Trajectory of adherence to home rehabilitation among older adults with hip fractures and cognitive impairment

This study aimed to identify different trajectories of adherence to home rehabilitation for older adults with hip fracture and cognitive impairment, to examine associations between different adherence trajectories and postoperative recovery outcomes, and to explore the predictors of adherence trajectories. Group-based trajectory modeling showed two adherence trajectories: low (39.06%) and high (60.94%) adherence. The high adherence group had better activities of daily living (β=11.77, p<.001), instrumental activities of daily living (β=0.56, p<.01), femoral muscular strength (β=3.35, p<.01) on the fractured side and quality of life (β=-0.81, p=.02) than the low adherence group. Participants who established exercise habits (OR=6.49, p<.01) and consulted a physical therapist (OR=4.29, p=.03) during hospitalization were more likely to be in the high adherence group.     

Bone Metabolism Discrepancy in Type 2 Diabetes Mellitus Patients With and Without Non-Alcoholic Fatty Liver Disease

To explore the distribution of several bone metabolic indicators in type 2 diabetes patients (T2DM) with and without non-alcoholic fatty liver disease (NAFLD) and to preliminarily evaluate the relationship of bone metabolism with NAFLD in patients with T2DM. The hospitalized patients with T2DM were divided into the group of T2DM complicated with NAFLD and the group of T2DM alone according to the results of ultrasonic diagnosis. The general information and laboratory test data such as bone metabolism indexes of these patients were collected and the differences of the indexes between the 2 groups were compared. Furthermore, the independent influencing factors of NAFLD in patients with T2DM were analyzed. A total of 186 patients were included in the study. Compared with patients with T2DM only, patients with T2DM combined with NAFLD were characterized with younger age (p < 0.001), higher BMI (p = 0.016), ALT (p = 0.001), TG (p = 0.005), HOMA-IR (p = 0.005), and lower HDL-C (p = 0.031). Significant discrepancy of age (OR 1.052, p = 0.001), ALT (OR 0.964, p = 0.047), HOMA-IR (OR 0.801, p = 0.005), and T-PINP (OR 1.022, p = 0.008) was found using multivariate logistic regression model. Significant discrepancy of T-PINP was found in T2DM patients with and without NAFLD. Further studies are needed to explore whether T-PINP could be used as a predictor of fatty liver disease, osteoporosis, and other related complications in patients with T2DM.     

Predictors of postoperative acute kidney injury in patients undergoing hip fracture surgery: A systematic review and meta-analysis

BackgroundThe present study aimed to summarize the predictors of acute kidney injury (AKI) in patients after hip surgery.MethodsA literature search was performed using PubMed, EMBASE, Cochrane Library, and Web of Science for studies assessing the predictors of AKI after hip fracture surgery. Pooled odds ratio (OR) and mean difference (MD) of those who experienced AKI compared to those who did not were calculated for each variable. Evidence was assessed using the Newcastle–Ottawa Scale.ResultsTen studies with 34 potential factors were included in the meta-analysis. In the primary analysis, 12 factors were associated with AKI, comprising males (OR 1.25; 95% confidence interval (CI) 1.14–1.36), advanced age (MD 2.28; 95% CI 0.80–3.75), myocardial infarction (OR 1.39; 95% CI 1.18–1.63), hypertension (OR 1.46; 95% CI 1.13–1.89), diabetes (OR 1.84; 95% CI 1.40–2.42), chronic kidney disease (OR 3.66; 95% CI 2.21–6.07), hip arthroplasty (OR 1.35; 95% CI 1.22–1.50), angiotensin-converting enzyme inhibitors/angiotensin receptor blockers use (OR 2.28; 95% CI 1.68–3.08), more intraoperative blood loss (MD 44.06; 95% CI 2.88–85.24), higher preoperative blood urea nitrogen levels (MD 5.29; 95% CI 3.38–7.20), higher preoperative serum creatinine levels (MD 0.4; 95% CI 0.26–0.53), and lower preoperative estimated glomerular filtration rate (MD −19.59; 95% CI −26.92–−12.26). Another 13 factors related to AKI in individual studies were identified in the systematic review.ConclusionRelated prophylaxis strategies should be implemented in patients involved with the above-mentioned characteristics to prevent AKI after hip surgery.     

人骨髓MSC对PHA活化T细胞周期以及表型和细胞因子分泌的影响

目的研究人骨髓间充质干细胞(MSC)对T细胞周期和活化的影响,探讨MSC对T细胞增殖抑制的作用机制。方法Ficoll密度梯度离心法分离纯化人骨髓MSC,体外扩增培养3代后用于实验。应用流式细胞术分析MSC对PHA作用下T细胞周期和早期表型CD25、CD69表达的影响,ELISA法检测细胞因子水平。结果人骨髓MSC体外可使PHA刺激下的T细胞滞留于细胞周期的G0/G1期,下调活化T细胞早期表型CD25、CD69的表达,抑制IL-2、IFN-r的分泌。结论人骨髓MSC体外可通过对T细胞周期的影响抑制其活化和增殖。     

Effects of intradialytic exercise on health-related quality of life in patients undergoing maintenance haemodialysis: a systematic review and meta-analysis

Quality of Life Research - To summarize the current evidence regarding the effectiveness of intradialytic exercise (IDE) on the health-related quality of life (HRQOL) of patients undergoing...     

D-dimer for diagnosis of periprosthetic joint infection: A meta-analysis

BackgroundThe D-dimer test is easily available to detect periprosthetic joint infection (PJI). This study aimed to estimate the diagnostic accuracy of the D-dimer test in PJI diagnosis and identify possible independent factors affecting the diagnostic value of this test.MethodsMEDLINE and EMBASE databases identified literature until February 2020 that utilized the D-dimer test for PJI diagnosis. The pooled sensitivity, specificity, area under the curve (AUC), diagnostic odds ratio (DOR), positive likelihood ratio (PLR), and negative likelihood ratio (NLR) were calculated to evaluate the diagnostic accuracy of the D-dimer test. Meta-regression and subgroup analyses were performed to assess potential heterogeneity.ResultsThe databases identified 243 records, and eight studies were included in the final analysis. The pooled sensitivity and specificity of the D-dimer test for PJI diagnosis were 0.78 (95% confidence interval [CI], 0.69–0.84) and 0.74 (95% CI, 0.85–0.99), respectively. The AUCs and DORs of the D-dimer test were 0.83 (95% CI, 0.79–0.86) and 10 (95% CI, 4–24), respectively. The PLR and NLR of the D-dimer test for PJI detection were 3.0 (95% CI, 1.9–4.8) and 0.30 (95% CI, 0.20–0.47), respectively. The results of the meta-regression and subgroup analyses indicated that studies that excluded patients with hypercoagulation disorder had higher sensitivity (0.85 vs 0.86) and specificity (0.83 vs 0.62). The sensitivity of the D-dimer test also improved in studies that excluded patients with inflammatory arthritis (0.81 vs 0.75).ConclusionThe D-dimer test is a practical method for PJI diagnosis, especially in patients without history of hypercoagulation disorder and inflammatory arthritis.