Abstract:Objective To analyze the risk factors for cardiovascular events related to potentially inappropriate medication (PIM) among community-dwelling elderly people and investigate the impact of PIM on mortality in order to provide a reference for promoting rational use of medicine. Methods Between September 2009 and June 2010, a survey was conducted on the elderly people aged≥65 years living in the Wanshou Road area of Beijing based on the Beers standard (2019 version). Parallel double entry was employed to input the data through EpiData. SPSS statistics 25.0 was used for data analysis. Student′s t test, Mann-Whitney U test, Chi-square test, or Fisher exact test was applied for intergroup comparison depending on data type. Multivariate logistic regression model was conducted to analyze the influencing factors for PIM. Cox proportional hazards regression model was utilized to determine the effect of PIM on mortality. Results For the 1 730 included elderly people, they suffered from 0-7 types of cardiovascular diseases and had polypharmacy of 0-11 types of conventional medicines. The patients with comorbidity of multiple cardiovascular diseases accounted for 50.4% (872/1 730), the incidence of polypharmacy was 8.0% (139/1 730), and the incidence of PIM was 18.6% (321/1 730). Comorbidity of multiple cardiovascular diseases (OR=2.610,95%CI 1.974-3.451), multiple use of drugs in the cardiovascular system (OR=1.805,95%CI 1.215-2.681), and endogenous creatinine clearance rate (Ccr) <30 ml/min (OR=2.446,95%CI 0.991-6.035) were risk factors for PIM in the elderly population in the community. Education level of college degree or above (OR=0.474,95% CI 0.351-0.640) and married (OR=0.681,95%CI 0.502-0.924) were protective factors for PIM. The occurrence of PIM increased the risk of cardiovascular death by 78.3% (HR=1.783,95%CI 1.155-2.752) in the general population and 114.8% (HR=2.148,95%CI 1.154-3.996) in the male. Conclusion PIM is quite common among community-dwelling old adults and can be regarded as a reference indicator for predicting mortality risk.

Abstract:Objective To explore the efficacy of mechanical ventilation and its influencing factors in elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated by respiratory failure. Methods A retrospective analysis was made of a total 160 elderly AECOPD patients with respiratory failure admitted to the First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People′s Hospital from June 2022 to June 2023. All patients were treated with invasive-noninvasive sequential mechanical ventilation. The clinic efficacy, and changes in lung function and blood gas indicators before and 24 hours after treatment were analyzed. SPSS 26.0 was used for statistical analysis. Data comparison between two groups was performed using t test orχ² test depending on data type. Univariate and multivariate logistic regression were used to analyze the independent factors influencing the efficacy of mechanical ventilation. Results All 160 patients received invasive non-invasive sequential mechanical ventilation treatment, of whom 116 (72.50%) were successfully ventilated and weaned off (successful ventilation group), and 44 (27.50%) failed to ventilate (failed ventilation group). In all patients treated with mechanical ventilation for 24 h forced vital capacity (FVC), peak expiratory flow (PEF), forced expiratory volume in one second (FEV1), pH and arterial oxygen partial pressure (PaO₂) were higher than those before treatment, the heart rate (HR) and arterial partial pressure of carbon dioxide (PaCO₂) were lower after treatment, and the differences were statistically significant (P<0.05). Logistic regression analysis showed that age ≥ 70 years (OR=1.589,95%CI 1.210-2.087), diabetes mellitus (OR=2.257,95%CI 1.319-3.862), multiple organ dysfunction syndrome (MODS) (OR=4.710,95%CI 2.580-8.598), acute physiology and chronic health evaluationⅡ (APACHEⅡ) score≥19 points (OR=22.280,95%CI 2.538-195.586), PaO₂<55 mmHg (OR=8.712,95%CI 2.220-34.189), and PaCO₂≥75 mmHg (OR=25.800,95%CI 4.703-141.535) were independent influencing factors of the efficacy of mechanical ventilation in elderly AECOPD patients with respiratory failure (P<0.05). Conclusion The elderly AECOPD patients with respiratory failure can obtain good efficacy by receiving invasive-non-invasive sequential mechanical ventilation, effectively improving hypoxia symptoms and lung function. However, age, diabetes mellitus, MODS, APACHE Ⅱ score, PaO₂, and PaCO₂ are independent factors of the efficacy, which requires attention in clinical application.

