Coronary atherosclerotic heart disease is the leading cause of disability and death among the elderly adults in China. Coronary computed tomography angiography (CCTA) is an important imaging technique for evaluating coronary atherosclerotic plaques. However, in elderly patients, coronary lesions often present as diffuse multi-vessel diseases, severe calcification burden, and vulnerable plaques that are difficult to identify. Additionally, elderly patients are more susceptible to contrast-induced nephrotoxicity, and the higher prevalence of coronary stents and cardiac pacemakers limit the application of conventional energy-integrating detector-based CCTA in this population. Photon-counting computed tomography (PCCT) represents a major breakthrough in CT imaging over the past decade. Its ultra-high spatial resolution significantly improves the assessment of coronary atherosclerotic plaques, offering a new technological approach to address the aforementioned clinical challenges. This article provides a systematic review of the key technical features of PCCT, discusses its application value in the precise diagnosis and treatment of coronary heart disease in the elderly, and offers insights into future research directions, aiming to promote the better application of PCCT in the diagnosis and management of coronary heart disease in the elderly.

Objective To investigate the impact of different slice thicknesses and kernels on image quality of coronary CT angiography (CCTA) using photon-counting CT (PCCT), and to identify the optimal reconstruction parameters. Methods A total of 40 patients with suspected coronary artery disease (CAD) who underwent CCTA at Nanjing Drum Tower Hospital from June to August 2025 were prospectively enrolled. Images were reconstructed using three kernels (Bv40, Bv48, Bv56) and two slice thicknesses (0.4 mm, 0.6 mm). Quantitative measurements of CT attenuation, image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and peak signal-to-noise ratio (PSNR) were performed at the aortic root and coronary arteries. A linear mixed-effects model was used to analyze the main and interaction effects of the kernel and slice thickness. Box plots and correlation analysis were conducted to assess image stability and parameter relationships. Results Although thin-slice reconstruction combined with sharper kernels enhanced edge sharpness, it significantly increased image noise and reduced image stability. The Bv56 + 0.4 mm combination yielded the highest noise level and the lowest SNR and CNR. The Bv40 + 0.6 mm combination demonstrated the best performance across multiple metrics, including image noise, SNR, CNR, and PSNR. Box plots showed this parameter combination had the smallest interquartile ranges, indicating minimal parameter fluctuation.The kernel type was the most dominant factor affecting all image quality metrics (all P<0.01).No significant interaction effect was found between the kernel and slice thickness. Conclusions For CCTA using PCCT, the Bv40 kernel + 0.6 mm slice thickness provides an optimal balance between spatial resolution and noise control, achieving superior image quality and consistency.

Objective To explore the diagnostic performance and clinical application value of dual-source photon-counting computed tomography (PCCT) coronary angiography for detecting coronary artery obstructive stenosis in elderly patients with severe coronary artery calcification. Methods This study continuously enrolled 41 elderly patients (aged ≥ 65 years; 94 blood vessels) who were clinically suspected or diagnosed with coronary heart disease and underwent PCCT coronary artery imaging at the Second Affiliated Hospital of Zhejiang University School of Medicine from September 2024 to February 2025, with a calcification score ≥400, and underwent invasive coronary angiography (ICA) within 2 weeks after PCCT. The diagnostic efficacy of PCCT for coronary obstructive stenosis was evaluated by using ICA results as the gold standard. Results The average age of the patients was 72.95±5.32 years old, including 26 male patients (63.4%). The mean calcification score was 936.99±600.41. At the patient level, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of PCCT in the diagnosis of coronary obstructive stenosis were 100.0%, 33.3%, 95.0%, 100.0% and 95.1%, respectively. At the vessel level, the corresponding values were 98.7%, 58.8%, 91.6%, 90.9% and 91.5%, respectively. Conclusions For elderly patients with severe coronary artery calcification, PCCT coronary angiography has a high accuracy in the diagnosis of obstructive coronary artery stenosis.

