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20 July 2021, Volume 35 Issue 7 Previous Issue    Next Issue

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Reliability and validity of the Chinese version of the Rowland Universal Dementia Assessment Scale HUANG Xin-yi, HAN Yue, GENG Gui-ling, GU Ting 2021, 35 (7):  668-672.  doi: 10.3969/j.issn.1003-9198.2021.07.002 Abstract ( 351 )   PDF (1197KB) ( 1457 )   Save Objective To translate the Rowland Universal Dementia Assessment Scale (RUADS) into a Chinese version, and to conduct a reliability and validity test and determine a cut-off value. Methods After being authorized by Dr. Rowland, the Brislin method was used in the translation of RUDAS, back translation, cross-cultural adaptation and pre-test to form a Chinese version. Convenience sampling was used to survey subjects who match the inclusion criteria in three nursing homes in the community. SPSS 23.0 and AMOS 21.0 software were used for statistical analysis of the data. Results The Cronbach's α coefficient of the Chinese version of RUDAS was 0.818, and the test-retest reliability was 0.942, and the inter-rater reliability was 0.977, and the content validity was 0.97, and the criterion-related validity was 0.886. The exploratory factor analysis obtained a single factor analysis model, with a cumulative contribution rate of 60.423%, and the corresponding principal component loadings of 6 items were all> 0.4. Confirmatory factor analysis showed a ratio of chi-square value to degrees of freedom (χ2/df)=1.686, a goodness of fit index (GFI)=0.962, a root mean square of approximate error (RESEA) of 0.074, and a comparative fit index (CFI) of 0.981, and the results suggested that the model fit well. Average Variance Extracted (AVE)=0.621 and composite reliability (CR)=0.88 indicated good aggregation (convergence) validity. According to the Youden Index (YI) maximization principle, 21 was are the best cut-off value for the Chinese version of RUDAS. Conclusions As a multicultural cognitive assessment scale, the Chinese version of RUDAS has concise entries and good reliability and validity. It is suitable for the screening of high-risk populations of dementia with low education or illiteracy in clinical and community. References | Related Articles | Metrics

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Value of early transcranial color-coded duplex sonography and APACHE Ⅱ score in evaluating the cerebral functional resuscitation in elderly patients receiving cardiopulmonary resuscitation GUO Hui, QI Hui-jun, LYU Chang, LI Hong-ling, JIA Yang-juan, LI Jian-guo 2021, 35 (7):  673-675.  doi: 10.3969/j.issn.1003-9198.2021.07.003 Abstract ( 262 )   PDF (1249KB) ( 989 )   Save Objective To explore the clinical application value of early transcranial color-coded duplex sonography (TCCD) and acute physiology and chronic health evaluation (APACHE Ⅱ) score to evaluate the cerebral functional recovery after cardiopulmonary resuscitation. Methods A total of 70 patients with cardiac arrest who were successfully rescued by cardiopulmonary resuscitation from February 2017 to February 2019 in our hospital were enrolled in this study, and their clinical data were analyzed retrospectively. The patients were divided into observation group (30 patients with good prognosis) and control group (40 patients with poor prognosis) according to cerebral performance category (CPC). The cerebral blood flow was measured by TCCD, and APACHE Ⅱ score was calculated 24 hours after operation. The value of TCCD and APACHE Ⅱ score in evaluting the prognosis of cerebral functional recovery after cardiopulmonary resuscitation was analyzed. Results Compared with the control group, the end diastolic velocity (VD), peak systolic velocity (VS) and average peak velocity (VM) of the observation group increased significantly within 24 hours; The pulsation index and APACHE Ⅱ score of the middle cerebral artery in the observation group decreased significantly, with significant difference (P<0.05). The receiver operating characteristic (ROC) curves of cerebral blood flow and APACHE Ⅱ score were drawn to predict the prognosis of cerebral function. The results showed that the area under the cerebral blood flow curve and the best critical value was 0.725, 5.661, with a sensitivity and specificity of 66.0% and 78.5%, and the area under APACHE Ⅱ score curve and the best critical value was 0.846, 19.43, with a sensitivity and specificity of 78.6% and 79.6%, respectively. Conclusions In the early stage of cardiopulmonary resuscitation, the cerebral blood flow will increase and APACHE Ⅱ score will decrease significantly, which are associated with the prognosis of cerebral functional resuscitation. Monitoring the above indicators is conducive to clinical evaluation of patients’ condition. References | Related Articles | Metrics

