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20 December 2022, Volume 36 Issue 12 Previous Issue    Next Issue

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Risk factors for postoperative delirium in elderly patients with preoperative malnutrition undergoing hip arthroplasty under endotracheal intubation and general anesthesia ZHANG Ying, HU Yu-ping, GUO Xian, ZHANG Li-dong 2022, 36 (12):  1203-1206.  doi: 10.3969/j.issn.1003-9198.2022.12.005 Abstract ( 143 )   PDF (1132KB) ( 917 )   Save Objective To explore the risk factors for postoperative delirium (POD) in the elderly patients with preoperative malnutrition undergoing hip arthroplasty under tracheal intubation and general anesthesia. Methods A total of 149 elderly patients with malnutrition or risk of malnutrition before surgery undergoing hip arthroplasty were selected and divided into the POD group and the non-POD group according to whether they presented with delirium after the operation. The clinical data in two groups were observed and compared. Multivariate Logistic regression analysis was used to analyze the risk factors for POD in the elderly patients with preoperative malnutrition undergoing hip arthroplasty under tracheal intubation and general anesthesia. Results Among 149 patients, POD occurred in 60 patients, and the incidence rate of POD was 40.27%.There were significant differences in age, body mass index(BMI), hypoxemia, electrolyte disturbances, nutritional status, levels of cognitive function score, serum albumin and hemoglobin, length of operation, intraoperative bleeding, postoperative analgesia between the two groups (P<0.05). Multivariate Logistic regression analysis suggested that age ≥75 years, BMI <20, Mini-Nutritional Assessment Short-Form score <7, Mini-Mental State Examination score <27 and serum albumin <30 g/L were the risk factors for POD (P<0.05), and the postoperative analgesia was a protective factor for POD (P<0.05) in the elderly patients with preoperative malnutrition or malnutrition risk undergoing hip arthroplasty under general anesthesia. Conclusions The incidence of POD in the elderly patients with preoperative malnutrition or malnurtition risk undergoing hip arthroplasty under endotracheal intubation and general anesthesia is high. The incidence of POD is closely related to the patients' age, BMI, nutritional status,cognitive function, level of albumin and postoperative analgesia. References | Related Articles | Metrics

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Clinical value of serum lncRNA 00707 in the diagnosis of gastric cancer SHI Heng-chuan, KONG Shan 2022, 36 (12):  1207-1210.  doi: 10.3969/j.issn.1003-9198.2022.12.006 Abstract ( 125 )   PDF (1332KB) ( 1042 )   Save Objective To investigate the clinical value of long non-coding RNA (lncRNA 00707), carcinoembryonic antigen (CEA) and carbohydrate antigen (CA19-9) in peripheral blood in the diagnosis of gastric cancer in the elderly patients. Methods The serum samples of 40 patients with gastric cancer confirmed by pathology and 40 healthy subjects were collected. The relative expression level of serum lncRNA 00707 was detected by real-time fluorescence quantitative PCR (RT-qPCR). The levels of CEA, CA19-9 and the biochemical parameters were detected. The diagnostic efficacy of serum lncRNA 00707, CEA and CA19-9 alone and in combination was evaluated by receiver operating characteristic (ROC) curve. Results The expression of lncRNA 00707 was detected by RT-qPCR with high repeatability and stability. The serum level of LncRNA 00707 in the patients with newly diagnosed gastric cancer was significantly higher than that in the healthy subjects, and the combined detection of lncRNA 00707 and CEA could improve the diagnostic efficiency of gastric cancer. The expression level of lncRNA 00707 decreased in the patients with gastric cancer after surgery. Conclusions The expression level of serum lncRNA 00707 in the patients with newly diagnosed gastric cancer is significantly up-regulated. Detection of serum lncRNA 00707 can assist in the diagnosis of gastric cancer, and is expected to become a new target for the diagnosis and treatment of gastric cancer. References | Related Articles | Metrics

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Establishment of diagnostic model of colorectal polyps using blood indicators in the elderly ZHANG Xin-rui, YU Qin-qi, LI Xiao-lin 2022, 36 (12):  1211-1214.  doi: 10.3969/j.issn.1003-9198.2022.12.007 Abstract ( 117 )   PDF (1442KB) ( 1139 )   Save Objective To explore the relationship between blood indicators and the types of colorectal polyps, and to construct a diagnostic model for early diagnosis of colorectal cancer in the elderly patients. Methods The data of the elderly patients who preformed electronic colonoscopy and polypectomy in Jiangsu Province Hospital from January to June 2020 were collected and compared between the groups with different pathological types, including baseline information (gender, age), blood indicators (blood cell counter, liver enzyme, bilirubin, lipid indices, nutrition state, electrolytes, tumor makers, coagulation indices, inflammatory indicators) and the area, maximum diameter of the polyps. Binary Logistic regression was used to analyze the influencing factors of adenomatous polyps. A polyp diagnostic model was established. Results The levels of serum potassium, monocytes, lymphocyte /monocyte (LM ratio), platelet, neuron-specific enolase (NSE), polyp size, and maximum polyp diameter in the elderly patients with adenomatous polyps were significantly different from those in the elderly with other types of of polyps. A binary Logistic regression model was established to plot the ROC curve and Calibration curve. The AUC value of the serological model to diagnose adenomatous polyps was 0.824(P=0.000) . Conclusions The independent risk factors of adenomatous polyps in the elderly patients include serum potassium, monocytes, LM ratio, platelet, NSE, polyp area and maximum diameter. And the pre-endoscopic diagnostic model of colorectal polyps shows significant value in diagnosing adenomatous polyps. References | Related Articles | Metrics

