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20 August 2021, Volume 35 Issue 8 Previous Issue    Next Issue

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Heat shock protein A12A is necessary for pulmonary protection during endotoxemia DAI Yuan, LIU Jia-li, MIN Xin-xu, LI Yun-fan, MAO Qian, DING Zheng-nian 2021, 35 (8):  803-806.  doi: 10.3969/j.issn.1003-9198.2021.08.004 Abstract ( 176 )   PDF (1298KB) ( 1347 )   Save Objective To investigate the effects of heat shock protein A12A (HSPA12A) on lung injury during endotoxemia. Methods HSPA12A knockout mice (Hspa12a-/-) and wild type littermates (WT) mice aged 8-10 weeks were enrolled in this study. The mice were injected with lipopolysaccharide (LPS) intraperitoneally to induce endotoxemia, while normal saline (NS)-treated mice served as the controls. According to the type of mice and treatment mode, the mice were divided into NS-WT group, NS-Hspa12a-/- group, LPS-WT group and LPS-Hspa12a-/- group. Six hours after LPS or NS treatment, the lung tissues were harvested for the detection of protein levels and paraffin sections. The arterial blood was collected for arterial blood gas analysis. Protein expression levels were detected by immunoblotting. Pulmonary injury scores were obtained according to the histopathological changes of the lung tissues by H&E staining, and the pulmonary function was evaluated by blood gas analysis. Results The expression level of HSPA12A in the lungs of LPS-treated mice was 150% of that in NS-treated mice (P<0.05). After LPS treatment, the lung tissues showed obvious pathological changes, and Hspa12a-/- mice showed severer pulmonary histological abnormalities and higher injury scores than those in WT mice (P<0.01). Hspa12a-/- mice showed increased CO2 accumulation in arterial blood than WT mice during endotoxemia (P<0.05). Conclusions HSPA12A plays an important role in the protection against sepsis/septic shock-induced lung injury. References | Related Articles | Metrics

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Changes and significance of urine levels of NGAL, KIM-1, IL-18 and NAG in elderly patients complicated with acute kidney injury after cardiac surgery TAN Dan, PENG Wei, WU Fang-hao, ZHAO Liang, ZHANG Guo-bin, YANG Bo, HUO Wen-qian 2021, 35 (8):  807-811.  doi: 10.3969/j.issn.1003-9198.2021.08.005 Abstract ( 202 )   PDF (1359KB) ( 1061 )   Save Objective To analyze the changes and significance of urine levels of neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule 1 (KIM-1), interleukin-18 (IL-18) and N-acetyl-β-D-glucosaminidase (NAG) in the elderly patients complicated with acute kidney injury (AKI) after cardiac surgery. Methods A total of 60 elderly patients who underwent cardiac surgery in our hospital from March 2020 to July 2020 were enrolled. According to presence or absence of AKI, the patients were divided into non-AKI group and AKI group. The changes of the urine levels of NGAL, KIM-1, IL-18 and NAG, the serum levels of creatinine (Scr) and blood urea nitrogen (BUN),and the urine volume before and after the operation were detected and compared between the two groups. The correlation between urine NGAL, KIM-1, IL-18, NAG and Scr, BUN were analyzed. The urine levels of NGAL, KIM-1, IL-18 and NAG were compared in patients with different outcomes (survival or death within 28 d) in AKI group. The predictive value of urine NGAL, KIM-1, IL-18 and NAG for AKI was analyzed by drawing ROC curves. Results The urine levels of NGAL, KIM-1, IL-18 and NAG in the two groups after the surgery were significantly higher than those before the surgery in both groups, especially in the AKI group (P<0.05).After the operation, the urine volume in both groups was increased, but the urine volume in the AKI group was significantly lower than that in non-AKI group 24,48 h after the operation (P<0.05). The correlation analysis showed that the urine levels of NGAL, KIM-1, IL-18 and NAG were positively correlated with BUN within 48 h after surgery, and the urime levels of NGAL and KIM-1 were positively correlated with Scr in the AKI patients (P<0.05). At 28 d after surgery, the urime levels of NGAL, KIM-1, IL-18 and NAG within 48 h after surgery in the death group were significantly higher than those in the survival group (P<0.05). ROC curve analysis showed that sensitivity, specificity and area under the curve (AUC) of NGAL combined with KIM-1, IL-18 and NAG for predicting AKI were all higher than those of single index. Conclusions The elderly patients are prone to AKI after cardiac surgery. Monitoring urine levels of NGAL, KIM-1, IL-18 and NAG is of great significance for early diagnosis and prognostic judgement of AKI. References | Related Articles | Metrics

