Mediating effect of mental health on job burnout and aggressive driving behavior in bus drivers / 中国职业医学

OBJECTIVE: To explore the mediating effect of mental health on job burnout and aggressive driving behavior in bus drivers. METHODS: A total of 447 bus drivers was selected as study subjects using a convenience sampling method. The status of job burnout, mental health and aggressive driving behaviors were investigated using the Maslach Burnout Inventory-Human Services Survey, Symptom Check List 90, and the Aggressive Driving Questionnaire. RESULTS: The score of aggressive driving behaviors of bus drivers were positively correlated with emotional exhaustion, depersonalization, personal accomplishment dimension score and mental health total score[Spearman correlation coefficient(r_S)=0.23, 0.27, 0.15, 0.34, all P<0.01]. The mental health total score was positively correlated with emotional exhaustion and depersonalization dimensions scores(r_S=0.46, 0.47, all P<0.01), and not correlated with personal accomplishment dimension score(r_S=-0.04, P>0.05). Emotional exhaustion can affect aggressive driving behaviors through mental health, and the standardized mediating value was 0.16, accounting for 72.7% of the total effect. Depersonalization can influence aggressive driving behaviors through mental health, and the standardized mediating value was 0.17, accounting for 70.8% of the total effect. CONCLUSION: Mental health plays a mediating role in emotional exhaustion, depersonalization and aggressive driving behavior of bus drivers.

Bridging system for severe comminuted femoral fracture / 中国骨伤

OBJECTIVE@#To explore the clinical effect of bridging system in the treatment of severe comminuted femoral fracture.@*METHODS@#From March 2016 to October 2018, 50 patients with severe comminuted femoral fracture including 35 males and 15 females, aged 48 to 72(54.6±8.7) years, were admitted. All cases were comminuted fractures of the femoral shaft, 16 with proximal femur fractures and 7 with distal femur fractures. All cases were all unilateral fractures, 23 on the left and 27 on the right. The time from injury to operation was 5 to 60 (26.7±13.3) hours. The cause of injury was traffic accident, 12 cases with high fall, 35 cases fell and 3 cases fell accidentally. The patients were treated with bridge combined internal fixation system, and the operative effect and fracture healing were analyzed.@*RESULTS@#The operation was successful in all patients. There was no change to other fixed operation. The operation time was (75.8±12.3) min, the amount of bleeding was(356.4±64.8) ml, and there was no serious postoperative complications such as infection, internal fixation displacement, re fracture and nonunion. After 6 to 36 months follow-up, the fracture healing was evaluated by Warden's score. With the extension of observation time, Warden's score gradually increased, and the time of bone healing was(5.5±0.9) months. Harris score and HSS score were used to evaluate the function of hip and knee joint respectively. With the extension of time, Harris score and HSS score increased gradually. Six months after operation, Harris score was 83.5±11.2, HSS score was 79.7±10.5. During the follow-up period, there were no serious complications such as internal fixation displacement, re-fracture, nonunion of fracture and deep vein thrombosis of lower extremity.@*CONCLUSION@#The bridge combined internalfixation system has better safety and effectiveness in the treatment of severe comminuted femoral fracture. As long as the requirements of local anatomy and biomechanics are strictly mastered and the operation risks are fully evaluated in combination with imaging, the better fixation effect can be achieved. The operation has less trauma, fewer complications and simple operation, which is believed to have a wider application potential. Due to the limited sample size and follow-up time, no clinical control was set up, the results of the study still need to be further verified by prospective trials.

Progress in Clinical Application of Methadone in Cancer Pain Patients / 中国药师

Opioids are the main treatment drugs for the patients with moderate and severe cancer pain,and methadone is one of opioid drugs. Compared with the other opioids, methadone has the advantages of low cost, high oral bioavailability and better effect on neuropathic pain. However, methadone also shows such disadvantages as prolonged QT interval and large individual variance in pharmacokinetics. Although the safety of methadone has no difference from the other opioids in the treatment of cancer pain,the lack of knowledge and experience still limits its clinical application. This article aimed to summarize the clinical application of methadone in cancer patients,so as to help clinicians understand and apply methadone better.

