Table of Content

20 April 2022, Volume 36 Issue 4 Previous Issue    Next Issue

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Study on the status and influencing factors of medication adherence to phosphorus binding agent in elderly patients undergoing maintenance hemodialysis in close-type medical association XIE Qing-lei, ZHANG Liu-ping, WANG Yue, LI Meng-ting, WANG bin 2022, 36 (4):  328-332.  doi: 10.3969/j.issn.1003-9198.2022.04.002 Abstract ( 141 )   PDF (1119KB) ( 1127 )   Save Objective To investigate the characteristics and influencing factors of the medication adherence to phosphorus binding agent in the elderly patients undergoing maintenance hemodialysis(MHD) in the close-type medical association. Methods The elderly patients who were treated in three dialysis centers of close-type medical association in our hospital from June to December 2020 were enrolled. The patients were investigated by general information questionnaire, simplified medication compliance questionnaire and laboratory indicators, and the relevant influencing factors of medication adherence were analyzed. Results A total of 327 patients were surveyed and 312 patients completed, the effective recovery was 95.4%. Out of the patients, 252 cases(70.8%) had good adherence to phosphorus binding agent, and 60 patients(19.2%) had poor compliance. The blood phosphorus control rate in the good compliance group was significantly higher than that in the poor compliance group. Logistic regression analysis showed that dialysis age and primary diseases were the influencing factors of medication compliance(P<0.05). The medication compliance in the center was significantly higher than that in the two subcenters(P<0.05), but there was no significant difference between the two subcenters(P>0.05). Conclusions The adherence to phosphorus binding agent in the elderly MHD patients needs to be further improved. The dialysis age and the primary diseases in the elderly patients are the independent risk factors affecting the adherence to phosphorus binding agent. References | Related Articles | Metrics

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Analysis of current status and influencing factors of constipation in elderly patients undergoing dialysis DING Zhi-qiang, LI Meng-ting, ZHANG Liu-ping, WANG Yue 2022, 36 (4):  333-336.  doi: 10.3969/j.issn.1003-9198.2022.04.003 Abstract ( 153 )   PDF (1109KB) ( 882 )   Save Objective To investigate the incidinence of constipation in the elderly patients undergoing hemodialysis(HD) or peritoneal dialysis(PD), and to explore its influencing factors. Methods From January to June 2021, 300 elderly patients who received HD or PD treatment in the Blood Purification Center of Zhongda Hospital of Southeast University were selected for questionnaire survey. The general information, Constipation Assessment Scale(CAS) scores, Patient-Assessment of Constipation Quality of Life(PAC-QOL)and the levels of laboratory indicators of the patients were collected. According to CAS score, the patients were divided into constipation group and non-constipation group, and binary Logistic regression was performed to analyze the risk factors of constipation. Results A total of 300 questionnaires were distributed, and 291 (97.0%)were effectively recovered. The incidence rate of constipation was 66.92% in HD patients, and 89.29% in PD patients. There were statistically significant differences in the total quality of life scores and the scores of physical discomfort, psychosocial discomfort, anxiety and satisfaction between the constipation group and the non-constipation group(P<0.05). There were significant differences in age and dialysis age between the constipation group and the non-constipation group in HD patients (P<0.05); And the age and blood phosphorus of PD patients showed significant difference between the constipation group and the non-constipation group(P<0.05). Logistic regression analysis showed that dialysis method(OR=2.28, 95%CI: 1.49-3.50, P<0.001), age(OR=1.71, 95%CI:1.21-2.43, P=0.003), dialysis age(OR=0.38, 95%CI: 0.15-0.98, P=0.046), diabetes(OR=3.23, 95%CI:1.88-5.57, P<0.001) were independent risk factors for constipation. Conclusions Dialysis method, age, dialysis age, and diabetes show effects on the incidence of constipation in the elderly patients. References | Related Articles | Metrics

