1.Research progress on sarcopenia with malignant tumor in the elderly
Yanqing SHI ; Hui HAN ; Huashan HONG
Chinese Journal of Geriatrics 2025;44(3):366-371
Sarcopenia is highly prevalent in old patients with cancer, forcing a vicious circle.Sarcopenia increases the incidence of tumor treatment-related side effects and even mortality risk in the elderly.The progression and certain treatments of cancer can lead to an increased risk or severity of sarcopenia, which exacerbate in older adults, accompanied by aggravated physical function impairment.Except for patients with terminal malignant tumors undergoing palliative therapy, screening for sarcopenia is recommended for older patients at the time of diagnosis of malignancy and before initiation of tumor-related treatment, and a more comprehensive geriatric assessment should be conducted, if necessary, to improve the detection rate of sarcopenia and identify the risk factors of sarcopenia.A clear treatment plan should be tailored to meet the needs of tumor treatment at each stage, and the benefits and risks should be weighed in consideration of the intervention goals and physical function status.It is a promising intervention that holistic care including individualized nutrition therapy and progressive resistance training, in collaboration with the multi-disciplinary team, to maintain or improve skeletal muscle mass, strength and physical function, and improve the prognosis and outcome of cancer among elderly patients with sarcopenia.
2.Research progress on sarcopenia with malignant tumor in the elderly
Yanqing SHI ; Hui HAN ; Huashan HONG
Chinese Journal of Geriatrics 2025;44(3):366-371
Sarcopenia is highly prevalent in old patients with cancer, forcing a vicious circle.Sarcopenia increases the incidence of tumor treatment-related side effects and even mortality risk in the elderly.The progression and certain treatments of cancer can lead to an increased risk or severity of sarcopenia, which exacerbate in older adults, accompanied by aggravated physical function impairment.Except for patients with terminal malignant tumors undergoing palliative therapy, screening for sarcopenia is recommended for older patients at the time of diagnosis of malignancy and before initiation of tumor-related treatment, and a more comprehensive geriatric assessment should be conducted, if necessary, to improve the detection rate of sarcopenia and identify the risk factors of sarcopenia.A clear treatment plan should be tailored to meet the needs of tumor treatment at each stage, and the benefits and risks should be weighed in consideration of the intervention goals and physical function status.It is a promising intervention that holistic care including individualized nutrition therapy and progressive resistance training, in collaboration with the multi-disciplinary team, to maintain or improve skeletal muscle mass, strength and physical function, and improve the prognosis and outcome of cancer among elderly patients with sarcopenia.
3.Risk Prediction of Recent Delivery in Pregnant Women with Threatened Early Preterm Labor
Yanqing LIU ; Yuhong YUAN ; Qi SHI
Journal of Practical Obstetrics and Gynecology 2024;40(8):670-675
Objective:To explore the establishment of a Cox proportional hazard prediction model for the re-cent(within a week)delivery of pregnant women with threatened early preterm labor(28-33+6 weeks).Meth-ods:The clinical data of 293 patients with threatened early preterm labor at 28-33+6 weeks admitted to the De-partment of Obstetrics,Affiliated Hospital of North Sichuan Medical College from January 2021 to December 2022 were retrospectively collected.According to whether the patient gave birth recently(within a week)during hospi-talization,they were divided into delivery group(n=88)and non-delivery group(n=205).Demographic data,specialty conditions and clinical biochemical indicators were collected,and the differences of each observation in-dex between the two groups were compared.Cox multivariate analysis was used to screen variables,and then the Cox proportional hazard prediction model was constructed to calculate the hazard ratio(HR).The C-index was used to test the predictive ability of the model,and the nomogram was drawn to visualize the Cox proportional hazard prediction model.The calibration curve was used to test the consistency between the model prediction re-sults and the actual situation.Results:The average age of the delivery group was 30.2±5.0 years old,and the average prolonged pregnancy time was 61.3±47.5 hours.Compared to the group that gave birth and did not give birth,the proportion of patients with body mass index(BMI)at admission,parity>1,gestational diabetes mellitus or diabetic pregnancy