Objective:To evaluate the effects of a reduced-positioning restrictions nursing program on postoperative recovery, sleep quality, self-care ability, and hip joint function in patients undergoing total hip arthroplasty (THA), providing a reference for postoperative positioning management.Methods:A randomized controlled trial was conducted, and 140 THA patients admitted to Zhejiang Provincial People′s Hospital from January 2022 to June 2023 were selected using convenience sampling. They were divided into a control group (70 cases) and an observation group (70 cases) using a random number table. The control group received conventional rehabilitation care, while the observation group received a reduced-positioning restrictions nursing program in addition to the conventional care. The incidence of dislocation at 3 months postoperatively, the activities of daily living, the hip joint function recovery at 1 month and 3 months postoperatively, the sleep quality at 1 month postoperatively were compared between the two groups.Results:Finally 63 cases in the control group and 64 cases in the observation group completed the study. The control group included 25 males and 38 females, with an average age of (65.44 ± 10.97) years, while the observation group included 28 males and 36 females, with an average age of (65.13 ± 12.18) years. At 3 months postoperatively, there was no significant difference in the dislocation rate between the control group and the observation group ( P>0.05). At 1 month and 3 months postoperatively, the scores of activities of daily living in the observation group were (77.89 ± 6.71) and (93.52 ± 6.59) points respectively, which were higher than those in the control group [(69.68 ± 5.53) and (87.38 ± 7.72) points], the differences were statistically significant ( t=5.38, 6.96, both P<0.05), the time, interaction and inter-group effects were all statistically significant ( F=33.93, 10.81, 876.91, all P<0.05). At 1 month postoperatively, the excellent and good rate of hip joint function score grade in the observation group was 73.44% (47/64), which was higher than 41.27% (26/63) in the control group, the difference was statistically significant ( Z=-3.67, P<0.05), there was no statistically significant difference between the two groups at 3 months postoperatively ( P>0.05). At 1 month after the operation, the excellent and good rate of sleep quality score grades in the observation group was 81.25% (52/64), which was higher than 57.14% (36/63) in the control group, and the difference was statistically significant ( Z=-3.00, P<0.05). Conclusions:Incorporating a reduced-positioning restrictions nursing program into the perioperative management of THA does not increase the risk of prosthesis dislocation. This approach enhances patient comfort, improves sleep quality, increases self-care ability, and supports the recovery of hip joint function.

Objective:To explore the effect of behavioral activation therapy on subthreshold depression and quality of life in patients with diabetes foot amputation, and to provide reference for clinical psychotherapy and quality of life improvement in patients with diabetes foot amputation.Methods:A randomized controlled trial was conducted to select 50 patients with diabetes foot amputation from September to December 2023 in the People′s Hospital Affiliated to Shandong First Medical University by convenient sampling. The participants were divided into an control group and a observation group, with 25 cases in each group, using a random number table method. The patients in the control group received routine nursing care of diabetes feet, and the patients in the observation group were given behavior activation therapy on the basis of the control group. The Centre for Epidomiological Studies Depression Scale (CES-D), Behavioral Activation for Depression Scale-Short Form (BADS-SF), and Short Form Health Measure (SF-12) were used to assess patients′ subthreshold depression, behavior, and quality of life before the intervention, at the end of the intervention, and 3 months after the intervention.Results:The final number of patients who completed the study in the control group and observation group were 23 and 24, respectively. There were 11 males and 12 females in the control group, with an age of (69.70 ± 7.01) years. There were 12 males and 12 females in the observation group, with an age of (69.17 ± 6.83) years. At the end of the intervention and 3 months after the intervention, the CES-D scores of the observation group were (21.13 ± 2.19) and (18.83 ± 1.86) points, respectively, which were significantly lower than those of the control group (25.70 ± 1.72) and (25.91 ± 1.65) points, and the differences were statistically significant ( t=-7.93, -13.80, both P<0.05). At the end of the intervention and 3 months after the intervention, the BADS-SF behavioral activation dimension scores in the observation group were (17.67 ± 2.41) and (18.50 ± 2.19) points, respectively, higher than the control group's (11.83 ± 1.78) and (11.57 ± 2.02) points, and the differences were statistically significant ( t=31.65, 34.45, both P<0.05). The behavioral avoidance dimension scores were (9.48 ± 1.50) and (9.65 ± 1.99) points, respectively, lower than the control group's (10.75 ± 1.42) and (11.88 ± 1.57) points, and the differences were statistically significant ( t=6.53, 13.17, both P<0.05). Three months after the intervention, the total score of SF-12 in the observation group was (65.96 ± 2.94) points, and the psychological dimension score was (37.50 ± 4.14) points, both of which were higher than those in the control group (60.30 ± 2.42) and (30.13± 5.15) points, and the differences were statistically significant ( t=51.54, 5.42, both P<0.05). There were statistically significant differences in time, between groups, and interaction effects in CES-D score, scores of two dimensions of BADS-SF and SF-12 total score ( F values were 10.04-190.71). Conclusions:Behavioral activation therapy can improve the symptoms of subthreshold depression in patients with diabetes foot amputation, enhance their behavioral activation level, and improve the quality of life to a certain extent.

