Volume 25,2026 Issue 3

Clinical Research

• Application of ultrasound-guided percutaneous transhepatic gallbladder drainage in treatment of acute cholecystitis in the elderly

  Wang Juanjuan, Hou Qingbing, Yuan Zhongxu, Lu Qifang, Zhang Hongwei

  2026,25(3):161-165, DOI: 10.11915/j.issn.1671-5403.2026.03.035

  Abstract: (111) HTML (0) PDF (422.08 KB)(243)

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  Objective To explore the application value of ultrasound-guided percutaneous transhepatic gallbladder drainage (PTGD) in the treatment of acute cholecystitis and sequential laparoscopic cholecystectomy(LC) surgery in the elderly. Methods A total of 41 elderly patients who underwent PTGD and sequential LC at Anhui Provincial Second People′s Hospital from June 2020 to January 2025 were selected as the observation group. The patients′ clinical data, inflammatory indicators [white blood cell (WBC), neutrophils (NEU) and C-reactive protein (CRP)], and liver function indicators [albumin (ALB), total bilirubin (TBIL), serum amylase (AMS), alanine aminotransferase (ALT), aspartate transaminase (AST), gamma-glutamyl transferase (GGT)] before and after PTGD were compared. Another 45 elderly AC patients who underwent direct LC were selected as the control group. The general data before treatment, as well as intraoperative and postoperative clinical data of LC were compared between the two groups. SPSS statistics 25.0 was used for statistical analysis. Data comparison between two groups was performed using t test, Mann-Whitney U test,χ² test, or Fisher′s exact probability method depending on the data type. Results Before the treatment, WBC, NEU, ALT and treatment costs were higher in the observation group than the control group (P<0.05); there were statistically significant differences between the two groups in terms of cardiovascular system, nervous system, respiratory system diseases, uncontrolled diabetes, and recent thrombolysis therapy history (P<0.05). All patients in the observation group achieved successful one-time catheter placement. Compared with preopera-tively, there were statistically significant differences in body temperature, abdominal pain symptoms, WBC, NEU, CRP, TBIL, ALT and AST at 3 d after PTGD (P<0.05). Except for a few patients with underlying liver diseases, liver function returned to normal in the others at 2 weeks after PTGD, with statistically significant differences (P<0.05). Pericholecystic adhesions, LC operation time, intraoperative blood loss, time to ambulation, and length of hospital stay in the observation group were significantly lower than those in the control group (P<0.05). There were no statistically significant differences in complication rates and conversion to open surgery rate (P>0.05). Conclusion PTGD can rapidly alleviate AC symptoms in elderly patients, reduce inflammatory response, and lower liver function indicators. Meanwhile, it can create favorable surgical conditions for later LC, reduce surgical injury and promote faster recovery for patients.

• Correlation between blood pressure variability within 24 h of admission and early disease progression in elderly patients with acute mild ischemic stroke complicated with hypertension

  Song Yingjie, Zhang Zhijuan, Yu Quntao, Gao Wenyong

  2026,25(3):166-172, DOI: 10.11915/j.issn.1671-5403.2026.03.036

  Abstract: (89) HTML (0) PDF (508.05 KB)(227)

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  Objective To investigate the correlation between blood pressure variability (BPV) within 24 hours of admission and early disease progression in elderly patients with acute mild ischemic stroke (MIS) complicated with hypertension. Methods A retrospective analysis was conducted of the clinical data of 120 elderly MIS patients with hypertension in Hankou Hospital, Wuhan University of Science and Technology from August 2024 to October 2024. The patients were divided into a disease progression group and a control group based on whether their National Institutes of Health Stroke Scale (NIHSS) score increased by ≥ 2 points from the baseline at admission at any time within 3 d of admission. The 24-hour ambulatory blood pressure monitoring data were collected, recording standard deviation (SD), coefficient of variation (CV), average real variability (average of the sum of the absolute differences between adjacent blood pressure values), and range (difference between the maximum and minimum values) of the systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean blood pressure. Data on patient age, gender, laboratory test indicators, and imaging findings were also collected. A binary logistic regression model was used to analyze factors affecting early disease progression in elderly MIS patients with hypertension. Receiver operating characteristic (ROC) curves were plotted to analyze the value of blood pressure variability on predicting early progression of disease. Data analysis was performed by using SPSS statistics 26.0, and t test or Chi-square test was performed according to the data type. Results Among the 120 elderly MIS patients, 42 (35.00%) experienced disease progression by the 3^rd day after admission. Comparison found that the NIHSS score at admission, the proportion of patients with leukoaraiosis, SBP-CV, and SBP-SD in the progression group were higher than those in the control group, and there was a significant difference in the Trial of Org 10172 in acute stroke treatment classification (TOAST) between the two groups (P<0.05). Using whether the disease progressed within 3 d of admission as the dependent variable, binary logistic multivariate regression analysis indicated that NIHSS score at admission (OR=1.510, 95%CI 1.053-2.165), TOAST atherosclerotic type (OR=1.972, 95%CI 1.173-3.315), concurrent leukoaraiosis (OR=2.040, 95%CI 1.169-3.560), and SBP-CV (OR=2.323, 95%CI 1.610-3.352) were risk factors for disease progression, and that TOAST cardiogenic type (OR=0.200, 95%CI 0.081-0.490) was a protective factor. Correlation analysis indicated that SBP-CV and SBP-SD were positively correlated with NIHSS score on the 3^rd day of admission (r=0.463,0.356; both P<0.001). ROC curve analysis found that the area under the curve (AUC) for SBD-CV in predicting early disease progression in MIS patients was 0.804. When the SBP-CV cut-off value was 4.97, the Youden index was the maximal, with a predictive sensitivity of 0.786 and a specificity of 0.705. Conclusion NIHSS score at admission, TOAST typing, leukoaraiosis, and SBP-CV are factors affecting early neurological deterioration in elderly MIS patients. When SBP-CV≥4.97, it has high value in predicting early neurological deterioration.

