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20 January 2022, Volume 36 Issue 1 Previous Issue    Next Issue

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Influence of obesity on the effect of non-invasive mechanical ventilation in patients with stable chronic obstructive pulmonary disease HU Yu-jie, YUAN Wei-feng, LI Hao-hua, WU Wei-ling 2022, 36 (1):  19-22.  doi: 10.3969/j.issn.1003-9198.2022.01.006 Abstract ( 151 )   PDF (978KB) ( 1410 )   Save Objective To investigate the effects of besity on the efficacy of non-invasive ventilation (NIV) in the patients with stable chronic obstructive pulmonary disease (COPD). Methods A total of 80 patients with stable COPD were admitted and divided into control group (BMI<25) and obesity group(BMI>30) according to BMI, with 40 patients in each group. Both groups were given the treatment of drug combined with NIV according to GOLD. The levels of arterial blood gas, C reactive protein(CRP) and fractional exhaled nitric oxide(FeNO), COPD assessment test(CAT) score and 6 minute walking distance (6MWD), times of hospitalization were compared between the two groups. Results After the treatment with NIV, the level of PaO2 increased, and the level of PaCO2 decreased significantly in the two groups, especially in control group(P<0.05). After treatment, the level of CRP was significantly decreased in control group, but showing no significant change in obesity group. The level of FeNO was significantly lower in control group than that in obesity group (P<0.05). The score of CAT and 6MWD were significantly improved in obesity group after treatment, but were lower than those in control group (P<0.05). The time of hospitalization showed no significant difference between the two groups. Conclusions The treatment of NIV can relieve the clinical symptoms of COPD combined with obesity. However, the COPD patients presenting with obesity get poorer treatment effect. Invasive ventilation is considered to be an alternative for obesitive COPD patients. References | Related Articles | Metrics

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Correlation of serum β2 microglobulin and lipoprotein-associated phospholipase A2 with post-stroke cognitive impairment ZHANG Mei-ni, LI Min, XUE Jia-jing, YANG Qian, WANG Tao 2022, 36 (1):  23-26.  doi: 10.3969/j.issn.1003-9198.2022.01.007 Abstract ( 174 )   PDF (987KB) ( 1193 )   Save Objective To explore the correlation of serum β2 microglobulin (β2-MG) and lipoprotein-related phospholipase A2(Lp-PLA2) with post-stroke cognitive impairment(PSCI) in the patients with acute ischemic stroke (AIS). Methods The AIS patients hospitalized in the Department of Neurology of Shaanxi Provincial People’s Hospital were recruited.Fasting serum levels of β2-MG,Lp-PLA2, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and other indicators were detected at admission.After 3 months of routine treatment,all the patients were divided into PSCI group (MoCA <26) and normal cognition group (MoCA≥26). Multi-variate Logistic regression analysis was performed to analyze the risk factors of PSCI. Finally, Receiver operating characteristic (ROC) curve analysis was carried out to determine the cut-off potint of β2-MG and Lp-PLA2. Results A total of 102 AIS patients were enrolled. The prevalence of PSCI after 3 months of routine treatment was 53.9% (55 cases). The age, the ratio of hypertension,years of education, the serum levels of Lp-PLA2 and β2-MG of the PSCI group were higher than those of the normal cognition group (P<0.05).Logistic regression analysis showed that serum levels of β2-MG, Lp-PLA2 were important risk factors for PSCI (P<0.05). The area under ROC curve of β2-MG,Lp-PLA2 and combined detection was 0.654,0.790, 0.872, with a sensitivity of 80.0%, 78.2%, 87.3%, and a specificity of 66.0%,74.5%, 80.8% respectively. Conclusions AIS patients with higher serum levels of β2-MG, Lp-PLA2 are more likely to occur PSCI 3 months after stroke. These index can be used as the predictors of PSCI. References | Related Articles | Metrics

