Influencing factors analysis of spontaneous knee joint osteoarthritis among middle aged and old aged pople in Xi'an

Objective:To explore the prevalence rate of knee joint osteoarthritis and its pathogenetic fea- tures among the middle-aged and old aged people in the urban and rural area of Xi'an.Methods:From May to October 2005,1538 Han nationality above 40 years in Xi'an were investigated according to strati- fied and cluster random sampling.The same questionnaire was delivered to subjects who had been given normotopia and lateral position radiographic examination in both knees.Excluded from etiological arthri- tis,some subjects with clinical symptoms and a radiographic grade (beyond Kellgren & Lawrence gradeⅡ) were finally diagnosed as spontaneous knee joint osteoarthritis.All analyses were performed with SPSS 13.0 and t test,U test.Single factor analysis and multiple logistic regression analysis were used to analyze dates.Results:The total prevalence of spontaneous knee joint osteoarthritis was 12.1% with 2.5% and 2.1% for right and left knees,respectively.The prevalence of knee joint osteoarthritis in wom- en was 2.5 times of that in men (17.2% vs 6.8%,P=0.000).the osteophyte prevalence in women was 2.3 times of that in men (26.5% vs 11.4%,P=0.000).The prevalence of knee joint osteoarthritis and osteophyte increased with the growth of age.So did the symptomatic knee,except for the age group of 56- 60 years and 66-70 years.The prevalence of symptomatic knee joint for urban area was significantly higher than that for rural area (56.3% vs 45.3%,P=0.003).In women,the prevalence of knee joint os- teoarthritis increased significantly with the increasing of body mass index,which had not been observed in men.Female and obesity are the risk factors for osteoarthritis,but bean and its products and meat could prevent the osteoarthritis.Conclusion:Old age,female and obesity serve as risk factors for knee joint os- teoarthritis.

Analysis of the Variations of Body Build of Middle-and Old-aged and Research on the Prototype

The characteristics of body build of middle - and old -aged women and its rule of variations as well as the basic sizes of various parts are discussed. All these are based on the body measurements of this age group, and also on the statistical studies of the measurement data. By setting the regression equation, the calculating formulae of various control parts are obtained, thus establishing the prototype of this age group for women.

Bystanders or not?Microglia and lymphocytes in aging and stroke

As the average age of the world population increases,more people will face debilitating aging-associated conditions,including dementia and stroke.Not only does the incidence of these conditions increase with age,but the recovery afterward is often worse in older patients.Researchers and health professionals must unveil and understand the factors behind age-associated diseases to develop a therapy for older patients.Aging causes profound changes in the immune system including the activation of microglia in the brain.Activated microglia promote T lymphocyte transmigration leading to an increase in neuroinflammation,white matter damage,and cognitive impairment in both older humans and rodents.The presence of T and B lymphocytes is observed in the aged brain and correlates with worse stroke outcomes.Preclinical strategies in stroke target either microglia or the lymphocytes or the communications between them to promote functional recovery in aged subjects.In this review,we examine the role of the microglia and T and B lymphocytes in aging and how they contribute to cognitive impairment.Additionally,we provide an important update on the contribution of these cells and their interactions in preclinical aged stroke.

Progress in the treatment of elderly patients with patent foramen ovale complicated with cryptogenic stroke

Background The incidence of cryptogenic stroke(CS)accounts for about 25%of ischemic stroke.Current studies have shown that cryptogenic stroke is closely related to patent foramen ovale(PFO).Evaluating the correlation between PFO and CS needs to be combined with multidisciplinary evaluation.Many clinical studies have shown that drug therapy can reduce the risk of ischemic stroke in elderly PFO patients(>60 years old).However,whether elderly PFO patients(>60 years old)can benefit from PFO closure is still controversial.This article reviewed the research progress of drug therapy and PFO closure therapy for cryptogenic stroke associated with PFO in the elderly.[S Chin J Cardiol 2024;25(1):50-56].

