Correlation between psychological traits and the use of smart medical services in young and middle-aged adults: An observational study

BACKGROUND Psychological problems affect economic development.However,there is a huge gap between mental health service resources and mental health service needs.Existing mental health service technology and platforms cannot meet all the diverse mental health needs of people.Smart medicine is a new medical system based online that can effectively improve the quality and efficiency of medical services and make mental health services accessible.AIM To explore the level of intelligent medical use among young and middle-aged people and its correlation with psychological factors.METHODS Convenience sampling was used to select 200 young and middle-aged patients with medical experience at the Third People's Hospital of Chengdu between January 2022 and January 2023 as the research subjects.The general condition Questionnaire,Eysenck Personality Questionnaire,Symptom Checklist-90,General Health Questionnaire,and Smart Medical Service Use Intention Questionnaire were used to collect data.Pearson’s correlation was used to analyze the correlation between the participants’willingness to use smart medical services and their personality characteristics,psychological symptoms,and mental health.RESULTS The results revealed that the mental health of young and middle-aged people was poor,and some had psycho-logical problems such as anxiety,depression,and physical discomfort.Familiarity,acceptance,and usage of smart healthcare in this population are at a medium level,and these levels correlate with psychological characteristics.Acceptance was positively correlated with E,and negatively correlated with P,anxiety,fear,anxiety/insomnia,and social dysfunction.The degree of use was negatively correlated with P,obsessive-compulsive symptoms,depression,anxiety,hostility,paranoia,and somatic symptoms.CONCLUSION The familiarity,acceptance,and usage of smart medical services among the middle-aged and young groups are related to various psychological characteristics.

Public Square Dancing Intervention on Subjective Well-Being of Middle-Aged and Elderly People:A Meta-Analysis

Objective:To understand the influence of public square dancing on the subjective well-being of middle-aged and elderly people.Methods:According to the principle of Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines,we search Chinese databases,such as CNKI,Wanfang Data,and VIP,and English databases,such as Proquest,Web of Science,Pubmed,Cochrane,and ScienceDirect,and collect relevant articles at home and abroad from 2006 to December 2019 for meta-analysis in January 2020.Result:A total of 10 articles were included.The meta-analysis results showed that the well-being of middle-aged and elderly people in the public square dancing intervention group was significantly higher than that of the other exercise group and control group(both P<0.01).The results of the subgroup analysis showed the following:Different durations of intervention significantly influence the intervention effect(P<0.01).No difference was found between the effect of the mixed-gender intervention and the individual female intervention(P>0.05).No significant difference was found between the groups with weekly intervention frequency(P>0.05).Conclusion:Public square dancing intervention is effective for middle-aged and elderly people’s subjective well-being.Neither mixed intervention nor the times of weekly intervention have an impact on the intervention effect.However,the length of duration of intervention influences the intervention effect.

The Relationship between Mental Health Literacy and Subjective Well-Being of Young and Middle-Aged Residents: Perceived the Mediating Role of Social Support and Its Urban-Rural Differences

This study investigates mental health literacy among young and middle-aged urban and rural residents and the differences in mental health literacy,perceived social support and subjective well-being.From January to February 2022,620 participants(320 rural and 300 urban residents)from three provinces of China were selected by con-venience sampling.A general data questionnaire,mental health literacy scale,perceived social support scale and subjective well-being scale were administered.The mental health literacy scores of urban residents were 3.34±0.57 and those of rural residents were 2.73±0.79.The results of multiple regression analysis showed that the mental health literacy scores of rural residents were more significant than those of urban residents in terms of sex and age,while urban residents’mental health literacy scores were more significant than those of rural resi-dents in terms of monthly income.Mental health literacy,perceived social support and subjective well-being of young and middle-aged urban and rural residents were all positively correlated(P<0.01).While the level of mental health literacy is better among urban residents than rural residents,perceived social support plays a partial mediating role between mental health literacy and subjective well-being of both urban and rural residents,and should be the focus of researchers seeking to improve the level of well-being of residents.

