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20 April 2021, Volume 35 Issue 4 Previous Issue    Next Issue

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Alpha-lipoic acid inhibits endothelial cell proliferation WANG Juan, WANG Zhu-yao, NI Yan, CAO Xiao-fei, DING Zheng-nian 2021, 35 (4):  341-344.  doi: 10.3969/j.issn.1003-9198.2021.04.006 Abstract ( 145 )   PDF (1573KB) ( 1056 )   Save Objective To investigate the effect of alpha-lipoic acid (LA) on the proliferation of endothelial cells. Methods Human umbilical vein endothelial cells(HUVECs) were treated with LA. Cell viability was determined by MTT assay. Cell proliferation was evaluated by EdU incorporation. Cell death was determined by lactate dehydrogenase (LDH) leakage and Hoechst33342 staining assays. Gene expression was examined by polymerase chain reaction and Western blot analysis. Results LA reduced viable HUVECs in a dose- and time-dependent manner. LA inhibited HUVECs proliferation and the expression of C-Myc. LA did not result in LDH leakage and nuclei condensation. Conclusions LA inhibits HUVECs proliferation whereas not causing cell death. LA may have theropeutic potentials in the excessive angiogenesis-related diseases such as cancers. References | Related Articles | Metrics

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Antithrombotic therapy and reason of readmission in elderly patients with atrial fibrillation combined with coronary heart disease WU Jun, MEN Chen, WANG Sen, PANG Si-si, WANG Xiang-ming, XU Di, GUO Yan 2021, 35 (4):  345-349.  doi: 10.3969/j.issn.1003-9198.2021.04.007 Abstract ( 218 )   PDF (1330KB) ( 1002 )   Save Objective To evaluate the antithrombotic therapy in the elderly patients with atrial fibrillation combined with coronary heart disease, and to analyze the main adverse cardiovascular events (MACE) and the reasons of rehospitalization. Methods A total of 976 patients with atrial fibrillation combined with coronary heart disease from January 2013 to December 2014 in our hospital were selected, and were divided into acute coronary syndrome (ACS) group and stable coronary heart disease (SCAD) group and were followed up for 3 years. The selection of antithrombotic drugs, the incidence rate of readmission due to MACE in the two groups were compared. Results The patients in ACS group preferred dual antiplatelet therapy (DAPT), while those in SCAD group more inclined to anticoagulant therapy, and there was a significant difference between the two groups (P<0. 05). In ACS group, the rate of readmission was 23. 9%, compared with 35. 5% in the SCAD group(P<0. 05). Ventricular arrhythmia, heart failure, and ACS were the top three reasons for readmission in SCAD group. Myocardial infarction and heart failure were the main reasons of ACS group readmission. Conclusions ACS patients with atrial fibrillation tend to choose DAPT treatment, while SCAD patients tend to take oral anticoagulation therapy. Compared with ACS patients, SCAD patients have a higher MACE rate and readmission rate. References | Related Articles | Metrics

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Risk factors related to mild cognitive impairment in patients with Parkinson’s disease and its impact on quality of life DONG Zhen, HU Yue, HONG Yin, XU Jun, WEI Yan-qiu, SUN Sheng-nan, XU Yao 2021, 35 (4):  350-353.  doi: 10.3969/j.issn.1003-9198.2021.04.008 Abstract ( 235 )   PDF (1011KB) ( 1018 )   Save Objective To study the influencing factors of Parkinson’s disease (PD) with mild cognitive impairment (MCI) in Chinese population and the impact on quality of life. Methods A total of 127 non-demented PD patients were included. The patients were divided into PD with normal cognitive (PD-NC) group and PD-MCI group according to the Chinese version of Montreal Cognitive Assessment score. Clinical characteristics and quality of life of the two groups were compared and analyzed. Multivariate Logistic regression was used to analyze the relevant factors of PD-MCI. Results PD-MCI was present in 45. 67% of non-demented PD patients. Univariate analysis showed that age, onset age (early onset, late onset), years of education, Unified Parkinson’s Disease Rating Scale (UPDRS)-Ⅲ score, Hoehe-Yehr grade, Hamilton Anxiety Scale score and serum homocysteine levels showed statistically significant differences between the two groups(P <0. 05). Multivariate Logistic regression analysis showed that hight UPDRS-Ⅲ score and serum level of homocysteine were risk factors for PD-MCI, and high education level was a protective factor. UPDRS-Ⅱ score and Activity of Daily Living (ADL) score in PD-MCI group were higher than those in PD-NC group, while the score of Parkinson’s disease quality of life questionnaire-39 (PDQL-39) was lower than that in PD-NC group(P<0. 05). Conclusions The higher serum homocysteine level, the more severe movement disorder, and the lower education level of the PD patients, the higher risk of cognitive impairment. In addition, PD-MCI patients have a worse quality of life than PD-NC patients. References | Related Articles | Metrics

