Ultrasound-driven microbubble oscillation and translation within small phantom vessels

The use of ultrasound radiation force to manipulate microbubbles in blood vessels has attracted recent interest as a method to increase the efficiency of ultrasonic molecular imaging and drug delivery. However, recent studies indicate that microbubble oscillation is diminished within small blood vessels, and therefore we investigate microbubble oscillation and translation within 12 μm vessels using high-speed photography. With each 0.1- to 1-MPa ultrasound pulse, microbubbles (radius of 1, 1.5 and 2 μm) within 12 μm tubes translate 5 to 10 times less than those within 200 μm tubes. Application of a pulse train with a high pulse repetition frequency displaces bubbles to the wall of 12- and 200-μm tubes within an interval (1 s) that is reasonable for clinical translation. Modeling of coupled oscillation and translation for unconstrained microbubbles, based on a modified Rayleigh-Plesset (RP) and the trajectory equations, is compared with experimental observations and demonstrates agreement for the larger displacements observed within the 200 μm tubes. This study has implications for contrast-assisted ultrasound applications, aiding the manipulation of targeted microbubbles and for further theoretical understanding of the complex bubble dynamics within constrained vessel. (E-mail: kwferrara@ucdavis.edu)     

急性心肌梗死患者疲劳发展轨迹的调查研究

目的 探讨急性心肌梗死（acute myocardial infarction,AMI）患者疲劳发展轨迹及影响因素。方法 2019年12月—2021年1月,采用方便抽样法,选取湖州市某三级甲等医院心内科首次发生AMI的206例患者作为调整对象。采用多维疲劳量表在患者入院后第2天、出院后1个月、2个月、4个月调查患者的疲劳水平,采用潜类别增长模型及单因素分析进行数据处理。结果 识别出AMI患者疲劳轨迹分为3个潜在类别,分别为明显改善组（15.2%）、缓慢缓解组（62.8%）、持续疲劳组（22.0%）;不同轨迹类别在性别（χ²=29.384,P<0.001）、婚姻状况（χ²=6.774,P=0.034）、共病个数（χ²=27.131,P<0.001）和心功能分级（χ²=20.416,P<0.001）方面,差异有统计学意义。结论 AMI患者从急性入院至出院后4个月内,大部分患者的疲劳能得到良好的改善,其疲劳轨迹存在群体异质性,护士应根据疲劳变化轨迹及其影响因素,给予患者阶段性及特异性的护理干预。     

Genetic sensitivity to hot-plate nociception in DBA/2J and C57BL/6J inbred mouse strains: possible sex-specific mediation by δ2-opioid receptors

The inbred mouse strains, DBA/2J (D2) and C57BL/6J (B6), display differential sensitivity to acute, thermal nociception as measured on the hot-plate (HP) assay. In an ongoing quantitative trait locus (QTL) mapping study designed to reveal genomic loci showing genetic linkage to HP sensitivity, a putative QTL on chromosome 4 (50–80 cM from the centromere) has been identified that appears to account for variability in this trait in male, but not female mice. An obvious candidate gene located in this same chromosomal region is Oprd1, which encodes the murine δ-opioid receptor. In an attempt to evaluate whether Oprd1 represents this sex-specific QTL for HP sensitivity, we tested D2 and B6 mice of both sexes for HP latencies (hindpaw-lift, -lick or -flutter) following systemic injections of saline, or the opioid receptor antagonists naloxone (NAL; 0.1 and 10 mg/kg), nor-binaltorphimine (nor-BNI; 5 mg/kg), naltrindole (NTI; 5 mg/kg), 7-benzylidenenaltrexone (BNTX; 0.7 mg/kg), or naltriben (NTB; 1 mg/kg). High-dose (10 mg/kg) NAL lowered HP latencies in D2, but not B6 mice, suggesting that the higher HP latencies exhibited by D2 mice reflect opioid mechanisms. HP latencies in both strains and both sexes were unaffected by pretreatment with low-dose (0.1 mg/kg) NAL or nor-BNI, suggesting that neither μ nor κ receptors affect basal nociceptive sensitivity. The δ-receptor antagonist, NTI, and the δ₂-specific antagonist, NTB, (but not the δ₁-specific antagonist, BNTX) effectively lowered HP latencies in a strain- and sex-dependent manner: D2 male>B6 male>D2 female>B6 female. These data support the possibility that Oprd1 is a QTL mediating HP sensitivity in mice, and more generally illustrate the important roles of genetic background and gender in the perception of pain.     

