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20 February 2022, Volume 36 Issue 2 Previous Issue    Next Issue

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Effect of acupuncture intervention on intestinal microflora of postmenopausal osteoporosis model rats ZHANG Chu-qiong, SHI Na, OUYANG Gang 2022, 36 (2):  129-133.  doi: 10.3969/j.issn.1003-9198.2022.02.006 Abstract ( 229 )   PDF (1353KB) ( 1663 )   Save Objective To observe the changes of intestinal flora related to bone metabolism in the postmenopausal osteoporosis model rats receiving the intervention of electroacupuncture. Methods A total of 32 3-month-old female SD rats were randomly divided into blank group, sham operation group, model group and electroacupuncture group, with 8 rats in each group. The rats in the model group and the electroacupuncture group underwent bilateral ovariectomy. The electroacupuncture group was alternately given electroacupuncture intervention at "Guanyuan(CV4) + Sanyinjiao(SP6)"(double) and "Shenshu(BL23) + Housanli(ST36)"(double) for 20 min each time, once a day, for 5 consecutive days every week for 12 weeks. After 12 weeks, the bone mineral density(BMD) of the right tibia and femur was measured by bone densitometer. The feces were taken for 16S rDNA flora detection. Results Compared with blank group and sham operation group, the level of BMD in model group was significantly decreased(P<0.05). Compared with model group, the level of BMD in electroacupuncture group was significantly increased(P<0.05). At the phylum level, the abundance of Tenericutes, Actinobacteria and Deferribacteria in model group increased significantly compared with blank group and sham operation group(P<0.05), while the abundance of Firmicutes, Bacteroidetes, Proteobacteria and Melainabacteria decreased(P<0.05). Compared with the model group, the abundance of Firmicutes, Bacteroidetes, Proteobacteria and Melainabacteria in electroacupuncture group increased(P<0.05), and the abundance of Tenericutes, Actinobacteria and Deferribacteria in electroacupuncture group decreased(P<0.05). At the genus level, the abundance of Bacteroides, Lactobacillus and Enterococcus in model group decreased(P<0.05) compared with blank group and sham operation group. Compared with model group, the abundance of Bacteroides, Lactobacillus and Enterococcus in electroacupuncture group increased. Conclusions Electroacupuncture can improve the level of BMD of ovariectomized rats and regulate their intestinal microflora structure. References | Related Articles | Metrics

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Expression of high mobility group protein A2 in the serum of elderly patients with idiopathic pulmonary fibrosis and its relationship with the prognosis YUE Yuan-yuan, ZHANG Yu-yang, HAN Hui, LI Zhong-mei 2022, 36 (2):  134-137.  doi: 10.3969/j.issn.1003-9198.2022.02.007 Abstract ( 217 )   PDF (1103KB) ( 1580 )   Save Objective To investigate the expression of high mobility group protein A2 (HMGA2) in the serum of elderly patients with idiopathic pulmonary fibrosis (IPF), and to investigate the relationship with the prognosis. Methods A total of 102 elderly patients with IPF who were treated in our hospital from 2017 to 2018 were selected. All patients were followed up for 2 years. The patients were divided into the good prognosis group and the poor prognosis group according to the prognosis. The clinical data of all patients were collected, and the serum levels of HMGA2, type Ⅳ collagen (Ⅳ C) and hyaluronic acid (HA) were detected. Pearson correlation analysis was used to analyze the correlation between serum HMGA2 and fibrosis indexes. Multivariate unconditional Logistic regression model was used to analyze the influencing factors of poor prognosis in the IPF patients. Receiver operating characteristic (ROC) curve was used to analyze the prognostic value of serum HMGA2 in the patients with IPF. Results The follow-up results showed that 48 out of the 102 IPF patients presented with poor prognosis, and 54 showed good prognosis. The proportion of smoking, the serum levels of Ⅳ C, HA and HMGA2 in the poor prognosis group were significantly higher, and the levels of FEV1% and DLCO% were significantly lower than those in the good prognosis group (P<0.01). Pearson correlation analysis showed that the serum level of HMGA2 was positively correlated with the serum level of Ⅳ C and HA (P<0.01). Multivariate analysis showed that Ⅳ C, HA, and HMGA2 were risk factors for poor prognosis in the IPF patients (P<0.05), and DLCO% was a protective factor (P<0.05). The area under the ROC curve of serum HMGA2 predicting poor prognosis of the IPF patients was 0.815 (95% CI: 0.733-0.897). Conclusions The serum level of HMGA2 in the IPF patients is closely related to the prognosis. HMGA2 may participate in the occurrence and development of the disease by regulating the progression of pulmonary fibrosis. References | Related Articles | Metrics

