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20 June 2023, Volume 37 Issue 6 Previous Issue    Next Issue

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Impact of isoflurane on conventional and speckle tracking echocardiographic parameters in mouse model of aging WANG Ying, WU Xiao-fen, RUAN Lei, ZHANG Cun-tai, WANG Guan 2023, 37 (6):  551-554.  doi: 10.3969/j.issn.1003-9198.2023.06.004 Abstract ( 97 )   PDF (1924KB) ( 1143 )   Save Objective To investigate the effects of isoflurane on conventional as well as speckle tracking echocardiographic (STE) parameters using mouse model of aging. Methods C57BL/6 mice aged 3 weeks, 3 months, 6 months and 20 months old were enrolled in this study. The Vevo 2100 echocardiographic system was applied. The conventional and STE parameters including left ventricular posterior wall thickness at systolic stage and diastolic stage (LVPWTs, LVPWTd),left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD),left ventricular ejection fraction (LVEF),left ventricular short axis fractional shortening (FS),longitudinal strain (LS)and strain rate (LSr) under 1% and 2% isoflurane anesthesia were compared. Results The levels of LVPWTd,LVPWTs,LVEF,FS,LS and LSr remained unchanged under 1% and 2% isoflurane anesthesia in 3 weeks, 3 months, and 6 months old mice (P>0.05). While the levels of LVPWTs,LVEDD,LVESD,LVEF, FS, LS and LSr were significantly reduced, and the levels of LVEDD, LVESD were significantly increased under 2% than those under 1% isoflurane anesthesia in 20 months old mice(P<0.05). Conclusions 1% isoflurane anesthesia shows weak effects on the cardiac function in aging mice. References | Related Articles | Metrics

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Current situation and influencing factors of home care services for community oldest-old adults in Chengdu DENG Chuan-yao, HOU Li-sha, LIU Shuang, CAO Li, LIN Xiu-fang, DONG Bi-rong, YUE Ji-rong 2023, 37 (6):  555-559.  doi: 10.3969/j.issn.1003-9198.2023.06.005 Abstract ( 107 )   PDF (1083KB) ( 895 )   Save Objective To investigate the current situation and influencing factors of home care services for community oldest-old adults in Chengdu. Methods The elderly aged≥80 years old in four communities in Chengdu were selected to conduct a household survey to investigate their health characteristics and the demands for home care services. Multivariate Logistic regression was used to analyze the influencing factors of the demands for home care services in the community oldest-old adults. Results A total of 336 oldest-old adults were investigated in this study, including 168 male and 168 female; with an average age of 84. 63±3.95 years; The main demands for home care services were medical care and daily life care services.Multivariate Logistic regression analysis showed that age, living condition, activity of daily living, cognitive function, the number of chronic diseases and self-rated health status were the influencing factors of the demands for daily life care services;Living condition, activity of daily living, multiple drug use, and self-rated health status were the influencing factors of the demands for medical care services;While depression and self-rated health status were the influencing factors of the demands for mental comfort services. Conclusions The main demands for home care services for the oldest-old adults in Chengdu community are medical care and daily life care services. The results of self-rated health status have a greater impact on the demands for home care services, and the community should establish targeted individual management programs for the elderly with healthy problems. References | Related Articles | Metrics

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Prevalence and risk factors of sleep disorder in elderly patients with meningiomas before surgery WANG Juan, HAO Pei, HU Lei, CUI Miao-maio, DAI Shu-hui, WANG Zhen-zhen, ZHANG Mei-xia 2023, 37 (6):  560-563.  doi: 10.3969/j.issn.1003-9198.2023.06.006 Abstract ( 98 )   PDF (1070KB) ( 885 )   Save Objective To study the prevalence and risk factors of sleep quality in the elderly patients with meningiomas before surgery. Methods Seventy-one elderly patients with meningiomas aged over 65 years old admitted to Neurosurgery Department 3rd Ward of the First Affiliated Hospital, Air Force Military Medical University from January to December 2020 were retrospectively analyzed. The Pittsburgh Sleep Quality Index(PSQI) was used to assess the quality of sleep. Univariate analysis and multivariate Logistic regression were used to identify the independent risk factors of sleep disturbance(SD). Results Among the 71 patients, 34(47.9%) suffered from SD and 37(52.1%) showed good sleep quality. Univariate analysis showed that body mass index(BMI), exercise, the scores of Numerical Rating Scale(NRS), Karnofsky Performance Status (KPS), Multidimensional Fatigue Inventory(MFI-20) and Hospital Anxiety and Depression Scale(HADS) were significantly different between the PSQI-based subgroups(P<0.05 or P<0.01). Multivariate Logistic regression model further identified that higher NRS score, higher MFI-20 score, higher HADS-A score and lower KPS score were the independent risk factors for SD in the elderly patients with meningiomas. Conclusions SD is one of the common symptoms in the elderly patients with meningiomas.Poor physical functional status, anxiety, fatigue and pain may induce SD. References | Related Articles | Metrics

