Objective:To explore the effect of Ephedrine on oxygen glucose deprivation/reoxygenation(OGD/R)induced neu-ronal injury by regulating receptor interacting protein-1/receptor interacting protein-3/mixed lineage kinase domain-like protein(RIP1/RIP3/MLKL)signaling pathway.Methods:OGD/R model was constructed by hypoxia/reoxygenation;human cortical neuron HCN cells were separated into control group,model group(OGD/R group),Ephedrine group(800 μg/ml),Compound 6i group(RIP1 acti-vator Compound 6i,0.94 μmol/L),Ephedrine+Compound 6i group(800 μg/ml Ephedrine+0.94 μmol/L Compound 6i),Nec-1 group(RIP1 specific inhibitor Nec-1,5 μmol/L)and Ephedrine+Nec-1 group(800 μg/ml Ephedrine+5 μmol/L Nec-1);CCK-8 method was applied to detect HCN cell proliferation;DCFH-DA method was applied to detect ROS level in HCN cells;flow cytometry was ap-plied to detect HCN cell apoptosis;ELISA was applied to detect levels of TNF-α and IL-6;Western blot was applied to detect RIP1/RIP3/MLKL signaling pathway and apoptotic proteins expressions in HCN cells.Results:Compared with control group,ROS level,apop-tosis rate,p-MLKL,RIP3,Bax,IL-6,TNF-α and RIP1 expressions of HCN cells in OGD/R group were significantly increased,A450 value and Bcl-2 protein were significantly decreased(P<0.05);compared with OGD/R group,ROS level,apoptosis rate,p-MLKL,RIP3,Bax,IL-6,TNF-α and RIP1 expressions of HCN cells in Ephedrine group and Nec-1 group were significantly reduced,A450 val-ue and Bcl-2 protein were significantly increased,the trend of Compound 6i group was opposite(P<0.05);Compound 6i was able to weaken the effect of Ephedrine in improving OGD/R induced neuronal injury,Nec-1 was able to enhance the effect of Ephedrine in im-proving OGD/R induced neuronal injury.Conclusion:Ephedrine attenuates OGD/R induced neuronal injury by inhibiting RIP1/RIP3/MLKL signaling pathway.

Objective:To compare the value of the fall risk self-assessment scale(FRSAS)and the modified falls efficacy scale(MFES)in the fall risk assessment of community-dwelling older adults.Method:A total of 1710 respondents aged 65 and above were recruited from four community health service centers in Beijing through convenient sampling.The general information questionnaire,FRSAS scale and MFES scale were used for data collection,and the fall incidence was obtained through telephone follow-up six months later.Result:Total 1686 subjects completed survey,1670 subjects received telephone follow-up,152 subjects report-ed falls.The total score of MFES was(127.77±24.39),with the full score accounting for 55.3％.Cronbach's α coefficient of MFES was 0.975.The total score of FRSAS was(9.62±5.01),Cronbach's α coefficient was 0.80.The correlation coefficient r of the two scales was-0.563,showing a moderate negative correlation.The AUC under the curve of MFES and FRSAS were 0.615 and 0.739,respectively.The diagnostic accuracy of FRSAS was better than MFES.When the cut off value of MFES was 134,Youdon index,sensitivity,specific-ity,positive predictive value,negative predictive value were 0.195,49.3％,70.2％,14.2％,93.3％,respectively.When the cut off value of FRSAS was 10,Youdon index,sensitivity,specificity,positive predictive value,negative predictive value were 0.399,80.9％,59.0％,16.5％,96.9％,respectively.The prediction accuracy of FR-SAS was better than that of MFES for individuals without falls.Conclusion:Compared with MFES,FRSAS has no ceiling effect and has more predictive value.It can be used as a fall risk screening tool for the elderly in the community.

