Objective To observe clinical therapeutic effect of treating insomnia by moxibustioning Balhui (DU20)and Sisbencong(EX-HN 1) . Methods 276 cases of insomnia were divided into treatment group and control group. The treatment group was treated by moxibustioning on Baihui (DU 20) and Sishencong(EX-HN 1); while the control group was treated by moxibutioning on Zusanli (ST 36). Evaluate the therapeutic effects and PSQI index of the two groups. Results Clinical symptoms got improvement in the both groups. The treatment group was better than the control group in terms of therapeutic effect of the (P＜0.05) and the improvement of PSQI (P＜0.01). Conclusion Moxibustioning on Baihui(DU 20)and Sishencong (EX-HN 1) has a good therapeutic effect for insomnia.

Objective To evaluate the patient's health care demands in communication,diagnosis,treatment and medical counseling of geriatric BPH outpatients in China.Methods A survey study was carried out in 33 medical centers from 11 different cities in China (North:Lanzhou,Beijing,Shenyang; South:Chengdu,Changsha,Wuhan,Jinan,Nanjing,Hangzhou,Shanghai,Guangzhou).2027 BPH outpatients aged (60 years participated in the survey to measure their health care demands using a questionnaire.Results There were 955 cases (47.1％) thinking communication is necessary before inspection items by a doctor,807 (39.8 ％)thinking communication is necessary before determining the treatment program,389 cases(19.2％) thinking respection items by a doctor is necessary,730 cases(36.0％)the treatment program by a doctor is necessary,849 cases (41.9 ％)thinking health guidance on BPH dignosis is necessary,934 cases (46.1 ％)thinking health guidance on BPH treatment is necessary,The multilevel model showed the demands scores data is similarity among the north and the south.And the patients with more severe lower urinary tract symptoms have more demands on communication and medical counseling.Conclusions It is to get better therapy,considering the patient's health care demands.

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 diagnostic and therapeutic status of lower urinary tract symptoms(LUTS)/benign prostatic hyperplasia (BPH) (LUTS/BPH) in outpatient department for elderly patients, and to understand the patients' attitude and knowledge on the disease. Methods The investigation was conducted in 34 outpatient departments for elderly patients located in 11 cities from February to September 2008. The male patients who came to the clinic during the survey time were investigated whether they had LUTS /BPH history or not. Then some eligible patients were chosen to accept a more detailed questionnaire and BPH-related examinations. Results There were 31371 male patients who came to the clinic. 47.0% of them (14748 cases) had the history of LUTS / BPH, and 72.4 % (10678 cases) had medical or surgical treatments presently or previously, whereas 27.6% were untreated. The three most commonly performed examinations in clinical practice were urinalysis, prostate specific antigen (PSA) and transabdominal ultrasonography. In 3542 patients receiving medical investigation, 32.6% (1155 cases) were given 5a reductase inhibitor, and 35.0% (1239 cases) received a combination therapy of 5a reductase inhibitor plus a receptor blocker. 84.5 (1796 cases) and 79.0% (1678 cases) of all the patients were satisfied with the examinations and treatments respectively. Conclusions LUTS and BPH are common in outpatient department for elderly patients. There are discrepancies of examinations and medical treatments between real medical practice and international suggestion, and the patients' understanding of the disease should be improved

Objective To study the present situation of benign prostatic hyperplasia (BPH) of male patients in geriatrics department. Methods Two thousand one hundred and twenty-five patients aged 60 years and above with BPH in geriatrics department of Chengdu, Lanzhou, Hangzhou, Wuhan, Changsha, Guangzhou, Shenyang, Shanghai, Nanjing, Jinan and Beijing were investigated using stratified cluster random sampling method. Results The constituent ratio of patients with benign prostatic hyperplasia in geriatrics department was 47.0%, and the proportions of the elderly of 60～,70～ ,80～ years old among the patients with benign prostatic hyperplasia were 18.1%,49.4 and 32.5%, respectively (x2 = 83.68, P<0.001). There was a significant difference in the occupation distribution of BPH constituent ratio: 66.4% for staffs of state organs, 18.0% for professional technical personnel and 14.7% for works and peasants (x2=410.27,P<0.001). The international prostate symptom scores (IPSS) were different among different cities (x2=101.00, P<0. 001 ). Logistic regression analysis showed that the IPSS was correlated with age and profession (age: OR= 1.029;worker and peasant as control group, working staff of state organs OR=O.707, professional technical personnel OR=0.339 ). Conclusions The benign prostatic hyperplasia is a common disease in male elderly patients in China, but the consultation rate is low. The IPSS of benign prostatic hyperplasia is correlated with age and profession. Prevention and treatment of benign prostatic hyperplasia in the elderly should be strengthened.

