目的   研究非酒精性脂肪肝老年人体质辨识及中医治未病服务对其治疗效果。方法   选择2023年1月—2024年1月贵州中医药大学第一附属医院就诊的非酒精性脂肪性肝病老年患者70例作为研究对象，根据患者就诊顺序分配为两组。对照组35例，接受常规干预；观察组35例，其在对照组基础上予中医“治未病”理念下体质辨识干预模式。比较两组干预效果，以及干预前后血脂水平、肝功能、生存质量的变化。结果   观察组的治疗总有效率91.43%，高于对照组的68.57%，差异有统计学意义（P＜0.05）。治疗前，两组各项血脂水平、肝功能、慢性肝病问卷（CLDQ）评分比较，差异无统计学意义（P＞0.05）；治疗后，两组各项血脂水平优于治疗前，各项肝功能低于治疗前，CLDQ评分高于治疗前，差异有统计学意义（P＜0.05）；治疗后，观察组的各项血脂水平优于对照组，各项肝功能低于对照组，CLDQ评分高于对照组，差异有统计学意义（P＜0.05）。结论   对非酒精性脂肪性肝病老年患者而言，中医“治未病”理念下体质辨识干预服务能够提高其治疗效果，调节血脂水平的异常，改善肝功能及生存质量，值得应用。

       Objective  To study the physical identification of nonalcoholic fatty liver in the elderly and the therapeutic effect of traditional Chinese medicine on preventing disease before arising．Methods  A total of 70 elderly patients with nonalcoholic fatty liver disease treated in the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from January 2023 to January 2024 were selected as the study objects．Patients were assigned to two groups，control group（35 cases）received  routine intervention，observation group（35 cases）received physical identification intervention based on preventing disease before arising of traditional Chinese medicine additionally．The effect of intervention and the changes of blood lipid levels，liver function and quality of life before and after intervention were compared between the two groups．Results  The total effective rate of the observation group was 91.43%，higher than that of the control group（68.57%），the difference was statistically significant（P＜0.05）．Before treatment，there were no significant differences in blood lipid levels，liver function and CLDQ scores between the two groups（P＞0.05）．After treatment，the levels of blood lipids were better than those before treatment，liver function was lower than that before treatment，CLDQ score was higher than that before treatment，the difference was statistically significant（P＜0.05）．After treatment，the blood lipid levels of the observation group was better than that of the control group，the liver function was lower than that of the control group，and the CLDQ score was higher than that of the control group，with statistical significance（P＜0.05）．Conclusions  For elderly patients with nonalcoholic fatty liver disease，the intervention service of body constitution identification under the concept of preventing disease before arising of traditional Chinese medicine can improve the therapeutic effect，regulate the abnormal blood lipid levels，improve liver function and quality of life，which is worthy of application．

目的 探讨养老机构老年人死亡态度及其影响因素。方法 选取2018年1月—2022年12月广州市养老机构的593名老年人进行问卷调查,统计养老机构老年群体对死亡的态度,并分析其死亡态度发生的影响因素。结果 经过研究发现,对死亡的态度呈自然接受的老年人数量最少,为42例,占比为7.1%,其次从高到低依次为逃离接受老年人308例,占比为51.9%;死亡恐惧老年人83例,占比为14.0%;死亡逃避老年人81例,占比为13.7%;趋近接受老年人79例,占比为13.3%。患者的死亡态度与患者所患的疾病病种有关,影响死亡态度的因素包括：生理心理因素、文化思想因素、社会环境因素,其中发生概率最高的是生理心理因素,占比为50.9,其次从高到低依次为文化思想因素,占比为26.5%;社会环境因素,占比为22.6%。死亡态度中趋近接受维度的分值相对更高,其次依次为死亡恐惧、自然接受、死亡逃避以及逃离接受。单因素分析显示差异有统计学意义的项目包含家庭内讨论死亡、性别、健康自评状况、年龄、患病种数、经济结构。结论 在养老机构中,大多数老年人对死亡是无法自然接受的,大部分老年群体对死亡的态度是逃离接受,部分群体对死亡的态度是恐惧、逃避;而影响老年群体死亡态度的因素主要是生理心理因素。

