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20 June 2022, Volume 36 Issue 6 Previous Issue    Next Issue

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Relationship between homocysteine and atrial fibrillation: a cross-section analysis of Rugao Aging Cohort Study WANG Xi, SONG Qi, ZHANG Hui, JIANG Xiao-yan, WANG Xiao-feng 2022, 36 (6):  552-555.  doi: 10.3969/j.issn.1003-9198.2022.06.002 Abstract ( 154 )   PDF (1165KB) ( 1188 )   Save Objective To explore the relationship between atrial fibrillation (AF) and homocysteine (Hcy) in the Chinese elderly. Methods The data were obtained from the survey of the population aged 70-89 years old in the fourth follow-up of Rugao Aging Cohort Study. According to the quartile level or the recommended cut point (15 μmol/L) of Hcy, the subjects were devided into Q1 group, Q2 group, Q3 group and Q4 group or high level of Hcy group and normal level of Hcy group. The relationships between different levels of Hcy and AF were analyzed by Logistic regression model. Results A total of 1798 subjects were included in this study, and the average age was 79.09±4.38 years old. Among them, 814 were male and 984 were female; 90 cases presented with AF (5.0%), and 867 cases presented with high level of Hcy (48.2%). There were statistically significant differences in age, smoking history, drinking history, Hcy level and the proportion of people with high Hcy level between AF group and non-AF group (P<0.05). Logistic regression analysis showed that, compared with Q1 group, the risk of AF in Q2 group (OR=2.884, 95%CI: 1.201-6.930), Q3 group (OR=3.644, 95%CI: 1.547-8.580) and Q4 group (OR=6.607, 95%CI: 2.932-14.891) were significantly increased; Compared with normal level of Hcy group, the risk of AF in high level of Hcy group was significantly increased (OR=2.774, 95%CI: 1.742-4.419); For each standard deviation increased in logHcy, the risk of AF was 1.441 times as high as the original one (OR=1.441, 95%CI:1.227-1.692); The differences were still statistically significant after adjusting for age, gender, marital status, body mass index, education, occupation, smoking, drinking, hypertension and diabetes (P<0.05). Conclusions Elevated Hcy level is correlated with the increased risk of AF in the Chinese elderly, and it suggests that Hcy may be a risk factor for the occurrence of AF. References | Related Articles | Metrics

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Analysis of clinical diagnosis and treatment of appendix pseudomyxoma peritonei in the elderly DING Hui, DING Yong-bin 2022, 36 (6):  556-559.  doi: 10.3969/j.issn.1003-9198.2022.06.003 Abstract ( 155 )   PDF (1100KB) ( 894 )   Save Objective To analyze the clinicopathological characteristics of appendix pseudomyxoma peritonei in the elderly and the effect of surgical treatment strategy on prognosis. Methods The general data, clinical manifestation, imaging feature, surgical treatment strategies, pathological results and prognosis of 48 elderly patients with appendix pseudomyxoma peritonei were analyzed retrospectively. Results Among the 48 patients, 38 presented with unruptured tumors (unruptured tumor group) and 10 presented with ruptured tumors during the surgery (ruptured tumor group). There were no significant differences in age, gender, tumor markers, clinical manifestation and tumor diameter between the two groups (P>0.05). There were 5 patients with malignant tumor in unruptured tumor group and 6 patients with malignant tumor in ruptured tumor group, and the difference between the two groups was statistically significant (P<0.05). This study was followed up for 13 to 101 months (mean 34 months), and no patient died during the follow-up period. In unruptured tumor group, 8 patients recurred within one year after surgery, including 5 patients who were initially diagnosed as malignant tumor; Within three years after surgery, 10 patients recurred and all of them underwent secondary surgery, and 3 patients who were initially diagnosed as benign transformed to malignant. All the patients in unruptured tumor group had no recurrence within 3 years after surgery. The risk of recurrence and malignant transformation in ruptured tumor group were significantly higher than those in unruptured tumor group (P<0.05). Conclusions Complete resection is key to the treatment of elderly patients with appendiceal pseudomyxoma peritonei. The tumor is more prone to malignant transformation and recurrence after rupture, and the patients rarely benefit from chemotherapy. References | Related Articles | Metrics