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Clinical observation of multidisciplinary treatment for femoral neck fracture complicated with chronic renal failure in the elderly ZHENG Hong-rui, FAN Lei, HE Bin, QIN Hu, SHEN Ya-jun, WANG Yun-hua 2022, 36 (2):  138-141.  doi: 10.3969/j.issn.1003-9198.2022.02.008 Abstract ( 211 )   PDF (1048KB) ( 1465 )   Save Objective To explore the clinical effect of multidisciplinary treatment (MDT) in the elderly patients with femoral neck fracture complicated with chronic renal failure. Methods A total of 44 elderly patients with femoral neck fracture complicated with chronic renal failure treated in the Second Affiliated Hospital of Nanjing Medical University from February 2017 to December 2020 were randomly divided into two groups: the MDT group (n=24) and the traditional treatment group (n=20). The curative effect was evaluated by Harris score. The curative effect, the waiting time before operation, the total hospital stay, the incidence rate of early and medium-term complications of fracture and the incidence rate of deterioration of renal function were recorded and compared between the MDT group and the traditional treatment group. Results All the patients were followed up to June 2021. The operation rate of the MDT group was significantly higher than that of the traditional treatment group (83.3% vs. 30.0%, P＜0.05);The preoperative waiting time and the total hospitalization days in the MDT group were significantly shorter than those in the traditional treatment group (P＜0.05);The Harris hip score in the MDT group was higher than that in the traditional treatment group 6 months after operation (P＜0.05);After operation,The incidence rate of deterioration of renal function after operation and the incidence rate of early and medium-term complications of fractures in the MDT group were significantly lower than those in the traditional treatment group (P＜0.05). Conclusions MDT mode is helpful to increase the operation rate and improve the clinical effect of the elderly patients with femoral neck fracture complicated with chronic renal failure, which could reduce the incidence of early and medium-term complications of fracture and the deterioration of renal function after operation, and shorten the waiting time before operation and hospitalization time. References | Related Articles | Metrics

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Relationship between subclinical hypothyroidism and diabetic nephropathy in elderly patients with type 2 diabetes mellitus GE Jing, SUN Xin-yi, YU Qian, ZHANG Shu, MIAO Jun-jun 2022, 36 (2):  142-145.  doi: 10.3969/j.issn.1003-9198.2022.02.009 Abstract ( 222 )   PDF (1046KB) ( 1659 )   Save Objective To explore the correlation between hypothyroidism and diabetic nephropathy (DKD) in the elderly patients with type 2 diabetes mellitus (T2DM). Methods A total of 366 elderly T2DM patients who were diagnosed and treated in the Department of Endocrinology of Jiangsu Provincial Hospital of Traditional Chinese Medicine from January 2019 to December 2020 were selected and divided into normal thyroid function group (normal group) and subclinical hypothyroidism group (hypofunction group). The clinical data were compared between the two groups. Results The proportion of female patients in the hypofunction group was higher than that in the normal group (P<0.05). The incidence rate of DKD in the normal group was significantly lower than that in the hypofunction group (P<0.05). The levels of systolic blood pressure (SBP), diastolic blood pressure (DBP), serum cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), glycosylated hemoglobin (HbA1c) and urinary albumin creatinine ratio (UACR) showed significant differences between the two groups (P<0.05). Conclusions The glucose and lipid metabolism of the elderly patients with T2DM combined with hypothyroidism is different from that of the patients with normal thyroid function. References | Related Articles | Metrics

