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Objective:To compare clinical characteristics and results on parameters for muscle measurement in elderly sarcopenia patients of different age groups.Methods:This was a cross-sectional study, and 404 outpatients aged 60 years and over were enrolled and received a long-term follow-up.According to the World Health Organization classification of the elderly, the subjects were divided into a youngest-old group, a middle old group and an oldest-old group; and according to the diagnostic criteria of the Asian Working Group for Sarcopenia in 2019, elderly people of all ages were divided into a sarcopenia group and a non-sarcopenia group.General clinical data were recorded, and the upper arm circumference, leg circumference, skeletal muscle index, grip strength and walking speed, the Short Physical Performance Battery and timed up and go were conducted.At the same time, the body composition was measured by multifrequency bioelectrical impedance analysis.Results:The subjects had a mean age of(85.24 ± 8.23)years, including 90(22.28%)youngest-old, 165(40.84%)middle old and 149(36.88%)oldest-old.123 patients(30.45%)were diagnosed with sarcopenia, with a prevalence of 27.78%(25)in the youngest-old group, 28.48%(47)in the middle old group and 34.23%(51)in the oldest-old group.Compared with those without sarcopenia, the basal metabolic rate in sarcopenia patients of all age groups decreased significantly, the levels of hemoglobin and albumin in youngest-oldsarcopenia patients decreased, the waist circumference and body mass index in middle old and oldest-old sarcopenia patients decreased, and the body fat rate in middle old sarcopenia patients increased.In the subjects with sarcopenia, the proportion of men in the oldest-old group was higher than in the other two groups.Compared with the youngest-old group, the levels of alanine aminotransferase and prealbumin decreased, serum creatinine increased, and skeletal muscle index values did not change in the middle old and longest-old groups, but handgrip strength(27.7±5.9 vs.23.2±6.9 vs.21.4±5.8, F=5.81, P=0.004), gait speed(0.8±0.2 vs.0.7±0.2 vs.0.5±0.2, F=11.88, P=0.000)and calf circumference(33.4±3.3 vs.15.9± 8.4 vs.31.5±3.1 vs.30.9±3.3, F=3.58, P=0.031)significantly decreased, and time up and go values(10.0±2.1 vs.15.9±8.4 vs.20.8±12.8, F=6.98, P=0.001)increased in the middle old and longest-old groups.Partial correlation analysis showed that age had a significant negative correlation with handgrip( r=-0.374, P=0.001), daily gait speed( r=-0.441, P=0.000), and calf circumference( r=-0.223, P=0.017), but a significant positive correlation with timed up and go( r=0.319, P=0.009). Conclusions:Compared with youngest-old sarcopenia patients, middle old patients show significant decline in muscle function, muscle strength and muscle mass in the lower limb.With increasing age, the impact of changes in muscle function, muscle strength and regional muscle mass on adverse events should receive heightened attention.
