A Comparative Study of Risk Factors and Prognosis in Young and Elderly Patients with Acute ST-Segment Elevation Myocardial Infarction

Objective:To investigate the differences in risk factors and prognosis between young and elderly patients with acute ST-segment elevation myocardial infarction(STEMI)so as to provide a basis for the prevention of young patients with acute STEMI.Methods:Patients initially diagnosed with STEMI in the 920"Hospital of Joint Logistic Support Force of PLA from January 1,2018 to December 31,2022 were retrospectively enrolled in this study.A total of 235 STEMI patients aged≤45 years old and 532 STEMI patients aged≥65 years old were screened.The baseline characteristics,laboratory indicators,clinical characteristics,coronary angiography,SYNTAX score and major adverse cardiovascular events(MACE)during 1-year follow-up were analyzed and compared.Results:A total of 767 STEMI patients were enrolled,including 235 in the young group and 532 in the elderly group.Among the STEM patients in the young group,224 cases were male,and smoking and drinking were common.Compared with the elderly group,the young group had shorter hospital stays and more family history of ischemic heart disease(IHD).The level of low-density lipoprotein in the young group was higher than that in the old group,while the level of high-density lipoprotein in the young group was lower than that in the old group.The level of high uric acid and homocysteine in the young group was significantly higher than that in the old group.The main cause of STEMI in the young group was fatigue,and the most common symptom was angina pectoris.Coronary angiography showed that single vessel disease was more common in the young group than in the elderly group,and the lesion in the young group was the left anterior descending artery.The SYNTAX score was significantly lower in the young group than in the elderly group according to the anatomical characteristics of coronary artery disease.In the forest plot,diabetes mellitus and a family history of IHD showed a trend of major adverse cardiovascular events(MACE)in both groups.Conclusion:Males,smokers,alcohol drinkers and family history of ischemic heart disease are more common in young patients.Common risk factors include fatigue,hyperuricemia,hyperlipidemia and so on.In addition,age itself is an independent risk factor.Management of diabetes,hyperuricemia,and homocysteine levels is essential to reduce the incidence of cardiovascular events in young patients.By controlling these factors,the incidence of young patients with acute STEMI can be effectively prevented and the corresponding prevention and treatment basis can be provided.

Design Method for Optimizing the Interactive Interface of Live Broadcasting Platform for the Elderly Users

In the era of network live broadcasting for everyone,the development of live broadcasting platforms is also more intelligent and diversified.However,in the face of a large group of elderly users,the interface interaction design mode used is still mainly based on the interaction mode for young groups,and is not designed for elderly users.Therefore,a design method for optimizing the interaction interface of live broadcasting platform for elderly users was proposed in this study.Firstly,the case study method and Delphi expert survey method were used to determine the design needs of elderly users and the design mode was analysed.Secondly,the orthogonal design principle was used to design a test sample of the interactive interface of live broadcasting platform applicable for the elderly users,and then a user evaluation system was established to calculate the weights of the design elements using hierarchical analysis,and then the predictive relationship between the design mode of the interactive interface of live broadcasting platform and the elderly users was established by Quantitative Theory I.Finally,Genetic Algorithm was applied to generate the optimized design scheme.The results showed that the design method based on the Genetic Algorithm and the combination of Quantitative Theory can scientifically and effectively optimize the design of the interactive interface of the live broadcasting platform for the elderly users,and improve the experience of the elderly users.

Oxidative Stress During Antituberculous Therapy in Young and Elderly Patients

Using allantoin (ATN ) as a marker for reactive oxygen species (ROS), oxidative stress during antituberculous (anti-TB) therapy was compared in 10 young and 9 elderly patients.Before treatment, ATN plasma concentrations in patients were similar to that of volunteers. Administration of a combination of isoniazid (INH ), rifampicin (RIF) and pyrazinamid e (PZA) increased plasma ATN in both groups of patients. ATN concentrations (M± SE) at six hours were higher (P <0.05 ) in elderly than in young patients on day one,8.22 ± 1.50 vs 1.89 ± 0.98 μg/mL); day 30, (5.85 ± 0.82 vs 0.87 ± 0.57 μg/mL; and day 90, (4.84 ± 1.24 vs 0.52 ± 0.50μg/mL). Because total amount of ATN excreted was similar in both groups on the three occasions, more ATN was formed in elderly than young patients. In conclusion, there was more oxidative stress in elderly than young patients. It is thereby suggested that Anti-TB drugs induce formation of ROS and elderly patients are at a greater risk of toxicity probably because of poor antioxidant mechanisms

