Table of Content

20 February 2025, Volume 39 Issue 2 Previous Issue    Next Issue

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Advance in the diagnosis and treatment of Parkinson's disease SUN Gaohui, FENG Meijiang 2025, 39 (2):  110-115.  doi: 10.3969/j.issn.1003-9198.2025.02.002 Abstract ( 67 )   PDF (1057KB) ( 102 )   Save Parkinson's disease (PD) is a common neurodegenerative disease that primarily affects the motor functions of patients and is accompanied by a range of non-motor symptoms, severely impacting the quality of life. With the aging population, the incidence of PD continues to rise, highlighting the importance of early diagnosis and effective treatment. In recent years, significant progress has been made in the diagnosis and treatment of PD, particularly in the development of early diagnostic techniques, pharmacological treatments, surgical interventions and emerging therapies. For example, advancements in imaging technology have made early identification of PD possible, while the emergence of new generation drugs has provided patients with more treatment options. Additionally, surgical treatments such as deep brain stimulation have shown good results in improving motor symptoms. This article will discuss these advancements, aiming to provide new insights and inspiration for clinical practice and promote the development of comprehensive management and treatment strategies for PD. References | Related Articles | Metrics

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Advances in the diagnosis of multiple system atrophy LI Lin, LIU Anru, WAN Lijun, LIU Xuewu 2025, 39 (2):  116-120.  doi: 10.3969/j.issn.1003-9198.2025.02.003 Abstract ( 61 )   PDF (1198KB) ( 88 )   Save Multiple system atrophy(MSA) is a rapidly progressive neurodegenerative disease characterized by a variety of clinical symptoms such as Parkinson's disease-like symptom clusters, cerebellar ataxia and autonomic dysfunction. At present, the biomarkers used in clinical diagnosis of MSA lack specificity, which makes early diagnosis difficult and easy to misdiagnose. MRI and cerebro spinal fluid(CSF) examination can assist in the diagnosis of MSA, but they are costly and have low specificity. It will take some time for the latest early detection technology of MSA, α-synuclein positron emission computed tomography (PET) imaging, to be applied in clinical practice. Blood and urine α-synuclein testing has the potential to be used in clinical diagnosis. Neurofilament light chain (NfL) and glial fibrillary acidic protein(GFAP) can also be used as biomarkers for the diagnosis of MSA, but further research is needed. The development of precise molecular biomarkers for the diagnosis of MSA is crucial, as it can revolutionize the diagnosis and treatment of MSA, and will facilitate early intervention and improve prognosis of the disease. References | Related Articles | Metrics

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Advance in the diagnosis and treatment of Alzheimer's disease XIN Mengfan, FENG Meijiang 2025, 39 (2):  121-126.  doi: 10.3969/j.issn.1003-9198.2025.02.004 Abstract ( 61 )   PDF (1123KB) ( 91 )   Save Alzheimer's disease(AD) is a neurodegenerative disease that occurs in late adulthood and early old age, characterized by an insidious onset and a progressive course, with a poor prognosis. Its central syndrome is acquired cognitive impairment, affecting various cognitive domains including memory, learning, orientation, understanding, judgment, calculation, language and visuospatial skills. These impairments can significantly impact daily living abilities and social occupational functions, ultimately progressing to complete dementia. This article reviews the evolution of diagnostic criteria for AD, relevant diagnostic biomarkers, and advances in treatment, aiming to enhance the accuracy of early diagnosis and the precision of treatment for AD.     References | Related Articles | Metrics

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Advances in the diagnosis and treatment of amyotrophic lateral sclerosis WANG Jie, DU Ailian 2025, 39 (2):  127-133.  doi: 10.3969/j.issn.1003-9198.2025.02.005 Abstract ( 45 )   PDF (1178KB) ( 89 )   Save Amyotrophic lateral sclerosis(ALS) is a neurodegenerative disease that mainly affects the cerebral cortex, brainstem and the upper and lower motor neurons of spinal cord. Its main clinical manifestations include progressive skeletal muscle weakness, muscle atrophy, bulbar palsy and pyramidal tract signs. The early clinical manifestations of ALS are highly heterogeneous, and the lack of specific biomarkers pose a challenge in its early diagnosis. The research progress in biomarkers such as body fluids, imaging, and neuroelectrophysiology is helpful for improving the accuracy of its early diagnosis.In term of treatment, although there are some approved small molecule drugs, the efficacy is limited. Drugs targeting neuroinflammation, gene therapies such as various antisense oligonucleotides(ASOs), and cell-gene therapies are new directions for ALS therapy. In addition, the treatment with ropinirole has achieved some exploratory results. In the future, the research on early diagnostic biomarkers and multi-target drugs will significantly promote the early diagnosis and treatment of ALS, in order to delay disease progression, improve the quality of life and prolong the survival time. References | Related Articles | Metrics

