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20 October 2023, Volume 37 Issue 10 Previous Issue    Next Issue

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Application of resistance training combined with high milk protein nutrition in elderly patients with type 2 diabetes mellitus and sarcopenia ZHANG Lin-ying, MEI Qun-chao, ZHANG Wei-qi, HU Yi-lan 2023, 37 (10):  995-999.  doi: 10.3969/j.issn.1003-9198.2023.10.005 Abstract ( 107 )   PDF (1036KB) ( 839 )   Save Objective To explore the effect of resistance training combined with high milk protein nutrition in the elderly patients with type 2 diabetes mellitus (T2DM) and sarcopenia. Methods A total of 78 elderly patients with T2DM and sarcopenia admitted to our hospital from January 2021 to January 2022 were selected as the study subjects, and were randomly divided into two groups, with 39 cases in each group. The control group received routine treatment, while the study group received resistance training combined with high milk protein nutrition intervention on the basic treatment of the control group. The skeletal muscle mass index, grip strength, fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), quality of life (QOL) and the incidence of falls in two groups were observed and compared. Results After intervention, the levels of skeletal muscle mass index and grip strength in the study group were significantly higher than those before intervention and those in the control group (P<0.05). The levels of FPG and HbA1c were significantly decreased in two groups after intervention, especially in the study group (P<0.05). After intervention, the scores of QOL of all dimensions were significantly higher than those before intervention in the study group (P<0.05), and the scores of physiological function, role physical, overall health, and mental health in the study group were higher than those in the control group (P<0.05). The incidence rate of falls in the study group was lower than that in the the control group (5.13% vs 23.08%,P<0.05). Conclusions Resistance training combined with high milk protein nutrition can significantly improve the skeletal muscle mass index and grip strength of the elderly T2DM patients with sarcopenia, reduce blood glucose, improve the QOL of the patients and reduce the incidence of falls. References | Related Articles | Metrics

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Predictive value of early changes of syndecan-1 for clinical outcome in elderly patients with sepsis CHEN Cheng, CUI Jing, JI Xiao-qi, YAO Li 2023, 37 (10):  1000-1003.  doi: 10.3969/j.issn.1003-9198.2023.10.006 Abstract ( 116 )   PDF (1238KB) ( 823 )   Save Objective To investigate the predictive value of syndecan-1(SDC-1) for the prognosis in the elderly patients with sepsis. Methods A total of 102 elderly patients with sepsis in Department of Critical Medicine of our hospital from May 2021 to June 2022 were enrolled. Among them, 44 cases survived (survive group) and 58 cases died (death group) within 28 days. Acute Physiology and Chronic Health Evaluation (APACHEⅡ) and Sequential Organ Failure Assessment (SOFA) were used to evaluate the severity of disease. The levels of lactate (Lac), procalcitonin (PCT), heparin-binding protein (HBP), white blood cell (WBC), neutrophil percentage (N%), platelet (PLT), SDC-1 and the decrease of syndecan-1 (ΔSDC-1) in three days were observed and compared between the two groups. Multivariate Logistic regression analysis was used to explore the risk factors of the prognosis. The receiver operating characteristic (ROC) curve was drawn and the area under the curve (AUC) was calculated to evaluate the predictive value of the influencing factors in the elderly patients with sepsis. Results Compared with survival group, the APACHEⅡscore, SOFA score, and the levels of PCT, HBP, Lac and SDC-1 in death group were significantly increased, and the level of ΔSDC-1 was significantly decreased (P<0.01).ΔSDC-1, SOFA score and APACHEⅡ score were the independent risk factors for 28 d mortality in the elderly patients with sepsis (P<0.05). The ROC curve analysis showed that the predictive value of SOFA score for 28 d death in the elderly patients with sepsis was the highest, followed by ΔSDC-1 level and APACHEⅡ score. Conclusions The dynamic decline level of SCD-1 has a high value in assessing the risk of death in the elderly patients with sepsis. References | Related Articles | Metrics

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Polymorphism analysis of UGT1A1*28 and *6 genes in elderly patients with colorectal cancer JIANG Lu, DING Ying, JI Pan, MIAO Chen, LYU Jun-wen, CHEN Xu-yan, SHI Shan-shan, LI Xiao 2023, 37 (10):  1004-1008.  doi: 10.3969/j.issn.1003-9198.2023.10.007 Abstract ( 92 )   PDF (1044KB) ( 978 )   Save Objective To analyze the gene polymorphisms of UGT1A1*28/*6 in the elderly patients with colorectal cancer by molecular pathological assay. Methods The tissue samples of the elderly patients with colorectal cancer were analyzed by polymerase chain reaction(PCR)-capillary electrophoresis and sequencing. Results The distribution patterns of UGT1A1*28 and UGT1A1*6 genotypes in the elderly patients with colorectal cancer were wild type, mutant hybrid type and mutant homozygous type. There were no significant differences in gender, tumor types, tumor T-stage and primary tumor site between the two genetic polymorphisms(P>0.05). Conclusions The distribution patterns of UGT1A1*28 and UGT1A1*6 genotypes were not affected by gender, tumor types, tumor T-stage and primary tumor site in the elderly patients with colorectal cancer. UGT1A1*6 is more susceptible to occur pure mutation than UGT1A1*28. If a pure mutation occurs at either gene locus, there may be mutational rejection at the other locus. References | Related Articles | Metrics

