Objective To analyze the changes in optical coherence tomography angiography (OCTA) parameters in patients with essential hypertension，and to explore the effect of blood pressure on OCTA parameters. Methods A total of 164 patients with essential hypertension were selected and divided into controlled blood pressure group (n=92) and uncontrolled blood pressure group (n=72). OCTA examination was performed on the optic disc and macula of all patients, and the right eyes were selected for analysis. Results There were no significant differences in retinal nerve fiber layer (RNFL) thickness, radial peripapillary capillary (RPC) total vascular density, RPC total small vessel density, perifovea superficial capillary plexus (SCP) vascular density, and perifovea deep capillary plexus (DCP) vascular density between the two groups of patients. There were no significant differences in foveal avascular zone (FAZ) area, FAZ diameter, and fovea retinal thickness between the two groups of patients. The density of the parafovea SCP, parafovea DCP, and fractal dimension (FD) in the uncontrolled blood pressure group were significantly lower than those in the controlled blood pressure group (P＜0.05). Multiple linear regression analysis showed that elevation of blood pressure was a independently related factor of reduced parafovea DCP density (P＝0.026), while there was no correlation between the uncontrolled blood pressure and parafovea SCP density and FD level. Conclusions The blood pressure level is correlated with the parafovea DCP density, while has no correlation with other OCTA parameters in hypertension patients.

Falls are an adverse health outcome in older adults and are strongly associated with their intrinsic capacity.All five dimensions of intrinsic capacity(locomotion, vitality, cognition, sensory function, and psychosocial function)are associated with falls.This article provided a review of the concept, significance, and impact of each dimension of intrinsic capacity on falls, with the aim of providing relevant information for further research and clinical work.

Objective:To evaluate the relationship between the blood uric acid/high-density lipoprotein cholesterol ratio (UHR) and diabetes retinopathy (DR) in diabetic and pre-diabetic population.Methods:A cross-sectional study. The data from a health survey from 2010 to 2011 on chronic diseases and risk factors in Changping District in Beijing was used in this study. Total of 2 507 pre-diabetic and diabetic patients who met the inclusion and exclusion criteria were screened out in this study, included 1 212 men and 1 295 women. The patients were divided into DR group and non-DR (NDR) group according to whether DR was present or not. Independent sample t-test, chi-square test and multivariate logistic regression were used for case-control study to investigate whether there was independent correlation between UHR and DR. The receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic value of UHR for DR. Results:There were gender differences in the relationship between uric acid related indicators and DR, no significant correlation was found in women. In males, the age, duration of diabetes,fasting blood glucose (FPG), glycosylated hemoglobin (HbA 1c), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglyceride (TG), serum uric acid, UHR levels and the proportion of diabetes and hypertension history in DR group were all significantly higher than those in NDR group (all P<0.05). Logistic regression analysis showed that SUR ( OR=1.054, 95%CI: 1.004-1.106, P=0.033) and UHR ( OR=1.391, 95%CI: 1.061-1.823, P=0.017) were the relative risk factors of DR. After adjusting for age, registered residence, education level, smoking, drinking, physical exercise, waist circumference, hypertension history, SBP, DBP, total cholesterol and other risk factors, UHR was still associated to DR [ OR ( 95%CI): 1.438 (1.084-1.908), P=0.012]. The area under the ROC curve of UHR was 0.610 ( 95%CI: 0.514-0.707, P=0.030). When the cut-off value of UHR for predicting DR was 0.24, the sensitivity and specificity were the highest, which was 78.8% and 58.7%, respectively. Conclusion:UHR is significantly correlated with the risk of DR in men with pre-diabetes and diabetes, but not in women. The risk of DR increases with the elevated level of UHR. UHR is helpful to diagnose DR and screen people with DR risk.

