Medicine education must pay attention to humanity education,which is determined by the nature of medicine.The present situation and problems of the medical humanity education in china were reviewed and new approaches to improve long-term mechanism of the medical humanity education in china were enhanced from the following four apects:constructing teaching staff,setting up curriculum,reforming teaching methods and building campus-culture.

Objective To compare the clinical effect of locking plate and ordinary T-plate fixation for unstable distal radial fracture,thus to provide evidence for the treatment of unstable distal radius fractures.Methods 46 patients with unstable distal radius fractures were selected,and they were randomly divided into two groups,23 cases in each group.The control group received normal T-plate fixation,the observation group was treated with locking plate fixation.The wrist function,postoperative fracture reduction and complications were compared in the two groups.Results After treatment,the wrist joint function excellent rate in the control group was 69.57％,which was significantly lower than 95.65％ in the observation group,the difference was statistically significant between the two groups (x2 =7.41,P ＜ 0.05).The radial height,ulnar deviation and palmar angle of the observation group were (2.51 ±0.59) mm,(13.08 ± 4.71) ° and (20.11 ± 7.02) ° respectively,which were all better than (1.12 ± 0.41) mm,(9.39 ± 4.18)° and (14.37 ± 5.22)° of the control group,the differences were statistically significant (t =4.023,6.081,7.339,all P ＜ 0.05).The observation group had 1 case of fat facilitation,the incidence rate of complication was 4.35 ％,the control group had 1 case of cut nonunion,1 case of wound infection and 1 case of screw loosening,the incidence rate of complications was 13.04％,the incidence of adverse reactions had statistically significant difference between the two groups(x2 =10.17,P ＜ 0.05).Conclusion Locking plate fixation for treatment of unstable distal radius fractures can achieve satisfactory outcome and effective sustain fractures,meanwhile,patients get good wrist function recovery,reducing the incidence of complications,so it is worthy of clinical use.

Objective To investigate the therapeutic effect of the complicated fracture of tibial plateau treated by open reduction and internal fixation. Methods Surgical treatment in 68 cases with complicated fractures of the tibial plateau were analyzed retrospectively, T type plate, L type buttress plate, double plates, anatomical plate,locking plate and less invasive stabization system were adopted for different fractures,iliac or artificial bone grafted in the reconstruction of bone defect after the depression replaced. The time of operation and the effect of functional exercise in the postoperative patients to recover the function of the knees were analyzed at the same time. Results 52 patients of 68 cases were followed-up. Based on Rasmussen rating system,the recovery of knee joint function were excellent in 42cases(67%) ,good in 12 cases(19%) ,fair in 6 cases(10%) and poor in 2 cases(4%) ,the excellent-and-good rate was 86%. Conclusion Surgical treatment of the complicated fractures of the tibial plateau depended on the kind of fracture, therapeutic principles by stages. Moreover, bone grafte after the depression replaced in bone defect was neeassary,good internal fixtion oould meet functional exercise,soft tissue injuries like ligament and meniscus should be well treated,follow the principles of early exercise and delay weightbearing.

Objective To explore the effect of the 3rd generation Gamma nail in the treatment of intertrochanteric fractures.Methods 32 cases with intertrochanteric fractures were treated with the third generation Gamma nail internal fixation.Results Mter follow-up,the excellent and good rate was 87.6％.Conclusion The third generation Gamma nail treatment is a good internal fixation for intertrochanteric fracture of femur.

BACKGROUND:Artificial total disc replacement is one treatment of low back pain in recent years, but the report on the effect of disc replacement on lumbar sagittal plane is rare. OBJECTIVE:To analyze the effect of lumbar disc replacement on lumbar lordosis. METHODS:Retrospective analysis of radiographic data of 17 patients who underwent lumbar disc replacement for single segment degenerative disc disease was carried out. Data measurement included preoperative and postoperative lumbar lordosis, diseased segmental lordosis and lumbar intervertebral angle. RESULTS AND CONCLUSION:Al the 17 patients were fol owed-up for more than 12 months. Lumbar disc replacement was performed at L4-5 segment in three cases and L5-S1 segment in 14 cases. The average diseased segmental lordosis and lumbar lordosis were increased significantly after replacement when compared with those before replacement (P<0.05);the lumbar intervertebral angle was increased after replacement when compared with that before replacement, but the difference was not significant. The results indicate that lumbar disc replacement for the treatment of single segment degenerative disc disease can increase the lumbar lordosis and diseased segmental lordosis, which can help to improve the lumbar sagittal balance. The postoperative lumbar intervertebral angle has no correlation with the implant angle of the prosthesis on the replace segment.

