Pub Date : 2020-02-20DOI: 10.3760/CMA.J.ISSN.0254-9026.2020.02.001
Qiong Chen, Weiwei Yu, Lijing Wang, H. Xi, Qiang Zhang, Xinyu Chen, Kui Huang, Xiang Lu, Xinmin Liu, Cun-yuan Zhang, Jianye Wang
The population is commonly susceptible to the 2019 novel coronavirus(2019-nCoV), especially the elderly with comorbidities. Elderly patients infected with 2019-nCoV tend to have higher rates of severe illnesses and mortality. Immunoaging is an important cause of severe novel coronavirus pneumonia(NCP)in the elderly.Due to the combination of underlying diseases, elderly patients may exhibit a typical manifestations in clinical symptoms, supplementary examinations and pulmonary imaging, deserving particular attention. The general condition of the elderly should be considered during diagnosis and treatment. In addition to routine care and measures such as oxygen therapy, antiviral therapy and respiratory support, treatment of underlying disease, nutritional support, sputum expectoration, complication prevention and psychological support should also be considered for elderly patients. Based on literature review and expert panel discussion, we drafted the Key Points for the Prevention and Treatment of the Novel Coronavirus Pneumonia in the elderly, aiming to provide help with the prevention and treatment of NCP and the reduction of harm to the elderly population. Key words: 2019 Novel coronavirus(2019-nCoV); Pneumonia; Prevention and treatment; The elderly
{"title":"Key points for the prevention and treatment of the novel coronavirus pneumonia in the elderly","authors":"Qiong Chen, Weiwei Yu, Lijing Wang, H. Xi, Qiang Zhang, Xinyu Chen, Kui Huang, Xiang Lu, Xinmin Liu, Cun-yuan Zhang, Jianye Wang","doi":"10.3760/CMA.J.ISSN.0254-9026.2020.02.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2020.02.001","url":null,"abstract":"The population is commonly susceptible to the 2019 novel coronavirus(2019-nCoV), especially the elderly with comorbidities. Elderly patients infected with 2019-nCoV tend to have higher rates of severe illnesses and mortality. Immunoaging is an important cause of severe novel coronavirus pneumonia(NCP)in the elderly.Due to the combination of underlying diseases, elderly patients may exhibit a typical manifestations in clinical symptoms, supplementary examinations and pulmonary imaging, deserving particular attention. The general condition of the elderly should be considered during diagnosis and treatment. In addition to routine care and measures such as oxygen therapy, antiviral therapy and respiratory support, treatment of underlying disease, nutritional support, sputum expectoration, complication prevention and psychological support should also be considered for elderly patients. Based on literature review and expert panel discussion, we drafted the Key Points for the Prevention and Treatment of the Novel Coronavirus Pneumonia in the elderly, aiming to provide help with the prevention and treatment of NCP and the reduction of harm to the elderly population. \u0000 \u0000 \u0000Key words: \u00002019 Novel coronavirus(2019-nCoV); Pneumonia; Prevention and treatment; The elderly","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"39 1","pages":"113-118"},"PeriodicalIF":0.0,"publicationDate":"2020-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41834183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Recent advances in the physical rehabilitation and reconstruction of coronary microcirculation","authors":"Shao-hua Zhao","doi":"10.3760/CMA.J.ISSN.0254-9026.2020.01.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2020.01.003","url":null,"abstract":"冠状动脉(冠脉)微循环障碍在心绞痛患者中普遍存在，相对于传统的心外膜冠脉血运重建，冠脉微循环血运重建对改善心绞痛患者的症状和预后同样重要。体外心脏震波、增强型体外反搏和远隔缺血预适应等物理康复疗法具有多靶点、多通路作用的优势，可通过改善血管内皮和平滑肌功能，促使冠脉侧支循环形成和毛细血管床开放，为冠脉微循环血运重建开辟了新的路径。","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"39 1","pages":"20-22"},"PeriodicalIF":0.0,"publicationDate":"2020-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45271601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-14DOI: 10.3760/CMA.J.ISSN.0254-9026.2020.01.016
Zhao Nan, Yufeng Du
Objective To analyze related factors for whether or not to make the living will by investigating the current status of recognition and acceptance of living will among elderly inpatients in Shanxi Province, in order to provide the evidence for promoting the living will in elderly hospitalized patients in Shanxi Province. Methods A questionnaire survey was conducted on elderly inpatients in Shanxi Province from January 2017 to December 2017, including general information(age, gender, ethnicity, religious belief, dwelling place, education and profession, children, spouse), awareness of living wills and willingness to sign documents of "My Five Wishes" . The chi-square test and Logistic regression analysis were used to analyze the related factors for elderly inpatients' willingness to sign living will documents Results The 411 elderly inpatients in Shanxi Province had a low level of cognition of living will(146 cases, 35.5%). In general socio-demographic characteristics, only education level and profession were related to the cognition of living will(χ2=12.093 and 11.906, P=0.001 and 0.008). Multivariate Logistic