Inflammatory granuloma of the trachea: a rare case with Epstin-Barr virus infection / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Epstein-Barr virus (EBV), a double-stranded DNA virus with an envelope, is a ubiquitous pathogen that is prevalent in humans, although most people who contract it do not develop symptoms (Kerr, 2019). While the primary cells EBV attacks are epithelial cells and B lymphocytes, its target range expands to a variety of cell types in immunodeficient hosts. Serological change occurs in 90% of infected patients. Therefore, immunoglobulin M (IgM) and IgG, serologically reactive to viral capsid antigens, are reliable biomarkers for the detection of acute and chronic EBV infections (Cohen, 2000). Symptoms of EBV infection vary according to age and immune status. Young patients with primary infection may present with infectious mononucleosis; there is a typical triad of symptoms including fever, angina, and lymphadenectasis (Houen and Trier, 2021). In immunocompromised patients, response after EBV infection may be atypical, with unexplained fever. The nucleic acid of EBV can be detected to confirm whether high-risk patients are infected (Smets et al., 2000). EBV is also associated with the occurrence of certain tumors (such as lymphoma and nasopharyngeal carcinoma) because it transforms host cells (Shannon-Lowe et al., 2017; Tsao et al., 2017).

Perforation of the esophagus: an overlooked cause of chest pain as a complication of esophageal foreign bodies / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Chest pain is one of the most common complaints in the emergency department. Diseases of the heart, aorta, lungs, esophagus, stomach, mediastinum, pleura, and abdominal viscera can all cause chest discomfort (Gulati et al., 2021; Jiao et al., 2021; Lu et al., 2022). Clinicians in the emergency department are expected to immediately recognize life-threatening chest pain (Jiao et al., 2021). Delayed diagnosis further increases the risk of complications and mortality (Liu et al., 2021). In this case, we present an elderly Chinese female who had a history of myocardial infarction two years previously, with chest pain eventually found to be caused by ingestion of a duck bone.

Latest progress: study on intestinal microecology and sarcopenia / 中华老年医学杂志

Sarcopenia causes significant changes inskeletal muscle mass and function in the elderly, and leads to an increased incidence of related diseases, which has affected the quality of life in the elderly.The causes and mechanisms of sarcopenia are closely related to genetic and innate factors, endocrine disorders, reduced number of muscle fibers, nutritional deficiency, inflammation, immune dysfunction and other factors.This paper systematically describes the progress of studying the effects of intestinal microecology on sarcopenia, so as to provide potential targets for the prevention and treatment of sarcopenia.

Research progress on the correlation between chronic constipation and the gut microbiota in the elderly / 中华老年医学杂志

The specific mechanisms linking chronic constipation and changes in the gut microbiota in the elderly remain unclear.This review analyzes the relationship between chronic constipation and the gut microbiota in the elderly and explores the mechanisms of the gut microbiota in the development of chronic constipation, aiming to provide new insights for novel treatments of chronic constipation in the elderly.

Clinical analysis of 42 elderly patients with pulmonary cryptococcosis / 中华老年医学杂志

