Abstract:Objective To investigate the clinicopathological characteristics of idiopathic membranous nephropathy (IMN) complicated with glomerulosclerosis and to analyze the relevant factors for the formation of glomerulosclerosis. Methods A retrospective analysis was performed on 430 IMN patients diagnosed by renal puncture biopsy in Department of Nephrology of Guangdong Provincial Hospital of Traditional Chinese Medicine from January 2012 to December 2021. According to complication of glomerulosclerosis or not, they were divided into two groups, and the clinicopathological features were compared between the IMN patients with glomerulosclerosis and those without. SPSS statistics 25.0 was used for statistical analysis. Data comparison between two groups was performed usingt test, Mann-Whitney U test, χ²test or Fisher′s exact probability test depending on data type. Results Of the 430 patients with IMN, 252 (58.6%) had concomitant glomerulosclerosis. The patients complicated with glomerulosclerosis had significantly longer course of disease, older age, larger proportions of hypertension and diabetes mellitus, and higher serum creatinine (SCr) level, but lower estimated glomerular filtration rate (eGFR) and hemoglobin (Hb) level when compared to those without glomerulosclerosis (P<0.05). Univariate logistic regression analysis indicated that age, course of disease, hypertension, diabetes melitus, Hb, SCr, eGFR, blood urine nitrogen, renal tubular atrophy and interstitial fibrosis were related influencing factors of glomerulosclerosis in IMN patients (P<0.05). Multivariate logistic regression analysis suggested that age (OR=1.047,95%CI 1.022-1.072; P<0.001), hypertension (OR=2.079,95%CI 1.211-3.570; P=0.008) and interstitial fibrosis (OR=2.564,95%CI 1.382-4.755; P=0.003) were associated with glomerulosclerosis formation. Conclusion IMN patients with concomitant glomerulosclerosis are in more serious conditions, and age, hypertension and interstitial fibrosis are independent influencing factors for glomerulosclerosis. In clinical practice, for the IMN patients with identified glomerulosclerosis in renal puncture biopsy, clinicians should strengthen the monitoring of renal function related indicators and actively treat and evaluate the progression of IMN.

Abstract:Objective To investigate the prevalence of chronic kidney disease (CKD) in Wuhan and analyze its influencing factors. Methods A total of 2187 permanent residents from 13 administrative districts of Wuhan were selected by stratified multistage cluster sampling from January 2022 to December 2023. The general demographic characteristics, health status and past medical history, lifestyle and behavior factors were investigated. SPSS 22.0 was used for data analysis. Chi-square test or rank sum test was performed for between-group comparison according to the data type. Multivariate logistic regression analysis was used to analyze the influencing factors of CKD.Results In total, 221 cases were diagnosed with CKD, with a prevalence rate of 10.11% (221/2187). Among them, 52 cases were stage 1,68 stage 2,57 stage 3,29 stage 4, and 15 stage 5; 173 (7.91%) had decreased renal function, 96 (4.39%) had positive hematuria, 118 (5.40%) had positive proteinuria, and 89 (4.07%) had abnormal renal B-ultrasound. Multivariate logistic regression analysis showed that age (OR=4.575,95%CI 3.123-6.710), hypertension (OR=2.785,95%CI 2.224-3.492), diabetes mellitus (OR=2.437,95%CI 1.859-3.194), cardiovascular disease (OR=2.191,95%CI 1.596-3.009), hyperuricemia (OR=1.867,95%CI 1.346-2.594), hypertriglyceridemia (OR=1.783,95%CI 1.347-2.363), low high-density lipoprotein cholesterol (HDL-C) (OR=1.352,95%CI 1.003-1.825), smoking history (OR=1.466,95%CI 1.139-1.887), high-salt diet (OR=1.468,95%CI 1.141-1.886) and heavy physical labor (OR=1.672,95%CI 1.238-2.256) were all independent influencing factors of CKD (P<0.05). Conclusion Advanced age, hypertension, diabetes mellitus, cardiovascular disease, hyperuricemia, hypertriglyceridemia, low HDL-C, smoking, high-salt diet and heavy physical labor are all independent influencing factors of CKD in Wuhan, and early screening and intervention for high-risk population needs to be strengthened.

