Objective:To explore the efficacy of multi-component exercise intervention in the rehabilitation nursing of elderly patients with intertrochanteric femoral fractures and frailty.Methods:Between January and December 2023, 130 elderly patients with intertrochanteric femoral fractures and frailty admitted to Zhengzhou Orthopaedic Hospital were selected by convenience sampling method. The patients were divided into control group ( n=65) and observation group ( n=65) using the random number table method. Control group implemented conventional nursing and observation group was treated with multi-component exercise intervention, both intervening for three months. The rehabilitation status of two groups of patients was evaluated with the Modified Barthel Index (MBI) and Functional Independence Measure (FIM) . Harris Hip Score (HHS) , Physical Frailty Phenotype, Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) and Compliance Scale of Functional Exercise for Orthopedic Patients were used to evaluate the hip function, frailty, quality of life and exercise compliance. Results:After intervention, the MBI score, FIM score and SF-36 score of control group were lower than those of observation group, and the Physical Frailty Phenotype score was higher than that of observation group, and the differences were statistically significant ( P<0.05) . At one and three months after intervention, the HHS scores of observation group were higher than those of control group, and the differences were statistically significant ( P<0.05) . During the intervention period, the exercise compliance of patients in observation group was higher than that of control group, and the difference was statistically significant ( P<0.05) . Conclusions:Multi-component exercise intervention promotes postoperative rehabilitation, improves hip function and quality of life, alleviates the frailty, and enhances exercise compliance in elderly patients with intertrochanteric femoral fractures and frailty.

Objective:To explore the efficacy of multi-component exercise intervention in the rehabilitation nursing of elderly patients with intertrochanteric femoral fractures and frailty.Methods:Between January and December 2023, 130 elderly patients with intertrochanteric femoral fractures and frailty admitted to Zhengzhou Orthopaedic Hospital were selected by convenience sampling method. The patients were divided into control group ( n=65) and observation group ( n=65) using the random number table method. Control group implemented conventional nursing and observation group was treated with multi-component exercise intervention, both intervening for three months. The rehabilitation status of two groups of patients was evaluated with the Modified Barthel Index (MBI) and Functional Independence Measure (FIM) . Harris Hip Score (HHS) , Physical Frailty Phenotype, Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) and Compliance Scale of Functional Exercise for Orthopedic Patients were used to evaluate the hip function, frailty, quality of life and exercise compliance. Results:After intervention, the MBI score, FIM score and SF-36 score of control group were lower than those of observation group, and the Physical Frailty Phenotype score was higher than that of observation group, and the differences were statistically significant ( P<0.05) . At one and three months after intervention, the HHS scores of observation group were higher than those of control group, and the differences were statistically significant ( P<0.05) . During the intervention period, the exercise compliance of patients in observation group was higher than that of control group, and the difference was statistically significant ( P<0.05) . Conclusions:Multi-component exercise intervention promotes postoperative rehabilitation, improves hip function and quality of life, alleviates the frailty, and enhances exercise compliance in elderly patients with intertrochanteric femoral fractures and frailty.

