With the emerging of aging society and advances of information sciences, telemedicine has gradually become a new medical model.Telemedicine can be used in health monitoring, disease diagnosis, counseling, education, chronic disease management and long-term care in elderly population;particularly in management of chronic heart failure, diabetes and other chronic diseases, as well as in referral and continuous medical care.To promote telemedicine in the elderly population can break the physical limitations of different health care settings, so that geriatrician and the allied team members are enable to maximize their values in providing corresponding health services.This article reviews the progress of telemedicine in foreign countries, which would be of reference value for development of telemedicine for elderly people in China.

Objective To investigate the differences of four equations to estimate glomerular filtration rate (GFR) and their impacts on chronic kidney disease (CKD) prevalence in communitydwelling elderly people in Beijing.Methods A total of 489 participants aged above 70 years were enrolled.The GFR was estimated using the Cockcroft Gault (CG) equation,Chronic Kidney DiseaseEpidemiology Collaboration (CKD-EPI) equation,Modification of Diet in Renal Disease (MDRD) equation and Berlin Initiative Study (BIS) equation respectively.The internal-consistency check was made on the four equations for the GFR (ml min 1 1.73m 2) estimates.Results The mean age of participants was (81.8±7.6) years.The mean GFR estimated using the CG,CKD-EPI,MDRD and BIS equation was 58.4± 17.2,71.9± 15.3,76.7± 19.1 and 62.7± 12.7,respectively.And the prevalence of CKD was 56.2％,22.7％,17.8％ and 41.7％,respectively.The greatest differences of equations to estimate GFR were seen in elderly people aged 90 and above,and those with body mass index＜ 20.0 kg/m2 or serum creatinine concentration＜ 88.4 μmol/L.Conclusions The GFR estimated using different equations has a large difference which has a significant effect on CKD classification in elderly people.The equation to estimate GFR for the elderly is urgently needed.Until then,the eGFR and CKD classification estimated using different equations should be regarded with caution.

Objective To summarize the progress of research on the influence of nutrition support on quality adjusted life year (QALY) in elderly patients with nutritional risk, and to evaluate the feasibility of QALY as an outcome indicator.Methods Literature in Chinese, English and Japanese relating to the feasibility of QALY and cost-utility in evaluating the influence of nutrition support on the outcomes of patients with nutritional risk published from 1980 to 2013 were searched in Wanfang, China National Knowledge Infrastructure,PubMed, Nature databases.The methodological quality of randomized controlled trials was assessed using Jadad scale combined with Schulz allocation concealment, and the quality of cohort studies with Newcastle-Ottawa scale.Results Totally 10 articles were fotnd, in which 8 were selected, including 6 randomized controlled trial and 2 cohort studies, covering 1 130 patients;the other 2 were excluded for not conforming to inclusion criteria.Four of the 6 randomized controlled trial indicate that QALY is higher and all-cost is lower in the treatment group compared with the control group (or cost-utility is higher in the treatment group).The 2 cohort studies indicate that total parenteral nutrition support at home could improve the QALY of malnourished patients and could save cost compared with nutrition support at hospital when necessary.Conclusions Nutrition support for patients with nutritional risk can improve prognosis, reduce cost, and increase QALY.More large-scale, high-quality randomized controlled trials are needed to evaluate the effect of nutrition support on the QALY of elderly patients with nutritional risk.