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Curative effect of intensity modulated radiotherapy combined with low-dose apatinib in the treatment of elderly patients with esohageal cancer WANG Yu-fang, LIU Mei-rong, LI Ming-jun 2022, 36 (2):  146-149.  doi: 10.3969/j.issn.1003-9198.2022.02.010 Abstract ( 211 )   PDF (1051KB) ( 1291 )   Save Objective To compare the efficacy and adverse effects of intensity modulated radiotherapy combined with apatinib and intensity modulated radiotherapy alone in the elderly patients with esophageal cancer. Methods A total of 60 elderly patients with esophageal cancer were retrospectively collected and divided into the radiotherapy group and the radiotherapy combined with apatinib group (combination group). Both groups received intensity modulated radiotherapy, and the combination group received apatinib tablets 250 mg/d in addition during and after radiotherapy. Results All the patients completed radiotherapy as planned, and the overall efficacy rate of the combined group and the radiotherapy group was 76.67%(23/30) and 70.00%(21/30), respectively, with no significant difference(P>0.05). The proportion of cases with depth of response≥50% in the combination group was 73.34%(22/30), compared with 46.67%(14/30) in the radiotherapy group(P=0.035). The median progression-free survival time(PFS) in the combination group was 16 months, compared with 11 months in the radiotherapy group(P=0.042). The 2-year survival rate of the combination group and the radiotherapy group was 49.00% and 40.00% respectively, and there was no significant difference(P=0.064). The incidence rate of radiation esophagitis was not significantly different between the two groups (P>0.05); Additionally, in the combination group, 23.33%(7/30) showed proteinuria, 20.00%(6/30) showed hypertension, and 10.00% (3/30) showed hand-foot syndrome, all of which were grade I-II adverse effects. Conclusions Low-dose apatinib combined with radiotherapy can in crease the depth of tumor response and PFS, without increasing the risk of radiation esophagitis, and the other side effects can be tolerated. References | Related Articles | Metrics

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Relationship between masticatory ability and mild cognitive impairment of elderly in community WU Xiao-hua, QIU Xun-ding, LIU Kai, GAO Zhao, ZHANG Kun, LU Shao-quan, HU An-quan, WANG Chun-miao 2022, 36 (2):  150-153.  doi: 10.3969/j.issn.1003-9198.2022.02.011 Abstract ( 236 )   PDF (1045KB) ( 1901 )   Save Objective To investigate the prevalence of mild depressive disorder(MCI) and to analyze the relationship between MCI and masticatory ability in the community elderly. Methods A total of 2950 elderly people aged 60 years old and over were selected from 210 urban and rural communities in Haikou City to participate in the cross-sectional study. The masticatory ability of all cases was assessed by discolored gum based on chewing effect. Cognitive impairment was assessed by Montreal cognitive assessment(MoCA) and mini-mental state examination(MMSE). Socio-demographic characteristics, activities of daily living(ADL) and mini-nutritional assessment(MNA) were also analyzed. Results The median age of the subjects was 81.5 years old(70-102 years old), of which 67.8% were women, and 590(20%) presented with MCI. The age and the proportion of women in cases with MCI were higher, and the levels of ADL, masticatory ability and nutritional status were lower than those without MCI(P <0.001). Multivariate Logistic regression analysis showed that age and masticatory ability were independent influencing factors of MCI in the community elderly(P<0.05). Conclusions The prevalence rate of MCI in community elderly is about 20%, and the poor masticatory ability is related to MCI. References | Related Articles | Metrics