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Enhanced recovery after surgery(ERAS) principles in nutritional management for elderly patients with head and neck cancer perioperatively LI Fenhong, WEI Yanan, WU Mengli, SHEN Xiaohui, TANG Leilei 2025, 39 (2):  134-138.  doi: 10.3969/j.issn.1003-9198.2025.02.006 Abstract ( 53 )   PDF (1050KB) ( 87 )   Save Objective To explore the application effects of nutrition management based on enhanced recovery after surgery(ERAS) in the elderly patients with head and neck cancer during the perioperative period. Methods The data of 81 patients who underwent head and neck cancer surgery at Nanjing Drum Tower Hospital from October 2022 to October 2023 were retrospectively collected and divided into control group(n=39) and experimental group(n=42). The control group received traditional nutritional support, whereas the experimental group received ERAS-based nutritional support. Postoperative recovery time, nutritional status one week after operation, incidence of complications and feeding tolerance were compared between the two groups. Results The experimental group had significantly shorter time for the first flatus passage, getting out of bed, and resuming oral intake, as well as lower hospitalization costs and length of stay compared to the control group(P<0.05). One week after surgery, the changes of albumin, prealbumin, transferrin, body mass index (BMI), body weight, fat-free mass, skeletal muscle, protein and body water content were significantly lower in the experimental group compared to those in the control group(P<0.05). The incidence rates of postoperative complications and the incidence rates of diarrhea, abdominal distension and constipation in the experimental group were lower than those in the control group(P<0.05). Conclusions Nutritional management based on the ERAS concept in elderly patients with head and neck cancer perioperatively can promote the recovery of gastrointestinal function, improve feeding tolerance and nutritional status, reduce the incidence of postoperative complications, accelerate recovery, shorten hospital stays, and improve the quality of life. References | Related Articles | Metrics

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Correlation between respiratory dysfunction and articulation function in elderly patients with stroke HAO Shijie, LIU Xihua, WEI Chen, ZOU Jianpeng 2025, 39 (2):  139-143.  doi: 10.3969/j.issn.1003-9198.2025.02.007 Abstract ( 53 )   PDF (1054KB) ( 87 )   Save Objective To analyze the characteristics of respiratory dysfunction and the correlation between respiratory dysfunction and articulation function in the elderly patients with stroke. Methods Twenty elderly patients with stroke admitted to Rehabilitation Medicine Department of Affiliated Hospital of Shandong University of Traditional Chinese Medicine from August 2022 to April 2023 were enrolled in the observation group. At the same time, 20 healthy elderly were enrolled in the control group. Two groups received pulmonary function tests, respiratory muscle function and articulation function evaluation. Pearson correlation analysis and multiple linear regression analysis were used to analyze the correlation between respiratory function and articulation function. Results Compared with the control group, the observation group had significantly reduced lung ventilation function, respiratory muscle function and articulation function (P<0.05). The maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), forced expiratory volume in the first second (FEV1), maximal voluntary ventilation (MVV) were significantly negatively correlated with the score of Frenchay dysarthria assessment (FDA),and significantly positively correlated with maximum phonation time (MPT) (P<0.05); Forced vital capacity (FVC), peak expiratory flow (PEF), MEP were positively correlated with maximum counting ability(MCA) in the observation group (P<0.05). The results of multiple linear regression analysis showed that MIP and MEP were independent influencing factors of FDA score; FEV1 and MIP were independent influencing factors of MPT; FVC, PEF and MEP were independent influencing factors of MCA. Conclusions Respiratory function is significantly decreased in the elderly patients with stroke, and it may have an impact on articulation function. The decreases in FVC, FEV1, PEF, MIP and MEP may be risk factors for post-stroke articulation disorders. References | Related Articles | Metrics

