Table of Content

20 January 2025, Volume 39 Issue 1 Previous Issue    Next Issue

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Effects of environmental exposure on frailty PANG Shu, JIANG Chunyan 2025, 39 (1):  3-7.  doi: 10.3969/j.issn.1003-9198.2025.01.002 Abstract ( 45 )   PDF (1147KB) ( 130 )   Save Frailty is a complex geriatric syndrome characterized by decreased physiological reserve capacity, decreased physiological function and increased susceptibility to stressful events. As an important external factor of frailty, environmental exposure has gradually become a research hotspot. This article aims to review the effects of environmental exposures on frailty and explore the main environmental exposure factors and their mechanisms, epidemiology, intervention strategies, and future research directions, so as to provide more scientific basis for early identification and intervention of frailty. References | Related Articles | Metrics

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Relationship between environmental exposure and sarcopenia DONG Xiaofei, ZHANG Fei, WANG Jiahe 2025, 39 (1):  8-11.  doi: 10.3969/j.issn.1003-9198.2025.01.003 Abstract ( 52 )   PDF (1007KB) ( 307 )   Save With the rapid development of society, the harm of environmental pollution has become increasingly prominent. With the progress of population aging, the prevelence of sarcopenia is increasing, which increases the national public health burden. This article reviews the effects and mechanisms of common environmental exposures such as air pollution, heavy metal exposure and noise pollution on sarcopenia, and elucidates that mitochondrial dysfunction and chronic inflammation caused by environmental pollution are closely related to the occurrence and progression of sarcopenia, and emphasizes the hazards of heavy metal exposure, in order to provide new ideas for the clinical diagnosis, treatment, and scientific research of sarcopenia. References | Related Articles | Metrics

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Effects of environmental exposure on geriatric depression YANG Na, HU Zhongyi, GAO Yang 2025, 39 (1):  12-16.  doi: 10.3969/j.issn.1003-9198.2025.01.004 Abstract ( 38 )   PDF (1200KB) ( 158 )   Save Geriatric depression belongs to a type of geriatric syndrome. With the progress of the global population aging, geriatric depression has become a major public health problem. Environmental exposures, including air pollution, noise, heavy metals and pesticides, have been considered as potential preventable risk factors for depression in the elderly adults. This artical aims to review the latest research results and to explore how these environmental factors affect geriatric depression. References | Related Articles | Metrics

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Effects of environmental exposure on sleep disorders LI Maomao, MA Yanling, LI Jiehua 2025, 39 (1):  17-21.  doi: 10.3969/j.issn.1003-9198.2025.01.005 Abstract ( 48 )   PDF (1131KB) ( 139 )   Save Sleep is essential for human physical and mental health, and about 40% of the global population is afflicted by sleep disorders (SD). This article reviews the impacts and mechanisms of environmental exposures such as noise, air pollution, light pollution, and electromagnetic radiation on sleep. It is found that the above environmental exposures can affect sleep through multiple pathways and increase the risks of related diseases. However, most of the existing studies are cross-sectional studies, and it is difficult to establish causality, and most of them rely on subjective measurement. In the future, basic research should be carried out to explore the specific mechanisms and consider the interaction effects of environmental factors to improve the understanding and prevention of SD. References | Related Articles | Metrics

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Effects of environmental exposure on cognitive impairment WANG Siya, YIN Shi 2025, 39 (1):  22-25.  doi: 10.3969/j.issn.1003-9198.2025.01.006 Abstract ( 47 )   PDF (1121KB) ( 282 )   Save In recent years, the impact of environmental exposure on human health, especially on cognitive impairment, has attracted increasing attention. This article reviews the influence of exposure to common air pollutants (including particulate matter, ozone, sulfur dioxide, nitrogen oxides, carbon monoxide, etc.) and metals (such as plumbum, cadmium, mercury, arsenic, etc.) in daily life and production on cognitive impairment, and investigates the related manifestations and potential mechanisms on cognitive impairment. References | Related Articles | Metrics

