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Objective:To establish a composite functional evaluation system to study the clinical efficacy of single plate and double plate internal fixation in the treatment of C3 distal radius fractures in the elderly.Methods:62 elderly patients (≥ 60 years old) with type C3 distal radius fractures who were admitted to the First Affiliated Hospital of Anhui University of Science and Technology from September 2018 to August 2021 were retrospectively selected and divided into two groups according to the surgical methods: bilateral plate internal fixation treatment group (double plate group) and unilateral plate internal fixation treatment group (single plate group); The preoperative anatomical angle, wrist mobility (flexion and extension) and radius shortening of the two groups were recorded. The anatomical angle, wrist mobility (flexion and extension), clinical Gartland-Werley, DASH Score for Upper Limb Function (DASH) , Wrist Joint Cooney Score and clinical healing time at the 3rd, 6th, 9th and 12th months after operation were followed up. A composite evaluation table was established to comprehensively evaluate the postoperative recovery of patients in the two group.Results:There was no significant difference in anatomical indexes of radius between the two groups before operation (all P>0.05). All anatomical angles and wrist range of motion were within the normal range after operation, and there was no statistical difference between the two groups in each anatomical index of radius within 3 and 6 months after operation (all P>0.05). However, the palmar inclination, ulnar deviation, wrist flexion and dorsiflexion mobility of the double plate group were relatively stable at 9 and 12 months after operation, which were better than those of the single plate group (all P<0.05). The palmar inclination and ulnar deviation of the single plate group increased with time. After operation, the radius shortening of the two groups recovered significantly, and the radius length of the double plate group was maintained better than those of the single plate group for 9 and 12 months (all P<0.05). There was no significant difference in the scores of the two groups within 3 and 6 months after operation (all P>0.05), but the Gartland Werley score, DASH score and Cooney wrist score of the double plate group were significantly better than those of the single plate group at 9 and 12 months after operation (all P<0.05). The clinical healing time of single plate treatment was (14.51±0.88)weeks, the longest was 108 days, while that of double plate treatment was (12.03±1.77)weeks, the longest was 129 days, with statistically significant difference ( P<0.05). There was no significant difference in the incidence of complications between the two groups ( P>0.05). There was no statistically significant difference between the two groups in the final composite evaluation results ( P>0.05), but the total score of the double plate group was smaller than that of the single plate group, with a difference of 39.67 points, indicating that the double plate group still had certain advantages in various scores. Conclusions:According to the composite evaluation system, both single plate and double plate treatment of C3 distal radius fractures in the elderly can achieve satisfactory results. Double plate fixation of distal radius fractures still has a certain significance in maintaining joint stability and improving joint mobility.
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Objective:To observe the effect of evidence-based early activity training on postoperative delirium in patients with brain tumor resection.Methods:This study used non-contemporary comparison method, a total of 238 patients admitted to the Second Affiliated Hospital of Zhejiang University School of Medicine in 2019, were included. 121 patients who met the inclusion criteria and signed informed consent after craniotomy during January 1st,2019 to June 31th,2019 were included in the control group, and 117 patients who met the criteria and obtained informed consent after craniotomy during July 1 to December 31,2019, were included in the experimental group. Neurosurgical postoperative routine nursing care were given to the control group. The experimental group received evidence-based early activity training. The incidence of delirium, duration of delirium, Barthel Index (BI), delirium-related adverse events and other indicators of postoperative hospitalization were compared between two groups.Results:The incidence of delirium, duration of delirium and postoperative hospital stay in the experimental group were 9.5%, 2.0 (1,3) days and 7 (5,10) days, lower than 23.3%, 3.0 (1,5) days and 8 (6,11) days in control group, and the differences were statistically significant ( χ2 value was 8.17, Z value were 2.96 and -2.01, P<0.05). BI index 1 week and 1 month after discharge in the experimental group was 90 (85, 90), 100 (100, 100), higher than the control group of 90 (86, 90) and 100 (100,100), with statistically significant difference ( Z values were -2.41 and -2.46, P<0.05), the comparison of adverse events, 0 case in experimental group, 1 case in control group, there was no statistically significant difference ( χ2 value was 0.97, P>0.05). Conclusions:Early evidence-based activities in patients with brain tumor resection can reduce the incidence of postoperative delirium, shorten the duration of postoperative delirium and postoperative hospital stay, and improve the ability of patients to take care of themselves after surgery, which is safe and effective.
