Abstract:Objective To explore the clinical value of the 5-factor modified frailty index (mFI-5) in predicting complications after total hip arthroplasty in the elderly with a view to providing a reference for patients with a comprehensive intervention during the peri-operative period. Methods A retrospective analysis was made of the clinical data of 639 patients aged ≥65 years, who underwent total hip arthroplasty in the Department of Orthopedics of the First Medical Center of the Chinese People′s Liberation Army General Hospital from January 2014 to August 2019. mFI-5 was calculated by collecting patient demographics, surgery-related information, mFI-5 scoring variables, and postoperative complications. According to the mFI-5 score, the patients were divided into a frail group (mFI-5≥2 points) and a non-frail group (mFI-5<2 points). Postoperative complications included postoperative delirium, stroke, pneumonia, deep vein thrombosis, and atelectasis. The two groups were compared in the incidence of postoperative complications. SPSS 26.0 was used for statistical analysis. Intergroup comparison was performed using t test or χ² test depending on data type. Multivariate logistic regression analysis was used to investigate the predictive effect of frailty on postoperative complications in patients with total hip arthroplasty. Results There were 190 cases (29.73%) in the frail group and 449 cases (70.27%) in the non-frail group. There were significant differences in gender, American Society of Anesthesiologists classification and anesthesia method between the two groups (all P<0.05). The frail group had significantly higher incidences in five aspects:history of chronic obstructive pulmonary disease or chronic pneumonia [27 (14.21%) vs 9 (2.00%)], dependent functional status [132 (69.47%) vs 43 (9.58%)], history of type 2 diabetes mellitus [92 (48.42%) vs 23 (5.12%)], history of congestive heart failure within 30 d before surgery [2 (1.05%) vs 0 (0.00)], and history of hypertension requiring drug treatment [176 (92.63%) vs 177 (39.42%)；all P<0.001] . The incidence of total complications in the frail group was significantly higher than that in the non-frail group [94 (49.47%) vs 20 (4.45%); P<0.001]. Multivariate logistic regression analysis showed that the risk of postoperative complications in the frail group was 12.23 times that of the non-frail group (OR=12.23,95%CI 6.51-23.98; P=0.002), and the difference was statistically significant (P<0.05). Frailty was independent risk factors of delirium (OR=10.32,95%CI 5.63-23.79; P=0.022), stroke (OR=12.24,95%CI 5.09-69.01; P<0.001), pulmonary infection (OR=5.88,95%CI 2.31-23.91; P<0.001) and DVT (OR=27.61,95%CI 3.02-78.24; P=0.034). Conclusion mFI-5 is an effective tool for predicting postoperative complications in the elderly patients with total hip arthroplasty, mFI-5≥2 being an important indicator to predict postoperative complications.

Abstract:Objective To investigate the current status of cognitive function of the elderly in the community and explore its influencing factors. Methods A face-to-face survey was conducted among urban residents of 4 community in Shaanxi Province using the general information questionnaire and mini-mental state examination (MMSE) scale from September 2019 to March 2020, assessing the cognitive status and analyzing influencing factors of cognitive impairment in the elderly. A total of 367 questionnaires were distributed and 342 valid ones were recovered. SPSS statistics 25.0 was used for data analysis. Depending on the data type, t-test orχ² test were used for inter-group comparison. The influencing factors of mild cognitive impairment (MCI) were determined by multivariate logistic regression analysis. Results Among 342 elderly patients, 118 (34.50%) had MCI with a MMSE score of (21.44±5.041) points. Univariate analysis showed that gender, age, marriage, smoking and alcohol drinking history affected the occurrence of cognitive impairment. Multivariate logistic regression analysis showed that gender (OR=2.319,95%CI 1.257-4.277; P=0.007) and age (OR=1.044,95%CI 1.010-1.079;P=0.011) were the influencing factors of cognitive dysfunction in the elderly. Conclusion The cognitive function of the elderly in the community is at a relatively low level, the aged and women should be given more attention. Association of smoking and drinking with MCI in the elderly needs further exploration.