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Diagnostic value of serum MPO combined with hs-TNT in elderly patients with acute myocardial infarction BAO Lei, SUN Caizhi, ZHU Chenchen, QIN Haidong 2025, 39 (2):  144-147.  doi: 10.3969/j.issn.1003-9198.2025.02.008 Abstract ( 36 )   PDF (1083KB) ( 107 )   Save Objective To explore the diagnostic value of myeloperoxidase (MPO) combined with high-sensitivity troponin T(hs-TNT)in the elderly patients with acute myocardial infarction (AMI). Methods A total of 122 elderly patients with suspected AMI admitted to Nanjing First Hospital from August 2023 to January 2024 were retrospectively enrolled. According to the time from onset to admission, they were divided into <2 h group, 2－6 h group and >6 h group. The serum levels of MPO, hs-TNT, creatine kinase (CK) and creatine kinase-MB (CK-MB) were detected in all patients and compared between AMI group and non-AMI group. Receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic efficacy of serum MPO level in elderly patients with AMI. Results Among the elderly patients admitted within 2 h and 2－6 h, the MPO level in AMI group was significantly higher than that in non-AMI group (P<0.05), while there were no significant differences in the levels of hs-TNT, CK and CK-MB between the two groups (all P>0.05). Among the elderly patients admitted after 6 h, there were significant differences in the levels of serum MPO, hs-TNT, CK and CK-MB between AMI group and non-AMI group (all P<0.05). The results of ROC curve analysis showed that in the patients admitted within 2 h and 2－6 h, MPO had a significantly high diagnostic efficacy for AMI, with AUC of 0.85 and 0.83 respectively (both P<0.001). In the elderly patients admitted after 6 h, MPO combined with hs-TNT had a significantly high diagnostic efficacy for AMI (AUC=0.88, P<0.001). Conclusions Serum MPO is a reliable indicator for the diagnosis of AMI in the elderly patients. For those elderly AMI patients with a long time from onset to admission, MPO needs to be combined with hs-TNT for diagnosis. References | Related Articles | Metrics

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Establishment of prediction model for behavioral and psychiatric symptoms in elderly patients with ischemic stroke ZHU Yinghua, ZHOU Shuling, YAN Mingzhu, SHI Yan 2025, 39 (2):  148-152.  doi: 10.3969/j.issn.1003-9198.2025.02.009 Abstract ( 53 )   PDF (1175KB) ( 83 )   Save Objective To investigate the incidence of behavioral and psychiatric symptoms (BPS) in the elderly patients with acute ischemic stroke (AIS), and to establish a reliable risk prediction model. Methods A total of 174 elderly patients with AIS treated in Xijing Hospital from January 2021 to August 2023 were enrolled in this study and divided into BPS group and non-BPS group according to the results of neuropsychiatric inventory (NPI). Univariate analysis was used to compare the general data, laboratory indicators and imaging indexes between the two groups, and logistic regression analysis was used to screen the independent influencing factors of BPS and to establish a risk prediction model. Results Among the 174 patients, 94 (54.02%) cases presented with BPS within 1 month after stroke, and the types of BPS were different in the patients with different infarction sites. Univariate analysis showed that years of education, platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR),Montreal Cognitive Assessment Scale(MoCA) score and activities of daily living(ADL) score showed significant differences between the two groups (P<0.05). Multivariate logistic regression analysis showed that PLR, NLR, MoCA score and ADL score were independent influencing factors of BPS (P<0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) of the model was 0.899 (95%CI: 0.855-0.944). Conclusions The incidence of BPS in the elderly patients with AIS is relatively high, and the constructed risk prediction model can provide an effective risk assessment result for clinical practice, which is helpful for early identification and prevention of BPS. References | Related Articles | Metrics

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Effect of hemocoagulase combined with low-molecular-weight heparin on the prognosis of super-aged patients with intertrochanteric femur fractures receiving internal fixation LU Qifeng, LI Qingsong, TANG Genlin, MIAO Afeng 2025, 39 (2):  153-157.  doi: 10.3969/j.issn.1003-9198.2025.02.010 Abstract ( 37 )   PDF (1338KB) ( 68 )   Save Objective To explore the effect of hemocoagulase combined with low-molecular-weight heparin (LMWH) on the prognosis and the survival time in the patients aged ≥90 years old with intertrochanteric femur fractures(ITFF) who received internal fixation operation. Methods From January 2016 to December 2019, a total of 67 patients aged ≥90 years old with ITFF who underwent proximal femoral nail antirotation (PFNA) operation were enrolled in this study. According to the perioperative anticoagulation therapy, they were divided into the combination group using hemocoagulase and LMWH (combination group, n=35) and LMWH group (n=32) using LMWH alone. The intraoperative blood loss, postoperative drainage volume, postoperative hidden blood loss, preoperative and postoperative hemoglobin (Hb) levels and survival time were compared between the two groups, and the factors affecting the long-term prognosis of the super-aged patients were analyzed. Results The hidden blood loss in LMWH group was 627.19±88.7 mL, compared with 521.71±92.75 mL in combination group (P<0.001). The Hb level in LMWH group was significantly lower than that in combination group 1 day and 3 days after operation (P<0.05). The cumulative survival rate within 30 months after operation in combination group was significantly higher than that in LMWH group (P=0.025). Cox proportional hazards model showed that LMWH therapy alone and high ASA classification significantly increased the risk of death in the super-aged patients with ITFF undergoing PFNA operation. Conclusions The combination of thrombin and LMWH can reduce postoperative hidden blood loss in super-aged patients with ITFF undergoing PFNA operation, and improve the prognosis of the patients. References | Related Articles | Metrics