Objective:To compare the value of the fall risk self-assessment scale(FRSAS)and the modified falls efficacy scale(MFES)in the fall risk assessment of community-dwelling older adults.Method:A total of 1710 respondents aged 65 and above were recruited from four community health service centers in Beijing through convenient sampling.The general information questionnaire,FRSAS scale and MFES scale were used for data collection,and the fall incidence was obtained through telephone follow-up six months later.Result:Total 1686 subjects completed survey,1670 subjects received telephone follow-up,152 subjects report-ed falls.The total score of MFES was(127.77±24.39),with the full score accounting for 55.3％.Cronbach's α coefficient of MFES was 0.975.The total score of FRSAS was(9.62±5.01),Cronbach's α coefficient was 0.80.The correlation coefficient r of the two scales was-0.563,showing a moderate negative correlation.The AUC under the curve of MFES and FRSAS were 0.615 and 0.739,respectively.The diagnostic accuracy of FRSAS was better than MFES.When the cut off value of MFES was 134,Youdon index,sensitivity,specific-ity,positive predictive value,negative predictive value were 0.195,49.3％,70.2％,14.2％,93.3％,respectively.When the cut off value of FRSAS was 10,Youdon index,sensitivity,specificity,positive predictive value,negative predictive value were 0.399,80.9％,59.0％,16.5％,96.9％,respectively.The prediction accuracy of FR-SAS was better than that of MFES for individuals without falls.Conclusion:Compared with MFES,FRSAS has no ceiling effect and has more predictive value.It can be used as a fall risk screening tool for the elderly in the community.

Objective:To explore the effect of Ephedrine on oxygen glucose deprivation/reoxygenation(OGD/R)induced neu-ronal injury by regulating receptor interacting protein-1/receptor interacting protein-3/mixed lineage kinase domain-like protein(RIP1/RIP3/MLKL)signaling pathway.Methods:OGD/R model was constructed by hypoxia/reoxygenation;human cortical neuron HCN cells were separated into control group,model group(OGD/R group),Ephedrine group(800 μg/ml),Compound 6i group(RIP1 acti-vator Compound 6i,0.94 μmol/L),Ephedrine+Compound 6i group(800 μg/ml Ephedrine+0.94 μmol/L Compound 6i),Nec-1 group(RIP1 specific inhibitor Nec-1,5 μmol/L)and Ephedrine+Nec-1 group(800 μg/ml Ephedrine+5 μmol/L Nec-1);CCK-8 method was applied to detect HCN cell proliferation;DCFH-DA method was applied to detect ROS level in HCN cells;flow cytometry was ap-plied to detect HCN cell apoptosis;ELISA was applied to detect levels of TNF-α and IL-6;Western blot was applied to detect RIP1/RIP3/MLKL signaling pathway and apoptotic proteins expressions in HCN cells.Results:Compared with control group,ROS level,apop-tosis rate,p-MLKL,RIP3,Bax,IL-6,TNF-α and RIP1 expressions of HCN cells in OGD/R group were significantly increased,A450 value and Bcl-2 protein were significantly decreased(P<0.05);compared with OGD/R group,ROS level,apoptosis rate,p-MLKL,RIP3,Bax,IL-6,TNF-α and RIP1 expressions of HCN cells in Ephedrine group and Nec-1 group were significantly reduced,A450 val-ue and Bcl-2 protein were significantly increased,the trend of Compound 6i group was opposite(P<0.05);Compound 6i was able to weaken the effect of Ephedrine in improving OGD/R induced neuronal injury,Nec-1 was able to enhance the effect of Ephedrine in im-proving OGD/R induced neuronal injury.Conclusion:Ephedrine attenuates OGD/R induced neuronal injury by inhibiting RIP1/RIP3/MLKL signaling pathway.

