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20 October 2024, Volume 38 Issue 10 Previous Issue    Next Issue

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Effects of alexithymia and social support on anhedonia and depressive symptoms in elderly patients with late-life depression ZHANG Jian, JIANG Chenguang, YUAN Yonggui 2024, 38 (10):  997-1001.  doi: 10.3969/j.issn.1003-9198.2024.10.007 Abstract ( 87 )   PDF (1115KB) ( 460 )   Save Objective To investigate the effects of alexithymia and social support on anhedonia and depressive symptoms in the elderly patients with late-life depression (LLD). Methods A total of 216 elderly LLD patients aged ≥60 years who visited Psychosomatic Medicine Department of Zhongda Hospital, Southeast University, from 2020 to 2023 were assessed using the 17-item Hamilton Depression Rating Scale (HAMD-17), the Snaith-Hamilton Pleasure Scale (SHAPS), the Toronto Alexithymia Scale (TAS), and the Social Support Rating Scale (SSRS).The relationships of the variables were explored by Pearson correlation analysis. The structural equation model (SEM) containing alexithymia, social support, anhedonia and depressive symptoms was constructed and analyzed by path analysis. Results The score of TAS was positively correlated with the scores of HAMD-17(r=0.294, P<0.001) and SHAPS (r=0.455, P<0.001), and negatively correlated with the score of SSRS (r=-0.210, P=0.002). The score of SSRS was negatively correlated with the scores of HAMD-17 (r=-0.299, P<0.001) and SHAPS (r=-0.230, P=0.001). The path analysis showed that the more severe alexithymia,the more severe depressive symptoms and anhedonia, while lower level of social support was associated with more severe alexithymia, depressive symptoms, and anhedonia. The final model showed good fit (χ2=0.211, df=1, χ2/df=0.211, RMSEA<0.001, CFI=1.000, GFI=1.000). Conclusions Enhancing social support can mitigate alexithymia and depressive symptoms, thereby improving the overall psychological health of LLD patients. References | Related Articles | Metrics

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Correlation of triglyceride-glucose index with low-density lipoprotein subtypes in elderly patients with type 2 diabetes mellitus WANG Su, ZHAO Yijing, WEI Chenmin, CHEN Kun, CAO Wen, WANG Kun, YANG Yu 2024, 38 (10):  1002-1006.  doi: 10.3969/j.issn.1003-9198.2024.10.008 Abstract ( 98 )   PDF (1271KB) ( 369 )   Save Objective To investigate the correlation between triglyceride-glucose (TyG) index and low-density lipoprotein (LDL) subtypes in the elderly patients with type 2 diabetes mellitus (T2DM). Methods The clinical data of 360 elderly T2DM patients admitted to Affiliated Jiangning Hospital of Nanjing Medical University from January 2022 to March 2023 were analyzed retrospectively. The correlation between TyG index and LDL subtypes was analyzed, and the cut-off value of elevated small dense low-density lipoprotein cholesterol (sdLCL-C) level was defined by receiver operating characteristic (ROC) curve analysis. Results All patients were divided into 4 groups according to the quartiles of TyG index level. The level of TyG index was positively correlated with LDL-C3, LDL-C4, LDL-C5, LDL-C6 and LDL-C7 (P<0.01), and negatively correlated with LDL-C1 and LDL-C2 (P<0.01). Logistic regression analysis showed a significant positive correlation between TyG index level and high sdLDL-C level. The cut-off value of TyG index to predict the occurrence of high sdLDL-C was 9.0, and the area under the curve was 0.70. Conclusions In the elderly patients with T2DM, TyG index is closely related to sdLDL-C level, which may be a simple and feasible clinical indicator to recognize the increase of the level of sdLDL-C. References | Related Articles | Metrics

