Table of Content

20 June 2026, Volume 40 Issue 6 Previous Issue   

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Physical resilience and healthy aging WANG Jiao, DENG Yiping, ZHANG Liying, GE Ning, YUE Jirong, GAO Langli 2026, 40 (6):  541-544.  doi: 10.3969/j.issn.1003-9198.2026.06.001 Abstract ( 48 )   PDF (1157KB) ( 74 )   Save Global population aging underscores the urgent need to advance healthy aging as a public health priority.Physical resilience, as the core capacity of older adults to maintain or restore functional stability when exposed to physiological stressors such as surgery, infection, or acute illness, offers a new perspective for assessing and promoting healthy aging.This paper systematically elaborates on the conceptual framework and assessment system of physical resilience, examines its intrinsic association with healthy aging, and explores its application value and future directions in clinical practice and public health. References | Related Articles | Metrics

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Research progress on physical resilience and functional recovery in older adults following acute stress DU Juan, ZHANG Liying, WU Chenkai 2026, 40 (6):  545-550.  doi: 10.3969/j.issn.1003-9198.2026.06.002 Abstract ( 50 )   PDF (1137KB) ( 85 )   Save Older adults frequently experience varying degrees of functional decline and incomplete recovery following acute stressors such as surgery and infection, representing a critical turning point toward disability. Physical resilience (PR) refers to an individual's ability to maintain or restore physical function through dynamic regulation after exposure to acute stress and has emerged as an important perspective for predicting functional prognosis in the acute phase of aging. This review focuses on the conceptual framework and theoretical foundations of PR, systematically summarizes its assessment tools and the patterns of functional recovery following acute stress, analyzes the key physiological mechanisms and multidimensional regulatory factors influencing the recovery process, and discusses its clinical applications and intervention strategies across different settings. References | Related Articles | Metrics

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Research progress on assessment methods for physical resilience SHU Xiaoyu, JIANG Tingting, SONG Quhong, YUE Jirong, XU Zherong 2026, 40 (6):  551-555.  doi: 10.3969/j.issn.1003-9198.2026.06.003 Abstract ( 36 )   PDF (1096KB) ( 71 )   Save Physical resilience, defined as the capacity to maintain or restore homeostasis following health stressors, has emerged as a critical component of healthy aging. Its conceptual framework is evolving from a static, trait-based description toward a dynamic, multisystem adaptive process. This review critically analyzes the existing assessment frameworks, including subjective report-based instruments and objective monitoring-driven assessment models. We further discuss key challenges in current research, including conceptual heterogeneity, limited generalizability of tools across populations, and constraints in capturing dynamic processes. Future research should focus on establishing a standardized conceptual framework, developing integrated, multi-dimensional (physiological-psychological-social) dynamic assessment systems, and promoting their translational application in clinical risk stratification and personalized interventions. References | Related Articles | Metrics

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Effect of physical resilience on the occurrence and development of frailty and its intervention potential MA Ya, LIU Xiaolei 2026, 40 (6):  556-560.  doi: 10.3969/j.issn.1003-9198.2026.06.004 Abstract ( 36 )   PDF (1097KB) ( 66 )   Save Frailty is a highly prevalent clinical syndrome among the elderly population, defined by diminished physiological reserve and heightened susceptibility to stressors. This condition substantially increases the risk of falls, disability, and mortality. As a dynamic adaptive capacity enabling individuals to cope with internal and external stressors, physical resilience is closely intertwined with the onset, progression, and outcome of frailty. In this review, we systematically synthesize the conceptual dimensions of physical resilience and comprehensively dissect the physiological and pathological mechanisms through which it modulates the frailty trajectory—spanning cellular and molecular pathways, tissue and organ function, and systemic crosstalk. Building on these mechanisms, we summarize the current research evidence supporting multidimensional intervention strategies, including exercise, nutrition, and psychological interventions. The primary objective of this work is to outline future research directions and provide a theoretical foundation as well as practical implications for delaying or ameliorating frailty via enhancing physical resilience. References | Related Articles | Metrics

