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20 April 2010, Volume 24 Issue 2 Previous Issue    Next Issue

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Ｅxpression of p21WAF1/CIP1/SDI1 in aging rat kidneys ZHUO Li, LIU Fu-You, CAI Guang-Yan, WANG Yang, SHI Suo-Zhu 2010, 24 (2):  113-117.  Abstract ( 882 )   Save ＯｂｊｅｃｔｉｖｅTo investigate the effect of p21WAF1/CIP1/SDI1 on the renal lesions in aging kidneys in rats. ＭｅｔｈｏｄｓMale Wistar rats at the ages of 3, 12, 24 months were used in this study. The renal tissues were processed for senescence associated βgalactosidase (SAβgal) staining. TUNEL assay was used to detect apoptosis of renal tubular epithelial cells. The expression and location of p21WAF1/CIP1/SDI1 in kidneys were studied by immunohistochemistry. The mRNA and protein levels of p21WAF1/CIP1/SDI1 were detected by Western blot and RTPCR, respectively. ＲｅｓｕｌｔｓThe expression of neutral βgalactosidase activity was increased in aging kidneys.  The number of apoptotic cells increased in kidney with advancing age(P＜005). The p21WAF1/CIP1/SDI1 staining appeared in the podocyte and interstitium in kidney. The staining intensity of p21WAF1/CIP1/SDI1 in kidneys in old animals was markedly increased, as compared to that in young and middleaged rats (P＜005).The mRNA level of p21WAF1/CIP1/SDI1 was significantly increased in aging kidneys, as compared to that at the age of 3 and 12 months, meanwhile the p21WAF1/CIP1/SDI1 proteins expression was dramatically increased with advancing age (P＜005). Ｃｏｎｃｌｕｓｉｏｎｓp21WAF1/CIP1/SDI1 expression increases with the aging of kidneys, which may serve as an important marker of organismal aging. Related Articles | Metrics

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Attenuation of bupivacaineinduced injury by α-Lipoic acid in mouse neuroblastoma cells WANG Xiao-Hui, YAO Yu-Zhen, DING Zheng-Nian, LIU Li 2010, 24 (2):  118-121.  Abstract ( 795 )   Save ＯｂｊｅｃｔｉｖｅTo investigate the neurotoxicity of bupivacaine (Bup) and the protective effects of αLipoic acid (LA). ＭｅｔｈｏｄｓMouse neuroblastoma N2a cells were employed in the present study. N2a cells were treated with variant concentrations of Bup (0, 300, 600, 900, 1500, 2000 μmol/L) for different durations (12, 24, 36 h). MTT assay and nuclear condensation analysis were used to evaluate the cell viability and apoptosis, respectively. N2a cells were pretreated with LA (0, 100, 300, 500, 1000, 2000 μmol/L) for 12 h, and followed by treatment with Bup (900 μmol/L) for 24 h. Cell viability was measured by MTT assay. Ｒｅｓｕｌｔｓ(1) Bup significantly induced injury in N2a cells, in both dose and timedependent manners. (2) LA markedly attenuated Bupinduced neurotoxicity in N2a cells, with the maximal protective efficiency at the concentration of 500 μmol/L.ＣｏｎｃｌｕｓｉｏｎｓTreatment of Bup could result in substantial injury in N2a cells. Pretreatment with LA could attenuate neurotoxicity induced by Bup. Related Articles | Metrics

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Relationship between characteristics of sleep disorder and cognitive impairment in the elderly with obstructive sleep apnea syndrome ZHANG Bao-He, WANG Lu-Ning 2010, 24 (2):  122-124.  Abstract ( 1079 )   Save ＯｂｊｅｃｔｉｖｅTo explore the relationship between obstructive sleep apnea syndrome(OSAS) and cognitive impairment in the elderly. ＭｅｔｈｏｄｓThirtysix elderly patients were divided into two groups，eighteen patients with OSAS and 18 controls. Polysomnography at home, Pittsburgh sleep quality index（PSQI）, Epworth sleepiness scale（ESS）, minimental state examination（MMSE），Wechsler memory scale，clock drawing，word list recall and digital symbol test were detected in two groups. ＲｅｓｕｌｔｓThe delta sleep ratio, minimum and mean saturation of blood oxygen decreased,and the apnea and hypopnea index increased significantly in OSAS group than those in control group（P＜005）. Scores of the MMSE, Wechsler memory scale, digital symbol test， clock drawing in the OSAS group were impaired significantly compared with the control group. ＣｏｎｃｌｕｓｉｏｎｓThe elderly with OSAS have less deep sleep and decreased blood oxygen level at night.There is a relationship between OSAS and cognitive impairment in the elderly. Related Articles | Metrics

