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20 October 2022, Volume 36 Issue 10 Previous Issue    Next Issue

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Role and the mechanism of synovial tissue in the treatment of osteoarthritis by mesenchymal stem cells CAO Juan, YAO Yao, LI Ling-ling, WU Wen-hui, XIAO Yun-yun, DING Cong-zhu 2022, 36 (10):  996-1000.  doi: 10.3969/j.issn.1003-9198.2022.10.006 Abstract ( 153 )   PDF (2136KB) ( 1234 )   Save Objective To investigate the changes of synovial membrane in osteoarthritis(OA),and to investigate the therapeutic effect of umbilical cord mesenchymal stem cells (UC-MSCs) on OA through synovial membrane and the related mechanism. Methods Fifteen healthy adult New Zealand white rabbits were selected and divided into 3 groups, including control group, OA model group and UC-MSCs intervention group, with five rabbits in each group. After successful OA modeling, intra-articular injection of UC-MSCs was given to UC-MSCs intervention group. Imaging and pathological changes of the joints were observed after 4 weeks of treatment. The expression levels of interleukin-6(IL-6), matrix metalloproteinase-13(MMP-13)and extracellular signal regulated kinase(ERK) proteins in the synovial tissues of rabbits in each group were detected by immunohistochemistry and the protein expression levels of IL-6, MMP-13, ERK and mitogen-activated protein kinase (MAPK) in the synovial tissues of rabbits were detected by Western blot. Results Magnetic resonance examination showed that compared with control group, the synovium of the knee joint in OA model group was significantly thickened and the effusion of the joint cavity was significantly increased; Synovial thickening and joint effusion were significantly improved in UC-MSCs intervention group compared with OA model group. Pathological results showed that the number of synovial inflammatory cells and synovial hyperplasia and edema were significantly increased in OA model group compared with control group. Compared with OA model group, the infiltration of synovial inflammatory cells and synovial hyperplasia and edema were significantly reduced in UC-MSCs intervention group. The levels of ERK, IL-6 and MMP-13 in synovial membrane of rabbit in OA model group were significantly higher than those in control group (P<0.05).The levels of ERK and MMP-13 in UC-MSCs intervention group were decreased compared with OA model group (P<0.05).Western blot analysis showed that the expression levels of IL-6, MMP-13, MAPK and ERK in OA model group were significantly higher than those in control group (P<0.05), while significantly decreased in UC-MSCs intervention group (P<0.05). Conclusions Inflammatory factors of synovial tissue are involved in the formation and progression of OA.UC-MSCs has a protective effect on the synovial membrane of OA, which is related to the inhibition of inflammatory response. References | Related Articles | Metrics

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Relationship of platelet-to-lymphocyte ratio with left ventricular diastolic function in elderly patients with heart failure with preserved ejection fraction LIU Xian-ling, HONG Jian, XU Di 2022, 36 (10):  1001-1005.  doi: 10.3969/j.issn.1003-9198.2022.10.007 Abstract ( 149 )   PDF (1054KB) ( 1223 )   Save Objective To study the relationship between platelet-to-lymphocyte ratio (PLR) and left ventricular diastolic function in the elderly patients with heart failure with preserved ejection fraction (HFpEF). Methods A total of 53 elderly patients with HFpEF were enrolled. According to the transmitral flow velocities to mitral annulus tissue velocities ratio in early diastole (E/e'), the patients were divided into low E/e' group (E/e'＜8), middle E/e' group (8≤E/e'≤14) and high E/e' group (E/e'＞14). The clinical characteristics, biochemical indicators, cardiac ultrasound and other related indicators of these patients were detected and compared among the three groups. And the relationship between PLR and E/e' was analyzed. Results There were significant differences in age, lymphocyte count (LY) and PLR among the three groups (P＜0.05), but there were no significant differences in other indicators among the three groups (P＞0.05). Spearman correlation analysis showed that PLR was negatively correlated to E/e' (P＜0.05); LY and age were positively correlated to E/e' (P＜0.05). Left ventricular end-diastolic diameter and left ventricular end-systolic diameter had positive correlation with PLR (P＜0.05). Simple linear regression analysis showed that PLR showed significant effect on E/e' (F=12.361, P＝0.001), and the regression equation can be obtained as E/e'=18.145-0.030×PLR. Multiple linear regression analysis showed that PLR was an independent factor influencing E/e' (b=-0.025, t=-2.401, P=0.020). Conclusions PLR is closely related to the left ventricular diastolic function in the elderly patients with HFpEF. References | Related Articles | Metrics

