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Yao Yanzhu, Wang Yuyan, Mao Shuai, Liu Yuqi, Zhao Yunzhang, Wang Yifan, Lyu Chao, Yin Tong
2026,25(1):1-6, DOI: 10.11915/j.issn.1671-5403.2026.01.001
Abstract:
Objective To investigate the expression of platelet-derived circular RNA hsa_circ_0001535 and to analyze its correlation with antiplatelet reactivity in patients with acute coronary syndrome (ACS) after dual antiplatelet therapy. Methods A total of 169 consecutive ACS patients hospitalized in the Department of Cardiology of Chinese PLA General Hospital between October 2020 and March 2022 and treated with aspirin combined with a P2Y12 receptor antagonist were enrolled. All patients underwent thromboelasto-graphy (TEG) after receiving a single dose of dual antiplatelet therapy. Adenosine diphosphate (ADP)-induced platelet-fibrin clot strength (MAADP) of platelet-fibrin clot strength and ADP-induced platelet inhibition rate (PIADP) were used to reflect antiplatelet reactivity. With PIADP 75% as the cutoff value, patients were divided into a low on-treatment platelet reactivity group (LTPR group, n=106, PIADP > 75%) and a high on-treatment platelet reactivity group (HTPR group, n=63, PIADP≤ 75%). Platelet RNA was extracted from peripheral whole blood, and the relative expression level of hsa_circ_0001535 in platelets was detected by fluorescent quantitative multiplex polymerase chain reaction (PCR). Data analysis was performed using SPSS 27.0 and R language version 4.4.2. Based on data type, intergroup comparisons were conducted using the t-test, Wilcoxon rank-sum test, orχ2 test. Multivariate logistic regression analysis revealed that age (OR=1.07,95%CI 1.02-1.13; P=0.0071), body mass index (OR=0.82,95%CI 0.72-0.94; P=0.0030), platelet-derived hsa_circ_0001535 (OR=1.22,95%CI 1.04-1.43; P=0.0160) , clopidogrel (OR=2.45,95%CI 1.12-5.35; P=0.0242), and CYP2C19 loss-of-function (OR=1.24,95%CI 1.01-1.51; P=0.0421) were independent factors affecting antiplatelet reactivity after dual antiplatelet therapy in ACS patients. Results In the 169 patients, the median relative expression level of platelet-derived hsa_circ_0001535 was 1.47 (0.83,2.66), the median MA ADP was 19.40 (10.63,31.18), and the median PI ADP was 88.20% (55.04%, 94.55%), all showing a skewed distribution. Spearman correlation analysis found that the relative expression level of platelet-derived hsa_circ_0001535 was negatively correlated with PI ADP (r=-0.16, P=0.039). The expression level of platelet-derived hsa_circ_0001535 was significantly higher in the HTPR group than that in the LTPR group [1.94 (1.15,3.76) vs. 1.28 (0.59,2.14); P=0.0006)]. Multivariate logistic regression analysis revealed that platelet-derived hsa_circ_0001535 was an independent factor affecting antiplatelet reactivity after dual antiplatelet therapy in ACS patients (OR=1.22,95%CI 1.04-1.43; P=0.0160). Conclusion The relative expression level of platelet-derived hsa_circ_0001535 is independently correlated with antiplatelet reactivity in ACS patients after dual antiplatelet therapy.
