Objective To investigate the incidence of contrast induced nephropathy (CIN) among different patient groups after contrast agent injection.Methods A total of 1243 patients were included in this study (male =694,female =549).The SCr level one week before and 72 hours after the CT examination and the incidence of CIN were recorded and comparison was made among groups according to sex,age,body mass index (BMI),the history of high blood pressure (HBP),diabetes mellitus (DM),chronic kidney disease (CKD),chronic heart failure (CHF),tumor,nephrotoxicity drug (NTD) usage.The frequency,type,dose and injection velocity of the contrast media(CM)were also recorded.Multivariate predictors of CIN were identified by Logistic regression using step-wise selection with entry and exit criteria of P ＜0.10,results were tabulated as odds ratios (OR) with 95％ confidence intervals (CI).Results Among 1243 consecutive patients,the incidence of CIN was 5.5％ (68/1243).Patients with a history of HBP,DM,CHF,CKD or tumor presented with higher incidence of CIN than that of controls (5.9％,51/868 vs.4.5％,17/375).CIN developed in 9 of 203 patients (4.4％,9/203) with CKD and in 59 of 1040 patients (5.7％,59/1040)without CKD.There was no significant difference between the two groups(x2 =0.51,P =0.30).In CKD (-) group,the incidence of CIN was higher in females,patients with DM and patients using LOCM than those of males,DM (-) and using low osmolality contrast medium (IOCM) (P ＜ 0.05),but there was no statistical significance in CKD (+) group.Logistic regression analysis showed that women,age ≥ 75 years,DM,LOCM,NTD,tumor,the time of using CM more than once per month were the most significant predictors of CIN (OR ＞ 1).Conclusion Women,age ≥ 75 years,LOCM,NTD,tumor,and the frequency of using CM more than once per month were more likely to develop CIN.

External fixation devices(EFDs)are generally accepted one of standard treatment methods to patients with complicated limbs fracture.The data of nursing care of 46 cases with complicated limbs fracture treated by EFDs were analyzed retrospectively.Psychological rehabilitation nursing care is very important to treatment for patients with complicated limbs fracture treated by EFDs.

Objective To observe the effects of standardized pain management on old patients with hip fracture. Methods From January, 2015 to June, 2016, 75 old patients (more than 58 years old) with hip fracture were randomly divided into control group (n=37) and observa-tion group (n=38). The control group accepted routine pain management, while the observation group accepted standardized pain manage-ment. They were assessed with Visual Analogue Score (VAS) of the most intensive pain, and their scores for satisfaction were compared. Re-sults There was no significant difference in VAS between two groups before operation (Z=0.845, P>0.05). The VAS was significantly lower in the observation group than in the control group postoperatively (Z=5.427, P<0.001). The scores of satisfaction was more in the observa-tion group than in the control group (t=21.346, P<0.001). Conclusion Standardized pain management can significantly reduce perioperative pain in old patients after hip fracture surgery, and improve the satisfaction.

Objective To explore the effect of continuous nursing intervention on limb function and nursing quality after proximal femoral nail antirotation (PFNA) internal fixation for femoral intertrochanteric fracture in the elderly. Methods From February, 2017 to November, 2018, 100 elderly patients with femoral intertrochanteric fracture who underwent PFNA internal fixation in our hospital were randomly divided into control group (n = 50) and observation group (n = 50), who accepted routine nursing and continuous nursing respectively for three months. They were assessed with Harris score and visual analogue scale for pain (VAS) before and after the intervention. The postoperative nursing effect was compared. Results The Harris score increased in both groups after the intervention (t > 45.98, P < 0.001), and increased more in the observation group than in the control group (t = 15.03, P < 0.001). The VAS score decreased in both groups after the intervention (t > 16.33, P < 0.001), and decreased more in the observation group than in the control group (t = 9.749, P < 0.001). The effect of nursing was better in the observation group than in the control group (Z = -2.272, P = 0.023). Conclusion Continuous nursing intervention can significantly improve the limb function and nursing satisfaction of elderly patients with femoral intertrochanteric fracture after PFNA.