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20 September 2022, Volume 36 Issue 9 Previous Issue    Next Issue

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Effect of WeChat video combined with teach-back method on the quality of bowel preparation in elderly patients LIU Mei-hong, LU Xi, ZHAO Dan-dan, GU Ze-juan 2022, 36 (9):  869-872.  doi: 10.3969/j.issn.1003-9198.2022.09.002 Abstract ( 156 )   PDF (1232KB) ( 1093 )   Save Objective To investigate the effect of the WeChat video combined with teach-back method on the quality of bowel preparation before colonoscopy for elderly patients. Methods A total of 266 elderly patients who underwent colonoscopy in Department of Gastroenterology from October 2018 to October 2019 were enrolled, with 123 cases in the intervention group and 143 cases in the control group. The control group was given routine oral education and written instruction. The intervention group received video education on WeChat official account combined with the feedback method. The bowel cleansing rate, compliance of bowel preparation and the incidence rate of adverse reactions between the two groups were compared. Results Compared with the control group, the score of Ottawa Bowel Preparation Scale(OBPS) was improved, the qualified rate of bowel preparation increased,the taking proportion of bowel preparation solutions ≥75% increased and the compliance of walking activity improved in the intervention group. The incidence rates of abdominal distension, nausea and vomiting in the intervention group were significantly lower than those in the control group. Conclusions WeChat video combined with the teach-back method can improve bowel preparation quality, compliance, and enhance the patients' satisfaction. References | Related Articles | Metrics

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Effects of project management on bowel preparation in the elderly patients undergoing enteroscopy treatment ZHU Ling, XU Xin, CHEN Xiao-li, LIU Yu 2022, 36 (9):  873-877.  doi: 10.3969/j.issn.1003-9198.2022.09.003 Abstract ( 121 )   PDF (1790KB) ( 1061 )   Save Objective To explore the effects of project management on the cleansing rate after the bowel preparation in the elderly patients undergoing enteroscopy treatment. Methods Project management in the bowel preparation was carried out from July to December 2020. A total of 70 elderly patients treated by enteroscopy in our department during this period were enrolled in this study. And 70 elderly patients from January to June 2020 were enrolled as control group.The cleansing rate after the bowel preparation and the nursing job satisfaction of the discharged patients in the two groups were recorded . Results After the implementation of the project management, the intestinal cleansing rate of the elderly patients undergoing enteroscopy increased from 94.78% to 97.99%, and the nursing job satisfaction of the discharged patients increased from 98.82% to 99.9%. Conclusions Project management can improve the bowel cleansing rate after the bowel preparation in the elderly patients undergoing enteroscopy treatment. It is beneficial for improving the treatment effect of enteroscopy, nursing quality and patients'satisfaction. References | Related Articles | Metrics

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Efficacy and safety of double-balloon enteroscopy in the diagnosis and treatment of small intestinal diseases in elderly patients JIANG Wen-yu, JIAO Chun-hua, TANG Na-na, ZHANG Hong-jie, MA Jing-jing 2022, 36 (9):  878-882.  doi: 10.3969/j.issn.1003-9198.2022.09.004 Abstract ( 138 )   PDF (1627KB) ( 1119 )   Save Objective To evaluate the value of double-balloon enteroscopy (DBE) in the elderly patients with small intestinal diseases. Methods The clinical data of 418 patients with suspected small intestinal diseases who underwent double-balloon enteroscopy in the First Affiliated Hospital of Nanjing Medical University from January 2021 to May 2022 were retrospectively analyzed. The patients were divided into the young and middle-aged group (aged <60 years, n=357) and the elderly group (aged ≥60 years, n=61) . The diagnostic accuracy of DBE, etiology of small bowel disease, endoscopic treatment and complications were compared between the two groups. Results Small bowel bleeding and abdominal pain were the most common reasons for DBE in the elderly patients, accounting for 68.9% and 14.8%, respectively. The diagnostic accuracy was 90.1% in the elderly group,which was similar with that in the young and middle-aged group(93.8%)(P=0.251). The common diseases in the elderly group were intestinal ulcer and erosion (41.8%), vascular malformation (18.2%) and small intestinal tumor (12.7%),compared with Crohn's disease (57.1%), intestinal ulcer and erosion (24.5%) and diverticulum (4.5%) in the young and middle-aged group. The causes of small bowel diseases were significantly different between the two groups(P<0.001). 63.6% (7/11) of the elderly patients diagnosed as vascular malformations were successfully treated with DBE. No severe complications occurred in 418 patients. Conclusions DBE is a safe and effective method for the elderly patients with suspected small intestinal disease and has a high diagnostic accuracy. DBE is valuable for the treatment of vascular malformations in the elderly patients. References | Related Articles | Metrics