regression analysis showed that as compared with inpatients aged 60-69 years, inpatients aged 70-79 years(OR=0.592, 95%CI: 0.360~0.974, P=0.039)and 80-89 years(OR=0.408, 95%CI: 0.238~0.701, P=0.001)held a significantly negative attitude towards signing the living will documents.According to dwelling place, as compared with countryside, urban elderly inpatients were more willing to sign living will documents in advance(OR=2.293, 95%CI: 1.335~3.940, P=0.003). At the comparison of other occupations with medical workers, teachers(P=0.429), civil servants(P=0.068), only medical workers(OR=3.156, 95%CI: 1.419-7.020, P=0.005)were more willing to sign living will documents in advance.As comparing elderly inpatients with children, the childless elderly inpatients were more willing to sign living will documents in advance(OR=3.156, 95%CI: 1.287~7.740, P=0.012). Conclusions Elderly inpatients in Shanxi Province have a low level of cognition of living will and a poor acceptance of signing the document of "my five wishes" in advance.In order to benefit the public, we need to increase the promotion and popularization of signing documents of living will in our province. Key words: Living will; Informed consent; Medical autonomy
{"title":"Investigation on the current status of recognition and acceptance of living will in elderly inpatients in Shanxi Province","authors":"Zhao Nan, Yufeng Du","doi":"10.3760/CMA.J.ISSN.0254-9026.2020.01.016","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2020.01.016","url":null,"abstract":"Objective \u0000To analyze related factors for whether or not to make the living will by investigating the current status of recognition and acceptance of living will among elderly inpatients in Shanxi Province, in order to provide the evidence for promoting the living will in elderly hospitalized patients in Shanxi Province. \u0000 \u0000 \u0000Methods \u0000A questionnaire survey was conducted on elderly inpatients in Shanxi Province from January 2017 to December 2017, including general information(age, gender, ethnicity, religious belief, dwelling place, education and profession, children, spouse), awareness of living wills and willingness to sign documents of \"My Five Wishes\" . The chi-square test and Logistic regression analysis were used to analyze the related factors for elderly inpatients' willingness to sign living will documents \u0000 \u0000 \u0000Results \u0000The 411 elderly inpatients in Shanxi Province had a low level of cognition of living will(146 cases, 35.5%). In general socio-demographic characteristics, only education level and profession were related to the cognition of living will(χ2=12.093 and 11.906, P=0.001 and 0.008). Multivariate Logistic regression analysis showed that as compared with inpatients aged 60-69 years, inpatients aged 70-79 years(OR=0.592, 95%CI: 0.360~0.974, P=0.039)and 80-89 years(OR=0.408, 95%CI: 0.238~0.701, P=0.001)held a significantly negative attitude towards signing the living will documents.According to dwelling place, as compared with countryside, urban elderly inpatients were more willing to sign living will documents in advance(OR=2.293, 95%CI: 1.335~3.940, P=0.003). At the comparison of other occupations with medical workers, teachers(P=0.429), civil servants(P=0.068), only medical workers(OR=3.156, 95%CI: 1.419-7.020, P=0.005)were more willing to sign living will documents in advance.As comparing elderly inpatients with children, the childless elderly inpatients were more willing to sign living will documents in advance(OR=3.156, 95%CI: 1.287~7.740, P=0.012). \u0000 \u0000 \u0000Conclusions \u0000Elderly inpatients in Shanxi Province have a low level of cognition of living will and a poor acceptance of signing the document of \"my five wishes\" in advance.In order to benefit the public, we need to increase the promotion and popularization of signing documents of living will in our province. \u0000 \u0000 \u0000Key words: \u0000Living will; Informed consent; Medical autonomy","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"39 1","pages":"83-88"},"PeriodicalIF":0.0,"publicationDate":"2020-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69870400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-14DOI: 10.3760/CMA.J.ISSN.0254-9026.2020.01.004
Xinqiang Wang, Bin Li, Xiaojing Wang, Yuezhen Shen, Yanfei Chen
Objective To evaluate the cognitive impairment in elderly patients with minor ischemic stroke and to analyze risk factors for stroke recurrence. Methods This was a retrospective case-control study.Ninety-five elderly patients with acute ischemic stroke hospitalized in the neurology department of Second People's Hospital of Liaocheng were enrolled from January 2016 to January 2017.Based on the National Institutes of Health Stroke Scale(NIHSS), all cases were divided into the minor stroke group(NIHSS score≤3, n=62)and the medium-severe stroke group(NIHSS score>3, n=33). After 12-month follow-up, the NIHSS, modified Rankin scale(mRS)and Montreal cognitive assessment(MoCA)were used to evaluate the study subjects. Results Of the 95 patients, there were 62 males(65.3%)and 33 females(34.7%), with age of(68.3±6.7)years.No significant differences were found in baseline characteristics