Abstract:Objective To compare the efficacy of open versus laparoscopic surgery for elderly patients with cholecystolithiasis complicated with liver cirrhosis based on propensity score matching. Methods The clinical data were retrospectively collected of 159 elderly patients with cholecystolithiasis and liver cirrhosis admitted to the First Affiliated Hospital of Hebei North University from January 2022 to December 2023. According to the surgical methods, they were divided into a laparoscopic group (n=78) and an open surgery group (n=81). The 1∶1 matching was performed by propensity score matching. Surgery-related indexes, liver function [alanine amino-transferase (ALT), aspartate aminotransferase (AST), cholinesterase activity (CHE), prealbumin (PA), total bilirubin (TBIL), total bile acid (TBA)], immune function [T lymphocyte subsets (CD4⁺, CD8⁺), CD4⁺/CD8⁺], stress response [norepinephrine (NE), adrenocorticotropic hormone (ACTH), cortisol (Cor)] before and 3 d after surgery were compared between the two groups, and complications were evaluated. SPSS 24.0 was used for data analysis. Propensity score matching used R language software R3.6.1 Match It package. Intergroup comparison was performed using t test,χ² test or Fisher′s exact probability method depending on data type. ResultsBefore propensity score matching, there were statistically significant differences between the two groups in age, serum albumin, and Child-Pugh grading (P<0.05). After propensity score matching eliminated the unbalanced variables, 69 pairs of patients with balanced data were obtained. There were no statistically significant differences in the general data between groups after matching (P>0.05). The laparoscopic group had shorter surgical time, less intraoperative blood loss, shorter postoperative drainage time, and shorter hospital stay than the open surgery group (P<0.05). At 3 d after surgery, ALT, AST, PA, TBIL, TBA, NE, ACTH, and Cor levels rose significantly compared with levels before surgery in both groups (P<0.05), but these values in the laparoscopic group were lower than those in the open surgery group after surgery (P<0.05). CHE, CD4⁺, CD8⁺, and CD4⁺/CD8⁺ decreased in both groups as compared with before surgery (P<0.05), but CHE, CD4⁺, and CD4⁺/CD8⁺ in the laparoscopic group were higher than those in the open surgery group after surgery (P<0.05). There were no statistically significant differences in intraoperative complications between the two groups (P>0.05). The total incidence of postoperative complications in the laparoscopic group was significantly lower than that in the open surgery group [4.35% (3/69) vs 14.49% (10/69); P<0.05], with a statistically significant difference. Conclusion Compared with open cholecystectomy, laparoscopic cholecystectomy has the advantages of less invasiveness and faster recovery. It can reduce postoperative liver function damage, immunosuppression, and stress response in elderly patients with cholecystolithiasis and liver cirrhosis, with higher safety, making it more suitable for promotion and application.

Abstract:Objective To construct a risk prediction model for short-term poor prognosis in elderly patients with traumatic acute subdural hematoma (ASDH). Methods A prospective study was conducted on 140 elderly patients with traumatic ASDH in the First Affiliated Hospital of Nanjing Medical University from January 2022 to December 2023. They were followed up for 6 months and were divided into a good prognosis group and a poor prognosis group according to the Glasgow outcome scale (GOS) score. Binary logistic multivariate regression analysis was used to analyze the factors affecting the patient prognosis and to construct a risk prediction model. Receiver operating characteristic (ROC) curve was drawn to analyze the application value of predictive models. SPSS 26.0 was used for data analysis. Comparison between two groups was performed using t test or χ² test depending on data type. Results After 6 months of follow-up, among 140 elderly patients with traumatic ASDH, 10 (7.14%) had severe disability and were classified as the poor prognosis group, 55 (39.29%) had moderate disability, and 75 (53.57%) had good recovery, and these 130 patients were combined into the good prognosis group. Binary logistic multivariate regression analysis indicated that age ≥ 80 years (HR=5.028,95%CI 2.392-10.568), GCS score at admission ≤ 11 points (HR=7.156,95%CI 3.991-12.834), disappearance of pupillary light reflex (HR=4.310,95%CI 2.011-9.239), subarachnoid hemorrhage (HR=2.942,95%CI 1.493-5.796), compression or occlusion of cisterna ambiens (HR=3.785,95%CI 1.509-9.490), and significant midline shift (HR=3.593,95%CI 1.330-9.706) were independent risk factors for prognosis in elderly patients with traumatic ASDH (P<0.05). Based on the binary logistic multivariate regression analysis, the prognosis prediction model equation for elderly patients with traumatic ASDH was established as P=1+[e^{(1.615×1+1.968×2+1.461×3+1.079×4+1.331×5+1.279×6)}]. The ROC curve showed the model had a sensitivity of 0.754, a specificity of 0.696, and an area under the ROC curve of 0.773 in predicting poor prognosis in elderly patients with traumatic ASDH. Conclusion The prognosis of elderly ASDH patients is poor. Age, GCS score at admission, pupillary light reflex, comorbid subarachnoid hemorrhage, cisterna status, and midline shift are factors affecting the prognosis of elderly patients with traumatic ASDH. The prediction model constructed based on these factors has certain value in predicting poor prognosis in elderly patients with traumatic ASDH.

