ObjectiveTo develop an exercise intervention program for patients undergoing total knee arthroplasty based on the daily goal management pathway, and preliminarily verify its clinical feasibility and effectiveness. MethodsThe intervention program was formulated based on the daily goal management pathway and hope theory, combined with literature analysis, qualitative interviews and expert consultation. Feasibility evaluation was conducted among orthopedic nurses and patients in Beijing Bo'ai Hospital from September to November, 2025. A controlled pilot study was performed with 15 patients in each group: the control group received routine rehabilitation care, while the experimental group received the developed intervention program. The Hospital for Special Surgery Knee Score (HSS), range of motion (ROM) of knee, functional exercise compliance score, Visual Analogue Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were compared between two groups. ResultsThe program covered three themes from admission to three weeks postoperatively, including seven training methods and 32 specific recommendations. Feasibility results showed 100% patient recruitment rate, 93.75% retention rate and 96.94% program acceptance rate. A total of 21 orthopedic nurses scored ≥ 4.5 on all four dimensions of the program. After intervention, HSS score and knee ROM significantly increased (|t| > 6.205, P < 0.001), while WOMAC and VAS score decreased (t = 9.127, Z = -3.415, P < 0.01) in the experimental group; in the control group, VAS score decreased (Z = -3.122, P = 0.002), and knee ROM reduced (t = -2.622, P = 0.015), with no significant improvement in other indicators (P > 0.05); all the indexes were better in the experimental group than in the control group (|t| > 7.949, |Z| > 2.990, P < 0.01), including the functional exercise compliance (t = -8.565, P < 0.001). ConclusionThe exercise intervention program based on the daily goal management pathway is scientific, feasible and preliminarily effective, which can provide a new structured and humanized nursing for early exercise training of patients during hospitalization for total knee arthroplasty.

Objective To explore the effect of continuous nursing intervention on limb function and nursing quality after proximal femoral nail antirotation (PFNA) internal fixation for femoral intertrochanteric fracture in the elderly. Methods From February, 2017 to November, 2018, 100 elderly patients with femoral intertrochanteric fracture who underwent PFNA internal fixation in our hospital were randomly divided into control group (n = 50) and observation group (n = 50), who accepted routine nursing and continuous nursing respectively for three months. They were assessed with Harris score and visual analogue scale for pain (VAS) before and after the intervention. The postoperative nursing effect was compared. Results The Harris score increased in both groups after the intervention (t > 45.98, P < 0.001), and increased more in the observation group than in the control group (t = 15.03, P < 0.001). The VAS score decreased in both groups after the intervention (t > 16.33, P < 0.001), and decreased more in the observation group than in the control group (t = 9.749, P < 0.001). The effect of nursing was better in the observation group than in the control group (Z = -2.272, P = 0.023). Conclusion Continuous nursing intervention can significantly improve the limb function and nursing satisfaction of elderly patients with femoral intertrochanteric fracture after PFNA.

Objective To observe the effects of standardized pain management on old patients with hip fracture. Methods From January, 2015 to June, 2016, 75 old patients (more than 58 years old) with hip fracture were randomly divided into control group (n=37) and observa-tion group (n=38). The control group accepted routine pain management, while the observation group accepted standardized pain manage-ment. They were assessed with Visual Analogue Score (VAS) of the most intensive pain, and their scores for satisfaction were compared. Re-sults There was no significant difference in VAS between two groups before operation (Z=0.845, P>0.05). The VAS was significantly lower in the observation group than in the control group postoperatively (Z=5.427, P<0.001). The scores of satisfaction was more in the observa-tion group than in the control group (t=21.346, P<0.001). Conclusion Standardized pain management can significantly reduce perioperative pain in old patients after hip fracture surgery, and improve the satisfaction.