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Efficacy of Huangkui capsule combined with semaglutide in the treatment of diabetic nephropathy in the elderly LI Yuhan, LI Da, WU Hengyu 2024, 38 (10):  1007-1010.  doi: 10.3969/j.issn.1003-9198.2024.10.009 Abstract ( 73 )   PDF (1122KB) ( 364 )   Save Objective To analyze the clinical effects of Huangkui capsule combined with semaglutide in the treatment of diabetic nephropathy in the elderly. Methods A total of 102 elderly patients with diabetic nephropathy treated in Lianyungang First People’s Hospital from June 2021 to August 2023 were selected and divided into control group and study group by random number table method, with 51 cases in each group. The control group was treated with semaglutide, and the study group was treated with Huangkui capsule on the basis of the control group. Both groups were treated for 3 months. The levels of blood glucose and renal function, clinical efficacy, inflammatory reactions and adverse reactions were compared between the two groups. Results After treatment, the levels of glycosylated hemoglobin (HbA1c), 2 h postprandial plasma glucose (2hPPG) and fasting plasma glucose (FPG) in the two groups were significantly decreased (P<0.05), with no significant differences between the two groups (P>0.05). After treatment, the levels of serum creatinine, urinary albumin-to-creatinine ratio (UACR) and 24 h urinary protein quantity (24hUTP) in the two groups were significantly decreased (P<0.05), especially in the study group (P<0.05). The total effective rate in the study group was higher than that in the control group (90.20% vs. 72.55%, P<0.05). After treatment, the levels of serum transforming growth factor β (TGF-β), intercellular cell adhesion molecule-1 (ICAM-1) and high mobility group protein B1 (HMGB1) in the two groups were significantly decreased (P<0.05), especially in the study group (P<0.05). There was no difference in the total incidence rate of adverse reactions between the two groups (P>0.05). Conclusions Semaglutide combined with Huangkui capsule can protect renal function in the elderly patients with diabetic nephropathy, reduce inflammatory response and maintain stable blood glucose, with significant effect and good safety. References | Related Articles | Metrics

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Effect of Feilike Mixture combined with tiotropium bromide powder aerosol in elderly patients aged≥80 years old with chronic obstructive pulmonary disease ZHOU Yun, ZHANG Yingying, GAO Yanfen 2024, 38 (10):  1011-1015.  doi: 10.3969/j.issn.1003-9198.2024.10.010 Abstract ( 90 )   PDF (1090KB) ( 269 )   Save Objective To observe the effect of Feilike Mixture combined with tiotropium bromide powder aerosol in elderly patients aged≥80 years old with chronic obstructive pulmonary disease (COPD). Methods From May 2016 to January 2021, 86 elderly patients with COPD were selected and divided into the study group (n=43) and the control group (n=43) by random number table method. Both groups received basic treatment, and the control group received tiotropium bromide powder inhalation, and the study group received Feilike mixture treatment on the basis of the control group. Both groups were treated for 2 weeks. Lung function, immune function, cytokine level, clinical efficacy, relevant scale score and adverse reactions were compared between the two groups. Results After treatment, the levels of peak expiratory flow rate (PEF), forced expiratory volume in 1 second (FEV1), FEV1/ forced vital capacity (FVC), CD3+ and CD4+, helper T cell 17 (Th17)/regulatory T cell (Treg),interleukin-10 (IL-10) and the scores of Health Survey Summary Form (SF-36) were all significantly increased in both groups (P<0.05), especially in the study group (P<0.05). After treatment, the levels of CD8+and IL-17,the score of chronic obstructive pulmonary disease assessment test (CAT) were significantly decreased in both groups (P<0.05), especially in the study group (P<0.05). The total effective rate in the study group was significanthy higher than that in the control group (95.35% vs. 79.07%, P<0.05). There was no difference in the total incidence rate of adverse reactions between the two groups (P>0.05). Conclusions Feilike Mixture combined with tiotropium bromide powder aerosol is effective in the treatment of COPD in the elderly patients aged ≥80 years old, which can safely improve the immune function, lung function and quality of life of the patients, and reduce inflammation and regulate Th17/Treg balance. References | Related Articles | Metrics

