Table of Content

20 July 2024, Volume 38 Issue 7 Previous Issue    Next Issue

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Analysis of related factors for cardiac valve calcification in elderly patients with maintenance hemodialysis TIAN Ying, DING Hong, CAO Jingyuan, XU Li, ZHU Jinhua 2024, 38 (7):  649-653.  doi: 10.3969/j.issn.1003-9198.2024.07.001 Abstract ( 146 )   PDF (1046KB) ( 385 )   Save Objective To analyze the influencing factors of cardiac valve calcification(CVC) in the elderly patients receiving maintenance hemodialysis(MHD). Methods A total of 104 elderly MHD patients treated at the Blood Purification Center of Yangzhong People's Hospital from June to September 2022 were selected as the study subjects. Based on the presence of CVC, they were divided into CVC group(45 cases) and non-CVC group(59 cases). Baseline data, vascular endothelial function, coronary artery calcification scores, and cardiac structure and function were compared between the two groups. Logistic regression analysis was used to identify the risk factors for CVC in the elderly MHD patients. Results Age, total score of coronary artery calcification, left main coronary artery and right coronary artery calcification score, post-diastolic left ventricular wall thickness, post-diastolic ventricular septal thickness and left ventricular mass index in CVC group were significantly higher and brachial arterial flow-mediated dilatation(FMD) in CVC group was significantly lower than those in non-CVC group. Multivariate Logistic regression analysis showed that aging (OR=1.121,95%CI:1.025-1.227)and the level of FMD(OR=0.879,95%CI:0.791-0.978) were the related factors for CVC in the elderly MHD patients(All P<0.05). Conclusions Aging and the decline of FMD are risk factors for CVC in the elderly MHD patients. Detection of FMD may be helpful for early identification and early warning of CVC. References | Related Articles | Metrics

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Verification of the reliability and validity of the modified Edmonton symptom assessment system in elderly patients receiving maintenance hemodialysis SUN Wei, ZHANG Liuping, LI Mengting, CAO Jingyuan, ZHANG Wei 2024, 38 (7):  654-657.  doi: 10.3969/j.issn.1003-9198.2024.07.002 Abstract ( 196 )   PDF (1175KB) ( 586 )   Save Objective To evaluate the reliability and validity of the modified Edmonton symptom assessment system(ESAS) in the elderly patients undergoing maintenance hemodialysis(MHD). Methods A total of 330 elderly patients(184 males and 146 females) who received MHD treatment in Blood Purification Center of Zhongda Hospital Southeast University from November to December 2023 were investigated by convenience sampling method. And the reliability and validity of the modified ESAS scale was tested. Results There were 11 items in the modified ESAS scale, and the correlation coefficient between each item and the total score was 0.60-0.77. Exploratory factor analysis showed that one common factor was extracted, and the cumulative variance contribution rate was 48.25%. The factor load of each item on the corresponding common factor was 0.60-0.76. The total Cronbach's α coefficient of the scale was 0.883, the Cronbach's α coefficient of each item ranged 0.866-0.880, and the broken half coefficient was 0.856. Conclusions The modified ESAS scale has good reliability and validity, and can be used to evaluate the symptoms of the elderly MHD patients. References | Related Articles | Metrics

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Analysis of risk factors of left ventricular diastolic dysfunction in elderly patients with maintenance hemodialysis DONG Fengming, HUANG Bikun, CAO Jingyuan, CHEN Huimin, ZHANG Yu, ZHANG Liuping, ZhANG Wei 2024, 38 (7):  658-661.  doi: 10.3969/j.issn.1003-9198.2024.07.003 Abstract ( 101 )   PDF (1035KB) ( 499 )   Save Objective To explore the risk factors of left ventricular diastolic dysfunction(LVDD) in the elderly patients undergoing maintenance hemodialysis(MHD). Methods A total of 178 elderly MHD patients who underwent dialysis treatment in Blood Purification Center of Zhongda Hospital Southeast University from March to December 2022 were enrolled in this study, and were divided into LVDD group and non-LVDD group. General information, biochemical indicators and echocardiographic indexes were collected and compared between the two groups. Multivariate Logistic regression analysis was used to screen the independent risk factors for LVDD in the elderly MHD patients. Results The dialysis age and the levels of interventricular septal thickness(IVST),parathyroid hormone(PTH), and brain natriuretic peptide(BNP) in LVDD group were significantly higher than those in non-LVDD group(P<0.05). Multivariate Logistic regression analysis showed that dialysis age(OR=1.284,95%CI:1.102-1.497) and IVST(OR=83.876,95%CI:5.942-118.404) were the risk factors for LVDD in the elderly MHD patients(P<0.01). Conclusions It is important to pay attention to LVDD in the elderly MHD patients with high levels of dialysis age and IVST . References | Related Articles | Metrics

