The use of five or more drugs (polypharmacy) is common problem in the elderly,and need to attach importance.Optimization of drug treatment is a major part of medication in older adults,and also is a challenge to clinical physician.Beers Criteria provided by American Geriatrics Society (AGS) is a strong guarantee for improving medication safety in older adults

A 27-peptide,a fragment of hepatitis delta antigen(HDAg),was synthesized and used to develop an ELISA method for ihe detection of anti-HD.It was found that positive anti-HD reaction occurred between the coated 27-peptide and a stored sample of serum which was known anti-HD positive.Absorption test revealed that the synthetic peptide competed with natural HDAg for anti-HD,suggesting that the peptide possessed the antigenicity similar to that of natural HDAg.The antigenicity of the synthetic peptide was quite specific wihtout cross reaction with normal human and mouse sera and with anti-HA.anti-HB and anti-HC sera.Among 300 blood donors,there was only 1 case(0.33%)anti-HD positive with an ALT level 2 times higher than normal.In 41 cases of non-B hepatitis and 52 cases of HAV hepatitis,none was anti-HD positive.In 211 cases of various types of HBV hepatitis,21 were(9.95%)anti-HD positive,among whom 2/82(2.5%)werehealthy HBV carriers,6/43(13.95%)were patients with a-cute icteric hepatitis,6/60(10.00%)were patients of chronic active hepatitis,4/18(22.20%)were patients of severe hepatitis,and 3/8(37.50%)were those with liver cirrhosis.These results were consistent with those in our previous reports.

Objective To investigate the efficacy and safety of local immune regulation therapy of thyroid disease.Methods Totally 110 patients with confirmed diagnosis of autoimmune thyroid disease were recruited.All patients received thyroid local immune regulation therapy with glucocorticoids 1~3 courses of treatment and followed up for 2~3 years,each being taken good care of during the whole observation.Results About 94.0% of the patients had significantly improved their subjective symptoms,such as pain,fatigue,and lethargy.About 67.7% of the cases had reached normal or markedly improved thyroid function after thyroid local immune regulation therapy.About 92.0% of the volumes of thyroid were reduced.Serum antithyroperoxidase antibody levels were decreased from(338.2?43.2)mU/L to(266.9?42.2)mU/L(P

Objective To evaluate the long-term efficacy and safety profile of alpha-1-thymosin (T?_1) combined with Lamivudine(LAM) in the patients with chronic hepatitis B. Methods Eighty patients with chronic hepatitis B were randomly assigned by 1∶1 proportion to be given 100 mg LAM orally alone (LAM group) or T?_1 1.6 mg subcutaneous injection, combined with LAM(LAM+T?_1 group). Results 51.4 percent (18/35) of the patients achieved HBeAg seroconversion in combination group, while 5.4%(2/37) of the patients in LAM group achieved HBeAg seroconversion at 52 week, P

Objective:To evaluate therapeutic effect of olmesartan on patients with mild to moderate essential hyper-tension (EH) and its influence on cardiovascular risk factors .Methods:A total of 150 mild/moderate EH patients were enrolled using opened ,non-control and multi-center method .According to random number table ,they were randomly and equally divided into olmesartan group (received olmesartan 20~40 mg/d) and losartan group (re-ceived losartan 50~100 mg/d) .Changes of systolic blood pressure (SBP) ,diastolic blood pressure (DBP) , levels of risk indexes of cardiovascular diseases ,such as high sensitive C reactive protein (hsCRP) ,urinary albumin/creati-nine ,homocysteine (Hcy) and carotid intima-media thickness (IMT) were observed in two groups before and after treatment .Results:After eight-month treatment , compared with before treatment , all indexes significantly im-proved in both groups;compared with losartan group ,there were significant reductions in SBP [ (145 ± 12) mmHg vs .(132 ± 9) mmHg] and DBP [ (90 ± 7) mmHg vs .(80 ± 5) mmHg] , P<0.01 all;and significant reductions in levels of hsCRP [ (0.54 ± 0.09) mg/L vs .(0.34 ± 0.09) mg/L] ,urinary albumin/creatinine [ (26.5 ± 19.4) mg/g vs .(23.1 ± 18.3) mg/g] ,Hcy [ (13.2 ± 4.8)μmol/L vs .(10.3 ± 4.2)μmol/L] and IMT [ (0.83 ± 0.29) mm vs . (0.74 ± 0.28) mm] in olmesartan group , P< 0.05 all .Conclusion:Besides intensively lowering blood pressure olmesartan can also significantly decrease cardiovascular risk factors in patients with mild to moderate hypertension .

Palliative and hospice care for patients suffering severe or end-stage illness with projected short life expectancy.Such services aim to improve patients' quality of life through prognosticating,prevention and treatment of their ailment.The main components include evaluation and treatment of symptoms,pain control,family care,alleviating and treating patients' psychological burden and depression,and offering comfort and dignity.Hospice and palliative care are different from euthanasia,because they neither hasten nor delay the dying process.Instead,they focus on patients'physical and psychological needs and helping patients to maintain their independence and make their own choice.As a new medical subspecialty,palliative and hospice care are considered one of the important frontier in modern medicine.They employ a multi-disciplinary team approach,and the team members require special skill sets including those in communication and symptom management.

A 64-year old man was admitted on July 2011 with masses both in liver and right kidney.After PET-CT and blood test examination,dual primary advanced cancers were speculated to be co-existed in this patient,which having poor prognosis.By evaluation with comprehensive geriatric assessment,the patient also had hypertension,diabetes and atherosclerosis,liver and renal insufficiency.After multidisciplinary consultation and detailed discussion with the patient,the decision of no surgery and just keep the follow-up was made.The patient has been followed up for 18 months and the functional evaluation is the same as before.It is very important to evaluate the risk/benefit equation and improve the standard of care,and make the decision as patient centered rather than disease-centered in the elderly patients.

Myocardial infarction and ischemic stroke share many common risk factors.Their pathophysiological processes are also similar and the 2 diseases often occur at the same time.Coronary artery disease is one of the important causes of embolic stroke in the elderly population.However,there are a few reported stroke events available after myocardial infarction.This article reviews ischenic stroke following acute myocardial infarction.

In April 2016,the American Geriatrics Society(AGS)entered into a cooperative agreement with U.S.Department of Transportation.National Highway Traffic Safety Administration (NHTSA) updates and expands the Clinician's Guide to Assessing and Counseling Older Drivers to the 3rd Edition.The main goal of the Guide is to reduce traffic accidents and injuries to older drivers.According to the workflow of evaluation and management provided by Plan for Older Driver Safety(PODS),clinicians can conduct driving strategies after screening,evaluation and result analysis.The evaluation is done based on the Clinical Assessment of Driving Related Skills(CADReS) by a team including physicians,nurse practitioners,physician assistants,pharmacists,occupational therapists,driving rehabilitation specialists,and social workers.The CADReS including a series of assessment tools are used to evaluate in the key areas,such as vision,cognition,and motor/sensory function related to driving.Some measures will be taken based on the evaluation conclusions to help to explore the potential of driving safely for old adults.