Effect of high-quality care on limb function recovery and quality of life after osteoporotic hip fracture surgery in the elderly

Objectives:To evaluate the effect of high-quality care on limb function recovery and quality of life (QOL) after osteoporotic hip fracture (OHF) surgery in the elderly.Methods:116 elderly patients with OHF enrolled in our hospital from January 2017 to December 2019 were assigned into observation group (high-quality care, n=58) and control group (routine care, n=58). After one month of intervention, Harris Hip Score (HHS) and Barthel Index (BI) were used to evaluating limb function and self-care ability, pain intensity numerical rating scale (PINRS) for pain assessment, self-rating anxiety scale (SAS), and self-rating depression scale (SDS) for emotion assessment. Besides, postsurgical complications, QOL and patient satisfaction were examined.Results:HHS and BI were higher in observation group (P<0.05); PINRS, SAS and SDS were lower in observation group (P<0.05); incidence of postsurgical complications in the observation group was significantly lower than that in the control group (P<0.05); QOL and patient satisfaction in the observation group were higher than those in the control group (P<0.05).Conclusion:High-quality care promotes the recovery of limb function, the QOL and the satisfaction of elderly patients.     

A critique of methods for measuring life history trade-offs

Constraints have important effects on the evolution of life history strategies, but several difficulties have been encountered in determining constraints empirically. Here we investigate methods for measuring a specific type of constraint known as a trade-off. A trade-off between two traits implies a perfect negative correlation between the traits. Trade-offs may involve more than two traits, however, and pairs of traits involved in such a higher-dimensional trade-off may be positively correlated. If some of the traits involved in a trade-off are omitted from the experimental design, the trade-off may not even be detectable. Direct measures of trade-offs are thus complicated, and indirect means of identifying trade-offs may often provide the only feasible measures.     

A critique on the water-scarcity weighted water footprint in LCA

The water footprint (WF) has been developed within the water resources research community as a volumetric measure of freshwater appropriation. The concept is used to assess water use along supply chains, sustainability of water use within river basins, efficiency of water use, equitability of water allocation and dependency on water in the supply chain. With the purpose of integrating the WF in life cycle assessment of products, LCA scholars have proposed to weight the original volumetric WF by the water scarcity in the catchment where the WF is located, thus obtaining a water-scarcity weighted WF that reflects the potential local environmental impact of water consumption. This paper provides an elaborate critique on this proposal. The main points are: (1) counting litres of water use differently based on the level of local water scarcity obscures the actual debate about water scarcity, which is about allocating water resources to competing uses and depletion at a global scale; (2) the neglect of green water consumption ignores the fact that green water is scarce as well; (3) since water scarcity in a catchment increases with growing overall water consumption in the catchment, multiplication of the consumptive water use of a specific process or activity with water scarcity implies that the resultant weighted WF of a process or activity will be affected by the WFs of other processes or activities, which cannot be the purpose of an environmental performance indicator; (4) the LCA treatment of the WF is inconsistent with how other environmental footprints are defined; and (5) the Water Stress Index, the most cited water scarcity metric in the LCA community, lacks meaningful physical interpretation. It is proposed to incorporate the topic of freshwater scarcity in LCA as a “natural resource depletion” category, considering depletion from a global perspective. Since global freshwater demand is growing while global freshwater availability is limited, it is key to measure the comparative claim of different products on the globe's limited accessible and usable freshwater flows.     

