Pub Date : 2019-12-14DOI: 10.3760/CMA.J.ISSN.0254-9026.2019.12.016
Shuxia Han, Qing Liu, Ke Ding
Objective To investigate the surgical methods and their effects on endometrial cancer in the elderly, in order to provide the reference for clinical treatment plans. Methods From January to December 2018, 90 elderly patients with endometrial cancer in our hospital were treated with the conventional radical hysterectomy(the control group, n=45)and the extensive hysterectomy with pelvic autonomic nerve(the observation group, n=45). The operation and postoperative complications of the two groups were observed and analyzed. Results There was no significant difference in the operation time and intraoperative blood loss between the two groups(t=1.305 and 0.240, P=0.097 and 0.405), but the patients had the postoperative extubation time, exhaust time and defecation time in the observation group were significantly shorter than in the control group(9.5±1.6 d vs.13.8±1.7 d, 35.6±4.7 h vs.45.1±4.2 h, 70.3±7.6 h vs.84.5±6.6 h, t=12.356, 10.110, 9.463 and 29.160, respectively, all P=0.000). The total incidence of postoperative complications was lower in the observation group than in the control group(11.11% or 5/45 vs.35.56% or 16/45, χ2=7.516, P=0.006). Conclusions Compared with the traditional radical hysterectomy, extensive hysterectomy with systematic preservation of pelvic nerve for the treatment of endometrial cancer can significantly reduce surgical trauma, protect pelvic function and promote postoperative recovery, and it has a positive effect on long-term quality of life in the elderly. Key words: Endometrial neoplasms; Hysterectomy; Autonomic nervous system
{"title":"Clinical effects of different surgical treatment on endometrial cancer in elderly patients","authors":"Shuxia Han, Qing Liu, Ke Ding","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.12.016","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.12.016","url":null,"abstract":"Objective \u0000To investigate the surgical methods and their effects on endometrial cancer in the elderly, in order to provide the reference for clinical treatment plans. \u0000 \u0000 \u0000Methods \u0000From January to December 2018, 90 elderly patients with endometrial cancer in our hospital were treated with the conventional radical hysterectomy(the control group, n=45)and the extensive hysterectomy with pelvic autonomic nerve(the observation group, n=45). The operation and postoperative complications of the two groups were observed and analyzed. \u0000 \u0000 \u0000Results \u0000There was no significant difference in the operation time and intraoperative blood loss between the two groups(t=1.305 and 0.240, P=0.097 and 0.405), but the patients had the postoperative extubation time, exhaust time and defecation time in the observation group were significantly shorter than in the control group(9.5±1.6 d vs.13.8±1.7 d, 35.6±4.7 h vs.45.1±4.2 h, 70.3±7.6 h vs.84.5±6.6 h, t=12.356, 10.110, 9.463 and 29.160, respectively, all P=0.000). The total incidence of postoperative complications was lower in the observation group than in the control group(11.11% or 5/45 vs.35.56% or 16/45, χ2=7.516, P=0.006). \u0000 \u0000 \u0000Conclusions \u0000Compared with the traditional radical hysterectomy, extensive hysterectomy with systematic preservation of pelvic nerve for the treatment of endometrial cancer can significantly reduce surgical trauma, protect pelvic function and promote postoperative recovery, and it has a positive effect on long-term quality of life in the elderly. \u0000 \u0000 \u0000Key words: \u0000Endometrial neoplasms; Hysterectomy; Autonomic nervous system","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1391-1394"},"PeriodicalIF":0.0,"publicationDate":"2019-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41447572","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 : 2019-12-14DOI: 10.3760/CMA.J.ISSN.0254-9026.2019.12.008
Wenbin Pan
Objective To compare the clinical efficacy and safety of concurrent chemoradiotherapy and sequential chemoradiotherapy for bone metastasis of non-small cell lung cancer(NSCLC). Methods This was a retrospective cohort study, in which 120 patients with bone metastases from NSCLC admitted to our hospital from June 2013 to June 2018 were enrolled.Of these patients, 60 received sequential chemotheradiotherapy and 60 patients received concurrent chemoradiotherapy.Bone pain was measured before treatment, at 1-month, 2-months into treatment, and 1-month after treatment.Short-term efficacy and adverse reactions were compared between the two groups. Results There were no significant differences in pain relief rate at 1-month, 2-months into treatment and 1-month after