Objective To investigate the prevalence of cardiovascular and cerebrovascular diseases in the army old male hypertensive patients in Beijing. Methods From October 2011 to April 2014, old male patients in the geriatric department of the General Hospital of Chi-nese People's Liberation Army were enrolled and categorized into 3 groups: normotensive, well-controlled hypertensive and poorly-con-trolled hypertensive groups. The prevalence of cardiovascular and cerebrovascular diseases was recorded and binary logistic regression was used to analyze the differences among the groups. Results 719 old male patients were enrolled, 228 in normotensive group, 389 in well-con-trolled hypertensive group and 102 in poorly-controlled hypertensive group. Compared to normotensive group, there was more incidence of angina (OR=2.547, P<0.001), myocardial infarction (OR=2.493, P=0.003), cerebral thrombosis (OR=3.438, P=0.003) and peripheral artery atherosclerotic disease (OR=1.766, P=0.026) in the well-controlled hypertensive group, and it was more of angina (OR=4.123, P<0.001), la-cunar infarction (OR=2.810, P=0.020), cerebral thrombosis (OR=3.484, P=0.001) and peripheral artery atherosclerotic disease (OR=3.773, P<0.001) in the poorly-controlled hypertensive group. There was not significant difference of prevalence of cerebral hemorrhage (0.9%, 1%and 1%, respectively). Conclusion In the army old male hypertensive patients in Beijing, control rate of blood pressure was higher than com-mon population, but the prevalence of ischemic diseases was still higher than in the normotensive patients. Anti-hypertension and control of other risk factors could reduce the mobidity of cerebral haemorrahge.

Objective To evaluate the diagnostic accuracy of diffusion tensor imaging (DTI) of corticospinal tract in amyotrophic lateral sclerosis (ALS) and find optimal testing strategies and optimal cutoff values of DTI indices for individual patient discrimination.Methods Thirty-three ALS patients and 34 healthy controls,collected at Peking Union Medical College Hospital from June 2004 through July 2005,undergoing brain DTI studies and fractional anisotropy (FA) examinations along the corticospinal tract,were analyzed by receiver operating characteristic (ROC) curves.Results Compared with the controls,ALS group had significantly decreased FA values in subcortical white matter of the precentral gyrus,the posterior limb of the internal capsule and the cerebral peduncle.In ROC analysis,the average FA value of the former two positions showed the best performance with an area under the curve of 0.917,an optimal cut-off value of 0.604,a sensitivity of 0.759 and a specificity of 0.912.The corresponding data for the average FA of all the three positions and each single position were listed as follows:average of three 0.914,0.648,0.759,0.912; precentral gyrus 0.875,0.509,0.733,0.824; internal capsule 0.845,0.692,0.656,0.941 ; and cerebral peduncle 0.752,0.742,0.656,0.735.Conclusions FA values of the corticospinal tract have a good accuracy in detecting upper motor neuron involvement in ALS.Precentral gyrus and posterior limb of the internal capsule and the average FA values of these two positions were suggested as the preferred testing places and DTI indices for clinical use.

Objective To summarize the experience of nursing the patients with liver transplantation complicated with early portal vein thrombosis treated with post-embolectomic anticoagulation. Method The clinical data of 5 cases of liver transplantation-induced portal vein thrombosis treated with post-embolectomic anticoagulation was reviewed to summarize the curative effect , key points for disease conditions and anticoagulative nursing. Results The anticoagulative effect was not good in only one case. 4 other cases were recovered by embolectomy and postoperative anticoagulation therapy as well as related nursing measures. Conclusion The nursing measures such as close observation of the disease processing, early reasonable anticoagulation, accurate medication, prevention of patent complication are critical for preventing the recurrence of portal vein thrombosis after liver transplantation.

Objective To investigate the diffusion tensor imaging(DTI)and magnetic resonance spectroscopy(MRS)changes in amyotrophic lateral sclerosis(ALS)and to study on the physiopathology of ALS.Methods Thirty-eight AIS patients,8 patients with pure lower motor neuron involvement and 5 patients with mixed-type cervical spondylosis and 34 healthy controls were enrolled and examined with the conventional brain MRI,DTI and 1H-MRS.Results T2-weighted and T2 FLAIR images revealed abnormal high signals in bilateral pyramidal tract positions in 21%(8/38)of ALS patients,which was higher than that in the coaex When compared with the control group,the values of FA in the precentral gyms(0.492±0.059 vs 0.552±0.045,F=17.150,P<0.01),the posterior limb of the internal capsule(0.679±0.048 vs 0.727 4-0.031.F=19.481.P<0.01)and the cerebral peduncle(1eft:0.740 4-0.038 vs 0.761 4±0.024.F=4.290;right:0.720 ±0.044 vs 0.746 ±0.034,F=3.264,both P<0.01)of the ALS group were decreased significantly.so were the values of NAA/Cr.And the FA reduction rate was 10.9%,6.6% and 2.8%-3.5% respectively.There was also a significant decrease in FA in the anterior limb of the internal capsule and the occipital lobe in the ALS group.Conclusion Not only does the application of DTI and MRS help to demonstrate upper motor neuron involvement in the brain and facilitate the diagnosis and differential diagnosis of ALS,but also increases the understanding of the lesion distribution and physiopathology in ALS.