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Effect of electroacupuncture on intraoperative cerebral oxygen saturation and postoperative delirium in elderly patients with fragile brain function undergoing hip replacement LI Xue-fei, ZHENG Man, ZHAN Wei-fang, WANG Wei, ZOU Rong 2021, 35 (7):  676-679.  doi: 10.3969/j.issn.1003-9198.2021.07.004 Abstract ( 177 )   PDF (1107KB) ( 1092 )   Save Objective To investigate the effect of electroacupuncture on intraoperative cerebral oxygen saturation and postoperative delirium in the elderly patients with fragile brain function undergoing hip replacement. Methods A total of 60 elderly patients with fragile brain function receiving hip repalcement surgery under general anesthesia were randomly divided into electroacupuncture group (EA group) and non-electroacupuncture group (C group),with 30 cases in each group. EA group received electroacupuncture from 30 min before induction of anesthesia to 30 min before the end of surgery, while no intervention was performed on the C group. Regional cerebral oxygen saturation (rSO2) was recorded before anesthesia induction (T0), after tracheal intubation (T1), at the beginning of operation (T2), 30 min and 1 h after beginning(T3, T4), and at the end of operation (T5). The mean rSO2(rSO2mean), minimum rSO2 (rSO2min) and maximum declining percentage compared with baseline values (rSO2%max) was calculated.The extubation time, Ricker sedation-agitation scale (RSAS) score and the residence time of postanesthesia care unit (PACU) were recorded. Postoperative delirium and postoperative recovery quality questionnaire (QoR-15) were evaluated 1 d, 2 d and 3 d after surgery. Results Compared with C group, rSO2 at T1-T5, rSO2mean and rSO2min was significantly increased in EA group (P＜0.05), while rSO2%max was significantly decreased (P < 0.05); The incidence of delirium in EA group was significantly decreased 1 d after surgery (P<0.05); The extubation time as well as the residence time of PACU was significantly shortened (P<0.05), and RSAS score was significantly reduced in EA group (P<0.05); QoR-15 score was significantly increased on 1 d, 2 d and 3 d after surgery in EA group(P<0.05). Conclusions Electroacupuncture can improve intraoperative rSO2 in the elderly patients with fragile brain function undergoing hip replacement, reduce the incidence of postoperative delirium, improve the quality of recovery, and accelerate the quality of postoperative recovery, which may be due to the improvement of cerebral oxygen metabolism. References | Related Articles | Metrics

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Design and application of a comprehensive geriatric assessment software for rapid screening JIANG Hong, LIU Xin-tong, ZHU Yue-ping, YANG Jun 2021, 35 (7):  680-683.  doi: 10.3969/j.issn.1003-9198.2021.07.005 Abstract ( 177 )   PDF (1092KB) ( 1088 )   Save Objective To design a comprehensive geriatric assessment (CGA) software for rapid screening in hospital for the elderly. Methods With the help of computer-based network technology and information technology, the geriatricians, clinical nursing specialists and IT technicians jointly developed a software used for rapid screening of CGA. The mean assessment time, accuracy and satisfaction rate of the patients were compared before and after the application of the software. Results After the application of the software, the mean assessment time decreased from 79.5 (53.0,116.0) min to 35.0 (30.5,56.5) min (P<0.05). The accuracy rate of assessment increased from 92.5% to 98.3% (P < 0.05). The satisfaction rate of the patients for the assessment was significantly higher than that before (P < 0.05). Conclusions The CGA software for rapid screening can promote the normalized,scientized and systematized management, and improve working efficiency, evaluation quality and patients’ satisfaction. References | Related Articles | Metrics

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Characteristics and trends of chronic pain among the Chinese elderly——based on China Health and Retirement Longitudinal Study LUO Er-dan, WANG Yao, BIAN Ying 2021, 35 (7):  684-687.  doi: 10.3969/j.issn.1003-9198.2021.07.006 Abstract ( 369 )   PDF (1199KB) ( 1465 )   Save Objective To investigate the characteristics and trends of chronic pain among Chinese elderly people in recent decades. Methods The nationwide survey data of China Health and Retirement Longitudinal Study (CHARLS) from 2008 to 2015 was applied to analyze the general situation and risk factors of chronic pain, and to describe the treatment and recognition of pain among the elderly patients in recent years. Results A total of 27 859 elderly participants were investigated on pain condition in CHARLS, and 35.71% of them suffered from chronic pain. The factors affecting chronic pain included age, gender, education, living area, disability, some chronic diseases, occupation and economic level. Chronic pain located mostly in waist, accounting for 13.09% of body pain. From 2013 to 2015, the prevalence of taking traditional Chinese medicine, western medicine, acupuncture, and professional massage therapy all increased. Patients’ recognition on pain became diversified. Conclusions There are 35.71% of Chinese elderly people suffering from chronic pain. Female, rural residential, and low-education people have a higher risk of chronic pain. In recent years, more patients received analgesic treatment, indicating gradual awareness of pain among the elderly in China. References | Related Articles | Metrics

