Objective To explore the incidence rate and independent risk factors of synchronous multiple early gastric cancer (SMEGC) in patients with early gastric cancer, and to provide evidence for early screening and intervention of high-risk population. Methods A retrospective analysis was performed on 308 patients with early gastric cancer who received treatment in the hospital from March 2019 to March 2024. The incidence rate of SMEGC was counted, and the risk factors were analyzed by univariate and multivariate Logistic regression analyses. Results Among the 308 patients with early gastric cancer in this study, 23 cases were SMEGC and 285 were single early gastric cancer, which were included in the SMEGC group and the single group respectively. The incidence rate of SMEGC was 7.47% (23/308). Compared with the single group, the proportions of male, smoking history, tumor diameter≤2 mm, chronic atrophic gastritis and intestinal metaplasia degree were higher in the SMEGC group (2=4.331、8.608、4.618、6.490、4.897，P=0.037、0.003、0.032、0.001、0.027). Logistic regression analysis suggested that chronic atrophic gastritis (OR=3.133, 95%CI: 1.240-7.918) and moderate-to-severe intestinal metaplasia (OR=3.171, 95%CI: 1.252-8.029) were independent risk factors for SMEGC (P<0.05). Conclusion Some patients with early gastric cancer are SMEGC. Chronic atrophic gastritis and moderate-to-severe intestinal metaplasia are independent risk factors affecting the occurrence of SMEGC. It is recommended to regularly screen high-risk patients and optimize management strategies to reduce the risk of SMEGC.

Objective To analyze the status quo and related factors of treatment compliance in elderly patients with advanced gastric cancer complicated with cancer pain. Methods Three hundred and ten elderly patients with advanced gastric cancer from January 2021 to June 2024 were selected, and their general data were collected. Hospital Anxiety and Depression Scale (HADS), Beliefs about Medicines Questionnaire (BMQ), Numerical Rating Scale (NRS) and 8-item Morisky Medication Adherence Scale (MMAS-8) were adopted to investigate the psychological status, necessity of medication belief, degree of cancer pain and treatment compliance. Univariate analysis, correlation analysis and multivariate logistic regression analysis were used to describe and analyze the treatment compliance status and related factors in elderly advanced gastric cancer with cancer pain. Results A total of 310 patients were divided into group A (good compliance, 93 cases), group B (moderate compliance ,102 cases) and group C (poor compliance , 115 cases) by means of compliance degree. There were significant differences in education level , pain duration and intensity and analgesic category (P<0.05). Treatment compliance was associated with education level, analgesic category, psychological status, medication belief and pain degree (P<0.05). The necessity of medication belief and pain duration and degree were influencing factors of treatment compliance. Conclusion The treatment compliance in advanced gastric cancer with cancer pain is poor, and can be affected by the necessity of medication belief and duration and degree of pain.

Objective To explore the rehabilitation effect of abdominal breathing training and the improvement status of cardiopulmonary function in elderly patients with chronic obstructive pulmonary disease (COPD) over 60 years old. Methods A total of 520 COPD patients over 60 years old admitted to the hospital were selected from June 2021 to March 2024 as the research subjects. The patients were divided into reference group (routine intervention, n=260) and abdominal rehabilitation group (abdominal breathing training on the basis of routine intervention, n=260) by adopting computer random function. Cardiopulmonary tolerance, respiratory muscle condition and pulmonary function markers were compared between the two groups before and after intervention. Results Compared with the reference group after intervention, the abdominal rehabilitation group had higher maximum oxygen uptake and minute ventilation volume, lower anaerobic threshold, and higher maximal expiratory pressure (MEP). The maximal inspiratory pressure (MIP), forced expiratory volume in one second (FEV1), forced expiratory volume (FVC), ratio of forced expiratory volume to forced vital capacity in one second (FEV1/FVC), the percentage of FEV1 to the predicted value (FEV1%pred) and 1 min maximum ventilation volume (MVV) (P<0.05) were all higher in the abdominal rehabilitation group than the reference group after intervention. Conclusion Abdominal breathing training for patients with COPD over 60 years old can effectively enhance cardiopulmonary tolerance, and improve respiratory muscle physiology and pulmonary function.

