Cardiovascular risk factors among older persons with cognitive frailty in middle income country

BACKGROUND Cognitive frailty,characterized by the coexistence of cognitive impairment and physical frailty,represents a multifaceted challenge in the aging population.The role of cardiovascular risk factors in this complex interplay is not yet fully understood.AIM To investigate the relationships between cardiovascular risk factors and older persons with cognitive frailty by pooling data from two cohorts of studies in Malaysia.METHODS A comprehensive approach was employed,with a total of 512 communitydwelling older persons aged 60 years and above,involving two cohorts of older persons from previous studies.Datasets related to cardiovascular risks,namely sociodemographic factors,and cardiovascular risk factors,including hypertension,diabetes,hypercholesterolemia,anthropometric characteristics and biochemical profiles,were pooled for analysis.Cognitive frailty was defined based on the Clinical Dementia Rating scale and Fried frailty score.Cardiovascular risk was determined using Framingham risk score.Statistical analyses were conducted using SPSS version 21.RESULTS Of the study participants,46.3%exhibited cognitive frailty.Cardiovascular risk factors including hypertension(OR:1.60;95%CI:1.12-2.30),low fat-free mass(OR:0.96;95%CI:0.94-0.98),high percentage body fat(OR:1.04;95%CI:1.02-1.06),high waist circumference(OR:1.02;95%CI:1.01-1.04),high fasting blood glucose(OR:1.64;95%CI:1.11-2.43),high Framingham risk score(OR:1.65;95%CI:1.17-2.31),together with sociodemographic factors,i.e.,being single(OR 3.38;95%CI:2.26-5.05)and low household income(OR 2.18;95%CI:1.44-3.30)were found to be associated with cognitive frailty.CONCLUSION Cardiovascular-risk specific risk factors and sociodemographic factors were associated with risk of cognitive frailty,a prodromal stage of dementia.Early identification and management of cardiovascular risk factors,particularly among specific group of the population might mitigate the risk of cognitive frailty,hence preventing dementia.

Clinical risk factors for preterm birth and evaluating maternal psychology in the postpartum period

BACKGROUND Although the specific pathogenesis of preterm birth(PTB)has not been thoroughly clarified,it is known to be related to various factors,such as pregnancy complications,maternal socioeconomic factors,lifestyle habits,reproductive history,environmental and psychological factors,prenatal care,and nutritional status.PTB has serious implications for newborns and families and is associated with high mortality and complications.Therefore,the prediction of PTB risk can facilitate early intervention and reduce its resultant adverse consequences.AIM To analyze the risk factors for PTB to establish a PTB risk prediction model and to assess postpartum anxiety and depression in mothers.METHODS A retrospective analysis of 648 consecutive parturients who delivered at Shenzhen Bao’an District Songgang People’s Hospital between January 2019 and January 2022 was performed.According to the diagnostic criteria for premature infants,the parturients were divided into a PTB group(n=60)and a full-term(FT)group(n=588).Puerperae were assessed by the Self-rating Anxiety Scale(SAS)and Self rating Depression Scale(SDS),based on which the mothers with anxiety and depression symptoms were screened for further analysis.The factors affecting PTB were analyzed by univariate analysis,and the related risk factors were identified by logistic regression.RESULTS According to univariate analysis,the PTB group was older than the FT group,with a smaller weight change and greater proportions of women who underwent artificial insemination and had gestational diabetes mellitus(P<0.05).In addition,greater proportions of women with reproductive tract infections and greater white blood cell(WBC)counts(P<0.05),shorter cervical lengths in the second trimester and lower neutrophil percentages(P<0.001)were detected in the PTB group than in the FT group.The PTB group exhibited higher postpartum SAS and SDS scores than did the FT group(P<0.0001),with a higher number of mothers experiencing anxiety and depression(P<0.001).Multivariate logistic regression analysis revealed that a greater maternal weight change,the presence of gestational diabetes mellitus,a shorter cervical length in the second trimester,a greater WBC count,and the presence of maternal anxiety and depression were risk factors for PTB(P<0.01).Moreover,the risk score of the FT group was lower than that of the PTB group,and the area under the curve of the risk score for predicting PTB was greater than 0.9.CONCLUSION This study highlights the complex interplay between postpartum anxiety and PTB,where maternal anxiety may be a potential risk factor for PTB,with PTB potentially increasing the incidence of postpartum anxiety in mothers.In addition,a greater maternal weight change,the presence of gestational diabetes mellitus,a shorter cervical length,a greater WBC count,and postpartum anxiety and depression were identified as risk factors for PTB.

