"我最近真的不知道怎么了,每天晚上淘宝直播刷得停不下来,不刷睡不着觉,刷着刷着入睡都要一两点了,白天上班一点精神都没有,想要改变这种不好的状态,但是却不知道怎么办."眼睛红肿的郎女士(化名)坐在浙江医院精神卫生科门诊诉说着这几天的状态.

目的 探讨老年高血压患者的睡眠情况对血压控制及血压变异性的影响.?方法 选取2011年5月至2013年1月在浙江医院住院的老年高血压患者160例(≥60岁).收集患者的一般临床资料、睡眠时间及动态血压指标,使用匹兹堡睡眠质量指数量表(PSQI)评估患者睡眠质量,分析睡眠状况对血压控制及血压变异性的影响.?结果 160例患者中80例患者睡眠质量优良,80例患者睡眠较差.其中不同睡眠质量组的24h收缩压、24 h舒张压、白昼收缩压、白昼舒张压、夜间血压变异性的差异有统计学意义(t=-6.287、-3.458、-5.490、-2.773、-2.888,P<0.05).根据患者的睡眠时间情况分为三组:<6 h组、6～8 h组、>8 h组.不同睡眠时间患者的白昼收缩压、白昼舒张压均值标准差差异有统计学意义(F=3.582、3.292,P<0.05).睡眠质量优良组血压控制达标率(72.6％)高于睡眠质量较差组(57.5％),差异有统计学意义(χ2=5.353,P<0.05).睡眠时间不同组别的血压控制达标率(<6 h组:68.0％;6～8 h组:66.1％;>8 h组:80％)之间比较差异无统计学意义(χ2=0.463,P>0.05).对睡眠质量和睡眠时间进行相关性分析,发现两者存在交互影响(相关系数为-0.538,P<0.05).联合睡眠时间和质量进行分组并进一步分析时显示,各个组别之间的血压控制达标率不同,且差异有统计学意义(χ2=13.183,P<0.05),其中睡眠质量较差合并<6 h组的血压控制达标率最低(18.2％).进一步对各个组进行两两比较发现,睡眠质量较差合并<6 h组与睡眠质量优良合并>8 h组、睡眠质量优良合并6～8 h组以及睡眠质量较差合并>8 h组血压达标率比较差异均有统计学意义(χ2=6.671、3.884、5.507,P<0.05).?结论 老年高血压患者的血压控制水平与睡眠质量有一定关系,睡眠质量好的患者血压控制达标率更高,睡眠时间不同的患者血压达标率比较无差异.睡眠质量与睡眠时间存在交互影响,血压达标率随着睡眠时间的增长而呈现出升高趋势.