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Diagnostic value of growth differentiation factor 15 and cytokines in elderly patients with coronary heart disease complicated with frailty YANG Xue, NING Chun, ZHAO Juan, HAO Jing-bo, YANG Rong-li 2023, 37 (10):  1009-1013.  doi: 10.3969/j.issn.1003-9198.2023.10.008 Abstract ( 100 )   PDF (1210KB) ( 835 )   Save Objective To investigate the diagnostic value of growth differentiation factor 15 (GDF15) and cytokines in the elderly patients with coronary heart disease (CHD) complicated with frailty. Methods A total of 88 elderly CHD patients treated at the Affiliated Hospital of Xuzhou Medical University from July to September 2022 were enrolled in this study. According to the Frail scale, the patients were divided into the frailty group (27 cases) and the non-frailty group (61 cases). The general data, serum levels of GDF15 and cytokines of the two groups were detected and compared. The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of GDF15 and cytokines for frailty in the elderly patients with CHD. Results The age, age-adjusted Charlson comorbidity index (ACCI) and the levels of GDF15, interleukin-1β(IL-1β), IL-5, IL-6, IL-10, interferon-α(IFN-α), IFN-γ and tumor necrosis factor-α(TNF-α) in the frailty group were significantly higher than those in the non-frailty group (P＜0.05). The area under the ROC curve (AUC) showed that the combined diagnosis of IFN-α, IFN-γ and GDF15 for frailty in the elderly CHD patients was superior to the diagnostic value of each single indicator (P＜0.05). Conclusions IFN-α, IFN-γ and GDF15 can serve as diagnostic indicators for frailty in the elderly CHD patients, and the efficacy of the combination of three indicators is higher. References | Related Articles | Metrics

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Influence of intrinsic capacity decline on quality of life of the community elderly ZHAO Ya-xuan, ZHANG Li, WU Gen-li, ZHOU Jing-lei, SONG Nan-nan 2023, 37 (10):  1014-1018.  doi: 10.3969/j.issn.1003-9198.2023.10.009 Abstract ( 103 )   PDF (1036KB) ( 1017 )   Save Objective To explore the impact of intrinsic capacity decline on quality of life in the community elderly. Methods From October to December 2021, 577 elderly people aged ≥60 years old in 3 communities in Bengbu were enrolled in this study by convenience sampling. The questionnaire survey was conducted with self-made general condition questionnaire, intrinsic capacity assessment tool, quality of life scale and other tools. Results Among the 577 community elderly, 87% (502/577) of the elderly presented with intrinsic capacity decline in different dimensions. The physical component summary (PCS) score was 64.28(42.85, 78.57), and the mental component summary (MCS) score was 80.95(71.42, 85.71) of the community elderly. Regression analysis showed that after controlling general demographic variables, frailty status, comorbidity and decreased intrinsic capacity were closely correlated with the PCS score; Comorbidity status and decreased intrinsic capacity were closely correlated with the MCS score. Conclusions The intrinsic capacity of the community elderly is generally decreased. Intrinsic capacity is closely related to the quality of life of the elderly. References | Related Articles | Metrics

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Analysis of the incidence and risk factors of postoperative delirium in elderly patients with different personalities undergoing laparoscopic hysterectomy XU Huan-xi, LI Xian-rui, WU Hao, XU Xu 2023, 37 (10):  1019-1022.  doi: 10.3969/j.issn.1003-9198.2023.10.010 Abstract ( 94 )   PDF (1019KB) ( 832 )   Save Objective To explore the incidence and risk factors of postoperative delirium(POD) in the elderly patients with different personalities undergoing laparoscopic hysterectomy. Methods A total of 168 elderly patients undergoing laparoscopic hysterectomy were enrolled in this study, and the related data such as age, hemoglobin level, CO2 pneumoperitoneum time and pressure, blood loss, preoperative anxiety and postoperative pain control, and the dimension score of personality questionnaire were observed and recorded. All the patients were divided into POD group and non-POD group according to whether they presented with POD. Single factor and multiple factor binary Logistic regression analysis were used to analyze the relevant factors for POD in the patients. Results Among 168 elderly patients undergoing laparoscopic hysterectomy, 53 cases (31.55%) presented with POD. The incidence of POD in the patients with introverted personality (48.08%) was significantly higher than that in the patients with extroverted (18.37%) and intermediate (28.36%) personality (P<0.05). Multivariate Logistic regression analysis showed that age >70 years, preoperative anemia, CO2 pneumoperitoneum time >90 min, poor postoperative pain control and internal and external dimension score <43.3 were the risk factors of POD, while neuroticism dimension score <43.3 was the protective factor of POD. Conclusions The elderly patients with laparoscopic hysterectomy have a high incidence of POD. The personalities show effects on the occurrence of POD. References | Related Articles | Metrics