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Expression and the relationship with nasal polyps of Klotho and interleukin-8 in nasal mucosa of elderly patients with chronic rhinosinusitis HAO Jian-hai, ZHANG Jun-yao, WANG Min 2022, 36 (6):  560-564.  doi: 10.3969/j.issn.1003-9198.2022.06.004 Abstract ( 134 )   PDF (1122KB) ( 897 )   Save Objective To investigate the expression and the relationship with nasal polyps of Klotho and interleukin-8 (IL-8) in nasal mucosa of the elderly patients with chronic rhinosinusitis (CRS). Methods From September 2017 to September 2020, 80 elderly patients with CRS who underwent endoscopic surgery in our hospital were selected and divided into CRS without nasal polyps (CRSsNP) group (n=37) and CRS with nasal polyps (CRSwNP) group (n=43). The clinical data were collected. The expression level of Klotho protein was detected by Western blot, and the expression levels of Klotho mRNA and IL-8 mRNA were detected by real-time fluorescent quantitative polymerase chain reaction. Pearson correlation coefficient was used to describe the relationship of the expression of Klotho mRNA and IL-8 mRNA with the proportions of neutrophils and eosinophils in the elderly patients with CRS; and the risk factors of nasal polyps in the elderly patients with CRS were analyzed by multivariate Logistic regression analysis. Results Compared with CRSsNP group, the proportion of peripheral blood neutrophils in CRSwNP group was significantly lower (P<0.01), and the proportion of eosinophils in CRSwNP group was significantly higher(P<0.01); The expression of Klotho protein and Klotho mRNA in CRSwNP group were significantly lower (P<0.001), and the expression of IL-8 mRNA in CRSwNP group was significantly higher (P<0.001). The expression of Klotho mRNA was negatively correlated with the expression of IL-8 mRNA and the proportion of eosinophils, but positively correlated with the proportion of neutrophils in the elderly patients with CRS. The expression of IL-8 mRNA was negatively correlated with the proportion of neutrophils, but positively correlated with the proportion of eosinophils in the elderly patients with CRS. The expression of Klotho mRNA and IL-8 mRNA in nasal mucosa were the influencing factors for the occurence of nasal polyps in the elderly patients with CRS. Conclusions The expression of Klotho mRNA is low and the expression of IL-8 mRNA is high in the nasal mucosa of the elderly patients with CRSwNP, which may be used as important indicators to evaluate the occurrence of nasal polyps in the elderly patients with CRS. References | Related Articles | Metrics

