BACKGROUND:With more and more research available,there are different classification systems for intertrochanteric fracture,from Evans and Boyd-Griffin classification to Evans-Jensen and AO/OTA classification,all providing guidance for choosing an appropriate treatment scheme.OBJECTIVE:To review the advance in the treatment of senile unstable intertrochanteric fractures.METHODS:PubMed,Web of Science,WanFang and CNKI databases were searched with the keywords of intertrochanteric fracture,intramedullary nail,hip arthroplasty in English and Chinese,respectively.1 535 literatures were retrieved firstly,and finally 47 articles were included in accordance with the inclusion and exclusion criteria.RESULTS AND CONCLUSION:The therapy conception of intertrochanteric fractures has been changed from conservative traction to early surgical treatment.With the development of technology,the internal fixators have been improved continuously.Screw-plate system has been developed from Jewett plate,AO/ASIF plate to dynamic hip screw.Intramedullary nails such as Gamma,proximal femoral and proximal femoral antirotation nails have been successfully applied in clinic.Senile patients with unstable intertrochanteric fractures also obtain favorable prognosis through active internal fixation,but the high incidence of complications appears because of osteoporosis,osteogenesis deficiency and accompanied by degenerative hip diseases.Thereafter,hip arthroplasty is recommended to treat senile unstable intertrochanteric fractures so as to achieve rapid functional recovery,desired efficacy and low incidence of complications.However,it still remains controversial to choose internal fixation or hip arthroplasty.

Objective To explore the accuracy and feasibility of infrared computer navigation for femur,tibia tunnel positioning in arthroscopic anterior cruciate ligament (ACL) reconstruction.Methods Data of patients who had undergone ACL reconstruction using infrared computer navigation from January 2012 to June 2013 were retrospectively analyzed.There were 26 males and 9 females,with an average age of 26.8 years old.35 patients were with concomitant meniscal injury 21 cases,and 3 cases with medial collateral ligament injury.All patients were treated with gracilis and semitendinosus knit stitch as grafts,and bone ends were made with hydroxyapatite extrusion screws,door-shaped nails and porous plate.Results The mean follow-up time was 16 months.The rate of postoperative femoral tunnel site measurements was 63.8％±6.6％,and tibial tunnel site measurements was 45.7％±4.2％.1 patient appeared heterotopic ossification in tibia tracker pinhole 3 months after surgery,and the joint activities was normal.Lachman test:there were 1 case with Ⅱ degree,30 with Ⅲ degree,and 4 with Ⅳ degree before operation,and 33 with Ⅰ degree,1 with Ⅱ degree,1 with Ⅲ degree after operation.The KT-1000 test was from 6.47±0.75 mm preoperatively to 1.01±1.14 mm postoperatively.Preoperative knee laxity differences was more than 5 mm in 32 cases,3-5 mm in 3,and after operation they were 0-3 mm in 31,3-5 mm in 2,and less that 0 mm in 2 cases.Lysholm score and Tegner scores were from preoperative 52.74± 10.91 points and 4.64± 1.34 points to postoperative 93.97±4.13 and 6.56±0.81 points.ROM was from 85.6°± 11.2° to 118.3°±5.7°;33 cases were without flexion and extension limited; two cases had knee flexion,extension limitation less than 10°.After straight leg raising training and proprioception functional training for 6 months,the knee ROM returned to normal.Conclusion Infrared computer assisted navigation system for arthroscopic ACL reconstruction is to navigate through the use of anatomical landmarks and kinematic data,kinematic data by detecting and recording the knee,selected a secure tunnel site,viable surgical method,you can make femur,tibia tunnel position more accurately,good curative effect evaluation.

Data of 55 patients with duodenal mass lesions treated by endoscopic submucosal dissection (ESD) were retrospectively analyzed. Risk factors of delayed bleeding after ESD were explored by univariate analysis and multivariate unconditional logistic regression analysis. Duodenal delayed bleeding occurred in 5 patients (9.09%). No closure treatment under endoscopy( P=0.035) was significantly different between the delayed bleeding group and the non-delayed bleeding group. Multivariate non-conditional logistic regression showed no closure treatment under endoscopy was an independent risk factor for delayed bleeding after ESD in duodenal mass lesions ( P=0.029, OR=0.079, 95% CI: 0.008-0.776). Patients older than 60 years and who did not take endoscopic closure treatment have higher incidences of delayed bleeding after ESD. No closure treatment under endoscopy is directly related to postoperative delayed bleeding.

