Pub Date : 2019-11-14DOI: 10.3760/CMA.J.ISSN.0254-9026.2019.11.020
L. Meng, Xiaodong Liu, Wei Zhang, Jj Wang, Miao Wang, Xu Sen
Objective To evaluate the effectiveness and safety of sacral neuromodulation(SNM)in the treatment of non-neurogenic and non-obstructive dysuria in elderly patients. Methods Six elderly patients with non-neurogenic and non-obstructive(2 males and 4 females)treated with SNM were recruited from multiple medical centers across the country in this retrospective study from January 2012 to December 2016.All patients received two or more conservative treatments including behavior therapy, oral therapy, etc., with no good effect.Data of the average residual urine volume, average urine volume, maximum urine volume, average urinary frequency and quality of life score before operation, after implantation of stage Ⅰ tined lead, and at the end of follow-up after implantation of stage Ⅱ implanted pulse generator(IPG)were compared. Results The average age in the 6 patients was 69.5(65~79)years.The results of SNM treatment showed that the objective findings and/or subjective symptoms in all patients were significantly improved in more than 50% of indexes before treatment.All patients chose embedding of IPG at the end of stage Ⅰ, with 100.0% of the conversion rate from stage Ⅰ to stage Ⅱ.The curative effect was stable in general.At stages of baseline, personal experience and end of follow-up respectively, the average residual urine volumes were(161.7±110.2)ml, (70.0±52.2)ml, and(50.0±44.7)ml, the average urine volume were(105.0±74.0)ml, (163.3±93.1)ml, and(155.0±92.3)ml, and the maximum urine volume were(146.7±81.2)ml, (216.7±93.1)ml, and(206.7±112.7)ml, which showed continuously significant improvements with patients' great satisfaction.The mean duration of fellow-up in 6 cases was 17.5 months(7-57 months). No severe adverse reactions such as wound infection, electrode dislocation and hematoma were observed. Conclusions SNM treatment is safe and effective for elderly patients with non-neurogenic and non-obstructive dysuria who are refractory to other treatments.SNM has a stable medium-term curative effect and a high-transfer-rate from stage Ⅰ to stage Ⅱ, which is appropriate for non-neurogenic and non-obstructive dysuria.The duration of SNM may be positively correlated with the improvement of residual urine volume and urination frequency. Key words: Dysuria; Sacral neuromodulation
{"title":"Analysis of efficiency of sacral neuromodulation in the treatment of non-neurogenic and non-obstructive dysuria in elderly patients","authors":"L. Meng, Xiaodong Liu, Wei Zhang, Jj Wang, Miao Wang, Xu Sen","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.11.020","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.11.020","url":null,"abstract":"Objective \u0000To evaluate the effectiveness and safety of sacral neuromodulation(SNM)in the treatment of non-neurogenic and non-obstructive dysuria in elderly patients. \u0000 \u0000 \u0000Methods \u0000Six elderly patients with non-neurogenic and non-obstructive(2 males and 4 females)treated with SNM were recruited from multiple medical centers across the country in this retrospective study from January 2012 to December 2016.All patients received two or more conservative treatments including behavior therapy, oral therapy, etc., with no good effect.Data of the average residual urine volume, average urine volume, maximum urine volume, average urinary frequency and quality of life score before operation, after implantation of stage Ⅰ tined lead, and at the end of follow-up after implantation of stage Ⅱ implanted pulse generator(IPG)were compared. \u0000 \u0000 \u0000Results \u0000The average age in the 6 patients was 69.5(65~79)years.The results of SNM treatment showed that the objective findings and/or subjective symptoms in all patients were significantly improved in more than 50% of indexes before treatment.All patients chose embedding of IPG at the end of stage Ⅰ, with 100.0% of the conversion rate from stage Ⅰ to stage Ⅱ.The curative effect was stable in general.At stages of baseline, personal experience and end of follow-up respectively, the average residual urine volumes were(161.7±110.2)ml, (70.0±52.2)ml, and(50.0±44.7)ml, the average urine volume were(105.0±74.0)ml, (163.3±93.1)ml, and(155.0±92.3)ml, and the maximum urine volume were(146.7±81.2)ml, (216.7±93.1)ml, and(206.7±112.7)ml, which showed continuously significant improvements with patients' great satisfaction.The mean duration of fellow-up in 6 cases was 17.5 months(7-57 months). No severe adverse reactions such as wound infection, electrode dislocation and hematoma were observed. \u0000 \u0000 \u0000Conclusions \u0000SNM treatment is safe and effective for elderly patients with non-neurogenic and non-obstructive dysuria who are refractory to other treatments.SNM has a stable medium-term curative effect and a high-transfer-rate from stage Ⅰ to stage Ⅱ, which is appropriate for non-neurogenic and non-obstructive dysuria.The duration of SNM may be positively correlated with the improvement of residual urine volume and urination frequency. \u0000 \u0000 \u0000Key words: \u0000Dysuria; Sacral neuromodulation","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1273-1277"},"PeriodicalIF":0.0,"publicationDate":"2019-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42163249","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 : 2019-11-14DOI: 10.3760/CMA.J.ISSN.0254-9026.2019.11.021