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Effect of enteral nutrition combined with Bifidobacterium triple viable on cardiac function and microinflammation in elderly patients with chronic heart failure LUO Te-dan, ZHOU Chong-chong, HUANG He-ming 2022, 36 (9):  883-887.  doi: 10.3969/j.issn.1003-9198.2022.09.005 Abstract ( 145 )   PDF (1082KB) ( 1515 )   Save Objective To explore the effect of enteral nutrition combined with Bifidobacterium triple viable on cardiac function and the levels of interleukin-1β(IL-1β), interleukin-6 (IL-6), serum amyloid A(SAA) in the elderly patients with chronic heart failure. Methods A total of 210 elderly patients with chronic heart failure in Department of Geratology of Shenzhen People's Hospital from November 2018 to May 2021 were randomly divided into the control group, the enteral nutrition group and the enteral nutrition combined with Bifidobacterium triple viable group(the combination group), with 70 cases in each group. The enteral nutrition group received basic treatment of heart failure and enteral nutrition. The combination group was treated with Bifidobacterium triple viable on the basis of the enteral nutrition group. The control group was given normal diet on the basis of the basic treatment. Four weeks later, the nutritional status indexes including albumin(ALB), prealbumin(PA), transferrin(TF), the levels of inflammatory factors including IL-1β, IL-6, SSA and cardiac function indexes including N-terminal pro-brain natriuretic peptide(NT-proBNP), ischemia-modified albumin(IMA) and left ventricular ejection fraction(LVEF) of the three groups before and after treatment were compared. Results The levels of ALB, PA, TF in the combination group after treatment were higher than those before treatment and those in the enteral nutrition group(P<0.05). The levels of ALB, PA, TF of the enteral nutrition group after treatment were higher than those before treatment and those in the control group(P<0.05). The level of LVEF in the three groups was increased after treatment(P<0.05). There was no significant difference in LVEF among the three groups after treatment (P>0.05). After treatment, the levels of IL-1β, IL-6, SSA and NT-proBNP, IMA were lowest in the combination group, followed by the enteral nutrition group and the control group(P<0.05). Conclusions Enteral nutrition combined with Bifidobacterium triple viable can improve the heart function of the elderly patients with chronic heart failure by improving the nutritional status and regulating the micro-inflammatory state. References | Related Articles | Metrics

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Myocardial microperfusion and prognosis in elderly patients with high thrombus burden of acute ST segment elevation myocardial infarction undergoing selective PCI after thrombus aspiration and recombinant human prourokinase LUO De-feng, LUAN Bo, HOU Ai-jie, WANG Cheng-fu, ZHAO Hong-wei, MENG Qing-kun, ZHANG Xiao-jiao, LI Yi, WANG Yong 2022, 36 (9):  888-891.  doi: 10.3969/j.issn.1003-9198.2022.09.006 Abstract ( 127 )   PDF (1122KB) ( 1319 )   Save Objective To investigate the effect of selective percutaneous coronary intervention(PCI) on myocardial microperfusion and prognosis in the elderly patients with acute ST segment elevation myocardial infarction (STEMI) and high thrombus burden (HTB) after thrombus aspiration and targeted intracoronary administration of recombinant human prourokinase (rhPro-UK). Methods A total of 141 elderly patients with STEMI-HTB were consecutively divided into emergency PCI group (69 cases) and delayed PCI group (72 cases). The delayed PCI group underwent selective PCI after receiving rhPro-UK to restore thrombolysis in myocardial infarction(TIMI)2-3 degree blood flow by puncturing balloon after thrombus aspiration; The emergency PCI group underwent emergency PCI after thrombus aspiration. The baseline information, intervention related indicators, myocardial microperfusion and prognosis of the two groups were compared. Results The peak value of creatine kinase myocardial isoenzyme(CK-MB), cardiac troponin I (cTnI), the number of stents implanted, the length of stents, the ratio of slow flow/no reflow, the corrected TIMI frames (cTFC) and TIMI myocardial perfusion frame count(TMPFC) in delayed PCI group were significantly lower than those in emergency PCI group (P＜0.05). At 1 month follow-up, there were no significant differences in all-cause death, stroke, target vessel revascularization(TVR) and heart failure between the emergency PCI group and the delayed PCI group (P>0.05). The level of left ventricular ejection fraction(LVEF) in the delayed PCI group one month later was significantly higher than that in the emergency PCI group (P=0.038). There were no significant differences in major and minor bleeding events between the two groups in hospital and during one month of follow-up (P>0.05). Conclusions Delayed PCI can significantly improve the myocardial microperfusion and cardiac function in the elderly patients with STEMI-HTB without an increase in major and minor bleeding. References | Related Articles | Metrics