Objective:To investigate the sleep quality of elderly patients with overlap syndrome (OS) of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA).Methods:166 elderly patients admitted to Zhejiang Hospital from February 2018 to February 2019 were selected, including 45 COPD patients (COPD group), 45 OSA patients (OSA group), 48 OS patients (OS group), and 28 healthy volunteers in the same period (healthy control group). The clinical data of all subjects were collected, Pittsburgh sleep quality index scale and polysomnography (PSG) were used to evaluate subjective and objective sleep quality. Univariate analysis of variance and rank sum test were used for comparison among multiple groups, LSD-t test and Bonferroni method were used for pairwise comparison, and counting data were compared by χ2 inspection.Results:There were significant differences in BMI, neck circumference, ESS score, percentage of forced expiratory volume in one second (FEV1) and FEV1/forced vital capacity (FVC) among the four groups (F=5.693, 12.804, 4.805, 195.050, 452.290, P < 0.01). The BMI of OS group and OSA group was significantly higher than that of healthy control group (P < 0.05), and the BMI of OS group was significantly higher than that of COPD group (P < 0.05). The neck circumference of OS group and OSA group was significantly higher than that of healthy control group and COPD group (P < 0.05). The ESS score of OS group and OSA group was significantly higher than that of healthy control group (P < 0.05), and the ESS score of OSA group was significantly higher than that of COPD group (P < 0.05). The FEV1% and FEV1/FVC in OS group and COPD group were significantly higher than those in healthy control group and OSA group (P < 0.05). There were significant differences in PSG monitoring indexes among the four groups (F=806.326, 59.965, 8.916, 24.168, 81.969, 15.666, P < 0.01). The apnea hypopnea index and the longest apnea time in OS group and OSA group were significantly higher than those in healthy control group and COPD group (P < 0.05). The apnea hypopnea index and the longest apnea time in OS group were significantly higher than those in OSA group (P < 0.05). The micro arousal index, mean blood oxygen saturation, minimum blood oxygen saturation and the percentage of blood oxygen saturation < 90% in the total monitoring time in OS group were significantly higher than those in other groups (P < 0.05). There were significant differences in other indexes except subjective total sleep time and objective sleep latency among the four groups (F=5.196, 6.470, 10.444, 6.785, 2.947, 8.591, 7.452, P < 0.05 or 0.01). The total time of subjective awakening and objective awakening after falling asleep in OS group, OSA group and COPD group were significantly higher than those in healthy control group (P < 0.05), and the subjective sleep efficiency, objective total sleep time and objective sleep efficiency were significantly lower than those in healthy control group (P<0.05).Conclusion:There is a significant decline in sleep quality in elderly patients with COPD and OSA overlap syndrome, which may be the cause and effect of sleep quality, affecting the course of the disease.

Objective:To explore the effect of implementing group empowerment management model based on Myers-Briggs Type Indicator (MBTI) Scale on the quality of orthopedic nursing management.Methods:From January 2018 to December 2019, MBTI Scale was used to test the personality types of 46 nurses in Department of Orthopedics in Zhejiang Hospital. Test results were analyzed and nurses were grouped and given empowerment management measures. Score of orthopedic nurses on the leaders, score of psychological empowerment of nurses and score of nursing quality were compared before and after the improvement of management.Results:MBTI Scale was used to classify personality types of 46 orthopedic nurses, among which ISFJ, ISTJ, ENFP and ESFJ were the most common personality types. After the implementation of empowerment management, score of nurses on the leaders, score of psychological empowerment of nurses and score of nursing quality were all improved than before, and the differences were statistically significant ( P<0.05) . Conclusions:Based on MBTI Scale, the group empowerment management of orthopedic nurses can give full play to the core advantages of nurses, improve self-management ability of nurses and nursing quality.

Objective:To investigate the effects of pulmonary rehabilitation on anxiety/depression and subjective/objective sleep quality of elderly patients with stable chronic obstructive pulmonary disease(COPD).Methods:From February 2018 to February 2019, 120 elderly patients with stable COPD were selected and randomly divided into the experimental group (pulmonary rehabilitation exercise combined with conventional COPD treatment) and the control group (simple COPD conventional treatment). Sixty cases in each group were intervened for 8 weeks. Before and after treatment, Hamilton anxiety scale (HAMA) was used to evaluate anxiety, Hamilton depression scale(HAMD)was used to evaluate depression, Pittsburgh sleep quality index(PSQI)and sleep log were used to evaluate subjective sleep quality, and objective sleep quality was monitored by multi-channel sleep monitor.SPSS 21.0 software was used to analyze and process the data. Chi square test, independent sample t test and paired t test were used for statistical analysis. Results:After 8 weeks of intervention, the HAMA and HAMD scores of the experimental group were lower than those of the control group (HAMA: (7.57±3.19) vs (10.15±4.89), t=-3.428, P=0.001; HAMD: (8.22±4.73) vs (10.60±6.49), t=-2.300, P=0.023). COPD patients with anxiety decreased (χ 2=7.566, P=0.006). After treatment, the subjective sleep latency of the experimental group was shorter than that of the control group ((42.00±9.88)min vs (47.25±10.27)min, t=-2.854, P=0.005). The subjective sleep efficiency was higher than that of the control group ((76.00±4.50)% vs (74.00±5.20)%, t=2.272, P=0.025), and the objective sleep latency was shorter than that of the control group ((28.02±5.59)min vs (32.95±6.21)min, t=-4.575, P<0.05). Conclusion:Pulmonary rehabilitation exercise can improve the anxiety and depression of elderly patients with stable COPD, and improve the subjective and objective sleep quality.

