Objective To analysis and conclude the problem of preventing post-operational acute pulmonary embolism. Methods Data from 29 cases of post-operational acute pulmonary embolism,including primary disease ,high risk factors ,process of operation, the coming on of post-operational acute pulmonary embolism,and the problem of prevention . Results There is inadequate attention on the prevention of post-operational acute pulmonary embolism.Conclusions Failing of bring the prevention measures into effect is the reason of the high incidence rate and mortality rate of post-operational acute pulmonary embolism.

Objective To investigate the change of renal tubular function in elderly patients after use of β lactam antibiotic. Methods The elderly patients with pulmonary infection were treated with β lactam antibiotic,the dosage was 50%-70% of normal use. The renal tubular function indicated by urine α1-MG, β2-MG, pro/Cre, NAG/Cre and glomerulus function marked by eGFR, serum creatinine (Cre)), cystatin C were detected during drugs treatment and 7 days after stopping medications. Results The infection was controlled well in 3-7 days after treatment. Urine α1-MG, β2-MG, pro/Cre and NAG/Cre were abnormal before treatment, were elevated in 3, 14 days after using antibiotic, and came down to the level before treatment on 7 days after stopping treatment. The level of Cre and eGFR was (89.0±25.97) μmol/L and (26.39±8.17) ml/min before treatment, then elevated and decreased in 14 days after treatment, respectively, and down to the level before treatment on 7 days after stopping of antibiotic. Cystatin c was abnormal before treatment and did not change significantly after treatment and after stopping antibiotic. Conclusions It is important to protect renal tubular function and to adjust antibiotic dosage according to eGFR during using antibiotic in elderly patients to control infection.

Objective To investigate the clinical characteristics and laboratory examinations in incident dialysis effect on the prognosis of elderly patients undergoing hemodialysis.Methods Ninety-three patients aged 65 years or older initiating hemodialysis were enrolled from Hemadialysis Center of Beijing Hospital from January lst,2007 to June 30th,2016.The duration time of HD of all patients was more than three months.Patients were divided into death group and non-death group.The clinical characteristics and laboratory examinations were compared between the two groups.Cox proportional hazards regression was used for the multivariate analysis to determine independent prognosis factors.Results The average year of patients was 74.2±6.5 years old with 43 months of median time of follow-up.The first two causes of death were infection (n =25,49.0％) and cardiovascular and cerebrovascular diseases (n =16,31.4％).Cox single factor regression analysis showed that the older ages,diabetic nephropathy being the cause of end-stage renal disease (ESRD),complicating with diabetes mellitus or congestive heart failure,the higher Charlson cardiovascular diseases score,ALB being under 35 g/L were correlated with poor outcome respectively(P＜0.05).Cox multivariate regression analysis indicated that older ages (HR =1.056,P =0.021),diabetic nephropathy being the cause of ESRD (HR =2.661,P =0.001),the higher Charlson cardiovascular diseases score (HR =1.675,P =0.010),central venous catheters being vascular access(HR=1.167,P=0.048) on incident dialysis were the main risk factors for mortality in elderly patients.Conclusion The older ages,diabetic nephropathy being the cause of ESRD,the higher Charlson cardiovascular diseases score,central venous catheters being vascular access on incident dialysis are independent risk factors influencing survival of elderly patients.

Objective To explore the clinical and histopathological characteristics and the diagnostic status of seborrheic keratosis (SK) Methods The clinical and pathological data of 286 cases were analyzed retrospectively.Results Among the 286 patients,the elderly patients accounted for the majority and more males were diagnosed with SK than females.The lesions were found among 46.2％ of patients in the exposure sites,such as face and neck.The most frequent types were hyperkeratosis and acanthosis.The clinical diagnosis consisted with pathologic diagnosis in 152 cases.The clinical misdiagnosis rate was 36.7％.Conclusion SK is related to gender,age,and sunlight.Histopathological examination is important in the diagnosis and differential diagnosis of SK.