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Risk factors and establishment of predictive model of 28-day death in elderly patients with sepsis JIAN Wan-jun, JIANG Chang-hua, FU Yi-long, SHU Ai-ya, ZHENG Chun 2022, 36 (9):  892-896.  doi: 10.3969/j.issn.1003-9198.2022.09.007 Abstract ( 138 )   PDF (1157KB) ( 1096 )   Save Objective To explore the risk factors of 28-day death in elderly patients with sepsis, and to further construct the prediction model. Methods A retrospective analysis of the clinical data of 637 elderly patients with sepsis from the ICU of our hospital from October 2016 to December 2020 was carried out. The clinical data of the patients were collected through the electronic medical record system, and the 28-day prognosis was recorded. Multivariate Logistic regression was used to analyze the risk factors of 28-day death in the elderly patients with sepsis, and the selected influencing factors were used to construct a predictive model, and the receive operating characteristic (ROC) curve was used to verify the model. Results Among 637 elderly patients with sepsis, 130 died in 28 days, with a mortality rate of 20.41%. Multivariate Logistic regression analysis showed that neutrophil-to-lymphocyte ratio (NLR)>17.50, APACHE Ⅱ score>22.75, neutrophil gelatinase-associated lipid carrier protein (NGAL)>535.29 ng/mL, activated partial thrombin time (APTT) >39.05 s at admission were the risk factors of death in 28 days in the elderly patients with sepsis. Lactic acid clearance (LCR) >25.36% was the protective factor. According to the results of Logistic regression analysis, a prediction model for death of sepsis patients was established. ROC curve analysis showed that the area under the curve (AUC) of the model predicting poor prognosis of sepsis was 0.878 (95%CI:0.802-0.935, P<0.001) in internal verification, with an accuracy of 80.85%. AUC was 0.856(95%CI:0.793-0.921, P<0.001) and the accuracy was 80.22% in external validation. Conclusions Elevated NLR, APACHE Ⅱ score, NGAL, APTT are risk factors, and elevated LCR is a protective factor for 28-day death due to sepsis in the elderly. The risk model constructed on this basis may predict the short-term mortality of the patients with sepsis. References | Related Articles | Metrics

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Investigation of functional fitness and the relationship with multimorbidity in the elderly XU Jing, LI Jiao-jiao, CHEN Ya, WANG Li 2022, 36 (9):  897-901.  doi: 10.3969/j.issn.1003-9198.2022.09.008 Abstract ( 138 )   PDF (1076KB) ( 1175 )   Save Objective To investigate the functional fitness in the elderly with multimorbidity, and to analyze the relationship between functional fitness and the occurrence of multimorbidity. Methods From March to June 2020, 432 elderly people in community were enrolled and received the screening of multimorbidity through the multimorbidity questionnaire and the fitness test including 2-minute step, 30 s chair stand, 30 s arm curl, back scratch, chair sit-and-reach, timed up and go test (TUGT) and body mass index (BMI). Results Compared with the elderly without multimorbidity, the elderly with multimorbidity had less repeated times in 2-minute step, 30 s arm curl and 30 s chair stand (P<0.05), and longer time in TUGT (P=0.007). With the increase of the number of chronic diseases, the results of 2-minute step and 30 s chair stand test showed a downward trend (P<0.05), while BMI and TUGT time showed an upward trend (P=0.038, 0.024). Logistic regression analysis showed that, in addition to age and economic source, 30 s arm curl times and BMI were the risk factors of multimorbidity (P<0.05). Conclusions The levels of aerobic capacity, muscle strength and motor agility/dynamic balance in the elderly patients with multimorbidity are lower than those without multimorbidityy. Age, economic source, obesity and upper limb strength show influence on the incidence of multimorbidity in the elderly. References | Related Articles | Metrics

