Diagnosing value of fasting blood glucose on MODSE caused by pulmonary infection in elderly patients with diabetes / 中华危重病急救医学

Objective To evaluate the clinical value of fasting blood glucose (FBG) in the diagnosis of multiple organ dysfunction syndrome (MODS) caused by pulmonary infection in elderly patients with diabetes. Methods Patients over 65 years old with diabetic pulmonary infection admitted to Department of Cadres Ward of Bethune International Peace Hospital of PLA from July 2015 to December 2016 were enrolled. According to the patient's highest FBG level during pulmonary infection, all patients were divided in two groups. The cases whose FBG ≥8.83 mmol/L were served as suspicious multiple organ dysfunction syndrome in the elderly (MODSE) group, and those had FBG < 8.83 mmol/L were served as suspicious non-MODSE group. The incidence of MODSE in suspicious MODSE group and suspicious non-MODSE group was compared. The receiver operating characteristic curve (ROC) was drawn, and the clinical value of highest FBG in the diagnosis of MODSE caused by pulmonary infection in elderly patients with diabetes was assessed. Results 119 elderly patients with diabetes and pulmonary infection were enrolled in the analysis. All patients were male, with age of 76-105 years with an average of (89.41±4.16) years. Among 119 patients, 55 of them with suspected MODSE, 64 of them with suspected non-MODSE. The incidence of MODSE in suspicious MODSE group was significantly higher than that in suspicious non-MODSE group (78.2% vs. 12.5%), with statistically significant difference (χ2 = 52.108, P = 0.000). The area under the ROC curve of the highest FBG for diagnosis of MODSE was 0.895, and 95% confidence interval (95%CI) was 0.839-0.951 (P < 0.001). When using FBG ≥ 8.83 mmol/L to diagnose MODSE induced by pulmonary infection in elderly patients with diabetes, the sensitivity was 84.3% and the specificity was 82.4%. Conclusion FBG ≥ 8.83 mmol/L, as an indicator reflecting the changes of metabolic function, have a diagnostic value for MODSE caused by pulmonary infection in elderly patients with diabetes.

Evaluation of the early prediction score system for multiple organ dysfunction syndrome in the elderly / 中华全科医师杂志

Objective To evaluate the early prediction score system for multiple organ dysfunction syndrome in the elderly (MODSE) induced by pulmonary infection. Methods A total of 316 patients with pulmonary infection aged over 60 were admitted from 2007 Jun to 2009 Jun. All patients were scored by the early prediction score system for MODSE and then classified as high-risk group and non high-risk group. χ2 test was used to analyze the difference in morbidity of MODSE between high-risk group and non high-risk group. Receiver operating characteristic (ROC) curve was drawn, and the area under the curve, sensitivity and specificity was calculated. Results The morbidity of MODSE in high-risk group was higher than that in non high-risk group(χ2=87.569,P＜0.01).The area under the ROC curve was 0.864(P＜0.01).The sensitivity and specificity of the early prediction score system of MODSE were 84.2% and 72. 1%, respectively. Conclusion The early prediction score system for MODSE can be used to predict MODSE induced by pulmonary infection and to screen for the high risk population.

Study on the scoring system for early predictim of multiple organ dysfunction syndrome induced by pulmonary infection in elderly patients / 中华老年医学杂志

Objective To establish the scoring system for early prediction of multiple organ dysfunction syndrome (MODSE) induced by pulmonary infection in the elderly. Methods A total of 393 inpatients with pulmonary infection, aged 60 years and over, were enrolled in this study and the data of them from January 2001 to December 2006 were analyzed retrospectively. All patients were divided into MODSE group and non-MODSE group. The effects of age, chronic disease and blood test items of healthy examination on the pathogenesis of MODSE were explored. The early prediction indexes which were selected from age, 21 chronic diseases and 15 blood test items of healthy examination were scored to establish the scoring system for early predicting MODSE. Results The age, chronic obstructive pulmonary disease, chronic respiratory failure, pulmonary fibrosis, chronic cardiac insufficiency, cerebrovascular disease, diabetes, chronic renal failure, hemoglobin, albumin,urea nitrogen and fasting blood glucose were selected to establish the scoring system for early predicting MODSE. Conclusions The scoreing system for early predicting MODSE may be used to screen the high risk population of MODSE induced by pulmonary infection, which is valuable in early prediction of MODSE.

Prediction value of the early prediction score system of multiple organ dysfunction syndrome in the elderly / 中华急诊医学杂志

Objective To evaluate the prediction value of the early prediction score system of multiple organ dysfunction syndrome in the elderly (MODSE). Method A total of 393 patients with pulmonary infection, who were above60 years old, were divided into non MODSE(n =224) and MODSE group(n = 169) and were scored by the early prediction score system of MODSE. Independent-samples t Test was used to analyze the difference of forecast score between MODSE and non MODSE group. Receiver operating characteristic (ROC) curve was drawn,and the area under the curve was calculated. The prediction accuracy of scores for MODSE was assessed using sen-sitivity and specificity, and the optimal forecast point for MODSE was found. Results The score of MODSE group was higber than that of non MODSE[(19.38±12.049) vs. (45.78±20.257), P <0.001]. The area under the ROC curve was 0.889 (P <0.001) ond 95% (0.857～0.920). As the value of forecast score was 27.5, the sensitivity of the early prediction score system of MODSE was 82.8 %, the specificity of the early prediction score system of MODSE was 80.3 %. Conclusions The early prediction score system of MODSE is valuable in predic-tion of MODSE, which may be used to forecast MODSE and find the high risk population of MODSE.

