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28 June 2021, Volume 35 Issue 6 Previous Issue    Next Issue

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Expression and functional analysis of non-coding microRNA-200 family and U78 in elderly patients with oral squamous cell carcinoma FANG Xu, LIU Wei-xian, HUANG Yu-jing, RUAN Qiang 2021, 35 (6):  555-559.  doi: 10.3969/j.issn.1003-9198.2021.06.005 Abstract ( 120 )   PDF (1569KB) ( 820 )   Save Objective To screen and identify the expression of non-coding microRNAs in oral squamous cell carcinoma (OSCC) and normal tissues in the elderly patients, and to analyze the clinical significance in the occurrence of OSCC. Methods A total of 44 OSCC specimens and 23 oral tissue specimens were collected, and the expression of non-coding microRNAs closely related to OSCC were screened. The transcription levels of microRNAs 200 family (miR-200a, miR-200b, miR-200c, miR-141 and miR-429) and U78 in OSCC tissues and normal tissues were detected by TaqMan quantitative PCR method. Then, the results were analyzed by statistical methods. Bioinformatics tools were used to predict the biological function. Results Microarray and TaqMan quantitative PCR results confirmed that the expression levels of microRNA-200 family and U78 in OSCC tissues were significantly higher than those in normal oral tissues. Bioinformatics analysis indicated that microRNA-200 family could target genes closely related to tumor development, such as β-catenin and transforming growth factor β2. Multiple linear regression analysis showed that the expression of U78 was significantly correlated with pathological grade (P=0.023), but not with clinical stage and metastasis. Conclusions MicroRNA-200 family and U78 may be involved in the occurrence of OSCC and may be potential biomarkers for the clinical diagnosis of OSCC. References | Related Articles | Metrics

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Analysis of sleep condition of elderly people with subjective memory decline in the community ZHU Mo, FANG Yuan, LI Xia 2021, 35 (6):  560-563.  doi: 10.3969/j.issn.1003-9198.2021.06.006 Abstract ( 134 )   PDF (1194KB) ( 757 )   Save Objective To study the sleep problems in the elderly with subjective memory decline (SMD), and to further discover the characteristics of SMD. Methods The elderly people who participated in the community health survey of Shanghai Yangpu District in November 2017 were selected. They were divided into two groups, SMD group (147 cases) and corrtrol group (177 cases) according to the existence of persistent SMD. The Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleeping Scale (ESS) were used to evaluate the sleep condition. Results SMD group had a higher proportion of sleep quality problems than the control group (25.9% vs 13.0%). The proportion of sleep duration, sleep disturbance and daytime dysfunction in SMD group (44.9%, 7.5%, 11.6%) were higher than those in the control group (33.3%, 2.3%, 3.4%), with statistically significant differences. Logistic regression analysis showed that the Geriatric Depression Scale (GDS) score (OR=1.198, 95% CI:1.059-1.235), ESS score (OR=1.068, 95% CI:1.007-1.133), sleep quality (OR=1.944,95% CI:1.072-3.525), hypertension (OR=1.609, 95% CI:1.016-2.548) were the risk factors for SMD. Conclusions The elderly people with SMD are more prone to presenting with sleep problems. Depressive mood, daytime sleepiness, sleep quality problems and hypertension are risk factors for SMD. References | Related Articles | Metrics

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Effects of astragalus polysaccharide on expression and function of regulatory T cells in elderly patients with advanced gastric cancer LYU Cai-xia, YUAN Xiao-ye, SHAO Wei-hua, LIN Hua, WANG Su-xing, ZHAO Jing-ru, ZHANG Ming-ming 2021, 35 (6):  564-567.  doi: 10.3969/j.issn.1003-9198.2021.06.007 Abstract ( 145 )   PDF (1200KB) ( 734 )   Save Objective To investigate the effect of astragalus polysaccharide on regulatory T cells (Tregs) in the peripheral blood of the elderly patients with advanced gastric cancer. Methods A total of 60 elderly patients with advanced gastric cancer were randomly divided into control group, low-dose astragalus polysaccharides group and high-dose astragalus polysaccharides group. Flow cytometry was used to detect the expression of CD4+CD25+Tregs and CD4+CD25+FoxP3+Tregs in the peripheral blood before or after the treatment. The levels of interleukin-10 (IL-10) and transforming growth factor-β1(TGF-β1) were detected by enzyme linked immunosorbent assay method. Results The expressions of CD4+CD25+Tregs and CD4+CD25+FoxP3+Tregs in the peripheral blood of the high-dose group were significantly lower than those before the administration (P<0.05).However, the expressions of CD4+CD25+Tregs and CD4+CD25+FoxP3+Tregs were not significantly decreased in the low-dose group and the control group. At the same time, the levels of IL-10 and TGF-β1 in the high-dose group were significantly lower than those before the administration (P<0.05), while showing no significant changes in the control group. The level of TGF-β1 in the low-dose group was lower than that before administration(P<0.05). Conclusions Astragalus polysaccharide may reduce the immunosuppressive status of the elderly patients with advanced gastric cancer by reducing the expression and function of Tregs. References | Related Articles | Metrics

