Objective To explore the incidence rate and independent risk factors of synchronous multiple early gastric cancer (SMEGC) in patients with early gastric cancer, and to provide evidence for early screening and intervention of high-risk population. Methods A retrospective analysis was performed on 308 patients with early gastric cancer who received treatment in the hospital from March 2019 to March 2024. The incidence rate of SMEGC was counted, and the risk factors were analyzed by univariate and multivariate Logistic regression analyses. Results Among the 308 patients with early gastric cancer in this study, 23 cases were SMEGC and 285 were single early gastric cancer, which were included in the SMEGC group and the single group respectively. The incidence rate of SMEGC was 7.47% (23/308). Compared with the single group, the proportions of male, smoking history, tumor diameter≤2 mm, chronic atrophic gastritis and intestinal metaplasia degree were higher in the SMEGC group (2=4.331、8.608、4.618、6.490、4.897，P=0.037、0.003、0.032、0.001、0.027). Logistic regression analysis suggested that chronic atrophic gastritis (OR=3.133, 95%CI: 1.240-7.918) and moderate-to-severe intestinal metaplasia (OR=3.171, 95%CI: 1.252-8.029) were independent risk factors for SMEGC (P<0.05). Conclusion Some patients with early gastric cancer are SMEGC. Chronic atrophic gastritis and moderate-to-severe intestinal metaplasia are independent risk factors affecting the occurrence of SMEGC. It is recommended to regularly screen high-risk patients and optimize management strategies to reduce the risk of SMEGC.

Objective To analyze the status quo and related factors of treatment compliance in elderly patients with advanced gastric cancer complicated with cancer pain. Methods Three hundred and ten elderly patients with advanced gastric cancer from January 2021 to June 2024 were selected, and their general data were collected. Hospital Anxiety and Depression Scale (HADS), Beliefs about Medicines Questionnaire (BMQ), Numerical Rating Scale (NRS) and 8-item Morisky Medication Adherence Scale (MMAS-8) were adopted to investigate the psychological status, necessity of medication belief, degree of cancer pain and treatment compliance. Univariate analysis, correlation analysis and multivariate logistic regression analysis were used to describe and analyze the treatment compliance status and related factors in elderly advanced gastric cancer with cancer pain. Results A total of 310 patients were divided into group A (good compliance, 93 cases), group B (moderate compliance ,102 cases) and group C (poor compliance , 115 cases) by means of compliance degree. There were significant differences in education level , pain duration and intensity and analgesic category (P<0.05). Treatment compliance was associated with education level, analgesic category, psychological status, medication belief and pain degree (P<0.05). The necessity of medication belief and pain duration and degree were influencing factors of treatment compliance. Conclusion The treatment compliance in advanced gastric cancer with cancer pain is poor, and can be affected by the necessity of medication belief and duration and degree of pain.

Objective To explore the rehabilitation effect of abdominal breathing training and the improvement status of cardiopulmonary function in elderly patients with chronic obstructive pulmonary disease (COPD) over 60 years old. Methods A total of 520 COPD patients over 60 years old admitted to the hospital were selected from June 2021 to March 2024 as the research subjects. The patients were divided into reference group (routine intervention, n=260) and abdominal rehabilitation group (abdominal breathing training on the basis of routine intervention, n=260) by adopting computer random function. Cardiopulmonary tolerance, respiratory muscle condition and pulmonary function markers were compared between the two groups before and after intervention. Results Compared with the reference group after intervention, the abdominal rehabilitation group had higher maximum oxygen uptake and minute ventilation volume, lower anaerobic threshold, and higher maximal expiratory pressure (MEP). The maximal inspiratory pressure (MIP), forced expiratory volume in one second (FEV1), forced expiratory volume (FVC), ratio of forced expiratory volume to forced vital capacity in one second (FEV1/FVC), the percentage of FEV1 to the predicted value (FEV1%pred) and 1 min maximum ventilation volume (MVV) (P<0.05) were all higher in the abdominal rehabilitation group than the reference group after intervention. Conclusion Abdominal breathing training for patients with COPD over 60 years old can effectively enhance cardiopulmonary tolerance, and improve respiratory muscle physiology and pulmonary function.

Objective To understand the epidemiological characteristics and risk factors of hospital-acquired pneumonia in elderly diabetic patients. Methods Elderly patients with diabetes mellitus who were hospitalized in the hospital were selected from October 2020 to October 2023 as the research subjects. The epidemiological characteristics of hospital-acquired pneumonia were analyzed, and the risk factors affecting hospital-acquired pneumonia in elderly patients with diabetes mellitus were analyzed . Results There were 65 cases of hospital-acquired pneumonia in 388 elderly patients with diabetes mellitus, with an incidence of 16.75%, of which 56.92% were males and 43.08% were females. The proportion of patients aged≥80 years was higher than that of patients aged<80 years. There were no significant differences in gender, body mass index, education level, course of diabetes mellitus, smoking history, drinking history, hypertension, coronary heart disease and anemia between groups (P>0.05), but significant differences were shown in age, hospitalization time, tracheal invasive operation, types of antibacterial drug use and dysphagia between both groups (P<0.05). Logistic multivariate analysis showed that age≥80 years old, hospitalization time≥30 d, tracheal invasive operation, use of antibacterial drugs≥ 2 types, and dysphagia were independent risk factors for hospital-acquired pneumonia in elderly diabetic patients (P<0.05). Conclusion The risk of hospital-acquired pneumonia is high in elderly patients with diabetes mellitus. Patients with age≥80 years old, hospitalization time≥30 days, tracheal invasive operation, abuse of antibacterial drugs and dysphagia are high-risk population. It is necessary to take active intervention measures for such patients.

