Abstract:Objective To investigate the correlation between platelet-derived microRNA-126 (miR-126) and antiplatelet responsiveness of ticagrelor in patients with acute coronary syndrome (ACS). Methods A total of 272 ACS patients who received stable antiplatelet treatment with ticagrelor in Chinese PLA General Hospital from January 2019 to January 2020 were recruited continuously. After three days of ticagrelor treatment, thromboelastography (TEG) was applied to detect the adenosine diphosphate (ADP) inhibition (ADP%) with platelet mapping for platelet reactivity. Then, 49 patients with high ADP% were assigned into high antiplatelet reactivity (HAPR) group, and 49 ones with low ADP% were into low antiplatelet reactivity (LAPR) group. Platelet RNA was extracted from peripheral blood samples to measured miR-126 expression by using quantitative polymerase chain reaction (qPCR). SPSS statistics 27.0 was used for data analysis. Data comparison between two groups was performed using t test, Wilcoxon rank sum test orχ² test depending on data type. Pearson correlation analysis was performed to analyze the correlation between platelet miR-126 and ticagrelor antiplatelet reactivity. Results The HAPR group had significantly higher ADP% than LAPR group [94.50% (92.95%, 97.42%) vs 67.40% (57.00%, 75.05%)], and elevated platelet expression level of miR-126 [2.97 (0.16,31.37) vs 1.00 (0.17,3.31)] when compared with the LAPR group (P<0.001). Platelet miR-126 was positively correlated with ADP% after ticagrelor treatment (r=0.25; P=0.013). Conclusion Platelet miR-126 may affect ticagrelor antiplatelet reactivity in ACS patients.

Abstract:Objective To investigate the risk factors of quality of life in elderly inpatients with coronary heart disease (CHD) and to explore its correlation with exercise tolerance. Methods A retrospective analysis was made of the clinical data of 285 elderly CHD patients hospitalized in the First Affiliated Hospital of Nanjing Medical University from January 2022 to October 2023. On admission, exercise tolerance and quality of life were evaluated using the 《Basic Guidelines for Coronary Heart Disease Rehabilitation (2020)》 and health status questionnaire. The quality of life scores of elderly CHD inpatients with different exercise tolerance were compared, and the correlation between exercise tolerance and quality of life was analyzed by Spearman′s correlation coefficient. At the same time, the patients′ clinical data and information were collected, and their quality of life scores with different clinical characteristics were compared. Multivariate logistic regression analysis was used to identify the risk factors affecting the quality of life of elderly CHD inpatients. SPSS statistics 22.0 was used for statistical analysis. Data comparison between two groups was performed using t test,χ² test or analysis of variance depending on data type. Results There were significant differences in the quality of life scores of the elderly CHD inpatients with different exercise tolerance. The quality of life scores of patients with > 7 metabolic equivalents ( METs) was significantly higher than those of patients with 5-7 METs and < 5 METs, while the quality of life scores of patients with 5-7 METs was significantly higher than those of patients with < 5 METs, and the difference was statistically significant (P<0.05). The exercise tolerance was positively correlated with all dimensions of quality of life and total score in elderly CHD inpatients (P<0.05). Quality of life scores of elderly CHD inpatients differed with age, New York Heart Association (NYHA) cardiac function grade, CHD duration, education level, number of chronic diseases, monthly income, exercise tolerance and revascularization, and the differences were statistically significant (P<0.05 for all). Multivariate logistic regression analysis confirmed that age ≥70 years (OR=1.930,95%CI 1.189-3.133), NYHA class Ⅲ/Ⅳ (OR=1.230,95%CI 1.028-1.472), CHD duration ≥5 years (OR=3.102,95%CI 1.475-6.524), junior high school education (OR=2.287,95%CI 1.174-4.455), ≥3 chronic diseases (OR=1.577,95%CI 1.015-2.450), monthly income <2 000 yuan (OR=2.149,95%CI 1.374-3.361), exercise tolerance ≤7 METs (OR=3.775,95%CI 1.159-12.296), and no revascularization (OR=3.987,95%CI 1.178-13.492) were the risk factors affecting the quality of life of elderly CHD inpatients (P<0.05 for all). Conclusion Exercise tolerance is significantly correlated with quality of life in elderly CHD inpatients. Age ≥70 years, NYHA class Ⅲ/Ⅳ, CHD course ≥5 years, junior high school education, three or more comorbid chronic diseases, monthly income <2 000 yuan, exercise tolerance ≤7 METs, and no revascularization were risk factors affecting the quality of life of elderly CHD inpatients. The management of these factors should be strengthened clinically to improve patients′ quality of life.