Objective To understand the epidemiological characteristics and risk factors of hospital-acquired pneumonia in elderly diabetic patients. Methods Elderly patients with diabetes mellitus who were hospitalized in the hospital were selected from October 2020 to October 2023 as the research subjects. The epidemiological characteristics of hospital-acquired pneumonia were analyzed, and the risk factors affecting hospital-acquired pneumonia in elderly patients with diabetes mellitus were analyzed . Results There were 65 cases of hospital-acquired pneumonia in 388 elderly patients with diabetes mellitus, with an incidence of 16.75%, of which 56.92% were males and 43.08% were females. The proportion of patients aged≥80 years was higher than that of patients aged<80 years. There were no significant differences in gender, body mass index, education level, course of diabetes mellitus, smoking history, drinking history, hypertension, coronary heart disease and anemia between groups (P>0.05), but significant differences were shown in age, hospitalization time, tracheal invasive operation, types of antibacterial drug use and dysphagia between both groups (P<0.05). Logistic multivariate analysis showed that age≥80 years old, hospitalization time≥30 d, tracheal invasive operation, use of antibacterial drugs≥ 2 types, and dysphagia were independent risk factors for hospital-acquired pneumonia in elderly diabetic patients (P<0.05). Conclusion The risk of hospital-acquired pneumonia is high in elderly patients with diabetes mellitus. Patients with age≥80 years old, hospitalization time≥30 days, tracheal invasive operation, abuse of antibacterial drugs and dysphagia are high-risk population. It is necessary to take active intervention measures for such patients.

Objective To explore the nutritional risk investigation and influencing factors of elderly patients with community-acquired pneumonia (CAP). Methods The clinical data of 239 elderly patients with CAP in Western Theater General Hospital were retrospectively analyzed from January 2022 to January 2024. Nutritional risk screening scale (NRS2002) was used to investigate the nutritional risk of patients. According to the nutritional risk investigation results, 239 elderly patients with CAP were divided into higher risk group (NRS2002≥3 points) and lower risk group (NRS2002<3 points). Univariate analysis was used to compare the gender, age, education level, body mass index (BMI), family monthly income, living condition, severity of pneumonia, smoking history, presence or absence of chronic diseases, cognitive dysfunction and self-care ability. The independent risk factors of nutritional risk in elderly patients with CAP were analyzed by binary logistic regression analysis. Results According to NRS2002 score, there were 87 cases (36.4%) in higher risk group and 152 cases (63.6%) in lower risk group. The NRS2002 scores in higher risk group were significantly higher than those in lower risk group (P<0.05). There were no obvious differences in gender, BMI, family monthly income and presence or absence of smoking history between groups (P>0.05). The higher risk group had significantly higher rates of age>70 years old, education level (high school and below), living condition (living alone), severity of pneumonia (high-risk pneumonia), chronic disease, cognitive dysfunction and poor self-care ability than the lower risk group (P<0.05). Binary logistics regression analysis showed that age>70 years old , education level of high school and below, living condition (living alone), severity of pneumonia (high-risk pneumonia), chronic diseases, cognitive dysfunction and self-care ability (poor) were independent risk factors for nutritional risk in elderly CAP patients (P<0.05). Conclusion Elderly patients with CAP have high nutritional risk, which may be affected by many factors such as age, education level, living condition, severity of pneumonia, presence or absence of chronic diseases, cognitive dysfunction and self-care ability. It is necessary to formulate targeted intervention measures according to the above factors to improve the nutritional risk of patients.

Chronic venous insufficiency(CVI), a prevalent condition within vascular surgery, displays marked variation in prevalence in the world. The management of CVI poses a significant challenge to healthcare systems and profoundly impacts patients′ well-being, warranting heightened attention. Current therapeutic approaches to CVI encompass both non-surgical and surgical interventions. Non-surgical treatments aim to alleviate symptoms through compression and medication, while surgical methods focus on repairing or removing diseased veins to restore normal blood flow. However, the effectiveness of existing treatments remains suboptimal, necessitating further research and the exploration of novel therapeutic schedule. This review article delves into the attributes and characteristics of current treatment modalities for lower extremity venous insufficiency and speculates on potential future trends in management.

