To investigate the levels of serum growth differentiation factor-15 (GDF-15), soluble human stromalysin 2 (sST2) and galectin-3 (Gal-3) in evaluating the severity and prognosis of elderly patients with heart failure.

74 elderly patients with heart failure who were hospitalized in the First Affiliated Hospital of USTC from January 2018 to August 2018 were selected. According to the outcome of adverse events (cardiovascular death or rehospitalization due to heart failure) after 1 year of follow-up, they were divided into the event group and the event-free group. Univariate comparison was used between the two groups (the measurement data were tested by t test or rank sum test, while the count data were tested by chi-square test). Then, meaningful indicators were included in multivariate COX regression analysis. The characteristic curve (ROC) evaluates the prognostic value of combined detection of GDF-15, sST2, and Gal-3 in elderly patients with heart failure.

During the follow-up period, 28 adverse events occurred (event group), no adverse events occurred in 46 cases(non-event group). GDF-15, sST2, and Gal-3 were significantly higher in the event group than in the non-event group (t=4.880, 3.325, z=-4.213, P < 0.05). Correlation analysis showed that GDF-15, sST2, Gal-3 were positively correlated with N-terminal B-type natriuretic peptide and NYHA cardiac function grades (r=0.647, 0.706, 0.471, 0.668, 0.603, 0.446, P < 0.05), GDF-15 and sST2 were positively correlated with left ventricular end-diastolic inner diameter (r=0.322, 0.289, P < 0.05), and negatively correlated with left ventricular ejection fraction (LVEF) (r=-0.262, -0.481, P < 0.05). Multivariate COX regression analysis showed that sST2 was the risk factor for adverse events in elderly patients with heart failure within one year (OR=1.032, 95%CI=1.009-1.054, P < 0.05). ROC curve results showed that the area under the curve of serum GDF-15, sST2 and Gal-3 combined detection was the highest, which was 0.851 (95%CI=0.763-0.937).

Serum GDF-15, sST2 and Gal-3 levels can reflect the severity of the disease in elderly patients with heart failure, and have certain prognostic value.

With the development of medical technology, human life expectancy has increased greatly. However, with the increase of age, the prevalence of frailty and cardiovascular diseases is also increasing, especially for the elderly. At present, there are few reports on the correlation between frailty and cardiovascular diseases in China. This article focuses on weak muscle strength assessment and pace of appraisal in elderly patients with coronary heart disease in the treatment of cardiac rehabilitation applications, in order to show weakness assessment for predicting the importance of cardiac rehabilitation outcomes for patients with senile coronary heart disease, hoping to cause the attention of clinical each related disciplines, in order to provide new ideas for the diagnosis, treatment and prevention of the elderly patients with coronary heart disease.

To explore the clinical application of comprehensive geriatric assessment in the treatment of chronic obstructive pulmonary disease.

99 hospitalized elderly patients with chronic obstructive pulmonary disease (>60 years old) were randomly divided into routine treatment group (48 cases) and comprehensive assessment group (51 cases) in January 2017 to April 2018. We compare the general data of the subjects, the treatment effect of the two groups before and after the treatment, the slow lung assessment test, the 6 minute walk test, and the percentage of the one second forced expiratory volume.

There was no significant difference in general data between the two groups (P>0.05). There was no statistically significant difference between the two groups before and after treatment (P>0.05). The differences in gait, fall, cognitive function, anxiety and depression were statistically significant (P<0.05). The routine treatment group was compared with the CGA group at admission, and the BADL, IADL, gait, and fall of the patients were compared. There was no significant difference in the difference of cognitive function, anxiety and depression (P>0.05). After 1 month of discharge, the difference of BADL and IADL in the CGA group was not statistically significant (P>0.05), but the difference in gait, fall, cognitive function, anxiety and depression was statistically significant (P<0.05). The test showed that before treatment, there was no significant difference in the therapeutic effect between the 2 groups (P>0.05), and after 1 month of discharge, the symptoms, activity, social influence, FEV1/FVC and 6MWT control groups in group CGA were statistically significant (P<0.05), but there was no significant difference in sleep (P>0.05). After the treatment of the 2 groups, the differences of reacute attack, rehospitalization and complication were statistically significant (P<0.05), and there was no significant difference between death and respiratory failure (P>0.05).

