Pub Date : 2019-12-14DOI: 10.3760/CMA.J.ISSN.0254-9026.2019.12.030
Jiyi Xu, Zhi Zhou, B. Qin
The theory of amyloid-induced Alzheimer's disease(AD)has been challenged by the scientific community.However, with the deep study of amyloid beta(Aβ)cascade metabolic reaction process and the characteristics and functions of various Aβ polypeptides, people have a profound understanding of the pathogenesis of AD caused by Aβ.Currently, several Aβ antibodies, including the protofibril selective antibody BAN2401, are in clinical trials for treating Alzheimer's disease.After the good results of targeted therapy for Aβ(Ban2401), this theory has attracted our attention again.In this paper, the pathogenesis of Aβ and the progress of targeted therapy were reviewed systematically. Key words: Alzheimer disease; Amyloid; Targeted therapy
{"title":"Research advances in anti-Aβ targeted therapy for Alzheimer's disease: An update","authors":"Jiyi Xu, Zhi Zhou, B. Qin","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.12.030","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.12.030","url":null,"abstract":"The theory of amyloid-induced Alzheimer's disease(AD)has been challenged by the scientific community.However, with the deep study of amyloid beta(Aβ)cascade metabolic reaction process and the characteristics and functions of various Aβ polypeptides, people have a profound understanding of the pathogenesis of AD caused by Aβ.Currently, several Aβ antibodies, including the protofibril selective antibody BAN2401, are in clinical trials for treating Alzheimer's disease.After the good results of targeted therapy for Aβ(Ban2401), this theory has attracted our attention again.In this paper, the pathogenesis of Aβ and the progress of targeted therapy were reviewed systematically. \u0000 \u0000 \u0000Key words: \u0000Alzheimer disease; Amyloid; Targeted therapy","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1441-1444"},"PeriodicalIF":0.0,"publicationDate":"2019-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43648504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Report a case of main cause of thirst, polydipsia, and polyuria. The pituitary vasopressin test after water deprivation is consistent with the characteristics of central diabetes insipidus. Enhanced magnetic resonance imaging in the sellar region indicates inflammatory lesions in the pituitary gland and pituitary stalk. Laboratory investigation shows a significant increase in IgG4, considering IgG4 related pituitary inflammation, central diabetes insipidus, and autoimmune pancreatitis.
{"title":"IgG4-related hypophysitis with the initial symptoms of central diabetes insipidus: a case report","authors":"Tingting Yuan, Guo-yun Wang, Xin Zhao","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.12.027","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.12.027","url":null,"abstract":"报道一例主因烦渴、多饮、多尿，禁水垂体加压素试验符合中枢性尿崩症特征，鞍区增强核磁提示垂体和垂体柄炎性病变，实验室追查IgG4明显升高，考虑IgG4相关性垂体炎、中枢性尿崩症、自身免疫性胰腺炎。","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1431-1432"},"PeriodicalIF":0.0,"publicationDate":"2019-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41692812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To evaluate the efficacy and safety of intravenous thrombolysis with recombinant tissue-plasminogen activator (rt-PA) in elderly patients with early-stage mild ischemic stroke (IS). Methods This was a prospective, open-label, controlled study.Ninety-four elderly patients with mild IS admitted to our hospital from January 2014 to December 2017 were randomized into a thrombolysis arm (TA, n=46) and a control arm (CA, n=48). The short-term endpoints were the National Institutes of Health stroke scale (NIHSS) scores on 3rd, 7th, 14thday after admission and the secondary endpoints were the modified Rankin Scale (mRS) score and the morbidity of recurrence IS within 90 days.Safety was evaluated by the incidence of intracranial hemorrhage (IH) and early neurological deterioration (END) during hospitalization. Results The baseline NIHSS scores of patients in the TA and CA groups were similar [(4.1±0.7) vs.