Objective:Network analysis was used to explore the complex inter-relationships between social participation activities and depressive symptoms among the Chinese older population,and the differences in network structur...Objective:Network analysis was used to explore the complex inter-relationships between social participation activities and depressive symptoms among the Chinese older population,and the differences in network structures among different genders,age groups,and urban-rural residency would be compared.Methods:Based on the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey(CLHLS),12,043 people aged 65 to 105 were included.The 10-item Center for Epidemiologic Studies Depression(CESD)Scale was used to assess depressive symptoms and 10 types of social participation activities were collected,including housework,tai-chi,square dancing,visiting and interacting with friends,garden work,reading newspapers or books,raising domestic animals,playing cards or mahjong,watching TV or listening to radio,and organized social activities.R 4.2.1 software was used to estimate the network model and calculate strength and bridge strength.Results:21.60%(2,601/12,043)of the participants had depressive symptoms.The total social participation score was negatively associated with depressive symptoms after adjusting for sociodemographic factors.The network of social participation and depressive symptoms showed that“D9(Inability to get going)”and“S9(Watching TV and/or listening to the radio)”had the highest strength within depressive symptoms and social participation communities,respectively,and“S1(Housework)”,“S9(Watching TV and/or listening to the radio)”,and“D5(Hopelessness)”were the most prominent bridging nodes between the two communities.Most edges linking the two communities were negative.“S5(Graden work)-D5(Hopelessness)”and“S6(Reading newspapers/books)-D4(Everything was an effort)”were the top 2 strongest negative edges.Older females had significantly denser network structures than older males.Compared to older people aged 65e80,the age group 81e105 showed higher network global strength.Conclusions:This study provides novel insights into the complex relationships between social participation and depressive symptoms.Except for doing housework,other social participation activities were found to be protective for depression levels.Different nursing strategies should be taken to prevent and alleviate depressive symptoms for different genders and older people of different ages.展开更多
Ventral globus pallidus-injured rats by kainic acid(10 mg) were used to derter-mine the monoamine levels in four different brain regions.In this model,a great decrease of NE con-centration was observed in both hippoca...Ventral globus pallidus-injured rats by kainic acid(10 mg) were used to derter-mine the monoamine levels in four different brain regions.In this model,a great decrease of NE con-centration was observed in both hippocampus and frontal cortex compared with nonnal contro.This result hints that a damage of noradrenergic neurons in this model has occurred. DA concentrations in the four brain zones after kainic acid injection were all reduced, but only in the frontal cortex and striatum the pronounced reductions were discovered while DA turnover rates in frontal cortex, stria-tum and meddullapons were significantly reduced. These results revealed a DA metabolic disorder occurring in these regions.However,5-HT concentrations as well as DBH activity, expressed by ratio of NE/DA,showed no marked difference in this model. In our study it is found that the changes of monoamine levels in this model basically reflect those discovered in AD patients.展开更多
Under the auditory evoked brain stem potential (ABP) examination, the latent period of V wave and the intermittent periods of III-V peak and I-V peak were significantly shortened in Parkinson's disease patient... Under the auditory evoked brain stem potential (ABP) examination, the latent period of V wave and the intermittent periods of III-V peak and I-V peak were significantly shortened in Parkinson's disease patients of the treatment group (N=29) after acupuncture treatment. The difference of cumulative scores in Webster's scale was also decreased in correlation analysis. The increase of dopamine in the brain and the excitability of the dopamine neurons may contribute to the therapeutic effects, in TCM terms, of subduing the pathogenic wind and tranquilizing the mind.……展开更多
Lifting and thrusting with reducing method at acupoint Huatuojiaji (Extra 21) of the affected side was performed to make the limb of the affected side contract involuntarily 1-2 times in 53 cases with cervical spondyl...Lifting and thrusting with reducing method at acupoint Huatuojiaji (Extra 21) of the affected side was performed to make the limb of the affected side contract involuntarily 1-2 times in 53 cases with cervical spondylopathy. The maneuver produced a much better total effective rate than the routine maneuver (P展开更多
Thirty cases of vertebral-artery-type cervical spondylopathy were treated by Dr. Zhang Tao's technique. The cure rate was 50%, and the total effective rate was 100%.