Abstract:Objective To explore the status quo and influencing factors of postoperative lower limb lymphedema (LLL) in elderly patients with type 2 diabetes mellitus (T2DM) complicated with endometrial cancer (EC), and to construct an early warning model of postoperative LLL. Methods A total of 200 elderly T2DM patients with EC admitted in our hospital from January 2022 to December 2023 were enrolled and divided into a training set (n=140) and a validation set (n=60) in a 7∶3 ratio. All patients received radical resection of EC. During six months of follow-up after surgery, the incidence of LLL was observed. And then the patients in the training set were assigned into a LLL subgroup (29 cases) and a non-LLL (NLLL) group (111 cases). SPSS 26.0 was used for data processing, and t test or Chi-square test was performed for between-group comparison depending on data type. Multivariate logistic regression analysis was used to construct a prediction model of postoperative LLL in elderly T2DM patients with EC. Hosmer-Lemeshow test was used to verify the fitting of the model. Receiver operating characteristic (ROC) curve was drawn and the area under the curve (AUC) was utilized to evaluate the predictive ability of the model. The sensitivity and specificity were used to evaluate the practical application efficiency of the model. Results Among the 200 eligible patients, 19.50% (39/200) experienced LLL within six months after surgery. The incidence of LLL was 20.71% (29/140) in the training set and 16.67% (10/60) in the validation set, but no statistical difference was seen between them (χ²=0.438, P=0.508). Multivariate logistic regression analysis suggested that International Federation of Gynecology and Obstetrics (FIGO) stage Ⅲ (OR=4.473,95%CI 1.617-12.370), poorly differentiated tumor tissue (OR=2.998,95%CI 1.805-4.981), lymph node metastasis (OR=2.408,95%CI 1.676-3.461), laparotomy (OR=2.192,95%CI 1.574-3.053) and dissected lymph nodes >20 (OR=5.663,95%CI 2.303-13.924) were independent risk factors, and sentinel lymph node biopsy (OR=0.476,95%CI 0.257-0.882) and retention of circumflex iliac lymph nodes (OR=0.626,95%CI 0.499-0.784) were protective factors for postoperative LLL in elderly T2DM patients with EC. According to the regression coefficient (β) of each variable in the regression equation, the risk prediction model was shown as Y=1.498×FIGO stage Ⅲ+1.098×low differentiation+0.879×lymph node metastasis+0.785×laparotomy-0.743×sentinel lymph node biopsy-0.469 × retention of circumflex iliac lymph node + 1.734 × number of lymph node dissection (>20) -4.491. ROC curve analysis revealed that the model had an AUC value of 0.803 (95%CI 0.723-0.883), a sensitivity of 0.862 and a specificity of 0.676 in the training set, and an AUC value of 0.760 (95%CI 0.586-0.934), a sensitivity of 0.700 and a specificity of 0.800 in the validation set. Hosmer-Lemeshow goodness of fit test revealed that the training set showedχ²=1.897 and P=0.771, and the validation setχ²=2.741 and P=0.469. Conclusion The incidence of LLL in elderly T2DM patients with EC is quite high within six months after surgery. Multivariate logistic regression analysis indicates that our prediction model for LLL occurrence has good application value, and can provide a basis for clinicians to screen high-risk LLL population.