Abstract:Objective To explore the differences in symptom clusters, psychological distress and quality of life between elderly and non-elderly patients with gastric cancer during postoperative chemotherapy, and to analyze the related factors affecting the quality of life in the elderly patients. Methods A total of 160 patients with gastric cancer undergoing postoperative chemotherapy in our hospital from April 2020 to April 2023 were enrolled, and according to their age, they were divided into elderly group (≥60 years, n=83) and control group (<60 years, n=77). After chemotherapy was completed, Chinese version of memory symptom assessment scale (MSAS) was used to evaluate the symptom clusters and severities during chemotherapy, and distress thermometer (DT) was applied to assess the psychological distress, and quality of life instruments for cancer patients-stomach cancer (QLICP-ST) was adopted to evaluate the quality of life of the patients. SPSS statistics 25.0 was used for data analysis. Depending on data type, t test or Chi-square test was used for intergroup comparison. Pearson correlation analysis was performed to explore the correlation of severity of each symptom cluster, psychological distress and quality of life during postoperative chemotherapy. Multivariate linear regression model was utilized to identify the related factors affecting the quality of life in these elderly patients. Results The scores of energy deficiency symptom cluster, psychosomatic symptom cluster, gastrointestinal symptom cluster, surgery-related symptom cluster and neurological symptom cluster during chemotherapy were significantly higher, while the average score of DT scale and detection rate of psychological significant distress were obviously lower in the elderly group than the control group (P<0.05). After chemotherapy, the elderly group had notably higher score of psychological attitude dimension of QLICP-ST scale and lower scores of other dimensions and total score when compared to the control group (P<0.05). Pearson correlation analysis showed that the symptom clusters during postoperative chemotherapy including energy deficiency, psychosomatic symptom, gastrointestinal symptom, surgery-related symptom and neurological symptom in the elderly group, were negatively correlated with total score of quality of life QLICP-ST scale (r=-0.364, -0.411, -0.376, -0.268, -0.344; P<0.001), the DT score was also negatively correlated with total score of QLICP-ST scale (r=-0.371; P<0.001), and various symptom clusters were positively correlated with DT score (r=0.275,0.233,0.325,0.263,0.316; P<0.05). Multivariate linear regression analysis suggested that age ≥79 years (β=-0.334; P<0.001) and tumor stage Ⅲ (β=-0.241; P=0.007) negatively predicted the quality of life in the elderly patients, while family monthly income ≥5 000 yuan (β=0.316; P<0.001) positivelyed predicted the quality of life of patients during chemotherapy, and these variables could explain 39.40% of the variation of quality of life. Conclusion For gastric cancer patients during chemotherapy, the elderly ones have milder psychological distress, but worse chemotherapy tolerance and overall quality of life than the other age groups. It is suggested that in clinical practice, attention should be paid to evaluating body state of these elderly patients and to preventing and treating various symptom clusters during chemotherapy, so as to improve their quality of life during the period.

