Objective To understand the experiences of the disabled ages occurring safety risks in the communities.Methods Phenomenology method was used.13 disabled ages who occurred safety risks in Chongqing participated in semi-structured and in-depth interview,regarding their experiences of occurring safety risks.The data were analyzed using Colaizzi method.Results Four themes were found,including enduring mental stress,lack of safety knowledge,expecting perfection of society support system,desiring to achieve self-worth.Conclusions The nurses in the communities should provide better guidance for the disabled ages as well as the caregivers,for improving their living quality.

Fall is one of major causes of disability, reduced mobility, shortness of life span and increased medical costs in the elderly.There are multiple risk factors for falls in the elderly, but they can be preventable and controlled.This article reviews the evidences regarding the clinical effectiveness, practicalness and security of these fall risk assessment methods and measures of interventions by evidence-based medicine in the elderly and analyzes their research directions.

Objective To observe the change of blood pressure variability (BPV)in elderly hypertension patients,and to analysis the correlation between BPV and stages of renal function damage.Methods 127 elderly primary hypertensive patients with chronic kidney disease(CKD) were divided into three groups:stage 2 CKD group (aged 60-90 years,n=50),stage 3 CKD group (aged 62-93 years,n=40) and stage 4 CKD group (aged 64-94 years,n=37),according to National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (K/DOQI) guide.24 h ambulatory blood pressure monitoring (24 hABPM) was used to measure 24 h mean systolic blood pressure (24 hSBP),24 hSBP standard deviation (24 hSBPSD),and to calculate 24 hSBP coefficient of variation (24 hSBPCV).Differences in above indicators among groups were analyzed by ANOVA.The relationship between above indicators and estimated glomerular filtration rate (eGFR),urinary albumin excretion rates(UAER) were assessed by Spearman rank correlation coefficient.Logistic regression analysis was employed to assess the relationship between BPV and the degrees of impaired renal function.Results 24 h SBPSD and 24h SBPCV were lower in stage 2 CKD group than in stage 3 CKD and stage 4 CKD groups [(11.91±2.56) vs.(13.98±2.89),(14.25±3.16);(9.79±2.01)vs.(11.28± 1.70),(11.53±2.65) ;all P＜0.05].24 h SBPSD,24 h DBPCV and 24 h diastolic blood pressure (24 hdBP) CV were negatively correlated with eGFR (all P＜0.01) and were positively correlated with UAER (all P＜0.01).Logistic regression analysis showed that 24 h DBPSD and 24h SBPCV were related to impaired renal function (both P＜0.05).Conclusions Blood pressure variability is increasing along with impairing renal function in elderly hypertensive patients.Blood pressure variability is associated with renal function damage.

Objective To observe blood pressure variability(BPV) and analyze the correlation between BPV and carotid artery-intima media thickness (CA-IMT) in elderly hypertension. Methods Totally 156 patients with primary hypertension were divided into 3 groups:patients aged 45-59years (48 cases) 60-79 years (52 eases),and 80-94 years (56 cases).24 h ambulatory blood pressure monitoring (24 h ABPM) was used to measure 24 h mean systolic blood pressure (24 hSBP),24 h SBP standard deviation (24 h SBPSD),and to calculate 24 h SBP coefficient of variation (24 hSBP CV).Meanwhile,SBP of daytime (DSBP) and nighttime (NSBP),DSBPSD and NSBPSD were measured,and DSBPCV and NSBPCV were calculated.CA-IMT was examined by ultrasound.Spearman rank correlation coefficient was employed to assess the relationship between above indicators and CA-IMT,age. Results No differences were found in 24 h SBP,DSBP and NSBP among the groups.24 hSBPSD( 14.3 ± 3.1),24 h SBPCV ( 11.5 ± 2.1 ),DSBPSD ( 13.8 ± 3.8),DSBPCV ( 10.7 ± 2.6),NSBPSD (13.4±3.3)of patients aged 80-90 years were higher than those of patients aged 60-79 years (12.2±2.5,10.1±2.0,11.6±2.6,9.5±2.3,11.9±2.8)and patients aged 40-59 years (11.7±2.8,9.4±1.9,10.9±3.1,8.4±1.8,11.6±3.0) (P＜0.05).NSBPCVof patients aged 80-90years was increased as compared with patients aged 40-59 years (10.9±2.7 vs.9.6±2.4,P＜0.05).24 h SBPSD,24 h SBPCV were associated with CA-IMT and age(r=0.26,0.39;0.28,0.42,all P＜0.01). Conclusions SBPSD and SBPCV of 24 h ABPM are higher in very older patient with hypertension and could be the useful markers for assessment of BPV.

