Table of Content

22 March 2021, Volume 35 Issue 3 Previous Issue    Next Issue

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Analysis of serum level of CA19-9 and related influencing factors in elderly patients with type 2 diabetes mellitus ZHOU Shao-juan, LU Xiang 2021, 35 (3):  237-240.  doi: 10.3969/j.issn.1003-9198.2021.03.007 Abstract ( 181 )   PDF (1035KB) ( 1552 )   Save Objective To investigate the level and influencing factors of serum carbohydrate antigen 19-9 (CA19-9) in the elderly patients with type 2 diabetes mellitus (T2DM). Methods A total of 536 elderly T2DM patients who hospitalized in Department of Endocrinology in our hospital from March to October 2019 were selected. The levels of CA19-9 and related indexes of glucose and lipid metabolism were measured, and the use of hypoglycemic drugs and microvascular complications were recorded. The clinical characteristics of the patients with different CA19-9 levels were compared. The correlation between CA19-9 and related indexes of glucose and lipid metabolism were analyzed by Spearman correlation analysis and multiple stepwise regression analysis. Results The incidence rate of elevated CA19-9 level in the elderly T2DM patients was 7. 5%. There were significant differences in low density lipoprotein cholesterol (LDL-C), glycosylated hemoglobin (HbA1c), calcium and postprandial C-peptide between CA19-9 ＜37 U/mL group and CA19-9≥37 U/mL group (P<0. 05 or P<0. 01). The level of CA19-9 in metformin group was lower than that in non-metformin group (P<0. 05). Spearman correlation analysis showed that the level of CA19-9 was positively correlated with age, total cholesterol, triglyceride, hypersensitive C-reactive protein and HbA1c, but negatively correlated with albumin and postprandial C-peptide (P<0. 05). Multiple stepwise regression model showed that HbA1c was independent influencing factor of CA19-9. Conclusions The elderly patients with T2DM treated with metformin may have lower level of CA19-9. The level of CA19-9 is closely related to the status of blood glucose control in the elderly patients with T2DM. References | Related Articles | Metrics

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Correlation between fibrinogen to albumin ratio and poor prognosis 90 days after endovascular treatment in elderly patients with acute ischemic stroke ZHANG Zhong-hua, HUANG Qing, LIU Chun-mei, SHI Bao-zhu 2021, 35 (3):  241-245.  doi: 10.3969/j.issn.1003-9198.2021.03.008 Abstract ( 182 )   PDF (1122KB) ( 1158 )   Save Objective To investigate the predicting value of the ratio of fibrinogen to albumin (FAR) for the adverse prognosis in the elderly patients with acute ischemic stroke receiving endovascular treatment. Methods The clinical data of the elderly patients who received endovascular treatment of anterior circulation in Nanjing First Hospital were collected, prospectively, from May 2015 to November 2018. The outcome of the patients was evaluated 90 days after treatment, and they were divided into good prognosis group and poor prognosis group. The baseline data were compared between the two groups. The influencing factors of prognosis were investigated by the multivariate Logistic regression. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of FAR to the poor prognosis after 90 days. Results The age, history of stroke, baseline NIHSS score, ASITN/SIR collateral circulation grade 0-2, symptomatic intracranial hemorrhage, fasting blood glucose and FAR in the poor prognosis group were significantly higher than those in the good prognosis group, and the level of homocysteine in the poor prognosis group was lower (P<0. 05). Multivariate Logistic regression showed that FAR (OR=25. 048, 95%CI:8. 938-44. 733) was an independent predictor of poor prognosis after 90 days, after adjusting for the confounding factors including age, history of stroke, baseline NIHSS score, ASITN/SIR collateral circulation grade 0-2, symptomatic intracranial hemorrhage, fasting blood glucose and homocysteine. The area under the ROC curve of the FAR for predicting poor prognosis after 90 days was 0. 711 (95% CI: 0. 645-0. 772, P<0. 001). The sensitivity and specificity of predicting the poor prognosis were 60. 23% and 84. 17%, and the optimal cut-off value of FAR was 0. 0868. Conclusions The increasing FAR level may be able to predict poor outcome at 90 days in the elderly patients with acute ischemic stroke undergoing the endovascular treatment of anterior circulation. References | Related Articles | Metrics