Abstract:Objective To explore the influencing factors of ventilator-associated pneumonia (VAP) in elderly patients with hypertensive cerebral hemorrhage, and then construct a prediction model. Methods The relevant data of 140 elderly patients with hypertensive cerebral hemorrhage admitted to our hospital from February 2020 to June 2023 were collected and retrospectively analyzed. According to the occurrence of VAP or not, they were divided into a VAP group (n=41) and a non-VAP group (n=99). The factors affecting the occurrence of VAP were analyzed, and the prediction model was built. SPSS statistics 20.0 was used for data analysis. Depending on data type, t test orχ² test was used for comparison between groups, and multiple logistic regression was employed to identify the influencing factors for VAP concurrence. And then a prediction model was constructed based on the obtained factors, and its predictive value was assessed with receiver operating characteristic (ROC) curve analysis. Results The incidence of VAP in the 140 patients was 29.29% (41/140). There were significant differences between two groups in terms of smoking history, chronic obstructive pulmonary disease (COPD), state of consciousness, position during ventilation, connection by orotracheal intubation (OTI) or tracheostomy tube, duration of mechanical ventilation, and antibiotic use (P<0.05). Multiple logistic regression analysis showed that smoking history, COPD, position during ventilation, duration of mechanical ventilation and antimicrobial use were the influencing factors for the occurrence of VAP (P<0.05). The constructed prediction model was Log P=-1.649+0.486× smoking history+0.359×COPD+0.675×position during ventilation+0.426×duration of mechanical ventilation+0.776×antibacterial use. Hosmer-Lemeshow test indicated that χ²=5.263, P=0.336; ROC curve analysis displayed that the area under the curve was 0.868 (95%CI 0.826-0.926), with a sensitivity of 81.32% and a specificity of 79.85%. Conclusion Smoking history, COPD, position during ventilation, smoking history and duration of mechanical ventilation are factors affecting the occurrence of VAP in elderly patients with hypertensive intracerebral hemorrhage.

Abstract:Objective To investigate the effect of high triglyceride (TG) and/or high waist circumference phenotypes on the risk of major adverse cardiovascular events (MACE) in elderly males with obstructive sleep apnea (OSA). Methods A total of 704 consecutive elderly male OSA patients were enrolled from multiple centers including the Chinses PLA General Hospital and Peking University International Hospital, etc, from January 2015 to October 2017. The patients were categorized into four groups according to triglyceride-waist-circumference phenotype, normal TG with normal WC (NTNW) group (n=173), high TG with normal WC (HTNW) group (n=95), normal TG with enlarged WC (NTGW) group (n=299), and high triglyceride-waist-circumference (HTGW) group(n=137) . SPSS 26.0 was used for data analysis. According to the data type, Kruskal-Wallis test orχ² test was used to compare the differences in demographic characteristics, clinical pathological characteristics, comorbidities, sleep parameters, and laboratory findings among the four groups. Kaplan-Miere survival analysis was used to test the cumulative survival rate among the four groups of elderly male OSA patients, and Cox regression analysis was used to analyze the occurrence of MACE of elderly male OSA patients with HTGW phenotype. Results The differences were all statistically significant among the four groups in age, body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), TG, low-density lipoprotein cholesterol (LDL-C), apnea hypopnea index (AHI), oxygen desaturation index (ODI), history of hyperlipidemia, and history of hypertension (P<0.05). Of the 704 patients, MACE occurred in 68 (9.7%), with the highest incidence of MACE in the HTGW group (16.1%). The cumulative survival rate was lower in the HTGW group than those in the other three groups (PLogrank=0.007). COX regression analysis showed that HTGW was associated with the occurrence of MACE in elderly male OSA patients, with a hazard ratio (HR) of 2.290 (95%CI 1.153-4.548; P=0.018). After adjusting for confounders, the findings were consistent, with an adjusted hazard ratio (aHR) of 4.433 (95%CI 1.496-13.132; P=0.007). In addition, age (HR=1.051,95%CI 1.017-1.086; P<0.01), and high systolic blood pressure level (HR=1.025,95%CI 1.012-1.038; P<0.001) were risk factors of MACE in elderly OSA patients. Conclusion Elderly male OSA patients with HTGW phenotype have a relatively higher risk of MACE.

