Objective:To investigate the clinical impact of wearable devices, specifically quantum microwave functional clothing, on elderly patients experiencing low back pain.Methods:This prospective cohort study recruited patients aged 60 and above who visited the Orthopedics Clinic of Beijing Hospital between November 25, 2021, and March 10, 2022, and presented with complaints of low back pain.Following the specified inclusion and exclusion criteria, a total of 40 patients were ultimately included in the study.These forty elderly patients with low back pain were randomly assigned to either an intervention group consisting of 20 cases(receiving conventional medical intervention along with wearing quantum micromagnetic wave functional clothing)or a control group of 20 cases(receiving only conventional medical intervention).Patients in the intervention group wore the quantum microwave functional clothing continuously for 24 hours a day throughout the 3-month study duration.The treatment effect was assessed using the visual analog scale(VAS), Oswestry disability index(ODI)scores, and lumbar spine MRI examination results.Intra-group and inter-group differences between patients in the intervention group and the control group were compared before and after treatment.Results:One patient in the control group withdrew from the study due to personal reasons, and 39 patients completed the clinical study.The comparison results of the VAS and ODI scores between the intervention and control groups at the initial and follow-up visits indicated a significant decrease in both VAS and ODI scores in the intervention group.The differences in the change of VAS scores(ΔVAS score)and ODI scores(ΔODI score)between the two groups were statistically significant( Z=-3.787, -3.884, both P<0.001).Soft tissue inflammation around the lumbar spine was assessed through lumbar spine MRI examination.Results revealed that in the control group, 13 cases(86.7%)showed no significant change in soft tissue inflammation and 2 cases(13.3%)improved; whereas in the intervention group, 5 cases(31.3%)showed no significant change and 11 cases(68.7%)improved.The improvement in soft tissue inflammation around the lumbar spine was significantly greater in the intervention group compared to the control group( χ2=9.764, P=0.002). Conclusions:In addition to conventional medical intervention, consistent use of quantum micromagnetic wave functional clothing for a period of 3 months has been found to effectively reduce low back pain in elderly individuals.

Objective:To assess the predictive performance of the risk of cardiovascular diseases (CVD) derived from the China Kadoorie Biobank (CKB-CVD) model, prediction for atherosclerotic cardiovascular disease (ASCVD) risk in China (China-PAR) model, and the risk of fatal and nonfatal ischemic cardiovascular diseases derived from the USA-People′s Republic of China Collaborative Study (USA-PRC) model in Chinese Multi-provincial Cohort Study (CMCS).Methods:In this prospective cohort study, a total of 21 948 individuals aged ≥35 years without CVD were selected from 8 provinces and cities in China during the CMCS survey from 1992 to 2005 for 10-year follow-up. The occurrence of CVD or ASCVD events during the follow-up period was used as the gold standard. The CKB-CVD and China-PAR models were used to calculate the predicted risk of CVD events, while the USA-PRC model was used to calculate the predicted risk of ASCVD events. The discrimination of the models was evaluated using the C-statistic, and the calibration was assessed using the Hosmer-Lemeshow χ2 test and decile plot. Results:During the 10-year follow-up, a total of 955 (4.4%) CVD events, including 791 (3.6%) ASCVD events, were recorded among the study participants. The C-index for the CKB-CVD, China-PAR, and USA-PRC models were 0.775 (95% CI: 0.757-0.793), 0.781 (95% CI: 0.763-0.798), and 0.769 (95% CI: 0.750-0.789) for men, and 0.762 (95% CI: 0.737-0.788), 0.769 (95% CI: 0.745-0.794), and 0.767 (95% CI: 0.741-0.794) for women, respectively. China-PAR model showed good calibration for men ( χ2=2.20), however, both CKB-CVD and USA-PRC models demonstrated poor calibration in both men and women ( χ2>20). The results indicated that the CKB-CVD model overestimated the risk of CVD events in both males and females, while the China-PAR model underestimated the risk in females. Furthermore, the USA-PRC model underestimated the risk of ASCVD in both males and females in most decile groups, but overestimated the risk in the highest decile group. Conclusion:The CKB-CVD, China-PAR, and USA-PRC risk assessment models show some degree of deviation from the actual risk of events in the CMCS cohort, but all exhibit good discrimination.

