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20 January 2023, Volume 37 Issue 1 Previous Issue    Next Issue

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Relationship of serum Ficolin-3 level with degree of renal function damage and prognosis in elderly patients with chronic glomerulonephritis ZHOU Mei, TANG Yi-bing, CAO Lei, SHAO Yun-xia 2023, 37 (1):  26-30.  doi: 10.3969/j.issn.1003-9198.2023.01.007 Abstract ( 191 )   PDF (1068KB) ( 897 )   Save Objective To explore the relationship of the level of serum Ficolin-3 with the degree of renal function damage and the prognosis in the elderly patients with chronic glomerulonephritis (CGN). Methods A total of 140 elderly patients with CGN (CGN group) in our hospital from September 2017 to September 2019 and 140 elderly healthy people (control group)were enrolled in this study. The general data and the level of serum Ficolin-3 of the two groups were observed and compared. According to the estimated glomerular filtration rate (eGFR), the patients with CGN were divided into three groups: normal/mild decline group (43 cases), moderate decline group (57 cases) and severe decline group (40 cases). The patients were followed up for 2 years, of which 10 cases presented with chronic renal failure (CRF) (CRF group) and 130 cases showed remission/no progress (non-CRF group). Pearson correlation analysis was used to analyze the relationship of serum ficolin-3 with renal function indexes such as uric acid (UA), urea nitrogen (BUN) and serum creatinine (SCr) in patients with CGN; Receiver operating characteristic(ROC)curve was used to analyze the value of serum Ficolin-3 and renal function indexes in the evaluation of CRF in the patients with CGN; Multivariate Cox regression analysis was used to analyze the influencing factors of CRF. Results The levels of UA, BUN, SCr and serum Ficolin-3 in CGN group were significantly higher than those in control group (P<0.01). The levels of UA, BUN, SCr and serum Ficolin-3 were the highest in severe decline group, followed by moderate decline group and normal mild decline group (P<0.05). The level of serum Ficolin-3 in the patients with CGN was positively correlated with UA, BUN and SCr (r=0.559,0.394,0.427,P<0.05). The levels of UA, BUN, SCr and serum Ficolin-3 in CRF group were significantly higher than those in non-CRF group (P<0.05). The area under the curve (AUC) of serum Ficolin-3 combined with the renal function indexes in the evaluation of CRF in patients with CGN was 0.944, which was significantly higher than that of Ficolin-3, UA, BUN and SCr alone (P<0.05). BUN ≥ 9.07 mmol/L, SCr ≥ 88.64 μmol/L and Ficolin-3 ≥ 45.02 mg/L were the risk factors of CRF in the patients with CGN (P<0.05). Conclusions The level of serum Ficolin-3 in the elderly patients with CGN is high, and it is related to the degree of renal function damage and the prognosis in the patients with CGN. References | Related Articles | Metrics

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Epidemiological characteristics and risk factors of activities of daily living decline before admission in elderly patients JIANG Yang-yang, HOU Li-sha, CAO Li 2023, 37 (1):  31-34.  doi: 10.3969/j.issn.1003-9198.2023.01.008 Abstract ( 128 )   PDF (1043KB) ( 1206 )   Save Objective To explore the epidemiological characteristics and risk factors of activities of daily living(ADL) decline before admission in the elderly patients in order to provide reference for the improvement of life quality and function. Methods A cross-sectional study was conducted in the elderly patients aged ≥ 65 years from January 12, 2017 to February 28, 2018 from West China Hospital of Sichuan University. Demographic information and number of diagnosis were collected. The FRAIL scale and Barthel index rating scale were used to evaluate frailty status and ADL respectively. Multivariate Logistic regression analysis was used to analyze the risk factors of ADL decline during 2 weeks before admission. Results Among 1855 subjects, 849(45.8%) presented with ADL decline before admission. The main decreased activities were as follows: going up and down stairs, transferring, walking and bathing. Multivariate Logistic regression analysis showed that age, frailty,acute health problems,number of diagnosis and mild impairment of activity at baseline were the independent risk factors for the loss of ADL before admission. Conclusions It is of great clinical significance to manage weakness, to reduce or control the occurrence or progression of diseases, and to maintain activity ability for alleviating the further decline of ADL in long-term care for older people. References | Related Articles | Metrics

