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  • 文章类型: Journal Article
    This article highlights the use of rodents as preclinical models to evaluate the management of nerve injuries, describing the pitfalls and value from rodent nerve injury and regeneration outcomes, as well as treatments derived from these rodent models. The anatomic structure, size, and cellular and molecular differences and similarities between rodent and human nerves are summarized. Specific examples of success and failure when assessing outcome metrics are presented for context. Evidence for translation to clinical practice includes the topics of electrical stimulation, Tacrolimus (FK506), and acellular nerve allografts.
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  • 文章类型: Journal Article
    免疫治疗被认为是治疗肿瘤最有前途的方法之一。目前正在考虑针对致死性胶质母细胞瘤(GBM)的多种免疫治疗思想。然而,免疫治疗剂的问题,如有限的体内稳定性,血脑屏障(BBB)穿透性差,GBM定位不足,代表单一疗法,阻碍了免疫治疗干预措施的成功。此外,即使在常规药物递送系统的帮助下,结果仍然是次优的。仿生策略试图通过模仿自然界的智能结构和功能来克服这些强大的药物递送挑战。利用生物结构和功能的多样性,仿生药物递送系统为多种免疫治疗剂的共同递送提供了具有增强的生物相容性的通用平台。此外,它们固有的穿越BBB和在GBM上回家的能力有望增强GBM免疫疗法的疗效。因此,这篇综述首先回顾了关于GBM免疫治疗的各种想法和药物。然后,分析了GBM免疫治疗成功的障碍,并从功能和结构的角度探讨了相应的仿生策略。最后,阐述了仿生策略的临床翻译现状和前景。这篇综述旨在为GBM免疫治疗的发展提供新的视角。
    Immunotherapy is regarded as one of the most promising approaches for treating tumors, with a multitude of immunotherapeutic thoughts currently under consideration for the lethal glioblastoma (GBM). However, issues with immunotherapeutic agents, such as limited in vivo stability, poor blood-brain barrier (BBB) penetration, insufficient GBM targeting, and represented monotherapy, have hindered the success of immunotherapeutic interventions. Moreover, even with the aid of conventional drug delivery systems, outcomes remain suboptimal. Biomimetic strategies seek to overcome these formidable drug delivery challenges by emulating nature\'s intelligent structures and functions. Leveraging the variety of biological structures and functions, biomimetic drug delivery systems afford a versatile platform with enhanced biocompatibility for the co-delivery of diverse immunotherapeutic agents. Moreover, their inherent capacity to traverse the BBB and home in on GBM holds promise for augmenting the efficacy of GBM immunotherapy. Thus, this review begins by revisiting the various thoughts and agents on immunotherapy for GBM. Then, the barriers to successful GBM immunotherapy are analyzed, and the corresponding biomimetic strategies are explored from the perspective of function and structure. Finally, the clinical translation\'s current state and prospects of biomimetic strategy are addressed. This review aspires to provide fresh perspectives on the advancement of immunotherapy for GBM.
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  • 文章类型: Journal Article
    本研究旨在评估组合水解2型胶原蛋白的效果,甲磺酰基甲烷(MSM),硫酸葡糖胺(GS),并补充硫酸软骨素(CS)对膝骨关节炎(OA)患者膝关节疼痛强度的影响。
    这个多中心,观察,非干预性研究包括98例患者(78例女性,20名男性;平均年龄:52.8±6.5岁;范围,40至64岁),在2022年5月至2022年11月期间患有1-3级膝关节OA。患者被处方为水解2型胶原蛋白的组合,MSM,GS,和CS作为膝关节OA的补充。包含1250毫克水解2型胶原蛋白的组合补充剂的小袋形式,750毫克MSM,750毫克GS,并连续两个月每天一次使用400mgCS。根据西安大略省和麦克马斯特大学骨关节炎指数(WOMAC)对患者进行评估,视觉模拟量表(VAS)-疼痛,健康评估问卷(HAQ)。在第1次访视(基线;研究的第0天)后,安排患者进行4周(访视2)和8周(访视3)的随访。
    对于VAS疼痛,WOMAC,WOMAC-分量表,和HAQ分数,3次访视之间的改善差异显著(均p<0.001).患者对补充剂的依从性中位数为96.77%,访问2和访问3。
    水解2型胶原蛋白的组合,MSM,GS,和CS在膝OA治疗八周被认为是一种有效和安全的营养补充剂。
    UNASSIGNED: This study aimed to evaluate the effects of the combined hydrolyzed type 2 collagen, methylsulfonylmethane (MSM), glucosamine sulfate (GS), and chondroitin sulfate (CS) supplement on knee pain intensity in patients with knee osteoarthritis (OA).
