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20 October 2021, Volume 35 Issue 10 Previous Issue    Next Issue

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Correlation of body composition and bone mineral density with aging CAO Ming, RUAN Lei, WU Xiao-fen, ZHANG Cun-tai, YANG Si-si 2021, 35 (10):  1012-1015.  doi: 10.3969/j.issn.1003-9198.2021.10.004 Abstract ( 207 )   PDF (1130KB) ( 1272 )   Save Objective To analyze the correlation between body composition and bone mineral density (BMD) among different age groups. Methods A total of 288 healthy people who underment physical examination in our hospital were enrolled and tested by body composition analyzer.The age, body mass index (BMI), body fat percentage, body fat mass, visceral fat area, lean mass and muscle mass were recorded. The value of BMD of all the populations was measured by HOLOGIC discovery system. The subjects were divided into young group (30-44 years old, n=70), middle-aged group (45-59 years old, n=105) and elderly group (60-75 years old, n=113) according to the age. Pearson correlation coefficient was used to describe the correlation between body composition and BMD. The independent factors of BMD were analyzed by multiple linear regression. Results The value of BMD in the elderly group was significantly lower than that in the young and middle-aged groups(P<0.05), and the incidence rate of osteoporosis in the elderly group was significantly higher than that in the young group (P<0.05). There were no significant differences in body mass, BMI or body fat percentage among the three groups (P>0.05). Compared with the young group, the area of visceral fat in the middle-aged and elderly groups was significantly increased, while the lean mass and muscle mass of the elderly group were significantly decreased, with statistical significant differences (P<0.05). Pearson correlation analysis showed that BMD was negatively correlated of BMD with age of the three groups. With the increase of age, the correlation of BMD with age was more significant (r=-0.22, -0.28, -0.37, all P<0.01). BMD was positively correlated with lean mass and muscle mass in the middle-aged and elderly group, especially in the elderly group (middle-aged group:r=0.27, r=0.27; elderly group: r=0.49, r=0.49, both P<0.01). Multiple linear regression analysis showed that age was an independent risk factor for BMD, while lean mass and muscle mass were protective factors for BMD. Conclusions Loss of bone mass in the elderly is associated with aging and age-related changes in lean mass and muscle mass. Lean mass and muscle mass are protective factors for BMD. References | Related Articles | Metrics

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Correlation between RANK gene methylation and frailty in elderly men in agricultural and pastoral areas of Xinjiang ZHUO-YA Mai-mai-ti-wu-si-man, XIANG Hong, BAI Xue, LI Yang-jing, WANG Hong-mei 2021, 35 (10):  1016-1018.  doi: 10.3969/j.issn.1003-9198.2021.10.005 Abstract ( 147 )   PDF (1065KB) ( 1022 )   Save Objective To investigate the correlation between RANK gene methylation and frailty in the elderly men in agricultural and pastoral areas of Xinjiang. Methods This study was based on the epidemiological cross-sectional investigation of male residents aged over 65 years old in agricultural and pastoral areas of Xinjiang from April to May 2018, and 90 cases were randomly selected, including 30 Kazak, 28 Uygur and 32 Han. General information was obtained by questionnaire, and 5 mL of fasting peripheral blood were collected to extract DNA. The methylation rate of the promoter region of RANK gene was identified by bisulfite genomic sequence. Fried phenotye was used to evaluate whether the subjects were frailty or not. The subjects with frailty were taken as the case group and the others without frailty as the control group. The correlation between the methylation rate of CpG island in the promoter region of RANK gene and frailty was analyzed by covariance analysis. Results There was no difference in the methylation rate of RANK gene among the control groups and case groups of Kazak, Uygur or Han (P>0.05). The methylation rates of RANK gene in the case groups of the three nationalities were significantly lower than those in the control groups of the three nationalities (P<0.05). After adjusting body mass index, drinking, smoking, age, hypertension and diabetes, the covariance analysis still showed that the methylation rate of RANK gene in the case group was significantly lower than that in the control group (P<0.05). Conclusions Among the elderly men in agricultural and pastoral areas of Xinjiang, the decreased methylation rate of RANK gene may be associated with frailty. References | Related Articles | Metrics