Objective To study 18F-deoxyglucose-positron emission tomography and CT fusion (FDG PET) in three dimensional conformal radiotherapy for non-small -c ell lung carcinoma (NSCLC). Methods Gross tumor volume (GTV) of 13 NSCLC patient s were determined by FDG PET and CT separately (GTV PET-CT and GTV CT ), which were then compared. Results Except 2 patients, all the other patients' GTV PET-CT dif fered from their GTV CT. Compared with GTV CT, GTV PET-CT was in creased by an avera ge of 29.2?cm3 in 5 patients and decreased by an average of 41.6?cm3 in 6 patien ts. Conclusions 18F-deoxyglucose-positron emission tomography, which can improve target definition between benign and malignant lesions in the lung, is proved t o be more sensitive and specific in detecting mediastinal lymph node involvement . FDG PET may provide accurate target definition and improve the local control.

Objective To evaluate the effect and complication of inductio n chemot herapy combined with three-dimensional conformal radiation therapy (3DCRT) for l ocally advanced non small cell lung cancer (NSCLC). Methods Ninety-two such pa t ients were randomized into radiation therapy alone group(RT-, 50 patients) and i nduction chemotherapy combined radiotherapy group (CMT-, 42 patients). The indu c tion chemotherapy consisted of 2-4 cycles of platinum-based regimen. Results Th e overall median survival time was 15 months with 12 months in the RT group and 18 months in the CMT group(P=0.014)respectively. The 1-year o verall survival rates were 48.6% and 71.2% in RT and CMT group,respectively (P=0.004). The 2-year survival rates w ere 20.8% and 37.6% in RT and CMT group, respectively (P=0.0 41). Treatment was w ell tolerated and the toxicities were similar in either group. C onclusion The ad dition of induction chemotherapy to 3DCRT takes a survival advantage over 3DCRT alone for Stage Ⅲ NSCLC without increasing toxicities.

etabolic response to radiotherapy may predict the prognosis of paitents with locally advanced NPC. The prognosis is poor for patients with high FDG uptake before and after radiotherapy or SUV max-NSUV max-P .

Objective:To compare death causes and the survival time in elderly patients undergoing hemodialysis versus peritoneal dialysis in the nephrology department of Beijing Hospital in the last 10 years.Methods:This was a retrospective study.Patients aged more than 60 years who had undergone dialysis and died in the dialysis center of Beijing Hospital between January 2010 and January 2019 were enrolled.A detailed medical history including gender, age, primary diseases, diabetes mellitus, time of dialysis initiation, time of death and direct cause of death were recorded.Results:A total of 153 elderly dialysis patients were enrolled, with a mean age of 76.6±7.7 years, a median dialysis vintage of 54.1(26.9, 86.4)months, including 83(54.2%)cases with diabetes.Patients were divided into the hemodialysis group(HD, n=114)and the peritoneal dialysis group(PD, n=39)according to the dialysis method.The mean ages of patients in the HD and PD groups were 77.1±7.9 and 75.0±7.0 years, and the median dialysis vintages were 56.5(27.4, 104.2)and 48.3(26.3, 66.6)months, respectively.The primary diseases of patients undergoing HD and PD were diabetic nephropathy(DN, 32.5% vs.48.7%), chronic glomerulonephritis(29.8% vs.17.9%)and hypertensive renal damage(21.1% vs.10.3%). The top three causes of mortality in patients undergoing HD and PD were cardiovascular diseases(32.4% vs.43.6%), infections(29.8% vs.28.2%)and cerebrovascular diseases(11.4% vs.15.4%). The compositions of primary diseases and death causes were similar between the two groups, with no significant difference.Kaplan-Meier curves indicated that the survival time of dialysis patients with diabetes mellitus was shorter than that of patients without diabetes mellitus(chi-square value was 12.829, P<0.001), and the survival time of HD patients was longer than that of PD patients(chi-square value was 8.161, P=0.004). In patients without diabetes mellitus, the survival time of HD patients was longer than that of PD patients( Z=-2.716, P=0.007). In patients with diabetes mellitus, HD and PD had similar survival outcomes( Z=-0.581, P=0.561). Conclusions:The proportion of patients with diabetic nephropathy is high in elderly dialysis patients.Cardiovascular and cerebrovascular diseases and infections are the main causes of death in elderly dialysis patients.The survival time is longer in HD patients than in PD patients.