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Objective To explore the eff cacy and safety of 6-month and 12-month dual antiplatelet therapy(DAPT)after implantation of biodegradable polymer-drug eluting stents(BP-DES) in elderly patients. Methods This study was a subgroup analysis of the I-LOVE-IT 2 trial, which was a prospectively randomized study enrolling 2737 patients receiving either a BP-SES or a DP-SES in a 2:1 ratio. This studied further divided the patients who were randomized to the BP-SES group,whose age ≥ 65 year old, in a 1:1 ratio to receive a 6-month DAPT (n=319) or 12-month DAPT (n=308)randomly before the index PCI. The primary end point of this study was 12-month target lesion failure (FhF, including cardiac death,target vessel myocardial infarction and clinically indicated target lesion revascularization)and the secondary end points was 12-month net adverse clinical and cerebral events (including all-cause death, all myocardial infarction, stroke and all bleeding). Results Rates of TLF at 12 months were 7.1% in the 6-month DAPT group and 7.2% in the 12-month DAPT group (P=0.980). No diff erences were observed in the occurrence of events in the secondary endpoint at 12 months follow-up between the 6-month DAPT group and 12-months DAPT group(14.1% versus 13.0%, P=0.726). There were no signifi cant diff erences in stent thrombosis or bleeding complications between the 2 groups. Conclusions This study shorted that 6-month DAPT did not increase the risk of TLF at 12 months after implantation of DES in elderly patients compared with 12-month DAPT. Elderly patients are at high risk of bleeding and ischemic events and study show that 6-month DAPT would be adequate. These results need to be confi rmed with trials of scale in the future.
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Objective To investigate influence of dexmedetomidine on postoperative cognitive function in elder patients after hip re-placement surgery under spinal anesthesia. Methods Forty elderly patients with ASAⅠ~Ⅲ,undergoing hip replacement with spinal anesth-sia,were randomly divided into dexmedetomidine group( group A) and normal saline group( group B) ,with 20 patients in each group. Dexme-detomidine was given with 1 μg/kg after anesthesia and followed with 0. 5 μg·kg-1 ·h-1 in group A. The equal volume of normal saline was infused in group B. Cognitive function was evaluated before anesthesia,3 and 7 days after surgery by mini-mental state examination( MMSE) . The intraoperative concentration of TNF-α,IL-6,MDA were detected at the time of before surgery(T0),end of surgery(T1),3 days after sur-gery(T2),7 days after suegery. Results There was no significant difference in MMSE score before anesthesia between the two groups (P>0. 05). The difference of MMSE score at postoperative 3 days between two groups was statistical significance (P0. 05). Compared with T0,the concentration of TNF-α,IL-6,MDA at T1,T2 in group B increased,the difference was significant. And the concentration of IL-6 at T1 in group A decreased,compared with that at T0,the difference was significant(P<0. 05). The concentra-tion of TNF-α,IL-6 at T1,T2 and MDA at T2 in group A were lower than those in group B,the difference was significant. (P<0. 05). Con-clusion Dexmedetomidine can decreased the concentration of TNF-α,IL-6,MDA,and improve the postoperative cognitive dysfunction of eld-erly patients who finished the hip replacement surgery under spinal anesthesia.