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Effect of HNRNPC on proliferation, invasion, migration, and apoptosis of lung adenocarcinoma cells WU Kaiyue, SONG Yiyi, LIN Xin, ZHU Zhen, KONG Zhibin 2025, 39 (1):  26-31.  doi: 10.3969/j.issn.1003-9198.2025.01.007 Abstract ( 51 )   PDF (1461KB) ( 155 )   Save Objective To investigate the expression of heterogeneous nuclear ribonucleoprotein C (HNRNPC) in lung adenocarcinoma cell and the effect of knocking-down HNRNPC on the proliferation, invasion, migration, and apoptosis of lung adenocarcinoma cells line, as well as its possible mechanism. Methods The expression levels of mRNA and protein of HNRNPC in the normal lung epithelial cell line BEAS-2B were compared with those in the lung adenocarcinoma cell line A549 detected by quantitative real-time PCR (qPCR) and western blot (WB), respectively. Lentiviral tools were used to construct the low-expression stable transformation of HNRNPC. The effects of HNRNPC knockdown on the proliferation, clone formation, invasion, and migration of A549 cells were studied using CCK-8 method, plate cloning, Transwell assay and cell scratch assay. Flow cytometry and WB were employed to detect the effects of HNRNPC knockdown on cell cycle, apoptosis, and the expression of cyclin CDK1 in A549 cells. Results The expression levels of mRNA and protein of HNRNPC in lung adenocarcinoma cell lines were higher than those in normal lung epithelial cell lines. Knockdown of HNRNPC gene using lentiviral tools significantly inhibited the proliferation and clone formation ability of A549 cells, decreased the invasion and migration ability, increased cell cycle arrest and apoptosis, and reduced the expression level of CDK1 protein. Conclusions HNRNPC is highly expressed in A549 cells and plays a role of an oncogene in lung adenocarcinoma. Knocking-down HNRNPC can inhibit the proliferation, invasion, and induce apoptosis of A549 cells. HNRNPC may serve as a new potential target for the diagnosis and treatment of lung adenocarcinoma. References | Related Articles | Metrics

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Study on association of serum levels of VEGF and BDNF with severity of vascular dementia and predictive value for prognosis WANG Xue, ZHANG Zhenyong, XU Bin, ZHU Ya, ZHOU Xuan, ZHANG Yongjia, ZHUANG Ruijuan 2025, 39 (1):  32-36.  doi: 10.3969/j.issn.1003-9198.2025.01.008 Abstract ( 50 )   PDF (1212KB) ( 215 )   Save Objective To explore the relationship of the levels of serum vascular endothelial growth factor (VEGF) and brain-derived neurotrophic factor (BDNF) with the severity of vascular dementia (VD) in the elderly patients, and to investigate the predictive value of VEGF and BDNF for prognosis. Methods A retrospective analysis was performed on the clinical data of 102 elderly patients with VD admitted to Affiliated Hospital of Jiangnan University from January 2022 to December 2023. The patients were divided into mild group (37 cases), moderate group (43 cases) and severe group(22 cases) according to the severity of the VD.Fasting venous blood samples were collected within 24 h after admission. The levels of BDNF and VEGF were determined by enzyme-linked immunosorbent assay, and the relationship between BDNF, VEGF and the severity of VD was analyzed. The patients were followed up for 3 months after discharge, and were divided into good prognosis group (77 cases) and poor prognosis group (25 cases) according to the prognosis. The influencing factors of prognosis were analyzed. The predictive value of BDNF and VEGF for the prognosis of patients was analyzed by receiver operating characteristic (ROC) curve. Results The levels of VEGF and BDNF were lowest in severe group, followed by moderate group and mild group (P<0.05). The score of Mini-mental State Examination (MMSE) was negatively correlated with the levels of VEGF and BDNF (P<0.05). Univariate analysis showed significant differences in age, proportion of smoking history and severe disease severity, and the levels of VEGF and BDNF between the good prognosis group and the poor prognosis group (P<0.05). Binary Logistic regression analysis showed that age and disease severity were independent risk factors for the prognosis of patients, and VEGF and BDNF were independent protective factors (P<0.05). The results of ROC curve showed that the sensitivity of VEGF, BDNF and their combination to predict the prognosis of patients was 76.20%, 72.00%, 92.10%, respectively, the specificity was 75.30%, 72.70%, 90.90%, respectively, and the area under the curve (AUC) was 0.831, 0.805 and 0.938, respectively (P<0.05). Conclusions The severity of VD is significantly negatively correlated with the levels of VEGF and BDNF. The combined detection of BDNF and VEGF levels can effectively predict the prognosis of VD patients. References | Related Articles | Metrics

