ObjectiveTo investigate the classification of seizures, etiology,EEG examination, treatment and prognosis of senile epilepsy.
MethodsThe clinical data of 92 senile epileptsy patients in the Second Affiliated Hospital Of Chongqing Medical University from January 2012 to September 2015 were retrospectively analyzed.
ResultsFrom the selected sample,15 cases suffered from SPS(16.3%),22 cases suffered from CPS(23.9%),40 cases suffered from GTCS(43.5%),4 cases suffered from partial seizures with secondary generalization(4.3%),11 cases suffered from both partial seizures and generalized seizures(12.0%).The common causes include cerebrovascular disease (57.6%),intracranial tumors (10.9%), degenerative brain diseases (7.6%) and so on.The abnormal ratio of REEG and AEEG was 87.1% and 91.7% respectively.The ratio of typical epileptiform activity in the REEG and AEEG was 22.6% and 70.8% respectively.82 cases(89.1%) were treated with AED,but only 69 cases had been taking orally AED among the patients treated with AED.57 cases(82.6%) were on monotherapy.55 cases (67.1%) were controlled effectively with drug treatment,11 cases (13.4%) were ineffective and 16 patients (19.5%) died. Advanced age was the important cause of death. Age was positively correlated with the fatality rate.9 cases(10.9%) appeared side effect,the frequency of sleepiness was the highest among all the adverse reactions.
ConclusionThe majority of senile epilepsy suffer from symptomatic epilepsy.The main cause is cerebrovascular disease,the generalized tonic-clonic seizures constituted a high proprotion in the sample.The ratio of typical epileptic discharge in the REEG was low from senile patients with epilepsy,we recommend the AEEG examination in the senile patients suspected with epilepsy. AED has excellent therapeutic effects in senile epileptics,and a few patients appeared light adverse reactions.
ObjectiveTo explore the diagnostic efficacy of Geriatric Nutritional Risk Index (GNRI) in malnutrition of elderly patients with chronic obstructive pulmonary disease (COPD) in outpatient department. MethodsOne hundred and five elderly outpatients with COPD were enrolled in the study, and their nutritional screening was carried out. The clinical and laboratory parameters of patients in the normal nutrition group (high GNRI group) and malnutrition group (low GNRI group) were compared, and the correlation analysis was conducted. The diagnostic efficacy of GNRI was evaluated based on the malnutrition universal screening tool (MUST). ResultsThe prevalence of malnutrition was high in COPD elderly outpatients. The prevalence of malnutrition in group D was 61.8%. There were significant differences between the two groups in body mass index, serum albumin, FEV1 percentage in the predicted value, 6-minute walk distance, and the number of acute exacerbations in the past year. GNRI was significantly related to the above parameters. The sensitivity, specificity and accuracy of GNRI were 81.8%, 83.6% and 82.9%, using MUST as the standard. ConclusionGNRI can be used for nutritional screening of COPD patients in elderly outpatients, which is simple, convenient and relatively accurate, and can be popularized in other medical institutions.
【摘要】 目的 用老年大鼠建立一種與人類發病年齡相符的穩定可重復的急性心肌梗死動物模型。 方法 Wistar大鼠經戊巴比妥鈉麻醉后，氣管切開插管，連通呼吸機，開胸后結扎左冠狀動脈前降支。分不同時間點測血流動力學后取出心臟行病理組織學觀察。 結果 成功建立老年大鼠心肌梗死模型并進行病理組織學驗證。 結論 建立老年大鼠心梗模型是可靠的，有助于指導臨床實踐。【Abstract】 Objective To develop a steady and repeatable acute myocardial infarction model in old rats in accordance to human age. Methods Wistar rats were anaesthetized with sodium phenobarbital. After tracheotomy intubation, respiration machine was linked. Left anterior thoracotomy was performed to ligate the left anterior descending coronary artery. After hemodynamic parameters were obtained at various time points, hearts of the rats were taken for pathologic and histological examinations. Results The model of acute myocardial infarction in old rats was established successfully and proved by pathologic and histological staining. Conclusion It is reliable to establish the myocardial infarction model in old rats, which is helpful in guiding clinical practices.
ObjectiveTo evaluate the predictive value of the geriatric nutritional risk index (GNRI) for postoperative overall and severe complications after pancreaticoduodenectomy (PD) in the elderly patients with pancreatic cancer. MethodsThe clinical data of the elderly (65 years old or more) patients with pancreatic cancer underwent PD were retrospectively collected, who were admitted to the Fifth Affiliated Hospital of Xinjiang Medical University from January 2017 to October 2021. The incidences of postoperative overall and severe complications (Clavien-Dindo grade Ⅲ–Ⅴ was defined as severe complications) were summarized. The univariate and multivariate logistic regression models were used to analyze whether GNRI was a risk factor for overall and severe complications after PD. The area under the receiver operating characteristic curve (AUC) was used to evaluate the ability of GNRI to distinguish whether overall or severe complications occurred after PD and to confirm the optimal threshold. Then the patients were assigned into a high nutritional risk group (greater than the optimal threshold) and low nutritional risk group (the optimal threshold or less) based on this. Simultaneously, the clinical outcomes of the two groups were compared. ResultsIn this study, 190 elderly patients with pancreatic cancer were enrolled, 95(50.0%) of whom developed complications, including 28(29.5%) cases of serious complications. The results of multivariate logistic regression model analysis showed that the decreased GNRI was a risk factor for the occurrence of overall and severe complications after PD for the elderly patients [OR(95%CI)=0.361(0.154, 0.848), P=0.019; OR(95%CI)=0.906(0.834, 0.983), P=0.018]. The AUC of GNRI for assessing the occurrence of overall and severe complications was 0.765 and 0.715, respectively, with the optimal critical values of 98 and 96, respectively. Compared with the low nutritional risk group, the high nutritional risk group had higher postoperative total hospitalization costs (Z=–2.37, P=0.019), higher occurrences of overall complications (χ2=44.61, P<0.001) and severe complications (χ2=29.39, P＜0.001). ConclusionsIn elderly patients with pancreatic cancer underwent PD, incidence of serious complications is not lower. GNRI has a good discriminative value in terms of postoperative overall and severe complications. When preoperative GNRI is 98 or less and GNRI is 96 or less, patients should be given early preoperative nutritional support treatment in time.