Objective:To explore the sequential chemotherapy efficacy of different chemotherapeutic regimens in ovarian epithelial carcinoma, fallopian tube carcinoma, and primary peritoneal carcinoma.Methods:A retrospective analysis was conducted on clinical and pathological data of 100 patients with platinum-sensitive ovarian epithelial carcinoma, fallopian tube carcinoma, and primary peritoneal carcinoma treated at Peking University Peopel′s Hospital from January 1992 to January 2019. All patients underwent staging surgery or cytoreductive surgery followed by adjuvant chemotherapy. Based on different postoperative adjuvant chemotherapy regimens, patients were divided into the sequential chemotherapy group (70 cases) and the conventional chemotherapy group (30 cases). Clinical and pathological characteristics, chemotherapy efficacy, adverse reactions, and prognosis were compared between the two groups.Results:(1) Clinical and pathological characteristics: the age, tumor types (including ovarian epithelial carcinoma, fallopian tube carcinoma, and primary peritoneal carcinoma), pathological types, International Federation of Gynecology and Obstetrics (FIGO) stage, postoperative residual disease size, presence of neoadjuvant chemotherapy, and total number of chemotherapy cycles were compared between the sequential chemotherapy group and the conventional chemotherapy group. There were no statistically significant differences observed in these characteristics between the two groups (all P>0.05). (2) Chemotherapy efficacy: the median sum of complete response (CR)+partial response (PR) duration in the sequential chemotherapy group was 80.0 months (range: 39 to 369 months), whereas in the conventional chemotherapy group, it was 28.0 months (range: 13 to 52 months). A statistically significant difference was observed between the two groups ( Z=-7.82, P<0.001). (3) Chemotherapy adverse reactions: in the sequential chemotherapy group, 55 cases (79%, 55/70) experienced bone marrow suppression and 20 cases (29%, 20/70) had neurological symptoms. In the conventional chemotherapy group, these adverse reactions occurred in 11 cases (37%, 11/30) and 2 cases (7%, 2/30), respectively. Statistically significant differences were observed between the two groups for both bone marrow suppression and neurological symptoms (all P<0.05). For the other chemotherapy adverse reactions compared between the two groups, no statistically significant differences were observed (all P>0.05). (4) Prognosis: during the follow-up period, the recurrence rate in the sequential chemotherapy group was 73% (51/70) and in the conventional chemotherapy group was 100% (30/30). The median sum of recurrence-free interval was 70.5 months (range: 19 to 330 months) in the sequential chemotherapy group and 15.0 months (range: 6 to 40 months) in the conventional chemotherapy group. Statistically significant differences were observed between the two groups for both recurrence rate and median recurrence-free interval (all P<0.01).In the sequential chemotherapy group, the median progression-free survival (PFS) time was 84.0 months (range: 34 to 373 months), and the median overall survival (OS) time was 87.0 months (range: 45 to 377 months). In contrast, in the conventional chemotherapy group, the median PFS time was 30.5 months (range: 14 to 60 months), and the median OS time was 37.5 months (range: 18 to 67 months). Statistically significant differences were observed between the two groups for both PFS and OS (all P<0.001). In the sequential chemotherapy group, the 3-year, 5-year, and 10-year OS rates were 100% (70/70), 93% (65/70), and 21% (15/70), respectively. In contrast, in the conventional chemotherapy group, the OS rates were 50% (15/30) at 3 years, 3% (1/30) at 5 years, and 0 at 10 years, respectively. The two groups were compared respectively, and the differences were statistically significant (all P<0.05). Conclusions:Sequential chemotherapy significantly prolongs PFS and OS in patients with ovarian epithelial carcinoma, fallopian tube carcinoma, and primary peritoneal carcinoma. The efficacy is superior to that of the conventional chemotherapy, with manageable adverse reactions. The use of sequential chemotherapy as first-line treatment for patients with ovarian epithelial carcinoma, fallopian tube carcinoma, and primary peritoneal carcinoma is recommended.

Objective:To monitor and evaluate in vivo dose changes of intensity-modulated radiotherapy (IMRT) in patients with cervical cancer in a real-time manner. Methods:Twelve patients with cervical cancer admitted to our hospital were enrolled in this study. The in vivo doses were monitored by PerFRACTION?. Electronic portal imaging device (EPID) were collected in each treatment fraction for two-dimensional in vivo dose verification[γ index and dose difference (DD) index]. Log files were recorded for three-dimensional in vivo dose verification (γ index). The correlation between in vivo dose and treatment duration was analyzed by Pearson correlation analysis. Results:A total of 206 sets of EPID images and corresponding Log files were collected. The three-dimensional in vivo dose verification γ 1%/1mm of all patients was not correlated with treatment fraction ( P>0.05). Among them, the absolute difference of γ 1%/1mm of 94.66% fractions was< 1%. The mean DD 3% of two-dimensional in vivo dose verification of all patients was negatively correlated with treatment fraction ( P<0.05). Among which, the average γ 3%/3mm of 9 patients was>89% in the treatment fractions, and the average γ 3%/3mm of 98.57% fractions of these 9 patients was>93%. The other 3 patients had an average γ 3%/3mm ranged from 38% to 100%. CBCT images showed that the bladder volume of these 3 patients was significantly decreased with the relative changes by 82.08%, 84.41% and 73.59%, respectively, and the target area was retracted significantly with the relative changes by 38.12%, 59.79% and 24.46%, respectively. Conclusion:Combined with γ index and DD index, PerFRACTION? can monitor the mechanical stability of accelerator and MU delivery accuracy during treatment fractions, and monitor the changes of in vivo dose in patients with cervical cancer, which can improve the safety and quality assurance of IMRT for cervical cancer patients and provide guidance for patients with adaptive radiotherapy.

Objective To analyze the indications and evaluate the efficacy of the needle to 'double reverse' traction reset,inside and outside double column locking plate internal fixation with MiPPO for tibial plateau fractures.Methods From August 2015 to March 2017,a total of 31 patients with tibial plateau fractures in our hospital were divided into treatment group and control group.The treatment group with 12 cases were treated with the needle to be 'double reverse' traction reset,inside and outside double column locking plate MiPPO fixation.The control group with 19 cases received open reduction and internal fixation with locking plate.Results In treatment group,the operation time was (51.3±6.5)minutes,the intraoperative bleeding was (60±8.7)mL.In the control group,the operation time was (68.5±6.6)minutes,the intraoperative bleeding was (230±7.8)mL.The operation time and blood loss of treatment group were less than those of control group,the differences were statistically significant(P<0.05).The postoperative X ray film of fracture showed that the bone plate and screw position were ideal compared with those before operation,no complication occurred.Conclusion The needle 'double inverse' traction and locking plate MiPPO fixation treatment have good clinical effect for patients of Schatzker Ⅴ,Ⅵ tibia platform fracture,with less complication.