Survey for late-onset hypogonadism among old anti middle-aged males in Shanghai communities

This study sought to investigate late-onset hypogonadism （LOH） in old and middle-aged males in Shanghai communities, using symptom score evaluation systems and measurements of sex hormone levels. One thousand cases of males aged 40-70 years were investigated. The aging male symptoms （AMS） scale and androgen deficiency in aging males （ADAM） questionnaire were used at the beginning of the investigation, followed by measurement of the sex hormone-related factors （total testosterone （TT）, free testosterone （fT）, sex hormone-binding globulin （SHBG） and bioavailability of testosterone （Bio-T））. There were 977 valid questionnaires. The LOH-positive rates shown by AMS and ADAM were 59.88% and 84.65%, respectively; values increased with the age of the patients. There were 946 results related to sex hormone measurements, which showed the following results： TT was not related to aging （P〉O.05）; levels of SHBG increased with age; and fT and Bio-T decreased with age. There was a significant difference in fT between LOH-positive and LOH-negative patients, as shown by the ADAM. In summary, TT levels were not related to aging, even though SHBG did increase while fT and Bio-T decreased with aging. Clinically, the diagnosis of LOH cannot be based on serum TT level.

Relationship between Waist Circumference, Waist-Height Ratio, Body Fat Percentage, Visceral Fat and Bone Mineral Density in Middle-Aged and Elderly Zhuang of China

Objective: To understand the correlation between different degrees of obesity and bone mineral density (BMD). Methods: 772 cases (300 men and 472 females) of Zhuang over 40 years old were randomly selected. The BMD and T score were calculated by measuring the right heel bone using a quantitative-ultrasound densitometer. Body composition index of body weight, waist circumference (WC), waist height ratio (WtHR), body fat percentage (BFP) and visceral fat (VF) were measured using a bioelectrical impedance method. Results: The BMI, WC, and WtHR of the male osteoporosis group were lower than those of the normal bone mass (NBM) group (P Conclusion: BMI is positively correlated with BMD in Zhuang. BFP has a greater correlation with female BMD, and a small reduction in BFP can result in a significant decrease in BMD. BMD of male was positively correlated with abdominal obesity indicators (WC, WtHR, VF). However, abdominal obesity has no obvious effect on the promotion of BMD in women, and increased WtHR can lead to a decrease in BMD. Zhuang can appropriately increase the amount of fat within the normal weight range. At the same time, reasonable exercise and balanced nutrition to avoid excessive obesity or low body weight can reduce the incidence of osteoporosis and osteoporosis fractures.

Association of Fibrin Monomer Polymerization Function, Cerebrovascular Risk Factors and Ischemic Cerebrovascular Disease in Old People

In order to investigate the association of fibrin monomer polymerization function (FMPF) with traditional cerebrovascular risk factors and ischemic cerebrovascular disease in old people. 1∶1 paired case-control comparative study was performed for FMPF and traditional cerebrovascular risk factors on 110 cases of old ischemic cerebrovascular disease and 110 controls matched on age, sex and living condition. The results showed that cerebrovascular risk factors were more prevalent in case group than in control group. In the case group, FMPF was significantly higher than in control group. There was a significant positive correlation between hypertension and fibrin monomer polymerization velocity (FMPV), hypertension and fibrinogen (Fbg), alcohol consumption and Fbg, but no significant correlation between diabetic mellitus, smoking and FMPF was found. Among the parameters of blood lipids, there were significant positive correlations between total cholesterol (TC) and parameters of FMPF to varying degrees, triglycerides (TG) and FMPV, TG and Fbg. Our results also showed there were significant linear trends between TC and FMPV (P<0. 001), TC and Fbg (P=0. 0087), TG and FMPV/Amax (maximum absorbance)(P=0. 0143) respectively. Multiple logistic regression analysis revealed that FMPF in case group remained significantly higher than control group after adjustment of all risk factors that were significant in univariate analysis. It was concluded that there is a possible pathophysiological link between FMPF and cerebrovascular risk factors. An elevated FMPF is associated with ischemic cerebrovascular disease and an independent risk factor of this disease. In old people, detection of FMPF might be a useful screening to identify individuals at increased cerebrothrombotic risk.