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Wei Wei, Wu Ling, Zhao Xiaoqian
2026,25(1):7-11, DOI: 10.11915/j.issn.1671-5403.2026.01.002
Abstract:
Objective To investigate the relationship of chemotherapy-related cognitive impairment and cancer-related fatigue with quality of life in elderly patients with non-Hodgkin lymphoma at different stages. Methods A cross-sectional study was conducted on 350 elderly patients with non-Hodgkin lymphoma admitted to the First Affiliated Hospital of Nanjing Medical University (Jiangsu Provincial People′s Hospital) from August 2023 to May 2024. They were grouped according to disease stage. Because of the small number of stage Ⅳ patients, stage Ⅲ and Ⅳ patients were included in one group, resulting in stage Ⅰ group, stage Ⅱ group, and stage Ⅲ-Ⅳ group. The Chinese version of the functional assessment of cancer therapy-cognitive function (FACT-Cog) was used to assess chemotherapy-related cognitive impairment, the cancer fatigue scale (CFS) was used to assess the degree of cancer-related fatigue, and the quality of life questionnaire (QLQ-C30) was used to assess the patients′ quality of life. Pearson correlation analysis was used to analyze the correlation of chemotherapy-related cognitive impairment with cancer-related fatigue and quality of life in elderly patients with non-Hodgkin lymphoma. SPSS 20.0 was used for statistical analysis. Data comparison between two groups was performed using t test, F test orχ2 test depending on data type. Results Patients at different disease stages had statistically significant differences in perceived cognitive impairment, impact on quality of life, evaluation of others, cognitive function scores, and total scores (F=116.472,246.146,282.293,191.500,231.825; P<0.05). There were statistically significant differences in the score of physical fatigue, affection and cognition, and total scores among patients at different disease stages (F=369.548,101.615,97.400,370.149; P<0.05). There were statistically significant differences in scores of emotional function, role function, cognitive function, social function and physical function scores, and total scores among patients at different disease stages (F=80.100,80.106,52.536,60.791,91.967,75.300; P<0.05). Chemotherapy-related cognitive impairment in elderly patients with non-Hodgkin lymphoma was significantly positively correlated with cancer-related fatigue (r=0.571, P<0.05) and negatively correlated with quality of life (r=-0.360, P<0.05), and cancer-related fatigue was significantly negatively correlated with quality of life (r=-0.376, P<0.05). Chemotherapy-related cognitive impairment and cancer-related fatigue were positively correlated with disease stage (r=0.751,0.781; P<0.05), while quality of life was negatively correlated with disease stage (r=-0.497, P<0.05). Conclusion Chemotherapy-related cognitive impairment and cancer-related fatigue are significantly correlated with quality of life of elderly patients, particularly among those at different disease stages. This finding emphasizes the importance of comprehensive assessment of elderly patients with non-Hodgkin′s lymphoma, suggesting that clinicians should comprehensively consider cognitive function and fatigue when formulating treatment regimens to optimize patients′ quality of life.
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2026,25(1):12-16, DOI: 10.11915/j.issn.1671-5403.2026.01.003
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Objective To investigate the status quo of chemotherapy-induced peripheral neuropathy (CIPN) in elderly patients with breast cancer and to analyze the effect of non-drug intervention on CIPN. Methods A prospective study was conducted on 160 elderly patients with breast cancer who received chemotherapy in our hospital from January 2023 to December 2023. At the end of the first chemotherapy cycle, 96 patients developed CIPN. The CIPN patients were randomly divided into an observation group (n=48) and a control group (n=48). The control group were only given health education for CIPN, while the observation group received non-drug intervention (exercise therapy + acupoint massage + acupuncture and moxibustion) on basis of health education. The scores of CIPN assessment tool (CIPNAT) and Berg balance scale (BBS) were compared between groups before and after intervention. SPSS 26.0 was used for data processing, and t test or Chi-square test was performed for between-group comparison depending on data type. Binary logistic regression model was employed to identify the related factors affecting the occurrence of CIPN. Results Among the 160 elderly patients, the detection rate of CIPN was 60.00% (96/160). Multivariate logistic regression analysis suggested that age ≥80 years (OR=2.487, 95%CI 1.265-4.890), obesity (OR=2.065, 95%CI 1.105-3.858), diabetes mellitus (OR=3.074, 95%CI 1.691-5.589), sleep disorder (OR=1.270, 95%CI 1.048-1.539), breast cancer pathological stage Ⅲ-Ⅳ (OR=1.726, 95%CI 1.104-2.699) and combined radiotherapy (OR=1.756, 95%CI 1.271-2.426) were risk factors for CIPN occurrence in elderly patients with breast cancer, and exercise frequency ≥4 times/week (OR=0.708, 95%CI 0.565-0.887) was a protective factor. After intervention, the observation group had significantly lower total score of CIPN symptom experience and score of influence of CIPN symptoms on activities of daily living (ADL), while higher BBS score when compared with the control group (P<0.05). Conclusion The incidence of CIPN is quite high in the elderly patients undergoing breast cancer chemotherapy, and it is related to age, obesity, diabetes mellitus, breast cancer stage and combined radiotherapy. Active exercise and good sleep have certain potential in reducing the risk of CIPN, while combined non-exercise intervention can effectively relieve the clinical symptoms of CIPN, improve ADL and enhance the balance abilities.