Objective To assess the prevalence of and risk factors for postprandial hypotension （PPH） among old and very old Chinese men. Methods The study included 349 Chinese men aged 65 and older, grouped into two age catego...Objective To assess the prevalence of and risk factors for postprandial hypotension （PPH） among old and very old Chinese men. Methods The study included 349 Chinese men aged 65 and older, grouped into two age categories： group 1 （old） included 163 men aged 65 to 80 years; group 2 （very old） included 186 men aged over 80 years. Blood pressure changes after meals were assessed every 15 min by ambulatory blood pressure monitoring. Symptoms after meal ingestion and after standing up and changes in the baseline condition relative to blood pressure changes were observed continuously. Additional baseline data included body mass index, medical history, and medication use Results The prevalence of PPH was 59.3% overall and was significantly higher in group 2 than group 1 （63.4% vs. 54.6%, P 〈 0.05）. In group 2, the prevalence of PPH after breakfast （33.8%） and lunch （32.1%） were higher than that after supper （20.9%）, P 〈 0.05. Hypertension and age were significant risk factors for PPH （OR = 2.188, 95% CI： 1.134-4.223, P = 0.02; OR = 1.86, 95% CI： 1.112-3.11, P = 0.018, respectively）. In contrast, acarbose use was protective against PPH （OR = 0.4, 95% CI： 0.189-0.847, P = 0.017）. The decrease in blood pres- sure during PPH was 20-40 mmHg and the maximum was 90 mmHg. PPH usually occurred at 30-60 min after a meal and lasted 30-120 rnin. Conclusions These findings demonstrate that the prevalence of PPH in men aged over 80 years is significantly higher than those in men aged 65 to 80 years, and the blood pressure decline is also higher for men aged over 80 years. In addition, hypertension and age were main risk factors for PPH in the older men, which suggest that preventing and treating PPH is worthwhile.展开更多
Chronic renal insufficiency is the result of renal injuries and progressive deterioration caused by various reasons. At the late stage, i.e. the period of uremia, it may be complicated with abnormalities of variou... Chronic renal insufficiency is the result of renal injuries and progressive deterioration caused by various reasons. At the late stage, i.e. the period of uremia, it may be complicated with abnormalities of various systems. Along with the development and popularization of hemodialysis, the survival time of uremic patients can be prolonged, but uremic pruritus affects greatly the quality of life of the patients. For this purpose, we have treated 68 cases of the patients with acupuncture and western medicine respectively, and made clinical observations on the therapeutic results. A report follows.……展开更多
AIM To study the tolerance and the efficiency of FOLFIRINOX in elderly patients diagnosed with colorectal or pancreatic cancer.METHODS This retrospective study included elderly patients aged over 70 years of age treat...AIM To study the tolerance and the efficiency of FOLFIRINOX in elderly patients diagnosed with colorectal or pancreatic cancer.METHODS This retrospective study included elderly patients aged over 70 years of age treated at Georges-Francois Leclerc Center by FOLFIRINOX for histological proved colorectal or pancreatic cancer between January 2009 and January 2015. Chemotheapy regimen consisted of oxaliplatin(85 mg/m2 in over 120 min) followed by leucovorin(400 mg/m2 in over 120 min), with the addition, after 30 min of irinotecan(180 mg/m2 in over 90 min) then 5 fluorouracil(5FU)(400 mg/m2 administred intravenous bolus), followed by 5FU(2400 mg/m2 intraveinous infusion over 46 h) repeated every 2 wk. Geriatric parameters were recorded at the beginning. Toxicities were evaluated with the Common Terminology Criteria for Adverse Events 4.03. Tumor response was evaluated by CT scan. Treatment continued until disease progression, unacceptable toxicities or patient refusal.RESULTS Fifty-two patients aged from 70 to 87 years were treated by FOLFIRINOX, 34 had colorectal cancer and 18 had pancreatic cancer. Most of them were in good general condition, 82.7% had a 0-1 performance status and 61.5% had a Charlson Comorbidity Index < 10. The most frequent severe toxicities were neutropenia(17 patients, n = 32.7%) and diarrhea(35 patients n = 67.3%); 10 of the case of neutropenia and 5 of diarrhea registered a grade 4 toxicity. Thirty-nine patients(75%) initially received an adapted dose of chemotherapy. The dosage was adjusted for 26% of patients during the course of treatment. Tumor response evaluated by RECIST criteria showed a controlled disease for 25 patients(48.1%), a stable disease for 13 and a partial response for 12 patients. Time under treatment was higher for colorectal cancer with a median time of 2.44 mo(95%CI: 1.61-3.25). Overall survival was 43.88 mo for colorectal cancer and 12.51 mo for pancreatic cancer. In univariate or multivariate analysis, none of geriatric parameters were linked to overall survival. Only the type of tumor(pancreatic/colorectal) was linked in both analysis.CONCLUSION For people over 70 years old, FOLFIRINOX regimen seems to induce manageable toxicities but similar, even higher, median survival rates compared to younger people.展开更多