Abstract:Objective To analyze the clinical characteristics of pulmonary tuberculosis (PTB) and the factors influencing know-ledge awareness of its prevention and control in the elderly. Methods A total of 165 elderly PTB patients (aged ≥ 60 years) admitted to the Shanghai Public Health Clinical Center from July 2017 to October 2019 were selected as the study group (elderly group), and another 165 middle-aged and young PTB patients admitted during the same period were chosen as the control group (young and middle-aged group). Clinical data of the two groups of patients were collected for analysis and their clinical characteristics were compared, including clinical manifestations, laboratory tests, and chest CT findings. In addition, a questionnaire survey on the knowledge of tuberculosis prevention and treatment was conducted among the elderly patients with pulmonary tuberculosis, and based on the questionnaire results, patients were divided into the fully informed group and the non-fully informed group. Univariate and multivariate logistic regression analyses were performed to identify factors influencing the knowledge awareness of prevention and treatment of pulmonary tuberculosis among the elderly patients. SPSS statistics 26.0 was used for statistical analysis. Data comparison between two groups was performed usingχ² test.Results Clinical manifestations of the elderly patients with pulmonary tuberculosis mainly included cough (58.18%), chest tightness (57.58%), and chest pain (55.76%). There were 73 cases (44.24%) with two or more clinical manifestations, and 92 cases (55.76%) with three or more symptoms. Laboratory tests showed a positive rate of 69.70% for tuberculin purified protein derivative (PPD) test and 40.00% for acid-fast bacilli smear, and common chest CT findings included nodular shadows (89.09%), calcification (54.55%), ground-glass opacities (45.45%), and pleural effusion (41.82%). The ratio of chest pain in the elderly patients with pulmonary tuberculosis was higher than that in the young and middle-aged patients, the ratios of fever and night sweats were lower than those in the young and middle-aged patients (P<0.05), and the ratios of nodular shadows, pericardial effusion and calcifications were higher than those in the young and middle-aged group (P<0.05 for all). The results of the questionnaire survey on the knowledge of tuberculosis prevention and treatment showed that the overall awareness rate was 36.97% among the elderly patients with pulmonary tuberculosis, with the highest awareness rate for the primary transmission routes of tuberculosis (66.06%) and the lowest for managing adverse reactions to tuberculosis drugs (44.85%). Single-factor analysis revealed significant differences in age, education level, and family member having tuberculosis between the fully informed group and the non-fully informed group (P<0.05). Multivariate logistic regression analysis indicated that education level (primary school or illiterate) and family member having tuberculosis were the factors influencing knowledge awareness of tuberculosis prevention and treatment in the elderly patients (OR=2.849,2.735；P<0.05). Conclusion Elderly patients with pulmonary tuberculosis are more likely to experience chest pain, and imaging examinations show higher rates of nodular shadows, pericardial effusion, and calcifications. Education level and family member having tuberculosis are factors influencing knowledge awareness of the tuberculosis prevention and treatment in the elderly patients. Targeted campaigns for tuberculosis prevention and treatment can be conducted based on these influencing factors.

Abstract:Objective To investigate the participation of a stage I cardiac rehabilitation program after percutaneous coronary intervention (PCI) in elderly patients with acute myocardial infarction (AMI) and its influencing factors. Methods A retrospective analysis was made of the clinical data of 184 elderly AMI patients who underwent stage I cardiac rehabilitation after emergency PCI at Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January to December 2023. The patient′s information was collected by reviewing medical records, and the patient′s participation in rehabilitation programs was evaluated. The participation of patients with different clinical characteristics in rehabilitation program was compared. Multiple logistic regression was used to analyze the influencing factors of participation in rehabilitation programs in elderly AMI patients after PCI. SPSS 22.0 was used for data analysis. According to the data type, t-test or analysis of variance was used for inter-group comparison. Results In this study, 184 elderly AMI patients who underwent stage I cardiac rehabilitation after emergency PCI had the lowest participation rate of 19.00%, the highest of 100.00%, and an average of 73.55%. There were statistically significant differences in the participation rate in the rehabilitation program after PCI among elderly AMI patients in terms of age, number of comorbid chronic diseases, educational level, smoking history, cardiac function classification, monthly income, anxiety or depression, nutritional status, rehabilitation exercise risk level after PCI, number of diseased blood vessels, and number of stents implanted (P<0.05 for all). Multivariate logistic regression analysis showed that age (OR=2.854,95%CI 1.366-5.963), number of comorbid chronic diseases (OR=3.261,95%CI 1.329-8.002), education level (OR=5.571,95%CI 2.125-14.605), smoking history (OR=3.287,95%CI 1.574-6.864), cardiac function classification (OR=3.209,95%CI 1.594-6.460), monthly income (OR=1.149,95%CI 1.594-6.460), anxiety or depression (OR=2.775,95%CI 1.059-1.247), nutritional status (OR=2.649,95%CI 1.204-6.396), risk level of rehabilitation exercise after PCI (OR=3.036,95%CI 1.523-4.607), number of diseased blood vessels (OR=4.532,95%CI 1.779-11.545) and number of stents implanted (OR=1.994, 95%CI 1.108-3.588) were the influencing factors of participation in rehabilitation program in elderly AMI patients after PCI. ConclusionThe participation of elderly AMI patients in the stage I cardiac rehabilitation program after PCI is affected by many factors. During the implementation of rehabilitation program, attention should be paid to high-risk groups in order to timely intervene in relevant factors and thus to enhance the patient′s participation in rehabilitation program in clinical practice.