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Airway classification management in elderly patients with severe pneumonia and its effect on compliance RUAN Zheng, ZHANG Yu-qin, JIN Ye, XUE Yan-li 2021, 35 (8):  812-815.  doi: 10.3969/j.issn.1003-9198.2021.08.006 Abstract ( 146 )   PDF (967KB) ( 1075 )   Save Objective To explore the application of airway classification management in the elderly patients with severe pneumonia and its effect on compliance. Methods A total of 184 elderly patients with severe pneumonia admitted to our hospital from January 2018 to December 2019 were selected and divided into control group and observation group, with 92 cases in each group. The control group was treated with conventional chest physical therapy, while the observation group was treated with chest physical therapy on the basis of airway classification management. The indexes of circulatory function, renal function, blood gas analysis, and the related complications and compliance of the two groups were observed and compared. Results After the intervention,the systolic blood pressure(SBP), diastolic blood pressure(DBP), left ventricular ejection fraction(LVEF),E/A ratio, arterial partial pressure of oxygen(PaO2),oxygenation index and the compliance rate were significantly higher, and the levels of serum creatinine, blood urea nitrogen, partial pressure of carbon dioxide(PaCO2) and the incidence of related complications were significantly lower in the observation group than those in the control group (P<0.05). Conclusions The efficacy of airway classification management in the treatment of elderly patients with severe pneumonia is significant, which is helpful to improve the circulatory function, renal function and respiratory function, improve the compliance of patients, reduce the risk of complications, and promote the recovery of patients. References | Related Articles | Metrics

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Relationship of glycemic variability with bone mineral density in postmenopausal patients with type 2 diabetes mellitus WANG Lin-jiao, YANG Xiao-hua, XI Wei, YUAN Xiao-lan 2021, 35 (8):  816-819.  doi: 10.3969/j.issn.1003-9198.2021.08.007 Abstract ( 146 )   PDF (967KB) ( 934 )   Save Objective To investigate the relationship of glycemic variability with bone mineral density (BMD) in the postmenopausal patients with type 2 diabetes mellitus(T2DM). Methods A total of 88 postmenopausal patients with T2DM were enrolled. All the patients accepted the detect of the flash glucose monitoring (FGM), and the mean blood glucose (MBG), the time in range (TIR), plasma glucose standard deviation (SD), glucose coefficient of variation (CV), and the mean amplitude of glycemic excursions (MAGE) were observed. Correlation between the biochemical indicator,glycemic variability and BMD was analyzed. Results With the decrease of BMD, the age, course of disease, glycosylated hemoglobin (HbA1c), SD, CV, MAGE were gradually increased, and body mass index (BMI), 25 (OH) D3 and TIR were decreased, with statistically significant (P<0.05). Pearson correlation analysis showed that HbA1c, SD, CV and MAGE were negatively correlated with BMD (r =-0.251, -0.317, -0.317, -0.288,all P<0.05), while BMD was positively correlated with TIR (r=0.391,P<0.001).Further, multiple linear regression analysis showed that TIR was a relevant factor of BMD (P<0.05). Conclusions Glycemic variability is related to BMD in the postmenopausal patients with T2DM, and TIR is independently and positively associated with BMD. Reducing glycemic variability may help delay the decline of bone mass. References | Related Articles | Metrics

