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20 February 2024, Volume 38 Issue 2 Previous Issue    Next Issue

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Intelligent detection and intervention of freezing of gait in Parkinson's disease SUN Yi, RONG Zhe, WANG Feng, XU Chang, ZHENG Huifen 2024, 38 (2):  123-127.  doi: 10.3969/j.issn.1003-9198.2024.02.004 Abstract ( 135 )   PDF (1109KB) ( 890 )   Save Objective To observe the effects of visual and audio intelligence system on freezing of gait(FOG) in the patients with Parkinson's disease(PD). Methods Based on a wearable inertial sensor equipment, a set of automatic detection and intelligent intervention system for FOG of PD was established to observe the changes of FOG through three different intervention methods including visual, audio and the combination of audio-visual. Furthermore, visual intervention with different distances and audio intervention with different step frequencies were used to intervene the specific patients. Results The wearable inertial sensor device system can detect most FOG events in real time, and the detection rate was 96.67%. The results of different intervention methods showed that compared with the non-intervention group, the FOG frequency was decreased, the maximum freezing index was reduced, and the average step length was increased after the visual intervention. After audio intervention, the FOG frequency was decreased and the turn time was shortened. After the combined intervention, the number of FOG frequency and the average duration of FOG were significantly decreased, the maximum and average freezing index were significantly reduced, and the turn time, average stride frequency and average step length were increased. Six patients showing more significant effects after visual intervention were further intervened with different laser line spacing. The results showed that the FOG frequency was decreased, average freezing index was reduced, and the step length was increased in the patients with 1-time step length compared with those with 1.5-time step length. The freezing evaluation indexes and gait evaluation indexes in the patients with 1-time step length were both improved compared with those with 2-time step length. Six patients showing more significant effects after audio intervention were further intervened with different audio step frequencies. Compared with the patients with 0.9-time audio step frequency, the number of FOG frequency and FOG duration were decreased, the average and maximum freezing index were reduced, the turn time was shortened, the average stride frequency and step length were increased in the patients with 1.1-time audio step frequency. Compared with the patients with 1-time audio step frequency, the number of FOG frequency and average freezing index were decreased, the average stride frequency and step length were increased in the patients with 1.1-time step frequency. Conclusions The combination of visual and audio intervention shows more significant relief of FOG, and the intelligent intervention could significantly shorten the duration of FOG, and improve the turn speed, stride frequency and stride length of patients. References | Related Articles | Metrics

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Analysis of incidence and risk factors of infection in elderly patients after laparoscopic cholecystectomy CHEN Wenjun, RUI Yiqi, WANG Peng, GAO Ji, BAI Jianfeng, SHI Yi 2024, 38 (2):  128-131.  doi: 10.3969/j.issn.1003-9198.2024.02.005 Abstract ( 119 )   PDF (1073KB) ( 609 )   Save Objective To investigate the incidence of postoperative infection in the elderly patients receiving laparoscopic cholecystectomy(LC), and to investigate the influencing factors. Methods A total of 140 elderly patients who underwent LC in Geriatric Hospital of Nanjing Medical University from January 2021 to December 2022 were enrolled in this study. The incidence of infection during hospitalization was recorded, and the baseline data and laboratory indicators including white blood cell count(WBC), platelet count(PLT), albumin(ALB), procalcitonin(PCT) and C-reactive protein(CRP) were collected. The influencing factors of postoperative infection in the elderly patients after LC were analyzed by Logistic regression analysis. Results Among the 140 elderly patients receiving LC, 28 cases(20%) presented with infections during hospitalization. Compared with the non-infection group, the infection group showed higher proportion of surgeries conducted more than 72 hours after admission, higher incidence rate of gallbladder stones and lower ALB level(P<0.05 or P<0.01). Logistic regression analysis showed that surgeries conducted more than 72 hours after admission, the presence of gallbladder stones, and low serum ALB level was independent risk factors for postoperative infections in the elderly patients after LC(OR=21.012, 9.082, 0.888, P<0.05). Conclusions Surgeries conducted more than 72 hours after admission, gallbladder stones and low serum ALB level can affect the incidence of postoperative infection in the elderly patients after LC. References | Related Articles | Metrics