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Effect of respiratory function training combined with balloon dilation on the rehabilitation of cricopharyngeal muscle achalasia LIANG Xiuyan, LUO Dingyuan, FANG Guochang, YU Tong, YIN Tao 2025, 39 (2):  158-161.  doi: 10.3969/j.issn.1003-9198.2025.02.011 Abstract ( 39 )   PDF (1031KB) ( 76 )   Save Objective To explore the rehabilitation effect of respiratory function training combined with balloon dilation on swallowing function in the cerebral stroke patients with cricopharyngeal muscle achalasia (CPA). Methods A total of sixty stroke patients with CPA admitted to Taian City Central Hospital from October 2020 to October 2023 were enrolled in this study. They were randomly divided into the control group and the observation group using a random number table method, with 30 cases in each group.The control group received basic treatment and balloon dilation, while the observation group received respiratory function training additionally. The rehabilitation treatment effects including the grade of Functional Oral Intake Scale (FOIS), surface averaged electromyography (AEMG) and root mean square (RMS) values of the subhyoid muscle group, the score of videofluorographic swallowing study (VFSS), and respiratory function indicators such as maximum expiratory pressure (MEP), forced vital capacity(FVC) and maximum indoiratory pressure(MIP) of the two groups were compared. Results After treatment, the grade of FOIS, AEMG, RMS, VFSS scores, FVC, MIP and MEP showed significant improvements in the two groups(P<0.05), especially in the observation group (P<0.05). Conclusions The combination of respiratory function training and balloon dilation can significantly improve the swallowing function of the patients with CPA, which is worthy of further clinical promotion. References | Related Articles | Metrics

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Value of shear wave elastography combined with biparametric MRI in the diagnosis of clinically significant prostate cancer ZHU Jia, PAN Yongsheng, LIU Xiang, CAO Xinyu, XI Wenjun, CHEN Hao, ZHENG Bing, ZHANG Zhongxin 2025, 39 (2):  162-166.  doi: 10.3969/j.issn.1003-9198.2025.02.012 Abstract ( 34 )   PDF (1060KB) ( 72 )   Save Objective To investigate the diagnostic value of shear wave elastography(SWE) combined with biparametric MRI(bpMRI)for clinically significant prostate cancer(csPCa). Methods The clinical data of 172 patients with suspected prostate cancer were collected, and they were divided into csPCa group(n=117) and non-csPCa group(n=55) according to the puncture pathology. The predictive value of SWE parameters including maximum Young's modulus(Emax), mean Young's modulus(Emean), minimum Young's modulus(Emin) and bpMRI score for csPCa at different locations in the subgroups with different prostate volumes were analyzed. Results There were statistically significant differences in age, total prostate specific antigen(tPSA), free prostate specific antigen(fPSA), fPSA-to-tPSA ratio(f/tPSA), prostate specific antigen density(PSAD), prostate volume, lesion location, maximum lesion diameter, bpMRI prostate imaging reporting and date system(PI-RADS) score, and Emax, Emean, Emin in abnormal elasticity regions between csPCa group and non-csPCa group(P<0.05).The results of receiver operating characteristic (ROC) curve analysis showed that the areas under the curve(AUCs) of Emax, Emean, Emin in predicting csPCa at peripheral zone and inner gland in the prostate volume ≥60 mL group were 0.706, 0.698, 0.597 and 0.763, 0.756, 0.642,respectively.And in prostate volume <60 mL group, the AUCs were 0.793, 0.787, 0.695 and 0.808, 0.809, 0.728, respectively. The AUCs of bpMRI PI-RADS score in predicting csPCa at peripheral zone and inner gland in the prostate volume ≥60 mL group and prostate volume <60 mL group were 0.867, 0.896, and 0.775, 0.821, respectively. The AUCs of SWE combined with bpMRI PI-RADS score in predicting csPCa were significantly increased. Conclusions SWE has higher diagnostic performance for csPCa in the subgroup with smaller prostate volume. SWE combined with bpMRI has a certain higher clinical value in the diagnosis of csPCa. References | Related Articles | Metrics