Research on Information Architecture Design of Short-Form Video Social Platforms Based on Cognitive Psychology

This study investigates how cognitive psychology principles can be integrated into the information architecture design of short-form video platforms,like TikTok,to enhance user experience,engagement,and sharing.Using a questionnaire,it explores TikTok users’habits and preferences,highlighting how social media fatigue(SMF)impacts their interaction with the platform.The paper offers strategies to optimize TikTok’s design.It suggests refining the organizational system using principles like chunking,schema theory,and working memory capacity.Additionally,it proposes incorporating shopping features within TikTok’s interface to personalize product suggestions and enable monetization for influencers and content creators.Furthermore,the study underlines the need to consider gender differences and user preferences in improving TikTok’s sharing features,recommending streamlined and customizable sharing options,collaborative sharing,and a system to acknowledge sharing milestones.Aiming to strengthen social connections and increase sharing likelihood,this research provides insights into enhancing information architecture for short-form video platforms,contributing to their growth and success.

Psychological Influence Factors Analysis of the New Generation Employees’ Moral Choices from the Perspective of Cognitive Neurology

At present,the academic researches on moral choices focus mainly on the individuals’external behaviors,without fully considering the influences of the individuals’internal psychological factors.Based on the model of complete information static games in the Non-cooperative Game theory,the present research has designed a“Red and Blue Experiment”to explore the psychological influencing factors of the new generation employees’moral choices.The research has conducted psychoanalysis on the new generation employees through experiments and interviews with 118 data sources,and concluded the characteristics in relation to the different stages of psychological processes and moral choices of the experimental population.Through comparative analysis,it is found that:the psychological factors,such as trust,doubt,and guilt will influence the new generation employees’moral choices,guiding them to make choices,such as risk aversion and mutual benefit and win-win,in the process.Additionally,the research has also provided effective scientific evidence for the new generation employees’mental health development and career planning.

Effect of cognitive behavior therapy training and psychological nursing on the midwifery process in the delivery room

BACKGROUND The severe physical and psychological impact of pain on the physical and mental health of women during labor leads to increased risks and complications during childbirth,presenting a major public health concern.Some studies have shown that cognitive behavioral therapy(CBT)has a positive effect on maternal psychology during delivery,reducing stress and shortening labor time.Thus,CBT training for mothers and delivery room staff may be beneficial in minimizing complications and adverse effects during natural birth.AIM To investigate the clinical effects of CBT training and psychological care during delivery,and their therapeutic effects on women in labor.METHODS This study used a retrospective analysis and included 140 mothers admitted to the maternity ward between January 2021 and January 2023.The study subjects were randomized into two groups:control(n=70)and observation(n=70).Routine care,CBT training,and psychological care were provided to mothers in both groups.Psychological status scores,delivery time,and satisfaction with care pre-and post-delivery were compared,and the incidence of complications after receiving care was analyzed between the two groups.RESULTS Although the psychological state of both groups improved significantly in the late stages of labor,the psychological state scores of the mothers in the observation group were significantly lower than those of the mothers in the control group(P<0.05).The duration of labor and incidence of complications in the observation group were significantly lower than those in the control group(P<0.05).The mothers in the observation group were significantly more satisfied with nursing care during the course of labor than those in the control group(P<0.05).CONCLUSION CBT training and psychological care for mothers in the midwifery process can effectively improve anxiety and depression,shorten labor duration,reduce postnatal complications,and improve nursing satisfaction and nurse-patient relationships.Its clinical application is effective and has popularization value,providing a new way to protect maternal mental health.

