Objective:To analyze the effect of atorvastatin combined with trimetazidine in the treatment of elderly coronary artery disease and the effect on patients’cardiac function.Methods:60 cases of elderly coronary artery ...Objective:To analyze the effect of atorvastatin combined with trimetazidine in the treatment of elderly coronary artery disease and the effect on patients’cardiac function.Methods:60 cases of elderly coronary artery disease patients were divided into 2 groups by randomization method,and all of them received conventional symptomatic treatment,while atorvastatin was added to the control group and trimetazidine was combined with atorvastatin in the observation group,and the clinical indexes were compared.Results:After treatment,the angina attack,cardiac function indexes,and inflammatory factor levels of the observation group were better than those of the control group(P<0.05),and the differences in adverse reactions between the two groups were not significant(P>0.05).Conclusion:Combined treatment of coronary heart disease in the elderly with atorvastatin and trimetazidine can positively reduce angina symptoms,improve cardiac function,and reduce inflammatory reactions,and the effect is definite.展开更多
Heart failure (HF) is a major health problem for the geriatric population. In the United States, most of the 5 millions patients with HF are elderly.1 Seventy-five percent of HF hospitalizations occurred in patients o...Heart failure (HF) is a major health problem for the geriatric population. In the United States, most of the 5 millions patients with HF are elderly.1 Seventy-five percent of HF hospitalizations occurred in patients older than 65 years and 50% in patients 75 years and older.1 In the Framingham population, the prevalence of HF increased eightfold among men from the fifth decade of life to the seventh decade.2 However, despite of considerable improvement in the treatment, the mortality of HF patients remained relatively constant between 1948 and 1997.展开更多
BACKGROUND： Thrombolysis therapy is not suitable for the elderly patients with acute ischemic stroke who delayed to be diagnosed for more than 3 hours, but traditional medicine is also not very ideal. OBJECTIVE： To ...BACKGROUND： Thrombolysis therapy is not suitable for the elderly patients with acute ischemic stroke who delayed to be diagnosed for more than 3 hours, but traditional medicine is also not very ideal. OBJECTIVE： To observe the clinical therapeutic effect of modified hemodilution combined therapy applied in elderly patients with acute cerebral thrombosis and analyze the mechanism of this therapeutic method. DESIGN： 1：1 paired grouping according to gender and controlled observation SETTING： Department of Internal Medicine, Chengzhanyuan District, First Hospital Affiliated to Zhejiang University. PARTICIPANTS： Totally 90 elderly patients with acute ischemic stroke who received the treatment in the Cadre Ward and Mental Ward, Department of Internal Medicine, Chengzhanyuan District, First Hospital Affiliated to Zhejiang University from March 1996 to June 2004 were recruited. They all met the diagnosis criteria revised by the Fourth Academic Conference of National Cerebrovascular Diseases in 1995 and were diagnosed as acute ischemic stroke by skull CT. They were informed of therapeutic plan and detected items. According to 1：1 paired principle in gender, 90 enrolled patients were assigned into treated group （n=45） and control group （n=45）. There were 39 male and 6 female in the treatment group, and they were aged （76±6）years, ranging from 71 to 84 years, and hospitalized at the 14^th to 76^th hours after onset. There were 39 male and 6 female in the control group, and they were aged （76±6）years , ranging from 70 to 82 years, and hospitalized at the 16^th to 72^th hours after onset. METHODS： Therapeutic method： Patients of treated group received modified hemodilution combined therapy. 200 mL whole blood of patients was exchanged with 500 mL dextran-40 （including 20 mL danshen parenteral solution and 32 mg heparin） at the beginning of therapy; From the 2^nd day, compound huangqi tea bag （Huangqi mainly, including danshen, honghua, chuanxiong, shishao and a little acetyl salicylic acid） was made, twice a day, 1 bag once. At the same time, the above-mentioned dextran-40 liquid of 500 mL was intravenously injected, once a day, 14 days in total; On the 6^th day after therapy, the above-mentioned aseptic autoblood stored in refrigerator at 4℃ was transfused back into the patients following pre-treatment of high-concentration oxygenation and ultraviolet irradiation by light quantum instrument. Patients of control group were intravenously injected of 0.4 g venoruton（Traditional Chinese medicine compound parenteral solution for promoting blood circulation and removing blood stasis ） and 50 g/L glucose of 500 mL, 75 mg acetosal was taken orally, once a day, 14 days in total. ② Measurement and observation of index： Blood coagulation index, change of platelet aggregation rate and change of hemorrheology of patients in two groups were monitored before and after therapy. The level of blood lipid of patients in two groups was measured with American Beckman automatic biochemistry analyzer. Blood