combined(GDM/PGDM),abnormal fetal orientation,regular contractions at admis-sion,vaginal cleanliness≥ Ⅲ,white blood cell count ≥10 ×109/L at admission and cervical length<20 mm,the difference was statistically significant(P<0.05).Multivariate Cox regression analysis:BMI>30 kg/m2(HR 2.178,95%CI 1.208-3.928,P=0.010),parity>1(HR 3.095,95%CI 1.759-5.447,P<0.001),regular uterine contraction(HR3.447,95%CI 2.216-5.362,P<0.001),cervical length<20 mm(HR3.594,95%CI 2.289-5.646,P<0.001)and white blood cell count≥10 ×109/L(HR2.124,95%CI 1.352-3.335,P=0.001)on admission were independent risk factors for recent(within a week)delivery of pregnant women with threatened early preterm birth.When the above 5 indicators were included in the prediction model,the C-index was 0.797(95%CI 0.750-0.844),indicating that the model had good prediction ability.The calibration chart shows that the prediction results of the model are in good agreement with the actual results.Conclusions:Preg-nant women with BMI>30 kg/m2 at admission,parity>1,regular uterine contraction at admission,cervical length<20 mm at admission and white blood cell count≥10 ×109/L at admission are prone to premature delivery in the near future.Cox proportional risk prediction model based on the above risk factors has certain accuracy,which can be used to guide clinical workers to take corresponding intervention measures in advance to avoid or reduce the possibility of premature delivery in the near future and improve maternal and infant outcomes.
4.Risk Prediction of Recent Delivery in Pregnant Women with Threatened Early Preterm Labor
Yanqing LIU ; Yuhong YUAN ; Qi SHI
Journal of Practical Obstetrics and Gynecology 2024;40(8):670-675
Objective:To explore the establishment of a Cox proportional hazard prediction model for the re-cent(within a week)delivery of pregnant women with threatened early preterm labor(28-33+6 weeks).Meth-ods:The clinical data of 293 patients with threatened early preterm labor at 28-33+6 weeks admitted to the De-partment of Obstetrics,Affiliated Hospital of North Sichuan Medical College from January 2021 to December 2022 were retrospectively collected.According to whether the patient gave birth recently(within a week)during hospi-talization,they were divided into delivery group(n=88)and non-delivery group(n=205).Demographic data,specialty conditions and clinical biochemical indicators were collected,and the differences of each observation in-dex between the two groups were compared.Cox multivariate analysis was used to screen variables,and then the Cox proportional hazard prediction model was constructed to calculate the hazard ratio(HR).The C-index was used to test the predictive ability of the model,and the nomogram was drawn to visualize the Cox proportional hazard prediction model.The calibration curve was used to test the consistency between the model prediction re-sults and the actual situation.Results:The average age of the delivery group was 30.2±5.0 years old,and the average prolonged pregnancy time was 61.3±47.5 hours.Compared to the group that gave birth and did not give birth,the proportion of patients with body mass index(BMI)at admission,parity>1,gestational diabetes mellitus or diabetic pregnancy combined(GDM/PGDM),abnormal fetal orientation,regular contractions at admis-sion,vaginal cleanliness≥ Ⅲ,white blood cell count ≥10 ×109/L at admission and cervical length<20 mm,the difference was statistically significant(P<0.05).Multivariate Cox regression analysis:BMI>30 kg/m2(HR 2.178,95%CI 1.208-3.928,P=0.010),parity>1(HR 3.095,95%CI 1.759-5.447,P<0.001),regular uterine contraction(HR3.447,95%CI 2.216-5.362,P<0.001),cervical length<20 mm(HR3.594,95%CI 2.289-5.646,P<0.001)and white blood cell count≥10 ×109/L(HR2.124,95%CI 1.352-3.335,P=0.001)on admission were independent risk factors for recent(within a week)delivery of pregnant women with threatened early preterm birth.When the above 5 indicators were included in the prediction model,the C-index was 0.797(95%CI 0.750-0.844),indicating that the model had good prediction ability.The calibration chart shows that the prediction results of the model are in good agreement with the actual results.Conclusions:Preg-nant women with BMI>30 kg/m2 at admission,parity>1,regular uterine contraction at admission,cervical length<20 mm at admission and white blood cell count≥10 ×109/L at admission are prone to premature delivery in the near future.Cox proportional risk prediction model based on the above risk factors has certain accuracy,which can be used to guide clinical workers to take corresponding intervention measures in advance to avoid or reduce the possibility of premature delivery in the near future and improve maternal and infant outcomes.
