Flicker and photopic eletroretinogram(ERG)were recorded for 45 eyes of dry type of age-related macular degeneration(AMD)and 24 eyes of wet type of AMD respectively,the amplitud and phase of fundamental response compomeng(30Hz)by discrete Fourier tranform(DFT)were analysed.The abnormality ratios of phases and amplitudes in fundamental responses,amplitudes of photopic white or red b-waves were 48.89%,8.89%,10.11% and 8.89% respectively.The visual acuities of 24 eyes were 1.0 or better,the abnormality ratios of phases were up to 37.50%.These suggest that the change of phases is a sensitive method for detecting the early abnormality of visual function in AMD.The abnormality ratios of phases and amplitudes in fundamental responses were 62.5% and 45.84% in wet type of AMD.The differences between dry type and wet type in amplitudes of fundamental responses and photopic b-waves were statistically significant(P＜0.01).This shows that the change of amplitudes is associated with the degree of pathological change of AMD. （Chin J Ocul Fundus Dis,1996,12: 41-43）
OBJECTIVE To summarize the clinical results of hollow compression screw in treatment of fracture of neck of femur in the aged. METHODS: From November 1993 to October, 1998, 52 aged patients with several types of fracture of neck of femur were treated; among them, there were 25 males and 27 females aged from 60 to 83 years (70 years on average). There were 48 cases of fresh fracture and 4 cases of old fracture. Forty-two cases were performed closed reduction internal fixation, 10 cases with open reduction internal fixation. RESULTS: All the patients could sit by themselves 4 to 6 days after operation, and could walk with a crutch 10 to 15 days after operation. The mobility of hip joint was nearly normal 4 weeks after operation. All the patients were followed 26 to 84 months, 48.5 months on average. Bone union was achieved in 50 cases, nonunion in 2 cases. The average healing time was 4.7 months. There were no other complications, such as ankylosis and muscular atrophy, but ischemic necrosis in 3 cases. CONCLUSION: This method has following advantages, convenient manipulation, less injury, stable fixation, and the short-term recovery, which avoid some common complications. It is a reliable method worthy of popularizing.
【Abstract】ObjectiveTo investigate whether heme oxygenase-1 can alleviate the ischemiareperfusion injury of the aged donor liver. MethodsThe activity of superoxide dismutase (SOD) and catalase (CAT), and the contents of tocopherol (Vit E), ascorbic acid (Vit C) and malondialdehyde (MDA) were measured in the livers of adult SD rats (n=5) and aged SD rats (n=5). The experimental aged donor group (n=30) received intraperitoneal injection of Hemin 24 hours before operation, the control aged donor group(n=30) received saline. The histologic changes and apoptosis in the donor liver were observed. ResultsThe activity of SOD and the contents of Vit E and Vit C decreased significantly in 5 aged rats（P＜0.05）, but the content of MDA increased（P＜0.05）. Before the harvesting of the grafts, the activity of SOD and the contents of Vit E and Vit C increased significantly in rats pretreated with Hemin （P＜0.05） and the content of MDA decreased（P＜0.05）. The apoptotic cells in the livers pretreated with Hemin also decreased significantly after reperfusion（P＜0.05）. ConclusionThe liver of aged rat presents oxidative stress and peroxidative state. Ischemia-reperfusion injury can be alleviated by the induction of HO-1.
Objective\ To discuss the characteristics and experience of coronary artery bypass grafting in senile patients. Methods\ The operative techniques and postoperative management of coronary artery bypass grafting in 31 cases of patients with coronary atherosclerotic heart disease over 70 years old at our hospital were analyzed retrospectively. Results\ No operative death and no severe postoperative complications happened among this group. Conclusion\ Coronary artery bypass grafting for patients over 70 y...
