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.

BACKGROUND: Sliding cupping has been used for treating cervical spondylosis, with the effects of dredging the meridian system, activating qi and removing blood stasis.OBJECTIVE: To probe into symptomatic improvement of cervical spondylosis with sliding cupping and the relationship between curative effect and course of disease as well as age.DESIGN: Self controlled observation.SETTING: Department of Physiotherapy, General Hospital of Air Force of Chinese PLA.PARTICIPANTS: Totally 100 out-patients with cervical spondylosis receiving treatment in the Department of Physiotherapy, General Hospital of Air Force of Chinese PLA were involved from December 2000 to December 2003. Among them, 39 cases were male and 61 cases were female; 9 cases were under 30 years old, 38 cases were 31 to 40 years old, 42 cases were 41 to 50 years old and 11 cases were above 50 years old. There were 36 cases with less-than-one-year course of disease, 49 with 1 to 5-year course and 15 with more-than-5-year course. Fifty-one cases were cervical type; 25 cases vertebral artery type; 24 cases nerve root type. X-ray examination revealed that there were 69 cases whose cervical vertebral physiological curvature became straight or reverse, or with certain degree of degenerative change. Vertebroarterial blood supply insufficiency was detected in 23 cases by rheoencephalogram.INTERVENTIONS: The patients were asked to be in prone sitting position,their nape and shoulder were fully exposed, and the negative pressure cupping was applied to patient' s nape and shoulder until petechiae appeared on the skin. The treatment was given once or twice a week. After one-month treatment, the curative effect was calculated according to subjective symptoms, signs, and the results of X-ray and rheoencephalogram examination before and after treatment. Symptom disappearance: pain was 0 grade; the cervical vertebral physiological curvature restored by 10°- 15° and rheoencephalogram showed that the contraction peak velocity of the vertebroarterial blood supply became normal. Marked improvement: the pain reduced by more than 2 grade, the cervical vertebral physiological curvature restored by 6°9° and rheoencephalogram showed that the vertebroarterial blood supply restored to 80% of the normal range. Improvement: the pain reduced by 1 grade, the cervical vertebral physiological curvature restored by 3°- 5° and rheoencephalogram showed that the vertebroarterial blood supply restored to 40% - 80% of the normal range. Inefficacy: the pain did not reduce, the cervical vertebral physiological curvature restored by less than 3° and rheoencephalogram showed that the vertebroarterial blood supply became less than 40%.RESULTS: According to the intention-to-treat analysis, 100 patients entered the result analysis. For symptom disappearance, marked improvement,improvement, inefficacy there were 27, 17, 5 and 2 cases respectively in cervical type; 8, 10,4 and 3 cases respectively in the vertebral artery type;4,9,7 and 4 cases respectively in the nerve root type. There were 19, 12, 3 and 2 cases respectively with less-than-one-year course of disease; 18, 19, 7 and 5 cases respectively with 1 to 5-year course; 2, 5, 6 and 2 cases respectively with more-than-5-year course. And there were 5, 3 and 1 cases respectively with age ＜ 30 years; 18, 13, 4 and 3 cases respectively with age of 31 to 40 years; 15, 18, 5 and 4 cases respectively with age of 41 to 50years; 1, 2, 6 and 2 cases respectively with age ＞ 50 years.CONCLUSION: The effect of sliding cupping was good for patients with cervical spondylosis of vertical type, next of vertebroarterial type and bad of nerve root type. The shorter the course of disease is, the younger the patient is, and the better the curative effect is.

Objective To study the imaging findings, clinical and pathological characteristics of langerhans cell histiocytosis(LCH)in limbs of children, and to improve the imaging diagnostic accuracy of LCH . Methods Imaging findings and clinical data of 12 patients with limbs LCH were analyzed retrospectively. X-ray examination was performed in 10 cases, while 9 cases underwent CT and 7 cases underwent MRI examination. All imaging findings were analyzed. Results Seven lesions were solitary, including 4 lesions in the tibia, 2 in the radius and 1in the ulna. Five cases had limbs lesion in multiple sites, which included 12 bone lesions in total, with 6 lesions in the femur, 3 in the humerus (1 case involved the epiphysis), 2 in the tibia and 1in the radius. The X-ray or CT images of the lesions showed osteolytic destruction and swelling of the bone, which was commonly associated with the reaction of periosteum. Eleven cases were with peripheral soft tissue swelling, and one case had soft tissue mass. The lesions showed low signal on T1WI and high signal or mixed signal on T2WI. Six cases were diagnosed as LCH at the first time and the other 6 cases were diagnosed as infectious lesions. Twelve cases were regularly followed up after the treatment, and the prognosis of the patients with single lesion was better. Conclusions LCH of limbs usually involves diaphyseal and metaphyseal bone. The imaging features include osteolytic destruction and swelling of the bone, with peripheral soft tissue swelling or mass of the soft tissue. Although LCH of limbs has some specific imaging features, it is difficult to differentiate it from malignant bone tumors. Multi-imaging modalities such as radiography, CT and MRI imaging may suggest the diagnosis and provide important information for evaluating prognosis.