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Effects of acetylcysteine aerosol inhalation combined with splenic polypeptide on the level of free cortisol and adrenocortictrophic hormone in elderly patients with severe lung infection LIU Feng, TAN Yan, XU You-ling, HU Sha-sha 2022, 36 (2):  154-157.  doi: 10.3969/j.issn.1003-9198.2022.02.012 Abstract ( 225 )   PDF (1042KB) ( 1522 )   Save Objective To analyze the effects of acetylcysteine atomization inhalation combined with spleen polypeptide on the serum levels of free cortisol(COR) and adrenocorticotrophic hormone (ACTH) in the elderly patients with severe pulmonary infection, and to analyze the efficacy. Methods A total of 86 elderly patients with severe pulmonary infection were selected from March 2018 to April 2019. All cases were randomly divided into the control group and the observation group according to the admission time. Patients in the control group were treated with acetylcysteine inhalation on the basis of routine treatment. Patients in the observation group received intravenous drip of spleen polypeptide on the basis of the control group. The clinical efficacy, the serum levels of free COR, ACTH and respiratory dynamics were compared between the two groups. Results The effective rate in the observation group was significantly higher than that in the control group(P<0.05). After treatment, and the levels of arterial partial pressure of oxygen(PaO2) and oxygenation index in the observation group were significantly higher, and the level of arterial partial pressure of carbon dioxide(PaCO2) was significantly lower than that in the control group(P<0.05). After treatment, the serum levels of free COR, ACTH in the observation group were significantly lower than those in the control group(P<0.05). The clinical symptoms of fever, cough, shortness of breath and moist rales of the lungs in the observation group were improved significantly earlier than those in the control group(P<0.05), and the mechanical ventilation time was significantly shortter than that of the control group(P<0.05). Conclusions Acetylcysteine atomization inhalation combined with spleen polypeptide can effectively improve the clinical symptoms, decrease the serum levels of free COR and ACTH in the elderly patients with severe pulmonary infection. It has a good clinical application prospect. References | Related Articles | Metrics

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The expression and clinical significance of miR-3934-5p in elderly patients with gastric cancer SUN Jie, ZHA Xiu-fang, ZHANG Nan-nan, SANG Nan, ZHAO Jun-ning, HE Wei 2022, 36 (2):  158-163.  doi: 10.3969/j.issn.1003-9198.2022.02.013 Abstract ( 234 )   PDF (2328KB) ( 2288 )   Save Objective To analyze the correlation of miR-3934-5p expression with the clinical features and prognosis in patients with gastric cancer(GC). Methods In this study, the data sets of miR-3934-5p were got from the Cancer Genome Atlas(TCGA) database. TargetScan, miRDB, miRWalk, and DIANA were used to predict target genes of miR-3934-5p. Cytoscape software was used to identify the hub genes, and gene ontology(GO) analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway analysis were performed. Bioinformatics methods were used to explore the relationship between the expression of miR-3934-5p and the clinical characteristics of the GC patients. Results The expression level ofmiR-3934-5p in GC tissues was significantly higher than that in normal tissues(P<0.001). The high expression of miR-3934-5p was related to age(>65 vs ≤65,OR=1.901, P<0.001) and T stage(T3&T4 vs T1&T2,OR=0.585, P=0.015). Receiver operation characteristic curve analysis showed that miR-3934-5p could distinguish GC patients obviously(area under the curve =0.808). Survival analysis showed that elderly GC patients with high expression of miR-3934-5p had worse prognosis(P=0.024). The GO/KEGG enrichment analysis showed that the target genes of miR-3934-5p were involved in cell signal transduction, cell cycle, cellular senescence, DNA replication, homologous recombination and other processes mediated by p53, which might be involved in the occurrence and development of GC in miR-3934-5p up-regulated patients. Conclusions The expression of miR-3934-5p is up-regulated in GC patients, and miR-3934-5p may be involved in the occurrence and progression of GC. It may be used as a biomarker for diagnosing and predicting prognosis of GC. References | Related Articles | Metrics