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Effect of aging on the expression of CD4+CD25+Foxp3+ regulatory T cells, CD4+T cells and cytokines in peripheral blood YANG Xiang, WAN Wen-hui, GONG Ge, ZHANG Yuan, CHEN Yang-xi, LIU Yu, ZHANG Xing-hu, LUO Jie, LI Han-qing 2021, 35 (4):  354-357.  doi: 10.3969/j.issn.1003-9198.2021.04.009 Abstract ( 193 )   PDF (1014KB) ( 834 )   Save Objective To investigate the effects of aging on the expression of CD4+CD25+Foxp3+ regulatory T cells (Treg), CD4+T cells in human peripheral blood and the levels of cytokines. Methods The absolute counts of CD4+T cells and CD4+CD25+Foxp3+ Treg, and the levels of interleukin-2 (IL-2), interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), IL-10 and IL-17 were measured respectively in peripheral blood of 40 young persons (20-45 years old), 40 middle-aged persons (50-75 years old) and 40 elderly persons (above 80 years old), and also the percentage of CD4+CD25+Foxp3+Treg in CD4+T cells in peripheral blood of the three groups was calculated. The differences among the three groups were compared. Results The absolute count of CD4+T cells in peripheral blood decreased significantly in the elderly group than those in the young group and the middle-aged group(P<0. 05). The absolute count of CD4+CD25+Foxp3+Treg was significantly higher in peripheral blood in the elderly group and the middle-aged group than that in the young group(P<0. 05). The percentage of CD4+CD25+Foxp3+Treg in CD4+T cells was the highest in the elderly group, followed by the middle-aged group and the young group (P<0. 05). The levels of IL-2, IFN-γ and IL-17 in the elderly group were significantly lower than those in the young group and the middle-aged group (P<0. 05), and the level of IL-2 in the middle-aged group was significantly lower than that in the young group (P<0. 05). The level of IL-10 in the elderly group was significantly higher than that in the young group and the middle-aged group (P<0. 05), and the level of TNF-α among the three groups showed no significant difference (P>0. 05). Conclusions The absolute count of CD4+CD25+Foxp3+Treg in peripheral blood increases significantly after middle-age. With the increase of age, the ratio of CD4+CD25+Foxp3+Treg/CD4+T cells increases significantly. In the elderly, the absolute count of CD4+T cells and the levels of IL-2, IFN-γ, IL-17 decrease significantly, while the level of IL-10 significantly increases, indicating that the immune function of the elderly further decreases and the microenvironment is changed. References | Related Articles | Metrics

