Table of Content

20 March 2022, Volume 36 Issue 3 Previous Issue    Next Issue

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Association between cognitive impairment and coronary heart disease in elderly inpatients LIU Ying, YANG Ji-hong, SHI Hong, LI Jing, JIN Ying, ZHOU Jin-meng, WANG Hui, HUANG Jia-shun, SHEN Ji, LIU Yang 2022, 36 (3):  237-239.  doi: 10.3969/j.issn.1003-9198.2022.03.006 Abstract ( 161 )   PDF (1066KB) ( 995 )   Save Objective To explore the association of cognitive impairment and coronary heart disease(CHD) in the elderly inpatients. Methods A total of 678 elderly patients were enrolled in this study, and were divided into CHD group (n=203) and non-CHD group (n=478). The cognitive function was assessed by Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE); Depression was evaluated by Hamilton Depression Scale (HAMD), and anxiety was evaluated by Hamilton Anxiety Scale (HAMA); Barthel index was used to assess the activities of daily living (ADL). Multivariate Logistic regression analysis was used to analyze the risk factors of CHD. Results The scores of MoCA, MMSE and Barthel index in CHD group were lower than those in non-CHD group, while the scores of HAMA and HAMD were higher than those in non-CHD group (P<0.05). Multivariate Logistic regression analysis showed that higher MoCA score was the protective factor of CHD (OR=0.962, 95% CI: 0.931-0.994) (P<0.05), and older age (OR=1.031, 95% CI: 1.004-1.058), higher HAMA score (OR=1.042, 95% CI: 1.014-1.071), longer duration of hypertension (OR=1.024, 95% CI: 1.010-1.038) and longer duration of diabetes (OR=1.036, 95% CI: 1.013-1.060) were the risk factors of CHD. Conclusions The development of CHD in the elderly inpatients may be related to old age, long course of hypertension, long course of diabetes, anxiety and cognitive impairment. References | Related Articles | Metrics

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Study on sleep apnea hypopnea and cognitive injury in elderly patients with Parkinson’s disease ZHU Jun, ZHANG Li, XU Shu-lan, YAN Jun, ZHANG Juan, ZHU Yin, CHEN Shu 2022, 36 (3):  240-243.  doi: 10.3969/j.issn.1003-9198.2022.03.007 Abstract ( 150 )   PDF (1029KB) ( 980 )   Save Objective To explore the relationship between the cognitive impairment and sleep apnea hypopnea syndrome in the elderly patients with Parkinson’s disease(PD). Methods This study evaluated 425 elderly patients with PD using Unified PD Rating Scale (UPDRS) part Ⅲ, Hoehn and Yahr (H&Y) staging, Non-Motor Symptoms Questionnaire (NMS-Quest), PD Sleep Scale (PDSS), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD) and Montreal Cognitive Assessment (MoCA). At the same time, polysomnography (PSG) was used to assess the sleep conditions. The relationship between cognitive impairment and sleep apnea hypopnea was analyzed. Results Cognitive damage was found in 182 PD patients(42.8%) with higher scores of HAMA, NMS, HAMD and anxiety/somatosis, body quality change and the awareness damage, with lower score of PDSS (P<0.05). The patients with cognitive injury presented with lower sleep efficiency, delayed sleep latency and average oxygen, with higher rate of NREM sleep stage 1 time (N1 time) and higher level of sleep-related apnea hypopnea index (AHI) and micro-wake index (all P<0.05). Logistic regression analysis indicated that AHI index was a risk factor of cognitive injury, while higher PDSS score, sleep efficiency, and average blood oxygen saturation in sleep were protective factors (P<0.05). Conclusions The cognitive damage in the elderly PD patients is closely related to sleep apnea hypopnea. References | Related Articles | Metrics

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Clinical significance of serum α1-antichymotrypsin level in elderly patients with acute coronary syndrome ZUO Guang-feng, XIE Hao, REN Xiao-min, ZHENG Ya-guo, JIN Guo-zhen, LIN Song 2022, 36 (3):  244-248.  doi: 10.3969/j.issn.1003-9198.2022.03.008 Abstract ( 135 )   PDF (1218KB) ( 987 )   Save Objective To explore the clinical significance of serum α1-antichymotrypsin (AACT)levels in the elderly patients with acute coronary syndrome (ACS). Methods Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of AACT and interleukin-6 (IL-6) in the elderly patients with ACS (including acute myocardial infarction and unstable angina pectoris),stable angina pectoris (SAP) and controls. Receiver operating characteristic (ROC) curve was constructed to analyze the diagnostic value of AACT for ACS. Western Blot was applied to determine the expression of AACT and IL-6 in human coronary artery endothelial cells (HCAEC) treated with or without recombinant human AACT protein. Results The serum levels of AACT and IL-6 in the ACS patients were significantly higher than those in SAP group and control group (P<0.01). ROC analysis revealed that the optimal cut-off value of AACT level for the diagnosis of ACS was 12.40 ng/mL, with a sensitivity of 84.26% and a specificity of 84.29%, and the area under the curve was 0.951(P<0.01). The expression of AACT and IL-6 was significantly up-regulated in HCAEC treated with human recombinant AACT protein (100 ng/mL) (P<0.01). Conclusions AACT promotes the endothlial inflammation, and the serum AACT level can be used as a diagnostic marker for ACS. References | Related Articles | Metrics