非霍奇金淋巴瘤患者焦虑抑郁情况分析及与病情分期、生活质量的相关性研究

摘要 目的：探讨非霍奇金淋巴瘤（NHL）患者焦虑、抑郁情况,并分析二者与患者病情分期、生活质量的相关性。方法：纳入我院2017年9月～2020年9月收治的NHL患者120例作为NHL组,另选取100例健康志愿者作为对照组,针对两组受试者行焦虑自评量表（SAS）、抑郁自评量表（SDS）评分。根据病情分期将NHL患者分成Ⅰ期组（n=23）、Ⅱ期组（n=40）、Ⅲ期组（n=39）、Ⅳ期组（n=18）,根据患者抑郁、焦虑发生情况分成负面情绪组（n=49）、无负面情绪组（n=71）。利用简明生活质量量表（SF-36）评估生活质量,经Logistic多元回归模型分析NHL患者负面情绪发生的影响因素。结果：NHL组的SDS、SAS评分高于对照组,且Ⅲ期、Ⅳ期组的SDS、SAS评分高于Ⅰ期、Ⅱ期组,Ⅳ期组高于Ⅲ期组（P＜0.05）。负面情绪组躯体功能、躯体疼痛、躯体角色功能、情绪角色功能、心理健康、精力、总体健康评分低于无负面情绪组（P＜0.05）。Pearson线性分析结果显示,SDS、SAS评分与躯体功能、躯体疼痛、躯体角色功能、情绪角色功能、心理健康、精力、总体健康评分呈负相关（P＜0.05）。Logistic多元回归分析结果提示,病情分期Ⅲ～Ⅳ期是NHL患者负面情绪发生的危险因素,受教育年限＞8年、家庭月收入≥5000元是预防负面情绪的保护性因素（P＜0.05）。结论：NHL患者病情分期越高,则焦虑、抑郁越明显,进而降低患者生活质量。     

Effect of age and sex on jumping mechanography and other measures of muscle mass and function

Objectives:

Sarcopenia increases falls and fracture risk. Sarcopenia clinical trials require robust quantitative tools to evaluate muscle function; jumping mechanography (JM) is likely one such tool. However, US data comparing JM with traditional tests across the lifespan is limited. This study evaluated the effect of age and sex on JM compared with traditional function tests and lean mass.

Methods:

US adults (213 women/119 men; mean age 65.4 years, range 27-96) performed functional tests including JM, Short Physical Performance Battery (SPPB) and grip strength (GS). Appendicular lean mass (ALM) was measured using DXA.

Results:

Men had higher relative jump power [mean (SD) 28.5 (10.52) vs. 21.9 (7.11) W/kg], GS [35.5 (9.84) vs. 22.7 (6.98) kg] and ALM/ht² [8.25 (1.35) vs. 6.99 (1.38) kg/m²] (all p<0.0001); no difference was observed for SPPB components. JM parameters were more strongly correlated with age than traditional tests (R²=0.38-0.61 vs. R²=0.01-0.28) and weakly with GS and chair rise time (R²=0.30-0.36).

Conclusion:

JM parameters are correlated with GS and chair rise time and demonstrate stronger correlations with age. JM shows promise as a valuable tool to evaluate and monitor interventions for sarcopenia as it could potentially detect change in muscle function more precisely than existing tools.     

溶质转运蛋白超家族的功能及结构研究进展

溶质转运蛋白(solute carriers,SLC)超家族是人类细胞膜(含胞内膜)上最重要的膜转运蛋白家族之一,它参与了细胞间的物质运输、能量传递、营养代谢、信号传导等重要生理活动。SLC转运蛋白超家族包含52个亚家族,共有400多名成员。研究表明,人类基因突变所致SLC蛋白表达异常或功能缺陷与糖尿病、高血压、抑郁症等多种重大疾病密切相关,使得该家族蛋白的功能研究近年来备受关注。SLC转运家族蛋白三维结构的解析有助于阐述其底物选择性结合与转运的精确分子机制,为研究该家族功能相关疾病的分子机理以及针对理性药物研发奠定了精细的三维结构基础。本文对近年来溶质转运蛋白超家族的结构及功能研究进展进行了总结,试图对该家族的共性规律进行阐述。     

