guided intercostal nerve block combined with general anesthesia can significantly alleviate postoperative pain, improve the comfort of patients, reduce the degree of stress reaction, and obtain good results, which is worthy of promotion and application. References | Related Articles | Metrics

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Changes of blood lipid and renal function in elderly patients with type 2 diabetic nephropathy MIAO Jun-jun, SUN Xin-yi, JIA Jia, GE Jing 2021, 35 (2):  177-179.  doi: 10.3969/j.issn.1003-9198.2021.02.017 Abstract ( 132 )   PDF (1027KB) ( 1599 )   Save Objective To investigate the relationship between blood lipid and renal function in the elderly patients with type 2 diabetic nephropathy(DN). Methods From January 2018 to December 2019, 100 cases of elderly diabetic patients aged over 60 years old were selected. According to the levels of urinary albumin excretion rate (UAER), they were divided into normal albuminuria group, microalbuminuria group and massive albuminuria group. At the same time, 40 healthy elderly people were selected as the control group. The levels of total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), urea nitrogen (BUN), creatinine (Cr), Cystatin C (Cys-c) in each group were compared. Results Compared with the microalbuminuria group and normal albuminuria group, the level of HDL-C decreased and the levels of Cys-c, Cr increased significantly in the massive albuminuria group. Compared with the normal albuminuria group, the levels of TC,TG,BUN increased in the massive albuminuria group(P<0. 05), and the level of BUN increased in the microalbuminuria group(P<0. 05). Conclusions The levels of TC, TG and Cys-c increase and the level of HDL-C decreases in the patients with DN. The level of Cys-c can be used as an important indicator of early renal damage in the elderly patients with DN. References | Related Articles | Metrics

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Combined detection of serum gastrin-17, pepsinogen and H.pylori in screening precancerous lesions and early gastric cancer in the elderly HUANG Ren-xiang, LIU Yu-hui, YU Zhong-gui 2021, 35 (2):  180-183.  doi: 10.3969/j.issn.1003-9198.2021.02.018 Abstract ( 142 )   PDF (1095KB) ( 1725 )   Save Objective To explore the value of serum gastrin-17 (G-17), pepsinogen (PG) combined with Helicobacter pylori (HP) in screening gastric precancerous lesions and early gastric cancer. Methods A total of 194 patients who were diagnosed with gastric lesions due to upper abdominal discomfort admitted in our hospital from January 2015 to August 2019 were selected as the research objects. Among them, 102 patients aged ≥60 years old were divided into the elderly group, and 92 patients younger than 60 years old were divided into young and middle-aged group. All the patients were diagnosed as benign lesions, precancerous lesions or early gastric cancer by gastroscopy and pathological examination. The levels of G-17, pepsinogen ratio (PGR) and positive rate of HP in different groups were compared, and the diagnostic value of HP, G-17 and PGR were analyzed. Results The proportion of gastric cancer family history of the patients with benign lesions was significantly lower than that of the patients with precancerous lesions and early gastric cancer in both elderly group and young and middle-aged group (P<0. 05). The positive rate of HP, the levels of G-17 and PGⅡ of the patients with benign lesions were significantly lower and the level of PGR was significantly higher than those of the patients with precancerous lesions and early gastric cancer in the elderly group (P<0. 05). The positive rate of HP of the patients with benign lesions was lower than that of the patients with precancerous lesions and early gastric cancer in the young and middle-aged group (P<0. 05). Compared with the elderly group, the positive rate of HP, the level of PGR were significantly higher and the levels of G-17, PGⅡ were significantly lower in the patients with precancerous lesions patients in young and middle-aged group(P<0. 05); The level of PGR was significantly higher and the levels of G-17, PGⅡ were significantly lower in in the patients with early gastric cancer patients in young and middle-aged group(P<0. 05). Receiver operating characteristic curve analysis showed that the area under curve (95%CI) of HP combined with G-17 and PGR for the diagnosis and evaluation of precancerous lesions and early gastric cancer in the elderly was 0. 765 (0. 622-0. 939) and 0. 757 (0. 654-0. 876), respectively. Conclusions The combination detection of G-17, PGR and HP has a application value in screening early gastric cancer and precancerous lesions in the elderly. References | Related Articles | Metrics