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Reliability and validity of the Clinical pHysical rEsilience assEssment Scale (CHEES) in elderly inpatients LIU Chuan, PAN Yiming, YU Wenhua, ZHANG Wanshu, LI Jiatong, LI Xiaxia, XING Yiwen, LI Jing, MA Lina 2025, 39 (1):  37-40.  doi: 10.3969/j.issn.1003-9198.2025.01.009 Abstract ( 49 )   PDF (1080KB) ( 143 )   Save Objective To test the reliability and validity of the Clinical pHysical rEsilience assEssment Scale (CHEES) in the elderly inpatients in China. Methods A total of 362 elderly inpatients aged 60 years and over were enrolled in this study. Cronbach’s α coefficient, Spearman-Brown coefficient and Guttman coefficient were used for reliability test. Validity was assessed by content validity and construct validity based on exploratory factor analysis. Results The acceptance rate of CHEES was 90.88%, and the qualified rate of the scale was 100%. The Cronbach’s α coefficient of the total scale was 0.826, Spearman-Brown coefficient was 0.737, and Guttman coefficient was 0.731. The items of the scale were based on sufficient basis, and the expert consultation process was authoritative and reliable, and the content was comprehensive. Exploratory factor analysis extracted three common factors. The factor load of each item was 0.446-0.656, and the cumulative variance contribution rate was 57.49%. Conclusions CHEES has good reliability and validity, and is suitable for the evaluation of physical resilience of the older adults in the hospital environment. References | Related Articles | Metrics

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Correlation of self-management ability, swallowing training compliance, psychological burden with malnutrition in elderly patients with post-stroke dysphagia ZHAO Tianxue, NIE Tingting, ZHAO Leyan 2025, 39 (1):  41-45.  doi: 10.3969/j.issn.1003-9198.2025.01.010 Abstract ( 48 )   PDF (1062KB) ( 117 )   Save Objective To investigate the prevalence and influencing factors of malnutrition in the elderly patients with post-stroke dysphagia (PSD), and to provide effective reference for nutritional intervention. Methods A total of 102 elderly PSD patients admitted to Beijing Friendship Hospital from January 2022 to June 2023 were selected and divided into malnutrition group (n=54) and non-malnutrition group (n=48) based on whether they presented with malnutrition after PSD. The self-made general information questionnaire, activities of daily living (ADL) scale, exercise of self-care agency scale (ESCA), self-made swallowing training compliance scale, self-perceived burden scale (SPBS) were used to analyze the basic information, ADL, swallowing training compliance, self-management ability and psychological burden.The influencing factors of malnutrition in the elderly PSD patients were analyzed by multivariate Logistic regression model, and a prediction model of malnutrition was constructed. Results The incidence rate of malnutrition was 52.94% (54/102) in the PSD patients. There were statistically significant differences in age, SPBS score, ADL score, history of stroke, swallowing training compliance score, ESCA score, eating habits and the incidence of other complications between the two groups (P<0.05). Logistic regression analysis showed that age(OR=2.565, 95%CI: 1.394－4.719), swallowing training compliance score (OR=0.830, 95%CI: 0.715－0.964), SPBS score (OR=1.283, 95%CI: 1.022－1.610), ESCA score (OR=0.839, 95%CI: 0.748－0.942) and other complications (OR=3.080, 95%CI: 1.270－7.470) were the influencing factors of malnutrition in the elderly PSD patients.The area under the receiver operator characteristic curve of the Logistic regression model in predicting malnutrition was 0.946. Conclusions The prevalence of malnutrition in the elderly PSD patients is high, and age, self-management ability, psychological burden, swallowing training compliance and complications are the influencing factors of malnutrition in the elderly PSD patients, and the prediction model based on Logistic regression has certain predictive value for the occurrence of malnutrition in the elderly PSD patients. References | Related Articles | Metrics