Objective To evaluate the effectiveness and the value of balloon kyphoplasty in treating aged osteoporosis thoracolumbar vertebrae burst fracture. Methods Between January 2003 and January 2008, 36 thoracolumbar vertebrae burst fracture patients were treated. There were 15 males and 21 females with an average age of 65.4 years (range, 59-72 years). Fourteen cases had no obvious history of trauma, 19 had a history of sl ight trauma, and 3 had a history of severe trauma. Forty vertebral bodies were involved, including 1 T7, 3 T9, 8 T10, 10 T12, 9 L1, 7 L2, and 2 L4. All patients displayed local pain and osteoporosis by bone density measurement with no neurological symptom of both lower limbs. Balloon kyphoplasty through unilateral (31 cases) or bilateral (5 cases) vertebral pedicles with polymethylmethacrylate was performed at the injection volume of (3.46 ± 0.86) mL per vertebral body. Before and after operation, the anterior height and posterior height of fractured vertebral body and the sagittal displacement were measured. Results Two cases had intraoperative cerebrospinal fluid leakage; 1 case had no remission of waist-back pain and pain was released after symptomatic treatment. All 36 patients were followed up 2.3 years on average (range, 1.5-4.0 years). No cement leakage was found with good diffusion of cement on X-ray film. The restoration of the height of vertebral bodies was satisfactory without nerve compression symptoms and other compl ications. The Visual Analogue Score at last follow-up (2.34 ± 1.03) was significantly lower than that of preoperation (6.78 ± 1.21), (P lt; 0.05). The compressive percentage of anterior height (19.80% ± 1.03%) of fractured vertebral body after operation was significantly lower than that before operation(25.30% ± 2.50%), (P lt; 0.05). There was no significant difference in posterior compressive percentage and sagittal displacement between pre- and post- operation (P gt; 0.05). Conclusion Based on roentgenographic scores, balloon kyphoplasty is selectively used to treat aged osteoporosis thoracolumbar vertebrae burst fracture, and the radiographic and cl inical results were satisfactory.
ObjectiveTo evaluate the diagnostic performance of different screening tools for sarcopenia in the community for the elderly with sarcopenia, and to provide evidence-based support for the accurate screening of elderly patients with sarcopenia. MethodsThe PubMed, Web of Science, Cochrane Library, Embase, CINAHL, VIP, CBM, and WanFang Data databases were searched by computer, and the relevant research on the diagnosis of sarcopenia in the elderly by publicly published risk screening tools was found. The retrieval time was from inception to June 2023. Two researchers independently screened the literature, extracted data, and evaluated the quality of the included studies, and then data analysis was performed by using Stata 15.1 and Meta Disc 1.4 software. ResultsA total of 24 studies were included, including 10 961 patients, involving 8 risk screening tools for sarcopenia in the elderly: leg circumference, MSRA-5, MSRA-7, upper arm circumference, ring test, Ishii score, SARC-CalF and SARC-F. Meta-analysis showed that the combined sensitivities of eight screening tools were 0.84 (95% CI 0.61 to 1.15), 0.82 (95% CI 0.48 to 1.38), 0.80 (95% CI 0.47 to 1.36) and 0.72 (95%CI 0.33 to 1.55), 0.67 (95%CI 0.37 to 1.21), 0.63 (95%CI 0.33 to 1.19), 0.49 (95%CI 0.38 to 0.63), 0.24 (95%CI 0.18 to 0.30), and the combined specificities were 0.39 (95%CI 0.18 to 0.82)、0.52 (95%CI 0.29 to 0.93)、0.54 (95%CI 0.29 to 1.03)、0.62 (95%CI 0.49 to 0.79)、0.63 (95%CI 0.50 to 0.78).The results of reticular meta-analysis showed that the surface under the cumulative ranking curve (SUCRA) of the eight screening tools ranked from high to low according to the cumulative sensitivity: calf circumference (67.4%) > MSRA-5 (65.3%) > MSRA-7 (64.1%) > upper arm circumference (54.5%) > ring test (46.5%) > Ishii score. The values of specificity SUCRA from highest to lowest were as follows: SARC-F (72.2%) > SARC-CALF (71.3%) > Ishii score (60.2%) > ring test (57.1%) > upper arm circumference (40.1%) > lower leg circumference (36.2%) > MSRA-5. ConclusionThe simple screening tool for common sarcopenia has high sensitivity and high specificity, so medical staff can give priority to the combination of the two screening tools, namely SARC-CalF. