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Clinical and polysomnographic characteristics in elderly patients with obstructive sleep apnea hypopnea syndrome

Chinese Journal of Geriatrics.2011;30(1):17-19. doi:10.3760/cma.j.issn.0254-9026.2011.01.004

Objective To investigate the clinical and pdysomnographic characteristics and related factors of obstructive sleep apnea hypopnea syndrome (OSAHS) in elderly patients. Methods The 163 elderly patients with OSAHS confirmed by polysomnography were classified into obesity group and non-obesity group according to body mass index (BMI). All cases were grouped into mild,moderate and severe groups according to the apnea hypopnea index (AHI) and night SaO2. The 190non-elderly OSAHS patients were as control group at the same time. The clinical and polysomnographic characteristics were recorded and analyzed. Results (1)The proportion of obesity in OSAHS patients was 79. 1%, there was significant difference between the elderly-obesity group and non-elderly-obesity group (70.3% vs. 83.6%, P＜0.05). (2)The proportions of moderate and severe OSAHS patients were lower in elderly group than in non-elderly group. There were significant differences in AHI, the lowest arterial O2 saturation (LSaO2) and % TRT SaO2 ＜90% between the two groups (all P＜0.05). (3)The sleep architecture disturbance was significantly severer in elderly group than in non-elderly group. The percentages of non-rapid eye movementsleep (NREM sleep)stage Ⅲ-Ⅳ sleep were significantly decreased, and the arousal was significantly increased. (4) The syndrome of OSAHS in elderly group was untypical and the clinical complication was increased.Conclusions The elderly OSAHS patients are less severe than non-elderly group, but the elderly patients have worse sleep architecture disturbance and more complications such as hypertension and other cardiovascular diseases.

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Ordinal regression analysis on influence factors of health literacy in middle-aged and elderly people in Hunan province

Li ZHAO ; Zhenqiu SUN ; Donghua XIE ; Dongxian YE ; Xiaohua ZHAO ; Fang ZENG ; Youzhe ZENG ; Zhongmin LI

Chinese Journal of Geriatrics.2011;30(1):69-72. doi:10.3760/cma.j.issn.0254-9026.2011.01.018

Objective To explore the influence factors of health literacy in middle-aged and elderly people in Hunan province.Methods With multi-stage randomized cluster sampling, people aged 45 years and over were selected from both urban and rural areas of six geographical regions of Hunan province, using the China residents health literacy questionnaire developed by Chinese Health Education Center, by face to face survey to get data. The influence factors were analyzed retrospectively with univariate and ordinal regression analysis.Results The 1158 persons were investigated and the valid questionnaires were 1154, the effective recovery rate was 99.7%. Univariate analysis showed that there were significant differences in heath literacy among different degree of education, age, gender, marital status, income, region and occupation (all P＜0.05). The results of ordinal regression analysis Showed that the major influence factors were degree of education, income,age and occupation.Conclusions The people at low levels of education or income should be concerned about health education and health promotion strategies.

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Experimental study on changes of Th1/Th2 cytokines and its relationship with lipopolysaccharide in pretreatment of relieving nonalcoholic steatohepatitis

Jianhong GUO ; Dewu HAN ; Yanlin GUO ; Ruiling XU ; Feng WANG ; Ling LI ; Yuanchang ZHAO

Chinese Journal of Geriatrics.2011;30(1):50-53. doi:10.3760/cma.j.issn.0254-9026.2011.01.014

Objective To investigate the changes of Th1/Th2 cytokines and its relationship with lipopolysaccharide (LPS) in pretreatment of relieving nonalcoholic steatohepatitis (NASH).Methods The 24 male Wistar rats were randomly divided into 3 groups: normal control group, liver injury group and LPS pretreatment group. The rats were given normal diet in normal control group,high-sucrose and high-fat diet both in liver injury group and in LPS pretreatment group, and the rats in LPS pretreatment group were given hypodermic injection of LPS 0. 5 mg/kg every other day. The level of plasma endotoxin (ET), activity of alanine aminotransferase (ALT), content of tumor necrosis factor-α (TNF-α) and interleukin-10 (IL-10) were determined. At the end of week 9, the rats were executed, and the liver tissue slices were prepared to investigate hepatic pathologic change by hematoxylin and eosin (HE) staining.Results The level of plasma ET was significantly higher in liver injury group than in normal control group. The level of plasma ALT and infiltrating lymphocytes in liver tissue were significantly lower in LPS pretreatment group than in liver injury group. The level of plasma TNF-α was significantly lower in LPS pretreatment group compared with liver injury group.In contrast, the level of plasma IL-10 was higher (P＜0. 05). Histology with HE staining showed that hepatocyte steatosis was obviously relieved with smaller lipid droplet in LPS pretreatment group than in liver injury group. Conclusions LPS pretreatment can alleviate high-sucrose and high-fat induced NASH. The disequilibrium of Th1/Th2 cytokines may be an important part of mechanism.

