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Objective:To systematically evaluate the risk factors for postoperative pulmonary complications (PPCs) in elderly patients undergoing hip fracture surgery.Methods:PubMed, Embase, Cochrance Library, CBM, CNKI and Wanfang Databases were searched.Search strategy was subject word combined with random word.The case control and cohort studies involving the influencing factors for PPCs in elderly patients undergoing hip fracture from January 2000 to November 2020 were retrieved.PPCs included pneumonia, aspiration pneumonitis, pulmonary infections, respiratory failure, atelectasis and pleural effusion, etc.The quality of literatures was assessed by using Newcastle-Ottawa Scale, data were extracted and analysis was performed using RevMan5.3 software.Results:A total of 18 studies were finally enrolled, including 15 case control studies and 3 cohort studies.The results of analysis showed that the advanced age, male, history of smoking, low body mass index, history of cerebrovascular accident, history of chronic obstructive pulmonary disease, history of diabetes, preoperative albumin concentration<35 g/L, preoperative hemoglobin concentration<120 g/L, American Society of Anesthesiologists Physical Status classification≥Ⅲ, operation delay≥48 h and general anesthesia were the risk factors for PPCs ( P<0.05). Conclusions:There are numerous risk factors for PPCs in elderly patients undergoing hip fracture surgery, and advanced age, male, history of smoking, low body mass index, history of cerebrovascular accident, history of chronic obstructive pulmonary disease, history of diabetes, preoperative albumin concentration<35 g/L, preoperative hemoglobin concentration<120 g/L, American Society of Anesthesiologists Physical Status classification≥Ⅲ, operation delay≥48 h and general anesthesia are the risk factors for PPCs in elderly patients undergoing hip fracture surgery.
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Objective:To explore the correlation between middle cerebral artery (MCA) pulsatility index (PI) and total magnetic resonance imaging (MRI) burden in elderly patients with cerebral small vessel diseases (CSVD).Methods:A total of 203 CSVD inpatients aged 60 years and above who were hospitalized in the Department of Neurology of Hebei General Hospital from March 2017 to December 2020 were enrolled. The clinical data, transcranial Doppler ultrasound parameters and brain MRI data were collected. According to the total burden score, the patients were divided into low burden group (0-1 point) and high burden group (2-4 points). Univariate and multivariate Logistic regression analysis was used to analyze the correlation between MCA PI and total MRI burden in the elderly patients with CSVD. Subsequently, the receiver operating characteristic curve was used to evaluate the value of MCA PI for predicting the high MRI burden of CSVD in the elderly.Results:Hypertension ( OR=2.569, 95% CI 1.068-6.182, P=0.035), systolic blood pressure ( OR=1.033, 95% CI 1.006-1.061, P=0.016), creatinine ( OR=1.044, 95% CI 1.009-1.079, P=0.013) and MCA PI ( OR=1.125, 95% CI 1.087-1.166, P<0.001) were independently correlated with the increasing total MRI burden in the elderly patients with CSVD. Spearman rank correlation analysis revealed that there was strong and positive correlation between MCA PI and high MRI burden in the elderly patients with CSVD ( r=0.65, P<0.001). The analysis showed that when the cut-off for MCA PI was 1.11, it could identify high MRI burden of CSVD in the elderly. The area under the curve was 0.908 (95% CI 0.864-0.953, P<0.001). The sensitivity and specificity were 0.852 and 0.880, respectively. The positive predictive value was 92.38%, and the negative predictive value was 77.70%. Conclusion:The MCA PI is positively correlated with total MRI burden in the elderly patients with CSVD, and has a higher value in predicting the total MRI burden in the elderly CSVD patients, which probably bring brighter prospects for its clinical application.
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White matter hyperintensity refers to spots or patches changes of white matter in the paraventricular or subcortical regions, which is closely related to the occurrence of cognitive impairment and dementia. This article reviews the neuroimaging examination and imaging evaluation scale of white matter hyperintensity.
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OBJECTIVE: To review the development and mechanism of platelet-rich plasma (PRP) and the unsolved problems so as to provide reference for the clinical application of PRP.DATA SOURCES: Articles on effects of platelet-rich plasma on bone repair are searched from Medline between January 1995 and June 2005 on computer. The key words were platelet rich plasma, bone, and repair.Meanwhile, the same search was conducted to determine the correlated articles during January 1998 to June 2005 from Wanfang database with key words of platelet-rich plasma, bone and repair in Chinese.STUDY SELECTION: Literatures at home and abroad on the PRP and bone repair were chosen; Non-randomized controlled literatures were included.DATA EXTRACTION: Totally 40 out of 49 reports related to PRP and bone repair met the criteria. 9 reports were excluded due to the repeated same research. The rest 40 reports were sorted out and conducted literature review.DATA SYNTHESIS: Platelet-rich plasma was originally used in clinic to repair mandibular defect in 1998, by adding PRP to grafts with a radiographic maturation rate 1.62 to 2.16 times that of grafts without PRP. Up to now, PRP has been used in many medical areas to accelerate tissue healing due to its advantages of safety, simple, low-cost. But some problems still remain to be studied and solved.CONCLUSION: PRP includes many sorts of growth factors and has been proved to be beneficial to the maturation of both bone tissue and soft tissues. PRP is autologous and can be produced easily and safely from autologous blood, without the concerns of transmissions and immunological rejection of various diseases.