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Application value of lung ultrasound in early management of elderly patients with acute anterior myocardial infarction CAO Qiu-mei, LI Zhen-yong, ZHANG Yi-gang, XU Min 2022, 36 (3):  249-252.  doi: 10.3969/j.issn.1003-9198.2022.03.009 Abstract ( 141 )   PDF (1030KB) ( 994 )   Save Objective To investigate the value of lung ultrasound in the early management of elderly patients with acute anterior myocardial infarction undergoing revascularization. Methods A total of 349 elderly patients with acute anterior myocardial infarction who underwent emergency revascularization from January 2017 to December 2018 were retrospectively analyzed. They were divided into control group (178 cases) and observation group (171 cases). The control group received routine treatment according to the guidelines for acute ST segment elevation myocardial infarction, while the observation group received routine treatment and adjusted treatment under the guidance of lung ultrasound. Results The average hospital day in cardiac care unit (CCU) and the frequency of symptomatic heart failure attack in the observation group were significantly lower than those in the control group (P<0.05). The dosage of diuretics in the observation group was less than that in the control group (P<0.05); The creatinine level in the observation group was lower than that in the control group (P<0.05). Conclusions Lung ultrasound can optimize the early management of acute anterior myocardial infarction in the elderly, and reduce the attack of symptomatic heart failure. It should be widely used in CCU. References | Related Articles | Metrics

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Pre-rehabilitation of intestinal function in elderly patients with colorectal tumor complicated with intestinal obstruction GONG Guan-wen, CHENG Hui, PAN Hua-feng, LIU Jiang, MA Kun, CHENG Shuang, WANG Qi-fei, JIANG Zhi-wei 2022, 36 (3):  253-256.  doi: 10.3969/j.issn.1003-9198.2022.03.010 Abstract ( 131 )   PDF (1222KB) ( 1047 )   Save Objective To observe the effect of transanal ileus tube combined with early enteral nutrition in the treatment of the elderly patients with colorectal cancer complicated with closed loop obstruction. Methods Forty-three patients with colorectal malignant tumor complicated with intestinal obstruction admitted to the Department of General Surgery of Jiangsu Province Hospital of Traditional Chinese Medicine from January 2018 to October 2020 were selected and divided into the treatment group (n=23) and the control group (n=20). The treatment group received transanal ileus tube decompression combined with early enteral nutrition. The control group received routine treatment such as fasting and parenteral nutrition. Both groups received operation after 5-7 days. The postoperative inflammation, nutrition and immune indexes, the rate of laparoscopic surgery, the rate of anastomosis, the postoperative fever rate, the time of first deflation, the postoperative hospital stay and the total hospitalization expense were compared between the two groups. Results In the treatment group, the rate of laparoscopic surgery, the rate of anastomosis, the time of first deflation, postoperative hospitalization day, total hospitalization expense were better than those in the control group (P<0.05 or P<0.01), and there was no statistical difference in fever rate between the two groups (P>0.05). The levels of postoperative inflammatory indexes in the treatment group were lower than those in the control group (P<0.05 or P<0.01). The levels of albumin and transferrin in the treatment group were higher than those in the control group (P<0.01). CD3, CD4 and CD8 cell counts in the treatment group were higher than those in the control group (P<0.05 or P<0.01), and there was no significant difference in CD4/CD8 (P>0.05). Conclusions The method adopted in this study has a pre-rehabilitation effect on intestinal function, and can effectively improve the inflammatory, nutritional and immune status of the patients, and reduce the complications, which is conducive to the recovery of patients. References | Related Articles | Metrics

