1.Multicenter retrospect analysis of early clinical features and analysis of risk factors on prognosis of elderly patients with severe burns
Qimin MA ; Wenbin TANG ; Xiaojian LI ; Fei CHANG ; Xi YIN ; Zhaohong CHEN ; Guohua WU ; Chengde XIA ; Xiaoliang LI ; Deyun WANG ; Zhigang CHU ; Yi ZHANG ; Lei WANG ; Choulang WU ; Yalin TONG ; Pei CUI ; Guanghua GUO ; Zhihao ZHU ; Shengyu HUANG ; Liu CHANG ; Rui LIU ; Yongji LIU ; Yusong WANG ; Xiaobin LIU ; Tuo SHEN ; Feng ZHU
Chinese Journal of Burns 2024;40(3):249-257
Objective:To investigate the early clinical characteristics of elderly patients with severe burns and the risk factors on prognosis.Methods:This study was a retrospective case series study. Clinical data of 124 elderly patients with severe burns who met the inclusion criteria and were admitted to the 12 hospitals from January 2015 to December 2020 were collected, including 4 patients from the Fourth People's Hospital of Dalian, 5 patients from Fujian Medical University Union Hospital, 22 patients from Guangzhou Red Cross Hospital of Jinan University, 5 patients from Heilongjiang Provincial Hospital, 27 patients from the First Affiliated Hospital of Naval Medical University, 9 patients from the First Affiliated Hospital of Nanchang University, 10 patients from Affiliated Hospital of Nantong University, 9 patients from Tongren Hospital of Wuhan University & Wuhan Third Hospital, 12 patients from the 924 th Hospital of PLA, 6 patients from Zhangjiagang First People's Hospital, 4 patients from Taizhou Hospital of Zhejiang Province, and 11 patients from Zhengzhou First People's Hospital. The patients' overall clinical characteristics, such as gender, age, body mass index, total burn area, full-thickness burn area, inhalation injury, causative factors, whether combined with underlying medical diseases, and admission time after injury were recorded. According to the survival outcome within 28 days after injury, the patients were divided into survival group (89 cases) and death group (35 cases). The following data of patients were compared between the two groups, including the basic data and injuries (the same as the overall clinical characteristics ahead); the coagulation indexes within the first 24 hours of injury such as prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time, D-dimer, fibrinogen degradation product (FDP), international normalized ratio (INR), and fibrinogen; the blood routine indexes within the first 24 hours of injury such as white blood cell count, platelet count, neutrophil-to-lymphocyte ratio, monocyte count, red blood cell count, hemoglobin, and hematocrit; the organ function indexes within the first 24 hours of injury such as direct bilirubin, total bilirubin, urea, serum creatinine, aspartate aminotransferase, alanine aminotransferase, total protein, albumin, globulin, blood glucose, triglyceride, total cholesterol, alkaline phosphatase, creatine kinase, electrolyte indexes (potassium, sodium, chlorine, calcium, magnesium, and phosphorus in blood), uric acid, myoglobin, and brain natriuretic peptide; the infection and blood gas indexes within the first 24 hours of injury such as procalcitonin, C-reactive protein, pH value, oxygenation index, base excess, and lactate; treatment such as whether conducted with mechanical ventilation, whether conducted with continuous renal replacement therapy, whether conducted with anticoagulation therapy, whether applied with vasoactive drugs, and fluid resuscitation. The analysis was conducted to screen the independent risk factors for the mortality within 28 days after injury in elderly patients with severe burns. Results:Among 124 patients, there were 82 males and 42 females, aged 60-97 years, with body mass index of 23.44 (21.09, 25.95) kg/m 2, total burn area of 54.00% (42.00%, 75.00%) total body surface area (TBSA), and full-thickness burn area of 25.00% (10.00%, 40.00%) TBSA. The patients were mainly combined with moderate to severe inhalation injury and caused by flame burns. There were 43 cases with underlying medical diseases. The majority of patients were admitted to the hospital within 8 hours after injury. There were statistically significant differences between patients in the 2 groups in terms of age, total burn area, full-thickness burn area, and inhalation injury, and PT, APTT, D-dimer, FDP, INR, white blood cell count, platelet count, urea, serum creatinine, blood glucose, blood sodium, uric acid, myoglobin, and urine volume within the first 24 hours of injury (with Z values of 2.37, 5.49, 5.26, 5.97, 2.18, 1.95, 2.68, 2.68, 2.51, 2.82, 2.14, 3.40, 5.31, 3.41, 2.35, 3.81, 2.16, and -3.82, respectively, P<0.05); there were statistically significant differences between two groups of patients in whether conducted with mechanical ventilation