Variability of post-methionine load plasma homocysteine assays

Background: Numerous variations of the methionine load test are frequently used as dynamic function tests to assess homocysteine metabolism. Lack of standardization impedes inter-laboratory comparisons. Criteria based on biological variation are suggested to standardize the methionine load test. Methods: Weekly methionine load tests (n=5) with blood sampling at 0, 4, 6 and 8 h were performed on 15 young men. For both basal and post-methionine load homocysteine measurements, total variance (σ_S²), within-subject variance (σ_I²), between-subject variance (σ_G²) and analytical variance (σ_A²) were calculated from an appropriate analysis of variance (ANOVA). Results: Plasma homocysteine concentrations measured 6 h after methionine loading had analytical, within-subject and between-subject coefficients of variation of 5.2%, 17.5% and 9.7%, respectively. Measurements at 4 h had a higher within-subject coefficient of variation. Adjustment of post-methionine load homocysteine concentrations for basal levels resulted in considerable increases of all the measures of variation. Conclusions: Adjustment of post-methionine load plasma homocysteine concentrations for basal levels does not improve the interpretation of changes in serial results due to the higher analytical and biological variance of adjusted concentrations. It is suggested that the methionine load test is standardized to a single, unadjusted homocysteine measurement at 6 h.     

Intrathecal pertussis toxin produces hyperalgesia and allodynia in mice

Pertussis toxin (PTX), which causes the ADP-ribosylation and thereby inactivation of G_i-proteins, has been employed in analgesia testing to elucidate receptors that are coupled to inhibitory G-proteins, such as the mu-opioid receptor. Consistent with previous findings, the antinociceptive effects of morphine (1–10 μg) as measured by tail-flick latency using a 55°C water bath, were blocked by a single intrathecal injection of 0.5 μg PTX 6 days prior to intrathecal morphine administration. In addition, mice treated intrathecally with 0.5 μg of PTX had significantly shorter baseline tail-flick latencies compared with vehicle treated mice using a 55°C water bath when tested 6 days after PTX or vehicle administration. Morphine-induced antinociception was blocked in a dose-dependent manner by PTX with complete blockade of morphine following a 0.3-μg dose of PTX. Further, mice administered 0.1 μg or 0.3 μg PTX intrathecally had significantly shorter tail-flick latencies compared with vehicle injected mice using a 40, 45 or 50°C water bath when tested 7 days after intrathecal injection. Shorter tail-flick latencies were observed at 45°C as early as 48 h after intrathecal administration of 0.03, 0.1 or 0.3 μg PTX and these shorter tail-flick latencies were observed up to 90 days after intrathecal PTX administration. The intrathecal administration of PTX caused hyperalgesia and allodynia that appears similar to the symptoms reported by patients suffering from neuropathic pain, and suggests that deficiencies in inhibitory systems, as compared with increases in excitatory systems, may play a role in the pathophysiology of at least some central or neuropathic pain states.     