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Clinical analysis of liraglutide in the treatment of early type 2 diabetic nephropathy in elderly RUAN Yi, LI Jing, HUANG Xiao-rong 2021, 35 (6):  568-571.  doi: 10.3969/j.issn.1003-9198.2021.06.008 Abstract ( 129 )   PDF (1193KB) ( 779 )   Save Objective To observe the efficacy of liraglutide in the elderly patients with early type 2 diabetic nephropathy and the effects on glucolipid metabolism, 24 h microalbuminuria and renal function. Methods A total of 124 elderly patients with early type 2 diabetic nephropathy from December 24, 2019 to November 13, 2020 in West China Hospital, Sichuan University were enrolled and divided into observation group and control group according to the random number table method, with 62 cases in each group. The patients in control group received routine treatment for hyperlipoidemia and hypertension, and insulin injection or oral administration of hypoglycemic drugs. The patients in observation group received liraglutide on the basis of control group. The total effective rate 8 weeks after treatment, as well as glucose metabolism indexes [fasting plasma glucose (FPG), postprandial 2 h blood glucose (2hPG), glycosylated hemoglobin (HbA1c), fasting insulin (FINS)], lipid metabolism indicators [total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C)], 24 h microalbuminuria and renal function indicators [Cystatin C (CysC), random urine albumin/creatinine ratio (UACR)] before treatment and 8 weeks after treatment were compared between the two groups. Results After 8 weeks of treatment, the total effective rate in observation group was higher than that in control group (P<0.01). The levels of FPG, 2hPG, HbA1c, FINS, TC, TG, LDL-C, 24h microalbuminuria, CysC and UACR in the two groups were lower than those before treatment, and the level of HDL-C was higher than that before treatment, especially in observation group (P<0.01). Conclusions Liraglutide shows an exact efficacy in the treatment of early type 2 diabetic nephropathy in the elderly. And it can effectively improve the glucolipid metabolism and protect the renal function, with a certain clinical application value. References | Related Articles | Metrics

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Relationship between Apolipoprotein E genotype with SYNTAX score in elderly patients with coronary artery disease in Nanjing: a retrospective study YANG Yang, ZHOU Ying, TIAN Yun-fan, SHI Jing 2021, 35 (6):  572-574.  doi: 10.3969/j.issn.1003-9198.2021.06.009 Abstract ( 133 )   PDF (1181KB) ( 744 )   Save Objective To investigate the relationship between the polymorphism of Apolipoprotein E (APOE) gene and SYNTAX score in the elderly patients with coronary artery disease (CAD) in Nanjing. Methods A total of 109 patients diagnosed as CAD by coronary angiography (CAG) were enrolled. The complexity of CAD of all the patients was assessed by SYNTAX score, and the genotype of ApoE was detected by polymerase chain reaction. Results The patients were divided into three groups according to the gene phenotype of ApoE. Among them, 22, 71 and 16 patients were identified with the genotype of ApoE2, ApoE3 and ApoE4. The mean value of SYNTAX score of the patients with ApoE2, ApoE3 and ApoE4 was 7.75±7.62, 14.77±9.52 and 15.53±7.14, respectively. The SYNTAX score of ApoE3 group and ApoE4 group was both significantly higher than that of ApoE2 group (P<0.05), while there was no significant difference in SYNTAX score between ApoE3 group and ApoE4 group. Conclusions The elderly patients with the genotype of ApoE3 or ApoE4 have higher SYNTAX score than those with the genotype of ApoE2, suggesting that ApoE3 and ApoE4 may be related with the complexity of CAD. References | Related Articles | Metrics