A Risk-Adjusted Retrospective Data Analysis between Younger and Elderly Patients with Acute Coronary Syndromes—Long-Term Prognosis

Purpose: To compare the demographic data and outcomes of younger versus elderly patients with acute coronary syndromes. Methods: This was a retrospective data bank analysis study with 966 patients (268 in the younger group (less than 55 years) and 698 in the elderly group (more than 55 years)). Data were obtained about clinical characteristics, angiography, and medication used at hospital and coronary definitive treatment. The primary endpoint was all cause of in-hospital death and combined events. Comparison between groups was made by Anova and Q-square. Multivariative analysis was determined by logistic regression and was considered significative when p < 0.05. Long-term mortality and combined events were studied using Kaplan- Meyer curves with median follow-up of 11.21 months. Results: The median age in the younger group was 48 years versus 69 years in the elderly group. In the younger group 26% was ST-myocardial infarction versus 18% in the elderly group. About 7% of younger patients were submitted to coronary bypass surgery and 42% to percutaneous coronary angioplasty versus 12% and 25% in elderly group, respectively. Significant difference was observed between the younger versus elderly groups in deaths (1.5% × 7.5%, p = 0.004), combined events (14.9% × 26.3%, p = 0.02) and killip III/IV (3.7% × 8.3%, p = 0.04). Long-term mortality was 3.7% × 10.2%, p = 0.01). Conclusions: In patients with acute coronary syndromes age was an important predictor factor of mortality and complications. Significative differences in outcomes were observed between the two groups in-hospital and long-term follow-up.

Hepatitis C treatment in the elderly:New possibilities and controversies towards interferon-free regimens

Due to the progressive aging of the hepatitis C virus(HCV) population which have acquired the infection during its maximum spread after the Second World War, the management of the elderly HCV-infected patient is emerging as a hot topic. Unfortunately, although it is recognized that the progression of HCV-related liver disease gets faster with aging, and that even extrahepatic manifestations of HCV infection are probably worse in the elderly, till now, treatment attempts in this population have been significantly limited by the wellknown contraindications and side effects of interferon(IFN). The arrival of several new anti-HCV drugs, and the possibility to combine them in safe and effective anti-viral regimens, is relighting the hope of a cure for many elderly patients who had been cut out of IFN-based treatments. However, although these new regimens will be certainly more manageable, it should be underscored that IFN-free doesn't mean free from any contraindication or side-effect. Moreover, one issue which promises to become central is that of the possible interactions between antiviral therapy and the multiple drugs frequently assumed by elderly patients because of comorbidities. In this review, we will revise the epidemiology pointing to HCV as an infection of the elderly, the evidences that HCV harms the health of the aged patient more than that of the young one, and the available experiences of HCV treatment in the elderly with the "old" IFN-based regimens and with the newer drugs. We will conclude that the availability of IFNfree regimens should prompt us to change our mind and consider a significantly larger number of possible candidates among elderly patients, who would take significant advantage from viral eradication. Rather than the anagraphic age, drug-drug interactions and, mainly in case of economic restrictions, an evaluation of life expectancy dependent on liver disease with respect to that dependent on comorbidities, are likely to be the key issues guiding treatment indication in the next future. The sooner we will change our mind with respect to an a priori obstacle for anti-HCV treatment in the elderly, the sooner we will begin to spare many aged HCV patients from avoidable liver-related complications.