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Epidemiological survey and analysis about senile dementia among the elderly living in groups in Xi'an GUO Ming-Xian, GUO Feng, GAO Li, ZHANG Gui-Gong, ZHANG Xiu-Fen, LV Shu-Ping 2010, 24 (2):  125-127.  Abstract ( 898 )   Save ＯｂｊｅｃｔｉｖｅTo investigate the status about senile dementia among the elderly of nursing homes and analyze the risk factors of dementia in Xian.ＭｅｔｈｏｄｓQuestionnaires and measuring scales of demography, health history, MMSE, ADL, HDS and so on were used as screening tools.ＲｅｓｕｌｔｓThe prevalence of senile dementia was 36.7% in those who lived in nursing homes, which was much higher than that of other elderly groups. Dementia prevalence raised with increasing age and descending ADL scores, while it was reduced in groups with elevating education level. Old age, living in nursing homes and high ADL scores remained risk factors for dementia.ＣｏｎｃｌｕｓｉｏｎｓThe prevalence of dementia in those living in groups in Xian is high, especially in those living in nursing homes. Related Articles | Metrics

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Effects of simvastatin on the expression of HMGB1 in atherosclerotic rats YIN Ya-Xin, LIU Run-Mei, ZHAI Hong-Xia, LI Liang, ZHANG Jin-Jin, CHEN Hai-Wei, WANG Lei, LI Na, XIA Yun-Feng 2010, 24 (2):  128-131.  Abstract ( 1214 )   Save ＯｂｊｅｃｔｉｖｅTo observe the effects of simvastatin on the protein and gene expression of HMGB1 and morphology of the atherosclerotic plaques in atherosclerotic rats, and to discover the protective mechanism of simvastatin for atherosclerosis.ＭｅｔｈｏｄｓThirty rats were randomly divided into 3 groups:control group, atherosclerosis group and simvastatin group.The atherosclerotic rats in simvastatin group were treated with simvastatin for 4 weeks. The histopathology change and the protein and gene expression of HMGB1 in the atherosclerotic plaques of aorta were observed, and compared in three groups.Ｒｅｓｕｌｔｓ(1) Simvastatin could inhibit the formation of the atherosclerotic plaques obviously, and the area of plaques decreased evidently. The expression of HMGB1 was enhanced in the area infiltrated with inflammatory cells and in the matrix around the necrotic cells.(2)The HMGB1 mRNA expression in all atherosclerotic rats was significantly increased(P＜001 ); In the simvastatin group, the gene expression of HMGB1 was lower than that in atherosclerosis group, while higher than that in the control group.(3)The plasma level of HMGB1 was significantly higher in the atherosclerotic group than that in the simvastatin group and the control group(P＜005 or P＜001) .Ｃｏｎｃｌｕｓｉｏｎｓ(1) The HMGB1 expression is increased in the atherosclerosis group.(2)Simvastatin could alleviate the formation of the plaques in the atherosclerotic rats, decreasing the protein and gene expression of HMGB1, then protecting the vessels by alleviating the inflammation. Related Articles | Metrics

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Application of glargine in elderly type 2 diabetic patients during perioperative period HONG Bing, XU Xiao-Wen, YU Wei-Nan, XU Wei, HU Wen 2010, 24 (2):  132-134.  Abstract ( 1075 )   Save ＯｂｊｅｃｔｉｖｅTo investigate the clinical efficacy of glargine in elderly type 2 diabetic patients during the perioperative period. ＭｅｔｈｏｄｓSixtyone cases of perioperative elderly patients with type 2 diabetes were divided into three groups. One group receiving subcutaneous injection of glargine, another group receiving insulin pump and basic dose of insulin, still another group receiving intravenous insulin infusion. Blood glucose controlled time, the average blood glucose, blood glucose fluctuations, insulin dosage per day, the incidence of hypoglycemia and the average daily cost were compared among three groups after treatment.ＲｅｓｕｌｔｓThe blood glucose controlled time, the average blood glucose, insulin dosage per day, the incidence of hypoglycemia and blood glucose fluctuations in glargine group had no significant difference compared with insulin pumps group (P＞005), but were significantly lower than those in the intravenous insulin infusion group (P＜001). The average daily cost in glargine group was significantly lower than that in insulin pumps group (P＜001). ＣｏｎｃｌｕｓｉｏｎｓThe efficacy and the safety of glargine treatment applied in elderly patients with type 2 diabetes during the perioperative period are similar to that of insulin pumps treatment, but the cost of treatment is significantly lower than that of insulin pump. Related Articles | Metrics

