Abstract: Objective To analyze the effect of Chinese diabetes risk score in health checkup of elderly population and to explore the risk factors of abnormal glucose metabolism in the elderly patients. Methods Chinese diabetes risk score(C-DRs)screening, glucose tolerance test(OGTT), blood biochemical parameters and history collection were performed in 1 181 elderly people participating the health checkup.The area under the ROC curve(AUC)was used to evaluate the accuracy of the screening method.The effect of different cumulative C-DRs on screening target population was reflected by the Gordon index.Multivariate logistic regression analysis was used to analyze relevant risk factors for the glucose metabolic abnormalities. Results The AUC of screening for diabetes was 0.749(95%CI: 0.715-0.782), and the best cut-point value was 32.5 points.The sensitivity was 86.50%, the specificity was 60.84%, and the Gordon index was 0.47(P=0.000). The AUC of screening for the pre-diabetes was 0.760(95%CI: 0.733-0.787), and the best cut-point was 33.5 points.The sensitivity was 70.89%, the specificity was 68.72%, and the Gordon index was 0.40(P=0.000). The AUC of screening for MS was 0.797(95% CI: 0.772-0.823), and the best cut-point value was 32.5 points.The sensitivity was 83.62%, the specificity was 64.90%, and the Gordon index was 0.49(P=0.000). The AUC of screening for insulin resistance was 0.609(95%CI: 0.645-0.734), and the best cut-point value was 30.5 points.The sensitivity was 81.25%, the specificity was 44.81%, and the Gordon index was 0.26(P=0.000). Multiple logistic regression analysis showed that age over 80 years, abdominal obesity(waist circumference, male ≥ 90 cm, female ≥ 85 cm), hypertension, hypertriglyceridemia, family history of diabetes were risk factors for abnormality of glucose metabolism in the elderly.The odd ratio values of the above were 1.557, 1.543, 1.495, 1.569, 1.625, 1.715(all P<0.05). Conclusions Chinese diabetes risk score may be used to screen for diabetes, metabolic syndrome and insulin resistance in the elderly population.Old age, abdominal obesity, hypertension, hypertriglyceridemia and family history of diabetes are independent risk factors for abnormal glucose metabolism in the elderly population. Key words: Diabetes Mellitus; Multiphasic screening; Risk factors

Abstract: Objective To evaluate the preventive effects of Haishe capsules on the conversion of amnestic mild cognitive impairment (aMCI) to Alzheimer's disease(AD). Methods Patients (n=120) with aMCI from our department were recruited and randomly divided into the treatment group and the control group (n=60 in each group). The treatment group was given 0.9 gram of Haishe capsules three times a day while the control group received no drug treatment. Data on the conversion ratio, memory and cognitive function were comparedbetween the groups in a 24-months follow-up. Results By the end of the study, 12 patients in the treatment group and 15 in the control group dropped out. Valid data for 93 patients were available for statistical analysis (48 in the treatment group and 45 in the control group). The number of aMCI patients who converted to AD was 6, with a conversion ratio of 12.5% (6/48); and the number of patients who went through conversion in the control group was 13, with a conversion ratio of 28.8%(13/45). The difference in conversion between the two groups was statistically significant (χ2=3.83, P<0.05). After 24 months, MMSE scores for the treatment group (25.52±1.07) had no significant change compared with baseline levels, while MMSE scores for the control group decreased significantly(24.75±1.49) and were markedly lower than thosefor the treatment group (t=2.85, P<0.05). MoCA scores for the treatment group (19.39±2.01) did not show decline until the end of the study, while those for the control group started to decrease about half way through the study and were lower than scores for the treatment group (t=2.41, P<0.05). Compared with baseline levels, ADAS-Cogscores for the treatment group (7.62±1.06) did not increase significantly during the course of the study. ADAS-Cogscores forthe control group were higher at both half way (7.70±0.75) and the end of the study (8.18±0.80)than base line levels, and there was a statistically significant difference in end-of-study ADAS-Cog scores between the two groups(t=-2.6, P<0.05). Conclusions Haishe capsules not only effectively maintain memory and cognitive function, but also delay the conversion from aMCI to AD. Key words: Mild cognitive impairment; Alzheimer’s disease; Haishe capsules

