Comparative effect of different neuromuscular exercises on pain and motor function of knee in patients with early knee osteoarthritis / 中国康复理论与实践

ObjectiveTo compare the effect of proprioceptive neuromuscular training methods on pain and motor ability of knee in patients with early knee osteoarthritis (KOA) . MethodsFrom November, 2022 to May, 2023, 60 early KOA patients from Beijing Bo'ai Hospital and community were randomly divided into groups A, B and C, with 20 patients in each group. Group A received proprioceptive neuromuscular facilitation (PNF), group B received neuromuscular exercise (NEMEX), and group C received PNF and NEMEX, for six weeks. They were assessed with Visual Analogue Scale for pain (VAS), angle reappearance test, difference of pre-motor reaction time (VM-VL), active range of motion (AROM) of knee flexion, 10-meter walk test (10MWT), and Knee Injury and Osteoarthritis Outcome Score (KOOS) before and after treatment. ResultsAll the indexes improved in all the groups after treatment (|t| > 2.532, P < 0.05). Among the groups, the VAS score was the least in group A, and then groups C and B; the angle reappearance error was the least in group C, and similar in groups A and B; the VM-VL was the least in groups A and C, followed by group B. ConclusionPNF, NEMEX and PNF+NEMEX can relieve the pain and improve the motor function of knee in patients with early KOA, however, PNF is the most effective on relieving pain, and PNF+NEMEX is the most effective on improving knee function.

Analysis of the current situation of radiological health management in 66 medical institutions in Nanyang, China / 中国辐射卫生

Objective To determine the current situation of radiological health management in medical institutions in Nanyang, China, to analyze existing problems and propose improvement measures, and to improve the management level of radiological diagnosis and treatment practice in medical institutions. Methods According to the work plan of the Occupational Disease Prevention and Control Project in Henan Province, China, 66 medical institutions engaged in radiological diagnosis and treatment at different levels were selected for a questionnaire survey, in combination with on-site inspections, inquiries, and access to relevant materials. Results Of 66 medical institutions, 65 institutions held radiological diagnosis and treatment licenses, with a license holding rate of 98.5%. There were 17 “new construction, reconstruction, and expansion” projects, with an evaluation rate of 94.1%. In this survey, a total of 391 radiological diagnosis and treatment equipment were involved, and 387 units of equipment were tested for status, with a detection rate of 99.0% and a qualification rate of 94.8% (367/387); 55 units of equipment were tested for stability, with a detection rate of 14.1%; the workplace protection detection rate was 99.0%, and the qualification rate was 100%; 66 medical institutions had 1809 radiation workers, with an occupational health examination rate of 97.8%; 1262 people were trained, with a training rate of 95.7%; 1773 people were monitored for individual dose, with a monitoring rate of 98.0%. Conclusion Medical institutions should further strengthen management in licensing change, construction project evaluation, and equipment stability monitoring to improve the level of radiological health management.

Perioperative characteristics of hip fractures and effects of early rehabilitation in elderly patients / 中华老年医学杂志

Objective To investigate the perioperative characteristics of hip fractures and the effects of early rehabilitation in elderly patients. Methods Clinical data of 123 elderly patients admitted to our department from January 2012 to January 2014 were retrospectively analyzed. Patients were divided into a rehabilitation group and a control group ,based on whether rehabilitation therapy was offered.Comparison was made between the two groups on postoperative mortality and postoperative complications. Results Of 123 patients ,there were 51 males and 72 females ,with a mean age of (83.5 ± 4.8)years(aged 67~96 years).Femoral fractures were seen in 32 patients and femoral intertrochanteric fractures in 91 patients.Before operation ,112 (91.1% ) patients had concomitant diseases. There were significant differences in postoperative complications and one-year mortality after operation between patients receiving early rehabilitation and controls (5/60 or 8.3% vs.14/63 or 22.2% ,4/60 or 6.7% vs.13/63 or 20.6% ,χ2=4.539 and 5.034 ,P=0.033 and 0.025 , respectively ). Conclusions Elderly hip fracture patients have many concomitant diseases before operation.With appropriate perioperative management ,well-chosen methods of anesthesia and surgery ,and early postoperative rehabilitation measures ,the incidence of perioperative complications and one-year mortality can be decreased ,and desirable surgical outcomes can be attained.

