上海市某社区中老年妇女自我保健现状及分析

目的 了解社区中老年妇女自我保健意识和行为状况及相关影响因素。方法 自行设计问卷，随机选择老西门社区4个里委共400名35岁以上妇女作现场问卷调查。结果 (1)400名中老年妇女自我保健意识和保健行为不尽如人意。(2)学历高低与经济收入多少对妇女保健知识的认知和行为实施有影响。(3)74．25％的妇女从电视、广播获取保健知识，从社区健康宣教中获得占10．00％。(4)92．25％的妇女对社区开展妇女保健宣教有需求。结论 社区卫生服务应把普及妇女保健知识，促进中老年妇女主动保健意识和行为作为重要服务内容，强化社区健康宣教的作用。     

1989-2015年云南省德宏州50岁及以上HIV感染者流行病学特征分析

目的 分析云南省德宏州1989-2015年50岁人群艾滋病疫情特征及流行趋势。方法 收集国家艾滋病防治综合信息系统中报告现住址为云南省德宏州,年龄50岁的临床诊断和实验室诊断艾滋病病毒感染者/艾滋病患者（HIV/AIDS）,截止日期为2015年12月31日,对其构成比、三间分布和趋势构成变化等进行分析。结果 现住址累计报告50岁HIV/AIDS病例1 193例,占累计报告数的7.98%;1 193例病例中,截止2015年底已死亡496例,病死率为41.58%。自2000年以来50岁HIV/AIDS的构成比逐年上升,从2000年的2.97%上升至2015年的19.94%。50岁HIV/AIDS在全州5县均有分布,芒市占当地报告HIV/AIDS构成比最高（占11.67%）。50岁HIV/AIDS人群分布以男性为主（64.79%,773/1 193）,平均年龄（58.316.96）岁,93.38%患者的文化程度为初中及以下,94.02%的职业为农民、待业和离退休人员。89.52%通过性接触传播,10.48%通过注射吸毒传播。女性、无配偶者、性接触传播者、农民和临床就诊检测发现者所占比例在不同时间段（1989-2003年、2004-2011年和2012-2015年）呈现上升趋势。结论 德宏州50岁人群艾滋病流行形式较为严峻,艾滋病防控工作应关注该年龄人群,结合艾滋病防治常规工作开展多元化的性健康教育应成为该人群艾滋病防治工作的重心。     

Serum Testosterone and Dihydrotestosterone and Prostate Cancer Risk in the Placebo Arm of the Reduction by Dutasteride of Prostate Cancer Events Trial

Background

Findings of studies on the association between androgens and prostate cancer (PCa) are mixed. Androgens may affect prostate-specific antigen (PSA) levels, thereby influencing biopsy recommendations. Also, androgens may stimulate prostate growth at very low levels with no additional effects at higher levels (saturation model).

Objective

To test whether androgens were associated with PCa risk in the placebo arm of a prospective study in which biopsies were performed regardless of PSA level.

Design, setting, and participants

Of 8122 men in the Reduction by Dutasteride of Prostate Cancer Events (REDUCE) trial, 4073 men (50.1%) received placebo. Key entry criteria were PSA 2.5–10 ng/ml and one prior negative biopsy.

Intervention

Per-protocol biopsies at 2 and 4 yr; for-cause biopsies at physician discretion.

Outcome measurements and statistical analysis

Multivariable logistic regression was used to test the association between baseline log-transformed testosterone and dihydrotestosterone (DHT) levels and the risk of detecting either PCa or low-grade PCa (Gleason score <6) compared with high-grade PCa (Gleason score >7). In secondary analysis, we stratified the analysis by low baseline androgen levels (testosterone <10 nmol/l; DHT <0.76 nmol/l) compared with normal baseline androgen levels.

