【摘要】 目的 探讨康复宣教与训练等干预手段对股骨干骨折患者围手术期的影响。 方法 2010年6月－2011年3月收治股骨干骨折患者90例，其中男48例，女42例；年龄17~58岁，平均38岁。开放性骨折28例，闭合性骨折62例。股骨骨折部位:上1/3骨折33例，中1/3骨折35例，下1/3骨折20例，多段骨折2例。横形骨折20例，斜形骨折30例，粉碎性骨折40例。将90例患者随机分为康复组（46例）和对照组（44例）。对照组采用骨科术前常规处理，康复组采用骨科术前常规处理加康复宣教与训练。 结果 康复组住院时间为（5.35±1.27） d，对照组为（7.67±1.85） d，两组比较差异有统计学意义（Plt;0.05）。 康复组治疗后发生并发症7例，对照组16例，康复组并发症发生率（15.2%）明显低于对照组（36.4%），差异有统计学意义（Plt;0.05）。治疗后5 d，康复组疗效获优35例，良6例，可3例，差2例，优良率89.1%；对照组获优25例，良5例，可12例，差2例，优良率68.2%；两组疗效比较差异有统计学意义（Plt;0.05）。 结论 康复宣教与训练能预防与改善股骨干骨折围手术期卧床引起的并发症，减轻患者腿部疼痛及肿胀，缩短围手术期时间，使患者能尽早手术，加快住院床位周转，提高患者生活质量。【Abstract】 Objective To explore the effects of rehabilitation education and training interventions on perioperative patients with femoral shaft fractures. Methods A total of 90 patients with femoral shaft fractures were selected from June 2010 to March 2011, including 48 males and 42 females aged from 17 to 58 years (mean 38 years). In these 90 patients, open fracture was in 28 and closed fracture was in 62. Fracture site: upper 1/3 fracture was in 33, middle 1/3 fracture was in 35, lower 1/3 fracture was in 20 and multiple fractures was in 2. There were transverse fractures in 20 patients, oblique fractures in 30 patients and comminuted fractures in 40 patients. All of the patients were randomly divided into experimental group (46 patients) and control group (44 patients). The patients in the control group underwent the routine treatment before the orthopedic surgery; besides the routine treatment, the patients in the experimental group were given the rehabilitation education and training before the orthopedic surgery. Results The hospital duration in the rehabilitation group was (5.35±1.27) days while in the control group was (7.67±1.85) days, the difference was statistically significant (Plt;0.05). There were 7 cases who had complications in rehabilitation group compared with 16 patients in the control group; the incidence of the complications in the rehabilitation group (15.2%) was significantly lower than that in the control group (36.4%) (Plt;0.05). After the treatment for 5 days, the therapeutic effect in rehabilitation group were excellent in 35 cases, good in 6 cases, middle in 3 cases and poor in 2 cases (with the good rate of 89.1%); while in the control group were excellent in 25 cases, good in 5 cases, middle in 12 cases and poor in 2 cases (with the good rate of 68.2%); the difference was significant between the two groups (Plt;0.05). Conclusion Rehabilitation education and training could prevent the perioperative complications in patients with femoral shaft fracture, decrease the pain and edema, speed up the turnover of hospital beds, and improve the patients’ quality of life.
