Objective:To develop a Beijing norm of Memory and Executive Screening (MES) scale to facilitate its further promotion and application in the future.Methods:Study subjects were selected based on the inclusion and exclusion criteria, including patients who visited the memory clinic of Xuanwu Hospital of Capital Medical University from March 20, 2017 to January 6, 2021, and normal people recruited simultaneously from community, and trained and qualified investigators conducted questionnaire surveys through face-to-face interviews. Then strict quality control, data collection and statistical analysis were performed.Results:A total of 607 participants were included, including 239 normal people, 293 individuals with subjective cognitive decline (SCD), and 75 individuals with mild cognitive impairment (MCI). There was a negative correlation between the scores of MES and age ( r=-0.19, P<0.001), but a positive correlation between scores of MES and education level ( r=0.29, P<0.001). The optimal cut-off value of this scale in Beijing was 86 points, the area under curve (AUC) of the cut-off value to distinguish MCI was 0.847 (normal people vs MCI) and 0.826 (SCD vs MCI), and after adding demographic variables, AUC showed slight increase (0.847 to 0.850 and 0.826 to 0.847), whereas the differences were not statistically significant ( Znormal peoplevsMCI=0.49, ZSCDvsMCI=1.21, P>0.05). And there was no statistically significant difference between MES and Montreal Cognitive Assessment scales in diagnostic power for normal people and people with MCI ( Zscale alone=1.03, Zafter adding demographic variables=1.13, P>0.05). Conclusions:The MES scale has a better distinguishing power for MCI, and its optimal cut-off value in Beijing is 86 points, which is different from previous studies. In the future, the sample size needs to be further expanded to verify this norm.

BACKGROUND:Early diagnosis and appropriate antibiotic treatment are important to survival of Listeria monocytogenes (L. monocytogenes) bacteremia. Penicillin tends to be the most commonly used antibiotic. However, there are limited data on antibiotic use in elderly patients with serious complications. We describe the clinical presentation, antibiotic therapy, and traceability of L. monocytogenes in a centenarian with a history of eating frozen food.CASE SUMMARY:A 102-year-old man suffered from high fever with chill after hematochezia. Tentative diagnoses were lower gastrointestinal hemorrhage and localized peritonitis. Meropenem and ornidazole were the empirical therapy. The patient did not respond and developed multiple system dysfunction even after teicoplanin was added to the therapy. L. monocytogenes was identified from blood cultures on day 5 of admission. The patient had a history of consuming frozen dumplings. Meropenem/ornidazole/teicoplanin were replaced with meropenem/linezolid. The patient gradually became afebrile. He received meropenem/linezolid for 10 d, and piperacillin/tazobactam was applied as step-down treatment for 2 wk with good clinical results. There was no sign of relapse during follow-up after discharge. L. monocytogenes isolates from the patient and frozen dumplings belonged to different serotypes and sequence types (STs): 1/2b and ST5 from the patient and 1/2c and ST9 from the dumplings.CONCLUSION:More awareness of listeriosis should be raised. Linezolid might be an option for listeriosis in elderly people with serious complications.

目的 探讨代谢综合征(MS)与老年女性缺血性脑卒中患者预后的关系.方法 前瞻性连续入选2017年9月1日～2018年6月30日首都医科大学宣武医院综合科和神经内科住院首次发病的老年女性急性缺血性脑卒中患者298例,根据患者入院评估分为MS组106例,非MS组192例.比较2组年龄、吸烟、饮酒、体质量指数、脑卒中史、高血压、糖尿病等脑卒中危险因素,并随访3个月和1年,采用多因素logistic回归分析MS对患者结局的影响.结果 MS组体质量指数、高血压、糖尿病、空腹血糖、TG、LDL-C和高敏C反应蛋白水平明显高于非MS组,HDL-C水平明显低于非MS组,差异有统计学意义(P＜0.05,P＜0.01).随访3个月和1年,MS组预后不良比例明显高于非MS组(18.9％vs14.6％,17.9％vs 15.6％,P＜0.01).多因素logistic回归分析显示,MS、年龄≥75岁、脑卒中史、入院美国国立卫生研究院卒中量表评分＞4分和糖尿病是老年女性缺血性脑卒中患者1年预后不良的独立危险因素(P＜0.01).结论 多种常见危险因素会对老年女性缺血性脑卒中患者的预后产生影响,MS是老年女性缺血性脑卒中患者预后不良的独立危险因素.

