目的:分析杞菊地黄汤加减沐足治疗老年高血压合并失眠的临床效果.方法:选取2020年5月—2021年5月东部战区总医院镇江医疗区收治高血压合并失眠的老年患者124例,随机分为研究组和对照组各62例.对照组患者采取常规治疗方案,即常规西药降压处理,同时配合心理疏导等方法缓解焦虑情绪.研究组患者在常规治疗方案基础上,以杞菊地黄汤加减沐足治疗.观察两组患者治疗前后的收缩压和舒张压、PSQI评分以及疗效.结果:治疗前两组患者的收缩压、舒张压比较,差异无统计学意义(P ＞ 0.05);治疗后,两组血压均有显著改善,且

Objective To elaborate the characteristics of the obstructive sleep apnea hypopnea syndrome( OSAHS) and the cardiovascular diseases.Methods OSAHS complicating Cardiovascular diseases is that a patient with OSAHS got a second-ary cardiovascular diseases.Results To summarize the prevalence rate,mechanism,diagnostic criteria,characteristic of clinic and treatments of the OSAHS complicating cardiovascular diseases.Conclusion OSAHS is an important pathogenic factor of cardiovascular diseases.Active preventions and treatments for SOAHS can reduce the risks of cardiovascular diseases and improve the prognosis.

阻塞性睡眠呼吸暂停低通气综合征(OSAHS)是老年人的常见病和多发病,随着人们对本病认识的提高和诊治技术的发展,越来越多的患者能从中受益.本文就OSAHS诊断技术研究进展作一综述. 1 老年OSAHS人体特征 1.1 症状特征作者曾对598例老年OSAHS临床症状进行分析,主要症状分别为:憋醒、白天嗜睡、不宁腿、记忆力减退、夜间多尿、晨间头痛、乏力、胸痛、恶梦、头晕、精神异常、反应迟钝、遗尿、痴呆、惊恐、语言障碍,上述症状均较无OSAHS组(1270例)显著增多.

ObjectiveTo investigate senile degenerative heart valvular diseases (SDHVD) and multiple organ diseases. MethodsA multi-center study was carried out in somesanatoriums for retiredveterancadresand their couples from October 2008 to June 2014. There were 3896 elderly patients recruited (all with full medical records and undergoing overall physical examination every year), including2884males and1012females,with ageof(78±13) years (ranging from60 to 103 years). Clinical data of their echocardiography, physical examination, and auxiliary examination were collected and analyzed for multiple organ diseases.Results Among the 3896 elderly patients, there were 1225 having SDHVD (31.4%). The incidences of multiple organ diseases in the SDHVD group and non-SDHVD groupwere as follows respectively: hypertension 49.3%vs 28.4%, coronary heart disease 38.5%vs23.8%, heart failure 36.2%vs 17.3%, pulmonary heart disease 6.3%vs 3.1%, stroke 21.6%vs 9.6%, renal insufficiency 6.9%vs 3.2%,gastroesophageal reflux disease 21.3%vs 10.3%, and diabetes mellitus 11.2%vs 12.1%. Significant differences were found in all above incidences except for that of diabetes mellitus between the 2 groups (P<0.05).Conclusion Multiple organ diseasesare more common in the elderly suffering from SDHVD. It might be due tothatSDHVDinducescardiac remodelingandabnormalhemodynamics, and thus triggersthe occurrence and development of multiple organ diseases.

Objective To investigate the status of sleep disturbances among legionary retired veterans and their spou-ses.Methods 5786legionaryretiredveteransandtheirspouseswereinvestigatedwithPittsburghSleepQualityIndex(PSQI) from January 2010 to January 2012.There were 2 915 males and 2 871 females,whose average age was(79.36 ±12.21)years old.Results Subjective sleep quality scored(2.16 ±0.48).Sleep latency scored(2.12 ±0.39).Sleep duration scored(1.65 ± 0.71).Sleep efficiency scored(2.11 ±0.42).Sleep disturbances scored(2.13 ±0.49).Use of sleep medication scored(1.20 ± 0.5).Daytime dysfunction scored(2.02 ±0.32).Scores of male were higher than of female(P<0.01).Conclusion The inci-dence of sleep disturbances is very high among legionary retired veterans and their spouses,and sleep disturbances weaken their life quality seriously.

