Abstract:Objective To study the quality of life (QoL) at discharge in elderly patients with pulmonary infection in emergency department. Methods A total of 310 elderly patients with community-acquired pneumonia (CAP) admitted in emergency ward of our hospital from January 2022 to January 2023 were recruited in this study. The mortality of the patients during hospitalization was counted, and the QoL of survivors was investigated by 36-item short-form health survey (SF-36) at discharge. According to the SF-36 scale score, the elderly emergency CAP survivors were divided into high-level group (the score ≥ the average score, n=126) and low-level group (the score < the average score, n=134). All these patients were followed up for one year after discharge, and the readmission rate and mortality due to CAP were counted. SPSS statistics 22.0 was used for statistical analysis. Data comparison between two groups was performed by using t test, χ² test or Fisher′s exact probability test depending on data type. Binary logistic regression model was adopted to analyze the related factors affecting the QoL at discharge in the elderly CAP survivors in emergency department. Results Among the 310 subjected patients, 43 (13.87%) died during hospitalization, and 267 (86.13%) survived at discharge. There were 260 valid questionnaires collected in the 267 survivors, with an effective recovery rate of 97.39%. The total score of the SF-36 scale of the enrolled subjects was (573.63±65.69) points. The score of each dimension and the total score of the SF-36 scale at discharge were significantly lower in the elderly emergency CAP survivors than the domestic norm (P<0.05). Taking the QoL of elderly emergency CAP survivors at discharge as the dependent variable, binary logistic regression analysis found that length of hospital stay ≥14 d (OR=2.201,95%CI 1.373-3.530), underlying diseases > two kinds (OR=3.916,95%CI 1.736-8.832), CRP level >42.03 mg/L (OR=1.889,95%CI 1.027-3.475), hypoproteinemia (OR=2.326,95%CI 1.142-4.737), pneumonia severity index (PSI) grade 4-5 (OR=2.210,95%CI 1.279-3.818) and activities of daily living scale score at admission <90 points (OR=1.925,95%CI 1.196-3.100) were risk factors of QoL at discharge, and influenza and (or) pneumococcal vaccination (OR=0.259,95%CI 0.116-0.580) was a protective factor (P<0.05). The readmission rate and mortality due to CAP within one year of follow-up were obviously higher in the low-level group than the high-level group (P<0.05). Conclusion The QoL at discharge in elderly CAP survivors in emergency department is significantly lower than that of the norm. The status is affected by many factors, and it may also impact the prognosis. It is suggested that improving the QoL of the patients during hospitalization from various dimensions may have certain significance in improving the prognosis.

Abstract:Objective To explore the correlation of nutritional status and self-efficacy with quality of life in elderly maintenance hemodialysis (MHD) patients with tuberculosis . Methods A retrospective analysis was made of the clinical data of 150 elderly MHD patients with tuberculosis admitted to Nanjing Hospital Affiliated to Nanjing University of Traditional Chinese Medicine from November 2020 to October 2023. The nutritional risk scale 2002 (NRS2002), general self-efficacy scale (GSES) and 36-item short form health survey (SF-36) were used to assess the nutritional risk, self-efficacy and quality of life scores of the patients, respectively. SPSS 26.0 was used for data analysis. According to the data type, t test or analysis of variance was used for comparison between groups. Pearson correlation analysis was used to evaluate the linear relationship between nutritional status and quality of life, and between self-efficacy and quality of life in elderly MHD patients with tuberculosis. Multivariate logistic regression model was used to analyze the factors influencing quality of life in elderly MHD patients with tuberculosis. Results The patients scored (4.85±1.39) points for NRS2002, (16.46±2.89) points for GSES, and (59.68±5.44) points for quality of life. Pearson correlation analysis showed that the score of NRS2002 was negatively correlated with the score of quality of life (r=-0.582; P<0.05) in elderly MHD patients with tuberculosis, and the score of self-efficacy was positively correlated with the score of quality of life (r=0.539; P<0.05). The multivariate logistic regression analysis showed that the average annual family income (OR=2.861,95%CI 1.507-5.430), treatment payment method (OR=3.093,95%CI 1.363-7.017), NRS2002 score (OR=0.378,95%CI 0.191-0.748) and GSES score (OR=3.013,95%CI 1.389-6.535) were the factors influencing quality of life in elderly MHD patients with tuberculosis (P<0.05). Conclusion The nutritional level and self-efficacy of elderly MHD patients with tuberculosis are factors that affect their quality of life. Assessing the nutritional status and self-efficacy of patients and providing relevant interventions are important for improving the quality of life of patients.