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Analysis of factors influencing physical resilience in older adults from the perspective of the biopsychosocial model WANG Shuo, WANG Jinfeng, LI Ying 2026, 40 (6):  561-565.  doi: 10.3969/j.issn.1003-9198.2026.06.005 Abstract ( 38 )   PDF (1102KB) ( 74 )   Save Against the backdrop of intensifying global population aging, physical resilience, which is the essential capacity for individuals to resist functional decline and facilitate health restoration, carries profound significance for achieving successful aging. Based on the biopsychosocial model, this study systematically analyzes the influencing factors of physical resilience in older adults. With regard to biological factors, age-related physiological degeneration, genetic predisposition, exercise habits, and dietary structure significantly modulate physiological reserve and restorative capacity; Acute and chronic diseases, acting as stressors, directly challenge the homeostatic maintenance and reparative potential of the organism. Among psychological determinants, self-efficacy and optimism enhance resilience by promoting health-related behaviors and alleviating inflammatory responses, whereas negative emotions such as anxiety and depression, as well as cognitive impairment, attenuate restorative capacity via neuroendocrine and immunological mechanisms. Social factors encompass social support, living environment, community resources, socioeconomic status, and cultural background, which collectively constitute the external support system influencing health in older adults. We propose that the enhancement of physical resilience necessitates the integration of multi-level intervention strategies spanning biological, psychological, and social domains. Future research should be dedicated to establishing individualized and multi-dimensional frameworks for improving resilience, thereby comprehensively promoting the overall health status of the elderly population. References | Related Articles | Metrics

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Joint effect of triglyceride glucose index and body roundness index on incidence risk of dementia in Chinese older adults: a cohort study of CHARLS ZHANG Liying, ZHANG Lulu, WANG Jiao 2026, 40 (6):  566-572.  doi: 10.3969/j.issn.1003-9198.2026.06.006 Abstract ( 43 )   PDF (3447KB) ( 85 )   Save Objective To investigate the independent and joint effects of the triglyceride glucose index (TyG) and the body roundness index (BRI) on the risk of dementia in the elderly. Methods The data were obtained from the 2011 China Health and Retirement Longitudinal Study (CHARLS), and a total of 2 710 older adults without dementia at baseline were selected, who underwent questionnaire surveys and physical examinations. Participants were categorized based on the median values of TyG and/or BRI. The occurrence of dementia during the follow-up in 2018 was recorded. Logistic regression models were used to analyze the associations between TyG/BRI and dementia onset, and their additive and multiplicative interactions were further assessed. Results The mean age of the 2 710 participants was 66.5±5.5 years. During follow-up in 2018, a total of 443 incident dementia cases were identified, with an incidence rate of 16.3%. In the multivariable-adjusted models, after adjusting for age, gender, educational level, marital status, residence, body mass index, smoking, alcohol consumption, social engagement, diabetes, hypertension, cardiovascular disease, dyslipidemia, and baseline cognitive function, both high TyG (OR=1.41,95%CI:1.09-1.82) and high BRI(OR=1.68,95%CI:1.22-2.32)were associated with an increased risk of dementia. Compared to the low TyG/low BRI group, the group with high TyG and high BRI had the highest risk of dementia (OR=2.28,95%CI:1.53-3.41). No significant additive or multiplicative interaction was found between TyG and BRI. Subgroup analysis further revealed that the joint effect of high TyG and high BRI on dementia risk was more pronounced among participants aged ≥65 years(OR=2.68, 95%CI:1.62-4.44) and among current smokers(OR=3.29, 95%CI:1.53-7.08). Conclusions Both TyG and BRI are significantly associated with dementia. The combined assessment of TyG and BRI enhances the predictive capability for dementia, underscoring the critical role of insulin resistance and visceral obesity in identifying and screening individuals for dementia risk. References | Related Articles | Metrics