of age, male ratio, subtypes and history between two groups(all P>0.05). But, the treatment rate of intravenous thrombolysis was lower in minor stroke group than in medium-severe stroke group[6.5%(4 cases)vs.42.4%(14 cases)(P 0.05), while the rate of post stroke depression had a significant difference between two groups(P<0.05). Furthermore, there was lower rate of mortality and stroke recurrence in the minor stroke group than in the medium-severe group(0.0% or 0/62 vs.30.3% or 10/33, and 21.0% or 13/62 vs.42.4% or 14/33, P<0.05). Cox proportional hazard model showed that baseline NIHSS score, diabetes and stroke history were the risk factors for stroke recurrence in patients with minor stroke(P<0.05). Conclusions The treatment rate of intravenous thrombolysis with rt-PA, mortality rate and stroke recurrence rate are lower in patients with minor stroke than in patients with medium-severe stroke, while the incidence of post stroke cognitive impairment is high.High score of baseline NIHSS, diabetes and stroke history are risk factors for stroke recurrence in elderly patients with minor stroke. Key words: Brain ischemic; Stroke; Cognitive impairment; Risk factor
{"title":"The evaluation of cognitive impairment and analysis of risk factors for stroke recurrence in elderly patients with minor ischemic stroke","authors":"Xinqiang Wang, Bin Li, Xiaojing Wang, Yuezhen Shen, Yanfei Chen","doi":"10.3760/CMA.J.ISSN.0254-9026.2020.01.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2020.01.004","url":null,"abstract":"Objective \u0000To evaluate the cognitive impairment in elderly patients with minor ischemic stroke and to analyze risk factors for stroke recurrence. \u0000 \u0000 \u0000Methods \u0000This was a retrospective case-control study.Ninety-five elderly patients with acute ischemic stroke hospitalized in the neurology department of Second People's Hospital of Liaocheng were enrolled from January 2016 to January 2017.Based on the National Institutes of Health Stroke Scale(NIHSS), all cases were divided into the minor stroke group(NIHSS score≤3, n=62)and the medium-severe stroke group(NIHSS score>3, n=33). After 12-month follow-up, the NIHSS, modified Rankin scale(mRS)and Montreal cognitive assessment(MoCA)were used to evaluate the study subjects. \u0000 \u0000 \u0000Results \u0000Of the 95 patients, there were 62 males(65.3%)and 33 females(34.7%), with age of(68.3±6.7)years.No significant differences were found in baseline characteristics of age, male ratio, subtypes and history between two groups(all P>0.05). But, the treatment rate of intravenous thrombolysis was lower in minor stroke group than in medium-severe stroke group[6.5%(4 cases)vs.42.4%(14 cases)(P 0.05), while the rate of post stroke depression had a significant difference between two groups(P<0.05). Furthermore, there was lower rate of mortality and stroke recurrence in the minor stroke group than in the medium-severe group(0.0% or 0/62 vs.30.3% or 10/33, and 21.0% or 13/62 vs.42.4% or 14/33, P<0.05). Cox proportional hazard model showed that baseline NIHSS score, diabetes and stroke history were the risk factors for stroke recurrence in patients with minor stroke(P<0.05). \u0000 \u0000 \u0000Conclusions \u0000The treatment rate of intravenous thrombolysis with rt-PA, mortality rate and stroke recurrence rate are lower in patients with minor stroke than in patients with medium-severe stroke, while the incidence of post stroke cognitive impairment is high.High score of baseline NIHSS, diabetes and stroke history are risk factors for stroke recurrence in elderly patients with minor stroke. \u0000 \u0000 \u0000Key words: \u0000Brain ischemic; Stroke; Cognitive impairment; Risk factor","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"39 1","pages":"23-26"},"PeriodicalIF":0.0,"publicationDate":"2020-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46572905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-14DOI: 10.3760/CMA.J.ISSN.0254-9026.2020.01.015
Yan-Chun Qin, Yan-Qiang Huang, H. Tang, Gan-rong Huang, Hong-Yu Wei, Zhenfeng Xie, Gang Lu
Objective To investigate the bacterial species, characteristics and differences of oral bacteria flora of saliva in the longevous elderly between in Bama county and in Debao county in Guangxi, in order to explore the relationship between longevity and oral salivary bacteria flora in the elderly. Methods The saliva was taken from the longevous elderly in Bama county(BM group)and people aged over 60 years in Debao county(BS group)separately, and the total DNA was extracted.The 16S rDNA-V4 region was amplified by PCR and analyzed by sequencing.The main species and diversity of bacterial colonies were recorded for difference analysis. Results A total of 14 saliva samples were collected from 7 cases in BM group and 7 cases in BS group.A total of 369 OTUs were generated by cluster analysis of 14 samples.At the genus level, the dominant salivary bacteria flora were Ctinomyces, Capnocytophaga, Chryseobacterium, Fusobacterium, Haemophilus, Lactobacillus, Leptotrichia, Neisseria, Porphyromonas, Prevotella, Rothia, Streptococcus, Veillonella in both BM group and BS group.The OTU PCA analysis showed that some evidence for indeterminate differences