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Using clinical decision support system to reduce potentially inappropriate medication and polypharmacy in elderly patients: a systematic review HE Cui-lin, TIAN Fang-yuan, WU Jin-hui 2023, 37 (6):  564-568.  doi: 10.3969/j.issn.1003-9198.2023.06.007 Abstract ( 131 )   PDF (1402KB) ( 1130 )   Save Objective To systematically evaluate the intervention effect of clinical decision support system (CDSS) on potentially inappropriate medication (PIM) and polypharmacy in the elderly patients. Methods The database searches were carried out through PubMed,Embase and Web of Science to collect the randomized controlled trials (RCTs) data about the intervention effect of CDSS on polypharmacy and PIM in the elderly patients until April 2022. Two reviewers screened the literatures, extracted data and assessed the quality independently. Results A total of 14 studies involving 641 143 patients were included. There were 10 studies involving 629 599 patients analyzing the intervention effect of CDSS on PIM and 4 studies involving 11 544 patients analyzing the intervention effect of CDSS on polypharmacy. A meta-analysis was not possible due to the significant heterogeneity among the systems used and the measurement outcomes. In general, CDSS could reduce the prevalence of PIM in the elderly and further data were needed on the effects of CDSS on polypharmacy. Conclusions The application of CDSS has potential to reduce PIM in the elderly patients. References | Related Articles | Metrics

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Effect of environmental stimulation intervention on lower limbs motor function in elderly patients with post-stroke hemiplegia ZHUANG Xin, ZHANG Chao, XU Hua, MENG Qing-yu, WU Li-li, DING Yu-qing, ZHANG Qian, ZHANG Li-xia 2023, 37 (6):  569-572.  doi: 10.3969/j.issn.1003-9198.2023.06.008 Abstract ( 110 )   PDF (1065KB) ( 998 )   Save Objective To investigate the effect of environmental stimulation intervention on motor function of lower limbs in the elderly patients with post-stroke hemiplegia. Methods Sixty elderly patients with post-stroke hemiplegia who met the inclusion criteria were divided into the observation group(n=30) and the control group(n=30) according to the random number table method. The control group underwent conventional rehabilitation training and the observation group underwent environmental stimulation intervention. The Fugl-Meyer Motor Function Scale of the Lower Extremity (FMA-L), the 10-m walk test (10MWT) and the Modified Barthel Index (MBI) were measured in the two groups before and after 4 weeks of treatment, respectively. Results After 4 weeks of treatment, the levels of FMA-L,10MWT and MBI in both groups were improved(P＜0.05), especially in the observation group (P＜0.05). Conclusions The environmental stimulation intervention can improve the motor function of lower limbs and the ability of daily living in the elderly patients with post-stroke hemiplegia. References | Related Articles | Metrics

