Objective To explore the influence of cognitive-behavioral therapy on the quality of life of elderly depression patients with chronic pain.Methods 60 patients were divided into the cognitive-behavioral therapy(CBT) group and non-cognitive-behavioral therapy(N-CBT) group,30 cases in each group.The patients in CBT group were treated with cognitive-behavioral therapy combined with mirtazapine,and the patients in N-CBT group were treated with mirtazapine only.Before treating and after the 4th week and 12th week,depression,anxiety and chronic pain were assessed respectively with Hamilton Depression Scale ( HAMD),Hamilton Anxiety Scale (HAMA),and Visual Analogue Scales (VAS),the quality of life was assessed with the WHO Quality of Life ( WHO.QOL-100).No significant different scores of HAMD,HAMA,VAS and WHOQOL-100 existed between two groups before treatment.Results Depression,anxiety and chronic pain were significantly related to the life quality of elderly depression patients with chronic pain ( r =-0.506 ～ -0.676,P ＜ 0.01 ).At the end of the 12th treating week,the scores of HAMD(36.82 ±7.93),HAMA(8.26 ±3.13),VAS(4.35 ±0.52) and WHOQOL100 ( respectively ( 65.71 ± 17.29 ),( 92.36 ± 13.55 ),( 77.91 ± 12.26 ),( 78.33 ± 12.81 ),( 81.79 ± 12.43 ),( 18.95 ± 11.91 ),( 19.98 ± 11.56 ) ) were significantly different from those before treatment in CBT group,and the change of each indicator score was significantly greater in CBT group than those in N-CBT group ( t =3.020 ～9.761,P＜ 0.01 ).Conclusion Cognitive-behavioral therapy can effectively improve the life quality of the elderly depression patients with chronic pain.

Medical literature was searched for articles concerning “femoral nonunion”and “exchange nailing”on Medline to evaluate the successful rate of the primary operation. Because of wide use of locking intramedullary nailing in recent years, the successful rate of the primary operation with exchange of ream ed intramedullary nailing for aseptic femoral shaft nonunion tends to decrease s ignificantly. Only reaming and exchange for nailing of a larger diameter can not completely resolve the problem of instability, and excessive reaming may result in new instability. The effective length of nail-bone contact should be emphas ized.

The appearance of theoretical medic ine is an inevitable result of develo pment of medicine.The development of molecular biology an d molecular immunology has laid the b asis of theoretical medicine,which studies various systems in life so as to reveal the essential laws of life phenomen a.The mystery of fracture healing wi ll be explained only from the viewpoint of theoretical medicine.The primary c allus response(PCR)is the basic event of fracture healing that is a process of numerous repetition of PCR and accum ulation of the surplus repair of PCR.The pathologic process of fracture healing shares very similar cellular and molecular mechanisms with the physiologic process of bone remodeling.This theory has been referred to as monistical theory of fracture healing.[

Objective To explore optimal proposal and theorical mechanism for treatment of chronic ulcerative colitis(UC) with the therapeutic instrument inducting combined energies into anus.Methods 76 patients with mid-range chronic UC were sampled and divided into two groups randomly.Patients in both groups were all withdrawn from drugs and treated with the therapeutic instrument inducting the combined energies into the anus by choosing different combined energies.There were 41cases in the treated group and they were treated with intracavity electrod synchronizing with electrotherapy,heat therapy,magnetic therapy and massor.35 cases in the control group were treated with intracavity electrod synchronizing with heat therapy and magnet therapy.The two groups were compared after twelve months.Results The general improvement rate and cure rate of the two groups showed great significant difference(P

Objective o observe the therapeutic effects of suspension-assisted functional rehabilitation training of motor function for patients with cerebral infarction. Methods Ninety-six patients with cerebral infarction were divided randomly into a treatment group and a control group. All patients were given routine medical treatment and routine limb movement therapy. Those in the treatment group also used an electrically-driven suspension device to aid in their functional rehabilitation training. The patients were assessed with a simplified Fugl-Meyer Motor Functional Assessment (S-FMMFA), and using the Postural Assessment Scale for stroke patients ( PASS), the Barthel Index (BI) and the 6-minute walking distance test before and after treatment and at a 6-month foliowup. Results The average S-FMMFA, PASS, BI and the 6-minute walk results in the treatment group were all significantly better than those in the control group. Conclusions Suspension-assisted training can significantly help improve limb movement function and ADL performance in cerebral infarction patients.

