Abstract:Objective To explore the mediation effects of nutrition and cognition in Apolipoprotein E Allele 4 (APOE ε4) with neuropsychiatric symptoms (NPSs) in Alzheimer′s Disease (AD). Methods A spectrum of 293 AD patients from amnestic mild cognitive impairment (aMCI) to AD dementia stage was consecutively collected from the Alzheimer′s Disease Biomarkers and Lifestyle Study (CIBL) cohort of Beijing Tiantan Hospital Affiliated to Capital Medical University from June 2021 to January 2023. The patients were divided into the carrier group (with APOE ε4, n=107) and the non-carrier group (without APOE ε4, n=186). Patients in significant NPS sub-groups were further analyzed in age, gender, body mass index (BMI), mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA), and micro-nutritional assessment (MNA). SPSS 26.0 was used for data processing. According to the data type, t test, Mann-Whitney U test or χ² test was used for comparison between groups, and statistically significant factors in the hypothesis test were determined as confounding factors in the subsequent mediating effect analysis. A simple mediation effect model was used to analyze the potential mediating effects of nutritional status and cognitive function on APOE ε4 and NPS and its subtypes. Results Compared with non-carrier group, the carrier group had higher rates of hallucinations, apathy, and abnormal motor behaviors, the differences were statistically significant (P<0.05). The NPS subtype patients were analyzed separately. Compared with non-hallucination group, patients in hallucination group were older, had lower education years, carried a higher proportion of APOE ε4, and lower MMSE, MoCA and MNA scores. Compared with non-apathy group,patients in apathy group had a higher proportion of males, carried a higher proportion of APOE ε4, and had lower MMSE, MoCA and MNA scores.Compared with non-aberrant motor activity group, patients in aberrant motor activity group were older, had a lower proportion with hyperlipidaemia, carried a lower proportion of APOE ε4, and had lower MMSE, MoCA and MNA scores, with statistically significant differences (P<0.05). After adjusting for confounding factors, MNA scores mediated 29.80% (95%CI 0.062-0.522) of the correlation between APOE ε4 and apathy and 19.95% (95%CI 0.011-0.419) of the correlation between APOE ε4 and aberrant motor behaviors. The correction mediated by MMSE scores on APOE ε4 and hallucinations, apathy, aberrant motor behaviors were 24.21% (95%CI 0.078-0.573), 39.01% (95%CI 0.155-0.914), and 23.37% (95%CI 0.068-0.576). Conclusion For patients with aMCI and AD, nutritional status and cognitive function partially mediate the correlation between APOE ε4 and apathy and aberrant motor behaviors, and cognition also partially mediate the correlation between APOE ε4and hallucination.

Abstract:Objective To investigate the predictive value of triiodothyronine and cognitive function in readmission of elderly patients with chronic heart failure (CHF) due to cardiovascular events. Methods Elderly CHF patients (≥65 years) admitted in the geriatric and cardiologic departments of Yichang Central People′s Hospital from September 2020 to September 2022 were enrolled. According to whether they were readmitted due to cardiovascular events within two years after discharge, they were divided into readmission group (n=79) and non-readmission group (n=54). General clinical data were compared between two groups. Multivariate logistic regression analysis was performed to identify risk factors in elderly CHF patients, and receiver operating characteristic (ROC) curve was plotted to evaluate the predictive value of each factor for the risk of readmissions due to cardiovascular events. SPSS statistics 26.0 and GraphPad Prism were adopted for statistical analysis. Data comparison between two groups was performed using student′s t test, χ² test or rank-sum test depending on data type. Results Significantly decreased albumin, blood calcium and triiodothyronine levels, larger ratio of co-existing diabetes, and declined cognitive function score were observed in the readmission group than the non-readmission group (P<0.05). Multivariate logistic regression analysis showed that triiodothyronine (OR=0.522,95%CI 0.303-0.900), blood calcium (OR=0.003,95%CI 0.000-0.777) and cognitive function (OR=71.093,95%CI 17.855-282.589) were independent risk factors for readmission in elderly CHF patients (P<0.05). ROC curve analysis indicated that the area under the curve of triiodothyronine and cognitive function in predicting the two-year readmission risk of cardiovascular events in elderly CHF patients was 0.660 (95%CI 0.561-0.758; P<0.01) and 0.913 (95%CI 0.866-0.960; P<0.001), respectively. Conclusion Triiodothyronine and cognitive function are independent risk factors in elderly patients with CHF, and have good predictive value for readmission risk of cardiovascular events.

