Metabolic Disorders Increase the Risk to Incident Cardiovascular Disease in Middle-aged and Elderly Chinese

Objective The association of metabolic syndrome （MetS） with cardiovascular diseases （CVD） has not been adequately explored in middle-aged and elderly Chinese. This study aimed to investigate MetS＇ prevalence and its impact on the CVD incidence in this specific population group. Methods A data set of a community-based prospective cohort study was analyzed. A total of 2300 subjects aged 40-94 years were followed up for the CVD events. MetS defined according to the JCDCG criteria was assessed at baseline, and the middle-aged and elderly groups were classified by the WHO definition. Results As compared with the middle-aged group, the prevalence of MetS increased by 0.6 times （34.6% vs. 21.3%） and the incidence density of CVD increased by 4.9 times in the elderly group （52.3/1000 person-year vs. 8.9/1000 person-year）. Furthermore, the multivariate Cox regression revealed that the risk to CVD incidence was independently related to increased waist circumference in the middle-aged group （HR=2.23, P〈0.01） and to elevated blood glucose in the elderly group （HR=1.39, P〈O.01）. Conclusion MetS was highly prevalent in middle-aged and elderly Chinese. MetS significantly increased the risk to OdD incidence in the elderly. All individuals with metabolic disorders should receive active clinical care to reduce the incidence of CVD.

Public Square Dancing Intervention on Subjective Well-Being of Middle-Aged and Elderly People:A Meta-Analysis

Objective:To understand the influence of public square dancing on the subjective well-being of middle-aged and elderly people.Methods:According to the principle of Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines,we search Chinese databases,such as CNKI,Wanfang Data,and VIP,and English databases,such as Proquest,Web of Science,Pubmed,Cochrane,and ScienceDirect,and collect relevant articles at home and abroad from 2006 to December 2019 for meta-analysis in January 2020.Result:A total of 10 articles were included.The meta-analysis results showed that the well-being of middle-aged and elderly people in the public square dancing intervention group was significantly higher than that of the other exercise group and control group(both P<0.01).The results of the subgroup analysis showed the following:Different durations of intervention significantly influence the intervention effect(P<0.01).No difference was found between the effect of the mixed-gender intervention and the individual female intervention(P>0.05).No significant difference was found between the groups with weekly intervention frequency(P>0.05).Conclusion:Public square dancing intervention is effective for middle-aged and elderly people’s subjective well-being.Neither mixed intervention nor the times of weekly intervention have an impact on the intervention effect.However,the length of duration of intervention influences the intervention effect.

Relationship between platelet-lymphocyte ratio and carotid atherosclerosis in middle-aged and elderly patients with type 2 diabetes mellitus

Objective:To investigate the relationship between platelet-lymphocyte ratio(PLR)and carotid atherosclerosis(CAS)in middle-aged and elderly patients with T2DM.Methods:A total of 420 middle-aged and elderly patients with T2DM who were hospitalized in the Endocrinology Department of our hospital from September 2018 to September 2020 and were examined by ultrasound were selected as the subjects.The carotid artery intima-media thickness(CIMT)was examined by color Doppler ultrasonography,including normal CIMT group(n=111),CIMT thickening group(n=103)and CAS plaque group(n=206).The differences of serum PLR levels among the three groups were compared.Multivariate Logistic regression was used to analyze the relationship between PLR and CAS plaque formation.The receiver operating curve(ROC)was used to evaluate the value of multivariate Logistic regression model(Logit P)in the diagnosis of CAS lesions.Results:The mean value of PLR in CAS plaque group(127.86±48.54)was significantly higher than that in CIMT normal group(109.15±48.35).Multivariate Logistic regression analysis showed that after adjusting for other confounding factors,the increase of PLR was an independent risk factor for the occurrence of CAS plaque.ROC showed that the efficacy of multivariate Logit P model in the diagnosis of CAS plaque was(AUC=0.807,95%CI=0.759-0.858).Conclusions:PLR is one of the important risk factors for the occurrence of CAS lesions.At the same time,the multivariate Logistic regression model established in this study has clinical reference value in predicting CAS lesions in middle-aged and elderly patients with T2DM.