Objective:To analyze the clinical features, imaging characteristics, diagnosis and treatment of elderly patients with pulmonary cryptococcosis, and to propose considerations for the early diagnosis and treatment of pulmonary cryptococcosis.Methods:Clinical data of 42 elderly patients with pulmonary cryptococcosis diagnosed at the First Affiliated Hospital of Zhejiang University School of Medicine from January 2015 to September 2020 were retrospectively analyzed.Differences in clinical data were compared between immunocompromised patients and immunocompetent patients by using the SPSS software.Results:The mean age of patients of with pulmonary cryptococcosis was(66.0±5.3)years.Of the cases, 27 were immunocompromised, with common underlying diseases such as autoimmune rheumatic disorders, tumors and chronic kidney disease.Main clinical manifestations were cough, sputum expectoration, fever and chest tightness.Twenty-two cases showed nodules on chest CT scans, most of which contained multiple nodules.Twenty-four cases showed unilateral lesions, mainly in the lower lobe.There was no significant difference in clinical manifestations, lesion types or location distribution between the immunocompromised and immunocompetent groups( P>0.05), while the incidence of air bronchograms was higher in the immunocompetent group than in the immunocompromised group( P<0.05). Seventeen cases were diagnosed by histopathology, and the clinical diagnosis of 25 cases was confirmed by the positive detection of capsular polysaccharide antigens.Nine cases were treated surgically, 1 case underwent clinical observation postoperatively, and 8 cases were treated with fluconazole after surgery.Thirty-three cases were treated with antifungal therapy, 6 of whom were treated with a combination of drugs.Eight cases were lost to follow-up, 29 were cured or improved, 2 progressed, and 3 died. Conclusions:Pulmonary cryptococcosis in the elderly is more common in immunocompromised patients, with atypical clinical symptoms and a high rate of misdiagnosis.Cryptococcal capsular polysaccharide antigen testing is helpful for early diagnosis, and treatment plans need to be chosen and adjusted according to the patient's immune status and specific conditions.

Research progress on the correlation between chronic obstructive pulmonary disease and sarcopenia / 中华老年医学杂志

As the population ages, the incidences of age-related diseases such as chronic obstructive pulmonary disease(COPD)and sarcopenia are on the rise.A growing number of studies have found that there is a close relationship between COPD and sarcopenia.Quadriceps weakness, atrophy, and fiber type conversion of skeletal muscles are common in patients with COPD.At the same time, respiratory muscles also have adaptive changes, resulting in limited mobility, decreased quality of life and increased hospitalization rates and mortality.However, mechanisms underlying the interaction between COPD and sarcopenia have not been fully illuminated.Moreover, clinicians usually fail to make early identification and start intervention for COPD-related skeletal muscle dysfunction.This article reviews progress on the epidemiology, mechanisms linking the two conditions and treatment of COPD-related sarcopenia as a reference for clinical practice.

Effects of enteral nutrition preparations on glucose and lipid metabolism in elderly diabetic patients / 中华老年医学杂志

Objective To investigate the effects of enteral nutritional emulsions on glucose and lipid metabolism in elderly patients with diabetes. Methods This randomized controlled trail recruited 80 elderly diabetic patients whose MNA-SF scores were between 0-11 with dysphagia or inability for oral feeding and who were randomized into a TPF-DM group ,a TPF-D group ,a TPF-T group ,and a TPF group.Glycolipid metabolism indexes and nutritional indexes were measured before intervention and at 1 m ,2 m and 3 m after intervention. Results Compared with baseline levels , FBG and HbA1c declined in the TPF-DM group[(5.70 ± 0.69)mmol/L vs .(7.90 ± 1.71)mmol/L and (6.39 ± 1.11)% vs .(7.92 ± 1.50)%,all P＜0.05]and the TPF-D group[(5.72 ± 1.12)mmol/L vs . (7.63 ± 1.73 )mmol/L and (6.86 ± 0.97 )% vs .(7.81 ± 1.04 )%,all P＜ 0.05 ]after 3 months of treatment ,but no significant difference was found between these two groups. The TPF-DM ,TPF-D , TPF-T groups showed significantly narrower fluctuation ranges of 24 h blood glucose levels after 3 months[(2.20 ± 0.88)mmol/L vs .(4.43 ± 2.07)mmol/L ,(2.94 ± 1.16)mmol/L vs .(4.22 ± 1.60) mmol/L ,(3.21 ± 1.64)mmol/L vs .(4.36 ± 1.88)mmol/L ,all P ＜ 0.05).Serum albumin levels increased in all four groups ,compared with baseline levels (all P＜0.05) ,but there was no significant difference between the groups(all P＞0.05). Furthermore ,the serum HDLC level increased in all four groups than baseline (all P＜ 0.05). Conclusions Enteral nutritional emulsions containing slow release starch and fructose ,dietary fibers and proper ω6 and ω3 ratio can stabilize blood sugar ,regulate blood lipids ,and improve nutritional status.

