Aortic valve stenosis： treatments options in elderly high-risk patients

In the last decades, a trend towards a worldwide aging has been reported and diseases which are common in the elderly people would have important implications in clinical practice. Aortic stenosis （AS） is perhaps the most common and most often cause of sudden death among valvular heart diseases. Its prevalence is low among adults aged 〈 60 years, but increases to almost 10% in adults ≥ 80 years.[2] Since the degenerative calcific disease represents the lead- ing cause of AS in developed countries, the improved understanding on its pathogenesis （atherosclerotic processes and/or skeleton key） may offer potentially new targets for preventing and inhibiting AS development and progres- sion.[3] Patients with AS are generally asymptomatic for a prolonged period and the development of symptoms is a critical point in the natural history. Indeed, the prognosis changes dramatically with the onset of symptoms of angina,

上消化道出血几个危险因素的临床观察

目的观察患者的性别、年龄、职业、季节、吸烟、饮酒及Hp感染等七个相关危险因素与上消化道出血（UGB）的关系方法有上消化道症状的患者12748例，内镜检查前按事先设计的提纲和表格，详细询问并登记UGB表现和相关因素状况．UGB的诊断依据为内镜前2wk有呕和（或）黑便．出血的病因诊断以内镜和活检病理为准．有关数据行综合分析，统计学处理，x2检验．从中检出UGB者1869例，总出血率为14．7％（1869／12748）．结果①UGB与性别的关系：男性出血率17．5％（1493／8521），女性8．8％（376／4227）（P＜0．01），男性出血病因以DU最常见（22．6％），其次为胃癌（1．4％）和AGML（16．9％），女性以AGML最常见（19．7％），其次为胃癌（18．4％）和慢性胃炎（16．8％）．②UGB与年龄的关系：年龄≤35岁者出血率10．6％（535／5046），36岁～59岁15．4％（898／5836），≥60岁23．4％（436／1866）（P＜0．01）．重度出血者三个年龄组分别为14．2％，14．5％和20％（P＜0．05）．出血病因，≤35岁者依次为DU（32．5％），AGML（23．2％）和慢性胃炎（11．6％），35岁～59岁为DU（19．4％），AGML（16．70％），胃癌（16％），≥60岁者为胃癌（46．2％），GU（12．2％）和AGML（1．2％）．③UGB与职业的关系?