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Relationship between obesity indicators and hyperuricemia in the elderly XUE Jian-qiang, LIU Yu-ping, NI Guo-hua, SUN Ping, LIU Ying-ying, SHUAI Ping 2022, 36 (10):  1006-1009.  doi: 10.3969/j.issn.1003-9198.2022.10.008 Abstract ( 164 )   PDF (1047KB) ( 1308 )   Save Objective To explore the relationship between the indicators of obesity and hyperuricemia (HUA) in the elderly people aged≥ 60 years old, and to provide evidence for the screening and management of HUA. Methods The clinical data including age, height, weight, systolic blood pressure, diastolic blood pressure, blood uric acid, triglycerides, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and waist circumference (WC) were collected by reviewing the physical check report, and body mass index (BMI), body roundness index (BRI), relative fat mass index (RFM), lipid accumulation product (LAP) and visceral adiposity index (VAI) were calculated. The relationship between the obesity indicators and HUA was analyzed by Logistic regression model. Results A total of 10 582 cases were enrolled in this study. There were statistically significant differences in the levels of BMI, WC, BRI, RFM, LAP and VAI between HUA group and non-HUA group(P<0.05). Logistic regression analysis showed that WC (OR=1.029, 95%CI:1.018-1.040), BMI (OR=1.227, 95%CI:1.070-1.407), LAP (OR=1.007, 95%CI:1.003-1.011), BRI (OR=1.474, 95%CI:1.288-1.688) and RFM (OR=1.070, 95%CI:1.046-1.095) were associated with HUA. The area under the receiver operating characteristic curve of LAP in predicting HUA was greatest. Conclusions Some obesity indicators are risk factors for HUA in the elderly, and LAP has the greatest predictive value, which provides evidence for the management of HUA. References | Related Articles | Metrics

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Clinical observation of different dose-fractionations of intensity-modulated radiotherapy for elderly patients with esophageal squamous cell carcinomas LI Xiao-long, LIU Qiu-fang, LI Liang, WANG Tian-chang, WANG Feng-gang, WU Lei, DAI Zhen, LU Wan-lin 2022, 36 (10):  1010-1014.  doi: 10.3969/j.issn.1003-9198.2022.10.009 Abstract ( 122 )   PDF (1007KB) ( 1080 )   Save Objective To investigate the clinical effects of different dose-fractionations of intensity-modulated radiotherapy for esophageal squamous cell carcinomas in the elderly patients, and to explore the optimal dose-fractionation. Methods A total of 102 elderly patients with esophageal squamous cell carcinoma who received radiotherapy in our hospital from October 2010 to February 2015 were enrolled in this study. According to different dose-fractionations model, all cases were divided into three groups, group A receiving a single radiotherapy dose of 2.0 Gy, 25-30 times in total, with total dose of 50-60 Gy, with a biologically effective dose (BED) of 60-72 Gy; Group B receiving a single radiotherapy dose of 2.2 Gy, 23-27 times in total, with total dose of 50.6-59.4 Gy, with a BED of 61.7-72.5 Gy; Group C receiving a single radiotherapy dose of 2.5 Gy, 19-23 times in total, with total dose of 47.5-57.5 Gy, with a BED of 59.4-71.9 Gy. The adverse reaction rate, local control rate and survival rate of the three groups were analyzed. Results The total effective rate in group A, group B and group C was 82.8%(24/29), 91.7%(44/48) and 96.0%(24/25), resprectively, with no statistically significant difference (P>0.05). There were no significant differences in local control rate for 1-3 years and the survival rates for 1-2 years among the three groups(P>0.05). The 3-year survival rate in group A, group B and group C was 17.2%, 31.3%, 16.0%, respectively, with statistically significant difference (P=0.049). Conclusions Hypofractionated radiotherapy mode (2.2 Gy) in intensity-modulated radiotherapy is an optional radiotherapy scheme for advanced esophageal squamous cell carcinoma in the elderly, but the optimal mode still needs further clinical research. References | Related Articles | Metrics

