AIM:To investigate myopia status and analyze the influence factors in children and adolescent in Wulong district of Chongqing.METHODS:Cross-sectional study. A stratified cluster sampling method was used to select 2 504 primary and secondary school students in Wulong district, and all students underwent myopia screen and questionnaire survey, statistics and analyses the data.RESULTS:Totally 2 431 students were participated in this study, and 1 217 students with myopia were screened out, the prevalence rate of myopia was 50.06%, awareness rate of myopia was 64.59%, glasses wearing rate of myopia was 51.85%. The prevalence of myopia increased with age and grade(P<0.05), the prevalence of myopia in male(46.97%)was lower than in female(53.18%), and the prevalence of myopia in township(47.06%)was lower than in urban area(52.11%; all P<0.05). Regression analysis showed that outdoor activities were protective factor for myopia, while female, myopic parents, near vision work, short sleep duration and sweet tooth were risk factors for myopia.CONCLUSION:The prevalence rate of myopia was higher in children and adolescent in Wulong district of Chongqing, awareness rate of myopia and glasses wearing rate of myopia were lower, and the genesis of myopia is highly relevant to outdoor activities, gender, myopic parents, near vision work, short sleep duration and sweet tooth.

Objective:To understand and compare the clinical characteristics of children and adults infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant BA.5 and BA.2 subtypes in Shanghai City.Methods:The clinical data of 524 children hospitalized with coronavirus disease 2019(COVID-19) at the Children′s Hospital of Fudan University during the period of BA.5 predominance from December 1, 2022 to January 20, 2023 were collected, which included age, gender, clinical symptoms and laboratory examination results. And the clinical data of household close contacts were also collected. The clinical data of children and their household contacts infected with Omicron BA.2 subtypes during the period of BA.2 predominance from April 4 to April 30, 2022 were collected and compared.The clinical characteristic of critical and non-critical cases, child and adult cases during the period of BA.5 predominance were compared.Statistical analyses were conducted using independent samples t-test, Mann-Whitney U test, chi-square test or Fisher′s exact test. Results:The age of 524 hospitalized children was five days to 16 years old. Among them, 301(57.4%) were male and 223(42.6%) were female. Additionally, there were 29 critical cases (5.5%) and 495 non-critical cases (94.5%). Critical cases had significantly higher fever peak, more shortness of breath occurrence, more pneumonia and underlying diseases compared to non-critical cases, with statistically significant differences ( t=12.06, χ2=34.90, 10.04 and 31.10, respectively, all P<0.05). Regarding laboratory examinations, critical cases exhibited significantly higher frequencies of decreased lymphocyte count, elevated levels of C-reactive protein, procalcitonin and interleukin-6, abnormal liver function and kidney function, and abnormal creatine kinase isoenzyme compared to non-critical cases, with statistically significant differences ( χ2=8.18, Z=-4.61, Z=-4.28, Z=-5.13, χ2 =195.90, Fisher′s exact test and χ2=136.13, respectively, all P<0.05). Non-critical children cases infected with Omicron variant BA.5 subtype exhibited a higher proportion of symptomatic infections compared to adults. Among children, the occurrence rates of fever and gastrointestinal symptoms (nausea, vomiting, diarrhea) were higher, whereas among adults, the occurrence rate of cough was higher. The differences were statistically significant ( χ2=11.16, 11.83, 8.50 and 28.14, respectively, all P<0.05).From December 1, 2022 to January 20, 2023, a total of 588 children cases and 791 adult cases were collected, while from April 4 to April 30, 2022, a total of 355 children cases and 755 adult cases were collected.In the children group, the occurrence rates of cough, convulsions and critical cases were higher in BA.5 subtype-infected children compared to those infected with the BA.2 subtype, with statistically significant differences ( χ2=37.95, 40.78 and 15.54, respectively, all P<0.001).In the adult group, BA.5 subtype-infected individuals had higher fever peak, longer duration of fever, and higher occurrence of fever, cough and gastrointestinal symptoms, compared to those infected with the BA.2 subtype.The differences were statistically significant ( t=-4.40, Z=-9.64, χ2=47.29, 124.09 and 29.90, respectively, all P<0.001). Conclusions:During the peak periods of BA.5 subtype of the Omicron variant in Shanghai City, critical cases have severe systemic symptoms and a higher prevalence of underlying diseases compared to non-critical cases. Among non-critical cases infected with BA.5 subtype, the proportion of symptomatic infections in children is higher than adults, with fever and gastrointestinal symptoms more common than adults, while cough symptoms are more common seen in adults.The occurrence rate of convulsions and critical cases is higher in children infected with variant BA.5 subtype compared to those infected with BA.2 subtype.The systemic symptoms are more severe in adults infected with BA.5 subtype compared to those infected with BA.2 subtype.