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Early changes of bone turnover markers in elderly patients with osteoporotic vertebral compression fractures WEI Xuan-di, YUE Jian-biao, GOU Jing 2022, 36 (9):  902-906.  doi: 10.3969/j.issn.1003-9198.2022.09.009 Abstract ( 141 )   PDF (1081KB) ( 1044 )   Save Objective To explore the early changes of bone turnover markers in the elderly patients with osteoporotic vertebral compression fractures (OVCF). Methods A total of 35 elderly OVCF patients in our hospital were selected as the research group, and 35 healthy elderly were selected as the control group. The clinical data, serum levels of typeⅠprocollagen amino terminal propeptide (PINP), type Ⅰ collagen cross-linked carboxyl terminal peptide (CTX), 25-hydroxy vitamin D [25(OH)D] 1, 2, 3, 6, 8 and 12 weeks after fracture and dual-energy X-ray bone mineral density 1 and 12 weeks after fracture were detected and compared in the patients with different genders, ages, and the number of vertebral fractures. And the correlation between each index at the first week after fracture and gender, age, the number of vertebral fractures was analyzed. Results The serum levels of PINP, CTX, 25(OH)D and bone mineral density in the research group were lower than those in the control group at admission (P<0.05). The serum levels of PINP, CTX and 25(OH)D at the 2nd, 3rd, 6th, 8th and 12th weeks in the research group were significantly higher than those in the first week after fracture (P<0.05). The serum levels of PINP, CTX, 25(OH)D, the bone mineral density in the first week after fracture, and the bone mineral density 12 weeks after fracture showed significant differences in the patients with different gender, age and the number of vertebral fractures, respectively (P＜0.05). The serum levels of PINP, CTX, 25(OH)D and bone mineral density in the first week after fracture were significantly correlated with gender, age, and the number of vertebral fractures in the elderly patients with OVCF (P<0.01). Conclusions The serum levels of PINP, CTX, 25(OH)D and bone mineral density of the elderly patients with OVCF are significantly abnormal in the early stage after fracture, and the related factors include gender, age and the number of vertebral fractures. References | Related Articles | Metrics

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Effect of total laparoscopy and laparoscopic-assisted radical gastrectomy for distal gastric cancer in elderly patients LIU Bin-yang, LIU Zu-ding, LIU Zhong-ning, YANG Sheng-rong, ZHOU Qi-nan 2022, 36 (9):  907-910.  doi: 10.3969/j.issn.1003-9198.2022.09.010 Abstract ( 126 )   PDF (1059KB) ( 1111 )   Save Objective To investigate the effect of total laparoscopy and laparoscopic-assisted radical gastrectomy in the elderly patients with distal gastric cancer. Methods A total of 80 elderly patients with distal gastric cancer admitted to the Second People's Hospital of Guilin from January to August 2021 were divided into the laparoscopic-assisted group (n=40) and the total laparoscopic group (n=40) according to the treatment method. And the clinical data was collected retrospectively. Both groups were followed up for 2 weeks. The indicators before and after operation, the scores of visual analogue scale(VAS) 1, 2 and 3 d after operation and the complications during follow-up were compared between the two groups. Results The intraoperative blood loss in the total laparoscopic group was lower than that in the laparoscopic-assisted group, and the time of gastrointestinal anastomosis, exhaust, feeding and hospital stay were shorter than those in the laparoscopic-assisted group (P<0.05). The scores of VAS decreased in the two groups 1, 2, 3 d after operation, especially in the total laparoscopic group (P<0.05). During follow-up, the incidence rate of incision infection, duodenal stump fistula, lymphatic leakage and anastomotic fistula in the total laparoscopic group was 2.50%, 0, 2.50% and 0, respectively, compared with 5.00%, 0, 5.00% and 2.50% in the laparoscopic-assisted group (P>0.05). Conclusions Compared with laparoscopic-assisted radical gastrectomy for distal gastric cancer, total laparoscopy can significantly reduce the intraoperative blood loss in the elderly patients with distal gastric cancer, relieve pain and promote recovery, with high safety. References | Related Articles | Metrics

