1.The correlation between the timed up and go test and fall risks in elderly frail patients
Zhao MA ; Jianjun WANG ; Xia GAO ; Aixin GUO ; Jin XING ; Danyang SONG ; Zheng WANG ; Fei LI ; Xiaoya ZHANG ; Mengyan SUN
Chinese Journal of Geriatrics 2021;40(5):614-617
Objective:To evaluate the correlation between the timed up and go(TUG)test and fall risks in elderly frail patients.Methods:From July to September 2019, elderly frail patients who were treated at the cardiovascular department of our hospital were enrolled.Basic clinical data and fall-related information of patients were collected.Patients were divided into the fall group and the non-fall group.Results on the body mass index(BMI), TUG, 4-meter maximum walking speed(4 m MWS)and Barthel index were compared between the two groups.The correlation between TUG and each indicator was examined.Multivariate Logistic regression analysis was used to analyze the correlation between the TUG and falls in elderly patients.Results:A total of 96 eligible patients were enrolled, including 35 in the fall group and 61 in the non-fall group.The average TUG time was longer in the fall group than in the non-fall group(16.45±6.44 s vs.10.17±2.91 s, t=-6.556, P<0.001). The correlation analysis results showed that the TUG was correlated with falls and 4 m MWS( r=0.582 and 0.875, both P<0.001). Multivariate Logistic regression analysis showed that the TUG( OR=1.201, 95% CI: 1.111-1.470, P=0.004)and 4 m MWS( OR=1.146, 95% CI: 1.063-1.244, P=0.015)were risk factors for falls. Conclusions:The TUG is correlated with fall risks in elderly frail patients and should be recommended as a routine test in clinical practice.
2.MRI Features and Pathological Basis of Aggressive Angiomyxoma in Pelvic and Perineal Areas
Mengyan SUN ; Mandi WANG ; Yue WANG ; Huanwen WU ; Jingjing LU ; Dingrong ZHONG
Chinese Journal of Medical Imaging 2018;26(4):290-293
Purpose To summarize the clinical features, MRI features and pathological features of aggressive angiomyxoma (AAM) occurring in pelvic and perineal areas. Materials and Methods The clinical, MR and pathological data of 7 patients with AAM pathologically confirmed were retrospectively analyzed. Results Seven cases of AAM were all females, aged from 12 to 45 years old. Among them, 5 cases were treated due to perineal area tumors, and 2 cases due to relapses after surgical treatment of perineal area AAM in other hospitals. MRI findings: 7 cases were single occurrence with the maximum diameter of 5.9-15.7 cm; 6 cases were in irregular shape, with no envelope and unclear borders with adjacent tissues or organs; 1 case was in long column shape with clear boundary and pseudocapsule visible. On T1WI, AAM showed equal signal (4/7) or equal, low mixed signal (3/7). On T2WI, AAM showed high and low mixed signals with 5 cases of "vortex sign". 5 cases underwent routine enhancement examinations, all demonstrating significant enhancement, 4 cases of which displayed heterogeneous enhancement ("vortex sign" was detected in 2 cases) and 1 case homogeneous enhancement. On diffusion weighted imaging, AAM manifested as homogeneous (3/7) or heterogeneous (4/7) high signal. Pathological examination showed that a large amount of mucin-like matrix was contained in AAM, and there were scattered fusiform and astral tumor cells and abundant arterial and venous blood vessels seen locally. Tumor cells infiltrated the peripheral fat or muscle tissues at the border. Conclusion The characteristic MRI of AAM is manifested as "vortex sign", which corresponds to its pathological features such as sparse tumor cells, mucin-like matrix in large amount, and locally rich blood vessels, suggesting great significance for imaging diagnosis.
