Objective　To investigate the feasibility of hypocaloric nutrition support in elderly patients.Methods　Sixteen elderly patients ( ＞ 85 years) were treated with hypocaloric nutrition for 4 weeks. The calorie intake was 75-96 kJ·kg-1·d -1 , including 44％ -59％ of carbohydrates ( 137-207 g·d -1 ) , 26％ -42％ of lipids (40-67 g·d-1) , and 14％-16％ of proteins (0.7-0.9 g·kg-1·d-1). Nonprotein calorie-to-nitrogen ratio was 131∶1-150∶1. After 4 weeks of treatment, changes in blood routine test, biochemistry, and clotting function were compared with those before hypocaloric nutrition support. Results　After hypocaloric nutrition support, the plasma proteins, blood fats, and lymphocytes in these 16 elderly patients were well maintained, and no obvious adverse effect on clotting function or liver/kidney functions was observed. Conclusion　Hypocaloric nutrition support is safe and effective for elderly patients who are older than 85 years.

0 05). The results suggested that early diagnosis and treament were important factors to improve survival rate and prolong life expectancy for elderly patients with mutiple primary malignant tumors. Cardiac and cerebral vascular accidents, respiratary faliure, and gastrointestinal bleeding were common causes of death in elderly without eancer.

Objective To investigate the clinical value of serum CEA, CA19-9 and CA724 in patients with colonic carcinoma. Methods Serum levels of CEA, CA19-9 and CA724 were detected with ELISA in 89 patients suffering from colonic cancer. Results The positive rates of CEA, CA19-9 and CA724 in Dukes' stages C and D patients were remarkably higher than those in Dukes' stages A and B patients(64% vs 26%,46% vs 22%,26% vs 8% respectively, P

2cm) and undifferentiated type were significantly related to lymph node metastasis in submucosal cancer. No lymph node metastasis was observed in 25 patients with submucosal invasion who showed none of the three risk factors, whereas 72.7% (8/11) of patients with all the three factors had lymph node metastasis. Conclusion The tumor size and lymphatic vessel involvement are related with lymph node metastasis in mucosal cancer. Poor differentiation, tumor size and lymphatic vessel involvement are related with lymph node metastasis in submucosal cancer.

Objective To analyze clinicopathological characteristics of recurrence after gastrectomy for early gastric cancer. Methods 308 patients were treated surgically for early gastric cancer from 1983 to 2005. 245 patients were followed up after gastric resection.Clinicopathologic factors were investigated by using univariate methods and multivariate analysis for the possible relationship to recurrence. Results 30 patients developed recurrent disease (median 28 months). The 1-year, 3-year, 5-year, 7-year, 10-year and 15-year recurrent rates were 5.49%, 8.44%, 11.27%, 14.83%, 16.39% and 37.79%, respectively. 13 patients with mucosal gastric cancer developed recurrent disease (median 24 months). The 1-year, 3-year, 5-year, 7-year, 10-year and 15-year recurrent rates were 4.23%, 6.68%, 7.75%, 9.34%, 9.34% and 28.24%, respectively. 17 patients with submucosal gastric cancer developed recurrent disease (median 31 months). The 1-year, 3-year, 5-year, 7-year, 10-year and 15-year recurrent rates were 7.39%, 11.14%, 16.54%, 24.49%, 29.69% and 64.85%, respectively. Cox multivariate analysis showed that submucosal invasion (P=0.044, OR=2.172) was a positive independent risk factor and paracarcinomatous mucosal medium-severe intestinal metaplasia (P=0.047, OR=0.460) was a negative independent risk factor for recurrence. 76.7% (23/30) patients with recurrence did not have indication of resection for a cure, and they did not undergo surgery again. 23.3% (7/30) patients with recurrence had indication for curative resection, and 4 of whom underwent curative resection, but 3 did not because of poor health. Pathological examination after surgery showed that in 3 patients there was early gastric cancer in the remnant stomach without lymph node metastasis, and in one patient there was advanced gastric cancer in remnant stomach with regional lymph node metastasis. The patient with advanced gastric cancer survived for 28 month without detectable tumor. Logistic regression analysis showed paracarcinomatous mucosal medium-severe intestinal metaplasia (P=0.016, OR=17.000) was a positive independent predictor for second radical surgery. The follow-up examinations including endoscopy were performed in 86.7% (26/30) of patients after operation at least every 1-2 years. Conclusion Early gastric cancer patients with submucosal invasion have a high risk of recurrence, and those with paracarcinomatous mucosal medium-severe intestinal metaplasia have a low risk of recurrence. The patients with paracarcinomatous mucosal medium-severe intestinal metaplasia and cancer recurrence are feasible for a curative resection. The follow-up examinations including endoscopy every 1 or 2 years contributed highly to finding an early recurrent cancer in the remnant stomach. But it is not so helpful to increase the possibility of a curative surgery in patients with recurrence and metastasis after gastrectomy.