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Influencing factors for analgesic efficacy for cancer pain in elderly patients with malignant tumors
Wang Yunhua, Zhang Qinyong, Wang Quanli, Song Tingting, Ren Jing
2026,25(1):17-21, DOI: 10.11915/j.issn.1671-5403.2026.01.004
Abstract:
Objective To explore the influencing factors for analgesic efficacy in elderly patients with malignant tumors complicated with cancer pain. Methods A total of 226 elderly patients with malignant tumors and concomitant cancer pain admitted to our hospital from January 2022 to January 2024 were enrolled as the research subjects. All of them received standardized analgesic therapy according to the National Comprehensive Cancer Network (NCCN) Guidelines for Cancer Pain Control in Adults. The pain intensity was evaluated by numerical rating scale (NRS) every day during treatment. After one week of analgesic treatment, the patients getting a pain relief rate of ≥50% were included in a good analgesia group (196 cases), and those with the rate <50% in a poor analgesia group (30 cases). The demographic data, cancer-related data and analgesia-related data were collected. SPSS statistics 26.0 was performed for data analysis. Chi-square test was carried out depending on data type. Binary logistic regression model was employed to analyze the related factors affecting the analgesic efficacy of cancer pain in the patients. Results The proportions of patients with knowing own conditions, lymph node metastasis, cancer stage Ⅲ-Ⅳ, severe initial pain intensity at admission, breakthrough pain, adverse analgesic reactions and anxiety in poor analgesia group were higher than those in good analgesia group, the differences were statistically significant. (P<0.05). Binary logistic regression analysis revealed that awareness of their own conditions (OR=1.376, 95%CI 1.167-1.622), lymph node metastasis (OR=1.976, 95%CI1.218-3.206), cancer stage Ⅲ-Ⅳ (OR=2.046, 95%CI 1.424-2.941), severe initial pain intensity at admission (OR=1.647, 95%CI 1.216-2.232), breakthrough pain (OR=2.173, 95%CI 1.096-4.306), analgesics-induced adverse reactions (OR=1.322, 95%CI 1.080-1.617) and anxiety (OR=1.215, 95%CI 1.111-1.330) were risk factors for poor analgesic effect. Conclusion Analgesic efficacy of elderly inpatients with cancer pain is affected by many factors, such as tumor related factors, characteristics of cancer pain, analgesics-induced adverse reactions and social psychological factors. For the patients with poor analgesic efficacy, it is necessary to adjust appropriately analgesic regimens to enhance the efficacy.
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Li Wanjing, Lin Mingming, Huang Shaohua
2026,25(1):22-25, DOI: 10.11915/j.issn.1671-5403.2026.01.005
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Objective To investigate the related factors affecting the physical activity in elderly patients with knee osteoarthritis (KOA). Methods A prospective study was conducted on 300 elderly KOA out- and in-patients admitted to our department from January 2021 to January 2024. International physical activity questionnaire (IPAQ) was used to evaluate the physical activity level of the partici-pants. SPSS statistics 27.0 was employed for statistical analysis. Data comparison was performed using t test or Chi-square test depending on data type. Binary logistic regression model was adopted to analyze the related factors affecting the physical activity volume in the elderly patients. Results After 300 questionnaires were distributed, 291 valid ones were collected, with an effective recovery rate of 97.00%. Among the subjected 291 elderly patients, 67 (23.02%), 131 (45.02%) and 93 cases (31.96%) had high, medium and low levels of physical activity, respectively. Binary logistic regression analysis suggested that age ≥80 years (OR=4.923, 95%CI 2.082-11.640), female (OR=2.583, 95%CI 1.288-5.180), bilateral knee disease (OR=3.418, 95%CI 1.418-8.240) and depression (OR=1.852, 95%CI 1.366-2.509) were risk factors for low physical activity level in elderly patients with KOA, and regular exercise habit (OR=0.323, 95%CI 0.119-0.882) and exercise self-efficacy (medium-to-high) (OR=0.845, 95%CI 0.743-0.959) were protective factors. ConclusionFor elderly KOA patients, age, gender, disease location, depression, regular exercise habit and exercise self-efficacy are related factors affecting the physical activity volume. It is suggested that the above factors should be taken into consideration to improve the physical activity volume and ensure the prognosis of the elderly KOA patients.
