城乡结合部养老机构老年人健康价值和自我护理能力及相关影响因素调查

[目的]了解城乡结合部养老机构老年人健康价值、自我护理能力及相关影响因素。[方法]采用整群抽样的方法,选取咸宁市7个城乡结合部社区养老机构280名老年人进行健康价值和自我护理能力调查。[结果]老年人健康价值总分为(7.45±1.45)分,自我护理能力总分为(100.25±22.56)分,不同年龄、教育程度、婚姻状况、收入状况的老年人健康价值得分及自我护理能力得分比较差异均有统计学意义,自我护理能力和健康价值相关(r=0.521)。多元线性回归分析显示,健康价值、婚姻状况和年龄是自我护理能力的预测因素。[结论]城乡结合部老年人健康价值越高者自我护理能力也较高,可采用"知信行"模式,通过改善其健康价值提升自我护理能力。     

养老机构老年人护理服务需求的调查分析

[目的]了解养老机构老年人的日常生活能力、抑郁自评以及护理服务需求状况,比较夫妇共同居住机构老年人和独自居住机构老年人的差异性,为提高养老机构的照护水平提供依据。[方法]采用日常生活能力量表、流行病调查用抑郁自评量表(CES-D)、自编的一般情况调查表与养老机构老年人护理服务需求问卷对福州市11所养老机构260名老年人进行调查。[结果]夫妇同居机构老年人的生活自理能力得分为18.03分±4.71分,≤16分27人,16分32人。独居机构老年人的生活自理得分为21.49分±6.68分,≤16分58人,16分143人。夫妇同居机构老年人与独居机构老年人生活自理能力得分≤16分人数比较差异有统计学意义(P0.05)。夫妇同居机构老年人CES-D得分为8.44分±4.32分,≤16分57人,16分2人。独居机构老年人CES-D得分为15.04分±7.54分,≤16分111人,16分90人。夫妇同居机构老年人与独居机构老年人CES-D得分≤16分人数比较差异有统计学意义(P0.05)。养老机构老年人护理服务需求总分为3.95分±0.28分。夫妇同居机构老年人与独居机构老年人护理服务需求总分及各维度得分比较差异均有统计学意义(P0.05)。[结论]养老机构应针对不同婚姻状况居住的老年人提供更具个性化的护理服务,重点关注独居机构老年人的心理护理问题,提高照护水平,提升养老机构老年人的生活质量。     

不同养老模式下高龄老人抑郁与生活质量、社会支持的相关性分析

[目的]了解养老机构高龄老人与居家高龄老人的抑郁、生活质量及社会支持现状,并分析其相关性。[方法]采用一般情况调查问卷、Beck抑郁自评量表、世界卫生组织生存质量测定量表简表(WHOQOL-BREF)、社会支持量表对四川省28家养老机构268名机构高龄老人和四川省185名居家高龄老人进行现场调查。[结果]不同年龄、婚姻状况、月收入与子女情况的机构养老与居家高龄老人的一般资料差异有统计学意义(P0. 05),居家高龄老人的生活质量得分[(73. 02±8. 63)分]高于机构高龄老人[(70. 18±8. 71)分],机构高龄老人的社会支持得分[(29. 25±7. 21)分]高于居家高龄老人[(24. 15±5. 84)分],机构高龄老人的生活质量和社会支持均与抑郁程度呈负相关(P0. 05)。[结论]应重视改善不同养老模式下高龄老人的抑郁情绪,进而提高其社会支持和生活质量。     

乌鲁木齐市养老机构老年人生活质量现况及影响因素研究

目的调查乌鲁木齐市养老机构老年人生活质量现况及影响因素。方法对乌鲁木齐市12个养老机构406名老年人进行生活质量调查,通过多元线性回归分析探讨影响因素。结果乌鲁木齐市养老机构老年人生活质量得分为(102.82±17.76)分,51.48%的老年人生活不能完全自理;年龄、民族、文化程度、婚姻状况、家庭人均月收入、自理能力及慢性病是老年人生活质量的影响因素。结论养老机构老年人生活质量处于中等水平,改善老年人生活质量状况需要社会各界共同努力,并以影响因素为着手点,提高养老机构老年人生活质量。     