全膝关节置换术后患者恐动症的影响因素研究

目的 通过建立结构方程模型分析全膝关节置换术后患者恐动症的影响因素。 方法 采用便利抽样法,于2019年12月—2020年9月采用凯斯勒10量表、抑郁自评量表、D型人格量表、疼痛灾难化量表和恐动症Tampa评分,对河南省某三级甲等综合医院494例行全膝关节置换术的患者进行调查。 结果 最终共纳入463例患者,恐动症发生率为38.2%,构建的模型数据拟合度良好。其中,疼痛灾难化对恐动症有直接正向效应（β=0.461,P<0.001）,抑郁对恐动症有直接和间接正向效应（β=0.162,P<0.001;β=0.063,P<0.001）,D型人格和压力水平对恐动症有间接正向效应（β=0.144,P<0.001;β=0.186,P<0.001）。 结论 全膝关节置换术后患者恐动症发生率偏高,科研及临床工作者均应重视患者的疼痛灾难化、心理状况、人格及压力水平对其恐动症的影响,以便采取措施改善全膝关节置换术后患者的康复结局。     

潍坊市养老院老年人吞咽障碍与误吸调查

目的 调查潍坊市养老院老年人吞咽障碍与误吸的发生情况及具体表现。方法 2021年1月至6月,随机抽取潍坊市10家养老院入住的837位老年人,采用基本情况调查问卷、Fried衰弱表型、Ohkuma问卷和容积-黏度吞咽测试进行调查。结果 养老院老年人吞咽障碍与误吸的发生率分别为44.2%、12.3%。不同年龄和健康状况老年人的吞咽障碍发生率有显著性差异(χ2> 8.437, P <0.05)。男性吞咽障碍与误吸的发生率均高于女性(χ2> 4.060, P <0.05)。男性口腔期吞咽功能障碍发生率显著高于女性,食管期吞咽功能障碍发生率显著低于女性(χ2> 20.830,P <0.001)。患有脑卒中、阿尔茨海默病和帕金森病的老年人以口腔期功能障碍为主(χ2=27.579, P <0.001),患有慢性呼吸道疾病老年人以咽期和气道保护功能障碍为主(χ2> 20.241, P <0.01)。结论 养老院老年人吞咽障碍与误吸发生率较高,不同性别、基础疾病间的吞咽障碍表现不同。     

Rapid determination of plasma glucose by measurement of oxygen consumption

Simple apparatus is described, which used in conjunction with a pH/Blood Gas Analyzer or expanded scale pH meter enables the determination of plasma glucose levels.

Quantitative assays of glucose using 100 μl of untreated plasma may be made within a few minutes of blood collection.     

Biochemical assay for amyloid beta deposits to distinguish Alzheimer's disease from other dementias

Biochemical markers for Alzheimer's disease (AD) are of great value for precise diagnosis and in studies of the pathogenetic processes of this disease. A new biochemical assay allowing to differentiate AD from other forms of dementia is described. The assay is based on the extraction of amyloid β (Aβ) from milligram amounts of brain tissue by using 20% acetonitrile in 0.1% trifluoroacetic acid and its detection by Western blotting. The presence of the 4 kDa Aβ was demonstrated in all cases of AD (n=8) that were diagnosed by the independent histopathological examination of the postmortem tissues. No Aβ was found in tissue extracts from seven out of eight cases of other forms of dementia. In contrast to other biochemical techniques of Aβ detection in brain, the developed assay is simple; it does not require any special equipment and allows detection of Aβ using milligram amounts of brain tissue.     