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Application of proximal forearm autogenous arteriovenous fistula in elderly patients receiving hemodialysis ZHUANG Feng, WANG Ying-deng 2021, 35 (2):  184-188.  doi: 10.3969/j.issn.1003-9198.2021.02.019 Abstract ( 129 )   PDF (1070KB) ( 1299 )   Save Objective To investigate the advantages and disadvantages and clinical outcome of autologous arteriovenous fistula in proximal forearm of the elderly patients receiving hemodialysis. Methods The elderly patients who established autologous arteriovenous fistula in our hospital for the first time were divided into proximal group (anastomosis between radial artery and median vein or cephalic vein) and distal group (anastomosis between radial artery and cephalic vein) according to the methods of surgery. The postoperative complications, fistula blood flow, maturity and prognosis of internal fistula were observed and compared between the two groups. Results The immediate success rate of all fistula operations was 100%. Ultrasound evaluation of fistula was performed 6-8 weeks after operation. The blood flow volume of proximal group and distal group was 1328±234 mL/min and 1125. 6±198. 1 mL/min (P=0. 03), and the first puncture time was 56±15 d and 62±13 d (P<0. 05), the success rate of first puncture was 87. 8% and 78. 9% (P<0. 05), respectively. There was no significant difference in postoperative complications between the two groups (P>0. 05). The overall patency rate of all operations for 6 months was 92. 41%, and the overall patency rate for 1 year was 81. 01%. The 1-year survival rate of the internal fistula in the two groups was 85. 2% and 74. 1% (P=0. 32). The survival rate of the proximal group in the second year was 74. 3%, which was significantly higher than that of the distal group (P<0. 05). At the same time, the incidence rate of internal fistula occlusion and the times of surgical intervention caused by thrombosis in the proximal group were also lower than those in the distal group (P<0. 05). Conclusions The proximal forearm autogenous arteriovenous fistula has the advantages of rapid maturity, sufficient flow and high patency rate, which can be given priority to the elderly patients who need to establish internal fistula because of poor vascular condition of the distal forearm. References | Related Articles | Metrics

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Effect of different concentrations of heparin sealing solution in elderly patients with central venous catheter sealing QIN Ai-hong, DENG Bao-feng, JI Dong-mei, HU Xiao-yu, GAO Mao-long, BI Jing 2021, 35 (2):  206-208.  doi: 10.3969/j.issn.1003-9198.2021.02.026 Abstract ( 186 )   PDF (1031KB) ( 1237 )   Save Objective To observe the effect of different concentrations of heparin sealing fluid on central venous catheter sealing in the elderly patients, and to provide theoretical basis for the use of the best concentration of sealing fluid. Methods A total of 495 elderly patients with central venous catheter were randomly divided into group A, B and C, with 165 cases in each group. In group A, B and C, heparin solution with concentration of 10. 00 U/mL, 31. 25 U/mL and 62. 50 U/mL was used for positive pressure sealing, respectively. The incidence of central venous catheter occlusion, platelet count(PLT) and coagulation function before and after catheter closure were observed and compared. Results There was no significant difference in the incidence rate of central venous catheter occlusion among the three groups (P>0. 05). There was no significant difference in the level of PLT among the three groups (P>0. 05). There were significant differences in prothrombin time (PT) and prothrombin activity (PA) before and after sealing in group C(P<0. 05). Conclusions 10 U/mL heparin sealing solution shows few effect on the elderly patients, and it can be used as the standard for sealing the central venous catheter in the elderly patients. References | Related Articles | Metrics