Surgical Treatment for Colorectal Cancer with Obstruction in Elderly Patients / 中国肿瘤临床

Objective: To evaluate the surgical procedures and prognostic factors for colorectal carcinoma in patients aged over 70. Methods: We retrospectively reviewed 31 colorectal cancer patients aged over 70 seen in our hospital between January 1992 and December 2001.Treatment procedures and outcome of these patients were analyzed.Kaplan-Meier method was used for survival analysis and Cox regression analysis was conducted to analyze prognostic factors. Results: The median age of these patients was 74 years.The median follow-up period was 12 months.The postoperative complication rate was 22.6%.The thirty-days mortality was 6.5%.There were 28 cases of tubular adenocarcinoma (well differentiated in 5 cases,moderately differentiated in 16 cases,and poorkly differentiated in 7 cases)and 3 cases of mucinous adenocarcinoma.As to Dukes stage,there were 8 cases of B stage,9 cases of C stge,and 14 cases of D stage.The overall 5-year survival rate was 22.7%.The 5-year survival rate was 44.4%in the radical surgery group and 7.7%in the palliative surgery group.The median survival period of all patients was 12 months.The median survival period was 38 months in the radical surgery group and 9 months in the palliative surgery group.Univariate analysis showed that the predictors for survival were age,co-morbidity,preoperative serum CEA level,preoperative serum albumin concentration,duration of surgery,radical surgery,and cancer stage. Conclusion: Radical resection is a prerequisite for cure of colorectal cancer with obstruction in elderly patients.Age and preoperative serum albumin concentration are independent prognostic indicators.

Relationship between serf-efficacy and subjective well-being of the elderly in community / 中国实用护理杂志

Objective To investigate the relationship between self-efficacy(SE)and subjective wellbeing(SWB)of the elderly in community.Methods 212 elderly people underwent a questionnaire survey by the Memorial University of New Foundland Scale of Happiness and the General Self-efflcacy Scale.Results The level of self-efficacy of the elderly in community was(2.39±0.63),of which impact factor was the level of education and average monthly income per person.The level of SWB was(37.31±7.24),of which impact factor was the level of education and occupation.The level of SE and SWB of the elderly sas mdderately positively correhted,r=0.36,P＜0.01. Conclusions In the practice of community care services,community nurses should take SE theory as a framework and to improve SWB by a vailety of nursing measures.

Comparison of the curative effects of two operative methods for the treatrant of intertrochanteric fractures in aged / 中国基层医药

Objective To compare the curative effects of intertrochantefie fractures in aged by two operative methods. Methods 85 cases of elderly patients suffered from intertrechanteric fractures were retrospectively ana-lyzed. Out of the 85 cases,45 cases were treated with dynamic hip screw(DHS) and 40 cases were fixed with Gamma nails. The curative effects and complications were compared simultaneously. Results The total excellent rate was 83.5% in 85 patients,the rates of DHS and Gamma nails group were 77. 8% and 90% (X2 = 2. 84, P 0. 05), re-spectively. The operative time (66. 4 ± 19. 4)min in DHS group were less than the Gamma nail group (875 ± 25.5) rain (t=2. 451 ,P < 0. 05), but the length of surgical incision (19. 6± 5. 1)cm greater than the Gamma nail group (10. 3 ± 4. 7) cm(t = 2. 501, P < 0. 05). The complications of DHS group (11.1%) were significanfly higher than that of Gamma nail group(2. 5%) (X2 =3.94,P<0. 05). Conclusion As long as the physical condition can toler-ate,surgery recommend the use of DHS and Gamma nail surgical techniques in aged patients with intertrechanteric fractures.