OBJECTIVETo observe the clinical results of proximal femoral nail anti-rotation (PFNA) combined with zoledronic acid injection in the treatment of osteoporotic intertrochanteric fractures in the elderly.

METHODS60 elderly patients with osteoporotic intertrochanteric fractures were diagnosed using a dual energy X-ray bone density instrument. Patients were randomly divided into treatment or control groups (30 cases in each group). Patients in both groups were treated by closed/open reduction and internal fixation using PFNA. In the treatment group, patients received one zoledronic phosphonic acid injection of 5 mg/100 ml via intravenous drip, in addition to 600 mg of Caltrate D (qd) and 0.25 mg of alpha ossification alcohol (qd). The control group received 600 mg of Caltrate D (qd) and 0.25 mg of alpha ossification alcohol (qd). The oral drugs were administered for 12 months. Bone pain relief was observed, and changes in the bone mineral density (BMD) of the lumbar and health-side hip were recorded. Clinical results were evaluated using the Visual Analogue Scale (VAS), Harris joint function score, and Osteo- porosis Quality of Life Scale (OQOLS).

RESULTSCompared with the control group, bone pain symptoms were significantly alleviated (p < 0.05) in the treatment group. In the treatment and control groups, both between-group and within-group differences in BMD were significantly increased in L1e4, femoral neck and trochanter (p < 0.05). No significant differences were found between the two groups in regard to the involved hip or the total rate of improvement at the end of the follow-up period, although cases in the treatment group had higher OQOLS scores than those of the controls (p = 0.04). Cases in the treatment group healed more quickly than those in the control group [(13 ± 3.2) weeks vs (15 ± 4.6) weeks, p = 0.02]. During the follow-up period, cases in the treatment group had no new fractures, whereas 2 new cases of hip fracture and 2 cases of distal radial fractures were observed among the controls.

CONCLUSIONZoledronic acid injection combined with PFNA is a favorable treatment option for the elderly patients with osteoporotic intertrochanteric fracture. It can effectively relieve bone pain, increase bone density, improve quality of life, reduce the occurrence of new fractures and promote fracture healing.

Aged ; Aged, 80 and over ; Bone Density ; Bone Nails ; Combined Modality Therapy ; Diphosphonates ; administration & dosage ; Female ; Hip Fractures ; psychology ; therapy ; Humans ; Imidazoles ; administration & dosage ; Injections ; Male ; Middle Aged ; Osteoporotic Fractures ; psychology ; therapy ; Quality of Life

PURPOSE: To examine the psychometric properties of a Turkish version of the Diabetes Fear of Injecting and Self-testing Questionnaire (D-FISQ). METHODS: Forward-backward translation of the D-FISQ from English into Turkish was conducted. Original English and translated forms were examined by a panel group. Validity was investigated using content, confirmatory factor analysis, and divergent validity. Reliability was assessed using Cronbach α values, item-total correlations, and intraclass correlations. The sample comprised 350 patients with diabetes. Data were analyzed using SPSS 15.0 for Windows and LISREL 8. RESULTS: The content validity index for the panel members was .90, which indicated perfect content validity; items in D-FISQ were clear, concise, readable, and distinct. Confirmatory factor analysis confirmed the original construct of the D-FISQ. All items had factor loadings higher than the recommended level of .40. The D-FISQ scores were discriminated by the level of anxiety. Reliability results were also satisfactory. Cronbach α values were within ideal limits. Item-total correlation coefficient ranged from .72 to .86. In terms of test-retest reliability, intraclass correlation coefficient was found to be over .90. CONCLUSIONS: D-FISQ is a valid and reliable questionnaire in assessing needle-prick fear among Turkish patients with diabetes. We recommend performing the Turkish D-FISQ in determining and screening patients with diabetes who have fear related to self-insulin injection and finger-prick test. Thus, health care professionals should be aware of the potential consequences of injection fear such as insulin misuse and poor self-monitoring of blood glucose, which may have unfavorable effects on optimal diabetes management.
Anxiety/etiology ; Blood Glucose Self-Monitoring/psychology ; Diabetes Mellitus, Type 1/drug therapy/*psychology ; Diabetes Mellitus, Type 2/drug therapy/*psychology ; *Fear ; Female ; Humans ; Hypoglycemic Agents/administration & dosage ; Injections/psychology ; Insulin/administration & dosage ; Male ; Middle Aged ; Psychometrics ; Reproducibility of Results ; Self Care/psychology ; Surveys and Questionnaires/standards ; Translations ; Turkey

BACKGROUNDThe aim of this study was to assess the efficacy and safety of vinorelbine and cisplatin (NP chemotherapy) alone or in combination with Aidi injection for the treatment of advanced nonsmall cell lung cancer (NSCLC).