• Influencing factors of fall risk in 6 537 elderly individuals from a tertiary hospital in Beijing

  Liu Linan, Yang Hua, Zhao Junyu, Li Ning, Ku Hong′an, Xiao Hongju

  2026,25(3):173-178, DOI: 10.11915/j.issn.1671-5403.2026.03.037

  Abstract: (104) HTML (0) PDF (417.80 KB)(203)

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  Objective To investigate the risk factors for falls among elderly individuals admitted to a tertiary hospital and to provide a reference for the formulation of fall prevention programs. Methods A total of 6 537 adults aged 60 years and above who visited the multidisciplinary fall prevention clinic at First Medical Center of Chinese PLA General Hospital between June 2021 and October 2023 were enrolled. Based on the occurrence of falls, the participants were divided into a fall group (913 cases) and a non-fall group (5 624 cases). General information, disease history, and medication history were collected. Sensory and physical functions were assessed. Statistical analysis was performed using SPSS 26.0. Chi-square test or t test was used for intergroup comparison depending on data type. Multivariate logistic regression model was employed to analyze the influencing factors for falls in the elderly. Results Among the 6 537 participants, 913 (13.97%) reported falls. Univariate analysis showed that there were statistical differences between those fell and those didn′t fall in terms of gender, age, education level, proportions of hypotension, diabetes, osteoporosis, neurological diseases, degenerative joint disease, and abnormal sensation in the lower limbs or feet, and failures in balance and lower limb muscle strength (all P<0.05). Multivariate logistic regression analysis indicated that high school (OR=1.708,95%CI 1.359-2.146),college degree and above (OR=2.582,95%CI 2.150-3.101), female (OR=1.563,95%CI 1.328-1.840), aged 70-80 years (OR=1.264,95%CI 1.060-1.506), visual impairment (OR=1.297,95%CI 1.101-1.529), abnormal sensation in lower limbs or feet (OR=1.604, 95%CI 1.363-1.886), failure in the four-stage balance test (OR=1.300,95%CI 1.087-1.555), failure in the five times-sit-to-stand Test (OR=1.263,95%CI 1.055-1.512), neurological diseases (OR=1.407,95%CI 1.130-1.753), degenerative joint disease (OR=1.580,95%CI 1.304-1.914), polypharmacy (OR=1.578,95%CI 1.268-1.965), and nocturia three or more times at night (OR=1.673,95%CI 1.378-2.030) were risk factors for falls (P<0.05). Living with spouse, children, or others (OR=0.647, 95%CI 0.497-0.842) and living in a nursing home (OR=0.503,95%CI 0.307-0.825) were protective factors against falls (P<0.05). Conclusion Advanced age, female, high school and above, sensory impairment, nocturia, polypharmacy, declined muscle strength, balance dysfunction, neurological diseases, and degenerative joint disease are independent risk factors for falls in the elderly. Targeted screening and precise interventions should be enhanced for these high-risk populations.

• Efficacy of traditional Chinese medicine smear and wet compress combined with infrared irradiation and Western medicine in treatment of senile rheumatoid arthritis with damp-heat arthralgia type

  Mi Hongming, Gao Xiang, Meng Jinhui, Zhao Na

  2026,25(3):179-183, DOI: 10.11915/j.issn.1671-5403.2026.03.038

  Abstract: (78) HTML (0) PDF (422.64 KB)(212)

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  Objective To explore the clinical efficacy of traditional Chinese medicine (TCM) smear and wet compress combined with infrared irradiation and Western medicine in elderly rheumatoid arthritis (RA) patients with damp-heat arthralgia type. Methods A total of 140 elderly eligible patients admitted to our hospital from March 2022 to March 2024 were selected and divided into two groups according to different treatment methods. The control group (n=70) received conventional Western medicine treatment, while the study group (n=70) received TCM smear and wet compress combined with infrared irradiation and Western medicine treatment. The therapeutic effects, TCM syndrome scores, disease activity score in 28 joints (DAS28), visual analogue scale (VAS) scores, erythrocyte sedimentation rate (ESR), levels of rheumatoid factor (RF) and inflammatory factors [tumor necrosis factor-α(TNF-α), interleukin 6 (IL-6), and C-reactive protein (CRP)], and incidence of adverse reactions were compared between the two groups. SPSS statistics 26.0 was applied for data process. Depending on data type, t test andχ² test were used for comparison between groups. Results After treatment, the total effective rate was 92.86% (65/70) in the study group, and 80.00% (56/70) in the control group, with that of the study group significantly higher than that of the control group (P<0.05). The study group exhibited obviously lower TCM syndrome score, DAS28 and VAS score, ESR, RF, TNF-α, IL-6 and CRP levels than the control group [(5.41±1.03) vs (7.94±1.50) points, (2.28±0.51) vs (3.01±0.93) points, (2.02±0.37) vs (3.40±0.85) points, (22.08±4.13) vs (29.15±5.91) mm/h, (72.49±10.41) vs (91.08±15.37) IU/ml, (23.04±2.95) vs (30.01±4.25) μg/L, (20.41±2.39) vs (26.95±3.08) ng/L, (12.19±1.17) vs (18.75±2.94) mg/L; P<0.05]. There was no statistical difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion TCM smear and wet compress combined with infrared irradiation and Western medicine shows definite efficacy in elderly RA patients with damp-heat arthralgia type, and obviously improve symptoms, reduces pain and significantly suppresses inflammation.

• Health-related status of elderly patients with lateral skull base-related head and neck malignant tumors at six months after surgery

  Zhou Min, Qi Meihao, Yao Min, Zha Dingjun

  2026,25(3):184-188, DOI: 10.11915/j.issn.1671-5403.2026.03.039

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  Objective To survey the health-related status of patients with lateral skull base-related head and neck malignant tumors at six months after surgery. Methods A total of 78 elderly patients with lateral skull base-related head and neck malignant tumors admitted to our hospital from January 2021 to January 2024 were recruited in this study. Quality of Life specific Scale for Cancer Patients was used to assess the health-related status in the patients before and at six months after surgery. Based on the results six months postoperatively, the patients were divided into a poor health-related status group (n=37) and a control group (n=35). Binary logistic regression model was adopted to analyze the related factors affecting the postoperative health-related status. SPSS statistics 27.0 was employed for statistical analysis. Data comparison between two groups was performed using t test or χ² test depending on data type. ResultsAmong the 78 elderly patients, 72 cases completed the relevant survey, with an effective recovery rate of 92.31%. The scores of physical function, psychological function and symptom/side effects and the total score of the scale were increased after surgery when compared with those before surgery (P<0.05). The postoperative overall health-related status was at a general level in these patients, and there were 15 cases (20.83%) with good health-related status, 20 cases (27.78%) with general health-related status and 37 cases (51.39%) with poor health-related status. The poor status group had significantly larger proportions of mesenchymal malignant tumors, re-treatment and anxiety, and lower proportions of postoperative radiotherapy/chemotherapy and having high social support level than the control group (all P<0.05). Taking the health-related status of these patients at six months after surgery as the dependent variable (general/good=0, poor=1), binary logistic regression analysis revealed that re-treatment (OR=1.846,95%CI 1.140-2.990) and anxiety (OR=1.292,95%CI 1.109-1.505) were risk factors for poor status, and postoperative radiotherapy/chemotherapy (OR=0.685,95%CI 0.514-0.911) and high social support level (OR=0.840,95%CI 0.783-0.902) were protective factors (P<0.05). Conclusion Though the postoperative health-related status is improved in elderly patients with lateral skull base-related head and neck malignant tumors, the ratio of poor status is still high. Re-treatment, anxiety, postoperative radiotherapy/chemotherapy and social support level are related factors affecting the postoperative health-related status of patients. It is suggested that clinical intervention measures should be formulated to improve the health-related status of these patients after surgery.