Abstract:Objective To analyze the correlation of metabolic score for insulin resistance (METS-IR) and triglyceride and glucose (TyG) index with the severity of coronary stenosis in patients with coronary artery disease (CAD) who carry the ε4 allele of apolipoprotein E (ApoE). Methods A retrospective analysis was conducted on 308 patients with coronary heart disease identified by coronary angiography carrying ApoE4 genotypes ε3ε4 and ε4ε4 admitted in Affiliated Hospital of Xuzhou Medical University from January 2021 to December 2022. Their clinical data were collected, and TyG index and METS-IR were calculated. According to the results of modified Gensini score (GS) of 2019 for CAD stenosis, they were divided into low (n=106), intermediate (n=100), and high GS (n=102) groups. SPSS statistics 27.0 was used for statistical analysis. One-way analysis of variance, Kruskal-Wallis H test, or Chi-square test was employed for intergroup comparison depending on data type. Logistic regression analysis was applied to explore the influencing factors for severity of CAD stenosis in patients carrying the ApoEε4 allele. Spearman correlation analysis was performed to analyze the correlation of METS-IR and TyG index with GS. Receiver operating characteristic (ROC) curve was plotted and Delong test was conducted to compare the predictive value of METS-IR and TyG index for the severity. Results METS-IR were significantly higher in the high GS group than in the other two GS groups, and TyG in high GS group was significantly higher than that in low GS group(P<0.05). Spearman correlation analysis indicated a positive correlation of METS-IR and TyG index with GS (r=0.210,0.658; P<0.001). Logistic regression analysis showed that METS-IR was an independent predictor of stenosis severity in CAD patients carrying ApoEε4 allele (OR=1.147,95%CI 1.077-1.221; P<0.001). ROC curve analysis revealed that the area under the curve of METS-IR and TyG index in prediction for coronary stenosis in the CAD population with ApoEε4 allele was 0.824 and 0.608, respectively, and METS-IR had better performance. Conclusion METS-IR is superior to TyG index in prediction for severity of coronary stenosis in ApoEε4 allele CAD patients.

Abstract:Objective To investigate the distribution characteristics of pathogenic bacteria, changes in the T-lymphocyte (T-cell) subsets and prognosis in the elderly patients with acute ischemic stroke complicated with severe pneumonia (SP). Methods A total of 150 elderly patients with acute ischemic stroke complicated with pneumonia at the Emergency Center of the First Affiliated Hospital of Xinjiang Medical University from March 2021 to March 2023 were enrolled as the study subjects. According to the severity of pneumonia, the patients were divided into the SP group and the non-SP (NSP) group. Clinical data, pathogenic bacteria culture and drug sensitivity test results, proportions of T-cell subsets in peripheral blood and 28-d mortality rate of patients were collected. SPSS 22.0 was used for statistical analysis. Data comparison between two groups was performed using t test orχ² test depending on data type. Results The mean age, National Institutes of Health Stroke Scale (NIHSS) score, prevalence of chronic obstructive pulmonary disease (COPD) and incidence of consciousness disorder in the SP group were higher than those in the NSP group, and the differences were statistically significant (P<0.05). The difference in the stroke site between the two groups was statistically significant (P<0.05). In 70 SP patients, 68 strains of pathogenic bacteria were cultured, including 60 (88.24%) Gram-negative bacteria and 8 (11.76%) Gram-positive bacteria. The three pathogenic bacteria with the top three detection rates were Acinetobacter baumannii (47.06%, 32/68), Pseudomonas aeruginosa (14.71%, 10/68) and Klebsiella pneumoniae (13.24%, 9/68). Acinetobacter baumannii was relatively sensitive to cotrimoxazole and cefoperazone/sulbactam. Pseudomonas aeruginosa was highly sensitive to tobramycin and amikacin and relatively sensitive to gentamicin and quinolones. Klebsiella pneumoniae was most sensitive to amikacin and imipenem. The levels of CD3⁺, CD4⁺ and CD4⁺/CD8⁺ in the SP group were lower than those in the NSP group, and the CD8⁺ was higher than that in NSP group, with statistically significant differences (P<0.05). The 28-d mortality rate in the SP group was 45.71% (32/70), which was higher than 6.25% (5/80) in NSP group (χ²=31.290; P<0.05). The levels of CD3⁺, CD4⁺ and CD4⁺/CD8⁺ in the deceased were lower than those in the survivors in the NSP group; CD8⁺ level was higher than that in the survivors; the differences were statistically significant (P<0.05). Conclusion Ischemic stroke with SP will increase the risk of death in patients. Age, NIHSS score, complication of CODP and disturbance of consciousness may be factors contributing to the progression of general pneumonia to SP in ischemic stroke. In addition, immune imbalance may also be involved in the mechanism of SP occurrence in ischemic stroke and increase the risk of death in patients.

