Pub Date : 2019-12-14DOI: 10.3760/CMA.J.ISSN.0254-9026.2019.12.005
Q. Lu, Mei-ling Xu, Huanyuan Wang, Qiping Yu
Objective To investigate the relationship of National Institute of Health Stroke Scale(NIHSS)with heart rate variability(HRV)and cardiac complication in elderly patients with acute cerebral infarction, and to clarify the effect of early drug intervention on the regulation of autonomic nerve function in patients with high NIHSS score. Methods One hundred twenty-six inpatients with first-onset acute cerebral infarction(ACI)(the cerebral infarction group)and 40 healthy subjects with no history of stroke(the control group)were retrospectively enrolled.All subjects underwent examinations of NIHSS and 24 h dynamic electrocardiogram.According to NIHSS score, patients in the cerebral infarction group were divided into 3 subgroups: NIHSS score 0-4 group(n=32), NIHSS score 5-15 group(n=66)and NIHSS score ≥ 15 group(n=28). The difference in HRV parameters were compared between ACI patients and the controls.Ninety-four ACI patients with NIHSS score ≥5 were randomly divided into 2 groups: (1)the traditional treatment group(n=44), taking routine drugs for cerebral infarction; (2)the special treatment group(n=42), taking metoprolol sustained release tablet and Shensonyangxin capsule as add-on to the routine drugs for cerebral infarction.The 24 h dynamic electrocardiogram examination were conducted 30 days after treatment.The differences in HRV parameters and cardiac complications were compared between the two treatment groups. Results In patients with acute cerebral infarction, the time-domain parameters of normal-to-normal intervals(NNI), standard deviation of normal-to-normal intervals(SDNN), square root of the mean squared successive differences between normal-to-normaI RR intervals(RMSSD), percentage of adjacent normal-to-normal intervals that differed more than 50 ms(PNN50), frequency domain parameters low-frequency(LF)power and high-frequency(HF)power were significantly reduced as compared with those in the control group(P<0.05). While, pulse rate and frequency domain parameters of sympathetic vagus balance index(LF/HF)were significantly increased(P<0.05). The time-domain parameters(NNI, SDNN, RMSSD and PNN50)and frequency domain parameters(LF, HF)were significantly reduced in the NIHSS score 5-15 group and NIHSS score ≥15 group as compared with the control group and the NIHSS score 0-4 group(P<0.05). The time-domain parameters(RMSSD and PNN50)and frequency domain parameters(LF and HF)were reduced(P<0.05), and the frequency domain parameters(LF/HF)were increased(P<0.05)in NIHSS score ≥15 group compared with in NIHSS score 5-15 group(P<0.05). Compared with pre-treatment, the special treatment group after treatment showed that the time domain parameters(NNI, SDNN, RMSSD and PNN50)and frequency domain parameters(LF and HF)were significantly increased(P<0.05), the frequency domain parameters(LF/HF)were significantly reduced(P<0.05)and the incidence of cardiac complication(total incidence of atrial arrhythmias and ventricular arrhythmias and cardi
{"title":"Study on the relationship of National Institutes of Health Stroke Scale score with heart rate variability and cardiac complication in elderly patients with acute cerebral infarction","authors":"Q. Lu, Mei-ling Xu, Huanyuan Wang, Qiping Yu","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.12.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.12.005","url":null,"abstract":"Objective \u0000To investigate the relationship of National Institute of Health Stroke Scale(NIHSS)with heart rate variability(HRV)and cardiac complication in elderly patients with acute cerebral infarction, and to clarify the effect of early drug intervention on the regulation of autonomic nerve function in patients with high NIHSS score. \u0000 \u0000 \u0000Methods \u0000One hundred twenty-six inpatients with first-onset acute cerebral infarction(ACI)(the cerebral infarction group)and 40 healthy subjects with no history of stroke(the control group)were retrospectively enrolled.All subjects underwent examinations of NIHSS and 24 h dynamic electrocardiogram.According to NIHSS score, patients in the cerebral infarction group were divided into 3 subgroups: NIHSS score 0-4 group(n=32), NIHSS score 5-15 group(n=66)and NIHSS score ≥ 15 group(n=28). The difference in HRV parameters were compared between ACI patients and the controls.Ninety-four ACI patients with NIHSS score ≥5 were randomly divided into 2 groups: (1)the traditional treatment group(n=44), taking routine drugs for cerebral infarction; (2)the special treatment group(n=42), taking metoprolol sustained release tablet and Shensonyangxin