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Predictive value of neutrophil to lymphocyte ratio combined with body mass index for decreased muscle mass in elderly patients with chronic heart failure YIN Ji-xia, LIU Jia, HU Song, WANG Mei, WANG Yi-ru, MAO Yong-jun 2022, 36 (6):  565-569.  doi: 10.3969/j.issn.1003-9198.2022.06.005 Abstract ( 150 )   PDF (1144KB) ( 1066 )   Save Objective To investigate the predictive value of neutrophil to lymphocyte ratio (NLR) combined with body mass index (BMI) for decreased muscle mass in the elderly patients with chronic heart failure (CHF). Methods A total of 94 CHF patients aged≥65 years old who were hospitalized from January 2018 to August 2021 in Department of Geriatrics of the Affiliated Hospital of Qingdao University and the Eighth People’s Hospital of Qingdao were selected. According to the diagnostic criteria set by Asian Sarcopenia Working Group in 2019, the patients were divided into muscle mass loss group(n=29) and non-muscle mass loss group (n=65). The general data and laboratory indicators of the patients in different groups and different cardiac function grades were compared. The risk factors for decreased muscle mass in the elderly patients with CHF were analyzed by multivariate Logistic regression. The predictive value of NLR and BMI for decreased muscle mass in the elderly patients with CHF was evaluatd by receiver operating characteristic (ROC) curve. Results There were statistically significant differences in age, gender, nutrition risk screening (NRS2002) score, NLR, BMI and lymphocyte count between muscle mass loss group and non-muscle mass loss group (P＜0.05). There were statistically significant differences in age, NRS2002, NLR, N-terminal pro-B-type natriuretic peptide,BMI, left ventricular ejection fractions (LVEF) and skeletal muscle index (SMI) among the patients with different cardiac function grades (P＜0.05). Logistic regression analysis showed that BMI (OR=0.764, 95%CI:0.600-0.972) and NLR(OR=2.266,95%CI:1.092-4.704) were the independent influencing factors for muscle mass loss. ROC curve analysis suggested that the area under the curve (AUC) of NLR and BMI was 0.764 (95%CI:0.660-0.868) and 0.726 (95%CI:0.613-0.839) in predicting muscle mass loss, respectively, and the AUC of NLR combined with BMI was 0.845 (95%CI:0.759-0.932) in predicting muscle mass loss, with a sensitivity of 82.8％, and a specificity of 81.2％. Conclusions NLR and BMI are the independent influencing factors for decreased muscle mass in the elderly patients with CHF, and the combination of NLR and BMI shows higher predictive value for decreased muscle mass. References | Related Articles | Metrics

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Value of serum advanced glycation end products (AGEs) and soluble receptor for AGEs in differential diagnosis of idiopathic pulmonary fibrosis and fibrotic parenchymal lung disease ZHANG Xuan, QIAN Yuan-yuan, CHEN Xiao-chen, GUO Chun-yan 2022, 36 (6):  570-574.  doi: 10.3969/j.issn.1003-9198.2022.06.006 Abstract ( 143 )   PDF (1127KB) ( 1191 )   Save Objective To investigate the expression of serum advanced glycation end products (AGEs) and soluble receptor for AGEs (sRAGEs) in the elderly patients with idiopathic pulmonary fibrosis (IPF) and the correlations with pulmonary function indexes, and to analyze the value of serum AGEs, sRAGEs in the differential diagnosis of IPF, chronic hypersensitivity pneumonitis (cHP) and fibrotic nonspecific interstitial pneumonia (fNSIP). Methods Seventy-nine elderly IPF patients (IPF group), 30 elderly cHP patients (cHP group) and 30 elderly fNSIP patients (fNSIP group) were enrolled in this study from February 2016 to August 2021, while 30 healthy elderly volunteers were enrolled as control group. The levels of serum AGEs, sRAGE, AGEs/sRAGE, pulmonary function indexes such as forced vital capacity predicted (FVC%), percentage of predicted diffusing capacity of lung for carbon monoxide (DLCO%) and total lung capacity (TLC) were detected and compared among the four groups. The diagnostic value of serum AGEs, sRAGE and AGEs/sRAGE were analyzed by receiver operating characteristic (ROC) curve and likelihood ratio test. Pearson correlation coefficient was used to describe the relationship between serum AGEs, sRAGE and pulmonary function in the elderly patients with IPF. Results The levels of FVC%, DLCO% and TLC in cHF group, fNSIP group and IPF group were significantly lower than those in control group (P＜0.05). The level of serum sRAGE in IPF group and CHP group was significantly lower than that in control group and fNSIP group (P＜0.05), and the level of AGEs and the ratio of AGEs/sRAGE were significantly higher than those in control group and fNSIP group (P＜0.05). However, there were no significant differences in serum levels of AGEs and sRAGE between control group and fNSIP group (P＞0.05). ROC curve analysis showed that AGEs, sRAGE, AGEs/sRAGE had good diagnostic value in the differential diagnosis between IPF and fNSIP (all AUC＞0.7). The accuracy and likelihood ratio of AGEs/sRAGE in the differential diagnosis of IPF and fNSIP were higher than those of serum AGEs and sRAGE. Pearson correlation analysis showed that serum AGEs was negatively correlated with sRAGE (r=-0.541, P<0.001), and serum sRAGE was positively correlated with FVC%, DLCO%, TLC (r=0.445,0.452,0.312, all P<0.001), however, AGEs was not correlated to FVC%, DLCO% or TLC (P＞0.05). Conclusions AGEs/sRAGE is helpful for the differential diagnosis of IPF and fNISP, and serum level of sRAGE can reflect the degree of lung function injury in the elderly patients with IPF to a certain extent. References | Related Articles | Metrics

