Objective To investigate fracture patients' perception about pain and analgesic.Methods In-depth interview for 30 min was done for 20 fracture patients within 12 h after their admission.Data were analyzed based on Colaizzi phenomenological research method.Results Fracture patients underestimated the influence that pain had dosne to them.When they were suffering from pain,most of them chose to endure until they couldn't endure anymore.For analgesics,most of them chose to avoid from using them unless they couldn't endure anymore.Conclusions Pain management education should be done to help patients correct their bias about pain,know more about analgesics according to their personal conditions,and help them self-report their pain and manage their pain timely and properly.

Objective To understand use of blood pressure-lowering medications and to identify factors contributing to their compliance among hypertensive patients at a community health-care service center under Huairou County Hospital, Beijing to improve community management for hypertensive therapy.Methods Medical records of hypertensive patients who visited Qiaozizhen community health-care service center in Huairou county, Beijing during June 2008 to May 2009 were analyzed and 849 of them were interviewed using a pre-tested, structured questionnaire with most closed ended questions included to understand their use of anti-hypertensive drugs and its related factors. Results In 849 hypertensive patients under community management, 78.92% percent (670/849) took anti-hypertensive drugs, 72.54%percent (486/670) in good compliance with drug treatment, and 29. 63 percent (144/486) under guidance of their general practitioners or visited secondary-care hospitals or above, 62. 14 percent (302/486) took drugs by themselves and 8. 23 percent (40/486) took drugs following advice by their relatives or other hypertensive patients. The most common used drugs in 503 hypertensive patients who could remember names of the drugs included reserpine compound tablets, reserpine and triamterene compound tablets (302/503, 60. 04% ) and calcium-channel blockers ( 181/503,35.98% ). Overall, blood pressure was under control in ( 289/849,34. 04% ) percent of those with community management, and( 189/486, 38. 89% ) percent of them kept in a good compliance, significantly higher than that in those with poor compliance (48/179,26. 82% ) (P =0. 0032). Results of multivariate logistic regression analysis showed that drug compliance associated mainly with complications of hypertension ( OR of 4. 423 and 95% CI of ORs 2. 141 - 9. 137). Conclusions Drug compliance among hypertensive patients is still poor in rural Beijing, most with reserpine compound tablets.It is necessary to pay more attention to health education among hypertensive patients, particularly about when to start drug-taking and how to take drugs in a scientific way-regularly and complying with physicians'prescription.

Objective To evaluate the clinical application of postprocessing technique of spiral CT images in chest diseases.Methods Chest spiral CT was performed in 105 cases and 10 normal controls.The postprocessing images were done using software and compared to conventional CT, fiberoptic bronchoscopy, operation and pathological results. Results The postprocessing images had better MPR and 3D view of organs, nice contrast between of lesion and sorroundings structures.This postprocessing techniques provided more informations in observing and analysing the chest disease.Conclusion Postprocessing technique of spiral CT images is an important complimentation for 2D CT analysis, and has many advantages especially on thoracic disease diagnosis,but they should be applied in combination with two-dimensional CT to achieve accurate diagnosis.

OBJECTIVETo study the biomechanical change of the craniovertebral junction in conditions of atlas assimilation.

METHODSMimics software was used to process CT data of the craniovertebral junction in a health adult to obtain the three-dimensional reconstruction and the cloudy points of C1, C2 and part of the occipital bone. Then the cloudy points were imported into the Abaqus 6. 8 software to establish the occipito-atlantoaxial finite element model in normal structure. According to the established model in normal structure, the model in conditions of atlas assimilation was set by changing the model parameters. Both models of normal structure and atlas assimilation were loaded with 1. 5 N . m static moment to simulate four motions of flexion, extension, lateral bending and axial rotation respectively. The movement characteristics,joint stress force and ligament deformation was analyzed.

RESULTSUnder 1. 5 N . m moment, in model of atlas assimilation the C1-C2 range of movement decreased from 13. 55° to 11.88° in flexion,increased from 13. 22° to 15. 24° in extension and from 4. 05° to 4. 23° in lateral bending and remained unchanged in axial rotation when compared with the normal model. In flexion movement, the contact force of the atlanto-dental joint increased from 1. 59 MPa to 3. 28 MPa and the deflection of apical ligament, tectorial membrane and alar ligament increased 129. 1%, 157. 6% and 75. 1% respectively when compared with the normal model.

CONCLUSIONSThe normal C1-C2 motion mode is destructed in conditions of atlas assimilation, leading to the changes of the range of movement,joint stress force and the ligament deformation at C1 C2 junction. The atlantoaxial instability will likely occur in flexion motion.