Wei Zhu, Shao-Qing Wang, Guang-hui Du, Hailang Liu, Jinjin Lu
Objective To investigate the clinical characteristics during the perioperative period of pheochromocytoma in patients aged 60 years and over. Methods Data of age, sex, tumor size, anesthesia time, intraoperative bleeding volume, intraoperative blood pressure, complications and hospitalization time from patients with pheochromocytoma in our hospital treated by the retroperitoneal laparoscopic adrenalectomy from January 2008 to October 2018 were retrospectively analyzed.The relationships of age with the intraoperative hemodynamic instability and postoperative complications were analyzed. Results A total of 203 patients with pheochromocytoma met the inclusion criteria were enrolled.Age over 60 years(OR1.771, 95%CI=1.015-3.089, P=0.044)was an independent risk factor for intraoperative hemodynamic instability. Conclusions Laparoscopic retroperitoneal adrenalectomy is a safe surgical method for pheochromocytoma patients aged 60 years and over.For elderly patients with pheochromocytoma, especially those with a tumor diameter of more than 5 cm, special attention should be paid to the prevention of intraoperative hypertension crisis. Key words: Pheochromocytoma; Perioperative period
{"title":"Clinical characteristics during the perioperative period of pheochromocytomas in the elderly","authors":"Wei Zhu, Shao-Qing Wang, Guang-hui Du, Hailang Liu, Jinjin Lu","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.11.021","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.11.021","url":null,"abstract":"Objective \u0000To investigate the clinical characteristics during the perioperative period of pheochromocytoma in patients aged 60 years and over. \u0000 \u0000 \u0000Methods \u0000Data of age, sex, tumor size, anesthesia time, intraoperative bleeding volume, intraoperative blood pressure, complications and hospitalization time from patients with pheochromocytoma in our hospital treated by the retroperitoneal laparoscopic adrenalectomy from January 2008 to October 2018 were retrospectively analyzed.The relationships of age with the intraoperative hemodynamic instability and postoperative complications were analyzed. \u0000 \u0000 \u0000Results \u0000A total of 203 patients with pheochromocytoma met the inclusion criteria were enrolled.Age over 60 years(OR1.771, 95%CI=1.015-3.089, P=0.044)was an independent risk factor for intraoperative hemodynamic instability. \u0000 \u0000 \u0000Conclusions \u0000Laparoscopic retroperitoneal adrenalectomy is a safe surgical method for pheochromocytoma patients aged 60 years and over.For elderly patients with pheochromocytoma, especially those with a tumor diameter of more than 5 cm, special attention should be paid to the prevention of intraoperative hypertension crisis. \u0000 \u0000 \u0000Key words: \u0000Pheochromocytoma; Perioperative period","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1278-1281"},"PeriodicalIF":0.0,"publicationDate":"2019-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46014217","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 : 2019-11-14DOI: 10.3760/CMA.J.ISSN.0254-9026.2019.11.019
Chen Jianbin, Wei Sidong, Sun Jianjun, Liu Guangbo, Tan Gaofeng, Xie Zhantao
Objective To compare the clinical effects between laparoscopic cholecystectomy and choledochotomy versus traditional open cholecystectomy plus choledochotomy. Methods One hundred and sixty-eight elderly patients with gallbladder and choledocholithiasis were divided into a laparoscopy group(n=75, receiving laparoscopic cholecystectomy and choledochotomy)and an open abdominal group(n=93, undergoing traditional open cholecystectomy and common bile duct exploration). The surgical incision length, operation time, intraoperative blood loss, anal exhaust time, hospital stay and postoperative complications were compared between the two groups. Results The surgical incision length, operation time, intraoperative blood loss, anal exhaust time, hospital stay were lower in the laparoscopic group than in the open abdominal group(P<0.05). The incidence of postoperative complications was lower in the laparoscopic group than in the open group(P<0.05). Conclusions Laparoscopic cholecystectomy and choledochotomy can obviously improve the clinical efficacy and reduce complications in elderly patients with gallbladder and choledocholithiasis, and it is worthy of clinical application. Key words: Laparoscopes; Cholecystolithiasis; Choledocholithiasis
{"title":"The comparison of clinical effects between laparoscopic cholecystectomy and choledochotomy versus laparotomy for the treatment of the gallbladder and choledocholithiasis in elderly patients","authors":"Chen Jianbin, Wei Sidong, Sun Jianjun, Liu Guangbo, Tan Gaofeng, Xie Zhantao","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.11.019","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.11.019","url":null,"abstract":"Objective \u0000To compare the clinical effects between laparoscopic cholecystectomy and choledochotomy versus traditional open cholecystectomy plus choledochotomy. \u0000 \u0000 \u0000Methods \u0000One hundred and sixty-eight elderly patients with gallbladder and choledocholithiasis were divided into a laparoscopy group(n=75, receiving laparoscopic cholecystectomy and choledochotomy)and