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Analysis of the influencing factors of depression in the elderly REN Jiang-lei, MO Bao-qing, ZHANG Peng-peng, LI Bo-han, FENG Qing 2021, 35 (6):  575-579.  doi: 10.3969/j.issn.1003-9198.2021.06.010 Abstract ( 140 )   PDF (1215KB) ( 864 )   Save Objective To investigate the status of depression and the influencing factors in the elderly aged over 65 years old. Methods The relationship was analyzed between depression and lifestyle or personal situation, according to the data of the follow-up survey on the influencing factors of elderly health in China in 2018. Results A total of 11 727 people were included in this analysis, among which 2487 (21.21%) presented with depression. The results of binary Logistic regression showed that the protective factors of depression were good living quality (OR=0.23, 95% CI: 0.09-0.59),good health condition (OR=0.23, 95% CI: 0.13-0.42),satisfied health change (OR=0.46, 95% CI: 0.29-0.75),high quality sleeping (OR=0.09, 95% CI: 0.06-0.13),daily intake of vegetables (OR=0.65, 95%CI:0.48-0.88),frequently vegetable oil (OR=0.75, 95%CI: 0.63-0.88),regular exercise (OR=0.71, 95% CI: 0.62-0.80),adequate living capital (OR=0.62, 95% CI:0.53-0.71),timely medical service during diseases (OR=0.70, 95%CI: 0.51-0.95),common shopping provided by community (OR=0.65, 95% CI: 0.53-0.79), daily housework (OR=0.78, 95% CI: 0.69-0.89),daily reading (OR=0.69, 95%CI:0.56-0.85), playing poker and mahjong (OR=0.76, 95% CI: 0.56-0.97),watching TV and listening to radio every day (OR=0.77, 95% CI: 0.67-0.88),married cohabitation (OR=0.49, 95% CI: 0.29-0.82) and living with the family members(OR=0.70, 95% CI: 0.52-0.95), while the risk factors were female (OR=1.21, 95% CI: 1.08-1.37) and suffering from more than three kinds of chronic diseases (OR=1.22, 95% CI: 1.07-1.39). Conclusions The influencing factors for depression are gender, marriage and living situation, health and activity level, daily shopping service provided by community, diet, sleep quality, adequate living funds and medical services in the elderly. References | Related Articles | Metrics

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Study on lymphocyte-to-monocyte ratio in evaluating prognosis of multiple myeloma in elderly patients JIN Ling, ZHOU Zhi-gang 2021, 35 (6):  580-583.  doi: 10.3969/j.issn.1003-9198.2021.06.011 Abstract ( 130 )   PDF (1195KB) ( 731 )   Save Objective To explore the value of lymphocyte-to-monocyte ratio (LMR) in evaluating the prognosis of multiple myeloma in the elderly aged over 65 years old at the first diagnosis. Methods From January 2014 to January 2019, 81 newly diagnosed elderly patients with multiple myeloma who were admitted to Yixing Hospital of Jiangsu University were enrolled. The number of lymphocytes and monocytes before treatment were collected, and LMR was calculated. The receiver operating characteristic (ROC) curve was used to determine the cutoff value of LMR in predicting the prognosis. All the patients were divided into high LMR group and low LMR group according to the cutoff value. The patients were followed up, and the relationship between LMR and overall survival (OS) and disease-free survival (DFS) was analyzed. Results A total of 75 patients were followed up, with a follow-up success rate of 92.6%. The follow-up time was 12-72 months, with a median follow-up time of 24 months. The results of ROC curve analysis showed that the area under the curve for predicting the death by LMR was 0.78 (P=0.003), with a specificity of 65.2% and a sensitivity of 81.0%, and the LMR cutoff was 0.15. The complete response rate in the low LMR group was lower than that in the high LMR group (26.67% vs 60.00%, P<0.05). The proportion of Durie-Salmon (DS) stage Ⅲ in the low LMR group was higher than that in the high LMR group(P<0.05). The Kaplan-Meier method and Log-rank test showed that the OS, DFS in the low LMR group were shorter than those in the LMR group (P<0.05). Cox multivariate analysis showed that LMR, age, LDH and DS staging were independent factors affecting OS (P<0.05), and LMR, LDH and DS staging were independent influencing factors of DFS in the elderly patients with multiple myeloma (P<0.05). Conclusions LMR has significant value in predicting the prognosis of the elderly patients with newly diagnosed multiple myeloma. References | Related Articles | Metrics

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Construction and application of early simple cardiac rehabilitation program for elderly patients with acute heart failure in compensatory period TONG Lin, XU Sai, YANG Hai-xia, DING Yuan-yuan 2021, 35 (6):  584-587.  doi: 10.3969/j.issn.1003-9198.2021.06.012 Abstract ( 172 )   PDF (1195KB) ( 742 )   Save Objective To construct an early simple cardiac rehabilitation program for the elderly patients with acute heart failure in the compensatory phase and to explore the intervention effects. Methods A sports rehabilitation team was established, and the preliminary plan for early simple cardiac rehabilitation was formed after literature search, and the final plan was formed after the discussion of the expert group meeting. An arbitrary sampling method was used to select 104 elderly patients with compensatory acute heart failure who were hospitalized in our hospital from August 2015 to August 2020 as the research objects, with 52 cases in the observation group and the control group. The related indicators before and after the intervention of the early simple cardiac rehabilitation program in the two groups were recorded and analyzed. Results The Minnesota Living with Heart Failure Question maire score and the level of amino-terminal pro-brain natriuretic peptide in the observation group were lower than those in the control group (P＜0.05 or 0.01); The levels of the forced expiratory volume in one second (FEV1), 6 minutes walk distance and the times of 30-second arm curl were significantly higher than those in the control group (P＜0.05 or 0.01). Conclusions The early simple cardiac rehabilitation program can ensure the safe progress of the patients’ early exercise through team supervision and management, and can improve the cardiac function of the elderly patients with acute heart failure in the compensatory phase and improve the quality of life. References | Related Articles | Metrics