Abstract:Objective To evaluate the nutritional status in elderly patients with acute pancreatitis (AP) and analyze its relationship with immune function and prognosis. Methods A total of 122 elderly AP patients admitted in Department of Hepatobiliary and Pancreatic Surgery of our hospital from July 2021 to December 2023 were recruited, and divided into mild, moderate and severe groups according to the severity of AP (51,39 and 32 cases, respectively). The nutritional status [albumin (ALB) and transferrin (TRF) levels, geriatric nutritional risk index (GNRI)] and immune function (CD4⁺ and CD8⁺, and CD4⁺/CD8⁺) were compared among the three groups. Based on their clinical outcomes within 28 d after admission, they were assigned into survival group (110 cases) and death group (12 cases). SPSS statistics 24.0 software was used to process and analyze the data. Pearson correlation coefficient analysis was employed for correlation analysis, and receiver operating characteristic (ROC) curve was adopted to assess the predictive value of nutritional status and immune function indicators on death of elderly AP patients. Results There were statistical differences in ALB, GNRI, TRF, CD4⁺ and CD4⁺/CD8+ at admission among elderly patients with different severities of AP (P<0.05), and the above indicators were significantly lower in the severe group than the mild group and moderate group (P<0.05), and in the moderate group than the mild group (P<0.05). Pearson correlation coefficient analysis showed that ALB, GNRI and TRF were positively correlated with CD4⁺ and CD4⁺/CD8+ in elderly AP patients (P<0.05). At admission, the ALB, GNRI, TRF, CD4⁺ and CD4⁺/CD8⁺ in death group were significantly lower than those in survival group, and the differences were statistically significant (P<0.05 for all). ROC curve revealed that AUC value of ALB, GNRI, TRF, CD4⁺ and CD4⁺/CD8⁺ at admission in predicting death of elderly AP patients was 0.843 (95%CI 0.717-0.969, P<0.05), 0.741 (95%CI 0.597-0.884, P<0.05), 0.732 (95%CI 0.594-0.870, P<0.05), 0.796 (95%CI 0.669-0.923, P<0.05), and 0.911 (95%CI 0.848-0.974, P<0.05); optimum cut-off value was 31.97g/L, 88.25、2.08g/L, 36.37% and 1.59, respectively. The value was as high as 0.947 (95%CI 0.906-0.998, P<0.05) when the above five indicators combined together. Conclusion Malnutrition and immunosuppression promote the disease progression in elderly AP patients, and the nutritional status is closely associated with their immune function. Detecting ALB, GNRI, TRF, CD4⁺ and CD4⁺/CD8⁺ at admission is of significance in prediction of death in the patients.

Abstract:Objective To investigate the occurrence and influencing factors of postoperative symptom clusters in elderly patients with lung cancer. Methods A total of 150 elderly patients with lung cancer admitted to our hospital from January 2022 to March 2023 were recruited and surveyed with the lung cancer module of M.D.Anderson symptom inventory-Chinese (MDASI-C) for the occurrence of postoperative symptom clusters. SPSS statistics 20.0 was used for statistical analysis. Data comparison was performed using t test or ANOVA depending on data type. Multivariate logistic regression analysis was employed to identify the influencing factors for the occurrence of postoperative symptom clusters in elderly patients with lung cancer. Results The analysis on clinical symptoms found that fatigue, decreased appetite and nausea were most common symptoms in the patients. The symptoms with higher severity score were pain, fatigue, sleep disturbance, anorexia, forgetfulness and mouth dryness. Multivariate logistic regression analysis showed that platelet count <100×10⁹/L (OR=3.931,95%CI 1.185-13.047), alanine aminotransferase (ALT) ≥40 U/L (OR=4.125,95%CI 1.198-14.207), white blood cell count >10×10⁹/L (OR=3.248,95%CI 1.191-8.860), per capita monthly family income <2000 yuan (OR=3.912,95%CI 1.379-11.098), and duration of chest tube retention ≥3 d (OR=5.228,95%CI 1.298~21.064) were independent risk factors for postoperative symptoms in elderly patients with lung cancer (P<0.05). Conclusion There are various postoperative symptom clusters in elderly patients with lung cancer. Pain, fatigue, sleep disturbance, anorexia, forgetfulness and dry mouth are serious symptoms. Clinical intervention should be strengthened for related patients to implement effective management of symptom clusters.