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Prediction value of left ventricular end-diastolic pressure combined with ankle-brachial index for no-reflow and prognosis in patients with acute myocardial infarction after percutaneous coronary intervention LI Sheng, LIU Ying-feng, YU Jia-feng, LI Zhi-cong, ZHAO Xin, MIAO Fei 2022, 36 (3):  257-260.  doi: 10.3969/j.issn.1003-9198.2022.03.011 Abstract ( 126 )   PDF (1036KB) ( 1019 )   Save Objective To explore the predictive value of left ventricular end diastolic pressure (LVEDP) combined with ankle-brachial index (ABI) on no-reflow and prognosis in the elderly patients receiving percutaneous coronary intervention (PCI) for acute myocardial infarction(AMI). Methods A total of 280 patients with AMI admitted in our hospital from January 2017 to December 2018 were divided into normal group and no-reflow group according to the occurrence of reflow during the operation. The clinical data, the levels of LVEDP and ABI were compared between the two groups, and Logistic regression was used to analyze the risk factors of no-reflow. The patients were followed up for one year after PCI, and the incidence of major adverse cardiovascular events (MACE) was recorded and compared. The prediction value of LVEDP and ABI was analyzed by receiver operating characteristic (ROC) curve. Results The levels of LVEDP and B-type natriuretic peptide (BNP), the proportion of Killip grades Ⅲ-Ⅳ, the peak of creatine kinase isoenzyme in no-reflow group were significantly higher than those in normal group (P<0.05), and the levels of left ventricular ejection fraction (LVEF) and ABI were significantly lower than those in normal group (P<0.001). Logistic regression analysis showed that Killip classification of cardiac function, LVEDP, BNP and ABI were independent risk factors of no-reflow during PCI (P<0.05). After 1 year of follow-up, all-cause mortality (4.33% vs 11.11%) and total MACE incidence rate (16.83% vs 34.72%) in normal group were significantly lower than those in no-reflow group (P<0.05). The area under the ROC curve (AUC) of LVEDP combined with ABI predicting MACE was significantly higher than LVEDP and ABI alone (P<0.05). Conclusions LVEDP and ABI are the independent risk factors for no-reflow of AMI through PCI intervention. The combined detection shows potential application value for the prognosis prediction. References | Related Articles | Metrics

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Study on analgesic effect and mechanism of pulsed radiofrequency thoracic dorsal root ganglion combined with drugs in the treatment of postherpetic neuralgia in elderly patients WANG Qin, SONG Jian-min, LI Yan, LIU Shao-zheng, WANG Xian-feng, LIU Dong-hua 2022, 36 (3):  261-264.  doi: 10.3969/j.issn.1003-9198.2022.03.012 Abstract ( 135 )   PDF (1021KB) ( 1133 )   Save Objective To explore the effect of pulsed radiofrequency thoracic dorsal root ganglion combined with drugs in the treatment of elderly patients with severe postherpetic neuralgia (PHN), and to analyze the changes of cytokines. Methods A total of 88 elderly patients with PHN admitted to our hospital were enrolled and randomly divided into the control group and the combined group, with 44 cases in each group. The control group was treated with oral pregabalin and conventional drugs, and the combination group was treated with pulsed radiofrequency thoracic dorsal root ganglion at the same time on the basis of the control group. Results The score of visual analogue scale(VAS) in the combined group was lower than that in the control group 1, 4, 8, 12 weeks after treatment (P<0.05); The score of life satisfaction index B(LSI-B) in the combined group was higher than that in the control group 4, 12 weeks after treatment (P<0.05). After treatment, the serum level of IL-10 in the two groups was significantly lower than that before treatment (P<0.05), especially in the combined group (P<0.05). After treatment, the serum levels of substance P(SP) and neurokinin 1(NK-1) were significantly lower than those before treatment (P<0.05), especially in the combined group (P<0.05). The adverse reaction rate showed no significant difference between the combined group and the control group (P>0.05). Conclusions The effect of pulsed radiofrequency thoracic dorsal root ganglion combined with drugs in the treatment of PHN in the elderly patients is better than that of drug treatment alone, which may be related to the regulation of the patients’ immune imbalance. References | Related Articles | Metrics

