With the aging of the global population,frailty is now considered a unique old age syndrome,has become an important worldwide public health problems.The elderly people is at increased risk of falls,hip fractures,disability,death and other risks.Motor system disease as an independent risk factor participates in frailty progress and interacts with each other.This article reviews recent studies on frailty and motor system diseases.

Objective To compare the outcomes of giant hepatic hemangioma undergoing enucleation and hepatectomy and to summarize our experience of surgical management of liver hemangioma.Methods A retrospective study was conducted in patients undergoing giant hepatic hemangioma resection (lager than 10 cm in size) in General Hospital of PLA,during 2006 through 2014.Patients were divided into two groups according to the types of operation.Results Of 145 patients with giant liver hemangioma,81 underwent enucleation and 64 had hepatectomy.The differences of tumor size (12.0 cm vs.15.5 cm,u =3.68,P ＜0.01),time of operation (210 min vs.280 min,u =3.89,P ＜ 0.01) and the ratio of inflow control (81.5％ vs.56.3％,x2 =10.91,P ＜ 0.01) of enucleation and hepatectomy was significant.The difference of intraoperative blood loss (500 ml vs.800 ml,u =1.85,P =0.07) and the postoperative morbidity (8.6％ vs.7.8％,x2=0.03,P =0.86) was not statistically significant.There was no inhospital mortality in both groups.Conclusions Both of enucleation and hepatectomy are effective operative approaches for giant liver hemangioma,patients with liver hemangioma should be prudently chosen for surgery,and the operation type should be individualized with the guidance of precision liver surgery.

Objective To explore the relationship between diameter of liver hemangioma and operation risk.Methods The clinical data of 362 patients with liver hemangioma who were admitted to the PLA General Hospital from January 2006 to January 2014 were retrospectively analyzed.All patients were divided into the 3 groups according to diameter of gross specimen,217 with tumor diameter≥5 cm and ≤ 10 cm in the large hemangioma group,119 with tumor diameter ＞ 10 cm and ≤20 cm in the giant hemangioma group and 26 with tumor diameter≥20 cm in the extremely large hemangioma group.The operation method included open surgery and laparoscopic surgery.Hepatectomy and enucleation of liver hemangioma were major operation procedures.The operation time,volume of intraoperative blood loss,number of patients with intraoperative blood transfusion,number of patients with postoperative complications and duration of hospital stay were evaluated.Count data were analyzed using the chi-square test.Measurement data with normal distribution were presented as (x) ± s,and comparison among groups was analyzed using the ANOVA.Skewed distribution data were described as M (P25,P75),comparison among groups was analyzed by Kruskal-wallis test and pairwise comparison was done by the MannWhitney U test.Results All patients underwent operation successfully without perioperative death,including 315 receiving open surgery (175 in the large hemangioma group,114 in the giant hemangioma group and 26 in the extremely large hemangioma group) and 47 receiving laparoscopic surgery (42 in the large hemangioma group and 5 in the giant hemangioma group).The operation time,volume of intraoperative blood loss,number of patients with blood transfusion,number of patients with postoperative complications and duration of hospital stay were 160 minutes (125 minutes,205 minutes),300 mL (100 mL,500 mL),31,5 and 8 days (7 days,9 days) in the large hemangioma group,220 minutes (175 minutes,275 minutes),500 mL (300 mL,1 000mL),36,5 and 9 days (8 days,10 days) in the giant hemangioma group,330 minutes (280 minutes,420 minutes),1 975 mL (800 mL,4 000mL),20,7 and 11 days (9 days,13 days) in the extremely large hemangioma group,respectively,with significant differences (x2 =84.24,80.94,53.65,31.54,47.67,P ＜ 0.05).The operation time,volume of intraoperative blood loss,number of patients with intraoperative blood transfusion and duration of hospital stay were compared,showing significant differences between large hemangioma group and giant hemangioma group (Z =6.39,6.51,x2 =11.29,Z =4.73,P ＜ 0.05),with significant differences between large hemangioma group and extremely large hemangioma group and between giant hemangioma group and extremely large hemangioma group (Z =7.28,6.91,x2=51.22,Z =5.57,P ＜ 0.05;Z =5.33,4.86,x2=17.69,Z =3.5 1,P ＜ 0.05).Seventeen patients had postoperative complications with an incidence of 4.70％ (17/362),intra-abdominal hemorrhage were detected in 7 patients,perihepatic effusion in 4 patients,pleural effusion in 3 patients,bile leakage in 2 patients and fat liquefaction of abdominal incision in 1 patient.There was no significant difference in the number of patients with postoperative complications between large hemangioma group and giant hemangioma group (x2 =0.41,P ＞ 0.05).There were significant differences in the number of patients with postoperative complications between large hemangioma group and extremely large hemangioma group and between giant hemangioma group and extremely large hemangioma group (x2 =24.96,11.67,P ＜ 0.05).Conclusions Diameber of liver hemangioma is associated with operation time,volume of intraoperative blood loss,number of patients with intraoperative blood transfusion,number of patients with postoperative complications and duration of hospital stay,and there is a high risk in the surgical treatment of patients with liver hemangioma diameter≥20 cm.