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Objective:To investigate the prevalence of sarcopenia and associated factors in hospitalized elderly patients.Methods:This was a cross-sectional study.A total of 578 patients admitted to the Geriatrics Department of our hospital were consecutively recruited according to the admission criteria.Patients were divided into the sarcopenia group(n=202, 34.95%)and non-sarcopenia group(n=376, 65.05%)based on the diagnostic criteria(2014)of the Asian Working Group for Sarcopenia.Their clinical data and laboratory parameters were collected.All patients underwent comprehensive geriatric assessment.Results:(1)The detection rate of sarcopenia in these hospitalized patients was 34.95%.(2)Age, free thyroxine(FT4), and the prevalences of diabetes and osteoporosis and the incidence of falls in the past year were higher while body mass index(BMI), calf circumference, hemoglobin(Hb), albumin(ALB), triglycerides(TG), low-density cholesterol(LDL), glycosylated hemoglobin(HbA1c)and free triiodothyronine(FT3)were lower in sarcopenia patients than in non-sarcopenia patients, with statistical significance.Scores on the mini-mental state examination(MMSE)and activities of daily living(ADL)were lower in sarcopenia patients than in non-sarcopenia patients while scores on nutritional risk screening 2002(NRS2002)and the FRAIL scale were higher, all with statistical significance.(3)Binary logistic regression analysis revealed that osteoporosis and FRAIL score were risk factors for sarcopenia( OR=9.083 and 2.505, P<0.001)and BMI, calf circumference and ADL score were protective factors for sarcopenia( OR=0.735, 0.774 and 0.967, P<0.05). (4)ROC analysis showed that the areas under the curve for FRAIL score, BMI, calf circumference and ADL score were 0.832, 0.805, 0.841 and 0.812, respectively, with threshold values at 2.5 points, 23.52 kg/m 2, 32.5 cm and 92.5 points.(5)The chi-square test for sarcopenia screening using various related factors found osteoporosis, calf circumference <32.5 cm and ADL <90 points had higher sensitivity(0.787, 0.807, 0.817)while FRAIL ≥ 3 points and BMI <23.5 had slightly lower sensitivity(0.683, 0.708), with each related factor having a high negative detection rate(0.833-0.888). Conclusions:The prevalence of sarcopenia in hospitalized elderly is more than 1/3.Osteoporosis and FRAIL score are risk factors for sarcopenia.BMI, calf circumference and ADL score are protective factors for sarcopenia.All relevant factors have practical clinical value and can be used for preliminary screening of sarcopenia.
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Objective To investigate the health status of centenarian hospitalized patients and analyze the risk factors for in-hospital death in Nanjing district.Methods All centenarians hospitalized patients who were discharged from wards of 10 upper first-class general hospitals in Nanjing district during the past five years were retrieved from their hospital information systems.Then,a retrospective study was performed on centenarians' data of general information,laboratory test results,Charlson comorbidity index (CCI),neutrophil to lymphocyte ratio (NLR) and shock index(SI),etc.were calculated and collected.Relevant risk factors for in-hospital death were analyzed by multivariate logistic regression analysis.Results A total of 156 patients aged 100 years and over,with an average age of (101.0±2.1)years,were enrolled during the past 5 years.The top 3 admitting diagnosis for the patients were pulmonary infection(30.1％,47/156 cases),coronary heart disease(10.9％,17/156 cases)and cerebrovascular disease(7.1％,11/156 cases).Fifty patients died during hospitalization,with a mortality of 32.1％ (50/156).Pneumonia was the most common admitting diagnosis(40.0％,20/50 case).Among causes of death,the combined admitting diagnosis with dementia,chronic renal insufficiency,one or more basic disease were significantly associated with death.There were statistically significant differences between bad vs.good vs.indifferent prognosis in heart rate,shock index,leukocyte count,neutrophil count,NLR,hemoglobin,albumin,albumin/globulin,fasting blood glucose,blood urea nitrogen,serum creatinine,C-reactive protein(CRP)and CCI levels.Multivariate logistic regression analysis suggested that NLR≥13.18,fasting blood glucose ≥7.56 mmol/L,blood urea nitrogen ≥20.74 mmol/L,CRP≥65 mg/L and CCI≥3 might be predictors for in-hospital death in the cohort(OR =48.91、3.43、1.22、6.55、1.55,all P＜0.05).Conclusions Pulmonary infection is the most common reason for admission and the cause of death in centenarian inpatients.Comorbidities increase the risk of death.To lower in-hospital mortality,CCI and other assessment indicators should be used to strengthen the comprehensive assessment and chronic disease management of hospitalized centenarians.Infectious diseases should be prevented beforehand.