Teaching Experience of Orthopaedic Rehabilitation Resident Standardization Training / 中国康复理论与实践

Orthopaedic rehabilitation is an important part of rehabilitation resident standardization training, that is complex and unique. Introduction of the discipline, as well as optimizing teaching methods, clinical practice and test are very important for a satisfactory out-come, such as combination of theory and practice, and systematical rehabilitation procedures, principles and operation.

Association between ABCB1 Gene Polymorphisms and Chemotherapy-induced Severe Neutropenia in Pa-tients with Breast Cancer / 中国药房

OBJECTIVE:To discuss the association between ABCB1 gene polymorphisms and adriamycin and cyclophospha-mide(AC)combined with chemotherapy-induced severe neutropenia in patients with breast cancer. METHODS:218 breast cancer patients receiving AC combined with chemotherapy were selected from our hospital during 2012-2015;PCR-RFLP was used to de-tect polymorphisms of ABCB1 2677G>T/A and 3435C>T. The associated between different age,BMI,clinical stages genotypes, etc and AC combined with chemotherapy-induced severe neutropenia were investigated,and risk factors of neutropenia were ana-lyzed by multivariate logistic regression. RESULTS:Among 218 breast cancer patients,170 patients suffered from severe neutrope-nia,accounting for 78.0%. Among ABCB1 2677G>T/A polymorphisms,distribution frequency of GT or GA genotype,TT,TA or AA genotype,GG genotype in severe neutropenia were 80.6%,86.2% and 60.0%,with statistical significance (PT polymorphisms,distribution frequency of TT,CT and CC genotype in severe neutropenia were 86.4%, 78.4% and 72.7%,there was no statistical significance(P>0.05). AST and ABCB1 2677G>T/A polymorphisms were correlated with severe neutropenia (PT/A polymorphism was a strong predictor of neutropenia [OR=3.875, 95%CI(1.555,9.922),P=0.008]. CONCLUSIONS:ABCB1 2677>T/A polymorphisms may be aggravate AC combined with che-motherapy-induced neutropenia in patients with breast cancer.

Efficacy analysis of three surgical treatments for femoral intertrochanteric fractures in elderly patients / 中华老年医学杂志

Objective To compare the efficacy and complications among three surgical treatments of femoral intertrochanteric fractures in elderly patients.Methods Totally 209 elderly patients with femoral intertrochanteric fracture were divided into 3 groups:DHS group[n =115,patients treated with dynamic hip screws (DHS)],PFNA group [n=57,patients treated with proximal femoral nails anti-rotation (PFNA)] and SEFT group [n=37,patients treated with singlearm external fixator technique (SEFT)].The length of hospitalization,operative time,bleeding volume,hip function scores and complications were compared among the three groups.Results All patients were followed up for 5-12 months (10.6 months in average).The length of hospitalization,operative time,bleeding volume,weight-bearing time and Harris hip score in postoperative 3 months were (14.3±2.7) d,(102.4±22.7) min,(240.8±38.4) ml,(50.2±7.7) d,(88.7±12.8) min in DHS group,(11.2±3.4) d,(50.3±15.6) min,(80.5±18.7) ml,(22.6±4.8) d,(92.6±15.4)min in PFNA group,(15.1±3.3) d,(35.8±10.9) min,(52.6±12.9) ml,(55.4±10.1) d,(87.3 ± 12.6) min in SEFT group,respectively.There were significant differences in the length of hospitalization,operative time,bleeding volume,weight-bearing time and Harris hip score in postoperative 3 months among the three groups (all P ＜ 0.05),while there was no significant difference in healing time among the three groups (all P＞0.05).The incidence of complications was highest in DHS group,higher in SEFT group,and lowest in PFNA group (all P＜0.05).Conclusions DHS is more suitable for patients with good physical condition and stable fractures.SEFT is suitable for patients with poor condition,who can not tolerate trauma,anesthesia and bleeding.PFNA has more advantages including stable fixation,less invasive,less complications and wide indications,which is more suitable for femoral intertrochanteric fractures than the other two treatments.

Characteristics and Early Rehabilitation of Knee Stiffness post Different Fractures / 中国康复理论与实践

@#ObjectiveTo investigate the characteristics of knee stiffness and the results of rehabilitation after the fractures of distal femur （DF）, tibial plateau （TP） or patella （PF）. Methods70 cases with knee stiffness after DF, TP or PF were analyzed retrospectively. ResultsNo significant difference was observed in passive range of motion (PROM) among three groups (F=1.671，P=0.196) before rehabilitation. The differences were significantly different (F=19.264, P=0.000) 8 weeks after rehabilitation. Further LSD analysis revealed that there was significant difference between DF and TP (P=0.000) as well as DF and PF (P=0.000), but no significant difference was observed between TP and PF (P=0.114). ConclusionThe outcome of rehabilitation is associated with the locations of fracture, and the distal femoral fractures is the worst.