Hospitalization-associated disability(HAD)is defined as a new loss of the ability to complete one or more activities of daily living without assistance developed between hospital admission and discharge.It is commonly seen in hospitalized older adults.There are numerous risk factors for the development of HAD, including general health status, specific diseases, hospital-associated and post-discharge factors.HAD can increase the length of hospitalization and care burden after discharge.It also results in a higher risk for disability and death and increases healthcare costs.In clinical practice, early identification of individuals at high risk of developing HAD is necessary for proactive intervention.This article reviews the definition, epidemiology, risk factors, screening tools, treatment and intervention, in order to promote awareness and management skills of HAD among geriatric care professionals and thus to improve the prognosis of hospitalized elderly patients.

Objective:To explore the effect of narrative nursing in patients with retinal detachment undergoing surgery.Methods:From February 2020 to August 2021, 40 patients with retinal detachment who underwent surgical treatment in the Department of Geriatrics and Ophthalmology of Beijing Tongren Hospital, Capital Medical University were selected as the research object by the convenient sampling method. According to the random number table method, the patients were divided into the observation group and the control group, 20 cases in each. The patients in the control group were given routine nursing, and the patients in the observation group received narrative nursing on this basis. Before and after the intervention, Self-Rating Anxiety Scale (SAS) , Self-Rating Depression Scale (SDS) , Memorial University of Newfoundland Scale of Happiness (MUNSH) , and Generic Quality of Life Inventory-74 (GQOLI-74) were used to investigate the two groups of patients. The hospitalization time and complications of the two groups of patients were recorded.Results:At discharge, the SAS and SDS scores of the observation group were lower than those of the control group, the GQOLI-74 and MUNSH scores of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.01) . The hospitalization time of the observation group was shorter than that of the control group, and the difference was statistically significant ( P<0.05) . There was no significant difference in the number of cases of postoperative intraocular hypertension between the two groups ( P>0.05) . Conclusions:Narrative nursing can effectively relieve anxiety and depression in patients with retinal detachment surgery, improve patients' well-being and quality of life, and shorten hospitalization time.

Balance impairment significantly correlates with falls in the elderly.The timed up and go test(TUGT)is a common and simple assessment tool to evaluate balance and gait function and widely used to screen for the risk of falls in the elderly.In this review, we explore the following issues on TUGT: the development, the association with computerized dynamic posturography, and the validity and reference value for fall risk prediction.This may further improve the applicability and prediction accuracy of the screening tool for falls in the elderly.

Fall is one of major causes of disability, reduced mobility, shortness of life span and increased medical costs in the elderly.There are multiple risk factors for falls in the elderly, but they can be preventable and controlled.This article reviews the evidences regarding the clinical effectiveness, practicalness and security of these fall risk assessment methods and measures of interventions by evidence-based medicine in the elderly and analyzes their research directions.

The prevalence of hyperuricemia in elderly population aged over 60 years in China ranges from 5.5%-19.3%.With the population ageing, the number of the patients with hyperuricemia can be expected to grow.Whether elderly patients with asymptomatic hyperuricemia need active uric acid-lowering therapy is still a debatable entity because of lacking relevant clinical guidelines.In this paper, the metabolic process of uric acid, pathophysiologic mechanism of hyperuricemia, the treatment principle of hyperuricemia in combination with different comorbidities, and specific therapeutic schedules for asymptomatic hyperuricemia as well as drug therapy progress were reviewed as follows.

