Objective:To explore the effectiveness of percutaneous coronary rotational atherectomyin the interventional treatment of severe coronary artery calcification lesions.Methods:A total of 107 patients with severe coronary artery calcification requiring percutaneous coronary intervention (PCI) admitted to Gaotang County Hospital affiliated with Jining Medical College from April 2020 to March 2022 were selected. Among them, 53 patients were treated with PCI (control group), and 54 patients were treated with percutaneous coronary rotational atherectomy in addition (observation group). The intervention related indicators, cardiac function, and the occurrence of complications and major cardiovascular adverse events were observed. T test was used for comparison of measurement data, and χ2 test was used for comparison of counting data.Results:The differences in balloon dosage and pre dilation frequency between the two groups were statistically significant (t=3.969, 5.625; P < 0.01). After treatment, left ventricular end diastolic volume and left ventricular end systolic volume of both groups decreased compared with before treatment, while left ventricular ejection fraction increased. However, there was no statistically significant difference between the two groups before and after treatment (P > 0.05). There was no statistically significant difference in the incidence of complications and major cardiovascular adverse events between the two groups (χ2=0.976, 0.853; P > 0.05).Conclusion:For patients with severe coronary artery calcification undergoing PCI, the use of coronary rotational atherectomy has good interventional effects and safety.
Objective:To explore the effect of family empowerment intervention on family nursing management quality and prognosis of elderly stroke patients.Methods:A total of 646 elderly stroke patients who were treated in Linyi People's Hospital from January 2019 to December 2021 were selected and divided into an intervention group (320 cases) and a control group (326 cases) based on the time of admission. The intervention group received routine nursing and family empowerment intervention, while the control group received routine nursing only. The caregivers' awareness rate of stroke knowledge, nursing operation qualification rate, and nursing job satisfaction were used to assess the family nursing quality; The National Institutes of Health Stroke Scale and the modified Barthel index were used to assess patients' stroke rehabilitation self-efficacy and ability of daily life. T test and repeated measurement analysis of variance were used for comparison of measurement data, and χ2 test was used for comparison of counting data.Results:The hospitalization time in the intervention group was significantly shorter than that in the control group (t=1.887, P < 0.01). Before and after the intervention, the stroke knowledge awareness rate, nursing operation qualification rate, nursing job satisfaction, self-efficacy score and modified Barthel index score of the two groups were compared, and there were inter-group effects (F=72.280, 22.361, 96.442, 31.514, 79.552; P < 0.01). There was no significant difference in all indexes between the two groups before intervention (P > 0.05), and after 1, 3, and 6 months of intervention, the indicators in the intervention group were significantly better than those in the control group (P < 0.01). The incidence of complications, recurrence rate of stroke, and mortality in the intervention group were significantly lower than those in the control group (χ2=26.635, 12.407, 18.122; P < 0.01).Conclusion:Family empowerment intervention can significantly improve the quality of family nursing management and prognosis of elderly stroke patients, reduce the incidence of adverse events, which is worth of clinical promotion.
Objective:To investigate the predictive value of neutrophil/lymphocyte ratio (NLR) and C-reactive protein/lymphocyte ratio (CLR) for 28-day mortality in elderly patients with sepsis.Methods:A total of 330 elderly patients with sepsis admitted to Zhejiang Hospital from January 2017 to January 2021 were selected, and their general information, clinical examination indicators, and survival after 28 days of follow-up were collected. Univariate analysis (including t test, rank sum test and χ2 test) was used to compare various indicators of patients in the survival group and the death group. Logistic regression was used to analyze independent risk factors of death at 28 days. Receiver operating characteristic (ROC) curve was drawn, and area under the curve (AUC) was used to evaluate the prognostic value of relevant indicators.Results:There were 177 patients in the survival group and 153 in the death group. There were statistically significant differences in acutephysiologyandchron-icheadlthevaluation (APACHEⅡ) score, albumin, proportion of renal dysfunction, procalcitonin (PCT), C-reactive protein, lactic acid, NLR, CLR, and C-reactive protein/albumin ratio (CAR) between the two groups (t=-19.345, 2.765; χ2=4.905; Z=-7.672, -8.118, -5.826, -7.209, -9.992, -8.354; P < 0.05 or P < 0.01). NLR, CLR, PCT, lactic acid and APACHEⅡ scores were independent risk factors for 28-day prognosis in elderly patients with sepsis (P < 0.05 or P < 0.01). The predictive value of CLR was significantly higher than that of NLR and PCT (95%CI=0.036-0.142, 0.005-0.144; P < 0.05 or P < 0.01), and the predictive value of CLR+PCT was significantly higher than that of NLR+PCT (95%CI=0.006-0.092, P < 0.05).Conclusion:For prediction of short-term prognosis in elderly sepsis patients, CLR has an advantage over PCT, and the combination of the two has greater predictive value.