Perioperative delirium in the elderly with hip fracture / 中华老年医学杂志

Objective To assess the influencing factors of perioperativc delirium in the elderly with hip fracture and to define strategies for prevention and management. Methods DSM-Ⅳ was adopted to diagnosis of perioperative delirium in the elderly with hip fracture, The data of 148 elderly patients with hip fracture were analyzed retrospectively and classified according to the clinical characteristics. The differences were analyzed statistically between the delirious group and the control group. Results There were 26 (17.6%) cases diagnosed with delirium in the perioperative period, including 22 cases with postoperative delirium, and the delirious symptom lasted 3 days in average. For the type of delirium, there were 15 cases with mania type, 4 cases with inhibitory type and 7 cases with mixed type. Compared with patients in control group, patients with perioperative delirium were older [(79.67±7.7) years old vs. (75.5±7.0)years old, t=2.668, P=0.008)]. Five cases who had previous delirium occurred perioperative delirium, and five patients who received external fixator showed no perioperative delirium. Conclusions Perioperative delirium is a heterogeneous symptom on the basis of brain aging and degeneration. It affects the prognosis of the elderly patients with hip fracture and should be viewed as a separate entity, which can be prevented and treated through comprehensive management.

Outcome of Total Knee Arthroplasty with Retaining Patellar in Osteoarthritis / 中国康复理论与实践

@#Objective To analyze the outcome of total knee arthroplasty with retaining patellar in osteoarthritis.Methods 45 knee joints in osteoarthritis were performed operatively with posterior stabilized knee arthroplasty between January 2005 and June 2008. The series include 7 sides(males) and 38 sides(females). The mean age of patients was 65.7 years ranging from 52 to 79 years, and the data were analyzed by The Hospital for Special Surgery(HSS) score system. Results The follow-up period was averagely 25 months ranging from 8 to 51 months. According to HSS score system, 28 sides were rated as excellent（62.2%）, 12 sides as good（26.7%）, 4 fair（8.9%）and 1 poor（2.2%）, and the excellent-good rate was 88.9%. Conclusion Posterior stabilized knee arthroplasty with retaining patellar represents a simple and valuable treatment methodology for the most osteoarthritis of the knee joint.

Effect of Internal Fixation of Plates on Displaced Intra-articular Fracture of Calcaneus / 中国康复理论与实践

@#Objective To investigate the effect of internal fixation of plates on displaced intra-articular fracture of the calcaneus. Methods 27 patients with calcaneal fracture and treated surgically with open reduction and internal fixation were analyzed retrospectively. Results All the cases are closed fracture. According to the Sanders classification, 18 cases were type 2 calcaneal fractures, and 9 were type 3. 6 cases (22.2%) showed wound-healing problems. The average Bohler's angle before and after surgery was 7.5° and 27.54° respectively. 20 patients were followed up for average 16.8 months, and all showed excellent walking ability and normal gait, and no shoe wear complaints. Conclusion Open reduction and internal fixation can guarantee the anatomic reduction of displaced calcaneal fractures, and the outcomes are satisfied.

External Fixation and Early Rehabilitation of Unstable Pelvic Fracture: 31 Cases Report / 中国康复理论与实践

@# Objective To investigate the management of unstable pelvic fracture using external fixation and rehabilitation. Methods 31 cases with unstable pelvic fractures were analyzed retrospectively. Results All the patients accepted pelvic external fixation and early rehabilitation training. No death, deep infection or nerve injury happened. The fractures healed very well in 16 cases, well in 11 cases, satisfactory in 4 cases. Conclusion Pelvic external fixation is a simple, safe, minimally invasive and effective approach. Early physical training is an essential component of the management after external fixation.

Advance in Treatment of Phantom Limb Pain(review) / 中国康复理论与实践

@# Phantom limb pain(PLP) is a common sequela of amputation. With the lucubration of the pathophysiological mechanisms underlying PLP, lots of progression for the treatment of PLP has been achieved. Combined modality therapy is very important especially in psychological, behavior and operative therapy.