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Efficacy and safety of different doses of ticagrelor in elderly patients with acute myocardial infarction after percutaneous coronary intervention WANG Ning-ning, ZHANG Feng-mei, REN Guo-cheng, WU Di, SONG Shuang, XU Xin-yu 2021, 35 (3):  246-249.  doi: 10.3969/j.issn.1003-9198.2021.03.009 Abstract ( 157 )   PDF (1121KB) ( 1877 )   Save Objective To compare the efficacy and safety of antiplatelet therapy in the patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) between low-dose ticagrelor (180 mg loading, 60 mg twice daily) and standard-dose ticagrelor (180 mg loading, 90 mg twice daily). Methods A total of 196 patients with AMI who were successfully treated by PCI were randomly divided into low-dose ticagrelor group and standard-dose ticagrelor group. The major adverse cardio-cerebrovascular events (MACCE) and bleeding events during hospitalization and one-year follow-up were recorded in detail. Results There was no significant difference in MACCE between low-dose ticagrelor group and standard-dose ticagrelor group during hospitalization (10. 5% vs 11. 7%, P= 0. 825). The risk of minor bleeding (8. 4% vs 18. 6%, P=0. 061) and major bleeding (1. 1% vs 2. 9%, P=0. 622) were comparable between the two groups. Kaplan-Meier survival analysis showed that there was no significant difference in 1-year MACCE-free survival rate between low-dose ticagrelor group and standard-dose ticagrelor group (P=0. 823). The risk of minor bleeding was significantly lower in low-dose ticagrelor group than that in standard-dose ticagrelor group (16. 8% vs 36. 9%, P=0. 002) 1 year after PCI, and there was no significant difference in major bleeding (1. 1% vs 3. 9%, P=0. 371). Conclusions Compared with the routine dose, low-dose ticagrelor does not increase the incidence of MACCE, while reduce the risk of minor bleeding in the patients with AMI after PCI. References | Related Articles | Metrics

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Relationship between frailty and osteoporosis in the community elderly XI Jing, ZHU Xing-bo 2021, 35 (3):  250-253.  doi: 10.3969/j.issn.1003-9198.2021.03.010 Abstract ( 178 )   PDF (1027KB) ( 1041 )   Save Objective To explore the relationship between frailty and osteoporosis in the community elderly. Methods A cross-sectional survey was conducted. The Tilburg Frailty Indicator(TFI) was used to evaluate frailty, and Osteoporosis Self-assessment Tool For Asians (OSTA) was used to evaluate osteoporosis in the community elderly. The general data was recorded and physical test was conducted in the meanwhile. Logistic regression analysis was used to evaluate the influencing factors of frailty. Results The incidence rate of osteoporosis in the frailty patients was significantly higher than that in the non-frailty patients(21. 4% vs 4. 8%,P＜0. 01). There were significant differences in the incidence rate of frailty, score of TFI and physical fitness between the different osteoporosis risk groups (P<0. 01). The correlation between the OSTA index and the total score of frailty, physical function score and psychological score was significant (r=-0. 297,-0. 320,-0. 114,P<0. 05). The independent influencing factors of frailty were the number of comorbidities, osteoporosis, the habit of drinking tea and exercise. Conclusions There is a correlation between frailty and osteoporosis, which is one of the risk factors of frailty. References | Related Articles | Metrics