Evaluation of Postoperative Psychological Distress and Its Driving Factors in Patients with Oral and Maxillofacial Malignant Tumors

Objective:To explore and analyze the evaluation and driving factors of postoperative psychological pain inpatients with oral and maxillofacial malignant tumors.Methods:Relevant data were collected from 80 patients with oral and maxillofacial malignant tumors who attended the outpatient clinic for follow-up consultations between May 2021 to May 2023.The patients used the psychological distress thermometer(DT)to circle words that best described their experiences in the past week,assigning a numerical value(0-10)to indicate their pain level on each day.The scoring results were employed to assess the psychological pain in these patients.A self-developed patient basic information questionnaire was utilized to record demographic details.Logistic regression analysis was employed to evaluate patients two weeks after surgery,focusing on the assessment of psychological distress and the identification and location of driving factors.Results:Following evaluation,the results revealed that the average postoperative DT score for the 80 patients with oral and maxillofacial malignant tumors was 4.53±1.98 points.Scores<4 points indicated no psychological pain(Group N)in 48 cases,while scores≥4 points indicated psychological pain(Group Y)in 32 cases.The differences in postoperative DT scores among patients with varying educational levels,fears and worries about disease progression,economic problems,sleep problems,level of hope,and oral pain were statistically significant(P<0.05).Multiple linear regression analysis results indicated that education level,fear and worry about disease progression,economic problems,sleep problems,level of hope,and oral pain are driving factors of postoperative psychological pain in patients with oral and maxillofacial malignant tumors(P<0.05).Conclusion:The postoperative psychological pain level in patients with oral and maxillofacial malignant tumors is at a moderate level.Educational level,fear and worry about disease progression,economic problems,sleep problems,level of hope,and oral pain were identified as driving factors for postoperative psychological pain in these patients.

Diagnostic delay in oral squamous cell carcinoma: the role of cognitive and psychological variables

This retrospective study investigated, in two cohorts of subjects living in Southern Italy and awaiting treatment for oral squamous cell carcinoma （OSCC）, the variables related to diagnostic delay ascribable to the patient, with particular reference to the cognitive and psychological ones. A total of 156 patients with OSCC （mean age： 62 years, M/F： 2.39 ： 1） were recruited at the Universities of Palermo and Naples. Risk factors related to patient delay included： sociodemographic, health-related, cognitive and psychological variables. The analysis was conducted by considering two different delay ranges： dichotomous （≤1 month vs. 〉 1 month） and polytomous （〈1 month, 1-3 months, 〉3 months） delay. Data were investigated by univariate and multivariate analyses and a Pvalue≤0.05 was considered statistically significant. For both delay measurements, the most relevant variables were： ＇Personal experience of cancer＇ （dichotomous delay： P=0.05, odds ratio （0R）=0.33, 95% confidence interval （CI）=0. 11-0.99; polytomous delay： P=0.006, Chi-square= 10.224） and ＇Unawareness＇ （dichotomous delay： P〈0.01, 0R=4.96, 95% CI--2.16-11.37; polytomous delay： P=0.087, Chi-square=4.77）. Also ＇Denial＇ （P〈0.01, 0R=6.84, 95% CI=2.31-20.24） and ＇Knowledge of cancer＇ （P=0.079, Chi-square=8.359） were found to be statistically significant both for dichotomous and for polytomous categorization of delay, respectively. The findings of this study indicated that, in the investigated cohorts, the knowledge about cancer issues is strongly linked to the patient delay. Educational interventions on the Mediterranean population are necessary in order to increase the patient awareness and to emphasize his/her key role in early diagnosis of OSCC.

Computerized cognitive remediation therapy on cognitive impairment and social function in patients with chronic schizophrenia

BACKGROUND Patients with schizophrenia may have various disease manifestations,most of which gradually tend toward incurable chronic decline,leading to mental disability.The basic symptoms of the disease can impair social function,whereas long-term hospitalization produces hospitalization syndrome,causing serious damage to social function.AIM To investigate the effects of Computerized Cognitive Remediation Therapy(CCRT)on cognitive and social functioning in patients with chronic schizophrenia.METHODS A retrospective analysis of 120 patients with chronic schizophrenia in Shanghai Pudong New Area Mental Health Center was performed.They were divided into an intervention group(60 cases treated with CCRT combined with conventional medication)and a control group(60 cases treated with conventional medication).After treatment,effects on cognitive function and social roles were observed in both groups.The Positive and Negative Syndrome Scale(PANSS)was used to assess the patients'psychiatric symptoms.The Wisconsin Card Sorting Test(WCST)was used to assess the patients'cognitive functioning,and the Social Functioning Scale for Psychiatric Inpatients(SSPI)was used to assess the social functioning of the inpatient psychiatric patients.RESULTS No significant differences were observed in the PANSS,WCST,and SSPI intergroup scores before treatment(P>0.05).After 2,4,and 6 wk of therapy,general psychopathological factors,positive symptoms,negative symptoms,and total PANSS scores of PANSS in the intervention group were lower than in the control group(P<0.05).After 2,4,and 6 wk of treatment,the number of false responses,number of persistent bugs,and total responses in the WCST were significantly lower in the intervention group than in the control group(P<0.05),and the amount of completed classification was significantly higher than in the control group(P<0.05).After 2,4,and 6 wk of therapy,the SSPI scores were significantly greater than those of the controls(P<0.05).After 6 wk of treatment,the efficacy rates of the control and intervention groups were 81.67%and 91.67%,respectively.The curative effect in the intervention group was significantly higher than that in the control group(P<0.05).CONCLUSION CCRT can significantly improve cognitive function and social abilities in patients with chronic schizophrenia.