and whether applied with vasoactive drugs (with χ2 values of 9.44 and 28.50, respectively, P<0.05). Age, total burn area, full-thickness burn area, serum creatinine within the first 24 hours of injury, and APTT within the first 24 hours of injury were the independent risk factors for the mortality within 28 days after injury in elderly patients with severe burns (with odds ratios of 1.17, 1.10, 1.10, 1.09, and 1.27, 95% confidence intervals of 1.03-1.40, 1.04-1.21, 1.05-1.19, 1.05-1.17, and 1.07-1.69, respectively, P<0.05). Conclusions:The elderly patients with severe burns had the injuries mainly from flame burns, often accompanied by moderate to severe inhalation injury and enhanced inflammatory response, elevated blood glucose levels, activated fibrinolysis, and impaired organ function in the early stage, which are associated with their prognosis. Age, total burn area, full-thickness burn area, and serum creatinine and APTT within the first 24 hours of injury are the independent risk factors for death within 28 days after injury in this population.
2.Recent advance in role of resolvin D1 in inflammatory injury of major neurological diseases
Xiaoyu LYU ; Ziyou ZHANG ; Zhuang LI ; Dandan LI ; Mingrui LIU ; Yangyang ZHONG ; Yusong HE ; Yannan SHAO ; Yan YU ; Bensi ZHANG
Chinese Journal of Neuromedicine 2024;23(11):1172-1178
Neurodegenerative diseases are often associated with inflammatory mechanisms, where persistent or excessive inflammatory responses can lead to neuronal damage and subsequent pathological changes. In acute neurological conditions such as stroke or traumatic brain injury, inflammation is a key factor that triggers acute neuronal injury and long-term sequelae. In chronic neurodegenerative diseases, including Alzheimer's disease, cognitive dysfunction, Parkinson's disease, and multiple sclerosis, the chronic activation of inflammation is closely related to gradual degeneration of neurons. Resolvin D1 (RvD1), an endogenous pro-resolving mediator, plays a crucial role in controlling the intensity and duration of inflammation by inhibiting excessive activation of immune cells, modulating the release of pro-inflammatory cytokines, and maintaining the integrity of the blood-brain barrier. This review focuses on the mechanisms of RvD1 in mediating inflammatory damage in major neurological diseases, aiming to provide theoretical support for a deeper understanding of disease mechanism, optimized therapeutic strategies, and enhanced outcome.
3.Construction and application of a management system for pregnant women undergoing first visit in non-obstetric departments
Kaiyang GENG ; Yusong ZOU ; Song BIAN ; Junli LU ; Meizhu XIAO ; Yuhua ZHANG ; Xue MA
Chinese Journal of Hospital Administration 2024;40(8):609-612
Early identification and intervention of high-risk factors during pregnancy is important for the prevention of maternal mortality. A certain hospital has established a management system for pregnant women undergoing first visit in non-obstetric departments and started applying it in three campus of the hospital in July 2023. Through the information management module for pregnant women undergoing first visit in non-obstetric departments that embedded in the hospital information system, abnormal pregnancy situations could be screened in a timely, comprehensive, and standardized manner, and quality control management could be carried out. At the same time, the hospital established a graded management path based on the severity of the condition of pregnant women, and provided early intervention for critically ill pregnant women reported through standardized management and multidisciplinary collaboration. From July to December 2023, a total of 5 766 pregnant women were first diagnosed and reported in 41 non-obstetric departments. Telephone follow-up showed a true reporting rate of 93.0%, and a total of 11 critical illness case were reported, including 2 cases of misoperation, with an accuracy rate of 81.8%. There were no adverse outcomes caused by failure to detect critical illness cases in a timely manner. In contrast, the relevant statistical data from January to June 2023 showed that there were 257 cases of pregnant women reported by non-obstetric departments, including 0 cases of critical illness and 1 case of missed critical illness. In addition, the time for non-obstetricians to screen for critically illness pregnant women of childbearing age has been reduced from 5-10 min per person before the system application to 15 s-1 min per person. The application of this system has reduced the missed reporting of critical illnesses, effectively ensured the safety of pregnant women, and improved work efficiency. It can provide reference for safety management of pregnant women in other medical institutions.