    UNASSIGNED: This multicenter, observational, noninterventional study included 98 patients (78 females, 20 males; mean age: 52.8±6.5 years; range, 40 to 64 years) who had Grade 1-3 knee OA between May 2022 and November 2022. The patients were prescribed the combination of hydrolyzed type 2 collagen, MSM, GS, and CS as a supplement for knee OA. The sachet form of the combined supplement containing 1250 mg hydrolyzed type 2 collagen, 750 mg MSM, 750 mg GS, and 400 mg CS was used once daily for two consecutive months. Patients were evaluated according to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Visual Analog Scale (VAS)-pain, and Health Assessment Questionnaire (HAQ). Patients were scheduled to visit for follow-up four weeks (Visit 2) and eight weeks (Visit 3) after Visit 1 (baseline; day 0 of the study).
    UNASSIGNED: For the VAS-pain, WOMAC, WOMAC-subscale, and HAQ scores, the differences in improvement between the three visits were significant (p<0.001 for all). The patient compliance with the supplement was a median of 96.77%, both for Visit 2 and Visit 3.
    UNASSIGNED: The combination of hydrolyzed type 2 collagen, MSM, GS, and CS for eight weeks in knee OA was considered an effective and safe nutritional supplement.
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  • 文章类型: Journal Article
    非小细胞肺癌(NSCLC),包括肺鳞状细胞癌(LUSC)和肺腺癌(LUAD)亚型,是一种恶性肿瘤类型,5年生存率低。识别新的强大的诊断生物标志物,预后生物标志物,和NSCLC的潜在治疗靶点是迫切需要的。
    UCSCXena,UALCAN,和GEO数据库用于筛选和分析差异表达基因,监管模式,非小细胞肺癌的遗传/表观遗传改变。UCSCXena数据库,GEO数据库,组织微阵列,和免疫组织化学染色分析用于评估诊断和预后价值。进行功能增益测定以检查作用。估计,TIMER,链接的组学,STRING,和DAVID算法用于分析潜在的分子机制。
    NR3C2被鉴定为NSCLC中潜在的重要分子。NR3C2在NSCLC中低水平表达,LUAD,和LUSC组织,这与这些患者的临床指标显着相关。受试者工作特征曲线分析提示NR3C2表达模式改变对NSCLC有诊断价值,LUAD,尤其是LUSC患者。NR3C2表达水平的降低可以帮助预测NSCLC和LUAD患者的不良预后,而不是LUSC患者。这些结果已通过数据库分析和组织微阵列上的真实世界临床样品得到证实。拷贝数变异有助于NSCLC和LUAD中NR3C2的低表达水平,而启动子DNA甲基化参与其在LUSC中的下调。两个NR3C2启动子甲基化位点对LUSC诊断具有较高的敏理性和特异性,具有临床运用潜力。NR3C2可能是NSCLC发生发展的关键参与者,与肿瘤微环境和免疫细胞浸润密切相关。NR3C2共表达的基因参与许多癌症相关的信号通路,进一步支持NR3C2在NSCLC中的潜在重要作用。
    NR3C2是一种新的NSCLC潜在的诊断和预后生物标志物和治疗靶点。
    UNASSIGNED: Non-small cell lung cancer (NSCLC), including the lung squamous cell carcinoma (LUSC) and lung adenocarcinoma (LUAD) subtypes, is a malignant tumor type with a poor 5-year survival rate. The identification of new powerful diagnostic biomarkers, prognostic biomarkers, and potential therapeutic targets in NSCLC is urgently required.
    UNASSIGNED: The UCSC Xena, UALCAN, and GEO databases were used to screen and analyze differentially expressed genes, regulatory modes, and genetic/epigenetic alterations in NSCLC. The UCSC Xena database, GEO database, tissue microarray, and immunohistochemistry staining analyses were used to evaluate the diagnostic and prognostic values. Gain-of-function assays were performed to examine the roles. The ESTIMATE, TIMER, Linked Omics, STRING, and DAVID algorithms were used to analyze potential molecular mechanisms.