Objective:To explore the clinical value of a trinity strategy for the treatment of multiple orthopedic trauma.Methods:A retrospective case series study was conducted to analyze the clinical data of 1 267 patients with multiple orthopedic trauma admitted to Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and the First Affiliated Hospital of Navy Medical University from June 2013 to May 2023, including 862 males and 405 females, aged 18-93 years [(55.2±19.8)years]. Associated injuries included hemorrhagic shock in 632 patients, traumatic wet lung in 274, cranial injuries in 135, abdominal and pelvic bleeding in 116, pneumothorax in 89, urinary injury in 13, and vesical rupture in 8. All the patients were treated with the trinity strategy and the treatment process was divided into the phases of first aid, remodeling, and rehabilitation. The first aid phase focused on stabilizing symptoms and saving lives; the remodeling phase centered on restoring the anatomical structure and alignment; the rehabilitation phase aimed for functional recovery through the integration of both Western and traditional Chinese medicine. The all-cause mortality within 30 days after surgery and fracture healing time were calculated; the excellent and good rates of Constant-Murley shoulder score, Mayo elbow score, Gartland-Werley wrist score, Harris hip score, Hospital for Special Surgery (HSS) knee score and the American Orthopedic Foot & Ankle Society (AOFAS) ankle-hindfoot score at the last follow-up and the overall excellent and good rate of all joint function scores were measured. The short form health survey (SF-36) scores were collected preoperatively and at 6 months postoperatively, including 8 aspects such as physical functioning, physical role, bodily pain, general health, vitality, social functioning, emotional role, and mental health. The incidence of postoperative complications was recorded.Results:All the patients were followed up for 6-18 months [(10.2±4.2)months]. The mortality rate during the acute phase (within 30 days after surgery) was 2.37% with 12 deaths due to hemorrhagic shock, 10 due to traumatic brain injury, 6 due to multiple organ dysfunction syndrome (MODS), and 2 due to pulmonary infection. The average fracture healing time averaged 3.8-18 months [(11.5±4.2)months], with 89.49% of the patients having bone union within 12 months after surgery, 8.93% having bone union within 18 months after surgery, and 1.58% undergoing reoperation. For the patients with internal fixation failure and nonunion, the average healing time was extended to (10.2±2.2)months and (13.7±3.3)months respectively. At the last follow-up, the excellent and good rates of Constant-Murley shoulder score, Mayo elbow score, Gartland-Werley wrist score, Harris hip score, HSS knee score, and AOFAS ankle-hindfoot score were 83.93%, 90.24%, 94.12%, 85.57%, 88.46%, and 92.31% respectively, with an overall excellent and good rate of 89.11%. At 6 months after surgery, the SF-36 scores of all the patients in the eight dimensions,including the physical functioning, physical role, bodily pain, general health, vitality, social functioning, emotional role, and mental health were (74.4±8.6)points, (44.7±14.4)points, (77.4±10.9)points, (68.4±18.2)points, (72.5±16.0)points, (76.8±8.7)points, (49.9±17.6)points, and (72.8±17.9)points, significantly improved compared with those before operation [(63.4±12.7)points, (30.9±17.4)points, (56.4±18.0)points, (55.4±24.7)points, (53.5±21.0)points, (55.8±24.3)points, (36.9±24.0)points, (58.8±21.6)points] ( P<0.01). Complications of different degrees occurred in 214 patients (16.89%), including lung infections in 118 patients (9.31%), lower extremity deep vein thrombosis in 50(3.95%), pressure injuries in 26(2.05%), internal fixation failure in 12(0.95%), and nonunion in 8(0.63%). Conclusions:The trinity strategy provides whole-process management, personalized treatment, and overall rehabilitation for multiple orthopedic trauma. It can decrease mortality, shorten fracture healing time, improve joint function and quality of life, and reduce the incidence of complications.