5.The types of dyslipidemia with poor blood glucose control in type 2 diabetes mellitus patients and their changes after intensive hypoglycemic therapy
Lihui YANG ; Zhengyi TANG ; Yanqing SHI
Chinese Journal of Diabetes 2024;32(12):903-906
Objective To investigate the types of dyslipidemia with poor blood glucose control in patients with type 2 diabetes mellitus(T2DM)and their changes after intensive hypoglycemic therapy. Methods A total of 140 T2DM patients who were hospitalized in the Endocrinology Department of Ruijin Hospital Wuxi Branch Shanghai Jiao Tong University of Medicine were enrolled in this study from August 2022 to July 2023. All the participants were divided into no therapy(Con,n=50),oral medication therapy (OAD,n=41),and insulin therapy group (Ins,n=49). Results The age and DM duration were higher in OAD and Ins groups than in Con group (P<0.05). HOMA-IR and FC-P were lower in Ins group than in OAD group (P<0.05). Compared with baseline,FPG,TC,TG,LDL-C,and fructosamine decreased and FC-P increased after treatment in each group (P<0.05). Pearson correlation analysis showed that the changes in TG after treatment in the Con and Ins groups were positively correlated with △fructosamine (P<0.05). Conclusions TC,TG,and LDL-C are increased when blood glucose control is poor in T2DM patients. After intensified hypoglycemic treatment,TC,TG,and LDL-C are decreased. The change in TG after treatment is positively correlated with △fructosamine.
6.Risk Prediction of Recent Delivery in Pregnant Women with Threatened Early Preterm Labor
Yanqing LIU ; Yuhong YUAN ; Qi SHI
Journal of Practical Obstetrics and Gynecology 2024;40(8):670-675
Objective:To explore the establishment of a Cox proportional hazard prediction model for the re-cent(within a week)delivery of pregnant women with threatened early preterm labor(28-33+6 weeks).Meth-ods:The clinical data of 293 patients with threatened early preterm labor at 28-33+6 weeks admitted to the De-partment of Obstetrics,Affiliated Hospital of North Sichuan Medical College from January 2021 to December 2022 were retrospectively collected.According to whether the patient gave birth recently(within a week)during hospi-talization,they were divided into delivery group(n=88)and non-delivery group(n=205).Demographic data,specialty conditions and clinical biochemical indicators were collected,and the differences of each observation in-dex between the two groups were compared.Cox multivariate analysis was used to screen variables,and then the Cox proportional hazard prediction model was constructed to calculate the hazard ratio(HR).The C-index was used to test the predictive ability of the model,and the nomogram was drawn to visualize the Cox proportional hazard prediction model.The calibration curve was used to test the consistency between the model prediction re-sults and the actual situation.Results:The average age of the delivery group was 30.2±5.0 years old,and the average prolonged pregnancy time was 61.3±47.5 hours.Compared to the group that gave birth and did not give birth,the proportion of patients with body mass index(BMI)at admission,parity>1,gestational diabetes mellitus or diabetic pregnancy combined(GDM/PGDM),abnormal fetal orientation,regular contractions at admis-sion,vaginal cleanliness≥ Ⅲ,white blood cell count ≥10 ×109/L at admission and cervical length<20 mm,the difference was statistically significant(P<0.05).Multivariate Cox regression analysis:BMI>30 kg/m2(HR 2.178,95%CI 1.208-3.928,P=0.010),parity>1(HR 3.095,95%CI 1.759-5.447,P<0.001),regular uterine contraction(HR3.447,95%CI 2.216-5.362,P<0.001),cervical length<20 mm(HR3.594,95%CI 2.289-5.646,P<0.001)and white blood cell count≥10 ×109/L(HR2.124,95%CI 1.352-3.335,P=0.001)on admission were independent risk factors for recent(within a week)delivery of pregnant women with threatened early preterm birth.When the above 5 indicators were included in the prediction model,the C-index was 0.797(95%CI 0.750-0.844),indicating that the model had good prediction ability.The calibration chart shows that the prediction results of the model are in good agreement with the actual results.Conclusions:Preg-nant women with BMI>30 kg/m2 at admission,parity>1,regular uterine contraction at admission,cervical length<20 mm at admission and white blood cell count≥10 ×109/L at admission are prone to premature delivery in the near future.Cox proportional risk prediction model based on the above risk factors has certain accuracy,which can be used to guide clinical workers to take corresponding intervention measures in advance to avoid or reduce the possibility of premature delivery in the near future and improve maternal and infant outcomes.