沈阳市养老机构失能老年人生活质量调查及其影响因素分析

[目的]调查沈阳市养老机构失能老年人的生活质量并分析其生活质量的影响因素,为改善失能老年人的生活质量提供依据.[方法]采用目的抽样的方法对沈阳市养老机构640例失能老年人进行问卷调查,对所获数据进行统计分析.[结果]沈阳市养老机构失能老年人的生活质量总分为78.56分±11.55分,多元逐步回归分析显示,影响沈阳市养老机构失能老年人生活质量的主要因素有年龄、婚姻状况、文化程度和经济状况,可解释失能老年人生活质量总变异的61.4％.[结论]沈阳市养老机构失能老年人的生活质量受多种因素影响,在健全养老服务机构的同时应关注失能老年人这一特殊群体,提高失能老年人的生活质量.     

乌鲁木齐市养老机构老年人社会支持现状及影响因素研究

[目的]了解乌鲁木齐养老机构老年人社会支持现状及相关影响因素。[方法]于2014年2月—9月,通过分层整群随机抽样法,从乌鲁木齐市31所登记在册的养老机构中抽取18所,按纳入标准和排除标准对其中符合要求的305例老年人发放社会支持量表及一般情况问卷进行现场横断面调查。通过单因素方差分析、Logistic回归及Pearson相关分析,探讨乌鲁木齐市养老机构老年人社会支持的影响因素及各维度之间的相关性。[结果]符合入选条件的老年人291例,年龄(77.30±8.88)岁,社会支持水平(19.67±4.01)分,处于较低水平。单因素方差分析显示年龄、性别、曾经从事职业、每周运动次数、家庭月收入、家庭人口数、婚姻状况和教育水平在社会支持得分上差异有统计学意义(P0.05)。Logistic回归分析显示社会支持的独立影响因素是年龄、家庭月收入、教育水平(OR值分别为0.392,0.202,4.600,4.211,5.553,1.895)。主观支持、客观支持、对支持的利用度得分均具有相关性(P0.05)。[结论]养老机构老年人社会支持水平较低,应进行科学有效的干预,通过提高主观支持和对支持的利用度水平,改善老年人的社会支持状况。     

养老机构老年人社会支持现况及其影响因素

[目的]了解乌鲁木齐市养老机构社会支持状况及影响因素。[方法]2013年9月—2014年3月使用调查问卷对乌鲁木齐市12家养老机构老年人进行现场横断面调查,调查表内容包括一般资料及社会支持量表。[结果]社会支持得分为(30.55±6.65)分,处于中等偏下水平;单因素及多因素分析结果显示,养老机构性质、文化程度、婚姻状况、曾经从事职业、入住时间、居住方式以及经济收入对社会支持程度有显著影响,(P0.05)。[结论]养老机构老年人社会支持状况并不乐观,改善其现状需要全社会共同努力。     

乌鲁木齐市养老机构老年人认知功能对健康状况与健康服务利用的影响

[目的]探讨养老机构老年人认知功能与健康状况、健康服务利用的关系。[方法]2014年2月—4月,采用分层整群随机抽样法,从乌鲁木齐市27所登记在册的养老机构中抽取12所养老机构的老年人296人,发放简易精神状态量表(MMSE)及一般情况问卷,进行现场横断面调查。[结果]老年人认知功能评分为(23±3)分,处于较低水平。单因素分析结果显示,不同年龄、性别、每周运动次数、家庭月收入、家庭人口数、婚姻状况、教育水平老年人认知功能评分比较差异有统计学意义(P <0.05);Logistic 回归分析表明,养老机构老年人认知功能的独立影响因素有年龄(75岁~84岁、≥85岁)、每周运动次数(不运动或很少运动)、文化程度、住院次数(3次/年、≥4次/年)、距离上次体检时间(从未体检过)。[结论]老年人的认知功能对健康服务利用有一定影响,应通过健康教育改善老年人的认知功能,采取措施使老年人更好地利用健康服务来促进自己的健康,提高其生活质量。     