Abstract:Objective To explore the application effect of exercise rehabilitation training in elderly patients with chronic heart failure (CHF). Methods A total of 190 elderly CHF patients admitted to the Department of Rehabilitation Medicine of Handan First Hospital from January 2020 to January 2022 were selected as the study subjects. The patients were divided into an exercise group and a control group (95 in each group) using random number table method. The control group received conventional intervention, and the exercise group received exercise rehabilitation training on the basis of conventional intervention. After three months of intervention, the psychological and emotional status, heart failure symptoms, cardiac function, myocardial metabolism, blood pressure, blood glucose, blood lipids, and quality of life were observed in both groups. Data analysis was performed using SPSS 23.0, and t test or Chi-square test was performed according to the data type. Results In the exercise group, 78 patients successfully completed exercise rehabilitation training, follow-up and related investigations, and 89 patients in the control group completed follow-up and related investigations. After three months of intervention in the exercise group, the scores of self-rating anxiety scale (SAS), self-rating depression scale (SDS), negative impact dimension of geriatric mental state scale (GMS), and the severity scores of heart failure symptoms such as shortness of breath, leg and arm edema, dizziness and palpitation in the memorial symptom assessment scale-heart failure (MSAS-HF), N-terminal pro-brain natriuretic peptide (NT-proBNP), myocardial energy expenditure (MEE), circumferential end-systolic wall stress (cESS), systolic blood pressure (SBP), glycosylated hemoglobin (HbA1c) and low-density lipoprotein cholesterol (LDL-C) were all lower than those before intervention, and were lower than those in control group after intervention; the left ventricular ejection fraction (LVEF) and Minnesota living with heart failure questionnaire (MLHFQ) were higher than those before intervention, and higher than those in control group after intervention, with statistically significant differences (P<0.05). Conclusion Exercise rehabilitation training based on cardiac function can effectively improve the adverse psychological and emotional status, relieve the heart failure symptoms, improve the myocardial energy metabolism disorder, and increase LVEF in elderly CHF patients. It is also beneficial to the control of the blood pressure, blood glucose, and blood lipid metabolism, thereby improving the quality of life.

Abstract:Objective To dynamically observe T lymphocyte subsets in the peripheral blood and quality of life in elderly patients with ovarian cancer during chemotherapy. Methods A total of 150 elderly patients with ovarian cancer scheduled to receive chemotherapy in the First Hospital of Zhangjiakou were enrolled in the study from March 2018 to June 2023. The quality of life [functional assessment of cancer therapy-ovary cancer (FACT-O)] and T lymphocyte subsets in the peripheral blood (CD3, CD4, CD8, CD4/CD8) were observed before chemotherapy (T₀), at the beginning of chemotherapy (T₁), in the middle of chemotherapy (T₂) and at the end of chemotherapy (T₃), at 1 month after the chemotherapy (T₄), and at 3 months after chemotherapy (T₅). Pearson correlation analysis was used to analyze the correlation between immune status and quality of life of patients at each period. 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 Of all patients, 129 completed chemotherapy and research index collection after excluding those who withdrew from chemotherapy, unwilling to fill out the questionnaire and lost to follow-up. Statistics found that the levels of CD3, CD4 and CD4/CD8 were significantly reduced compared with those at T₀, began to rise at T₂, but the levels at T₅were still lower than those at T₀ (P<0.05). Compared with that at T₀, the level of CD8 in patients was increased significantly and began to decrease at T₂, and the CD8 level at T₅ was still higher than that at T₀ (P<0.05). FACT-O score for physiological status in elderly patients with ovarian cancer during chemotherapy showed a decreasing trend at T₀, T₁, T₂ and T₃, and gradually rose at T₄ and T₅, but were still lower than that at T₀ (P<0.05). The scores of emotional status and functional status were the lowest at T₁, then were gradually enhanced, returned to the T₀ level at T3 and maintained at T₅ (P<0.05). The ovarian cancer-specific module score and total score showed decreasing trends at T₀, T₁, T₂ and T₃, and gradually increased at T₄, but the scores at T₅ were still lower than those at T₀ (P<0.05). Pearson correlation analysis showed that the CD4/CD8 level at T₁ in elderly patients with ovarian cancer during chemotherapy was positively correlated with physiological status (r=0.412; P<0.001), functional status (r=0.374; P<0.001), ovarian cancer-specific module (r=0.386; P<0.001) and total score (r=0.345; P<0.001). The CD4/CD8 level at T₃ was positively correlated with physiological status (r=0.336; P<0.001), ovarian cancer-specific module (r=0.325; P<0.001) and total score (r=0.394; P<0.001) of quality of life scale. Conclusion The cellular immunosuppression status in elderly patients with ovarian cancer is the most serious in the early stage of chemotherapy. With the progress of chemotherapy, the immunosuppression status is gradually relieved. The overall quality of life in elderly patients with ovarian cancer shows a downward trend during chemotherapy and gradually begins to rise at 1 month after chemotherapy. In addition, there is a positive correlation between peripheral blood CD4/CD8 and quality of life of patients during chemotherapy.