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Analysis of clinical risk factors for slow coronary artery flow ZHANG Yue, TAN Xiao 2021, 35 (10):  1019-1022.  doi: 10.3969/j.issn.1003-9198.2021.10.006 Abstract ( 153 )   PDF (1039KB) ( 891 )   Save Objective To explore the potential relationship between common clinical inflammatory indicators and coronary slow flow (CSF), and to explore the risk factors for CSF. Methods The clinical data of 120 elderly patients who underwent coronary angiography (CAG) in the Second Affiliated Hospital of Nanjing Medical University from July 2018 to June 2020 were retrospectively analyzed. Among them, 58 patients with CSF were enrolled as the observation group, and 62 patients with coronary stenosis <40% and not diagnosed as CSF by CAG were enrolled as the control group. The general information, results of CAG and neck ultrasound, the levels of serum high sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6) and neutrophil gelatinase-associated lipocalin (NGAL) were compared between the two groups. The risk factors for CSF were analyzed by multivariate Logistic regression analysis. Results There were no significant differences in general sociological data between the two groups (P>0.05). The corrected TIMI frame count (CTFC), corrected left anterior descending (cLAD) TIMI frame count, left circumflex artery (LCX) TIMI frame count, right coronary artery (RCA) TIMI frame count and Mean carotid intima-media thickness (Mean-IMT) in the observation group were higher than those in the control group; The levels of serum hs-CRP, IL-6 and NGAL in the observation group were higher than those in the control group, with statistically significant differences (P<0.05 or P<0.01). Multivariate Logistic regression analysis showed that hs-CRP, IL-6, NGAL, Mean-IMT and CTFC were risk factors affecting CSF. Conclusions The patients with CSF have higher level of intima-media thickness. Serum inflammatory factors such as hs-CRP, IL-6 and NGAL, Mean-IMT and CTFC are risk factors affecting CSF. References | Related Articles | Metrics

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Effect of new high-flow humidified oxygen therapy in elderly patients with stroke-associated pneumonia HU Ying, LU Min, ZHAN Hui 2021, 35 (10):  1023-1026.  doi: 10.3969/j.issn.1003-9198.2021.10.007 Abstract ( 159 )   PDF (1024KB) ( 1255 )   Save Objective To investigate the effect of new high-flow humidified oxygen therapy in the elderly patients with stroke-associated pneumonia (SAP). Methods A total of 70 elderly patients with acute ischemic stroke (AIS) complicated with SAP after intravascular interventional treatment in the Intensive Care Unit of Neurology Department of our hospital from September 2017 to September 2019 were enrolled, and they were divided into the intervention group and the control group by random number table, with 35 cases in each group. Both groups were given standard treatment such as anti-inflammation, expectorant and antitussive drugs. The intervention group was treated with nasal high-flow humidified oxygen therapy, while the control group was treated with conventional oxygen therapy by nasal cannula or face mask. The clinical pulmonary infection score (CPIS) and the levels of arterial blood gas analysis indexes, white blood cell (WBC) and high-sensitivity C-reaction protein (hs-CRP) in the two groups were compared before and after treatment. The hospitalization time of the two groups was recorded and compared. Results There was no significant difference in CPIS between the two groups before treatment and 24 h after treatment (P>0.05). The level of CPIS of the intervention group was significantly lower than that of the control group 36 h and 7 d after treatment. After treatment, the levels of pH value and arterial partial pressure of oxygen (PaO2) were significantly higher, and the levels of arterial partial pressure of carbon dioxide (PaCO2), WBC and hs-CRP were significantly lower in both groups than those before treatment. The pH value of the intervention group was higher than that of the control group (P<0.05). There were no significant differences in the levels of PaO2, PaCO2, WBC and hs-CRP between the two groups after treatment (P>0.05). The average hospital stay in the intervention group was shorter than that in the control group (P<0.001). Conclusions The new high-flow humidified oxygen therapy can significantly improve the blood gas level and pulmonary infection in the elderly SAP patients, and shorten the hospitalization duration. References | Related Articles | Metrics