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Correlation between hemoglobin level and hospital stay in elderly patients undergoing artificial hip arthroplasty FANG Wei, XU Chengzhen, SU Zhihui, SUN Yantao, JIANG Zhigang, LI Huaimu, XU Shaojun, YANG Wengui, WANG Fang, LIU Junjun 2025, 39 (2):  167-170.  doi: 10.3969/j.issn.1003-9198.2025.02.013 Abstract ( 48 )   PDF (1200KB) ( 80 )   Save Objective To investigate the correlation between the level of preoperative hemoglobin(Hb) and postoperative hospital stay in the elderly patients undergoing primary hip arthroplasty(PHA). Methods The basic information and related clinical data of 137 patients aged ≥65 years who underwent PHA in Nanjing Meishan Hospital from 2016 to 2022 were retrospectively collected. Multivariate linear regression was used to analyze the correlation between postoperative hospital stay and preoperative Hb level. Non-linear relationship was assessed by generalized additive mixed model and threshold effect model. Piecewise regression was used to evaluate segmented effect of Hb on hospital stay. Results Multiple linear regression analysis showed a negative correlation between hospital stay and preoperative Hb level in PHA patients(β=－0.51, P=0.031). After adjusting confounding factors, the results of the generalized additive mixed model curve fitting showed a nonlinear relationship between Hb level and hospital stay, with an inflection point at Hb 95 g/L. When the level of Hb was <95 g/L, there was a negative correlation between Hb and hospital stay(β=－0.52, P=0.003); When the level of Hb was >95 g/L, the correlation between the two factors was not statistically significant(P=0.482). Conclusions The decrease of preoperative Hb level shows significant effects on hospital stay in the elderly patients undergoing PHA, and 95 g/L is the threshold of Hb for prolonging hospital stay in PHA patients. References | Related Articles | Metrics

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Reliability and validity of the Chinese version of the delirium screening scale in elderly inpatients MEI Kele, GAO Langli, LIU Yadong, LYU Juan, YUE Jirong 2025, 39 (2):  171-174.  doi: 10.3969/j.issn.1003-9198.2025.02.014 Abstract ( 40 )   PDF (1033KB) ( 73 )   Save Objective To assess the reliability, validity and applicability of the Chinese Delirium Screen(CDScreen) scale for elderly inpatients in clinical settings. Methods The elderly patients admitted to the Geriatrics Center of West China Hospital of Sichuan University from January to December 2023 were enrolled in this study, and the clinical data were collected using a general information questionnaire and the CDScreen scale.The Diagnostic and Statistical Manual of Mental Disorders(fifth edition)(DSM-Ⅴ) judgment of delirium status was defined as the gold standard for delirium. The assessment of the CDScreen scale was performed separately by two charge nurses to verify the inter-assessor reliability. The internal consistency was assessed by Cronbach's alpha coefficient; The diagnostic performance of the scale was verified by sensitivity, specificity, positive predictive value, and negative predictive value; And the applicability was assessed by questionnaire completion rate, missing rate and mean duration of the assessment. Results A total of 908 elderly patients were enrolled in the study with a mean age of 76.6±8.4 years. The questionnaire return rate was 100%. The mean time taken by the nurses to complete the CDScreen scale was 3.6±0.2 min. Cronbach's alpha coefficients for each dimension of the scale ranged from 0.666 to 0.854. The results of the retest reliability and inter-rater reliability assessments also showed good reliability performance.The CDScreen scale had high sensitivity and specificity in the diagnostic experiment, with a sensitivity of 94.83%, specificity of 100.00%. The positive predictive value was 100.00% and the negative predictive value was 99.20%. Conclusions The CDScreen scale has satisfactory reliability and validity in internal medicine wards in China, and its assessment is concise and actionable, so it can be used as a valid tool for assessing delirium in the elderly hospitalized patients. References | Related Articles | Metrics