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Relationship between negative emotion and glucose and lipid metabolism in elderly patients with type 2 diabetes and depression CHEN Tao, GU Tao 2021, 35 (6):  588-590.  doi: 10.3969/j.issn.1003-9198.2021.06.013 Abstract ( 137 )   PDF (1227KB) ( 745 )   Save Objective To explore the relationship between negative emotion and the indexes of glucose and lipid metabolism in the elderly patients with type 2 diabetes mellitus (T2DM) complicated with depression. Methods A total of 84 elderly patients with T2DM complicated with depression (study group) and 79 elderly T2DM patients (control group) admitted to the hospital from January 2019 to October 2020 were selected as the research objects. The negative emotion and the glucose and lipid metabolism of the two groups were compared. The correlation between negative emotions and the indicators of glucose and lipid metabolism in the study group was analyzed. Results The scores of the Anxiety Self-Rating Scale (SAS) and the Hamilton Depression Scale (HAMD) in the study group were higher than those in the control group (P<0.05), and the score of Perceived Social Support Scale (PSSS) in the study group was lower than that in the control group (P <0.05). The levels of fasting blood glucose (FPG), glycosylated hemoglobin (HbA1c), insulin resistance index (HOMA-IR), triglycerides (TG) and total cholesterol (TC) in the study group were higher than those in the control group (P＜0.05). The levels of FPG, HbA1c, HOMA-IR, TG and TC in the study group were positively correlated with HAMD score (P<0.05), and were negatively correlated with PSSS score (P<0.05 ). Conclusions Negative emotion is closely related to glucose and lipid metabolism in the elderly patients with T2DM and depression. The more serious the negative emotions, the more disordered the glucose and lipid metabolism. It is recommended to strengthen clinical health education and psycho-emotional treatment. References | Related Articles | Metrics

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Effects of edaravone on penumbra volume and nervous function deficiency in elderly patients with ischemic stroke CHEN Dong-li, SONG Li-yun, CHEN Jie, YANG Zhen, GUO Min 2021, 35 (6):  591-594.  doi: 10.3969/j.issn.1003-9198.2021.06.014 Abstract ( 136 )   PDF (1193KB) ( 781 )   Save Objective To explore the clinical effect of edaravone in the elderly patients with ischemic stroke and the influence on penumbra volume and nervous function deficiency. Methods From June 2017 to June 2019, 108 elderly patients with ischemic stroke who were admitted to the Shunyi Airport Hospital were enrolled in this retrospective study, and they were divided into control group and study group according to different treatment methods, with 54 cases in each group. The control group was treated with aspirin enteric-coated tablets, while the study group was treated with edaravone on the basis of the control group. The efficacy was compared between the two groups. National Institute of Health Stroke Scale (NIHSS) score, Glasgow coma score (GCS) and ability of daily living (ADL) score were evaluated, and the levels of coagulation function, T cell subsets and penumbra volume were detected and compared between the two groups. Results After treatment, the scores of GCS and ADL, and the levels of prothrombin time (PT) and activated partial thromboplastin time (APTT) in the study group were higher than those in the control group (P＜0.05). The levels of CD4+ and CD4+/ CD8+ in the study group were higher than those in the control group (P＜0.05), while the level of CD8+ was lower than that in the control group (P＜0.05). The NIHSS score of the study group was lower than that of the control group (P＜0.05), and the penumbra volume of the study group was smaller than that of the control group (P＜0.05). Conclusions Edaravone shows significant clinical effect in the treatment for ischemic stroke. It can not only improve the patients′ blood coagulation function, neurological function, and peripheral blood T cell subsets, but also improve the patients′ ADL. References | Related Articles | Metrics