Objective To analyze Pseudomonas aeruginosa (PA) infection and drug resistance in the elderly with respiratory tract infection, so as to provide a basis for the control of nosocomial infection and rational use of antibiotics. Methods The samples from elderly inpatients with respiratory tract infection were collected between March 2020 and March 2022. PA infection/colonization were investigated, and the drug resistance of pathogens was determined according to CLSI criteria (2019 version). Results There were 123 strains of PA isolated from the sputum and bronchoscopy lavage fluid of elderly patients with respiratory tract infection. The main departments with positive PA detection were respiratory department, ICU ward and neurology department. The difference of PA detection in different years was not statistically significant (P>0.05). The proportion of nosocomial infection in 2021 was lower than that in 2020 (44.44% vs 63.33%, c2=4.410, P=0.036). The resistance rate of 123 isolated PA strains to piperacillin was >90.00%, and they were resistant to ceftazidime, cefotaxime, cefepime, aztreonam and gentamicin to varying degrees. There was no significant difference in resistance rate of PA to antibiotics in different years (P>0.05). In the 123 strains of pathogens, there were 17 strains (13.82%) of carbapenem-resistant PA, and their resistance to common antibiotics was significantly higher than that of carbapenem-sensitive PA (P<0.05). Conclusion The main pathogen of nosocomial infection is PA, and the proportion of nosocomial infection shows a downward trend. The detection rate of carbapenem-resistant PA is high. In clinical treatment, targeted antibiotics can be applied.

Objective To explore the epidemiological characteristics of pulmonary infection in elderly patients with chronic obstructive pulmonary disease (COPD), and to construct a risk prediction model. Methods Among of 125 elderly patients with COPD from May 2020 to June 2022 were selected as the research subjects. The epidemiological characteristics of infected patients were counted, and the risk factors of pulmonary infection in patients were analyzed and a prediction model was constructed. Results A total of the 125 elderly patients with COPD, there were 46 cases of pulmonary infection, with the infection rate of 36.80%. The detection rate of Gram-negative bacteria was higher than that of Gram-positive bacteria or fungi (64.44% vs 33.33% or 2.22%, P<0.05). Smoking history, presence of diabetes mellitus, mechanical ventilation, irrational use of antibiotics, and hypoalbuminemia were risk factors for pulmonary infection in elderly patients with COPD (P<0.05). Prediction model of pulmonary infection in elderly patients with COPD obtained by multivariate logistic regression analysis was shown as PI=-1.981+0.657×smoking history+0.806×presence of diabetes mellitus+0.521×mechanical ventilation+0.639×irrational use of antibiotics+0.715×presence of hypoalbuminemia. Hosmer-Lemeshow test showed that Hosmer-Lemeshow χ²=0.812 and P=0.295. ROC curve analysis revealed that the AUC value of the prediction model on predicting the pulmonary infection in elderly patients with COPD was 0.802. Conclusion The pathogenic bacteria of elderly patients with COPD complicated with pulmonary infection are mainly Gram-negative bacteria. The prediction model constructed according to the risk factors of pulmonary infection in patients has predictive value on pulmonary infection in patients.