Abstract:Objective To analyze the high risk factors of pressure injury (PI) in elderly patients receiving total cystectomy and cutaneous ureterostomy and construct a prediction model. Methods Clinical data of 312 elderly eligible patients in our hospital from January 2022 to November 2023 were collected in this retrospective study. The participants were divided into a training set and a validation set in a ratio of 2∶1. In the training set, univariate and multivariate logistic regression analyses were used to screen the risk factors of PI in the patients. Then a prediction model for PI in elderly patients with ureterostomy was constructed. Receiver operating characteristic (ROC) curve was plotted to evaluate the efficiency of the prediction model. SPSS statistics 23.0 was used for statistical analysis. Data comparison between two groups was performed using t test or χ² test depending on data type. Results There were 208 cases in the training set and 104 cases in the validation set. PI occurred in 23 cases (11.06%) in the training set and 11 cases (10.58%) in the validation set, and no statistical difference was observed in the PI incidence between the two sets (P=0.898). Multivariate logistic regression analysis indicated that in the training set, age, preoperative geriatric nutritional risk index (GNRI) ≤98, postoperative temperature gradient monitored by infrared thermography >2 ℃, and postoperative Braden score <13 points were independent risk factors of PI in elderly patients with ureterostomy (P<0.05). The constructed prediction model based on these factors was shown as In(P/1-P)=-5.306+0.905×age+0.952×preoperative GNRI+1.256×postoperative temperature gradient+1.124×postoperative Braden score. ROC curve analysis revealed that AUC value of the prediction model in the training set was 0.854 (95%CI 0.772-0.936; P<0.05), and that in the verification set was 0.870 (95%CI 0.796-0.945; P<0.05), suggesting good predictive efficiency in both training set and verification set. Conclusion The incidence of PI in elderly patients with ureterostomy is related to age, preoperative nutritional status, postoperative temperature gradient by infrared thermography and Braden score. The prediction model based on these factors has clinical guiding value for screening patients at high risk for PI.

Abstract:Objective To investigate the impact of changes in nap duration on cognitive function in middle-aged and elderly Chinese. Methods Based on data from the China Health and Retirement Longitudinal Study (CHRLS) in 2011 and 2020, cognitive function was assessed in 6 454 individuals aged 45 years and older using a simplified version of the telephone interview for cognitive status (TICS), memory tests, and drawing tests. Napping for 1-89 min was defined as the recommended duration, while no napping and napping ≥90 min were defined as non-recommended durations. Based on changes in napping duration from 2011 to 2020, the participants were divided into five groups:stable recommended group (n=1 192), stable non-recommended group (n=1 112), recommended-to-non-recommended group (n=1 332), non-recommended-to-recommended group (n=1 966), and extreme-change group (n=852). Data analysis was conducted using SPSS 24.0 and R 3.6.1. Depending on the data type, intergroup comparisons were performed using the Kruskal-Wallis H test or the Chi-square test. A generalized linear model was used to explore the impact of changes in nap duration from 2011 to 2020 on cognitive function. Results The generalized linear analysis of nap duration change and cognitive function from 2011-2020 showed that, compared with the stable non-recommended group, the stable-recommended group had a higher TICS (β=0.41,95%CI 0.26-0.57), memory test (β=0.28,95%CI 0.17-0.39), and overall cognitive scores (β=0.71,95%CI 0.50-0.93), with statistically significant differences (P<0.05); and that the non-recommended-to-recommended group had higher TICS (β=0.31,95%CI 0.14-0.48), memory test (β=0.24,95%CI 0.12-0.36), and overall cognitive scores (β=0.56,95%CI 0.32-0.80) than the stable non-recommended group, with statistically significant differences (P<0.05). Conclusion Maintaining a habit of napping within 90 min helps protect cognitive function, and changing from no napping or napping over 90 min is associated with better cognitive function.