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Effect of different dosage of physical activities in the frail elderly LAI Xiao-xing, WU Zhao, LIU Cai-yun, BO Lin, ZHU Hong-wei, HUO Xiao-peng 2022, 36 (1):  27-30.  doi: 10.3969/j.issn.1003-9198.2022.01.008 Abstract ( 158 )   PDF (1023KB) ( 1275 )   Save Objective To explore the effect of different dosage of physical activities on muscle strength, physical fitness and sleep quality of the frail elderly. Methods A total of 88 frail elderly meeting the inclusion criteria were enrolled and randomly divided into control group, small-amount and medium-intensity group, small-amount and high-intensity group, large-amount and high-intensity group, with 22 elderly in each group. The control group did not have any targeted physical training. The three intervention groups practiced resistance exercise of lower limbs with the corresponding amount and intensity of physical exercise according to the scheme. The muscle strength of lower limb, physical fitness and sleep status of the frail elderly were evaluated before and 12 weeks after the intervention. Results There were no significant differences in the muscle strength of lower limb, physical fitness and sleep status before and after the intervention in the control group (P>0.05); Compared with those before intervention, the above indexes in the other three exercise groups were improved significantly after the intervention (P<0.05 or P<0.01). Compared with small-amount and medium-intensity group, the muscle strength of lower limbs, 6-minute walking distance, 30-second sit-to-stand test and total sleep time in small-amount and high-intensity group, large-amount and high-intensity group were significantly improved (P <0.01). Conclusions Resistance exercise can effectively improve the muscle strength, physical fitness and sleep of the frail elderly. The amount and intensity of physical activity are conducive to the improvement of muscle strength, physical fitness and sleep status in the frail elderly, but the intensity of physical activity is the main factor influencing the above health indicators. References | Related Articles | Metrics

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Effects of sarcopenia complicated with cognitive impairment on poor prognosis of elderly patients after discharge ZHANG Lu-yin, MO Yong-zhen, OUYANG Xiao-jun, WANG Jie, SHEN Xiao-xing, ZHU Hai-qiong, WANG Xiao-rong, CHEN Xian 2022, 36 (1):  31-36.  doi: 10.3969/j.issn.1003-9198.2022.01.009 Abstract ( 166 )   PDF (1087KB) ( 1183 )   Save Objective To explore the relationship between sarcopenia complicated with cognitive impairment and adverse survival outcomes, such as fall, readmission,decline in self-care ability, decline in quality of life and death in the elderly who were followed up for 6 months after discharge. Methods A total of 116 subjects enrolled from October 2019 to January 2020 were followed up for 6 months. The subjects were divided into four groups according to their diagnosis: no sarcopenia and no cognitive impairment group (n=48), only sarcopenia group (n=19), only cognitive impairment group (n=28), and sarcopenia complicated with cognitive impairment group (n=21). The general data and outcomes of the four groups were compared and analyzed. Results The detection rate of sarcopenia, cognitive impairment and sarcopenia combined with cognitive impairment in hospitalized elderly patients was 34.38%, 42.24%, and 18.10% respectively. The subjects with sarcopenia and cognitive impairment presented with older age, higher serum level of CRP, and lower scores of physical activity, nutrition, quality of life and self-care ability (P<0.05). After 6-month follow-up, the change of basic activity of daily living after follow-up in the sarcopenia combined with cognitive impairment group was more significant than that in no sarcopenia and no cognitive impairment group and only sarcopenia group (P<0.05). Cox proportional hazards regression modle showed that after adjusting the confounding factors, sarcopenia combined with cognitive impairment was an independent factor affecting the readmission of the elderly patients within 6 months after discharge (HR=4.27,95%CI:1.01-18.02). Conclusions For the patients discharged from Departement of Geriatrics within 6 months, sarcopenia with cognitive impairment can predict the decline of self-care ability of daily life and increase the risk of readmission. References | Related Articles | Metrics