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Yu Ying, Zhou Xiaoqi, Liang Yajing, Liu Mengfan, Tang Qiqun, Cheng Jie, Cheng Xiaohua, Chen Fang
2026,25(1):26-30, DOI: 10.11915/j.issn.1671-5403.2026.01.006
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Objective To investigate the mediating effect of nutritional status on tooth number and frailty in elderly stroke patients. Methods Convenience sampling was used to subject 419 elderly patients with stroke admitted in our hospital from June to December 2023. According to Tilburg frailty indicator (TFI), the patients with the score ≥5 were assigned into a frail group (n=231), while those scoring <5 into a non-frail group (n=188). Statistical analysis was conducted using SPSS 25.0. Depending on data type, Chi-square test was employed for intergroup comparison. Binary logistic regression model was utilized to identify independent risk factors for frailty in elderly stroke patients. Spearman rank correlation analysis was applied to analyze the correlations of number of teeth, nutritional status, and frailty in the patients. R package for mediation analysis was utilized to assess the mediating effect of nutritional status between number of tooth and frailty in the patients, and Bootstrap test was employed to verify the significance of this mediation. Results Statistical differences were observed between the two groups in terms of age, type of stroke, number of teeth, National Institute Health stroke scale (NIHSS) score and nutritional status (P<0.05). Binary logistic regression model showed that age 70-80 years (OR=2.184, 95%CI 1.258-3.793), age≥80 years (OR=7.996,95%CI 2.409-26.539), hemorrhagic stroke (OR=5.071,95%CI 2.801-9.182), moderate to severe stroke (OR=2.836,95%CI 1.307-6.152), malnutrition (OR=4.443,95%CI 2.188-9.021), number of teeth 0-9 (OR=3.181,95%CI 1.305-7.752), and number of teeth 10-19 (OR=1.945,95%CI 1.113-3.396) were associated with high risk of frailty in elderly stroke patients (P＜0.05). Spearman rank correlation analysis indicated that number of teeth was positively correlated with nutritional status (r=0.270, P<0.001), and negatively with frailty score (r=-0.352, P<0.001), and nutritional status was negatively correlated with frailty (r=-0.380, P<0.001). The results of the mediation analysis showed that nutritional status had a partial mediating effect between the number of teeth and frailty in elderly stroke patients, with a mediating effect value of -0.090, contributing 51.14% to the total effect. Conclusion Nutritional status has a partial mediating effect between tooth number and frailty in elderly stroke patients. Early nutritional intervention and promoting the preservation of natural teeth can delay the process of frailty in elderly stroke patients.
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Xie Kuihua, Liu Puping, Zhou Jie, Xu Junwei, Zhang Qing
2026,25(1):31-35, DOI: 10.11915/j.issn.1671-5403.2026.01.007
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Objective To investigate the relationship between body mass index (BMI) and intrinsic capacity (IC) in elderly inpatients with cardiovascular diseases (CVD). Methods A total of 409 elderly CVD patients hospitalized in Nanshan District People′s Hospital from April to October 2023 were consecutively included as study subjects, and according to their IC score, they were divided into a high IC group (n=174) and a low IC group (n=235). General condition questionnaire, intrinsic capacity measurement scale, handgrip strength meter, and Charlson comorbidity index (CCI) index scale were used to survey the included patients. Multivariate logistic regression analysis was applied to explore the relationship between BMI and IC, and restricted cubic spline model was employed to analyze the dose-response relationship between BMI and IC. SPSS statistics 25.0 and R 4.4.1 were used for statistical analysis. Data comparison between two groups was performed using t test, rank-sum test orχ2 test depending on data type. Results Univariate analysis showed that IC is correlated with gender, education level, smoking, alcohol consumption, place of residence, BMI, handgrip strength, diastolic blood pressure (DBP), and age-adjusted CCI (a-CCI) (P<0.05). Multivariate logistic regression model revealed that underweight was negatively associated with IC (RR=10.110,95%CI 1.270-80.484; P=0.029), and overweight (RR=0.383,95%CI 0.234-0.628; P<0.001) and obesity (RR=0.473,95%CI 0.226-0.989; P=0.047) were positively correlated with IC. Restricted cubic spline model showed a nonlinear association between BMI and IC (nonlinear P=0.001 6, overall association P＜0.001), and the risk of IC decline was reduced when BMI was greater than 23.9 kg/m2. Conclusion In elderly CVD patients, their BMI shows a nonlinear dose-response relationship with IC, and overweight and obesity can reduce the risk of IC decline.