Multi-point fixation with absorbable cartilage screws for the treatment of osteochondral fracture caused by patellar instability / 中国骨伤

<p><b>OBJECTIVE</b>To study clinical effects of multi-point fixation with bioabsorbable cartilage screws for the treatment of osteochondral fracture caused by patellar instability.</p><p><b>METHODS</b>During the period from August 2014 to Steptember 2016, there were 21 patients with osteochondral fracture caused by patellar dislocation, including 7 males and 14 females, ranging in age from 12 to 42 years old, with an average of 27 years old. During the operation, free fractures fragments of cartilage were found with a open surgery, and the patients were treated with fixation by absorbable cartilage screws combined with lateral retinaculum release and medial retinaculum shrinkage. The Lysholm scoring scale was used to evaluate the knee joint functions before and after operation. The retrospective study analyzing the data was carried out.</p><p><b>RESULTS</b>All the patients underwent successful surgeries and were followed up with a mean period of 12 months(ranged, 8 to 22 months). The CT and X-ray examinations were performed after the operation which showed the fracture fragments were on good positon. The exercise level in all the patients basically returned to the pre-injury level. The postoperative Lysholm score was 86.11±4.97.</p><p><b>CONCLUSIONS</b>The absorbable cartilage nail can effectively fix the free cartilage fragments of the osteochondral fracture due to the patellar instability, which is a simple operation, and worthy of clinical promotion.</p>

Protective Effects of Calpain Inhibition on Neurovascular Unit Injury through Downregulating Nuclear Factor-κB-related Inflammation during Traumatic Brain Injury in Mice / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>In addition to neurons, all components of the neurovascular unit (NVU), such as glial, endothelial, and basal membranes, are destroyed during traumatic brain injury (TBI). Previous studies have shown that excessive stimulation of calpain is crucial for cerebral injury after traumatic insult. The objective of this study was to investigate whether calpain activation participated in NVU disruption and edema formation in a mouse model of controlled cortical impact (CCI).</p><p><b>METHODS</b>One hundred and eight mice were divided into three groups: the sham group, the control group, and the MDL28170 group. MDL28170 (20 mg/kg), an efficient calpain inhibitor, was administered intraperitoneally at 5 min, 3 h, and 6 h after experimental CCI. We then measured neurobehavioral deficits, calpain activity, inflammatory mediator levels, blood-brain barrier (BBB) disruption, and NVU deficits using electron microscopy and histopathological analysis at 6 h and 24 h after CCI.</p><p><b>RESULTS</b>The MDL28170 treatment significantly reduced the extent of both cerebral contusion (MDL28170 vs. vehicle group, 16.90 ± 1.01 mm΃ and 17.20 ± 1.17 mm΃ vs. 9.30 ± 1.05 mm΃ and 9.90 ± 1.17 mm΃, both P < 0.001) and edema (MDL28170 vs. vehicle group, 80.76 ± 1.25% and 82.00 ± 1.84% vs. 82.55 ± 1.32% and 83.64 ± 1.25%, both P < 0.05), improved neurological scores (MDL28170 vs. vehicle group, 7.50 ± 0.45 and 6.33 ± 0.38 vs. 12.33 ± 0.48 and 11.67 ± 0.48, both P < 0.001), and attenuated NVU damage resulting (including tight junction (TJ), basement membrane, BBB, and neuron) from CCI at 6 h and 24 h. Moreover, MDL28170 markedly downregulated nuclear factor-κB-related inflammation (tumor necrosis factor-α [TNF-α]: MDL28170 vs. vehicle group, 1.15 ± 0.07 and 1.62 ± 0.08 vs. 1.59 ± 0.10 and 2.18 ± 0.10, both P < 0.001; inducible nitric oxide synthase: MDL28170 vs. vehicle group, 4.51 ± 0.23 vs. 6.23 ± 0.12, P < 0.001 at 24 h; intracellular adhesion molecule-1: MDL28170 vs. vehicle group, 1.45 ± 0.13 vs. 1.70 ± 0.12, P < 0.01 at 24 h) and lessened both myeloperoxidase activity (MDL28170 vs. vehicle group, 0.016 ± 0.001 and 0.016 ± 0.001 vs. 0.024 ± 0.001 and 0.023 ± 0.001, P < 0.001 and 0.01, respectively) and matrix metalloproteinase-9 (MMP-9) levels (MDL28170 vs. vehicle group, 0.87 ± 0.13 and 1.10 ± 0.10 vs. 1.17 ± 0.13 and 1.25 ± 0.12, P < 0.001 and 0.05, respectively) at 6 h and 24 h after CCI.</p><p><b>CONCLUSIONS</b>These findings demonstrate that MDL28170 can protect the structure of the NVU by inhibiting the inflammatory cascade, reducing the expression of MMP-9, and supporting the integrity of TJ during acute TBI.</p>