益阳市养老机构老年人自我护理能力与生活质量的相关性研究

[目的]探讨益阳市养老机构老年人的自我护理能力和生活质量的相关性。[方法]采用方便抽样方法,运用自我护理能力量表和简明健康测量量表对益阳市4所养老机构的101名老年人进行调查。[结果]养老机构老年人自我护理能力总分为(58.15±10.18)分,自我护理能力较低者占81.19%;生活质量总分为(103.25±18.13)分,处于中等水平者占75.25%。老年人自我护理能力与其生活质量的8个维度及总的生活质量呈正相关。[结论]养老机构老年人自我护理能力处于较低水平,生活质量处于中等水平,老年人的自我护理能力越好,其生活质量越高。     

益阳市养老机构老年人生活质量现状及影响因素分析

[目的]调查益阳市养老机构老年人生活质量现状及影响因素。[方法]采用方便抽样的方法,运用简明健康测量量表对益阳市4所养老机构的101名老年人进行生活质量调查,通过多元线性回归分析探讨影响因素。[结果]益阳市养老机构老年人生活质量总分为(103.25±18.13)分,处于中等水平者76人,占75.2%。多元回归分析结果显示,患病种类、内设医疗室是老年人生活质量的影响因素(P0.05)。[结论]养老机构老年人的生活质量处于中等水平,患病种类越多的老年人生活质量较低,设有医疗室的养老机构老年人生活质量较高。     

Measurement of L-carnitine and acylcarnitines in body fluids and tissues in children and in adults

We have developed a reliable and validated radio-enzymatic method for the assay of L-carnitine and acylcarnitines, using a modification of existing methods. The sensitivity of the assay is 10 mumol/l using 10 microliters of plasma or urine. It is also suitable for measurements of carnitine in a 10 mg sample of liver or muscle obtained by percutaneous biopsy. The use of N-ethylmaleimide in the reaction mixture together with an excess of [1-14C]acetyl CoA ensures that the reaction proceeds to completion and a linear response is obtained. Using this method control ranges have been established for plasma and urine carnitine concentrations in healthy children and adults, and for the carnitine content of liver and muscle in adults. No significant difference was found between fasting and post-prandial plasma carnitine levels. An age-related increase was found in urinary total carnitine and acylcarnitine concentration throughout childhood. These data provide a reliable basis for studies of patients with abnormal carnitine and acylcarnitine metabolism, distribution and excretion.     

Activity of amikacin and ampicillin in succession and in combination

One strain each of Escherichia coli and Streptococcus faecalis were exposed to amikacin and ampicillin in combination as well as in succession. Exposure to ampicillin for 1 hr followed by amikacin for 3 or 4 hr had the greatest antibacterial activity when the antibiotics were applied in succession. The least effective exposures for both organisms were 1 hr to amikacin followed by 3 or 4 hr to ampicillin. Exposure to the antibiotics in combination each at 1 MIC had the overall greatest antibacterial activity. Simultaneous exposure to the antibiotic combination does not necessarily mean simultaneous activity of both ampicillin and amikacin on the E. coli. The cell wall autolytic activities produced by ampicillin are triggered within 10 min after physical contact with the bacteria. In contrast, amikacin requires at least 30 min after physical contact to manifest its activity on the ribosome. Although physical exposure to both antibiotics in the combination is simultaneous, the specific activity of each is in fact sequential, with ampicillin acting first. This explains the synergistic effect of the combination. It appears, therefore, that the synergistic or antagonistic affect of a drug combination is determined by the sequence and timing of the antibacterial manifestations of its components.     