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Impact of frailty on prognosis and construction of nomogram model for elderly patients with non-small cell lung cancer treated with EGFR-TKI WU Miao, LI Jing, WANG Xiaoying, QIN Mengbin 2026, 40 (6):  573-578.  doi: 10.3969/j.issn.1003-9198.2026.06.007 Abstract ( 32 )   PDF (1624KB) ( 67 )   Save Objective To investigate the impact of frailty before treatment on the prognosis of elderly patients with non-small cell lung cancer (NSCLC) receiving epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) therapy, and to construct a prognostic prediction model. Methods A retrospective analysis was performed on clinical data of 221 elderly NSCLC patients treated with EGFR-TKI in Handan Central hospital from January 2020 to December 2023. The simplified 5-factor modified frailty index (mFI-5) was used to assess frailty status before treatment. Overall survival (OS) was set as the follow-up endpoint, with follow-up ending on August 1, 2025. Results Among the patients, 53 cases (24.0%) had frailty before treatment and 22 cases (10.0%) died during follow-up. Logistic regression analysis indicated that pleural invasion, lymphatic invasion, advanced age, tumor size and smoking index were independently associated with frailty (P<0.05). Cox regression analysis revealed that lymphatic invasion, squamous cell carcinoma, smoking index and frailty status were independent risk factors for poor prognosis (P<0.05). The median survival time of frail patients was 2.71 years, which was significantly shorter than that of non-frail patients (Log rank P<0.001). A nomogram model was constructed based on the above four prognostic risk factors. Internal validation via the Bootstrap method (1000 resamplings) showed that the concordance index (C-index) of the model was 0.79. Receiver operating characteristic (ROC) curve analysis revealed that the area under the curve (AUC) of the model for predicting poor prognosis was 0.81(95%CI: 0.69-0.92). Conclusions Frailty status assessed by mFI-5 is associated with decreased OS in elderly NSCLC patients treated with EGFR-TKI. The nomogram model incorporating frailty status, lymphatic invasion, squamous cell carcinoma and smoking index has high predictive value for poor prognosis in these patients. References | Related Articles | Metrics

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Effect of transcutaneous aurcular vagus nerve stimulation on sleep and autonomic function in elderly patients with type 2 diabetes mellitus BAI Lili, WANG Xiaoliang, SHI Hongwei, HU Xiajuan, CAO Yuanyuan, CHENG Zhongjuan 2026, 40 (6):  579-584.  doi: 10.3969/j.issn.1003-9198.2026.06.008 Abstract ( 32 )   PDF (1052KB) ( 72 )   Save Objective To observe the effects of transcutaneous auricular vagus nerve stimulation (taVNS) on sleep quality and autonomic nerve function in elderly patients with type 2 diabetes mellitus (T2DM). Methods Eighty elderly T2DM patients were selected and divided into taVNS group and control group according to a random number table. Participants in the taVNS group received taVNS at the left cymba conchae region. The control group underwent identical electrode placement with the device switched off after a brief ramp-up. The intervention was administered twice daily, five days a week, for four consecutive weeks. The ActiGraph accelerometer and the Pittsburgh Sleep Quality Index (PSQI) were used to record objective and subjective sleep conditions of the two groups, respectively. Heart rate variability (HRV) was monitored, and emotional status was assessed using Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS). Assessments were conducted at baseline, immediately after, and 12 weeks after the intervention. Adverse reactions were recorded in both groups. Results Compared with baseline, the taVNS group exhibited a decrease in total PSQI score, shortened sleep onset latency, reduced times of awakenings, prolonged total sleep time, improved sleep efficiency, increased proportion of deep sleep and rapid eye movement sleep, increased HRV-related parameter values, and decreased SAS and SDS scores on the day after treatment and 12 weeks after treatment(P<0.05). These improvements were significantly greater in the taVNS group than those in the control group at both time points (all P<0.05), expect for proportion of deep sleep and rapid eye movement sleep. No taVNS-related adverse reactions occurred. James' blinding index in this study was 0.16, indicating good blinding effectiveness. Conclusions Four weeks of continuous taVNS can safely and effectively improve sleep quality and autonomic nerve function, and alleviate anxiety and depression in elderly patients with T2DM. References | Related Articles | Metrics

