Objective To observe efficacy and safety of long-term Statins treatment in elderly patients aged over 80 years,and to provide clinical evidence for the rational use of Statins.Methods 224 patients aged 80 years and over were divided into two groups:Statin group given Statins (n=107),and control group not given Statin (n=117).The serum levels of total cholesterol (TC),lowdensity lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) were measured,and liver and renal function,alanine aminotransferase (ALT),creatine phosphokinase (CPK) and epidermal growth factor receptor (EGFR) were tested.Results Pretreatment levels of TC and LDL-C levels were (4.6 ± 1.0) and (2.6 ± 0.8) mmol/L and were decreased to (4.3±0.9) and (2.4±0.6) mmol/L after 1 year treatment (t=3.535,3.448,both P＜0.05).The target rate in statin group for LDL C was 35.5 ％ in patients at very high risk.There were no significant differences in levels of ALT,CK and eGFR between pre-and post-treatment in both two groups [(20.2±9.2) U/L vs.(21.4±12.1) U/L,(86.5±53.9) U/L vs.(86.6±67.5) U/Land (53.1±17.3) ml/min vs.(51.9±18.0) ml/min,all P＞0.05].Compared with pre-treatment,1 year treatment showed that glucose level was increased [(5.9± 1.0) mmol/L vs.(6.0± 1.0) mmol/L,t=2.287,P＜0.05].Conclusions Long-term Statin treatment in elderly patients is safe and effective.We should correctly administer statin drugs,and closely monitor the safety indicators.

Objective To investigate the prevalence and characteristics of thyroid nodule and its relationship with thyroid function in a group of middle-aged to elderly individuals.Methods A cross-sectional,stratified,and cluster random sampling study was performed in 1 721 subjects (average age 71.4 years,from 40 to 108 years).All subjects underwent ultrasound thyroid scan,and the prevalence of thyroid nodule and its size,quantity,property,and distribution were age-stratified and analyzed.The relationship between nodule existence and thyroid function was assessed in subjects who randomly accepted TSH,FT4,and FT3 tests.Results The prevalence of thyroid nodule reached to 76.6％.The incidence of nodule increased with age (x2 =92.08,P＜0.01),and was more common in female (87.4％ vs 75.5％,P =0.001).In patients with thyroid nodule,the prevalence of solitary nodule was 25％,compared with 75％ of multiple nodules,which increased with age (x2 =78.55,P＜0.01).The prevalence of small nodule reached to 68.2％,compared with 31.8％ of large nodules,which also increased with age (x2 =36.82,P＜0.01).As to the property of nodule,solid nodule was the most common form (72.3 ％),cyst-solid nodule accounted for 26.6％,and detection rate of cyst nodule was only 2.1％,and there was no significant difference among the different age groups (x2 =14.22,P=0.076).884 among the total subjects underwent thyroid function test,multiple logistic regression analysis demonstrated that the reduction of TSH was the only independent predicting factor of thyroid nodule (P =0.005).Conclusions The prevalence of thyroid nodules was considerably high according to the examing of ultrasonographic image,especially in the elderly.The incidence of thyroid nodule,especially multiple nodules or larger nodule,increased with age and solid nodule was the most common finding.

Objective To summarize the age-related changes and the risk factors of renal tubular function in the elderly male cases.Methods Totally 229 cases without chronic kidney disease were divided into two groups:group aged ＜80 years and group aged ≥80 years.We measured the urine routine,serum creatine,serum urea,urine β2-microglobin (β2-MG),urine α1-microglobin (α1-MG)and calculated the eGFR based on Cockcroft-Gault equation.Logistic regression was used to analyze the risk factors which may accelerate the progression of the renal tubular impairment.Results The average age of 229 cases was (76±10)years.There were 142 cases in the group of ＜80 years old and 87 cases in the group of ≥80 years old.The level of eGFR in the group of ≥80 years old was (55.0±12.7) ml/min,which was lower than that of the group of ＜ 80 years old (80.3 ± 18.0 ml/min) (t =9.882,P＜0.01).The level of urine SG was decreased in the group of ≥80 years old versus in the group of ＜80 years old(1.016±0.006 vs.1.013±0.006).The value changes of urine pH,urine β2-MG and urine α1-MG were of statistical differences between the two groups [(6.2±0.8) vs.(6.6±0.8),(0.96±1.02)mg/L vs.(2.08 ±3.56)mg/L,(6.67±3.57) mg/L vs.(8.71±6.59)mg/L].The correlation analysis showed that age correlated negatively with eGFR and urine SG(r =-0.692and r=-0.280,both P＜0.01)and positively with urine pH(r=0.255),urine β2 MG(r=0.262),urine α1-MG(r=0.228)(all P＜0.01).The Logistic regression analysis showed that coronary heart disease was an independent risk factor for the progression of renal tubular impairment (OR=4.251,P=0.002).Conclusions Renal tubular functions is decreased with ageing age in the elderly male,especially in the advanced elderly.The coronary heart disease is an independent risk factor of the progression of renal tubular impairment.