Brain-derived neurotrophic factor, sex hormones and cognitive decline in male patients with schizophrenia receiving continuous antipsychotic therapy

BACKGROUND There are systematic differences in clinical features between women and men with schizophrenia(SCZ).The regulation of sex hormones may play a potential role in abnormal neurodevelopment in SCZ.Brain-derived neurotrophic factor(BDNF)and sex hormones have complex interacting actions that contribute to the etiology of SCZ.AIM To investigate the influence of BDNF and sex hormones on cognition and clinical symptomatology in chronic antipsychotic-treated male SCZ patients.METHODS The serum levels of follicle-stimulating hormone,luteinizing hormone(LH),estradiol(E2),progesterone,testosterone(T),prolactin(PRL)and BDNF were compared between chronic antipsychotic-treated male(CATM)patients with SCZ(n=120)and healthy controls(n=120).The Positive and Negative Syndrome Scale was used to quantify SCZ symptoms,while neuropsychological tests were used to assess cognition.Neuropsychological tests,such as the Digit Cancellation Test(DCT),Semantic Verbal Fluency(SVF),Spatial Span Test(SS),Paced Auditory Serial Addition Test(PASAT),Trail Making Task(TMT-A),and Block Design Test(BDT),were used to assess executive functions(BDT),attention(DCT,TMT-A),memory(SS,PASAT),and verbal proficiency(SVF).RESULTS Although E2 levels were significantly lower in the patient group compared to the healthy controls,T,PRL,and LH levels were all significantly higher.Additionally,the analysis revealed that across the entire sample,there were positive correlations between E2 Levels and BDNF levels as well as BDNF levels and the digital cancellation time.In CATM patients with SCZ,a significant correlation between the negative symptoms score and PRL levels was observed.CONCLUSION Sex hormones and BDNF levels may also be linked to cognitive function in patients with chronic SCZ.

Meta-Analysis of Risk Factors of Vascular Cognitive Disorder in Acute Cerebral Infarction Patients

Objectives: To identify the main risk factors of vascular cognitive impairment in patients with acute cerebral infarction by Meta-analysis, and provide references for the effective prevention of the cognitive impairment in stroke patients. Methods: To retrieve the observational research literatures that refer to the risk factors of vascular cognitive impairment in patients with ischemic stroke, which are published on China National Knowledge Infrastructure (CNKI), Wanfang and Weipu Chinese databases. The screening and data extraction of these literatures are independently completed by two researchers, who also give the quality evaluation of the literatures according to the evaluation criterion of the Australian JBI Evidence-Based Health Care Center. Then, Meta-analysis is conducted by using Revman5.3 software. Results: There are twenty-eight articles selected from 1507 literatures, with a total of 10,711 cases and 50 risk factors included. Among them, there are combined effects of ten factors which have statistical significance, such as infarction area, alcohol consumption, smoking, hyper homocysteinemia, hypertension, diabetes mellitus, age, history of cerebral infarction, hyperlipoidemia and education level. The relational merging OR value and 95% CI between the type-variable factors and cognitive impairment are 3.25 (1.84, 5.76);2.98 (2.58, 3.45);2.79 (1.69, 4.59);2.35 (1.93, 2.85);2.25 (1.86, 2.71);2.14 (2.10, 2.18);1.82 (1.62, 2.03);1.54 (1.24, 1.92);1.45 (1.34, 1.56);0.83 (0.78, 0.89). Conclusion: Infarction area, alcohol consumption, smoking, hyper homocysteinemia, hypertension, diabetesmellitus, age, history of cerebral infarction, hyperlipoidemia and low education level are the main risk factors for vascular cognitive impairment in patients with acute cerebral infarction. Clinical nursing staff should include it into the routine assessment of patients with acute cerebral infarction and actively prevent and intervene.