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Prevalence and influencing factors of sarcopenia in elderly patients with H-type hypertension DU Yutian, LIAO Xinyi, ZHANG Suqiong, SHI Lei, CHENG Daomei 2024, 38 (7):  665-668.  doi: 10.3969/j.issn.1003-9198.2024.07.005 Abstract ( 83 )   PDF (1090KB) ( 471 )   Save Objective To explore the prevalence and influencing factors of sarcopenia(SA)in the elderly patients with H-type hypertension, and to provide reference for prevention and early intervention. Methods A total of 191 elderly patients(aged ≥60 years old) with H-type hypertension who received medical examinations from March to June 2021 were enrolled. According to the diagnostic criteria of SA of Asian Working Group for Sarcopenia 2019(AWGS), the patients were divided into the SA group(n=93) and the non-SA group(n=98). General information and laboratory test results were collected and compared between the two groups. Binary Logistic regression analysis was used to analyze the influencing factors for SA in the elderly patients with H-type hypertension. Results The waist circumference, neck circumference, calf circumference and BMI were significantly lower and the levels of age, diastolic blood pressure, platelet count and high-density lipoprotein cholesterol(HDL-C)were higher in the SA group than those in the non-SA group(P<0.01). The SA detection rates were 100%, 72.2%, 23.4% and 6.7% in the emaciated, normal-sized, overweight and obese individuals, respectively. The SA detection rate decreased with the increase of BMI (χ2 trend= 59.78, P < 0.001). Logistic regression analysis showed that BMI(OR=0.682,95%CI:0.555-0.838)and calf circumference(OR=0.621,95%CI:0.480-0.805)were the protective factors for the development of SA(P<0.05), and platelet counts(OR=1.012,95%CI:1.004-1.019)and HDL-C levels(OR=3.026,95%CI:1.105-8.283) were the risk factors for SA in the elderly patients with H-type hypertension(P<0.05). Conclusions The prevalence of SA in the elderly patients with H-type hypertension is high. Platelet count, HDL-C, BMI and calf circumference are the influencing factors for SA in the elderly patients with H-type hypertension. References | Related Articles | Metrics

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Association between the expression of a novel check point Siglec-15 and the prognosis of elderly patients with colorectal cancer DING Run, XU Li, YANG Junrong, MAO Yuan, ZHU Yidan, LIANG Guodong 2024, 38 (7):  669-673.  doi: 10.3969/j.issn.1003-9198.2024.07.006 Abstract ( 75 )   PDF (1937KB) ( 353 )   Save Objective To examine the expression of Sialic acid-binding immunoglobulin-like lectins(Siglec)-15 in the elderly patients with colorectal cancer(CRC) and to investigate the relationship of the expression of Siglec-15 with the clinical characteristics and the prognosis of CRC. Methods One-step quantitative polymerase chain reaction(qPCR) test was used in 6 fresh CRC samples as well as the corresponding non-cancerous tissue samples and tissue microarrays,and 60 elderly CRC samples and non-cancerous samples were detected by immunohistochemistry analysis. Cox regression and Kaplan-Meier survival analysis were conducted to evaluate the prognostic parameters in this elderly patients with CRC. Results The results of qPCR test and immunohistochemistry analysis showed that the expression of Siglec-15 in CRC tissues was significantly higher than that in paracancerous tissues(P=0.002,0.019,respectively). Moreover, the expression level of Siglec-15 protein in CRC was significantly related to gender(P=0.037), tumor location(P=0.040),lymph node metastasis(P=0.037) and TNM stage(P=0.003). Cox regression and Kaplan-Meier survival analysis showed that high Siglec-15 expression(HR=2.39),tumor differentiation (HR=3.81), distant metastasis(HR=9.53) were the influencing factors in the elderly patients with CRC(P＜0.05). Conclusions Siglec-15 is highly expressed in the CRC tissue, and is correlated with clinicopathological features of CRC. Siglec-15 may serve as a novel prognostic factor for the elderly patients with CRC. References | Related Articles | Metrics