According to the TCM theory that the kidney is in charge of the bone, the authors carried out a study on the effect of acupuncture on bone mineral density in 40 postmenopausal women with osteoporosis treated by th... According to the TCM theory that the kidney is in charge of the bone, the authors carried out a study on the effect of acupuncture on bone mineral density in 40 postmenopausal women with osteoporosis treated by the method of reinforcing the kidney to strengthen the bone, with satisfactory therapeutic results reported as follows.……展开更多
1 Introduction Ischemic heart disease is caused by atherosclerotic and/or thrombotic obstruction of coronary arteries. Clinical spec- trum of ischemic heart disease expands from asymptomatic atherosclerosis of corona...1 Introduction Ischemic heart disease is caused by atherosclerotic and/or thrombotic obstruction of coronary arteries. Clinical spec- trum of ischemic heart disease expands from asymptomatic atherosclerosis of coronary arteries to acute coronary syn- dromes （ACS） including unstable angina, acute myocardial infarction （non-ST elevation myocardial infarction and ST elevation myocardial infarction）. Stable ischemic heart dis- ease （SIHD） refers to patients with known or suspected SIHD who have no recent or acute changes in their symp- tomatic status, suggesting no active thrombotic process is underway.展开更多
AIM:To evaluate the glycated hemoglobin(HbA_(1c)) determination methods and to determine fructosamine in patients with chronic hepatitis,compensated cirrhosis and in patients with chronic hepatitis treated with ribavi...AIM:To evaluate the glycated hemoglobin(HbA_(1c)) determination methods and to determine fructosamine in patients with chronic hepatitis,compensated cirrhosis and in patients with chronic hepatitis treated with ribavirin. METHODS:HbA_(1c) values were determined in 15 patients with compensated liver cirrhosis and in 20 patients with chronic hepatitis using the ion-exchange high performance liquid chromatography and the immunoassay methods. Fructosamine was determined using nitroblue tetrazolium. RESULTS:Forty percent of patients with liver cirrhosis had HbA_(1c) results below the non-diabetic reference range by at least one HbA_(1c)method,while fructosamine results were either within the reference range or elevated.Twenty percent of patients with chronic hepatitis(hepatic fibrosis) had HbA_(1c)results below the non-diabetic reference range by at least one HbA_(1c)method.In patients with chronic hepatitis treated with ribavirin,50% of HbA_(1c)results were below the non-diabetic reference using at least one of the HbA_(1c)methods. CONCLUSION:Only evaluated in context with all liver function parameters as well as a red blood count including reticulocytes,HbA_(1c)results should be used in patients with advanced liver disease.HbA_(1c)and fructosamine measurements should be used with caution when evaluating long-term glucose control in patients with hepatic cirrhosis or in patients with chronic hepatitis and dbavidn treatment.展开更多
Objectives:Intensive health services'utilization is common in older individuals affected by chronic diseases.This study assessed whether a structured family nurse-led educational intervention would be effective in...Objectives:Intensive health services'utilization is common in older individuals affected by chronic diseases.This study assessed whether a structured family nurse-led educational intervention would be effective in reducing health services'use(readmissions and/or emergency service access)among older people affected by chronic conditions.Methods:This is a non-randomized before-after pilot study.A sample of 78 patients was recruited from two general practices in Italy and 70 among them were followed for 8 months.Standard home care was provided during the first four months'period(months 1-4),followed by the educational intervention until the end of the study(months 5-8).The intervention,based on the teach-back method,consisted of by-weekly 60-min home sessions targeting aspects of the disease and its treatment,potential complications,medication adherence,and health behaviours.Rates of health services'use were collected immediately before(T0),and after the interventions(T1).Differences in utilization rates were examined by the McNemar's test.Potential factors associated with the risk of health services'use were explored with a Cox proportional hazard regression model.Results:The sample(n=78)was predominantly female(n=50,64.1%),and had a mean age of 76.2(SD=4.8)years.Diabetes mellitus was the most frequent disease(n=27,34.6%).McNemar's test indicated a significant reduction in health services'use at T1(McNemar χ^(2)==28.03,P<0.001).Cox regressions indicated that time and patient education,as well as their interaction,were the only variables positively associated with the probability of health services'use.Conclusion:A teach-back intervention led by a family nurse practitioner has the potential to reduce health services'use in older patients with chronic diseases.展开更多
基金supported by the National Key Research and Development Plan Project(grant number:2022YFC3600904)The funding organization had no role in the survey’s design,implementation,and analysis.