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Meta-analysis of sacubitril valsartan in the treatment of elderly patients with chronic heart failure LI Shan-shu, LYU Yi-ning, GONG Hui-min, ZHANG Gai-gai 2023, 37 (10):  1023-1026.  doi: 10.3969/j.issn.1003-9198.2023.10.011 Abstract ( 102 )   PDF (1660KB) ( 1014 )   Save Objective To systematically evaluate the efficacy and safety of sacubitril valsartan in the treatment of chronic heart failure(CHF) in the elderly patients. Methods The related literatures were retrievaled in the databases such as Chinese National Knowledge Infrastructure (CNKI), VIP, China Biology Medicine (CBM), Wanfang database and PubMed. Randomized controlled trials(RCTs)about the efficacy of sacubitril valsartan in the treatment of CHF in the elderly patients were collected. The retrieved literatures were screened and the data were extracted. Meta-analysis was performed by using RevMan 5.3 software. Results A total of 1299 patients from 12 RCTs were enrolled. The results showed that the efficacy of sacubitril valsartan in the treatment of the elderly patients with CHF (experiment group) was better than basic treatment alone (control group) (RR =1.23,95%CI: 1.18-1.30). Meanwhile, the left ventricular ejection fraction(MD=6.16,95%CI:5.66-6.55), N-terminal pro B-type natriuretic peptide(MD=-363.44,95%CI:-397.35--329.53), left ventricular end-diastolic dimension (MD=-4.58,95%CI:-6.10--3.06)and 6-minute walk distance(MD=57.3,95%CI:23.76-90.84) in experiment group were more significantly improved than those in the control group. The incidence of adverse reactions was reported in 8 out of 12 articles. The results showed that there was no significant difference in the incidence rate of adverse reactions between the two groups(RR=0.87,95%CI:0.63-1.20). Conclusions The treatment of sacubitril valsartan in the elderly patients with CHF can significantly improve the clinical efficacy and cardiac function, while the incidence of adverse reactions is not increased. References | Related Articles | Metrics

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Application of modified UE video laryngoscope glottis exposure method in emergency tracheal intubation outside the operating room for elderly patients LI Nan, LIU Yang, LIU Cun-ming, YANG Chun, DING Zheng-nian, LIU Shi-jiang 2023, 37 (10):  1027-1030.  doi: 10.3969/j.issn.1003-9198.2023.10.012 Abstract ( 90 )   PDF (1017KB) ( 835 )   Save Objective To compare the glottis exposure time and complications between the modified UE video laryngoscope glottis exposure method and the traditional method during tracheal intubation in emergency elderly patients. Methods A total of 128 elderly patients receiving emergency tracheal intubation in our hospital from January 2021 to January 2022 were enrolled in this study, including 90 males and 38 females. The elderly patients were divided into modified group (group M) and traditional group (group T), with 64 cases in each group. For the patients in group M, the blade of the UE video laryngoscope was put into the patient's mouth alone, and then the video laryngoscope was clamped into the blade. In group T, the UE video laryngoscope with the installed blade was placed directly into the patient's mouth. The glottis exposure time, the degree of glottic visualization, the time to complete intubation, the number of finger-assisted exposure cases and the occlusal force level were recorded. The incidence of the complications such as bleeding of lips, gums, oral mucosa was recorded. Results There was no significant difference in the glottis exposure time between the two groups (P>0.05). The incidence rate of bleeding complications of lips, gums and oral mucosa in group M was significantly lower than that in group T (P<0.01), especially when the elderly patients had occlusal force of grade Ⅰ (P=0.006). Conclusions The modified UE video laryngoscope glottis exposure method could reduce the intubation complications such as the bleeding of lips, gums and oral mucosain in the elderly patients, without increasing the glottis exposure time References | Related Articles | Metrics