Research advances in muscle stem cells and sarcopenia / 中华老年医学杂志

Sarcopenia is characterized by a loss of skeletal muscle mass and a decrease in muscle strength and function.The major etiological factors of sarcopenia include lack of exercise,decline of neuromuscular function,malnutrition and so on.Sarcopenia is associated with decreased numbers and function of muscle stem cells(also known as satellite cells).Muscle stem cells have a strong ability of self-renewal,with multi-potency,immune privilege,and antioxidant and anti-inflammatory properties, and are capable of promoting skeletal muscle regeneration.The mechanisms underlying cell proliferation,differentiation and self-renewal of satellite cells are not clear,but the number and activity of satellite cells are related to sarcopenia.Satellite cells work together with a variety of proliferation and differentiation factors to regulate muscle cell formation and muscle repair.Especially noteworthy is that p38α binds to a large number of myogenic gene promoters to regulate the proliferation and differentiation of satellite cells.In animal experiments,muscle stem cell therapy has shown regeneration and repair of muscle cells.Studies on changes at the molecular and gene levels in muscle fibers and their environment will be of great significance for the prevention and treatment of muscular disorders in the elderly.

Research progress of treatments on colorectal cancer in elderly patients / 中华老年医学杂志

The patients aged ≥ 60 years account for 70％ of Chinese population with colorectal cancer.However,with the increase of age,the treatment methods such as surgery,radiotherapy,chemotherapy become inappropriate and impeding factors for the self-care of the elderly.Several clinical trials show that only a part of the elderly,who are in good health condition,can get the clinical benefits from these therapies.Therefore,this review focused on the comprehensive treatments for elderly patients with colorectal cancer,then reached the best individualized treatment,so as to improve the survival and quality of life.

Research progress of treatments on colorectal cancer in elderly patients / 中华老年医学杂志

The patients aged ≥ 60 years account for 70％ of Chinese population with colorectal cancer.However,with the increase of age,the treatment methods such as surgery,radiotherapy,chemotherapy become inappropriate and impeding factors for the self-care of the elderly.Several clinical trials show that only a part of the elderly,who are in good health condition,can get the clinical benefits from these therapies.Therefore,this review focused on the comprehensive treatments for elderly patients with colorectal cancer,then reached the best individualized treatment,so as to improve the survival and quality of life.

Study on the changes in intestinal phylum firmicutes in elderly patients with type 2 diabetes / 中华老年医学杂志

Objectives To compare the differences in intestinal phylum firmicutes between elderly patients with type 2 diabetes (T2DM)and the healthy elder people.Methods 37 elderly patients with T2DM and 69 healthy controls in Shaoxin city were recruited.DNA of phylum firmicutes from fecal samples was extracted.The real-time quantitative PCR was used with special primers for bacterial genus including Faecalibacterium prausnitzii,Eubacterium rectale,Clostridium leptum,and Peptostrepyococc.The differences in content of different bacteria between two groups were analyzed and compared.Results In healthy elderly group versus the elder patient with T2DM,the contents of intestinal phylum firmicutes were[(6.22±1.41) × 107 versus(5.41± 1.40) × 107,t=2.83,P=0.006] in Eubacterium rectale,[(7.46 ± 0.98) × 107 versus (6.96 ± 1.40) × 107),t =2.13,P =0.036] in Faecali bacterium prausnitzii,[(7.89±0.89) × 107 versus(7.46±1.11) × 107,t=2.15,P=0.034]in Clostridium leptum,and[(4.86 ± 1.33) × 107 versus (4.21 ± 1.24) × 107,t=2.45,P =0.016] in Peptostrepyococc,which showed that the contents of intestinal phylum firmicutes were less in T2DM group than in healthy elderly group.Conclusions There are some differences in intestinal flora between the elderly patients with T2DM and healthy people.These intestinal flora may play an important role in the development of T2DM.This study may provide new evidences for probiotic treatment of T2DM.

