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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 analyze of the effect of artificial lengthening femoral head replacement in elderly patients with stage Ⅰ of unstable femoral intertrochanteric fracture.Methods 203 patients with stage Ⅰ of unstable femoral intertrochanteric fracture were selected as the research object,and they were taken artificial lengthening femoral head replacement,among which 65caese were male,female in 138 cases.The Harris scoring,SF-36,VAS pain scores on admission,2 weeks after operation,postoperative follow-up limb were counted,and the pain of the affected limb and the hip scores were compared amond 3 time periods.Results All 203 cases of senile patients with follow-up,average operation time was 83.64 minutes,the intraoperative blood loss was 355.41mL.The curative effect was evaluated according to the Harris score,SF-36 and VAS pain scoring criteria,and the Harris scores of the affected limbs at admission,at 2 weeks after the operation and after the follow-up were (28.26 ± 5.50) points,(68.26 ±5.50) points,(93.13 ± 5.31) points,respectively,the differences were statistically significant (t =-71.27,-1 397.55,-46.07,all P ＜ 0.01);The VAS pain scores were (8.19 ± 0.48) points,(3.53 ± 0.71) points,(0.23 ± 0.42) points,respectively,the differences were statistically significant (t =88.06,324.17,60.84,all P ＜ 0.01).The sf-36 scores:physiological [(8.35 ± 1.24) points,(15.23 ± 2.17) points,(19.21 ± 2.12) points],social/family [(7.01 ±1.13) points,(14.12 ± 2.12) points,(19.85 ± 2.24) points],emotional [(4.83 ± 1.01) points,(10.12 ±1.22)points,(14.87 ± 1.32) points],function [(6.35 ± 1.21) points,(13.67 ± 1.87) points,(16.81 ±2.12) points],additional focus [(8.85 ± 1.45) points,(16.38 ± 2.12) points,(20.21 ± 2.42) points],total quality of life [(47.35 ± 4.76) points,(74.69 ± 5.87) points,(89.21 ± 6.12) points],the differences were statistically significant(-39.77,-62.92,-20.21,-44.87,-71.89,-26.79,-45.04,-89.01,-38.25,-45.79,-63.41,-15.29,-45.20,-60.39,-17.54,-52.12,-76.49,-22.58,all P＜0.O1).Conclusion Artificial lengthening femoral head replacement in elderly patients with stage Ⅰ of unstable femoral intertrochanteric fracture has good clinical effect,intraoperative high safety,less postoperative complications,postoperative limb functional recovery is good,and it is worthy of clinical promotion and application.
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Background and purpose: AMP-activated protein kinase (AMPK) plays an important role in the regulation of cell metabolism and energy balance and is associated with cell proliferation, survival and multiple signaling pathways. Recent reports found that AMPK is involved in tumor suppression and drug resistance. The aim of this study was to explore the effect of AMPK on the anti-tumor effect of adriamycin and underlying mechanism in breast cancer MCF-7/adr cells. Methods:The anti-proliferative effects of adriamycin was detected by methyl thiazolyl tetrazolium (MTT) assay in MCF-7/adr, MCF-7/adr-vector and MCF-7/adr-AMPKαcells. The cell morphology in each group was stained with the lfuorescent dye Hoechst 33528, and the effects on apoptosis induction were examined by lfow cytometry (FCM). The intracellular concentration of adriamycin was detected by lfuorescence assay. The resis-tance-and apoptosis-related proteins were analyzed by Western blot. Results:The growth of breast cancer MCF-7/adr cells was inhibited by adriamycin in a dose-and time-dependent manner. The IC50 values at 24 and 48 h were (36.8±2.1) and (28.8±1.3) μg/mL, respectively. AMPKαover-expression enhanced the cytotoxic effect of adriamycin in MCF-7/adr-AMPKαcells in a dose-and time-dependent manner. Its IC50 values at 24 and 48 h were (16.0±0.7) and (4.2±0.2) μg/mL, respectively. Fluorescent morphological assay showed that AMPKαoverexpression contributed to adriamycin induced apoptosis in MCF-7/adr-AMPKαcells. After treatment with 1.0 μg/mL adriamycin for 48 h, the apoptosis rates of MCF-7/adr, MCF-7/adr-vector and MCF-7/adr-AMPKα cells were (12.0±1.4)%, (12.7±1.6)% and (32.0±4.2)%, respectively, indicating that overexpression of AMPKα enhanced the adriamycin-induced apoptosis in MCF-7/adr cells. Fluorescence microplate assay showed that over expression of AMPKαsigniifcantly increased the intracellular accumulation of adriamycin, in a concentration dependent manner. Western blot analysis showed that, compared with MCF-7/adr and MCF-7/adr-vector cells, the expressions of Bax, caspase-3 and cleaved PARP proteins were increased. Meanwhile, Bcl-2 and P-gp protein expressions were decreased in MCF-7/adr-AMPKαcells. Furthermore, the release of cytochrome c from mitochondria into the cytosol was also observed in MCF-7/adr-AMPKαcells. Conclusion:AMP-Kαoverexpression can enhance the chemosensitivity of breast cancer MCF-7/adr cells to adriamycin through inhibiting the drug effux transporter and regulating the expression of apoptosis-related proteins.