Objective To explore the death attitudes and its influencing factors among the elderly in nursing institutions. Methods A questionnaire survey on death attitudes was conducted among 593 elderly individuals in nursing institutions in Guangzhou from January 2018 to December 2022,and their possible influencing factors were analyzed. Results There were 51.9% of the elderly individuals whose death attitudes were characterized by escape acceptance,while 7.1% demonstrated natural acceptance．However,the numbers of the elderly individuals with approaching acceptance,fear of death and escape from death showed no significant statistical difference,all being lower than the number of the elderly individuals with escape acceptance．The influencing factors of death attitude included physiological and psychological factors,cultural and ideological factors,and social environment factors．The probability of physiological and psychological factors influencing death attitudes was higher than that of other factors（P<0.05）．The score for the dimension of approaching acceptance in death attitudes was higher than that for other dimensions（P<0.05）. Conclusions In nursing institutions,the majority of elderly individuals cannot naturally accept death．Most elderly individuals exhibit an attitude of escape acceptance towards death,while some exhibit an attitude of fear and escape．However,the factors influencing the elderly's attitudes towards death are mainly physiological and psychological factors．

老年人工股骨头置换术后隐性失血是影响手术的重要因素之一,手术后机体生理、病理的变化是一个较为复杂的过程。目前中医对其病因病机尚无系统研究。临床中常存在辨证思维局限,难以客观、全面揭示该病病因病机的特点,进而导致遣方用药难以把握。该文旨在对老年人工股骨头置换术后隐性失血的病因病机进行探讨,认为该病的证候特点为气血亏虚兼瘀,病性为本虚标实,病位肝脾肾,其中气血亏虚贯穿疾病始终,而气为关键。

Hidden blood loss after artificial femoral head replacement in the elderly is one of the important factors affecting the operation,and the change of physiology and pathology after operation is a complicated process．At present,there is no systematic study on its etiology and pathogenesis in traditional Chinese medicine．In clinical practice,there are limitations of dialectical thinking,which make it difficult to Objective ly and comprehensively reveal the characteristics of the etiology and pathogenesis of the disease,and difficult to prescribe．The purpose of this paper is to explore the etiology and pathogenesis of hidden blood loss after artificial femoral head replacement in the elderly．It is considered that the syndrome of the disease is characterized by deficiency of qi and blood and blood stasis,and the disease is based on deficiency of liver,spleen and kidney,in which deficiency of qi and blood runs through the disease all the time,and qi is the key．

目的 探究前瞻性护理对老年吸入性肺炎的影响和作用。方法 选择2017年8月—2018年12月住院采取常规护理的94例老年患者作为对照组,选择2019年1月—2020年10月住院的114例老年患者作为观察组进行前瞻性护理,比较对照组和观察组吸入性肺炎的发病率。结果 观察组吸入性肺炎发病率低于对照组（P<0.05）。结论 前瞻性护理可及早筛选并识别老年患者发生吸入性肺炎的危险因素,依此采取相应的护理措施,降低吸入性肺炎的发病率。

Objective To explore the effect of prospective nursing on preventing aspiration pneumonia in elderly patients．Methods A total of 94 elderly patients who were hospitalized from August 2017 to December 2018 and received routine care were selected as the control group,and 114 elderly patients who were hospitalized from January 2019 to October 2020 were selected as the observation group for prospective care,and the incidence of aspiration pneumonia in the control group and the observation group were compared．Results The incidence of aspiration pneumonia in the observation group was lower than that in the control group（P<0.05）．Conclusions Prospective nursing can identify risk factors of aspiration pneumonia in elderly patients,and take appropriate nursing measures to reduce the incidence of aspiration pneumonia．

