Comorbidity is a prominent public health problem in the elderly population. To carry out research on the comorbidity of the elderly is not only an important breakthrough to realize the national strategy of actively responding to the aging population, but also a vivid practice of earnestly implementing the "Healthy China" and other action programs. Based on the major public health issues of elderly comorbidity, this paper lists the main contents and methods of elderly comorbidity research from the perspective of secondary research and empirical research, and holds that this field contains both the profound thought of "holistic concept" and the advanced idea of "integrative medicine". At the same time, under the background of the new era, the gradual deepening of the research in this field may give birth to a brand-new discipline - geriatric comorbidity.
[Abstract]With the increasing incidence of lung cancer in the elderly, how to improve the quality and speed of postoperative recovery on the basis of ensuring the therapeutic effect has become an important issue in surgical management. The postoperative recovery process of elderly patients with lung cancer shows higher complexity and challenge due to their unique frailty, comorbidity burden and treatment response. This article will focus on the postoperative rehabilitation strategy, systematically sort out the physiological, pathological and treatment response characteristics of postoperative recovery in elderly patients with lung cancer, propose five postoperative rehabilitation intervention modules based on the enhanced recovery after surgery concept, and further integrate the three challenges of insufficient compliance, research heterogeneity and health economic barriers, and propose a breakthrough method with precise rehabilitation and digital management as the core, providing theoretical support and practical guidance for the optimization and implementation of postoperative rehabilitation programs for elderly patients with lung cancer.
Objective To investigate the effect of topical appl ication of insul in on the burn wound heal ing in aging diabetes mell itus (DM) rats and to explore its mechanism. Methods Seventy-five SPF Wistar rats (female and/or male), aged 12-24 months and weighing 300-350 g, were selected and randomly divided into group A (burn control group, n=25), group B(DM burn control group, n=25), and group C (DM insul in treatment group, n=25). The rats in group B and group C were fedwith high-fat, high-protein, and high-sugar forage for 1 month and received intraperitoneal injection of streptozotocin (STZ)to establ ish experimental model of aging DM. The rats were fed with high-fat, high-protein, and high-sugar forage for another 8 weeks. Then, the deep second-degree burn model was establ ished in the rats of group B and group C. The wounds in group A and B underwent local subcutaneous injection of 2 mL isotonic sal ine and group C received local subcutaneous injection of 0.1 U insul in. The rate of wound heal ing was calculated 7, 14, and 21 days after burn injury. At 1, 3, 7, 14, and 21 days after burn injury, HE staining observation, immunohistochemistry staining for CD34, detection of sugar and hydroxyprol ine (HOP) content in wound tissue, and microvessel density (MVD) calculation were performed. Results At 7, 14, and 21 days after burn injury, the wound heal ing rates of group A and group C was significantly higher than that of group B (P lt; 0.05), and there was no significant difference between group A and group C (P gt; 0.05). Histology observation at 21 days after burn injury: in group A, certain degree of epithel ization was evident in the wound epithel ium; in group B, large quantity of necrotic tissue was evident; in group C, complete epithl ization occurred in the wound epithel ium with better epithel ial cell differentiation and more neonatal collagen. For the sugar content in the wound tissue, group A was significantly lower than group B or group C at 1, 3, 7, 14, and 21 days (P lt; 0.05) and group C was significantly lower than group B at 7, 14, and 21 days (P lt; 0.05). For the HOP content in the wound tissue and the MVD count, group A or group C was significantly higher than group B (P lt; 0.05) and there was no significant difference between group A and group C (P gt; 0.05). CD34 expression: in group A, it was (+) at 7 days, (++) at 14 days, and (+++) at 21 days; in group B, it was (+) at 14 and 21 days; in group C, it was (++) at 7 days and (+++) at 14 and 21 days. Conclusion Topical appl ication of insul in can promote the synthesis of wound collagen, accelerate the woundangiogenesis, and speed up the wound heal ing in aging DM rats.
With the continuous aging of the population in China, the aging of skeletal muscle in the elderly has seriously affected national health and poses a severe challenge to the public health system. Early detection of skeletal muscle aging, and early warning, prevention, and treatment are of great significance for achieving healthy aging. In order to select a series of clinically operable biomarkers for skeletal muscle aging, and to further standardize the early identification and precise diagnosis of skeletal muscle aging, a multidisciplinary team of experts has registered and written this protocol to provide a detailed introduction to the planning process for the development of the consensus.