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Development and validation of reliability and validity of Chinese version of activities of daily living scale ZHAO Yuan-ping, DING Rui, XIE Hong 2022, 36 (12):  1215-1219.  doi: 10.3969/j.issn.1003-9198.2022.12.008 Abstract ( 129 )   PDF (1144KB) ( 1228 )   Save Objective To construct the Chinese version of activity of daily living (ADL) scale for accurate assessment and provide long-term care services. Methods Convenient sampling method was used to evaluate 4590 elderly people in China with Chinese version of ADL scale and Barthel index at the same time. Descriptive analysis, exploratory factor analysis, Cronbach's α coefficients, clustering analysis, correlation analysis, paired chi square test were used to describe the scale and verify its reliability and validity. Results The Chinese version of ADL scale showed good reliability and validity, and the total score can be divided into 5 levels. The average score of ADL was 28.84±16.86. Compared with Barthel Index,The r value between corresponding items was -0.694--0.986 (P<0.01). The grade of very severe disability was used as the positive result of severe disability, and the kappa value was 0.875 (P<0.01) in paired chi square test. Conclusions The evaluation results of Chinese version of ADL scale and Barthel Index are consistent, and the accuracy of ADL scale in screening severe disability is higher, which can be widely used in the field of long-term care and pension. References | Related Articles | Metrics

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Influence of the ratio of stress-induced blood glucose elevation on the emergency outcome of elderly patients with heart failure XIAO Feng, QIN Hai-dong, SUN Cai-zhi, LIU Xiao-dong 2022, 36 (12):  1220-1224.  doi: 10.3969/j.issn.1003-9198.2022.12.009 Abstract ( 128 )   PDF (1194KB) ( 715 )   Save Objective To analyze the effect of stress hyperglycemia ratio (SHR) on the emergency outcome of elderly patients with heart failure. Methods A retrospective analysis was carried out on the clinical data of 106 elderly patients with heart failure admitted to our hospital from January 2018 to January 2021. The patients were divided into poor outcome group (n=68) and good outcome group (n=38) according to the emergency outcome. The endpoint events of the elderly patients with heart failure in poor outcome group were analyzed. The clinical data of the two groups were analyzed, and Logistic regression analysis was used to identify the risk factors for poor emergency outcome in the elderly patients with heart failure. The predictive value of SHR for poor emergency treatment in the elderly patients with heart failure was analyzed. Results A total of 68 out of 106 patients had adverse endpoint events, and 48 cases were major adverse cardiovascular events (MACE), with all-cause deaths (19.81%) as the main cause; the other 20 cases were the secondary endpoint events, with recurrence of angina pectoris (11.32%) as the main cause. Multivariate Logistic analysis showed that age ≥ 60 years, LVEF <40%, cardiogenic shock, SHR ≥ 1.05, NT-proBNP ≥ 5000 μg/L, WBC ≥ 7×109/L were the risk factors of poor emergency outcome in the elderly patients with heart failure (P<0.05). SHR has a sensitivity of 73.5% and a specificity of 73.7% in predicting poor emergency outcome in the elderly patients with heart failure. Conclusions SHR≥1.05 is a risk factor for poor emergency outcome in the elderly patients with heart failure, which has a better predictive value for poor emergency outcome. References | Related Articles | Metrics

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Influence and predictive value of operation duration on abnormal blood glucose in elderly non-diabetic patients receiving surgery WANG Lin, LIU Ting, WANG Ran, CAO Peng 2022, 36 (12):  1225-1228.  doi: 10.3969/j.issn.1003-9198.2022.12.010 Abstract ( 112 )   PDF (1201KB) ( 806 )   Save Objective To explore the predictive value of operation duration for the abnormal blood glucose in the elderly non-diabetic patients receiving surgery. Methods The data of 307 elderly patients receiving surgery from May to August 2021 in Xuanwu Hospital of Capital Medical University was analyzed. An arterial catheter was established before the operation to measure the blood glucose level during the operation. The arterial blood glucose during operation ranging from 4.2~6.4 mmol/L was defined as normal blood glucose. SPSS 24.0 software was used to analyze the data. Logistic regression analysis was used to analyze the correlation between operation time and abnormal blood glucose in the elderly non-diabetic patients receiving surgery, and the area under the receiver operating characteristic curve (AUC) was used to evaluate the predictive ability. Results A total of 200 elderly non-diabetic patients receiving surgery were enrolled. After adjusting for important confounding factors, the operation duration> 4 h was significantly correlated with intraoperative blood glucose abnormalities (OR=8.983,95% CI: 2.953-27.320,P＜0.001). The AUC for predicting abnormal blood glucose during operation was 0.819, with a sensitivity of 0.735, and a specificity of 0.774. Conclusions The operation time has a better predictive value for abnormal blood glucose during surgery in the elderly non-diabetic patients receiving surgery. It is important to improve the awareness and management of intraoperative blood glucose abnormalities. References | Related Articles | Metrics