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Risk factors for persistent atrial fibrillation in patients with heart failure with reducesd ejection fraction SHI Yun-tao, WANG Lian, XIE Jun 2021, 35 (3):  254-256.  doi: 10.3969/j.issn.1003-9198.2021.03.011 Abstract ( 179 )   PDF (1005KB) ( 1025 )   Save Objective To study the risk factors of persistent atrial fibrillation (AF) in the patients with heart failure with reduced ejection fraction (HFrEF ). Methods Totally 78 patients with HFrEF admitted in Gaochun People's Hospital from January to December 2017 were collected. According to the type of AF,the patients were divided into paroxysmal AF group (n=16)and persistent AF group (n=62). The risk factors for persistent AF were analyzed by multivariate Logistic regression analysis and receiver operator characteristic(ROC)curve analysis respectively. Results The levels of left atrial diameter (LAD), uric acid and the prevalence of type 2 diabetes were higher, and the level of body mass index, the prevalence of valvular heart disease were lower in persistent AF group than those in paroxysmal AF group(P＜0. 05). Multivariate Logistic regression analysis showed that LAD was the independent risk factor for patients with persistent AF(OR=1. 256,95%CI:1. 071-1. 473). ROC curve revealed that optimal cut-off point of LAD was 49. 5 mm, and area under ROC curve was 0. 871 with sensitivity and specificity of 51. 6% and 41. 5%. Conclusions LAD is an independent risk factor for persistent AF in the patients with HFrEF.     References | Related Articles | Metrics

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Effect of vitamin D on RAAS and IL-18 in elderly patients with chronic heart failure SHAO Wei-hua, LV Cai-xia, YAO Li-xia, LI Fang, WANG Su-xing, LI Shao-bing, GAO Li-xia 2021, 35 (3):  257-260.  doi: 10.3969/j.issn.1003-9198.2021.03.012 Abstract ( 167 )   PDF (1028KB) ( 971 )   Save Objective To observe the effects of vitamin D on renin-angiotensin-aldosterone system (RAAS) and the inflammation factors in the elderly patients with chronic heart failure (CHF),and to provide new ideas and methods for the treatment of CHF. Methods Sixty-eight elderly (≥80 years old) patients with CHF and vitamin D deficiency who were treated in the Geriatrics Department of our hospital from March 2018 to March 2019 were selected and divided into control group and observation group, with 34 cases in each group. The control group was treated according to the guidelines for heart failure, and the observation group was treated with calcitriol (0. 25 μg, twice a day) on the basis of the control group for 24 weeks. The levels of serum 25 (OH) D3, plasma renin activity (PRA), angiotensin Ⅱ (AngⅡ), lying aldosterone (ALD), N-terminal brain natriuretic peptide precursor (NT-proBNP), interleukin-18 (IL-18), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and left ventricular ejection fraction (LVEF) were measured before and after treatment and compared between two groups. Results The levels of serum 25 (OH) D3 and LVEF 24 weeks after in the observation group were higher than those before treatment and in the control groups (P<0. 05). The levels of NT-proBNP, PRA, AngⅡ, ALD, IL-18, CRP, TNF-α in the observation group were lower than those before treatment and in the control groups (P<0. 05). Conclusions Vitamin D supplementation on the basis of conventional anti-heart failure treatment can improve the heart function of the elderly patients with CHF. The mechanism may be related to vitamin D inhibiting renin-angiotensin-aldosterone system activity and reducing the body’s inflammatory response. References | Related Articles | Metrics

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Effects of MOTO tiles on cognitive and motor functions in the elderly with mild to moderate cognitive impairment WANG Jing, FANG Yuan, ZHANG Shao-wei, QIU Qi, LIU Xiang, LI Xia, WU Li-li, YANG Yang 2021, 35 (3):  261-264.  doi: 10.3969/j.issn.1003-9198.2021.03.013 Abstract ( 152 )   PDF (1031KB) ( 1117 )   Save Objective To explore the effect of MOTO tiles on the cognition function and motor balance function of the elderly with mild to moderate cognitive impairment. Methods The subjects were randomly divided into the intervention group and the control group. The intervention group received both 12 session MOTO tile training and daily care, while the control group only received daily care. The self-designed questionnaires, Montreal Cognitive Assessment (MoCA), Digit span test-Forward (DST-F), Digit span test-backward (DST-B), Berg Balance Scale(BBS), five times sit to stand test (FTSST) and time up & go test (TUGT) were tested respectively at baseline and 4 weeks later. Results No significant differences were found in age, gender, education, cognitive assessment and motor assessment scores between the two groups (P＞0. 05). After four weeks, the levels of MoCA, DST-F, DST-B, DST-F+B, and BBS scores were significantly higher and the levels of TUGT and FTSST were significantly lower in the intervention group than those at the baseline (P＜0. 05 or P＜0. 01). And the changes of MoCA、DST-F, DST-B, DST-F+B and BBS scores of intervention group were higher and the changes of TUGT and FTSST were shorter than those of the control group (P＜0. 01). Conclusions MOTO tiles training can improve the cognition and motor function in the elderly with mild to moderate cognitive impairment and can be promoted among the elderly. References | Related Articles | Metrics

