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Objective To explore the effects of enhanced recovery nutritional management on the perioperative comfort and nutritional status of the patients with fractures. Methods A total of 100 patients with traumatic fractures admitted to the department of trauma orthopedics of the hospital from March to September 2023 were selected and randomly divided into the study group and the control group, with 50 patients in each group. The control group received conventional perioperative management, while the study group received enhanced recovery nutritional management, including reduced preoperative fasting and perioperative oral nutritional supplementation. The preoperative discomfort, postoperative adverse reactions, and nutrition-related indicators were compared between the two groups. Results The incidence of moderate to severe preoperative thirst [34.00% (17/50)vs. 10.00% (5/50)], hunger [44.00% (22/50) vs. 16,00%(8/50)].and irritability [26.00% (13/50) vs. 8.00%(4/50)], as well as postoperative nausea/vomiting [16.00% (8/50) vs. 4.00(2/50), was significantly lower in the study group compared to the control group. The levels of plasma albumin on postoperative days 1.7, and 14. as well as hemoglobin levels on postoperative day 14, were significantly higher in the study group than in the control group, with all differences being statistically significant (P< 0.05). Conclusion Enhanced recovery nutritional management can improve perioperative comfort and nutritional status, contributing to early recovery in patients. [ABSTRACT FROM AUTHOR]

Obejective: To explore the predictive value of Caprini thrombosis risk score and serum D-dimer (D-D), vascular endothelial growth factor (VEGF), platelet-derived growth factor B (PDGF-B) for postoperative deep vein thrombosis (DVT) in patients with traumatic fracture, and to construct risk prediction model. Methods: 216 hospitalized patients with traumatic fracture admitted to The Affiliated Hospital of Xuzhou Medical University from June 2019 to May 2022 were selected as the research objects. According to the occurrence of postoperative DVT, they were divided into DVT group (62 cases) and non-DVT group (154 cases). The differences of Caprini thrombosis risk score, serum D-D, VEGF, PDGF-B and clinical data between the two groups were compared. Multivariate Logistic regression analysis was used to identify the risk factors of DVT, the prediction model was established, and the model was validated, and the receiver operating characteristic (ROC) curve was drawn for efficacy evaluation. Results: The occurrence rate of postoperative DVT in patients with traumatic fracture was 28.70%. The proportion of patients in the DVT group with the time from fracture to admission greater than 24 hours were more than those in the non-DVT group, and the prothrombin time (PT), activated partial thromboplastin time (APTT), D-D, VEGF, PDGF-B and Caprini thrombosis risk score were higher than those in the non-DVT group (P<0.05). Multivariate Logistic regression analysis showed that the time from fracture to admission greater than 24 hours, high levels of serum D-D, VEGF, PDGF-B and increased Caprini thrombosis risk score were independent risk factors for the occurrence of postoperative DVT in patients with traumatic fracture (P<0.05). Logistic regression analysis was used to analyze the 5 independent risk factors of the occurrence of postoperative DVT in patients with traumatic fracture, and the prediction model equation was established as follows: Logit (P) =-0.171 +1.170×time from fracture to admission +1.041×serum D-D +0.046×serum VEGF +0.100×serum PDGF-B +0. 080×Caprini thrombosis risk score, the internal verification results showed that the C-index count was 0.825 (95%CI: 0.740~0.892), and the Calibration curve showed that the Calibration curve was close to the ideal curve (P>0.05). External validation used this study sample: the area under curve (AUC) was 0.901, the sensitivity was 0.887, and the specificity was 0.870, which showed that the model had high predictive efficiency, it was significantly higher than the predictive efficacy of D-D, VEGF, PDGF-B and caprini thrombus risk score alone. Conclusion: The time from fracture to admission, serum D-D, VEGF, PDG and Caprini thrombosis risk score were the influencing factors of the occurrence of postoperative DVT in patients with traumatic fracture, the constructed prediction model had good predictive efficiency for the occurrence of DVT. [ABSTRACT FROM AUTHOR]

