Objective To investigate the clinical effectiveness of dynamic hip screw (DHS) internal fixation and proximal femoral nail (PFN) internal fixation for intertrochanteric femoral fractures.Methods One hundred and sixty-five patients with intertrochanteric femoral fractures were randomly divided into 2 groups,85 patients were in DHS group and 80 patients were in PFN group.The clinical effectiveness,index in operative procedure and complications were compared between two groups.Results The fine rate of DHS group and PFN group was 75.3％(64/85 ) and 83.8％( 67/80 ) (P ＞ 0.05 ).The indexes of function recover time,fracture healing time,amount of bleeding in operation,operation time in PFN group were significant lower than those in DHS group [(54.3 ± 11.7 ) d vs.(92.6 ± 10.5 ) d,(63.8 ± 12.2) d vs.(71.3 ± 10.6) d,(453.3 ± 50.7) ml vs.(627.5 ± 46.8) ml,(77.9 ± 25.2) min vs.( 115.7 ± 32.8) min](P＜0.05 ).The rate of short-term complications was 16.2％ (13/80) in PFN group,and 12.9 ％ ( 11/85 ) in DHS group(P ＞ 0.05 ).The rate of long-term complications was 1.2％( 1/80 ) in PEN group and 4.7％(4/85 ) in plts group (P ＜ 0.05).Conclusions As the treatment of intertrochanteric femoral fractures,PFN internal fixation has less bleeding and better efficacy,and can improve function recovery.PFN internal fixation is a better method for unstable femoral fracture.

Objective To analyze the characteristics and risk factors of preoperative deep vein thrombosis in patients with hip fracture,and provide a theoretical basis for clinical treatment and intervention.Methods 470 patients with hip fracture were chosen as the objects of study.The clinical data of the patients were retrospectively analyzed,including age,gender,injury,combined with other systemic diseases,fracture type (whether old fractures),two D-dimer level.All the patients with deep venous thrombosis of lower extremity were divided into DVT group and nonDVT group.There were 83 cases in DVT group,387 cases in non-DVT group.The factors like aboves as independent variables,presence of deep vein thrombosis as dependent variable,,preoperative deep venous thrombosis of the characteristics and risk factors were analyzed.Results 83 patients had DVT,the incidence rate was 17.7％.There were significant difference in age (40/83 vs 268/387),combined with other system diseases (57/83 vs 283/387),prevention measures (58/83 vs 196/387),D-thrombosis two dimer level (16/83 vs 122/387) of the two groups (x2 =13.712,14.836,9.876,5.313,all P ＜ 0.05).3 age ≥ 40 years,with other system diseases and injury,did not take to prevent the formation of thrombus measures were independent risk factors influencing the occurrence of DVT.Conclusion Age ≥40 years,combined with other system diseases and injury,don't take to prevent the formation of thrombus measures are independent risk factors influencing the occurrence of DVT.

Objective:To investigate dietary patterns of individuals aged ≥50 in Shanghai and analyze their association with frailty.Methods:Using data from the third wave of the Study on Global Ageing and Adult Health in Shanghai conducted between 2018 and 2019. We collected the frequency and average intake of food by the food frequency questionnaire. Factor analysis was used to extract dietary patterns, and a frailty index was constructed using the ratio of the cumulative total score of health deficits to 35 health-related variables considered. We used an ordinal multinomial logistic regression model to analyze the association between dietary patterns and frailty.Results:A total of 3 274 participants aged (67.9±9.2) years were included in the study, including 1 971 (60.2%) men and 1 303 (39.8%) women. We extracted four dietary patterns: high-protein-nuts pattern, potato-bean-vegetable-fruit pattern, poultry-meat pattern, and high-oil-salt pattern. After adjusting for confounding factors, the logistic regression analysis showed that compared with the high-oil-salt pattern, the high-protein-nuts pattern was negatively associated with the risk of higher frailty ( OR=0.743, 95% CI: 0.580-0.951). We did not find an association between dietary patterns and frailty between the different gender groups. In the age group 50-64, the high-protein-nuts and potato-bean-vegetable-fruit patterns were negatively correlated with a higher degree of frailty than the high-oil-salt pattern. In the low-level physical activity group, the high-protein-nuts pattern was negatively correlated with a higher degree of frailty than the high-oil-salt pattern ( OR=0.509, 95% CI: 0.361-0.720). However, we found no significant effect of the high-protein nuts pattern, potato-bean-vegetable-fruit pattern, and poultry-meat pattern on the risk of higher frailty compared to the high-oil-salt pattern in the moderate to high level of physical activity group. Conclusions:Compared to the high-oil-salt pattern, dietary patterns with a higher intake of high-protein nuts, potatoes, legumes, and fruits and vegetables might be associated with a lower risk of higher frailty in residents aged 50-64 years of age than with a high oil and salt pattern. At the same time, it may have a more significant protective effect in people with lower physical activity levels. It is suggested that a diet rich in high-protein foods, nuts, potatoes, beans, vegetables, and fruits may help reduce and delay the risk of frailty.