(4.1±0.7)]. However, there were significant differences in the NIHSS score on 3rd [(3.4±1.2) vs.(4.2±1.4)], 7th[(3.0±1.8) vs.(4.1±1.6)] and 14thday [(2.5±2.0) vs.(3.4±1.6)], respectively, between the TA group and the CA group.Furthermore, the TA group was associated with a significantly higher proportion of patients with good prognosis (mRS, 0-2), compared with the CA group (71.7% vs.35.4%, P 3 could benefit from thrombolytic therapy.There were 1 case of symptomatic IH and 1 case of progressive stroke in the TA group, and 1 case of IH and 2 cases of progressive stroke in the control group.There were no significant differences in the rate of either END or IH between the two groups (P>0.05). Two patients in the TA group and three patients in the control group had recurrent IS within 90 days and the recurrence rate of IS was also similar within 90 days (P>0.05). Conclusions Intravenous thrombolytic therapy with rt-PA can improve the prognosis of elderly patients with mild stroke without increased risk of END, IH, or recurrence of IS. Key words: Stroke; Brain Ischemia; Thrombolytic therapy
{"title":"The efficacy and safety of intravenous thrombolysis in elderly patients with mild ischemic stroke","authors":"Lidong Ding, Zhang-hua Xiao, Huawu Mao, Xiaofang Hang, Xiaobo Lu, Yuqing Shen, Q. Fang, Juemiao Chen","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.12.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.12.006","url":null,"abstract":"Objective \u0000To evaluate the efficacy and safety of intravenous thrombolysis with recombinant tissue-plasminogen activator (rt-PA) in elderly patients with early-stage mild ischemic stroke (IS). \u0000 \u0000 \u0000Methods \u0000This was a prospective, open-label, controlled study.Ninety-four elderly patients with mild IS admitted to our hospital from January 2014 to December 2017 were randomized into a thrombolysis arm (TA, n=46) and a control arm (CA, n=48). The short-term endpoints were the National Institutes of Health stroke scale (NIHSS) scores on 3rd, 7th, 14thday after admission and the secondary endpoints were the modified Rankin Scale (mRS) score and the morbidity of recurrence IS within 90 days.Safety was evaluated by the incidence of intracranial hemorrhage (IH) and early neurological deterioration (END) during hospitalization. \u0000 \u0000 \u0000Results \u0000The baseline NIHSS scores of patients in the TA and CA groups were similar [(4.1±0.7) vs.(4.1±0.7)]. However, there were significant differences in the NIHSS score on 3rd [(3.4±1.2) vs.(4.2±1.4)], 7th[(3.0±1.8) vs.(4.1±1.6)] and 14thday [(2.5±2.0) vs.(3.4±1.6)], respectively, between the TA group and the CA group.Furthermore, the TA group was associated with a significantly higher proportion of patients with good prognosis (mRS, 0-2), compared with the CA group (71.7% vs.35.4%, P 3 could benefit from thrombolytic therapy.There were 1 case of symptomatic IH and 1 case of progressive stroke in the TA group, and 1 case of IH and 2 cases of progressive stroke in the control group.There were no significant differences in the rate of either END or IH between the two groups (P>0.05). Two patients in the TA group and three patients in the control group had recurrent IS within 90 days and the recurrence rate of IS was also similar within 90 days (P>0.05). \u0000 \u0000 \u0000Conclusions \u0000Intravenous thrombolytic therapy with rt-PA can improve the prognosis of elderly patients with mild stroke without increased risk of END, IH, or recurrence of IS. \u0000 \u0000 \u0000Key words: \u0000Stroke; Brain Ischemia; Thrombolytic therapy","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1344-1347"},"PeriodicalIF":0.0,"publicationDate":"2019-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42002756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-14DOI: 10.3760/CMA.J.ISSN.0254-9026.2019.12.022
Yao Yao, S. Fu, Chi Zhang, Faqin Lyu, Fu Zhang, F. Luan, Yali Zhao