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Gray and white matter volumes mediate the relationship between left ventricular ejection fraction and cognitive impairment in stroke-free older adults:a cross-sectional retrospective study TAN Fuyun, WANG Yanqin, LU Xiaowei 2026, 40 (6):  585-590.  doi: 10.3969/j.issn.1003-9198.2026.06.009 Abstract ( 39 )   PDF (1929KB) ( 70 )   Save Objective To explore the association between left ventricular ejection fraction (LVEF) and brain structure as well as cognitive impairment in stroke-free older adults. Methods A total of 389 stroke-free older adults undergoing health examinations were retrospectively enrolled. Participants were divided into cognitive impairment group (n=138) and non-cognitive impairment group (n=251) based on their Mini-Mental State Examination (MMSE) scores. Whole-brain morphological analysis was conducted utilizing the Computational Anatomy Toolbox 12 (CAT12). After adjusting for relevant confounding factors, restricted cubic splines (RCS) were used to examine the potential nonlinear relationship between LVEF and cognitive impairment. Binary logistic regression was then employed to quantify their independent association, and mediation analysis was conducted to assess the mediating roles of gray matter volume (GMV) and white matter volume (WMV). Results RCS analysis revealed nonlinear associations between LVEF and WMV, and between cognitive scores and WMV, with linear relationships observed for all other variables. Logistic regression analysis indicated that LVEF (OR=0.951, 95%CI: 0.915－0.989, P=0.012), GMV (OR=0.989, 95%CI: 0.983－0.995, P<0.001), WMV (OR=0.991, 95%CI: 0.986－0.996, P=0.001), cortical thickness (OR=0.121, 95%CI: 0.019－0.760, P=0.024) and white matter hyperintensity volume (WMHV) (OR=1.051, 95%CI: 1.010－1.094, P=0.014) were associated with the risk of cognitive impairment. Mediation analysis showed that GMV (accounting for 16.8%) and WMV (significant only when LVEF<60%, accounting for 17.92%) partially mediated the association between LVEF and cognitive impairment. Conclusions In stroke-free older adults, reduced LVEF is significantly associated with cognitive impairment, and brain structural changes play a partial mediating role in this association. References | Related Articles | Metrics

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Association between the cardiometabolic index and cardiometabolic multimorbidity in older adults: uric acid as a potential mediator and combined predictive value ZHENG Hui, WANG Ying, DAI Hui 2026, 40 (6):  591-596.  doi: 10.3969/j.issn.1003-9198.2026.06.010 Abstract ( 38 )   PDF (1396KB) ( 70 )   Save Objective To examine the association between cardiometabolic index (CMI) and cardiometabolic multimorbidity (CMM) in older adults undergoing health examinations, and to explore the mediating role of serum uric acid (UA), both overall and stratified by gender, and to evaluate the discriminative performance of a combined model including CMI and UA for identifying CMM. Methods In this retrospective cross-sectional study, 11 336 adults aged ≥60 years who underwent health examinations from January to December 2024 were included. Multivariable logistic regression was used to assess the association between CMI and CMM. Restricted cubic spline (RCS) analysis was performed to examine the dose-response relationship. Mediation analysis was used to estimate the indirect effect of UA on the association between CMI and CMM, with sex-stratified analyses. Receiver operating characteristic (ROC) curves were used to assess the discriminative performance of CMI, UA, and the combined model. Results The prevalence of CMM was 5.5%. After adjustment for potential confounders, CMI was independently associated with CMM (OR=1.28, 95%CI: 1.111.44). RCS analysis indicated a nonlinear association between CMI and the risk of CMM (P for nonlinearity=0.03), with a steeper increase in risk at lower CMI levels (<0.522). Mediation analysis showed an inconsistent mediation/suppression effect of UA: the direct effect of CMI on CMM was positive (β=0.324, 95%CI: 0.2160.432), whereas the indirect effect through UA was negative (β=-0.082, bootstrap 95%CI: -0.118-0.050), and this pattern was more pronounced in men. ROC curve analysis showed limited discriminative ability for CMI and UA alone [the area under the curve (AUC) was 0.551 and 0.531, respectively)], while the combined model including CMI, UA, and basic covariates achieved an AUC of 0.709(95%CI: 0.6890.729), which was significantly higher than that of either single-indicator model (both P<0.001). Conclusions In older adults undergoing health examinations, CMI is independently and nonlinearly associated with CMM. UA shows an inconsistent mediation/suppression effect in the association between CMI and CMM, which should be interpreted primarily as a statistical association rather than causality. The combined model including CMI, UA, and basic covariates showed moderate discriminative value for identifying CMM. References | Related Articles | Metrics