Assessment of pathogenicity and functional characterization of APPL1 gene mutations in diabetic patients

BACKGROUND Adaptor protein,phosphotyrosine interacting with PH domain and leucine zipper 1(APPL1)plays a crucial role in regulating insulin signaling and glucose metabolism.Mutations in the APPL1 gene have been associated with the development of maturity-onset diabetes of the young type 14(MODY14).Currently,only two mutations[c.1655T>A(p.Leu552*)and c.281G>A p.(Asp94Asn)]have been identified in association with this disease.Given the limited understanding of MODY14,it is imperative to identify additional cases and carry out comprehensive research on MODY14 and APPL1 mutations.AIM To assess the pathogenicity of APPL1 gene mutations in diabetic patients and to characterize the functional role of the APPL1 domain.METHODS Patients exhibiting clinical signs and a medical history suggestive of MODY were screened for the study.Whole exome sequencing was performed on the patients as well as their family members.The pathogenicity of the identified APPL1 variants was predicted on the basis of bioinformatics analysis.In addition,the pathogenicity of the novel APPL1 variant was preliminarily evaluated through in vitro functional experiments.Finally,the impact of these variants on APPL1 protein expression and the insulin pathway were assessed,and the potential mechanism underlying the interaction between the APPL1 protein and the insulin receptor was further explored.RESULTS A total of five novel mutations were identified,including four missense mutations(Asp632Tyr,Arg633His,Arg532Gln,and Ile642Met)and one intronic mutation(1153-16A>T).Pathogenicity prediction analysis revealed that the Arg532Gln was pathogenic across all predictions.The Asp632Tyr and Arg633His variants also had pathogenicity based on MutationTaster.In addition,multiple alignment of amino acid sequences showed that the Arg532Gln,Asp632Tyr,and Arg633His variants were conserved across different species.Moreover,in in vitro functional experiments,both the c.1894G>T(at Asp632Tyr)and c.1595G>A(at Arg532Gln)mutations were found to downregulate the expression of APPL1 on both protein and mRNA levels,indicating their pathogenic nature.Therefore,based on the patient’s clinical and family history,combined with the results from bioinformatics analysis and functional experiment,the c.1894G>T(at Asp632Tyr)and c.1595G>A(at Arg532Gln)mutations were classified as pathogenic mutations.Importantly,all these mutations were located within the phosphotyrosinebinding domain of APPL1,which plays a critical role in the insulin sensitization effect.CONCLUSION This study provided new insights into the pathogenicity of APPL1 gene mutations in diabetes and revealed a potential target for the diagnosis and treatment of the disease.

Age and Gender-Related Differences in Physical Functions of the Elderly Following One-Year Regular Exercise Therapy

Reports on physical functions during maintenance period of the elderly with cardiac and other serious diseases are limited. This study aims to clarify age and gender-related differences in their physical functions. Participants included 167 elderly individuals (males, 78;mean age, 76.5 years;SD = 6.0 years;females, 89;mean age, 75.5 years;SD = 4.5 years) who participated in a 1-year regular exercise therapy twice a week. The following eight physical function tests were selected: grip strength, 10-m obstacle walking time, one-legged balance with eyes open, sit-ups, sitting trunk flexion, 6-min walk, stepping by sitting position, and a timed up & go (TUG). Two-way analysis of variance was used to examine mean differences by gender and age: young elderly group (aged 65 - 74 years) and old elderly group (aged ≥ 75 years). In the grip strength, sit-ups, 6-min walk, 10-m obstacle walking time, stepping by sitting position, and sitting trunk flexion tests, males were superior in the former four tests, and females were superior in the latter two tests. The young elderly group was superior in all tests except for sit-ups compared with the old elderly group. The balance during one-legged with eyes open test was superior in males compared with females in the young elderly group, but decreased in males in the old elderly group. In conclusion, physical functions of the elderly during maintenance period are different between genders. Muscle strength, muscle endurance, whole-body endurance, and walking ability are superior in males, whereas flexibility and agility are superior in females. The old elderly group was inferior in all the elements of physical function except muscle endurance.

