The Relationship Between Social Isolation, Psychological Resilience, and Psychological Well- Being Among Older People in the Community

Objective:To explore the relationship between social isolation,psychological resilience,and psychological well-being in community-dwelling older adults.Methods:A questionnaire survey was conducted with 265 community-dwelling older adults using the Social Isolation Scale for the Elderly(C-SIS),the 10-item Brief Psychological Resilience Scale,and the Comprehensive Happiness Questionnaire(MHQ).The results were statistically analyzed using SPSS 27.0.Results:The highest score on the Social Isolation Scale for Community Elderly was 23,with a mean entry score of 2.36±0.62.A score of 14 was the cut-off point,with scores of≤14 classified as social isolation.There were 136 cases with scores below 14,resulting in a social isolation incidence rate of 51.3%.The median(P50)psychological resilience score was 27,indicating a higher level of resilience.The total score on the Psychological Well-being Scale was 161,suggesting a moderate to slightly higher level of well-being.Social isolation had a direct negative effect on psychological well-being,while psychological resilience had a positive effect.Conclusion:Older adults should be supported in reducing the incidence of social isolation and increasing psychological resilience to enhance psychological well-being and promote successful aging.

Effect of infarct location and volume on cognitive dysfunction in elderly patients with acute insular cerebral infarction

BACKGROUND The aging of the population has become increasingly obvious in recent years,and the incidence of cerebral infarction has shown an increasing trend annually,with high death and disability rates.AIM To analyze the effects of infarct location and volume on cognitive dysfunction in elderly patients with acute insular cerebral infarction.METHODS Between January 2020 and December 2023,we treated 98 cases of elderly acute insula,patients with cerebral infarction in the cerebral infarction acute phase(3-4 weeks)and for the course of 6 months in Montreal Cognitive Assessment Scale(MoCA)for screening of cognition.Notably,58 and 40 patients were placed in the cognitive impairment group and without-cognitive impairment group,respec-tively.In patients with cerebral infarction,magnetic resonance imaging was used to screen and clearly analyze the MoCA scores of two groups of patients with different infarctions,the relationship between the parts of the infarction volume,and analysis of acute insula cognitive disorder in elderly patients with cerebral RESULTS The number of patients with cognitive impairment in the basal ganglia and thalamus was significantly higher than that without cognitive impairment(P<0.05).The total infarct volume in the cognitive impairment group was higher than that in the non-cognitive impairment group,and the difference was statistically significant(P<0.05).The infarct volumes at different sites in the cognitive impairment group was higher than in the non-cognitive impairment group(P<0.05).In the cognitive impairment group,the infarct volumes in the basal ganglia,thalamus,and mixed lesions were negatively correlated with the total MoCA score,with correlation coefficients of-0.67,-0.73,and-0.77,respectively.CONCLUSION In elderly patients with acute insular infarction,infarction in the basal ganglia,thalamus,and mixed lesions were more likely to lead to cognitive dysfunction than in other areas,and patients with large infarct volumes were more likely to develop cognitive dysfunction.The infarct volume in the basal ganglia,thalamus,and mixed lesions was significantly negatively correlated with the MoCA score.

Relationship between plasma risperidone concentrations and clinical features in chronic schizophrenic patients in China

BACKGROUND Prior studies have noted great variability in the plasma levels of risperidone(RIS).Plasma concentrations of RIS and its active moiety are highly variable and depend on absorption,metabolism,and other predictors of metabolic dysregulation;however,these factors are poorly understood and the association between metabolic change and change in psychopathology is uncertain.AIM To ascertain the characteristics of chronic schizophrenic patients treated with RIS,and to assess their relationship with plasma RIS levels.METHODS This was a descriptive cross-sectional study of 50 patients with a diagnosis of schizophrenic psychosis treated with RIS in a psychiatric service.The plasma concentrations of RIS and its metabolite 9-hydroxyrisperidone were determined by high performance liquid chromatography.The patients’demographic and clinical characteristics,and psychopathologies were assessed,and the associations between clinical variables and plasma levels of RIS were explored.RESULTS Male patients received higher doses of RIS than female ones,but plasma concentrations of RIS and risperidone+9-hydroxyrisperidone(active moiety)were higher in female patients.Age and the mean scores of the general psychopathology subscale of the Positive and Negative Syndrome Scale(PANSS)were significantly positively correlated with plasma concentrations of risperidone+9-hydroxyrisperidone adjusted for weight and dose in all 50 subjects.In male subjects,we found a statistically significant positive correlation between the concentrations of risperidone+9-hydroxyrisperidone in plasma/(dose×kg)and age,mean PANSS negative subscale scores,mean PANSS general psychopathology subscale scores,and mean PANSS total scores.CONCLUSION Long-term use of RIS should be closely monitored in older patients and females to minimize the risk of high concentrations which could induce side effects.

