Abstract:Objective To investigate the frailty status of elderly patients of diabetes mellitus (DM) and analyze its influencing factors so as to provide guidance for the intervention of frailty in the patients. Methods A total of 301 elderly DM patients who were hospitalized in endocrinological departments of eight medical centers of Chinese PLA General Hospital and Beijing Ruijing Diabetes Hospital from December 2022 to April 2023 were subjected with convenience sampling. The general data and related data of frailty were collected by face-to-face questionnaire survey. They were divided into frailty group (n=71) and non-frailty group (n=230). SPSS 26.0 was used for statistical analysis. Mann-Whitney U test, Chi-square test or Fisher exact test was employed for intergroup comparison based on data type. Binary logistic regression analysis was performed to determine the influencing factors of frailty in elderly DM patients. Results Significant differences were observed in age, regular exercise, hearing impairment, fall history within one year, sleep quality, chronic complications of DM, insulin therapy, nutritional status, depression, loneliness and mild cognitive impairment between the frailty and non-frailty groups (P<0.05). Binary logistic regression analysis showed that aging (OR=1.107,95%CI 1.051-1.167), malnutrition (OR=8.135,95%CI 1.680-39.399) and depression (OR=2.404,95%CI 1.156-4.998) were risk factors, while regular exercise (OR=0.265,95%CI 0.117-0.600) was a protective factor for frailty in elderly diabetic patients. Conclusion The frailty status of elderly DM patients is not optimistic. Nutrition, exercise and psychological interventions are potential intervention targets. Future studies should develop targeted intervention measures to reduce the occurrence of frailty in elderly diabetic patients.

Abstract:Objective To analyze the risk factors of pneumonia in the elderly patients with cerebral infarction and to investigate their impact on its prognosis. Methods A retrospective study was conducted of the clinical data of 275 elderly cerebral infarction patients admitted to the First Affiliated Hospital of Nanjing Medical University from January 2020 to December 2022. The patients were divided into pneumonia group (n=41) and non-pneumonia group (n=234) based on the development of pneumonia after cerebral infarction. The two groups were compared in general information, clinical manifestations, and findings in adjunct tests. SPSS statistics 22.0 was used for data analysis. Depending on the data type, t test or Chi-square test was used for data comparison between two groups. Multivariate logistic regression analysis was conducted to assess the risk factors influencing the occurrence of pneumonia in the elderly patients with cerebral infarction. Results The pneumonia group had higher age, more patients with a history of smoking over 10 years, higher rates in heart failure, atrial fibrillation, myocardial infarction, chronic lung disease, history of stroke, swallowing disorders, consciousness disorders, vomiting, indwelling gastric tubes, invasive tracheal procedures, ventilator-assisted breathing, chest X-ray examination, chest CT examination, brainstem or cerebellar infarction, and higher National Institute of Health stroke scale (NIHSS) scores on admission than the non-pneumonia group, the differences being statistically significant (P<0.05). The pneumonia group were found to have significantly longer hospitalization, higher hospitalization expenses, NIHSS scores after treatment, and mortality rates at one and three months than the non-pneumonia group with statistically significant differences (P<0.05). A 10-year smoking history (OR=3.432,95%CI 1.170-10.065), chronic lung disease (OR=15.580,95%CI 2.744-88.461), dysphagia (OR=2.757,95%CI 1.319-5.760), brain stem or cerebellar infarction (OR=2.036,95%CI 1.282-3.233) and high NIHSS score (OR=1.328,95%CI 1.231-1.434) were independent risk factors of cerebral infarction complicated with pneumonia. Conclusion In the elderly patients with cerebral infarction complicated by pneumonia, special attention should paid to the factors such as smoking history, chronic pulmonary diseases, swallowing disorders, brainstem or cerebellar infarction, and high NIHSS score in order to reduce the occurrence of pneumonia in stroke patients.