Major bleeding events in octagenarians associated with drug interactions between dabigatran and P-gp inhibitors

Background The direct oral anticoagulant dabigatran does not require any routine therapeutic drug monitoring.Yet,concerns about possible drug interactions susceptible to increase its inherent bleeding risk,especially in very elderly patients,have been raised recently.The aim of our study was to evaluate to what extent the co-prescription of P-gp inhibitors with dabigatran may increase its plasma levels and lead to bleeding complications,in usual conditions of care of the very elderly.Methods Fifty-eight patients over 85 years old with non valvular atrial fibrillation receiving dabigatran were included in a prospective cohort.Prescriptions were screened for the presence of P-gp inhibitors(Group A)or not(Group B).Results Patients from Group A had increased dabigatran mean plasma concentrations as compared with patients from Group B(A vs.B:182.2±147.3 vs.93.7±64.9 ng/m L).One third of the patients from Group A had dabigatran concentrations that were deemed"out of range"versus none in Group B(P=0.05).This was associated with more frequent bleeding complications in Group A(A:30.4%,B:8.6%,P=0.04).Conclusion In our cohort of very elderly patients,at least,the co-prescription of dabigatran with P-gp inhibitors in usual conditions of care resulted in higher dabigatran plasma concentrations and more frequent bleeding occurrences.

Cell cycle and complement inhibitors may be specific for treatment of spinal cord injury in aged and young mice: transcriptomic analyses

Previous studies have reported age-specific pathological and functional outcomes in young and aged patients suffering spinal cord injury,but the mechanisms remain poorly understood. In this study, we examined mice with spinal cord injury. Gene expression profiles from the Gene Expression Omnibus database （accession number GSE93561） were used, including spinal cord samples from 3 young injured mice （2–3-months old, induced by Impactor at Th9 level） and 3 control mice （2–3-months old, no treatment）, as well as 2 aged injured mice （15–18-months old, induced by Impactor at Th9 level） and 2 control mice （15–18-months old, no treatment）. Differentially expressed genes （DEGs） in spinal cord tissue from injured and control mice were identified using the Linear Models for Microarray data method,with a threshold of adjusted P 〈 0.05 and ｜logFC（fold change）｜ 〉 1.5. Protein–protein interaction networks were constructed using data from the STRING database, followed by module analysis by Cytoscape software to screen crucial genes. Kyoto encyclopedia of genes and genomes pathway and Gene Ontology enrichment analyses were performed to investigate the underlying functions of DEGs using Database for Annotation, Visualization and Integrated Discovery. Consequently, 1,604 and 1,153 DEGs were identified between injured and normal control mice in spinal cord tissue of aged and young mice, respectively. Furthermore, a Venn diagram showed that 960 DEGs were shared among aged and young mice, while 644 and 193 DEGs were specific to aged and young mice, respectively. Functional enrichment indicates that shared DEGs are involved in osteoclast differentiation, extracellular matrix–receptor interaction, nuclear factor-kappa B signaling pathway, and focal adhesion. Unique genes for aged and young injured groups were involved in the cell cycle （upregulation of PLK1） and complement （upregulation of C3） activation, respectively. These findings were confirmed by functional analysis of genes in modules （common, 4; aged, 2; young, 1） screened from protein–protein interaction networks. Accordingly, cell cycle and complement inhibitors may be specific treatments for spinal cord injury in aged and young mice, respectively.

Update on pharmacological treatment of acute coronary syndrome without persistent ST segment elevation myocardial infarction in the elderly

The increase in cardiovascular disease prevalence with ageing has been attributed to several age-related changes such as changes in the vascular wall elasticity, the coagulation and haernostatic system and endothelial dysfunction, among other causes. There is a 50% increased mortality risk per 10-year increase in age starting at 65 years old. Here, we aimed to discuss pharmacological treatment in acute coronary syndrome （ACS） without persistent ST segment elevation myocardial infarction in the elderly. The main aim of ACS treatment in elderly people is at preventing ischemia, myocardial damage and complications. A meta-analysis suggests that invasive revascularization therapy is probably most useful in older patients. Dual antiplatelet therapy is currently the standard of care post-ACS. Platelet P2Y12 inhibitors are among the most commonly used medications worldwide, due to their established benefits in the treatment and prevention of arterial throm- bosis. The main recommendation is to tailor antithrombotic treatment, considering body weight, renal function （Class I, level C） and careful evaluation of life expectancy, comorbidities, risk/benefit profile, quality of life and fxailty when invasive strategies are considered （Class IIa, level A） on top of the different recommendations given for a general non ST elevation ACS population. It is obvious that potent P2Y12 in- hibitors will continue to play an important role in pharmacological treatment for elderly ACS patients in the future.

