Background As independent and correctable risk factors, disturbances in lipid metabolism are significantly associated with type 2 diabetes mellitus (T2DM). This research investigated the mechanism underlying the lipid-regulating effects of Yam Gruel in diabetic rats. Methods First, rats in the control group were given a normal diet, and a diabetic rat model was established via the consumption of a diet that was rich in both fat and sugar for six weeks followed by the intraperitoneal injection of streptozotocin (STZ). After the model was established, the rats were divided into five distinct groups: the control group, model group, Yam Gruel (SYZ) group, metformin (MET) group, and combined group; each treatment was administered for six weeks. The fasting blood glucose (FBG), body and liver weights as well as liver index of the rats were determined. Total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), aspartic acid transaminase (AST), alanine aminotransferase (ALT), and nonesterified fatty acid (NEFA) levels were measured. Oil Red O staining was used to assess hepatic steatosis. In addition, the levels of Phospho-acetyl-CoA carboxylase (p-ACC), acetyl coenzyme A carboxylase (ACC), AMP-activated protein kinase (AMPK), Phospho-AMPK (p-AMPK), carnitine palmitoyl transferase I (CPT-1), and Malonyl-CoA decarboxylase (MLYCD) in liver tissues were measured by real-time PCR (q-PCR) and western blotting. Results After 6 weeks of treatment, Yam Gruel alone or in combination with metformin significantly reduced FBG level, liver weight and index. The concentrations of lipid indices (TG, TC, NEFA, and LDL-C), the levels of liver function indices (ALT and AST) and the degree of hepatic steatosis was improved in diabetic rats that were treated with Yam Gruel with or without metformin. Furthermore, Yam Gruel increased the protein levels of p-ACC/ACC, p-AMPK/AMPK, MLYCD, and CPT-1, which was consistent with the observed changes in gene expression. Additionally, the combination of these two agents was significantly more effective in upregulating the expression of AMPK pathway-related genes and proteins. Conclusions These results demonstrated that Yam Gruel may be a potential diet therapy for improving lipid metabolism in T2DM patients and that it may exert its effects via AMPK/ACC/CPT-1 pathway activation. In some respects, the combination of Yam Gruel and metformin exerted more benefits effects than Yam Gruel alone.

目的 汉化退休规划过程量表,并检验其信效度,为我国老年前期人群退休规划测评提供工具.方法 基于Brislin翻译模式,对退休规划过程量表进行汉化和跨文化调适,方便抽样选取 598 名老年前期人群进行问卷调查,对结果进行信度和效度分析.结果 中文版退休规划过程量表包含 4 个维度,39个条目,总量表的Cronbach α系数为 0.982、奇偶分半信度为 0.915、重测信度为 0.865.总量表的内容效度指数为 0.980,探索性因子分析提取了 4个公因子,累积方差贡献率为 74.387％;验证性因子分析显示各拟合指标均达标.各维度与量表总分的相关性为 0.816～0.930.结论 中文版退休规划过程量表具有良好的信度和效度,可作为我国老年前期人群退休规划的评估工具.

目的 探讨薯蓣粥对2型糖尿病大鼠肠道菌群及相关代谢物的影响.方法 将大鼠随机分为空白组(CTR,10 mL·kg?1·d?1生理盐水)、模型组(Model,10 mL·kg?1·d?1生理盐水)、薯蓣粥组(SYZ,12 g·kg?1·d?1)、二甲双胍组(MET,100 mg·kg?1·d?1)、联合用药组(COMB,薯蓣粥+二甲双胍,剂量同上),持续干预6周.检测大鼠体质量、空腹血糖(fasting blood glucose,FBG)和血脂水平,采用16S rRNA测序和超高效液相色谱-串联质谱法(ultra performance liquid chromatography-tandem mass spectrometry,UPLC-MS/MS)检测大鼠肠道菌群和代谢物的变化,Spearman分析构建差异菌群与差异代谢物的关联.结果 与Model组比较,SYZ、MET、COMB组显著降低FBG、总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)和低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)水平,而升高高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)水平(P<0.01).16S rRNA测序表明,薯蓣粥可以降低厚壁菌门和变形菌门丰度,增加拟杆菌门丰度,且COMB组的厚壁菌门/拟杆菌门(Firmicutes/Bacteroidetes,F/B)显著降低(P<0.05).SYZ组的优势菌属包括梭菌属(Clostridiaceae)、g_SMB53、苏黎世杆菌属(Turicibacter)、迷踪菌属(Elusimicrobiaceae)等.粪便代谢组学检测出正、负离子模式下SYZ和Model组分别有94个和60个显著性差异代谢物,Spearman分析表明肠道多种益生菌与代谢产物有很强的相关性.结论 薯蓣粥可能通过调节肠道菌群及其代谢物改善2型糖尿病大鼠糖脂代谢紊乱.