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo evaluate the reading speed and related factors of normally-sighted middle-aged and elderly people, and compare with those assessed in age-related macular degeneration (AMD) patients.MethodsProspective case control study. Participants aged 45 to 85 years old with junior high school or above education and BCVA no less than 0.6 from the community around the First Hospital of Tsinghua University were recruited. People with ocular and nervous system diseases were excluded. AMD patients without other ocular and nervous system diseases, with the BCVA of their better eye above 0.05, were recruited from the Low Vision Clinic of the First Hospital of Tsinghua University. The best corrected vision, contrast sensitivity, and reading acuity were tested. Reading speed was evaluated with IReST Chinese version. Single factor correlation analysis was used to assess different factors which may be related with the reading speed, then multiple linear regression analysis was conducted further.ResultsFrom January to April, 2016, 53 volunteers aged 60.7±8.8 years old participated in the survey including 17 males and 36 females. Their median of best vision acuity both distance and near was 1.0, and their average reading speed was 244±55 characters/min. The average reading speed of younger participants in the middle-aged group (45-59 years old) was statistically faster (P＜0.05) than the elderly group (≥60 years old), which was 267±53 and 227±51 characters/min separately. The reading speed was correlated with age (r=－0.476, P=0.000), gender (t=－2.291, P=0.031), educational level (t=2.656, P=0.011), reading habits (t=7.346, P=0.000), best corrected distance vision (r=－0.293, P=0.033), best corrected near vision (r=－0.460, P=0.001), and reading acuity (r=－0.558, P=0.000) by single factor correlation analysis. Further analysis with multiple linear regression showed that reading acuity, gender, education level, and reading habits were significantly correlated with reading speed (β=－283.312, 28.303, －37.700, －45.505; P=0.000, 0.022, 0.019, 0.023). Totally 22 AMD patients aged 77.4±8.2 (59-90) years old joined the study from September 2016 to August 2018, including 16 males and 6 females. The median reading speed was 118 characters/min. Compared with the normally-sighted elderly, there were more males in AMD patients (χ2=3.981, P=0.046). They were older (t=－4.285, P=0.000), with significant poorer visual acuity (t=-6.176, P=0.000) and lower reading speed (t=-5.719, P=0.000). Significant correlation was found between reading speed and best binocular distance or near vision, reading acuity and contrast sensitivity (r=－0.771, －0.805, －0.776, 0.511; P=0.000, 0.000, 0.000, 0.015), no statistic relationship was found between reading speed and age(r=0.021, P=0.926) or gender(Z=－0.382, P=0.703) in AMD patients.ConclusionsThe reading speed of normally-sighted people declined with age. Reading acuity may be a better predictive factor than distance vision for reading function. Compared with normally-sighted group, the reading acuity and reading speed of AMD patients was significantly lower. The main factor affecting their reading speed was the severity of their visual impairment.