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Correlation between subclinical hypothyroidism and acute coronary syndromes in the elderly SUN Yu, WANG Yan, XU Shu-hang, LIU Chao 2022, 36 (2):  164-167.  doi: 10.3969/j.issn.1003-9198.2022.02.014 Abstract ( 235 )   PDF (1053KB) ( 2390 )   Save Objective To investigate the correlation between subclinical hypothyroidism(SCH) and acute coronary syndrome(ACS) in the elderly. Methods Two hundreds and forty-seven elderly patients with chest pain who were admitted to Department of Cardiology, Suqian Hospital Affiliated to Xuzhou Medical University and diagnosed with coronary heart disease (CHD) by coronary angiography(CAG) were included from January 2017 to January 2021. They were divided into ACS group and stable coronary heart disease (SCHD) group.General clinical data, the levels of serum thyroid stimulating hormone(TSH), free thyroxine(FT4), free triiodothyronine(FT3) and other biochemical parameters were collected. An age-specific serum TSH reference range was used for the diagnosis of SCH in the elderly. Multiariable Logistic regression model was applied to analyze the correlation between SCH and the severity of CHD. Results The proportion of male, hypertension, history of smoking and the incidence rate of SCH in ACS group were higher than those in SCHD group(P<0.05).The level of TSH in ACS group was higher than that in SCHD group(P<0.05).Multivariate Logistic regression analysis showed that SCH was positively correlated with ACS. Conclusions SCH is an independent risk factor for ACS in elderly patients. The level of TSH in patients with ACS is higher than that in patients with SCHD, and TSH may promote the progression of ACS. References | Related Articles | Metrics

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Clinical characteristics and prognosis of patients with diabetic ketoacidosis in the elderly REN Ye, CHENG Hai-yan, WANG Xia-juan, WU Wen-jun 2022, 36 (2):  168-172.  doi: 10.3969/j.issn.1003-9198.2022.02.015 Abstract ( 237 )   PDF (1076KB) ( 1666 )   Save Objective To investigate the clinical characteristics and prognosis of dialetic ketoacidosis (DKA) in the elderly. Methods We conducted a retrospective analysis of adult patients with DKA admitted in Wuxi People’s Hospital Affiliated Nanjing Medical University from January 2009 to December 2018. The DKA patients were categorized by age into the young and middle-aged group(younger than 60 years) and the elderly group(60 years and older). The clinical features and prognosis of DKA patients were collected and compared between the two groups. Results During the decade, we observed 66 patients(19.5%) in the elderly group and 273 patients(80.5%) in the young and middle-aged group. The elderly group had a higher incidence rate of onset diabetes(P<0.05). Except for no obvious predisposing cause(34.8%), infections and non-compliance to insulin therapy were the two most frequent precipitating factors of DKA. The DKA severity of patients in the elderly group was lower than that in the young and middle-aged group(Z=-2.736, P=0.006), however,they had higher incidence rate of cardiovascular diseases, hyperosmotic status and pulmonary infection(P<0.05). The incidence rate of hypoglycemia in the elderly group was significantly higher than that in the young and middle-aged group, while the time to correct pH was shorter than that in the young and middle-aged group(P<0.05). The length of hospital stay was similar in both groups, but long-term prognosis in the elderly group was worse. Conclusions DKA is often the presenting symptom of new-onset diabetes in the elderly. The severity of DKA in the elderly is lower than that in young and middle-aged patients. However elderly patients with DKA are more likely to have comorbidities, hypoglycemia and poor long-term prognosis. It’s necessary to pay more attention to diagnosis and treatment of the comorbidities of elderly patients with DKA. References | Related Articles | Metrics

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Comparison of linezolid induced thrombocytopenia in elderly and young patients LIU Yang, HE Wei, LIANG Pei, XU Ying, QU Chen, GU Qin, DONG Dan-jiang 2022, 36 (2):  173-176.  doi: 10.3969/j.issn.1003-9198.2022.02.016 Abstract ( 236 )   PDF (1052KB) ( 831 )   Save Objective To compare the incidence of linezolid-related thrombocytopenia between the elderly and non-elderly patients, and to analyze the risk factors of drug-related thrombocytopenia. Methods Retrospective analysis was performed on 90 adult patients treated with intravenous injection of linezolid. All the patients were divided into young and middle-aged group and elderly group. The risk factors for linzolid-related thrombocytopenia were explored by multiple Logistic regression model. Results In the elderly group, the prevalence of hypertension, diabetes mellitus and initial platelet count were significantly higher, while the levels of bilirubin and creatinine clearance rate were significantly lower than those in the young and middle-aged group(all P<0.05). In the Logistic regression model, after adjusting multiple baseline risk factors according to pre-determined criteria, the age was the most important predictor of thrombocytopenia(P<0.05). Conclusions PLT count should be closely monitored when linezolid is used in the elderly patients. References | Related Articles | Metrics