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A cross-sectional study on the association between sleep characteristics and hypertension in middle-aged and elderly rural population DONG Jia-yi, WANG Jia-cheng, HE Qiu-hui, BIAN Sai,REN Jiang-lei, WANG Jin, WEI Lai, LU Hui, ZHOU Ming, SU Yi-min, SHEN Chong, HAN Hong-fang, ZHU Ke-qing 2021, 35 (3):  265-269.  doi: 10.3969/j.issn.1003-9198.2021.03.014 Abstract ( 181 )   PDF (1048KB) ( 1204 )   Save Objective To investigate the relationship between sleeping characteristics and hypertension in the middle-age and elderly rural population by a cross-sectional study. Methods A total of 429 villagers from 12 villages of Feng County were recruited and an epidemiological survey was conducted with questionnaire and physical examinations, including demographic characteristics, history of disease, living habits, sleep characteristics, height, weight, blood pressure and so on. Results The prevalence rate of hypertension in the whole population was 47. 6%(204/429),with 43. 8%(149/340) presenting with poor sleep quality, 18. 1%(76/421) presenting with sleep duration less than 6 h. After adjusting for confounding factors, the individuals who presented with poor sleep quality, moderate subjective sleep quality, poor subjective sleep quality, sleep latency score of 3, sleep duration less than 6 h showed a high risk of hypertension (OR=1. 735, 1. 761, 2. 495, 2. 061, 1. 980 respectively). The associations between sleep characteristics and hypertension in the whole study population were also found among females, ＞65 years, and overweight population. In addition, among overweight population, sleep efficiency ＜75% was associated with higher risk of hypertexion compared with sleep officiency ≥85% (OR=2. 287). Conclusions It is necessary to attach importance to the effect of sleep quality on hypertension and the hypertension management among the elderly population, and individualized interventions should be conducted regarding to different age, gender and weight. References | Related Articles | Metrics

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Sequential administration of two fluoroquinolones in the treatment of elderly patients with acute exacerbation of severe chronic obstructive pulmonary disease XU Hong-fei, LIU Yan-chun, WANG Chun-xian 2021, 35 (3):  270-273.  doi: 10.3969/j.issn.1003-9198.2021.03.015 Abstract ( 155 )   PDF (1030KB) ( 1106 )   Save Objective To compare the efficacy and safety of Moxifloxacin and Levofloxacin by sequential administration in the treatment of acute exacerbation of severe chronic obstructive pulmonary disease (AECOPD) in the elderly. Methods A total of 120 elderly patients with severe AECOPD admitted from January 2017 to October 2019 were randomly divided into observation group and control group with 60 cases in each group. In the observation group, Moxifloxacin was given sequentially, while in the control group, Levofloxacin was given sequentially. All subjects were treated continuously for 10 days. The bacteria clearance and the occurrence of side reaction were counted. Before and after treatment, the parameters of lung function, such as forced breath volume in the first second (FEV1), forced vital capacity (FVC), FEV1/FVC, arterial oxygen and carbon dioxide partial pressure (PaO2 and PaCO2) and arterial oxygenation were measured and compared. Results After treatment, the total effective rate of the observation group was 91. 67% (55/60), which was significantly higher than that of the control group (73. 33%). In the observation group, 38 strains were isolated and 31 strains were eliminated, and the pathogen clearance rate was 81. 58% (31/38), compared with 60. 00%(21/35) in the control group. After treatment, FEV1, FVC and FEV1 / FVC in the two groups were significantly higher than those before treatment, especially in the observation group (P<0. 05). The levels of PaO2 and SaO2 were significantly increased, and the level of PaCO2 was significantly decreased in both groups after treatment, and especially in the observation group(P<0. 05). There was no significant difference in the adverse reaction rate between the two groups (8. 33% vs 10. 00%, P>0. 05). Conclusions The sequential therapy of moxexine in the treatment of severe AECOPD in the elderly can improve the pulmonary function, hypoxia and carbon dioxide retention, and the clearance rate of pathogenic bacteria is more significantly than the sequential therapy of Levofloxacin.     References | Related Articles | Metrics