血清中IL-17和Eotaxin水平检测在支气管哮喘患儿中的应用价值

摘要 目的：研究血清中白介素-17（interleukin,IL-17）和嗜酸性粒细胞趋化因子（Eotaxin）水平检测在支气管哮喘患儿中的应用价值。方法：选择2018年1月～2019年12月陕西省中医医院和西安市第一医院的60例支气管哮喘患儿为观察组,其中的18例缓解期患儿为缓解期组,42例急性发作期患儿为急性发作期组,且选择在我院体检的60例健康儿童为对照组。比较缓解期组、急性发作期组患儿和对照组儿童的血清IL-17和Eotaxin水平;比较缓解期组、急性发作期组患儿的一秒钟用力呼气量（forced expiratory volumeat 1st,FEV₁）以及最大呼气流量（peak expiratory flow,PEF）和生活质量评分;分析缓解期组、急性发作期组患儿的血清IL-17与Eotaxin的相关性;并分析缓解期组、急性发作期组患儿的血清IL-17、Eotaxin水平与PEF、FEV₁和生活质量评分的相关性。结果：缓解期组、急性发作期组患儿的血清IL-17和Eotaxin水平明显高于对照组（P<0.05）,且急性发作期组患儿的血清IL-17和Eotaxin水平明显高于缓解期组（P<0.05）;急性发作期组患儿的PEF、FEV₁和生活质量评分明显低于缓解期组（P<0.05）;缓解期组、急性发作期组患儿的血清IL-17与Eotaxin之间均呈明显的正相关性（P<0.05）;缓解期组患儿的血清IL-17、Eotaxin水平与PEF、FEV₁和生活质量评分均呈明显的负相关性（P<0.05）;急性发作期组患儿的血清IL-17、Eotaxin水平与PEF、FEV₁和生活质量评分均呈明显的负相关性（P<0.05）。结论：血清IL-17和Eotaxin在支气管哮喘患儿的发病过程中可以相互影响,共同参与患儿生理病理改变过程,血清IL-17和Eotaxin可作为评估支气管哮喘患儿病情严重程度和生活质量的客观指标。     

A Durkheimian critique of contemporary multiculturalism

Multiculturalism has been under scrutiny and subject to heated debates by politicians, commentators, and academics over the past two decades. Behind these debates lie concerns about the erosion of social cohesion, national security, and economic problems. This article frames and explains the debates over cultural diversity from the perspective of Durkheimian functionalism. This article presents a systematic review of Durkheim's theory and debunks (mis)interpretations that transpose his notion of division of labour to cultural diversity. It is argued that the competitive nature of the global nation-state system poses challenges for sustaining cultural diversity within national borders. After contrasting the Durkheimian functionalist perspective on multiculturalism with contemporary social justice perspectives, the article highlights and analyses the pressure point between multiculturalism within and the competitive global nation-state system without.     

Evaluation of newly developed devices for denture placement and removal in the dependent elderly

doi: 10.1111/j.1741‐2358.2011.00547.x Evaluation of newly developed devices for denture placement and removal in the dependent elderly Objective: The purpose of this study was to subjectively evaluate the utility of newly developed denture placement and removal devices. Objective observations were also made to support the evidence. Materials and method: Twenty‐one subjects were instructed to place and remove their dentures with and without the devices. We evaluated the device based on a questionnaire. Objective observations were based on a 2‐D image analysis. We analysed three factors: the time, the area and the circumference required to insert and remove the dentures. Results: Image analysis showed that the effectiveness and ease with which the subject used the device significantly improved with practice. The questionnaire data showed that a majority of the subjects appreciated the device after the first and second time. While there was no significant decrease in time required to place and remove dentures even with the device, the area and circumference of the movement on 2‐D images were significantly reduced. Conclusion: In this study, the utility of denture placement and removal devices was evaluated both subjectively and objectively. Our data reveal that the device is effective in the elderly. Further minor improvement in the device might be required to increase its effectiveness.     

Pre-radiotherapy daily exercise training in non-small cell lung cancer: A feasibility study

AimTo examine the feasibility of an individual, supervised, structured moderate-to-high intensity cycle ergometer exercise training immediately before radiotherapy in patients undergoing concomitant chemoradiotherapy for locally advanced non-small cell lung cancer (NSCLC).BackgroundLung cancer is the most common form of cancer. Despite significant advancements in therapy and supportive care it is still the leading cause of cancer-related death worldwide.Materials and methodsRandomized controlled study design; patients with NSCLC receiving concomitant chemoradiotherapy were recruited and randomly assigned to either the exercise (EXE) or the control (CON) group. Exercise training consisted of 20 min moderate-to-high intensity aerobic interval training 5 times per week (Mon–Fri) prior to radiotherapy. Secondary outcomes were assessed at baseline and after 7 weeks: peak oxygen consumption (VO_2peak), functional capacity (6MWD), pulmonary function (FEV1), psychosocial parameters (quality of life (FACT-L), anxiety and depression (HADS)) and cancer-related side effects (reported daily).ResultsFifteen patients were included. All patients completed a baseline test, while 13 patients were eligible for a posttest. The recruiting rate was 44.1% and the overall attendance rate to exercise was 90.0% with an adherence rate to full exercise participation of 88.1%. No adverse events or any unexpected reactions were observed during the exercise sessions. No significant differences were observed within or between groups from baseline to post intervention in any of the secondary outcomes.ConclusionThis study demonstrated ‘proof of principle’ that daily moderate-to-high intensity cycle ergometer exercise was feasible, safe and well tolerated among newly diagnosed patients with locally advanced NSCLC undergoing concomitant chemoradiotherapy. Larger randomized controlled trials are warranted.     