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Value of chest high-resolution computed tomography in elderly patients with severe chronic obstructive pulmonary disease LI Yan, DOU Tong, WANG Xiaoxiao, REN Xiaoping, WEI Shenghong, WEN Hongxia 2025, 39 (1):  46-50.  doi: 10.3969/j.issn.1003-9198.2025.01.011 Abstract ( 44 )   PDF (1149KB) ( 113 )   Save Objective To explore the value of quantitative analysis of emphysema with chest high-resolution computed tomography (HRCT) in the elderly patients with severe chronic obstructive pulmonary disease (COPD)who couldn’t tolerate pulmonary function tests (PFT). Methods A total of 85 hospitalized patients with COPD were enrolled in this study. According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, all patients were classified into four groups: GOLD Ⅰ,Ⅱ,Ⅲ and Ⅳ, and comparative analysis of demographic characteristics, blood gas analysis, blood routine and LAA%-950HU was conducted among the four groups. Ordered multinomial Logistic regression was employed to analyze the related risk factors of GOLD classification. ROC curve was drawn to investigate the predictive value of various indicators for GOLD Ⅳ. Results Duration of COPD, arterial oxygen partial pressure (PaO2), arterial carbon dioxide partial pressure (PaCO2), and the percentage of low attenuation area below -950 HU (LAA%-950HU) were significantly different among the four groups (P＜0.05). Logistic regression analysis indicated that GOLD classification was positively correlated with duration of COPD, PaCO2 and LAA%-950HU , but negatively correlated with peripheral blood eosinophil count. Receiver operating characteristic curve analysis showed that the areas under the curve of LAA%-950HU and PaCO2 in predicting GOLD grade Ⅳ were 0.751 and 0.870, and the cut-off values were 34.8% and 42.5 mmHg, respectively. Conclusions The pulmonary function in the elderly COPD patients with severe airflow restriction who could not tolerate the PFT can be evaluated based on LAA%-950HU and PaCO2, which have certain clinical value for the formulation and adjustment of treatment. References | Related Articles | Metrics

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Effects of erector spinae plane block combined with stellate ganglion block in elderly patients undergoing total laparoscopic hysterectomy ZHOU Jing, SUN Luoyang, WANG Ling, MA Jiaxu 2025, 39 (1):  51-55.  doi: 10.3969/j.issn.1003-9198.2025.01.012 Abstract ( 34 )   PDF (1055KB) ( 122 )   Save Objective To investigate the effects of erector spinae plane block (ESPB) combined with stellate ganglion block (SGB) in the elderly patients undergoing laparoscopic total hysterectomy (LTH). Methods A total of 116 elderly patients who underwent LTH in Lianyungang Maternal and Child Health Hospital from January 2021 to December 2023 were selected and divided into two groups by random number table method, with 58 cases in each group. The patients in the control group were narcotized by ESPB, and those in the combined group were narcotized by ESPB combined with SGB. The operation indicators, anesthetic drug dosage, VAS score, rescue analgesia, postoperative recovery, stress indicators, adverse reactions, heart rate (HR) and mean arterial pressure (MAP) before anesthesia induction (T0), 5 min after anesthesia (T1) and at the end of operation (T2) were compared between the two groups. Results There were no significant differences in operation time, intraoperative bleeding, time to get out of bed, hospital stay and incidence of adverse reactions between the two groups (P>0.05). The consumption of propofol and sufentanil, pressing times of analgesic pump, rescue analgesia rate and the first postoperative exhaust time in the combined group were lower than those in the control group (P<0.05). At the time of 6, 12 and 24 hours after operation, the VAS score in the two groups gradually decreased, especially in the combined group (P<0.05). The levels of MAP and HR were significantly increased at T1,and then significantly decreased at T2 in the two groups, but the levels of MAP and HR at T1 and T2 in the combined group were lower than those in the control group (P<0.05). After operation, the levels of cortisol (Cor) and substance P (SP) were higher than those before operation in the two groups, especially in the control group (P<0.05). Conclusions ESPB combined with SGB can effectively improve the analgesic effect, reduce the dosage of analgesic drugs, maintain hemodynamic stability, reduce stress response, and is safe and reliable in the elderly patients undergoing LTH. References | Related Articles | Metrics