文摘Objective:Network analysis was used to explore the complex inter-relationships between social participation activities and depressive symptoms among the Chinese older population,and the differences in network structures among different genders,age groups,and urban-rural residency would be compared.Methods:Based on the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey(CLHLS),12,043 people aged 65 to 105 were included.The 10-item Center for Epidemiologic Studies Depression(CESD)Scale was used to assess depressive symptoms and 10 types of social participation activities were collected,including housework,tai-chi,square dancing,visiting and interacting with friends,garden work,reading newspapers or books,raising domestic animals,playing cards or mahjong,watching TV or listening to radio,and organized social activities.R 4.2.1 software was used to estimate the network model and calculate strength and bridge strength.Results:21.60%(2,601/12,043)of the participants had depressive symptoms.The total social participation score was negatively associated with depressive symptoms after adjusting for sociodemographic factors.The network of social participation and depressive symptoms showed that“D9(Inability to get going)”and“S9(Watching TV and/or listening to the radio)”had the highest strength within depressive symptoms and social participation communities,respectively,and“S1(Housework)”,“S9(Watching TV and/or listening to the radio)”,and“D5(Hopelessness)”were the most prominent bridging nodes between the two communities.Most edges linking the two communities were negative.“S5(Graden work)-D5(Hopelessness)”and“S6(Reading newspapers/books)-D4(Everything was an effort)”were the top 2 strongest negative edges.Older females had significantly denser network structures than older males.Compared to older people aged 65e80,the age group 81e105 showed higher network global strength.Conclusions:This study provides novel insights into the complex relationships between social participation and depressive symptoms.Except for doing housework,other social participation activities were found to be protective for depression levels.Different nursing strategies should be taken to prevent and alleviate depressive symptoms for different genders and older people of different ages.
文摘Ventral globus pallidus-injured rats by kainic acid(10 mg) were used to derter-mine the monoamine levels in four different brain regions.In this model,a great decrease of NE con-centration was observed in both hippocampus and frontal cortex compared with nonnal contro.This result hints that a damage of noradrenergic neurons in this model has occurred. DA concentrations in the four brain zones after kainic acid injection were all reduced, but only in the frontal cortex and striatum the pronounced reductions were discovered while DA turnover rates in frontal cortex, stria-tum and meddullapons were significantly reduced. These results revealed a DA metabolic disorder occurring in these regions.However,5-HT concentrations as well as DBH activity, expressed by ratio of NE/DA,showed no marked difference in this model. In our study it is found that the changes of monoamine levels in this model basically reflect those discovered in AD patients.
文摘 Under the auditory evoked brain stem potential (ABP) examination, the latent period of V wave and the intermittent periods of III-V peak and I-V peak were significantly shortened in Parkinson's disease patients of the treatment group (N=29) after acupuncture treatment. The difference of cumulative scores in Webster's scale was also decreased in correlation analysis. The increase of dopamine in the brain and the excitability of the dopamine neurons may contribute to the therapeutic effects, in TCM terms, of subduing the pathogenic wind and tranquilizing the mind.……
文摘Lifting and thrusting with reducing method at acupoint Huatuojiaji (Extra 21) of the affected side was performed to make the limb of the affected side contract involuntarily 1-2 times in 53 cases with cervical spondylopathy. The maneuver produced a much better total effective rate than the routine maneuver (P
文摘Thirty cases of vertebral-artery-type cervical spondylopathy were treated by Dr. Zhang Tao's technique. The cure rate was 50%, and the total effective rate was 100%.
