Objective To investigate the presumed correlation between lactate level and clearance during extracorporeal life support(ECLS)and death in elderly cardiac intensive care patients.Methods A total of 93 elderly cardiac intensive care patients who received ECLS in Department of Critical Care Medicine,Xiangya Medical College Affiliated Changsha Hospital,Central South University,from March 2019 to October 2024 were retrospectively included to manage low cardiac production syndrome after major cardiac surgery.According to hospital outcomes,the patients were divided into a death group(n=45)and a survival group(n=48).Blood lactate measurements were performed every 4 hours from the beginning of ECLS treatment to calculate peak lactate and lactate clearance rate(LCR).Routine ICU scores,such as sequential organ failure score(SOFA)and reactive organ dysfunction(ROD)score,and postoperative complications were recorded.Results The death group received larger amounts of packed red blood cell concentrate,fresh frozen plasma and platelet concentrate,and exhibited higher ratios of norepinephrine and epinephrine administration and higher incidences of re-thoracotomy and hemolytic episodes when compared with the survival group(P＜0.05,P＜0.01).At the end of ECLS,higher SOFA and ROD scores were observed in the death group(P＜0.01).The death group also demonstrated higher lactate level from venoarterial ECLS(P＜0.001)and increased median peak lactate level,but lower median LCR than the survival group(P＜0.01).Multivariate logistic analysis showed that peak lactate and LCR were independent prognostic factors in the elderly cardiac ICU patients(P＜0.05,P＜0.01).The AUC value(95％CI)of peak lactate and LCR in predicting patient outcomes was 0.723(95％CI:0.615-0.831)and 0.846(95％CI:0.761-0.932),respectively,and the value of their combination in predicting in-hospital death was 0.846(95％CI:0.762-0.931),with a sensitivity of 0.629 and a specificity of 0.937.Conclusion Lactate level and its clearance rate during ECLS can affect the survival rate of elderly cardiac intensive care patients.Peak lactate and LCR can predict the prognosis of elderly cardiac intensive care patients,and can be used as prognostic indicators for clinical monitoring.

Objective:To investigate the incidence of mild cognitive impairment(MCI)and malnutrition among centenarians, as well as to explore the relationship between cognitive impairment and nutritional status.Methods:A cross-sectional study was conducted between November and December 2023, involving 121 elderly individuals aged ≥ 100 years in the Baoshan District of Shanghai.The survey collected general information and included the Ascertain Dementia 8-item Questionnaire(AD8), the Mini Nutritional Assessment Short-Form(MNA-SF), and anthropometric nutritional measurements such as waist circumference(WC), hip circumference(HC), arm circumference(AC), calf circumference(CC), and grip strength.The prevalence of MCI and malnutrition among centenarians was calculated, and the correlation between MCI and MNA-SF scores, along with anthropometric nutritional measurement indicators, was analyzed.Results:The age range of centenarians was between 100 and 105 years, with an average age of 101.0±3.5 years.The majority of centenarians were female(76.9%), illiterate(58.7%), and lived with family members(73.6%).All participants had medical insurance(100%).Most had no history of long-term smoking 118(97.5%), long-term alcohol consumption 108(89.3%), long-term use of health supplements 109(90.1%), long-term tea or coffee habits 114(94.2%), chronic medical conditions 84(69.4%), or family history of dementia 102(84.3%).Additionally, 62(51.2%)reported their health status over the past year as general.According to the AD8 screening results, the negative and positive detection rates of MCI in centenarians were 79(65.3%)and 47(34.7%), respectively.Based on the MNA-SF scoring results, the detection rates of normal nutrition, malnutrition risk, and malnutrition among centenarians were 36(29.8%), 61(50.4%), and 24(19.8%), respectively.There was a statistically significant difference in AC between the non-MCI group and the MCI group among centenarians( t=0.01, P=0.03).The AD8 scores of centenarians were significantly negatively correlated with AC, CC, and MNA-SF scores( r=-0.20, r=-0.26, r=-0.29; all P<0.05). Conclusions:The cognitive function of centenarians is associated with their nutritional status, indicating that higher cognitive abilities correlate with better nutritional status.