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Risk factors and preventive measures of pneumothorax in elderly patients with pleural effusion after puncture and drainage LU Rui-qi, SUN Yan-chuan, GUO Chang, YANG Ze-xi, XU Hai-liang, SONG Jian-min 2022, 36 (2):  177-179.  doi: 10.3969/j.issn.1003-9198.2022.02.017 Abstract ( 215 )   PDF (1031KB) ( 1233 )   Save Objective To study the risk factors and preventive measures of pneumothorax in the elderly patients with pleural effusion after puncture and drainage. Methods A total of 478 patients with pleural effusion treated in our hospital from January 2018 to December 2019 were selected as the research subjects, and 50 patients were complicated with pneumothorax. The clinical data and general data of pneumothorax group and non-pneumothorax group were compared, and the risk factors of pneumothorax in the elderly patients with pleural effusion after puncture and drainage were analyzed. Results The age of pneumothorax group (t=13.110, P<0.01) was significantly higher and the body mass index (t=2.079, P=0.043) was significantly lower than that of non-pneumothorax group. In the two groups,the ratios of patients with puncture time ＞30 min (χ2=19.552, P<0.001), puncture angle ＞30° (χ2=22.361, P<0.001), puncture times ＞3 times (χ2=22.571, P<0.001), lesion size ＜3 cm (χ2=16.921, P<0.001) and lesion depth ＞5 cm (χ2=9.621, P<0.001) between the two groups were statistically different. Multivariate Logistic analysis showed higher age (OR=4.019, 95%CI:1.009-23.926), puncture time ＞30 min (OR=14.089, 95%CI:2.002-67.065), puncture angle ＞30° (OR=13.020, 95%CI:2.006-56.930), puncture times ＞3 times (OR=10.320, 95%CI:4.223-102.987), the size of the lesion ＜3 cm (OR=21.002, 95%CI:14.001-102.568), and the depth of the lesion ＞5 cm (OR=10.564, 95%CI:2.335-55.974) were risk factors for pneumothorax. Conclusions The incidence of pneumothorax in elderly patients with pleural effusion after puncture and drainage is influenced by puncture time, puncture angle, puncture times, lesion size and lesion depth. It is suggested that the clinical technology innovation and early intervention for the above patients can further reduce the occurrence of pneumothorax. References | Related Articles | Metrics

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Relationship of pulmonary hypertension and hypercoagulability with serum adiponectin and 8-isoprostaglandin F2α in elderly patients with chronic obstructive pulmonary disease FU Sha-sha, CHEN Zong-cun, WANG Zhi-feng, OU Zong-xing 2022, 36 (2):  180-183.  doi: 10.3969/j.issn.1003-9198.2022.02.018 Abstract ( 185 )   PDF (1062KB) ( 1041 )   Save Objective To investigate the relationship of pulmonary hypertension (PH) and hypercoagulability with serum adiponectin and 8-iso prostaglandin F2α in the elderly patients with chronic obstructive pulmonary disease (COPD). Methods A total of 132 COPD patients at stable period were enrolled in this study. The patients were divided into COPD group (56 cases) and COPD combined with PH group(76 cases) according to whether pulmonary artery systolic pressure (PASP) was ≥40 mmHg measured by echocardiography. The age, gender, smoking history, body mass index (BMI) and forced expiratory volume in the first second accounted for the percentage of forced vital capacity (FEV1/FVC) were collected. Serum levels of adiponectin and 8-iso prostaglandin F2α were measured by enzyme linked immunosorbent assay. The levels of fibrinogen (FIB) and D-dimer (D-D) were also detected. Results There were no significant differences in age, gender, smoking history, BMI, blood pressure, blood glucose and blood lipid between the two groups (P>0.05). COPD with PH group had higher levels of 8-iso prostaglandin F2α, D-D, FIB and lower levels of FEV1/FVC and adiponectin than those in the COPD group(all P<0.05). After adjustment for age, gender, BMI, FEV1/FVC and other confounding factors by Logistic regression, adiponectin had negative effect and 8-iso prostaglandin F2α had postive effect on PH (all P<0.05). In the COPD combined with PH group, FIB and D-D were negatively related to adiponectin, while positively related to 8-iso prostaglandin F2α (all P<0.05). Conclusions The levels of adiponectin and oxidative stress are closely related to PH and hypercoagulability in the elderly patients with COPD complicated with PH. References | Related Articles | Metrics

