Objective To explore the value of OMOM capsule endoscopy in the diagnosis of gastrointestinal diseases in the elderly patients.Methods A retrospective analysis of the clinical data on 86 elderly patients completed OMOM capsule endoscopy during May 2008 to April 2013 were performed.Results All the patients were well tolerated,and capsules were successfully excreted.The mean detention time in gastrointestinal was 50.64 min,the mean run time was 315.86 min.Thirty-eight (44.19％,38/86) patients gained positive diagnosis.In 45 patients with unknown reason,28 patients (62.22％,28/45) gained positive diagnosis.In 28 patients with abdominal pain and diarrhea,5 patients gained positive diagnosis.In 4 patients with other reason,no patients gained positive diagnosis.Conclusions The manipulation of OMOM capsule endoscopy is simple,safe and effective.And the elderly patients can tolerate well.Obscure gastrointestinal bleeding is the main reason to check,and has a higher diagnostic yield.

Aim To explore the role of AMPK/ PGC-1α pathway in cardioprotection of hydrogen sulfide ( H2 S ) against ischemia/reperfusion ( I/R ) injury. Methods Langendorff perfusion apparatus was used to build an isolated rat myocardial I/R model. Seventy-two male SD rats were randomly divided into 6 groups (n=12):control group (Control), ischemia/reperfu-sion group ( I/R ) , DMSO group ( DMSO ) , inhibitor Compound C group ( CC) , H2 S postconditioning group ( NP) , and H2 S with Compound C group ( N +C ) . The heart rate ( HR ) , the left ventricular developed pressure ( LVDP ) , the maximum rate of increase or decrease of left ventricular pressure ( ± dp/dtmax ) and the left ventricular diastolic pressure ( LVEDP ) were registered at 20 min of baseline and 60 min of reperfu-sion separately. Triphenyl tetrazolium chloride ( TTC) staining and HE staining were used to determine the myocardial infarct size and the myocardial tissue mor-phological change of each group was observed respec-tively. Immunohistochemistry was used to determine the expression of PGC-1α. The expressions of total AMPK ( tAMPKα ) , phosphorylated AMPK ( pAMPKα) and PGC-1α were detected with Western blot anaylsis. Results There were no differences in e-quilibrium hemodyamics observed between the experi-mental groups(P>0. 05). At the end of reperfusion, compared with I/R group, NP group had obviously a-meliorated functional recovery and significantly de-creased myocardial infarct size [ ( 23. 9 ± 3. 4 )% vs (60. 9 ± 3. 8 )%, ( P <0. 05 ) ] . HE staining showed that in NP group, the myocardial injury was reduced. Meanwhile, the expression of pAMPKα and PGC-1αincreased significantly. However, Compound C re-versed the cardioprotection effects provided by hydro-gen sulfide postconditioning and reduced the expression of pAMPKαand PGC-1α. Conclusion AMPK/ PGC-1α pathway is involved in the role of hydrogen sulfide against ischemia/reperfusion injury.

OBJECTIVETo investigate the role of autophagy on the pathogenesis of spinocerebellar ataxia 3/Machado-Joseph disease (SCA3/MJD).

METHODSHEK293 cells expressing polyglutamine-expanded ataxin-3 were used as cell model for SCA3/MJD. The level of polyglutamine-expanded ataxin-3 was detected after cells were treated with different inhibitors or inducer of autophagy.

RESULTSInhibition of autophagy increased aggregate formation and cell death in HEK293 cells expressing mutated ataxin-3, and vice versa.

CONCLUSIONThe data suggested that autophagy is involved in the degradation of mutant ataxin-3, resulting in a decrease in the proportions of aggregate-containing cells and cell death in HEK293 cells expressing polyglutamine-expanded ataxin-3. It is possible that autophagy may be applied as a potential therapeutic approach for SCA3/MJD.

Ataxin-3 ; Autophagy ; Cell Line ; Humans ; Machado-Joseph Disease ; genetics ; metabolism ; physiopathology ; Mutation ; Nerve Tissue Proteins ; genetics ; metabolism ; Nuclear Proteins ; genetics ; metabolism ; Peptides ; metabolism ; Repressor Proteins ; genetics ; metabolism