Abstract:Objective To investigate the postoperative self-rehabilitation in the elderly patients with total hip/knee arthroplasty (THA/TKA) and analyze the factors affecting their quality of life. Methods A total of 190 elderly THA/TKA patients in Qionghai People′s Hospital from January 2020 to January 2022 were enrolled as the study subjects. A questionnaire survey was conducted to statistically analyze the status quo of their at-home self-rehabilitation at 6 months after discharge. SPSS statistics 20.0 was employed to process the data. According to the data type, one-way analysis of variance, t test orχ² test was used for intragroup comparison. Multivariate linear regression analysis was used to analyze the factors affecting the postoperative quality of life of the elderly THA/TKA patients. Results Among the 190 questionnaires distributed, 179 valid responses were returned. The survey found that the average score of various dimensions of 36-item short form health survey (SF-36) in the 179 elderly THA/TKA patients was (54.41±8.77) points. The excellent and good rate of the hip was 40.00% (36/90) in the THA patients, and that of the knee was 42.70% (38/89) in the TKA patients. The overall self-care ability and social support were mostly at low and middle levels [(85.47% (153/179) and 88.83% (159/179)]. The incidence rates of anxiety and depression were 25.14% (45/179) and 27.37% (49/179) respectively. The compliance to the self-rehabilitation training was mostly good [(33.52% (60/179)] or poor [(46.37% (83/179)]. Multivariate linear regression analysis suggested that postoperative complications (β =-3.854; P<0.001) and depression (β =-0.277; P<0.001) had a negative predictive effect on the quality of life of the elderly THA/TKA patients, and that self-care ability (β =0.236; P<0.001), social support level (β =0.611; P<0.001) and compliance to the self-rehabilitation training (β =0.213; P<0.001) had a positive predictive effect, and the regression equation was significant (F=13.115; P<0.001). These variables together explained 50.60% of the variation in quality of life. Conclusion The overall self-rehabilitation in the elderly THA/TKA patients at 6 months after surgery is not good, and postoperative complications, self-care ability, social support, depression and compliance to self-rehabilitation training are independent factors affecting their quality of life. It is suggested to improve the quality of life of patients after surgery in these aspects.

Abstract:Objective To analyze the quality of life and its influencing factors in the elderly tumor patients transitioning out of the intensive care unit (ICU). Methods A retrospective analysis was conducted of the clinical data of 240 elderly tumor patients in ICU of Affiliated Tumor Hospital of Xinjiang Medical University between June 2021 and February 2023. All patients were in the transition period of ICU transfer. The patients with a score<50 on 36-item short-form health survey (SF-36) were included in the observation group (n=70), and those with a SF-36 score≥50 in the control group (n=170). The physical status (ZPS) score was used to evaluate the patient′s general condition and health status, the mini-nutritional assessment scale (MNA) to evaluate the patients′ nutritional status, the self-rating depression scale (SDS) and self-rating anxiety scale (SAS) to evaluate the patients′ psychological status, and visual analogue scale (VAS) to evaluate pain level. SPSS 20.0 was used for statistical analysis. Data comparison between two groups was performed using t-test or χ² test, depending on the data type. Multivariate logistic regression analysis was used to analyze the influencing factors on the quality of life of the elderly tumor patients transitioning out of ICU. Results The SF-36 scores and medical service satisfaction in the observation group were significantly lower than those in the control group [(41.15±5.74) vs (68.88±7.43) points; (83.43±8.87) vs 9(4.65±9.46) points] with statistically significant differences (P<0.05 for both). The proportions of patients aged 76-85 years, chronic diseases>3 types, severe depression, severe anxiety, moderate pain, surgical treatment and ICU stay>5 d, and ZPS scores in the observation group were significantly higher than those in the control group, but the levels of white blood cell and platelet count and MNA scores were significantly lower than those in control group (P<0.05 for all). Multivariate Logistic regression analysis indicated that moderate pain (OR=2.964,95%CI 2.004-7.964) and ICU stay>5 d (OR=5.750,95%CI 2.442-7.975) were the risk factors of the decline in the quality of life in the elderly tumor patients transitioning out of ICU, while MNA score (OR=0.973,95%CI 0.955-0.991) was the protective factor (P<0.05). Conclusion The quality of life declines in the elderly tumor patients transitioning out of ICU. Medical staff should closely monitor the patients for changes in condition and their psychological state and implement the treatment measures based on their quality of life to promote their physical recovery.