Objective To investigate the presumed correlation between lactate level and clearance during extracorporeal life support(ECLS)and death in elderly cardiac intensive care patients.Methods A total of 93 elderly cardiac intensive care patients who received ECLS in Department of Critical Care Medicine,Xiangya Medical College Affiliated Changsha Hospital,Central South University,from March 2019 to October 2024 were retrospectively included to manage low cardiac production syndrome after major cardiac surgery.According to hospital outcomes,the patients were divided into a death group(n=45)and a survival group(n=48).Blood lactate measurements were performed every 4 hours from the beginning of ECLS treatment to calculate peak lactate and lactate clearance rate(LCR).Routine ICU scores,such as sequential organ failure score(SOFA)and reactive organ dysfunction(ROD)score,and postoperative complications were recorded.Results The death group received larger amounts of packed red blood cell concentrate,fresh frozen plasma and platelet concentrate,and exhibited higher ratios of norepinephrine and epinephrine administration and higher incidences of re-thoracotomy and hemolytic episodes when compared with the survival group(P＜0.05,P＜0.01).At the end of ECLS,higher SOFA and ROD scores were observed in the death group(P＜0.01).The death group also demonstrated higher lactate level from venoarterial ECLS(P＜0.001)and increased median peak lactate level,but lower median LCR than the survival group(P＜0.01).Multivariate logistic analysis showed that peak lactate and LCR were independent prognostic factors in the elderly cardiac ICU patients(P＜0.05,P＜0.01).The AUC value(95％CI)of peak lactate and LCR in predicting patient outcomes was 0.723(95％CI:0.615-0.831)and 0.846(95％CI:0.761-0.932),respectively,and the value of their combination in predicting in-hospital death was 0.846(95％CI:0.762-0.931),with a sensitivity of 0.629 and a specificity of 0.937.Conclusion Lactate level and its clearance rate during ECLS can affect the survival rate of elderly cardiac intensive care patients.Peak lactate and LCR can predict the prognosis of elderly cardiac intensive care patients,and can be used as prognostic indicators for clinical monitoring.

Objective:To investigate the incidence of mild cognitive impairment(MCI)and malnutrition among centenarians, as well as to explore the relationship between cognitive impairment and nutritional status.Methods:A cross-sectional study was conducted between November and December 2023, involving 121 elderly individuals aged ≥ 100 years in the Baoshan District of Shanghai.The survey collected general information and included the Ascertain Dementia 8-item Questionnaire(AD8), the Mini Nutritional Assessment Short-Form(MNA-SF), and anthropometric nutritional measurements such as waist circumference(WC), hip circumference(HC), arm circumference(AC), calf circumference(CC), and grip strength.The prevalence of MCI and malnutrition among centenarians was calculated, and the correlation between MCI and MNA-SF scores, along with anthropometric nutritional measurement indicators, was analyzed.Results:The age range of centenarians was between 100 and 105 years, with an average age of 101.0±3.5 years.The majority of centenarians were female(76.9%), illiterate(58.7%), and lived with family members(73.6%).All participants had medical insurance(100%).Most had no history of long-term smoking 118(97.5%), long-term alcohol consumption 108(89.3%), long-term use of health supplements 109(90.1%), long-term tea or coffee habits 114(94.2%), chronic medical conditions 84(69.4%), or family history of dementia 102(84.3%).Additionally, 62(51.2%)reported their health status over the past year as general.According to the AD8 screening results, the negative and positive detection rates of MCI in centenarians were 79(65.3%)and 47(34.7%), respectively.Based on the MNA-SF scoring results, the detection rates of normal nutrition, malnutrition risk, and malnutrition among centenarians were 36(29.8%), 61(50.4%), and 24(19.8%), respectively.There was a statistically significant difference in AC between the non-MCI group and the MCI group among centenarians( t=0.01, P=0.03).The AD8 scores of centenarians were significantly negatively correlated with AC, CC, and MNA-SF scores( r=-0.20, r=-0.26, r=-0.29; all P<0.05). Conclusions:The cognitive function of centenarians is associated with their nutritional status, indicating that higher cognitive abilities correlate with better nutritional status.

Objective:To design a heating and pressurizing flushing device and to assess its application effect in hysteroscopic surgery.Methods:The heating and pressurizing flushing device was composed of a heating and pressing device,a liquid crystal control panel module,flushing pipeline,heating pipeline and a support frame.A total of 100 female patients who underwent gynecological hysteroscopic surgery at Shengjing Hospital of China Medical University from May 2021 to April 2022 were selected and divided into observation group and control group by random number table method,with 50 cases in each group.The observation group adopted a heating and pressurizing device to perform heating and pressurizing operations during hysteroscopic surgery,the control group adopted manual inflatable pressurized infusion bags to perform heating and pressurizing operations during hysteroscopic surgery by inflating and squeezing the air bag.The clarity of dilated uterus,operation time,preoperative,intraoperative and postoperative body temperature of the patients,and satisfaction of doctors and nurses were compared between the two groups.Results:The clarity rate of dilated uterus and satisfaction of doctors and nurses in the observation group were significantly higher than those in the control group,the difference was statistically significant(x2=7.862,8.392,P<0.05).The operation time of the observation group was significantly lower than that of the control group,the difference was statistically significant(t=51.099,P<0.05).The body temperature of the patients at 15 minutes during operation and 20 minutes after operation in the observation group were higher than those in the control group,the difference was statistically significant(t=-13.153,-17.911,P<0.05).Conclusion:The use of heating and pressurizing device in gynecological hysteroscopic surgery can increase the clarity of dilated uterus,effectively shorten operation time,save human resources,reduce complications and improve the satisfaction of medical staff.The clinical application effect is good.