Abstract:Objective To explore the clinical characteristics of elderly patients with Parkinson′ s disease (PD) complicated with rapid eye movement sleep behavior disorder (RBD), and to analyze the influencing factors of mild cognitive impairment (MCI) in the patients. Methods A total of 130 elderly PD patients admitted to our hospital from January 2021 to January 2024 were recruited, and according to the results of RBD screening questionnaire (RBDSQ) and polysomnography (PSG), they were divided into a RBD group (n=63) and a non-RBD group (NRBD, n=67). The clinical data, sleep parameters and Montreal cognitive assessment (MoCA) score were compared between groups, and the incidence of MCI was analyzed in the two groups. Data analysis was performed by using SPSS 26.0, and Chi-square test or t test was applied depending on data type. Binary logistic regression model was adopted to analyze the risk factors affecting the occurrence of MCI in the patients. Results Among the 130 PD patients, 63 (48.46%) was confirmed with RBD. The RBD group exhibited higher male ratio, increased evodopa equivalent dose, larger proportion of Hoehn-Yahr (H-Y) grade ≥3, and elevated scores of Movement Disorder Society-unified Parkinson′ s disease rating scale Ⅲ (UPDRS-Ⅲ), Epworth sleepiness scale (ESS), Pittsburgh sleep quality index (PSQI), Hamilton anxiety scale (HAMA) and Hamilton depression scale-24 (HAMD-24), longer course of PD when compared with the NRBD group (P<0.05). In addition, lower sleep efficiency (SE) and higher arousal index (AI) and periodic limb movement of sleep index (PLMSI) were observed in the RBD group than the NRBD group (P<0.05). The scores of memory and attention dimensions and total score of MoCA scale were lower, and the detection rate of MCI (57.14% vs 34.33%) was higher in the RBD group than the NRBD group (P<0.05). With whether MCI was detected in elderly PD patients as the dependent variable, binary logistic regression analysis indicated that education level (OR=0.466,95%CI 0.275-0.789), UPDRS-Ⅲ score (OR=1.394, 95%CI 1.117-1.739), homocysteine (Hcy) (OR=1.368, 95%CI 1.162-1.609) and concurrent RBD (OR=1.589, 95%CI 1.301-1.940) were independent risk factors for MCI in elderly PD patients. Conclusion The incidence of RBD is quite high in elderly PD patients. The PD patients with concomitant RBD have more severe central nervous system disorders, more pronounced emotional disorders, accompanied with changed sleep structure and higher incidence of MCI. Concurrent RBD is an independent risk factor for MCI in PD patients.

Abstract:Objective To explore the risk factors of contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI) in elderly patients with coronary heart disease (CHD). Methods A total of 320 elderly CHD patients who received PCI in Xingtai Central Hospital from September 2020 to January 2024 were enrolled. The patients were divided into a CIN group (n=40) and non-CIN (NCIN) group (n=280) according to the occurrence of CIN after PCI. The data of patients′ age, gender, serum creatinine, contrast agent dosage, and comorbid underlying diseases were collected. Factors that influence the occurrence of CIN and its impact on the major adverse cardiovascular events (MACEs) with half a year after surgery were analyzed. SPSS 26.0 was used for data analysis. And t test or Chi-square test was performed for between-group comparison according to the data type. Multivariate logistic regression was employed to analyze the factors affecting the occurrence of CIN in patients. Results CIN occurred in 40 of 320 elderly CHD patients receiving PCI, with an incidence 12.50%. Multivariate logistic regression analysis found that comorbid diabetes mellitus (OR=2.065, 95%CI 1.440-2.961), hyperuricemia (OR=2.502, 95%CI 1.619-3.866), underlying kidney disease (OR=3.056, 95%CI 1.238-7.543), and perioperative use of diuretics (OR=3.543, 95%CI 1.686-7.447) were risk factors of CIN after PCI in elderly CHD patients. The incidence of MACEs in CIN patients within half a year after surgery was higher than that in NCIN group (15.00% vs 3.93%), and the difference was statistically significant (P<0.05). Conclusion Comorbid diabetes mellitus, hyperuricemia, underlying kidney disease and perioperative use of diuretics are risk factors of CIN after PCI in elderly CHD patients with coronary heart disease, and CIN increases the risk of postoperative adverse cardiovascular events.