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Curative effect of acupoint autohemotherapy combined with scutellaria baicalensis ointment in the treatment of pruritus in elderly YAO Yan, WANG Xiaohong 2025, 39 (2):  175-178.  doi: 10.3969/j.issn.1003-9198.2025.02.015 Abstract ( 43 )   PDF (1029KB) ( 90 )   Save Objective To observe the effect of acupoint autohemotherapy combined with scutellaria baicalensis ointment in the treatment of pruritus in the elderly. Methods Sixty-two elderly patients with pruritus treated in the Affiliated Hospital of Nanjing University of Chinese Medicine from January 2021 to March 2023 were enrolled in this study and randomly divided into treatment group (32 cases) and control group (30 cases). The patients in the treatment group were treated with acupoint autohemotherapy combined with scutellaria baicalensis ointment, and the patients in the control group were treated with scutellaria baicalensis ointment only. The treatment lasted for 4 weeks. The scores of Visual Analogue Scale (VAS), Xie-Kawashima Itch Scale (Xie-Kawashima), Dynamic Pruritus Scale (DPS) and pruritus-specific quality of life instrument (ItchyQoL) were compared between the two groups before treatment and 1-4 weeks after treatment. Results There were no significant differences in the scores of VAS, Xie-Kawashima, DPS and ItchyQoL between the two groups before treatment. After treatment, the scores of VAS and Xie-Kawashima were gradually decreased in the two groups (P<0.01), especially in the treatment group (P<0.01).One and two weeks after treatment, the score of DPS in the two groups showed no significant difference compared with that before treatment (P＞0.05). From the third week after treatment, DPS score in the treatment group was significantly increased, and was higher than that in the control group (P<0.01). After 4 weeks of treatment, the score of ItchyQoL was significantly decreased in the two groups (P<0.01),especially in the treatment group (P<0.01). Conclusions Scutellaria baicalensis ointment can significantly improve the pruritus symptoms and quality of life in the elderly patients with senile pruritus. Acupoint autohemotherapy combined with scutellaria baicalensis Huangqin ointment shows a faster and better effect. References | Related Articles | Metrics

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Correlation between serum dehydroepiandrosterone sulfate-to-age ratio and diabetic kidney disease in elderly male patients with type 2 diabetes mellitus RONG Can, MU Dinghuang, HU Yun 2025, 39 (2):  179-182.  doi: 10.3969/j.issn.1003-9198.2025.02.016 Abstract ( 37 )   PDF (1094KB) ( 70 )   Save Objective To evaluate the correlation between the serum dehydroepiandrosterone sulfate-to-age ratio (DHEAS/AGE) and diabetic kidney disease (DKD) in the elderly male patients with type 2 diabetes mellitus (T2DM). Methods A total of 195 elderly male T2DM patients treated in Nanjing Drum Tower Hospital from 2021 to 2023 were enrolled in the study. All patients were divided into DKD group and non-DKD group. The general information, serum DHEAS level, DHEAS/AGE were compared between the two groups. The relationship of DHEAS/AGE with metabolic parameters, renal function parameters, and the risk of DKD were analyzed by correlation analysis and unconditional Logistic regression analysis. Results DHEAS/AGE in DKD group was significantly lower than that in non-DKD group (P＜0.05). DHEAS/AGE was significantly negatively correlated with age, hypertension, urinary albumin creatinine ratio (UACR), and significantly positively correlated with estimated glomerular filtration rate (eGFR) (all P<0.05). All patients were divided into 4 groups according to DHEAS/AGE quartiles from low to high (Q1 to Q4), and the corresponding incidence rate of DKD was 41.7%, 20.8%, 28.0%, and 16.3% (Ptrend<0.05), respectively. After adjusting the factors such as age, body mass index and hypertension, when compared with the Q1 group (reference, 1.00), the risk of patients with DKD in Q2, Q3 and Q4 groups were 0.267(0.097-0.732), 0.369(0.139-0.978) and 0.122(0.036-0.415)(Ptrend<0.05), respectively. Conclusions DHEAS/AGE reduction is significantly correlated with an increased risk of DKD in the elderly male patients with T2DM. References | Related Articles | Metrics