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Clinical characteristics of newly diagnosed type 2 diabetic patients with different age of onset YU Yun, TANG Wei, LOU Qing-lin 2022, 36 (10):  1015-1018.  doi: 10.3969/j.issn.1003-9198.2022.10.010 Abstract ( 155 )   PDF (998KB) ( 986 )   Save Objective To explore the differences of clinical characteristics between the patients with aged-onset and middle-aged-onset newly diagnosed type 2 diabetes mellitus (T2DM). Methods A total of 1555 newly diagnosed T2DM patients were enrolled and divided into two groups according to the onset age of diabetes, including 972 aged-onset patients(aged≥60 years old)and 583 middle-aged-onset patients(aged 40-59 years old). The levels of glycosylated hemoglobin(HbA1c), fasting plasma glucose(FPG), postprandial glucose(PPG), serum creatinine(SCr), triglyceride(TG), total cholesterol(TC), low-density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol(HDL-C), albumin creatinine ratio(ACR) and ankle-brachial index(ABI) were measured and compared between the two groups. Results The levels of HbA1c, FPG and PPG in the patients with aged-onset newly diagnosed T2DM were significantly lower than those in the patients with middle-aged-onset newly diagnosed T2DM(all P<0.01). Aged-onset patients had higher control target rate of HbA1c than middle-aged-onset patients ( 45.6% vs 33.79%, P<0.01). Compared with middle-aged-onset patients, aged-onset patients had significantly higher prevalence of hypertension and higher levels of systolic blood pressure, while significantly lower levels of TG and TC (all P<0.01), and had significantly higher control rates of TG and TC (all P<0.01). Aged-onset patients showed significantly higher proportions of diabetic macrovascular complications (coronary heart disease and peripheral vascular disease) and chronic kidney disease (CKD) compared with middle-aged-onset patients (all P<0.01). Conclusions Compared with the patients with middle-aged-onset newly diagnosed T2DM, the patients with aged-onset newly diagnosed T2DM are more likely to control glucose levels and achieve HbA1c target. We should pay more attention to the management and control of blood pressure. The patients with aged-onset newly diagnosed T2DM have significantly higher proportions of diabetic macrovascular complications and CKD. References | Related Articles | Metrics