Objective:To explore the application of Omaha system-based specialized precise nursing intervention in patients with acute coronary syndrome (ACS).Methods:This study recruited 120 hospitalized patients with ACS in the Department of Cardiology, the First Affiliated Hospital of Xi′an Jiaotong University from June 2019 to December 2019. These patients were randomly allocated into the experimental ( n=60) or control group ( n=60) by using a random number table. Patients in the control group received routine care only, while those in the experimental group also received the Omaha system-based specialized precise nursing intervention. Results:After the intervention, compared with the control group, the score of cognitive and behavioral status in the experimental was significantly improved. In particular, the cognitive scores of pain, chest tightness, arrhythmia, hypertension, edema, dizziness, constipation, wound bleeding, swelling, fatigue, insomnia, diet, medication, smoking, drinking, overweight, exercise, mental stress, social regression, and awareness were significantly improved ( t values were 1.39-5.06, P<0.05). The behavioral scores of pain, chest tightness, arrhythmia, hypertension, edema, dizziness, constipation, wound bleeding, swelling, fatigue, diet, medication, overweight, exercise, mental stress, and social regression were significantly improved ( t values were 1.41-4.80, P<0.05). The fatigue, insomnia, exercise compliance, mental stress, and social regression were significantly improved ( t values were 1.44-4.27, P<0.05). Conclusions:Omaha system-based specialized precise nursing intervention can comprehensively evaluate the nursing problems of patients with ACS, can implement precision specialized nursing, can effectively solve the nursing problems of patients, and can promote the recovery of heart function and rehabilitation of patients with ACS.

Objective To explore the effect of cluster nursing intervention in elderly patients with swallowing dysfunction. Methods A total of 105 elderly patients with a Water Swallowing Test (WST) score of ≥3 and a Fried Frailty Phenotype (FP) score of ≥33 admitted to the department of geriatrics in our hospital from August 2022 to December 2023 were selected as research subjects and randomly divided into study group (n=55) and control group (n=50). The control group received routine nursing care for swallowing dysfunction, while the study group received cluster nursing care. The frailty status, swallowing disorders, and quality of life were compared between the two groups after 1 month of intervention. Results Due to changes in the condition, 2 cases dropped out from the control group and 3 cases from the study group, leaving 52 cases in the study group and 48 cases in the control group. There was no statistically significant difference in general information between the two groups (P>0.05). Before the intervention, there was no statistically significant difference in the proportion of patients with different WST grades between the two groups (P>0.05). After 1 month of intervention, there was a statistically significant difference in the proportion of patients with WST grades 3, 4, and 5 compared to before the intervention (P < 0.05). After 1 month of intervention, there was a statistically significant difference in the proportion of patients with different WST grades between the two groups (P < 0.05). Before the intervention, the Swallowing-Quality of Life(SWAL-QOL) score of the study group was (108.47±19.99) points, and was (109.17±20.34) points in the control group. There was no statistically significant difference in SWAL-QOL scores between the two groups before the intervention (P>0.05). After 1 month of intervention, the SWAL-QOL score of the study group was (143.07±16.55) points, and was (133.52±21.06) points in the control group. The SWAL-QOL scores of both groups improved compared to before the intervention, and the study group had a higher score than the control group (P < 0.05). Conclusion Cluster nursing for elderly patients with swallowing disorders and frailty can effectively improve their frailty status, swallowing function, and quality of life.

Objective:To explore the effect of food intake management based on swallowing safety assessment in elderly patients with frailty.Methods:From April 2020 to March 2021, convenience sampling was used to select 126 elderly patients with frailty in the Department of Geriatrics, Beijing Friendship Hospital, Capital Medical University, as the research object. According to the random number table method, the patients were divided into the observation group and the control group, with 63 cases in each group. The control group implemented routine food intake management, and the observation group carried out food intake management based on swallowing safety assessment for a period of 12 weeks. The nutritional indicators, incidence of aspiration, quality of life and frailty status of the two groups of patients were compared.Results:After the intervention, the hemoglobin, serum total protein, serum albumin levels and the Short Form 36 Health Survey Questionnaire (SF-36) scores of the observation group were higher than those of the control group, and higher than this group before the intervention, and the differences were statistically significant ( P<0.05) . The incidence of aspiration in the observation group and the control group were 11.11% (7/63) and 33.33% (21/63) respectively, and the difference was statistically significant ( P<0.05) . Conclusions:Food intake management based on swallowing safety assessment can effectively improve the nutritional status and quality of life of elderly patients with frailty, and reduce the incidence of aspiration.

Objective:To construct a remote health management program based on dynamic blood glucose monitoring system for elderly patients with diabetes and sarcopenia, so as to provide new ideas for health management of elderly patients with diabetes and sarcopenia.Methods:The first draft of remote health management program based on dynamic blood glucose monitoring system for elderly patients with diabetes and sarcopenia was formed through team building and literature research. The Delphi method was used to determine the final management program after two rounds of expert consultation.Results:In two rounds of expert consultation, 16 questionnaires were distributed and 16 valid questionnaires were collected, with an effective recovery rate of 100%. After two rounds of expert consultation, the Kendall's coefficients of the first, second, and third level indicators were 0.438, 0.147, 0.167, and 0.495, 0.199, 0.150, respectively ( P<0.05). The finally remote health management program based on dynamic blood glucose monitoring system for elderly patients with diabetes and sarcopenia included 3 first level indicators (remote health management service content, remote health management system, service project description), 11 second level indicators and 25 third level indicators. Conclusions:The remote health management program based on dynamic blood glucose monitoring system for elderly patients with diabetes and sarcopenia is scientific, practical and applicable, and has practical significance for clinical nursing.

