老年人预防跌倒意识与行为研究

目的：描述老年人跌倒状况,比较有无跌倒史老人的预防跌倒意识及行为差异,研究预防跌倒意识与行为的关系。方法：入选160例60岁以上老人,通过访谈,调查其跌倒状况、预防跌倒意识与行为关系。结果：老年人跌倒发生率为27．0％,且随着年龄的增高而上升;跌倒大多发生在室内,占51．5％,主要由腿脚无力和障碍物绊倒所致;跌倒主要造成软组织损伤者占60．0％;无跌倒史老人的预防跌倒意识和行为均优于有跌倒史老人。预防跌倒意识与行为呈正相关。结论：提高老年人预防跌倒意识可促进其预防跌倒行为,从而降低跌倒的发生率。     

男性老年患者跌倒状态及对跌倒认识的调查

目的 通过对90例男性老年患者171次跌倒状态分析及对跌倒认知的调查，探讨与老年人跌倒有关的环境、个人行为因素，以提高防护意识，从而有效地预防跌倒的发生。方法采用方便取样的方法，以自编的调查表调查住院老人对跌倒的认知状况及跌倒者跌倒时的情况。结果156例患者中有90例曾在1年内发生1次以上的跌倒。发生率为57．69％；1年内共发生171次跌倒。分析结果发现：①慢性疾病是导致老年患者跌倒发生率高的基础。②老年人跌倒与活动能力有关。③导致跌倒的原因以地面因素为直接因素。④跌倒的状态以变换体位及洗澡时发生率高。⑤调查对象均对跌倒有一定的认知，但75—80岁年龄段的老年人不能正确评估自己的运动能力．导致跌倒的频繁发生。结论老年人的跌倒状态与环境设施、不适宜的活动状态有关。调查提示要对高危人群积极开展防护教育：进一步改善老年人生活环境及生活设施，以减少跌倒的发生。     

秦皇岛市城市社区老年人跌倒现状调查

目的 探讨秦皇岛市城市社区老年人跌倒的发生情况及特点.方法 用分层随机抽样的方法选择居住在秦皇岛市城市社区的60岁及以上老年人 1600例,用自行设计的调查表对过去1年的跌倒和跌倒的相关情况进行调查.结果 调查人群过去 1年跌倒发生率为 9.8%,女性及高龄人群多见.跌倒发生的时间以早饭-午饭期间多见,占 51.2%;跌倒发生月份以冬春季最高(4月15.5%).跌倒发生的地点,在家中占45.8%,在小区占 54.2%.跌倒自身原因中以注意力不集中(22.9%),腿发软(22.9%)和运动中没保持平衡(12.0%)最常见;环境原因中以路滑(18.8%),没有保护措施(13.8%)和外力作用(11.3%)最常见.在发生跌倒的157名调查对象中, 15例(9.6%)发生骨折.结论 秦皇岛市城市社区老年人跌倒发生率较高,且严重危害老年人健康.老年人跌倒相关因素有本地区特点,应采取针对性措施预防老年人跌倒.     

社区老年人跌倒认知和行为调查与分析

目的：了解社区老年人跌倒认知与行为现状,并分析其影响因素,为社区医务人员实施跌倒干预措施提供科学依据。方法：采用自行设计的跌倒认知和预防行为问卷,对本社区200例老年人进行调查。结果：老年人对药物因素所引起跌倒的认知率低于因疾病因素所引起的跌倒;老年人在个人、环境方面预防跌倒措施较少;文化程度影响老年人对跌倒的认知,但不同文化程度的老人在采取预防跌倒行为方面差异无统计学意义（P＞0.05）。结论：老年人对预防跌倒的认知和行为水平较低,社区医务人员应根据个体情况制定综合性干预措施,降低跌倒的发生率。     

住院老年人跌倒原因分析与应用护理程序干预

目的：探讨有效防止住院老年人跌倒和因此导致医疗护理纠纷发生的应对方法。方法：回顾性分析采用护理程序的方法对有跌倒危险因素的住院老年人进行干预后发生跌倒的原因。结果：有7例发生了跌倒，无医疗护理纠纷发生。结论：应用护理程序能有效预防住院老年人跌倒，从而达到提高老年人的自我防跌倒意识和生活质量。     

多因素评估及干预在预防社区老年人跌倒中的效果评价

目的：评价多因素评估及干预在预防社区老年人跌倒中的效果。方法：2013年1月—12月对本街道老年人进行跌倒危险评估,筛选出高危人群200人,实施多因素评估及针对性干预,主要包括健康教育、用药干预、运动干预、饮食干预、环境干预、日常生活方式干预及心理调适,每月上门指导1次。干预后随访1年,通过比较老年人干预前后的跌倒发生率、跌倒危险因素认知、预防跌倒行为,评价上述干预措施的效果。结果：老年人的跌倒发生率从干预前的38%（76/200）下降至干预后的27.1%（52/192）,差异有统计学意义（P＜0.05）。干预后老人对预防跌倒认知水平提高（P＜0.05）。在预防跌倒行为中,除居家环境改造项目外,其他项目干预前后差异均有统计学意义（P＜0.05）。结论：多因素评估及干预能有效提高社区老年人的跌倒认知水平,促使其采取措施以预防跌倒的发生,降低了社区老年人跌倒发生率,提高了老年人的健康水平和生活质量。     