Abstract: Objectives To observe the clinical efficacy and safety of Decitabine combined with half of CAG regimen in older patients with acute myeloid leukemia. Methods 29 older patients with acute myeloid leukemia treated from June 2010 to December 2016 were randomly divided into observation group and control group.Observation group(n=14)were treated with decitabine combined with half of CAG(aclacinomycin, cytarabine, granulocyte colony-stimulating factor)regimen.The control group(n=15)were treated with CAG regimen. Results The overall effective rate was higher in observation group(78.6%)than in control group(53.5%), but there was no statistically significant difference(χ2=2.042, P=0.153). The rate of lung infections was significantly lower in observation group(28.6%)than in control group(73.3%), (χ2=5.811, P=0.016). The survival time of patients was significantly longer in observation group(17.5±5.7 months)than in control group(12.6±6.2 months), the difference was statistically significant(t=2.211, P=0.018). Conclusions The treatment program of Decitabine combined with half of CAG regimen in older patients with acute myeloid leukemiais is safe and effective, which is worthy of clinical promotion. Key words: Decitabine; Acute myeloid leukemia

Abstract: Objective To summarize studies about palliative care (PC) in mainland China and to provide a guidance for propagandizing the concept of palliative care and to carry out related investigations. Methods Key words of"Shu Huan Yi Xue, Gu Xi Zhi Liao, An Ning Liao Hu, Ling Zhong Guan Huai, Shu Huan Yi Liao", together with"conception, acceptance"were used in CBM.And"palliative care AND China AND(acceptance OR acknowledgement OR concept OR conception)"were used in PubMed.Above searches were for articles, without any other limitations such as publishing date, author, journal, type or language.Eligible articles investigating acceptance of palliative care in mainland China were screened out with artificial work.Descriptive analysis was adopted as a statistic method. Results A total of 35 articles related with palliative care were picked out.Most of the investigation methods were questionnaire.The palliative care-accepting degrees were 25.3% to 86.6% in overall, 25.3%~70.8% in the elderly, 30.8%~56.2% in advanced stage of cancers, 61.7%~68.4% in families of patients, and 56.6%~95.8% in health care workers.In the subgroup analysis, the acceptance showed no difference between genders.But age, followed by careers, degrees of medical education and religions and nationalities were all effective factors for the acceptance of palliative care, which was mostly agreed in all the articles. Conclusions People in mainland China are insufficient very much in the perception of palliative care idea.More publicity and education are needed to popularize the palliative care idea.More studies with better design and more rigorous protocol are needed to have a better understanding of the acceptance of palliative care. Key words: Palliative care; Review literature as topic

Abstract: Objective To analyze the prevalence rate and risk factors for aspiration pneumonia in elderly inpatients, and to identify a high-risk population for aspiration pneumonia. Methods Totally 398 inpatients aged ≥60 years in Beijing Hospital from April 2014 to April 2015 were selected.A questionnaire survey was performed for aspiration risk factors, including gender, age, smoking and drinking history, swallowing function, basal diseases, medication history, activities of daily living(ADL), occurrence of aspiration pneumonia over the past year.The patients were divided into aspiration pneumonia group and non-aspiration pneumonia group, and the prevalence rate and risk factors for aspiration pneumonia were studied. Results 364 cases with complete data were collected, and 14.3%(52/364)were identified definitively as aspiration pneumonia over the past year.The ADL score was(77.0±33.9)scales in aspiration pneumonia group, and(88.0±22.2)scales in non-aspiration pneumonia group, with statistically significant difference(P<0.05). The incidence rate of aspiration pneumonia was increased along with the increase of the age of patients.Risk factors for aspiration pneumonia were different in different age group.The proportion of patients aged 60-69, 70-79 and over 80 years were 23.1%(12 cases), 36.5%(19 cases), 40.4%(23 cases)in the aspiration pneumonia group, respectively.Under the condition of a propensity score-matched case-control pair design on 104 subjects with versus without aspiration pneumonia, the logistic regression analysis showed that smoking history, coronary heart disease, Parkinson’s disease, dementia, chronic obstructive pulmonary disease(COPD), gastro-esophageal reflux disease(GERD), long-term uses of theophylline, calcium antagonists, nitrates, diazepam, antidepressants, anti-Parkinson drugs were the risk factors for aspiration pneumonia in elderly(all P<0.05). Conclusions Smoking history, basal diseases and medication history are associated with the incidence rate of aspiration pneumonia in elderly.Assessment of these risk factors for aspiration pneumonia should be emphasized, and preventive measures should be considered conscientiously to lower the incidence rate of aspiration pneumonia in elderly. Key words: Pneumonia, aspiration; Risk factors