Atlanto-Axial Joint ; physiology ; Biomechanical Phenomena ; Cervical Atlas ; physiology ; Cervical Vertebrae ; Finite Element Analysis ; Humans ; Imaging, Three-Dimensional ; Joint Instability ; Ligaments, Articular ; Occipital Bone ; Range of Motion, Articular ; Rotation

Objective To evaluate the effect of palliative care in the treatment of pain and life quality in later period tumor patients.Methods 103 patients with advanced tumors in our hospital were selected and divided into group A(51 patients) and group B(52 patients) based on the methods of treatment.The patients in group A were given conventional treatment,and the patients in group B were given palliative care program on the basis of the treat-ment in group A.The effects of the groups A and B were observed and compared.Results The pain levels of group A and B before treatment had no statistically significant difference (P>0.05).The pain level score of group B after treatment was (26.41 ±3.55)points,which was lower than (32.56 ±7.12)points in group A,and the difference was statistically significant (t=6.430,P<0.05).The difference in life quality of the two groups before treatment was not significant (P>0.05).After treatment,the life quality score of group B was (66.85 ±6.75)points,which was higher than (53.39 ±6.74)points in group A,and the difference was statistically significant (P<0.05).Conclusion It is effective for palliative care to treat the patients with advanced tumors on their pain management and quality of life, which is worthy of clinical application.

Objective To investigate the efficacy of zoledronic acid in the treatment of senile unstable femoral intertrochanteric fractures with anatomical locking plate. Methods 67 patients were randomly divided into two groups. Five days after the operation, group A received one intravenous injection of 5 mg zoledronic acid, while patients in group B did not receive the injection. The two groups were compared in terms of hospitalization time, complications, limb weight-bearing time, fracture healing time, hip function score after operation, preoperative and postoperative serum calcium and serum ALP, bone mineral density of proximal femur before operation and 1 year after operation. Results There were no statistically significant differences between the two groups in age, type of fracture, hospital stay, partial weight-bearing time, fracture healing time, hip function at 1 month and 1 year after operation, preoperative bone mineral density and blood calcium. But the differences were statistically different in hip function at 3 months after operation , averaged bone mineral density of proximal femur and serum ALP 1 year after operation. Moreover, 5 patients in group A developed muscle pain or fever after intravenous injection of zoledronic acid. Conclusion The locking plate combined with zoledronic acid injection in treatment of elderly patients with unstable femoral intertrochanteric fracture could inhibit bone loss, increase bone mineral density, and accelerate limb function recovery after operation. On the other hand, Zoledronic acid has a high incidence of adverse reaction.

BACKGROUND: The middle ear is a little aerated cavity with a complex anatomy and a deep location. Computed tomagraphy virtual endoscopy (CTVE) can be used to reconstruct the stereoscopic images of internal surface of hollow organs using spiral CT volumetric data, providing findings similar to fiberendoscope.OBJECTIVE: To vedfy the ability to show the normal middle ear and the clinical application of virtual endoscopy based on 64-detector CT data.DESIGN, TIME AND SETTING: A confirmatory controlled observation was performed at Department of Radiology, First Affiliated Hospital of Sun Yat-sen University between October 2005 and March 2006.PARTICIPANTS: A total of 33 patients (66 ears) with suspected middle ear disease who underwent spiral CT examination were included in this study. Among included ears, 35 were normal, and 31 were impaired, including 24 ears presenting with chronic suppurative otitis media (10 simple otitis media, 5 granulomatous otitis media, and 9 middle ear cholesteatoma), 2 ears with post-operative recurred suppurative otitis media, 2 ears with carcinoma of middle ear, and 2 ears with temporal bone fracture, and lear with foreign body granuloma.METHODS: CT images of the temporal bone were obtained using 0.5 mm thick axis slices with a soft reconstruction kemel at 0.3 mm intervals. Virtual endoscopic images of middle ear on CT were generated from volumetric data using the Navigator software. CTVE images were observed from multiple directions using the Fly Through software, and compared with the axial and coronal images and surgery findings.MAIN OUTCOME MEASURES: The following structures were observed: auditory ossicle and joints, superior, middle, and inferior tympanum, sinus tympani, external acoustic meatus, tympanum, facial recess, tegmental wall, anterior and superior ligaments of malleus, posterior ligament of incus, and retrotympanum.RESULTS: A series of images were acquired as the virtual endoscope moved from the extemal auditory canal to the middle ear cavity. CTVE displayed the structures of normal middle ear with high details in 100%, except the anterior and posterior limbs of stapes in 68.6% (24/35) and 74.3 %(26/35), respectively. In the ears with supperative otitis media, the destruction of bone of handle, head of malleus, long and short limbs of incus, and limbs of stapes was found on CTVE in 91.7%(22/24), 95.8%(23/24), 95.8%(23124), 100%(24/24), and 87.5%(21/24), respectively. CTVE clearly showed the destruction of promontory, tegmental wall and facial nerve tube in one ear with carcinoma. CTVE showed the dislocation of incudomallear joint in one ear with temporal bone fracture. It took about 10-15 minutes to perform CTVE.CONCLUSION: CTVE can be used as a noninvasive and reliable method in displaying normal and pathologic middle ears. In cases of suspected bony destruction and confirmed trauma, it is helpful for diagnosis and surgical planning. CTVE of the middle ear can currently be considered as a complementary technique to conventional CT, and it is time-saving and reserves clinical generalization.