目的 探讨老年人代谢综合征(MS)与骨质疏松的相关性.方法 选择我院老年综合科诊治的老年患者258例,根据骨密度水平分为骨质疏松组93例和非骨质疏松组165例.又根据MS诊断分为MS组96例,非MS组162例.比较2组一般情况、体质量指数(BMI)、糖脂代谢、炎性因子等指标,并行多因素logistic回归分析.结果 骨质疏松组年龄、女性、LDL-C、高敏C反应蛋白及白细胞介素6水平明显高于非骨质疏松组,BMI、腰围、臀围、四肢骨骼肌质量、四肢骨骼肌质量指数、HDL-C、维生素D、骨钙素水平明显低于非骨质疏松组(P＜0.05,P＜0.01).MS组骨密度及T值(腰椎、左股骨颈、右股骨颈)、骨钙素和维生素D水平明显低于非MS组(P＜0.05,P＜0.01).logistic回归分析显示,校正混杂因素后,MS、女性、LDL-C为老年患者骨质疏松的危险因素(OR=2.36,95％CI:1.08～4.13,P=0.000;OR=2.82,95％ CI:1.64～5.07,P=0.000;OR=1.97,95％ CI:1.19～3.12,P=0.000),BMI、HDL-C为老年患者骨质疏松的保护因素(OR=0.89,95％CI:0.79～0.96,P=0.001;OR =0.93,95％CI:0.82～0.98,P=0.001).结论 MS、女性、LDL-C、BMI、HDL-C是老年人骨质疏松的影响因素.

Abstract Background Since SCD (plus) was standardized, little is known about its demographic characteristics and its outcomes of neuropsychological assessments, including the SCD questionnaire 9 (SCD‐Q9). Objective To characterize SCD (plus) by comparing the neuropsychological features among its subgroups and with normal controls (NC). Also, to explore its demographics and to understand the relation of the chief complaints and the scores of SCD‐Q9. Methods Multistage stratified cluster random sampling was conducted to select participants. As a result, 84 NC and 517 SCD (plus) were included. SCD (plus) was further classified into several subgroups (SCD‐C: concerned cognitive decline; SCD‐F: complaints about SCD within the past five years; SCD‐P: feeling performance being not as good as their peers; SCD+: presented> 3 of SCD (plus) features; SCD‐: presented ≤ 3 of SCD (plus) features (see the diagnostic criteria for the details)) and between‐group comparisons of neuropsychological scores were conducted. Point‐biserial correlation and binary logistic regression analyses were performed to investigate the demographic characteristics of its subgroups. Finally, Spearman correlation was used to better understand the relation of SCD (plus) to SCD‐Q9. Results (1) Scores of AVLT‐LR (AVLT‐LR: Auditory Verbal Learning Test‐Long Delayed Recall) and MoCA‐B (MoCA: Montreal Cognitive Assessment‐Basic) were lower in the SCD‐P group than those in the NC group, and the SCD+ group scored lower in the MoCA‐B and CDT(CDT: Clock Drawing Test) than the SCD‐ group. (2) Females were more concerned than male participants. Individuals with lower education level felt that their cognitive performance were worse than their peers. Also, younger people might express concerns more than the more elderly. People who had complaints of SCD‐P might be more likely to report SCD‐C, but less likely to report SCD‐F. (3) Positive correlations were found between the chief complaints of SCD (plus) and some items of SCD‐Q9. Conclusions SCD (plus) may be related to demographic factors. Individuals with SCD (plus) already exhibited cognitive impairment, which can be detected by SCD‐Q9.

