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20 May 2021, Volume 35 Issue 5 Previous Issue    Next Issue

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Study on chemotherapy-induced taste changes in elderly patients with gastrointestinal cancer and the effects on nutrition, psychological status and quality of life NI Yu-dan, CHEN Yu-hong, XU Li, LIANG Wei 2021, 35 (5):  451-454.  doi: 10.3969/j.issn.1003-9198.2021.05.005 Abstract ( 176 )   PDF (4255KB) ( 1573 )   Save Objective To explore the chemotherapy-induced taste changes in the elderly patients with gastrointestinal cancer and the effects on nutrition, psychological status and quality of life. Methods A total of 189 elderly patients with gastrointestinal cancer admitted to our hospital from January 2019 to January 2020 were selected. The Chinese version of chemotherapy-induced taste alteration scale(CiTAS), nutrition risk screening scale 2002, self-rating anxiety scale(SAS), self-rating depression scale (SDS) and European cancer treatment organization quality of life scale (EORTC QLQ-C30) were used to evaluate patients’ chemotherapy-induced taste changes, nutritional status, mental status and quality of life, and to analyze their correlation. Results Among 189 patients, 156 cases (82.54%) presented with chemotherapy-induced taste changes, who were assigned to changed group. The CiTAS score of changed group was higher than that of non-changed group(P < 0.05). The incidence rate of malnutrition risk in changed group was higher than that of non-changed group(50.0% vs 21.2%, P<0.05); The SAS score and SDS score of changed group were higher than those of non-changed group(P<0.05); The scores of physical function, emotional function and general health status of changed group were lower than those of non-changed group, and the scores of nausea and vomiting, fatigue, constipation, diarrhea, loss of appetite and insomnia were higher than those of non-changed group (P < 0.05). The CiTAS score was significantly correlated with SAS score, SDS score, and EORTC QLQ-C30 score in changed group. Conclusions The incidence of chemotherapy-induced taste changes in the elderly patients with gastrointestinal cancer is high, and the risk of malnutrition is high, which has a serious impact on the psychological status and quality of life. References | Related Articles | Metrics

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Association between physical performance and depressive symptoms in elderly patients with end-stage renal disease undergoing peritoneal dialysis: a cross-sectional study ZHANG Hai-fen, HUANG Jia-ying, GU Ai-ping, LAI-LAN Shu-hui, TAO Xing-juan 2021, 35 (5):  455-458.  doi: 10.3969/j.issn.1003-9198.2021.05.006 Abstract ( 186 )   PDF (4255KB) ( 1011 )   Save Objective To explore the association between performance-based physical function and depressive symptoms in the elderly patients with end-stage renal disease undergoing peritoneal dialysis(PD). Methods Physical function was assessed by handgrip strength (HGS), timed up and go (TUG) test, 5-repetition sit-to-stand test (5-STS) and comfortable gait speed (GS). Depressive symptoms were measured by using the Geriatric Depression Scale (GDS-15). Multiple Logistic regression analysis was performed to investigate the factors that influenced the depressive symptoms. Results A total of 115 PD patients with a mean age of 69.7 years old were included. 72.2% of the patients showed a GDS-15 score more than 5. The patients with depressive symptoms presented with poorer physical performance, and had a higher percentage reporting in income level less than 3000 RMB/month(P<0.05). The levels of 5-STS(r=0.264), GS(r=-0.242), TUG(r=0.399)performance were significantly associated with GDS-15 score. TUG impairment was a risk factor of depressive symptoms(OR=5.293,95%CI:1.013-27.651). Conclusions There is a high prevalence of depressive symptoms in the elderly patients undegoing PD, and TUG performance is associated with the depressive symptoms. References | Related Articles | Metrics