flow rate of middle cerebral artery of resting electrocardiogram were measured with American HP SONOS 2500 sonoscope. Neuro-dysfunction score revised in the national conference （1995） was used to evaluate the recovery of neurological function of the patients in two groups at the 3rd, 5^th, 7^th and 14^th days after therapy. ③Therapeutic effect and adverse effect were observed at the same time. MAIN OUTCOME MEASURES ： ① Changes of coagulation index, blood lipid level and hemorheology; ② Blood flow rate of middle cerebral artery and NDS of patients with acute ischemic stroke in two groups; ③Adverse effect of drug. RESULTS： Totally 90 patients were enrolled in the experiment. One patient from treated group died of hyperosmolar nonketotic diabetic coma of complicated diabetes mellitus. One patient from control group died of severe pulmonary infection. The rest 88 patients entered the stage of result analysis. ① Change of coagulation index and platelet aggregation rate： prothrombin time （PT）, activated partial thromboplastin time （APTT） and thrombin time （TT） of patients after therapy were significantly longer than those before therapy in the treated group and those after therapy in control group [After therapy in treated group： （18.4±1.9）, （41.8±2.1）, （19.7±1.7） s, Before therapy in treated group： （13.4±1.3）, （35.8±1.3）, （12.5±0.9） s, After therapy in control group： （16.9±1.5）, （39.1±1.1）, （11.9±2.1） s, P〈 0.05]：Concentration of fibrinogen （Fbg） after therapy was significantly lower than that before therapy in the treated group and that after therapy in control group[After therapy in treated group： （3.4±0.4） g/L; Before therapy in treated group： （4.3±0.7） g/L; After therapy in control group：（4.0±0.6） g/L; P 〈 0.05]. Platelet aggregation rate decreased from （37.92 ±0.85）% before therapy to （26.42±1.01）% after therapy （P 〈 0.01）. ②Change of blood lipid level： Levels of total cholesterol （TC）, triacylglycerol（TG） and low density lipoprotein cholesterol （LDL-C） of patients after therapy were significantly lower than those before therapy in treated group and those after therapy in control group [After therapy in treated group： （5.2±0.9）, （1.9±0.9）, （2.08±1.1） mmol/L, before therapy in treated group： （5.9±1.2）, （2.8±0.9）, （3.94±0.5） mmol/L, After therapy in control group： （6.0±1.1）, （2.6±0.8）, （3.84±0.9） mmol/L, P 〈 0.05]. ③Change of hemorheology index： Hematocrit of patients of treated group was significantly lower after therapy than before therapy [Before therapy： （43.84±4.55）% ;After therapy： （40.48±4.02）%;P 〈 0.05]. Blood flow rate of middle cerebral artery of patients of treated group was significantly lower before therapy than after therapy [（90±1.2）, （97±2.1） cm/s,P〈 0.01]. ⑤NDS of patients in treated group was significantly lower than of control group 14 days after therapy. The total effective rate after therapy was significantly higher in the treated group than in the control group （93%,78%, P 〈 0.05）. ⑥There was no obvious adverse effect. CONCLUSION： Modified hemodilution combined therapy can improve hemorheology, decrease hematocrit, increase blood flow rate of middle cerebral artery, so as to improve the impaired clinical neurological function of elderly patients with acute cerebral thrombosis through anticoagulation and antiplatelet aggregative activity as well as regulating blood lipid.展开更多
In this issue of the Journal of Geriatric Cardiology,Rigatelli and colleagues tackled the issue of concomitant noncoronary atherosclerosis among elderly patients undergoing cardiac surgery.1 Ilio-femoral disease, ... In this issue of the Journal of Geriatric Cardiology,Rigatelli and colleagues tackled the issue of concomitant noncoronary atherosclerosis among elderly patients undergoing cardiac surgery.1 Ilio-femoral disease, renal artery stenosis, carotid stenosis, and even disease of supra-aortic vessels may variously impact the patient's recovery from surgery. Also, the fact that involvement of two or more arterial beds are more common among the elderly makes this article all the more relevant at this time.……展开更多
The most important risk factor for stroke and neurodegeneration is aging. In fact, survival after stroke diminishes largely with aging. In fact, recovery after brain artery occlusion is dramatically worsened by aging,...The most important risk factor for stroke and neurodegeneration is aging. In fact, survival after stroke diminishes largely with aging. In fact, recovery after brain artery occlusion is dramatically worsened by aging, even normal aging is associated with neuron damage and cognitive decline. Mechanisms involved in aging-related, cognitive decline and susceptibility to neuron damage in stroke and neurode- generation are largely unknown. One of the most important mech- anisms contributing to neural dysfunction and death is excitotox- icity. This process is based on the fact that the excessive glutamate receptor stimulation may lead to neuronal damage. This overstim- ulation may be due to increased concentration of glutamate, or the prolonged activation of receptors.展开更多
Persons aged 80 and above are the fastest growing age group in the United States population, having increased 50% since 1990 and predicted to grow another 25% by 2020.