    UNASSIGNED: NR3C2 was identified as a potentially important molecule in NSCLC. NR3C2 is expressed at low levels in NSCLC, LUAD, and LUSC tissues, which is significantly related to the clinical indexes of these patients. Receiver operating characteristic curve analysis suggests that the altered NR3C2 expression patterns have diagnostic value in NSCLC, LUAD, and especially LUSC patients. Decreased NR3C2 expression levels can help predict poor prognosis in NSCLC and LUAD patients but not in LUSC patients. These results have been confirmed both with database analysis and real-world clinical samples on a tissue microarray. Copy number variation contributes to low NR3C2 expression levels in NSCLC and LUAD, while promoter DNA methylation is involved in its downregulation in LUSC. Two NR3C2 promoter methylation sites have high sensitivity and specificity for LUSC diagnosis with clinical application potential. NR3C2 may be a key participant in NSCLC development and progression and is closely associated with the tumor microenvironment and immune cell infiltration. NR3C2 co-expressed genes are involved in many cancer-related signaling pathways, further supporting a potentially significant role of NR3C2 in NSCLC.
    UNASSIGNED: NR3C2 is a novel potential diagnostic and prognostic biomarker and therapeutic target in NSCLC.
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  • 文章类型: Journal Article
    脊髓损伤(SCI)通常会导致毁灭性的运动障碍,显著影响受影响个体的生活质量。在过去的几十年里,脊髓电刺激似乎对受影响患者的运动恢复有令人鼓舞的影响。这篇综述旨在通过应用硬膜外电刺激来确定专注于运动功能恢复的临床试验。经皮电刺激,和功能性电刺激。几项临床试验符合这些标准,关注上述干预措施对步行的影响,站立,游泳,树干稳定性,和上肢功能,尤其是把握。经过全面的PubMed在线数据库研究,该综述包括37项临床试验,共192名患者。他们中的许多人似乎在功能上有所改善,临床评估或通过肌电图记录。这篇综述概述了电刺激技术可以帮助SCI患者运动恢复的各种方式。它强调了医学研究的持续需求,以完善这些技术并最终提高临床环境中的康复效果。
    Spinal cord injury (SCI) often leads to devastating motor impairments, significantly affecting the quality of life of affected individuals. Over the last decades, spinal cord electrical stimulation seems to have encouraging effects on the motor recovery of impacted patients. This review aimed to identify clinical trials focused on motor function recovery through the application of epidural electrical stimulation, transcutaneous electrical stimulation, and functional electrical stimulation. Several clinical trials met these criteria, focusing on the impact of the aforementioned interventions on walking, standing, swimming, trunk stability, and upper extremity functionality, particularly grasp. After a thorough PubMed online database research, 37 clinical trials were included in this review, with a total of 192 patients. Many of them appeared to have an improvement in function, either clinically assessed or recorded through electromyography. This review outlines the various ways electrical stimulation techniques can aid in the motor recovery of SCI patients. It stresses the ongoing need for medical research to refine these techniques and ultimately enhance rehabilitation results in clinical settings.
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  • 文章类型: Journal Article
    背景:肥胖是射血分数保留的心力衰竭(HFpEF)的重要危险因素。在这项研究中,我们探索体重指数(BMI)和脂肪组织之间的关系,如内脏脂肪组织(VAT),皮下脂肪组织(SAT),和心外膜脂肪组织(EAT),关于左心室收缩功能保留的受试者的左心室(LV)结构和功能。
    方法:在2020年1月至12月之间,这项回顾性研究包括749名表现出保留的左心室收缩功能并接受了经胸超声心动图和腹部计算机断层扫描的参与者。LV结构和功能变量以及EAT,VAT,使用超声心动图和计算机断层扫描评估SAT厚度。
    结果:SAT下降,而增值税和饮食随着年龄的增长而逐渐增加。BMI与各种脂肪组织之间存在显著的相关性,与增值税(r=.371,p<.001)或EAT(r=.135,p<.001)相比,SAT的相关性最强(r=.491,p<.001)。然而,EAT显示出与左心室舒张末期尺寸降低的最实质性关联,左心室收缩末期内径,间隔二尖瓣环速度和增加的相对壁厚(所有p<0.05),而调整临床变量后,VAT和SAT与LV重塑和功能参数无显著相关性.
    结论:EAT是影响左心室几何和功能变化的最关键的脂肪组织,与增值税或SAT相比。厚EAT与小LV室尺寸相关,同心重塑,和放松异常。
    BACKGROUND: Obesity is a significant risk factor for heart failure with preserved ejection fraction (HFpEF). In this study, we explore the relationships between body mass index (BMI) and adipose tissue compartments such as visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and epicardial adipose tissue (EAT), with respect to left ventricular (LV) structure and function in subjects with preserved LV systolic function.
