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Li Rui, Men Yingying, Yu Jie, Zhang Qian
2024,23(3):161-165, DOI: 10.11915/j.issn.1671-5403.2024.03.034
Abstract:
Objective To investigate the prevalence of microvascular complications in elderly patients with diabetes mellitus, and analyze the risk factors of microvascular diseases. Methods A retrospective analysis was conducted on the clinical data of 495 elderly diabetic patients admitted to Peking Union Medical College Hospital from January 2020 to December 2022. Their baseline information and biochemical indicators were collected, and the incidences of microvascular complications such as diabetic retinopathy, diabetic nephropathy and peripheral neuropathy were recorded. According to the type of microvascular complications, the patients were divided into diabetic retinopathy group (n=107), diabetic nephropathy group (n=81), peripheral neuropathy group (n=169) and non-complication group (n=138). SPSS statistics 22.0 was used for data analysis. Based on different data type, one-way ANOVA or Chi-squared test was employed for intergroup comparison. Multivariate logistic regression analysis was applied to determine the related risk factors leading to diabetes microvascular disease. Results Among the 495 elderly patients with diabetes mellitus, 357 had microvascular complications, with a total prevalence rate of 72.12%, including 21.62% (107/495) of diabetes retinopathy, 16.36% (81/495) of diabetes nephropathy, and 34.14% (169/495) of peripheral neuropathy. Compared with the patients of the non-complication group, those of the diabetic retinopathy group had a longer course of diabetes mellitus, higher systolic blood pressure (SBP) and glycosylated hemoglobin A1c (HbA1c), and lower low-density lipoprotein cholesterol (LDL-C) level; those of the diabetic nephropathy group had longer course of diabetes mellitus and higher TG and 24-hour urine albumin excretion rate (UAER); and those with peripheral neuropathy had higher levels of SBP, diastolic blood pressure (DBP), HbA1c, total cholesterol (TC) and triglyceride (TG) (all P<0.05). Multivariate logistic regression analysis showed that the long duration of diabetes mellitus (OR=3.013, 95%CI 1.206-7.526; P=0.019), high SBP (OR=2.445, 95%CI 1.105-5.408; P=0.028) and high HbA1c (OR=3.093, 95%CI 1.112-8.606; P=0.031) were independent risk factors for diabetic retinopathy. Long duration of diabetes mellitus (OR=2.404, 95%CI 1.185-4.877; P=0.016), high TG (OR=2.654, 95%CI 1.241-5.677; P=0.012) and high UAER (OR=3.432, 95%CI 1.303-9.036; P=0.013) were independent risk factors for diabetic nephropathy. High SBP (OR=2.020, 95%CI 1.228-3.323; P=0.006), high DBP (OR=2.560, 95%CI 1.109-5.912; P=0.028), high HbA1c (OR=2.382, 95%CI 1.321-4.297; P=0.004), high TC (OR=2.779, 95%CI 1.057-7.303; P=0.039) and high TG (OR=2.266, 95%CI 1.237-4.152; P=0.008) were independent risk factors for peripheral neuropathy. Conclusion Elderly diabetes patients have a higher prevalence of microvascular complications. Long duration of diabetes mellitus, high SBP, DBP, HbA1c, TC, TG and UAER are risk factors for the aforementioned complications, and attention should be paid to these factors.
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Zhao Xinjing, Zhang Yang, Xu Qianqian, Shaya·Mahati
2024,23(3):166-169, DOI: 10.11915/j.issn.1671-5403.2024.03.035
Abstract:
Objective To explore the influencing factors of perioperative neurocognitive disorders (PND) in the elderly patients with brain tumors and effectiveness of rehabilitation treatment. Methods A retrospective analysis was made of the clinical data of 120 elderly brain tumor patients admitted to First Affiliated Hospital of Xinjiang Medical University from December 2020 to July 2022. Based on whether they experienced PND, the patients were divided into PND group (n=78) and non-PND group (n=42). The two groups were compared in the demographic information and clinical indicators. According to the intervention methods, the PND patients were classified into the control group (n=41) and the observation group (n=37). The two groups were compared in the effects of different intervention methods on improving neurocognitive function and quality of life. SPSS statistics 22.0 was used to process the data, and according to the type of data, t test orχ2 test was used for inter-group comparison. Logistic regression model was used to analyze the factors affecting the PND in the elderly patients with brain tumors. Results The incidence of PND in 120 elderly patients with brain tumors was 65.0% (78/120). There was a statistically significant difference in age, tumor location, WHO pathological tumor grading, and tumor volume between PND group and non-PND group (P<0.05). After treatment, the Montreal cognitive assessment (MoCA) score, and the role, physical, social and emotional functions scores in the observation group were higher than those in the control group, and the difference was statistically significant (P<0.05). Multivariate logistic regression analysis showed that the factors affecting the occurrence of PND in the elderly brain tumor patients were tumor site (OR=1.879, 95%CI 1.103-3.203), WHO′s pathological tumor grading (level Ⅱ:OR=1.964, 95%CI 1.021-3.780; level Ⅲ:OR=2.186, 95%CI 1.099-4.349; level Ⅳ:OR=2.462,95%CI 1.162-5.216) and tumor volume (20-＜40 cm3:OR=1.793, 95%CI 1.016-3.166; 40-＜60 cm3:OR=2.038, 95%CI 1.114-3.727; ≥60 cm3:OR=2.207, 95%CI 1.207-4.298). Conclusion The incidence of PND is relatively high in the elderly patients with brain tumors, especially in those with tumors located in the frontal and temporal lobes, high grades on WHO tumor classification and large tumor volumes, and high-risk groups require special attention. After the onset of PND, rehabilitation therapy can help improve neurocognitive function.