Physical activity,fitness and all-cause mortality:An 18-year follow-up among old people

Background：Little is known about change in physical activity（PA） and its relationship to all-cause mortality among old people.There is even less information about the association between PA,fitness and all-cause mortality among people aged 80 years and above.The objective is to investigate persistence and change in PA over 5 years as a predictor of all-cause mortality,and fitnes as a mediator of this association,among people aged 80 and 85 years at the beginning of an 18-year mortality follow-up period.Methods：Using Evergreen Project data（started in 1989）,4 study groups were formed according to self-reported changes in PA level,over a 5-year period（starting in 1989–1990 and ending in 1994–1995）：remained active（RA,control group）,changed to inactive（CI）,remained inactive（RI）,and changed to active（CA）.Mortality was followed up over the 18-year period（1994–2012）.Cox models with different covariates such as age,sex,use of alcohol,smoking,chronic diseases,and a 10 m walking test were used to analyze the association between change in PA level and mortality.Results：Compared to RA,those who decreased their PA level（CI） between baseline and follow-up had higher all-cause mortality（hazard ratio（HR=2.09;95%CI：1.63–2.69） when adjusted for age,gender,and chronic diseases.RI showed the highest all-cause mortality（HR = 2.16;95%CI：1.59–2.93）.In CA,when compared against RA,the risk of all-cause mortality was not statistically significan（HR=1.51;95%CI：0.95–2.38）.In comparison with RA,when walking speed over 10 m was added as a covariate,all-cause mortality risk was almost statistically significan only in CI（HR=1.37;95%CI：1.00–1.87）.Conclusion：Persistence and change in PA level was associated with mortality.This association was largely explained by fitnes status.Randomized controlled studies are needed to test whether maintaining or increasing PA level could lengthen the life of old people.

The New Social and Identitary Models of Old People—Deepening the Concept of Successful Ageing

The concept of ageing society includes the quantitative factor that there will be more and more older people according to population transitions. But, at the same time, qualitative factors such as quality of life, identity changes and the experience of high changes in the subjectivity need to be included alongside these quantitative factors. So, the purpose and significance of the paper indicate that is necessary to ensure structures that can tolerate the new scenarios of this current generation of older people, who seek new life options, renewed emotional perspectives and transgenerational confrontation with traditional models of ageing and grandparenthood.

How to Improve Old People＇s Music-Learning Level in the Aging Society —— An analysis of old people＇s psychology in the learning of music

The world has paid more and more attention to the old people＇s life, physiology and mental health, which became a popular and hot issue that attracted the expert＇s sight. Questions of how to teach them, how to create a harmonious teaching environment, how to communicate with them about the key point and how to teach them in a more scientific way need to be considered and discussed further,

椎管内麻醉与全身麻醉下手术的下肢骨折老年患者LDVT发生率比较

目的:比较椎管内麻醉与全身麻醉下手术对下肢骨折老年患者下肢深静脉血栓(LDVT)发生率的影响。方法:选取2020年1月至2022年1月在永城市人民医院接受手术治疗的90例下肢骨折老年患者,依据随机数字表将全部患者均分为对照组(全身麻醉)与观察组(椎管内麻醉),各45例。比较两组患者手术情况、术后恢复情况、麻醉情况、术中生命体征、术后48 h运动功能状态,统计术后LDVT与麻醉并发症发生率。结果:观察组患者手术时间、术中出血量、术后床旁活动时间及住院时间均少于对照组,差异具有统计学意义(P<0.05);观察组患者麻醉生效时间、术后睁眼时间、语言陈述恢复时间、术中麻醉药物用量均少于对照组,差异具有统计学意义(P<0.05);观察组患者麻醉后10 min(T1)、术毕即刻(T2)时心率、平均动脉压均低于对照组,差异具有统计学意义(P<0.05);观察组患者术后48 h的运动功能分级优于对照组,差异具有统计学意义(Z=2.183,P<0.05);观察组患者术后LDVT发生率与麻醉不良反应总发生率均低于对照组,差异具有统计学意义(P<0.05)。结论:椎管内麻醉与全身麻醉相比,能够有效降低下肢骨折老年患者术后LDVT发生风险。