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Analysis of prospective memory rehabilitation nursing intervention in elderly patients undergoing dialysis LU Wen, LI Meng-ting, ZHANG Liu-ping, WANG Yue, XIE Qing-lei, WANG Bin, WANG Li-juan 2022, 36 (4):  337-340.  doi: 10.3969/j.issn.1003-9198.2022.04.004 Abstract ( 146 )   PDF (1123KB) ( 876 )   Save Objective To analyze the prospective memory(PM)function and the effect of rehabiliation nursing intervention on PM in the elderly patients undergoing dialysis. Methods A total of 100 elderly patients undergoing hemodialysis in our hospital from 2018 to 2020 were selected and divided into the control group and the experimental group by random number table method, with 50 cases in each group. The control group was treated with routine nursing care, and the experimental group was treated with PM rehabilitation training on the basis of routine nursing care. The score of Chinese version of the Cambridge Prospective Memory Test Scale(C-CAMPROMPT), the levels of laboratory indicators and the score of quality of life were compared between the two groups before and after intervention. Results Before the intervention, there were no significant differences in the scores of C-CAMPROMPT dimensions, the levels of laboratory indicators and quality of life score between the two groups(P>0.05). After the intervention, the scores of C-CAMPROMPT dimensions of the two groups were all increased, and the scores of C-CAMPROMPT dimensions and quality of life in the experimental group were significantly higher than those in the control group.The levels of hemoglobin, albumin were significantly increased, and the levels of serum calcium and phosphate were significantly decreased in the two group after the intervention, especially in the experimental group(P<0.05). Conclusions Routine nursing supplemented with PM rehabilitation training intervention can improve the PM function of elderly patients, and improve the cognitive function and executive ability. References | Related Articles | Metrics

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Application of Internet + Wechat group health education in anemia management of elderly patients receiving dialysis PAN Meng-jiao, LI Meng-ting, ZHANG Liu-ping, WANG Yue 2022, 36 (4):  341-344.  doi: 10.3969/j.issn.1003-9198.2022.04.005 Abstract ( 148 )   PDF (1142KB) ( 927 )   Save Objective To explore the effect of applying Internet+ WeChat group health education in the management of anemia in the elderly patients undergoing dialysis. Methods A total of 84 elderly patients who received dialysis treatment in our hospital from January 2019 to January 2021 were included as the research objects. All the patients were given health education by Internet+ WeChat group, and the score of self-management behaviors, the levels of anemia related indicators and satisfaction before and after intervention were analyzed. Results The self-management behavior-related scores of the patients after the intervention were higher than those before the intervention(P<0.05). The levels of transferrin saturation(TS), hemoglobin(Hb), serum ferritin(SF), hematocrit(Hct) and the satisfaction of the patients after the intervention were all significantly higher than those before the intervention(P<0.05). Conclusions The Internet + WeChat group health education can improve patients' self-management behavior, thereby effectively improving patients' anemia and increasing patients' satisfaction. References | Related Articles | Metrics

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Epidemiology and influencing factors of renal anemia in elderly patients undergoing maintenance hemodialysis LIU Hai-fei, ZHAO Xiao-qian, LI Zhao-ting, WANG Gao-yuan, CAO Yun, FANG Hui-wen, ZOU Chun-bo, CAO Jing-yuan 2022, 36 (4):  345-349.  doi: 10.3969/j.issn.1003-9198.2022.04.006 Abstract ( 153 )   PDF (1184KB) ( 962 )   Save Objective To evaluate the epidemiology and the influencing factors of renal anemia in the elderly patients undergoing maintenance hemodialysis (MHD). Methods Cross-sectional study was carried out among the patients undergoing MHD treatment in the hemodialysis center of Taizhou People's Hospital in January 2022. According to inclusion and exclusion criteria, the general information and laboratory examination information of the patients were included. All the patients were divided into aged group (n=124) and young and middle-aged group (n=236). The patients in the aged group were divided into anemic subgroup and non-anemic subgroup. Logistic regression was performed to analyze the risk factors of renal anemia. Results The standardization rate of renal anemia control in our hemodialysis center was 53.1%. The standardization rate in aged group was 44.4%, which was significantly lower than that of young and middle-aged group (57.6%) (P=0.02). The levels of hemoglobin (Hb) was positively correlated with hematocrit (HCT), serum albumin (ALB), total cholesterol (TC), triglyceride (TG), magnesium, calcium, transferrin saturation, serum iron, and was negatively correlated with red cell distribution width (RDW-CV) and C-reactive protein (CRP) in the elderly MHD patients. Logistic regression analysis revealed that low level of TG and serum iron were independent risk factors of renal anemia. Conclusions The incidence rate of renal anemia in the elderly MHD patients is much higher than that in the young and middle-aged group. The low level of TG and serum iron is associated with the incidence of renal anemia in the elderly MHD patients. References | Related Articles | Metrics