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Application value of combined magnetic resonance PWI and DWI in diagnosis of acute cerebral infarction WANG Juan, ZHU Zhi-ping, LI Zhen-yu, SUN Chang-lu, NIU Yong-chao, YAN Rui-fang 2022, 36 (1):  37-40.  doi: 10.3969/j.issn.1003-9198.2022.01.010 Abstract ( 170 )   PDF (1546KB) ( 1009 )   Save Objective To investigate the application value of perfusion weighted imaging(PWI) combined with diffusion weighted imaging (DWI) in the diagnosis of acute cerebral infarction. Methods The clinical and imaging data of 56 elderly patients with cerebral infarction within 1 h to 72 h after the onset of symptoms were collected by the retrospective study. Twenty patients were in hyperacute phase with time since stroke onset<6 h, and 36 patients were in acute phase with time since stroke onset 7-72 h. All the patients were examined by PWI and DWI. The main items for observation included abnormal regions and parameters of DWI and PWI, such as cerebral blood flow (CBF), cerebral blood volume (CBV), mean transient time (MTT) and time to peak (TTP) in affected brain tissue of cerebral infarction. Results PWI showed that MTT and TTP were prolongated. In hyperacute phase, the level of CBF decreased in 18 cases (90.00%) and remained normal in 2 cases (10.00%); the level of CBV decreased in 10 cases (50.00%), remained normal in 5 cases (25.00%), and increased in 5 cases (25.00%). In acute phase, the level of CBF decreased in 36 cases (100.00%); the level of CBV decreased in 26 cases (72.22%), remained normal in 5 cases (13.89%), and increased in 5 cases (13.89%). DWI in hyperacute phase showed less abnormal signal region than PWI in all cases. In acute phase, there were 21 cases with DWI <PWI, 10 cases with DWI=PWI, and 5 cases with DWI > PWI. Conclusions DWI can show the necrotic area of cerebral infarction, while PWI can show both the necrotic area of cerebral infarction and its surrounding ischemic penumbra. Combined use of DWI and PWI can define the range of cerebral infarction and ischemic penumbra. References | Related Articles | Metrics

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Application value of Lee Silverman Voice Treatment in patients with dysphagia after cerebral infarction ZHANG Lin-mei, WANG Zhao-xia, PENG Lei, CHEN Peng 2022, 36 (1):  41-44.  doi: 10.3969/j.issn.1003-9198.2022.01.011 Abstract ( 153 )   PDF (969KB) ( 1507 )   Save Objective To explore the effect of Lee Silverman Voice Treatment (LSVT) on the voice quality and ability of daily living (ADL) in the elderly patients with dysphagia after cerebral infarction. Methods A total of 124 elderly patients with dysphagia after cerebral infarction admitted in our hospital from January 2019 to April 2020 were selected as the research objects, and were randomly divided into observation group and control group, with 62 cases in each group. The control group was given regular speech intervention, and the observation group was given LSVT on the basis of the control group, and the intervention was continued for 12 weeks. The swallowing function, voice quality and ADL score of the patients in the two groups before and after intervention were compared. Results After intervention, the swallowing function, the scores of Voice Handicap Index, GRBAS voice meter and Barthel index of the two groups were significantly improved, especially in the observation group (P<0.05). Conclusions LSVT can significantly improve the speech function and voice quality of the elderly patients with dysphagia after cerebral infarction, and can improve the patients’ swallowing function and ADL. References | Related Articles | Metrics

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Correlation between frailty and carotid intima-media thickness in the elderly YU Yue-cai, LI Jie 2022, 36 (1):  45-48.  doi: 10.3969/j.issn.1003-9198.2022.01.012 Abstract ( 149 )   PDF (985KB) ( 1221 )   Save Objective To investigate the correlation between frailty and carotid intima-media thickness(cIMT)in the elderly. Methods By using purposive sampling method, a totall of 457 elderly people aged 65 years and over who underwent physical examination in the Second Affiliated Hospital of Hainan Medical University during June to December 2020 were selected as the subjects.All the subjects received an interviewer-administered questionnaire survey using self-designed general data questionnaire and FRAIL scale. And the levels of cIMT and serum biochemical indexes of the subjects were measured. According to FRAIL scale score, the subjects were divided into frailty group (FRAIL scale score≥3) and non-frailty group (FRAIL scale score＜3). Univariate analysis, multiple linear regression analysis and receiver operating characteristic (ROC) curve were used to explore the association between frailty and cIMT in the elderly. Results The prevalence rate of frailty in the elderly was 29.76%. Age, the levels of BMI, systolic blood pressure (SBP), Charlson complication index (CCI), cIMT and estimated glomerular filtration rate (eGFR) were significantly different between the two groups(P＜0.01). Multiple linear regression analysis showed that age, CCI score, cIMT and eGFR were the independent influencing factors of FRAIL scale score in the elderly(P＜0.05 or P＜0.01). ROC curve analysis showed that the area under curve of cIMT for predicting frailty was significantly greater than that of age (0.812 VS 0.667, Z=3.644, P＜0.001), CCI score (0.812 VS 0.724, Z=2.573, P=0.010) and eGFR (0.812 VS 0.689, Z=3.653, P＜0.001).The optimal cut-off value of cIMT was 1.089 mm, which displayed a sensitivity of 69.12% and a specificity of 87.85% for the prediction of frailty in the elderly. Conclusions The elderly people have higher prevalence rate of frailty. Age, CCI score, cIMT and eGFR are closely related to frailty. cIMT may be used for the evaluation of frailty status in the elderly. References | Related Articles | Metrics