Introduction
Affecting over half a million people per year, stroke is the third leading cause of death in the United States. Approximately 30% of strokes are caused by carotid occlusive disease.……
Ms. BP is an 83 year old white female with a long history of congestive heart failure (HF). She is now symptomatic with minimal exertion, has a left ventricular ejection fraction (LVEF) of 20%. Her CHF is due to hyper...Ms. BP is an 83 year old white female with a long history of congestive heart failure (HF). She is now symptomatic with minimal exertion, has a left ventricular ejection fraction (LVEF) of 20%. Her CHF is due to hypertension (HTN) plus coronary artery disease (CAD) and she is on angiotensin converting enzyme inhibitor (ACEI), furosemide, digoxin,spironolactone, low dose beta blocker and nitrates. Her beta-natriuretic peptide (BNP) in clinic is 3030 pg/ml, heart rate (HR) 100, blood pressure (BP) 89/43.展开更多
The systemic response to tissue injury, regardless of cause is characterized by a cytokine-mediated alteration in the hepatic synthesis of a number of different plasma proteins,known collectively as 'acute pha... The systemic response to tissue injury, regardless of cause is characterized by a cytokine-mediated alteration in the hepatic synthesis of a number of different plasma proteins,known collectively as 'acute phase reactants'. These proteins include C-reactive protein, serum amyloid A protein, alphal glycoprotein, ceruloplasmin, alpha macroglobulins, complement components (C1-C4, factor B, C9, C11), alpha1antitrypsin, alpha1 antichymotrypsin, fibrinogen, prothrombin,factor Ⅷ, plasminogen, haptoglobin, ferritin, immunoglobulins and lipoproteins. The initiation of the acute phase response is linked to the production of hormone-like polypeptide mediators now called cytokines, namedly, interleukin 1(IL-1),tumor necrosis factor, interferon gamma, interleukin 6 (IL-6),leukemia inhibitory factor, ciliary neurotropic factor, oncostatin M, and interleukin 11 (IL- 11).……展开更多
Heart failure (HF) affects 5 million Americans, of whom three-fourths are over age 65 and half are over age 75.1 HF is currently the leading cause of hospitalization among older adults in the U.S., and it is the m... Heart failure (HF) affects 5 million Americans, of whom three-fourths are over age 65 and half are over age 75.1 HF is currently the leading cause of hospitalization among older adults in the U.S., and it is the most costly medical illness by a factor of almost two.……展开更多
Chronic heart failure (CHF) is a clinical syndrome as a common pathway at the end stage of cardiac diseases of different etiologies, and it is currently the only cardiovascular disease with an increasing prevalenc... Chronic heart failure (CHF) is a clinical syndrome as a common pathway at the end stage of cardiac diseases of different etiologies, and it is currently the only cardiovascular disease with an increasing prevalence in the developed countries. In the United States, the prevalence of CHF at age 50 years is 1.0%, whereas it reaches 7.5% at age 80years. In the United Kingdom, the prevalence of CHF is5.0% at age 60-70 years, and 10-20% at age 80 years. The situation is similar in Italy and Portugal. Despite being a developing country in Asia, China has experienced rapid progress in acquiring medical knowledge and advancing techniques in recent years. Due to the markedly declined mortality of acute myocardial infarction (AMI) as well as the aging of Chinese population, about four million Chinese have CHF with a prevalence of 0.9%, most of whom are 60 years of age and older.……展开更多
Introduction
Sudden cardiac death (SCD) accounts for approximately 300,000 deaths each year in the United States. Ventricular fibrillation, as the initial event, had been reported in 65%-85% of these patients.1 An imp...Introduction
Sudden cardiac death (SCD) accounts for approximately 300,000 deaths each year in the United States. Ventricular fibrillation, as the initial event, had been reported in 65%-85% of these patients.1 An implantable cardioverterdefibrillator (ICD) is the single most effective life saving device to date. The advances in medicine and technology have led to wide spread utilization of defibrillators in developed countries.展开更多