Exploring Personal Factors That Might Influence the Vulnerability of Construction Employees to Occupational Psychological Disorders

Personal factors could act as intervening variables between the causes and effects of psychological health conditions of employees. This study focused on six personal intervening factors that were associated with the risks of occupational psychological disorders namely: low self-esteem, negative personality trait, unproductive core beliefs, poor self-concept evaluation on performance, poor relationship with others and poor time management skills. An investigation on the level of severity of these personal intervening factors was conducted involving 150 construction professionals and 150 construction trade workers, who were purposively selected in Ghana. The personal factors that were found to be prevalent among the construction employees were low self-esteem and poor time management skills. Correlation analysis and regression analysis were used to determine the relationships between the personal intervening factors and demographic factors such as the age, educational levels and marital status of the research participants. The results of the study indicated that the age and marital status of the respondents had no significant relationship with any of the personal intervening factors. Personal factors such as personality trait and relationship with others also had no relation with any of the demographic factors analyzed. The educational level of the respondents, however, had a significant relationship with the factors of self-esteem, productive core beliefs, self-evaluation on performance and time management skills. An independent two-sample T-test was used to compare the means of the factors with significant relations. This study revealed that construction employees who were highly educated had better self-esteem and time management skills than those who were less educated. The findings from this study broaden the view of moderators on influential sources of psychological health conditions of employees.

Evaluation of factors affecting psychological morbidity in emergency medicine practitioners

BACKGROUND: Assessing and evaluating mental health status can provide educational planners valuable information to predict the quality of physicians' performance at work. These data can help physicians to practice in the most desired way. The study aimed to evaluate factors affecting psychological morbidity in Iranian emergency medicine practitioners at educational hospitals of Tehran.METHODS: In this cross sectional study 204 participants(emergency medicine residents and specialists) from educational hospitals of Tehran were recruited and their psychological morbidity was assessed by using a 28-question Goldberg General Health Questionnaire(GHQ-28). Somatization, anxiety and sleep disorders, social dysfunction and depression were evaluated among practitioners and compared to demographic and job related variables.RESULTS: Two hundreds and four participants consisting of 146(71.6%) males and 58(28.4%) females were evaluated. Of all participants, 55(27%) were single and 149(73%) were married. Most of our participants(40.2%) were between 30–35 years old. By using GHQ-28, 129(63.2%) were recognized as normal and 75(36.8%) suffered some mental health disorders. There was a signifi cant gender difference between normal practitioners and practitioners with disorder(P=0.02) while marital status had no significant difference(P=0.2). Only 19(9.3%) declared having some major mental health issue in the previous month.CONCLUSION: Females encountered more mental health disorders than male(P=0.02) and the most common disorder observed was somatization(P=0.006).

Physical, Psychological, and Social Health Impact of Temperature Rise Due to Urban Heat Island Phenomenon and Its Associated Factors

The Urban Heat Island Effect（UHI）has now become a commonly observed phenomenon worldwide.Indeed,it has become a significant environmental effect of urbanisation.In Malaysia,research results showed that UHI effects are very evident in several cities such as Kuala Lumpur and Putrajaya.UHI effect has long been observed to cause temperature of cities.