Objective:To observe the clinical efficacy of multidisciplinary team (MDT) co-management in hip replacement treatment for elderly patients with hip fractures and renal failure undergoing dialysis.Methods:A total of 62 elderly patients with hip fractures and renal failure require hemodialysis who underwent hip replacement treatment in Nanjing Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine from August 2016 to August 2021 were selected. Among them, 30 patients received conventional treatment mode (routine group) and 32 patients received multidisciplinary collaborative treatment mode (cooperative group). The preoperative hospitalization time, operation time, postoperative time to the ground, total hospitalization time, Harris score, Functional Independence Scale (FEM) score, and postoperative complications were compared between the two groups. T test and repeated measurement analysis of variance were used for comparison of measurement data, and χ2 test was used for comparison of counting data.Results:Compared with the routine group, the preoperative hospitalization time, postoperative ground time, and total hospitalization time were shortened in the cooperative group (t=4.203, 10.052, 4.295; P < 0.01). There was no difference between the two groups in postoperative Harris score and FIM score (F=1.125, 3.146; P > 0.05). One month and one year after surgery, the number of complications in the collaborative group decreased compared with the routine group (Z=-1.980, 2.890; P < 0.05).Conclusion:MDT co-management can accelerate postoperative functional recovery, and improve quality of life in elderly hip fracture patients with renal failure undergoing joint replacement treatment.
Objective:To explore the causes of eye pain in elderly cataract patients after phacoemulsification.Methods:Ninety elderly cataract patients who underwent phacoemulsification surgery at Ji'nan Second People's Hospital from February 2017 to October 2020 were selected. After the surgery, visual analogue scale was used to evaluate eye pain and analyze its causes.Results:Twenty-eight patients reported eye pain after surgery, with a pain incidence rate of 31.11%. There were 20 cases with mild pain (71.43%), 6 cases with moderate pain (21.43%), and 2 cases with severe pain (7.14%). There were 5 cases of postoperative eye pain caused by surgical related factors (17.86%), 8 cases of postoperative eye pain caused by patients' own factors (28.57%), and 15 cases of postoperative eye pain caused by psychological factors (53.57%).Conclusion:Eye pain in elderly cataract patients after phacoemulsification is affected by many factors. In order to reduce the occurrence of postoperative eye pain, psychological intervention, health education and pain management should be strengthened in clinic, and the surgeon should continuously improve surgical skills.