Abstract:Objective To investigate the influencing factors of glycosylated hemoglobin (HbA1c) control during long-term follow-up in the elderly patients with type 2 diabetes mellitus. Methods A total of 200 elderly male patients with type 2 diabetes mellitus were selected for the study, who received continuous glucose monitoring (CGM) in the Second Medical Center of Chinese PLA General Hospital from January 2017 to January 2011. They were divided into groups according to age (60 years≤age<70 years, n=57; 70 years≤age<80 years, n=51; age≥80 years, n=92), diabetes duration (diabetes<10 years, n=57; 10≤ diabetes <20 years, n=89; diabetes≥20 years, n=54), or baseline HbA1c level (HbA1c<6.5%, n=74; 6.5%≤HbA1c<7.5%, n=72; HbA1c≥7.5%, n=54). The groups were compared in mean HbA1c during long-term follow-up. Data analysis was performed using SPSS 13.0. Comparison between groups was performed with variance analysis or Chi-square test depending on the data types. The influencing factors of HbA1c control during follow-up were analyzed by logistic regression. Results All participants were followed up for an average of 12.5 years. There was no difference in mean HbA1c and adequate HbA1c control rate between different age groups during follow-up (P＞0.05). Compared with the diabetes duration<10 years group, the mean HbA1c increased (P<0.01) and the adequate HbA1c control rate decreased (P<0.05) in the diabetes duration≥20 years group. With the increasing baseline HbA1c, the mean HbA1c increased gradually (P<0.01), and adequate HbA1c control rate decreased gradually (P<0.01). The univariate logistic regression analysis showed that diabetes duration, baseline HbA1c, fasting plasma glucose, 2 h postprandial glucose, baseline glycemic variability, and insulin therapy were the influencing factors of HbA1c control during follow-up (P<0.01). Unconditional multivariate logistic regression analysis suggested that baseline HbA1c (OR=5.73,95%CI 3.02-10.88, P<0.001) was the most important influencing factor of HbA1c control during follow-up. Conclusion Diabetes duration, baseline HbA1c, fasting plasma glucose, 2 h postprandial glucose, baseline glycemic variability, and insulin therapy were the influencing factors of HbA1c control in elderly patients with type 2 diabetes during follow-up, baseline HbA1c being the most important one.

Abstract:Objective To analyze the CT features of bacterial positive cavitary pulmonary tuberculosis in the elderly and young patients in order to improve the understanding of the disease in the elderly. Methods Clinical data of 42 elderly patients (≥60 years old, elderly group) and 45 young patients (<45 years old, youth group) with cavitary pulmonary tuberculosis identified with sputum culture and pathological results in our hospital from January 2017 to January 2021 were collected and analyzed retrospectively. The CT imaging signs were compared between the 2 groups. SPSS statistics 22.0 was used for data analysis. According to the data type, Chi-square test was employed for comparison between groups. Results The elderly group had significantly larger proportions of lesions involving the whole lung lobe, presence of insect phagocytic cavities, small nodules, consolidation or atelectasis, pulmonary calcification, pleural effusion, mediastinal lymphadenopathy and hilar lymphadenopathy when compared with the youth group [78.6% (33/42) vs 31.1% (14/45), 42.9% (18/42) vs 20.0% (9/45), 95.2% (40/42) vs 80.0% (36/45), 47.6% (20/42) vs 24.4% (11/45), 57.1% (24/42) vs 13.3% (6/45), 33.3% (14/42) vs 13.3% (6/45), 40.5% (17/42) vs 15.6% (7/45), 28.6% (12/42) vs 2.2% (1/45); all P<0.05]. There were obviously rarer tree bud sign and millet shadow in the elderly group than the youth group [47.6% (20/42) vs 80.0% (36/45), 2.4% (1/42) vs 17.8% (8/45); both P＜0.05]. Conclusion The CT findings of senile cavitary pulmonary tuberculosis have certain characteristics, which play a positive guiding role in clinical treatment, prognosis evaluation and prevention of drug resistance.

