4 ml, which was 45.1% (23 of 51)(?2=20.7, P4 ml were 3.8% (4 of 105) and 29.4% (15 of 51) respectively, with statistically significant difference between the two groups (?2=21, P68Gy was 81.3% (65 of 80), and group ≤68Gy 56.6% (43 of 76)(?2=11.1, P

5 ml groups were 95.5% and 81.1% respectively. This difference was statistically significant (P5 ml groups were 4.5 % and 32.1%, respectively (P50 Gy was increased statistically, but the occurrence of complications was also increased. Conclusions Stereotactic radiosurgery improves the outcome of the elderly patients with brain metastases. Radiation dosage and tumor volume are significantly related with the therapeutic efficacy and the occurrence of complications.

Objective To study the regularity of occurrence and development in the elderly with AAA. Methods Twenty-seven elderly cases with abdominal aortic aneurysm(AAA) were analyzed and followed up with ultrasound for ten years. Results The AAA diameters were 2.5 ~6.6 cm,with the average in crease of(0.14 ? 0.01) cm/ year. Intraluminal thromi(ILT) were found in 63.0% of all the patients. ILT were found(3.9?2.0 ) years after the AAA diagnosis with the average in crease of(0.21 ? 0.05)cm / year. Conclusions The size of AAA in the elderly is slowly enlarged to varying degree with ageing. ILT are found in more than half of all the patients. A few cases of AAA are found ruptured and a few cases of ILT exfoliated.

Objective To investigate the manifestation and the prevention means of video display terminal (VDT) visual fatigue in old people. Methods Conventional eye inspection were performed for 45 patients, including optical muscle movement, position of eye, confluence function and presbyopia. Results We found that the average difference between middle distance correcting lens and 33 cm reading distance from presbyopia correcting lens was about 0.52 DS( P

ObjectiveTo investigate the visual condition and causes of blindness and low vision of ov er 60 years old people found by routine physical examination. Methods A total of 892 cases over 60 years old people took a yearly routine examinatio n, such as far and near vision in daily life, anterior segment and fundus of the eye and intraocular pressure. If the vision were under 0 3, the refractive vis ion needs to be corrected. The blindness and low vision patients were selected a nd taken further related examinations to analyse statistically the causes of bli ndness. Results Among 892 cases investigated, blindness together with low vision were 42 cases (4 71%). The morbidity rate of blindness and low vision were 1 01% (9 cases) a nd 3 70% (33 cases) respectively. Diseases caused blindness were macular lesio ns (57 14%), glaucoma(11 91%), cataract (9 52%), retinal diseases, optic nerv e atrophy, keratopathy etc. Refractory eye diseases were obviously more than t he eye diseases which can be treated. The morbidity rate of over 80 years old pe ople were obviously more than that of under 80 years group. Conclusions With ageing, the old people easily suffer from eye diseases and results in bli ndness. For the prevention and treatment of blindness for the elderly, much atte ntion to treatment of eye diseases should not only paid, active training is also important.

Objective To evaluate the efficacy and safety of the damage-controlling surgery for the elderly patients with obstructive biliary diseases. Methods 278 elderly patients with obstructive biliary diseases were divided into the damage-controlling surgery group and definite surgery group.The obstructive biliary diseases were divided into the benign obstructive group and the malignant obstructive group. The complication rate and mortality between the 2 groups were analyzed and compared. Results One hundred and eighteen elderly patients were treated by damage-contolling surgery, its complication rate was 9.32 % and the mortality was 0 %. One hundred and sixty elderly patients,were treated by definite surgery, its complication rate was 24.38%, the mortality was 6.88%. There were significant differences in complication rate and mortality between the damage-controlling surgery group and the definite surgery group (all P＜0.01). The complication rate of the benign obstructive diseases group treated by damage-controlling surgery was 17.3%, the mortality was 0%. The complication rate of the benign obstructive diseases group treated by definite surgery was 16.3%, the mortality was 4.34%. There was no significant difference in the complication rate and mortality between the 2 groups (all P＞0.05). The complication rate and mortality of the malignant obstructive biliary diseases group treated by damage-controlling surgery were 4.45% and 0% respectively, and were 35.29% and 10.29% by definite surgery, there were significant differences in the complication rate and mortality between the 2 groups (P＜0.01 and P＜0.05). Conclusions Damage-controlling surgery may decrease the complication rate and mortality of the elderly patients with obstructive biliary diseases, and improve the operation safety of the elderly patients.