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Treatment of fusion of the first metatarsophalangeal joint combined with arthroplasty of lesser metatarsal heads for elderly patients with rheumatoid forefoot WANG Xu, DU Bin, SUN Guang-quan 2021, 35 (6):  595-598.  doi: 10.3969/j.issn.1003-9198.2021.06.015 Abstract ( 157 )   PDF (1349KB) ( 769 )   Save Objective To observe the efficacy of fusion of the first metatarsophalangeal joint combined with arthroplasty of lesser metatarsal heads for elderly patients with rheumatoid forefoot. Methods From May 2015 to December 2019, 30 elderly patients (48 feet) with rheumatoid forefoot were treated by fusion of the first metatarsophalangeal joint combined with arthroplasty of lesser metatarsal heads. All the patients received regular postoperative follow-up. The clinical efficacy was evaluated by hallux valgus angle (HVA), intermetatarsal angle(IMA), visual analgue scale(VAS) and American Orthopedic Foot and Ankle society (AOFAS) scoring standard before operation and at the last follow-up. Results The final follow-up was successful in all patients, and they were followed up for 23 months on average (8~48 months). All the incisions were healed at first intention after operation, and the first metatarsophalangeal joint nonunion was found in 2 feet. The AOFAS score, HVA, IMA and VAS score were significantly improved after the treatment (P<0.01). Conclusions Fusion of the first metatarsophalangeal joint combined with arthroplasty of lesser metatarsal heads can correct the deformity of rheumatoid forefoot, relieving pain and restore forefoot function, with few postoperative complications. References | Related Articles | Metrics

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Study on the characteristics of sleep disorders in the elderly patients with dementia ZHOU En-zhu, XIA Li, LYU Yang, LIU Xin-tong 2021, 35 (6):  599-601.  doi: 10.3969/j.issn.1003-9198.2021.06.016 Abstract ( 114 )   PDF (1172KB) ( 816 )   Save Objective To investigate the characteristics of sleep disorders in the elderly patients with different degrees of dementia. Methods A total of 752 elderly patients were enrolled from the Department of Geriatrics in the First Affiliated Hospital of Chongqing Medical University from 2016 to 2019. The patients were divided into normal cognition group (n=411) and dementia group (n=341) according to the score of Mini-Mental State Examination (MMSE).The dementia group was further divided into three groups as mild group (n=133, 21-26 scores), moderate group (n=167,10-20 scores) and severe group (n=41, 0-9 scores). The scores of Pittsburgh Sleep Qualit Index (PSQI) scales of the four groups were analyzed and compared. Results The total score of PSQI and the scores of sleep onset, sleep efficiency and day function disorder were significantly higher in dementia group than those in normal cognition group (P<0.05). The total score of PSQI was generally increased with the increase of the degree of dementia (P<0.05). The score of day function disorder in the the mild group was less than that in the other two groups (P<0.05), while the scores of sleep onset, sleep efficiency and day function disorder in severe group were higher than those in mild group and moderate group (P<0.05). Conclusions The patients with dementia present with sleep disorders which is associated with the degree of dementia. Day function is affected at the early stage of dementia, followed by sleep onset and sleep efficiency. References | Related Articles | Metrics

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Efficacy and safety of active vitamin D intervention in postmenopausal women with type 2 diabetes mellitus GONG Hui, ZHONG Tian-ying, YU Xiao, WANG Qi-yu 2021, 35 (6):  602-605.  doi: 10.3969/j.issn.1003-9198.2021.06.017 Abstract ( 116 )   PDF (1196KB) ( 774 )   Save Objective To investigate the efficacy and safety of vitamin D intervention in the postmenopausal women with type 2 diabetes mellitus (T2DM). Methods A total of 64 postmenopausal women with T2DM in Nanjing Maternity and Child Health Care Hospital and the Gariatric Hospital of Nanjing Medical University from January 2016 to December 2019 were selected and divided into observation group (n=32) and control group (n=32). The control group was treated with dynamic monitoring of plasma glucose combined with insulin pump, and the observation group was given alfacalicol soft capsule intervention on the basis of the control group. The levels of fasting plasma glucose (FPG), 2 h postprandial blood glucose and glycated hemoglobin (HbA1c), interleukin-6 (IL-6), C-reactive protein (CRP), IL-17 and IL-13 before and after the intervention were observed in the two groups. Results After vitamin D supplementation, the levels of FPG, 2-h postprandial blood glucose, HbA1c, IL-6, CRP and IL-17 in the observation group were significantly lower than those in the control group, and the level of IL-13 was significantly higher than that in the control group (all P<0.01). Conclusions Active vitamin D combined with insulin hypoglycemic therapy is a safe and effective treatment for T2DM in the postmenopausal women. References | Related Articles | Metrics