Objective:To investigate the efficacy, feasibility, and safety of task-oriented exercise training for hospitalized elderly diabetic patients.Methods:This study is a parallel randomized controlled trial with a positive control and a single-blinded assessor.From July 2020 to July 2021, we included 84 elderly patients with type 2 diabetes who were hospitalized in the Department of Endocrinology at Beijing Hospital.These patients were randomly divided into two groups: the task-oriented exercise training group(TOE group)and the regular exercise training group(regular group). The TOE group participants were trained using a task-oriented exercise program that was specifically developed by our research team.On the other hand, the regular group participants were trained using a classical program that comprised of all exercise modes.Each subject received individualized exercise training for 10 consecutive days while staying in the hospital.We evaluated the efficacy, feasibility, and safety of the training programs by measuring the physical fitness of the participants, assessing the feasibility of the program, and monitoring any exercise-related adverse events that occurred.Results:A total of 79 subjects completed the entire intervention and follow-up period, with 40 subjects in the TOE group and 39 subjects in the regular group.In terms of efficacy, both groups showed improvement in their physical fitness indexes after the intervention, with no significant differences in the degree of improvement between the two groups(all P>0.05). When considering feasibility, the TOE group had a higher proportion of prospective feasibility at 87.5%(35 out of 40)compared to the regular group at 71.8%(28 out of 39). Similarly, the TOE group had a higher proportion of practical feasibility at 75.0%(30 out of 40)compared to the regular group at 53.8%(21 out of 39). The TOE group showed a significant advantage in practical feasibility between the two groups( χ2=3.862, P=0.049). As for safety, there were no exercise-related adverse events during the intervention in either group. Conclusions:The efficacy and safety of the task-oriented exercise program for hospitalized elderly diabetic patients is comparable to that of the regular program.Additionally, the task-oriented program is more feasible than the regular program.

Objective:To analyze the satisfaction of elderly outpatient experience, based on a satisfaction questionnaire survey of outpatients in public hospitals, for references to improve the medical experience of elderly patients.Methods:This study extracted the satisfaction survey questionnaires for outpatients in second level and above public hospitals nationwide from the National Health Commission′s satisfaction survey platform from 2019 to 2022. The questionnaire content included six dimensions: registration experience, doctor-patient communication, nurse-patient communication, environment and labeling, privacy protection, and medical staff response, as well as overall satisfaction. The satisfaction, relative satisfaction, and dissatisfaction rates of elderly outpatients were analyzed using standardized assignment of question options, etc; T-test was used for inter group comparison.Results:A total of 10.095 7 million outpatient satisfaction questionnaires were included in this study, including 0.576 3 million questionnaires for elderly outpatients. From 2019 to 2022, the overall satisfaction of outpatients had been increasing year by year, and the overall satisfaction scores of elderly patients were significantly higher than that of non-elderly patients( P<0.01). The satisfaction scores of elderly patients in the nurse communication dimension(86.55 to 91.03 points) and relative satisfaction(1.000) were the higher in each year, while the satisfaction scores in the environment and identification dimension(81.05 to 86.03 points) and relative satisfaction(0.935 to 0.955) were lower. In 2019 and 2022, elderly patients had higher dissatisfaction rates in the two dimensions of registration experience(2.26%, 1.91%) and doctor communication(0.80%, 0.53%). Conclusions:From 2019 to 2022, the overall satisfaction of elderly patients in secondary and above public hospitals in China was relatively higher with a steady increasing tendency. However, there was still room for further improvement in the environment and labeling, cultural construction, and registration experience for elderly patients.

