Abstract:Objective To investigate the prevalence of microvascular complications in elderly patients with diabetes mellitus, and analyze the risk factors of microvascular diseases. Methods A retrospective analysis was conducted on the clinical data of 495 elderly diabetic patients admitted to Peking Union Medical College Hospital from January 2020 to December 2022. Their baseline information and biochemical indicators were collected, and the incidences of microvascular complications such as diabetic retinopathy, diabetic nephropathy and peripheral neuropathy were recorded. According to the type of microvascular complications, the patients were divided into diabetic retinopathy group (n=107), diabetic nephropathy group (n=81), peripheral neuropathy group (n=169) and non-complication group (n=138). SPSS statistics 22.0 was used for data analysis. Based on different data type, one-way ANOVA or Chi-squared test was employed for intergroup comparison. Multivariate logistic regression analysis was applied to determine the related risk factors leading to diabetes microvascular disease. Results Among the 495 elderly patients with diabetes mellitus, 357 had microvascular complications, with a total prevalence rate of 72.12%, including 21.62% (107/495) of diabetes retinopathy, 16.36% (81/495) of diabetes nephropathy, and 34.14% (169/495) of peripheral neuropathy. Compared with the patients of the non-complication group, those of the diabetic retinopathy group had a longer course of diabetes mellitus, higher systolic blood pressure (SBP) and glycosylated hemoglobin A1c (HbA1c), and lower low-density lipoprotein cholesterol (LDL-C) level; those of the diabetic nephropathy group had longer course of diabetes mellitus and higher TG and 24-hour urine albumin excretion rate (UAER); and those with peripheral neuropathy had higher levels of SBP, diastolic blood pressure (DBP), HbA1c, total cholesterol (TC) and triglyceride (TG) (all P<0.05). Multivariate logistic regression analysis showed that the long duration of diabetes mellitus (OR=3.013, 95%CI 1.206-7.526; P=0.019), high SBP (OR=2.445, 95%CI 1.105-5.408; P=0.028) and high HbA1c (OR=3.093, 95%CI 1.112-8.606; P=0.031) were independent risk factors for diabetic retinopathy. Long duration of diabetes mellitus (OR=2.404, 95%CI 1.185-4.877; P=0.016), high TG (OR=2.654, 95%CI 1.241-5.677; P=0.012) and high UAER (OR=3.432, 95%CI 1.303-9.036; P=0.013) were independent risk factors for diabetic nephropathy. High SBP (OR=2.020,95%CI 1.228-3.323; P=0.006), high DBP (OR=2.560, 95%CI 1.109-5.912; P=0.028), high HbA1c (OR=2.382, 95%CI 1.321-4.297; P=0.004), high TC (OR=2.779, 95%CI 1.057-7.303; P=0.039) and high TG (OR=2.266, 95%CI 1.237-4.152; P=0.008) were independent risk factors for peripheral neuropathy. Conclusion Elderly diabetes patients have a higher prevalence of microvascular complications. Long duration of diabetes mellitus, high SBP, DBP, HbA1c, TC, TG and UAER are risk factors for the aforementioned complications, and attention should be paid to these factors.

