Objective To investigate the efficacy and adverse reactions of gefitinib in treatment of elderly patients with advanced non-small-cell lung cancer.Methods 30 elderly patients with advanced non-small cell lung cancer were treatment with oral gefitinib,250mg/d,every 4 weeks for a treatment period.The efficacy,adverse reactions,quality of life were observed.Results Of 30 cases,the rate of complete response(CR) ,partial response(PR), stability of disease(SD) .progression of disease(PD) and disease control was 0.0% ,26.6% ,26.6% ,49.6% ,53.3% ,respectively;The disease control rate( 84.0% ) in adenocarcinoma was significantly higher than that in squamous cell carcinoma( 20.0% ) (x2 = 9.125, P < 0.01) ; The disease control rate (100.0% ) in stage- Ⅲ was significantly higher than that in stage Ⅳ(77.8%)(x2 =3.879,P<0.05);The median progression-free survival was 3.8 months, and median survival was 5.2 months;The most common toxicity was skin toxicity, hematologic toxicity was not observed.Conclusion As the first-line treatment for advanced NSCLC, gefitinib was effective and tolerable for the elderly.

ObjectiveTo investigate the effects of surgical treatment of severe valvular heart disease to improve early survival. Methods100 cases with severe heart valve surgery were opercted,The mitralvalve replacement (MVR) in 50 cases, aortic valve replacement (AVR) in 30 cases, MVR + AVR in 20 cases;tricuspid valvuloplasty (TVP) in 50 cases,dissection of left atrial thrombus in 25 cases,left atrial plication in 12 cases,coronary artery bypass grafting(CABG) in 20 patients; The Ⅲ grade of heart function( n = 60), Ⅳ grade( n = 40). ResultsA total of 4 cases died(4％ )died of postoperative low cardiac output syndrome in 1 case, sudden ventricular fibrillation in 3 cases died,the other 96 cases discharged;heart function recovered to 10 cases of grade Ⅰ, Ⅱ Grade 29 cases, Ⅲ grade 14 cases. Postoperative cardiothoracic ratio reduced to varying degrees;The 12 cases(40％ ) with aortic valve calcification or hardening,13 cases(26％ ) with mitral valve sclerosis or calcification in patients with severe valvular heart disease by echocardiography; The left ventricular end-diastolic diameter(LVEDD) (53 ± 7.0) mm after 20 months were lower than the discharge ( 64.0 ± 6.2) mm( t = 3.789, P ＜ 0.05 ) ; The left ventricular ejection fraction (LVEF)after 20 months(42.5 ±11.0)％were highter than that at discharge(37.5 +6.2)％ ,(t =3.799,P ＜0.05). Conclusion Improving heart function, keeping the flap tissue to enhance prevention of postoperative complications, could significandy improve the results of valve replacement for the patients with severe valvular heart disease.