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Correlation between heart rate variability and postoperative infection in elderly patients with hip fracture HUANG Ze-xiao, XING Bo 2021, 35 (5):  459-462.  doi: 10.3969/j.issn.1003-9198.2021.05.007 Abstract ( 151 )   PDF (4255KB) ( 1064 )   Save Objective To explore the correlation between heart rate variability (HRV) and postoperative infection in the elderly patients with hip fracture. Methods A total of 171 elderly patients with hip fractures admitted to our hospital for surgery from January 2018 to April 2020 were selected and divided into infection group (n=33) and non-infection group (n=138) according to whether there were infected within 7 d after operation.The differences between the two groups in basic conditions, blood biochemical indexes, and total power (TP), low frequency power (LF), very low frequency power (VLF), ratio of LF to high frequency power (LF/HF), standard deviation of R-R interval (SDNN) of HRV were compared. Multi-Logistic regression analysis was used to explore the correlation between HRV and postoperative infection in the elderly patients with hip fracture. Results The age and the proportion of diabetes mellitus in infection group were significantly higher than those in non-infection group (P<0.05). Compared with non-infection group, the levels of VLF and LF/HF in infection group were significantly lower (P<0.01). Multi-Logistic regression analysis showed that VLF (OR=0.986, 95%CI:0.976-0.997, P=0.012) and LF/HF (OR=0.416, 95%CI: 0.259-0.667, P<0.002) were independent influencing factors for postoperative infection in the elderly patients with hip fracture. The area under ROC curve (AUC) of LF/HF for predicting postoperative infection in the patients with hip fracture was significantly greater than that of VLF(0.819 vs 0.679, Z=2.227,P=0.026). The optimal cutoff value of LF/HF was 0.91,which showed a sensitivity of 60.6% and a specificity of 89.4% for the prediction of postoperative infection in the elderly patients with hip fracture. Conclusions The levels of VLF and LF/HF are closely related to postoperative infection in the elderly patients with hip fracture, and LF/HF can be a better indicator for evaluating postoperative infection in the elderly patients with hip fracture. References | Related Articles | Metrics

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Clinical effect and influencing factors of intravenous thrombolysis with ateplase in patients with acute cerebral infarction aged 80 years and over LI Yin-zhen, ZHANG Jing-wen, ZHENG Yong-qiang 2021, 35 (5):  463-466.  doi: 10.3969/j.issn.1003-9198.2021.05.008 Abstract ( 267 )   PDF (4255KB) ( 5581 )   Save Objective To investigate the clinical efficacy, safety and influencing factors of intravenous thrombolysis with ateplase (rt-PA) in the elderly patients with acute cerebral infarction. Methods A total of 117 patients with acute cerebral infarction with onset time less than 4.5 hours admitted to our hospital from January 2017 to October 2020 were retrospectively analyzed, including 81 males and 36 females. According to age, 83 patients were assigned in control group (＜80 years old) and 34 patients in observation group(≥80 years old). All patients of the two groups were given intravenous thrombolysis with 0.9 mg/kg rt-PA. The acute efficacy [improvement of National Institute of Health stroke scale (NIHSS) score within 14 days], short-term efficacy (Modified Rankin Scale score within 90 days) and safety of rt-PA in the two groups were compared. The influencing factors for the prognosis of intravenous thrombolysis were analyzed by multiple Logistic regression. Results There were no significant differences in curative effect, the incidence rate of complications induced by thrombolysis and mortality after thrombolytic therapy between the two groups (P>0.05). The incidence rate of complications not induced by thrombolysis in observation group was higher than that in control group (20.59% vs 6.02%, P=0.018). Based on multiple Logistic regression analysis, NIHSS score before thrombolysis and complications not inducecd by thrombolysis were independent risk factors for the clinical outcome of intravenous thrombolysis after 90 days. Conclusions Using rt-PA in the thrombolytic time window of the elderly patients with acute cerebral infarction is safe and effective. The score of NIHSS before thrombolysis and complications not induced by thrombolysis shows effects on the prognosis of the patients with acute cerebral infarction aged 80 years old and over. References | Related Articles | Metrics