Objective To explore the effect of low-load resistance training on physical fitness in aged adults. Methods Select the aged adults who will go to the outpatient Department of Rehabilitation Medicine of Peking Union Medical College Hospital between June 1, 2020 and May 31, 2021. The aged adults were randomly divided into three groups by using the method of random number table: medium intensity aerobic training group (aerobic training group), standard-load resistance training group (standard-load group) and low-load resistance training group (low-load group). The basic information, exercise endurance (peak power, peak oxygen uptake), exercise cardiopulmonary function [peak heart rate, predicted peak heart rate, peak minute ventilation (VE), ventilatory equivalent for carbon dioxide at anaerobic threshold (EqCO2 during AT)], muscle strength, and muscle oxygen related indexes were collected blindly before the first exercise and after 12 weeks of training, respectively. To compare the differences of the indexes before and after training. Results A total of 90 patients were enrolled, 30 in each group. There was no significant difference in age, sex, height, weight and body mass index among the three groups (P>0.05). There was no significant difference in cardiopulmonary endurance, cardiopulmonary function, muscle strength, muscle oxygen related indexes between the groups before and after training (P>0.05). Except for the indexes related to cardiac function (peak heart rate, predicted peak heart rate) and resting muscle oxygen level (P>0.05), other indexes related to pulmonary function, cardiopulmonary endurance, muscle strength, and time of muscle oxygen falling to the valley in the three groups were statistically significant compared with those before training (P<0.05). Except for peak power, peak oxygen uptake and time of muscle oxygen falling to the valley (P>0.05), the difference of muscle strength before and after training in the three groups was statistically significant (P<0.05), including grip strength, chest push, sitting rowing, leg extension, hip abduction, body bending and horizontal push and push, and the low-load group was better than the aerobic training group (P<0.05), but the improvement of body bending and horizontal push and push in the standard-load group was better than the low-load group (P<0.05). Conclusions Low-load resistance training, standard-load resistance training and aerobic training have almost the same effect on improving the physical fitness of the elderly. Low-load resistance training is superior to medium intensity aerobic training in improving muscle strength, which is an effective method to improve the physical fitness of the aged adults.
Objective To study the ultrasonographic manifestation character of age-related macular degeneration (AMD). Methods The ultrasonographic manifestation of thirty-five cases (38 eyes) of AMD diagnosed by fundus fluorescein angiography (FFA) with positive findings of ultrasonic B-scan were analysed． Results The ultrasonic appearance of interlamellar transaudient cleft were found in 26 eyes, in which FFA appearance were serous detachment of pigment epithelium and subretinal neovascularization, 5 of them associated with small excavation of choroid, 4 of them associated with b echo belt at the posterior edge of the interlamellar transaudient cleft in which the FFA appearance was extensive subretinal neovascularization．In another 4 eyes with choroidal hematoma under FFA revealed thin echo light spots in the interlamellar transaudient cleft． There was scar-staining in the other 8 eyes in which the ultrasonic appearance showed an unequal thickening of the ocular wall in the posterior pole,unequal echo of interior edge and irregular inner echo． Conclusion The main ultrasonographic manifestation of AMD is the presence of interlamellar transaudient cleft in the thickened ocular wall. (Chin J Ocul Fundus Dis,2000,16:228-230)
Objective To explore the clinical effect and complications of lumbar plexus block through different approaches on perioperative analgesia in aged proximal femur surgery, and find the best method for analgesia in these patients. Methods From January to December 2015, 150 elderly patients scheduled for proximal femur surgery were randomly divided into three groups: psoas compartment block (PCB group, n=50), Winnie " 3 in 1” block (Winnie group, n=50), and fascia iliaca compartment block (FICB group, n=50). Twelve hours before surgery, guided by ultrasound and nerve stimulator, lumbar plexus blocks were performed in all the patients, then patient-controlled analgesia (the formula and the usage were the same) was done. All patients received epidural anesthesia, and were maintained postoperative analgesia for 72 hours. If Rest Visual Analogue Scale>3 or Initiative Movement Visual Analogue Scale>4, sufentanyl 10 μgi.m. was given. Muscle strength grades and complications were recorded. Anesthetic effect of sensory block of femoral, lateral femoral cutaneous, and obturator nerves were measured and recorded too. Results There were two cases of epidural block, and one case of puncture point bleeding in group PCB; no complication in the other groups was found. There was no remedy for inadequate analgesia in the three groups. Compared with group PCB, the muscle strength grades during postoperative 24–72 hours in group FICB were higher (P<0.05). The successful rate of the block of lateral femoral cutaneous nerves was 64%, 91% and 96% in group Winnie, group PCB and group FICB, respectively, and the differences between the three groups were all statistically significant (P<0.05). The successful rate of the block of obturator nerves in group FICB (62%) was lower than that in group PCB (89%) and Winnie group (84%) (P<0.05). Conclusion Continuous fascia iliaca compartment block on perioperative analgesia in aged proximal femur surgery, with exact effect, less complications and simple operation, is better than the psoas compartment block and Winne " 3 in 1” nerve block.