Abstract:Objective To investigate the predictive value of age, creatinine and ejection fraction (ACEF) score for cardiac death and adverse cardiac events in patients over 75 years old with acute ST-segment elevation myocardial infarction (STEMI) within 1 year after percutaneous coronary intervention (PCI). Methods The clinical data of 432 STEMI patients undergoing PCI in the Dongnan Hospital from January 2015 to June 2020 were collected and analyzed retrospectively. According to their ACEF score before PCI, the patients were divided into low to moderate risk group (ACEF≤1.3 points, n=96) and high risk group (ACEF>1.3 points, n=336). The incidences of cardiac death and adverse cardiac events within 1 year after PCI were observed. Cox hazard proportional regression analysis was used to analyze the risk factors influencing the occurrence of cardiac death and adverse cardiac events within 1 year after PCI in the patients, and receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of ACEF score. SPSS statistics 20.0 was used for statistical analysis. Data comparison between 2 groups was performed using student′s t test, or Chi-square test depending on data type. Results The age was obviously older and the heart rate was significantly higher in the high risk group than the low to moderate risk group [(81.02±4.33) vs (78.94±3.05) years, (76.94±18.67) vs (71.36±16.84) times/min, P<0.05]. The low to moderate risk group had significantly higher left ventricular ejection fraction [(59.12±21.38)% vs (43.88±16.17)%, P<0.05] and better estimated glomerular filtration rate (P<0.05) than the high risk group. The rate of complete revascularization was statistically lower in the low to moderate risk group than the high risk group [10 cases (10.42%)vs 67 cases (19.94%), P<0.05]. But no remarkable differences were seen in other treatment-related parameters. Cox regression showed that ACEF score was an independent risk factor affecting cardiac death and adverse cardiac events within 1 year in patients (RR=1.557,1.626; P=0.000,0.000). The area under ROC curve predicted by ACEF score for cardiac death 1 year after PCI was 0.846, and the best cut-off point for diagnosis was 1.61. The area under the ROC curve for predicting adverse cardiac events was 0.891, and the best cut-off point for diagnosis was 1.47. Conclusion Preoperative ACEF score can predict cardiac death and adverse cardiac events within 1 year after emergency PCI in STEMI patients over 75 years old.

Abstract:Objective To analyze the relationships of lipoprotein a , von willebrand factor (vWF) and intercellular adhesion molecule-1 (ICAM-1) with the severity of vascular cognitive impairment in patients with ischemic cerebral small vessel disease (CSVD). Methods A retrospective analysis was performed on 110 patients with ischemic CSVD admitted to our hospital from January to December 2019. According to their mini-mental state examination (MMSE) and Wechsler adult intelligence scale (WAIS) scores, they were divided into cognitive impairment group (CSVD-1 group, n=59; MMSE≤26 points, WAIS≤69 points) and normal cognitive group (CSVD-2 group, n=51; MMSE＞26 points, WAIS＞69 points). Another 50 healthy subjects taking physical examination during the same period served as the control group. Lp(a) level was detected by immunoturbidimetry, and the levels of vWF and ICAM-1 were detected by enzyme-linked immunofluorescence assay. The relationship of the 3 indicators and cognitive impairment in ischemic CSVD patients was analyzed. SPSS statistics 25.0 was used for statistical analysis. According to data types, ANOVA was used for inter-group comparison, and LSD-t test was used for further pairwise comparison. Logistic regression was used to analyze the risk factors of cognitive impairment in CSVD patients. Receiver operating characteristic (ROC) curve was drawn to evaluate the predictive values of Lp(a) and ICAM-1 levels in the CSVD patients. Results Compared with the control group, the levels of TC, Lp(a), vWF and ICAM-1 were significantly increased, and the level of high-density lipoprotein cholesterol (HDL-C) was significantly decreased in the CSVD-1 and CSVD-2 groups (P<0.05). Compared with the CSVD-2 group, the levels of TC, Lp(a) and ICAM-1 were significantly increased, and the level of HDL-C was significantly decreased in the CSVD-1 group (P<0.05). However, the difference in the vWF level was not significant (P>0.05). Binary logistic regression analysis showed that Lp(a) (OR=1.872,95%CI 1.406-2.492; P=0.008) and ICAM-1 (OR=1.115,95%CI 1.031-1.206; P=0.002) were independent risk factors for cognitive impairment in CSVD patients. When the cut-point values of Lp(a) and ICAM-1 for predicting CSVD risk factors were 30.89 mg/dl and 300.25 μg/L, respectively, the combined detection of the 2 indicators had the highest predictive value (area under the ROC curve=0.930, P=0.000). Conclusion Lp(a) and ICAM-1 are closely associated with vascular cognitive impairment, and their combined detection has higher predictive value in patients with CSVD.