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2024,23(3):170-175, DOI: 10.11915/j.issn.1671-5403.2024.03.36
Abstract:
Objective To investigate the correlation between DR-FLASH score and epicardial adipose tissue (EAT) volume around the left atrium (LA), and explore the predictive value of their combination for left atrial low voltage zone (LVZ) in patients with non-valvular atrial fibrillation (NVAF). Methods A total of 268 NVAF patients who received radiofrequency catheter ablation for first time in Department of Cardiovascular Diseases, Affiliated Hospital of Xuzhou Medical University from September 2019 to April 2121 were consecutively recruited in this single-center retrospective clinical observation study. All patients underwent CTA scanning of pulmonary vein preoperatively, and then the volume of LA-EAT was measured. DR-FLASH score were calculated after admission. During the operation, the high-density voltage mapping of the LA was performed under sinus rhythm, and the patients were divided into LVZ group and non-LVZ group according to LVZ existence (bipolar voltage <0.5 mV as low voltage area). SPSS statistics 24.0 was used for statistical analysis. Intergroup comparison was performed using student′s t test, U test or Chi-square test depending on data type. Spearman correlation analysis was employed to determine the correlation between DR-FLASH score and LA-EAT volume. Receiver operating characteristic (ROC) curve was plotted to analyze the value of DR-FLASH score, LA-EAT volume and their combination to predict LVZ occurrence. Results In the subjected 246 patients, their average age was (60.8±10.6) years, and at least one LVZ was found in 56 patients (22.8%). The correlation analysis showed that the DR-FLASH score was positively correlated with LA-EAT volume (r=0.439; P<0.001). Multivariate analysis revealed that DR-FLASH score (OR=1.824,95%CI 1.390-2.394; P<0.001) and LA-EAT (OR=1.048,95%CI 1.013-1.085; P=0.007) were independent risk factors for LVZ after radiofrequency catheter ablation. The area under the ROC curve was 0.712,0.750 and 0.796, respectively for LA-EAT volume, DR-FLASH score, and their combination. Conclusion For NVAF patients, their DR-FLASH score is positively correlated with LA-EAT volume. The two indicators are independent predictors of left atrial LVZ in them. Their combination can improve the predictive value of left atrial LVZ in NVAF patients with non-valvular atrial fibrillation.
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Wang Zuocai, Chen Jianping, Wang Ping
2024,23(3):176-180, DOI: 10.11915/j.issn.1671-5403.2024.03.037
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Objective To explore the efficacy and safety of hemi-hip and total hip joint replacement in the treatment of femoral neck fractures in the elderly. Methods A retrospective analysis was conducted on 106 elderly patients with femoral neck fractures who were admitted to our department from January 2016 to October 2019. All patients underwent hip arthroplasty following Guideline for the Diagnosis and Treatment of Adult Femoral Neck Fractures. They were divided into hemiarthroplasty group (n=53) and total hip arthroplasty group (n=53) based on the surgical technique they received. Operational indicators, hip joint function and pain, quality of life, and safety were compared between two groups. SPSS 22.0 software was used to process the statistical analysis, and depending on data type, student′s t test or Chi-square test was employed for intergroup comparison. Results There were no significant difference in the number of blood transfusion patients and length of hospital stay between two groups (P>0.05). Compared with the hemiarthroplasty group, the total hip arthroplasty group had more intraoperative blood loss, 24-h postoperative drainage and longer bed-ridden time (P<0.05). In three months after surgery, the Harris hip score (HHS) was increased, the number of unequal length cases was decreased, and the score of Visual analogue scale (VAS) of pain was reduced in both groups when compared with the conditions before surgery. The HHS score was obviously higher and VAS score was notably lower in the hemiarthroplasty group than the total hip arthroplasty group (P<0.05), but no significant difference was found in the number of unequal length cases between two groups in three months postoperatively (P>0.05). The results of medical outcomes study 36-item short from health survey (SF-36) in three months after surgery showed there were no significant differences in the scores of overall health status, social function and emotional function between two groups (P>0.05), but the total hip arthroplasty group had higher SF-36 scores of physiological function, role-physical, physical pain, vitality and mental health than the hemiarthroplasty group (P<0.05). The complication rate was 3.77% (2/53) in the total hip arthroplasty group, which was significantly lower than that of hemiarthroplasty group [16.98% (9/53), P<0.05]. Conclusion Hemiarthroplasty and total hip arthroplasty have their own advantages in the treatment of elderly patients with femoral neck fractures. For those with poor preoperative general condition and low postoperative functional requirements, it is advisable to undergo hemiarthroplasty. While, for those with good preoperative general condition and certain requirements for postoperative functional recovery, total hip arthroplasty is recommended.
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Ding Fei, Dai Shanshan, Zhang Qing
2024,23(3):181-184, DOI: 10.11915/j.issn.1671-5403.2024.03.038
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Objective To analyze the impact of preoperative resting heart rate (RHR) on the efficacy of percutaneous coronary intervention (PCI) and prognosis in the elderly patients with ST-segment elevation myocardial infarction (STEMI). Methods A total of 211 elderly STEMI patients admitted to the Wanbei Coal-Electricity Group General Hospital between January 2020 and January 2021 were included as the study subjects. According to the preoperative RHR level, the patients were divided into RHR1 group (RHR<60 times/min; n=43), RHR2 group (RHR:60-79 times/min; n=76), RHR3 group (RHR:80-99 times/min; n=55) and RHR4 group (RHR≥100 times/min; n=37). The case data of each group were compared. Blood flow grading and myocardial perfusion grading of Thrombolysis in Myocardial Infarction (TIMI) after PCI were recorded, and deaths and major adverse cardiovascular events (MACE) at 30 days and 1 year after PCI were counted. SPSS 19.0 was used for statistical analysis. Data comparison between two groups was preformed using t test orχ2 test depending on data type. Cox proportional hazard regression was employed to analyze the relationship between preoperative RHR level and prognosis in the STEMI patients. Results There were statistically significant differences among RHR groups in the proportion of diabetic cases, systolic blood pressure, diastolic blood pressure, low-density lipoprotein cholesterol and neutrophil count at admission, proportion of cases with left ventricular ejection fraction ≤40%, myocardial infarction area and plasma N-terminal pro-B-type natriuretic peptide (P<0.05). There were statistically significant differences among RHR groups in TIMI blood flow grades and myocardial perfusion grades (P<0.05). There were statistically significant differences in the incidence rate of MACE and death rate within 30 days after PCI and at one year after PCI among RHR groups (P<0.05). Multivariate Cox proportional hazard regression analysis suggested that preoperative RHR≥100 beats/min was a risk factor for death (RR=3.985; P<0.001) and MACE (RR=6.091; P=0.013) within 30 days after PCI in the STEMI patients, and that preoperative RHR≥100 beats/min was a risk factor for death (RR=2.744; P<0.001) and MACE (RR=3.114; P<0.001) in STEMI patients at one year after PCI. Conclusion Preoperative RHR≥100 times/min will increase the risk of death and MACE in STEMI patients after PCI.