Multiple Organ Dysfunction Syndrome after Pulmonary Infection in Elderly: 169 Case Report / 中国康复理论与实践

@#Objective To explore the clinical feature of multiple organ dysfunction syndrome in the elderly (MODSE) induced by pulmonary infection. Methods The clinical sign of 169 cases with MODSE induced by pulmonary infection admitted from January 2001 to September 2006 were reviewed. Results All cases complicated more than one chronic disease. 82.9% cases complicated more than 4 chronic diseases. The first failure organ of MODSE induced by pulmonary infection included lung, heart, kidney or gastrointestinal tract, and the respiratory failure was the most commonly. The incidence of primary failure in organs dysfunction group was significantly higher than those in organs normal function group (P<0.001). Binary Logistic stepwise regression showed that clinical stage of MODSE, renal failure and circulatory failure were the high risk factors for mortality （P＜0.05）. Conclusion Lung or other dysfunction organs is the first failure organ in MODSE induced by pulmonary infection in most cases. Clinical stage of MODSE, renal failure and circulatory failure were the high risk factors for mortality. The mortality of MODSE may be reduced by preventing renal failure and circulatory failure.

Advance in Multiple Organ Dysfunction Syndrome in the elderly(review) / 中国康复理论与实践

@#Multiple organ dysfunction syndrome in the elderly (MODSE) is an important research topic of geriatrics. This article would review the advance of study in MODSE.

Senile hypertension:296 cases report / 中国康复理论与实践

@#: ObjectiveTo explore the clinical features of senile hypertension.MethodsThe clinical manifestations of 296 cases with senile hypertension admitted from January 2001 to September 2004 were analyzed retrospectively.ResultsThere were 16 cases in stage 1 (5.4%), 100 cases in stage 2 (33.8%), 180 cases in stage 3 (60.8%). came on with Hypertension had been found before 60 years old in 143 cases (48.3%), after 60 years old in other 153 cases (51.7%). 63 cases presented systolic hypertension(21.3%), other 233 were mixed type hypertension (78.7%). Comparing the type of senile hypertension came on before 60 years with the type of senile hypertension came on after 60 years, The ratio of different type of senile hypertension was significant difference between the patients who were found to have hypertension before or after 60 years old(χ2=18.87,P<0.01).ConclusionSome of senile hypertension happened in middle age. Most of them were in stage 2～3. The type of senile hypertension was related to pathogenic time.

Effect of kidney and spleen-tonifying and blood flow-promoting traditional Chinese prescription on serum interleukin-6 in rats with senile osteoporosis / 中国组织工程研究

BACKGROUND: In recent years, the effects of cytokines on osteoporosis have Received much attention, and of these cytokines, interleukin-6(IL-6) is considered to play an important role in the regulation of bone absorption.OBJECTIVE: To observe the changes of bone mineral density(BMD) and serum IL-6 rats with in senile osteoporosis after reperfusion with kidney and spleen-tonifying and blood flow-promoting prescription of traditional Chinese medicine.DESIGN: A randomized controlled experimental study based on the experimental animals.SETTING: Second Department of Cadre, Bethune International Peace Hospital of Chinese PLA; department of regimen and rehabilitation in a college of traditional Chinese medicine.MATERIALS: The experiment was conducted in the Center of Experimental Animals, Hubei College of Traditional Chinese Medicine between May and August 2003. Thirty 15-month-old Wistar rats(15 males and 15 females) were provided by the Experimental Animal Center of Tongji Medical College,Huazhong University of Science and Technology.METHODS: According to random number table method, 30 rats were divided into normal control group, pathological control group and traditional Chinese prescription treatment group. Rat models of senile osteoporosis were established in the latter two groups by injection with 2.5 mg/kg dexamethasone given twice a weeks for 6 consecutive weeks. Rats in normal control group and pathological control group were given oral administration of saline,and those in the treatment group were treated with the traditional Chinese prescription. After 6 weeks of treatment, blood samples were obtained from all rats by removing the eyeballs and the serum was separated by centrifugation,followed by truncation of the right hindlimb for dissection of the femoral bone. Serum IL-6 was measured by radioimmunoassay and BMD determined by means of displacement of acetone.MAIN OU TCOME MEASURES: BMD of the femoral bone and serum IL-6 level.RESULTS: The BMD of the pathological control group was significantly lower ( P < 0.01), but the serum IL-6 level was significantly higher( P < 0.01 ) than those of the normal control group. The BMD of the treatment group was significantly higher but serum IL-6 level significantly lower than those of the pathological control group ( P < 0.01 for both comparisons).CONCLUSION: The traditional Chinese prescription can decrease the production of IL-6 and lower serum IL-6 level to reduce the bone loss in senile rats.