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Correlation between serum level of thymus and activation-regulated chemokine 17 and rapid decline of lung function in elderly patients with chronic obstructive pulmonary disease WANG Yong-sheng, LI Dong-xu, MENG Xian-wei, WANG Pei-pei, ZHAO Rui-xue 2022, 36 (3):  265-268.  doi: 10.3969/j.issn.1003-9198.2022.03.013 Abstract ( 116 )   PDF (1029KB) ( 911 )   Save Objective To explore the correlation between the serum level of thymus and activation-regulated chemokine/CC chemokine ligand 17(CCL17) and the rapid decline of forced expiratory volume in one second (FEV1) in the elderly patients with chronic obstructive pulmonary disease (COPD). Methods A total of 203 patients with stable COPD treated in our hospital from August 2018 to December 2019 were enrolled in this study, and the patients were divided into rapid decline group and control group according to FEV1 variation within 1 year of follow up. The basic data of two groups were compared,and the relationship between CCL17 and FEV1 variation within 1 year of follow up(ΔFEV1) was analyzed. Multivariate Logistic regression was performed to analyze the related factors of rapid decline of lung function. Results The frequency of acute exacerbation,the serum levels of amyloid A (SAA),CCL17 and fasting plasma glucose (FPG) in the rapid decline group were higher than those in the control group,and the level of body mass index (BMI) in the rapid decline group was lower than that in the control group(all P<0.05). CCL17 was positively correlated with ΔFEV1 (r=0.525,P<0.001). Multivariate Logistic regression showed that SAA,CCL17 and smoking were the independent risk factors of rapid decline in lung function, and BMI was the independent protective factor. The cut-off value of CCL17 to predict rapid decline of lung function in the elderly COPD patients was 364.04 pg/mL,with an AUC of 0.876,with a sensitivity of 80.00%. Conclusions Serum CCL17 level is related to lung function variation in the elderly patients with COPD,and detecting serum CCL17 may bring benefits to predict the patients’ prognosis. References | Related Articles | Metrics

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Clinical study on Tongmai Yangxin Pill combined with tirofiban in the treatment of elderly patients with unstable angina pectoris SHI Jian-hua, JIN Lei, LIU Ji-hong, LIU Ai-jun 2022, 36 (3):  269-272.  doi: 10.3969/j.issn.1003-9198.2022.03.014 Abstract ( 130 )   PDF (1014KB) ( 1164 )   Save Objective To explore the clinical efficacy of Tongmai Yangxin Pill combined with tirofiban in the treatment of elderly patients with unstable angina pectoris (UAP). Methods From May 2016 to April 2019, a total of 121 patients with UAP treated in Benxi Central Hospital were divided into two groups by using random number table method. The control group was injected with tirofiban hydrochloride and sodium chloride, and the observation group took Tongmai Yangxin Pills on the basis of the control group. After 8 days of treatment, the clinical efficacy, serum indexes, coagulation indexes and the adverse events of the two groups were compared. Results The clinical effective rate in the observation group was higher than that in the control group (P<0.05). There were no significant differences in the serum indicators of galectin-3 (Gal-3), intercellular cell adhesion molecule-1 (ICAM-1), nitric oxide (NO), superoxide dismutase (SOD), D-dimer (D-D), prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT) and fibrinogen (FIB) before treatment between the two groups. After treatment, the levels of Gal-3, NO, D-D, PT, TT, APTT and FIB decreased significantly, and the levels of ICAM-1 and SOD increased significantly in the two groups(P<0.05), especially in the observation group. Compared with the control group, the incidence rate of adverse events and the recurernce rate was significantly lower in the observation group (P<0.05). Conclusions Tongmai Yangxin Pill combined with tirofiban hydrochloride in the treatment of UAP can effectively reduce the level of inflammation, improve the blood coagulation function, and have good safety and clinical efficacy. References | Related Articles | Metrics

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Effects of serum cystatin C and high-sensitivity C-reactive protein in predicting prognosis of elderly patients with arrhythmia and heart failure LIU Jie-jie, SHU Liang-hui, JIANG Wei, SUI Li-jun 2022, 36 (3):  273-276.  doi: 10.3969/j.issn.1003-9198.2022.03.015 Abstract ( 110 )   PDF (1037KB) ( 1044 )   Save Objective To investigate the effects of serum cystatin C and high-sensitivity C-reactive protein (hs-CRP) in predicting the prognosis of the elderly patients with arrhythmia and heart failure. Methods The clinical data of 96 elderly patients with arrhythmia and heart failure admitted to our hospital from December 2016 to May 2020 were collected. They were divided into death group and survival group according to the survival of the patients after 12 months of follow-up after treatment. The levels of serum cystatin C and hs-CRP were compared between the two groups, and receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of cystatin C and hs-CRP for the prognosis of the elderly patients with arrhythmia and heart failure. Results All 96 patients were followed up for 12 months, and 28 patients died and 68 patients survived. The ratio of grade Ⅲ-Ⅳ of cardiac function and the levels of brain natriuretic peptide (BNP), N-terminal pro-brain natriuretic peptide (NT-proBNP), left ventricular ejection fraction (LVEF) in the death group were significantly higher than those in the survival group (all P<0.01); The levels of hs-CRP and cystatin C in the elderly patients were positively correlated with BNP, NT-proBNP and LVEF (all P<0.05). The area under the curve of serum cystatin C and hs-CRP for predicting the prognosis of the elderly patients with arrhythmia and heart failure was 0.800 (95%CI: 0.700-0.901) and 0.635 (95%CI: 0.515-0.754), respectively. Conclusions Serum cystatin C and hs-CRP have certain predictive value for the prognosis of the patients with arrhythmia and heart failure, and the sensitivity of serum cystatin C is higher. References | Related Articles | Metrics

