Disuse osteoporosis is a kind of osteoporosis correlated with movement limitation,disorder or weightlessness which let bone be in the condition of unloading or mechanical stress reduction.And general or local mineral substance reduction and bone loss happen subsequently.When the bone lacunar-canalicular system which is the sensory receptor of osseous tissue affected by force,fluid in bone canaliculi flows subsequently.Both of shear force and voltage produced by the flowing fluid act on microfilaments on protuberance of osteocyte.Mechanical signals transfer in the form of electric current among osteoblasts.Meanwhile,the microfilaments are affected by force which would be transferred to the whole cytoskeleton through an actin linked to an integrin on the surface of osteocyte membrane.Factors and enzymes physically connected to the cytoskeleton would be deformed.Bone reconstruction will be regulated by chemical reactions produced by the deformation afterwards.However,reduction or lack of force may generate strains less than threshold of bone reconstruction which would affect bone reconstruction process mentioned above.The change of process results in a phenomenon that bone generation can not keep up with bone resorption and disuse osteoporosis may happen.Common mechanical test methods used in the studies on disuse osteoporosis contain tensile test,compression test,bending test,torsion test,and so on.Many studies present exercise may lead to prevention and treatment of disuse osteoporosis through two approaches.One of the approaches is that bone reconstruction mechanism mentioned above affected by force lead to promoting generation of bone tissue.The other one is that bone mineral density is increased in the result of improvement of nerve growth factors secretion,regulation of calcium balance and humoral regulation via exercise.The article is an introduction to mechanism,prevention and treatment of disuse osteoporosis led by mechanical factors in the level of tissue,cell,and molecule.It may provide convenience for researchers in relative fields to understand mechanism,prevention and treatment of disuse osteoporosis in the perspective of mechanics.

In light of their hospital's reform and development in the past five years, the authors summarize the new attempts that have been made in their hospital in selecting training and appinting managerial personnel.Prominence has been given to openness in ways of selection, variety in means of training and flexibility in the system of appointments. For the purpose of the scienfific development tnd rational allocation of the hoapital's resources in managerial personnel and the full promotion of its reform in the personnel system, active exporation has been made so as to brng up a contingent of high-caliber and professional hospital managerial personnel able to shoulder important tasks in the new century.

BACKGROUND: Abnormal changes of bone mineral density (BMD) easily occur in patients with non-insulin-dependent diabetes mellitus (NIDDM),however the mechanisms are still unclear.OBJECTIVE: To investigate the pathophysiological features of changes of BMD and metabolism in patients with NIDDM from the angle of traditional Chinese medicine (TCM) syndrome types.DESIGN: A case controlled and comparative observation.SETTING: Department of Endocrinology of Guangzhou General Hospital of Guangzhou Military Area Command of Chinese PLA PARTICIPANTS: Totally 103 cases (55 males and 48 females) of patients with NIDDM admitted in Department of Endocrine of Guangzhou General Hospital of Guangzhou Military Area Command of PLA from April 2003 to April 2004 were enrolled. They were, according to TCM syndrome types, divided into 3 groups: yin deficiency with heat excess (32 cases),deficiency of both qi and yin (36 cases), and deficiency of both yin and yang (35 cases) groups. The healthy persons of 30 staff, 16 males and 14 females, in the hospital were concurrently recruited as control group. Informed consent was obtained from all the subjects.METHODS: ①A dual-energy X-ray absorption meter was used to determine the bone mineral densities of orthophoric 1-4 lumber vertebrae, total hipbone and head of femur in left hip in each group. ② Radioimmunoassay was taken to measure the content of serum osteocacin (OC). ③Colorimetry was used to measure the level of serum tartrate resistant acid phosphatase (TRACP). ④ q-test and x2-test were respectively used for comparison of measurement and enumeration data.MAIN OUTCOME MEASURES: ①The BMD of the 1-4 lumber vertebrae, total hipbone and head of femur in left hip in each group. ②The morbidities of osteoporosis of subjects in each group. ③ The levels of OC and TRACP in each group.RESULTS:All 103 NIDDM patients and 30 healthy subjects entered the final result analysis. ① The BMD of the 1-4 lumber vertebrae, total hipbone and head of femur in left hip of subjects: The BMD in yin deftciency with heat excess, deficiency of both qi and yin and control groups were obviously higher than that in deficiency of both yin and yang group (P ＜ 0.05-0.01 ) ② The morbidity of osteoporosis: The morbidities of osteoporosis in yin deficiency with heat excess, deficiency of both qi and yin and control groups were obviously lower than that in deficiency of both yin and yang group[34%(ll/32),42% (15/36), 33% (10/30), 71% (25/35),P ＜ 0.01]. ③ The level of OC: The levels in yin deficiency with heat excess and deficiency of both qi and yin groups were obviously higher than that in deficiency of both yin and yang group (P ＜ 0.01 ), but lower than that in deficiency of both yin and yang group (P ＜ 0.05). ④ The level of TRACP: There was no significant difference among groups(P ＞ 0.05).CONCLUSION: ① The volume and formation of bone in NIDDM patients of deficiency of both yin and yang syndrome type were obviously lower than those in healthy persons and NIDDM patients of yin deficiency with heat excess and deficiency of both qi and yin syndrome types, and the osteoporosis morbidity in them was obviously higher than those in healthy persons and the other two syndrome-type patients. ② The quantity and formation of bone in NIDDM patients of deficiency of both yin and yang syndrome type were near to those in healthy persons.