Atrial fibrillation is the most common sustained arrhythmia and results in significant morbidity, especially in the elderly. The prevalence of atrial fibrillation increases dramatically with advancing age to almost 6%...Atrial fibrillation is the most common sustained arrhythmia and results in significant morbidity, especially in the elderly. The prevalence of atrial fibrillation increases dramatically with advancing age to almost 6% in individuals older than 65 years. In fact, 84% of people with atrial fibrillation are over 65 years of age.1 Additionally, the risk of stroke increases with advancing age, such that one-third of strokes in patients over the age of 65 are caused by atrial fibrillation.展开更多
The current issue of the Journal of Geriatric Cardiology contains an interesting paper by Dr. Yixin Song and colleagues raising important issues in the diagnosis and management of heart failure in elderly patients. Re...The current issue of the Journal of Geriatric Cardiology contains an interesting paper by Dr. Yixin Song and colleagues raising important issues in the diagnosis and management of heart failure in elderly patients. Readers of this journal are in all likelihood aware that the epidemic of heart failure is of great impact medically and economically worldwide.展开更多
The World Health Organization estimates there are over thirty-two million major atherothrombotic events occur worldwide each year with nearly seventeen million directly attributable deaths.
Objective To compare the efficacy of 3 internal fixations,locking proximal femoral plate (LPFP),ASI-AN IMHS and InterTAN,for intertrochanteric femoral fractures in elderly patients.Methods A retrospective study was do...Objective To compare the efficacy of 3 internal fixations,locking proximal femoral plate (LPFP),ASI-AN IMHS and InterTAN,for intertrochanteric femoral fractures in elderly patients.Methods A retrospective study was done to analyse展开更多
Objective:To observe the analgesic effect of combined spinal and epidural anesthesia on older patients undergoing hip fracture surgery.Method:One hundred and twenty elderly hip fracture surgery patients treated in our...Objective:To observe the analgesic effect of combined spinal and epidural anesthesia on older patients undergoing hip fracture surgery.Method:One hundred and twenty elderly hip fracture surgery patients treated in our hospital from January 2021 to December 2022 were selected and randomly divided into two groups,with 60 cases in the experimental group and 60 in the control group.The experimental group was given combined spinal-epidural anesthesia intervention measures,while the control group was given epidural anesthesia intervention measures.The analgesic effect,tumor necrosis factor-alpha(TNF-α),C-reactive protein(CRP)levels,and other observation indicators were analyzed after anesthesia intervention.Result:After the intervention,the analgesic effect and the evaluation results of the subjects in the experimental group were better than those in the control group(P<0.05);the obtained values of TNF-αand CRP levels in the experimental group were higher than those of the control group(P<0.05).Conclusion:The combined spinal-epidural anesthesia intervention demonstrated positive outcomes.The analgesic effect of patients during surgery and their inflammatory factor levels improved,which makes this intervention worthy of clinical application and promotion.展开更多
Objective:To analyze the combined therapeutic effect of clopidogrel(CLO)and aspirin(ASP)on coronary heart disease(CHD)in community-dwelling elderly.Methods:Thirty elderly patients with CHD who were admitted to the Xin...Objective:To analyze the combined therapeutic effect of clopidogrel(CLO)and aspirin(ASP)on coronary heart disease(CHD)in community-dwelling elderly.Methods:Thirty elderly patients with CHD who were admitted to the Xinxin Community Health Service Station,Pangzhuang Street,Quanshan District,Xuzhou City,from November 2020 to November 2022 were selected and randomly grouped into an observation group and a control group,with 15 cases in each group.The observation group was given the combination of CLO and ASP and the reference group was given only ASP.The total effective rate and other treatment indicators between the two groups were compared.Results:The total effective rate of the observation group(93.33%)was higher than that of the reference group(60.00%)(P<0.05).The adverse drug reaction rate(13.33%)and long-term cardiovascular adverse event rate(6.67%)of the observation group were lower than those of the reference group at 46.67%and 40.00%respectively,(P<0.05).Before treatment,the two groups had no difference in the quality-of-life scores(P>0.05).After treatment,the quality-of-life scores of the observation group were higher than those of the reference group(P<0.05).Conclusion:CLO combined with ASP improved the therapeutic effect of community-dwelling elderly patients with CHD,reduced adverse reactions during medication,prevented adverse cardiovascular events,and comprehensively improved the patient’s quality of life.展开更多