Objective:To investigate the clinical characteristics of family clustering pediatric and adult cases with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant infection in Shanghai City.Methods:A field investigation among the pediatric cases with Omicron variant infection and their household contacts from April 4 to April 30, 2022 in Children′s Hospital of Fudan University was conducted. The informations on case finding, clinical manifestations and SARS-CoV-2 vaccination status were collected. The epidemiological and clinical characteristics were compared between pediatric cases and adult cases. The independent sample t test or chi-square test was used for statistical analysis, and the relative risk ( RR) and 95% confidence interval (95% CI) were used to evaluate the protective effect of vaccination on the infection of Omicron variant. Results:There were 1 274 family members in 297 families including 370 children and 904 adults of whom 1 110(87.13%) were infected with Omicron variant, with 989(89.10%) symptomatic and 121(10.90%) asymptomatic. There were 355 children infected with Omicron variant, of whom 337(94.93%) were symptomatic, and the main manifestations were fever (96.74%(326/337)) and cough (40.36%(136/337)). Only one pediatric case with Rett syndrome developed critically severe pneumonia. A total of 194 pediatric cases had imaging examination, 64(32.99%) showed pulmonary inflammatory lesions. There were 755 adult cases infected with Omicron variant, of whom 652(86.26%) reported symptoms, and the main manifestations were fever (73.16%(477/652)) and cough (49.85%(325/652)). Among symptomatic cases, fever was more common in pediatric cases than in adult cases, while cough was more common in adult cases than in pediatric cases, and the differences were both statistically significant ( χ2=80.87 and 8.04, respectively, both P<0.01). The fever spike was higher in pediatric cases than in adult cases ((39.3±0.7) ℃ vs (38.6±0.6) ℃), and the difference was statistically significant ( t=9.85, P<0.001). The interval from the onset of symptoms to cycle threshold (Ct) value of the nucleic acid of Omicron variant≥35 was longer in pediatric cases than in adult cases ((13.0±3.1) d vs (10.9±3.6) d), and the difference had statistically significance ( t=2.97, P=0.004). Among 160 children aged 3 to 18 years, 54 (33.75%) received two-dose vaccination. Among the 904 adults, 388 (42.92%) received two-dose vaccination and 293 (32.41%) received a booster dose. In the adult cases, the risk of symptomatic infection was reduced by only 8% ( RR=0.92, 95% CI 0.86 to 0.98, P=0.014) following two-dose vaccination, and the risks of fever and cough following booster vaccination were reduced by 42%( RR=0.58, 95% CI 0.49 to 0.67, P=0.001) and 50% ( RR=0.50, 95% CI 0.34 to 0.78, P=0.001), respectively. Conclusions:Secondary attack rate and symptomatic rate of household infection are high in the context of the Omicron variant outbreak in Shanghai. Symptomatic infection is common in children and adults in household setting. Fever is the most common symptom and fever duration is short. Booster vaccination may provide certain protection against common symptoms caused by Omicron variant infection.