Based on a review of literature and the current reform of public hospital corporate governance,such corporate governance is divided intocombined regulation and operation,anddivided regulation and operationmodels.Then the principal-agent theory was called into play to analyze the main problems and causes of the existing models.From the perspectives of government supervision and assessment,professionalization of hospital directors,market competition mechanism,thoughts were made on how to improve such corporate governance.

Objective To investigate the clinical characteristics of non-motor symptoms ( NMS) in early stage newly diagnosed Parkinson 's disease ( PD) patients in different age group and different subtypes .Methods Total 96 newly diagnosed PD patients without taking any drugs and 102 normal controls were collected in outpatient visits , and their clinic information and related scales were evaluated and compared .Results Ninety-one(93.83%) PD patients had at least one NMS, common symptoms were, in order, recent memory (70.83%,68 cases)、constipation (48.96%,47 cases)、attention dysfunction (47.92%,46 cases), and they were significantly higher than PD group (all P<0.01).The incidence of anxiety and panic in patients≤60 years old was significantly higher than that in patients>60 years old (P<0.01).The incidence of urgency in rigidity type was significantly higher than in tremor type(P<0.01).Conclusions NMS in patients with newly diagnosed PD are complex and diverse .The performance in different age groups and different clinical subtypes are also different .

AIM: To investigate the clinical efficacy of trimebutine maleate combined with Morita therapy in the treatment of patients with irritable bowel syndrome (IBS). METHODS: 108 patients were randomly assigned to two groups. Trimebutine maleate group (n=54) was given trimebutine maleate 200 mg, po, tid, combined with Mortia therapy. The patients were analyzed by self rating anxiety scale (SAS) and self rating depression scale (SDS) before and after the treatment. Control group (n=54) was only given trimebutine maleate 200 mg, po, tid. The course was 4 weeks. RESULTS: The total efficacy rates were 87.04 % and 72.22 % in trimebutine maleate group and in control group, respectively. The therapeutic effects in trimebutine maleate group were better than those in the control group (P

Objective To monitor pulse oxygen saturation(SpO_2)continuously in patients with chronic obstructive pulmonary disease (COPD) so as to study its clinical implication.Methods SpO_2, thoracic and abdominal respiratory activity was continually recorded during meal time by PSG in 19 patients with COPD. Body mass index and lung function were measured respectively. Results SpO_2 was lower after meal(P

[Objective]To investigate the treatment of nonunion after Pilon fracture with fibula approach fixation of tibia and ankle joint fixation and its clinical efficacy.[Method]Six cases of nonunion after Pilon fracture were collected from 1999 to 2004,which included 4 males and 2 females,with the average age of 34.7 years(21~53 years).All fractures were found invasion to the tibia-fibula joint and ankle malformation.Fibula and tibia were opened from posterolateral approach and reconstruction plate was placed laterally on the fibula,with screws crossing the fibula into the tibia directly.Autogenous bone graft was used in fracture position and area between tibia and fibula to gain tibia-fibula fusion.[Result]All cases were followed up from 8 months to 4 years with the average of 22 months.Bone fusion were gained in 5 cases with the average time of 3.5 months.Plate broken was found in 1 case for too early weight bearing.[Conclusion]Fibula approach fixation of tibia and ankle joint fixation has advantages of promoting fracture healing,preventing complications,and correction joint malformation.It is a convenient and reliable method for clinical surgeons.

[Objective]To summarize the experience about treatment of segmental and comminuted femoral fractures with intramedullary nail in multiple injuries.[Method]From March 2002 to July 2006,28 patients with segmental and comminuted femoral fractures were treated surgically,13 with AO type C1,9 with C2 and 6 with C3.All of the fractures were treated with close reduction static intramedullary nail fixation.[Result]The postoperative follow-up ranged from 11 to 34 months with an average of 21 months.All of the fractures were healed.Limit load was required for 5 patients who had delayed union without special treatment.After 18-30 months the patients healed up.There were no fat embolisms.No complications such as infection,intramedullary bending or break occurred.[Conclusion]Treatment of femoral fractures with intramedullary nail is a standard method.However,to achieve satisfactory results,comprehensive treatment,careful planning and procedure should be taken for segmental and comminuted femoral fractures in multiple injuries.

Objective To study PFSDQ-M in evaluating meal-induced hypoxemia in patients with chronic obstructive pulmonary disease.Methods PFSDQ-M scores were collected from 63 COPD patients;49 of them were performed spirometry and meal-related SpO2 monitoring.On the basis of different lung function parameters,data analysis was used to assess the relationship between PFSDQ-M and meal-induced hypoxemia.Results The SpO2 fluctuation during eating period was of significant difference in COPD patients with 3 respective levels of pulmonary function parameters (P