Objective To discuss the technical essentials of microsurgery using suboccipital muscle stratification for the treatment of complex vertebrobasilar aneurysms via far lateral approach.Methods The clinical data of 8 patients with vertebrobasilar aneurysm underwent suboccipital muscle stratification via far lateral approach at the Department of Neurosurgery,Xuanwu Hospital,Capital Medical University were analyzed retrospectively,including 5 patients with subarachnoid hemorrhage (Hunt-Hess grade Ⅱ 3 cases;grade Ⅲ 1 case;grade Ⅳ 1 case),and 3 with symptomatic dissecting aneurysm.Six patients underwent occipital artery-posterior inferior cerebellar artery and anterior inferior cerebellar artery bypass grafting,and aneurysm trapping,and the aneurysms of the other 2 cases were clipped directly in the operation.The modified Rankin scale (mRS) was used to evaluate the clinical efficacy.Results Postoperative digital subtraction angiography (DSA) revealed that all the bridge vessels were patent.The obtained length of occipital artery in the actual measurement of the operation was 12.5±1.1 cm.The distance between the anastomosis site and the skin incision in 6 cases was 50±6 mm.They were followed up for 4-21 months after procedure.The mRs score in 7 cases was 0-1.Two patients had new-onset hoarseness and recovered completely within 3 months after procedure.Another patient had postoperative cerebellar hemisphere dominant regional cerebral infarction and the mRs score was 4.None of them had poor wound healing,infection and cerebrospinal fluid leakage after procedure.Conclusion Suboccipital muscle stratification via far lateral approach can effectively obtain a longer occipital artery,reduce the occupation effect of muscle and depth of field.It is beneficial to expose lesions and operation of deep anastomosis.It is a more safe and practical technique in neurosurgery for the treatment of vertebrobasilar artery aneurysms.

Objective To evaluate arterial stiffness in middle-age and elderly patients on the treatment of hemodialysis and to investigate the risk factors of arterial stiffness. Method A total of 87 in middle-age and elderly patients on the treatment of hemodialysis were enrolled. The distensibility coefficient (DC) of the common carotid artery was evaluated by an ultrasonic phase-locked echo-tracking system. Serum albumin, total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), triglyceride (TG), glucose, creatinine,calcium, phosphorus, and intact parathyroid hormone (iPTH) were determined with well established methods. Results The ages of 87 patients ranged from 45 to 81 years, and the duration of treatment with hemodialysis was varied from 3 to 204 months . The carotid DC was ( 13.39 ± 5.32 ) × 10-3/kPa in middle-age and elderly patients on hemodialysis. In stepwise multiple regression analysis, systolic blood pressure (β = -0.349, P ＜ 0.001), age (β=-0.323, P ＜ 0.001), diabetes (β =-0.195,P = 0.027), and serum calcium (β =-0.276,P =0.002) were independently correlated with carotid DC. Conclusions Systolic blood pressure, age, diabetic,serum calcium were independent determinants for arterial stiffness of carotid artery in middle-age and elderly patients on hemodialysis.

Objective To explore the characteristics of event-based prospective memory (EBPM) and time-based prospective memory (TBPM) impairments in patients with Parkinson's disease (PD). Methods EBPM and TBPM were examined in 87 PD patients and 85 healthy controls. And both of them were divided into two groups: aged group (≥60 years old) and non-aged group (＜60 years old). Results (1) The scores of EBPM were significantly lower in aged PD patients and non-aged PD patients than in age-matched control groups [(2. 5±0. 4) vs. (5.8± 1.3),(3.9±2.4) vs. (6.3±1.5), both P＜0. 01]. There were no significant differences in the scores of EBPM between aged PD patients or non-aged PD patients and their age-matched control groups [(3.6±0.5) vs. (3.8±0.8), (4.8±0.9) vs. (4.9±0.9), both P＞0.05]. (2)The Hoehn-Yahr grade in PD patients was significantly correlated with scores of EBPM, but not with scores of TBPM.Conclusions The patients with PD have an impairment in EBPM, but not in TBPM. The impairment of EBPM may be related to the disease severity of PD.

Objective　To evaluate the methods of surgical treatment for tumors of brain stem and their curative effects. Methods: 25 cases of tumors of brain stem were analysed retrospectively. Results: There were 18 cases of astrocytomas, 2 cases of cavernous angioma, 1 cases of hemangioblastoma, 1 cases of dermoid cyst, 1 cases of syringopontia, 1 cases of inflammatory granuloma accompanied with hecrosis and 1 cases of AVM of brain stem in 25 cases. Four patients died after operation. Conclusion: Extrinsic tumors of brain stem could be resected totally or subtotally, resulting in good outcome.