was found, but statistically significant differences did not exist in the dominant components of oral flora between the two groups(P>0.05). Also, the same tendency toward the diversity(P>0.05)was presented.Similarly, the species annotation analysis and the heat map showed that there were no significant differences(P>0.05)in oral salivary flora composition between the two groups.Lactobacillu was always the prevailing flora in the Phylume, Class, Order, Family and Genus, but the abundance ratio was different between the two groups as following: Lactobacillus abundance in salivary bacteria flora was higher in BM Group than in the BS group, while Mycoplasma abundance was lower in BM Group than in the BS group(P<0.05). Conclusions The dominant salivary bacteria flora is Lactobacillus in both BM and BS group, while, the abundance of Lactobacillus is higher in the BM group than in the BS group, which indicates that the longevity of population in Bama county may be related to Lactobacillus. Key words: Longevity; Saliva; DNA, bacterial
{"title":"Analysis of difference in oral bacteria flora in saliva among elderly people in longevity zone of Guangxi","authors":"Yan-Chun Qin, Yan-Qiang Huang, H. Tang, Gan-rong Huang, Hong-Yu Wei, Zhenfeng Xie, Gang Lu","doi":"10.3760/CMA.J.ISSN.0254-9026.2020.01.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2020.01.015","url":null,"abstract":"Objective \u0000To investigate the bacterial species, characteristics and differences of oral bacteria flora of saliva in the longevous elderly between in Bama county and in Debao county in Guangxi, in order to explore the relationship between longevity and oral salivary bacteria flora in the elderly. \u0000 \u0000 \u0000Methods \u0000The saliva was taken from the longevous elderly in Bama county(BM group)and people aged over 60 years in Debao county(BS group)separately, and the total DNA was extracted.The 16S rDNA-V4 region was amplified by PCR and analyzed by sequencing.The main species and diversity of bacterial colonies were recorded for difference analysis. \u0000 \u0000 \u0000Results \u0000A total of 14 saliva samples were collected from 7 cases in BM group and 7 cases in BS group.A total of 369 OTUs were generated by cluster analysis of 14 samples.At the genus level, the dominant salivary bacteria flora were Ctinomyces, Capnocytophaga, Chryseobacterium, Fusobacterium, Haemophilus, Lactobacillus, Leptotrichia, Neisseria, Porphyromonas, Prevotella, Rothia, Streptococcus, Veillonella in both BM group and BS group.The OTU PCA analysis showed that some evidence for indeterminate differences was found, but statistically significant differences did not exist in the dominant components of oral flora between the two groups(P>0.05). Also, the same tendency toward the diversity(P>0.05)was presented.Similarly, the species annotation analysis and the heat map showed that there were no significant differences(P>0.05)in oral salivary flora composition between the two groups.Lactobacillu was always the prevailing flora in the Phylume, Class, Order, Family and Genus, but the abundance ratio was different between the two groups as following: Lactobacillus abundance in salivary bacteria flora was higher in BM Group than in the BS group, while Mycoplasma abundance was lower in BM Group than in the BS group(P<0.05). \u0000 \u0000 \u0000Conclusions \u0000The dominant salivary bacteria flora is Lactobacillus in both BM and BS group, while, the abundance of Lactobacillus is higher in the BM group than in the BS group, which indicates that the longevity of population in Bama county may be related to Lactobacillus. \u0000 \u0000 \u0000Key words: \u0000Longevity; Saliva; DNA, bacterial","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"39 1","pages":"78-82"},"PeriodicalIF":0.0,"publicationDate":"2020-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41727584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-14DOI: 10.3760/CMA.J.ISSN.0254-9026.2020.01.007
Hong Yang, Xiao‐yu Sun, Jing Liu, Yu-Qing Yuan
Objective To evaluate the effect of Sacubitril/Valsartan for alleviating chronic heart failure(CHF)in elderly patients after acute myocardial infarction(AMI). Methods A total of 87 elderly patients with AMI-induced CHF treated in Heze Shili Hospital from October 2017 to August 2018 were enrolled and randomly divided into the experimental group(n=42)and the control group(n=45). All patients were given standard AMI treatments, and patients in the experimental group were given Sacubitril/Valsartan(100 mg bid)while those in the control group received Valsartan(80 mg qd). After a follow-up of 12 months, levels of N-terminal pro-brain natriuretic peptide(NT-proBNP), left ventricular end-diastolic diameter(LVDd), left ventricular ejection fraction(LVEF), rates of rehospitalization for heart failure and all-cause mortality were compared between the two groups. Results Among the 87 patients, 51 patients(58.6%)were male and 36 were female, with an averageage of(67.4±4.0)years.After 12-months of treatment, patients in the experimental group were associated with significantly lower levels of LVDd[(47.86±3.86)mm vs.(50.73±4.39)mm, P<0.05]and NT-proBNP[(793.43±335.43)ng/L vs.(1 068.44±344.46)ng/L, P<0.05]and higher levels of LVEF[(53.74±4.08)% vs.(44.42±7.41)%, P<0.05]than those in the control group.Moreover, the rehospitalization rate for heart failure was markedly higher in the control group than that in the experimental group[15(33.3%)vs.5(11.9%), P<0.05], while the rate of all-cause mortality was similar between the two groups[2(4.8%)vs.3(6.7%), P=0.703]. Conclusions Compared with Valsartan, Sacubitril/Valsartan can reduce the incidence of CHF after AMI, improve left ventricular function, and reduce the rehospitalization rate due to CHF in elderly patients. Key words: Myocardial infarction; Heart failure; Neprilysin