    METHODS: Between January and December 2020, this retrospective study included 749 participants who exhibited preserved LV systolic function and underwent transthoracic echocardiography along with abdominal computed tomography. LV structural and functional variables as well as EAT, VAT, and SAT thickness were evaluated using echocardiography and computed tomography.
    RESULTS: SAT decreased, while VAT and EAT progressively increased with age. There were significant correlations between BMI and various adipose tissues, with the strongest correlation observed with SAT (r = .491, p < .001) compared to VAT (r = .371, p < .001) or EAT (r = .135, p < .001). However, EAT demonstrated the most substantial association with decreased LV end-diastolic dimension, LV end-systolic dimension, and septal mitral annular velocity and increased relative wall thickness (all p < .05), while VAT and SAT did not show significant associations with LV remodeling and functional parameters after adjusting for clinical variables.
    CONCLUSIONS: EAT is the most critical adipose tissue influencing LV geometric and functional changes, compared with VAT or SAT. Thick EAT is associated small LV chamber size, concentric remodeling, and relaxation abnormalities.
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  • 文章类型: Journal Article
    日常功能的变化构成有临床意义的结果,甚至在阿尔茨海默病的早期阶段。基于绩效的日常功能评估可能有助于发现这些早期变化。我们旨在调查认知未受损的老年人的日常功能随时间的变化与tau和淀粉样蛋白的关系。
    76名认知未受损的参与者(72±6岁,61%的女性)在2.0±0.9年内完成了多项哈佛自动电话任务(APT)评估。哈佛APT由三个任务组成,通过自动电话系统执行,参与者补充处方(APT-Script),选择新的初级保健医生(APT-PCP),并转账支付账单(APT-Bank)。参与者在基线时接受了匹兹堡化合物B和flortaucipir正电子发射断层扫描。我们计算了皮质淀粉样蛋白聚集体的分布体积比以及内侧颞叶和新皮质tau区域的标准化摄取体积比。在单独的线性混合模型中,基线淀粉样蛋白时间和tau时间相互作用用于预测哈佛APT任务表现的纵向变化.还研究了tau与时间相互作用的三元淀粉样蛋白。最后,我们在探索性体素全脑分析中研究了tau与哈佛APT评分变化之间的关联.所有模型都根据年龄进行了调整,性别,和教育。
    淀粉样蛋白[非标准化部分回归系数估计值(β)=-0.007,95%置信区间(95%CI)=(-0.013,-0.001)],内侧颞叶tau[β=-0.013,95%CI=(-0.022,-0.004)]仅与APT-PCP随时间的变化相关,即,较高的基线淀粉样蛋白和较高的基线tau与APT-PCP的急剧下降率相关.体素分析显示,tau与APT-PCP评分随时间变化之间存在广泛关联。
    即使在没有认知障碍的老年人中,认知复杂日常活动的表现随时间的变化与基线时皮质淀粉样蛋白和广泛的脑tau负担有关.这些发现支持了阿尔茨海默病病理与功能之间的联系,并强调了在临床前疾病阶段测量日常功能的重要性。
    UNASSIGNED: Changes in everyday functioning constitute a clinically meaningful outcome, even in the early stages of Alzheimer\'s disease. Performance-based assessments of everyday functioning might help uncover these early changes. We aimed to investigate how changes over time in everyday functioning relate to tau and amyloid in cognitively unimpaired older adults.
    UNASSIGNED: Seventy-six cognitively unimpaired participants (72 ± 6 years old, 61% female) completed multiple Harvard Automated Phone Task (APT) assessments over 2.0 ± 0.9 years. The Harvard APT consists of three tasks, performed through an automated phone system, in which participants refill a prescription (APT-Script), select a new primary care physician (APT-PCP), and transfer money to pay a bill (APT-Bank). Participants underwent Pittsburgh compound-B and flortaucipir positron emission tomography scans at baseline. We computed distribution volume ratios for a cortical amyloid aggregate and standardized uptake volume ratios for medial temporal and neocortical tau regions. In separate linear mixed models, baseline amyloid by time and tau by time interactions were used to predict longitudinal changes in performance on the Harvard APT tasks. Three-way amyloid by tau by time interactions were also investigated. Lastly, we examined associations between tau and change in Harvard APT scores in exploratory voxel-wise whole-brain analyses. All models were adjusted for age, sex, and education.