目的 探讨应激性生活事件(SLE)和社会支持缺陷(SSD)对急性冠脉综合征(ACS)患者后期功能恢复的影响.方法 以2016年9月至2019年6月在浙江医院接受治疗的ACS患者为研究对象,根据威胁事件列表及社会支持量表评估结果分为A组(无SLE无SSD)、B组(有SLE无SSD)、C组(无SLE有SSD)和D组(有SLE有SSD).1年后采用社会和职业功能评定量表(SOFAS)、WHO残疾评定量表检查者12项(WHODAS-12)、WHO生活质量简表(WHOQOL-BREF)评估并比较患者的功能状态及生活质量.结果 共纳入652例ACS患者,其中398例完成1年随访.4组患者在性别、独居、Montgomery Asberg抑郁评定量表(MADRS)评分、焦虑症方面比较,差异均有统计学意义(均P<0.05).校正这4个协变量后,经协方差重复测量分析发现4组患者SOFAS、WHODAS-12评分以及WHOQOL-BREF的生理因素、社会关系、环境背景评分均存在组间及时间的交叉反应(均P<0.05).结论 ACS早期阶段存在SLE和SSD,预示患者后期功能恢复差和生活质量低下.

睡梦中为何"拳打脚踢" 年届七旬的顾老太晚上睡觉时总是"不安分",十年前开始梦话连篇,后来发展为做噩梦,经常做跟蛇有关的梦,有几次居然从床上摔到地板.原本就郁郁寡欢的顾老太也因此变得更加心烦、乏力,体重也下降了4千克.

目的 研究抗菌药物预防心肌梗死患者介入治疗后医院感染的效果.方法 选取2015年12月-2017年11月医院急性心肌梗死介入治疗术患者336例为研究对象,根据术前 、术后使用抗菌药物的情况,随机按照1:1:1:1比例将其分为I组 、II组 、III组和IV组,各84例.I组患者,术前预防性使用抗菌药物0.5 h、术后抗菌药物预防使用72 h以上;II组患者,术前预防性使用抗菌药物0.5 h、术后抗菌药物预防使用72 h;III组患者仅术前预防性使用抗菌药物0.5 h;IV组患者,介入前后均未采用任何抗菌药物预防医院感染.比较四组患者心肌梗死介入治疗后白细胞计数 、中性粒细胞百分比及介入术后医院感染情况.结果 医院感染率I、II、III组低于IV组(P<0.05);多药耐药率I组高于II、III、IV组(P<0.05);白细胞计数异常率 、中性粒细胞百分比异常率I、II、III组低于IV组(P<0.05);四组患者心肌梗死介入治疗后呼吸道感染构成比均高于同组泌尿道感染 、介入部位感染和血行感染构成比(P<0.05);住院时间I、II、III组短于IV组(P<0.05);成本-效果比I、II、III组小于IV组,III组小于I、II组(P<0.05).结论 术前预防使用抗菌药物0.5 h能有效降低心肌梗死介入术后医院感染率,但过度使用可使耐药率升高 、增加经济负担.