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Correlation between monocyte-to-HDL-cholesterol ratio and aortic arch calcification in elderly hemodialysis patients ZOU Chun-bo, YU Ping, LIU Hai-fei, SU Ting-ting, CHEN Xiao-qin 2022, 36 (4):  350-353.  doi: 10.3969/j.issn.1003-9198.2022.04.007 Abstract ( 120 )   PDF (1136KB) ( 1064 )   Save Objective To explore the relationship between monocyte to high density lipoprotein-cholesterol ratio (MHR) and aortic arch calcification in the elderly patients undergoing maintenance hemodialysis(MHD). Methods A total of sixty-one elderly MHD patients who met the inclusion criteria were selected, and the clinical data of the patients were collected. According to the chest X-ray calcification rating of aortic arch calcification degree, the patients were divided into mild calcification group, moderate calcification group and severe calcification group. Spearman correlation analysis was used to analyze the relationship between the aortic arch calcification and the related indexes. Multiple Logistic regression analysis was used to analyze the risk factors of the aortic arch calcification. Results Compared with mild calcification group, the levels of MHR, neutrophil count / lymphocyte count (NLR), platelet to lymphocyte ratio (PLR),alkaline phosphatase (ALP) and corrective calcium were significantly increased, while the level of albumin was significantly decreased in moderate and severe calcification groups(P<0.05). Aortic arch calcification was positively correlated with MHR, NLR, PLR,corrected calcium and ALP(r=0.611,0.376,0.339,0.322,0.519, respectively, all P<0.05), and negatively correlated with albumin(r=-0.309,P<0.05). Multivariate regression analysis showed that MHR(OR=6.612,95%CI: 2.697-10.528,P=0.001)was an independent risk factor for aortic arch calcification in the elderly MHD patients. ROC curve showed that MHR had value in predicting moderate and severe aortic arch calcification, with a sensitivity of 87% and the optimal cut-off value of 0.407. Conclusions MHR has clinical predictive value for aortic arch calcification in the elderly MHD patients. References | Related Articles | Metrics

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Analysis of skeletal muscle microRNA-mRNA regulatory network during aging DOU Yuan-yuan, HOU Jing-wen, WANG Mei 2022, 36 (4):  354-359.  doi: 10.3969/j.issn.1003-9198.2022.04.008 Abstract ( 137 )   PDF (2003KB) ( 1137 )   Save Objective To explore the changes of miRNA and mRNA during muscle aging through integrating high-throughput microRNA(miRNA)/mRNA expression data. Methods Two different age(6 and 24 months) mice gastrocnemius miRNA databases were used, and the combined analysis of “differential miRNA targeted regulatory genes” and differential mRNA was carried out. The core regulatory network in the skeletal muscle aging process was constructed. GSEA software was used to analyze the gene ontology(GO) function and Kyoto encyclopedia of genes and genomes(KEGG )signaling pathway involved in the differential gene. Representative differential miRNA and targeted mRNA expression were detected by real-time fluorescent quantitative PCR (qRT-PCR)and Western blot. Results A total of 877 and 84 differentially expressed genes and miRNAs were identified in the skeletal muscle of young and old mice, respectively. The construction of a miRNA-mRNA network resulted in 21 miRNAs, and among them, there were 9 miRNAs with more than 7 target genes, and the qRT-PCR verification is consistent with the sequencing results. Pathway analysis showed that the differential genes were mainly related to transcription, metabolism and skeletal muscle differentiation. The skeletal muscle differentiation process contained early growth response protein 2(EGR2), Ring1, transcription factor Yin-Yang1(YY1)and Ring1 andYY1-binding protein(Rybp). qRT-PCR verified that the mRNA levels of 4 genes increased during skeletal muscle differentiation. Rybp also increased in protein levels. Conclusions miRNA may promote muscle aging through interventing the processes such as transcription, metabolism and skeletal muscle differentiation. Rybp and its presumed regulatory miRNA miR-136 may promote the aging process of muscles. References | Related Articles | Metrics