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Correlation of serum angiotensin Ⅱ and nitric oxide levels with cognitive dysfunction in elderly patients with chronic heart failure CHENG Qing, XU Yan, CHEN Guofei, DENG Xinyue 2024, 38 (2):  132-135.  doi: 10.3969/j.issn.1003-9198.2024.02.006 Abstract ( 97 )   PDF (1304KB) ( 612 )   Save Objective To investigate the correlation of serum angiotensin Ⅱ(AngⅡ) and nitric oxide(NO) with cognitive dysfunction in the elderly patients with chronic heart failure(CHF), and to analyze the predictive value of AngⅡ and NO for cognitive dysfunction. Methods A total of 86 elderly patients with CHF admitted to Department of Cardiology in our hospital from January 2020 to December 2022 were selected. According to the score of Montreal Cognitive Assessment Scale(MoCA), the patients were divided into cognitive dysfunction group with MoCA score <26 and normal cognitive function group with MoCA score ≥ 26. The general data of the patients were collected, and the serum levels of AngⅡand NO were detected. The correlations of the levels of serum AngⅡand NO with MoCA score were analyzed by Pearson correlation coefficient, and the influencing factors of cognitive dysfunction in elderly patients with CHF were analyzed by Logistic regression. The predictive value of serum AngⅡand NO for cognitive dysfunction in the elderly patients with CHF was analyzed by receiver operating characteristic curve. Results The proportion of education length >12 years, the levels of left ventricular ejection fraction(LVEF) and NO in the cognitive dysfunction group were lower than those in the normal cognitive function group, and the serum level of Ang Ⅱ was higher than that in the normal cognitive function group(P<0.01). Logistic regression analysis showed that LVEF and NO were the protective factors of cognitive dysfunction in the elderly patients with CHF, and AngⅡ was the risk factor. Both AngⅡ and NO had predictive value for cognitive dysfunction in the elderly patients with CHF, and the combination of the two indexes had a better predictive value with the sensitivity of 82.69% and specificity of 85.29%, respectively. Conclusions The levels of AngⅡ and NO are related to the occurrence of cognitive dysfunction in the elderly patients with CHF. The combination of AngⅡ and NO has a better predictive value for the cognitive dysfunction in the elderly patients with CHF. References | Related Articles | Metrics

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Value of serum albumin for rehabilitation in elderly patients after hip fracture operation MENG Dejing, SHI Xiaoyun 2024, 38 (2):  136-140.  doi: 10.3969/j.issn.1003-9198.2024.02.007 Abstract ( 101 )   PDF (1088KB) ( 869 )   Save Objective To investigate the value of serum albumin for rehabilitation in the elderly patients after hip fracture operation. Methods A total of 100 elderly patients with hip fracture in our hospital from December 2019 to December 2021 were enrolled in this study. The serum albumin level was detected at admission, 1 day and 1 week after surgery. The rehabilitation effect was evaluated by Harris score of hip function 3 months after surgery. The clinical data and serum albumin levels of the patients with different rehabilitation effects were compared. Lasso regression and Logistic regression were used to analyze the factors affecting the postoperative rehabilitation of the patients, and receiver operating characteristic(ROC) curve was used to evaluate the efficacy in predicting rehabilitation. Results There were significant differences in age, number of comorbidity and proportion of delayed weight bearing between the patients with different rehabilitation effects(P<0.05). The serum albumin level in the patients with poor rehabilitation was lower than that in the patients with good rehabilitation one week after operation(P<0.05). Lasso regression and Logistic regression analysis showed that age, number of comorbidity, proportion of delayed weight bearing and serum albumin level 1 week after surgery were the influencing factors of postoperative rehabilitation(P<0.05). Correlation analysis showed that serum albumin level 1 week after operation was positively correlated with Harris score(P<0.05). ROC curve showed that the area under curve(AUC) of serum albumin level 1 week after surgery predicting rehabilitation effect was 0.806, and the sensitivity and specificity was 80.41% and 87.53%, respectively. Conclusions Serum albumin level is closely related to postoperative rehabilitation effect in the elderly patients with hip fracture, which can provide reference for clinical prediction of postoperative rehabilitation effect. References | Related Articles | Metrics

