To explore the correlation of skeletal muscle mass with cardiac structure and function.
Methods
General information， laboratory tests and body composition indicators of 911 patients aged 60 and above who visited the Department of Geriatrics in Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from May 2021 to August 2023 were collected. The cardiac structure and function were evaluated using echocardiography. Logistic regression was used to analyze the impact of sarcopenia on cardiac structure and function， and Pearson correlation analysis was further used to analyze the correlation of skeletal muscle mass index with cardiac structure and function indicators.
Results
Out of 911 patients， 183（20.1%） were diagnosed with sarcopenia. The differences in left ventricular end diastolic internal diameter， left ventricular end systolic internal diameter， left atrial internal diameter， left ventricular posterior wall thickness， interventricular septal thickness， and brain natriuretic peptide were statistically significant between the sarcopenia group and the non-sarcopenia group （P ＜ 0.05）. Logistic regression analysis showed that there was some effect of sarcopenia on the patient's cardiac structure-related indexes such as left atrial internal diameter， interventricular septal thickness， left ventricular end diastolic internal diameter， left ventricular end systolic internal diameter，and left ventricular posterior wall thickness （P ＜ 0.01）， while no significant effect was seen on the cardiac function-related indexes such as left ventricular endocardial shortening fraction， left ventricular ejection fraction， and brain natriuretic peptide （P ＞ 0.05）. Pearson's correlation analysis showed that in 183 patients with sarcopenia， appendicular skeletal muscle mass index was associated with the left atrial internal diameter （r=0.185， 95%CI: 0.041-0.321， P ＜ 0.05）， interventricular septal thickness （r=0.338，95%CI: 0.203-0.461， P ＜ 0.01）， left ventricular end diastolic internal diameter （r=0.285， 95%CI: 0.146-0.413， P ＜ 0.01）， left ventricular end systolic internal diameter （r=0.247， 95%CI: 0.105-0.378， P ＜ 0.01），and left ventricular posterior wall thickness （r=0.436， 95%CI: 0.301-0.546， P ＜ 0.01）.
Conclusion
There is a correlation between skeletal muscle mass and cardiac structure and function， which may serve as an independent risk factor for predicting cardiovascular disease.
To investigate the effect of cutting balloon on the long-term prognosis of mild-to-moderate coronary artery calcification lesions in the elderly.
Methods
Elderly patients with coronary heart diseases treated in the Baoding No. 1 Central Hospital from January to December 2018 were included. Coronary artery stenosis combined with mild-to-moderate coronary artery calcification was confirmed by coronary angiography. A total of 1 901 patients were divided into 158 cases in the cutting balloons group and 1 743 cases in the conventional balloon group. A propensity score matching（PSM） model was established and matched 1:1 with 143 cases in each group. After 5 years of follow-up，the incidence of major adverse cardiovascular and cerebrovascular event （MACCE） in the two groups after PSM was compared through Kaplan-Meier survival curve， and the risk of MACCE was analyzed by Cox proportional hazard regression model.
Results
MACCE occurred in 54 of 286 patients （18.9%）.Kaplan-Meier survival curve analysis showed that the risk of MACCE， all-cause death， target vessel revascularization， and in-stent thrombosis was lower in the cutting balloon group compared with those in the conventional balloon group （P ＜ 0.05 or P ＜ 0.01）. Multivariate Cox proportional hazard regression model analysis showed that compared with conventional balloon dissection， cutting balloon dissection was associated with a lower risk of MACCE， all-cause death， acute myocardial infarction， target vessel revascularization， in-stent thrombosis， and ischemic stroke （P ＜ 0.05 or P ＜ 0.01）.
Conclusion
Cutting balloon therapy improves long-term prognosis in elderly patients with mild-to-moderate coronary artery calcification.
To evaluate the clinical efficacy of contrast-enhanced ultrasound-guided injection in treating adhesive capsulitis of the shoulder （ACS） in elderly patients， focusing on improvements in shoulder joint function， pain relief， and reduction of joint adhesions.
Methods
This study included 63 patients aged 60 years or older diagnosed with ACS and treated at Zhejiang Hospital from January 2020 to December 2023. Patients were divided into an observation group （n=30） and a control group（n=33）. The observation group underwent contrast-enhanced ultrasound-guided drug injection， while the control group received traditional corticosteroid injections. Clinical efficacy was evaluated by comparing Constant-Murley scores （CMS）， Visual Analog Scale （VAS） scores， and post-treatment axillary recess thickness between the two groups. T tests were used to compare the measurement data， χ2 tests were used to compare the counting data.