capsule as add-on to the routine drugs for cerebral infarction.The 24 h dynamic electrocardiogram examination were conducted 30 days after treatment.The differences in HRV parameters and cardiac complications were compared between the two treatment groups. \u0000 \u0000 \u0000Results \u0000In patients with acute cerebral infarction, the time-domain parameters of normal-to-normal intervals(NNI), standard deviation of normal-to-normal intervals(SDNN), square root of the mean squared successive differences between normal-to-normaI RR intervals(RMSSD), percentage of adjacent normal-to-normal intervals that differed more than 50 ms(PNN50), frequency domain parameters low-frequency(LF)power and high-frequency(HF)power were significantly reduced as compared with those in the control group(P<0.05). While, pulse rate and frequency domain parameters of sympathetic vagus balance index(LF/HF)were significantly increased(P<0.05). The time-domain parameters(NNI, SDNN, RMSSD and PNN50)and frequency domain parameters(LF, HF)were significantly reduced in the NIHSS score 5-15 group and NIHSS score ≥15 group as compared with the control group and the NIHSS score 0-4 group(P<0.05). The time-domain parameters(RMSSD and PNN50)and frequency domain parameters(LF and HF)were reduced(P<0.05), and the frequency domain parameters(LF/HF)were increased(P<0.05)in NIHSS score ≥15 group compared with in NIHSS score 5-15 group(P<0.05). Compared with pre-treatment, the special treatment group after treatment showed that the time domain parameters(NNI, SDNN, RMSSD and PNN50)and frequency domain parameters(LF and HF)were significantly increased(P<0.05), the frequency domain parameters(LF/HF)were significantly reduced(P<0.05)and the incidence of cardiac complication(total incidence of atrial arrhythmias and ventricular arrhythmias and cardi","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1339-1343"},"PeriodicalIF":0.0,"publicationDate":"2019-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43623796","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 "nine syndromes" are characterized by eight and a half syndromes, hemiplegia, and hemisensory impairment, which have important localization significance for hemipontine transverse infarction. Here is a report on a patient with atypical "nine syndromes" (eight and a half syndromes+hemiplegia) diagnosed and treated in our department with acute bilateral pontine infarction.
{"title":"A case of acute bilateral pontine infarction presenting as \"Nine\" syndrome","authors":"Shugang Cao, Rongfeng Wang, Mingwu Xia","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.12.025","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.12.025","url":null,"abstract":"\"九个综合征\"表现为八个半综合征＋偏瘫与偏身感觉障碍，对于脑桥半侧横贯性梗死有重要的定位意义。现将我科诊治的1例表现为不典型的\"九个综合征\"(八个半综合征＋偏瘫)的急性双侧脑桥梗死患者报道如下。","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1426-1427"},"PeriodicalIF":0.0,"publicationDate":"2019-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42096289","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.0254-9026.2019.12.011
Wenfeng Zhao, Hongfeng Guo, Shihua Jin, Lei Wang
Objective To investigate clinical characteristics of urodynamics in elderly male patients with indwelling urinary catheterization. Methods Clinical urodynamics of 497 male patients with indwelling urinary catheterization aged 60 years and over from December 2010 to April 2019 in our center were retrospectively analyzed and divided into 3 groups: 60-69-year-old group(n=114), 70-79-year-old group(n=220), and 80-111-year-old group(n=163). According to the catheter indwelling time, the patients were divided into 3 groups: 1-2 weeks group(n=262), 2-4 weeks group(n=47)and over 4 weeks group(n=188). The cause of indwelling urinary catheterization, bladder outlet obstruction, acontractile detrusor and other indicators were observed. Results The main cause of indwelling urinary catheterization in elderly men was acute urinary retention(55.1%, 274 cases), in that the most common diagnosis was benign prostatic hyperplasia(90.3%, 449 cases). No statistically significant difference in the different catheter indwelling time-related urodynamics between the different age groups was found(χ2=1.606, 0.199 and 2.477, all P>0.05). There were statistically significant differences both in the incidences of bladder outlet obstruction between the 1-2 weeks vs.2-4 weeks vs.over 4 weeks groups[56.9%(149/262)vs.55.3%(26/47) vs.42.6%(80/188), χ2=9.315, P 0.05). Clinical urodynamics had no statistically significant in different age groups(P>0.05). Conclusions Bladder outlet obstruction is the main cause of indwelling urinary catheterization in elderly men.Urodynamic examination can be performed 1-2 weeks after indwelling urinary catheterization.Age has no significant effect on the catheter indwelling time-related urodynamics.The duration of indwelling urinary catheterization has little effect on the urodynamic diagnosis in patients with normal or weak detrusor muscle contractile strength.The elderly patients may have acontractile detrusor if the duration of indwelling urinary catheterization is more than 4 weeks. Key words: Urethral Catheterization; Urodynamics