Objective To evaluate the health status of Hainan centenarians and compare the gender disparity, and to determine whether the'male-female health-survival paradox’is present among them. Methods A cross-sectional study was conducted on the health status and gender disparity of individuals aged 100 and over in Hainan province from June 2014 to December 2016.Data of sociodemographics, lifestyles as well as health-related parameters were collected.The multi-dimensional health assessment of centenarians was conducted based on the recognition of standard on Chinese healthy elderly in 2013. Results A total of 940 centenarians(men 18.6%, women 81.4%)were included.The prevalences of hypertension, diabetes and dyslipidemia were 66.1%, 9.8%, and 21.2%, respectively, while no significant gender difference was found.Male centenarians were more independent in activity of daily living than did female centenarians(41.1% vs.25.9%, P<0.001). The prevalences of dementia(7.7% vs.4.0%)and depression(33.6% vs.18.9%)were more dominant in females than in males.Multivariate logistic regression showed that the proportions of functional disability, depression and sleep disorders were higher in female centenarians than in male centenarians(P<0.05)after adjusting for general demographic characteristics, lifestyle and other health indicators. Conclusions Although the female proportion dominates the centenarian population, female general health states are worse than male centenarians.More attentions on physical and mental health should be paid to the female centenarians. Key words: Centenarians; Health assessment
{"title":"A study of health status in Hainan centenarians","authors":"Yao Yao, S. Fu, Chi Zhang, Faqin Lyu, Fu Zhang, F. Luan, Yali Zhao","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.12.022","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.12.022","url":null,"abstract":"Objective \u0000To evaluate the health status of Hainan centenarians and compare the gender disparity, and to determine whether the'male-female health-survival paradox’is present among them. \u0000 \u0000 \u0000Methods \u0000A cross-sectional study was conducted on the health status and gender disparity of individuals aged 100 and over in Hainan province from June 2014 to December 2016.Data of sociodemographics, lifestyles as well as health-related parameters were collected.The multi-dimensional health assessment of centenarians was conducted based on the recognition of standard on Chinese healthy elderly in 2013. \u0000 \u0000 \u0000Results \u0000A total of 940 centenarians(men 18.6%, women 81.4%)were included.The prevalences of hypertension, diabetes and dyslipidemia were 66.1%, 9.8%, and 21.2%, respectively, while no significant gender difference was found.Male centenarians were more independent in activity of daily living than did female centenarians(41.1% vs.25.9%, P<0.001). The prevalences of dementia(7.7% vs.4.0%)and depression(33.6% vs.18.9%)were more dominant in females than in males.Multivariate logistic regression showed that the proportions of functional disability, depression and sleep disorders were higher in female centenarians than in male centenarians(P<0.05)after adjusting for general demographic characteristics, lifestyle and other health indicators. \u0000 \u0000 \u0000Conclusions \u0000Although the female proportion dominates the centenarian population, female general health states are worse than male centenarians.More attentions on physical and mental health should be paid to the female centenarians. \u0000 \u0000 \u0000Key words: \u0000Centenarians; Health assessment","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1413-1417"},"PeriodicalIF":0.0,"publicationDate":"2019-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42178644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-14DOI: 10.3760/CMA.J.ISSN.0254-9026.2019.12.012
P. Zhen, L. Gu, Ya-Liang Chen, Ming Hu