Significance of Fractional Exhaled Nitric Oxide Combined with Serum Procalcitonin and C-Reactive Protein in Evaluation of Elderly Asthma

Bronchial asthma is a common chronic airway inflammatory disease. Asthma is associated with high mortality, especially in the elderly patients. Repeated exacerbations cause disease progression. Therefore, identifying the onset of acute elderly asthma as soon as possible and giving the effective treatment is crucial to improve the prognosis. This study was to investigate the significance of fractional exhaled nitric oxide （FeNO） combined with serum procalcitonin （PCT） and C-reactive protein （CRP） in the evaluation of elderly asthma. A total of 120 elderly patients with an acute attack of asthma from July, 2010 to May, 2012 were studied. On presentation, FeNO, serum PCT and CRP concentrations were measured and sputum culture was also performed. The elderly patients were re-evaluated when they had returned to their stable clinical state. The elderly patients were classified into two groups： positive bac- terial culture group （A） and negative bacterial culture group （B）. The results showed that： （1） In patients with an acute exacerbation of asthma, 48 （40%） patients had positive sputum bacterial culture and 72 （60%） had negative sputum bacterial culture. （2） The levels of FeNO in patients with acute exacerbation of asthma were significantly higher than in those with no acute exacerbation state （63.8±24.6 vs. 19±6.5 ppb, P〈0.05）. There was no significant difference in FeNO between group A and group B （P〉0.05）. （3） The levels of PCT and CRP in group A patients with an acute exacerbation of asthma were significantly higher （P〈0.05） than in group B （for PCT： 27.46±9.32 vs. 7.85±3.52 ng/mL; for CRP： 51.25±11.46 vs. 17.11±5.87 mg/L, respectively）. When they had returned to stable clinical state, the levels of PCT and CRP in group A were decreased significantly （P〈0.05）, and those in group B had no significant change （P〉0.05） when compared with the exacerbation group. There were no significant differences in the levels of PCT and CRP between the two groups in non-acute exacerbation state （/9〉0.05）. These results suggest that the increase in FeNO indicates the acute exacerbation of asthma, and the elevation of serum PCT and CRP levels may be associated with bacterial infection.

Treatment of Asthma in the Elderly: Questionnaire Survey in Japan

Introduction: The prevalence of asthma in the elderly has been increasing due to the aging of the global population. Appropriate treatment for asthma in the elderly is now a major issue, as the disease is often fatal and incurs high medical costs in the elderly population. There have been few recent reports on asthma treatment for the elderly in the real-world clinical settings. Objectives: This study was performed to assess how respiratory physicians manage asthma in elderly patients in clinical settings in Japan. Methods: Respiratory physicians in 16 Japanese hospitals responded to a questionnaire survey on asthma and COPD treatment between December 2014 and February 2015. The analysis was performed using data collected from medical records on 2041 asthma patients. Results: The mean patient age was 61.2 years, and 36.6% of the patients were men. In the breakdown by age, 1018 (49.9%) of the patients were elderly (≥ 65 years). Compared to the non-elderly, the elderly patients had a significantly lower BMI, greater smoking history in pack-years, and poorer pulmonary function. There were no significant differences between the elderly and non-elderly in the prescription rates of common medications such as inhaled corticosteroids, long-acting beta-agonists (LABA) administered via inhaler or transdermal patch, long-acting muscarinic antagonists, or leukotriene receptor antagonists. In contrast, mucoactive drugs (18.7% vs. 12.3%, P P P = 0.02). Conclusions: According to this survey, the prescription rates of mucoactive drugs, macrolides, and transdermal LABA were significantly higher in the elderly than in the non-elderly.