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Effect of intestinal microecological preparation on residual renal function, micro-inflammation and oxidative stress in elderly patients with chronic renal failure undergoing peritoneal dialysis LIU Cui-lan, JIN Yu-jie, HAN Xiao-li, LIU Sheng-jun, GUO Bao-zhu, LIU Jun-fen 2021, 35 (4):  358-361.  doi: 10.3969/j.issn.1003-9198.2021.04.010 Abstract ( 158 )   PDF (1010KB) ( 918 )   Save Objective To observe the effect of intestinal microecological preparation in the elderly patients with chronic renal failure at end stage undergoing peritoneal dialysis. Methods A total of 100 elderly patients with chronic renal failure at end stage who underwent peritoneal dialysis in the hospital from January 2019 to January 2020 were selected, and they were divided into observation group and control group according to parity number method, with 50 cases in each group. The control group was treated with peritoneal dialysis and routine treatment, and the observation group was treated with peritoneal dialysis, routine treatment and intestinal microecological preparation. Both groups were treated for 2 months. The residual renal function, micro-inflammation state [C-reactive protein (CRP), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)] and oxidative stress response [malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px)] of the two groups were detected before treatment and 2 months after treatment; The incidence rate of peritonitis in the two groups was recorded during 2 months of treatment. Results After 2 months of treatment, the residual renal function of both groups was significantly lower than that before treatment, especially in the observation group (P<0. 05); The levels of CRP, hs-CRP, IL-6, TNF-α and MDA in both groups were significanty lower, while the levels of SOD and GSH-Px were significantly higher than those before treatment, especially in the observation group (P<0. 05); During the treatment, the incidence rate of peritonitis in the observation group was lower than that in the control group (P<0. 05). Conclusions The combination of intestinal microecological preparation in treatment of peritoneal dialysis in the elderly patients with chronic renal failure at end stage can improve the residual renal function, alleviate the degree of systemic micro-inflammatory response and oxidative stress, and decrease the incidence rate of peritonitis, which has a high clinical application value. References | Related Articles | Metrics

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Relationship between blood pressure parameters and renal dysfunction in elderly male patients with chronic kidney disease CHEN Ying, LIU Qi 2021, 35 (4):  362-365.  doi: 10.3969/j.issn.1003-9198.2021.04.011 Abstract ( 233 )   PDF (1049KB) ( 922 )   Save Objective To explore the relationship between blood pressure parameters and renal dysfunction in the elderly male patients with CKD and hypertension. Methods The elderly male patients with CKD at stage 3-4 and hypertension in our hospital from January 2015 to December 2019 were selected. The clinical laboratory data and 24 h ambulatory blood pressure in two years were recorded in a row. The patients were divided into two groups according to eGFR decline [the level of eGFR decreased >8 mL/(min·1. 73m2)in two years]. The data of stable renal function group and progressive renal function group were statistically analyzed. Results The baseline level of renal function in the stable renal function group was lower than that in the progressive renal function group (P<0. 05), but there was no significant difference in other clinical data (P>0. 05); There was no significant difference in the observed parameters of renal function between the two groups two years later (P>0. 05). Compared with stable renal function group, the status of hypertension control in progressive renal function group was worse, especially in SBP(P<0. 05). Conclusions High blood pressure variability is common in the elderly male patients with CKD and hypertension. Poor control of SBP may be one of the main reasons for the renal progression. References | Related Articles | Metrics

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Effects of isoniazid injection by fiberoptic bronchoscope on inflammatory factors and pulmonary function in elderly patients with bronchial tuberculosis BA Qing-yun, HAN Qing 2021, 35 (4):  366-369.  doi: 10.3969/j.issn.1003-9198.2021.04.012 Abstract ( 223 )   PDF (1001KB) ( 1008 )   Save Objective To investigate the clinical effect of fibrobronchoscope Olympus BF40 combined with isoniazid injection in the elderly patients with bronchial tuberculosis and its influence on the inflammatory factors and pulmonary function. Methods A total of 122 elderly patients with bronchial tuberculosis who were treated from January 2017 to December 2018 were selected and divided into control group (n=61) and observation group (n=61) according to the treatment methods. The control group was given 3HRZE/9HRE treatment, and the observation group was treated with fibrobronchoscope Olympus BF40 combined with isoniazid injection on the basis of the control group. After 6 months of treatment, the rate of sputum negative conversion, the levels of inflammatory factors and lung function of the two groups were compared. Results The sputum negative conversion rates of the observation group were 80. 33% and 91. 80% 3 months and 6 months after treatment, compared with 62. 30% and 73. 77% in the control group respectively. The level of interferon-γ in the observation group was higher, and the levels of CRP and IL-6 were lower than those in the control group (P<0. 01); The levels of forced expiratory volume in one second (FEV1), FEV1/forced vital capacity (FVC) and maximal voluntary ventilation (MVV) of the observation group were higher than those of the control group 6 months after treatment (P<0. 01). There was no significant difference in the incidence rate of adverse events between the two groups (χ2=1. 291, P=0. 536). Conclusions Olympus BF40 combined with isoniazid injection in the elderly patients with bronchial tuberculosis is helpful to improve the negative conversion rate of sputum bacteria, improve the levels of inflammatory factors and pulmonary function, which is worthy of promotion and application. References | Related Articles | Metrics