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Application of exercise training complicated with home exercise in elderly patients receiving pulmonary rehabilitation YU Chun-ni, WEI Jun, FAN Xiao-jun, GONG Yu-lei 2021, 35 (3):  274-277.  doi: 10.3969/j.issn.1003-9198.2021.03.016 Abstract ( 166 )   PDF (1020KB) ( 912 )   Save Objective To explore the application effect of exercise training combined with home exercise in elderly patients with pulmonary rehabilitation and its influence on the scores of St. George’s Respiratory Questionnaire (SGRQ) and dyspnea index (mMRC). Methods A total of 60 elderly patients who underwent pulmonary rehabilitation exercises from June 2017 to June 2019 were selected. They were divided into two groups by random number table method, with 30 cases in each group. The control group was given a routine rehabilitation mode, and the observation group received exercise training combined with home exercises. Both groups completed 4 weeks of intervention. The lung function, blood gas indexes, dyspnea score, 6-min walking distance (6MWD), SGRQ score and BODE index were compared between the two groups. Results The lung function in the observation group after intervention was better than that of the control group, and the arterial oxygen partial pressure was higher than that of the control group, and the blood carbon dioxide partial pressure was lower than that of the control group (P<0. 05). The score of mMRC in the observation group was lower than that of the control group, and 6MWT was longer than that of the control group (P<0. 05). The scores of SGRQ and BODE index in the observation group after intervention were lower than those in the control group (P<0. 05). Conclusions The application of exercise training combined with home exercise in the elderly patients undergoing pulmonary rehabilitation can significantly improve the patients' lung function, improve the ability to perform exercise endurance, and reduce the discomfort symptoms, the recurrence rate, and family and social stress. References | Related Articles | Metrics

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Application of urine microalbumin/creatinine in screening chronic kidney disease in the elderly SUN Zhi-ping, DAI Ying, ZHOU Rong, WU Xiao-chun 2021, 35 (3):  278-281.  doi: 10.3969/j.issn.1003-9198.2021.03.017 Abstract ( 207 )   PDF (1030KB) ( 1411 )   Save Objective To investigate the application of urinary microalbumin/creatinine (ACR) in screening chronic kidney disease (CKD) in the elderly. Methods A total of 1029 elderly who underwent ACR examination in the health management center of the Second Affiliated Hospital of Nanjing Medical University from March 2016 to June 2019 were randomly selected and divided into two groups: ACR+ group with ACR≥30 mg/g and ACR- group with ACR<30 mg/g. The general clinical characteristics and laboratory parameters of the two groups were compared. The clinical data were stratified and assigned into Logistic regression equation to analyze the influencing factors of ACR+. Results The detection rate of ACR+ was 21. 67% in the elderly undergoing physical examination. The levels of body mass index (BMI), fasting plasma glucose (FPG), systolic blood pressure, blood uric acid and triglyceride (TG) of ACR+ patients were significantly higher than those of ACR- patients. Most of the subjects were in the stage before CKD 3 stage, and ACR+ was positively correlated with CKD stage. Multivariate Logistic regression analysis showed that age (OR=1. 761, 95% CI: 1. 406-2. 205), BMI (OR=1. 479, 95% CI: 1. 237-1. 767), hypertension (OR=1. 228, 95% CI: 1. 228-1. 872), FPG blood glucose (OR=1. 913, 95% CI: 1. 544-2. 371) were positively correlated with ACR+. Conclusions High blood glucose, hypertension and high BMI are independent risk factors of proteinuria in the elderly. ACR detection is helpful for early detection of CKD in these people. References | Related Articles | Metrics