treatment between the two groups(all P>0.05). Meanwhile, the objective response rate(50.0% vs.36.7%)and disease control rate(90.0% vs.83.3%)were also similar between the two groups(χ2=2.172, 1.154, P=0.141, 0.283). The incidences of toxic and side effects, including neutropenia(90.0% vs.60.0%), leukopenia(96.7% vs.63.3%)and nausea(50.0% vs.23.0%)were significantly higher in the concurrent chemoradiotherapy group than those in the sequential chemotherapy/radiotherapy group(all P 0.05). Conclusions Compared with sequential chemoradiotherapy, concurrent chemoradiotherapy has similar short-term efficacy in pain relief for bone metastasis of NSCLC, but the incidence of side effects is higher. Key words: Carcinoma, non-small cell lung; Neoplasm metastasis; Radiotherapy
{"title":"Comparison of different chemoradiotherapy methods for bone metastasis of non-small cell lung cancer","authors":"Wenbin Pan","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.12.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.12.008","url":null,"abstract":"Objective \u0000To compare the clinical efficacy and safety of concurrent chemoradiotherapy and sequential chemoradiotherapy for bone metastasis of non-small cell lung cancer(NSCLC). \u0000 \u0000 \u0000Methods \u0000This was a retrospective cohort study, in which 120 patients with bone metastases from NSCLC admitted to our hospital from June 2013 to June 2018 were enrolled.Of these patients, 60 received sequential chemotheradiotherapy and 60 patients received concurrent chemoradiotherapy.Bone pain was measured before treatment, at 1-month, 2-months into treatment, and 1-month after treatment.Short-term efficacy and adverse reactions were compared between the two groups. \u0000 \u0000 \u0000Results \u0000There were no significant differences in pain relief rate at 1-month, 2-months into treatment and 1-month after treatment between the two groups(all P>0.05). Meanwhile, the objective response rate(50.0% vs.36.7%)and disease control rate(90.0% vs.83.3%)were also similar between the two groups(χ2=2.172, 1.154, P=0.141, 0.283). The incidences of toxic and side effects, including neutropenia(90.0% vs.60.0%), leukopenia(96.7% vs.63.3%)and nausea(50.0% vs.23.0%)were significantly higher in the concurrent chemoradiotherapy group than those in the sequential chemotherapy/radiotherapy group(all P 0.05). \u0000 \u0000 \u0000Conclusions \u0000Compared with sequential chemoradiotherapy, concurrent chemoradiotherapy has similar short-term efficacy in pain relief for bone metastasis of NSCLC, but the incidence of side effects is higher. \u0000 \u0000 \u0000Key words: \u0000Carcinoma, non-small cell lung; Neoplasm metastasis; Radiotherapy","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1353-1356"},"PeriodicalIF":0.0,"publicationDate":"2019-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49525007","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 : 2019-12-14DOI: 10.3760/CMA.J.ISSN.0254-9026.2019.12.017
J. Jin, Yuxing Zhang
Objective To observe the clinical efficacy of photodynamic therapy on oral leukoplakia in elderly patients. Methods In this prospective study, fifteen elderly patients with oral leukoplakia were treated with 5-aminolevulinic acid-based photodynamic therapy(ALA-PDT). After 2 hours of dressing, patients were irradiated using a 635nm semiconductor laser with the power density of 300mW/cm2.Each lesion was irradiated for 6 minutes with energy density of 100J/cm2.The curative effect was evaluated and the adverse reactions were recorded based on the observation of lesion changes. Results Of the 15 lesions in 15 patients, 4 lesions were treated once, 3 lesions were treated twice.And 6 lesions were cured after three treatments, and 2 patients were cured after four treatments.The average treatment frequency was(2.4±1.1)treatment.The postoperative adverse reaction was pain.The average visual analogue scale was(2.2±0.8)scores after operation, and the duration of pain was(2.6±1.1)days after operation.There was no recurrence for 3 to 9 months after operation.No abnormalities of oral sensation and function were found in patients. Conclusions ALA-PDT is an effective method for the treatment of oral leukoplakia in elderly patients. Key words: Aminolevulinic acid; Photo chemo therapy; Leukoplakia, oral