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Comparison of NIV-PSV and NIV-NAVA on weaning rate and lung function in ICU patients with AECOPD complicated with respiratory failure HUANG Fei 2021, 35 (8):  820-824.  doi: 10.3969/j.issn.1003-9198.2021.08.008 Abstract ( 172 )   PDF (994KB) ( 1105 )   Save Objective To analyze and compare the effects of non-invasive patient-ventilator synchrony ventilation (NIV-PSV) and non-invasive neurally adjusted ventilatory assist (NIV-NAVA) on weaning rate and lung function in the patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with respiratory failure in the intensive care unit (ICU). Methods A retrospective analysis was performed on the clinical data of 86 patients with AECOPD and respiratory failure who underwent non-invasive mechanical ventilation intervention in the ICU of our hospital. Among them, 32 patients underwent NIV-NAVA ventilation (NIV-NAVA group), and 54 patients underwent NIV-PSV ventilation (NIV-PSV group). Respiratory mechanics [peak airway pressure (Ppeak), airway platform pressure (Pplat), patient work of breathing (WOBp)], patient-ventilator synchrony (trigger delay time, switching delay time, invalid trigger rate, patient-ventilator asynchrony index) and ventilation efficiency [dead space ventilation rate (VD/VT), functional residual capacity (FRC)] were recorded in the two groups after 1 h of ventilation. The blood gas analysis [arterial partial pressure of blood oxygen (PaO2), partial pressure of carbon dioxide (PaCO2)] before ventilation and 1 h after the ventilation,the lung function [forced vital capacity (FVC), peak expiratory flow rate (PEFR)] before ventilation and 7 d after the ventilation were observed and compared, and the success rate of weaning and ICU stay were analyzed in the two groups. Results After 1 h of ventilation, the Ppeak, Pplat, WOBp and trigger delay time, switching delay time, invalid trigger rate, patient-ventilator asynchrony index, VD/VT, and FRC in the NIV-NAVA group were significantly lower than those in the NIV-PSV group (P<0.01). The level of PaO2 was higher and the level of PaCO2 was lower in the two groups than those before the ventilation (P<0.05), especially in the NIV-NAVA group (P<0.05). After 7 d of ventilation, the levels of FVC and PEFR in the two groups were significantly higher than those before the ventilation (P<0.05),especially in the NIV-NAVA group (P<0.05). The success rate of weaning in NIV-NAVA group was higher and the intubation rate within 48 h and ICU stay were lower than those in the NIV-PSV group (P<0.05). Conclusions NIV-NAVA ventilation model is superior to NIV-PSV in patient-ventilator synchrony, ventilation efficiency and lung protection. It can successfully wean in the AECOPD patients with respiratory failure and improve the lung function, with significant application value. References | Related Articles | Metrics

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Analysis of related factors of frailty in elderly patients with coronary heart disease ZENG Ming, LI Xuan, DING Jing-yun, WU Wei-tao, XIAO Xiao-hua 2021, 35 (8):  825-828.  doi: 10.3969/j.issn.1003-9198.2021.08.009 Abstract ( 183 )   PDF (971KB) ( 1173 )   Save Objective To study the risk factors of frailty in the elderly patients with coronary heart disease (CHD). Methods A total of 230 elderly patients with CHD admitted to our hospital from October 2018 to October 2020 were selected as the research objects. The hand grip strength, walking speed, five times sit up tests, 3 m stand up walk test and full foot distance test were evaluated in all patients. The general information of the patients was collected, including age, gender, body mass index(BMI), cardiac function classification, complications, depression and anxiety, and the laboratory biochemistry indexes were observed and analyzed. The patients were divided into the frail group and the non-frail group according to the evaluation of the Fried frailty criteria. The independent influencing factors of frailty were analyzed by multivariate Logistic regression. Results Of 230 cases of the elderly patients with CHD, there were 39 cases in prophase of frailty and 27 cases in phase of frailty, and they were enrolled in the frail group; And 164 cases(71.30%) withnot frailty were enrolled in the non-frail group. The age, 5 times sit up test and 3 m stand up walk test time of the frail group were significantly higher than those of the non-frail group, while the level of hemoglobin (Hb), hand grip strength and walking speed in the frail group were significantly lower than those in the non-frail group (P<0.05). The proportions of the patients with cardiac function grade Ⅱ, depression and unable to complete the full foot distance test of the frail group were significantly higher than those of the non-frail group (P<0.05). Multivariate Logistic regression analysis showed that age (OR=1.421,95%CI:1.217-1.659), cardiac function classification(OR=1.542,95%CI:1.086-2.189), depression(OR=1.482,95%CI:1.246-1.763),Hb(OR=1.427,95%CI:1.104-1.845), hand grip strength(OR=1.607,95%CI:1.214-2.127), walking speed(OR=1.352,95%CI:1.104-1.656), time of five times sit up test(OR=1.413,95%CI:1.201-1.662), time of 3 m standing walking (OR=1.541,95%CI:1.217-1.951), failure to complete the full foot distance test(OR=1.324,95%CI:1.075-1.631)were the independent risk factor for frailty in the elderly patients with CHD(P＜0.05). Conclusions Age, heart function grade, depression, Hb and muscle function test index are independent factors of frailty in the elderly patients with CHD. References | Related Articles | Metrics