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Study on the effect and mechanism of spleen polypeptide injection combined with imipenem and cilastatin sodium in the treatment of elderly patients with severe community-acquired pneumonia MENG Chong, CHEN Yong-xing, XIE Tian 2022, 36 (1):  49-52.  doi: 10.3969/j.issn.1003-9198.2022.01.013 Abstract ( 176 )   PDF (978KB) ( 1018 )   Save Objective To investigate the clinical efficacy of spleen polypeptide injection combined with imipenem and cilastatin sodium in the treatment of severe community acquired pneumonia (SCAP) and the effects on the levels of C-reactive protein (CRP), interleukin (IL)-6, IL-8 and T lymphocyte subpopulation in the elderly patients. Methods From January 2018 to January 2020, a total of 92 elderly patients with SCAP were randomly divided into the observation group and the control group, with 46 cases in each group. The control group was treated with imipenem and cilastatin sodium, and the observation group was treated with spleen polypeptide injection on the basis of the control group for 14 days. The levels of CRP, IL-6, IL-8 and T lymphocyte subpopulation (CD3+, CD4+, CD4+/CD8+) and APACHE Ⅱ scores of the two groups were compared before and after treatment. The clinical effects and the length of stay, 28-day mortality and adverse rections were recorded. Results The total effective rate of the observation group was 95.7% (44/46), which was significantly higher than that of the control group (80.4%, 37/46)(P<0.05). After treatment, the levels of CRP, IL-6 and IL-8 were significantly lower, the levels of CD3+, CD4+ and CD4+/CD8+ in peripheral blood were significantly higher, and the scores of APACHE Ⅱ were significantly decreased in both groups, especially in the observation group (P<0.05). Compared with the control group, the length of hospitalization in the observation group was significantly shorter (P<0.05). There was no significant difference in 28-day mortality and the rate of adverse reactions between the two groups (P>0.05). Conclusions Spleen polypeptide injection combined with imipenem and cilastatin sodium has a satisfactory overall efficacy in the treatment of the elderly patients with SCAP. The mechanism may be related with down-regulating CRP, IL-6 and IL-8 in vivo and maintaining the balance and stability of T lymphocyte subpopulation in peripheral blood. References | Related Articles | Metrics

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Early- and long-term effect of high-flow nasal cannula oxygen therapy on pulmonary rehabilitation in COPD patients complicated with respiratory failure WANG Guo-yu, SHI Wen-da, WANG Lu, WANG Hao-yu 2022, 36 (1):  53-56.  doi: 10.3969/j.issn.1003-9198.2022.01.014 Abstract ( 159 )   PDF (979KB) ( 1487 )   Save Objective To explore the effects of high-flow nasal cannula oxygen therapy on blood gas indexes, pulmonary function in chronic obstructive pulmonary disease (COPD) patients complicated with respiratory failure, and to explore the complications and long-term effect. Methods A total of 82 subjects were selected in our hospital from January 2017 to May 2020 and divided into observation group (n=42) and control group (n=40). The patients in observation group received high-flow nasal cannula oxygen therapy, and the patients in control group were treated with non-invasive positive pressure ventilation therapy. The blood gas indexes, pulmonary function, effective rate and the complications after 3 days of treatment and the prognosis after 6 months of treatment were compared between the two groups. Results After 3 days of treatment, the levels of arterial partial pressure of oxygen (PaO2), forced expiratory volume in 1 s (FEV1), FEV1% predicted(FEV1% pred), forced vital capacity (FVC)% predicted(FVC% pred), FEV1/FVC in observation group were higher than those in control group (P<0.05), while the level of partial pressure of carbon dioxide in artery (PaCO2) was lower than that in control group(P<0.05). The effective rate of observation group (92.85%) was higher than that of control group (57.50%). There was no significant difference in the incidence rate of complications between the two groups(P>0.05). The 6-minute walk distance (6MWD) and the score of modified British medical research council (mMRC)were higher, while the score of COPD assessment test (CAT), Borg score and BODE index were lower than those in control group after 6 months of follow-up(P<0.05). Conclusions High-flow nasal cannula oxygen therapy can improve the blood gas indicators, pulmonary function and outcome, which has a significant clinical application value. References | Related Articles | Metrics