Abstract:Objective To evaluate the status quo of postoperative edema and pain in the elderly patients with mixed hemorrhoids and to analyze its influencing factors. Methods A retrospective analysis was made of the clinical data of 92 elderly patients with mixed hemorrhoids, who were treated with external stripping and internal ligation at Huainan First People′s Hospital from January 2020 to December 2022. The patients′ perianal edema and pain were evaluated using sphere volume formula and visual analogue scale (VAS) at five days after surgery. Patients with perianal edema grade Ⅱ and above and/or moderate-to-severe pain were positive and were included in the edema-pain group (29 cases), and non-positive patients were included in the non-edema pain group (63 cases). SPSS 24.0 was used for data processing. According to the data type, t test or Chi-square test was performed for comparison between groups. Binary logistic regression analysis was used to evaluate the influencing factors of perianal edema and pain at five days after external stripping and internal ligation. Results At five days after surgery, 29 cases of grade 0,35 cases of grade 1,22 cases of grade 2,6 cases of grade 3 and no case of grade 4 of anal margin edema in elderly patients with mixed hemorrhoids, and there were 32 cases of no pain, 34 cases of mild pain, 21 cases of moderate pain and 5 cases of severe pain. Binary logistic regression analysis showed that annular mixed hemorrhoids (OR=4.802,95%CI 2.965-7.776; P<0.05), surgical flap malalignment (OR=2.672,95%CI 1.510-4.729; P<0.05) and postoperative constipation/diarrhea (OR=2.818,95%CI 1.611-4.929; P<0.05) were risk factors for anal margin edema and pain at five days after surgery in elderly patients with mixed hemorrhoids, and postoperative traditional Chinese medicine sitz bath/fumigation was a protective factor (OR=0.373,95%CI 0.014-0.765; P<0.05). Conclusion Some elderly patients with mixed hemorrhoids have anal margin edema and pain at five days after external stripping and internal ligation. Annular mixed hemorrhoids, unreasonable operation and abnormal postoperative defecation can increase the risk of anal margin edema and pain. Traditional Chinese medicine sitz bath/fumigation after surgery is beneficial to relieving the anal margin edema and pain.

Abstract:Objective To investigate the relationship of fear of cancer recurrence (FCR), self-efficacy and quality of life in the elderly breast cancer survivors. Methods A total of 116 elderly breast cancer patients admitted to Beijing Shijitan Hospital of Capital Medical University from May 2020 to January 2023 were enrolled as the study subjects. Chinese version of Fear of Progression Questionnaire-Short Form (FoP-Q-SF) and Chinese version of Cancer Self-efficacy Assessment Scale and Quality of Life Questionnaire-Core 30 (QLQ-C30) were used to investigate the FCR, self-efficacy and quality of life of the elderly breast cancer survivors. Pearson correlation analysis was used to analyze the correlation between FCR, self-efficacy and quality of life in the elderly breast cancer survivors, and a structural equation model was constructed using AMO25.0 for mediation analysis. SPSS 19.0 was used for statistical analysis. Data comparison between two groups was performed using t test, analysis of variance orχ² test, depending on data type. Results The recovery rate of the valid questionnaires was 91.38% (106/116), and the average score of FoP-Q-SF scale in the elderly breast cancer patients was (31.66±4.32) points. Among the patients, 43 (40.57%) had psychological disorders. The total score on Chinese version of Cancer Self-Efficacy Assessment Scale was (26.14±3.58) points, and the average score on QLQ-C30 scale was (50.69±6.37) points. The scores of self-efficacy and quality of life in the patients complicated with psychological disorders were lower than those in the patients without psychological disorders, and the differences were statistically significant (P<0.05). Pearson correlation analysis showed that FCR was negatively correlated with self-efficacy and quality of life in the elderly breast cancer patients (r=-0.388, -0.325; P<0.001), and was positively correlated with self-efficacy and quality of life (r=0.294; P<0.001). Mediation analysis suggested that FCR had a direct negative predictive effect on the quality of life of the elderly breast cancer survivors (β=-0.338; P<0.05) and could indirectly affect the quality of life through self-efficacy (β=-0.188; P<0.05), with a total effect of β=-0.526. Conclusion Severe FCR can reduce the self-efficacy and quality of life of the elderly breast cancer survivors. It is recommended that attention should be paid to the FCR and the value of self-efficacy on regulating FCR and quality of life of the elderly breast cancer patients in clinical practice.