Objective To explore the rehabilitation effect of abdominal breathing training and the improvement status of cardiopulmonary function in elderly patients with chronic obstructive pulmonary disease (COPD) over 60 years old. Methods A total of 520 COPD patients over 60 years old admitted to the hospital were selected from June 2021 to March 2024 as the research subjects. The patients were divided into reference group (routine intervention, n=260) and abdominal rehabilitation group (abdominal breathing training on the basis of routine intervention, n=260) by adopting computer random function. Cardiopulmonary tolerance, respiratory muscle condition and pulmonary function markers were compared between the two groups before and after intervention. Results Compared with the reference group after intervention, the abdominal rehabilitation group had higher maximum oxygen uptake and minute ventilation volume, lower anaerobic threshold, and higher maximal expiratory pressure (MEP). The maximal inspiratory pressure (MIP), forced expiratory volume in one second (FEV1), forced expiratory volume (FVC), ratio of forced expiratory volume to forced vital capacity in one second (FEV1/FVC), the percentage of FEV1 to the predicted value (FEV1%pred) and 1 min maximum ventilation volume (MVV) (P<0.05) were all higher in the abdominal rehabilitation group than the reference group after intervention. Conclusion Abdominal breathing training for patients with COPD over 60 years old can effectively enhance cardiopulmonary tolerance, and improve respiratory muscle physiology and pulmonary function.

Objective To understand the epidemiological characteristics and risk factors of hospital-acquired pneumonia in elderly diabetic patients. Methods Elderly patients with diabetes mellitus who were hospitalized in the hospital were selected from October 2020 to October 2023 as the research subjects. The epidemiological characteristics of hospital-acquired pneumonia were analyzed, and the risk factors affecting hospital-acquired pneumonia in elderly patients with diabetes mellitus were analyzed . Results There were 65 cases of hospital-acquired pneumonia in 388 elderly patients with diabetes mellitus, with an incidence of 16.75%, of which 56.92% were males and 43.08% were females. The proportion of patients aged≥80 years was higher than that of patients aged<80 years. There were no significant differences in gender, body mass index, education level, course of diabetes mellitus, smoking history, drinking history, hypertension, coronary heart disease and anemia between groups (P>0.05), but significant differences were shown in age, hospitalization time, tracheal invasive operation, types of antibacterial drug use and dysphagia between both groups (P<0.05). Logistic multivariate analysis showed that age≥80 years old, hospitalization time≥30 d, tracheal invasive operation, use of antibacterial drugs≥ 2 types, and dysphagia were independent risk factors for hospital-acquired pneumonia in elderly diabetic patients (P<0.05). Conclusion The risk of hospital-acquired pneumonia is high in elderly patients with diabetes mellitus. Patients with age≥80 years old, hospitalization time≥30 days, tracheal invasive operation, abuse of antibacterial drugs and dysphagia are high-risk population. It is necessary to take active intervention measures for such patients.

Objective:To investigate long-term auditory changes and characteristics of Alport syndrome（AS） patients with different degrees of renal injury. Methods:Retrospectively analyzing clinical data of patients diagnosed AS from January 2007 to September 2022, including renal pathology, genetic detection and hearing examination. A long-term follow-up focusing on hearing and renal function was conducted. Results:This study included 70 AS patients, of which 33（25 males, 8 females, aged 3.4-27.8 years） were followed up, resulting in a loss rate of 52.9%.The follow-up period ranged from 1.1to 15.8 years, with 16 patients followed-up for over 10 years. During the follow-up, 10 patients presenting with hearing abnormalities at the time of diagnosis of AS had progressive hearing loss, and 3 patients with new hearing abnormalities were followed up, which appeared at 5-6 years of disease course. All of which were sensorineural deafness. While only 3 patients with hearing abnormalities among 13 patients received hearing aid intervention. Of these patients,7 developed end-stage renal disease（ESRD）, predominantly males （6/7）. The rate of long-term hearing loss was significantly different between ESRD group and non-ESRD group（P=0.013）. There was no correlation between the progression of renal disease and long-term hearing level（P>0.05）. kidney biopsies from 28 patients revealed varying degrees of podocyte lesion and uneven thickness of basement membrane. The severity of podocyte lesion was correlated with the rate of long-term hearing loss（P=0.048）, and there was no correlation with the severity of hearing loss（P>0.05）. Among 11 cases, theCOL4A5mutationwas most common （8 out of 11）, but there was no significant correlation between the mutation type and hearing phenotype（P>0.05）. Conclusion:AS patients exhibit progressive hearing loss with significant heterogeneity over the long-term.. THearing loss is more likely to occur 5-6 years into the disease course. Hearing abnormalities are closely related to renal disease status, kidney tissue pathology, and gene mutations, emphasizing the need for vigilant long-term hearing follow-up and early intervention.
Male ; Child ; Female ; Humans ; Nephritis, Hereditary/pathology* ; Retrospective Studies ; Kidney ; Deafness ; Hearing Loss/genetics* ; Kidney Failure, Chronic/pathology* ; Mutation