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Clinical effect of high tibial osteotomy combined with intraarticular ozone injection for knee osteoarthritis QIAO Ningning, REN Xinhua, GUAN Xiaorui, CHENG Fei, LI Zhiqiang 2024, 38 (10):  1016-1019.  doi: 10.3969/j.issn.1003-9198.2024.10.011 Abstract ( 67 )   PDF (1119KB) ( 332 )   Save Objective To investigate the clinical effect of combined treatment of intraarticular injection of medical ozone and high tibial osteotomy (HTO) for knee osteoarthritis. Methods A total of 84 elderly patients with KOA admitted to 541 General Hospital from January 2020 to January 2022 were randomly divided into group A (n=42) and group B (n=42). Group A was treated with HTO, and group B was treated with intraarthroscopic injection of medical ozone before HTO. The operation status, pain degree, knee joint function, gait index and postoperative complications were recorded and compared between the two groups. Results The scores of visual analogue scale (VAS) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and the biphase levels in the two groups were gradually decreased after surgery (P<0.05), and especially in group B (P<0.05). The medial proximal tibial angle (MPTA) was reduced in both groups after the surgery (P<0.05), especially in group A (P<0.05); The knee function score, joint range of motion (ROM), step length, step speed and step frequency were increased in both groups after surgery (P<0.05), especially in group B (P<0.05). There was no significant difference in the incidence rate of adverse reactions between the two groups (P>0.05). Conclusions Preoperative treatment with medical ozone intraarticular injection can further improve the gait index and knee joint function in the patients with KOA, relieve the patients’ pain, and have high safety. References | Related Articles | Metrics

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Clinical effect analysis of routine rehabilitation combined with intensive hip training after full spinal endoscopy in elderly patients SONG Hanjing, SUN Wenjiang, YU Bo 2024, 38 (10):  1020-1024.  doi: 10.3969/j.issn.1003-9198.2024.10.012 Abstract ( 70 )   PDF (1086KB) ( 170 )   Save Objective To analyze the clinical effect of routine rehabilitation combined with intensive hip training in the elderly patients after full spinal endoscopy. Methods Sixty patients with lumbar disc herniation undergoing full spinal endoscopic surgery from August 2021 to August 2022 were enrolled in this study. Among them, 28 patients in observation group were treated with routine rehabilitation and intensive hip training after operation, and 32 patients in control group were only treated with routine rehabilitation after surgery. The scores of visual analogue scale (VAS), Oswestry Disability Index (ODI), Japanese Orthopaedic Society Scale (JOA) and Barthel index (BI) were recorded before and 3 months after surgery. Results The VAS scores of low back pain and lower extremity pain in both groups were all significantly relieved 3 months after surgery. The JOA score and BI in observation group were significantly higher than those in control group(P<0.05), and the ODI score in observation group was significantly lower than that in control group (P<0.05). Conclusions Routine rehabilitation combined with intensive hip training can improve the low back pain in the elderly patients receiving full spinal endoscopy and accelerate postoperative rehabilitation. References | Related Articles | Metrics

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Efficacy of dapagliflozin in elderly patients undergoing coronary intervention with type 2 diabetes mellitus and ejection fraction reduced heart failure GU Chonghuai, XIANG Xuejun, ZHENG Yuanxi, QIAO Rui, LIN Song 2024, 38 (10):  1025-1029.  doi: 10.3969/j.issn.1003-9198.2024.10.013 Abstract ( 71 )   PDF (1084KB) ( 216 )   Save Objective To investigate the efficacy of dapagliflozin in the elderly patients with heart failure with reduced ejection fraction (HFrEF) complicated with type 2 diabetes mellitus (T2DM) who underwent percutaneous coronary intervention (PCI). Methods The clinical data of 80 elderly patients with coronary heart disease complicated with T2DM and HFrEF who were hospitalized in Department of Cardiovascular Medicine of Anqing Municipal Hospital from November 2019 to November 2022 were retrospectively analyzed.The patients were divided into dapagliflozin group (n=44) and control group (n=36) according to whether they used dapagliflozin or not. The incidence of major adverse cardiovascular events (MACEs) during hospitalization and follow-up period was recorded and analyzed in each group. Results There were no significant differences in the clinical baseline data between the two groups (P>0.05). However, the overall incidence rate of MACEs was significantly lower in dapagliflozin group than that in control group (4.54% vs. 19.44%, P=0.036). Cox regression analysis showed that the use of dapagliflozin was a strong protective factor for MACEs in the elderly patients with HFrEF complicated with T2DM (HR=0.030, 95%CI:0.010-0.921). Conclusions Dapagliflozin is a protective factor in the elderly patients with HFrEF complicated with T2DM undergoing PCI,which could reduce the incidence rate of medium and long-term MACEs. References | Related Articles | Metrics