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Predictive value of prognostic nutritional index for the prognosis of elderly patients with severe chronic obstructive pulmonary disease YANG Jun-hong, LIANG Lan-yu, SHAN Qing 2022, 36 (9):  911-915.  doi: 10.3969/j.issn.1003-9198.2022.09.011 Abstract ( 133 )   PDF (1141KB) ( 1271 )   Save Objective To explore the predictive value of prognostic nutritional index (PNI) for the prognosis of the elderly patients with severe chronic obstructive pulmonary disease(COPD). Methods A retrospective analysis of the clinical data of 132 elderly patients with severe COPD who were admitted into the Affiliated Hospital of Yangzhou University from January 2016 to December 2019 was conducted. The receiver operator characteristic (ROC) curve was used to analyze the correlation between PNI and the prognosis. The patients were divided into a death group and a survival group according to the survival 6 months later, and the differences in the levels of the clinical indicators were compared between the two groups. COX regression model and Kaplan-Meier curve were used to explore the relationship between PNI and the prognosis of the elderly patients with severe COPD. Results A total of 132 patients were included, with 72 cases in the death group and 60 cases in the survival group. The best cut-off value of PNI was 37.32. Multivariate COX regression analysis indicated that age, PNI<37.32 and total hospital stay were the independent prognostic factors for death in the elderly patients with severe COPD. Conclusions PNI shows predictive value for the prognosis of the elderly patients with severe COPD, and PNI<37.32 indicates poor survival. References | Related Articles | Metrics

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A case-control study on risk factors of nosocomial pulmonary infection during chemotherapy for lung cancer in elderly SHI Bin, WANG Rui, HAN Han, WANG Xiao-yu, WANG Li-fang, LIU Xing, SHI Yi 2022, 36 (9):  916-919.  doi: 10.3969/j.issn.1003-9198.2022.09.012 Abstract ( 146 )   PDF (1052KB) ( 1194 )   Save Objective To investigate the risk factors of nosocomial pulmonary infection during chemotherapy for lung cancer in the elderly. Methods A total of 98 patients who presented with nosocomial pulmonary infection during chemotherapy in the Department of Respiratory and Critical Care Medicine of the Affiliated Suqian Hospital of Xuzhou Medical University from July 2016 to December 2019 were selected as the case group, and 98 patients treated with the same number of chemotherapy cycles who did not suffer from pulmonary infection were adopted as the control group. The age, gender, pathological type and other factors were compared between the case group and the control group, and the risk factors of nosocomial pulmonary infection during chemotherapy were analyzed. Results Univariate Logistic regression analysis showed that age ≥70 years old, complicated with underlying diseases, colonization of pathogenic bacteria in airway, small cell lung cancer, lung cancer at stage Ⅲ-Ⅳ, posterior chemotherapy, combined with radiotherapy, neutropenia and infection in other sites were associated with nosocomial pulmonary infection during chemotherapy(P<0.05). Binary Logistic regression analysis showed that age ≥70 years, colonization of pathogenic bacteria in airway, small cell lung cancer, combined with radiotherapy and neutropenia were the independent risk factors for nosocomial pulmonary infection during chemotherapy in the elderly patients with lung cancer (P<0.05). Conclusions The incidence of nosocomial pulmonary infection during chemotherapy in the elderly patients with lung cancer is high, and there are many risk factors. Therefore, active measures should be taken to strengthen the prevention of relevant risk factors. References | Related Articles | Metrics