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Mukadaisi·Abudouwaili, Liang Zelan, Zhou Ping, Tian Mengzhen, Dai Xinyan, Shi Zhenfeng
2024,23(3):185-188, DOI: 10.11915/j.issn.1671-5403.2024.03.039
Abstract:
Objective To explore the changes in quality of life (QOL) after radical prostatectomy in patients with prostate cancer and influencing factors in Xinjiang Uygur Autonomous Region. Methods Clinical data of 240 patients with prostate cancer who underwent radical surgery in the People′s Hospital of Xinjiang Uygur Autonomous Region from January 2021 to December 2022 were collected and retrospectively analyzed. According to their score of QOL, they were divided into good QOL group (n=85) and poor QOL group (n=155). SPSS statistics 20.0 was used to perform the statistical analysis. Student′s t test or Chi-square test was employed for intergroup comparison depending on data type. Logistic regression analysis was applied to analyze the factors influencing the QOL in patients undergoing radical prostatectomy due to prostate cancer. Results The functional assessment of cancer therapy-prostate (FACT-P) score was increased in the prostate cancer patients after surgical treatment (P<0.05). Logistic regression analysis showed that age >60 years (OR=3.920,95%CI 1.216-12.631; P=0.023), education duration ≤5 years (OR=3.967,95%CI 1.156-13.610; P=0.029), abnormal creatinine level (OR=4.948,95%CI 1.204-20.331; P=0.027), smoking (OR=5.233,95%CI 1.281-21.376; P=0.022), alcohol drinking (OR=5.463,95%CI 1.774-16.828; P=0.003), diabetes mellitus (OR=5.669,95%CI 1.157-27.787; P=0.033), hypertension (OR=4.874,95%CI 1.426-16.658; P=0.012), depression (OR=4.968,95%CI 1.710-14.429; P=0.003), testosterone ≤10 nmol/L (OR=5.964,95%CI 1.350-15.458; P=0.015), tumor metastasis (OR=3.939,95%CI 1.416-10.959; P=0.009), and per capita family income≤2 000 Yuan (OR=3.626,95%CI 1.200-10.951; P=0.023) were influencing factors for QOL in patients with prostate cancer. Conclusion Age >60 years, education duration ≤5 years, abnormal creatinine level, smoking, alcohol drinking, diabetes mellitus , hypertension, depression, testosterone ≤10 nmol/L, tumor metastasis, and per capita family income ≤2 000 Yuan are influencing factors for poor QOL in prostate cancer patients after radical prostatectomy in Xinjiang Uygur Autonomous Region. Therefore, clinical interventions targeting these factors should be implemented to promote postoperative recovery.
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Wang Wenqiang, Qiao Guiyuan, Xiong Zhenfang, Yang Fen, Zhu Xinhong, Hou Xuebei, Fu Qingrong
2024,23(3):189-193, DOI: 10.11915/j.issn.1671-5403.2024.03.040
Abstract:
Objective To explore the impact of physical function on multimorbidity in the elderly adults. Methods From the China Health and Retirement Longitudinal Study (CHARLS), 2 452 elderly adults aged≥60 years from the 2011 baseline survey were selected as the study population and followed up to 2015. The survey included grip strength, short physical performance battery (SPPB), chronic diseases, demographic variables, and health behavior variables. SPSS statistics 26.0 was used for data analysis. Generalized estimating equations were employed to analyze the influencing factors of multimorbidity, and the impact of physical function on multimorbidity was analyzed based on generalized estimating equations after adjusting for confounding factors. Results The prevalence of multimorbidity among older adults increased from 48.9%(1 199/2 452) in 2013 to 56.1%(1 375/2 452) in 2015, showing an upward trend. The risk of multimorbidity was higher in females (OR=1.287,95%CI 1.124-1.474; P=0.000) and subjects with fall(OR=1.784,95%CI 1.560-2.040; P=0.000) and lower grip strength and lower SPPB scores. The grip strength values were referenced to Q4, and the risks for Q1, Q2, and Q3 were (OR=1.435,95%CI 1.213-1.698; P=0.000), (OR=1.513,95%CI 1.287-1.780; P=0.000) and (OR=1.188,95%CI 1.023-1.379; P=0.024). The SPPB scores were referenced to 10-12 points, and the risks for 0-6 points and 7-9 points were (OR=1.671,95%CI 1.245-2.243; P=0.001) and (OR=1.278,95%CI 1.134-1.440; P=0.000). After controlling for confounding factors, older adults with lower grip strength and lower SPPB scores also have a higher risk of multimorbidity. The risk for grip strength values Q1, Q2 and Q3 were (OR=1.274,95%CI 1.053-1.542; P=0.013), (OR=1.374, 95%CI 1.151-1.641; P=0.000) and (OR=1.147,95%CI 0.985-1.337; P=0.078); the risk of SPPB scores for 0-6 points and 7-9 points were (OR=1.508,95%CI 1.119-2.033; P=0.007) and (OR=1.220,95%CI 1.081-1.376; P=0.001). Conclusion Physical function is significantly associated with the risk of multimorbidity in the elderly adults, and physical function measures can be used as an effective means of screening for multimorbidity, which is helpful for early identification and targeted prevention and control of individuals at higher risk of multimorbidity.
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Chen Yu, Gu Sulian, Wang Qiaoqiao
2024,23(3):194-197, DOI: 10.11915/j.issn.1671-5403.2024.03.041
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Objective To analyze the status quo and influencing factors of quality of life in elderly patients with hemiplegia after discharge due to acute ischemic stroke (AIS). Methods Clinical data of 408 elderly AIS hemiplegic patients admitted to our department from January to December 2022 were collected. Stroke Specific Quality of Life Scale (SSQOL) was used to assess the quality of life of these patients one month after discharge. According to the SSQOL score, they were divided into a good life-quality group (SSQOL score ≥123, n=225) and a poor life-quality group (SSQOL score <123, n=183). SPSS 23.0 statistical software was employed for data analysis. Independent sample t test or Chi-square test was utilized for intergroup comparison depending on different data type. Multivariate logistic regression analysis was applied to identify risk factors affecting the quality of life of elderly AIS hemiplegic patients after discharge. Results The SSQOL score of 408 elderly patients with AIS hemiplegia at one month after discharge was (136.35±5.38), and the standardized score was (56.30±5.21)%, which was at a moderate level. There were statistically significant differences between poor life-quality group and good life-quality group in terms of payment method of medical expense, marital status, main caregivers, Ashworth spasm grade of affected side, activity of daily living and depression symptom (P<0.05). Multivariate logistic regression analysis showed that self-paying of medical expense (OR=2.573,95%CI 1.550-4.271), affected side at Ashworth spasm grade Ⅱ (OR=2.085,95%CI 1.030-4.223), heavy dependence on daily life (OR=3.435,95%CI 2.285-5.163), and depression symptom (OR=3.114,95%CI 1.919-5.054) were risk factors for poor quality of life in elderly patients with AIS hemiplegia after discharge, and married status (OR=0.573,95%CI 0.031-0.892) and spouse as the main caregiver (OR=0.642,95%CI 0.109-0.980) were protective factors (all P<0.05 ). Conclusion Medical economic burden, high muscle tension of affected side, limited ability of daily life and depression are important influencing factors of quality of life in elderly patients with AIS hemiplegia after discharge, and spouse companionship and care are beneficial to improving their quality of life.