Atherosclerosis,its risk factors,and cognitive impairment in older adults

Objective To examine the association of atherosclerotic cardiovascular disease(ASCVD)and its risk factors with cognitive impairment in older adults.Methods Six hundred and fourteen subjects,aged≥65 years,from one center(2016–2018)underwent clinical,laboratory assessments and the Montreal Cognitive Assessment(Mo CA).Using regression analysis,the relationship between ASCVD and its risk factors was evaluated in subjects with and without cognitive impairment(MoCA score<26).Results Older age(b=-1.3 per 5 years,95%CI:-1.7 to-0.9,P<0.001),history of stroke(b=-1.6,95%CI:-3.0 to-0.3,P=0.01),and myocardial infarction(MI;b=-2.2,95%CI:-3.6 to-0.8,P=0.003)were independently associated with lower MoCA scores,whereas more education(b=1.5 per 3 years,95%CI:1.1 to 1.9,P<0.001),higher body mass index(BMI;b=0.5 per 3 kg/m^2,95%CI:0.0 to 1.0,P=0.04),higher estimated glomerular filtration rate(eGFR;b=0.8 per 15 U,95%CI:0.1 to 1.4,P=0.03),left ventricular ejection fraction(LVEF;b=0.4 per 5%,95%CI:0 to 0.8,P=0.04)and statin use(b=1.3,95%CI:0.3 to 2.3,P=0.01)were associated with a higher MoCA score.Cognitive impairment was independently associated with older age(OR=1.51 per 5 yrs,95%CI:1.28 to 1.79,P<0.001),less education(OR=0.55 per 3 years,95%CI:0.45 to 0.68,P<0.001),lower BMI(OR=0.78 per 3 kg/m^2,95%CI:0.62 to 0.98,P=0.03)and higher levels of high sensitivity c-reactive protein(hsCRP;OR=1.08 per 1 mg/L,95%CI:1.02 to 1.15,P=0.01).Conclusions Beyond age,cognitive impairment was associated with prior MI/stroke,higher hsCRP,statin use,less education,lower eGFR,BMI and LVEF.

A Study on the Psychological Status of the Caregivers to Patients Out of ICU after Craniocerebral Tumor Surgery and Their Factors

Objective: So as to provide a theoretical basis for the future development of intervention measures to reduce the negative psychological mood of caregivers. To investigate the psychological status of the main caregivers for patients who were transferred out of ICU after craniocerebral tumor surgery and analyze their factors. Methods: 112 patients with cerebral tumor surgery were reviewed from sun yat-sen university cancer hospital. The research object is caregivers. The general data questionnaire, hospital anxiety depression scale and migration of ICU patients’ family members stress questionnaire scale investigation are collected. Multiple linear regression analysis in cerebral tumor patients with postoperative ICU transition out main factors influencing the psychological condition of the caregivers. Results: The anxiety and depression scores were (15.60 ± 5.83) and (38.73 ± 3.23) respectively. The results of multiple regression analysis showed that the gender, education level, relationship with the patient and family monthly income of the primary caregivers of the patients were the influencing factors of anxiety, depression and migration stress psychological state (P < 0.05). Conclusion: The main caregivers of patients who were transferred out of ICU after craniocerebral tumor surgery had relatively severe anxiety, depression and migration stress. Medical staff should pay attention to the psychological status of caregivers and take effective measures to promote their physical and mental health.

The psychological status investigation on the nursing staff in a 3A‑level hospital during the prevalence of COVID‑19 and the analysis of its influencing factors

Objective:The objective of the study is to investigate the psychological status of nursing staff both working on nonfront line and on the front line during the epidemic period of COVID‑19 and to analyze the influencing factors related to mental health state,as well as to provide targeted psychological intervening measures for nursing staff in the face of this major public health event.Methods:We used data from January 28,2019,to February 08,2020,on the number of cases who worked in the 3A‑level hospital as nonfront‑line nurses(n=29,54%)and those who worked in Wuhan infectious hospital as the front‑line supporters(n=25,46%)came from the 3A‑level hospital.The participants completed the symptom checklist 90,and the researchers recorded data on demographics,psychological status,and the influencing factors.Results:In our baseline scenario,we estimated that the total symptom index was 1.676±0.654 for nurses who worked on the front line,1.260±0.304 for those who worked as the front‑line reserve nurses,and was 1.486±0.647 for those who worked as the nonfront‑line nurses.The results of correlation analysis show that the factors related to the psychological status of nurses include age,professional title,marital status,and family support;different factors have different effects on psychological status.Conclusion:In the face of major public health emergencies,both front‑line nursing staff and nonfront‑line staff are confronted with different degrees of psychological stress,so effective psychological support should be given to improve the working efficiency and enthusiasm of nurses.