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Relationship of serum total homocysteine and macrovascular diseases in elderly patients with type 2 diabetes mellitus ZHU Jian-Yi, LV Zhi-Gang, SHI Heng-Chuan 2010, 24 (2):  135-137.  Abstract ( 1067 )   Save Related Articles | Metrics

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Safety and variation of blood potassium during argentine stimulation test in patients with type 2 diabetes mellitus WU Hai-Di, BIAN Rong-Wen, HU Yan 2010, 24 (2):  138-140.  Abstract ( 1221 )   Save ＯｂｊｅｃｔｉｖｅTo evaluate the safety and variation of blood potassium during argentine stimulation test in patients with type 2 diabetes mellitus(T2DM).ＭｅｔｈｏｄｓThe argentine stimulation test was performed in 70 individuals with T2DM. The feelings after being injected with argentine of each patient were recorded. Plasma glucose(PG), insulin and potassium levels were measured.ＲｅｓｕｌｔｓThe most common feelings included metallic taste, tongue numbness and burning sensation, all of which were tolerable. Plasma glucose increased with no stalistical significance（ΔPG＝0.46±1.13 mmol／L，P＞005）, while insulin significantly increased（ΔINS=128±073 mmol／L，P＜005）, after injection of argentine. Blood potassium significantly decreased after injection of argentine[ΔK=-(033±025)mmol／L，P＜001]. ΔK  was positively correlated to fasting potassium level.ＣｏｎｃｌｕｓｉｏｎｓIt is safe to conduct argentine stimulation test in patients with T2DM, especially in those with higher blood glucose level. Related Articles | Metrics

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Application of microinjection pump in high concentration potassium chloride infusion in the aged with severe hypokalemia ZHENG Juan, LI Xiao-Hong, ZHU Xue-Yun, CHEN Jun, WANG Hong-Xia 2010, 24 (2):  141-143.  Abstract ( 2005 )   Save 【Ａｂｓｔｒａｃｔ】　ＯｂｊｅｃｔｉｖｅTo research the safety and efficacy of high concentration potassium chloride infusion with micropump through central vein in aged patients with severe hypokalemia.ＭｅｔｈｏｄｓFortytwo elderly patients with severe hypokalemia were randomly divided into two groups: experimental group and control group.Patients in the experimental group were treated with micropump infusion of 6% KCl solution through central vein while the control group were treated with 03% KCl solution. Both groups were infused at the speed of 1-15 g/h KCl. Responses to the treatment in two groups were  observed.ＲｅｓｕｌｔｓWhen the potassium concentration rose to 3.0 mmol/L, patients in experimental group spent 395±257 h, and 405±188 g KCl,and 115±25 ml liquid was infused, compared with 723±445 h, 836±378 g, 2054±1250 ml in control group. To relieve the pernicious arrhythmia caused by hypokalemia,the experiment group spent 122±035 h, compared with 255±086 h in the control group. All of the above figures had statistic difference between the two groups (P＜005). However, to raise the blood potassium to 45 mmol/L, the two groups patients had been infused with KCl 355±123 g and 416±15.5 g respectively, with no statistical difference (P＞005).ＣｏｎｃｌｕｓｉｏｎｓIn aged patients with severe hypokalemia, high concentration potassium chloride infusion with micropump through central vein was safe and effective. Related Articles | Metrics