Objective:To analyze changes in nutritional status and immune function of elderly men receiving regular physical examinations, and to investigate the effects of aging on the nutritional status and immune function among elderly men.Methods:A total of 209 elderly men aged 60-101(72.9±11.5)years and receiving regular physical check-ups were enrolled.All research subjects were subjected to nutritional risk screening(NRS2002)and monitoring of nutrition and immune-related indicators, including routine blood work, blood biochemistry, immunoglobulin and T lymphocyte subsets.Results:Body weight, body mass index, hemoglobin, total protein, albumin and serum iron of elderly men decreased with age( F=21.754, 6.257, 47.528, 12.285, 18.397, 18.667, all P<0.001), with those aged 80 and above showing more significant decline and a greater proportion with malnutrition( χ2=77.134, P<0.001). The B lymphocyte counts of elderly men aged 80 and above were significantly lower( P<0.05)while serum IgA and IgG levels were significantly higher( F=3.110, 3.866, P=0.047, 0.022)than those of the 70-79 year old group.In addition, the B lymphocyte count and B lymphocyte ratio in malnourished elderly men were significantly lower( t=2.512, 2.874, P=0.013, 0.005), and IgA was significantly increased( t=2.513, P=0.017), compared with those with normal nutrition. Conclusions:The risk of malnutrition and reduced immune function among elderly men aged 80 years and above is significantly increased, and assessment and screening of the risk of malnutrition in the elderly should be stressed.

Objective:To investigate the correlation between decline of intrinsic capacity and falls in the elderly, in order to provide a new method and basis for fall risk assessment.Methods:A total of 125 elderly inpatients were selected between March 2019 and December 2019 for the survey.The intrinsic capacity of elderly inpatients was evaluated, and the history of falls in the past year were obtained through interviewing.The impact of intrinsic capacity on the risk of falls was analyzed by using logistics regression analysis.Results:Of 125 elderly patients, 37 had experienced falls in the past year, with an incidence of 29.6%(37/125). A decline of intrinsic capacity in varying degrees was found in 92.0%(115/125)of elderly patients and the average score of decline was 2.2(1.0, 3.0). The more intrinsic capacity decreased, the greater the risk of falls( OR=2.425, 95% CI: 1.132-4.848, P=0.016). After taking demographics into consideration, age( OR=1.786, 95% CI: 1.034-2.023)and decline of intrinsic capacity( OR=2.425, 95% CI: 1.132-4.848)were independent risk factors for falls. Conclusions:Decline of intrinsic capacity is closely related to the occurrence of falls.The five-dimension framework of intrinsic capacity provides new ideas and directions for predicting the risk of falls.

Objective To perform a systematic review of the literature on the cost-effectiveness of stroke rehabilitation care ,and to provide evidence for medical insurance payment and clinical decision making on stroke rehabilitation care. Methods We included published randomized controlled trails (RCTs)which compared rehabilitation care (RC)and usual care(UC)on stroke ,and summarized clinical outcome ,resource use ,costs ,and other indexes as outcomes of interest. Results Among included eight RCT studies ,the results of four models of stroke care were found as following. (1)Four studies involving early supported discharge(ESD)showed lower costs in rehabilitation care ,but similar(n＝3) or better(n＝1)clinical outcome. (2)Two studies involving home-based rehabilitation showed similar costs in one and lower costs in the other ,with no difference in clinical outcome between two trials. (3) One study involving stroke unit care showed higher costs and better clinical outcome. (4)One trial involving integration stroke service was associated with lower costs ,but no difference in the effectiveness. Conclusions For patients with stroke ,rehabilitation care leads to significant improvements on cost-effectiveness. Promoting the clinical use of rehabilitation care will bring about clinical benefits ,increase the efficiency of medical resources use ,and improve patient's quality of life.

Gut microbiota ,as the most important part of human microbial ecosystem ,develops with aging. For the past few years ,increasing studies focused on the potential association of microbiota with diseases and health of the total elderly population and found that multiple factors such as ageing , multiple medications ,life style ,diet ,etc.effectively affected the changes of gut microbiota.The changes of gut microbiota could be used in the future as a target for the comprehensive assessment ,dynamic surveillance or intervention therapy of frailty ,sarcopenia and chronic diseases. Therefore ,this review focused on gut microbiota composition ,influencing factors of gut microbiota ,the feature of gut microbiota in common geriatric diseases ,microbiota-based interventions therapy and the longevity microbial resources.