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Application of artificial pneumothorax and endobronchial blocker in thoracoscopic McKeown surgery in elderly patients with middle-lower esophageal carcinoma LIU Yan-hu, LI Qing-guo, LI Ya-dong, XUE Dong 2021, 35 (7):  688-691.  doi: 10.3969/j.issn.1003-9198.2021.07.007 Abstract ( 183 )   PDF (1099KB) ( 1128 )   Save Objective To investigate the application of artificial pneumothorax and endobronchial blocker in thoracoscopic McKeown surgery for mid-lower esophageal carcinoma and the effect on perioperative complications. Methods A total of 102 patients with middle-lower section esophageal cancer were randomly divided into the artificial pneumothorax group (AP group, n=50) and the bronchial blockade group (BB group, n=52). Lung collapse scores, chest operation time, chest blood loss, operation time, extubation time, number of thoracic lymph nodes dissected, cases of recurrent laryngeal nerve injury, cases of perioperative arrhythmia, postoperative delirium and incidence of pulmonary complications were recorded and compared between the two groups. Results There were no significant difference between the two groups in the amount of thoracic hemorrhage, the number of dissected lymph node, the operation time, the number of thoracic lymph rodes dissected, and cases of recurrent laryngeal nerve injury (P >0.05). Compared with AP group, BB group had lower lung collapse score (P<0.05), shorter thoracic operation time and extubation time (P<0.05), and lower incidence of perioperative arrhythmias, pulmonary complications and postoperative delirium (P<0.05). Conclusions Compared with artificial pneumothorax, bronchial blockers can provide better exposure to the operative field, reduce the incidence of perioperative arrhythmia and postoperative pulmonary complications, and can be used as the preferred airway management method for thoracoscopic McKeown surgery for the elderly patients with middle-lower esophageal cancer under indications. References | Related Articles | Metrics

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Metabonomics study of blood and urine in patients with Alzheimer's disease CUI Yu, SUN Hong, WANG Xiao-kun, ZHANG Yan 2021, 35 (7):  692-695.  doi: 10.3969/j.issn.1003-9198.2021.07.008 Abstract ( 792 )   PDF (1149KB) ( 1281 )   Save Objective To explore the changes of metabolites in serum and urine in the patients with Alzheimer's disease (AD), so as to provide basis for early diagnosis of AD. Methods The content of 17 kinds of amino acids in blood and urine of the elderly AD patients (AD group) and the healthy elderly (control group) were detected by automatic amino acid analyzer. All urine samples were detected by UPLC-QETOF-MS, and biomarkers were screened by multivariate statistical analysis. Results The levels of the amino acids as Thr, Ser, Val and Lys in urine and the levels of Thr, Cys,Met and Leu in blood were significantly different between AD group and control group (P<0.05). There were 15 metabolites in urine of AD group were detected, which were not detected in control group. Conclusions Compared with the healthy elderly, there are significant differences in the contents of metabolites in serum and urine of the elderly with AD. Some metabolites may be used as potential metabolic markers for clinical diagnosis and treatment of AD. References | Related Articles | Metrics

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Relationship between handgrip strength and all-cause mortality in elderly inpatients with hypertension YANG Hui, WANG Qing, LU Fei, FU Lin-lin, WANG Peng 2021, 35 (7):  696-700.  doi: 10.3969/j.issn.1003-9198.2021.07.009 Abstract ( 219 )   PDF (1229KB) ( 1018 )   Save Objective To investigate the association between handgrip strength and all-cause mortality in the elderly inpatients with hypertension. Methods A prospective cohort study in the elderly inpatients with hypertension aged ≥65 years was conducted. The basic information, biochemical indicators, blood pressure, comorbidities and polypharmacy were recorded at admission. Activities of daily living (ADL), cognitive function and the level of nutrition were assessed by Katz-ADL, Mini-Mental State Examination (MMSE) and Mini Nutritional Assessment Short-From (MNA-SF) respectively. The handgrip strength was measured by dynamometer. After discharge, the mortality was followed up for more than 1 year. Spearman correlation coefficient was used to analyze the correlation between handgrip strength and the variables of different gender inpatients. Kaplan Meier curve and Cox regression analysis were used to analyze the correlation between handgrip strength and mortality. Results A total of 572 patients (84.02 ± 5.98 years, 58.7% men) were enrolled. During a median follow-up of 3.17 years (IQR 2.50-3.75), 111 participants (19.4%) died. Spearman correlation analysis revealed that handgrip strength was negatively correlated with age and Charlson comorbidity index, and positively correlated with hemoglobin levels, Katz-ADL, MMSE, and MNA-SF scores (P<0.05) in different genders. Handgrip strength was divided into quartile groups. The Kaplan Meier curve showed that the mortality increased with the decrease of handgrip strength (log rank: P<0.001). Cox regression analysis with adjustment for potential confounding variables showed that compared to the strongest quartile, the males in the weakest group had higher mortality(HR=2.484,95% CI:1.200-5.140,P=0.014), but this association was not found in female. Conclusions In the elderly male inpatients with hypertension, low handgrip strength is associated with the risk of all-cause mortality. Handgrip strength could be a simple and effective prognostic indicator for health outcomes. References | Related Articles | Metrics