Abstract:Objective To determine the median effective dose (ED₅₀) of remidazolam for inducing loss of consciousness during general anesthesia induction in frail elderly patients undergoing elective non-cardiac surgery. Methods A total of 23 frail elderly patients who underwent elective non-cardiac surgery with general anesthesia in our hospital from April 2023 to August 2023 were enrolled in this study. Sequential method was used to determine the median effective dose of remimazolam. After a first intravenous injection dose of 0.2 mg/kg was given, their consciousness status within two minutes after medication was recorded. After the disappearance of consciousness, sulfentanil and rocuronium were administered before placement of a laryngeal mask. Regression equations were established with Probit regression. The 50% effective dose (ED₅₀), 95% effective dose (ED₉₅), and corresponding 95%CI were measured for the patients, and a dose-effect relationship diagram was plotted. The hemodynamic indicators at one (T2) and three minutes after anesthesia (T3), as well as the time of laryngeal mask placement (T4) were noted and compared with these indicators before anesthesia induction (T1). The occurrence of adverse reactions were recorded as well. SPSS statistics 26.0 was used for statistical analysis. Repeated measures ANOVA was performed to compare the data within the group.Results Remimazolam′s ED₅₀ of causing loss of consciousness in frail elderly patients was 0.091 mg/kg (95%CI 0.057-0.118 mg/kg), and its ED₉₅ was 0.142 mg/kg (95%CI 0.116-0.352 mg/kg). The mean arterial pressure at T2, T3 and T4 was significantly lower than that at T1 (P<0.05), but the decline was 20% lower than the baseline. There were no statistical differences in heart rates and pulse oxygen saturation at all above points. Hiccup was observed in two patients within two minutes after remimazolam injection, and both of them were transient. Conclusion For frail elderly patients, the ED₅₀ of remimazolam is 0.091 mg/kg in inducing loss of consciousness during general anesthesia induction, with stable hemodynamic parameters and low incidence of adverse reactions.

Abstract:Objective To investigate the oral health status and its influencing factors in the elderly patients with newly diagnosed type 2 diabetes mellitus (T2DM) in Qionghai City. Methods The study enrolled 376 elderly patients with newly diagnosed T2DM from June 2021 to January 2023 in Qionghai People′ s Hospital. Oral health examination was performed for the patients, and those with periodontal diseases were included in the observation group and those without in the control group. The patients′ cognition of oral health in diabetes mellitus was investigated, and the factors such as oral health behavior, sleep quality, blood glucose control and regular exercise were compared between the two groups. Binary logistic regression model was used to analyze the factors affecting the periodontal diseases in the elderly patients with newly diagnosed T2DM. SPSS 22.0 was used for data analysis. According to the data type, t test or Chi-square test was used for comparison between groups. Results Of 367 questionnaires distributed, 351 (95.64%) were recovered as valid. There were 286 (81.48%) patients with periodontal diseases, including 77 with gingivitis and 209 with periodontitis. The survey found that 19.94% (70/351) patients knew that diabetic patients were more likely to suffer from periodontal diseases, 35.04% (123/351) knew that dental calculus and plaque would promote the occurrence of periodontal diseases, 22.79% (80/351) knew that serious periodontal diseases would affect the blood glucose control, 21.37% (75/351) knew that periodontal disease treatment would help blood glucose control, and 33.90% (119/351) knew that gingival bleeding was an early manifestation of periodontal diseases. Multivariate regression analysis suggested that body mass index ≥ 24 kg/m²(OR=3.180, 95%CI 1.516-6.672), smoking (OR=1.766, 95%CI 1.375-2.270) , and poor diabetes mellitus control (OR=2.104, 95%CI 1.021-4.337) were the risk factors affecting the occurrence of periodontal diseases in the elderly patients with newly diagnosed T2DM, and that regular exercise (OR=2.447, 95%CI 1.264-4.738), at least one oral health examination per year (OR=0.347, 95%CI 0.148-0.815), vertical brushing (OR=0.431, 95%CI 0.215-0.865), flossing or toothpick (OR=0.660, 95%CI 0.456-0.956) and oral health related education (OR=0.476, 95%CI 0.313-0.724) were the protective factors (P<0.05). Conclusion Elderly patients with newly diagnosed T2DM in Qionghai City have a high prevalence of periodontal diseases and low awareness rate of periodontal disease-related knowledge. Encouraging patients to manage blood glucose well, quit smoking in time, develop regular exercises, a reasonable diet and good oral health behaviors as well as suggesting patients to do a good job in oral health education and be active in maintaining oral health care, may have certain value in improving the periodontal health of patients with T2DM in the later stage of the disease.