7.Risk Prediction of Recent Delivery in Pregnant Women with Threatened Early Preterm Labor
Yanqing LIU ; Yuhong YUAN ; Qi SHI
Journal of Practical Obstetrics and Gynecology 2024;40(8):670-675
Objective:To explore the establishment of a Cox proportional hazard prediction model for the re-cent(within a week)delivery of pregnant women with threatened early preterm labor(28-33+6 weeks).Meth-ods:The clinical data of 293 patients with threatened early preterm labor at 28-33+6 weeks admitted to the De-partment of Obstetrics,Affiliated Hospital of North Sichuan Medical College from January 2021 to December 2022 were retrospectively collected.According to whether the patient gave birth recently(within a week)during hospi-talization,they were divided into delivery group(n=88)and non-delivery group(n=205).Demographic data,specialty conditions and clinical biochemical indicators were collected,and the differences of each observation in-dex between the two groups were compared.Cox multivariate analysis was used to screen variables,and then the Cox proportional hazard prediction model was constructed to calculate the hazard ratio(HR).The C-index was used to test the predictive ability of the model,and the nomogram was drawn to visualize the Cox proportional hazard prediction model.The calibration curve was used to test the consistency between the model prediction re-sults and the actual situation.Results:The average age of the delivery group was 30.2±5.0 years old,and the average prolonged pregnancy time was 61.3±47.5 hours.Compared to the group that gave birth and did not give birth,the proportion of patients with body mass index(BMI)at admission,parity>1,gestational diabetes mellitus or diabetic pregnancy combined(GDM/PGDM),abnormal fetal orientation,regular contractions at admis-sion,vaginal cleanliness≥ Ⅲ,white blood cell count ≥10 ×109/L at admission and cervical length<20 mm,the difference was statistically significant(P<0.05).Multivariate Cox regression analysis:BMI>30 kg/m2(HR 2.178,95%CI 1.208-3.928,P=0.010),parity>1(HR 3.095,95%CI 1.759-5.447,P<0.001),regular uterine contraction(HR3.447,95%CI 2.216-5.362,P<0.001),cervical length<20 mm(HR3.594,95%CI 2.289-5.646,P<0.001)and white blood cell count≥10 ×109/L(HR2.124,95%CI 1.352-3.335,P=0.001)on admission were independent risk factors for recent(within a week)delivery of pregnant women with threatened early preterm birth.When the above 5 indicators were included in the prediction model,the C-index was 0.797(95%CI 0.750-0.844),indicating that the model had good prediction ability.The calibration chart shows that the prediction results of the model are in good agreement with the actual results.Conclusions:Preg-nant women with BMI>30 kg/m2 at admission,parity>1,regular uterine contraction at admission,cervical length<20 mm at admission and white blood cell count≥10 ×109/L at admission are prone to premature delivery in the near future.Cox proportional risk prediction model based on the above risk factors has certain accuracy,which can be used to guide clinical workers to take corresponding intervention measures in advance to avoid or reduce the possibility of premature delivery in the near future and improve maternal and infant outcomes.