Abstract:Objective To explore the association between severity of coronary artery lesions and risk of tumors in patients with coronary artery disease (CAD). Methods Data that met the inclusion and exclusion criteria were retrieved from CAD patients who underwent coronary angiography for the first time in the Department of Cardiology of the First Medical Centre, Chinese PLA General Hospital, from January 2011 to December 2015. A total of 4625 patients were randomly selected for clinical data and were followed up until December 31,2023. A retrospective cohort study was conducted of 4085 patients who were successfully followed up. The Gensini scoring was performed based on findings of coronary angiography. The upper quartile of the Gensini score (53 points) was set as the cutoff point. The patients were divided into high Gensini score group (n=1022; Gensini score≥53 points) and low Gensini score group (n=3063; Gensini scores<53 points). SPSS 26.0 was used for data analysis. The t test, Mann-Whitney U test, orχ² test was used for inter-group comparison based on data types. Kaplan-Meier survival curve was used to assess the cumulative risk of cancer in patients with different severity of coronary artery lesions. Cox regression analysis was used to explore the correlation between severity of coronary artery lesions and the risk of tumors in CAD patients. Results During a median follow-up of 8.0 years, 174 out of 4085 (4.3%) CAD patients developed tumors. The cumulative tumor incidence was significantly higher in the high Gensini score group than that in the low Gensini score group (Log-rank P=0.008). A significant positive correlation was found between the severity of coronary artery lesions and the risk of tumors in CAD patients (HR=1.560,95%CI 1.128-2.159; P=0.007). Conclusion The severity of CAD is correlated with the risk of tumors in CAD patients. Patients with high severity of coronary artery lesions have an increased risk of tumors.

Abstract:Objective To observe the alterations in the methylation of brain derived neurotrophic factor (BDNF) gene promoter region and its expression level in peripheral blood of Parkinson′s disease (PD) patients, and analyze their correlation in order to explore the pathogenesis of PD from the perspective of epigenetic regulation. Methods A total of 54 PD patients (PD group) admitted to the First Affiliated Hospital of Baotou Medical College from September 2020 to October 2023 were enrolled, and another 51 healthy individuals who taking physical examination in the hospital during same period served as control group. Methylation-specific polymerase chain reaction (MS-PCR) was applied to assess the methylation status of peripheral BDNF promoter, and quantitative real-time polymerase chain reaction (Q-PCR) was conducted to determine the mRNA expression of BDNF in peripheral blood. SPSS statistics 20.0 was used for data analysis. Depending on data type, t test or Mann-Whitney U test was used for inter-group comparison. Spearman rank correlation analysis was employed to analyze the correlation between the methylation level of BDNF gene promoter region and mRNA expression. Pearson correlation analysis was utilized to analyze the correlation of BDNF mRNA level with the total score, motor symptom score and non-motor symptom score of unified Parkinson′s disease rating scale (UPDRS). Binary logistic regression model was built to identify the influencing factors for PD incidence. Results The methylation rate of peripheral BDNF promoter was significantly higher in the PD group than the control group, and the rate was also higher in the PD patients in mid-to-late stage than those in early stage (P<0.05). The PD patients exhibited significantly lower expression level of peripheral blood BDNF than the control group, and the level was notably lower in mid-to-late-stage PD patients than the early-stage PD patients (P<0.05). In PD group, the mRNA level of BDNF in peripheral blood was negatively correlated with its promoter methylation level (r=-0.928; P<0.001), and the total score, motor symptom score and non-motor symptom score of UPDRS (r=-0.461, -0.429, -0.298; P<0.05). Binary logistic regression analysis showed that the methylation status of BDNF promoter was a risk factor for PD (OR=3.887,95%CI 1.035-14.597; P=0.044), and triglyceride was a protective factor for PD (OR=0.392,95%CI 0.155-0.997; P=0.049). Conclusion In PD patients, peripheral BDNF promoter is abnormally hypermethylated, its mRNA expression is down-regulated, and there is a negative correlation between the two indicators. It is suggested that abnormal promoter hypermethylation of BDNF may be involved in the occurrence and development of PD by down-regulating its expression.