AIM:To compare the difference between diopter of refration measured after cycloplegic mydriasis with retinoscopy and hand-held autorefractor so as to explore the feasibility of using hand - held autorefractor for refraction screening in cadet candidates.
METHODS:Respectively using hand-held autorefractor and streak retinoscope to do optometry examination in 317 cadet candidates students ( 634 eyes ) after mydriasis. Main index of refraction values ( spherical, cylindrical mirror degree and axial) were analyzed by difference test and correlation analysis. And the elimination rate was comparatively analyzed.
RESULTS: Diopters of sphere and cyclic refraction measured by hand-held autorefration were significantly higher than those by retinoscopy ( P< 0. 05 ), but the correction analysis showed that there was high correlation (r=0. 733, 0. 694), axial of refration measured by these two methods were non - significant ( P > 0. 05 ). The disqualifying rate using autorefraction was much higher than that using retinoscopy. It was easy to be wrongly eliminated.
CONCLUSION:Because of the high correlation between diopters of autorefraction measured by retinascopy and autorefractor, autorefraction has application value in refraction screening in cadet candidates with normal vision.

Objective To comparison of clinical efficacy between mini-invasive transforminal lumbar interbody fusion(mis-TLIF) assisted by Quadrant system and open posterior lumbar interbody fusion (PLIF)treatment for lumber spondylolisthesis,to find a better treatment for lumbar spondylolisthesis.Methods A total of 65 cases who were under lumber spondylolisthesis were retrospectively selected from our hospital,26 cases in mini-invasive transforminal lumbar interbody fusion assisted by Quadrant system (mis-TLIF group).39 cases in open posterior lumbar interbody fusion(PLIF group).Record the incision length,intraoperative blood loss,opertive time,bed time,hospital time,pre-and post-operative visual analogue scale(VAS) and Oswestry disability index(ODI) score were recorded respectively.After surgery,the imaging(X-Ray) evalute the vertebral fusion status.Results There were no significant difference between mis-TLIF group and PLIF group in BMI [(22.77 ± 4.38) kg/m2 and (21.28 ± 5.24) kg/m2],preoperative VAS score [(6.46 ± 1.67) and (6.59 ± 1.56)],preoperative ODI score [(58.70 ± 7.19) ％ and (60.10 ± 9.56) ％] (all P ＞ 0.05).There were significant difference between two groups in incision length [(6.10 ± 0.95) cm and (11.12 ± 2.02) cm],intraoperative blood loss [(247.31 ± 36.72) ml and (340.51 ± 64.32) ml],opertive time[(179.96 ± 17.54) min and(151.85 ± 16.06) min],bed time[(3.62 ± 1.44) d and (4.98 ± 1.74) d],hospital time [(9.38 ± 2.60) d and (11.95 ± 3.61) d] (all P ＜ 0.05).Postoperatively VAS score was assesssd at 1 month [(3.15 ± 1.08]),3months [(1.58 ± 0.81)],6months [(1.08 ± 0.74)] and ODI score was(30.77 ± 6.45) ％,(25.54 ± 6.33) ％,(20.23 ± 7.05) ％,respectively in mis-TLIF group were lower than those of PLIF group (P ＜ 0.05).There were no significant difference between two groups in the fusion rate in 3 months,6 months after operation.Conclusion Mis-TLIF had a lot of advantages relative to PLIF in the treatment of lumber spondylolisthesis,be like less trauma,less bleeding,less hospital time,quick rehabilitation and good curative effect,provide a new minimally invasive method for lumber spondylolisthesis patient.

Retinitis pigmentosa (RP) is a large group of common hereditary eye diseases with highlyheterogeneous genetic background. Over forty genes with diverse functionalities are associated with RP and they include a set of ubiquitously expressed genes. These include five genes involved in the precursor messenger RNA( premRNA) splicing. Recent progress in disease gene identification for RP has established the involvement of pre-mRNA splicing as one important mechanism in the disease etiology and has shed light on the splicing process itself, a fundamental biological process. To this date, studies in this field have been focused on two major issues. First, how do the mutations of the adRP associated splicing factors (adRP-SF) affect the splicing function? Second, how do the mutations in these ubiquitously expressed genes lead to specific retinopathy? The two topics fit with the two continuous important steps of the disease pathogenesis. Recently, researchers have made a dramatic progress in the first topic. The identification of the SNRNP200 gene,the fifth adRP-SF and its relevant functional study has shown significance to the progress in the study of RP. Numerous investigations are also being carried out in addressing the second issue.Generation of a variety of models led to a better description of the pathological process of the disease. However, in respect to the key pathogenic mechanism,researchers are still puzzled with a number of confusing questions. In this commentary,the results from the latest investigations were summarized, and in particular,the difficulties in studying the molecular mechanism by which the pre-mRNA splicing deficiency causes RP were detailed.

