吸烟对老年人认知功能障碍的影响

目的了解重庆市部分敬老院老年人吸烟和认知功能的基本现状,探讨吸烟对老年人认知功能的影响。方法采用分层随机抽样的方法,根据相应的纳入、排除标准,从重庆市11家各型敬老院中抽取≥60岁老年人230名,使用自编老年人营养健康情况调查表和简易智能状态量表（MMSE）进行调查,采用χ2检验和Fisher确切概率法对结果进行分析。结果对符合条件的230名老年人完成了MMSE测定,有认知功能异常率的为151人（65.65%）;结果显示,现在是否吸烟与认知功能障碍具有统计学意义（χ2=12.897 7,P=0.000 3）,而过去吸烟与认知功能障碍差异无统计学意义（χ2=1.330 0,P=0.248 8）;现在吸烟时间长短,与老年人认知功能异常具有统计学意义（χ2=16.887 9,P〈0.000 1）。结论现在吸烟是老年人认知状况减退的危险因素,并且吸烟时间越长危险性越大,尽早的戒烟可能是降低老年人认知功能发生的有效措施。     

高龄老人轻度认知功能障碍现状及危险因素的性别差异

目的 探讨80岁以上高龄老人轻度认知功能障碍(MCI)的现状及其相关危险因素的性别差异.方法 采用简易精神状态检查量表(MMSE)、总体衰退量表(GDS)、日常生活量表(ADL)、哈金斯基缺血指数等对236名80岁以上老年人的认知功能进行调查;同时收集人口学资料、吸烟、饮酒、高血压、糖尿病、高血脂、冠心病及脑卒中等危险因素,对不同性别的高龄老人的认知功能障碍进行多因素分析.结果 在236名80岁以上老年人中,轻度认知功能障碍的总构成比为32.6%,男性患者构成比30.4%,女性患者构成比37.1%,两者轻度认知功能障碍构成比差异无统计学意义(P>0.05).危险因素的多元logistic回归分析显示,对于高龄男性老人,冠心病(OR=10.74,95%CI:3.41～33.79)、高血压(OR=15.71,95%CI:4.62～53.46)及脑卒中(OR=8.59,95%CI:2.69～27.38)是认知功能减退的危险因素;而高龄女性MCI患者则存在低教育水平(OR=5.06,95%CI:1.44～17.83)、独居或丧偶(OR=5.09,95%CI:1.59～16.15)的可能.结论 我国高龄老人中,MCI比例高.MCI相关危险因素存在着性别差异.     

缺血性脑卒中合并认知障碍影响因素分析

目的 分析缺血性脑卒中合并认知功能障碍的相关影响因素,旨在为其临床预防提供参考。方法 选取2020年5月至2022年1月上海交通大学医学院附属第九人民医院黄浦分院神经内科诊治的120例缺血性脑卒中合并认知功能障碍患者(研究组)及120例单纯缺血性脑卒中患者(对照组)为研究对象,收集两组患者一般临床资料、神经影像学资料以及蒙特利尔认知评估表(MoCA)、简易精神状态评价量表(MMSE)、痴呆评分量表(CDR)评估结果。采用logistic回归分析缺血性脑卒中合并认知功能障碍的影响因素。结果 logistic回归分析显示,教育水平为保护因素(OR=0.430,95%CI:0.193～0.959);吸烟(OR=2.136,95%CI:1.061～4.300),嗜酒(OR=1.919,95%CI:1.201～3.066),既往原发性高血压(OR=4.623,95%CI:1.046～20.423),糖化血红蛋白水平升高(OR=1.943,95%CI:1.142～3.304),同型半胱氨酸水平升高(OR=2.620,95%CI:1.251～5.484),低密度脂蛋白水平升高(OR=1.931,95...     