Abstract:Objective To analyze the influencing factors of digestive system damage after chemotherapy in elderly patients with breast cancer, and explore the correlation between digestive system damage and quality of life. Methods A total of 90 elderly patients with breast cancer admitted to our hospital from August 2019 to April 2023 were enrolled. Their clinical data, including basic information, tumor features, drug use, biochemical indicators and other indicators were collected. According to the severity of digestive system damage, they were divided into severe group (moderate to severe, n=27) and non-damage group (no or mild damage). World Health Organization quality of life scale-100 was applied to evaluate their quality of life. SPSS 26.0 was used for statistical analysis. Univariate and multivariate logistic regression were employed to analyze the influencing factors for digestive system damage in these elderly patients. Spearman correlation analysis was conducted to evaluate the correlation between the damage and quality of life of patients. Results Significant differences were observed between the severe group and the non-damage group in terms of age, hypertension, course of breast cancer, tumor node metastasis stage and chemotherapy course (all P<0.05). Multivariate logistic regression analysis showed that age (OR=2.815,95%CI 1.268-6.251) and duration of chemotherapy (OR=2.675,95%CI 1.255-5.701) were the influencing factors of digestive system damage in the patients (P<0.05). The quality of life score was (53.81±4.76) in the elderly breast cancer patients after chemotherapy. Spearman correlation analysis indicated that digestive system damage was negatively correlated with quality of life of the patients (r=-0.741, P<0.05). Conclusion There are many factors affecting digestive system damage in elderly patients with breast cancer after chemotherapy. More attention should be paid to those with high risk factors in clinical practice.

Abstract:Objective To explore the influencing factors of cancer burden and cancer symptoms in the elderly patients with lung cancer during targeted therapy. Methods A retrospective analysis was made of clinical data of 98 elderly lung cancer patients who received targeted therapy at Suzhou Kowloon Hospital, School of Medicine, Shanghai Jiao Tong University from January 2019 to December 2022. The cancer burden and symptom distress were assessed by self-perceived Burden Scale (SPBS) and symptom distress scale (SDS) three months after treatment. The SPBS and SDS scores of the patients with different clinical characteristics were compared, and multivariate logistic regression was used to analyze the risk factors affecting SPBS and SDS scores in the elderly lung cancer patients during targeted therapy. SPSS statistics 22.0 was used for statistical analysis. Data comparison between two groups was performed using t test or F test depending on data type. Results The SPBS scores of 98 elderly lung cancer patients during targeted therapy were 13-26 (19.34±6.28) points, and the SDS scores were 23-40 (31.57±8.19) points. The elderly lung cancer patients with stage Ⅲ-Ⅳ of tumor node metastasis (TNM), over three comorbid chronic diseases, self-funded medical payment, monthly income < 2 000 yuan, low social support and low family care had higher SPBS scores during targeted therapy than those with stage Ⅰ-Ⅱ of TNM, three or fewer comorbid chronic diseases, free medical payment or partial reimbursement, and monthly income ≥2 000 yuan, medium or high social support, and medium or high family care, and the difference was statistically significant (P<0.05). The elderly lung cancer patients with stage Ⅲ-Ⅳ of TNM, over three comorbid chronic diseases, low social support and low family care during targeted therapy had higher SDS scores than those with stage Ⅰ-Ⅱ of TNM, three or fewer comorbid chronic diseases, medium or high social support, medium or high family care, and the difference was statistically significant (P<0.05). Multivariate logistic regression analysis confirmed that stage Ⅲ-Ⅳ of TNM, over three comorbid chronic diseases, self-funded medical payment , monthly income < 2 000 yuan, low social support, low family care were the risk factors of SPBS score in the patients (P < 0.05), and that stage Ⅲ-Ⅳ of TNM, over three comorbid chronic diseases, low social support and low family care were the risk factors of SDS score (P<0.05). Conclusion SPBS and SDS scores in the elderly lung cancer patients during targeted therapy were affected by multiple factors, such as TNM stage, number of comorbid chronic diseases, social support, and family care. Clinicians should try to identify and pay attention to them during the treatment of the disease.

