Objective To explore the clinical features and perioperative treatment effects of colorectal cancer in elderly patients.Methods Retrospective analysis of clinical data especially focusing on perioperative treatment from 104 elderly patients with coloreetal cancer were performed.Results A total of 99 patients (95.2%) were cured or improved at discharge.Perioperative pulmonary infection occurred in 13 cases (12.5%), of whom 6 cases (5.8%) suffered from respiratory failure.Lower extremity deep venous thrombosis occurred in 3 cases (2.9%), incision infection in 6 cases (5.8%), wound dehiscence in 2 cases (1.9%), intestinal fistula in 1 case (1.0%) and gastroparesis in 1 case (1.0%).About 5 cases (4.8%) died from multiple organ failure.Conclusions Old age is not a contraindication in surgical treatment for colorectal cancer.Paying attention to accurate and timely treatment in perioperative peroid can reduce postoperative complications and improve patients' quality of life.

Objective To observe the efficacy of early application of continuous venovenous hemofiltration (CVVHF) in elderly patients with contrast-induced acute kidney injury (AKI) .Methods A total of 36 elderly inpatients with contrast-induced AKI were randomly divided into two groups:CVVHF group (n= 18) and routine treatment group (n = 18).The renal function, the incidences of contrast-induced nephropathy (CIN), in-hospital events (pulmonary edema, myocardial infarction and shock), temporary renal-replacement therapy and in-hospital mortality were observed.Results The incidence of CIN was higher in routine treatment group than in CVVHF group [88.9% (16/18) vs.16.7% (3/18), P<0.05].Temporary renal-replacement therapy was required in 13(72.2%) patients of routine treatment group and in 2(11.1%) patients of CVVHF group (P<0.05).The rate of in-hospital events was higher in routine treatment group than in CVVHF group [83.3%(15/18) vs.22.2% (4/18), P<0.01].In-hospital mortality rate was higher in routine treatment group than in CVVHF group [16.7%(3/18) vs.5.6%(1/18), P>0.05].Conclusions Early application of CVVHF in patients with contrast-induced AKI after percutaneous coronary intervention appears to be effective in preventing the deterioration of renal function, and it could improve in-hospital outcomes.

Objective To analyze the antibiotic resistance of clinical isolated bacteria in elderly inpatients in Beijing Hospital from 2006 to 2008.Methods A total of 5710 strains isolated from elderly inpatients received antibiotic sensitivity test (AST) by using K-B method, and the data were analyzed with WHONET 5.4 software.Results During the 3 years, in constituent ratio of bacteria, P.aeruginosa, E.coli and Stenotrophomonas maltophilia were at the top of gram-negative bacteria.And S.aureus, coagulase-negative Staphylococcus (CONS), S.pneumoniae and Enterococcus spp.were at the top of gram-positive bacteria.The results of AST in vitro showed that 19 of 121 strains of S.pneumoniae were penicillin-insensitive S.pneumoniae (PNSP).In 690 strains of S.aureus, the methicillin-resistant S.aureus (MRSA) ratio was 80.2%, and vancomycin-insensitive strains were not found.And 114 strains of Enterococeus faecalis and 95 strains of Enterococcus faecalis were isolated, while the antibiotic resistance of the latter was stronger than the former, and 19 strains were vancomycin-resistant strains.The detection ratios of E.colt producing ESBLs were 41.7%, 55.0% and 56.8%, and the detection ratios of Klebiella pneumonia producing ESBLs were 16.0%, 22.4% and 27.3 %.The antibiotic resistance of ESBL-producing bacteria was much stronger than non-ESBLs producing bacteria.Multi-antibiotic resistant strains of Pseudomonas aeruginosa and Acinetobacter spp.were found.Conclusions It is necessary to detect the drug-resistant strains periodically for understanding the changes in bacterial resistance and providing a theoretical basis for the medication by the clinical experience.