Objective: To investigate the correlation between the expression of serum alkaline phosphatase (ALP), osteoprotegerin (OPG) and the balance of helper T cell 1 (Th1)/helper T cell 2 (Th2) in traumatic fracture. 80 patients with traumatic fracture admitted to our hospital from February 2019 to December 2022 were selected as the study subjects and divided into observation group, and 80 healthy volunteers who came to our hospital for physical examination at the same time were selected as the control group. The fasting venous blood of the patients in the observation group and the control group in the morning after admission were taken to detect the expression levels of ALP, OPG, Th1 and Th2, and to analyze the correlation between the expression of serum ALP, OPG and Th1/Th2 balance. Eighty patients in the observation group were followed up 12 months after the operation. They were divided into fracture healing group (n=54) and delayed healing group (n=26) according to the degree of fracture healing. The clinical general situation and the expression level of ALP, OPG, Th1/Th2 in the two groups were compared, and the multiple factors affecting the fracture healing of traumatic fracture patients were analyzed. There were differences in the expression of ALP, OPG and helper T cells between the observation group and the control group. The levels of ALP, OPG and Th2 in the observation group were higher than those in the control group, and the levels of Th1 and Th1/Th2 were lower than those in the control group (P<0.05); Spearman correlation analysis showed that serum ALP and OPG were negatively correlated with Th1/Th2 balance (P<0.05); There was no difference in sex, age, cause of injury and Th2 between the fracture healing group and the delayed healing group (P>0.05). There was difference in BMI, ALP, OPG, Th1 and Th1/Th2 levels between the two groups (P<0.05); The above univariate analysis has statistical difference indicators to assign values. The multi-factor analysis results show that ALP, OPG, Th2, Th1/Th2 are independent influencing factors affecting the fracture healing of traumatic fracture patients (P<0.05). The occurrence of traumatic fracture will lead to the increase of ALP and OPG levels and the change of Th1/Th2 balance. There is a significant correlation between the serum ALP and OPG levels of patients and Th1/Th2 balance. In addition, changes in the levels of ALP, OPG, Th1, Th1/Th2 can affect the level of postoperative fracture healing in patients with traumatic fracture. Therefore, clinically, patients with elevated ALP and OPG levels and Th1/Th2 imbalance should be alert to the occurrence of poor fracture healing. [ABSTRACT FROM AUTHOR]

Objective: To investigate the influencing factors of psychological resilience in patients with traumatic fractures, and to analyze its influence on post-traumatic growth. Methods: A total of 197 patients with traumatic fractures admitted to Changsha Fourth Hospital from April 2019 to March 2021 were selected as the research subjects. The mental toughness of all the subjects was evaluated by the resilience scale (CD-RISC), and they were divided into group A (CD-RISC score ≥ 60 points), 76 cases and group B (CD-RISC score) according to the evaluation results. <60 points) 121 cases. Multiple stepwise regression analysis was used to analyze the influencing factors of mental toughness in patients with traumatic fractures. In addition, the post-traumatic growth rating scale (C-PTGI) was used to assess the post-traumatic growth status of all subjects, and the differences between groups A and B were compared. The relationship between mental toughness and posttraumatic growth was analyzed by Pearson correlation. Results: The univariate analysis showed that the psychological toughness of patients with traumatic fractures was related to age, gender, trauma severity and personality (all P<0.05). The results of multiple stepwise regression analysis showed that gender, age, trauma severity and personality were all influencing factors of CD-RISC score in patients with traumatic fractures (all P<0.05). The C-PTGI scores and total scores of patients in group A were higher than those in group B (all P<0.05). The Pearson correlation analysis showed that the CD-RISC score of patients with traumatic fracture was positively correlated with the scores of each dimension of C-PTGI and the total score of C-PTGI (all P<0.05). Conclusion: The influencing factors of psychological resilience in patients with traumatic fractures include age, gender, trauma severity and personality, and psychological resilience is closely related to post-traumatic growth. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationship between serum thrombomodulin (TM), P-selectin, high density lipoprotein (HDL-C) and coagulation function and postoperative deep vein thrombosis (DVT) in patients with traumatic fracture. Methods: 100 cases of traumatic fracture patients with postoperative occurrence DVT from January 2018 to January 2020 in our hospital were selected as the DVT group, at the same time, and 100 cases of traumatic fracture patients without DVT as the non DVT group. The serum TM, P-selectin, HDL-C, plasma coagulation function index [thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), D-Dimer (D-D)] were compared between the two groups. Ultivariate logistic regression was used to analyze the influencing factors of DVT in patients with traumatic fracture. Results: The serum TM, P-selectin, plasma D-D, FIB levels and proportion of age ≥ 60 years in the DVT group were higher than those in the non DVT group, and the serum HDL-C levels were lower than those in the non DVT group (P＜0.05). In DVT group, serum TM and P-selectin were positively correlated with plasma D-D and FIB (P＜0.05), while serum HDL-C was negatively correlated with plasma D-Dand FIB (P＜0.05), and there were no significant correlation with other plasma coagulation function indexes (P>0.05). Multivariate Logistic regression analysis showed that age ≥ 60 years, serum TM≥ 9.50 IU/mL, P-selectin ≥ 70.00 ng/ml, HDL-C<1.00 mmol/L, plasma D-D≥ 700.00 g/L and FIB≥ 4.00 g/L were the risk factors of postoperative DVT in patients with traumatic fractures (P＜0.05). Conclusion: In patients with traumatic fractures, the serum TM and P-selectin are higher than those without DVT, and HDL-C is lower than those without DVT, Combined detection of serum TM, P-selectin, HDL-C and coagulation function indicators may help to reduce the risk of DVT. [ABSTRACT FROM AUTHOR]