Objective Background Acute heart failure (AHF) is a complex clinical syndrome responsible for high morbidity and mortality and frequently complicated by concomitant hypertension and atrial fibrillation (AF).Despite advances in the management of heart failure ,the prognosis of these patients remains poor and there is a critical need for new treatment strategies improving the clinical outcomes. The aim of this study was to evaluate whether a1-blocker ,urapidil ,provides additional therapeutic benefits compared to nitroglycerin (NG)in treatment of acute heart failure complicated by hypertension and atrial fibrillation in elderly patients. Methods Fifty-eight elderly consecutive patients from Cardiology Department of Xuan Wu Hospital were randomized into 2 groups that received treatment with urapidil or NG. All patients were received normal treatments containing diuretic ,ACEI ,and cardiac stimulant. Patients in control group (n = 28) were treated with NG 5-10μg/min ,while those in case group (n = 30) were treated with urapidil 50-100 μg/min. The duration was 7 days. The blood pressure and heart rate before treatment and 24 ,48 ,72 h ,7 days after treatment were compared between the two groups ,indicators which reflect the cardiac function such as NT-proBNP ,LVEDD ,LVEDV ,EF and CI were also compared between the two group.Results Patients receiving urapidil had significantly lower systolic BP than their counterparts in NG group (P ﹤ 0.05) . Moreover ,patients inurapidil group showed lower NT-proBNP levels ,LVEDD and LVEDV but higher ejection fraction (t= 2.206 ,P ﹤ 0.05) ,cardiac index (t = 3.13 ,P ﹤ 0.05) compared to NG group. There were no reflectively heart rateaccelerating in case group. Urapidil showed no bad influence on blood glucose ,cholesterol and triglyceride. Patients receiving urapidil had significantly lessside effects than their counterparts in NG group (P ﹤ 0.05).Conclusions Urapidil demonstrated better efficacy and less side effects than nitroglycerin on lowering and stabilizing systolic BP ,attenuating cardiac afterload and improving cardiac function. Urapidil is a therapeutic option for the acute heart failure patients complicated with hypertension and atrial fibrillation.

Objective Background Acute heart failure (AHF) is a complex clinical syndrome responsible for high morbidity and mortality and frequently complicated by concomitant hypertension and atrial fibrillation (AF). Despite advances in the management of heart failure, the prognosis of these patients remains poor and there is a critical need for new treatment strategies improving the clinical outcomes.The aim of this study was to evaluate whether a1-blocker, urapidil, provides additional therapeutic benefits compared to nitroglycerin(NG)in treatment of acute heart failure complicated by hypertension and atrial fibrillation in elderly patients. Methods Fifty-eight elderly consecutive patients from Cardiology Department of Xuan Wu Hospital were randomized into 2 groups that received treatment with urapidil or NG.All patients accepted normal treatments containing diuretic, ACEI, and cardiac stimulant.Patients in control group (n=28) were treated with NG 5-10 μg/min intravenously, while those in case group (n=30) were treated with urapidil 50-100 μg/min intravenously.The duration was 7 days.The blood pressure and heart rate before treatment and 24, 48, 72 hours, 7 days after treatment were compared between the two groups, NT-proBNP, LVEDD, EDV, ejection fraction (EF) and cardiac index (CI) were also compared between the two groups. Results Patients receiving urapidil had significantly lower systolic BP than those in NG group (P<0.05). Moreover, patients in urapidil group showed lower NT-proBNP levels, LVEDD and EDV but higher EF (t=2.206, P<0.05), CI(t=3.13, P<0.05) compared to NG group.There was no reflectively heart rate accelerating in case group.Urapidil showed no adverse influence on blood glucose, cholesterol and triglyceride.Patients receiving urapidil had significantly less side effects than those in NG group (P<0.05). Conclusions Urapidil demonstrated better efficacy and less side effects than nitroglycerin on lowering and stabilizing systolic BP, attenuating cardiac afterload and improving cardiac function.Urapidil is a therapeutic option for acute heart failure patients complicated with hypertension and atrial fibrillation. Key words: Hypertension; Atrial fibrillation; Heart failure; Urapidil