an open abdominal group(n=93, undergoing traditional open cholecystectomy and common bile duct exploration). The surgical incision length, operation time, intraoperative blood loss, anal exhaust time, hospital stay and postoperative complications were compared between the two groups. \u0000 \u0000 \u0000Results \u0000The surgical incision length, operation time, intraoperative blood loss, anal exhaust time, hospital stay were lower in the laparoscopic group than in the open abdominal group(P<0.05). The incidence of postoperative complications was lower in the laparoscopic group than in the open group(P<0.05). \u0000 \u0000 \u0000Conclusions \u0000Laparoscopic cholecystectomy and choledochotomy can obviously improve the clinical efficacy and reduce complications in elderly patients with gallbladder and choledocholithiasis, and it is worthy of clinical application. \u0000 \u0000 \u0000Key words: \u0000Laparoscopes; Cholecystolithiasis; Choledocholithiasis","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1270-1272"},"PeriodicalIF":0.0,"publicationDate":"2019-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45270208","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 prevalence of malnutrition in elderly cancer inpatients based on global leadership initiative on malnutrition(GLIM)diagnostic criteria. Methods Clinical data of 1 472 inpatients with cancer aged 65 years and over from a multicenter study in 2012 were retrospectively analyzed.Nutritional assessment was performed based on GLIM diagnostic criteria and the prevalence of malnutrition in a different stratifieddiagnosis was recorded. Results Of 1472 consecutive patients, 924 cases(62.8%)were diagnosed as nutritional risk.The malnutrition rate was 51.8%(762 cases)based on GLIM diagnostic criteria, with 29.6%(436 cases)of moderate malnutrition and 22.3%(326 cases)of severe malnutrition.The prevalences of nutritional risk, total malnutrition and severe malnutrition were increased along with aging(P=0.000). There were 906 cases not receiving surgery treatment.Among the 906 cases, the prevalence of nutritional risk and malnutrition were 61.9%(561/906 cases)and 53.3%(483 /906 cases), the moderate malnutrition rate was 53.3%(483/906 cases)and the severe malnutrition rate was 22.1%(200/906 cases)respectively.There were 566 cases undergoing surgery treatment.And among 566 cases, the prevalence of nutritional risk and malnutrition were 64.1%(236 cases)and 49.5%(280 cases), the moderate malnutrition rate was 26.9%(152 cases)and the severe malnutrition rate was 22.6%(128 cases). The prevalence of nutritional risk was high in patients with gastrointestinal cancer who underwent surgery, and the prevalence of malnutrition in patients with gastrointestinal cancer or lung cancer was higher in the non-surgical group than in the surgical group. Conclusions The prevalence of malnutrition is high in elderly cancer inpatients, which is increased along with aging.GLIM diagnostic criteria has clinical operability, and its availability needs more studies in the future. Key words: Neoplasms; Malnutrition
目的根据全球营养不良领导倡议(global leadership initiative on nutrition, GLIM)诊断标准，调查老年癌症住院患者营养不良的发生率。方法回顾性分析2012年1 472例65岁及以上住院肿瘤患者的临床资料。根据GLIM诊断标准进行营养评估，并记录不同分层诊断中营养不良的发生率。结果1472例患者中，924例(62.8%)诊断为营养风险。根据GLIM诊断标准，营养不良发生率为51.8%(762例)，其中中度营养不良发生率为29.6%(436例)，重度营养不良发生率为22.3%(326例)。营养风险、总营养不良和严重营养不良患病率随年龄增长而增加(P=0.000)。906例未接受手术治疗。906例患者中，营养风险发生率为61.9%(561/906例)，营养不良发生率为53.3%(483/906例)，中度营养不良率为53.3%(483/906例)，重度营养不良率为22.1%(200/906例)。手术治疗566例。566例患者中，营养风险和营养不良发生率分别为64.1%(236例)和49.5%(280例)，中度营养不良率为26.9%(152例)，重度营养不良率为22.6%(128例)。胃肠癌手术患者营养风险发生率较高，胃肠癌或肺癌患者营养不良发生率非手术组高于手术组。结论老年肿瘤住院患者营养不良发生率较高，且随年龄增长而增加。GLIM诊断标准具有临床可操作性，可操作性有待进一步研究。关键词:肿瘤;营养不良
{"title":"A cross-section investigation of malnutrition in elderly cancer inpatients","authors":"Jingyong Xu, Jian Yang, Wei Chen, Mingwei Zhu, Junmin Wei","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.11.026","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.11.026","url":null,"abstract":"Objective \u0000To investigate the prevalence of malnutrition in elderly cancer inpatients based on global leadership initiative on malnutrition(GLIM)diagnostic criteria. \u0000 \u0000 \u0000Methods \u0000Clinical data of 1 472 inpatients with cancer aged 65 years and over from a multicenter study in 2012 were retrospectively analyzed.Nutritional assessment was performed based on GLIM diagnostic criteria and the prevalence of malnutrition in a different stratifieddiagnosis was recorded. \u0000 \u0000 \u0000Results \u0000Of 1472 consecutive patients, 924 cases(62.8%)were diagnosed as nutritional risk.The malnutrition rate was 51.8%(762 cases)based on GLIM diagnostic criteria, with 29.6%(436 cases)of moderate malnutrition and 22.3%(326 cases)of severe malnutrition.The prevalences of nutritional risk, total malnutrition and severe malnutrition were increased along with aging(P=0.000). There were 906 cases not receiving surgery treatment.Among the 906 cases, the prevalence of nutritional risk and malnutrition were 61.9%(561/906 cases)and 53.3%(483 /906 cases), the moderate malnutrition rate was 53.3%(483/906 cases)and the severe malnutrition rate was 22.1%(200/906 cases)respectively.There were 566 cases undergoing surgery treatment.And among 566 cases, the prevalence of nutritional risk and malnutrition were 64.1%(236 cases)and 49.5%(280 cases), the