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Correlation of the levels of serum copeptin and the inflammatory factors with the ventricular remodeling in elderly patients with chronic heart failure CAI Jie, WEI Wei, ZHANG Yu-qing 2021, 35 (7):  701-704.  doi: 10.3969/j.issn.1003-9198.2021.07.010 Abstract ( 259 )   PDF (1099KB) ( 1006 )   Save Objective To investigate the correlation of the levels of serum copeptin (CPP) and the inflammatory factors with the ventricular remodeling in the elderly patients with chronic heart failure (CHF). Methods A total of 83 elderly patients with CHF admitted to our hospital from July 2018 to July 2019 were selected (CHF group), and 46 healthy elderly who underwent physical examination in our hospital during the same period were selected as the control group.The serum level of the CPP, the levels of inflammatory cytokines such as high-senstitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and the indicators related to ventricular remodeling, including left ventricular ejection fraction (LVEF), left artrial diameter (LAD), left ventricular end-diastolic inner diameter (LVEDD) were detected and compared between the two groups. The correlation between serum levels of CPP, inflammatory factors and the ventricular remodeling related indicators was analyzed by Pearson product moment correlation analysis. Results Serum levels of CPP, hs-CRP, TNF-α and IL-6, and the levels of LAD and LVEDD in CHF group were significantly higher than those in the control group (P＜0.01), while the level of LVEF in CHF group was lower than that in the control group (P＜0.01). Pearson correlation analysis showed that the serum levels of CPP,hs-CRP, TNF-α and IL-6 in CHF group were positively correlated with the level of LAD(r=0.683, 0.666, 0.614, 0.595, P=0.028, 0.027, 0.024, 0.019), which were also positively correlated with the level of LVEDD (r=0.537, 0.603, 0.612, 0.597, P=0.016, 0.020, 0.022, 0.018), and were negatively correlated with the level of LVEF (r=-0.611, -0.533, -0.604, -0.607, P=0.020, 0.016, 0.019, 0.021). Conclusions Serum levels of CPP and the inflammatory factors are abnormally increased in the elderly patients with CHF, and closely related to ventricular remodeling. Detection of serum levels of CPP and the inflammatory factors shows an important auxiliary role in the clinical diagnosis of CHF. References | Related Articles | Metrics

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Clinical efficacy of parathyroid hormone in the treatment of elderly patients with osteoporotic intertrochanteric fracture SONG Yao-dong 2021, 35 (7):  705-708.  doi: 10.3969/j.issn.1003-9198.2021.07.011 Abstract ( 206 )   PDF (1100KB) ( 947 )   Save Objective To investigate the clinical efficacy of parathyroid hormone assisted in the elderly patients with osteoporotic fracture in the course of healing. Methods A total of 60 patients with osteoporotic fracture admitted to our hospital from January 2019 to December 2019 were prospectively selected and randomly divided into two groups, with 30 cases in each group. The control group was treated with conservative osteoporosis therapy, and the experimental group were treated with intermittent adjuvant subcutaneous injection of parathyroid hormone 20 μg /d on the basis of the treatment of the control group. The recovery of fracture, bone metabolism index and pain degree and joint function were observed and compared. Results After the operation, the pain of joint was significantly alleviated, the excellent rate of hip Harris score was increased, the fracture healing time was shorter, the levels of bone mineral density (BMD) and bone gla protein (BGP) were increased,while the levels of alkaline phosphatase and β-CrOSSlaps(β-CTX) were decreased significantly in two groups(P<0.05),especially in the experimental group(P<0.05). Conclusions Parathyroid hormone has a significant effect on postoperative healing of osteoporotic fracture, which can reduce postoperative pain and promote fracture healing and joint function recovery. References | Related Articles | Metrics

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Overall functional level and its influencing factors in 321 elderly patients with maintenance hemodialysis CHENG Dan, YAO Qiong, ZHANG Bing, ZHAO Ya-jing 2021, 35 (7):  709-712.  doi: 10.3969/j.issn.1003-9198.2021.07.012 Abstract ( 765 )   PDF (1093KB) ( 1149 )   Save Objective To investigate the status and influencing factors of overall function in the elderly patients with maintenance hemodialysis (MHD), and to improve the overall functional level of patients with MHD. Methods A total of 321 elderly patients with MHD from three tertiary hospitals in Beijing were investigated with general information questionnaire, World Health Organization Disability Assessment Schedule 2.0 (WHO DAS 2.0), Dialysis Symptom Index (DSI), Medical Coping Modes Questionnaire (MCMQ) and social support rating scale. The influencing factors for overall function in the elderly patients with MHD were analyzed by multiple linear regression analysis. Results The WHO DAS 2.0 score for the MHD patients was 66.42±21.37. Multiple linear regression analysis showed that dialysis symptoms, dialysis age, marital status, and acceptance-resignation were independent factors for the overall functional level of the MHD patients. Conclusions The overall functional level of MHD patients is disorder mildly. Clinical medical staff should actively control the patient's dialysis symptoms, and attach importance to communication with the patient's spouse, encourage the patient to actively participate in social activities and face life optimistically. References | Related Articles | Metrics

