To improve the Morse Fall Risk Assessment Scale using the Geriatric Comprehensive Assessment (CGA) technique and explore its role in fall risk management for elderly hospitalized patients.

From June 2020 to December 2021, our center admitted 238 patients who completed the Morse Fall Assessment Scale and Comprehensive Geriatric Assessment (CGA) software screening, including 48 patients with falls. Compare the Morse Fall Risk Assessment Scale before and after improvement to predict high-risk fall populations, and use receiver operating characteristic (ROC) curves to compare the area under the curve (AUC), sensitivity, specificity, and Jordan index of the scale in predicting fall risk.

According to the Morse Fall Risk Assessment Scale, among the 238 patients, 86 were of high risk of falling, 109 were of medium risk, and 43 were of low risk; According to the modified Morse Fall Risk Assessment Scale, among the 238 patients, 86 were of high risk of falling, 111 were of medium risk, and 41 were of low risk.The scores of 48 fall patients before and after improvement were higher than those of non fall patients (P < 0.01), but the proportion of medium risk patients evaluated by the improved scale increased compared to before improvement (6.42% and 8.10% respectively), while the proportion of low-risk patients decreased (11.63% and 7.31% respectively), and the proportion of high-risk patients remained unchanged. The ROC curve analysis results showed that the AUC of the Morse Fall Risk Scoring Scale for predicting falls was 0.828 (95%CI: 0.773-0.873, P < 0.01), and the AUC of the modified Morse Fall Risk Scoring Scale was improved to 0.848 (95%CI: 0.795-0.891, P < 0.01), but the difference between the two was not statistically significant (Z=1.116, P > 0.05). The sensitivity of the Morse Fall Risk Scoring Scale was 64.58%, the specificity was 95.79%, and the Youden index was 0.604; The sensitivity of the modified Morse Fall Risk Scoring Scale was 60.42%, the specificity was 97.89%, and the Youden index was 0.583.

The Morse Fall Risk Assessment Scale, improved based on CGA, can improve the accuracy of fall risk prediction.

To screen and analyze the prevalence of nutritional risk, sarcopenia and frailty in hospitalized elderly patients with coronary heart disease.

Patients aged 60 and over who were hospitalized in the Cardiology Department of the Second Hospital of Tianjin Medical University from May to August 2023 and were definitely diagnosed with coronary heart disease were collected, and the patients were randomly selected according to the hospitalization number for sampling investigation. Nutritional Risk Screening Scale (NRS2002), SARC-CalF Scale and FRAIL Scale were used to screen nutritional risk, sarcopenia and frailty respectively, and malnutrition and chronic heart failure were diagnosed according to the GLIM criteria for the diagnosis of malnutrition and the criteria in National Heart Failure Guide 2023. T test, rank sum test and chi-square test were used to compare the differences of nutritional risk, sarcopenia and frailty among patients with or without heart failure, and analyze the correlation between nutritional indicators and heart failure indicators by multiple linear regression analysis.

A total of 378 elderly inpatients with coronary heart disease were collected, including 111 cases with heart failure. Among 378 patients, the incidence rates of nutritional risk, malnutrition, sarcopenia and frailty were 16.93%, 5.55%, 6.35% and 21.95% respectively, and the incidence rates of nutritional risk, sarcopenia and frailty in heart failure group were higher than those in non-heart failure group (χ²=32.330, 4.519, 42.024; P < 0.05 or P < 0.01). N-terminal pro-brain natriuretic peptide (NT-proBNP) level was negatively correlated with hemoglobin level (B=-58.410, P < 0.05), but positively correlated with FRAIL scale score (B=2 128.215, P < 0.05). The area under the curve of NT-proBNP was 0.88 (0.67, 1.00), and when NT-proBNP≥3 181.85 ng/L, its sensitivity and specificity for diagnosing frailty were 0.80 and 0.94.