Humans ; Medicine, Chinese Traditional ; methods

Objective To analyze the literature distribution and research status of depression in the elderly published in Chinese Medical Association journals.Methods The literatures of elderly depression published in 85 kinds of Chinese Medical Association journals from 2003 to 2012 were collected.The publication year,distribution,content,author,institution and region of these literatures were analyzed.Results From 2003 to 2012,there were 85 articles on depression in the elderly published in 15 kinds of journals of the Chinese Medical Association.These literatures were published mostly in 2011 (18 articles,21.2％),secondly in 2010 (13 articles,15.3％) and 2012 (12 articles,14.1％),which were published mostly in Chinese Journal of Geriatrics (29,34.1％).These articles mainly included basic science,inventory survey,diagnostic methods and clinical treatment strategy,and the most published form was treatise (77 articles,90.6％).The author who published the most articles was YUAN Gui yong from Nanjing (3 articles,3.5％),the institution which published the most articles was People's Hospital of Hainan Province (4 articles,4.7％),and the provinces or cities which published the most articles were Beijing (15 articles,17.6％),Shandong (9 articles,10.6％) and Zhejiang (7 articles,8.2％) by turns.Among the 85 articles,31 articles (36.5％) were supported by foundations.The definition,epidemiology,mechanism,influence factors,clinical characteristics,diagnosis and treatment strategy of elderly depression,and especially secondary depression were well discussed in these literatures.Conclusions The literatures of elderly depression published in Chinese Medical Association journals are insufficient in quantity,and more than half of the literatures are published from 2010 to 2012.The distribution of journals is relatively concentrated,but the distribution of author,institution and region in these articles is dispersed.Secondary depression in the elderly is concerned especially.

Objective To investigate the situation and development of international literatures on geriatrics and gerontology in mainland China.Methods The literatures on geriatrics and gerontology written by mainland Chinese scholars as the first author were selected from Thomson Scientific database in 1979-2011 period.Researches on basic theory,summary reports of clinical practice and reviews were collected.The quantity of published articles,article types,international cooperation research and funding programs,hospital rankings,as well as the 2011 geriatrics professional journals,thesis topic disciplines distribution and high-performance papers were analyzed by Thomson Data Analyzer software.Results From 1979 to 2011,the quantity of literatures written by Chinese scholars as the first author (not including Hong Kong,Macao and Taiwan regions) was 1927,including 1769 research articles,86 reviews,18 editorials,54 letters.Average paper was cited 7.6 times and the average number of article citation was 30.6.International cooperation research articles occupied 379 (19.7 ％).Articles with research sponsorship were 734 (38.1 ％),in which most subject discipline was geriatric and gerontology.Conclusions The development of geriatric medicine in China is rapid.The international scientific and technological cooperation is very extensive.It is important to further improve the world impact of geriatric medicine from China.The development of geriatric medicine in a large,cooperative,comprehensive,interdisciplinary,interagency direction,and the prospective,multicenter,cooperative study need to promote.It is extremely urgent to establish the English version of Chinese journals of geriatrics with a international influence.