Abstract:Objective To explore the influencing factors of perioperative neurocognitive disorders (PND) in the elderly patients with brain tumors and effectiveness of rehabilitation treatment. Methods A retrospective analysis was made of the clinical data of 120 elderly brain tumor patients admitted to First Affiliated Hospital of Xinjiang Medical University from December 2020 to July 2022. Based on whether they experienced PND, the patients were divided into PND group (n=78) and non-PND group (n=42). The two groups were compared in the demographic information and clinical indicators. According to the intervention methods, the PND patients were classified into the control group (n=41) and the observation group (n=37). The two groups were compared in the effects of different intervention methods on improving neurocognitive function and quality of life. SPSS statistics 22.0 was used to process the data, and according to the type of data, t test orχ² test was used for inter-group comparison. Logistic regression model was used to analyze the factors affecting the PND in the elderly patients with brain tumors. Results The incidence of PND in 120 elderly patients with brain tumors was 65.0% (78/120). There was a statistically significant difference in age, tumor location, WHO pathological tumor grading, and tumor volume between PND group and non-PND group (P<0.05). After treatment, the Montreal cognitive assessment (MoCA) score, and the role, physical, social and emotional functions scores in the observation group were higher than those in the control group, and the difference was statistically significant (P<0.05). Multivariate logistic regression analysis showed that the factors affecting the occurrence of PND in the elderly brain tumor patients were tumor site (OR=1.879, 95%CI 1.103-3.203), WHO′s pathological tumor grading (level Ⅱ:OR=1.964, 95%CI 1.021-3.780; level Ⅲ:OR=2.186, 95%CI 1.099-4.349; level Ⅳ:OR=2.462,95%CI1.162-5.216) and tumor volume (20-＜40 cm³:OR=1.793, 95%CI 1.016-3.166; 40-＜60 cm³:OR=2.038, 95%CI 1.114-3.727; ≥60 cm³:OR=2.207, 95%CI 1.207-4.298). Conclusion The incidence of PND is relatively high in the elderly patients with brain tumors, especially in those with tumors located in the frontal and temporal lobes, high grades on WHO tumor classification and large tumor volumes, and high-risk groups require special attention. After the onset of PND, rehabilitation therapy can help improve neurocognitive function.

Abstract:Objective To investigate the correlation between DR-FLASH score and epicardial adipose tissue (EAT) volume around the left atrium (LA), and explore the predictive value of their combination for left atrial low voltage zone (LVZ) in patients with non-valvular atrial fibrillation (NVAF). Methods A total of 268 NVAF patients who received radiofrequency catheter ablation for first time in Department of Cardiovascular Diseases, Affiliated Hospital of Xuzhou Medical University from September 2019 to April 2121 were consecutively recruited in this single-center retrospective clinical observation study. All patients underwent CTA scanning of pulmonary vein preoperatively, and then the volume of LA-EAT was measured. DR-FLASH score were calculated after admission. During the operation, the high-density voltage mapping of the LA was performed under sinus rhythm, and the patients were divided into LVZ group and non-LVZ group according to LVZ existence (bipolar voltage <0.5 mV as low voltage area). SPSS statistics 24.0 was used for statistical analysis. Intergroup comparison was performed using student′s t test, U test or Chi-square test depending on data type. Spearman correlation analysis was employed to determine the correlation between DR-FLASH score and LA-EAT volume. Receiver operating characteristic (ROC) curve was plotted to analyze the value of DR-FLASH score, LA-EAT volume and their combination to predict LVZ occurrence. Results In the subjected 246 patients, their average age was (60.8±10.6) years, and at least one LVZ was found in 56 patients (22.8%). The correlation analysis showed that the DR-FLASH score was positively correlated with LA-EAT volume (r=0.439; P<0.001). Multivariate analysis revealed that DR-FLASH score (OR=1.824,95%CI 1.390-2.394; P<0.001) and LA-EAT (OR=1.048,95%CI 1.013-1.085; P=0.007) were independent risk factors for LVZ after radiofrequency catheter ablation. The area under the ROC curve was 0.712,0.750 and 0.796, respectively for LA-EAT volume, DR-FLASH score, and their combination. Conclusion For NVAF patients, their DR-FLASH score is positively correlated with LA-EAT volume. The two indicators are independent predictors of left atrial LVZ in them. Their combination can improve the predictive value of left atrial LVZ in NVAF patients with non-valvular atrial fibrillation.