{"title":"Effect of Sacubitril/Valsartan for alleviating chronic heart failure in elderly patients after acute myocardial infarction","authors":"Hong Yang, Xiao‐yu Sun, Jing Liu, Yu-Qing Yuan","doi":"10.3760/CMA.J.ISSN.0254-9026.2020.01.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2020.01.007","url":null,"abstract":"Objective \u0000To evaluate the effect of Sacubitril/Valsartan for alleviating chronic heart failure(CHF)in elderly patients after acute myocardial infarction(AMI). \u0000 \u0000 \u0000Methods \u0000A total of 87 elderly patients with AMI-induced CHF treated in Heze Shili Hospital from October 2017 to August 2018 were enrolled and randomly divided into the experimental group(n=42)and the control group(n=45). All patients were given standard AMI treatments, and patients in the experimental group were given Sacubitril/Valsartan(100 mg bid)while those in the control group received Valsartan(80 mg qd). After a follow-up of 12 months, levels of N-terminal pro-brain natriuretic peptide(NT-proBNP), left ventricular end-diastolic diameter(LVDd), left ventricular ejection fraction(LVEF), rates of rehospitalization for heart failure and all-cause mortality were compared between the two groups. \u0000 \u0000 \u0000Results \u0000Among the 87 patients, 51 patients(58.6%)were male and 36 were female, with an averageage of(67.4±4.0)years.After 12-months of treatment, patients in the experimental group were associated with significantly lower levels of LVDd[(47.86±3.86)mm vs.(50.73±4.39)mm, P<0.05]and NT-proBNP[(793.43±335.43)ng/L vs.(1 068.44±344.46)ng/L, P<0.05]and higher levels of LVEF[(53.74±4.08)% vs.(44.42±7.41)%, P<0.05]than those in the control group.Moreover, the rehospitalization rate for heart failure was markedly higher in the control group than that in the experimental group[15(33.3%)vs.5(11.9%), P<0.05], while the rate of all-cause mortality was similar between the two groups[2(4.8%)vs.3(6.7%), P=0.703]. \u0000 \u0000 \u0000Conclusions \u0000Compared with Valsartan, Sacubitril/Valsartan can reduce the incidence of CHF after AMI, improve left ventricular function, and reduce the rehospitalization rate due to CHF in elderly patients. \u0000 \u0000 \u0000Key words: \u0000Myocardial infarction; Heart failure; Neprilysin","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"39 1","pages":"38-42"},"PeriodicalIF":0.0,"publicationDate":"2020-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47897350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-14DOI: 10.3760/CMA.J.ISSN.0254-9026.2020.01.019
Mengyang Zhang, J. Fan, Yacong Liu
Induction of coronary collateral circulation, that is, therapeutic angiogenesis, is considered a promising treatment for coronary heart disease.However, coronary collateral growth is a complex process and is related to a variety of factors.Although it has achieved promising outcomes in animal experiments, clinical trials have so far failed to replicate these results.Further studies on the growth mechanisms of coronary collateral circulation are still needed before a feasible clinical treatment strategy becomes available. Key words: Coronary circulation; Collateral circulatio
{"title":"Mechanisms and potential therapeutic targets for coronary collateral growth","authors":"Mengyang Zhang, J. Fan, Yacong Liu","doi":"10.3760/CMA.J.ISSN.0254-9026.2020.01.019","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2020.01.019","url":null,"abstract":"Induction of coronary collateral circulation, that is, therapeutic angiogenesis, is considered a promising treatment for coronary heart disease.However, coronary collateral growth is a complex process and is related to a variety of factors.Although it has achieved promising outcomes in animal experiments, clinical trials have so far failed to replicate these results.Further studies on the growth mechanisms of coronary collateral circulation are still needed before a feasible clinical treatment strategy becomes available. \u0000 \u0000 \u0000Key words: \u0000Coronary circulation; Collateral circulatio","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"39 1","pages":"96-99"},"PeriodicalIF":0.0,"publicationDate":"2020-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48357042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-14DOI: 10.3760/CMA.J.ISSN.0254-9026.2020.01.010
Wenjie He, Xuhao Fang, Xiaowei Wang, P. Gao, Weiquan Shu, Xing Gao, Jiejiao Zheng, J. Chang, Y. Hua, R. Mao
