Objective:To compare the efficacy and safety of octreotide and somatostatin in the treatment of liver cirrhosis and up-per digestive tract hemorrhage. Methods:The randomized controlled trails ( RCTs) on the comparison between octreotide and soma-tostatin in the treatment of liver cirrhosis and upper digestive tract hemorrhage were searched from Cochrane Library, PubMed, Med-line, Embase, China National Knowledge Infrastructure(CNKI), VIP China Science and Technology Journal Database and Wanfang database (till February 2017). The randomized controlled trails meeting the inclusion criteria were collected and the quality of included RCTs was assessed according to the Cochrane Collaboration system review, and then Meta -analysis was performed using RevMan 5. 3 software after data extraction and bias risk assessment. Results:A total of 11 RCTs were included. Meta-analysis showed the efficacy of octreotide group was similar to that of somatostatin group (OR=1. 10, 95%CI:0. 79-1. 53, P=0. 56). The levels of blood transfu-sion and hemostasis of octreotide group were higher than those of somatostatin group (MD=0. 68, 95%CI:0. 54-0. 82, P<0. 01 and MD=6. 26, 95%CI:4. 89-7. 63, P<0. 01). The risk of abdominal pain in octreotide group was lower than that in somatostatin group (OR=0. 43, 95%CI:0. 22-0. 86, P=0. 02). The other adverse reactions were similar in both groups. Conclusion:The efficacy of octreotide is similar to that of somatostatin in the treatment of liver cirrhosis and upper digestive tract hemorrhage, and the effect of som-atostatin is quicker than that of octreotide with less blood transfusion. The adverse reactions are similar in both groups, except that oct-reotide has a lower risk of abdominal pain. The long-term safety of octreotide still needs to be confirmed by performing higher quality and large-sample RCTs.

Frailty is a distinct clinical syndrome wherein the individual has low reserves and is highly vulnerable to internal and external stressors. Although it is associated with disability and multiple comorbidities, it can also be present in individuals who seem healthy. Frailty is multidimensional and its pathophysiology is complex. Early identification and intervention can potentially decrease or reverse frailty, especially in the early stages. Primary care physicians, community nurses and community social networks have important roles in the identification of pre-frail and frail elderly through the use of simple frailty screening tools and rapid geriatric assessments. Appropriate interventions that can be initiated in a primary care setting include a targeted medical review for reversible medical causes of frailty, medication appropriateness, nutritional advice and exercise prescription. With ongoing training and education, the multidisciplinary engagement and coordination of care of the elderly in the community can help to build resilience and combat frailty in our rapidly ageing society.
Aged ; Aging ; Community Health Services ; Frail Elderly ; Frailty ; Geriatric Assessment ; methods ; Geriatrics ; methods ; Humans ; Nurses ; Nursing ; Primary Health Care ; methods ; Social Support