Analysis of Risk Factors Associated with Cognitive Dysfunction in Patients with Atrial Fibrillation

Objective: To discuss the risk factors of cognitive dysfunction in patients with atrial fibrillation. Methods: The 150 cases of patients with atrial fibrillation were analyzed in the first affiliated hospital of Nanchang University who were treated in the cardiovascular department, general medicine department and gerontology department from August 2018 to June 2019. We used Mini-Mental State Examination (MMSE) score to evaluate cognitive function of patients with atrial fibrillation. According to the level of education and MMSE score, patients with atrial fibrillation were divided into three groups: normal cognitive function group, mild cognitive impairment group (MCI) and dementia group. And then the demographic data, the previous use of taking drugs, the results of ultrasonic cardiogram (UCG) and laboratory test were analyzed. Results: 1) The basic situation of research object: a total of 150 patients with atrial fibrillation were enrolled in the study, and the average age of these patients was 65.05 ± 8.74 years old, which included 78 males (52%) and 72 females (48%). The mean MMSE score was 23.42 ± 4.65. According to MMSE score, 86 cases (57.3%) of cognitive dysfunction occurred in 150 patients with atrial fibrillation, which included 41 cases (27.3%) of mild cognitive impairment and 45 cases (30%) of dementia. 2) The comparison of general clinical data: there were significant differences in age, smoking, level of education, left ventricular ejection fraction, left atrial diameter, D-dimer, fibrinogen, homocysteine, platelet and previous use of taking warfarin, dabigatran, CCB, statins among the three groups (P < 0.05). 3) The linear correlational analysis between risk factors of cognitive function and MMSE score in patients with atrial fibrillation: there was a positive correlation between left ventricular ejection fraction and MMSE score, but age, left atrial diameter, homocysteine, low density lipoprotein, platelet, BMI, NT-proBNP, D-dimer were negatively correlated with MMSE score. 4) The risk factors with statistical significance in ANOVA were analyzed by ordinal and multinomial logistic regression, which showed that age (OR = 1.174, 95% CI: 0.091 - 0.231), the level of education (illiteracy OR = 4.162, 95% CI: -0.032 - 2.955, primary school OR = 2.751, 95% CI: -0.172 - 2.197, junior high school OR = 3.539, 95% CI: -0.048 - 2.577, senior high school and special secondary school OR = 1.332, 95% CI: -1.080 - 1.655), no CCB (OR = 1.174, 95% CI: 0.091 - 0.231), no warfarin (OR = 13.749, 95% CI: 1.480 - 3.762), no dabigatran (OR = 16.395, 95% CI: 1.462 - 4.131), D-dimer (OR = 2.745, 95% CI: -0.611 - 2.631), fibrinogen (OR = 3.228, 95% CI: 0.399 - 1.946) were related to the high occurrence of cognitive dysfunction. Conclusions: 1) Patients with atrial fibrillation had a higher risk of cognitive dysfunction (the incidence of 57.4%). 2) There was a positive correlation between left ventricular ejection fraction and MMSE score, but age, left atrial diameter, homocysteine, low density lipoprotein, platelet, BMI, NT-proBNP, and D-dimer were negatively correlated with MMSE score. 3) High level of education, previous use of taking warfarin and dabigatran etexilate were protective factors for cognitive function in patients with atrial fibrillation;but age, previous use of taking CCB, D-dimer and fibrinogen were the risk factors in patients with atrial fibrillation.

Correlation between psychological factors and the expression of galanin and 5‑hydroxytryptamine in different subtypes of gastroesophageal reflux disease

Objective:The aim of this study is to analyze the differences in galanin(GAL)and 5‑hydroxytryptamine(5‑HT)levels in patients with different subtypes of gastroesophageal reflux disease(GERD)and its correlation with anxiety and depression in patients.Methods:Using the reflux disease questionnaire,238 patients with GERD were selected as the study group.According to the endoscopic performance,they were divided into the nonerosive reflux disease(NERD)group(114 patients)and the RE group(124 patients).Sixty healthy people were selected as the control group.All research subjects were tested using the self‑rating anxiety scale(SAS)and the self‑rating depression scale(SDS)to assess the severity of anxiety and depression.The levels of 5‑HT and GAL were analyzed using enzyme‑linked immunosorbent assay.Results:Compared with the control group,5‑HT level in GERD patients without anxiety and depression was higher(t=1.97,P<0.05)and GAL level was lower(t=1.97,P<0.05).NERD patients demonstrated more server anxiety(F=55.92,P<0.05)and depression problems(F=36.51,P<0.05)compared to reflux esophagitis(RE)patients.The 5‑HT level was lower(F=54.53,P<0.05)and the GAL level was higher(F=8.00,P<0.05)in NERD patients compared with the control group.Furthermore,5‑HT level was negatively correlated with SAS(r=−0.789,P<0.05)and SDS(r=−0.787,P<0.05)scores;GAL level was positively correlated with SAS(r=0.688,P<0.05)and SDS(r=0.705,P<0.05)scores;5‑HT and GAL level were negatively correlated(r=−0.744,P<0.05).Conclusions:5‑HT level is higher and GAL level was lower in GERD patients without anxiety and depression than healthy people;the symptoms of anxiety and depression of NERD patients are more severe compared to those of RE patients;the severity of anxiety and depression was negatively correlated with the level of 5‑HT and positively with GAL level.

