关于汉语副词“也”的用法,马真同志在《说“也”》一文中,认为“也”的基本意义是表示类同。但是,日本学者中川正之又注意到这样一种现象: ① a他们俩都上了年纪,李刚八十岁了,张海也七十五岁了。 b他们俩都上了年纪,李刚七十五岁了...关于汉语副词“也”的用法,马真同志在《说“也”》一文中,认为“也”的基本意义是表示类同。但是,日本学者中川正之又注意到这样一种现象: ① a他们俩都上了年纪,李刚八十岁了,张海也七十五岁了。 b他们俩都上了年纪,李刚七十五岁了,张海也八十岁了。 同是两个并列句,句①a由于是“减轻附加”,用“也”很自然,句(1)b由于是“加重累加”,用“也”就不自然。我们觉得这和“也”的表义作用有关,如果上面两句不用“也”,两种说法就都是自然的了。这说明“也”在表示类同的同时,还隐含着一种递减意义。 仅仅观察上例,人们容易把递减理解为数量多的在前,数量少的在后。其实,这和数量并没有关系,请看下面的例句:展开更多
The aging of the population results in a rise of number of elderly patients(aged 80 years and older) with pancreatic or periampullary cancer, and more pancreatectomies could eventually be performed in such complex pat...The aging of the population results in a rise of number of elderly patients(aged 80 years and older) with pancreatic or periampullary cancer, and more pancreatectomies could eventually be performed in such complex patients. However, early and long-term results after pancreatic resection in octogenarians are still controversial, and may trouble the surgeon when approaching this type of population. Evaluation of reported experiences shows that for almost all Authors, pancreatectomy can be performed safely in elderly population, although overall morbidity and mortality rates were 34.9% and 13.2% respectively, with a mean length of hospital stay of 18 d. These features appear higher in older patients compared to the younger counterpart. Less than 50% of patients underwent adjuvant therapy after operation. Long-term survival is reported not significantly different in aged 80 years and older patients, with a median overall survival time of 17.6 mo. The quality of life after pancreatic resection is only sporadically evaluated but, when considered, it highlights the need of health facility service after operation for these "frail" patients. Prospective studies on the quality of life of pancreatectomized octogenarians are welcome. Proper selection of patients, geriatric assessment with multidisciplinary approach, centralization of pancreatic surgery in high-volume centres and rehabilitation programs after surgery appear to be crucial points in order to improve surgical treatments of pancreatic tumors in very elderly patients.展开更多
AIM To characterize colorectal cancer(CRC) in octogenarians as compared with younger patients.METHODS A single-center, retrospective cohort study which included patients diagnosed with CRC at the age of 80 years or ol...AIM To characterize colorectal cancer(CRC) in octogenarians as compared with younger patients.METHODS A single-center, retrospective cohort study which included patients diagnosed with CRC at the age of 80 years or older between 2008-2013. A control group included consecutive patients younger than 80 years diagnosed with CRC during the same period. Clinicopathological characteristics, treatment and outcome were compared between the groups. Fisher's exact test was used for dichotomous variables and χ2 was used for variables with more than two categories. Overall survival was assessed by Kaplan-Meier survival analysis, with the log-rank test. Cancer specific survival(CSS) and disease-free survival were assessed by the Cox proportional hazards model, with the Fine and Gray correction for non-cancer death as a competing risk.RESULTS The study included 350 patients, 175 patients in each group. Median follow-up was 40.2 mo(range 1.8-97.5). Several significant differences were noted. Octogenarians had a higher proportion of Ashkenazi ethnicity(64.8% vs 47.9%, P < 0.001), a higher rate of personal history of other malignancies(22.4% vs 13.7%, P = 0.035) and lower rates of family history of any cancer(36.6% vs 64.6%, P < 0.001) and family history of CRC(14.4% vs 27.3%, P = 0.006). CRC diagnosis by screening was less frequent in octogenarians(5.7% vs 20%, P < 0.001) and presentation with performance status(PS) of 0-1 was less common in octogenarians(71% vs 93.9%, P < 0.001). Octogenarians were more likely to have tumors located in the right colon(45.7% vs 34.3%, P = 0.029) and had a lower prevalence of well differentiated histology(10.4% vs 19.3%, P = 0.025). They received less treatment and treatment was less aggressive, both in patients with metastatic and non-metastatic disease, regardless of PS. Their 5-year CSS was worse(63.4% vs 77.6%, P = 0.009), both for metastatic(21% vs 43%, P = 0.03) and for non-metastatic disease(76% vs 88%, P = 0.028).CONCLUSION Octogenarians presented with several distinct characteristics and had worse outcome. Further research is warranted to better define this growing population.展开更多