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Mediating effect of perceived stress on self-neglect and frailty in hospitalized elderly patients YUAN Sheng-nan, ZHOU Jing, LI Min 2022, 36 (9):  920-923.  doi: 10.3969/j.issn.1003-9198.2022.09.013 Abstract ( 144 )   PDF (1109KB) ( 1186 )   Save Objective To investigate the mediating role of perceived stress between self-neglect and frailty in hospitalized elderly patients, and to provide theoretical basis for improving the physical and mental health of hospitalized elderly patients. Methods The samples were selected by convenience sampling. General information questionnaire, Elderly Self-Neglect Questionnaire, Fried Frailty Phenotype, Chinese Perceived Stress Scale and Short-Form Mini-Nutritional Assessment were used in 380 elderly patients. Process V3.5 plug-in in SPSS 23.0 was used to test the mediating effect of perceived pressure. Results Perceived stress score had a positive correlation with self-neglect and frailty. Self-neglect had a positive correlation with frailty. Perceived stress mediated the relationship between self-neglect and frailty, accounting for 20.63% of the total effects. Conclusions Perceived pressure plays a mediating role in the relationship between self-neglect and frailty in hospitalized elderly patients. It is important to pay more attention to the relationship between self-neglect and perceived pressure in hospitalized elderly patients to reduce the incidence of frailty. References | Related Articles | Metrics

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Effects of abiraterone on PI3K/AKT signaling pathway and tumor markers in elderly patients with prostate cancer WANG Jian-wei, WANG Qiang, LI Ding 2022, 36 (9):  924-928.  doi: 10.3969/j.issn.1003-9198.2022.09.014 Abstract ( 121 )   PDF (1084KB) ( 858 )   Save Objective To study the effects of abiraterone on phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT) signal pathway and the levels of tumor markers in the elderly patients with prostate cancer. Methods A total of 88 elderly patients with prostate cancer treated in our hospital from June 2018 to June 2020 were enrolled in this study. They were randomly divided into two groups, with 44 cases in each group. The control group was treated with prednisone and the observation group was treated with abiraterone acetate on the basis of the control group. The expression of PI3K/AKT signal pathway after treatment was detected, and the levels of serum prostate specific antigen (PSA), carcinoembryonic antigen (CEA), tumor cytokeratin 19 fragment (CYFRA21-1) and neuron specific enolase (NSE) were measured and compared between the two groups before and after treatment. The distribution of T lymphocyte subsets and the inflammatory factor including interleukin-8 (IL-8) and tumor necrosis factor α (TNF-α)were observed before and after treatment. All patients were followed up for 1 year, and the 1-year survival rate of the two groups was compared. Results The expression levels of AKT and PI3K in the observation group were significantly lower than those in the control group (P＜0.05 or P<0.01). The levels of serum PSA, CEA, CYFRA21-1 and NSE in the two groups after treatment were significantly lower than those before treatment (P<0.05), especially in the observation group (P<0.01). The levels of CD4+, CD4+/CD8+ after treatment were significantly higher than those before treatment in both groups (P<0.05), especially in the observation group(P<0.01). The levels of IL-8, TNF-α were significantly lower than those before treatment in both groups, especially in the observation group (P<0.05 or P<0.01). The 1-year overall survival rate in the observation group was significantly higher than that in the control group (P<0.05). Conclusions Abiraterone can effectively improve the inflammatory level and immune function of the elderly patients with prostate cancer, and can inhibit the expression of PI3K and AKT and reduce the levels of tumor markers. It is valuable to prolong the survival time of the patients. References | Related Articles | Metrics