Objective:To compare the clinical efficacy of unilateral and bilateral percutaneous vertebroplasty (PVP) in the treatment of Kummell disease.Methods:A total of 47 patients with single-level thoracolumbar Kummell's disease (stageⅡ) without neurological symptoms in the Second Hospital of Shanxi Medical University during January 2016 and July 2019 were selected. Among them, 24 cases were treated with unilateral pedicle surgery (unilateral PVP group), and 23 cases were treated with bilateral pedicle surgery (bilateral PVP group). Oswestry disability index (ODI), Roland-Morris disability questionnaire (RDQ) and visual analogue scale (VAS) were used for clinical evaluation before operation, 3 months and 12 months after operation. The vertebral height and kyphosis angle were measured on preoperative and postoperative X-ray films. The total operation time and the incidence of bone cement leakage in each group were recorded. T test and repeated measurement analysis of variance were used for comparison of measurement data, and χ2 test was used for comparison of counting data.Results:There were no intergroup difference in the comparison of ODI, RDQ, and VAS scores before and after surgery (F=0.743, 2.117, 0.429; P > 0.05). Compared with bilateral PVP group, the operation time of unilateral PVP group was significantly shortened (t=0.010, P < 0.01). There were no significant differences in the correction of spinal deformity and complications between the two groups.Conclusion:Unilateral PVP and bilateral PVP have similar efficacy in the treatment of Kummell's disease, but unilateral PVP can shorten the operation time, so can be used as the first choice of surgical method for Kummell's disease.
Objective:To construct a scientific and practical group activity program for senile dementia.Methods:A systematic search was conducted to identify the literature on group activities of senile dementia in the Registered Nurses Association of Ontario, guidelines from National Institute for Health and Care Excellence, JBI EBP database, Cochrane Library, PubMed, Embase, China National Knowledge Infrastructure, WanFang Data until January 1, 2022. Two researchers independently evaluated the methodological quality of the included literature. According to the retrieved literature, the first draft of group activity program was made. Two rounds of Delphi expert correspondence were conducted with experts from medical, nursing, rehabilitation and community care fields, and evaluated by expert authority coefficient and coordination coefficient, finally, the content index system of group activity program for senile dementia was established.Results:The recovery rates of the two rounds of expert consultation questionnaires were 94.44% and 94.74%, the degree of authority were 0.79 and 0.82, the coordination coefficients of importance were 0.149 and 0.184, and the coordination coefficients of feasibility were 0.130 and 0.366, all P < 0.01. Finally, the group activities program for senile dementia consists of 4 first-class indicators, 15 second-class indicators and 38 third-class indicators.Conclusion:The group activity program for senile dementia is scientific and feasible, and can be promoted and implemented within institutions with qualification and professional capabilitie at different levels.
Objective:To investigate the effect of individualized nutritional support on respiratory rehabilitation therapy for elderly patients with advanced lung cancer.Methods:A total of 60 elderly patients with stageⅣ lung cancer admitted to the General Hospital of Southern Theater Command of the Chinese People's Liberation Army from May 2020 to July 2021 were enrolled in the study. According to the random number table method, the patients were divided into control group and observation group, with 30 patients in each group. The control group received routine care and respiratory rehabilitation therapy, while the observation group received individualized nutritional support in addition. All patients received 3 weeks of continuous intervention. The lung function, exercise tolerance, nutritional index, immune fuction, and quality of life of the two groups before and after intervention were compared. T test was used to compare each index before and after intervention.Results:After intervention, the forced vital capacity, forced expiratory volume in one second, and total lung capacity of both groups increased, residual volume decreased, and 6-min walk distance increased in both groups, especially in the observation group (t=2.869, 2.759, 2.236, 6.033, 3.351; P < 0.05 or P < 0.01); the body mass index, serum albumin, prealbumin, and immunoglobulin G/A/M levels were improved in both groups, and the improvements in the observation group were more significant (t=2.110, 2.465, 2.271, 5.618, 2.467, 4.695; P < 0.05 or P < 0.01); the emotional function, role function, physical function, cognitive function and social function increased in both groups, and the observation group had higher scores than control group (t=4.750, 2.577, 2.689, 4.304, 2.427; P < 0.05 or P < 0.01).Conclusion:Individualized nutritional support can significantly improve the lung function, exercise tolerance, nutritional status, and immune function of elderly patients with advanced lung cancer undergoing respiratory rehabilitation, thus improving their quality of life.