Objective To evaluate the image quality and reduction in radiation achieved by a “dual-low” protocol (low radiation dose and low contrast agent volume) using photon-counting CT (PCCT) in coronary CT angiography (CCTA). Methods Eighty patients with suspected coronary artery disease were prospectively enrolled between June and August 2024 and randomly assigned to two groups. The control group (group A, n=40) underwent CCTA with a conventional energy-integrating detector CT (EID-CT) at 100 kVp and a standard contrast agent dose (0.6 mL/kg). The experimental group (group B, n=40) was scanned using PCCT at 140 kVp with a reduced contrast agent dose (0.3 mL/kg). Radiation dose parameters, including CT does index volume (CTDIvol), dose length product(DLP), effective does(ED) and contrast agent volume, both subjective and objective image quality assessments were compared. Two radiologists independently scored image quality using a 5-point Likert scale in a blinded manner, with interobserver agreement assessed by Cohen’s Kappa. Results The ED was significantly lower in group B (3.24±1.49 mSv) than that in group A (6.64±2.93 mSv), representing a 51.2% reduction (P<0.001). The contrast agent volume was also significantly reduced in group B (25.91±7.92 mL vs 51.52±9.29 mL, P<0.001), representing a 49.7% decrease. Objective analysis revealed significantly higher signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) in the aortic root and all coronary segments in group B than those in group A (all P <0.05), with CNR improvements ranging from 42% to 90%. Subjective scores showed that the rate of excellent and good image quality (4-5 points) in group B reached 95%, which was significantly higher than that in group A in terms of contrast, noise and artifacts (P<0.05). Conclusions The PCCT “dual-low” protocol for CCTA significantly reduces radiation exposure and contrast agent volume while simultaneously improving image quality.

Objective To explore the advantages of ultra-high resolution (UHR) mode of photon-counting detector CT (PCCT) over conventional imaging mode of energy-integrating detector CT (EID-CT) in coronary stent CT imaging. Methods The imaging data of 15 patients (32 stents) received coronary stent implantation were prospectively analyzed. All patients underwent coronary CT angiography (CCTA) with PCCT in UHR mode, and had a prior CCTA examination performed with EID-CT. Objective evaluation parameters included the diameter of the inner lumen of the stent, the outer diameter of the stent, the blooming artifact index, the difference in CT values inside versus outside the stent, and the noise within the stent lumen. Subjective evaluation was conducted using Likert’s 5-point method, including the display of the lumen in the stent, delineation of stent structure, visualization of calcified plaques outside the stent,display of peri-stent blood vessels, diagnostic confidence of in-stent restenosist,beam hardening artifacts and blooming artifacts. Results The internal diameter of the stent and the internal lumen noise of the stent measued by PCCT were significantly higher than those measured by EID-CT(P<0.001), while the blooming artifact index and the differences in the internal and external stent CT values of the stent measured by PCCT were significantly lower than those measured by EID-CT (P<0.001). There was no significant difference in the outer diameter of the stents beween the two groups of images (P=0.366). The PCCT images showed significantly higher scores for all subjective indexes than those of the EID-CT images (P<0.001). Conclusions PCCT can obtain better image quality and diagnostic confidence than traditional EID-CT in coronary stent imaging, and it may become a new method for clinical non-invasive evaluation of coronary stent patency in the future.