Objective:To explore the relationship between atrial fibrillation stroke risk score (CHA2DS2-VASc score) and short-term prognosis of aged patients with nonvalvular atrial fibrillation (NVAF)complicated ischemic cerebral stroke (ICS).Methods:A total of 206 aged NVAF+ ICS patients who hospitalized in our hosipital from Jun 2011 to Aug 2013 were selected.CHA2DS2-VASc score was used to perform stroke risk stratification,and patients were di- vided into low risk group (n=24,0 score),medium risk group (n=78,1 score)and high risk group (n=104,2~9 scores).Modified Rankin scale (mRS)was used to assess patients'prognosis on three months after onset.According to mRS score,patients were divided into good prognosis group (n=89,0~2 scores)and poor prognosis group (n=117,3~6 scores).Independent predictors for poor prognosis in three months were analyzed.Results:Compared with low risk group,there were significant rise in age,percentages of hypertension,diabetes mellitus (DM),heart failure,stroke and vascular disease history,scores of United States national institutes of health stroke score (NIHSS) in medium and high risk groups (P<0.05 or <0.01).Compared with good prognosis group,there were significant rise in age [(72.81±7.68)years vs.(81.56±8.03)years],percentages of hypertension (58.4% vs.71.8%)and stroke history (9.0% vs.29.9%),scores of NIHSS [(2.97±1.42)scores vs.(7.67±3.92)scores]and CHA2DS2- VASc [(1.70±1.63)scores vs.(4.03±2.53)scores]in poor prognosis group,P<0.05 or <0.01. Multi-factor Logistic regression analysis indicated NIHSS score (high risk:OR=1.78,95%CI:1.27~2.56,P=0.001 ), CHA2DS2-VASc scores (high risk:OR=3.24,95%CI:1.32~6.98,P=0.001)and age (high risk:OR=1.23, 95%CI:1.07~1.54,P=0.01)were independent predictors for poor prognosis on three months in aged NVAF +ICS patients.Conclusion:CHA2DS2-VASc score is related to early improvement of patients with NVAF + ICS;age,scores of NIHSS and CHA2DS2-VASc are independent predictors for poor short-term prognosis.

目的 探讨老年慢性心力衰竭(chronic heart failure,CHF)患者同型半胱氨酸(Hcy)水平与N末端B型利钠肽原(N-terminal-pro-B-type natriuretic peptide,NT-proBNP)、左心室结构和功能的相关性.方法 我院心脏科住院治疗老年CHF患者84例作为CHF组,依据纽约心脏病学会(NYHA)心功能分级标准将CHF组分为心功能Ⅱ级34例,Ⅲ级38例,Ⅳ级12例;纳入同期在我院健康体检者78例作为对照组.检测两组患者Hcy、NT-proBNP,运用彩色多普勒超声进行左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)测定,进行比较及相关性分析.CHF组患者入院后给予常规治疗基础上加用重组人脑利钠肽(recombinant human brain natriuretic peptide,rhBNP)抗心力衰竭治疗,先给予1.5 μg/kg负荷量,继之以0.01 μg·k-1·min-1静脉持续泵入72小时.在保证血压的情况下,维持治疗7天,比较治疗前后CHF组患者Hcy、NT-proBNP,LVEDD及LVEF.结果 ①CHF组Hcy、NT-proBNP均较对照组明显升高(P＜0.05);②心功能Ⅳ级组Hcy、NT-proBNP水平最高,与心功能Ⅱ、Ⅲ组比较有统计学意义(P＜0.05);心功能Ⅲ级组Hcy、NT-proBNP水平比心功能Ⅱ级组增高(P＜0.05);③CHF症状改善后血清Hcy、NT-proBNP水平较治疗前明显下降(P＜0.05);而LVEDD、LVEF治疗前后无明显变化(P＞0.05);④CHF组血清Hcy水平与NT-proBNP、LVEDD呈正相关(r=0.586,r=0.284,P＜0.05),与LVEF呈负相关(r=-0.492,P＜0.05).结论 老年CHF患者Hcy水平随着CHF程度的加重而相应升高,与NT-proBNP、LVEDD及LVEF有良好的相关性,可以反映CHF严重程度.