OBJECTIVE:To explore the correlation between obstructive sleep apnea hypopnea syndrome (OSAHS) and multiple organ diseases.METHODS:Home-visit questionnaires were performed in 1 868 subjects (956 male, 912 female) with an average age of (79 ± 5) years, and a prospective follow-up was performed for a period of 20 years with annual medical examinations. Multiple organ diseases included hypertension, coronary heart disease, stroke, diabetes, pulmonary heart disease, renal insufficiency and erythrocytosis. The subjects were grouped by the diagnosis of OSAHS.RESULTS:Among the 1 868 subjects, 598 (32.0%) were diagnosed with OSAHS, and 1 270 (68.0%) of non-OSAHS as the control group. By the end of follow-up, in the OSAHS group there were 477 (79.8%) cases with hypertension, 337 (56.4%) cases with coronary heart disease, 167 (27.9%) cases with stroke, 76 (12.7%) cases with diabetes, 37 (6.2%) cases with pulmonary heart disease, 73 (12.2%) cases with renal insufficiency and 211(35.3%) cases with erythrocytosis, all of which were significantly higher than those of the control group [323(25.4%), 315 (24.8%), 95 (7.5%), 69 (5.4%), 40 (3.2%), 58 (4.6%), 30 (2.4%), P < 0.01]. The number of diseases in the OSAHS group was also higher than that in the control group (P < 0.05) .CONCLUSION:The incidence of multiple organ diseases was remarkably higher in the OSAHS group than that in the control group, which indicated that OSAHS was a risk factor for multiple organ diseases. These diseases in OSAHS patients may be related to hypoxia caused by OSAHS, endocrine and metabolic disorders, unhealthy lifestyles and arteriosclerosis.

Objective To compare the efficacy of rabeprazole and omeprazole in treatment of peptic ulcer in elderly people. Methods 92 patients suggestive of H pylori positive peptic ulcer by endoscope were enrolled. All patients were randomly divided into two groups:the observed group(n=46)and the control group(n=46).the eradication rate of pylori, the healing rate of peptic ulcer and adverse reactions were evaluated. Results The rates of ulcer pain disappearance in a day in observed group and the control group were 84.8%and 47.8%,the rates of ulcer pain disappearance in a week in the observed group and control group were 95.7%and 76.1%respectively,significant differences among 2 groups(P<0.01 and P<0.05). The ulcer healing rate in both group was 80.4% and 52.2%(P<0.05),the global effective rate in both group was 97.8%and 82.6%(P<0.01),and the H pylori eradication rate in both groups was 84.8% and 63.0%,respectively(P<0.01). Conclusion Rabeprazole is superior to omeprazole in improving symptoms and curing ulcers,and has better therapeutic effects for peptic ulcer in elderly.

目的对近年来食管癌的化学预防进展情况作一综述。方法本文通过对食管癌癌前病变、高危人群、常见的食管癌化学预防药物种类进行分析。结果食管癌的化学预防取得了明显进展,为食管癌的防治提供了希望。结论大多数化学预防药物多为小样本临床研究或处于基础实验阶段,还缺乏大规模随机对照研究,要根本实现食管癌的防治目标尚有很大的距离。

目的 提高对胰腺导管内乳头状黏液性肿瘤(IPMNs)的认识和减少误诊.方法 报告1例IPMN的诊断治疗经过,并通过检索国内外有关文献,复习IPMNs的临床特点和诊治进展.结果 本例老年男性患者,反复出现上腹部疼痛伴血、尿淀粉酶增高5年余,发病初期诊断为急性胰腺炎.因临床症状频繁发作,2008年4月第一次行内镜逆行胰胆管造影(ERCP)检查考虑慢性胰腺炎,并给予胰管支架治疗,效果欠佳.2010年7月经内镜超声(EUS)及第二次ERCP检查明确诊断为IPMN,给予内镜下取石气囊胰管清理治疗,术后胰腺炎发作次数明显减少.结论 IPMNs早期诊断困难;对于老年患者,反复出现急性胰腺炎症状,要警惕IPMNs可能;EUS及ERCP检查有助于明确诊断.

objective Investigation follow-up obstructive sleep apnea syndrome(OSAS) and coronary heart disease of the relationship.Methods In November 1989 to November 2009 1868 cases of prospective follow-up crowd,through the family visit type survey,the follow-up period 1 year medical examination,check the blood pressure,blood fat,sugar,electrocardiogram and X-ray chest radiograph,found coronary heart disease performance for follow-up end point,followed up for 20 years.Results Among the 1868 cases of 956 cases of male,female in 912 cases,age range,53 to 82 years,average age 63 + 6 years old.The diagnosis of OSAS 598(32.0%) patients,1270(68.0%) were no OSAS(control group).Conclusions The long-term follow-up,in patients with coronary disease OSAS effort likely more average crowd high,consider OSAS and the correlation between coronary disease.20 years of follow-up tip OSAS may be independent risk factors for coronary heart disease.