Abstract:Objective To observe the dynamic changes in quality of life and its related influencing factors in elderly patients with esophageal cancer during radiotherapy. Methods A prospective trial was conducted on 123 elderly patients with esophageal cancer undergoing radiotherapy in our hospital from January 2022 to January 2023. In the early, middle and late stages of radiotherapy (at 1 d, 4 weeks after and the end of radiotherapy), quality of life questionnaire core-30 (QLQ-C30), hospital anxiety and depression (HAD) scale, simplified coping style questionnaire (SCSQ) and patient-generated subjective global assessment (PG-SGA) scale were used to survey the quality of life, having anxiety and depression, coping styles and baseline nutritional status in the patients. SPSS 22.0 software was used for data analysis. Multivariate linear regression model was applied to analyze the related factors affecting the quality of life of these patients during radiotherapy. Results Among the 123 elderly patients, 10 gave up due to various radiotherapeutic complications, and the remaining 113 cases completed the radiotherapy plan and related investigation. The scores of physical function, role function, emotional function, social function and total health score of QLQ-C30 scale showed downward trends in turn at the time points of before and in the early, middle and late stages of radiotherapy, and the differences between any two time points were statistically significant (all P<0.05). The scores of fatigue, pain, nausea and vomiting, as well as sleep disorders, loss of appetite, dyspnea and economic status were in upward trends in turn, and there were significant differences between the two time points (all P<0.05). Multivariate linear regression analysis indicated that family monthly income (β=0.311; P<0.001) and SCSQ (positive coping) (β=0.069; P=0.036) had a positive predictive effect, and clinical stage (β=-0.243; P<0.001) and HAD (anxiety) (β=-0.271; P<0.001) had a negative predictive effect on the QLQ-C30 scale score in the early stage of radiotherapy, and the above variables jointly explained 42.30% of the variation in the QLQ-C30 scale score in the early stage of radiotherapy. PG-SGA (≥9 points) (β=-0.766; P<0.001) and HAD (anxiety) (β=-0.183; P<0.001) had a negative predictive effect, and precision radiotherapy (β=0.322; P<0.001) and SCSQ (positive coping) (β=0.671; P<0.001) had a positive predictive effect on the QLQ-C30 scale score in the middle stage of radiotherapy, and these variables jointly explained 51.40% of the variation in the QLQ-C30 scale score in the middle stage of radiotherapy. PG-SGA (≥9 points) (β=-0.173; P=0.016), acute side effects of radiotherapy (β=-0.465; P=0.023), neurotoxicity (β=-0.365; P=0.024) and HAD (depression) (β=0.591; P<0.001) had a negative predictive effect, and precision radiotherapy (β=0.465; P=0.023) and SCSQ (positive coping) (β=0.311; P<0.001) had a positive predictive effect on the QLQ-C30 scale score in the late stage of radiotherapy, which together explained 48.60% of the variation in the QLQ-C30 scale score in the late stage of radiotherapy. Conclusion With the progress of radiotherapy, the quality of life of the elderly patients with esophageal cancer is gradually decreased. The factors affecting quality of life in different periods of radiotherapy is various. In clinical practice, taking targeted interventions based on the characteristics of patients in different periods of radiotherapy, and actively improving the negative coping style are of great significance in enhancing the quality of life of the patients during the whole period of radiotherapy.

Abstract:Objective To investigate the sleep quality and quality of life in elderly patients with hypermyotonia after ischemic stroke (IS), and to analyze the influencing factors for sleep quality. Methods Convenience sampling was used to screen 365 elderly patients with hypermyotonia during recovery period of IS admitted in First Affiliated Hospital of Air Force Medical University from January 2022 to June 2023. A survey was conducted on them, including demographic data, Pittsburgh sleep quality index (PSQI) and stroke specific quality of life scale (SS-QoL). The patients were divided into poor sleep quality group (PSQI ≥7 points, 176 cases) and good sleep quality group (PSQI <7 points, 182 cases) according to their PSQI score. SPSS 23.0 was used for data analysis. Based on data type, student′s t test or Chi-square test was employed for intergroup comparison. Logistic regression analysis was utilized to identify the influencing factors for poor sleep quality in elderly patients with hypermyotonia during recovery period of IS. Results There were 358 valid questionnaires collected from 365 patients, with an effective recovery rate of 98.08%. The average PSQI score was (7.20±1.46) points in the 358 valid participants. The poor sleep quality group had significantly lower scores of dimensions of energy, activity ability, self-care and upper limb function and total score of SS-QoL than the good sleep quality group (P<0.05). Logistic regression analysis showed that muscular tension grade 3 (OR=3.357,95%CI 1.766-6.381; P<0.05), severe dependence on daily activity (OR=4.121,95%CI 2.389-7.107; P<0.05), depression performance (OR=2.838,95%CI 1.425-5.652; P<0.05), and vitamin D deficiency (OR=2.606,95%CI 1.347-5.043; P<0.05) were risk factors for poor sleep quality in elderly patients with hypermyotonia during recovery period of IS. Conclusion Severely intensified muscular tension during recovery period of elderly IS, low daily activity, depression and vitamin D deficiency may lead to a decrease in sleep quality and affect the quality of life of the patients.

