Objective To assess the quality of randomized controlled trials (RCTs) of delirium prevention of elderly published in China.Methods The literatures from China National Knowledge Infrastructure(CNKI),WANFANG Data and VIP Database for Chinese Technical Periodicals were evaluated according to Cochrane collaboration's tool for assessing risk of bias and Jadad scale.Results A total of 53 RCTs were included,14 (26.4％,14/53) described radom number table used to generate the random allocation sequence,4 (7.5％,4/53) conducted experiments in a blinded manner,7 (13.2％,7/53) did not use intentionto-treat to analyse those who did not complete the study,9 (17.0％,9/53) had high risk of other bias,none described allocation concealment mechanism and blinding to participants and intercention implementers.Based on Jadad scales,the score was 1-4,average score was (2.3±0.8),19 (35.8％,19/53) were high-quality literatures.Conclusions The quality of present published literatures is not high,the further domestic studies should be designed high-quality to better improve clinical practice.

Cardiovascular disease is a severe threat to human health and life. Among many risk factors of cardiovascular disease, genetic or gene-based ones are drawing more and more attention in recent years. Accumulated evidence has demonstrated that the loss or mutation of ataxia telangiectasia mutated (ATM) gene can result in DNA damage repair dysfunctions, telomere shortening, decreased antioxidant capacity, insulin resistance, increased lipid levels, etc., and thus can promote the occurrence of cardiovascular risk factors, such as aging, atherosclerosis and metabolic syndrome. In this review, we discusses the possible mechanisms between ATM gene and cardiovascular risk factors, which could be helpful to the related research and clinical application.
Aging ; Ataxia Telangiectasia Mutated Proteins ; genetics ; Cardiovascular Diseases ; genetics ; DNA Damage ; DNA Repair ; Humans ; Mutation ; Risk Factors

This study aims to assess the expression of Klotho and insulin-like growth factor-1 (IGF-1) and the association between Klotho and IGF-1 in rats with dementia model. Thirty rats were randomly divided into three groups. Morris water maze was used to investigate the learning and memory functions, and enzyme linked immunosorbent assay was used to analyze the levels of Klotho and IGF-1. Klotho and IGF-1 levels in the model group were lower than those in other 2 groups. Morris water maze test showed that the model group had longer escape latency times and shorter step platform times compared to other groups. Line correlation model demonstrated that Klotho level was positively correlated with IGF-1 level in rats with dementia (P= 0. 029). The levels of Klotho and IGF-1 both reduced at hippocampus in rats with dementia model, suggesting that it may be a close relationship between Klotho and IGF-1 in the pathogenesis of dementia.
Animals ; Dementia ; metabolism ; Female ; Glucuronidase ; genetics ; metabolism ; Hippocampus ; metabolism ; Insulin-Like Growth Factor I ; genetics ; metabolism ; Male ; Maze Learning ; Memory ; physiology ; Rats ; Rats, Wistar

This study was aimed to determine the relationship between coronary artery disease(CAD) and insertion/deletion(I/D) polymorphism of the angiotensin coverting enzyme(ACE) gene. The ACE genotypes of 105 patients with CAD (50 of them were accompanied by essential hypertension (EH)) and 102 healthy people were detected by polymerase chain reaction. The results showed that in terms of ACE genotypes, no significant difference was noted between CAD group and control group, nor was it observed between CAD group and CAD accompanied by EH group, and nor was it seen between CAD/CAD accompanied by EH group and control group. These findings suggest that there is no relationship between the polymorphism of ACE gene and CAD (including those accompanied by EH).
Adult ; Aged ; Aged, 80 and over ; Coronary Disease ; complications ; enzymology ; genetics ; Female ; Gene Deletion ; Genotype ; Humans ; Hypertension ; complications ; Male ; Middle Aged ; Peptidyl-Dipeptidase A ; genetics ; Polymorphism, Genetic

