Objective:To investigate the therapeutic effect of comprehensive geriatric assessment(CGA) in elderly patients with chronic heart failure(CHF) complicated with sarcopenia, and to provide a theoretical reference for clinical application.Methods:This study was a prospective randomized controlled study. 110 elderly CHF patients with myopenia admitted to the Third People's Hospital of Hefei from January 2019 to February 2022 were selected. Using the random number table method, 56 cases were divided into an observation group and 54 cases into a control group. Before treatment, the control group of patients underwent a selective single assessment based on the hospital's requirements and the patient's actual situation, including a fall risk assessment, nutritional risk screening checklist assessment, and routine medication to improve cardiac function and prognosis; Before treatment, the patients in the observation group were assessed with CGA, including the assessment of physical function, mental and psychological status, multiple drug management, pain, Sleep disorder, and social environment. According to the assessment results, individual diagnosis and treatment plans were formulated, implemented, and dynamically adjusted. The two groups were treated for 12 weeks. The general information, treatment compliance, B-type brain natriuretic peptide (BNP) level, left ventricular Ejection fraction (LVEF), 6 min walking distance (6MWD), arm strength of upper limbs and 6 m walking speed, clinical efficacy and prognosis of the two groups were compared before and after treatment. The measurement data is represented by xˉ± s, group t-tests are used for inter group comparison, and paired t-tests are used for intra group comparison before and after treatment; Counting data is represented as an example (%), and inter group comparisons are made using χ 2 test, non parametric rank sum test was used for inter group comparison of hierarchical data. Results:There was no statistically significant difference in gender, age, course of CHF, smoking, alcohol consumption, number of comorbidities, cardiac function grading, and treatment compliance between the two groups of patients (all P>0.05), indicating comparability. Before treatment, there was no statistically significant difference in plasma BNP, LVEF, 6MWD, upper limb grip strength, and 6-meter walking speed between the two groups of patients (all P>0.05); After treatment, the BNP of both groups of patients was lower than before treatment and the observation group was lower than the control group. LVEF, 6MWD, upper limb grip strength, and 6-meter walking speed were all higher than before treatment and the observation group was higher than the control group [(343.45±34.95) ng/L vs (387.09±46.96) ng/L, (49.61±7.11)% vs (42.94±5.72)%, (348.92±37.73) m vs (297.74±43.48) m, (22.64±3.82) kg vs (19.48±3.88) kg, (0.97±0.10) m/s vs (0.83±0.12) m/s], The differences were statistically significant ( t-values were 5.51, -5.40, -6.60, -4.31, -6.60, all P<0.001). After 12 weeks of treatment, there was no statistically significant difference in clinical efficacy between the two groups of patients ( P=0.216), but the overall poor prognosis rate in the follow-up observation group was lower than that in the control group [7.14%(4/56) vs 22.22% (12/54)], and the difference was statistically significant (χ 2=5.03, P=0.025). Conclusions:Developing, implementing, and dynamically adjusting the individualized treatment plan involving CGA can improve the prognosis of elderly CHF patients with sarcopenia, help improve cardiac function, increase grip strength and somatic function, and reduce the risk of major adverse cardiovascular events ,all-cause mortality in elderly patients with CHF combined with sarcopeni and has certain clinical application value.

Objective To investigate the effects of hyperbaric oxygen (HBO) on the cognition of the patients with stroke during the acute stage of cerebral infarction.Methods Ninety-four patients with acute cerebral infarction hospitalized in the department of the hospital from January to March,2017 were enrolled for the study.A randomized controlled study was performed and the patients were randomly divided into 2 groups.During hospitalization,the treatment group was treated with HBO in addition to conventional treatment for cerebral infarction,while the control group was just given conventional therapy for cerebral infarction.National Institutes of Health Stroke Scale (NIHSS) scores and MoCA scores were assessed at time of admission.After 6 months of follow-ups,4 patients with recurrent cerebral infarction or death or without medical follow-ups were excluded from the study,and the remaining 90 were included in the study.NIHSS scores,MoCA scores and mRS scores were calculated once again for the study.General medical data and scores were compared between the groups.Logistic regression was used to identify independent influential factors of cognitive impairment after stroke.Results There was no statistical significance in general medical data and various scores detected at the time of admission,when comparisons were made between the 2 groups.Six months after onset,statistical significance could neither be seen in NIHSS scores and the rate of good outcome,as compared with those of the control group.However,incidence of cognitive impairment after stroke was significantly lower than that of the control group(26.7％ vs 48.9％) (P ＜ 0.05).Six months after onset,the MoCA scores were significantly lower than those of the control group,with statistical significance (27.3 ± 1.52 vs 26.2 ± 1.95) (P ＜ 0.05).Six months after onset of cerebral infarction,the scores of visual space/executive function and memory in the HBO group were considerably higher than those in the control group [4 (4,5) vs 4 (4,4)] (P ＜ 0.05).Logistic regression analysis revealed that education background (OR =0.711,95％ CI 0.556-0.910) (P =0.007),homocysteine (OR =1.271,95 ％ CI 1.015-1.591) (P =0.037) and leukoaraiosis (OR =2.854,95％ CI 1.327-6.147) (P =0.007) were independent factors of cognitive impairment after stroke,and whether not to choose HBO therapy was not an independent factor of cognitive impairment after stroke.Conclusion HBO therapy during the acute stage of cerebral infarction seemed to have little effect on the prognosis of the impairment 6 months after onset.However,it could significantly reduce the incidence of cognitive impairment after stroke and improve the visual spatial/executive function and memory.