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Analysis of status and influencing factors of the uncertain stress among community elderly YANG Xin-jie, ZHU Jing-wen, YU Bin, SUN An-shuo, WANG Xiao-lei 2023, 37 (1):  35-38.  doi: 10.3969/j.issn.1003-9198.2023.01.009 Abstract ( 167 )   PDF (1038KB) ( 1269 )   Save Objective To investigate the status and the influencing factors of uncertain stress in the community elderly, and to provide reference for health promotion in the community elderly. Methods A total of 539 community elderly were enrolled in this study from Hangzhou, and they were surveyed by general survey scale and uncertainty stress scale. Results The total score of uncertainty stress in the community elderly was 25.24 ± 13.91, and 201(37.3%) cases presented with high uncertainty stress. The uncertain stress of the community elderly can be affected by whether there was an activity center in community, type of medical insurance, relationship with children, intelligent operation, income of the family, whether there were physical disorders, whether there were accidents such as falls in the past year, whether they helped their children do things, and self-assessment of physical state (P＜0.05). Conclusions The level of uncertainty stress in the community elderly is not optimistic, especially in the elderly population with physical activity disorder, history of accidental injury in the past year, poor health and weak intergenerational relationship. It is helpful for the health promotion in the community elderly to optimize the community public service facilities and medical insurance policy, and to carry out psychological guidance. References | Related Articles | Metrics

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Epidemiological characteristics of abnormal weight status among people aged ≥60 years old in Nanjing, China YAO Zhu-ling, WANG Zhi-yong, TANG Wei, XU Fei 2023, 37 (1):  39-42.  doi: 10.3969/j.issn.1003-9198.2023.01.010 Abstract ( 139 )   PDF (1041KB) ( 855 )   Save Objective To investigate the prevalence and distribution characteristics of body weight status among people aged ≥60 years old in Nanjing, China. Methods In this cross-sectional study, 20 883 regular residents aged ≥60 years were enrolled using a multistage stratified sampling approach from April to October 2017 in Nanjing. The demographic information and anthropometric characteristics were collected. The body weight status was defined and categorized as underweight [body mass index (BMI)<18.5], normal weight(18.5≤BMI<24), overweight(24≤BMI<28) and obesity(BMI≥28). The distribution characteristics of body weight were analyzed. Results The mean BMI of the elderly population in Nanjing was 24.4±3.3, while 2.5% of the participants presented with underweight, 44.4% with normal weight, 40.0% with overweight, and 13.1% with obesity. The overweight rate was significantly higher in men(41.0%) than that in women(39.1%), but the obesity rate(11.3%) was lower than that in women(14.8%). The underweight rate in the elderly population tended to increase with age, while the overweight rate tended to decrease with age (P<0.05). The obesity rate significantly decreased with the increase of the educational level among the participants (P<0.05). Conclusions The elderly show a low rate of underweight and a high rate of overweight and obesity in Nanjing, China. Tailored precision intervention strategies on healthy weight campaigns with participants’ characteristics are crucial for public health in China. References | Related Articles | Metrics

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Clinical characteristics of 183 elderly inpatients with Henoch-Schonlein purpura CAO Yan, ZHANG An-ping 2023, 37 (1):  43-46.  doi: 10.3969/j.issn.1003-9198.2023.01.011 Abstract ( 116 )   PDF (1046KB) ( 911 )   Save Objective To investigate the clinical characteristics of Henoch-Schonlein purpura (HSP) in the elderly. Methods A total of 183 elderly inpatients with HSP aged ≥60 years old in the First Affiliated Hospital of Anhui Medical University from March 2002 to June 2021 were retrospectively analyzed. Results Among 183 elderly inpatients with HSP, the average age was 69.41±6.81 years, and the ratio of male to female patients was 1∶1.316. The disease occurred mostly in autumn and winter. The main clinical types of elderly HSP patients were renal purpura (47.00%) and mixed purpura (40.98%). The main predisposing factor of HSP was infection (32.2%), and the main type of infection was upper respiratory tract infection (72.9%). Gastrointestinal damage occurred in 42.6% of the patients during the course of the disease. In addition, the increased fibrin degradation products (FDP) level was statistically different between the patients with gastrointestinal damage and those without gastrointestinal damage (P<0.05). Conclusions The incidence of HSP in the elderly patients is associated with the gender and season, and the main clinical types of HSP in the elderly were renal purpura and mixed purpura. The elderly patients with HSP are prone to develop gastrointestinal damage, and monitoring blood FDP level is helpful to determine the occurrence of gastrointestinal damage. References | Related Articles | Metrics