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Effect of primary suture of the common bile duct under laparoscope in elderly patients with choledocholithiasis FENG Yong-heng, ZHAO Si-qi, ZHOU Jin, XIAO Hua 2022, 36 (9):  929-932.  doi: 10.3969/j.issn.1003-9198.2022.09.015 Abstract ( 107 )   PDF (1064KB) ( 884 )   Save Objective To investigate the therapeutic effects of primary suture of the common bile duct under laparoscope and T tube drainage in the treatment of the elderly patients with choledocholithiasis. Methods A total of 135 elderly patients with common bile duct stones admitted to the Department of General Surgery, Nanjing Hospital Affiliated to Nanjing Medical University from January 2017 to January 2021 were enrolled. According to the suture method of the common bile duct, the patients were divided into primary suture group (n=64) and T-tube drainage group (n=71). The general data, preoperative examination data, intraoperative exploration findings and postoperative recovery of the patients in the two groups were compared and analyzed. Results There were no significant differences between the two groups in general conditions, first symptoms, preoperative examinations, the average common bile duct diameter, tube wall thickness and mean intraoperative blood loss (P>0.05). The average duration of the operation in the primary suture group was shorter than that in the T-tube drainage group (P<0.05). There were no significant differences in the time of first ventilation, hospital stay and the incidence rate of postoperative biliary fistula between the two groups (P>0.05). One case received re-operation due to severe biliary fistula in the primary suture group. In the T-tube drainage group, one patient's T-tube slipped off after being discharged from the hospital, and another 3 cases suffered from a biliary fistula when the T-tube was removed. Conclusions The primary suture of the common bile duct under laparoscope will not lead to an increase of complications, and at the same time, it can improve the comfort and satisfaction of the patients after treatment. It is a safe and effective method for the treatment of the elderly patients with choledocholithiasis. References | Related Articles | Metrics

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Study on a clinical and radiomics data-based model for predicting biochemical recurrence of prostate cancer YANG Hao, SHI Jie 2022, 36 (9):  933-937.  doi: 10.3969/j.issn.1003-9198.2022.09.016 Abstract ( 128 )   PDF (1503KB) ( 960 )   Save Objective To develop a model based on clinical data and contrast-enhanced ultrasound (CEUS) and MRI results for predicting biochemical recurrence of prostate cancer (PCa) in the elderly patients confirmed by targeted biopsy. Methods The clinical data of 169 elderly patients who underwent radical prostatectomy from January 2018 to February 2020 in Taizhou Hospital of Traditional Chinese Medicine were analyzed retrospectively. The cases were divided into biochemical recurrence group (n=65) and normal group (n=104) according to the results of 2-4 years of follow-up. PCa biochemical recurrence was defined as two consecutive detection of PSA ≥0.2 ng/mL . General data model, CEUS model, MRI radiomics model and combined model to predict the biochemical recurrence of PCa were established based on the clinical-imaging data of these patients. The predictive effects were compared among the four models. Results Logistic regression analysis showed that the tumor diameter, preoperative PSA concentration, treatment mode, elastography grade, small area high gray level emphasis and run variance were the independent risk factors of biochemical recurrence. In the training set, the combined model based on clinical-imaging parameters showed the highest predictive efficiency of PCa biochemical recurrence than general data model, contrast-enhanced ultrasound model and MRI radiomics model. Conclusions The predictive value of clinical data or imaging data alone for PCa biochemical recurrence is not ideal. The combined model provides an opportunity for clinical screening of biochemical recurrence population and helps to improve the prognosis of PCa. References | Related Articles | Metrics

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Study on three-agent and dual-track interactive intervention based on mobile platform after total knee replacement HUA Long-ang, JI Hai-biao, CHEN Gao-xiang, YANG Shuai 2022, 36 (9):  938-941.  doi: 10.3969/j.issn.1003-9198.2022.09.017 Abstract ( 134 )   PDF (1116KB) ( 1541 )   Save Objective To observe the rehabilitation effect of three-agent and dual-track interactive intervention based on mobile platform after total knee replacement. Methods A total of 86 patients receiving total knee replacement were divided into control group and observation group according to random number table, with 43 patients in each group. The control group received routine rehabilitation treatment, and the observation group received three-agent and dual-track interactive intervention based on the mobile platform. The active range of motion (AROM), hospital for special surgery(HSS) knee score, timed up and go test(TUGT), Berg Balance Scale(BBS) and World Health Organization Quality of Life-abbreviated version(WHOQOL-BREF)were used to evaluate the therapeutic effect of the two groups. Results There were no significant differences in AROM, HSS knee score, BBS score, time of TUGT and WHOQOL-BREF score between the two groups before intervention. After 12 weeks of intervention, AROM, the scores of HSS, BBS and WHOQOL-BREF in the two groups were higher than those before intervention, and the time of TUGT was less than that before intervention, especially in the observation group (P<0.05). Conclusions Three-agent and dual-track interactive intervention based on mobile platform can increase the knee range of motion in the patients receiving total knee arthroplasty, promote the recovery of knee joint function, improve the walking ability and balance ability, and has positive significance for improving the quality of life. References | Related Articles | Metrics