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Gao Xing, Huan Xiang, Wang Long, Li Na
2026,25(1):36-40, DOI: 10.11915/j.issn.1671-5403.2026.01.008
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Objective To analyze the effect of thyroid hormone levels and the sensitivity indicators on occurrence of postoperative delirium (POD) in elderly patients after colorectal cancer (CRC) surgery. Methods A total of 165 elderly patients undergoing elective CRC surgery in our hospital from January 2022 to September 2024 were recruited in the study. Their preoperative serum levels of free triiodo-thyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) were measured. The FT3/FT4 ratio was calculated to reflect the sensitivity of peripheral tissues to thyroid hormones, and the thyroid stimulating hormone index (TSHI), thyroid stimulating hormone resistance index (TT4RI) and thyroid feedback quantile index (TFQI) were collected to indicate the sensitivity of central nerve system to thyroid hormones. The patients were categorized into a POD group (n=34) and a non-POD (NPOD) group (n=131) according to the occurrence of delirium. Logistic regression model was performed to identify the risk factors for POD. Receiver operating characteristic (ROC) curve was plotted to determine the cut-off values of the risk factors. SPSS statistics 23.0 was used for statistical analysis. Data comparison between two groups was performed using t test, Mann-Whitney U test,χ2 test or Fisher exact test depending on data type. Results The incidence of POD was 20.6% (34 cases) among the 165 participants. The POD group exhibited significantly lower levels of hemoglobin, hematocrit, FT3 and TSH, advanced age, higher urea nitrogen level, longer operation time, time to extubation and length of post-anesthesia care unit (PACU) stay, and increased values of TFQI, TT4QI and TSHI when compared with the NPOD group (P<0.05). Logistic regression analysis showed that FT3, TSHI, age and length of PACU stay were independent risk factors for POD (P<0.05). ROC curve analysis revealed that the area under the curve of FT3, TSHI, age and length of PACU stay was 0.707,0.711,0.652 and 0.681, respectively, with a cut-off value of 4.3 pmol/L, 2.38,72 years and 45 min, separately. ConclusionFT3, TSHI, age and length of PACU stay are independent risk factors for POD in elderly patients undergoing CRC surgery, which providing clinical reference for early prevention and treatment of POD.
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Zhang Ying, Zhu Hongyan, He Yinli
2026,25(1):41-44, DOI: 10.11915/j.issn.1671-5403.2026.01.009
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Objective To explore the value of peripheral blood neutrophil-to-platelet ratio (NPR), interleukin-6 (IL-6) and procalcitonin (PCT) in predicting the prognosis of elderly patients with acute respiratory failure. Methods A total of 126 elderly patients with acute respiratory failure admitted to our hospital from December 2022 to December 2023 were recruited, and according to the survival status within 28 d after admission, they were divided into a death group (n=34) and a survival group (n=92). The general clinical data and peripheral blood NPR, IL-6 and PCT levels at admission were compared between groups. SPSS 22.0 was used for data analysis. Depending on data type, t test or Chi-square test was performed for comparison between groups. Logistic regression model was applied to identify the independent influencing factors of prognosis. Receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of NPR, IL-6 and PCT on prognosis. Results The death group exhibited significantly advanced age, higher acute physiologic and chronic health evaluation Ⅱ (APACHEⅡ) score and levels of peripheral blood NPR, IL-6 and PCT than the survival group (P<0.05). Pearson correlation analysis showed that the levels of NPR, IL-6 and PCT in peripheral blood were positively correlated with APACHEⅡ score (r=0.522,0.609,0.482; all P<0.05). Binary logistic regression analysis suggested that APACHEⅡ score (OR=1.170, 95%CI 1.059-1.293, P=0.002), and peripheral blood NPR (OR=1.331, 95%CI 1.096-1.616, P=0.004), IL-6 (OR=1.049, 95%CI 1.017-1.083, P=0.003) and PCT (OR=1.962, 95%CI 1.200-3.209, P=0.008) were independent influencing factors for death within 28 d after admission in elderly patients with acute respiratory failure. ROC curve analysis revealed that the cut-off values of peripheral blood NPR, IL-6 and PCT levels in predicting the death of elderly patients with acute respiratory failure within 28 d after admission were 0.15,55.41 pg/ml and 2.32 ng/ml respectively, with the corresponding areas under the ROC curves (AUCs) of 0.897(95%CI 0.818-0.975), 0.902 (95%CI 0.833-0.972) and 0.871(95%CI 0.784-0.957) respectively, and the AUC value of the three indicators combined was 0.968 (95%CI 0.940-995). Conclusion Peripheral blood levels of NPR, IL-6 and PCT are independent influencing factors for predicting the death of elderly patients with acute respiratory failure within 28 d after admission. The combined detection of the three indicators has high expected value for the prognosis.