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Objective To investigate the effect and mechanism of terazosin combined with Qianlielongbitong in the treatment of non-bacterial prostatitis.Methods One hundred and two patients with non-bacterial prostatitis were divided into two groups:one group was treated with terazosin 4 mg qn and Qianlielongbitong,while the other group was treated with terazosin and Levoofloxacin.We compared three indices of chronic prostatitis symptom index (NIH-CPSI),prostatic secretion examination(EPS) and urodynamic data in three different steps:before treatment,after 4-week treatment and after 8-week treatment.Results The NIH-CPSI of both groups was greatly improved after treatment( all P ＜0.01 ).Inside the treatment group,the NIH-C-PSI after 8-week treatment was better than that after 4- week treatment ( all P ＜ 0.01 ).However,in both groups,there was no significant difference between the index after 8-week treatment and the one after 4 week.EPS,AFR and MFR were greatly improved in both groups( all P ＜0.01 ).Conclusion Terazosin can relieve the clinical symptom,and improve the life quality.
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Objective To discuss the significance of the retrograde urethrography in diagnosis and treatment of urethraltrauma. Methods 78 cases with urethraltrauma treated by the retrograde urethrography were retrospectively analyzed. Results The location and extent of urethral injury was determined according to the place and speed of contrast medium overflow and the diffuse range. Among 78 cases ,29 cases were bulbar urethral trauma and other 49 cases were membranous urethral trauma.Conclusion Retrograde urethrography is simple, practical and easy to operate for determining the injured part of urethra and the extent of damage of urethraltrauma, and was instructional for the choice of operation method and incision.
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Objective To investigate the role of oxidative stress in type 2 diabetes patients with macrovascular complications. Methods Serum levels of 8-hydroxy-deoxygnan osine (8-OHdG) and hemoglobin Alc (HbAlc) in 32 cases of type 2 diabetic patients with macrovascular complications and 46 cases of patients without complications were determined. 8-OHdG was detected by enzyme linked immu-nosorbent assay (ELISA). Results The level of 8-OHdG (2.93±1.37) ng/mL in type 2 diabetic patients with macrovascular complica-tions was higher than those without complications, whose 8-OHdG level was (2.67±1.30)ng/mL, but the difference was not significant(P>0.05). Compared with all kinds of macrovascular complications in patients, the 8-OHdG levels were increased, but the difference were not significant (P>0.05). Compared with patients without complications, the duration and age of the patients with macrovascular compli-cations also increased significantly (P<0.05), but the HbAlc levels were not statistical difference between them (P>0.05). Spearman regression analysis showed that 8-OHdG level was positively correlated with the duration (r=0.33, P<0.05), while the age and HbAlc level had no obvious correlation (P>0.05). Conclusion The role of oxidative stress may not be the important reason in type 2 diabetes with macrovascular complications, but the duration and age of the patients may be closely related with the disease.
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Objective To evaluate the morbidity of the post-prostatectomy incontinence of supra-pubic transvesical prostatectomy(SPP) and transurethral resection of prostate(TURP). Methods One hundred and thirtyfive patients were divided into two groups. 82 patients underwent SPP and 53 patients underwent TURP. We ob-served the morbidity and the time lasting of post-prostatectomy incontinence, the severity of post-prostatectomy in-continence as evaluated by Stamey incontinence grading system,patients who had more than one week postoperativeincontinence were received urodynamic tests,then we got the information of their incontinence types. Results We found that patients who underwent SPP had higher morbidity, severity and time lasting than those who underwent TURP. SPP group had much more morbidity of stress incontinence than TURP group, but the same morbidity of ur-gent incontinence after operation as the later. Conclusion TURP may be better than SPP in consideration of the post-prostateetomy incontinence. SPP group has more stress incontinence and it may be caused by complete resection of prostate and damnifieation of the mucous membrane of membranous urethra.
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Objective To discuss the causes leading to dissatisfying result after operation therapy for BPH.Methods 42 patients who had not acquired satisfying result after operation therapy for BPH were underwent the urodynamic examination.Results 42 patients were classified into two groups according to their different symptoms:difficuhy to void,32 case8,including 8 cases with low contractifity of detrusor,and 24 cases with Madder outflow obstruction(BOO);incontinence,10 eases,including 6 cases of urgency incontinence and 4 cases of stress incontinence.Condusion We can see that the causes leading to dissatisfying resuh after operation for BPH are mainly the dysfunction of detmsor and BOO,and the result of urodynamic examine can guide us the causes and the next therapy.