Objective To study the level of fall-related self-awareness among the elderly in community and to explore the influence of cognitive reserve and social cohesion on fall-related self-awareness,thereby providing a reference for developing targeted interventions.Methods Toally 500 old people in communities were recruited by convenience sampling in Hengyang between August and September 2024.Data were collected with the general information questionnaire,neighbourhood cohesion scale,self-awareness of falls in elderly scale,and cognitive reserve index questionnaire.Hierarchical multiple linear regression analysis was employed to explore the effects of cognitive reserve and social cohesion on fall-related self-awareness while controlling for demographic variables.Results A total of 467 valid questionnaires were returned.The score of fall-related self-awareness was 54.60±6.64(moderate level).Social cohesion scores was 29.84±5.52(moderate level),and cognitive reserve score was 93.27±10.83(moderate level).The cognitive reserve and social cohesion were both positively correlated with fall-related self-awareness(all P<0.01).Community integration accounted for 9.10%of its total variability,and cognitive reserve accounted for 5.70%of the total variability of fall vigilance,while controlling for variables such as body mass index(BMI),sleep quality,sedentary habits,fear of falling and financial resources.Conclusion The elderly in communities exhibit a low level of fall-related self-awareness.More attention to risk of falling is required along with developing targeted and individualised training programs aiming at improvement of cognitive reserve and social cohesion,thereby reducing the incidence of falls.

Objective To study the level of fall-related self-awareness among the elderly in community and to explore the influence of cognitive reserve and social cohesion on fall-related self-awareness,thereby providing a reference for developing targeted interventions.Methods Toally 500 old people in communities were recruited by convenience sampling in Hengyang between August and September 2024.Data were collected with the general information questionnaire,neighbourhood cohesion scale,self-awareness of falls in elderly scale,and cognitive reserve index questionnaire.Hierarchical multiple linear regression analysis was employed to explore the effects of cognitive reserve and social cohesion on fall-related self-awareness while controlling for demographic variables.Results A total of 467 valid questionnaires were returned.The score of fall-related self-awareness was 54.60±6.64(moderate level).Social cohesion scores was 29.84±5.52(moderate level),and cognitive reserve score was 93.27±10.83(moderate level).The cognitive reserve and social cohesion were both positively correlated with fall-related self-awareness(all P<0.01).Community integration accounted for 9.10%of its total variability,and cognitive reserve accounted for 5.70%of the total variability of fall vigilance,while controlling for variables such as body mass index(BMI),sleep quality,sedentary habits,fear of falling and financial resources.Conclusion The elderly in communities exhibit a low level of fall-related self-awareness.More attention to risk of falling is required along with developing targeted and individualised training programs aiming at improvement of cognitive reserve and social cohesion,thereby reducing the incidence of falls.

Objective:To develop a prediction model of acute gastrointestinal injury (AGI) grading combined with qSOFA score for the diagnosis of sepsis, and evaluate its value.Methods:This was a prospective observational study. The patients with infection or suspected infection in the General Ward of Changshu Hospital Affiliated to Soochow University from September 2018 to September 2019 were included. Patients younger than 18 years, pregnant, abandoned treatment and died within 3 days after admission were excluded. Clinical characteristics, laboratory test results and AGI grading from 48 h before the infection to 24 h after the onset of infection were recorded. The patients were divided into the sepsis and non-sepsis groups according to whether they were diagnosed with sepsis. The patients were allocated randomly to a modeling cohort and a validation cohort with a ratio of 7:3. Univariate and multivariate logistic regression analyses were used to analyze the relevant risk factors for sepsis in the modeling cohort. Three types of diagnostic models were constructed in the modeling cohort: model A (qSOFA model), model B (the combined model of AGI grading and qSOFA score), and model C (the combined model of clinical parameters). The clinical usefulness of the diagnostic models was assessed by receiver operating characteristic curve (ROC), calibration curve and decision curve analysis (DCA) in the validation cohort. The nomograms were developed based on these models.Results:A total of 2 553 patients were enrolled in the study, 1 789 patients in the modeling cohort and 764 patients in the validation cohort. and 326 were diagnosed with sepsis. There was no statistical difference in the basic conditions of patients in the two groups. Univariate analysis showed that age, gender, the source of infection, temperature, heart rate, polypnea, changes in consciousness, severe edema, hyperglycemia, white blood cell, C-reactive protein and procalcitonin, hypotension, hypoxemia, acute oliguria, coagulation disorders, hyperlacticemia, capillary filling damage or piebaldskin, AGI grading and qSOFA score were significantly correlated with sepsis (all P<0.01). Multivariate logistic regression analysis showed that age ( OR=1.027, P<0.01), source of infection ( OR=2.809, P=0.03), hypotension ( OR=35.449, P<0.01), hypoxemia ( OR=57.018, P<0.01), and AGI grading ( OR=19.313, P<0.01) were significantly associated with sepsis. ROC analysis showed that the area under the curve (AUC) of model A, B and C were 0.784, 0.944 and 0.971 in the modeling cohort, and 0.832, 0.975 and 0.980 in the validation cohort, respectively. The sensitivities were 63.9%, 89.5% and 97.5% in the modeling cohort, and 72.7%, 90.9% and 96.6% in the validation cohort; and the specificities were 90.8%, 90.3% and 88.1% in the modeling cohort, and 92.2%, 94.5% and 92.8% in the validation cohort, respectively. AUC of model B and C were significantly higher than that of model A ( P<0.01). Model A in the validation cohort was poorly calibrated, with low accuracy and high risk of missed sepsis diagnosis ( P=0.044). The net benefits of model B and C were better than that of model A. Conclusions:AGI grading combined with qSOFA score has a high predictive value and accuracy in the diagnosis of sepsis.

Objective To evaluate the efficacy of point application combined with catgut implantation at acupoint for lung-distention. Methods A total of 122 patients with lung-distension were randomized into a treatment group (62 patients) and a control group (60 patients). The patients in the control group received conventional treatment, and those in the treatment group were additionally treated with point application combined with catgut implantation at acupoint on the basis of the control group for 4 weeks. At 6 months follow-up, pulmonary function including the forced expiratory volume in first second (FEV1) and the percentage of FEV1 to forced vital capacity (FEV1/FVC), the total effective rate and acute exacerbation rate were compared in both groups. Results The total effective rate in the treatment group was significantly higher than that in the control group (98.4%vs. 85.0%;χ2=5.592, P<0.05). There were no significant difference in the acute exacerbation rate between the treatment group and the control group (8.1%vs. 20.0%;χ2=3.358, P>0.05).The FEV1 (treatment group: 71.58% ± 2.23% vs. 59.98% ± 2.19%, t=29.223, P<0.01; control group: 66.99% ± 2.25% vs. 61.03% ± 2.50%, t=13.726, P<0.01) and the FEV1/FVC (treatment group:68.99%± 1.33%vs. 50.77%± 1.45%, t=72.914, P<0.01; control group: 62.67% ± 1.47% vs. 51.89% ± 1.88%, t=34.989, P<0.01) after the treatment were significantly increased compared with before the treatment in both groups and such improvement in the treatment group was greater in the treatment group than that in the control group (FEV1: t=13.726, P<0.01;FEV1/FVC:t=34.989, P<0.01). Conclusion Point application combined with catgut implantation at acupoint can improve lung function and clinical effects in patients with lung-distention.