Objective To investigate the biomechanical characteristics of the acromioclavicular joint,put forward the treatment of acromioclavicular joint dislocation based on the principle of anchor and apply to clinic.Methods From August 2011 to March 2015,24 patients with the acromioclavicular joint dislocation in department of orthopedics of Chinese Medicine Hospital of Changshu were divided into the treatment group and the control group,with 12 cases in each group.The treatment group were treated by vertical suspension buttons steel cable system based on principle of anchor,while the control group were treated by the hook plate technology.The clinical results of the two groups were evaluated by Karlsson score system.Results All the patients were followed up for 6 to 12 months.In terms of the curative effect in the treatment group,there were 11 cases of excellent and 1 case of good,with the excellent and good rate of 100%,and no complication occured.In the control group,there were 7 cases of excellent and 3 case of good,with the excellent and good rate of 83.3%.And there was 1 case of subacromial osteolysis.Conclusion To treat acromioclavicular joint dislocation above Rockwood Ⅲ with vertical suspension buttons steel cable system based on principle of anchor may be an ideal treatment method.

SUMMARY Pheochromocytomaisrareinpregn’ancy.Clinicalfeaturesofacaseofpheochromocytoma during pregnancy in the Peking University People’s Hospital was investigated and the literature reviewed to discuss the diagnosis and treatment of this disease.The patient manifested with hypertension and pro-teinuria,who was easily misdiagnosed with gestational hypertension disease.When she was transferred to our hospital,the symptoms such as,paroxysmal palpitation,dizziness,vomiting were noticed,and the possibility of pheochromocytoma was considered due to the accompanying abdominal mass.An emergent cesarean section was performed successfully due to preterm labor during the treatment of the disease.Af-ter the delivery the drug preparation continued.And the laparoscopic resection of pheochromocytoma pro-ceeded when the blood pressure was steady.The patient recovered fully after the surgery.The final diag-nosis of pheochromocytoma was confirmed with the pathology.Its diagnosis and treatment experiences could improve our understanding and treatment of secondary hypertension due to pheochromocytoma in pregnancy.

Objective To explore the effect of polyethylene terephthalate artificial ligament revascularization on the treatment of distal tibiofibular syndesmosis injury .Methods The data of 18 patients with distal tibiofibular syndesmosis injury in our hospital from March 2013 to March 2014 were retrospectively analyzed .Fourteen patients received the bilateral suspension fixed technology ,and 4 cases were fixed with unilateral suspension fixation by extrusion screw which could be absorbed .The ankle joint mobility was measured during the follow-up,which were evaluated by American orthopedic foot and ankle society ( AOFAS) .Results Eighteen patients with distal tibiofibular syndesmosis in-jury were followed up for 12~17 months,with an average of 13.5 months.Imagings showed that the tibiofibular space was normal on postop-erative X-ray films,and there was no lost in 1 year.The PET of artificial ligaments were taken out ,and the artificial ligament and bone tissue were combined with a good ligament toughness .The pathological examination revealed the fibrous tissue grew in the artificial ligaments .Ac-cording to AOFAS ankle function grading evaluation of curative effect ,11 cases were excellent ,6 cases were good ,and 1 case was not obvious . Conclusion PET artificial ligament revascularization can recover the hinge functions of tibiofibular syndesmosis for patients with early recov -ery of ankle plantar flexion range in a short time .Different ways of fixed ligament had no obvious effect on functional recovery ,however,the extrusion screw technology can shorten the time of surgery .

Objective To discuss the interactive management mode (IMM) of preventive treatment on osteoporosis self-rehabilitation of rural elderly residents.Methods IMM was used to manage osteoporosis patients in the community of Changshu,and general self-efficacy scale was adopted for evaluation.Results Self-efficacy score (34.2) increased comparing with before(23.5 ) the medical management,the difference was statistically significant ( P＜0.05 ).Conclusion IMM of preventive treatment can effectively improve the rural community general self-efficacy level.

ObjectiveTo study the effect of TCM diagnostic method flow reconstruction and optimized management in the mass injuries emergency previewing reception.MethodsWorking mode of TCM optimized receiving and dispatching flow were established and enforced.Results27 batch of 216 cases were received by emergency previewing reception in 2009～2010.Compared to 2009,patient dispatching time was shorten by 3.0 min,area dispatching time was shorten by 2.9 min in average.Emergency treatment satisfaction was elevated from 65％ to 95％ and rescue successful rate was increased from 82.3％ to 89.6％.ConclusionTCM diagnostic method flow reconstruction and optimized management improved the level of management of in the mass injuries emergency previewing reception and obtained better results.