Objective To evaluate the demands of patients with benign prostatic hyperplasia (BPH) and its influencing factors. Methods One thousand five hundred and twenty-seven patients (≥60 years old) with BPH in 26 hospitals of 9 cities were selected in the study by using stratified random sampling method. The demands of patients with BPH and its influencing factors were evaluated by rank sum test and rank correlation analysis. Results In 1527 BPH patients, most patients thought that doctors' communication with them before opening examination items (1297/ 1527,84.9%),health guidance for BPH progress(1310/1527,85.8%), BPH diagnosis(1279/1527, 83.8 %) and BPH treatment(1329/1527,87. 0%) were necessary. Doctors'communication with them before opening examination items, health guidance for BPH progress, BPH diagnosis and BPH treatment showed significant statistical difference among patients with different age, medical care, the lasting time of clinical symptoms, diagnosis time, international prostate symptom scores and quality of life scores (all P<0. 05). While in patients with different nation, retirement status, marital status, living style and average family income, there were no significant statistical difference in needing the doctors'communication with them before opening examination items, health guidance for BPH progress, BPH diagnosis and BPH treatment(all P>0.05). Conclusions Patients with BPH have a higher demand for treatment. The demand degree is related with age group, health care, the lasting time of clinical symptoms, diagnosis time, international prostate symptom scores and quality of life scores. Most patients have desire to accept health guidance.

Objective To investigate the associations of cognitive function with apolipoprotein E (APOE) gene polymorphism and chronic diseases among long-lived people in Zhongxiang City of Hubei Province.Methods A total of 110 long-lived elderly residents aged 90 years and over were collected.Their cognitive function was determined face-to-face using questionnaires by trained interviewers.According to mini-mental state examination(MMSE) scores,subjects were divided into a no dementia risk group and a high dementia risk group.General demographic characteristics,activities of daily living,depression state and nutrition status were compared between the two groups.Correlations of dementia with APOE gene polymorphism and chronic diseases were analyzed.Results The average MMSE score was 22.3±4.8.Among the 110 long-lived people,18 cases had a high risk for dementia,accounting for 16.4％,and 92 cases had no risk of dementia,accounting for 83.6％.The risk of dementia in long-lived elderly people was correlated with activities of daily living,mental state,nutritional status and falls(all P＜0.05).There were 8 cases with the APOE gene ε4/ε3 genotype in the high dementia risk group and 16 cases with the APOE gene ε4/e3 genotype in the no dementia risk group,with the former group showing a higher frequency of the APOE ε4/ε3 genotype (44.4％ vs.17.4％,x2 =6.46,P＜0.05).The former group also seemed to have a higher APOE ε4 frequency,but the difference was not statistically significant(22.2 ％ vs.10.3 ％,x2 =3.96,P =0.055)Chronic diseases prevalent in the long-lived people were hypertension(86 cases,78.2 ％),hearing loss (72 cases,65.5％),hyperlipidemia(56 cases,50.9％),anemia(43 cases,39.1％),impaired vision(39 cases,35.5 ％),chronic kidney diseases(25 cases,22.7 ％),chronic heart diseases (18 cases,16.4 ％) and osteoarthritis(18 cases,16.4％).No correlation was found between the risk of dementia and chronic diseases(P＞0.05).Conclusions Cognitive function is highly correlated with activities of daily living,mental state and nutritional status among long-lived elderly people in Zhongxiang City.The risk of dementia has a correlation with the APOE gene e4/e3 genotype but not with chronic diseases in long-lived people.

