Objective To investigate the anxiety in the relatives of patients with severe brain injury at acute period and discuss the effective solving pathway.MethodsA questionnaire-based survey was conducted in 120 relatires of patients with severe brain injury during March 2006 to March 2007 by using state-trait anxiety inventory (STAI).Results Comparison of anxiety score between relatives of patients and normals,the scores of state anxiety and trait anxiety in the relatives of patients[(52,40±8.42),(46.73±7.56)]were significantly higher than those in normal people[(38.97±8.45),(41.31±7.54),P＜0,01].And between relatives of man and woman,the Scores of state anxiety and trait anxiety in the relatives of patients in female were significantly higher than those in male ones(P＜0.01).The scores of state anxiety and trait amv,iety in the 51～65 old group were significantly higher than ihosein 31～50 old group and 17～30 old group(P＜0.01).The scores of state anxiety and trait anxiety in the little educated group were significantly higher than that higher educated group(P＜0.05,P＜0.01),and higher in those having self-medical service than in those having public medical service.The scores for,mate is signkfigantly higher than that other roles(all is P＜0.05).Conclusion The relatives of patients with severe brain injury have anxiety of different degrees.Medical staff should pay attention to the relatives anxiety,and so to better the relationship of medical staff and patient

The pharmacokinetics of morphine in rats was studied after treatment with morphine, as well as morphine and lofexidine. The results showed that in lofexidine group the T 1/2ka and CL of morphine was significantly increased, while the C max ,AUC and T 1/2k of morphine were significantly decreased. Our results indicate that the lofcxidine can reduce the absorption rate of the morphine and the concentration of morphine in blood, and then can increase the total clearance rate of morphine in rats.

Objective To compare the clinical effect of two kinds of internal fixation of locking plate and anatomical plate in the treatment of Pilon fracture.Methods 64 patients with Pilon fracture undergoing elective surgery were randomly divided into study group and control group by digital table method,32 cases in each group.The study group received locking plate internal fixation for the treatment,the control group was treated with anatomical plate internal fixation.The clinical efficacy and safety of two kinds of internal fixation methods were compared.Results After treatment,the excellent rate of ankle joint function in the study group(96.88%)was significantly higher than that in the control group (81.25%),and the difference had statistical ssignificance (χ2 =4.01,P <0.05 ).The operative time,hospitalization time and fracture healing time[(57.32 ±10.98)min,(13.72 ±591 )d,(15.72 ± 2.82)weeks]in the study group were shorter than those in the control group[(68.11 ±11.85 )min,(16.62 ± 5.21)d,(17.81 ±3.42)weeks],and the differences had statistical significance(t =3.98,3.11,321,all P <0.05). The amount of bleeding (153.32 ±21.36)mL in the study group was less than that in the control group [(188.65 ± 26.24)mL](t =5.46,P <0.05).The incidence rate of delayed fracture healing of the study group (3.13%)was significantly lower than that in the control group(28.13%),the difference had statistical significance(χ2 =7.59,P <0.05).There were no significant differences in the incidence of other complications between the two groups(χ2 =1.95,102,102,0.35,all P >0.05).Conclusion Locking plate fixation in the treatment of Pilon fractures could significantly promote the recovery of joint function,and has the advantages of short operation time,fast fracture healing,less complications and other advantages,it is better than anatomical plate internal fixation.

Objective To investigate the correlation of the expressions of P170,topoisomerase Ⅱ(TOPⅡ)and the proliferation in gliomas.Methods Ki-67 was used as the marker of the proliferation in gliomas.The expressions of P170,TOPⅡ and Ki-67 were tested by S-P immunohistochemical technique using monoclonal antibody to their protein in 54 cases of low-grade gliomas(WHO Ⅰ～Ⅱ grade)and 54 cases of high-grade gliomas(WHO Ⅲ～Ⅳ grade),analysis of the clinical and follow-up were performed.Results The expressions of P170,TOPⅡ and Ki-67 had significant differences between low-grade and high-grade gliomas(P<0.01).Correlation analysis showed that the expression of P170 was negatively related with Ki-67(r=-0.276,P=0.019);the expression of TOPⅡ was positively related with Ki-67(r= 0.637,P<0.001);there was no correlation between the expressions of P170 and TOPⅡ.Conclusion The expressions of P170 and TOPⅡ are associated with the malignant prognosis in gliomas.