The relationship between hyperuricemia and senile diseases / 中华老年医学杂志

Uric acid is the end product of metabolism of purine which is synthesized in the body and from food.It is also an antioxidant in the body,and closely related to the bone,cardiovascular system,endocrine system,respiratory system,nervous system,urinary system,ophthalmology and otorhinolaryngology especially in the elderly.Therefore,more attentions should be paid to the relationship between hyperuricemia and senile diseases.Early screening and treatment of hyperuricemia might enable an improvement of the quality of life and even an extension of the life of older people.

Study on the changes in muscle mass in elderly people of different ages in Hangzhou / 中华老年医学杂志

Objective To investigate the changing characteristics of muscle mass by dual energy X-ray absorptiometry (DEXA) in middle aged and elderly people with different ages.Methods This study included 343 healthy people aged 50-89 years (178 males and 165 females).Subjects were divided into 4 groups:aged 50-59,60-69,70-79,and 80-89 years group.Fat-free body mass (FFM),the appendicular lean body mass (aLM),trunk lean mass (tLM) were measured by DEXA.The aLM/body weight (Wt％) and aLM index (ASMI) were calculated by DEXA.Results The tLM in both gender was decreased in aged 80-89 years group than in aged 50-59 years group [male (10.6± 1.8) kg vs.(18.4±2.9) kg,female (7.1±1.2) kg vs.(14.8±2.1) kg,F=5.7 and 7.8,P＜ 0.01].The average ASMI in both gender was decreased in aged 70-79 and 80-89 years groups than in aged 50-59 years groups [male (5.5±0.4) kg/m2,(4.9±0.7) kg/m2 vs.(6.1±0.5) kg/m2,female (4.3±0.4) kg/m2,(3.9±0.5) kg/m2 vs.(4.8±0.6) kg/m2,F=24.9 and 9.6,both P＜0.01].The quality of muscle mass was decreased with aging in the elderly.Conclusions Ageing is an important risk factor for sarcopenia in the elderly.DEXA can be used to evaluate the muscle mass in middle aged and the elderly,and ASMI can be used as a reliable measurement index.

Relationship between the prothrombotic state and leukoaraiosis in elderly patients with metabolic syndrome / 中华老年医学杂志

Objective To investigate the relationship between the prothrombotic state and leukoaraiosis(LA)in elderly patients with metabolic syndrome.Methods A total of 350 metabolic syndrome patients in the affiliated hospital of Zhejiang University who received treatment from January 2013 to January 2015.According to the results of head MRI,patients were divided into LA group(n=203)and non-LA group(n=147).The severity of LA was graded by its MRI appearance and the Blennow scale.The plasma levels of fibrinogen (Fib),prothrombin time (PT),thrombin time (TT),activated partial blood coagulation time(APTT),D-dimer (D-D) and yon willebrand factor (vWF) were measured and compared between the two groups.Results The levels of Fib,vWF and D-D were higher in LA group than in non-LA group(all P＜0.05).Spearman correlation analysis showed that the severity of leukoaraiosis was positively correlated with Fib,vWF and D-D(r=0.014,0.089,0.215,respectively,all P ＜ 0.05).Multivariate linear regression analysis showed that Fib,course of hypertension,vWF and HbA1c were the main influencing factors with the standardized regression coefficient of 2.516,0.312,0.206 and 0.167 respectively for leukoaraiosis in elderly patients with metabolic syndrome.Conclusions The course of hypertension and HbAlc level are positively related with LA.The prothrombotic state markers including Fib and vWF can be considered as the predictors for LA severity in elderly patients with metabolic syndrome.

