A nomogram for predicting mild cognitive impairment in older adults with hypertension.

BACKGROUND: Hyper- and hypotension increase the risk of cognitive dysfunction. As effective control of blood pressure can reduce the risk of mild cognitive impairment (MCI), early risk assessment is necessary to identify MCI in senile hypertension as soon as possible and reduce the risk of developing dementia. No perfect risk-prediction model or nomogram has been developed to evaluate the risk of MCI in older adults with hypertension. We aimed to develop a nomogram model for predicting MCI in older patients with hypertension. METHODS: We selected 345 older patients with hypertension in Xixiangtang District, Nanning City, as the modeling group and divided into the MCI (n = 197) and non-MCI groups (n = 148). Comparing the general conditions, lifestyle, disease factors, psychosocial and other indicators. Logistic regression was used to analyze risk factors for MCI in older hypertensive patients, and R Programming Language was used to draw the nomogram. We selected 146 older patients with hypertension in Qingxiu District, Nanning City, as the verification group. The effectiveness and discrimination ability of the nomogram was evaluated through internal and external verification. RESULTS: Multivariate logistic regression analysis identified 11 factors, including hypertension grade, education level, complicated diabetes, hypertension years, stress history, smoking, physical exercise, reading, social support, sleep disorders, and medication compliance, as risk factors for MCI in older patients with hypertension. To develop a nomogram model, the validity of the prediction model was evaluated by fitting the curve, which revealed a good fit for both the modeling (P = 0.98) and verification groups (P = 0.96). The discrimination of the nomogram model was evaluated in the modeling group using a receiver operating characteristic curve. The area under the curve was 0.795, and the Hosmer-Lemeshow test yielded P = 0.703. In the validation group, the area under the curve was 0.765, and the Hosmer-Lemeshow test yielded P = 0.234. CONCLUSIONS: We developed a nomogram to help clinicians identify high-risk groups for MCI among older patients with hypertension. This model demonstrated good discrimination and validity, providing a scientific basis for community medical staff to evaluate and identify the risk of MCI in these patients at an early stage.

Study on the role of cupping therapy on the implementation of the constitution nursing of elderly hypertension patients with phlegm-dampness constitution in the community / 中国实用护理杂志

Objective:To explore the effect of cupping therapy on regulating phlegm dampness constitution of elderly patients with hypertension in the community.Methods:From August to November in 2019, 120 elderly patients with phlegm dampness hypertension were randomly divided into control group and intervention group, 60 cases in each. The control group was given traditional Chinese medicine (TCM) health care in the community, and the intervention group was given cupping therapy intervention on this basis, to evaluate the changes of the scores of TCM phlegm wet body mass table, the total score reduction rate of TCM phlegm wet body mass, the conversion rate of TCM phlegm wet body mass, blood pressure, body mass index and waist circumference between the two groups before the intervention, 1 month, 2 months, 3 months after the intervention.Results:Finally, there were 51 cases in the intervention group and 57 cases in the control group. The TCM phlegm dampness constitution sub-scale and total scores of the comparison between groups at four different time points showed that except for the dimension of abdominal hypertrophy, the sub-scale and total scores of TCM phlegm-dampness constitution scale in the two groups were lower than before, and the differences were statistically significant ( F values were 3.450-94.995, P<0.05). The total score reduction rate of phlegm dampness constitution in the intervention group was 0.17 ± 0.10, higher than that in the control group (0.12 ± 0.09), and the difference was statistically significant ( t value was - 2.773, P < 0.05). The transformation rate of phlegm-dampness constitution was 47.1% (24/51) in the intervention group, which was higher than that in the control group (33.3%,19/57). The value of systolic blood pressure was lower in the intervention group [(135.10±2.64) mmHg,1 mmHg=0.133 kPa] than that in the control group [(138.88±2.42) mmHg] after 2 months of intervention, and the difference was statistically significant ( F value was 6.586, P<0.05). The value of diastolic blood pressure was lower in the intervention group [(80.75±3.03) mmHg] than that in the control group [(78.14±3.43) mmHg] after 3 months of intervention, and the difference was statistically significant ( F value was 6.758, P<0.05). Conclusions:On the basis of TCM physical nursing in the community, the effect of cupping therapy on reducing the score of phlegm and dampness physical fitness of elderly hypertension patients in the community, promoting the transformation of phlegm and dampness physical fitness of elderly hypertension patients in the community, and reducing the blood pressure level of elderly hypertension patients in the community is better than that of TCM physical nursing in the community, which is worth being promoted in the community.

Strategies for general surgery related issues in the treatment of critically ill patients diagnosed with COVID-19 / 中华消化外科杂志

In order to improve the cure rate of critically ill patients in Wuhan epidemic area and reduce the fatality rate, the state have dispatched medical staffs from the whole country to support Wuhan and treat critically ill patients in dedicated facilities. A medical team from the First Affiliated Hospital of Xi’an Jiaotong University, consisting of 133 medical staffs major in critical care medicine, respiralogy, infection, cardiology, and general surgery, entirely took over the critical care unit of the East Hospital of the Renmin Hospital of Wuhan University, and formed a multidisciplinary collaboration team with local medical staffs to treat patients together. Up to March 13th in 2020, the author′s medical team has admitted a total of 109 patients, of which 48 had been discharged up on recovery. Critically ill patients with Corona Virus Disease 2019 mainly have elder age, comorbidities, complicated conditions, and difficult diagnosis and treatment. The author and the author′s team combined with clinical practice, share experience and strategies of general surgery related issues in the treatment of critically ill patients, providing reference for collegues in general surgery.

Changes of cardiac rhythms in a swine model of adult asphyxial cardiac arrest / 中华急诊医学杂志

Objective To observe the changes of cardiac rhythms in a swine model of adult asphyxia! cardiac arrest. Method Sixteen Pigs were aphyxiated by endotracheal tube clamping until 8 min after loss of aortic pulsations. Resuscitation was then provided and swinds were assigned to received 0.045 mg/kg epinephrine intravenously after 3 min of basic life support. The animals with restoration of spontaneous circulation within 20 min from CPR were defined as successfully resuscitated, while the rest were identified as unresuscitation. Electrocardiogram ( EGG) were monitored from the start of asphyxia to the start of the CPR. Results When loss of pulsations occurred, 2 of 16 animals had ventricular fibrillation; 10 pigs exhibited pulseless electrical activity, and 4 pigs had asystole. During the 8 min after the loss of aortic pulsations, pulseless electrical activity converted to VF in 7 pigs. Immidiatedly prior to resuscitation, VF occurred in 9 pigs, asystole in 4 pigs, and PEA in 3 pigs. Conclusions Most of animals in this swine model of asphyxial cardiac arrest presented PEA, but most of them converted to VF especially late in the asphyxial process.