The comprehensive evaluation technique of old age has effect on the clinical treatment of chronic obstructive pulmonary disease. It is worth popularizing. It is suggested that the comprehensive evaluation technique should be applied as early as possible, and effective intervention should be taken to maintain and improve the functional status and quality of life of the elderly patients to the maximum.

The feasibility of frailty index based on a comprehensive geriatric assessment (CGA) in Chinese hospitalized elderly patients was explored and the frailty status was analyzed.

A total of 105 patients were interviewed using CGA and Clinical Frailty Scale-09 (CFS-09), and frailty index was calculated based on CGA (FI-CGA). Besides, the health status of hospitalized elderly patients was evaluated with CFS-09 and the correlation between FI-CGA and CFS level was analyzed. The comparison between the two groups was tested by t-test, and the comparison between groups was based on the single factor variance analysis, and the correlation was analyzed by Spearman correlation.

The FI-CGA values of 105 patients was 0.01~0.57 and the average was 0.18±0.11; The CFS score of 105 patients was 2~7 and the mean was 3.56±1.24. The average FI-CGA and CFS was higher in female (FI-CGA: 0.05~0.57, 0.21±0.11; CFS: 2~7, 3.69±1.23) than in male (FI-CGA: 0.01~0.48, 0.17±0.11; CFS: 2~7, 3.51±1.24), but this difference was not statistically significant (t=-0.686, P > 0.05; t=-1.800, P > 0.05) . Both FI-CGA (F=11.175, P < 0.01) and CFS (F=6.937, P < 0.01) increased with age and FI-CGA was positively correlated with CFS in different age groups (60-69 group: r=0.700, P < 0.01; 70-79 group: r=0.796, P < 0.01; ≥80 group: r=0.906, P < 0.01).

FI-CGA model, a valid, reliable and sensible clinical measure, is capable of quantifying the degree of frailty and evaluating the health status of hospitalized elderly patients. This model is worthy to be widely applied to clinical geriatric medicine.

To understand the services demands of elderly people with different ability levels in urban nursing homes.

The services demands of 674 elderly people with different ability levels living in 18 nursing homes in 9 provinces were investigated. The ability level was judged by ability assessment for older adults (MZ/T 039-2013). ANOVA was used to compare the demands with different groups.

Six hundred and seventy-four elderly people were mainly constituted by 70~89 years old (82.2%), having no spouse (61.3%), self-funded (86.8%), and the main reason (58.9%) for living in nursing homes is their relatives had no time to take care of them. The demands of daily life care services, medical and health services and psychological comfort services gradually rose with aggravation of physical damage. The demands of leisure and entertainment services declined with aggravation of physical damage. The differences were statistically significant(F=177.546, 11.269, 4.484, 10.097, all P<0.01). The demand degrees of all the daily life care services rose with aggravation of physical damage (F=150.468, 123.718, 129.496, 78.739, 138.319, 160.589, all P<0.01). Except health education and health care of traditional Chinese Medicine, the demand degrees of other medical and health services rose with aggravation of physical damage (F=8.648, 7.948, 13.009, 10.388, 7.703, 16.342, all P<0.01). The demand degrees of all the leisure and entertainment services declined with aggravation of physical damage (F=3.287, 16.570, 4.127, all P<0.05 or P<0.01). In the dimension of psychological comfort services, the differences among groups in adding visitation frequency were statistically significant (F=7.918, P<0.01). The ability level of elderly people was positively correlated with demand of daily life care services, medical and health services and psychological comfort services (r=0.606, 0.214, 0.108, all P<0.01), and was negatively correlated with demand of leisure and entertainment services(r= -0.197,P<0.01).

