目的:比较不同运动强度对老年人心血管功能的影响。方法:将某市区120例离退休岁的老人随机分为慢走组、太极拳组和健身操组,进行3个月的运动,比较运动前后的各项指标.结果:经过3个月的运动锻炼,3组老人心率较运动前有所降低,但差异无统计学意义(Pgt;0.05);血压较运动前显著下降,太极拳组和健身操组降幅更大,CO、SV、SI、CI和PEP较运动前显著提高,太极拳组和健身操组提高幅度更大,差异有统计学意义(Plt;0.05)。结论:通过匀和有氧运动能有效锻炼老年人心血管机能、防病、抗老, 达到健身强体延年益寿之目的。
ObjectiveTo systematically review the associations of cognitive frailty with mortality and hospitalization in the elderly. MethodsThe VIP, PubMed, CNKI, WanFang Data, CBM, Embase, Cochrane Library and Web of Science databases were electronically searched to collect cohort studies on the association of cognitive frailty with mortality or hospitalization in the elderly from inception to May, 2023. Two reviewers independently screened the literature, extracted data and assessed risk of bias of the included studies. Meta-analysis was performed by R 4.2.2 software. ResultsA total of 19 cohort studies involving 63 624 elderly were included. The results of meta-analysis showed that compared with healthy elder, the elder with cognitive frailty had a higher mortality (OR=2.75, 95%CI 2.10 to 3.59, P<0.01) and hospitalization (OR=1.67, 95%CI 1.40 to 2.00, P<0.01). Subgroup analysis showed that cognitive frailty was related to the risk of death in different status of frailty and cognitive function, different assessment tools, different countries of development, different follow-up time and research sites. At the same time, different status of frailty and cognitive function and different levels of development of countries were related to the risk of hospitalization. ConclusionCurrent evidence shows that cognitive frailty can increase the risk of hospitalization and mortality in the elderly. It is suggested that early screening and intervention of cognitive frailty should be carried out to effectively reduce the risk of adverse consequences, so as to achieve healthy aging.
Objective To investigate the effect of treatment with proximal femoral nail (PFN) on femur intertrochanteric fractures in the old. Methods A retrospective study of 62 patients with femur intertrochantericfractures treated with PFN from October 2001 to September 2003 was carried out.The data of operative time, blood loss, intraoperative complications, wound drainage, postoperative complications, healing time, and hip function were recordedand compared with previous literature so as to evaluate the effect. Results All patients were followed up for 8-22 month(13.6 months on average). Intraoperative fracture occurred again in 2 cases. Two patients died of brain embolism and pulmonary infection respectively. Heterogeneous ossification occurred in 2 cases. Hip varus occurred in 1 case. Extra hip anteversion occurred in 1 case. The effect of other cases was satisfactory. The operative time was 76.5±29.1 min, the mean blood loss was 385.7±98.4 ml, the wound drainage was 45.5±21.7 ml, and the healing time was 13.2±3.8 weeks. According to the Sanders post-trauma hip function assessing system, the excellent and good rate was 89.6%. Conclusion The application of PFN is characterized by short operative time, less blood loss, stable fixation, so it is an effective way to treat femur intertrochanteric fracture in the old.
Objective To evaluate effectiveness of proximal femur bionic nail (PFBN) in treatment of intertrochanteric fractures in the elderly compared to the proximal femoral nail antirotation (PFNA). Methods A retrospective analysis was made on 48 geriatric patients with intertrochanteric fractures, who met the selection criteria and were admitted between January 2020 and December 2022. Among them, 24 cases were treated with PFBN fixation after fracture reduction (PFBN group), and 24 cases were treated with PFNA fixation (PFNA group). There was no significant difference in baseline data such as age, gender, cause of injury, side and type of fracture, time from injury to operation, and preoperative mobility score, American Society of Anesthesiologists (ASA) score, Alzheimer’s disease degree scoring, self-care ability score, osteoporosis degree (T value), and combined medical diseases between the two groups (P>0.05). The operation time, intraoperative blood loss, number of blood transfusions, transfusion volume, length of hospital stay, occurrence of complications, weight-bearing time after operation, and postoperative visual analogue scale (VAS) score, walking ability score, mobility score, self-care ability score were recorded and compared between the two groups. And the radiographic assessment of fracture reduction quality and postoperative stability, and fracture healing time were recorded. ResultsThe operations in both groups were successfully completed. All patients were followed up 6-15 months with an average time of 9.8 months in PFBN group and 9.6 months in PFNA group. The operation time was significantly longer in PFBN group than in PFNA group (P<0.05), but there was no significant difference in intraoperative blood loss, number of blood transfusions, transfusion volume, length of hospital stay, change in activity ability score, and change in self-care ability score between the two groups (P>0.05). The weight-bearing time after operation was significantly shorter in PFBN group than in PFNA group (P<0.05), and the postoperative VAS score and walking ability score were significantly better in PFBN group than in PFNA group (P<0.05). Radiographic assessment showed no significant difference in fracture reduction scores and postoperative stability scores between the two groups (P>0.05). All fractures healed and there was no significant difference in fracture healing time between the two groups (P>0.05). The incidence of complications was significantly lower in PFBN group (16.7%, 4/24) than in PFNA group (45.8%, 11/24) (P<0.05). ConclusionCompared with PFNA, PFBN in the treatment of elderly intertrochanteric fractures can effectively relieve postoperative pain, shorten bed time, reduce the risk of complications, and facilitate the recovery of patients’ hip joint function and walking ability.