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Effect of noninvasive positivepressure respiration on serum Nterminal probrain natriuretic peptide in elderly patients with chronic heart failure GUO Hui-Feng, YANG Jing-Ye, ZHANG Xing-Liang, LI Sheng-Qian 2010, 24 (2):  144-146.  Abstract ( 1172 )   Save ＯｂｊｅｃｔｉｖｅTo investigate the effect of noninvasive positivepressure respiration on serum Nterminal probrain natriuretic peptide (NTproBNP) in elderly patients with chronic heart failure(CHF).ＭｅｔｈｏｄｓOne hundred and twenty patients with CHF were randomly divided into two groups. The control group received only routine treatment, the experimental group received routine treatment, and was also treated with bilevel positive airway pressure ventilation ( BiPAP). The levels of NTproBNP were measured before and 12 h, 24 h, 72 h, 7 d and 14 d after the treatment in two groups. The symptoms and physical signs of heart failure were evaluated.ＲｅｓｕｌｔｓAfter 24hour treatment, the levels of NTproBNP in the experimental group descended significantly compared with that of control group. Additional improvement was higher in the experimental group compared with the control group. There was significant difference in two groups ( P＜001). ＣｏｎｃｌｕｓｉｏｎｓApplication of BiPAP respiratory ventilation could decrease the plasma NTproBNP level in elderly patients with CHF. It is an effective and safe method in treating CHF. Related Articles | Metrics

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Clinical significance of tombstoning of ST segment in elderly patients with acute myocardial infarction CHEN Qing-Ping, HUANG Xue-Cheng, DENG Zi-Qian, ZHANG Feng-Ling, HUANG Ning 2010, 24 (2):  147-149.  Abstract ( 1257 )   Save ＯｂｊｅｃｔｉｖｅTo investigate clinical significance of tombstoning of ST segment in acute myocardial infarction (AMI) in the elderly.ＭｅｔｈｏｄｓAmong 468 patients with AMI, there were 42 cases whose ECG showed tombstoning of ST segment. According to the patients’age, those 42 cases were divided into elder tombstoning of ST segment group and nonelder tombstoning of ST segment group. Besides, 50 cases whose ECG showed ST segment elevation in other shapes were chosen randomly as control group in the 468 patients. Some indexes were analyzed in these three groups.Ｒｅｓｕｌｔｓ100% of the elderly patients with tombstoning ST segment elevation were found to have underlying diseases.The incidence rate of postmyocardial infarction angina before PCI，complication, mortality, leads of ST segment elevation  or  pathologic Q wave, amplitude were all significantly higher than those of the nonelder patient groups. And all the above values in tombstoning group were higher than those in other groups,and the difference was statistically significant. And the incidence rate of ischemic myocardial reperfusion after PCI is significantly higher in tombstoning group than that in nonelder patient groups.ＣｏｎｃｌｕｓｉｏｎｓThe tombstoning of ST segment suggests the poor prognosis in AMI patients, especially in elderly patients. These patients should be cautioned against reperfusion injury. Related Articles | Metrics

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Effect of supplementary therapy with budesonide on acute exacerbation of COPD LI Wei, Shi Ming, XUE Ke-Ying, CHENG Li 2010, 24 (2):  150-152.  Abstract ( 1291 )   Save ＯｂｊｅｃｔｉｖｅTo investigate the clinical effect of supplementary therapy with budesonide on acute exacerbation of chronic obstructive pulmonary disease (COPD).ＭｅｔｈｏｄｓSixty patients presenting with acute exacerbation of COPD were randomly divided into three groups. The control group received routine treatment, including nebulized β2agonists, ipratropium bromide, antibiotics, and supplemental oxygen. The budesonide group and the methylprednisolone group received combined therapy of routine treatment and nebulized budesonide or intravenous infusion of methylprednisolone, respectively. All patients underwent the measurement of pulmonary function and arterial blood gas analysis.ＲｅｓｕｌｔｓThe FEV1% and blood gas parameters were more significantly improved in the budesonide group and methylprednisolone group than those in the control group, while there was no difference in FEV1% and blood gas parameters between budesonide group and methylprednisolone group.ＣｏｎｃｌｕｓｉｏｎｓNebulized budesonide may be an alternative to systemic corticosteroids in the treatment of acute exacerbations of COPD. Related Articles | Metrics