基于功能性经口摄食分级的吞咽管理对高龄吞咽障碍病人的影响

目的:探讨基于功能性经口摄食分级的吞咽管理对高龄吞咽障碍病人的影响。方法:选取2022年1月—7月入住某三级甲等医院老年病科的高龄病人80例作为研究对象,由电脑产生随机序号对病人进行随机分组,对照组和干预组各40例。对照组采用常规治疗和护理方法,干预组实施基于功能性经口摄食分级的吞咽管理。比较两组病人吞咽功能康复疗效、营养状况、吞咽相关生活质量、鼻胃管留置率、吸入性肺炎发生率。结果:干预8周后,干预组病人吞咽功能康复疗效优于对照组;血清白蛋白为(39.24±1.89)g/L,血清前白蛋白为(0.24±0.03)g/L,均高于对照组[血清白蛋白为(37.65±1.82)g/L,血清前白蛋白为(0.21±0.03)g/L];吞咽相关生活质量得分为(144.90±5.87)分,高于对照组[(139.20±5.35)分];鼻胃管留置率为37.5%,吸入性肺炎发生率为5.0%,均低于对照组(鼻胃管留置率为67.5%,吸入性肺炎发生率为20.0%),差异均有统计学意义(P<0.05)。结论:对高龄吞咽障碍病人实施基于功能性经口摄食分级的吞咽管理,有利于病人吞咽功能恢复,改善其营养状况,降低病人鼻胃管留置率及吸入性肺炎发生率,提高病人的吞咽相关生活质量。

一例老年中毒性表皮坏死松解症合并消化道穿孔患者的护理

总结2022年9月我院收治的1例老年中毒性表皮坏死松解症(TEN)合并消化道穿孔患者的护理经验。护理要点:早期识别消化道穿孔,及早进行急诊手术;在全面皮损评估的基础上,分别从预防表皮分离、创面处理及黏膜护理3个方面制定有效的创面护理方案;适时采取多种疼痛干预措施;多学科协作为患者制定个性化的营养支持方案;做好体液管理和用药护理。经过12d的精心治疗和护理,患者病情好转出院。出院1周后随访,患者皮损完全愈合,术后恢复良好。

老年患者胆总管结石首次行sEST联合EPBD治疗的安全性分析

目的探讨老年胆总管结石患者首次行内镜逆行胰胆管造影(ERCP)治疗的临床效果和安全性。方法回顾性分析2019年1月至2023年8月安徽理工大学第一附属医院收治的首次行内镜下逆行胰胆管造影术(ERCP)+内镜下乳头括约肌小切开术(sEST)+内镜下乳头球囊扩张术(EPBD)治疗的胆总管结石患者临床资料。根据患者年龄分为老年组和非老年组,老年组年龄≥70岁,非老年组年龄<70岁。对比两组胆总管结石患者临床资料,分析ERCP+sEST+EPBD治疗老年胆总管结石患者的临床效果和术后并发症。结果老年组患者在年龄、术前合并症、胆总管结石取净率和胆道支架上与非老年组相比差异有统计学意义(P<0.05)。两组术后并发症相比差异无统计学意义(P>0.05),两组术前口服血小板药、插管次数≥2次比较差异有统计学意义(P<0.05)。结论老年患者首次行ERCP+sEST+EPBD治疗胆总管结石是安全的,但胆总管结石取净率低于非老年组。对于术前口服血小板药和插管次数≥2次的患者,需警惕术后并发症的发生。

老旧小区老年人户外活动安全影响要素研究

老旧小区是老年人居家养老的重要载体,但老旧小区破旧的性能无法支持老年人安全地进行户外活动。在老旧小区更新工作全面推进的大背景下,文章通过探讨哪些要素会影响老旧小区老年人户外活动安全,以促进老旧小区的安全升级,使老年人出行放心、养老安心。结果表明:老旧小区的安全性质可分为道路安全、绿化安全、设施安全3类。其中,道路安全分为2类,包含了14项要素;绿化安全包含了5项要素;设施安全分为6类,包含了19项要素。根据研究结果对老旧小区更新工作提出适当建议,可为后期相关研究与设计提供思路。