Abstract:Objective To investigate the nagative emotions, self-care ability and quality of life (QOL) in elderly patients with primary hepatic carcinoma (PHC) undergoing transcatheter arterial chemoembolization (TACE), and to analyze the influencing factors for QOL. Methods A total of 348 elderly PHC patients who received TACE treatment in our hospital from March 2020 to March 2023 were recruited in the study. Self-rating anxiety scale (SAS), self-rating depression scale (SDS), exercise of self-care agency scale (ESCA) and European Organization for Research of Cancer (EORTC) quality of life-core 30 questionnaire (QOL-C30) were used to investigate the negative emotions, self-care ability and QOL in this patients before surgery and at three months after discharge. SPSS statistics 22.0 was used for data analysis. According to the data type, t test or one-way analysis of variance was performed for comparison between groups. Multivariate linear regression model was employed to analyze the related factors affecting the postoperative QOL in them, and the effect of the obtained risk factors on anxiety, depression and self-care ability was analyzed. Pearson correlation analysis was conducted to analyze the correlation of postoperative QOL with anxiety, depression and self-care ability in these elderly patients. Results After TACE, the SAS and SDS scores were significantly decreased, while those of ESCA and QOL-C30 were obviously increased in elderly PHC patients (P<0.05). There were statistically differences in postoperative anxiety, depression and self-care ability among the patients with different ages, history of hepatocellular carcinoma resection, and informed condition of disease (P<0.05). Multivariate linear regression analysis showed that age (β=-0.320; P<0.001), history of hepatocellular carcinoma resection (β=-0.245; P=0.001) and informed condition of disease (β=-0.290; P=0.001) significantly affected the QOL in these patients after TACE, and jointly explained 69.30% of the variation in their QOL after TACE (F=35.128, P<0.001). Pearson correlation analysis showed that the score of postoperative QOL-C30 was negatively correlated with the SAS and SDS scores (r=-0.627, -0.609; P<0.05), and positively with the ECSA score (r=0.383; P<0.05) in elderly PHC patients. Conclusion After TACE treatment, though the QOL level is increased in the elderly PHC patients, the overall level is still poor. For the elderly PHC patients who are≥75 years old, have a history of hepatocellular carcinoma resection and ignorance of disease condition, they have worse QOL, and are prone to anxiety and depression and worse self-care ability. It is suggested that attention should be paid to the postoperative QOL in elderly patients with above characteristics in clinical practice, and guidance of negative emotions and cultivation of self-care ability attention should also be focused on.

Abstract:Objective To investigate the quality of life (QOL) in elderly patients with endometrial cancer after chemotherapy and analyze its influencing factors. Methods A questionnaire survey was conducted on 158 elderly patients with postoperative chemotherapy for endometrial cancer from June 2018 to June 2023. Their QOL level was assessed by endometrial cancer module of the fourth edition of functional assessment of cancer therapy-general (FACT-G). According to their score of FACT-G, they were divided into good QOL group (≥ average level, 82 cases) and poor QOL group (< average level, 76 cases). Pathological stage and type, differentiation grade, chemotherapy regimen and other data were collected. SPSS statistics 24.0 was used for data analysis. Depending on data type, Chi-square test or student′s t test was applied for intergroup comparison, and logistic regression analysis was adopted to identify the influencing factors for poor QOL in elderly patients with postoperative chemotherapy for endometrial cancer. Results The average score of FACT-G was (79.68±10.85) points in the 158 patients. The poor QOL group had significantly higher mutation rate of p53 in tumor foci, incidence of adverse reaction grades 3-4 and rates of depression, anxiety and fear of cancer recurrence than the good QOL group (P<0.05). Logistic regression analysis showed that p53 mutation (OR=2.670,95%CI 1.343-5.309), adverse reaction grades 3-4 (OR=4.646,95%CI 2.734-7.896), depression (OR=2.612,95%CI 1.315-5.186), anxiety (OR=3.284,95%CI 1.787-6.036) and fear of cancer recurrence (OR=3.442,95%CI 1.892-6.262) were risk factors for poor QOL in elderly patients with postoperative chemotherapy for endometrial cancer. Conclusion Molecular type in tumor foci, severe adverse reactions and negative emotions such as depression, anxiety and fear of cancer recurrence are important reasons for the decline of QOL in elderly patients with endometrial cancer after chemotherapy. It is necessary to formulate targeted physiological and psychological intervention measures so as to enhance their QOL in clinical practice.