Objective To investigate the effect of ischemic preconditioning(IPC) on myocardial ischemic reperfusion injury(I/R) of elderly rats. Methods Fiftysix Wistar rats, of which there were 28 aged from 21-23months(elderly rat) and 28 aged from 4-5months(young rat), were used to build isolated heart perfusion Langendorff model. The rats were divided into 7 groups with random number table（8 in each group）: adult control group, adult I/R group, adult IPC group, elderly control group, elderly I/R group, elderly IPC group and elderly enhanced IPC group. The control group underwent a 90-min perfusion without any intervention; the I/R group underwent a 30-min equilibration period, then a 30-min ischemia and a 30-min reperfusion; the IPC group underwent a 10-min equilibration period, then a 5-min ischemia for twice and a 5-min reperfusion, after that a 30-min ischemia and [CM(158-3mm]a 30-min reperfusion; the enhanced IPC group underwent a 10-min equilibration period, then a 5-min ischemia for 4-times and a 5-min reperfusion, after that a 30-min ischemia and a 30-min reperfusion. The recovery rates of cardiac output(CO), left ventricular developed pressure (LVDP), the maximum rising and descending rate of left ventricular pressure (±dp/dtmax) after a 30-min reperfusion were compared among groups. The activity of creatine kinase (CK) in coronary outflow, the level of malonyldialdehyde (MDA) and superoxide dismutase (SOD) before ischemia and after a 30min reperfusion were detected. The myocardial infarction areas were compared among groups. Results After a 30min reperfusion, compared with adult I/R group, in adult IPC group CK reduced significantly(89.48±18.72 U/L vs. 115.76±16.72 U/L，q=6.061，Plt;0.01)，the level of MDA decreased significantly（9.53±3.44 nmol/ml vs. 16.84±2.29 nmol/ml，q=7.732，Plt;0.01)，the level of SOD increased significantly（584.7±122.62 U/ml vs. 429.46±85.24 U/ml，q=4.754，Plt;0.01)，the recovery rates of CO,LVDP,+dp/dtmax and -dp/dtmax increased ignificantly(78.69%±9.68% vs. 65.10%±8.63%，83.61%±8.46% vs. 67.23±8.68%，81.68±8.68% vs. 67.89%±6.89%，89.79%±7.78% vs. 66.79%±8.46%，Plt;0.01), the myocardial infarction areas reduced significantly (5.25%±4.33% vs. 14.75%±8.02%,q=7.458，Plt;0.01)。There was no statistical significance between elderly IPC group and elderly I/R group in the above indexes（Pgt;0.05）.However, There was statistical significances between elderly enhanced IPC group and I/R group. CK reduced significantly (88.60±28.32 U/L vs. 105.76±9.64 U/L，q=5.620，Plt;0.01)，the level of MDA decreased significantly（8.38±3.36 nmol/ml vs. 16.80±3.06 nmol/ml，q=7.500，Plt;0.01)，the level of SOD increased significantly（558.87±78.66 U/ml vs. 433.75±86.65 U/ml，q=7.335，Plt;0.01)，the recovery rates of CO,LVDP,+dp/dtmax and -dp/dtmax increased significantly (77.99%±10.02% vs. 66.26%±9.78%，85.59%±6.67% vs. 73.90%±6.66%，83.87%±9.98% vs. 68.90%±8.68%，86.01%±766% vs. 70.39%±7.98%，Plt;0.01)， the myocardial infarction areas reduced significantly (795%±6.32% vs. 1568%±10.36%,q=8.680， Plt;0.01). 〖WTHZ〗Conclusion The protective effect of IPC on I/R elderly rat hearts has weakened. The enhanced IPC is able to regain the protective effect of IPC on elderly rat hearts.
ObjectiveTo investigate the efficacy and safety of bortezomib combined with dexamethasone and thalidomide regimens on aged patients with multiple myeloma.
MethodsA total of 166 multiple myeloma patients were selected between January 2009 and June 2013; all patients were assigned to regimens of T-VD or T-VAD named T-VD group or T-VAD group (with 25 patients in T-VD group and 29 in T-VAD group). Efficacies and toxicities were analyzed and compared after two cycles.
ResultsOverall response rate (OR) in T-VD group was 84.0%; there was 6 patients achieved complete response (OR) or very good partial response (VGPR) (24.0%). However, Overall response rate (OR) in T-VAD group was 48.3%; there was only one patient achieved CR or VGPR (3.4%); significant difference between two groups was found (χ2=7.513, P<0.05). The major adverse reactions were debilitation, nausea, vomiting, myelo-suppression, cardiac toxicity, and peripheral neuropathy. There were highest incidence of nausea and vomiting in T-VAD group compared to T-VD group (χ2=5.794, P<0.05).
ConclusionBortezomib combined with dexamethasone and thalidomide regimens is effective and safe, which can be widely used for aged patients with multiple myeloma.