Relationship among Health Related Quality of Life, Quality of Sleep, and Oral Health Condition

Japan’s aging rate (ratio of elderly aged 65 and older to total population) has exceeded 20%. The aim of this study was to clarify the relationships between Health Related Quality of Life, Body Mass Index (BMI), and sleep quality. Subjects were 51 adults over 55 years old with chronic disease who living in the community. Instruments and structured interviews were used giving due consideration to privacy. Interviews were conducted within 10 - 20 minutes at the out-patient department. The evaluation instruments included bodymass index, Pittsburgh Sleep Quality Index (PSQI), Health Related Quality of Life (HRQOL), and Oral Health Impact Profile (OHIP-14). A significant positive correlation (ρ = 0.321, p < 0.05) between PSQI and QOL (OHIP-14) scores was confirmed with sleep quality being lower with lower QOL scores. A negative correlation (ρ = ?0.339, p < 0.05) between physical health component summary scores (PCS) and mental health component summary scores (MCS) of HRQOL was confirmed, demonstrating that PCS was low, and the level of MCS was high. Sleep quality was found lower among those with lower oral health-related QOL scores. Moreover, in subjects with lower MCS scores, the PCS scores were found to be higher. Accordingly, it was considered appropriate that dental treatment and care, support the maintenance of activities and sleep, and mental health promotion which are likely requisites critical for elderly persons’ maintenance of independent lifestyles in their familiar community.

Effect of Bushen Hemai decoction on vascular stiffness in elderly patients with isolated systolic hypertension

Objective: To investigate the effect of Bushen Hemai decoction on the wall stiffness of middle-aged and elderly patients with simple systolic hypertension. Methods: The 126 middle-aged and elderly patients with simple systolic hypertension admitted to our hospital from May 2010 to May 2015 were randomly divided into control group (63 cases) and observation group (63 cases). The control group was treated with conventional Western medicine, while the observation group was treated with Bushen Hemai decoction on the basis of the control group. The two groups were treated for 4 weeks. Results: The systolic blood pressure of the two groups decreased after treatment (observation group: T=16.165, control group: T=13.537, P<0.05);the systolic blood pressure of the two groups did not change significantly after treatment (observation group: T=1.857, control group: T=0.483, P>0.05);the systolic blood pressure of the observation group was lower than that of the control group after treatment (T=16.165, P<0.05). After treatment, the level of ST segment of ECG in the two groups was lower than that before treatment (observation group: T=22.145, control group: T=11.007, P<0.05);after treatment, the level of ST segment of ECG in the observation group was lower than that in the control group (T=8.130, P<0.05). After treatment, the pulse conduction velocity of the two groups was lower than that of the control group (observation group:T=8.694, control group: T=3.944, P<0.05);after treatment, the pulse conduction velocity of the observation group was lower than that of the control group (T=5.326, P<0.05). The total effective rate of the observation group (93.65%) was higher than that of the control group (76.19%) (P<0.05). Conclusion: Bushen Hemai Decoction has a significant clinical effect on middle-aged and elderly patients with simple systolic hypertension, and can improve the stiffness of the tube wall, which is worthy of clinical reference.

颈动脉斑块超声特征与中老年患者缺血性脑卒中的关联性研究

背景颈动脉粥样硬化斑块与缺血性脑卒中(ischemic cerebral stroke,ICS)的发生关系密切,超声检查是颈部血管疾病筛查的首选方式。目的通过对中老年患者颈动脉斑块超声检测指标与ICS的相关性分析,以颈动脉斑块超声特征作为预警指标,简化临床评估路径,从而提高超声诊断价值和ICS筛查效率。方法选取2017年9月-2019年11月吉林医药学院附属医院诊治的≥45周岁的ICS患者为ICS组,采用随机抽样的方法抽取同时间段来院诊治的同年龄段非ICS患者作为对照组,对所有受试者进行颈动脉超声检查。结果共收集资料完整的ICS组患者992例,对照组患者1117例,两组年龄差异无统计学意义(P>0.05),ICS组男女性别比高于对照组(594/398 vs 493/624,P<0.01)。超声结果显示,两组间斑块形成、斑块数目、回声、形态、颈动脉狭窄的差异有统计学意义(P均<0.05)。ICS组伴颈动脉粥样硬化斑块形成的比例高于对照组(86.90%vs 69.92%,P<0.01)。ICS组多发斑块、不均匀斑块、不规则斑块的比例高于对照组(95.71%vs 88.09%,51.62%vs 45.45%,24.13%vs 16.90%,P均<0.05)。ICS组颈动脉狭窄的比例高于对照组(18.33%vs 11.91%,P<0.01)。ICS组颈动脉重度狭窄或闭塞的比例高于对照组(3.71%vs 1.15%,2.09%vs 0.51%,P均<0.01)。斑块超声特征指标与脑卒中的多因素logistic回归结果显示,斑块数目(OR=1.702)、斑块形态(OR=1.381)、颈动脉狭窄(OR=1.435)与中老年患者ICS的发生有关联性(P均<0.05)。结论对中老年患者进行ICS筛查时,颈动脉斑块是否形成是具有关联性的重要指标。在斑块超声特征的描述中,斑块数目、形态、是否造成颈动脉狭窄与ICS发生相关。ICS组颈动脉狭窄的比例更高、程度更重。