    UNASSIGNED: Amyloid [unstandardized partial regression coefficient estimate (β) = -0.007, 95% confidence interval (95% CI) = (-0.013, -0.001)], and medial temporal tau [β = -0.013, 95% CI = (-0.022, -0.004)] were associated with change over time in years on APT-PCP only, i.e., higher baseline amyloid and higher baseline tau were associated with steeper rate of decline of APT-PCP. Voxel-wise analyses showed widespread associations between tau and change in APT-PCP scores over time.
    UNASSIGNED: Even among cognitively unimpaired older adults, changes over time in the performance of cognitively complex everyday activities relate to cortical amyloid and widespread cerebral tau burden at baseline. These findings support the link between Alzheimer\'s disease pathology and function and highlight the importance of measuring everyday functioning in preclinical disease stages.
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  • 文章类型: Journal Article
    背景:世界卫生组织报告说,背痛是全球疾病的主要原因。它是最常见的肌肉骨骼疾病,疼痛有限,肌肉紧张,和刚度,70-80%的人一生中经历过一次,女性患病率高于男性。本研究旨在探讨臀肌强化运动核心稳定训练(基于GSE的CST)对疼痛的影响,函数,恐惧回避模式,慢性背痛患者的生活质量。方法:本研究纳入34例非特异性慢性下腰痛患者。每个17个人被包括在基于GSE的CST和对照组中。基于GSE的CST组进行GSE和CST15分钟,一周三次,连续四周,对照组每天进行CST30分钟,一周三次,四个星期。采用数字疼痛评定量表对治疗前后的疼痛进行评价,罗兰-莫里斯残疾问卷用于评估功能,恐惧-回避信念问卷用于评估恐惧-回避模式,和生活质量测量使用短表格-36。结果:在这项研究中,疼痛,函数,两组恐惧回避模式均显著降低(P<0.05)。在评估生活质量的过程中,两组患者的身心因素均显著增加(p<0.05)。基于GSE的CST组和对照组之间的疼痛和生活质量存在显着差异(p<0.05)。结论:因此,基于GSE的CST可以作为有效干预以增强疼痛的基础,函数,恐惧回避模式,和生活质量,强调未来非特异性慢性背痛患者需要加强臀肌锻炼。
    Background: The World Health Organization reports that back pain is a major cause of disorder worldwide. It is the most common musculoskeletal disorder with limited pain, muscle tension, and stiffness, and 70-80% of all individuals experience it once in their lifetime, with higher prevalence in women than in men. This study aimed to investigate the effects of gluteal muscle strengthening exercise- based core stabilization training (GSE-based CST) on pain, function, fear-avoidance patterns, and quality of life in patients with chronic back pain. Methods: This study included 34 patients with non-specific chronic low back pain. Seventeen individuals each were included in GSE-based CST and control groups. The GSE-based CST group performed GSE and CST for 15 min, three times a week for four weeks, and the control group performed CST for 30 min a day, three times a week for four weeks. The numeric pain rating scale was used to evaluate pain before and after treatment, Roland-Morris disability questionnaire was used to evaluate function, fear-avoidance beliefs questionnaire was used to evaluate fear-avoidance patterns, and quality of life was measured using the short form-36. Results: In this study, pain, function, and fear-avoidance pattern decreased significantly in both groups (All p < 0.05). During the evaluation of quality of life, both groups showed significant increase in physical and mental factors (p < 0.05). There were significant differences in pain and quality of life (p < 0.05) between the GSE-based CST and control groups. Conclusions: Therefore, GSE-based CST can be used as a basis for effective intervention to enhance pain, function, fear-avoidance patterns, and quality of life, emphasizing the need for gluteal muscle strengthening exercises in patients with non-specific chronic back pain in the future.
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  • 文章类型: Journal Article
    心脏移植是治疗终末期心脏病的主流疗法。然而,心脏移植功能受多种因素影响。监测HT患者的移植物功能障碍迹象很重要。经胸超声心动图是一种简单的,第一行,和非侵入性的方法来评估心脏功能。新兴的斑点追踪超声心动图(STE)可以比传统的超声心动图快速轻松地提供附加信息。STE纵向变形参数是心室功能早期损害的标志。虽然曾经被称为“被遗忘的心室”,右心室(RV)评估近年来受到关注。这篇综述强调了STE在评估临床上良好的HT患者的RV收缩功能中的潜在有利作用。
    Heart transplantation (HT) is the mainstream therapy for end-stage heart disease. However, the cardiac graft function can be affected by several factors. It is important to monitor HT patients for signs of graft dysfunction. Transthoracic echocardiography is a simple, first-line, and non-invasive method for the assessment of cardiac function. The emerging speckle-tracking echocardiography (STE) could quickly and easily provide additive information over traditional echocardiography. STE longitudinal deformation parameters are markers of early impairment of ventricular function. Although once called the \"forgotten ventricle\", right ventricular (RV) assessment has gained attention in recent years. This review highlights the potentially favorable role of STE in assessing RV systolic function in clinically well HT patients.
