目的 评估北京地区老年髋部脆性骨折患者术后抗骨质疏松症药物(AOM)治疗现状并探讨其影响因素。方法 横断面研究。纳入2018年11月—2019年11月北京积水潭医院、北京医院、北京安贞医院、北京市昌平区医院、北京市顺义区医院、北京市房山区良乡医院收治的髋部脆性骨折患者1 963例,总结其人口学特征,并收集患者入院后30、120、365 d的临床资料,AOM治疗及健康基本补充剂使用情况。通过单因素和多因素logistic回归分析AOM治疗的影响因素。结果 1 963例老年髋部脆性骨折患者,住院时年龄65~102(79.3±7.2)岁,≥80岁患者占56.7%(1 113/1 963);男性患者占30.8%(604/1 963),女性患者占69.2%(1 359/1 963);股骨颈骨折846例,股骨粗隆间骨折1 077例,股骨粗隆下骨折40例。综合3个时间点,在髋部骨折后1年内,33.0%(648/1 963)的患者接受过AOM治疗,71.0%(1 394/1 963)的患者使用过健康基本补充剂。入院后30、120、365 d患者AOM治疗率分别为23.0%(451/1 963)、17.9%(353/1 963)、21.0%(412/1 963),健康基本补充剂使用率分别为59.0%(1 158/1 963)、45.0%(883/1 963)、38.0%(746/1 963)。单因素分析结果显示,年龄≥80岁[粗比值比(OR)=0.645,95%可信区间(CI) 0.495~0.840]、男性(粗OR=0.760,95% CI 0.581~0.996)、共管模式(粗OR=3.025,95% CI 0.973~9.405)、居住地农村(粗OR=0.523,95% CI 0.388~0.704)、AOM服用史(粗OR=7.612,95% CI 2.227~26.020)、既往骨质疏松症史(粗OR=5.065,95% CI 3.149~8.147)、骨质疏松评估(粗OR=1.379,95% CI 1.105~2.451)是AOM治疗的影响因素。多因素分析结果显示,年龄≥80岁(调整后OR=0.618,95% CI 0.488~0.781)、男性(调整后OR=0.716,95% CI 0.565~0.908)、居住地农村(调整后OR=0.492,95% CI 0.375~0.645)是AOM治疗的危险因素;共管模式(调整后OR=2.632,95% CI 1.004~6.897)、AOM服用史(调整后OR=4.870,95% CI 2.080~11.402)、既往骨质疏松症史(调整后OR=4.804,95% CI 3.253~7.096)、骨质疏松评估(调整后OR=1.393,95% CI 1.041~1.862)是AOM治疗的保护因素。结论 北京地区老年髋部脆性骨折患者的AOM治疗率偏低。年龄≥80岁、男性、在农村居住的髋部脆性骨折患者治疗率较低,可采取共管模式,术前进行骨质疏松诊断与评估,提高骨质疏松治疗率。 相似文献
Penile fracture is described as a traumatic rupture of the tunica albuginea caused by blunt injury to the erect penis. It usually occurs as a single rupture of the tunica albuginea in one of two corpora cavernosa; a rupture with urethral injury is an extremely rare condition. Although its diagnosis is usually clinical, ultrasound plays an important role in confirming diagnosis and identifying the site of the injury. Here, we presented a case of penile fracture with complete urethral injury. A 43-year-old male was admitted to the hospital because of trauma to the genital and dysuria following sexual intercourse. After admission, the patient was diagnosed with double penile fracture and complete urethral injury after the physical and B-ultrasound examinations. Emergency surgery to remove the hematoma and repair the urethra was performed. The patient recovered smoothly and was discharged on the third day after operation. After two months’ follow-up, the patient urinated smoothly and achieved an adequate erection without other complications. In this case, consistent with previous studies, emergency surgery for penile fracture is necessary and can preserve the urethral function and sexual function. In addition, there are two lesions in tunica albuginea in this case, so careful search for the penile shaft during the surgery is important to avoid the missed injuries. This report provides evidence of an uncommon and underreported clinical case. 相似文献
Based on a typical residential area, this paper studies the characteristics of pollutant concentration changes in two rainfall runoffs and the first flush effect of rainfall. In rainfall runoff, the concentrations of seven pollutants (CODMn, TN, DTN, NH3-N, TP, DTP, and PO43−) increased during the initial rainfall period and decreased in the later period. Rainfall causes the erosion of pollutants on the underlying surface so that water pollution begins when rainfall runoff occurs, and the pollution level drops over time. The seven pollutants all experience this first flush effect, of which, rainfall has the strongest scouring effect on NH3-N produced by domestic sewage. The significant excess of pollutants in rainfall runoff should be considered by management departments. In addition, the existence of the first flush effect makes it possible in theory to partially intercept rainfall runoff to control water pollution, thereby reducing the cost of pollution control.
Journal of Public Health - China bears the largest global stroke burden, yet little is known about its rates in Chongqing, southwest China. We aimed to investigate the prevalence and related risk... 相似文献
A hot topic in cone-beam CT research is exact cone-beam reconstruction from a general scanning trajectory. Particularly, a nonstandard saddle curve attracts attention, as this construct allows the continuous periodic scanning of a volume-of-interest (VOI). Here we evaluate two algorithms for reconstruction from data collected along a nonstandard saddle curve, which are in the filtered backprojection (FBP) and backprojection filtration (BPF) formats, respectively. Both the algorithms are implemented in a chord-based coordinate system. Then, a rebinning procedure is utilized to transform the reconstructed results into the natural coordinate system. The simulation results demonstrate that the FBP algorithm produces better image quality than the BPF algorithm, while both the algorithms exhibit similar noise characteristics. 相似文献