老年人跌倒防控信息管理系统的建立及其应用

目的：探索建立老年人跌倒防控信息管理系统,并进行应用及效果评价。方法：依托物联网技术和信息化手段,将老年人跌倒综合防控策略从线下导入线上,建立集风险评估、远程教育、反馈评价于一体的老年人跌倒防控信息管理系统。运用该系统对126名干休所老年人（年龄≥ 60岁）进行评估,量化跌倒风险等级,对筛选出的84名高危老年人进行远程连续综合干预,干预措施包括分发宣传画册,制作宣教幻灯片及视频进行远程播放与讲解。采用自身前后对照,分析评价干预6个月后跌倒相关情况。结果：高危人群跌倒发生率由21.43%降至4.76%（P<0.01）;身体平衡能力和步态稳定性改善情况明显（P<0.01）;能够自觉进行正确防控行为的比例显著提高（P<0.01）;进行复杂行为时更有信心不会跌倒（P<0.01）;居家环境安全性整体提高（P<0.01）。结论：老年人跌倒防控信息管理系统可通过全面评估筛选出高危人群,实施远程连续综合干预,降低跌倒发生率,可进一步推广应用。     

老年患者跌倒危险因素评估及护理干预

目的分析老年患者跌倒的危险因素,采取相应的护理干预,确保老年患者医疗安全。方法对我院2011年1月~2013年1月收治的216例老年住院患者跌倒的危险因素进行评估,并采取针对性的护理干预;同时选择2009年1月~2010年12月住院的采用常规护理的208例老年患者作为对照组,采用自行设计的调查问卷进行调查,并对老年防跌倒知识掌握程度及跌倒发生率进行分析比较。结果观察组跌倒知识知晓率为87.5%,发生跌倒1例,发生率为0.46%;对照组跌倒知识知晓率为34.62%,发生跌倒26例,跌倒发生率为12.5%。两组比较差异具有显著性(P0.05)。结论通过对老年人跌倒危险因素进行全面评估,有的放矢的进行干预,可预防老年人跌倒的发生,确保老年患者医疗安全。     

橘皮素与乳清蛋白的合用对短跑运动员冬训期间血清睾酮、皮质醇水平的影响*

目的:探讨补充橘皮素对短跑运动员冬训期间血清睾酮、皮质醇水平的影响。方法:将24名短跑运动员配对、随机分为试验组和对照组。冬训期间,试验组补充橘皮素补剂(含橘皮素200 mg),对照组补充安慰剂,为期4周。分别在每周第一天(T1、T2、T3、T4)及干预结束次日(T5)采集血液样本,检测血清睾酮、皮质醇、超氧化物歧化酶(SOD)、促肾上腺皮质激素(ACTH)等指标,并在干预开始和结束时测试身体成分。结果:干预4周后,①对照组的血清皮质醇水平上升,血清睾酮和SOD活性水平显著下降(P＜0.05);②试验组的血清皮质醇(P＜0.05)和ACTH(P＜0.01)均显著下降,血清睾酮维持稳定,SOD活性水平小幅上升;③试验组和对照组的肌肉量均有增加,但前者的增加量显著大于后者。结论:补充4周橘皮素能减少冬训期间高强度运动引起的机体氧化应激反应,维持机体血清睾酮水平稳定,抑制皮质醇过度分泌,促进肌肉合成。     

12周基础性抗载荷训练对某航空学校飞行学生体能影响研究*

目的: 观察12周基础性抗载荷体能训练对某航空学校学生身体成分、力量素质及体力活动水平的影响,探讨其在飞行员体能训练应用的可能性。方法: 以某航空学校飞行学生为研究对象,抽取自愿参加研究的男性学生37人,随机分为对照组(19人)和试验组(18人),试验组进行12周的基础性抗载荷体能训练,包括高强度间歇训练(HIIT)和高强度力量训练联合干预,测试训练前后两组学生身体成分、力量素质及体力活动水平变化。结果: 与对照组相比,试验组去脂体重和肌肉量,下肢蹬伸力量和躯干等长收缩、伸展力量,体力活动能量消耗和活动步数均显著增加(P＜0.05)。结论: 12周基础性抗载荷训练能促进飞行学生抗载荷关键素质提高,可作为飞行员体能训练内容尝试应用。     