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Predictive value of Pcv-aCO2/Ca-cvO2 combined with quick sequential organ failure assessment on prognosis of elderly patients with septic shock ZHAO Ting-ting, WANG Hui, XUE Qian-long, LI Wen-hui, HAN Shu-chi 2021, 35 (10):  1027-1030.  doi: 10.3969/j.issn.1003-9198.2021.10.008 Abstract ( 136 )   PDF (1041KB) ( 1060 )   Save Objective To evaluate the predictive value of Pcv-aCO2/Ca-cvO2 combined with quick sequential organ failure assessment (qSOFA) on the prognosis of elderly patients with septic shock. Methods A total of 68 elderly patients with septic shock admitted to Emergency ICU from January 2017 to December 2020 were selected and divided into survival group (n=38) and death group (n=30) according to the 28 d prognosis. The clinical data, the ratio of Pcv-aCO2/Ca-cvO2, and the scores of qSOFA and Acute Physiology and Chronic Health Evulation (APACHEⅡ) were compared between the two groups. The influencing factors of prognosis were analyzed by Logistic regression model. The predictive value of Pcv-aCO2/Ca-cvO2, qSOFA and their combination on the prognosis of elderly patients with septic shock was analyzed by receiver operating characteristic (ROC) curve analysis. Results The levels of creatinine, procalcitonin, Pcv-aCO2/Ca-cvO2, and the scores of qSOFA and APACHE Ⅱ in the death group were siginificantly higher than those in the survival group (P<0.05); Logistic regression analysis showed that Pcv-aCO2/Ca-cvO2, qSOFA and APACHE Ⅱ were the independent influencing factors of prognosis in the elderly patients with septic shock. ROC curve analysis showed that the sensitivity of Pcv-aCO2/Ca-cvO2 and qSOFA in predicting the prognosis of elderly patients with septic shock was 70.00% and 53.33%, respectively; The sensitivity of the combination of the two indexes in predicting the prognosis was 80.00%, which was better than the single index. Conclusions Pcv-aCO2/Ca-cvO2, qSOFA and APACHE Ⅱ are independent influencing factors for the prognosis in the elderly patients with septic shock. The combination of Pcv-aCO2/Ca-cvO2 and qSOFA has a certain value in predicting the prognosis of elderly patients with septic shock. References | Related Articles | Metrics

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Comparison of vertebroplasty and curved vertebroplasty in the treatment of elderly patients with osteoporotic vertebral compression fractures GUO Jie, YU Li-feng, SUN Wei, WANG Qiang, LIU Xin-wei, WANG Chun-sheng 2021, 35 (10):  1031-1035.  doi: 10.3969/j.issn.1003-9198.2021.10.009 Abstract ( 237 )   PDF (1102KB) ( 946 )   Save Objective To compare the efficacy of vertebroplasty and curved vertebroplasty in the treatment of elderly patients with osteoporotic vertebral compression fractures (OVCF). Methods From January 2018 to December 2019, 108 elderly patients with OVCF in our hospital were selected and divided into group A and group B by using random number table, with 54 cases in each group. Group A was treated with conventional vertebroplasty bone cement injection, and group B was treated with curved vertebroplasty bone cement injection treatment. The distribution of bone cement, leakage rate, and the incidence rate of re-fracture were compared between the two groups. All the patients were followed up for 12 months after operation. The anterior edge height of injured vertebral body, Oswestry dysfunction index, and the score of Visual Analogue Scale (VAS) in both groups were recorded and compared before and after operation. Results The ideal rate of bone cement distribution in group B was 88.89%, compeared with 37.04% in group A (P<0.01). Twelve months after operation, the anterior edge height of injured vertebral body in both groups was significantly higher than that before operation (P<0.01), and the Oswestry dysfunction index in both groups was significantly lower than that before operation(P<0.01), but there were no significant differences in the two indexes between group A and group B (P＞0.05). The score of VAS 1 month, 3 months, 6 months and 12 months after operation in both groups was significantly lower than that before operation (P<0.05), but there was no significant difference in the score of VAS between the two groups 1 month and 3 months after operation (P>0.05). The score of VAS in group B was significantly lower than that in group A 6 months and 12 months after operation (P<0.05). The rate of bone cement leakage in group B was 12.96%, compared with 29.63% in group A (P<0.05). There was no significant difference in the rate of postoperative vertebral re-fracture between the two groups (P>0.05). Conclusions Compared with vertebroplasty, curved vertebroplasty in the treatment of elderly patients with OVCF has better bone cement distribution, lower leakage rate, and more obvious improvement in long-term pain. References | Related Articles | Metrics