Objective:To investigate and analyze the status quo and risk factors of swallowing function and safe eating behavior in elderly type 2 diabetes patients with frailty, so as to provide a reference for clinical early identification and early prevention.Methods:From July 2021 to December 2022, 295 patients with type 2 diabetes accompanied with frailty were selected from the Endocrinology Department of Beijing Friendship Hospital Affiliated to Capital Medical University by convenience sampling. Patients were surveyed using the Tilburg Frailty Indicator (TFI) and the Eating Assessment Tool-10. Single factor analysis and Logistic regression analysis were used to explore the influencing factors of swallowing function and safe eating behavior in elderly type 2 diabetes patients with frailty.Results:A total of 295 questionnaires were distributed, and 291 valid questionnaires were collected, with an effective response rate of 98.64%. There were 94 cases in the group with abnormal swallowing function and safe eating behavior, and 197 cases in the group with normal swallowing function and safe eating behavior. There were statistical differences in age, body mass index, duration of diabetes, TFI score, education level, and number of chronic diseases between the two groups ( P<0.05). Logistic regression analysis showed that the duration of diabetes ( OR=1.047, P=0.024), TFI score ( OR=1.147, P=0.009), and the number of chronic diseases ( OR=1.282, P=0.035) were the influencing factors of swallowing function and safe eating behavior in elderly type 2 diabetes patients with frailty. Conclusions:Abnormal swallowing function and safe eating behavior are common in elderly type 2 diabetes patients with frailty, and the duration of diabetes, frailty and chronic comorbidity are independent risk factors.

Objective:This study aims to investigate the prevalence of chronic pain among elderly inpatients and its association with physical and cognitive frailty.Methods:A total of 540 elderly patients from the Department of Geriatric Medicine at Beijing Friendship Hospital were included in the study between January 2019 and December 2023.Based on the Numerical Rating Scale(NRS)scores, patients were categorized into two groups: those experiencing pain and those without pain.Univariate analysis was conducted to compare general information, physical frailty, and cognitive frailty between the two groups; however, no significant relationship was identified between cognitive decline and chronic pain.Additionally, Binary Logistic regression was employed to identify the independent factors influencing chronic pain.Results:The prevalence of chronic pain among elderly hospitalized patients was found to be 19.4%.Univariate analysis indicated that factors such as educational background, anxiety and depression, activities of daily living(ADL), polypharmacy, and physical frailty were associated with chronic pain.Furthermore, binary logistic regression identified educational background, polypharmacy, and physical frailty as independent influencing factors of chronic pain.Conclusions:The prevalence of chronic pain in elderly hospitalized patients is notably high, highlighting the need for more prospective studies to explore the relationship between chronic pain and multi-dimensional frailty, including social frailty.Addressing chronic pain in the elderly necessitates multidisciplinary interventions that consider the potential impact of frailty on pain.

Objective: To explore the feasibility of applying Omaha system theory to patients with coronary heart disease (CHD) through comparative analysis of nursing description. Methods: Using content extraction analysis method, the nursing records, nursing plans and nursing measures of discharged patients with CHD were retrieved from the medical records, and then the conceptual consistency of the extracted records and the problem classification system and intervention measures in the Omaha system were evaluated by cross mapping method. Results: A total of 2 609 nursing problems and intervention measures were extracted from the medical records of 68 patients with CHD. Among them, 1 844 (70.68%) records were labeled as "perfect fit", 608 records (23.30%) as "partial fit", and 157 (6.02%) recordsas "not fit at all". The total fit rate was 93.98% (perfect fit and partial fit). The most frequently reported problems were in physiological domain, followed by health-related behaviors domain, psychosocial domain and environmental domain. The nursing interventions extracted accounted for 26.67% (1 968 sentences) of directions and l00.00% (4 kinds) of categories in the intervention scheme of Omaha system. Conclusions The conceptual congruence between the medical records of patients with CHD and the Omaha System is quite high. It can help to improve nursing problems of patients of CHD in health-related behavioral domain, psychosocial domain and environmental domain, and can be applied to such patients after appropriate adjustment, so as to help clinical nursing staff to provide specialized and all-round guidance for patients with CHD.