Objective To analyze the articles published in Chinese Journal of Geriatrics from 2008 to 2012 so as to understand the characteristics of published papers and research progress in geriatric medicine.Methods Based on Wanfang database,bibliometric analysis was conducted to analyze the quantity,types,authors,affiliations,fund support of all the articles published from 2008 to 2012 in Chinese Journal of Geriatrics.Results A total of 1567 papers were published in the journal from 2008 to 2012.The column with the most published papers was clinical research (1008 papers,64.3 ％),followed by experimental researches,reviews and lectures,investigations etc.The discipline with the most articles published in the journal was cardiovascular medicine,followed by surgery,neurology; respiratory etc.1356 authors from 506 affiliations published paper as the first author in the journal during this five years,with the maximal number being 7 papers and the major affiliation being affiliated hospitals of medical colleges (733 papers,49.3 ％).Authors from Beijing,Zhejiang,Jiangsu,Shanghai published more papers than those from other provinces.29.0％ (455papers) of the total papers were supported by fund,among which the majority was provincial fund,followed by national fund,municipal fund,ministry fund and military fund.Conclusions A relatively stable core author group has formed for Chinese Journal of Geriatrics,and the articles are of high quality.Chinese Journal of Geriatrics is one of the highest academic journals in geriatric medicine.

Objective To understand the research status and development tendency of domestic geriatrics.Methods To analyze all the key words in the academic articles from five representative Chinese journals of geriatrics from 2009 to 2013 through key words frequency analysis.Results From 2009 to 2013,the 55212 key words in 15314 articles were analyzed.The percentages of the articles indexing 3,4 and 5 keywords were 39.3％ (6012/15314),33.3％ (5092/15314) and 13.9％(2123/15314),respectively.There were 45 high-frequency keywords,among which 17 key words (37.8％) were in the top 30 every year.The main research object of geriatrics was Aged,the main research contents were common diseases in the elderly,including Diabetes Mellitus,Coronary Artery Disease,Alzheimer's Disease,Hypertension,Cerebral Infarction,Cognition Disorders and etc.The Risk Factors,Therapeutics and Prognosis of these common diseases were always explored.Co-words analysis showed that there were 51 pairs of key words with a frequency more than or equal to 20.Conclusions The hot-spot of geriatric research in our country is relatively concentrated.We should pay attention to body disease,and focus on the mental health problems in the elderly.

Objective To investigate the characteristics of the author groups in 《Chinese Journal of Geriatrics》,in order to provide references for the future construction and development of the author ranks.Methods Bibliometric method was used to analyze the quantity of papers,region distributions,core authors and cooperative rate in 《Chinese Journal of Geriatrics》 from 2009 to 2013.Results The total amount of papers published in 《Chinese Journal of Geriatrics》》 from 2009 to 2013 was 1636,involving 31 provinces,autonomous regions,municipalities and administrative region.Among these,Beijing,Zhejiang,Tianjin and Jiangsu were the 3 top contributing regions,accounting for 54.0 percent (884/1636 papers).The 1636 papers were contributed by 1435 authors (first authors),of whom 1275 authors published only one paper,accounting for 87.7％ (1275/1435),and their papers accounted for 77.9％ of the total published papers (1275 /1636).27 authors had high yield of 3 or more papers published and deep influence,and they published 95 papers (5.8％).The degree of cooperation was 4.6 (7599 /1636),and the cooperation rate was 93.8％ (1534/1636) within the five years.Conclusions 《Chinese Journal of Geriatrics》is quite influential and attractive in the fields of geriatrics,and a good cooperative relationship is displayed between different authors and authors' institutions.