乙醛脱氢酶2基因多态性与四川地区老年汉族人群认知功能障碍的相关性研究

目的探讨ALDH2基因Glu504Lys多态性与老年汉族人群认知功能障碍的相关性。方法选择2017年4月至2018年4月在四川省人民医院健康管理中心进行体检的老年人,采用简易智能状态检查量表(MMSE)得分对其进行认知功能评定后将存在认知功能障碍的老年人200例做为认知功能障碍组,将认知功能正常的老年人200例作为认知功能正常组。使用DNA微阵列芯片法检测对比两组研究对象的ALDH2基因多态性分布情况,并行多因素Logistic回归分析。结果认知功能障碍组和认知功能正常组基因型分布均符合Hardy-Weinberg平衡定律。与认知功能正常组相比,认知功能障碍组ALDH2基因AA/AG基因型及A等位基因频率显著升高(分别为58. 5%vs35. 5%和33. 0%vs19. 3%),差异有统计学意义(P<0. 05)。进一步行多因素Logistic回归分析显示,在调整了调整年龄、性别、受教育年限等危险因素后,ALDH2基因多态性与认知功能障碍相关(OR=0. 527,95%CI:0. 491～11. 532,P=0. 021)。结论 ALDH2基因多态性与四川地区老年汉族人群认知功能障碍相关,ALDH2基因多态性可能在老年认知功能障碍遗传易感性方面发挥了重要作用。     

重庆市老年人认知功能障碍的社区调查

目的：研究年龄、性别与老年人认知功能障碍的相关性。方法 采用随机整群抽样的方法从重庆市高新区、渝北区中分别抽取了两个居委会≥60岁老年人做为调查对象，并用简易智能量表（MMSE）等对他们进行认知功能评定。结果 有1106人完成了MMSE测定。重庆市老年人认知功能异常率为14.38%；认知功能异常率呈现随年龄增长而增加的趋势，且老年人MMSE得分亦随年龄的增长而下降；女性老年人除认知功能异常率明显高于男性外，认知功能障碍程度也显著重于男性老年人。结论 年龄、性别是老年人认知功能障碍的主要影响因素。     

日常生活活动能力等因素对老年人认知功能的影响

目的　研究日常生活活动能力 (Activityofdailyliving ,ADL)等因素对老年人认知功能的影响。方法　在对重庆市 3 0 12名≥ 60岁老年人进行认知功能障碍患病率调查的基础上 ,采用成组匹配对病例对照研究设计 ,对所检出的认知功能障碍患者 3 60例进行认知功能障碍危险因素研究。调查因素主要包括 :受教育水平、职业、ADL等。结果　认知功能障碍患者所占百分比随着ADL水平的下降而增高 ,分别为 :40 .49%、64 .63 %、81.82 %。在多因素Logistic回归分析中 ,ADL的下降与老年人认知功能障碍显著相关 (OR =2 .170 ,P <0 .0 0 1) ,且受教育水平、职业和经济状况也与老年人认知功能障碍密切相关 (OR值分别为 1 5 2 8,1 5 89,1 5 89,2 875 ;P <0 .0 5 )。结论　老年人认知功能减退是否发生和减退的速度受到日常生活活动能力、受教育水平、职业、经济状况等多方面因素的影响 ,具有综合性、复杂性     

社会参与对老年人认知功能的影响

目的 考察社会参与程度对老年人认知功能的影响,为轻度认知功能障碍的预防提供理论依据.方法 采用自编社会参与程度问卷评估老年人的社会参与情况,采用简易精神状态评价量表(MMSE)评估老年人的认知能力.对234例60岁以上老年人的社会参与程度及认知能力进行调查,分析老年人社会参与对其认知功能的影响.结果 年龄、受教育水平、婚姻状况、居住情况不同的老年人的认知功能比较,差异有统计学意义(P＜0.05).拥有良好人际网络(夫妻关系、子女/孙关系、亲朋关系较好,亲朋来往频繁)、积极参与闲暇活动的老年人认知功能较好(P＜0.05).在控制年龄、受教育水平后,社会参与程度对MMSE总分、定向力、注意力和计算力、回忆能力和语言能力有正向预测作用(△R2 =0.02～0.11,P＜0.05).结论 积极的社会参与是认知老化的保护因素.     