Objective To investigate the prevalence of chronic kidney disease (CKD) and its risk factors in Chinese elderly persons.Methods All of the people who underwent physical examination and treatment in the geriatric department of Beijing Hospital during January 2004 to January 2007 were included in the study.Age, body height, body mass index and blood pressure were recorded.Bloody urine was ascertained by phase-contrast microscope, and urine protein was measured by dipstick test.The hemoglobulin, serum eretinine, blood urea nitrogen, blood lipid and serum uric acid were measured by autobiochemical analyzer.HbsAg was checked by enzyme-linked immunosorbent assay (ELISA).Glomerular filtration rate (GFR) was estimated by Crockeroft-Gauh equation and abbreviated MDRD equation.Binary logistic regression analysis was used to test the risk factors for proteinuria and CKD.Results The prevalence of proteinuria was 4.9% in 1082 elderly persons.And 47.23% of the elderly suffered from decreased renal function.The morbidity of CKD was 48.43%.Binary logistic regression analysis showed that diabetes(OR= 2.257) and microscopic hematuria(OR=5.324) were the risk factors of proteinuria (both P<0.05).And the risk factors for CKD were hypertension(OR= 1.459), coronary arth'erosclerotic heart disease(OR=3.290), chronic obstructive lung diseases(OR=2.094), malignant tumor(OR=2.072), hyperuricemia(OR= 1.928),anemia(OR=8.122)and hematuria( OR= 1.604) (all P<0.05).Conclusions The morbidity of CKD in Chinese elderly persons was 48.43%.And the related risk factors were diabetes,hypertension, hyperuricemia, coronary artherosclerotic heart disease and chronic obstructive lung disease.

Objective To evaluate the clinical value of OLGA (Operative Link on Gastritis Assessment) system in pathological assessment of gastric mucosa from Chinese patients.Methods Endoscopic and pathological data of patients,who underwent the endoscopic examination of upper gastrointestinal tract from 2007 to 2012,were analyzed.Using the Sydney protocol,we graded atrophy and staged the Helicobacter pylori infection status in gastric biopsies from 108 patients with dyspepsia.We applied the OLGA system to assess the relationship between OLGA staging and grading and dysplasia/cancer,and the relationship between OLGA grading and Helicobacter pylori infection.Results Two cases of early gastric adenocarcinoma were detected at stage Ⅱ and Ⅳ,respectively.The detection rates of precancerous lesions (including intestinal metaplasia and dysplasia) in cases clustered in stages Ⅲ-Ⅳ were significantly higher than those in stages 0-Ⅱ (intestinal metaplasia:100.0％ VS 65.3％,P ＜0.001 ;dysplasia:77.8％ VS 13.9％,P ＜0.001,respectively),and there were significant differences between OLGA staging and the degree of dysplasia (r =0.671,P ＜0.001).In the subjects at stage 0-Ⅱ,we observed only 10 cases (13.9％) of mild dysplasia.The difference in rate of Helicobacter pylori infection was significant at different OLGA grade (P ＜ 0.001),and the correlation between OLGA grading and infection degree of Helicobacter pylori was significant (r =0.586,P ＜ 0.001).Conclusion Precancerous lesions and gastric adenocarcinoma tend to be discovered in patients clustered at high-risk (Ⅲ-Ⅳ) OLGA stages.OLGA staging of dysplasia can effectively differentiate the risks of gastric cancer.The OLGA grading system is consistently associated with the Helicobacter pylori infection.

Objective To investigate the potential mechanism for symptoms related to epigastric discomfort in patients without Helicobacter pylori (H.pylori) infection.Methods Patients who underwent gastric endoscopy and conformed H.pylori negative by histologic examination were enrolled.Among them,232 adult patients were collected between August 2006 and November 2006 and 31 children were collected between September 2005 and August 2009.All patients showed no apparent abnormality by endoscopic examination.The endoscopic biopsy was examined with HE or Warthin-Starry staining.Results In adult group,arteriole obstruction was found in 16 (8.8%) cases and focal haemorrhage in 82 (45.6%) cases.Both were existed in 82 (45.6%) cases.The histopathologic findings showed that arteriole obstruction in transition zone (65.2 %,P = 0.159) was common,whereas the focal haemorrhage in gastric fundus and corpus (65.6%,P=0.001) was in predominance.The symptom of heartburn was less in patients with arteriole obstruction and/or focal haemorrhage in comparison with those without these changes (x2 =8.564,P=0.003).In adolescent group,arteriole obstruction and/or focal haemorrhage accounted for 96.8% (30/31).Conclusion Gastric mucosa ischemic resulted from arteriole obstruction are commonly seen in both adult and adolescent patients,which is an important reason for epigastric discomfort in H.pylori negative patients.