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Long-term clinical efficacy of transjugular intrahepatic portosystemic shunt in elderly patients with cirrhosis and portal hypertension HUANG Shan, YAO Xin, ZHOU Hao, CHEN Xue-ling, TANG Shan-hong, QIN Jian-ping 2021, 35 (7):  713-717.  doi: 10.3969/j.issn.1003-9198.2021.07.013 Abstract ( 257 )   PDF (1125KB) ( 1057 )   Save Objective To evaluate the safety and long-term efficacy of transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of cirrhosis and portal hypertension in the eldely patients . Methods The clinical data of 88 elderly patients with cirrhosis and portal hypertension who received TIPS in our hospital because of bleeding or ascites from January 2014 to January 2017 were selected and analyzed retrospectively. The changes of the levels of biochemical indexes before and after TIPS were observed. The remission of ascites, recurrent bleeding, stent dysfunction, hepatic encephalopathy and survival were followed up. Kaplan-Meier method was used to analyze the postoperative rate.Cox regression was used to analyze the influencing factors of the postoperative mortality. Results The technical success rate of TIPS was 100%. The level of portal vein pressure decreased significantly after the operation (32.83±6.82 cmH2O vs 18.77±5.89 cmH2O, P<0.01). The level of total bilirubin and Child-Pugh score were increased in a short term, and then returned to baseline at 1 year after operation. The Cumulative rebleeding rate was 6.2%,8.2%,11.2% in 1, 2, 3 years after TIPS respectively. The ascites remission rate after 6 months was 81.5%,and the cumulative incidence of hepatic encephalopathy was 17.2%,19.8%,22.6%,27.4%,31.3% in 3, 6, 12, 24, 36 months after TIPS respectively. 1, 2, 3 years after the operation,the patency rate of stent was 93.3%, 86.3%, 79.1%, and the cumulative survival rate was 82.2%,75.5%,68.3% respectively. Cox multivariate regression showed that model for end-stage liver disease (MELD) score (HR=1.24, 95% CI: 1.07-1.44, P=0.004), Child Pugh classification (HR=2.63,95%CI:1.06-6.53,P=0.037)and combined basic diseases (HR=5.96,95%CI:2.16-16.44,P=0.001) were independent risk factors for death. Conclusions TIPS is a safe and effective method in the treatment of the elderly patients with cirrhosis and portal hypertension.MELD score, Child Pugh classification and the combination of basic diseases are the independent factors that affect the postoperative death of the patients. References | Related Articles | Metrics

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Association between hand grip strength and health-related quality of life in elderly patients with cancer BAO Bei, SHI Xiao-xin, ZHU Li-ren, WANG Yan 2021, 35 (7):  718-721.  doi: 10.3969/j.issn.1003-9198.2021.07.014 Abstract ( 327 )   PDF (1362KB) ( 1069 )   Save Objective To assess the association between hand gripstrength (HGS) and health-related quality of life (HRQoL) among elderly patients with cancer in Shanghai. Methods A cross-sectional survey was conducted among 1115 elderly cancer survivors from our hospital, Shanghai Changning and Hongkou communities from March 2019 to March 2020. HGS was detected and the HRQoL was evaluated by EuroQol-5 dimension (EQ-5D) in all patients. The relationship between HGS and HRQoL was analyzed. Results Of 1115 questionnaires, 983 were valid. Among 983 cancer survivors, 197 cases showed weak HGS according to gender-specific cut-off values (lowest quintile<29.7 kg in men and <19.7 kg in women). Individuals with weak HGS showed significantly increased impairment in all five dimensions of the EQ-5D compared with the patients with normal HGS(P＜0.05). The Logistic multiple factors regression analysis showed that the impaired risk were all decreaed in four dimensions (mobility, self-care, usual activity and pain/discomfort) with the increase of HGS (P<0.05). Conclusions The increase of HGS may indicate better HRQoL in the elderly cancer patients. References | Related Articles | Metrics