Objective To investigate the vision and the eye conditions of the longevous aged 90 years or over Methods The vision was examined by Snellen chart, and the outer eye, anterior segment, fundus and intraocular pressure were examined by slit lamp, funduscope and non contact tonometer in 135 longevous cases Some related examinations were adopted on suspective cases The refractive errors were corrected in 53 cases who were cooperative to examination Results The visions of right eyes were 0 01～1 0 with the average of 0 46?0 50, and the left eyes were 0 03～1 0, with the average of 0 49?0 50. The probabilities of blindness and low vision were 5 93% and 10 27% respectively. In 43 cases (81 13%)the vision increased by 1～5 lines (the average in 3 lines)after optometry compared with pre optometry ( P

Objective To assess the value of endoscopic ultrasonography (EUS) and abdominal CT scan on preoperative T and N staging of advanced gastric cancer.Methods A total of 188 patients with advanced gastric cancer received EUS and CT scan to evaluate the T and N staging and lymphatic metastasis before surgical operation.The postoperative pathologic results acted as gold standard for comparison of the two methods.The results consistent with pathologic results were considered as correct otherwise were incorrect.The accuracy of EUS and CT and the each consistency of two methods with pathology were analyzed.Results For T staging, the accuracy of EUS and CT was 87.2%(164/188), 76.6%(144/188), respectively, and Kappa value of EUS and CT was 0.726 and 0.509, respectively.There was a statistical difference between the two methods(χ2=7.181,P=0.007).For lymph node metastasis, the accuracy of EUS and CT was 72.9%(137/188) and 79.8%(150/188), respectively, and Kappa value of EUS and CT was 0.397 and 0.487, respectively.No statistical difference was found between them(χ2=0.963,P=0.326).The consistency test between the two methods for T and N staging and lymph node metastasis revealed that the Kappa value was 0.507 and 0.649, respectively.The accuracy of EUS on T staging was 93.0%, 93.3%, 96.8% and 91.5% in cardiac cancer, gastric fundus cancer, gastric corpus cancer, and gastric antrum cancer, respectively.Corresponding Kappa value in the 4 different positions were 0.843,0.881,0.940 and 0.710, respectively according to consistency tests.The accuracy of gastric antrum cancer with pylorus invasion was 63.2% and the consistency test Kappa value was 0.340.Conclusion EUS is an accurate method for T staging and lymphatic metastasis of advanced gastric cancer, but there is a lower accuracy for T staging of gastric antrum cancer with pylorus invasion.

Objective　To evaluate the direct economic costs of four major kinds of nosocomial infections such as nosocomial pneumonia,urinary tract infection, deep surgical wound infection and intracranial infection. Methods　A matched case-control study was conducted among 95 pairs of hospitalized patients to investigate the direct economic costs of nosocomial infections. Results　The average medical cost for patients in the case group was 38 741 RMB Yuan, 20 365 Yuan more than that in the control group patients (P＜0.000 1). The largest part of extra costs was found in drug expenses, taking up 62.07%, while other extra costs such as non-drug therapies, blood transmission and laboratory examinations, accounted for 10.32%, 7.40% and 5.72% respectively. Extra economic burden caused by nosocomial infections varied in different degrees with different departments, with the heaviest found in the department of tumourology and hematology at an average extra cost of 34 944 Yuan. The average extra charges in case group caused by nosocomial pneumonia,urinary tract infection, deep surgical wound infection and intracranial infection were 31 940 Yuan,7 436 Yuan,17 332 Yuan and 17 349 Yuan respectively. The average length of hospital stay was 50.57 days in case group and 25.22 days in control group, showing a 25.53 extra days (P＜0.000 1) of hospitalization due to nosocomial infections. Conclusion　Nosocomial infections had significantly added to the economic burden of managing the underlying diseases, led to prolonged hospitalization of the patients and lowered the turnover rate of hospital bed. There is a need to call for better infection control program, which would bring tremendous social and economic profits.

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.