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Expression of transcription factor activator protein-2a in elderly patients with lung adenocarcinoma and its relationship with clinicopathological parameters FANG Le-ping, FAN Wei-fei, DONG Zhen 2021, 35 (10):  1036-1039.  doi: 10.3969/j.issn.1003-9198.2021.10.010 Abstract ( 133 )   PDF (1457KB) ( 1236 )   Save Objective To investigate the expression of transcription factor activator protein-2a (TFAP-2a) in the elderly patients with lung adenocarcinoma and its relationship with clinicopathological parameters. Methods The difference of TFAP-2a expression between lung adenocarcinoma and normal lung tissue and its effect on the prognosis of lung adenocarcinoma were analyzed by bioinformatics data. A total of 64 cases of elderly lung adenocarcinoma tissue and 25 cases of elderly normal lung tissue were collected from August 2015 to March 2020, and the expression of TFAP-2a was detected by immunohistochemical staining, and the correlation between TFAP-2a expression and clinicopathological parameters was analyzed. Results The GEPIA database analysis results showed that the expression level of TFAP-2a in lung adenocarcinoma tissue was significantly higher than that in normal lung tissue (P<0.05), but there were no significant differences among lung adenocarcinoma tissues with different TNM staging (P>0.05). KMplot database analysis results showed that the progression-free survival and overall survival of the patients with lung adenocarcinoma with low expression of TFAP-2a were better than those with high expression of TFAP-2a (all P<0.05). The immunohistochemical staining results showed that the proportion of high expression of TFAP-2a in the elderly lung adenocarcinoma tissue was significant higher than that in the elderly normal lung tissue (P<0.01), and the proportion of high expression of TFAP-2a in the elderly patients with lung adenocarcinoma who had lymph node metastasis and moderate-low differentiation was higher (P<0.05). Conclusions TFAP-2a is highly expressed in the elderly patients with lung adenocarcinoma. The lung adenocarcinoma with over expression of TFAP-2a is poorer in differentiation and more prone to lymph node metastasis. References | Related Articles | Metrics

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Comparison of the anesthesia effect and safety between ultrasound-guided costoclavicular brachial plexus block and ultrasound-guided axillary brachial plexus block in elderly patients ZHU Wei, ZHOU Yu, YANG Xu-li, ZHANG Jin-wei 2021, 35 (10):  1040-1044.  doi: 10.3969/j.issn.1003-9198.2021.10.011 Abstract ( 140 )   PDF (1273KB) ( 892 )   Save Objective To compare the safety and clinical efficacy of different concentrations of ropivacaine by ultrasound-guided costoclavicular brachial plexus block (CBPB) or ultrasound-guided axillary brachial plexus block (ABPB) in the elderly patients with bilateral distal arm fracture. Methods A total of 80 elderly patients with bilateral distal arm fracture were selected. All the patients were stratified by gender and randomly divided into A1 group, A2 group, B1 group and B2 group. A1 group received CBPB under ultrasound guidance with 0.25% ropivacaine 0.5 mL/kg; A2 group received CBPB under ultrasound guidance with 0.1875% ropivacaine 0.5 mL/kg; B1 group received ABPB under ultrasound guidance with 0.25% ropivacaine 0.5 mL/kg; B2 group received ABPB under ultrasound guidance with 0.1875% ropivacaine 0.5 mL/kg. The block operation time, needle adjustment times, onset time, block rate of sensory nerve and motor nerve, adverse reactions and postoperative satisfaction of the patients in the four groups were recorded and compared. Results Compared with A1 group, the operation time, the onset time of the radial nerve and musculocutaneous nerve in B1 and B2 group were prolonged, and the frequency of needle adjustment was increased (P<0.01); The onset time of each branch in A2 group was prolonged (P<0.05 or P<0.01). Compared with A2 group, the operation time and radial nerve onset time of B1 and B2 group were prolonged, the ulnar nerve onset time was shortened, and the frequency of needle adjustment was increased (P<0.01). The block rates of sensory nerve and motor nerve in each branch of A1 group were significantly higher than those of B2 group (P<0.05); There was no significant difference in the block rate of sensory nerve or motor nerve between A1 group and A2 group (P>0.05). There was no significant difference in the incidence rate of adverse reactions among the four groups (P>0.05). The patients’ satisfaction of A1 and A2 group was significantly higher than that of B1 and B2 group (P<0.01). Conclusions Compared with ABPB, the elderly patients with bilateral distal arm fracture receiving ultrasound-guided CBPB with 0.1875% ropivacaine (0.5 mL/kg) show short operation time, less needle adjustment times, good nerve block effect and high patient’s satisfaction, and satisfactory clinical effect. References | Related Articles | Metrics