Abstract:Objective To explore the influencing factors for postoperative coping style in elderly patients with pituitary tumor, and analyze its correlation with quality of life. Methods A total of 140 elderly patients with pituitary tumor admitted to our hospital from July 2021 to June 2023 were recruited and assigned into a pituitary tumor group, and 115 healthy individuals who taking physical exami-nation served as a norm group. Medical coping modes questionnaire and 36-item short form health survey (SF-36) were used to evaluate the coping styles and quality of life of the participants. The patients were divided into facing (n=32), avoidance (n=65) and submission (n=43) subgroups according to their coping styles. SPSS 20.0 statistical software was used for data processing. According to data type, t test orχ² test was employed for intergroup comparison. Pearson correlation analysis was applied to analyze the relationship between postoperative coping styles and quality of life. Multivariate logistic regression analysis was conducted to identify the related factors affecting the coping styles of the elderly patients after pituitary tumor surgery. Results After pituitary tumor surgery, the patients had a score of (17.03±3.32) in facing dimension, of (8.95±2.37) in submission dimension, and of (17.16±4.75) in avoidance dimension, which were significantly lower in the first dimension and higher in the latter two dimensions than those of the norm group (19.11±2.54,8.64±1.29,15.26±2.17), respectively (all P<0.05). The SF-36 scores were significantly lower in the pituitary tumor group than the norm group across all dimensions (all P<0.05). In the elderly pituitary tumor patients, the score of the facing dimension was positively, and the scores of the avoidance and submission dimensions were negatively correlated with all dimension scores of SF-36 scale (all P<0.05). Statistical differences were observed among the patients with different postoperative coping styles in terms of education level, payment method, household monthly income, tumor size, recurrence, and bodily pain (all P<0.05). Multivariate logistic regression analysis showed that education level of junior high school and below (OR=3.766,95%CI 1.297-10.938), self-financing (OR=4.894,95%CI 1.426-16.791), per capita monthly household income <2 000 yuan (OR=11.235,95%CI 1.163-108.497), macroadenome (OR=5.063,95%CI 1.247-20.561) and relapse (OR=3.920,95%CI 1.183-12.982) were independent risk factors for postoperative coping styles in elderly patients with pituitary tumors (P<0.05). Conclusion Postoperative coping styles of elderly patients with pituitary tumors are significantly correlated with their quality of life, and the education level of junior high school and below, self-financing, per capita monthly household income <2 000 yuan, megaladenoma, and relapse have certain impacts on postoperative coping styles. Clinical interventions for the above factors should be enhanced to further improve their ability to actively respond to the disease.