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Transesophageal echocardiography combined with agitated saline contrast echocardiography in the diagnosing and characteristic analysis of elderly patients with patent foramen ovale XU Yufeng, ZHOU Min, SHEN Xin, YONG Yonghong 2026, 40 (6):  597-601.  doi: 10.3969/j.issn.1003-9198.2026.06.011 Abstract ( 35 )   PDF (1036KB) ( 67 )   Save Objective To investigate the utility of transesophageal echocardiography combined with agitated saline contrast echocardiography in the diagnosis of patent foramen ovale (PFO) in elderly patients and to evaluate the clinical characteristics of PFO. Methods A total of 769 patients with PFO admitted to Echocardiography Department of the First Affiliated Hospital with Nanjing Medical University from June 2022 to June 2024 were included. They were divided into the young and middle-aged group (<60 years old) and the elderly group (≥ 60 years old). The clinical data, PFO shunt degree and cardiac structural characteristics of the two groups were compared. The correlation between clinical characteristics and shunt degree was analyzed, and the implementation situation of the transcatheter closure procedure and the follow-up results in the elderly group were recorded. Results The study included 652 patients in the young and middle-aged group and 117 patients in the elderly group. The elderly group had a higher prevalence of hypertension, cerebral infarction, and atrial fibrillation, but a lower incidence of headache/migraine compared with the young and middle-aged group (all P<0.01). There were no significant differences in gender or the occurrence of transient ischemic attack (P>0.05). Moderate-to-large PFO shunts (grade Ⅱ+grade Ⅲ) were less common in the elderly group,and there was a negative correlation between age and the degree of shunt (r=0.117, P<0.01). Left atrial enlargement was more frequent in the elderly group (P<0.01), whereas no significant differences were observed in the incidence of atrial septal aneurysm or pulmonary hypertension. The elderly group who underwent the transcatheter closure procedure had a lower stroke recurrence rate, and a higher headache/migraine relief rate within one year after the procedure compared to those who did not undergo transcatheter closure procedure (P<0.01). Conclusions Elderly patients with PFO exhibit distinct and clinically complex characteristics. The combined use of transesophageal echocardiography and agitated saline contrast echocardiography supports optimized, individualized diagnostic and therapeutic strategies for elderly patients with PFO. References | Related Articles | Metrics

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Clinical study on the correlation between TRAF3IP2 expression level and coronary artery calcification in the elderly XU Jie, GENG Jin, ZENG Yang, ZHANG Qing, WANG Bingjian 2026, 40 (6):  602-606.  doi: 10.3969/j.issn.1003-9198.2026.06.012 Abstract ( 32 )   PDF (1043KB) ( 70 )   Save Objective To investigate the correlation between tumor necrosis factor receptor 3-interacting protein 2 (TRAF3IP2) and coronary artery calcification (CAC) in the elderly population. Methods This was a prospective study. A total of 216 hospitalized patients aged ≥ 60 years who underwent coronary angiography at the Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University from October 2024 to August 2025 were selected. According to the presence of coronary artery calcification, the patients were divided into the non-calcification group (n=132) and the calcification group (n=84). The clinical data of the patients were collected, and enzyme-linked immunosorbent assay was used to dectect the serum level of TRAF3IP2. Multivariate logistic regression analysis was used to explore the relationship between TRAF3IP2 and CAC in the elderly population. The predictive efficacy of TRAF3IP2 for CAC was evaluated by receiver operating characteristic (ROC) curve. Results The serum level of TRAF3IP2 in the calcification group was significantly higher than that in the non-calcification group (P<0.05). Logistic regression model showed that TRAF3IP2 was independently and positively correlated with the occurrence and the severity of CAC in the elderly population (after adjustment for all covariates, OR=1.092, 1.166, all P<0.01). ROC curve analysis revealed that the area under the curve (AUC) of TRAF3IP2 for predicting CAC in the elderly population was 0.664, the diagnostic sensitivity was 44.7% and the specificity was 89.3%. Conclusions TRAF3IP2 is correlated with CAC in the elderly population, and it may be involved in the progression of CAC in the elderly population. References | Related Articles | Metrics