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Expression of serum high mobility group protein B1 and effect of N-acetylcysteine effervescent tablets in elderly patients with acute exacerbation of chronic obstructive pulmonary disease ZHANG Li-nan, DI Hong, LIU Ming 2021, 35 (4):  370-373.  doi: 10.3969/j.issn.1003-9198.2021.04.013 Abstract ( 146 )   PDF (1002KB) ( 1062 )   Save Objective To investigate the expression of serum high mobility group protein B1 (HMGB1) in the elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and the intervention effect of N-acetylcysteine effervescent tablets. Methods From January 2018 to October 2019, 82 elderly patients with AECOPD were selected as AECOPD group; 71 elderly patients with stable COPD treated at the same time were selected as COPD group, and 51 cases of healthy physical examination were selected as control group. Enzyme-linked immunosorbent assay was used to detect the levels of HMGB1 and tumor necrosis factor-α (TNF-α) in the three groups. According to whether they were treated with N-acetylcysteine effervescent tablets, the AECOPD patients were divided into used group and non-used group, with 41 cases in each group. The levels of HMGB1, TNF-α, lung function and COPD assessment test (CAT) score between the two groups before and after treatment were compared. Results The levels of HMGB1 and TNF-α in the AECOPD group were higher than those in the COPD group and the control group (P<0. 05). The levels of HMGB1 and TNF-α in the COPD group were higher than those in the control group (P<0. 05). In the AECOPD group, the levels of HMGB1 and TNF-α in severe patients were higher than those in mild and moderate patients (P<0. 05). After treatment, the levels of HMGB1, TNF-α and CAT scores in AECOPD patients were lower than before treatment(P<0. 05). The levels of HMGB1, TNF-α and CAT scores after treatment in the used group were lower than those in the non-used group (P<0. 05). The pulmonary function of AECOPD patients were improved after 1 month of intervention, and the levels of forced vital capacity rate of one second (FEV1), forced vital capacity (FVC) and FEV1/FVC in the used group were higher than those of the non-used group(P<0. 05). The incidence rate of nausea and vomiting, diarrhea, constipation, blood pressure fluctuation, liver and kidney abnormalities during the treatment between the AECOPD subgroups showed no statistically significant difference (P>0. 05). Conclusions HMGB1 is highly expressed in the elderly patients with AECOPD. On the basis of conventional treatment, N-acetylcysteine effervescent tablets can reduce the levels of HMGB1 and TNF-α and improve patients’ lung function, which is worthy of promotion and application. References | Related Articles | Metrics

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Relationship of the change in mean platelet volume with prognosis of elderly patients with severe pneumonia during hospitalization TAN Yun-hui, FENG Li 2021, 35 (4):  374-377.  doi: 10.3969/j.issn.1003-9198.2021.04.014 Abstract ( 149 )   PDF (1008KB) ( 834 )   Save Objective To explore the correlation between the change in mean platelet volume(MPV)during hospitalization and prognosis of the elderly patients with severe pneumonia(SP). Methods The clinical data of 158 elderly patients with SP who were admitted to our hospital from January 2017 to December 2019 were retrospectively analyzed. The patients were divided into group A with ΔMPV(MPV on discharge minus MPV at admission)<0. 6 fL and group B with ΔMPV≥0. 6 fL. The clinical characteristics, the rate of transfering to the intensive care unit, the rate of receiving mechanical ventilation, duration of hospital stay and death rate were compared between groups A and group B. The risk factors of in-hospital death in the elderly patients with SP were analyzed by multivariate Logistic regression analysis. Results There were statistically difference between groups A and group B in age, incidence rate of renal dysfunction, and cerebrovascular disorder, CURB-65 score, PSI score, rate of receiving mechanical ventilation therapy and in-hospital mortality(P＜0. 05). Multivariate Logistic regression analysis showed that ΔMPV≥0. 6 fL, high CURB-65 score, high PSI score, cerebrovascular disorder were risk factors for recent poor prognosis in the elderly patients with SP (P＜0. 05). Conclusions ΔMPV during hospitalization is closely related to CURB-65 score, PSI score and in-hospital mortality in the elderly patients with SP, which is an probable high-risk factor for recent poor prognosis of the elderly patients with SP. References | Related Articles | Metrics