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Effects of sacubitril valsartan sodium in elderly patients with chronic heart failure LIU Jin, HUANG Yanqiu, ZHU Yi, ZHUO Lili 2024, 38 (10):  1030-1033.  doi: 10.3969/j.issn.1003-9198.2024.10.014 Abstract ( 79 )   PDF (1125KB) ( 384 )   Save Objective To analyze the effects of sacubitril valsartan sodium on the efficacy and overall function in the elderly patients with chronic heart failure (CHF). Methods A retrospective analysis was conducted in 80 patients with CHF from August 2020 to July 2023. These patients were divided into two groups according to the treatment methods, with 40 patients in each group. The control group was treated with enalapril, whereas the observation group was treated with sacubitril valsartan sodium. Before and after treatment, the scores of comprehensive geriatric assessment (CGA), the levels of renal function indicators, B-type natriuretic peptide (BNP) and echocardiography parameters were detected and compared between the two groups, and rehospitalization rate due to heart failure and the incidence rate of adverse reactions during treatment were recorded and compared between the two groups. Results Before treatment, there were no significant differences between the two groups in the scores of CGA, and the levels of renal function indicators, BNP and echocardiography parameters (P>0.05). After treatment, the scores of Activity of Daily Living scale and Hamilton Anxiety Scale and the levels of renal function indicators in the observation group were better than those in the control group. The levels of BNP, left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD) were significantly lower than those in the control group (P<0.05), while the levels of left ventricular ejection fraction (LVEF) and left ventricular fraction shortening (LVFS) were significantly higher than those in the control group (P<0.05). The rate of heart failure rehospitalization and the incidence rate of adverse reactions were significantly lower in the observation group than those in the control group (P<0.05). There were no differences in the scores of Mini-Mental State Examination, Hamilton Depression Scale and Nutrition Risk Screening 2002 between the two groups (P>0.05). Conclusions During the treatment period, sacubitril valsartan sodium can safely improve cardiac and renal function and daily living ability, reduce anxiety and the rehospitalization rate in the elderly patients with CHF. References | Related Articles | Metrics

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Effects of accelerated rehabilitation with eight section brocade on early ambulation in elderly gastric cancer patients CAI Hui, WANG Qing, HU Jincao, WANG Yan, HAN Xiaoling 2024, 38 (10):  1034-1038.  doi: 10.3969/j.issn.1003-9198.2024.10.015 Abstract ( 60 )   PDF (1084KB) ( 210 )   Save Objective To evaluate the effect of accelerated rehabilitation with eight section brocade on early ambulation in the elderly patients with gastric cancer underwent operation. Methods A total of 61 elderly patients with gastric cancer who received laparoscopic radical gastrectomy from March 2020 to June 2022 in Jiangsu Province Hospital of Traditional Medicine were enrolled in this study, and were divided into control group (30 cases) and study group (31 cases). The control group received routine enhanced recovery after surgery (ERAS) during the perioperative period, while the study group received eight section brocade for accelerated rehabilitation based on routine ERAS. The first postoperative ambulation time, anal exhaust and defecation time, oral feeding time, hospital stay, the incidence rate of postoperative complications and adverse events were recorded and compared between the two groups. Results There were no statistically significant differences in age and gender between the two groups before intervention (P>0.05); The first postoperative ambulation time was shorter in the study group than that in the control group (P<0.05); The early ambulation compliance rates 24, 48, 72 h after operation in the study group were higher than those in the control group (P<0.05). There were no statistically significant differences in the incidence rates of postoperative complications and activity-related adverse events between the two groups (P>0.05). Conclusions Eight section brocade can safely promote early ambulation and promote postoperative gastrointestinal function recovery in the elderly patients with gastric cancer. References | Related Articles | Metrics