Based on the research history of the biomechanics of occipito-atlantoaxial complex, we have systematically summarized the use of finite element method for studying biomechanics of occipito-atlantoaxial complex. Then, combined with four basic principles of establishing an effective finite element model for mechanics, our comments are focused on the establishment of geometrical model, finite element model, finite element mechanics model, and on the method and implementation for validating the model. In addition, the developing trends, existing problems and future researching directions in this area are discussed.
Atlanto-Axial Joint ; physiology ; Atlanto-Occipital Joint ; physiology ; Biomechanical Phenomena ; Computer Simulation ; Finite Element Analysis ; Humans ; Models, Biological ; Range of Motion, Articular ; physiology

OBJECTIVETo investigate the relationship between fetal growth restriction and decreased ovarian reserve (DOR) in adulthood to screen high-risk population for early interventions.

METHODSForty-four patients with FGR and 88 normal women aged 18-40 years were enrolled. All the subjects were examined for serum levels of follicle-stimulating hormone (FSH), inhibin B (INH-B), and anti-mullerian hormone (AMH) using enzyme-linked immunosorbent assay method in the first 3-5 days of the menstrual cycle, and the counts of antrum ovarian follicle were detected by transvaginal or transabdominal ultrasonography.

RESULTSThe serum levels FSH, INHB, AMH, and AFC in FGR group differed significantly from those in the control group (P<0.05).

CONCLUSIONFGR will affect reproductive endocrine function in adulthood to cause a decreased ovarian reserve.

Adolescent ; Adult ; Anti-Mullerian Hormone ; blood ; Case-Control Studies ; Enzyme-Linked Immunosorbent Assay ; Female ; Fetal Growth Retardation ; Follicle Stimulating Hormone ; blood ; Humans ; Inhibins ; blood ; Menstrual Cycle ; Ovarian Follicle ; physiology ; Ovarian Reserve ; Prospective Studies ; Young Adult

Cation transporters play important roles in modulating the concentration of intracellular metal ions. The vacuole is an important storage organelle for many ions. Cation (Ca+)/H+ antiporters (CAXs) located at vacuolar membrane are mainly involved in the Ca2+ flux into the vacuole, and appear to be capable of transporting various divalent cations to some degree. Several CAX genes have been isolated and characterized from various plants in recent years. Four domains of plant CAXs have been identified: NRR regulates Ca2+ transport by a mechanism of N-terminal autoinhibition; Ca domain and C domain confer Ca2+ and Mn2+ specificity among CAX transporters, respectively; D domain plays a part in the regulation of cytosolic pH. AtCAXs identified in Arabidopsis thaliana are involved in the growth, development and stress adaption of plant. AtCAX3 is the mainly Ca2+/H+ transporter in response to salt stress; AtCAX2 and AtCAX4 participate in transportation and detoxicification of heavy metal ions (Cd2+, Zn2+, and Mn2+) in cells under heavy metal stress, and impact root/shoot Cd partitioning in plant. These suggest that CAX genes may be useful for nutritional enhancement of plants, and for increasing phytoremediation potential. Here, the classification, structure and function of CAXs in plants are reviewed.
Antiporters ; chemistry ; physiology ; Arabidopsis ; chemistry ; Arabidopsis Proteins ; chemistry ; physiology ; Calcium ; metabolism ; Cation Transport Proteins ; chemistry ; physiology ; Membrane Proteins ; physiology ; Metals, Heavy ; metabolism ; Plant Physiological Phenomena ; Plant Proteins ; physiology ; Plants ; chemistry ; Proton Pumps ; chemistry ; physiology ; Vacuoles ; metabolism ; physiology