{"title":"Observation of clinical effect of photodynamic therapy on oral leukoplakia in elderly patients","authors":"J. Jin, Yuxing Zhang","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.12.017","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.12.017","url":null,"abstract":"Objective \u0000To observe the clinical efficacy of photodynamic therapy on oral leukoplakia in elderly patients. \u0000 \u0000 \u0000Methods \u0000In this prospective study, fifteen elderly patients with oral leukoplakia were treated with 5-aminolevulinic acid-based photodynamic therapy(ALA-PDT). After 2 hours of dressing, patients were irradiated using a 635nm semiconductor laser with the power density of 300mW/cm2.Each lesion was irradiated for 6 minutes with energy density of 100J/cm2.The curative effect was evaluated and the adverse reactions were recorded based on the observation of lesion changes. \u0000 \u0000 \u0000Results \u0000Of the 15 lesions in 15 patients, 4 lesions were treated once, 3 lesions were treated twice.And 6 lesions were cured after three treatments, and 2 patients were cured after four treatments.The average treatment frequency was(2.4±1.1)treatment.The postoperative adverse reaction was pain.The average visual analogue scale was(2.2±0.8)scores after operation, and the duration of pain was(2.6±1.1)days after operation.There was no recurrence for 3 to 9 months after operation.No abnormalities of oral sensation and function were found in patients. \u0000 \u0000 \u0000Conclusions \u0000ALA-PDT is an effective method for the treatment of oral leukoplakia in elderly patients. \u0000 \u0000 \u0000Key words: \u0000Aminolevulinic acid; Photo chemo therapy; Leukoplakia, oral","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1395-1397"},"PeriodicalIF":0.0,"publicationDate":"2019-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47648719","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}
The prevalence of functional constipation in the elderly is high, which seriously affects their quality of life and leads to many diseases such as cardiovascular and cerebrovascular diseases; Its causes are complex and often related to the physiological, pathological, psychological, and systemic organic diseases of the elderly, as well as medication. Clinical diagnosis and treatment need to be comprehensively considered, emphasizing both overall and local considerations; Traditional Chinese and Western medicine have their own advantages and disadvantages, and active cooperation, mutual learning, and collaborative diagnosis and treatment will greatly benefit the elderly.
{"title":"Expert consensus on integrated traditional Chinese and Western medicine in diagnosis and treatment of functional constipation in the elderly","authors":"Ye Li, Baoshan Wang, Pulin Yu, H. Shi, L. Xu, Junxiang Li, Shengsheng Zhang, Yi Li","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.12.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.12.002","url":null,"abstract":"老年人功能性便秘患病率高，严重影响老年人生活质量，引发心脑血管病等诸多疾患；其成因复杂，多与老年人的生理、病理、心理和全身器质性疾病及药物等因素相关，临床诊疗需要综合考量，注重整体与局部兼顾；中西医各有优势和不足，积极配合、互相借鉴、协同诊疗，将使老年人更大获益。","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1322-1328"},"PeriodicalIF":0.0,"publicationDate":"2019-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44838871","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 : 2019-12-14DOI: 10.3760/CMA.J.ISSN.0254-9026.2019.12.014
Wen Xinping, Hu-ping Song, Zou Chaobin, Sha Liyan, Mao Yongjun
Objective To investigate the prevalence of postoperative delirium(PD)and its risk factors in patients aged 80 and over with hip fracture treated with total hip arthroplasty(THA). Methods Clinical history and perioperative data of patients aged 80 years and over with hip fractures who underwent THA in our hospital from Sep.2017 to Mar.2019 were analyzed.Patients were divided into delirium group and non-delirium group.The prevalence of postoperative delirium of THA and its risk factors were analyzed by multiple Logistic regression. Results A total of 90 patients were eligible for inclusion for this study.Of them, 27 patients(30.0%)were diagnosed as PD and 63(70.0%)did not experience PD.Multivariate stepwise Logistic regression analysis showed that a history of stroke(OR=17.702, 95%CI: 1.514-207.034, P=0.022), preoperative lower serum albumin(OR=1.524, 95%CI: 1.132-2.051, P=0.005), Mini-Nutritional Assessment short-form score(MNA-SF)(OR=1.481, 95%CI: 1.045-2.099, P=0.027)were independent risk factors for PD. Conclusions The prevalence of postoperative delirium of THA is higher in patients aged 80 years and over with hip fractures.Prevention and correction of risk factors, such as malnutrition, may help prevent the postoperative delirium. Key words: Aged, 80 and over; Delirium; Hip fractures