恶性黑色素瘤术后患者免疫检查点抑制剂辅助治疗早期疲劳发展轨迹研究

目的 免疫检查点抑制剂中的程序性细胞死亡蛋白受体1（programmed cell death protein1,PD-1）抑制剂已被用于多种晚期肿瘤的治疗中,该研究旨在识别恶性黑色素瘤术后PD-1抑制剂单药辅助治疗患者早期疲劳发展轨迹及其影响因素。 方法 采用便利抽样法,选取2020年4月—2021年12月于河南省某三级肿瘤医院和吉林省某三级甲等医院肿瘤科住院的患者作为调查对象,采用癌症疲乏量表调查患者首次PD-1抑制剂治疗后1、2、3、4周后的疲乏现状,利用组基轨迹模型识别106例PD-1抑制剂单药辅助治疗患者早期疲劳症状发展轨迹,运用多元Logistic回归分析患者早期疲劳症状发展轨迹的影响因素。 结果 识别出“疲劳缓解组”和“疲劳升高组” 2种早期疲劳发展轨迹。单因素分析结果显示,各亚组在肿瘤部位、自理能力、休息后是否缓解、伴有其他免疫相关不良事件个数方面的差异均具有统计学意义（P<0.05）。多元Logistic回归分析结果显示,早期疲劳症状休息后缓解[RR=0.026,95%CI（0.004,0.179）]、不伴有其他免疫相关不良事件[RR=0.255,95%CI（0.181,0.361）]被归属为类型2“疲劳升高组”的可能性较小。 结论 恶性黑色素瘤术后患者PD-1抑制剂辅助治疗早期疲劳发展呈现不同的变化轨迹,护士应重视疲劳症状休息后不缓解、伴有其他免疫相关不良事件患者早期疲劳症状的评估和干预。     

老年结肠镜检查患者肠道准备失败风险评分模型的构建及验证

目的 分析老年结肠镜检查患者肠道准备失败的危险因素,并构建风险评分模型,为制订针对性的干预措施提供依据。 方法 采用便利抽样法,选取2021年5月—10月在太原市某三级甲等医院进行结肠镜检查的610例老年患者作为调查对象,采用随机数字表法分为建模组（406例）和验证组（204例）。依据肠道准备质量,将建模组患者分为肠道准备成功组和失败组,采用Logistic回归分析确定肠道准备失败的独立危险因素,并构建风险评分模型。采用Hosmer-Lemeshow χ²检验及受试者操作特征曲线下面积评价模型的预测效果。 结果 Logistic回归分析结果显示,年龄>65岁、BMI≥24、合并便秘、合并糖尿病、有结直肠手术史、首次进行结肠镜检查是老年患者肠道准备失败的独立危险因素,相应的风险评分依次为2、2、3、2、5、4分,评分≥8分为高风险人群。建模组检验结果显示,Hosmer-Lemeshow χ²=8.969,P=0.255;受试者操作特征曲线下面积为0.717（P<0.001）,灵敏度为50.89%,特异度为79.59%。验证组检验结果显示,Hosmer-Lemeshow χ²=4.188,P=0.840;受试者操作特征曲线下面积为0.720（P<0.001）,灵敏度为48.38%,特异度为81.69%,正确率为71.57%。 结论 该研究构建的风险评分模型的预测效果良好,可为临床医护人员评估老年结肠镜检查患者肠道准备失败的风险提供参考。     

针灸联合生物反馈治疗直肠癌保肛术后排便失禁的效果

目的 探讨针灸联合生物反馈治疗直肠癌保肛术后排便失禁的效果。方法 2016年1月1日至2018年6月30日,本院收治的直肠癌保肛根治术后患者226例,筛选出排便失禁者120例,随机分为对照组(n = 40)、针灸组(n = 40)和观察组(n = 40)。术后1个月,三组均接受提肛锻炼,另外,针灸组接受针灸治疗,观察组接受针灸联合生物反馈治疗,共3个月。治疗前,治疗1、2、3个月分别检测各组大便失禁克利夫兰评分(CCF-FIS)、肛门直肠压力、盆底表面肌电和生活质量评分。结果 治疗前,三组CCF-FIS、肛门直肠压力、盆底表面肌电和生活质量评分均无显著性差异(F < 2.943, P> 0.05)。治疗后,三组CCF-FIS均下降,肛门直肠压力、盆底表面肌电和生活质量评分均明显改善(F > 5.235, P< 0.01);不同时间点,针灸组和观察组各指标均优于对照组(P< 0.05),观察组优于针灸组(P<0.05)。观察组治疗1个月疗效与肿瘤位置高低有关(χ² = 5.230, P< 0.05),治疗后各时间点疗效与术中是否行盆腔自主神经保存术(χ² > 5.657, P< 0.05)、术后是否增加放疗(χ² > 4.329, P< 0.05)有关。治疗结束后3个月随访时,观察组复发率(8.6%)低于针灸组(35.7%)和对照组(35.0%) (χ²> 5.976, P< 0.05),三组均未发生并发症。结论 针灸联合生物反馈治疗可改善直肠癌保肛患者术后排便失禁症状,促进肛门功能康复。     

Barriers to accessing safe motherhood and reproductive health services: the situation of women with disabilities in Lusaka, Zambia

Purpose: To ascertain how well health services in Lusaka, Zambia currently meet the safe motherhood and reproductive health care needs of women who have physical impairment leading to disability.