基于Mathematica的杨氏双缝干涉的仿真实验研究

以杨氏双缝干涉理论作为基础,利用Mathematica强大的交互式操作和色彩显示功能,通过编程对杨氏双缝干涉现象进行仿真,可以灵活地调节参数,动态地反映干涉条纹随参数的改变而发生变化的过程。本文模拟了改变缝宽、缝和接收屏之间的距离和波长参数及外加因素等,观察到双缝干涉条纹的相应变化,最后成功实现了非单色光双缝干涉图样。利用Mathematica软件仿真典型的光学实验,仿真图像能形象直观地展示光学现象可应用于辅助教学。

Comparison of Inspection Data by Difference in Odour Inspection Kit (Including Results of Young and Old Age)

The present study examined the relationship between olfactory function for ten years. A personal function test was calculated from the Nagoya Women’s University study database, and the odor stick identification test and open essence identification test were administered to healthy young and elderly people. The participants were community dwellers who voluntarily participated in the Nagoya Women’s University Study and had managed everyday life by themselves. We combined data of 2018 and checked two kinds of the olfactometry result. These data were made from a consultation result list which was handed to a testee by hand. The test age was in his/her 80s from 40s and in his/her 20s from 10s. The data were compared according to the generation (young age is 20.1 ± 0.7 years old and old age is 74.5 ± 10.0 years old). We conducted two kinds of olfaction tests. The Odour Stick Identification Test (OSIT-J) was used to assess odour perception. This test possesses high reliability and validity. The OSIT-J includes 12 different odorants to be identified. The Odour Essence Identification Test was used to assess odour perception, too. It also includes 12 different odorants to be identified. We compared the answer of generation and compared the results of the two olfactory tests. As a result, there were no statistically significant differences in the total number of correct answers in young people and old people in the two olfactory test results. In addition, we compare young people and old people who increased the number of correct answer in the two kinds of olfactory examination, the same person, and those who decreased, but there was no statistically significant difference. However, there were statistically significant differences between India ink and perfume and Household (domestic) gas compared with young people and old people with two kinds of olfactory test results. From the results of this study, it was found that the results of two kinds of olfactory test can be used together as a research result for the result of correct answer rate number. However, it became clear that careful handing is necessary for individual smell.

Medicinal Plants, Precautions for Their Use in the Elderly

Objective:To relate physiologic changes and presence of illnesses in older adults,with the risk of appearance of adverse reactions and pharmacological interactions as consequence of the use of medicinal plants.Methods:To carry out a search in the last 5 years and to present a general vision about what have been published related to the use of medicinal plants with risk of appearance of adverse reactions and interactions in older adults.Conclusions:Technological prevision based on the search of articles in the Virtual Library in Health(BVS)and using the words key“medicinal plants”,“older adult”,“pharmacokinetics”,“adverse reactions”,“elderly”,“pharmacological interactions”,and the association among them.

How Resilient Is the Family? An Empirical Study of Family Care for the Young and the Elderly

This study explores the strategies Chinese families employ to navigate substantial caregiving challenges in the context of demographic changes characterized by low birth rates and an aging populace, alongside a dearth of public and commercial caring resources. It delves into familial intergenerational cooperation, utilizing various resources such as connections, norms, and emotions to develop resilience that withstands external pressures. The research acknowledges the positive role of family resilience in safeguarding vulnerable members and maintaining social stability. However, it also highlights the fact that family resilience has its limits and does not have unlimited sustainability. Sustainable family resilience can be bolstered by redefining the distribution of duties and resources among the government, the community, and families for the care of the young and the elderly. This involves creating a multifaceted welfare system anchored by government backing that places families at its center and by improving the commercial provision of care services. This facilitates the positive self-generation and reproduction of caring resources within the familial framework.

Foods and Herbs That May Interact with Medications Used for Arterial Hypertension and Dyslipidemia

The aim of this review was to verify the risks of drug-nutrient interactions in the elderly. This is an integrative literature review, with a descriptive approach, carried out through research in indexed databases, legislation and pharmacopoeias. Data collection took place in the year 2022, through the analysis of literature collected of the last 10 years collected. The data showed that many of the continuous drugs use by the elderly can lead to interactions of different orders with nutrients, increasing the risk of plasmatic fluctuation as grapefruit, orange, lemon and lime interact with systemic arterial hypertension, increasing the risk of drug intoxication in the elderly. The action of the health team is essential, through the careful evaluation of the administered drugs, diet therapy and the interaction between them, to benefit the elderly with better use of the therapy and improvement of nutritional conditions.