{"title":"Analysis of urodynamics in elderly male patients with indwelling urinary catheterization","authors":"Wenfeng Zhao, Hongfeng Guo, Shihua Jin, Lei Wang","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.12.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.12.011","url":null,"abstract":"Objective \u0000To investigate clinical characteristics of urodynamics in elderly male patients with indwelling urinary catheterization. \u0000 \u0000 \u0000Methods \u0000Clinical urodynamics of 497 male patients with indwelling urinary catheterization aged 60 years and over from December 2010 to April 2019 in our center were retrospectively analyzed and divided into 3 groups: 60-69-year-old group(n=114), 70-79-year-old group(n=220), and 80-111-year-old group(n=163). According to the catheter indwelling time, the patients were divided into 3 groups: 1-2 weeks group(n=262), 2-4 weeks group(n=47)and over 4 weeks group(n=188). The cause of indwelling urinary catheterization, bladder outlet obstruction, acontractile detrusor and other indicators were observed. \u0000 \u0000 \u0000Results \u0000The main cause of indwelling urinary catheterization in elderly men was acute urinary retention(55.1%, 274 cases), in that the most common diagnosis was benign prostatic hyperplasia(90.3%, 449 cases). No statistically significant difference in the different catheter indwelling time-related urodynamics between the different age groups was found(χ2=1.606, 0.199 and 2.477, all P>0.05). There were statistically significant differences both in the incidences of bladder outlet obstruction between the 1-2 weeks vs.2-4 weeks vs.over 4 weeks groups[56.9%(149/262)vs.55.3%(26/47) vs.42.6%(80/188), χ2=9.315, P 0.05). Clinical urodynamics had no statistically significant in different age groups(P>0.05). \u0000 \u0000 \u0000Conclusions \u0000Bladder outlet obstruction is the main cause of indwelling urinary catheterization in elderly men.Urodynamic examination can be performed 1-2 weeks after indwelling urinary catheterization.Age has no significant effect on the catheter indwelling time-related urodynamics.The duration of indwelling urinary catheterization has little effect on the urodynamic diagnosis in patients with normal or weak detrusor muscle contractile strength.The elderly patients may have acontractile detrusor if the duration of indwelling urinary catheterization is more than 4 weeks. \u0000 \u0000 \u0000Key words: \u0000Urethral Catheterization; Urodynamics","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1368-1371"},"PeriodicalIF":0.0,"publicationDate":"2019-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47539915","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.0254-9026.2019.12.020
Qiong Wei, Ling Li, Shao-hua Wang, Yuxiang Sun, Zi-lin Sun
Objective To investigate the effects of acylated ghrelin and des-acylated ghrelin on skeletal muscle atrophy in elderly mice. Methods Eighteen-month-old wild type(WT)mice and ghrelin-/- mice were selected to perform body composition analysis and wheel-running test under conditions of feeding versus fasting.The gene expressions of myogenic regulatory factors including muscle differentiation factor MyoD, myogenin, atrogin-1, muscle-specific RING finger protein 1(muRF-1), and insulin growth factor 1(IGF-1)in mice gastrocnemius muscle were detected by realtime polymerase chain reaction(PCR). Results The locomotor activity during the wheel-running test were significantly lower in elderly ghrelin-/- mice than in elderly WT mice(3 929±263 times/h vs.5359±601 times/h, t=4.87, P 0.05). After 48 h fasting, the decrements of body weight, fat and muscle weight were more in ghrelin-/- mice than in WT mice(P<0.05). In fasting old ghrelin-/- mice, the gene expressions of MyoD and myogenin were increased(improved)(t=232.00 and 121.00, P<0.05), and the gene expressions of atrogin-1 and muRF-1 were decreased(improved)(t=30.40 and 54.00, P<0.05)after treatment with both acylated ghrelin and desacylated ghrelin. Conclusions The acylated ghrelin and desacylated ghrelin may play protective roles in age-related muscle atrophy. Key words: Ghrelin; Muscular atrophy