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Analysis of the incidence and influencing factors of postoperative delirium in elderly patients with different nutritional status undergoing proximal femoral nail antirotation under general anesthesia ZHANG Xiao-jie, CHEN Xue, RAO Li-hua, LIU Wei 2023, 37 (10):  1031-1034.  doi: 10.3969/j.issn.1003-9198.2023.10.013 Abstract ( 90 )   PDF (1027KB) ( 674 )   Save Objective To explore the incidence and risk factors of postoperative delirium (POD) in the elderly patients with different nutritional status who received proximal femoral nail antirotation (PFNA) internal fixation, and to provide basis for targeted intervention. Methods A total of 335 elderly patients were selected from Suqian Hospital of Nanjing Drum Tower Hospital Group who received PFNA internal fixation under general anesthesia. Mini Nutritional Assessment Short-form (MNA-SF) was used to assess the nutritional status before operation, and Confusion Assessment Method (CAM) was used to assess the incidence of POD. Multiple Logistic regression analysis was performed to analyze the influencing factors of the occurrence of POD. Results The incidence rate of POD was 26.23% (48/183)in the elderly patients with normal nutrition, compared with 41.45% (63/152) in those with MNA-SF score of 0-11 (P<0.05). The incidence rate of POD in the elderly patients with MNA-SF score of 0-7 was significantly higher than that in the patients with score of 8-11 (60.78% vs 31.68%, P<0.05). Multivariate Logistic regression analysis showed that age ≥ 75 years, body mass index <20, malnutrition, hypoalbuminemia, general anesthesia time ≥ 120 min, poor postoperative analgesia effect and MMSE score<27 were the risk factors for POD in the elderly patients receiving PFNA internal fixation. Conclusions The incidence rate of POD in the elderly patients undergoing PFNA surgery with malnutrition risk or malnutrition is higher. The patients with poorer nutritional status are more likely to have POD. References | Related Articles | Metrics

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Influencing factors of hemorrhagic transformation in elderly patients with acute cerebral infarction after thrombolysis with alteplase NIU Cui, YANG Hua, ZHANG Xiao-xia, LI Zhi-wen, YIN Hai-qing 2023, 37 (10):  1035-1038.  doi: 10.3969/j.issn.1003-9198.2023.10.014 Abstract ( 98 )   PDF (1125KB) ( 615 )   Save Objective To analyze the influencing factors of hemorrhagic transformation (HT) after thrombolysis with alteplase (rt-PA) in the elderly patients with acute cerebral infarction (ACI). Methods A total of 80 elderly patients with ACI who received intravenous thrombolysis with rt-PA from July 2019 to July 2021 in our hospital were enrolled. The patients were divided into HT group (n=16) and non-HT group (n=64) according to whether the patients presented with HT. The clinical data of the two groups were compared. Multivariate Logistic regression was used to analyze the independent influencing factors of HT after thrombolysis in the elderly patients with ACI. The receiver operating characteristic (ROC) curve was drawn to analyze the efficacy of the related factors to predict HT after thrombolysis in the elderly patients with ACI, and nomogram prediction model was constructed and its efficiency was evaluated. Results The history of atrial fibrillation (AF), National Institutes of Health Stroke Scale (NIHSS) score before thrombolysis, mean platelet volume (MPV) and platelet distribution width (PDW) were the independent risk factors of HT in the elderly patients with ACI after thrombolysis, while Alberta stroke program early CT (ASPECT) score was an independent protective factor (P<0.05). The area under the ROC curve (AUC), sensitivity and specificity of the combination of the influencing factors in predicting HT were significantly higher than those of each factor alone (P<0.05). The nomograph model showed a high degree of discrimination, accuracy, and effectiveness. Conclusions The history of AF, NIHSS score before thrombolysis, ASPECT score, MPV and PDW are closely related to the occurrence of HT after thrombolysis in the elderly patients with ACI. References | Related Articles | Metrics

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Application of soothing music during conscious colonoscopy examination of elderly patients ZANG Ling, HE Wei 2023, 37 (10):  1069-1071.  doi: 10.3969/j.issn.1003-9198.2023.10.024 Abstract ( 83 )   PDF (999KB) ( 840 )   Save Objective To investigate the effect of soothing music on the elderly patients undergoing conscious colonoscopy examination. Methods A total of 220 elderly patients were randomly selected from the patients who made an appointment for conscious colonoscopy in our center (non anesthetic colonoscopy), and were randomly divided into the control group (n=110) and the observation group (n=110). The patients in the control group received routine health education and nursing, while the patients in the observation group received soothing music intervention on the basis of routine education and nursing. The differences in discomfort and tolerance between the two groups were compared. Results The time of entering the microscope, the degree of abdominal pain and distension, the incidence rate of nausea and vomiting, anxiety and fear scores in the observation group were lower than those in the control group with significant differences (P<0.05). Conclusions The application of soothing music during colonoscopy examination can significantly shorten the time of colonoscopy, relieve the discomfort and the bad mood accompanying the examination, and improve the tolerance of the elderly patients, which is a good auxiliary method for elderly patients during conscious colonoscopy examination. References | Related Articles | Metrics