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Value of serum levels of amyloid A and C1q/tumor necrosis factor related protein 9 in predicting cardiovascular adverse events in elderly patients with type 2 diabetes mellitus LI Bai-jun, LUO Hua-fu, WANG Xiao-shu, WEI Qian 2022, 36 (6):  575-579.  doi: 10.3969/j.issn.1003-9198.2022.06.007 Abstract ( 120 )   PDF (1116KB) ( 933 )   Save Objective To investigate the predictive value of the serum levels of amyloid A (SAA) and C1q/tumor necrosis factor associated protein (CTRP) 9 for cardiovascular adverse events in the elderly patients with type 2 diabetes mellitus(T2DM). Methods A total of 110 elderly T2DM patients who received blood glucose control and management in our hospital from April 2016 to April 2019 were selected as the research subjects. All the patients were followed up regularly for 2 years, and the occurrence of adverse cardiovascular events (acute coronary syndrome, arrhythmia, acute heart failure, etc.) was recorded. All patients were divided into the occurrence group and the non-occurrence group. The basic data, laboratory indexes and serum levels of SAA and CTRP9 at admission were compared between the two groups. The risk factors of cardiovascular adverse events in the patients were analyzed by multiple Logistic regression; The receiver operating characteristic (ROC) curve was drawn to analyze the value of serum SAA and CTRP9 alone and combined in predicting the risk of cardiovascular adverse events in the patients; The correlation between SAA and CTRP9 was described by Spearman correlation coefficient. Results Among 110 elderly patients with T2DM, 31 cases had cardiovascular adverse events, with an incidence rate of 28.18%. Compared with the non-occurrence group, the level of SAA was higher, and the level of CTRP9 was lower in the occurrence group, with statistically significant differences (P<0.01). Multivariate Logistic regression analysis showed that the high expression of SAA and the low expression of CTRP9 at admission were risk factors for the occurrence of cardiovascular adverse events in the elderly T2DM patients. ROC curve analysis showed that the area under curve of serum SAA and CTRP9 alone and in combination to predict the risk of cardiovascular adverse events in the elderly T2DM patients was 0.842, 0.815, 0.883, respectively. Spearman correlation analysis showed that there was a negative correlation between SAA and CTRP9 (r=-0.316, P=0.001). Conclusions The serum levels of SAA and CTRP9 at admission have certain predictive value for the incidence of cardiovascular adverse events in the elderly patients with T2DM, and the predictive value of their combination is the highest. References | Related Articles | Metrics