Abstract:Objective To explore the efficacy and safety of hemi-hip and total hip joint replacement in the treatment of femoral neck fractures in the elderly. Methods A retrospective analysis was conducted on 106 elderly patients with femoral neck fractures who were admitted to our department from January 2016 to October 2019. All patients underwent hip arthroplasty following Guideline for the Diagnosis and Treatment of Adult Femoral Neck Fractures. They were divided into hemiarthroplasty group (n=53) and total hip arthroplasty group (n=53) based on the surgical technique they received. Operational indicators, hip joint function and pain, quality of life, and safety were compared between two groups. SPSS 22.0 software was used to process the statistical analysis, and depending on data type, student′s t test or Chi-square test was employed for intergroup comparison. Results There were no significant difference in the number of blood transfusion patients and length of hospital stay between two groups (P>0.05). Compared with the hemiarthroplasty group, the total hip arthroplasty group had more intraoperative blood loss, 24-h postoperative drainage and longer bed-ridden time (P<0.05). In three months after surgery, the Harris hip score (HHS) was increased, the number of unequal length cases was decreased, and the score of Visual analogue scale (VAS) of pain was reduced in both groups when compared with the conditions before surgery. The HHS score was obviously higher and VAS score was notably lower in the hemiarthroplasty group than the total hip arthroplasty group (P<0.05), but no significant difference was found in the number of unequal length cases between two groups in three months postoperatively (P>0.05). The results of medical outcomes study 36-item short from health survey (SF-36) in three months after surgery showed there were no significant differences in the scores of overall health status, social function and emotional function between two groups (P>0.05), but the total hip arthroplasty group had higher SF-36 scores of physiological function, role-physical, physical pain, vitality and mental health than the hemiarthroplasty group (P<0.05). The complication rate was 3.77% (2/53) in the total hip arthroplasty group, which was significantly lower than that of hemiarthroplasty group [16.98% (9/53), P<0.05]. Conclusion Hemiarthroplasty and total hip arthroplasty have their own advantages in the treatment of elderly patients with femoral neck fractures. For those with poor preoperative general condition and low postoperative functional requirements, it is advisable to undergo hemiarthroplasty. While, for those with good preoperative general condition and certain requirements for postoperative functional recovery, total hip arthroplasty is recommended.

Abstract:Objective To analyze the impact of preoperative resting heart rate (RHR) on the efficacy of percutaneous coronary intervention (PCI) and prognosis in the elderly patients with ST-segment elevation myocardial infarction (STEMI). Methods A total of 211 elderly STEMI patients admitted to the Wanbei Coal-Electricity Group General Hospital between January 2020 and January 2021 were included as the study subjects. According to the preoperative RHR level, the patients were divided into RHR1 group (RHR<60 times/min; n=43), RHR2 group (RHR:60-79 times/min; n=76), RHR3 group (RHR:80-99 times/min; n=55) and RHR4 group (RHR≥100 times/min; n=37). The case data of each group were compared. Blood flow grading and myocardial perfusion grading of Thrombolysis in Myocardial Infarction (TIMI) after PCI were recorded, and deaths and major adverse cardiovascular events (MACE) at 30 days and 1 year after PCI were counted. SPSS 19.0 was used for statistical analysis. Data comparison between two groups was preformed using t test orχ² test depending on data type. Cox proportional hazard regression was employed to analyze the relationship between preoperative RHR level and prognosis in the STEMI patients. Results There were statistically significant differences among RHR groups in the proportion of diabetic cases, systolic blood pressure, diastolic blood pressure, low-density lipoprotein cholesterol and neutrophil count at admission, proportion of cases with left ventricular ejection fraction ≤40%, myocardial infarction area and plasma N-terminal pro-B-type natriuretic peptide (P<0.05). There were statistically significant differences among RHR groups in TIMI blood flow grades and myocardial perfusion grades (P<0.05). There were statistically significant differences in the incidence rate of MACE and death rate within 30 days after PCI and at one year after PCI among RHR groups (P<0.05). Multivariate Cox proportional hazard regression analysis suggested that preoperative RHR≥100 beats/min was a risk factor for death (RR=3.985; P<0.001) and MACE (RR=6.091; P=0.013) within 30 days after PCI in the STEMI patients, and that preoperative RHR≥100 beats/min was a risk factor for death (RR=2.744; P<0.001) and MACE (RR=3.114; P<0.001) in STEMI patients at one year after PCI. Conclusion Preoperative RHR≥100 times/min will increase the risk of death and MACE in STEMI patients after PCI.

