The incidence of fragility fractures of the pelvis (FFP) in elderly patients has been gradually increased. FFP has become another type of injury that threatens the lives of elderly patients because of high disability rate and mortality. The special physical condition of the elderly patients such as osteoporosis, chronic medical diseases and disability determines the specialty in diagnosis and treatment of FFP. The perioperative treatment is more difficult than other patients. FFP in elderly patients is different from the high violent mechanism of pelvis fractures in young patients, and its fracture morphology and classification are also varied. Surgical treatment is to stabilize the mechanical transmission structure of the pelvic ring, improve clinical symptoms, reduce long-term bed-related complications and restore painless daily self-care. In recent years, the surgical treatment of the pelvic fractures has made significant progress. However, there still remains controversy in treating FFP in elderly patients. The authors discuss the perioperative hot issues on FFP in elderly patients, hoping to realize the standard management of FFP.

Objective To analyze the characteristics of alcohol-related brain damage according to 18F-fluorodeoxy-glucose (18F-FDG) position emission tomography-computer tomography (PET-CT).Methods Excessive alcohol consumption patients accepted 18F-FDG PET-CT in our hospital from August 2016 to November 2018 were chosen as excessive alcohol consumption group and non-drinking patients accepted 18F-FDG PET-CT in our hospital at the same time were chosen as non-drinking group according to 1:4 ratio.The 18F-FDG PET-CT imaging data were analyzed;the characteristics of abnormal changed rate of CT sequences after stratification by age and the relations of alcohol consumption with abnormal CT sequences and PET sequences were compared between the two groups.Results A total of 52 patients with excessive alcohol consumption and 200 non-drinking patients were chosen.Among patients aged 45-59 years,the abnormal changed rate of CT sequences in the excessive alcohol consumption group was significantly higher than that in the non-drinking group (P＜0.05).In the CT sequences,33 patients in the 2 groups presented abnormalities,mainly including cerebral atrophy and lacunar infarction.In the PET sequences,62 patients in the two groups presented abnormalities,mainly manifesting as reduced metabolism level of bilateral frontal and parietal lobes.Among the 52 patients from excessive alcohol consumption group,those with abnormal CT sequences were older,had longer drinking history and had higher total drinking amount than those with normal CT sequences,and the differences were statistically significant (P＜0.05).As compared with those in patients with normal PET sequences,those with abnormal PET sequences had higher weekly and total alcohol consumption,and longer drinking history,and the differences were statistically significant (P＜0.05).Conclusion Excessive alcohol consumption is an important risk factor for structural damages in middle-aged men,which can cause a decrease of glucose metabolism level in the frontal and parietal lobes.

Objective:To explore the changes of levels of coagulation factors at acute phase (within one week) of aneurysmal subarachnoid hemorrhage (aSAH) and their relations with deep venous thrombosis (DVT).Methods:Two hundred and two aSAH patients (aSAH group), admitted to our hospitals from March 2015 to March 2019, were selected in our study, and these patients were divided into a combined DVT subgroup and a uncombined DVT subgroup according to whether they were combined with DVT on the first and third d of onset. One hundred healthy physical examiners whose age and gender matched with those of aSAH group were selected as control group; one, 3, 5, and 7 d after onset, and one d after enrolling of subjects from the control group, thromboelastogram (TEG) was used to detect the R value of TEG (TEG-R) in all subjects. One, two, 3, 4, 5, 6 and 7 d after onset, color Doppler ultrasonography was used to determine whether aSAH patients had DVT.Results:A total of 73 patients (36.14%) were combined with DVT at acute stage of aSAH; 66 were with asymptomatic thrombosis and 7 with symptomatic thrombosis; 59 were with lower extremity intermuscular vein thrombosis and 14 were with intermuscular vein thrombosis. The incidence of DVT (68/73 [93.2%]) peaked on the 1 st-3 rd d of onset. The TEG-R of patients in aSAH group was statistically lower than that of the control group on the 1 st-3 rd d of onset ( P<0.05); the TEG-R of patients in aSAH group on the 1 st-3 rd d of onset was significantly lower than that on 5 th and 7 th d of onset ( P<0.05). The TEG-R of patients in combined DVT subgroup was significantly lower than that of the uncombined DVT subgroup ( P<0.05). Conclusions:Hyperfunction of coagulation factors at acute stage of aSAH is noted within one-3 d of onset; the incidence of DVT is the highest within 3 d of onset, mainly featured as asymptomatic intermuscular venous thrombosis. Whether or not aSAH would combine with DVT is associated with hyperfunction of coagulation factors.