文摘The aging of the population results in a rise of number of elderly patients(aged 80 years and older) with pancreatic or periampullary cancer, and more pancreatectomies could eventually be performed in such complex patients. However, early and long-term results after pancreatic resection in octogenarians are still controversial, and may trouble the surgeon when approaching this type of population. Evaluation of reported experiences shows that for almost all Authors, pancreatectomy can be performed safely in elderly population, although overall morbidity and mortality rates were 34.9% and 13.2% respectively, with a mean length of hospital stay of 18 d. These features appear higher in older patients compared to the younger counterpart. Less than 50% of patients underwent adjuvant therapy after operation. Long-term survival is reported not significantly different in aged 80 years and older patients, with a median overall survival time of 17.6 mo. The quality of life after pancreatic resection is only sporadically evaluated but, when considered, it highlights the need of health facility service after operation for these "frail" patients. Prospective studies on the quality of life of pancreatectomized octogenarians are welcome. Proper selection of patients, geriatric assessment with multidisciplinary approach, centralization of pancreatic surgery in high-volume centres and rehabilitation programs after surgery appear to be crucial points in order to improve surgical treatments of pancreatic tumors in very elderly patients.
文摘AIM To characterize colorectal cancer(CRC) in octogenarians as compared with younger patients.METHODS A single-center, retrospective cohort study which included patients diagnosed with CRC at the age of 80 years or older between 2008-2013. A control group included consecutive patients younger than 80 years diagnosed with CRC during the same period. Clinicopathological characteristics, treatment and outcome were compared between the groups. Fisher's exact test was used for dichotomous variables and χ2 was used for variables with more than two categories. Overall survival was assessed by Kaplan-Meier survival analysis, with the log-rank test. Cancer specific survival(CSS) and disease-free survival were assessed by the Cox proportional hazards model, with the Fine and Gray correction for non-cancer death as a competing risk.RESULTS The study included 350 patients, 175 patients in each group. Median follow-up was 40.2 mo(range 1.8-97.5). Several significant differences were noted. Octogenarians had a higher proportion of Ashkenazi ethnicity(64.8% vs 47.9%, P < 0.001), a higher rate of personal history of other malignancies(22.4% vs 13.7%, P = 0.035) and lower rates of family history of any cancer(36.6% vs 64.6%, P < 0.001) and family history of CRC(14.4% vs 27.3%, P = 0.006). CRC diagnosis by screening was less frequent in octogenarians(5.7% vs 20%, P < 0.001) and presentation with performance status(PS) of 0-1 was less common in octogenarians(71% vs 93.9%, P < 0.001). Octogenarians were more likely to have tumors located in the right colon(45.7% vs 34.3%, P = 0.029) and had a lower prevalence of well differentiated histology(10.4% vs 19.3%, P = 0.025). They received less treatment and treatment was less aggressive, both in patients with metastatic and non-metastatic disease, regardless of PS. Their 5-year CSS was worse(63.4% vs 77.6%, P = 0.009), both for metastatic(21% vs 43%, P = 0.03) and for non-metastatic disease(76% vs 88%, P = 0.028).CONCLUSION Octogenarians presented with several distinct characteristics and had worse outcome. Further research is warranted to better define this growing population.