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Correlation of carbon monoxide diffusion with exercise tolerance, dyspnea and ventilation efficiency in patients with chronic obstructive pulmonary disease WANG Ruiping, ZHANG Ni 2024, 38 (2):  141-144.  doi: 10.3969/j.issn.1003-9198.2024.02.008 Abstract ( 99 )   PDF (1127KB) ( 706 )   Save Objective To explore the correlation of diffusion of lung for carbon monoxide(DLCO) with exercise tolerance, dyspnea and ventilation efficiency in the patients with chronic obstructive pulmonary disease(COPD). Methods A total of sixty patients with stable COPD were divided into normal DLCO group and low DLCO group according to the results of diffusion capacity per unit alveolar volume(DLCO/VA) in the first static pulmonary function examination at the time of enrollment. The static pulmonary function parameters of the two groups were collected and exercise tolerance, ventilation efficiency were tested by cardiopulmonary exercise test(CPET). The dyspnea scale(mMRC) was used to evaluate dyspnea. Pearson correlation analysis and liner regression were used to evaluate the correlation of DLCO with exercise tolerance, dyspnea and ventilation efficiency. Results The ratio of DLCO to predicted value [(DLCO/VA)/pred], Peak Load, peak oxygen uptake to predicted value(Peak VO2/pred), peak oxygen uptake per kilogram of body weight(Peak VO2/kg) in the low DLCO group were lower, while CO2 ventilation equivalent at anaerobic threshold( EQCO2@AT), mMRC score were higher than those in the normal DLCO group(P<0.01). Correlation analysis showed (DLCO/VA)/pred was positively correlated with Peak Load, Peak VO2/pred and Peak VO2/kg, while EQCO2@AT and mMRC score showed negative correlation with (DLCO/VA)/pred(P<0.05). Multiple linear regression analysis showed that (DLCO/VA)/pred was an independent predictor of respiratory distress, exercise endurance and ventilation efficiency in COPD patients(P<0.05). Conclusions DLCO is related to dyspnea, exercise endurance and ventilation efficiency in the patients with COPD. References | Related Articles | Metrics

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Analysis of efficacy and safety of azacytidine combined with homoharringtonine in treatment of chronic myelomonocytic leukemia FENG Jiangzhou, SUN Xiaoxing, JI Xiaojuan, GE Hongfeng 2024, 38 (2):  145-148.  doi: 10.3969/j.issn.1003-9198.2024.02.009 Abstract ( 101 )   PDF (1075KB) ( 538 )   Save Objective To evaluate the efficacy and safety of azacitidine combined with homoharringtonine in the treatment of chronic myelomonocytic leukemia(CMML) in the elderly. Methods A total of 40 elderly patients with CMML in our hospital from 2018 to 2022 were enrolled in this study. The patients were divided into the experimental group and the control group according to the random number table. The experimental group received azacitidine combined with homoharringtonine, and the control group received azacitidine regimen. The efficacy and safety of the two groups were analyzed and compared. Results Thirty-six patients were enrolled, with 19 cases in the experimental group and 17 cases in the control group. The overall relieve rate(ORR) of the experimental group was higher than that of the control group(82.4% vs 52.9%, P=0.041).The adverse effects showed no statistically significant differences between the two groups(P>0.05). The median survival time of the patients in the experimental group was 33.8 months, compared with 21.2 months in the control group(P<0.05). Conclusions Azacitidine combined with homoharringtonine is safe and effective in the treatment of CMML in the elderly. References | Related Articles | Metrics

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Correlation between laminin and major adverse cardiovascular events in elderly patients with acute myocardial infarction ZHANG Ying, XIE Ling, YE Jiaqi, QIANG Wenhui, YAN Xiaoyun, JIANG Ying, ZHANG Qing 2024, 38 (2):  149-151.  doi: 10.3969/j.issn.1003-9198.2024.02.010 Abstract ( 96 )   PDF (1053KB) ( 657 )   Save Objective To evaluate the prognostic value of laminin(LN) in predicting major adverse cardiovascular events(MACE) in the elderly patients with acute myocardial infarction(AMI). Methods The data of 132 elderly patients with AMI treated in our hospital were retrospectively analyzed. According to the occurrence of MACE during hospitalization, the patients were divided into the event group and the non-event group. The level of LN was detected and compared between the two groups, and the predictive value of LN on the occurrence of MACE in the elderly patients with AMI was analyzed. Results A total of 37(28.03%) cases presented with MACE in the 132 elderly patients with AMI. The level of LN in the event group was higher than that in the non-event group(P<0.01). Logistic regression analysis showed that high LN level was a risk factor for MACE in the elderly patients with AMI(OR=1.010,95%CI:1.001-1.020). Receiver operating characteristic (ROC) curve showed that the area under the curve (AUC) of LN predicting MACE in the elderly patients with AMI was 0.819. Conclusions The level of LN is associated with the occurrence of MACE in the elderly patients with AMI. References | Related Articles | Metrics