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  • 文章类型: Journal Article
    目的:主要目的是评估全髋关节置换术(THA)是否能够在髋关节囊内骨折后恢复与健康相关的生活质量(HRQoL)。次要目的是评估髋关节特定功能的变化,健身/虚弱,死亡风险,并发症和翻修风险,以及与这些因素独立相关的因素。
    方法:这项回顾性队列研究包括42个月期间从急诊科收治的所有年龄≥50岁髋部骨折患者。患者人口统计学,围手术期变量,并发症,修订版,和死亡率被收集。在最后的随访中评估患者报告的结果指标(PROM)。
    结果:在250名确定的患者中,189名女性(75.6%),平均年龄为70.3岁(50-94岁)。平均随访时间为2.3(SD1.1)年。植入物和患者2年生存率均为95.5%(95%置信区间(CI)+/-2.7)。年龄(风险比[HR]1.22,95%CI1.12-1.33,p<0.001)和男性(HR3.33,95%CI1.15-10.0,p=0.026)与死亡率独立相关。有19(7.6%)术后并发症,包括6(2.4%)假体周围骨折,5(2.0%)深部感染,和8(3.2%)脱位,其中13人进行了修订。增加手术时间(HR1.02,95%CI1.01-1.03,p=0.017)与术后并发症独立相关。166例(66.4%)患者术后可使用PROM。EuroQol-5D有显著(p<0.001)恶化(平均差[MD]0.192,95%CI0.133-0.252),牛津髋关节评分(MD2.5,95%CI1.5-3.6),和适应性(Rockwood评分MD0.7,95%CI0.5-0.8)相对于术前功能水平。
    结论:THA可能是身体活动患者的首选治疗方法,目的是恢复他们的HRQoL,髋关节功能,和健身,但这没有被观察到。此外,并发症发生率很高,这与手术时间增加有关。
    方法:III,回顾性队列研究。
    OBJECTIVE: The primary aim was to assess whether a total hip arthroplasty (THA) was able to restore health-related quality of life (HRQoL) following an intracapsular hip fracture. The secondary aims were to assess changes in hip-specific function, fitness/frailty, mortality risk, complications and revision risk, and factors independently associated with these.
    METHODS: This retrospective cohort study included all patients aged ≥ 50 years admitted with a hip fracture from the emergency department at a single centre during a 42-month period. Patient demographics, perioperative variables, complications, revision, and mortality were collected. Patient-reported outcome measures (PROMs) were assessed at final follow-up.
    RESULTS: Among 250 identified patients, 189 (75.6%) were women with a mean age of 70.3 (range 50-94 years). Mean follow-up was 2.3 (SD 1.1) years. The implant and patient survival rates at 2 years were both 95.5% (95% confidence intervals (CI) +/- 2.7). Older age (hazard ratio [HR] 1.22, 95% CI 1.12-1.33, p < 0.001) and male sex (HR 3.33, 95% CI 1.15-10.0, p = 0.026) were independently associated with mortality. There were 19 (7.6%) postoperative complications that included 6 (2.4%) periprosthetic fractures, 5 (2.0%) deep infections, and 8 (3.2%) dislocations, of which 13 underwent revision. Increasing time to theatre (HR 1.02, 95% CI 1.01-1.03, p = 0.017) was independently associated with a postoperative complication. Postoperative PROMs were available for 166 (66.4%) patients. There were significant (p < 0.001) deteriorations in EuroQol-5D (Mean difference [MD] 0.192, 95% CI 0.133-0.252), Oxford hip score (MD 2.5, 95% CI 1.5-3.6), and fitness (Rockwood score MD 0.7, 95% CI 0.5-0.8) relative to preoperative levels of function.
    CONCLUSIONS: THA may be the treatment of choice in a physically active patient with the aim of restoring their HRQoL, hip function, and fitness, but this was not observed. Furthermore, there was a high complication rate which was associated with increasing time to theatre.
    METHODS: III, retrospective cohort study.
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