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Effects of minimally invasive removal of intracranial hematoma on blood-brain barrier index and prognosis

Qilong FANG ; Chengsheng JIN ; Yongqing HE ; Jinhai ZHANG ; Zhonghao ZHOU ; Yifeng RUI ; Jun LI

Chinese Journal of Geriatrics.2011;30(1):31-33. doi:10.3760/cma.j.issn.0254-9026.2011.01.008

Objective To explore the effects of minimally invasive removal of intracranial hematoma on blood-brain barrier (BBB) index, serum myelin basic protein (MBP) and activity of daily living (ADL) in hypertensive patients with cerebral hemorrhage.Methods Through observing 30cases operated within 3.0 hours, 32 case operated between 3. 1-8. 0 hours, 28 cases operated between 8. 1 to 24.0 hours and 22 cases operated over 24 hours, the changes of BBB index, serum MBP and ADL were analyzed. Results The BBB index and serum MBP were significantly lower in patients operated within 8. 0 hours than in patients operated over 8. 1 hours [≤3.0 hours group:(6.57±0.69)×10-3 and (3. 12±0.40)μg/L;3. 1-8.0 hours group: (7. 37±1.29)×10-3 and (3.25±0.60)μg/L;8. 1-2.0 hours group: ( 12. 02± 1.51 ) × 10 3 and (4. 60±0. 48)μg/L;over 24.0 hours group: ( 14. 68±2.07)×10-3 and (5.88±0.64)μg/L,Q＞13.8,P＜0. 05]. And the ADL was lower in patients operated within 8. 0 hours than in patients operated over 8. 1 hours [≤3.0 hours group: (2. 60± 1.07)scores; 3.1-8.0 hours group: (3. 06±0. 91 )scores;8. 1-24.0 hours group: (4.00±0.67) scores;over 24.0 hours group:(3.68±1.32)scores,Q＞3. 1,P＜0.05].Conclusions The minimally invasive surgery of intracranial hematoma within 8.0 hours can mitigate the cytotoxicity-damaged BBB so as to lighten brain edema and improve the patients quality of life.

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Prevalence survey of metabolic syndrome and its components in the elderly at Tanggu Community in Tianjin

Fenglin CAO ; Jianzhong CHEN ; Fang HOU ; Guangyu GU ; Zhengzheng BI ; Shaoxiong ZHENG ; Shenguo LI

Chinese Journal of Geriatrics.2010;29(12):1039-1041. doi:10.3760/cma.j.issn.0254-9026.2010.12.023

Objective To investigate the prevalence of metabolic syndrome (MS) and its components among the elderly at Tanggu community in Tainjin. Methods The elderly inhabitants were drawn out randomly from one community at Tanggu in Tianjin to examine the MS-related indexes. There were 623 samples with complete data aged (67.4±6.0) years, including 261 males with mean age of (68.3±6.1) years and 362 females with mean age of (66.9±6.0) years. Diagnosis of MS was done by criteria of Chinese Medical Association Diabetes Branch in 2004. Results The standardized prevalence of MS for the elderly in the community was 18.5% with the highest risk group aged 60～69 years. Standardized prevalences of hypertension, high triglycerides, high blood sugar, overweight, obesity, low HDL-C were 49.5%, 38.8%, 25.3%, 42.0%, 4.2%, 3.0% in the elderly. Conclusions The prevalence of MS in the elderly is lower in Tanggu community in Tianjin than in Shanghai, Foshan in Guangdong, Qingdao in Shandong and Beijing city. The condition in female is more severe than in male, the highest prevalence occurs in hypertension, and overweight, high triglycerides and high blood sugar follow it, but few of them are obesity, low HDL-C is fewer too.

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Effect of antihypertensive therapy on brachial-ankle pulse wave velocity in patients with essential hypertension

Tingli QIN ; Hong JIANG ; Yuannan KE

Chinese Journal of Geriatrics.2011;30(1):13-16. doi:10.3760/cma.j.issn.0254-9026.2011.01.003

