目的:探讨血清铁蛋白（SF）、红细胞参数（红细胞计数RBC、血红蛋白HGB、红细胞体积MCV）及炎症标志物（白细胞计数WBC、纤维蛋白原FIG、血沉ESR）与老年代谢综合征（MS）的关系。方法:148例老年人,依据MS组分数量多少分为MS0（无MS组分）、MS1～2（有1～2个MS组分）和MS3～5（有3～5个MS组分）三组。测定三组的血SF、空腹血糖FPG、甘油三酯TG、高密度脂蛋白胆固醇HDL-C、RBC、HGB、MCV、WBC、FIG及ESR水平,并进行分析。结果:老年女性及非吸烟老年男性MS组SF、RBC、HGB、WBC及ESR均较MS0组高。老年女性的SF、WBC与腰围,SF、RBC、HGB、WBC与MS组分数量,SF与RBC,均呈正相关。老年非吸烟男性的WBC与TG,HGB与MS组分数量,MCV与BMI及腰围,FIG与BMI,呈正相关。老年人HGB与DBG、TG呈正相关；与HDL-C呈负相关。结论:SF水平与MS发展相关,MS组分数量增加与聚集、超重与肥胖,可能促进体内感染状态。有MS的老年男女,常呈现低度感染状态,但同时又有一定的铁储备及相对稳定的造血机能；无MS的老年男女造血功能倾向减退。老年男性吸烟者较非吸烟者易呈现感染状态,并具有较低的铁储备。
ObjectiveTo discuss the demands for nursing knowledge among family caregivers for elderly people, in order to provide a basis for nurses to provide effective education for these people. MethodsBetween May and June 2012, a questionnaire which contained the condition of demands for nursing knowledge and the burden of care was used to investigate 1 600 family caregivers for the elderly people. ResultsThe caregivers had a demand for nursing knowledge, which may include the knowledge on medicine, disease and caregiving. The demand for knowledge was correlated with relationship between the caregivers and care recipients, health condition of the caregivers and care burden. ConclusionThe demands for nursing knowledge are higher in those who have spouse and high burden of care, without disease and symptom; we should pay more attention on them and take measures to reduce their burden of care.
Objective To broaden the current understanding of the usage willingness about artificial intelligence (AI) robots and relevant influence factors for elderly patients. Methods The elderly patients in the inpatient ward, outpatient department and physical examination of the Department of Geriatrics, West China Hospital of Sichuan University were selected by convenient sampling for investigation between February and April 2020, to explore the willingness of elderly patients to use AI robots and related influencing factors. Results A total of 446 elderly patients were included. There were 244 males and 202 females. The willingness to use AI robots was (14.40±3.62) points. There were statistically significant differences among the elderly patients with different ages, marital status, living conditions, educational level, current health status, current vision status, current hearing status, self-care ability and family support in their willingness to use AI robots (P<0.05). Multiple linear regression analysis showed that age, education level and family support were the influencing factors of use intention (P<0.05). Among the elderly patients, 60.76% had heard of AI robots, but only 28.03% knew the medical application of AI robots, and only 13.90% had used AI robot services. Most elderly patients (>60%) thought that some adverse factors may reduce their usage willingness, like “the price is too expensive” and “the use is complex, or I don’t know how to use”. Conclusions Elderly patients’ cognition of AI robots is still at a low level, and their willingness to use AI robots is mainly affected by age, education level and family support. It is suggested to consider the personalized needs of the elderly in terms of different ages, education levels and family support, and promote the cheap and user-friendly AI robots, so as to improve the use of AI robots by elderly patients.