Objective To evaluate the diagnostic accuracy of ultra-high-resolution coronary computed tomography angiography (CCTA) using photon-counting CT (PCCT) in elderly patients with coronary artery disease (CAD). Methods A retrospective analysis was conducted on 57 patients (mean age 70.9±6.4 years, 43 males) who underwent both ultra-high-resolution PCCT-CCTA and invasive coronary angiography (ICA) at Geriatric Hospital of Nanjing Medical University from July 2024 to January 2025. With ICA as the gold standard, the consistency between PCCT-CCTA and ICA was assessed using the intraclass correlation coefficient (ICC) and Bland-Altman analysis. The diagnostic performance (sensitivity, specificity, accuracy) of CCTA reconstructions at 0.2 mm, 0.4 mm, and 0.8 mm slice thickness was calculated, with stenosis ≥50% considered hemodynamically significant. Results ICC analysis indicated excellent consistency between CCTA and ICA at the 0.2 mm segment-level (ICC=0.98, 95%CI: 0.97－0.98). Bland-Altman analysis showed a mean bias of －0.44%, with 95% limits of consistency ranging from －12.39% to 11.52%. The diagnostic performance of CCTA exhibited an inverse relationship with slice thickness. The 0.2 mm reconstruction demonstrated superior diagnostic performance at both the segment level and vessel level. Conclusions In elderly CAD patients, CCTA based on photon-counting CT shows high consistency with ICA for quantifying coronary artery stenosis. The Ultra-high-resolution reconstruction mode (0.2 mm) provides superior diagnostic accuracy, which could be used as a reliable noninvasive imaging method for coronary stenosis evaluation.

Objective To investigate the effect of wearable cardiopulmonary rehabilitation support system in exercise rehabilitation for the elderly patients with chronic heart failure, and to provide clinical evidences for developing a new model of cardiopulmonary rehabilitation monitoring and disease management based on wearable technology. Methods The elderly patients with chronic heart failure admitted to Inner Mongolia People’s Hospital from 2023 to 2024 were randomly assigned to the drug group(group M), the drug combined with exercise group(group ME), and the drug combined with wearable devices guided exercise group (group MED). The cardiopulmonary exercise test (CPET) indicators, left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), N-terminal pro-brain natriuretic peptide (NT-proBNP), 6-minute walk distance (6MWD), and Minnesota Heart Failure Quality of Life Questionnaire (MLHFQ) scores were recorded before and 3 months after intervention and compared among the groups. Results After the intervention,the levels of peak oxygen uptake (PeakVO₂), anaerobic threshold oxygen uptake (VO₂AT), anaerobic threshold metabolic equivalent (MetsAT), LVEF, 6MWD, NT-proBNP and MLHFQ scores in group ME and group MED were more significantly improved than those in group M(P<0.05);Compared with group ME, the levels of VO₂AT, MetsAT, LVEF and 6MWD were significantly increased, and the level of NT-proBNP was significantly decreased in group MED (P<0.05). Conclusions The application of wearable cardiopulmonary rehabilitation support system in exercise rehabilitation for elderly patients with chronic heart failure has a positive effect on their treatment effect and prognosis.

Objective To explore the clinical value of glucose fluctuation combined with nerve injury markers in predicting peripheral neuropathy in the elderly patients with type 2 diabetes mellitus (T2DM). Methods In this case-control study, 158 elderly T2DM patients with peripheral neuropathy (case group) and 158 elderly T2DM patients without peripheral neuropathy (control group) were selected from Hai’an Traditional Chinese Medicine Hospital from April 2021 to September 2024. The clinical data of the two groups were compared, and the independent influencing factors for peripheral neuropathy in elderly T2DM patients were analyzed by logistic regression analysis, and a risk prediction model was subsequently constructed. Results The levels of glycosylated hemoglobin (HbA1c), diurnal maximum-minimum glucose (DMMG), and myelin basic protein (MBP) were significantly higher, while the time in range (TIR) was significantly lower in the case group compared to the control group (all P<0.05). Multivariate logistic regression analysis showed that HbA1c (OR=3.340, 95%CI: 1.499－7.441), DMMG (OR=3.725, 95%CI: 1.672－8.298), and MBP (OR=4.166, 95%CI: 1.869－9.277) were risk factors for peripheral neuropathy in elderly T2DM patients (P <0.05), while TIR (OR=0.334, 95%CI: 0.150－0.745) was a protective factor (P<0.05). The risk prediction model integrating these four factors achieved an area under the receiver operating characteristic (AUC) curve of 0.783 (95%CI: 0.686－0.880), with a sensitivity of 85.01%, and a specificity of 76.93%. Conclusions HbA1c, DMMG, MBP, and TIR are related to the occurrence of peripheral neuropathy in elderly T2DM patients. The prediction model combining these indicators demonstrates good discriminatory ability and may aid in the early identification of high-risk individuals.