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Tang Bo, Yan Xiaohong, Zhou Xia
2024,23(3):198-201, DOI: 10.11915/j.issn.1671-5403.2024.03.042
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Objective To analyze the quality of life and the influencing factors in the elderly patients with comorbidities. Methods A retrospective analysis was made of clinical data of 150 elderly comorbid patients admitted to the Geriatric Department of Union Wuhan Red Cross Hospital from February 2022 to February 2023. The patients′ chronic disease status was recorded, and their quality of life was evaluated using a concise quality of life scale. The quality of life among the elderly comorbid patients was compared in gender, age, marital status, education level, monthly income, residential regions, severity of comorbidities, number of comorbidities, and cognitive functions. The data were processed using SPSS 22.0. According to the data type, independent sample t test, one-way analysis of variance, orχ2 test was used for inter-group comparison. Unconditional logistic stepwise regression analysis was used to identify risk factors affecting the quality of life of the elderly comorbid patients. Results The common chronic diseases in 150 elderly patients were hypertension, diabetes and respiratory diseases. Of all the patients, 44 (29.33%) had two comorbid chronic diseases, 77 (51.33%) had three comorbid chronic diseases, and 29 cases (19.33%) had more than three chronic diseases. The elderly comorbid patients aged ≥70 years, having an income <3 000 yuan/month, living alone, having severe comorbidities, having more than 3 comorbidities and having cognitive dysfunction had significantly lower life quality scores than those aged < 70 years, having an income ≥3 000 yuan/month, not living alone, having mild to moderate comorbidities, having 2 or 3 comorbidities, and having no cognitive dysfunction. The differences were statistically significant (t=6.276,2.785,2.599,19.519,233.834,4.254; P<0.05). Multivariate logistic regression analysis showed that age ≥70 years (OR=5.245,95%CI 1.667-16.483), monthly income <3 000 yuan (OR=1.975, 95%CI 1.307-2.984), living alone (OR=4.881,95%CI 1.526-15.612), severity of comorbidities (OR=3.748,95%CI 1.600-8.780), number of comorbidities more than 3 (OR=1.997,95%CI 1.371-2.909), and cognitive dysfunction (OR=1.520,95%CI 1.136-2.034) were the risk factors affecting the quality of life of the elderly comorbid patients. Conclusion The quality of life of the elderly comorbid patients is affected by many factors such as cognitive function and disease status and needs to be improved.
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Ren Lin, Wang Qian, Chen Hao, Zhao Jiayu, Ma Lixiang
2024,23(3):202-206, DOI: 10.11915/j.issn.1671-5403.2024.03.043
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Objective To investigate the effect of prolonged ticagrelor on clinical outcomes after percutaneous coronary intervention (PCI) in the elderly patients (age≥65 years) with acute ST-segment elevation myocardial infarction (STEMI). Methods From February 2018 to February 2021, a total of 105 patients (aged≥65 years) with acute STEMI were enrolled, who received dual antiplatelet therapy (DAPT) with ticagrelor plus aspirin (DAPT≥2) after PCI at the First Hospital of Qinhuangdao. On the basis of long-term use of aspirin, the patients were divided into the control group (n=37; ticagrelor for one year) and the observation group (n=68; ticagrelor over one year). The observation group was divided into two subgroups according to the dose of ticagrelor:observation group A (n=40; standard dose, 90 mg/time, 2 times daily) and observation group B (n=28; low dose, 45 mg/time, 2 times daily). The three groups were compared after emergency PCI in thrombolysis in myocardial infarction (TIMI) grade 3 blood flow, proportion of complete regression of electrocardiogram (ECG) signs, platelet function (MA) in thrombelastogram (TEG), adenosine diphosphate-induced platelet aggregation rate, and 1-year follow-up, including major adverse cardiovascular and cerebrovascular events (MACCE) and bleeding events. SPSS 25.0 was used to process the data, and t test andχ2 test were used for comparison between groups. Results After PCI, the proportion of patients with TIMI grade 3 blood flow in the two observation groups was significantly higher than that in the control group (χ2=4.699,4.353; P=0.030,0.036). At two years after PCI, the MA value and adenosine diphosphate-induced platelet aggregation rate on thromboelastography of the two observation groups were significantly lower than those in the control group (t=8.752,6.524; P<0.001). After one year follow-up, there was significant difference in the incidence of MACCE among the three groups (χ2=4.354; P=0.039). The incidence of MACCE in the two observation groups was significantly lower than that in the control group (χ2=4.769,5.082; P=0.028,0.024), but there was no significant difference between the two observation groups. There was no significant difference in the incidence of bleeding events among the three groups. Conclusion Prolonged ticagrelor after PCI in the elderly (≥65 years old) STEMI patients (DAPT≥2 points) may reduce the incidence of MACCE, and low-dose (45 mg) ticagrelor does not increase the risk of bleeding, which needs to be further confirmed with long-term follow-up.
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Kuang Hongmei, Peng Zhiying, Tan Xi
2024,23(3):207-211, DOI: 10.11915/j.issn.1671-5403.2024.03.044
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Objective To explore the clinical efficacy of sacubitril/valsartan in the treatment of ventricular arrhythmias caused by heart failure (HF) in elderly patients. Methods A total of 186 elderly HF patients hospitalized in our department from April 2020 to December 2022 were enrolled and then randomly divided into control group (n=93, conventional treatment plan) and observation group (n=93, sarcubatrixartan administration besides conventional treatment). The clinical efficiency and incidence of adverse reactions were compared between the two groups. The following indicators were compared between the two groups before and after treatment, includ-ing electrocardiogram indicators[QRS time limit, corrected QT interval (QTc), QT dispersion (QTd), Sv1+Rv5], cardiac function indicators [left ventricular ejection fraction (LVEF), left ventricular end diastolic dimension (LVEDD), left ventricular posterior wall thickness (LVPWT), 6-minute walking test (6MWT), premature ventricular contraction (PVCs), non-sustained ventricular tachycardia (NSVT), sustained ventricular tachycardia (SVT)] and serum indicators [serum creatinine (SCr), blood urea nitrogen (BUN), B-type brain natriuretic peptide (BNP), and cardiac troponin T (cTnT)]. SPSS statistics 22.0 was used for data analysis. Student′s t test or Chi-square test was employed for intergroup comparison depending on date type. Results The total clinical efficiency rate was significantly higher in observation group than control group (95.70% vs 86.02%, P<0.05). No statistical difference was observed in incidence of adverse reactions between the two groups (11.83% vs 7.53%, P>0.05). Before treatment, there were no obvious differences in electrocardiogram, cardiac function and serum indicators between the two groups (P>0.05). After treatment, the observation group obtained better QRS duration, QTc, QTd, and Sv1+Rv5, notable declines in the proportions of SVT patients and NSVT patients, lower PVCs times and average SVT and NSVT times, great improvements in LVEF, LVEDD and 6MWT, and reduced serum levels of SCr, BUN, BNP and cTnT when compared with the control group (P<0.05). Conclusion Shakubaqu/valsartan shows significant clinical efficacy in treatment of HF-caused ventricular arrhythmia in elderly patients, with advantages of good safety and reliability, reducing the occurrence of ventricular arrhythmia, and improving heart function, exercise tolerance and myocardial injury.