Objective:To investigate the safety and efficacy of a combined anterior and posterior approach in total hip arthroplasty (THA) for fused/ankylosed hip.Methods:37 patients who underwent THA for fused/ankylosed hip from January 2015 to December 2020 were retrospectively analyzed, including 28 males and 9 females, with an average age of 47.9±12.0 years (range, 26-72 years). Etiologies included 23 cases of ankylosing spondylitis, 9 cases of infectious arthritis of the hip in youth, and 5 cases of traumatic arthritis after acetabulum or femoral neck fracture. All patients underwent THA with combined anterior and posterior approach. These factors include operation time, blood loss, amount of transfused blood, blood transfusion rate, preoperative and postoperative Harris score, postoperative range of motion of the hip, and perioperative complications, etc. were evaluated. Postoperative radiography of the hip was performed to evaluate acetabular abduction angle, anterior inclination angle, the prosthesis fixation, osteolysis and heterotopic ossification around the hip.Results:A total of 37 patients were enrolled. The mean operative time was 147.6±16.8 min (range, 129-190 min); the mean estimated blood loss (EBL) was 850.0±10.8 ml (range, 600-1,200 ml); the blood transfusion rate was 59% (22/37), and the mean blood transfusion was 420±45.0 ml (range, 0-800 ml). All patients were followed up for 4.2±0.9 years (range, 1.2-7.2 years). The average abductor angle of the acetabular was 43.7°±5.4° (range, 31°-55°), and the average inclination angle was 20.9°±6.7° (range, 10°-35°); the preoperative Harris score was 47.1±9.9 (range, 40-55) and the mean Harris score at the last follow-up was 83.4±12.4 (range, 75-90). The preoperative range of motion of the hip in all directions was 0°. Postoperative hip range of motion was good, with a mean hip flexion of 95.5°±12.2° (range, 80°-110°), mean extension of 10.5°±3.4° (range, -10°-25°), and mean abduction of 38.0°±8.2° (range, 10°-50°). Postoperative complications were minor, including 2 case with poor wound healing, 2 cases with paresthesia or tingling sensation in the anterior or anterolateral thigh, which returned to normal within 3 months after surgery, and no deep infection or dislocation occurred. The acetabular cup was in poor position in 2 cases and the femoral stem was varus in 1 case, but the prosthesis was stable and no treatment was needed. All the acetabular cups and femur stems were confirmed with bone ingrowth on the last follow-up radiographs, and one patient had heterotopic ossification (Brooker grade 1). No osteolysis or wear of the acetabular liner was observed.Conclusion:Combined anterior and posterior approach (Gibson posterolateral approach + modified Hardinge approach) in THA for fusion/ankylosed hip can fully expose the operative field and sufficiently release the soft tissue, and the function of hip recovered well postopratively.

Objective:To evaluate the efficacy and safety of non-osteotomy total hip arthroplasty (THA) in the treatment of Crowe IV developmental dysplasia of the hip (DDH).Methods:From Jan 2013 to Sep 2021, 46 patients (46 hips) in our department who underwent total hip arthroplasty without osteotomy for unilateral Crowe IV DDH were retrospectively analyzed, including 6 males and 40 females, with an average age of 41.2±7.2 years (25-61 years). The reduction of the femoral head was achieved successfully through moderate upward-posterior displacement of the movement center, gradual osteotomy of the calcar femorale, proper sinking of the femoral prosthesis and sufficient soft tissue release. The evaluation indexes included the basic condition of the operation (operation time, blood loss, blood transfusion, volume), clinical evaluation (Harris score of hip joint function, patient satisfaction, Trendelenburg sign), imaging evaluation (measurement of limb length and pelvic inclination) and incidence of complications.Results:The mean follow-up time was 72.2±8.8 months (8-101 months). The operation time was 97.2±12 min (84-112 min). The average intraoperative bleeding volume was 550±60 ml (350-850 ml). No patient had periprosthetic infection or fracture, no periprosthetic osteolysis or prosthesis loosening, and no patient needed revision surgery at the last follow-up of all cases. The average HHS score of patients increased from 42.5±12.3 points before surgery to 89.2±10.8 points at the last follow-up, and the difference was statistically significant ( t=19.35, P<0.001). Patient self-rated satisfaction: none was very dissatisfied, 1 patient were less satisfied (2%, 1/46), 4 patients were average (9%, 4/46), 19 patients were relatively satisfied (41%, 19/46), and 22 patients were very satisfied (48%, 22/46). The Trendelenburg sign of 46 cases was positive before operation, and all were negative at the last follow-up. The patients' true leg length discrepancy (LLD) measurement was -2.5±0.6 mm before surgery and 11.5±3.2 mm at the last follow-up ( t=29.17, P<0.05). Patients' perceived LLD was 28.2±5.1 mm before surgery and 3.4±1.4 mm at the last follow-up ( t=32.18, P<0.05). The length of the residual calcar femorale was 3.2±0.4 mm after THA. The limb extended distance of affected limb was 45.2±4.6 mm. The preoperative iliolumbar angle was -6.5°±2.3°, which returned to -0.5°±1.3° at the last follow-up ( F=651.97, P<0.05). Conclusion:For patients with unilateral type IV DDH, non-osteotomy THA is a safe and effective surgical method with simple operation and few complications. It can quickly correct pelvic tilt and lumbar compensatory scoliosis postoperatively.