Abstract:Objective To analyze and compare the quality of life (QoL) before and after surgery in elderly patients with bladder tumors and to evaluate the influencing factors of poor QoL. Methods A prospective questionnaire survey was conducted on 158 elderly patients with non-muscle invasive bladder cancer (NMIBC), who received transurethral resection of bladder tumor (TURBT) in People′ s Hospital of Xinjiang Uygur Autonomous Region from June 2021 to September 2023. European Organization for Research and Treatment of Cancer-Quality of Life in superficial bladder cancer patients (EORTC QLQ-BLS24) was used to evaluate the patients′ QoL before surgery, and at 1 month and 3 months after surgery. Finally, 147 patients completed questionnaires three times. The total EORTC QLQ-BLS24 score in the 147 elderly NMIBC patients was (160.72±17.43) points at 1 month after surgery. According to this score, the patients were divided into a good QoL group (total QLQ-BLS24 score ≤ average, n=75) and a poor QoL group (total QLQ-BLS24 score > average, n=72). The two groups were compared in general data including gender, age, and preoperative geriatric nutritional risk index (GNRI). SPSS 26.0 was used for statistical analysis. Comparison between two groups was performed using t test, Chi-square test or Fisher′s exact probability method depending on data type. Logistic regression analysis was used to evaluate the influencing factors of poor QoL in elderly NMIBC patients at 1 month after TURBT. Results At 1 month after TURBT, the scores of urinary tract symptom, treatment problems, intestinal symptom, sexual function, and total scores of EORTC QLQ-BLS24 in elderly NMIBC patients were significantly higher than those before surgery and at 3 months after surgery (P<0.05), and the score of worrying about the future was lower than that before surgery (P<0.05), but was higher than that at 3 months after surgery (P<0.05). There were statistically significant differences in preoperative GNRI, intravesical instillation regimen, adverse reactions to intravesical instillation, and anxiety between the poor QoL group and good QoL group (P<0.05). Logistic regression analysis showed that preoperative GNRI≤98 (OR=3.397,95%CI 2.073-5.567; P<0.05), adverse reactions to intravesical instillation (OR=2.776,95%CI 1.517-5.081; P<0.05) and anxiety (OR=2.326,95%CI 1.186-4.560; P<0.05) were risk factors for poor QoL at 1 month after TURBT. Gemcitabine intravesical instillation was a protective factor (OR=0.566,95%CI 0.013-0.924; P<0.05). Conclusion QoL in elderly NMIBC patients declines initially at 1 month after TURBT and improves by 3 months. Preoperative GNRI≤98, adverse reactions to intravesical instillation, and anxiety are risk factors for poor postoperative QoL. Gemcitabine intravesical instillation can improve postoperative QoL.

Abstract:Objective To explore the correlation of loneliness with social avoidance and quality of life in elderly patients with hemiplegia after hypertensive cerebral hemorrhage. Methods A retrospective analysis was conducted on 240 hemiplegia patients after hypertensive cerebral hemorrhage admitted to Department of Neurosurgery of our hospital from July 2020 to July 2023. According to the severity of hemiplegia, they were divided into mild group (n=84), moderate group (n=109) and severe group (n=47). Social avoidance scale, loneliness scale and World Health Organization Quality of Life Scale were used to evaluate their social avoidance, loneliness and quality of life. SPSS statistics 20.0 was used for statistical analysis. Data comparison between two groups was performed using LSD-t test, Wilcoxon test, χ² test or F test depending on data type. Pearson correlation analysis was employed to analyze the correlation of loneliness with social avoidance and quality of life in the patients. Spearman analysis was applied to analyze the correlation of loneliness, social avoidance and quality of life with severity of the condition. Results Among the patients with different severities of hemiplegia after hypertensive cerebral hemorrhage, there were significant differences in social avoidance, social distress and total score (F=113.224,130.427,217.624; P<0.05), in the scores of interpersonal communication, subjective feeling, communication ability, self-cognition and total score (F=461.700,559.952,377.621,280.156,510.410; P<0.05), and in environmental, social, psychological and physiological scores and total score (F=163.106,113.470,72.978,80.031,101.783; P<0.05). Loneliness in the elderly hemiplegia patients was positively correlated with social avoidance and the severity of hemiplegia (r=0.669,0.873; P<0.05), and negatively with quality of life (r=-0.566; P<0.05). Social avoidance was negatively correlated with quality of life (r=-0.547; P<0.05), and positively with the severity of hemiplegia (r=0.810; P<0.05). The quality of life was negatively correlated with the severity of hemiplegia (r=-0.681; P<0.05). Conclusion In the elderly hemiplegia patients after hypertensive cerebral hemorrhage, loneliness is significantly correlated with social avoidance and quality of life. In clinical practice, besides treatment for the main symptoms, clinicians should actively pay attention to loneliness in these elderly patients and intervene it in time to improve their quality of life and social ability.