Abstract:Objective To study the clinical characteristics and quality of life in elderly patients undergoing multiple surgeries for intrahepatic and extrahepatic bile duct stones. Methods Patients with multiple surgeries for intrahepatic and extrahepatic bile duct stones in Beijing Chaoyang Hospital of Capital Medical University from January 2019 to January 2022 were included as the study subjects. According to age, they were divided into an elderly group (age ≥60 years; n=64) and a middle-aged group (aged 45-60 years; n=66). The general demographic data, data of previous biliary tract surgery, and data of the current surgery were collected and analyzed in both groups, and the clinical characteristics of the elderly group were analyzed. The patients were followed up after surgery until October 2023. The postoperative quality of life was investigated in elderly patients undergoing multiple surgeries for intrahepatic and extrahepatic bile duct stones using the 36-item short-form health survey (SF-36). SPSS statistics 19.0 was used for statistical analysis. Data comparison between two groups was perfomed using t test,χ² test or rank-sum test depending on data type. Results The age in the elderly group was older than in the middle-aged group, the proportions of patients with type 2 diabetes mellitus (T2DM), hypertension, respiratory system diseases and coronary heart disease in the elderly group were higher than those in the middle-aged group, and the differences were statistically significant (P<0.05 for all). There were no statistically significant differences in the number of previous biliary tract surgeries, the reason for the first surgery and the method of the first surgery between the two groups. The reasons for the current surgery in the two groups were stone residual or recurrent stones. The interval between the last surgery and the current surgery was longer in the elderly group than in the middle-aged group. The proportions of patients with clinical upper abdominal pain and fever were lower, while the proportion of patients with extrahepatic bile duct stones was higher in the elderly group than in the middle-aged group. The stone diameter was larger, the proportion of patients with combined surgical treatment was higher, the surgical time and hospital stay were longer, the intraoperative blood loss and the incidence rates of postoperative complications were higher in the elderly group than in the middle-aged group (P<0.05). The scores of dimensions and total score of quality of life on SF-36 scale in the two groups at 6 months after surgery increased as compared with those before surgery, and the differences were statistically significant (P<0.05 for all). The scores of physical function (PF), role physical (RP) and general health (GH), and SF-36 total score were higher in the middle-aged group compared to the elderly group at 6 months after surgery (P<0.05). Conclusion The reason for the current surgery in patients of different ages with multiple surgeries for intrahepatic and extrahepatic bile duct stones was stone residual or recurrence. However, the preoperative clinical symptoms were not obvious in the elderly group. In addition, the elderly patients had more underlying diseases, longer interval between last surgery and the current surgery, lareger stone diameters, and more complex surgical regimen, thus it is necessary to pay attention to the surgical risk control and postoperative complication management.

Abstract:Objective To analyze the impact of surgical timing on postoperative complications and quality of life in elderly patients with hip fractures. Methods A prospective trial was conducted on 152 elderly patients undergoing fractured hip surgery in our department from April 2020 to April 2023. According to their surgical timing, they were divided into early surgery group (from fracture to surgery <48 h, n=84) and delayed surgery group (≥48 h, n=68). The perioperative parameters, hip function recovery, postoperative complications and quality of life were compared between two groups. SPSS statistics 20.0 was used for data analysis. Depending on data type, student′s t test orChi-square test were applied for comparison between groups. Results Significantly less intraoperative blood loss, shorter length of hospital stay and fracture healing time, lower visual analogue scale score at 24 h and 3 months postoperatively, and reduced incidence rates of postoperative deep venous thrombosis and urinary tract infection, and higher Harris score, and increased excellent and good rate of hip function recovery at 6 months after surgery were observed in the early surgery group than the delayed surgery group (all P<0.05). The World Health Organization quality of life-BREF scores of physiology, psychology, social relations and environment were elevated in both groups than before surgery (P<0.05), and the scores in early surgery group were obviously higher than those in the other group (P<0.05). Conclusion For the elderly patients with hip fracture, early surgery (within 48 h after fracture) can shorten the hospital stay and fracture healing time, reduce the postoperative pain, and lower the risk of deep venous thrombosis and urinary tract infection, and thus, result in better postoperative hip function and quality of life.

Abstract:Objective To analyze the correlation of self-perceived burden with self-care ability and quality of life in elderly patients undergoing hemodialysis. Methods Clinical data of 385 elderly patients undergoing maintenance hemodialysis (MHD) admitted in our hospital from February 2021 to February 2023 were collected. Self-perceived burden scale (SPBS), exercise of self-care agency scale (ESCA), and kidney disease quality of life short form version 1.3 (KDQOL-SFTM1.3) were used to evaluate the self-perceived burden, self-care ability and quality of life of the patients, respectively. According to SPBS score, they were divided into severe burden group and non-severe burden group (no obvious burden to moderate burden). SPSS statistics 24.0 was used for statistical analysis. Data comparison between two groups was performed using t test orχ² test depending on data type. Logistic regression analysis was employed to identify the influencing factors of severe self-perceived burden in elderly MHD patients, and Pearson correlation coefficient analysis was utilized to evaluate the correlation between self-perceived burden and self-care ability and quality of life in them. Results There were 178 patients assigned into severe burden group and 207 into non-severe burden group. Significant differences were observed between two groups in terms of socioeconomic status, daily living ability, and incidence of complications (P<0.05). Logistic regression analysis showed that low socioeconomic status (OR=2.646,95%CI 1.485-4.716), moderately dependent daily life ability (OR=3.408,95%CI 2.134-5.442) and complication (OR=2.380,95%CI 1.260-4.495) were risk factors of severe self-perceived burden in elderly MHD patients (P<0.05). Pearson correlation coefficient analysis revealed that in the elderly MHD patients, SPBS score was negatively correlated with ESCA score, and kidney-related score, general health-related score and total score of KDQOL-SFTM1.3 (r=-0.655, -0.836, -0.683, -0.734; P<0.05). Conclusion Elderly MHD patients with complications, poor daily life ability and low socioeconomic status are more likely to have strong self-perceived burden. Self-perceived burden of these patients is closely associated with their self-care ability and quality of life.