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Association between serum insulin-like growth factor-1, insulin-like growth factor binding protein-3 and frailty in elderly inpatients HUANG Bao-feng, CHEN Wen-bo, JIANG Ke-wei, JIANG Xin 2022, 36 (1):  57-60.  doi: 10.3969/j.issn.1003-9198.2022.01.015 Abstract ( 160 )   PDF (976KB) ( 1052 )   Save Objective To investigate the relationship between serum insulin-like growth factor-1(IGF-1), insulin-like growth factor binding protein-3(IGFBP-3) and frailty in the elderly inpatients. Methods A total of 195 elderly inpatients aged 65 years old and over in the geriatric department were recruited from January 2018 to June 2019. Frailty phenotype assessment and comprehensive geriatric assessment were conducted. The serum levels of IGF-1 and IGFBP-3 were detected by enzyme-linked immunosorbent assay (ELISA). The correlations between IGF-1, IGFBP-3 levels and frailty were analyzed by ordinal multi-factorial Logistic regression. Results Serum levels of IGF-1 and IGFBP-3 in the elderly inpatients with frailty were significantly lower than those in non frailty and pre-frailty groups (P＜0.05). Ordered multi-variate Logistic regression analysis showed that the serum levels of IGF-1(OR=0.943, 95%CI:0.894-0.994,P＜0.05)and IGFBP-3(OR=0.397, 95%CI:0.259-0.607, P＜0.001)were significantly correlated with frailty. Conclusions Serum levels of IGF-1 and IGFBP-3 are significantly correlated with frailty in the aged inpatients, and might be used as a predictor for frailty in the aged. References | Related Articles | Metrics

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Effect of early sequential nutrition support on prognosis in elderly patients with acute exacerbation of chronic obstructive pulmonary disease WANG Peng, WANG Shuang, LI Wei, XIA Jia-jia, XIANG Qin 2022, 36 (1):  61-64.  doi: 10.3969/j.issn.1003-9198.2022.01.016 Abstract ( 140 )   PDF (978KB) ( 1193 )   Save Objective To explore the effect of early sequential nutrition support on inflammation reaction, immune function, lung function and nutritional status in the elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods In this prospective randomized controlled trial, 112 AECOPD patients diagnosed in our hospital from February 2019 to January 2020 were divided into sequential enteral nutrition support group(experiment group, n=56) and conventional nutrition support group(control group, n=56). The nutrition index, lung function index, inflammatory index and immune index were measured and compared before and after treatment in the two groups. The hospitalization time of the two groups were compared. Results After treatment, the score of Nutrition Risk Screeing (NR S2002) and the levels of BMI, serum albumin, serum prealbumin, and total protein in the experiment group were improved significantly than those before treatment and those in the control group(P<0.05). The forced expiratory volume in 1 s/forced vital capacity(FEV1/FVC),FEV1% predicted(FEV1% pred)in the experimental group, and white blood cell(WBC), neutrophil count(N), high-sensitivity C-reactive protein(hs-CRP), tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), immune function indexes (CD3+, CD4+, CD4+/CD8+, total lymphocyte count) were significantly improved than those in the control group (P<0.05). And the hospitalization time was significantly shorter than that of the control group (P<0.05). Conclusions For elderly patients with AECOPD, early individualized sequential nutritional support can help improve the prognosis and quality of life. References | Related Articles | Metrics