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Correlation between TyG index and left ventricular diastolic function in elderly hypertensive patients with normal ejection fraction DUAN Lidan, XI Ling, XU Jianping 2024, 38 (2):  152-156.  doi: 10.3969/j.issn.1003-9198.2024.02.011 Abstract ( 95 )   PDF (3236KB) ( 766 )   Save Objective To analyze the correlation between triglyceride-glucose (TyG)index and left ventricular diastolic function in the elderly hypertensive patients with normal ejection fraction, and to explore the influencing factors affecting diastolic function. Methods A total of 220 elderly patients with essential hypertension were randomly selected from our hospital,and they were divided into normal diastolic function group and abnormal diastolic function group. The clinical data of the patients were collected. Pearson correlation analysis was conducted to investigate the relationship between TyG index and left ventricular diastolic function, and a multiple linear regression model was established to analyze the risk factors influencing the left ventricular diastolic function. Results TyG index was positively correlated with E/e′, peak velocity of tricuspid regurgitation(TRPV) and left atrial maximum volume index(LAVI). There was no correlation between TyG index and E/A, isovolumic relaxation time(IVRT). Multiple linear regression model analysis showed that age, female, systolic blood pressure and TyG index had significant effects on E/e′ and were independent influencing factors of left ventricular diastolic function. Conclusions The increase of TyG index in the hypertensive elderly has certain clinical value in indicating the decrease of left ventricular diastolic function. References | Related Articles | Metrics

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Predictive value of different nutritional indexes on postoperative frailty in elderly patients with gastrointestinal tumors LI Jiajia, WANG Mei, WU Changmei, GENG Lan 2024, 38 (2):  157-161.  doi: 10.3969/j.issn.1003-9198.2024.02.012 Abstract ( 102 )   PDF (1099KB) ( 787 )   Save Objective To analyze the different nutritional indexes affecting postoperative frailty in the elderly patients with gastrointestinal tumor, and to explore their predictive value for frailty. Methods A total of 315 elderly patients with gastrointestinal tumors were enrolled in this study from the surgical ward of the First Affiliated Hospital of Anhui Medical University from December 2021 to July 2022. According to the Chinese version of Tilburg scale, the patients were divided into frailty group(n=180) and non-frailty group(n=135). The demographic data, disease data and nutrition-related data of the two groups were collected. Multivariate Logistic regression analysis was used to analyze the influencing factors of postoperative frailty in the elderly patients with gastrointestinal tumors. Receiver operating characteristic(ROC) curve of different nutritional indexes to predict postoperative frailty was drawn, and the area under ROC curve(AUC) was calculated to compare the predictive value of the nutritional indexes. Results There were significant differences in age, body mass index(BMI), preoperative frailty, tumor location, operation mode, pathological stage, geriatric nutritional risk index(GNRI), prognostic nutritional index(PNI), hemoglobin(Hb), serum albumin(ALB) and nutritional risk screening 2002(NRS2002) score between the two groups(P<0.01). Logistic regression analysis showed that tumor location, GNRI, Hb and NRS2002 score were the independent influencing factors of postoperative frailty in the elderly patients with gastrointestinal tumors(P<0.05). The AUC of GNRI, Hb and NRS2002 in predicting postoperative frailty in the elderly patients with gastrointestinal tumors was 0.827(95%CI: 0.781-0.867), 0.767(95%CI: 0.717-0.813) and 0.699(95%CI: 0.645-0.749), respectively. The AUC of GNRI was greater than that of Hb(Z=2.112, P=0.035) and NRS2002(Z=3.665, P<0.001). Conclusions The assessment of preoperative nutritional status of elderly patients with gastrointestinal tumors by GNRI, Hb and NRS2002 can be used to predict postoperative frailty. GNRI may have the strongest predictive ability. References | Related Articles | Metrics