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Study on follow-up via WeChat to promote compliance of elderly patients with early gastric cancer and precancerous lesions after endoscopic submucosal dissection XU Zhen-zhen, JIANG Jing-wei, XU Gui-fang, LI Wen, YANG Hua, TENG Yu-fang, YANG Jin-ping 2021, 35 (7):  722-726.  doi: 10.3969/j.issn.1003-9198.2021.07.015 Abstract ( 200 )   PDF (1117KB) ( 998 )   Save Objective To investigate the effect of follow-up via WeChat on the compliance of the elderly patients with early gastric cancer or precancerous lesions after endoscopic submucosal dissection (ESD). Methods A total of 307 elderly patients with early gastric cancer or precancerous lesions who underwent ESD from January to September 2019 in our hospital were enrolled. The patients before June 1, 2019 were assigned into the control group(n=166) receiving routine outpatient service and telephone follow-up, the patients after June 1,2019 were assigned into observation group(n=141) receiving WeChat follow-up.Postoperative consultation, compliance of regular endoscopic reexamination and Hp eradication were analyzed between the two groups. The follow-up satisfaction of WeChat platform in the observation group and medical staff was recorded. Results The pathological results (25.1%), registration for reexamination (24.1%), diet (16.9%), medication (15.0%), and discomfort response (14.0%) were the most common questions consulted by the patients with early gastric cancer or precancerous lesions after ESD . In addition,the questions of consultation were changed with the time after surgery. The compliance of endoscopic reexamination 3, 6 months after surgery and Hp eradication in the observation group were significantly higher than those in the control group(71.6% vs 57.8%,38.3% vs 27.7%,70.3% vs 46.9%,respectively,all P<0.05). Univariate analysis showed that follow-up of WeChat platform and living in urban areas could improve the patients' compliance with regular endoscopic reexamination (P<0.01). The patients with WeChat platform follow-up and family history of tumor showed better compliance with Hp eradication (P<0.05). All medical staffs and 87.9% of the patients were satisfied with the follow-up by WeChat platform. Conclusions The follow-up via WeChat can promote the compliance of the elderly patients with early gastric cancer or precancerous lesions after ESD with high satisfaction of the patients and the medical staffs. References | Related Articles | Metrics

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Cognitive frailty and its influencing factors in hospitalized elderly patients with hypertension YAN Jing, CHEN Xin-tao, MO Dong-ni, WU Zhu-jie, MA Li, HUANG Li-ting, LIU Ying 2021, 35 (7):  727-730.  doi: 10.3969/j.issn.1003-9198.2021.07.016 Abstract ( 462 )   PDF (1106KB) ( 1715 )   Save Objective To investigate the prevalence of cognitive frailty and its influencing factors and to provide evidence for early evaluation and intervention of cognitive frailty in the elderly patients with hypertension. Methods The clinical data of 106 elderly patients with hypertension hospitalized in our hospital from January to October 2019 were enrolled. Fried standard was used to evaluate the state of frailty, and Mini-Mental State Examination scale (MMSE) was used to evaluate the cognitive status of patients. The patients with frailty and cognitive impairment were defined as cognitive frailty. A total of 106 hospitalized elderly patients with hypertension were divided into cognitive frailty group (n=26) and non-cognitive frailty group (n=80).The general demographic data, geriatric syndrome and chronic disease history of the two groups were observed and analyzed. Multivariate Logistic regression was used to analyze the independent related factors of cognitive frailty. Results The incidence of hypertension complicated with cognitive frailty in the elderly was 24.5%. The age in the cognitive frailty group was older and the third grade of hypertension was more common than that in the non-cognitive frailty group (P<0.01). The ratio of malnutrition or the risk of malnutrition, falls, chronic pain, multiple drugs, coronary heart disease, type 2 diabetes and chronic kidney disease in the cognitive frailty group were significantly higher than those in the non-cognitive frailty group (P<0.05). Multivariate Logistic regression analysis showed that the age(OR=7.828,95%CI:1.558-39.321), malnutrition or the risk of malnutrition (OR=20.364,95%CI:3.724-111.346)and chronic kidney disease (OR=5.699,95%CI:1.172-27.716)were the independent risk factors of cognitive frailty in the elderly patients with hypertension (all P<0.05). Conclusions The incidence of cognitive frailty in the elderly patients with hypertension is higher. Age, malnutrition or the risk of malnutrition and chronic kidney disease are the independent related factors of cognitive frailty in the elderly patients with hypertension. References | Related Articles | Metrics

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Analysis of risk factors for re-fracture after osteoporotic fracture in elderly women JI Hong, ZHANG Yu-qin, ZHANG Chun-yan, YANG Zhi-mei, LI Ying 2021, 35 (7):  731-733.  doi: 10.3969/j.issn.1003-9198.2021.07.017 Abstract ( 237 )   PDF (1087KB) ( 966 )   Save Objective To investigate the risk factors for re-fracture after osteoporotic fracture in the elderly women. Methods A retrospective analysis of 85 elderly women with osteoporotic fractures admitted to our hospital from September 2018 to January 2020 were divided into re-fracture group(n=45) and new fracture group (n=40). The basic data and clinical data of the two groups were compared, and the risk factors of re-fracture after osteoporotic fracture were analyzed by multivariate Logistic regression analysis. Results There were significant difference in the age, body mass index (BMI), bone mineral density(BMD), transition time from supine to standing position and total alkaline phosphatase(TALP) between the two groups (P<0.05). Multivariate Logistic regression analysis showed that the risk factors for re-fracture after osteoporotic fracture in the elderly women were age ≥75 years (OR=1.612, 95%CI: 1.129-8.994), BMI ≤21.00 (OR=1.725, 95%CI: 1.160-5.338), T value of BMD＜-3.50 (OR=2.125, 95%CI: 1.815-4.888), the transition time from supine to standing position≥20 s (OR=1.688, 95%CI: 1.009-3.228) and TALP≥110.00 μg/L (OR=1.123, 95%CI: 1.015-2.177). Conclusions Older, less BMI and BMD, longer transition time from supine to standing position, and increased TALP level are the independent risk factors of re-fractures after osteoporotic fractures in the elderly women. References | Related Articles | Metrics

