老年人跌倒危险因素及预防研究进展

阐述老年人跌倒发生情况,并从内部因素和外部因素综述老年人跌倒的危险因素以及预防措施的研究进展。     

Clostridium butyricum Potentially Improves Immunity and Nutrition through Alteration of the Microbiota and Metabolism of Elderly People with Malnutrition in Long-Term Care

Recent research advances examining the gut microbiome and its association with human health have indicated that microbiota-targeted intervention is a promising means for health modulation. In this study, elderly people in long-term care (aged 83.2 ± 5.3 year) with malnutrition (MNA-SF score ≤ 7) were recruited in a community hospital for a 12-week randomized, single-blind clinical trial with Clostridium butyricum. Compared with the basal fluctuations of the control group, an altered gut microbiome was observed in the intervention group, with increased (p < 0.05) Coprobacillus species, Carnobacterium divergens, and Corynebacterium_massiliense, and the promoted growth of the beneficial organisms Akketmanse muciniphila and Alistipes putredinis. A concentrated profile of 14 increased Kyoto Encyclopedia of Genes and Genomes (KEGG) orthologs (KOs) that were enriched in cofactor/vitamin production and carbohydrate metabolism pathways were discovered; the genes were found to be correlated (p < 0.05) with an elevated abundance of plasma metabolites and short-chain fatty acids (SCFAs), unsaturated medium- to long-chain fatty acids (MFA, LFA), carnitines, and amino acids, thus suggesting a coordinated ameliorated metabolism. Proinflammatory factor interferon-gamma (IFN-γ) levels decreased (p < 0.05) throughout the intervention, while the gut barrier tight junction protein, occludin, rose in abundance (p = 0.059), and the sensitive nutrition biomarker prealbumin improved, in contrast to the opposite changes in control. Based on our results obtained during a relatively short intervention time, C. butyricum might have great potential for improving nutrition and immunity in elderly people in long-term care with malnutrition through the alteration of gut microbiota, increasing the abundance of beneficial bacteria and activating the metabolism in SCFA and cofactor/vitamin production, bile acid metabolism, along with efficient energy generation.     

Alternative Healthy Eating Index-2010 and Incident Non-Communicable Diseases: Findings from a 15-Year Follow Up of Women from the 1973–78 Cohort of the Australian Longitudinal Study on Women’s Health

Non-communicable diseases (NCDs) and multimorbidity (≥two chronic conditions), are increasing globally. Diet is a risk factor for some NCDs. We aimed to investigate the association between diet quality (DQ) and incident NCDs. Participants were from the Australian Longitudinal Study on Women’s Health 1973–78 cohort with no NCD and completed dietary data at survey 3 (2003, aged 25–30 years) who responded to at least one survey between survey 4 (2006) and survey 8 (2018). DQ was measured by the Alternative Healthy Eating Index-2010 (AHEI-2010). Outcomes included coronary heart disease (CHD), hypertension (HT), asthma, cancer (excluding skin cancer), diabetes mellitus (DM), depression and/or anxiety, multimorbidity, and all-cause mortality. Repeated cross-sectional multivariate logistic regressions were performed to investigate the association between baseline DQ and NCDs over 15 years. The AHEI-2010 mean (±sd) for participants (n = 8017) was 51.6 ± 11.0 (range: 19–91). There was an inverse association between AHEI-2010 and incident asthma at survey 4 (OR_Q5–Q1: 0.75, 95% CI: 0.57, 0.99). Baseline DQ did not predict the occurrence of any NCDs or multimorbidity between the ages of 25–45 years. Further well-planned, large prospective studies conducted in young women are needed to explore dietary risk factors before the establishment of NCDs.     

平人红外热图年节律变化规律研究

目的:用红外热成像技术探讨健康人群体表温度的变化规律及与四季温度变化规律间的关系。方法:运用红外热像仪FLIR-SC660采集2年内健康人群的红外热图,并进行分析和研究。结果:1)人体正面与背面体表温度变化规律呈现一致性与可重复性;2)人的体表温度具有相对稳定性、体温变化具有四时节律性;3)人体温度变化与四季温度变化规律呈现相关性。结论:健康人的体表温度在保持相对稳定的同时,还随着四季温度变化而呈现出相同的变化,为传统中医学天人相应理论提供了客观依据。     

Application of a Modified Healthy Eating Index (HEI-Flex) to Compare the Diet Quality of Flexitarians,Vegans and Omnivores in Germany

