The use of five or more drugs (polypharmacy) is common problem in the elderly,and need to attach importance.Optimization of drug treatment is a major part of medication in older adults,and also is a challenge to clinical physician.Beers Criteria provided by American Geriatrics Society (AGS) is a strong guarantee for improving medication safety in older adults

Objective:To evaluate therapeutic effect of olmesartan on patients with mild to moderate essential hyper-tension (EH) and its influence on cardiovascular risk factors .Methods:A total of 150 mild/moderate EH patients were enrolled using opened ,non-control and multi-center method .According to random number table ,they were randomly and equally divided into olmesartan group (received olmesartan 20~40 mg/d) and losartan group (re-ceived losartan 50~100 mg/d) .Changes of systolic blood pressure (SBP) ,diastolic blood pressure (DBP) , levels of risk indexes of cardiovascular diseases ,such as high sensitive C reactive protein (hsCRP) ,urinary albumin/creati-nine ,homocysteine (Hcy) and carotid intima-media thickness (IMT) were observed in two groups before and after treatment .Results:After eight-month treatment , compared with before treatment , all indexes significantly im-proved in both groups;compared with losartan group ,there were significant reductions in SBP [ (145 ± 12) mmHg vs .(132 ± 9) mmHg] and DBP [ (90 ± 7) mmHg vs .(80 ± 5) mmHg] , P<0.01 all;and significant reductions in levels of hsCRP [ (0.54 ± 0.09) mg/L vs .(0.34 ± 0.09) mg/L] ,urinary albumin/creatinine [ (26.5 ± 19.4) mg/g vs .(23.1 ± 18.3) mg/g] ,Hcy [ (13.2 ± 4.8)μmol/L vs .(10.3 ± 4.2)μmol/L] and IMT [ (0.83 ± 0.29) mm vs . (0.74 ± 0.28) mm] in olmesartan group , P< 0.05 all .Conclusion:Besides intensively lowering blood pressure olmesartan can also significantly decrease cardiovascular risk factors in patients with mild to moderate hypertension .

A 64-year old man was admitted on July 2011 with masses both in liver and right kidney.After PET-CT and blood test examination,dual primary advanced cancers were speculated to be co-existed in this patient,which having poor prognosis.By evaluation with comprehensive geriatric assessment,the patient also had hypertension,diabetes and atherosclerosis,liver and renal insufficiency.After multidisciplinary consultation and detailed discussion with the patient,the decision of no surgery and just keep the follow-up was made.The patient has been followed up for 18 months and the functional evaluation is the same as before.It is very important to evaluate the risk/benefit equation and improve the standard of care,and make the decision as patient centered rather than disease-centered in the elderly patients.

Objeetive To detect the influence of psychological nursing intervention in 215 Prlmiparas Methods Taking whole course psychological nursing intervention of 215 primiparas who were making appointments on obstetrical outpatient department.Take psychological care,education of in-hospital and person to person care of in-delivery room as experiment group.and choose 205 Primiparas who were delivery in ordinary way at random.Compare the rate of viginal delivmy and the rate of cesarean section and neonatal asphyxia and the rate of postpartum hemorrhage.Evaluate the effect of Psychological nursing intervention to Primiparas.Results The rate of、riginal delivery on experiment group Was higher than the control group.It also shorten the duration of labor,and control the rate of cesarean section,neonatal asphyxia and postpartum hemorrhage effectively.There ale significant difference between two groups(P＜0.05).Conclusion The psychological nursing intervention is positive to the primiparasis in labor.It can increase the of viginal delivery shorten the duration of labor.and decrease the rate of cesarean section neonatal asphyxia and postpartum hemorrhage.

Palliative and hospice care for patients suffering severe or end-stage illness with projected short life expectancy.Such services aim to improve patients' quality of life through prognosticating,prevention and treatment of their ailment.The main components include evaluation and treatment of symptoms,pain control,family care,alleviating and treating patients' psychological burden and depression,and offering comfort and dignity.Hospice and palliative care are different from euthanasia,because they neither hasten nor delay the dying process.Instead,they focus on patients'physical and psychological needs and helping patients to maintain their independence and make their own choice.As a new medical subspecialty,palliative and hospice care are considered one of the important frontier in modern medicine.They employ a multi-disciplinary team approach,and the team members require special skill sets including those in communication and symptom management.

Myocardial infarction and ischemic stroke share many common risk factors.Their pathophysiological processes are also similar and the 2 diseases often occur at the same time.Coronary artery disease is one of the important causes of embolic stroke in the elderly population.However,there are a few reported stroke events available after myocardial infarction.This article reviews ischenic stroke following acute myocardial infarction.

Objective To investigate the efficacy and safety of local immune regulation therapy of thyroid disease.Methods Totally 110 patients with confirmed diagnosis of autoimmune thyroid disease were recruited.All patients received thyroid local immune regulation therapy with glucocorticoids 1~3 courses of treatment and followed up for 2~3 years,each being taken good care of during the whole observation.Results About 94.0% of the patients had significantly improved their subjective symptoms,such as pain,fatigue,and lethargy.About 67.7% of the cases had reached normal or markedly improved thyroid function after thyroid local immune regulation therapy.About 92.0% of the volumes of thyroid were reduced.Serum antithyroperoxidase antibody levels were decreased from(338.2?43.2)mU/L to(266.9?42.2)mU/L(P

Objective To investigate the clinical significance of tumor necrosis factor-?(TNF-?)and interleukin-6(IL-6)in the ascitic fluid of cirrhotic patients with spontaneous bacterial peritonitis(SBP).Methods TNF-? and IL-6 in the ascitic fluid of 32 cirrhotic patients with SBP were measured by ELISA.The group was compared with the value in transudatory ascites of 30 cirrhotic patients.Results The levels of TNF-? and IL-6 in the ascitic fluid of cirrhotic patients with SBP were much higher than those in transudatory ascites of cirrhotic patients(P

AIM: To establish the quality standard for Yinchai Granules (Caulis Lon icerae, Radix Bupleuri, Folium Eriobotryae, etc). METHODS: TLC was used to identify Radix Bupleuri, Folium Eriobotrya e and HPLC to determinate the chlorogenic acid content was determined by HPLC. RESULTS: The linear range of chlorogenic acid was 23.64～378.24ng, r=0.9999, respectively. The average recovery was 99.14%. CONCLUSION: The method is simple. The result is accurate and the reproducibility is good and can be used as the quality control of Yin chai Granules.