Objective:To construct a scoring system for assessing intrinsic capacity in older adults, thus to provide scientific guidance on defining the intrinsic capacity among older adults.Methods:Adopting the theoretical concepts from previous research on healthy aging, the primary set of indexes is constructed through literature analysis. And the content of intrinsic capacity evaluation index system for older adults is determined through Delphi experts consultation. The weighted values of the evaluation indexes are established by the analytic hierarchy process.Results:Eighteen experts were selected and invited for correspondence consultation. The effective recovery rates of the questionnaires were 88.89% and 93.75%, the expert authority coefficients were 0.882 and 0.900, and the Kendall harmony coefficients were 0.225 and 0.227. After a two-rounded Delphi experts consultation involving 18 experts, an intrinsic capacity evaluation index system for older adults was established, including five first level indexes and 14 secondary indexes. The weights of primary indicators were as follows: cognitive function (0.310), mobility (0.184), vision and hearing (0.183), psycho-social (0.172), and vitality (0.151). The corresponding secondary indicators of cognitive function were time and spatial orientation (0.116), memory (0.072), language ability (0.064), calculate ability (0.058). The corresponding secondary indicators of vision and hearing were visual impairment (0.091), hearing impairment (0.091).The weights of the secondary indicators corresponding to mobility were movement restriction (0.107) and fall risk (0.076). The corresponding secondary index weights of psycho-social were subjective perceived social isolation (0.067), loss of interest (0.056), and depressed (0.050). The corresponding secondary indicators of vitality were malnutrition (0.062), oral frailty (0.050), loss of appetite (0.040).Conclusion:A comprehensive evaluation index for the intrinsic capacity of the older adults was established, which provides the scheme for comprehensive evaluation of the intrinsic capacity of the older adults, and provides possibility for early intervention based on comprehensive evaluation in the older adults.
Objective:To investigate the value of heparin binding protein (HBP) level in early diagnosis of disease severity and prognosis prediction in elderly sepsis patients.Methods:A multi-center prospective study was used. Patients admitted to the intensive care unit (ICU) of 18 tertiary A hospitals across the country during July 2014 and March 2015 were enrolled in the study. Once patients were included in the study, they received fluid resuscitation and active treatment immediately according to the guidelines as needed. Venous blood was collected on the day of enrollment and 24 hours after enrollment, and the levels of plasma HBP, procalcitonin (PCT), and C-reactive protein (CRP) were detected. According to the sepsis 2.0 diagnostic criteria, the patients were divided into sepsis group, severe sepsis group, septic shock group and non-infectious systemic inflammatory response syndrome (SIRS) group. The gender, age, underlying diseases, acute physiology and chronic health scoreⅡ (APACHEⅡ) score, 28-day mortality, and the levels of HBP, PCT, CRP were compared among the groups. The correlation between HBP, PCT, CRP levels and APACHEⅡ score were analyzed using Spearman non parametric correlation coefficient, and the predictive value of HBP for the prognosis of patients was evaluated using survival function.Results:A total of 295 patients were included in the study, including 124 patients with sepsis, 58 patients with severe sepsis, 73 patients with septic shock, and 40 patients with SIRS. There were differences in APACHEⅡ scores, baseline HBP, PCT and CRP levels among the groups (F=3.841; H=14.470, 44.298, 14.778; P < 0.01), and only HBP was correlated with APACHEⅡscore on the day after enrollment (r=-0.196, P < 0.05). The 28-day mortality rates in the SIRS group, sepsis group, severe sepsis group, and septic shock group were 2.50%, 2.42%, 18.97%, and 20.55%, respectively, and the survival rate of patients with HBP≥15 μg/L was higher (χ2=0.020, P < 0.05).Conclusion:The level of HBP is correlated with the severity of disease in elderly sepsis patients. Baseline HBP can be used to predict the prognosis, and patients with baseline HBP >15 ng/mL have an increased risk of death.