Objective To confirm the correlation between general information、physical functioning and delirium among elderly patients in medical units by systematic review and meta-analysis. Methods With strictly designed search strategies, electronic databases as follows: CBM, CNKI, VIP, WanFang, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Embase, MEDLINE, MEDLINEIn-Process & Other Non-Indexed Citations(OVID), PsycInFo, CINAHL (EBSCO), SCI(Web of Science)were searched dated from the database building to October 2015.Two researchers confirmed the included studies according to the inclusion and exclusion criteria, evaluated the methodological quality of studies and extracted data independently. The Revman 5.3 was used for data analysis. Results (1) Age:results reported indichotomous,combined OR=2.57 (95％CI:1.69-3.89), P<0.00001;results reported in continuous,combined MD=2.67 (95％CI:1.57-3.77), P< 0.01.(2) Male:OR=1.34 (95％CI:0.91-1.97),P=0.14;inverse variance, OR=1.11(95％CI:0.95-1.30), P=0.20. (3)Activities of daily living: OR=2.66 (95％CI:1.90-3.70),P< 0.01. (4)Vision impairment: combined OR=2.31 (95％CI:1.24-4.32), P = 0.009.(5) Physical restraints: OR=6.60(95％CI:4.22-10.31), P < 0.01. Conclusions Physical restraintsis correlative with delirium among elderly patients in medical units. Age, vision impairment, activity of daily living may be correlative with delirium among elderly patients. We suggest to pay attention to those factors to implement delirium prevention, treatment and nursing to reduce the incidence and improve clinical outcomes for elderly patients.

Objective To translate the 3-minute diagnostic confusion assessment method(3D-CAM)into Chinese,to revise it,and to test its reliability and validity in elderly patients.Methods We translated and culturally adapted 3D-CAM into Chinese.The sample was formed by 230 elderly patients over 65 years of age.We tested inter-assessors reliability and criterion validity (diagnostic validity)and then computed the sensitivity,specificity,positive predictive value,and negative predictive value of the Chinese version of 3D-CAM.Results Correlation analyses between each item and its total score showed that the correlation coefficients ranged between 0.290 and 0.724,all reaching statistical significance(P＜0.01).Inter-assessor reliability in a sample size of 30 patients resulted in a kappa value of 0.78 (P ＜ 0.001).Compared with the gold standard,the diagnostic and statistical manual of mental disorders(DSM-5)by American Psychiatric Association(APA),the sensitivity of the Chinese version of 3D-CAM was 94.73％,the specificity was 97.92％,the positive predictive value was 90.00％,and the negative predictive value was 98.95％.Conclusions The Chinese version of 3D-CAM has achieved satisfactory reliability and validity through pilot runs in surgery and internal medicine inpatients,proved to be easy and convenient to administer,and can be used as an assessment tool for delirium in elderly surgery and internal medicine patients.

Objective To investigate influencing factors for comprehensive geriatric assessment carried out in geriatric departments of comprehensive hospitals in Sichuan province and its influential factors ,in order to verify whether education affects CGA and to raise medicine quality of senile disease. Methods The self-designed questionnaires were distributed to 40 hospitals in difference downs and cities in Sichuan province. The data were collected ,including items of CGA carried out in each hospital ,structure of staff ,scale ,bed distribution ,numbers of bed in geriatric department ,etc. The correlations of CGA items with the related factors were analyzed by using multiple linear regression analysis. Results The items of CGA carried out was positively related with hospital grade (β= -5.4 ,P=0.03) ,the staff-attending three times or more of geriatric training course (β=0.2 ,P=0.05) , the number of nurses per bed(β=15.6 ,P=0.03) ,the number of physicians with master's degree(β=-0.2 ,P=0.04) ,and the lower average age of medical staff (β= -0.6 ,P=0.05). Conclusions The grade of hospital ,attending actively geriatric training course ,the number of the nurses per bed ,the number of physicians with master's degree ,and the younger average age of medical staff were positively associated with the items of CGA carried out in hospitals.

Sarcopenia is a geriatric syndrome associated with aging, accompaning with decreased skeletal muscle mass and muscle hypofunction, which will contribute to many adverse outcomes and seriously threaten the health status of the elderly.There are many studies concerning its risk factors and adverse outcomes of sarcopenia, but the correlation between sarcopenia and chronic pain is not fully clarified.This article will review the association between sarcopenia and chronic pain so as to provide a theoretical reference for future research on the risk factors and early prevention of sarcopenia.