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Current situation and influencing factors of oral health-related quality of life in elderly with mild cognitive impairment YE Niansi, HU Hui, DENG Bei, LIU Xueting, ZHOU Shi, LI Yucan, WANG Xiaomeng 2024, 38 (7):  674-678.  doi: 10.3969/j.issn.1003-9198.2024.07.007 Abstract ( 111 )   PDF (1045KB) ( 455 )   Save Objective To investigate the current situation and influencing factors of oral health-related quality of life(OHRQoL) in the elderly with mild cognitive impairment(MCI). Methods From March to June 2023, a total of 166 elderly patients with MCI were enrolled in this study. Professional oral examination, oral health status and behavior assessment scale were used to evaluate the oral health status and behavior of the elderly with MCI. The Geriatric Oral Health Assessment Index Scale(GOHAI) was used to assess the level of OHRQoL. Single factor analysis and multiple linear regression were used to analyze the influencing factors of OHRQoL in the elderly patients with MCI. Results The total GOHAI score of the elderly patients with MCI was 45.67±7.99. The score of GOHAI showed significant differences between the elderly with or without caries, paradentitis, unilateral chewing, oral and maxillofacial pain, and between the elderly with different self-perceived oral health status, brushing time and brushing style(all P＜0.05).Multivariate linear regression showed that chewing ability, oral and maxillofacial pain, self-perceived oral health status, brushing time and brushing style were the independent influencing factors for OHROoL in the elderly with MCI(all P< 0.05). Conclusions The OHRQoL of the elderly patients with MCI is at a low level. Attention should be paid to the elderly patients with MCI who have poor mastication ability, oral and maxillofacial pain, poor self-perceived oral health status, incorrect burshing time and incorrect brushing methods. References | Related Articles | Metrics

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Relationship of serum 25(OH) D, Hcy and prethrombotic state molecular markers with cognitive impairment in elderly patients with hypertension LUO Xing, LIANG Zhenling, DING Ling, HUANG Fang 2024, 38 (7):  679-682.  doi: 10.3969/j.issn.1003-9198.2024.07.008 Abstract ( 84 )   PDF (1034KB) ( 329 )   Save Objective To investigate the relationship of serum 25-hydroxyvitamin D[25(OH)D], homocysteine(Hcy) and prethrombotic state molecular markers with cognitive impairment in the elderly patients with hypertension. Methods The clinical data of 100 elderly hypertensive patients in our hospital from March 2021 to March 2023 were retrospectively analyzed, and the patients were divided into the cognitive impairment group(n=26) and the non-cognitive impairment group(n=74) according to whether they presented with cognitive dysfunction. The general data of the patients were collected, and the levels of 25(OH)D, Hcy, fibrinogen(Fbg), plasminogen activator inhibitor-1(PAI-1), vascular willebrand factor(vWF) and granule membrane protein-140(GMP-140) were detected and compared between the two groups. The receiver operating characteristics (ROC) curve was used to analyze the diagnostic efficiency of each index. The influencing factors for cognitive impairment in the elderly hypertensive patients were analyzed by multivariate Logistic regression analysis. Results The levels of age, Hcy, Fbg, PAI-1, vWF and GMP-140 were significantly higher, and the level of 25(OH) D in the cognitive impairment group was significantly lower than those in the non-cognitive impairment group(P<0.01). Multiple Logistic regression analysis showed that 25(OH) D, Hcy, Fbg, PAI-1, vWF, GMP-140 were the influencing factors of cognitive dysfunction in the elderly patients with hypertension(P<0.05). ROC curve analysis showed that the areas under the curve(AUC) of 25(OH) D, Hcy, Fbg, PAI-1, vWF and GMP-140 in predict cognitive dysfunction in the elderly patients with hypertension was 0.875, 0.850, 0.944, 0.876, 0.905 and 0.864, respectively. Conclusions The levels of 25(OH) D, Hcy and Fbg, PAI-1, vWF, GMP-140 are closely related to cognitive dysfunction in the elderly hypertensive patients, and the above indicators can be used to predict cognitive dysfunction in the elderly hypertensive patients. References | Related Articles | Metrics

