Arthroplasty, Replacement, Knee ; methods ; Bone Transplantation ; Bone Wires ; Female ; Humans ; Middle Aged ; Tibia ; surgery ; Transplantation, Homologous

Total knee arthroplasty has become one of the effective operation methods on end-stage knee osteoarthritis. However,the postoperative pain has been plaguing the clinicians. The cause of postoperative pain can be divided into iatrogenic, prosthesis and patient. Pain treatment in perioperative period includes preoperative education, analgesia in advance, and the selection and design of reinforcement; during operation mainly includes the appropriate surgical approach, keep the balance of soft tissue around the knee joint, cocktail analgesia pain around the knee joint; after operation mainly includes oral analgesic drugs, femoral nerve tissue and patient controlled analgesia. And the multimodal analgesi.a which is the analgesic methods combined application in perioperative period raised in resent years fully intervene the pain in perioperative period,so that it can effectively reduce the pain of patients after knee replacement, promote the patients do functional exercise more better and get better operation result.
Analgesia, Patient-Controlled ; Arthroplasty, Replacement, Knee ; Humans ; Nerve Block ; Pain Management ; Pain, Postoperative ; drug therapy ; etiology

OBJECTIVETo evaluate the applicability of the modified physiological and operative severity score for enumeration of mortality and morbidity (POSSUM) scoring system in predicting mortality in the patients undergoing hip joint arthroplasty.

METHODSA total of 295 patients with hip fractures were analyzed using the modified POSSUM surgical scoring system. The mean ages of the patients were 66.59 years in the complicative group, 62.28 years in noncomplicative group, 77.89 years in the death group and 63.25 years in the living group, respectively. The comparisons between the observed and predicted morbidity, between the observed and predicted mortality were made within 30 days after operation.

RESULTSThe average physiological scores and operative severity scores was 18.96+/-4.83 and 13.47+/-2.01 in complicative group, while 15.65+/-3.66 and 11.74+/-2.26 in noncomplicative group (P less than 0.05). The average physiological scores and operative severity scores was 25.56+/-3.78 and 14.22+/-0.67 in death group, while 16.46+/-4.09 and 12.25+/-2.33 in living group (P less than 0.05). Though POSSUM scoring system over-predicted the overall risk of death, its estimate was very close in the high risk groups (larger than 10% ). There was perfect consistence between the observed and the predicted morbidity as calculated by published predictor equation for morbidity, and consistence for mortality in the high risk band.

CONCLUSIONSModified POSSUM scoring system may be used to predict the morbidity in patients with hip fracture. Furthermore, POSSUM scoring system overpredicts the overall risk of death, but its estimate is close to the actual data in the high risk band (larger than 10%).

Aged ; Hip Fractures ; mortality ; surgery ; Humans ; Middle Aged ; Osteoporosis ; complications ; Postoperative Complications ; Severity of Illness Index ; Treatment Outcome

OBJECTIVETo explore the relationship between job satisfaction and occupational stress in the workers of a thermal power plant.

METHODSThe cluster sampling method was used to investigate 875 workers in a thermal power plant. The job satisfaction, occupational stressors, strains, personalities, meeting strategy and social support were measured using occupational stress instruments, job content questionnaire and effort-reward imbalance questionnaire.