我国青少年运动员接受反兴奋剂教育的影响因素研究

目的:探究当前影响我国青少年运动员接受反兴奋剂教育各种因素,为优化我国青少年运动员反兴奋剂教育提供理论参考依据。方法:基于自编的《青少年运动员反兴奋剂教育影响因素问卷》分析影响接受反兴奋剂教育各种因素,并探讨不同维度影响因素之间的相互关系。结果:研究发现,趣味娱乐需求对于运动项目及训练年限、教育形式对于年龄、教育形式和竞技发展需求对于运动等级都存在非常显著性差异;同时,各个维度的各项指标拟合度较好,教育内容、他人的行为态度、竞技发展需求分别为认知维度、人际维度、动力维度中权重占比最大的二级影响因子;将认知维度作为调节变量时模型拟合度最高。结论:优化我国青少年运动员反兴奋剂教育应当以教育内容和教育形式为主线,遵循青少年运动员的身心发展规律,同时扩大教育范围,以达到期望的反兴奋剂教育效果。

基于实体交互的老幼共娱产品设计研究

充分研究老年人和儿童这两类人群对老幼共娱产品的需求,利用实体交互理论指导老幼共娱产品设计研究,训练用户的认知能力,促进老幼两代之间的情感交流。本文以实体交互理论为指导,综合运用文献分析法、问卷调查法、用户访谈法、观察法等,对老幼互动行为、实体交互介入老幼共娱产品的设计策略进行了着重研究。结合实体交互理论,提出了以讲述中国传统故事为主题,积木为实体产品,平板电脑为移动终端的老幼共娱产品设计策略。为当代城市隔代教育家庭出现的现实问题提供全新的解决途径。

压水堆核电站完整和破损燃料棒硬度和杨氏模量研究

利用热室内金相显微镜、纳米压痕仪和拉曼光谱仪分别对燃耗为41 GW·d/tU破损棒和45 GW·d/tU完整棒的化学相互作用(FCCI)层、包壳及燃料芯块进行了表征分析。结果表明:完整棒燃料芯块外围硬度较小,其主要原因是芯块外缘出现了多孔隙的高燃耗结构(HBS);破损棒燃料芯块硬度则沿径向朝内整体呈下降趋势,这主要与燃料芯块孔隙率的变化和重构有关。燃料棒破损后,冷却水进入包壳芯块间隙与芯块发生反应,芯块外缘孔隙率显著降低,从而导致芯块外缘区域硬度较高;同时,气孔的迁移引起晶粒重构形成大尺寸柱状晶,造成破损棒燃料芯块中间和中心区域硬度下降且低于完整棒燃料芯块。燃料棒的破损不会改变芯块的相组成,因此完整棒与破损棒芯块的杨氏模量区别不大。完整棒FCCI层硬度沿包壳向芯块逐渐增加,杨氏模量则先减小后增加;破损棒FCCI层硬度先增加后减小,杨氏模量变化与硬度变化基本相似,该现象的出现可能源于FCCI层相结构的转变、辐照硬化和裂变产物掺杂的共同作用。燃料棒破损后包壳的氢化及氧化使得破损棒包壳硬度与杨氏模量均显著高于完整棒。

基于薄膜壳体理论的仿淋巴瓣膜结构设计

淋巴系统中的瓣膜结构是控制淋巴液单向流动的关键结构,进而影响肿瘤细胞的淋巴转移过程。基于薄膜壳体理论设计了仿淋巴瓣膜结构,通过COMSOL有限元仿真分析了瓣膜厚度、弹性对其变形的影响。配制了聚二甲基硅氧烷(PDMS)与Ecoflex00—30的混合材料,通过调整二者的体积比,使其杨氏模量与生物组织实际值更接近。采用软刻蚀技术制作了仿淋巴管微通道,测试了其单向截流性能。结果表明:在80 Pa压力下,仿淋巴瓣膜结构无明显漏液现象,单向截流性能良好。