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Objective:To investigate the correlation between serum lipoprotein (a) [LP(a)] and the severity of white matter hyperintensities (WMHs) in the middle-aged and elderly people in the community.Methods:Consecutive middle-aged and elderly residents residing in the community underwent physical examinations in the Affiliated Jiangning Hospital of Nanjing Medical University from June 2016 to August 2021 were retrospectively collected. Fasting venous blood was collected on the next day of admission to detect the level of Lp(a). During hospitalization, cranial MRI examination was performed and the severity of WMHs was graded using the Fazekas visual scoring method. Ordinal multivariate logistic regression analysis was used to determine independent related factors for the severity of WMHs.Results:A total of 1 752 patients were included in the analysis. There were 969 males (55.31%) and 783 females (44.69%). Their age was 66.18±10.32 years old. There were 1 167 patients (66.61%) in the mild WMHs group, 407 (23.23%) in the moderate WMHs group, and 178 (10.16%) in the severe WMHs group. Ordinal multivariable logistic regression analysis showed that after adjusting for confounding factors, a higher serum Lp(a) level was independently related to the severity of WMHs (with the first quartile as a reference, the third quartile: odds ratio 1.441, 95% confidence interval 1.050-1.976, P=0.023; the fourth quartile: odds ratio 1.717, 95% confidence interval 1.252-2.354, P=0.001). Conclusion:Serum Lp(a) is independently correlated with the severity of WMHs.
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Objective To evaluate the application of Addenbrooke′s cognitive examination revised(ACE?R)scale to evaluate cognitive function in patients with chronic kidney disease(CKD). Methods We used ACE?R scale to evaluate the cognitive function on 205 cases of CKD patients received outpatient and inpatient treatment in renal Department of four hospitals in Nanjing. One?way ANOVA analysis ,receiver operating characteristic (ROC)curve and other statistical methods were adopted to compare differences. Results (1)There is significant difference of ACE?R scale scores among group NC?NCDs(89.18 ± 4.80),group Mild?NCDs(77.28 ± 5.80)and group Major?NCDs(55.90 ± 10.90)(F = 292.28,P < 0.01). There is significant difference between any two groups(all P<0.01).(2)(ACE?R)scale(AUC=0.944,P<0.01)showed significantly higher sensitivity than mini?mental state examination(MMSE)scale(AUC = 0.777,P < 0.01)on identifying Mild?NCDs patients with chronic kidney disease(P < 0.01);(3)The optimal cut?off value of total ACE?R score between group NC?NCDs and group Mild?NCDs was 83/84,(sensitivity 88.00%,specificity 85.90%,Youden index 0.739),the optimal cut?off value between group Mild?NCDs and group Major?NCDs was 83/84(sensitivity 89.70%,specificity 96.10%, Youden index 0.858). Conclusion ACE?R possesses a good ability in distinguishing different severity of cognitive impairment in patients with CKD. ACE?R can effectively identify early mild cognitive impairment ,which is suitable for clinical application as a tool to evaluating and studying of cognitive function in patients with CKD.
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Objective To discuss the function of respiratory exerciser tri‐ball in pulmonary rehabilitation (PR) patients with chronic obstructive pulmonary disease(COPD) .Methods Prospectie case‐control study was used in COPD patients ,the patients were randomly divided into three groups ,60 COPD patients (group A) using respiratory exerciser TRI‐BALL ,58 COPD patients (group B) using traditional pursed lips ventral breathing training ,and 58 COPD patients(group C) using general internal medicine treatment .Results Group A :compared with before breath training ,the increases of FEV1/FEV1 predicted (% ) and MVV/MVV predicted (% ) and the decrease of quality of life score (QOL) were statistically significant after breath training (P0 .05) .Group B :compared with before breath training ,the decrease of QOL was statistically significant (P0 .05) .Compared with control group after breath training ,the increases of FEV1/FEV1 predicted (% ) and MVV/MVV predicted (% ) and the decrease of quality of life score (QOL) were statistically significant in group A (P0 .05) .Compared the changes of pulmonary function test(PFT) index and QOL between group A and B ,the increments of FEV1/FEV1 predicted (% ) and MVV/MVV predicted (% ) were statistically significant in group A(P0 .05) .Conclusion It is useful to improve the pulmonary function and quality of life in patients with COPD using respiratory exerciser tri‐ball .It is more effective than traditional pursed lips ventral breathing training ,due to the equipment is very small ,cheap ,easy to quantify training and convenient for household use ,it is worth to be popularized in primary hospital .
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Objective:To explore diagnostic value of nocturnal ST-T changes in 24h dynamic electrocardiogram (DCG)for coronary heart disease (CHD)and its clinical significance.Methods:A total of 103 cases,who showed ST-T changes in 24h DCG,received selective coronary angiography (CAG).Among them,the 56 patients with in-termittent nighttime significant ST-T changes were regarded as research group,while the other 47 patients with per-sistent ST-T changes were treated as control group.CAG results were compared and analyzed between two groups. Results:Compared with control group,there were significant rise in CAG positive rate (31.9% vs.67.9%),inci-dence rates of dyspnea and chest pain (27.7% vs.66.1%),hypertension (48.9% vs.71.4%),hyperlipidemia (31.9% vs.42.9%)and diabetes mellitus (17.0% vs.46.4%),percentages of lesions in left anterior descending artery (LAD,21.3% vs.57.1%),left circumflex coronary artery (LCX,14.8% vs.37.5%)and right coronary artery (RCA,12.8% vs.35.7%)in research group,P <0.05 or <0.01. Conclusion:Nocturnal ST-T signifieantly changes in 24h DCG,it possesses more diagnostic value for CHD,which can be regarded as a more sensitive index diagnosing myocardial ischemia.