4.Association between the rs1800591 variation of the microsomal triglyceride transfer protein gene and the risk of nonalcoholic fatty liver disease in the elderly population
Jinhan ZHAO ; Jing ZHANG ; Yang ZHANG ; Xiaoyi XU ; Yusong GOU ; Hangfei XU ; Yan WAN ; Jian WU
Journal of Clinical Hepatology 2023;39(3):552-561
Objective To investigate the association between the polymorphism of the microsomal triglyceride transport protein (MTTP) gene at rs1800591 locus and the risk of nonalcoholic fatty liver disease (NAFLD) in the elderly population. Methods The clinical cohort of this study was established in Menkuang Hospital, Beijing Jingmei Group General Hospital. A total of 1098 healthy elderly volunteers were recruited for physical examination in communities in Mentougou District of Beijing, China, from January 11, 2020 to September 30, 2021, among whom there were 614 patients with NAFLD and 484 individuals without NAFLD. Gene microarray was used to determine the genotypes of MTTP rs1800591; demographic data were collected, and blood biochemical parameters were measured. The independent samples t -test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the chi-square test was used for comparison of categorical data between groups. The chi-square test was used to investigate whether the distribution of genotype frequency was in accordance with Hardy-Weinberg equilibrium. The unconditional logistic regression model was used to calculate odds ratio ( OR ) and its 95% confidence interval ( CI ) to investigate the association of gene polymorphism with the risk of NAFLD and other comorbidities. Results There were significant differences in sex and age between the two groups ( P < 0.05). Compared with the non-NAFLD group, the NAFLD group had significantly higher levels of body mass index (BMI), waist-hip ratio, triglyceride, alanine aminotransferase, aspartate aminotransferase, controlled attenuation parameter (CAP), and liver stiffness measurement and a significantly lower level of high-density lipoprotein (HDL) (all P < 0.05). Compared with the non-NAFLD group, the NAFLD group had a significantly higher proportion of patients with hypertension, diabetes, obesity, and metabolic syndrome (all P < 0.05). The distribution of genotype frequency at MTTP rs1800591 locus was in accordance with Hardy-Weinberg equilibrium in the control group ( χ 2 =1.097, P =0.29). There were a significant differences in the genotype and the distribution of alleles at MTTP rs1800591 locus between the patients with NAFLD and the control group (all P < 0.001). In the total population, there was a significantly lower carrying rate of T allele (GT+TT, n =351) in male individuals, and the individuals carrying T allele had significantly higher BMI and CAP than those carrying GG allele ( n =747) ( P < 0.001). Compared with the individuals who did not carry T allele, the individuals carrying T allele (GT+TT, n =232) had a significantly higher proportion of patients with obesity and a significantly lower NFS score ( P < 0.05). As for the individuals with NAFLD, the individuals carrying T allele had a significantly lower proportion of male individuals, a significantly lower waist-hip ratio, and a significantly higher level of HDL compared with those who did not carry T allele (GG, n =382), and the GT+TT group had a significantly lower NFS score than the GG group (all P < 0.05). The non-conditional logistic regression analysis showed that after adjustment for the confounding factors of sex, age, and BMI, the GT+TT genotype at MTTP rs1800591 locus significantly increased the risk of NAFLD ( OR =1.643, 95% CI : 1.226-2.203, P =0.001), and carrying T allele also increased the risk of obesity in the total population ( OR =1.371, 95% CI : 1.051-1.788, P =0.02). Conclusion MTTP rs1800591 polymorphism is associated with the development of NAFLD in the elderly population, and carrying T allele may promote hepatic steatosis and increase the risk of obesity in NAFLD, while it may inhibit the progression of liver fibrosis.