CT Parameter for Patellofemoral Alignment / 中国康复理论与实践

@#Objective To screen the parameter of CT scan for distinguishing patellofemoral malalignment. Methods 22 patients (42 knees) with patellofemoral pain and 12 asymptomatic volunteers (24 knees) were studied. The patellofemoral joints were examined with CT scan at 0°, 15°, 30° and 60° flexion. The parameters including femoral trochlear angle, lateral patellofemoral angle, patellar tilt angle, congruent angle and patellofemoral index were compared. Results Congruent angle and patellofemoral index in symptomatic group were bigger than those in asymptomatic group (P<0.01), but others were not different significantly between two groups (P>0.05). Conclusion CT scans is useful in diagnosis of patellofemoral malalignment. Congruent angle and patellofemoral index are more susceptible parameters for it.

Prevention of Complication and Early Rehabilitation of Limb Fracture in Earthquake / 中国康复理论与实践

@#Most of patients received in hospital with the upper and lower extremity fracture are caused by the earthquake.These fractures have apparent characters,such as:the serious situation,complexity and lots of complications which can be divided two periods:the early and the late.These complications include shock,the nerve and vascular injury,the acute kidney failure,fat embolism,infection,deep venous thrombosis,decubitus ulcer and so on.These complications should be known completely and the therapy should be given early.Practice can not be taken because of pain and some other reasons,and this will lead to the muscle atrophy,adynamia and the joint disfuction.Finally the abilty to work was lost partly or completely.If some measures about rehabilitation were taken early,we can reduce the complication and the disability possibly.

Prevention of Complication and Early Rehabilitation of Limb Fracture in Earthquake / 中国康复理论与实践

@#Most of patients received in hospital with the upper and lower extremity fracture are caused by the earthquake.These fractures have apparent characters,such as:the serious situation,complexity and lots of complications which can be divided two periods:the early and the late.These complications include shock,the nerve and vascular injury,the acute kidney failure,fat embolism,infection,deep venous thrombosis,decubitus ulcer and so on.These complications should be known completely and the therapy should be given early.Practice can not be taken because of pain and some other reasons,and this will lead to the muscle atrophy,adynamia and the joint disfuction.Finally the abilty to work was lost partly or completely.If some measures about rehabilitation were taken early,we can reduce the complication and the disability possibly.

Treatment of Ankle Fracture by Surgery Combined with Early Rehabilitation / 中国康复理论与实践

@#Objective To investigate the management of ankle fracture with surgery and postoperative rehabilitation.Methods The data of 39 inpatients with ankle fracture from 2001 to 2005 were analyzed retrospectively. All patients were treated surgically with open reduction and internal fixation (ORIF) except one medial ankle fracture with closed reduction. All patients were encouraged to perform active and passive range of motion exercises of ankle and the involved limb on the 2nd day after surgery, and partial weight-bearing was allowed at 4th week after surgery.Results No patients had wound-healing problems and deep venous thrombosis, no significant calf muscle atrophy exist at discharging. 29 patients showed excellent ankle joint function and normal gait when the internal fixation was removed at an average 17.9 postoperative months.Conclusion The surgery combined with early rehabilitation used for ankle fracture can improve the recovery of ankle function.

Comparison of Wrist Joint Imagings Taken with Different Angles / 中国康复理论与实践

@#ObjectiveTo compare the effect of imagings taken with different angles to observe relationship of wrist joint and distal screws.Methods29 patients with the distal radius fractures were performed operatively with the open reduction and internal fixation. The standard antero-posterior and lateral imagings of the wrist joint were taken during operation, and two different angle imagings of the wrist joint were also taken meantime in all 29 patients.ResultsScrews were found to penetrate into the joint in antero-posterior imagings of 23 cases and standard lateral imagings of 25 cases. However, no screws were found to penetrate into the joint in two different angle imagings.ConclusionTwo different angle imagings can fully show the articular surface of distal radius without screws.

Clinical effect of unstable femoral intertrochanteric fracture treated with DHS / 中国康复理论与实践

@#ObjectiveTo observe the clinical effect of unstable femoral intertrochanteric fracture treated with DHS. Methods Summarized 37 cases of unstable femoral intertrochanteric fracture treated by DHS,all cases were commented by fracture type,operation method and clinical effect. ResultsWe have followed up 37 cases from 0.8 to 4.7 years with average of 2.5 years.Conclusions DHS is one of the best implants due to its merits of strong fixation, little complication and early rehabilitation exercise.