Gliquidone versus metformin: differential effects on aorta in streptozotocin induced diabetic rats / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Diabetic cardiovascular complication is a major cause of mortality in type 2 diabetic patients. Hyperglycemia markedly increases the risk of cardiovascular disease. Endothelial dysfunction is common in type 2 diabetes mellitus (DM) and is an early indicator of diabetic vascular disease. Therefore, it is necessary to identify the effect of different hypoglycemic agents on vascular endothelium. The aim of the study was to examine and compare the effects of metformin and gliquidone on atherosclerotic lesions in streptozotocin-induced diabetic rats.</p><p><b>METHODS</b>Forty male Sprague-Dawley rats (age, 8 weeks; weight, 180-200 g) were included in this study and fed with a normal chow diet for 1 week. Rats (n = 10) served as the normal control group (NC group) were fed with a normal chow for another 2 weeks and received an injection of saline. The rest 30 rats fed with a high-fat diet for 2 weeks and injected streptozotocin were randomly assigned to three groups (n = 10 rats per group) as follow: type 2 DM group (DM group), DM + gliquidone group (GLI group) and DM + metformin group (MET group). Five weeks later, all rats were fasted overnight and taken tail blood samples for biochemical determinations. Then rats in the NC and DM groups were administrated with normal saline, while rats in the MET and GLI groups were administrated with metformin (100 mg/kg) or gliquidone (10 mg/kg), respectively. All medicines were given via intragastric administration for 8 weeks. After 16 weeks, plasma triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) were measured. The aortic arch was isolated from diabetic rats and was assessed by pathological sectioning using H&E staining.</p><p><b>RESULTS</b>Metformin treatment prevented weight gain ((315.80 ± 52.16) g vs. (318.70 ± 68.48) g, P = 0.773), improved plasma TG, HDL-C and LDL-C levels (P = 0.006, 0.003, 0.001, respectively, all P < 0.05). However, gliquidone showed no significant effects on plasma TG and TC levels (P = 0.819, 0.053, respectively). LDL-C and HDL-C in the GLI group changed ((0.46 ± 0.10) mmol/L vs. (0.36 ± 0.14) mmol/L, P = 0.007; (0.99 ± 0.27) mmol/L vs. (1.11 ± 0.18) mmol/L, P = 0.049). Both metformin and gliquidone treatment lowered blood glucose levels (P = 0.001, 0.004, respectively, P < 0.05). Under light microscopy, no changes were observed in the aortic wall structure of each layer; the intima was smooth and the membrane elastic fibers were normal in the NC group. In the DM group, the aortic wall structure was unclear, the intima was thickened with irregular intima, and membrane elastic fibers collapsed. The aortic intima in the MET and GLI groups was smoother compared with the DM group, but the endothelial structure of the MET group was closer to that of the NC group.</p><p><b>CONCLUSIONS</b>Both metformin and gliquidone have anti-atherosclerotic effects. But the endothelial structure of the MET group was closer to that of the NC group. Metformin and gliquidone therapy can reduce serum level of LDL-C and increase level of HDL-C, whereas gliquidone therapy did not lose weight and decrease serum level of TG. These data may have important implications for the treatment of patients with type 2 DM.</p>

Effects of and Smeton on inflammatory mediator levels and therapeutic outcomes in elderly patients with chronic obstructive pulmonary disease / 中华老年医学杂志