ObjectiveTo investigate the inhibitory effect of heat shock protein 90 (HSP90) inhibitors of 17-propylene amino-17-demethoxy geldanamycin (17-AAG) combining with paclitaxel on human anaplastic thyroid cancer FRO cell line. Method①The proliferation inhibition rates of FRO cells were detected by mmethyl thiazolyl tetrazolium (MTT) assay in different concentration groups (17-AAG: 0.312 5, 0.625 0, 1.2500, 2.5000, and 5.0000 μmol/L; paclitaxel: 0.001 0, 0.0100, 0.1000, and 1.0000 μmol/L; combination group, 17-AAG: 0.625 0 μmol/L, paclitaxel: 0.001 0, 0.0100, 0.1000, and 1.0000 μmol/L) and at different time points (24, 48, and 72 hours). ②The change of cell cycle and apoptosis rates of FRO cells were detected in 17-AAG group (0.625 0 μmol/L), paclitaxel group (0.1000 μmol/L), and combination group (17-AAG: 0.625 0 μmol/L, paclitaxel: 0.1000 μmol/L) by flow cytometry at 24 hours after treatment. ③activity of Caspase-3 and Caspase-9 in FRO cells of 17-AAG group (0.625 0 μmol/L), paclitaxel group (0.1000 μmol/L), and combination group (17-AAG: 0.625 0 μmol/L, paclitaxel: 0.1000 μmol/L) was detected by Caspase-3 detection reagent box and Caspase-9 detection reagent box respectively. FRO cells of normal control group were treated without any drug, but culture solution. Results①The proliferation inhibition rates of FRO cells increased with the increase of concentra-tion (17-AAG, paclitaxel, combination of 17-AAG and paclitaxel), there was significant difference between any 2 groups (normal control group included), P<0.05. In addition, the proliferation inhibition rates of FRO cells in any concentration group (normal control group excluded) increased over time (24, 48, and 72 hours), there was significant difference between any 2 time points (P<0.05). The proliferation inhibition rates of FRO cells in combination group were all higher than those of 17-AAG group and paclitaxel group in condition of same time point and same concentration (P<0.05). The q value of combination group was higher than 1.15 at 3 time points in all concentration, that meant 17-AAG could increase the efficiency of paclitaxel. ②The apoptosis rate of FRO cells in normal control group was lower than those of 17-AAG group, paclitaxel group, and combination group (P<0.05), and apoptosis rate of FRO cells in combination group was higher than those of 17-AAG group and paclitaxel group (P<0.05). ③Activity of Caspase-3 and Caspase-9 of FRO cells in normal control group were lower than those of 17-AAG group, paclitaxel group, and combination group (P<0.05), and activity of Caspase-3 and Caspase-9 of FRO cells in combination group were higher than those of 17-AAG group and paclitaxel group (P<0.05). Conclusions17-AAG and paclitaxel can significantly inhibit the proliferation and induce the apoptosis of FRO cells. The combination of the two kinds of drugs may generate synergy, with dose-dependence effect.
Objective To investigate the status of health condition and activities of daily living of “50630” retired cadres in Mianzhu, and analyze the related factors affecting their activities of daily living. Methods According to the registration information of Mianzhu administration of elderly cadres in Sichuan, the method of cluster sampling was adopted in March 2019 to select retired cadres who participated in work between October 1st, 1949 and June 30th, 1950 in urban and rural areas respectively. The survey and analysis were carried out using the self-designed general condition questionnaire, Berg balance scale, Hoffer walking ability rating scale, and modified Barthel Index, to understand the activities of daily living ability of retired cadres and analyze the relevant factors affecting their self-care ability of daily life. Results A total of 64 “50630” retired cadres were investigated, with an average age of (86.39±3.37) years. 64.06% of the patients with poor balance function needed wheelchair, 10.94% could not walk, and 56.25% were heavily dependent on activities of daily living. Age (r=−0.421, P=0.001) and underlying diseases (r=−0.060, P=0.032) were negatively correlated with activities of daily living. Balance ability (r=0.658, P<0.001), walking ability (r=0.393, P=0.001), spouse status (r=0.669, P<0.001), care status (r=0.830, P<0.001), place of residence (r=0.706, P<0.001) were positively correlated with activities of daily living. Education level (r=0.096, P=0.380) and gender (r=0.122, P=0.265) had no correlation with activities of daily living. Multiple linear regression analysis showed that the main influencing factors of daily living activities of “50630” retired cadres in Mianzhu were balance function, walking ability, spouse or not and type of care. Conclusions There are many related factors affecting the activities of daily living of “50630” retired cadres, which can be intervened according to basic diseases, balance function and walking ability. Through multi-disciplinary and multi-sectoral cooperation, integrating community health service resources, providing all-round health care services, formulating personalized rehabilitation measures, and organizing community group activities, it is possible to improve their social participation, psychological status, and ability of daily living activities, and reduce the disability, so as to further improve the quality of life of veteran cadres.