• Influencing factors and prognostic implications of multimorbidity among community-dwelling elderly adults in Nantong

  Jiang Ying, Zhuang Jianfen, Cai Huiping, Zhu Hongxin, Chen Yu, Wu Yan, Huang Ruming, Zhang Qing

  2026,25(3):189-194, DOI: 10.11915/j.issn.1671-5403.2026.03.040

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  Objective To investigate the influencing factors and prognosis of multimorbidity among the community-dwelling elderly in Nantong. Methods A retrospective cohort study was conducted, including 488 community-dwelling elderly residents with ≥2 chronic diseases who underwent health check-ups at the Xiaohai Subdistrict Community Health Service Center in Nantong City from January to December 2020. After excluding 16 cases lost to follow-up or with incomplete data, a total of 472 cases were finally included. Patients were categorized into three groups based on the number of comorbidities:2-disease group (n=157), 3-disease group (n=212), and ≥4-disease group (n=103). Baseline demographic characteristics and chronic disease data were collected by reviewing residents′ health records. A 3-year follow-up was conducted, with all-cause mortality as the endpoint. SPSS statistics 22.0 was used for statistical analysis. Ordinal logistic regression analysis was employed to examine the factors influencing multimorbidity in community-dwelling elderly individuals. Kaplan-Meier method was used to plot survival curves for the three groups, and log-rank test was used to compare intergroup survival differences. A Cox regression model was utilized to assess factors associated with adverse prognosis. Results Multivariate ordinal logistic regression analysis showed that age (OR=1.027,95%CI 1.000-1.055; P=0.048) and the number of medications used [with ≥ 4 medications as the reference group, no medication (OR=0.212,95%CI 0.048-0.936; P=0.041), 1 medication (OR=0.145,95%CI 0.065-0.325; P<0.001), 2 medications (OR=0.427,95% CI 0.276-0.662; P<0.001), and 3 medications (OR=0.379,95%CI 0.246-0.586; P<0.001)] were significantly correlated with multimorbidity. During a median follow-up period of 47.97 months, 80 community-dwelling elderly residents experienced all-cause mortality (event group), while 392 survived (non-event group). Kaplan-Meier survival curve analysis showed a statistically significant difference in cumulative survival time among patients with different number of comorbidities (χ²=7.236, P=0.027). Compared with those having 2 diseases, the hazard ratio for death was 1.603 (95%CI 0.968-2.654; P=0.111) for those with 3 diseases, 2.314 (95%CI 1.248-4.288; P=0.008) for those with ≥ 4 diseases, indicating a significant increase. The results of multivariate Cox regression analysis showed that age (HR=1.096,95%CI 1.056-1.138; P<0.001), multimorbidity (HR=2.096,95%CI 1.095-4.012; P=0.026), and number of medications used (HR=1.815,95%CI 1.005-3.277; P=0.048) were risk factors for death in community-dwelling elderly, while body mass index (HR=0.900,95%CI 0.841-0.663; P=0.002) and fasting plasma glucose level (HR=0.715,95%CI 0.592-0.864; P<0.001) were protective factors. Conclusion Age and number of medications used were independent factors influencing multimorbidity in community-dwelling elderly. Age, multimorbidity, and number of medications may increase their risk of death, whereas higher body mass index and fasting glucose levels may reduce the risk of death.

• Factors influencing post-traumatic stress disorder and discharge readiness among elderly stroke patients and their prediction for unplanned readmission risk

  Wang Jie, Yang Lin, Xue Donghui, Zhan Zhen

  2026,25(3):195-199, DOI: 10.11915/j.issn.1671-5403.2026.03.041

  Abstract: (77) HTML (0) PDF (397.63 KB)(205)

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  Objective To investigate the correlation between post-traumatic stress disorder (PTSD), discharge readiness and subsequent readmission in elderly stroke inpatients. Methods A retrospective analysis was conducted of general clinical data of 160 elderly stroke patients admitted to the Affiliated Brain Hospital of Nanjing Medical University from January 2022 to April 2024. The PTSD Checklist-Civilian Version (PCL-C) was used to assess PTSD, and Readiness for Hospital Discharge Scale was used to assess discharge readiness. Factors influencing PTSD and readiness for discharge were analyzed, and the relationship between PTSD, discharge readiness, and subsequent readmission among these inpatients was further analyzed. SPSS statistics 23.0 was used for statistical analysis. Comparison between two groups was performed using t test. Logistic regression analysis was used to identify risk factors influencing PTSD and discharge readiness in elderly stroke inpatients. Spearman analysis was employed to examine the correlations between PTSD, discharge readiness, and unplanned readmission rates in elderly stroke inpatients. Results Logistic regression analysis revealed that schooling < 9 years, monthly household income per capita <3 000 yuan, dysphagia, negative coping with illness, and low level of social support were independent risk factors affecting PTSD in elderly stroke inpatients (P<0.05); and that schooling < 9 years, monthly household income per capita < 3 000 yuan, self-paid medical care, and comorbid hypertension were independent risk factors influencing the discharge readiness in elderly stroke inpatients (P<0.05). Among the 160 patients, 26 were readmitted within 6 months after discharge. The PTSD scores in the readmission group were significantly higher than those of the non-readmission group, but the discharge readiness scores in the readmission group were lower (P<0.05). There was a significant positive correlation between PTSD and unplanned readmission in elderly stroke inpatients (P<0.05), and a significant negative correlation between discharge readi-ness and unplanned readmission (P<0.05). Conclusion Less schooling years, monthly household income per capita < 3 000 yuan, dysphagia, negative coping attitude towards the disease, and low level of social support may affect PTSD in elderly stroke inpatients, while self-paid medical care, combined hypertension, and doctor′s recommendation for discharge are independent risk factors affecting discharge readiness. There is a significant correlation between PTSD and discharge readiness in elderly stroke inpatients and their unplanned readmissions, highlighting the need to strengthen the monitoring and management of PTSD and discharge readiness in elderly stroke patients to reduce the risk of readmissions.