Objective To explore the relationship between body mass index(BMI)and blood pressure(BP),blood lipids,waist-to-hip ratio(WHR),and hemoglobin(Hb)in the elderly.Methods A total of 10 978 elderly individuals aged≥65 years old in a community in Baoshan District,Shanghai from February 2023 to October 2023 were selected as the research subjects.Height,body mass,waist circumference(WC),hip circumference(HC),systolic blood pressure(SBP),diastolic blood pressure(DBP),total cholesterol(TC),high-density lipoprotein(HDL),low-density lipoprotein(LDL),Hb were measured,and BMI and WHR were calculated.According to the Chinese BMI reference standard,the elderly were divided into a lean group(BMI＜18.5 kg/m2,n= 310),a normal body mass group(18.5 kg/m2≤BMI＜24 kg/m2,n=4 692),a overweight group(24 kg/m2≤BMI＜28 kg/m2,n= 4 615),and an obese group(BMI≥28 kg/m2,n=1 361).The levels of BP,blood lipids,WHR,and Hb in the four groups were compared and correlation analysis was conducted.Results The levels of BMI,WC,HC,WHR,SBP,DBP,and Hb in elderly men were higher than those in elderly women(all P＜0.01),while the levels of TC,HDL,and LDL were lower than those in elderly women(all P＜0.01).The differences in SBP,DBP,TC,HDL,LDL,WHR,and Hb among the four groups were statistically significant(all P＜0.05),and BMI was positively correlated with SBP,DBP,TC,LDL,WHR,and Hb(r=0.109,0.064,0.041,0.042,0.108,0.089,all P＜0.01),and negatively correlated with HDL(r=﹣0.106,P＜0.01).The BMI of elderly men in the normal body mass group was higher than that of elderly women,while the BMI of elderly women in the obesity group was higher than that of elderly men(both P＜0.01).In the normal body mass group,the BMI of elderly people aged＜75 years old was higher than that of elderly people aged≥75 years old(P＜0.05).Conclusions BMI is closely related to the health of the elderly,and maintaining an ideal BMI is the foundation for health management and prevention of chronic diseases in the elderly.

Objective:To investigate the effects of computerized cognitive remediation therapy (CCRT) combined with social skill training on the improvement of negative symptoms of schizophrenia.Methods:A total of 102 schizophrenic patients who received treatment in Shanxi Province Social Welfare Kangning Psychiatry Hospital from March 2019 to June 2021 were included in this study. They were randomly divided into an intervention group and a control group ( n = 51/group). During the intervention process, because of the reasons such as midway discharge, only 93 patients were included in the final analysis, consisting of 47 patients in the intervention group and 46 patients in the control group. All patients received social skills training. Patients in the intervention group received 8-week CCRT. The Positive and Negative Syndrome Scale and Social Skills Checklist were used to evaluate curative effect in the two groups. Results:After treatment, total score of the Positive and Negative Syndrome Scale and the score of negative symptoms in the intervention group were (46.36 ± 9.33) points and (11.15 ± 3.53) points, respectively, which were significantly lower than (51.06 ± 10.26) points and (16.42 ± 4.75) points in the control group ( t = 2.07, 5.41, both P < 0.05). The total score of Social Skills Checklist, conflict resolution ability score and relationship building ability score in the intervention group were (16.05 ± 6.85) points, (3.36 ± 1.65) points and (3.14 ± 1.83) points, respectively, which were significantly lower than (21.08 ± 8.24) points, (5.92 ± 2.35) points and (6.75 ± 2.51) points, respectively ( t = 2.87, 5.34, 7.00, all P < 0.01). Conclusion:CCRT combined with social skill training can effectively improve the negative symptoms of patients with schizophrenia.