Abstract:Objective To explore the characteristics of blood pressure variability (BPV) in elderly patients at emergency admission for acute ischemic stroke (AIS) and evaluate the influence on prognosis. Methods A retrospective analysis was conducted on 134 elderly patients with AIS admitted in the Second Affiliated Hospital of Xi′an Jiaotong University from February 2022 to May 2024. According to the National Institutes of Health stroke scale (NIHSS) score at emergency admission, they were divided into mild group (NIHSS score <9,69 cases) and moderate-to-severe group (NIHSS score ≥9,65 cases). Their baseline data, 24-hour systolic blood pressure coefficient of variation (SBPCV), diastolic blood pressure coefficient of variation (DBPCV) and pattern of circadian blood pressure rhythm were compared between the two groups. At three months after onset, modified Rankin scale (mRS) was used to evaluate the short-term prognosis of the patients, and thus they were classified into good prognosis group (mRS score ≤2,102 cases) and poor prognosis group (mRS score >2,32 cases). The baseline SBPCV, DBPCV and circadian blood pressure rhythm were compared between the above two groups. SPSS statistics 25.0 was adopted for data processing, and t test or Chi-square test was performed for comparison between groups depending on data type. Multivariate logistic regression analysis was applied to identify the risk factors for short-term poor prognosis in elderly AIS patients. Results The most common circadian blood pressure rhythm pattern was dipper type in the moderate-to-severe group and mild group (accounting for 44.62% and 55.07%, respectively). There were statistical differences in the proportion of circadian blood pressure rhythm, SBPCV, DBPCV and incidence of atrial fibrillation between the two groups (P<0.05). In the 134 elderly AIS patients, the incidence of short-term poor prognosis was 23.88% (32/134). Significant differences were observed between the poor prognosis group and good prognosis group in terms of incidence of atrial fibrillation, NIHSS score at admission, SBPCV, DBPCV and circadian blood pressure rhythm (P<0.05). Multivariate logistic regression analysis indicated that atrial fibrillation (OR=2.790,95%CI 1.471-5.292; P<0.05), NIHSS score ≥9 at admission (OR=8.715,95%CI 4.577-16.592; P<0.05), SBPCV (OR=5.778,95%CI 3.094-10.790; P<0.05), DBPCV (OR=5.382,95%CI 2.833-10.222; P<0.05) and reverse dipper circadian blood pressure rhythm (OR=4.773,95%CI 2.505-9.906; P<0.05) were risk factors for short-term poor prognosis in elderly AIS patients. Conclusion In elderly patients with emergency ischemic stroke, those with severe stroke are characterized by high BPV, reverse dipper circadian blood pressure rhythm and atrial fibrillation. Atrial fibrillation, NIHSS score at admission, BPV and reverse dipper circadian blood pressure rhythm are influencing factors of short-term poor prognosis, and may provide new ideas for emergency and clinical management of elderly AIS patients.

Abstract:Objective To explore the correlation of chronic multimorbidities and phase angle (PhA) with falls, and to analyze the predictive value of the combination of chronic multimorbidities and PhA for falls. Methods A retrospective study was conducted of the clinical data of 353 elderly patients who visited the Geriatrics Department or were hospitalized at the Internal Medicine Department of Western Theater General Hospital from December 2020 to December 2023. According to the history of falls in the past year, patients were divided into a fall group (n=126) and a non-fall group (n=227). Patient′s basic information and laboratory test results were collected. The age-adjusted Charlson Comorbidity Index (aCCI) was used to analyze chronic multimorbidities. A body composition analyzer was used to measure body mass index (BMI), phase angle (PhA), waist circumference, and skeletal muscle mass index (SMI). SPSS 26.0 was used for data analysis. Univariate and multivariate logistic regression models were used to analyze the influencing factors for falls in elderly patients. Receiver operating characteristic (ROC) curves and the area under the curve (AUC) were used to evaluate the predictive efficacy of the influencing factors. Results The age and aCCI in the fall group were significantly higher, and SMI, PhA, BMI, hemoglobin, albumin, prealbumin, retinol binding protein, lymphocyte count, vitamin D, grip strength, and 6-meter walking speed were significantly lower than those in the non-fall group (P<0.05). Multivariate logistic regression analysis showed that PhA (OR=0.732,95%CI 0.684-0.954) and SMI (OR=0.521,95%CI 0.367-0.789) were protective factors for falls in elderly patients, while aCCI (OR=3.432,95%CI 1.248-3.679) was a risk factor (P<0.05). The AUCs of SMI, aCCI, and PhA for predicting falls in elderly patients were 0.662 (95%CI 0.367-0.789; P=0.032), 0.751 (95%CI 0.723-0.854; P<0.001), and 0.807 (95%CI 0.683-0.820; P<0.001), respectively. When aCCI>10, the sensitivity was 0.619, and specificity was 0.893 for predicting falls in elderly people. When PhA<4.25°, the sensitivity was 0.893 and specificity was 0.642. The combination of aCCI and PhA had a higher predictive value for falls in elderly patients, with an AUC of 0.818 (95%CI 0.757-0.879; P<0.001), a sensitivity of 0.891, and a specificity of 0.825. ConclusionaCCI, PhA, and SMI are correlated with the risk of falls in the elderly. As aCCI increases and SMI and PhA decrease, the risk of falls in the elderly rises. The combination of PhA and aCCI has a high predictive value for falls in elderly patients.

