中年须防隐性病

人到中年，会患各种疾病。但是，一些疾病的早期虽然没有任何症状，也没有给自己的身体带来不适，却更危险。常见的中年隐性疾病有以下这些：

Adenocarcinoma of gastric cardia in the elderly: Surgical problems and prognostic factors

AIM： To analyze retrospectively, our results about patients who underwent surgical treatment for adenocarcinoma of the cardia in relation to age, in order to evaluate surgical problems and prognostic factors. METHODS： From January 1987 to March 2003, 140 patients with adenocarcinoma of the cardia underwent resection in the authors＇ institution. They were divided into three groups with regard to age. Patients 〈70 and 〉 60 year old （31） were excluded; we also excluded 18 out of 109 patients with poor general status or systemic metastases. So, we compared 51 elderly （≥ 70 year old） and 58 younger patients （≤ 60 year old）. The treatment was esophagectomy for type I tumors, and extended gastrectomy and distal esophagectomy for type Ⅱ and Ⅲ lesions. RESULTS： Laparotomy was carried out in 91 patients （83.4%）, 38 in the elderly （74.5%） and 53 in younger patients （91.3%, P〈0.05）. Primary resection was performed in 81 cases （89%） without significant differences between the two groups. Postoperative death was higher in the elderly （12.1%） than the other group （4.1%, P〈0.05）, while morbidity was similar in both groups. A curative resection （R0） was performed in 59 patients （72.8%）, 69.6% in the elderly and 75% in the younger group （P〉0.05）. The overall 3- and 5-year survival rates were 26.7% and 17.8% respectively for the elderly and 40.7% and 35.1% respectively for younger patients （P = 0.1544）. Survival rates were significantly associated with R0 resection, pathological node-poskive category and tumor differentiation in both groups.CONCLUSION： As the age of the general population increases, more elderly patients with gastric cardia cancer will be candidates for surgical resection. Age alone should not preclude surgical treatment in elderly patients with gastric cardia cancer and a tumor resection can be carried out safely. Certainly, we should take care in defining the surgical treatment in elderly patients, particularly as regarding the surgical approach; although the surgical approach does not influence the survival rate, the transhiatal way still remains the best one due, to the lower incidence of respiratory morbidity and thoracic pain.

Clinicopathologic characteristics of gastric carcinoma in elderly patients: A comparison with young patients

AIM:To examine the clinicopathologic features of elderly patients with gastric carcinoma and to investigate the relationship between prognosis and age.METHODS: We reviewed the hospital records of 2 014patients with gastric carcinoma retrospectively to compare the clinicopathologic findings in elderly (age ＞70 years) and young (age ＜36 years) patients during the period from 1986 to 2000 in a tertiary referral center in Gwangju, Korea. Overall survival was the main outcome measure.RESULTS: Of the 2 014 patients, 194 (9.6%) were in the elderly group and 137 (6.8%) were in the young group.The elderly and young patients had similar distributions with respect to depth of invasion, nodal involvement, hepatic metastasis, peritoneal dissemination, tumor stage at the initial diagnosis, and type of surgery. Synchronous multiple carcinomas were found in 14/194 (7.2%) of the elderly group and 4/137 (2.9%) of the young group (P＜0.05). Using the Borrmann classification, type Ⅳ was more frequent in the young patients than in the elderly patients (P＜0.05).Significantly more elderly patients had a well or moderately differentiated histology, and more young patients had a poorly differentiated histology and signet ring cell carcinoma (P＜0.001). The 5-year survival rates of elderly and young patients did not differ statistically (52.8% vs 46.5%,P = 0.5290). Multivariate analysis showed that the histologic type, nodal involvement and operative curability were significant prognostic factors, and age itself was not an independent prognostic factor of survival for elderly gastric carcinoma patients.CONCLUSION: Elderly patients with gastric carcinoma do not have a worse prognosis than young patients. The important prognostic factor is whether the patients undergo a curative resection.