Abstract:Objective To investigate the correlation between carotid plaque (CP) and age-related decline of renal function in healthy individuals. Methods A retrospective cohort study was conducted on 449 subjects who visited Department of Geriatrics or took physical examination in Physical Examination Center in Huashan Hospital Affiliated to Fudan University from January 2016 to January 2019. Their clinical data, including CP, renal function, blood pressure, and blood glucose and lipids were collected at baseline, and CP and renal function were detected regularly during the follow-up, which was completed in June 2023. According to their age at baseline, they were divided into a young group (<60 years, n=286) and an elderly group (≥60 years, n=163). Subjects were divided into CP group (n=153) and non-CP group (n=296) according to whether CP was present at the time of enrollment. Based on the changes in CP at baseline and follow-up, they were assigned into four groups:Group 1 (without CP at baseline or follow-up, n=244), Group 2 (without CP at baseline but newly developed at follow-up, n=52), Group 3 (with CP at baseline but disappeared CP at follow-up, n=26) and Group 4 (with CP both at baseline and follow-up, n=127). SPSS statistics 26.0 was used for data analysis. Depending on data type, student′s t test, one-way analysis of variance, Mann-Whitney U test or Chi-square test was used for intergroup comparison. Logistic regression model was employed to identify the influencing factors for CP. Results The elderly group had significantly higher incidence of CP (53.4% vs 25.2%), increased systolic blood pressure (SBP), and elevated levels of cholesterol (CHO), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), uric acid (UA) and glycosylated hemoglobin A1c (HbA1c), but lower hemoglobin (Hb) level and decreased estimated glomerular filtration rate at baseline (baseline-eGFR), when compared with the young group (P<0.05). Advanced age, increased SBP, higher levels of CHO, TG, LDL-C and UA, but lower high-density lipoprotein-cholesterol (HDL-C) level and baseline-eGFR were observed in the participants with CP at baseline than those without CP (P<0.05). At the end of follow-up, 52 participants developed new plaques (11.6%) and 26 had plaque disappeared (5.6%). Compared with Group 1, baseline-eGFR was lower, its annual decline was increased, older age, higher SBP, and elevated CHO, TG, LDL-C, UA and HbA1c levels were observed in Group 2 (P<0.05). Similarly, lower baseline-eGFR level, obvious increase of annual decline of eGFR, older age, higher SBP, and raised CHO, LDL-C and UA were found in Group 4 when compared with Group 3 (P<0.05). Multivariate logistic regression analysis showed that age (OR=5.098,95%CI 1.125-8.718; P＜0.001),SBP (OR=1.986,95%CI 1.019-3.289; P＜0.001),CHO (OR=1.804,95%CI 1.109-4.597; P=0.018), LDL-C (OR=1.814,95%CI 1.010-1.964; P=0.031), baseline-eGFR (OR=0.974,95%CI 0.907-0.985; P＜0.001)and the annual decline of eGFR (OR=1.228,95%CI 1.014-1.572; P=0.016) were independent risk factors for CP. Conclusion There is an age-related decline in renal function in healthy adults, and eGFR and its annual decline are independent risk factor for CP. In the process of aging, besides active control for blood pressure and blood lipids, regular monitoring of renal function is helpful to prevent the occurrence and development of atherosclerosis.