Objective To quantitatively study the posterior fossa effective space and its relationship with hemifacial spasm (HFS).Methods We conducted a case-control study of patients diagnosed with HFS and sex-and age-matched healthy controls.All subjects underwent high-resolution three-dimensional MRI.The software of 3D-Slicer was used to measure the posterior fossa space and hindbrain tissue volume between the two groups.Results Sixty patients and 60 controls were enrolled in this study.Compared to controls,patients with HFS had a higher posterior fossa crowdedness index (PFCI;83.7％ ± 0.6％ vs 79.2％ ± 0.4％;t =2.58, P =0.01).The multivariate linear regression analysis revealed that a higher PFCI was associated with younger age (r =-0.61, P =0.02), female gender (r =0.76, P =0.003) and HFS (r =-0.43, P =0.01).Conclusions Patients with HFS have a more crowded posterior fossa space than healthy controls, potentially leading to cranial nerve and vascular structure crowding, thus increasing HFS risk.Women have a higher PFCI, which may explain the strong female preponderance in epidemiologic studies.

Objective To investigate the effect of hyperbaric oxygen preconditioning (HBO) on activation of extracellular signal-regulated kinase (ERK) and death-associated protein kinase 1 (DAPK1)in ischemia-like treated neurons.Methods (1) Cultured mouse primary neurons were allocated into control,ischemia-like condition treated and HBO preconditioning groups.Neurons in ischemia-like condition treated group were treated with 95％ NO2+5％ CO2 for 30 min,and cells in the HBO preconditioning group were pretreated with 98％ O2+2％ CO2 for 2 h,followed by ischemia-like condition treatment.At the end ofthe treatment,the growth of neurons was measured by MTT assay and expression of phosphorylated extracellular signal-regulated kinase (p-ERK) was detected by Western blotting.Neurons were transfected with ERK over-expression vector and pretreated with HBO and ischemia-like condition,and then,the expressions of activated caspase-3 (cleavage caspase-3) and DAPK1 in neurons were analyzed by Western blotting.The interactions of ERK with DAPK1 were also detected by irnmunoprecipitation.(2) Forty-five BALB/c mice were randomized into control,ischemia treated and HBO preconditioning groups.After finishing the treatments,the interactions of ERK with DAPK1 in hippocampal neurons were detected by immunoprecipitation.Results As compared with control group,cells in ischemia-like condition group showed a reduction of cell survivals,while cells in HBO preconditioning group exhibited an inhibition effect on ischemia-like condition-induced cell survival reduction.The expressions of p-ERK were increased by ischemia-like condition,while decreased by HBO preconditioning,with significant difference (P＜0.05).Moreover,over-expression of ERK promoted level of cleavage caspase-3 in neurons; however,DAPK1 expressions were not affected by ischemia-like condition or HBO preconditioning.The interactions of ERK with DAPK1 were attenuated by HBO preconditioning as compared with those by ischemia-like condition treatment.Conclusion HBO preconditioning inhibits ERK activation and disturbs the interaction between ERK and DAPK1,which blocks cell apoptosis and thus induces ischemic tolerance.

Objective To analyze the cause of anemia in patients after hip arthroplasty and to explore correlative nursing intervention. Methods 47 patients undergoing hip arthroplasty in our hospital from 2007 to 2010 were reviewed, they were divided into elderly group (≥70 years old) and non-elderly group (<70 years old). Intra-operative blood loss, post-operative visible blood loss, hidden blood loss, total blood loss, perioperative hemoglobin and number of anemia were compared. Results The average volume of intra-operative blood loss and extra- operative blood loss were significantly lower in elderly group than in non-elderly group (P<0.001); the hidden blood loss was significantly higher in elderly group and in non-elderly group (P<0.001); the incidence of anemia in elderly group was higher than in non-elderly group (P<0.05). Conclusion More post-operative hidden blood loss can be found in patients over 70 years old after hip arthroplasty, so as to the incidence of anemia. The perioperative nursing care and observation should be strengthened to reduce the incidence of anemia.