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Application of two-dimensional speckle tracking technology in evaluating the elasticity of ascending aorta in patients with hypertension SHEN Yan, CHEN Zu-qian, HOU Xiao-hui, CHENG Yue-hong, WANG Li, GUO Shan 2021, 35 (8):  829-832.  doi: 10.3969/j.issn.1003-9198.2021.08.010 Abstract ( 152 )   PDF (1211KB) ( 1284 )   Save Objective To investigate the feasibility of two-dimensional speckle tracking imaging (2D-STI) in evaluating the aortic elasticity of the patients with essential hypertension(EH). Methods A total of 60 patients with EH were enrolled in EH group and 60 cases with normal blood pressure were selected as control group. According to the age, the two groups were divided into elderly subgroup(aged≥60 years old)and non-eldely subgroup (aged<60 years old) respectively. Echocardiography was performed in all cases and the corresponding speckle tracking images were acquired using 2D-STI. The changes of aortic strain rate was analyzed, and the arterial dilatation (AD) and arterial stiffness index (ASI) were calculated and compared. Results The value of AD was significantly lower and the value of ASI was significantly higher in EH group than that of control group(P<0.01).In the two groups, compared with non-elderly subgroup, the value of AD was lower and the value of ASI was higher in elderly subgroup(P<0.05); There were significant differences in the above indexes between the two subgroups in EH group and control group respectively(P<0.05). Conclusions Age and EH are important factors in the reduction of arterial elasticity. Simplified 2D-STI can evaluate the aortic elasticity and provide new ideas for clinical treatment of aortic diseases and has certain clinical value. References | Related Articles | Metrics

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Relationship of FGFR1 protein level and Ki67 expression with microvessel density in triple negative breast cancer tissue XU Chao, HAN Zheng-xiang, ZHOU Lei, SUN Bo 2021, 35 (8):  833-836.  doi: 10.3969/j.issn.1003-9198.2021.08.011 Abstract ( 185 )   PDF (969KB) ( 895 )   Save Objective To explore the relationship of fibroblast growth factor receptor-1(FGFR1) protein level and Ki67 expression with microvessel density(MVD) in triple negative breast cancer (TNBC) tissue. Methods A total of 140 breast cancer patients diagnosed and treated in our hospital from May 2018 to March 2019 were enrolled, including 100 cases of TNBC patients(TNBC group) and 40 cases of non-TNBC patients (non-TNBC group). The expression levels of FGFR1, Ki67 and MVD in the two groups were compared, and the relationship of FGFR1 protein level and Ki67 expression with MVD in the TNBC patients with different pathological states was analyzed. Results The expression levels of FGFR1 and Ki67 in TNBC group were significantly higher than those in non-TNBC group (P<0.01). There were significance differences in the expression levels of GFR1, Ki67, MVD between the TNBC patients with different tumor size, TNM stage, lymphatic metastasis and MVD level (P＜0.05). Correlation analysis showed that the tumor size, TNM stage, lymph node metastasis and MVD level were all positively correlated with the expression levels of GFR1 and Ki67 (P＜0.05). Conclusions The expressions of FGFR1 and Ki67 in TNBC tissue are significantly correlated with MVD. In the future, FGFR1 and Ki67 can be used to analyze the disease progression. References | Related Articles | Metrics

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Study on the efficacy and mechanism of sacubitril valsartan in the treatment of elderly patients with chronic heart failure QIN Shao-qiang, ZHANG Zhan-shuai, SHI Jin-zheng, LI Zhuo-ran, ZHAO Han-ting, WANG Ya-ling, LI Fang-jiang 2021, 35 (8):  837-839.  doi: 10.3969/j.issn.1003-9198.2021.08.012 Abstract ( 214 )   PDF (1006KB) ( 1062 )   Save Objective To analyze the efficacy of sacubitril valsartan in the treatment of elderly patients with chronic heart failure and the influence on the heart function, serum levels of cardiotrophin-1(CT-1) and β-endorphin(β-EP). Methods A total of 100 patients with chronic heart failure in our hospital from April 2019 to June 2020 were randomly divided into the observation group and the control group,with 50 cases in each group. The control group was treated with conventional treatment, and the observation group was given sacubitril valsartan sodium tablets on the basis of the control group. The curative effect of the two groups was observed and evaluated. The heart function indexes, 6-minute walking distance (6MWD), Minnesota Living with Heart Failure Questionaire (MLHFQ) score, the serum levels of CT-1 and β-EP before and after the treatment were detected and compared. Results The clinical effective rate of the observation group was significantly higher than that of the control group (94.0% vs 74.0%, P<0.05). After treatment, the levels of left ventricular ejection fraction (LVEF), stroke volume (SV), 6MWD and CT-1 were significantly higher and the levels of left ventricular end-diastolic dimension (LVEDD),β-EP score and MLHFQ score were significantly lower in two groups than those before treatment, especially in the observation group (P<0.01). Conclusions Sacubitril valsartan can effectively improve the clinical efficacy, cardiac function and serum levels of CT-1 and β -EP of the elderly patients with chronic heart failure. References | Related Articles | Metrics