Methods: A qualitative study was conducted in Lusaka, Zambia. In-depth tape-recorded interviews were conducted with 24 purposively selected women with disabilities and with 25 safe motherhood/reproductive public sector health service providers. Qualitative analysis was conducted using NVivo software.

Results: Women with disabilities encounter various social, attitudinal and physical barriers to accessing safe motherhood and reproductive health (RH) services in this particular setting. The strong desire for children and affection can increase vulnerability to sexual exploitation. At the same time, a generalized assumption among reproductive health service providers that women with disabilities will not be sexually active, and not require RH services, leads to increased vulnerability to sexually transmitted infection including HIV. Once pregnant, traditional beliefs about transmission of disabilities can create barriers to integration in ante-natal clinics. Nurse-midwives' fear of delivery complications in women with physical impairments can also result in routine over-referral to a tertiary maternity facility which is outside the locality and harder for women with mobility limitations to get to.

Conclusion: Greater understanding of the influences underpinning societal attitudes towards sexuality and disability in this setting, and more extensive communication between health care staff and women with disabilities would facilitate positive action towards improving safe motherhood and reproductive health services for women with disabilities.     

A pilot study of a web-based physical activity motivational program for adults with physical disabilities

Purpose. Develop, deliver, and assess the efficacy of a 4-week web-based leisure-time physical activity (LTPA) motivational program based on the Transtheoretical Model and tailored to inactive adults with physical disabilities.

Method. This was a pilot-based study incorporating a true experimental design with one treatment and one control group. The intervention program was delivered on the web and was based on the constructs of the Transtheoretical Model. From the 151 individuals who completed the LTPA standardized questionnaire at baseline, 75 people participated in the 1-month post-test assessment.

Results. The results of the analysis confirmed the pretest LTPA scores as the study covariate for the post-test assessment (F (1,72) = 16.06, p = 0.001, η² = 0.18). Based on the one-way ANCOVA, there were no statistically significant differences in LTPA scores between the treatment and control groups at post-test. However, the corresponding effect size and variance explained by the treatment approached a moderate level of significance (d = 0.34 and η² = 0.04).

Conclusions. Although conclusive statements about program effectiveness cannot be secured, several 'lessons learned' from this project may be 'key factors' for program improvement. Given the pilot nature of the study and the limited resources for program development and monitoring, continued examination of such motivational materials and delivery mechanisms for people with physical disabilities appear warranted.     

前列腺电切手术专用保暖套装的制作及应用

目的自制前列腺电切手术专用保暖套装并探讨其应用效果。方法该研究制作的前列腺电切手术专用保暖套装由上衣和裤子2个部分组成。选取2020年4月—2021年3月在某三级医院进行前列腺电切手术的120例患者为应用对象,按手术通知单的先后顺序编号,采用随机数字表法将患者分为试验组60例和对照组60例。试验组采用自行制作的前列腺电切手术专用保暖套装,对照组采用传统病号服。观察两组在前列腺电切围手术期医护人员及患者对保暖套装的满意度、围手术期非手术部位衣裤与皮肤接触面积。结果试验组医护人员对保暖套装操作便捷、节时省力、保护隐私3个方面满意度高于对照组,差异具有统计学意义(χ2=9.766,9.003,9.163,P<0.05);试验组手术患者对保暖套装穿着方便、热舒适度及保护隐私3个方面的满意度高于对照组,差异具有统计学意义(χ2=8.312,8.802,9.869,P<0.05);试验组围手术期非手术部位衣裤与皮肤接触面积多于对照组,差异具有统计学意义(χ2=7.908,P<0.05)。结论前列腺电切手术专用保暖套装穿脱简便、保暖性强、隐私保护到位,有助于提升患者前列腺电切手术的...     