Objective To discuss the uhrasonography and hemodynamic characteristics of carotid atherosclerosis in elderly patients with coronary heart disease (CHD).Methods The 548 people were divided into CHD group (n = 373) and control group (n = 175) by the coronary angiography.And the patients in CHD group were sorted into myocardial infarction (MI) group (n= 160) and non-MI group (n= 213).All patients were above 60 years of age, and underwent carotid artery ultrasound examination.The data of carotid sonography and hemodynamics were classified and analyzed using SPSS 10.0 software.Results The carotid intima-media thickness (IMT), plaque thickness and score were much more in CHD group than in control group [(0.96±0.24) mm vs.(0.78±0.11) mm, (1.90±0.36) mm vs.(1.66±0.13)mm, (2.2±0.7) vs.(1.9±0.4), t= 14.81, 27.89 and 27.83, all P=0.00].A total of 161 (43.2%) patients had atherosclerotie plaques in CHD group, and there were 7 (4.0%) people with plaques in healthy control group(χ~2 =337.18, P =0.00).And there were 81.3% of patients with plaques in MI group, it was more than non-MI group, in which there were 12.9% of patients with plaques (χ~2 =60.88, P=0.00).The carotid peak systolic velocity (PSV) and resistance index (RI) were both higher in CHD group than in control group [(77.0±11.9) cm/s vs.(65.2±3.1) cm/s and 0.77±0.06 vs.0.67±0.08, (t= 12.26 and 50.43, P=0.00)].Conclusions Carotid ultrasonography could evaluate not only CHD, but also CHD severity in the elderly.

Objective To assess the accuracy and repeatability of real-time three-dimensional eehoeardiography (RT-3DE) for the measurements of left ventricular (LV) mass in elderly patients compared with magnetic resonance imaging (MRI).Methods A total of 31 patients (26 men) aged ≥60 years (72.1±6.6) years with various cardiovascular diseases were evaluated by MRI and RT- 3DE on the same day.RT-3DE was performed with a Philips iE-33 echocardiographic system, and LV mass was analyzed with the assistance of TomTec software.The results of LV mass obtained by manual tracing were compared with Signa 1.5-T MRI data.The acquisition of RT-3DE datasets was feasible in all 31 patients.Results A good correlation was observed between RT-3DE data with manual border detection and MRI for LV mass (r=0.869, y=0.943 x+11.69, SE= 19.09 g, P< 0.01), with a mean difference of (4.7±37.7)g.The average LV mass was (123.9±35.0)g (74.4-208.1 g) evaluated by MRI, and was (128.6±37.9)g (67.0-222.9 g) evaluated by RT-3DE.There was good inter- or intra-observer correlation between RT-3DE by two sonographers for LV mass.Conclusions The assessment of LV mass from RT-3DE data is feasible in elderly patients.The mass can be determined with high accuracy and low interobserver variability in elderly patients with adequate eehocardiographic image quality.

Objective To investigate the relationship between fasting plasma glucose (FPG) level and insulin secretion in normal glucose tolerance (NGT) subjects.Methods Totally a community-based population of 2095 residences aged above 30 years received oral glucose tolerance test (OGTT), and was classified according to FPG and 2-hour plasma glucose (2 hPG) into NGT group, impaired glucose tolerance (IGT) group, impaired fasting glucose (IFG) group, both IGT and IFG (IFG/IGT) group and diabetes mellitus (DM) group.The subjects in NGT group were further divided into 6 groups according to age and FPG separately, the HOMA β-cell function index (HBCI) was compared among the groups.Results For the patients in NGT group, the FPG level was higher in group aged 60-69 years than in group aged 50-59 years [(5.17±0.48)mmol/L vs.(5.09±0.44)mmol/L, P<0.05], and was also higher in group aged 50-59 years than in group aged 40-49 years [(5.09±0.44) mmol/L vs.(5.00± 0.47) mmol/L, P<0.01].A decreasing tendency of HOMA-β and fasting insulin level with age could be observed with statistical significance.The HBCI was lower in NGT group with FPG above 5.0 mmol/L than with FPG below 5.0 mmol/L (4.22±0.70 vs.4.39±0.58, P<0.05).HBCI was negatively correlated with age as the main factor.Conclusions In NGT subjects, the FPG increases with age and there may be abnormality of insulin secretion in subjects with FPG higher than 5.0 mmol/L.