The elderly are a special group, with their unique pathophysiology and disease characteristics.The measures and goals of diagnosis and treatment for the elderly are different from those for children, young and middle-aged people.Taking into consideration of the national and international literature, the insight from our long-term clinical practice and in-depth reflections, the authors have written this article as a reference for our colleagues in geriatric care.

BACKGROUND: With social development, the average life span is prolonged. The issue of aging has increasingly attracted people's attention. It is necessary to promote the health status and the guality of life of the elderly..OBJECTIVE: To understand the status and distribution features of several common diseases which influence the quality of life of elderly.DESIGN: Random cluster sampling methods and a cross-section survey.SETTING: Beijing Institute of Geriatrics of Beijing Hospital.PARTICIPANTS:Totally 1 558 old people aged ≥60 years living in 10 communities affiliated to Jianguomen district office of the Eastern District of Beijing City,and 8 villages affiliated to Xiangyang and Henan Villagers'Commissions of Shunyi County of Beijing from May 1997 and October 1997 were recruited.In fact,1 434 persons responded,with a response rate being 92％,319 males and 498 females came from the city;242 males and 375 females came from the villages.METHODS:Questionnaires were filled up,and physical examinations were conducted in all the elderly. MAIN OUTCOME MEASURES: The 6 common diseases were observed among the elderly: Hyperplasia of prostate, abnormal audition, cartaract ,osteoarthritis, fracture and constipation.RESULTS:Totally 1434 elderly entered the stage of result analysis.①The incidence of hyperplasia of prostate in the males from the urban areas was lower than that in the rural areas (61.4％,65.7％, P ＜ 0.01 ). ② The incidence of abnormal audition among the elderly from the urban areas was lower than that in the rural areas (53.9％,64.7％,P ＜ 0.01).③ The incidence of cataract of the two eyes in the elderly from the urban areas was higher than that in the rural areas(46.4％,44.4％, P ＜ 0.01). ④ The incidence of osteoarthropathy in the elderly from the urban areas was higher than that in the rural areas (24.4％,14.9, P ＜ 0.01). ⑤ The incidence of fracture in the elderly from the urban areas was higher than that in the rural areas (14.2％,9.1％, P ＜ 0.05). ⑥ The incidence of constipation of the elderly in urban areas was lower than that in the rural areas(18.2％,23.0％,P ＜ 0.05).CONCLUSION:There is a difference between the elderly from the urban areas and the rural areas in hyperplasis of prostate,abnormal audition, cataract, osteoarthropathy, fracture and constipation, and this is related with the economy, nutrition, medical conditions and cultural traits.Therefore, attention should be attached to nutrition and health knowledge of the elderly and prevention and treatment of common diseases among the elderly people.

Objective:To evaluate the effect of procalcitonin(PCT)guiding anti-infection therapy on the prognosis of elderly patients.Methods:By searching PubMed, EMBASE database, Cochrane library, Cochrane clinical trial center registry and SinoMed database in Chinese, we searched for a randomized controlled clinical(RCT)study on the effect of PCT-guided anti-infection treatment on the prognosis of elderly patients, which was conducted according to the PRISMA statement.The main purpose of the study was to evaluate the time of antibiotic application.Results:After retrieval, 9 RCT clinical studies were finally included, involving 2 702 elderly patients, with an average follow-up of 3.5 months(1-12 months). The average age was(71.3±8.9)years old, with 52.8% of males and baseline levels of white blood cell(WBC)was 12.9×10 9/L, C-reactive protein(CRP)was 18.9 mg/L, PCT was 0.38 μg/L.Compared with conventional anti-infective therapy, PCT-guided anti-infective therapy can reduce the antibiotic application time of elderly patients[standard mean difference( SMD)=-2.39 days, 95% CI(-4.03, -0.75)days, P=0.004]. However, PCT-guided anti-infection treatment had no significant effect on the length of hospital stay[ SMD=-0.46 d, 95% CI(-0.05, 0.14)d, P=0.135], the rate of reinfection[ RR=0.87, 95% CI(0.73, 1.03), P=0.105]and the risk of all-cause death[ RR=1.02, 95% CI(0.80, 1.31), P=0.863]. Conclusions:PCT-guided anti-infection treatment can reduce the time of antibiotic application in elderly patients, but other clinical effects need to be verified by more large-scale studies