Objective To investigate the risk factors for drug resistance of urinary tract infections-causing Escherichia coli producing extended spectrum beta-Lactamases (ESBLs) in elderly people (≥65 years old), in order to provide evidence for rational use of antibiotics in clinic. Methods Clinical data of elderly patients diagnosed as urinary tract infections in Beijing Chao-Yang Hospital from January 2016 to December 2017 were retrospectively analyzed. According to whether ESBLs were produced by Escherichia coli isolated from urine samples, the patients were divided into the ESBLs-producing E. Coli group (ESBLs group) and the control group. Single factor analysis was performed by Chi-square test.Logistic regression analysis was used to analyze the risk factors for ESBLs-producing Escherichia coli infections in urinary tract on the basis of statistical significance. Results A total of 452 strains of Escherichia coli were isolated, including 253 strains (55.97%) producing ESBLs, and 199 strains (44.03%) not producing ESBLs. The ureteral calculi (OR=2.675, 95%CI: 1.129-6.341), urinary obstructive diseases (≥ 2 kinds) (OR=8.680, 95%CI: 2.508-30.040), indwelling catheters (OR=5.762, 95%CI: 2.698-12.155), antibiotic treatment more than 2 weeks for urinary tract infections within one year (OR=3.461, 95%CI: 1.766-6.784) were independent risk factors for ESBLs-producing Escherichia coli urinary tract infections. The incidence rate of Escherichia coli resistance to various antibiotics was higher in elderly patients with urinary tract infection than in non-elderly patients. Conclusions Escherichia coli producing ESBLs can be easily isolated from elderly patients with urinary tract obstructive diseases, indwelling catheters and repeated long-term administration of broad-spectrum antibiotics. The proportion of ESBLs Escherichia coli-caused urinary tract infections is higher in elderly patients. Thereby, carbapenems or piperacillin/tazobactam is the reasonable antibiotics. Ampicillin, piperacillin, levofloxacin and ciprofloxacin should not be the first choice for the treatment of urinary tract infections in the elderly. Key words: Urinary tract infections; Escherichia coli infections; Drug tolerance
{"title":"Analysis of drug susceptibility and risk factors for drug resistance of Escherichia coli in elderly patients with urinary tract infection","authors":"P. Zhen, L. Gu, Ya-Liang Chen, Ming Hu","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.12.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.12.012","url":null,"abstract":"Objective \u0000To investigate the risk factors for drug resistance of urinary tract infections-causing Escherichia coli producing extended spectrum beta-Lactamases (ESBLs) in elderly people (≥65 years old), in order to provide evidence for rational use of antibiotics in clinic. \u0000 \u0000 \u0000Methods \u0000Clinical data of elderly patients diagnosed as urinary tract infections in Beijing Chao-Yang Hospital from January 2016 to December 2017 were retrospectively analyzed. According to whether ESBLs were produced by Escherichia coli isolated from urine samples, the patients were divided into the ESBLs-producing E. Coli group (ESBLs group) and the control group. Single factor analysis was performed by Chi-square test.Logistic regression analysis was used to analyze the risk factors for ESBLs-producing Escherichia coli infections in urinary tract on the basis of statistical significance. \u0000 \u0000 \u0000Results \u0000A total of 452 strains of Escherichia coli were isolated, including 253 strains (55.97%) producing ESBLs, and 199 strains (44.03%) not producing ESBLs. The ureteral calculi (OR=2.675, 95%CI: 1.129-6.341), urinary obstructive diseases (≥ 2 kinds) (OR=8.680, 95%CI: 2.508-30.040), indwelling catheters (OR=5.762, 95%CI: 2.698-12.155), antibiotic treatment more than 2 weeks for urinary tract infections within one year (OR=3.461, 95%CI: 1.766-6.784) were independent risk factors for ESBLs-producing Escherichia coli urinary tract infections. The incidence rate of Escherichia coli