目的:了解汶川地震老年伤员存在的身体结构与功能受损程度及活动、参与能力受限程度,明确其康复护理需求。方法:方便抽样的方法选取研究对象,采用自行设计的调查表由康复医师在征得其同意后对其完成资料的收集。结果:共选取研究对象40名。伤员存在多系统多器官的结构和功能受损,存在呼吸道感染者4例(10%),截肢者2例(5%),颅脑损伤导致瘫痪者1例(2.5%),骨折者28例(70%)。伤后早期即出现运动功能的下降,26例(65%)患者存在关节活动受限,26例(65%)肌力下降。疼痛是需要解决的一个重要问题,19例(47.5%)患者存在不同程度的疼痛问题。伤后老年伤员日常活动生活能力下降,生活能基本自理者仅13例(32.5%);参与能力受限也是一个不容忽视的问题,职业能力受限者36例(90%),休闲娱乐能力受限者33例(82.5%),社交能力受限者25例(62.5%)。结论:老年伤员的康复现状不容乐观,应该引起重视,康复治疗需要及早进行。
Objective To systematically review the effect of different nutrient interventions on the physical function of elderly people with frailty through network meta-analysis. Methods The PubMed, Cochrane Library, EMbase and Web of Science were electronically searched to collect randomized controlled trials of different nutrient interventions on physical function of the elderly with frailty, from database inception to June 30, 2022. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Network meta-analysis was then performed using ADDIS 1.16.8, GeMTC 14.3, and Stata 15.0 software. Results A total of 13 studies involving 1 144 patients were included. There was no statistically significant difference in handgrip strength, time up to go test, gait speed, and short physical performance battery (SPPB) among different nutrient interventions. Significant differences were not found in vitamin D+ whey protein (VDWP) vs. placebo and Leu vs. placebo in handgrip strength, or VDWP vs. placebo in SPPB. The probability ranking diagram showed that the most effective of handgrip strength, time up to go test, gait speed, and SPPB were milk protein concentrate (MPC80), L-carnitime (L-Car), leucine (Leu), and MPC80, respectively. Conclusion The current evidence suggests that nutritional intervention did not significantly improve physical function in the frail elderly. MPC80, Leu, L-Car, and VDVEWP may play a role in improving the physical function of frail elderly people. Nutritional support programs that increase the above nutrients, combined with exercise training may become a better way to improve the physical function of frail elderly.
Objective To evaluate effectiveness of proximal femur bionic nail (PFBN) in treatment of intertrochanteric fractures in the elderly compared to the proximal femoral nail antirotation (PFNA). Methods A retrospective analysis was made on 48 geriatric patients with intertrochanteric fractures, who met the selection criteria and were admitted between January 2020 and December 2022. Among them, 24 cases were treated with PFBN fixation after fracture reduction (PFBN group), and 24 cases were treated with PFNA fixation (PFNA group). There was no significant difference in baseline data such as age, gender, cause of injury, side and type of fracture, time from injury to operation, and preoperative mobility score, American Society of Anesthesiologists (ASA) score, Alzheimer’s disease degree scoring, self-care ability score, osteoporosis degree (T value), and combined medical diseases between the two groups (P>0.05). The operation time, intraoperative blood loss, number of blood transfusions, transfusion volume, length of hospital stay, occurrence of complications, weight-bearing time after operation, and postoperative visual analogue scale (VAS) score, walking ability score, mobility score, self-care ability score were recorded and compared between the two groups. And the radiographic assessment of fracture reduction quality and postoperative stability, and fracture healing time were recorded. ResultsThe operations in both groups were successfully completed. All patients were followed up 6-15 months with an average time of 9.8 months in PFBN group and 9.6 months in PFNA group. The operation time was significantly longer in PFBN group than in PFNA group (P<0.05), but there was no significant difference in intraoperative blood loss, number of blood transfusions, transfusion volume, length of hospital stay, change in activity ability score, and change in self-care ability score between the two groups (P>0.05). The weight-bearing time after operation was significantly shorter in PFBN group than in PFNA group (P<0.05), and the postoperative VAS score and walking ability score were significantly better in PFBN group than in PFNA group (P<0.05). Radiographic assessment showed no significant difference in fracture reduction scores and postoperative stability scores between the two groups (P>0.05). All fractures healed and there was no significant difference in fracture healing time between the two groups (P>0.05). The incidence of complications was significantly lower in PFBN group (16.7%, 4/24) than in PFNA group (45.8%, 11/24) (P<0.05). ConclusionCompared with PFNA, PFBN in the treatment of elderly intertrochanteric fractures can effectively relieve postoperative pain, shorten bed time, reduce the risk of complications, and facilitate the recovery of patients’ hip joint function and walking ability.