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Effects of personalized nutrition intervention on lung function and immune status in elderly patients with chronic obstructive pulmonary disease MA Shengjun, ZHENG Aibo, SHEN Yibo, GU Li, SUN Kai, HUANG Dan 2024, 38 (7):  683-687.  doi: 10.3969/j.issn.1003-9198.2024.07.009 Abstract ( 82 )   PDF (1049KB) ( 490 )   Save Objective To explore the effects of personalized nutrition intervention on lung function and immune status in the elderly patients with chronic obstructive pulmonary disease (COPD)and malnutrition risk. Methods A total of 128 elderly COPD patients with malnutrition risk screened by Nutrition Risk Screening 2002(NRS 2002) score were divided into the personalized nutrition intervention group and the control group according to random number table method,with 64 cases in each group.The personalized nutrition intervention group was given individualized nutrition treatment,and the control group was given routine nutrition guidance.The indexes of nutritional status, lung function, exercise tolerance and immune status were observed and compared after 3 months of treatment. Results After treatment, the indexes of nutritional status, lung function, exercise tolerance and immune status in the individualized nutrition intervention group were all significantly improved compared with those before treatment(P<0.05), and showed significant difference with those in the control group(P<0.05).The indexes of nutritional status and immune status in the control group were significantly improved after treatment(P<0.05),while there were no significant difference in the lung function and exercise tolerance(P>0.05). Conclusions Individualized nutritional intervention can improve nutritional status, enhance lung function and exercise tolerance, and restore immune status in the elderly COPD patients with the risk of malnutrition. References | Related Articles | Metrics

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Diagnostic value of rapid on-site evaluation combined with radial probe endobronchial ultrasound transbronchial lung biopsy for peripheral pulmonary lesions in elderly patients JIANG Ting, LI Li, WANG Yan 2024, 38 (7):  688-692.  doi: 10.3969/j.issn.1003-9198.2024.07.010 Abstract ( 76 )   PDF (2071KB) ( 415 )   Save Objective To explore the value of rapid on-site evaluation(ROSE) during radial probe endobronchial ultrasound transbronchial lung biopsy(EBUS-TBLB) for peripheral pulmonary lesions(PPLs) in the elderly patients. Methods A total of 112 elderly patients who presented with undiagnosed PPLs by computed tomography(CT) were enrolled in this study. All patients received EBUS-TBLB examination, and biopsy specimens obtained from each operation underwent ROSE operation. The ROSE results were compared with the final pathological results, and the number of biopsies and operating time in ROSE positive group and ROSE negative group were recorded and compared. The feasibility and safety of ROSE combined with EBUS-TBLB in the the elderly patients with PPLs were analyzed. Results The diagnostic accuracy, sensitivity and specificity of ROSE combined with EBUS-TBLB for PPLs in the elderly patients were 90.2%, 86.7% and 97.3%, respectively. The number of biopsies and operating time were lower in ROSE positive group than those in ROSE negative group(All P＜0.05). No serious operative complications were observed. Conclusions ROSE combined with EBUS-TBLB is a safe and effective method for diagnosing PPLs in the elderly patients. References | Related Articles | Metrics

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Study on the relationship between percentage of body fat and blood glucose fluctuation in elderly patients with type 2 diabetes mellitus SHAN Zhuzi, WANG Xuefei, WU Haidi, LIU Dongmei, JIANG Hua, TANG Wei, MO Yongzhen, CUI Yan 2024, 38 (7):  693-696.  doi: 10.3969/j.issn.1003-9198.2024.07.011 Abstract ( 83 )   PDF (1034KB) ( 551 )   Save Objective To investigate the relationship between body fat percentage (BFP)and blood glucose fluctuation in the elderly patients with type 2 diabetes mellitus(T2DM). Methods The levels of BFP and blood glucose of 188 elderly patients with T2DM were collected, and the blood glucose standard deviation(SDBG) was used to reflect blood glucose fluctuation. According to the level of SDBG,all the patients were divided into great blood glucose fluctuation group(SDBG≥2 mmol/L) and small blood glucose fluctuation group(SDBG＜2 mmol/L). The levels of waist circumference, hip circumference, waist-to-hip ratio and BFP in the two groups were observed and compared.The relationship between SDBG and above indexes was analyzed. Results Compared to small blood glucose fluctuation group,the course of disease was significantly longer, and the waist circumference, hip circumference,waist-to-hip ratio,BFP were significantly lower in the great blood glucose fluctuation group(P<0.05). SDBG was negatively correlated with waist circumference,hip circumference,waist-to-hip ratio and BFP(r=-0.225,-0.162,-0.166,-0.232,respectively,all P<0.05). Binary Logistic regression analysis showed that BFP was the influencing factor of blood glucose fluctuation after adjusting course of disease, waist-to-hip ratio(OR=0.946, 95%CI: 0.903-0.991, P=0.020). Conclusions There is a negative correlation between BFP and blood glucose fluctuation in the elderly patients with T2DM. It is important to maintain reasonable BFP in the elderly patients with T2DM. References | Related Articles | Metrics