Abstract:Objective To study the effect of serum non-high-density lipoprotein cholesterol (non-HDL-C) on the occurrence of coronary heart disease (CHD) and the severity of coronary artery stenosis in elderly non-smokers. Methods A total of 360 elderly non-smokers (≥65 years old) who admitted to Chengde Central Hospital due to chest pain and underwent coronary angiography from June 2016 to June 2019 were recruited in this study. According to having CHD or not, they were divided into non-CHD group (n=110) and CHD group (n=250). The 250 cases of CHD patients were further assigned into mild lesion group and severe lesion group according to the severity of coronary artery stenosis (Gensini score), and into single, double, multi vessel lesion group based on the number of involved coronary arterial branches. The clinical data, biochemical indicators, and results of coronary angiography were compared among the subgroups. SPSS statistics 25.0 was used for data analysis. Student′s t test, ANOVA, Mann-Whitney U test or Chi-square test was employed for inter-group comparison. Spearman correlation analysis was adopted to analyze the correlation between non-HDL-C and Gensini score, logistic regression analysis was used to analyze the risk factors of severe CHD, and receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic efficiency of CHD. Results The levels of uric Acid (UA), lipoprotein-a (Lp-a), triglyceride (TG), total cholesterol (TC), HDL-C, and non-HDL-C were significantly higher in the CHD group than the non-CHD group (P<0.05). Compared with the mild lesion group, the severe lesion group had higher levels of Lp-a, TC, HDL-C and non-HDL-C (P<0.05). With more branches involved in coronary artery disease, non-HDL-C level and Gensini score were significantly increased; and with the increase of serum non-HDL-C level, the Gensini score was also elevated (P<0.05). Spearman correlation analysis showed that non-HDL-C level was significantly positively correlated with Gensini score (r=0.812, P＜0.001). Logistic regression analysis indicated that non-HDL-C was an independent risk factor for severe coronary artery disease in CHD patients. The ROC curve suggested that when the serum non-HDL-C level was 3.58 mmol/L, the diagnostic efficiency was the highest, with an area under the curve of 0.837 (95%CI 0.803-0.870), a sensitivity of 64.20% and a specificity of 96.70%. Conclusion Non-smoking elderly CHD patients are more common with multivessel coronary artery lesions and severe stenosis. Serum non-HDL-C is an independent risk factor affecting the severity of coronary artery disease in them, and shows a high efficiency in the diagnosis of CHD.