河北省石家庄地区中老年脑卒中危险因素现况分析

目的分析石家庄社区中老年人群脑卒中危险因素,以掌握该地区脑卒中流行病学趋势。方法选取石家庄市卒中筛查防治基地医院河北医科大学第二医院为项目点,于2017年3月对项目点所属社区≥40岁常住居民进行脑卒中危险因素现况调查。了解脑卒中相关危险因素的暴露情况及对其患病率的影响。结果石家庄地区脑卒中患病率为4.49%;脑卒中危险因素的暴露情况情况:最大为血脂异常(77.5%),其次为明显超重或肥胖(26.1%)、高血压(25.4%)、卒中家族史(8.8%)、糖尿病(8.1%)、吸烟(7.9%)、很少体育活动(7.7%)、房颤(1.5%);多因素Logistic回归模型分析地区、年龄、高血压、房颤、吸烟、很少体力活动、卒中家族史与脑卒中显著相关(OR=0.628、1.062、4.753、3.414、2.651、4.289,P<0.05)。结论石家庄地区卒中防控形势严峻,应加强对脑卒中危险因素的管理,预防脑卒中的发生。

小剂量ASA预防高血压病人IS的10年研究

目的 :探讨中老年高血压病人长期服用小剂量阿斯匹林 (ASA)预防缺血性脑卒中 (IS)的临床价值 ;方法 :对 1 2 1 8例男性中老年高血压病及 2 80 2例无高血压的男性中老年者ASA连续干预前后 1 0年的IS发病、死亡等相关问题对照研究 ;结果 :ASA干预前 ,高血压IS发病率为 1 4 78‰ ,显著高于对照组 (2 86‰ ) ,ASA连续干预治疗的9年中 ,高血压组IS发病率呈现明显下降趋势 ,其发病危险度 (RR)较干预前减低 40 %左右。而ASA未使出血性脑卒中 (HS)发病率和死亡率增加 ;结论 :长期服用ASA对于中老年高血压IS发病有明显预防作用 ,且不增加HS的危险性。

早期康复对改善中老年脑卒中患者生活质量的研究

目的探讨早期康复对改善中老年脑卒中患者生活质量的影响。方法108例中老年脑卒中患者随机分为早期康复组和常规康复组,比较两组患者日常生活能力的改善情况。结果康复3个月后,两组患者日常生活能力差异有统计学意义(P<0.01)。早期康复组在出院和康复3个月后,功能独立性和日常生活能力均得到明显改善(P<0.05或P<0.01)。早期康复组患者及家属对康复服务的满意度是96.43%,高于常规康复组的80.77%,差异有统计学意义(P<0.05)。结论早期康复明显改善中老年脑卒中患者的功能独立性和日常生活能力,增强其生活自理能力,提升患者及家属对康复服务的满意度。

河北省张家口地区中老年人群脑卒中患病率及其相关危险因素调查

目的探讨河北省张家口地区中老年人口中脑卒中的患病率及其相关危险因素。方法在河北省张家口地区两个乡镇45岁以上中老年城乡居民10410名中,采用单纯随机抽签法入选2124人,男1183人,女941人,年龄45～95岁,平均(70±25)岁。以Rose问卷阳性者为本研究的诊断标准。结果在河北省张家口地区中老年人口中,脑卒中患病率为2170/10万,男2620/10万,女1590/10万。男性卒中患者主要危险因素为:大量饮酒、高脂饮食、气候寒冷变化、高血压、吸烟、肥胖、心房纤颤、高龄(70岁以上)、糖尿病及其家族史等;女性卒中患者主要危险因素为:高血压、肥胖、气候寒冷变化、高脂饮食、高龄(70岁以上)、心房纤颤,糖尿病及其家族史、大量饮酒、吸烟等。结论河北省张家口地区中老年人口脑卒中患病率为2170/10万,男性高于女性。大量饮酒、高脂饮食、气候寒冷变化、高血压、吸烟、肥胖是中老年脑卒中的常见危险因素。