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Risk factors of poor prognosis in elderly patients with acute anterior circulation cerebral infarction undergoing intravenous thrombolysis WANG Wei, FANG Chuan-qin, CAO Lei, LIU Xue-yun 2022, 36 (10):  1019-1023.  doi: 10.3969/j.issn.1003-9198.2022.10.011 Abstract ( 117 )   PDF (1009KB) ( 1193 )   Save Objective To investigate the risk factors of poor prognosis in the elderly patients with acute anterior circulation cerebral infarction(AACI) undergoing intravenous thrombolysis. Methods A total of 106 elderly patients with AACI who received intravenous thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) in our hospital from January 2019 to May 2021 were enrolled. According to the score of modified Rankin scale (mRS) 3 months after the treatment, they were divided into good prognosis group (58 cases) (0-2 points) and poor prognosis group (48 cases) (3-6 points). The clinical data of the two groups were retrospectively analyzed.Multivariate Logistic regression was used to analyze the influencing factors of poor prognosis, and receiver operating characteristic (ROC) curve was used to evaluate the predictive value of the related factors for poor prognosis. Results Age, the incidence rate of atrial fibrillation, neutrophil to lymphocyte ratio (NLR), activated partial thromboplastin time(APTT), Alberta stroke program early CT score (DWI-Aspects), clot burden score (CBS), collateral circulation Tan score, baseline NIHSS score, and the incidence rate of early neurological deterioration (END) were significantly different between the two groups (P<0.05). Multivariate Logistic regression analysis suggested NLR(OR=1.426,95%CI:1.023-1.989, P=0.036), baseline NIHSS score (OR=1.144, 95%CI:1.020-1.284, P=0.022) and END(OR=25.818,95%CI:2.523-264.182, P=0.006) were the independent risk factors, while collateral circulation Tan score (OR=0.249, 95%CI:0.115-0.540, P<0.001) was a protective factor of poor prognosis.ROC curve analysis showed that the area under curve (AUC) of NLR, collateral circulation Tan score,baseline NIHSS score and END for predicting prognosis was 0.657,0.832,0.743 and 0.681 respectively. Conclusions There are many risk factors for poor prognosis in the elderly patients with AACI after intravenous thrombolysis. NLR, Tan score of collateral circulation, baseline NIHSS score and END before thrombolysis show good predictive value for prognosis. References | Related Articles | Metrics

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Clinical value of carotid plaque combined with ABI in predicting long-term new cardiovascular and cerebrovascular adverse events in elderly FENG Wei-tao, LI Yao, LI Wei 2022, 36 (10):  1024-1027.  doi: 10.3969/j.issn.1003-9198.2022.10.012 Abstract ( 109 )   PDF (1043KB) ( 1331 )   Save Objective To investigate the clinical value of carotid plaque combined with ankle branchial index (ABI) in predicting long-term new cardiovascular and cerebrovascular adverse events in the elderly. Methods A total of 821 elderly subjects participating in physical examination and receiving carotid ultrasound and ABI examination from January 2013 to January 2015 in our hospital were enrolled. All patients were divided into 3 groups, group A with no carotid plaque and ABI>0.9, group B with carotid plaque and ABI>0.9, and group C with carotid plaque and ABI≤0.9. The clinical characteristics and cardiovascular and cerebrovascular events were compared among the groups. Multivariate Cox proportional hazard model was used to evaluate the value of carotid plaque combined with ABI level in predicting the risk of long-term ischemic cardiovascular and cerebrovascular events. Results There were significant differences in age, gender, smoking and drinking ratio, systolic blood pressure (SBP), fasting plasma glucose (FPG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and the proportion of receiving lipid-lowering drugs among the three groups (P<0.05). There were significant differences in the incidence rates of ischemic cardiovascular and cerebrovascular events and acute myocardial infarction (AMI) among the three groups(P<0.05). Univariate analysis of Cox proportional risk model showed that the risk of long-term ischemic cardio-cerebrovascular events, AMI and cerebral infarction in group B and group C were significantly higher than those in group A(P<0.05). Multivariate Cox proportional hazards model analysis showed that the risk of long-term ischemic cardiovascular and cerebrovascular events in group B and group C was 4.76 times(HR=4.76,95%CI:1.32-7.07),8.51 times(HR=8.51,95%CI:1.65-11.80) of that in group A after adjusting for age, gender, smoking and alcohol consumption, SBP, FPG, LDL-C, HDL-C and treatment with lipid-lowering drugs(P<0.05). Conclusions The elderly population with carotid plaque and ABI ≤ 0.9 are more likely to present with long-term new cardiovascular and cerebrovascular adverse events. References | Related Articles | Metrics