The ability level of elderly people living in the urban nursing homes was relevant with the demand of daily life care services, medical and health services, leisure and entertainment services and psychological comfort services. The differences of ability level groups were statistically significant. Nursing homes should pay attention to the ability assessment, and divide functional area, develop care plan, service delivery personally according to the demands.

Chinesization the CP - FI - CGA questionnaire which is common used in foreign countries, and evaluate its reliability and validity.

CP - FI - CGA questionnaire was translated and cross-cultural revised. 300 patients of geriatric ward of 4 top three general hospitals were selected to evaluate the reliability and validity. Independent sample t-test was applied to test the degree of differentiation, simple correlation analysis was to test internal consistency reliability, test-retest reliability, split-half reliability, criterion-related validity, and construct validity. Cronbach's alpha coefficient was to calculate internal consistency.

Delete the item 36 (no able to drive), and add the new entry "have major surgery within six months". The final questionnaire has 43 items. The retest reliability r=0.97, test-retest reliability r=0.995, split-half reliability r=0.851,internal consistency Cronbach's a=0.883. The I-CVI of 44 items was from 0.727 to 1. The S - CVI/Ave of questionnaire is 0.986. Coefficient with CFS simple correlation r=0.829 (P<0.01). The simple correlation of coefficient with age r=0.449 (P<0.01). The simple correlation coefficient between each item and FI r=0.131-0.719 (P<0.01). The patients' acceptance of item length, item content and questionnaire's content scope was 100%. The acceptance of length of the questionnaire's was 98.67%. The questionnaire's completion time was (5.45±0.65 min). Men and women patients' frailty level distribution and FI scores had no statistically significance (z =-0.875, t=1.170; P>0.05).

Chinesization of CP-FI-CGA questionnaire has high acceptability, good validity and reliability which can be used for screening geriatrics patients, frailty degree and provide reference for clinical grading nursing.

The research aims to evaluate the curative effects of community health management interventions on stable chronic obstructive pulmonary disease (COPD).

The research is based on the information of 252 COPD patients who are over the age of 65. They were randomly selected from 12 communities of Taiyuan city. With the assessment of their baseline information, the patients were randomly assigned to the experimental group and the control group. A set of comprehensive intervention measures were applied to the patients of experimental group, such as health education, specification of drug therapy and pulmonary rehabilitation training. In addition, the patients were advised to see their doctors regularly or the doctors followed up their patients actively. While there was only specification of drug therapy for the control group. Patients were followed up for 1 year. The patients of two groups were given the tests before and after the management as follows: FEV₁/FVC, FEV₁/pred, mMRC, CAT, Acute exacerbation frequency, 6MWD and SF-MNA. And the results were compared within and between groups by student t test for normal distributed data, non-parametric analysis for abnormal distributed data, Chi-square test for categorical data.

There was a significant difference in FEV₁%pred, mMRC, CAT, 6MWD and MNA-SF in experimental group after treatment (t=3.584, 12.151, 17.156, -21.911, -10.500, and P < 0.01); There was a significant difference within the statistics of the control group before and after the intervention in FEV₁/FVC, FEV₁%pred, mMRC, CAT, 6MWD (t=4.145, 5.038, 5.653, -5.777, -9.749, and P < 0.01). There was a significant difference in FEV₁/FVC, CAT, 6MWD between the two groups before the intervention (t=4.754, -4.758, 4.026, and P < 0.05); and a significant difference in mMRC, MNA-SF, FEV₁/FVC, CAT, 6MWD between the two groups after the intervention (t=-12.267, 6.675, 10.599, -10.166, 21.811, and P < 0.01). There was a significant difference in the constituent ratio of acute exacerbation frequency. The frequency of the experimental group was less than the control group (χ²=19.33, P < 0.01).

It is possible to improve the symptoms of dyspnea, enhance the quality of life, boost the exercise tolerance, improve the nutrition state and decrease the risk of worsening through community management intervention in the elderly with COPD.