Objective To investigate the relationships of intracranial compartment volumes with the severity of clinical symptoms before surgery, and the degree of symptom improvement one year after cerebrospinal fluid(CSF)shunt surgery in patients with idiopathic normal pressure hydrocephalus(iNPH). Methods Twenty-one patients meeting the diagnosis criteria of international guidelines of iNPH and undergoing CSF shunt surgery in Department of Neurosurgery in our hospital from 2016 to 2017 were included.All patients underwent brain MRI measurement before surgery, and were evaluated by using 3-meter timed up and go test(TUG), minimum mental state examination(MMSE), idiopathic normal pressure hydrocephalus grading scale(iNPHGS)and modified Rankin scale(mRS)before and one year after CSF shunt procedures.The ventricular volume, brain volume, pericerebral CSF volume, total intracranial volume and Evans' index were measured in the pre-operative imaging of the brain.The following four pre-operative intracranial compartment volumes were calculated: the relative ventricular volume, brain volume ratio, pericerebral CSF volume ratio and the ratio of ventricular volume to pericerebral CSF volume. Results The scores of gait, cognitive function and urinary function were improved after surgery in iNPH patients(all P 0.05). There was no significant difference in intracranial compartment volumes between patients having improvement in mRS, TUG, MMSE and iNPHGS and patients having no improvement one year after surgery in iNPH patients(all P>0.05). Conclusions Patients with iNPH can benefit from CSF shunt surgery and have improvements of clinical symptoms including gait, cognitive function and urinary function.Preoperative intracranial compartment volumes(the relative ventricular volume, brain volume ratio, pericerebral CSF volume ratio and the ratio of ventricular volume to pericerebral CSF volume)and Evans' index have no correlations with the severity of clinical symptoms before surgery, and have no correlations with the degree of symptom improvement one year after surgery in iNPH patients.For this reason, preoperative intracranial compartment volumes and Evans' index cannot be used to predict whether or not CSF shunt surgery can improve specific clinical symptoms. Key words: Hydrocephalus, normal pressure; Cerebral ventricles; Cerebrospinal fluid shunts
{"title":"Relationships between intracranial compartment volumes and clinical symptoms in patients with idiopathic normal pressure hydrocephalus before and after cerebrospinal fluid shunt surgery","authors":"Wenjie He, Xuhao Fang, Xiaowei Wang, P. Gao, Weiquan Shu, Xing Gao, Jiejiao Zheng, J. Chang, Y. Hua, R. Mao","doi":"10.3760/CMA.J.ISSN.0254-9026.2020.01.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2020.01.010","url":null,"abstract":"Objective \u0000To investigate the relationships of intracranial compartment volumes with the severity of clinical symptoms before surgery, and the degree of symptom improvement one year after cerebrospinal fluid(CSF)shunt surgery in patients with idiopathic normal pressure hydrocephalus(iNPH). \u0000 \u0000 \u0000Methods \u0000Twenty-one patients meeting the diagnosis criteria of international guidelines of iNPH and undergoing CSF shunt surgery in Department of Neurosurgery in our hospital from 2016 to 2017 were included.All patients underwent brain MRI measurement before surgery, and were evaluated by using 3-meter timed up and go test(TUG), minimum mental state examination(MMSE), idiopathic normal pressure hydrocephalus grading scale(iNPHGS)and modified Rankin scale(mRS)before and one year after CSF shunt procedures.The ventricular volume, brain volume, pericerebral CSF volume, total intracranial volume and Evans' index were measured in the pre-operative imaging of the brain.The following four pre-operative intracranial compartment volumes were calculated: the relative ventricular volume, brain volume ratio, pericerebral CSF volume ratio and the ratio of ventricular volume to pericerebral CSF volume. \u0000 \u0000 \u0000Results \u0000The scores of gait, cognitive function and urinary function were improved after surgery in iNPH patients(all P 0.05). There was no significant difference in intracranial compartment volumes between patients having improvement in mRS, TUG, MMSE and iNPHGS and patients having no improvement one year after surgery in iNPH patients(all P>0.05). \u0000 \u0000 \u0000Conclusions \u0000Patients with iNPH can benefit from CSF shunt surgery and have improvements of clinical symptoms including gait, cognitive function and urinary function.Preoperative intracranial compartment volumes(the relative ventricular volume, brain volume ratio, pericerebral CSF volume ratio and the ratio of ventricular volume to pericerebral CSF volume)and Evans' index have no correlations with the severity of clinical symptoms before surgery, and have no correlations with the degree of symptom improvement one year after surgery in iNPH patients.For this reason, preoperative intracranial compartment volumes and Evans' index cannot be used to predict whether or not CSF shunt surgery can improve specific clinical symptoms. \u0000 \u0000 \u0000Key words: \u0000Hydrocephalus, normal pressure; Cerebral ventricles; Cerebrospinal fluid shunts","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"39 1","pages":"51-56"},"PeriodicalIF":0.0,"publicationDate":"2020-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46513571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-14DOI: 10.3760/CMA.J.ISSN.0254-9026.2020.01.006