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Influence of exercise training on exercise tolerance in aged patients with stable angina pectoris WU Zi-Qiang, DING Li, JIANG Ya-Wen, XIE Zhi-Quan, WANG Ji-Ye, ZHOU Pei-Yi, WANG Li-Li 2010, 24 (2):  153-155.  Abstract ( 1044 )   Save ＯｂｊｅｃｔｉｖｅTo investigate the influence of exercise training on exercise tolerance in aged patients with stable angina pectoris(SAP).ＭｅｔｈｏｄｓSixty patients with SAP, receiving the same drug treatment, were divided into exercise group(n=30) and nonexercise group(n=30).The patients in exercise group received exercise training such as walking, jogging, up and down stairs, or Taiji. Exercise tolerance was evaluated by treadmill exercise test(MET) and 6minute walking distance (6MWD) test.ＲｅｓｕｌｔｓThere was significant correlation (r=0816,P＜001)between 6MWD and MET.There were longer 6MWDs in exercise group and nonexercise group after intervention（P＜001, P＜005 respectively）.There were much longer 6MWD in exercise group than that in nonexercise group(P＜0.05).ＣｏｎｃｌｕｓｉｏｎｓExercise training can increase exercise tolerance in aged patients with SAP, and the exercise tolerance can be estimated by 6MWD. Related Articles | Metrics

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Determination of islet autoantibodies in elderly diabetic patients by immunoblotting test HU Lan-Ping, GU Ping, WANG Jian, SHAO Jia-Qiang, DU Hong, WANG Yang-Tian, LU Bin, PENG Li 2010, 24 (2):  156-158.  Abstract ( 1132 )   Save ＯｂｊｅｃｔｉｖｅTo estimate the value of immunoblotting test in detecting islet autoantibodies (IAA) of elderly diabetic patients.ＭｅｔｈｏｄｓThree hundred and fifty elderly diabetic patients and one hundred and twenty healthy people were measured for autoantibodies：glutamic acid decarboxylase antibody(GADA)，islet cell antibody (ICA)and IAA with immunoblotting test and ELISA respectively.ＲｅｓｕｌｔｓThe positive rate of GADA with immunoblotting test was higher than that with ELISA in elderly diabetic patients whereas there were no significant differences in the positive rates of ICA and IAA between two methods. The positive rates of GADA and ICA in patients with a course more than five years were lower than patients with a course less than five years with two methods. The positive rate of GADA with immunoblotting test was higher than that with ELISA in patients with a course more than five years.ＣｏｎｃｌｕｓｉｏｎｓThe sensibility of immunoblotting test was better than ELISA in detecting IAA in elderly diabetic patients, especially for GADA. Related Articles | Metrics

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Study on relationship of urinary 11dehydrothromboxane B2 with cognitive function in elderly senior intellectuals with symptomatic cerebral infarction CUI Liang, YAN Hong, ZHONG Yuan, JIN Jun, WANG Bei-Yun 2010, 24 (2):  159-161.  Abstract ( 902 )   Save ＯｂｊｅｃｔｉｖｅTo discuss the relationships of the level of urinary 11dehydrothromboxane B2 (11DHTXB2) with cognitive function in elderly senior intellectuals with asymptomatic cerebral infarction.ＭｅｔｈｏｄｓSixty patients (40 men, 20 women) with a mean age of 722±61 years, participated in this study and definitely suffered from asymptomatic cerebral infarction confirmed by brain MRI. Their education were all higher than the university levels (including university). Urinary 11DHTXB2 level was detected by enzyme linked immunosorbent assay. MMSE and MOCA were used to assess their cognitives and recorded, then statistical analysis was carried out with SPSS 17.0.ＲｅｓｕｌｔｓThe urinary 11DHTXB2 level of the abnormal MMSE group was apparently higher than that of the normal MMSE group (P＜001). The score of MMSE in the abnormal MMSE group was negatively correlated with the urinary 11DHTXB2 level (P＜001). The urinary 11DHTXB2 level of the abnormal MOCA group was apparently higher than that of the normal MOCA group (P＜001). The score of MOCA in the abnormal MOCA group was negatively correlated with the urinary 11DHTXB2 level (P＜001).ＣｏｎｃｌｕｓｉｏｎｓThe urinary 11DHTXB2 level is correlated with cognitive hypofunction in elderly senior intellectuals with asymptomatic cerebral infarction. Related Articles | Metrics