Objective: To investigate the clinical and genetic character of Chinese children with the aarF domain containing kinase 4 (ADCK4)-associated glomerulopathy. Methods: Applying next generation sequencing to detect possible gene mutation(renal disease associated monogene was pooled as one panel) in 69 children with steroid-resistant nephrotic syndrome (SRNS) or persistent proteinuria of unknown origin. Sanger sequencing was used to confirm the significant mutations found in the children and to validate these mutation sites in their patients. Using online software (PolyPhen2, SIFT, Mutation Taster) to predict whether the detected missense mutations were disease causing or not. Collecting and analyzing clinical data of children with ADCK4-associated glomerulopathy, which included onset age, clinical manifestation, and renal pathology. Results: The ADCK4 gene mutation was detected in 8 children with a positive rate of 11.6% (8 out of 69), among which 3 patients carried homozygous c.748G>C mutation, 3 patients carried homologous c.737G>A mutation, 1 patient carried compound heterozygous mutation(c.748G>C and c.737G>A), and 1 patient carried compound heterologous mutation(c.551A>G and c.737G>A). Collectively, there were only 3 mutation sites found in total 8 patients, in which the mutation sites of c.748G>C and c.737G>A had high detection frequency in these 8 patients. These 3 mutation sites were all missense mutation which were predicted to be disease causing by online software and not reported before. The average onset age was 6.5 years (2 years-11.75 years). Four patients presented with SRNS and the other 4 presented with persistent proteinuria. All 8 patients had no extrarenal manifestation, renal biopsy revealed focal segmental glomerulosclerosis (FSGS) in most patients, among which 3 cases had gone to end-stage renal disease (ESRD) at disease onset, and 2 cases progressed to ESRD 2 and 5 years after onset respectively. Seven patients had received glucocorticoid and/or immunosuppressive drug while only one patient getting partial response. All 8 patients were treated with large amount of coenzyme Q₁₀ (15 mg·kg^-1·d^-1) after definite diagnosis of ADCK4 mutation-some patients had acquired encouraging curative effect. Conclusions ADCK4-associated glomerulopathy is not rare especially in the children with SRNS. The onset age is relatively old and the extrarenal manifestation is less common. FSGS is a main pathology type. Patients usually have no response to immunosuppressive therapy, but may benefit from addition of large amount of coenzyme Q₁₀. Some patients may only manifest with insidious proteinuria, causing the early diagnosis to be difficult, which deserves more attention. Three new missense mutations expand disease causing mutation repertoire of ADCK4 gene, among which the two sites of c.748G>C and c.737G>A may be mutation hotspot of ADCK4-associated glomerulopathy in Chinese population, and need further study.

Objective: To summarize the clinical manifestation and molecular characteristics of COQ6 mutation induced nephrotic syndrome, and to evaluate efficacy of CoQ₁₀ therapy. Method: Clinical data of the case with infantile nephrotic syndrome was summarized, including clinical manifestations, laboratory findings and family investigation. The patient received CoQ₁₀ 30 mg/(kg·d) therapy. Urine protein/creatinine ratio, serum albumin and creatinine were detected to assess the efficacy of the therapy. Result: (1) The 10 months old boy was presented with nephrotic level proteinuria and hypoalbuminemia. Extra-renal manifestations included cardiovascular abnormality, motor and mental retardation and unilateral ptosis. The patient had no consanguinity. A novel homozygous p. R360W mutation in COQ6 gene was identified and confirmed by next-generation sequencing and Sanger sequencing, respectively. Family analysis showed that homozygous p. R360W mutation in COQ6 gene was inherited from his parents. Missense p. R360W mutation was damaging by prediction online PolyPhen and SIFT software. After 2 months of CoQ₁₀ complementary therapy, the patient′s urine protein/creatinine ratio declined from 7.2 to 1.3, and decreased further to 0.01 mg/mg with normal albumin level and renal function within 3 months. Nephropathy remission was maintained and growth retardation improved significantly during the last follow-up. Nevertheless, the patient manifested with sensorineural deafness at the age of 2 years. (2) There were 6 different mutations in coenzyme Q₁₀ biosynthesis monooxygenase 6 (COQ6) in 13 individuals from 7 families by homozygosity mapping in the whole world. Each mutation was linked to early-onset SRNS with sensorineural deafness. Renal biopsy revealed FSGS in 7 cases and DMS in 1 case. Other manifestations included ataxia, seizures, facial dysmorphism, nephrolithiasis and growth retardation. Four patients received CoQ₁₀ supplementation and responded to the treatment. Conclusion Renal disease caused by recessive COQ6 gene mutation was nephrotic syndrome. The patient benefited from early CoQ₁₀ complement and reached nephropathy remission.

Frailty is a geriatric syndrome that has been implicated as a causative and prognostic factor for cardiovascular disease (CVD).Frailty and CVD are often concurrent and mutually promotive.The prevalence of frailty ranges from 10％ to 60％ in patients with CVD,depending on different tools and cutoffs chosen to define frailty.Short-and long-term prognosis of CVD are both affected by frailty.The presence of frailty is correlated with an increase in complications,outpatient and emergency department visits,hospital admissions and stays,and mortality in patients with CVD.Early prevention and clinical intervention can delay or even reverse the development of frailty,thus improving the prognosis for CVD.