Purpose: Inconsistent outcome about association between insufficient sleep and bone mineral density (BMD) has been reported. The present study aimed to determine whether BMD was associated with score of Pittsburgh Sleep Quality Index (PSQI). Methods: A total of 410 patients (mean age 81.6 ± 5.9 years) attending our hospital for evaluation of sleep were retrospectively studied. Dual-Energy X-ray Absorptiometry was used to measure BMD and T-score at femoral neck and lumbar spines over L2–L4 regions. Subjective sleep status was evaluated by the PSQI questionnaires. The Mann–Whitney U test and chi-square analysis were used to compare continuous variables and categorical variables, respectively. Spearman correlation test was conducted to find the relationship between BMD and other clinical factors. Multinomial logistic regressions analysis was performed to analyze independent factors predicting BMD. Results: Majority of the participants with osteoporosis (OP) were female and had lower body mass index (BMI) and higher sleep onset latency score. Spearman correlation test showed that gender, BMI, score of total PSQI, and sleep onset latency were significantly related to BMD and T-score in femoral neck and lumbar region L2–L4. Finally, multinomial logistic regression analysis demonstrated that gender and age were independent factors for OP and osteopenia and that after adjustment for gender, age, and BMI, sleep onset latency of , 15 minutes (OR: 0.38; 95% CI: 0.15–0.96; P = 0.04) and 16–30 minutes (OR: 0.37; 95% CI: 0.17–0.79; P = 0.01) were less likely to have reduced BMD. Conclusion: There was a significant association between BMD and sleep onset latency, sug-gesting that, in elderly patients with sleep problem, BMD measurement and intervention for OP might be valuable.

目的 探讨太极拳运动对在职1级高血压患者情绪及心率变异性的影响.方法 选择2014年6月～2017年5月在浙江医院初诊的在职高血压患者208例,随机分成研究组和对照组.对照组给予一般日常生活方式干预,研究组在一般日常生活方式干预基础上给予24式简化太极拳运动锻炼3个月,所有患者于研究结束后随访,研究前后分别检测患者的心率变异性(HRV)参数(SDNN、SDANN、RMSSD),并采用焦虑自评量表(SAS)、抑郁自评量表(SDS)评估患者研究前后的焦虑抑郁症状,观察2组治疗前后相关指标变化.结果 (1)运动后,研究组98例在职高血压患者中焦虑抑郁有36例,占37％;对照组100例在职高血压患者中焦虑抑郁有42例,占42％.(2)运动后,研究组收缩压(SBP)、舒张压(DBP)均下降(P＜0.05);研究组SAS、SDS量表评分较运动前均有降低(P＜0.05);研究组与对照组比较,SAS、SDS量表评分较对照组低(P＜0.05);研究组SDNN、SDANN、RMSSD较运动前升高(P＜0.05);研究组SDANN较对照组高(P＜0.05).(3)在焦虑抑郁亚组中,运动后,研究组SBP、SDNN、SDANN、RMSSD、SAS、SDS等指标较运动前均有显著性差异(P＜0.05);运动后,研究组SBP、DBP、SDNN、SDANN、RMSSD、SAS、SDS等指标较对照组均有显著性差异(P＜0.05).结论 太极拳运动能够改善在职高血压患者的血压水平,改善焦虑抑郁情绪,改善心率变异性,是一项适合在职高血压患者康复的有氧运动.

目的 探讨高血压患者血清同型半胱氨酸(Hcy)水平与肌酐(Cr)、尿酸(UA)、甲状旁腺激素(PTH)的关系.方法 根据Hcy水平将189例高血压患者分为Hcy正常组(68例)和Hcy升高组(121例)两组,检测其Cr、UA、PTH水平,分析Hcy与Cr、UA、PTH的关系.结果 Hcy升高高血压组患者Cr[(78.65±27.75)μmol/L vs (61.96±10.97)μmol/L,P＜0.01]、UA[(370.34±93.54)μmol/L vs(328.04±80.78)μmol/L,P＜0.05]、PTH[(59.51±11.95)pg/ml vs(37.30±10.18)pg/ml,P＜0.05]显著高于Hcy正常高血压组.皮尔逊相关系数分析发现高血压患者中Hcy水平与PTH呈正相关(r =0.66,P＜0.05).结论 Hcy升高的高血压患者易出现Cr、UA、PTH升高,且Hcy水平变化与PTH相关.