循证护理模式在预防老年住院患者跌倒的应用

目的观察循证护理模式在预防老年住院患者跌倒的应用效果。方法选择2007年10月至2011年9月60岁以上的老年住院患者400例作为研究对象,2007年10月至2009年9月200例患者采用一般常规护理（传统组）,2009年10月至2011年9月200例患者应用循证护理模式（循证组）,包括积极评估危险因素,加强安全教育与管理、落实健康教育,加强护士素质培训,加强用药观察、做好用药指导等措施。结果循证组护理依从性及自我防跌倒意识较传统组高,跌倒率较传统组明显降低,传统组跌倒发生例数30例,跌倒发生率为15％,而循证组跌倒发生例数6例,跌倒发生率为3％。结论应用循证护理模式可有效预防老年住院患者跌倒,提高患者的自我防跌倒意识和生活质量。     

健康宣教对老年患者预防跌倒的重要性及临床应用

目的:健康宣教对预防住院老年患者跌倒的影响。方法:通过跌倒安全评佑表高风险老年患者重点进行预防跌倒的健康宣教。结果:患者及家属不同程度的掌握了患者跌倒的相关危险因素以及预防跌倒的相关知识。结论:综合护理干预可有效地提高老年人防跌倒认知水平、促进老年人防跌倒的行为改变。     

对老年住院患者跌倒认知行为的研究

目的了解护士对住院老年人跌倒认识现状,正确评价护士认识上存在的问题,以便采取有效的对策,预防老年人住院期间发生跌倒。方法自行设计问卷,采用随机抽样的方法,对2010年5月我院临床一线的护理工作人员150名,发放问卷150份,回收有效问卷150份,回收率为100%。以SPSS15.0统计软件对资料进行录入、分析,使用百分率、构成比等对资料进行描述,用t和χ2检验对资料进行统计分析。结果认同住院老年人跌倒是护士工作职责占46.0%,认同预防住院老年跌倒需要护理专业知识和技能的占44.0%,认同预防住院老年人跌倒是提高患者满意占41.7%。工作年限越高对预防住院老年人跌倒意识越强,反之越低。结论掌握相关专业知识和接受过相关老年人跌倒知识培训的护理人员,对住院老年人跌倒的认知方面的知识和预防意识提高,可有效的减少住院老年人跌倒事件发生。     

老年人骨质疏松性骨折的危险因素与干预措施

目的 调查老年人骨质疏松性骨折的危险因素,并探讨相应的干预措施.方法 从2014年起选取80名合适的老年人作为研究对象,随机分为干预组(n=40)和对照组(n=40),并进行为期2年的干预管理.结果 在发生骨折的危险因素中,女性、70岁以上、低钙饮食、骨密度低的骨质疏松老年人较容易发生骨折.经过护理后,干预组骨质疏松老年人总骨折发生率10.0%,远低于对照组的27.5%,差异具有统计学意义(P<0.05).干预组骨质疏松患者护理后的总满意率(95.0%)高于对照组患者(80.0%),差异具有统计学意义(P<0.05).结论 通过积极的社区干预能预防老年人骨质疏松性骨折及老年人跌倒发生率,在降低老年人骨质疏松性骨折发生率的同时,提高老年人的生活质量.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg x kg(-1)) or i.p. (50 mg x kg(-1)) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) 1 x h(-1) x kg(-1) in the male rat and 10.6 (95% CI: 7.5, 15.0) 1 x h(-1) x kg(-1) in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was approximately 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p < 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p < 0.001) in plasma obtained from the male (8.8 +/- 2.0%) compared with the female rat (11.7 +/- 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Changes in angiopoietin expression in glomeruli involved in glomerulosclerosis in rats with daunorubicin-induced nephrosis

AIM: To study the potential pathological role of endogenous angiopoietins in daunorubicin-induced progressive glomerulosclerosis in rats. METHODS: Seventy male Wistar rats were allocated randomly into a daunorubicin group (DRB; n=40) or a control group (n=30). The rats in the DRB group were injected with DRB (15 mg/kg), in their tails. Subsequently, at intervals of 1, 2, 4, 6, 8, and 12 weeks, 5 male Wistar rats in each group were chosen randomly for 24 h urinary protein quantitative measurements (24 h UPQM), and determination of plasma tumor necrosis factor alpha (TNF-alpha), angiopoietin-1 (Ang1), and angiopoietin-2 (Ang2) levels. Kidney sections were examined by electron microscopy, Periodic Acid Schiff (PAS) staining, immunohistochemical staining and in situ hybridization histochemistry. RESULTS: As glomerulosclerosis progressed in the DRB group, expression of Ang1 mRNA and protein in glomeruli decreased and expression of TNF-alpha protein, Ang2 mRNA and protein in glomeruli increased. Expression of Ang1 mRNA and protein in glomeruli were negatively correlated with 24 h UPQM, Fn protein expression, and mean area of extracellular matrix (MAECM). In comparison, expression of Ang2 mRNA and protein in glomeruli were positively correlated with 24 h UPQM, Fn protein expression and MAECM; furthermore, there was a positive correlation between plasma Ang2 and 24 h UPQM. Plasma TNF-alpha and expression of TNF-alpha in glomeruli were positively correlated with expression of Ang2 mRNA and protein in glomeruli. There was a negative correlation between Ang1 protein expression and Ang2 protein expression in glomeruli. CONCLUSION: During DRB-induced glomerulosclerosis, podocyte injury led to a shift in the balance of Ang1 and Ang2 in glomeruli. Increased TNF-alpha in plasma and glomeruli may upregulate Ang2 expression in glomeruli. Elevated Ang2 in both plasma and glomeruli may mediate protein permeability through the glomerular filtration barrier. Moreover, local expression of Ang2 may facilitate the progress of glomerulosclerosis by upregulating a component expression of extracellular matrix.     

Trichinellosis in immigrants in Switzerland

We describe a case of trichinellosis diagnosed at the Division of Infectious Diseases, Hospital of Lugano, in January 2009. This case was associated with a cluster of cases and was traced to the consumption of contaminated meat after a wild boar hunt in Bosnia.