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Study on the effects of duloxetine and fluxetine on lateonset patients with depression LIU Xiao-Wei, YANG Q-ing, ZHU Pei-Jun, WANG Jin-Liang 2010, 24 (2):  162-164.  Abstract ( 655 )   Save ＯｂｊｅｃｔｉｖｅTo evaluate the efficacy and safety of duloxetine in the treatment for lateonset patients with depression. ＭｅｔｈｏｄｓSeventytwo lateonset patients with depression were randomly divided into study group (receiving duloxetine) and control group (receiving fluxetine). Efficacy and side effects were assessed with HAMD, HAMA and TESS respectively before and after treatment. ＲｅｓｕｌｔｓAfter eight weeks, the efficacy showed no differences between two groups. No significant difference was found in all scores of HAMD and HAMA between the two groups. But the scores of anxiety / somatization and sleep disorder in study group were significantly different from control group. No difference was found in the adverse event between the two groups. ＣｏｎｃｌｕｓｉｏｎｓDuloxetine shows better efficacy and high safety in the treatment of lateonset depression, which could be recommended to all lateonset patients with somatization symptoms. Related Articles | Metrics

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Exercise pulmonary function test in evaluation for elderly patients with chronic obstructive pulmonary disease Wu Hao, XU Zi-Ban, LI Jian-Guo, JIANG Long-Yuan, HUANG Zi-Tong 2010, 24 (2):  165-167.  Abstract ( 1092 )   Save ＯｂｊｅｃｔｉｖｅTo investigate the clinical manifestations in exercise pulmonary function test of the elderly patients with chronic obstructive pulmonary disease(COPD). ＭｅｔｈｏｄｓTwentytwo patients with stable COPD were divided into two groups，elderly group and control group. All patients underwent spirometry and exercise pulmonary function test. ＲｅｓｕｌｔｓThere were no significant differences in resting spirometric parameters between two groups(P＞005). The maximal rate of work, maximal oxygen uptake, the maximal volume of ventilation per minute were lower in elderly group than those in control group(P＜005), but the maximal dead space/tidal volume ratio was higher in elderly group than that in control group(P＜005). ＣｏｎｃｌｕｓｉｏｎｓExercise pulmonary function test is safe for the elderly patients with COPD.It can reflect exercise tolerance of patients and the change of ventilation during exercise. Related Articles | Metrics

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Study on the relationship between familial factors and mental health in elderly people in Beijing MA Li-Na, TANG Zhe, GUAN Shao-Chen, FANG Xiang-Hua, Wu Xiao-Guang, DIAO Li-Jun, LIU Hong-Jun, SUN Fei 2010, 24 (2):  168-170.  Abstract ( 1797 )   Save ＯｂｊｅｃｔｉｖｅTo explore the relationship between familial factors and mental health in elderly people in Beijing. ＭｅｔｈｏｄｓA sample of 1706 elderly people living in Beijing was investigated, and they received the examination with self evaluation scale and CESD.The data  on demographic characteristics, living conditions and health  were surveyed.Ｒｅｓｕｌｔｓ Familial factor affected the mental health of elderly people.Those who lived alone,mateless,in an inharmonious family, or were not respected in family and did not speak up  one’s mind had poor mental health.  ＣｏｎｃｌｕｓｉｏｎｓThe mental health of elderly people is affected by familial factors. Good family relationship can decrease the incidence of mental problems.The traditional virtue of Chinese people of  respecting the old and maintaining a harmonious family relationship should be carried forward. Related Articles | Metrics

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Clinical analysis of 46 elderly patients with grievous hemorrhoidal diseases treated by modified procedure for prolapse and hemorrhoids CHEN Qian-Yi, HE Xiao-Hua, HU Jian-Wei, BI Yu-Ying 2010, 24 (2):  171-173.  Abstract ( 1090 )   Save ＯｂｊｅｃｔｉｖｅTo treat grievous hemorrhoidal diseases in elderly patients with modified procedure for prolapse and hemorrhoids (PPH), and to observe the efficacy and summarize the clinical experience. ＭｅｔｈｏｄｓFrom June 2007 to June 2009，46 patients aged ≥60 years，who suffered from Ⅲ，Ⅳ degree hemorrhids with bump emersion and bleeding of dominating symptoms，underwent the operation of modified PPH．The clinical data and longterm outcome of the patients was retrospectively analyzed． ＲｅｓｕｌｔｓWith less hurt，lighter pain and faster recovery，modified PPH showed significant effects in controlling bleeding，preventing emersion and decreasing accompanying syndrome． ＣｏｎｃｌｕｓｉｏｎｓPPH might be used to treat grievous hemorrhoidal diseases in elderly patients． Related Articles | Metrics