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Dose optimization of rivaroxaban in anticoagulant therapy for elderly patients with heart failure complicated with atrial fibrillation XU Yu-wen, LIU Qiong, SHEN Qiong, ZHU Yan, FANG Hong-jun 2022, 36 (10):  1028-1032.  doi: 10.3969/j.issn.1003-9198.2022.10.013 Abstract ( 169 )   PDF (1010KB) ( 1105 )   Save Objective To study the dose optimization of rivaroxaban in the anticoagulant treatment of heart failure complicated with atrial fibrillation in the patients aged ＞80 years. Methods The clinical data of 85 elderly patients with heart failure complicated with atrial fibrillation in our hospital from February 2018 to February 2021 were collected retrospectively. According to the prescription dose of rivaroxaban, they were divided into low dose group (5 mg/d, n=25), medium dose group (10 mg/d, n=41) and high dose group (20 mg/d, n=19). The indexes of coagulation function [prothrombin time (PT), D-dimer (D-D)] and cardiac function [left ventricular ejection fraction (LVEF), pulmonary artery pressure (PAP), N-terminal B-type natriuretic peptide precursor (NT-proBNP)] were compared before treatment and 1 month after treatment, and all patients were followed up for 6 months. Results There were no significant differences in PT and D-D between the three groups before and after treatment (P>0.05). After treatment, the level of PT was longer and the level of D-D was lower than that before treatment in the three groups (P< 0.05). There were no significant differences in the levels of LVEF, PAP and NT-proBNP between the three groups before and after treatment (P>0.05). After treatment, the level of LVEF in the three groups was higher than that before treatment, and the levels of PAP and NT-proBNP were lower than those before treatment (P<0.05). In the middle dose group, the total embolism rate was lower than that in the low dose group (P<0.05), while the total incidence rate of bleeding was lower than that in the high dose group (P<0.05). Conclusions For elderly patients with heart failure complicated with atrial fibrillation, rivaroxaban can improve the coagulation function and cardiac function, and 10 mg/d may be the best dose of anticoagulant therapy. References | Related Articles | Metrics

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Predictive value of left atrial strain for long-term poor prognosis of elderly patients with heart failure MA Xiao-ying, LI Jiu-min, QIN Pei, LIU Miao, JIN Ming-lei 2022, 36 (10):  1033-1037.  doi: 10.3969/j.issn.1003-9198.2022.10.014 Abstract ( 133 )   PDF (1015KB) ( 945 )   Save Objective To explore the predictive value of left atrial strain for the long-term poor prognosis of elderly patients with heart failure. Methods A total of 136 elderly patients with heart failure age ≥ 65 years old admitted to Chengde Central Hospital from July 2018 to July 2019 were prospectively selected as the research subjects. The patients were followed up for 2 years. According to the all-cause death results, they were divided into poor prognosis group and good prognosis group. The influencing factors of long-term poor prognosis of the elderly patients with heart failure were analyzed by multivariate Cox regression. Results By the end of the follow-up, 42 cases (33.60%) presented with all-cause death and 83 cases (66.40%) with a good prognosis. There were significant differences in the levels of left atrial volume index (LAVI), left atrial reserve strain (LARS), left ventricular ejection fraction (LVEF) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) between poor prognosis group and good prognosis group. Multivariate Cox regression analysis showed that NT-proBNP (HR=1.001, 95%CI: 1.000-1.002) and LAVI (HR=1.082, 95%CI:1.002-1.168) were the independent risk factors of long-term poor prognosis, and LVEF (HR=0.944, 95%CI:0.893-0.998) and LARS (HR=0.945, 95%CI:0.902-0.991) were the protective factors of long-term poor prognosis in the elderly patients with heart failure (all P<0.05). ROC curve analysis showed that the area under curve(AUC) of LARS was higher than that of LVEF and LAVI. Conclusions LAVI, LARS, LVEF and NT-proBNP can predict the long-term poor prognosis of elderly patients with heart failure, and LARS is more valuable than other parameters. References | Related Articles | Metrics