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Risk factors of type 2 diabetes mellitus complicated with cognitive impairment ZHU Ling-ling, ZHU Jun, WANG Min, DONG Jing-de 2021, 35 (6):  606-608.  doi: 10.3969/j.issn.1003-9198.2021.06.018 Abstract ( 123 )   PDF (1178KB) ( 753 )   Save Objective To explore the relationship between type 2 diabetes mellitus (T2DM) and cognitive impairment. Methods From January 2015 to August 2019, a total of 50 hospitalized T2DM patients with cognitive impairment in Nanjing Brain Hospital Affiliated to Nanjing Medical University were selected. In addition, 50 case of T2DM patients without cognitive impairment in the same period were selected. All the patients were aged over 65 years old. The general data and disease information of the two groups were collected, and the levels of blood lipid, glycosylated hemoglobin (HbA1c), fasting insulin (FINS), creatinine (Cr), homocysteine (Hcy), free fatty acids (FFAs) and inflammatory factors were measured. Multivariate Logistic regression was used to analyze the risk factors of cognitive impairment in the T2DM patients. Results Compared with T2DM group, age, disease course, body mass index (BMI), low-density lipoprotein cholesterol (LDL-C), HbA1c, Hcy, lipoprotein phospholipase(Lp-PLA2), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) levels in the T2DM patients with cognitive impairment were increased, while the folate level was decreased (P<0.05). Logistic regression analysis showed that age, disease course, Hcy, HbA1c, LDL-C and TNF-α were independent risk factors for cognitive impairment in the T2DM patients. Conclusions Age, course of disease, Hcy, HbA1c, LDL-C and TNF-α may play certain roles in the process of cognitive dysfunction in the elderly patients with T2DM. It is important to control these factors to prevent and delay the cognitive dysfunction in the patients with type 2 diabetes. References | Related Articles | Metrics

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Efficacy and pharmacoeconomic evaluation of tiotropium bromide combined with salmeterol/fluticasone in elderly patients with stable chronic obstructive pulmonary disease WU Ling, ZHANG Dan-dan, XIE Long, HUANG Li 2021, 35 (6):  609-611.  doi: 10.3969/j.issn.1003-9198.2021.06.019 Abstract ( 143 )   PDF (1175KB) ( 759 )   Save Objective To evaluate the effects of tiotropium bromide combined with salmeterol/fluticasone on lung function and St. George’s respiratory questionnaire (SGRQ) score in the elderly patients with stable chronic obstructive pulmonary disease (COPD), and to analyze the cost-effectiveness. Methods A total of 60 patients with stable COPD were randomly divided into the observation group(n=30) and the control group(n=30). The control group was treated with salmeterol/fluticasone and the observation group were treated with tiotropium bromide combined with salmeterol/fluticasone. After six months of treatment, the lung function, SGRQ score, number of acute exacerbations were compared between the two groups, and a cost-effectiveness analysis was performed for the two treatment options. Results After the intervention, the levels of forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) in the observation group were higher than those in the control group, and the SGRQ score was lower than that in the control group (P<0.05). FEV1/ FVC showed no significant differences between two groups (P> 0.05). The cost-effectiveness analysis showed that the cost-effectiveness ratio (C/E) of the observation group was significantly better than that of the control group (P<0.05). Conclusions The regimen of tiotropium bromide combined with salmeterol/fluticasone for the treatment of stable COPD in the elderly patients can significantly improve the lung function and SGRQ score, reduce the number of acute exacerbations, which shows better cost-effectiveness. References | Related Articles | Metrics

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Efficacy and safety of icotinib in the elderly patients with advanced non-small cell lung cancer XU Wei, FANG Le-ping, LIU Su-yao, WANG Lin, XU Ju-qing, YANG Shu, WANG Jun, FAN Wei-fei 2021, 35 (6):  612-615.  doi: 10.3969/j.issn.1003-9198.2021.06.020 Abstract ( 145 )   PDF (1246KB) ( 786 )   Save Objective To observe the efficacy and safety of icotinib in the elderly patients with advanced non-small cell lung cancer (NSCLC). Methods A total of 41 advanced NSCLC patients aged >60 years old were retrospectively analyzed from January 2015 to February 2020. Results The clinical data of 41 elderly patients including 28 cases of epidermal growth factor receptor(EGFR) mutation and 13 cases of wild type with advanced NSCLC were enrolled in this study. The patients’ overall objective response rate (ORR) was 53.7% and the disease control rate (DCR) was 80.5%; In the patients with EGFR mutation, ORR was 67.9%, DCR was 92.9%, which were significantly higher than those in the patients with EGFR gene wild type. Single factor analysis showed that EGFR mutation and performance status (PS) score were related with PFS (P<0.05), and multiple Cox regression analysis showed that PS score was the independent influencing factor of the prognosis. The most common adverse events were rash, diarrhea and fatigue. Only 2 patients discontinued the medication due to severe liver injury. Conclusions Icotinib is a safe and effective targeted therapy in the elderly patients with advanced NSCLC, especially in the patients with better PS scores and EGFR mutation.     References | Related Articles | Metrics