Identification of late-onset hypogonadism in middle-aged and elderly men from a community of China

In this study, we investigated the essential criteria for late-onset hypogonadism （LOH） syndrome based on the presence of symptoms associated with low testosterone levels in Han Chinese men. Blood tests for total testosterone （TT） and sex hormone-binding globulin （SHBG） were performed, and the aging male symptoms （AMS） questionnaire was conducted in a randomly selected cohort composed of 944 Chinese men aged 40 to 79 years from nine urban communities. Three sexual symptoms （decreased ability/frequency of sexual activity, decreased number of morning erections, and decreased libido） were confirmed to be related to the total and free testosterone levels. The thresholds for TT were approximately 12.55 nmol l^-1 for a decreased ability/frequency to perform sex, 12.55 nmol l^-1 for decreased frequency of morning erections, and 14.35 nmol l^-1 for decreased sexual desire. The calculated free testosterone （CFT） thresholds for these three sexual symptoms were 281.14, 264.90, and 287.21 pmol l^-1, respectively. TT 〈13.21 nmol l^-1 （OR =1.4, 95%Ch 1.0-1.9, P= 0.037） or CFT 〈268.89 pmol l^-1 （OR - 1.5, 95%Ch 1.1-20, P=0.020） was associated with an increase in the aforementioned three sexual symptoms. The prevalence of LOH was 9.1% under the criteria, including all three sexual symptoms with TT levels 〈13.21 nmol l^-1 and CFT levels 〈268.89 pmol l^-1. Our results may improve the diagnostic accuracy of LOH in older men.

Prevalence of late-onset hypogonadism among middle-aged and elderly males in China:results from a national survey

This study aimed to propose an operational definition of late-onset hypogonadism(LOH)that incorporates both clinical symptoms and serum testosterone measurements to evaluate the prevalence of LOH in aging males in China.A population-based sample of 6296 men aged 40 years-79 years old was enrolled from six representative provinces in China.Serum total testosterone(TT),sex hormone-binding globulin(SHBG),and luteinizing hormone(LH)were measured and free testosterone(cFT)was calculated.The Aging Males’Symptoms(AMS)scale was used to evaluate the LOH symptoms.Finally,5078 men were included in this analysis.The TT levels did not decrease with age(P=0.59),and had no relationship with AMS symptoms(P=0.87 for AMS total score,P=0.74 for≥3 sexual symptoms).The cFT levels decreased significantly with age(P<0.01)and showed a negative association with the presence of≥3 sexual symptoms(P=0.03).The overall estimated prevalence of LOH was 7.8%(395/5078)if a cFT level<210 pmol l−1 combined with the presence of≥3 sexual symptoms was used as the criterion of LOH.Among them,26.1%(103/395)and 73.9%(292/395)had primary and secondary hypogonadism,respectively.After adjustment for confounding factors,primary and secondary hypogonadism was positively related to age and comorbidities.Body mass index was an independent risk factor for secondary hypogonadism.The results suggest that the AMS total score is not an appropriate indicator for decreased testosterone,and that the cFT level is more reliable than TT for LOH diagnosis.Secondary hypogonadism is the most common form of LOH.

Prevalence of stroke and metabolic disorders in the middle-aged and elderly Chinese with type 2 diabetes

Background Stroke is now the most prevalent and debilitating disease affecting diabetic population in China. The study aimed to investigate the prevalence of stroke and metabolic disorders in the middle-aged and elderly Chinese with type 2 diabetes. Methods A total of 4 629 subjects with type 2 diabetes （males： 1 917; females： 2 712） aged ≥ 40 years from Shijingshan district, Beijing, China from November 2011 to August 2012 were included in the study. Data on demographic information, lifestyle, history of diabetes mellitus, stroke, coronary heart disease, hypertension, and dyslipidemia were collected. The oral glucose tolerance test or a standard meal test was performed. Non-fatal stroke was reported by the subjects. The 2-tailed test was used, and P 〈0.05 was regarded as statistically significant. Results Prevalence of stroke in the subjects with type 2 diabetes was 5.5%. The prevalence of smoking, overweight or obesity, hypertension, and dyslipidemia was 41.0%, 65.8%, 67.4%, and 52.0% in males, and 2.2%, 65.5%, 69.5%, and 57.6% in females. Multivariate Logistic regression analysis showed that increased age, hypertension, diabetic duration, and overweight or obesity were positively correlated with stroke in the population with type 2 diabetes, whereas high- density lipoprotein cholesterol level was negatively correlated with stroke. After adjustment for age and gender, the odds ratio values of stroke in subjects having 1,2 or ≥3 of 4 risk factors, including smoking, overweight or obesity, hypertension and dyslipidemia, were 2.302 （95% CI： 0.789-6.712）, 4.089 （95% CI： 1.470-11.373）, 6.023 （95% CI： 2.176-16.666）, compared with subjects without any of the above 4 risk factors. Conclusions The prevalence of stroke was higher in middle-aged and eldedy Chinese with type 2 diabetes than that in the general population. With the aggregation of risk factors, the prevalence of stroke increased.