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Correlation between control nutritional status score and heart failure in elderly patients with coronary artery disease ZHANG Jingjing, ZHU Xiaoxia, YAO Chunlei, WANG Wei 2024, 38 (7):  697-700.  doi: 10.3969/j.issn.1003-9198.2024.07.012 Abstract ( 68 )   PDF (1029KB) ( 324 )   Save Objective To investigate the correlation between controlling nutritional status score(CONUT) and heart failure(HF)in the elderly patients with coronary artery disease(CAD). Methods A total of 202 patients who underwent coronary angiography(CAG) in the Second Affiliated Hospital of Anhui Medical University from January 2016 to January 2022 were enrolled, and they were divided into HF group(n=63) and non-HF(NHF) group(n=139). Multivariate Logistic regression was used to analyze the risk factors for HF in the elderly CAD patients . The predictive value of the related index was analyzed by receiver operating characteristic(ROC) curve. Results The age, proportion of advanced age, level of uric acid(UA), the socres of Gensini and CONUT were significantly higher and the levels of serum albumin and triglyceride(TG) were significantly lower in HF group than those in NHF group(P<0.05). Multivariate Logistic regression analysis showed that UA, Gensini score and CONUT score were the risk factors for HF in the elderly patients with CAD. The areas under the ROC curve(AUC) of CONUT score, UA, Gensini score and the combination of three indicators in predicting HF in the elderly patients with CAD were 0.587,0.685,0.614 and 0.729 respectively. Conclusions CONUT score is high in the elderly CAD patients with HF, and it has certain predictive value for the incidence of HF in the elderly patients with CAD. References | Related Articles | Metrics

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Risk factors for secondary hyperkalemia after potassium supplement in elderly patients with hypokalemia XIE Yuanyuan, CHEN Jingmian, DENG Ting, GAO Lei 2024, 38 (7):  701-704.  doi: 10.3969/j.issn.1003-9198.2024.07.013 Abstract ( 74 )   PDF (1032KB) ( 489 )   Save Objective To explore the risk factors for secondary hyperkalemia after potassium supplementation in the elderly patients with hypokalemia. Methods A total of 648 elderly patients with hypokalemia who were hospitalized in China Rehabilitation Research Center(Beijing Bo'ai Hospital) from January to December 2020 were consecutively enrolled. The patients presenting with secondary hyperkalemia after potassium supplementation were enrolled into the secondary hyperkalemia group, and the other patients were enrolled into the control group. The clinical data of two groups were collected for retrospective analysis. Binary Logistic regression analysis was used to analyze the rise factors for hyperkalemia in the elderly patients with hypokalemia. Results The incidence rate of secondary hyperkalemia after potassium supplementation in the elderly patients with hypokalemia was 11.6%(75/648). The age, prevalence rate of stroke and chronic renal insufficiency, baseline level of blood potassium, the rate of oral potassium supplementation and the usage rate of insulin and antibiotics were significantly higher while the levels of estimated glomerular filtration rate(eGFR) and hemoglobin(Hb) were significantly lower in the elderly patients with hypokalemia followed by hyperkalemia than those in the control group(P<0.05). Binary Logistic regression analysis showed that eGFR<60 mL/(min·1.73m2)(OR=2.49, 95%CI:1.43-4.32), Hb<90 g/L(OR=2.86, 95%CI:1.49-5.51), high baseline serum potassium level(OR=1.78,95%CI:1.09-2.92), insulin use(OR=2.57,95%CI:1.47-4.50) and antibiotic use(OR=2.39, 95%CI:1.05-5.43) were the risk factors for hyperkalemia after hypokalemia in the elderly patients. Conclusions The elderly patients with hypokalemia have a high risk of hyperkalemia after potassium supplementation, and potassium supplementation should be used with caution in these patients. References | Related Articles | Metrics