Results and limitations

Of 4073 men, 3255 (79.9%) had at least one biopsy after randomization and were analyzed. Androgen levels tested continuously or by quintiles were generally unrelated to PCa detection or grade. PCa detection was similar among men with low compared with normal baseline testosterone levels (25.5% and 25.1%; p = 0.831). In secondary analysis, higher testosterone levels at baseline were associated with higher PCa detection (odds ratio: 1.23; 95% confidence interval, 1.06–1.43; p = 0.006) only if men had low baseline testosterone (<10 nmol/l). For men with normal baseline testosterone (≥10 nmol/l), higher testosterone levels at baseline were unrelated to PCa risk (p = 0.33). No association was found for DHT and PCa (all p > 0.85).

Conclusions

Baseline serum testosterone and DHT levels were unrelated to PCa detection or grade. Our findings of the lowest testosterone levels being associated with the lowest PCa risk with no further changes with higher testosterone support a saturation model but must be confirmed in future studies using an a priori defined hypothesis.

ClinicalTrials.gov identifier

NCT00056407.     

中国和印度中老年人健康状况公平性研究

目的分析中国和印度中老年人健康状况公平性及影响因素。方法利用全球老龄化与成人健康研究调查数据,采用失能评估量表得分反映健康状况,计算集中指数并对集中指数进行分解。结果中国和印度中老年人失能评估量表平均分分别为7.32和23.38,集中指数分别为-0.1909和-0.0831。集中指数分解后,经济水平、受教育程度和工作类型的贡献率均较高。在中国,三种因素的贡献率分别为66.41%、16.45%和13.10%;在印度,三种因素的贡献率分别为65.96%、24.04%和7.37%。结论中国和印度中老年人存在健康状况不公平,较好的健康状况集中在经济水平较高的人群中。与印度相比,中国中老年人健康状况更好,但健康状况不公平程度较严重。社会经济地位差异是造成两国中老年人健康状况不公平的主要因素。为了更好地应对人口老龄化,中国和印度政府应该继续加强并完善适宜的社会福利和医疗保障措施。     

Association of dietary isoflavone consumption with subclinical cardiovascular disease in middle-aged and elderly Chinese people

Background and aimsThe association between isoflavone (ISF) consumption and cardiovascular disease (CVD) remains controversial because of limited evidence. Carotid atherosclerosis is an established indicator of subclinical CVD. The study aimed to investigate the relationship between dietary ISF intake and subclinical CVD in middle-aged and elderly adults.Methods and resultsA total of 873 subjects aged 40–70 years without CVD were enrolled in this cross-sectional study. A restricted cubic spline was used to investigate the association between ISF intake and subclinical CVD risk. The odds ratio (OR) and 95% confidence interval of the risk of subclinical CVD for ISF were estimated by two-segmented logistic regression analysis. In Model 2, there was a non-linear association between ISF intake and the risk of subclinical CVD among women (P_non-linear = 0.002), with an inverse association below the change point. The nadir for the risk of subclinical CVD among women was 7.26 mg/day (energy-adjusted). Below the change point, an increase of 1 mg ISF/day reduced the risk of subclinical CVD by 15%. There was no significant association between ISF intake and subclinical CVD risk above the change point (OR = 1.01 [0.99, 1.04]). ISF intake was not associated with subclinical CVD risk in men (Model 2: P_non-linear = 0.224).ConclusionsBelow the change point (7.26 mg/day), women with a higher intake of ISF had a significantly lower risk of subclinical CVD. Encouraging the consumption of ISF-rich foods may help to lower CVD risk in middle-aged and elderly women.Trial registrationThis study is registered at http://www.chictr.org.cn (ChiCTR 1900022445).     

Effects of Forest Therapy on Psychological Improvement in Middle-aged Women in Korea

ObjectivesWomen experience more stress in middle age than in other periods of their lives. Therefore, health management programs that enable middle-aged women to cope with and manage stress are needed. This study investigated the psychological effects of a meditation-focused forest therapy program among 53 middle-aged women living in urban areas in Korea.MethodsParticipants were divided into 2 groups: one group underwent the program for 3 days in a forest, followed by 3 days in an urban environment, and the other group underwent the program for 3 days in the urban environment, followed by 3 days in the forest. The psychological effects of the forest therapy program were evaluated using the Profile of Mood States-Brief (POMS-B). Differences in mood state before and after the program conducted in the forest (experimental group) and in the urban environment (control group) were evaluated using the paired-samples t-test.ResultsThe program in the forest significantly reduced tension, depression, anger, fatigue, and confusion among the domains of the POMS-B. The program in the urban area significantly reduced tension, but not depression, anger, fatigue, or confusion.ConclusionsMeditation-focused forest therapy programs are expected to contribute to promoting psychological health and enhancing the quality of life of middle-aged women.     

