桂西地区中老年人骨密度调查分析

目的：探讨桂西地区中老年人骨密度（BMD及骨质疏松（OP）的变化规律。方法：采用单光子吸收仪（SPA）测定桂西地区415例中老年人的骨密度，同时用化学发光仪测定女性血雌二醇（E2）和男性血睾酮（T）浓度。结果：随着年龄增加BMD、T、E2逐渐下降。同龄男性BMD大于女性。OP随着年龄增加而逐渐上升，女性更为明显。女性50岁以后OP的发病率为51．78％，男性发病率为36．13％。结论：桂西地区50岁左右女性和男性应预防骨质疏松的发生。     

社区中老年居民尿失禁患病率及三级医疗机构就诊率调查

目的调查社区中老年居民尿失禁患病率和在三级医疗机构的就诊率,指导社区预防保健工作。方法调查对象为北京市某社区40～70岁常住居民,采用国际尿失禁咨询委员会尿失禁问卷表简表(ICI-Q-SF)和居民就医状况调查表进行调查。结果 40～70岁居民尿失禁总体患病率为42.5%,其中轻度、中度、重度患病率分别为21.3%、12.4%和8.7%,且女性患病率与男性比较,差异有统计学意义(χ2=34.5,P<0.05)。随着年龄的增加,尿失禁患病率增加,40～49岁、50～59岁、60～70岁的患病率分别为30.2%、46.1%和60.6%。在尿失禁筛查阳性居民中,总体就诊率为32.4%,且首选社区卫生站、二级医院、三级医院的比例分别为9.2%、18.1%和72.7%,而影响患者选择的最主要原因是医疗水平。结论社区医务人员应普及尿失禁知识、提高居民对尿失禁的认识和指导居民合理选择医疗机构。     

我国中老年人群骨关节炎罹患现状及其关联因素分析

目的 了解我国中老年人群罹患骨关节炎现状及其关联因素。方法 采用2015年和2018年中国健康养老追踪调查（CHARLS）数据,纳入中老年人群（≥45岁）作为研究对象,运用χ2检验和多因素logistic回归分析中老年人群骨关节炎的关联因素。结果 纳入7 050名中老年人,骨关节炎患病率为33.69％。多因素logistic回归结果表明,从个体社会人口学特征看,年龄≥60岁（OR = 2.254,95%CI:1.985～2.558）、女性（OR = 1.353,95%CI:1.200～1.527）是骨关节炎的危险因素;从慢性病患病情况看,患有高血压（OR = 1.228,95%CI:1.072～1.408）、心脏病（OR = 1.607,95%CI:1.361～1.897）、中风（OR = 2.303,95%CI:1.604～3.306）、肾脏疾病（OR = 2.147,95%CI:1.744～2.644）、胃部疾病或消化系统疾病（OR = 2.810,95%CI:2.487～3.175）是骨关节炎的危险因素;从居住环境看,居住在城市地区（OR = 0.637,95%CI:0.541～0.750）、住房有电梯（OR = 0.879,95%CI:0.785～0.985）、坐式厕所（OR = 0.669,95%CI:0.580～0.770）是骨关节炎的保护因素。结论 我国中老年人群骨关节炎患病状况不容乐观,其关联因素是多方面的,应从个体层面到环境层面重视对骨关节炎的防控。     

Gynaecology of middle-aged women--menstrual and reproductive histories

The aim of this study was to investigate menstrual history, reproductive functions, fertility regulation and gynaecological operations is a representative sample of middle-aged women. A sample consisting of 1746 women aged 40-66 was randomly selected. Of those initially selected, a total of 1413 (81%) were investigated. Gynaecological data were acquired by means of questionnaires. Eighty-six percent of menstruating women reported a cycle length of 22-30 days and menstrual flows lasting 4-7 days. The median age at natural menopause was 50.9 yr. The oldest menstruating women were 57 yr old. Curettage had been performed in 53%, and 9% were hysterectomised. Every fourth woman had had three or more children, and 15% were nulliparous. Abortion (spontaneous or induced) was reported by 28% of the women. Of 714 menstruating women, 62% were utilising contraceptive methods, among which barrier or natural methods predominated. Nine percent of women aged 40-44 used combined oral contraceptives. Previous or current use of contraceptive pills was reported by 32% of all the women, and of these 20% had been on the pill for 10 or more yr.     

中年人自我概念及其相关因素对心理健康的影响

目的探讨中年人自我概念与心理健康的关系。方法应用田纳西自我概念量表(TSCS)与中文版心理健康类型诊断量表(MHP)对243名城镇中年人的自我概念和心理健康状况进行测试研究。结果相关分析结果显示,①除TSCS的自我批评之外,自我概念各维度及总分与MHP的心理性应激、社会性应激、躯体性应激和应激程度呈不同程度的负相关(P<0.05~P<0.001),与生活质量呈正相关(P均为<0.001);②自我批评与心理性应激、社会性应激、躯体性应激和应激程度呈显著性正相关(P均为<0.001)。多元回归结果显示,①生理自我对心理性、社会性和躯体性应激具有不同程度的负向影响(β=-0.13~-0.53,t=-2.507~-9.870,P<0.05~P<0.001);②家庭自我对心理性应激(β=-0.21,t=-3.650,P<0.001)具有负向影响;③自我批评对心理性、社会性和躯体性应激具有不同程度的正向影响(β=0.19~0.34,t=3.406~3.614,P<0.01~P<0.001),对生活质量具有负向影响(β=-0.14,t=-2.577,P<0.05);④社会自我(β=0.31,t=4.943,P<0.001)和心理自我(β=0.28,t=4.484,P<0.001)对生活质量具有正向影响。结论中年人的自我概念对心理健康有着重要的影响。     