3.Effect of frailty phenotype on activities of daily living in maintenance hemodialysis patients
Jinping YING ; Genlian CAI ; Mengyan PAN ; Xiaoxian SUN ; Biyun SHAO ; Shilong XIANG ; Weiping YU ; Jianghua CHEN ; Jing YUAN
Chinese Journal of Nephrology 2021;37(8):639-646
Objective:To investigate the status of frailty and activities of daily living (ADL) in maintenance hemodialysis (MHD) patients, and to explore the effect of frailty phenotype on ADL.Methods:The patients who underwent MHD in Kidney Disease Center of the First Affiliated Hospital from March 2019 to March 2020 were enrolled in this study. The demographic and laboratorial data were collected by cross-sectional survey method. Fried frailty phenotype scale and ADL scale were used to evaluate the frailty and ADL, respectively. The differences of basic data and different frailty phenotypes between the normal function group and the function decline group were compared in terms of ADL, physical self-maintenance ability and instrumental ADL ability. Pearson correlation analysis was used to analyze the correlation between frailty and ADL, and binary logistic regression analysis was used to analyze the influencing factors of ADL.Results:A total of 676 MHD patients were included in this study, including 434 males (64.2%) and 242 females (35.8%). The age was (59.2±19.4) years old, and the median dialysis age was 59.0 (25.3, 110.0) months. There were 159 frailty patients (23.5%), 230 pre-frailty patients (34.0%), and 287 non-frailty patients (42.5%). The ADL was decreased in 163 patients (24.1%), including 131 patients (19.4%) with decreased physical self-maintenance ability and 161 patients (23.8%) with decreased instrumental ADL ability. Pearson correlation analysis showed that the frailty score was positively correlated with total ADL score ( r=0.728, P<0.001), physical self-maintenance ability score ( r=0.669, P<0.001) and instrumental ADL ability score ( r=0.729, P<0.001). Binary logistic regression analysis results showed that older age and lower physical activity, fatigue, slowed steps and lower grip strength in the frailty phenotypes were the independent influencing factors of ADL, physical self-maintenance ability and instrumental ADL ability (all P<0.05). Conclusions:The prevalence of frailty is 23.5% in MHD patients, and 24.1% of MHD patients have decreased ADL. Elder age and lower physical activity, fatigue, reduced step counts, and lower grip strength in frailty phenotypes are the independent influencing factors for poor ADL, poor physical self-maintenance ability and poor instrumental ADL ability.
4.Research progress of the mechanism of traditional Chinese medicine in the prevention and treatment of athero-sclerosis based on miRNA regulation of vascular endothelial cell injury
Dandan LIU ; Hewei QIN ; Yang GAO ; Mengyan SUN ; Mengnan WANG ; Yuqing NIU ; Xuemei SONG
China Pharmacy 2023;34(12):1524-1528
The injury of vascular endothelial cells is not only the initial condition to promote the occurrence of early atherosclerosis (AS) plaques, but also an important link in the pathogenesis of AS. The microRNA (miRNA), as an important medium of intercellular communication and gene regulatory factor, can affect vascular endothelial function and participate in the development of AS. The molecular mechanism of miRNA’s multi-target intervention in vascular endothelial cell injury has become a hot topic in the research of cardiovascular diseases. Monomers of traditional Chinese medicines such as ginsenoside Rb2 and paeonol, as well as traditional Chinese medicine for resolving phlegm and removing blood stasis could regulate miRNA to improve endothelial cell inflammation; astragaloside Ⅳ, dihydromyricetin and notoginsenoside could target miRNA and inhibit vascular endothelial oxidative stress; Danhong injection, Jianpi qutan and huayu prescription and paeonol could affect endothelial autophagy through miRNA; resveratrol, Bushen huoxue formula and Bushen tongmai formula could inhibit vascular endothelial aging by miRNA; dendrobine played an active role in regulating miRNA and improving endoplasmic reticulum stress. In the future, more in- depth research is needed on the effectiveness, mechanism of action, diagnosis and treatment plans, and safety of targeted regulation of miRNA for AS therapy by traditional Chinese medicine.