Objective To compare the effects of and Smeton on inflammatory mediator levels and therapeutic outcomes in elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods Ninety AECOPD patients hospitalized at our department from June 2012 to June 2013 were selected and randomly divided into the group and the Smeton group.In addition to routine therapy,such as anti-infection medication and water & electrolyte balance maintenance,for both groups,patients in the group were given a single 10 mg oral dose of,taken at night before bedtime,while patients in the Smeton group were given 2 pills of a compounding formulation containing,three times a day,for two months.Changes in plasma inflammatory mediator levels before and after treatment and therapeutic outcomes were monitored.Results Highsensitivity C-reactive protein (hs-CRP) levels decreased and interleukin-10 (IL-10) levels increased two months after treatment,compared with pretreatment levels [hs-CRP,(4.01±0.69) mg/L vs.(15.23±4.39) mg/L,and IL-10,(19.44±6.35) g/L vs.(7.86±3.24) g/L,for the group; hsCRP,(7.09±1.70) mg/L vs.(7.86±3.24) g/L,andIL-10,(11.6±3.2 g/L vs.6.7±2.8 g/L),for the Smeton group; P＜0.05 or 0.01].The magnitude of increases or decreases in inflammatory mediator levels was greater in the group than in the Smeton group (P＜0.05 for both),and the overall effectiveness rate was higher in the Smeton group than in the group (95.6％ vs.82.2％,x2 =4.05,P ＜0.05).Conclusions When used for treatment of patients with AECOPD,ontelukast has more beneficial effects on inflammatory mediator levels,whereas is more effective in clinical symptom improvement.

Initial investigation of magnetic resonance perfusion-weighted imaging in leukoaraiosis / 中华老年医学杂志

Objective To investigate whether perfusion-weighted imaging (PWI) can be used to evaluate blood perfusion of patients with leukoaraiosis (LA), its relationship to clinical features, and the therapy effect of LA. Methods The 44 patients with LA were recruited in the study. All the subjects were examined with both conventional and dynamic susceptibility contrast-enhanced perfusion MR imaging, 13 of them repeated the examinations after the treatment. The shapes and sizes of the biggest lesions in each patient were confirmed by conventional MR imaging, then the values of relative cerebral blood volume (rCBV), relative cerebral blood flow (rCBF) and relative mean transit time (rMTT) in each lesion were calculated respectively. Furtherly, a Pearson's correlation analysis was performed to show whether these values were correlated with mini-mental state examination (MMSE)scores or activities of daily living (ADL) scores. Results The 44 lesions of all the subjects showed significant decreases in rCBV (0. 797 ± 0. 160) and rCBF (0. 779± 0. 164) but increase in rMTT (1. 029±0. 073). There were positive correlations between rCBV and MMSE (r = 0. 524, P =0. 000), between rCBV and ADL (r=0. 621, P=0. 000), between rCBF and MMSE (r=0. 555, P=0. 000), and between rCBF and ADL (r= 0. 690, P= 0. 000), and negative correlations between rMTTand MMSE (r=-0.307, P=0.043), and between rMTT and ADL (r=-0.434, P=0. 003). The blood perfusion was enhanced in 10 out of 13 patients who received the repeated examinations after the treatment, most of whom showed the improvement of clinical symptoms.Conclusions Perfusion MR imaging can assess hemodynamic alterations in LA, which could reflect the clinical symptoms. Moreover, the changes of blood perfusions can be used to evaluate and monitor the therapy effect of LA.

Comparison of changes of intestinal microecology between different age groups in the healthy people / 中华老年医学杂志

Objective To analyze the diversity of intestinal microecology in different healthy age groups and explore the relationship between age and the composition of intestinal microflora.MethodsFecal samples were collected from the children,adult and elderly groups.The main intestinal microflora were cultured and quantified,and the qualitative and quantitative changes in the level of category were determined by fluorescence quantitative PCR.The Bifidobacteria/Enterobacteriaceae (B/E) ratio reflexing intestinal colonization resistance was also calculated.Results The germiculture of fecal samples indicated that the counts of Bifidobacteria and Lactobacillus (P＜0.01 and P＜0.05,respectively) were significantly lower in the adult and aged groups than in children group.The number of Bacteriodes and Enterobacteriaceae in the elderly group were higher than in the children and the adult groups (all P＜0.01).The counts of Enterococcus were increased in the adult and the aged groups (P＜0.05 and P＜0.01) compared with the children group,and were higher in the aged group than in the adult group (P＜0.05).The B/E ratio was significantly decreased in the aged group (0.88-±-0.13) as compared with the children (1.15±0.15) and the adult groups ( 1.01± 0.20) ( both P ＜ 0.01).The diversities of Bifidobacteria,Bacteriodes,Enterobacteriaceae and B/E ratio by fluorescent quantification PCR were consistent with the results by germiculture technology.The diversity of Lactobacillus (P＜0.01) between the children and the aged groups as well as between the children group and the adult group significantly improved (P＜0.01 and P＜0.05 ) in PCR compared with the germiculture technology. ConclusionsThe numbers of intestinal Bifidobacterium and Lactobacillus are decreased with lower colonization resistance,while the numbers of Bacteriodes,Enterobacteriaceae and Enterococcus are increased with aging.

