用Cox’s回归模型分析老年人舌鳞癌生存率

目的：探讨老年人舌鳞癌预后的影响因素。方法：收集经病理证实的６３例老年人舌鳞癌,对影响其生存率的众因素进行回归分析。结果：影响其预后的因素依次为①肿瘤的局部控制;②治疗方法;③颈部淋巴结的预防性根治术;④肿瘤大小;⑤年龄。结论：肿瘤的局部控制是影响其预后的关键;其次是颈部淋巴结的根治术;另外综合治疗明显优于单一治疗。建议尽可能选择综合治疗,特别要强调肿瘤的局部控制和预防性颈部淋巴结清扫术。     

尿激酶溶栓治疗高龄急性心肌梗塞的疗效观察

目的 为观察尿激酶 天普洛欣（ＵＫＴＰ）静脉溶栓治疗高龄急性心肌梗塞（ＡＭＩ）的临床有效性和安全性。方法 收集５０２例ＡＭＩ患者,按年龄分为３组：≥７０岁组（１１７例）,￣６８岁组（１５２例）和〈６５岁组（２３３例）,观察临床疗效,副作用及病死率等。ＵＫＴＰ剂量为２００万Ｕ至３００万Ｕ,采用Ｂｏｌｕｓ法３０ｍｉｎ内给药。结果 ①按临床梗塞相关血管（ＩＲＡ）再通标准,再通率依次为７０．９％,７９．６     

老年学习记忆减退大鼠空间参考记忆和工作记忆能力的改变

目的　探讨老年学习记忆损害鼠空间学习记忆能力的改变特征。方法　用改良Morris 水迷宫检测40 只老年SD 大鼠(24m) 的空间学习记忆能力,按通用标准将其分为老年学习记忆减退组和老年学习记忆正常组,与青年组对照,检测其空间参考记忆和空间工作记忆能力。结果　老年学习记忆损害大鼠的行为学改变特征为:1) 简单学习记忆任务的学习能力没有明显变化。2) 空间参考记忆能力明显减退,寻找平台所用的游泳时间(ST) ,40cm 环内游泳时间(A40T) 和平台跨越次数(PC) 是反映老年学习记忆害大鼠空间参考记忆能力的理想指标。3) 空间工作记忆能力减退不明显。结论　A40T,PC 是反映空间参考记忆能力的敏感指标,ST 结合A40T 可筛选出理想的老年学习记忆减退动物模型。     

老年自发性气胸误诊原因及影响疗效的因素分析

目的：为了分析老年人自发性气胸的临床特点,找出易发生误诊的原因以及影响疗效的因素;方法：对７５例老年人 性气胸的临床资料与同期６０例中青年人自发性气胸作对比分析;结果：老年气胸存在的基础病和发生并发症比例高,气急为最突出症状,以开放型,张力型气胸居多,与对照组有显著差异。老年气胸胸痛相对较轻,肺压缩程度显著低于对照组。老年气胸肺复张时间长,需行胸腔闭式引流术比例高。严重病例易发生呼吸衰竭和多器官衰     

High Cervical Disc Lesions in Elderly Patients – Presentation and Surgical Approach

Summary  The incidence of high cervical disc lesions is extremely rare, and the mechanism of their development is unclear. We report these three cases, and discuss the possible mechanisms. We also describe surgical strategies for these lesions.  The first and second cases were an 82-year-old male and an 84-year-old male with retro-odontoid disc hernia. The third was an 83-year-old female with a herniated disc at C2/C3. To investigate Aetiological mechanisms of these lesions, we examined the findings on cervical images in extension and flexion, and compared the results in a younger than 80-year-old group and an older than 80-year-old group.  The patients underwent surgery via a posterolateral intradural approach. Wide laminectomy and incision of the dentate ligaments enabled access to the ventral space of the upper cervical spinal canal and sufficient decompression. All patients became ambulatory postoperatively without special fixation of the cervical spine. In the younger group, the level mostly loaded during cervical movement was C5/6, however, the levels in the older group were C2/3 and C3/4.  In elderly patients, less mobilization of the middle and/or lower cervical spine due to spondylotic change causes overloading at higher levels resulting in high cervical disc lesions. Retro-odontoid disc lesions can be caused by a herniated disc at C2/C3, which migrates upward. Regarding surgical strategy, the posterolateral intradural approach is less invasive and more advantageous for these lesions.     