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Correlation of Parkinsons disease with gut microbiota, short-chain fatty acids and inflammatory factors in elderly LI Jian-lan, YU Xuan, HU Qing-ting, ZUO Dan-dan 2021, 35 (3):  282-285.  doi: 10.3969/j.issn.1003-9198.2021.03.018 Abstract ( 158 )   PDF (1043KB) ( 1303 )   Save Objective To investigate the correlation between gut microbiota, short-chain fatty acids and inflammatory factors in the elderly patients with Parkinson's disease(PD). Methods The 16S rDNA gene real-time fluorescent quantitative PCR method was used to detect the levels of F. prausnitzii, E. rectale, Bifidobacterium and Lactobacillis in the feces of PD patients and control group. Gas chromatography was used to detect the levels of short-chain fatty acids (acetic acid, propionic acid and butyric acid) in the intestinal feces and ELISA method was used to detect serum levels of tumor nerosis factor (TNF-α), interloukin-6(IL-6) and IL-10 of the two groups. Results Compared with the control group, the levels of E. rectal, F. prausnitzii, Lactobacillis, propionic acid and butyric acid in the PD group were significantly decreased (P<0. 05). Compared with the control group, the plasma levels of TNF-α and IL-6 in the PD group were significantly increased (P<0. 05). The total score of the Unified Parkinson's Disease Rating Scale was negatively correlated with the levels of E. rectal, F. prausnitzii propionic acid and butyric acid in intestines (P<0. 05), and positively correlated with the serum levels of TNF-α and IL-6 (P<0. 05). Conclusions In elderly patients with PD, the level of short-chain fatty acid-producing bacteria in the intestines is reduced. Short-chain fatty acids may induce inflammation in the body and aggravate the occurrence and development of PD, but the mechanism needs further study. References | Related Articles | Metrics

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Effects of different methods infusion of propofol on delirium in elderly patients receiving hip replacement surgery YAO Jie, CHEN Yan-lin, XU Xiao-qing, WANG Li, TENG Jin-liang, LI Fu-long, LIU Fei, ZUO Mu-yan 2021, 35 (3):  286-289.  doi: 10.3969/j.issn.1003-9198.2021.03.019 Abstract ( 181 )   PDF (1033KB) ( 1159 )   Save Objective To investigate the effects of propofol infusion by different methods on delirium in the elderly patients receiving hip replacement surgery. Methods Sixty patients undergoing hip replacement with general anesthesia were assigned into dose-loop target control infusion group(group A)and experienced group(group B) by random number table with 30 cases in each group. The events in operation were recorded and compared, including anesthesia time, surgery time, fluid volume, blood loss, urine volume. The total usage of propofol, remifentanil and cisatraeurium, and the incidence rates of emergence agitation, postoperative nausea and vomiting and intraoperative awareness were also recorded and compared. The cognitive function score of patients before and after anesthesia, the incidence rate of postoperative delirium were recorded and compared between the two groups. Results The perioperative dosages of propofol and cisatraeurium in group A were significantly lower than those in group B (P<0. 05). The CAM scores in group A were significantly lower than those in group B 2, 6 hours after operation. The incidence rate of postperative delirium in group A and group B was 17. 2%, 37. 9% respectively (P=0. 078). Conclusions Closed loop target control infusion of propofol can reduce the dosage of anesthetics and the incidence rate of postoperative delirium. References | Related Articles | Metrics