BACKGROUND:With a gradually aging population,improving the ability to screen for the risk of death after arthroplasty and implementing timely personalized intervention programs for the increasing number of elderly patients with femoral neck fractures is key to improving the postoperative status of patients and prolonging survival expectations. OBJECTIVE:To investigate the risk factors for postoperative mortality in elderly patients with femoral neck fractures and to construct a nomogram predictive model to predict their mortality risk. METHODS:The study was conducted on 155 elderly patients(≥65 years old)who underwent arthroplasty for femoral neck fracture from January 2016 to January 2021,and 147 patients who met the inclusion criteria were analyzed to collect clinical data that may affect the patients'postoperative mortality.Single-factor and multi-factor Cox regression analyses were successively used to screen independent risk factors associated with postoperative mortality.The column line graph model was constructed and validated using Rstudio software. RESULTS AND CONCLUSION:(1)Age,frailty(age-adjusted Charlson comorbidities score),preoperative activity status,osteoporosis,and postoperative serum albumin level were five independent risk factors for postoperative mortality in elderly patients with femoral neck fractures(P<0.05).(2)The nomogram predictive model was constructed based on the results of multifactorial analysis,with a consistency index of 0.819(95%CI:0.771-0.868).Receiver operating characteristic curve analysis showed that the area under curve for 1-year and 3-year survival prediction was 0.8543 and 0.7263,respectively,indicating that the nomogram predictive model has good discriminatory and predictive power;calibration curve and decision curve analysis also showed good model discriminative power and clinical utility value.(3)The constructed nomogram predictive model has good diagnostic efficacy and accuracy,and can effectively assess the risk of postoperative death of patients.

BACKGROUND:Arthroplasty is the primary treatment for displaced femoral neck fractures in the elderly,and the choice of total hip arthroplasty versus hemiarthroplasty is currently the subject of considerable debate. OBJECTIVE:To compare the mid-and long-term survival status of total hip arthroplasty versus hemiarthroplasty under a direct anterior approach for displaced femoral neck fractures in the elderly based on the propensity score matching method. METHODS:One hundred and forty-seven elderly patients(≥65 years of age)with displaced femoral neck fractures were admitted from January 2016 to January 2021,of whom 88 had total hip arthroplasty(total hip arthroplasty group)and 59 had artificial femoral head replacement(hemiarthroplasty group).For the patients'preoperative comorbidities,the age-corrected Charlson Comorbidity Scale was used to quantify the scores and calculate patient frailty.The propensity score matching method was used to match the two groups 1:1 and to compare the operation time,bleeding,postoperative hospitalization time,hospitalization cost,nutritional index,postoperative complications,and mortality between the two groups after matching.Postoperative survival time was determined by Kaplan-Meier Survival analysis. RESULTS AND CONCLUSION:(1)After propensity score matching,a total of 42 matched pairs were successful in both groups,and the preoperative data of patients in both groups were balanced and comparable after matching(P>0.05).(2)Compared with the hemiarthroplasty group,operation time(79.71 minutes vs.59.07 minutes,P<0.001),bleeding volume(839.64 mL vs.597.83 mL,P=0.001),and hospitalization cost(56 508.15 yuan vs.41 702.85 yuan,P<0.001)were significantly higher in the total hip arthroplasty group.However,the mortality rate was lower in the total hip arthroplasty group than in the hemiarthroplasty group(36%vs.57%,HR=0.44,95%CI:0.23-0.87,P=0.018),and the mean survival time was longer in the total hip arthroplasty group than in the hemiarthroplasty group(59.4 months vs.43.7 months,P=0.024).(3)There were no statistically significant differences in postoperative hospitalization time,preoperative and postoperative nutritional indicators,and overall postoperative complication rate between the two groups(P>0.05).However,in terms of postoperative pain,the incidence of pain was significantly higher in the hemiarthroplasty group than that in the total hip arthroplasty group(24%vs.7%,P=0.035).(4)Overall,total hip arthroplasty has a better prognosis for survival,while hemiarthroplasty is more appropriate for patients with poor physical fitness.At the same time,postoperative pain may largely affect the quality and survival time of patients after hip arthroplasty.