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Zhang Di, Zhang Ting, Jiang Shan, Liu Yi
2024,23(3):212-216, DOI: 10.11915/j.issn.1671-5403.2024.03.045
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Objective To explore the influencing factors of prolonged preoperative hospitalization in elderly patients with lung cancer undergoing thoracoscopic lobectomy. Methods A retrospective analysis was conducted on 1 848 lung cancer patients aged over 65 years who had undergone thoracoscopic lobectomy in Chinese PLA General Hospital from January 2013 to December 2019. Their preoperative data were collected from the hospital information system (HIS), including general information, medical history, results of laboratory tests, consultation and other preoperative diagnosis and treatment data. According to their preoperative hospital stay, they were divided into normal group (≤6 d, n=755) and prolonged group (>6 d, n=1 093). SPSS statistics 24.0 was used to analyze the data. Based on different data type, student′s t test, Mann Whitney U test or Chi-square test was employed for intergroup comparison. Multivariate logistic regression analysis was applied to determine the influencing factors of prolonged preoperative hospital stay. Results Among these 1 848 elderly patients, 59.1% (1 093/1 848) of them had prolonged preoperative hospitalization. There were significant differences in age, diastolic blood pressure, neutrophils count, plasma activated partial thromboplastin time, plasma thrombin time, preoperative consultation, and proportions of coronary heart disease (CHD) and chronic obstructive pulmonary disease (COPD) between the normal group and the prolonged group (P<0.05). Multivariate logistic regression analysis showed that age >70 years (OR=1.275,95%CI 1.024-1.587), CHD (OR=1.523,95%CI 1.021-2.274), COPD (OR=1.360,95%CI 1.042-1.775) and preoperative consultation (OR=1.310,95%CI 1.046-1.641) were independent influencing factors for the prolongation of preoperative hospitalization time in elderly lung cancer patients. Conclusion Among the elderly lung cancer patients who planned to undergo thoracoscopic lobectomy, age>70 years, CHD, COPD and preoperative consultation are the influencing factors for the prolongation of preoperative hospitalization.
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Shen Jian, Zhang Xin, Jiao Yang, Su Yongkang, Li Ying, Zhou Boning, Shen Mingzhi, Fu Zhenhong
2024,23(3):217-222, DOI: 10.11915/j.issn.1671-5403.2024.03.046
Abstract:
Objective To verify whether sacubitril valsartan(S/V) can ameliorate the apoptosis level of hypoxic H9c2 cardiomyocytes by regulating mitochondrial dynamic system,and exert cardioprotective effects. Methods H9c2 cardiomyocytes were cultured and established a glucose oxygen deprivation model (OGD).The cells were divided into three groups:control group(CON), model group(OGD), S/V group(S/V). Apoptosis and reactive oxygen species (ROS) were detected by flow cytometry, mitochondrial membrane potential was detected by JC-1, and mitochondrial fusion protein 1(Mfn1), mitochondrial fusion protein 2 (Mfn2), dynamin related protein 1(Drp1), mitochondrial fission protein 1(FIS1), cytochrome c (CytC), B-cell lymphoma 2(Bcl-2),Bcl-2-associated X protein (Bax) and cysteinyl aspartate specific proteinase (Caspase-3) expression were detected by Western blotting (WB). GraphPad Prism 8 statistics was used for data analysis,multiple groups comparisons were conducted using one-way analysis of variance,and LSD-t test was performed for pairwise multiple comparisons. Results H9c2 cardiomyocytes were used to establish OGD cell model, and the morphology of cardiomyocytes was signifcantly improved by S/V treatment under light microscope. Flow cytometry analysis showed that S/V significantly reduced the level of intracellular ROS and inhibited cardiomyocyte apoptosis (P<0.05). Fluorescence microscope analysis showed that S/V significantly improved the level of mitochondrial membrane potential(P<0.05); WB showed S/V significantly increase the protein expression levels of Mfn2, mfn1 and Bcl-2, and reduce the protein expression levels of Drp1, FIS1, CytcC, Bax and Caspase-3 (P<0.05). Conclusion S/V may regulate mitochondrial homeostasis, reduce ROS production and cardiomyocyte apoptosis by promoting mitochondrial fusion and inhibiting mitochondrial division.
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2024,23(3):225-228, DOI: 10.11915/j.issn.1671-5403.2024.03.048
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Coronary artery disease (CAD) is one of the leading causes of human mortality, and is a common heart condition that involves atherosclerotic plaque formation in the vessel lumen, which then leads to coronary stenosis or occlusion of the vascular lumen, resulting in myocardial ischemia, hypoxia, or necrosis. Inflammation plays a vital role in mediating the occurrence and development of atherosclerosis. Inflammation has been a research hotspot in the study of the pathogenesis of CAD. Increasingly attention has been attracted to whether anti-inflammatory drugs can carry out targeted intervention on inflammation and positively impact the prognosis of CAD patients. In this article, we briefly review the essential inflammatory molecules in the pathogenesis and the research progress of anti-inflammatory drugs for the condition.
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Ren Yan, Yang Yongxue, Chen Shanping, Zheng Xiaomei, Yan Xuedan, Zhou Lihua
2024,23(3):229-232, DOI: 10.11915/j.issn.1671-5403.2024.03.049
Abstract:
Frailty is a clinical state or syndrome that predispose the patients to adverse health outcomes due to the decline of physiological reserve and stress adaptability. No gold standard is available for the assessment of frailty, but the cumulative defect model has been found to be better at predicting various adverse clinical events than other frailty assessment methods. This paper reviews the relevant research in the frailty index based on the principle of cumulative defects and the approaches to its construction, common types and applications to provide new insights into and tools for frailty evaluation.