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Effects of individualized enteral nutrition under the concept of ERAS on immune function and inflammatory cytokines in elderly patients with craniocerebral injury LIU Hui, HUANG Min, TIAN Ya-li, BI Li-qing, TONG Zi-rong, CHU Bo-wen, ZHAO Qian 2023, 37 (6):  573-576.  doi: 10.3969/j.issn.1003-9198.2023.06.009 Abstract ( 126 )   PDF (1062KB) ( 856 )   Save Objective To investigate the effects of individualized enteral nutrition under the concept of enhanced recovery after surgery(ERAS) on immune function and inflammatory cytokines in the elderly patients with craniocerebral injury. Methods A total of 94 elderly patients with craniocerebral injury were randomly divided into the observation group and the control group, with 47 patients in each group. The observation group was given individualized enteral nutrition support 48 hours after admission, and the control group was given routine enteral nutrition treatment. The levels of inflammatory factors such as interleukin 6(IL-6), IL-8, tumor necrosis factor-α(TNF-α) and T lymphocyte subsets were measured before and 14 days after treatment. The infection rate and hospitalization time were compared between the two groups. Results After 14 days of treatment, the levels of serum IL-6, IL-8 and TNF-α in the two groups were significantly decreased (P<0.05), and the immune function indexes such as CD4+, CD8+ and CD4+/CD8+ were significantly increased (P<0.05),especially in the observation group (P＜0.05 or P<0.01). The hospitalization time of the observation group was significantly shorter than that of the control group. Conclusions Under the concept of ERAS, individualized enteral nutrition can effectively improve the immune function of the elderly patients with craniocerebral injury, reduce the levels of inflammatory factors, and promote the patients' recovery. References | Related Articles | Metrics

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Efficacy of superior or inferior gluteal artery bilobed flap in repairing hip pressure ulcers in elderly patients XU Pei, ZHANG Hong-ling, LONG Zhong-heng, ZHANG Xiang-ming, LIU Xiao-qin 2023, 37 (6):  577-580.  doi: 10.3969/j.issn.1003-9198.2023.06.010 Abstract ( 115 )   PDF (1248KB) ( 902 )   Save Objective To investigate the effects of superior or inferior gluteal artery bilobed flap in repairing hip pressure ulcer in the elderly patients. Methods The clinical data of 21 elderly patients with stage 4 gluteal pressure ulcer admitted to our hospital from 2015 to 2021 were retrospectively analyzed. Among them, 13 cases were repaired with superior gluteal artery bilobed flap and 8 cases were repaired with inferior gluteal artery bilobed flap. The situations of blood supply and survival of the flap, wound healing and complications were observed. After discharge, the patients were followed up for the appearance of the hip donor and recipient areas and recurrence of the pressure ulcer. Results The wound area after debridement or extended resection ranged from 7.5 cm×6 cm to 12 cm×10 cm. All flaps survived with good blood supply and no incision dehiscence occurred. The flap healed by the first stage in 20 patients. One patient presented with a 2 cm× 2 cm wound on the flap 5 days after operation, and the local infection crept along the subcutaneous area. After debridement, dressing change and delayed suture, the flap healed by stage Ⅲ. All patients were followed up for 1 to 12 months. The appearance of the donor and recipient areas of the buttocks was smooth and there was no recurrence of pressure ulcer. Conclusions The superior gluteal artery or inferior gluteal artery double leaf flap can solve the problem of high tension in the donor area of single leaf flap, with reliable blood supply of the flap, less postoperative complications and well restored appearance of the donor area and the recipient area, which is especially suitable for repairing hip pressure ulcer in the elderly patients with atherosclerosis occlusion. References | Related Articles | Metrics

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Correlation between triglyceride-glucose index and chronic kidney disease in the elderly population in Nanjing ZHENG Hui, WANG Ying, WANG Hui, YIN Hong-li,CHENG Yang, YIN Dong-hua 2023, 37 (6):  581-585.  doi: 10.3969/j.issn.1003-9198.2023.06.011 Abstract ( 93 )   PDF (1202KB) ( 1242 )   Save Objective To investigate the relationship between triglyceride-glucose index (TyG index) and the risk of evalucated glomerular filtration rate (eGFR) in the elderly population, and to explore its value as a simple indicator of insulin resistance(IR) in predicting the risk of chronic kidney disease (CKD). Methods A total of 5946 elderly patients (mean age: 70.54 years old, male account for 63.2%) who participated in physical examination from January to December 2019 were enrolled in this study. Through cross-sectional study, multi-factor Logistic regression and stratified analysis were used to explore the correlation between TyG index and CKD, and the receiver operating characteristic (ROC) curve predicting CKD was drawn. Results In 5946 subjects aged≥ 60 years, the incidence rate of CKD was 4.6%. Multi-factor Logistic regression model showed that TyG index was a risk factor for CKD. After adjusting sex, age, hypertension and body mass index (BMI), there was still a significant correlation between elevated TyG index and the risk of CKD. ROC curve analysis showed that TyG index and the clinical factors including age, sex, obesity and hypertension had a certain value in evaluating the occurrence of CKD, and the area under the curve (AUC) was 0.579 and 0.774, respectively. Further study showed that the predictive effect of TyG index combined with clinical factors was significantly better, and the AUC was 0.791. Conclusions As a simple index, TyG index has certain value in predicting the risk of CKD in the elderly population in Nanjing. References | Related Articles | Metrics