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Correlation between serum lipoprotein(a) and the risk of venous thrombus embolism in elderly inpatients KONG Chaomin, LYV Caixia, YAO Lixia, YUAN Xiaoye, WANG Suxing, SHAO Weihua, BAI Xuedong, WU Sisi, YANG Shuang, LI Fang 2024, 38 (7):  705-708.  doi: 10.3969/j.issn.1003-9198.2024.07.014 Abstract ( 76 )   PDF (1287KB) ( 344 )   Save Objective To investigate the correlation between the level of lipoprotein(a)[Lp(a)] and the risk of venous thrombus embolism(VTE) in the elderly inpatients. Methods A total of 246 patients admitted to Department of Geriatrics of Hebei General Hospital from January to June 2021 were divided into low-risk VTE group(<4 points) and high-risk VTE group(≥4 points) according to Padua score. The clinical data and the level of Lp(a) were collected and compared between the two groups. Spearman correlation analysis was used to analyze the correlation between Lp(a) and Padua score. Multivariate Logistic regression analysis was used to analyze the influencing factors for the risk of VTE in the elderly inpatients. The predictive value of Lp(a) for VTE was analyzed by receiver operating characteristic(ROC) curve. Results The levels of age, Lp(a) and D-dimer(D-D) in the high-risk VTE group were significantly higher than those in the low-risk group(P<0.01). The level of Lp(a) was positively correlated with Padua score and D-D(r=0.427, 0.225; P<0.01). Multivariate Logistic regression analysis showed that Lp(a), D-D and age were the risk factors for VTE in the elderly inpatients(P<0.01). ROC curve showed that the area under curve(AUC) of Lp(A) to evaluate the high risk of VTE was 0.742, with the cut-off value of 268.5 mg/L, the sensitivity of 66.0%, and the specificity of 76.0%. Conclusions Lp(a) level is significantly correlated with the risk of VTE in the elderly inpatients. References | Related Articles | Metrics

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CT-guided application of methylene blue combined with indocyanine green in preoperative localization of pulmonary nodule in the elderly HUANG Renhua, SHI Minke 2024, 38 (7):  709-712.  doi: 10.3969/j.issn.1003-9198.2024.07.015 Abstract ( 77 )   PDF (1851KB) ( 355 )   Save Objective To compare the feasibility and safety of Hookwire and methylene blue combined with indocyanine green (MB＆ICG)for the preoperative localization of pulmonary nodule (PN) in the elderly, and to explore the risk factors for common complications. Methods A retrospective analysis was conducted on the clinical data of 88 elderly patients who underwent preoperative localization of PN before video-assistant thoracoscopic surgery (VATS) at Nanjing Drum Tower Hospital from January to May 2023. The patients were divided into Hookwire group (n=50) and MB＆ICG group (n=38) group according to preoperative localization methods. General clinical data, operative data, localization effect and related complications of the two groups were compared. Multivariate Logistic regression was used to analyze the risk factors of common complications. Results No deaths or serious complications occurred during localization. Compared with MB＆ICG group, Hookwire group had higher incidence rate of pneumothorax, higher pain score and shorter positioning time (P<0.05). There was no significant difference in the localization success rate between the two groups (P>0.05). Multivariate Logistic regression analysis showed that location mode was an independent risk factor for pneumothorax (OR=17.708, 95%CI: 3.481-90.085, P<0.05). Conclusions Hookwire and MB ＆ICG under CT guidance had achieved good results in preoperative localization of PN in the elderly. Although the localization time of MB＆ICG was longer, the patients have a lower incidence of pneumothorax and less pain. References | Related Articles | Metrics