Value of MRI in the diagnosis of radial head fracture with forearm interosseous membrane injury / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the diagnostic value of MRI in radial head fracture with forearm interosseous membrane injuries.</p><p><b>METHODS</b>From December 2011 to December 2012,26 patients with fractures of capitulum radial in our hospital were collected. There were 15 males and 11 females, ranging in age from 21 to 53 years old,with an average of 37.6 years old. All the patients visited hospital within 72 hours after injuries. X-ray radiography of full ulnar radial length in injured side, CT in injured side (three-dimensional reconstruction if necessary) and MRI (including the elbow and wrist joints) were performed within a week after the injury. The MRI manifestations of the forearm interosseous membrane (with or without damage, the injured location and the injury degree ) and the fractures degree of radial head were observed and compared for the relativity.</p><p><b>RESULTS</b>Radial head fracture from Mason type I to III was associated with the forearm interosseous membrane injury. Radial head fracture degree was positive correlated with forearm interosseous membrane injury degree (P < 0.05).</p><p><b>CONCLUSION</b>Radial head fracture with suspicious forearm interosseous membrane injury is necessary to take MRI for checking for any interosseous membrane injury and injury degree, then choose the right treatment for radial capitulum fracture, only in this way can be helpful for the functional recovery of elbow and forearm.</p>

Effects of ambient temperature on hemorheological characteristics of rats / 医用生物力学

Objective To study different ambient temperatures effected on hemorheological characteristics of rats. Methods 70 rats were divided into 7 groups evenly and raised at the ambient temperature of 7, 12, 16, 22, 28, 32 and 35 ℃, respectively, for 7 days. 5 mL blood was collected by heart puncture technique from each rat to test their hemorheological parameters within 2 hours. Results When the ambient temperature was at 7, 12, 32 or 35 ℃, the hemorheological parameters were abnormal, the variability of erythrocytes was reduced, the resistance of capillaries was increased and the erythrocytes was assembled easily, thus preventing the normal blood circulation, slowing the local blood stream, causing the hypoxia and affecting the organic metabolism and function. Conclusions The hemorheological parameters were optimal within the ambient temperature range of 16~28 ℃, with the resistance of blood flow being smaller and the rheological properties of red blood cells being better. As for keeping the good microcirculation of the organism, it seems that the lowest and highest ambient temperature should be around 7 ℃ and 32 ℃, respectively.

Associations between CYP11B2 gene -344T/C polymorphism and essential hypertension in the Han nationality in Shandong province / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate whether the -344T/C polymorphism of CYP11B2 gene is associated with essential hypertension in the Hans in Shandong province.</p><p><b>METHODS</b>Plasma renin activity (PRA) and plasma aldosterone concentration (PAC) were measured with radioimmunoassays; the hypertensives were classified as low-renin and normal- or high-renin group by PAC/PRA ratio. -344T/C polymorphism was determined by polymerase chain reaction-restricted fragment length polymorphism (PCR-RFLP) in controls and hypertensives.</p><p><b>RESULTS</b>No significant differences were found in genotype distribution or allele frequency between groups of control and primary hypertension or between groups of control and normal- or high-renin hypertension. The C allele frequency in low-renin hypertension group was significantly higher than that in normotensives and normal- or high-renin hypertension group (P < 0.05).</p><p><b>CONCLUSION</b>These results suggest that -344T/C polymorphism of CYP11B2 gene may be associated with low-renin essential hypertension in the Han nationality in Shandong province.</p>