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Relationship between the awareness rate of core knowledge of chronic diseases and blood pressure control in elderly hypertensive patients QIN Zhen-zhen, QI Sheng-xiang, CHEN Yi-jia, WU Jie, YANG Hua-feng, YE Qing, WANG Chen-chen, HONG Xin 2023, 37 (6):  586-589.  doi: 10.3969/j.issn.1003-9198.2023.06.012 Abstract ( 95 )   PDF (1057KB) ( 936 )   Save Objective To investigate the influence of core knowledge of chronic diseases on blood pressure control in the elderly hypertensive patients in Nanjing. Methods A cross-sectional surveillance data on chronic diseases between 2017 and 2018 in Nanjing was used to evaluate the association between the awareness rate of core knowledge of chronic diseases and blood pressure control in elderly hypertensive patients. A total of 5997 reported hypertensive residents were enrolled in this study. Generalized linear mixed model regression was adopted to analyze the association. Results The awareness rate of core knowledge of chronic diseases in this study was 74.9%.After adjusting age, education level, smoking, drinking and other factors, the blood pressure control rate of the patients with core knowledge of chronic diseases was significantly higher than that of the patients without core knowledge of chronic diseases (OR=1.21, 95%CI:1.07-1.38). Stratified analysis showed similar effects in different genders (male:OR=1.21, 95%CI:1.01-1.45; female:OR=1.22, 95%CI:1.01-1.47) and regional groups(suburb area: OR=1.46, 95%CI:1.16-1.84), respectively. Conclusions The awareness rate of core knowledge of chronic diseases affects the blood pressure control of the elderly hypertensive patients. It is suggested that various targeted measures to popularize the core knowledge of chronic diseases should be taken to effectively control the blood pressure in the elderly with hypertension. References | Related Articles | Metrics

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A survey of blood glucose management in elderly patients with type 2 diabetes mellitus from the perspective of health status stratification ZONG Qian-xing,ZONG Xiao-yan,WANG Xue-fei, TAO Lu, GUO Chun, TANG Wei, WU Hai-di, LIU Dong-mei, FAN Yao, MO Yong-zhen 2023, 37 (6):  590-594.  doi: 10.3969/j.issn.1003-9198.2023.06.013 Abstract ( 101 )   PDF (1094KB) ( 709 )   Save Objective To explore the proportion, demographic and clinical characteristics of different health status stratifications in the elderly patients with type 2 diabetes mellitus (T2DM), and to analyze the blood glucose control level and the status of blood glucose attainment under different guidelines. Methods After a comprehensive evaluation of comorbidity, cognition and daily activities, the 253 elderly patients with T2DM were divided into good health group(n=87), intermediate health group(n=133)and poor health group(n=33). Demographic data, clinical characteristics and the compliance rate of blood glucose were compared among the three groups. Results Gender, age, marriage, living style, education level, drinking, complications, course of disease, diastolic blood pressure and insulin use showed significant differences among different stratification groups (P<0.05). Of all the patients, 44.3% (112/253) presented with glycosylated hemoglobin (HbA1c) value ＜7%. The control rate of blood glucose was 48.3% (42/87),41.4% (55/133)and 45.5% (15/33) in good health group,intermediate health group and poor health group, with no statistical difference (χ2=1.043, P=0.594). With the 2020 edition of the guidelines as reference, the HbA1c control rate of the three groups was 63.2% (55/87),66.9% (89/133) and 72.7%(24/33), respectively, which increased by 14.9%, 25.5% and 27.2%. According to the 2021 edition of the guideline, the control rate of HbA1c in the three groups decreased by 18.4%, 29.3%and 33.3%, respectively, compared with the 2020 edition.The HbA1c control rate was less than 40% in the poor health group, and the proportion of those who failed to meet the standard due to low blood glucose value was higher than that of those with high blood glucose value. Conclusions On the perspective of health status stratification, the level of HbA1c in the elderly patients with T2DM is low, and a considerable proportion of the patients have not met the standard recommended by the guidelines.In clinical practice, it is necessary to set glycemic control targets in combination with stratification and the use of drugs with high risk of hypoglycemia, so as to promote safer and more effective management. References | Related Articles | Metrics