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Value of serum sTREM-1 combined with procalcitonin in predicting secondary acute cholangitis in elderly patients after biliary calculisurgery SHI Yi, GAO Ji, WANG Peng, RUI Yiqi, BAI Jianfeng 2024, 38 (7):  713-717.  doi: 10.3969/j.issn.1003-9198.2024.07.016 Abstract ( 78 )   PDF (1063KB) ( 295 )   Save Objective To investigate the predictive value of serum soluble myeloid cell trigger receptor-1 (sTREM-1) and procalcitonin (PCT) for secondary acute cholangitis (AC) in the elderly patients undergoing biliary calculi surgery. Methods A total of 145 elderly patients undergoing biliary calculus surgery from January 2019 to September 2022 were enrolled in this study, and the patients were divided into control group (without postoperative AC, n=56) and observation group (with postoperative AC, n=89). According to the degree of AC, the observation group was divided into three subgroups: mild group (n=37), moderate group (n=29) and severe group (n=23). The serum levels of white blood cells (WBC), C-reactive protein (CRP), PCT and sTREM-1 were detected and compared among the groups. Logistic regression was used to analyze the influencing factors of secondary AC and the severity. ROC curve was drawn to analyze the predictive efficiency of PCT and sTREM-1 levels for secondary AC in the elderly patients undergoing biliary caculi surgery. Results Compared with control group, the serum levels of WBC, CRP, PCT and sTREM-1 in observation group were significantly increased (P<0.01). Compared with mild group, the serum CRP, PCT and sTREM-1 levels in moderate group and severe group were significantly increased; Compared with moderate group, the serum levels of WBC and PCT in severe group were significantly increased (all P<0.05).Logistic regression analysis showed that the serum levels of CRP, PCT and sTREM-1 were the independent risk factors of postoperative AC and severe degree in the elderly patients (all P<0.05). ROC curve results showed that the combination detection of serum PCT and sTREM-1 showed higher predicting efficiency than single detection of them in predicting the incidence of postoperative AC and the severe degree (all P<0.05). Conclusions The serum PCT and sTREM-1 levels in the elderly patients with secondary AC after biliary calculi operation are significantly increased, and the combined detection of PCT and sTREM-1 has good predictive value for the incidence of postoperative AC. References | Related Articles | Metrics

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Correlation analysis of clinicopathologic features and prognosis in eighty-one elderly patients with pancreatic neuroendocrine tumors XUE Bingyan, XU Ruitong, GU Danyang, ZHU Guoqin 2024, 38 (7):  718-721.  doi: 10.3969/j.issn.1003-9198.2024.07.017 Abstract ( 61 )   PDF (1035KB) ( 608 )   Save Objective To investigate the clinicopathological features and the relationship with prognosis in the elderly patients with pancreatic neuroendocrine tumors (pNENs). Methods The clinicopathological and follow-up data of 81 elderly patients with pNENs who were hospitalized in the First Affiliated Hospital of Nanjing Medical University from January 2018 to June 2022 were collected. Univariate analysis was performed using χ2test, and binary Logistic regression analysis was used to evaluate the independent risk factors for prognosis. Results Among the 81 elderly patients aged 60 to 89 years old (41 males and 40 females), 68 cases presented with non-functional pNENs, and 13 cases presented with functional pNENs which were diagnosed as insulinoma. The pathological classification showed 21 cases (25.93%) of G1 grade, 43 cases (53.09%) of G2 grade, 6 cases (7.41%) of G3 grade, 8 cases (9.88%) of neuroendocrine tumor (NEC) and 3 cases (3.70%) of mixed neuroendocrine-non-neuroendocrine neoplasms (MiNEN). The follow-up time ranged from 1 to 58 months. There were 18 cases of death. Single factor analysis showed that tumor function (P=0.028), tumor grade (χ2=44.387, P < 0.01), TNM stage (χ2=25.980, P < 0.01), surgery (P=0.002) were associated with the overall prognosis of the patients with pNENs. Logistic regression analysis indicated that tumor TNM stage (P=0.035) was the independent risk factor for the prognosis of pNENs. Conclusions Tumor TNM stage is a key indicator affecting the prognosis of the patients with pNENs. References | Related Articles | Metrics

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Analysis of clinical and serological characteristics of hepatitis E in 50 elderly patients CHEN Tufen, ZHANG Bo 2024, 38 (7):  722-726.  doi: 10.3969/j.issn.1003-9198.2024.07.018 Abstract ( 67 )   PDF (1061KB) ( 333 )   Save Objective To investigate the clinical and serological characteristics of hepatitis E in the elderly patients. Methods The differences in the clinical characteristics and serum biochemical indexes between 50 elderly patients with hepatitis E(elderly group) and 50 young and middle-aged patients with hepatitis E(young and middle-aged group) were analyzed. Results The incidence rate of liver failure, skin itching, comorbidities and complications and the hospital stay and disease course were higher while the incidence rate of fever was lower in elderly group than that in young and middle-aged group(P<0.01). Before treatment, the levels of total bilirubin(TBiL), creatinine(Cr), ptrothrombin time(PT), international normalized ratio(INR) were significantly higher and the levels of alanine aminotransferase(ALT)and albumin(ALB) were lower in elderly group than those in young and middle-aged group(P<0.05).After treatment, the levels of TBiL,ALT, aspartate aminotransferase(AST), gamma-glutamyl transferase(γ-GGT), alkaline phosphatase(AKP) in the two groups were significantly lower and the level of ALB was significantly higher than that before treatment(P<0.05), and the levels of TBiL, AKP, PT, INR decreased more significantly in young and middle-aged group(P<0.05). Conclusions The elderly patients with hepatitis E have obvious skin pruritus, deep jaundice, more hypoalbuminemia, high incidence of liver failure, common complications, prolonged course of disease and slow recovery, and most patients have a good prognosis. References | Related Articles | Metrics