Objective:To explore the impact of a modified blood management strategy on blood loss and transfusion rates during outpatient total hip arthroplasty(THA).Methods:The retrospective research was performed in a total of 125 patients (125 hips) who underwent outpatient primary THA from January 2019 to December 2021 at a medical center. According to whether a modified blood management protocol was used or not, all patients were divided into two groups. Group A was used the original perioperative blood management strategies (1 g tranexamic acid, intravenously, 10 minutes before skin incision), and group B was used the modified perioperative blood management strategy (on the basis of the original protocol, 2 g tranexamic acid was sprayed locally in the joint cavity before the incision was closed, 1 g tranexamic acid was injected intravenously 3 hours after surgery, and 1 g tranexamic acid was injected intravenously again on the first day after surgery). There were 52 cases in group A, including 32 males and 20 females, aged 58.5±9.8 years (range, 39-69 years), 13 cases were developmental hip dysplasia (Crowe I°-II°), 24 cases were avascular necrosis of the femoral head, 10 cases were hip osteoarthritis, 3 cases were ankylosing spondylitis involving hip joint, and 2 cases were femoral neck fracture. Among the 73 patients in group B, there were 43 males and 30 females, aged 55.8±10.4 years (range, 42-67 years), including 17 cases of developmental hip dysplasia (Crowe I°-II°), 32 cases of avascular necrosis of the femoral head, 16 cases of hip osteoarthritis, 7 cases of ankylosing spondylitis involving hip joint, and 1 case of femoral neck fracture. Intraoperative blood loss, transfusion, deep vein thrombosis (DVT) events (vascular ultrasound, 2w Postop.), the hemoglobin (Hb) drop, the hematocrit (Hct) drop and other complications were recorded.Results:After using the modified strategy, the intraoperative blood loss was significantly reduced (305.6±38.6 ml vs. 416.2±88.3 ml, t=9.51, P<0.001), and the drop of hemoglobin was significantly decreased (18.1±4.0 g/L vs. 22.3±5.8 g/L, t=4.97, P<0.001). The drop of Hct also decreased significantly (7.3%±0.7% vs. 9.6%±1.3%, t=10.21, P<0.001), and total blood loss decreased significantly (720.6±57.4 ml vs. 919.6±86.3 ml, t=15.49, P<0.001). The hidden blood loss was also significantly lower than that in group A (414.9±71.1 ml vs. 503.5±96.4 ml, t=5.91, P<0.001). One patient (in group A) developed intra-articular hemorrhage 2 h after surgery and was transferred back to the inpatient ward for treatment after transfusion. Three patients (2.4%, 1 in group A and 2 in group B) developed symptomatic anemia and were discharged successfully after conservative treatment. Calf muscular venous thrombosis occurred in 3 patients (2.4%), but no symptomatic deep vein thrombosis occurred in all patients. Conclusion:According to this retrospective research, the use of modified blood management strategy during outpatient THA can further reduce intraoperative blood loss, hidden blood loss and postoperative hematocrit drop, and does not increase the occurrence of perioperative thrombosis-related complications.

Objective:To design and construct a bone nonunion organoid on chip and explore the mechanism of aseptic bone nonunion.Methods:First a semi-open microfluidic chip was designed, on which human bone marrow mesenchymal stromal cells (BMSC), human fetal lung fibroblast 1, (HFL1) and human umbilical vein endothelial cells (HUVEC) were co-cultured, and a three-dimensional organ on chip system was established. Different proportions of HFL1 and HUVEC were co-cultured with BMSC, which were divided into the control group (HFL1∶HUVEC=1∶1), the fibrosis group (HFL1∶HUVEC=3∶1) and the vascularization group (HFL1∶HUVEC=1∶3). The osteogenic differentiation of BMSC was observed by alkaline phosphatase (ALP) and Alizarin red staining. The transcription level of osteogenic marker genes SP7, RUNX2, ALPL, and BGLAP, and vascularization related genes KDR and VWF were analyzed by qPCR. The expression levels of RUNX2 and ALP were determined by Western Blot. Results:In the co-culture system of BMSCs, HFL1, and HUVECs, BMSCs exhibited normal growth and apparent biomineralization behavior. Endothelial cells were capable of forming structured vascular networks, confirming the successful establishment of the system. Compared to the baseline group, the fibrotic group showed no significant decrease in BMSC osteogenic differentiation. The relative expression levels of the mineralization marker genes ALPL and BGLAP were 0.55±0.19 ( P<0.001) and 0.42±0.27 ( P<0.001), respectively. Vascularization genes KDR and VWF were downregulated, with relative expression levels of 0.49±0.17 ( P<0.001) and 0.49±0.21 ( P<0.001). In contrast, in the vascularized group, BMSC osteogenic differentiation genes SP7, RUNX2, ALPL, and BGLAP were upregulated, with relative expression levels of 2.91±0.52 ( P<0.001), 3.83±1.87 ( P<0.001), 3.22±1.29 ( P<0.001), and 5.21±1.46 ( P<0.001), respectively. Vascularization genes KDR and VWF were also upregulated, with relative expressions of 8.24±2.84 ( P<0.001) and 5.32±1.67 ( P<0.001). Western blot results indicated increased expression of RUNX2 and ALP in the vascularized group and decreased expression in the fibrotic group. Conclusion:The bone nonunion organoid on chip could partially simulate the local microenvironment of bone nonunion. Fibrosis may lead to a significant decrease in bone formation ability and vascularization level, which might be an important reason for the occurrence of aseptic bone nonunion.