Objective:To clarify the clinicopathological, especially molecular, features of early-onset gastric cancer with the aim of informing analysis of treatment strategies.Methods:In this retrospective case-control study, we examined data from a dedicated gastric cancer database in Zhongshan Hospital affiliated to Fudan University. The original cohort comprised 2506 patients with gastric cancer who had undergone gastrectomy in Zhongshan Hospital Fudan University from July 2020 to October 2021, including 198 with early-onset gastric cancer (aged ≤45 years) and 2,308 with non-early gastric cancer. We used a simple random sampling method to select 396 of the 2,308 patients aged >45 years (ratio of 1:2) as the control group and then compared molecular diagnostic data and clinicopathological features of the two groups.Results:The median age was 39 years in the early-onset gastric cancer group, while 66 years in the control group. The clinicopathological features of early-onset gastric cancer included female predominance (59.1% [117/198] vs. 27.8% [110/396], χ 2=54.816, P<0.001), less comorbidity (32.3% [64/198] vs. 57.1% [226/396], χ 2=32.355, P<0.001), poorer differentiation (93.9% [186/198] vs. 74.5% [295/396], χ 2=30.777, P<0.001) and higher proportion of diffuse type (40.4% [80/198] vs. 15.9% [63/396], χ 2=69.639, P<0.001), distant metastasis (7.1% [14/198] vs. 2.8% [11/396], χ 2=6.034, P=0.014). Regarding treatment, distal gastrectomy was more commonly performed than proximal gastrectomy (55.1% [109/198] vs. 47.0% [186/396], 1.5% [3/198] vs. 8.3% [33/396], χ 2=11.644, P=0.003). Family history of gastric cancer, TNM stage, tumor size, lymph node dissection, nerve invasion, nodes harboring metastases, range of lymph node dissection, digestive tract reconstruction procedure, implementation of laparoscopic surgery, combined resection, and preoperative treatment did not differ significantly between the two groups (all P>0.05). Molecular diagnosis showed there was a smaller percentage of mismatch repair deficiency in the early-onset gastric cancer than in the control group (1.0% [2/198] vs. 10.1% [40/396], χ 2=16.301, P<0.001), and a higher rate of positivity for Claudin 18.2 (77.8% [154/198] vs. 53.0% [210/396], χ 2=5.442, P<0.001). HER-2 and Epstein–Barr virus positivity rates did not differ significantly between the two groups. Conclusion:Early-onset gastric cancer is a distinct type of gastric cancer with a high degree of malignancy, and treatment targeting Claudin 18.2 may be effective.

Objective:To clarify the clinicopathological, especially molecular, features of early-onset gastric cancer with the aim of informing analysis of treatment strategies.Methods:In this retrospective case-control study, we examined data from a dedicated gastric cancer database in Zhongshan Hospital affiliated to Fudan University. The original cohort comprised 2506 patients with gastric cancer who had undergone gastrectomy in Zhongshan Hospital Fudan University from July 2020 to October 2021, including 198 with early-onset gastric cancer (aged ≤45 years) and 2,308 with non-early gastric cancer. We used a simple random sampling method to select 396 of the 2,308 patients aged >45 years (ratio of 1:2) as the control group and then compared molecular diagnostic data and clinicopathological features of the two groups.Results:The median age was 39 years in the early-onset gastric cancer group, while 66 years in the control group. The clinicopathological features of early-onset gastric cancer included female predominance (59.1% [117/198] vs. 27.8% [110/396], χ 2=54.816, P<0.001), less comorbidity (32.3% [64/198] vs. 57.1% [226/396], χ 2=32.355, P<0.001), poorer differentiation (93.9% [186/198] vs. 74.5% [295/396], χ 2=30.777, P<0.001) and higher proportion of diffuse type (40.4% [80/198] vs. 15.9% [63/396], χ 2=69.639, P<0.001), distant metastasis (7.1% [14/198] vs. 2.8% [11/396], χ 2=6.034, P=0.014). Regarding treatment, distal gastrectomy was more commonly performed than proximal gastrectomy (55.1% [109/198] vs. 47.0% [186/396], 1.5% [3/198] vs. 8.3% [33/396], χ 2=11.644, P=0.003). Family history of gastric cancer, TNM stage, tumor size, lymph node dissection, nerve invasion, nodes harboring metastases, range of lymph node dissection, digestive tract reconstruction procedure, implementation of laparoscopic surgery, combined resection, and preoperative treatment did not differ significantly between the two groups (all P>0.05). Molecular diagnosis showed there was a smaller percentage of mismatch repair deficiency in the early-onset gastric cancer than in the control group (1.0% [2/198] vs. 10.1% [40/396], χ 2=16.301, P<0.001), and a higher rate of positivity for Claudin 18.2 (77.8% [154/198] vs. 53.0% [210/396], χ 2=5.442, P<0.001). HER-2 and Epstein–Barr virus positivity rates did not differ significantly between the two groups. Conclusion:Early-onset gastric cancer is a distinct type of gastric cancer with a high degree of malignancy, and treatment targeting Claudin 18.2 may be effective.