肝癌患者疾病感知状况、希望水平与生活质量的关系研究

摘要 目的：探讨肝癌患者疾病感知状况、希望水平与生活质量的相关性。方法：选取我院2017年10月～2020年10月收治的肝癌患者126例,采用疾病感知问卷（BIPQ）评估患者的感知状况,利用Herth希望指数量表（HHI）评估希望水平,患者的生活质量经简明生活质量量表（SF-36）评估。分析肝癌患者BIPQ、HHI评分与临床资料的关系。根据肝癌患者BIPQ评分,将其分成BIPQ≥48分组、BIPQ＜48分组,根据HHI评分分成HHI≥24分组、HHI＜24分组,比较不同BIPQ、HHI评分患者的SF-36评分。分析肝癌患者BIPQ、HHI评分与SF-36评分的相关性。结果：受教育年限＜9年、临床分期Ⅲ期、合并肝硬化的患者BIPQ评分高于受教育年限≥9年、临床分期Ⅰ-Ⅱ期、无肝硬化的患者,而受教育年限＜9年、临床分期Ⅲ期、家庭月收入＜3000元、合并肝硬化的患者HHI评分低于受教育年限≥9年、临床分期Ⅰ-Ⅱ期、家庭月收入≥3000元、无肝硬化的患者（P＜0.05）。BIPQ≥48分组的社会功能、躯体功能、躯体疼痛、心理健康、躯体角色功能、精力、情绪角色功能、总体健康评分低于BIPQ＜48分组,HHI≥24分组SF-36各维度评分高于HHI＜24分组（P＜0.05）。BIPQ评分与SF-36各维度评分呈负相关,HHI评分与SF-36各维度评分呈正相关（P＜0.05）。结论：肝癌患者疾病感知状况以及希望水平受多种因素影响,且二者与生活质量密切相关,疾病负面感知越低、希望水平越高的患者生活质量越好。     

Quality of Life after Gastric Bypass Surgery: A Cross-Sectional Study

Objective: Numerous reports document significant weight loss after gastric bypass; however, there is little objective data on postsurgical changes in health-related quality of life (HRQL). Research Methods and Procedures: This study examined HRQL in four groups of patients: presurgery (T1), several weeks postsurgery (T2), 6 months postsurgery (T3), and 1 year postsurgery (T4). Subjects were given three HRQL measures: the short form 36 (SF-36), the Impact of Weight on Quality of Life-Lite Questionnaire (IWQOL-Lite), and the Bariatric Analysis and Reporting Outcome System (BAROS). Subjects also completed the Beck Depression Inventory (BDI) and the Rosenberg Self-Esteem Scale (RSE). Results: There were no significant differences among the groups on demographics or presurgical body mass index. Results showed significant differences between T1 and T2 on several SF-36 and IWQOL-Lite subscales, as well as the RSE and BDI. Significant differences were found on all measures between T2 and T3. Significant differences were found on all subscales of the IWQOL-Lite, but no subscales of the SF-36, the RSE, or the BDI between T3 and T4. Discussion: This study is the first to objectively document these differences in several objective measures of HRQL, depression, and self-esteem after gastric bypass in a large sample. It is notable that many differences are apparent within several weeks after surgery. Furthermore, results indicate that the IWQOL-Lite may be more sensitive than the SF-36 to the changes of quality of life that gastric bypass patients report.     