Abstract:Objective To investigate the predictive value of geriatric nutritional risk index (GNRI) combined with serum uric acid (SUA) for the prognosis of elderly patients with acute respiratory distress syndrome (ARDS). Methods The clinical data of 159 ARDS patients admitted to our hospital between January 2018 and September 2021 were collected and retrospectively analyzed. According to their 28-day outcomes, they were divided into survival (n=116) and death (n=43) groups. Based on their oxygenation index, they were assigned into mild (n=35), moderate (n=70) and severe (n=54) groups. Clinical data of the patients were collected, GNRI values were calculated, and SUA levels were detected. The data were analyzed by SPSS statistics 22.0. Receiver operating characteristic (ROC) curve and Kaplan-Merier curves were used to analyze the prognostic values of GNRI and SUA for elderly patients with ARDS. Results The survival and death patients differed in oxygenation index, severity of illness, and scores of Acute Physiology and Chronic Health Evaluation Ⅱ and Sequential Organ Failure Assessment (all P<0.05). The deceased patients had significantly lower GNRI level [(77.42±7.06) vs (88.17±10.39) points] and higher SUA level [(544.46±63.97) vs (469.70±45.69) μmol/L] than the survival group (both P<0.05). The severe ARDS patients had significantly lower GNRI level [(81.37±10.14) vs (90.17±10.69) and (85.81±10.15) points; both P<0.05] and higher SUA level [(514.05±61.52) vs (458.84±58.10) and (486.84±54.64)μmol/L; both P<0.05], when compared with the mild and moderate patients. Pearson correlation analysis revealed that oxygenation index was positively correlated with GNRI (r=0.412, P<0.01) and negatively with SUA (r=-0.403,P <0.01). ROC curve analysis showed that GNRI combined with SUA had an area under curve of 0.892, a sensitivity of 83.72% and a specificity of 81.90% for predicting the outcome of ARDS patients, which was superior to single index test. Kaplan-Meier curve analysis indicated that the 28-day mortality rate in the patients of GNRI≥83.07 points and SUA≤493.13 μmol/L, respectively, was lower in those with GNRI<83.07 points and with SUA>493.13 μmol/L (P<0.05). Conclusion GNRI and SUA are closely associated with disease severity and prognosis in elderly patients with ARDS, and the 2 indicators combined together have greater predictive value for the prognosis of elderly patients with ARDS.

Abstract:Objective To investigate the ratio, risk factors and prognosis of very old patients suffering from hospital-acquired pneumonia (HAP) complicated with sepsis. Methods A total of 156 very old HAP patients (≥80 years old) admitted in our hospital from January 2017 to December 2020 were recruited in this study. They were divided into sepsis group (n=72) and non-sepsis group (n=84). The clinical outcomes were observed, with the indicators such as in-hospital mortality, 28-day mortality and 30-day readmission rates after discharge. SPSS 22.0 software was used for data analysis. Data comparison between two groups was perfomed using t test, Fisher test or χ² test depending on data type. Logistic regression analysis was adopted to analyze the risk factors. Results Malnutrition (OR=2.419,95%CI 1.151-5.084, P=0.020), diabetes mellitus (OR=2.335,95%CI 1.007-5.415, P=0.048) and chronic renal disease (OR=7.602,95%CI 2.365-24.429, P=0.001) were independent risk factors for sepsis. There was no difference in 30-day readmission rate between the 2 groups, while the in-hospital and 28-day mortalities were significantly higher in the sepsis group than the non-sepsis group [18(25.0%) vs 8(9.5%), 21(29.2%) vs 8(9.5%), both P<0.05]. The independent risk factors of in-hospital mortality were malnutrition (OR=3.331,95%CI1.010-10.851, P=0.020), chronic heart failure (OR=5.904,95%CI 1.947-17.903, P=0.048) and chronic renal disease (OR=1.973,95%CI 1.243-13.619, P=0.001). Conclusion Malnutrition, diabetes mellitus and chronic renal disease may be associated with the occurrence of sepsis in the very old HAP patients, and the complication greatly increases the mortality in the population.