Abstract:Objective To explore the influence of ambroxol hydrochloride on oxygenation index, D-D and inflammatory indexes in elderly patients with pneumonia, and its predictive efficiency for prognosis of the patients . Methods A total of 226 elderly pneumonia patients admitted to the General Practice Department of Beijing Chaoyang Hospital Affiliated to Capital Medical University from January 2022 to January 2023 were enrolled and randomly divided into a control group and an ambroxol hydrochloride group, with 113 cases in each group. After exclusion and grouping modification, 110 patients were eventually included in each of the two groups. According to the severity of the disease, the control group was assigned into severe and mild subgroups (36 and 74 cases, respectively), and the ambroxol hydrochloride group also into severe and mild subgroups (38 and 72 cases, respectively). The control group was given routine treatments such as oxygen inhalation support, sedation, cough relieving and phlegm relieving, while the ambroxol hydrochloride group was given intravenous injection of ambroxol hydrochloride on the basis of routine treatments. The effective rate, as well as oxygenation index, and D-D, C-reactive protein (CRP) and procalcitonin (PCT) levels before and after treatment were observed in the two groups. Receiver operating characteristic (ROC) curve was plotted to analyze the predictive performance of each indicator. Kaplan-Meier curve was drawn to analyze the survival of these patients. Results The total effective rate was significantly higher in the ambroxol hydrochloride group than the control group [89.09% (98/110) vs 70.91% (78/110); P<0.05]. When compared to the levels before treatment, the patients from the two mild subgroups of the control and ambroxol hydrochloride groups obtained significantly higher oxygenation index [(275.69±27.82) vs (153.26±11.89) mmHg, (297.19±23.53) vs (156.87±12.47) mmHg] and lower D-D level [(1.79±0.66) vs (2.43±0.91) mg/L, (1.34±0.47) vs (2.41±0.88) mg/L] after treatment; and those of the two severe subgroups had obviously increased oxygenation index [(257.58±25.19) vs (126.33±12.19) mmHg, (279.51±27.02) vs (127.83±13.53) mmHg] and decreased D-D level [(1.93±0.73) vs (2.56±0.78) mg/L, (1.77±0.59) vs (2.61±0.79) mg/L]. Ambroxol hydrochloride treatment resulted in statistically higher oxygenation index [(297.19±23.53) vs (275.69±27.82) mmHg, (279.51±27.02) vs (257.58±25.19) mmHg] and lower D-D level [(1.34±0.47) vs (1.79±0.66) mg/L, (1.77±0.59) vs (1.93±0.73) mg/L] in either mild or severe patients (P<0.05). Both routine and ambroxol hydrochloride treatment decreased CRP [(54.35±9.27) vs (87.55±8.19) mg/L, (41.56±9.57) vs (88.49±9.17) mg/L] and PCT [(0.99±0.37) vs (1.89±0.52) μg/L, (0.53±0.21) vs (1.90±0.49) μg/L] levels in the two mild subgroups, and the ambroxol hydrochloride group obtained more lower CRP [(41.56±9.57) vs (54.35±9.27) mg/L, (55.12±7.58) vs (60.58±9.82) mg/L] and PCT [(0.53±0.21) vs (0.99±0.37) μg/L, (0.75±0.25) vs (1.12±0.55) μg/L] levels in both mild and severe patients than the control group (all P<0.05). After the follow-up of 28 d, the cumulative survival rate was notably higher in the ambroxol hydrochloride group than the control group [89.09% (98/110) vs 69.09% (76/110), P<0.001]. The area under the ROC curve of oxygenation index, D-D level, combined with inflammatory markers CRP and PCT for prognosis of elderly pneumonia patients was 0.837, with a sensitivity of 88.50 and a specificity of 78.30. Conclusion Ambroxol hydrochloride can promote the treatment effectiveness in elderly pneumonia patients, significantly improving their oxygenation index, D-D level, inflammatory indicators, and survival rate. The combination of oxygenation index and D-D, CRP and PCT levels has high predictive value for patient prognosis, and can be further promoted and applied in clinical practice.