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Correlation between vitamin D and muscle content of the hip in elderly men SUN Jing, YANG Fan, YANG Li 2022, 36 (10):  1038-1041.  doi: 10.3969/j.issn.1003-9198.2022.10.015 Abstract ( 125 )   PDF (987KB) ( 1017 )   Save Objective To explore the association between the serum level of 25-hydroxyvitamin D (25(OH)D)] and the muscle content of hip in the elderly men with different age, and to provide a new viewpoint for the prevention of sarcopenia. Methods The clinical data of 180 elderly men in Department of Geriatrics, Nanjing Drum Tower Hospital from January 2020 to October 2021 were retrospectively analyzed. Local muscle content of the hip and waist were measured using dual-energy X-ray absorptiometry (DXA). The data of the muscle mass ratio around the waist and hip were collected according to the local BMD model. The subjects were divided into three groups according to the age (60-69 years group,70-79 years group and ≥80 years group). The relationship between vitamin D and local muscle content was analyzed using partial correlation analysis and multiple linear regression. Results With the increase of age, there were significant decreases in muscle content of the hip and BMI (P<0.05).There were no significant differences in the serum level of 25(OH)D and the muscle content of the waist between the three groups. There was a positive correlation between the serum level of 25(OH)D and the muscle content of the hip in 60-69 years group (r=0.165, P<0.05). The results of multiple linear regression analysis showed that the serum level of 25(OH)D and waist muscle content were positively correlated with hip muscle content(B=0.069, 0.335, P<0.05), and BMI was negatively correlated with hip muscle content( B=-0.326, P<0.05). Conclusions In the elderly men aged 60-69 years old, the decrease of serum level of 25(OH)D has a significant effect on muscle content of the hip, and supplementing vitamin D is helpful to reduce the incidence of sarcopenia and osteoporosis. References | Related Articles | Metrics

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Effect of recombinant human brain natriuretic peptide on myocardial injury markers in elderly patients with acute left heart failure DING Chao, CHU Yue-feng, FENG Jun 2022, 36 (10):  1042-1045.  doi: 10.3969/j.issn.1003-9198.2022.10.016 Abstract ( 153 )   PDF (987KB) ( 1264 )   Save Objective To study the effect of recombinant human brain natriuretic peptide (rhBNP) on the levels of myocardial injury markers in the elderly patients with acute left heart failure. Methods From November 2016 to November 2019, 80 patients with acute left heart failure in our hospital were enrolled. They were randomly divided into the observation group and the control group, with 40 cases in each group. Both groups received routine treatment after admission. The observation group was treated with rhBNP, and the control group was treated with nitroglycerin additionally. The clinical efficacy, cardiac function indexes [ left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), left ventricular short axis shortening rate (LVFS) ], myocardial injury markers [ creatine kinase (CK), lactate dehydrogenase (LDH), N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI) ] and the incidence of adverse reactions were compared between the two groups after treatment. Results The total effective rate of cardiac function improvement in the observation group was significantly higher than that in the control group(P＜0.05).The levels of LVESD and LVEDD in the two groups after treatment were significantly lower than those before treatment, while the levels of LVEF and LVFS were significantly higher than those before treatment(P＜0.05). The levels of cTnI, CK, LDH and NT-proBNP in the two groups after treatment were significantly lower than those before treatment(P < 0.05),especially in the observation group(P＜0.05). The incidence rate of the adverse reactions in the observation group was significantly lower than that in the control group (P＜0.05). Conclusions rhBNP can significantly improve the therapeutic effect in the elderly patients with acute left heart failure, improving the cardiac function, reducing the cardiac load, improving the level of myocardial injury markers, with less side effects. References | Related Articles | Metrics