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Liu Wei, Yang Jing, Chen Huihui, Liu Cuifang
2026,25(1):45-49, DOI: 10.11915/j.issn.1671-5403.2026.01.010
Abstract:
Objective To analyze the changes in T helper 17 cells (Th17) and regulatory T cells (Treg) in elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), and evaluate the predictive value for short-term prognosis of the patients. Methods Clinical data of 152 elderly AECOPD patients admitted to our hospital from March 2021 to March 2024 were collected. The changes in peripheral blood proportions of Th17 and Treg and Th17/Treg ratio, and serum levels of chemokine CXC ligand 10 (CXCL10), interleukin-13 (IL-13) and interleukin-17 (IL-17) at admission and at discharge were recorded. According to the acute rehospitalization condition at one month after discharge, the patients were divided into a poor prognosis group (rehospitalization due to acute exacerbation) and a good prognosis group (no acute exacerbation). The differences in Th17, Treg and Th17/Treg, CXCL10, IL-33 and IL-17 were compared between two groups at admission. Receiver operating characteristic (ROC) curve was plotted to evaluate the predictive value of the above indicators for the poor short-term prognosis in elderly patients with AECOPD. SPSS statistics 24.0 was used for statistical analysis. Data comparison between two groups was performed using t test, Chi-square test or rank sum test depending on data type. Results At discharge, Th17 proportion, Th17/Treg ratio, and CXCL10, IL-33 and IL-17 levels in the elderly AECOPD patients were significantly decreased than those at admission (P<0.05), while Treg proportion was obviously increased (P<0.05). Among the 152 elderly patients, 26 patients (17.11%) were re-hospitalized due to acute exacerbation at one month after discharge, and they were included in the poor prognosis group, and the other 126 patients (82.89%) without acute exacerbation rehospitalization were enrolled in the good prognosis group. There were no statistical differences in Th17 and Treg proportions between two groups (P>0.05). The poor prognosis group exhibited notably higher Th17/Treg ratio and CXCL10, IL-33 and IL-17 levels than the good prognosis group (P<0.05). ROC curve analysis showed that Th17/Treg [(area under the curve, AUC)=0.823,95%CI 0.739-0.908, P<0.05], CXCL10 (AUC=0.730,95%CI 0.612-0.848, P<0.05), IL-33 (AUC=0.833,95%CI 0.739-0.927, P<0.05) and IL-17 (AUC=0.848,95%CI 0.750-0.947, P<0.05) were all statistically significant in predicting poor short-term prognosis in elderly patients with AECOPD (P<0.05), with a cut-off value of 1.77,130.14 pg/ml, 41.69 pg/ml and 17.38 pg/ml, respectively, and the AUC value of the four indicators combined together was as high as 0.960 (P<0.05). Conclusion In elderly AECOPD patients, the immune disorder and inflammatory response are significantly relieved after admission. The detection of Th17/Treg ratio and CXCL10, IL-33 and IL-17 levels is beneficial to predict the acute exacerbation rehospitalization at one month after discharge, which may provide new ideas for the clinical management of elderly patients with AECOPD.
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Shi Jingwen, Tang Wen, Xing Yunli, Wan Shan, Lu Shangxin, Hou Xiaopei, Liu Bing, Hu Jieqiong, Sun Ying
2026,25(1):50-54, DOI: 10.11915/j.issn.1671-5403.2026.01.011
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Objective To investigate the correlation between age-adjusted Charlson comorbidity index (aCCI) and the occurrence of major adverse cardiovascular and cerebrovascular events (MACCE) within one year after discharge in older adults with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Methods A retrospective cohort study was conducted on 528 inpatients enrolled from Cardiovascular Center and Department of Geriatrics in our hospital between January 2020 and November 2021. The participants were categorized into a low aCCI group and a high aCCI group based on the aCCI value. The incidence of MACCE at different aCCI patients was estimated by Kaplan-Meier method. Multivariate Cox regression analysis was conducted to assess the correlation between different aCCI groups and occurrence of MACCE within one year after discharge in these patients. SPSS statistics 27.0 was used for statistical analysis. Data comparison between two groups was performed using t test, nonparametric test or χ2test depending on data type. Results The participants had a median age of 72 (68,76) years, and 58.3% of them (308) were males. The cohort comprised 251 patients in the high aCCI group and 277 patients in the low aCCI group. The high aCCI group exhibited advanced age, higher levels of cardiac injury biomarkers, and larger proportions of frailty, polypharmacy, and lower scores of Activities of Daily Living when compared with the lower aCCI group (P<0.05). During one-year of follow-up, the risk of MACCE was significantly higher in the high aCCI group (log-rank P=0.000 2). After adjusting for various confounding factors, when aCCI was treated as a continuous variable, each one-unit increase in aCCI was associated with 21.3% increase in the risk of MACCE (HR=1.213,95%CI 1.043-1.412; P=0.012), and when aCCI was analyzed as a categorical variable, high aCCI group increased 85.8% risk of MACCE (HR=1.858,95%CI 1.119-3.083; P=0.017). Conclusion In older adults with NSTE-ACS, higher aCCI is associated with increased risk of MACCE. Early assessment of aCCI can improve unfavorable prognosis in these elderly patients.
