Bowel preparation protocol for hospitalized patients ages 50 years or older:A randomized controlled trial

BACKGROUND The incidence and mortality rate of colorectal cancer progressively increase with age and become particularly prominent after the age of 50 years.Therefore,the population that is≥50 years in age requires long-term and regular colonoscopies.Uncomfortable bowel preparation is the main reason preventing patients from undergoing regular colonoscopies.The standard bowel preparation regimen of 4-L polyethylene glycol(PEG)is effective but poorly tolerated.AIM To investigate an effective and comfortable bowel preparation regimen for hospitalized patients≥50 years in age.METHODS Patients were randomly assigned to group 1(2-L PEG+30-mL lactulose+a lowresidue diet)or group 2(4-L PEG).Adequate bowel preparation was defined as a Boston bowel preparation scale(BBPS)score of≥6,with a score of≥2 for each segment.Non-inferiority was prespecified with a margin of 10%.Additionally,the degree of comfort was assessed based on the comfort questionnaire.RESULTS The proportion of patients with a BBPS score of≥6 in group 1 was not significantly different from that in group 2,as demonstrated by intention-to-treat(91.2%vs 91.0%,P=0.953)and per-protocol(91.8%vs 91.0%,P=0.802)analyses.Furthermore,in patients≥75 years in age,the proportion of BBPS scores of≥6 in group 1 was not significantly different from that in group 2(90.9%vs 97.0%,P=0.716).Group 1 had higher comfort scores(8.85±1.162 vs 7.59±1.735,P<0.001),longer sleep duration(6.86±1.204 h vs 5.80±1.730 h,P<0.001),and fewer awakenings(1.42±1.183 vs 2.04±1.835,P=0.026)than group 2.CONCLUSION For hospitalized patients≥50 years in age,the bowel preparation regimen comprising 2-L PEG+30-mL lactulose+a low-residue diet produced a cleanse that was as effective as the 4-L PEG regimen and even provided better comfort.

Characteristics of the HIV/AIDS Epidemic among People Aged≥50 Years in China during 2018–2021

Objective This study aimed to determine the current epidemiological status of PLWHA aged≥50 years in China from 2018 to 2021.It also aimed to recommend targeted interventions for the prevention and treatment of HIV/AIDS in elderly patients.Methods Data on newly reported cases of PLWHA,aged≥50 years in China from 2018 to 2021,were collected using the CRIMS.Trend tests and spatial analyses were also conducted.Results Between 2018 and 2021,237,724 HIV/AIDS cases were reported among patients aged≥50 years in China.The main transmission route was heterosexual transmission(91.24%).Commercial heterosexual transmission(CHC)was the primary mode of transmission among males,while non-marital non-CHC([NMNCHC];60.59%)was the prevalent route in women.The proportion of patients with CHC decreased over time(Z=67.716,P<0.01),while that of patients with NMNCHC increased(Z=153.05,P<0.01).The sex ratio varied among the different modes of infection,and it peaked at 17.65 for CHC.The spatial analysis indicated spatial clustering,and the high-high clustering areas were mainly distributed in the southwestern and central-southern provinces.Conclusion In China,PLWHA,aged≥50 years,were predominantly infected through heterosexual transmission.The primary modes of infection were CHC and NMNCHC.There were variations in the sex ratio among different age groups,infected through various sexual behaviors.HIV/AIDS cases exhibited spatial clustering.Based on these results,the expansion of HIV testing,treatment,and integrated behavioral interventions in high-risk populations is recommended to enhance disease detection in key regions.

Improving the Use of Insecticide-Treated Nets among Children under Five Years Old in Benin, West Africa