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Clinical value of serum amyloid-beta 42 and phosphorylated Tau in elderly patients ZHENG Qian, TAO Yue, CHEN Yi-qiang, LIU Si-yuan, CHEN De-zhu, PENG Lu, GU Shou-yong, CAI Min-qi, BAI Bing 2022, 36 (12):  1229-1232.  doi: 10.3969/j.issn.1003-9198.2022.12.011 Abstract ( 129 )   PDF (1139KB) ( 836 )   Save Objective To investigate the clinical value of serum amyloid-beta 42(Aβ42) and phosphorylated Tau (p-Tau). Methods A total of 425 elderly cases were enrolled in this study who received the measurement of Aβ42 and p-Tau at the same time. The positive rate of Aβ42 and p-Tau was analyzed in the elderly patients with dementia or other diseases. Results The overall positive rate of serum Aβ42 and p-Tau was 36.2% and 24.7% respectively, and 21.4% of the patients presented with both positive Aβ42 and p-Tau. Among the patients diagnosed as cognitive impairment, dementia and AD, the positive rate of Aβ42 was 23.8%, 44.9%, 50.0% respectively, and the positive rate of p-Tau was 12.4%, 22.4%, 16.7% respectively. However, both of them were positive in 64.7% of the patients with pulmonary infection or inflammation diseases, and they were almost positive simultaneously in a patient. Conclusions The diagnostic values of serum Aβ42 and p-Tau for AD might be limited, but they might be potential indicators of pulmonary infection or inflammation disorders. References | Related Articles | Metrics

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Comparison of the prevalence of hypertension in 2000 and 2017 among elderly aged ≥ 60 years old in urban areas of Nanjing, China TIAN Si-yu, WANG Zhi-yong, DOU Yu, XU Fei 2022, 36 (12):  1233-1237.  doi: 10.3969/j.issn.1003-9198.2022.12.012 Abstract ( 128 )   PDF (1141KB) ( 740 )   Save Objective To investigate the prevalence of hypertension among the elderly aged ≥ 60 years old in urban areas of Nanjing. Methods Two cross-sectional surveys were carried out in the same urban areas of Nanjing, China, in 2000 and 2017. The same multi-stage sampling approach was used to randomly select participants. The information of the participants' demographic and anthropometric characteristics was collected. The level of blood pressure was measured. The outcome variables were self-reported hypertension and field-measured hypertension. Chi-square test was used to examine the differences in the prevalence of hypertension between the subgroups by demographic characteristics. Results The crude prevalence of hypertension in the elderly in uban area of Nanjing was 52.9% in 2000 and 65.8% in 2017 (P<0.05). The prevalence of hypertension in the male was higher than that in the female in both years (P<0.05). There were significant differences in the prevalence of hypertension among the elderly with different ages and education levels (P<0.05). The prevalence of self-reported hypertension was increased, while the prevalence of field-measured hypertension was decreased with time (P<0.05). There was a difference in self-reported hypertension prevalence, while no difference in field-measured hypertension prevalence between the elderly with different genders. The highest self-reported hypertension prevalence was observed in those aged 70-79 years old (P<0.05). The awareness rate, treatment and control rate of hypertension in 2017 were significantly higher than those in 2000 (P<0.05). Conclusions The prevalence of hypertension is high in the elderly population in Nanjing, and shows a rising trend. It is important to pay attention to the prevention of hypertension in the male elderly, or in the elderly aged ≥70 years old or with low education level. References | Related Articles | Metrics

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Effect of long-term use of ACEI/ARB on the renal function in elderly patients receiving percutaneous coronary intervention ZHU Jing-dong, XU Yu, CHEN Qun, WANG Li-qun 2022, 36 (12):  1238-1241.  doi: 10.3969/j.issn.1003-9198.2022.12.013 Abstract ( 107 )   PDF (1142KB) ( 802 )   Save Objective To observe the effects of long-term use of angiotensin-converting enzyme inhibitor (ACEI) or angiontensin receptor blocker(ARB) on the renal function in the elderly patients receiving percutaneous coronary intervention (PCI). Methods A total of 112 elderly patients with normal or mild abnormal renal function who underwent PCI were divided into observation group (using ACEI or ARB, n=58) and control group (not using ACEI or ARB, n=54). The serum level of creatinine(CRE) and glomerular filtration rate(eGFR) before or 24, 48 hours after PCI were detected and compared between the two groups. Results The level of CRE was significantly higher and the level of eGFR was significantly lower in both groups 24, 48 hours after PCI than that before PCI, especially in observation group (P<0.05). One patient(1.85%) presented with contrast-induced nephropathy (CIN) in control group. There was no statistical difference in the incidence rate of CIN between two goups (P=0.482). Conclusions In the elderly patients undergoing coronary intervention,long-term use of ACEI or ARB would reduce the effect of contrast medium on the renal function,but does not show a significant adverse effect on the incidence of CIN. References | Related Articles | Metrics

