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Objective To investigate the influencing factors of cognitive dysfunction in elderly patients with hypertension.Methods From October 2015 to October 2016,one hundred and fifty-one elderly hypertensive patients treated in the Affiliated Hospital of North China University of Science and Technologywere selected as the observation group,and 151 healthy subjects in the same period were enrolled in the control group.The blood pressure measurement and cognitive function evaluation were given to analyze the influencing factors of elderly hypertensive patients with cognitive dysfunction.Results Diastolic pressure ((98.5 ±4.2) mmHg),systolic pressure ((157.6 ± 8.9) mmHg),pulse pressure ((59.1 ± 4.3) mmHg) and cognitive impairment rate(27.2％) in observation group were higher than those in the control group((82.7±3.6 mmHg,(122.4± 6.8) mmHg,(39.7 ± 2.5) mmHg,0.0％),the differences were statistically significant (t =4.951,5.868,8.128,P＜ 0.05).The language fluency ((2.5 ± 0.2) points),memory ability ((2.7 ± 0.4) points),visual spatial executive ability ((2.9±0.2) points),naming ability ((2.6±0.1 points),abstract generalization ability ((1.7±0.2) points),orientation ability ((5.0 ± 0.4) points),attention and calculation ability ((5.1 ±0.3) points),total score ((22.5±0.8) points)in observation group were lower than those in the control group ((2.8±0.1) points,(4.8 ± 0.2) points,(4.7 ± 0.3) points,(2.8 ± 0.2) points,(1.9 ± 0.1) points,(5.7 ±0.1) points,(5.7±0.2) points,(28.4±0.6) points) (t=4.202,10.778,9.206,3.769,4.173,4.405,4.278,5.727,P＜0.05).Diastolic pressure ((103.7 ± 2.5)mmHg),systolic pressure ((164.8 ±4.1) mmHg),pulse pressure((64.5± 1.6) mmHg)in patients with cognitive dysfunction were higher than those in patients without cognitive dysfunction ((92.6±2.8) mmHg,(145.7±3.9) mmHg,(46.3± 1.5) mmHg) (t =4.195,4.310,6.913,P＜0.05).Age distribution (≤65 years old in 9 cases,＞65 years old in 32 cases),BMI index distribution (≤24 kg/m2 in 11 cases,＞24 kg/m2 in 30 cases) in patients without cognitive dysfunction were better than those in patients with cognitive dysfunction ((≤ 65 yeas old in 64 cases,＞ 65 years old in 46 cases),(≤ 24 kg/m2 in 68 cases,＞ 24 kg/m2 in 42 cases)).The differences were statistically significant (x2 =15.700,14.657,P ＜ 0.05).Multiple linear regression analysis showed that cognitive function in elderly hypertensive patients was related to age,BMI index,diastolic blood pressure and pulse pressure (OR (95％CI):4.265 (2.038 ～ 8.927),3.991 (1.956～8.142),3.294 (1.532 ～ 7.084),3.521 (1.640 ～ 7.561),5 (2.375 ～10.528);P=0.000).Condusion Age,BMI index,diastolic blood pressure,systolic blood pressure,pulse pressure are influencing factors in elderly hypertension patients with cognitive dysfunction.
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Objective To investigate the relationship between mild cognitive impairment and quality of life in hemodialysis patients with diabetic nephropathy.Methods One hundred and twenty-five hemodialysis patients with diabetic nephropathy were selected in Affiliated Hospital of North China University of Science and Technology from December 2014 to December 2016,and were divided into two groups according to mild cognitive impairment,including 73 patients without mild cognitive impairment as control group,and 52 patients with mild cognitive impairment as observation group.Patients received Montreal cognitive assessment scale and kidney disease quality of life scale.Patients received clinical index detection.Results Montreal cognitive assessment scale(visual space and execution(3.0±0.7) points,naming(2.4±0.3) points,attention(4.3±0.7) points,language(2.1±0.4) points,abstraction(1.1±0.2) points,delayed recall(1.6±0.3) points,orientation(5.4±0.5) points) score,kidney disease quality of life scale(physical(70.3±3.5) points,physical constraints due to work and life(14.6±2.8) points,pain(56.4±7.1) points,general health(36.2±3.4) points,emotional status(51.3±2.6) points,social function(52.7±3.4) points,mental status(43.2±3.6) points,emotional constraints due to work and life(41.3±2.8) points,symptoms(73.6±2.1) points,work status(20.3±1.6) points,cognitive function(72.7±1.8) points,nephropathy effect(49.1±3.2) points,sexual function(53.2±4.0) points,burden of nephropathy(21.3±2.6) points,sleep quality(70.1±1.5) points,social quality(43.3±1.9) points,social support(71.2±2.3) points) score in observation group were lower than control group((4.4±0.8) points,(3.0±0.0) points,(5.4±0.5) points,(2.7±0.3) points,(1.8±0.4) points,(3.4±0.6) points,(6.0±0.0) points),((78.6±4.1) points,(25.7±3.6) points,(69.8±4.2) points,(41.0±2.7) points,(58.5±3.0) points,(61.2±3.8) points,(53.4±2.8) points,(46.5±2.4) points,(82.9±3.2) points,(24.2±2.7) points,(81.6±2.3) points,(65.3±4.0) points,(62.8±3.9) points,(35.7±2.8) points,(79.3±2.0) points,(59.7±2.4) points,(82.4±2.6) points)(t=7.667,5.502,5.558,5.857,9.364,14.250,4.112,4.038,10.603,5.321,4.326,4.403,4.613,5.361,4.262,4.315,4.923,4.224,6.265,4.804,6.712,4.316,6.787,4.573,all P<0.05).Conclusion Hemodialysis patients with diabetic nephropathy has mild cognitive impairment,while quality of life is low.