The incidence of malnutrition, frailty and sarcopenia is high in elderly patients with coronary heart disease, especially in elderly patients with heart failure. For patients with NT-proBNP≥3181.85 ng/L, it is suggested to conduct a comprehensive screening and evaluation of frailty.

To investigate the occurrence of hyponatremia in elderly patients with corona virus disease 2019 (COVID-19) admitted to the emergency department.

Data of 159 patients with COVID-19 admitted to the Emergency Department of the Second Hospital of Tianjin Medical University during December 26, 2022 and January 5, 2023 were retrospectively analyzed. According to serum sodium ion level, all patients were divided into eunatremia group and hyponatremia group. Clinical symptoms, medical history, laboratory test results, clinical classification and severity were compared between the two groups. T test was used to compare the measurement data, and χ² test was used to compare the counting data.

Hyponatremia was developed in 65 out of 159 patients, with an incidence of 40.9%, and mild hyponatremia was the most popular (73.85%). Compared with the eunatremia group, patients in hyponatremia group were older, the proportion of women was higher, the symptoms such as fever and anorexia were more popular, and the proportions of patients with hypertension, coronary atherosclerotic heart disease, type 2 diabetes, and chronic kidney disease were higher (t=6.257; χ²=5.122, 4.924, 11.610, 9.803, 6.409, 6.183, 4.078; P < 0.05 or P < 0.01); The percentage of neutrophils, C-reactive protein, D-dimer, and N-terminal pro brain natriuretic peptide levels were higher, while blood sodium concentration and plasma osmotic pressure were lower (t=3.540, 4.420, 3.243, 4.488, -20.050, -15.142; P < 0.01); The proportion of patients with moderate, severe, and critical conditions significantly increased, and the proportion of patients recommended for hospitalization by emergency doctors was higher (χ²=38.868, 35.688; P < 0.01).

The incidence of hyponatremia in elderly COVID-19 patients is high, and COVID-19 patients with hyponatremia have more complications, stronger inflammatory reactions, and more severe conditions, so active treatment should be carried out to reduce the risk of death.

To investigate the effect of intrathoracic-intraperitoneal perfusion chemotherapy followed by high-frequency hyperthermia therapy in elderly patients with malignant pleural and peritoneal effusions.

A total of 200 elderly patients with malignant pleural and peritoneal effusions who were admitted to Tai'an City Central Hospital from January 2022 to January 2023 were selected. One hundred patients who received intrathoracic-intraperitoneal perfusion chemotherapy alone were assigned to the control group, and the other 100 patients who received intrathoracic-intraperitoneal perfusion chemotherapy followed by high-frequency hyperthermia were assigned to the observation group. After treatment, the amount of pleural and peritoneal effusion was measured under B-mode ultrasound to compare the short-term effects between the two groups. Additionally, the levels of tumor markers, quality of life, and adverse reactions were observed in both groups. T test was used to compare the measurement data, and Chi-square test was used to compare the counting data.

The total effective rate in the observation group was significantly higher than that in the control group (81.00% vs. 68.00%; χ²=4.448, P < 0.05). The levels of tumor markers such as carcinoembryonic antigen, carbohydrate antigen 125, and carbohydrate antigen 199 decreased more significantly in the observation group compared with those in the control group (t=4.574, 7.125, 14.153; P < 0.01). The improvement rate of Karnofsky score was significantly higher in the observation group than that in the control group (82.00% vs. 69.00%; χ²=4.568, P < 0.05). However, there was no statistically significant difference in the incidence of adverse reactions (including gastrointestinal symptoms, neutropenia, thrombocytopenia, liver insufficiency, and renal insufficiency) between the two groups (χ²=0.130, 0.177, 0.411, 0.072, 0.096; P > 0.05).

Intrathoracic-intraperitoneal perfusion chemotherapy followed by high-frequency hyperthermia therapy is safe and reliable in elderly patients with malignant pleural and peritoneal effusions, which can effectively improve short-term efficacy with reducing the levels of tumor markers and improving the quality of life.