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Effect of moderate aerobic exercise on the levels of serotonin, norepinephrine and autonomic function in elderly patients with depression ZHANG Yi, ZHENG Su-zhen, YANG Li-wei, LIN Qiang 2023, 37 (6):  595-598.  doi: 10.3969/j.issn.1003-9198.2023.06.014 Abstract ( 106 )   PDF (1056KB) ( 903 )   Save Objective To analyze the intervention effect of moderate aerobic exercise on the levels of serotonin (5-HT) and norepinephrine (NE) and autonomic function in the elderly patients with depression. Methods A total of 100 elderly patients with depression treated in our hospital from January 2020 to June 2021 were enrolled in this study, and were divided into the control group and the observation group according to the alternating grouping method, with 50 cases in each group. The control group received paroxetine, and the observation group received moderate aerobic exercise based on the control group for 12 weeks. The levels of 5-HT, NE, low frequency band (LF), high frequency band (HF), LF/HF ratio, the scores of self-rating depression scale (SDS) and Mini-mental State Examination (MMSE) and the intervention effect of the two groups were observed and compared. Results After intervention, the levels of 5-HT, NE, LF, LF/HF ratio and the MMSE score in the two groups increased significantly, especially in the observation group (P<0.01), and the SDS scores of the two groups decreased significantly, especially in the observation group (P<0.01). The total effective rate of the observation group was higher than that of the control group (P<0.05). Conclusions Moderate aerobic exercise intervention can improve the levels of 5-HT and NE, and has a positive effect on the autonomic nervous function in the elderly patients with depression. References | Related Articles | Metrics

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Effect of drug-coated balloons in patients with Medina 0,0,1 coronary bifurcation lesion ZHENG Ya-guo, XU Tian, ZUO Guang-feng, CHEN Liang, LIN Song 2023, 37 (6):  599-602.  doi: 10.3969/j.issn.1003-9198.2023.06.015 Abstract ( 120 )   PDF (1753KB) ( 889 )   Save Objective To evaluate the efficacy and safety of drug-coated balloons (DCB) in the treatment for Medina 0,0,1 coronary bifurcation lesion. Methods A total of 81 consecutive patients with Medina 0,0,1 coronary bifurcation lesion who were admitted to our hospital from January 2018 to June 2021 were enrolled in this study, and the clinical features, treatment and follow-up results were collected and analyzed. Results Among the 81 patients, there were 58 males and 23 females, with a mean age of 70.1±7.1 years old; Nine cases presented with ST-elevation myocardial infarction, 7 cases with non ST-elevation myocardial infarction, 55 cases with unstable angina and 10 cases with stable angina. Coronary angiography showed that ostial circumflex was involved in 29 cases, ostial diagonal was involved in 44 cases, ostial obtuse marginal was involved in 4 cases, and ostial posterior lateral was involved in 4 cases. The lesion length was 18.98±6.40 mm, the DCB length was 20.38±3.26 mm and the acute lumen gain was 1.12±0.32 mm after procedure. The late lumen loss was 0.02±0.32 mm during angiographic follow-up. Drug-eluting stent (DES) were used in 5 cases because of severe coronary dissection. During the follow-up, 4 patients underwent target revascularization, including 3 cases after DCB treatment and 1 case after salvage stent treatment. There were no death and myocardial infarction during the follow-up. Conclusions DCB treatment for Medina 0,0,1 coronary bifurcation lesions is effective and safe, but further studies are still needed to demonstrate the results. References | Related Articles | Metrics