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Risk factors of bloodstream infections in the aged critically ill patients CHEN Chang-quan, XU Biao 2022, 36 (10):  1046-1049.  doi: 10.3969/j.issn.1003-9198.2022.10.017 Abstract ( 140 )   PDF (989KB) ( 1003 )   Save Objective To investigate the risk factors of bloodstream infections(BSI) in the aged critically ill patients in Intensive Care Unit(ICU). Methods The study retrospectively analyzed the clinical data of 120 cases of aged critically ill patients admitted to Nanjing Hospital of Chinese Medicine from January 2017 to December 2020. According to the results of blood culture, the cases were divided into BSI group(n=64) and non-BSI group(n=56). The differences in gender, age, APACHEⅡscore, Nutric score, comorbidities, the length of ICU stay, invasive operations between the two groups were analyzed. Then multivariate Logistic regression analysis was performed to investigate the risk factors of BSI. Results Univariate analysis showed that the patients in BSI group had higher nutritional risk than non-BSI group. The incidence rates of tumor, diabetes, urinary tract infection, gastrointestinal dysfunction and antimicrobial exposure in BSI group were higher than those in non-BSI group(P < 0.05). Multivariate Logistic regression analysis showed that malignant tumors (OR=2.476, 95%CI: 1.032-5.941), gastrointestinal dysfunction (OR=3.410, 95% CI: 1.366-8.514), history of antimicrobial exposure (OR=3.705, 95% CI: 1.516-9.057) and high nutritional risk (OR=7.005, 95% CI: 2.588-18.957, P< 0.01) were the independent risk factors of BSI in the aged critically ill patients. Conclusions The aged critically ill patients with high malnutrition risk, malignant tumor, gastrointestinal dysfunction and history of antimicrobial exposure are prone to suffer from BSI. References | Related Articles | Metrics

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Relationship between the anatomical and morphological characteristics, volume of left atrial appendage and age in patients with atrial fibrillation HU Xiao-hua, ZHU Ye, CHEN Juan 2022, 36 (10):  1050-1053.  doi: 10.3969/j.issn.1003-9198.2022.10.018 Abstract ( 134 )   PDF (1046KB) ( 746 )   Save Objective To investigate the anatomical and morphological characteristics and volume of left atrial appendage(LAA) in the patients with atrial fibrillation evaluated by multi-slice spiral computed tomography (MSCT), and to investigate the relationship with age. Methods A total of 92 patients with paroxysmal atrial fibrillation treated in our hospital from August 2019 to August 2021 were continuously enrolled. All the patients underwent MSCT and three-dimensional volume reconstruction before operation. The anatomical and morphological characteristics and corrected volume of LAA under MSCT were observed, and the relationship between LAA and age was analyzed. Results The LAA of 92 patients with atrial fibrillation showed abundant comb muscles and muscle trabeculae, lobulated surface and irregular shape. Among them, chicken wing type LAA accounted for 60.9%, and the average volume after LAA correction was 6.7±4.8 mL/m2. With the increase of average volume after LAA correction, the proportion of non-chicken wing LAA increased. The proportion of LAA corrected mean volume ≥6.7 mL/m2 in the elderly patients aged ≥65 years old was significantly higher than that in the patients aged <65 years old. Pearson correlation analysis showed that the average volume after LAA correction was significantly positively correlated with age in the patients with atrial fibrillation (r=0.429, P=0.009). In addition, the proportion of non-chicken wing LAA increased with age. Univariate and binary Logistic regression analysis showed that age, duration of atrial fibrillation and LAA corrected mean volume were the independent influencing factors for the occurrence of non-chicken wing LAA. Conclusions The distribution of non-chicken wing LAA was positively correlated with age. The influence of age should be fully considered when using non-chicken wing LAA to evaluate the risk factors of stroke in patients with atrial fibrillation. References | Related Articles | Metrics