Objective To establish and validate a nomogram model for predicting overall survival (OS) in the elderly patients with esophageal cancer treated with immune checkpoint inhibitors (ICIs). Methods The clinical data of the elderly patients with esophageal cancer treated with ICIs at the First Affiliated Hospital with Nanjing Medical University from December 2019 to June 2024 were retrospectively analyzed. The independent prognostic factors were identified using Cox regression combined with stepwise regression based on laboratory data within two weeks before the first immunotherapy session. A predictive nomogram model was constructed and internally validated. Results Geriatric nutritional risk index (GNRI), neutrophil-to-lymphocyte ratio (NLR), M-stage, surgery, and carcinoembryonic antigen (CEA) were independent predictors of OS in elderly patients with esophageal cancer treated with ICIs (P<0.05). The consistency index (c-index) was 0.806 of the predictive model. After 1000 times of Bootstrap resampling validations, the corrected c-index was 0.815.Calibration curves closely matched the ideal line. The area under the curve (AUC) for 1-year and 2-year survival was 0.81 (95%CI: 0.72－0.90) and 0.88 (95%CI: 0.82－0.95) respectively. Decision curve analysis (DCA) confirmed the clinical utility of the model. Conclusions GNRI, NLR, M-stage, surgery, and CEA are valuable prognostic markers for elderly esophageal cancer patients treated with ICIs. The developed nomogram provides an effective tool for individualized survival prediction.

Objective To explore the predictive value of the global immune-nutrition-inflammation index (GINI) for 90-day prognosis of elderly patients with first-onset acute minor ischemic stroke (AMIS). Methods A total of 371 elderly patients diagnosed with first-onset AMIS admitted to the Stroke Center of the Affiliated Hospital of Jiangsu University from July 2021 to July 2023 were included. Based on the modified Rankin Scale score (mRS) at 90 days, patients were categorized into a favorable prognosis group (mRS ≤ 2, n=337) and a poor prognosis group (mRS > 2, n=34). Comparative analysis of general clinical data was performed between the two groups. Multivariate logistic regression analysis was employed to identify independent risk factors associated with poor prognosis. Receiver operating characteristic (ROC) curve analysis was utilized to assess the predictive value of GINI for 90-day poor prognosis. Results In comparison to the favorable prognosis group, the poor prognosis group exhibited higher enrichments of red blood cells and monocytes, alongside a more pronounced inflammatory response characterized by elevated levels of C-reactive protein and neutrophils. This group also experienced more severe neurological impairment, larger infarct volume, and extended hospital stay (P<0.05). Multivariate logistic regression analysis revealed that GINI was an independent predictor of prognosis at 90-day in elderly patients with AMIS (OR=1.576, 95%CI: 1.219－2.072, P<0.05). ROC curve analysis demonstrated that the area under the curve of GINI for predicting poor prognosis in the elderly first-onset AMIS patients was 0.759 (95%CI: 0.692－0.827, P<0.05) with an optimal cutoff value of 1.689. Conclusions GINI is independently associated with poor prognosis at 90-day in elderly patients with first-onset AMIS, and may serve as a potential predictive factor.