8.Risk Prediction of Recent Delivery in Pregnant Women with Threatened Early Preterm Labor
Yanqing LIU ; Yuhong YUAN ; Qi SHI
Journal of Practical Obstetrics and Gynecology 2024;40(8):670-675
Objective:To explore the establishment of a Cox proportional hazard prediction model for the re-cent(within a week)delivery of pregnant women with threatened early preterm labor(28-33+6 weeks).Meth-ods:The clinical data of 293 patients with threatened early preterm labor at 28-33+6 weeks admitted to the De-partment of Obstetrics,Affiliated Hospital of North Sichuan Medical College from January 2021 to December 2022 were retrospectively collected.According to whether the patient gave birth recently(within a week)during hospi-talization,they were divided into delivery group(n=88)and non-delivery group(n=205).Demographic data,specialty conditions and clinical biochemical indicators were collected,and the differences of each observation in-dex between the two groups were compared.Cox multivariate analysis was used to screen variables,and then the Cox proportional hazard prediction model was constructed to calculate the hazard ratio(HR).The C-index was used to test the predictive ability of the model,and the nomogram was drawn to visualize the Cox proportional hazard prediction model.The calibration curve was used to test the consistency between the model prediction re-sults and the actual situation.Results:The average age of the delivery group was 30.2±5.0 years old,and the average prolonged pregnancy time was 61.3±47.5 hours.Compared to the group that gave birth and did not give birth,the proportion of patients with body mass index(BMI)at admission,parity>1,gestational diabetes mellitus or diabetic pregnancy combined(GDM/PGDM),abnormal fetal orientation,regular contractions at admis-sion,vaginal cleanliness≥ Ⅲ,white blood cell count ≥10 ×109/L at admission and cervical length<20 mm,the difference was statistically significant(P<0.05).Multivariate Cox regression analysis:BMI>30 kg/m2(HR 2.178,95%CI 1.208-3.928,P=0.010),parity>1(HR 3.095,95%CI 1.759-5.447,P<0.001),regular uterine contraction(HR3.447,95%CI 2.216-5.362,P<0.001),cervical length<20 mm(HR3.594,95%CI 2.289-5.646,P<0.001)and white blood cell count≥10 ×109/L(HR2.124,95%CI 1.352-3.335,P=0.001)on admission were independent risk factors for recent(within a week)delivery of pregnant women with threatened early preterm birth.When the above 5 indicators were included in the prediction model,the C-index was 0.797(95%CI 0.750-0.844),indicating that the model had good prediction ability.The calibration chart shows that the prediction results of the model are in good agreement with the actual results.Conclusions:Preg-nant women with BMI>30 kg/m2 at admission,parity>1,regular uterine contraction at admission,cervical length<20 mm at admission and white blood cell count≥10 ×109/L at admission are prone to premature delivery in the near future.Cox proportional risk prediction model based on the above risk factors has certain accuracy,which can be used to guide clinical workers to take corresponding intervention measures in advance to avoid or reduce the possibility of premature delivery in the near future and improve maternal and infant outcomes.
9.Risk Prediction of Recent Delivery in Pregnant Women with Threatened Early Preterm Labor
Yanqing LIU ; Yuhong YUAN ; Qi SHI
Journal of Practical Obstetrics and Gynecology 2024;40(8):670-675
Objective:To explore the establishment of a Cox proportional hazard prediction model for the re-cent(within a week)delivery of pregnant women with threatened early preterm labor(28-33+6 weeks).Meth-ods:The clinical data of 293 patients with threatened early preterm labor at 28-33+6 weeks admitted to the De-partment of Obstetrics,Affiliated Hospital of North Sichuan Medical College from January 2021 to December 2022 were retrospectively collected.According to whether the patient gave birth recently(within a week)during hospi-talization,they were divided into delivery group(n=88)and non-delivery group(n=205).Demographic data,specialty conditions and clinical biochemical indicators were collected,and the differences of each observation in-dex between the two groups were compared.Cox multivariate analysis was used to screen variables,and then the Cox proportional hazard prediction model was constructed to calculate the hazard ratio(HR).The C-index was used to test the predictive ability of the model,and the nomogram was drawn to visualize the Cox proportional hazard prediction model.The calibration curve was used to test the consistency between the model prediction re-sults and the actual situation.Results:The average age of the delivery group was 30.2±5.0 years old,and the average prolonged pregnancy time was 61.3±47.5 hours.Compared to the group that gave birth and did not give birth,the proportion of patients with body mass index(BMI)at admission,parity>1,gestational diabetes mellitus or diabetic pregnancy combined(GDM/PGDM),abnormal fetal orientation,regular contractions at admis-sion,vaginal cleanliness≥ Ⅲ,white blood cell count ≥10 ×109/L at admission and cervical length<20 mm,the difference was statistically significant(P<0.05).Multivariate Cox regression analysis:BMI>30 kg/m2(HR 2.178,95%CI 1.208-3.928,P=0.010),parity>1(HR 3.095,95%CI 1.759-5.447,P<0.001),regular uterine contraction(HR3.447,95%CI 2.216-5.362,P<0.001),cervical length<20 mm(HR3.594,95%CI 2.289-5.646,P<0.001)and white blood cell count≥10 ×109/L(HR2.124,95%CI 1.352-3.335,P=0.001)on admission were independent risk factors for recent(within a week)delivery of pregnant women with threatened early preterm birth.When the above 5 indicators were included in the prediction model,the C-index was 0.797(95%CI 0.750-0.844),indicating that the model had good prediction ability.The calibration chart shows that the prediction results of the model are in good agreement with the actual results.Conclusions:Preg-nant women with BMI>30 kg/m2 at admission,parity>1,regular uterine contraction at admission,cervical length<20 mm at admission and white blood cell count≥10 ×109/L at admission are prone to premature delivery in the near future.Cox proportional risk prediction model based on the above risk factors has certain accuracy,which can be used to guide clinical workers to take corresponding intervention measures in advance to avoid or reduce the possibility of premature delivery in the near future and improve maternal and infant outcomes.
