Objective To investigate the prognosis of middle-aged and elderly patients with aspiration pneumonia and related influencing factors in integrated medical and elderly care institutions. Methods A total of 604 elderly patients with aspiration pneumonia were selected from integrated medical and elderly care institutions from January 2016 to December 2020. The prognosis of the patients was counted, and the prognostic factors were analyzed by univariate and multivariate logistic regression equations. The receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to analyze the predictive value of logistic regression model for the prognosis of elderly patients with aspiration pneumonia. Results Univariate analysis showed that Alzheimer's disease, severe pneumonia, ability of daily living (ADL), and the number of rescues were related to the prognosis of elderly patients with aspiration pneumonia (P<0.05). Logistic regression model showed that the death risk of patients with Alzheimer's disease was 2.883 times higher than that of patients without Alzheimer's disease, the death risk of patients with severe pneumonia was 3.292 times higher than that of patients without severe pneumonia, the death risk of patients with severe dependence in ADL was 3.719 times higher than that of patients with mild dependence, the death risk of patients with moderate dependence in ADL was 2.558 times higher than that of patients with mild dependence, and the death risk of patients with rescue times ≥ 2 times was 2,922 times higher than that of patients without rescue times (P < 0.05). Logistic regression equation: logistic (P=-8.264+2.883)×Alzheimer disease ≥60 years old + 3.292×severe pneumonia + 3.719×severe dependence in ADL+2.558×moderate dependence in ADL +2.922× number of rescues. The predicted prognosis AUC of elderly aspiration pneumonia was 0.907 (95%CI: 0.848-0.966). When logistic(P>12.97), the predictive value was the best, with the predictive sensitivity being 83.87%, and the specificity being 84.15%. Conclusion Alzheimer&#39;s disease, severe pneumonia, moderate and severe dependence in the ability of daily living and rescue times ≥ 2 are related to the prognosis of middle-aged and elderly patients with aspiration pneumonia in the integrated medical and elderly care institutions, which can be used as a prognostic plan for clinical treatment and nursing management. At the same time strengthening the intervention of patients with the above characteristics will help to promote the improvement of prognosis.

[摘 要] 目的：探讨紫甘薯花色苷（purple sweet potato anthocyanin, PSPA）是否通过circ_0003998/miR-145轴调控乳腺癌MDA-MB-231细胞的增殖、迁移和侵袭。方法：选用乳腺癌MDA-MB-231细胞，将其分为对照组，200、400和800 μg/ml PSPA组，pcDNA组、pcDNA-circ_0003998组、si-NC组、si-circ_0003998组、si-circ_0003998+anti-miR-145组、PSPA+pcDNA组、PSPA+pcDNA-circ_0003998组和PSPA+anti-miR-145组。用qPCR法检测细胞中circ_0003998和miR-145的表达，CCK-8法、Transwell小室法分别检测转染前后细胞的增殖、迁移和侵袭能力，WB法检测细胞中Ki-67、MMP-2和MMP-9蛋白的表达。用双荧光素酶报告基因实验验证circ_0003998与miR-145的靶向关系。结果：与对照组比较，各剂量PSPA组MDA-MB-231细胞的增殖抑制率、miR-145表达水平均显著升高（均P<0.01），Ki-67、MMP-2、MMP-9蛋白和circ_0003998的表达水平、细胞迁移和侵袭细胞数均显著降低（均P<0.01），并呈现浓度依赖性。circ_0003998可以靶向负调控miR-145的表达。敲减circ_0003998后，MDA-MB-231细胞的增殖抑制率、miR-145表达水平显著升高，Ki-67、MMP-2和MMP-9蛋白表达水平、细胞迁移和侵袭细胞数均显著减少（均P<0.01）。共转染si-circ_0003998和anti-miR-145则可逆转敲减circ_0003998表达对MDA-MB-231细胞增殖、迁移和侵袭的抑制作用，过表达circ_0003998或抑制miR-145表达可逆转PSPA对MDA-MB-231细胞增殖、迁移和侵袭的抑制作用。结论：PSPA通过circ_0003998/miR-145轴抑制乳腺癌MDA-MB-231细胞的增殖、迁移和侵袭。

AIM: To compare effects of combined glaucoma-cataract surgery on pseudoexfoliation glaucoma(PXG)and primary open angle glaucoma(POAG).

METHODS: This was a retrospective case-control study conducted the hospitalized patients at department of glaucoma from January 2015 to January 2018. The PXG group included 40 eyes of 38 cases, with 46 eyes of 36 cases on POAG group, which were matched for baseline data. Visual acuity, intraocular pressure(IOP), number of anti-glaucoma medications used and occurrence of complications were observed in both groups after trabeculectomy + phacoemulsification + IOL implantation. Surgical success was defined according to the following 2 criteria: criterion A: IOP≤21mmHg, criterion B: IOP≤18mmHg. Complete success, and qualified success is defined as patients met these criteria with medical treatment(≤3 medications).

RESULTS: The visual acuity was improved, with IOP and the number of anti-glaucoma medications used both reduced in both group after surgery. There was no statistically significant difference in complete and qualified success rates between the two groups at 1 and 3mo after surgery(P>0.05). Postoperative 6mo, 1 and 2a, for criterion A: the qualified success rates in PXG group(90%, 80%, 74%)were slightly lower than that of POAG group(91%, 86%, 82%, P>0.05). The complete success rates in PXG group(50%, 40%, 29%)were significantly lower than that of POAG group(85%, 64%, 61%, P<0.05). For criterion B: the qualified success rates in PXG group(70%, 70%, 59%)were slightly lower than that of POAG group(80%, 80%, 75%, P>0.05). The complete success rates in PXG group(45%, 30%, 18%)were significantly lower than that of POAG group(78%, 61%, 54%, P<0.05).

CONCLUSION: The combined glaucoma-cataract surgery in PXG and POAG patients can significantly improve visual acuity and reduce intraocular pressure. The short-term success rates of both types of glaucoma were similar, however the long-term success rates of PXG patients was significantly lower, and it was difficult to achieve a low level IOP.