Objective To investigate the predictive value of atherogenic index of plasma (AIP) combined with low-density lipoprotein cholesterol (LDL-C) for intracoronary thrombus load in elderly patients with ST-segment elevation myocardial infarction (STEMI) undergoing emergency percutaneous coronary intervention (PCI). Methods A retrospective analysis was performed on 387 elderly STEMI patients who underwent emergency PCI at General Hospital of Ningxia Medical University from January to December 2019. According to the thrombolysis in myocardial infarction (TIMI) thrombus grading criteria, the patients were divided into small thrombus load (STB) group (273 cases) and large thrombus load (LTB) group (114 cases). The clinical data of the two groups were compared.Multivariate logistic regression was used to identify independent risk factors for LTB, and receiver operating characteristic (ROC) curve analysis was applied to evaluate the predictive performance of AIP and LDL-C. Results Compared to the STB group, the LTB group had significantly lower rates of Killip grade 1 and postoperative TIMI flow grade 3, lower levels of systolic/diastolic blood pressure and left ventricular ejection fraction(LVEF), but higher levels of serum creatinine, troponin Ⅰ, triglyceride(TG), LDL-C, AIP, door-to-balloon time, and a higher proportion of preoperative TIMI flow grade 0-2 (all P<0.05). Multivariate logistic regression analysis showed that AIP, LDL-C, portal time, and preoperative TIMI blood flow grade 0-2 were independent risk factors for LTB, while Killip grade 1 was a protective factor. The area under the ROC curve of AIP combined with LDL-C for predicting LTB was 0.707 (95%CI: 0.648-0.765; P<0.001), with a sensitivity of 73.7% and a specificity of 36.3%. Conclusions AIP and LDL-C are independent risk factors for high thrombus burden in elderly STEMI patients, and their combination shows certain predictive value for intracoronary LTB, which may serve as an auxiliary indicator for clinical risk assessment.

Objective To investigate the association of serum levels of pentosidine, soluble receptor for advanced glycation end products (sRAGE) with sarcopenia in elderly patients with type 2 diabetes mellitus (T2DM). Methods A total of 136 T2DM patients aged over 60 years admitted to Department of Endocrinology of Baoding NO.1 Central Hospital from June 2024 to May 2025 were enrolled and divided into sarcopenic group (42 cases) and non-sarcopenic group (94 cases) based on the Asian Working Group for Sarcopenia criteria. The general information and biochemical indicators were collected, and serum levels of pentosidine and sRAGE were measured by enzyme-linked immunosorbent assay (ELISA).Multivariate logistic regression was applied to identify independent factors associated with sarcopenia in the elderly T2DM patients. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive value of serum pentosidine and sRAGE for sarcopenia in the elderly T2DM patients. Results Compared with the non-sarcopenic group, the patients in sarcopenic group had significantly higher age, diabetes duration, glycated hemoglobin (HbA1c), and serum pentosidine levels, while their body mass index (BMI), albumin (ALB), triglyceride (TG), and sRAGE levels were lower (P<0.05). Logistic regression analysis showed that low BMI(OR=0.767, 95%CI: 0.634-0.929), high pentosidine levels (OR=1.018, 95%CI: 1.007-1.029), and low sRAGE levels(OR=0.994, 95%CI: 0.991-0.997)were independent risk factors for sarcopenia in elderly T2DM patients (P<0.05). The area under the ROC curve for the combination of serum pentosidine and sRAGE was 0.881 (95%CI: 0.815-0.947) in predicting sarcopenia in elderly patients with T2DM,which was significantly better than that of either single indicator (P<0.05). Conclusions Serum levels of pentosidine and sRAGE are closely related to sarcopenia in elderly T2DM patients. The combination of the two indicators has excellent efficacy in identifying sarcopenia in elderly T2DM patients, suggesting their potential utility as auxiliary diagnostic biomarkers.