METHODSPertinent publications were identified in PubMed, EMBASE, Cochrane Library, CNKI, CQVIP, and Wanfang databases, up to December 8, 2015. After quality assessment of all included randomized controlled trials evaluating Aidi injection combined with NP chemotherapy for the treatment of advanced NSCLC, a meta-analysis was performed by Review Manager 5.2 and STATA 12.0 for statistical analyses.

RESULTSTwelve studies including 509 and 503 cases in the experimental and control groups, respectively, were finally analyzed. The meta-analysis revealed that when cisplatin dose ranging from 20 to 40 mg/m 2 , combination of Aidi injection and NP chemotherapy was statistically different compared with NP chemotherapy alone in enhancing efficiency (relative risk [RR] = 1.24, 95% confidence interval [CI] [1.05-1.47], P = 0.010) and reducing the incidence of Grade II or above nausea and vomiting (RR = 0.49, 95% CI [0.30-0.80], P = 0.005). Meanwhile, with cisplatin ranging from 80 to 120 mg/m 2 , no significant differences in efficiency (RR = 1.11, 95% CI [0.87-1.42], P = 0.390) and Grade II or above nausea and vomiting (RR = 0.88, 95% CI [0.71-1.10], P = 0.260) were obtained. In addition, Aidi injection combined with NP chemotherapy was superior to NP chemotherapy alone in improving the quality of life, alleviating Grade II or above leukopenia and thrombocytopenia.

CONCLUSIONSAidi injection combined with NP chemotherapy can enhance efficiency, improve the quality of life, and decrease adverse effects in patients with advanced NSCLC.

Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; psychology ; Cisplatin ; administration & dosage ; Drugs, Chinese Herbal ; administration & dosage ; Humans ; Injections ; Lung Neoplasms ; drug therapy ; psychology ; Publication Bias ; Quality of Life ; Vinblastine ; administration & dosage ; analogs & derivatives

PURPOSE: To evaluate the effect of intravitreal expansile gas (C3F8) with anti-VEGF injection for the treatment of large submacular hemorrhage (SMH) secondary to age-related macular degeneration (ARMD). METHODS: In this report, 18 eyes of 18 patients with large SMH secondary to ARMD were treated with a simultaneous injection of 0.3 cc C3F8 and 0.05 ml anti-VEGF intravitrealy. RESULTS: The mean age was 64.89 +/- 5.68 years and the mean size of SMH was 4.44 +/- 1.25 disc diameters (DD). The minimum follow-up period was 12 months (range: 12-17 months). Mean preoperative best corrected visual acuity (BCVA) was 1.72 +/- 0.56 log MAR which improved significantly to 1.01 +/- 0.68 log MAR at 12 months (p = 0.002). SMH displacement occurred in all eyes. BCVA improved 2 or more lines in 11 eyes (61.1%) and deteriorated in 1 eye (5.6%). CONCLUSIONS: In this report, intravitreal injection of an expansible gas (C3F8) with anti-VEGF produced successful results in anatomical displacement of SMH and early visual improvement.
Displacement (Psychology) ; Eye ; Follow-Up Studies ; Hemorrhage ; Humans ; Intravitreal Injections ; Macular Degeneration ; Visual Acuity

PURPOSE: The purpose of this study was to evaluate the effects of teaching method using Standardized Patients (SPs) on nursing competence, self-directed learning readiness, and problem solving ability-focusing on subcutaneous insulin injection. METHODS: This research was a nonequivalent control group non-synchronized post-test design. The subjects consisted of 62 junior nursing students at E University. Scenarios to train SPs and checklists to evaluate the students' competence were developed by our research team. The experimental group (n=31) participated in the teaching class using SPs. The control group (n=31) received traditional practice education. The collected data were analyzed with descriptive analysis, chi-square/Fisher's exact test, t-test, Pearson's correlation coefficient, and Cronbach's alpha using SPSS WIN 14.0 Program. RESULTS: The mean scores of competence, self-directed learning readiness, and problem solving were significantly higher in the experimental group than the control group. CONCLUSION: As confirmed by this research findings, the teaching method using SPs was more effective than the traditional method to improve junior nursing students' competence, self-directed learning readiness, and problem solving. Therefore, It is necessary to develop a various of scenarios and to testify their effectiveness.
*Clinical Competence ; *Education, Nursing, Baccalaureate ; Female ; Humans ; *Injections, Subcutaneous ; Insulin/administration & dosage ; Learning ; *Problem Solving ; Program Evaluation ; Students, Nursing/psychology ; Teaching/*methods/standards ; Young Adult

