Objective To suggest the developmental direction of geriatrics based on the current status of domestic and international gerontological researches. Methods Professional literature in the gerontological field published domestically and abroad in recent 10 years were retrieved, and the current status and trend of progress in gerontology were analyzed. Results In recent 10 years, great progress was witnessed in geriatrics both in basic research and clinical diagnosis and treatment. With indept research concerining aging and anti-aging genetics, the secrets of prolonging longevity and the underlying mechanism of senescence of human being would be revealed, thus a theoretical basis for anti-aging strategy could be formalated. The research on multi-organ dysfunction, hypertension, coronary heart disease, multi-factor heart failure and senile degenerative valvular heart disease, Alzheimer disease, senile pulmonary disease and osteoporosis, and other common diseases in aged individuals might be able to reveal the clinical characteristics, improvement in their diagnostic accuracy, prevention, and control. The development of evidence-based medicine and community medicine would contribute to improve the quality of life and physical and mental health of the elderly people. Conclusions Gerontological research should focus on the causes and features of aging in the future to guide the clinical practice with the latest research findings, new medicines and prevention measures of common chronic diseases in elderly people, and also focus on community medicine to improve prevention and health care for the elderly people.

Objective Brachial-ankle pulse wave velocity (baPWV) is widely used as a simple noninvasive measure of arterial stiffness. The aim of this study was to evaluate the usefulness of baPWV as a predictor of the carotid artery atherosclerosis in the elderly. Methods A total of 721 elderly participants (mean±SD age, 70.3 5.6years) were enrolled in the current study. All participant underwent both baPWV measurement and B-mode ultrasound for the intima-media thickness. Carotid atherosclerosis (CAS) was defined as the present of carotid plaque or and/or intima media thickness for at least 1.1 mm. Results A multivariate logistic regression analysis reveals that age, sex, brachial-ankle pulse wave velocity, smoking and LDL-C level showed a significant correlation with the presence of CAS. The odds ratios of CAS associated with a 500cm/s increase of brachial-ankle pulse wave velocity were 2.378 [95% confidence interval, 1.36 to 4.00, P<0.05], 3.733 [95% confidence interval, 1.729 to 8.058, P<0.01], 4.438 [95% confidence interval, 1.659 to 11.803, P<0.01]. The baPWV significantly correlated with IMT by bivariate correlation analysis (r=0.39; p=0.001). After adjusting for factors influencing, baPWV all the same correlated with IMT (r=0.35; p=0.001).Conclusion These results indicate that brachial-ankle PWV is an independent predictor of CAS in the elderly.It also means that the direct measurement of arterial stiffness by this simple method may be of great help for the evaluation of carotid artherosclerosis, at least in the elderly.

Objective To study the sub-chronic toxicity of lake water treated with effect microorganisms(EM).Methods One hundred and ten Wistar rats were randomly divided into five groups,11 males and 11 females in each.Three groups were treated orally with lake water depurated with EM,at the doses of 125,250,500 ml/kg respectively,for 90 consecutive days.The other two groups were treated with the untreated lake water(250 ml/kg) and tap water,respectively.The animal's behavior,body weight,blood and organ tissue indicators were examined.Results No poisoning signs were observed in all animals,no significant difference was found in body weight,blood routine test indexes,the serum test indexes between all treated groups and control groups,and no significant pathological change in the organ tissues of all treated groups and control groups was seen.Conclusion The lake water depurated with EM at doses of 125 to 500 ml/kg may not induce sub-chronic toxicity in rats.

Objective The aim of the study is to explore the relationship of lung infection(LI)and multiple organ failure in the elderly(MOFE).Methods Consecutive patients ,who were admitted to the Institute of Geriatric Cardiovascular Diseases of the PLA General Hospital and the Endocardial Department of the Air Force General Hospital,withage≥65 years old were enrolled into 5 groups retrospectively by following criteria:acute LI alone,LI with the first presentation of acute lung edema,chronic bronchitis complicated with LI,chronic heart failure complicated with LI,and nic bronchitis and heart failure complicated with LI.Results Sixty-eight patients were selected of(72.5?7.6)years old ( 38 male).There were 4 cases of pure LI(4%),12 cases of LI firstly presented with the symptoms of acute lung edema(18%),16 cases of LI complicated with chronic bronchitis(24%),15 cases of LI based on chronic heart failure(22%)and 22 cases of LI complicated with chronic bronchitis and heart failure(32%).LI initiated MOFE in 25 cases(37%).Most of them were developed on the basis of chronic bronchitis and/or heart failure(34%).Mortality of secondary LI was higher than that of the primary LI(7.4% VS 0%,P

To evaluate the influence of known coronary artery disease(CAD)on perioperative cardiac events in elderly patients undergoing noncardiac surgery,3028 consecutive patients who underwent major noncardiac procedures, with or without a history of CAD, were analyzed in terms of types and nature of surgery, clinical history and perioperative cardiac complications. Among the patients CAD, there were more urologic operations, and clinical history of internal diseases compared with the patients without CAD. Patients with CAD had an increased odds ratio for myocardial ischemia and arrhythmia (OR, 20 3 [95% CI, 6 5 to 65 7] and OR, 7 4 [CI, 4 4 to 12 3]) during operation, and also for postoperative myocardial ischemia, myocardial infarction, cardiogenic pulmonary edema and arrhythmia (OR, 8 3 [95% CI, 4 7 to 14 7], OR, 3 9 [95% CI, 1 2 to 12 2], OR, 7 9 [95% CI, 3 8 to 16 6] and OR, 1 7 [CI, 1 3 to 2 4]) compared with patients without CAD. The results indicated that elderly patients with CAD who underwent noncardiac surgery were more frequently associated with clinical history of internal diseases, and had a higher rate of major perioperative cardiac complications.