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Effects of transnasal humidified rapid-insufflation ventilatory exchange in the elderly patients receiving painless gastroscopy combined with colonoscopy CAO Yuan-yuan, DING Ke, ZHAO Xiu-xiu, XU Man, HU Jing, FANG Zhao-jing 2022, 36 (12):  1242-1246.  doi: 10.3969/j.issn.1003-9198.2022.12.014 Abstract ( 110 )   PDF (1143KB) ( 768 )   Save Objective To observe the efficacy and safety of transnasal humidified rapid insufflation ventilatory exchange (THRIVE) in the elderly patients receiving painless gastroscopy combined with colonoscopy. Methods One hundred and twenty patients who need painless gastroscopy combined with colonoscopy, aged 65-79 years old, with an American Society of Anesthesiologists physical status of Ⅰ-Ⅲ, with body mass index of 18-28, with a Mallampatti of Ⅰ or Ⅱ, were divided into two groups (n=60) using a random number table method, nasal catheter oxygen inhalation group (group C) and THRIVE group (group T). The adverse reactions and treatments related to hypoxia during operation were recorded according to the procedure of Society of Intravenous Anaesthesia (SIVA). The other adverse events including involuntary limbs swing, choking cough, vomiting, airway injury and air pressure injury were recorded as well. The levels of the hemodynamic index of the patients before anesthesia (T0), after insertion of the gastroscope (T1), and at the time of awaking (T2) were recorded. The operation time, recovery time, total dose of propofol and remifentanil, satisfaction of the anesthesiologists, operators and the patients were recorded after the operation. Results Compared with group C, the incidence rates of SpO2<95%, jaw-lift, pressured mask, inserted asopharyngeal airway and involuntary limbs swing in group T were significantly decreased(P<0.05), and the dosage of propofol was increased (P<0.05), and the satisfaction of the anesthesiologists, operators and the patients was significantly improved (P<0.05).The levels of hemodynamic index, the dose of remifentanil, the operation and recovery time showed no significant differences between the two groups (P>0.05). No patients presented with airway injury or air pressure injury in both groups. Conclusions THRIVE can maintain the oxygenation in the elderly patients receiving painless gastroscopy combined with colonoscopy more safely and effectively, reducing the incidence of the involuntary limbs swing and improving the satisfaction of the doctors and patients. References | Related Articles | Metrics

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Analysis of clinical characteristics and related risk factors of heart failure with preserved ejection fraction in elderly patients with hypertension ZHANG Ming-rui, CUI Wen-xia, GAO Lei, LI Man, HU yun 2022, 36 (12):  1247-1250.  doi: 10.3969/j.issn.1003-9198.2022.12.015 Abstract ( 124 )   PDF (1135KB) ( 786 )   Save Objective To investigate the clinical characteristics and related risk factors of heart failure with preserved ejection fraction (HFpEF) in the elderly patients with hypertension. Methods A total of 569 elderly patients with hypertension were enrolled in this study. According to whether presenting with HFpEF, the patients were divided into HFpEF group and control group. The clinical characteristics of the two groups were analyzed. Multiple Logistic regression was used to analyze the risk factors of HFpEF in the elderly patients with hypertension. Results The age, proportion of female, overweight, type 2 diabetes mellitus, serum levels of B type natriuretic peptide, urea nitrogen and creatinine in HFpEF group were significantly higher than those in control group (P< 0.05). The diastolic ventricular septal thickness, diastolic left ventricular diameter, diastolic left ventricular posterior wall thickness, left atrial diameter and left ventricular mass index in HFpEF group were significantly higher than those in control group (P < 0.01). Logistic regression analysis showed that the related risk factors of HFpEF in the elderly hypertensive patients included female, overweight, type 2 diabetes mellitus and left ventricular mass index. Conclusions The incidence of HFpEF might be influenced by gender, overweight, type 2 diabetes mellitus and left ventricular mass index in the elderly hypertensive patients. References | Related Articles | Metrics