F. Xu, Xiaodan Cheng, Dongwei Yang
Objective To investigate the clinical significance of the monocyte count/high-density lipoprotein cholesterol ratio(MHR)in evaluating imperfect ST-segment resolution in elderly patients with acute ST-elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI). Methods This was a retrospective cohort study.A total of 274 elderly patients with STEMI underwent PCI in our hospital from December 2015 to December 2018 were enrolled.Based on the extent of the ST-segment resolution of the postoperative electrocardiogram, patients were divided into an imperfect ST-segment resolution group(observation group, n=79)and a favorable ST-segment resolution group(control group, n=195). General clinical data were compared between the two groups, and logistic regression equation was used to analyze the association of MHR with ST-segment resolution.Receiver operating characteristic(ROC)curve was performed to assess the predictive value of MHR for imperfect ST-segment resolution. Results Compared with patients in the control group, patients in the observation group were associated with a significantly higher proportion of anterior wall myocardial infarction and heart failure(≥Killip 2), A longer duration of chest pain to balloon expansion, higher levels of creatine kinase isoenzyme, N-terminal pro-brain natriuretic peptide, hypersensitive C-reactive protein, blood sugar, blood uric acid, fibrinogen, triglyceride and mononuclear cell count, and lower levels of high density lipoprotein cholesterol and lymphocyte count(all P<0.05). Meanwhile, there was a significant difference in MHR between the observation group and the control group [(0.75±0.22)vs.(0.48±0.19), t=9.831, P=0.001]. Multivariate Logistic regression analysis showed that MHR was an independent risk factor for imperfect ST-segment resolution(OR=1.950, 95%CI: 1.646-5.430, P=0.003)and ROC curve showed the threshold value of MHR at 0.67, the area under the curve at 0.867, the sensitivity at 79.72%, and the specificity at 79.61%. Conclusions MHR may be an independent risk factor and a good predictive index for imperfect ST-segment resolution in elderly patients with STEMI after PCI. Key words: Monocytes; Lipoproteins HDL; Myocardial infarction
{"title":"Clinical significance of the monocyte to high-density lipoprotein cholesterol ratio in the assessment of imperfect ST-segment resolution in elderly patients with acute ST-elevation myocardial infarction after percutaneous coronary intervention","authors":"F. Xu, Xiaodan Cheng, Dongwei Yang","doi":"10.3760/CMA.J.ISSN.0254-9026.2020.01.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2020.01.006","url":null,"abstract":"Objective \u0000To investigate the clinical significance of the monocyte count/high-density lipoprotein cholesterol ratio(MHR)in evaluating imperfect ST-segment resolution in elderly patients with acute ST-elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI). \u0000 \u0000 \u0000Methods \u0000This was a retrospective cohort study.A total of 274 elderly patients with STEMI underwent PCI in our hospital from December 2015 to December 2018 were enrolled.Based on the extent of the ST-segment resolution of the postoperative electrocardiogram, patients were divided into an imperfect ST-segment resolution group(observation group, n=79)and a favorable ST-segment resolution group(control group, n=195). General clinical data were compared between the two groups, and logistic regression equation was used to analyze the association of MHR with ST-segment resolution.Receiver operating characteristic(ROC)curve was performed to assess the predictive value of MHR for imperfect ST-segment resolution. \u0000 \u0000 \u0000Results \u0000Compared with patients in the control group, patients in the observation group were associated with a significantly higher proportion of anterior wall myocardial infarction and heart failure(≥Killip 2), A longer duration of chest pain to balloon expansion, higher levels of creatine kinase isoenzyme, N-terminal pro-brain natriuretic peptide, hypersensitive C-reactive protein, blood sugar, blood uric acid, fibrinogen, triglyceride and mononuclear cell count, and lower levels of high density lipoprotein cholesterol and lymphocyte count(all P<0.05). Meanwhile, there was a significant difference in MHR between the observation group and the control group [(0.75±0.22)vs.(0.48±0.19), t=9.831, P=0.001]. Multivariate Logistic regression analysis showed that MHR was an independent risk factor for imperfect ST-segment resolution(OR=1.950, 95%CI: 1.646-5.430, P=0.003)and ROC curve showed the threshold value of MHR at 0.67, the area under the curve at 0.867, the sensitivity at 79.72%, and the specificity at 79.61%. \u0000 \u0000 \u0000Conclusions \u0000MHR may be an independent risk factor and a good predictive index for imperfect ST-segment resolution in elderly patients with STEMI after PCI. \u0000 \u0000 \u0000Key words: \u0000Monocytes; Lipoproteins HDL; Myocardial infarction","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"39 1","pages":"33-37"},"PeriodicalIF":0.0,"publicationDate":"2020-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43132670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-14DOI: 10.3760/CMA.J.ISSN.0254-9026.2020.01.008