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Effects of intraoperative subanesthetic dose of esketamine on early postoperative cognitive dysfunction in elderly patients undergoing spinal surgery SUN Li, YIN Weihong, JING Jun, QIAN Xiali 2024, 38 (10):  1039-1043.  doi: 10.3969/j.issn.1003-9198.2024.10.016 Abstract ( 73 )   PDF (1091KB) ( 306 )   Save Objective To investigate the effects of intraoperative subanesthetic dose of esketamine on early postoperative cognitive dysfunction (POCD) and the expression of triggering receptor expressed on myeloid cells 1 (TREM1) and TREM2 in the elderly patients undergoing spinal surgery. Methods From October 2022 to September 2023, 60 elderly patients who underwent spinal surgery under general anesthesia were selected and divided into observation group (n=30) and control group (n=30) according to random number table method. The patients in observation group were intravenously injected with esketamine 0.2 mg/kg, while the patients in control group were treated with the same amount of saline before anesthesia induction. Two groups received the same anesthetic drugs. The levels of mean arterial pressure (MAP), heart rate (HR), regional oxygen saturation (rSO2), Montreal cognitive assessment (MoCA) score, TREM1 and TREM2 were observed and compared between the two groups before and after anesthesia. The incidences of POCD and adverse reactions were also recorded. Results The MoCA scores in observation group 1, 3, 7 d after the surgery were significantly higher than those in control group (P<0.05). The level of TREM2 showed no significant change in the two groups after the operation (P>0.05). The level of TREM1 showed no significant change in observation group after the operation. Compared with observation group, the level of TREM1 in control group was significantly increased 24 h and 72 h after the operation (P<0.05). At each time point after anesthesia induction, the level of rSO2 in observation group was significantly higher than that in control group (P<0.05), and there were no significant differences in the levels of MAP and HR between the two groups. The incidence rate of early POCD in observation group was significantly lower than that in control group (6.7% vs 30.0%,P<0.05). Conclusions The sub-anesthetic dose of esketamine can maintain a higher rSO2 in the elderly patients undergoing spinal surgery after anesthesia without obvious effect on the intraoperative circulation; At the same time, it can inhibit the upregulation of the level of TREM1 in peripheral blood, reduce the inflammatory reactions and the incidence of the early POCD in the elderly patients after spinal surgery. References | Related Articles | Metrics

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Study on expression of serum IL-33/sST2 axis in elderly patients with acute exacerbation of COPD and its predictive value for prognosis LEI Wanfeng, MA Xiuhong 2024, 38 (10):  1044-1048.  doi: 10.3969/j.issn.1003-9198.2024.10.017 Abstract ( 66 )   PDF (1326KB) ( 227 )   Save Objective To investigate the expression of serum interleukin-33 (IL-33)/soluble ST2 (sST2) axis in the elderly patients with acute exacerbation chronic obstructive pulmonary disease (AECOPD) and its prognostic value. Methods A total of 138 elderly patients with AECOPD admitted to Beijing Huairou Hospital from June 2019 to June 2022 were enrolled in the study group, and 138 elderly patients with stable COPD admitted to our hospital during the same period were enrolled in the control group. The serum levels of IL-33, sST2, IL-4 and IL-10 were detected and compared between the two groups, and the patients in the study group were divided into good prognosis group and poor prognosis group. Logistic regression analysis was used to evaluate the risk factors affecting the prognosis of the elderly patients with AECOPD, and receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of serum IL-33, sST2, IL-4 and IL-10 levels for the prognosis of the elderly patients with AECOPD. Results The levels of IL-33 and sST2 in the study group were higher and the levels of IL-4 and IL-10 were lower in the study group than those in the control group (P<0.05). Among the 138 patients in the study group, 9 cases( 6.52%) were lost to follow-up. Among the 129 patients, 30 cases (23.26%) presented with poor prognosis. The levels of serum IL-33 and sST2, course of disease and proportion of complications number ≥2 in the poor prognosis group were higher than those in the good prognosis group (P<0.05), and the levels of IL-4 and IL-10 were lower than those in the good prognosis group (P<0.01). Logistic regression analysis showed that the levels of IL-33 and sST2, course of disease and complications number ≥2 were independent risk factors, and IL-4 and IL-10 were protective factors for poor prognosis in the elderly patients with AECOPD (P<0.05). ROC curve showed that the area under the curve of combined detection of serum IL-33, sST2, IL-4 and IL-10 predicting poor prognosis in the elderly patients with AECOPD was 0.864, which was higher than that of serum IL-33, sST2, IL-4 and IL-10 alone (P<0.05). Conclusions The abnormal expression of serum IL-33, sST2, IL-4 and IL-10 is closely related to the prognosis in the elderly patients with AECOPD, and the combined detection of these indicators has a higher predictive value for the poor prognosis of the elderly patients with AECOPD. References | Related Articles | Metrics