ObjectiveTo systematically review the dose-effect relationship between resistance exercise intervention and lower extremity muscle strength and function enhancement in the aging. MethodsEBSCO, PubMed, Web of Science, CNKI, VIP, and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) on the effects of resistance exercise on muscle strength and function of the lower extremities in older adults from inception to July 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. A network meta-analysis was then performed by using RevMan 5.4 and Stata 15.0 software. ResultsA total of 32 RCTs with a total sample size of 1 594 individuals were included. The results of network meta-analysis showed that the elements of resistance exercise prescription: intensity 50%-70% 1RM, period 8-12 weeks, frequency 3-4 times/week, duration 30-45 min, and intervals 1.1-2 min were superior to other doses. ConclusionThe optimal dose of resistance exercise for improving lower extremity muscle strength and function in older adults is moderate exercise intensity (50%-70% 1RM) for 8-12 weeks, 3-4 times per week, 30-45 min per exercise, and 1.1-2 min interval between sets.
ObjectiveTo assess the effect of plasmid-mediated short hairpin RNA (shRNA) on Klotho gene in mice medullary collecting duct (IMCD3) cells. MethodsThree pairs of shRNA for Klotho (the first, second, and third pairs of shRNA) were designed and pRNAU6-Klotho were constructed, which were transfected into IMCD3 cells by Lipofactine2000. The negative control group and untreated group were set up at the same time. After 24 hours, the expressions of Klotho mRNA and protein levels were detected by reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting, respectively. ResultsThe second pairs of shRNA had the best interference effect compared with the control group according to RT-PCR (P<0.01). The results of Western blotting showed that the Klotho protein levels in the second pairs of shRNA group differed much from all the other 4 groups (P<0.001). ConclusionPlasma-mediated shRNA can highly inhibit the expression of Klotho, which suggests that it may be potential to study the pathogenesis in kidney disease.
Age-related macular degeneration is one of the major causes of blindness in the elderly. As an important pathway of cell metabolism, autophagy maintains intracellular homeostasis through the degradation and recycle of damaged organelles and macromolecules. Understanding its mechanism may promote discoveries to delay aging process, reduce the incidence of age-related diseases. In mammals, silent information regulator protein 6 (SIRT6) plays its deacetylase and ribonucleotransferase activity in multiple signaling pathways, including inhibition of cellular senescence, tumorigenesis, metabolic diseases, regulating cellular lifespan. It has a significant impact on the structure and function of tissues and organs. SIRT6 regulates intracellular autophagy mainly through the insulin-like growth factor-protein kinase B-mammalian target of rapamycin, reducing the accumulation of toxic metabolites and cellular senescence. The function of SIRT6 in age-related macular degeneration need to be combined with the genetic background, pathogenesis, clinical manifestations and other aspects of the disease, and it is expected to be further studied in subsequent studies.
In order to solve the predicament brought by the aging society, China has promoted the combination of medical care. Hence, rehabilitation for the elderly may become a new strategy for the development of rehabilitation. According to the development of three different models and situation of China, we focus on improving the function of the elderly based on the families, the communities and institutions. Finally, the elderly feel happy and respected by getting professional means of rehabilitation while aging. The insurance system is the guarantee of promoting rehabilitation for the elderly and the " ternary theory” rehabilitation theory should be the guide concept. In the future, the trend is to build China’s three-level " intelligent rehabilitation for the elderly system” by artificial intelligence and big data cloud platform.
Rapidly advancing demographic aging in China has led to an increasing prevalence of terminal patients suffering from malignant tumors and chronic diseases, thereby escalating the demand for palliative care services. Palliative care is a multidisciplinary comprehensive management model for patients in the terminal stage and at the end of life. It aims to effectively alleviate the patients' painful symptoms, improve their quality of life, and ensure their comfortable and dignified departure. Symptom control is at the core of palliative care, and rational drug use is the foundation of symptom control. The complexity of physical and psychological factors in terminal patients and the ethical background pose significant challenges to rational drug use. In addition, elderly hospice patients usually suffer from multiple diseases, and their physiological functions decline, resulting in specific pharmacokinetics and reactivity, which undoubtedly increases the complexity of medical decision-making, making doctors often face multiple medication challenges during the treatment process, which in turn poses potential drug treatment risks. Based on current evidence, a multidisciplinary team led by geriatricians registered and drafted the "Protocol for Medication Guideline for Symptom Management in Elderly Hospice Care (2025)". This paper provides a detailed introduction to the planning process for the development of the guidelines.
The aging of the population has generated significant challenges and unprecedented opportunities for the development of geriatrics in China. The core idea of its overall concept, treatment according to syndrome differentiation and the characteristics of " preventive treatment of disease” have unique advantages, which are required to be explored and studied. This paper reviewed the development history of modern geriatrics in the west and China, analyzed and summarized the research hotspots in the field of integrated traditional Chinese and western medicine for geriatrics in the past five years. It then described the current development status and advantages of integrated traditional Chinese and western medicine in the treatment of common clinical geriatric diseases. Finally, it summarized and visioned the development of integrated traditional Chinese and western medicine for geriatrics.