The Association between Interpersonal Relationship and Erectile Dysfunction of Middle-Aged and Elderly Men in a Rural Area of Zhejiang,China

Objective:To explore the association between interpersonal relationship and erectile dysfunction(ED)of middle-aged and elderly men.Methods:A population-based cross-sectional research was conducted in the rural area of Jiashan County,Zhejiang Province,in 2016.Middle-aged and elderly men(aged 40-80)were selected as study participants.The face-to-face questionnaire was collected,including basic information,lifestyles,interpersonal relationship,and sexual function.The interpersonal relationship was evaluated based on marital relationship,neighborhood relationship,and relatives/friends relationship.According to the International index of erectile function,the study participants were divided into ED group(mild ED,moderate-to-severe ED),and non-ED group.Correlations were evaluated between interpersonal relationship indices and the prevalence or the severity of ED.Potential confounders were adjusted by the logistical regression model.Results:There were 674 study participants with average age of 60.4±8.5 years,and 489 ED patients with prevalence of 72.6%.With age increasing,the prevalence and the severity of ED increased significantly.The men who could get help from spouse when an emergency occurred or who were more cared about by their neighbors had lower ED risk,and odds ratios(ORs)(95%confidence intervals[CIs])were 0.23(0.13-0.42)and 0.58(0.46-0.75),respectively.After the adjustment of the covariates(age,education degree,household income,smoking,and drinking),the ORs(95%CIs)were 0.29(0.14-0.60)and 0.54(0.39-0.74),respectively.Good marital relationship and good neighborhood relationship were associated with a less severity of ED.

Effect of Atorvastatin on the levels of adiponectin and leptin and adiponectin-leptin ratio in the elderly and middle-aged patients with type 2 diabetes and combined hyperlipidemia

Objective To evaluate effects of Atorvastatin on the levels of adiponectin and leptin and adiponectin-leptin ratio in the elderly and middle-aged patients with type 2diabetes and combined hyperlipidemia.Methods Totally80 elderly and middle-aged patients with type 2 diabetes and combined hyperlipidemia were treated with Atorvastatin(10 mg/d)for 12 weeks.Fasting plasma levels

The study of the correlation between serum uric acid and insulin resistance in middle-aged and elderly hospitalized patients with type 2 diabetes

Objective To study the relationship between serum uric acid and insulin resistance in type 2 diabetic patients.Methods A total of 728 middle-aged and elderly type 2 diabetic patients were recruited and the anthropometric,clinical and biochemical parameters and

Analysis of the impact of exercise education interventions on middle-aged and elderly people in Central-western rural China

This study aims to analyze the impact of health education effort that promote exercise activities have had on middle-aged and older people in central-western rural China.The Project for Family Health Care(PFHC)of the population in central and western China used questionnaires completed anonymously to survey 4217 randomly selected respondents in the baseline year of 2011,and 4529 in the end-line year of 2015.We used bivariate and multivariate analyses to examine the associations between several factors and regular exercise activities.The 2011 baseline year sample indicated that 90.5%of respondents knew the functions of regular exercise,but that only 45.4%participated in regular exercise activities.In the baseline multivariate model,a number of factors were positively associated with the prevalence of participation in regular exercise activities.Respondents who were women,older,retired,lived with children,had chronic diseases,and self-reported better health were more likely to participate in regular exercise.The proportion of those participating in regular exercise increased to 75.9%among the end-line year respondents after health education.This study revealed that health education interventions effectively encouraged rural middle-aged and elderly people to participate in regular exercise activities.Health education efforts of this sort for rural middle-aged and older adults should be further strengthened,and more public facilities for exercise should be provided.