resistance to various antibiotics was higher in elderly patients with urinary tract infection than in non-elderly patients. \u0000 \u0000 \u0000Conclusions \u0000Escherichia coli producing ESBLs can be easily isolated from elderly patients with urinary tract obstructive diseases, indwelling catheters and repeated long-term administration of broad-spectrum antibiotics. The proportion of ESBLs Escherichia coli-caused urinary tract infections is higher in elderly patients. Thereby, carbapenems or piperacillin/tazobactam is the reasonable antibiotics. Ampicillin, piperacillin, levofloxacin and ciprofloxacin should not be the first choice for the treatment of urinary tract infections in the elderly. \u0000 \u0000 \u0000Key words: \u0000Urinary tract infections; Escherichia coli infections; Drug tolerance","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1372-1376"},"PeriodicalIF":0.0,"publicationDate":"2019-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41801313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-14DOI: 10.3760/CMA.J.ISSN.0254-9026.2019.12.010
F. Fang, Min Zhang, Dijuan Meng, Songtao Hu, Yanming Li, Dong-ge Liu
Objective To study on the diagnostic value of non-tumor lung biopsy by the multidisciplinary discussion including clinician, radiologist and pathologist. Methods Clinical data, imaging data and data of hematoxylin-eosin, immunohistochemical and special staining of pathological lung tissues in 217 cases undergoing non-tumor lung biopsy in Beijing Hospital during July 2015 to July 2018 were retrospectively analyzed.The diagnosis results were summarized and analyzed. Results The age range in 217 cases was 45-89 years, and the median age was 67 years, with 92 females and 125 males.The descriptive diagnoses were found in forty-two cases(19.4%, 42/217). And 175 cases could be confirmatively diagnosed by the multidisciplinary discussion of clinician, radiologist and pathologist.And the diagnostic rate of lung puncture biopsy was 80.6%(175/217 cases). Inflammatory lesions were divided into infection and non-infection.A total of 68 infection cases(31.3%, 68/217)included tuberculosis(43/68, 63.2%), bacterial pneumonia(14/68, 20.6%)and fungal infection(11/68, 16.2%). A total of 107 cases(49.3%, 107/217)of non-infective cases included the following: organized pneumonia(53/107, 49.5%), interstitial pneumonia with autoimmune features(iPAF)(16/107, 15.0%), nonspecific interstitial pneumonia(NSIP)(13/107, 12.1%), hypersensitivity pneumonitis(8/107, 7.5%), granulomatosis with polyangiitis(GPA)(4/107, 3.7%), eosinophilic pneumonia(2/107, 1.9%), sarcoidosis(2/107, 1.9%), acute fibrinous and organizing pneumonia(AFOP)(2/107, 1.9%)and coal pneumoconiosis(2/107, 1.9%, for each), and IgG4 related diseases(1/107, 0.9%), pleuraparenchymal fibroelastomatosis(PPFE)(1/107, 0.9%), asbestos lung(1/107, 0.9%), lipid pneumonia(1/107, 0.9%)and inhaled pneumonia(1/107, 0.9%). Conclusions The diagnoses of the puzzled non-tumor lung diseases were more accurate by pathological examination of lung tissue by using special stain, immunohistochemical stain and other pathological means, and by close multidisciplinary consultation of clinician, radiologist and pathologist, so as to facilitate the diagnosis and treatment of diseases. Key words: Biopsy, needle; Lung disease, interstitial; Immunohistochemistry
{"title":"Multidisciplinary discussion for diagnosis of lung diseases: A retrospective analysis of 217 cases undergoing non-tumor lung biopsy","authors":"F. Fang, Min Zhang, Dijuan Meng, Songtao Hu, Yanming Li, Dong-ge Liu","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.12.