目的 探讨薯蓣粥改善2型糖尿病糖代谢和胰岛素抵抗的可能作用机制.方法 50只雄性Wistar大鼠随机分为空白组8只和造模组42只.造模组给予高脂高糖饲料喂养6周后结合腹腔注射链脲佐菌素(STZ)建立2型糖尿病大鼠模型.造模成功的32只大鼠随机分为模型组、薯蓣粥组、二甲双胍组、联合用药组,每组8只.薯蓣粥组给予薯蓣粥灌胃,其中山药含量12g/(kg·d),二甲双胍组给予盐酸二甲双胍片100 mg/(kg·d)灌胃,联合用药组上午给予薯蓣粥,下午给予盐酸二甲双胍片灌胃(剂量同上),空白组、模型组给予10 ml/ (kg·d)生理盐水灌胃,持续干预6周.检测干预前及干预第2、4、6周各组大鼠空腹血糖(FBG)水平,干预6周后各组大鼠进行口服葡萄糖耐量试验(OGTT),计算曲线下面积(AUC)、血清空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR),检测大鼠骨骼肌单磷酸腺苷酸激活蛋白激酶(AMPK)、葡萄糖转运蛋白4(GLUT-4)mRNA表达,骨骼肌AMPK、磷酸化单磷酸腺苷酸激活蛋白激酶(p-AMPK)、GLUT-4蛋白水平.结果 与模型组比较,薯蓣粥组、二甲双胍组、联合用药组干预2、4、6周AUC、FINS、HOMA-IR及干预第4、6周FBG水平均降低,p-AMPK/AMPK,GLUT-4蛋白及mRNA表达显著增加(P＜0.05).与薯蓣粥组比较,联合用药组AUC、FINS、HOMA-IR降低,GLUT-4蛋白及mRNA、AMPK mRNA表达升高,干预第4周、第6周FBG水平显著降低(P＜0.05).薯蓣粥组大鼠FBG水平从干预第2周开始至第6周逐渐降低(P＜0.05);二甲双胍组和联合用药组大鼠FBG水平从干预前至第6周逐渐降低(P＜0.05).在OGTT试验中,模型组的血糖水平未见明显回落,薯蓣粥组、二甲双胍组、联合用药组在0.5h时血糖出现高峰,1h时开始明显下降.结论 薯蓣粥能够改善2型糖尿病模型大鼠的糖代谢及胰岛素功能,且与二甲双胍联用效果更佳,其作用机制可能与调节骨骼肌的AMPK通路相关.

This paper introduced formation background，content and characteristics of Australia's comprehensive evaluation system for elderly care，summarized enlightenment of Australia's comprehensive evaluation system for elderly care to Chinese aged care work.It aimed at providing reference for construction and improvement of Chinese aged care service system.

目的 分析、了解社区老年前期人群个人层面养老准备的内涵与特点,为构建城市养老模式提供依据.方法 对10名年龄50～59岁的社区居民进行半结构式访谈,用Colaizzi分析法对访谈资料进行分析、归纳.结果 共析出7个主题:(1)越临近退休,养老准备的想法越强烈;(2)不愿给子女添麻烦,准备进行自我养老;(3)增加收入、减少开支,自主进行养老金积累;(4)自主进行健康管理,延缓身心衰老;(5)强烈的学习需求,渴望获取预防保健知识;(6)加强亲友关系维护,渴望回报支持;(7)帮助子女照顾孙辈,减少潜在养老负担.结论 城市社区老年前期人群的养老准备具有主动选择自我养老方式,提前储蓄经济、健康、情感等养老资源的特点,提示城市社区具有提升自我养老能力的良好条件以及构建自我养老模式的群众基础.

目的 "以老养老"照护模式供-求预测调查,为"实施健康中国战略"献良策.方法 在分层随机抽样的社区中采用自行设计的问卷对800名年轻老人、200名高龄老人进行调查.结果 年轻老人(供给侧)"以老养老"照护意愿总分为(70.12±10.21)分,其中参与意愿得分为(65.10±3.52)、服务意愿得分为(66.34±2.95),愿意提供服务的时间为(84.00±21.26)min/天.高龄失能老人(需求侧)需要照顾的总时间为(323.46±112.24)min/天,需要照顾的内容按所需时间从多到少分别是生活照顾、情感陪伴、医疗护理、外出.结论 从供-求预测来看,"以老养老"照护模式有实际可行的操作性,可以充分挖掘年轻老人的剩余价值,提倡老年人积极老龄化,形成老年人自我服务系统.