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Effects of andolin capsule on inflammatory factors and apoptosis of peripheral blood mononuclear cells in elderly patients with nasopharyngeal carcinoma undergoing radiotherapy XIA Hong-juan, YUAN Fang, MEI Li-gu, ZOU Yun 2021, 35 (5):  467-469.  doi: 10.3969/j.issn.1003-9198.2021.05.009 Abstract ( 185 )   PDF (4255KB) ( 2228 )   Save Objective To investigate the effect of andolin capsule on the levels of interleukin-6(IL-6) and tumor necrosis factor-α (TNF-α) and the apoptosis of peripheral blood mononuclear cells in the elderly patients with nasopharyngeal carcinoma (NPC) undergoing radiotherapy. Methods From January to December 2019, a total of 40 patients with NPC over 65 years old were enrolled in the Department of Cancer Radiotherapy. According to the random number table, all the cases were divided into two groups: the treatment group (20 cases) and the control group (20 cases). The two groups had the same radiotherapy plan. The treatment group added 4 capsules of andolin capsule three times a day until the end of radiotherapy. The incidence of oral mucositis, the levels of IL-6, TNF-α and the apoptosis rate of peripheral blood mononuclear cells were observed. Results There was no significant difference in the severity of oral mucositis between the two groups before radiotherapy(P>0.05). After radiotherapy, the severity degree of oral mucositis in the control group was worse than that in the treatment group (P<0.05). There were no significant differences in the levels of serum IL-6, TNF-α and the apoptosis rate of peripheral blood mononuclear cells between the two groups before treatment (P>0.05). The levels of serum IL-6 and TNF-α and the apoptosis rate of peripheral blood mononuclear cells in the control group were higher than those in the treatment group after treatment (P<0.05). Conclusions Andolin capsule can effectively reduce the progression of oral mucositis in the elderly patients with NPC during radiotherapy. The mechanism may be associated with the regulation of TNF-α and IL-6 levels and the protection of peripheral blood mononuclear cells. References | Related Articles | Metrics

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Expressions and clinical significance of Klotho and TXNIP in the elderly with diabetic cardiomyopathy YI Fen-xiu 2021, 35 (5):  470-474.  doi: 10.3969/j.issn.1003-9198.2021.05.010 Abstract ( 176 )   PDF (4255KB) ( 1325 )   Save Objective To explore the correlation between the levels of serum thioredoxin-interacting protein (TXNIP) and Klotho and diabetic cardiomyopathy(DCM) in the elderly. Methods From May 2018 to March 2020, 67 elderly patients with DCM were selected as DCM group; At the same time, 72 elderly patients with diabetic mellitus (DM) without cardiomyopathy were selected as DM group, in addition, 84 cases of elderly healthy people were treated as normal control group. The expression of Klotho mRNA was detected by real-time fluorescence quantitative PCR (qRT-PCR); The level of serum TXNIP was detected by enzyme-linked immunosorbent assay (ELISA); The correlation between the levels of serum Klotho mRNA, TXNIP and serum parameters in the patients with DCM was analyzed, and the influencing factors of DCM were analyzed by Logistic regression. Results The levels of serum TXNIP, brain natriuretic peptide (BNP), cardiac troponin I (cTnI), tissue inhibitor of matrix metalloproteinase-1 (TIMP-1), atrial natriuretic peptide (ANP) in DCM group were higher than those in DM group and normal control group, and the levels of Klotho mRNA and matrix metalloproteinase-2 (MMP-2) were lower than these in DM group and normal control group (P<0.05). There was a negative correlation between serum Klotho mRNA and TXNIP in the patients with DCM (r=-0.646, P<0.05); Klotho mRNA (TXNIP) was positively (negatively) correlated with MMP-2 (P < 0.05), and negatively (positively) correlated with BNP, cTnI, TIMP-1 and ANP (P < 0.05). Logistic regression showed that TXNIP and ANP were the independent risk factors of DCM (P < 0.05), and Klotho mRNA was the protective factor of DCM (P < 0.05). Conclusions TXNIP is highly expressed in the serum of the patients with DCM, while Klotho is lowly expressed, which may have a high reference value for clinical application. References | Related Articles | Metrics