目的 观察重组人脑利钠肽(recombinant human brain natriuretic peptide,rhBNP)在治疗合并心力衰竭的急性非ST抬高心肌梗死的老年患者的临床疗效.方法 选择2013年6月至2014年3月在宣武医院综合科和心内科确诊为急性非ST抬高心肌梗死合并心力衰竭住院的高龄老年患者86例,男47例,女39例,平均年龄(79.63±4.41)岁.随机分为rhBNP治疗组(41例)及硝酸甘油对照组(45例),2组均给予常规治疗,治疗组在此基础上加用rhBNP,先给予1.5μg/kg负荷量,继之以0.01 μ g/(kg·min)静脉持续泵入72h.对照组在常规治疗基础上加用硝酸甘油10-15μg/min静脉持续泵入72h.2组均总治疗7d.分别对2组治疗前及治疗后48h、72h、7d收缩压、舒张压、心率、N末端B型利钠肽原(N terminal B type natriuretic peptide,NT-proBNP)、左室射血分数(Left ventricular ejection fraction,LVEF)、左室舒张末期内径(Left ventricular end diastolic dimensio,LVEDD)、左室收缩末期内径(Left ventricular endsystolic volume,LVSDD)、每搏输出量(Stroke volume,SV)、心排血量(Cardiac output,CO)等指标进行检测.观察记录患者住院期间及出院后1个月6min步行试验(6 minutes walking test,6MWT),随访1个月内发生的不良心血管事件(Major adverse cardiacevents,MACE),包括恶性心律失常、再次心肌梗死以及死亡发生情况.结果 治疗7d后rhBNP组收缩压、心率和NT-proBNP与对照组比较明显下降(P＜0.05).rhBNP组治疗后左室射血分数(LVEF)、每搏输出量(SV)、心排血量(CO)均优于对照组(P＜0.05),左室舒张末期内径(LVEDD)和左室收缩末期内径(LVSDD)较对照组显著降低(P＜0.05).rhBNP组患者6MWT大于对照组(P＜0.05).rhBNP组住院及出院后1个月内MACE明显低于对照组(P＜0.05).结论 对老年急性非ST抬高心肌梗死并发心力衰竭患者常规治疗基础上加用rhBNP治疗,可进一步改善心功能,减少MACE.

Background: CHADS2 and CHA2 DS2-VASc scores are validated tools for assessing stroke risk in patients with atrial fibrillation. We aimed to investigate the correlation of CHA2DS2-VASc and CHADS2 scores with short-term prognosis in acute ischemic stroke patients with non-valvular atrial fibrillation (NVAF) in elderly patients. Methods: A total of 216 patients with non-valvular atrial fibrillation were enrolled in this study. Consecutive ischemic stroke patients with non-valvular atrial fibrillation who were hospitalized within 7 days after stroke were registered. Patients were divided into 3 groups on the basis of CHADS2 scores (0, l, 2 to 6) and CHA2DS2-VASc score (0, l, 2 to 9). And recovery was assessed by modified Rankin Scale (mRS) at 3 months follow-up (mRS≤2 reflected good prognosis and mRS≥3 implicated unfavorable outcome). After screening the risk factors affecting prognosis using univariate analysis, the correlation of CHADS2 and CHA2DS2-VASc scores for short-term prognosis was estimated using Logistic regression model. Results: A total of 206 cases (95.3%) were included in the study. The groups with CHADS2 scores of 0, 1, and 2-6 points contained 31, 83, and 92 cases, respectively, while the groups with CHA2DS2-VASc scores of 0, 1, and 2-9 points had 22, 78, and 106 cases, respectively. There were 89 (43.2%) patients with good prognoses and 117 (56.8%) with poor prognoses. The proportion of high-risk group was significantly higher (P<0.01) while that of low-risk group significantly lower as stratified by CHA2DS2-VASc score than by CHADS2 scores (P<0.01). High-risk (≥2) CHADS2 and CHA2DS2-VASc scores are both associated with 3-month poor functional outcomes (CHADS2: OR 2.85, 1.32-4.05; CHA2DS2-VASc: OR 3.24, 1.32-6.98) after adjusting for baseline differences in age, sex and neurological impairment. The CHA2DS2-VASc score is better than the CHADS2 score in estimating 3-month stroke outcomes in acute ischemic stroke patients with nonvalvular atrial fibrillation. Conclusions: The CHA2DS2-VASc score appears to be a simple tool for identifying patients at lower risk of poor outcomes and serious cardiac complications within 3 months following ischemic stroke in patients with AF.