Abstract:Objective To explore the changes in quality of life (QOL) after radical prostatectomy in patients with prostate cancer and influencing factors in Xinjiang Uygur Autonomous Region. Methods Clinical data of 240 patients with prostate cancer who underwent radical surgery in the People′s Hospital of Xinjiang Uygur Autonomous Region from January 2021 to December 2022 were collected and retrospectively analyzed. According to their score of QOL, they were divided into good QOL group (n=85) and poor QOL group (n=155). SPSS statistics 20.0 was used to perform the statistical analysis. Student′s t test or Chi-square test was employed for intergroup comparison depending on data type. Logistic regression analysis was applied to analyze the factors influencing the QOL in patients undergoing radical prostatectomy due to prostate cancer. Results The functional assessment of cancer therapy-prostate (FACT-P) score was increased in the prostate cancer patients after surgical treatment (P<0.05). Logistic regression analysis showed that age >60 years (OR=3.920,95%CI 1.216-12.631; P=0.023), education duration ≤5 years (OR=3.967,95%CI 1.156-13.610; P=0.029), abnormal creatinine level (OR=4.948,95%CI 1.204-20.331; P=0.027), smoking (OR=5.233,95%CI 1.281-21.376; P=0.022), alcohol drinking (OR=5.463,95%CI 1.774-16.828; P=0.003), diabetes mellitus (OR=5.669,95%CI 1.157-27.787; P=0.033), hypertension (OR=4.874,95%CI 1.426-16.658; P=0.012), depression (OR=4.968,95%CI 1.710-14.429; P=0.003), testosterone ≤10 nmol/L (OR=5.964,95%CI 1.350-15.458; P=0.015), tumor metastasis (OR=3.939,95%CI 1.416-10.959; P=0.009), and per capita family income≤2 000 Yuan (OR=3.626,95%CI 1.200-10.951; P=0.023) were influencing factors for QOL in patients with prostate cancer. Conclusion Age >60 years, education duration ≤5 years, abnormal creatinine level, smoking, alcohol drinking, diabetes mellitus , hypertension, depression, testosterone ≤10 nmol/L, tumor metastasis, and per capita family income ≤2 000 Yuan are influencing factors for poor QOL in prostate cancer patients after radical prostatectomy in Xinjiang Uygur Autonomous Region. Therefore, clinical interventions targeting these factors should be implemented to promote postoperative recovery.

Abstract:Objective To explore the impact of physical function on multimorbidity in the elderly adults. Methods From the China Health and Retirement Longitudinal Study (CHARLS), 2 452 elderly adults aged≥60 years from the 2011 baseline survey were selected as the study population and followed up to 2015. The survey included grip strength, short physical performance battery (SPPB), chronic diseases, demographic variables, and health behavior variables. SPSS statistics 26.0 was used for data analysis. Generalized estimating equations were employed to analyze the influencing factors of multimorbidity, and the impact of physical function on multimorbidity was analyzed based on generalized estimating equations after adjusting for confounding factors. Results The prevalence of multimorbidity among older adults increased from 48.9%(1 199/2 452) in 2013 to 56.1%(1 375/2 452) in 2015, showing an upward trend. The risk of multimorbidity was higher in females (OR=1.287,95%CI 1.124-1.474; P=0.000) and subjects with fall(OR=1.784,95%CI 1.560-2.040; P=0.000) and lower grip strength and lower SPPB scores. The grip strength values were referenced to Q4, and the risks for Q1, Q2, and Q3 were (OR=1.435,95%CI 1.213-1.698; P=0.000), (OR=1.513,95%CI 1.287-1.780; P=0.000) and (OR=1.188,95%CI 1.023-1.379; P=0.024). The SPPB scores were referenced to 10-12 points, and the risks for 0-6 points and 7-9 points were (OR=1.671,95%CI 1.245-2.243; P=0.001) and (OR=1.278,95%CI 1.134-1.440; P=0.000). After controlling for confounding factors, older adults with lower grip strength and lower SPPB scores also have a higher risk of multimorbidity. The risk for grip strength values Q1, Q2 and Q3 were (OR=1.274,95%CI 1.053-1.542; P=0.013), (OR=1.374, 95%CI 1.151-1.641; P=0.000) and (OR=1.147,95%CI 0.985-1.337; P=0.078); the risk of SPPB scores for 0-6 points and 7-9 points were (OR=1.508,95%CI 1.119-2.033; P=0.007) and (OR=1.220,95%CI 1.081-1.376; P=0.001). Conclusion Physical function is significantly associated with the risk of multimorbidity in the elderly adults, and physical function measures can be used as an effective means of screening for multimorbidity, which is helpful for early identification and targeted prevention and control of individuals at higher risk of multimorbidity.