Effects of Total Intravenous Anesthesia and Static Aspiration Combined General Anesthesia on Postoperative Cognitive Function and Psychological State of Elderly Patients with Esophageal Cancer

Objective: To compare the effects of total intravenous anesthesia and static aspiration combined general anesthesia on postoperative cognitive function and psychological state of elderly esophageal cancer patients. Methods: From July 2020 to April 2021, 180 elderly patients who underwent radical esophageal cancer surgery in our hospital were randomly divided into 90 cases in the control group and 90 in the observation group. The control group used static aspiration compound general anesthesia, and the patients in the observation group used intravenous anesthesia to compare the cognitive function and psychological state of the two groups of patients. Results: There was no statistical difference in the cognitive function score of patients in the observation group 30 minutes before anesthesia, 1 h and 24 hours after anesthesia compared with that in the control group, P > 0.05;there was no statistical difference between the Hamilton Anxiety Scale (HAMA) scores 30 minutes before and 24 hours after anesthesia in the observation group compared with the control group, P > 0.05;the cognitive function score of patients in the observation group of 4 h after surgery and 12 h after operation was significantly higher than that of the control group;the HAMA scores of patients in the observation group of 1 h, 4 h and 12 h after surgery were significantly lower than that of the control group, P Conclusion: The application of total intravenous anesthesia in elderly patients with esophageal cancer surgery can reduce the impact of anesthesia on their cognitive function and psychological state, which is worth popularizing and applying in clinical practice.

Effects of Electroacupuncture Combined with General Anesthesia on Postoperative Neurocognitive Dysfunction and Inflammatory Factors in Elderly Patients: a Meta-analysis

Objective:To systematically review the effects of electroacupuncture on neurocognitive dysfunction and inflammatory factors in elderly patients after general anesthesia.Methods:Computer retrieval of EMBASE,The Cochrane Library,PubMed,Web of Science,CBM,CNKI,Wanfang Data,and VIP databases.The time limit was until April 17,2021.The literature on the effect of electroacupuncture on postoperative neurocognitive dysfunction in elderly patients was searched.Two researchers separately strictly screened and evaluated the included literature,and then analyzed them using RevMan 5.3 software.Results:Electroacupuncture improved the MMSE score on the first[SMD=2.08,95%CI(1.14,3.02),P<0.0001]and third days[SMD=0.87,95%CI(0.15,1.59),P=0.02]after surgery;the incidence of PNCD on the first[OR=0.37,95%CI(0.26,0.54),P<0.00001]and third days[OR=0.37,95%CI(0.25,0.56),P<0.00001]after surgery were reduced;IL-6 expression at the end of the operation[SMD=-0.96,95%CI(-1.88,-0.04),P=0.04]was reduced;accelerated the recovery time from anesthesia[SMD=-1.15,95%CI(-1.43,-0.87),P<0.00001];the incidence of postoperative nausea and vomiting[OR=0.39,95%CI(0.20,0.78),P=0.007]was reduced.Compared with the control group,the expression of IL-6 on the first[SMD=-0.24,95%CI(-0.83,0.36),P=0.43]and second days[SMD=-0.35,95%CI(-0.93,0.23),P=0.24]after operation,and the expression of TNF-αat the end of operation[SMD=-0.65,95%CI(-1.33,0.03),P=0.06]and the first day[SMD=-0.51,95%CI(-1.02,-0.01),P=0.05]after operation had no statistically significant difference.Conclusion:Electroacupuncture can effectively reduce the incidence of postoperative neurocognitive dysfunction and postoperative nausea and vomiting in elderly patients,and accelerate the recovery time from anesthesia.The difference in the frequency and duration of electroacupuncture may potentially affect clinical efficacy.