Objective:To explore the types and characteristics of the grief reactions of adolescents to friends'death repeatedly,so as to provide reference for effective psychological intervention. Methods:Three college students aged nineteen and twenty years who experienced the death of friends at least twice in adolescence participa-ted in the study by means of an open recruitment in a college. They had friends died at the age of 9 and 12. And then it happened again when they were 15 and 17. Data was collected by semi-structured interviews with the three selected,and analyzed by thematic analysis to classify the grief reactions after the loss of their friends. Results:The common grief reactions of a friend's death in the interview are:shocked,regret and angry,denying,disbelieving, fear of the death,feeling the cruelty of death,crying,searching for support,shirking and recognizing the cruelty of death. The special grief reactions in the interview,especially when they experienced the second death of a friend are:caring for the dead loved ones,having a mental shadow over friend's role,reducing social activities,seeking stimulating and venting,revolting against the school,violence,and working harder. Conclusion:The grief reactions of adolescents to friends'death repeatedly are diversity. It presents the characteristics of the psychological develop-ment of adolescence. And the adolescents need to be given special attention and appropriate psychological interven-tion.

Objective To study the relationship of implicit memory and amnesia effect of oral midazolarn premedication and toobserve its anterograde amnesia, the effect on short-term memory and the onset time and out come of retrograde amnesia. Methods60 patients with ASA I - Ⅱ status undergoing abdomen and limb operations were divided into 3 groups with 20 cases each. Group A:oral midazolam 7.5mg;Group B:oral 15mg;Group C:placebo. The patients received combined spinal-epidural anesthesia after oral midazolam. The parameterns of EEG, SEF 95 %, BISwere collected at the same time and the degree and remark of sedation were dome according to OAA/S. The amnesia and implicit memory were investigated with pictures and muddy identified hearing rate 6 hours after operation. Results (1)Twenty min following drug ad dministration the remarks of sedation of group A and B were significantly loWver than that before and that of group C, Which was not significently different between group A and B. ( 2)The amnesia rates tested six hrs after surgery were significantly higher at 30min in group A, 20min in group B than those before treatment and were kept at 70%-80% levels, which in group C was remained zero. (3)The muddy identified hearing rate was not different significantly, among the three groups. (4) The short-term memory was all 100%during the period of drug action. (5)BIS and SEF 95% Were lower 30min after the treatment and all kept at 80 Hz and 20 Hz, which were not different remarkably between group A and B. ConclnsionOral midazolam 7. 5mg has a good effect on anterograde amnesia 30min after treatment, which may not be improved with increament in dosage. It does not lead to retrograde amnesia. The long-term memory, but not short-term memory, was impaired by midazolam. It only affects the explicit memory. Oral premnedication with midazolam can not prevent the awareness during operation totally.

ObjectiveTo compare the efficacy of 3 internal fixations, locking proximal femoral plate(LPFP), ASIAN IMHS and InterTAN, for intertrochanteric femoral fractures in elderly patients.MethodsA retrospective study was done to analyse 185 elderly patients who had been treated for intertrochanteric femoral fractures from February 2008 to December 2009 in our hospital and fully followed up.They were treated with LPFP (group A, 95 cases), ASIAN IMHS (group B, 52 cases) and InterTAN (group C, 38 cases) . Statistical analyses were conducted to compare the 3 groups in operative time, blood loss,fluoroscopy exposure, hospital charges, intrraoperative complications and functional outcome(Harris hip score).Results The average follow-up was 14. 5 months(from 6 to 28 months). Compared with group A, groups B and C showed significant advantages in operative time, blood 1oss and functional outcome but significant disadvantages in fluoroscopy exposure and hospital charges ( P ＜ 0. 05 ). Compared with group A,groups B and C had significant fewer implant failures ( P ＜ 0. 05).There were no significant differences in all the indexes between groups B and C( P ＞ 0. 05) .Conclusions The ASIAN IMHS and InterTAN appear to be more reliable than LPFP for the treatment of intertrochanteric femoral fractures in the elderly.There appear to be no significant differences between ASIAN IMHS and InterTAN.

Objective To study the dynamic change of high-sensitivity C-reactive protein(hCRP),interleukin-1(IL-1?)interleukin-6(IL-6)in acute traumatic brain injury,and the correlation between the dynamic change and the scale of brain injury and the prognosis of the patients.Methods 192 cases patients were divided into different groups according to the Glasgow Coma Scale(GCS)and the Glasgow outcome Scale(GOS)three months later discharged from hospital respectively.The concentration of serum CRP,IL-1?,IL-6 were detected with immunoturbidimetry and ABC-ELISA 24 with in hours after traumatic brain injury and the concentration of serum after iniwn at ond day,three days and seven days was detected as well.Results Serum hCRP levels were remarkably elevated and reached peak value within 24 hours,and then gradually decreased.There were a negative correlation between hCRP,IL-1?,IL-6 and the patient's GCS groups(r=-0.162,P

Objective The objective of this study was to explore the value of enhanced recovery surgery(ERAS)in perioperative period of laparoscopic assisted colorectal cancer surgery.Methods From November 2015 to July 2016,86 patients with colorectal cancer treated with colorectal surgery were divided into ERAS group and routine treatment group.All patients underwent laparoscopic radical resection of colorectal cancer.The operative situation,postoperative recovery and complications were analyzed in this study.Results There was no difference in the operation time and bleeding volume between the operation group and the conventional treatment group(P>0.05).The postoperative ventilation and defecation time in the ERAS group were earlier than those in the routine treatment group.The postoperative hospital stay and the postoperative pain score were lower than those in the routine treatment group.The rate of postoperative complications was lower than that in the routine treatment group(P<0.05).Conclusion The operation of laparoscopic colorectal cancer under the guidance of ERAS can help patients to recover from hospital,shorten the hospitalization time and reduce the cost of hospitalization.The further application of ERAS should be combined with various disciplines.