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Establishment and validation of nomogram model for prediction of delirium risk in elderly patients after cardiac surgery LIU Hai-tang, TANG Qian-yun, ZHOU Sen 2021, 35 (8):  840-844.  doi: 10.3969/j.issn.1003-9198.2021.08.013 Abstract ( 209 )   PDF (1299KB) ( 1335 )   Save Objective To analyze the risk factors of delirium in the elderly patients undergoing cardiac surgery,and to establish and validate a nomogram model for predicting the risk of delirium. Methods The elderly patients who underwent cardiac surgery and were admitted to intensive care unit (ICU) of the Second Affiliated Hospital of Hainan Medical College from January 2018 to August 2020 were enrolled. The combination of the Richmond Agitation Sedation Scale (RASS) and the ICU-Confusion Assessment Method (CAM-ICU) were used to evaluate delirium.The patients were divided into delirium group and non-delirium group according to whether delirium occurred within 3 days after ICU admission,and the clinical characteristics of the two groups were observed and compared. The risk factors of delirium were identified by multivariate Logistic regression analysis. The predicting nomogram model for delirium in the elderly patients undergoing cardiac surgery was established by R 3.6.2 software. The modelling was validated by the Bootstrap method.The deviation and prediction efficiency of nomogram model for delirium were evaluated by calibration curve and receiver operating characteristic(ROC) curve, respectively. Results A total of 274 cases were enrolled in this study. The incidence rate of delirium was 9.1%(25 cases).Multivariate Logistic regression analysis showed that advanced age(OR=1.038,95%CI:1.004-1.247), high Charlson Comorbidity Index score(OR=1.760,95%CI: 1.154-2.685), cardiopulmonary bypass(OR=5.489,95%CI: 1.501-20.068) and intraoperative hypotension(OR=4.630,95%CI: 1.260-17.015) were independent risk factors for delirium in the elderly patients undergoing cardiac surgery.The internal validation C-index of nomogram prediction model was 0.876(95%CI:0.799-0.952),with good discrimination and stability. The calibration curve revealed that the mean absolute error between predicted delirium risk and the actual delirium risk was 0.017,and ROC curve showed that the area under the curve(AUC) for the nomogram model predicting delirium was 0.871(95%CI:0.819-0.923). Conclusions The nomogram model established in this study for predicting the risk of delirium has good discrimination,accuracy and clinical practicability.And it has certain guiding significance for predicting high-risk population of delirium and making targeted prevention strategies. References | Related Articles | Metrics

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Clinical characteristics of elderly patients with diastolic heart failure complicated with sarcopenia ZHAO Wen-xue, FAN Tian-shu, LU Miao, WANG Xiang-ming, ZHA Zhi-min, GUO Yan 2021, 35 (8):  845-848.  doi: 10.3969/j.issn.1003-9198.2021.08.014 Abstract ( 152 )   PDF (977KB) ( 1002 )   Save Objective To investigate the clinical characteristics of the elderly patients with diastolic heart failure (DHF) complicated with sarcopenia, and to analyze the effect of sarcopenia on physical activity. Methods A total of 120 eligible inpatients were included and divided into the sarcopenia group (n=65) and the non-sarcopenia group (n=55). The general clinical data, skeletal muscle mass index (SMI), grip strength, walking speed of 4 m in two groups were compared. Physical acticity decreasing was identified as 4 m walking speed less than 0.8 m/s. Logistic regression analysis was used to analyze the risk factors of physical activity decreasing. Results In the DHF patients, 54.17% patients were complicated with sarcopenia. Compared with the non-sarcopenic group, the body mass index(BMI), tridlyceride(TG), SMI, grip strength and the walking speed of 4 m in the sarcopenia group were significantly decreased, and the age was older(P<0.05). Logistic regression analysis showed that the age, cerebral infarction and SMI were independent influencing factors for decreased physical activity. Conclusions Sarcopenia is a common complication in DHF patients. Age, cerebral infarction and SMI will influence the patients’ physical activity ability, thus affecting their quality of life. References | Related Articles | Metrics

