Community acquired pneumonia(CAP)is characterized by high morbidity and mortality in immunocompromised patients, with the elderly as the main vulnerable population.However, current guidelines in China and elsewhere do not offer specific recommendations on the diagnosis and treatment of such patients.This paper reviews the definition, classification, epidemiology, etiological characteristics, clinical manifestations, diagnosis, treatment and prognosis of CAP in immunocompromised elderly patients, to provide a theoretical framework for its diagnosis and treatment and for the formulation of guidelines.

Aspiration is the entry of oropharyngeal or gastric contents into the lower respiratory tract through the glottis, a common and important cause of death in elderly patients due to lung infections.However, a lack of accurate and rapid clinical methods for the diagnosis of aspiration leads to misdiagnosis, missed diagnosis or delayed diagnosis of aspiration, especially aspiration pneumonia.In recent years, with further research into the mechanisms of aspiration syndromes, multiple aspiration biomarkers with potential and clinical translational value have been found, and may help early detection of aspiration and have important and practical significance for elderly health.Therefore, this article reviews aspiration biomarkers such as pepsin, α-amylase, bile acid and other potential biomarkers as well as current relevant research, detection methods, their clinical value and prospects concerning challenges and directions of innovation in future research.

Objective: To observe and evaluate the clinical efficacy of laparoscopic abdominoperineal intersphincteric resection com-bined with ileostomy for the treatment of ultra-low rectal cancer. Methods: Clinicopathologic data of 74 patients undergoing laparo-scopic radical resection for ultra-low rectal cancer at Coloproctology Hospital of Chengdu from January 2015 to June 2017 were retro-spectively analyzed. In total, 43 patients underwent laparoscopic abdominoperineal intersphincteric resection combined with ileosto-my (ISR group), and 31 patients underwent laparoscopic low anterior resection combined with ileostomy (LAR group). The periopera-tive condition, radical resection of tumor, and postoperative anal function were compared between the two groups. Results: There were no significant differences in blood loss, postoperative hospital stay, and postoperative complications between the groups (all P>0.05). The mean operative time was (306.6 ± 25.1) minutes in the ISR group and (239.7 ± 26.4) minutes in the LAR group (P=0.010). There were no significant differences in pT and pN between the groups (all P values>0.05). The coincidence rate of T stage diagnosis was 93.0% in the ISR group and 93.5% in the LAR group. The positive rate of circumferential resection margin in the two groups was 0. The mean distance of the distal margin was (2.3±0.1) cm in the ISR group and (1.4±0.3) cm in the LAR group (P<0.001). All patients were followed up for 12-42 (mean 23.4) months. The local recurrence rate was 0 in the ISR group and 12.9% (4/31) in the LAR group (P=0.027); no distant metastasis was observed in any of the groups. There was no significant difference in the results of the anorectal manometry test between the groups (P>0.05). The proportion of patients with good continence of anal function after closure of ileos- tomy was 83.7% in the ISR group and 87.1% in the LAR group (P>0.05). Conclusions: Laparoscopic abdominoperineal intersphincteric resection combined with ileostomy is safe and feasible for the treatment of ultra-low rectal cancer, and it leads to satisfactory anal function and a short-term curative effect.