目的 观察认知记忆训练对老年人记忆障碍的康复训练效果.方法 采用简易智能精神状态检查量表(MMSE)、MMSE的回忆得分及日常生活能力量表(ADL)对老年记忆障碍患者进行评估.将102名患者随机分为训练组和对照组;对照组维持原有的治疗和生活习惯,训练组采用加做计算机辅助认知记忆训练,训练前和训练3个月后通过MMSE、MMSE的回忆及ADL评分评价训练效果.结果 对训练组训练前后的MMSE和MMSE的回忆得分成绩进行比较,结果显示训练组训练后得分均较前有显著提高,而对照组成绩提高无统计学意义,表明记忆训练可显著改善患者记忆能力.干预后训练组的ADL得分较对照组及干预前均显著降低(P＜0.05).结论 计算机辅助认知记忆训练对老年记忆障碍患者的记忆功能有明显改善,并能提高患者的日常生活能力.

目的 探讨有氧运动联合艾司西酞普兰对老年抑郁症患者预后的影响.方法 收集浙江医院精神卫生科就诊的老年抑郁症患者,随机分为有氧运动+艾司西酞普兰组(E+AE组)、普通运动+艾司西酞普兰组(E+NAE组)和艾司西酞普兰组(E组),观察三组干预前及干预1个月、2个月、4个月、6个月后的疗效及汉密尔顿抑郁量表(HAMD)评分的变化情况.HAMD评分≤10分作为抑郁症状临床缓解的标准.结果 共有108例老年抑郁症患者随机入组,在研究末,E组中56.7％、E+NAE组中63.0％、E+AE组中80.0％获得临床缓解(x2=12.8,P=0.002).E+AE组与E+NAE组和E组比较,能在更短的时间内获得临床缓解(P＜0.05).结论 老年抑郁症患者在药物治疗的基础上联合有氧运动安全有效.

目的 调查医务人员对抑郁症和老年期痴呆诊治技术了解情况.方法 选择浙江省10个地市的医务人员进行《抑郁症和老年期痴呆诊治问卷》调查,共发放问卷527份,回收521份,其中有效问卷512份.结果 随着医院等级的提高,两种疾病技术的了解程度逐渐提高,但街道与社区卫生服务的基层医务人员对两种疾病的诊疗技术的了解程度较低(P＜0.01).在社区卫生服务中心的医务人员不了解的人群远远高于了解的人群,除精神专科医务人员,其他专业的医务人员对抑郁症的精神访谈技术及心理测试技术(包括量表自评及他评),不了解的人群基本上多于了解的人群(P＜0.01).老年期痴呆的诊断、评估、治疗、康复管理等技术的医务人员不了解超过了解(P＜0.01).综合医院和精神专科医院的医务人员对两种疾病的技术了解的人群高于不了解的人群,而在社区卫生服务中心的医务人员不了解的人群远远高于了解的人群(P＜0.01).随着工作年限的增加,抑郁症识别技术、精神访谈技术、药物治疗、心理治疗技术及康复技术了解的人群要高于不了解的人群(P＜0.05或0.01).结论 基层医务人员作为精神疾病防控、康复的第一线,对相关知识的了解程度令人担忧,应该通过各种方式,把专业知识向基层进行传播.

