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Objective:To evaluate the relationship between preoperative frailty and postoperative cognitive dysfunction (POCD) in elderly patients undergoing non-cardiac surgery.Methods:A total of 336 elderly patients of both sexes, aged≥65 yr, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, with body mass index of 18.6-25.1 kg/m 2, undergoing elective non-cardiac surgery under general anesthesia, were enrolled in the study.Faltering status was assessed with the Clinical Faltering Scale at 1 day before surgery.Mini-Mental State Examination score, Digital Span Test, Digit Symbol Substitution Test, Stroop Color and Word Test, Visual Word Learning Test and Trail Making Test were performed at 1 day before surgery and at 1, 7 and 30 days after surgery.The Z score was used to identify POCD.The patients was divided into non-POCD group and POCD group according to the occurrence of POCD within 30 days after surgery.Logistic regression analysis was used to identify the risk factors for POCD in elderly patients undergoing non-cardiac surgery. Results:The results of logistic regression analysis showed that preoperative frailty and diabetes mellitus were independent risk factors for POCD in elderly patients undergoing non-cardiac surgery ( P<0.05). Conclusion:Preoperative frailty is an independent risk factor for POCD in elderly patients undergoing non-cardiac surgery.
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Objective To investigate the clinical effect of methotrexate combined with dilatation and curettage on the treatment of cesarean section scar pregnancy and the effect on HCG (chorionic gonadotropin). Methods 130 cases with cesarean section scar pregnancy admitted in Taizhou hospital from January 2016 to March 2017 were randomly divided into two groups. The control group wasreceived dilatation and curettage. The study group was given methotrexate combined with dilatation and curettage.The effect and the influence to HCG in the two groups were compared. Results The effective rate in the study group was significantly higher than that in the control group (P<0.05). There was no significant difference in HCG level between the two groups before treatment. The levels of HCG in the study group were significantly lower than that in the control group (P<0.05). Conclusion Methotrexate combined with curettage on the treatment of cesarean scar pregnancy, can improve the therapeutic effect, reduce postoperative bleeding and hospitalization time, reduce the level of HCG.
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Objective To explore the factors influencing the mild cognitive impairment(MCI)in elderly Uyghur patients with diabetes mellitus and their possible interactions.Methods The crosssectional study was undertaken on 510 elderly Uyghur patients with diabetes mellitus.Based on using a variety of neuropsycholological rating scales for evaluating MCI,the patients were divided into the mild cognitive impairment group (n =182,MCI)and the normal cognitive group (n =328,NMCI),and 200 healthy subjects matched by nation,age and gender served as non-diabetes control group.The collecting of relevant medical history,biochemical examination,evaluation of cognitive function and diabetic complication were performed.Risk factors for cognitive function impairment were determined by single factor analysis and multivariate Logistic analysis.The interactions between factors were analyzed by additive effects model.Results Multiple regression analysis showed that the risk factors for cognitive function decline were ageing,long diabetes duration,higher glycated hemoglobin,lacunainfarction,leukoaraiosis,diabetic microangiopathy (P ＜ 0.05 or P ＜ 0.01).Diabetic microangiopathy had an interaction with cerebral small vessel disease(lacunarinfarction,leukoaraiosis),their percentages of effects of responsibility attribution were 69.9％ and 33.8％,and relative risk ratios of renewable energy research laboratory(RERI)were 10.67 and 7.52 respectively.Conclusions Age,diabetic duration,glycosylated hemoglobin,diabetic microangiopathy and cerebral small vessel disease may be the main risk factors for cognitive dysfunction.Diabetic microangiopathy has a positive interaction with lacunarinfarction and leukoaraiosis in elderly Uyghur type 2 diabetes mellitus with mild cognitive impairment.
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Objective To identify the risk factors for postoperative cognitive dysfunction (POCD).in the elderly patients requiring general anesthesia.Methods Three hundred elderly patients,aged 65-80 yr,scheduled for thoracic or abdominal surgery under general anesthesia,were enrolled in this study.Cognitive function was assessed by Mini-Mental State Examination (MMSE) at 1 day before operation and 3 days after operation.The patients were diagnosed as having POCD if MMSE ＜ 21.The patients were assigned into POCD and non-POCD group.The general data,fasting plasma glucose,glycosylated hemoglobin (HbAlc) and blood pressure were measured.If there was no significant difference between the 2 groups,the factor was analyzed using logistic regression to select the risk factor for the incidence of POCD.Results Ninety-eight patients developed POCD (32.7 ％).Logistic regression model showed that older age,diabetes and hypertension were independent risk factors for POCD (P ＜ 0.05).Conclusion Older age,diabetes and hypertension are independent risk factors for POCD in the elderly patients requiring general anesthesia.
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In the light of such basic concepts as yin-yang, Sanjiao, five elements, and eight trigrams in TCM, the left forearm is selected as the treatment area to enhance treatment results. This method is extensively accepted by both doctors and patients.