5.Iodine nutrition level and its spatial distribution in key populations in Hubei Province in 2020
Wenjing XIAO ; Yusong DING ; Shangzhi XU ; Ping YAO ; Biyun ZHANG
Chinese Journal of Endemiology 2023;42(2):139-143
Objective:To learn about the iodine nutrition level and its spatial distribution status in key populations in Hubei Province, so as to provide a basis for adjustment of iodine supplementation policy and the realization of scientific and accurate iodine supplementation.Methods:In 2020, a sampling was carried out in Hubei Province according to the "National Iodine Deficiency Disorders Monitoring Plan (2016 Edition)" to monitor the concentration of salt iodine and urinary iodine of key populations (children ages 8 - 10 years old and pregnant women). The spatial distribution of iodine nutrition levels was analyzed by spatial epidemiology.Results:The median salt iodine of 17 263 children's family salt samples was 25.0 mg/kg, and the median urinary iodine (MUI) was 217.0 μg/L. There was significant spatial aggregation in the distribution of urinary iodine level in children at the county level ( Moran's Index = 0.36, P < 0.001). The significant hot spot areas with high urinary iodine level among children were located in Shiyan City and Xiangyang City, while the significant cold spot areas with low urinary iodine level were mainly concentrated in Yichang City. The median salt iodine of 8 618 pregnant women's family salt samples was 25.1 mg/kg, the MUI was 176.3 μg/L. The urinary iodine level among pregnant women at the county level was spatially clustered ( Moran's Index = 0.22, P = 0.003) . The significant hot spot areas with high urinary iodine level among pregnant women were mainly in Enshi Tujia and Miao Autonomous Prefecture, the significant cold spot areas were mainly concentrated in Yichang City. Conclusions:In 2020, the iodine nutrition of children in Hubei Province is at a super appropriate level (200 - 299 μg/L), and the iodine nutrition status of pregnant women is more sensitive, which is close to the lower limit of the appropriate level (150 μg/L). The urinary iodine level of children and pregnant women has significant spatial aggregation at the county level. Targeted intervention will be needed in counties (dictricts) where the urinary iodine level is lower or higher than the normal range, to achieve accurate and scientific iodine supplementation.
6.Analysis of the Expression of Glycoprotein M6A in Glioma based on Bioinformatics Methods
Journal of Medical Research 2023;52(12):89-92,133
Objective To investigate the expression of glycoprotein M6A(GPM6A)in glioma specimens and its prognostic signifi-cance.Methods Bioinformatics methods were used to analyze the expression of GPM6A in 325 cases obtained from the Chinese Glioma Genome Atlas(CGGA)database.The STRING online database was used to screen and analyze the possible protein PPI interaction net-work and GO functional annotation that interact with GPM6A to explore its potential mechanism.The relationships between GPM6A and glioma cell purity and the level of CD8+T cell were assessed using the TIMER2.0database.Results The online analysis of the CGGA database showed that GPM6A was expressed in histopathological grades(WHO:G2,G3,G4)and histopathological types,and there were significant differences in GPM6A expression levels between all grades and all types of gliomas(Grades:F=50.25,P<0.001;Types:F=14.26,P<0.001);the expression level of GPM6A was closely related to molecular IDH mutation status,combined deletion of 1p19q,and patient age(all P<0.01),regardless of patient gender(t=1.45,P>0.05).The expression level of GPM6A in primary glioma was higher than that in secondary glioma,and the difference was not statistically significant(t=1.82,P>0.05).The survival time of patients with low GPM6A expression was significantly shortened(x2=69.79,P<0.001),but in glioblastoma(GBM)patients,regard-less of the level of GPM6A expression,there was no difference in survival time(x2=0.63,P>0.05).GO functional analysis showed that GPM6A was closely related to the functions of transmembrane protein transport,synapse formation and development,and information ex-change between cells in the nervous system.TIMER2.0database analysis showed that GPM6A was positively correlated with glioma tumor cell purity and the level of CD8+T cell.Conclusion The prognosis of glioma patients with low GPM6A expression is significantly worse than that of patients with high expression,and its expression level can be used as a predictor for evaluating the prognosis of glioma.