• Status quo and multi-dimensional influencing factors of exercise compliance in elderly patients with metabolic dysfunction-associated fatty liver disease

  Li Ying, Miao Liang, Weng Yuhong, Yang Xu

  2026,25(3):200-204, DOI: 10.11915/j.issn.1671-5403.2026.03.042

  Abstract: (59) HTML (0) PDF (402.20 KB)(206)

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  Objective To investigate the status quo of exercise compliance in elderly patients with metabolic dysfunction-associated fatty liver disease (MAFLD) and analyze the influencing factors of poor compliance. Methods A questionnaire survey was conducted on 212 elderly MAFLD patients admitted to our hospital from January 2024 to December 2024. After totally 212 questionnaires were distributed, 204 valid questionnaires were recovered, with an effective rate of 96.23%. Taking cumulative time of moderate-intensity aerobic exercise per week >135 min as the exercise standard for exercise compliance, the patients were divided into poor exercise compliance group (98 cases) and good exercise compliance group (106 cases). The general data were compared between the two groups. SPSS statistics 25.0 was used for statistical analysis. Data comparison between two groups was performed using t test or Chi-square test depending on data type. Univariate and multivariate logistic regression analyses were performed to evaluate the influencing factors for poor exercise compliance in elderly MAFLD patients. Results The poor exercise compliance group exhibited significantly advanced age, higher body mass index (BMI) and greater proportions of malnutrition and sarcopenia, while lower 25-hydroxyvitamin D [25 (OH)D] level and reduced score of exercise self-efficacy scale (ESE) when compared with the good exercise compliance group (P<0.05). Multivariate logistic regression analysis showed that age (OR=3.710,95%CI 1.983-6.942), BMI (OR=3.604,95%CI 1.892-6.866) and sarcopenia (OR=4.080,95%CI 2.291-7.264) were independent risk factors for poor exercise compliance in elderly MAFLD patients, and 25(OH)D (OR=0.234,95%CI 0.006-0.529) and ESE score (OR=0.159,95%CI 0.001-0.375) were independent protective factors (all P<0.05). Conclusion The current situation of exercise compliance is not good in elderly MAFLD patients. Old age, obesity and sarcopenia may increase the risk of poor exercise compliance, while high 25(OH)D and high ESE score may be helpful to exercise compliance, which can provide reference for exercise management in these elderly patients.

• Correlation of systemic immune-inflammation index with risk of incident prefrailty and frailty

  Li Liangchen, Yu Lu, Yu Lei, Xu Yanlai

  2026,25(3):205-209, DOI: 10.11915/j.issn.1671-5403.2026.03.043

  Abstract: (79) HTML (0) PDF (476.80 KB)(203)

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  Objective To investigate the correlation between the systemic immune-inflammation index (SII) and the risk of developing prefrailty and frailty among community-dwelling elderly adults. Methods A total of 676 “healthy” [frailty index (FI) ≤0.10 ] elderly adults with FI and SII data from the 2008 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) were selected as study subjects. They were followed up until 2011, with the endpoint events being the onset of pre-frailty (0.100.21). Subjects were categorized into T1, T2, and T3 groups based on SII tertiles, and their baseline characteristics were compared. The associations between SII levels and the risk of developing pre-frailty or frailty were assessed using Cox proportional hazards models and Fine-Gray competing risk models. The predictive value of SII for prefrailty and frailty was further evaluated by receiver operating characteristic (ROC) curves. Stata 17.0 and R 4.1.2 were used for statistical analysis. Data comparison between two groups was performed using Kruskal-Wallis H test or χ² test depending on data type. Results Over the 3-year follow-up, 159 “healthy” elderly adults progressed to pre-frailty or frailty. The incidence rates of pre-frailty or frailty in the T1, T2, and T3 groups were 17.8% (40/225), 25.1% (57/227) and 27.7% (62/224), respectively, with a statistically significant difference (P=0.037). Multivariate Cox model analysis indicated that the T3 group had a significantly higher risk of developing pre-frailty or frailty (HR =2.03,95%CI 1.12-3.70). This association remained significant in the Fine-Gray model treating death as a competing event (HR=1.53,95%CI 1.18-1.98). ROC curve analysis indicated that SII had good predictive value for the onset of pre-frailty or frailty among community-dwelling older adults [area under the curve (AUC)=0.733,95%CI 0.677-0.790)]. Conclusion Elevated SII levels were significantly associated with an increased risk of incident prefrailty and frailty among community-dwelling elderly adults. SII may serve as a potential inflammatory biomarker for predicting the progression of frailty in the elderly.

• Risk factors for pulmonary complications in elderly patients with traumatic rib fractures receiving conservative treatment

  Hu Jian, Hou Yijun, Qian Yun, Ding Ji

  2026,25(3):210-214, DOI: 10.11915/j.issn.1671-5403.2026.03.044

  Abstract: (88) HTML (0) PDF (825.80 KB)(214)