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Application of prehabilitation during the perioperative period of total knee arthroplasty in the elderly patients with severe flexion deformity LI Jing-jing 2021, 35 (7):  762-765.  doi: 10.3969/j.issn.1003-9198.2021.07.027 Abstract ( 202 )   PDF (1102KB) ( 1164 )   Save Objective To explore the effect of prehabilitation during the perioperative period of total knee arthroplasty (TKA) in the elderly patients with severe flexion deformity. Methods A total of 30 elderly patients with severe flexion deformity undergoing TKA in our hospital from January 2019 to December 2019 were selected and divided into study group (15 cases) and control group (15 cases) according to the random number table method. The control group received conventional perioperative nursing support, and the study group received prehabilitation nursing support. All patients received the assessment of the self-rating anxiety score (SAS), visual Analogue scale (VAS) and mini nutritional assessment (MNA-sf), knee range of motion (ROM), hand muscle test (MMT), Muller knee stability score, daily activity difficulty (WOMAC) and quality of life scale (SF-36) at admission, before operation, 7 d, 3 months, and 6 months after surgery. Results There were no significant differences in the scores of SAS, VAS, MNA-sf, MMT, Muller knee joint stability, WOMAC, SF-36 and ROM at admission between the two groups (P>0.05). Before and 7 days after operation, the scores of VAS and SAS in the study group were significantly lower than those in the control group, while the score of MNA-sf was significantly higher than that in the control group (P<0.05). Before operation, 7 days, 3 and 6 months after operation, the scores of ROM, MMT, Muller knee stability and SF-36 in the study group were significantly higher than those in the control group, while the score of WOMAC was significantly lower (P<0.05). Conclusions Prehabilitation nursing support for elderly patients with severe flexion deformity during TKA perioperative period can improve their preoperative nutritional level and functional reserve, which is beneficial to the rapid rehabilitation of postoperative knee joint function and the improvement of long-term prognosis. References | Related Articles | Metrics

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Application of cluster nursing intervention in the upper airway management in the elderly patients with non-artificial airway in Department of Neurosurgery GUO An-na, REN Xing-zhen 2021, 35 (7):  766-768.  doi: 10.3969/j.issn.1003-9198.2021.07.028 Abstract ( 259 )   PDF (1129KB) ( 1291 )   Save Objective To explore the effect of cluster nursing intervention in the management of upper respiratory tract in the elderly patients with non-artificial airway in Department of Neurosurgery. Methods A total of 110 elderly patients in Department of Neurosurgery with non-artificial airway were selected and divided into the control group and the intervention group by the order of admission, with 55 cases in each group. The control group received routine non-artificial airway nurse,and the intervention group was treated by the cluster management of non-artificial airway nursing mode. The incidence of pulmonary infection and tracheal intubation,the time of Glasgow score increase in the patients with acute disturbance of consciousness,the hospitalization time of the two groups were observed and analyzed. Results After the intervention,the incidence rate of pulmonary infection and tracheal intubation in the intervention group were significantly decreased than those in the control group(P＜0.05). The hospitalization time and the time of Glasgow score increase in the patients with acute disturbance of consciousness in the intervention group were significantly lower than those in the control group(P＜0.05). Conclusions Appling the cluster nursing can not only effectively reduce respiratory tract complications,but also avoid further increase of intracranial pressure and shorten hospitalization time in the elderly with non-artificial airway. References | Related Articles | Metrics

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Study on the influencing factors of fatigue after endovascular treatment in elderly patients with acute ischemic stroke ZHANG Yuan, ZHAN Hui, XU Yi-ming, ZHOU Jun-shan 2021, 35 (7):  769-772.  doi: 10.3969/j.issn.1003-9198.2021.07.029 Abstract ( 200 )   PDF (1096KB) ( 1140 )   Save Objective To investigate the influencing factors of fatigue after endovascular treatment in the elderly patients with acute ischemic stroke. Methods The elderly patients (aged ≥65 years old) with acute ischemic stroke, who underwent endovascular treatment in Nanjing First Hospital, were enrolled in this study from January 2016 to February 2019. The patients were divided into fatigue group and non-fatigue group according to the score of Fatigue Severity Scale. Multivariable Logistic regression analysis was used to determine the influencing factors of fatigue after endovascular treatment in the elderly patients with acute ischemic stroke. Results A total of 371 patients were enrolled, and 169 (45.6%) patients were diagnosed as fatigue. Compared with non-fatigue group, fatigue group showed older age (P=0.001), less male (P=0.011), higher proportion of infarct site in the left cerebral hemisphere (P=0.001) and lower education level (P=0.001). Multivariate Logistic regression analysis indicated that older age, infarct site in the left cerebral hemisphere were risk factors of fatigue, and higher education level was protective factor of fatigue after endovascular treatment. Conclusions Older age and infarct site and low education level may induce the presence of fatigue after endovascular treatment in the elderly patients with acute ischemic stroke. References | Related Articles | Metrics