moderate malnutrition rate was 26.9%(152 cases)and the severe malnutrition rate was 22.6%(128 cases). The prevalence of nutritional risk was high in patients with gastrointestinal cancer who underwent surgery, and the prevalence of malnutrition in patients with gastrointestinal cancer or lung cancer was higher in the non-surgical group than in the surgical group. \u0000 \u0000 \u0000Conclusions \u0000The prevalence of malnutrition is high in elderly cancer inpatients, which is increased along with aging.GLIM diagnostic criteria has clinical operability, and its availability needs more studies in the future. \u0000 \u0000 \u0000Key words: \u0000Neoplasms; Malnutrition","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1298-1303"},"PeriodicalIF":0.0,"publicationDate":"2019-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44250703","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 : 2019-11-14DOI: 10.3760/CMA.J.ISSN.0254-9026.2019.11.029
Wenbin Wu
{"title":"Geriatric refeeding syndrome: a case report","authors":"Wenbin Wu","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.11.029","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.11.029","url":null,"abstract":"","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1309-1311"},"PeriodicalIF":0.0,"publicationDate":"2019-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46338339","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 : 2019-11-14DOI: 10.3760/CMA.J.ISSN.0254-9026.2019.11.008
Feng Wang, Weihua Zhang
Objective To investigate the clinical and prognosis value of left ventricular diastolic function(LVDF)in predicting the short-term prognosis of sepsis-associated acute lung injury/acute respiratory distress syndrome(ALI/ARDS)in the elderly. Methods This was a prospective case-control study.A total of 93 elderly patients with sepsis-associated ALI/ARDS, who admitted to our hospital between February 2015 and February 2018, were selected as the study subjects.And they were divided into ALI group(n=52)and ARDS group(n=41). Meanwhile 50 elderly sepsis patients without ALI/ARDS were selected as the control group.Based on the prognosis at the 28th days of admission, patients with ALI/ARDS were divided into a death group and a survival group.General clinical data and left ventricular diastolic function index at different time points after admission were compared between groups. Results There were statistically significant differences among the ALI group, ARDS group and control group(P<0.05)on admission and at 3 and 7 days after admission in the parameters as the following: heart rate, mean arterial pressure(MAP), acute physiology and chronic health evaluation system Ⅱ(APACHEⅡ)score, acute lung injury score(LIS), oxygenation index(PaO2/FiO2), arterial blood lactic acid, blood glucose, serum creatinine, troponin I, B-type brain natriuretic peptide(BNP), procalcitonin(PCT), C-reactive protein(CRP)and early diastolic transmitral velocity to early mitral anulus diastolic velocity ratio(E/Em). APACHEⅡscore, LIS score, blood glucose, troponin I, BNP, PCT, CRP and E/Em were higher in the death group than in the survival group on admission and at 3 and 7 days after admission(all P<0.05). Multivariate logistic regression analysis showed that E/Em on admission and at 3 and 7 days after admission were the independent predictors for mortality in patients with sepsis-associated ALI/ARDS(OR=1.346, 2.150 and 1.954, respectively, P<0.05). ROC curve analysis showed that the area under curve(AUC)of E/Em for predicting death on admission and at 3 and 7 days after admission were 0.687, 0.840 and 0.771, respectively, with the optimal threshold value of 13.26, 14.90 and 14.62, respectively, and the sensitivity and specificity were 74.2% and 67.1%, 81.5% and 84.2%, 79.1% and 87.8%, respectively, .The mortality rate was higher in patients with E/Em above the optimal threshold value than below the optimal threshold value at each time point(all P<0.05). Conclusions The impairment of LVDF is serious in elderly patients with sepsis-associated ALI/ARDS, may be an independent predictor for recent death in such patients, and has a good predictive value for the prognosis of elderly patients with sepsis-associated ALI/ARDS. Key words: Ventricular function, left; Sepsis; Acute lung injury; Respiratory distress syndrome, adult; Prognosis
{"title":"Clinical value of left ventricular diastolic function in predicting the short-term prognosis of sepsis-associated acute lung injury/acute respiratory distress syndrome in the elderly","authors":"Feng Wang, Weihua Zhang","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.11.