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  Objective To analyze the risk factors for pulmonary complications in elderly patients with traumatic rib fractures undergoing conservative treatment. Methods A total of 170 elderly patients with traumatic rib fractures admitted to the Department of Thoracic Surgery of Yizheng People′s Hospital from January 2022 to January 2024 were selected as the study subjects, and they received conservative treatment. Ten patients lost to follow-up were excluded. According to the occurrence of pulmonary complications within 3 months after fracture, 160 patients were divided into a positive group (n=56) and a negative group (n=104). The clinical data were compared between two groups. The risk factors of pulmonary complications were analyzed by a binary logistic regression model. SPSS 27.0 was used for data analysis. Intergroup comparison was performed usingχ² test. Results Among 160 patients, 56 (35.00%) developed pulmonary complications. Among them, 20 (35.71 %) had pleural effusion, with the highest proportion, followed by atelectasis in 16 (28.57%), pulmonary infection in 9 (16.07%), aspiration pneumonia in 7 (12.50%), and respiratory failure in 4 (7.14%). Using the occurrence of pulmonary complications as the dependent variable (Y; 0=negative, 1=positive), binary logistic regression analysis indicated that age ≥80 years (OR=1.579,95%CI 1.092-2.336), comorbid underlying lung diseases (OR=1.418,95%CI1.061-1.895), multiple rib fractures (OR=1.376,95%CI 1.015-1.864), posterolateral segment fracture (OR=1.817,95%CI 1.197-2.758), expectoration disorder (OR=1.511,95%CI 1.075-2.126), and bed rest time >3 d (OR=1.317,95%CI 1.128-1.537) were risk factors for pulmonary complications in elderly patients with rib fractures, and the analgesic drug use time >3 d (OR=0.742,95%CI 0.580-0.947) was a protective factor (P＜0.05). Conclusion The incidence of pulmonary complications is high in elderly patients with rib fractures receiving conservative treatment. Age, comorbid underlying lung diseases, multiple rib fractures, fracture location, expectoration status, bed rest time, and analgesic use time are all factors affecting the risk of pulmonary complications.

Basic Research

• Luteolin attenuates vascular smooth muscle cell senescence by regulating ferroptosis through SLC7A11/GPX4 signaling pathway

  Chen Sijia, Lu Tingting, Wang Linghuan, Yin Huijia, Li Yinglei, Wang Tianhu, Zhou Yang, Sun Naiyuan, Shen Xiaoying, Cao Feng

  2026,25(3):215-221, DOI: 10.11915/j.issn.1671-5403.2026.03.045

  Abstract: (97) HTML (0) PDF (1.29 MB)(204)

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  Objective To investigate the molecular mechanism by which luteolin (Lut) alleviates vascular smooth muscle cells (VSMCs) senescence by regulating ferroptosis via the solute carrier family 7 member 11 (SLC7A11)/glutathione peroxidase 4 (GPX4) signaling pathway, thereby providing novel insights for the prevention and treatment of vascular aging-related diseases. MethodsMouse vascular smooth muscle cells (MOVAS) were subjected and randomly divided into blank control group (Con group), Lut group (5 μmol/L Lut for 24 h), doxorubicin group (DOX group, 1 μmol/L DOX for 24 h), and combined treatment group (DOX+Lut group, pretreatment of 5 μmol/L Lut for 24 h followed by DOX treatment). Cell senescence and viability were evaluated using senescence-associated β-galactosidase (SA-β-gal) staining and cell counting kit-8 (CCK-8) assay, respectively. The expression of senescence-related proteins (P53, P21, P16) and ferroptosis pathway proteins (SLC7A11, GPX4) was detected by Western blot. Reactive oxygen species (ROS) production was measured by flow cytometry. Lipid peroxidation and intracellular ferrous iron (Fe²⁺) levels were detected using lipid peroxidation fluorescent probes and FerroOrange fluorescent probe, respectively. Additionally, glutathione (GSH) and malondialdehyde (MDA) contents in cell lysates were measured. SLC7A11 inhibitor Erastin was used to intervene ferroptosis to observe the changes in senescence phenotypes. GraphPad Prism 10.0 software was employed for data analysis. Multiple-group comparison was performed using one-way ANOVA followed by Tukey′s post hoc test, and intergroup comparison was applied using a two-tailed independent sample t test. Results Compared with the Con group, the DOX group exhibited significantly decreased cell viability (IC₅₀=1.799 μmol/L) and an obviously increased proportion of SA-β-gal-positive senescent cells (approximately 63%, P<0.05), accompanied with upregulated senescence proteins (P53, P21, P16), elevated ROS and lipid peroxidation levels, marked accumulation of Fe²⁺, reduced GSH content, and notably downregulated expression of SLC7A11 and GPX4 proteins (P<0.05). The addition of Lut pretreatment remarkably improved the aforementioned indicators, such as the IC₅₀ value increasing to 2.192 μmol/L, the proportion of senescent cells decreasing to approximately 38%, and restored protein levels of SLC7A11 and GPX4 when compared with the levels in the DOX group (P<0.05). Conclusion Lut effectively inhibits DOX-induced ferroptosis and alleviates VSMC senescence by activating the SLC7A11/GPX4 signaling pathway, providing a theoretical basis for the treatment of vascular aging-related diseases.

Review

• Research progress in protective effects of hydromorphone on vital organs

  Luo Zitian, Li Sen, Lin Renzhe, Lan Jinxin, Yang Duo, Zhang Huankai, Zhang Longsheng

  2026,25(3):224-228, DOI: 10.11915/j.issn.1671-5403.2026.03.047

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  Hydromorphone, an opioid receptor agonist, is clinically primarily used for analgesic treatment of moderate to severe pain. Recent studies have indicated that hydromorphone also holds potential value in the induction and maintenance of general anesthesia and in organ protection. Hydromorphone can exert protective effects on vital organs and reduce organ damage through mechanisms such as inhibiting oxidative stress, alleviating inflammatory responses, and regulating cell apoptosis. In this article, we reviewed the pharmacological properties of hydromorphone and its protective mechanisms on key organs, including the brain,cardiovascular system, and lungs, and to explore its rational clinical application strategies to maximize its protective effects on vital organs.

• Research progress on assessment tools for colorectal cancer risk perception

  Su Jiayi, Li Xia, Yuan Li, Zhou Aixin, Zhang Hua

  2026,25(3):229-232, DOI: 10.11915/j.issn.1671-5403.2026.03.048

  Abstract: (73) HTML (0) PDF (360.34 KB)(198)

  Abstract:

  Colorectal cancer is one of the most frequent malignant tumors in the world, and its prevalence and mortality rate are rising year after year, posing a severe threat to public health. Cancer risk perception is an important motivator for developing cancer prevention awareness and behavior, and it is critical for lowering colorectal cancer incidence and mortality. In this article, we reviewed the measurement contents, clinical applications, advantages, and limitations of colorectal cancer risk perception assessment tools, aiming to provide references for the development and application of localized colorectal cancer risk perception assessment tools in China.