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Effects on muscle function and fall efficacy in the elderly sarcopenia patients with high risk of falling by sitting exercise therapy ZHU Qian-qian, MEI Ke-wen, CHEN shu 2021, 35 (7):  773-775.  doi: 10.3969/j.issn.1003-9198.2021.07.030 Abstract ( 169 )   PDF (1079KB) ( 1121 )   Save Objective To investigate the effects on muscle function and fall efficacy in the elderly sarcopenia patients with the high risk of falling by sitting exercise therapy. Methods From August 2017 to January 2020, 45 elderly patients with sarcopenia were intervened with resistance and aerobic exercise for 4 months. The score of Short Physical Performance Battery(SPPB), grip strength, muscle mass, fall efficacy and fall risk were evaluated and compared before and after the intervention. Results Compared with before intervention, there were no significant difference in grip strength and left arm muscle mass (P>0.05); The scores of SPPB, right arm muscle mass, both leg muscle mass, fall efficacy and fall risk were significantly improved (P<0.05). Conclusions Sitting exercise intervention prescription can significantly reduce the risk of falls and improve some muscle function of the elderly sarcopenia patients with high fall risk. References | Related Articles | Metrics

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Clinical efficacy of photon therapy combined with functional exercise in elderly patients with end-stage renal disease CHEN Ying, ZHAO Mei 2021, 35 (7):  776-779.  doi: 10.3969/j.issn.1003-9198.2021.07.031 Abstract ( 360 )   PDF (1099KB) ( 921 )   Save Objective To explore the effect of photon therapy combined with functional exercise in the elderly patients with end-stage renal disease(ESRD). Methods A total of 60 elderly patients with ESRD who underwent autologous arteriovenous fistula plasty in our hospital from January 2018 to May 2019 were enrolled and divided into control group (n=30) and research group (n=30) randomly. The control group was given functional exercise, and the study group was given photon therapy on the basis of the control group. The success rate of puncture, maturity rate of internal fistula, internal diameter of cephalic vein, blood flow of arteriovenous fistula, pump-controlled blood flow during hemodialysis, quality of life and nursing satisfaction were observed and compared. Results The success rate of puncture, the maturation rate of fistula 1 month and 2 months after operation, the internal diameter of cephalic vein, the blood flow of arteriovenous fistula and pump-controlled blood flow during hemodialysis and the nursing satisfaction score in the study group were significantly higher than those in the control group (P<0.05). Compared with the control group, the scores of symptoms, burden of nephropathy, nephropathy and pain in the study group were significantly lower 3 months after operation(P<0.05), while the scores of physical function, social function, energy, physical strength and emotional status were significantly higher(P<0.05). Conclusions Photon therapy combined with functional exercise is helpful to improve the vascular diameter and blood flow in the elderly patients with ESRD undergoing hemodialysis through autologous arteriovenous fistula, and to promote the maturity of arteriovenous fistula, and to improve the quality of life and nursing satisfaction. References | Related Articles | Metrics

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Effect of self-made fecal collection device on the intake status of enteral nutrition and incontinence dermatitis in elderly patients with severe incotinence WANG Shi-fang, FENG Ping, LI Chun 2021, 35 (7):  780-783.  doi: 10.3969/j.issn.1003-9198.2021.07.032 Abstract ( 193 )   PDF (1094KB) ( 930 )   Save Objective To investigate the effect of one-piece anal ostomy bag combined with negative pressure suction device on the intake status of enteral nutrition(EN) and incontinence dermatitis(IAD) in the elderly patients with severe incentinence. Methods A total of 76 cases of elderly patients with severe fecal incontinence admitted in our department from 2018 to 2019 were selected, and were divided into research group and control group with 38 cases in each group. The EN programme was conducted in all patients according to the doctor's advice.One-piece anal ostomy bag combined with negative pressure suction device was used for fecal collection in the research group; The control group received local skin cleaning and protection standard cleaning, 3M ostomy powder and skin protective film. Results The incidence rate of IAD was significantly higher and the rate of nutritional compliance, the level of PAB after nutrition intake were lower in the recearch group than those in the control group (P < 0.05).The nursing workload and nurse acceptance were all significantly improved in the research group than those in the control group(P<0.05). Conclusions One-piece anal ostomy bag with negative pressure suction device can improve the nutritional status of patients with severe fecal incontinence, reduce the incidence rate of IAD, and improve the quality of care. References | Related Articles | Metrics