Abstract:Objective To investigate the diagnostic value of color Doppler ultrasonography (CDU) combined with serum high-sensitivity C-reactive protein (hs-CRP) and Omentin-1 (OMentin-1) in the elderly patients with type 2 diabetes mellitus (T2DM) complicated with lower extremity vascular disease (LEVD). Methods A total of 250 elderly T2DM patients admitted to the Hai′an People′s Hospital from July 2020 to October 2022 were selected and divided into T2DM group (n=118) and T2DM-LEVD group (n=132) according to the occurrence of LEVD. Another 100 healthy elderly volunteers who underwent physical examination during the same period were selected as the normal group (NC group). General data of the subjects were collected, and CDU was performed to obtain the lower extremity hemodynamics, plaque formation rate and rate of dorsalis pedis artery stenosis. Serum hs-CRP and Omentin-1 levels were measured. The three groups were compared in the above indexes. Binary logistic regression model was used to analyze factors affecting T2DM-LEVD, and receiver operating characteristic (ROC) curve was drawn to analyze the diagnostic value of the CDU combined with serum hs-CRP and Omentin-1 detection for T2DM-LEVD. SPSS statistics 24.0 was used for statistical analysis. Data comparison between two groups was perfomed using t test, χ² test or analysis of variance depending on data type. Results There were no diffe-rences in gender, age, body mass index (BMI), history of smoking, history of drinking, and course of disease among the three groups (P>0.05). The levels of glycosylated hemoglobin (HbA1c), fasting blood glucose (FPG), total cholesterol (TC), triglyceride (TG), fasting insulin (FINS), insulin resistance (HOMA-IR) index, urea nitrogen (BUN), rate of plaque formation, rate of dorsalis pedis artery stenosis, and the serum hs-CRP in the T2DM-LEVD group were higher than those in the T2DM and NC groups, and those in the T2DM group were higher than those in the NC group. The high-density lipoprotein cholesterol (HDL-C) and albumin (ALB), internal diameter and blood flow of the femoral artery, popliteal artery and dorsal foot artery, and serum Omentin-1 level in the T2DM were lower than those in the T2DM and NC groups, and those in the T2DM group were lower than those in the NC groups, and the differences were statistically significant (P<0.05). Logistic analysis showed that HbA1c, FPG, and the internal diameter and blood flow of the femoral artery, popliteal artery and dorsal pedis artery, hs-CRP, and Omentin-1 were the factors affecting the occurrence of T2DM-LEVD (P<0.05). ROC curve showed that the area under the curve (AUC), sensitivity and specificity of the combined CDU, hs-CRP and Omentin-1 were higher than any of the three alone in the diagnosis of T2DM-LEVD (P<0.05). Conclusion CDU combined with serum hs-CRP and Omentin-1 levels is of high diagnostic value in the elderly patients with T2DM and LEVD.

Abstract:Objective To investigate the quality of life at one year after percutaneous coronary intervention (PCI) in the elderly patients with coronary heart disease (CHD) and to analyze its influencing factors and correlation with frailty. Methods A total of 166 elderly CHD patients who underwent PCI for the first time in Qionghai People′ s Hospital between January 2021 and January 2022 were included as the study subjects. Their quality of life and frailty were investigated before PCI and at one year after PCI. The data was processed with SPSS statistics 19.0. According to the data type, analysis of variance, t test or Chi-square test was used for comparison between groups. The factors affecting the postoperative quality of life in patients were analyzed by multivariate linear regression model. Pearson correlation analysis was employed to analyze the correlation between frailty and quality of life. Results At one year after PCI, the scores of physical health and psychological health and total score of quality of life scale of elderly CHD patients increased compared with before the surgery (P<0.05). Multivariate linear regression analysis found that gender, living alone, marital status, smoking after surgery and types of underlying diseases were negatively correlated with quality of life in the elderly CHD patients after PCI(β =-0.153, -0.136, -0.173, -0.383, -0.125; P<0.05), and that psycho-social adaptation ability, health education and physical exercise were positively correlated with quality of life(β =0.165,0.056,0.189；P<0.05), which together explained 63.4% of the variance of quality of life in elderly CHD patients at 1 year after PCI (F=58.484, P<0.001). The incidence rate of frailty was 24.10% (40/166), and the score of frailty scale was negatively correlated with quality of life (r=-0.411; P<0.001). Conclusion The quality of life in the elderly CHD patients after PCI is significantly improved compared with before the surgery. Actively carrying out health education, improving bad habits and strengthening exercise are of some value in enhancing the patients′ quality of life.