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Objective: To investigate the effect of early dynamic treatment of interlocking intramedullary nail on the healing of traumatic fracture. Methods: 150 cases of tibial fractures were randomly divided into experimental group and control group, with 75 cases in each group. Patients in the control group were treated with routine interlocking intramedullary nailing. Patients in the experimental group were treated with early dynamic method of interlocking intramedullary nail. The treatment method was identical with the control group. According to the patient's recovery, 6-10 weeks after operation, the dynamic treatment of intramedullary nail was carried out. Observation and comparison with human bone protection element (OPG). bone glutamate protein (BGP) level, clinical healing time, bone healing time and the incidence of adverse reactions and complications of the two groups of patients. Results: Compared with before treatment, the OPG. BGP levels of both groups were significantly increased after treatment (P < 0.05). Compared with the control group, the OPG. BGP levels were higher in the experimental group, the clinical healing time, bone healing time were shorter, the incidence of adverse reaction and complication was lower (P<0.05). Conclusion: Early power of interlocking intramedullary nail could increase the level of OPG and BGP of patients with traumatic fracture and accelerate the fracture healing with high safety. [ABSTRACT FROM AUTHOR]

Objective To analyze the application of human blood albumin among patients with traumatic fracture. Methods A retrospective analysis was conducted in 86 patients with hypoalbuminemia after traumatic fracture from December 2013 to May 2014 in our hospital， including 43 patients with closed fractures and 43 patients with open fracture. To observe the curative effect， patients with closed fracture and open fracture were divided into the treatment group and the control group respectively according to the use of human albumin. Results Among the patients with closed fracture in the therapeutic group and the control group，wound healing time，soft tissue swelling fade time，white blood cell count， neutrophil percentage， c-reactive protein and wound infection rates were compared and no significant differences were seen (>0.05). In terms of the treatment of open fractures， the observed indicators showed statistical significance after the application of human blood albumin compared with the control group (<0.05). Conclusion Not all the patients with hypoalbuminemia after traumatic fractures are suitable for the application of human blood albumin at the first place. Advantages are seen among patients with hypoalbuminemia after open fractures when they are applied with human blood albumin. Human blood albumin can promote postoperative recovery of the fractures and reduce the risk of infection，which is worthy of popularization and application. [ABSTRACT FROM AUTHOR]

Objective: To analyze the effect of using multilayer spiral CT three-dimensional reconstruction technique in traumatic fracture. Methods: Choosed 80 cases of traumatic fracture to treat with MSCT three-dimensional reconstruction technique to compare with X ray. Results: The diagnose accordance rate of MSCT was 99.2%, higher than 82.3% of X ray(P<0.05). Conclusion:Treating traumatic fracture with MSCT is effective to extend in clinic. [ABSTRACT FROM AUTHOR]