Abstract: Objective To examine whether autophagy plays a role in the development of chronic intermittent hypoxia-induced cardiac hypertrophy, whether resveratrol can reverse the process by modulating autophagy and what molecular pathways are involved. Methods Rats were randomly divided into four groups.Eight rats were treated with normoxia (control group), eight were exposed to chronic intermittent hypoxia (CIH) (CIH group), eight were exposed to CIH plus resveratrol (RSV) (CIH+RSV group) and eight were exposed to CIH, RSV and chloroquine (Cq) (CIH+RSV+Cq group). After treatment for seven weeks, the levels of LC3, Beclin, P62, ANP, β-MHC, AMPK, P-AMPK, mTOR, P-mTOR and cleaved-caspase 3 were detected by Western blot.The area of cardiomyocytes and the ratio of brotic area to the total area were obtained by HE and Sirius Red staining. Results Rats in the CIH+RSV group were associated with an increased ratio of LC3Ⅱ/LC3Ⅰ, increased Beclin levels and decreased P62 levels, compared with those in the control and CIH groups (all P 0.05). Conclusions Chronic intermittent hypoxia and resveratrol can affect the level of cardiac hypertrophy by autophagy through activating the AMPK/mTOR pathway. Key words: Sleep apnea, obstructive; Cardiomyopathy, hypertrophic; Autophagy

Abstract: Objective To examine changes in bone mineral density, serum bone turnover markers and serum cytokines after health education intervention in elderly patients with osteoporosis. Methods Two hundred and twenty elderly patients with osteoporosis were randomly divided into two groups.The control group(n=110)was given routine treatment, including anti-osteoporosis drugs and daily supplements of calcium and vitamin D. In addition to routine drug treatment, the observation group(n=110)also underwent health education intervention, which included instructions on lifestyle, diet, and exercise.After one year follow-up, levels of bone mineral density(BMD), propeptide of type I procollagen(PINP), β-crosslaps(β-CTX), parathyroid hormone(PTH), 25-dihydroxyvitamin D[25(OH)VD], interleukin-2(IL-2), and insulin-like growth factor-1 receptor(IGF-1R)were analyzed. Results After one year follow-up, all indicators, except the β-CTX level, were significantly improved in the observation group compared with those in the control group(all P<0.05). Mean while, compared with pre-treatment levels, both groups had significantly increased levels of BMD(both P<0.05), which were markedly higher in the observation group(P<0.05). Furthermore, improvement was achieved in cognitive ability and lifestyle in the observation group(both P<0.05). Conclusions Health education intervention can effectively improve BMD in elderly patients with osteoporosis, significantly improve lifestyle, and play an important role in integrated management of osteoporosis. Key words: Osteoporosis; Health education

Abstract: Sarcopenia and osteoporosis are two common diseases with adverse effects on the health of the elderly and share many characteristics.As target organs of the two diseases, muscles and bones are closely connected, not only in anatomy and physiology, but also in pathophysiological processes.Initially, mechanical stimulation was conducted to explain the relationship between muscle and bone at the macroscopic level.Currently, research is increasingly focused at the cellular and molecular levels.Both muscle and bone tissues can secrete a number of growth factors, cytokines, polypeptides, and so on.Myokines include fibroblast growth factor-2(FGF-2), myostatin, irisin, insulin-like growth factor-1(IGF-1), interleukins, musclin, among others.Osteokines comprise osteocalcin, fibroblast growth factor-23, IGF-1, vascular endothelial growth factor, etc.In this review, we summarize the roles of myokines and osteokines in muscle-bone interactions. Key words: Muscular diseases; Osteoporosis