食管癌住院患者营养风险筛查及营养不良状况对生活质量和预后的影响

摘要 目的：利用营养风险筛查工具（NRS2002）对食管癌住院患者的营养风险进行评估,并分析营养不良情况对患者生活质量及预后的影响。方法：前瞻性选取我院2017年10月～2019年10月收治的食管癌住院患者110例,治疗前经NRS2002分析营养风险,经主观整体营养评估法（PG-SGA）评估营养不良情况,分析营养不良的危险因素。根据PG-SGA评分将患者分成营养正常组、轻度营养不良组、中度营养不良组、重度营养不良组。经简明生活质量量表（SF-36）评估患者生活质量,随访12个月观察预后情况,比较四组SF-36评分与预后。结果：110例患者中,NRS2002分析提示有营养风险者78例,无营养风险者32例。PG-SGA评分提示营养正常37例,轻度营养不良28例,中度营养不良25例,重度营养不良20例。多因素Logistic回归分析显示,年龄≥60岁（95%CI：1.312-3.374,OR=2.104）、消化道症状数目＞2个（95%CI：1.052-6.701,OR=2.655）、吞咽障碍（95%CI：1.711-13.601,OR=4.824）、术前合并症（95%CI：1.274-10.406,OR=3.641）是食管癌住院患者营养不良的危险因素（P＜0.05）。轻、中、重度营养不良组的躯体疼痛、精力、躯体功能、情绪角色功能、心理健康、社会功能、总体健康评分较营养正常组降低,且中、重度营养不良组低于轻度营养不良组,重度营养不良组低于中度营养不良组（P＜0.05）。营养正常组生存率为94.59%,高于重度营养不良组的70.00%（P＜0.05）。营养正常组、轻度营养不良组、中度营养不良组的生存率比较无统计学差异（P＞0.05）。结论：食管癌住院患者营养风险及营养不良发生率较高,其营养状态主要受患者年龄、消化道症状数目、吞咽障碍、术前合并症的影响,对患者生活质量和预后影响较大,营养评估有望成为预测食管癌住院患者生活质量及预后的指标。     

心理干预对非小细胞肺癌患者免疫功能及心理状态的临床研究

目的：研究心理干预对非小细胞肺癌患者免疫功能及心理状态的影响。方法：70例NSCLC患者随机分为治疗组（Tl=36）和阳性对照组（n=34）,另设正常对照组（n=30）,治疗组进行心理干预,阳性对照组和正常对照组不给予干预,30天后,计算患者的EORTCQLQ—C30积分并测定T细胞亚群CD3＋、CD4＋、CD8＋、CD4＋／CD8＋指标。结果：治疗组患者干预后的生存质量（一般情况、躯体功能、社会功能等）及CD3＋、CD4＋、CD8＋含量较干预前均有差异（P〈0．01或P〈0．05）,治疗组患者干预后的生存质量及CD3＋、CD4＋、CD8＋含量较阳性对照组干预后均有差异（P〈0．01或P〈0．05）。结论：心理干预对非小细胞肺癌患者的心理状态有积极作用,同时能提高患者的免疫力。     

胃癌患者营养风险与生活质量及近期预后的关系研究

摘要 目的：探讨胃癌患者的营养风险的危险因素,并分析其与患者生活质量及近期预后的关系。方法：纳入我院2017年4月～2019年10月收治的胃癌患者81例,利用营养风险筛查2002（NRS2002）评分分析患者有无营养风险,经Logistic多元回归分析胃癌患者营养风险的危险因素。经简明生活质量量表（SF-36）评估患者生活质量并进行比较,前瞻性随访3、12个月,统计患者近期预后,分析胃癌患者NRS2002评分与SF-36评分的相关性。结果：在81例胃癌患者中,营养风险发生率为53.09%。Logistic多元回归分析显示：年龄≥60岁（OR=1.657,95%CI：1.042-2.635）、疼痛分度Ⅲ～Ⅳ度（OR=4.515,95%CI：1.656-12.310）、消化道反应Ⅲ～Ⅳ度（OR=3.947,95%CI：1.599-9.743）是胃癌患者营养风险发生的危险因素（P＜0.05）,而营养补充（OR=0.899,95%CI：0.846-0.955）是胃癌患者营养风险发生的保护因素（P＜0.05）。营养风险组情绪角色功能、躯体角色功能、躯体功能、总体健康、心理健康、躯体疼痛评分低于无营养风险组,NRS2002评分高于无营养风险组（P＜0.05）。胃癌患者NRS2002评分与情绪角色功能、躯体角色功能、躯体功能、总体健康、心理健康、躯体疼痛评分呈负相关（P＜0.05）。营养风险组随访3个月的生存率为95.35%,与无营养风险组的100%比较无差异（P＞0.05）。营养风险组随访12个月的生存率为79.07%,低于无营养风险组的94.74%（P＜0.05）。结论：胃癌患者营养风险发生率较高,其发生与多种因素有关,营养风险会影响生活质量和近期预后,临床需及时对胃癌患者进行营养风险评估,并尽早干预。     

