Hidden blood loss after intertrochanteric fractures in elderly patients and its influence on the postoperative function recovery:a random controlled trial

Objective To investigate hidden blood loss after various types of intertrochanteric fractures and to determine whether oral iron supplementations is benefical for the postoperative functional recovery in elderly patients.Methods From

Analysis on Nutritional Risk Screening and Influencing Factors of Hospitalized Patients in Central Urban Area

Rational nutritional support shall be based on nutritional screening and nutritional assessment. This study is aimed to explore nutritional risk screening and its influencing factors of hospitalized patients in central urban area. It is helpful for the early detection of problems in nutritional supports, nutrition management and the implementation of intervention measures, which will contribute a lot to improving the patient＇s poor clinical outcome. A total of three tertiary medical institutions were enrolled in this study. From October 2015 to June 2016, 1202 hospitalized patients aged ≥18 years were enrolled in Nutrition Risk Screening 2002（NRS2002） for nutritional risk screening, including 8 cases who refused to participate, 5 cases of same-day surgery and 5 cases of coma. A single-factor chi-square test was performed on 312 patients with nutritional risk and 872 hospitalized patients without nutritional risk. Logistic regression analysis was performed with univariate analysis（P〈0.05）, to investigate the incidence of nutritional risk and influencing factors. The incidence of nutritional risk was 26.35% in the inpatients, 25.90% in male and 26.84% in female, respectively. The single-factor analysis showed that the age ≥60, sleeping disorder, fasting, intraoperative bleeding, the surgery in recent month, digestive diseases, metabolic diseases and endocrine system diseases had significant effects on nutritional risk（P〈0.05）. Having considered the above-mentioned factors as independent variables and nutritional risk（Y=1, N=0） as dependent variable, logistic regression analysis revealed that the age ≥60, fasting, sleeping disorders, the surgery in recent month and digestive diseases are hazardous factors for nutritional risk. Nutritional risk exists in hospitalized patients in central urban areas. Nutritional risk screening should be conducted for inpatients. Nutritional intervention programs should be formulated in consideration of those influencing factors, which enable to reduce the nutritional risk and to promote the rehabilitation of inpatients.

Influencing factors for the disappearance of hemispatial neglect in patients during acute stroke

BACKGROUND： Some researches are proved that early sitting balance and body motor control performed on patients with stroke and hemiplegia is related to functional prognosis. For patients with hemispatial neglect （HSN） dunng acute stroke, whether HSN disappearance is related to those trainings or not should be further studied. OBJECTIVE： To analyze the correlation between HSN disappearance and related intervention of patients during acute stroke. DESIGN ： Case analysis SETTING ： Department of Neurology, First Affiliated Hospital of Guangxi Medical University PARTICIPANTS： A total of 21 patients with stroke were selected from the Department of Neurology, the First Affiliated Hospital of Guangxi Medical University from May 2005 to March 2006. Diagnosis criteria： ① Stroke was diagnosed by CT and MRI; ② Diagnosis was coincidence with HSN evaluation criteria; ③ All cases were consent. Exclusion cnteda： Patients who had poly-focus, conscious disturbance, severe amentia and hard communication combined with aphasia were excluded. A total of 12 males and 9 females were included, and the mean age was （68±10） years. Among them, 14 patients had cerebral infarction and 7 had cerebral hemorrhage. METHODS： Disappearance and existence of HSN were analyzed with HSN evaluation criteria： body agnosia, left and nght agnosia, maintenance of supine position, place of things, sitting up straight, center of line measured by eyes, and cutting 30 lines with paring method, Items mentioned below belonged to HSN disappearance： ① without body agnosia; ② without left and nght agnosia; ③ be able to maintain supine position; ④ knowing place of things; ⑤ sitting up straight by one＇s own; ⑥ be able to measure the center of line by eyes; ⑦ be able to cut 30 lines with paring method. However, only one item belonged to HSN remnant; but only one item belonged to HSN remnant. Numbers of patients who were of body agnosia, left and nght agnosia and difficult maintenance of supine position were observed during acute period （within 1 week） and recovery period （at 2 weeks after onset）. Related factors with HSN disappearance contained time of physiotherapy, duration of sitting training （sitting in bed and near bedside： heels fallen to ground, feet loaded heavies, center of gravity located at middle line, head raised towards frontage） and hospitalized time. However, control group was not set up.Measurement data were expressed as Mean＋SD and compared with ttest; enumeration data were compared with Chi-square test and Mann-Whitney Utest. P 〈 0.05 was regarded as significant difference. MAIN OUTCOME MEASURES： ① HSN disappearance; ②Numbers of body agnosia, left and right agnosia and difficult maintenance of supine position;③ Correlation among therapeutic time, sitting-training time and hospitalized time. RESULTS： All 21 patients were involved in the final analysis. ① HSN disappearance： Among 21 cases, 2 patients had right HSN disappearance, 19 left HSN disappearance, 8 （38%, 8/21） HSN disappearance, and 13 （62%, 13/21） HSN remnant. Among 8 patients of HSN disappearance, symptoms of 4 cases lasted for 7 days and that of another 4 lasted for 8-12 days. ② Evaluation of HSN disappearance at various phases： Within 1 week, 19% （4/21） HSN patients had body agnosia, left and right agnosia; during recovery period, body agnosia of 20 cases was disappeared and that of 1 case was still survived. Within 1 week, cases with difficult maintenance of supine position were 67% （13/21）, but 43% （17/21） during recovery period. ③ Analysis of effective factors on HSN disappearance and related intervention： At acute phase, HSN disappearance through sitting training lasted for （2.5±1.3） days, and remaining HSN symptoms were relieved for （5.0±3.7） days. There was significant difference between them （ x^2= 3.96, P = 0.039）. The hospitalized time of patients with HSN disappearance and HSN remnant was （17.6±10.4）, （16.2±4.9） days, but there was no significant difference between them （x^2 = 1.41, P = 0.679）. Physiotherapy time of patients with HSN disappearance and HSN remnant was （11.1 ±7.5）, （11.4±4.1 ） days, but there was no significant difference between them （x^2 = 1.05, P = 0.894）. CONCLUSION： Early sitting training may play a possible role in HSN symptom disappearance of patients with stroke.

STUDY ON ALTERATION OF WHITE BLOOD CELL DEFORMABILITY OF NIDDM PATIENTS AND THE INFLUENCING FACTORS

Microfiltration technique was used to measure white blood cell deformability (WCD) in one hundred and thirty patients with non-nsulin-dependent diabetes mellitus (NIDDM or type Ⅱ). It was found that WCD of the diabetics was significantly decreased compared with fifty controls (P<0.01) and further reduced with the rise of levels of plasma fibrinogen (Fg), plasma lipid, hemoglobin Ale (HbAlc) and fasting blood glucose (FBG), and also with the increase of age, the duration of diabetes, and the reduction of plasma magnesium concentration. It was shown that the decrease of WCD in diabetes mellitus was closely related to the degree of metabolic disturbance of the failure of diabetic control.