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Comparison of patient-controlled intravenous analgesia with oliceridine or sufentanil on postoperative pain and quality of recovery in elderly patients after thoracoscopic pulmonary resection CAI Yongliang, SUN Heliang, JIANG Yihao, WANG Zhongyun 2026, 40 (6):  607-612.  doi: 10.3969/j.issn.1003-9198.2026.06.013 Abstract ( 38 )   PDF (1182KB) ( 74 )   Save Objective To compare the efficacy of oliceridine and sufentanil for patient-controlled intravenous analgesia (PCIA) in elderly patients after thoracoscopic pulmonary surgery, and to evaluate their impact on postoperative recovery quality. Methods A total of 154 patients scheduled for thoracoscopic lung resection from August to November 2025 were enrolled and randomly assigned to oliceridine group and sufentanil group. After surgery, the oliceridine group received PCIA with oliceridine, while the sufentanil group received PCIA with sufentanil. The analgesic effect within 0-48 h after the loading dose of PCIA was compared between the two groups using the time-weighted sum of pain intensity difference (SPID). The following parameters were recorded: the pressing time of analgesic pump, cases of postoperative rescue analgesia, 15-item Quality of Recovery (QoR-15) scores 24 h and 48 h after operation, time to first ambulation, postoperative hospital stay, and adverse reactions. Results The least squares (LS) mean of SPID during 0-24 h and 24-48 h were significantly lower in the oliceridine group than those in the sufentanil group (P<0.05). The oliceridine group also showed a lower pressing time of analgesic pump and fewer rescue analgesia cases(both P<0.05). Compared with the sufentanil group, the oliceridine group had higher QoR-15 scores 24, 48 h after operation and a shorter time to first ambulation (P<0.05). There was no significant difference in postoperative hospital stay between the two groups (P>0.05). The incidence of postoperative nausea was lower in the oliceridine group (P< 0.05), while no significant differences were observed in postoperative vomiting, constipation, dizziness, pruritus, or severe respiratory depression between the two groups (P>0.05). Conclusions Compared with sufentanil, oliceridine for PCIA after thoracoscopic pulmonary resection in elderly patients provides more effective pain relief, reduces postoperative nausea, and improves the quality of postoperative recovery. References | Related Articles | Metrics

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Correlation between perioperative dynamic change of C-reactive protein and the risk of postoperative delirium in elderly patients undergoing non-cardiac surgery LIU Yuting, LIU Wen, JI Muhuo 2026, 40 (6):  613-618.  doi: 10.3969/j.issn.1003-9198.2026.06.014 Abstract ( 34 )   PDF (1177KB) ( 69 )   Save Objective To investigate the correlation between perioperative dynamic change of C-reactive protein (ΔCRP) and postoperative delirium (POD), and to evaluate its predictive value for POD. Methods A total of 574 elderly patients undergoing elective general anesthesia at the Second Affiliated Hospital of Nanjing Medical University from February 2021 to July 2025 were enrolled and divided into a POD group (n=118) and a non-POD (N-POD) group (n=456) based on the occurrence of POD. Baseline data and laboratory test results were collected, and the CRP levels one day before surgery and the highest CRP value within three days after surgery were recorded to calculate ΔCRP. The correlation of ΔCRP level with POD was analyzed and the predictive value of ΔCRP level for POD was assessed. Results POD occurred in 118 patients. Compared with N-POD group, the proportion of urban residents, educational level, preoperative mini-mental state examination (MMSE) scores, the levels of red blood cells, hemoglobin, albumin, alanine aminotransferase, and creatine kinase were significantly lower, while American Society of Anesthesiologists (ASA) classification, intraoperative blood loss, total intraoperative fluid input, operation time, and the levels of prothrombin time, fibrinogen, D-dimer, preoperative CRP, postoperative CRP, and ΔCRP were significantly higher in POD group (P<0.05). Multivariable logistic regression analysis showed significant association between ΔCRP and POD (increased by 1 mg/L: OR=1.013, 95%CI: 1.008－1.018; increased by 10 mg/L: OR=1.136, 95%CI: 1.079－1.196). The patients were divided into 4 groups according to quartile of ΔCRP, and the risk of POD in Q4 group was significantly increased (OR=5.078, 95%CI: 2.332－11.059). The AUC of ΔCRP for predicting POD was 0.788 (95%CI: 0.746－0.830). Conclusions Perioperative ΔCRP exhibits a significant dose-dependent positive correlation with the risk of POD and is an independent risk factor for POD occurrence. References | Related Articles | Metrics