An analysis: Colon cancer mortality in Tianjin, China, from 1981 to 2000

AIM: To analyze the data from Tianjin Cancer Registry of mortality due to colon cancer from 1981 to 2000 in Tianjin, China. METHODS: Tumors diagnosed in this study were coded according to ICD-9. Mortality rates were calculated by sex and calendar year of diagnosis. RESULTS: Seventy point four percent of colon cancer deaths occurred in the age group of 55-79 years and the mortality rate reached its peak in the age group of 75-80 years. The average age at death was 64.10 years. An ascending trend was observed in the mean age of death due to colon cancer from 1981 through 2000. However, as for the sex ratio, there was no clear trend exhibited. During 1981-2000, the total number of deaths was 2147, 1041 males and 1106 females. The mean mortality rate of colon cancer was 3.04/100 000. The mortality caused by colon cancer ascended from 1981 to 2000. CONCLUSION: The epidemic trend of colon cancer in Tianjin and its risk factors and prevention should be studied further.

100 CASES OF INTRACTABLE MIGRAINE TREATED BY ACUPUNCTURE AND CUPPING

The author has treated 100 cases ofintractable migraine by acupuncture andcupping with satisfactory therapeutic results,as reported as follows.Clinical Data There were 100 cases in this series,including 38 males and 62 females. 8

Comparison of presentation and impact on quality of life of gastroesophageal reflux disease between young and old adults in a Chinese population

AIM:To compare the presentation and impact on qual-ity of life of gastroesophageal reflux disease(GERD)in old and young age groups.METHODS:Data from adult patients with GERD di-agnosed by endoscopic and symptomic characteristics were collected between January and November 2009.Exclusion criteria included combined peptic ulcers,ma-lignancy,prior surgery,antacid medication for more than 2 mo,and pregnancy.Enrolled patients were assigned to the elderly group if they were 65 years or older,or the younger group if they were under 65 years.They had completed the GERD impact scale,the Chinese GERD questionnaire,and the SF-36 question-naire.Data from other cases without endoscopic f ind-ings or symptoms were collected and these subjects comprised the control group in our study.RESULTS:There were 111 patients with GERD and 44 normal cases:78(70.3%)and 33 patients(29.7%)were in the younger and elderly groups,respectively.There were more female patients(60.3%)in the younger group,and more males(72.7%)in the elderly group.The younger cases had more severe and fre-quent typical symptoms than the elderly patients.Sig-nif icantly more impairment of daily activities was noted in the younger patients compared with the elderly group,except for physical functioning.CONCLUSION:Elderly patients with GERD were pre-dominantly male with rare presentation of typical symp-toms,and had less impaired quality of life compared with younger patients in a Chinese population.

Treatment of Urticaria with Cupping at Back-Shu Points——A Report of 40 Cases

Urticaria is a common and frequently encountered disease, which is mainly manifested by extreme pruritus and lumpish eruption of the skin. Acute urticaria with a short disease course can be cured, while the chronic one with repeated attacks is a lingering disorder. In the past few years, 40 cases of urticaria were treated by cupping at the back-shu points of the five zang-organs and Geshu (BL 17). Another 20 cases in the control group were treated with Fang Feng Tong Sheng Wan (防风通圣丸Miraculous Pills of Ledebouriella) and chlorpheniramine maleate. The therapeutic effect in the treatment group was significantly superior to that in the control group. The results are reported as follows.

CT image morphology features of pulmonary sclerosing hemangiomas

Objective: The aim of the study was to analyze the CT morphology features of pulmonary sclerosing hemangiomas (PSHs) and improve the diagnosis ability of this disease.Methods: The 18 cases of pulmonary sclerosing hemangioma (PSH) confirmed by operation and histopathology from August 2002 to May 2009 were collected,including 17 females and 2 males,aged from 19 to 60 years old,with an average age of 43 years.All the cases underwent plain CT scan,among them,16 cases received enhanced CT scan.Results: The 18 cases had isolated mass.Mean long-axis diameter of these lesions was (2.7 ± 1.3) cm (range,1.9–4.2 cm).Of all cases,5 cases (27.8%) were round in shape,9 cases (50%) were oval,4 cases (22.2%) were lobulated,and 14 cases (77.8%) were smooth margin.The air meniscus sign was in 2 cases (11.1%),and the halo sign in 3 cases (16.7%).Two cases (11.1%) contained small nodular calcification,the remaining 16 cases (70%) were homogeneous density,the CT density of the masses ranged from 24–47 HU,and the mean value was 35 HU.Sixteen cases received enhanced scan,the welt vessel sign was in 8 cases (44.4%),1 case showed less enhancement,5 cases showed marked homogeneous enhancement and 10 cases showed intense and patchy heterogeneous enhanced.The CT density of the enhancing masses ranged from 60–110 HU,the mean value was 35 HU,and the net enhancement value was 14–80 HU,the mean value was 55 HU.Conclusion: PSH should be considered in middle-aged female whose CT found that single round or oval pulmonary nodules,with smooth margin,or associated with the air meniscus sign,the halo sign,or the marked enhancement.

