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.

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 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.

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 investigate the safety and effectiveness of Solitaire FR stent mechanical thrombectomy combined with 5F Navien catheter aspiration technique for the treatment of acute middle cerebral artery occlusion.Methods From February 2016 to May 2016,the case data of 11 consecutive patients with acute middle cerebral artery occlusion treated with Solitaire FR stent mechanical thrombectomy combined with 5F Navien catheter aspiration technique at the Department of Neurosurgery,Xuanwu Hospital,Capital Medical University were enrolled retrospectively.The age,gender,National Institutes of Health Stroke Scale (NIHSS) score on admission,thrombolysis in cerebral infarction (TICI) grade,operation-related complications,NIHSS score at 24 h after operation,and modified Rankin Scale (mRS) score at day 90 after operation were documented.The relevant data differences before and after treatment were analyzed with the SPSS software.Results Among the 11 patients with acute middle cerebral artery occlusion,7 were men and 4 were women,the age ranged from 44 to 78 years,and the mean age was 66 ± 11 years.The preoperative and postoperative NIHSS scores were 18 ± 3 and 8 ±4 respectively.There was significant difference before and after treatment (t =5.327,P ＜ 0.01).The recanalization of occluded middle cerebral artery achieved successfully.The follow-up at day 90 after operation,the good prognosis of the patients (mRS 0-2) was in 7 cases.No complications associated with severe M1 segment catheter operation occurred.Conclusion The preliminary experience showed,Solitaire FR stent mechanical thrombectomy combined with 5F Navien catheter aspiration technique for the treatment of acute middle cerebral artery occlusion was a safe and effective endovascular mechanical thrombectomy method.

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.

BACKGROUND:Transforaminal endoscopic discectomy needs to dissociate the ligamentum flavum, and if
combined with the continuous dilator and working channel, it can keep the intact ligamentum flavum no matter how smal the incision may be (even 3-5 mm).
OBJECTIVE:To present the technique of interlaminar endoscopic lumbar discectomy with ligamentum flavum splitting.
METHODS:We performed operations on 16 male and 14 female patients by interlaminar endoscopic lumbar
discectomy with ligamentum flavum splitting. The average age of the patients in the study was (48±15) years. The chief complaint before surgery was radiculopathy confined to one leg. The anatomic operative level was L 3-4 in
one case, L 4-5 in 13 cases and L 5-S 1 in 16 cases. The ruptured disc migrated superiorly in four cases and
inferiorly in seven cases, and intraoperative electromyo-graphic monitoring was performed in al surgeries. The
ligamentum flavum was split, and after withdrawing the working channel, the ligamentum flavum could reset itself. RESULTS AND CONCLUSION:The total operation time was 20-40 minutes, and the fol ow-up period was
(149±108) days. There were no abnormal signals on the intraoperative electromyography in any cases, and the reported symptoms were immediately improved in al patients after the operation. Fol ow-up magneticresonance imaging showed a disappearance of the ruptured disc without defect in the ligamentum flavum. There were no operation-associated complications in al the patients. Interlaminar endoscopic lumbar discectomy with
ligamentum flavum splitting is a feasible approach.

Objective To characterize emotional memory impairment in untreated patients with Parkinson' s disease (PD) in the early stages of the disease. Methods Emotional memory tasks using standardized sets of emotional pictures including positive, neutral and negative valence were tested in 33 untreated patients with PD in the early stages and 31 healthy controls matched with age, sex, and education.Results Compared with the healthy adults (13.4 ± 1.4), PD patients had significant loss of negative valence picture memorizing ( 8. 9 ± 1.0; t = - 14. 87, P ＜ 0. 01 ).There was no significant difference between PD patients and normal controls in positive ( 11.8 ± 1.0 vs 12. 4 ± 2. 2 , t = - 0. 95 ) and neutral (7.9 ± 1.4 vs 8.2 ± 1.3, t = - 0. 89) valence picture memorizing ( both P ＞ 0. 05 ). ConclusionThe emotional memory for negative valence pictures is impaired but the emotional memory for positive and neutral is relatively spared in early PD patients without treatment.

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.

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.