RNAi在医学实验动物研究中的应用

RNAi的发现使基因功能的研究和人类疾病的治疗有了新的途径,特别是在抗病毒、抗肿瘤研究中具有较高的应用前景,同时在心血管疾病、神经系统疾病、内分泌系统疾病等研究中也将发挥重要作用。RNAi将会是医学实验动物模型建立与研究的有力工具。     

心理干预对非小细胞肺癌患者免疫功能及心理状态的临床研究

目的:研究心理干预对非小细胞肺癌患者免疫功能及心理状态的影响。方法:70例NSCLC患者随机分为治疗组(n=36)和阳性对照组(n=34),另设正常对照组(n=30),治疗组进行心理干预,阳性对照组和正常对照组不给予干预,30天后,计算患者的EORTC QLQ-C30积分并测定T细胞亚群CD3+、CD4+、CD8+、CD4+/CD8+指标。结果:治疗组患者干预后的生存质量(一般情况、躯体功能、社会功能等)及CD3+、CD4+、CD8+含量较干预前均有差异(P<0.01或P<0.05),治疗组患者干预后的生存质量及CD3+、CD4+、CD8+含量较阳性对照组干预后均有差异(P<0.01或P<0.05)。结论:心理干预对非小细胞肺癌患者的心理状态有积极作用,同时能提高患者的免疫力。     

A demographic analysis of skeletons from the Larson site (39WW2) Walworth County,South Dakota: Vital statistics

A life table methodology was used for paleodemographic analysis of skeletons from the Larson site (39WW2), an Arikara village and cemetery dated to circa A.D. 1750–1785. Vital statistics on mortality, survivorship, age-specific probability of death, life expectancy and crude mortality rate were derived from skeletal data. The population had an extremely high infant mortality rate and high rates of childhood mortality. The lowest probability of death was for adolescents. Mortality increased for young adults, ages 15–19. This increase was especially marked for females, the actual peak of adult female mortality was during ages 15–19. A second mode in the female mortality curve occurred at ages 35–39. The greatest percentage of male deaths was observed in the fourth decade, ages 30–34. Only 4.0% of the population attained the age of 50. The population crude death rate was 76 per thousand per year. This estimate, although high, is congruent with archaeological and historical sources which report a rapid Arikara population decline during the Post-Contact period. Causes of specific deaths appear to be linked to childbirth (affecting mother and infant), starvation, diseases especially tuberculosis, and intertribal warfare.     

国际功能、残疾和健康分类理念下的作业训练对脑卒中患者认知功能、心理状态和生活质量的影响

目的:探讨国际功能、残疾和健康分类(ICF)理念下的作业训练对脑卒中患者认知功能、心理状态和生活质量的影响。方法:选取我院2018年1月~2020年1月收治的脑卒中患者140例,根据随机数字表法,分成观察组(n=70)、对照组(n=70)。对照组行常规作业训练,观察组采用基于ICF理念下的作业训练。两组均观察3个月,分别在干预前、干预3个月后,经蒙特利尔认知评估量表(MOCA)评价两组认知功能的变化。经抑郁自评量表(SDS)、焦虑自评量表(SAS)分析患者的焦虑、抑郁情况。经Fugl-Meyer运动功能评定量表(FMA)、功能综合评定量表(FCA)评估患者运动功能、综合功能。利用健康状态调查量表(SF-36)评估两组生活质量。结果:两组干预后MOCA评分高于干预前,且观察组高于对照组(P<0.05)。两组干预后SDS、SAS评分低于干预前,且观察组低于对照组(P<0.05)。两组干预后FMA、FCA评分高于干预前,且观察组高于对照组(P<0.05)。两组干预后SF-36各维度评分均高于干预前,且观察组高于对照组(P<0.05)。结论:基于ICF理念下的作业训练能进一步改善脑卒中患者的认知功能以及心理状态,且有利于提升运动功能与综合功能,改善生活质量。