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Effect of chest pain center on diagnosis and treatment process and short-term prognosis in elderly patients with acute non-ST-segment elevation myocardial infarction LIU Jun-rong, SHI Jun-song, LI Lin 2022, 36 (4):  360-363.  doi: 10.3969/j.issn.1003-9198.2022.04.009 Abstract ( 161 )   PDF (1010KB) ( 929 )   Save Objective To evaluate the effect of the establishment of the chest pain center(CPC) on the diagnosis and treatment process and short-term prognosis in the elderly patients with acute non-ST-elevation myocardial infarction(NSTEMI). Methods A total of 33 patients with NSTEMI who were treated in the Department of Emergency of our hospital before the construction of the CPC were enrolled as the control group, and 37 patients with NSTEMI who were treated after the construction of the CPC in April 2019 were recruited into the observation group. Diagnosis and treatment process related indicators, including time of emergency double antibody treatment, time of first medical contact to percutaneous coronary intervention(PCI), and the hospital mortality, the incidence of malignant arrhythmia, heart failure and other adverse cardiac events in two groups were observed and compared. The levels of left ventricular ejection fraction(LVEF), left ventricular end systolic volume(LVESV) and left ventricular end diastolic volume(LVEDV) before and after treatment in two groups one week after PCI were detected for evaluation of the short-term prognosis. Results There were no significant difference in the constituent ratios of the way of hospital admission, emergency PCI and elective PCI between the two groups(P> 0.05). The duration of emergency dual antiplatelet therapy in the patients with intermediate and high risk, and the duration of first medical exposure-PCI in the patients with high risk in the observation group were shorter than those in the control group(P<0.05). There were no significant difference in the LVEDV, LVESV, and LVEF at 1 week after PCI between the two groups(P> 0.05). The incidence rate of cardiac adverse events in the observation group during hospitalization was significantly lower than that in the control group(10.81% vs 27.27%, P<0.05). Conclusions The establishment of CPC can shorten the diagnosis and treatment process and improve the short-term prognosis in the elderly patients with NSTEMI. References | Related Articles | Metrics