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Effect of Solumbra technology in the treatment of elderly patients with cerebral infarction and the change of nerve injury markers BAI Jian-bing, WANG Yang, LI Zi-biao, XIANG Wen-jie 2023, 37 (6):  603-606.  doi: 10.3969/j.issn.1003-9198.2023.06.016 Abstract ( 108 )   PDF (1114KB) ( 743 )   Save Objective To analyze the clinical efficacy of Solumbra technology in the treatment of the elderly patients with cerebral infarction and the effects on the serum nerve injury markers. Methods A total of 220 patients with cerebral infarction admitted to our hospital from January 2019 to January 2021 were randomly divided into the observation group and the control group, with 110 cases in each group. The observation group was treated with Solumbra technique, and the control group was treated with conventional stent thrombectomy. The clinical effect, adverse events, the scores of National Institute of Health Stroke Scale(NIHSS) and modified Rankin Scale (mRS), the levels of serum brain-derived neurotrophic factor (BDNF), neuron specific enolization (NSE) and nerve growth factor (NGF) were compared between the two groups. Results The number of thrombectomy and thrombectomy time were significantly lower, and the first-pass revascularization rate was significantly higher in the observation group than those in the control group (P<0.05). The thrombolysis in cerebral infarction (TICI) grade of the observation group was significantly better (P<0.05), and the incidence rate of secondary embolism was significantly lower in the observation group than those in the control group. The NIHSS score of the observation group was significantly lower than that of the control group 72 hours, 1 week and 30 days after operation (P<0.01). Thirty days after operation, the levels of BDNF and NGF were significantly higher, and the level of NSE was significantly lower in the observation group than those in the control group (P<0.01). Ninety days after operation, the good prognosis rates and mRS score of the observation group were significantly higher than those of the control group(P<0.05). Conclusions Solumbra thrombectomy can effectively improve the clinical efficacy and improve the neurological function and nerve injury markers. References | Related Articles | Metrics

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Correlation between serum creatinine/cystatin C ratio and islet beta-cell function in elderly women with type 2 diabetes mellitus XIA Yun, ZHANG Guang-di 2023, 37 (6):  607-611.  doi: 10.3969/j.issn.1003-9198.2023.06.017 Abstract ( 101 )   PDF (1094KB) ( 788 )   Save Objective To investigate the correlation between serum creatinine/cystatin C ratio (Cr/Cys-C) and pancreatic β-cell function in the elderly female patients with type 2 diabetes mellitus(T2DM). Methods A total of 180 elderly female patients with T2DM aged≥65 years were enrolled, and the general clinical data were collected. All patients underwent 75 g oral glucose tolerance test (OGTT), and insulin resistance index (HOMA-IR), insulin secretion index (HOMA-β) and glucose disposal index (DI) were calculated. All patients were divided into three groups according to the tri-sectional quantiles of Cr/Cys-C and the above indexes were compared. The relationship between Cr/Cys-C and indicator of β-cell function was analyzed. Results Compared to the lower tertile group, InsAUC30, InsAUC120, HOMA-β and DI30 were significantly higher, and the levels of body mass index (BMI), waist circumference and HbA1c were significantly lower in the middle tertile group and the upper tertile group (P<0.05). Cr/Cys-C was positively correlated with fasting serum insulin (FINS) (r=0.187, P=0.005), InsAUC30(r=0.268, P<0.001), InsAUC120(r=0.216, P=0.002), HOMA-β(r=0.279, P<0.001), DI30(r=0.245, P<0.001) and DI120(r=0.183, P=0.005). After adjusting age, BMI, disease duration and HbA1c, these correlations were still present (P<0.05). Conclusions There is a positive correlation between serum Cr/Cys-C and pancreatic β-cell function in the elderly female patients with T2DM. References | Related Articles | Metrics

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Effect of hemoglobin on hospital acquired pressure ulcer in elderly long-term inpatients HAN Shan-shan, SHEN Xiao-xing 2023, 37 (6):  612-614.  doi: 10.3969/j.issn.1003-9198.2023.06.018 Abstract ( 91 )   PDF (1094KB) ( 1008 )   Save Objective To evaluate the association between hemoglobin(Hb) level and hospital acquired pressure ulcer(HAPU) in the elderly long-term inpatients. Methods A total of 838 elderly long-term inpatients(aged≥80 years) in Geriatric Hospital of Nanjing Medical University from 2017 to 2021 were selected. The patients' general information,the condition of stay in bed, incontinence and pressure ulcers, the status of cognition, Braden score and Hb level were collected. Single factor analysis and multivariate Logistic regression analysis were used to analyze the influencing factors of HAPU in the elderly long-term inpatients. Results Among 838 patients, 78 cases presented with HAPU, with an incidence rate of 9.31%. The patients with HAPU were mainly distributed in Intensive Care Unit, Hematology Oncology Department, Nephrology Department and Geriatric Department. Mann-Whitney U test showed that the incidence rate of HAPU in the patients with different Hb level was statistically significant(P<0.001). When the level of Hb decreased from ≥130 g/L to <100 g/L, the incidence rate of HAPU increased from 6.19% to 20.63%. Binary Logistic regression analysis showed that stay in bed, low Braden score and low Hb level were the independent risk factors for HAPU in the elderly long-term inpatients. Conclusions The Hb level of elderly long-term inpatients is associated with the risk of HAPU, so it is necessary to monitor the level of Hb in these patients. References | Related Articles | Metrics