{"title":"Effects of exogenous ghrelin on muscle atrophy in elderly mice","authors":"Qiong Wei, Ling Li, Shao-hua Wang, Yuxiang Sun, Zi-lin Sun","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.12.020","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.12.020","url":null,"abstract":"Objective To investigate the effects of acylated ghrelin and des-acylated ghrelin on skeletal muscle atrophy in elderly mice. Methods Eighteen-month-old wild type(WT)mice and ghrelin-/- mice were selected to perform body composition analysis and wheel-running test under conditions of feeding versus fasting.The gene expressions of myogenic regulatory factors including muscle differentiation factor MyoD, myogenin, atrogin-1, muscle-specific RING finger protein 1(muRF-1), and insulin growth factor 1(IGF-1)in mice gastrocnemius muscle were detected by realtime polymerase chain reaction(PCR). Results The locomotor activity during the wheel-running test were significantly lower in elderly ghrelin-/- mice than in elderly WT mice(3 929±263 times/h vs.5359±601 times/h, t=4.87, P 0.05). After 48 h fasting, the decrements of body weight, fat and muscle weight were more in ghrelin-/- mice than in WT mice(P<0.05). In fasting old ghrelin-/- mice, the gene expressions of MyoD and myogenin were increased(improved)(t=232.00 and 121.00, P<0.05), and the gene expressions of atrogin-1 and muRF-1 were decreased(improved)(t=30.40 and 54.00, P<0.05)after treatment with both acylated ghrelin and desacylated ghrelin. Conclusions The acylated ghrelin and desacylated ghrelin may play protective roles in age-related muscle atrophy. Key words: Ghrelin; Muscular atrophy","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1404-1407"},"PeriodicalIF":0.0,"publicationDate":"2019-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48778688","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.0254-9026.2019.12.024
Yanni Wang, Cui Li, Xiaoming Wang
{"title":"A case reports of still disease in the elderly","authors":"Yanni Wang, Cui Li, Xiaoming Wang","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.12.024","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.12.024","url":null,"abstract":"","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1424-1425"},"PeriodicalIF":0.0,"publicationDate":"2019-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41942006","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 retrospectively analyze clinical data of elderly patients with small-cell lung cancer(SCLC)in order to investigate their prognostic factors. Methods Clinical data of SCLC patients aged 65 years and over in our hospital from January 2006 to February 2017 were analyzed.Survival data were analyzed by Kaplan-Meier method.Univariate analysis of prognosis was conducted by Log rank test.Multivariate analysis was performed by Cox regression. Results A total of 143 patients were enrolled, the median overall survival(OS)was 17.9 months, with 21.3 months for limit stage(LD)and 9.6 months for extensive stage(ED). For LD patients, age(HR=18.688, 95%CI: 3.237-107.889), smoking index(HR=2.783, 95%CI: 1.196-6.475), thoracic irradiation(HR=0.305, 95%CI: 0.120-0.779), chemotherapy efficacy(HR=0.210, 95%CI: 0.065-0.685)were the independent risk factors for the prognosis.For ED patients, chemotherapy cycles(HR=0.461, 95%CI: 0.229-0.927)and performance status(HR=0.422, 95%CI: 0.218-0.818)were the independent risk factors for prognosis. Conclusions Smoking index, tumor stage and treatment mode can influence the survival of SCLC patients.The LD patients, who were aged less than 75 years, with smoking index less than 1000, receiving thoracic irradiation and achieving remission with chemotherapy, show a longer OS.For ED patients, a good performance status and sufficient chemotherapy can predict an improved OS. Key words: Smallcell lung carcinoma; Prognosis
{"title":"Prognostic factor analysis of elderly patients with small-cell lung cancer","authors":"Yi-xia Yin, Zhangzhou Huang, Yunjian Huang, Biao Wu","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.12.