Objective To investigate the efficacy of flupentixol combined with ondansetron in preventing postoperative nausea and vomiting(PONV)in patients receiving sufentanil and dezocine patient-controlled intravenous analgesia(PCIA).Methods Surgical patients receiving sufentanil and dezocine PCIA were randomly divided into treatment and control groups using a random number table.The control group received sufentanil 150 μg,dezocine 20 mg,and ondansetron 8 mg for PCIA,while the treatment group received sufentanil 150 μg,dezocine 20 mg,flupentixol 5 mg,and ondansetron 8 mg for PCIA.The incidence of PONV,severity of PONV,heart rate(HR),mean arterial pressure(MAP),blood oxygen saturation(SPO2)levels at different time points after surgery,surgery-related indicators,visual analogue scale(VAS)scores,Ramsay scores,PCIA pressing times,and incidence of adverse drug reactions were compared between the two groups.Results The incidence of PONV in the treatment group and the control group at 2,12,24,36 and 48 hours after surgery were 1.64％,4.84％,6.56％,3.28％,0 and 14.75％,18.03％,19.67％,16.39％,9.84％,respectively.The HR at 24 hours after surgery in the treatment group and the control group were(91.42±8.75)and(98.13±9.62)beat·min-1,respectively;the MAP were(91.98±4.56)and(99.05±4.17)mmHg;SPO2 were(98.13±1.65)％and(98.95±1.82)％;VAS scores were 2.68±0.49 and 2.97±0.63;Ramsay scores were 2.27±0.65 and 2.05±0.32;PCIA pressing times were(2.14±0.37)and(4.36±0.78)times,respectively.The differences in the above indicators between the treatment group and the control group were statistically significant(all P＜0.05).The incidence of total adverse drug reactions after surgery in the treatment group and the control group were 13.12％and 8.20％,respectively,with no statistically significant difference(P＞0.05).Conclusion Flupentixol combined with ondansetron can reduce the risk of PONV caused by sufentanil combined with dezocine PCIA after surgery,ensuring good analgesic effects and safety.

Adequate inflammation can effectively eliminate harmful substances and prevent disease as a self-protective measure to prevent further damage to the body,while abnormally activated inflammation is detrimental to the body.Nucleotide binding and oligomerization domain-like receptor protein 3(NLRP3)inflammasome that participates in inflammatory responses are closely related to many physiological and pathological processes and play an important role in the occurrence and development of pulmonary diseases.This article mainly reviewed the activation mechanism and hypothesis of NLRP3 inflammasome,as well as the research on treating respiratory diseases by interfering with NLRP3 inflammasome.

Objective To explore the nutritional risk investigation and influencing factors of elderly patients with community-acquired pneumonia (CAP). Methods The clinical data of 239 elderly patients with CAP in Western Theater General Hospital were retrospectively analyzed from January 2022 to January 2024. Nutritional risk screening scale (NRS2002) was used to investigate the nutritional risk of patients. According to the nutritional risk investigation results, 239 elderly patients with CAP were divided into higher risk group (NRS2002≥3 points) and lower risk group (NRS2002<3 points). Univariate analysis was used to compare the gender, age, education level, body mass index (BMI), family monthly income, living condition, severity of pneumonia, smoking history, presence or absence of chronic diseases, cognitive dysfunction and self-care ability. The independent risk factors of nutritional risk in elderly patients with CAP were analyzed by binary logistic regression analysis. Results According to NRS2002 score, there were 87 cases (36.4%) in higher risk group and 152 cases (63.6%) in lower risk group. The NRS2002 scores in higher risk group were significantly higher than those in lower risk group (P<0.05). There were no obvious differences in gender, BMI, family monthly income and presence or absence of smoking history between groups (P>0.05). The higher risk group had significantly higher rates of age>70 years old, education level (high school and below), living condition (living alone), severity of pneumonia (high-risk pneumonia), chronic disease, cognitive dysfunction and poor self-care ability than the lower risk group (P<0.05). Binary logistics regression analysis showed that age>70 years old , education level of high school and below, living condition (living alone), severity of pneumonia (high-risk pneumonia), chronic diseases, cognitive dysfunction and self-care ability (poor) were independent risk factors for nutritional risk in elderly CAP patients (P<0.05). Conclusion Elderly patients with CAP have high nutritional risk, which may be affected by many factors such as age, education level, living condition, severity of pneumonia, presence or absence of chronic diseases, cognitive dysfunction and self-care ability. It is necessary to formulate targeted intervention measures according to the above factors to improve the nutritional risk of patients.