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Study on change of the ratio of CD8+CD25+ regulatory T cells in peripheral blood of elderly patients with T2DM and relationship with insulin resistance ZHANG Xiao-lan, CHEN Rui 2022, 36 (3):  277-279.  doi: 10.3969/j.issn.1003-9198.2022.03.016 Abstract ( 132 )   PDF (1008KB) ( 998 )   Save Objective To investigate the change in the ratio of CD8+CD25+ regulatory T cells (Treg) in peripheral blood in the elderly patients with type 2 diabetes mellitus (T2DM), and to investigate the relationship with insulin resistance. Methods From April 2019 to September 2020, 42 elderly patients with T2DM and 40 healthy elderly who underwent physical examination in our hospital were selected and divided into the study group and the control group, respectively. The general data, biochemical indicators, CD8+CD25+Treg ratio and insulin resistance index (HOMA-IR) of the two groups were compared. Pearson correlation analysis was used to explore the relationship between the change of CD8+CD25+Treg ratio and HOMA-IR in the elderly patients with T2DM. Results The levels of body mass index (BMI), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG), postprandial 2 h plasma glucose (2hPG), glycosylated hemoglobin (HbA1c) and fasting insulin (FINS) in the study group were higher than those in the control group (P<0.05). The level of HOMA-IR in the study group was higher than that in the control group (P＜0.01), and the ratio of CD8+CD25+Treg was lower than that in the control group (P＜0.01). CD8+CD25+Treg ratio was negatively correlated with HOMA-IR and FINS (r=-0.506, -0.382, P＜0.05). Conclusions Compared with healthy elderly, the ratio of CD8+CD25+Treg in elderly T2DM patients is abnormally lower, which may be related to insulin resistance in elderly T2DM patients. References | Related Articles | Metrics

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A diagnostic method of high myopia based on artificial intelligence ResNeXt WAN Cheng, CHEN Bai-bing, SHEN Jian-xin, CHEN Zhi-qiang 2022, 36 (3):  280-283.  doi: 10.3969/j.issn.1003-9198.2022.03.017 Abstract ( 142 )   PDF (1748KB) ( 1317 )   Save Objective To promote the development of computer-aided diagnosis, and to improve the diagnosing efficiency of high myopia. Methods ResNeXt-50 network was used to diagnose high myopia with few parameters and fast training speed. It was used to distinguish normal fundus and high myopia fundus in this study. Results This study used 6571 high myopia color photos and 6212 normal color photos from Jiangsu Province Geriatric Hospital as the data set. In the end, the diagnostic method got an accuracy of 94.10%, a sensitivity of 92.33%, a specificity of 95.94% and an AUC of 0.9861 for high myopia. The average time of each image took 0.035 s, which was within the acceptable range of real-time diagnosis, which met the real-time performance of medical auxiliary diagnosis. Conclusions ResNeXt-50 has a good classification performance. It can diagnose high myopia efficiently and accurately. References | Related Articles | Metrics

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Correlation between chronic inflammation, telomere length and cognitive function in patients with Alzheimer′s disease LIU Ya-ling, PAN Xiao-dong, ZHOU Chen, SHU Ting-ting 2022, 36 (3):  284-287.  doi: 10.3969/j.issn.1003-9198.2022.03.018 Abstract ( 147 )   PDF (1081KB) ( 1099 )   Save Objective To investigate the relationship of high-sensitivity C-reactive protein(hs-CRP) and telomere length(TL) with cognitive function in the patients with Alzheimer′s disease (AD), and to investigated the characteristics of cognitive impairment in the patients with different TL. Methods A total of 135 elderly patients were involved and divided into normal control group (NC group, n=49) and AD group (n=86). Demographic and general clinical data were collected. Venous blood was extracted to measure hs-CRP, and peripheral blood leukocyte DNA was extracted to measure TL. The score of Montreal Cognitive Assessment (MoCA) was used to evaluate the level of cognitive function. The levels of hs-CRP and TL were compared between the two groups. The AD patients were further categoried into three subgroups by TL, and the MoCA scores were compared between the subgroups. Results The level of TL in AD group was significantly shorter than that in NC group(P<0.01), while the level of hs-CRP was higher (P<0.05). Binary Logistic regression analysis showed that hs-CRP, serum homocysteine and shortening TL were the independent risk factors for AD. In the AD group, the patients with short telomere presented with more serious cognitive impairment in visual space, executive ability, attention, calculation ability, abstraction and memory compared with the patients with long telomere. Conclusions TL shows linear correlation with cognitive dysfunction in AD patients. References | Related Articles | Metrics