7.CXCR4 antagonist AMD3100 attenuates epileptic activity by enhancing inhibitory neurotransmission in rats
Yusong ZHANG ; Zhiguo CHEN ; Zishan YANG ; Lei LI
Chinese Journal of Neuromedicine 2022;21(1):6-12
Objective:To investigative the molecular mechanism of C-X-C chemokine receptor type 4 (CXCR4) antagonist AMD3100 in epileptic seizure.Methods:(1) Animal experiment: 36 adult male SD rats were randomly divided into control group (Con, n=12), epilepsy group (Epi, n=12), Epi+AMD3100 group ( n=12). Experimental epilepsy rat models in the Epi group were induced by intraperitoneal injection of pentrazole (PTZ, 40 mg/kg); rats in the Epi+AMD3100 group were given intraperitoneal injection of PTZ (40 mg/kg) 20 min after lateral intracerebroventricular injection of 5 μL (5 mg/mL) AMD3100; rats in the Con group were given intraperitoneal injection of normal saline. Racine grading was used to evaluate the levels of epileptic seizure and the latency of epileptic seizure was recorded in rats from each group. EEG was used to record the abnormal discharges of brain neurons in rats from each group. The content of γ -aminobutyric acid (GABA) in the hippocampus was detected by ELISA kit; γ -aminobutyric acid A receptor α1 subunit ( GABAAR α1) mRNA levels of hippocampal neurons in each group were detected by real-time fluorescent quantitative PCR (qRT-PCR). (2) Cell experiment: the hippocampal neurons from 1-d-old SD rats were primarily cultured; 7 d after cultivation, these cells were divided into control group, epilepsy group and AMD3100 group; the cellular epileptic models in the epileptic group were induced by magnesium-free external fluid; neurons in the AMD3100 group were cultured in magnesium-free external solution containing 10 nmol/L AMD3100 for 3 h, and then changed to Neurobasal medium for further culture; cells in the control group were cultured with Neurobasal medium. Whole cell patch clamp technique was used to detect the spontaneous inhibitory postsynaptic currents (sIPSCs) after AMD3100 (10 nmol/L) perfusion. Results:(1) Animal experiment: the seizure latency in Epi+AMD3100 group was significantly shorter than that in Epi group ([663.30±74.84] s vs. [164.40±17.20] s, t=6.490, P<0.001). The frequency of seizures>grading 4 in the Epi+AMD3100 group was significantly decreased as compared with that in the Epi group (3.75±0.39 vs. 9.00±0.73, t=4.680, P<0.001). ELISA results showed that GABA content in the 3 groups was significantly different ( F=17.850, P<0.001): that in the Epi group was significantly lower than that in the Con group, and that in the Epi+AMD3100 group was significantly higher than that in Epi group ( P<0.05). The qRT-PCR results showed that GABAAR α1 mRNA content among the 3 groups was significantly different ( F=14.400, P<0.001): that in the Epi group was significantly lower than that in the Con group, and that in the Epi+AMD3100 group was significantly higher than that in the Epi group ( P<0.05). EEG results showed that the discharge frequency of rats in the Epi+AMD3100 group was lower than that in Epi group; there was no significant difference in EEG power among the 3 groups ( F=3.220, P<0.001), but the EEG power in the Epi+AMD3100 group was lower than that in Epi group and control group. (2) Cell experiment: patch clamp technique showed that the average frequency and amplitude of sIPSCs in the 3 groups were statistically significant ( F=13.670, P<0.001; F=10.920, P<0.001). As compared with those in the control group and epilepsy group, the average frequency and amplitude of sIPSCs in AMD3100 group were significantly increased ( P<0.05). Conclusion:CXCR4 antagonist AMD3100 can reduce seizure frequency by enhancing inhibitory neurotransmission.