Objective: To explore the impact of the personal rehabilitation treatment on life quality and curative offect of the schizophrenia patients. Methods: A total of 84 patients with chronic schizophrenia in Shanxi Rongjun Corelle Hospital from December 2016 January 2018 were randomly divided into intervention group and control group on the basis of random number table, the two groups received psychiatric routine therapy nursing and general entertainment therapy, and the intervention group received 8 weeks of individualized rehabilitation therapy on this basis.The Schizophrenics Quality of Life Scale(SQLS) and Positive and Negative Symptoms Scale(PANSS) were respectively used to evaluate the effect of the two groups before and after intervention. Results: After 8 weeks of systematic social skills training, the scores of negative symptoms, general psychopathology and total PANSS score in the intervention group were (14.65±3.68)points, (24.21±3.23)points, (52.83±7.12)points, respectively, which in the control group were (21.82±4.25)points, (28.08±4.56)points, (60.67±9.52)points, respectively, the differences between the two groups were statistically significant(t=5.18, 3.35, 3.92, all P<0.01), while the positive symptom score had no statistically significant difference between the two gorups (P>0.05). The PANSS scores and total score in the intervention group after intervention had statistically significant differences compared with those before intervention (t=2.17, 5.98, 3.86, 4.13, all P<0.05). After the intervention training, the psychosocial score, motivation and energy score, symptoms and adverse reactions score, and total score of SQLS in the intervention group were (32.64±7.32)points, (39.45±10.87)points, (18.16±10.48)points, (90.34±24.17)points, which in the control group were (35.32±10.64)points, (43.82±12.43)points, (21.05±11.52)points, (98.25±32.29)points, respectively, and the differences between the two groups were statistically significant (t=2.46, 3.51, 3.12, 3.96, all P<0.05). The SQLS scores and total score in the intervention group after intervention had statistically significant differences compared with those before intervention(t=3.94, 4.72, 3.87, 5.01, all P<0.01). Conclusion The personal rehabilitation treatment can greatly promote the curative offect of patients with chronic schizophrenia, improve their life qualities.

Objective To explore the impact of the systematic social skills training on recovery of chronic schizophrenia patients with negative symptom and social skills defects.Methods A total of 82 cases of long -term hospitalized patients with chronic schizophrenia were randomly divided into intervention group and control group by digital table,41 cases in each group.The two groups received psychiatric routine therapy and nursing,and general entertainment therapy,and systemic social skills training was conducted in the intervention group for 12 weeks.PANSS and SSC were respectively used to evaluate the two groups before and after the intervention.Results After 12 weeks of systematic social skills training,the total score of SSC[(24.5 ±4.5)points]in the intervention group was apparently lower than that in the control group[(29.2 ±5.2)points],and the difference was statistically significant(t =3.212, P <0.01).Compared with the control group[(20.5 ±4.3)points,(27.2 ±4.2)points,(59.1 ±9.5)points],in the intervention group the score of negative symptom mental pathology and total score of PANSS were (14.9 ± 3.7)points,(24.5 ±3.5)points,(52.8 ±7.1)points.The differences of total score between the two groups were sta-tistically significant(t =5.199,3.317,3.239,all P <0.01),while the positive symptoms score was not statistically significant(P >0.05).Compared with before intervention,in the negative symptom table,the differences of total score N2,N3,N4,N6 had statistically significant differences(t =4.533,5.413,4.501,4.668,all P <0.01).Conclusion The systematic social skills training can greatly promote chronic schizophrenia patients with negative symptom and social skills defects,improve their social skills and life qualities.

Objective To explore the impact of the systematic social skills training on recovery of in -patients with chronic schizophrenia.Methods A total of 78 cases of long -term hospitalized patients with chronic schizophrenia were randomly divided into intervention group and control group on the basis of random number table. The two groups received psychiatric routine therapy and nursing,and general entertainment therapy,and the patients in the intervention group received group social skills training for 12 weeks.IPROS and SSSI were respectively used to evaluate two groups before the intervention,trained for 12 weeks.Results After 12 weeks'of systematic social skills training,social function defect levels SSSI score in the intervention group was apparently higher than that in the control group,and the difference was significant (χ2 =8.952,P <0.05 ).Compared with the control group (19.4 ± 4.5)points,(16.5 ±4.7 )points,(13.6 ±4.1 )points,(5.5 ±3.1 )points,(18.2 ±4.2 )points,(73.2 ± 16.3)points,in the intervention group public medical situation (10.3 ±5.5)points,life ability(12.1 ±5.7)points, social ability(6.2 ±3.5)points,antiseptic ability (3.3 ±3.3)points,concern and interest (9.6 ±4.5)points as well as the total score of IPROS (44.6 ±20.4),the differences were significant(t =7.760,6,188,8.165,2.568, 6.632,8.259,all P <0.05).Compared with before intervention,each factor in IPROS and the total score in the inter-vention group had statistically significant differences (t =8.890,7.923,8.321,3.195,8.21,9.852,all P <0.01). Conclusion The systematic social skills training can greatly promote the recovery of in -patients with chronic schiz-ophrenia,improve their social skills and life qualities.Compared with control group,the social function of patients in the intervention group has recovered positively.