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Evaluation of left ventricular myocardial mechanical properties in aged patients with coronary heart disease using three-dimensional speckle tracking imaging SHEN Bo, CAO Mei, HUI Wenqing, ZHANG Pingyang 2026, 40 (6):  619-623.  doi: 10.3969/j.issn.1003-9198.2026.06.015 Abstract ( 33 )   PDF (1316KB) ( 65 )   Save Objective To evaluate the left ventricular myocardial mechanics in elderly patients with coronary heart disease (CHD) without no regional wall motion abnormalities (RWMA)at rest using three-dimensional speckle tracking imaging (3D-STI), and to determine the technique's efficacy in evaluating the serious degree of CHD, as quantified by the Gensini score (GS). Methods A total of 56 elderly patients with normal left ventricular ejection fraction and no RWMA who underwent coronary angiography (CAG) were enrolled in this study. Each participant underwent both standard echocardiographic examination and three-dimensional speckle tracking echocardiographic assessment. The patients were divided into two groups according to the Gensini score(GS): the non-significant stenosis group (GS≤38, n=25) and the significant stenosis group(GS>38, n=31) .General clinical data, standard echocardiographic measurements, and strain parameters derived from 3D-STI were compared between the two groups. The correlations between 3D-STI parameters and GS were analyzed. The diagnostic efficacy of 3D-STI parameters for severe CHD (GS>38) was evaluated using the receiver operating characteristic (ROC) curve. Results There were statistically significant differences in global area strain (GAS) and global longitudinal strain (GLS) between the two groups (P<0.05). However, global circumferential strain (GCS) and global radial strain (GRS) showed no significant differences between the two groups (P>0.05). A significant positive correlation was identified between the GS and both GAS (r=0.715, P<0.001) and GLS (r=0.671, P< 0.01).ROC curve analysis revealed that GAS had high diagnostic value for identifying severe CHD, with a cut-off value of -28.5%, a sensitivity of 93.5%, and a specificity of 72.0% (AUC=0.912). For GLS, a cut-off value of -16.5% provided a sensitivity of 61.3% and a specificity of 80.0% for detecting severe CHD, corresponding to an AUC of 0.791. Conclusions In the elderly patients with CHD without RWMA, left ventricular myocardial strain parameters measured by 3D-STI show certain characteristic changes and are closely associated with the severity of coronary artery lesions. Among these parameters, GAS demonstrates good evaluative efficacy and may serve as an effective non-invasive predictor for the severity of coronary artery lesions. References | Related Articles | Metrics

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Research advances in perioperative comorbidity management for elderly lung cancer patients: from risk assessment to comprehensive intervention YE Lian, LIANG Rui, LI Linlong, GE Ning 2026, 40 (6):  624-629.  doi: 10.3969/j.issn.1003-9198.2026.06.016 Abstract ( 33 )   PDF (1039KB) ( 86 )   Save Elderly patients show high incidence and mortality of lung cancer, often accompanied by comorbidities including metabolic, cardiovascular and chronic respiratory diseases. Such complex comorbidities affect treatment choices, surgical tolerance, and raise perioperative risks and poor prognosis, complicating clinical management.Perioperative care should focus on risk assessment based on comprehensive geriatric evaluation, integrating comorbidities, frailty, cognitive, nutritional and functional status to establish multi-level risk identification and stratified strategies. Multidisciplinary precise interventions help deliver personalized perioperative management.Future efforts should standardize risk assessment tools, strengthen clinical application and optimize comorbidity-oriented integrated models to improve perioperative safety and long-term quality of life for elderly lung cancer patients. References | Related Articles | Metrics