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.11.008","url":null,"abstract":"Objective \u0000To investigate the clinical and prognosis value of left ventricular diastolic function(LVDF)in predicting the short-term prognosis of sepsis-associated acute lung injury/acute respiratory distress syndrome(ALI/ARDS)in the elderly. \u0000 \u0000 \u0000Methods \u0000This was a prospective case-control study.A total of 93 elderly patients with sepsis-associated ALI/ARDS, who admitted to our hospital between February 2015 and February 2018, were selected as the study subjects.And they were divided into ALI group(n=52)and ARDS group(n=41). Meanwhile 50 elderly sepsis patients without ALI/ARDS were selected as the control group.Based on the prognosis at the 28th days of admission, patients with ALI/ARDS were divided into a death group and a survival group.General clinical data and left ventricular diastolic function index at different time points after admission were compared between groups. \u0000 \u0000 \u0000Results \u0000There were statistically significant differences among the ALI group, ARDS group and control group(P<0.05)on admission and at 3 and 7 days after admission in the parameters as the following: heart rate, mean arterial pressure(MAP), acute physiology and chronic health evaluation system Ⅱ(APACHEⅡ)score, acute lung injury score(LIS), oxygenation index(PaO2/FiO2), arterial blood lactic acid, blood glucose, serum creatinine, troponin I, B-type brain natriuretic peptide(BNP), procalcitonin(PCT), C-reactive protein(CRP)and early diastolic transmitral velocity to early mitral anulus diastolic velocity ratio(E/Em). APACHEⅡscore, LIS score, blood glucose, troponin I, BNP, PCT, CRP and E/Em were higher in the death group than in the survival group on admission and at 3 and 7 days after admission(all P<0.05). Multivariate logistic regression analysis showed that E/Em on admission and at 3 and 7 days after admission were the independent predictors for mortality in patients with sepsis-associated ALI/ARDS(OR=1.346, 2.150 and 1.954, respectively, P<0.05). ROC curve analysis showed that the area under curve(AUC)of E/Em for predicting death on admission and at 3 and 7 days after admission were 0.687, 0.840 and 0.771, respectively, with the optimal threshold value of 13.26, 14.90 and 14.62, respectively, and the sensitivity and specificity were 74.2% and 67.1%, 81.5% and 84.2%, 79.1% and 87.8%, respectively, .The mortality rate was higher in patients with E/Em above the optimal threshold value than below the optimal threshold value at each time point(all P<0.05). \u0000 \u0000 \u0000Conclusions \u0000The impairment of LVDF is serious in elderly patients with sepsis-associated ALI/ARDS, may be an independent predictor for recent death in such patients, and has a good predictive value for the prognosis of elderly patients with sepsis-associated ALI/ARDS. \u0000 \u0000 \u0000Key words: \u0000Ventricular function, left; Sepsis; Acute lung injury; Respiratory distress syndrome, adult; Prognosis","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1223-1228"},"PeriodicalIF":0.0,"publicationDate":"2019-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45669297","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 : 2019-11-14DOI: 10.3760/CMA.J.ISSN.0254-9026.2019.11.009
Baoliang Guo, Zhanlu Li
Objective To analyze the correlation of growth differentiation factor-15(GDF-15)level with the severity of coronary artery disease and prognosis and in elderly patients with acute coronary syndrome. Methods A total of 168 elderly patients with acute coronary syndrome admitted into Hangzhou Xixi Hospital and Shaoyifu Hospital Affiliated to Medical College of Zhejiang University from March 2017 to April 2018 were enrolled in the study.Patients were divided into three groups: GDF-15>1 800 μmol/L(n=28), GDF-15 between 1 200-1 800 μmol/L(n=45), and GDF-15<1 200 μmol/L(n=95). Plasma levels of high-sensitivity C-reactive protein(hs-CRP)and GDF-15, and SYNTAX score, single-vessel-, double-vessel, multi-vessel coronary disease and major adverse cardiovascular events(MACE)were analyzed and compared between groups. Results Plasma levels of hs-CRP and GDF-15 had significant differences among the three groups(P<0.05). There were significant statistically differences in SYNTAX score, single-vessel, double-vessel and multi-vessel coronary disease and MACE among the three groups(P<0.05). Logistic regression analysis showed that the levels of GDF-15(OR=2.092, 95%CI: 1.585~2.687), SYNTAX score(OR=1.948, 95%CI: 1.097~2.098), double-vessel lesions(OR=1.124, 95%CI: 1.006~1.251)and multi-vessel lesions(OR=1.744, 95%CI: 1.149~2.642)(all P<0.05)were statistically significant influencing factors for the prognosis. Conclusions GDF-15 level is correlated with SYNTAX score, double-vessel lesions and multi-vessel lesions, and could predict the severity of coronary artery lesions and prognosis in patients with acute coronary syndrome. Key words: Acute coronary syndrome; Growth differentiation factors; Prognosis
{"title":"Correlation of serum growth differentiation factor-15 level with degree of coronary artery lesion and prognosis in elderly patients with acute coronary syndrome","authors":"Baoliang Guo, Zhanlu Li","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.11.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.11.009","url":null,"abstract":"Objective \u0000To analyze the correlation of growth differentiation factor-15(GDF-15)level with the severity of coronary artery disease and prognosis and in elderly patients with acute coronary syndrome. \u0000 \u0000 \u0000Methods \u0000A total of 168 elderly patients with acute coronary syndrome admitted into Hangzhou Xixi Hospital and Shaoyifu Hospital Affiliated to Medical College of Zhejiang University from March 2017 to April 2018 were enrolled in the study.Patients were divided into three groups: GDF-15>1 800 μmol/L(n=28), GDF-15 between 1 200-1 800 μmol/L(n=45), and GDF-15<1 200 μmol/L(n=95). Plasma levels of high-sensitivity C-reactive protein(hs-CRP)and GDF-15, and SYNTAX score, single-vessel-, double-vessel, multi-vessel coronary disease