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Application value of two-dimensional speckle tracking imaging in assessing arterial function in overweight elderly with normal carotid artery structure WANG Meijuan, JIANG Xuezhong, WANG Hui, LIU Xiaojing, PANG Huiyan 2025, 39 (1):  56-60.  doi: 10.3969/j.issn.1003-9198.2025.01.013 Abstract ( 41 )   PDF (1049KB) ( 113 )   Save Objective To assess the arterial stiffness and arterial strain with two-dimensional speckle tracking imaging (2D-STI) among overweight elderly with normal carotid intima-media thickness (cIMT). Methods A total of 124 elderly aged ≥60 years old who visited Geriatric Hospital of Nanjing Medical University from September 2023 to March 2024 were enrolled and divided into the normal group (BMI<24,n=65) and the overweight group (BMI≥24,n=59) according to the level of BMI, and then the overweight group was divided into cIMT1 group (cIMT≤0.66 mm,n=32) and cIMT2 group (cIMT > 0.66 mm,n=27). The detection of carotid ultrasound and carotid 2D-STI was performed. Results Compared with the normal group, the levels of stiffness index (longitudinal), elastic modulus (longitudinal) and pulse wave velocity (PWV) (longitudinal) were significantly higher (P <0.05), and the levels of radial strain (radial, longitudinal) were significantly lower in the overweight group (P<0.05).The levels of arterial compliance and arterial dilation in cIMT1 group were significantly higher than those in cIMT2 group (P<0.05), and the levels of stiffness index, elastic modulus and PWV in cIMT2 group were higher than those in cIMT1 group (P<0.05). Conclusions In the overweight elderly with normal cIMT, arterial stiffness escalates and stress diminishes. 2D-STI can be utilized to monitor the early alterations in arterial stiffness among the elderly. References | Related Articles | Metrics

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Study on nonlinear analysis of EEG related to memory ability in elderly patients YIN Pengcheng, WANG Xinzhi, ZHANG Linzhong 2025, 39 (1):  61-65.  doi: 10.3969/j.issn.1003-9198.2025.01.014 Abstract ( 31 )   PDF (1066KB) ( 114 )   Save Objective To explore the changes of nonlinear dynamic parameters of electroencephalogram (EEG) before and after operation in the elderly patients undergoing elective general anesthesia, and to investigate its role in the study of memory capacity. Methods The elderly patients undergoing elective non-cardiac surgery under general anesthesia were randomly divided into group with anesthesia depth monitoring (group A) and group without anesthesia depth monitoring (group N). The EEG signals of the two groups of patients before and after operation in rest state and memory task state were collected, and the nonlinear analysis index including correlation dimension and approximate entropy of the two groups of patients were compared and analyzed. The memory and execution screening scale (MES) was used to evaluate the memory ability of patients before and after operation. Results One day before operation, there was no significant difference in correlation dimension and approximate entropy between the two groups in rest state and memory task state (P>0.05); On the first day after surgery, the correlation dimension and approximate entropy decreased in both groups in both states, but the indexes in group A were higher than those in group N, and the difference was statistically significant (P<0.05). There was no significant difference in MES score between the two groups 1 day before operation (P>0.05). On the first day after operation, the MES score in both groups decreased (P<0.05), but the score of group A was higher than that of group N (P<0.05). Conclusions For elderly patients, there may be a decrease in EEG nonlinear analysis index and short-term memory ability after general anesthesia surgery, especially in patients without intraoperative anesthesia depth monitoring. References | Related Articles | Metrics