Abstract:Objective To evaluate the effect of fistulotomy with seton drainage (FSD) versus traditional seton fistulotomy (TSF) in the treatment of high complex anal fistula in the elderly based on propensity score matching. Methods The clinical data of 220 patients in the Department of Anorectal Surgery of Beijing Rectum Hospital from March 2020 to March 2023 were retrospectively analyzed, including 117 in the FSD group and 103 in the TSF group. Propensity score matching was used to select a matched cohort of 82 pair (1∶1). The postoperative efficacy, recovery, pain degree, anorectal dynamics, anal canal function and recurrence were compared between the two groups. SPSS 22.0 was used for data analysis. According to the data type, t test or Chi-square test were performed for intergroup comparison. Logistic regression model was used to calculate the propensity score, and the nearest neighbor matching method was used for 1:1 matching. Results After matching at 24 h postoperatively, the visual analogue scale (VAS) score in the FSD group was lower than that in the TSF group [(4.21±1.18) vs (5.04±1.36) points], the total clinical effective rate in the FSD group was higher than that in the TSF group [96.34% (79/82) vs 87.80% (72/82)], and the wound healing time in the FSD group was shorter than that in the TSF group [(12.34±2.45) vs (14.67±2.89) d]; all the differences were statistically significant (P<0.05). At 1 month postoperatively, the FSD group had greater anal function length [(2.86±0.34) vs (2.31±0.46) cm], maximum tolerance dose [(135.21±19.87) vs (119.52±20.13) ml] and initial sensory threshold [(25.16±2.57) vs (22.89±2.92) ml] than the TSF group, and the differences were statistically significant (P<0.05). At 1 month postoperatively, the Wexner score was lower in the FSD group than that in the TSF group [(0.92±0.27) vs (1.17±0.35)pionts], and the recurrence rate in the FSD group was also lower [3.66% (3/82) vs 12.20% (10/82)]; and the difference was statistically significant (P<0.05). Conclusion FSD is effective in the treatment of high complex anal fistula in the elderly, with fast postoperative wound healing, little damage to anal canal function, and low recurrence rate.

Abstract:Objective The purpose of this study was to investigate the effects of xanthine oxidase (XO) inhibitors (allopurinol and febuxostat) on atrial electrical remodeling in a rabbit model of atrial fibrillation (AF) induced by rapid atrial pacing (RAP). Methods Twenty-four healthy male New Zealand white rabbits were randomly divided into four groups:sham-operated group (S group), RAP group (P group), RAP-allopurinol group (ALL group), and RAP-febuxostat group (FP group). Enzyme-linked immunosorbent assay (ELISA) kit was used to detect the activity of high-sensitivity C-reactive protein (hs-CRP), growth differentiation factor-15 (GDF-15) and galectin-3, and the activity of superoxide dismutase (SOD) and the levels of XO and xanthine dehydrogenase (XDH) in left atrial tissues. Before pacing and four weeks after RAP, electrophysiological examinations were performed to evaluate the atrial effective refractory period at 200 ms (AERP200) and the inducibility of AF. Real-time fluorescence quantitative polymerase chain reaction (PCR) and Western blotting were used to detect the messenger RNA (mRNA) and protein expressions of calcium voltage-gated channel subunit α1C (Cav1.2) and potassium voltage-gated channel subfamily D3 (Kv4.3). SPSS statistics 26.0 was used for data analysis. According to different data type, one-way analysis of variance or χ²test was used for data comparison between groups. Results Compared with S group, the SOD activity was significantly decreased, and the levels of XO, XDH, hs-CRP, GDF-15 and galectin-3 were increased in P group, and the differences were statistically significant (P<0.01). After using XO inhibitor, the activity of SOD recovered significantly, and the activities of XO, hs-CRP, GDF-15 and galectin-3 were significantly decreased, and the differences were statistically significant (P<0.05). The activity of SOD in FP group was significantly higher than in ALL group, whereas the activities of XDH, hs-CRP, GDF-15 and galectin-3 in FP group were obviously lower compared with ALL group (P<0.05). However, there was no significant difference in the level of XO between FP group and ALL group (P>0.05). Additionally, the activity of XDH in FP group was significantly lower than in P group, and the differences were statistically significant (P<0.01). Nevertheless, there was no significant diffe-rence in the level of XDH between ALL group and P group (P>0.05). After RAP, AERP200 was significantly lower in P group than S group (P<0.01), and the AERP200 of FP group was significantly higher than that of P group and ALL group (P<0.05). Except for S group, AF inducibility of P group, ALL group and FP group was significantly higher than the baseline before pacing (P<0.05). After the intervention of XO inhibitors, the AF inducibility was reduced to a certain extent, especially in FP group. RAP could reduce down-regulation of Cav1.2 and Kv4.3 mRNA and protein expression levels in left atrial tissue, and the intervention of XO inhibitors could partially inhibit these changes, which was particularly evident in FP group. Conclusion XO inhibitors (especially febuxostat) could inhibit the down-regulation of Cav1.2 and Kv4.3 expression levels in left atrial by reducing inflammation and oxidative stress damage, thereby prolonging AERP, reducing the inducibility of AF, and mitigating atrial electrical remodeling.