Objective To investigate the prevalence of osteoporosis,osteopenia,fall and brittle fracture and their associated factors in men aged 80 years and over.Methods In a prospective study,184 study subjects with good self-care ability aged 80 years and over were enrolled.The questionnaire included living habits,falls,comorbidities,related symptoms and medicines.The bone mineral density,hand-grip strength,gait speed,timed up and go test(TUG),chair rising test(CRT),bone turnover markers and related hormones were measured.Binary Logistic regression model was used to analyze associated factors for osteoporosis,osteopenia,fall and brittle fracture.Results The prevalence of osteoporosis (OP)and osteopenia(OPA) were 12.5 ％ (23/184) and 45.1％ (83/184) respectively in this study.The height,weight and body mass index were lower,and serum levels of procollagen type 1 N terminal propeptide(P1NP)and C-telopeptides of type 1 collagen(s-CTx)were higher in osteoporosis group than in normal bone mass(NBM) group(P＜0.05,P＜0.01).The estradiol levels were lower in OP and OPA group than in NBM group(P＜ 0.05).The risk factors for OP and OPA included smoking(OR =3.607,P＜0.05),decreased body weight (OR=0.823,P ＜ 0.05) and elevated S-CTx level (OR =12.427,P ＜ 0.01).55.4％ (102/184) of study subjects had fall history after 80-year old.The prevalence of fragile fracture was 17.4％ (4/23),18.1 ％ (15/ 83)and 3.8％(3/78)in OP,OPA and NBM groups respectively,with total prevalence of 12.0％ (22/184).The risk factors for fragile fracture were a decreased total hip BMD(OR 0.017,P＜0.05)and fall history after 80-year-old(OR 13.126,P ＜ 0.05).Conclusions Based on associated factors of osteoporosis,osteopenia,falls and fragile fracture in male aged 80 years and over,the primary and secondary prevention of osteoporosis may need a comprehensive geriatric intervention including lifestyle adjustment,fall prevention and pharmacologic treatments.

Objective To understand the blood lipidcondition of perimenopausal women ,control and standard-reaching situ-ation of dyslipidemi.MethodSix hundred and forty inpatientaged 45-55 yearold (including 400 femaleand 200 males) ad-mitted in the Jiangbei People′Hospital from January 2000 to January 2014 and 200 femaleaged ove60 yearwere selected .TG , TLDL-,HDL-,complicating disease,control of blood pressure and blood lipid,and the lipid-regulating drugapplication situ-ation were recorded .ResultThe prevalence rate of dyslipidemiin perimenopausal women wa23 .40% .The blood lipidcontrol standard-reaching rate wa40 .80% ;the average levelof TG ,LDL-and Tin the perimenopausal women were highethan those in the men of the same age ,while the average level of HDL-walowethan thain the men of the same age .The prevalence rate of dyslipidemiwahighethan thain the men .The average lipid level in the femaleaged ove60 yearwere highethan thaof the perimenopausal women .Conclusion The lipid level of perimenopausal women ihighethan thain the men athe same age . The prevalence rate of dyslipidemiilowethan thain the femaleaged ove60 year,and the control standard-reaching rate is lower.