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Clinical characteristics of 1598 elderly inpatients with dermatosis FAN Jiao-jiao, CAO Yan, ZHANG An-ping 2021, 35 (10):  1045-1048.  doi: 10.3969/j.issn.1003-9198.2021.10.012 Abstract ( 140 )   PDF (1079KB) ( 889 )   Save Objective To investigate the prevalence and proportion of geriatric dermatoses of dermatology department. Methods The clinical data of inpatients in the Department of Dermatology of the First Affiliated Hospital of Anhui Medical University from 2017 to 2019 was retrospectively analyzed. Results There were 1598 elderly dermatological inpatients (≥60 years old), accounting for 29.34% of the total dermatological inpatients during the same period, and the ratio of male to female was 1.41∶1. The skin diseases of the elderly inpatients were divided into 18 categories and 48 kinds, among which the top 3 diseases were allergic skin diseases (n=473, 29.60%), viral skin diseases (n=448, 28.04%) and immune bullous diseases (n=228, 14.27%). The inpatients aged 60-69 years old mainly suffered from allergic skin diseases, followed by viral skin diseases; The inpatients aged 70-79 and 80-89 years old mainly suffered from viral skin diseases, followed by allergic skin diseases; The inpatients aged 90 years and over mainly suffered from autoimmune bullous disease, followed by allergic skin disease. Hierarchical analysis showed that the top six skin diseases leading to hospitalization in the elderly were herpes zoster (28.04%), eczema (12.70%), drug eruption (9.64%), bullous pemphigoid (9.51%), psoriasis (7.38%) and urticaria (4.46%). Among them, eczema and psoriasis were more common in male patients, while herpes zoster, drug eruption and urticaria were more common in female patients. In addition, there were significant differences in the prevalence rates of above skin diseases between elderly patients and pre-aged patients (45-59 years old). Conclusions Elderly dermatological inpatients account for nearly 1/3 of the total number of dermatological inpatients during the same period, and there are significant differences in the distribution of skin diseases among different genders and different ages. References | Related Articles | Metrics

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Analysis of echocardiography parameters in elderly patients with heart failure with preserved ejection fraction CAO Ya-ru, JIANG Su-rong, WANG Ying-ying, WANG Xiao-yan, XU Di, GUO Yan 2021, 35 (10):  1049-1053.  doi: 10.3969/j.issn.1003-9198.2021.10.013 Abstract ( 169 )   PDF (1062KB) ( 967 )   Save Objective To investigate the diagnostic value of echocardiography parameters in the elderly patients with heart failure with preserved ejection fraction (HFpEF). Methods A total of 76 HFpEF patients admitted to the Geriatric Cardiology Department of the First Affiliated Hospital with Nanjing Medical University from November 2019 to January 2021 were selected as observation group and 54 patients without heart failure as control group. General data,N-terminal B-type natriuretic peptide(NT-proBNP) level and conventional biochemical index results of all the patients were collected, and the echocardiography parameters detection was performed. Results The incidence of atrial fibrillation, diuretic use and the level of NT-proBNP in HFpEF group were significantly higher than those in control group (P<0.01).The levels of left atrium diameter(LAD),left ventricular diameter(LVD), left ventricular ejection fraction(LVEF), left atrial volume index(LAVI) and tricuspid regurgitation velocity(TRV), and the ratio of peak transmitral flow velocities of early to late in diastole (E/A) and transmitral flow velocities to mitral annulus tissue velocities in early diastole (E/e′) in HFpEF group were higher than those in control group(P<0.01). Receiver operating characteristic curve analysis showed that the area under curve (AUC) of HFpEF diagnosed by LAVI was 0.976, which was higher than E/e′, NT-proBNP and TRV. When the cut-off value of LAVI was 31.43 mL/m2, the sensitivity and specificity was 0.98 and 0.89 respectively. Spearman correlation analysis showed that LAVI was positively correlated with LAD, E/A, E/e′, TRV and NT-proBNP, but not significantly correlated with age and systolic blood pressure. Conclusions LAVI has a greater guiding significance for the clinical diagnosis and treatment of elderly patients with HFpEF. References | Related Articles | Metrics