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Median effective concentration and 95% effective concentration of remifentanil inhibiting pain response in elderly patients undergoing percutaneous kyphoplasty RUAN Shan, CHEN Xia, YANG Wen, ZHANG Peng, GUI Bo, QU Lei-qiu 2022, 36 (12):  1251-1254.  doi: 10.3969/j.issn.1003-9198.2022.12.016 Abstract ( 124 )   PDF (1181KB) ( 804 )   Save Objective To explore the median effective concentration (EC50) and 95% effective concentration (EC95) of remifentanil inhibiting balloon dilation-induced pain response in the elderly patients undergoing percutaneous kyphoplasty (PKP). Methods The patients scheduled for selective PKP under monitored anesthesia care (MAC) were sequentially enrolled in this trial. Target-controlled infusion (TCI) of remifentanil was performed from 5 min before surgery to time-point of bone cement implantation. The plasma concentration of remifentanil was set at 1.44 ng/mL in the first patient, and the ratio of adjacent target concentrations was 1.2. When the patients were treated with balloon dilatation,the score of Numerical Rating Scale(NRS)>3 was regarded as positive reaction. When a positive reaction occurred, the next patient will be treated with an increased concentration gradient. And if a negative reaction occurred, the next patient will be treated with a decreased concentration gradient. The trial was finished until 6 intersections from positive reaction to negative one. EC50 and EC95 of remifentanil effectively inhibiting pain response induced by vertebral balloon dilatation in the elderly patients were calculated by Probit regression analysis method. Results A total of 20 patients were enrolled, with ASA grade Ⅰ-Ⅲ. TCI of remifentanil significantly decreased the intraoperative NRS in the elderly patients scheduled for PKP. By Probit regression analysis method, EC50 and EC95 of remifentanil inhibiting the pain response induced by balloon dilation in the elderly patients undergoing percutaneous kyphoplasty was 0.950 ng/mL (95%CI: 0.768-1.103 ng/mL) and 1.179 ng/mL (95%CI: 1.049-4.595 ng/mL), respectively. Conclusions TCI of remifentanil can effectively inhibit the pain response induced by balloon dilation in the elderly patients undergoing PKP. EC50 and EC95 of remifentanil is 0.950 ng/mL and 1.179 ng/mL, respectively. References | Related Articles | Metrics

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Single center retrospective study on the distribution of pathogens in elderly patients with acute exacerbation of chronic obstructive pulmonary disease ZHANG Jing, TAN Yan, LEI Jing, GAO Lin, GE Yi-yue, JIN Jia-jia, WANG Li, WANG Xiao-ping 2022, 36 (12):  1255-1258.  doi: 10.3969/j.issn.1003-9198.2022.12.017 Abstract ( 127 )   PDF (1131KB) ( 1145 )   Save Objective To explore the distribution and correlation of pathogens in the elderly patients with AECOPD, so as to guide the rational use of antibiotics and hormones in clinic. Methods A total of 111 patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) admitted to Nanjing First Hospital from January 2019 to January 2020 were retrospectively analyzed. The basic data such as eosinophil, neutrophil and lymphocyte count, the levels of C-reactive protein (CRP) and erythrocyte sedimentation rate(ESR )in blood routine examination were collected. Further, the pathogens were qualified by sputum fluorescence quantitative polymerase chain reaction, and the pathogens distribution was analyzed. Results The level of ESR and the ratio of cardiovascular diseases showed significant differences between the pathogen-positive group and pathogen-negative group. In this study, the top five pathogens in AECOPD patients were EB virus (21.6%), Haemophilus influenzae (19.8%), Streptococcus pneumoniae (17.1%), herpes simplex virus (14.4%), influenza A virus (14.4%). The detection rate of influenza A virus was correlated with influenza B virus and Aspergillus (P<0.05); The detection rate of respiratory syncytial virus was correlated with Candida, Moraxella catarrholis, Streptococcus pneumoniae and Haemophilus influenzae (P<0.05); The detection rate of Escherichia coli was correlated with rhinovirus, adenovirus, Klebsiella pneumoniae and Acinetobacter baumannii (P<0.05); The detection rate of Candida was correlated with that of Moraxella catarrholis and Pseudomonas aeruginosa (P<0.05); The detection rate of human coronavirus was correlated with Haemophilus influenzae, herpes simplex virus and Streptococcus pneumoniae (P<0.05). Conclusions AECOPD are mostly induced by different pathogens, especially mixed infection of bacteria and virus. It is helpful to guide the rational use of antibiotics by analyzing the etiological characteristics in the elderly patients with AECOPD. References | Related Articles | Metrics

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Predictive value of preoperative hemoglobin, albumin, lymphocyte and platelet(HALP) score for prognosis of elderly patients with non-small cell lung cancer undergoing surgery YUAN Meng-yi, WANG Pei-shan, MENG Rui-xia, YANG Jian-jun, ZHOU Cheng-mao, JIAO Zhong-yu 2022, 36 (12):  1259-1263.  doi: 10.3969/j.issn.1003-9198.2022.12.018 Abstract ( 166 )   PDF (1149KB) ( 767 )   Save Objective To investigate the predictive value of preoperative hemoglobin, albumin, lymphocyte and platelet (HALP) score for the prognosis of the elderly patients with non-small cell lung cancer (NSCLC) undergoing surgery. Methods The clinical data of 270 elderly patients with NSCLC undergoing surgery in Xinxiang Central Hospital from January 2015 to December 2019 were collected, and the predictive value of HALP score for the prognosis was analyzed. Results Univariate Cox regression analysis showed that preoperative HALP score, ΔHALP score, tumor TNM stage, tumor differentiation, smoking history, tumor location, serum albumin level, hemoglobin level and postoperative hospital stay were associated with postoperative overall survival (OS) and progression-free survival (PFS) (all P<0.05). Multivariate Cox regression analysis showed that preoperative HALP score, tumor TNM stage and tumor differentiation were the independent risk factors for OS and PFS, and preoperative serum albumin level was an independent risk factor for OS (all P＜0.05). Conclusions HALP score can be used as a predictor for postoperative survival in the elderly patients with NSCLC after surgery, which could assist clinical targeted intervention to improve prognosis. References | Related Articles | Metrics