Abstract: Objective To investigate the influence of elastic band resistance training on cardiac function in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Methods 64 hospitalized patients with acute myocardial infarction after PCI from January 2016 to June 2016, were randomly divided into two groups: rehabilitation group (n=30) and control group (n=34). The control group received a routine treatment and guidance, rehabilitation group received elastic band training as add-on therapy to above routine treatment and guidance.After 6 months of therapy, cardiac function, the number of daily chest discomfort and its duration were compared between two groups. Results After six months of therapy, 6MWT〔(530.9±39.9)m versus (328.3±26.8)m, (t=24.104, P<0.01)〕and LVEF ≥50%〔n(%)〕(83.3% versus 50% )(χ2=7.850, P< 0.01)were significantly higher in the rehabilitation group than in control group, with statistically significant difference (t=24.104, χ2=7.850, all P< 0.01). In addition, an average number of daily chest discomfort (χ2=11.563, P< 0.01) and its duration (χ2=9.067, P< 0.05) were obviously improved in rehabilitation group than in control group, with statistically significant difference. Conclusions Anti-resistance training can significantly improve the cardiac function of patients with acute myocardial infarction after PCI and can be applied in clinical practice. Key words: Angioplasty, transluminal, percutaneous coronary; Myocardial infarction; Resistance training; Heart function

Abstract: Objective To analyze the pathologically confirmed pulmonary Actinomycosis in the 11 patients in focusing on clinical features and mis-diagnostic reasons so as to improve physicians' awareness of this rare disease and reduce the misdiagnosis. Methods We retrospectively reviewed the medical records of 11 cases with pathologically confirmed pulmonary Actinomycosis during January 2003-August 2015.The clinical data and main causes of misdiagnosis in these cases were collected and analyzed. Results The study included 11 patients with a mean age of(53.0±11.6.0)years.Among the 11 cases, 8(72.7%)patients had complications, 6(54.5%)were current or ex-smokers.Main clinical manifestations of 11 cases were cough(11/11, 100.0%), sputum(11/11, 100.0%), hemoptysis(7/11, 63.6%), chest pain(6/11, 54.5%)and fever(3/11, 27.3%). Ten patients presented with one lobe of lung lesions, including 4 patients in the lower lobe and 3 in the upper lobe of the left lung, 2 in the upper lobe and 1 in the lower lobe of the right lung.While, the remained one case presented with lesion locating in right main bronchus.Iconography often presented as pulmonary mass shadow, consolidation shadow, spicule sign, lobulation sign, hilar and/or mediastinal lymphadenopathy and pleural effusion.Vacuolar lesions were observed in some of the focuses.Flexible bronchoscopy was performed in 8(72.7%)patients.Among them, 7 patients showed mucosal swelling and congestion, luminal occlusion with purulence secretion, 2 cases with polypoid neoplasm.Initial misdiagnosis rate were 100%(11/11), among which 7 cases were misdiagnosed as lung cancer, 2 cases as fungus infection, and 1 case as pulmonary tuberculosis and 1 case as pneumonia, respectively.All patients were definitely diagnosed by biopsy finding an evidence of hyphae of Actinomycosis in lung tissue specimens.The definitive diagnosis was made by CT-guided percutaneous lung biopsy in 4 cases, by transbronchial lung biopsy(TBLB)in 5 cases and by thoracotomy or video-assisted thoracoscopic surgery(VATS)in 1 case respectively.Actinomycosis in most patients was cured with high-dose penicillin administration over a prolonged period. Conclusions The diagnosis of pulmonary Actinomycosis remains challenging via its non-specific clinical symptoms and iconography features, and the presence of comorbidity may further increase the difficulty and complexity of diagnosis, leading to delaying-or mistaking-diagnosis.Obtaining positively pathological specimens is diagnostic key.Transbronchial lung biopsy through a bronchoscope and CT-guided percutaneous needle biopsy are the priority methods. Key words: Actinomycosis; Diagnostic errors