Objective:To systematically evaluate the efficacy of dexmedetomidine in elderly patients undergoing cardiac surgery.Methods:Clinical controlled trials in PubMed, Embase, Ovid, Web of Science, CNKI, Wanfang database and VIP database were retrieved. Two researchers independently extracted data and evaluated the quality of the included literature. A meta-analysis was performed on the extracted data by RevMan 5.3.Results:A total of 2 072 patients in 10 studies were included. The results of the meta-analysis showed that the incidence of postoperative delirium and the operative mortality in dexmedetomidine group were significantly lower than that in control group (RR=0.77, 0.40; 95%CI: 0.63-0.95, 0.17-0.91; Z=2.46, 2.18; P < 0.05), and the postoperative mechanical ventilation time was shorter than that in control group (WMD=-2.07, 95%CI:-2.73--1.41, Z=6.13, P < 0.01). However, there were no significant differences in postoperative ICU stay, postoperative hypotension and postoperative bradycardia between the two groups (P > 0.05).Conclusion:Dexmedetomidine can reduce the incidence of postoperative delirium, postoperative mortality and mechanical ventilation time in elderly cardiac surgery patients, but has no significant effect on postoperative ICU stay, incidence of postoperative hypotension, and postoperative bradycardia.
Objective:To evaluate the effect of modified phacoemulsification for high myopia complicated with cataract.Methods:A total of 66 patients with high myopia complicated with cataract who visited the Harbin Aier Eye Hospital from March 2019 to April 2020 were selected and divided into control group and observation group by random number table method, with 33 cases in each group. The control group received conventional phacoemulsification, while the observation group received modified phacoemulsification. The visual acuity recovery, corneal endothelial cell count before and after surgery, and postoperative complications of the two groups were compared. χ2 test was used for comparison of counting data, t test and repeated measurement analysis of variance were used for comparison of measurement data.Results:After 6 months, the proportion of patients in the observation group and the control group whose visual acuity recovered to 0.5 or above was 93.94% and 72.73%, respectively. The observation group was significantly better than the control group (χ2=5.346, P < 0.05). After surgery, there was a statistically significant difference in the corneal endothelial cell count between the two groups of patients (F=11.460, P < 0.05), and the corneal endothelial cell count in the observation group was significantly lower than that in the control group at 1 and 3 months after surgery (P < 0.01). After surgery, The incidence of postoperative complications in the observation group was significantly lower than that in the control group (6.06% vs. 33.3%; χ2=7.759, P < 0.01).Conclusion:Modified phacoemulsification can effectively improve the visual acuity of patients with high myopia and cataract, protect corneal endothelial cells, reduce postoperative complications, which is worth promoting in clinic.
新型冠状病毒感染（coronavirus disease 2019, COVID-19）是一种新发急性感染性疾病，人群普遍易感，以发热、乏力、干咳为主要表现，重症/危重症患者在发病早期即可出现呼吸困难和（或）低氧血症，快速进展为急性呼吸窘迫综合征（acute respiratory distress syndrome, ARDS）、脓毒症休克、难以纠正的代谢性酸中毒和出凝血功能障碍及多器官功能衰竭等。高龄（>60岁）及合并基础疾病是造成重型/危重型新冠病毒感染患者高病死率的重要原因[1]。如何降低重型/危重型患者的病死率，是其救治的重点和难点。我们对1例老年重型COVID-19患者进行血浆吸附治疗，在阻止ARDS进展方面取得良好的效果，现将诊治过程和体会报道如下。
Objective:To investigate the clinical value of MRI apparent diffusion coeffecient (ADC) and intravoxel incoherent motion (IVIM) parameters in differential diagnosis of pulmonary nodule properties in middle-and-old age patients.Methods:From January 2019 to January 2022, 85 middle-and-old age patients with newly diagnosed single focal pulmonary nodules were selected from the People's Hospital of Boxing County, including 53 malignant nodules (malignant nodules group) and 32 benign nodules (benign nodules group). All patients underwent single b value, multiple b value magnetic resonance diffusion-weighted imaging (DWI-MRI) and conventional MRI scans. T test was used to compare ADC, standard ADC, voxel true water diffusion (D), perfusion fraction and MRI time-signal intensity curve (TIC) between the two groups. Receiver operating characteristic curve (ROC curve) was used to evaluate the diagnostic efficiency of each parameter in diagnosing pulmonary nodule properties.Results:The ADC, standard ADC and D values in the malignant nodules group were lower than those in the benign nodules group, and the perfusion fraction was higher than that in the benign nodules group, with statistical significance (t=6.441, 10.555, 12.181, 7.721, P < 0.01). TIC type III in the malignant nodules group was significantly higher than that in the benign nodules group, and TIC type I was significantly lower than that in the benign nodules group (χ2=21.175, P < 0.01). With surgical/pathological biopsy as the gold standard, the area under the curve of ADC, standard ADC, D value and perfusion fraction for differential diagnosis of benign and malignant pulmonary nodules were 0.892, 0.928, 0.935 and 0.924, respectively, and the sensitivities and specificities were high.Conclusion:ADC and IVIM parameters have good diagnostic value in differentiating benign and malignant pulmonary nodules in middle-and-old age patients.