Objective:To evaluate the effects of a reduced-positioning restrictions nursing program on postoperative recovery, sleep quality, self-care ability, and hip joint function in patients undergoing total hip arthroplasty (THA), providing a reference for postoperative positioning management.Methods:A randomized controlled trial was conducted, and 140 THA patients admitted to Zhejiang Provincial People′s Hospital from January 2022 to June 2023 were selected using convenience sampling. They were divided into a control group (70 cases) and an observation group (70 cases) using a random number table. The control group received conventional rehabilitation care, while the observation group received a reduced-positioning restrictions nursing program in addition to the conventional care. The incidence of dislocation at 3 months postoperatively, the activities of daily living, the hip joint function recovery at 1 month and 3 months postoperatively, the sleep quality at 1 month postoperatively were compared between the two groups.Results:Finally 63 cases in the control group and 64 cases in the observation group completed the study. The control group included 25 males and 38 females, with an average age of (65.44 ± 10.97) years, while the observation group included 28 males and 36 females, with an average age of (65.13 ± 12.18) years. At 3 months postoperatively, there was no significant difference in the dislocation rate between the control group and the observation group ( P>0.05). At 1 month and 3 months postoperatively, the scores of activities of daily living in the observation group were (77.89 ± 6.71) and (93.52 ± 6.59) points respectively, which were higher than those in the control group [(69.68 ± 5.53) and (87.38 ± 7.72) points], the differences were statistically significant ( t=5.38, 6.96, both P<0.05), the time, interaction and inter-group effects were all statistically significant ( F=33.93, 10.81, 876.91, all P<0.05). At 1 month postoperatively, the excellent and good rate of hip joint function score grade in the observation group was 73.44% (47/64), which was higher than 41.27% (26/63) in the control group, the difference was statistically significant ( Z=-3.67, P<0.05), there was no statistically significant difference between the two groups at 3 months postoperatively ( P>0.05). At 1 month after the operation, the excellent and good rate of sleep quality score grades in the observation group was 81.25% (52/64), which was higher than 57.14% (36/63) in the control group, and the difference was statistically significant ( Z=-3.00, P<0.05). Conclusions:Incorporating a reduced-positioning restrictions nursing program into the perioperative management of THA does not increase the risk of prosthesis dislocation. This approach enhances patient comfort, improves sleep quality, increases self-care ability, and supports the recovery of hip joint function.

Objective:To explore the effect of behavioral activation therapy on subthreshold depression and quality of life in patients with diabetes foot amputation, and to provide reference for clinical psychotherapy and quality of life improvement in patients with diabetes foot amputation.Methods:A randomized controlled trial was conducted to select 50 patients with diabetes foot amputation from September to December 2023 in the People′s Hospital Affiliated to Shandong First Medical University by convenient sampling. The participants were divided into an control group and a observation group, with 25 cases in each group, using a random number table method. The patients in the control group received routine nursing care of diabetes feet, and the patients in the observation group were given behavior activation therapy on the basis of the control group. The Centre for Epidomiological Studies Depression Scale (CES-D), Behavioral Activation for Depression Scale-Short Form (BADS-SF), and Short Form Health Measure (SF-12) were used to assess patients′ subthreshold depression, behavior, and quality of life before the intervention, at the end of the intervention, and 3 months after the intervention.Results:The final number of patients who completed the study in the control group and observation group were 23 and 24, respectively. There were 11 males and 12 females in the control group, with an age of (69.70 ± 7.01) years. There were 12 males and 12 females in the observation group, with an age of (69.17 ± 6.83) years. At the end of the intervention and 3 months after the intervention, the CES-D scores of the observation group were (21.13 ± 2.19) and (18.83 ± 1.86) points, respectively, which were significantly lower than those of the control group (25.70 ± 1.72) and (25.91 ± 1.65) points, and the differences were statistically significant ( t=-7.93, -13.80, both P<0.05). At the end of the intervention and 3 months after the intervention, the BADS-SF behavioral activation dimension scores in the observation group were (17.67 ± 2.41) and (18.50 ± 2.19) points, respectively, higher than the control group's (11.83 ± 1.78) and (11.57 ± 2.02) points, and the differences were statistically significant ( t=31.65, 34.45, both P<0.05). The behavioral avoidance dimension scores were (9.48 ± 1.50) and (9.65 ± 1.99) points, respectively, lower than the control group's (10.75 ± 1.42) and (11.88 ± 1.57) points, and the differences were statistically significant ( t=6.53, 13.17, both P<0.05). Three months after the intervention, the total score of SF-12 in the observation group was (65.96 ± 2.94) points, and the psychological dimension score was (37.50 ± 4.14) points, both of which were higher than those in the control group (60.30 ± 2.42) and (30.13± 5.15) points, and the differences were statistically significant ( t=51.54, 5.42, both P<0.05). There were statistically significant differences in time, between groups, and interaction effects in CES-D score, scores of two dimensions of BADS-SF and SF-12 total score ( F values were 10.04-190.71). Conclusions:Behavioral activation therapy can improve the symptoms of subthreshold depression in patients with diabetes foot amputation, enhance their behavioral activation level, and improve the quality of life to a certain extent.