Objective To realize and analyze the current status of medical treatment for benign prostatic hyperplasia in special clinic for elderly in China.Methods The informations were gathered from 34 clinics for elderly located in 11 Chinese cities from February 2008 to September 2008.First, all male patients who visited the clinic were inquired about their history of benign prostatic hyperplasia , and then 1000 benign prostatic hyperplasia patients who were receiving medical treatment were selected to finish a detailed questionnaire and to get several examinations for benign prostatic hyperplasia.Results Among the 1000 patients, 774 completely finished the questionnaire, patients with middle or severe international prostate symptom score (IPSS) and with high volume of prostate occupied a large proportion.Medical treatments included the combined therapy of α-blockers plus 5α reductase inhibitors (45.48 %), α-blockers (36.30%), 5α reductase inhibitors (13.05 %) and other medicines (including phytotherapeutic agents and traditional medicines, 5.17%).Conclusions Nowadays in China, as to the prescription for benign prostatic hyperplasia in the clinic for elderly presents, doctors only concentrate on the improvement of symptoms, whereas ignore the progression of the disease.There is still a considerable gap between real medical treatment and international guidelines.Therefore, improvements of medical treatment are still needed in the future clinical practice.

Objective To evaluate the impact of depression on 5-year survival rate of elderly patients with chronic obstructive pulmonary disease (COPD).Methods From January 2002 to June 2004, a total of 401 elderly inpatients with COPD were enrolled.They were assigned into two groups according to their HAD-D scores: depression group (HAD-D scores≥8) and non-depression group (HAD-D scores<8).The follow-up time was 5 years.Results The 5-year survival rate was lower in depression group than in non-depression group (log-rank test, χ~2 = 6.94, P<0.01).Depression was independently associated with mortality in elderly patients with COPD (HR: 1.84, 95% CI: 1.08 to 3.11).Conclusions Depression in elderly COPD patients is associated with poor 5-year survival rate, and it is an independent influencing factor of 5-year mortality.

Objective To investigate the endothelial function and atherosclerosis in patients with coronary artery disease (CAD).Methods Two-dimensional echocardiography (2-DE) was used tomeasure changes in brachial artery inner diameter as parameter of endothelium-dependant and endothelium-nondependant vascular diastolic function and pathologic characters of carotid atherosclerosis in 90 elderly CAD patients and 30 controls.Results Endothelium-dependant vascular diastolic function and endothelium-non dependant diastolic function were significantly decreased in CAD group as compared with control group [(9.08±2.28)% and (6.14±2.21)% vs.(15.58±2.20)%, P<0.01].The carotid intima-media thickness and plaque score were significantly increased in CAD group as compared with control group.Conclusions There are correlations of endothelium dysfunction and carotid atherosclerosis are relatied to with coronary atherosclerosis.

Objective To evaluate the efficacy and safety of use of platelet membrane glycoprotein (GP) Ⅱ b/Ⅲ a inhibitor tirofiban for percutaneous coronary interventional (PCI) in elderly patients with acute ST segment elevation myocardial infarction (STEMI).Methods A total of 120 elderly patients who suffered from STEMI and underwent PCI were selected from July 2007 to November 2009.The patients were randomly assigned to control group, standard-dose tirofiban group and low-dose tirofiban group.We observed coronary blood reflow, the bleeding complication, coagulation factor(TF,vWF) and cell adhesion molecular(sICAM-1 and sVCAM-1).Results Total 116 patients accomplished this study (control group: 38 cases; standard-dose group: 39 cases; low-dose: 39 cases).The percentages of TIMI 3 flow after PCI were higher in the two tirofiban groups than in control group (P<0.05).The incidences of bleeding complications in both tirofiban groups (12.8%,5.1%) were higher than that in control group (2.6%, P<0.05).The concentration of TF, vWF,sICAM-1 and sVCAM-1 were lower in both tirofiban groups than in control group(P< 0.05).Conclusions GP Ⅱ b/Ⅲ a inhibitor tirofiban can benefit the elderly patients with STEMI referred for PCI therapy, low-dose tirofiban may offer almost the same level of efficacy as standard-dose, with less associated bleeding.