Objective To understand the relationship between age and chronic complications in hospitalized aged patients with hypertension, to provide evidence for hypertension prevention and control. Methods To retrospectively analyze the clinical and laboratory data on 17,682 patients with essential hypertension during Jan 1st,1993-Dee 12th, 2008 in PLA general hospital. Results 1)Among all of the inrolled cases, those aged 60-64 account for 27.87%, 65-69 years group account for 26.55%, 70-74 years group accounted for 23.96%, 75-79 years group accounted for 14.14%, 80-84 years group accounted for 5.26%, 85-89 years group accounted for 1.69%, > 90 years accounted for 0.41%. 2) The prevalence rate of chronic complications in 60-69 years group were 31.3-31.2% for diabetes and,22.6-27.0% for cerebrovascular disease, 9.5-11.1% for myocardial infarction, 6.7-9.1% for heart failure, 5.8-6.0% for renal dysfanction 4.9-6.8% for atrial fibrillation, 0.1-0.3% for multiple organ dysfunction syndrome (MODS) in the elderly(P <0.05 ). 3) The first four complications of hypertension were diabetes(33.5%), cerebrovascular disease (31.9%), myocardial infarction(13.2%) and heart failure(12.3%) in 70-74 years group (P<0.05), cerebrovascular disease (42.8%), diabetes (32.8%), heart failure (16.5%) and myocardial infarction(15.9%) in 75-79 years group (P<0.05), cerebrovascular disease (45.4%), diabetes (35.0%), heart failure (21.1%) and myocardial infarction(15.9%) in 80-84 years group (P<0.05), cerebrovascular disease(42.5%), diabetes (35.8%), heart failure (23.1%) and renal dysfanction (17.7%) in 85-89 years group(P<0.05 ),and cerebrovascular disease (45. 2%), heart failure(31.5%), diabetes (26.0%) and renal dysfanction (20.5%) in patients more than 90 years group (P<0.05). Conclusions The prevalence rate and kinds of chronic complications in hospitalized aged patients with hypertension were changed with the increasing age, and the first kind of complication is cerebrovascular disease. It is of more importance to prevent the occurrence of renal dysfanction and heart failure in those hypertension patients who were more than 80 years old.

OBJECTIVETo retrospectively analyze the causes of death in elderly patients with hypertension in a hospital-based population from 1993 to 2012.

METHODSDuring the study period of over 19 years, a total of 2866 cases of death in 25238 hospitalized hypertensive patients with the age of 60 years or older were documented. Age, gender, complications, cause of death and other relevant variables were collected. All patients were divided into different subgroups according to gender, age or hypertension stage and risk stratification. The mortality of elderly hypertensive patients was analyzed using chi-square test.

RESULTS(1) Target organ damage (TOD) associated with hypertension was present in a substantial proportion of elderly patients. The complications related to death were heart disease (45.15%), stroke (34.37%), renal failure (11.88%), infective disease (4.58%), and cancer (4.06%). (2) Mortality in male elderly hypertension was higher than in women (53.31% vs 46.69%). The percentage of deaths from heart disease and stroke were higher in men than those in women (heart disease: 46.73% vs 43.35%; stroke: 37.04% vs 31.32%). (3) Age-specific constituent ratio of cause of death showed that deaths from stroke were significantly lower in very old patients (> or = 90 years) than in patients with 60-79 years of age (P < 0.01). In addition, deaths from heart disease, renal failure and infection disease were significantly lower in patients with more than 90 years than other patients. Deaths from cancer were highest in patients with 70-79 years of age (P < 0.01). (4) When compared with patients at stage 1 and 2 hypertension, subjects at stage 3 were more likely to die from stroke (P < 0.01) and renal failure (P < 0.05), while less likely to die from heart disease and cancer (P < 0.01). Patients in high and very high risk stratification of hypertension, compared with subjects in low and medium risk were likely to die from renal failure (P < 0.01) whereas less likely to die from heart disease (P < 0.05) and stroke (P < 0.01).

CONCLUSIONPrevalence of complication and TOD is high in elderly hypertensive inpatients, especially in deaths. The male patients and 60- 79-year-old patients have a higher percentage of causes of death. The stage and risk stratification of hypertension are associated with constituent ratios of the causes of death.