三合一心理干预模式对中老年脑卒中后护理效果的影响

目的:分析中老年脑卒中后应用三合一心理干预模式对护理效果的影响。方法:将78例中老年脑卒中患者根据就诊时间分为两组,对照组38例行常规护理,观察组40例在常规护理基础上行三合一心理干预护理,比较两组护理效果。结果:护理后观察组焦虑、抑郁情绪评分及日常生活活动能力(ADL)评分均明显低于对照组(P<0.05),观察组护理满意度明显高于对照组(P<0.05)。结论:为中老年脑卒中患者行三合一心理干预护理,可有效减轻患者不良情绪,增强其生活自理能力,且有助于构建和谐护患关系。

中老年脑卒中患者发生衰弱综合征的影响因素

目的探讨中老年脑卒中患者发生衰弱综合征的危险因素。方法选取2021年1月至2022年1月中国人民解放军联勤保障部队第九八八医院老年病科、神经内外科及全科医学科收治的180例脑卒中患者,采用横断面调查法及问卷调查法进行研究,根据衰弱指数(FI)进行分组,采用logistic回归分析相关影响因素。结果180例脑卒中患者中男110例,女70例,年龄48~93(72.43±9.27)岁。其中无衰弱组47例(占26%),衰弱前期组101例(占56%),衰弱组32例(占18%)。logistic回归分析结果显示高血压、糖尿病、多重用药、存在肢体障碍、营养状况差、缺血性脑卒中及出血性脑卒中均是脑卒中患者发生衰弱的危险因素(P<0.05)。结论中老年脑卒中患者发生衰弱综合征的相关因素有高血压、糖尿病、多重用药、存在肢体障碍、营养状况差、缺血性脑卒中及出血性脑卒中,临床工作中应对以上因素进行早期筛查、早期干预,改善临床结局。

综合疗法联合单唾液酸神经节苷脂钠治疗中老年重症脑卒中的疗效观察

目的探析研究综合疗法联合单唾液酸神经节苷脂钠治疗中老年重症脑卒中的临床效果。方法选择本院2015年4月~2017年5月间收治的重症脑卒中患者中符合本次研究纳入标准以及排除标准的70例患者作为研究对象,依据信封法分为对照组和观察组,每组35例。对照组采取常规综合疗法进行治疗,观察组使用单唾液酸神经节苷脂钠进行治疗。对两组生存质量、血清超氧化物歧化酶活性、丙二醛水平以及神经功能改善情况进行比较分析。结果治疗前两组血清超氧化物歧化酶活性、丙二醛水平、生存质量评分以及神经功能评分比较差异无统计学意义。观察组治疗后生存质量评分为(88.9±3.2)分,均显著优于对照组(80.1±2.5)分(P<0.05)。观察组神经功能缺损评分为(9.6±2.1)分,均显著优于对照组(15.2±3.4)分(P<0.05)。两组治疗后血清超氧化物歧化酶活性、丙二醛水平,结果提示观察组SOD水平为(8.4±1.3)μmol/L,MDA为(5.5±1.1)pg/L,对照组分别为(9.5±1.4)pg/L,(7.7±1.2)pg/L,两组对比结果均提示观察组更低(P<0.05)。结论对中老年重症脑卒中患者采取综合疗法联合单唾液酸神经节苷脂钠进行治疗可有效提高该病症的治疗效果,改善患者的预后康复效果以及生活质量,故值得临床推广。

深圳市福田区社区中老年人群脑卒中调查

目的通过对深圳市福田区社区中老年人脑卒中的调查分析,为脑卒中的社区干预提供科学依据。方法采用整群随机抽样的方法对深圳市福田区3 642名≥40岁常住人口进行问卷调查,按照国家卫生部《脑卒中高危人群初筛评估简表》进行筛查,并进行血糖、血脂、血压、身高、体重的检测。结果脑卒中患病率为1.18%,TIA患病率3.08%,高危人群发生率30.83%,男性脑卒中、短暂性脑缺血发作(TIA)患病率和高危人群发生率分别为1.65%、3.82%、38.51%,分别是女性脑卒中患病率(0.77%)、TIA患病率(2.42%)和高危人群发生率(24.11%)的2.14、1.58、1.60倍,差异有统计学意义(χ2分别为5.93、5.96、88.09,P均<0.05)。脑卒中、TIA患病率随年龄的增长而升高,高危人群发生率随年龄的增长而降低,脑卒中患病率、高危人群发生率随文化程度升高而降低,TIA患病率不同文化程度患病率差异无统计学意义。结论脑卒中的社区干预应重点加强男性、文化程度低及中年社区人群的一级预防。