Transformers are required to demonstrate the ability to withstand short circuit currents. Over currents caused by short circuit can give rise to windings deformation. In this paper, a novel method is proposed to monitor the state of transformer windings, which is achieved through on-line detecting the leakage inductance of the windings. Specifically, the mathematical model is established for on-line identifying the leakage inductance of the windings by applying least square algorithm (LSA) to the equivalent circuit equations. The effect of measurement and model inaccuracy on the identification error is analyzed, and the corrected model is also given to decrease these adverse effect on the results. Finally, dynamic test is carried out to verify our method. The test results clearly show that our method is very accurate even under the fluctuation of load or power factor. Therefore, our method can be effectively used to on-line detect the windings deformation.

Objective To explore the echocardiography characteristics of non-compaction of ventricular myocardium(NVM),and assess its value in the diagnosis of NVM.Methods Philips SONOS 5500 color Doppler ultrasound system with 2-4 MHz transducers was used in 9 patients with NVM.Results In all 9 patients,the presence of multiple trabeculations and multiple deep intertrabecular Space communicating with the ventricular cavity was demonstrated by color Doppler imaging.Both ventricles were involved in 1 patient,only the left ventricle in 7 patients,and right ventricle in 1 patient.Conclusions NVM has typical ultrasonic appearance on echocardiography.It Can find out the NVM manifestations even if patients do not have any symptoms.It is a reliable and convenient way for diagnosing NVM.

BACKGROUND:The region around the hip is a bone tumor predilection site. It is difficult to conduct tumor resection due to the involvement of weight loading area. Tumor resection requires high surgical technique. The pelvis and hip are often needed to be rebuilt.
OBJECTIVE:To compare the effects of three reconstruction methods after tumor resection around the hip.
METHODS:From January 2007 to December 2012, 20 patients with bone tumors around the hip were treated by surgery in the Zhongshan Hospital, Wuhan University, including 7 benign tumors, 13 borderline and malignant tumors. Eight patients received al ograft. Eight patients received arthroplasty. Four patients received saddle prosthesis.
RESULTS AND CONCLUSION:A total of 20 patients were fol owed up for 5 to 60 months (averagely 40 months). According to Enneking evaluation criterion, the operative outcome was evaluated as excellent in 8 cases, good in 5 cases, average in 4 cases, and poor in 3 cases. Excellent and good rate was 65%. Results suggested that after excision of bone tumors, al ograft, arthroplasty or saddle prosthesis can significantly elevate patient’s survival rate, improve patient’s living quality and is an effective therapy for treating tumors around the hip.

Objective To analyze the curative effects of total knee arthroplasty(TKA)for severe genu varus combined with flexion deformity.Methods The clinical data of 25 patients(36 knees),who had undergone TKA for severe genu varus combined with flexion deformity from January 2005 to October 2010,were retrospectively analyzed.There were 7 males and 18 females,aged from 55 to 80 years(average 70.5 years).The primary diseases were osteoarthritis in 22 cases and rheumatoid arthritis in 3 cases.HSS knee score was used before and after the operation to assess the efficacy of the TKA.Results All of the patients were followed up for 4 to 9 years(average 6 years).The degree of flexion deformity was reduced from (21 ±63)°to(1.1 ±2.3)°;the degree of the varus decreased from(210 ±4.8)°to(175.6 ±2.1)°;range of motion of the knee joint increased from(70.5 ±20.5)°to(115.1 ±5.3)°;knee score augmen-ted from(33.2 ±10.5)to(90.7 ±8.5);function score added from(35.5 ±14.2)to(85.6 ±10.5);there were 21 cases(8 knees)rated as excellent,2(3 knees)as good and 2(3 knees)as fair,and the excel-lent and good rate was 86%.Most of the patients had normal force line of the knee joint,but 2 patients re-mained varus deformity of 5°~10°.Conclusion Satisfying outcome can be achieved by TKA in treating severe genu varus combined with flexion deformity of the knee.