One Hundred Cases of Sciatica Treated by Surrounding Puncture

From 1989 to 1995,the authors used the methodof surrounding puncture to treat 100 cases of sciaticaand obtained satisfactory therapeutic results asreported in the following.General DataIn the treatment group,of 100 cases,43 weremale and 57 female with the ages ranging from 15 to26 years,averaging 38 years.The duration of diseasewas from 3 days to 1.5 years,averaging 25 days.Ofthem,76 cases were spinal cord type and 24 nerveroot type;29 cases were diagnosed after CT examand 71 by lateral lumbar vertebra X-ray.

A Study of Classification of Figures and Sizes for Middle-and Old-Aged Men

The characteristics of human figures, variable laws and the basic sizes of each part of human body have been found by means of anthropomctric measurements of the middle-arid old-aged men and data analyses. Also, proposals of how to classify dimensions and sizes of the medium human figures among the middle-and old-aged men have been put forward.

CLINICAL OBSERVATION ON ELECTROTHERMAL ACUPUNCTURE IN TREATMENT OF 16 CASES OF VULVAR DYSTROPHY

Electrothermal acupuncture,amodification of the traditional“hot-red”puncturing technique, is generally adopted forsoftening and resolving hard mass,

Catheter ablation of atrial fibrillation in the elderly

Background Atrial fibrillation （AF） catheter ablation has emerged as a promising treatment strategy for AF, but has not been widely adopted in the elderly population. The present study aimed to determine the safety and efficacy of AF catheter ablation in the elderly popula-tion. Methods and Results The study population consisted of 316 patients with paroxysmal AF who underwent left atrial ablation. Ninety-five patients were≥65 years （48 males, mean age 68.9 ± 3.0 years old） and 221 patients were〈65 years old （130 males, mean age 52.5 ± 10.4 years old）. After a mean follow-up period of 34.0 ± 15.1 months, 55 （57.9%） patients in the elderly group were free from ar-rhythmia recurrence compared with 149 （67.4%） patients in the younger group （P=0.169）. Procedural complications were uncommon in both study groups. In logistic regression analysis, left atrial diameter （P=0.003）, hypertension （P=0.001）, dyslipidemia （P=0.039）, and coronary artery disease （P=0.018） were independent predictors of AF recurrence in the elderly population. Conclusions Catheter ablation of AF is safe and effective in older patients. Invasive strategies should be considered as an alternative choice in symptomatic elderly patients with AF.

Cupping Therapy for 103 Cases of High Fever due to Infection of the Upper Respiratory Tract

The cupping therapy has remarkable antipyretic effect in the treatment of fever. In recent years, the author has treated 103 cases of high fever caused by infection of the upper respiratory tract and obtained quite satisfactory therapeutic results. A report follows.

Cardiovascular care for older adults： hypertension and stroke in the older adult

1 Introduction Hypertension and cerebrovascular disease incidence and prevalence rise dramatically with age, owing to longer exposure time to age-associated alterations in vascular function and structure and cardiovascular risk factors. This chapter is aimed at connecting age-related alterations in vascular function and structure to the resultant target organ damage, and to raise awareness of unique presentations and treatment strategies for hypertension and stroke in older adults.