Vulnerability to HIV among older men who have sex with men users of dating apps in Brazil

IntroductionThe elderly population is increasingly benefiting from recent technological advances. In this scenario, geolocation-based dating applications provide a viable alternative for finding partners in a practical and timely manner, but may be accompanied by certain risk behaviors for HIV infection. Although there are considerable number of users over 50 on these applications, no studies have addressed this problem. The aim of the present study was to analyze factors of vulnerability to HIV/Aids among the population of men who have sex with men (MSM) age 50 years or older who use dating apps.MethodsThis was a cross-sectional, population-survey-based, analytical study, conducted exclusively online with a sample of 412 MSM. The data was collected from the following apps: Grindr®, Hornet®, Scruff® and Daddy Hunter®.ResultsFactors associated with a higher chance of having HIV were: sexual relations with an HIV-infected partner (ORa = 5.53; 95%CI = 2.23–13.73); chemsex (ORa = 3.97; 95%CI = 1.72–8.92); and, above all, having an HIV-infected partner (ORa = 8.02; 95%CI = 2.01–32.01). The belief that apps increase protection against sexually transmitted infections (ORa = 0.43; 95%CI = 0.19–0.95) and not being familiar with post-exposure prophylaxis (ORa = 0.43; 95%CI = 0.19–0.95) were associated with decreased chances of having HIV.ConclusionsWe highlight some important factors that structure the vulnerability of the MSM surveyed in relation to HIV infection. The findings should be used to customize care for this population, which could bring them in more for health care services.     

河北省阜城县某社区中老年男性艾滋病相关知识态度和行为现况调查

目的了解中老年男性的艾滋病相关知识、态度和行为的现状,为有针对性地开展中老年男性艾滋病健康教育工作提供参考。方法采用整群抽样及按年龄分层抽样的方法,对河北省阜城县707位城乡中老年男性进行了问卷调查。结果城乡中老年男性对于艾滋病相关知识平均知晓率为60．15％。艾滋病传播途径和预防措施的知晓率较高,分别为81．36％和80．98％;艾滋病非传播途径的知晓率仅为35．93％;对艾滋病错误认识的正确回答率及联合国艾滋病规划署（UNAIDS）确定的5个关键问题的知晓率分别为50．64％和56．89％;均存在明显的城乡、文化程度、年龄和职业差异（P〈0．01）。81．3％的人对艾滋病存在恐惧,许多人介意与艾滋病及感染者接触。艾滋病相关知识的主要来源是电视、报刊、广播等媒体。结论农村中老年男性艾滋病相关知识知晓率较城市中老年男性低,且对艾滋病病毒感染者的歧视和排斥态度较严重。仍需要加大对艾滋病相关知识的宣传及普及力度。     

中老年舒张性心力衰竭158例临床分析

目的对中老年舒张性心力衰竭（DHF）进行临床分析。方法回顾分析我院2007年1月至2010年2月收治的舒张性心力衰竭患者。结果舒张性心力衰竭早期心力衰竭症状较轻,可提前至中年发生,合并SHF（收缩性心力衰竭）者心力衰竭较重。结论彩色多普勒超声检查为评价DHF的主要方法,可对DHF进行分期,患者大多左房增大,部分患者左室及右房增大,LVEF正常或基本正常,舒张功能异常,左心型DHF占多数,少数患者合并右心型,综合治疗可延缓心室重构,改善心衰症状。     

中老年高血压患者心血管病多重危险因素及其相互关联的临床研究

目的探讨中老年高血压患者心血管病（EH）多重危险因素及其相互关系。方法回顾性分析1997年7月至2007年7月入住我院中老年EH人群合并其他心脑血管疾病的常见危险因素及检测指标,以单因素Logistic回归方法研究其对急性心脑血管事件的影响。结果高胆固醇、糖代谢异常、Hs-CRP分层≥3.0mg/L、TG水平≥1.7mmol/L、HDL≤1.04mmol/L、低运动量（体育锻炼〈1次/周）、靶器官损伤、蔬菜摄入量过低及心情抑郁等因素都是促进中老年EH患者其他心脑血管病发生的高危因素。结论高血压与多种心血管病发病因素之间存在密切联系,有效预防措施包括控制体重、积极锻炼及养成良好的生活习惯等。     

中老年髋关节置换术患者治疗的术式比较

目的：探讨半髋关节置换术和全髋关节置换术在治疗中老年股骨颈骨折的疗效比较。方法：选取2006年5月～2009年5月本院收治的62例中老年股骨颈骨折患者,其中,全髋关节置换43例,半髋关节置换19例,对两组患者的手术出血量、手术时间、住院时间及关节功能等进行比较。结果：全髋关节置换组的术中出血量、平均手术时间及术后4年Harris评分明显要多于半髋关节置换组,P〈0.05,差异有统计学意义;住院时间、术后半年及1年的关节功能比较,P〉0.05,差异无统计学意义。结论：人工全髋关节置换可以弥补半髋置换髋臼易磨损的缺陷,安全可靠,疗效好,使用寿命更长,应根据患者的年龄、身体状况等来进行全髋关节置换和半髋关节置换的选择。