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Analysis of serum levels of miR-222, interleukin-6 and brain natriuretic peptide in patients with calcified valvular heart disease and pulmonaryarterial hypertension ZHOU Hua-lan, LI Xia, XU Pei-jing, HU You-dong 2021, 35 (8):  849-851.  doi: 10.3969/j.issn.1003-9198.2021.08.015 Abstract ( 154 )   PDF (958KB) ( 1130 )   Save Objective To explore the serum levels of microRNA-222 (miR-222), interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) and their clinical value in the patients with calcified valvular heart disease (CVHD) and pulmonaryarterial hypertension(PH). Methods A total of 158 patients with CVHD were divided into CVHD group (n=86) and CVHD combined with PH group(n=72). Thirty healthy people were selected as the control group. The serum levels of miR-222, IL-6, NT-proBNP and hs-CRP were detected and compared among the three groups, and the correlation between miR-222 and IL-6, NT-proBNP, hs-CRP was analyzed. Results The serum levels of miR-222, IL-6, NT-proBNP and hs-CRP in CVHD group increased significantly, especially in CVHD combined with PH group(P<0.05 or P＜0.01). In the patients with CVHD, the serum levels of IL-6, NT-proBNP, hs-CRP, miR-222 were all positively correlated with the level of miR-222 (r=0.507,0.390,0.509, P＜0.01). Conclusions Serum inflammatory factors such as miR-222 and IL-6 are involved in the occurrence and progression of CVHD and the development of PH. References | Related Articles | Metrics

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Effect of multi-disciplinary team management for frail elderly based on interRAI BO Lin ,LAI Xi-ao-xing, ZHU Hong-wei, XIE Hai-yan, HUO Xiao-peng 2021, 35 (8):  883-886.  doi: 10.3969/j.issn.1003-9198.2021.08.025 Abstract ( 152 )   PDF (969KB) ( 1643 )   Save Objective To explore the effect of multi-disciplinary team management based on interRAI in the frail elderly. Methods By convenient sampling, 64 frail elderly patients were selected from January to December 2019 in the Department of Health Care in Peking Union Medical College Hospital. The subjects were randomly divided into control group and intervention group with 32 cases in each group. The control group was given routine care, while the intervention group was given multi-disciplinary team management on the basis of the control group. The Tilburg Frailty Indicator(TFI) score,walking speed, grip strength, muscle strength of lower limb and the levels of hemoglobin and albumin were observed and compared at admission and 24 weeks after intervention. Results After 24 weeks of intervention, the TFI score was significantly decreased, the levels of walking speed, grip strength, muscle strength of lower limb, hemoglobin and albumin were significantly increased in the intervention group compared with those in the control group (P＜0.01). Conclusions Multi-disciplinary team management based on interRAI could effectively improve the frail status, physical function and nutritional status of the frail elderly. References | Related Articles | Metrics

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Effect of precision nursing intervention on secondary hyperparathyroidism in elderly uremic patients PENG Jun, YAN Ying 2021, 35 (8):  887-890.  doi: 10.3969/j.issn.1003-9198.2021.08.026 Abstract ( 167 )   PDF (969KB) ( 1038 )   Save Objective To explore the effect of precision nursing intervention on secondary hyperparathyroidism in the elderly uremic patients. Methods A total of 62 elderly uremic patients who received hemodialysis treatment in our hospital from January 2017 to December 2019 were selected and divided into two groups randomly, with 31 cases in each group. The observation group was treated with precision nursing intervention and the control group was treated with routine nursing intervention. The serum levels of parathyroid hormone (PTH), calcium (Ca), phosphor (P), creatinine (Cr), blood urine nitrogen (BUN) and alkaline phosphatase (AKP), the incidence of anxiety and depression,the quality of life were observed and compared between the two groups before and after the intervention. Results After nursing intervention, the levels of PTH, P, SCr, BUN and AKP were significantly lower and the level of Ca was significantly higher in the two groups than those before the intervention(P<0.05),especially in the observation group(P<0.05).Compared with the control group, the incidence rates of anxiety and depression in the observation group were significantly lower and the nursing satisfaction, the scores of the mental state, social function, health status and total score were significantly higher in the observation group(P<0.05). Conclusions Precision nursing intervention can reduce the complications of the elderly uremic patients with secondary hyperparathyroidism, and reduce the incidence of anxiety and depression, improve the quality of life. References | Related Articles | Metrics