PURPOSE: This study explored the factors influencing disaster response competency, that is, demographic and disaster-related characteristics, personal disaster (household and workplace) preparedness, disaster risk perception, and self-efficacy in handling disasters among emergency medical technicians in South Korea.METHODS: The study follows a descriptive, cross-sectional design and uses a self-reported questionnaire. Emergency medical technicians, amounting to 1,020 in all, currently working in firefighting organizations from four South Korean cities (Busan, Daegu, Daejeon, and Ulsan) participated in the study.RESULTS: Disaster risk perception, self-efficacy for disaster, participation experience in disaster education/training, and personal disaster (household and workplace) preparedness predicted the disaster response competency of emergency medical technicians in South Korea.CONCLUSION: There is a need for an antidisaster program to enhance the disaster risk perception, self-efficacy, personal disaster (household and workplace) preparedness, and the disaster education/training participation rate toward enhancing disaster response competency of emergency medical technicians in South Korea.
Daegu ; Disasters ; Emergencies ; Emergency Medical Technicians ; Humans ; Korea ; Self Efficacy

In order to produce a stable denture for severe alveolar bone loss area, it is not only important that .0a suitable occlusion is established but also to consider compatibility with the surrounding muscle to form a suitable polished surfaces. Neutral zone is defined as a potential area where the neuromuscular system of the tongue, cheeks and lips is balanced can be determined through the neutral zone impression technique. And if artificial teeth are aligned within the neutral zone and the polished surface follows the anatomical form of the dynamic muscle, higher stability and retention of the denture may be obtained through coordination with the surrounding muscle tissue. This case is being reported since the concept of the neutral zone was applied to a patient with severely atrophic residual alveolar ridge and the result was clinically satisfactory in both function and aesthetics.
Alveolar Bone Loss ; Alveolar Process ; Cheek ; Denture, Complete ; Dentures ; Esthetics ; Humans ; Lip ; Rehabilitation ; Tongue ; Tooth, Artificial

Purpose: There is limited information on the clinical characteristics and prognosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy. The clinical features and risk factors for hypoxemia development were investigated in pregnant women with coronavirus disease-2019 (COVID-19). Materials and Methods: From August 2020 to February 2022, we performed a retrospective cohort study of 410 pregnant women with COVID-19. The clinical characteristics and prognoses were compared between pregnant COVID-19 patients requiring oxygen and those who did not. Results: Of 410 patients, 100 (24.4%) required oxygen therapy. Among them, fever [163 (52.6%) vs. 81 (81.0%), p<0.001] and cough [172 (56.4%) vs. 73 (73.0%), p=0.003] were more frequently observed than in non-oxygen group. The proportion of unvaccinated women was higher in oxygen group than in non-oxygen group [264 (85.2%) vs. 98 (98.0%), p=0.003]. During the Omicron wave, patients were more likely to have no oxygen requirement [98 (31.6%) vs. 18 (18.0%), p=0.009]. The risk of hypoxemic respiratory difficulty increased if SARS-CoV-2 infection occurred during the third trimester [adjusted odds ratio (aOR) 5.083, 95% confidence interval (CI): 1.095–23.593, p=0.038] and C-reactive protein (CRP) was elevated (≥1.0 mg/dL) at admission (aOR 5.878, 95% CI:3.099–11.146, p<0.001). The risk was higher in unvaccinated patients (aOR 5.376, 95% CI: 1.193-24.390, p=0.028). However, the risk was lower in patients during the Omicron wave (aOR 0.498, 95% CI: 0.258–0.961, p=0.038). Conclusion A quarter of SARS-CoV-2-infected women developed hypoxemic respiratory difficulty during pregnancy. SARSCoV-2 infection during the third trimester, CRP elevation at admission, and no vaccination increased the risk of hypoxemia in pregnant women.