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Clinical significance of heat shock protein 70, visfatin and carbohydrate antigen 724 in elderly patients with endometrial cancer HU Meng, NIU San-qiang, CHEN Yan, LIU Ning 2022, 36 (6):  580-583.  doi: 10.3969/j.issn.1003-9198.2022.06.008 Abstract ( 143 )   PDF (1217KB) ( 906 )   Save Objective To investigate the serum levels and clinical significance of heat shock protein 70 (HSP70), visfatin and carbohydrate antigen 724 (CA724) in the elderly patients with endometrial cancer. Methods A total of 125 elderly patients with endometrial cancer admitted to our department from December 2018 to March 2021 were selected as endometrial cancer group.Another 100 healthy elderly people were selected as control group.The serum levels of HSP70, visfatin and CA724 were detected and compared between the two groups.The levels of HSP70, visfatin, CA724 of different clinicopathological characteristics groups of the elderly patients with endometrial cancer were compared. The diagnostic efficiency of HSP70, visfatin, CA724 alone and combination of the three indexes for endometrial cancer was analyzed by receiver operating characteristic (ROC) curve. Results The serum level of HSP70 in endometrial cancer group was lower than that in control group, and the serum levels of visfatin and CA724 were higher than those in control group, with statistically significant differences (P<0.01). There were significant differences in serum levels of HSP70, visfatin and CA724 in the patients with different TNM stages, tumor tissue differentiation degree, and lymph node metastasis (P<0.05). ROC curve analysis showed that the combination of HSP70, visfatin and CA724 had an area under the curve of 0.878 for the diagnosis of endometrial cancer, and the sensitivity and specificity was 0.872 and 0.824, respectively, which were higher than the parameters alone. Conclusions The changes of serum HSP70, visfatin and CA724 levels are related to the occurrence and development of endometrial cancer in the elderly. The combined detection of the three indicators is expected to become a new biomarker for predicting and diagnosing endometrial cancer in the elderly. References | Related Articles | Metrics

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Clinical effect of flexible ureteroscopy and lasertripsy combined with Paishi Granule in the treatment of elderly patients with upper urinary tract calculi LIU Chen-xi, CAO Lei, LU Xin-zhe, ZHAO Hong-juan, XU Yang-tao, PAN Yan, ZHAO Guo-bin 2022, 36 (6):  584-587.  doi: 10.3969/j.issn.1003-9198.2022.06.009 Abstract ( 129 )   PDF (1104KB) ( 821 )   Save Objective To investigate the effect of flexible ureteroscopy and lasertripsy (FURSL) combined with Paishi Granule on the levels of inflammatory factors, procalcitonin (PCT) and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score in the elderly patients with upper urinary tract stones with a diameter of 2-4 cm. Methods A total of 120 elderly patients with upper urinary tract calculi who were diagnosed and treated in our hospital were selected. According to random number table, the patients were divided into observation group and control group, with 60 cases in each group. All the patients underwent FURSL, and the observation group was treated with Paishi Granule additionally. The rate of calculi clearance, the levels of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), IL-6 and PCT, the score of APACHE Ⅱ, and the complications were compared between the two groups. Results The stone free rate in the observation group was significantly higher than that in the control group (91.67% vs 78.33%, P=0.041). After treatment, the levels of CRP, PCT, IL-1β, TNF-α and IL-6 and the score of APACHE Ⅱ in both groups were decreased significantly, especially in the observation group (P<0.01). There were no significant differences in the incidence rates of hyperamylasemia, pancreatitis and enterobrosis between the two groups (P>0.05). Conclusions FURSL combined with Paishi Granules in the treatment of the elderly patients with upper urinary tract calculi with a diameter of 2-4 cm is safe and effective. The levels of inflammatory factors and PCT, and the score of APACHE Ⅱ in the patients can be significantly decreased, which is recommended to be popularized in clinic. References | Related Articles | Metrics

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Study on 3D-Slicer-assisted localization of decompression range of bone flap in the treatment for massive cerebral infarction in elderly patients GAO Xiang, LI Ming, GONG Hai-jiao, XIAO Qian, LI Yao 2022, 36 (6):  588-591.  doi: 10.3969/j.issn.1003-9198.2022.06.010 Abstract ( 145 )   PDF (1093KB) ( 1586 )   Save Objective To analyze the effect of 3D-Slicer-assisted localization of decompression range of bone flap in the treatment for massive cerebral infarction in the elderly patients. Methods One hundred elderly patients with massive cerebral infarction who did not receive 3D-Slicer treatment from January 2018 to December 2020 were selected as the control group, and 50 patients treated with 3D-Slicer were enrolled as the observation group. The control group was treated with standard large bone flap decompression, and the observation group was assisted by 3D-Slicer treatment on the basis of the control group. The displacement of midline structure was observed. The quality of short-term prognosis and neurological function were evaluated and compared between the two groups. Results The intracranial pressure in the observation group was significantly lower than that in the control group at different time points after operation (P<0.01). After treatment, the Glasgow Coma Scale (GCS) score and good recovery rate in the observation group were significantly higher than those in the control group (P<0.01). Logistic regression analysis showed that age, extent of involvement, GCS score, midline displacement and treatment plan were the independent influencing factors of the quality of prognosis of the patients with massive cerebral infarction (P<0.05). Conclusions 3D-Slicer-assisted localization of decompression range of bone flap in the elderly patients massive cerebral infarction can effectively improve the clinical efficacy and prognostic quality, and the age, extent of involvement, GCS score, midline displacement and treatment plan might affect the prognostic quality. References | Related Articles | Metrics