慢性心力衰竭患者院外健康管理程序的构建及应用

目的 构建慢性心力衰竭(chronic heart failure,CHF)患者院外健康管理的应用程序,并验证其应用价值.方法 构建由患者版手机端、医护版手机端和电脑版管理端组成的"心管家"应用程序,应用于2017年4月—2018年4月广西壮族自治区某三级甲等医院出院的150例CHF患者的院外健康管理.将出院的150例...     

A Trial of Intravenous Lidocaine on the Pain and Allodynia of Postherpetic Neuralgia

This study investigated the effect of intravenous lidocaine at two doses (1 mg/kg and 5 mg/kg over 2 hours) and an intravenous saline placebo on the pain and allodynia of postherpetic neuralgia (PHN). Twenty-four patients were studied using a randomized, double-blind, within-patient crossover design. Each patient received normal saline, lidocaine 0.5 mg/kg/h, and lidocaine 2.5 mg/kg/h for a 2-h period. The McGill Pain Questionnaire Short Form, visual analogue scores (VAS), and area of allodynia were measured at intervals during the infusions. Free plasma lidocaine levels were also measured. The results were statistically analyzed using Student’s t-test for paired data. The VAS for ongoing pain showed a significant reduction after all the infusions (P < 0.05). For dynamic pressure-provoked pain, the VAS was unaffected by placebo but showed a reduction at an equal level of significance with both lidocaine infusions (P < 0.05). The area of allodynia of PHN, as mapped by brush stroke, declined in association with intravenous lidocaine (0.5 mg/kg/h = P < 0.05; 2.5 mg/kg/h = P < 0.001). Placebo had no significant effect on the area of allodynia. These findings demonstrate a positive effect on pain and allodynia following a brief intravenous infusion of lidocaine. The higher dose infusion may produce plasma levels in the toxic range, with no significant clinical increase in response.     

身体约束缩减策略在ICU有创机械通气患者中的应用研究

目的 评价身体约束缩减策略对改善ICU有创机械通气患者身体约束的效果。方法 2021年2月—2022年2月,选择ICU有创机械通气患者为研究对象,按随机数字表法分为试验组和对照组,试验组采用身体约束缩减策略,对照组采用常规身体约束方法,比较两组身体约束时间、非计划拔管率、谵妄发生率、有创机械通气时间和ICU住院时间等。结果 113例患者完成研究,试验组57例,对照组56例。试验组和对照组身体约束率、非计划拔管率和皮肤异常的比较,差异无统计学意义(P>0.05)。两组身体约束时间、谵妄发生率、有创机械通气时间和ICU住院时间的比较,差异有统计学意义(P<0.05)。试验组身体约束累积使用率低于对照组,差异有统计学意义(χ²=18.491,P<0.001)。试验组有创机械通气累积使用率低于对照组,差异有统计学意义(χ²=9.244,P=0.002)。结论 身体约束缩减策略可减少ICU有创机械通气患者身体约束时间,减少谵妄发生率、有创机械通气时间和ICU住院时间。     

Thermal phase transitions in plasma membranes of cancer cells measured by means of Qdot fluorescence

Laser scattered-light applicators used for laser-induced tumor therapy (LITT) facilitate precise thermal metastases destructions. Major tissue-optical parameters (absorption coefficient μ_a, scattering coefficient μ_s, anisotropy factor g) reveal biological tissues to be strongly scattering media exhibiting a so-called “optical window” in NIR. In this spectral range therapeutic laser radiation is scattered and absorbed at deeper tissue levels leading to virtual enlargement of the laser applicator.