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Serum levels of suPAR and MSTN in elderly patients with chronic heart failure and their relationship with cardiac function and prognosis AN Su, JIANG Yun-lu, WANG Hua-ying, HUANG Guo-peng, TAO Li 2022, 36 (1):  65-68.  doi: 10.3969/j.issn.1003-9198.2022.01.017 Abstract ( 150 )   PDF (1083KB) ( 1046 )   Save Objective To explore the serum levels of soluble urokinase-type plasminogen activator receptor (suPAR) and myostatin (MSTN) in the elderly patients with chronic heart failure(CHF) and their relationship with cardiac function and prognosis. Methods A total of 120 patients with CHF admitted to our department from January 2017 to June 2019 were selected as observation group. In the same period, another 100 healthy volunteers were selected as control group in our hospital. Enzyme-linked immunosorbent assay was used to detect the serum levels of suPAR and MSTN for the two groups. The CHF patients were followed up for 1 year after discharge, and were divided into poor prognosis group (n=32) and good prognosis group (n=88) according to whether the patients had cardiovascular adverse events. Receiver operating characteristic (ROC) curve was performed to analyze the predictive value of serum suPAR and MSTN for the poor prognosis of the CHF patients. Results The levels of serum suPAR, MSTN in the observation group were significantly higher than those in the control group (P<0.05). There were statistically significant differences in serum levels of suPAR, MSTN, N-terminal pro B type natriuretic peptide (NT-proBNP), and left ventricular ejection fraction (LVEF) between different cardiac function classes (P<0.05). Pearson correlation analysis showed that the serum levels of suPAR and MSTN were positively correlated with NT-proBNP, and negatively correlated with LVEF (all P<0.05). The serum levels of suPAR, MSTN, NT-proBNP and LVEF in the poor prognosis group were significantly different from those in the good prognosis group (P<0.05). The ROC curve showed that the sensitivities of serum suPAR, MSTN and the combined detections to predict the poor prognosis of the patients were 0.785, 0.754, 0.908, and the specificities were 0.743, 0.716, 0.779, and the areas under the curve were 0.867, 0.815, 0.912, respectively. Conclusions The serum levels of suPAR and MSTN in the elderly patients with CHF are significantly increased, which are closely related to the patients’ cardiac function classification and clinical prognosis. The combined detection of serum suPAR and MSTN has a high clinical value for the prognosis of the elderly patients with CHF, and can be used as a monitoring indicator of the patient’s condition. References | Related Articles | Metrics

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Influence of inhaled oxygen concentration on postoperative pulmonary complications in the elderly patients undergoing laparoscopic radical colonectomy WANG Juan, CAO Xiao-fei, QI Tao 2022, 36 (1):  69-72.  doi: 10.3969/j.issn.1003-9198.2022.01.018 Abstract ( 134 )   PDF (979KB) ( 1374 )   Save Objective To investigate the influence of low oxygen concentration (30%) and high oxygen concentration (80%) on postoperative pulmonary complications(PPCs) in the elderly patients undergoing laparoscopic radical colonectomy. Methods A total of 120 patients aged 65-80 years old who underwent laparoscopic radical resection of colon cancer were selected, with an American Society of Anesthesiologists gradeⅠ-Ⅱ and the expected operation time was more than 1 h. The patients were randomly divided into 30% fraction of inspiration oxygen (FiO2) group (L group) and 80% FiO2 group (H group). The incidence and the severity of PPCs of the two groups 7 days after operation was recorded and compared, as well as the intraoperative fluid infusion volume and blood loss, duration of surgery and anesthesia, dosage of analgesics, incidence of postoperative nausea and vomiting, and length of hospital stay. Results The incidence rate of PPCs, including lung infection, atelectasis, pleural effusion, pneumothorax and respiratory failure, was not significantly different between the two groups (P> 0.05). The incidence rate of PPCs with grade 2 and above in L group was significantly lower than that in H group(P＜0.05). There were no significant differences in the intraoperative fluid infusion volume, blood loss, duration of surgey, dosage of analgesics, hospital stay and other adverse reactions. Conclusions 30% FiO2 and 80% FiO2 show no different influence on the occurrence of PPCs in the elderly patients undergoing elective laparoscopic radical colonectomy, but 30% oxygen concentration can reduce the severity of PPCs. References | Related Articles | Metrics