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Relationship between serum stromal cell-derived factor-1, chemokine CCL21 and clinical prognosis in elderly patients with acute coronary syndrome LI Ya-yun 2022, 36 (6):  592-595.  doi: 10.3969/j.issn.1003-9198.2022.06.011 Abstract ( 120 )   PDF (1104KB) ( 1005 )   Save Objective To investigate the predictive value of serum stromal cell-derived factor-1 (SDF-1) and chemokine CCL21 for the clinical prognosis of the elderly patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). Methods The clinical data of 186 elderly patients with ACS who received PCI in our hospital from 2016 to 2018 were retrospectively analyzed. According to the occurrence of major adverse cardiovascular events (MACE) during 1-year follow-up, the patients were divided into poor prognosis group (86 patients with MACE) and good prognosis group (100 patients without MACE). The serum levels of SDF-1 and CCL21 were measured by enzyme-linked immunosorbent assay (ELISA). The risk factors for poor prognosis of the elderly patients were analyzed by multivariate Logistic regression. Receiver operating characteristic(ROC) curve was drawn to evaluate the diagnostic value of serum SDF-1 and CCL21 for the short-term poor prognosis of the elderly ACS patients after PCI. Results There were significant differences in the levels of heart rate, left ventricular ejection fraction (LVEF), SDF-1, CCL21, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), troponin and N-terminal pro-B type natriuretic peptide (NT-proBNP), the prevalence of hypertension and the score of GRACE scale between the two groups (P<0.05 or 0.01). Multivariate Logistic regression analysis showed that LVEF, GRACE score, SDF-1 and CCL21 were the independent influencing factors for poor prognosis in the elderly patients. The area under the ROC curve of serum SDF-1 combined with CCL21 in predicting short-term poor prognosis of the elderly patients was 0.930, with a sensitivity and a specificity of 0.841 and 0.857, respectively. Conclusions Serum SDF-1 and CCL21 are the independent influencing factors for short-term poor prognosis of the elderly ACS patients after PCI. The combination of the two indicators has a high predictive value for clinical prognosis in the elderly patients with ACS. References | Related Articles | Metrics