Objective To investigate the effects of hyperbaric oxygen (HBO) on the cognition of the patients with stroke during the acute stage of cerebral infarction.Methods Ninety-four patients with acute cerebral infarction hospitalized in the department of the hospital from January to March,2017 were enrolled for the study.A randomized controlled study was performed and the patients were randomly divided into 2 groups.During hospitalization,the treatment group was treated with HBO in addition to conventional treatment for cerebral infarction,while the control group was just given conventional therapy for cerebral infarction.National Institutes of Health Stroke Scale (NIHSS) scores and MoCA scores were assessed at time of admission.After 6 months of follow-ups,4 patients with recurrent cerebral infarction or death or without medical follow-ups were excluded from the study,and the remaining 90 were included in the study.NIHSS scores,MoCA scores and mRS scores were calculated once again for the study.General medical data and scores were compared between the groups.Logistic regression was used to identify independent influential factors of cognitive impairment after stroke.Results There was no statistical significance in general medical data and various scores detected at the time of admission,when comparisons were made between the 2 groups.Six months after onset,statistical significance could neither be seen in NIHSS scores and the rate of good outcome,as compared with those of the control group.However,incidence of cognitive impairment after stroke was significantly lower than that of the control group(26.7％ vs 48.9％) (P ＜ 0.05).Six months after onset,the MoCA scores were significantly lower than those of the control group,with statistical significance (27.3 ± 1.52 vs 26.2 ± 1.95) (P ＜ 0.05).Six months after onset of cerebral infarction,the scores of visual space/executive function and memory in the HBO group were considerably higher than those in the control group [4 (4,5) vs 4 (4,4)] (P ＜ 0.05).Logistic regression analysis revealed that education background (OR =0.711,95％ CI 0.556-0.910) (P =0.007),homocysteine (OR =1.271,95 ％ CI 1.015-1.591) (P =0.037) and leukoaraiosis (OR =2.854,95％ CI 1.327-6.147) (P =0.007) were independent factors of cognitive impairment after stroke,and whether not to choose HBO therapy was not an independent factor of cognitive impairment after stroke.Conclusion HBO therapy during the acute stage of cerebral infarction seemed to have little effect on the prognosis of the impairment 6 months after onset.However,it could significantly reduce the incidence of cognitive impairment after stroke and improve the visual spatial/executive function and memory.

Objective To evaluate the detection of membrane neutrophil alkaline phosphatase (NAP)in diagnosis of infection in patients with acute cerebral hemorrhage.Methods A total of 208 patients with acute cerebral hemorrhage,including 1 52 cases without infection (uninfected group)and 56 cases with infection (infected group),admitted in the Second Affiliated Hospital of Nantong University during January 201 0 to July 201 6 were enrolled,30 healthy subjects were also enrolled in the study as control group.The peripheral blood from all subjects were collected,and the counts of white blood cell (WBC), percentage of neutrophil,serum procalcitonin (PCT)and NAP were measured.The value of above 4 indicators in diagnosing infection was determined by receiver operating characteristic (ROC ) curves. ANOVA and t test were used to analyze the data,Pearson correlation was performed to analyze the correlation between NAP and PCT in infected group.Results The levels of WBC,percentage of neutrophil and NAP in both infected and uninfected group were higher than those in healthy control group at admission(F =1 1 7.64, 1 00.69 and 425.09,all P <0.01 ),and the levels of WBC,PCT and NAP were also higher when infection occurred compared with those at admission in infected group (t =3.1 4,34.30 and 36.39,all P <0.01 ). The expression of NAP was positively correlated with PCT in infected group (r =0.762,P <0.05).ROC curve analysis showed that the areas under the curves of NAP and PCT in diagnosis of infection were 0.875 and 0.884,respectively.When 1 0655.28 AB/c and 5.01 mg/L were taken as cut-off values,the sensitivities of NAP and PCT in diagnosis of infection were 85.50% and 87.66%;the specificities were 90.50%和 90.31 %,respectively.The level of NAP in infected patients with gram-positive bacterial infections was higher than that in patients with gram-negative bacterial infections (t =6.29,P <0.01 ). Conclusion The expression of NAP in patients with acute cerebral hemorrhage increases when infection occurs,which may be helpful to the clinical diagnosis of bacterial infection.

