Frailty is a common comorbidity among patients with chronic obstructive pulmonary disease （COPD）. Chronic inflammatory responses， oxidative stress imbalance， and gut microbiota dysbiosis induced by COPD collectively contribute to the pathophysiological processes underlying frailty in these patients. COPD patients， particularly elderly individuals， are more prone to developing frailty syndrome， thereby significantly increasing their risk of adverse clinical outcomes. This article provides a comprehensive review of recent research advances in the epidemiological characteristics， risk factors，possible pathogenic mechanisms， assessment methods， and intervention strategies for COPD complicated by frailty syndrome， in order to provide a reference for clinical diagnosis and treatment.
Oral frailty， as a new dimension in the field of frailty， is gradually gaining attention.This article summarizes and analyzes the definition， epidemiology， correlation with frailty， clinical manifestations， diagnostic criteria， screening tools， risk factors， impact on overall health， and prevention and treatment of oral frailty. The purpose is to provide a reference for future research on oral frailty should focus on conducting large-scale multicentric clinical data analysis in China， developing diagnostic criteria suitable for the elderly population， and enriching screening tools that are more objective and comprehensive.
Diabetes， a significant chronic disease that affects the functional status of the elderly，is closely associated with the onset and progression of sarcopenia and frailty. With aging， the body undergoes muscle-adipose tissue remodeling， leading to decreased muscle function and exacerbated insulin resistance. This creates a vicious cycle between diabetes and frailty， significantly impacting the clinical prognosis and treatment decisions for elderly diabetic patients. This paper comprehensively explores a multidimensional frailty management approach for elderly diabetic patients， including optimizing glycemic control strategies， implementing personalized nutritional interventions， developing tailored exercise prescriptions， and precision medication selection， so as to provide scientific guidance for improving patients' overall functional capacity and clinical outcomes.
To investigate the the predictive value of the monocyte-to-lymphocyte ratio （MLR） for postoperative pulmonary infection （PPI） in elderly patients with hip fractures.
Methods
A retrospective analysis was conducted on clinical data from 265 elderly hip fracture patients admitted to a tertiary hospital in Hangzhou between January 2018 and December 2024. Patients were divided into a pulmonary infection group and a non-infection group based on the occurrence of PPI. Univariate analysis was used to identify risk factors for PPI. Receiver operating characteristic （ROC） curves were plotted to evaluate the predictive value of MLR postoperatively for PPI in elderly patients with hip fractures. The further analysis of independent risk factors was conducted using a multiple logistic regression model.
Results
The incidence of PPI in elderly hip fracture patients was 5.7% （15/265）. Univariate analysis revealed that ICU admission and elevated MLR at 24 hours postoperatively were associated with PPI（P ＜ 0.05）. Multivariate analysis demonstrated that MLR≥0.7 postoperatively was an independent risk factor for PPI （OR=4.161， 95%CI： 1.038-16.676， P ＜ 0.05）. The area under the ROC curve （AUC） for MLR in predicting PPI was 0.691 （95%CI： 0.561-0.820， P ＜ 0.05）， with an optimal cutoff value of 0.7.
Conclusion
An early postoperative MLR value of ≥0.7 in elderly hip fracture patients is associated with PPI. This biomarker may aid in early clinical identification of high-risk patients.
To analyze the expression changes of cholesterol metabolism-related genes in prostate cancer， and to construct a risk prediction model for prostate cancer recurrence.
Methods
RNA sequencing data and clinical data of prostate cancer case samples were obtained from the Cancer Genome Atlas database， and cholesterol metabolism-related genes were retrieved from the molecular characteristics database. Cholesterol metabolism-related genes as biomarkers of prostate cancer recurrence were identified by differential expression analysis and weighted gene co-expression network analysis. univariate Cox analysis and LASSO algorithm were used to further screen the genes， and a risk prediction model for prostate cancer recurrence was established and validated. The association between risk scores and clinical characteristics of prostate cancer patients were analyzed， and the univariate and multivariate Cox regression analyses were performed to identify independent predictors of prostate cancer recurrence. A nomogram was developed based on the independent predictors， and its predictive performance was evaluated using calibration curves.
Results
Three cholesterol metabolism-related genes， COMP， MYOCD and ACTC1， were identified as biomarkers for prostate cancer recurrence. The risk model was constructed， and the high-risk group had a significantly higher probability of recurrence than the low-risk group （P ＜ 0.05）. The area under the curve for predicting 1-， 3-， and 5-year recurrence in prostate cancer patients exceeded 0.6. The nomogram incorporating the risk score and T-stage demonstrated excellent predictive accuracy， with calibration curve slopes approaching 1， indicating satisfactory predictive performance.