• Application progress of Manchester Pain Management Model in postoperative pain management of surgical patients

  Zha Tian, Fu Guangjin, Chen Lu

  2026,25(3):233-236, DOI: 10.11915/j.issn.1671-5403.2026.03.049

  Abstract: (82) HTML (0) PDF (410.96 KB)(177)

  Abstract:

  Postoperative pain in surgical patients can activate the sympathetic nervous system, increase systemic oxygen consumption, and cause a series of adverse events such as hypercoagulability and immunosuppression. Poorly controlled acute pain is prone to progress to chronic pain, affecting the long term prognosis. Manchester Pain Management Model (MPMM) significantly optimizes the clinical outcomes of postoperative pain management by integrating full-dimensional assessment, multidisciplinary collaboration, and patient participation mechanisms. Based on the latest literature at home and abroad, in this article, we reviewed the application status of MPMM in postoperative pain management, analyzed the challenges in its implementation, and explored the future development directions in order to provide theoretical reference for optimizing clinical pain intervention strategies.

• Research progress in impact of sarcopenia on postoperative complications and prognosis in elderly patients with hip fractures

  Xie Yi, Xu Junma, Shao Chan, Xu Fangqin

  2026,25(3):237-240, DOI: 10.11915/j.issn.1671-5403.2026.03.050

  Abstract: (77) HTML (0) PDF (374.24 KB)(196)

  Abstract:

  Hip fracture is a prevalent and severe traumatic injury in the elderly population, significantly impairing patients′ quality of life and imposing a substantial socioeconomic burden. Sarcopenia, a major degenerative disorder of the musculoskeletal system in elderly individuals, serves as an independent risk factor for hip fractures and is closely associated with postoperative complications, functional dependence, and increased mortality. In this article, we reviewed current research progress in the impact of sarcopenia on postoperative complications and prognosis in elderly patients with hip fractures, aiming to provide reference for optimizing clinical management strategies.

• Apoptosis and autophagy of vascular smooth muscle cells of abdominal aortic aneurysm

  DU YaHAO, ZHENG YueHong, TIAN Cui, et al

  2010,9(3):217-221, DOI:

  Abstract: (2160) HTML (0) PDF (426.31 KB)(27668)

  Abstract:

  Objective To investigate the relationship of apoptosis and autophagy of vascular smooth muscle cells (SMC) with the pathogenesis of abdominal aortic aneurysm (AAA). Methods In situ terminal transferase-mediated dUTP nick end-labeling(TUNEL) was used to detect the apoptosis of SMC of AAA and human normal aorta. The expression of LC3 was measured by immunohistochemistry. RNA extraction from the tissue of AAA and human normal aorta was performed. The mRNA levels of autophagy-related genes Beclin1,Atg4b,Bnip3,and Vps34 are tested by RT-PCR. Results The number of TUNEL-positive SMC in AAA was higher than that in normal aorta (P<0.05). The expression level of LC3 protein was significantly increased in AAA compared with that in normal aorta (P<0.05). The mRNA expression levels of Beclin1,Atg4b,Bnip3 and Vps34 were markedly up-regulated in AAA compared with that in normal aorta (P<0.05). Conclusion The apoptosis and autophagy of vascular SMC play an important role in the pathogenesis of AAA.

老年周围血管疾病治疗专栏

• Research progress on roles of CXC chemokine receptor 2 and its ligands in cardiovascular diseases

  SUN Bo, ZHENG Yue-Hong

  2018,17(8):613-616, DOI: 10.11915/j.issn.1671-5403.2018.08.141

  Abstract: (2006) HTML (0) PDF (2.28 MB)(25330)

  Abstract:

  C-X-C chemokine receptor 2 (CXCR₂) is a member of chemokine family, and has been much sought after both in preclinical and clinical research because its activation by its ligands plays an important role in the pathophysiology of a range of cardiovascular diseases, including hypertension, cardiac remodeling, atherosclerosis, and abdominal aortic aneurysm. This review focuses on the progress made in the studies about roles of CXCR₂ in cardiovascular diseases.

• Effects of indapamide and/or felodipine on ambulatory blood pressure in elderly patients with hypertension

  FU Xin, HUANG Zhen Wen, et al

  2010,9(2):138-141, DOI:

  Abstract: (1749) HTML (0) PDF (267.15 KB)(15504)

  Abstract:

  Objective To investigate the efficacy of indapamide/felodipine combination in decreasing blood pressure in elderly patients with hypertension.Methods A total of 150 consecutive elderly cases of hypertension,average age (65.4 ± 3.6) years,were randomized into 3 groups:indapamide group (1.5 mg/d),felodipine group (5 mg/d),and indapamide (1.5 mg/d)/felodipine (5 mg/d) combination group,with 50 in each group.The treatment duration was 3 months.The average 24-hour,daytime and night-time systolic blood pressure/diastolic blood pressure and systolic blood pressure/diastolic blood pressure load,as well as mean heart rate,were determined at baseline and after 3 months.Results The average 24-hour,daytime and night-time systolic blood pressure/diastolic blood pressure,and blood pressure load were significantly decreased in all groups after treatment for 3 months,which was more significant in combination group than in single drug treatment group.The mean heart rate showed no significant change after 3 months of treatment.Conclusion Combination of calcium antagonist with long-acting diuretics at low dose provides substantial and stable antihypertensive benefit,and has few side effects.The regimen is strongly recommended for elderly patients with hypertension.?更多

Basic Research

• Therapeutic effects of compound Chinese herbal medicine, Shiguanning decoction,on reflux esophagitis:a rat model study

  DUAN Bing-Xia, CHEN Hong-Ci, XU An, XIAO Min, TIAN Dai-Zhi

  2021,20(8):615-620, DOI: 10.11915/j.issn.1671-5403.2021.08.128

  Abstract: (559) HTML (0) PDF (674.42 KB)(13645)

  Abstract:

  Objective To observe the effectiveness of Shiguanning (SGN) decoction, a traditional Chinese medicine (TCM) formula, on reflux esophagitis (RE). Methods A total of 60 male SD rats were randomly divided into sham operation group (sham group), model group (M group), low- and high-dose SGN groups (1 and 2 g/ml SGN, L and H groups), and the positive control group (esomeprazole magnesium enteric-coated tablet 0.24 mg/ml, W group), each with 12 rats. The rat model of RE was established with pyloric ligation and lower esophageal sphincter incision operation. The sham group only underwent open and closed abdominal surgery. Then the histopathological score, plasma content of motilin (MTL) and mRNA levels of interleukin-17 (IL-17) and tumor necrosis factor-α (TNF-α) of esophageal tissues were compared among the groups. SPSS statistics 22.0 was used to perform the statistical analysis. Chi-square test or rank sum test was employed for intergroup comparison depending on different data types. Results The M group had the highest histopathological score of esophageal mucosa, lowest plasma content of MTL, and highest mRNA levels of IL-17 and TNF-α when compared with the other 4 groups (all P<0.05). Conclusion SGN can elevate the plasma content of MTL, thereby increasing the pressure of the lower esophageal sphincter; inhibit the mRNA expression of IL-17 and TNF-α in esophageal tissue, thus alleviating the inflammatory response. SGN have therapeutic effects on RE.