目的:了解福建省社区中年居民"互助养老"群体决策意愿.方法:以群体决策理论及群体决策流程为理论依据,自设"互助养老"群体决策意愿调查表,方便选取福建省各社区中40～59岁的居民550名进行入户调查.结果:福建省社区中年居民对"互助养老"接受意愿为64.18％～70.6％,提供意愿为71.64％～95.03％,愿意为邻近高龄老人提供生活照顾的时间愿意为(4.32±2.04)周.结论:福建省社区中年居民对"互助养老"提供意愿高于接受意愿,在相关政策保障下,有望成为各种养老模式中养老人力资源不足的替代与补充.

[目的]系统评价中医食疗干预对2型糖尿病患者的血糖和生存质量的影响.[方法]计算机检索PubMed、EMbase、The Cochrane Library、CNKI、CBM、WanFang Data、维普数据库,搜集中医食疗干预2型糖尿病患者的随机对照试验(RCT),检索时限均从建库至2018年9月.由2名研究者独立筛选文献、提取资料和评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析.[结果]纳入12个RCT,包括1178例患者,其中中医食疗干预组593例,常规治疗组585例.Meta分析结果显示:益气养阴法食疗法可降低2型糖尿病患者的空腹血糖[MD=-0.99,95％CI(-1.35,-0.63),P<0.00001]、2 h餐后血糖[MD=-0.73,95％CI(-1.07,-0.39),P<0.0001]和糖化血红蛋白[MD=-0.45,95％CI(-0.63,-0.26),P<0.0001]水平;中医食疗干预组仅在生存质量的生理维度优于常规治疗组[SMD=-0.45,95％CI(-0.63,-0.26),P<0.00001],在心理和社会维度方面,两组比较差异无统计学意义.[结论]现有证据表明,中医食疗干预能有效降低2型糖尿病患者的血糖水平,并在一定程度上改善患者的生活质量.今后的研究应提高研究质量,细化干预方案,并延长持续干预时间以观察远期效果.

[目的]了解城市居家老年人个人层面的养老行为特点,为构建城市养老服务体系提供依据.[方法]用现象学研究方法对8名老年人选行半结构式访谈,对所获资料进行整理、分析、提炼主题.[结果]共提炼出以下6个主题:①理解养老困境,自主选择自我养老模式;②以健康为中心,自觉维护自身健康;③老有所乐,主动交友;④老有所学,不愿与社会脱节;⑤营造良好家庭氛围,主动分担家务;⑥热心参加公益活动,希望能够建立良好循环.[结论]城市老人养老行为的特点是自我养老,表现为自主选择自我养老模式、自觉维护自身健康和主动满足老有所乐、老有所学等的直接自我养老,主动分担家务、参加社会公益活动等的间接自我养老.

[目的]评估2型糖尿病患者的健康素养水平及其影响因素,探讨健康素养对2型糖尿病患者自我管理能力和健康结局的影响,为改进糖尿病健康管理模式,提高患者自我管理能力提供理论依据.[方法]选取2016年10月～2017年5月于福建省中医药大学附属人民医院就诊的248名2型糖尿病患者,采用基本情况调查表、慢性病患者健康素养量表(HelMs)、糖尿病管理自我效能量表(C-DMSES)、糖尿病自我管理行为量表(SDSCA)进行统一问卷调查,并检测患者糖化血红蛋白(HbA1c)值.[结果]74.2％的调查对象具备慢性病健康素养,其中经济支持意愿维度的得分最高,交流互动能力维度的得分最低.女性患者、年龄越小、学历越高者健康素养总得分越高.健康素养水平与自我效能、自我管理行为呈正相关,与HbA1c呈负相关.[结论]识别健康素养低水平人群,开展健康教育,提升健康素养水平是促进2型糖尿病患者自我管理能力的有效途径.

目的 了解居家养老老人的幸福度现状并分析其影响因素,为完善老年人居家养老护理提供依据.方法 采用方便抽样的方法,抽取福州的居家老年人332名,利用老年人幸福度量表对老人进行入户调查,并采用单因素分析和多元逐步回归分析法分析其影响因素.结果 共收回321份有效问卷,321名居家养老老年人的幸福度总分为(30.82±9.62)分,子女数、健康状况与患病种类是影响老年人幸福度的重要因素(均P<0.05).结论 居家养老老年人幸福度有待提高,针对主要影响因素完善社区居家养老服务以提高老年人的幸福水平.

Objective To understand the aged desire for elderly service and its difficulty,and discuss the possibility of “aged-support-aged”mode for elderly. Methods 220 elderly persons whose age was 80 or above are selected by questionnaire.SPSS statistic 17.0 was used to carry on description and Friedman test. Results The effective questionaire return rate was 90.9%,and the home-based care was the first choice of elderly service for the aged.The desired care-givers were sons,daughters,or partners,but the real difficulty was that sons,daughters,or partners can not provide care for them.Based on elderly people’s desire and its difficulty,the“aged-support-aged”mode was welcomed by most elderly people. Conclusion“aged-support-aged”mode is an active,initiative,self-dependent and helpful mode,which was a new mode based on Chinese conditions and culture.This study was a preliminary discuss for the feasibility of “aged-support-aged”mode so as to explore how to build the model in the future study.