中国老年人群轻度认知障碍影响因素的荟萃分析

目的对中国老年人群轻度认知障碍(MCI)的影响因素进行荟萃分析。方法检索中国知网、万方、维普、PubMed、Embase和Web of Science共6个中英文数据库, 收集从建库至2022年3月13日国内外公开发表的中国老年人群MCI影响因素的相关文献。采用Stata17.0软件进行统计分析, 计算合并的RR值及其95%CI, 检验异质性, 评估发表偏倚。结果共检索到文献2 450篇, 最终纳入文献49篇, 包括5篇队列研究和44篇病例对照研究。荟萃分析显示, 男性(RR=0.778, 95%CI:0.696～0.870, I2=73.1)、受教育年限>6年(RR=0.428, 95%CI:0.374～0.490, I2=86.9)、经常进行锻炼(RR=0.496, 95%CI:0.421～0.585, I2=81.5)是MCI的保护因素;而年龄≥70岁(RR=2.431, 95%CI:2.086～2.833, I2=79.3)、有痴呆家族史(RR=3.228, 95%CI:2.140～4.867, I2=0.0)、吸烟(RR=1.214, 95%CI:1.098～1.342...     

社区老年人肌少症与认知功能和体力活动的相关性研究

目的:研究乌鲁木齐市社区老年人肌少症与认知功能、体力活动水平和体力活动类型的现状及相关性,为防治老年人肌少症提供依据。方法:采用便利抽样法,于2022年1月至7月,选取乌鲁木齐市65岁及以上的社区老年人为调查对象;采用亚洲肌少症工作组2019年标准诊断社区老年人罹患肌少症的情况,采用简易精神状态检查量表(MMSE)、老年人体力活动量表(PASE)评估老年人认知功能与体力活动水平,分析认知功能、体力活动水平和体力活动类型对社区老年人罹患肌少症的影响。结果:共调查534例老年人,年龄65～93岁,平均(73.04±5.85)岁。社区老年人的肌少症患病率为15.36%;MMSE评分和PASE评分与肌少症呈负相关(P<0.05);二元Logistic逐步回归分析显示,较高的定向力(OR=0.737,95%CI 0.627～0.867,P<0.05)、休闲性活动(OR=0.979,95%CI 0.968～0.991,P<0.05)和家务性活动(OR=0.991,95%CI0.983～0.999,P<0.05)评分为肌少症的保护因素;每日静坐>4h(OR=5.129,...     

对于无神经系统疾病的老年人脑白质变性的危险因素及其与认知功能变化的相关性研究

目的 探讨无神经系统疾病的老年人脑白质变性(WMH)与认知功能变化的相关性.方法 方便选取该院2015年1月—2017年1月所收纳352名健康老年人(男性186名,52.8%)年龄在50~83岁,平均(66.7±9.6)岁之间的健康老年人,行头MRI检测,并且完成MMSE评分.同时记录其他相关临床数据.结果 年龄(OR=10.862,95%CI 2.588~45.584)、高脂血症(OR=4.683,95%CI 2.524~8.689)、冠心病(OR=14.621,95%CI 1.582~135.154)、高血压(OR=23.537,95%CI 5.437~101.899)、糖尿病(OR=15.623,95%CI 1.508~161.798)是病变的独立影响影响因素(P<0.05).以高血压与WMH的关系最密切(OR=23.537).教育程度和腔梗个数,对经由MMSE评定的智能是否存在异常具有显著影响(P<0.05).结论 WMH的危险因素有高血压,糖尿病,高脂血症,高血压,年龄.而高血压对WMH的影响最大.教育程度和腔梗个数,对经由MMSE评定的智能是否存在异常具有显著影响.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.