Objective:To systematically review the characteristics of sleep patterns in the elderly with subjective cognitive decline (SCD) and the relationship between subjective cognitive decline and sleep disorders.Methods:Observational studies on sleep patterns in the elderly with SCD were retrieved by computer in Chinese and English databases such as PubMed, Embase, Web of Science, ScienceDirect, China National Knowledge Infrastructure (CNKI) , WanFang Data and VIP, and the retrieval time was from the establishment of the database to March 31, 2020. Two researchers independently conducted article screening, data extraction and quality evaluation according to the standard. The random-effects model was used for Meta-synthesis of studies with data that could be pooled, and descriptive analysis for studies that could not be pooled.Results:A total of 12 articles were included, with a total sample size of 67 474 cases. The prevalence of SCD in the elderly was 25.9% (95% CI: 6.4%-52.5%) . The sleep patterns of the elderly with SCD were characterized by decreased total sleep time, prolonged wake-time after sleep onset, and frequent awakenings at night. Compared with the normal elderly, the elderly with SCD had a higher risk of poor sleep quality, insomnia and excessive daytime sleepiness ( OR=2.1, 1.15, 2.6) , and excessive daytime sleepiness (ESD) increased the risk of SCD in the elderly ( OR=6.06) . Conclusions:Compared with the normal elderly, the overall sleep quality of the elderly with SCD is poor, and sleep disorders can increase the risk of SCD in the elderly. Existing studies have differences in the diagnostic criteria of SCD, and future studies need to further confirm the causal relationship between SCD and sleep disorders in the elderly.

Objective To preliminarily evaluate efficacy and safety of endoscopic embolization with Glubran-2 glue for gastric varices in liver cirrhosis. Methods Forty-nine patients with cirrhosis gastric varices,admitted to Beijing You′an Hospital from January 2011 to December 2012,underwent endoscopic embolization with Glubran-2 glue under gastroscopy. Of the 49 cases,40 were males and 9 females with age of 34-82(55 ± 11)years. Of these patients,19 were at Child-Pugh class A,23 class B,and 7 class C. Of the 49 patients,22(44. 9%)had isolated gastric varices(IGV)and 27 patients(55. 1%)had gastro-esophaged varices( GOV ). The methods were as follows:50% glucose was prefilled in injection syringe and,after injecting Glubran-2 glue at the location of gastric varices,the left Glubran-2 glue in injection syringe was injected into the varicose vein via the 50% glucose. The Glubran-2 glue was given by way of one spot or multiple spot and each spot needed Glubran-2 glue 1. 0-3. 0 ml. The endoscopic embolization completed at one time as possible. The situation of varicose veins disappearing was observed under gastroscopy at months 1,3,6 after treatment. Safety evaluation index included postoperative burning sensation below the xiphoid,ectopic embolism,fever,blood routine test before operation and at 3 days after operation,and liver and renal functions before operation and at months 1,3,6 after operation. Results The total dose of Glubran-2 glue for IGV patients was 2. 0-12. 0 ml every patient with an average dose of (4. 7 ± 2. 6)ml and for GOV patients was 1. 0-9. 0 ml with an average dose of(4. 2 ± 2. 1)ml. Of the 49 patient,varicose veins of 45 patients(91. 8%)disappeared and varicose veins of 4 patients(8. 2%) improved;extrusions of glue was seen in 18 patients(36. 7%)at one month,30 patients(61. 3%)at 3 month,and 1 patient(2. 0%)at 6 months after treatment. All the patients experienced burning sensation below the xiphoid after glue injection. Three patients presented with fever after operation but their temperature did not exceed 38 ℃. No patient developed ectopic embolism. Nine patients(18. 4%)deve-loped errhysis due to local ulcer because of extrusions of glue and massive haemorrhage did not occur. There were no obvious differences in blood routine test and liver and renal functions before and after treatment. Conclusion Endoscopic embolization with Glubran-2 glue is effective and safe for treatment of gastric varices in liver cirrhosis patients.

Objective To preliminarily evaluate efficacy and safety of endoscopic embolization with Glubran-2 glue for gastric varices in liver cirrhosis. Methods Forty-nine patients with cirrhosis gastric varices,admitted to Beijing You′an Hospital from January 2011 to December 2012,underwent endoscopic embolization with Glubran-2 glue under gastroscopy. Of the 49 cases,40 were males and 9 females with age of 34-82(55 ± 11)years. Of these patients,19 were at Child-Pugh class A,23 class B,and 7 class C. Of the 49 patients,22(44. 9%)had isolated gastric varices(IGV)and 27 patients(55. 1%)had gastro-esophaged varices( GOV ). The methods were as follows:50% glucose was prefilled in injection syringe and,after injecting Glubran-2 glue at the location of gastric varices,the left Glubran-2 glue in injection syringe was injected into the varicose vein via the 50% glucose. The Glubran-2 glue was given by way of one spot or multiple spot and each spot needed Glubran-2 glue 1. 0-3. 0 ml. The endoscopic embolization completed at one time as possible. The situation of varicose veins disappearing was observed under gastroscopy at months 1,3,6 after treatment. Safety evaluation index included postoperative burning sensation below the xiphoid,ectopic embolism,fever,blood routine test before operation and at 3 days after operation,and liver and renal functions before operation and at months 1,3,6 after operation. Results The total dose of Glubran-2 glue for IGV patients was 2. 0-12. 0 ml every patient with an average dose of (4. 7 ± 2. 6)ml and for GOV patients was 1. 0-9. 0 ml with an average dose of(4. 2 ± 2. 1)ml. Of the 49 patient,varicose veins of 45 patients(91. 8%)disappeared and varicose veins of 4 patients(8. 2%) improved;extrusions of glue was seen in 18 patients(36. 7%)at one month,30 patients(61. 3%)at 3 month,and 1 patient(2. 0%)at 6 months after treatment. All the patients experienced burning sensation below the xiphoid after glue injection. Three patients presented with fever after operation but their temperature did not exceed 38 ℃. No patient developed ectopic embolism. Nine patients(18. 4%)deve-loped errhysis due to local ulcer because of extrusions of glue and massive haemorrhage did not occur. There were no obvious differences in blood routine test and liver and renal functions before and after treatment. Conclusion Endoscopic embolization with Glubran-2 glue is effective and safe for treatment of gastric varices in liver cirrhosis patients.

The data is taken from Chinese Longitudinal Healthy Longevity Survey(CLHLS)between 2005 and 2008 to study health insurance’s impact on Chinese rural elders’ health demand. It found that health insurance significantly increased Chinese rural elders’ total health expenditure by 19%; however, it could neither significantly lengthen life expectancy nor decrease the risk of death. Chinese rural elders’ excessive demand induced by health insurance is probably inefficient. Therefore, to insure Chinese rural elders’ diseases could be treated, the government should improve medical security and control unreasonable increases in health service price.