Objective:To investigate the clinical characteristics, preferences for cardiopulmonary resuscitation(CPR)and end-of-life care status in elderly patients with cancer vs.non-cancer diseases under geriatric care, and to provide the basis for different elderly groups to carry out palliative care.Methods:Medical records of deceased residents aged ≥60 years from 2014 to 2017 in the department of geriatrics of our hospital were retrospectively reviewed.Data on clinical characteristics, preferences for CPR, application of life-sustaining treatments and end-of-life care were collected.A total of 129 patients were divided into the cancer death group (n=48) and the non-cancer death group (n=81)according to the cause of death.Clinical characteristics and end-of-life care status were compared between the two groups.Results:A total of 129 cases including 98 males(76.0%)and 31 females(24.0%), with a median age of 87(60~100)years and 110 cases(85.3%)aged 80 years and above, were enrolled in this study.The main causes of death were malignant solid tumors(48 cases, 37.2%)and infectious diseases(47 cases, 36.4%). Compared with the cancer death group(n=48), the proportion of patients aged 80 years and above was higher(n=81)(95.1% or 77 cases vs. 68.7% or 33 cases), the proportion of painkiller utilization(5.0% or 4 cases vs. 29.2% or 14 cases)and Charlson Comorbidity Index scores(5.7±2.3 vs.8.9±2.7)were lower in the non-cancer death group( P<0.01). There was no difference in proportions admitted to the intensive care unit, with moderate and severe disability, or with polypharmacy between the two groups( P>0.05). Compared with the cancer death group, the proportions opting for CPR on admission day(70.9% or 56 cases vs. 39.6% or 19 cases), administration of ventilators(38.3% or 38 cases vs. 16.7% or 8 cases)and respiratory stimulants(71.6% or 58 cases vs. 52.1% or 25 cases)were higher in the non-cancer death group( P<0.05). There was no difference in preference for do-not-resuscitate(DNR), utilization of extracardiac compression, electrical defibrillation, tracheotomy, tracheal intubation or vasoactive drugs utilization( P>0.05). Conclusions:The status of hospitalized elderly patients under geriatrics is complex and the burden of end-of-life care is heavy, so it is urgent to practice geriatric palliative care.In addition to focusing on cancer patients, symptom control, early advance care planning (ALP) plans and avoidance of overuse of life-sustaining treatment (LST) at the end stage of non-cancer diseases also need to be addressed.

Objective To evaluate the value of semi-quantitative indices of 68Ga-prostate specific membrane antigen (PSMA)-11 PET/CT in differentiating malignant and benign prostate lesions.Methods From November 2017 to June 2018,30 patients (age:52-86 years) who underwent 68Ga-PSMA-11 PET/CT imaging in the Third Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed,and the serum total prostate specific antigen (tPSA) and free prostate specific antigen (fPSA) were examined within 1 week before PET/CT imaging.Semi-quantitative indices of 68Ga-PSMA-11 PET/CT on prostate lesions were measured by automatic segmentation algorithm method,including PSMA-related lesion volume (VPSMA),maximum standardized uptake value (SUVmax),mean standardized uptake value (SUVmean),peak standardized uptake value (SUVpeak) and total lesion uptake value of PSMA (TLUPSMA).The indices were compared between malignant and benign prostate lesions,and the optimal cut-off values for differentiating malignant and benign prostate lesions were obtained by receiver operating characteristic (ROC) curve analysis.Results According to the pathological results,19 patients had malignant lesions and 11 were with benign diseases.The differences of tPSA,SUVmax,SUVmean SUVpeak and TLUPSMA between malignant and benign prostate lesions were statistically significant (u values:17.00-48.00,all P＜0.05),but there were no significant differences of fPSA,fPSA/tPSA and VPSMA between 2 groups (u values:64.00-99.00,all P＞0.05).The optimal cut-off value of tPSA was 18.30 μg/L for differentiating malignant and benign prostate lesions,with sensitivity of 13/17 (PSA of 2 patients were missing),specificity of 9/11 and area under curve (AUC) of 0.743.The optimal cut-off values of SUVmax,SUVmean and SUVpeak were 5.50,3.09 and 3.56,respectively,with all corresponding sensitivity of 18/19,all specificity of 9/11,and AUC of 0.902,0.907 and 0.919,respectively.The optimal cut-off value of TLUPSMA was 54.81 cm3,with sensitivity of 14/19,specificity of 9/11 and AUC of 0.804.Conclusion The semi-quantitative indices of 68Ga-PSMA-11 PET/CT are valuable for differentiating malignant and benign prostate lesions,in which SUVpeak is superior to other indices.