and major adverse cardiovascular events(MACE)were analyzed and compared between groups. \u0000 \u0000 \u0000Results \u0000Plasma levels of hs-CRP and GDF-15 had significant differences among the three groups(P<0.05). There were significant statistically differences in SYNTAX score, single-vessel, double-vessel and multi-vessel coronary disease and MACE among the three groups(P<0.05). Logistic regression analysis showed that the levels of GDF-15(OR=2.092, 95%CI: 1.585~2.687), SYNTAX score(OR=1.948, 95%CI: 1.097~2.098), double-vessel lesions(OR=1.124, 95%CI: 1.006~1.251)and multi-vessel lesions(OR=1.744, 95%CI: 1.149~2.642)(all P<0.05)were statistically significant influencing factors for the prognosis. \u0000 \u0000 \u0000Conclusions \u0000GDF-15 level is correlated with SYNTAX score, double-vessel lesions and multi-vessel lesions, and could predict the severity of coronary artery lesions and prognosis in patients with acute coronary syndrome. \u0000 \u0000 \u0000Key words: \u0000Acute coronary syndrome; Growth differentiation factors; Prognosis","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1229-1231"},"PeriodicalIF":0.0,"publicationDate":"2019-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44911264","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 : 2019-11-14DOI: 10.3760/CMA.J.ISSN.0254-9026.2019.11.016
L. Liang, Hongyi Li, Jiang-bo Ren, Min Wang, Guanhuan Zhang, Yu Wang
Objective To evaluate the impact of long-term treatment with Entecavir(ETV)on renal function in elderly patients with chronic hepatitis B(CHB). Methods Elderly patients with CHB receiving ETV(0.5 mg/d)antiviral therapy who were followed up for 234 weeks in Beijing Friendship Hospital were retrospective analyzed.The estimated glomerular filtration rate(eGFR)(CKD-EPI creatinine formula)was used to evaluate renal function changes at baseline and 52, 104, 156, 208 and 234 weeks after treatment. Results A total of 40 included patients with CHB aged 60-81 years were enrolled, with baseline eGFR value(n=40) of (64.25±11.32)ml·min-1·1.73 m-2.The eGFR values at all time points after treatment were as following: (63.85±11.53)ml·min-1·1.73 m-2, (63.71±11.58)ml·min-1·1.73 m-2, (59.95±9.59)ml·min-1·1.73 m-2, (62.28±15.32)ml·min-1·1.73 m-2, (65.78±15.99)ml·min-1·1.73 m-2 at 52 weeks(40 cases), 104 weeks(40 cases), 156 weeks(38 cases), 208 weeks(36 cases)and 234 weeks(28 cases)after ETV treatment respectively.And the difference of eGFR values among all time points was not statistically significant(F=0.291, P=0.072). The results of the pairwise comparison showed that as compared with the baseline eGFR value, the eGFR values had no statistically significant difference at all time points after treatment(P>0.05). The baseline creatinine value in all 40 patients was(57.23±9.67)μmol/L.Creatinine values at 52 weeks(15 cases), 104 weeks(5 cases), 156 weeks(6 cases), 208 weeks(8 cases)and 234 weeks(6 cases)after ETV treatment, were(63.78±8.63)μmol/L, (67.86±11.21)μmol/L, (71.46±13.75)μmol/L, (68.22±8.99)μmol/L and(79.53±9.58)μmol/L respectively, with no significant difference(F=0.266, P=0.067). The results of the pairwise comparison showed that as compared with the baseline creatinine value, the creatinine values had no significant difference at all time points after ETV treatment(P>0.05). Conclusions ETV treatment has no effect on renal function in elderly patients with chronic hepatitis B. Key words: Hepatitis B, chronic; Antiviral agents; Renal function
{"title":"Impact of long-term antiviral therapy with Entecavir on renal function in elderly patients with chronic hepatitis B","authors":"L. Liang, Hongyi Li, Jiang-bo Ren, Min Wang, Guanhuan Zhang, Yu Wang","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.11.016","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.11.016","url":null,"abstract":"Objective \u0000To evaluate the impact of long-term treatment with Entecavir(ETV)on renal function in elderly patients with chronic hepatitis B(CHB). \u0000 \u0000 \u0000Methods \u0000Elderly patients with CHB receiving ETV(0.5 mg/d)antiviral therapy who were followed up for 234 weeks in Beijing Friendship Hospital were retrospective analyzed.The estimated glomerular filtration rate(eGFR)(CKD-EPI creatinine formula)was used to evaluate renal function changes at baseline and 52, 104, 156, 208 and 234 weeks after treatment. \u0000 \u0000 \u0000Results \u0000A total of 40 included patients with CHB aged 60-81 years were enrolled, with baseline eGFR value(n=40) of (64.25±11.32)ml·min-1·1.73 m-2.The eGFR values at all time points after treatment were as following: (63.85±11.53)ml·min-1·1.73 m-2, (63.71±11.58)ml·min-1·1.73 m-2, (59.95±9.59)ml·min-1·1.73 m-2, (62.28±15.32)ml·min-1·1.73 m-2, (65.78±15.99)ml·min-1·1.73 m-2 at 52 weeks(40 cases), 104 weeks(40 cases), 156 weeks(38 cases), 208 weeks(36 cases)and 234 weeks(28 cases)after ETV treatment respectively.And the difference of eGFR values among all time points was not statistically significant(F=0.291, P=0.072). The results of the pairwise comparison showed that as compared with the baseline eGFR value, the eGFR values had no statistically significant difference at all time points after treatment(P>0.05). The baseline creatinine value in all 40 patients was(57.23±9.67)μmol/L.Creatinine values at 52 weeks(15 cases), 104 weeks(5 cases), 156 weeks(6 cases), 208 weeks(8 cases)and 234 weeks(6 cases)after