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.12.010","url":null,"abstract":"Objective \u0000To study on the diagnostic value of non-tumor lung biopsy by the multidisciplinary discussion including clinician, radiologist and pathologist. \u0000 \u0000 \u0000Methods \u0000Clinical data, imaging data and data of hematoxylin-eosin, immunohistochemical and special staining of pathological lung tissues in 217 cases undergoing non-tumor lung biopsy in Beijing Hospital during July 2015 to July 2018 were retrospectively analyzed.The diagnosis results were summarized and analyzed. \u0000 \u0000 \u0000Results \u0000The age range in 217 cases was 45-89 years, and the median age was 67 years, with 92 females and 125 males.The descriptive diagnoses were found in forty-two cases(19.4%, 42/217). And 175 cases could be confirmatively diagnosed by the multidisciplinary discussion of clinician, radiologist and pathologist.And the diagnostic rate of lung puncture biopsy was 80.6%(175/217 cases). Inflammatory lesions were divided into infection and non-infection.A total of 68 infection cases(31.3%, 68/217)included tuberculosis(43/68, 63.2%), bacterial pneumonia(14/68, 20.6%)and fungal infection(11/68, 16.2%). A total of 107 cases(49.3%, 107/217)of non-infective cases included the following: organized pneumonia(53/107, 49.5%), interstitial pneumonia with autoimmune features(iPAF)(16/107, 15.0%), nonspecific interstitial pneumonia(NSIP)(13/107, 12.1%), hypersensitivity pneumonitis(8/107, 7.5%), granulomatosis with polyangiitis(GPA)(4/107, 3.7%), eosinophilic pneumonia(2/107, 1.9%), sarcoidosis(2/107, 1.9%), acute fibrinous and organizing pneumonia(AFOP)(2/107, 1.9%)and coal pneumoconiosis(2/107, 1.9%, for each), and IgG4 related diseases(1/107, 0.9%), pleuraparenchymal fibroelastomatosis(PPFE)(1/107, 0.9%), asbestos lung(1/107, 0.9%), lipid pneumonia(1/107, 0.9%)and inhaled pneumonia(1/107, 0.9%). \u0000 \u0000 \u0000Conclusions \u0000The diagnoses of the puzzled non-tumor lung diseases were more accurate by pathological examination of lung tissue by using special stain, immunohistochemical stain and other pathological means, and by close multidisciplinary consultation of clinician, radiologist and pathologist, so as to facilitate the diagnosis and treatment of diseases. \u0000 \u0000 \u0000Key words: \u0000Biopsy, needle; Lung disease, interstitial; Immunohistochemistry","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1363-1367"},"PeriodicalIF":0.0,"publicationDate":"2019-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43675785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sarcoma like carcinoma of the renal pelvis is an extremely rare malignant tumor, and there are few reports at home and abroad. This patient, a 63 year old man, was admitted to the hospital in May 2010 due to bilateral lumbar pain and discomfort for 2 years, which worsened in January. Admission diagnosis: bilateral kidney stones with hydronephrosis, urinary tract infection. After undergoing anti infection treatment, percutaneous nephrolithotripsy for left renal calculi under general anesthesia was performed using phase I holmium laser lithotripsy. During the operation, a large amount of papillary new organisms and gray white necrotic substances were found in the left renal pelvis. A frozen biopsy was performed during the operation, indicating urothelial carcinoma, and the surgery was terminated. One week after the first surgery, laparoscopic radical resection of left renal pelvis cancer was performed under general anesthesia. Due to the tight adhesion between the kidney and surrounding tissues during the surgery, it was difficult to separate. Therefore, an open surgery was performed to remove the left kidney and ureter, and a sleeve shaped resection was performed at the entrance of the left ureter into the bladder. Postoperative pathological diagnosis: Sarcoma like carcinoma of the left renal pelvis. It is recommended that the patient be transferred to the oncology department for further treatment after surgery, but the patient refused. After discharge, the patient will be followed up regularly by phone, and the patient will die by the 10th month after surgery. The cause of death is late stage cachexia of the tumor. The patient's clinical manifestations are atypical and the prognosis is poor. So far, only one case has been admitted to our hospital.
