Objective: Cancer is one of the most common diagnoses in elderly patients. Of all types of abdominal cancer, colorectal cancer(CRC) is undoubtedly the most frequent. Median age at diagnosis is approximately 70 years o...Objective: Cancer is one of the most common diagnoses in elderly patients. Of all types of abdominal cancer, colorectal cancer(CRC) is undoubtedly the most frequent. Median age at diagnosis is approximately 70 years old worldwide. Due to the multiple comorbidities affecting elderly people, frailty evaluation is very important in order to avoid over- or undertreatment. This pilot study was designed to investigate the variables capable of predicting the long-term risk of mortality and living situation after surgery for CRC.Methods: Patients with 70 years old and older undergoing elective surgery for CRC were prospectively enrolled in the study. The patients were preoperatively screened using 11 internationally-validated-frailty-assessment tests. The endpoints of the study were long-term mortality and living situation. The data were analyzed using univariate Cox proportional-hazard regression analysis to verify the predictive value of score indices in order to identify possible risk factors.Results: Forty-six patients were studied. The median follow-up time after surgery was 4.6 years(range, 2.9-5.7 years) and no patients were lost to follow-up. The overall mortality rate was 39%. Four of the patients who survived(4/28, 14%) lost their functional autonomy. The preoperative impaired Timed Up and Go(TUG), Eastern Cooperative Group Performance Status(ECOG PS), Instrumental Activities of Daily Living(IADLs), Vulnerable Elders Survey(VES-13) scoring systems were significantly associated with increased long term mortality risk.Conclusion: Simplified frailty-assessing tools should be routinely used in elderly cancer patients before treatment in order to stratify patient risk. The TUG, ECOG-PS, IADLs and VES-13 scoring systems are potentially able to predict long-term mortality and disability. Additional studies will be needed to confirm the preliminary data in order to improve management strategies for oncogeriatric surgical patients.展开更多
Filling velocity and thickness of soft layer are major factors affecting subgrade stability according to an example study by means of finite element stress method(FESM). A case is studied and shows that the subgrade w...Filling velocity and thickness of soft layer are major factors affecting subgrade stability according to an example study by means of finite element stress method(FESM). A case is studied and shows that the subgrade was slided because of excessive filling velocity. To determine a reasonable filling velocity is a key problem to a subgrade with marine soft soil.展开更多
The interactive effects of natural and human factors on ecosystems have been well studied, and the quantitative assessment of large-scale ecological vulnerability caused by natural and human factors is now one of the ...The interactive effects of natural and human factors on ecosystems have been well studied, and the quantitative assessment of large-scale ecological vulnerability caused by natural and human factors is now one of the most active topics in the ifeld. Taking the Guangxi Xijiang River Economic Belt in southwest China （GXEB） as a case study, we assess ecological vulnerability based on the Vulnerability Scoping Diagram （VSD） model. The indices system is decomposed into three sub objects, ten elements and 25 indicators layer by layer, which included factors from both natural and human ifelds. Results indicate that zones with lower, middle-lower, middle, middle-higher and higher vulnerability account for 11.31%, 22.63%, 27.60%, 24.39%, and 14.07%, respectively. The western and eastern parts of GXEB are more vulnerable than the central part and the mountain and urban areas are of higher vulnerability than the basins and river valleys. Compared with a vulnerability assessment based on natural factors only, it is concluded that human activities indeed cause the transition from naturally stable zones to vulnerable zones. The nature-dominated vulnerable zones are different with human-dominated ones in size and distribution, the latter being smaller, more scattered and distributed in urban areas and their surroundings. About 53%of total construction land is distributed in zones with middle and middle-higher ecological vulnerability;less vulnerable zones should attract construction in the future. Relevant suggestions are proposed on how to reduce vulnerability according to inducing factors. The VSD model has a signiifcant advantage in the quantitative evaluation of ecological vulnerability, but is insufficient to distinguish nature- or human-dominated vulnerability quantitatively.展开更多
文摘Objective: Cancer is one of the most common diagnoses in elderly patients. Of all types of abdominal cancer, colorectal cancer(CRC) is undoubtedly the most frequent. Median age at diagnosis is approximately 70 years old worldwide. Due to the multiple comorbidities affecting elderly people, frailty evaluation is very important in order to avoid over- or undertreatment. This pilot study was designed to investigate the variables capable of predicting the long-term risk of mortality and living situation after surgery for CRC.Methods: Patients with 70 years old and older undergoing elective surgery for CRC were prospectively enrolled in the study. The patients were preoperatively screened using 11 internationally-validated-frailty-assessment tests. The endpoints of the study were long-term mortality and living situation. The data were analyzed using univariate Cox proportional-hazard regression analysis to verify the predictive value of score indices in order to identify possible risk factors.Results: Forty-six patients were studied. The median follow-up time after surgery was 4.6 years(range, 2.9-5.7 years) and no patients were lost to follow-up. The overall mortality rate was 39%. Four of the patients who survived(4/28, 14%) lost their functional autonomy. The preoperative impaired Timed Up and Go(TUG), Eastern Cooperative Group Performance Status(ECOG PS), Instrumental Activities of Daily Living(IADLs), Vulnerable Elders Survey(VES-13) scoring systems were significantly associated with increased long term mortality risk.Conclusion: Simplified frailty-assessing tools should be routinely used in elderly cancer patients before treatment in order to stratify patient risk. The TUG, ECOG-PS, IADLs and VES-13 scoring systems are potentially able to predict long-term mortality and disability. Additional studies will be needed to confirm the preliminary data in order to improve management strategies for oncogeriatric surgical patients.
基金Supported by Foundation of Innovation Project of Jilin University
文摘Filling velocity and thickness of soft layer are major factors affecting subgrade stability according to an example study by means of finite element stress method(FESM). A case is studied and shows that the subgrade was slided because of excessive filling velocity. To determine a reasonable filling velocity is a key problem to a subgrade with marine soft soil.
基金National Natural Science Foundation of China(41201110)Young Talents Foundation of Nanjing Institute of Geography and Limnology of CAS(NIGLAS2011QD03)
文摘The interactive effects of natural and human factors on ecosystems have been well studied, and the quantitative assessment of large-scale ecological vulnerability caused by natural and human factors is now one of the most active topics in the ifeld. Taking the Guangxi Xijiang River Economic Belt in southwest China （GXEB） as a case study, we assess ecological vulnerability based on the Vulnerability Scoping Diagram （VSD） model. The indices system is decomposed into three sub objects, ten elements and 25 indicators layer by layer, which included factors from both natural and human ifelds. Results indicate that zones with lower, middle-lower, middle, middle-higher and higher vulnerability account for 11.31%, 22.63%, 27.60%, 24.39%, and 14.07%, respectively. The western and eastern parts of GXEB are more vulnerable than the central part and the mountain and urban areas are of higher vulnerability than the basins and river valleys. Compared with a vulnerability assessment based on natural factors only, it is concluded that human activities indeed cause the transition from naturally stable zones to vulnerable zones. The nature-dominated vulnerable zones are different with human-dominated ones in size and distribution, the latter being smaller, more scattered and distributed in urban areas and their surroundings. About 53%of total construction land is distributed in zones with middle and middle-higher ecological vulnerability;less vulnerable zones should attract construction in the future. Relevant suggestions are proposed on how to reduce vulnerability according to inducing factors. The VSD model has a signiifcant advantage in the quantitative evaluation of ecological vulnerability, but is insufficient to distinguish nature- or human-dominated vulnerability quantitatively.