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 Totall...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展开更多
文摘Objective:To analyze the effect of atorvastatin combined with trimetazidine in the treatment of elderly coronary artery disease and the effect on patients’cardiac function.Methods:60 cases of elderly coronary artery disease patients were divided into 2 groups by randomization method,and all of them received conventional symptomatic treatment,while atorvastatin was added to the control group and trimetazidine was combined with atorvastatin in the observation group,and the clinical indexes were compared.Results:After treatment,the angina attack,cardiac function indexes,and inflammatory factor levels of the observation group were better than those of the control group(P<0.05),and the differences in adverse reactions between the two groups were not significant(P>0.05).Conclusion:Combined treatment of coronary heart disease in the elderly with atorvastatin and trimetazidine can positively reduce angina symptoms,improve cardiac function,and reduce inflammatory reactions,and the effect is definite.
文摘Heart failure (HF) is a major health problem for the geriatric population. In the United States, most of the 5 millions patients with HF are elderly.1 Seventy-five percent of HF hospitalizations occurred in patients older than 65 years and 50% in patients 75 years and older.1 In the Framingham population, the prevalence of HF increased eightfold among men from the fifth decade of life to the seventh decade.2 However, despite of considerable improvement in the treatment, the mortality of HF patients remained relatively constant between 1948 and 1997.
基金the Grant from Science and Technology Development Foundation of Railway Bureau of Shanghai, No. 3402052304/A
文摘BACKGROUND： Thrombolysis therapy is not suitable for the elderly patients with acute ischemic stroke who delayed to be diagnosed for more than 3 hours, but traditional medicine is also not very ideal. OBJECTIVE： To observe the clinical therapeutic effect of modified hemodilution combined therapy applied in elderly patients with acute cerebral thrombosis and analyze the mechanism of this therapeutic method. DESIGN： 1：1 paired grouping according to gender and controlled observation SETTING： Department of Internal Medicine, Chengzhanyuan District, First Hospital Affiliated to Zhejiang University. PARTICIPANTS： Totally 90 elderly patients with acute ischemic stroke who received the treatment in the Cadre Ward and Mental Ward, Department of Internal Medicine, Chengzhanyuan District, First Hospital Affiliated to Zhejiang University from March 1996 to June 2004 were recruited. They all met the diagnosis criteria revised by the Fourth Academic Conference of National Cerebrovascular Diseases in 1995 and were diagnosed as acute ischemic stroke by skull CT. They were informed of therapeutic plan and detected items. According to 1：1 paired principle in gender, 90 enrolled patients were assigned into treated group （n=45） and control group （n=45）. There were 39 male and 6 female in the treatment group, and they were aged （76±6）years, ranging from 71 to 84 years, and hospitalized at the 14^th to 76^th hours after onset. There were 39 male and 6 female in the control group, and they were aged （76±6）years , ranging from 70 to 82 years, and hospitalized at the 16^th to 72^th hours after onset. METHODS： Therapeutic method： Patients of treated group received modified hemodilution combined therapy. 