Objective: To examine the effects of obesity and central obesity on hypertension, so as to provide insights into the prevention and control measures of hypertension. Methods: From September to December 2018, residents at ages of 35 to 75 years were sampled using the multi-stage random sampling method in Baiyin District, Baiyin City, Gansu Province, and subjected to questionnaire surveys and physical examinations. The interaction between obesity/central obesity and hypertension was evaluated using logistic regression analysis. The synergy index ( SI ), relative excess risk due to interaction ( RERI ) and attributable proportion due to interaction ( AP ) were calculated using Excel compiled by Andersson et al. Results: A total of 6 246 questionnaires were allocated and 6 169 valid questionnaires were recovered, with an effective recovery rate of 98.77%. The respondents included 3 038 men ( 49.25% ) and 3 131 women (50.75%), with a mean age of ( 52.05±8.78 ) years. There were 832 respondents with obesity ( 13.49% ) and 2 278 with central obesity ( 36.93% ). The crude and standardized prevalence rates of hypertension were 35.89% and 33.05%, respectively. Multivariable logistic regression analysis showed that obesity ( OR=2.020, 95%CI: 1.705-2.393 ) and central obesity ( OR=1.622, 95%CI: 1.433-1.836 ) were statistically associated with hypertension. There was no multiplicative interaction between obesity or central obesity and hypertension ( OR=1.011, 95%CI: 0.655-1.560 ), and no additive interaction was detected between obesity or central obesityand hypertension ( SI=1.405, 95%CI: 0.815-2.424; RERI=0.658, 95%CI: -0.298 to 1.614; AP=0.201, 95%CI: -0.075 to 0.476 ). Conclusions Obesity and central obesity increase the risk of hypertension; however, no interaction is detected between obesity or central obesity and hypertension.

Objective:To retrieve, evaluate, and integrate domestic and foreign evidence on the prevention of central venous access device medical adhesive-related skin injury (CVAD-MARSI) , and analyze and summarize the best evidence, so as to provide a reference for establishing a sound intravenous infusion treatment system and CVAD-MARSI management mechanism.Methods:Evidence-based nursing methods were applied, and the evidence on the prevention of CVAD-MARSI in British Medical Journal (BMJ) Best Practice, UpToDate, Australia Joanna Briggs Institute (JBI) Evidence-Based Practice Database, Canada Registered Nurses' Association of Ontario, Scottish Intercollegiate Guidelines Network, National Institute for Health and Clinical Excellence, Cochrane Library, Intravenous Nurses Society, PubMed, Medlive, Chinese Biomedical Literature Database, Wanfang Data, China National Knowledge Infrastructure (CNKI) was retrieved according to the "6S" model system. The evidence included guidelines, best practices, systematic reviews, expert consensus, and evidence summary. The search time limit was from January 1, 2011 to February 1, 2021. Two researchers independently completed the quality evaluation of the included literature, and carried out the evidence extraction and summary of literature that met the quality standards.Results:A total of 10 articles were included, including 3 guidelines, 1 systematic review, 5 expert consensuses, and 1 evidence summary. The best evidence covered 5 aspects including patient evaluation, skin preparation, dressing use, improvement of comfort, and organization management, with a total of 26 pieces of evidence.Conclusions:Clinical medical and nursing staff can take measures in terms of patient evaluation, skin preparation, dressing use, improvement of comfort, and organization management. In the process of evidence application, the best targeted evidence should be selected combined with the clinical situation, so as to reduce the harm of CVAD-MARSI.

Objective To compare differences among measured rest energy expenditure (REE) by using indirect calorimetry (IC) and predictive REE from predictive equations (PE) and human body component analyzer (HBCA).Methods Young and middle-aged healthy volunteers of light manual labor were recruited in this study.REEs were obtained from IC,PE (WHO-Schofield and Harris-Benedict equations) and HBCA.Results A total of 30 healthy participants were included,of whom 12 were males (25-46 years old) with an average age of (37.8±7.4) and 18 were females (26-52 years old) with an average age of (40.4±7.8).Measured REE of the males was (1 848.33± 155.01) kcal/d,which was significantly different from the predictive REE result of H-B equation (P=0.003) but not from results of WHO-Schofield equation and HBCA.In females,however,measured REE was (1 294.44± 134.23) kcal/d,which was significantly different from predictive REE results of both equations and HBCA,P=0.002 (WHO-Schofield),P=0.031 (H-B) and P=0.002 (HBCA).Results of measured REE were related to weight (P=0.033) and percentage of body fat (P=0.036) in males,and to height and muscle mass (P=0.003) in females.Conclusion In young and middle-aged healthy females of light manual labor,IC represented a more accurate way to measure REE,while in males WHO-Schofield equation and HBCA could be considered as alternative choices to predict REE.