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Analysis of the efficacy and prognostic factors of mechanical thrombectomy in elderly patients with acute ischemic stroke HU Hang-jia,ZHOU Xuan, JIAN Neng-ri, GAO Rong-hui, HU Fa-yun 2021, 35 (5):  475-478.  doi: 10.3969/j.issn.1003-9198.2021.05.011 Abstract ( 164 )   PDF (4255KB) ( 1366 )   Save Objective To evaluate the efficacy and safety of endovascular mechanical thrombectomy in the elderly patients with anterior circulation acute ischemic stroke. Methods A retrospective analysis of the patients who underwent the endovascular mechanical thrombectomy for acute ischemic stroke from February 2018 to September 2019 was conducted, and finally 90 cases were included.Thirty-eight patients aged ≥80 years were enrolled in the elderly group, and 52 patients aged <80 years were enrolled in the young age group.The baseline data and perioperative data of all patients were collected. The efficacy was analyzed by comparing modified Thrombolysis in Cerebral Infarction (mTICI) scores, and the scores of National Institutes of Health Stroke Scale(NIHSS), the Modified Rankin Scale(mRS). The safety was analyzed by comparing the risk of symptomatic cerebral hemorrhage and mortality. Multivariate Logistic regression analysis was used to analyze the independent influencing factors of the prognosis. Results There were significant differences in the time from puncture to vascular recanalization and 90-d prognosis between the two groups. Multivariate Logistic regression analysis showed that complete recanalization(mTICI3) was the positive factor for the prognosis. Conclusions Endovascular mechanical thrombectomy is effective for the elderly patients with acute ischemic stroke in the anterior circulation. In the case of complete recanalization of mTICI3, the elderly patients can also achieve good prognosis. References | Related Articles | Metrics

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Study on success rate of blood lipid and its influencing factors in elderly patients with coronary heart disease ZHANG Jin-lian, LIU Huan-bing, HU Mei-di, JIANG Chang-wen 2021, 35 (5):  479-482.  doi: 10.3969/j.issn.1003-9198.2021.05.012 Abstract ( 167 )   PDF (4255KB) ( 1201 )   Save Objective To understand the success rate of blood lipid among the elderly patients with coronary heart disease(CHD) undergoing secondary prevention regularly and to explore the risk factors. Methods This study enrolled 450 elderly patients who were diagnosed with CHD for more than one years during January 2017 to January 2018, and regularly received the secondary prevention of CHD. The patients’ characteristics, including gender, age, course of CHD, medical history (hypertension, diabetes), laboratory results such as total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (N-HDL-C), fasting plasma glucose (FPG), creatinine, glycosylated hemoglobin, examination results (coronary angiography, cardiac ultrasound, carotid ultrasound) were collected and analyzed. The patients were divided into eligible group and ineligible group according to the guidelines, whether LDL-C was <1.8 mmol /L or N-HDL-C was <2.6 mmol /L.The risk factors of the success rate of blood lipid were analyzed by univariate analysis and multivariate analysis. Results Among the 450 elderly patients with CHD, 192(42.6%) patients achieved the target level of LDL-C,while 274(60.89%) patients achieved the target level of N-HDL-C. The univariate analysis showed that the influencing factors of the LDL-C and N-HDL-C success rate were gender, diabetes, serum glucose level and poor glucose control (P ＜ 0.05). In multivariate regression analysis, gender, diabetes and poor glucose control were independent factors that influenced LDL-C success rate, and gender and poor glucose control were influencing factors of N-HDL-C success rate. Conclusions The elderly patients with CHD undergoing second prevention have higher success rate of serum lipid. Gender and diabetes are the main factors affecting the serum lipid success rate in the elderly patients with CHD. References | Related Articles | Metrics