Early warning prevention and control strategies to reduce perioperative venous thromboembolism in patients with gastrointestinal cancer

BACKGROUND Venous thromboembolism(VTE)is a major cause of unexpected and perioperative in-hospital deaths.It is characterized by high morbidity,high mortality,high misdiagnosis rate,and high missed diagnosis rates.VTE is a common postoperative complication in cancer patients.VTE is preventable,and early identification of risk factors leading to VTE and appropriate early preventive actions can reduce its occurrence and mortality.Presently,there is no uniform standard for the prevention and control of VTE in clinical practice,and hospitals in China lack mature and effective protocols for the assessment,prevention,and treatment of VTE.AIM To explore whether an early warning program could influence the occurrence of deep vein thrombosis(DVT)postoperatively.METHODS This is a comparative retrospective cohort study,which enrolled patients who underwent laparotomic or laparoscopic gastrointestinal tumor resection for gastrointestinal cancer between January 2016 and December 2019.Patients were divided into a control group and an early warning group depending on whether or not the early warning program was implemented.A venous thromboembolism prevention and control team was established.The outcomes included the occurrence of DVT,the correct rate of VTE assessment,the coagulation indicators,and the mastery of VTE knowledge by the nurses.RESULTS A total of 264 patients were included in this study,with 128 patients in the control group and 136 patients in the early warning group.The occurrence rate of DVT in the early warning group was 6.6%(9/136),compared with 14.1%(18/128)in the control group(P<0.05).The correct rates of VTE risk assessment by the nurses and standard implementation rate of VTE preventive measures were 86.8%vs 65.6%and 80.2%vs 57.8%in early warning and control groups,respectively(all P<0.001).The independent factors associated with postoperative DVT occurrence were age(OR=1.083,95%CI:1.070-3.265,P=0.032),Hyperlipidemia(OR=1.127,95%CI:1.139-2.564,P=0.042),preoperative high VTE risk(OR=2.131,95%CI:1.085-5.178,P=0.001),time of operation(OR=2.268,95%CI:2.005-5.546,P=0.026)and not adoption of early warning prevention(OR=3.747,95%CI:1.523-6.956,P=0.017).CONCLUSION The early warning strategy was independently associated with the decreasing occurrence of VTE,and it might be suitable for protection from VTE in patients undergoing gastrointestinal cancer surgery.

Lichong decoction inhibits micro-angiogenesis by reducing the expressions of hypoxia inducible factor-1αand vascular endothelial growth factor in hysteromyoma mouse model

OBJECTIVE:To investigate the efficacy of Lichong decoction(LD)from Traditional Chinese Medicine,on micro-angiogenesis in a mouse model of hysteromyoma.METHODS:A mouse model of hysteromyoma was developed by orthotopic intrauterine injection of primary human myoma cells isolated from patients from the Beijing Obstetrics and Gynecology Hospital into CB-17 Scid mice.Mice were administered high-dose LD,low-dose LD,mifepristone or water(control)daily by gavage for 4 weeks.Uterine diameter and coefficient(uterine weight/body weight)were measured.Uterine morphology was assessed by light microscopy(hematoxylin and eosin)and transmission electron microscopy.Serum levels of estradiol,progesterone,follicle-stimulating hormone and luteinizing hormone(LH)were measured by enzyme-linked immunosorbent assay.Uterine protein expression of hypoxia inducible factor(HIF)-1α,CD31 and proliferating cell nuclear antigen(PCNA)was detected by immunohistochemistry.VEGF and HIF-1αm RNAs were quantified by RT-PCR.RESULTS:High-dose LD,low-dose LD and mifepristone reduced uterine diameter and coefficient,and attenuated the morphologic abnormalities associated with hysteromyoma.High-dose LD,low-dose LD and mifepristone inhibited hysteromyoma-induced micro-angiogenesis,as evidenced by a decrease in the number of new microvessels co-immunostaining for CD31 and PCNA(P<0.01).High-dose LD and mifepristone lowered serum levels of estradiol,progesterone and LH(P<0.05).High-dose LD,low-dose LD and mifepristone down-regulated HIF-1αm RNA and protein expressions and VEGF m RNA expression(P<0.01).CONCLUSION:The inhibition of hysteromyoma by LD may involve reductions in HIF-1αand VEGF expression and suppression of micro-angiogenesis.

Lichong decoction reduces Matrix Metalloproteinases-2 expression but increases Tissue Inhibitors of Matrix Metalloproteinases-2 ex-pression in a rat model of uterine leiomyoma

OBJECTIVE:To study the effect of Lichong decoction(LD) on expression of matrix metalloproteinase-2(MMP-2) and metalloproteinase-2(TIMP-2) in a rat model of uterine leiomyoma(UL).METHODS:UL was induced in rats using exogenous estrogen and progesterone.LD was administered(p.o.) for 4 weeks,and mifepristone(RU-486)used as a control.To observe the effect of LD on the uterine coefficient and uterine transverse diameter,a radioimmunoassay method was used to detect serum levels of sex hormones.Light microscopic analyses of pathologic changes in the tissues of UL rats were evaluated.Expression of the proteins of matrix metalloproteinases(MMPs) and tissue inhibitors of metalloproteinases(TIMPs) in uterine tissues was assessed by immunohistochemical staining and western blotting.RESULTS:A UL model in rats was established successfully.LD reduced uterine weight,uterine coefficient,and uterine transverse diameter compared with untreated controls.LD reduced levels of estradiol,progesterone,follicle-stimulating hormone,and luteinizing hormone in our UL models.LD improved the pathologic condition of uterine muscle.Expression of MMP-2 protein decreased to varying extents in LD-treated groups,but TIMP-2 levels were enhanced.LD appears to reduce MMP-2 expression and increase TIMP-2 expression in UL tissue.CONCLUSION:These data suggest that the mechanism of action of LD on ULs may involve reduction of MMP-2 expression and increase in TIMP-2 expression in rats.