Abstract: Objective To evaluate the feasibility of using comprehensive geriatric assessment (CGA) in estimating if standard dose treatment is fit for the elderly patients with diffuse large B cell lymphoma. Methods Comprehensive geriatric assessments including three assessments of activity of daily living, instrumental activity of daily living and comorbidity scoring according to Cumulative Illness Rating Score for Geriatrics were adopted to assess if standard dose treatment is fit for the elderly patients in our prospective study.Thirty seven patients with diffuse large B cell lymphoma, aged >70 years were enrolled in the study, and grouped into fit, unfit and frail groups according to comprehensive geriatric assessment scoring and their age. The treatment protocolswere not determined by comprehensive geriatric assessment scores, but by clinical judgments made by clinicians based on their clinical experience and disease features.The clinically effective response and overall survival (OS) were analyzed in the three groups. Results According to CGA scores, patients were grouped into "fit" 〔21 cases (56.8%)〕, "unfit" 〔7(18.9%)〕 and "frail" 〔9(24.3%)〕. 37 cases received 213 courses of treatment at average 5.76 courses per case.The overall response (complete / partial remission) rates were 〔85.7%(18/21) vs. 28.6% (2/7) vs. 44.4% (4/9), χ2=9.69, P=0.008〕 and median survival times were (44 months vs. 10 months vs. 9 months; χ2=7.03, P=0.03) among "fit" , "unfit" and "frail" groups with statistically significant differences.Total effective rate (achieving all clinical targets) in "fit" group of 21 cases were 100%(12/12)with receiving standard dose therapy, and 66.7% of(6/9)with low dose therapy(P=0.06). Overall response rate(total/partial remission) 〔85.7%(18/21) vs. 28.6%(2/7) vs. 44.4%(4/9), χ2=9.69, P=0.008〕 and median survival (44 months vs. 10 months vs. 9 months; χ2=7.03, P=0.03) among "fit" , "unfit" and "frail" groups.In "fit" group, the two-year overall survival was higher in patients receiving standard dose treatment than receivingpalliativetreatment, with statistical significance 〔83.3% (10/12) vs. 33.3% (3/9), P =0.032〕, without significant hematologic toxicity observed between the subgroups. Conclusions Comprehensive geriatric assessment can identify if elderly patients diffuse large B cell lymphoma can acquire a satisfactory curative effect from a standard dose treatment ofimmunochemotherapy. Key words: Lymphoma; Risk assessment

Abstract: Objectives To examine the clinical effects of α-lipoic acid(ALA)combined with epalrestat in elderly patients with diabetic peripheral neuropathy(DPN)and its influence on plasma levels of high-sensitivity C-reactive protein(hs-CRP)and homocysteine(Hcy). Methods A total of 120 DPN patients aged over sixty years were randomly divided into the control group and the treatment group with 60 cases in each group.The control group received 0.6 g ALA in 250 ml saline given by an intravenous drip once a day and the treatment group was additionally given 50 mg epalrestat orally three times a day.Both groups were treated for two weeks.Improvement in clinical symptoms, nerve conduction velocity, and peripheral blood levels of hs-CRP and Hcy were compared between the two groups before and after treatment. Results TSS scores of all items and the total scores of the two groups decreased after treatment, with greater margins seen in the treatment group than in the control group(each P<0.05). NCV increased in both groups after treatment(each P<0.05), with greater increase in the treatment group(each P<0.05). Levels of hs-CRP and Hcy were significantly reduced(each P<0.05). A statistically significant difference was observed in hs-CRP(t=2.620, P=0.010)but not in Hcy(t=0.380, P=0.700)between the two groups. Conclusions ALA combined with epalrestat can significantly improve the symptoms of patients with DPN, with better outcomes than ALA alone, and effectively decrease the peripheral blood level of hs-CRP. Key words: Diabetes mellitus, type 2; Thioctic acid; Aldehyde reductase

Abstract: Objective To investigate the relationship between benign paroxysmal positional dizziness (BPPV) and cerebrovascular disease and to promotethe practice of evidence-bases medicinein thediagnosis, treatment and recurrenceprevention of BPPV in the elderly. Methods A total of 80 elderly patients were consecutively recruited from the Dizziness Outpatient Clinic from January 2013 to June, 2014, with 80 non-BPPV elderly individuals receiving routine physical checkups during the same period serving as the control group.Clinical characteristics, lab test results and imaging data were compared between the two groups.Single factor and multivariate logistic regression analyses were conducted to identify independent risk factors for BPPV in the elderly. Results The experimental group showed higher rates of lacunar infarction, leukoaraiosis and intracranial artery stenosis than the control group(χ2=10.180, 4.606 and 3.956, respectively; P=0.001, 0.032 and 0.047, respectively). The prevalences of hyperlipidemia and type 2 diabetes were higher in the BPPV group than in the control group(χ2=5.013 and 6.041, respectively; P=0.025 and 0.014, respectively). Differences in number of carotid atherosclerotic plaque cases, total cholesterol, triglyceride, homocysteine and uric were found between the two groups (χ2=11.237, t=2.862, 2.230 and 4.270, respectively; P=0.001, 0.005, 0.027 and 0.000, respectively). Multivariate logistic regression analysisfound that blood uric acid, hyperglycemia, type 2 diabetes and hypertension were independent risk factors for BPPV (OR=1.006, 7.104, 3.152 and 3.273, respectively; P=0.005, 0.000, 0.004 and 0.002, respectively). The existence of carotid atherosclerotic plaques also increased the risk of BPPV(OR=384.570, 95%CI: 46.935~3151.055, P=0.000). Conclusions BPPV in the elderlyis closely associated with cerebrovascular disease and its risk factors.Therefore, it is of great clinical significance to assess cerebrovascular function and carotid atherosclerotic plaque development for improved prognosis and effective prevention of recurrence of BPPV in the elderly. Key words: Vertigo; Cerebrovascular disorders