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BACKGROUND:Three-dimensional finite element simulation has been widely used in biomechanics. However, there is little research in knee joint replacement. The study of femoral prosthesis is less. OBJECTIVE:To analyze the optimal positioning parameters of knee replacement and femoral prosthesis implantation, and to verify the efficacy of Gemini-PS knee prosthesis in total knee arthroplasty. METHODS: (1) Knee finite element model in total knee replacement was constructed. Orthogonal experiment was performed in femoral osteotomy positioning parameters. The shift amount A, external rotation degree B, and valgus degree C of femoral prosthesis were selected as the relevant factors for orthogonal experiment. Three values were taken for each parameter to establish orthogonal tables. Nine experimental combined knee replacement finite element models were created and analyzed with finite element. Analysis of variance and range analysis were used by optimization. (2) Totally 42 patients (47 knees) with knee osteoarthritis received total knee arthroplasty with Gemini-PS knee joint prosthesis. Knee joint function was evaluated after replacement with Hospital for Special Surgery knee score and American Knee Society knee score. Knee pain was assessed with Visual Analogue Scale score. RESULTS AND CONCLUSION:(1) Minimal polyethylene substrate surface compressive stress peak was translation 0 mm, external rotation of 3°, valgus 6°; the peak stress was 15.9 MPa. Among the influential factors, the effects of internal and external translation were larger than that of external rotation angle, and greater than that of valgus angle. The optimal positioning parameter combination was pan 0 mm, external rotation 3°, valgus 6° by range analysis and variance analysis. Orthogonal experiment was valid by simulation. (2) 42 patients were folowed up for 12-36 months. One patient affected subcutaneous fat liquefaction of the lower segment of the incision. Hospital for Special Surgery knee score and American Knee Society knee score were significantly higher after implantation (P < 0.05). Visual Analogue Scale score was significantly lower after replacement (P < 0.05). X-ray films showed that osteolysis, dislocation or loosening was not found. The recovery of knee joint was good after operation. (3) These findings
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Objective To study the inhibition effect of non custodial terpenes-3β-alcohol to experimentally in-duced autoimmune encephalomyelitis in guinea pigs. Methods Different doses (25 mg/kg, 50 mg/kg and 100 mg/kg) of non custodial terpenes-3β-alcohol were given to the experimentally induced autoimmune encephalomyelitis model of guinea pigs by gavage for 8 weeks. Plasma levels of CD4+/CD8+, IL-1, IL-2, IL-6, IL-10, neuropeptide Y (NPY), beta endorphin (β-EP) , transforming growth factor-β(TGF-β), matrix metalloproteinase (MMP-2), nitric oxide synthase (NOS) and leuko-cyte differentiation antigen CD3 were assessed. The brain neuron morphology changes was observed under light microscopy while its ultrastructure changes was observed under electron microscope. NOS expression in neurons was observed through immunofluoresce technology. Results Non custodialterpenes-3β-alcohol inhibited the increase of plasma CD4+/CD8+, IL-1, IL-2, IL-6, IL-10, MMP-2, CD3 and NPY while decrease of plasmaβ-EP, brain TGF-β. It also increase NOS expres-sion in neuronal cytoplasm and maintained neuron morphology. Conclusion Non custodial terpenes-3β-alcohol inhibit-ed the experimental autoimmune encephalomyelitis in guinea pig.