主动脉瓣疾病是常见的心脏瓣膜病，严重危害患者的身体健康，大大降低了患者的生活质量，使该类人群的预期寿命明显缩短，部分严重病变的预后甚至要比转移性癌症更差。由于传统手术疗效并不理想，因此我们对收治的1例老年重度心力衰竭患者实施顺向导丝结合导丝抓捕技术行急症经颈动脉经导管主动脉瓣置换术，现报道如下。
Patients with critical illness are at the high risk of venous thromboembolism (VTE), and the older the patient, the higher the incidence of VTE. Despite its poor prognosis, VTE is preventable. At present, although there are many consensus or guidelines on the prevention of VTE at home and abroad, there is still a lack of consensus or guidelines for the prevention of VTE in elderly patients with critical illness. In order to standardize the prevention of VTE in elderly patients with critical illness in China, Expert consensus on the prevention of venous thromboembolism for elderly patients with critical illness in China (2023) was developed by Critical Care Medicine Division of Chinese Geriatric Society and Zhejiang Provincial Clinical Research Center for Critical Care Medicine. Members of the working group consulted relevant domestic and foreign guidelines, integrated evidence-based medical evidence and clinical experience, formed the draft consensus, submitted it to the expert group for discussion for many times, revised it for many times, and finally sent it to the expert group in the form of electronic questionnaire, and the expert gave a comprehensive score according to the theoretical basis, scientific nature and feasibility of the consensus items. The recommendation strength of each item was determined, and 21 recommendations were finally formed to provide reference for the prevention of VTE in elderly patients with critical illness.
人口老龄化是全球面临的重要社会问题之一，据统计2019年世界范围内65岁以上的老年人群将达到7亿人，其中我国已成为全球老年人口规模最大的国家[1]。2021年第七次全国人口普查65岁及以上老年人口达1.9亿，占总人口的13.5%。根据中国发展研究基金会发布的《中国发展报告2020：中国人口老龄化的发展趋势和政策》，2035到2050年将是人口老龄化的高峰阶段，据估计2050年65岁及以上老年人口将达3.8亿，占总人口近30%[2]。随着老龄化的日趋严重，老年人群骨质疏松的发病率逐年升高。2015年，国际骨质疏松基金会公布，6个欧洲国家女性和男性的骨质疏松患病率已经分别达到22%和7%，而在发展中国家，如中国，2018年的骨质疏松患病率已经高达24%，而65岁以上老年人群的患病率已经超过60%[3,4]。
Objective:To investigate the myocardial protection effect of erector spinae plane block for preemptive analgesia in elderly patients undergoing thoracoscopic radical surgery for lung cancer.Methods:A total of 40 elderly patients who underwent thoracoscopic radical resection of lung cancer in Huizhou Central People's Hospital were selected. According to the wishes of patients, 19 patients were treated with ESPB combined with general anesthesia (observation group), and the other 21 patients were treated with simple general anesthesia (control group). Cardiac troponinⅠ(cTnⅠ), heart-type fatty acid binding protein (H-FABP) and creatine kinase isoenzyme (CK-MB) were detected at time points before induction (T0), at the beginning of surgery (T1), at the end of surgery (T2) and at 4 h after surgery (T3), and record the mean artery pressure (MAP) and heart rate at each time point. T test was used for comparison between groups, and repeated ANOVA was used for repeated measurement data.Results:The differences of MAP, heart rate, cTnⅠ, H-FABP and CK-MB between the two groups showed inter group effect, time effect and interaction effect (MAP: F=24.021, 33.512, 9.184, heart rate: F=10.340, 46.992, 3.494, cTnⅠ: F=5.354, 691.994, 64.177, H-FABP: F=7.906, 14.067, 11.560, CK-MB: F=15.926, 84.106, 4.116, P < 0.05 or P < 0.01). Compared with T0, MAP, heart rate, H-FABP and CK-MB showed significant changes at T1, T2 and T3 (P < 0.05), and cTnⅠ showed significant changes at T2 and T3 (P < 0.05).Conclusion:The application of ESPB in advanced analgesia during thoracoscopic radical operation for elderly patients with lung cancer can significantly reduce the level of myocardial injury related factors and play a protective role in the myocardium.