目的 总结超声引导下经皮经肝穿刺胆管引流术(PTCD)的优、缺点,为临床治疗重症急性胆管炎（SAC）提供参考。方法 回顾性分析我院1994年8月至2008年7月期间对156例老年SAC患者行在超声引导下的PTCD治疗的临床资料。结果 156例行PTCD均获成功,1次穿刺成功140例，其成功率达89.7%（140/156）; 16例首次穿刺失败后再次穿刺均成功。无一例发生腹腔出血、胆汁性腹膜炎等并发症。本组引流效果较好,中毒危象缓解，黄疸减退，肝功能改善。结论 PTCD较外科手术创伤小、操作简单、快速,具有微创的特点,对老年、有严重合并症及复杂疾病不能耐受手术及麻醉的SAC患者，其作为紧急抢救措施切实可行,并为后期施行根治性手术争取了时间。
Objective To analyze the current status of metabolic syndrome (MetS) and its influencing factors among physical examination population aged 60 years old and above in Chengdu, and to provide evidence for the screening and management of MetS in people aged 60 years old and above. Methods Retrospective analysis of the data of people aged 60 years old and above who participated in physical examination in the North District of the Department of Health Management of Sichuan Provincial People’s Hospital between January 2018 and December 2020. According to whether the elderly occurred to have MetS, they were divided into MetS group and non-MetS group, to observe the distribution of MetS in different genders and different age groups, and to analyze the influencing factors of MetS by multivariate logistic regression. Results A total of 10 335 elderly were enrolled, 2 769 cases (26.79%) in MetS group and 7 566 cases (73.21%) in non-MetS group. Except for gender and low-density lipoprotein cholesterol (LDL-C) (P>0.05), there were significant differences in other general data between the two groups (P<0.05). There was a statistically significant difference in the detection rate of MetS among different age groups (χ²=64.332, P<0.001). In MetS group, 951 cases (34.34%) of abdominal obesity, 716 cases (25.86%) of high fasting blood glucose (FBG), 1 938 cases (69.99%) of hypertension, 1 011 cases (36.51%) of high triglycerides (TG) and 303 cases (10.94%) of low high-density lipoprotein cholesterol (HDL-C) were detected. Except hypertension and high TG (P>0.05), there were statistically significant differences in the detection rates of abdominal obesity, high FBG and low HDL-C among different genders in MetS (P<0.05). Except hypertension (P<0.05), there was no significant difference in the detection rates of MetS abdominal obesity, high FBG, low HDL-C and high TG in different age groups (P>0.05). Logistic regression analysis showed that body mass index [odds ratio (OR)=1.055, 95% confidence interval (CI) (1.014, 1.097), P=0.008], systolic blood pressure [OR=1.032, 95%CI (1.027, 1.037), P<0.001], diastolic blood pressure [OR=0.992, 95%CI (0.985, 1.000), P=0.049], FBG [OR=1.853, 95%CI (1.764, 1.947), P<0.001], TG [OR=3.787, 95%CI (3.352, 4.278), P<0.001], hemoglobin [OR=0.991, 95%CI (0.986, 0.996), P<0.001], waist circumference [OR=1.158, 95%CI (1.141, 1.175), P<0.001], HDL-C [OR=0.243, 95%CI (0.170, 0.346), P<0.001], total cholesterol [OR=0.615, 95%CI (0.490, 0.773), P<0.001], LDL-C [OR=1.594, 95%CI (1.303, 1.948), P<0.001], and uric acid [OR=1.001, 95%CI (1.000, 1.002), P=0.042] were related to MetS. Conclusions The prevalence of MetS is high among people aged 60 years old and above who undergo physical examination. Routine screening should be carried out during physical examination to take measures to intervene the controllable risk factors, so as to improve the health level of the region.
ObjectiveTo systematically review the association between overweight, obesity, abdominal obesity, and cognitive impairment (CI) in the elderly. MethodsThe CNKI, WanFang Data, VIP, CBM, PubMed, Web of Science, Embase, and Cochrane Library databases were electronically searched for studies on the relationship between overweight, obesity/abdominal obesity, and CI in the elderly from their inception to July 2024. Two researchers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was performed using Stata 15.0 software. ResultsA total of 38 studies involving 1 783 087 subjects were included. Meta-analysis results showed that compared with normal-weight individuals, overweight (OR=0.96, 95%CI 0.91 to 1.02, P=0.201) was not statistically significant in the risk of CI in the elderly. Obesity (OR=1.14, 95%CI 1.02 to 1.28, P=0.03) and abdominal obesity (OR=1.16, 95%CI 1.11 to 1.21, P<0.001) may be risk factors for CI in the elderly. Subgroup analysis was conducted based on study type, BMI standards, cognitive diagnostic standards, national development level, abdominal obesity diagnostic standards, and follow-up time. Among the subgroups analyzing the correlation between overweight and CI in the elderly, follow-up time ≤5 years (OR=0.68, 95%CI 0.58 to 0.80) showed a lower proportion of CI compared to other follow-up periods. In the subgroups analyzing the correlation between obesity and CI in the elderly, follow-up time ≤5 years (OR=0.71, 95%CI 0.50 to 1.01) was not statistically significant compared to other follow-up periods. For abdominal obesity, a significant association with increased CI risk in the elderly was found only in the subgroup with a follow-up time of 5-10 years (OR=1.21, 95%CI 1.15 to 1.27), compared with other follow-up periods. ConclusionCurrent evidence suggests that obesity and abdominal obesity may increase the risk of CI in the elderly. Proper weight management is crucial for preventing and delaying the progression of CI in the elderly.