{"title":"Prevalence of postoperative delirium and its risk factors in patients aged 80 years and over with hip fracture","authors":"Wen Xinping, Hu-ping Song, Zou Chaobin, Sha Liyan, Mao Yongjun","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.12.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.12.014","url":null,"abstract":"Objective \u0000To investigate the prevalence of postoperative delirium(PD)and its risk factors in patients aged 80 and over with hip fracture treated with total hip arthroplasty(THA). \u0000 \u0000 \u0000Methods \u0000Clinical history and perioperative data of patients aged 80 years and over with hip fractures who underwent THA in our hospital from Sep.2017 to Mar.2019 were analyzed.Patients were divided into delirium group and non-delirium group.The prevalence of postoperative delirium of THA and its risk factors were analyzed by multiple Logistic regression. \u0000 \u0000 \u0000Results \u0000A total of 90 patients were eligible for inclusion for this study.Of them, 27 patients(30.0%)were diagnosed as PD and 63(70.0%)did not experience PD.Multivariate stepwise Logistic regression analysis showed that a history of stroke(OR=17.702, 95%CI: 1.514-207.034, P=0.022), preoperative lower serum albumin(OR=1.524, 95%CI: 1.132-2.051, P=0.005), Mini-Nutritional Assessment short-form score(MNA-SF)(OR=1.481, 95%CI: 1.045-2.099, P=0.027)were independent risk factors for PD. \u0000 \u0000 \u0000Conclusions \u0000The prevalence of postoperative delirium of THA is higher in patients aged 80 years and over with hip fractures.Prevention and correction of risk factors, such as malnutrition, may help prevent the postoperative delirium. \u0000 \u0000 \u0000Key words: \u0000Aged, 80 and over; Delirium; Hip fractures","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1383-1386"},"PeriodicalIF":0.0,"publicationDate":"2019-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41936723","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 : 2019-12-14DOI: 10.3760/CMA.J.ISSN.0254-9026.2019.12.023
Xianlong Li, Fengjian Yang, Yang Lu, Xiaoxi Cai, Cong Chen
The knee osteoarthritis(KOA)is a kind of degenerative disease, which is more common in the elderly.In recent years, according to the Knee Uneven Settlement Theory, a new treatment method for the knee osteoarthritis by using the proximal fibula osteotomy is popularized in many hospitals.In this article, we reported 1 case undergoing the total knee arthroplasty after the proximal fibula osteotomy for the treatment of knee osteoarthritis and reviewed the relevant literatures. Key words: Knee prosthsis; Fibula; Osteotomy
{"title":"Total knee arthroplasty after proximal fibula osteotomy for knee osteoarthritis: A case report and discussion","authors":"Xianlong Li, Fengjian Yang, Yang Lu, Xiaoxi Cai, Cong Chen","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.12.023","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.12.023","url":null,"abstract":"The knee osteoarthritis(KOA)is a kind of degenerative disease, which is more common in the elderly.In recent years, according to the Knee Uneven Settlement Theory, a new treatment method for the knee osteoarthritis by using the proximal fibula osteotomy is popularized in many hospitals.In this article, we reported 1 case undergoing the total knee arthroplasty after the proximal fibula osteotomy for the treatment of knee osteoarthritis and reviewed the relevant literatures. \u0000 \u0000 \u0000Key words: \u0000Knee prosthsis; Fibula; Osteotomy","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1418-1423"},"PeriodicalIF":0.0,"publicationDate":"2019-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46532367","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 : 2019-12-14DOI: 10.3760/CMA.J.ISSN.0254-9026.2019.12.003
Linlin Fu, Qing Wang, Weihua Lyu
Objective To investigate the predictability on adverse events(re-hospitalization and death)in elderly discharged inpatients among frailty phenotype(FP), frail scale(FS)and clinical frailty scale(CFS), in order to screen the simple and feasible frailty assessment tools for elderly discharged inpatients. Methods Elderly discharged inpatients aged 65 years and over were recruited for this prospective cohort study.And they underwent frailty assessment by using FP, FS and CFS, respectively.Patients were followed up for more than 6 months after discharge, and adverse events including re-hospitalization or death after discharge were recorded.Cox regression model was adopted to evaluate the relationship between frailty and death or re-hospitalization.Predictive effects of three assessment methods on adverse events were compared by using receiver operating characteristic(ROC). Results A total of 527 elderly patients aged(84.1±6.0)years with males of 61.9%(326/527)were successfully followed up.The detection rate of frailty by FP and FS evaluation tools was 26.0%(137/527)and 26.0%(137/527), respectively.The detection rate of moderate and severe frailty by CFS was 25.2%(133/527). The Cox regression model showed that the mortality was