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Characteristics and analysis of influencing factors of postoperative electrolyte level changes in patients with craniopharyngioma JIA Heng, LI Jun, WANG Xing-qi, GONG Liang, MIAO Fa-an, FAN Yue-chao 2022, 36 (6):  596-600.  doi: 10.3969/j.issn.1003-9198.2022.06.012 Abstract ( 115 )   PDF (1108KB) ( 1128 )   Save Objective To investigate the change characteristics of early postoperative electrolyte level in the patients with craniopharyngioma and to analyze the influencing factors. Methods The data of the cases of craniopharyngioma receiving surgery in the Affiliated Hospital of Xuzhou Medical University from 2011 to 2020 were analyzed retrospectively. According to the age, the patients were divided into elderly group (14 cases), middle-aged group (25 cases) and youth group (43 cases). The changes of electrolyte and thyroid hormone levels in different age groups before and one day after surgery were compared, and the correlations were also analyzed. Results There was significant difference in gender among the three groups (P=0.042), and there were no significant differences in tumor classification and surgical approach (P>0.05). The patients with craniopharyngioma in this study mainly showed hypernatremia, hypocalcemia, hypokalemia and hyperchloremia one day after surgery. There were no significant changes in the levels of all electrolytes in the elderly group after operation(P>0.05). One day after surgery, the levels of potassium and calcium in youth group and the levels of potassium and phosphorus in middle-aged group were significantly decreased, and the differences were statistically significant (all P<0.05). After operation, the levels of free triiodothyronine (FT3) and hypersensitive thyrotropin (sTSH) in the three groups were significantly lower than those before operation, and the level of free thyroxine (FT4) in youth group was significantly lower than that before surgery, and that in middle-aged group and elderly group.Correlation analysis showed that the level of chloride changed was negatively correlated with the level of FT4 changed (r=-0.251, P=0.035), and the level of phosphorus changed was positively correlated with the level of FT3 changed (r=0.281, P=0.020). Conclusions The levels of the electrolytes fluctuate little in the elderly patients with craniopharyngioma one day after surgery, and a personal management of pituitary stalk in the surgery is necessary. Electrolyte monitoring and hormone replacement therapy should be performed well after surgery. References | Related Articles | Metrics

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Effects of palliative care implementation on elderly patients with dementia: a systematic review and meta-analysis ZHANG Nan, ZUO Wen-hang, WU Jin-hui 2022, 36 (6):  606-611.  doi: 10.3969/j.issn.1003-9198.2022.06.015 Abstract ( 154 )   PDF (1432KB) ( 1315 )   Save Objective To systematically assess the effects of palliative care on quality of life, symptoms, and care preferences discussion in the elderly patients with dementia. Methods Embase, MEDLINE, CENTRAL, APA PsycInfo, CINAHL, Web of Science Core Collection, ClinicalTrials.gov Database, CBM, CNKI, VIP and Wanfang Data were searched to screen the randomized controlled trials of palliative medical intervention in the patients with dementia. The included studies were evaluated for risk of bias, and meta-analysis was performed using Stata 17.0 BE software. Results Finally, 13 studies were enrolled, including 3394 cases of dementia (mean age: 82.0 years; 65.8% being female). Meta-analysis showed that, compared with usual care,palliative care was significantly related to the discussion of care preferences(5 trials, n=996; RR=2.11,95%CI: 1.14-3.90;I2=87.3%), but not related to the improvement of quality of life [4 trials, n=762; SMD=-0.04 (95%CI:-0.43-0.35]; I2=79.7%] and symptoms (6 trials,n=1047; SMD=0.26,95%CI:-0.06-0.58; I2=80.8%). Conclusions Compared with usual care, palliative care is associated with the discussion of care preferences, and there is insufficient evidence of correlation with quality of life or symptoms. References | Related Articles | Metrics

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Reliablity and validity of the Chinese version of Edmonton Frailty Scale for Chinese elderly inpatients GUO Xin-ying, HAO Yin, ZHANG Yu, ZHU Ming-lei 2022, 36 (6):  623-626.  doi: 10.3969/j.issn.1003-9198.2022.06.019 Abstract ( 164 )   PDF (1142KB) ( 1161 )   Save Objective To translate and develop a Chinese version of the Edmonton Frailty Scale(EFS)from the English version, and to investigate the validity and reliability of the Chinese version of EFS in Chinese elderly inpatients. Methods After the authorization, this study adopted a seven-step approach to translate and culture-adapt the English version of EFS to a Chinese version. Then, a total of 64 elderly inpatients received the assessement of Chinese version of EFS and Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) test at site. The data were recorded and analyzed by using Excel and SPSS 16.0 software. The reliability of the scale was described by Cronbach’s α coefficient. The construct validity and predictive validity of the scale was described by Spearman correlation coefficient. Results The Cronbach’s α coefficient of the Chinese version of EFS was 0.703, which suggested that the intenal consistency reliability of the scale was good. Excepted for the second item ‘number of hospitalizations in last year’ of the Chinese version of EFS, the Spearman correlation coefficient between the other items and the total score of the scale was 0.338-0.718 (P<0.01), which suggested that the construct validity of the scale was ideal. The total score of the Chinese version of EFS was negatively correlated with the total score of SF-36 (r=-0.622, P<0.01), which suggested that the predictive validity of the Chinese version of EFS was ideal. Conclusions The Chinese version of EFS has a good reliability and validity, which could be used as a tool in the evaluation of frailty in Chinese elderly inpatients. References | Related Articles | Metrics