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Investigation and analysis of influencing factors of the medication adherence in patients with Alzheimer’s disease in Xi’an GUO Xiao-juan, LIU Jie, WANG Jin, LU Wen-hui, GAO Ling, QU Qiu-min 2023, 37 (1):  47-50.  doi: 10.3969/j.issn.1003-9198.2023.01.012 Abstract ( 127 )   PDF (1048KB) ( 1074 )   Save Objective To investigate the status of medication adherence in the patients with Alzheimer’s disease (AD) taking guideline-recommended drugs (donepezil, galantamine, rivastigmine, and memantine) in Xi’an, and to analyze the influencing factors. Methods From May 2016 to April 2021,a total of 473 AD patients from the Memory Clinic of the First Affiliated Hospital of Xi’an Jiaotong University were selected and divided into the good adherence group and the poor adherence group. The demographic data, first visit data and basic information of caregivers in the two groups were observed and compared. Multivariate Logistic regression analysis was performed to analyze the influencing factors of medication adherence in the AD patients. Results Of the 473 patients, 45.0% had poor 1-year adherence. There were significant differences in the residence, education degree, medical insurance type, score of Mini-Mental State Examination(MMSE), mental behavior symptoms, drug combination, monthly drug costs, education degree of caregivers, occupation of caregivers and the monthly family income between the good adherence group and poor adherance group(P<0.05). Caregivers believing that the treatment showed no significant effect was the most important reason for discontinuation. Multivariate Logistic analysis showed that the influencing factors of medication adherence included caregivers’ occupation (OR=0.405, 95% CI:0.266-0.616, P<0.001), MMSE score (OR=1.071, 95%CI:1.030-1.115, P=0.001), psycho-behavioral symptoms (OR=0.660, 95% CI:0.436-1.000, P=0.049), and drug combination (OR=0.389, 95%CI:0.250-0.606, P<0.001). Conclusions It is important to improve the poor medication adherence in AD patients in Xi’an. The attitude of caregivers to the disease, the sever degree of the disease, and the drug strategies are the main factors affecting medication adherence. References | Related Articles | Metrics

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Association between the triglyceride-glucose index and MRI parameters of cerebral small vessel disease in the elderly DOU Miao-miao, CENG Yan, WEI Qian, CHENG Xi, LU Xiao-wei 2023, 37 (1):  51-55.  doi: 10.3969/j.issn.1003-9198.2023.01.013 Abstract ( 137 )   PDF (1059KB) ( 875 )   Save Objective To investigate the association between triglyceride-glucose(TyG)index and MRI parameters of cerebral small vessel disease(CSVD)in the elderly. Methods A total of 297 consecutive non-stroke patients in Department Geriatrics, Jiangsu Province Hospital from 2016 to 2018 were retrospectively enrolled. The demographic and clinical data were collected. TyG index was calculated and all patients were divided into 4 groups according to TyG index (Q1＜6.7796,Q2:6.7796-7.0584,Q3: 7.0585-7.4191,Q4＞7.4191) by quartile method. The correlation between TyG index and MRI parameters of CSVD was analyzed by binary Logistic regression, and the relationship between TyG index and the total burden of CSVD was analyzed by ordered regression. Results The incidence of paraventricular white matter hyper-density (P-WMH) and severe CSVD total burden were significantly higher in group Q4 than those in the other groups (P<0.05). The risk of P-WMH increased by 0.539 (95%CI: 1.106-2.142, P=0.025) if TyG index was increased by one standard deviation after adjusting the confounding factors. Binary Logistic regression analysis showed that the risk of P-WMH in group Q4 was 2.848 folds of that in group Q1 (95%CI: 1.201-6.752, P=0.018). Ordinal regression showed that the risk of increase of CSVD total burden in group Q4 was 2.164 (95%CI: 1.130-4.150, P= 0.020) folds of that in group Q1. Conclusions TyG Index is an independent risk factor for P-WMH and severe CSVD burden. References | Related Articles | Metrics