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Association of serum uric acid to creatinine ratio with insulin resistance and B-cell function in elderly patients with type 2 diabetic YU Yun,TANG Wei, LOU Qing-lin 2021, 35 (4):  378-381.  doi: 10.3969/j.issn.1003-9198.2021.04.015 Abstract ( 192 )   PDF (1011KB) ( 870 )   Save Objective To explore the association between serum uric acid to creatinine ratio (SUA/SCr ) and insulin resistance or B-cell function in the elderly patients with type 2 diabetes mellitus (T2DM). Methods A total of 784 elderly T2DM patients (512 males and 272 females) were enrolled. All patients underwent 75 g oral glucose tolerance test (OGTT). The levels of SUA, SCr, triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), hemoglobin A1c (HbA1c), glucose, and insulin were measured. Insulin resistance and B-cell function indexes were calculated. Results The patients with higher level of SUA/SCr were younger, and had lower levels of HbA1c and SCr, while had higher levels of BMI, TG, SUA and eGFR (all P <0. 01). SUA/SCr was positively correlated with HOMA-IR(r=0. 112, P=0. 002), HOMA-β(r =0. 189, P <0. 001), InsAUC30(r=0. 164, P<0. 001), IG30(r=0. 140, P<0. 001), InsAUC120(r=0. 193, P<0. 001) and IG120(r=0. 169, P<0. 001). After further adjustment for age, gender, diabetic duration, BMI and TG, the above correlations remained (all P <0. 01). Conclusions SUA/SCr in the elderly patients with T2DM are positively associated with insulin resistance and B-cell function. References | Related Articles | Metrics

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Study on situational factors of falls in 45 elderly patients with neuropsychiatric disease ZHANG Li,XU Liu-liu,ZHANG Yan 2021, 35 (4):  382-385.  doi: 10.3969/j.issn.1003-9198.2021.04.016 Abstract ( 217 )   PDF (998KB) ( 872 )   Save Objective To investigate the status of fall injury in elderly patients with neuropsychiatric diseases and explore the situational factors affecting fall injury. Methods A total of 45 cases of neuropsychiatric diseases aged 65 years old and over suffering from fall reported by the information management system of nursing adverse events in 2017 were enrolled in this study. The clinical data were collected and the situational factors affecting fall injury were analyzed. Results Drug number, things they were dong, self-feeling when falling, use of antihypertensive drugs and antidepressants 24 h before falling were influencing factors of falling injury in the elderly patients with neuropsychiatric diseases (P<0. 05). Logistic regression analysis showed that self-feeling imbalance (OR=97. 341,P＝0. 002) and drug number (take three medications OR=21. 969,P=0. 025, taking four drugs OR=25. 897,P=0. 048) were risk factors of fall injury. Conclusions Imbalance and multiple medication use at the same time may increase the risk of fall injury. Specific intervention should be implemented to reduce the probability of fall injury. References | Related Articles | Metrics

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Clinical efficacy of different treatment methods in elderly patients with end-stage renal failure ZHAO Jun, ZHANG Zhi-yong, LI Ming-xu, YU Hai, LI Nan, XUAN Fang, ZHAO Yi-xin 2021, 35 (4):  386-389.  doi: 10.3969/j.issn.1003-9198.2021.04.017 Abstract ( 156 )   PDF (1006KB) ( 938 )   Save Objective To explore the appropriate treatment methods for the elderly patients with end-stage renal failure. Methods A total of 59 elderly patients with end-stage renal failure diagnosed and treated in our hospital were collected. Eighteen cases were treated with medication alone, and 22 cases were treated with conventional hemodialysis, and 19 cases were treated with low-dose dialysis for the purpose of preserving residual renal function. The vital signs, blood biochemical indicators, prognosis and other indicators among the 3 groups were compared. Results At the initial stage of treatment (6 months), the conventional dialysis group and the low-dose dialysis group showed better effect than the drug group in terms of anemia, acidosis, heart failure correction and quality of life (P<0. 05). There were significiant differences in residual urine volume between the conventional dialysis group and the low-dose dialysis group (P<0. 05). In the later period of treatment (24 months), the low-dose dialysis group showed better effects than the drug group and the conventional dialysis group in terms of residual urine volume and quality of life (P<0. 05). The incidence rate of multiple organ dysfunction syndrome (MODS) and the survival rate showed with no significantly statistic differences among the three groups. Conclusions The elderly patients with end-stage renal failure choose hemodialysis treatment should preserve the residual renal function as much as possible, which is conductive to impove the quality of life of patients. References | Related Articles | Metrics