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Li Bin, Guo Qianqian, Liu Chao
2026,25(1):55-60, DOI: 10.11915/j.issn.1671-5403.2026.01.012
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Objective To investigate the incremental value of three-dimensional transesophageal echocardiography (TEE) in predicting the occurrence of atrial fibrillation (AF) after coronary artery bypass grafting (CABG). Methods A total of 100 patients who underwent CABG at Beijing Aerospace General Hospital from March 2021 to March 2024 were selected as the study subjects. According to occurrence of AF within 2 to 3 days after surgery, the patients were divided into an AF group (n=33) and a non-AF group (n=67). The TEE parameters [number of left atrial appendage (LAA) lobes, left atrial appendage volume, left atrial appendage ejection fraction, left atrial appendage emptying velocity] and coronary microcirculation indicators [coronary flow reserve (CFR), index of microcirculation resistance (IMR)] were observed in both groups. Data analysis was performed using SPSS 23.0, and t test orχ2 test was used for intergroup comparison based on the data type. A generalized additive model (GAM) was used to analyze the correlation between TEE parameters and coronary microcirculation indicators. Multivariate linear regression analysis was used to explore the association between TEE parameters and postoperative new-onset AF. The predictive value of TEE parameters for postoperative AF occurrence was evaluated by the receiver operating characteristic (ROC) curve. Results The number of LAA lobes, LAA volume, and IMR in the AF group were higher than those in the non-AF group; LAA ejection fraction, LAA emptying velocity and CFR were lower than those in the non-AF group, with statistically significant differences (P<0.05). Multivariate linear regression analysis showed that the number of LAA lobes (β=0.462,0.562,1.011; P<0.05) and LAA volume (β=0.316,0.498,0.627,1.126; P<0.05) were risk factors for postoperative new-onset AF. LAA ejection fraction (β=-0.853, -0.512, -0.489, -0.362; P<0.05) and LAA emptying velocity (β=-0.801, -0.625, -0.562, -0.440; P<0.05) were protective factors against postoperative new-onset AF. ROC curve analysis showed that TEE parameters had good predictive value for postoperative new-onset AF, and that the combination of four parameters had a higher predictive value for postoperative new-onset AF [cut-off value was 35.27; sensitivity was 80.12%; specificity was 73.02%; AUC was 0.902 (95%CI 0.796-0.987; P=0.015). Conclusion Parameters measured by TEE can not only independently predict new-onset AF after CABG, but also their combined application can significantly enhance the predictive efficacy, providing incremental value for clinical risk assessment.
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2026,25(1):65-68, DOI: 10.11915/j.issn.1671-5403.2026.01.015
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With the extension of life expectancy, the incidence of cholangiopancreatic diseases is gradually increasing in very old adults (≥ 80 years). Endoscopic retrograde cholangiopancreatography (ERCP) has the advantages of less trauma and fast postoperative recovery, etc. However, due to the declines in physiological functions, elderly patients often have multiple underlying diseases and may also have changes in anatomical structures, which might make the endoscopic treatment of cholangiopancreatic diseases more difficult for the elderly. Nowadays, clinical studies on the application of ERCP in elderly patients with cholangiopancreatic diseases are still limited. In this article, we reviewed the indications, treatment strategies, and adverse events of ERCP for elderly patients, aiming to provide a reference for clinical practice.
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2026,25(1):69-72, DOI: 10.11915/j.issn.1671-5403.2026.01.016
Abstract:
Chronic kidney disease (CKD) is a significant public health issue globally. Its early diagnosis and progression monitoring are crucial for improving patients′ prognosis. In recent years, ultrasound shear wave elastography (SWE), as a novel non-invasive imaging technique, has been widely used in the assessment of CKD due to its excellent ability to quantitatively assess renal tissue stiffness. In this article, we reviewed the specific SWE applications in different types of CKD, including diabetic nephropathy, ischemic nephropathy, chronic glomerulonephritis, and hypertensive nephropathy.