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Huang Liyin, Zhang Ying, Cao Zhidong, Cheng Mengqin
2024,23(3):233-236, DOI: 10.11915/j.issn.1671-5403.2024.03.050
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Hip fracture in the elderly is a common type of severe fractures with a high risk of secondary fracture. Falls are an independent risk factor of a secondary fracture. Therefore, the continuous control of fall risk of hip fracture in the elderly patients is of positive significance for the prevention of a secondary fracture. This review summarizes the common risk factors of falls, risk assessment, and risk intervention strategies in the elderly patients with hip fracture. It aims to provide a practical basis for the continuous fall risk management in the elderly patients with hip fracture.
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Liu Jiru, Li Juan, Yuan Pingqiao, Li Chunwei, Tian Fang, Yu Jie
2024,23(3):237-240, DOI: 10.11915/j.issn.1671-5403.2024.03.051
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At present, China′s aging process is accelerating. Sarcopenic dysphagia and oral frailty, as the emerging concept of geriatric syndrome in recent years, has become a research hotspot. This study reviews their conceptual connotations, status quo, correlation mechanism, influencing factors, prognosis and management strategies to explore their correlation. The aim is to provide new ideas for future research of sarcopenic dysphagia and oral frailty in China,providing reference for preventing and reducing the occurrence of both.
Volume 23,2024 Issue 3
Clinical Research
Basic Research
Review
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Research Progress on Ketone Oxidative Metabolism in Cardiovascular Diseases
Xiefukaiti Nilupaer, Gao Xiao-ming
Abstract:
Cardiovascular diseases pose a major threat worldwide with high morbidity and mortality，often resulting from hyperlipidemia, atherosclerosis, hypertension, and acute coronary syndromes. Currently, for myocardial ischemic injury, early restoration and reconstruction of blood flow through thrombolytic therapy, coronary intervention or coronary artery bypass grafting surgery is the most effective way to reduce myocardial infarct size and improve clinical prognosis. However, restoring blood supply to the ischemic myocardium often results in myocardial ischemia-reperfusion injury (I/R), which further aggravates myocardial injury. Accordingly, reducing myocardial I/R injury and ameliorating cardiac function impaired by ischemia is a challenging clinical puzzle. Increased ketone body oxidation has been found to curb myocardial injury caused by myocardial ischemia or hypertrophy. Under pathological conditions such as ischemia, the energy supply efficiency of fatty acids and glucose is significantly reduced, and ketones serve as alternative energy substrate to sustain ventricular contractile function. In this review, we briefly retrospect the role and mechanism of ketone body metabolism in cardiovascular diseases according to the latest reports.
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DU YaHAO, ZHENG YueHong, TIAN Cui, et al
2010,9(3):217-221, DOI:
Abstract:
Objective To investigate the relationship of apoptosis and autophagy of vascular smooth muscle cells (SMC) with the pathogenesis of abdominal aortic aneurysm (AAA). Methods In situ terminal transferase-mediated dUTP nick end-labeling(TUNEL) was used to detect the apoptosis of SMC of AAA and human normal aorta. The expression of LC3 was measured by immunohistochemistry. RNA extraction from the tissue of AAA and human normal aorta was performed. The mRNA levels of autophagy-related genes Beclin1,Atg4b,Bnip3,and Vps34 are tested by RT-PCR. Results The number of TUNEL-positive SMC in AAA was higher than that in normal aorta (P<0.05). The expression level of LC3 protein was significantly increased in AAA compared with that in normal aorta (P<0.05). The mRNA expression levels of Beclin1,Atg4b,Bnip3 and Vps34 were markedly up-regulated in AAA compared with that in normal aorta (P<0.05). Conclusion The apoptosis and autophagy of vascular SMC play an important role in the pathogenesis of AAA.
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2018,17(8):613-616, DOI: 10.11915/j.issn.1671-5403.2018.08.141
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C-X-C chemokine receptor 2 (CXCR2) is a member of chemokine family, and has been much sought after both in preclinical and clinical research because its activation by its ligands plays an important role in the pathophysiology of a range of cardiovascular diseases, including hypertension, cardiac remodeling, atherosclerosis, and abdominal aortic aneurysm. This review focuses on the progress made in the studies about roles of CXCR2 in cardiovascular diseases.
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2010,9(2):138-141, DOI:
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Objective To investigate the efficacy of indapamide/felodipine combination in decreasing blood pressure in elderly patients with hypertension.Methods A total of 150 consecutive elderly cases of hypertension,average age (65.4 ± 3.6) years,were randomized into 3 groups:indapamide group (1.5 mg/d),felodipine group (5 mg/d),and indapamide (1.5 mg/d)/felodipine (5 mg/d) combination group,with 50 in each group.The treatment duration was 3 months.The average 24-hour,daytime and night-time systolic blood pressure/diastolic blood pressure and systolic blood pressure/diastolic blood pressure load,as well as mean heart rate,were determined at baseline and after 3 months.Results The average 24-hour,daytime and night-time systolic blood pressure/diastolic blood pressure,and blood pressure load were significantly decreased in all groups after treatment for 3 months,which was more significant in combination group than in single drug treatment group.The mean heart rate showed no significant change after 3 months of treatment.Conclusion Combination of calcium antagonist with long-acting diuretics at low dose provides substantial and stable antihypertensive benefit,and has few side effects.The regimen is strongly recommended for elderly patients with hypertension.?更多
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HAN Ping, YANG Zhanqing, LI Zijian, et al
2011,10(5):478-480, DOI:
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Prostate cancer is an important health concern for male population in China and deserves great attention. The onset of prostate cancer tended to be insidious and it developed slowly. The early diagnosis of prostate cancer may achieve satisfactory outcome. Currently, prostate cancer has low early detection rate and high mortality. Large scale epidemiological survey is necessary to screen out the specific risk factors of prostate cancer, including case-control study, randomized follow-up visit etc. We need a guideline for early diagnosis of prostate cancer suitable for Chinese population to improve the sensitivity and specificity of early diagnosis of prostate cancer in China.
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SUN Bao-Hua, Li Fang-Da, NIE Hao, LIU Duan, ZHENG Yue-Hong
2018,17(8):621-625, DOI: 10.11915/j.issn.1671-5403.2018.08.143
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Ubiquitin-proteasome system (UPS) is the primary non-lysosomal pathway of protein degradation in eukaryotic cells, whose proteolytic activities are closely associated with subunits β1, β2, β5. Subunits β1, β2, β5 can be replaced respectively by subunits β1i, β2i and low-molecular-mass proteasome 7 (LMP7 or β5i), with β5i being most active and the new structure being called immunoproteasome. β5i plays an important role in autoimmune diseases, cardiovascular and cerebrovascular diseases, obesity and metabolic diseases, and tumor. This article introduced the latest progress in β5i in relation to the above diseases in view of providing effective intervention targets for drug therapy and improving the prognosis of the diseases.