Objective To evaluate the efficacy and safety of programmed death-1 (PD-1) monoclonal antibody combined with cisplatin and 5-fluorouracil in elderly patients with initially unresectable advanced esophageal squamous cell carcinoma (ESCC), as well as the surgical conversion rate. Methods The study enrolled 26 elderly patients and 21 non-elderly patients, all of whom received three cycles of induction therapy with PD-1 monoclonal antibody, cisplatin, and 5-fluorouracil. PD-L1 expression and tumor mutational burden (TMB) were recorded. Primary endpoints were the incidence of grade 3 or higher adverse events, major pathological response (MPR) rate, and pathological complete response (pCR) rate. Secondary endpoints included surgical conversion rate, R0 resection rate, progression-free survival (PFS), and overall survival (OS). Results The incidence rate of grade 3 or higher adverse events was 15.4% in the elderly group and 14.3% in the non-elderly group (P=0.916). The MPR rate was 46.2% and 33.3% (P=0.373), and the pCR rate was 42.3% and 23.8% (P=0.237) in the elderly group and the non-elderly group, respectively. For secondary endpoints, the surgical conversion rate was 56.5% in the elderly group and 50.0% in the non-elderly group (P=0.669); The R0 resection rate was 100% in the elderly group and 90.0% in the non-elderly group (P= 0.244). Survival analysis showed that the median PFS was not reached in the elderly group and was 16 months in the non-elderly group (P=0.041), and the median OS was 36 months and 22 months, respectively (P=0.029). In the elderly group, patients who successfully underwent surgery had significantly longer PFS (24 months vs 9 months, P=0.01) and OS (not reached vs 16 months, P=0.007) compared to those who did not undergo surgery. Additionally, patients with TMB ≥10 mutations/Mb in the surgical group showed better PFS (not reached vs 20 months, P=0.049). PD-L1 expression status had no significant impact on survival (P=0.172). Conclusions PD-1 monoclonal antibody combined with chemotherapy is effective and tolerable in elderly patients with ESCC, associated with a superior survival benefit compared to non-elderly patients. PD-1 monoclonal antibody combined with chemotherapy is a promising treatment strategy for surgical conversion therapy in elderly patients with initially unresectable advanced ESCC.

Objective To explore the safety and short-term efficacy of intestinal stent combined with elective surgery for elderly patients with left colorectal cancer and acute intestinal obstruction. Methods A retrospective analysis was conducted on 75 elderly patients with left colorectal cancer and acute intestinal obstruction who underwent surgery at Department of General Surgery, Beijing Fengtai You’anmen Hospital form December 2021 to October 2024. Based on the treatment approach, the patients were divided into two groups. The observation group (n=34) underwent intestinal stenting as a bridge to elective surgery, and the control group (n=41) underwent direct emergency surgery. The perioperative clinical outcomes were compared between the two groups. Results The baseline characteristics of the two groups were comparable (P>0.05). No perioperative death or anastomotic leakage was observed in both groups. The observation group showed superior outcomes compared to the control group in surgical duration, surgical approach, lymph node dissection count, colostomy rate, prophylactic ileostomy rate, and complications incidence (P<0.05). The total hospitalization cost was significantly higher in the observation group than that in the control group (P<0.05). There were no significant differences between the two groups in intraoperative blood loss and postoperative feeding time (P>0.05). Conclusions For elderly patients with left colorectal cancer and acute intestinal obstruction, intestinal stent combined with time-limited surgery can shorten the surgical duration, increase the laparoscopic operation opportunity, reduce the colostomy rate, and improve the quality of life of the patients. The short-term efficacy is significant, which is worthy of clinical promotion and application.