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.12.009","url":null,"abstract":"Objective \u0000To retrospectively analyze clinical data of elderly patients with small-cell lung cancer(SCLC)in order to investigate their prognostic factors. \u0000 \u0000 \u0000Methods \u0000Clinical data of SCLC patients aged 65 years and over in our hospital from January 2006 to February 2017 were analyzed.Survival data were analyzed by Kaplan-Meier method.Univariate analysis of prognosis was conducted by Log rank test.Multivariate analysis was performed by Cox regression. \u0000 \u0000 \u0000Results \u0000A total of 143 patients were enrolled, the median overall survival(OS)was 17.9 months, with 21.3 months for limit stage(LD)and 9.6 months for extensive stage(ED). For LD patients, age(HR=18.688, 95%CI: 3.237-107.889), smoking index(HR=2.783, 95%CI: 1.196-6.475), thoracic irradiation(HR=0.305, 95%CI: 0.120-0.779), chemotherapy efficacy(HR=0.210, 95%CI: 0.065-0.685)were the independent risk factors for the prognosis.For ED patients, chemotherapy cycles(HR=0.461, 95%CI: 0.229-0.927)and performance status(HR=0.422, 95%CI: 0.218-0.818)were the independent risk factors for prognosis. \u0000 \u0000 \u0000Conclusions \u0000Smoking index, tumor stage and treatment mode can influence the survival of SCLC patients.The LD patients, who were aged less than 75 years, with smoking index less than 1000, receiving thoracic irradiation and achieving remission with chemotherapy, show a longer OS.For ED patients, a good performance status and sufficient chemotherapy can predict an improved OS. \u0000 \u0000 \u0000Key words: \u0000Smallcell lung carcinoma; Prognosis","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1357-1362"},"PeriodicalIF":0.0,"publicationDate":"2019-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49071615","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.0254-9026.2019.12.015
Hongjian Liu
Objective To investigate the clinical effect of surgical treatment of pituitary adenoma via neuroendoscopic-assisted transsphenoidal approach in elderly patients. Methods This was a prospective case-control study.Eighty-five patients with senile pituitary adenoma admitted to our hospital from May 2015 to February 2018 were consecutively enrolled in our study.Patients with pituitary adenoma were divided into the control group(n=42)undergoing conventional microsurgery and the observation group(n=43)receiving microsurgery via neuroendoscopic-assisted transsphenoidal approach.The effect of surgery, perioperative indexes(intraoperative blood loss, operation time, hospitalization time)and the serum level changes of prolactin(PRL), growth hormone(GH)and adrenocorticotropic hormone(ACTH)before and after surgery were recorded and compared between two groups.The incidences of complications in both groups and the dimensions of life quality(physical, cognitive, emotional, social activities)before and after surgery were calculated and assessed. Results The total effective rate was higher in the observation group(88.4%, 38/43)than in the control group(69.0%, 29/42)(P 0.05). However, serum levels of PRL, GH and ACTH were deceased in both groups at 3 days after operation compared with before operation.The incidence of complications was lower in the observation group than in the control group(4.7% or 2/43 vs.21.4% or 9/42, P<0.05). The quality of life scores of the cognitive, role, physical, emotional and social dimensions were higher in the observation group than in the control group(P<0.01). Conclusions Neuroendoscopic-assisted transsphenoidal approach for surgical treatment of senile pituitary adenomas has less intraoperative blood loss, shorter operation time and lower complication rate, improves the endocrine hormone levels and the quality of life, and shortens the hospital stays. Key words: ACTH-secreting pituitary adenoma; Neuroendoscopes; Transsphenoidal approach; Pituitary adenoma resection
{"title":"Efficacy and safety of pituitary adenomectomy purely endoscopically via a transsphenoidal approach in elderly patients","authors":"Hongjian Liu","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.12.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.12.015","url":null,"abstract":"Objective \u0000To investigate the clinical effect of surgical treatment of pituitary adenoma via neuroendoscopic-assisted transsphenoidal approach in elderly patients. \u0000 \u0000 \u0000Methods \u0000This was a prospective case-control study.Eighty-five patients with senile pituitary adenoma admitted to our hospital from May 2015 to February 2018 were consecutively enrolled in our study.Patients with pituitary adenoma were divided into the control group(n=42)undergoing conventional microsurgery and the observation group(n=43)receiving microsurgery via neuroendoscopic-assisted transsphenoidal approach.The effect of surgery, perioperative indexes(intraoperative blood loss, operation time, hospitalization time)and the serum level changes of prolactin(PRL), growth hormone(GH)and adrenocorticotropic hormone(ACTH)before and after surgery were recorded and compared between two groups.The incidences of complications in both groups and the dimensions of life quality(physical, cognitive, emotional, social activities)before and after surgery were calculated and assessed. \u0000 \u0000 \u0000Results \u0000The total effective rate was higher in the observation group(88.4%, 38/43)than in the control group(69.0%, 29/42)(P 0.05). However, serum levels of PRL, GH and ACTH were deceased in both groups at 3 days after operation compared with before operation.The incidence of complications was lower in the observation group than in the control group(4.7% or 2/43 vs.21.4% or 9/42, P<0.05). The quality of life scores of the cognitive, role, physical, emotional and social dimensions were higher in the observation group than in the control group(P<0.01). \u0000 \u0000 \u0000Conclusions \u0000Neuroendoscopic-assisted transsphenoidal approach for surgical treatment of senile pituitary adenomas has less intraoperative blood loss, shorter operation time and lower complication rate, improves the endocrine hormone levels and the quality of life, and shortens the hospital stays. \u0000 \u0000 \u0000Key words: \u0000ACTH-secreting pituitary adenoma; Neuroendoscopes; Transsphenoidal approach; Pituitary adenoma resection","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1387-1390"},"PeriodicalIF":0.0,"publicationDate":"2019-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42194654","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.0254-9026.2019.12.021
Wen-zheng Hu, Shuai Liu, J. Gan, Xiaoshan Du, Han Zhu, Xiyu Li, Zhihong Shi, Yong Ji
Objective To investigate the prevalence of autonomic dysfunction and its influencing factors in the elderly in Jizhou community of Tianjin. Methods By using a cross-sectional study, a questionnaire survey was conducted in the elderly in order to investigate the prevalence of autonomic dysfunction and its influencing factors. Results A total of 1 292 elderly patients were enrolled.Of them, 196 cases had autonomic dysfunction(15.2%, 196/1 292). The main symptoms of autonomic dysfunction were frequent urination, urination urgency, urination incontinence(19.7%, 255/1 292)and constipation(15.9%, 205/1 292). Multivariate Logistic regression analysis showed that women(OR=1.808, 95%CI: 1.253~2.607), 75-85 years of age(OR=1.573, 95%CI: 1.109~2.232), general anesthesia history(OR=1.552, 95%CI: 1.044~2.307), sleep disorders(OR=2.906, 95%CI: 1.506~2.916), diabetes(OR=1.791, 95%CI: 1.197~2.678)and headache(OR=2.589, 95%CI: 1.482~4.520)were risk factors for autonomic dysfunction. Conclusions The prevalence of autonomic dysfunction is high in the elderly in Jizhou community of Tianjin city.It is necessary to pay great attention to potential risk factors of autonomic dysfunction in the elderly.And the autonomic dysfunction symptoms should be diagnosed and treated as early as possible. Key words: Autonomic nervous system diseases; Prevalence; Epidemiologic factors; Cross-sectional studies
{"title":"Prevalence of autonomic dysfunction and its influencing factors in Chinese elderly","authors":"Wen-zheng Hu, Shuai Liu, J. Gan, Xiaoshan Du, Han Zhu, Xiyu Li, Zhihong Shi, Yong Ji","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.12.021","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.12.021","url":null,"abstract":"Objective \u0000To investigate the prevalence of autonomic dysfunction and its influencing factors in the elderly in Jizhou community of Tianjin. \u0000 \u0000 \u0000Methods \u0000By using a cross-sectional study, a questionnaire survey was conducted in the elderly in order to investigate the prevalence of autonomic dysfunction and its influencing factors. \u0000 \u0000 \u0000Results \u0000A total of 1 292 elderly patients were enrolled.Of them, 196 cases had autonomic dysfunction(15.2%, 196/1 292). The main symptoms of autonomic dysfunction were frequent urination, urination urgency, urination incontinence(19.7%, 255/1 292)and constipation(15.9%, 205/1 292). Multivariate Logistic regression analysis showed that women(OR=1.808, 95%CI: 1.253~2.607), 75-85 years of age(OR=1.573, 95%CI: 1.109~2.232), general anesthesia history(OR=1.552, 95%CI: 1.044~2.307), sleep disorders(OR=2.906, 95%CI: 1.506~2.916), diabetes(OR=1.791, 95%CI: 1.197~2.678)and headache(OR=2.589, 95%CI: 1.482~4.520)were risk factors for autonomic dysfunction. \u0000 \u0000 \u0000Conclusions \u0000The prevalence of autonomic dysfunction is high in the elderly in Jizhou community of Tianjin city.It is necessary to pay great attention to potential risk factors of autonomic dysfunction in the elderly.And the autonomic dysfunction symptoms should be diagnosed and treated as early as possible. \u0000 \u0000 \u0000Key words: \u0000Autonomic nervous system diseases; Prevalence; Epidemiologic factors; Cross-sectional studies","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1408-1412"},"PeriodicalIF":0.0,"publicationDate":"2019-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43459725","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.0254-9026.2019.12.018