睡眠障碍对老年认知功能的影响机制及防治研究进展

由于年龄相关的退行性病变及并发症等因素,老年人睡眠障碍发生率高且易被忽略,增加了认知功能障碍、谵妄及心血管事件的发生率。本文就近年来睡眠障碍对认知功能影响的机制及其防治策略进行综述,以期为临床老年患者睡眠障碍的防治提供思路。

老年多重用药患者医院—家庭过渡期用药体验的质性研究

目的了解老年多重用药患者在医院—家庭过渡期参与药物相关医疗护理活动的体验,为后续提升过渡期药物管理质量提供参考。方法采用描述性现象学,于2022年8月—9月以目的抽样法选取重庆市某三级甲等医院出院1周后的16例老年多重用药患者为研究对象,对其进行面对面半结构式访谈,并采用Colaizzi 7步分析法对资料进行分析。结果共访谈17次,访谈录音约493 min,转录文字约4.2万字,提炼出4个主题:在用药决策方面参与感不足、感知掌握出院用药信息困难(因出院时间仓促无法完全消化出院用药指导内容、对医务人员解释的出院用药信息充满困惑)、对出院药物清单存在困惑(对出院药物清单存在辨认困难、难以理解出院药物清单中的专业术语、无法从出院药物清单中获取完整和准确的用药信息)、出院用药困难而需家庭支持(独立管理出院用药存在负担、需依靠家庭支持帮助提高药物管理信心)。结论老年多重用药患者在医院—家庭过渡期所经历的药物相关医疗护理活动体验较差,应构建合理的工作流程以提高过渡期药物管理质量,从而保障患者过渡期间药物治疗的准确性和连续性。

健康老龄化背景下不同运动干预改善老年人体适能的实证研究

目的进行为期12周的运动干预,探索瑜伽运动和健身操运动对改善老年人体成分和体适能效果的影响。方法以66老年人为研究对象,对照组21人,瑜伽组25人,健身操组24人,实验前后分别测试有氧适能、柔韧适能、力量适能、平衡适能和体成分。结果12周干预后:瑜伽组去脂体重、肌肉量改善程度具有显著性(P<0.05);瑜伽组六分钟走、30秒椅子站坐、椅子坐位体前屈和八英尺走,改善程度具有显著性(P>0.05);30秒屈臂举和四步平衡改善程度具有非常显著性(P<0.01)。健身操组去脂体重、肌肉量、体脂肪量、腰围和腰臀比改善程度具有显著性(P<0.05);健身操组六分钟走、30秒屈臂举和八英尺走改善程度具有非常显著性(P<0.05);30秒站坐改善程度具有非常显著性(P<0.01)。结论瑜伽和健身操均能改善改善老年人体成分和体适能水平。但瑜伽对于柔韧和平衡的改善效果优于健身操;健身操对于肌肉和体成分的改善效果优于瑜伽。

老年人认知状态转移规律及其影响因素研究

目的了解老年人认知状态转移规律及其影响因素,为认知障碍早期干预提供科学依据。方法基于ADNI数据,选取基线年龄≥60岁且至少完成一次随访的受试者为研究对象,认知状态分为认知正常(normal cognition,CN)、轻度认知功能障碍(mild cognitive impairment,MCI)和阿尔兹海默症(Alzheimer′s disease,AD)三类。采用多状态Markov模型探索三种认知状态间的转移规律以及年龄、性别、教育程度、是否携带APOE4等位基因、婚姻状况等对认知状态转移的影响。结果共纳入1907名受试者的10073条记录,基线年龄73.9±6.45岁,平均随访6.6次。多状态Markov模型拟合发现,MCI发展至AD的转移强度是其逆转为CN的2.88倍(0.118 vs.0.041);处于CN的受试者,10年后仍处于CN的概率较第一年降低33.6%,而发展为MCI和AD的概率比第一年分别增加了约3倍和55倍;处于MCI的受试者,10年后仍为MCI的概率仅为0.238,而发展为AD的概率是其逆转概率的3.95倍(0.608 vs.0.154)。此外,CN和MCI状态的平均停留时间分别为18.43年和6.30年。多因素分析发现,性别为男、高龄、低教育程度和携带APOE4等位基因会增加MCI的发病风险。结论随着时间的推移,老年人认知功能呈下降趋势,高龄、低教育年限和携带APOE4基因是认知下降的危险因素。