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Correlation between osteoporosis and serum levels of leptin, adiponectin and chemokine in elderly LIANG Jie, CUI Yun-wen, ZHAO Ying 2022, 36 (2):  184-187.  doi: 10.3969/j.issn.1003-9198.2022.02.019 Abstract ( 225 )   PDF (1049KB) ( 2342 )   Save Objective To investigate the correlation between osteoporosis and serum levels of leptin, adiponectin and chemokine in the elderly. Methods A total of 72 elderly patients with osteoporosis were selected as the study subjects who were admitted to our hospital from September 2016 to February 2019, and 65 elderly cases with normal bone mass were selected as control group who underwent physical examination in our hospital during the same period. The serum levels of leptin, adiponectin, chemokine, bone mineral density(BMD) of lumbar 1-4,BMD of left hip joint and related biochemical indexes were detected and compared between the two groups. Results The levels of chemokine and adiponectin in osteoporosis group were higher than those in control group, while the level of leptin was lower than that in control group (P <0.05). Pearson correlation analysis showed that serum levels of chemokine and adiponectin were negatively correlated with BMD of lumbar spine and hip in osteoporosis group (r=-0.630, r=-0.569, P<0.01; r=-0.275, r=-0.197, P<0.01). The level of leptin was positively correlated with BMD of lumbar spine and hip(r=0.428, r=0.332, P<0.05 or P <0.01). Multivariate Logistic regression analysis showed that the serum level of chemokine increased the risk of osteoporosis after adjusting age, sex and body mass index(OR=1.25, 95%CI:1.09-1.43). The level of leptin reduced the risk of osteoporosis(OR=0.21, 95%CI:0.07-0.65). Adiponectin was not associated with osteoporosis obviously(OR=1.03, 95%CI:0.96-1.12). Conclusions The serum level of chemokine is positively correlated with the occurrence of osteoporosis in the elderly, which is a risk factor of osteoporosis and may be a predictor of the potential risk of osteoporosis. The serum level of leptin is negatively correlated with the risk of osteoporosis in the elderly, which may play a protective role in the development of osteoporosis and provide theoretical basis for clinical prevention and treatment of osteoporosis in the elderly. References | Related Articles | Metrics

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Application value of serum angiopoietin-like protein 8 combined with ABCD-3I score in predicting short-term cerebral infarction in elderly patients with transient ischaemic attack CHUAI Hong-fei 2022, 36 (2):  188-191.  doi: 10.3969/j.issn.1003-9198.2022.02.020 Abstract ( 216 )   PDF (1055KB) ( 1409 )   Save Objective To investigate the application value of angiopoitin-like protein 8 (ANGPTL8) combined with ABCD-3I score in predicting short-term cerebral infarction in the elderly patients with transient ischaemic attack (TIA). Methods A total of 246 elderly patients with TIA who were treated in our hospital from March 2018 to October 2020 were selected. The patients were divided into cerebral infarction group (32 cases) and TIA group (214 cases) according to whether they presented with cerebral infarction in 3 months. The clinical data,ABCD-3I score and serum ANGPTL8 level were compared between the two groups. Multiple Logistic regression was conducted to analyze the risk factors of short-term cerebral infarction. Results The age, the incidence rate of hypertension or diabetes mellitus, ABCD-3I score and serum ANGPTL8 level in cerebral infarction group were statistically higher than those in TIA group (P<0.05); The incidence rate of cerebral infarction in the high ANGPTL8 expression group was significantly higher than that in the low expression group (P<0.05); Multivariate Logistic regression analysis showed that age, hypertension, diabetes mellitus, ABCD-3I score and serum ANGPTL8 were risk factors for cerebral infarction in the TIA patients (P<0.05); Receiver operating characteristic curve analysis showed that serum level of ANGPTL8 and ABCD-3I score could be used to predict the risk of cerebral infarction in TIA patients in the near future, and the area under the curve was 0.757 (95% CI: 0.666-0.847) and 0.765 (95% CI: 0.684-0.846), respectively. The combination of the two indexes could effectively improve the predictive value, and the area under the curve was 0.863 (95% CI: 0.786-0.939). Conclusions Serum ANGPTL8 and ABCD-3I score are risk factors for cerebral infarction in the elderly patients with TIA, and they can be used to predict the risk of cerebral infarction. References | Related Articles | Metrics