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A meta-analysis of the effects of humor therapy in alleviating psychological problems in the elderly HE Lu-sheng, ZHANG Li, NIE Chen-cong, CHEN Jia-zeng, YANG Ting, ZHOU Rui-yi 2023, 37 (1):  56-61.  doi: 10.3969/j.issn.1003-9198.2023.01.014 Abstract ( 136 )   PDF (1386KB) ( 1117 )   Save Objective To explore the effects of humor therapy in alleviating the psychological problems of the elderly, and to provide reference for the clinical adjuvant treatment for the patients with mental diseases. Methods VIP database, Wanfang Digital Journal Full-text Database, CNKI full-text database, Wiley Online Library, PubMed, Web of Science, EBSCO were searched for the literatures published from the establishment of the database to December 30, 2021. All randomized and semi-randomized controlled trials were conducted to analyze the effects of laughter therapy or humor therapy on alleviating anxiety, depression and other psychological problems in the elderly. Revman 5.3 software was used to conduct meta-analysis. Results Eight randomized controlled trials with a total of 587 cases were enrolled in this study. Compared with conventional intervention or blank control, humor therapy was significantly associated with depression score(SMD=-0.76, 95%CI :-1.04 - -0.27, Z=5.46, P<0.001), loneliness score (SMD=-1.43, 95%CI:-2.58 - -0.28, Z=2.43, P<0.05) and quality of life score(SMD=0.77, 95%CI:0.45-1.09, Z=4.68, P<0.001). Conclusions Humor therapy can effectively alleviate the depression, anxiety and loneliness of the elderly and improve their quality of life. It plays an important role in the treatment of mental diseases and is worth popularizing. References | Related Articles | Metrics

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Effects of enhanced recovery after surgery on the efficacy of arthroscopic acromioplasty in elderly patients with subacromial impingement syndrome FAN Yu-dong, CHEN Bing-qian, SHAO Yun-chao, XIA Qing 2023, 37 (1):  62-65.  doi: 10.3969/j.issn.1003-9198.2023.01.015 Abstract ( 122 )   PDF (1041KB) ( 1214 )   Save Objective To analyze the effects of enhanced recovery after surgery(ERAS) measures in the elderly patients with subacromial impingement syndrome(SAIS) undergoing arthroscopic acromioplasty. Methods The clinical data of 38 elderly patients with SAIS receiving arthroscopic acromioplasty in our hospital from July 2017 to November 2021 was retrospectively collected. All the patients were divided into the traditional group(18 cases) and the ERAS group(20 cases) according to different perioperative management. The scores of the modified UCLA Shoulder Rating Scale(UCLA scale) and visual analogue scale (VAS) before operation, at discharge, 1,2,3 months after discharge and the postoperative hospital stay, and the incidence of complications were observed and compared between the two groups. Results The scores of UCLA scale and VAS were significantly improved in both groups after operation. The UCLA score in the ERAS group at discharge and 1 month after discharge was significantly higher than that in the traditional group, and the VAS score in the ERAS group was lower than that in the traditional group 1 month after discharge (P<0.05 or P<0.01). There was significant difference in hospital stay between the two groups (P<0.05),while the incidence rate of complications showed no statistical difference. Conclusion ERAS management may relieve the pain, accelerate shoulder rehabilitation and shorten the postoperative hospital stay time in the elderly patients with SAIS undergoing arthroscopic acromioplasty. References | Related Articles | Metrics

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Investigation and construction of nursing service demands in elderly specialized outpatient based on Kano model XIAO Tian, JIN Huan, SONG Wen-jun, WANG Qiong, WANG Qin 2023, 37 (1):  87-91.  doi: 10.3969/j.issn.1003-9198.2023.01.022 Abstract ( 133 )   PDF (1121KB) ( 1261 )   Save Objective To explore the nursing service demands in the elderly specialized outpatients, and to study how to improve the satisfaction of elderly outpatients, and to provide a basis for building outpatient nursing service quality and service content for the elderly patients. Methods Kano model was used to design a questionnaire on the demands for the quality and content of nursing service in the specialized outpatients. The nursing service demands of 343 elderly specialized outpatients were investigated and analyzed, and the demand attributes of the elderly specialized outpatients were analyzed. Results Among the 33 items of the nursing service demands, 18.18% was must-be requirement, 39.39% was one-diamensional requirement, 36.36% was attractive requirement, and 6.06% was indifferent requirement. In the summary of importance and satisfaction quadrants, health education and medical environment were the main attractive requirement, and service attitudes and operating techniques were the main one-diamensional requirement. Conclusions While essential demands are met, we should vigorously promote the improvement of one-diamensional requirement, pay attention to the improvement of attractive requirement, which will help to improve nursing services, and further increasing the efficiency of outpatient clinic and the satisfaction of elderly outpatients. References | Related Articles | Metrics