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Objective To explore the effect of Shexiang baoxin Pillls on super‐elder patients with myocardial infarction ,and observe and analyze its prognosis .Methods Two hundred super‐elder patients with myocardial infarction were selected in the hos‐pital from December 2013 to November 2014 ,they were randomly divided into control group(n=100) and observation group(n=100) .The control group used conventional drug treatment ,and the observation group treated with Shexiang baoxin pillls on the ba‐sis of the control group .Three months wasr a treatment period .To observe the clinical therapeutic effect ,echocardiography was used to detected the left ventricular wall thickness ,left ventricular end‐diastolic diameter (LVEDD) ,left ventricular ejection fraction (LVEF) before and after treatment .Observed 6 minutes walking distance .Total cholesterol (TC) ,blood lipid ,low density lipopro‐tein (LDL‐C) ,c‐reactive protein (CRP) ,and other indicators were detected .Results The total effective rate of the observation group was [72 .00% (72/100)] was higher than the control group [65 .00% (65/100)] ,P<0 .05 .The re‐hospitalization rate of the observation group was [23 .00% (23/100)] was lower than the control group [34 .00% (34/100)] ,P<0 .05 .The left ventricular posterior wall thickness and LVEDD of the observation group after treatment were(10 .12 ± 0 .40)mm and(49 .11 ± 1 .39)mm , which were lower than the control group after treatment [(11 .06 ± 0 .52)mm and (51 .36 ± 1 .46)mm] ,LVEF (% ) of the observa‐tion group after treatment was (0 .51 ± 0 .12)% ,which was higher than the control group after treatment (0 .47 ± 0 .11)% ,all P<0 .05 .TC ;LDL‐C and CRP of the observation group after treatment were (5 .19 ± 0 .32) mmol/L ,(2 .83 ± 0 .30) mmol/L and (54 . 11 ± 4 .83) mg/L ,they were lower than the control group after treatment [(5 .48 ± 0 .37) mmol/L ,(3 .10 ± 0 .33) mmol/L and (62 . 38 ± 4 .36) mg/L] ,all P<0 .05 .6 min walking distance of the observation group after treatment was (376 .38 ± 19 .41)m ,it was higher than the control group after treatment(331 .04 ± 22 .18)m ,P<0 .05 .The complications of the observing group[38 .00% (38/100)] was lower than the control group after treatment 47 .00% (47/100) ,P<0 .05 .Conclusion There is better clinical effect on super‐elder patients with myocardial infarction by Shexiang baoxin Pillls ,which can reduce hospitalization rates again ,improve left heart function and blood lipid levels ,reduce complications .
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Objective To analyze the clinical characteristics and risk factors of nosocomial infection (NI) in elder patients with cerebral infarction Methods A retrospective study was performed.Three hundred and two patients over 60 years old with cerebral infarction were selected as our subjects,who were in a cadre ward from Jan.2011 to Jun.2013.The incidence rate of NI and the predisposing factors of NI were investigated.Results Of 302 patients with cerebral infarction,46 cases developed NI and the incidence was 15.23％.The most common site of NI was lower respiratory tract infection,counting for 60.87％ (28/46),followed by urinary tract infection(21.74％ (10/46)).The risk factors of NI included age,prolonged hospitalization,disturbance of consciousness,invasive operation and the use of antibiotics (x2 =5.720,11.517,5.185,4.218,11.931 ; P ＜ 0.05).Conclusion The clinical staff should pay close attention to the risk factors of NI in elder patients with cerebral infarction.The methods include controlling the disease as soon as possible,shortening hospital stays,reducing invasive operation and the rational use of antibiotics can reduce the incidence of NI.
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Objective To investigate the influence of sevoflurane and total intravenous anesthesia with propofol on hepatic and renal function in elder patients under gastrectomy .Methods 55 patients between the ages of 60-75 ,ASA physical status class Ⅰor Ⅱ ,scheduled for an elective gastrectomy were randomly divided into two groups .Anesthesia was maintained with sevoflurane 1% -1 .2% and remifentanil (0 .1-0 .2)μg · kg -1 · min-1 in the group S and propofol (1 -2)mg · kg -1 · h-1 and remifentanil (0 .1-0 .2)μg · kg -1 · min-1 in the group T .The hepatic and renal function ,aspartate aminotransferase (AST ) ,alanine amin-otransferase(ALT),bloodureanitrogen(BUN)andcreatinineweretestedatpreoperation(baseline),postoperative1dayand3 days .Results AST was increased at postoperative 1 day and 3 day ,compared with that of the preoperation in the group S and group T .Serum BUN at 3 day and creatinine at 1 day and 3 day were significantly higher from the preoperative values in group S (P0 .05) .There were no significant difference in the AST ,ALT , BUN and creatinine between the groups(P>0 .05) .Conclusion The changes of hepatic and renal effect after inhalation anesthesia with sevoflurane and remifentanil and TIVA with propofol and remifentanil for gastrectomy are clinically insignficant ,and there is no difference between the two methods .
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Objective To explore the effects of amiodarone on rapid ventrile rate atrial fibrillation (Af) in elder patients with acute myocardial infarction (AMI). Methods Besides the injection, an oral amiodarone was given to 96 elder patients,observing the condition of converting and maintaining of atrial fibrillation,ventricular rate controlling, blood pressure changing,mortality in 30 days and negative effects in 96 elder patients with AMI and Af. Results Eighty-two cases (84.4%) restore sinus rhythm, the cardioversion rate is 85.4%(P0.05). Conclusion In AMI, vein plus oral application amiodarone treat the fast ventricular rate is effective and safety for patients with Af.