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Effect of cardiac intervention on inflammatory factors and ventricular remodeling in elderly patients with acute myocardial infarction WANG Hong-yin, XU Cai-yun, WANG Hai-yun 2021, 35 (3):  290-293.  doi: 10.3969/j.issn.1003-9198.2021.03.020 Abstract ( 151 )   PDF (1023KB) ( 1023 )   Save Objective To investigate the clinical efficacy of cardiac intervention therapy in the elderly patients with acute myocardial infarction and the influence on inflammatory factors and ventricular remodeling. Methods A total of 88 elderly patients with acute myocardial infarction from March 2018 to March 2019 were divided into control group (n=44) and observation group (n=44). The control group was given interventional therapy, and the observation group received cardiac intervention on the basis of the control group. The effect was evaluated after 4 weeks of treatment. The levels of cardiac function, inflammatory factors, ventricular remodeling and incidence rate of cardiovascular complications were compared between the two groups. Results The level of left ventricular ejection fraction (LVEF) in the observation group was higher than that of the control group 4 weeks after treatment (P<0. 05); The levels of left ventricular end diastolic diameter (LVEDD) and left ventricular end systolic diameter (LVESD) in the observation group were lower than those in the control group (P<0. 05). The levels of the inflammatory factors including B-type natriuretic peptide (BNP), soluble apoptosis related factor (s-fas), interleukin-6 (IL-6) and high sensitivity C-reactive protein (hs-CRP) in the observation group were lower than those in the control group (P<0. 05). The incidence rate of cardiovascular complications including recurrent angina pectoris, heart failure, cardiogenic shock, arrhythmia and recurrent myocardial infarction in the observation group was lower than that in the control group(P<0. 05). Conclusions Cardiac intervention in the elderly patients with acute myocardial infarction can improve the level of cardiac function and the ventricular remodeling, and reduce the level of inflammatory factors and the incidence rate of interventional therapy complications, which is worthy of promotion and application. References | Related Articles | Metrics

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Clinical study of donepezil combined with ginkgo biloba tablet for moderate to severe Alzheimer’s disease WU Huan-yu, ZHANG Li-juan, ZHANG Xue-lian, SHI Lu-hang 2021, 35 (3):  294-296.  doi: 10.3969/j.issn.1003-9198.2021.03.021 Abstract ( 201 )   PDF (1049KB) ( 1110 )   Save Objective To study the effect of donepezil combined with ginkgo biloba tablet for moderate to severe Alzheimer’s disease (AD). Methods From June 2017 to June 2019, 98 elderly patients with moderate to severe AD were selected as the research subjects. All the patients were randomly divided into two groups according to random number table method, including 49 patients in the control group (receiving donepezil) and 49 patients in observation group (receiving donepezil + ginkgo biloba). The changes of Min-Mental State Examination (MMSE), Barthel Index (BI), the Neuropsychiatric Inventory (NPI) before and after treatment were compared between the two groups. The incidence rate of adverse reaction during treatment was compared between the two groups. Results After treatment, the scores of MMSE and BI in both groups were significantly increased, and the score of NPI was significantly decreased, especially in the observation group(P<0. 05). The difference of the incidence rate of adverse reactions between the two groups was not statistically significant (P>0. 05). Conclusions Donepezil combined with ginkgo biloba tablet is reliable and effective in the treatment of moderate to severe Alzheimer’s disease. References | Related Articles | Metrics

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Comparison of two kinds of intrathoracic anastomosis in minimally invasive surgery for elderly patients with esophageal cancer ZHU Mao-shan, ZHANG Ting-ting, SHI Xiao-qing, NI Bin 2021, 35 (3):  297-300.  doi: 10.3969/j.issn.1003-9198.2021.03.022 Abstract ( 160 )   PDF (1030KB) ( 921 )   Save Objective To compare the feasibility and safety of inverted puncture and conventional intrathoracic anastomosis in esophagectomy in the elderly patients with esophageal cancer. Methods A retrospective study was conducted including 42 patients aged over 60 years old with esophageal cancer from January 2017 to January 2020. According to the different methods of thoracic anastomosis, 42 patients were divided into group A and group B with 21 case in each group. Group A was anastomosed by inverted puncture. Group B received routine anastomosis. The general data of patients before operation were collected, and the data of anastomotic time, anastomotic site, intraoperative bleeding, postoperative anastomotic complications and postoperative hospital stay were compared between the two groups. Results A total of 17 patients in group A successfully completed the operation. Four patients were transferred to surgery for various reasons. All the patients in group B completed smoothly. There were no significant differences in general data of sex and age between the two groups(P>0. 05). The anastomosis time was lower, and anastomotic site was higher in group A than those in group B (P<0. 05). There were no significant differences in the volume of intraoperative hemorrhage, postoperative hospitalization days and complications between the two groups (P> 0. 05). Conclusions Both inverted puncture and conventional thoracic anastomosis are feasible and safe. References | Related Articles | Metrics

