Objective To provide references for clinical management of patients with orbital blow-out fractures. Methods Evidence was retrieved from The Cochrane Library online (Issue 1, 2009), ACP online, NGC (1998 to March 2009), PubMed (January 1950 to February 2009), and CBM (1994 to February 2009). The collected evidence was then graded. Results After preliminary research, we identified 12 relevant articles: either retrospective studies or comments from specialists. They studied orbital soft tissue entrapment, diplopia, enophthalmos, or severe oculocardiac reflex in the surgical indications of orbital blow-out fractures. Most of the literature suggested less than five days after the injury incursion for children and less than two weeks for adults was the optimal time to undergo operation. However, advanced surgery was still a good option for the patients that could not undergo early surgery. With regard to the use of poly-pdioxanon- foil and titanium-dynamic mesh, two randomized controlled trials suggested that the former was superior to the latter. Conclusion The application of this surgery should be cautious because of low levels of evidence. Individual therapies should be used after close consideration of clinical characteristics.
ObjectiveTo analyze the influencing factors of preoperative frailty in elderly esophageal cancer patients, and to construct and evaluate a nomogram model. MethodsElderly esophageal cancer patients hospitalized in the First Affiliated Hospital of Navy Medical University from January 2022 to August 2024 were selected. General information of the patients was collected, and the patients were divided into a frailty group and a non-frailty group according to the frailty score. Single-factor and multi-factor logistic regression analysis were used to screen the independent influencing factors of preoperative frailty in elderly esophageal cancer patients, and the nomogram model was constructed and evaluated accordingly. ResultsA total of 332 elderly esophageal cancer patients were included, including 256 males and 76 females, with an average age of (69.71±5.95) years. The incidence of preoperative frailty was 45.48%. Multivariate analysis showed that age≥70 years [OR=2.986, 95%CI (1.796, 4.965), P<0.001], basic diseases≥2 types [OR=3.129, 95%CI (1.794, 5.457), P=0.012], self-care ability [OR=2.599, 95%CI (1.512, 4.467), P<0.001], and depression [OR=3.784, 95%CI (2.135, 6.706), P=0.005] were independent risk factors for preoperative frailty in elderly esophageal cancer patients. The nomogram model was constructed as follows: Z=−2.038+1.094×(age≥70 years)+1.141×(basic diseases≥2 types)+0.955×self-care ability (non-independent)+1.331×depression, with an area under the receiver operating characteristic (ROC) curve of 0.802 [95%CI (0.756, 0.847)], and the sensitivity and specificity were 78.8% and 65.2%, respectively. The goodness of fit test showed that the model had good discrimination and calibration (χ2=6.64, P>0.05). ConclusionAge≥70 years, basic diseases≥2 types, self-care ability, and depression are independent risk factors for preoperative frailty in elderly esophageal cancer patients. The constructed nomogram model shows good predictive performance and can identify elderly esophageal cancer patients with preoperative frailty, providing a reference for the formulation of corresponding intervention measures.