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Expression and clinical significance of latent transforming growth factor binding protein 2 in the serum of elderly patients with cervical cancer TANG Gu-ping, LI Zhao-hui, CHEN Li-rong, HE Hong-mei, GUO Jin-xi 2021, 35 (5):  483-486.  doi: 10.3969/j.issn.1003-9198.2021.05.013 Abstract ( 179 )   PDF (4255KB) ( 1207 )   Save Objective To investigate the expression and significance of latent transforming growth factor binding protein 2 (LTBP2) in the serum of the elderly patients with cervical cancer. Methods A total of 78 elderly patients with cervical cancer admitted to our hospital from July 2017 to July 2019 were included in this study. In addition, 31 patients with chronic cervicitis and 37 healthy volunteers who underwent physical examination in our hospital during the same period were included as the control group. The clinical and pathological data of the patients with cervical cancer were collected, and the serum level of LTBP2 was detected by enzyme-linked immunosorbent assay. The differences of serum level of LTBP2 among the three groups were compared, and the relationship between LTBP2 levels and clinicopathological characteristics of cervical cancer was analyzed. Results The level of serum LTBP2 in cervical cancer group was significantly higher than that in the chronic cervicitis group and the control group (P<0.05), while showing no significant difference between the chronic cervicitis group and the control group (P>0.05).There were significant differences in serum level of LTBP2 among the patients with different clinical stages, differentiation degree and lymph node metastasis (P<0.05).The serum level of LTBP2 in the patients with cervical cancer 1,3,6 months after operation was significantly lower than that before operation, and gradually decreased with time (P < 0.05).In 78 patients, the positive rate of serum LTBP2 was 46.15% before operation and 2.56% 6 months after operation (P < 0.05). Conclusions The expression of LTBP2 in the serum of the elderly patients with cervical cancer is increased, and it is related to clinical stage, differentiation degree and lymph node metastasis. Monitoring serum level of LTBP2 has certain clinical value for the evaluation of the disease condition of the elderly patients with cervical cancer before and after operation. References | Related Articles | Metrics

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Effect of Shendong Xihuang Decoction on radiation pneumonitis and serum levels of cytokines in elderly patients with thoracic malignancies undergoing radiotherapy LYU Qing, CHEN Yan-chun, ZHU Guo-min, CHEN Sheng-dong, WANG Da-fei 2021, 35 (5):  487-490.  doi: 10.3969/j.issn.1003-9198.2021.05.014 Abstract ( 181 )   PDF (4255KB) ( 1016 )   Save Objective To observe the clinical efficacy of Shendong Xihuang Decoction against radiation pneumonitis in the elderly patients with thoracic malignancies undergoing radoitherapy and the effects on the serum levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and transforming growth factor-β1 (TGF-β1). Methods A total of 68 eligible patients were randomly divided into the control group and the experimental group, with 34 cases in each group. The control group was only treated with chest radiotherapy, while the experimental group was treated with chest radiotherapy and oral Shendong Xihuang Decoction. The patients’ general condition, incidence rate and grading-score of radiation pneumonitis were observed. The serum levels of IL-6, TNF-α and TGF-β1 before treatment, at the end of radiotherapy and 3 months after radiotherapy in the two groups were detected and compared. Results At the end of radiotherapy, the quality of life in the experimental group was better than that in the control group(P＜0.05). The incidence rate of radiation pneumonitis and the percentage of grade-3 and grade-4 radiation pneumonitis in the experimental group were significantly lower than those in the control group (22.22% vs 64.71%, 5.56% vs 29.41%, all P＜0.05). During the period of radiation treatment, the serum levels of IL-6, TGF-β1 and TNF-α increased significantly at the end of radiotherapy in the two groups, especially in the control group(P＜0.05), and decreased significantly 3 months after radiotherapy, especially in the experimental group (P<0.05). Conclusions Shendong Xihuang Decoction could reduce the incidence rate and the grade of radiation pneumonia in the elderly patients with thoracic malignancies. It has favorable effects in improving their quality of life. The potential mechanism may be related with reducing the serum levels of IL-6, TNF-α, TGF-β1. References | Related Articles | Metrics