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Correlation between oral health and frailty in rural empty nesters of Shanxi province WANG Zhi-yan, YANG Yu-lin, CHEN Ling, GAO Huan-ling 2021, 35 (10):  1054-1057.  doi: 10.3969/j.issn.1003-9198.2021.10.014 Abstract ( 143 )   PDF (1026KB) ( 979 )   Save Objective To investigate the correlation between oral health and frailty in the rural empty nesters of Shanxi province. Methods A total of 483 empty nesters were conveniently selected from Pingyao county of Shanxi province.The questionnaire survey was carried out by using the Fried Phenotype, self-designed general situation questionnaire and Geriatric Oral Health Assessment Index (GOHAI). Results Among the 483 rural empty nesters, the mean score of GOHAI was 38.12±15.23 and 206 cases (42.7%) were assessed as frailty.The scores in all dimensions and total score of GOHAI in the elderly with frailty were significantly lower than those in the elderly without frailty (P＜0.01). Spearman correlation analysis showed that the total score and score of each dimension of GOHAI were negatively correlated with the score of Fried Phenotype (P＜0.01). Conclusions The oral health of the rural empty nesters is negatively correlated with frailty. Medical staff should pay more attention to the frailty assessment of the elderly with poor oral health,and early intervention should be taken as soon as possible, so as to improve the quality of life in the rural empty nesters. References | Related Articles | Metrics

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Effect of laryngeal mask airway intubation with visualization technology on hemodynamic parameters in elderly patients with general anesthesia ZHU Tong-tong, WANG Chao-xia, QI Yue 2021, 35 (10):  1058-1062.  doi: 10.3969/j.issn.1003-9198.2021.10.015 Abstract ( 135 )   PDF (1053KB) ( 1262 )   Save Objective To investigate the effect of visualized laryngeal mask airway intubation on hemodynamics in the elderly patients with general anesthesia. Methods Seventy-eight elderly patients with general anesthesia were randomly divided into observation group (receiving visualized laryngeal mask airway intubation, 39 cases) and control group (receiving tracheal intubation, 39 cases) by random number table method. The patients’ heart rate (HR) and mean arterial pressure (MAP) at base value (T0), before intubation immediately (T1), after intubation immediately (T2), 3 min after intubation (T3), when the tube drawing (T4), extubation immediately (T5) and 3 min after extubation (T6) were recorded and compared between the two groups. The operation time, anesthesia time, recovery time and anesthetic dosage were compared between the two groups, and the incidence rates of complications in recovery period and early postoperative period were recorded and compared. Results There was no significant difference in HR at all time points of the observation group (P>0.05), HR at T2, T3, T5 and T6 of the observation group were significantly lower than those of the control group (P<0.05). In the control group, the differences of HR at all time points were statistically significant (P<0.05), in which T1 was lower than T0; T2 and T3 were higher than T0, T1 and T4; T5 was higher than T0-T4; T6 was higher than T0, T1, T3 and T4, but lower than T2 and T5. There were significant differences in MAP at all time points of the two groups. In the observation group, the level of MAP at T0 was lower than that at T1-T6. In the control group, the level of MAP at T0 was higher than that at T1, T3 and T4, but lower than that at T2 and T5, and approximately equal to T6. The levels of MAP at T2, T3, T5 and T6 in the observation group were significantly lower than those in the control group (P<0.05). There were no significant differences in operation time, anesthesia time and the dosage of remifentanil between the two groups (P>0.05). The wake time of the observation group was significantly shorter than that of the control group (P<0.01). The dosage of propofol in the observation group was significantly lower than that in the control group (P<0.01). The incidence rates of cough, body movement, sore throat and swallowing pain in the observation group were significantly lower than those in the control group (P<0.05). There were no significant differences in the incidence rates of nausea, vomiting and hoarseness between the two groups (P>0.05). Conclusions Visualized laryngeal mask airway intubation is safe and reliable in the airway management of the elderly patients with general anesthesia. Compared with tracheal cannula, it has stable hemodynamics and fewer complications, which is worthy of clinical promotion. References | Related Articles | Metrics