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Application of high-flow nasal insufflation in elderly patients with acute respiratory failure compicated with comorbidities GAO Ming-xin, MENG Xiang-ling, ZHANG Zhi-hui, LI Bai, WU Shu-hua 2022, 36 (2):  192-195.  doi: 10.3969/j.issn.1003-9198.2022.02.021 Abstract ( 228 )   PDF (1154KB) ( 1661 )   Save Objective To explore the therapeutic effect of high-flow nasal insufflation (HFNI) in the elderly patients with acute respiratory failure complicated with comorbidities. Methods By comparing with noninvasive ventilation (NIV), the therapeutic effect, comfort, and tolerance of the patients with acute respiratory failure after HFNI were analyzed. Results The levels of pH and arterial partial pressure of carbon dioxide(PaCO2) in the two groups showed a downward trend compared with those before treatment(P＞0.05); The levels of arterial partial pressure of oxygen(PaO2) and oxygenation index showed an upward trend, but there were no statistical difference between the two groups(P>0.05). After treatment, the HFNI group had significant improvements in comfort, sputum viscosity and dyspnea compared with the NIV group (P<0.05), and the average hospital stay was lower than that of the NIV group(P<0.05).But the mortality and failure rate of treatment showed no statistical difference between the two groups (P>0.05). Conclusions Both HFNI and NIV can be used in the elderly patients with acute respiratory failure complicated with comorbidities to improve the oxygenation function of patients. Compared with NIV, HFNI is more comfortable and has fewer side effects. References | Related Articles | Metrics

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Comparison of different evaluation methods for subcutaneous adipose hyperplasia at insulin injection sites in elderly patients with diabetes SONG Xiao-bo, WU Hai-di, WU Dan, XU Ting, LOU Qing-lin, GU Liu-bao, HU Yan, DAI Jing 2022, 36 (2):  206-208.  doi: 10.3969/j.issn.1003-9198.2022.02.025 Abstract ( 229 )   PDF (1078KB) ( 1401 )   Save Objective To compare the effects of inspection, palpation and B-ultrasonography in evaluating the subcutaneous adipose hyperplasia at insulin injection sites in the elderly patients with diabetes. Methods A total of 90 hospitalized elderly patients with diabetes were included from June to December 2019, and these patients had received insulin injections for more than 1 year. Inspection, palpation and B-ultrasonography were used to evaluate the subcutaneous adipose hyperplasia at injection site. The false positive rate, false negative rate and error rate of inspection and palpation were evaluated based on B-ultrasonography results. Results The detection rate of subcutaneous adipose hyperplasia was 56.7% by B-ultrasonography. The detection rate by inspection was 16.7%, which was lower than that by B-ultrasonography(P<0.01). The positive detection rate by palpation examination was 54.4%, which was equivalent to that by B-ultrasonography, but higher than that by inspection. The false positive rate, false negative rate and error rate of inspection was 5.1%, 74.5% and 44.4%, respectively. The false positive rate, false negative rate and error rate of palpation were 28.2%, 25.5% and 26.7%, respectively. Conclusions The routine use of B-ultrasonography is the main assessment method to evaluate the subcutaneous adipose hyperplasia at the injection site in the diabetic patients, which can reduce the error rate. References | Related Articles | Metrics