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The elderly are a special group, with their unique pathophysiology and disease characteristics.The measures and goals of diagnosis and treatment for the elderly are different from those for children, young and middle-aged people.Taking into consideration of the national and international literature, the insight from our long-term clinical practice and in-depth reflections, the authors have written this article as a reference for our colleagues in geriatric care.
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The decline of body function and senile diseases caused by aging seriously affect human health and life span， which is an important topic in the field of life science. Bazi Bushen capsules is a representative Chinese patent medicine for tonifying essence， invigorating Qi and anti-aging， guided by Qiluo doctrine， and essence， Qi and spirit theory. Previous pharmacological and clinical studies have confirmed that this preparation has the comprehensive advantages of anti-aging， and prevention and treatment of aging-related diseases. Among them， pharmacological studies showed that Bazi Bushen capsules had the effect of improving the appearance status of mice， improving the level of sex hormones， inhibiting the formation of atherosclerosis， improving cardiac function， improving learning and memory cognitive ability， improving neurological function， improving osteoporosis and muscle function， improving sperm count and quality. The mechanism was related to the up-regulation of the recombinant sirtuin （SIRT6） level， down-regulation of the levels of aging-related proteins p53 and p16， up-regulation of telomerase reverse transcriptase level， and alleviation of inflammation and oxidative response. Clinical studies have proved that it can improve the symptoms of patients with kidney essence deficiency， improve exercise ability， and improve the sexual function of impotence patients. Anti-aging research of Bazi Bushen capsules based on Qiluo doctrine fully embodies the new mode of academic innovation and transformation of traditional Chinese medicine （TCM） with the combination of "theory-new drug-experiment-clinic"， which has made a demonstration for the anti-aging research of TCM.
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Along with increasing degree of population aging globally， senility， good health and long life have become the focus of the world. Guided by Qiluo doctrine， an essence， Qi and spirit theory is proposed as below， essence is the origin of life， Qi is the impetus of life and spirit is the embodiment of life. Based on holistic view of kidney deficiency involving the five internal organs and injuries of the five internal organs definitely affecting the kidney， a mechanism of aging is proposed as below， deficiency of kidney essence is the foundation of aging， deficiency of promordial Qi is the key of aging and physical and spiritual loss is the manifestation of aging. It provides a theoretical guidance for anti-aging study of rejuvenating the elderly and making the strong person stronger. By virtue of the experiences in kidney-tonifying medication accumulated for more than two thousand years， Bazi Bushen capsules has been developed， which has anti-aging efficacy， including tonifying kidney， replenishing essence， coordinating Yin and Yang， supplementing primordial Qi and nourishing body and spirit. Experimental researches have demonstrated that Bazi Bushen capsules can improve overall aging and systemic aging， as well as prevent and treat aging related diseases. Preliminary clinical studies demonstrate that this capsules can enhance athletic ability and improve sexual function， and is expected to become a representative Chinese patent medicine of anti-aging. This paper addresses aging and anti-aging on the basis of Qiluo doctrine， in the hope of helping prevention and treatment of aging related diseases.
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Objective:To explore the age-related changes of Pole2 expression levels in peripheral blood lymphocytes of healthy people, and analyze the differences of Pole2 expression levels in peripheral blood lymphocytes of four common senile disease patients between normal peers.Methods:Healthy people and patients in the physical examination center of Xuanwu Hospital of Capital Medical University from December 2018 to December 2019 were selected as the research objects, the mRNA and protein level of Pole2 in heathy individual as 20-29,30-39,40-49,50-59,60-69,70-79 y were checked by RT-PCR and Western blot,and the age-related curve was drew. The mRNA and protein expression levels of Pole2 were also detected in the peripheral blood lymphocytes of patients of DM,CHD,AD,CVD. And the deviation with healthy people of the same age was analyzed from one way ANOVA and repeated measurement were used to compare the mean of multiple groups.Results:The mRNA and protein levels of Pole2 increased in the lymphocytes of healthy people at 20-29 y and 50-59 y grouy, and decreased after 60-69 y and 70-79 y ( P<0.001). The Pole2 levels of mRNA and protein in the lymphocytes of patients of CHD,AD,DM and CVD cerebral atherosclerosis were significantly higher than that of healthy people of the same age. Moreover, the Pole2 level of lymphocytes of AD patients was significantly higher than that of other patient groups ( P<0.001). Conclusion:The expression level of Pole2 in peripheral blood lymphocytes increases with age before the age of 60 years old and decreases with age after 60 years old ;and the expression in four common senile diseases was higher than that in normal people.
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Objective To investigate the effect of statin on trabecular bone microstructure by using trabecular bone score (TBS), a new type of bone microstructure evaluation index. Methods A total of 253 middle and aged patients hospitalized in the First Affiliated Hospital of Nanjing Medical University between January 2014 and March 2016 were retrospectively analyzed. According to whether statin was used or not, patients were divided into two groups: 90 patients in the statin use group (statin was use for more than 1 year) and 163 in the control group (not taken any statin). Serum biochemical indicators, such as triacylglycerol, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, alkaline phosphatase, fasting blood glucose and 25 hydroxy vitamin D, were compared between the two groups. Dual energy X-ray absorptiometry (DXA) was used to measure the bone mineral density (BMD) of lumbar spine and femoral neck. TBS was calculated with TBS iNsight? software, and the DXA image of lumbar spine were analyzed. Results Values of total cholesterol and low density lipoprotein cholesterol were significantly lower in statin group compared with those of control group (P0.05). There was higher lumbar spine BMD statin group compared to that of control group (g/cm2:1.04 ± 0.19 vs. 0.96 ± 0.14, P0.05). Conclusion Statin increases lumbar spine BMD and improves trabecular bone microstructure in middle and aged people.
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Objective To investigate the relationship between cholecystectomy and the subsequent occurrence of primary choledocholithiasis and to review the surgical treatment of primary choledocholithiasis.Methods The clinical data of 70 patients with forward common bile duct stones after cholecystectomy who were admitted to our hospital from January 2007 to December 2013 were retrospectively analyzed.Results All 70 patients underwent open surgery for removal of common bile duct stones,which were identified as bile pigment calculi.The postopera-tive complications included incisional wound infection (8 cases)and lung infection (5 cases),and no severe complications as biliary leak-age or hematobilia were observed.All patients fully recovered at the time of discharge.Eight cases of recurrent common bile duct stones were found and surgeries were performed 2.5 to 4 years after the recurrence.All patients were cured by choledocholithotomy,common bile duct transection,and Roux-en-Y hepaticojejunostomy.Conclusion Primary choledocholithiasis is an age-related disease,not a long-term complication of cholecystectomy.If no bile duct injury occurs during the cholecystectomy,the incidence rate of primary choledocholithiasis will not be increased.Surgical treatment is required for primary choledocholithiasis.For the cases of choledochectasia with the diameter of common bile duct greater than 2.5 cm or recurrent choledocholithiasis,the laparotomy with common bile duct transection and Roux-en-Y anastomosis is recommended.
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This article explored professor YANG Shao-shan's clinical experiences in treating senile diseases with ointment.He proposes that the TCM method is as following: First,invigorating kidney for protecting semen,pay attention to nourishing yin and decreasing yang.Second,invigorating spleen and stomach,pay attention to "vegetarian diet".Third,eliminating pathogenic factor,like phlegm and stasis.Forth,reinforcing the three treasures.