Objective To establish CT image-based, three-dimensional finite element models of healthy tibiae and plateau-fracture tibiae, and to calculate the displacement and stress distribution of the tibial models .Methods Continuous-time tomographic images of knee joints of a healthy adult and a patient with tibial plateau fractures were obtained using multi-slice spiral CT scan , and inputed to Mimics to establish three-dimensional surface mesh models of tibiae .The models underwent global meshing procedures and material properties assignment to construct finite element models of normal and plateau-fracture tibiae in ANSYS , and the newly established models were analyzed and calculated .Results In case of applied load on the tibial plateau , the peak strains of the load-contact sites in the healthy subject and the patient presented divergent directions , with peak strains on the medial tibia in the healthy subject and lateral tibia in the patient , respectively . Equivalent stress decreased gradually down the tibiae and concentrated in the one -third of the upper and middle regions in both types of tibiae .Moreover, concentration of stress was also present in the locus of the fractured tibia .The deformation displacement gradients were more evident in the healthy tibia than in the fractured tibiae .There was significant difference in overall stress distribution between the two types of tibiae .Conclusion Three-dimensional finite element models of tibiae have been established that can demonstrate the differences in biomechanical properties between healthy and plateau -fracture tibiae, which might provide reference and guidance for orthopedic regimens .

Objective:To explore the effect of continuous nursing on the nutritional status, muscle strength, physical activity function, quality of life, and degree of weakness of elderly patients.Methods:120 cases of elderly debilitated patients admitted in Beijing Friendship Hospital from June 2019 to July 2020 were selected and divided into a control group and a continuous care group according to the random number table method, with 60 cases in each group. The control group was given routine nursing, and the continuing nursing group was given continuous nursing. The cumulative frailty index (FI); the score of grip strength, timed up and go test (TUGT), short physical performance battery (SPPB); body mass index (BMI), serum albumin level and quality of life score of the two groups were compared.Results:After the intervention, the FI score, SPPB score and overall health score of the continuous nursing group were 0.25±0.05, 9.35±1.36, 68.22±6.32 respectively, and those of the control group were 0.36±0.12, 7.55±1.18, 60.56±6.38 respectively, the differences between the two groups were statistically significant ( t value was -6.554, 7.744, 6.607, P<0.05); after the intervention, the grip strength, TUGT level, BMI and serum albumin level in the continuous nursing group were (28.36±1.52) kg, (15.34±2.14) s, (21.15±0.95) kg/m 2, (36.85±3.92) g/L, respectively, while those in the control group were (25.22±1.78) kg, (19.56±2.68) s, (19.28±1.18) kg/m 2, (32.18±4.82) g/L, and the differences between the two groups were statistically significant ( t value was -9.531-10.391, P<0.05). Conclusion:Continuous nursing can effectively ameliorate the nutritional status of elderly debilitated patients, improve muscle strength, physical activity and quality of life, and delay the debilitating process.

Objective To investigate the incidence and influencing factors of geriatric syndrome (GS) in Beijing area, and to analyze the relationship between GS and Barthel Index (Barthel ADL) score and quality of life. Methods From June 2018 to December 2018, a community-based or door-to-door survey of elderly people >65 years old in some communities in Beijing was conducted. The incidence of GS and its gender distribution, age distribution, and type distribution were investigated. At the same time, GS patients were selected as the observation group, and among people without GS in physical examination, a random sampling method was used to select the control group. The general data, Barthel ADL score, and World Health Organization Quality of Life (WHOQOL-BREF) score were compared between the two groups. The relevant influencing factors of GS and its correlation with the Barthel ADL score and WHOQOL-BREF scores were analyzed. Results Among 500 elderly people in the community investigated in the present study, 97.00% of patients had ≥1 types of GS, 84.80% of patients had ≥2 types, and 70.20% of patients had ≥3 types of GS. High education level (OR=0.329, 95%CI: 0.259-0.418) and retirement pension (OR=0.727, 95%CI: 0.576-0.918) were the protective factors for the occurrence of GS. Hyperlipidemia (OR=3.176, 95%CI: 2.518-4.007), diabetes (OR=2.473, 95%CI: 1.718-3.559), coronary heart disease (OR=2.658, 95%CI:1.649-4.286), hypertension (OR=3.230, 95%CI:2.008-5.197), osteoarthropathy (OR=4.166, 95%CI: 3.008-5.769), cancer (OR=3.008, 95%CI: 1.894-4.778), acute cerebral infarction (OR=3.420, 95%CI: 2.335-5.009), and acute myocardial infarction (OR=2.112, 95%CI: 1.169-3.814) were the risk factors for GS (P<0.05). The Barthel ADL score and WHOQOL-BREF score of the observation group were lower than those of the control group (P<0.05). GS was negatively correlated with Barthel ADL and WHOQOL-BREF scores (P<0.05). Conclusion GS was common in the elderly in Beijing, and its occurrence was related to factors such as education level, retirement pension, hyperlipidemia, diabetes, coronary heart disease, hypertension, osteoarthropathy, cancer, acute cerebral infarction, and acute myocardial infarction. Strengthening the early assessment and management of GS will help improve the daily life and quality of life of the elderly.