Objective To investigate the occurrence of recent cardiovascular events (CVEs) for elderly patients with stable coronary artery disease (sCAD) after acute lower respiratory tract infection (ALRTI) and to analyze the related clinical risk factors.Methods Total of 210 stable elderly patients with coronary heart disease hospitalized in Wuji County Hospital of Hebei Province from June 2013 to June 2015 were selected. Patients were divided into infection group (110 cases) and control group (100 cases) according to whether associated with acute lower respiratory tract infection. The basic conditions of patents in the two groups were compared and routine examinations (indicators of blood, inflammation and nutrient intake) were performed, respectively. Follow-up was performed in both groups and cardiovascular events (acute heart failure, ST-elevation myocardial infarction, non-ST-elevation acute coronary syndrome, venous thromboembolism and acute ischemic stroke) were recorded. All the causes of death were compared and the risk factors were investigated.Results Compared with the control group, the follow-up results at the 10th day, 30th day and 60th day showed that the incidence of CVEs of patients in the infection group was 10.00%, 20.00% and 37.27%, respectively, with significant differences (χ2 = 2.34, 3.22, 4.18;P = 0.02, 0.01, 0.04). The all-cause mortality rates of patients in the infection group were 1.82%, 4.55% and 13.64%, which were significantly different compared with the control group (χ2 =1.86, 2.07, 2.55;P = 0.03, 0.00, 0.03). The RDW of patients in the infection group had a unit of (15.76 ± 1.58)%, which was significantly higher than that of the control group [(13.35 ± 0.96)%], with significant difference (t = 0.25,P = 0.03). The RDW of patients with cardiovascular event was (14.18 ± 1.96)%, which was significantly higher than that of the patients without cardiovascular event [ (13.48 ± 1.02)% ], with significant difference (t = 1.36,P= 0.02).Conclusions Acute respiratory infections in elderly patients with stable coronary heart disease could increase the incidence of CVEs and the incidence of all-cause mortality. Increased RDW, acute lower respiratory tract infection, rapid heart rate and chronic kidney disease were independent predictors of CVEs and all-cause mortality in elderly patients with stable coronary heart disease.

Objective To study the clinical value of serum procalcitonin (PCT) concentration in elderly patients with heart failure during the treatment of anti-infective therapy. Methods A total of 200 elderly patients with heart failure who were treated in ICU from February,2015 to March,2016 were randomly divided into two groups:experimental group (PCT) and control group (conventional treatment group) people. The two groups of patients were routine treatment,the control group of patients by physician analysis to determine the best time to use antimicrobial therapy,the experimental group by a certain number of elderly patients with heart failure after admission in the first 1,3,7,14 days. Analysis of changes in PCT concentration to determine whether anti-infective treatment of patients with the use of antimicrobial drugs. Observe the two groups of patients with antibiotic treatment,hospital stay, hospital costs,double infection rate and other indicators. Results There were no significant differences in age,sex,course of disease, LVEF and leukocyte between the two groups. Among the pathogens isolated from the two groups,klebsiella pneumoniae,acinetobacter baumannii,the number of pseudomonas aeruginosa was the highest,the average hospitalization cost of the experimental group was lower than that of the control group. The course of antimicrobial treatment was significantly lower in the experimental group than that in the control group. The dosage and cost of the antibiotics in the experimental group were lower than the control group ,The infection rate was 7% in the control group and 3% in the control group. The difference was statistically significant (P < 0.05). Conclusion PCT dynamic changes in the elderly patients with severe heart failure to guide the use of antimicrobial agents have a certain significance,according to the level of PCT changes to determine whether the use of antibiotics,whether to disable antibiotics,and evaluate the efficacy of antibiotics. In ICU elderly patients with heart failure in the treatment of anti-infection treatment of PCT concentration changes in the use of drugs,can reduce the use of antimicrobial drugs and hospital stay and drug resistance.