Abstract:Objective To investigate the predictive value of QRS duration on electrocardiogram combined with serum levels of interleukin (IL)-11 and soluble urokinase type plasminogen activator receptor (suPAR) in the prognosis of elderly patients with chronic heart failure (CHF). Methods A total of 236 elderly CHF patients diagnosed and treated in our department of cardiovascular diseases from January to December 2020 were recruited in this study. According to the occurrence of major adverse cardiovascular events (MACE) within 12 months of follow-up, they were divided into MACE group (n=76) and non-MACE group (n=160). The general data, QRS duration, and serum IL-11 and suPAR levels were compared between the 2 groups. SPSS 22.0 was used for statistical analysis. The predictive values of QRS duration and serum IL-11 and suPAR levels on the prognosis of elderly CHF patients were analyzed by receiver operating characteristic (ROC) curve. Kaplan-Meier curve was used to analyze the prognosis of the patients with different QRS duration and serum IL-11 and suPAR levels. Multivariate logistic regression analysis was adopted to analyze the prognostic factors of the patients. Results Compared with non-MACE group, the MACE group had significantly longer QRS duration [(126.74±9.63) vs (110.29 ± 9.47) ms] and higher levels of IL-11 [(64.05±14.49) vs (46.26±11.86) pg/ml] and suPAR [(3.64±0.99) vs (2.32±0.85) ng/ml] (P<0.01). ROC curve analysis showed that the area under the curve of QRS duration, IL-11 and suPAR to predict MACE in elderly CHF patients was 0.886,0.838 and 0.842, respectively, and the best cut-off value was 121.07 ms, 52.24 pg/ml and 2.88 ng/ml, respectively. The area under the curve of the combination of 3 indicators was 0.968, the sensitivity was 94.74%, and the specificity was 91.87%. Kaplan-Meier survival analysis showed that there were significant differences in the incidence of MACE among the elderly CHF patients with different QRS duration and IL-11 and suPAR levels (P<0.001). Logistic regression analysis indicated that left ventricular ejection fraction (OR=0.784,95%CI 0.684-0.898), cardiac function classification of New York Heart Association (OR=2.561, 95%CI 1.044-6.284), QRS duration (OR=1.195,95%CI 1.105-1.292), IL-11 (OR=1.115,95%CI 1.059-1.174) and suPAR (OR=4.316,95%CI 2.012-9.260) were independent influencing factors for MACE in elderly patients with CHF. Conclusion QRS duration and serum IL-11 and suPAR levels are independent risk factors for MACE in elderly patients with CHF. Combined detection of these 3 indicators has higher predictive value for the prognosis of elderly patients with CHF.

Abstract:Objective To investigate whether the reversal effect of rat bone marrow mesenchymal stem cells (BMSCs) on microglia in inflammatory response to ischemic stroke is mediated by ligand 1 of CX3C (CX3CL1). Methods A total of 30 rats were subjected in this study, and one rat was randomly selected for cerebral TTC staining. Modified Zea-Longa suture method was applied to establish rat model of middle cerebral artery occlusions (MCAO), and finally 20 model rats was recruited for the following experiments, including 2 rats undergoing TTC staining to detect cerebral infarction. The MCAO rats were randomly divided into control group (lateral ventricle localization injection of BMSCs, n=9) and experimental group (same injection of BMSCs after CX3CL1 lentivirus infection, n=9). The rats of 2 groups were decapitated on days 1,3 and 7 respectively to collect brain tissue. All brain tissue sections were subjected to anti-Iba and anti-CD206/TNF-α double immunofluorescence staining, and then the number of double positive cells was counted and compared under laser scanning confocal microscope. SPSS statistics 18.0 was used for statistical analysis. Data comparison between 2 groups was performed using Chi-square test. Results Rat MCAO model was successfully established, with infarcted lesions in the blood supply area of middle cerebral artery by TTC staining. The statistical results of immunofluorescence staining showed that compared with experimental groups, the number of anti-inflammatory microglia (Iba⁺CD206⁺) in the control group was significantly increased on days 1,3 and 7 [(8.644±1.131) vs (3.000±1.206), (7.866±1.254) vs (3.155±1.205), (7.111±1.555) vs (2.866±1.272) n/per 400×high-power field, all P<0.001], and the number of pro-inflammatory microglia (Iba⁺TNF-α⁺) was obviously decreased on days 3 and 7 [(4.222±0.974)vs (8.355±1.264), (4.267±1.321) vs (7.822±1.556) n/per 400×high-power field, both P<0.001]. Conclusion CX3CL1 may be the molecule mediating the reversal effect of BMSCs transplantation on microglia in cerebral ischemic area of MCAO rats.

