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Geriatrics Research
CN: 37-1522/R
ISSN: 2096-9058
Governed by: Health Commission of Shandong Province
Sponsored by: Shandong Provincial Hospital Affiliated to Shandong First Medical University
Editor-in-Chief: SUN Zhijian
Deputy Editor-in-Chief: WANG Jianchun
Founded in 2020, bimonthly.
Indexed by: CNKI, Wanfang, Weipu, Chaoxing, CBM.
Expert consensus on the construction and management of geriatrics departments in Shandong Province
WANG Jianchun;Shandong Province has a huge problem of aging which develops rapidly. It is one of the first provinces that have entered a moderately aging society and the demand for elderly health care services is urgent. To actively respond to the challenges of population aging, the Geriatrics Branch of Shandong Medical Doctor Association has formulated the expert consensus on the construction and management of geriatrics departments in Shandong Province, based on the current situation of Shandong Province and in line with national policies as well as industry guidelines. As for the construction standards, it is explicitly required to independently establish geriatric wards, outpatient clinics, and comprehensive assessment rooms, rationally allocate bed resources, and optimize the structure of medical staff. As for the promotion of service capabilities, implementation of comprehensive geriatric assessment, management of geriatric syndromes, and collaboration of multidisciplinary diagnosis and treatment will be strengthened. Through standardized and refined management practices, the quality and safety of geriatric medical services will be comprehensively improved.
The validity of ultrasound measurement of subclavian vein variability in volume assessment of elderly patients undergoing hip replacement
WANG Lin;HU Qiangfu;Objective To evaluate the efficacy of subclavian vein collapsibility index(SCV-CI) in assessing volume status in elderly patients undergoing hip replacement surgery. Methods This prospective study enrolled 60 elderly patients scheduled for elective hip replacement under general anesthesia combined with nerve block at the Fifth Affiliated Hospital of Zhengzhou University from November 2023 to June 2024. All patients fasted for 8 hours and abstained from fluids for 2 hours preoperatively. After standard monitoring(ECG, SpO2, etc.), the FloTrac/Vigileo system was used to measure stroke volume(SV). Following anesthetic induction and endotracheal intubation, ultrasound was performed to determine the maximum(dSCVmax) and minimum(dSCVmin) diameters of the subclavian vein, from which SCV-CI and inferior vena cava collapsibility index(IVC-CI) were calculated. A fluid challenge with 7 mL/kg of 6% hydroxyethyl starch 130/0. 4 in saline was administered, and SCV-CI/IVC-CI were remeasured 3 minutes post-expansion. Patients were stratified by volume responsiveness （ΔSV≥15%: responders； ΔSV <15%: non-responders）. Correlation analyses compared SCV-CI and IVC-CI before/after expansion. Receiver operating characteristic(ROC) curves were plotted to determine the optimal predictive threshold of SCV-CI, with area under the curve(AUC) calculated. Results Both SCV-CI and IVC-CI demonstrated significant positive correlations before and after fluid expansion(pre-expansion: r=0. 782, P<0. 05; post-expansion: r=0. 463, P<0. 05). ROC analysis revealed that SCV-CI had an AUC of 0. 863 for predicting fluid responsiveness in elderly hip replacement patients. At a cutoff value of ≥22. 85%, SCV-CI exhibited a sensitivity of 87. 2% and specificity of 85. 7%. Similarly, IVC-CI showed an AUC of 0. 894, with an optimal threshold of ≥29. 65%, yielding a sensitivity of 89. 7% and specificity of 90. 5%. Conclusions As an alternative volume assessment indicator, SCV-CI can effectively evaluate volume responsiveness. The value of 22. 85% serves as the optimal cutoff for assessing intraoperative volume responsiveness in elderly patients undergoing hip arthroplasty.