Results
Patients in the observation group showed significantly better improvement in CMS and VAS scores than the control group （t=4.142， -4.873； P ＜ 0.01），axillary capsule thickness after treatment was less than that of the control group （t=-2.164， P ＜ 0.05）， and the observation group required significantly fewer treatment sessions than the control group （t=-33.292，P ＜ 0.01）.
Conclusion
Contrast-enhanced ultrasound-guided intracapsular injection therapy is more effective in improving shoulder function， reducing pain and minimizing joint adhesions in elderly patients with ACS.
To investigate the predictive value of neutrophil-to-lymphocyte ratio（NLR） in the progression of severe community-acquired pneumonia （SCAP） to sepsis in elderly patients.
Methods
A total of 78 elderly patients with SCAP admitted to Xunyi County Hospital in Xianyang City from January 2022 to October 2023 were selected as the study objects. According to whether they progressed to sepsis， the subjects were divided into sepsis group （n=24） and non-sepsis group （n=54）.T test or χ2 test were used for univariate analysis of the relevant data of the two groups. Multivariate Logistic regression was used to analyze the factors influencing the progression of SCAP to sepsis in elderly patients， and receiver operating characteristics （ROC） curve was used to evaluate the predictive value of NLR.
Results
The results of univariate analysis showed that the acute physiology and chroni health evaluation （APACHE） Ⅱ score， procalcitonin （PCT）， NLR， neutrophil count and lymphocyte count were higher in the sepsis group than those in the non-sepsis group （P ＜ 0.05）. Multivariate Logistic regression analysis showed that APACHE-Ⅱ score （OR=1.476， 95%CI: 1.051-2.071）， PCT （OR=1.975，95%CI: 1.295-3.012）， NLR （OR=1.958， 95%CI: 1.259-3.045） were risk factors for the progression of SCAP to sepsis in the elderly （P ＜ 0.05）. ROC curve analysis showed that the area under the curve of NLR for predicting SCAP progression to sepsis in the elderly was 0.858 （95%CI: 0.778-0.939）， which was higher than those of APACHE-Ⅱ score and PCT.
Conclusion
The NLR can effectively predict the risk of SCAP progression to sepsis in the elderly， and the detection is rapid and simple， which is worthy of clinical promotion.
Dietary patterns refer to the combination of food types， quantities， and proportions，which represent specific consumption habits， and influenced by factors such as culture， geography， and lifestyle. Healthy dietary patterns play a crucial role in improving dyslipidemia and are considered a key measure for preventing and treating arteriosclerotic cardiovascular disease. Studies have shown that reducing saturated fat intake， moderately consuming legumes and nuts， choosing low-fat meat and dairy products， increasing whole grains， unsaturated fatty acids， dietary fiber， and antioxidants may help improve lipid profile and reduce the risk of cardiovascular diseases. This review aims to summarize several widely recognized dietary patterns and elucidate the possible mechanisms by which they affect lipid profiles， providing insights for developing personalized dietary interventions tailored to the elderly population.
As the aging population in China continues to increase， the effect of senescence on tendons has attracted much attention. At present， the pathogenic mechanisms of senescence have not been fully elucidated. This article summarizes the effects of senescence on tendon cells， tendon stem cells，and extracellular matrix， and discusses the epidemiological characteristics of senescence-related diseases such as rotator cuff injury and Achilles tendon rupture， as well as potential ameliorations and treatments for senescence tendons. The aim is to provide new ideas for further research into the pathological and physiological mechanisms of senescence tendons， the development of effective intervention strategies，and the treatment of related diseases.
Delirium is one of the most common perioperative complications， which affects short and long term outcomes of elderly patients， and brings burden to patients' families and society. Stress response plays an important role in the pathophysiological process of delirium. Acute brain dysfunction，namely delirium， is a failure of higher- risk individuals to show resilience in response to perioperative stressors. This review focuses on previous research of perioperative delirium and its connection to stress response. It aims to summarize the clinical and basic studies regarding the effect of stress on neuroinflammation， neurotransmitter imbalance， and circadian rhythm disorder. Furthermore， it analyzes how the highly reactive hypothalamic-pituitary-adrenal axis and elevated levels of glucocorticoids may mediate the occurrence of delirium. This review will offer new insights for exploring the mechanism of delirium， providing references for future research on improving delirium management plans.