Abstract:Objective To analyze the status quo and influencing factors of quality of life in elderly patients with hemiplegia after discharge due to acute ischemic stroke (AIS). Methods Clinical data of 408 elderly AIS hemiplegic patients admitted to our department from January to December 2022 were collected. Stroke Specific Quality of Life Scale (SSQOL) was used to assess the quality of life of these patients one month after discharge. According to the SSQOL score, they were divided into a good life-quality group (SSQOL score ≥123, n=225) and a poor life-quality group (SSQOL score <123, n=183). SPSS 23.0 statistical software was employed for data analysis. Independent sample t test or Chi-square test was utilized for intergroup comparison depending on different data type. Multivariate logistic regression analysis was applied to identify risk factors affecting the quality of life of elderly AIS hemiplegic patients after discharge. Results The SSQOL score of 408 elderly patients with AIS hemiplegia at one month after discharge was (136.35±5.38), and the standardized score was (56.30±5.21)%, which was at a moderate level. There were statistically significant differences between poor life-quality group and good life-quality group in terms of payment method of medical expense, marital status, main caregivers, Ashworth spasm grade of affected side, activity of daily living and depression symptom (P<0.05). Multivariate logistic regression analysis showed that self-paying of medical expense (OR=2.573,95%CI 1.550-4.271), affected side at Ashworth spasm grade Ⅱ (OR=2.085,95%CI 1.030-4.223), heavy dependence on daily life (OR=3.435,95%CI 2.285-5.163), and depression symptom (OR=3.114,95%CI 1.919-5.054) were risk factors for poor quality of life in elderly patients with AIS hemiplegia after discharge, and married status (OR=0.573,95%CI 0.031-0.892) and spouse as the main caregiver (OR=0.642,95%CI 0.109-0.980) were protective factors (all P<0.05 ). Conclusion Medical economic burden, high muscle tension of affected side, limited ability of daily life and depression are important influencing factors of quality of life in elderly patients with AIS hemiplegia after discharge, and spouse companionship and care are beneficial to improving their quality of life.