Abstract:Objective To explore the risk factors of biloma in elderly patients with primary hepatocellular carcinoma after interventional surgery. Methods A total of 632 elderly patients who underwent transcatheter arterial chemoembolization (TACE) for primary hepatocellular carcinoma (HCC) in Changzhi People′s Hospital affiliated to Changzhi Medical College from January 2021 to March 2023 were selected as the study subjects. They were followed up for 6 months, and 14 cases were lost to follow-up. According to whether they developed biloma after TACE, the patients were divided into biloma group (n=46) and non-biloma group (n=572). The general data such as gender, age, Child-Pugh grading, gamma-glutamyl transferase (GGT) and alkaline phosphatase (ALP) were compared between groups. SPSS 24.0 was used for data analysis. According to the data type, t test, Chi-square test or Fisher exact probability method was used for data comparison. Logistic regression analysis was used to evaluate the risk factors of biloma after TACE in elderly patients with primary HCC. Results The incidence of biloma after TACE was 7.44% (46/618) in 618 elderly patients with primary HCC. The incidence rate of preoperative biliary tract dilatation, the proportion of intraoperative use of polyvinyl alcohol particle, and the abnormal increase rates of GGT and ALP at one week after surgery in the biloma group were higher than those in the non-biloma group (P<0.05). Among the 46 patients with biloma, 36 (78.26%) were asymptomatic, among whom one had enlarged bilioma during follow-up and shrank after percutaneous biloma drainage. The other asymptomatic patients had no change or did not shrink. Ten (21.74%) patients had fever and jaundice. After percutaneous biloma drainage, biloma shrank in eight patients, disappeared in one, and shrank in one after percutaneous transhepatic biliary drainage due to poor drainage effect. Logistic regression analysis showed that preoperative biliary tract dilatation (OR=2.542,95%CI 1.503-4.300; P<0.05), intraoperative use of polyvinyl alcohol particle (OR=3.391,95%CI 2.145-5.360; P<0.05), abnormal increase of GGT at one week after surgery (OR=2.056,95%CI 1.049-4.031; P<0.05), and abnormal increase of ALP at one week after surgery (OR=2.450,95%CI 1.380-4.350; P<0.05) were risk factors of biloma in elderly patients with primary HCC after TACE. Conclusion Preoperative biliary tract dilatation, embolization with polyvinyl alcohol particle, and abnormal increases of GGT and ALP at one week after surgery are risk factors of biloma in elderly patients with primary HCC after TACE. Accordingly, it is necessary to formulate clinical prevention and control measures in order to improve the prognosis of patients.