河南省76 698例体检人群心肺功能检查结果与分析*

目的: 肺功能和心电图检查是心肺运动试验（CPET）人体心肺代谢整体功能评估不可或缺的组成部分,本研究对肺通气功能、换气功能和小气道功能异常及其临床相关特征进行分析。方法: 采用横断面研究方法对2016年1月至2019年l2月在河南省人民医院就诊76 698例体检人员行常规心电图、肺通气和换气功能检查,比较不同性别、年龄组心肺功能异常检出率,进一步分析心肺功能异常严重程度的特点。结果: ①在76 698例常规心电图异常检出率为71.04%。②肺通气功能异常检出率36.86％,其中男性44.78％（17 570/39 237）,女性28.57％（10 703/ 37 461）,男性显著高于女性（P<0.01）,且各年龄段男性检出率均高于女性（P均<0.01）。③小气道功能异常检出率为56.26％,男性57.73%（22 661/39 237）,女性54.72％（20 499/37 461）,不同性别比较,差异有统计学意义（P<0.01）,其中30~39岁组,40-49岁组女性检出率高于男性（P均<0.05）,20~29岁组,50~59岁组,60~69岁组,≥70岁组均男性高于女性（P<0.05）。④换气功能异常检出率为28.54％,其中男性30.55％（7 433/24 327）,女性26.50％（5 507/20 780）,二者差异有统计学意义（P<0.05）;30~39岁组（P<0.05）、20~29岁组和40~49岁组（P均>0.05）,检出率女性高于男性,50~59岁组,60~69岁组,≥70岁组,男性检出率均高于女性（P均<0.05）。结论: 河南体检人群心功能、肺通气功能、换气功能及小气道功能异常的检出率较高,男性明显大于女性,年龄≥70岁者高于其他年龄段。     

护理干预对心内科住院患者跌倒的影响

目的:探讨护理干预对心内科住院患者跌倒的影响,为临床护理及有效预防跌倒提供科学有效的依据。方法:对我院2010年1月-2010年7月心内科991例住院患者进行问卷调查与深入的访谈,对患者进行跌倒风险评估及危险因素分析,实施护理干预后再次评估。结果:心内科住院患者发生跌倒的危险系数高,属于高危密集人群。实施使用床栏、使用固定及身体约束带、对患者及家属进行安全教育和改善科室环境护理措施后,跌倒发生率有显著下降。结论:对患者进行跌倒风险评估后,有针对性的实施护理干预,可以有效的降低心内科住院患者跌倒发生率,提高患者的生存质量,保护患者住院期间的安全。     

太极拳运动对老年人步态稳定性的影响

目的：本实验通过对比老年人参加太极拳锻炼后的步态学参数的变化,旨在探究太极拳运动对老年人步态稳定性的影响。方法：（1）研究对象：选取40名社区老年人为研究对象。其中练习太极拳两年以上者20人为实验组（练习内容均为简化二十四式太极拳）,其中男女各10名;未曾练习太极拳而且未参加其他项目锻炼者20名为对照组,其中男女各10名。（2）测试方法：采用BIODEX步态训练仪对两组不同老年人进行步态测试。实验数据采用SPSS13.0统计软件进行处理,以P〈0.05为有显著性差异,P〈0.01为有非常显著性差异。结果：随着年龄的增长,老年人的步态稳定性逐渐下降,同年龄段的老年人女性的步态稳定性优于男性老年人,男性老年人步长大于女性老年人。女性老年人的左脚功能明显优于男性老年人左脚功能。长期参加太极拳锻炼的老年人步态稳定性明显提高,在步速一定的情况下,通过加大步长,降低步频提高了步态的稳定性。结论：太极拳锻炼对促进老年人步态稳定提高平衡能力有显著效果,经常参加太极拳锻炼有助于老年人下肢功能的维持,应大力开展老年人太极拳锻炼。     