Abstract:Objective To investigate the economic burden, psychological distress and quality of life in elderly patients undergoing radical resection of prostate cancer (PCa) and to analyze their correlation. Methods A total of 118 elderly PCa patients were included as the study subjects, who underwent radical resection in the First Affiliated Hospital of Xinjiang Medical University from February 2020 to August 2022 and paid a follow-up visit at 3 months after surgery according to the doctor′s advice. A questionnaire survey was conducted to statistically analyze the economic burden of disease, psychological distress, and quality of life. SPSS 19.0 was used for statistical analysis. Data comparison between two groups was preformed using t test orχ² test, depending on data type. Pearson correlation analysis was used to analyze the relationship between economic burden, psychological pain, and quality of life. Multiple linear regression models were used to analyze the factors affecting the quality of life of the elderly PCa patients. Results Totally, 118 questionnaires were distributed and 108 were collected (91.53%). The total score of functional assessment of cancer therapy-prostate (FACT-P) quality of life scale was found to be (101.41±16.27) points, the average score of comprehensive scores for financial toxicity based on the patient-reported outcome measures (COST-PROM) scale to be (24.25±6.14) points, and the average score of distress thermometer (DT) to be (3.43±0.53)points, and the patients with DT≥4 points accounted for 41.67% (45/108). Pearson correlation analysis showed that quality of life in the elderly PCa patients was negatively correlated with DT (r=-0.346; P<0.05) and was positively correlated with score of COST-PROM scale (r=0.433; P<0.001). Multivariate linear regression showed that urinary tract compression symptoms (β =0.296; P<0.001), psychological distress (β =0.296; P<0.001) and economic burden (β =-0.342; P<0.001) were factors affecting the quality of life in the elderly patients undergoing radical resection of PCa. Conclusion The quality of life in the elderly patients after radical resection of PCa is not high with different degrees of psychological distress, and the overall economic burden is at a moderate level. Adjusting the psychological distress and economic burden of patients can enhance the postoperative quality of life to some extent.

Abstract:Objective To investigate the predictive value of serum inflammatory indicators C-reactive protein (CRP) and procalcitonin (PCT) combined with neutrophil/lymphocyte ratio (NLR) in predicting major adverse cardiovascular events (MACE) in the elderly (≥60 years old) diabetic Han Chinese infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant during hospitalization. Methods All 1038 consecutive elderly patients hospitalized in the Affiliated Hospital of Xuzhou Medical University due to infection with the Omicron variant were enrolled from December 2022 to February 2023, and 94 were excluded, leaving 944 for final analysis. Patients were divided into diabetes mellitus (DM) group (n=189) and non-DM group (n=755) according to the presence of diabetes mellitus. Based on occurrence of MACE during hospitalization, they were divided into MACE group (n=89) and non-MACE group (n=100). SPSS statistics 25.0 was used for data analysis. Based on the data type, student′s t test, Mann-Whitney U test, or Chi-square test was employed for intergroup comparison. Multivariate logistic regression analysis and receiver operating charac-teristic (ROC) curve were used to analyze the influence of serum inflammatory indicators (PCT, CRP and NLR) and their predictive value for MACE in the elderly diabetic patients during hospitalization. Results Of the 944 elderly patients, 244 (25.8%) had MACE during hospitalization. Diabetic patients had a higher rate of MACE than non-diabetic patients (47.1% vs 20.5%), and the difference was statistically significant. Among diabetic patients, compared with the non-MACE group, the MACE group were older, had higher fasting blood glucose, had a significant higher proportion of patients with a history of cerebral infarction, higher levels of all three serum inflammatory indexes (PCT, CRP, and NLR), and a higher white blood cell (WBC) count, the differences being statistically significant (P<0.05). Multivariate logistic regression analysis showed that age (OR=1.062, 95%CI 1.009-1.118; P=0.021), PCT (OR=1.614, 95%CI 1.340-1.943; P<0.001), CRP (OR=1.008, 95%CI 1.000-1.016; P=0.038), and NLR (OR=1.261, 95%CI 1.103-1.441;P=0.001) were independent predictors of MACE in elderly diabetic patients infected with the Omicron variant during hospitalization. The ROC curve and Delong test indicated that the PCT+CRP+NLR model had a better clinical predictive value for MACE in the patients during hospitalization than single inflammatory indicators. Conclusion Serum inflammatory indicators PCT, CRP, and NLR have good predictive power for MACEs in the elderly diabetic patients infected with the Omicron variant during hospitalization.