10.Risk Prediction of Recent Delivery in Pregnant Women with Threatened Early Preterm Labor
Yanqing LIU ; Yuhong YUAN ; Qi SHI
Journal of Practical Obstetrics and Gynecology 2024;40(8):670-675
Objective:To explore the establishment of a Cox proportional hazard prediction model for the re-cent(within a week)delivery of pregnant women with threatened early preterm labor(28-33+6 weeks).Meth-ods:The clinical data of 293 patients with threatened early preterm labor at 28-33+6 weeks admitted to the De-partment of Obstetrics,Affiliated Hospital of North Sichuan Medical College from January 2021 to December 2022 were retrospectively collected.According to whether the patient gave birth recently(within a week)during hospi-talization,they were divided into delivery group(n=88)and non-delivery group(n=205).Demographic data,specialty conditions and clinical biochemical indicators were collected,and the differences of each observation in-dex between the two groups were compared.Cox multivariate analysis was used to screen variables,and then the Cox proportional hazard prediction model was constructed to calculate the hazard ratio(HR).The C-index was used to test the predictive ability of the model,and the nomogram was drawn to visualize the Cox proportional hazard prediction model.The calibration curve was used to test the consistency between the model prediction re-sults and the actual situation.Results:The average age of the delivery group was 30.2±5.0 years old,and the average prolonged pregnancy time was 61.3±47.5 hours.Compared to the group that gave birth and did not give birth,the proportion of patients with body mass index(BMI)at admission,parity>1,gestational diabetes mellitus or diabetic pregnancy combined(GDM/PGDM),abnormal fetal orientation,regular contractions at admis-sion,vaginal cleanliness≥ Ⅲ,white blood cell count ≥10 ×109/L at admission and cervical length<20 mm,the difference was statistically significant(P<0.05).Multivariate Cox regression analysis:BMI>30 kg/m2(HR 2.178,95%CI 1.208-3.928,P=0.010),parity>1(HR 3.095,95%CI 1.759-5.447,P<0.001),regular uterine contraction(HR3.447,95%CI 2.216-5.362,P<0.001),cervical length<20 mm(HR3.594,95%CI 2.289-5.646,P<0.001)and white blood cell count≥10 ×109/L(HR2.124,95%CI 1.352-3.335,P=0.001)on admission were independent risk factors for recent(within a week)delivery of pregnant women with threatened early preterm birth.When the above 5 indicators were included in the prediction model,the C-index was 0.797(95%CI 0.750-0.844),indicating that the model had good prediction ability.The calibration chart shows that the prediction results of the model are in good agreement with the actual results.Conclusions:Preg-nant women with BMI>30 kg/m2 at admission,parity>1,regular uterine contraction at admission,cervical length<20 mm at admission and white blood cell count≥10 ×109/L at admission are prone to premature delivery in the near future.Cox proportional risk prediction model based on the above risk factors has certain accuracy,which can be used to guide clinical workers to take corresponding intervention measures in advance to avoid or reduce the possibility of premature delivery in the near future and improve maternal and infant outcomes.

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