The effect of smoking at different life stages on bone mineral density in elderly men and women

To assess the effect of smoking on bone mineral density (BMD) at different life stages, to examine whether the effect of smoking differs between men and women, and to discover whether its effect in women differs according to history of estrogen use, a cohort study was carried out with single cross-section measurement of BMD by single and dual photon absorptiometry. The setting was the Framingham Study, a population-based cohort study with over 40 years prospectively collected data on smoking. Subjects (n=1164) consisted of cohort members participating in the 20th biennial Framingham examination (1988–1989). The measurements included in the study were BMD measured at the hip, spine and radius, smoking history ascertained at all Framingham Study examinations since 1948, and other factors affecting BMD (age, weight, estrogen use, caffeine use, alcohol use and physical activity). Neither current smoking, recent (last 10 years) smoking, nor early adulthood smoking resulted in significantly lower BMD at any skeletal site among women who had not taken estrogen. Among women who had taken estrogen, BMD at most sites was lower among current or recent smokers, although the small numbers of smokers made it difficult to find significant differences at all skeletal sites. Among men, a consistently lower BMD at all skeletal sites was observed for smokers regardless of when in their life they smoked (4–15.3% lower), although the effect of smoking during early adulthood was of a lesser magnitude (4–8% lower). Former male smokers who had quit <10 years ago had lower BMD than men who had quit 10 years ago. In conclusion, in women who had used estrogen, BMD was lower in current or recent smokers than it was in non-smokers. In men, smoking at any stage of life had adverse effects on the skeleton that was independent of weight, alcohol or caffeine use, implying other mechanisms for smoking's effect on bone.     

Neurofibrillary tangles and Lewy bodies in the locus ceruleus neurons of the aged brain

Summary The presence of Lewy body and neurofibrillary tangle in the locus ceruleus neurons of aged brain is described. Ultrastructural study revealed that in some Lewy bodies the presence of twisted tubules or paired helical filaments amongst the filaments of the Lewy body. A quantitative analysis of serial sections of locus ceruleus from aged brain, incidences of the Lewy body and neurofibrillary change were 0.07% (9/11,515) and 6.6% (15/11,515), respectively. The incidence of neurons containing both structures was 0.008% (1/11,515).     

老年性痴呆患者的听觉损害

目的　确定老年性痴呆患者 (seniledementiaoftheAlzheimer′sdisease ,AD)有无周围性听功能障碍及其与认知障碍的关系。方法　利用纯音测听、言语识别率、声导抗、听觉脑干反应检测AD患者 43例 ,健康老年人 50例 ,评定受试者测听可信度 ,统计测试结果 ,并将上述结果同受试者简易精神状态量表 (mini mentalscaleofequastionnaire ,MMSE)得分进行对照分析 ,寻找二者之间的关系。结果　受试者两耳间周围听力差异无显著性 ,以右耳听力结果 ( x±s)进行统计。AD组纯音听阈为 (2 6 3± 8 5)dBHL和 (2 9 1± 8 7)dBHL ,言语识别率为 (85 5± 5 5) % ;对照组纯音听阈为 (2 3 2± 1 0 6)dBHL和 (2 6 2± 1 1 8)dBHL ,言语识别率为 (87 6± 6 8) %。虽然AD组周围听功能检查结果低于对照组 ,但无统计学意义 (P >0 0 5)。测听可信度、声导抗和ABR阈值两组间差异无显著性 (P >0 0 5)。结论　老年性痴呆患者纯音听阈和言语识别率与老年聋相似 ,其周围听功能障碍与MMSE认知量表得分无关。     

三维适形低分割放射治疗老年非小细胞肺癌疗效观察

目的　探讨三维适形低分割放射治疗老年非小细胞肺癌的疗效。方法　 4 5例患者均采用低分割治疗 ,处方剂量为 4～ 5Gy,隔日 1次 ,总量 4 8～ 5 5Gy。结果　CR 2 3例 ( 5 1.1% ) ,PR 15例( 33.3% ) ,NC 5例 ( 11.1% ) ,PD 2例 ( 4 .4 % ) ,RR 38例 ( 84 .4 % )。 1、2、3年生存率分别为 6 6 .7%、4 8.9%、39.1%。结论　三维适形放射治疗对于老年非小细胞肺癌是一种反应较小 ,痛苦较轻 ,安全有效的治疗措施     

老年人突发性聋

为探讨老年人突发性聋的发病特点，以指导临床诊断与治疗，将４５例６０岁以上老年突聋和临床表现、并发症及预后等，与５７例中青年突聋进行对比分析。结果发现：４５例中，２４例合并有心血管疾病，明显高于对照组。老年组听力曲线以下降型多见，对照组以上升型曲线多见。入院时两组平均听力分别为８７．３ｄＢ和８４．６ｄＢ治疗后老年组听力平均提高２０．５ｄＢ，对照组提高３８．９ｄＢ。研究说明，老年突聋常合并较高的心血管