Abstract:Objective To investigate the status quo and its related influencing factors of postoperative rehabilitation compliance in elderly patients after total knee arthroplasty (TKA). Methods A total of 150 elderly patients receiving TKA treatment in our hospital between January 2020 and January 2022 were enrolled in this study. The compliance of home-based rehabilitation training within 6 months after discharge was investigated, and the effect of the rehabilitation training compliance on knee function was analyzed. According to rehabilitation compliance scale score, they were divided into high-, middle- and low-level grades, and then those with high-level and middle-level grades were assigned into good compliance group, while those with low-level grades into poor compliance group. Binary logistic regression model was applied to analyze the related factors of home-based rehabilitation training compliance in the elderly patients after TKA. SPSS statistics 20.0 was used for statistical analysis. Data comparison between two groups was performed using t test, One-way analysis of variance orχ² test depending on data type. Results In our survey, 133 valid questionnaires were obtained, with a recovery rate of 88.67%. Among them, 74 patients (55.64%) received motion training in lower limb joint range, 51 cases (38.35%) underwent strength training for lower limb muscle, and 19 patients (14.29%) did not carry out any home-based rehabilitation training. Eleven patients (8.27%) did not persist in training for 1 month, 67 patients (50.38%) persisted in home-based rehabilitation training for over 1 month, 26 patients (19.55%) persisted in training for more than 3 months, and only 10 patients (7.52%) persisted in training for 6 months. The hospital for special surgery knee (HSS) scale score was increased in all the patients with different compliance levels after 6 months than the score at discharge (P<0.05), and significant differences were observed in the score after 6 months of training among the 3 compliance groups (P<0.05), with the high-level compliance group having the highest score, followed by the middle-level and then low-level compliance groups in order (P<0.05). Binary logistic regression analysis showed that marital status (OR=1.738, 95%CI 1.224-2.469), recognition of the importance of rehabilitation training (OR=3.747, 95%CI 1.228-11.430), fear of pain (OR=2.330, 95%CI 1.650-3.290), social support level (OR=0.263, 95%CI 0.091-0.759), no guidance for rehabilitation training (OR=6.679, 95%CI 4.417-10.100) and inconvenient travel (OR=3.501, 95%CI 2.417-5.071) were related factors affecting the rehabilitation training compliance (P<0.05). Conclusion The compliance of postoperative family rehabilitation training is generally not high in elderly patients after TKA. Marital status, recognition of the importance of rehabilitation training, fear of pain, social support level, no guidance for rehabilitation training, and inconvenient travel are related factors affecting the compliance of rehabilitation training.

