Objective To evaluate whether cardiac resynchronisation therapy （CRT） implantation was feasible and safe in octogenarians and the asso- ciation with symptoms. Methods Consecutive patients undergoing CRT implantation...Objective To evaluate whether cardiac resynchronisation therapy （CRT） implantation was feasible and safe in octogenarians and the asso- ciation with symptoms. Methods Consecutive patients undergoing CRT implantation were recruited from two UK centers. Patients grouped according to age： 〈 80 ＆ ≥ 80 years. Baseline demographics, complications and outcomes were compared between those groups. Results A total of 439 patients were included in this study, of whom 26% were aged ≥ 80 years. Octogenarians more often received cardiac resynchronization therapy pacemaker in comparison to cardiac resynchronisation therapy-defibrillator. Upgrade from pacemaker was common in both groups （16% 〈 80 years vs. 22% ≥ 80 years, P = NS）. Co-morbidities were similarly common in both groups （overall diabetes： 25%, atrial fibrillation： 23%, hypertension： 45%）. More patient age ≥ 80 years had significant chronic kidney disease （CKD, estimated glomerular filtration rate 〈 45 mL/min per 1.73 m^2, 44% vs. 22%, P 〈 0.01 ）. Overall complication rates （any） were similar in both groups （16% vs. 17%, P = NS）. Both groups demonstrated symptomatic benefit. One-year mortality rates were almost four fold greater in octogenarians as compared with the younger cohort （13.9% vs. 3.7%, P 〈 0.01）. Conclusions CRT appears to be safe in the very elderly despite extensive co-morbidity, and in particular frequent severe CKD. Symptomatic improvement appears to be meaningful. Strategies to increase the appropriate identification of elderly patients with CHF who are potential candidates for CRT are required.展开更多
At present, the world＇s aging population is developing at an unprecedented rate, how to deal with the community service for the elderly has become a top priority. For it not only relates to the community＇s harmony b...At present, the world＇s aging population is developing at an unprecedented rate, how to deal with the community service for the elderly has become a top priority. For it not only relates to the community＇s harmony but also to the whole social＇s stability. This paper summarized some experiences and practices from some typical foreign countries on their community endowment, such as the British community care model, the Japan＇s aged care at home, the PACE mode of United States, the Germany＇s long-term care services, the Australian＇s old-age community security. On the basis of a comparative analysis, this paper concluded some experience and enlightenment of serving the old in abroad urban community, this include： Give full play to the function and role of the community in the pension, take law as safeguard on the implementation of community endowment, professional services, government-led and multiple subject participation, provide comprehensive and diversified service, etc. Combined with China＇s national conditions, this paper puts forward some countermeasures and suggestions in the end to further perfect China＇s elderly community service.展开更多
This paper focuses on how aging can affect performance of safety-related structures in nuclear power plant (NPP). Knowledge and assessment of impacts of aging on structures are essential to plant life extension analys...This paper focuses on how aging can affect performance of safety-related structures in nuclear power plant (NPP). Knowledge and assessment of impacts of aging on structures are essential to plant life extension analysis,especially performance to severe loadings such as loss-of-coolant-accidents or major seismic events. Plant life extension issues are of keen interest in countries (like the United States) which have a large,aging fleet of NPPs. This paper addresses the overlap and relationship of structure aging to severe loading performance,with particular emphasis on containment structures.展开更多
文摘Objective To evaluate whether cardiac resynchronisation therapy （CRT） implantation was feasible and safe in octogenarians and the asso- ciation with symptoms. Methods Consecutive patients undergoing CRT implantation were recruited from two UK centers. Patients grouped according to age： 〈 80 ＆ ≥ 80 years. Baseline demographics, complications and outcomes were compared between those groups. Results A total of 439 patients were included in this study, of whom 26% were aged ≥ 80 years. Octogenarians more often received cardiac resynchronization therapy pacemaker in comparison to cardiac resynchronisation therapy-defibrillator. Upgrade from pacemaker was common in both groups （16% 〈 80 years vs. 22% ≥ 80 years, P = NS）. Co-morbidities were similarly common in both groups （overall diabetes： 25%, atrial fibrillation： 23%, hypertension： 45%）. More patient age ≥ 80 years had significant chronic kidney disease （CKD, estimated glomerular filtration rate 〈 45 mL/min per 1.73 m^2, 44% vs. 22%, P 〈 0.01 ）. Overall complication rates （any） were similar in both groups （16% vs. 17%, P = NS）. Both groups demonstrated symptomatic benefit. One-year mortality rates were almost four fold greater in octogenarians as compared with the younger cohort （13.9% vs. 3.7%, P 〈 0.01）. Conclusions CRT appears to be safe in the very elderly despite extensive co-morbidity, and in particular frequent severe CKD. Symptomatic improvement appears to be meaningful. Strategies to increase the appropriate identification of elderly patients with CHF who are potential candidates for CRT are required.
文摘At present, the world＇s aging population is developing at an unprecedented rate, how to deal with the community service for the elderly has become a top priority. For it not only relates to the community＇s harmony but also to the whole social＇s stability. This paper summarized some experiences and practices from some typical foreign countries on their community endowment, such as the British community care model, the Japan＇s aged care at home, the PACE mode of United States, the Germany＇s long-term care services, the Australian＇s old-age community security. On the basis of a comparative analysis, this paper concluded some experience and enlightenment of serving the old in abroad urban community, this include： Give full play to the function and role of the community in the pension, take law as safeguard on the implementation of community endowment, professional services, government-led and multiple subject participation, provide comprehensive and diversified service, etc. Combined with China＇s national conditions, this paper puts forward some countermeasures and suggestions in the end to further perfect China＇s elderly community service.
文摘This paper focuses on how aging can affect performance of safety-related structures in nuclear power plant (NPP). Knowledge and assessment of impacts of aging on structures are essential to plant life extension analysis,especially performance to severe loadings such as loss-of-coolant-accidents or major seismic events. Plant life extension issues are of keen interest in countries (like the United States) which have a large,aging fleet of NPPs. This paper addresses the overlap and relationship of structure aging to severe loading performance,with particular emphasis on containment structures.