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Relationship of ApoB/ApoA1 ratio and triglyceride glucose index with severity and prognosis of traumatic brain injury in the elderly LI Guangyao, YE Bihua, LI Xiaoliang, TANG Qin, LIU Cuihua 2024, 38 (10):  1049-1053.  doi: 10.3969/j.issn.1003-9198.2024.10.018 Abstract ( 68 )   PDF (1320KB) ( 359 )   Save Objective To investigate the relationship of apolipoprotein B (ApoB)/apolipoprotein A1 (ApoA1) ratio, triglyceride-glucose (TyG) index with the severity and prognosis of traumatic brain injury (TBI) in the elderly. Methods A retrospective study was conducted. A total of 112 patients with TBI (TBI group) and 79 healthy volunteers (control group) in Mianyang Central Hospital from January 2018 to January 2023 were selected. The patients with TBI were divided into moderate group (64 cases) and severe group (48 cases) according to the score of Glasgow Outcome Scale (GCS) at admission. The neurological prognosis was assessed by Glasgow Prognosis Scale (GOS) 6 months after discharge. According to GOS score, the patients with TBI were divided into poor prognosis group (23 cases) and good prognosis group (89 cases). The clinical data were collected, and ApoB/ApoA1 ratio and TyG index were calculated. Pearson correlation analysis was used to analyze the correlation of ApoB/ApoA1 ratio and TyG index with insulin resistance (HOMA-IR) and GCS score, and multivariate Logistic regression analysis was conducted to analyze the factors affecting the prognosis of TBI. Receiver operating characteristic (ROC) curve analysis was used to analyze the value of ApoB/ApoA1 ratio and TyG index in predicting prognosis of TBI. Results ApoB/ApoA1 ratio, TyG index and HOMA-IR in TBI group were significantly higher than those in control group (P < 0.05), and were significantly higher in severe group than those in moderate group (P < 0.05). The ApoB/ApoA1 ratio and TyG index were negatively correlated with GCS score (P < 0.05), and positively correlated with HOMA-IR in the patients with TBI (P < 0.05). Ventricular hemorrhage, high ApoB/ApoA1 ratio, high TyG index and high HOMA-IR were risk factors for poor prognosis in TBI patients (P < 0.05). The area under the curve of ApoB/ApoA1 ratio and TyG index in predicting the prognosis of TBI was 0.744 and 0.755, which was close to HOMA-IR (0.794, P>0.05); The area under the curve of combination of ApoB/ApoA1 ratio, TyG index and HOMA-IR in predicting the prognosis of TBI patients was 0.888, which was higher than them alone (P < 0.05). Conclusions Increased ApoB/ApoA1 ratio and TyG index in the elderly patients with TBI are associated with aggravated nerve injury and poor prognosis. Detection of ApoB/ApoA1 ratio and TyG index is helpful to assess the risk of poor prognosis in the elderly patients with TBI. References | Related Articles | Metrics