目的 明确上海市闵行区社区老人轻度认知功能障碍（MCI）发生现状,分析MCI发生的影响因素间的交互作用关系。方法 采用横断面研究方法,应用AD-8与CSI-D对该区2021年65岁以上老人MCI发生现状进行双量表评估。应用SPSS 26.0 软件,先后采用χ²检验分析受检老人吸烟、饮酒、慢性病等因素在不同检出情况的构成、二分类非条件Logistic回归分析MCI发生的影响因素,再将各因素依次纳入双因素交互作用分析模型,分析各变量对MCI发生的交互作用。结果 应用AD8与CSI-D双量表评估法具有较高的灵敏度,评估闵行区社区老人MCI阳性率为26.6%,高于其他研究,低年龄（OR=1.09,95%CI：1.04~1.14）、良好的健康心态（OR=1.67,95%CI：1.15~2.42）是减少老人MCI的保护因素,职业类型（OR=1.19,95%CI：1.04~1.38）、照料者类型（OR=1.56,95%CI：1.09~2.22）与老人MCI的发生存在相关关系。家庭月总收入与照料者类型之间、是否饮酒与照料者类型之间对老人MCI的发生存在交互作用（P均<0.05）。结论 保持良好的心态可以降低老人MCI发生风险,不同职业类型、照料者类型与老人MCI的发生具有相关关系,照料者选择保姆可能会增加老人MCI风险。

Objective To clarify the current situation of mild cognitive impairment（MCI）in the community elderly in Minhang District,Shanghai,and analyze the interaction relationship between the influencing factors of MCI．Methods A cross-sectional study method was used,and AD8 and CSI-D were used to evaluate the current situation of MCI in the elderly over 65 years old in this district in 2021．SPSS 26.0 software,chi-square test and binary unconditional Logistic regression model were used to analyze the composition of smoking,drinking,chronic diseases and other factors in different detected conditions and the influencing factors of MCI occurrence in the elderly．A factor interaction analysis model was used to analyze the interaction of each variable on the occurrence of MCI．Results The AD8 and CSI-D double-scale evaluation method had high sensitivity．The positive rate of MCI in the community elderly in Minhang District was 26.6%,which was higher than other studies．Younger age（OR=1.09,95%CI：1.04~1.14）,good health mentality（OR=1.67,95%CI：1.15~2.42）were protective factors for reducing MCI in the elderly,occupation type（OR=1.19,95%CI：1.04~1.38）,caregiver type（OR=1.56,95%CI：1.09~2.22）were correlated with the occurrence of MCI in the elderly．There were interaction effects between the total monthly household income and the type of caregivers,whether drinking or not and the type of caregivers on the occurrence of MCI in the elderly（all P<0.05）．Conclusions Maintaining a good attitude can reduce the risk of MCI in the elderly．Different occupational types and types of caregivers are related to the occurrence of MCI in the elderly．Caregivers choosing nanny may increase the risk of MCI in the elderly．

目的 调查分析老年精神疾病住院患者潜在不适当用药(PIM)现状。方法 回顾分析2021年3月老年住院患者临床诊断、用药情况等资料,依据2017年版《中国老年人潜在不适当用药判断标准》分析处方PIM情况。结果 125例研究对象中,平均年龄(73.31±7.87)岁,平均用药(6.62±2.68)种。101例(80.80%)患者存在140项PIM,81例(64.80%)患者使用了A级警示药物共103项,33例(40.74%)患者使用了B级警示药物共37项;高风险药物39项(27.86%),低风险药物101项(72.14%);PIM发生率排名前3位的药物是奥氮平、利培酮、劳拉西泮;12例患者存在4项与疾病状态相关的PIM。结论 该院PIM发生率偏高,医生和药师应加大力度降低PIM比例,减少不良反应,提高用药安全,促进合理用药。

Objective To investigate the current status of potentially inappropriate medications (PIM) for elderly inpatients with mental illness in a psychiatric hospital. Methods Based on the 2017 edition of “Judgment Standards for Potentially Inappropriate Medications for the Elderly in China”, we retrospectively analyzed the PIM by investigating the clinical diagnosis and medication status of 125 elderly psychiatric inpatients in March 2021. Results Among 125 subjects, the average age was (73.31±7.87) years, and the average medication was (6.62±2.68). There were 101 patients (80.80%) had 140 items of PIM, 81 patients (64.80%) used a total of 103 items of A-level warning drugs, 33 patients (40.74%) used a total of 37 items of B-level warning drugs; there were 39 high-risk drugs(27.86%), 101 low-risk drugs (72.14%); the drugs with top three PIM incidence were olanzapine, risperidone and lorazepam; 12 patients had 4 PIMs related to the disease state. Conclusions The incidence of PIM in this hospital is relatively high. Doctors and pharmacists should be advised to increase their efforts to reduce the proportion of PIM, reduce the incidence of adverse reactions, improve medication safety, and promote rational drug usage.