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The expression and influencing factors of serum IGF-1 and IL-17 in elderly patients with chronic heart failure with different nutritional status LI Wei, ZHAO Cui, WANG Guo-yu, JIANG Hai-sen 2022, 36 (1):  73-76.  doi: 10.3969/j.issn.1003-9198.2022.01.019 Abstract ( 159 )   PDF (976KB) ( 1086 )   Save Objective To study the expression of serum insulin like growth factor 1(IGF-1) and interleukin 17 (IL-17) and the influencing factors in the elderly patients with chronic heart failure (CHF) with different nutritional status. Methods A total of 200 elderly patients with CHF aged over 60 years old who were admitted to our hospital from December 2016 to December 2018 were selected as the subjects. According to the scores of the Mini Nutritional Assesment Scale (MNA), the patients were divided into malnutrition group (MNA<24) and normal nutrition group (MNA≥24). The levels of body mass index (BMI), upper arm circumference (AMC), calf circumference (CC), triceps skinfold thickness (TSF) were measured and compared between the two groups; The serum levels of total protein (TP), transferrin (TRF), prealbumin (PA), total cholesterol (TC), triacylglycerol (TG), hemoglobin (Hb), IGF-1 and IL-17 were detected and compared between the two groups. The linear regression model was established by stepwise regression to analyze the relationship between plasma IGF-1, LI-17 and nutritional status. Results The level of IGF-1 in the normal nutrition group was significantly higher, and the level of IL-17 was significantly lower than that in the malnutrition group (P<0.05); The levels of BMI, AMC, CC and TSF in the normal nutrition group were significantly higher than those in the malnutrition group (P<0.05). The levels of TP, TRF, PA, TC, TG and Hb in the normal nutrition group were significantly higher than those in the malnutrition group (P<0.05); The levels of BMI, AMC, CC, TSF, TP, PA, Hb were positively correlated with the level of IGF-1, and negatively correlated with the level of IL-17. They were the independent influencing factors of IGF-1 and IL-17. Conclusions In the elderly patients with CHF, the levels of IGF-1 and IL-17 are closely related to nutritional status. Malnutrition is a risk factor for the prognosis of the elderly patients with CHF. References | Related Articles | Metrics

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Relationship between serum TBIL, Hcy, hs-CRP, UA and unstable coronary plaque formation in elderly patients with coronary heart disease ZHANG Qian, YUAN Jing, XU Xiao-ying, FAN Jia-wei, WU Fa-guo 2022, 36 (1):  77-80.  doi: 10.3969/j.issn.1003-9198.2022.01.020 Abstract ( 194 )   PDF (976KB) ( 1309 )   Save Objective To investigate the relationship between serum total bilirubin (TBIL), homocysteine (Hcy), hypersensitive C-reactive protein (hs-CRP), uric acid (UA) and unstable coronary plaque formation in the elderly patients with coronary heart disease (CHD). Methods A total of 198 patients with CHD admitted to our hospital from April 2019 to April 2021 were enrolled in the study, and they were divided into the unstable group (n=54) and the stable group (n=144). The baseline data and serum indexes of the two groups were compared, and multivariate Logistic regression analysis was used to clarify the risk factors of unstable coronary plaque formation in the elderly patients with CHD. Results The level of serum TBIL in the unstable group was significantly lower than that in the stable group(P<0.05). The levels of serum Hcy, hs-CRP and UA in the unstable group were significantly higher than those in the stable group (P<0.05). Receiver operating characterise curve analysis confirmed that serum TBIL, Hcy, hs-CRP and UA could be used to predict the formation of unstable coronary plaque in the elderly patients with CHD, with an AUC of 0.956, 0.647, 0.870 and 0.842, respectively (P<0.05). Multivariate Logistic regression analysis confirmed that serum TBIL≤7.985 μmol/L, Hcy≥12.725 μmol/L, hs-CRP ≥3.895 mg/L and UA≥340.645 μmol/L were the risk factors for coronary unstable plaque formation in the elderly patients with CHD (P<0.05). Conclusions The formation of unstable coronary plaque in the elderly patients with CHD is closely related to the expression of serum TBIL, Hcy, hs-CRP and UA. TBIL≤7.985 μmol/L, Hcy≥12.725 μmol/L, hs-CRP≥3.895 mg/L, UA≥340.645 μmol/L are the best cut-off values for predicting the formation of unstable coronary plaque. References | Related Articles | Metrics