Objective To investigate the effect of antihypertensive therapy on brachial-ankle pulse wave velocity (baPWV) in patients with essential hypertension (EH). Methods The 150 EH patients (EH group)receiving antihypertensive therapy with valsartan 80 mg/d, and 135 healthy controls (control group) were enrolled in this study. Automatic pulse wave velocity (PWV)measurement system was employed to examine baPWV, and the investigation about cardiac risk factors, physical and laboratory examination was performed. The baPWV was used as an index to show artery stiffness.Results The baPWV was significantly higher in EH group than in control group [(2105.8±378.4) cm/svs. (1371.5±176.5) cm/s, t=4.05, P＜0.001]. The detection rate of atherosclerosis was 82.0% and 21.8% in EH and control group respectively. In EH group, there were positive relationships between age and baPWV (r= 0.51, P＜0. 001), SBP and baPWV (r=0.53, P＜0.001), pulse pressure (PP) and baPWV (r=0.43, P＜0. 05), PP index (PPI) and baPWV (r=0.51, P＜0.05), blood glucose and baPWV (r=0.39, P＜0.01). The baPWV decreased significantly from (2105.8±378.4) cm/s to (1704.2±332.0) cm/s (t=3.85, P＜0. 05) in EH group. The baPWV was significantly lower in the subgroup with a target BP than without a target BP in EH patients [(1588.8±278.7) vs. (1857.7±324.9) cm/s, t=3.67, P＜0.001].Conclusions The age and SBP are primary risk factors for baPWV in EH patients. The antihypertensive therapy can relieve baPWV with a target blood pressure.

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Effect of lung resection surgery on left heart hemodynamics in elderly patients

Huaibin WANG ; Wenjun ZHEN ; Hongfeng TONG

Chinese Journal of Geriatrics.2011;30(1):34-37. doi:10.3760/cma.j.issn.0254-9026.2011.01.009

ObjectiveTo observe the effects of lung resection surgery on left heart hemodynamics in elderly patients, and explore its correlation with postoperative arrhythmia.Methods The 16 elderly patients (age≥75 years) receiving lung resection surgery were selected. At the same time, 21 patients (age＜60 years) were selected as controls. The hemodynamic parameters of each patient were recorded at the time of preoperative (T1), surgery completion (T2) and first day after surgery (T3). For patients with arrhythmia during three days after operation, the parameters would be recorded before and after arrhythmia. Results There were no significant changes in heart rate (HR), mean arterial pressure (MAP), cardiac output (CO), cardiac stroke volume ( SV),acceleration index (ACI), systemic vascular resistance (SVR) at T2 and T3 compared with T1 for both the two groups (P＞0. 05). Only the central venous pressure (CVP) increased at T2 compared with that at T1 [elderly group: (7.58±0.45) cm H2O vs. (5.92±0. 51) cm H2O, t=2.641, P＜0.01; control group: (7.49±0.34) cm H2O vs. (6.23±0.47) cm H2O, t=1.982, P＜0.05], while the CVP recovered to the preoperative level at T3. The incidence of arrhythmia was significantly higher in elderly group than in control group (31.3% vs. 14.3%, x2 = 4.26, P＜0.05), but there were no significant changes in the parameters before and after arrhythmia compared with those before surgery (P ＞ 0. 05 ).Conclusions The effects of pulmonary resection surgery on left heart hemodynamics in elderly patients can be avoided through full assessment preoperatively, heart-lung protection intraoperatively, as well as the correctly and timely clinical treatment and intensive care postoperatively. Pulmonary resection surgery has no effect on left heart hemodynamics even for patients with postoperative arrhythmia.

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Bibliometric analysis of study status of geriatrics in Jiangsu province from 1998 to 2007

Weigong ZHONG ; Zhibo DU ; Jing ZHAO ; Jianfeng ZHAO

Chinese Journal of Geriatrics.2011;30(1):73-77. doi:10.3760/cma.j.issn.0254-9026.2011.01.019

Objective To investigate the current situation and development of geriatrics in Jiangsu Province, and to find out the characteristics and trend in development of geriatrics in Jiangsu Province. Methods The literatures in geriatric field of Jiangsu Province from 1998 to 2007 were collected from the database, www. cnki.net. Bibliometric methods and Mann-Whitney Test (performed by SPSS) were used to analyze the distribution of time, area, author, fund and discipline of the literatures. Results The total number of the literatures about geriatrics of Jiangsu Province from 1998 to 2007 was 4623, accounting for 7.72% of the total number of the literatures about geriatrics of China. The number of the literatures in South Jiangsu was the highest, followed by North Jiangsu and Center Jiangsu (P＜0.001). The authors publishing only one article made up 81.51% of the total number of the authors. The literatures with cooperating affiliations made up 12.24% of the total literatures. There were 212 literatures with research sponsorship. The literatures in geriatrics of Jiangsu province covered 39 subjects, and the literatures about cardiovascular diseases accounted for 14.56%. Conclusions Geriatrics in Jiangsu province shows a slow development and an imbalance between different areas and subjects. The core author team does not exist. This suggests that Jiangsu Province should increase the investment, and carry out a large and cooperating researchplan to promote the development of geriatrics in Jiangsu province.