Rui Wang, Fei-Fei Wang
Objective To investigate the clinical effect of microsurgical operation combined with liquid nitrogen cryotherapy on squamous cell carcinoma in elderly patients. Methods Forty-six patients with squamous cell carcinoma visiting dermatology department of our hospital from January 2011 to July 2014 were enrolled.They were randomizely divided into two groups: the control group(n=23)receiving a microsurgical treatment and the observation group(n=23)receiving liquid nitrogen cryotherapy as add-on to a microsurgical operation.All patients were followed up for 1-3 years.Clinical efficacy, 1-year recurrence rate, 1-year transfer rate and the survival rate were compared between the two groups. Results The total effective rate was higher in the observation group than in the control group(91.3% vs.82.6%, P<0.05). The 1-year recurrence rate and 1-year transfer rate were lower in the observation group than in the control group(13.4% vs.17.4%, 4.3% vs.8.7%, P<0.05). Conclusions The surgery combined with liquid nitrogen cryotherapy for cutaneous squamous cell carcinoma can significantly reduce the recurrence rate and transfer rate after operation and prolong the survival time, which is worthy of further research and promotion. Key words: Crgotherapy; Skin neoplasms; Neoplasms, squamous cell
{"title":"Clinical effect of microsurgical operation combined with liquid nitrogen cryotherapy on squamous cell carcinoma in elderly patients","authors":"Rui Wang, Fei-Fei Wang","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.12.018","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.12.018","url":null,"abstract":"Objective \u0000To investigate the clinical effect of microsurgical operation combined with liquid nitrogen cryotherapy on squamous cell carcinoma in elderly patients. \u0000 \u0000 \u0000Methods \u0000Forty-six patients with squamous cell carcinoma visiting dermatology department of our hospital from January 2011 to July 2014 were enrolled.They were randomizely divided into two groups: the control group(n=23)receiving a microsurgical treatment and the observation group(n=23)receiving liquid nitrogen cryotherapy as add-on to a microsurgical operation.All patients were followed up for 1-3 years.Clinical efficacy, 1-year recurrence rate, 1-year transfer rate and the survival rate were compared between the two groups. \u0000 \u0000 \u0000Results \u0000The total effective rate was higher in the observation group than in the control group(91.3% vs.82.6%, P<0.05). The 1-year recurrence rate and 1-year transfer rate were lower in the observation group than in the control group(13.4% vs.17.4%, 4.3% vs.8.7%, P<0.05). \u0000 \u0000 \u0000Conclusions \u0000The surgery combined with liquid nitrogen cryotherapy for cutaneous squamous cell carcinoma can significantly reduce the recurrence rate and transfer rate after operation and prolong the survival time, which is worthy of further research and promotion. \u0000 \u0000 \u0000Key words: \u0000Crgotherapy; Skin neoplasms; Neoplasms, squamous cell","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1398-1400"},"PeriodicalIF":0.0,"publicationDate":"2019-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48949190","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 investigate the clinical characteristics and risk factors for pulmonary infection in elderly patients with hip fracture after the treatment through a model of orthopedic-geriatric co-care, in order to provide prevention and control strategies. Methods Clinical data and laboratory results of elderly patients with hip fractures admitted into our hospital from January 2016 to May 2016 were collected.The differences in treatment outcome and adverse reactions were retrospectively compared between the two groups of patients with versus without pulmonary infection, and univariate and multivariate analysis of lung infection were performed. Results Of 207 patients, 43 were infected with pneumonia and 164 were not.The proportion of patients with the time interval<48 h from admission to surgery was 48.6%(86/177), and the time interval<1 week from admission to surgery was 98.9%(175/177). The average length of hospital stay was(7.9±3.5)days.There was no significant difference in the time interval from admission to surgery, the time spent on surgery, length of hospital stay, surgical procedure and inflammatory indicators between the pneumonia and non-pneumonia groups.Univariate analysis showed that advanced age, multiple primary diseases, primary lung