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Prevalence and its change of self-reported diabetes mellitus in 2000 and 2017 among elderly people in urban area of Nanjing, China TIAN Si-yu, WANG Zhi-yong, LOU Qing-lin, XU Fei 2023, 37 (6):  615-619.  doi: 10.3969/j.issn.1003-9198.2023.06.019 Abstract ( 101 )   PDF (1086KB) ( 845 )   Save Objective To investigate the prevalence trend and risk factors of self-reported diabetes mellitus in the elderly people living in urban areas of Nanjing. Methods Two cross-sectional surveys were undertaken in the same urban areas of Nanjing, China, in 2000 and 2017. The same multi-stage sampling approach was used to randomly select participants. Demographic features and health-related behaviors were collected using questionnaires, and the height and weight were measured. Chi-square test was used to examine the demographic features, prevalence rate and epidemiological distribution of self-reported diabetes mellitus between the subjects in 2000 and those in 2017. Results The prevalence of self-reported diabetes mellitus in the elderly population of Nanjing was 6.1%(95%CI: 0.055-0.067)in 2000 and 20.2%(95%CI: 0.192-0.212)in 2017 (P<0.05), respectively. There were statistically significant differences in the self-reported prevalence rate in the elderly with same gender, age, education level, smoking, drinking, BMI and physical activity (P<0.05)between the two groups.There was significant difference in the prevalence of self-reported diabetes mellitus between the elderly with different age in each group (P<0.05). In 2000, there were significant differences in the prevalence among the elderly with different levels of education and drinking (P<0.05).In 2017, there were significant differences in the prevalence among the elderly with different levels of BMI and physical activity(P<0.05). Conclusions The prevalence of self-reported diabetes mellitus is high in the elderly population in Nanjing, which shows a time-dependent trend of increase. References | Related Articles | Metrics

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Incidence, progression of anemia and impact on prognosis in patients with severe pneumonia in intensive care unit TANG Yan, FENG Ping, WANG Shi-fang 2023, 37 (6):  643-646.  doi: 10.3969/j.issn.1003-9198.2023.06.026 Abstract ( 112 )   PDF (1061KB) ( 1007 )   Save Objective To investigate the onset and progression, and the impact of anemia on the prognosis of the patients with severe pneumonia admitted to intensive care unit(ICU). Methods A retrospective case-control study was conducted involving the patients with severe pneumonia who were admitted to ICU of Nanjng First Hospital from March 1,2020 to March 31, 2022. The patients were divided into survival group and death group according to their clinical outcome. The clinical data were collected from electronic medical record system. The baseline data and the level of hemoglobin (Hb) during ICU hospitalization were compared between the two groups. Logistic regression analysis was used to analyze the risk factors affecting the prognosis of the patients. Results A total of 43 patients were enrolled in the study,of which 22 died and 21 survived. Compared with survival group, death group had older age, higher score of Sequential Organ Failure Assessment(SOFA)and Acute Physiology and Chronic Health Evaluation scoring system (APACHE Ⅱ), lower average level of Hb over ICU days. During the ICU stay, the level of Hb kept dropping. The average total decrease of Hb reached (24.70±23.39)g/L.Logistic regression analysis showed that age, comorbidity and the average level of Hb were associated with the risk of worse outcome of the patients with severe pneumonia. Conclusions Anemia has negative effect on the prognosis of the patients with severe pneumonia in ICU, and it is important to prevent and treat hospital-acquired anemia. References | Related Articles | Metrics