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Effects of edaravone on outcomes in the elderly patients with acute ischemic stroke treated with recombinant tissue plasminogen activator DING Gui-bing, WU Yan-feng, CHEN Liang, WU Jin, ZHANG Peng 2021, 35 (3):  301-305.  doi: 10.3969/j.issn.1003-9198.2021.03.023 Abstract ( 185 )   PDF (1042KB) ( 871 )   Save Objective To investigate the effect edaravone before or after recombinant tissue plasminogen activator (rt-PA) on the outcome of acute ischemic stroke in the elderly patients. Methods A retrospective cohort study was conducted using the stroke register database in the Second Affiliated Hospital of Nanjing Medical University. A total of 135 elderly patients with ischemic stroke from 2014 to 2018 were selected. The patients received edaravone before rt-PA administration were enrolled as study group (n=67), and those who received edaravone after rt-PA were enrolled as control group (n=68). The scores of modified Rankin Scale (mRS) 90 d after treatment, National Institutes of Health Stroke Scale (NIHSS) scores 24 h and 7 days after intravenous thrombolysis, the incidence rate of acute cerebral infarction hemorrhagic transformation, 7-day and 90-day mortality were compared between the two groups. Results The NIHSS scores 24 h and 7 days after intravenous thrombolysis were lower in study group than those in control group (8. 67±8. 55 vs 11. 88±8. 30; 5. 08±5. 35 vs 8. 60±7. 91), 90 d recanalization rate was higher in study group than that in the control group (53. 73% vs. 27. 94%). The rates of intracranial hemorrhage (ICH) (9. 1% vs. 18. 3%) and the rate of symptomatic intracranial hemorrhage (sICH) (2. 0% vs. 8. 7%) in study group were lower than those in control group. Logistic regression analysis showed that the administration of edaravone before rt-PA was significantly associated with lower mRS scores of the patients (OR=0. 28, 95%CI: 0. 14-0. 58). Conclusions The administration of edaravone before rt-PA may improve the outcome in the elderly patients with acute ischemic stroke treated with rt-PA. References | Related Articles | Metrics

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Application of sequential precision non-artificial airway management in elderly patients after posterior cranial fossa surgery CHEN Hua-yu, LI Ju-hua, WANG Bin-bin, DING Min, XU Qin, LI Chong 2021, 35 (3):  318-320.  doi: 10.3969/j.issn.1003-9198.2021.03.028 Abstract ( 130 )   PDF (1011KB) ( 1026 )   Save Objective To explore the effect of sequential accurate non-artificial airway management in the elderly patients with posterior fossa neuropathy after craniotomy. Methods A total of 70 patients with consciousness disturbance undergoing routine airway management after craniotomy from January to December 2018 were selected as the control group. At the same time, 67 patients received sequential, precise airway management from January to December 2019 were chosen as the study group. The incidence of sputum aspiration complications, endotracheal intubation rate and average length of hospital stay were evaluated and compared between the two groups. Results The incidence rate of sputum aspiration complications, pulmonary infection in the study group was significantly lower than that of the control group(P<0. 05), as well as the average length of hospital stay. There was no significant difference in the rate of endotracheal intubation between the two groups(P>0. 05). Conclusions Sequential precision non-artificial airway management can reduce the incidence of sputum aspiration complications, pulmonary infection and the length of hospital stay in patients with neurosurgical consciousness disorder, and is a safe and effective airway management method. References | Related Articles | Metrics