Abstract:Objective To explore the correlation between attributional style, psychological distress and quality of life in the elderly patients with breast cancer. Methods A total of 290 patients with breast cancer admitted to Mianyang Central Hospital from July 2021 to December 2022 were selected as the study subjects. According to age, the patients were divided into young and middle-aged group (18-＜60 years; n=123) and elderly group (≥60 years; n=167). Attributional style questionnaire (ASQ), distress thermometer (DT) and Chinese version of functional assessment of cancer therapy-breast (FACT-B) were used to investigate the attributional style, psychological distress and quality of life of the patients in the two groups. Data analysis was conducted using SPSS 19.0. According to the data type, comparison between groups was performed using t test, analysis of variance or Chi-square test respectively. Pearson correlation analysis was used to analyze the correlation between attributional style, psychological distress, and quality of life in the elderly patients with breast cancer. Results In the elderly group, the score of negative event of attributional style was lower, and the total score on ASQ scale was higher; the DT score was lower, and the incidence rate of significantly psychological distress was lower; the scores of physiological status and functional status and total score of FACT-B scale were lower than those in the young and middle-aged people group (P<0.05). Pearson correlation analysis indicated that the total score of positive events of attributional style in the elderly group was weakly negatively correlated with psychological distress (r=-0.263; P<0.001) and was weakly positively correlated with quality of life (r=0.214; P<0.001). The total score of negative events had a weak positive correlation with psychological distress (r=0.255; P<0.001) and a weak negative correlation with quality of life (r=-0.277; P<0.001). Psychological distress was negatively correlated with quality of life (r=-0.267; P<0.001). In the young and middle-aged group, the total score of positive events of attributional style was moderately negatively correlated with psychological distress (r=-0.553; P<0.001) and was moderately positively correlated with quality of life (r=0.633; P<0.001). The total score of negative events was moderately positively correlated with psychological distress (r=0.494; P<0.001) and was moderately negatively correlated with quality of life (r=-0.511; P<0.001), and psychological distress was moderately negatively correlated with quality of life (r=-0.577; P<0.001). Patients with better self-rated marital quality, higher the monthly income, better the emotional regulation ability had higher score for quality of life, and those with more chronic diseases had lower score for quality of life. In addition, the patients receiving endocrine therapy and chemotherapy after surgery scored higher for quality of life than those who did not (P<0.05). Conclusion Compared with the middle-aged and young patients with breast cancer, the elderly patients with breast cancer have healthier attributional style and milder psychological distress but worse quality of life. There is a weak correlation between quality of life and attributional style and psychological distress in the elderly patients with breast cancer. Additionally, comorbid chronic diseases, monthly income, postoperative endocrine therapy and chemotherapy, self-rated marital quality and emotional regulation are the factors affecting the postoperative quality of life in the elderly patients with breast cancer.

Abstract:Objective To explore the use of oxycodone combined with remifentanil for postoperative analgesia in the elderly patients with laparoscopic radical resection of colorectal cancer. Methods A total of 140 elderly patients were selected as the research subjects, who underwent selective laparoscopic radical resection of colorectal cancer under general anesthesia in the Second Affiliated Hospital of Hainan Medical University from May 2021 to May 2023. They were divided into an observation group and a control group by the random number table method, with 70 patients in each group. The control group was given patient-controlled analgesia (PCA) pump for analgesia after surgery, loaded with 0.2 μg/ml of remifentanil. On the basis of the control group, the observation group was given intravenous injection of 0.1 mg/kg of oxycodone hydrochloride prior to the completion of the surgery, and postoperative PCA was loaded with 0.2 μg/ml of remifentanil + 0.3 mg/ml of oxycodone hydrochloride. The two groups were compared in postoperative pain, PCA use and remedial analgesia, pain mediators and adverse reactions. SPSS 22.0 was used for statistical analysis. Data comparison between two groups was performed using t test orχ² test depending on data type. Results The Visual Analogue Scale (VAS) scores of pain at rest and during activity were lower in the observation group than those in the control group at 2,6, 12,24 and 48 hours after surgery (P<0.05). The observation group had longer PCA time and fewer effective compressions than the control group from the completion of surgery to the first compression (P<0.05). Serum levels of substance P and prostaglandin E2 (PGE2) in both groups at 24 hours after surgery were higher than those before surgery (P<0.05), but those in the observation group were lower than those in the control group (P<0.05). The incidence of nausea and vomiting in the observation group was lower than that in the control group (P<0.05). Conclusion Oxycodone combined with remifentanil can enhance the postoperative analgesic effect, reduce the use of analgesics, and reduce the incidence of postoperative nausea and vomiting in the elderly patients with laparoscopic radical resection of colorectal cancer.