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Relationship between pericoronary adipose tissue-related parameters and plaque stability in elderly patients with coronary heart disease HUANG Jianmei, ZHENG Yong 2025, 39 (1):  66-69.  doi: 10.3969/j.issn.1003-9198.2025.01.015 Abstract ( 31 )   PDF (1032KB) ( 102 )   Save Objective To investigate the relationship between pericoronary adipose tissue(PCAT)-related parameters and coronary plaque stability in the elderly patients with coronary heart disease (CHD). Methods A total of 135 elderly patients with CHD admitted to Suining Central Hospital from January 2021 to December 2022 were enrolled in this study. All patients received CT angiography (CTA) detection. According to the CTA results, the patients were divided into stable group (with stable plaque) and unstable group (with unstable plaque). The general data, PCAT volume and peri-coronary fat density (FAI) of the two groups were collected and compared. Logistic regression analysis was used to analyze the influencing factors of coronary plaque instability, and the receiver operating characteristic (ROC) curve was drawn to observe the predictive value of each factor for coronary plaque instability in the elderly patients with CHD. Results A total of 30 elderly CHD patients presenting with unstable coronary artery plaque were enrolled in the unstable group (n=30), and 105 patients with stable coronary artery plaque were enrolled in the stable group (n=105). There were significant differences in PCAT volume and FAI between the two groups (P<0.01). Logistic regression analysis showed that PCAT volume and FAI were risk factors of coronary plaque stability in the elderly patients with CHD. The areas under the curve (AUC) of PCAT volume and FAI in predicting plaque instability were 0.829, 0.814, with the sensitivity of 0.867, 0.700, and the specificity of 0.686, 0.838,respectively.And the optimal threshold was 63.050 cm3 and -76.620 HU. Conclusions PCAT volume and FAI are the influencing factors of coronary plaque instability in the elderly patients with CHD, and both indexes have high predictive value for the occurrence of coronary plaque instability. References | Related Articles | Metrics

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Analysis of the efficacy and factors affecting the second-line treatment of chronic myeloid leukemia in the elderly receiving flumatinib ZHANG Siqi, SUN Xiaoxing, YANG Shili, GE Hongfeng, FENG Jiangzhou 2025, 39 (1):  70-73.  doi: 10.3969/j.issn.1003-9198.2025.01.016 Abstract ( 38 )   PDF (1035KB) ( 188 )   Save Objective To analyze the efficacy and influencing factors of flumatinib as second-line treatment for elderly patients with chronic myeloid leukemia in chronic phase(CML-CP). Methods A retrospective study including 25 elderly CML-CP patients who received flumatinib as a second-line drug for more than 3 months in our hospital from 2020 to 2023 was conducted, and the efficacy and influencing factors were analyzed. Results A total of 25 patients who failed first-line imatinib treatment were collected, with a median follow-up of 24 (2-48) months, 22 (88.0%) patients obtained complete hematological response(CHR)and 10 (40.0%) patients obtained major molecular response(MMR). Univariate analysis showed that Sokal score was a factor influencing patients to obtain MMR; Sokal score, duration of imatinib treatment and pretreatment resistance status were influencing factors of CCyR. The median progression-free survival(PFS)and overall survival(OS)were 19.4 months and 22.5 months, respectively. The incidence rate of hematologic adverse events was 28.0% (7/25) and the incidence rate of non-hematologic adverse events was 20.0% (5/25). Conclusions Flumatinib is safe and effective in the second-line treatment of CML-CP in the elderly. References | Related Articles | Metrics

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Observation of the therapeutic effect of thread embedding therapy in elderly patients with lower limb muscle spasm after stroke ZHU Boyi, OUYANG Gang, GE Wei, HE Rui, YU Yue, BAO Huimin, WANG Ming 2025, 39 (1):  74-77.  doi: 10.3969/j.issn.1003-9198.2025.01.017 Abstract ( 38 )   PDF (1072KB) ( 199 )   Save Objective To observe the clinical efficacy of acupoint thread embedding therapy in the elderly patients with lower limb muscle spasms after stroke. Methods Forty elderly patients with post-stroke spasticity of lower limbs from Affiliated Geriatric Hospital of Nanjing Medical University were randomly divided into the treatment group and the control group, with 20 cases in each group. The control group received routine rehabilitation training, while the treatment group received thread embedding therapy(polydioxanone threads, PDO)combined with routine rehabilitation training. The grade of modified Ashworth scale, Peen scale and the scores of lower limb Fugl-Meyer assessment scale(FMA), and absolute value of Young’s modulus before and after treatment were compared between the two groups. Results There were no statistically significant differences in MAS grade, Peen grade, lower limb FMA score, and absolute value of Young’s modulus between the two groups before treatment (P＞0.05). After 24 hours of treatment, MAS grade and Peen grade in the treatment group were more significantly improved than those in the control group;On the 10th day after treatment, MAS score, Peen score, lower limb FMA score, and absolute value of Young’s modulus in the treatment group were more significantly improved than those in the control group (P＜0.05). Conclusions Acupoint thread embedding therapy combined with conventional rehabilitation training can significantly improve the therapeutic effect of lower limb muscle spasticity after stroke in the elderly patients. References | Related Articles | Metrics

