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Objective To determine the risk factors for postoperative hyperactive-type delirium (PHTD) in elderly patients undergoing orthopedic surgery.Methods A total of 7 171 elderly patients of both sexes,aged more than or equal to 65 yr,of American Society of Anesthesiologists physical status Ⅰ-Ⅳ,who underwent orthopedic surgery from January 2008 to December 2012 in Second Affiliated Hospital of Wenzhou Medical University,were retrospectively analyzed.Data such as gender,age,preoperative electrolytes,blood glucose,hemoglobin,albumin,senile dementia and use of benzodiazepines,type of operation,anesthesia methods,operation time,intraoperative use of anticholinergic agents and benzodiazepines and hypotension (decrease more than 20％ of the baseline),and postoperative electrolyte,hemoglobin,albumin and hypotension were collected.The patients were divided into postoperative PHTD group (group PHTD) and postoperative non-PHTD group (group non-PHTD) according to whether PHTD developed within 7 days after operation.The risk factors of which P values were less than 0.05 would enter the multivariate logistic regression to stratify the risk factors for postoperative PHTD.Results Ninety-nine patients developed PHTD,and the incidence was 1.38％.The results of logistic regression analysis showed that age more than or equal to 80 yr,hip surgery and preoperative anemia were independent risk factors for postoperative PHTD (P＜0.05).Conclusion Age more than or equal to 80 yr,hip surgery and preoperative anemia are independent risk factors for postoperative PHTD in elderly patients undergoing orthopedic surgery.
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Objective To investigate the efficacy of wax therapy plus functional training in treating ankylosing spondylitis. Method One hundred patients were randomly allocated to treatment and control groups, 50 cases each. The treatment group received wax therapy plus functional training and the control group, functional training alone. One course of treatment consisted of seven days in both groups. The therapeutic effects clinical were evaluated after two course of treatment. Result Joint pain severity and morning stiffness time improved in both groups after treatment (P＜0.05 or P＜0.01) and did more in the treatment group than in the control group (P＜0.01). The total efficacy rates in the two groups were 84.0%and 66.0%, respectively;there was a statistically significant difference between the two groups (P＜0.05). Conclusion Wax therapy plus functional training is safe, reliable, convenient and easy to perform in clinical treatment of ankylosing spondylitis.