8.Autologous blood transfusion drainage and simple drainage after lumbar surgery: A comparative study
Qiaomei YUAN ; Yusong JIA ; Jinyu LI ; Chenying ZHENG ; Chunxiao BAI ; Fan ZHANG ; Xueshi DI ; Shengqian KANG ; Shuiwen LONG ; Jiang CHEN
Chinese Journal of Blood Transfusion 2021;34(3):245-248
【Objective】 To investigate the effect of autologous blood transfusion(ABT) drainage system and simple drainage(using drainage bags) on the prognosis of patients after lumbar surgery. 【Methods】 The patients admitted to the Department of Orthopedics of our hospital from August 2018 to September 2020 who underwent posterior open lumbar internal fixation and fusion were divided into two groups according to different drainage methods adopted after surgery: 50 patients were randomly selected from the patients who received postoperative ABT system for drainage as ABT group, and 50 patients were randomly selected from the patients who received postoperative drainage by drainage bag as simple drainage bgroup(the control group). The postoperative drainage volume, actual postoperative drainage, total dominant blood loss, total autologous blood transfusion volume, as well as the postoperative anemia indexes, infection indexes and albumin levels in d1, d3 and d7 of the 2 groups were retrospectively analyzed. 【Results】 The gender, age, operation duration and operation segment of the 2 groups were comparable (P>0.05), and preoperative Hb, Hct, ALB, WBC, NE%, intraoperative blood loss, intraoperative autologous blood transfusion volume and actual postoperative drainage volume were similar (P>0.05). There were no significant differences in Hb, Hct, ALB, WBC, NE% and CRP in postoperative d1, d3 and d7, as well as in preoperative and postoperative Hb, Hct and ALB, and in postoperative and preoperative WBC, NE% and CRP (P>0.05). The postoperative drainage volume (mL) and total dominant blood loss (mL) in ABT group and the control group were 554.40±176.82 vs 337.80±102.43, and 1 048.40±282.87 vs 791.80±277.02, respectively (P<0.05). 【Conclusion】 The use of ABT drainage system after lumbar surgery increased the drainage volume compared with simple drainage, but the improvement of anemia, albumin and infection was not obvious. ABT system should not be used routinely for drainage after lumbar surgery.
9.Establishment and verification of the multi-dimensional peripheral contrast sensitivity function measurement based on Bayesian probability estimation algorithm
Zhipeng CHEN ; Yijing ZHUANG ; Zixuan XU ; Fang HOU ; Qingqing YE ; Yu JIA ; Yunsi HE ; Yusong ZHOU ; Shenglan ZHANG ; Lei FENG ; Zhonglin LYU ; Jinrong LI
Chinese Journal of Experimental Ophthalmology 2021;39(5):417-422
Objective:To evaluate the feasibility and accuracy of a multi-dimensional peripheral quick contrast sensitivity function (pqCSF) measurement established based on Bayesian probability estimation algorithm.Methods:A cross-sectional study was conducted.Nineteen eyes of 12 healthy emmetropic subjects in Zhongshan Ophthalmic Center of Sun Yat-sen University from September 2017 to March 2018 were included, with an average age of (22.92±2.91) years.The average spherical power and cylindrical power were (-0.34±0.52)D and (-0.30±0.42)D, respectively, and the average uncorrected vision acuity was≥1.0.Based on the Bayesian probability algorithm, the peak contrast sensitivity γ max, the peak spatial frequency ? max, the bandwidth β and the low contrast intercept δ were used to quickly describe the contrast sensitivity function (CSF) curve of the full spatial frequency through multi-dimensional pqCSF method.The 16 peripheral visual field positions of all subjects were tested at 6°, 12°, 18° and 24° eccentricity of the superior, inferior, the temporal and nasal visual field by the pqCSF method, but the 18° eccentricity of temporal field, which was near the physiological blind