Abstract:Objective To assess the value of anti-vascular endothelial growth factor (VEGF) therapy in improving the prognosis of elderly patients with diabetic retinopathy (DR) and its impact on pro-inflammatory factors. Methods A total of 93 elderly patients (126 eyes) with proliferative DR (PDR) admitted to our hospital from January 2022 to January 2023 were included in the study. All of them were scheduled to undergo pars plana vitrectomy (PPV). According to whether receiving intravitreal injection of anti-VEGF drug before PPV, they were divided into observation group (33 cases, 45 eyes, injection of anti-VEGF drug) and control group (60 cases, 81 eyes, no such injection). Before 23 G vitrectomy, the aqueous humor was collected to detect the levels of vascular endothelial growth factor-A (VEGF-A), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and transforming growth factor β (TGF-β). The PPV-related indicators and postoperative visual acuity were observed and compared between two groups. SPSS statistics 22.0 was used for statistical analysis. Data comparison between two groups was performed using t test,χ² test or Fisher′s exact probability test depending on data type. Pearson linear correlation analysis was employed to analyze the correlation between VEGF-A and other cytokines in the aqueous humor. Results The levels of VEGF-A, IL-6 and TNF-α in aqueous humor were significantly lower in observation group than the control group (all P<0.05). Pearson correlation analysis suggested that the VEGF-A level in aqueous humor in observation group was weakly positively correlated with IL-6 and TNF-α levels (r=0.261,0.273; P=0.037,0.031). The observation group had obviously shorter operation time, less intraoperative neovascularization bleeding, less electrocoagulation hemostasis, and lower incidence of iatrogenic hiatus eyes breaks than the control group (all P<0.05). When compared with the control group, the visual acuity improvement rate at two weeks after surgery was better in the observation group, and at six months after surgery, the ratio of best corrected visual acuity was higher, and the incidence of postoperative vitreous re-hemorrhage and number of postoperative rebleeding eyes were lower in the observation group (all P<0.05). Conclusion For the elderly PDR patients, anti-VEGF drug can not only effectively reduce the bleeding during PPV and improve the surgical safety, but also help control PDR by reducing the VEGF-A and inflammatory factor levels in the affected eyes.

Abstract:Objective To investigate the quality of life (QOL) in elderly stroke patients with hemiplegia and analyze the influencing factors. Methods A retrospective analysis was conducted on 200 elderly stroke patients with hemiplegia admitted to our hospital from December 2020 to December 2023. The clinical data were collected, and the status of QOL was evaluated with a QOL questionnaire. The influencing factors of the status were analyzed with multiple linear regression analysis. SPSS statistics 20.0 was used for statistical analysis. Data comparison between two groups was performed using t test or analysis of variance depending on data type. Results Their average QOL score was (162.84±32.65) points. There was statistical significance in the QOL score among the patients with different age, hypertension, hyperlipidemia, diabetes mellitus, education level and per capita monthly family income (P<0.05). The QOL score statistically differed in the patients with different stroke frequency and whether they received rehabilitation treatment (P<0.05). Multiple linear regression analysis showed that age, education level, per capita monthly family income, stroke frequency and whether to receive rehabilitation treatment were the influencing factors of QOL in the elderly stroke patients with hemiplegia (B=104.56,5.264,1.462, -2.527,3.411; all P<0.05). Conclusion The QOL status in the elderly stroke patients with hemiplegia is at a medium level. Age, education level, per capita monthly family income, stroke frequency and whether to receive rehabilitation treatment are the factors affecting the QOL of the patients, which should be paid close attention to in clinical practice.