纤维支气管镜在儿童咯血诊断与治疗中的应用

目的 评价纤维支气管镜术在儿童咯血病因诊断及治疗中的价值以及安全性.方法 应用用日本产Olympus BF 3c-40纤维支气管镜(最小外径3.6 mm)给58名咯血原因不明的患者行纤维支气管镜检查,并予镜下局部止血治疗.判断出血部位、观察病变情况和出血的原因、临床表现、其他辅助检查、治疗及转归等进行综合分析.结果 引起咯血的主要疾病为气管支气管、肺部的炎症24例(41.3%)、支气管内膜结核12例(20.7%)、支气管异物8例(13.7%)、特发性肺含铁血黄素沉着症7例(12.1%)、支气管扩张4例(6.9%)、心肺血管发育异常1例,原因不明2例.诊断阳性率为96.5%.镜下发现有活动性出血18例,镜下局部止血治疗后显效者10例,有效者8例,有效率为100%.术中并发短暂低氧血症(SaO2＜85%,＜20 s)15例,加大吸氧流量后均改善;术后发热3例均为低热,24 h后热退.结论 纤维支气管镜检查可明确出血部位及原因并可进行局部治疗,且安全的有效.     

Sites of in vivo extraction and interconversion of testosterone and androstenedione in dogs

The interconversion and extraction of testosterone and androstenedione across and within different tissues or areas have been studied by the constant infusion technique. The results were calculated using the (3)H/(14)C ratios and radioactive concentrations of testosterone and androstenedione obtained from afferent and efferent blood and tissues at equilibrium. In each tissue studied, the interconversion between testosterone and androstenedione inside the tissue was significantly higher than the corresponding interconversion across the tissue. The pulmonary contribution to the total interconversion between testosterone and androstenedione was far more important than that of any of the other tissues studied. The hepatic metabolic clearance rates of testosterone and androstenedione were not different from their metabolic clearance rates in the mesenteric area. The extraction of each of these compounds, although not negligible, was lower in the kidney and the femoral bed compared with the extraction in the liver and the mesenteric area. Finally, with the possible exception of the liver, testosterone and androstenedione were more completely metabolized when they originated from the cells than from afferent blood.The evaluation of these different tissue transfer constants provides more precise information concerning the relative importance of different sites in the metabolism of these interconverting hormones.     

Role of oxidants and antioxidants in atherosclerosis: results of in vitro and in vivo investigations

Both in vitro and in vivo studies have shown that oxidants are central in the development of atherosclerosis. Consequently, additional studies evaluated the protective effects of various natural and synthetic antioxidants, alone and in combination, with most studies focusing on alpha-tocopherol (vitamin E). Here, we summarize the role of oxidants in the pathomechanism of atherosclerosis. We also discuss epidemiological studies and others focused on the protective effect of vitamin E against atherosclerosis. Other antioxidants are also considered if they were included in studies involving vitamin E. The protective effect of antioxidants on atherosclerotic pathomechanisms has been confirmed in vitro, but only in some animal studies. Various epidemiological and observational studies have produced conflicting results on the protective effect of antioxidants. Most studies of primary or secondary prevention failed to show a protective effect. These conflicting results are biased by a number of factors, including differences between the study groups. Therefore, we describe these studies in detail.     

Pharmacokinetics and tolerance of flunitrazepam in neonates and in infants.

OBJECTIVE: To study the pharmacokinetics of flunitrazepam (used for sedation in neonates and infants), to determine the influence of both gestational and postnatal age on the pharmacokinetic parameters, and to analyze the relationship between the hemodynamic parameters and flunitrazepam plasma concentration. METHODS: Flunitrazepam was infused for 20 minutes as a single dose (0.2 mg x kg(-1)) and as multiple doses (0.1 mg x kg(-1)). Six to eight 1-mL blood samples were collected per patient. Flunitrazepam plasma concentration was measured by gas chromatography-mass spectrometry. RESULTS: Thirty-one patients (25 neonates and six infants) were included in the study. Only three of them received multiple doses. After the single dose (n = 28), half-life was 22.6 +/- 7.3 hours, clearance was 0.15 +/- 0.14 L x kg x h(-1), and volume of distribution was 4.6 +/- 4.1 L x kg(-1) (mean +/- SD). Plasma clearance and volume of distribution significantly increased with postnatal age (P < .05), but no pharmacokinetic parameter varied significantly with gestational age. Diastolic blood pressure significantly decreased with increasing flunitrazepam plasma concentrations (P < .05). CONCLUSION: Postnatal age but not gestational age influenced flunitrazepam pharmacokinetic parameters in neonates and infants. Diastolic blood pressure was inversely correlated to flunitrazepam plasma concentration.