Abstract:Objective To analyze the correlation of postoperative physical fitness with mental health and quality of life in elderly patients with non-small cell lung cancer (NSCLC), and to analyze the influencing factors for poor physical fitness. Methods A questionnaire survey was conducted on 132 elderly NSCLC patients who underwent thoracoscopic lobectomy in our hospital from March 2021 to August 2023. All patients received routine rehabilitation interventions such as early activity and deep breathing training after surgery. The general demographic questionnaire, Karnofsky performance status (KPS), Edmonton frailty scale, self-rating anxiety scale (SAS), self-rating depression scale (SDS), Tampa scale of kinesiophobia (TSK) and functional assessment of cancer therapy-lung (FACT-L) were used to investigate the patients at three month after surgery. Totally 126 valid questionnaires were recovered, with an effective recovery rate of 95.45%. According to KPS score, the 126 patients were divided into good physical fitness group (KPS score ≥70 points) and poor physical fitness group (KPS score <70 points). 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 applied to evaluate the influencing factors of postoperative poor physical fitness in elderly NSCLC patients. Pearson correlation coefficient was adopted to evaluate the correlation between postoperative physical fitness and mental health as well as quality of life. Results Logistic regression analysis showed that frailty (OR=3.040,95%CI 1.731-5.342), anxiety (OR=2.450,95%CI 1.263-4.751), depression (OR=2.713,95%CI 1.470-5.008), and kinesiophobia (OR=2.208,95%CI 1.058-4.606) were risk factors for poor postoperative physical fitness in the elderly NSCLC patients (P<0.05). The scores of SAS, SDS and TSK were significantly higher (P<0.05), while the FACT-L score was obviously lower in the poor physical fitness group than the good physical fitness group (P<0.05). Pearson correlation coefficient analysis indicated that the KPS score at three months after surgery was negatively correlated with the scores of SAS, SDS and TSK (r=-0.566, -0.630, -0.549; P<0.05), and was positively correlated with FACT-L score (r=0.607; P<0.05). Conclusion Poor postoperative physical fitness can lead to a decline in quality of life in elderly NSCLC patients. Frailty, anxiety, depression and kinesiophobia are the key factors causing poor postoperative physical fitness in them, so it is necessary to take targeted prevention and control measures in clinical practice.

Abstract:Objective To investigate the effects of T lymphocyte subsets and nutritional status on the prognosis of elderly patients after severe craniocerebral injury. Methods The clinical data of 109 elderly patients with severe craniocerebral injury admitted to our hospital between May 2022 to December 2023 were retrospectively collected and analyzed. According to the Glasgow outcome scale (GOS) in three months after discharge, they were divided into good prognosis group (n=56) and poor prognosis group (n=53). The clinical data were compared between the two groups, including basic data, T lymphocyte subsets and nutritional status [nutritional risk screening 2002 (NRS2002) score and serum albumin (ALB) levels]. SPSS statistics 26.0 was used for statistical analysis, and t test or χ² test was employed for intergroup comparison depending on data type. Multivariate logistic regression analysis was utilized to identify the factors affecting the prognosis of these elderly patients. Results The poor prognosis group had significantly smaller percentage of CD4⁺ T lymphocytes but larger percentage of CD8⁺ T cells, and lower CD4⁺/CD8⁺ level than the good prognosis group (all P<0.05). Obviously larger ratio of the patients with NRS2002 score ≥3 points, higher NRS2002 score, and lower ALB level were observed in the poor prognosis group when compared with the good prognosis group (all P<0.05). The Glasgow coma scale (GCS) was notably lower, and the intracranial hematoma, blood glucose level, systolic blood pressure (SBP) and diastolic blood pressure (DBP) at admission were markedly higher in the poor prognosis group than the good prognosis group (all P<0.05). Multivariate logistic regression analysis showed that CD4⁺/CD8⁺ (OR=2.849,95%CI 1.329-6.107), NRS2002 score (OR=0.312,95%CI 0.131-0.742), ALB level (OR=3.959,95%CI 1.434-10.927), baseline GCS score (OR=3.607,95%CI 1.538-8.462), intracranial hematoma (OR=0.330,95%CI0.150-0.724), baseline blood glucose (OR=0.370,95%CI 0.177-0.774) and SBP at admission (OR=0.298,95%CI 0.132-0.673) were influencing factors for prognosis of elderly patients with severe craniocerebral injury (P<0.05). Conclusion T lymphocyte subset and nutritional status are influencing factors for the prognosis of elderly patients with severe craniocerebral injury. Enhancing the immune function and nutritional status may improve prognosis of the patients.

