Objective To study the five-year survival status and influencing factors of elderly patients with lung cancer complicated with chronic obstructive pulmonary disease (COPD). Methods A cohort study was conducted to follow up 450 patients with lung cancer and chronic obstructive pulmonary disease who were hospitalized in our hospital from January 2018 to December 2023. The endpoint of the follow-up was the end of a five-year period or death. The Life Tables method was used to calculate survival rates and plot survival curves. The Cox proportional hazards model was used to analyze the influencing factors of five-year survival. Results The results indicated that the overall five-year survival rate of patients was 4.89%, and it decreased year by year. Cox regression analysis showed that age, gender, family functioning, and psychological status significantly influenced patient survival rate (all P<0.05). Stratified analysis found that the smoking status, family functioning, and psychological status of male patients all had an impact on survival rate (all P<0.05), while the psychological status of female patients had a more significant impact on survival (P=0.008). Conclusion This study provides a scientific basis for comprehensive intervention of elderly lung cancer patients with COPD. It is recommended that clinical attention should be paid to psychological and family factors to improve patient prognosis.

BackgroundWith the intensification of population aging， the prevalence of Alzheimer's disease （AD） has been increasing， and 10% to 20% of AD patients also suffer from chronic obstructive pulmonary disease （COPD）. Compared to patients with a single disease， those with comorbid AD and COPD show more severe cognitive impairment， reduced quality of life， and a greater disease burden. Both AD and COPD patients exhibit abnormal levels of neurotransmitters， which affect cognitive function. However， the alterations in neurotransmitter levels in patients with comorbid AD and COPD and their association with cognitive function remain unclear. ObjectiveTo analyze the relationship between neurotransmitter levels and cognitive function in patients with AD combined with COPD， and to provide references for improving the cognitive function in this population. MethodsA total of 120 patients who were hospitalized at The Third Hospital of Mianyang from January to September 2024 were divided into three groups： 40 patients meeting the International Classification of Diseases， tenth edition （ICD-10） diagnostic criteria for AD were defined as AD group， 40 patients meeting the diagnostic criteria for COPD according to the Global Initiative for Chronic Obstructive Lung Disease （GOLD） 2023 guidelines were defined as COPD group， another 40 patients meeting the diagnostic criteria for both conditions were defined as AD combined with COPD group. Additionally， 40 healthy individuals undergoing physical examination at the same hospital during the same period were selected as the control group. Encephalofluctuograph was used to detect the levels of γ-aminobutyric acid （GABA）， glutamate （Glu）， norepinephrine （NE）， 5-hydroxytryptamin （5-HT）， acetylcholine （Ach）， and dopamine （DA）. Cognitive function of the subjects was assessed using the Mini-Mental State Examination （MMSE） and the Montreal Cognitive Assessment （MoCA）. Spearman correlation analysis was used to investigate the correlation between neurotransmitter levels and cognitive function in AD combined with COPD patients. Multiple linear regression analysis was adopted to investigate the influencing factors of cognitive function in this population. Results①Significant differences were observed in MMSE and MoCA scores across all four groups （H=126.323， 128.489， P<0.01）. The AD combined with COPD group demonstrated significantly lower MMSE and MoCA scores compared with COPD group， AD group， and control group （P<0.05）. ②Statistically significant differences were found in the levels of GABA， Glu， Ach， NE，and DA among the four groups （H=61.094， 46.665， 135.289， 15.089， 129.636， P<0.01）. Compared with the COPD group， AD group， and control group， the AD combined with COPD group showed significantly lower levels of GABA， Ach， and DA， but higher Glu levels， with all differences being statistically significant （P<0.05）. ③In the AD combined with COPD group， the levels of GABA， Ach， and DA showed positive correlations with MMSE scores （r=0.633， 0.876， 0.580， P<0.05）， while Glu levels were negatively correlated with MMSE scores （r=-0.377， P=0.013）. ④The levels of Ach （B=0.253， 95% CI： 0.153–0.352）， GABA （B=0.137， 95% CI： 0.013–0.261）， age （B=-0.212， 95% CI： -0.356–-0.069） and education duration （B=-0.367， 95% CI： -0.608–-0.126） were the influencing factors of cognitive function in patients with AD combined with COPD. ConclusionCompared with the COPD group， AD group， and control group， patients with AD combined with COPD exhibited more severe cognitive impairment， along with lower levels of GABA， ACh， and DA， but higher Glu levels. Ach and GABA levels are potential influencing factors of cognitive function in AD combined with COPD patients.

BackgroundChronic obstructive pulmonary disease （COPD） is a common chronic respiratory disease， and patients with COPD often experience substantially emotional difficulties， such as anxiety and depression， all of which may cause serious detriment to the prognosis of patients. As a non-pharmacological intervention in clinical practice， group mindfulness-based stress reduction therapy （MBSR） is beginning to emerge， while has rarely been studied in COPD patients with concurrent emotional difficulties. ObjectiveTo evaluate the effects of group MBSR on depression， state of mindfulness and pulmonary function in stable COPD patients， so as to provide references for the application of group MBSR in patients with COPD. MethodsA total of 97 patients with stable COPD who were followed up in the Department of Respiratory and Critical Care Medicine of Mianyang Third People's Hospital from January to October 2019 were selected as the study objects， and they were assigned into study group （n=50） and control group （n=47） by random number table method. All individuals received routine medication therapy and an 8-week health education， based on this， participants in study group partook an 8-week intervention comprising group MBSR. At the baseline， 4 weeks and 8 weeks of intervention， participants were assessed with Self-rating Depression Scale （SDS）， Five Facet Mindfulness Questionnaire （FFMQ） and COPD Assessment Test （CAT）， as well as the pulmonary function testing. ResultsThere were 41 patients in study group and 42 cases in control group completed the study. The group * time interaction was interpreted as significant between two groups for SDS， FFMQ and CAT scores （F=54.858， 86.161， 69.862， P<0.01）. Baseline SDS， FFMQ and CAT scores of the two groups yielded no statistical difference between two groups （F=0.240， 0.052， 0.019， P>0.05）， while study group scored lower on SDS and CAT （F=12.900， 38.511， 7.797， 28.824， P<0.01） and higher on FFMQ （F=27.324， 82.412， P<0.01） than those of the control group after 4 and 8 weeks of intervention. With the prolongation of intervention time in study group， participants demonstrated an overall reduction in SDS and CAT scores （F=109.753， 124.144， P<0.01）， and an increase in FFMQ scores （F=228.194， P<0.01）. There were no between-group differences in forced expiratory volume in one second as percentage of predicted volume （FEV1%pred） after 4 and 8 weeks of intervention （F=0.104， P=0.748） ， and the within-group changes in FEV1%pred value over the intervention period in study group was not statistical （F=0.561， P=0.458）. ConclusionGroup MBSR may help relieve depressive symptoms， enhance mindfulness level， and alleviate clinical symptoms in stable COPD patients， but has no effect on pulmonary function. ［Funded by Mianyang Health and Health Commission Scientific Research Project （number， 201916）］