基于非靶向代谢组学的老年胃癌患者术前衰弱与代谢综合征代谢特征研究

目的基于非靶向代谢组学技术探讨老年胃癌患者术前衰弱与代谢综合征(MetS)的差异代谢物及代谢通路。方法收集非衰弱非MetS胃癌患者25例作为对照组,单纯衰弱组胃癌患者10例作为衰弱组;单纯合并MetS的胃癌患者13例作为MetS组,衰弱合并MetS组胃癌患者10例作为合并组。采用超高效液相色谱-质谱联用非靶向代谢组学技术测量血浆代谢物水平,采用主成分分析法、正交偏最小二乘法-模式识别分析法、聚类分析及代谢通路注释进行多元统计分析。结果基于非靶向代谢组学技术鉴定出了125种差异代谢物,包括氨基酸、甘油磷脂、鞘脂、脂肪酸、糖类、核苷及核苷酸、酸性化合物等类别。与对照组比较,MetS组、衰弱组、合并组分别存在41、32、52种差异代谢物。其中MetS组以脂质代谢物明显升高为特征;衰弱组以氨基酸及多数甘油磷脂类代谢物明显下降,且脂肪酸类及植物鞘氨醇明显升高为特征;合并组以核苷酸类代谢物及酸性化合物明显升高为特征。丙氨酸、天门冬氨酸、谷氨酸代谢途径在衰弱组中明显富集,甘油磷脂代谢途径在合并组中明显富集。结论单纯衰弱、单纯合并MetS以及衰弱合并MetS的老年胃癌患者存在不同的代谢特征,其中衰弱的老年胃癌患者氨基酸与甘油磷脂类代谢物均明显下降,需重视脂肪与蛋白质全面补充,MetS合并衰弱患者存在氨基酸、脂质、核苷酸、酸性化合物等多类代谢物异常,可能与肿瘤相关代谢紊乱有关。

老年人皮肤干燥发生率及影响因素的Meta分析

目的 系统评价老年人皮肤干燥现状及其影响因素。方法 计算机检索PubMed、Embase、Web of Science、中国知网、万方、维普、中国生物医学文献数据库,检索时限均为建库至2023年6月。由2名研究者独立进行文献筛选、信息提取与质量评价,采用Stata 17.0软件进行老年人皮肤干燥发生率及影响因素的Meta分析。结果纳入19篇文献,均为横断面研究,包括69 260例老年人,其中发生皮肤干燥的人数为24 580人。老年人皮肤干燥总发生率为49%[95%CI(36%,61%)];亚组分析显示,男性、欧洲地区、来自养老机构的老年人皮肤干燥发生率较高,样本量<1000例的文献、发表年份为2012—2017年的文献中老年人皮肤干燥发生率也相对较高,老年人下肢部位皮肤干燥发生率最高,其次为上肢、躯干和头面部。年龄[OR=1.43,95%CI(1.05,1.94),P=0.021]、性别[OR=0.15,95%CI(0.04,0.25),P=0.005]、罹患糖尿病[OR=1.18,95%CI(1.13,1.23),P <0.001]、心血管疾病[OR=1.15,95%CI(1.11,1.20),P <0.001]、皮肤瘙痒[OR=9.65,95%CI(6.36,14.64),P <0.001],以及使用利尿剂[OR=1.22,95%CI(1.10,1.35),P <0.001]和抗生素[OR=1.08,95%CI(1.03,1.13),P <0.001]是老年人发生皮肤干燥的影响因素。结论 老年人皮肤干燥发生率较高,年龄、性别、患有糖尿病、心血管疾病、皮肤瘙痒,以及使用利尿剂和抗生素是老年人皮肤干燥的影响因素,应重视相关人群皮肤干燥的评估和护理,本研究也存在一定局限性,未来应进一步开展高质量的研究来验证。