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Age-dependent changes in body composition in community-dwelling elderly of different gender YANG Ying, ZHANG Yun-yun, LU Shou-rong, YU Jie, XU Qiao, WANG Zhuo, ZHANG Bing-shan, HONG Kan 2022, 36 (1):  81-84.  doi: 10.3969/j.issn.1003-9198.2022.01.021 Abstract ( 172 )   PDF (979KB) ( 1015 )   Save Objective To describe the age-dependent changes in body composition in Chinese elderly who are dwelling in the community with independent living ability. Methods Cross-sectional data from 1017 community-dwelling elderly conducting physical examination at Wuxi Meicun Community Health Service Center from October to December 2020 were analyzed. The research subjects were divided into 3 groups according to their age (60-69 years old; 70-79 years old; ≥80 years old). Body composition parameters including height,body weight, body mass index (BMI),body fat percentage, waist-hip ratio, body fat content, body muscle mass,skeletal muscle masses and bone mineral content were measured with a bioelectrical impedance analyser. Results There were no significant changes in fat content, BMI, waist circumference, waist hip ratio and body fat percentage with the increase of age (P>0.05).The muscle masses and bone contents of whole body,the trunk,upper and lower limbs were decreased with the increase of age in women (P<0.01),but there was no difference in men (P> 0.05). The muscle masses and bone contents of whole body,the trunk,upper and lower limbs in men were higher than those in women of the same age group (P<0.001), while the fat content in women was higher than that in men of the same age group (P<0.05). Conclusions The decrease of muscle and bone content caused by aging is affected by gender, which is common in women, but aging has little effect on fat content. References | Related Articles | Metrics

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Construction and application of early warning score scale for respiratory failure in the elderly patients with early lung cancer CAO Chun-yan, CUI Geng-li, LI Yan, XU Zhi-xin 2022, 36 (1):  85-88.  doi: 10.3969/j.issn.1003-9198.2022.01.022 Abstract ( 180 )   PDF (975KB) ( 1065 )   Save Objective To explore the construction and application of the early warning score scale for respiratory failure in the elderly patients with early lung cancer. Methods The clinical data of 126 elderly patients with early lung cancer treated in our hospital from October 2018 to January 2020 were analyzed. They were divided into respiratory failure group (n=40) and the control group (n=86). Univariate and multivariate analysis were performed to identify the risk factors of respiratory failure and early warning score scale was established according to the results. Results Multivariate regression results suggested that age>75 years old, urban residence, smoking>400 cigarettes/year, maximum chase gas volume (MVV) < 60%, ratio of residual air volume to total lung volume (RV/TLC)> 50%, forced expiratory volume in 1s(FEV1)< 1.5 L, ventilation reserve (VR) <85% were risk factors of respiratory failure in the elderly patients with early lung cancer. The constructed early warning score scale was applied in the past 534 case, and the subjects were divided into 4 groups according to the interquartile range, and the ratio of the actual respiratory failure incidence rate(O) and the predicting respiratory failure incidence rate(E) of each risk group was calculated. The O/E ratio was 0.52-0.93 with the increase of the early warning scores. Conclusions The early warning score can predict the occurrence of respiratory failure and can be used as a screening tool for the risk of respiratory failure in the elderly patients with early lung cancer. References | Related Articles | Metrics

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Application of coronary heart disease management APP in self-management of the elderly patients receiving percutaneous coronary intervention YUAN Yu-han, GAO Chun-hong, TANG Yi-fan, HU Xiao-lin, DU Wen-jie, ZHANG Yu-lu 2022, 36 (1):  100-103.  doi: 10.3969/j.issn.1003-9198.2022.01.026 Abstract ( 164 )   PDF (969KB) ( 1447 )   Save Objective To study the effect of coronary heart disease management application (APP) on self-management ability of the elderly patients receiving percutaneous coronary intervention(PCI). Methods A total of 100 elderly patients undergoing PCI from December 2017 to September 2019 in our hospital were enrolled. According to random double-blind method, the patients were divided into test group (APP-based clinical guidance) and control group (routine guidance), with 50 cases in each group. After six months’ intervention, self-management in both groups were assessed by Wenjuanxing via wechat. Results Before intervention, the scores of self-management behaviors, Morisky medication adherence scale (MMAS-8) and the MOS 36-item short form health survey (SF-36) between the two groups were not significantly different (P＞0.05); After intervention, related scores in the test group were higher than those in the control group (P＜0.05). There was no significant difference in the incidence rate of major adverse cardiovascular events between the two groups(P＞0.05). Conclusions APP-based clinical guidance can improve the self-management ability, medication compliance, quality of life of the patients receiving PCI. References | Related Articles | Metrics