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2018,17(2):153-155, DOI: 10.11915/j.issn.1671-5403.2018.02.034
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Cardiovascular disease (CVD) has emerged as the leading cause of death worldwide. Acute coronary syndrome (ACS), one of the most harmful cardiovascular events, is, in most cases, triggered by the rupture of a vulnerable plaque followed by thrombosis formation at the rupture site. Deep understanding of vulnerable plaque formation can greatly impact therapeutic approaches for both prevention and treatment of acute cardiovascular events. In the article, we reviewed the concept, characteristics and the pathological mechanisms of vulnerable plaque.
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2012,11(11):856-857, DOI: 10.3724/SP.J.1264.2012.00219
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【ABSTRACT】Objective To discuss the curative effect of zoledronic acid and alpha D3 combined treatment in the aged with severe osteoporosis. Methods 120 patients were randomly divided into two groups, the treatment group (n=60) were taken Caltrate D added Zoledronic Acid and Alpha D3 treatment for 24 weeks, and the control group (n=60) received Caltrate D only. Results In the treatment group (excluded the drop-out cases), the bone pain eased faster than that of the control group(n=57), and the improvement of bone mineral density also significantly better than the control group (n=53) (P<0.05). The levels of plasma calcium, phosphorus in both groups, and alkaline phosphatase in the control group were no significant differences between pre and post treatment (P>0.05). But the alkaline phosphatase in the treatment group decreased significantly after treatment (P<0.05). Conclusion Zoledronic Acid combined Alpha D3 can significantly relieve pain and other symptoms, reduce bone mass lose, and improve bone mineral density of severe osteoporosis patients.
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CAI Ruikang, DANG Yuping, XU Canlong
2011,10(6):566-569, DOI:
Abstract:
Senile pruritus, a common chronic skin disease in the elderly, is a serious disease affecting the health of elderly patients because of its endurable itching and lack of effective treatment. The pathogenesis of senile pruritus is complex, which is mainly due to a series of physiological or pathological changes caused by aging, including the degeneration of the skin and the changes in immune function and endocrine system. Currently, the integrated traditional Chinese medicine and western medicine is ideal for therapy of senile pruritus. In this paper, we reviewed the etiology, pathogenesis and treatment of senile pruritus.
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WANG Wei, LI Fang-Da, NIE Hao, ZHENG Yue-Hong
2017,16(10):762-765, DOI: 10.11915/j.issn.1671-5403.2017.10.178
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Abdominal aortic aneurysms (AAAs) is a medical problem with high mortality rate, and so it is of great significance to understand its pathogenesis. One of main characteristics of the disease is extensive infiltration of macrophages, neutrophils and T-lymphocytes. Much evidence has confirmed that T lymphocytes are closely associated with the pathogenesis, but their role in the progression remains unclear. This article reviewed the possible roles of T lymphocytes in the pathogenesis of AAAs, and provided effective drug treatment strategies for the disease which still lacks of effective drug intervention.
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LIU Zi-Qi1, LIU Ai-Ping2, WANG Pei-Yu2*
2015,14(07):547-550, DOI: 10.11915/j.issn.1671-5403.2015.07.125
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Diabetes mellitus (DM) is a group of metabolic diseases characterized with high blood sugar levels, which is induced by a variety of factors, such as genetic factors, environmental factors, behavior and life styles, and other factors. Its pathological mechanism is insufficient insulin secretion or insulin resistance caused by structural damage and/or dysfunction of islet β-cell. Evidence shows that China has become the country with the largest number of DM patients in the world. Many nationwide epidemiological surveys concerning DM indicated that its prevalence increases gradually, and varies among different regions and population. To understand the present status of the epidemiological survey on DM research in China and to provide references for the corresponding prevention and control strategies, we reviewed the reports on national large-scale investigation and epidemiological trends related with DM prevalence in China.
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2012,11(1):74-78, DOI: 10.3724/SP.J.1264.2012.00018
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Establishment of aging animal model is an effective way to study the aging process of human being. It has been a focus to establish different aging models for research of aging and anti-aging agents according to the physiological characteristics and natural attributes of various animals. Compared with other aging models, including naturally aging model, ozone induced aging model, thymus removed aging model, and aging SAMP model, D-galactosis induced aging model has been widely used because of its easy feasibility, low lost, and stable performance. In this paper, regarding its application and development, we reviewed the D-galactosis induced aging models from the following aspects: the mechanism and the dosage of the D-galactose to induce aging, the specific protocols, and the evaluation for successful establishment. In addition, we summarized some indexes to assess aging, such as behavioral, biochemical, morphological and molecular biological indices. In summary, subcutaneous injection of 120～125mg/(kg?d) of D-galactose once per day for 6 to 8 weeks is a reliable and stable way to establish the aging model.
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2014,13(04):294-295, DOI: 10.3724/SP.J.1264.2014.00068
Abstract:
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2013,12(11):877-880, DOI: 10.3724/SP.J.1264.2013.00223
Abstract:
Postoperative cognitive dysfunction (POCD), one of severe postoperative complications in elderly patients, greatly increases the risk of postoperative morbidity and mortality, and severely reduces the quality of life at the same time in these patients. However, since the pathogenesis of POCD remains unclear, effective treatment has not been defined yet. Recent evidences suggest that postoperative inflammation be the main mechanism for POCD. This article reviewed the inflammatory mechanisms of POCD based on basic and clinical researches, and also introduced some anti-inflammatory drugs which are beneficial to POCD treatment.
