This paper mainly reviewed the status quo of physical activity in the elderly inpatients,including the level of physical activity,physical activity patterns and influencing factors,in order to provide reference for improving the physical activity level of elderly inpatients.

肌少症的发生与年龄密切相关，多见于老年人群，临床以骨骼肌肌量下降、肌力减退等特征性改变为主，可出现躯体活动障碍、认知功能障碍等常见表现，从而导致跌倒、生活质量下降等诸多不良结局[1]。研究已证实，肌少症和认知功能障碍存在密切相关性，且两者的危险因素存在一定共性，如老年、不良生活方式、代谢紊乱、机体持续炎症反应等[2,3]。肌少症患者一旦合并认知功能障碍，则可能进一步增加痴呆、跌倒甚至死亡的风险，给家庭和社会带来沉重的照护负担和精神负担。既往对于肌少症患者的护理干预多以肢体功能恢复为主导，未能对认知功能的干预给予足够重视，大多采用程式化干预，个体强化干预措施的实施力度不足，亦未能形成完整的护理干预方案，这可能导致患者认知功能的改善无法达到预期效果。鉴于此，浙江大学医学院附属第一医院在既往护理干预的基础上，制定护士主导的个体强化干预方案，以期为老年肌少症合并认知功能障碍患者生活质量的改善提供参考，现报告如下。

随着人口老龄化和高龄化,口腔衰弱这一综合征被逐渐认识和重视.通过国内外文献回顾,阐述了口腔衰弱的概念及流行情况、影响因素、评估工具,以期为我国口腔衰弱的研究发展提供参考依据.

在世界范围内,跌倒是老年人伤残、失能和死亡的重要原因,65岁及以上的社区老年人每年有1/3会发生摔倒,80岁及以上则达1/2[1].计算机决策支持系统UpToDate数据库提出当老年人发生任何新情况时,应始终牢记可能出现的药物不良事件,考虑其是否与药物有关,直到证明为其他原因引起[2].药物是跌倒的关键且可调节的因素之一,可引起老年人意识、精神、视觉、步态、平衡等方面出现异常而导致跌倒,且药物的种类、剂量、多重用药皆可增加老年人的跌倒风险[1].老年人由于机体生理功能老化、免疫力下降,易患多种慢性疾病,是服用药物种类和数量最多的群体,在美国和欧洲国家,85％的老年人至少服用1种药物,48％的老年人服用3种或更多药物[3].集束化是美国卫生保健研究所为改善护理过程和患者结局而制订的一系列有循证实践和基础的可操作结构化方法,通常有3～5种,从而为患者提供更可靠的最佳护理[4].患者教育是护理中必不可少的工作之一,有助于提高患者的自我管理、依从性和满意度.基于患者教育和认知之间、患者认知和跌倒之间的直接因果关系[5-6],本研究对浙江大学医学院附属第一医院的老年群体引入集束化的患者教育模式,有效提高了住院的老年患者对跌倒相关性药物的认知,说明其对减少老年住院患者跌倒具有重要的意义.

Objective To investigate the effect of genetic factors on the occurrence of chronic post-thoracotomy pain syndrome ( PTPS) from the perspective of genetic polymorphisms. Methods Two hun-dred patients of both sexes, of American Society of Anesthesiologists physical statusⅠ or Ⅱ, aged 18-80 yr, scheduled for elective video-assisted thoracoscopic radical lung cancer surgery, were enrolled in this study. Blood samples were taken before operation for genotype analysis of 20 SNP loci, such as rs4073 and rs3774932, after DNA extraction. Postoperative multimodal analgesia was applied to maintain the visual an-alogue scale score ＜3. All the patients were followed up for 2-4 months after operation to record the occur-rence of PTPS. The patients were divided into 2 groups according to whether PTPS occurred: non-PTPS group (group N) and PTPS group (group P). Results The incidence of PTPS was 38. 7％ after surgery, and there were 114 patients in group N and 72 cases in group P . There was significant difference in A/T al-lele and genotype frequency at interleukin-8 rs4073 site and NF-κB1 rs3774932 site between the two groups (P＜0. 05). Conclusion Interleukin-8 and NF-kappa B1 genetic polymorphisms are associated with the occurrence of PTPS.

Objective:To specify the teaching objectives of clinical nursing .Methods: Selected 85 clinical nursing interns from one certain hospital from January to October in 2015 and estimated their core competence according to China Competency Inventory of Registered Nurse .Results:According to each item, made an equal comparison among each dimension of their competency inventory and then arranged them from higher score to lower score .They were law /ethic practice (3.48 ±0.41), interpersonal relationships (3.38 ±0.51), education /consultation (3.28 ±0.32), leadership (3.28 ±0.47),pro-fessional development (3.23 ±0.29),clinical nursing ability(3.20 ±0.62), critical thinking /scientific ability (3.05 ±0.45)respectively.Conclusion:Regarding "clinical nursing ability"and"critical thinking/scientific ability"as the core point, cultivating nursing interns and stimulating their learning mo-tivation can help to raise the overall service quality of the nursing team .

小儿在全麻术后苏醒期容易发生躁动,直接影响术后恢复的质量、降低手术的满意度,一直以来是麻醉医师、外科医师和患儿家长共同关注的问题.在全麻苏醒期的镇静,既需要达到患儿安静、合作,又不延长其苏醒时间,也要保证患儿的安全,目前尚无统一的标准和相应的研究报道.