Objective To investigate the predictive value of the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), and red blood cell distribution width-to-platelet ratio (RPR) combined with simplified acute physiology score Ⅱ (SAPS Ⅱ)for the 90-day prognosis of elderly patients with sepsis-associated acute kidney injury (SA-AKI). Methods Based on the MIMIC-Ⅳ 2.2 database, a retrospective analysis was conducted on 4589 elderly SA-AKI patients admitted to the ICU for the first time from 2008 to 2019. According to their 90-day outcome, the patients were divided into a survival group (n=2978) and a death group (n=1611). Univariate and multivariate Cox regression analysis were used to identify independent risk factors for prognosis. The predictive performance of each indicator and combined models for the 90-day prognosis was assessed using the area under the receiver operating characteristic (ROC) curve (AUC). Results Multivariate Cox regression analysis showed that NLR, LMR, RPR, 24-hour urine output, lactate, blood urea nitrogen (BUN), and the SAPS Ⅱ were independent risk factors for 90-day mortality in elderly SA-AKI patients (P<0.05). ROC curve analysis revealed that the combined model of NLR+LMR+RPR+SAPS Ⅱ had an AUC of 0.717 (95%CI: 0.701-0.733) for predicting 90-day prognosis, which was significantly higher than the AUC of 0.692 (95%CI: 0.676-0.709) for the model combining BUN+24-hour urine output+SAPS Ⅱ (DeLong’s test, P<0.001). Conclusions The combination of complete blood count-derived ratios (NLR, LMR, RPR) and SAPS Ⅱ has good predictive value for the 90-day prognosis of SA-AKI patients, outperforming the model combining traditional kidney injury markers and SAPS Ⅱ.

Objective To perform latent profile analysis (LPA) on the clinical phenotypes of elderly emergency patients with heart failure with preserved ejection fraction (HFpEF) and explore their associations with clinical outcomes. Methods A total of 300 elderly emergency patients with HFpEF admitted to the Affiliated Hospital of Qinghai University from January 2023 to December 2024 were selected. Core variables were chosen based on the pathophysiological mechanisms of HFpEF. LPA was conducted to determine the optimal classification. Patients were followed for 30 days and divided into adverse or favorable outcome groups based on their disease progression. Binary multivariate logistic regression was used to identify independent factors influencing outcomes. Results The 4-class model was identified as optimal. The probability of latent categories being assigned to specific types was 96.24%～99.02%, indicating high reliability. The four clinical phenotypes were designated as metabolic-hypertensive type (35.00%), multimorbidity coexistence type (30.00%), inflammatory-volume overload type (25.00%), and isolated diastolic dysfunction type (10.00%). Multivariate logistic regression revealed that advanced age (OR=1.919, 95%CI: 1.278-2.882), comorbid atrial fibrillation (OR=2.272, 95%CI: 1.464-3.526), elevated left atrial volume index (LAVI) (OR=2.979, 95%CI: 1.294-6.858), and the inflammatory-volume overload phenotype (OR=3.201, 95%CI: 1.423-7.201)were independent risk factors for adverse outcomes. Conclusions LPA classifies elderly emergency HFpEF patients into four clinical phenotypes: metabolic-hypertensive, multimorbidity coexistence, inflammatory-volume overload, and isolated diastolic dysfunction. Patients with the inflammatory-volume overload phenotype have the worst prognosis, identifying it as a significant risk factor for adverse clinical outcomes.

Objective To compare the radiation dose, image quality, and scanning efficiency between dual-source CT FLASH Thorax scan and conventional Thorax scan in very elderly patients with viral pneumonia, and to explore the potential advantages of FLASH scanning in clinical imaging evaluation. Methods This retrospective study included 153 very elderly patients with viral pneumonia, of which 60 patients underwent scanning with dual-source CT FLASH technology, and 93 patients received conventional Thorax scans. The differences in scanning time, computed tomography dose index volume (CTDIvol), dose-length product (DLP), radiation dose, image quality, and lesion diagnosis value between the two groups were analyzed. Results The scanning time in the dual-source CT FLASH group was significantly shorter than that in the conventional Thorax group (P<0.01). In terms of radiation dose, the dual-source CT FLASH group showed significantly lower CTDIvol, DLP, and effective dose(ED) of radiation compared to the conventional Thorax group. The image quality scores in the dual-source CT FLASH group were significantly higher than those in the conventional Thorax group (P=0.006). The dual-source CT FLASH group exhibited superior signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and lesion diagnosis value compared to the conventional Thorax group. Conclusions Compared with conventional Thorax scaning, FLASH scanning shows shorter scan times, lower radiation doses, and superior image quality in very elderly patients with viral pneumonia.