To observe the impact of ultrasound-guided stellate ganglion block (SGB) on intrapulmonary shunt and cerebral oxygen metabolism in elderly patients undergoing single-lung ventilation.

Ninety-six elderly patients who underwent thoracic surgery under one lung ventilation at Suzhou Hospital Affiliated to Nanjing Medical University from April 2020 to October 2022 were selected. Among them, 48 patients received SGB on the ventilation side under ultrasound guidance before general anesthesia (SGB group), and the remaining 48 patients did not receive SGB (control group). At the immediate start of the procedure (T0), before single-lung ventilation (T1), 15 min (T2), 30 min (T3), 60 min (T4) after single-lung ventilation, and 15 min after resumption of two-lung ventilation (T5), the patient's physiological indices, including the mean arterial pressure (MAP) and heart rate (HR), were monitored and recorded; arterial and jugular venous blood gases were analyzed to obtain pulmonary shunt fractionn (Qs/Qt) and oxygenation index (OI); Jugular venous oxygen saturation (SvO₂) and obstructed side cerebral oxygen saturation (rSO₂) were recorded, and cerebral oxygen consumption rate (CERO₂) was calculated. Complications related to SGB and postoperative pulmonary complications within 72 hours were documented. T test or analysis of variance was used for measurement data, and Chi-square test was used for counting data.

A total of 93 patients were ultimately included in the statistical analysis, including 46 in the SGB group and 47 in the control group. The SGB group exhibited lower HR and more stable MAP during surgery compared with the control group (F=333.662, P < 0.05). After single-lung ventilation, both groups showed significantly increased intrapulmonary shunt. OI in the SGB group was higher, and Qs/Qt was lower than the control group at T2-T5 (F=793.218, 549.716; P < 0.05). At time points T2 to T4, the control group showed a significant decrease in SvO₂ and rSO₂ compared with preoperative values, accompanied by an increase in Ca-vO₂ and CERO₂. In contrast, the SGB group did not exhibit statistically significant changes in SvO₂, rSO₂, Ca-vO₂, and CERO₂ compared with the preoperative values. Intergroup comparisons revealed that at time points T2 and T3, SvO₂ and rSO₂ were higher in the SGB group than those in the control group (P < 0.05), while Ca-vO₂ and CERO₂ were lower in the SGB group than those in the control group (P < 0.05). Two cases of unilateral recurrent laryngeal nerve blockade and one case of brachial plexus blockade occurred in the SGB group, resolving within 24 hours without special treatment. No severe pulmonary complications occurred in both groups.

Ultrasound-guided SGB helps reduce intrapulmonary shunt during single-lung ventilation, improving intraoperative oxygenation and cerebral oxygen metabolism, providing a certain level of cerebral protection.

To investigate the feasibility of noninvasive detection of the left anterior descending intramural coronary artery by transthoracic echocardiography and the characteristics of Doppler flow spectrum.

A total of 43 patients with intramural coronary artery diagnosed by angiography or computed tomography angiography received echocardiography at the First Affiliated Hospital of Xi 'an Medical College from June 1, 2021 to December 1, 2023 were selected. The diagnosis of intramural coronary artery was based on the curving of coronary artery blood flow with an acceleration blood flow signal during diastolic, and its spectrum of Doppler blood flow was measured.

Echocardiography detected 32 left anterior descending intramural coronary artery, with the detection rate of 74.42%, including 3 in proximal left anterior descending branch, 25 in middle left anterior descending branch, and 4 in distal left anterior descending branch. All 32 patients had a "fingertip-like" Doppler’ blood flow spectrum in early diastole, with 9 patients had a "platform-like" in middle and late diastole, 5 patients had a "reverse" in systole, and 3 patients had an thickened and atherosclerotic changed wall of intramural coronary artery. The display rate of the left main coronary artery by transthoracic echocardiography in the examination of coronary artery plaque was 100.00%. The display rates of the proximal, middle, and distal anterior descending branch were 100.00%, 75.00%, and 6.25%, respectively; and the display rates of the proximal, middle, and distal right coronary artery were 61.54%, 16.67%, and 40.00%, respectively.

