Nutrition risk screening and nutrition support treatment in elderly patients with hip fracturein the perioperative period / 中华骨科杂志

With the aging of the Chinese society and the population, the incidence of hip fractures in the elderly is increasing significantly. Elderly patients have various basic diseases and decreased organ compensatory capacity, which increase the risks related to surgery and anesthesia, increase the incidence of postoperative complications and mortality, and affect the recovery process of patients. Malnutrition is one of the main causes of hip fractures in elderly patients, and it is also a major factor predicting the prognosis of patients. Elderly patients with hip fractures are considered at high risk of malnutrition. Malnutrition can lead to adverse clinical outcomes, such as increased mortality and complications, prolonged hospital stays, and increased hospital costs. Elderly patients with hip fracture should be routinely screened for nutritional risk. Those with malnutrition or nutritional risk, should be given nutritional support treatment. And conduct assessments and optimizations of nutritional support treatmentby observing the prognosis indicators such as complication rate, mortality, and rehabilitation status. At present, orthopedic surgeons who are the main body of elderly hip fracture treatment do not pay enough attention to the nutritional status of patients. Many elderly hip fracture patients undergo surgery while their malnutrition status has not improved. Therefore, it is important to improve their prognosis that strengthen the perioperative nutritional management of elderly patients with hip fracture. Domestic research on the nutritional status of elderly hip fracture patients started late. Many medical institutions have not carried out routine nutritional screening and active nutritional support treatment for elderly hip fracture patients, and there is also a lack of relevant clinical research and data statistics in the nutritional support and treatment of elderly patients with hip fractures. This article describes the current research status of nutritional risk screening and nutritional support treatment for elderly patients with hip fracture at home and abroad. However, due to differences in ethnicity, lifestyle, religious culture, and eating habits in various regions, foreign research data may not be suitable for domestic patients. Therefore, this article provides a reference for the research on perioperative nutritional screening and nutritional treatment of elderly hip fracture patients, and establishes a nutritional management plan suitable for elderly hip fracture patients in China.

Effect of percutaneous coronary artery interventional therapy on unprotected left main coronary artery disease / 中国基层医药

ObjectiveTo observe the effect of percutaneous coronary intervention(PCI) treatment on unprotected left main coronary artery(ULMCA) lesion.Methods40 patients with ULMCA lesions treated with PCI were followed up for 6 to 20 months,adverse cardiovascular events (MACE) occurrence were observed.ResultsAll patients treated by immediate PCI success rate was 100.0％.There were no serious complications.There were no serious adverse cardiovascular events during hospitalization.Patients were followed up 6 ～ 20 (7 ± 2) months,4 weeks after operation,acute myocardial infarction in 1 case,CAG confirmed circumflex artery open subacute stent thrombosis,re-PCI cure; postoperative mobilization of 28 patients took CAG in 6 ～ 12 months,including the opening circumflex artery stent restenosis in 3 cases,one distal left anterior descending branch of the trunk opening and then stenosis,2 cases of restenosis in patients with angina symptoms,3 patients re-line PCI,no need to CABG patients.No deaths during followup.The overall incidence of cardiovascular adverse events rate was 12.5％ (5/40),restenosis rate was 10.0％ (4/40).ConclusionThe choice of ULMCA lesions after PCI was safe and feasible,with good short and long term prognosis.

Study on the relationship between high sensitivity C-reactive protein level, myocardial perfusion and cardiovascular events after percutaneous coronary intervention / 中国基层医药

ObjectiveTo evaluate the relationship between high sensitivity C-reactive protein(hs-CRP) level,myocardial perfusion and cardiovascular events after percutaneous coronary intervention (PCI) for ST-segment elevation acute myocardial infarction(STEMI) patients.Methods120 cases of STEMI patients received hs-CRP detection after PCI.were selected The patients were divided into the normal hs-CRP group and elevated hs-CRP group according to the hs-CRP levels.Following up for six months,the cardiovascular events of two groups were recorded.Results(1)After PCI,the percentage of TIMI myocardial perfusion grade (TMPG) 0 ～ 1 in the elevated hs-CRP group was higher than that in the normal hs-CRP group,and the percentage of TMPG 3 in the elevated hs-CRP group was lower than that in the normal hs-CRP group ( P ＜ 0.05) ; (2) Following up for six months,the incidence of cardiovascular events in the elevated hs-CRP group was significantly higher than that in the normal hs-CRP group ( P ＜0.05 ).ConclusionFor STEMI patients after PCI,the increasing of hs-CRP indicated the poorly of myocardial perfusion;the early monitoring of hs-CRP was helpful to evaluate the prognosis of acute myocardial infarction after PCI.