ETV treatment, were(63.78±8.63)μmol/L, (67.86±11.21)μmol/L, (71.46±13.75)μmol/L, (68.22±8.99)μmol/L and(79.53±9.58)μmol/L respectively, with no significant difference(F=0.266, P=0.067). The results of the pairwise comparison showed that as compared with the baseline creatinine value, the creatinine values had no significant difference at all time points after ETV treatment(P>0.05). \u0000 \u0000 \u0000Conclusions \u0000ETV treatment has no effect on renal function in elderly patients with chronic hepatitis B. \u0000 \u0000 \u0000Key words: \u0000Hepatitis B, chronic; Antiviral agents; Renal function","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1258-1261"},"PeriodicalIF":0.0,"publicationDate":"2019-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48539636","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 : 2019-11-14DOI: 10.3760/CMA.J.ISSN.0254-9026.2019.11.017
Chuanyun Wang, Xiuhua Chen, Y. Liu, Xiaojing Fan, Wei Wang, Xin-ping Zhou, Xin Ai, Jun Du, Weide Dai
Objective To investigate the diagnostic value of ultrasonography.in elderly patients with gastric tumors. Methods A total of 42 elderly patients with gastric tumors confirmed by surgery pathology underwent oral contrast-enhanced ultrasonography and electronic gastroscopy.The diagnostic effect of oral contrast-enhanced ultrasonography and electronic gastroscopy were compared based on the gold standard of surgical pathology. Results Of the 42 elderly patients with gastric tumors, 40 patients were diagnosed by oral contrast-enhanced ultrasonography and the surgical pathology(40/42, 95.2%), with Kappa value of 0.812.And 38 cases were diagnosed by electronic gastroscopy and the surgical pathology(38/42, 90.5%), with Kappa value of 0.718(P<0.05). Based on gold standard of surgical pathology results, the accuracies of T1, T2, T3 and T4 stage by oral contrast-enhanced ultrasonography were 95.0%(38/40), 95.0%(38/40), 100.0%(40/40)and 100.0%(40/40), respectively.The sensitivity and specificity of T3 and T4 stage for oral contrast-enhanced ultrasonography reached to 100.0%.The diagnostic accuracies of N0, N1-N3, M0 and M1 by oral contrast-enhanced ultrasonography were 95.0%(38/40), 95.0%(38/40), 100.0%(40/40)and 100.0%(40/40). Conclusions Oral contrast-enhanced ultrasonography is a simple, painless and non-invasive method for the diagnosis of gastric tumors in the elderly.And its qualitative coincidence rate of the tumors diagnosis is similar to that of gastroscopy.So it can be used as the first choice for the examination of gastric tumors in the elderly.Oral contrast-enhanced ultrasonography has a high diagnostic accuracy on TNM staging of gastric tumor.When combined with electronic gastroscopy, it may provide a more reliable basis for the choice of evaluation of treatment and prognosis in elderly patients with gastric tumor. Key words: Oral contrast-enhanced ultrasonography; Stomach neoplasms; Ultrasonography; Gastroscopy
{"title":"Application value of oral contrast-enhanced ultrasonography in the diagnosis of gastric tumors in the elderly","authors":"Chuanyun Wang, Xiuhua Chen, Y. Liu, Xiaojing Fan, Wei Wang, Xin-ping Zhou, Xin Ai, Jun Du, Weide Dai","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.11.017","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.11.017","url":null,"abstract":"Objective \u0000To investigate the diagnostic value of ultrasonography.in elderly patients with gastric tumors. \u0000 \u0000 \u0000Methods \u0000A total of 42 elderly patients with gastric tumors confirmed by surgery pathology underwent oral contrast-enhanced ultrasonography and electronic gastroscopy.The diagnostic effect of oral contrast-enhanced ultrasonography and electronic gastroscopy were compared based on the gold standard of surgical pathology. \u0000 \u0000 \u0000Results \u0000Of the 42 elderly patients with gastric tumors, 40 patients were diagnosed by oral contrast-enhanced ultrasonography and the surgical pathology(40/42, 95.2%), with Kappa value of 0.812.And 38 cases were diagnosed by electronic gastroscopy and the surgical pathology(38/42, 90.5%), with Kappa value of 0.718(P<0.05). Based on gold standard of surgical pathology results, the accuracies of T1, T2, T3 and T4 stage by oral contrast-enhanced ultrasonography were 95.0%(38/40), 95.0%(38/40), 100.0%(40/40)and 100.0%(40/40), respectively.The sensitivity and specificity of T3 and T4 stage for oral contrast-enhanced ultrasonography reached to 100.0%.The diagnostic accuracies of N0, N1-N3, M0 and M1 by oral contrast-enhanced ultrasonography were 95.0%(38/40), 95.0%(38/40), 100.0%(40/40)and 100.0%(40/40). \u0000 \u0000 \u0000Conclusions \u0000Oral contrast-enhanced ultrasonography is a simple, painless and non-invasive method for the diagnosis of gastric tumors in the elderly.And its qualitative coincidence rate of the tumors diagnosis is similar to that of gastroscopy.So it can be used as the first choice for the examination of gastric tumors in the elderly.Oral contrast-enhanced ultrasonography has a high diagnostic accuracy on TNM staging of gastric tumor.When combined with electronic gastroscopy, it may provide a more reliable basis for the choice of evaluation of treatment and prognosis in elderly patients with gastric tumor. \u0000 \u0000 \u0000Key words: \u0000Oral contrast-enhanced ultrasonography; Stomach neoplasms; Ultrasonography; Gastroscopy","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1262-1265"},"PeriodicalIF":0.0,"publicationDate":"2019-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45111159","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 : 2019-11-14DOI: 10.3760/CMA.J.ISSN.0254-9026.2019.11.024