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Status and influencing factors of fear of hypoglycemia in elderly patients with diabetic nephropathy undergoing maintenance hemodialysis LI Rao, YUAN Li, CHEN Lin, YUAN Huai-hong, CHEN Hui, LIAO Zhou-yi 2022, 36 (6):  627-631.  doi: 10.3969/j.issn.1003-9198.2022.06.020 Abstract ( 122 )   PDF (1113KB) ( 1129 )   Save Objective To explore the status and the influencing factors of fear of hypoglycemia in the elderly patients with diabetic nephropathy undergoing maintenance hemodialysis. Methods A total of 97 elderly patients with diabetic nephropathy receiving maintenance hemodialysis in West China Hospital from May to December 2020 were enrolled in this study. A survey was carried out using general information questionnaire and Hypoglycemia Fear Scale-Ⅱ.Multiple linear regression analysis was performed to investigate the influencing factors of fear of hypoglycemia in the elderly patients with diabetic nephropathy undergoing maintenance hemodialysis. Results The average age of the patients was(68.61±7.70)years old, and the score of Hypoglycemia Fear Scale-Ⅱwas 40.02±15.00. Multiple linear regression analysis showed that hypoglycemia occurring in the last 1 month and long dialysis time were the major influencing factors of fear of hypoglycemia (P＜0.05). Conclusions Medical personnel should pay attention to the fear of hypoglycemia in the elderly patients with diabetic nephropathy who underwent maintenance hemodialysis, especially in the patients suffering from hypoglycemia in recent one month or suffering from hemodialysis for a long time. It is important to identify early and intervene early, and to develop personalized blood glucose management and psychological nursing plan to avoid the fear of hypoglycemia. References | Related Articles | Metrics

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Analysis of influencing factors of dysphagia in hospitalized elderly patients with sarcopenia BO Ying-ying, MO Yong-zhen, OUYANG Xiao-jun, SHEN Xiao-xing, ZHU Hai-qiong, WANG Jie, LIU Xiao-qin, LIU Mei-li, LIU Huan, XU Jia-ren 2022, 36 (6):  632-635.  doi: 10.3969/j.issn.1003-9198.2022.06.021 Abstract ( 111 )   PDF (1105KB) ( 1332 )   Save Objective To investigate the status and the related influencing factors of dysphagia in the elderly inpatients with sarcopenia. Methods A total of 86 elderly patients with sarcopenia hospitalized in Jiangsu Province Geriatric Hospital from November 2019 to October 2021 were selected. According to the result of water swallow test, the patients were divided into sarcopenia only group (n=29) and sarcopenia combined with dysphagia group (n=57). The general data of the two groups were collected and compared; The influencing factors of dysphagia in the elderly inpatients with sarcopenia were analyzed by binary Logistic regression analysis. Results The detection rate of dysphagia in the elderly inpatients with sarcopenia was 66.28%. There were statistically significant differences in age, marital status, residential status, smoking history, drinking history, exercise habit, activity of daily living and the prevalence of severe sarcopenia between the two groups (P<0.05 or 0.01). Binary Logistic regression analysis showed that exercise habit was an independent factor for dysphagia in the elderly inpatients with sarcopenia. Conclusions Exercise has a positive effect on swallowing function, so we should pay attention to the elderly’s daily exercise, and reduce the risk of sarcopenia combined with dysphagia. References | Related Articles | Metrics