目的 探讨弹力带抗阻训练对老年人骨骼肌功能的影响。方法 在我院筛选60例老年人随机分为两组,对照组30例患者采用常规康复训练,观察组30例患者采用弹力带抗阻训练;分别于干预前及干预3月后评价骨骼肌功能,分析跌倒风险指数。结果 对照组干预前后骨骼肌质量指数、握力、歩速以及平衡量表BBS评分比较无差异(P>0.05);观察组干预后骨骼肌质量指数、6 m步速、握力均高于对照组,平衡量表BBS评分低于对照组(P<0.05)。结论 弹力带抗阻训练能够提高老年人骨骼肌质量、改善老年人握力计和歩速,提高平衡能力。

Objective To investigate the effect of elastic band resistance training on skeletal muscle function in the elderly. Methods 60 elderly patients in our hospital were selected and randomly divided into two groups. 30 patients in the control group received conventional rehabilitation training, while 30 patients in the observation group received elastic band resistance training. Skeletal muscle function was evaluated before intervention and 3 months after intervention, and the fall risk index was analyzed. Results There were no significant differences in skeletal muscle mass index, grip strength, pacing and BBS scores of balance scale before and after intervention in the control group (P>0.05). After intervention, the skeletal muscle mass index, 6 m step speed and grip strength of the observation group were all higher than those of the control group, and the BBS score of balance scale was lower than that of the control group (P<0.05). Conclusion The elastic band resistance training can improve the skeletal muscle quality, improve grip strength and pacing, and improve the balance ability in the elderly.

目的 分析融合功能训练在大龄人群行斜视矫正术后建立双眼三级视功能及巩固术后效果的可能性。方法 回顾性研究2008年10月—2016年12月在广州爱尔眼科医院被诊断为共同性斜视并进行手术矫正的患者174例,术后进行融合功能训练。根据术前诊断斜视的类型分成共同性内斜视组、共同性外斜视组、间歇性外斜视组,根据两眼最佳矫正视力差别分为＞2行、≤2行组,训练时对单眼抑制及交叉抑制者先采用脱抑制训练再扩大融合功能训练,具有较小融合范围的矫正术后的患者直接从扩大融合功能开始训练,对比观察斜视手术矫正前和矫正后进行融合训练后融合功能及双眼视情况。结果 斜视矫正术后128例建立了正常的融合范围,随访1年斜视无复发,无视疲劳症状发生。其中共同性外斜视组、共同性内斜视组、间歇性外斜视组进行训练后治疗的有效率分别为32.35%、28.57%、100%,两眼最佳矫正视力相差＞2行和≤2行的有效率分别为11.54%、100%。结论 大龄斜视患者尤其是间歇性外斜视或双眼最佳矫正视力相差在2行以内的患者,经过融合训练均获得良好的双眼视,视疲劳得到改善,斜视手术效果得到巩固。

Objective To analyze the possibility of fusion function training to establish binocular tertiary vision function and consolidate the effect of postoperative strabismus correction in elderly people. Methods Conduct a retrospective study about 174 patients who were diagnosed with common strabismus and had corrective surgery at Guangzhou Aier Eye Hospital from October 2008 to December 2016, and those patients was performed after the fusion function training. According to the type of preoperative diagnosis of strabismus, they were divided into common esotropia group, common exotropia group, intermittent exotropia group. According to the difference of the best corrected visual acuity between the two eyes, they were divided into>2 lines group and ≤2 lines group. Monocular-suppression and cross-suppression patients firstly used de-inhibition training and then expand the fusion-range training. Patients with a smaller fusion range started training directly by expanding the fusion function. We compared and observed the fusion function and binocular condition between before and after strabismus surgery. Results The normal fusion range was established in 128 cases after strabismus correction, and there was no recurrence of strabismus and visual fatigue symptoms after 1 year of follow-up. Among them, the effective treatment rates of the common exotropia group, the common esotropia group, and the intermittent exotropia group after training are 32.35%, 28.57%, and 100%, respectively. The two groups which are divided into>2 lines group and ≤2 lines group are 11.54% and 100%, respectively. Conclusion Elderly patients with strabismus, especially those with intermittent exotropia or within two lines of best corrected visual acuity, have achieved good binocular vision after fusion training, have been improved visual fatigue, and the effect of strabismus surgery is consolidated.