Objective: To compare the clinical effects of surgery within and over 48 hours for hip fractures in elderly patients. Methods: From May 2017 to April 2018, 47 patients over 75 years old with hip fracture were operated in our hospital and met with inclusion criteria. The patients were divided into two groups: within 48-hour group and over 48-hour group according to study design. In the within 48-hour group, there were 22 patients including 5 males and 17 females, aged from 76 to 97 years, with an average age of 83.6±5.0 years, and there were 10 femoral neck fractures (3 total hip arthroplasty, 7 hemiarthroplasty) and 12 femoral intertrochanteric fractures (proximal femoral intramedullary nail fixation). There were 25 patients (7 males and 18 females) in the over 48-hour group, aged from 76 to 98 years, with an average age of 83.8±5.8 years, and there were 10 femoral neck fractures (2 total hip arthroplasty, 8 hemiarthroplasty) and 15 femoral intertrochanteric fractures (proximal femoral intramedullary nail fixation). At the end of the follow-up period, the clinical data of the two groups were compared. The differences in the length of stay, cost of stay (excluding implants), postoperative complications within 1 month, hip function score (Harris score) within 1 month and 3 months, and mortality within 3 months and at the end of follow-up were analyzed. Results: Both groups were followed up for 12 to 24 months, with an average of 17.7 months. The hospitalization time (7.9±3.0 d), hospitalization expenses (16 627.5±6 428.8 yuan), the incidence of early complications after operation (59.1%) and Harris score (80.9±8.6) in the within 48-hour group were significantly better than those in the over 48-hour group (12.3±4.1 d, 23 799.0±9 785.3 yuan, 88.0%, 71.1±9.2, respectively). At 3 months after operation, there was no significant difference in Harris score between the two groups (83.9±7.3 in within 48-hour group and 82.3±8.9 in over 48-hour group; t=0.668, P=0.507). Within 3 months, there was no death inwithin 48-hour group, but 2 in over 48-hour group; and 1 in within 48-hour group at the last follow-up. Conclusion Elderly patients with hip fracture benefit significantly from surgery within 48 hours after admission.

Objective To explore the association between resilience and cognitive impairment in the elderly. Methods A face-to-face questionnaire survey was conducted among 6 524 elderly people aged 60 and over in Anhui Province by cluster sampling. The survey included general demographic characteristics, resilience and cognitive function. Statistical methods such as t-test,chi-square test,binary Logistic regression were used for data analysis. Results The incidence of cognitive impairment in the elderly was 13. 6% (886/6 524). The score of resilience in the elderly with normal cognitive function was (64. 89±11. 96), while it was (56. 10±11. 12) in the elderly with impaired cognitive function and the difference was statisti-cally significant (t=20. 511,P<0. 001). Logistic regression analysis showed that there was a statistical cor-relation between resilience and cognitive impairment in the elderly ( OR=0. 936,95%CI:0. 930~0. 943). After adjusting for depression,gender,age and other related factors,there was still a statistical correlation be-tween resilience and cognitive impairment in the elderly (OR=0. 963,95%CI:0. 955~0. 971). Conclusions Resilience is related to cognitive impairment in the elderly,and higher resilience is the protective factor for cognitive impairment.