METABONOMICS CHARACTERISTICS OF MIDDLE-AGED AND ELDERLY CHINESE PEOPLE WITH QI-INSUFFICIENCY CONSTITUTION

The aim of the work was to investigate the metabonomic characteristics of qi-insufficiency constitution among middle-aged and elderly healthy Chinese people.All healthy Chinese participants were screened from 2012annual health check-up for middle-aged and elderly community residents(=50 years old)at Chajiao community,

Upper respiratory tract disease and bronchial asthma

930904 A clinical study on determination ofplasma vasoactive intestinal peptide and its rela-tionship with bronchial responsiveness in asth-matics.LIU Ao(刘翱),et al.Dept Respir Med,Kunming General Hosp,Kunming Command,Kunming,650032.Chin J Intern Med 1993;32(3):165-166.Vasoactive intestinal peptide(VIP),which islocalized in normal human lung,may play an im-portant role in regulating bronchial tone,pul-monary blood flow and mucus secretion.Thelevel of plasma VIP and bronchial responsivenesswere studied in patients with asthma,and chronicbronchitis and in the healthy subjects.The re-sults showed that the level of plasma VIP

桂林中老年群体智慧医疗服务使用意愿调查:基于技术采纳与应用整合理论模型

目的对中老年群体智慧医疗服务使用情况及其影响因素进行调查分析,为医疗机构优化智慧医疗服务、推动中老年群体数字鸿沟治理提供参考。方法在广西壮族自治区桂林市采用线下问卷调查、访谈等方法收集数据,结合技术采纳与应用整合理论模型,使用SPSS 26.0和AMOS 24.0进行不同变量描述统计、单因素分析、不同维度相关分析和结构方程模型路径分析,研究中老年群体在使用智慧医疗服务过程中的影响因素。结果桂林市中老年群体对智慧医疗服务的使用意愿得分为(3.14±0.76)分,除了性别,不同变量对中老年群体的使用意愿差异分别有统计学意义(P<0.05)。中老年群体的绩效期望、社群影响、配合情况对中老年群体使用智慧医疗服务意愿有正向影响,努力期望对于使用意愿的影响不明显。结论桂林市中老年群体智慧医疗服务使用意愿还有很大的提升空间,要从各维度入手提高中老年群体的使用意愿,多方共同努力推进智慧医疗服务的使用。

延续性护理对老年性哮喘患者的影响研究

目的探讨延续性护理对老年性哮喘患者的心理及生活质量的影响。方法选择老年性哮喘患者80例,随机平分为观察组和对照组,观察组给予延续性护理,对照组给予常规护理。对比两组患者出院前、出院后1月及出院后3月生活质量以及心理状态的变化。结果随着时间的延长观察组在症状、活动受限以及疾病影响评分三个方面的效果均优于对照组,有统计学意义,P<0.05。出院后3个月观察组在焦虑和抑郁情况改善方面均优于对照组,两组比较有显著性统计学意义,P<0.01。结论延续性护理可明显改善老年性哮喘患者的心理状态以及生活质量,值得临床推广。