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Clinical evaluation of atorvastatin combined with nicotinic acid in elderly patients with unstable angina pectoris FENG Hui-min, SUI Li-jun 2022, 36 (3):  288-291.  doi: 10.3969/j.issn.1003-9198.2022.03.019 Abstract ( 108 )   PDF (1024KB) ( 1000 )   Save Objective To explore the effect of atorvastatin combined with nicotinic acid on unstable angina pectoris in the elderly patients and the influence on electrocardiogram (ECG) changes and hemorheological indexes. Methods A total of 80 elderly patients with unstable angina pectoris admitted to our hospital from January 2019 to January 2021 were prospectively selected and divided into the control group and the study group, with 40 cases in each group. The control group was treated with atorvastatin, while the study group was treated with atorvastatin combined with nicotinic acid. The curative effects of the two groups were compared. Results The effective rate of the study group was 97.50%, compared with 82.50% in the control group (P<0.05). After treatment, the frequency and duration of angina pectoris and the levels of high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) were significantly lower in the study group than those in the control group (P<0.01). The total effective rate of ECG improvement in the study group was 95.00%, compared with 80.00% in the control group (P<0.05). After treatment, the plasma viscosity, whole blood high shear viscosity and whole blood low shear viscosity in the study group were significantly lower than those in the control group (P<0.05 or 0.01). There was no significant difference in adverse reaction rate between the two groups (P=0.644). Conclusions Atorvastatin combined with nicotinic acid is effective in the treatment of unstable angina pectoris in the elderly patients, which can improve the hemorheological indexes and inflammation level, and is safe and worthy of clinical application. References | Related Articles | Metrics

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Effects of Mulligan dynamic joint mobilization in the treatment of traumatic periarthritis of shoulder in the elderly ZHANG Gui-lin, OUYANG Gang, GUAN Chong-yuan, XU Shou-yong, BAO Hui-min 2022, 36 (3):  292-294.  doi: 10.3969/j.issn.1003-9198.2022.03.020 Abstract ( 168 )   PDF (1004KB) ( 1165 )   Save Objective To observe the clinical effects of Mulligan dynamic joint mobilization in the treatment of traumatic periarthritis of shoulder in the elderly. Methods From June 2019 to September 2020,60 elderly patients with traumatic periarthritis of shoulder were selected from Department of Traditional Medicine of Jiangsu Province Gerintric Hospital,and they were divided into the observation group(n=30)and the control group(n=30).The control group was given exercise therapy and joint mobilization,while the observation group was given exercise therapy and Mulligan dynamic joint mobilization. Each group was treated once a day,5 times a week,for 6 weeks.The visual analogue scale (VAS) of shoulder pain and the Constant-Murley shoulder function rating scale were used to evaluate the function and efficacy of the patients before and after 6 weeks of treatment. Results After 6 weeks of treatment,the score of VAS in both groups was significantly decreased,while Constant-Murley score was significantly increased (P<0.05), especially in the observation group (P<0.05). Conclusions Mulligan dynamic joint mobilization is effective in the treatment of traumatic periarthritis of shoulder in the elderly,which is worthy of clinical promotion and application. References | Related Articles | Metrics

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Effects of sleep duration and sleep efficiency on cognitive function of the elderly with mild cognitive impairment in rural areas YU Cheng, SUN Jing-xian 2022, 36 (3):  295-298.  doi: 10.3969/j.issn.1003-9198.2022.03.021 Abstract ( 135 )   PDF (1027KB) ( 1279 )   Save Objective To explore the effects of sleep duration and sleep efficiency on cognitive function of the elderly with mild cognitive impairment in rural areas. Methods A total of 114 elderly with mild cognitive impairment in rural areas were enrolled in this study. Pittsburgh Sleep Quality Index (PSQI) and Montreal Cognitive Assessment (MoCA) were used to investigate the sleep quality and cognitive function. According to sleep efficiency, the elderly were divided into 3 groups: > 85% group, 75%-85% group and <75% group. According to the sleep duration, they were divided into 3 groups: ≤6 h group, (6,8) h group and ≥8 h group. Results Except for the abstract dimension, the scores of MoCA showed significant correlation with the scores of PSQI in the elderly people with mild cognitive impairment in rural areas (P＜0.05). Compared with ≥8 h group, the scores of MoCA including the dimensions as visual space and executive function, naming, delayed recall were significantly lower, and the scores of PSQI, including the dimensions as subjective sleep quality, sleep time, sleep efficiency were significantly higher in ≤6 h group (P<0.05). Compared with ＜75% group, the scored of MoCA including the dimensions as naming and orientation were significantly higher, and the scores of PSQI, including the dimensions as subject sleep quality, sleep latancy, sleep time and sleep effitiency were significantly lower in ＞85% group. Conclusions Sleep duration and sleep efficiency have significant effects on the cognitive function in the elderly in rural areas. Therefore, improving the sleep quality of the elderly with mild cognitive impairment in rural areas will contribute to the improvement of the cognitive function. References | Related Articles | Metrics

