Objective To investigate the perioperative management of hip fracture in the elderly aged 80 years and over Methods An retrospective data of the elderly aged 80 years and over who received surgical treatment between Jan 1996 and Jun 2003 were reviewed The surgical procedure was determined according to the fracture type, osteoporosis and patients' health status Data of comorbidities, in hospital complications and other important data were collected Follow up lasting more than 6 months was made to evaluate the recovery Results Eighty two cases were femoral neck fracture while 88 cases were intertrochanteric fracture Their ages ranged from 80 to 96 years with an average of 84 9 years One hundred and twenty eight cases (75 3%) had preoperative comorbidities in which the circulation system was most often involved Thirty six cases (21 2%) had postoperative complications , among which the central nervous system and circulation system were most often involved The average in hospital time was 18 6 days , and 2 cases died of cerebral embolism and respiratory dysfunction in perioperative period respectively Totally 81 5% of them showed a good functional recovery in the follow up Conclusions The right operative intervention to the very aged hip fracture patients is feasible and effective Monitering the perioperative medical conditions and careful nursing should be emphasized

Objective To summarize the techniques and results of midfoot amputation and discuss the role of the tendon balance in this operation.Methods Twenty-six traumatic midfoot amputions were performed from 1990 to 1999. The amputation level ranged from the base of metatarsal to the Lisfranc's joint. The bone stump should be smooth, round and arc featured, the amputation line needn't pass the joints, four extensor longus tendons were divided into two groups and the groups were weaved each other. Bone stump were drilled a hole through which extensor tendon stumps were re-attached to the bone stump. Anterior tibial tendon could also be re-attached to the front aspect of the bone stump with the above mentioned procedure. In case the navicular could not be preserved, midfoot amputation should be given up. Results Among the group, 15 cases were followed-up 2 to 10 years after operation. No case had equinovarus deformity, all cases could flex ankle dorsally to 0? or more, but 4 cases had painful callus on the stump, and 1 case slight ulceration. The other cases in the group got satisfactory outcomes. Conclusion In terms of midfoot amputation, different amputation level leads to different tendon imbalance. Proper tendon balance and appropriate stump repairing is of importance to reconstruct balanced plantar biomechanics,and then, to achieve good long term result.

Objective To study the effect of animation in the course of medical statistics.Methods By convenience cluster sampling,271 undergraduates in two classes were recruited from the specialty of medical image,medical anesthesia and medical laboratory.The experimental group (n =139) and control group (n =132) were set up randomly.The animation design is only used in the teaching process among the experimental group,while traditional teaching method without animation was used in the control group.All participants were surveyed by questionnaire for the effectiveness after one week of the curriculum closure.SPSS 15.0 software was used to do data entry and statistical analysis and two-sample t-test was used to compare the differences in text scores between two groups.Evaluation was made on the courseware of animation in experimental group.P ＜ 0.05 signifies that the differences have statistical significances.Results The test scores in experimental group (79.62 ± 9.34)were significantly higher than those in control group (77.10 ± 9.18; P ＜ 0.05).More than 85 ％ of the experimental students think animation can stimulate their enthusiasm in studying medical statistics; and help them better understand the key points and main difficulties of the statistical knowledge.Conclusion It suggests that animation can enable students to study better the course of medical statistics.

Objective To explore the protective role of the receptor tyrosine kinase inhibitor in chondrocyte in vitro.MethodsReverse transcription-polymerase chain reaction (RT-PCR), immunocytochemistry (ICC) and toluidine blue staining were used to understand the changes of phenotype expression of collagenⅠ, Ⅱ and proteoglycan in chondrocyte in vitro. Results Genistein of 20 μg/mL and 25 μg/mL concentrations decreased the expression of collagen Ⅰ and increased the expression of collagen Ⅱ and proteoglycan (P< 0. 05). Conclusions This study showes that genistein can effectively inhibit the expression of collagen Ⅰ above certain concentration, and it can improve the expression of collagen Ⅱ and increase the synthesis of proteoglycan.

Objective To study the efficacy of treatment of proximal humeral fractures in elderly patients using cloverleaf plate combined with bone cement. Methods 13 aged patients with serious proximal humeral fractures were admitted from 2000.1 to 2001.6. Their X ray revealed displacement and crispation. After anterior reduction through the shoulder joint, the obvious osseous defects were filled with bone cement. Then the fractures were fixed with cloverleaf plates. Sling was applied for the patients postoperatively and the rehabilitation program started 3 weeks after operation. Results All the 13 cases were followed up. The follow up ranged from 5 to 10 months with an average of 8.3 months. The range of motion was satisfactory with a mean abduction over 90 degrees. X ray revealedthat no patient demonstrated osteonecrosis of the humeral head. Union was achieved in all the patients. According to Neers scale, the function of shouder was excellent in 10 cases, and good in 3 cases. Conclusion This methods is recommended for aged patients with osteoporosis, serious osseous defects and difficulty of using internal fixation alone, because it is convenient and reliable and can prevent replacement of joint prosthesis.