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ObjectiveTo investigate the effect of Buchangwenxin particles in maximum P wave (Pmax), dispersion of P wave(Pd) of elder patients with diastolic cardiac dysfunction and paroxysmal atrial fibrillation(PAF).Methods115 elder patients with diastolic cardiac dysfunction and PAF were randomly divided into two groups:group A received the routine drug therapy,and group B received Buchangwenbxin particles with routine drug therapy.Another 54 elder patients with diastolic cardiac function but without PAF was selected as control group.Changes in Pmax and Pd were compared between groups with or without PAF as well as subgroups.ResultsPmax and Pd were wider in PAF group than no PAF group(all P ＜0.01).There was no difference between group A and B in Pmax and Pd (all P＞ 0.05), and there were less atrial fibrillation as well as shortened Pmax and Pd in group B, which was significantly different with group A(all P ＜0.01).ConclusionPmax and Pd were wider in elder patients with diastolic cardiac dysfunction and PAF than those without PAF,and Buchangwenxin particles could shorten Pmax and Pd and reduce the attacks of atrial fibrillation.
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65Y) on maintenance hemodialysis at our hospital from Jan 2005 to Oct 2006 was selected.All subjects were divided into two groups according to serum albumin level:group A(ALB0.05);and mortality was higher in group A than in group B(P
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OBJECTIVE To understand the incidence of hospital acquired infection,the risk factors and the distribution of the pathogenic bacteria in elder patients in Cadre Unit and explore the curing measuresMETHODS The clinical data of 784 elder inpatients above 60 years old were retrospectively investigated.RESULTS Among 76 infected inpatients,the rate of infection was 9.7%.The main site of hospital acquired infection weas respiratory tract(47.4%)and urinary tract(21.1%).The main flora was gram-negative bacilli(52.9%)and then gram- positive cocci(30.5%).The risk factors included age,the time of stay in hospital,aggressive procedures,broad- spectrum antibiotic and underlying disease,etc.CONCLUSIONS The elder in-patients were the susceptible population hospital acquired infection.Curing underlying diseases,reducing the risk factors,increasing body immunity are very useful to control hospital acquired infection.
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The secondary mental disorder is one of the complications of senile cerebrovascular disease, the medication is different from generic mental disorder. This article summarized the medication of elder patients with secondary mental disorder.
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@#ObjectiveTo evaluate the two common anesthesia techniques used in the hip joint replacement surgery (HJRS) and provide references to the most reasonable choice for them. MethodsTo undertake a retrospective study on 34 patients that received continuous epidural anesthesia(CEA) or combined intravenous and inhaled anesthesia(CIIA)respectively in HJRS. Results and Conclusions CEA had higher incidence of bone cement reaction than that of CIIA, whereas there was no significant difference in blood loss and the anesthesia efficacy between them. CIIA seemed to be easier to be performed. CIIA sounds more reasonable than CEA in HJRS although both of them are safe anesthesia techniques.
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Objective To investigate the effect of thyroxine on elder patients with chronic heart insufficiency. Methods 82 elder patients with chronic heart insufficiency were divided into 2 groups randomly . 46 cases of observation group and 36 cases of control group. All of them were received routine treatment, including vasodilators, diuresis and cardiotonic etc anti-heart failure ways.The group of observation plus thyroxine (20mg/d oral,for 2 weeks ).Cardiac function degree,heart/lung ratio and change of cardiac ejection fraction(F) were observed before and after treatment. Results The value of EF,increased heart/lung ratio reduced,and function of heart were notably improved,as compared with those of the control group (P
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Objective: To explore The effect of rate responsive pacemaker in old patients with sick sinus symptom on Quality of life.Methods: 96 patients with sick sinus syndrome and atrioventricular block were enrolled and divided into rate responsive pacing-group and non-rate responsive pacing-group,the Quality of life were analyses by means of GQOLI-74.Results: The heart function were no different in the two groups;The daily maximum movement time and distance,Quality of life were improved significantly in rate responsive pacing-group.Conclusion: The implantation of rate responsive pacemaker can improve health-raltaed quality of life,meet with requirement of life in the elderly patients.