文摘Objective To assess the prevalence of and risk factors for postprandial hypotension （PPH） among old and very old Chinese men. Methods The study included 349 Chinese men aged 65 and older, grouped into two age categories： group 1 （old） included 163 men aged 65 to 80 years; group 2 （very old） included 186 men aged over 80 years. Blood pressure changes after meals were assessed every 15 min by ambulatory blood pressure monitoring. Symptoms after meal ingestion and after standing up and changes in the baseline condition relative to blood pressure changes were observed continuously. Additional baseline data included body mass index, medical history, and medication use Results The prevalence of PPH was 59.3% overall and was significantly higher in group 2 than group 1 （63.4% vs. 54.6%, P 〈 0.05）. In group 2, the prevalence of PPH after breakfast （33.8%） and lunch （32.1%） were higher than that after supper （20.9%）, P 〈 0.05. Hypertension and age were significant risk factors for PPH （OR = 2.188, 95% CI： 1.134-4.223, P = 0.02; OR = 1.86, 95% CI： 1.112-3.11, P = 0.018, respectively）. In contrast, acarbose use was protective against PPH （OR = 0.4, 95% CI： 0.189-0.847, P = 0.017）. The decrease in blood pres- sure during PPH was 20-40 mmHg and the maximum was 90 mmHg. PPH usually occurred at 30-60 min after a meal and lasted 30-120 rnin. Conclusions These findings demonstrate that the prevalence of PPH in men aged over 80 years is significantly higher than those in men aged 65 to 80 years, and the blood pressure decline is also higher for men aged over 80 years. In addition, hypertension and age were main risk factors for PPH in the older men, which suggest that preventing and treating PPH is worthwhile.
文摘 Chronic renal insufficiency is the result of renal injuries and progressive deterioration caused by various reasons. At the late stage, i.e. the period of uremia, it may be complicated with abnormalities of various systems. Along with the development and popularization of hemodialysis, the survival time of uremic patients can be prolonged, but uremic pruritus affects greatly the quality of life of the patients. For this purpose, we have treated 68 cases of the patients with acupuncture and western medicine respectively, and made clinical observations on the therapeutic results. A report follows.……
文摘AIM To study the tolerance and the efficiency of FOLFIRINOX in elderly patients diagnosed with colorectal or pancreatic cancer.METHODS This retrospective study included elderly patients aged over 70 years of age treated at Georges-Francois Leclerc Center by FOLFIRINOX for histological proved colorectal or pancreatic cancer between January 2009 and January 2015. Chemotheapy regimen consisted of oxaliplatin(85 mg/m2 in over 120 min) followed by leucovorin(400 mg/m2 in over 120 min), with the addition, after 30 min of irinotecan(180 mg/m2 in over 90 min) then 5 fluorouracil(5FU)(400 mg/m2 administred intravenous bolus), followed by 5FU(2400 mg/m2 intraveinous infusion over 46 h) repeated every 2 wk. Geriatric parameters were recorded at the beginning. Toxicities were evaluated with the Common Terminology Criteria for Adverse Events 4.03. Tumor response was evaluated by CT scan. Treatment continued until disease progression, unacceptable toxicities or patient refusal.RESULTS Fifty-two patients aged from 70 to 87 years were treated by FOLFIRINOX, 34 had colorectal cancer and 18 had pancreatic cancer. Most of them were in good general condition, 82.7% had a 0-1 performance status and 61.5% had a Charlson Comorbidity Index < 10. The most frequent severe toxicities were neutropenia(17 patients, n = 32.7%) and diarrhea(35 patients n = 67.3%); 10 of the case of neutropenia and 5 of diarrhea registered a grade 4 toxicity. Thirty-nine patients(75%) initially received an adapted dose of chemotherapy. The dosage was adjusted for 26% of patients during the course of treatment. Tumor response evaluated by RECIST criteria showed a controlled disease for 25 patients(48.1%), a stable disease for 13 and a partial response for 12 patients. Time under treatment was higher for colorectal cancer with a median time of 2.44 mo(95%CI: 1.61-3.25). Overall survival was 43.88 mo for colorectal cancer and 12.51 mo for pancreatic cancer. In univariate or multivariate analysis, none of geriatric parameters were linked to overall survival. Only the type of tumor(pancreatic/colorectal) was linked in both analysis.CONCLUSION For people over 70 years old, FOLFIRINOX regimen seems to induce manageable toxicities but similar, even higher, median survival rates compared to younger people.