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Analysis of the predictive value of interleukin, tumor necrosis factor and ferritin for the severity degree of mycoplasma pneumoniae pneumonia in the elderly LIU Yaling, SHU Tingting, WU Ling 2025, 39 (2):  183-186.  doi: 10.3969/j.issn.1003-9198.2025.02.017 Abstract ( 42 )   PDF (1035KB) ( 78 )   Save Objective To investigate the predictive value of interleukin, tumor necrosis factor α (TNF-α ) and serum ferritin (SF) in peripheral blood for the severity degree of mycoplasma pneumoniae pneumonia (MPP) in the elderly. Methods A total of 86 elderly patients with MPP admitted to Jiangsu Province Official Hospital from October 2022 to October 2023 were enrolled in the MPP group, and 100 healthy individuals were enrolled in the control group during the same period of time. The levels of serum interleukin 6 (IL-6), IL-10, IL-17, TNF-α, SF, white blood cell (WBC) and C-reactive protein (CRP) were detected and compared among the control group and the mild and severe MPP groups, and the value in predicting the severity of MPP in the elderly was expored. Results The serum levels of IL-6, IL-10, IL-17, TNF-α and SF were significantly higher in the MPP subgroups than those in the control group(P<0.05), especially in the severe MPP group (P<0.05). There were no statistically significant differences in WBC and CRP between the groups.The areas under receiver operating characteristic curve of IL-6, IL-10, IL-17, TNF-α and SF for predicting severe MPP in the elderly were 0.64, 0.80, 0.89, 0.71, and 0.80, respectively. Conclusions Serum levels of IL-6, IL-10, IL-17, TNF-α and SF are significantly elevated in the elderly patients with MPP, and can be used as effective biomarkers to predict severe MPP in the elderly. References | Related Articles | Metrics

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Therapeutic effect of acupuncture on elderly patients with diabetic peripheral neuropathy complicated with insomnia WANG Ming, GU Xiaomei, XI Yang, GUO Yuanying, GE Wei 2025, 39 (2):  187-190.  doi: 10.3969/j.issn.1003-9198.2025.02.018 Abstract ( 46 )   PDF (1073KB) ( 77 )   Save Objective To observe the clinical effect of acupuncture on the elderly patients with diabetic peripheral neuropathy(DPN) complicated with insomnia. Methods A total of 66 elderly patients with DPN combined with insomnia were randomly divided into treatment group and control group, with 33 cases in each group, and they were treated with acupuncture or sham acupuncture on the basis of medication, respectively. The changes of Toronto Clinical Scoring System(TCSS) score, nerve conduction velocity of median nerve(MN) and common peroneal nerve(CPN), and Pittsburgh sleep quality index(PSQI) were assessed before and 4 weeks after treatment, and the effective rate was compared between the two groups. Results After treatment, the total effective rate was 90.91% in the treatment group, compared with 75.76% in the control group(P<0.05). The TCSS score and PSQI were significantly lower and the nerve conduction velocity of MN and CPN were significantly higher after treatment in both groups than those before treatment(P<0.05),especially in the treatment group(P<0.05). Conclusions Acupuncture combined with medication can obviously relieve the clinical symptoms of limb pain and numbness in the elderly patients with DPN, and improve the nerve conduction velocity and sleep quality. References | Related Articles | Metrics

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Trends of injury-caused deaths among the elderly in Jiangsu Province from 2012 to 2021 DU Wencong, YANG Bingmo, YU Hao, WU Xun, ZHOU Jinyi, TAO Ran 2025, 39 (2):  191-196.  doi: 10.3969/j.issn.1003-9198.2025.02.019 Abstract ( 41 )   PDF (1104KB) ( 96 )   Save Objective To analyze the trends of injury-caused deaths among the elderly in Jiangsu Province from 2012 to 2021, and to provide scientific basis for injury prevention and intervention. Methods The death data of the elderly from major injuries in Jiangsu Province from 2012 to 2021 were analyzed, and the underlying cause of death was coded by the International Classification of Diseases(ICD-10). The crude death rate and standardized mortality rate of the four major injuries were calculated to describe the primary death rate. The trend analysis was performed by the Join-point Regression Program. Results From 2012 to 2021, the standardized mortality rates of total injuries and road traffic accidents of the elderly in Jiangsu Province showed a fluctuating upward trend, while those of accidental falls showed a steady upward trend [average annual percent change(AAPC) was 2.2%, 1.4% and 7.5% respectively, all P<0.05],and the standardized mortality of suicide showed a significant downward trend, and the drowning showed a fluctuating downward trend(AAPC was －4.4%,－1.5% respectively, all P<0.05). The increase in total injuries was highest in the 85 and older age group(AAPC=4.1%, P<0.001), and road traffic injuries were the first cause of death among people aged 60－74 years old, and accidental falls were the main cause of death among people aged over 75 years old. The death rate of road traffic accidents in urban elderly residents showed an increasing trend(AAPC=3.1%, P<0.001), the suicide and drowning death rates in the elderly residents in rural areas showed a decreasing trend(AAPC was －6.4%,－2.1% respectively, all P<0.05). Conclusions The injury death rate of the elderly residents in Jiangsu Province from 2012 to 2021 showed an increasing trend, especially the accidental fall standardized death rate, which is the future focus of elderly injury intervention in Jiangsu Province. References | Related Articles | Metrics

