Objective The epidemiological characteristics and risk factors of infection of non-tuberculous mycobacterial (NTM) by elderly bronchiectasis patients in Huai 'an area were analyzed, and the theoretical basis for prevention of NTM infection by elderly bronchiectasis patients in Huai 'an area was provided. Methods Among the 371 elderly patients with bronchiectasis admitted to our hospital from January 2020 to June 2022 were selected and divided into control group and NTM group according to whether they had NTM or not. The NTM strains were isolated and identified. Clinical data of patients were collected from the medical record system. Independent risk factors of NTM infection in elderly patients with ramus were analyzed by univariate analysis and logistic regression, including gender, age, previous smoking status, number of ramus, pulmonary cavities, hypoproteinemia, and CD4+T cell level. Results A total of 108 cases NTM infection (29.11%) among the 371 patients with branch enlargement. There was no statistical significance in cough, phlegm, hemoptysis and fever between the two groups (P>0.05). The proportion of chest tightness and shortness in NTM group was significantly higher than that in control group (P<0.05). Six mycobacterium species were isolated from 108 patients with NTM infection, including 57 intracellular, 22 abscess, 14 avium, 7 Kansas, 5 terrapin and 3 flavus. There were significant differences in age, sex, smoking history, place of residence, number of brandished lobes, hypoproteinemia, pulmonary cavities, and number of CD4+T lymphocytes between the two groups (P<0.05). Multivariate logistic regression analysis showed that smoking history >20 years (OR=1.692), number of branchial dilated lobe ≥5 (OR=2.671) and thin-walled cavity (OR=2.458) were independent risk factors for NTM infection in elderly patients with branchial dilated lobe (P<0.05). Conclusion Elderly patients with bronchiectasis in Huai 'an area have a high risk of NTM infection, which are mainly Mycobacterium intracellular and mycobacterium abscess. The main risk factors are the number of bronchiectasis lung ≥5, smoking history >20 years, and thin-walled cavity. Patients should actively quit smoking, improve the body immunity, and prevent NTM infection in patients with bronchiectasis.

Femoral neck fracture (FNF) in the elderly patients is currently a major health challenge worldwide, with excessive consumption of medical resources, high incidence of complications as well as suboptimal outcome and prognosis. Hip joint arthroplasty (HJA) has been the mainstream treatment for FNF in the elderly, but the conventional surgical approaches and techniques are still confronted with a series of bottlenecks such as dislocation, limp and limb length discrepancy. In recent years, direct anterior approach (DAA) for HJA (DAA-HJA) has been a major new choice in the field of joint replacement, which achieves improved clinical effectiveness of HJA in the treatment of elderly FNF, due to the fact that DAA approach involves the neuromuscular interface and accords with the idea of soft tissue retention and enhanced recovery after surgery. However, there is still a lack of unified understanding of standard technique and procedure of DAA-HJA in the treatment of elderly FNF. Therefore, relevant experts from the Hip Joint Group of Chinese Orthopedics Association of Chinese Medical Association, Youth Arthrology Group of Orthopedic Committee of PLA, Orthopedic Committee of Chongqing Medical Association, Branch of Orthopedic Surgeons of Chongqing Medical Doctor Association and Sport Medicine Committee of Chongqing Medical Association were organized to formulate the " Chinese expert consensus on the technical standard of direct anterior hip arthroplasty for elderly femoral neck fracture ( version 2023)" based on evidence-based medicine. This consensus mainly proposed 13 recommendations covering indications, surgical plans, prosthesis selections, surgical techniques and processes, and postoperative management of DAA-HJA in elderly patients with FNF, aiming to promote standardized, systematic and patient-specific diagnosis and treatment to improve the functional prognosis of the patients.