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Jiang Hui, Huang Xueli, Ouyang Qing
2026,25(1):73-76, DOI: 10.11915/j.issn.1671-5403.2026.01.017
Abstract:
Acute respiratory distress syndrome(ARDS)is the most serious respiratory complication in trauma patients, particularly those with traumatic brain injury and pulmonary contusion, and is a critical factor leading to exacerbation and even death. The main cause of ARDS after thoracic trauma is pulmonary contusion, while the causes of ARDS after traumatic brain injury include neurogenic pulmonary edema and systemic inflammatory responses. The mechanisms underlying ARDS in these two types of trauma are distinctly different. The protective pulmonary ventilation strategy characterized by low tidal volume and high positive end-expiratory pressure is the mainstay treatment for ARDS. For ARDS patients after thoracic trauma, strict adherence to protective pulmonary ventilation strategy is essential. However, for ARDS patients after traumatic brain injury, the protective pulmonary ventilation strategy should be used cautiously under the monitoring of intracranial pressure and cerebral perfusion pressure. Prone positioning ventilation and recruitment maneuver are not suitable for the above two types of patients with post-traumatic ARDS. More research is needed for the use of time-controlled adaptive ventilation mode in patients with post-traumatic ARDS.
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Tan Bingqian, Liu Ming, Liu Zan, Wan Fengjing
2026,25(1):77-80, DOI: 10.11915/j.issn.1671-5403.2026.01.018
Abstract:
Cognitive frailty is a syndrome that incorporates cognitive impairment with physical frailty, and has attracted increasing attention in the elderly population in recent years. Elderly patients with liver cirrhosis, due to their complex pathophysiological mechanism, are at risk of cognitive frailty. In this article, we reviewed the clinical characteristics and staging differences, assessment methods and related intervention strategies of cognitive frailty in elderly patients with liver cirrhosis, aiming to provide evidences for clinical staff to identify and intervene cognitive frailty at an early stage.
Volume 25,2026 Issue 1
Clinical Research
Review
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DU YaHAO, ZHENG YueHong, TIAN Cui, et al
2010,9(3):217-221, DOI:
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.
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2018,17(8):613-616, DOI: 10.11915/j.issn.1671-5403.2018.08.141
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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.
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2010,9(2):138-141, DOI:
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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
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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:
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.
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HAN Ping, YANG Zhanqing, LI Zijian, et al
2011,10(5):478-480, DOI:
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.
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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:
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.
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2018,17(2):153-155, DOI: 10.11915/j.issn.1671-5403.2018.02.034
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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.
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2012,11(11):856-857, DOI: 10.3724/SP.J.1264.2012.00219
Abstract:
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2017,16(8):624-628, DOI: 10.11915/j.issn.1671-5403.2017.08.147
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.
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2012,11(1):74-78, DOI: 10.3724/SP.J.1264.2012.00018
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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.
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CAI Ruikang, DANG Yuping, XU Canlong
2011,10(6):566-569, DOI:
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.
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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.
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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
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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.
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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:
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.
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2014,13(10):788-791, DOI: 10.3724/SP.J.1264.2014.000182
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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.
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WANG Xiao-Jing, CHEN Hai-Ping*
2014,13(05):396-400, DOI: 10.3724/SP.J.1264.2014.00092
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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.
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2014,13(04):294-295, DOI: 10.3724/SP.J.1264.2014.00068
Abstract:
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2013,12(02):108-110, DOI: 10.3724/SP.J.1264.2013.00029
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The pathogenesis of hyperthyroidism is relatively complicated. In clinical practice, diffuse toxic goiter accompanied with hyperthyroidism (as known as Graves￠ disease) is more common. The pharmaceutical treatment of Graves￠ disease includes antithyroid drugs (ATD), iodine, β-blocker, glucocorticoids and lithium carbonate. ATD are the main treatment for hyperthyroidism, and Methimazole (MMI) and propylthiouracil (PTU) are the two drugs which are most commonly used currently. Generally, ATD are safe and effective, though their clinical adverse reactions are also relatively common. These reactions are usually reversible and disappeared spontaneously when the drug is discontinued. However, the serious rare side effects also occur sometimes. MMI is usually preferred over PTU because it has significantly fewer adverse reactions in a dose-dependent fashion. MMI is the first choice for treating mild and moderate hyperthyroidism. Iodine is mainly used in hyperthyroidism crisis and before operation. Glucocorticoids are mainly used for Graves￠ ophthalmopathy and hyperthyroidism crisis. β-blocker is used to control the symptoms at initial treatment. Lithium carbonate is not commonly used, and only suitable for short-term treatment. The clinicians should evaluate comprehensively and individually to choose appropriate agents for better outcome, and closely monitor their efficiency and side effects.
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2013,12(11):877-880, DOI: 10.3724/SP.J.1264.2013.00223
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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.