Conclusion
This study confirms the potential of cholesterol metabolism-related genes as biomarkers for prostate cancer recurrence and lays the foundation for the establishment of a novel risk model with powerful stratification capabilities and clinical utility for personalized treatment.
To evaluate the efficiency of the Global Leadership Initiative on Malnutrition （GLIM） consensus criteria for diagnosing malnutrition in elderly inpatients， and to identify the optimal combination of nutritional assessment tools for the "nutritional screening-assessmentdiagnosis" clinical pathway.
Methods
A cross-sectional study was performed to compare GLIM with the nutritional risk screening 2002 （NRS2002）， the mini-nutritional assessment short-form （MNA-SF），the geriatric nutritional risk index （GNRI）， and the subjective global assessment （SGA）. The reliability of GLIM was evaluated by the Kappa （κ）. Sensitivity， specificity， the positive predictive value， the negative predictive value and Youden's index （γ） were used to evaluate GLIM's validity.
Results
Using NRS-2002， MNA-SF， GNRI， SGA， and GLIM as the diagnostic criteria for malnutrition， the incidence rates of malnutrition were 75.64%， 47.12%， 55.45%， 74.68%， and 51.28%， respectively. Among these， GLIM showed a high level of agreement with MNA-SF and SGA （κ=0.824， 0.824； γ=0.79， 0.83）， while the agreement between GLIM and NRS2002 as well as GNRI was relatively weak （κ=0.480， 0.344； γ=0.48，0.34） .
Conclusion
The prevalence of malnutrition or the risk of malnutrition among hospitalized elderly patients is relatively high. It is recommended to use NRS2002 and GNRI for nutritional risk screening， followed by GLIM for nutritional assessment and malnutrition diagnosis.
To evaluate the effect of evidence-based continuous quality improvement in enhancing the quality of bowel preparation for colonoscopy in hospitalized elderly patients.
Methods
Guided by the Continuous Quality Improvement （CQI） model developed by Fudan University， we conducted evidence acquisition through systematic retrieval and synthesis of evidence-based resources including evidence summaries， clinical practice guidelines， and systematic reviews related to colonoscopy and bowel preparation. Following a four-stage process comprising on-site audit， barrier analysis， strategy development， and outcome evaluation， we formulated best-practice evidence and implemented it among hospitalized elderly patients undergoing colonoscopy or related treatments. T test was used to compare the measurement data， χ2 test was used to compare the counting data.
Results
Ten evidence-based recommendations and 20 audit criteria were ultimately included. After implementing evidence-based practice， the Boston Bowel Preparation Scale （BBPS） scores improved from 5.83 ± 1.60 to 6.02 ± 0.82（t=1.430， P ＞ 0.05）， while the qualified rate of intestinal preparation significantly increased from 71.11%to 87.50% （χ2=7.675， P ＜ 0.01）. The risk assessment and education of intestinal preparation have both improved significantly： awareness of risk factors for adverse effects of bowel preparation rose from 16.67% to 100% （P ＜ 0.01）， proper assessment of these risk factors increased from 0 to 88.89% （P ＜ 0.01），and utilization of diverse patient education methods improved from 0 to 100% （P ＜ 0.01）.
Conclusion
The evidence-based bowel preparation practice for hospitalized elderly patients significantly enhanced preparation adequacy rates and nursing adherence to best-practice guidelines.
As the global ageing trend intensifies， the number of elderly patients suffering from ischaemic stroke （IS） is increasing. It is therefore essential to identify effective targets for treatment and improve the prognosis of elderly stroke patients. Mitochondrial dysfunction is closely related to ageing，which affects neuronal viability and functional prognosis， is a key factor in the pathogenesis of IS. This paper reviews mitochondrial dysfunction and IS-related signaling pathways ［nuclear factor erythroid 2 related factor （NRF2） signaling pathway， protein kinase RNA-like ER kinase （PERK） signaling pathway，Phosphoinositide 3-kinase /protein kinase B （PI3K/Akt） signaling pathway， cyclic GMP-AMP synthase（cGAS）-STING signaling pathway］by searching and analyzing the relevant literature， to provide new therapeutic strategies for preventing and treating ischemic stroke and decreasing the disability and mortality rates among the elderly.