significantly higher in frailty patients by FP, FS, and CFS than in the non-frailty patients(HR=3.72, 2.95 and 3.90, P=0.017, 0.016 and 0.002)after adjusting for age, smoking, co-morbidity and other variable; and that the re-hospitalization rate was significant higher in frailty patients by FP and CFS than in the non-frailty patients(HR=1.81 and 1.69, P=0.000 and 0.002). The areas under the receiver operating characteristic curve(AUC)of FP, FS and CFS for predicting death and re-hospitalization were 0.691, 0.645, 0.728 on death, and 0.570, 0.579, 0.602 on re-hospitalization(all P<0.01), respectively. Conclusions All three assessment tools of FP, FS and CFS have predictive effects on death in elderly inpatients with frailty, and CFS has better predictive effect than the other two tools.But FP, FS and CFS have poor predictive effect on re-hospitalization. Key words: Frailty; Risk assessment; Death; Patient readmission
{"title":"Comparison of predictability on adverse events among different assessment tools in elderly discharged inpatients","authors":"Linlin Fu, Qing Wang, Weihua Lyu","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.12.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.12.003","url":null,"abstract":"Objective \u0000To investigate the predictability on adverse events(re-hospitalization and death)in elderly discharged inpatients among frailty phenotype(FP), frail scale(FS)and clinical frailty scale(CFS), in order to screen the simple and feasible frailty assessment tools for elderly discharged inpatients. \u0000 \u0000 \u0000Methods \u0000Elderly discharged inpatients aged 65 years and over were recruited for this prospective cohort study.And they underwent frailty assessment by using FP, FS and CFS, respectively.Patients were followed up for more than 6 months after discharge, and adverse events including re-hospitalization or death after discharge were recorded.Cox regression model was adopted to evaluate the relationship between frailty and death or re-hospitalization.Predictive effects of three assessment methods on adverse events were compared by using receiver operating characteristic(ROC). \u0000 \u0000 \u0000Results \u0000A total of 527 elderly patients aged(84.1±6.0)years with males of 61.9%(326/527)were successfully followed up.The detection rate of frailty by FP and FS evaluation tools was 26.0%(137/527)and 26.0%(137/527), respectively.The detection rate of moderate and severe frailty by CFS was 25.2%(133/527). The Cox regression model showed that the mortality was significantly higher in frailty patients by FP, FS, and CFS than in the non-frailty patients(HR=3.72, 2.95 and 3.90, P=0.017, 0.016 and 0.002)after adjusting for age, smoking, co-morbidity and other variable; and that the re-hospitalization rate was significant higher in frailty patients by FP and CFS than in the non-frailty patients(HR=1.81 and 1.69, P=0.000 and 0.002). The areas under the receiver operating characteristic curve(AUC)of FP, FS and CFS for predicting death and re-hospitalization were 0.691, 0.645, 0.728 on death, and 0.570, 0.579, 0.602 on re-hospitalization(all P<0.01), respectively. \u0000 \u0000 \u0000Conclusions \u0000All three assessment tools of FP, FS and CFS have predictive effects on death in elderly inpatients with frailty, and CFS has better predictive effect than the other two tools.But FP, FS and CFS have poor predictive effect on re-hospitalization. \u0000 \u0000 \u0000Key words: \u0000Frailty; Risk assessment; Death; Patient readmission","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1329-1333"},"PeriodicalIF":0.0,"publicationDate":"2019-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45690855","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}
Objective To discuss the correlation between the effect of vitamin D treatment and vitamin D binding protein gene polymorphism in elderly patients with stable chronic obstructive pulmonary disease(COPD). Methods A total of 800 elderly patients with stable COPD admitted to the four Departments of Respiratory Medicine of four Wenzhou Hospitals were enrolled from September 2016 to November 2018.Because of the drop-out during follow-up, there were final 776 patients in our prospective research.According to the GC gene type, patients were divided into the GC1F-1S(n=214), the GC1F-1S(n=168), GC1F-2(n=160), GC1S-1S(n=132), GC1F-2(n=82)and GC2-2 groups(n=44), and each group was randomly divided into control group(n=400)receiving the conventional treatment and the treatment group(n=400)taking vitmain D 0.5 μg/d for 3 months as add-on to the conventional treatment.The lung function and the COPD assessment test(CAT)score before and after the therapy were observed and compared