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Exploring the comorbidity mechanism and treatment strategies of inflammatory bowel disease and sarcopenia in the elderly based on the gut microbiota-brain-muscle axis WANG Wanhong, SUN Wenyu, ZHANG Yu, QIU Zhengang, LI Changhao, ZHANG Xin 2026, 40 (6):  630-634.  doi: 10.3969/j.issn.1003-9198.2026.06.017 Abstract ( 33 )   PDF (1021KB) ( 69 )   Save Inflammatory bowel disease (IBD) and sarcopenia are two common diseases that seriously affect the quality of life of elderly patients. Recent studies have shown that there is a close connection between the two diseases in terms of pathological mechanisms. The gut microbiota-brain-muscle axis, as an important regulatory pathway connecting the intestinal microecology, nervous system, and muscle function, provides a new perspective for revealing the comorbidity mechanism of IBD and sarcopenia. This article systematically reviews how gut microbiota dysbiosis affects brain function and muscle metabolism through neuroimmune regulation, thereby promoting the occurrence and development of these two diseases. It focuses on key links such as inflammatory responses, neuroendocrine regulation, and metabolic abnormalities. Combining the latest basic and clinical research results, it explores potential therapeutic targets and intervention strategies, providing theoretical basis and direction guidance for future research and clinical treatment. References | Related Articles | Metrics

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Summary of the best evidence for improving cough ability in elderly patients with post-stroke cough dysfunction CHANG Meng, ZHU Huanhuan, MA Huizhen, LI Yao, CHEN Yan 2026, 40 (6):  635-639.  doi: 10.3969/j.issn.1003-9198.2026.06.018 Abstract ( 35 )   PDF (1187KB) ( 71 )   Save Objective To search and summarize the best evidence for improving cough ability in elderly patients with post-stroke cough dysfunction, so as to provide reference for clinical practice. Methods Based on the 5S evidence model, a systematic search was conducted in domestic and international databases for clinical practices, guidelines, expert consensuses, evidence summaries, and systematic reviews related to improving coughing ability in elderly patients with post-stroke cough dysfunction. Two researchers independently screened and evaluated the literature, with four researchers evaluating the guidelines. Evidence was extracted, summarized, and consolidated according to the themes. Results A total of 14 articles were included, including 4 clinical decision practices, 7 guidelines, and 3 expert consensuses. After evaluation and integration, 22 best pieces of evidence were formed from seven aspects: multidisciplinary teams, cough ability assessment, rehabilitation intervention measures, drug management, nutritional management, aspiration prevention, and traditional Chinese medicine intervention. Conclusions This study summarizes the best evidence for improving cough ability in elderly patients with post-stroke cough dysfunction, and provides an important reference for clinical medical staff to formulate and implement intervention measures. References | Related Articles | Metrics

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Construction and application of diversified non-drug intervention program for delirium in elderly patients undergoing mechanical ventilation after neurosurgery NI Fangfang, YE Lei, ZHANG Yingbei, CHEN Jiawei, ZHANG Yaojin, CUI Wei 2026, 40 (6):  640-645.  doi: 10.3969/j.issn.1003-9198.2026.06.019 Abstract ( 34 )   PDF (1055KB) ( 68 )   Save Objective To construct a diversified non-drug intervention program for delirium in elderly patients undergoing mechanical ventilation after neurosurgery, and to evaluate its application effect. Methods Through literature search and expert consultation, a diversified non-drug intervention program for delirium in elderly patients undergoing mechanical ventilation after neurosurgery was constructed. A non-concurrent controlled study was conducted. A total of 45 elderly patients undergoing mechanical ventilation after neurosurgery from July 1, 2023 to March 31, 2024 were selected as the control group, and 45 similar patients from October 1, 2024 to June 30, 2025 were selected as the observation group. The observation group received diversified non-drug intervention scheme to prevent delirium, while the control group received neurosurgical critical care.The incidence of delirium, duration of mechanical ventilation, length of ICU stay, dosage of sedative drugs and sleep quality score were compared between the two groups. Results The incidence of delirium, dosage of sedative drugs, duration of mechanical ventilation and length of ICU stay in the observation group were lower than those in the control group, and the sleep quality score was higher than that in the control group, with significant differences (P<0.01). Conclusions The diversified non-drug intervention program for delirium in elderly patients receiving mechanical ventilation after neurosurgery is scientific and comprehensive. The implementation of the program can reduce the incidence of delirium. References | Related Articles | Metrics