Objective:To observe the efficacy of Gushukang granules combined with alendronate sodium in the treatment of diabetic osteoporosis (DOP).Methods:Eighty patients with DOP admitted to the 903 Hospital of the Chinese PLA Joint Support Force during July 2018 and July 2021 were randomly divided into control group and observation group, with 40 cases in each group. The control group was given alendronate sodium and calcium carbonate D3 tablets, and the observation group was treated with Gushukang in addition. After 6 months of continuous treatment, the visual analogue score (VAS), quality of life Oswestry disability index (ODI) score, the bone mineral density (BMD), the biochemical indexes related to bone metabolism, diabetes control indexes and the occurrence of adverse drug reactions were compared between two groups. Measurement data and count data were compared between groups using t test or χ2 test, respectively.Results:The total effective rate of the observation group was significantly higher than that of the control group (χ2=8.793, P < 0.05). The incidence of adverse reactions in the observation group was significantly lower than that in the control group (χ2=6.254, P < 0.05). After treatment, the VAS, ODI scores, serum calcium, bone alkaline phosphatase, total typeⅠcollagen amino-terminal prolongating peptide, typeⅠcollagen carboxyl terminal peptide and amino-terminal osteocalcin in the observation group were significantly improved compared with those in the control group (t=7.909, 13.310, 3.535, 3.361, 2.107, 3.211, 5.667; P < 0.05).Conclusion:Gushukang combined with alendronate sodium is effective and safe for the patients with DOP.
Objective:To construct a core competency evaluation system for geriatric comprehensive assessment nurses.Methods:The core competency of geriatric comprehensive assessment nurses was determined through literature review, behavioral event interviews and semi-structured interviews, and 15 experts related to geriatric care were invited to conduct three rounds of expert inquiry to collect the experts’ revision opinions. The importance score, authority coefficients, coordination coefficient, and the coefficient of variation were calculated.Results:The authority coefficients of the three rounds of correspondence experts were 0.90, 0.93 and 0.95. In the first round, 4 out of 6 primary indicators modified, 3 out of 14 secondary indicators modified, and 23 out of 87 third-level indicators modified. After second and third rounds expert inquiry, the final established core competency evaluation system for geriatric comprehensive assessment nurses includes 6 primary indicators, 13 secondary indicators, and 72 third-level indicators with importance scores 3.93~5.00, coordinnation coefficient 0.702~0.796, and coefficient of variation 0~0.130.Conclusion:The core competency evaluation system of the elderly comprehensive evaluation is scientific and reasonable, which can provide reference for the admission, training and assessment of geriatric comprehensive assessment nurses.