Abstract:Objective To investigate the therapeutic effect of extracorporeal biofeedback training combined with Chinese herbal medicine "Yiqi Guyuan Decoction" on stress urinary incontinence (SUI) in elderly women. Methods A total of 90 elderly female SUI patients hospitalized in Jiangsu Provincial Hospital of Traditional Chinese Medicine from January 2021 to July 2024 were selected as the study subjects. This study employed a double-blind design. A random number sequence was generated by SPSS 26.0, and according to their order of treatment, the patients were randomly assigned to Group A, Group B, and Group C in a 1∶1∶1 ratio, with 30 patients in each group. Group A received conventional pelvic floor muscle (PFM) training, Group B received extracorporeal biofeedback training for PFMs, and Group C received a combination of external biofeedback training for PFMs and the Chinese herbal medicine "Yi Qi Gu Yuan Decoction." Before treatment, and at the post-treatment 2nd, 4th, and 6th months, the urinary leakage volume, average strength index (AvrS) of PFMs, sustained force duration of PFMs, international consultation on incontinence questionnaire-short form (ICI-Q-SF) scores, and incontinence quality of life (I-QOL) scores were recorded. Data analysis was conducted using SPSS 26.0. Depending on the data type, intergroup comparisons were performed using ANOVA,χ² tests, or Fisher′s exact probability method. Results Compared with Group A at the same observation time point, Group B showed significant improvement in AvrS of PFMs, sustained force duration and ICI-Q-SF scores after treatment at all time points, and in urinary leakage volume and I-QOL scores at the 4th and 6th months (P<0.05); Group C demonstrated significant improvement in urinary leakage volume, AvrS of PFMs, sustained force duration and ICI-Q-SF scores after treatment at all time points, and in I-QOL scores at the 4th and 6th months (P<0.05). Group C showed superior improvement in urinary leakage volume and AvrS of PFMs at the 4th and 6th months and in ICI-Q-SF and I-QOL scores at the 6th month as compared with Group B (P<0.05). Compared with before treatment, Group A showed improvement only in AvrS of PFMs and ICI-Q-SF score at the post-treatment 4th and 6th months (P<0.05); After treatment, both Group B and Group C showed significant improvement in urinary leakage, AvrS of PFMs, sustained force duration, ICI-Q-SF, and I-QOL scores at all time points (P<0.05). During the treatment process, only the improvement in AvrS of PFMs, sustained force duration, and I-QOL score showed a time-varying trend in group B, whereas the improvement in urinary leakage volume, AvrS of PFMs, sustained force duration, and I-QOL score in group C showed a significant time-varying trend (P<0.05). Efficacy analysis showed that the total effective rates of Group A, B, and C were 43.33%, 73.33%, and 90.00%, respectively, and the differences among the three groups were statistically significant (all P<0.05). Conclusion Compared with monotherapy, the extracorporeal biofeedback training combined with Chinese herbal medicine "Yiqi Guyuan Dicoction" can more effectively alleviate urinary leakage symptoms, improve pelvic floor muscle function, and enhance the quality of life in elderly female SUI patients, showing a better and more sustained trend of therapeutic effects.

Abstract:Objective To explore the correlation between the satisfaction of basic psychological needs and metacognitive beliefs about health anxiety in elderly patients with chronic rhinosinusitis (CRS) after nasal endoscopic surgery. Methods A retrospective analysis was conducted on 304 elderly CRS patients undergoing endoscopic surgery in our department from January 2022 to December 2023. Based on being accompanied by nasal polyps or not, they were divided into a CRS with nasal polyps (CRSwNP) group (n=156) and without nasal polyps (CRSsNP) group (n=148). Basic psychological needs satisfaction scale (BPNSS) was used to assess the satisfaction of basic psychological needs. Meta cognitions scale of health anxiety (MCQ-HA) was employed to evaluate the metacognitive beliefs about health anxiety. SPSS statistics 23.0 was used for statistical analysis. Depending on data type, t test or Chi-square test was performed for intergroup comparison, and Pearson analysis was conducted to analyze the correlation. Results The scores of competency need, relatedness need and autonomy need, and total score were significantly higher in the CRSwNP group than the CRSsNP group (t=6.717,7.827,10.631,14.104; P<0.05). so were the scores of biased thought belief, uncontrollable thought belief and ideational pathogenic belief and total score of metacognitive beliefs in the CRSwNP group when compared with the CRSsNP group (t=9.394,12.005,10.488,18.326; P<0.05), There was a significant positive correlation between the satisfaction of basic psychological needs and metacognitive beliefs about health anxiety in elderly CRSwNP and CRSsNP patients after nasal endoscopic surgery (r=0.544,0.516; P<0.05). Conclusion Significantly positive correlation is observed between the satisfaction of basic psychological needs and metacognition of health anxiety in elderly CRS patients after surgery. Our findings indicate that while paying attention to the surgical outcomes, clinical staff should emphasize the assessment and intervention of their mental state.