diseases, chronic respiratory failure, cerebrovascular disease, sequelae of cerebrovascular disease, immune system disease or long-term oral hormone therapy and preoperative anemia were risk factors for pulmonary infection in elderly patients with hip fracture(P<0.05 or<0.01). Multivariate regression analysis showed that advanced age(OR=1.239, 95%CI: 1.016~1.595, P=0.051), preoperative anemia(OR=2.491, 95%CI: 1.148~5.403, P=0.021), sequelae of cerebrovascular disease(OR=3.987, 95%CI: 1.354~11.741, P=0.012), primary lung diseases(OR=4.404, 95%CI: 1.800~11.078, P=0.001)and immune system diseases(OR=17.166, 95%CI: 1.750~168.409, P=0.015)were independent risk factors for pulmonary infection in elderly patients with hip fracture. Conclusions The orthopedic-geriatric co-care model seems to be in favour of controlling the progress of pulmonary infection in elderly patients with hip fracture, and to shorten waiting time before surgery and length of hospital stay.However, advanced age and chronic diseases are unpreventable risk factors for pulmonary infection in elderly patients with hip fractures.Clinicians should pay attention to the high-risk population and take prevention and control strategies to prevent the occurrence and development of lung infections. Key words: Hip fractures; Respiratory tract infections; Risk factors
{"title":"Analysis of clinical characteristics and risk factors for pulmonary infection in elderly patients with hip fracture","authors":"Yuan Yuan, W. Tian, Xiaohui Deng, Rui Yue, Xiaozhu Ge, Xinbao Wu, Ping Zhang","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.12.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.12.013","url":null,"abstract":"Objective \u0000To investigate the clinical characteristics and risk factors for pulmonary infection in elderly patients with hip fracture after the treatment through a model of orthopedic-geriatric co-care, in order to provide prevention and control strategies. \u0000 \u0000 \u0000Methods \u0000Clinical data and laboratory results of elderly patients with hip fractures admitted into our hospital from January 2016 to May 2016 were collected.The differences in treatment outcome and adverse reactions were retrospectively compared between the two groups of patients with versus without pulmonary infection, and univariate and multivariate analysis of lung infection were performed. \u0000 \u0000 \u0000Results \u0000Of 207 patients, 43 were infected with pneumonia and 164 were not.The proportion of patients with the time interval<48 h from admission to surgery was 48.6%(86/177), and the time interval<1 week from admission to surgery was 98.9%(175/177). The average length of hospital stay was(7.9±3.5)days.There was no significant difference in the time interval from admission to surgery, the time spent on surgery, length of hospital stay, surgical procedure and inflammatory indicators between the pneumonia and non-pneumonia groups.Univariate analysis showed that advanced age, multiple primary diseases, primary lung diseases, chronic respiratory failure, cerebrovascular disease, sequelae of cerebrovascular disease, immune system disease or long-term oral hormone therapy and preoperative anemia were risk factors for pulmonary infection in elderly patients with hip fracture(P<0.05 or<0.01). Multivariate regression analysis showed that advanced age(OR=1.239, 95%CI: 1.016~1.595, P=0.051), preoperative anemia(OR=2.491, 95%CI: 1.148~5.403, P=0.021), sequelae of cerebrovascular disease(OR=3.987, 95%CI: 1.354~11.741, P=0.012), primary lung diseases(OR=4.404, 95%CI: 1.800~11.078, P=0.001)and immune system diseases(OR=17.166, 95%CI: 1.750~168.409, P=0.015)were independent risk factors for pulmonary infection in elderly patients with hip fracture. \u0000 \u0000 \u0000Conclusions \u0000The orthopedic-geriatric co-care model seems to be in favour of controlling the progress of pulmonary infection in elderly patients with hip fracture, and to shorten waiting time before surgery and length of hospital stay.However, advanced age and chronic diseases are unpreventable risk factors for pulmonary infection in elderly patients with hip fractures.Clinicians should pay attention to the high-risk population and take prevention and control strategies to prevent the occurrence and development of lung infections. \u0000 \u0000 \u0000Key words: \u0000Hip fractures; Respiratory tract infections; Risk factors","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1377-1382"},"PeriodicalIF":0.0,"publicationDate":"2019-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43178698","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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