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Expression of AMPKα1/TLR4 pathway in elderly patients with diabetic nephropathy and the correlation with NF-κB and TGF-β1 levels LI Xiao-yan, ZHANG Ru, MO Li-wen 2021, 35 (6):  616-619.  doi: 10.3969/j.issn.1003-9198.2021.06.021 Abstract ( 166 )   PDF (1320KB) ( 869 )   Save Objective To investigate the expression of AMPKα1 / TLR4 pathway in the elderly patients with diabetic nephropathy and the correlation with the levels of nuclear factor-κB (NF-κB) and transforming growth factor-β1 (TGF-β1). Methods A total of 126 elderly patients with diabetic nephropathy confirmed by renal biopsy from March 2017 to May 2019 were selected as the observation group; And 81 elderly patients (non diabetic nephropathy) who underwent nephrectomy at the same time were selected as the control group. The levels of AMPKα 1 / TLR4 mRNA in different tissues were measured by real-time polymerase chain reaction and hematoxylin-eosin (HE) staining, and the levels of NF-κB and TGF-β1 in the two groups were measured by enzyme-linked immunosorbent assay. The correlations between AMPKα1 / TLR4 mRNA and NF-κB, TGF-β1 were analyzed by Pearson correlation coefficient. Results The level of AMPKα1/TLR4 mRNA in the observation group was lower than that in the control group (P<0.01). HE staining showed that the glomerular capillary basement in the observation group was diffusely thickened, accompanied with fibrosis, and the intima of small artery wall was thickened; While in the control group, the glomeruli and renal tubules showed no obvious pathological changes and no fibrosis. The levels of NF-κB and TGF-β1 in the observation group were higher than those in the control group. Pearson correlation analysis showed that AMPK α1 / TLR4 mRNA level was negatively correlated with NF-κB and TGF-β1 levels in the elderly patients with diabetic nephropathy (P < 0.05). Conclusions The expression of AMPK α1 / TLR4, NF-κB and TGF-β1 are abnormal in the elderly patients with diabetic nephropathy. They might directly participate in the occurrence and development of the disease. References | Related Articles | Metrics

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KIR2DL4 gene polymorphism and pro-apoptotic gene HtrA2 expression and their correlation with prognosis in elderly patients with leukemia ZHU Wen-yi, LI Sheng-jun, HOU Qian-qian 2021, 35 (6):  620-623.  doi: 10.3969/j.issn.1003-9198.2021.06.022 Abstract ( 113 )   PDF (1199KB) ( 795 )   Save Objective To investigate the expression of KIR2DL4 gene polymorphism and pro-apoptotic gene HtrA2 in the elderly patients with leukemia and their correlation with prognosis. Methods A total of 156 elderly patients with leukemia from July 2016 to January 2018 were selected as the observation group. Among the patients, 67 cases were acute lymphoblastic leukemia (ALL), 60 cases were acute myeloid leukemia, and 29 cases were chronic myeloid leukemia (CML). All patients were given conventional treatment, and completed a 2-year follow-up. There were 79 cases of elderly people who underwent healthy physical examinations during the same period were selected as control groups. All the subjects complete genomic DNA extraction, and specific PCR amplification of all coding regions; Real-time fluorescent PCR technology was used to determine the expression of pro-apoptotic genes HtrA2 mRNA. The correlation between the KIR2DL4 gene polymorphism and the expression of gene HtrA2 with the prognosis of leukemia was analyzed. Results There were no statistically significant in 2DL4-001, 2DL4-005, 2DL4-006, 2DL4-008 and 2DL4-0011 gene polymorphisms between the two groups(P>0.05). The gene polymorphisms of 9A type KIR2DL4 were higher and 10A KIR2DL4 was lower in the observation group than those in the control group (P<0.05). The expression of HtrA2 mRNA in the observation group was higher than that in the control group (P<0.05). During the follow-up period, 54 patients died, with a mortality rate of 34.62%. The detection rates of type 2DL4-0011 and type 9A Kir2DL4 in death group were higher, while the detection rate of type 10A Kir2DL4 and the expression of HtrA2 were lower than those in survival group (P<0.05). Cox regression analysis showed that the prognosis of patients with senile leukemia was related to the polymorphism of 9A Kir2DL4, 2DL4-006 and the expression of HtrA2(P<0.05). Conclusions KIR2DL4 gene polymorphism and pro-apoptotic gene HtrA2 are abnormally expressed and correlated with prognosis in the elderly patients with leukemia. References | Related Articles | Metrics