ObjectiveTo evaluate the Chinese guidelines and consensus of rehabilitation medicine published in the medical journals in 2022 using Scientific, Transparent and Applicable Rankings (STAR). MethodsGuidelines and consensus which were developed by Chinese institutions or led by Chinese scholars were retrieved in databases of CNKI, Wanfang Data, CBM, Chinese Medical Journal Network, PubMed and Web of Science, in 2022, followed by screening for rehabilitation medicine field. The literature were rated with STAR. ResultsSeven guidelines and eleven consensuses were included. The STAR scores ranged from 11.7 to 69.6, with a median score of 25.9 and mean score of 28.3. There was a significant difference in the total score between guidelines and consensus (U = 12.000, P = 0.014). The score ratio was high in the domains of recommendations (73.6%), evidence (39.5%) and others (33.3%), while it was low in the domains of protocol (1.4%), clinical questions (12.5%) and conflicts of interest (13.9%). The score ratio was high in the items of listing the institutional affiliations of all individuals involved in developing the guideline (94.4%), identifying the references for evidence supporting the main recommendations (94.4%), indicating the considerations (e.g., adverse effects) in clinical practice when implementing the recommendations (88.9%), and making the recommendations clearly identifiable, e.g., in a table, or using enlarged or bold fonts (75%); and it was low in the items of describing the role of funder(s) in the guideline development (0), indicating information about the evaluation and management of conflicts of interest (0), providing tailored editions of the guidelines for different groups of target users (0), presenting the guideline or recommendations visually, such as with figures or videos (0), providing details of the guideline protocol (2.8%), assessing the risk of bias or methodological quality of the included studies (2.8%), describing the responsibilities of all individuals or sub-groups involved in developing the guideline (5.6%), indicating how the clinical questions were selected and sorted (5.6%), formating clinical questions in PICO or other formats (5.6%), making the guideline accessible through multiple platforms (5.6%), and declaring that the funder(s) did not influence the guideline's recommendations (8.3%). ConclusionThe quality of current clinical practice guidelines and consensus of rehabilitation medicine is poor, which should be developed in accordance with the relevant standards.

Objective:To evaluate the correlation between the timed up and go(TUG)test and fall risks in elderly frail patients.Methods:From July to September 2019, elderly frail patients who were treated at the cardiovascular department of our hospital were enrolled.Basic clinical data and fall-related information of patients were collected.Patients were divided into the fall group and the non-fall group.Results on the body mass index(BMI), TUG, 4-meter maximum walking speed(4 m MWS)and Barthel index were compared between the two groups.The correlation between TUG and each indicator was examined.Multivariate Logistic regression analysis was used to analyze the correlation between the TUG and falls in elderly patients.Results:A total of 96 eligible patients were enrolled, including 35 in the fall group and 61 in the non-fall group.The average TUG time was longer in the fall group than in the non-fall group(16.45±6.44 s vs.10.17±2.91 s, t=-6.556, P<0.001). The correlation analysis results showed that the TUG was correlated with falls and 4 m MWS( r=0.582 and 0.875, both P<0.001). Multivariate Logistic regression analysis showed that the TUG( OR=1.201, 95% CI: 1.111-1.470, P=0.004)and 4 m MWS( OR=1.146, 95% CI: 1.063-1.244, P=0.015)were risk factors for falls. Conclusions:The TUG is correlated with fall risks in elderly frail patients and should be recommended as a routine test in clinical practice.

Blood flow restriction training is a method to improve the muscle mass and muscle strength by Pressing a pneumatic cuff wrapped around the proximal region of the target limb for limiting distal limb blood flow and by combining specific forms of movement.Current studies suggest that this method is simple and safe, and has few adverse events, which can improve muscle function and physical activity and reduce the risk of training injury in the elderly.This article reviewed and discussed the possible mechanism of blood flow restriction training and its clinical effect on the improvement of the physical activity in the elderly, in order to provide areference for further clinical research and application.

Immune senescence is a phenomenon in which immune function gradually decreases to dysfunction with the increase of age, and it is a gradual natural degeneration process of the gene-controlled immune system. It is mainly manifested in the weakening of immune recognition and immune response, and the disorder of immune function. The immune dysfunction and immune senescence may also occur to different degree in HIV-1-infected patients and aging people. HIV infection and aging will both lead to immune dysfunction. HIV infection is associated with abnormalities in all major lymphocyte populations, including B cells, which ultimately result in severe exhaustion of several lymphocyte functions and increases susceptibility to secondary and opportunistic infections. Recently, with the increasing trend of the aging of HIV-1-infected/AIDS patients, the elderly have become a high-risk group of HIV infection. Thus, it is of great practical and clinical significance to better understand the pathogenic mechanisms of B-cell abnormalities in HIV disease, compare and analyze the changes of immune system in elderly and young HIV patients, and explore more efficient ways of prevention and treatment of elderly HIV/AIDS patients.