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Risk factors and prediction model of secondary pulmonary infection in elderly patients with idiopathic interstitial pneumonia XIAO Qiong, HU Zefu, DENG Anbin, YU Lihua, ZHU Tiansong, WEN Xi, ZHANG Qin 2025, 39 (1):  78-82.  doi: 10.3969/j.issn.1003-9198.2025.01.018 Abstract ( 38 )   PDF (1555KB) ( 97 )   Save Objective To investigate the risk factors of secondary pulmonary infection (PI) in the elderly patients with idiopathic interstitial pneumonia (IIP), and to establish a predictive model. Methods A total of 248 patients with IIP treated in Dazhou Dachuan District People’s Hospital from January 2020 to January 2024 were selected and divided into IIP group and IIP-PI group according to whether they presented with secondary PI during hospitalization. The influencing factors of secondary PI in IIP patients were analyzed by multiple Logistic regression, and the prediction model was constructed. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of the prediction model for secondary PI in the elderly patients with IIP. Results Among 248 patients with IIP, 75 cases (30.24%) presented with PI. The age, disease course, the levels of white blood cell count and C-reactive protein (CRP), and the proportion of combined diabetes mellitus, prophylactic antibiotics and daily hormone use ≥30 mg in IIP-PI group were higher than those in IIP group, and the level of albumin was lower than that in IIP group (P<0.05). Multivariate Logistic regression analysis showed that age, combined diabetes, prophylactic use of antibiotics, course of disease, daily dose of hormone, white blood cell count and CRP were independent risk factors for secondary PI, and albumin was an independent protective factor (P<0.05). The AUC of Logistic regression model for predicting PI secondary to IIP was 0.929 (95%CI: 0.889－0.958). Conclusions Age, combined diabetes, prophylactic antibiotic use, course of disease, daily hormone use, white blood cell count, CRP and albumin are the influential factors for secondary PI in the elderly patients with IIP. The risk prediction model based on the above factors can be used as an important tool for secondary PI. References | Related Articles | Metrics

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Drug resistance of pathogenic bacteria and effects of drug resistance degree on serum levels of IL-6, IL-10 and CRP in elderly patients with pulmonary infection LI Ting, PEI Junfang, SUN Shanshan 2025, 39 (1):  83-87.  doi: 10.3969/j.issn.1003-9198.2025.01.019 Abstract ( 39 )   PDF (1058KB) ( 152 )   Save Objective To investigate the drug resistance of pathogenic bacteria in the elderly patients with pulmonary infection and the effects of drug resistance degree on the serum levels of interleukin-6 (IL-6), interleukin-10 (IL-10) and C-reactive protein (CRP). Methods A total of 214 elderly patients with pulmonary infection hospitalized in Yuncheng Central Hospital from May 2020 to May 2023 were selected to analyze the drug resistance of pathogenic bacteria, and the effects of species and drug resistance of pathogenic bacteria on the levels of serum IL-6, IL-10 and CRP were investigated. The correlation of serum IL-6, IL-10, CRP with the drug resistance degree of different pathogens was analyzed by Spearman correlation analysis. Results A total of 265 strains of pathogenic bacteria were detected in the sputum samples of 214 elderly patients with pulmonary infection. The proportion of Gram-negative bacteria and Gram-positive bacteria was 76.26% (202/265) and 23.77% (63/265), respectively. Of all cases, 47 cases showed general drug resistance (21.96%), and 105 cases showed multi-drug resistance (49.07%) and 62 cases showed extensive drug resistance (28.97%). There was no significant difference in drug resistance between the patients infected with Gram-negative bacteria and those infected with Gram-positive bacteria (P>0.05), but the serum levels of IL-6, IL-10 and CRP in the patients infected with Gram-negative bacteria were higher than those in the patients infected with Gram-positive bacteria (P <0.05). The levels of IL-6, IL-10 and CRP in the patients presenting with general drug resistance were lower than those in the patients presenting with multi-drug resistance, and the levels of IL-6, IL-10 and CRP in the patients presenting with multi-drug resistance were lower than those in the patients presenting with extensive drug resistance (P <0.05). Spearman correlation analysis showed that the levels of serum IL-6, IL-10 and CRP were positively correlated with the degree of drug resistance (P<0.05). Conclusions Gram-negative bacteria are the main pathogens in the elderly patients with pulmonary infection, and the proportion of multi-drug resistance is relatively high. The levels of serum IL-6, IL-10 and CRP are correlated with the degree of drug resistance of pathogenic bacteria. The degree of drug resistance of the pathogenic bacteria can be preliminarily estimated according to the levels of serum inflammatory factors, which can be used to guide the rational use of antibiotics in clinic. References | Related Articles | Metrics