Echocardiography could non-invasively detect left anterior descending intramural coronary artery, and the curving of coronary artery blood flow with an "fingertip-like" Doppler’ blood flow spectrum in early diastole maybe the characteristic change.

To investigate the evolving trends and hot points in the research of geriatric emergency medicine (GEM) over the past decade.

Conduct a field search in the core collection database of Web of Science using "geriatric emergency medicine" as the subject. The literature was analyzed visually using Citespace software, and Excel was utilized to create an annual trend chart for the number of published documents and a trend prediction chart for high-frequency words. Additionally, an online geographic visualized heat map of country publication volume was generated using datawrapper software.

A total of 2 562 literatures were included for visual analysis. The number of articles from 2012 to 2021 showed a increasing trend, and a more substantial increase was observed after 2015, with the number of publications in 2021 being approximately 2.5 times that of 2012. The top three countries in terms of publication volume are the United States (827 articles), China (661 articles, including 452 articles from Taiwan Province), and Canada (183 articles). The top three intermediary centrality rankings are the United States (0.24), Ukraine (0.13), and the United Kingdom (0.12). The high-frequency keyword detection results show that the frequency of "risk factor" is 538 times, ranking first; The frequency of "predictor" is 370, ranking fifth. The trend forecast chart indicates that these two areas represent the current research frontier, with an increasing trend over the years. Cluster analysis resulted in the identification of 8 distinct topics, with a Q value of 0.7548 and an S value of 0.9032.

The international research in the field of geriatric emergency medicine is gaining increasing popularity, and the future GEM research in China will reach a threshold peak. Among them, the focus and emphasis of GEM research lies in the study of risk factors and predictive factors. The research direction of GEM treatment in hospitals can concentrate on emergency room treatment, emergency general surgery treatment, palliative care, and prognosis assessment.

To investigate the awareness rate of sarcopenia knowledge and its influencing factors in the elderly population, and to provide a basis for launching educational campaigns on sarcopenia knowledge and preventive interventions for sarcopenia in the elderly.

A convenience sampling of 965 community-dwelling older adults aged 65 years and above in six cities and counties in Zhejiang province were surveyed for their awareness of three dimensions of sarcopenia knowledge (symptoms, risk factors, and preventive interventions), and their influencing factors were analyzed using binary logistic regression.

The awareness rates among the elderly population for sarcopenia symptoms, risk factors, and preventive interventions were 47.9%, 47.7%, and 36.3%, respectively. Binary logistic regression analysis revealed that being an empty-nester (dimension one: OR=3.509, 95%CI: 2.619-4.961, P < 0.01; dimension two: OR=3.602, 95%CI: 2.639-4.915, P < 0.01; dimension three: OR=3.457, 95%CI: 2.564-4.661, P < 0.01), level of education (dimension one: OR=1.728, 95%CI: 1.270-2.229, P < 0.01; dimension two: OR=1.502, 95%CI: 1.143-1.975, P < 0.01; dimension three: OR=1.569, 95%CI: 1.187-2.074, P < 0.01), and family income level (dimension one: OR=2.244, 95%CI: 1.523-2.868, P < 0.01; dimension two: OR=2.386, 95%CI: 1.754-3.245, P < 0.01; dimension three: OR=1.710, 95%CI: 1.259-2.323, P < 0.01) were factors influencing the awareness of sarcopenia among the elderly population.

The awareness of the elderly population regarding knowledge about sarcopenia is low, so it is necessary to strength sarcopenia knowledge education, and to increase the awareness of active prevention of sarcopenia in the elderly population.