200 mL whole blood of patients was exchanged with 500 mL dextran-40 （including 20 mL danshen parenteral solution and 32 mg heparin） at the beginning of therapy; From the 2^nd day, compound huangqi tea bag （Huangqi mainly, including danshen, honghua, chuanxiong, shishao and a little acetyl salicylic acid） was made, twice a day, 1 bag once. At the same time, the above-mentioned dextran-40 liquid of 500 mL was intravenously injected, once a day, 14 days in total; On the 6^th day after therapy, the above-mentioned aseptic autoblood stored in refrigerator at 4℃ was transfused back into the patients following pre-treatment of high-concentration oxygenation and ultraviolet irradiation by light quantum instrument. Patients of control group were intravenously injected of 0.4 g venoruton（Traditional Chinese medicine compound parenteral solution for promoting blood circulation and removing blood stasis ） and 50 g/L glucose of 500 mL, 75 mg acetosal was taken orally, once a day, 14 days in total. ② Measurement and observation of index： Blood coagulation index, change of platelet aggregation rate and change of hemorrheology of patients in two groups were monitored before and after therapy. The level of blood lipid of patients in two groups was measured with American Beckman automatic biochemistry analyzer. Blood flow rate of middle cerebral artery of resting electrocardiogram were measured with American HP SONOS 2500 sonoscope. Neuro-dysfunction score revised in the national conference （1995） was used to evaluate the recovery of neurological function of the patients in two groups at the 3rd, 5^th, 7^th and 14^th days after therapy. ③Therapeutic effect and adverse effect were observed at the same time. MAIN OUTCOME MEASURES ： ① Changes of coagulation index, blood lipid level and hemorheology; ② Blood flow rate of middle cerebral artery and NDS of patients with acute ischemic stroke in two groups; ③Adverse effect of drug. RESULTS： Totally 90 patients were enrolled in the experiment. One patient from treated group died of hyperosmolar nonketotic diabetic coma of complicated diabetes mellitus. One patient from control group died of severe pulmonary infection. The rest 88 patients entered the stage of result analysis. ① Change of coagulation index and platelet aggregation rate： prothrombin time （PT）, activated partial thromboplastin time （APTT） and thrombin time （TT） of patients after therapy were significantly longer than those before therapy in the treated group and those after therapy in control group [After therapy in treated group： （18.4±1.9）, （41.8±2.1）, （19.7±1.7） s, Before therapy in treated group： （13.4±1.3）, （35.8±1.3）, （12.5±0.9） s, After therapy in control group： （16.9±1.5）, （39.1±1.1）, （11.9±2.1） s, P〈 0.05]：Concentration of fibrinogen （Fbg） after therapy was significantly lower than that before therapy in the treated group and that after therapy in control group[After therapy in treated group： （3.4±0.4） g/L; Before therapy in treated group： （4.3±0.7） g/L; After therapy in control group：（4.0±0.6） g/L; P 〈 0.05]. Platelet aggregation rate decreased from （37.92 ±0.85）% before therapy to （26.42±1.01）% after therapy （P 〈 0.01）. ②Change of blood lipid level： Levels of total cholesterol （TC）, triacylglycerol（TG） and low density lipoprotein cholesterol （LDL-C） of patients after therapy were significantly lower than those before therapy in treated group and those after therapy in control group [After therapy in treated group： （5.2±0.9）, （1.9±0.9）, （2.08±1.1） mmol/L, before therapy in treated group： （5.9±1.2）, （2.8±0.9）, （3.94±0.5） mmol/L, After therapy in control group： （6.0±1.1）, （2.6±0.8）, （3.84±0.9） mmol/L, P 〈 0.05]. ③Change of hemorheology index： Hematocrit of patients of treated group was significantly lower after therapy than before therapy [Before therapy： （43.84±4.55）% ;After therapy： （40.48±4.02）%;P 〈 0.05]. Blood flow rate of middle cerebral artery of patients of treated group was significantly lower before therapy than after therapy [（90±1.2）, （97±2.1） cm/s,P〈 0.01]. ⑤NDS of patients in treated group was significantly lower than of control group 14 days after therapy. The total effective rate after therapy was significantly higher in the treated group than in the control group （93%,78%, P 〈 0.05）. ⑥There was no obvious adverse effect. CONCLUSION： Modified hemodilution combined therapy can improve hemorheology, decrease hematocrit, increase blood flow rate of middle cerebral artery, so as to improve the impaired clinical neurological function of elderly patients with acute cerebral thrombosis through anticoagulation and antiplatelet aggregative activity as well as regulating blood lipid.