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The prevalence and its related risk factors for post-stroke depression in ischemic stroke survivors from community-based medical centers

Hongjun LIU ; Xianghua FANG ; Liyuan MU ; Shuting LI ; Songling JIN ; Biao CHEN

Chinese Journal of Geriatrics.2011;30(1):65-68. doi:10.3760/cma.j.issn.0254-9026.2011.01.017

Objective To estimate the prevalence and related risk factors of post-stroke depression (PSD) in ischemic stroke survivors from community-based medical centers in urban areas of Beijing.Methods Five community-based medical centers in urban areas of Beijing were selected.Patients with first-ever or recurrent ischemic stroke were evaluated from January 2003 to December 2006. The prevalence of PSD was evaluated by Self-Rating Depression Scale (SDS), and the information on the onset of stroke, vascular risk factors and living style was also collected.Results Totally 1089 stroke patients were registered, 1074 cases among which had complete information and met inclusion criteria. The mean age of the patients was (65.0 ± 8.9) years with a median stroke course of 13.0 months. The overall prevalence of PSD was 49.9% (536/1074), and the proportions of mild, moderate and major PSD were 52.2%, 36.0% and 11.8%, respectively. There were no significant differences in prevalence of PSD among different stages of stroke and the prevalence of PSD was 51.3% within 6 months after stroke onset, 47. 1% during 6-18 months and 53.2% after 18months. Low education, activities of Daily Living (ADL) dependence, cognition impairment and recurrence of stroke were independent risk factors for PSD.Conclusions The prevalence of PSD among ischemic stroke patients is higher in community-based medical centers, but most of PSD patients are mild or moderate. More effective early intervention should be adopted to decrease PSD,promote the recovery of neural function and improve their quality of life.

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Effect of telmisartan on levels of serum adiponectin and expression of cardiac adiponectin receptor 1 in spontaneously hypertensive rats

Shupo LIN ; Jie LIN ; Xiaoyi ZHANG ; Jin SHI

Chinese Journal of Geriatrics.2011;30(1):59-64. doi:10.3760/cma.j.issn.0254-9026.2011.01.016

ObjectiveTo observe the effect of telmisartan on the level of serum adiponectin and the expression of cardiac adiponectin (APN) receptor 1 in spontaneously hypertensive rats (SHR) in order to explore the role of APN in ventricular remodeling caused by hypertension and the new possible mechanism that telmisartan protects the heart against ventricular remodeling.Methods The sixteen 12-week-old SHR were randomly divided into SHR control group (SHR group, n=8) and SHR+telmisartan group (TEL group, n=8), and eight age-matched male Wistar Kyoto rats were regarded as control group (WKY group). The TEL group was treated with telmisartan 5 mg-1 · kg-1 ·d-1 in a small amount of distilled water and the other two groups were given equal amount of distilled water by gavage.After 8 weeks, the left ventricular end diastolic diameters (LVEDD),thickness of interventricular septal thickness (IVST), left ventricular post wall thickness (LVPWT) and mitral valve blood flow spectrums were recorded by echoeardiograph.The E/A ratio was calculated by velocity of E peak divided by A peak. The left ventricular weight index (LVWI) was calculated. HE staining and Masson staining were used to detect the pathology changes of cardiac tissue and collagen volume fraction (CVF).Serum APN concentration of SHR was detected by enzyme-linked immunosorbent assay (ELISA). The myocardial protein expression of AdipoR1 was detected by in munohistochemical staining.Reverse transcription polymerase chain reactions (RTPCR) method was used to detect the mRNA expression of AdipoRl in myocardium.ResultsThe values of IVST, LVPWT and LVWI were higher, LVEDD and E/A ratio were lower in SHR group than in WKY group.The disordered arrangement of myocardialcells,interstitialfibroblast hypertrophy and hyperplasia were observed in SHR group. The CVF increased in SHR group than in WKY group [(6.22±0.16)％ vs. (3. 18±0. 17)％, P＜0.05]. The concentration of serum APN was significantly lower in SHR group [( 10.96±2. 15)μg/ml vs. (24.32±2. 20)μg/ml, P＜0. 01].The expressions of myocardial AdipoR1 mRNA and protein were significantly lower in SHR group.The values of IVST, LVPWT and LVWI were lower, LVEDD and E/A ratio were higher in TEL group than in SHR group. The arrangement of myocardial cells were relatively ordered and interstitial fibroblasts hypertrophy and hyperplasia were not significant, CVF was decreased in TEL group versus SHR group. The concentration of serum APN was significantly higher in TEL group [(17.71 ± 5.82)μg/ml, P＜0. 01]. The expressions of myocardial AdipoR1 mRNA and protein were significantly higher in TEL group than in SHR group. Conclusions When SHR undergoes ventricular remodeling, the level of serum APN is lower, the mRNA and protein expressions of myocardial AdipoRl are significantly reduced. Telmisartan can reverse the ventricular remodeling and play the role in protecting heart in SHR, which may be due to the serum APN levels increasing, cardiac APN receptor 1 and its mRNA up-regulation.

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