Sha-sha Sun, Jian Cao, Hongbin Liu, Jiakun Luo, Weihao Xu, Lu Liu, Yanqi Di, X. Zou, Jian-hua Li
Objective To investigate the efficacy and safety of Rivaroxaban for elderly patients with thrombotic diseases. Methods This was a retrospective study.A total of 301 elderly patients taking Rivaroxaban from October 2012 to November 2017 at the Second Medical Center of the Chinese PLA General Hospital were consecutively selected.The ages ranged from 60 to 102 years, with an average age of(86.5±8.4)years.Anticoagulation regimens were developed based on comprehensive evaluation of indications, creatinine clearance, ischemia and bleeding risk.Patients were divided into a Rivaroxaban 2.5-5.0 mg/d group(n=72), a 10.0 mg/d group(n=205), and a 15.0-20.0 mg/d group(n=24). Hepatic function, renal function, and coagulation indexes were measured before and after the administration of Rivaroxaban.Fatal bleeding, cardiovascular deaths, all-cause deaths, non-fatal bleeding and thromboembolic events were recorded during the follow-up period. Results The average dose of Rivaroxaban was(9.3±3.0)mg/d, and the minimum dose was 2.5 mg/d.The average follow-up time was(14.9± 13.9)months and the longest follow-up time was 48 months.One patient had intracranial bleeding.Twenty patients(6.6%)died with a cumulative incidence of 25.2%, three(1.0%)died of cardiac events, and 55.0% died of pneumonia and multiple organ failure.Forty patients(13.3%)had non-fatal hemorrhagic events with a cumulative incidence of 42.4%.Seven patients(2.3%)had thromboembolic events with a cumulative incidence of 16.0%, including 2 cases of non-fatal myocardial infarction, 3 cases of cerebral infarction and 2 cases of deep vein thrombosis.After treatment, levels of prothrombin time and fibrinogen significantly increased while levels of D-dimer significantly deceased(P<0.05). Conclusions Compared with previous reports, low-dose Rivaroxaban is safe and effective for elderly patients with thrombotic diseases.However, the risk of bleeding and ischemia should be comprehensively evaluated, and appropriate doses of Rivaroxaban should be selected individually. Key words: Rivaroxaban; Thromboembolism; Hemorrage
{"title":"The efficacy and safety of Rivaroxaban for elderly patients with thrombotic diseases","authors":"Sha-sha Sun, Jian Cao, Hongbin Liu, Jiakun Luo, Weihao Xu, Lu Liu, Yanqi Di, X. Zou, Jian-hua Li","doi":"10.3760/CMA.J.ISSN.0254-9026.2020.01.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2020.01.008","url":null,"abstract":"Objective \u0000To investigate the efficacy and safety of Rivaroxaban for elderly patients with thrombotic diseases. \u0000 \u0000 \u0000Methods \u0000This was a retrospective study.A total of 301 elderly patients taking Rivaroxaban from October 2012 to November 2017 at the Second Medical Center of the Chinese PLA General Hospital were consecutively selected.The ages ranged from 60 to 102 years, with an average age of(86.5±8.4)years.Anticoagulation regimens were developed based on comprehensive evaluation of indications, creatinine clearance, ischemia and bleeding risk.Patients were divided into a Rivaroxaban 2.5-5.0 mg/d group(n=72), a 10.0 mg/d group(n=205), and a 15.0-20.0 mg/d group(n=24). Hepatic function, renal function, and coagulation indexes were measured before and after the administration of Rivaroxaban.Fatal bleeding, cardiovascular deaths, all-cause deaths, non-fatal bleeding and thromboembolic events were recorded during the follow-up period. \u0000 \u0000 \u0000Results \u0000The average dose of Rivaroxaban was(9.3±3.0)mg/d, and the minimum dose was 2.5 mg/d.The average follow-up time was(14.9± 13.9)months and the longest follow-up time was 48 months.One patient had intracranial bleeding.Twenty patients(6.6%)died with a cumulative incidence of 25.2%, three(1.0%)died of cardiac events, and 55.0% died of pneumonia and multiple organ failure.Forty patients(13.3%)had non-fatal hemorrhagic events with a cumulative incidence of 42.4%.Seven patients(2.3%)had thromboembolic events with a cumulative incidence of 16.0%, including 2 cases of non-fatal myocardial infarction, 3 cases of cerebral infarction and 2 cases of deep vein thrombosis.After treatment, levels of prothrombin time and fibrinogen significantly increased while levels of D-dimer significantly deceased(P<0.05). \u0000 \u0000 \u0000Conclusions \u0000Compared with previous reports, low-dose Rivaroxaban is safe and effective for elderly patients with thrombotic diseases.However, the risk of bleeding and ischemia should be comprehensively evaluated, and appropriate doses of Rivaroxaban should be selected individually. \u0000 \u0000 \u0000Key words: \u0000Rivaroxaban; Thromboembolism; Hemorrage","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"39 1","pages":"43-46"},"PeriodicalIF":0.0,"publicationDate":"2020-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45808572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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