Review

• Chinese language

  HAN Ping, YANG Zhanqing, LI Zijian, et al

  2011,10(5):478-480, DOI:

  Abstract: (2297) HTML (0) PDF (192.61 KB)(12199)

  Abstract:

  Prostate cancer is an important health concern for male population in China and deserves great attention. The onset of prostate cancer tended to be insidious and it developed slowly. The early diagnosis of prostate cancer may achieve satisfactory outcome. Currently, prostate cancer has low early detection rate and high mortality. Large scale epidemiological survey is necessary to screen out the specific risk factors of prostate cancer, including case-control study, randomized follow-up visit etc. We need a guideline for early diagnosis of prostate cancer suitable for Chinese population to improve the sensitivity and specificity of early diagnosis of prostate cancer in China.

老年周围血管疾病治疗专栏

• Research progress in immunoproteasome subunit low-molecular-mass proteasome 7 (β 5i)

  SUN Bao-Hua, Li Fang-Da, NIE Hao, LIU Duan, ZHENG Yue-Hong

  2018,17(8):621-625, DOI: 10.11915/j.issn.1671-5403.2018.08.143

  Abstract: (1716) HTML (0) PDF (2.75 MB)(10086)

  Abstract:

  Ubiquitin-proteasome system (UPS) is the primary non-lysosomal pathway of protein degradation in eukaryotic cells, whose proteolytic activities are closely associated with subunits β1, β2, β5. Subunits β1, β2, β5 can be replaced respectively by subunits β1i, β2i and low-molecular-mass proteasome 7 (LMP7 or β5i), with β5i being most active and the new structure being called immunoproteasome. β5i plays an important role in autoimmune diseases, cardiovascular and cerebrovascular diseases, obesity and metabolic diseases, and tumor. This article introduced the latest progress in β5i in relation to the above diseases in view of providing effective intervention targets for drug therapy and improving the prognosis of the diseases.

Review

• Research progress in pathogenesis of coronary vulnerable plaque

  ZHOU Guang-Yan, YU Bo

  2018,17(2):153-155, DOI: 10.11915/j.issn.1671-5403.2018.02.034

  Abstract: (1814) HTML (0) PDF (1.73 MB)(9587)

  Abstract:

  Cardiovascular disease (CVD) has emerged as the leading cause of death worldwide. Acute coronary syndrome (ACS), one of the most harmful cardiovascular events, is, in most cases, triggered by the rupture of a vulnerable plaque followed by thrombosis formation at the rupture site. Deep understanding of vulnerable plaque formation can greatly impact therapeutic approaches for both prevention and treatment of acute cardiovascular events. In the article, we reviewed the concept, characteristics and the pathological mechanisms of vulnerable plaque.

Case Report

• Elderly functional constipation treated with long-term enema: one case report

  XIN Haiwei, FANG Xiucai

  2012,11(11):856-857, DOI: 10.3724/SP.J.1264.2012.00219

  Abstract: (1609) HTML (0) PDF (292.92 KB)(8574)

  Abstract:

Review

• Frailty assessment tools for the elderly and their application

  MA Li-Na, CHAN Piu

  2017,16(8):624-628, DOI: 10.11915/j.issn.1671-5403.2017.08.147

  Abstract: (2225) HTML (0) PDF (2.91 MB)(7443)

  Abstract:

  Frailty is defined as a syndrome of reserve and function decline caused by various reasons, and is associated with adverse outcomes, such as falls, depression, disability, mortality, and so on. There is no gold standard for frailty yet, but frailty assessment tools can help to screen frailty and predict the health outcomes. The frailty tools have wide application, and each frailty tool is targeted to a specified population. Thus, assessment of frailty in clinical practice can provide physicians strategies for early screening and management of diseases, so as to avoid or delay the adverse outcomes.

• An overview of researches on senile pruritus

  CAI Ruikang, DANG Yuping, XU Canlong

  2011,10(6):566-569, DOI:

  Abstract: (2589) HTML (0) PDF (294.70 KB)(7035)

  Abstract:

  Senile pruritus, a common chronic skin disease in the elderly, is a serious disease affecting the health of elderly patients because of its endurable itching and lack of effective treatment. The pathogenesis of senile pruritus is complex, which is mainly due to a series of physiological or pathological changes caused by aging, including the degeneration of the skin and the changes in immune function and endocrine system. Currently, the integrated traditional Chinese medicine and western medicine is ideal for therapy of senile pruritus. In this paper, we reviewed the etiology, pathogenesis and treatment of senile pruritus.

• Establishment and evaluation of D-galactose induced aging animal model

  WU Kefen, HU Yu

  2012,11(1):74-78, DOI: 10.3724/SP.J.1264.2012.00018

  Abstract: (2584) HTML (0) PDF (208.41 KB)(7015)

  Abstract:

  Establishment of aging animal model is an effective way to study the aging process of human being. It has been a focus to establish different aging models for research of aging and anti-aging agents according to the physiological characteristics and natural attributes of various animals. Compared with other aging models, including naturally aging model, ozone induced aging model, thymus removed aging model, and aging SAMP model, D-galactosis induced aging model has been widely used because of its easy feasibility, low lost, and stable performance. In this paper, regarding its application and development, we reviewed the D-galactosis induced aging models from the following aspects: the mechanism and the dosage of the D-galactose to induce aging, the specific protocols, and the evaluation for successful establishment. In addition, we summarized some indexes to assess aging, such as behavioral, biochemical, morphological and molecular biological indices. In summary, subcutaneous injection of 120～125mg/(kg?d) of D-galactose once per day for 6 to 8 weeks is a reliable and stable way to establish the aging model.