The effect of atorvastatin on lowering lipids in elderly patients with type 2 diabetic mellitus plus hyperlipidemia / 中华老年医学杂志

Objective To observe the effect of atorvastatin on lowering blood lipid in patients with type 2 diabetic mellitus plus hyperlipidemia. Methods All patients took 10 mg atorvastatin every night for 12 months. The levels of total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), serum alanine aminotransferase (ALT), aspartate aminotransferase fAST), fasting blood glucose (FBG), creatinine (Cr), intima media thickness (IMT) of carotid artery (CA), common lilac artery (CIA) and femoral artery (CFA) were examined before and 3, 6, 9, 12 months after the treatment. Results TC [(5.11±0.94) vs. (4.46±0.98) mmol/L, P<0.01] and LDL-C [(3.01±0.78) vs. (2.55± 0.83) mmol/L, P<0. 01] were significantly decreased one year after the treatment. At different detection time points, the levels of LDL-C all reached the therapy standard (<2.59 mmol/L). But TC reached the therapy standard (<4.04 mmol/L) only at nine months after the treatment. IMT of CA, CIA and CFA were at the decreased tendency (P>0. 05). No significant changes were observed in ALT, AST and Cr. Conclusions Atorvastatin may significantly decreased the level of blood lipid with little adverse effect in elderly patients with type 2 diabetic mellitus plus hyperlipidemia, and it also has the effect of protecting the vascular intima.

Effects of gastrodin injection on blood pressure and vasoactive substances in treatment of old patients with refractory hypertension: a randomized controlled trial / 中西医结合学报

OBJECTIVE: To examine and determine the contents of endothelin (ET) and nitric oxide (NO) in plasma, and to observe the effects of gastrodin injection on blood pressure, ET and NO levels in old patients with refractory hypertension. METHODS: A total of 63 old patients with refractory hypertension, 30 patients with common hypertension and 30 healthy people were included. The contents of ET and NO in plasma of patients in different groups and healthy people were examined and analyzed. The old patients with refractory hypertension were randomly divided into two groups: gastrodin-treated and routine treatment groups. Besides conventional hypotensive drugs, intravenous drip infusion of 1 000 mg gastrodin was administered to the patients in gastrodin-treated group for two courses (4 weeks), while the patients in routine treatment group were treated only with conventional hypotensive drugs. The changes of blood pressure, ET and NO levels before and after treatment in different groups were measured. RESULTS: The plasma level of ET in refractory hypertension group was higher than that in common hypertension group (t=3.27, P=0.008), while the level of NO was lower (t=-3.81, P=0.002). The systolic pressure and pulse pressure difference in gastrodin-treated group were decreased significantly after one course of treatment (t=1.85, P=0.03; t=1.74, P=0.04). The level of ET in gastrodin-treated group decreased gradually after treatment, but there were no significant difference between before treatment and two courses of treatment, while the level of NO in gastrodin-treated group was increased after treatment (t=-2.70; P=0.04). CONCLUSION: Gastrodin injection is beneficial to old patients with refractory hypertension, and can improve the balance of ET and NO levels in plasma.