Abstract:Objective To investigate the risk factors of frailty in the elderly patients with dysphagia after acute cerebral infarction (ACI) and to establish a risk-prediction nomograph model. Methods A retrospective analysis was conducted of the clinical data of 195 elderly patients with dysphagia after ACI, who were treated in Suzhou Hospital of Integrated Traditional and Western Medicine from February 2020 to March 2022. They were randomly divided into a modeling group (n=130) and validation group (n=65) in a ratio of 2∶1, and those in the modeling group were further divided into frailty group (n=83) and non-frailty group (n=47) according to the occurrence of frailty. Data statistical analysis was conducted using SPSS 26.0. t test andχ² test was employed for inter-group comparisons based on the data type. Multivariate logistic regression was used to analyze the risk factors of frailty in the elderly patients with dysphagia after ACI in the modeling group, and a risk-prediction nomograph model was established using R3.6.1 software. The receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) were drawn to evaluate the predictive efficiency, accuracy and clinical benefit of the nomogram model, and the validation group was used to evaluate the feasibility of the nomogram. Results The incidence of frailty in all 195 patients was 64.10% (125/195), 63.85% (83/130) in the modeling group, and 64.62% (42/65) in the validation group. Multivariate logistic regression analysis showed that the age above 75 years, course of swallowing disorders ≥21 d, living alone, self-financing, poor economic level, ≥3 complications, ≥3 medications, limb movement disorders, depression, malnutrition, and low social support level were risk factors for the frailty of elderly patients with dysphagia after ACI (OR=3.618,4.459,4.358,2.843,3.102,2.130,2.659,3.770,3.501,4.646,1.887; P＜0.05), and that dietary guidance was a protective factor (OR=0.570; P＜0.001). The ROC curve analysis showed that the area under the curve (AUC) of the prediction nomograph model was 0.853 for the modeling group and 0.844 for the validation group, with a sensitivity of 78.31% and 76.19%, and a specificity of 85.11% and 82.61%, respectively. The consistency index of the calibration curves was 0.798 for the modeling group and 0.793 for the validation group, and both calibration curves were close to the standard curve. The DCA results in both groups showed that the nomograph model had good net returns. Conclusion Age above 75 years, course of dysphagia, living alone, self-financing, poor economic level, ≥3 complications, ≥3 medications, limb movement disorder, depression, malnutrition, dietary guidance and low social support level are all influencing factors for the frailty in the elderly patients with dysphagia after ACI, and the nomograph model constructed based on the above factors is helpful to screen high-risk patients and guide early clinical intervention.

Abstract:Objective To investigate the current status of oral health behaviors in the elderly population and analyze the influencing factors. Methods A total of 550 permanent residents aged≥60 years in Hainan Province were selected as study subjects using multi-stage stratified cluster sampling. The qualified rate of oral health behaviors was calculated. SPSS 19.0 was used for statistical analysis. Data comparison between groups was performed using t test or χ² test, depending on data type. Binary logistic regression model was used to analyze the factors affecting oral health behaviors in the elderly population. Results Of the 550 questionnaires distributed, 521 (94.73%) were collected. The survey found that the best oral health behavior of the elderly population was brushing teeth in the morning and evening (62.38%, 325/521) and the worst was cleaning teeth at least once a year (9.60%, 50/521) with a qualified rate of oral health behaviors of 26.49% (138/521). Binary logistic regression analysis indicated that living in urban areas (OR=0.685, 95%CI 0.558-0.842), monthly household income>5000 yuan (OR=0.772, 95%CI 0.707-0.843), and frequent social contact (OR=0.641,95%CI 0.474-0.867) were protective factors for qualified oral health behaviors in the elderly population, while dental fear (OR=1.917, 95%CI 1.324-2.777) and poor self-care ability (OR=2.908, 95%CI 1.263-3.486) were risk factors (P＜0.05). Conclusion The qualified rate of oral health behaviors in the elderly population is at a poor level. Living in urban area, monthly household income>5000 yuan, and frequent social contact are protective factors of qualified oral health behaviors, while the dental fear and poor self-care ability are risk factors in the elderly population.