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Study on feasibility of dual-low-dose CT coronary angiography in elderly patients XU Shouyong, YUAN Yong 2024, 38 (10):  1054-1058.  doi: 10.3969/j.issn.1003-9198.2024.10.019 Abstract ( 69 )   PDF (1400KB) ( 134 )   Save Objective To analyze the feasibility of dual-low-dose coronary computed tomography angiography (CCTA) with low tube voltage and low contrast agents in the elderly patients. Methods This study consecutively enrolled the elderly patients who underwent CCTA examination in Geriatric Hospital of Nanjing Medical University from March 1, 2021 to August 31, 2021. The patients were randomly divided into two groups. Routine-dose group underwent routine-dose scanning with tube voltage of 100 kVp and contrast dose of 70 mL, and dual-low-dose group underwent dual-low-dose scanning with low tube voltage of 70 kVp and low contrast dose of 30 mL. The two groups were further divided into four subgroups according to whether the heart rate was >70 beats/min or whether the body mass index (BMI) was >25. The CCTA image quality and radiation dose were compared between the corresponding subgroups. Results The radiation dose in all subgroups of dual-low-dose group was significantly lower than that in the corresponding subgroup of routine-dose group(P<0.01). The coronary artery luminal CT value, image noise, signal-to-noise ratio, contrast-to-noise ratio and the overall subjective mean score of coronary artery showed no significant differences between the subgroups with BMI≤25 of dual-low-dose group and the corresponding subgroups of routine-dose group(P＞0.05). The coronary artery luminal CT value and the overall subjective mean score of coronary artery showed no significant differences(P＞0.05), while image noise, signal-to-noise ratio, contrast-to-noise ratio showed significant differences between the subgroup with heart rate ≤70 beats/min,BMI＞25 of dual-low-dose group and the corresponding subgroup of routine-dose group(P＜0.01 or 0.05).All the subjective and objective image quality indicators showed significant differences between the subgroup with heart rate ＞70 beats/min,BMI＞25 of dual-low-dose group and the corresponding subgroup of routine-dose group(P＜0.01 or 0.05). Conclusions In the elderly, BMI shows obvious effects on the image quality of dual-low-dose CCTA examination. The elderly patients with BMI ≤ 25 are suitable for dual-low-dose CCTA examination with low tube voltage and low contrast agents. References | Related Articles | Metrics

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Distribution characteristics of helper T cell subsets and its correlation with airway hyperrespon-siveness in elderly patients with subacute cough HE Huiqiong, WU Xi, ZHANG Yijie, CHEN Zhenmin, TANG Xiaojuan 2024, 38 (10):  1059-1063.  doi: 10.3969/j.issn.1003-9198.2024.10.020 Abstract ( 55 )   PDF (1096KB) ( 188 )   Save Objective To investigate the distribution characteristics of helper T lymphocyte subsets in the elderly patients with subacute cough and the correlation with airway hyperresponsiveness. Methods A total of 201 elderly patients with subacute cough treated in the General Hospital of Western Theater Command PLA from June 2021 to June 2023 were enrolled in this study. According to the grade of airway hyperresponsiveness, the patients were divided into mild airway hyperresponsiveness group (n=94) and severe airway hyperresponsiveness group (n=107). The general data and biochemical data of the two groups were compared. Multivariate Logistic regression analysis was used to analyze the risk factors for the degree of airway hyperresponsiveness in the elderly patients with subacute cough. Generalized linear mixed models (GLMMs) was used to analyze the relationships between the levels of T helper cell subsets and the degree of airway hyperresponsiveness in the elderly patients with subacute cough. Results There were significant differences in age, gender, laryngeal pruritis, recurrent respiratory tract infection, rhinitis, tracheal foreign body, CD3+, CD4+ and CD8+T lymphocytes, forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC, interleukin-25 (IL-25), IL-33 and fractional exhaled nitric oxide (FENO) between the two groups (P<0.05). Logistic regression analysis showed that recurrent respiratory infections, decreased levels of CD3+ and CD4+ T lymphocytes, and increased levels of CD8+ T lymphocytes, FEV1, IL-25, IL-33, and FENO were the risk factors for severe airway hyperreactivity hyperresponsiveness in the elderly patients with subacute cough (P<0.05). GLMMs analysis showed that the lower levels of CD3+ and CD4+ T lymphocytes and the higher levels of CD8+ T lymphocytes, the greater risk of aircoay hyperresponsiveness in the elderly patients with subacute couth(P<0.01). Conclusions The levels of peripheral blood CD3+ and CD4+ T lymphocytes are lower and the level of CD8+ T lymphocytes is higher in the patients with severe airway hyperresponsiveness than those in the patients with mild airway hyperresponsiveness, and the levels of CD3+, CD4+ and CD8+ T lymphocytes are correlated with the degree of airway hyperresponsiveness in the elderly patients with subacute cough. References | Related Articles | Metrics