Abstract:Objective To explore the application value of ultrasound-guided fascia iliac block combined with sacral plexus block during elderly hip surgery. Methods A total of 178 elderly patients undergoing hip surgery in our hospital from August 2018 to August 2021 were enrolled and served as the study subjects. According to anesthesia methods, they were divided into combined block group (ultrasound-guided fascia iliac block combined with sacral plexus block anesthesia, n=92) and hypobaric unilateral spinal anesthesia (HUSA) group (n=82). Propensity score matching was used to select 52 pairs of patients with matched baseline data in a ratio of 1∶1. Nerve block time, pain degree, hemodynamic parameters, stress indicators and incidence of complications were compared between the two groups. SPSS statistics 20.0 was used for data analysis. Depending on data type, student′s t test, repeated measures analysis of variance, orχ² test was employed for intergroup comparison. Results The rate of dopamine use and its average dosage were significantly lower in the combined blockade group than the HUSA group (both P<0.05). The combined block group had obviously longer onset times and durations of analgesic effect for both sensory block and motor block than the HUSA group (both P<0.05). The pain visual analog scale (VAS) scores at T1 (lateral position), and 12 and 24 h after surgery were notably lower, while the scores at T2 (skin incision) and T4 (end of surgery) were remarkably higher in the combined block group than the HUSA group (all P<0.05). The morphine dosage in the combined blockade group was less than that in the HUSA group at 0-24 h and 24-48 h after surgery (all P<0.05). The combined block group had lower mean arterial pressure (MAP) at T1, and higher MAP at T3 (30min after operation) and T4 when compared with the HUSA group (P<0.05). The MAP at T2, T3, and T4 in the combined block group were decreased than that at T0 (enter the operating room)(P<0.05); The MAP at T1 in the HUSA group was significantly higher than that at T0 (P<0.05), while the MAP at T2, T3, and T4 were significantly lower than that at T0 (P<0.05). The heart rate (HR) at T1 in the combined block group was lower than that in the HUSA group (P<0.05). The HR of HUSA group at T1 was significantly higher than that at T0 (P<0.05). The blood glucose and plasma cortisol levels were lower in the combined block group than the HUSA group in 24 h after surgery (P<0.05). The incidences of postoperative urinary retention, nausea and vomiting, dizziness and headache in the combined block group were lower than those in the HUSA group (P<0.05). Conclusion Ultrasound-guided fascia iliac block combined with sacral plexus block can maintain intraoperative hemodynamic stability, control postoperative pain, and reduce stress response and postoperative complications.

Abstract:Objective To explore the mediating effect of oral health-related self-efficacy on the relationship between oral frailty risk and nutrition in the elderly. Methods From March 2023 to April 2023,223 elderly people from five communities in Luzhou City were selected as subjects by convenience sampling. The patients were investigated using general data questionnaire, oral frailty index-8 (OFI-8), mini nutritional assessment short form (MNA-SF) and oral health related self-efficacy scale. SPSS 26.0 was used for statistical analysis. According to the data type, Mann-Whitney U test or Kruskal-Wallis H test was used for comparison between groups. Spearman correlation analysis was used to analyze the correlation between oral frailty risk and oral health-related quality of life and nutrition in the elderly. Stepwise regression was used to examine the effect of oral health-related self-efficacy on the relationship between oral frailty risk and nutrition in the elderly. Results The incidence of high risk of oral frailty in the elderly was 59.2% (132/223). The scores of oral health-related self-efficacy and nutrition were 54.0 (50.0,57.0) and 11.0 (10.0,13.0) points, respectively. The risk of oral frailty in the elderly was negatively correlated with oral health-related self-efficacy (r=-0.495; P<0.01) and negatively correlated with nutrition (r=-0.698; P<0.01 ). Oral health-related self-efficacy was positively correlated with nutrition (r=0.467, P<0.01 ). Oral health-related self-efficacy was a mediating variable between oral frailty risk and nutrition, and the mediating effect accounted for 14% of the total effect. Conclusion The risk of oral frailty in the elderly can indirectly affect nutrition through oral health-related self-efficacy. Medical professionals should pay attention to oral health education and intervention for the elderly, thus improving oral health-related self-efficacy and nutritional status of the elderly.