Abstract:Objective To explore the current status of fear of disease progression and quality of life in elderly patients with hypertension complicated with type 2 diabetes mellitus (T2DM). Methods A total of 380 elderly patients with hypertension and T2DM admitted to our hospital from January 2020 to January 2023 were recruited and served as the study subjects. Chinese version of fear of progression questionnaire-short form (FOP-Q-SF) and 36-item short form health survey (SF-36) were used to investigate their status of fear of disease progression and quality of life. SPSS statistics 22.0 was used for data analysis. ANOVA, Student′s t test or Chi-square test was adopted for intergroup comparison depending on data type. Multivariate linear regression model was applied to analyze the influencing factors for fear of disease progression and quality of life, and Pearson correlation analysis was employed to assess the correlation between fear of disease progression and quality of life. Results Among the 380 patients, 366 cases completed our questionnaire survey, with a recovery rate of 96.32%. Their total average score of FOP-Q-SF scale was (32.23±5.74) points. There were 162 cases (44.26%) of psychological function imbalance, and the total average score of SF-36 scale was (445.12±63.79) points. Pearson correlation analysis indicated that FOP-Q-SF score was negatively correlated with physical function, bodily pain, vitality, emotional role, mental health and total score of SF-36 scale (r=-0.463, -0.374, -0.465, -0.388, -0.473, -0.523; P<0.05). Multivariate linear regression analysis found that the duration of hypertension (β=0.136; P=0.029), duration of diabetes mellitus (β=0.094; P=0.008), and coronary heart disease (CHD) (β=0.174; P=0.014) had positive predictive effects on FOP-Q-SF score, while family monthly income (β=-0.184; P=0.012), controlled blood glucose (β=-0.143; P=0.019), controlled blood pressure (β=-0.155; P=0.011) and medication compliance (β=-0.184; P<0.001) had negative predictive effects on FOP-Q-SF score, which jointly explained 40.60% of the variation of the dependent variables. Family monthly income (β=0.176; P<0.001), physical exercise (β=0.135; P=0.007), controlled blood glucose (β=0.236; P<0.001), controlled blood pressure (β=0.116; P<0.001) and medication compliance (β=0.215; P<0.001) showed positive predictive effects on SF-36 score, while CHD (β=-0.165; P<0.001) and cerebral infarction (β=-0.174; P<0.001) had negative predictive effects on SF-36 score, which jointly explained 47.40% of the variation of the dependent variables. Conclusion The fear of disease progression is quite common in elderly patients with hypertension and T2DM, and a considerable proportion of them have psychological imbalance. We suggest to reduce their fear of disease progression and improve the quality of life from the aspects of enhancing medication compliance, urging to develop physical exercise habits, and improving the control effect of blood pressure and blood glucose in clinical practice.

Abstract:Objective To explore the relationship between quality of life and anxiety as well as depression in elderly patients with different comorbidity levels. Methods A secondary analysis was performed on the obtained survey data from a community-based elderly polypharmacy management study (including 917 patients finally) conducted at our department between May 2017 and May 2018. According to the Charlson comorbidity index (CCI) scores, the subjects were divided into CCI score ≤3 group (n=363), CCI score 4-6 group (n=400), and CCI score ≥7 group (n=154). Data collection encompassed demographic characteristics, chronic disease profiles, and results of 36-item short form health survey (SF-36) and hospital anxiety and depression scale (HADS). Pearson correlation analysis was employed to investigate the relationship of CCI and SF-36 scores with anxiety and depression. Furthermore, multiple linear regression analysis was utilized to identify factors influencing anxiety and depression in the elderly patients. Results The patients from the CCI score 4-6 and ≥7 groups had significantly older average age and lower scores in all dimensions of the SF-36 scale than those from the CCI score ≤3 group (all P<0.05). The hospital anxiety scale (HAS) and hospital depression scale (HDS) scores were obviously higher in the CCI score 4-6 and ≥7 groups than the CCI score ≤3 group, and in the CCI score ≥7 group than the CCI score 4-6 group (all P<0.05). Pearson correlation analysis showed a negative correlation of CCI, HAS and HDS scores with the score in each dimension of the SF-36 scale. CCI score was positively correlated with HAS and HDS scores, and HAS score was positively with HDS score (all P<0.05). Multiple linear regression analysis indicated that male (β=-0.301, -0.233), the scores of bodily pain (β=-0.026, -0.018), general health (β=-0.015, -0.009), social functioning (β=-0.026, -0.008), role emotional (β=-0.007, -0.002), and mental health (β=-0.021, -0.020) dimensions in the SF-36 scale were protective factors for HAS and HDS scores (P<0.05); age (β=0.022,0.016), monthly income (β=0.353,0.236), CCI score (β=0.145,0.152), and the score of physical functioning dimension in the SF-36 scale (β=0.015,0.008) were risk factors for HAS and HDS scores in the elderly comorbidity patients (P<0.05). Conclusion There exist significant correlations of severity level of comorbidities and quality of life with anxiety as well as depression in the elderly comorbidity patients.