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Analysis of influencing factors of frailty based on geriatric comprehensive assessment in the elderly patients with type 2 diabetes mellitus BAO Hai-tong, TAN Ping, YU Pei-wen, LIU Juan, DING Guo-xian, TONG Qiang-wei, WANG Xiao-dong 2022, 36 (12):  1264-1268.  doi: 10.3969/j.issn.1003-9198.2022.12.019 Abstract ( 140 )   PDF (1150KB) ( 1195 )   Save Objective To analyze the influencing factors of frailty in the elderly patients with type 2 diabetes mellitus (T2DM) by comprehensive geriatric assessment. Methods A total of 210 patients with T2DM aged ≥ 65 years old who were hospitalized in the Department of Geriatric Endocrine of Jiangsu Province Hospital from January 2020 to June 2021 were enrolled and divided into frailty group and non-frailty group according to the results of Physical Frailty Phenotype(PFP). The status of nutrition, cognition, psychology, prognosis and physical function of the patients were measured by Mini Nutritional Assessment Scale (MNA), Mini-mental State Examination (MMSE), Geriatric Depression Scale (GDS), Multidimensional Prognostic Index (MPI) score for inpatients, 4 m walking speed, Timed Up and Go (TUG) test, TUG manual (TUGman), TUG cognitive (TUGcog), respectively. Binary Logistic regression analysis was used to analyze the influencing factors of frailty in the hospitalized elderly patients with T2DM. Results There were significant differences in gender, age, marital status, residential status, course of disease, nutritional status, cognitive status, psychological status, risk of death, risk of fall, walking speed, TUG, glycated hemoglobin, body mass index and grip strength between two groups(P<0.05). Binary Logistic regression analysis showed that female, long course of diabetes, low grip strength and low 4 m walking speed were the risk factors of frailty in the hospitalized elderly patients with T2DM. Conclusions The assessment of frailty in the elderly patients with T2DM needs to be diversified. The comprehensive geriatric assessment method for the elderly can be used to investigate the influencing factors of frailty in the elderly patients with T2DM and improve the quality of life. References | Related Articles | Metrics

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Study on the status and the influencing factors of self-perceived burden in the elderly patients with diabetes mellitus and frailty CHEN Ming-zhu, XU Qin, CAI Ying-hua 2022, 36 (12):  1269-1272.  doi: 10.3969/j.issn.1003-9198.2022.12.020 Abstract ( 160 )   PDF (1131KB) ( 1124 )   Save Objective To investigate the status of self-perceived burden in the elderly patients with diabetes mellitus and frailty,and to analyze the influencing factors. Methods A total of 110 elderly patients with diabetes and fraity who were hospitalized in Department of Endocrinology of Wuxi People's Hospital from March 2020 to March 2021 were enrolled. The patients were surveyed by the general information questionnaire, the Chinese version of Tilburg Frailty Inventory (TFI), Self-Feeling Burden Scale (SPBS), Perceived Social Support Scale (PSSS), and the Chinese version of Diabetes Self-Management Behavior Scale (SDSCA). Results A total of 88 elderly patients with diabetes mellitus and frailty presented with self-perceived burden, accounting for 80%, with an average score of 30.22±7.00. Pearson correlation analysis showed that the total burden, physical burden, emotional burden were positively associated with frailty, and negatively correlated with the scores of PSSS and SDSCA (P<0.05). Multiple linear regression showed that medical payment mode, degree of frailty and perceived social support were the influencing factors of self-perceived burden (P<0.05). Conclusions The self-perceived burden of the elderly patients with diabetes mellitus and frailty is at a moderate level. It is suggested that medical staff should formulate appropriate comprehensive intervention measures based on the degree of frailty, medical security of patients and perceived social support, so as to reduce the self-perceived burden of patients and improve the quality of life. References | Related Articles | Metrics