Abstract:Objective To study the role of silent mating type information regulation 2 homolog-3 (Sirt3) in the process of cardiac senescence induced by advanced glycosylation end-products (AGEs) and to explore the mechanism of total saponins extracted from Dioscorea panthaica (TSDP) in cardiac senescence. Methods After neonatal rat cardiomyocytes were isolated and cultured and identified, the cells were incubated with AGEs. Small interfering RNA (siRNA) was used to knock down the expression of Sirt3 in the cells. Western blotting was used to detect the expression of P16 and P53 and superoxide dismutase-2 (SOD2). SA-β-Gal kit was employed to detect cardiomyocyte senescence, and 2,7-dichlorodi-hydrofluorescein diacetate (DCFH-DA) probe was used to detect intracellular reactive oxygen species (ROS). In the cells with TSDP pre-intervention after AGEs treatment, cardiac senescence was detected by SA-β-Gal kit. GraphPad Prism statistical analysis was performed. One-way ANOVA was conducted for data comparison between two groups. Results Compared with the control cells, the levels of SIRT3 and SOD2 were reduced, and that of P53 was increased, and the proportion of SA-β-Gal positive cells and production of ROS were elevated in the AGEs+negative control (NC) siRNA group. Same changing trends were observed in the AGEs+Sirt3 siRNA group, and the expression level of senescence-related protein P53 was also up-regulated. TSDP pre-intervention decreased the proportion of SA-β-Gal positive cells when compared with the AGEs+NC siRNA group, but the change was decreased after transfection with Sirt3 siRNA. Conclusion AGEs may decrease the expression of SOD2 by down-regulating Sirt3, then aggravate mitochondrial oxidative stress and promote cardiomyocyte aging. TSDP may affect cardiac senescence by regulating the expression of Sirt3.

Abstract:Immunosenescence is the most significant change in immune system with aging. It is closely associated with infectious diseases, autoimmune diseases and malignant tumors, and leads to the progression of severe coronavirus disease 2019 (COVID-19) in the elderly after SARS-CoV-2 infection. Immunosenescence changes the frequency, phenotype and function of immune cells in the innate and adaptive immune systems, results in immune dysfunction and imbalance of inflammatory response, and thus increases the risk of death and adverse prognostic events in elderly patients. In this article, we analyzed the relationship between immunosenescence and severe COVID-19 in order to explore effective treatment of severe COVID-19 in the elderly and improve the survival and prognosis of the elderly patients.

Abstract:Sepsis induced acute lung injury (ALI) is common clinically, with high incidence rate and mortality. Mitochondrial quality control plays a crucial role in sepsis induced ALI, including mitochondrial biosynthesis, mitochondrial fusion and fission, and mitophagy. Impairment of mitochondrial quality control can lead to mitochondrial dysfunction, leading to programmed death of pulmonary endothelial cells, which is an important mechanism for pathogenesis of ALI. Therefore, in recent years many studies have focused on the mitochondrial quality control as a targeted treatment strategy for sepsis induced ALI. In this study, we reviewed the recent research progress of mitochondrial quality control in septic induced ALI, hoping to provide theoretical reference for the clinical prevention and treatment of septic induced ALI.

Abstract:Intrinsic capacity refers to the combination of one′s physical and mental abilities, and its framework comprises mobility, vitality, cognition, psychological, and sensory domains. Intrinsic capacity plays an important role in healthy aging. Studies on the mechanism of intrinsic capacity show that chronic low-grade inflammation accompanying aging process may play an important role in its decline by acting on all the domains. In this article, we reviewed the relationship between chronic low-grade inflammation and intrinsic capacity.

Abstract:In June 2022, Shenzhen issued a local regulation for medical treatment, in which living wills are concerned for the first time in China. Living wills are conducive to relieving the pain of cancer patients, respecting their life autonomy and reducing the waste of medical resources. However, it is still very hard to promote and implement living wills in the population living with cancer, which was increasing year by year. In this article, we mainly elucidated the concept, theoretical basis and development process of living wills at home and abroad. We then analyzed the research status and influencing factors of the cognition, implementation and efficacy assessment of living wills in cancer patients in our country. Finally, we made ethical thinking about this issue from three different perspectives, that is, cancer patients, family and society, in order to provide reference for formulating related schemes of living wills in cancer patients.

Abstract:For medium/high-risk coronary heart disease patients undergoing non-cardiac surgery, the aims of routine preoperative coronary angiography and revascularization are improving risk stratification and reducing the risk of perioperative adverse cardiac events, though the effects remain not yet clear. Some studies suggest that the patients with symptoms and/or non-invasive examination showing the presence of coronary heart disease may require invasive coronary angiography before non-cardiac surgery, and if necessary, revascularization. Recent guidelines indicate that routine coronary angiography or revascularization before surgery is required routinely for the patients with acute coronary syndrome undergoing non-cardiac surgery, while for those with chronic coronary syndrome, the angiography or revascularization is only for high-risk populations (with poor drug treatment and/or high-risk lesions), and the optimal treatment plan for non-high-risk lesions is not clear yet.