Abstract:Objective To explore the potential link between liver injury caused by high-altitude hypoxic environment and nuclear factor E2-related factor 2 (NRF2) in rats. Methods Wistar rat model of hypoxic liver injury was constructed in a plateau simulation chamber (simulated altitude of 6 000 m). The expression of NRF2 was regulated by intraperitoneal injection of the NRF2-specific agonist-tert-butyl hydroquinone (TBHQ), 30 mg/(kg·d). The subjected Wistar rats were then divided into a control group (normoxic condition), high-altitude/hypoxia (HH) group, and hypoxia combined with TBHQ treatment (HH+TBHQ) group. HE staining and liver index were used to assess the pathological structural changes in rat liver. ELISA was employed to determine the oxidative stress and antioxidant capacity (MDA/SOD) in rat peripheral blood and liver tissues. The generation of reactive oxygen species (ROS) in the liver tissues was assessed by DHE probe, and cell apoptosis in the liver was detected by TUNEL staining. The mRNA and protein levels of NRF2 were determined by RT-qPCR and Western blotting, respectively. GraphPad Prism 8.0.1 was applied for statistical analysis. Intergroup comparison was performed using t test or one-way analysis of variance depending on data type. Results Compared with the control group, the HH group had significantly higher liver index (P<0.001), damaged liver tissue observed by HE staining, elevated liver ALT (P<0.001) and AST (P<0.05) contents, as well as ROS level (P<0.001), enhanced lipid peroxidation (P<0.05) but declined antioxidant capacity in both serum and liver tissues (P<0.05). TBHQ treatment resulted in obvious increases in both mRNA and protein expression of NRF2 in the liver tissues (P<0.001), decreased liver index (P<0.05), alleviation of structural damage in liver cells, decreases in serum ALT (P<0.01) and AST (P<0.01) levels, reduced ROS level (P<0.01), declined lipid peroxidation (P<0.01) but enhanced antioxidant capacity in both serum and liver tissues (P<0.05), when compared with the rats in the HH group. TUNEL staining indicated that the apoptosis in liver cells was significantly increased in the HH group than the control group (P<0.01), and the apoptotic level was notably decreased in the HH+TBHQ group (P<0.01). Conclusion Exposure to high-altitude hypoxic condition causes liver injury and declined liver function, which is accompanied by increases in NRF2 level and cell apoptosis. However, up-regulation of NRF2 can alleviate liver injury by reducing hepatocytic apoptosis.

Abstract:Social frailty refers to the gradual weakening of the social function of the elderly, manifested as reduced social relations, diminished social participation, and inadequate social support. Influencing factors include individual factors (e.g., health, economic status), family factors (e.g., family support, family structure), and social environmental factors (e.g., social welfare policies, cultural environment). Social frailty can exacerbate physical and mental health problems and seriously affect the quality of life of the elderly people. Timely intervention can help reverse this condition. In this article, we reviewed the status quo of social frailty in the elderly and its influencing factors by referring to relevant literature at home and abroad.

Abstract:Psychological insulin resistance may cause refuse or nonadherence to insulin therapy in patients with type 2 diabetes mellitus (T2DM), which leading to exacerbation of the condition. Recognizing and addressing psychological insulin resistance is crucial for improving treatment adherence and enhancing the quality of life in the patients. In this article, we provided a comprehensive review on the concept, current status, and influencing factors of psychological insulin resistance, as well as evaluation tools and intervention measures. We aimed at raising clinical awareness of its significance, optimizing blood glucose control, and reducing the incidence of complications in order to provide a theoretical framework for enhancing therapeutic efficacy and quality of life among T2DM patients.

Abstract:Demoralization syndrome and suicidal ideation are important risk factors affecting the quality of life and prognosis of cancer patients, and with the development of palliative care, comprehensive and precise suicide prevention has become an important prerequisite to improve the quality of life of the patients. The relationship between demoralization syndrome and suicidal ideation has not yet been clarified, and still needs further research. In this article, from the perspective of the concepts of demoralization syndrome and suicidal ideation, their relationship, possible action mechanism, and prevention and intervention strategies, we summarized the potential mechanism of their interaction in cancer patients, aiming to provide a reference for identifying high-risk population and implementing early intervention.

Abstract:Hip fractures are common traumatic injuries in the elderly and poses a serious public health problem. Preoperative anemia is prevalent in elderly hip fracture patient. Studies have shown that preoperative anemia is associated with postoperative infection and cardiovascular events in these patients and also impacts hospital stay, postoperative mortality, lower limb mobility, and ability of daily living. In this article, we reviewed the epidemiology of preoperative anemia in elderly hip fracture patients and recent research progress in its effects on complications and prognosis.