AIM: To determine whether an active intervention is beneficial for the survival of elderly patients with hepa-tocellular carcinoma (HCC). METHODS: The survival of 740 patients who received various treatments for HCC b...AIM: To determine whether an active intervention is beneficial for the survival of elderly patients with hepa-tocellular carcinoma (HCC). METHODS: The survival of 740 patients who received various treatments for HCC between 1983 and 2011 was compared among different age groups using Cox regression analysis. Therapeutic options were principal-ly selected according to the clinical practice guidelines for HCC from the Japanese Society of Hepatology. The treatment most likely to achieve regional control capa-bility was chosen, as far as possible, in the following order: resection, radiofrequency ablation, percutaneous ethanol injection, transcatheter arterial chemoembo-lization, transarterial oily chemoembolization, hepatic arterial infusion chemotherapy, systemic chemotherapy including molecular targeting, or best supportive care.Each treatment was used alone, or in combination, with a clinical goal of striking the best balance be-tween functional hepatic reserve and the volume of the targeted area, irrespective of their age. The percent survival to life expectancy was calculated based on a Japanese national population survey. RESULTS: The median ages of the subjects during each 5-year period from 1986 were 61, 64, 67, 68 and 71 years and increased significantly with time (P<0.0001). The Child-Pugh score was comparable among younger (59 years of age or younger), middle-aged (60-79 years of age), and older (80 years of age or older) groups (P=0.34), whereas the tumor-node-metastasis stage tended to be more advanced in the younger group (P=0.060). Advanced disease was significantly more frequent in the younger group compared with the middle-aged group (P=0.010), whereas there was no difference between the middle-aged and elderly groups (P=0.75). The median sur-vival times were 2593, 2011, 1643, 1278 and 1195 d for 49 years of age or younger, 50-59 years of age, 60-69 years of age, 70-79 years of age, or 80 years of age or older age groups, respectively, whereas the me-dian percent survival to life expectancy were 13.9%, 21.9%, 24.7%, 25.7% and 37.6% for each group, respectively. The impact of age on actual survival time was significant (P=0.020) with a hazard ratio of 1.021, suggesting that a 10-year-older patient has a 1.23-fold higher risk for death, and the overall survival was the worst in the oldest group. On the other hand, when the survival benefit was evaluated on the basis of per-cent survival to life expectancy, age was again found to be a significant explanatory factor (P=0.022); how-ever, the oldest group showed the best survival among the five different age groups. The youngest group revealed the worst outcomes in this analysis, and the hazard ratio of the oldest against the youngest was 0.35 for death. The survival trends did not differ substan-tially between the survival time and percent survival tolife expectancy, when survival was compared overall or among various therapeutic interventions. CONCLUSION: These results suggest that a thera-peutic approach for HCC should not be restricted due to patient age.展开更多
The elderly are the main objects of college students’volunteer service activities.At present,there are various forms of college students’volunteer service activities,which are highly valued by colleges and universit...The elderly are the main objects of college students’volunteer service activities.At present,there are various forms of college students’volunteer service activities,which are highly valued by colleges and universities and popular among college students.In order to further improve the mental health of the elderly,it could be achieved through paths like strengthening volunteering cooperation with aged services agencies,implementing the volunteer service mechanism of“one person-one file,one person-one policy”for the elderly,establishing a mental health mentor system for volunteer service activities,improving the mental health knowledge level of college student volunteers,carrying out a series of voluntary service activities with the theme of mental health,attaching importance on cultivating the positive and optimistic attitude of the elderly in volunteer service activities,and launching volunteer service activities to enrich the spiritual and cultural life of the elderly.展开更多
背景:老年衰弱综合征(Frailty)是机体衰老过程和某些慢性疾病相互作用的结果,会使老年人因机体功能减退而增加残疾和其他不良后果的风险。运动被认为是老年人对抗衰弱综合征相关身体损伤的主要策略之一,但实际生活中多数老年衰弱患者并...背景:老年衰弱综合征(Frailty)是机体衰老过程和某些慢性疾病相互作用的结果,会使老年人因机体功能减退而增加残疾和其他不良后果的风险。运动被认为是老年人对抗衰弱综合征相关身体损伤的主要策略之一,但实际生活中多数老年衰弱患者并未进行系统运动干预。目的:阐述不同运动改善老年衰弱综合征的研究进展,为不同状态老年人运动预治衰弱提供参考和依据。方法:以“衰弱、衰老、运动、体力活动、多组分干预”及“Exercise,Physical activity,Frailty,aging,Multi-Component Intervention”分别作为中、英文关键词检索PubMed、Web of Science、CNKI、VIP和万方数据库,对入选的72篇文献进行归纳总结。结果与结论:①在适合老年衰弱综合征的运动形式中,有氧运动是基础,力量训练是核心,爆发力训练和柔韧训练是辅助,平衡训练和虚拟训练是补充,综合运用多种训练方式的多组分运动干预策略是衰弱老年人运动防治的最佳选择。②针对强健老年人选用有氧训练和力量训练为主,平衡训练、柔韧训练、爆发力训练为辅的运动形式;针对衰弱前期老年人选用以力量训练和有氧运动为主,平衡训练、柔韧训练、爆发力训练为辅的运动形式;针对衰弱期老年人选用多组分训练,包括力量、耐力、爆发力、平衡、柔韧训练等;针对住院老年人选用以力量训练为主,有氧训练、虚拟训练、平衡和柔韧训练为辅的运动形式。③同时,对于不同状态老年人,随着衰弱程度的增加,运动强度逐渐降低,运动时间逐渐减少。展开更多