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Construction and evaluation of dynamic nomogram chart of the risk of enteral nutrition intolerance in patients with severe stroke SUN Xiao-lan, LI Zhan-xiao, YU Xiao-wen, CHAI Hui-rong 2022, 36 (9):  942-947.  doi: 10.3969/j.issn.1003-9198.2022.09.018 Abstract ( 150 )   PDF (1296KB) ( 1438 )   Save Objective To identify the influencing factors of enteral nutrition intolerance in the patients with severe stroke, and to build a dynamic prediction model and to verify the prediction effect. Methods A total of 282 patients with severe stroke admitted to our hospital from January 2018 to June 2020 were enrolled in this study. Single factor analysis and multivariate Logistic regression analysis were used to screen the risk factors of enteral nutrition intolerance, and a nomogram prediction model was established based on the risk factors. Internal and external evaluations of the model's predictive effect were conducted. Results Feeding intolerance occurred in 107 of the 282 patients with severe stroke, with an incidence rate of 37.94%. Based on the results of Logistic regression analysis, four factors including aged ≥60 years old(OR=1.965), use of 2 or more antibacterial drugs (OR=2.749), use of probiotics (OR=0.321), and implementation of mechanical ventilation (OR=3.035) were included in the R software to establish a predictive nomogram model of enteral nutrition intolerance in stroke patients. Internal and external verification showed that the areas under the receiver operating characteristic curve of the model group and the verification group were 0.794 and 0.764 respectively, and the calibration curves were all close to the ideal curve. The model group's maximum Youden index was 0.449, and the corresponding risk predictive value was 0.322, and the predictive threshold value was 200. When the decision curve analysis (DCA) threshold probability ranged 0.10-0.85, the model showed a positive net benefit. Conclusions The nomogram model established based on the risk factors of enteral nutrition intolerance in the patients with severe stroke shows good discrimination, consistency and clinical applicability. High-risk patients with a total score of ≥200 should be given great attention, and preventive care intervention should be implemented as soon as possible to reduce the occurrence of enteral nutrition intolerance. References | Related Articles | Metrics

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Clinical effects of water-filtered infrared-A combined with extracorporeal shock wave in elderly patients with rotator cuff injury XI Yang, GU Xiao-mei, KONG Yi-meng, ZHANG Gui-lin, SUN Zhi-cheng 2022, 36 (9):  948-951.  doi: 10.3969/j.issn.1003-9198.2022.09.019 Abstract ( 162 )   PDF (1062KB) ( 1112 )   Save Objective To observe the clinical effect of water-filtered infrared-A combined with extracorporeal shock wave in the treatment of elderly patients with rotator cuff injury. Methods A total of 62 elderly patients with rotator cuff injury were randomly divided into the control group and the observation group, with 31 cases in each group. Both groups received water-filtered infrared-A therapy, and the observation group received extracorporeal shock wave therapy additionally.Visual analog scale(VAS), University of California at Los Angeles(UCLA)shoulder scale and range of motion(ROM)were assessed before and 4 weeks after treatment,and the clinical efficacy was also compared between the two groups after 4 weeks of treatment. Results There were no significant differences in VAS, score of UCLA shoulder scale and ROM of shoulder joint of abduction,inward rotation and outward rotation between the two groups before treatment(P>0.05).After 4 weeks of treatment, the scores of VAS, UCLA shoulder scale and ROM of abduction,inward rotation and outward rotation improved in both groups,especially in the observation group(P<0.05 or P<0.01). After 4 weeks of treatment,the clinical effect of the observation group was more significant than that of the control group(P<0.05). Conclusions Water-filtered infrared-A combined with extracorporeal shock wave can relieve pain and improve the function and ROM of shoulder joint in the elderly patients with rotator cuff injury,and the clinical effect is significant. References | Related Articles | Metrics