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Clinical value of serum 25-hydroxyvitamin D, TRACP-5b, PINP, β-CTX in diagnosis of postmenopausal osteoporosis SHU Ting-ting 2022, 36 (12):  1273-1276.  doi: 10.3969/j.issn.1003-9198.2022.12.021 Abstract ( 141 )   PDF (1132KB) ( 822 )   Save Objective To analyze the clinical value of 25-hydroxyvitamin D [25(OH)D], serum tartrate-resistant acid phosphatase 5b (TRACP-5b), type Ⅰprocollagen amino-terminal propeptide (PINP) and β-isomerized C-terminal telopeptides (β-CTX) in the diagnosis of postmenopausal osteoporosis (OP). Methods A total of 150 patients diagnosed as postmenopausal OP (T≤-2.5 SD) in our hospital from March 2019 to July 2021 were selected as the OP group, and 150 postmenopausal women with normal bone mass density (BMD) during physical examination at the same period were selected as the control group. The levels of BMD, 25(OH)D, TRACP-5b, PINP and β-CTX were detected in all subjects. The relationship of all indexes of bone metabolism with OP were analyzed by Logistic regression, and the receiver operating characteristic(ROC) curve was drawn to evaluate the diagnostic value of 25(OH)D, TRACP-5b, PINP and β-CTX for OP. Results The serum levels of BMD and 25(OH)D in the OP group were significantly lower, and the serum levels of TRACP-5b, PINP and β-CTX were significantly higher than those in the control group. Pearson correlation analysis showed that serum level of 25(OH)D was positively correlated with BMD, and the levels of TRACP-5b, PINP and β-CTX were negatively correlated with BMD in the OP patients. Logistic regression analysis showed that the decrease of serum 25(OH)D and the increase of TRACP-5b, PINP and β-CTX may be the influencing factors for the occurrence of postmenopausal OP. ROC curve analysis showed that the efficiency of the above four indicators alone for diagnosing OP was 0.82, 0.87, 0.82, 0.70, respectively, and the combined diagnostic efficiency reached 0.90. Conclusions Serum levels of 25(OH)D, TRACP-5b, PINP and β-CTX can be used in combination to diagnose postmenopausal OP, and can provide some basis for clinical prevention and intervention. References | Related Articles | Metrics

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Effect of tai chi combined with resistance training on the elderly with frailty in a nursing home LI Zhan, ZHOU Kai-yun, BAO Feng-xiang, CHEN Yu-lun 2022, 36 (12):  1277-1280.  doi: 10.3969/j.issn.1003-9198.2022.12.022 Abstract ( 137 )   PDF (1128KB) ( 1022 )   Save Objective To investigate the effect of tai chi combined with resistance training on the frailty, physical activity ability and quality of life in the elderly with frailty in nursing homes. Methods From March to September 2020, a total of 60 elderly cases of frailty meeting the criteria were enrolled in this study from Fule Nursing Home in Lianyungang City. The subjects were divided into the experimental group and the control group by random number table method. The cases in the experimental group received tai chi training combined with resistance training for 30 weeks. No intervention was given in the control group. The frailty status, physical activity and quality of life of the two groups were evaluated before and after intervention. Results After intervention, the score of Frailty Phenotype and the 6 m walking time in the experimental group were lower than those before intervention and those in the control group (P<0.05); The level of grip strength was significantly higher than that before intervention and that in the control group (P<0.05). After intervention, the scores of SF-36 in all dimensions in the experimental group were significantly higher than those before intervention and those in the control group (P < 0.05). Conclusions Tai chi combined with resistance training is helpful to improve the elderly patients' frailty, physical activity ability and quality of life. References | Related Articles | Metrics

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Study on the influencing factors of illness perception in elderly patients with Parkinson's disease after deep brain stimulation surgery program control ZHU Xiao-juan, CAO Feng, LI Yuan-yuan, ZHANG Tian-yu, GUAN Li, GAO Jie, JIANG Zi-juan 2022, 36 (12):  1292-1295.  doi: 10.3969/j.issn.1003-9198.2022.12.026 Abstract ( 155 )   PDF (1131KB) ( 1398 )   Save Objective To explore the influencing factors of illness perception in the elderly patients with Parkinson's disease (PD) after deep brain stimulation surgery (DBS). Methods A cross-sectional study was conducted in 80 patients with PD aged >65 years old from January 2020 to January 2021. The illness perception,physician trust and personality characteristics of the patients were measured by Illness Perception Questionnaire Revised Edition (IPQ-R), the Wake Forest Physician Trust Scale (WFPTS) and Eysenck Personality Questionaire (EPQ), respectively. The illness perception score among the patients with different educational background,disease course and gender was compared, and the correlation of the patients' illness perception with physician trust and personality characteristics was analyzed. Results There were no significant difference in overall illness perception scores among the patients with different educational background,disease course and gender. The individual control of males was significantly lower than that of females (t=-2.03, P=0.045). Pearson correlation analysis showed a significant negative correlation between perceive disease outcome, treatment control, disease cycle, emotional statement score and physician trust, respectively (r =-0.23, -0.22, -0.24, -0.34, all P<0.05). The total score of personality evaluation,internal and external orientation,emotionality, self-concealment scores were positively correlated with the score of illness perceived consequences dimension (r=0.25, 0.27, 0.25, 0.24, all P<0.05); The total score of personality evaluation,internal and external orientation,psychoticism and self-concealed were negatively correlated with the score of individual control dimension of illness perception (r=-0.24, -0.26, -0.24, -0.25, all P<0.05). Conclusions Education background and course of the disease have no significant influence on patients' illness perception,and the individual control ability of patients with different genders is different. Physician trust and their personalities significantly influence the illness perception of the elderly patients with PD after DBS. References | Related Articles | Metrics

