Incidence and predictive value of social frailty among community-dwelling older adults in Southwest China: A prospective cohort study.

Background: Few studies have focused on the incidence and correlation of social frailty (SF) with adverse health events in Southwest China. This study aims to explore the predictive value of SF for adverse health events. Methods: A 6-year prospective cohort study was employed, a total of 460 community-dwelling older adults aged 65 years and above were analyzed to provide a baseline in 2014. Participants completed two longitudinal follow-ups at 3 (2017, 426 participants involved) and 6 (2020, 359 participants involved) years later. A modified social frailty screening index was used in this study, and adverse health events such as physical frailty (PF) deterioration, disability, hospitalization, falls, and mortality were evaluated. Results: Among these participants in 2014, the median age was 71 years, 41.1% were male, and 71.1% were married or cohabiting, up to 112 (24.3%) of them were classified as SF. It was observed that aging (OR = 1.04, 95% CI = 1.00-1.07, P = 0.047) and having family members die in the past year (OR = 2.60, 95% CI = 0.93-7.25, P = 0.068) were risk factors of SF, whereas having a mate (OR = 0.40, 95% CI = 0.25-0.66, P = 0.000) and having family members to help with care (OR = 0.53, 95% CI = 0.26-1.11, P = 0.092) were protective factors of SF. The cross-sectional study demonstrated that SF was only significantly associated with disability (OR = 12.89, 95% CI = 2.67-62.13, P = 0.001) at wave 1. Baseline SF significantly explained the incidence of mortality at the 3-year (medium-term, OR = 4.89, 95% CI = 2.23-10.71, P = 0.000) and 6-year follow-ups (long-term, OR = 2.22, 95% CI = 1.15-4.28, P = 0.017). Conclusion: SF prevalence was higher in the Chinese older population. Older adults with SF had a significantly increased incidence of mortality at the longitudinal follow-up. Consecutive comprehensive health management of SF (e.g., avoiding living alone and increasing social engagement) is urgently needed for the purposes of early prevention and multidimensional intervention in adverse health events, including disability and mortality.

RNA analysis of diet-induced sarcopenic obesity in rats.

Obesity has been suggested as a risk factor for sarcopenia. Sarcopenic obesity (SO), as a new category of obesity, is a high-risk geriatric syndrome in elderly individuals. However, knowledge about the molecular pathomechanisms of SO is still sparse. In the present study, starting at 13 months, male Sprague-Dawley (SD) rats were fed a high-fat diet (HFD) and normal diet (ND) for 28 weeks to establish a rodent animal model of SO with an identical protocol, which was further assessed and verified as a successful SO model. Through RNA-seq analysis of gastrocnemius muscle in SO rats, we found that differentially expressed genes (DEGs) and alternative splicing events (ASEs) focused mainly on inflammatory, immune-response, skeletal muscle cell differentiation, fat cell differentiation and antigen processing and presentation. Furthermore, as the core regulation factor of skeletal muscle, the mef2c (myocyte enhancer Factor 2C) gene also has a significant alternative 3' splice site (A3SS) and down-regulated expression in HFD-induced SO. The alternative genes targeted by mef2c identified by GO analysis were enriched in transcript regulation of RNA polymerase II promoter. In conclusion, these explorative findings in aging high-fat-fed rats might serve as a firm starting point for understanding the pathway and mechanism of sarcopenic obesity.

[Risk Factors Associated with Intraoperative Blood Loss in Patients with Early Cervical Cancer].

OBJECTIVE: To determine risk factors associated with intraoperative blood loss in patients with early cervical cancer (stage ⅠB-ⅡA). METHODS: The medical records of 892 patients who underwent surgical treatments for early cervical cancer in the Second West China University Hospital of from Dec 2010 to Sep 2017 were retrospectively reviewed: 127 having ≥500 mL intraoperative blood loss patients compared with 765 less than 500 mL. Differences between the two groups in age, body mass index (BMI), gravidity, history of abdominal and pelvic operations, chronic pelvic inflammation disease, clinical stage, methods of operation, neoadjuvant chemotherapy (NACT) and post-NACT operative opportunity, preoperative and postoperative hemoglobin, and intraoperative transfusion volume were analyzed through univariate and multivariate statistical methods. RESULTS: The univariate analyses identified age, BMI, gravidity, history of abdominal and pelvic operation, chronic pelvic inflammation disease, clinical stage, methods of operation, NACT and post-NACT operative opportunity assignificant factors associated with intraoperative blood loss ( P<0.05). The multivariate logistic regression analysis confirmed that age ≥40 yr. [partial regression coefficient (B)=2.100)], BMI ≥24 kg/m2 (relative to 18.5-23.9 kg/m2)(B=1.842) , clinical stage ⅡA (relative to phase ⅠB, B=2.401) , trans-abdominal operative method (relative to laparoscopy, B=1.347), no NACT (B=1.540) and post-NACT operative opportunity <2 or >3 weeks (relative to within 2-3 weeks) (B=1.723) were independent predictors of higher intraoperative blood loss (≥500 mL). CONCLUSION: Clinical stage and age, etc. are risk factors associated with intraoperative blood loss in patients with early cervical cancer.