Abstract: Objectives To compare the differences in intestinal phylum firmicutes between elderly patients with type 2 diabetes(T2DM)and the healthy elder people. Methods 37 elderly patients with T2DM and 69 healthy controls in Shaoxin city were recruited.DNA of phylum firmicutes from fecal samples was extracted.The real-time quantitative PCR was used with special primers for bacterial genus including Faecalibacterium prausnitzii, Eubacterium rectale, Clostridium leptum, and Peptostrepyococc.The differences in content of different bacteria between two groups were analyzed and compared. Results In healthy elderly group versus the elder patient with T2DM, the contents of intestinal phylum firmicutes were〔(6.22±1.41)×107 versus(5.41±1.40)×107, t=2.83, P=0.006〕in Eubacterium rectale, 〔(7.46±0.98)× 107 versus(6.96±1.40)×107), t=2.13, P=0.036〕in Faecali bacterium prausnitzii, 〔(7.89±0.89)×107 versus(7.46±1.11)×107, t=2.15, P=0.034〕in Clostridium leptum, and〔(4.86±1.33)×107 versus(4.21±1.24)×107, t=2.45, P=0.016〕in Peptostrepyococc, which showed that the contents of intestinal phylum firmicutes were less in T2DM group than in healthy elderly group. Conclusions There are some differences in intestinal flora between the elderly patients with T2DM and healthy people.These intestinal flora may play an important role in the development of T2DM.This study may provide new evidences for probiotic treatment of T2DM. Key words: Diabetes mellitus Type 2; Entero bacteriaceae

Abstract: Objective To investigate the association between rs14016(19+31C/T) polymorphisms of autophagy-related genes 7 (Atg7) and Parkinson's disease (PD) in Han population in China. Methods Totally 123 patients with Parkinson's disease (PD) (case group) and 101 synchronized health controls (control group) were selected from Chinese Han population between January 2013 and July 2016.A single nucleotide polymorphism (SNP) of rs14016 of Atg7 gene was detected by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) analysis.After gene sequencing for genotyping and detection of alleles, genotype and allele frequency distributions were analyzed in the two groups. Results The frequency distributions of TT genotype and T alleles were 17.9% (22/123) and 41.1% (101/246) in the case group, and 5.9% (6/101) and 31.2% (63/202) in the control group, respectively.The difference in genotype frequencies between the two groups was statistically significant (χ2=7.236, P=0.007, OR=3.01, 95% CI: 1.27-7.14). The frequencies of T and C alleles were 41.1% (101/246) and 58.9% (145/246) respectively in the case group, and 31.2% (63/202) and 68.8% (139/202) in the control group (χ2=4.655, P=0.031, OR=1.32, 95%CI: 1.02-1.70), with the statistically significant difference in the allele.The TT genotype of rs14016 showed statistical significance between the two groups by logistic regression analysis (OR=3.40, 95%CI: 1.32-8.80, P=0.012). Conclusions The T allele and TT genotype at the rs14016 of Atg7 gene might be associated with PD, and might increase the risk for suffering from PD, which is worthy of further fully researches. Key words: Autophagy-related genes 7; Polymorphism, single nucleotide; Parkinson disease; Autophagy