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Application of cloud platform management mode in the cardiac rehabilitation in elderly patients after PCI JIANG Li, GAO Chun-hong, HU Xiao-lin, YANG Lei, TANG Yi-fan, ZHANG Yi-ming 2022, 36 (12):  1296-1299.  doi: 10.3969/j.issn.1003-9198.2022.12.027 Abstract ( 145 )   PDF (1174KB) ( 920 )   Save Objective To explore the effect of cloud platform management mode used in cardiac rehabilitation in the elderly patients after percutaneous coronary intervention (PCI). Methods A total of 60 elderly patients with coronary heart disease who underwent PCI in the 3rd ward of the Department of Geriatric Cardiology, the First Affiliated Hospital of Nanjing Medical University from 2020 to 2021 were randomly divided into the control group and the observation group, with 30 patients in each group. The control group received routine treatment and nursing intervention,and the observation group received cloud platform management mode on the basis of the control group. Both groups were followed up for 6 months. The scores of Seattle Angina Pectoris Scale (SAQ), Quality of Life Scale (SF-36), Exercise Fear scale for patients with heart disease (TSK-SV heart), Medication Compliance (MMAS-8) 1 and 6 months after intervention were recorded and analyzed. Results After 6 months of intervention,the scores of SAQ, SF-36 and MMAS-8 in the observation group were higher than those in the control group (P<0.05), and the TSK-SV heart score was lower than that in the control group (P<0.05).The scores of SAQ, SF-36 and TSK-SV heart in the both groups were improved than those before intervention. Conclusions Cloud platform management mode could effectively improve the medication compliance, alleviate anxiety, and improve quality of life and the heart function in the elderly patients undergoing PCI. References | Related Articles | Metrics

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Effects of different tip positions of midline catheter in elderly patients BAI Jian, GUO Yan, MO Yong-zhen, WANG Jie, SONG Jian-nan 2022, 36 (12):  1300-1303.  doi: 10.3969/j.issn.1003-9198.2022.12.028 Abstract ( 122 )   PDF (1228KB) ( 716 )   Save Objective To compare the effects of different tip positions of midline catheter positioned under ultrasound in the elderly patients. Methods A total of 86 elderly patients hospitalized in our hospital from August 2020 to October 2021 were selected. According to the position of catheter tip, they were divided into control group (n=40) and study group (n=46). The tip of the catheter in the control group was located in the thoracic segment of axillary vein,and the tip of the catheter in the study group was located in the subclavian vein. The catheterization nurse used vascular ultrasound to position the catheter tip within the blood vessel, and the incidence of the complications was compared between the two groups. Results There were no significant differences in age, gender and puncture vessels between the two groups. No one presented with phlebitis and vascular catheter-related infection,but the incidence rate of cathter obstruction and the total incidence rate of the complications in the study group was lower than that in the control group (P<0.05). Conclusions The application of medium length catheter in the elderly patients with the tip in the subclavian vein can reduce the incidence of catheter obstruction. References | Related Articles | Metrics

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Effects of auricular acupoint pressing combined with mirror therapy on phantom limb pain and sleep quality in patients with malignant bone tumor receiving amputation CHEN Jia-jia, JIA Yan 2022, 36 (12):  1304-1307.  doi: 10.3969/j.issn.1003-9198.2022.12.029 Abstract ( 137 )   PDF (1125KB) ( 1015 )   Save Objective To investigate the effects of auricular acupoint pressing combined with mirror therapy on phantom limb pain and sleep quality in the patients of malignant bone tumor receiving amputation. Methods A total of 56 patients with phantom limb pain due to amputation of malignant bone tumors who were admitted to the bone tumor ward of our hospital from April 2019 to August 2021 were selected as the study subjects, and 29 patients from April 2019 to June 2020 were selected as the control group, and 27 patients from July 2020 to August 2021 were selected as the experimental group. The control group was given routine nursing, and the experimental group was given auricular acupoint pressing combined with mirror therapy on the basis of routine nursing. The scores of phantom limb pain and sleep quality of the two groups were compared. Results There were no significant differences in gender, amputation site and the levels of biochemical parameters between the control group and the experimental group (P > 0.05). There were statistically significant differences in the scores of pain numerical rating scale (NRS) and Pittsburgh sleep quality index (PSQI) (P＜0.01) between the control group and the experiment group 3 d after operation and before discharge. There were no significant differences in NRS and PSQI scores between the elderly group and the non-elderly group in the two groups 3 d after surgery and before discharge (P>0.05). Conclusions Auricular acupoint pressing combined with mirror therapy can improve the pain perception and sleep quality of amputee patients, and is also suitable for the elderly. References | Related Articles | Metrics