RESULTSThere were no significant differences of job satisfaction scores between different groups according to sex, educational level, marriage status, smoking and drinking (P > 0.05). But there were significant differences of job satisfaction scores between different age groups or between different service length groups (P < 0.01). The correlation analysis revealed that job satisfaction scores were related positively to responsibility for persons and things, promotion opportunity, job control, job stabilization, rewards, mental health, positive affectivity, self-esteem, superior support and coworker support scores (P < 0.05 or P < 0.01), negatively to role ambiguity and conflict, job future ambiguity, job demands, negative affectivity, depressive symptoms, patience, and mental locus of work control(P < 0.05 or P < 0.01). The results of variance analysis indicated that the job relationship, responsibility for persons and things, promotion opportunity, job control, job stabilization, reward, mental health, positive affectivity, self-esteem and buffer scores of the workers with high job satisfaction scores were significantly higher than those of workers with moderate and lower job satisfaction scores (P < 0.01), but the role ambiguity and conflict, job future ambiguity, job demands, and depressive symptoms scores and mental locus of work control of the workers with high job satisfaction scores were significantly lower than those of workers with moderate and lower job satisfaction scores (P < 0.05 or P < 0.01). The results of multivariate logistic regression analysis showed that the risk of job dissatisfaction for workers with low reward was about four times as high as that for workers with high reward (OR = 3.773), the risks of job dissatisfaction for workers with low social support and mental locus of external work control were about two times as high as that for workers with high social support or mental locus of internal work control (OR = 2.419 and 2.219, respectively). The daily life stress, low control strategy, low support strategy, low job control and negative affectivity were risk factors of job dissatisfaction (OR = 1.125 approximately 1.790), but the self-esteem and positive affectivity could reduce the risk of job dissatisfaction.

CONCLUSIONIncreasing the decision level, social support, meeting strategy and reward or decreasing the role conflict and ambiguity, demands and negative affectivity could improve worker's job satisfaction level.

Adolescent ; Adult ; Female ; Humans ; Job Satisfaction ; Male ; Middle Aged ; Occupational Diseases ; epidemiology ; Power Plants ; Social Support ; Stress, Psychological ; epidemiology ; Surveys and Questionnaires ; Young Adult

OBJECTIVETo analyse the relationship between coping strategy and occupational stress in rail freight dispatchers.

METHODS115 rail freight dispatchers were investigated by using group sampling method, investigation contents included coping strategies, occupational stressors, strains and personalities.

RESULTSThe proportion of using coping strategy in rail freight dispatchers is lower. The scores of job future ambiguity, type A behavior and work locus of control in workers with insufficient coping strategy were higher than those in workers with sufficient strategy (P < 0.05 or P < 0.01), but the score of organization commitment score in workers with insufficient coping strategy was lower than those in workers with sufficient strategy (P < 0.05), the differences of scores of some occupational stressor, strain and personality variables between workers with insufficient and those with sufficient in social support, job-family balance, job involvement coping factors of coping strategy were remarkable significant (P < 0.05 or P < 0.01), the differences of scores of occupational stressor, strain and personality variables between workers with insufficient and those with sufficient in ask, logic and time management factors of coping strategy weren't significant (P > 0.05). Logistic regression analysis showed that risk of being job dissatisfaction and daily life stress in workers with insufficient social support coping was three or four times than those with sufficient coping (OR = 3.06 or 4.38, respectively), risk of being daily life stress in workers with insufficient job involvement coping was three times than those with sufficient coping (OR = 3.26).

CONCLUSIONThe proportion of using coping strategy in rail freight dispatchers is lower. Coping strategy has influence on the individual's perception of occuaptional stressors, strains and personalities.

Adaptation, Psychological ; Adult ; Burnout, Professional ; psychology ; China ; Humans ; Middle Aged ; Occupational Diseases ; psychology ; Occupational Health ; Personality ; Railroads ; Social Support ; Stress, Psychological ; psychology

OBJECTIVETo explore the influence of affectivity trait on relationships between occupational stress and subjective physical health and job satisfaction.

METHODSSelf-reports for psychosocial work conditions and health and well-being in a sample of 878 workers from a thermal power plant in China were conducted using the job demand-control model, the effort-reward imbalance model, job satisfaction, depression symptom, and physical health complaints questionnaires. Logistic regression analysis was used by controlling for age, sex, and educational level.

RESULTSNegative and positive affectivity were correlated with occupational stressors or strains (P<0.01). In the most equation of job dissatisfaction, psychosomatic complaints and depressive symptoms as dependent variables respectively, odds ratios decreased greatly when negative affectivity or positive affectivity was controlled; Odds ratios decreased greater when negative affectivity and positive affectivity were controlled simultaneously. Furthermore in some equation no variable entered.