The present study was carried out to provide a guideline for injecting tribromoethanol (TBE) as the main anesthetic agent, while adjusting the doses of xylazine (X) and medetomidine (M) according to different strains of mice (male ICR, C57BL/6, and BALB/c). Seven intraperitoneal injection anesthesia protocols using TBE and mixtures of TBE and alpha2-adrenergic agonists (TBE/X and TBE/M) were compared in terms of their efficacy and safety (anesthetic duration, death rate, and the development of pathological lesions of abdominal organs). All animals that were injected with a low dose of TBE (200 mg/kg) displayed clear signs of light anesthesia with a strong pedal withdrawal reflex. Despite the good anesthetic effect, a high dose of TBE (400 mg/kg) was not a suitable anesthetic for major surgery in all mouse strains because of the risk of pathologic changes in the abdominal organs, such as retention of the digestive tract, peritonitis, and fibrinoid adhesion. TBE200/X10 and TBE200/M0.5 (TBE, 200 mg/kg; X, 10 mg/kg; M, 0.5 mg/kg) appeared to be safe and provided satisfactory anesthesia in ICR mice. Finally, there were clear differences in anesthetic efficacy among ICR, C57BL/6, and BALB/c strains. TBE/M and TBE/X did not anesthetize BALB/c mice, and it anesthetized C57BL/6 mice for a short time. When administered with TBE/X and TBE/M maintained the sedation of ICR mice. We were able to establish different regimes for each strain (TBE200/X20 for C57BL/6, TBE300/X10 and TBE200/M1 for BALB/c). Our results showed that TBE/X and TBE/M could be recommended as an anesthetic mixture, with the dose appropriately adjusted according to mouse strain.
Anesthesia ; Anesthetics ; Animals ; Ethanol ; Gastrointestinal Tract ; Injections, Intraperitoneal ; Light ; Medetomidine ; Mice ; Mice, Inbred ICR ; Peritonitis ; Reflex ; Retention (Psychology) ; Sprains and Strains ; Xylazine

The present study was carried out to provide a guideline for injecting tribromoethanol (TBE) as the main anesthetic agent, while adjusting the doses of xylazine (X) and medetomidine (M) according to different strains of mice (male ICR, C57BL/6, and BALB/c). Seven intraperitoneal injection anesthesia protocols using TBE and mixtures of TBE and alpha2-adrenergic agonists (TBE/X and TBE/M) were compared in terms of their efficacy and safety (anesthetic duration, death rate, and the development of pathological lesions of abdominal organs). All animals that were injected with a low dose of TBE (200 mg/kg) displayed clear signs of light anesthesia with a strong pedal withdrawal reflex. Despite the good anesthetic effect, a high dose of TBE (400 mg/kg) was not a suitable anesthetic for major surgery in all mouse strains because of the risk of pathologic changes in the abdominal organs, such as retention of the digestive tract, peritonitis, and fibrinoid adhesion. TBE200/X10 and TBE200/M0.5 (TBE, 200 mg/kg; X, 10 mg/kg; M, 0.5 mg/kg) appeared to be safe and provided satisfactory anesthesia in ICR mice. Finally, there were clear differences in anesthetic efficacy among ICR, C57BL/6, and BALB/c strains. TBE/M and TBE/X did not anesthetize BALB/c mice, and it anesthetized C57BL/6 mice for a short time. When administered with TBE/X and TBE/M maintained the sedation of ICR mice. We were able to establish different regimes for each strain (TBE200/X20 for C57BL/6, TBE300/X10 and TBE200/M1 for BALB/c). Our results showed that TBE/X and TBE/M could be recommended as an anesthetic mixture, with the dose appropriately adjusted according to mouse strain.
Anesthesia ; Anesthetics ; Animals ; Ethanol ; Gastrointestinal Tract ; Injections, Intraperitoneal ; Light ; Medetomidine ; Mice ; Mice, Inbred ICR ; Peritonitis ; Reflex ; Retention (Psychology) ; Sprains and Strains ; Xylazine