Objective To establish a scientific and feasible evaluation index system of the quality of health education among the elderly in the community.Methods Based on the results of literature review,theory analysis,cross-sectional study and interviews,a draft evaluation index system was formulated.Then Delphi method was conducted on 28 specialists around the country,the weight of each index was determined by hierarchy analysis.Results After three rounds of Delphi procedure,the response rates of the three round consultation were all above 85％,and the authority coefficient and coordination coefficients was 0.858,0.210,respectively.An evaluation index system which covered three first-level items,7 second-level items and 35 third-level items was formulated.Conclusions Based on survey of the elderly and interviews of health education staffs in the community,and using the method of Delphi to collect experts' suggestion,a strong maneuverability and high reliability quality evaluation index system was formulated,which provided guidance for community health education of the elderly,and promoted its development towards scientization and standardization.

OBJECTIVE:To consolidate the results of special antibacterial drug rectification so as to improve the rational medi-cation of antibacterial drugs. METHODS:By using the method of retrospective analysis,the antibacterial drug application data in 2011(before rectification and initial stage of rectification),2012(middle stage thereof)and 2013(later stage thereof)were sum-marized,compared and analyzed. RESULTS:After special rectification(Jan. 2011 vs. Dec. 2013),the utilization rate of antibacte-rial drugs in perioperative period for class I incision decreased from 80.42% to 24.49%. That of antibacterial drugs in emergency treatment decreased from 53.79% to 36.23%. The examination rate of microbial samples in inpatients who would use special-grade antibacterial drugs increased from 16.12% to 94.17%. The use intensity of antibacterial drugs by inpatients decreased from 70.28 DDDs/(100 persons·d) to 27.44 DDDs/(100 persons·d). The utilization rate of antibacterial drugs by inpatients decreased from 65.99% to 46.45%. CONCLUSIONS:Special rectification has remarkable effects on rational clinical application of antibacterial drugs. Regulation and evaluation should be strengthened to maintain the effects and continuously improvement should be made.

BACKGROUND:The chitin medical wound dressing can relieve the wound pain, bleeding, and promote wound healing. It has good biocompatibility and antibacterial properties. With the good permeability and natural
degradation in the body, it can be used clinicaly as a good biological wound dressing.
OBJECTIVE: To evaluate the clinical outcome of the chitin medical wound dressing paste and routine dressings used in changing the dressing and medication.
METHODS:We retrospectively studied 60 patients undergoing wound-treatment. They were divided into two
groups: chitin medical wound dressing paste group and routine dressing group. Each group had 30 patients. We recorded wound healing rate, detection rate of bacteria, visual analog scale score, healing time and cost of
treatment at 3, 7, 14 days after treatment.
RESULTS AND CONCLUSION: The wound healing rate, detection rate of bacteria, visual analog scale score, healing time of the chitin medical wound dressing paste group were better than those of the routine dressing change medicine group (P < 0.05). But there was no difference in the cost of treatment between the two groups. Therefore, we can made the conclusion that the chitin medical wound dressing paste used in changing the
dressing and medication can promote wound healing, reduce the antibacterial infection rate, and obtain better treatment satisfaction.

Objective To investigate the effect of valsartan,an angiotensinⅡtype 1 receptor (AT1 R)blocker,on radiosensitivity,invasive potential and proliferation activity of nasopharyngeal carcinoma cells(CNE-2)in vitro. Methods Radiosensitization of valsartan on CNE-2 cells in vitro was investigated by colony forming assay.Effect of ATl R blocker combined with radiation on invasive potential of CNE-2 cells was evaluated using 24-well Matrigel invasion chambers(Transwell).Apoptosis-inducing effect of valsartan combined with radiation on apoptosis of CNE-2 was identified by flowcytometry(FCM). Resuits When valsartan was given at 10-9.10-8 and 10-7 mol/L combined with radiation,sensitivity enhancement ratios (SER)were 1.10,1.20 and 1.36.and the invasive inhibition rates were 8.11%,16.49%and 16.77%,respectively.The SER of valsartan on CNE-2 distinctly increased when the exposure time was increased.After 24 h exposure to 10-8 mol/L valsartan combined witIl radiation.the apoptosis rate was 1.89%±0.09%,which was higher than 1.62%±0.06%in radiation alone group(t=4.79.P＜0.05). Conclusions AT1 R blocker valsartan combined with radiation can significantly inhibit the proliferation activity of nasophar,cngeal carcinoma cells in vitro in a dose- and time-dependent manner.Valsartan combined with radiation can potently inhibit the invasive potential of CNE-2.which may be involved in the mechanism of valsartan treatment in vivo.

To comparative study the effect of polysaccharide sulfate (PSS) and amlodipine on renal hemodynamics in dogs. The kidney was denervated, PSS or amlodipine was injected through renal artery. Renal hemodynamic parameters, including mean arterial pressure, renal blood flow, glomerular filtration, urine flow, et al, were measured. Both PSS and amlodipine significantly increased renal blood flow and urine flow (P

By setting up the medical affairs office and updating the hardware equipment,we improved the working mode of the triage nurses and optimized the triage procedure in the outpatient department,which resulted in a better order,a more convenient access to medical care and increased satisfaction of patients with outpatient services.

This article introduces our experience in reconstructing the service procedure in the outpatient department in order to raise the abilities of the nurses,optimize nursing service and promote service efficiency.Service procedure reconstruction can improve the service awareness of nurses,change the conception of nursing management,and better satisfy the needs of patients in the outpatient department.