OBJECTIVE:To explore the correlation between obstructive sleep apnea syndrome (OSAS) and cerebrovascular disease (CVD).METHODS:A cohort of 1868 people was screened for OSAS, and followed from November 1989 to November 2009. Annual medical examinations including blood pressure, blood fat, serum glucose, electrocardiogram and chest x-ray were performed. Computer tomography was carried out when CVD, the endpoint of the study, was manifested.RESULTS:Among the 1868 elderly people, 598 (32.0%) were confirmed to have OSAS, including 496 (82.9%) males and 102 (17.1%) females. Compared with the non-OSAS group, patients with OSAS had more symptoms including daytime somnolence, headache, decreased ability of memory, aphronesia and allolalia (P < 0.05). CVD occurred in 276 (46.2%) patients of the OSAS group, but in 150 (11.8%, P < 0.01) subjects of the non-OSAS group. During the 20-year follow-up, 817 people died, 66.2% (396/598) in the OSAS group, but 33.1% (421/1270) in the non-OSAS group (P < 0.01).CONCLUSION:Patients with OSAS are more likely to suffer from CVD. OSAS may be an independent risk factor for CVD.

睡眠呼吸暂停综合征(SAS)常因患者、家属及医务人员的不重视或认识不足而造成漏诊和误治[1],也常因并发心脑血管病而需急诊处理,因此需引起医护人员的高度重视,现就本院收治的SAS患者临床救治经验总结如下.

<正>目的:观察阻塞性睡眠呼吸暂停综合征(OSAS)与冠心病以及与总病死率的关系。方法:自1989年11月～2009年11月,通过对所属3市共13所军队和地方离退休干部休养所及部分地方人员共1 868(男956,女912)例,对OSAS患者进行20年随访。1989年11月共入选时年龄范围53～82

Objective To investigate the expression and clinical significance of MUC1,MUC2,MUC4 and MUC5AC in pancreatic ductal adenocarcinoma(PDA).Methods To analyze the expression profiles of MUC1,MUC2,MUC4 and MUC5AC in PDA(n=26),chronic pancreatitis(CP,n=4),normal pancreas(n=16)and intraductal papillary-mucinous neoplasm(IPMN)(n=2),solid-pseudo-papillary tumor of pancreas(SPT)(n=4),serous cystic neoplasm(SCN)(n=1)using immunohistochemistry.Results Positive staining with MUC1 Was exclusively found in normal pancreas and CP tissues(100%);the expression of MUC1,MUC4 and MUCSAC in PDA was 100%,88.5%(23/26)and 76.9%(20/26)in PDA tissue;MUC2 and MUC5AC were expressed in 2 samples of IPMN;none of the four mucins were expressed in Sfrr and SCN.There was no association between the expression of MUC4,MUC5AC and the clinicopathologic parameters in PDA(P＞0.05).Conclusions Multiple mucins were expressed in PDA.Measurement of the mucin profile including all 4 mueins(MUC1,MUC2,MUC4,and MUC5AC)may be helpful in the diagnosis and differential diagnosis of PDA.

Objective To detect mucin(MUC1,MUC2,MUC5AC) expressions in endoscopic ultrasound guided fine needle aspiration(EUS-FNA) specimens of the pancreatic neoplasms lesions and evaluate their diagnostic value.Methods The expression profile of MUC1,MUC2,MUC5AC from 54 EUS-FNA samples of pancreatic occupying lesions were examined by immunohistochemistry with mono- clonal antibodies.The results were correlated to the eytohistologic and clinical diagnosis of pancreatic cancer.Results Thirty-eight of the 54 patients had pancreatic cancer,6 patients had benign tumor,10 patients had chronic pancreatitis.The sensitivites of cytology and histology in diagnosing pancreatic cancer were 31.6%and 47.4%,respectively.The prevalence of MUC1,MUC2 and MUC5AC expres- sion in EUS-FNA samples of pancreatic cancer were 81.6%(31/38),10.5%(4/38),84.2%(32/38), respectively,and those in benign pancreatic neoplasms were 25%(4/16),31.3%(5/16),43.8%(7/16),respectively.There was statistically significance in MUCland MUCSAC expression between the two groups(P0.01).Furthermore,MUC1 expression in pancreatic cancer had positive correlation with clinical stage and lymphatic metastasis.Combined measurement of MUC1 and MUC5AC expression and cytohistologic analysis in EUS-FNA specimens could increase sensitivity to 89.5%in diagnosing pancreatic cancer.Conclusions Determination of MUC1 and MUCSAC expression in EUS-FNA speci- mens from pancreatic tissue will be helpful in diagnosing pancreatic cancer.In addition,MUC1 expres- sion can predict the clinical stages and lymphatic metastasis of cancer.