Objective Collagenous gastritis is a rare entity, characterized by the deposition of a subepithelial collagen band with an inflammatory infiltrate in the mucosa.This report describes the first case of collagenous gastritis occurring in a young Chinese woman and reviews the literatures.Methods The patient underwent the gastroscopy screening, and the biopsy specimens were treated with HE staining, Masson staining, Congo red staining and Warthin-Starry staining.Patients' clinical data was discussed and followed up.Results A twenty-year-old girl had intermittent epigastric pain for 4 years, abdominal distention, hiccup and weight loss for two months.The gastric endoscopy revealed diffuse white nodular appearance of the mucosa in angular incisure and antrum.Pathologic examination of the gastric biopsies from the antrum and angular showed a subepithelial collagen deposition with moderate infiltrates of lymphoplasma cells and eosinophils of the lamina propria.The collagen band measured up to 120.3 μm (mean 43.8 μm).Prednisone 20 mg/d for 4 weeks led to clinical remission and weight gain.Conclusion There are about 40 cases in literatures to date, and the cause and pathogenesis of collagenous gastritis remain unknown.According to the clinical and pathological characteristics, the patient in this article is the subtype of collagenous gastritis that occurring in children and young adults.Specific therapy has not been established, the gluten-free diet and glucocorticosteroid may be helpful to relieve symptoms in collagenous gastritis patients.

To investigate the characteristics of traditional Chinese medicine (TCM) syndromes and their elements in people with subhealth fatigue.

Objective To explore the application effect of the continuing nursing care in physical examination for the elderly with positive tumor marker .Methods Patients found a positive tumor marker in examination for the first time were selected .Control group ( n=78 ) received the original mode of care , while intervention group (n=78) received the continuing nursing care such as reviewing the program established by the team, face-to-face or telephone individualized health education , helping patients make an appointment time , and timely feedback to the physician in charge .After three months, the referral rates, health education and nursing satisfaction of patients were observed .Results Referral rate in the intervention group was significantly higher than that in the control group (91.03% vs 62.82%; χ2 =17.478,P <0.01).Before and after the intervention , the score of health education knowledge in the intervention group was significantly improved [(14.82 ±2.88) vs (6.76 ±0.75);t =18.104,P <0.01],and the nursing satisfaction was significantly increased [(34.10 ±1.19) vs (29.76 ±1.60);t =7.41,P <0.01].The important influencing factors of compliance were elderly with mobility , health education , and contradiction for the invasive examination .And 92.3%(72/78) of patients believed that nurses should provide service for review , and 96.2%(75/78) of patients believed that nurses should provide the service of making a review appointment .Conclusions Continuing nursing care for the elderly with positive tumor markers found in the examination can meet the needs of patients and improve the patients ’ level of knowledge , satisfaction and referral compliance , so as to achieve early detection , early diagnosis , and early treatment .

Objective: To investigate the effects of calcium supplementation during the pregnancy and early infancy stage on body mass index (BMI) and gut microbiota in the infants. Methods: A total of 1 752 healthy pregnant women and their infants (breast feeding) in two maternal and child health care hospitals of Beijing were chosen as the subjects in this study from May to October 2016. Questionnaires were used to obtain the general information and supplementation of calcium and vitamin D in mothers and their infants. The body length and weight of infants at birth and 6 months were recorded to calculate the BMI. The random number table method was used to randomly select 40 infants from each group for gut microbiota analysis (If less than 40 infants were all included in this study, 23 infants in the pregnancy and early infancy would be all treated with calcium supplements. There were 6 infants who was not added calcium during the pregnancy but added in the early infancy). Then it was compared that the effects of calcium supplementation during the pregnancy and early infancy on the BMI and gut microbiota composition of infants were determined at birth and 6 months. Results: Compared to the group with no calcium supplementation during the pregnancy ((12.76±1.23), (17.68±0.76)kg/m²), the BMI of infants at birth and 6 months in the group with calcium supplementation during the pregnancy ((13.51±0.47), (17.91±0.23)kg/m²) were significantly higher(P<0.05). In the group with maternal calcium supplementation, the BMI at 6 months ((18.63±0.52)kg/m²), BMI increment ((5.71±0.54)kg/m²) and the content of lactobacillus (21.04%±3.68%) in the only calcium supplementation subgroup in the early infancy were higher than those in only vitamin D supplementation subgroup ((17.69±0.89) kg/m², (4.17±1.01) kg/m² and 12.28%±3.86%) (P<0.05). In the group without maternal calcium supplementation, the content of lactobacillus (20.15%±4.87%) in the only calcium supplementation subgroup were also higher than those in only vitamin D supplementation subgroup (14.64%±3.71%) (P<0.05). Conclusion Appropriate calcium supplementation during the pregnancy is good for the growth and development of the fetus. Calcium supplementation in the early infancy could increase the BMI of infants, and promote the growth of intestinal lactobacillus.