Objective To investigate the effects of hyperbaric oxygen (HBO) combined with mecobalamin on electrophysiological changes in the treatment of carpal tunnel syndrome (CTS).Methods Eighty-four cases of CTS were randomly divided into the mecobalamin group (n =28),the HBO group (n =28) and the HBO + mecobalamin group (n =28).The mecobalamin group was treated with mecobalamin,the HBO group received HBO therapy,and the latter group was given combined therapy,i.e.HBO plus mecobalamin.Both before and after treatment,all the patients received electrophysiological detection.Results After treatment,the median nerve sensory nerve conduction velocity (SCV),motor nerve conduction velocity (MCV),and the wave amplitude of the motor nerve compound muscle action potential (CMAP) of the combined group were all higher than those before treatment (P ＜ 0.05),while CMAP latency (BML) was lower than that before treatment (P ＜ 0.05).Following treatment,SCV of the Mecobalamin group was higher than that before treatment (P ＜ 0.05).SCV and MCV of the HBO group after treatment were higher than those before treatment (P ＜ 0.05).SCV and CMAP wave amplitude of the combined group significantly elevated as compared with that of the mecobalamin group (P ＜ 0.05),and SCV of the combined group was significantly higher than that of the HBO group (P ＜ 0.05).Conclusions HBO combined with mecobalamin could produce significant effects in the treatment of CTS.

Objective To investigate the effects of hyperbaric oxygen (HBO) combined with mecobalamin on electrophysiological changes in the treatment of carpal tunnel syndrome (CTS).Methods Eighty-four cases of CTS were randomly divided into the mecobalamin group (n =28),the HBO group (n =28) and the HBO + mecobalamin group (n =28).The mecobalamin group was treated with mecobalamin,the HBO group received HBO therapy,and the latter group was given combined therapy,i.e.HBO plus mecobalamin.Both before and after treatment,all the patients received electrophysiological detection.Results After treatment,the median nerve sensory nerve conduction velocity (SCV),motor nerve conduction velocity (MCV),and the wave amplitude of the motor nerve compound muscle action potential (CMAP) of the combined group were all higher than those before treatment (P ＜ 0.05),while CMAP latency (BML) was lower than that before treatment (P ＜ 0.05).Following treatment,SCV of the Mecobalamin group was higher than that before treatment (P ＜ 0.05).SCV and MCV of the HBO group after treatment were higher than those before treatment (P ＜ 0.05).SCV and CMAP wave amplitude of the combined group significantly elevated as compared with that of the mecobalamin group (P ＜ 0.05),and SCV of the combined group was significantly higher than that of the HBO group (P ＜ 0.05).Conclusions HBO combined with mecobalamin could produce significant effects in the treatment of CTS.

Objective To investigate the effects of hyperbaric oxygen (HBO) therapy on serum matrix met-alloproteinase-9 (MMP-9) and intercellular adhesion molecule-1 (ICAM-1) levels, and on brain edema in patients with intracerebral hemorrhage. Methods Seventy-six subjects with intracerebral hemorrhage were divided into a routine treatment group (40 cases) and a.HBO treatment group (36 cases). 30 healthy persons served as a control group. Serum MMP-9 and ICAM-1 levels were measured before and after treatment. MRI images of the subjects' brains were prepared at the 5 ～ 7 th and 25th days. Absolute edema volumes and relative edema volumes were meas-ured on T2-weighted images. Results (1)The serum MMP-9 and ICAM-1 levels in the routine therapy and HBO groups were higher than those in the control group at the outset ( P≤0. 01 ). Both indices peaked on the 5th day, but there was no significant difference between the two treated groups. At the 15th and 25th day (after 10 and 20 HBO treatments) , the serum MMP-9 and ICAM-1 levels in the HBO group had decreased remarkably and were significant-ly lower than those in the routine therapy group (P≤0. 01 ). (2)At the 5 -7th and 25th days, both absolute edema volumes and relative edema volumes in the HBO group were significantly smaller than those in the routine therapy group ( P≤0. 05, P≤0. 01 ). (3) Serum MMP-9 and ICAM-1 levels were positively correlated with the brain edema volumes, and negatively correlated with decreased NIHSS scores (between pre- and post-treatment). Conclusions HBO therapy may reduce serum MMP-9 and ICAM-1 levels in patients with intracerebral hemorrhage, and lessen the severity and range of brain edema. HBO is helpful for restoring nerve function. Early and repeated multiple HBO treatments are beneficial for patients.