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Effects of different dietary structures on postprandial hypotension after breakfast in elderly patients with hypertension WU Wangyi, ZHAO Chunyan, SUN Yuxiao 2025, 39 (1):  88-92.  doi: 10.3969/j.issn.1003-9198.2025.01.020 Abstract ( 39 )   PDF (1103KB) ( 105 )   Save Objective To investigate the effects of different dietary structures on postprandial blood pressure, heart rate, incidences of postprandial hypotension (PPH) and clinical symptoms in the elderly patients with hypertension. Methods A total of 185 elderly patients with primary hypertension admitted to Department of Cardiology, East Hospital Affiliated to Tongji University from June 2021 to October 2022 were enrolled in this study by convenience sampling method.According to the time of admission, 61 cases were enrolled in the high-carbohydrate group, 62 cases enrolled in the high-protein group and 62 cases enrolled in the control group. The high-carbohydrate group received a breakfast with 85% of energy from carbohydrates, the high-protein group received a breakfast with 28% of energy from protein, and the control group received a breakfast with 57% of energy from carbohydrates and 14% of energy from protein. Blood pressure and heart rate were measured before breakfast and 30, 60, 90, 120 minutes after breakfast, and the incidences of PPH and clinical symptoms were recorded and compared among the three groups. Results The postprandial blood pressure in the high-carbohydrate group showed a continuous downward trend from 30 to 120 min after breakfast.The level of systolic blood pressure(SBP)from 60 to 120 min after breakfast in the high-carbohydrate group was significantly lower than that in high-protein group and the control group (P<0.05 or P<0.01).The incidence rate of PPH in the high-carbohydrate group (67.2%) was significantly higher than that in the high-protein group (32.3%) and the control group (41.9%) (P<0.01). Conclusions Reducing carbohydrate content and increasing protein content can reduce the drop of blood pressure after breakfast in the elderly patients with primary hypertension, and can reduce the incidence of PPH. References | Related Articles | Metrics

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A review of cellular senescence in chronic heart failure ZHAO Shuqing, ZHAO Ying, ZHANG Yu, LU Xiaohui 2025, 39 (1):  93-97.  doi: 10.3969/j.issn.1003-9198.2025.01.021 Abstract ( 34 )   PDF (1041KB) ( 177 )   Save Chronic heart failure (CHF) is the end stage of heart disease, which can be induced by various factors, with high mortality and poor prognosis. In recent years, it has been found that the risk of CHF increases with age and cell senescence, which plays an important role in CHF. Therefore, this article reviews the role and therapeutic progress of cellular senescence in CHF through the relationship between different types of cellular senescence and CHF, in order to provide new insights for the research and treatment of CHF. References | Related Articles | Metrics

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Effect and mechanism of short-chain fatty acids on sarcopenia in elderly patients complicated with type 2 diabetes mellitus SONG Chengya, YANG Ying, HONG Kan 2025, 39 (1):  98-101.  doi: 10.3969/j.issn.1003-9198.2025.01.022 Abstract ( 30 )   PDF (1069KB) ( 114 )   Save Sarcopenia is the main factor leading to disability and decreased quality of life in the elderly patients with type 2 diabetes mellitus. Many studies show that short-chain fatty acids (SCFAs) are involved in the regulation of intracellular signal transduction and insulin sensitivity, inflammatory factors, protein metabolism and fatty acid oxidation in muscle cells, and have a protective effect in the elderly patients with type 2 diabetes mellitus complicated with sarcopenia. This article reviews the above contents in order to provide a new method for clinical intervention of type 2 diabetes mellitus combined with sarcopenia in the elderly. References | Related Articles | Metrics