Abstract:Objective To analyze the correlation between body nutritional risk and prognosis in elderly patients with severe pneumonia, and to study the application value of geriatric nutritional risk index (GNRI) for elderly patients with severe pneumonia. Methods A total of 133 elderly patients with severe pneumonia admitted to Foshan Fosun Chancheng Hospital from January 2020 to January 2022 were recruited, and according to their GNRI within 24 h after admission, the patients with high nutritional risk were assigned into high-risk group, and the other patients were into other classification groups. The patients with high nutritional risk were given nutritional support treatment, and based on the intervention timing of nutritional support, they were divided into early-, middle- and late-stage subgroups. The prognosis was compared among the patients of different timing of nutritional support. After the 28-day mortality rate was counted, the patients were grouped into death and survival groups. SPSS statistics 19.0 was used to process the data. Data comparison between two groups was perfomed using t test orχ² test depending on data type.Binary logistic regression model was applied to analyze the related factors affecting the prognosis (death within 28 d) in elderly patients with severe pneumonia, and receiver operating characteristic (ROC) curve was drawn to analyze the value of GNRI in predicting the 28-day mortality in these elderly patients. Results Among the 133 elderly patients with severe pneumonia, there were 28 cases (21.05%) with high nutritional risk. The patients with high nutritional risk had advanced age, higher detection rate of Gram-negative bacteria, larger ratio of mechanical ventilation and higher incidence of shock, but lower body mass index, serum albumin and pre-albumin levels when compared with the other classification groups (P<0.05). After the patients with high nutritional risk were treated with nutritional support, the times for mechanical ventilation and vasoactive drug use and length of hospital stay were all in increasing trends in the patients with early, middle and late nutritional interventions in turn, and the death rate was lower in the patients with early intervention than those with late intervention (P<0.05). Among the 133 elderly patients with severe pneumonia, 35 cases (26.32%) eventually died within 28 d after admission. Binary logistic regression analysis confirmed that Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score at admission (OR=1.906, 95%CI 1.350-2.691), multiple organ dysfunction syndrome (MODS) score (OR=2.079, 95%CI 1.254-3.448), mechanical ventilation (OR=2.177, 95%CI 1.313-3.610) and high-risk GNRI grade (OR=2.575, 95%CI 1.778-3.730) were risk factors for 28-day death in elderly patients with severe pneumonia. ROC curve analysis found that the AUC value of GNRI (AUC=0.706, 95%CI 0.607-0.806) in predicting 28-day death in elderly patients with severe pneumonia was significantly higher (P<0.05) than that of APACHE Ⅱ score (AUC=0.534, 95%CI 0.428-0.641), MODS score (AUC=0.564, 95%CI 0.460-0.668) and mechanical ventilation (AUC=0.628, 95%CI 0.518-0.737). Conclusion It is suggested that GNRI should be used for nutritional risk screening in elderly patients with severe pneumonia as soon as possible after admission, and nutritional intervention should be carried out in time for those with high-risk malnutrition so as to improve the prognosis of patients.