Abstract:Objective To analyze the quality of life and the influencing factors in the elderly patients with comorbidities. Methods A retrospective analysis was made of clinical data of 150 elderly comorbid patients admitted to the Geriatric Department of Union Wuhan Red Cross Hospital from February 2022 to February 2023. The patients′ chronic disease status was recorded, and their quality of life was evaluated using a concise quality of life scale. The quality of life among the elderly comorbid patients was compared in gender, age, marital status, education level, monthly income, residential regions, severity of comorbidities, number of comorbidities, and cognitive functions. The data were processed using SPSS 22.0. According to the data type, independent sample t test, one-way analysis of variance, orχ² test was used for inter-group comparison. Unconditional logistic stepwise regression analysis was used to identify risk factors affecting the quality of life of the elderly comorbid patients. Results The common chronic diseases in 150 elderly patients were hypertension, diabetes and respiratory diseases. Of all the patients, 44 (29.33%) had two comorbid chronic diseases, 77 (51.33%) had three comorbid chronic diseases, and 29 cases (19.33%) had more than three chronic diseases. The elderly comorbid patients aged ≥70 years, having an income <3 000 yuan/month, living alone, having severe comorbidities, having more than 3 comorbidities and having cognitive dysfunction had significantly lower life quality scores than those aged < 70 years, having an income ≥3 000 yuan/month, not living alone, having mild to moderate comorbidities, having 2 or 3 comorbidities, and having no cognitive dysfunction. The differences were statistically significant (t=6.276,2.785,2.599,19.519,233.834,4.254; P<0.05). Multivariate logistic regression analysis showed that age ≥70 years (OR=5.245,95%CI 1.667-16.483), monthly income <3 000 yuan (OR=1.975, 95%CI 1.307-2.984), living alone (OR=4.881,95%CI 1.526-15.612), severity of comorbidities (OR=3.748,95%CI 1.600-8.780), number of comorbidities more than 3 (OR=1.997,95%CI 1.371-2.909), and cognitive dysfunction (OR=1.520,95%CI 1.136-2.034) were the risk factors affecting the quality of life of the elderly comorbid patients. Conclusion The quality of life of the elderly comorbid patients is affected by many factors such as cognitive function and disease status and needs to be improved.

Abstract:Objective To investigate the effect of prolonged ticagrelor on clinical outcomes after percutaneous coronary intervention (PCI) in the elderly patients (age≥65 years) with acute ST-segment elevation myocardial infarction (STEMI). Methods From February 2018 to February 2021, a total of 105 patients (aged≥65 years) with acute STEMI were enrolled, who received dual antiplatelet therapy (DAPT) with ticagrelor plus aspirin (DAPT≥2) after PCI at the First Hospital of Qinhuangdao. On the basis of long-term use of aspirin, the patients were divided into the control group (n=37; ticagrelor for one year) and the observation group (n=68; ticagrelor over one year). The observation group was divided into two subgroups according to the dose of ticagrelor:observation group A (n=40; standard dose, 90 mg/time, 2 times daily) and observation group B (n=28; low dose, 45 mg/time, 2 times daily). The three groups were compared after emergency PCI in thrombolysis in myocardial infarction (TIMI) grade 3 blood flow, proportion of complete regression of electrocardiogram (ECG) signs, platelet function (MA) in thrombelastogram (TEG), adenosine diphosphate-induced platelet aggregation rate, and 1-year follow-up, including major adverse cardiovascular and cerebrovascular events (MACCE) and bleeding events. SPSS 25.0 was used to process the data, and t test andχ² test were used for comparison between groups. Results After PCI, the proportion of patients with TIMI grade 3 blood flow in the two observation groups was significantly higher than that in the control group (χ²=4.699,4.353; P=0.030,0.036). At two years after PCI, the MA value and adenosine diphosphate-induced platelet aggregation rate on thromboelastography of the two observation groups were significantly lower than those in the control group (t=8.752,6.524; P<0.001). After one year follow-up, there was significant difference in the incidence of MACCE among the three groups (χ²=4.354; P=0.039). The incidence of MACCE in the two observation groups was significantly lower than that in the control group (χ²=4.769,5.082; P=0.028,0.024), but there was no significant difference between the two observation groups. There was no significant difference in the incidence of bleeding events among the three groups. Conclusion Prolonged ticagrelor after PCI in the elderly (≥65 years old) STEMI patients (DAPT≥2 points) may reduce the incidence of MACCE, and low-dose (45 mg) ticagrelor does not increase the risk of bleeding, which needs to be further confirmed with long-term follow-up.