Interest in plant-based nutrition has steadily increased in the western world in the recent years. The number of people following a meat-reduced, flexitarian diet is growing continuously. However, little is known about the diet quality of flexitarians compared to vegans or omnivores. Therefore, in this cross-sectional study, the food intake of 94 participants aged between 25–45 years was recorded via a validated food frequency questionnaire and 28 self-designed questions about the consumption of plant-based alternatives. An adapted Healthy Eating Index, HEI-flex, was developed to evaluate the diet quality of flexitarians, vegans and omnivores. Higher score points (SP) of the HEI-flex are associated with higher compliance with the official diet recommendations (V_max = 100 SP). Finally, flexitarians scored significantly more highly when compared to omnivores (54 ± 8 vs. 47 ± 9 SP; p = 0.008) but lower than vegans (54 ± 8 vs. 61 ± 10 SP; p = 0.010). The results showed that the HEI-flex is a useful tool for assessing and comparing the diet quality of flexitarians, vegans and omnivores. Despite the consumption of highly processed plant-based alternatives, reduction in meat and meat products seems to be accompanied by increased overall diet quality.     

探讨老年肾虚证与骨密度的关系

为探讨老年肾虚证与骨密度的关系 ,通过随机选择 60～ 78岁的肾虚证者 2 1 4例作为观察组 ,并设虚证 (肝肾两虚、肝虚、脾虚证 )组 366例和健康对照组 1 0 0例 ,采用超声成像骨密度测定法 ,测定足跟骨的骨密度。结果 :肾虚证组的骨密度低于正常对照组和肝肾两虚证、肝虚证、脾虚证组 (P <0 0 1 )。提示老年肾虚证与骨密度有直接相应变化的关系 ,骨密度测定可作为肾虚证本质辨证的客观评价指标和观察肾虚证治疗效果的参考依据。     

白三烯拮抗剂孟鲁斯特钠与舒利迭联合治疗在老年哮喘中的应用效果

目的探讨白三烯拮抗剂孟鲁斯特钠与舒利迭联合治疗在老年哮喘患者中的临床效果。方法选择本院102例支气管哮喘老年患者,随机分为观察组和对照组。两组均给予对照组治疗,对照组给予舒利迭,观察组给予舒利迭和孟鲁司特钠。观察两组患者治疗前后肺功能改变情况。结果观察组治疗后最大中期呼气流速、第1秒用力呼气量和最大呼气流速峰值分别与对照组治疗后比较,差异有统计学意义（P〈0.05）;观察组总有效率为96.1%,对照组总有效率为80.3%。观察组总有效率高于对照组,差异有统计学意义（P〈0.05）。结论孟鲁斯特钠与舒利迭联合治疗能够改善老年哮喘患者肺功能,治疗效果显著。     

中青年血清胆红素轻度增高者胆红素与血糖、血脂及血压的关系

目的观察中青年血清胆红素轻度增高者血糖、血脂及血压水平。方法中青年男女556人,高胆红素组296人,对照组260人。测定两组研究对象血清总胆红素、直接胆红素、空腹血糖、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇及血压并对数据进行分析。结果男性胆红素高于女性,差异有统计学意义（P〈0．01）。高胆红素组空腹血糖低于对照组,男性二组差异有统计学意义（P〈0．01）,女性二组差异无统计学意义（P〉0．05）。高胆红素组收缩压低于对照组,但差异无统计学意义（P〉0．05）,舒张压高于对照组,且差异有统计学意义（P〈0．05）。高胆红素组男性总胆固醇、甘油三酯高于对照组,高及低密度脂蛋白胆固醇低于对照组,其中高密度脂蛋白胆固醇与对照组差异有统计学意义（P〈0．05）。高胆红素组女性总胆固醇、甘油三酯、高与低密度脂蛋白胆固醇均高于对照组,但差异无统计学意义（P〉0．05）。空腹血糖与男性总胆红素、直及间接胆红素和女性直接胆红素负相关。舒张压与男性总胆红素及直接胆红素和女性总胆红素及间接胆红素正相关;收缩压与男性胆红素不相关,与女性直接胆红素负相关。男性低密度脂蛋白胆固醇、女性总胆固醇、腰围与直接胆红素负相关。男性腰围与总胆红素、间接胆红素正相关。结论胆红素不同形式对空腹血糖均有影响,中青年阶段空腹血糖随着胆红素的增高而降低。胆红素对中青年男女舒张压的维持有一定作用,对收缩压的影响有性别差异,女性胆红素较高者,舒张压较低。中青年男女在高胆红素水平时有较少的心脑血管危险因素。