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Research progress of calprotectin S100A8/S100A9 in Alzheimer's disease WU Jinli, YANG Xiaojuan 2025, 39 (2):  197-201.  doi: 10.3969/j.issn.1003-9198.2025.02.020 Abstract ( 41 )   PDF (1039KB) ( 187 )   Save Alzheimer's disease(AD) is characterized by progressive memory loss. Based on the emerging theory of microbe-gut-brain axis, the changes in intestinal flora might activate the intestinal inflammation. Calprotectin, as a marker of intestinal inflammation, is a key substance in the brain-gut axis of AD. Its subunits S100A8 and S100A9 are also closely related to the Aβ theory and neuroinflammation theory in AD, respectively. Therefore, this article reviews the main functions of S100A8/S100A9 protein and its new research progress in AD-related pathogenesis, risk factors, prevention and treatment, in order to provide new research directions for the treatment of AD. References | Related Articles | Metrics

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Mechanism of inflammaging in the progression of Alzheimer's disease MA Xiaoting, LIU Shanwen, YAO Linlin, BAO Runying, LI Yifeng, YANG Yifan, HU Hua 2025, 39 (2):  202-206.  doi: 10.3969/j.issn.1003-9198.2025.02.021 Abstract ( 44 )   PDF (1036KB) ( 82 )   Save As a low-grade chronic inflammatory state in the aging process, inflammaging is closely related to many chronic aging diseases. Age-related changes such as cellular senescence, mitochondrial dysfunction, defective autophagy and mitophagy, and intestinal microbial imbalance are involved in initiating and maintaining inflammaging, and play an important role in the occurrence and development of Alzheimer's disease (AD) through proinflammatory mechanisms. Related anti-inflammatory therapy is also considered to have great potential. This article analyzes the induction and regulation of inflammation by the above-mentioned factors in the aging process of AD, elucidates the important role of inflammaging in the process of AD, and provides new ideas for related anti-inflammation treatment. References | Related Articles | Metrics

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Predictive value of echocardiography for the risk of recurrence of atrial fibrillation after catheter ablation in elderly patients HE Yuli, LIU Qianhui, YAO Zijun, XU Yunfan, WU Jun 2025, 39 (2):  207-211.  doi: 10.3969/j.issn.1003-9198.2025.02.022 Abstract ( 43 )   PDF (1043KB) ( 151 )   Save Atrial fibrillation(AF) is one of the most common arrhythmias in the elderly. Currently, catheter ablation is one of the most effective methods for the treatment of atrial fibrillation, but the recurrence rate is high. Therefore, it is of great significance to find powerful predictors for the evaluation of clinical condition, curative effect and prognosis. Based on the mechanism of left atrial remodeling related to AF in the elderly, this article focuses on the predictive effects of important parameters of echocardiography, such as left atrial diameter (LAD), left atrial volume index (LAVI), left ventricular diastolic function parameter (E/e′), etc. for the recurrence after AF ablation, aiming to help screen patients who can benefit from catheter ablation and guide clinical practice. References | Related Articles | Metrics

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A review of association between type 2 diabetes mellitus and malignant tumors in elderly patients FEI Qinnan, CHEN Xinglan, OUYANG Xiaojun, GU Liubao 2025, 39 (2):  212-216.  doi: 10.3969/j.issn.1003-9198.2025.02.023 Abstract ( 44 )   PDF (1038KB) ( 82 )   Save With the aging of the population, the association between type 2 diabetes mellitus(T2DM) and malignant tumors in the elderly has attracted much attention. There is an increasing trend in the incidence rate of cancer in the elderly patients with T2DM, but the relative risk decreases with age.Age is a traditional clinical risk factor for cancer. Those diagnosed with T2DM at a younger age have a relatively higher cancer risk, and the tumor-promoting effect of T2DM may weaken in old age. There are differences in the incidence of cancer in specific sites between men and women. Blood glucose level is closely related to the occurrence of pancreatic cancer and digestive tract cancer. The relationship between the duration of diabetes and cancer risk remains unclear and needs verification. Among antidiabetic drugs, metformin can reduce cancer risk, while the impacts of insulin and other drugs are unclear. In the future, advanced researches are still needed to provide more comprehensive theoretical support for clinical prevention and treatment. References | Related Articles | Metrics