• Randomized controlled clinical trial of zoledronic acid and alpha D3 combined treatment in the aged with severe osteoporosis

  刘传慧

  (), DOI:

  Abstract: (275) HTML (0) PDF (0.00 ByteB)(6781)

  Abstract:

  【ABSTRACT】Objective To discuss the curative effect of zoledronic acid and alpha D3 combined treatment in the aged with severe osteoporosis. Methods 120 patients were randomly divided into two groups, the treatment group (n=60) were taken Caltrate D added Zoledronic Acid and Alpha D3 treatment for 24 weeks, and the control group (n=60) received Caltrate D only. Results In the treatment group (excluded the drop-out cases), the bone pain eased faster than that of the control group(n=57), and the improvement of bone mineral density also significantly better than the control group (n=53) (P<0.05). The levels of plasma calcium, phosphorus in both groups, and alkaline phosphatase in the control group were no significant differences between pre and post treatment (P>0.05). But the alkaline phosphatase in the treatment group decreased significantly after treatment (P<0.05). Conclusion Zoledronic Acid combined Alpha D3 can significantly relieve pain and other symptoms, reduce bone mass lose, and improve bone mineral density of severe osteoporosis patients.

Review

• Role of T lymphocytes in pathogenesis of abdominal aortic aneurysm

  WANG Wei, LI Fang-Da, NIE Hao, ZHENG Yue-Hong

  2017,16(10):762-765, DOI: 10.11915/j.issn.1671-5403.2017.10.178

  Abstract: (1849) HTML (0) PDF (2.01 MB)(6530)

  Abstract:

  Abdominal aortic aneurysms (AAAs) is a medical problem with high mortality rate, and so it is of great significance to understand its pathogenesis. One of main characteristics of the disease is extensive infiltration of macrophages, neutrophils and T-lymphocytes. Much evidence has confirmed that T lymphocytes are closely associated with the pathogenesis, but their role in the progression remains unclear. This article reviewed the possible roles of T lymphocytes in the pathogenesis of AAAs, and provided effective drug treatment strategies for the disease which still lacks of effective drug intervention.

• Epidemiological situation of diabetes prevalence in China

  LIU Zi-Qi1, LIU Ai-Ping2, WANG Pei-Yu2*

  2015,14(07):547-550, DOI: 10.11915/j.issn.1671-5403.2015.07.125

  Abstract: (2450) HTML (0) PDF (322.99 KB)(6263)

  Abstract:

  Diabetes mellitus (DM) is a group of metabolic diseases characterized with high blood sugar levels, which is induced by a variety of factors, such as genetic factors, environmental factors, behavior and life styles, and other factors. Its pathological mechanism is insufficient insulin secretion or insulin resistance caused by structural damage and/or dysfunction of islet β-cell. Evidence shows that China has become the country with the largest number of DM patients in the world. Many nationwide epidemiological surveys concerning DM indicated that its prevalence increases gradually, and varies among different regions and population. To understand the present status of the epidemiological survey on DM research in China and to provide references for the corresponding prevention and control strategies, we reviewed the reports on national large-scale investigation and epidemiological trends related with DM prevalence in China.

• Interaction of cardiac sodium current with other ion channel currents and its clinical significance

  WU Zhi-Juan, Li Yang*

  2014,13(10):788-791, DOI: 10.3724/SP.J.1264.2014.000182

  Abstract: (2043) HTML (0) PDF (335.56 KB)(5987)

  Abstract:

  Various ion currents on the myocardial cell membrane take part in cardiac electric activity under both physiological and pathological conditions. Cardiac sodium current (INa) is involved in the depolarization and repolarization of cardiomyocyte action potential (AP), and exerts an important effect on the conduction of AP. So, it is of great importance to explore the interactions, effects, and especially, clinical significance of INa with other ion channel currents. This study reviewed the interaction of INa with other cardiac currents, and elucidated the mechanism of cardiac arrhythmias from the perspective of ion flow interaction.

• Progress in definition and classification system of chronic kidney disease: interpretation of 2012-KDIGO clinical practice guidelines for management of chronic kidney disease

  WANG Xiao-Jing, CHEN Hai-Ping*

  2014,13(05):396-400, DOI: 10.3724/SP.J.1264.2014.00092

  Abstract: (2051) HTML (0) PDF (377.43 KB)(5769)

  Abstract:

  Chronic kidney disease (CKD) is a global public health problem. In 2002, National Kidney Foundation (NKF)’s Kidney Disease Outcomes Quality Initiative (K/DOQI) published a guideline, which introduced a definition and classification system for CKD. This guideline plays an important role in the diagnosis, treatment and prognosis improvement for CKD. However, lots of evidence from clinical and epidemiological trials caused plenty of debates and controversies towards the applicability of present K/DOQI-CKD definition and classification system. These problems included high prevalence of CKD, disproportionately high prevalence in CKD stage 3, and high prevalence of CKD in the elderly. What’s more, whether patients with simple renal cyst should be diagnosed as CKD or not have not reached a consensus yet. So Kidney Disease: Improving Global Outcomes (KDIGO) published another guideline in 2012. The new one revised the definition of CKD, established a combined staging system concerning causes, glomerular filtration rate (GFR) and albuminuria, made a risk stratified model to estimate prognosis, and recommended the application of CKD-EPI to estimate GFR.

Communications

• On treatment strategies for hyponatremia

  QIU Ming-Cai

  2014,13(04):294-295, DOI: 10.3724/SP.J.1264.2014.00068

  Abstract: (1705) HTML (0) PDF (282.17 KB)(5611)

  Abstract:

Review

• Inflammatory mechanism of postoperative cognitive dysfunction in the elderly: a research update

  XU Wei-Gang1, LI Yong-Qi2*

  2013,12(11):877-880, DOI: 10.3724/SP.J.1264.2013.00223

  Abstract: (1700) HTML (0) PDF (312.41 KB)(5582)

  Abstract:

  Postoperative cognitive dysfunction (POCD), one of severe postoperative complications in elderly patients, greatly increases the risk of postoperative morbidity and mortality, and severely reduces the quality of life at the same time in these patients. However, since the pathogenesis of POCD remains unclear, effective treatment has not been defined yet. Recent evidences suggest that postoperative inflammation be the main mechanism for POCD. This article reviewed the inflammatory mechanisms of POCD based on basic and clinical researches, and also introduced some anti-inflammatory drugs which are beneficial to POCD treatment.