Abstract:Objective To investigate the clinical pathologic features of gastric low-grade intraepithelial neoplasia (LGIN) and prognosis. Methods A retrospective analysis was conducted on 1060 patients diagnosed with LGIN through endoscopic examination and pathological biopsy in our hospital from January 2016 to October 2022 for the clinical and pathological characteristics of LGIN. Among them, 221 patients were followed up by endoscopy and biopsy pathology.Based on the first and last pathological comparison results, the patients were divided into regression group (166 cases) and non-regression group (55 cases). Univariate and multivariate analyses were conducted on variables that may affect the outcome of LGIN, and relevant factors affecting its outcome were screened. SPSS statistics 26.0 was used to perform the statistical analysis. Chi-square test was employed for intergroup comparison depending on data type. Binary logistic regression model was adopted to identify the relevant factors for the persistence and progression of LGIN. Results In the cohort, LGIN was more common in those aged 60 years and over, with a male to female ratio of 2.1∶1, the lesions were mainly found in the antrum, accounting for 57.5% (609/1060). The most common lesions were flat type, accounting for 47.6%(505/1060). The patients with intestinal metaplasia, atrophy, and Hp infection accounted for 63.2% (670/1060), 42.0% (445/1060), and 38.5% (408/1060), respectively. There were statistical differences in age, atrophic location, and microscopic morphology between the atrophy group and the non-atrophy group (P<0.05), and there were also significant differences in gender, age, and metaplastic location between the intestinal metaplasia group and the non-intestinal metaplasia group (P<0.05). During follow-up, 75.1% (166/221) of the patients had regression, 17.6% (39/221) were stable, and 7.2% (16/221) were progressive. The lesions in the cardia and fundus (OR=9.022, 95%CI 2.489-32.701; P＜0.05), lesion size >10 mm (OR=3.283,95%CI 1.028-10.481; P＜0.05), multiple lesions (OR=3.378, 95%CI 1.232-9.264; P＜0.05) and atrophy (OR=2.647, 95%CI 1.096-6.392; P＜0.05) were risk factors for the persistence and progression of LGIN. Conclusion Lesions in the cardia and fundus, lesions size >10 mm, multiple lesions and combined atrophy increase the risk for persistence and progression of LGIN. For LGIN patients with above risk factors, endoscopic resection should be actively performed to assist the diagnosis and treatment.

Abstract:Cardiovascular disease is a leading cause of death worldwide, characterized by high morbidity, high mortality, high disability rate, and high recurrence rates. In physiological condition, the heart primarily relies on the oxidative metabolism of fatty acids and glucose to generate energy. However, in various pathological conditions, such as myocardial infarction and heart failure, the metabolic pathways for fatty acids and glucose in cardiomyocytes become impaired. In these situations, ketone bodies emerge as an alternative ‘super-fuel’ for the heart′s energy supply. In this article, we reviewed the role and mechanism of ketone body metabolism in cardiovascular diseases based on the latest reports.

Abstract:Nerve damage poses a complex challenge for orthopedists and neurologists, currently with no definitive and effective treatment available. Angiopoietin (Ang) is recognized as an angiogenic factor, and its neuroprotective properties has been unveiled in recent years. Ang demonstrates neuroprotective capabilities by promoting angiogenesis, maintaining the integrity of the blood-brain barrier and blood-spinal cord barrier, as well as suppressing inflammatory responses and the influx of harmful ions into nerve cells post-injury. Notably, Ang can directly act on nerve cells by inhibiting autophagy and apoptosis following injury. In this article, we reviewed the neuroprotective effects and underlying mechanisms of Ang in the nervous system, offering valuable insights for further exploration of its potential as a novel neuroprotective agent.

Abstract:Alzheimer′s disease (AD) and Parkinson′s disease (PD) are the most common neurodegenerative diseases, and both of them and sarcopenia are senile disease. Existing studies show that PD, AD, and sarcopenia are closely related. Sarcopenia has a high prevalence in AD and PD patients, but the mechanism of the occurrence of sarcopenia in these patients has not been clarified. In this paper, we comprehensively reviewed the epidemiological characteristics, pathogenesis, and prevention measures of these two diseases with comorbid sarcopenia in order to improve the understanding of their comorbidity in the clinical professionals.