太极拳运动对老年人步态稳定性的影响

目的:本实验通过对比老年人参加太极拳锻炼后的步态学参数的变化,旨在探究太极拳运动对老年人步态稳定性的影响。方法:(1)研究对象:选取40名社区老年人为研究对象。其中练习太极拳两年以上者20人为实验组(练习内容均为简化二十四式太极拳),其中男女各10名;未曾练习太极拳而且未参加其他项目锻炼者20名为对照组,其中男女各10名。(2)测试方法:采用BIODEX步态训练仪对两组不同老年人进行步态测试。实验数据采用SPSS13.0统计软件进行处理,以P<0.05为有显著性差异,P<0.01为有非常显著性差异。结果:随着年龄的增长,老年人的步态稳定性逐渐下降,同年龄段的老年人女性的步态稳定性优于男性老年人,男性老年人步长大于女性老年人。女性老年人的左脚功能明显优于男性老年人左脚功能。长期参加太极拳锻炼的老年人步态稳定性明显提高,在步速一定的情况下,通过加大步长,降低步频提高了步态的稳定性。结论:太极拳锻炼对促进老年人步态稳定提高平衡能力有显著效果,经常参加太极拳锻炼有助于老年人下肢功能的维持,应大力开展老年人太极拳锻炼。     

神经内科患者跌倒相关因素分析及护理对策

目的：探讨影响神经内科患者跌倒的原圜及影响因素,以便医护人员采取有效的护理措施预防患者跌倒,为神经内科防控住院患者跌倒提供切实可行的依据。方法：本研究采用回顾性调查分析的方法,对我院2009年10月-2010年10神经内科住院患者跌倒原因进行调查分析。结果：研究显示,调查的2307例患者中,发生跌倒79例,跌倒发生率为3．42％,影响神经内科患者跌倒的危险因素包括患者自身的疾病、年龄、药物原因、运动能力障碍、视听力障碍和认知能力障碍。患者自身的疾病、年龄和药物原因为主要影响因素。结论：神经内科患者发生跌倒与其年龄、基础疾病严重程度及使用药物等有关,护理人员可依据致使患者发生跌倒的危险因素,有针对性的采取防控措施,降低神经内科患者跌倒发生率,有效保障患者安全,提高护理质量。     

狼疮性肾炎患者肾组织中胎源性微嵌合体的表达及其临床意义

目的：探讨胎源性微嵌合体（FMc）与狼疮性肾炎（LN）的相关性。方法：收集生育过男胎的24例LN和24例肾小球轻微病变（GML）的女性患者肾活检组织,采用荧光原位杂交技术（FISH）检测细胞中的Y染色体,并收集患者孕育史、临床和实验室资料进行分析。结果：在9例LN和3例GML的肾组织中发现Y染色体阳性嵌合细胞,两组发生率的差异有统计学意义（P<0.05）,但在LN组,嵌合细胞的出现与蛋白尿、血清肌酐、抗双链DNA抗体、抗核抗体、补体C3、C4水平及SLEDAI评分等之间均无相关（P>0.05）。结论：FMc在女性LN患者肾组织中的发生频率高于对照组GML患者,但FMc的存在很可能与LN的发病、疾病活动性和进展性无关。     

A comparison of the characteristics of injuries between obese and non-obese inpatients

Objective: The objective was to compare characteristics of injuries between a sample of U.S. obese and non‐obese inpatients. Methods: Discharge records from the 2002 Nationwide Inpatient Sample of the Healthcare Cost and Use Project were analyzed to identify records including an International Classification of Diseases, Ninth Revision, Clinical Modification injury diagnosis code (ICD‐9‐CM). Records with an exclusive obesity comorbidity were isolated, and proportionate injury ratios with 95% confidence intervals were calculated to compare the demographics and injury characteristics between obese and non‐obese persons hospitalized for an injury. Results: A total of 160,707 discharge records were analyzed. Type and cause of injury that required hospitalization were significantly associated with obesity status (p < 0.001). Sprains, strains, and dislocations represented significantly higher proportions of injury‐related hospitalizations among obese persons compared with non‐obese persons. By cause of injury, injuries among obese persons were more frequently due to falls, overexertion, and poisonings compared with non‐obese persons. Discussion: Injuries that required hospitalization among obese persons may have injury characteristics distinct from injuries among non‐obese persons.     