Objective To assess the clinical efficacy and safety of 20% autologous serum (AS) combined with artificial tears (AT) in treating moderate dry eye disease (MDED) after senile cataract surgery. Methods A retrospective study was conducted on 94 elderly patients with unilateral MDED after cataract surgery from 2023-2024. The patients were divided into the AS+AT group (47 cases) and the AT group (47 cases) based on treatment regimens. Both groups underwent 4 weeks of treatment. The evaluation indicators included Ocular Surface Disease Index (OSDI), corneal fluorescein staining (CFS), tear film breakup time (FBUT), corneal sensitivity, Schirmer Ⅰ test and tear inflammatory factor levels such as tumor necrosis factor(TNF)-α, interleukin(IL)-6, IL-1β, and the adverse events were recorded. Results The total effective rate was significantly higher in the AS+AT group than that in the AT group (78.7% vs 63.8%). The normalization rate of corneal sensitivity after treatment was improved significantly in both groups, especially in the AS+AT group (P<0.05). FBUT and Schirmer Ⅰ test results showed significant differences between the AS+AT group and the AT group(P<0.05), while OSDI or CFS showed no significant differences (P>0.05). The levels of inflammatory factors (TNF-α, IL-6, IL-1β) decreased significantly in both groups after treatment, especially in the AS+AT group (P<0.05). No statistically significant difference was found in the total adverse event rate between the two groups (4.26% vs 2.13%). Conclusions AS combined with AT therapy significantly enhances the clinical efficacy in the elderly patients with unilateral MDED after cataract surgery with favorable safety, improves corneal sensitivity and tear film stability, and effectively reduces the levels of inflammatory factors.

Hearing loss, cognitive impairment, and dementia are prevalent issues among the elderly population. Numerous studies have focused on the correlation between age-related hearing loss (ARHL) and cognitive decline (including dementia). While there are various hypotheses regarding the interaction between auditory dysfunction and cognitive impairment in older adults, ARHL is widely recognized as a modifiable risk factor for cognitive decline. This review explores the potential interconnections between ARHL and cognitive impairment or Alzheimer’s disease from multiple dimensions including etiology, pathology, clinical manifestations, and disease progression. It also introduces the changes of cognitive performance after interventions to improve auditory function. The aim is to raise awareness among geriatric medicine clinicians and researchers about the cognitive impairments caused by hearing decline, thereby promoting further research and clinical practice in this field.

Objective To develop an empowerment scale for older adults with malignant tumors in line with Chinese cultural characteristics, and to test its reliability and validity. Methods The Cancer Empowerment Questionnaire (CEQ) was translated, back-translated, and culturally adjusted, and 48 experts were invited to evaluate its content validity, finally developed the Chinese CEQ (C-CEQ). A total of 306 elderly patients with malignant tumors in Department of Geriatrics of Jiangsu Province Hospital were selected for the C-CEQ questionnaire survey to evaluate the reliability and validity of the scale. Results After analyzing the mean value of the critical ratio of each item, 32 items of the C-CEQ with statistical significance were obtained. Four factors were extracted by exploratory factor analysis, and the Kaiser-Meyer-Olkin (KMO) value was 0.949, and the cumulative variance contribution rate was 64.73%. Confirmatory factor analysis showed that the model had good fitness and reliability, and the average variance extracted (AVE) values were all above 0.5. The Cronbach’s α coefficient of the C-CEQ scale was 0.941, and the split-half reliability coefficients were 0.895 and 0.944, respectively. Conclusions The C-CEQ shows good reliability and validity in the elderly patients with malignant tumors with Chinese cultural characteristics and can be used as a tool for the clinical evaluation of the empowerment level. The C-CEQ plays an important role in evaluating the health empowerment level of the patients with malignant tumors and the effect of health empowerment interventions. It is of great significance to improve the theory of health empowerment and understand the needs of elderly patients with malignant tumors.