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Effects of intranasal dexmedetomidine on extubation stress response during general anesthesia extubation in elderly patients after laparoscopic surgery QIU Li-guo, SHI Jue-zhen, ZHU Wen-ning, CAO Xiao-fei 2022, 36 (3):  299-301.  doi: 10.3969/j.issn.1003-9198.2022.03.022 Abstract ( 136 )   PDF (1056KB) ( 1047 )   Save Objective To observe the effects of different doses of intranasal dexmedetomidine on stress response during extubation in the elderly patients after laparoscopic surgery. Methods A total of 80 elderly patients with selective laparoscopic renal cystectomy were randomly divided into control group and intranasal dexmedetomidine groups with different doses. Low-dose group, middle-dose group and high-dose group received 0.5 μg/kg, 1 μg/kg and 1.5 μg/kg intranasal dexmedetoidine 30 min before the end of the operation respectively, and control group was given 2 mL intranasal 0.9% sodium chloride solution. Heart rate (HR) and mean arterial pressure (MAP) were recorded at the end of operation (T1), during extubation (T2), 1 min after extubation (T3), 5 min after extubation (T4), and 10 min after extubation (T5), respectively. Postoperative recovery indicators were recorded. Results Compared with control group, the level of MAP in intranasal dexmedetomidine groups decreased significantly and the level of HR decreased significantly at T1-T5 (P<0.05). Compared with low-dose group, the level of HR in middle-dose group and high-dose group decreased significantly at T2-T5, and the level of MAP decreased significantly at T2-T3 (P<0.05). The extubation time and post anesthesia intensive care unit (PACU) observation time in control group, low-dose group and middle-dose group were significantly shorter than those in high-dose group (P<0.05). Ramsay score in intranasal dexmedetomidine groups at T5 was significantly higher than that in control group. However, the patients in high-dose group only responded to instructions (P<0.05). Conclusions The administration of 1 μg/kg intranasal dexmedetomidine 30 min before the end of laparoscopic renal cystectomy in the elderly patients can effectively inhibit the stress response during periextubation without affecting the postoperative recovery time. References | Related Articles | Metrics

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Analysis of risk factors for necrotizing fasciitis in elderly patients with perianal abscess CHEN Chang-quan, LYU Jing 2022, 36 (3):  302-305.  doi: 10.3969/j.issn.1003-9198.2022.03.023 Abstract ( 165 )   PDF (1025KB) ( 1168 )   Save Objective To investigate the risk factors of perianal necrotizing fasciitis in the elderly patients with perianal abscess, in order to guide clinical treatment. Methods The study reviewed 122 cases of severe perianal abscess admitted to Nanjing Hospital of Chinese Medicine from July 2019 to June 2020. The patients were divided into necrotizing fasciitis group (59 cases) and non-necrotizing fasciitis group (63 cases) according to the occurrence of necrotizing fasciitis. The gender,weight,basic diseases, serum albumin levels at admission were recorded and compared between the two groups.Multivariate Logistic regression analysis was performed to investigate the risk factors of perianal necrotizing fascitis. Results Compared with non-necrotizing fasciitis group, necrotizing fasciitis group had higher incidence rate of diabetes, lower level of serum albumin at admission, and higher level of basal blood glucose(P<0.05).Multivariate Logistic regression analysis showed that history of diabetes (OR=5.695, 95%CI: 1.389-20.042, P<0.05) and basal hyperglycemia (OR=2.362, 95%CI: 1.047-6.548, P<0.05) were the independent risk factors of perianal necrotic fasciitis. Conclusions The elderly patients with perianal abscess with a history of diabetes or basic hyperglycemia are prone to presenting with perianal necrotizing fasciitis. References | Related Articles | Metrics