Objective To investigate the needs for diagnosis and treatment techniques for depression and dementia in community doctors in Zhejiang province. Methods“Depression and senile dementia diagnosis and treatment questionnaire” (including 20 techniques) was designed. Community doctors were surveyed in ten cities. A total of 612 questionnaires were issued, and 590 were reclaimed, 533 of which were valid questionnaires. For different levels of hospitals, hospitals of different properties, different majors, different professions, different working experience of doctors on the technical demand percentage were compared and analyzed. Count data were compared by chi square test. Results Different levels of hospitals, hospitals of different properties, different majors, different professions, different working experience of doctors on the technical demand percentage were signiifcantly higher than the percentage of non-demand. The percentage of doctors in tertiary hospitals on the technology demand for MECT was significantly higher than secondary hospitals, street hospitals and community hospitals (χ2=11.42, 6.92, 8.75,allP< 0.01). Except for the modified electric shock technology and the senile dementia screening technology, there were no signiifcant differences in the needs of different professional physicians in the treatment of depression and senile dementia. The percentage of psychiatrists on the technology demand of MECT was higher than that of other professional physicians. The percentage of surgeons on the technology demand for Alzheimer's screening was lower than those of other professional physicians (χ2=8.90,P<0.01). The percentage of doctors' seniority in 1~3 years on the technology demand for psychiatric interview was lower than the percentage of other seniority groups (χ2=6.09, P<0.05). ConclusionPrimary medical staff in Zhejiang province have a strong demand for the technology of diagnosis and treatment in depression and senile dementia. After the questionnaire survey, the speciifc needs of the medical staff can be understood. It will be more targeted in the next step of the training and improve the training effect.

“过年了，孩子们都回来是热闹的，可是过完年，他们走了，心里不免又空落落的。”刘阿姨神情落寞地说。像刘阿姨这种子女常年在外，平时只有老两口过日子的空巢老人，往往容易患“节后空巢症”。

ObjectiveTo investigate the correlation among sleep quality, living quality and mental state among gerontal patients in hospital.MethodsPittsburgh Sleep Quality Index (PSQI), Short Form Health Survey (SF-36), the Geriatric Depression Scale (GDS) and Self-rating Anxiety Scale (SAS) were adopted to investigate the sleep quality, living quality, and mental states in 78 patients from April to November 2011, who older than 75 years in hospital. Measurement data of normal distributionwas expressed byx±s, the comparison between two groups was evaluated by independent-samplest test, correlativity was evaluated by pearson correlation analysis.Results The PSQI score of 78 patients was 0~18(7.9±3.8). The number of normal sleeper(PSQI≤7) was 38(48.7%); the number of sleep disorders patients(PSQI>7)was 40(51.3%). The scores of physical function (PF), role-physical (RP), Bodily Pain(BP), general health (GH) and vitality (VT), social function (SF), role emotional (RE), mental health were 0~100(63.9±22.1), 0~100(56.4±42.2), 12~100(71.4±23.0), 10~75(47.3±13.8), 20~90(56.6±16.6), 0~100(78.7±22.3), 0~100(73.4±40.2), 40~100(68.7±12.2)respectively. The scores of sleep quality, living quality, degree of anxiety and depression between men and female had no statistically signiifcant differences (P>0.05). The scores of PF, RP, GH, VT in sleep disorders group were signiifcant lower than that in sleep normal group(t=4.21, 2.30, 2.30, 2.96;P<0.05 or 0.01), meanwhile the score of SAS was signiifcant higher than that in sleep normal group(t=-3.05,P<0.01). The score of PSQI was negatively correlated with physical function (PF), role-physical (RP), general health (GH) and vitality (VT)(r=-0.51,-0.34,-0.25,-0.35;P<0.01), and positively with score of SAS(r=0.41,P<0.01). The score of GDS was negatively correlated with PF, BP, GH, VT, SF, RE and MH(r=-0.34,-0.29,-0.32,-0.27,-0.30,-0.31,-0.33;P<0.01), meanwhile was positively correlated with score of SAS(r=0.04,P<0.01). The score of SAS was negatively correlated with PF, BP, GH and RE(r=-0.33,-0.25,-0.25,-0.27;P<0.01).Conclusion There are close correlation among sleep quality, living quality and mental state among gerontal patients in hospital. Positive measures should be taken to intervene the sleep and mental problems, thereby improve the living quality of patients.