康复机器人对中老年脑卒中下肢功能康复影响

目的探索Lokomat康复机器人训练对中老年脑卒中偏瘫患者下肢运动功能康复的影响,给临床康复治疗积累数据。方法 2014年3月—2015年2月在海南省老年病医院接受康复治疗的中老年首发脑卒中并出现一侧下肢功能障碍的患者80例,完全随机区组分为研究组和对照组,每组各40例。两组患者都进行常规药物治疗和传统康复训练。研究组增加Lokomat下肢康复机器人辅助训练;对照组增加康复治疗师徒手辅助步行能力训练。治疗前后分别采用美国国立卫生院卒中量表(National institute of health stroke scale,NIHSS)、改良Rankin量表(Modified Rankin scale,MRS)、肢体运动功能评分表(Fugl-Meyer assessment,FMA)、功能性步行量表(Functional ambulation category scale,FAC)、Berg平衡量表(Berg balance scale,BBS)、改良Barthel指数(Modified Barthel index,MBI)评估患者的神经系统功能、下肢运动功能、步行功能、平衡功能及日常生活能力。结果治疗前两组患者FMA、FAC、BBS、MBI的评分差异无统计学意义(P>0.05),治疗6周后两组患者FMA、FAC、BBS、MBI的评分差异有统计学意义(P<0.001)。结论首发中老年脑卒中偏瘫患者早期结合康复机器人进行下肢功能康复训练能明显提高患者的下肢活动功能及日常生活活动能力,从而增加患者的生活质量和幸福指数。

中老年脑卒中患者的生活质量调查分析及康复护理干预

目的分析中老年脑卒中患者的生活质量及影响因素，探讨健康教育及康复护理干预对脑卒中患者生活活动能力（activities of daily living，ADL）及生活质量（quality o flife，QOL）改善的意义。方法将132例中老年脑卒中患者随机分为康复组和对照组。两组均接受脑卒中治疗，予针灸、神经肌肉治疗等，对照组予常规护理。康复组予健康教育及实施康复护理干预措施。均在入院后第1天、第1周、出院时进行生活活动能力和生活质量评分。结果康复组在生活活动能力、生活质量改善方面及住院天数均明显优于对照组，两组之间差异有显著性意义。结论重视中老年脑卒中患者的健康教育及早进行康复护理干预，帮助他们获取健康知识，能提高患者康复效果及生活质量。

中老年脑卒中运动性失语患者久坐行为与抑郁的相关性研究

目的探讨中老年脑卒中运动性失语(Broca aphasia,BA)患者久坐行为时间与卒中后抑郁(post-stroke depression,PSD)发病风险的相关性。方法于2021年1月—2022年5月采用方便抽样法选取新疆某三级甲等医院康复科和神经内科收治的中老年脑卒中BA患者112例为研究对象。采用一般资料调查表、脑卒中失语抑郁量表(Stroke Aphasia Depression Questionnaire,SADQ)、久坐行为评估对研究对象进行问卷调查。采用Pearson相关分析法和logistic回归模型对久坐行为时间PSD发病风险关系进行分析。结果112例脑卒中BA患者每日久坐行为时间(6.57±2.09)h,每日久坐行为时间≥5 h患者66例(58.9%),SADQ评分为(20.72±4.35)分,PSD发生率为44.6%。单因素分析表明,性别、年龄、职业状态、婚姻状况、个人月收入、居住方式、合并慢性病、波士顿失语诊断测验(Boston diagnostic aphasia examination,BDAE)评分、美国国立卫生院脑卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分、久坐行为时间与PSD具有相关性(P均<0.05)。相关性分析结果显示,久坐行为时间与SADQ总分呈正相关(r=0.450,P<0.05)。多因素logistic回归分析结果显示,久坐组[OR=1.527,95%CI(1.168~1.995)]与PSD患病风险相关,控制混杂因素后结果无明显变化。结论中老年脑卒中BA患者久坐行为时间与PSD发病风险呈正相关,医务人员应重视减少中老年脑卒中BA患者久坐行为时间健康教育,鼓励患者增加社会交往,减少PSD发生发展。