Objective To assess the correlation of CHADS2 and CHA2DS2-VASc scores for short-term prognosis in acute ischemic stroke patients with nonvalvular atrial fibrillation. Methods Consecutive ischemic stroke patients with nonvalvular atrial fibrillation who were hospitalized within 7 days after stroke were registered and 206 patients with nonvalvular atrial fibrillation were enrolled in this study. Patients were divided into 3 groups on the basis of CHADS2 scores (0,1,2 to 6) and CHA2DS2-VASc score (0,1,2 to 9) . And recovery was assessed by modified Rankin Scale (mRS) at 3 months follow-up (mRS≤2 reflected good prognosis and mRS ≥5 implicated unfavorable outcome). After screening the risk factors affecting prognosis using univariate analysis, the correlation of CHADS2 and CHA2DS2-VASc scores for short-term prognosis was estimated using Logistic regression model. Results The proportion of high-risk group was significantly higher (P < 0. 01) while that of low-risk group significantly lower as stratified by CHA2DS2-VASc score than by CHADS2 scores ( P < 0. 01 ) . Logistic regression model results suggested that CHA2DS2-VASc score was an independent predictor of good prognosis and unfavorable outcome. CHADS2≥2, and CHA2DS2-VASc≥2 were all correlated with prognosis, but multivariate logistic analysis identified only CHA2DS2-VASc≥2 as the independent risk factor for prognosis (OR = 3. 24, 95% CI:1. 32 - 6. 98,P= 0. 00). Conclusions The average score of CHA2DS2-VASc is higher than that of CHADS2 and has better predictive ability for prognosis in acute ischemic stroke patients with nonvalvular atrial fibrillation.

Objective To investigate the relationship between red blood cell distribution width and new onset atrial fi -brillation after acute ST segment elevation myocardial infarction in elderly patients .Methods A total of 328 patients diag-nosed with AMI in hospitalized elderly patients between January 2010 to June 2015 in Xuanwu Hospital of Capital University of Medical Sciences , department of Cardiology were enrolled .The patients were divided into AF group (42 cases) and non AF group (286 cases) by the presence or absence of AF .Clinical manifestations and echocardiography data were also evaluated in all patients.Results (1)Single factor analysis found that in the atrial fibrillation group the age , admission heart rate, RDW, high sensitive CRP (hs-CRP), NT-proBNP, left atrial diameter (LAD), LVEF, gender, smoking, the incidence of compli-cated with hypertension , killp grading of heart function , the incidence of anterior wall myocardial infarction , the use of beta blocker were significantly higher than the non-atrial fibrillation group.( t =2.096, t =3.182, t =2.026, t =3.562, t =4.082, t =2.804, t =3.092, P =0.037, P =0.002, P =0.028, P =0.001, P =0.001, P =0.012, P =0.008,χ2 =4.728,χ2 =3.165,χ2 =4.792,χ2 =14.817,χ2 =15.241,χ2 =13.469, P =0.020, P =0.038, P =0.024, P =0.001, P =0.001, P =0.001).(2)Multivariate logistic regression analysis showed that age , RDW, hs-CRP, NT-proBNP, LAD, the incidence of anterior wall myocardial infarction , the use of beta blocker were the independent predictive factors of the emerging of atrial fibrillation ( OR=1.658, OR=2.561, OR=3.841, OR=3.209, OR=4.946, OR=1.954, OR=3.815,OR=4.350,OR=2.245,95%CI 1.245-3.907,95%CI 1.641-9.720, 95%CI 1.186-13.228, 95%CI 1.209-11 .958 , 95%CI 0 .947 -20 .109 , 95%CI 1 .665-3 .842 , 95%CI 1 .167 -11 .498 , 95%CI 1 .016 -17 .817 , 95%CI 1.736-3.248).(3)Spesarman correlation analysis showed that RDW was positively correlated with inflammatory markers and NT-proBNP( r =0.31, r =0.28, P =0.001, P =0.001).Conclusion RDW is an independent risk factor for new onset atrial fibrillation after myocardial infarction in elderly patients , and its mechanism may be related to the inflammatory response and left ventricular dysfunction .

目的:探讨老年急性ST段抬高性心肌梗死(ASTEMI)患者直接经皮冠状动脉介入治疗(PPCI)时应用高剂量国产替罗非班的安全性及疗效.方法:2010年1月至2011年5月接受直接PCI并替罗非班治疗的64例,年龄65～75岁的老年ASTEMI患者,按照数字随机法被分为高剂量组(34例,术中给予负荷剂量20μg/kg,继之0.225μg·kg-1·min-1静脉维持)和常规剂量组(30例),评价两组出血风险差异及治疗的安全性;随访24～40个月,观察患者心功能、再住院次数、生存情况及疗效.结果:两组术后均无中、重出血事件及血小板减少症.随访期高剂量组年再住院数明显少于常规剂量组[(0.9277±0.8005)次/年比(1.6189±1.4208)次/年,P=0.019];术后18个月左室射血分数(LVEF)显著高于常规剂量组[(59.12±4.977)％比(55.53±6.208)％,P=0.011].结论:老年急性STEMI患者直接PCI时应用高剂量替罗非班可安全、显著改善患者术后心功能,降低年再住院次数.