In this study breast cancer cells MX1 were heat stressed to verify the maximum phase transition in MX1 plasma membranes. For this purpose, a novel method of quantum dots (Qdots) fluorescence dosimetry was developed. Qdot fluorescence was detected with a confocal laser scan microscope. Evaluation of measured laser-induced fluorescences yielded a first approximation of the phase transition in MX1 cells.

Monolayered MX1 cells were thermally stressed at 40, 42, 45, 50 or 56 °C (30 min each). Controls were kept at 37 °C. Fluorescent cell labeling was realized via biotinylated concanavalin A (ConA) targeting glycocalix sited carbohydrate residues covering the plasma membranes. ConA then was sandwiched by red-emitting Qdots™ 605 conjugated to biotin-binding streptavidin.

After exposure to low heat stress (40 or 42 °C) plasma membranes were not visibly affected. Heat stressings at 45 or 50 °C induced morphological changes of cells and tissue conformations. Also reorganization of plasma membrane structures were induced leading to more regular Qdot accumulations and higher fluorescence densities. This process coincided with shrinkage and rounding of cell shapes as a result of active stress response which was more pronounced in the 45 °C-stress group than in the 50 °C-stress group. Severe stressing at 56 °C inhibited active responses and caused destruction of membrane integrities shown by necrotic cell phenotypes associated with intracellular Qdot accumulation. Through domain formation during plasma membrane melting, the distribution of differential state transitions was relatively wide (50–56 °C).

Qdot labeling of heat stressed cancer cells demonstrated alterations of plasma membrane organizations and integrities, respectively. Extents of cell lesions observed by Qdot fluorescence definitely correlated with stress doses applied during heat treatments. The phase transition temperature calculated from Qdot fluorescence images of MX1 cells was approximately 52 °C and was 20% higher than phase transition of synthetic lipid membranes.     

社区与住院老年人跌倒的现状及影响因素

目的 分析社区和住院老年人跌倒的影响因素。方法 2021年5月至9月,采用随机系统抽样方法在南通大学附属医院医联体天生港社区卫生服务中心抽取50例社区老年人,在老年医学科抽取50例住院老年人,分别进行面对面问卷调查,并进行老年综合评估和血液、神经肌骨B超测试。采用单变量和多变量Logistic回归分析1年内有跌倒史的社区和住院老年人的跌倒现状及影响因素情况。结果 住院与社区老年人在跌倒史、Morse跌倒风险评估量表(MFS)评分、因跌倒史住院方面均有显著性差异(χ² > 6.250, Z=-3.132, P<0.05)。除跌倒相关因素外,年龄、生活自理能力、国际尿失禁咨询委员会尿失禁问卷表简表(ICI-Q-SF)评分、衰弱指数(FI)、身体活动快速评估(RAPA)部分2评分、健康调查简表(SF-36)评分、纽芬兰纪念大学幸福度量表(MUNSH)评分、腰臀比、臂围、腿围、红细胞计数、红细胞压积、血红蛋白和甘油三酯均与住院老年人跌倒有关(|Z| > 0.462, χ²=7.447, P<0.05);老年抑郁量表(GDS)-15评分、MFS评分、FI、SF-36评分和握力均与社区老年人跌倒有关(|Z| > 1.758, χ²=6.640, P<0.05)。多因素Logistic回归分析结果显示,住院老年人1年内有跌倒史的跌倒影响因素有年龄、MFS评分、FI、臂围、腿围、SF-36评分、血红蛋白和甘油三酯(P<0.05);社区老年人的跌倒影响因素有GDS-15评分、MFS评分、FI、握力、SF-36评分和MUNSH评分(P<0.05)。此外,住院和社区老年人发生跌倒后SF-36评分和MUNSH评分均降低(t=-3.108, Z > 2.567, P<0.05)。结论 住院老年人跌倒发生率、因跌倒住院率以及跌倒风险均较社区老年人高,影响因素各不相同。医护及社区、家庭成员应针对相应的影响因素进行干预,减少跌倒的发生。