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WANG Xu-Yun, XI Shao-Zhi, LIU Jia, JING Jing, CHEN Yun-Dai, YIN Tong*
2016,15(03):231-236, DOI: 10.11915/j.issn.1671-5403.2016.03.056
Abstract:
Objective To analyze the reasons associated with ticagrelor withdrawal and the impact on clinical outcomes in ticagrelor-treated patients with coronary artery disease (CAD). Methods Totally 642 consecutive CAD patients treated by ticagrelor and aspirin in the Department of Cardiology, Chinese PLA General Hospital from January 2014 to July 2015 were recruited. The incidence and the reasons of ticagrelor withdrawal were recorded and analyzed during the hospitalization, at discharge, as well as 3-month after discharge. In the patients treated by percutaneous coronary intervention (PCI), the occurrence of ischemic events [including major ischemic events (cardiovascular death, non-fatal myocardial infarction, ischemic stroke, defined or probable stent thrombosis, coronary revascularization) and secondary ischemic events (readmission of unstable angina)] and bleeding events [including Thrombolysis In Myocardial Infarction trial (TIMI) defined major and minor bleedings] were followed up for 6 months. Results Ticagrelor withdrawal occurred in 164 patients (25.55%), with 42 patients (25.61%) in-hospital, 7 patients(4.27%) at discharge and 115 patients (70.12%) after discharge, respectively. The distributions of ticagrelor withdrawal were 78.05% in unstable angina, 13.41% in ST-elevation myocardial infarction (STEMI), 4.27% in non-STEMI, 4.27% in stable CAD, respectively. The reasons for ticagrelor withdrawal in-hospital and at discharge were mainly attributed to ticagrelor-related dyspnea (32.65%), bleeding (22.45%) and PCI for non-complex coronary lesions (18.37%). Drug unavailability (68.70%) and cost consideration (16.52%) were the major reasons for ticagrelor withdrawal after discharge. Besides 10 dead patients, other patients with ticagrelor withdrawal undertook the alteration of the antiplatelet therapy under the guidance of physicians, with 153 switched to clopidogrel on top of aspirin treatment, 1 to aspirin alone. After 6-month follow-up in PCI patients (n＝499), compared with patients under continuous ticagrelor treatment, patients withdrawing ticagrelor had a higher risk of major ischemic events (4.58% vs 0.82%, HR 6.62, 95%CI 1.17?37.36, P＝0.032) and composited ischemic events (11.45% vs 4.89%, HR 2.46, and 95%CI 1.03?5.89, P＝0.043). No significant difference was found for the risk of composited bleeding events between these patients (16.03% vs 17.12%, HR 0.92, and 95%CI, 0.49?1.73, P＝0.795). Conclusion About one third of ticagrelor treated CAD patients undertake the ticagrelor withdrawal during hospitalization, discharge and within 3 months after hospitalization. Ticagrelor withdrawal in-hospital and at-discharge might be attributed mainly to ticagrelor-related dyspnea, bleeding and non-complex lesions for PCI. Drug unavailability and cost consideration might be the main reasons for out-hospital ticagrelor withdrawal. Ticagrelor withdrawal within 3-months in PCI treated CAD patients might be correlated with increased risk of major and composited ischemic events.
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2013,12(02):108-110, DOI: 10.3724/SP.J.1264.2013.00029
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The pathogenesis of hyperthyroidism is relatively complicated. In clinical practice, diffuse toxic goiter accompanied with hyperthyroidism (as known as Graves￠ disease) is more common. The pharmaceutical treatment of Graves￠ disease includes antithyroid drugs (ATD), iodine, β-blocker, glucocorticoids and lithium carbonate. ATD are the main treatment for hyperthyroidism, and Methimazole (MMI) and propylthiouracil (PTU) are the two drugs which are most commonly used currently. Generally, ATD are safe and effective, though their clinical adverse reactions are also relatively common. These reactions are usually reversible and disappeared spontaneously when the drug is discontinued. However, the serious rare side effects also occur sometimes. MMI is usually preferred over PTU because it has significantly fewer adverse reactions in a dose-dependent fashion. MMI is the first choice for treating mild and moderate hyperthyroidism. Iodine is mainly used in hyperthyroidism crisis and before operation. Glucocorticoids are mainly used for Graves￠ ophthalmopathy and hyperthyroidism crisis. β-blocker is used to control the symptoms at initial treatment. Lithium carbonate is not commonly used, and only suitable for short-term treatment. The clinicians should evaluate comprehensively and individually to choose appropriate agents for better outcome, and closely monitor their efficiency and side effects.
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ZHANG Xiao-Li, ZHENG Song-Bai*
2014,13(03):178, DOI: 10.3724/SP.J.1264.2014.00043
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Chronic constipation is a common clinical syndrome, and the elderly is one of its high-risk population. It not only brings harm to patients’ physical and mental health, and reduces their life quality, but also adds much more to the medical cost as well as the social and economic burden to these patients and the whole society. It is of great significance to conduct an in-depth survey on the epidemiology of chronic constipation aiming at revealing its epidemiological characteristics, especially its risk factors and high-risk populations, so as to establish prevention strategies and measures as well as to develop more comprehensive interventions in community. In this article, we reviewed recent progress in the epidemiology of chronic constipation in hope of providing some meaningful clues for clinical practices.
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LI Xiao-Qin1, LING Zhi-Yu2, YIN Yue-Hui2*
2013,12(06):429-433, DOI: 10.3724/SP.J.1264.2013.00107
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Objective To evaluate the predictive value of SYNTAX score (SXscore) and clinical SYNTAX score (CCS) in the primary endpoint events of coronary heart disease patients in 15 months after percutaneous coronary intervention (PCI). Methods A total of 547 patients undergoing selective or emergency PCI in our department from June 2009 to June 2011 were enrolled in this study. SXscore and CCS were carried out to grade the severity and extension of stenosis. The major adverse cardiac and cerebrovascular events (MACCE, including cardiac death, myocardial infarction, and revascularization and stroke from any cause), the secondary endpoint events (including target lesion failure, such as cardiac death and target-vessel driven myocardial infarction, and ischemia-driven target lesion revascularization), stent thrombosis, and hospitalization due to angina pectoris were observed during 15 months of follow-up by telephone or hospital visit. Results In the follow-up, the incidence of MACCE was 13.5%, 6.8% and 0.0%, respectively for those with high, medium and low scores in SXscore (P＜0.0001). After multivariable adjustment, the SXscore (RR=1.101, 95%CI 1.070～1.134; P＜0.0001) and CSS (RR=1.017, 95%CI 1.009～1.022; P＜0.0001) were both identified as independent predictor of MACCE. Conclusion Both SXscore and CSS are independent predictor of MACCE for coronary heart disease patients after PCI.
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WANG Xiao-Jing, CHEN Hai-Ping*
2014,13(05):396-400, DOI: 10.3724/SP.J.1264.2014.00092
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Chronic kidney disease (CKD) is a global public health problem. In 2002, National Kidney Foundation (NKF)’s Kidney Disease Outcomes Quality Initiative (K/DOQI) published a guideline, which introduced a definition and classification system for CKD. This guideline plays an important role in the diagnosis, treatment and prognosis improvement for CKD. However, lots of evidence from clinical and epidemiological trials caused plenty of debates and controversies towards the applicability of present K/DOQI-CKD definition and classification system. These problems included high prevalence of CKD, disproportionately high prevalence in CKD stage 3, and high prevalence of CKD in the elderly. What’s more, whether patients with simple renal cyst should be diagnosed as CKD or not have not reached a consensus yet. So Kidney Disease: Improving Global Outcomes (KDIGO) published another guideline in 2012. The new one revised the definition of CKD, established a combined staging system concerning causes, glomerular filtration rate (GFR) and albuminuria, made a risk stratified model to estimate prognosis, and recommended the application of CKD-EPI to estimate GFR.