Pattern of wood litter fall in five forests located along an altitudinal gradient in Central Himalaya

Wood and total litter fall were measured in five forests of the Kumaun Himalaya situated along an altitudinal gradient from 329 m to 1850 m. Total annual wood litter fall, which ranged from 93 to 197 g m², was inversely related with altitude and positively related with forest basal cover. Total litter fall ranged from 405 to 839 g m² yr¹ and was positively related with forest basal cover. Wood litter fall was highest in the rainy season and that of total litter in the summer season. Abscissed litter accounted for a maximum proportion of seasonal wood fall in summer. Monthly non-abscissed wood fall was positively related to the monthly rainfall on each site. The fractions in lower diameter classes (0–5 to 5–10 mm) dominated the annual wood fall in all forests and accounted for 59 to 78% of the total. Fractions in >10 mm size class fall maximally during the rainy months.Nomenclature follows Kanjilal & Gupta (1969) unless otherwise stated.The authors are thankful to Dr Uma Pandey for helpful suggestions and to the Department of Science and Technology, New Delhi for financial support.     

Phenology of the shrub strata of successional sub-tropical humid forests of north-eastern India

The phenology of 70 shrub species occurring in 5-, 25- and 60-yr old forest fallows, developed after slash and burn agriculture in north-eastern India, was studied. The early successional shrubs were largely deciduous with predominant leaf fall during the dry winter, while late successional shrubs were evergreen and with a less pronounced leaf fall pattern; the species in the 25-yr old fallow were largely of the leaf-exchanging-evergreen type. Peak leaf production, flowering and fruiting are delayed by one month in the 60-yr old fallow. The phenological separation of the growth types in the three fallows is discussed and related to possible micro-environmental differences.     

Automatic individual calibration in fall detection – an integrative ambulatory measurement framework

The objective of the current study was to demonstrate the utility of a new integrative ambulatory measurement (IAM) framework by developing and evaluating an individual calibration function in fall detection application. Ten healthy elderly persons were involved in a laboratory study and tested in a protocol comprising various types of activities of daily living and slip-induced backward falls. Inertial measurement units attached to the trunk and thigh segments were used to measure trunk angular kinematics and thigh accelerations. The effect of individual calibration was evaluated with previously developed fall detection algorithm. The results indicated that with individual calibration, the fall detection performance achieved approximately the same level of sensitivity (100% vs. 100%) and specificity (95.25% vs. 95.65%); however, response time was significantly lower than without (249 ms vs. 255 ms). It was concluded that the automatic individual calibration using the IAM framework improves the performance of fall detection, which has a greater implication in preventing/minimising injuries associated with fall accidents.     

Distribution, Ecology and Population Dynamics of the American Burying Beetle [Nicrophorus Americanus Olivier (Coleoptera, Silphidae)] in South-central Nebraska, USA

The endangered American burying beetle, Nicrophorus americanus Olivier, was previously widespread throughout eastern North America. In the past century numbers of this beetle have drastically declined and currently remnant populations are known from only six states despite intensive surveying efforts conducted for the last nine years. Efforts aimed at discovering and managing remnant populations have been generally limited by a lack of knowledge concerning N. americanus biology. We used baited pitfall traps to define the range of the Gothenburg, Nebraska population of N. americanus. Using mark-recapture techniques, we estimate that the annual Gothenburg population consists of more than one thousand individuals, meeting the recovery plan criterion to become the third breeding population in the Midwest region. Beyond estimates of population size and range, we present novel data on seasonal and daily activity, sex ratio, age-grading and foraging distances. In 1995 and 1996, the Nebraska population was univoltine and female biased, with over-wintering mature beetles emerging in early June and teneral beetles emerging in August. Nocturnal activity was highest in the third and fourth hours following sunset but was not strongly correlated with temperature. During foraging, beetles travel up to six kilometers, but the majority of our recaptures occurred at distances of less than 0.5 km, suggesting that distances between traps be increased to ensure independence of sampling units. This information will allow future work on captive breeding, re-introduction and genetic studies.     