Background: In Benin, malaria represents the first cause of consultation and hospitalization (48% for children under 5 years old) in health units. It also accounts for 23.1% of deaths recorded in health facilities (MoH, 2019). Between the two main components of vector control adopted by Benin government, the mass distribution campaigns of Insecticide-Treated Nets (ITNs) remained the only proven cost-effective way to rapidly achieve high and equitable coverage (WHO, 2017). After the fourth mass distribution campaign conducted in 2017, the Demographic and Health Survey (DHS) data indicated that the percentage of children who slept under an ITN has increased from 20% in 2006 to 70% in 2011-2012 and to 76% in 2017-2018 while the incidence of malaria (tested positive) is increasing rapidly among children under 5 years old, growing from 36.5% in 2009 to 28.8% in 2012 and then to 51.4% in 2019. This study aims to understand this contrast by identifying the origin of the increase in ITN use over time among children under five years old and the factors which determine this use. Methods: Data from the Demographic and Health Survey (DHS) conducted in Benin respectively in 2006 and in 20018 were used during the analysis, which covered 13,445 children under five years old from 2006 DHS and 12,255 children from 2017-2018 DHS. Firstly, the data were analyzed using decomposition method to highlight the origin of the increase of ITN use over time among children under five years old. Secondly, the chi-square test analysis estimated the association between ITN use and some characteristics (wealth index, maternal or caregiver education level and child age). Finally, the logistic regression model was used to identify the main factors, which influence the net use over the study period. Results: This study shows that the improvement of basic conditions is the main origin of behavior change in the use of ITNs among children under five years old. This improvement of the basic conditions consists of making ITNs available in households and informing household members about the benefits of ITN use. So, the free ITN distribution campaigns, routine distribution, awareness campaigns about the benefits of ITN use are the strategies, which increase the household capacities and knowledge, allowing household members to make their children sleep under net. The analysis also shows that region of residence, wealth index of household, household size, religion, and child age continue to determine the ITN use among children under age 5 years old and MNCP will integrate the factors in malaria prevention strategies in order to achieve universal use of ITNs. Conclusions: Although, sleeping under ITN behavior has indeed spread among children under 5 years old, policymakers and other stakeholders should design strategies to maintain and improve the current level of ITN use to reach the collective protection threshold (80% according to WHO). Therefore, to address the challenges of universal use of ITN, the study recommends expanding the routine distribution system to private sector health centers;discussing issues related to health service utilization (particularly ITN use) within a consultation framework at the communal level. In addition, collecting qualitative and quantitative data in the Oueme region will allow better understanding of all aspects of the ITN use gap among children under 5 years.

Ailogeneic hematopoietic cell transplantation for malignant hematological diseases in patients older than 50 years of age

Objective To investigate the efficiency and safety of allogeneic hematopoietic cell transplantation for malignant hematological diseases in patients older than 50 years of age. Methods From May 2002 to January 2010,35 patients P 】 50 years with malignant hematological diseases received allogeneic hematopoietic

深圳市龙岗区新发现≥50岁患者HIV感染/AIDS流行趋势特征和定量预测

目的掌握≥50岁患者的HIV感染/AIDS流行趋势特征,并进行定量预测,为指导疫情防控和风险评估提供科学依据。方法用描述流行病学方法分析深圳市龙岗区2018-2023年新发现≥50岁患者HIV感染/AIDS的趋势特征,用缓冲算子序列建立灰色均值GM(1,1)模型进行趋势判定和定量预测。结果2018-2023年深圳市龙岗区新发现≥50岁HIV感染/ADIS患者271例,年均(45±11)例;男/女性别比3.44∶1,50~59岁占62.37%,职业分布较广,以家务及待业(37.27%)和商业服务(15.87%)较多,已婚或有配偶占53.51%,初中以下文化占62.36%,外市户籍占81.18%;感染途径以异性传播(71.22%)为主,非婚异性性接触史高(63.10%);发现途径以医疗机构检测发现(76.38%)为主。各年≥50岁HIV感染/ADIS患者在人群特征、感染途径和检测样本来源等分布上未呈现趋势变化(P>0.05);在当年新发现HIV感染/ADIS患者构成比呈现出增长趋势(P<0.05)。建立的弱化算子GM(1,1)灰色模型优秀,平均相对误差<2.0%,精度>98.0%,发展系数为0.05,患者数呈增长趋势,预测2024-2028年≥50岁患者年发现数将可能从62例增长至75例。结论深圳市龙岗区≥50岁HIV感染/ADIS患者在构成占比和患者数上均呈增长趋势,应重点关注≥50岁HIV感染/ADIS患者,针对老年人群加强宣传教育、制定和完善AIDS综合干预和防治体系。灰色GM(1,1)预测模型可用于≥50岁人群中HIV感染/AIDS流行趋势判定和定量预测,对风险定量评估和疫情防控具有较好的指导意义。

Stereopsis after Implantation of Intraocular Lens in Patients under 40 Years Old with Unilateral Cataract