Abstract:Objective To explore the clinical efficacy of sacubitril/valsartan in the treatment of ventricular arrhythmias caused by heart failure (HF) in elderly patients. Methods A total of 186 elderly HF patients hospitalized in our department from April 2020 to December 2022 were enrolled and then randomly divided into control group (n=93, conventional treatment plan) and observation group (n=93, sarcubatrixartan administration besides conventional treatment). The clinical efficiency and incidence of adverse reactions were compared between the two groups. The following indicators were compared between the two groups before and after treatment, includ-ing electrocardiogram indicators[QRS time limit, corrected QT interval (QTc), QT dispersion (QTd), S_v1+R_v5], cardiac function indicators [left ventricular ejection fraction (LVEF), left ventricular end diastolic dimension (LVEDD), left ventricular posterior wall thickness (LVPWT), 6-minute walking test (6MWT), premature ventricular contraction (PVCs), non-sustained ventricular tachycardia (NSVT), sustained ventricular tachycardia (SVT)] and serum indicators [serum creatinine (SCr), blood urea nitrogen (BUN), B-type brain natriuretic peptide (BNP), and cardiac troponin T (cTnT)]. SPSS statistics 22.0 was used for data analysis. Student′s t test or Chi-square test was employed for intergroup comparison depending on date type. Results The total clinical efficiency rate was significantly higher in observation group than control group (95.70% vs 86.02%, P<0.05). No statistical difference was observed in incidence of adverse reactions between the two groups (11.83% vs 7.53%, P>0.05). Before treatment, there were no obvious differences in electrocardiogram, cardiac function and serum indicators between the two groups (P>0.05). After treatment, the observation group obtained better QRS duration, QTc, QTd, and S_v1+R_v5, notable declines in the proportions of SVT patients and NSVT patients, lower PVCs times and average SVT and NSVT times, great improvements in LVEF, LVEDD and 6MWT, and reduced serum levels of SCr, BUN, BNP and cTnT when compared with the control group (P<0.05). Conclusion Shakubaqu/valsartan shows significant clinical efficacy in treatment of HF-caused ventricular arrhythmia in elderly patients, with advantages of good safety and reliability, reducing the occurrence of ventricular arrhythmia, and improving heart function, exercise tolerance and myocardial injury.

Abstract:Objective To explore the influencing factors of prolonged preoperative hospitalization in elderly patients with lung cancer undergoing thoracoscopic lobectomy. Methods A retrospective analysis was conducted on 1 848 lung cancer patients aged over 65 years who had undergone thoracoscopic lobectomy in Chinese PLA General Hospital from January 2013 to December 2019. Their preoperative data were collected from the hospital information system (HIS), including general information, medical history, results of laboratory tests, consultation and other preoperative diagnosis and treatment data. According to their preoperative hospital stay, they were divided into normal group (≤6 d, n=755) and prolonged group (>6 d, n=1 093). SPSS statistics 24.0 was used to analyze the data. Based on different data type, student′s t test, Mann Whitney U test or Chi-square test was employed for intergroup comparison. Multivariate logistic regression analysis was applied to determine the influencing factors of prolonged preoperative hospital stay. Results Among these 1 848 elderly patients, 59.1% (1 093/1 848) of them had prolonged preoperative hospitalization. There were significant differences in age, diastolic blood pressure, neutrophils count, plasma activated partial thromboplastin time, plasma thrombin time, preoperative consultation, and proportions of coronary heart disease (CHD) and chronic obstructive pulmonary disease (COPD) between the normal group and the prolonged group (P<0.05). Multivariate logistic regression analysis showed that age >70 years (OR=1.275,95%CI 1.024-1.587), CHD (OR=1.523,95%CI 1.021-2.274), COPD (OR=1.360,95%CI 1.042-1.775) and preoperative consultation (OR=1.310,95%CI 1.046-1.641) were independent influencing factors for the prolongation of preoperative hospitalization time in elderly lung cancer patients. Conclusion Among the elderly lung cancer patients who planned to undergo thoracoscopic lobectomy, age>70 years, CHD, COPD and preoperative consultation are the influencing factors for the prolongation of preoperative hospitalization.

