Objective To assess the influence of community and hospital comprehensive Health management on quality of life in aged patients with coronary artery disease (CAD) after PCI.Methods 147 patients with CAD after PCI were divided into experimental group(72 cases) and control group (75 cases) accordance with their residential community.In control group,community health education was introduced.While in experimental group,hospital and community comprehensive healthy education lasted for one year.Before and after invention,major adverse cardiac events (MACE) was recorded and generic quality of life inventory (CQOLI-74),self-rating anxiety scale (SAS),and self-rating depression scale (SDS) were carried out on the basis of giving unite guiding words.Results The observation items of the SAS(34±6 vs41 ±7,t =2.714,P ＜0.01)and SDS(35 ±7 vs 41 ±8,t =2.572,P ＜0.05)scores in experimental group were lower than those in control group.Meanwhile the body health dimension(63 ± 12 vs 59 ±11,t =5.935,P ＜0.01 ),psychological health dimension(64 ± 14 vs 58 ± 13,t =6.116,P ＜0.01 ),social function dimension(64 ± 11 vs 58 ± 10,t =6.157,P ＜0.01 ) were higher than those in control group,but the difference of the material life dimension and the MACE rate were not statistically significant( P ＞0.05).Conclusions Community and Hospital comprehensive health management is a practical and valuable strategy for palliating the depression and anxiety and improving quality of life after PCI in aged patients.

Among 172 patients with coronary artery disease (CAD),94 received community and hospital joint management (joint group) after percutaneous coronary intervention (PCI) for Ⅰ year and 78 received community-based health education only (control group) after PCI.The compliance of medication,readmission rate,times of hospitalization,medical costs,major adverse cardiac events (MACE),and general quality of life inventory (CQOLI-74),self-rating anxiety scale (SAS) and self-rating depression scale (SDS) scores were compared between two groups.The rate of readmission,times of hospitalization,medical costs,the sores of SAS and SDS in joint group were lower than those in control group(P ＜ 0.01 or 0.05).The compliance of medication,body health dimension,psychological health dimension and social function dimension in joint group were better than those in control group,but there were no differences in material life dimension and the MACE rate between two groups(P ＞ 0.05).Community and hospital joint management can reduce the readmission rate and medical burden,and improve quality of life for elderly CAD patients after PCI.

BACKGROUND:The traditional fixation method for femoral neck fractures is three hollow screws inverted triangle fixation,and the optimal fixation method for femoral neck fractures that have not achieved anatomical reduction is inconclusive. OBJECTIVE:To compare the biomechanical properties of cannulated screws internal fixation for sub-capitated femoral neck fracture with different reduction qualities based on finite element analysis. METHODS:The three-dimensional digital model was reconstructed using CT data of the proximal femur from a healthy male volunteer.The femur was modeled to sub-capitated femoral neck fractures.Fracture models were divided into anatomical reduction group,coxa vara group,and coxa valgus group.All fracture model groups were transferred using the standard group,screw depression group,and screw elevation group.A vertical downward stress of 1 400 N was applied to the femoral head at the top of the acetabulum.The displacement and stress distribution of the femur and internal fixator under different fixation methods were observed,and the maximum stress and displacement of the femur and fixator were compared. RESULTS AND CONCLUSION:(1)For anatomical reduction femoral neck fracture,the peak stress of fixation in the standard group,screw depression group and screw elevation group was 41.35,31.27 and 43.32 MPa,respectively.The maximum peak stress of the femur was found on the screw elevation group(28.58 MPa),and the standard group had the maximum peak displacement.(2)During hip varus,the stresses in the three subgroups were relatively dispersed and even.The peak stress of the femur in the standard group was the smallest,but the peak displacement was the largest.The stability of fixation might be poor.The peak displacement of the femur in the screw depression group was the smallest.(3)In the hip valgus,obvious screw stress concentration appeared in the screw depression group,and the peak displacement was the largest among the three subgroups,and an in-out-in phenomenon appeared.The peak stress of the screws in the screw elevation group was the largest among the three subgroups,but the peak displacement was the smallest.(4)It is concluded that for sub-capitated femoral neck fractures that are completely anatomically reduced,it is recommended to use standard inverted triangular nails for fixation.When the hip varus and hip valgus occur within the allowable range of the reduction standard,it is recommended to use the inverted triangle screw to fix it by rotating the corresponding angle in the same direction as the hip varus or valgus.