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
随着世界范围步入人口老龄化,积极老龄化成为各国探讨的重要课题。本文通过文献计量学方法,以CNKI及Web of Science核心合集数据库中收录的文献作为数据来源,对中西方建筑学领域,积极老龄化文献进行大量研究。通过文献共引分析与关键词...随着世界范围步入人口老龄化,积极老龄化成为各国探讨的重要课题。本文通过文献计量学方法,以CNKI及Web of Science核心合集数据库中收录的文献作为数据来源,对中西方建筑学领域,积极老龄化文献进行大量研究。通过文献共引分析与关键词分析梳理中西方在积极老龄化研究过程的演变。发现不同文化背景下,中西方对积极老龄化研究出发点、热点、学科交叉等方面的异同。中国老龄化程度不断加深,本文以期为中国未来积极老龄化研究提供方向指引。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.
文摘随着世界范围步入人口老龄化,积极老龄化成为各国探讨的重要课题。本文通过文献计量学方法,以CNKI及Web of Science核心合集数据库中收录的文献作为数据来源,对中西方建筑学领域,积极老龄化文献进行大量研究。通过文献共引分析与关键词分析梳理中西方在积极老龄化研究过程的演变。发现不同文化背景下,中西方对积极老龄化研究出发点、热点、学科交叉等方面的异同。中国老龄化程度不断加深,本文以期为中国未来积极老龄化研究提供方向指引。