Abstract:Objective To explore the effect of hydrogen sulfide on the damage of the Parkinson′s disease (PD) cell model induced by 6-hydroxydopamine (6-OHDA), and investigate the role of PANoptosis in the process. Methods A PD cell model was constructed by inducing SH-SY5Y cells with 100 μmol/L 6-OHDA for 24 h. The SH-SY5Y cells were divided into four groups, that is, control group, 6-OHDA group (PD cell model), NaHS pretreatment group (200 μmol/L NaHS treatment in 30 min before modeling), NaHS treatment group (SH-SY5Y cells cultured in the medium containing 200 μmol/L NaHS). CCK-8 assay was used to detect cell viability of the four groups. The morphology and density changes were observed with inverted biological microscopy and transmission electron microscopy (TEM). The expression levels of receptor-interacting protein kinase 3 (RIPK3) and mixed lineage kinase domain-like protein (MLKL) were detected by Western blotting. SPSS statistics 25.0 was used for statistical analysis. Student′s t test or one-way analysis of variance was employed for intergroup comparison depending on data type. Results Compared with the control group, the 6-OHDA group exhibited significantly reduced cell viability, morphological changes, indicating 6-OHDA causing damage to SH-SY5Y cells. Combining the upregulation of RIPK3 and MLKL protein levels and the findings by TEM, it was found that the synergistic effects of apoptosis, pyroptosis, and necroptosis lead to SH-SY5Y cell damage. After pretreatment with NaHS (H₂S donor), 6-OHDA induced SH-SY5Y cell damage was alleviated, RIPK3 and MLKL protein levels were downregulated, and PANoptosis was reduced under TEM. Conclusion PANoptosis is involved in 6-OHDA induced SH-SY5Y cell damage. Hydrogen sulfide exerts a protective effect on PD cell model, which may be through its anti-PANoptotic effect.

Abstract:Cognitive impairment, characterized by the deterioration of cognitive functions due to various causes, has seen a rising prevalence year by year, and its underlying mechanisms remain yet to be fully elucidated. In recent years, the gut microbiota, as a complex microbial system, has increasingly become a much sought-after research focus due to its potential correlation with cognitive impairment. This article reviews the characteristics of the gut microbiota in the elderly population and its correlation with cognitive impairment and outlines the potential mechanisms by which the gut microbiota may influence cognitive. The aim is to provide new targets for the intervention and treatment of cognitive impairment in the elderly.

Abstract:Coronary heart disease (CHD) complicated with sleep disorders is a group of clinical syndromes with high incidence in the elderly population. The two interacting diseases cause serious damage to the physical and mental health of patients. In this article, we reviewed the correlation, pathogenesis, treatment and prognosis of CHD and sleep disorders in the elderly. The pathogenesis of CHD with concomitant sleep disorders has not been fully elucidated, which may be related to inflammatory factors, oxidative stress, sympathetic hyperactivity, autonomic nerve dysfunction, and so on. In view of the fact that sleep disorders can increase the incidence of CHD and decline the quality of life in the elderly, clinicians need to pay more attention to the elderly CHD patients with sleep disorders, and implement timely screening and interventions of sleep disorders in CHD patients.

Abstract:Homocysteine (Hcy) has been confirmed to be closely associated with various pathological conditions in epidemiological and clinical studies, including cardiovascular disease, neurological disorders, atherosclerosis, neural tube defects, diabetes mellitus, renal diseases, and certain tumors. In this article, we reviewed the research progress of Hcy in elderly central nervous system (CNS) diseases, such as Alzheimer′s disease, vascular dementia, Parkinson′s disease, ischemic stroke, and epilepsy, and explored its mechanisms of action and clinical significance, so as to provide new ideas for the prevention, diagnosis, treatment, and prognosis of these CNS disorders in the elderly.