Objective To investigate the related factors of nosocomial infection in elderly patients with cardiovascular and cerebrovascular diseases, and to provide evidence for effective measures to prevent nosocomial infection. Methods Total of 121 elderly patients with cardiovascular and cerebrovascular diseases in our hospital were selected from January 2013 to January 2015. The clinical information, history and behavioral data of the 121 cases were analyzed, retrospectively. Results Total of 28 patients among 121 cases were with hospital infection. The infection sites were the urinary system (9 cases, 7.44%), respiratory tract (15 cases, 12.40%), skin (2 cases, 1.65%) and soft tissue (2 cases, 1.65%), respectivly. Patients with Gram-negative bacteria accounted for 60.71% (17/28), among whom, 8 cases (28.57%) with Acinetobacter infection, 5 cases (17.86%) with Klebsiella pneumoniae infection, 4 cases (14.28%) with copper-green pseudomonocytosis bacteria infection. Patients with Gram-positive bacteria accounted for 28.57% (8/28), 6 cases (75.00%) of whom were with Staphylococcus aureus infection and 3 cases (10.71%) were with fungi infection. The cases of bedridden, cerebrovascular accident, pseudobulbar palsy, tracheotomy patients with hospital infection and unable to take care of themselves were 6 cases (10.34%), 6 cases (17.65%), 3 cases (8.82%), 5 cases (20.00%) and 8 cases (13.79%), respectively. Univariate and multivariate regression analysis showed that bedridden, cerebrovascular accident, pseudobulbar palsy, tracheotomy, unable to take care of themselves as well as disturbance of consciousness were significantly related with the rates of hospital infection (all P < 0.05, all OR > 1). Conclusions The pathogen of nosocomial infection was mainly Gram-negative bacteria in elderly patients with cardiovascular and cerebrovascular diseases. Bedridden, cerebrovascular accident, pseudo-ball paralysis, tracheotomy and unable to take care of themselves were the main risk factors causing hospital infection.

Objective To analysis the risk factors of intracranial artery stenosis in lacunar infarction patients. Meth-ods Retrospectively compare the clinical data of patients with lacunar infarction and to identify the independent risk factors of lacunar cerebral infarction complicated with intracranial artery stenosis. Results There were 198 patients with lacunar infarc-tion. The average age was(63. 89 ± 11. 17)years old. Intracranial artery stenosis group were 121 cases(67. 7% ),29 cases (24% )were the solitary artery stenosis,92 cases(76% )were multiple artery stenosis. And 120 cases(120 / 174,60. 6% ) with hypertension,98 cases(98 / 174,49. 5% )with hyperlipemia,62 cases(62 / 174,31. 3% )with coronary disease. Coronary heart disease(42. 1% vs. 14. 3% ;χ2 = 9. 205,P = 0. 002)and diabetes mellitus(25. 6% vs. 10. 4% ;χ2 = 3. 173,P =0. 007)and carotid IMT thickening(29. 7% vs. 7. 8% ;χ2 = 3. 962,P = 0. 047)was significantly higher in intracranial artery stenosis group than that in the patients without intracranial artery stenosis group. High density lipoprotein cholesterol(HDL-C)level was significantly lower than the no intracranial artery stenosis group[(1. 31 ± 0. 52)mmol/ L vs. (1. 57 ± 1. 54) mmol/ L;t = - 2. 242,P = 0. 026]. Multivariate lolgistic regression analysis showed that coronary heart disease(OR 10. 013, 95% CI 1. 079 ~ 92. 900;P = 0. 043])and diabetes mellitus(OR 6. 766,95% CI 1. 704 ~ 26. 870,P = 0. 006)were risk fac-tors of intracranial artery in patients with lacunar infarction narrow narrow. And higher levels of HDL(OR = 0. 015,95% CI =0. 001 - 0. 299)were the protective factors of intracranial artery stenosis in patients with lacunar infarction. Conclusion It is common with lacunar cerebral infarction patients with intracranial artery stenosis. Coronary heart disease and diabetes are inde-pendent risk factors of intracranial arterial stenosis associated with lacunar infarction.