Fibroadenomas are the most common benign breast tumors in women. Giant juvenile fibroadenomas, which represent about 0.5% to 2% of all fibroadenomas, are a rare variant of these tumors. Giant juvenile fibroadenomas develop between the ages of 11 to 18 years and are usually unilateral and solitary. In the case presented, a 21-year-old woman was found to have multilobular fibroadenomas in both breasts, each with a maximum diameter of over 20 cm. The masses weighed 636 g on the right side and 752 g on the left. The patient underwent nipple-sparing mastectomy and immediate reconstruction with implant insertion in both breasts. This case is notable for the unusual size and shape of the masses, which presented considerable challenges for surgical removal and breast reconstruction. The patient was discharged without postoperative complications and remains under outpatient observation.

OBJECTIVE: We compared the cell responsiveness of activated lymphocytes to rapamycin, which blocks the G1/S transition, between patients with Alzheimer's disease (AD) and normal controls to assess the early phase control defect in cell cycle. METHODS: Blood samples of 26 patients with AD and 28 normal controls were collected to separate peripheral lymphocytes. We measured the proportion of each cell cycle phase in activated lymphocytes using flow cytometry and evaluated the responsiveness of these lymphocytes to rapamycin. RESULTS: The patients with AD were older than the normal controls (AD 74.03+/-7.90 yr vs. control 68.28+/-6.21 yr, p=0.004). The proportion of G1 phase cells in the AD group was significantly lower than that in the control group (70.29+/-6.32% vs. 76.03+/-9.05%, p=0.01), and the proportion of S phase cells in the AD group was higher than that in control group (12.45+/-6.09% vs. 6.03+/-5.11%, p=0.001). Activated lymphocytes in patients with AD were not arrested in the G1 phase and they progressed to the late phase of the cell cycle despite rapamycin treatment, in contrast to those of normal subjects. CONCLUSION: The patients with AD probably have a control defect of early phase cell cycle in peripheral lymphocytes that may be associated with the underlying pathology of neuronal death.
Alzheimer Disease ; Cell Cycle ; Cell Cycle Checkpoints ; Flow Cytometry ; G1 Phase ; Humans ; Lymphocytes ; Neurons ; S Phase ; Sirolimus

Background: Various regional analgesia techniques are used to reduce postoperative pain in patients undergoing video-assisted thoracic surgery (VATS). This study aimed to determine the relative efficacy of regional analgesic interventions for VATS using a network meta-analysis (NMA). Methods: We searched the Medline, EMBASE, Cochrane Controlled Trial Register, Web of Science, and Google Scholar databases to identify all randomized controlled trials (RCTs) that compared the analgesic effects of the following interventions: control, thoracic paravertebral block (TPVB), erector spinae plane block (ESPB), serratus plane block (SPB), and intercostal nerve block (INB). The primary outcome was opioid consumption during the first 24-h postoperative period. Pain scores were also collected during three different postoperative periods: the early (0–6 h), middle (6–18 h), and late (18–24 h) periods. Results: A total of 21 RCTs (1391 patients) were included. TPVB showed the greatest effect on opioid consumption compared with the control (mean difference [MD] = −13.2 mg; 95% CI [−16.2, −10.1]). In terms of pain scores in the early period, ESPB had the greatest effect compared to control (MD = −1.6; 95% CI [−2.3, −0.9]). In the middle and late periods, pain scores showed that TPVB, ESPB and INB had superior analgesic effects compared to controls, while SPB did not. Conclusions TPVB had the best analgesic efficacy following VATS, though the analgesic efficacy of ESPBs was comparable. However, further studies are needed to determine the optimal regional analgesia technique to improve postoperative pain control following VATS.