Pycnogonid‐cnidarian trophic interactions in the deep Monterey Submarine Canyon

Abstract. Whale carcasses, sunken wood, and cold seeps provide organically enriched oases in the food‐limited deep‐sea benthos. At three such enriched habitats in Monterey Bay, CA, at a depth of nearly 3000 m, we observed pycnogonids (sea spiders) of at least two species, Colossendeis gigas and C. japonica, feeding on sea anemones that were commonly found there. Submersible remotely operated vehicles provided direct observations of feeding, as well as high definition video and photographic images. We recorded the co‐occurrence of both pycnogonids and prey anemones during ten of 12 visits during 2002–2006. Anemones and pycnogonids were conspicuously more abundant at these oases than in the surrounding benthos. The sedentary anemone Anthosactis pearseae was attached directly to whalebones while the pom‐pom anemone, Liponema brevicornis, was found resting on soft sediment, rolling in benthic currents, or accumulating where these currents were disrupted by topography, as at whale falls, wood falls, and clam fields. Both pycnogonid species were observed feeding on these anemones, either as predators or as micropredators.     

End-Permian Trace Fossil Dolopichnus and the Stresses of Ash Fall

The fossil burrow Dolopichnus, capped by an ash layer, was collected ～0.6 m below the Permian–Triassic Boundary at the Lung Cam section in North Vietnam. The burrow occurs at the top of Bed 9, directly below the stepped extinction in foraminifera that marks initiation of the global perturbations related to the end-Permian extinction event. Dolopichnus is a plug-shaped burrow, possessing lining and fills. This specimen was found capped by an undisrupted bentonite layer. The main chamber has internal structure throughout indicative of benthic organisms overcoming living pressures of repeated ash falls, which can be applied to paleoenvironmental research across different regions and times, including the recent.     

杭州市六种常见绿化树种叶片累积空气重金属特征及与环境因子的相关性

该研究选取杭州市2个污染区常见的6种绿化树种叶片作为材料,以清洁区为对照,采用电感耦合等离子体发射光谱法,测定受试树种叶内及对应样点降尘、土壤中Pb、Cd、Cr、Cu、Ni和Zn的含量,分析叶片的吸污能力以及重金属含量与土壤、降尘的相关性。结果表明:(1)污染区树种重金属含量明显高于对照区,绿化树种对环境重金属污染物有一定的吸收能力,重金属含量在不同的树种中具有明显差异;所测树种叶内Zn含量最大,Pb次之,Cd最小,指示能力则以枸骨(Ilex cornuta)对Cd和Pb、圆柏(Juniperus chinensis)对Cu、茶花(Camellia japonica)对Ni、广玉兰(Magnolia grandiflora)对Zn为最强。(2)3个样点树种叶片与对应样点土壤、降尘中重金属元素含量的相关性分析和回归分析表明,叶片重金属含量与土壤重金属含量的相关性较小,而与降尘呈显著正相关。因此,绿化树种叶片作为空气重金属污染的累积器和监测器是科学合理的,且上述4种树种对杭州市空气中6种重金属污染的指示作用具有一定参考价值,可作为监测城市空气质量的特型树种。该研究结果为减少城市空气重金属污染提供了科学依据和理论支持。     

A clinico-demographic analysis of maxillofacial trauma in the elderly

doi: 10.1111/j.1741‐2358.2010.00431.x A clinico‐demographic analysis of maxillofacial trauma in the elderly Introduction: The elderly represent an increasing proportion of society. Management of maxillofacial trauma in this population may be complicated by coexisting medical conditions, requiring multi‐disciplinary care. Methods: This retrospective audit assesses the incidence and pattern of maxillofacial trauma in elderly patients (≥60 years) presented to the Merseyside Regional Maxillofacial Unit. Over the time period of 2003, 2004 and 2005, 7905 trauma patients presented to the accident and emergency department, of whom 757 were elderly (10%). Results: Results indicated that the male to female ratio was 1:1.4. The commonest cause of injury was a fall (83%) followed by an assault (6%); the majority of falls occurring in the home. Conclusion: Management of maxillofacial injuries in this population should focus on targeted prevention programmes, which address known risk factors for falling. We believe that this is a public health issue. Members of the maxillofacial team should be aware of common risk factors of falls in elderly. Better collaboration with the Medicine for Elderly team should be considered at an early stage on managing these patients.