老年哮喘急性发作患者舒适护理干预效果评价

目的探讨老年哮喘急性发作患者舒适护理的应用效果。方法选择老年哮喘急性发作患者60例为研究对象,随机分为干预组和对照组各30例。干预组在常规护理的基础上给予舒适护理干预,对照组给予常规护理。比较两组患者SAS评分、SDS评分、治疗依从性、住院时间、护理满意度等相关情况。结果干预后,两组患者焦虑、抑郁评分较干预前均有显著下降,但干预组下降更明显,显著低于对照组(P<0.05或P<0.01)。干预组症状消失时间、体征消失时间、住院时间显著短于对照组(P<0.01);干预组依从率显著高于对照组,复发率显著低于对照组(P<0.01)。干预组患者对相关知识掌握情况、相关技能掌握情况、护理满意度均显著高于对照组(P<0.01)。结论老年哮喘患者采用舒适护理,能够提高患者治疗依从性,促使疾病恢复,减少复发。

老年哮喘患者采取舒适护理干预的临床效果分析

目的探讨分析老年哮喘患者采取舒适护理干预的临床效果。方法回顾性分析我院老年哮喘患者72例病历资料,根据护理方法分为护理干预组(40例)和对照组(32例)。对照组予常规护理,护理干预组在常规护理基础上给予舒适护理,并比较两组患者焦虑抑郁评分、患者的治疗依从性、护理满意度、住院时间等相关情况。结果经护理干预后,两组患者SAS、SDS评分较护理干预前均有明显下降,但护理干预组护理干预后较对照组明显降低(P<0.05)。护理干预组症状、体征消失时间显著短于对照组(P<0.05);护理干预组治疗依从率、护理满意度、对护理人员信任度、3个月复发率等也显著低于对照组(P<0.05)。结论舒适护理能够提高患者治疗依从性,提高患者的舒适度、满意度以及对护理人员的信任度,促使疾病恢复。

Study on Prevention and Treatment of Kidney Deficiency and Bone Mineral Loss in Middle－Aged and Elderly Fema

In this study, 48 cases of middle-aged and elderly female diabetes patients were dividedrandomly into two groups, and treated separately by western medicine alone ( glibenclamide) in group A, andby traditional Chinese medicine (herbs that replenish the Kidney and activate blood circulation ) and gliben-clamide in group B. Before treatment, the patients of both groups had elevated glycosylated hemoglobin(HbAlc) and fast blood glucose (FBG) levels, decreased serum estradiol (E2 ) and testosterone/estradiol(E2/T) ratio, and the loss of bone mineral (elevated urinary calcium,phosphorus levels) . Most ot the pa-tients in the two groups had the symptoms of soreness and weakness of the loins and knees, general weak-ness ,dizziness,decreased sexual libido , palpitation and frequent urination , etc. These symptoms in traditionalChinese medicine belong to the deficiency of the Kidney. After treatment in both groups. the patients' serumHbAlc, FBG, and urinary Beta-2-microglobulin (B2M) got reduced, the concentration of serum sex hormone(E2 , E2/T ratio) elevated, and the elimination of urinary calcium, phosphorus levels cut down. But , the ther-apeutic effect in group B is apparently better than that in group A. The symptoms of deficiency of the Kidneywas apparently improved in group B. So, The authors think the medicinal herbs(reinforcing Kidney and acti-vating blood circulation) have an important role in the prevention and treatment of the 'Kidney deficiency'and bone mineral loss in middle-aged and elderly female diabetes patients.

晚发老年哮喘28例诊治分析

目的 分析晚发老年哮喘的临床特点,以提高对晚发老年哮喘的认识. 方法 回顾性分析81例晚发老年哮喘患者的临床资料,将全部患者按起病时间（首次发病年龄）分为早发老年哮喘（早发组）和晚发老年哮喘（晚发组）,对比分析各项相关指标. 结果 晚发组28例（34.6%）,与早发组相比,吸烟史、过敏史及家族史、发病病因或诱因、临床表现、基础疾病及并发症、危重症比例、疾病转归、病死率等差异均无统计学意义（均P＞0.05）;晚发组误诊误治时间明显较早发组短（P＜0.05）;晚发组的季节性比早发组明显（P＜0.05）. 结论 晚发老年哮喘患者多有基础疾病、易误诊、易并发呼吸衰竭、病死率高等特点.