CONCLUSIONAffectivity trait has effect on relationships between occupational stress and subjective physical health and job satisfaction. According to the outcome category of study, the possible confounding role of affectivity should be controlled in the study of the relationships between occupational stress and health self-reports.

Adolescent ; Adult ; Affect ; Burnout, Professional ; Female ; Health Status ; Humans ; Job Satisfaction ; Logistic Models ; Male ; Middle Aged ; Occupational Health ; Surveys and Questionnaires ; Young Adult

OBJECTIVETo introduce bipolar hemiarthroplasty with a two-step osteotomy technique and observe its clinical result for unstable intertrochanteric fractures in senile patients.

METHODSFifteen consecutive patients with unstable intertrochanteric fractures aged from 81 to 92 years with a mean of 85 years were treated in our hospital from August 2006 to October 2011 (Evans type III in 4 cases, Evans type IV in 11 cases), who received bipolar hemiarthroplasty with a two-step osteotomy technique performed by a senior orthopedic surgeon through posterior approach under general anesthesia. All cases were evaluated by Zuckerman functional recovery score (FRS) and operative risk assessment software 1, based on the patients' physical and laboratory examinations preoperatively. The duration and blood loss have been recorded. There were 4 male cases (4 hips) and 11 female cases (11 hips). All prostheses consisted of Link SP II femoral stem and bipolar femoral head. All patients were followed up for more than 1 year.

RESULTSThe average preoperative FRS, predictive value of operative morbidity and mortality were 83.7 (81.7-85.9), 9.3% (7.3%-15.0%) and 3.5% (2.3%-4.2%), respectively. The average operation time was 50 minutes with a mean intraoperative blood loss of 310 ml. There were no operative or anesthetic complications or deaths within 30 days after operation. Sitting up was permitted 3 to 4 days, and partial weight bearing was allowed 5 to 7 days after operation. The average FRS was 79.3 at 30 days and 84.9 at 1 year postoperatively. Three patients died of unrelated causes (one due to myocardial infarction and the others due to cerebral hemorrhage during at least one-year follow-up).

CONCLUSIONBipolar hemiarthroplasty with a two-step osteotomy technique for unstable intertrochanteric fractures in the senile patients is a good choice for early ambulation and good hip function.

Aged ; Aged, 80 and over ; Female ; Hemiarthroplasty ; methods ; Hip Fractures ; physiopathology ; surgery ; Humans ; Male ; Osteotomy ; methods ; Recovery of Function ; Risk Factors

OBJECTIVEThis study aimed to investigate the epidemiological characteristics and correlated factors of daily hassles among thermal power plant workers.

METHODSA mass screening of daily hassles and correlated factors was conducted on 498 workers from a thermal power plant in Zhengzhou in July, 2008. The questionnaires included Daily Hassles Questionnaires, Work Roles Questionnaires, Job Content Questionnaires (Chinese version), Effort-Reward Imbalance (Chinese version), Work Locus of Control Scale and Type A Behavior Scale, with content covering demographic characters and occupational stress correlated factors among subjects. The daily hassles was divided into lower level and higher level according to scores, and the epidemiological characteristics and correlated factors of daily hassles were analyzed.

RESULTSA total of 446 qualified questionnaires were obtained, effective response rate was 89.6% (446/498). For respondents, the age was (36.96 ± 6.49) years old, working length of the current job was (12.05 ± 7.54) years, the daily hassles scores was (9.01 ± 2.50), and the prevalence rate of the higher level of daily hassles was 34.1% (152/446). The multiple non-conditional logistic regression analysis showed 5-14 years' working length of current job (OR = 0.451, 95%CI: 0.225 - 0.904), average income > 3000 yuan(OR = 0.372, 95%CI: 0.202 - 0.684), reward (OR = 0.557, 95%CI: 0.325 - 0.954) and coping strategy (OR = 0.552, 95%CI: 0.330 - 0.925) were negatively correlated with daily hassles, and shift-work (OR = 1.887, 95%CI: 1.108 - 3.215), effort (OR = 2.053, 95%CI: 1.198 - 3.519), psychological demand (OR = 1.797, 95%CI: 1.049 - 3.078), negative affectivity (OR = 3.421, 95%CI: 2.065 - 5.668) were positively correlated with daily hassles.