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Effect of Thera-Band elastic band on lower limb motor function in the patients with post-stroke hemiplegia DING Zhiqing, YANG Xiang, YAN Yuhan, LIU Beibei, LIU Zhenzhen, XIE Caizhong 2024, 38 (2):  162-165.  doi: 10.3969/j.issn.1003-9198.2024.02.013 Abstract ( 99 )   PDF (1064KB) ( 598 )   Save Objective To investigate the effect of Thera-Band elastic band resistance training on lower limb motor function in the patients with post-stroke hemiplegia. Methods Sixty patients with post-stroke hemiplegia admitted to our hospital from January 2022 to April 2023 were enrolled in this study, and were randomly divided into the observation group and the control group, with 30 cases in each group. The control group received routine rehabilitation treatment, and the observation group received Thera-Band resistance training on the basis of the control group. The simplified Fugl-Meyer Lower limb Motor Function Assessment(FMA), Berg Balance Scale(BBS), Timing up-and-go test(TUGT) and modified Barthel index(MBI) were evaluated before and after rehabilitation. Results After treatment, the scores of FMA, BBS, TUGT and MBI in the two groups were significantly improved(P<0.05), especially in the observation group(P<0.05). Conclusions Thera-Band elastic band can improve lower limb motor function, walking and balance function, self-care ability in the patients with post-stroke hemiplegia, which is worthy of further clinical promotion. References | Related Articles | Metrics

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Correlation between ultrasonic imaging features and molecular subtypes of elderly breast cancer ZHAO Yuzhe, WU Tianqi, ZHAO Yiran, NING Dianbin 2024, 38 (2):  166-170.  doi: 10.3969/j.issn.1003-9198.2024.02.014 Abstract ( 90 )   PDF (1086KB) ( 350 )   Save Objective To analyze the ultrasonic imaging features of different molecular subtypes of breast cancer in the elderly. Methods The clincal data of 117 elderly patients with breast cancer confirmed by pathology who underwent breast ultrasonic examination were retrospectively analyzed. The molecular typing of the patients were determined by the result of immunocytochemistry. The pathological characteristics, histological grading and ultrasonic imaging features of elderly breast cancer with different molecular subtypes were observed and compared. Results Among 117 patients, 70 cases presented with Luminal A type, 14 cases presenting with Luminal B type, 12 cases presenting with human epidermal growth factor receptor 2(HER-2) positive type and 21 cases presenting with triple-negative type. Invasive ductal carcinoma was the main pathological type among the patients with different molecular subtypes. The difference of histological grading among invasive ductal carcinoma patients with different molecular subtypes was statistically significant(χ2=19.700, P<0.001). According to the result of ultrasonic examination in the elderly patients with breast cancer, there were significant differences in the tumor morphology, tumor margin, internal calcification, posterior echo and axillary lymph node among the patients with different molecular subtypes(P<0.05); While there were no significant differences in tumor size, aspect ratio, internal echo and blood flow(P>0.05). Conclusions There is a certain correlation between the ultrasonic imaging features and molecular subtypes in the elderly patients with breast cancer. The ultrasonic imaging can be helpful to determine the molecular typing of elderly breast cancer. References | Related Articles | Metrics

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Predictive value of peripheral blood neutrophil to lymphocyte ratio on prognosis for elderly patients with metastatic esophageal cancer after immunotherapy ZHU Wugang, ZHAI Chentong, LIU Degan, XU Wenjing 2024, 38 (2):  171-175.  doi: 10.3969/j.issn.1003-9198.2024.02.015 Abstract ( 78 )   PDF (1291KB) ( 679 )   Save Objective To evaluate the predictive value of peripheral blood neutrophil/lymphocyte ratio(NLR) on the prognosis of the elderly patients with metastatic esophageal cancer who received immunotherapy. Methods The clinical data of 116 elderly patients with metastatic esophageal cancer before immunotherapy were retrospectively analyzed. The optimal critical value of NLR was determined by X-tile software, and single factor and multiple factor Cox regression model was used to analyze the influencing factors for prognosis. Kaplan-Meier method was used to plot survival curves for relevant risk factors. Results The optimal threshold value of NLR before treatment was 2.8, according to which the patients were divided into low NLR group and high NLR group. Cox regression showed that NLR and Eastern Cooperative Oncology Group(ECOG) score before treatment were the independent risk factors for the prognosis of the elderly patients with metastatic esophageal cancer after immunotherapy. NLR<2.8 before treatment was associated with longer progression free survival (PFS) (P<0.001) and longer overall survival (OS) (P<0.001). Conclusions The NLR level can predict the efficacy of immunotherapy in the elderly patients with metastatic esophageal cancer, and may be a simple, economical, and effective prognostic indicator. References | Related Articles | Metrics