Aged ; Cause of Death ; Female ; Humans ; Hypertension ; mortality ; Incidence ; Inpatients ; Male ; Middle Aged ; Renal Insufficiency ; mortality ; Retrospective Studies ; Risk Factors ; Stroke ; mortality

Objective To investigate the influence of age on recent prognosis of elderly inpatients with acute myocardial infarction (AMI).Methods A total of 2535 inpatients with AMI were divided into different age groups.The influences of age and coexistent diseases on prognosis in AMI patients were analyzed retrospectively.Results The hospital mortality and 30-day mortality were higher in patients aged ≥80 years compared with patients aged 65-79 years and patients aged 60-64 years(χ2 =46.378,P<0.01 ;χ2 = 44.534, P<0.01).In 60-64 years old patients with AMI, the prevalences of old myocardial infarction (OMI), renal insufficiency, respiratory insufficiency were higher and the prevalence of angina pectoris was lower in death group than in survival group (all P<0.05).In 65-79 years old patients with AMI, the prevalences of OMI, hypertension, diabetes,cerebrovascular disease, renal insufficiency, respiratory insufficiency were higher and the prevalence of angina pectoris was lower in death group than in survival group(P<0.05).In 80-94 years old patients with AMI, the prevalences of OMI, diabetes, cerebrovascular disease, renal insufficiency, respiratory insufficiency were higher and the prevalence of angina pectoris was lower in death group than in survival group(P<0.05).The prevalences of OMI, hypertension, diabetes, cerebrovascular disease,respiratory insufficiency were significantly increased in 80-94 years old death group versus 60-64 and 65-79 years old death group(all P<0.05).Conclusions The mortality rate of elderly patients with AMI is increased with age and atypical angina pectoris should be paid more attention in these patients.

Objective To explore effect of physic temperature dropping by ice blanket on incidence of pressure ulcer of stroke patients in ICU, and normalize the basic nursing procedure during temperature reduc-tion.Methods 230 fever patients were randomly divided into the group A(control temperature with ice blan-ket,108 cases)and the group B (control temperature with routine measure,122 cases).Thc incidence of pressure ulcer and surface temperature of pressed position in the two groups were compared.Results The incidence of pressure ulcer and surface temperature of pressed position in group A was lower than those of group B.Conclusions The incidence of pressure ulcer can be reduced by using ice blanket for physic temperature dropping.The pressure of pressed position were descended by alternative prostration and lateral position.

One influenza H3N2 virus, A/swine/Shandong/3/2005 (Sw/SD/3/2005), was isolated from pigs with respiratory disease on a farm in eastern China. Genetic analysis revealed that Sw/SD/3/2005 was a triple-reassortant virus with a PB2 gene from human-like HIN1, NS from classical swine H1NI, and the remaining genes from human-like H3N2 virus. These findings further support the concept that swine can serve as reservoir or mixing vessels of influenza virus strains and maintain genetic and antigenic stability of viruses. Furthermore, we have successfully established a reverse genetics system based on eight plasmids and rescued Sw/SD/3/2005 through cell transfection. HI tests and RT-PCR confirmed that the rescued virus maintained the biological properties of the wild type Sw/SD/3/2005. The successful establishment of the reverse genetics system of Sw/SD/3/2005 will enable us to conduct extensive studies of the molecular evolution of H3N2 influenza viruses in swine.

ObjectiveTo explore the relationship of circadian distribution of acute myocardial infarction with AMI location and ST segment changes in elderly patients.MethodsThe time of infarction, its anatomic location, changes of ST segment, and coronary angiography were studied in 909 elderly patients with acute myocardial infarction (AMI) ( 412 with anterior AMI and 423 with inferior AMI) admitted to our coronary care units from January 1996 to January 2006.ResultsThe onset of inferior myocardial infarction were more frequent between midnight and 6AM than other periods of the day (n=138/423,32.6% of all inferior myocardial infarction patients, P<0.01). The onset of anterior myocardial infarction were more frequent between 6AM and noon than other periods of the day (n=156/412, 37.9% of all anterior myocardial infarction patients, P<0.01). Coronary angiography was performed in 789 patients (86.8%, 516/909).118 cases of them with inferior infarction occured between midnight and 6AM, including 85.6% of them were due to right coronary artery occlusion and 14.0%(17/118) of them were due to left coronary artery occlusion (P<0.01).275 cases of them with inferior infarction oecured between 6AM and midnight, including 52.2% (149/275) of them were due to right coronary artery occlusion and 45.8% of them were due to left coronary artery occlusion (P>0. 05). The onset of inferior myocardial infarction between 6AM and noon was the most frenquent in patients with ST segment elevation (44.0%, 263/644), while the onset of inferior myocardial infarction between midnight and 6 AM was the most frenquent in patients with non-ST segment elevation (36.6%,96/265). ConclusionsThe frequency of AMI at night is higher in elderly patients with ST segment elevation than in elderly patients with non-ST segment elevation.AMI at night is usually due to right coronary artery occlusion, which suggests that a protective role of sleep may be limited to left coronary artery -related events and AMI of non-ST segment.