in patients with different GC sub-genotypes. Results Among the elderly patients enrolled in our research, GC1F-1F genotype was most common, accounting for 26.8%(214 cases), the followings of next order were GC 1F-1S genotype accounting for 21.0%(168 cases), and GC2-2 genotype was most rare, accounting for 5.5%(44 cases). The lung function were improved and the CAT score were reduced in all groups after therapy as compared with pre-treatment(P 0.05). Conclusions Vitamin D binding protein gene polymorphism is associated with the curative effect of supplement of vitamin D in elderly patients with stable COPD, which has a predictive value for the curative effect of vitamin D supplement. Key words: Vitamin D binding protein; Polymorphism, Single nucleotide; Pulmonary disease, chronic obstructive
{"title":"Research on the vitamin D binding protein gene polymorphism in elderly patients with stable chronic obstructive pulmonary disease","authors":"Huanhuan Jiang, Chenci Jin, Sunshun Yan, Qiong Chi, Jian-wei Zheng, Longxiang Jiang, Ningning Yu","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.12.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.12.007","url":null,"abstract":"Objective \u0000To discuss the correlation between the effect of vitamin D treatment and vitamin D binding protein gene polymorphism in elderly patients with stable chronic obstructive pulmonary disease(COPD). \u0000 \u0000 \u0000Methods \u0000A total of 800 elderly patients with stable COPD admitted to the four Departments of Respiratory Medicine of four Wenzhou Hospitals were enrolled from September 2016 to November 2018.Because of the drop-out during follow-up, there were final 776 patients in our prospective research.According to the GC gene type, patients were divided into the GC1F-1S(n=214), the GC1F-1S(n=168), GC1F-2(n=160), GC1S-1S(n=132), GC1F-2(n=82)and GC2-2 groups(n=44), and each group was randomly divided into control group(n=400)receiving the conventional treatment and the treatment group(n=400)taking vitmain D 0.5 μg/d for 3 months as add-on to the conventional treatment.The lung function and the COPD assessment test(CAT)score before and after the therapy were observed and compared in patients with different GC sub-genotypes. \u0000 \u0000 \u0000Results \u0000Among the elderly patients enrolled in our research, GC1F-1F genotype was most common, accounting for 26.8%(214 cases), the followings of next order were GC 1F-1S genotype accounting for 21.0%(168 cases), and GC2-2 genotype was most rare, accounting for 5.5%(44 cases). The lung function were improved and the CAT score were reduced in all groups after therapy as compared with pre-treatment(P 0.05). \u0000 \u0000 \u0000Conclusions \u0000Vitamin D binding protein gene polymorphism is associated with the curative effect of supplement of vitamin D in elderly patients with stable COPD, which has a predictive value for the curative effect of vitamin D supplement. \u0000 \u0000 \u0000Key words: \u0000Vitamin D binding protein; Polymorphism, Single nucleotide; Pulmonary disease, chronic obstructive","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1348-1352"},"PeriodicalIF":0.0,"publicationDate":"2019-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46743146","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 : 2019-12-14DOI: 10.3760/CMA.J.ISSN.0254-9026.2019.12.004
Leng Xu, Aiqun Chen, Chuanbao Li, Ban Zhao, Y. Mao
Objective To assess the value of different equations for estimating glomerular filtration rate (GFR) for evaluating renal function in people aged 70 years and older. Methods A retrospective study was conducted involving 11 966 elderly people aged 70 years and older, including 5 741 males (48.0%), who underwent routine physical examinations in Beijing Hospital from January 2012 to December 2014 and were followed up for 3 years.Baseline data, including the age, gender, and serum creatinine, were recorded. Results function was assessed using Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), Modification of Diet in Renal Disease (MDRD) Study, Chinese Modification of Diet in Renal Disease (MDRD) Study, full age spectrum (FAS) equation and Berlin Initiative Study (BIS) equation, respectively.Results The serum creatinine level increased with age in male and female subjects, and the standard deviation also increased with age, indicating greater variability of serum creatinine in the elderly.Of all equations, the FAS and BIS equations had the lowest GFR estimates.The five equations showed good consistency.In males, the Kendall's W coefficient was 0.796 (P = 0.000); the female Kendall's W coefficient was 0.715 (P = 0.000). Based on three ranges of serum creatinine (<88.4 μmol/L, ≥88.4 