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Serum level of vitamin D in middle-aged and elderly women and the correlation with anemia YANG Rui-xia, SONG Wei-juan, CUI Ting, TANG Wei-ming 2021, 35 (10):  1063-1066.  doi: 10.3969/j.issn.1003-9198.2021.10.016 Abstract ( 150 )   PDF (1032KB) ( 927 )   Save Objective To investigate the serum level of vitamin D in the middle-aged and elderly women and the correlation with anemia. Methods A total of 332 middle-aged and elderly women in Medical Examination Center of Jiangsu Province Hospital from January 2019 to September 2020 were selected. The levels of serum 25-hydroxy vitamin D [25-(OH)D] and red blood cell parameters were detected. The correlation between 25-(OH)D and red blood cell parameters was analyzed by Spearman correlation analysis. Results The serum 25-(OH)D level of 332 middle-aged and elderly women was 42.60 (19.10-73.10) nmol/L, 25-(OH)D deficiency accounting for 69.28%, 25-(OH)D insufficiency accounting for 30.72%. The level of 25-(OH)D in middle-aged group (aged 45-59 years old, n=270) was higher than that in elderly group (aged 60-79 years old, n=62), and the difference was statistically significant (Z=-5.140, P<0.001); The level of 25-(OH)D in summer to autumn group (detection from May to October, n=225) was significantly higher than that in winter to spring group (detection from November to April of the next year, n=107), and the difference was statistically significant (Z=-5.577, P<0.001). In the middle-aged group and the elderly group, there were no differences in the rate of anemia between 25-(OH)D insufficiency subgroup and 25-(OH)D deficiency subgroup (χ2 =3.112, 1.079; P=0.078, 0.299). In the middle-aged group, the levels of red blood cell (RBC), hemoglobin(Hb), hematocrit (HCT), mean corpuscular volume (MCV) and mean hemoglobin concentration (MCHC) in the 25-(OH)D insufficiency subgroup were significantly higher than those in the 25-(OH)D deficiency subgroup (P<0.05). In the elderly group, the levels of RBC and HCT in the 25-(OH)D insufficiency subgroup were significantly higher than those in the 25-(OH)D deficiency subgroup (P<0.01). In the middle-aged group, RBC and Hb were independently correlated with 25-(OH)D (β=14.545, 0.103; P<0.05); In the elderly group, RBC and HCT were independently correlated with 25-(OH)D (β=9.939, 0.672; P<0.05) . Conclusions Vitamin D deficiency and insufficiency is prevalent in middle-aged and elderly women. Vitamin D deficiency can affect the levels of red blood cell parameters. References | Related Articles | Metrics

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The status of self-perceived burden in elderly inpatients with multiple myeloma and its influencing factors CHU Hong, CHEN Yan, YING Xiu-hua, WANG Qian, HUANG Ting 2021, 35 (10):  1087-1091.  doi: 10.3969/j.issn.1003-9198.2021.10.022 Abstract ( 154 )   PDF (1043KB) ( 1016 )   Save Objective To explore the self-perceived burden of the elderly inpatients with multiple myeloma and to analyze its influencing factors. Methods A total of 103 elderly inpatients with multiple myeloma in Department of Haematology of Nanjing Drum Tower Hospital were surveyed by using general information questionnaire, Barthel Index scale, Self-rating Anxiety Scale, Self-Perceived Burden Scale (SPBS) Chinese version, and simple coping style questionnaire.The influencing factors for self-perceived burden of the elderly inpatients with multiple myeloma were analyzed by multiple linear stepwise regression analysis. Results All the inpatients had self-perceived burden, and the average score of SPBS was 33.08±5.48, which was at the middle level.Multiple linear stepwise regression analysis showed that clinical stage, anxiety and negative coping style were the main influencing factors for self-perceived burden of the elderly inpatients with multiple myeloma. Conclusions The self-perceived burden of the elderly inpatients with multiple myeloma is moderate and prevalent. Therefore, in order to reduce the self-perceived burden of the patients, medical staff could carry out targeted interventions by controlling the primary disease, implementing corresponding psychological nursing, and promoting patients to actively coping respond. References | Related Articles | Metrics