文摘 According to the TCM theory that the kidney is in charge of the bone, the authors carried out a study on the effect of acupuncture on bone mineral density in 40 postmenopausal women with osteoporosis treated by the method of reinforcing the kidney to strengthen the bone, with satisfactory therapeutic results reported as follows.……
文摘1 Introduction Ischemic heart disease is caused by atherosclerotic and/or thrombotic obstruction of coronary arteries. Clinical spec- trum of ischemic heart disease expands from asymptomatic atherosclerosis of coronary arteries to acute coronary syn- dromes （ACS） including unstable angina, acute myocardial infarction （non-ST elevation myocardial infarction and ST elevation myocardial infarction）. Stable ischemic heart dis- ease （SIHD） refers to patients with known or suspected SIHD who have no recent or acute changes in their symp- tomatic status, suggesting no active thrombotic process is underway.
文摘AIM:To evaluate the glycated hemoglobin(HbA_(1c)) determination methods and to determine fructosamine in patients with chronic hepatitis,compensated cirrhosis and in patients with chronic hepatitis treated with ribavirin. METHODS:HbA_(1c) values were determined in 15 patients with compensated liver cirrhosis and in 20 patients with chronic hepatitis using the ion-exchange high performance liquid chromatography and the immunoassay methods. Fructosamine was determined using nitroblue tetrazolium. RESULTS:Forty percent of patients with liver cirrhosis had HbA_(1c) results below the non-diabetic reference range by at least one HbA_(1c)method,while fructosamine results were either within the reference range or elevated.Twenty percent of patients with chronic hepatitis(hepatic fibrosis) had HbA_(1c)results below the non-diabetic reference range by at least one HbA_(1c)method.In patients with chronic hepatitis treated with ribavirin,50% of HbA_(1c)results were below the non-diabetic reference using at least one of the HbA_(1c)methods. CONCLUSION:Only evaluated in context with all liver function parameters as well as a red blood count including reticulocytes,HbA_(1c)results should be used in patients with advanced liver disease.HbA_(1c)and fructosamine measurements should be used with caution when evaluating long-term glucose control in patients with hepatic cirrhosis or in patients with chronic hepatitis and dbavidn treatment.
文摘Objectives:Intensive health services'utilization is common in older individuals affected by chronic diseases.This study assessed whether a structured family nurse-led educational intervention would be effective in reducing health services'use(readmissions and/or emergency service access)among older people affected by chronic conditions.Methods:This is a non-randomized before-after pilot study.A sample of 78 patients was recruited from two general practices in Italy and 70 among them were followed for 8 months.Standard home care was provided during the first four months'period(months 1-4),followed by the educational intervention until the end of the study(months 5-8).The intervention,based on the teach-back method,consisted of by-weekly 60-min home sessions targeting aspects of the disease and its treatment,potential complications,medication adherence,and health behaviours.Rates of health services'use were collected immediately before(T0),and after the interventions(T1).Differences in utilization rates were examined by the McNemar's test.Potential factors associated with the risk of health services'use were explored with a Cox proportional hazard regression model.Results:The sample(n=78)was predominantly female(n=50,64.1%),and had a mean age of 76.2(SD=4.8)years.Diabetes mellitus was the most frequent disease(n=27,34.6%).McNemar's test indicated a significant reduction in health services'use at T1(McNemar χ^(2)==28.03,P<0.001).Cox regressions indicated that time and patient education,as well as their interaction,were the only variables positively associated with the probability of health services'use.Conclusion:A teach-back intervention led by a family nurse practitioner has the potential to reduce health services'use in older patients with chronic diseases.