Objective To investigate the status of self-advocacy and symptom burden in breast cancer patients undergoing chemotherapy and explore the correlations between them so as to provide a reference for relieving their symptom burden.Methods A total of 240 breast cancer patients undergoing chemotherapy who were treated in a general hospital in Hubei province from July 2021 to January 2022 were enrolled in the study by convenience sampling method.The general data questionnaire,female self-advocacy in cancer survivorship scale,and Chinese version of Anderson symptom assessment scale(MDASI)were applied in the investigation.Pearson correlation analysis was employed to explore the correlation between self-advocacy and symptom burden among breast cancer patients undergoing chemotherapy.Hierarchical regression was employed to analyze the effect of self-advocacy on symptom burden.Results A total of 240 patients completed the study.The total score of self-advocacy of the patients was(68.89±10.66),and the total score of symptom burden was(66.70±18.80).The two variables were significantly correlated in a negative way(r=-0.683,P<0.05).Hierarchical regression showed that self-advocacy ability independently explained 9.3%of the total variation in the symptom burden.Conclusions The incidences of various symptoms in breast cancer patients undergoing chemotherapy are high,and multiple symptoms coexist in the whole chemotherapy cycle.Symptom burden cannot be ignored,for it is negatively correlated with self-advocacy.Therefore,strengthening the concept and ability of self-advocacy can help reduce symptom burden of patients.

Objective:To evaluate and summarize the evidence on postoperative exercise in patients with rotator cuff injury, so as to provide a basis for guiding the postoperative exercise in patients with rotator cuff injury.Methods:We searched the Joanna Briggs Institute (JBI) Evidence-Based Health Care Center Database, British Medical Journal (BMJ) Best Practice, UpToData, China Biomedical Literature Database, WanFang Data, China National Knowledge Infrastructure, and other databases on postoperative exercise in patients with rotator cuff injury, including guidelines, evidence summaries, systematic reviews, best practice information books, clinical decision-making, recommended practices, and expert consensus. The retrieval period was from the establishment of the database to June 4, 2022.Results:A total of 30 articles were included, including one guideline, one evidence summary, one clinical decision-making, two expert consensuses, and 25 systematic reviews. 22 pieces of evidence from 12 aspects were summarized, including applicable population, exercise benefit, exercise risk, exercise assessment, exercise program, exercise method, exercise time, exercise intensity, exercise monitoring, formulation principles, management mode, and health education were summarized.Conclusions:The evidence summary process is scientific, rigorous, and comprehensive in content. In the process of evidence transformation, medical and nursing staff should select the best evidence according to specific situations and individual patient factors, so as to guide patients with rotator cuff injury to exercise safely and effectively after surgery to improve clinical outcomes.

