Objective:To investigate the effects of sarcopenia on neurological function and quality of life in patients with cerebral infarction and its risk factors.Methods:Seventy acute cerebral infarction patients with sarcopenia (study group) and 70 age and gender-matched acute cerebral infarction patients without sarcopenia (control group) admitted in Shanxi Bethune Hospital from January 2017 to January 2019 were enrolled in the study. The fat free mass index (FFMI), National Institute of Health Stroke Scale (NIHSS), activity of daily living (ADL) and other related indexes were assessed at the admission and compared between the two groups. Three months after discharge, the neurological impairment, improvement of daily living ability and social regression ability were compared between two groups. Logistic regression analysis was conducted for the risk factors of sarcopenia.Results:The FFMI [(17.70±0.36) vs. (17.90±0.26)kg/m 2, t=3.751, P<0.05], NIHSS9[ (15.00±3.51) vs. (12.17±3.21), t=-4.947, P<0.05] and ADL scores[ (28.64±6.70) vs. (37.14±6.68), t=7.518, P<0.05] of the study group were lower than those of the control group at the admission. NIHSS and ADL scores of the two groups were improved three months after discharge. However, the degree of improvement in NIHSS and ADL of the study group was lower than that of the control group[ (-1.99±1.17) vs. (-3.93±1.47), t=8.651, P<0.05; (6.64±4.32) vs. (15.50±5.05), t=-11.158, P<0.05, respectively]. Meanwhile, the social regression score (SIS) of the study group was lower than that of the control group [ (64.59±5.48) vs.(74.51±4.58), t=-11.639, P<0.05]. Multivariate logistic regression showed that weight loss ( OR=5.094), osteoporosis ( OR=2.856), abnormal hormone levels ( OR=1.885) and comorbid diseases>3 ( OR=2.045) were risk factors of sarcopenia (all P<0.05). Conclusion:Acute cerebral infarction patients with sarcopenia have severe neurological function impairments and decreased activities of daily living. Weight loss, osteoporosis, abnormal hormone levels, and comorbid diseases>3 are risk factors for sarcopenia in cerebral infarction patients.

Objective: To explore the risk factors of elderly patients with multi-disease coexisting atrial fibrillation in our hospital, expect with coronary heart disease (CHD), and to provide evidence for clinical prevention and treatment and community chronic disease management. Methods: From March 2012 to June 2018, the hospitalization data of 223 patients with atrial fibrillation aged over 50 years in Shanxi Academy of Medical Sciences were collected.A total of 118 patients with CHD and 105 patients without CHD were included.The risk factors of atrial fibrillation in patients without CHD were analyzed retrospectively. Results: With the increase of age, the incidence of atrial fibrillation increased.There were 32 patients with hypertension, accounting for 30.47%; 19 patients with diabetes, accounting for 18.09%; 79 patients with co-infection, accounting for 75.23%, of which respiratory tract infection accounted for 41.77%, urinary tract infection accounted for 30.38%, biliary tract infection accounted for 27.84%.Twenty-four cases (22.86%) were complicated with chronic obstructive pulmonary disease (COPD). The results of multivariate regression analysis showed that age, infection, hypertension, diabetes mellitus and infection were significantly correlated. Conclusion In the elderly patients with co-existing diseases, atrial fibrillation has a high incidence, and there are many risk factors affecting its occurrence, except for the known high risk factors such as age, valvulopathy, hypertension, diabetes mellitus, COPD and so on.Infection is also a risk factor for atrial fibrillation.

Objective To investigate the correlation between serum homocysteine(Hcy)level and left ventricular geometric patterns in essential hypertensive patients.Methods Three hundred and sixteen patients with essential hypertension attending in Shanxi Dayi Hospital from January 2013 to June 2016 were enrolled in the study.Serum Hcy levels were measured and echocardiography was performed to measure left ventricular mass index (LVMI)and relative wall thickness(RWT).According to Hcy level patients were divided into H type hypertension group(Hcy≥10 μmol/L,group A)and non-H type hypertension group(Hcy<10 μmol/L, group B).The correlation of Hcy level with RWT and LVMI was analyzed.Results The percentages of concentric remodeling and concentric hypertrophy in group A were higher than those in group B(30.7% vs.25.3% and 24.7%vs.18.7%,χ2=3.342 and 3.894, P=0.033 and 0.025).Hcy level was positively correlated with RWT and LVMI(r=0.819 and 0.725,P=0.005 and 0.008).Conclusion Serum Hcy level is associated with left ventricular geometry in patients with essential hypertension.

Objective:To stablish a transitional nursing model for patients with chronic diseases under the hierarchical diagnosis and treatment system and clarify the structure and functions, so as to provide a chronic disease management model with practical operation, promotion and reference.Methods:In April 2019, a research group was established. Based on a large amount of literature and policy analysis, guided by the three-dimensional quality theory model of structure-process-results, the transitional nursing model was constructed and the index system letter consultation questionnaire was initially prepared. After the preliminary survey, it was revised to form the first-round consultation questionnaire. Delphi method was used to conduct 2 rounds of letter consultation among 19 experts. The positive coefficient of experts, the authoritative coefficient of experts and Kendall 's coordination coefficient were calculated. Analytic hierarchy process (AHP) was used to determine the weight coefficient of each index and quantify the importance degree of the index. Results:The effective recovery rates of the two rounds of letter consultation questionnaires of expert were both 100%. The authoritative coefficients of experts were respectively 0.80 and 0.84, Kendall 's coordination coefficient was 0.137 to 0.253 ( P<0.001) , and the coefficients of variation were all less than 0.25. The index system for the transitional nursing model of patients with chronic diseases finally established included 6 first-level indicators, 38 second-level indicators and 32 third-level indicators of "transitional nursing procedures", and the structural and functional diagram was generated. Conclusions:The established transitional nursing model for patients with chronic diseases is scientifically reliable and comprehensive in content, which has practical significance for promoting the deep integration of mobile Internet and medical and health fields, guiding the subsidence of advantageous resources and promoting the implementation of hierarchical diagnosis and treatment.