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Relationship of self-efficacy with drug literacy and medication compliance in elderly patients with coronary heart disease WANG Yue-ping, YU Fang, ZHAN Ling, YIN Wen-cai, WEI Yan 2022, 36 (3):  310-313.  doi: 10.3969/j.issn.1003-9198.2022.03.026 Abstract ( 146 )   PDF (1219KB) ( 1146 )   Save Objective To explore the mediating effect of self-efficacy on drug literacy and medication compliance in the elderly patients with coronary heart disease (CHD). Methods From February to March 2021, 86 elderly patients with CHD treated by percutaneous coronary intervention in the Department of Cardiology, the First Affiliated Hospital of University of Science and Technology of China were enrolled. All patients received the assessment of self-made general information questionnaire, self-efficacy scale, drug literacy scale and medication compliance scale. Results The total score of self-efficacy of the 86 elderly patients with CHD was 29.33±7.33; The total score of medication compliance was 4.34±1.57; The total score of drug literacy was 4.64±1.46. There was a positive correlation between self-efficacy and drug literacy in the elderly patients with CHD (r=0.369, P<0.01). Drug literacy and self-efficacy were positively correlated with medication compliance (r=0.489, 0.551, P<0.01). Bootstrap test showed that self-efficacy level had a significant mediating effect on drug literacy and medication compliance in the elderly patients with CHD (β=0.16), and the contribution rate of mediating effect of self-efficacy to the total effect was 32.70% (0.16/0.49). Conclusions Drug literacy has a positive predictive effect on medication compliance in the elderly patients with CHD, and self-efficacy plays a partial mediating effect between drug literacy and medication compliance. It is suggested that clinical medical staff can improve the medication compliance of patients by improving their drug literacy and self-efficacy. References | Related Articles | Metrics

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Clinical study on improved catheter removal technique to reduce extubation-related complications in elderly patients undergoing neurointerventional surgery XIA Meng, MAO Er-li, WANG Xue-mei, BAO Wan-ru, JIN Juan 2022, 36 (3):  314-317.  doi: 10.3969/j.issn.1003-9198.2022.03.027 Abstract ( 139 )   PDF (1182KB) ( 1014 )   Save Objective To investigate the effect of an improved catheter removal technique on reducing the extubation-related complications in the elderly patients undergoing neurointerventional surgery. Methods Thirty patients with urinary catheters after neurointerventional procedures from December 2020 to June 2021 in our hospital were selected as the intervention group, and another 30 patients were selected as the control group matched by gender, age and other conditions. In the control group, urinary catheters were removed according to the traditional standardized method. In the intervention group, an improved catheter removal technique was applied. All patients underwent mental urination training. Pain intensity during catheter removal, urinary tract irritation, and urination approaches after catheter removal were compared. Results The mean pain index during catheter removal and the rate of urinary tract irritation in the intervention group were significantly lower than those in the control group (P<0.01). The proportions of the patients with self-urination, induced urination and urinary retention showed significant differences between the intervention group and the control group (P<0.01). Conclusions This improved catheter removal technique can relieve the pain and reduce the complications in the elderly patients undergoing neurointerventional surgery. References | Related Articles | Metrics

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Analysis of the influencing factors of 6 min walking distance in elderly patients ZHU Jiao, XIA Li-li, LIU Ying, JIANG Heng 2022, 36 (3):  318-321.  doi: 10.3969/j.issn.1003-9198.2022.03.028 Abstract ( 126 )   PDF (1017KB) ( 1238 )   Save Objective To investigate the influencing factors of 6-minute walk distance (6MWD) in the elderly patients. Methods A total of 123 patients in the Department of Geriatric Cardiology of Jiangsu Province Hospital from June 2017 to June 2018 were enrolled in the study, and the clinical data were collected. The influencing factors of 6MWD were analyzed. Results Age, fall risk, fall efficiency, self-care ability, nutritional status, weakness, depression conditions, plasma level of albumin showed statistical difference among the patients with different 6MWD (P<0.05). Multiple linear regression analysis showed that age(B=-0.098,P＜0.01), fall risk(B=-0.262,P=0.004), fall efficiency(B=0.011,P=0.009), self-care ability(B=-0.021, P＜0.01), nutrition(B=-0.405, P=0.009), weakness(B=-0.653, P=0.001)and plasma level of albumin(B=0.127, P＜0.01)were the independent influencing factors of 6MWD in the elderly patients. Conclusions The level of 6MWD in the elderly patients is affected by age, self-care ability, fall risk, nutrition, weakness, depression and negative emotional factors. It is necessary to take early intervention. References | Related Articles | Metrics