Analysis of the current status and influencing factors of fall alertness in elderly patients with knee osteoarthritis
CHEN Min;HAN Shan;ZHOU Jing;ZHENG Haiou;CAI Ningge;Objective To investigate the status quo of fall alertness in elderly patients with knee osteoarthritis(KOA) and to analyze its influencing factors. Methods A total of 338 elderly patients with KOA who were admitted to the department of osteoarthritis of the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from October 2023 to October 2024 were selected as the study subjects by convenience sampling. The survey was conducted using the general information questionnaire, the fall alertness scale, the STEADI self-rating scale for fall risk in the elderly, the visual analogue scale and the Barthel index scale. Univariate analysis and multiple linear regression analysis were used to analyze the influencing factors of fall alertness in elderly patients with KOA. Results The fall alertness score of elderly KOA patients was(59. 98±10. 50), indicating a high fall alertness. The results of multiple linear regression showed that fall fear, fall risk, fall prevention education, and self-care ability were the influencing factors of fall alertness in elderly KOA patients(all P <0. 05). Conclusion Fall alertness is high in elderly patients with KOA, and the degree of fall alertness is affected by factors such as fall fear, accuracy of fall risk assessment, fall prevention education effect, and self-care ability.
Analysis of lymphocyte subsets in peripheral blood of patients with rheumatoid arthritis
HAO Tiantian;CHEN Hongxia;TANG Zizheng;XIE Kangqi;WANG Hui;Objective To investigate the changes of lymphocyte subsets in peripheral blood of patients with rheumatoid arthritis(RA). Methods Peripheral venous blood was collected from 45 RA patients(RA group) and 36 healthy subjects during the same period(control group) admitted to the Fourth People's Hospital of Jinan from January 2024 to January 2025. Lymphocyte subsets(T lymphocytes, B lymphocytes and NK cells), T lymphocyte subsets(CD4+ and CD8+) and CD4+ T lymphocyte subsets(Th1, Th2, Th17 and Treg) in the two groups were detected by flow cytometry and compared between the two groups. Results Compared with the control group, the levels of NK cells, CD4+ T lymphocytes, CD4+/CD8+ and Treg cells in the peripheral blood of the RA group were down-regulated(all P<0. 05). The levels of B lymphocytes, Th1 cells, Th1/Th2 and Th17/Treg were up-regulated(all P<0. 05). Conclusion Peripheral blood lymphocyte subsets are disordered in RA patients.
Meta-analysis of the application effect of compound heat preservation in elderly patients undergoing hip arthroplasty
WANG Yuelin;JIANG Yunlan;LI Le;CHEN Hong;WANG Jing;ZHANG Mengjie;BAI Xiaoyu;WU Senlin;Objective To systematically review the application effect of compound heat preservation in elderly patients undergoing hip arthroplasty. Methods PubMed, Cochrane Library, Embase, CINAHL, Web of Science, SinoMed, CNKI, WanFang and VIP databases were electronically searched to collect the randomized controlled trials of compound heat preservation applied to the elderly patients undergoing hip arthroplasty, from inception to November 12, 2024. The experimental group used ≥ 3 measures of compound heat preservation for patients during the perioperative period, while the control group received conventional insulation nursing measures. A meta-analysis was performed using RevMan5. 4 software. Results A total of 16 RCTs were included in the literature, including 1 272 elderly patients undergoing hip arthroplasty. The results of the meta-analysis showed that, compared with the control group, the experimental group was more effective in intraoperative insulation(MD=0. 31, 95% CI: 0. 25-0. 37, P<0. 000 01); low incidence of postoperative hypothermia(OR=0. 14, 95% CI: 0. 08-0. 23, P<0. 01), low incidence of postoperative chills(OR=0. 14, 95% CI: 0. 10-0. 21, P<0. 01), low incidence of postoperative agitation(OR=0. 23, 95% CI: 0. 06-0. 84, P=0. 03); reduced prothrombin time(MD=-3. 17, 95% CI:-5. 19--1. 14, P=0. 002), reduced activated partial thromboplastin time(MD=-5. 95, 95% CI:-9. 69--2. 20, P=0. 002), shortened anesthesia awakening time(MD=-3. 96, 95% CI:-5. 83--2. 08, P<0. 000 1); elevated CD4+ level(MD=2. 97, 95% CI: 2. 09-3. 85, P<0. 01), decreased CD8+ level(MD=-2. 30, 95% CI:-2. 98--1. 62, P<0. 01), and elevated CD4+/CD8+ level(MD=0. 22, 95% CI: 0. 17-0. 26, P<0. 01).However, the difference was not statistically significant for the fibrinogen(P=0. 17). Conclusion The compound heat preservation has a good insulation effect on elderly patients undergoing hip arthroplasty, can effectively reduces the incidence of postoperative complications, has less impact on patients' major coagulation and immune functions, and shortens the patients' anesthesia awakening time.