Abstract:Sarcopenia is an age-dependent progressive and generalised skeletal muscle disorder, mainly characterized by loss of skeletal muscle mass, reduced muscle strength, and impaired functional capacity. Chronic heart failure is one of the important diseases that affect the survival rate of patients in cardiovascular diseases. More and more evidence shows that chronic heart failure may cause or exacerbate sarcopenia, and the mechanism involved are malnutrition, decreased physical activity, inflammatory response, oxidative stress and hormonal changes. Current treatment strategies mainly include exercise intervention, nutritional support and drug therapy. This paper reviews the progress in the pathogenesis, mechanism and treatment regimens for chronic heart failure patients complicated with sarcopenia in recent years.

Abstract:The changes of myocardial energy metabolism play an important role in the occurrence and development of heart failure. In recent years, it has been found that the increase of plasma branched-chain amino acid (BCAAs) and its metabolites is an important feature of heart failure, and forms a malignant feedback loop, which will eventually lead to the progression of heart failure. By promoting the catabolism of BCAAs, reducing the accumulation of metabolites and restoring the metabolic balance of BCAAs are expected to become a new target for the treatment of heart failure. This article reviews the association between abnormal metabolism of BCAAs and heart failure.

Abstract:Cognitive dysfunction, including mild cognitive impairment, Alzheimer′s disease and dementia, is increasingly recognized as significant comorbidities or complications of type 2 diabetes mellitus (T2DM), disrupting glycemic management. This paper reviews the association between T2DM and cognitive dysfunction and glycemic control, screening and diagnosis of risk factors, T2DM management in patients with cognitive dysfunction (considering advanced age and frailty in older adults), and emerging preventative therapies. Satisfactory glycemic management and early cognitive testing are essential components of T2DM management, and persona-lized strategies should be implemented, including patient education, glycemic monitoring, and appropriate dietary and medication adjustments based on daily conditions (including physical exercises).

Abstract:Chronic heart failure (CHF) is a common heart disease, and sarcopenia is a recently recognized disease by the World Health Organization in 2016, characterized by a progressive decrease in skeletal muscle mass, muscle strength, and/or physical performance. Both are highly prevalent in the elderly. This article provides a comprehensive review of the epidemiological features, pathogenesis, interventions, and prognosis of patients with both sarcopenia and CHF. Current evidence suggests that sarcopenia has a high prevalence in CHF patients, but the mechanisms has not been elucidated. However, anorexia, malnutrition, reduced physical activities, chronic inflammation, and changes in hormone levels due to CHF might contribute to the occurrence of sarcopenia. Appropriate amount of exercise and nutritional supplements may be beneficial in patients with comorbid CHF and sarcopenia, and vitamin D supplementation may be beneficial for those with low serum vitamin D. In light of the fact that sarcopenia can shorten survival, increase readmission rates, and decrease quality of life of CHF patients, it is necessary to improve the awareness of CHF patients and clinicians about sarcopenia, and screening, prevention, and intervention should be implemented as early as possible for sarcopenia in CHF patients.

Abstract:Hypertension is the primary risk factor of cardiovascular and cerebrovascular diseases. Evidence shows moxibustion therapy has obvious effectiveness on blood pressure, but the underlying mechanism remains unclear, and needs further study. In this paper, we summarize the characteristics and acting mechanism of moxibustion therapy in the treatment of essential hypertension in recent years. Moxibustion therapy, usually alone or in combination with other therapeutics, different moxibustion methods are used based on syndrome differentiation. Early application of the therapy can correct the bias of hypertension, and has certain long-term efficacy. The mechanism of its effectiveness is mainly through regulating the neuroendocrine system, improving the function of endothelial cells, regulating blood rheology, and resisting oxidative stress, and it is mutually causal with human metabolic abnormalities.