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Relationship between postoperative cognitive dysfunction and intraoperative tissue oxygen saturation in elderly patients with hip fracture GONG Jian, LUO Cheng, SONG Chen, ZHAO Xiaoyong, FENG Zhijie 2024, 38 (7):  727-731.  doi: 10.3969/j.issn.1003-9198.2024.07.019 Abstract ( 67 )   PDF (1171KB) ( 386 )   Save Objective To analyze the correlation between intraoperative tissue oxygen saturation and postoperative cognitive dysfunction(POCD) in the elderly patients with hip fracture. Methods A total of 215 elderly patients with hip fracture treated in our hospital from January 2020 to June 2022 were selected and divided into POCD group(n=42) and non-POCD group(n=173) according to Z score method determined by the International Study of Postoperative Cognitive Dysfunction (ISPOCD). The levels of cerebral tissue oxygen saturation(SctO2) and lower limb muscle tissue oxygen saturation(SmtO2) were observed and compared between the two groups. Logistic regression model was used to analyze the risk factors of POCD in the elderly patients with hip fracture. Receiver operating characteristic(ROC) curve was drawn to analyze the predictive value of SctO2 for POCD in the elderly patients with hip fracture. Results The age, proportion of the patients with diabetes, intraoperative blood loss, anesthesia time, operation time, postoperative pain score and high sensitivity C reactive protein(hs-CRP) level were significantly higher, while the level of SctO2 and the years of education were significantly lower in POCD group than those in non-POCD group(P<0.05). Logistic regression analysis showed that aged ≥80 years old, complicated with diabetes mellitus, high level of intraoperative blood loss and low level of SctO2 were the risk factors for POCD(P<0.05). According to ROC curve analysis, SctO2(68% as the optimal cut-off point) showed predictive value for POCD in the elderly patients with hip fracture, with the sensitivity, specificity and AUC of 90.70%, 90.17% and 0.809(95%CI: 0.742-0.875), respectively. Conclusions Low SctO2, aged ≥80 years old, complicated with diabetes and high level of intraoperative blood loss are the risk factors for POCD in the elderly patients with hip fracture. SctO2 has a good predictive value for POCD in the elderly patients with hip fracture. References | Related Articles | Metrics

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Application and effectiveness evaluation of nursing health prescription in dental implant restoration for elderly patients with dental defects JI Qi, YUAN Miao 2024, 38 (7):  753-756.  doi: 10.3969/j.issn.1003-9198.2024.07.025 Abstract ( 80 )   PDF (1034KB) ( 301 )   Save Objective To explore the application effect of nursing health prescriptions in the elderly patients with dental defects undergoing dental implant restoration. Methods A total of 80 elderly patients with dental defects who underwent dental implant restoration in our hospital from January to December 2023 were selected and divide into two groups according to the random number table method, with 40 cases in each group. The control group received routine care, while the observation group received nursing health prescription care on the basis of the control group. After 3 months of intervention, the oral health literacy, psychological status, periodontal status and satisfaction with implant restoration were compared between the two groups. Results After intervention, the oral Health Literacy Scale(HOLD-14) score was significantly higher, and the scores of self-perceived Burden Scale(SPBS) and modified Dental Anxiety Scale(MDAS), plaque index(PLI), gingival sulcus bleeding index(SBI) and probing depth(PD) were lower in the observation group than those in the control group(P<0.05).The satisfaction of implant restoration in the observation group was higher than that in the control group(95.00% vs 77.50%, P<0.05). Conclusions Nursing health prescription interventions can effectively enhance oral health literacy, improve psychological and periodontal conditions, and further enhance satisfaction with dental implant restoration in the elderly patients with dental defects undergoing dental implant restoration. References | Related Articles | Metrics