CONCLUSIONThe prevalence rate of the higher level of daily hassles was considerable high for thermal power plant workers. Its negative correlated factors included 5 - 14 years' working length of the current job, average income > 3000 yuan, reward and coping strategy and its positive corelated factors included shift-work, effort, psychological demand and negative affectivity.

Adult ; Burnout, Professional ; epidemiology ; Female ; Humans ; Male ; Occupational Diseases ; epidemiology ; Power Plants ; Stress, Psychological ; epidemiology ; Surveys and Questionnaires

To explore the effects of psychological capital social support and their interaction on job satisfaction in Methods natural gas field workers. A total of 1 473 workers from a natural gas field were selected as the research subjects ， using convenient sampling method. Job Satisfaction Questionnaire Psychological Capital Questionnaire and Social Support ， Results Scale were used to investigate the scores of job satisfaction psychological capital and social support level. The ， ， detection rates of job satisfaction psychological capital and social support in the high level group were 55.9% 52.5% and ， 48.1% respectively. The detection rates of job satisfaction of workers in the high level psychological capital group and high level （ social support group were higher than those in the low level psychological capital group and low level social support group 67.4% vs ， vs ， P ） 43.3% 71.9% 41.2% all <0.01 . The results of multivariate logistic regression analysis showed that psychological capital ［ （CI） （ - ） and social support had positive effects on job satisfaction odds ratio and 95% confidence interval were 1.58 1.17 2.41 （ - ）， ， P ］ ， and 2.53 1.82 3.52 respectively all <0.01 . Moreover the psychological capital and social support had additive effect on ［ CI （ - ）， CI job satisfaction relative excess risk of interaction and 95% was 3.07 1.02 5.12 attributable proportion and 95% was （ - ）， CI （ - ）］， 0.48 0.35 0.61 synergy index and 95% was 2.34 1.72 3.16 but there was no multiplication interaction between （P ）Conclusion psychological capital and social support >0.05 . Psychological capital and social support can positively affect job satisfaction of natural gas workers. There is an additive interaction between psychological capital and social support on job ， satisfaction but no multiplicative interaction is found. Keywords: ； ； ； ； ； Psychological capital Social support Job satisfaction Interaction Natural gas Worker

OBJECTIVETo study the effect of job psychological demands and job control on mental health and their interaction.

METHODS93 male freight train dispatchers were evaluated by using revised Job Demand-Control Scale and 7 strain scales. Stepwise regression analysis, Univariate ANOVA, Kruskal-Wallis H and Modian methods were used in statistic analysis.

RESULTSKruskal-Wallis H and Modian methods analysis revealed the difference in mental health scores among groups of decision latitude (mean rank 55.57, 47.95, 48.42, 33.50, P < 0.05), the differences in scores of mental health (37.45, 40.01, 58.35), job satisfaction (53.18, 46.91, 32.43), daily life strains (33.00, 44.96, 56.12) and depression (36.45, 42.25, 53.61) among groups of job time demands (P < 0.05) were all statistically significant. ANOVA showed that job time demands and decision latitude had interaction effects on physical complains (R(2) = 0.24), state-anxiety (R(2) = 0.26), and daytime fatigue (R(2) = 0.28) (P < 0.05). Regression analysis revealed a significant job time demands and job decision latitude interaction effect as well as significant main effects of the some independent variables on different job strains (R(2) > 0.05).

CONCLUSIONJob time demands and job decision latitude have direct and interactive effects on psychosomatic health, the more time demands, the more psychological strains, the effect of job time demands is greater than that of job decision latitude.

Humans ; Mental Health ; Occupational Diseases ; psychology ; Regression Analysis ; Stress, Psychological ; psychology