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Objective : To explore diagnostic value of ankle brachial index (ABI) combined carotid intima‐media thickness (IMT) for CHD in aged patients with DM.Methods :A total of 198 aged DM patients were selected ,including 101 patients complicated with CHD (complicated CHD group ) and 97 non‐CHD patients (pure DM group ).According to number of diseased coronary vessels ,complicated CHD group was further divided into single vessel group (n＝29) ,double vessel group (n＝41) and multi‐vessel group(n＝31).Another 104 healthy aged people were enrolled as healthy control group simultane‐ously.Abnormal ABI rate (percentage of ABI＜0.9) and IMT were measured and compared among all groups .With coro‐nary angiography (CAG) as gold standard ,diagnostic value of single and combined detection of ABI and IMT for CHD were analyzed .Results :Compared with healthy control group ,there were significant rise in abnormal ABI rate (30.7% vs. 53.6% vs.69.3%) and IMT [(0.78 ± 0.46)mmvs.(1.14 ± 0.53)mm vs.(1.46 ± 0.38)mm]in pure DM group and com‐plicated CHD group ,and those of complicated CHD group were significantly higher than those of pure DM group , P＜0.05 or ＜0.01. Compared with single vessel group ,there was significant rise in abnormal ABI rate (51.7% vs.87.1%) in multi‐vessel group , P＝0.003 ;significant rise in IMT [(1.21 ± 0.42)mmvs.(1.42 ± 0.34)mmvs.(1.68 ± 0.36) mm]in double vessel group and multi‐vessel group ,and that of multi‐vessel group was significantly higher than that of double vessel group , P＜0.05 or ＜0.01. Sensitivity and specificity of single detection of ABI＜0.9 was 55.6% and 82.2% respectively in diagnosing CHD ;it′s 59.1% and 71.4% respectively for single detection of thickened IMT ;for combined detection ,sen‐sitivity can reach 84.51%(ABI＜0.9 or thickened IMT) and sensitivity can reach 88.91%(ABI＜0.9 combined thickened IMT).Conclusion :ABI combined IMT possesses high diagnostic value screening CHD in aged DM patients ,which is worth extending.
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Objective To study the clinical characteristics of very elderly patients aged 80 years and over with diabetes mellitus (DM).Methods Clinical data of 95 very elderly patients with diabetes mellitus were retrospectively analyzed.Results Among 95 patients,patients with type 2 diabetes mellitus accounted for 98.9％ (94/95),patients with asymptomatic onset accounted for 35.8％ (34/95).The incidence of acute complications of diabetes mellitus was 11.6 ％ (11/95).Chronic complications of peripheral neuropathy and diabetic nephropathy were more common,and their incidences were 83.2％ (79/95) and 45.3％ (43/95),respectively.The percentage of patients with multiple chronic complications was up to 45.3％ (43/95).The percentage of DM patients combined with hypertension,coronary heart disease,cerebral infarction,hyperlipidemia or cardiac valve calcification was 80.0％ (76/95),48.4％ (46/95),77.9％ (74/95),42.1％ (40/95)and 33.7％ (32/ 95),respectively.There were 29 patients (30.5％) with the simultaneous presence of DM,hypertension,cerebral infarction,coronary heart disease,and hyperlipidemia in a same patient.The proportion of DM patients with low serum albumin was 47.4％ (45/95),and the rate achieving the target low density lipoprotein level was only 35.8％ (34/95).In the treatment,67.4％ (64/95) of patients were treated with oral hypoglycemic agents combined with insulin injection.The incidence of hypoglycemia was 24.2％ (23/95),and 69.6％ (16/23) of them had no self-conscious hypoglycemic symptoms.Conclusions Chronic complications are common in elderly diabetes mellitus patients.The elderly DM patients are prone to have many complications at the same time,with a higher incidence of hypoglycemic value under 3.9 mmol/L and lower rate of hypoglycemic symptoms.
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Objective To investigate the effect and regulation mechanism of mimic ischemia/reperfusion (I/R) cul-ture of human umbilical vein endothelial cells (HUVECs) on levels of tumor necrosis factor(TNF)-αand intercellular adhe-sion molecule (ICAM)-1. Methods HUVECs were randomly divided into four groups:control group (normal media cell cul-ture+control siRNA transfection), mimic I/R+control siRNA transfection group (HUVECs were transfected with control siR-NA, for 48 h ,and then received mimic ischemic media culture for 30 min followed by normal media culture for 4 h), normal culture+p65 siRNA transfection group and mimic I/R+p65 siRNA transfection group. The expression levels of TNF-αand ICAM-1 mRNA and protein were determined by real-time PCR and enzyme linked immunosorbent assay (ELISA), respec-tively. Results The mRNA and supernatant protein levels of TNF-αand ICAM-1 were significantly increased in mimic I/R culture group (4.96±0.16 and 3.33±0.30)μg/L than those of other tree groups (P<0.05). The level of ICAM-1 mRNA was significantly higher in I/R+p65 siRNA transfection group (1.87±0.21)μg/L than that of control group (1.58±0.15) μg/L and normal culture+p65 siRNA transfection group [(1.69±0.21)μg/L, P<0.05]. The levels of TNF-αand ICAM-1proteins were (329.98 ± 12.18) μg/L and (654.74 ± 64.79) μg/L in mimic I/R+control siRNA transfection group, which were significantly higher than those of other three groups (P<0.05). The levels of TNF-αand ICAM-1 proteins were (129.65±22.42)μg/L and (185.76±11.27)μg/L in mimic I/R+p65 siRNA transfection group, which were significantly lower than those of contro group [(183.50±11.77)μg/L and (280.43±13.76)μg/L, P<0.05]. Conclusion The silencing of p65 through transfection of p65 siRNA in HUVECs inhibited mimic I/R-induced mRNA and protein expressions of TNF-αand ICAM-1.
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Objective To explore the relationship between depression and malnutrition in hospitalized aged patients. Methods The mini nutritional assessment (MNA) table and geriatric depression scale (GDS) were used to investigate the nutritional status and depression of 114hospitalized elderly. Results The prevalence of depression was 62.3% (71 patients), the prevalences of malnutrition and latent malnutrition were 43.9% (50 patients) and 41.2% (47patients) respectively. The prevalence of malnutrition and latent malnutrition was higher in depressive patients than in non-depressive patients. After controlling age, number of illnesses, bed-ridden or not and method of nutrition, the nutritional status was negatively correlated with the grade of depression.Conclusions The prevalence of malnutrition in depressive patients is high and is associated with the grade of depression.
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Objective To evaluate mini-nutritional assessment (MNA), short-form ~mini-nutritional assessment ( MNA-SF) and classical nutritional assessment (CNA) in order to assess the nutritional status of aged people. Methods By MNA, MNA-SF and classical nutritional biochemistry markers, the nutritional status of 144 hospitalized elderly was investigated. Results (1) The nutritional status of 144 hospitalized aged people measured by MNA was that the prevalence of malnutrition and risk of malnutrition were 36.1% and 46.5% respectively. By using MNA-SF, the prevalence of malnutrition was 71.5%, and the prevalence of malnutrition ranged from 13.2% to 72.2% when we used classical method. (2) The correlation coefficients of MNA and CNA indexes of BMI, the circumferences of leg and upper arm, TSF, serum albumin, PAB, TG and Hb were 0.204~0.617 (P