Objective:To understand the association between vitamin D level and grip strength in people aged ≥50 years in Shanghai.Methods:Data were obtained from the WHO's Study on Global Ageing and Adult Health in Shanghai during 2018-2019. Logistic regression model was used to analyze the association between vitamin D level and grip strength, and a stratified analysis was conducted for different gender, age and dairy product intake groups. Restricted cubic spline was used to evaluate the dose-response association between vitamin D level and low grip strength.Results:A total of 4 391 participants were included in the study, including 2 054 men (46.8%), with an average age of (67.02±8.81) years. And 1 421 individuals (32.4%) had low grip strength; 1 533 individuals (34.9%) had vitamin D deficiency, and 401 individuals (9.1%) had vitamin D deficiency. After adjusted for confounding factors, the logistic regression results analysis showed that individuals with vitamin D deficiency had a higher risk for low grip strength ( OR=1.41, 95% CI: 1.09-1.83). In men, after adjusting for confounding factors, vitamin D deficiency was positively associated with the risk for low grip strength ( OR=1.67, 95% CI: 1.12-2.50), but there was no significant association between vitamin D level and grip strength in women ( OR=1.30, 95% CI: 0.97-1.74). In age group 60-69 years and ≥80 years, there was significant association between vitamin D deficiency and low grip strength after adjusting for confounding factors ( OR=1.57, 95% CI: 1.05-2.35; OR=2.40, 95% CI: 1.08-5.31). In people who had daily intake of dairy product <250 ml, there was positive association between vitamin D deficiency and low grip strength, but there was no significant association in people who had daily dairy product ≥250 ml after adjusting for confounding factors. The restrictive cubic spline demonstrated that risk of low grip strength might decreased with the increase of vitamin D levels, however, the difference was not significant ( P>0.05). Conclusions:This study demonstrated that there is association between vitamin D level and grip strength. People with vitamin D deficiency have higher risk for low grip strength.

ObjectiveTo analyze the effect of frailty status on the risk of mortality in a community-based population aged 45 years and above in Shanghai with different characteristics， and to provide further basis for population-based interventions for frailty and prevention of adverse outcomes. MethodsData were derived from baseline data from the Shanghai prospective study on AGEing and adult health （2009-2010） and cohort follow-up of causes of death up to October 30， 2021. Frailty index （FI） scores were constructed from 40 variables. Those with frailty index FI≥0.2 were judged to be in a frail state， and a multifactorial Cox regression model was used to calculate the hazard ratio （HR） to evaluate the effect of frailty status on the risk of death in different age groups by gender. Socioeconomic characteristics （age， residence， marital status， education and family economic level， etc.） and health-related behaviors （smoking， alcohol consumption， fruit and vegetable intake， social participation， etc.） were included as control variables. ResultsThe study included 7 978 subjects， 777 （9.7%） of whom were in a frail state. After （11.3±1.8） years of follow-up， 1 043 （13.1%） individuals were dead， including 214 （27.5%） who were frail. The results of the multifactorial Cox regression analysis showed that the effect of frailty on the risk of death in each subgroup was in descending order of men in the middle-aged group （45‒ years） （HR=2.92， 95%CI： 1.38-6.19）， women in the low-aged elderly group （60‒ years） （HR=1.68， 95% CI： 1.08-2.60）， and women in the old-aged elderly group （≥75 years and older） （HR=1.59， 95%CI： 1.22‒2.06）. ConclusionFrailty is associated with the risk of death， and we should focus on the frailty status of men aged 45~59 years and women aged 60 years and above. Early screening and assessment of frailty status and taking appropriate preventive interventions may reduce the occurrence of adverse outcomes and premature death.