OBJECTIVETo analyze causes of missed diagnosis of hiding post-malleolar fractures in treating ankle joint fractures of pronation-external rotation type according to Lauge-Hansen classification and assess its medium-term outcomes.

METHODSAmong 103 patients with ankle joint fracture of pronation-external rotation type treated from March 2002 to June 2010,9 patients were missed diagnosis,including 6 males and 3 females,with a mean age of 35.2 years old (ranged, 18 to 55 years old) . Four patients were diagnosed during operation, 2 patients were diagnosed 2 or 3 days after first surgery and 3 patients came from other hospital. All the patients were treated remedially with lag screws and lock plates internal fixation. After operation,ankle joint function was evaluated according to American Orthopaedic Foot and Ankle Society (AOFAS).

RESULTSAll the 9 patients were followed up, and the duration ranged from 14 to 30 months (averaged, 17 months). No incision infection was found, and all incision healed at the first stage. At the latest follow-up, AOFAS was 83.0 +/- 4.4, the score of 4 patients diagnosed during operation was 85.0 +/- 2.9, and the score of 5 patients treated by secondary operation was 81.0 +/- 5.3. All the patients got fracture union observed by X-ray at a mean time of 2.2 months after operation. There were no complications such as internal fixation loosing, broken and vascular or nerve injuries.

CONCLUSIONAnkle joint fracture of pronation-external rotation type may be combined with hiding post-malleolar fractures. So to patients with ankle joint fracture of pronation-external rotation type, lateral X-ray should be read carefully, and if necessary, CT or MRI examination should be performed. If adding lateral X-ray examination after reduction of exterior and interior ankle joint fixation, the missed diagnosis may be avoided.

Adolescent ; Adult ; Ankle Fractures ; False Negative Reactions ; Female ; Fractures, Bone ; diagnosis ; diagnostic imaging ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Pronation ; Rotation ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult

Heavy-ions have the similar characteristic of depth-dose distribution with protons, but exhibit enhanced physical and radiobiological benefits. With increasing development in technical and clinical research, more facilities are being installed in the world. At the same time, many critical techniques of heavy-ion therapy facility were optimized and completed. This paper classified and reviewed the basic structure of heavy-ion system equipments, especially the accelerator, gantry, nozzle , TPS.
Cancer Care Facilities ; Heavy Ion Radiotherapy ; instrumentation ; Humans ; Neoplasms ; therapy

Objective To analyze the reasons of discarding as useless of ?-Se direct conversion digital flat panel detector (?-Se FPD). Methods (1) E-COM DR-2000CTM chest system, with high frequency X-ray machine made by CPI company of Canada, the X-ray tube made by VARIAN company of America and Direct Ray-1000 ?-Se FPD made by DRC company of America. (2) 50 cases were collected rondomizedly, each had 4 pieces of chest image and were analyzed by two experienced radiologists and two technicians. Results After about 14 months with 30,000 times exposure efficacious, some damage lines and points appeared in the detector. After about 34 months with 70,000 times exposure efficacious, a damage region (area is 6.7in*0.95in ) existed, this reduced the images' quality and at the end the detector was discarded as useless. Conclusion The ?-Se FPD needs maintenance and monitoring working circumstance.

Objective To explore the clinical value of thermal tomography (TT) in the diagnosis of breast diseases.Methods Totally 222 breast diseases patients underwent examinations by color Doppler ultrasound and TT.Some stable TT images were selected,and the TT curves of the lesions were analyzed according to the malignant tumor TT curve diagnosing standard,so that the benign and malignant tumors could be determined.Color Doppler ultrasound was used to describe the site,size and property of the lesion.Results Pathological examination found 95 cases of malignant tumors and 127 benign ones.TT had 198 results coincident with those by pathological examination while the remained 24 ones not,with 15 false positive results and 9 false negative ones.When compared with pathological examination,TT had the accuracy,sensitivity and specificity being 89.19％,90.43％ and 88.28％ respectively.Conclusion TT is non-invasive,accurate and sensitive when used to screen and diagnose breast diseases,and should be applied if possible in medical facilities.

BACKGROUND:There are many methods for evaluating anterior cruciate ligament reconstruction. However, doctors always like to assess the outcome with the objective criteria, such as range of motion and imaging examinations, and patient satisfaction is little considered.OBJECTIVE:To explore the factors that may influence the patient satisfaction after anterior cruciate ligament reconstruction. METHODS:Ninety-eight patients undergoing anterior cruciate ligament reconstruction were enroled, including 58 male and 40 female patients, and the average age was 27.4 years old. All patients were followed up (average 17.5 months) to investigate the patient satisfaction. The factors related to the satisfaction were analyzed, such as age, follow-up time, sex, injured knee, mental health, education, economic situation, postoperative athletic ability, and International Knee Documentation Committee scores. RESULTS AND CONCLUSION:After the follow-up, 72.4% patients said that they were satisfied with the outcome, and 27.6% dissatisfied with the outcome. The mental health, economy situation, postoperative athletic ability, and International Knee Documentation Committee scores were significantly related to the patient satisfaction (P < 0.05). To conclude, improved living and medical standard, intensive communication and psychological counseling, as well as rational postoperative rehabilitation scheme can improve the patient satisfaction after anterior cruciate ligament reconstruction.