Abstract:Objective To investigate the risk factors for peripherally inserted central catheter (PICC) related venous thrombosis (CRT) in elderly patients with gastrointestinal tumors, and analyze intervention measures. Methods A retrospective analysis was conducted on 2 033 elderly patients with gastrointestinal tumors treated in our hospital from January 2015 to January 2023. All patients underwent PICC catheterization, and those with CRT were included in the thrombus group (n=270), while those without in the control group (n=1 763). SPSS statistics 20.0 was used for data processing. Student′s t test or Chi-square test was employed for intergroup comparison depending on data type. Logistic regression analysis was applied to identify the risk factors for CRT in the patients. Results Among the 2 033 patients, 13.28% (270/2 033) had CRT. Logistic regression analysis showed that history of deep vein thrombosis (OR=4.778,95%CI 1.339-17.048), D dimer ≥5 mg/L (OR=3.951,95%CI 1.401-11.143), total cholesterol ≥6.7 mmol/L (OR=3.983,95%CI 1.582-10.026), body mass index (BMI) ≥25 kg/m² (OR=4.433,95%CI 1.336-14.710, catheter tip located in the subclavicular vein (OR=3.808,95%CI 1.316-11.016), concurrent chemoradiotherapy (OR=5.307,95%CI 1.299-21.678) and long-term bedridden rest (OR=4.749,95%CI 1.347-16.748) were independent risk factors for CRT in elderly patients with gastrointestinal tumors. Conclusion After PICC catheterization in elderly patients with gastrointestinal tumors, monitoring and early intervention are necessary for the patients with history of deep vein thrombosis, D-dimer ≥5 mg/L, total cholesterol ≥1.7 mmol/L, BMI ≥25 kg/m², catheter tip located in subclavian vein, concurrent chemoradiotherapy and long-term bedridden rest, in order to reduce the risk of CRT.

Abstract:Objective To survey the mental health status in elderly patients with uterine prolapse and investigate its influence on quality of life in them. Methods A total of 280 elderly patients with uterine prolapse admitted in our hospital from May 2018 to May 2023 were enrolled and served as the study subjects. Their clinical data were collected. Depression anxiety stress scales-21 (DASS-21) and World Health Organization quality of life-BREF (WHOQOL-BREF) were employed to evaluate the mental health status and quality of life of the patients, respectively. SPSS statistics 22.0 was used for data analysis. Based on different data type, t test or one-way analysis of variance was applied for intergroup comparison. Pearson correlation analysis was conducted for the correlation between mental health status and various dimensions of quality of life. Multivariate linear regression model was established to determine the effect of mental health status on quality of life after controlling the other potential influencing factors. Results The scores of depression dimension, anxiety dimension and stress dimension of DASS-21 scale were (10.79±3.33), (9.90±2.24) and (13.79±4.06) points, respectively in the 280 patients, and there were 46.07% (129/280), 52.14% (146/280) and 49.29% (138/280) of patients with depression, anxiety and stress, separately. The scores of physiological health, mental health, social relation and environment dimensions of WHOQOL-BREF in the elderly patients were obviously lower than those of domestic norms (P<0.05). Pearson correlation analysis showed that the scores of depression, anxiety and stress were negatively correlated with the scores of physiological health (r=-0.421, -0.396, -0.382; P<0.05), of mental health (r=-0.378, -0.435, -0.416; P<0.05), of social relation (r=-0.342, -0.365, -0.359, P<0.05) and of environment (r=-0.364, -0.387, -0.375; P<0.05). Multivariate linear regression analysis showed that uterine prolapse stage Ⅲ, depression, anxiety and stress were relevant factors of physiological health, mental health, social relation and environment (P<0.05), and comorbidity was a relevant factor of physiological health, mental health and social relation (P<0.05). Conclusion The mental health status of elderly patients with uterine prolapse, especially depression, anxiety and stress, significantly affects various dimensions of their quality of life.