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Prediction value of sTWEAK and KLK1 for the prognosis of elderly patients with acute non-ST segment elevation myocardial infarction receiving emergency percutaneous coronary intervention YIN Xue-jiao, LI Hui, LIANG Rong-zhen, LIU Wen, WANG Ling-na, LIN Li 2022, 36 (4):  364-368.  doi: 10.3969/j.issn.1003-9198.2022.04.010 Abstract ( 146 )   PDF (1056KB) ( 990 )   Save Objective To analyze the prediction value of serum levels of soluble tumor necrosis factor like weak inducer of apoptosis(sTWEAK) and tissue kallikrein 1(KLK1) for the prognosis of the elderly patients with acute non-ST segment elevation myocardial infarction(NSTEMI) after emergency percutaneous coronary intervention(PCI). Methods The data of 117 elderly patients with NSTEMI receiving emergency PCI in our hospital from April 2018 to December 2019 were retrospectively analyzed. The serum levels of sTWEAK, KLK1, cardiac troponin T(cTnT)and creatine kinase MB(CK-MB) at admission and 1 d after PCI were observed and compared. Aceording to the prognosis 1 year after PCI, the patients were divided into the good prognosis group and the poor prognosis group, and the serum levels of sTWEAK and KLK1 were compared between the two groups.The prediction value of serum sTWEAK and KLK1 was analyzed. Results The levels of sTWEAK, cTnT and CK-MB were significantly lower and the level of KLK1 was higher in 117 elderly patients with NSTEMI 1 day after PCI than those at admission(P<0.05). After 1 year of follow-up, there was 32 cases (27.35%)showing poor prognosis, and the level of sTWEAK in the poor prognosis group was higher and the level of KLK1 was lower than that in the good prognosis group(P<0.05).Logistic regression analysis showed that the over expression of sTWEAK (OR=1.167,95%CI: 1.095-1.243)and low expression of KLK1(OR=0.526, 95%CI: 0.402-0.688) might be risk factors for poor prognosis of emergency PCI in the elderly NSTEMI patients(P<0.05). Receiver operating characteristic curve(ROC) curve was drawn and showed that the AUC of serum sTWEAK and KLK1 or combination in predicting the prognosis of emergency PCI in the elderly NSTEMI patients was 0.814, 0.895 and 0.907 respectively. Conclusions The poor prognosis may be related to the over expression of sTWEAK and the low expression of KLK1. Early detection of sTWEAK and KLK1 levels at admission has certain predictive value for the prognosis in the elderly NSTEMI patients after the emergency PCI. References | Related Articles | Metrics

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Clinical characteristics of elderly patients with type 2 diabetes mellitus YU Yun, TANG Wei, LOU Qing-lin 2022, 36 (4):  369-373.  doi: 10.3969/j.issn.1003-9198.2022.04.011 Abstract ( 169 )   PDF (1054KB) ( 799 )   Save Objective To assess the differences of clinical characteristics in the elderly patients with type 2 diabetes mellitus(T2DM) with middle-aged onset and aged onset. Methods A total of 5670 patients with T2DM were enrolled, and were divided into three groups according to the age and diabetic onset age, including 2867 aged onset elderly patients, 1518 middle-aged onset elderly patients, and 1285 middle-aged onset non-elderly patients. The levels of fasting plasma glucose(FPG), postprandial glucose(PPG), glycosylated hemoglobin(HbA1c), total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, glycerin trilaurate, serum creatinine, microalbumin/creatinin ratio(ACR) and ankle brachial index(ABI) were detected and compared. Results The glucose control levels(FPG, PPG, HbA1c) of aged onset elderly patients were significantly better than those of middle-aged onset elderly patients and middle-aged onset non-elderly patients. The control rate of HbA1c in the three groups was 50.37%, 41.96% and 38.44%, respectively(all P< 0.05). The proportions of the patients receiving diet and exercise intervention or taking only one oral hypoglycemic drug were higher while the proportion of insulin use was significantly lower in aged onset elderly patients than those of middle-aged onset elderly patients. The proportions of diabetic macrovascular complications(coronary heart disease and peripheral vascular disease) showed no significant differences between the groups, while the proportion of diabetic microvascular complication(diabetic nephropathy) in aged onset elderly patients was significantly lower than that in middle-aged onset elderly patients(P< 0.05). Conclusions The majority of elderly patients with T2DM are aged onset patients. Compared with middle-aged onset elderly patients, aged onset patients are more easier to control glucose levels and need simpler hypoglycemic medications, and the proportion of diabetic microvascular complication(diabetic nephropathy) in aged onset elderly patients is significantly lower than that of middle-aged onset elderly patients. References | Related Articles | Metrics

