ObjectiveTo observe the effect of ultra early joint movement onthe rehabilitation of shoulder joint function in patients with breast cancer who underwent axillary lymph node dissection (ALND).MethodsA total of 100 patients with breast cancer who underwent ALND between August 2018 and December 2019 in Zhongnan Hospital of Wuhan University were randomly divided into the early movement group (n=50) and the ultra early movement group (n=50). Both groups received early rehabilitation intervention as recommended by the guidelines. Patients in the early movement group started the shoulder joint movement training on the 7th day after surgery, and patients in the ultra early movement group started the shoulder joint movement training on the 3rd day after surgery, 3 times a day, 5 days a week, for 4 weeks. The changes in pain and drainage volume 3 days, 1 week, and 2 weeks after surgery and the changes of shoulder joint range of motion 1 week, 2 weeks , and 3 weeks after surgery were compared between the two groups, changes in shoulder function and quality of life 1 week and 3, 6, and 12 weeks after surgery were compared by the Constant-Murley and the Medical Outcomes Study 36-item Short-form Health Survey (SF-36) scales, respectively.ResultsThree days, 1 week, and 2 weeks after surgery, no significant difference in the pain scores or drainage volumes was observed between the two groups (P>0.05). One week, 2 weeks, and 3 weeks after operation, the motion ranges of shoulder abduction, flexion, and external rotation in the ultra early movement group were significantly better than those in the early movement group (P<0.05), and the motion range of shoulder internal rotation 1 week after operation in the ultra early movement group was significantly better than that in the early movement group (P<0.05). One week and 3, 6, and 12 weeks after operation, the Constant-Murley scores in the ultra early movement group were 25.9±4.3, 55.4±5.3, 64.6±4.5, and 73.3±4.6, respectively, which were better than those in the early movement group (21.3±3.8, 48.9±7.8, 57.3±4.7, and 70.7±3.0, respectively; P<0.05). No significant difference in the SF-36 scale scores was observed between the two groups (P>0.05).ConclusionsUltra early joint movement can significantly improve the motion range and functions of shoulder joint in patients with breast cancer who underwent ALND. What’s more, ultra early joint movement does not increase the early drainage volume or pain, and has no significant impact on the later quality of life. It is worthy of clinical application.
Anterior cruciate ligament (ACL) injury is one of the most common and typical sports injuries. Neuromuscular proprioceptive training has been widely used in clinical practice in recent years due to its significant therapeutic effects, but the correlation between proprioception and ACL injury is still lacking in-depth exploration. ACL injury can result in the loss of mechanoreceptors, which in turn affects proprioceptive signal afferents, resulting in impaired neuromuscular control. Impaired neuromuscular control, in turn, can cause ligamentous structures to be overburdened beyond their stretch thresholds, leading to proprioceptive impairment, creating a vicious cycle. Based on neuromuscular control theory, this article further discusses the relationship between proprioception and ACL injury, aiming to provide new ideas for rehabilitation after ACL injury.
With the increasing burden of chronic diseases, the issue of comorbidities has become increasingly important. In practice, patients with comorbidity of chronic diseases struggle to access continuous and integrated healthcare experiences. This article introduces the construction of the referral management system for comorbidity of chronic diseases based on “internet plus” in West China Hospital of Sichuan University. By formulating a standardized and convenient referral process and using artificial intelligence to optimize the referral platform, it creates a referral system for comorbidity of chronic diseases suitable for the hospital’s clinical workflows, makes reasonable use of the resources of the return pool, and improves the referral efficiency. After the implementation of the comorbidity referral system, patient satisfaction has increased, providing new ideas and reference experience for the management of comorbidity of chronic diseases for other medical institutions.
In recent years, with the continuous development and increasing maturity of interventional techniques, interventional treatment for congenital heart disease (CHD) has been progressively disseminated to county- and city-level hospitals in China. Concurrently, the standardized management of adult CHD (particularly patent foramen ovale) and the lifelong management of complex CHD are gaining increasing clinical attention, while the emergence of new techniques and products continuously advances the discipline. This article aims to review the new progress made in the field of interventional treatment for congenital heart disease in China during 2024. It specifically reviews and analyzes the following key aspects: (1) annual statistics on interventional closure procedures for CHD; (2) recent insights into patent foramen ovale closure; (3) advances in transcatheter pulmonary valve replacement; (4) interventional treatment and lifelong management strategies for complex CHD; (5) new interventional techniques for acquired heart disease; and (6) the application of artificial intelligence in CHD management. Through the synthesis and discussion of these topics, this article seeks to provide a detailed analysis of the current landscape of interventional treatment for CHD in China and project its future development trends.