PURPOSE:To present the clinical feature of retinal toxicity of intravitreal tissue plasminogen activator which was used for treatment of submacular hemorrhage. CASE SUMMARY: An intravitreal injection of tPA (100 microg) with C3F8 gas tamponade (0.2 cc) was given to treat the submacular hemorrhage in a patient with ARMD. The therapeutic effect was measured by visual acuity, slit lamp examination, indirect funduscopy and fluorescein angiogram. Three months after the operation, the hemorrhage was decreased but a pigmentary change was observed on the peripheral retina. After 8 months, the submacular hemorrhage completely reabsorbed but the peripheral pigmentary change had increased. Ten months later, the retinal pigmentary change was observed on the entire retina except the posterior pole. The fluorescein angiogram showed peripheral hyperfluorescene of the retina due to window defect from the pigmentary change but no leakage was detected. The electroretinogram showed reduced amplitude in the right eye. CONCLUSIONS: Intravitreal tPA injection of 25 to 100 microg with pneumatic displacement is typically used for the treatment of submacular hemorrhage. However, there is no established safety dose of tPA for use in human eyes. In the present study, 100 microg of tPA was used and retinal toxicity was noted. Establishing a safety dose of tPA to prevent dosage dependent complications is necessary.
Displacement (Psychology) ; Eye ; Fluorescein ; Hemorrhage ; Humans ; Intravitreal Injections ; Retina ; Retinaldehyde ; Tissue Plasminogen Activator ; Visual Acuity

Amphetamine-type stimulants (ATS) is the most widespread narcotics in the 21st century. The methamphetamine's intoxication mechanism, psychological dependence, drug resistance and therapeutic drug development are the hot spots in current research. Establishment of animal model with methamphetamine poisoning is the basic for the relative studies, the normalization and standardization of the animal model settles the foundation for methamphetamine's further research. This article reviews the animal model of methamphetamine poisoning in China and abroad, the brief history of the acute, subacute and chronic animal model of methamphetamine poisoning, as well as the principles and methods of the animal model establishment and its evaluation criteria. The necessity, significance and its scientific expansion of performing experimental research on the methamphetamine poisoning animal model are also discussed.
Amphetamine-Related Disorders/psychology* ; Animals ; Behavior, Animal/drug effects* ; Central Nervous System Stimulants/poisoning* ; Cerebral Cortex/drug effects* ; Disease Models, Animal ; Forensic Toxicology ; Humans ; Injections, Intraperitoneal ; Methamphetamine/poisoning* ; Stereotyped Behavior/drug effects*

PURPOSE: To study the results of intravitreal tissue plasminogen activator (tPA) and expansile gas injection for the treatment of submacular hemorrhage in age-related macular degeneration (AMD). METHODS: Eleven consecutive patients (11 eyes) with submacular hemorrhage in AMD were included in this study. All patients were treated with intravitreal injections of tPA and C3F8 gas. Postoperatively, patients' follow-up period were at least 3 months. Outcome measures included early and final visual acuity, age, disc areas of hemorrhage, duration of symptoms, displacement of blood from the fovea, and final macular status. RESULTS: The maximum diameter of the hematoma ranged from 2 to 10 disc diameters. The mean duration of submacular hemorrhage was 7.5 days. Submacular blood was completely displaced in 7 patients (64%) and partially in four (36%). Best postoperative visual acuity improved in 7 eyes; in 6 eyes (55%), the improvement was two or more lines. Final visual acuity improved in 7 eyes (64%), remained stable in 2 eyes (18%), and worsened in 2 eyes (18%). Choroidal neovascularization positioned at subfovea in 7 eyes (64%) and juxtafovea in 4 eyes (36%). No significant difference was found between postoperative visual recovery and these factors. CONCLUSIONS: Our findings suggest that intravitreal tPA and expansile gas injection are safe and of useful for displacing hemorrhages secondary to age-related macular degeneration. Final visual acuity was limited by the underlying choroidal neovascularization of AMD.
Choroidal Neovascularization ; Displacement (Psychology) ; Eye ; Follow-Up Studies ; Hematoma ; Hemorrhage ; Humans ; Intravitreal Injections ; Macular Degeneration ; Outcome Assessment (Health Care) ; Tissue Plasminogen Activator ; Visual Acuity