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Clinical features and risk factors of venous thromboembolism in elderly patients with acute exacerbation of chronic obstructive pulmonary disease LI Jia, CHEN Xiao-lan, PAN Lei 2022, 36 (4):  374-377.  doi: 10.3969/j.issn.1003-9198.2022.04.012 Abstract ( 145 )   PDF (1041KB) ( 1101 )   Save Objective To investigate the clinical features and risk factors of venous thromboembolism(VTE) in the elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods From January 2016 to December 2019, 208 confirmed elderly patients with AECOPD in our hospital were enrolled. According to the occurence of VTE, the patients were divided into AECOPD + VTE group(49 cases) or AECOPD group(159 cases). The clinical and laboratory data were collected and compared between 2 groups, and the risk factors of VTE were analyzed. Results Intermuscular venous thrombosis occurred most in the AECOPD+VTE group, reaching 64.0% in the patients aged under 80 years old and 91.7% in the patients aged over 80 years old. There were significant differences in age, history of VTE, immobilization time＞3 d, asymmetrical edema, coronary heart disease(CHD), GOLD classification, serum levels of albumin and D-dimer between the two groups(P<0.05). Multivariate Logistic regression analysis showed that the history of VTE, CHD and higher level of D-dimer were independent risk factors of VTE in the elderly AECOPD patients. Conclusions The morbidity of lower-limb intermuscular venous thrombosis is high, and the history of VTE, CHD and higher level of D-dimer are independent risk factors of VTE in the the elderly AECOPD patients. References | Related Articles | Metrics

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Analysis of risk factors for 30-day unplanned readmission after radical gastrectomy for gastric cancer in elderly LIU Zi-Jie, CAO Qin-hong, YAO Xue-quan 2022, 36 (4):  378-381.  doi: 10.3969/j.issn.1003-9198.2022.04.013 Abstract ( 139 )   PDF (1008KB) ( 973 )   Save Objective To investigate the incidence, causes and risk factors for 30-day unplanned readmission after radical gastrectomy for gastric cancer in the elderly. Methods The clinical and surgical-related data of 626 elderly patients underwent radical gastric cancer surgery in our hospital from 2009 to 2019 were collected.All the patients were divided into the readmission group(19 cases) and the non- readmission group(607 cases) according to whether they were readmitted within 30 days after discharge, and the data of the two groups were compared to analyze the risk factors for 30-day unplanned readmission after radical gastrectomy for gastric cancer in the elderly. Results There were 19 patients(3.04%) readmitted within 30 days after initial discharge, with a median time of 10 d. Reasons for readmission were abdominal distention(n=7), infection(n=6), anastomotic fistula(n=3), intestinal obstruction(n=2), and renal insufficiency(n=1). There were significant differences in preoperative albumin level, Karnofsky Performance Status (KPS) score, operative time, and severity of postoperative complications between the readmission group and the non-readmission group(P<0.05). Logistic regression analysis showed that KPS score(OR=0.971, 95%CI: 0.949-0.993, P=0.011) and postoperative complications(OR=4.895, 95%CI: 1.843-12.999, P=0.001) were independent risk factors for 30-day unplanned readmission. Conclusions The incidence of unplanned readmission is 3.04%, and the KPS scores and postoperative complications are the independent risk factors for 30-day unplanned readmission after radical gastrectomy for gastric cancer in the elderly. References | Related Articles | Metrics

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Correlation between eGFR and the risk of hypoglycemia in elderly patients with diabetes mellitus HUANG Feng-mei, YUAN Li, YANG Xiao-ling, Li Rao, YE Zi-wei, GU Yan 2022, 36 (4):  382-385.  doi: 10.3969/j.issn.1003-9198.2022.04.014 Abstract ( 141 )   PDF (1019KB) ( 955 )   Save Objective To explore the relationship between estimated glomerular filtration rate(eGFR) and the risk of hypoglycemia in the elderly patients with diabetes mellitus(DM). Methods The clinical data of 532 elderly patients with DM who were hospitalized in West China Hospital of Sichuan University from July 2020 to April 2021 were collected. According to the level of eGFR, the patients were divided into 5 groups: eGFR≥90 mL/(min·1.73m2)(group A, n=80), 60 mL/(min·1.73m2)≤eGFR＜90 mL/(min·1.73m2)(group B, n=201), 30 mL/(min·1.73m2)≤eGFR＜60 mL/(min·1.73m2)(group C, n=84), 15 mL/(min·1.73m2)≤eGFR＜30 mL/(min·1.73m2)(group D, n=81), and eGFR<15 (mL/ min·1.73m2)(group E, n=86).The differences of baseline data among 5 groups were analyzed. Logistic regression analysis was used to analyze the risk factors of hypoglycemia. Results The overall incidence rate of hypoglycemia was 13.9%(74/532). The incidence rate of hypoglycemia increased from 17.9%(15/84) to 20.9%(18/86) with the decrease of eGFR, and the difference was statistically significant(P<0.05). After adjusting for age, gender, duration of diabetes, glycosylated hemoglobin (HbA1c), body mass index(BMI), insulin usage and other confounding factors, eGFR was still an independent risk factor for hypoglycemia. The risk of hypoglycemia in group C was 3.54 times higher than that in group A(95% CI: 1.06-11.84,P<0.05);and 3.92 times(95%CI: 1.14-13.44, P<0.05) in group D, 4.01 times(95%CI: 1.23-13.07, P<0.05) in group E, respectively. Conclusions eGFR is closely related to the risk of hypoglycemia in the elderly patients with DM. eGFR is expected to be used for personalized assessment and prediction of the risk of hypoglycemia in the elderly patients with DM. References | Related Articles | Metrics