文摘 In this issue of the Journal of Geriatric Cardiology,Rigatelli and colleagues tackled the issue of concomitant noncoronary atherosclerosis among elderly patients undergoing cardiac surgery.1 Ilio-femoral disease, renal artery stenosis, carotid stenosis, and even disease of supra-aortic vessels may variously impact the patient's recovery from surgery. Also, the fact that involvement of two or more arterial beds are more common among the elderly makes this article all the more relevant at this time.……
基金supported by grants VA145U13,BIO/VA33/13,BIO103/VA45/11 from Junta de Castillay León,SpainBFU2012-37146 from Ministerio de Economíay Competitividad,Spainsupported by a pre-doctoral fellowship from Junta de Castillay León,Spain and The European Social Fund
文摘The most important risk factor for stroke and neurodegeneration is aging. In fact, survival after stroke diminishes largely with aging. In fact, recovery after brain artery occlusion is dramatically worsened by aging, even normal aging is associated with neuron damage and cognitive decline. Mechanisms involved in aging-related, cognitive decline and susceptibility to neuron damage in stroke and neurode- generation are largely unknown. One of the most important mech- anisms contributing to neural dysfunction and death is excitotox- icity. This process is based on the fact that the excessive glutamate receptor stimulation may lead to neuronal damage. This overstim- ulation may be due to increased concentration of glutamate, or the prolonged activation of receptors.
文摘Persons aged 80 and above are the fastest growing age group in the United States population, having increased 50% since 1990 and predicted to grow another 25% by 2020.
文摘 Introduction
Affecting over half a million people per year, stroke is the third leading cause of death in the United States. Approximately 30% of strokes are caused by carotid occlusive disease.……
文摘Ms. BP is an 83 year old white female with a long history of congestive heart failure (HF). She is now symptomatic with minimal exertion, has a left ventricular ejection fraction (LVEF) of 20%. Her CHF is due to hypertension (HTN) plus coronary artery disease (CAD) and she is on angiotensin converting enzyme inhibitor (ACEI), furosemide, digoxin,spironolactone, low dose beta blocker and nitrates. Her beta-natriuretic peptide (BNP) in clinic is 3030 pg/ml, heart rate (HR) 100, blood pressure (BP) 89/43.
文摘 The systemic response to tissue injury, regardless of cause is characterized by a cytokine-mediated alteration in the hepatic synthesis of a number of different plasma proteins,known collectively as 'acute phase reactants'. These proteins include C-reactive protein, serum amyloid A protein, alphal glycoprotein, ceruloplasmin, alpha macroglobulins, complement components (C1-C4, factor B, C9, C11), alpha1antitrypsin, alpha1 antichymotrypsin, fibrinogen, prothrombin,factor Ⅷ, plasminogen, haptoglobin, ferritin, immunoglobulins and lipoproteins. The initiation of the acute phase response is linked to the production of hormone-like polypeptide mediators now called cytokines, namedly, interleukin 1(IL-1),tumor necrosis factor, interferon gamma, interleukin 6 (IL-6),leukemia inhibitory factor, ciliary neurotropic factor, oncostatin M, and interleukin 11 (IL- 11).……
文摘 Heart failure (HF) affects 5 million Americans, of whom three-fourths are over age 65 and half are over age 75.1 HF is currently the leading cause of hospitalization among older adults in the U.S., and it is the most costly medical illness by a factor of almost two.……
文摘 Chronic heart failure (CHF) is a clinical syndrome as a common pathway at the end stage of cardiac diseases of different etiologies, and it is currently the only cardiovascular disease with an increasing prevalence in the developed countries. In the United States, the prevalence of CHF at age 50 years is 1.0%, whereas it reaches 7.5% at age 80years. In the United Kingdom, the prevalence of CHF is5.0% at age 60-70 years, and 10-20% at age 80 years. The situation is similar in Italy and Portugal. Despite being a developing country in Asia, China has experienced rapid progress in acquiring medical knowledge and advancing techniques in recent years. Due to the markedly declined mortality of acute myocardial infarction (AMI) as well as the aging of Chinese population, about four million Chinese have CHF with a prevalence of 0.9%, most of whom are 60 years of age and older.……
文摘Introduction
Sudden cardiac death (SCD) accounts for approximately 300,000 deaths each year in the United States. Ventricular fibrillation, as the initial event, had been reported in 65%-85% of these patients.1 An implantable cardioverterdefibrillator (ICD) is the single most effective life saving device to date. The advances in medicine and technology have led to wide spread utilization of defibrillators in developed countries.