Abstract:Objective To explore the influencing factors for cancer-related fatigue in non-small cell lung cancer (NSCLC) patients. Methods Clinical data of 105 NSCLC patients admitted to Fifth Medical Center of Chinese PLA General Hospital from June 2020 to October 2023 were collected and retrospectively analyzed. According to the Piper fatigue scale score, they were divided into non or mild fatigue group (n=43) and moderate to severe fatigue group (n=62). SPSS statistics 26.0 was used for statistical analysis. Data comparison between two groups was performed using t test orχ² test depending on data type. Multivariate logistic regression analysis was applied to identify the influencing factors for the occurrence of cancer-related fatigue in these NSCLC patients. Results Among the 105 NSCLC patients, 20 had no fatigue, 23 had mild, 29 had moderate, and 33 had severe fatigue. The incidence of cancer-related fatigue was 80.95% (85/105) in the cohort. There were significant differences between the non or mild fatigue group and the moderate to severe fatigue group in terms of age, predisease smoking, depression, adverse reactions, white blood cell count, hemoglobin level and platelet count (all P<0.05). Multivariate logistic regression analysis showed that age ≥60 years (OR=3.625,95%CI 1.903-6.585), smoking before illness (OR=3.445,95%CI 1.827-6.832), adverse reactions (OR=2.309,95%CI 1.352-3.943), low white blood cell count (OR=4.689,95%CI 1.825-6.332), high hemoglobin concentration level (OR=2.486,95%CI 1.172-4.485) and high platelet count (OR=2.134,95%CI 1.347-4.032) were all risk factors for cancer-related fatigue in NSCLC patients (all P<0.05). Conclusion The incidence of cancer-related fatigue is relatively high in NSCLC patients, and its occurrence are affected mainly by age, smoking before illness, adverse reactions, low white blood cell count, high hemoglobin concentration level, and high platelet count.

Abstract:Otago exercise program (OEP) is a sports program based on family training, which has been widely studied and gradually applied in medical or pension institutions in foreign countries, targeting mostly the elderly. However, such research in China is rare. In order to cope with population aging in China, this article reviews the influence of the OEP on geriatric infirmity, cognitive behavior and social life, laying a theoretical foundation for its development and implementation in China in the future.

Abstract:Malnutrition is a common geriatric syndrome, perceived as an independent risk factor for poor prognosis of various diseases in the elderly. Currently, no gold standard is available for malnutrition screening specifically for them. Existing nutritional screening tools have a wide range of applications, and subjective and objective indicators of evaluation are different. Although they increase the convenience of use, the sensitivity and specificity of different assessment methods vary. The results obtained by different methods for the same target population may be different. This article reviews the common tools for malnutrition screening and assessing in the elderly.

Abstract:Physical resilience (PR) in the elderly refers to the physical ability to resist or recover after exposure to adverse stressors, reflecting the body′s reserve capacity. It is currently a much sought topic in geriatrics. PR levels vary greatly among individuals, and high-level individuals have ideal defense or recovery outcomes when exposed to stressors, which leads to lower risks of disability, shorter hospitalization and lower all-cause mortality, and thereby longer lifespan. At present, the mechanisms affecting PR levels remain unclear. Therefore, this article elaborates on the evaluation tools, physiological mechanisms, influencing factors, and serum markers of PR by searching for the keyword "Physical Resilience" in the "Pubmed" database, in order to help clinicians better understand PR and enhance healthy aging.

Abstract:Stroke is one of the most disabling and fatal diseases in China, with ischemic stroke accounting for about 80% and even higher in the elderly. Thrombosis-induced cerebrovascular occlusive events are one of the main causes of ischemic stroke. The successful application of mechanical thrombectomy in acute ischemic strokes in recent years has enhanced people′s understanding of thrombi. The pathological components of thrombi primarily include platelets, red blood cells (RBCs), white blood cells (WBCs), fibrin, and von Willebrand factor (VWF). The composition of a thrombus is often associated with the etiology of the stroke. Studies have shown that thrombi resulting from large artery atherosclerosis contain a higher proportion of RBCs than those from other causes. Different thrombus components exhibit distinct characteristics in imaging modalities such as CT, MRI and digital subtraction angiography. At the same time, the therapeutic efficacy of thrombolytic therapy and mechanical thrombectomy varies with thrombus components. This article provides a comprehensive review of the relationship between the pathological components of thrombi and stroke etiology, imaging and treatment modalities, aiming to guide the treatment and secondary prevention of stroke.