Objective To investigate the differences of clinical symptoms,risk factors,plasma D?dimer level and severity of acute pulmonary embolism( APE) between females and males. Methods Clinical data of 153 cases APE patients were analyzed retrospectively. Symptoms,risk factors,electrocardiogram( ECG) findings, plasma D?dimer level and risk classification were analyzed between females and males. Results The proportion of palpitation in females was significantly higher than that in males ( 29. 3%( 24/82 ) vs. 8. 5%( 6/71 ) ,χ2=10. 46,P<0. 01) . The proportion of chest pain in females was significantly lower than that in males ( 4. 9%( 4/82) vs. 25. 4%( 18/71) ,χ2=12. 96,P<0. 01) . The proportion of patients who had three or more symptoms was significantly higher in females than that in males ( 32. 9%( 27/82 ) vs. 7. 0%( 5/71 ) ,χ2 = 15. 41, P<0. 01). D?dimer mean level in females was significantly higher than that in males(334. 00(620. 00) μg/L vs. 528. 00( 812. 75) μg/L,Z=-2. 447,P<0. 05) . The proportion of low risk patients in females was lower than that in males ( 31. 7%( 26/82 ) vs. 53. 3%( 38/71 ) ,χ2 = 7. 44, P<0. 01 ) , while the proportion of the intermediate?high?risk patients was higher ( 34. 1% ( 28/82 ) vs. 14. 1 ( 10/71 )%,χ2 = 8. 20, P<0. 01) . Conclusion The symptoms was more variable in females with the main symptom of palptation. The level of plasma D?dimer is higher in females than that in males. The prognosis of females may be severe than that of males.

With the development of computer technique, Excel office software is widely applied in the management of clinical teaching. According to the problems existing in the clinical teaching management of our college, Excel electronic software is accepted to reform the present management measures. Its designation, essential archives establishment, method, result, analysis and discussion are introduced definitely in this paper.

Objective To investigate the application of functional assessment to determine the needs of intermediate care services of elderly,and to analyze the needs of intermediate care services of elderly patients in different grades of hospital,different departments and different age.Method 2481 cases of patients aged over 60 years hospitalized due to acute diseases were collected.The ability of activities of daily living (ADL) scale (Barthel index) and limb function were determined in patients aged over 60 years within 1 week after admission as acute diseases.According to the clinical data and scoring scales,the patients were divided into three groups of self-care group without declined independent function of life with Barthel index ＞ 95 points;intermediate care group in whom the ability of daily activities was decreased due to the acute diseases,the function of the body was decreased,and Barthel index was between 45 ～ 95 points;and long-term care group with long term bed rest,severely declined autonomic function or complete dependence and Barthel index less than 45 points,and no opportunity of further recovery.A total of 382 elderly patients (195 male) were in intermediate care group.Analyzed were the intermediate care needs of elderly patients in different levels of hospitals,different departments (including respiratory,cardiovascular,emergency department,geriatrics) and different age.Results The proportion of needs of intermediate care services was 16.1％ (194/1205) in third grade hospitals,24.3％ (33/136) in grade 2 hospitals,38.1 ％ (91/239) in grade 1 hospitals,and 7.1％ (64/901) in community hospital.In general hospital the proportion of needs of intermediate care services were 24.5 ％ (13/53) in emergency department,12.1％ (4/33) in cardiology department,14.6％ (6/41) in respiratory department,and 10.4％ (7/ 67) in geriatric department.The proportion of needs of intermediate care services was 19.0％ (22/ 116) in age group of 60～69,42.2％ (62/147) in age groupof 70～79,and 28.6％ (34/119) in age group of over 80 years.Conclusion The needs of intermediate care services are different in different age groups.Patients aged 70 ～ 79 years have the highest needs of intermediate care services.The needs of intermediate care services are different in different grade levels of hospitals and in different departments.

Objective To investigate the gene sequence and mutations of human papillomavirus(HPV)type16E6E7in patients with HPV infection in Beijing.Methods Sample DNA was extracted from lesions in patients with HPV infection.HPV types were identified by polymerase chain reaction(PCR).E6E7gene,isolated from samples infected with HPV16only,was cloned into plasmid pGEM-3zf and sequenced.Results The recombinant plasmid pGEM/16E6E7was constructed successfully.The whole HPV E6E7gene was776bp in length which was equal to that of the standard strain.Three nucleotides exchanges,i.e.,p60PROE6,p96GLUE6,p565SERE7,were found in E6E7gene.Conclusion The data suggest that there are nucleotide differences of HPV E6E7gene between HPV obtained from Beijing and that of standard sequence.