文摘Atrial fibrillation is the most common sustained arrhythmia and results in significant morbidity, especially in the elderly. The prevalence of atrial fibrillation increases dramatically with advancing age to almost 6% in individuals older than 65 years. In fact, 84% of people with atrial fibrillation are over 65 years of age.1 Additionally, the risk of stroke increases with advancing age, such that one-third of strokes in patients over the age of 65 are caused by atrial fibrillation.
文摘The current issue of the Journal of Geriatric Cardiology contains an interesting paper by Dr. Yixin Song and colleagues raising important issues in the diagnosis and management of heart failure in elderly patients. Readers of this journal are in all likelihood aware that the epidemic of heart failure is of great impact medically and economically worldwide.
文摘The World Health Organization estimates there are over thirty-two million major atherothrombotic events occur worldwide each year with nearly seventeen million directly attributable deaths.
文摘Objective To compare the efficacy of 3 internal fixations,locking proximal femoral plate (LPFP),ASI-AN IMHS and InterTAN,for intertrochanteric femoral fractures in elderly patients.Methods A retrospective study was done to analyse
基金Weifang Municipal Science and Technology Bureau(Medical)Project“Effects and Mechanisms of Oxycodone and Alfentanil on IgFs in Mouse Ovarian Granulosa Cells”(2021YX035)。
文摘Objective:To observe the analgesic effect of combined spinal and epidural anesthesia on older patients undergoing hip fracture surgery.Method:One hundred and twenty elderly hip fracture surgery patients treated in our hospital from January 2021 to December 2022 were selected and randomly divided into two groups,with 60 cases in the experimental group and 60 in the control group.The experimental group was given combined spinal-epidural anesthesia intervention measures,while the control group was given epidural anesthesia intervention measures.The analgesic effect,tumor necrosis factor-alpha(TNF-α),C-reactive protein(CRP)levels,and other observation indicators were analyzed after anesthesia intervention.Result:After the intervention,the analgesic effect and the evaluation results of the subjects in the experimental group were better than those in the control group(P<0.05);the obtained values of TNF-αand CRP levels in the experimental group were higher than those of the control group(P<0.05).Conclusion:The combined spinal-epidural anesthesia intervention demonstrated positive outcomes.The analgesic effect of patients during surgery and their inflammatory factor levels improved,which makes this intervention worthy of clinical application and promotion.
文摘Objective:To analyze the combined therapeutic effect of clopidogrel(CLO)and aspirin(ASP)on coronary heart disease(CHD)in community-dwelling elderly.Methods:Thirty elderly patients with CHD who were admitted to the Xinxin Community Health Service Station,Pangzhuang Street,Quanshan District,Xuzhou City,from November 2020 to November 2022 were selected and randomly grouped into an observation group and a control group,with 15 cases in each group.The observation group was given the combination of CLO and ASP and the reference group was given only ASP.The total effective rate and other treatment indicators between the two groups were compared.Results:The total effective rate of the observation group(93.33%)was higher than that of the reference group(60.00%)(P<0.05).The adverse drug reaction rate(13.33%)and long-term cardiovascular adverse event rate(6.67%)of the observation group were lower than those of the reference group at 46.67%and 40.00%respectively,(P<0.05).Before treatment,the two groups had no difference in the quality-of-life scores(P>0.05).After treatment,the quality-of-life scores of the observation group were higher than those of the reference group(P<0.05).Conclusion:CLO combined with ASP improved the therapeutic effect of community-dwelling elderly patients with CHD,reduced adverse reactions during medication,prevented adverse cardiovascular events,and comprehensively improved the patient’s quality of life.
文摘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
