Search

Background The prevalence of comorbidity in the elderly is showing a rising trend year by year with the acceleration of population aging. Comorbidity is a key risk factor for frailty in the elderly. Then frailty only increases the risk of adverse health outcomes for patients with comorbidity, but also significantly increases their family medical expenses. It has a certain guiding value for the management of comorbidity to identify the frailty conditions of elderly patients with comorbidity as early as possible. Objective To systematically review the prevalence of frailty in elderly patients with comorbidity. Methods CNKI, VIP, CBM, WanFang, PubMed, EmBase, Web of Science and Cochrane Library were searched in December 2021 for the investigation studies on the current status of frailty in elderly patients with comorbidity published from inception to December 4, 2021. Two researchers performed literature screening and data extraction independently. The cross-sectional study quality rating scale and Newcastle-Ottawa Scale (NOS) recommended by Agency for Healthcare Research and Quality (AHRQ) were used to assess the risk of bias of the included studies and Stata 14.0 was adopted for meta-analysis. Results A total of 25 studies involving 16 062 elderly patients with comorbidity were included. Meta-analysis results showed that the prevalence of frailty and pre-frailty in elderly patients with comorbidity was 26.7%〔95%CI (21.9%, 31.5%) 〕and 47.7%〔95%CI (43.9%, 51.4%) 〕. Subgroup analysis showed that the prevalence of frailty in older adults with≥2, ≥3, ≥4, and≥5 chronic diseases was 25.1%〔95%CI (19.3%, 30.8%) 〕, 27.4%〔95%CI (13.7%, 41.0%) 〕, 60.7%〔95%CI (29.0%, 92.4%) 〕, and 23.5%〔95%CI (8.6%, 38.5%) 〕, respectively. The prevalence of frailty in elderly patients with comorbidity in Oceania (52.1%) and Asia (31.3%) were significantly higher than Europe (16.9%) and South America (13.2%) . The prevalence of frailty in elderly patients with comorbidity in hospital (26.2%) was significantly higher than community (23.2%) . The prevalence of frailty in elderly patients with comorbidity screened by Clinical Frailty Scale (CFS) , Fried frailty phenotype scale and FRAIL Scale was 42.8%〔95%CI (38.4%, 47.1%) 〕, 22.2%〔95%CI (17.8%, 26.7%) 〕and 8.5%〔95%CI (6.3%, 10.6%) 〕, respectively. The prevalence of frailty in elderly patients surveyed in 2001—2010, 2011—2015, and 2016—2020 was 21.0%〔95%CI (13.2%, 28.8%) 〕, 19.0%〔95%CI (13.1%, 24.8%) 〕and 37.7%〔95%CI (22.6%, 52.9%) 〕, respectively. Conclusion The prevalence of frailty in elderly patients with comorbidity is gradually increasing, with differences by number of co-morbidities, continents, assessment tools and study sites. Therefore, relevant personnel should pay attention to early screening of frailty in elderly patients with comorbidity and take timely measures to prevent the development of frailty in elderly patients with comorbidity.

ObjectiveTo analyze the prevalence rate of non-suicidal self-injury （NSSI） behavior in Chinese adolescents with depression， so as to provide references for the intervention of NSSI behavior in adolescents with depression.MethodsThe literature databases such as CNKI， VIP， Wanfang， China Biology Medicine Disc， PubMed， Web of Science， Cochrane Library and Embase were searched via computer for the cross-sectional studies related to the prevalence of NSSI behavior in adolescents with depression published from inception to February， 2020. Then the eligibility assessment， data extraction and assessment of methodological quality were performed independently by two reviewers， and the Meta-analysis was performed by using RevMan 5.4.ResultsA total of 2 238 adolescents in 10 studies were included. Meta-analysis yielded that the prevalence rate of NSSI behavior in Chinese adolescents with depression was 51% （95% CI： 43%~59%）. Subgroup analysis of NSSI behavior in adolescents with depression implied that the prevalence rate was 36% （95% CI： 22%~50%） in female adolescents， which was higher than 18% （95% CI： 12%~24%） in male adolescents. The prevalence rate of NSSI behavior was 57% （95% CI： 38%~77%） in depression adolescents with suicidal ideation， which was higher than 4% （95% CI： 0~8%） in those without suicidal ideation. The prevalence rate of NSSI behavior was 54% （95% CI： 41%~67%） in depression adolescents diagnosed with Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5）， which was higher than 46% （95% CI： 40%~51%） in those diagnosed with the International Classification of Diseases， tenth edition （ICD-10）. The prevalence rate of NSSI behavior was 52% （95% CI： 41%~63%） in depression adolescents in the literatures with quality score of 7， which was close to 50% （95% CI： 44%~55%） in depression adolescents in the literatures with quality score of 6. The comparison of above subgroups all had statistical differences （P

Objective: To investigate the short-term effectiveness of three-dimensional (3D) printed trabecular metal pads for Paprosky type Ⅲ acetabular defect in hip revision., Methods: Between August 2014 and December 2015, the 3D printed trabecular metal pads were used to repair Paprosky type Ⅲ acetabular defects and reconstruct the annular structure of the acetabulums in 5 cases of primary hip revision. There were 3 males and 2 females, aged from 50 to 72 years, with an average age of 66 years. The time from initial replacement to revision was 10 to 18 years, with an average of 14.4 years. The types of prostheses in primary replacement were non-cemented in 3 cases and cemented in 2 cases. The types of acetabular bone defects were Paprosky type ⅢA in 3 cases and Paprosky type ⅢB in 2 cases. The preoperative Harris score was 34.23±11.67. The height of rotation center of affected hip was (38.17±8.87) mm and the horizontal position was (35.62±9.12) mm., Results: The operation time was 120-180 minutes, with an average of 142 minutes. The intraoperative bleeding volume was 800-1 700 mL, with an average of 1 100 mL. Five patients were followed up 18-24 months (mean, 21 months). At last follow-up, the Harris score was 79.82±8.70, which was significantly higher than that before operation ( t =16.991, P =0.000). At 1 week after operation, the abduction angle of acetabular cup was 38-42° (mean, 39.4 °) and the anteversion angle was 13-18 ° (mean, 14.6°). The height and horizontal position of rotation center of affected hip were (22.08±8.33) mm and (29.03±6.28) mm, respectively, showing significant differences when compared with those before operation ( P <0.05); there was no significant difference when compared with those of healthy hip [(28.62±7.73), (27.29±4.22) mm] ( P >0.05). During the follow-up, there was no complication such as prosthesis loosening, dislocation, or periprosthetic fracture., Conclusion: In hip revision, 3D printed trabecular metal pads can repair Paprosky type Ⅲ acetabular defect, reconstruct the structure of acetabulum, provide a stable supporting structure for the acetabular cup, reconstruct the relatively normal rotation center of the hip joint, avoid iatrogenic bone loss, and achieve satisfactory functional recovery of the hip. The long-term effectiveness needs further follow-up.