代谢综合征(metabolic syndrome,MS)是以糖代谢异常(糖尿病或糖调节受损)、高血压、血脂异常、中心性肥胖等多种主要疾病或危险因素在个体聚集为特征的一组临床症候群[1].随着社会经济发展、生活水平改善以及人口老龄化进程,MS患病率日趋上升,已成为一种新的慢性病和重要的公共卫生问题.

Objective To study the association of prevalence of cardio-cerebro vascular diseases (CCVD) with metabolic syndrome (MS) defined by different criteria in middle and aged people.Methods A cross-section survey was conducted among 1458 people aged 55 years and over in urban and rural areas of Beijing in 2009.MS definitions by World Health Organization (WHO),National Cholesterol Education Program-Adult Treatment Panel Ⅲ (NCEP-ATP Ⅲ ) revised,international diabetes mellitus (IDF) and Chinese Diabetes Society (CDS) were applied to analyze the association MS with the prevalence of CCVD.Results The risks of CCVD were all significantly higher in patients with MS than with non-MS using 4 definitions of MS.The definitions of WHO and CDS showed well agreement with the prevalence of CCVD.OR values of MS for CCVD were 2.14 folds (95％ CI:1.59-2.87) for WHO definition and 1.91 folds (95％ CI:1.43-2.55) for CDS definition,while OR values of MS for CCVD were 1.68 folds (95％ CI:1.32-2.15) for NCEP-ATPⅢ definition and 1.64 folds (95％ CI:1.26-2.13) for IDF definition as compared to non-MS,respectively.After adjustment for age,sex,region,history of smoking and alcohol drinking,the OR values in above four definitions were 1.91,1.88,1.67 and 1.80,respectively.The OR value of MS was highest for stroke by CDS definition and highest for coronary heart disease by WHO definition.Conclusions MS values defined by WHO and CDS are the optimal index of prevalence for CCVD in middle and aged people.

Objective: To compare the efficacy and safety of rapid-acting human insulin analogue(Aspart) and regular human in-sulin(Novolin R) delivered with continuous subcutaneous insulin infusion(CSII) pump and multiple subcutaneous insulin infusion(MSII) on perioperative period of patients with type 2 diabetes mellitus.Methods: l58 perioperative patients with poorly-controlled type 2 dia-betes in hospital were randomized to Group CSII(n=52,treated with insulin Aspart),Group MSII(A)(n=56,treated with insulin Aspart) and Group MSII(B)(n=50,treated with insulin Novolin R).AIl patients were treated to achieve target glycaemic control.The blood glu-cose,the time and the dose of insulin needed for good glycaemia control were compared of the three groups,the complications of surgery and incidence of hypoglycemia were evaluated too.Results: The levels of blood glucose in all groups were reduced after the treatments.The time for good glycaemia control was shorter in Group CSII than that in Group MSII(A) and Group MSII(B)(P0.05).The mean of the postprandial blood glucose was significantly lower in Group CSII than that in Group MSII(A) and Group MSII(B)(P0.01).The com-plications of surgery and incidence of hypoglycemia were significantly lower in Group CSII than that in Group MSII(A) and Group MSII(B)(P0.05).Conclusion: For the perioperative period of patients with type 2 diabetes mellitus,insulin Aspart provides a more effective and safety control of blood glucose,it can control the hyperglycemia rapidly with lower fluctuations of blood glucose than Novolin R.The insulin pump could be the best mode of insulin infusion for perioperative type 2 diabetes.

Obstructive sleep apnea hypopnea syndrome(OSAHS) is caused by a variety of pathogenicfactors of the high incidence of the risk of sleep apnea in a chronic disease. OSAHS with metabolic syndrome(MS) often in the big family of various diseases, such as obesity,insulin resistance, hypertension,diabetesand other incidental,or emerged successively,with the ultimate result of cardiovascular incident and the riskof death increased. This article makes a summary to OSAHS and the MS reciprocity.