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Correlation between social frailty and depression among community-dwelling elderly in Hubei Province, China ZHANG Wen-ya, FAN Jun-yao, WANG Tian-ying, LI Jie 2021, 35 (5):  491-494.  doi: 10.3969/j.issn.1003-9198.2021.05.015 Abstract ( 253 )   PDF (4255KB) ( 1042 )   Save Objective To investigate the prevalence of social frailty and depression as well as their correlation among the community-dwelling elderly in Hubei Province, China. Methods Questionnaires composed of demographic characteristics, general health information, Social Frailty Assessing Tool and Geriatric Depression Scale (GDS-15) were disseminated through face-to-face interviews with participants at their houses. A total of 359 valid and qualified questionnaires were finally included in this research. Results The 359 community-dwelling elderly were divided into social frailty group (n=39) and non-social frailty group (n=320). The two groups showed significant differences in age, educational level, marriage status, living region, life events, monthly income, current smoking habits and depression score (P<0.05). The prevalence of social frailty and depression among community-dwelling elderly in Hubei Province was 10.86% and 15.88% respectively. Social frailty and depression had a positive correlation with statistical significance (r=0.435, P<0.001). Conclusions The prevalence of social frailty and depression are both relatively high among community-dwelling elderly in Hubei Province. The participants presenting with socially frail have shown a greater proportion of depression at the same time. Community care providers should concentrate more on the screening and diagnose of social frailty and implement interventions to them in order to improve the quality of life for the elderly. References | Related Articles | Metrics

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Study on clinical characteristics of gastroesophageal reflux disease and the effects on anxiety and depression in the elderly OU-YANG Hao, LIU Lin-na, JIA Shu-juan, WANG Jing-tong 2021, 35 (5):  495-498.  doi: 10.3969/j.issn.1003-9198.2021.05.016 Abstract ( 232 )   PDF (4255KB) ( 1047 )   Save Objective To investigate the clinical characteristics of the elderly patients with gastroesophageal reflux disease(GERD) and to explore the status of anxiety and depression in the patients with GERD and its influencing factors. Methods From March 2018 to August 2019,a total of 681 patients with GERD in outpatient and inpatient departments underwent questionaire survey. Self-rating anxiety scale(SAS) and self-rating depression scale(SDS) were used to evaluate the anxiety and depression of the GERD patients. The clinical characteristics of the elderly group(≥60 years old) and the non-elderly group were compared and analyzed, and the risk factors of anxiety and depression in the elderly GERD patients were analyzed. Results The proportion of reflux esophagitis (RE) in the elderly group was higher than that in the non-elderly group (31.4% vs 23.3 %,P<0.05), and the proportion of typical symptoms (reflux,heartburn) was lower,the proportion of atypical symptoms was higher than that in the non-elderly group(P<0.05), including chest pain, abdominal pain, burning sensation in the upper abdomen, swallowing discomfort.In the elderly group, the proportion of patients with extraesophageal symptoms was higher than that in the non-elderly group (49.6%vs 38.1%,P<0.05), and the incidence rate of anxiety and depression was higher than that in the non-elderly group (44.3% vs 34.8%,P<0.05). Multivariate Logistic regression analysis showed that female, non-erosive gastrooesophageal reflux disease(NERD) and extraesophageal symptoms were risk factors for anxiety and depression in the elderly GERD patients. Conclusions The elderly GERD patients are more likely to have RE, atypical symptoms and extraesophageal symptoms, and the incidence rate of anxiety and depression is higher than that of non-elderly GERD patients. Female, NERD and extraesophageal symptoms are risk factors for anxiety and depression in the elderly GERD patients. References | Related Articles | Metrics

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Relationship between serum bilirubin, bile acid and diabetic retinopathy in elderly patients with type 2 diabetes mellitus SU Zhi-yan, LIU Wei, SHI Ting-ting, YANG Jin-kui 2021, 35 (5):  499-502.  doi: 10.3969/j.issn.1003-9198.2021.05.017 Abstract ( 263 )   PDF (4255KB) ( 1268 )   Save Objective To investigate the relationship between serum bilirubin, bile acid and diabetic retinopathy(DR) in the elderly patients with type 2 diabetes mellitus(T2DM). Methods A total of 363 elderly patients with T2DM in our hospital from January 2018 to December 2019 were retrospectively collected, 153 cases of them presenting with diabetic retinopathy(PDR), 210 cases of them presenting with non-diabetic retinopathy (NDR) with course over 10 years. The basic clinical data, serum levels of bilirubin and bile acid of the two groups were compared. All the patients were divided into three groups according to the serum levels of bilirubin or bile acid (low, medium and high level group), and the incidence rate of PDR in each group were compared. Multivariate Logistic regression analysis was used to analyze the risk factors of DR. Result The serum levels of bilirubin and bile acid in the NDR patients were significantly higher than those in the PDR patients(P<0.05); while the levels of cholesterol, low-density lipoprotein cholesterol(LDL-C) and urinary albumin excretion rate(UAER) were significantly lower (P<0.05). The incidence rate of PDR was decreased while the serum levels of bilirubin and bile acid increased. According to the Logistic regression analysis, serum bilirubin and bile acid were protecting factors of DR, while LDL-C and UAER>20 μg/min were risk factors. Conclusions In the elderly patients with T2DM, serum bilirubin and bile acid show particular relationships with DR, which may to be potential protecting factors. References | Related Articles | Metrics