中老年人群生活方式与血压水平和高血压发生风险的关联

目的  探讨中老年人群生活方式及其变化与血压水平和高血压发生风险的关联。方法  纳入东风-同济队列2008―2010年7 671名研究对象进行分析。分别采用线性回归和Logistic回归分析模型评估生活方式与血压水平和高血压发生风险的关联。结果  校正混杂因素后,生活方式评分增加与血压水平和高血压风险的降低均有剂量反应关系。与基线生活方式评分0~1分组相比,＞4分组的SBP、DBP和平均动脉压分别降低4.03、2.25和2.84 mm Hg,新发高血压的OR值为0.68(95% CI: 0.52~0.88)。且每增加1分,高血压发生风险降低9%(OR=0.91, 95% CI: 0.87~0.95)。而从基线至2013年随访5年间生活方式评分维持在＞3的个体,其新发高血压风险的OR值为0.61(OR=0.61, 95% CI: 0.47~0.80),但是从基线0~2分提高至随访＞3分并不能降低高血压风险(OR=0.87, 95% CI: 0.54~1.40)。结论  中老年人群尽早并长期坚持健康生活方式对于高血压防控效益最大。     

青岛市中青年领导干部心理健康状况的调查研究

本研究采用部卷方式，调查探讨了青岛市中青年领导干部的心理健康状况，结果表明，（1）青岛市中青年领导干部的心理健康状况远远好于普通人群。（2）青岛市中青年领导干部的“自我与经验的和谐水平”以及“自我的灵活性”极明显地高于大学生常模。(2)青岛市青年领导干部的“自我与经验的不和谐”水平与其心理健康程度密切相关；其“自我的灵活性”与心理健康的多个方面也有着密切的相关。     

胺碘酮治疗中老年人急性心肌梗死合并快速心室率心房颤动的疗效观察

目的观察胺碘酮治疗中老年人急性心肌梗死合并快速心室率心房颤动的临床疗效。方法对2013-05~2016-05收治的60例发生心肌梗死的中老年患者,入院24 h内并发心室率120次/mim快速心室率心房颤动的中老年患者,年龄48~78岁,给予胺碘酮静脉加口服治疗,观察临床疗效。结果 60例患者中51例(85%)在48 h转复为窦性心律,4例死亡,5例未转复,疗效显著,心室率下降明显(P0.01),血压无明显变化(P0.05)。不良反应:窦性心动过缓1例,长R-R间歇3例,血压下降1例,静脉炎1例,予停药或对症处理后均好转。56例患者出院后随访30 d内无一例死亡,无其他不良反应发生。结论中老年人急性心肌梗死合并快速心室率心房颤动患者,应用胺碘酮静脉加口服治疗疗效显著、不良反应率低,值得临床推广应用。     

龙岩市中老年人群骨质疏松的流行病学调查

目的:分析龙岩市中老年人群骨密度(BMD)及骨质疏松(OP)患病率变化规律,为骨质疏松预防提供科学依据.方法:随机对龙岩市40岁以上的人群进行BMD测定,受试者共176人,准确记录受试者性别、年龄,使用美国Lunar公司的DEXA测定L2～4及髋部的BMD,然后进行比较和统计分析.结果:男性的BMD以50岁组或60岁组最低;女性的BMD随年龄的增加而明显下降,但70岁组下降平缓;除了40岁组外,同龄组男性BMD大于女性BMD.男性各年龄组腰椎(L2～4)的骨质疏松症患病率均低于女性各组,且较女性迟10年.结论:女性在40岁以后应监测BMD的变化,男性在50岁以后应监测BMD的变化,60岁组应为男女性BMD监测的重点.龙岩市中老年人群应普及预防知识,加强锻炼,增加户外活动,以减少OP的发生.