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Objective To investigate clinical effect of mild hypothermia therapy assisted intracranial hematoma evacuation in treatment of cerebral hemorrhage.Methods One hundred and ten patients with cerebral hemorrhage were selected in Affiliated Hospital of North China University of Science and Technology from December 2011 to December 2013,and were randomly divided into two groups.Fifty-five patients treated intracranial hematoma evacuation as control group.Another 55 patients treated mild hypothermia therapy assisted intracranial hematoma evacuation as observation group.Treatment effect was compared between two groups.Results Serum S100β,neuron specific enolization (NSE) enzyme,tumor necrosis factor α (TNF-α),creactive protein(CRP),cognitive function score,daily life ability score,neurological function defect score before and after treatment in control group were (0.82±0.12) μg/L and (0.53±0.09) μg/L,(19.42±2.30) μg/L and (10.36±1.07) μg/L,(3.62±0.57) mg/L and (1.54±0.30) mg/L,(29.43±4.36) g/L and (10.25± 1.07) g/L,(13.42± 1.58) points and (25.03± 1.19) points,(21.45± 3.27) points and (37.92 ± 5.83)points,(13.27± 1.35) points and (4.84 ± 1.08) points,the differences were significant (t =8.471,11.834,17.026,22.539,12.230,10.619,25.531,P ＜ 0.05).Serum S100β,NSE,TNF-α,CRP,cognitive function score,daily life ability score,neurological function defect score before and after treatment in observation group were (0.84±0.13)μg/L and (0.41±0.10) μg/L,(19.48±1.76) μg/L and (8.75±0.84) μg/L,(3.64± ±0.61) mg/Land (1.17±0.29) mg/L,(29.58±3.62) g/L and (6.02±1.18) g/L,(13.29±1.34) points and (27.58± 1.27) points,(21.68±4.02) points and (48.26±7.14) points,(13.46± 1.21) points and (3.57±0.85) points,the differences were significant(t=13.498,16.739,25.728,41.836,13.769,15.857,36.352,P＜0.05).Compared with serum S100β,NSE,TNF-α,CRP,cognitive function score,daily life ability score,neurological function defect score before treatment,there were no difference between two groups (P ＞0.05).Serum S100β,NSE,TNF-α,CRP,neurological function defect score after treatment in observation group were lower than control group(t =5.926,4.839,6.162,10.054,6.714,P＜0.05).Cognitive function score,daily life ability score after treatment in observation group were higher than control group (t =4.008,5.973,P ＜0.05).Postoperative Glasgow prognosis classification in observation group (14 cases of grade Ⅰ,27 cases of grade Ⅱ,11 cases of grade Ⅲ,2 cases of grade Ⅳ,1 case of grade Ⅴ) was better than control group(8 cases of grade Ⅰ,12 cases of grade Ⅱ,23 cases of grade Ⅲ,7 cases of grade Ⅳ,5 cases of grade Ⅴ),the differences were significant between the two groups (Z=17.085,P =0.002).Total effective rate in observation group 94.5％ (52/55) was higher than control group 78.2％ (43/55),the differences were significant between the two groups (Z =6.253,P=0.012).Conclusion Mild hypothermia therapy assisted intracranial hematoma evacuation in treatment of cerebral hemorrhage,can significantly reduce inflammatory factor and S100βlevel,improve neurological function,has significant effect and good prognosis.It is worthy of clinical use.