A Variant Maneuver of Acupuncture in Treating Cervical Spondylopathy

Lifting and thrusting with reducing method at acupoint Huatuojiaji (Extra 21) of the affected side was performed to make the limb of the affected side contract involuntarily 1-2 times in 53 cases with cervical spondylopathy. The maneuver produced a much better total effective rate than the routine maneuver (P

Acupuncture Treatment for 34 Cases of Uremic Cutaneous Pruritus

Chronic renal insufficiency is the result of renal injuries and progressive deterioration caused by various reasons. At the late stage, i.e. the period of uremia, it may be complicated with abnormalities of various systems. Along with the development and popularization of hemodialysis, the survival time of uremic patients can be prolonged, but uremic pruritus affects greatly the quality of life of the patients. For this purpose, we have treated 68 cases of the patients with acupuncture and western medicine respectively, and made clinical observations on the therapeutic results. A report follows.……

Changes in Climatic Factors and Extreme Climate Events in Northeast China during 1961-2010

This study focuses on examining the characteristics of climate factors and extreme climate events in Northeast China during 1961- 2010 by using daily data from 104 stations, including surface air temperature, precipitation, wind speed, sunshine duration, and snow depth. Results show that annual mean temperature increased at a significant rate of 0.35℃ per decade, most notably in the Lesser Khingan Mountains and in winter. Annual rainfall had no obvious linear trend, while rainy days had a significant decreasing trend. So, the rain intensity increased. High-temperature days had a weak increasing trend, and low-temperature days and cold wave showed significant decreasing trends with rates of 3.9 d per decade and -0.64 times per decade, respectively. Frequency and spatial scope of low-temperature hazard reduced significantly. Warm days and warm nights significantly increased at 1.0 and 2.4 d per decade, while cold days and cold nights decreased significantly at -1.8 and -4.1 d per decade, respectively. The nighttime warming rate was much higher than that for daytime, indicating that nighttime warming had a greater contribution to the overall warming trend than daytime warming. The annual mean wind speed, gale days, and sunshine duration had significant decreasing trends at rates of-0.21 m s-1 per decade, -4.0 d per decade and -43.3 h per decade, respectively. The snow cover onset dates postponed at a rate of 1.2 d per decade, and the snow cover end date advanced at 1.5 d per decade, which leads to shorter snow cover duration by -2.7 d per decade. Meanwhile, the maximum snow depth decreased at -0.52 cm per decade. In addition, the snow cover duration shows a higher correlation with precipitation than with temperature, which suggests that precipitation plays a more important role in maintaining snow cover duration than temperature.

Acupuncture Treatment of Superficial Pain by Subcutaneous Needling

Subcutaneous needling is an old art of the 'twelve needling methods' in TCM for treating arthralgia due to cold or disorders in the superficial tissues. Some cases are effectively treated as introduced below.……

The Effects of Touch Button Size on Touchscreen Operability

The present study investigated the effects of touch button size on touchscreen operability and compared these effects between young adult and elderly participants. A total of 21 young adults （aged 22.3 ± 1.5 years） and 20 elderly adults （aged 68.1 ±4.9 years） were recruited and asked to press square number buttons （from 0 to 9） on an experimental touchscreen with their right index finger. The buttons＇ size changed during the experiment with six conditions （6, 8, 10, 12, 14 and 16 mm）. It was found that a decrease of the button size to l0 mm or below tended to increase the operation time and error rate, whereas it decreased the subjective overall operability of the touchscreen. Such effects were greater in the elderly adults than in the young adults. In addition, the reaction positions on the buttons were found to be close to the right side of them, which led the fingertip to approach the right outline of the buttons. These findings suggest that the use of small touch buttons should be minimised on touchscreens, especially for elderly users.

Effect of Acupuncture on the Auditory Evoked Brain Stem Potential in Parkinson's Disease

Under the auditory evoked brain stem potential (ABP) examination, the latent period of V wave and the intermittent periods of III-V peak and I-V peak were significantly shortened in Parkinson's disease patients of the treatment group (N=29) after acupuncture treatment. The difference of cumulative scores in Webster's scale was also decreased in correlation analysis. The increase of dopamine in the brain and the excitability of the dopamine neurons may contribute to the therapeutic effects, in TCM terms, of subduing the pathogenic wind and tranquilizing the mind.……