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Application of 3C checklist in elderly patients with craniocerebral trauma receiving operation CHEN Hui, WU Mei, TONG Zi-rong, ZHA0 Qian, WU Juan, SHAO Zheng-qun, BI Li-qing, ZHAO Lin 2021, 35 (10):  1092-1096.  doi: 10.3969/j.issn.1003-9198.2021.10.023 Abstract ( 135 )   PDF (1035KB) ( 947 )   Save Objective To observe the application effect of 3C checklist in the elderly patients with craniocerebral trauma receiving operation. Methods A total of 82 elderly patients undergoing craniocerebral trauma surgery in our hospital from June 2018 to June 2020 were selected and divided into observation group and control group according to random number table, with 41 cases in each group. The illness state in the observation group was recorded with structured 3C checklist, while the illness state in the control group was recorded with traditional form. A total of 200 nursing records were collected from each group, and the nurses’ mastery of the patients’ condition was compared between the two groups. The occurrence of postoperative complications and the score of Glasgow Coma Scale at 14 days after surgery were recorded and compared between the two groups. The patients’ satisfaction with nursing was investigated 1 day before discharge. Results There were significant differences in nurses’ overall mastery rate and the mastery rates of wound drainage, sensorimotor function, diet, the illness state sudden change, and high-risk warning between the two groups (P<0.05). Twenty-four patients (58.54%) in the observation group had good recovery and mild disability, while 10 patients in the control group (24.39%) had good recovery and mild disability, and the difference was statistically significant between the two groups (Z=17.829, P<0.001). The total incidence rate of postoperative complications in the observation group was lower than that in the control group (P<0.01). The total satisfaction of the elderly patients or their families in the observation group was higher than that in the control group (P<0.01). Conclusions Using 3C checklist to record the condition of the patients undergoing craniocerebral trauma surgery can reduce the postoperative complications and improve the prognosis. At the same time, it can also improve the primary nurses’ mastery of patients’ condition and patients’ satisfaction with nursing work. References | Related Articles | Metrics

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Application of nerve monitoring combined with zero defect intervention mode in elderly patients undergoing spinal surgery SONG Yang, PAN Ya-juan, HAN Ting-ting 2021, 35 (10):  1097-1100.  doi: 10.3969/j.issn.1003-9198.2021.10.024 Abstract ( 131 )   PDF (1028KB) ( 915 )   Save Objective To investigate the effect of nerve monitoring combined with zero defect intervention mode in the elderly patients undergoing spinal surgery. Methods A total of 86 elderly patients undergoing spinal surgery from December 2019 to September 2020 in our hospital were divided into control group and observation group according to random number table, with 43 cases in each group. The control group was treated with zero defect intervention mode, and the observation group was treated with zero defect intervention mode combined with nerve monitoring. Before intervention and 7 days after intervention, the serum levels of interleukin-6 (IL-6), IL-8, tumor necrosis factor-α (TNF-α), cortisol (Cor), norepinephrine (NE) were detected and compared between the two groups. The general compliance questionnaire was used to investigate the patients’ satisfaction and compliance. The perioperative indexes, and the incidence rate of complications 7 days after intervention were compared between the two groups. Results There were no significant differences in the operation time and intraoperative blood loss between the two groups (P>0.05); The time of postoperative ambulation, anal exhaust, eating and hospital stay in the observation group was shorter than that in the control group (P<0.05). The levels of IL-6, IL-8, TNF-α, Cor and NE in both groups after intervention were higher than those before intervention (P<0.05), and the levels of the above indexes in the observation group were signicantly lower than those in the control group (P<0.05). The total incidence rate of complications in the observation group was lower than that in the control group (P<0.05). The satisfaction of nursing methods, nursing content and service attitude, and the compliance of rehabilitation exercise, regular review and medication in the observation group were higher than those in the control group (all P<0.05). Conclusions Nerve monitoring combined with zero defect intervention mode can reduce the surgical trauma, inflammatory stress reaction and postoperative complications in the elderly patients undergoing spinal surgery, which is helpful to increase the patients compliance and is worthy of popularization and application. References | Related Articles | Metrics

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Effects of five-in-one rehabilitation model on the ability of daily life and motor function in elderly stroke patients CAI Jiao-yan, LI Zhong, Meng Si-jin 2021, 35 (10):  1101-1103.  doi: 10.3969/j.issn.1003-9198.2021.10.025 Abstract ( 155 )   PDF (1007KB) ( 990 )   Save Objective To observe the effects of five-in-one rehabilitation model on the ability of daily life and motor function in the elderly stroke patients. Methods Sixty-four elderly patients with first-attact of stroke were randomly divided into observation group (32 cases) and control group (32 cases). The control group was intervened by conventional rehabilitation mode, while the observation group was intervened by five-in-one rehabilitation mode of "doctor-therapist-nurse-patient-escort". Barthel Index (BI) scale and Brunnstrom Stage scale were used to evaluate the ability of daily life and motor function of the two groups before and after intervention. Results After intervention, the grades of Brunnstrom hemiplegia function of upper limbs, hands and lower limbs in both groups were significantly better than those before treatment (P<0.01), and the scores of BI in both groups were significantly higher than those before treatment (P<0.01), especially in the observation group (P<0.01). Conclusions The five-in-one rehabilitation model can better improve the ability of daily life and motor function of elderly stroke patients. References | Related Articles | Metrics