{"title":"A case report of sarcomatoid carcinoma of the renal pelvis in elderly patient","authors":"K. Lei, Ming Ma, Xu Wang, T. Sun","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.12.028","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.12.028","url":null,"abstract":"肾盂肉瘤样癌是一种极为罕见的恶性肿瘤，目前国内外报道较少，本患者男，63岁，因双侧腰部疼痛不适2年，加重1月于2010年5月入院。入院诊断：双肾结石并双肾积水，尿路感染。经抗感染治疗后在全麻下行经皮肾镜左肾结石Ⅰ期钬激光碎石术。术中见左侧肾盂内大量乳头状新生物及灰白色坏死物质，行术中冰冻活检，提示尿路上皮癌，遂终止手术。首次手术1周后，于全麻下行后腹腔镜左侧肾盂癌根治术。术中因肾脏与周围组织粘连紧密，不易分离，遂改行开放手术，切除左肾及左输尿管，并在左输尿管入膀胱处行袖套状切除。术后病理诊断：左肾盂肉瘤样癌。建议患者术后转肿瘤科进一步治疗，但患者拒绝，出院后定期电话随访，随访至术后第10个月时患者死亡，死亡原因为肿瘤晚期恶病质。患者临床表现不典型，预后差。迄今为止我院仅收治1例。","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1433-1434"},"PeriodicalIF":0.0,"publicationDate":"2019-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41604945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-14DOI: 10.3760/CMA.J.ISSN.0254-9026.2019.12.029
Q. Ren
Geriatric ability to live independently will be severely impaired when mild cognitive impairments(MCI)eventually develop into dementia.Patients with dementia usually suffer from micronutrients deficiencies(MNDs). In turn, MNDs may accelerate cognitive decline based on disruption of one carbon metabolism, DNA damage repair, mitochondrial function and glucose, lipid and phospholipids metabolism which lead to the damage of neurotransmitter synthesis, myelination and synaptogenesis.Clinical evidences show that the oral supplementation of B-group vitamins(vitamin B6 10-25 mg/d, vitamin B120.025-0.500 mg/d and folate 0.4-2.0 mg/d)and specific micronutrients compounds for at least 3 months may improve overall cognitive function and short-term memory ability of the elderly.More double-blind, placebo-controlled, randomized human intervention studies are still needed to evaluate effects of micronutrients supplementation on geriatric cognitive function and to determine the requirements, dosage and time of intervention. Key words: Micronutrient; Cognitive function
{"title":"The effect of micronutrients supplement on geriatric cognitive function: The latest research progresses","authors":"Q. Ren","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.12.029","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.12.029","url":null,"abstract":"Geriatric ability to live independently will be severely impaired when mild cognitive impairments(MCI)eventually develop into dementia.Patients with dementia usually suffer from micronutrients deficiencies(MNDs). In turn, MNDs may accelerate cognitive decline based on disruption of one carbon metabolism, DNA damage repair, mitochondrial function and glucose, lipid and phospholipids metabolism which lead to the damage of neurotransmitter synthesis, myelination and synaptogenesis.Clinical evidences show that the oral supplementation of B-group vitamins(vitamin B6 10-25 mg/d, vitamin B120.025-0.500 mg/d and folate 0.4-2.0 mg/d)and specific micronutrients compounds for at least 3 months may improve overall cognitive function and short-term memory ability of the elderly.More double-blind, placebo-controlled, randomized human intervention studies are still needed to evaluate effects of micronutrients supplementation on geriatric cognitive function and to determine the requirements, dosage and time of intervention. \u0000 \u0000 \u0000Key words: \u0000Micronutrient; Cognitive function","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1435-1440"},"PeriodicalIF":0.0,"publicationDate":"2019-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43593975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-14DOI: 10.3760/CMA.J.ISSN.0254-9026.2019.11.005
J. Chu, Xujiao Chen
{"title":"The interpretation of the Asia-Pacific clinical practice guidelines for the management of frailty","authors":"J. Chu, Xujiao Chen","doi":"10.3760/CMA.J.ISSN.0254-9026.2019.11.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-9026.2019.11.005","url":null,"abstract":"","PeriodicalId":9997,"journal":{"name":"中华老年医学杂志","volume":"38 1","pages":"1213-1215"},"PeriodicalIF":0.0,"publicationDate":"2019-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48407502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：