Abstract: Objective To analyze the anxiety and depression state in housebound elderly subjects and their influencing factors so as to provide theoretical basis for improving the psychological status of the elderly. Methods Three hundred and fifty elderly patients aged > 60 years suffering from anxiety and depression in two communities of Beijing were clusterly sampled and analyzed.The basic information of housebound elderly subjects with anxiety and depression was recorded during questionnaire survey.The influencing factors for anxiety and depression were explored by using the anxiety self-assessment scale and depression self-rating scale. Results Based on univariable analysis, the factors influencing anxiety and depression of the housebound elderly included ageing, lower cultural level, low income, infrequency of offspring visit and friends meeting, lost spouse, chronic diseases, many medications, and the unsatisfactory living environment(all P 0.05). Logistic multivariate regression showed that women(OR=1.432, 95%CI: 1.236-1.684, P<0.05), low income(OR=2.078, 95%CI: 1.675-2.412, P<0.05), the widowed(OR=2.342, 95%CI: 1.857-2.769, P<0.05), chronic diseases(OR=2.078, 95%CI: 1.674-2.531, P<0.05), medication(OR=3.056, 95%CI: 2.678-3.756, P<0.05), less visit by children(OR= 2.898, 95%CI: 2.475-3.425, P<0.05), less friends visiting(OR= 1.965, 95%CI: 1.685-2.446, P<0.05)were risk factors for anxiety in the elderly.Meanwhile, women(OR= 3.221, 95%CI: 2.674-3.853, P<0.05), low income(OR=2.342, 95%CI: 1.768-2.754, P<0.05), chronic disease(OR=2.078, 95%CI: 1.564-2.675, P<0.05), the widowed(OR=2.223, 95%CI: 1.789-2.746, P<0.05), less visit by children(OR=2.987, 95%CI: 2.463-3.524, P<0.05), less friends visiting(OR=2.658, 95%CI: 2.242-3.168, P<0.05)and poor satisfaction with surrounding environment(OR=1.765, 95%CI: 1.375-2.371, P<0.05)were risk factors for depression among the elderly. Conclusions The elderly, especially those with advanced age, low cultural level, low economic income, living alone and poor living environment, are more likely to have anxiety and depression.Therefore, some effective corresponding measures should be taken in order to improve the psychological condition and life quality of old people. Key words: Anxiety; Depression; Risk factors

Abstract: Objective To examine the time patterns and seasonality of death of hospitalized elderly patients and to propose proactive management measures. Methods Data were collected on 449 patients aged 60 years and over who had died between August of 2009 to August of 2013 during hospitalization at the Department of Geriatrics, Beijing Friendship Hospital, Capital Medical University.The seasonality and time patterns of the patients' deaths were analyzed retrospectively. Results Pulmonary infections(175 cases, 38.97%)and malignant tumors(162 cases, 36.08%)were the leading causes of death.Deaths from pulmonary infections were more frequent in spring and summer while deaths caused by malignant tumors were more frequent in summer, but the differences were not statistically significant(all P>0.05). The peak times of death in patients with cardiovascular and cerebrovascular disease were between 23: 00 pm to 7: 00 am(χ2 =11.10 and 14.19, respectively, P<0.05). Conclusions Pulmonary infections and malignant tumors are the main causes of death in elderly inpatients, which most often occurs during the latter half of the night in patients with cardiovascular and cerebrovascular diseases. Key words: Inpatient; Death time

Abstract: Objectives To explore the differences in therapeutic efficacy between decitabine combined with low dose HAG(D+ HAG)and CAG in elderly patients with acute myeloid leukemia(AML). Methods Totally 32 elderly patients with AML in our department from July 2012 to July 2015 were retrospectively analyzed.15 patients were on a therapy of decitabine combined with low dose HAG, and 17 patients with CAG.Efficacy and side effects were compared between the two groups. Results In(D+ HAG)versus CAG groups, the complete remission(CR)was 10 cases(66.7%)vs.6 cases(35.3%), partial remission(PR)was 2 cases(13.3%)vs.1 case(5.9%), non-remission(NR)was 3 cases(20%)vs.10 cases(58.8%), and the total efficacy rate(CR+ PR)was 80%vs.41.2%(P 0.05). Conclusions The treatment of decitabine combined with low dose of HAG is prior to CAG, and the side effects are all tolerated.So decitabine combined with low dose of HAG can be served as the first-line therapy for elderly AML patients. Key words: Leukemia, myloid; Antineoplastic combined chemotherapy protocols