μmol/L and <132.6 μmol/L, ≥132.6 μmol/L), all patients were divided into three groups.The BIS, MDRD, MDRDc and FAS equations were all consistent in staging CKD at any creatinine level; however, the CKD-EPI equation significantly overestimated renal function at higher levels of serum creatinine.There was no clear age-related trend when each of the five equations was used to calculate the average 3-year eGFR rate. Conclusions The CKD-EPI, MDRD, MDRDc, FAS and BIS equations can be used to assess renal function, but the results vary among different populations.Which equation has the best accuracy for the elderly in China remains inconclusive and further research is urgently needed. Key words: glomerular filtration rate; Aging
{"title":"Comparison of different equations for estimating glomerular filtration rate for evaluating renal function in people aged 70 years and older","authors":"Leng Xu, Aiqun Chen, Chuanbao Li, Ban Zhao, Y. Mao","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.12.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.12.004","url":null,"abstract":"Objective \u0000To assess the value of different equations for estimating glomerular filtration rate (GFR) for evaluating renal function in people aged 70 years and older. \u0000 \u0000 \u0000Methods \u0000A retrospective study was conducted involving 11 966 elderly people aged 70 years and older, including 5 741 males (48.0%), who underwent routine physical examinations in Beijing Hospital from January 2012 to December 2014 and were followed up for 3 years.Baseline data, including the age, gender, and serum creatinine, were recorded. \u0000 \u0000 \u0000Results \u0000function was assessed using Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), Modification of Diet in Renal Disease (MDRD) Study, Chinese Modification of Diet in Renal Disease (MDRD) Study, full age spectrum (FAS) equation and Berlin Initiative Study (BIS) equation, respectively.Results The serum creatinine level increased with age in male and female subjects, and the standard deviation also increased with age, indicating greater variability of serum creatinine in the elderly.Of all equations, the FAS and BIS equations had the lowest GFR estimates.The five equations showed good consistency.In males, the Kendall's W coefficient was 0.796 (P = 0.000); the female Kendall's W coefficient was 0.715 (P = 0.000). Based on three ranges of serum creatinine (<88.4 μmol/L, ≥88.4 μmol/L and <132.6 μmol/L, ≥132.6 μmol/L), all patients were divided into three groups.The BIS, MDRD, MDRDc and FAS equations were all consistent in staging CKD at any creatinine level; however, the CKD-EPI equation significantly overestimated renal function at higher levels of serum creatinine.There was no clear age-related trend when each of the five equations was used to calculate the average 3-year eGFR rate. \u0000 \u0000 \u0000Conclusions \u0000The CKD-EPI, MDRD, MDRDc, FAS and BIS equations can be used to assess renal function, but the results vary among different populations.Which equation has the best accuracy for the elderly in China remains inconclusive and further research is urgently needed. \u0000 \u0000 \u0000Key words: \u0000glomerular filtration rate; Aging","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1334-1338"},"PeriodicalIF":0.0,"publicationDate":"2019-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46141916","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}
Vestibular paroxysmal vertigo (VP) is characterized by recurrent positional vertigo, which is easily misdiagnosed as benign paroxysmal positional vertigo, Meniere's disease, posterior circulation ischemia, and other diseases. We report 3 elderly patients with onset of paroxysmal dizziness. Complete brain magnetic resonance imaging revealed vascular compression of the vestibular nerve. After oral treatment with drugs such as carbamazepine or sodium valproate, the symptoms of dizziness improved, and the final clinical diagnosis was vestibular paroxysmal syndrome.
{"title":"Three case reports of vestibular paroxysmal in the elderly","authors":"Lijiun Ma, Jiangxia Yin, Jing Bai, Fang Lv, Z. Hua","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.12.026","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.12.026","url":null,"abstract":"前庭阵发症(VP)以反复发作的体位性眩晕为主要临床表现，临床上易误诊为良性阵发性位置性眩晕、梅尼埃病、后循环缺血等疾病。我们报道3例老年患者以发作性眩晕起病，完善颅脑核磁共振检查发现血管压迫前庭神经，经口服卡马西平或丙戊酸钠等药物治疗后眩晕症状好转，最终临床诊断为前庭阵发症。","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1428-1430"},"PeriodicalIF":0.0,"publicationDate":"2019-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47919566","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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