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Effect of vitamin C deiodination on comfort and nursing satisfaction of elderly patients after endoscopic esophageal Lugol's iodine staining LI Xiao-min, SHAO Yun, FAN Yun-xia, XU Ying-hong 2022, 36 (10):  1062-1066.  doi: 10.3969/j.issn.1003-9198.2022.10.021 Abstract ( 179 )   PDF (1006KB) ( 893 )   Save Objective To investigate the effect of vitamin C solution (VCS) deiodination on comfort level and nursing satisfaction in the elderly patients receiving endoscopic esophageal Lugol's iodine staining. Methods From March to April 2019, 52 elderly patients (＞60 years old) with superficial esophageal mucosal lesions confirmed by gastroscopy in our center were selected and randomly assigned to VCS group and normal saline (NS) group according to the randomized allocation table. We formulated a Lugol's iodine staining-related comfort degree scale and simple nursing satisfaction scale according to the Bruggrmann comfort scale and previous studies.The patients' comfort degrees were recorded immediately after the examination and 30 minutes later, and the nursing satisfaction was surveyed at last. Results The acute symptoms after Lugol's iodine staining were mainly posterior sternal discomfort, and delayed reactions were mainly epigastric discomfort. The incidence rate of retrosternal discomfort after the examination in the VCS group was significantly lower than that in the NS group (P=0.02). After 30 minutes, throat discomfort in the VCS group was significantly alleviated than that in the NS group (P=0.02). The scores of total nursing satisfaction, communication and explanation and professional level in VCS group were significantly higher than those in NS group (all P<0.05). Conclusions VCS deiodination is superior to NS, which can significantly relieve the discomfort of the elderly patients after iodine staining and improve the nursing satisfaction. References | Related Articles | Metrics

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Research on the application of FMEA combined with PMT in the safety management of the elderly in nursing home JING Dong-mei, SONG Jia-mu, SONG Wei, XU Jing-xian 2022, 36 (10):  1067-1070.  doi: 10.3969/j.issn.1003-9198.2022.10.022 Abstract ( 155 )   PDF (979KB) ( 1630 )   Save Objective To explore the application effect of protection motivation theory (PMT)combined with failure mode and effect analysis (FMEA) in the safety management of the elderly in the nursing home. Methods A total of 80 elderly patients admitted to Nanjing Jiangning Muchunyuan Nursing Home from January 2019 to June 2020 were enrolled in this study. All subjects were divided into the observation group and the control group with 40 cases in each group. The control group received routine nursing model, and the observation group received nursing intervention based on FMEA and PMT. Both groups were treated for 3 months. The risk priority number (RPN), quality of life score, self-efficacy score, incidence of fall and nursing satisfaction were compared between the two groups before and after intervention. Results Before intervention, there were no significant differences in RPN, quality of life score and self-efficacy score between the two groups (P>0.05). After the intervention, the RPN of the two groups decreased significantly, and the scores of quality of life and self-efficacy increased significantly, especially in the observation group (P<0.05). After the intervention, the incidence rate of fall showed no significant difference between the two groups(P>0.05). The nursing satisfaction score was higher in the observation group than that in the control group (P<0.05). Conclusions Nursing intervention based on FMEA combined with PMT can effectively improve the quality of life and self-efficacy of the elderly, and show value in the safety management of the elderly in nursing home. References | Related Articles | Metrics

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Effect of simulated presence therapy on apathy in patients with mild and moderate dementia DU Hong-di, BO Lin, YIN Li-sha, LUO Dan-dan, HUO Xiao-peng 2022, 36 (10):  1071-1074.  doi: 10.3969/j.issn.1003-9198.2022.10.023 Abstract ( 137 )   PDF (982KB) ( 1322 )   Save Objective To explore the effect of simulated presence therapy on apathy in the patients with mild and moderate dementia. Methods A total of 77 patients with mild and moderate dementia were randomly divided into two groups by random number table. The control group (n=39) received routine nursing, and the observation group (n=38) received simulated presence therapy on the basis of routine nursing. The score of apathy and the score of quality of life were evaluated before and after 4 weeks' intervention, and were compared between the two groups. Results The score of apathy after intervention in the observation group was significantly lower than that in the control group (45.64±8.53 vs 53.94±8.87, P<0.05); The total score of quality of life in the observation group was significantly higher than that in the control group (36.15±6.01 vs 32.83±5.21, P<0.05). Conclusions Simulated presence therapy is helpful to improve the apathetic symptom and the quality of life of the patients with mild and moderate dementia. References | Related Articles | Metrics