Abstract:Objective To investigate the distribution characteristics and reference range of hemoglobin (Hb) in the elderly in Xinjiang. Methods A cross-sectional study was conducted in Xinjiang using simple random sampling. From January to December 2019, healthy elderly individuals aged ≥ 80 years were randomly recruited at survey sites to participate in a questionnaire survey and provide blood samples. The reference range of hemoglobin was established using the percentile method, and the age, gender, altitude, and regional distribution characteristics of Hb were analyzed. SPSS 26.0 was used for statistical analysis. Box plots were used to remove outliers in the Hb data, and the Kolmogorov Smirnov test (K-S test) was used for normality verification of Hb data. The range of Hb reference range was determined using the percentile method (P2.5, P97.5). Results A total of 14 554 permanent residents aged ≥ 80 years were recruited in this study, with 13 073 included in the data analysis. The Hb reference range was 108.0-173.0 g/L for elderly males and 103.1-160.0 g/L elderly females in Xinjiang, showing both lower limits of the reference values lower than that for Chinese adults and a wide reference range itself. The distribution of hemoglobin among elderly people in Xinjiang was characterized by a higher value in males than in females (143.0 vs 132.0g/L; P<0.001), a higher value in the 80-90 years age group than the ≥ 90 years age group (P<0.001), higher Hb levels in the high-altitude areas than in the low-altitude areas (P<0.001), and higher Hb levels in the southern Xinjiang than in the northern and eastern Xinjiang (P<0.001). Conclusion This study is the first to establish a Hb reference range in the elderly aged ≥ 80 years in Xinjiang, revealing significant differences in gender, altitude, age, and region in hemoglobin levels among this population.

Abstract:As the body function gradually decreases among the elderly with aging, their auditory system suffers from insufficient blood supply to the ear vessels and degeneration of the auditory nerve and cochlea, which leading to an increase in the prevalence of primary tinnitus. The condition seriously impairs the quality of life of patients. In this paper, we analyzed the current status of quality of life in elderly patients with primary tinnitus, its assessment tools, and influencing factors for the condition, and summarized the interventions to improve their quality of life, with the aim of providing a reference basis for relieving the symptoms and improving quality of life in clinical practice.

Abstract:Frailty in the elderly is a geriatric syndrome characterized by functional decline that can lead to an increased risk of falls, disability, hospitalization, and death. Studies have shown that different dietary patterns are related to the frailty in the elderly, and it can be prevented by improving their dietary patterns and providing dietary guidance. This review summarized dietary patterns and their relationship with frailty, and the role of dietary pattern in the prevention and management of frailty, to provide guidance for dietary pattern, nutrition management, and related research in clinical practice.

Abstract:Transcarotid artery revascularization (TCAR) is a new type of carotid stenting that not only avoids manipulation of the aortic arch but also effectively reduces the risk of embolic events during carotid interventions through a device or technical system for changing the direction of blood flow to provide protection. Evidence shows that TCAR has a lower risk of stroke or death than transfemoral stenting, and a comparable risk of stroke or death when compared to carotid endarterectomy. In addition, TCAR has the advantages of reducing the risk of myocardial infarction and cranial nerve injury, and shortening procedure time. An increasing body of evidence supports TCAR as a safe, effective, and promising procedure. In this article, we reviewed the surgical procedures, efficacy of different surgical approaches, and learning curve of TCAR.

Abstract:Falls are a common unintentional injury in the elderly population, and motor cognitive risk syndrome (MCR), a novel pre-dementia syndrome, exacerbates risk factors for falls in older adults. In the article, we reviewed the current status and risk factors of falls and nonpharmacological interventions in elderly patients with MCR syndrome at home and abroad, aiming to identify and assess the fall risk for them at an early stage, as well as to provide a reference basis for targeted intervention strategies.