spot, was excluded.The area under Log CSF (AULCSF) of different peripheral visual fields and the Log CSF of 19 spatial frequencies (distributed at equal intervals in logarithmic units) were compared.This study followed the Declaration of Helsinki, and the study protocol was approved by an Ethics Committee of Zhongshan Ophthalmic Center of Sun Yat-sen University (No.2018KYPJ017). Written informed consent was obtained from each subject prior to any examination. Results:With the increase of eccentricity in different visual fields, the AULCSF decreased gradually, and there were significant differences in AULCSF between different eccentricities (all at P<0.05). The AULCSF of the nasal and temporal visual field at 6°, 12° and 24° eccentricity was significantly larger than that of the superior and inferior visual field (all at P<0.05). As the distance from the fovea was increased, the pqCSF, the AULCSF, and the high-frequency cutoff were all decreased, and the standard deviation of AULCSF was increased gradually. Conclusions:The pqCSF method can depict a relatively complete peripheral CSF curve of a wide peripheral visual field, and reflect the function quality of the peripheral vision comprehensively and accurately.
10.Effects of exercise rehabilitation combined with psychotherapy in elderly patients with coronary heart disease after percutaneous coronary intervention
Xingfen WANG ; Yonghong GAO ; Yusong ZHANG
Chinese Journal of Geriatrics 2020;39(5):514-517
Objective:To investigate the effect of exercise rehabilitation combined with psychotherapy and exercise rehabilitationn alone in elderly patients with coronary heart disease(CHD)after percutaneous coronary intervention(PCI).Methods:A total of 150 elderly patients(≥65 years)admitted to our hospital with CHD after primary PCI were enrolled and randomly divided into the group A(conventional drug therapy), group B(conventional drug therapy+ exercise rehabilitation)and group C(conventional drug therapy + exercise rehabilitation+ psychotherapy), with 50 patients in each group.Patients in groups B and C were intervened at two weeks after PCI, once a week for 12 weeks.Changes of Hamilton anxiety scale(HAMD)scores, Hamilton depression scale(HAMA)score, 6 min walking test, left ventricular ejection fraction(LVEF)and metabolic equivalents(METs)were compared among the three groups.Results:Before treatment, the METs were significantly lower in the group B(3.58±0.14)compared with the groups A(3.69±0.18)and C(3.68±0.15), and were similar between groups A and C. After 12 weeks of treatment, compared with the indicators before treatment, the HAMA scores were similar in the group A(12.98±2.51 vs. 12.16±2.91, P>0.05), and were significantly decreased in groups B(12.90±2.12 vs.8.06±2.11, P<0.05)and C(13.03±2.52 vs.6.96±2.13, P<0.05); HAMD scores were all markedly decreased in all three groups(group A: 22.38±2.52 vs.20.87±2.12; group B: 22.58±2.57 vs.17.25±2.32; group C: 22.23±2.35 vs.13.39±2.25), and were decreased most in the group B, followed by groups A and B( P<0.05). Furthermore, the LVEF group A: (49.08±1.59)% vs.(52.15±1.91)%; group B: (48.99±2.11)% vs.(57.56±2.13)%; group C: (49.04±2.02)% vs.(59.92±1.93)%, 6 min walking distance test(m)(group A: 360.78±12.50 vs.370.16±12.41; group B: 359.21±10.54 vs.394.19±15.56; group C: 363.12±15.28 vs.413.29±18.15)and METs(group A: 3.69±0.18 vs.3.91±0.21; group B: 3.58±0.14 vs.4.89±0.09; group C: 3.68±0.15 vs.5.77±0.13)were significantly improved in all groups after the treatment.Among them, group C was improved most, followed by groups B and A(all P<0.05). Conclusions:Exercise rehabilitation combined with psychotherapy is of great significance to improve the physical condition of elderly patients with CHD after PCI, and it is better than the routine exercise rehabilitation alone.

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