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Lymphocyte-to-monocyte ratio in predicting high-risk colon adenomas in elderly patients SUN Jie, MA Qin-yan, ZHA Xiu-fang, SANG Nan, SU Han, ZHAO Jun-ning 2021, 35 (4):  390-392.  doi: 10.3969/j.issn.1003-9198.2021.04.018 Abstract ( 233 )   PDF (1109KB) ( 859 )   Save Objective To observe the changes of lymphocyte-to-monocyte ratio (LMR) and other inflammatory factors in the elderly patients with high-risk colon adenomas, and to investigate the predictive value of LMR for high-risk colon adenomas. Methods The clinical data of 157 elderly patients who underwent colonoscopy were retrospectively collected and analyzed. Logistic regression analysis was performed to identify the risk factors of high-risk colon adenomas. Receiver operating characteristic (ROC) curve was used to evaluate the predictive efficiency of LMR for high-risk colon adenoma. Results Univariate analysis showed that monocyte count, LMR and neutrophil-to-lymphocyte ratio (NLR) were influencing factors for high-risk adenomas (P<0. 05). Logistic regression analysis revealed that LMR was an independent risk factor for high-risk adenomas. ROC curve analysis showed that LMR could predict high-risk adenomas with a critical LMR of 4. 49, with sensitivity of 65. 6%, specificity of 70. 4%, area under the curve(AUC) of 0. 720(P<0. 001). Conclusions Lower LMR is associated with high-risk colon adenomas and it can be used as a new biomarker to diagnose high-risk colon adenomas in the elderly patients. References | Related Articles | Metrics

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Clinical effect of traditional Chinese medicine external application technology of waist and knee in treating knee osteoarthritis FAN Dong-hua, MAO Jun, MEI Wei, XING Run-lin, ZHANG Li, DING Liang, WANG Pei-min, HUANG Zheng-quan 2021, 35 (4):  393-397.  doi: 10.3969/j.issn.1003-9198.2021.04.019 Abstract ( 127 )   PDF (1029KB) ( 874 )   Save Objective To observe the clinical efficacy of knee osteoarthritis(KOA) by using the traditional Chinese medicine external application technology of waist and knee. Methods A total of 60 KOA cases, in accordance with the inclusion criteria, were randomly divided into the waist and knee co-medication group, the waist medication group, the knee medication group, according to the different medication sites of Layers Adjusting External Application (LAEA). The improvement of the symptoms such as joint pain, swelling and dysfunction in the three groups were observed and compared. Results After treatment, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores and Visual Analogue Scale (VAS) scores of the three groups were all decreased (P<0. 05). After two weeks of treatment, the pain, physical function scores of WOMAC and VAS scores in waist and knee co-medication group were significantly lower than those in the other two groups(P<0. 05). WOMAC pain score, WOMAC physical function score and VAS score in co-medication group and knee medication group were significantly lower than those in waist medication group after four weeks of treatment(P<0. 05). After 6 weeks, 8 weeks of therapy and 1 month of follow up, there were no significant differences in WOMAC scores and VAS scores among the three groups (P>0. 05). At the end of the treatment, the efficiency of the waist and knee co-medication group was 57. 9%, compared with 45. 0% and 20. 0% in knee medication group and waist medication group(P<0. 05). Conclusions LAEA is safe and effective to improve the KOA patients’ joint pain and life of quality, whether applying LAEA to waist, knee or both waist and knee. Nevertheless applying LAEA to both waist and knee can achieve better efficacy and shows significant advantage in early onset. References | Related Articles | Metrics