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Correlation between muscle function and cognitive function in elderly LI Bi-xi, ZHANG Ya-xin, LIU Pan, SONG Yu, LI Yun, MA Li-na 2022, 36 (4):  386-389.  doi: 10.3969/j.issn.1003-9198.2022.04.015 Abstract ( 168 )   PDF (1015KB) ( 888 )   Save Objective To investigate the correlation between muscle function and cognitive function in the elderly. Methods A total of 385 elderly patients admitted to Department of Geriatrics in Xuanwu Hospital were selected consecutively. The clinical and laboratory examination data, muscle function and cognitive function were evaluated and collected. The patients were divided into cognitive dysfunction group(n=32) and non-cognitive dysfunction group(n=353) according to the score of Mini-Mental State Examination(MMSE).The correlation between muscle function and cognitive function in the elderly people were analyzed. Results Age, “get-up and go” test time were significantly higher, and four meters step speed, upper arm circumference, lower leg circumference, grip strength, the levels of triylyceride, hemoglobin and MMSE score were significantly lower in the cognitive dysfunction group than those in the non-cognitive dysfunction group(P<0.05). Whereas gender, appendicular skeletal muscle mass(ASM), appendicular skeletal muscle mass index(ASMI), the incidence of hypertension, type 2 diabetes mellitus, coronary heart disease showed no significantly difference between the two groups(P> 0.05). Spearman correlation analysis showed that after controlling for age variables, cognitive function was positively related with grip strength(r=0.145, P=0.005) and four meters step speed(r=0.126, P=0.018). Logistic regression analysis revealed that grip strength was a risk factor for cognitive dysfunction(OR=1.099,95％CI:1.016-1.188,P=0.019). Conclusions Decreased muscle function significantly reduced cognitive function in the elderly. Cognitive function is positively related with muscle function. Grip strength was a risk factor for cognitive dysfunction. References | Related Articles | Metrics

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Prevalence and risk factors of sarcopenic dysphagia in elderly: a systematic review LI Wen-yan, LU Na, RUAN Hai-hui, LIU Jin, YUAN Rong-jing, WANG Ye-tong, SU Qing-ling, WANG Yan-hong 2022, 36 (4):  390-394.  doi: 10.3969/j.issn.1003-9198.2022.04.016 Abstract ( 158 )   PDF (1145KB) ( 1058 )   Save Objective To determine the prevalence and risk factors of sarcopenic dysphagia in the elderly by systematic review. Methods PubMed, EMbase, The Cochrane Library, Web of Science, CINAHL, CNKI, CBM, WanFang Data and VIP databases were searched to collect studies on the prevalence and influencing factors of sarcopenic dysphagia in the elderly from inception to June 2020. Meta analysis was then performed by using Stata 12.0 software. Descriptive analysis was used to analyze the risk factors. Results Finally 10 studies involving 4039 patients were included.The Meta analysis showed that the prevalence of sarcopenic dysphagia in the elderly (≥60 years old) was 4.0%(95%CI:3.0%- 4.0%). Subgroup analysis showed that the prevalence of sarcopenic dysphagia was higher in elderly females,>80 years old, and assessed by calf circumference and Food Intake Level Scales(FILS). Descriptive analysis showed that the factors that affecting sarcopenic dysphagia in the elderly including tongue muscle strength, muscle mass, grip strength, physical condition, nutritional status, energy intake. Conclusions The prevalence of sarcopenic dysphagia in the elderly is relatively high. Reduced tongue strength and muscle mass,low grip strength,poor physical condition,poor nutrition,and inadequate energy intake may increase the risk of sarcopenic dysphagia in the elderly. References | Related Articles | Metrics