Objective To provide anatomical basis of the zygomatic branch of the facial nerve for the rhytidectomy. Methods The clinical surgical anatomy of the zygomatic region was studied bilaterally on 12 embalmed cadaveric head specimens and 2 fresh cadavers. Results The zygomatic branches came out of the parotid and divided into 2 or 5 branches (66.70 %), three branches (25.00 %), or multiple branches (8.80 %). 91.67 % of the rami superficialis was observed, and its branches had three types. The path of the rami superficialis could be located beforehand in a plane section. The rami superficialis and the rami profundus had various anastomosis. Conclusions Zygomatic branches divide into the rami superficialis and the rami profundus according to crossing the zygomatic majar musle. The rami superficialis distribute on the upper one third of the zygomatic majar musle, and it accounts for 91.67% in the group. It can be labeled before rhytidectomy to avoid the nerve injury.

Objective To observe the efficacy and safety of fluticasone propionate ointment in the treatment of psoriasis vulgaris. Methods A randomized comparative clinical observation was performed in 68 patients with pso-riasis vulgaris, they were divided into experimental group and control group. The experimental group of 34 cases was treated with fluticasone propionate ointment and the control group of 34 cases with kenacort-A ointment. The response was evaluated at 6 weeks. Results The total effective rate of the experimental group was 94.1% and 70.6% in the control group after 6 weeks. There was a significant difference between the two groups in treatment effective rate(P<0.01). Conclusion It is effective and safety for fluticasone propionate ointment in the treatment of psoriasis vulgar-is.

Objective To study the experience of cricohiodoepiglottopexy(CHEP) in the cases with glottic cancer. Methods A retrospective analysis has been carried out in 36 cases with glottic cancer. All cases treated in our hospital with supracricoid laryngectomy with CHEP. Results All 36 cases kept the normal airway, swallowing and speech. Conclusion CHEP is a useful technique for laryngeal cancer, particularly for glottic cancer.

Objective:To evaluate the effects of modified neck dissection (MND)preserving jugular vein on patients with supraglottic laryngeal carcinoma,the clinical data of 88 cases were analyzed retrospectively.Methods:There were 48 males and 40 females,ranging in age from 37 to 72 years old who were diagnosed supraglottic laryngeal squamous cell carcinoma.The clinical stages were T18,T2 30,T3 28,T4 22,cN1 38,cN2 48,cN3 2;pN0 11,pN1 21,pN2 54 and pN3 2,respectively.Among 146 lateral neck dissections in 88 cases (bilateral 58 cases,one lateral 30 cases),106 were MND,40 being radical neck dissections (RND).Of 106 MND,64 were simultaneously performed bilateral neck dissections (18 cases preserved bilateral jugular veins,14 cases preserved on side jugular veins),52 subsequently bilateral neck dissections(first time was RND ,and the second time was all MND).One side MND was performed in 30 cases,which preserved jugular veins.Results:The 3-year survival rate was 81.5%(22/27)in the simultaneous bilateral neck dissection,60.9%(14/23)in the subsequent neck dissection,75.0%(15/20)in the one lateral neck dissection.The 5-year survival rate was 61.5%(16/26),40.9%(9/22),70.6%(12/17)respectively.The recurrent rate of lymph node postoperative was 12.9%(11/85)in the lymph node less than 3cm in diameter,47.6%(10/21)more than 3cm in diameter.The recurrent rate of lymph node was 22.5%(9/40)in the group of RND,19.8%(12/106)in the group of MND.Conclusions:Because the neck lymph node metastasis often occurred in supraglottic carcinoma,the bilateral neck dissection is necessary during which one side jugular vein must be preserved.Results suggested that if the metastasis lymph node was less than 3cm in diameter and had not adhered to jugular vein,the jugular vein should be preserved,which could lesson complications and get better life quality.

Objective To provide basis for treatment and prognosis judgement in order to further normalize diagnosis on non-small-cell lung cancer.Methods The diagnostic results of 146 cases with non-small-cell lung cancer were collected and analyzed.The patients received treatment in our department from Feb.2002 to Aug.2005.Results There were 123 cases of complete pathologic diagnosis,accounting for 84.2% of the total results;among other things there were 42 cases(28.8%)that obtained pathologic diagnosis through operation.There were respectively 31 cases(21.2%),18 cases(12.3%),15 cases(10.3%)and 11 cases(7.5%)that obtained diagnosis through phlegmy cytological examination,lymph node needle biopsy,hydrothorax cytology and bronchoscope among 104 cases without operation.There were 23 cases accounting for 15.7% through clinical diagnosis(on the basis of clinical physical sign and video examination without definite pathologic diagnosis).Conclusion To form a definite pathological diagnosis on tumors before treatment makes treatment be exact and helps to judge tumor development and prognosis.