文摘AIM: To determine whether an active intervention is beneficial for the survival of elderly patients with hepa-tocellular carcinoma (HCC). METHODS: The survival of 740 patients who received various treatments for HCC between 1983 and 2011 was compared among different age groups using Cox regression analysis. Therapeutic options were principal-ly selected according to the clinical practice guidelines for HCC from the Japanese Society of Hepatology. The treatment most likely to achieve regional control capa-bility was chosen, as far as possible, in the following order: resection, radiofrequency ablation, percutaneous ethanol injection, transcatheter arterial chemoembo-lization, transarterial oily chemoembolization, hepatic arterial infusion chemotherapy, systemic chemotherapy including molecular targeting, or best supportive care.Each treatment was used alone, or in combination, with a clinical goal of striking the best balance be-tween functional hepatic reserve and the volume of the targeted area, irrespective of their age. The percent survival to life expectancy was calculated based on a Japanese national population survey. RESULTS: The median ages of the subjects during each 5-year period from 1986 were 61, 64, 67, 68 and 71 years and increased significantly with time (P<0.0001). The Child-Pugh score was comparable among younger (59 years of age or younger), middle-aged (60-79 years of age), and older (80 years of age or older) groups (P=0.34), whereas the tumor-node-metastasis stage tended to be more advanced in the younger group (P=0.060). Advanced disease was significantly more frequent in the younger group compared with the middle-aged group (P=0.010), whereas there was no difference between the middle-aged and elderly groups (P=0.75). The median sur-vival times were 2593, 2011, 1643, 1278 and 1195 d for 49 years of age or younger, 50-59 years of age, 60-69 years of age, 70-79 years of age, or 80 years of age or older age groups, respectively, whereas the me-dian percent survival to life expectancy were 13.9%, 21.9%, 24.7%, 25.7% and 37.6% for each group, respectively. The impact of age on actual survival time was significant (P=0.020) with a hazard ratio of 1.021, suggesting that a 10-year-older patient has a 1.23-fold higher risk for death, and the overall survival was the worst in the oldest group. On the other hand, when the survival benefit was evaluated on the basis of per-cent survival to life expectancy, age was again found to be a significant explanatory factor (P=0.022); how-ever, the oldest group showed the best survival among the five different age groups. The youngest group revealed the worst outcomes in this analysis, and the hazard ratio of the oldest against the youngest was 0.35 for death. The survival trends did not differ substan-tially between the survival time and percent survival tolife expectancy, when survival was compared overall or among various therapeutic interventions. CONCLUSION: These results suggest that a thera-peutic approach for HCC should not be restricted due to patient age.
文摘The elderly are the main objects of college students’volunteer service activities.At present,there are various forms of college students’volunteer service activities,which are highly valued by colleges and universities and popular among college students.In order to further improve the mental health of the elderly,it could be achieved through paths like strengthening volunteering cooperation with aged services agencies,implementing the volunteer service mechanism of“one person-one file,one person-one policy”for the elderly,establishing a mental health mentor system for volunteer service activities,improving the mental health knowledge level of college student volunteers,carrying out a series of voluntary service activities with the theme of mental health,attaching importance on cultivating the positive and optimistic attitude of the elderly in volunteer service activities,and launching volunteer service activities to enrich the spiritual and cultural life of the elderly.
文摘背景:老年衰弱综合征(Frailty)是机体衰老过程和某些慢性疾病相互作用的结果,会使老年人因机体功能减退而增加残疾和其他不良后果的风险。运动被认为是老年人对抗衰弱综合征相关身体损伤的主要策略之一,但实际生活中多数老年衰弱患者并未进行系统运动干预。目的:阐述不同运动改善老年衰弱综合征的研究进展,为不同状态老年人运动预治衰弱提供参考和依据。方法:以“衰弱、衰老、运动、体力活动、多组分干预”及“Exercise,Physical activity,Frailty,aging,Multi-Component Intervention”分别作为中、英文关键词检索PubMed、Web of Science、CNKI、VIP和万方数据库,对入选的72篇文献进行归纳总结。结果与结论:①在适合老年衰弱综合征的运动形式中,有氧运动是基础,力量训练是核心,爆发力训练和柔韧训练是辅助,平衡训练和虚拟训练是补充,综合运用多种训练方式的多组分运动干预策略是衰弱老年人运动防治的最佳选择。②针对强健老年人选用有氧训练和力量训练为主,平衡训练、柔韧训练、爆发力训练为辅的运动形式;针对衰弱前期老年人选用以力量训练和有氧运动为主,平衡训练、柔韧训练、爆发力训练为辅的运动形式;针对衰弱期老年人选用多组分训练,包括力量、耐力、爆发力、平衡、柔韧训练等;针对住院老年人选用以力量训练为主,有氧训练、虚拟训练、平衡和柔韧训练为辅的运动形式。③同时,对于不同状态老年人,随着衰弱程度的增加,运动强度逐渐降低,运动时间逐渐减少。