Objective To sum up the trend of changes in symptoms of prolonged symptomatic gastroesophageal reflux(GERD), and discuss the relationship between reflux symptoms and the medical treatment in the elderly patients with GERD. Methods 98 elderly GERD patients over 60 years old were followed up for 5 years through questionaires. The changes of reflux symptoms and effect of medication were analyzed. Results Reflux symptoms were improved in 71 subjects (72.4%), disappeared in 10, worsened in 9, and remained unchanged in 18. The symptom improvement rate of medication group was significantly higher than that of non-medication group(P0.05). In 62 subjects who modified their life styles and diet habits, 53 of them had their symptoms improved (85.5%), and 9 of them had their symptoms unchanged (14.5%). Among 98 patients who underwent endoscopic examination, 44 were found to have erosive esophagitis, and were diagnosed as reflux esophagitis(RE). Although the other 54 subjects complained of typical "heart burn" and regurgitation symptoms, no erosive esophagitis was found with endoscopy, and they were regarded designated as having non-erosive reflux disease(NERD). The symptom improvement rate of NERD group was significantly higher than that of RE group(P

Objective To investigate the relationship between colonic dynamic abnormality and psychological factors in elderly patients(EP) with chronic idiopathic constipation(CIC). Methods 59 elderly patients with CIC and 36 elderly healthy subjects(EHS) were analysed. Total and segmental colonic transit times were assessed radiographically using radiopaque markers method. All subjects completed a self-rated inventory assessing psychological distress including depression(SDS) and anxiety(SAS). Results (1)Total and segmengal colonic transit times were significantly prolonged in elderly patients with CIC than in EHS (P

To investigate the expression of ICAM 1 and TNF ? in gastric mucosal cell during drug induced mucosal injury, the authors carried out the study in SD rats with aspirin by mouth with immunohistochemical method . The results showed that ICAM 1 began to express at 30min after administration of aspirin, peaked at 1h, maintained until 6h, decreased at 12h,and expressed slightly at 24h . TNF ? began to express at 15min, peaked at 3h to 6h,decreased at 12h, and expressed significantly at 24h. There was a slight ICAM 1 and TNF ? expression in gastric mucosal cells in the control group. It was suggested that the expression of ICAM 1 and TNF ? plays an important role in the mechanisms of gastric mucosal injury .

Objective To study the clinical features of acute pancreatitis (AP) in elderly patients. Methods The elderly AP patients from January 1993 to October 1999 in our hospital were studied retrospectively. Results There are 83 cases with a male to female ratio of 1 5∶1 and a median age of 72 7 years.AP was diagnosed in 83 cases for 107 times which included 80 times of mild AP and 27 times of severe AP 13 patien with APts were diagnosed for more than one times.Abdominal pain was the primary symptom in 94 4% patients. 6 patients had no pain 53 0%(44/83) and 84 6%(11/13) patients had cholelithiasis and recurrent AP respectively.60 5% and 72 6% patients were diagnosed by type B ultrasonic and CT respectively . Conclusions In elderly AP patients,abdominal pain was the primary symptom, but a part of patients had no typical symptoms.Cholelithiasis including biliary sludge was an inducement especially in recurrent AP patients. Type B ultrasonic and CT examination were important means in diagnosis.

Objective To investigate the relationship of gastric pH value with intragastric bacterium and pulmonary infection in rats at different ages.Methods Thirty Wister rats were divided into three groups: young control group, senile group garaged with saline and young omeprazole group garaged with omeprazole (30mg/kg/d). The gastric pH value was measured after two weeks, and bacterial culture of gastric and lung tissues were done and the pathological sections of lung tissues were made.Results The gastric pH (2. 450±1. 344), number of intragastric bacterium (5. 579±4. 316) cfu/g and number of pulmonary bacterium (1. 617±3. 509) cfu/g in senile group had no differences compared with young control group [(2. 010±0. 507), (1. 505±3. 259)cfu/ g, (0. 475±1. 503)cfu/g, respectively, all P>0. 05]. The differences in gastric pH value, number of intragastric bacterium and number of pulmonary bacterium had statistical significances between young omeprazole group and young control group [(5. 560±1. 007)vs. (2. 010±0. 507), (9. 942±1. 663) cfu/g vs. (1. 505±3. 259)cfu/g, (6. 272±3. 830) cfu/g vs. (0. 475±1. 503)cfu/g, all P<0. 01]. The lung tissues were slightly infiltrated with lymphocytes both in young control group and senile group, and 30% of rats in young omeprazole group had pulmonary infection.Conclusions The number of intragastric bacterium and pulmonary bacterium is increased with the increasing of the gastric pH value, and the pulmonary infection becomes heavier in these rats. But the number of intragastric bacterium and pulmonary bacterium and the pulmonary inflammation have no changes with the increasing of age.