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Effect of early progressive exercise training on self muscle strength and self-care ability of elderly patients in ICU JIA Jing-feng, XU Xiao, ZHAO Hong-mei 2022, 36 (4):  421-425.  doi: 10.3969/j.issn.1003-9198.2022.04.025 Abstract ( 125 )   PDF (1031KB) ( 940 )   Save Objective To analyze the intervention effect of early progressive exercise training on self muscle strength and self-care ability in the elderly patients in intensive care unit(ICU). Methods A prospective study was conducted on 132 elderly patients in ICU of our hospital from March 2019 to March 2021. The patients were randomly divided into two groups with 66 cases in each group. Routine ICU nursing intervention was used in both groups, and early progressive exercise training intervention was used in the observation group at the same time. The extensor and flexor muscle strength, self-care ability, scores of Medical Research Council(MRC), Barthel index and the quality of life were compared between the two groups before and after intervention. Results After the intervention, the indexes of extensor and flexor muscle strength in the observation group were higher than those in the control group, with statistically significant difference (P< 0.05). The scores of self-care ability, MRC and Barthel index in the two groups were significantly increased after the intervention than those before the intervention, especially in the observation group(P<0.05). The body pain score was significantly decreased and the other quality of life scores were significantly increased in the two groups after the intervention, and the differences were statistically significant between the two groups(P<0.05). Conclusions Eearly progressive exercise training intervention for the elderly patients in ICU can effectively improve their muscle strength, self-care ability and quality of life. References | Related Articles | Metrics

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Application of collaborative doctor-nurse management of medical care in the optimization of ophthalmic day ward procedure WANG Xiao-feng, ZHU hui, WANG Juan, CUI Ming-lan, WANG Ling-yan, XUE Chang-ping, MAO Jia 2022, 36 (4):  426-429.  doi: 10.3969/j.issn.1003-9198.2022.04.026 Abstract ( 147 )   PDF (998KB) ( 1025 )   Save Objective To explore the application of collaborative doctor-nurse management mode in the optimization of ophthalmic day ward procedure, so as to provide evidence for promoting and optimizing the procedure of day ward. Methods A total of 362 patients undergoing cataract surgery in the ophthalmic day ward of our hospital from September to December 2019 were enrolled into the control group (before the application of collaborative doctor-nurse management mode), and 328 patients from September to December 2020 were enrolled into the experimental group (after the application of collaborative doctor-nurse management mode). The non-attendance rate, the satisfaction rate of the patients to medical work, and the incidence rate of adverse events were compared between the two groups. Results After the application of collaborative doctor-nurse management mode, the non-attendance rate decreased significantly from 17.4% to 3.04% (χ2=37.480, P<0.01), and the incidence rate of adverse events decreased significantly from 16.85% to 3.35% (χ2=8.171, P<0.01), and the satisfaction rate of patients to medical work increased significantly from 91.99% to 100% (χ2=27.429, P<0.01). Conclusions Optimizing the ophthalmic day ward by collaborative doctor-nurse management mode can effectively reduce the non-attendance rate, increasing the efficiency of day surgery and the patients’ satisfaction to medical work, detecting and preventing adverse events, ensuring the safety of the patients, and improving the quality of medical care, which is worthy of popularization and application. References | Related Articles | Metrics