BACKGROUND:Previous published data on the association between CYP1A2 rs762551, rs2069514, rs2069526, and rs2470890 polymorphisms and lung cancer risk have not allowed a definite conclusion. The present meta-analysis of the literature was performed to derive a more precise estimation of the relationship.MATERIALS AND METHODS:8 publications covering 23 studies were selected for this meta-analysis, including 1,665 cases and 2,383 controls for CYP1A2 rs762551 (from 8 studies), 1,456 cases and 1,792 controls for CYP1A2 rs2069514 (from 7 studies), 657 cases and 984 controls for CYP1A2 rs2069526 (from 5 studies) and 691 cases and 968 controls for CYP1A2 rs2470890 (from 3 studies).RESULTS:When all the eligible studies were pooled into the meta-analysis for the CYP1A2 rs762551 polymorphism, significantly increased lung cancer risk was observed in the dominant model (OR=1.21, 95 % CI=1.00-1.46). In the subgroup analysis by ethnicity, significantly increased risk of lung cancer was observed in Caucasians (dominant model: OR=1.29, 95%CI=1.11-1.51; recessive model: OR=1.33, 95%CI=1.01-1.75; additive model: OR=1.49, 95%CI=1.12-1.98). There was no evidence of significant association between lung cancer risk and CYP1A2 rs2069514, s2470890, and rs2069526 polymorphisms.CONCLUSIONS:In summary, this meta-analysis indicates that the CYP1A2 rs762551 polymorphism is linked to an increased lung cancer risk in Caucasians. Moreover, our work also points out the importance of new studies for rs2069514 associations in lung cancer, where at least some of the covariates responsible for heterogeneity could be controlled, to obtain a more conclusive understanding about the function of the rs2069514 polymorphism in lung cancer development.

Objective To investigate the relationship between proinflammatory cytokines and cognitive function in patients with mild cognitive impairment (MCI).Methods From May 2007 to May 2009,70 patients (aged ≥ 60 years) with MCI were collected.Among them,50 cases were amnestic MCI,and 19 cases developed into AD.The cognitive function was assessed,and all patients were followed up.The venous blood samples were obtained and proinflammatory cytokines (IL-1α,IL 1β,IL-6,TNF-α) were detected by using enzyme linked immunosorbent assay.Results There were differences in the levels of proinflammatory cytokines between patients with aMCI and patients with Alzheimer's disease (AD) [IL-1β,(40.5 ± 7.7) μg/L vs.(38.6 ± 7.3) μg/L ; IL 6,(70.4 ±24.3) μg/'L vs.(53.6±20.5) μg/L;TNF-α,(58.6±13.5) μg/'L vs.(50.3±-17.1) μg/'L;t=3.537,2.229,2.226,P=0.002,0.039,0.039,respectively].Conclusions MCI is a preclinical state of AD.The cognitive function damage of MCI patients are different from that of AD patients,and the immune status of MCI patients is also changed.

Objective To investigate the relationship between sleep and quality of life of patients with coronary heart dis-ease. Methods Pittsburgh Sleep Quality Index (PSQI) and Short Form Health Survey (SF- 36) were adopted to investigate the sleep situation and life quality in both out- patients and in- patients receiving cardiac rehabilitation in Zhejiang Hospital from September 2011 to September 2012. Results The scores of SF were significantly lower in CHD patients with PSQI score ≥ 7 than those with PSQI score≤4 in aggregate scores and physiological function standard scores (PF), bodily pain standard scores (BP), the overal sense of health standard scores(GH), social functioning standard scores(SF), emotional problems role limitations due to standard scores(RE) (P<0.05). Conclusion Sleep disorders have comprehensive influence on physiological, psychologi-cal and social functions of CHD patients. It is necessary to take sleep intervention measures to improve the quality of life in CHD patients.