Absract: Objective To survey the cognition on and time for volunteer service for seniors of young people, to explore its influence factors and thus to provide objective basis for human resource management of the service for seniors. Methods With a convenient sampling, 782 young people were surveyed by a self-designed questionnaire. Results The score of cognition on volunteer service for seniors of young people was 64.54 ±9.03.Educational background and living area were main influence factors for cognition on volunteer service (all P<0.01). Young people desired to spend (33.11±15.13) d annually for the service;educational background, living area and family members were main factors exerting influence on the time for volunteer service of young people (all P<0.05). Conclusion The cognition on volunteer service of young people remains in an upper level and young people ’s time for volunteer service for seniors increase annually. Related policies and evaluation criteria should be formulated based on the main influence factors for the effective utilization and management of young people in volunteer service for the aged.

Objective To survey the prevalence of Fasting Venous Plasma Diabetes (FVPG) and Impaired Fasting Glucose (IFG) of seniors in one community in Xiamen and to provide reference for the prevention and treatment of diabetes. Methods With cluster sampling, the information of blood sugar of 766 seniors was collected and their FVPG and IFG were also investigated. Results The fasting plasma glucose of seniors was 7.37 ±2.75 mmol/L and the prevalence of FVPG and IFG was 38.3% and 24.8%. Conclusion There is high prevalence of FVPG and IFG in seniors in Xiamen and early healthy education for seniors benefits reducing the rate of diabetes mellitus.

目的 调查居家高龄老人的自理能力及照护需求情况,为提高高龄老人的晚年生活质量提供参考依据.方法 采用多阶段随机抽样的方法,抽取福建省4个市的6个县共702名居家高龄老人进行入户问卷调查.结果 居家高龄老人生活自理能力得分为(9.37±3.07)分,年龄、婚姻状况、患慢性病种类对生活自理能力有影响.居家高龄老人照护需求率从高到低依次是心理慰藉与陪伴(79.49％)、协助家务(72.27％)、医疗性照护(71.32％)、日常生活照护(37.78％).结论 居家高龄老人的生活自理能力较好,需求最高的是心理慰藉与陪伴,需求较低的是日常生活照护.

Objective:To investigate the willingness of middle and aged people on pension by elderly and time bank and analyze the related reasons,so as to provide the references for the relevant departments making the pension strategies.Methods:The convenience sampling method was used to select the middle and aged people in Fuzhou city,and the questionnaire survey was carried out.Results:The willingness of pension by elderly score was(66.12±10.79),the willingness of time bank was(4.78±2.31)weeks every year,which were in the middle level of the willingness;the multiple regression analysis showed that the willingness of pension by elderly had relationship with the educational level(P<0.05);while the willingness of time bank had relationship with age, occupation and educational level(P<0.05).Conclusion:The developing of pension by elderly model in which younger elderly took care of the older elderly was possibility and feasibility.

目的 了解本科实习护生的逆商现状,并探讨其与学业成绩的相关性,为开展逆商教育、提高逆境应对能力提供依据.方法 采用路西版逆商量表对212名本科实习护生进行问卷调查,并分析其与学业成绩的相关性.结果 护生逆商总分为(69.5±6.3)分,人数集中的分数段是50～69分和70～89分.逆商总体水平及各部分得分与护生护理专业课、人文课的平均成绩无相关性(均P＞0.05);仅护士人文修养课程成绩与才能欲望、信念与信仰及总体逆商呈正相关(均P＜0.05).结论 本科实习护生应对逆境的能力有待进一步提高,护理教育者应重视逆商教育,改革教学方法和教学内容,以加强其逆境应对能力.

目的 观察失能老人日间直接照顾内容及照顾者完成每项内容所需要的时间,为养老机构人力资源配置提供参考.方法 自设观察研究调查表,采用方便抽样,应用直接观察法对某养老院158名失能老人日间8h的直接照顾内容和完成各项照顾内容的时间进行观察记录.结果 失能老人日间直接照顾内容按所需时间的多少依次为:生活照顾(190.37±58.14)min(占39.66％)、精神慰藉(77.00±97.53)min(占16.04％)、康复护理(20.72±38.52)min(占4.31％)、医疗护理(15.06±17.60) min(占3.14％).结论 失能老人对专业技术要求较低的照顾所需时间较多,对专业技术要求较高的照顾所需护理时间较少,照护人员工作量呈现超负荷状态.管理者应根据工作量来优化人力资源配置,增加失能老人生活照顾和精神慰藉的人员配置.