Abstract:Objective To verify whether sacubitril valsartan(S/V) can ameliorate the apoptosis level of hypoxic H9c2 cardiomyocytes by regulating mitochondrial dynamic system,and exert cardioprotective effects. Methods H9c2 cardiomyocytes were cultured and established a glucose oxygen deprivation model (OGD).The cells were divided into three groups:control group(CON), model group(OGD), S/V group(S/V). Apoptosis and reactive oxygen species (ROS) were detected by flow cytometry, mitochondrial membrane potential was detected by JC-1, and mitochondrial fusion protein 1(Mfn1), mitochondrial fusion protein 2 (Mfn2), dynamin related protein 1(Drp1), mitochondrial fission protein 1(FIS1), cytochrome c (CytC), B-cell lymphoma 2(Bcl-2),Bcl-2-associated X protein (Bax) and cysteinyl aspartate specific proteinase (Caspase-3) expression were detected by Western blotting (WB). GraphPad Prism 8 statistics was used for data analysis,multiple groups comparisons were conducted using one-way analysis of variance,and LSD-t test was performed for pairwise multiple comparisons. Results H9c2 cardiomyocytes were used to establish OGD cell model, and the morphology of cardiomyocytes was signifcantly improved by S/V treatment under light microscope. Flow cytometry analysis showed that S/V significantly reduced the level of intracellular ROS and inhibited cardiomyocyte apoptosis (P<0.05). Fluorescence microscope analysis showed that S/V significantly improved the level of mitochondrial membrane potential(P<0.05); WB showed S/V significantly increase the protein expression levels of Mfn2, mfn1 and Bcl-2, and reduce the protein expression levels of Drp1, FIS1, CytcC, Bax and Caspase-3 (P<0.05). Conclusion S/V may regulate mitochondrial homeostasis, reduce ROS production and cardiomyocyte apoptosis by promoting mitochondrial fusion and inhibiting mitochondrial division.

Abstract:Coronary artery disease (CAD) is one of the leading causes of human mortality, and is a common heart condition that involves atherosclerotic plaque formation in the vessel lumen, which then leads to coronary stenosis or occlusion of the vascular lumen, resulting in myocardial ischemia, hypoxia, or necrosis. Inflammation plays a vital role in mediating the occurrence and development of atherosclerosis. Inflammation has been a research hotspot in the study of the pathogenesis of CAD. Increasingly attention has been attracted to whether anti-inflammatory drugs can carry out targeted intervention on inflammation and positively impact the prognosis of CAD patients. In this article, we briefly review the essential inflammatory molecules in the pathogenesis and the research progress of anti-inflammatory drugs for the condition.

Abstract:Frailty is a clinical state or syndrome that predispose the patients to adverse health outcomes due to the decline of physiological reserve and stress adaptability. No gold standard is available for the assessment of frailty, but the cumulative defect model has been found to be better at predicting various adverse clinical events than other frailty assessment methods. This paper reviews the relevant research in the frailty index based on the principle of cumulative defects and the approaches to its construction, common types and applications to provide new insights into and tools for frailty evaluation.

Abstract:Hip fracture in the elderly is a common type of severe fractures with a high risk of secondary fracture. Falls are an independent risk factor of a secondary fracture. Therefore, the continuous control of fall risk of hip fracture in the elderly patients is of positive significance for the prevention of a secondary fracture. This review summarizes the common risk factors of falls, risk assessment, and risk intervention strategies in the elderly patients with hip fracture. It aims to provide a practical basis for the continuous fall risk management in the elderly patients with hip fracture.

Abstract:At present, China′s aging process is accelerating. Sarcopenic dysphagia and oral frailty, as the emerging concept of geriatric syndrome in recent years, has become a research hotspot. This study reviews their conceptual connotations, status quo, correlation mechanism, influencing factors, prognosis and management strategies to explore their correlation. The aim is to provide new ideas for future research of sarcopenic dysphagia and oral frailty in China,providing reference for preventing and reducing the occurrence of both.