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Application of staged body placement in laparoscopic radical resection of rectal cancer in the elderly WANG Kai, ZHANG Chun-yan ZHANG Qing, WANG Zheng-mei 2021, 35 (6):  638-641.  doi: 10.3969/j.issn.1003-9198.2021.06.027 Abstract ( 28 )   PDF (1192KB) ( 84 )   Save Objective To explore the effect of staged placement in laparoscopic radical operation of rectal cancer in the elderly. Methods A total of 97 elderly patients undergoing laparoscopic Miles operation from January 2018 to December 2019 in our hospital were enrolled in this study, among which 45 patients from January to December 2018 were divided into the control group and 52 patients from January to December 2019 were divided into the study group. In the control group, the modified leg supporting frame was used throughout the operation. In the study group, the stirrup pneumatic leg supporting frame was used, and the whole operation was roughly divided into three stages, and the corresponding operation position was adopted at different stages. The incidence of postoperative lower extremity swelling and deep vein thrombosis, the comfort of lower extremity and the satisfaction for the operation position of the operator were compared between the two groups. Results The incidence of lower extremity swelling in the study group was lower than that in the control group 24 h after operation, and the comfort degree of lower extremity and the satisfaction degree of the operator for the operation position were better than those in the control group, with significant difference (P<0.05); There was no deep vein thrombosis in the two groups 72 hours after operation. Conclusions The placement of the elderly patients in different stages can not only reduce the incidence of complications and increase the postoperative comfort, but also fully expose the operation site and facilitate the operation. References | Related Articles | Metrics

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Correlation of postoperative elevation modes of lower limbs with deep venous thrombosis in elderly patients with hip fracture YU Yan, YU Yuan, LI Shuai 2021, 35 (6):  642-644.  doi: 10.3969/j.issn.1003-9198.2021.06.028 Abstract ( 132 )   PDF (1265KB) ( 726 )   Save Objective To investigate the correlation between elevation modes of lower limbs and deep venous thrombosis (DVT) in the elderly patients with hip fracture, and to decrease the risk of lower limb DVT in the patients. Methods The clinical data of 105 elderly patients with hip fracture in the department of orthopedics from June 2018 to June 2019 were retrospectively analyzed. The patients receiving postoperative elevation with fowler position were enrolled in group A (33 cases), the patients receiving triangle decubitus elevation were enrolled in group B (5 cases), and the patients receiving trapezoidal decubitus elevation were enrolled in group C (37 cases). The incidence of lower limb DVT was recorded and compared among the three groups after intervention. Results Seven to ten days after surgery, the color Doppler ultrasound of lower limbs showed that the incidence of lower limb DVT in group B was 34.29% (12/35), compared with 9.09% (3/33) in group A and 8.11% (3/37) in group C, with significant difference (χ2 =10.277, P=0.006). Conclusions The postoperative application of trapezoidal position and fowler position in the elderly patients with hip fracture can promote the venous velocity of lower limbs, thus decreasing the risk of lower limb DVT. The elevation mode of triangle position can not effectively prevent lower limb DVT. Therefore, it is necessary to avoid raising the affected limb with a soft pillow under the knee. References | Related Articles | Metrics

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Efficacy of vaccum sealing drainage combined with wound repair hydrogel in nursing care of traumatic infection in the elderly ZHANG Mei, QIN Su-ping 2021, 35 (6):  645-648.  doi: 10.3969/j.issn.1003-9198.2021.06.029 Abstract ( 126 )   PDF (1197KB) ( 757 )   Save Objective To explore the efficacy of vaccum sealing drainage (VSD) combined with wound repair hydrogel in nursing care of traumatic infection in the elderly. Methods A total of 60 elderly patients with traumatic infection admitted to Nanjing First Hospital from January 2017 to December 2019 were selected and divided into control group (n=30) and observation group (n=30) according to different treatment methods. The control group received conventional treatment measures such as surgical debridement and VSD treatment. The observation group was treated with wound repair hydrogel on the basis of the control group. The levels of inflammatory factors such as interleukin-6 (IL-6), C-reactive protein (CRP) and interleukin-17 (IL-17) as well as the changes in wound area and efficacy were compared between the two groups. Results After 14 days of nursing intervention, the levels of IL-6, CRP and IL-17 in the observation group were significantly lower than those in the control group (t=8.399, 5.060, 12.490, all P < 0.01). After 7 days of nursing intervention, the trauma area of the two groups was significantly different from that on the first day (t=6.669, 7.194, all P<0.01). After 7 days of nursing intervention, the wound area of the two groups showed significant difference (t=1.303, P>0.05). After 14 days and 21 days of nursing intervention, the wound area of the two groups showed significant difference (t=3.265, 5.574, all P<0.01). In addition, the total effective rate of nursing intervention in the observation group was 93.3%, compared with 73.3% in the control group (χ2=4.320, P<0.05). Conclusions VSD combined with wound repair biogel treatment strategy can significantly control the inflammatory factors in the elderly patients with traumatic infection, and can significantly improve the successful rate of controlling traumatic infection in the elderly patients. References | Related Articles | Metrics