0.05). The results indicated that prodromal angina pectoris showed no beneficial effcet on the outcome in patients of venarable age with acute myocardial infarction.

Objective To investigate and compare the change of extravascular lung water (EVLW) and levels of cytokines in septic patients without clinical acute lung injury (ALI) /acute respiratory distress syndrome (ARDS) with those in spetic patients with sepsis-induced ALI/ARDS in order to determine the role of EVLW involved in the pathogenesis of lung injury in the patients by quantifying the relationship between EVLW and biomarkers of lung injury in patients with sepsis.Methods A total of 40 septic patients complicated either with or without clinical ALI/ARDS after sepsis. In each patient,transpulmonary thermodilution (PiCCO) was used to measure cardiovascular hemodynamics and EVLWI for 7 days via an arterial cannula indwelled within 72 hours after diagnosis of severe sepsis was made, and serial bronchoalveolar lavages (BAL) were carried out.Other examinations including blood gas analysis,ventilator parameters,chest X-ray and the levels of pro-inflammatory cytokines such as tumor necrosis factor (TNF-oα),interleukin-1 in the BAL were recorded.In-hospital and ICU mortalities were also observed.Results Of total 40 patients,29 were complicated with clinically defined septic ALI/ARDS ( ARDS n =15,and ALI n =14).The septic patients complicated with ALL/ARDS had significantly higher amount of EVLWI and higher levels of TNF-α and interleukin-1 in the BAL than patients without ALI/ARDS ( P ＜ 0.05).The arterial oxygen tension/fractional inspired oxygen ratio,lung injury score,and the levels of TNF-α,IL-1 in the BAL correlated with EVLWI.Moreover,in-hospital mortality,ICU mortality and the length of ICU stay of the patients with high amount of EVLWI were markedly increased than those of patients with low amount of EVLWI. Conclusions In septic patients complicated with ALI/ARDS, the extravascular lung water index correlates with oxygenation,lung injury severity and inflammatory cytokines in lung.Determination of EVLWI may be useful for evaluation of severity of lung injury and prognosis of septic patients.

Objective To study the effect of continuous blood purification on inflammation and nutritional status in patients with sepsis, and to study relationship between inflammatory, malnutrition and illness. Method Forty-eight patients with severe sepsis were randomly divided into two groups: continuous renal replacement treat-ment (CRRT) group (n=27) and control group (n=21). The flowing biomarkers including albumin, preallbu-min, transfenin, insulin-like growth factor-1 (IGF-1), tumor necrosis factor (TNF-α) and C reactive protein (CRP) were determined before,and 1 week and 2 weeks after treatment. Results Compared with control group, levels of albumin, prealbumin and IGF-1 in treatment group increased significantly at 14 days after CRRT (P<0.05), and levels d CRP and TNF-α decreased significantly (P<0.05), resulted in increase in survival rate, shortened me-chanical ventilation time and decreased SOFA scores (P<0.05). The IGF-1 and prealbumin had a negative cor-relations with CRP and TNF-a in both groups (P<0.05). The survivors in both groups had significantly higher levels of IGF-1,prealbumin and TNF-α than the deads before trearment(P<0.05). Conclusions Continuous blood purification can effectively attenuate inflammation and improve nutritional status in patients with severe sep-sis.Maybe IGF-1 and prealbumin act as prognostic markers more sensitive in severe sepsis.

Objective To explore the effect of mild hypothermia on inflammation status,lung function protection and clinical prognosis in patients with acute respiratory distress syndrome (ARDS).Methods All of 56 patients with ARDS were randomly divided into two groups: trial group (29 patients,treatment with mild hypothermia) and control group (27 patients, treatment with common practice). The following parameters including tumor necrosis factor (TNF)-α,interleukin (IL)-6 and C reactive protein (CRP), oxygenation index, SOFA evaluation and injury of lungs evaluation were detemined before treatment and at the 3rd, 7th day after treatment, and survival rates and adverse reaction in 28 days also were observed.Results After treatment, the levels of TNF-α ,IL-6 and CRP were decreased significantly, and oxygenation index, the scores of SOFA evaluation and injury of lungs evaluation were improved significantly in trial group than those in control group (P<0.05 ). The survival rate in trial group was higher than that in control group after treatment of 28 days [65.5%(19/29) vs 51.9%(14/27)]. The courses of mechanical ventilation and staying in ICU in trial group were shorter than those in control group [(11.9±3.6)d vs (17.0±5.1)d,(14.1±4.2)d vs (21.5±7.7)d](P<0.05). Conclusion Mild hypothermia can effectively attenuate inflammation disorder, improve damaged lung function and prognosis in patients with ARDS.