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Relationship between the level of serum cystatin C and severity of coronary lesions in the elderly patients with acute coronary syndrome LIU Ya-juan, YIN Lei, LI Peng, WANG Qi-xin 2021, 35 (5):  503-506.  doi: 10.3969/j.issn.1003-9198.2021.05.018 Abstract ( 196 )   PDF (4255KB) ( 990 )   Save Objective To investigate the relationship between serum cystatin C (Cys C) and the degree of coronary artery disease in the elderly patients with acute coronary syndrome (ACS). Methods A total of 246 patients with ACS confirmed by coronary angiography were selected as the observation group, and 38 patients without coronary heart disease excluded by coronary angiography during the same period were selected as the control group. The level of serum Cys C in all the patients was detected within 24 hours, and the correlation between the level of serum Cys C and Gensini score in the patients with ACS was analyzed. Results With the increase of the degree of coronary lesion, the level of serum Cys C increased gradually, and there were statistical differences among different groups (P < 0.01). The level of serum Cys C was positively correlated with Gensini score in the patients with ACS (r=0.436, P<0.05). Logistic regression model and multiple linear regression model showed that the level of serum Cys C was an risk factor for ACS and Gensini score (OR=1.843, B=5.076,all P < 0.05). Receiver operating characteristic curve showed that Cys C could predict the incidence of ACS with a critical value of 8.35 mg/dL, with sensitivity of 0.683, specificity of 0.763. Conclusions The level of serum Cys C in the patients with ACS is related to the severity of coronary artery disease, which is a risk factor for the aggravation of coronary artery disease. References | Related Articles | Metrics

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Application of diagnosis-related groups in improving disease management in department of geriatrics XU Lan, ZHU Feng, ZHANG Dian-fu 2021, 35 (5):  537-540.  doi: 10.3969/j.issn.1003-9198.2021.05.029 Abstract ( 226 )   PDF (4255KB) ( 1290 )   Save Objective To explore the feasibility of using diagnosis-related groups(DRGs) to improve the level of disease management in Department of Geriatrics based on analysis of the abnormal cost of DRGs and training. Methods A total of 890 geriatric medical records of the discharged patients from January to June 2019 were collected,and all the abnormal cost records including extremely high cost records, very low cost records and ambiguous medical records were extracted. The geriatricians were trained based on the questions that acquired by the encoders and quality control doctors based on the DRGs principle. After training, a total of 685 medical records of the discharged patients from January to June 2020 were collected. The filling level in the medical record home page was evaluated. Results In the first half of 2019, the prevalence of the abnormal cases was 11.69% (104 cases), including 50 extremely high cost records (5.62%), 21 very low cost records (2.36%) and 33 ambiguous medical records (3.71%). The qualified rate of filling diagnosis and treatment in the medical record home page was 83.22%. The main reasons of abnormal medical records were choosing errors of diagnosis, omission of diagnosis, diagnosis or treatment name be not standardized and choosing errors of treatment. Compared with the first half of 2019, there were only 7 extremely high cost records (1.02%), 9 very low cost records (1.31%) and 4 ambiguous medical records (0.58%) in the first half of 2020 (all P＜0.05), and the qualified rate of filling in the home page was significantly enhaced (96.35 vs 83.22%, P＜0.05). Conclusions By the analysis of the abnormal typical cases and training based on the DRGs principle, the filling level in the medical record home page can be improved significantly, which reflects the improvement of diseases management level of Department of Geriatrics. References | Related Articles | Metrics