Abstract:Stroke is the second leading cause of death all over the world, and also a major risk factor for disability in elderly people. Preventing and delaying disability is key to promoting healthy aging. In order to change the current situation of “one disabled, whole family out of balance”, our country is vigorously carrying out a reform oriented rehabilitation project with Chinese characteristics, which combines medical care and nursing care to strengthen long-term care for disabled elderly people. In this article, we reviewed the application of integrated medical and nursing care in the rehabilitation of disabled patients after stroke in order to provide reference for their rehabilitation.

Abstract:Elderly patients with type 2 diabetes mellitus (T2DM) often have multiple coexisting diseases, and the complication of cardiovascular diseases (CVD) is the most common, which is the primary cause of disability and death. Sodium-glucose co-transporter protein 2 inhibitor (SGLT2i) is a novel hypoglycemic agent, which has received widespread attention for its cardio-protective effects, and shows good prospects for the treatment of co-morbidities of T2DM and CVD in the elderly. In this article, we reviewed the progress of SGLT2i in T2DM combined with heart failure, hypertension, atherosclerosis, myocardial infarction and other common CVD.

Abstract:Heart failure is a serious chronic progressive heart disease with high morbidity and mortality. Sotagliflozin is a novel sodium and glucose cotransporter-1/2 inhibitor, which can inhibit glucose absorption in the digestive tract and renal tubules at the same time. A number of studies have confirmed that sotagliflozin is not only as effective as sodium-glucose co-transporter-2 inhibitors in reducing cardiovascular mortality and rehospitalization rate in patients with heart failure, but also can reduce the incidence of stroke and myocardial infarction in patients with heart failure. This article reviews the mechanism and research progress of sotagliflozin in the treatment of heart failure, in order to provide help for the clinical treatment of patients with heart failure in the future.

Abstract:With the acceleration of ageing process, the prevalence of obstructive sleep apnea (OSA) and heart failure (HF) has been significantly increasing. Studies show that OSA and HF are causal and mutually influential. OSA is an independent risk factor for HF, which in turn causes OSA, increasing the risk of adverse outcomes such as symptom progression, hospitalization, and death in HF. The interaction between OSA and HF is inextricably linked to upper airway obstruction and chronic intermittent hypoxia. Currently, there is no definitive diagnosis and treatment protocol for OSA-associated heart failure. Considering the pathogenesis and symptoms of both, HF treatment drugs are usually recommended to be combined with continuous positive airway pressure, the first-line treatment for OSA. In this article, we reviewed the research on OSA and HF to provide necessary references for subsequent more effective targeted treatment.

Abstract:Ferrotosis is a mode of cell death newly identified in this century, characterized mainly by iron accumulation and lipid peroxidation. Ulcerative colitis (UC) is a type of inflammatory bowel disease associated with a variety of causes and an ever increasing incidence, seriously affecting people′s health. Therefore, active exploration of its pathogenesis is of great significance for its screening, diagnosis and treatment. In recent years, the relationship between ferroptosis and UC has attracted widespread attention and become a new research hotspot. This article reviews the role of the main mediators of ferroptosis in the pathogenesis of UC in combination with the latest research findings to provide new insight for the treatment of UC with ferroptosis as a target.