目的 探讨中药熏洗与膝关节自我锻炼管理对改善老年骨性膝关节炎功能康复效果。方法 选择90例在本院就诊的老年骨性关节炎患者,按数字表法分为观察组和对照组各45例,对照组采用膝关节康复护理知识教育、膝部中药熏洗与揉搓按摩等治疗,观察组在此治疗护理上加强对患者进行膝关节功能训炼和自我活动行为管理;随访6周,评价两组患者膝关节肿胀、疼痛、训练依从性、膝关节功能。结果 膝关节疼痛缓解、肿胀消退观察组优于对照组;膝关节功能康复效果观察组优于对照组,活动训练依从性观察组高于对照组。结论 应用中药熏洗与加强患者膝关节自我活动训炼管理,可缓解膝关节疼痛、减轻膝关节肿胀,改善患者膝关节功能,提高患者自我功能训练的依从性和生活质量。

Objective To explore the effect of traditional Chinese medicine fumigation and knee joint exercise management on the rehabilitation of senile osteoarthritis of the knee. Methods 90 cases in our hospital for treatment of senile osteoarthritis were randomly divided into observation group and control group with 45 cases in each group, the control group used the knee joint rehabilitation nursing knowledge education, herbal fumigation and massage knee treatment; the observation group on the treatment and nursingwith strengthening the function of knee joint training and self behavior management for the patients; 6 weeks of follow-up, we have evaluation of two groups of patients with knee joint swelling, pain, and knee joint function training compliance. Results The knee joint pain, swelling, knee joint function rehabilitation effect in the observation group were better than that of control group; training compliance in the observation group was better than that of control group. Conclusion The application of herbal fumigation and strengthen the self training of patients with knee joint activity management, may relieve the pain of knee joint, swelling and improve knee function. Theirtraining compliance and quality of life have been increased.

目的 观察和研究功能锻炼和心理护理对中风后肩手综合征老年患者功能康复的影响,以及对运动功能、日常生活活动能力的影响。方法 选取2015年6月—2017年2月收治的中风后肩手综合征老年患者60例为研究对象,随机法分为干预组与对照组,各30例。干预组在给予内科常规治疗及护理的同时,采用功能锻炼心理干预等方法进行处理;对照组仅进行内科的常规治疗及护理。运动功能则采用Fugl-Meyer评分法(FMA)进行评分,而日常生活活动能力采用改良Barthel指数(MBI)进行评分。并比较两组患者干预前后焦虑、抑郁水平。结果 干预组FMA评分以及MBI评分均高于对照组,差异有统计学意义(P<0.05)。干预后干预组患者焦虑、抑郁评分低于对照组,两组比较差异有统计学意义(P<0.01)。结论 采用功能锻炼和心理护理能提高中风后偏瘫患者的运动功能以及日常生活活动能力,缓解或消除患者焦虑抑郁等负性情绪,效果明显,值得推广应用。

Objective To observe and study of functional exercise and psychological nursing for stroke shoulder hand syndrome after the influence of the elderly patients with functional rehabilitation, and the influence on motor function and ability of daily life activities. Methods 60 cases of elderly patients with apoplexy after apoplexy were selected from June 2015 to February 2017. They randomly were divided into two groups: intervention group and control group, each with 30 cases. The intervention group was treated with functional exercise psychological intervention with giving routine treatment and nursing care as the same time. The control group only conducted routine treatment and nursing care. The exercise function was rated by the Fugl-Meyer scoring method (FMA), while the improved Barthel index (MBI) was used to score the daily activities. The anxiety and depression levels were compared between the two groups. Results The FMA score of the intervention group and MBI score were higher than that of the control group, and the difference was statistically significant(P<0.05). The anxiety and depression scores of the intervention group were lower than those in the control group, and the difference between the two groups was statistically significant(P<0.01). Conclusion The functional exercise and psychological care may improve movement function in patients with hemiplegia after stroke, and daily life activities ability, alleviate or eliminate negative emotions, including anxiety depression. It is worth promoting.