Xiao-yuan Chen, L. Deng, Shihai Xuan, Xin Chen
Objective To explore the application value of combined detection of serum macrophage inhibitory cytokine-1(MIC-1), carcinoembryonic antigen(CEA)and carbohydrate antigens in the diagnosis and prognosis of elderly patients with colorectal cancer.172 elderly patients with colorectal cancer were selected retrospectively as the observation group, 175 elderly patients with benign colorectal lesions were enrolled as the benign lesion group and 166 healthy elderly subjects as the control group. Methods The levels of MIC-1, CEA, carbohydrate antigens of 199(CA199), 724(CA724), 242(CA242), 125(CA125), and 50(CA50)were compared among the three groups, and the diagnostic efficacy was calculated.The difference in the above-mentioned indicators between patients with different stages and prognosis in the observation group were compared. Results Levels of MIC-1, CEA, CA199, CA242, CA724, CA125 and CA50 were higher in the observation group than in the benign lesion group and the control group, and the above indexes were higher in the benign lesion group than in the control group.The sensitivity, positive predictive value and negative predictive value of MIC-1 were the highest in single index test(68.6%, 72.8% and 84.6%, respectively). The specificity of CA199 was the highest(91.2%). The combined detections greatly improved sensitivity, positive predictive value and negative predictive value(89.0%, 79.3% and 94.1%, respectively). In the observation group, levels of MIC-1, CEA, CA199, CA242, CA724, CA125 and CA50 in the elderly colorectal cancer patients were higher in stage Ⅲ and Ⅳ than in stage Ⅰ and Ⅱ.The levels of MIC-1, CEA, CA199, CA242, CA724, CA125 and CA50 in elderly patients with recurrence and metastasis of colorectal cancer were higher than those in patients without recurrence and metastasis. Conclusions Combined detection of multiple indicators can improve the sensitivity of diagnosis, and is more conducive to the early diagnosis of elderly patients with colorectal cancer. Key words: Colorectal neoplasms; Macrophage migration-inhibitory factors; Carcinoembryonic antigen; Antigens, tumor-associated, carbohydrate
{"title":"Clinical application of combined detection of serum macrophage inhibitory cytokine-1, carcinoembryonic antigen and carbohydrate antigens for the diagnosis and prognosis of colorectal cancer in the elderly","authors":"Xiao-yuan Chen, L. Deng, Shihai Xuan, Xin Chen","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.11.024","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.11.024","url":null,"abstract":"Objective \u0000To explore the application value of combined detection of serum macrophage inhibitory cytokine-1(MIC-1), carcinoembryonic antigen(CEA)and carbohydrate antigens in the diagnosis and prognosis of elderly patients with colorectal cancer.172 elderly patients with colorectal cancer were selected retrospectively as the observation group, 175 elderly patients with benign colorectal lesions were enrolled as the benign lesion group and 166 healthy elderly subjects as the control group. \u0000 \u0000 \u0000Methods \u0000The levels of MIC-1, CEA, carbohydrate antigens of 199(CA199), 724(CA724), 242(CA242), 125(CA125), and 50(CA50)were compared among the three groups, and the diagnostic efficacy was calculated.The difference in the above-mentioned indicators between patients with different stages and prognosis in the observation group were compared. \u0000 \u0000 \u0000Results \u0000Levels of MIC-1, CEA, CA199, CA242, CA724, CA125 and CA50 were higher in the observation group than in the benign lesion group and the control group, and the above indexes were higher in the benign lesion group than in the control group.The sensitivity, positive predictive value and negative predictive value of MIC-1 were the highest in single index test(68.6%, 72.8% and 84.6%, respectively). The specificity of CA199 was the highest(91.2%). The combined detections greatly improved sensitivity, positive predictive value and negative predictive value(89.0%, 79.3% and 94.1%, respectively). In the observation group, levels of MIC-1, CEA, CA199, CA242, CA724, CA125 and CA50 in the elderly colorectal cancer patients were higher in stage Ⅲ and Ⅳ than in stage Ⅰ and Ⅱ.The levels of MIC-1, CEA, CA199, CA242, CA724, CA125 and CA50 in elderly patients with recurrence and metastasis of colorectal cancer were higher than those in patients without recurrence and metastasis. \u0000 \u0000 \u0000Conclusions \u0000Combined detection of multiple indicators can improve the sensitivity of diagnosis, and is more conducive to the early diagnosis of elderly patients with colorectal cancer. \u0000 \u0000 \u0000Key words: \u0000Colorectal neoplasms; Macrophage migration-inhibitory factors; Carcinoembryonic antigen; Antigens, tumor-associated, carbohydrate","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1289-1293"},"PeriodicalIF":0.0,"publicationDate":"2019-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43682444","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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