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Study on the application of multidisciplinary nutrition management model based on comprehensive geriatrics assessment in the geriatric ward HUANG Zhao-jing, LIU Hong, HE Xing-yue, MENG Zhang-min, XIE Dong-mei 2023, 37 (1):  92-95.  doi: 10.3969/j.issn.1003-9198.2023.01.023 Abstract ( 135 )   PDF (1043KB) ( 1307 )   Save Objective To explore the effect of a multidisciplinary nutrition management model based on comprehensive geriatric assessment(CGA) applied in the geriatric ward. Methods A total of 207 elderly patients with malnutrition risk and malnutrition were enrolled in this study. The 105 patients admitted in our hospital from April to July in 2021 were divided into the control group, and received routine nutritional intervention; the 102 inpatients from August to November in 2021 were divided into the intervention group, and received multidisciplinary nutrition management based on CGA. Results After treatment, the levels of hemoglobin, serum albumin, prealbumin, grip strength, and activities of daily living score in the intervention group were significantly better than those in the control group, and the length of hospital stay was significantly shorter than that in the control group(P<0.05). Conclusions The multidisciplinary nutrition management model based on CGA is beneficial in improving the nutritional status of the elderly patients, improving activities of daily living, shortening hospital stay, and promoting the rapid recovery of the disease. References | Related Articles | Metrics

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Correlation of anxiety and depression with quality of life in elderly patients with Parkinson’s disease HUANG Mei, CHEN Hua-yu, JI Jing, ZHANG Li 2023, 37 (1):  96-99.  doi: 10.3969/j.issn.1003-9198.2023.01.024 Abstract ( 119 )   PDF (1044KB) ( 1729 )   Save Objective To investigate the correlation of anxiety and depression with quality of life in the elderly patients with Parkinson’s disease(PD). Methods A total of 214 elderly patients with PD from the Department of Neurology and Department of Neurosurgery, the First Affiliated Hospital with Nanjing Medical University were enrolled in this study, and Parkinson’s Disease Quality of Life Questionnaire(PDQ-39), Beck Anxiety Inventory(BAI) and Geriatric Depression Scale(GDS) were used to investigate the patients’ quality of life, anxiety and depression, respectively. The correlation of anxiety and depression with quality of life was analyzed. Results The score of PDQ-39 in the elderly patients with PD was 90.75±22.34. The score of BAI was positively correlated with the score of affect and negatively correlated with the score of social support. The score of GDS was positively correlated with the score of affect, humiliation, cognition and somatic discomfort. Conclusions Anxiety and depression are the main risk factors for quality of life. It is important to pay attention to the psychological state of the elderly patients with PD and to strengthen psychological care. References | Related Articles | Metrics

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Effects of stroke specialist nurse system in intravenous thrombolysis in elderly patients with acute ischemic stroke XU Yi-ming, ZHAN Hui, ZHANG Yuan, ZHAI Qian 2023, 37 (1):  100-103.  doi: 10.3969/j.issn.1003-9198.2023.01.025 Abstract ( 150 )   PDF (1044KB) ( 1050 )   Save Objective To examine the effect of stroke specialist nurse system in the elderly patients with acute ischemic stroke(AIS) receiving intravenous thrombolysis. Methods In this retrospective case-control study, 574 elderly patients with AIS undergoing intravenous thrombolysis from October 2017 to February 2020 were enrolled. The patients receiving the intervention of stroke specialist nurses were divided into observation group, and the patients receiving routine nurse service were divided into control group.Time to treatment and clinical outcomes were compared between the two groups. Results The door-to-imaging time and door-to-needle time in observation group were shorter than those in control group(P<0.05), and the clinical prognosis was better and mortality was lower than those in control group(P<0.05). Conclusions The stroke nurse system helps to optimize the stroke green channel by improving the time efficiency of intravenous thrombolysis. References | Related Articles | Metrics