Purpose:.To investigate the stereopsis after single focus intraocular lens (SIOL) implantation in patients aged < 40 years with unilateral cataract. Methods: In total, 36 patients (36 eyes) were divided into emmetropia and myopia groups. Twenty seven subjects with good uncorrected distance visual acuity (UCDVA) after surgery were enrolled in the emmetropia group..The myopia group consisted of 9 subjects whose one eye had mild myopia postoperatively and the other was emmetropic or myopic. Visual acuity,.distance and near stereoacuity were measured post-operatively. Results:.In the emmetropia group,.uncorrected near visual acuity (UCNVA) did not differ significantly between eyes (t=1.87,P>0.05)..The LogMAR UCNVA of the operated and fellow eyes were (0.71±0.12) and (-0.05±0.07, t=28.4,P< 0.001) respectively..Distance stereoacuity was 60";.the near stereoacuity with uncorrected visual acuity and BCNVA in the operated eyes were 200" and 30" respectively (Z=-4.121,P< 0.001). In the myopia group,.the BCDVA did not differ significantly between the operated and fellow eyes (t=-0.636,P > 0.05)..The UCNVA of the operated eyes (0.18±0.12) was significantly better compared with that of the fellow eyes(-0.04±0.10,.t=4.2252,.P<0.001)..The distance stereoacuity with uncorrected visual acuity and BCDVA in the operated eyes were 200" and 60" respectively (Z =-2.371,P<0.05). The near stereoacuity with uncorrected visual acuity was 50". Conclusion:For patients with unilateral cataract aged<40 years, stereopsis is closely associated with refractive status after IOL implantation..Near stereoacuity in emmetropic eyes can be improved with refraction,.and that in mildly myopic eyes can be enhanced by leaving myopia uncorrected.

Treatment Outcomes in Head and Neck Cancer Patients 80 Years Old and over

Background: With the recent aging of society, the need for medical treatment of elderly patients with head and neck cancer seems to have been increasing. Method: The present study analyzed all 103 patients with head and neck cancer ≥80 years, and we compared results with those of the previous generation (Group P;range: 75 - 79 years) comprising 104 patients treated in the same period. Results: We provided treatment just as wanted and could not choose it often. The reasons were oncological factors such as unresectable tumor or distant metastasis, refusal of treatment, and physical factors such as poor PS or number of comorbidities. Conclusion: Treatment choices should be based on the wishes and motivations of the patient and the medical assessment of physical function. When a patient ≥80 years old is treated, the high incidence of complications and severity of the disease should be considered.

LESSONS FROM THE 50 POSTWAR YEARS

Fifty years is but a twinkle of the eye in the long stream ofhuman history,but each 50 year period is one of the links in thechain that connects the past to the present,and each link has itown significance.At the turn of the century it is fit for us to re-view cool-headly the changes in world politics in the last 50 yearsso as to be able to explore on the world of the 21st century.

Benefits for Future Sino-US Relations from Lessons of Past 50 Years

The roller coaster Sino-US relations over the past 50 years have dipped to a newlow once again this year, with clamor for strategic competition drowning outadvocacy of strategic cooperation on the other shore of the Pacific Ocean. Why bi-lateral ties have thus far failed to shatter this erratic puzzling bind ? A review of thepast 50 years will perhaps offer us much food for thought.

Fossils Reveal Flowers Originated 50 Million Years Earlier than Thought

The discovery in China of fossil specimens of a flower called Nanjinganthus from the Early Jurassic suggests that flowers originated 50 million years earlier than previously thought.Scientists have discovered the earliest flower specimens dating back to the Early Jurassic。

CAS RESEARCH CONTINGENT CONSTRUCTION IN THE PAST 50 YEARS

The achievement of high-level R&D results and the nurture of high-level research professionals are the two principal missions committed to the CAS by our nation. So, the development of a competent research contingent is ever regarded as a top priority in the work agenda of CAS leaders, and this is a topic of vital importance to the Party, the central government and the people.

A Healthy Relationship China-Africa medical cooperation still going strong after 50 years

The [medical] areas of cooperation [between China and Africa] have amso been expanded from sending medical teams to training local medical personnel; from building hospitals and providing free medication to conducting joint medical research.

Distribution and characteristics of initial PSA and PSA velocity in men younger than 50 years without prostate cancer

Objective To explore the distribution and characteristics of initial PSA and PSA velocity in men younger than years without prostate cancer. Methods PSA in men younger than 50 years without prostate cancer from January 2001 to November 2009 were retrieved retrospec-