Objective:To revise the 2017 classification of irreducible intertrochanteric fractures and summarize reduction techniques of 2021 classification.Methods:A retrospective analysis was conducted of the 17 patients with irreducible intertrochanteric fracture who had been treated at Department of Orthopaedic Surgery, The Ninth People's Hospital of Shanghai, Shanghai Jiaotong University School of Medicine from January 2015 to December 2019. They were 7 males and 10 females, with an age of (73.2 ± 16.1) years. On the basis of 2017 classification, the irreducible intertrochanteric fractures were classified into 2 types in the present 2021 classification. Type Ⅰ were interlocking fractures which were further classified into 3 subtypes: type ⅠA were sagittal interlocking ones (7 cases), type ⅠB greater trochanter interlocking ones (one case) and type ⅠC lesser trochanter interlocking ones (one case). Type Ⅱ were separating fractures which were further classified into 4 subtypes: type ⅡA were sagittal separating ones (4 cases), type ⅡB coronal separating ones (one case), type ⅡC rotational separating ones(one case) and type ⅡD complete separating ones (2 cases). All patients were treated by closed reduction and intramedullary nailing with different reduction strategies corresponding to their fracture types (application of ejector rods, clamps or prying techniques, etc.). A total of 132 patients with reducible femoral intertrochanteric fracture who had been admitted during the same period were selected as the control group. The fracture reduction time, intraoperative blood loss and Harris hip score at the last follow-up were compared between the 2 groups.Results:The 2 groups were comparable because there was no significant difference in their preoperative general data ( P>0.05). Type ⅠA accounted for the highest proportion of irreducible intertrochanteric fractures [41.3% (7/17)], followed by type ⅡA [23.6% (4/17)]. The fracture reduction time [(44.6 ± 6.7) min] in the irreducible group was significantly longer than that in the control group [(39.2 ± 9.6) min] ( P<0.05). There was no significant difference in intraoperative blood loss or Harris hip score at the last follow-up between the 2 groups ( P>0.05). Conclusions:Compared with the "2017 classification" , the "2021 classification" is more concise and easy to remember, and can directly prompt the corresponding proper fracture reduction techniques. The patients with irreducible intertrochanteric fracture using proper reduction techniques can obtain functional recovery similar to that in the patients with reducible intertrochanteric fracture after reduction and fixation.

With the transition from quantity-centric healthcare to value-centric healthcare, patient-reported outcome plays an important role in healthcare. Patient-reported outcome is an effective method for evaluating the outcome of hip replacement patients. It can be used not only in science research, but also in clinical practice and medical care quality assessment. This article reviews the patient-reported outcome measures in hip replacement, so as to provide references for clinical practice and research of clinical medical and nursing staff to accurately select appropriate patient-reported outcome measures in hip replacement.

【Objective】 To detect autoantibodies in Chinese systemic sclerosis (SSc) patients and analyze the relationship between clinical phenotype and autoantibodies in SSc. 【Methods】 We sequentially included 93 SSc patients. Their general information and clinical data were gathered. The differences in clinical characteristics among autoantibody negative and positive groups were analyzed statistically. 【Results】 Anti-nuclear antibodies were detected in 82 (88.2%) SSc patients. The positive rate of autoantibodies was detected in 26 cases (28.0%) of anti-Scl-70 antibody, 24 cases (25.8%) of anti-SSA/Ro-52 antibody, 19 cases (20.4%) of anti-U1-snRNP antibody, and 16 cases (17.2%) in anti-CENP-B antibody, respectively. The patients with positive anti-SSA/Ro-52 antibody had a significantly higher morbidity rate of pulmonary arterial hypertension (P=0.016). Patients with anti-Scl-70 antibody showed a higher incidence rate of digital tip ulcers or gangrene (P=0.004) and cardiac damage (P=0.014). The patients with anti-U1-snRNP antibody had a higher prevalence of pulmonary arterial hypertension (P=0.047) and Raynaud’s phenomenon (P=0.019), and showed an increased trend in the occurrence of interstitial lung disease (P=0.058). Those with anti-CENP-B antibody had a lower IgG level (P=0.049) and higher ALP (P=0.010) and γ-GT (P=0.003). The incidence of autoimmune liver disease was increased in anti-CENP-B positive patients (P=0.001). 【Conclusion】 Different autoantibodies in SSc are associated with clinical phenotype, and may contribute to the diagnosis, evaluation, and prognostic judgment of the disease.

Objective: To explore the genetic basis for a pedigree affected with Marfan syndrome (MFS). Methods: Clinical data of the patients was collected.With genomic DNA extracted from peripheral blood samples, potential mutation was detected by targeted exome sequencing.Candidate variants were validated by Sanger sequencing and bioinformatic analysis. Results: Targeted exome sequencing and Sanger sequencing revealed a missense c. 649T>C(p.Trp217Arg) variant in the exon 7 of FBN1 gene, which was unreported previously.Bioinformatics analysis suggested that the variant can cause amino acid replacement and affect the structure and function of fibrillin-1. Conclusion A novel missense variant of the FBN1 gene was identified, which probably underlies the autosomal dominant MFS in this pedigree.