[Objective]To evaluate the clinical result of surgical treatment of coronal shear fracture of the capitellum humeri of adults.[Method]From January 2001 to July 2005,6 cases of 2 males and 4 females with coronal fractures capitulum humeri were chosen open reduction and internal fixation utilizing screws.The fractures were terated under direct vision and were fixed with screws.The left arms in 4,right in 2,the age of the group were from 27 to 48 years old,with the average of 38 years.The operative time was from 3 days to 9 days after injury.All cases were fresh and close fractures.[Result]All operations were successful,no nerves and blood vessels injury was found,the incisions were all healed by first intention.The X-ray films showed that the fractures were anatomic reduction.The healing time was 7 weeks in average with 6 to 9 weeks range.All cases were followed up from 12 to 52 months with an average of 32 months,no postoperative complications such as myositis ossificans or avascular necrosis of capitulum humeri was found.According to BrobergMorrey Scale,there were 5 caese of excellent,1case of good.[Conclusion]The coronal shear fracture of the capitellum humeri of adults are suitable for opening reduced direct vision and fixing with screws,prompt treatment with anatomic reduction and internal fixation and early rehabilitation could lead to excellent or good outcomes.

Objective To evaluate the relationship between lasar in situ keratomileusis(LASIK) and macular hemorrhage after the operation.Methods 1840 patients(3430 eyes) treated by LASIK in our hospital were reviewed for macular hemorrhage in the past four years(July,2001 to 2005).Results The rate of macular hemorrhage was 0.26%(9/3430) after LASIK.The shortest period of time from the LASIK to the occurrence of macular hemorrhage was 20 days and the longest was 8 months 2 patients(2 eyes) with the history of macular hemorrhage suffered hemorrhage again after the LASIK,among the 65 cases with Fuchs spot in macula,there were 4 cases(6.15%) with macular hemorrhage.Conclusions We think there is no direct cause-effect relation between LASIK and macular hemorrhage.LASIK will not increase the rate of macular hemorrhage,but these cases with the history of macular hemorrhage,pathological changes with Fuchs,or fluorescence leaks in checking of FFA cannot receive LASIK.

BACKGROUND: An epidemic outbreak of poliomyelitis occurred in Pizhou City, Jangsu Province, 15 years ago. It is important to appraise the daily living and function of those survived children.OBJECTIVE: To investigate the physical status of the survived children and propose appropriate suggestions on rehabilitation.DESIGN: Case-based cross-sectional study based on patients.SETTING: Department of Rehabilitative Medicine of First Hospital Affiliated to Nanjing Medical University.PARTICIPANTS: Totally 545 patients with poliomyelitis sequela, which was onset in 1989, were found in Qizhou, and 333 of them were randomly selected from the local"New Hope" nursing house and its surrounding areas.All patients were assayed in one week.METHODS: The survey included 333 polio victims in the nursing house or from the surrounding areas. The study was conducted by five research groups, with two physiatrists and one therapist in each group. Assessment included muscle strength, joint rang of motion, limb deformities, activities of daily living, previous surgical interventions and orthosis. The distance was measured from the anterior superior iliac to medial malleolus and from nave to the medial malleolus, respectively. Anatomic length and functional length were also measured.MAIN OUTCOME MEASURES: Major outcomes included the forms,shapes, or functions of foot, pelvic, hip, knee and ankle joints.RESULTS: According to intention-to-treat analyses, 333 patients with poliomyelitis sequela entered the final analysis. Most of them aged from 15 to 17 years old, which accounted for 97%. Totally 135 patients(40.5% )walked independently and 148 (44.4%) walked with-orthsis and/or crutches. The discrepancy was between 0. 5 cm to 13.0 cm. Patients with paraplegia were 112(33.6% ), which was lesser than those with monoplegia (211, 65.8% ). There were 3 cases with quadriplegia and 2 cases with upper limb involvement. Another 46 sufferers had already underwent the scoliosis prthomorphia. There were 254 subjects with orthosis, including 110 knee ankle feet orthosis for both legs and 131 knee ankle feet orthosis for one leg,with 62 at left and 79 at right. Only three ankle-foot orthosis were employed.CONCLUSION: Besides the factor of muscle strength, limb teratism is the key factor that causes walking disorders. Physical functions maybe improved through surgical intervention, orthosis modification, and rehabilitation training. Every child who received survey required further rehabilitative therapy. A multi-disciplinary team is essential to achieve a better outcome.

Malignant biliary tract obstruction is a common disease.Nowadays,endoscopic biliary drainage (EBD) and percutaneous transhepatic biliary drainage (PTBD) have been used to treat such disease.EBD is a first-line intervention for lower segment of biliary duct obstruction caused by pancreatic cancer or other tumors.PTBD is a first-line treatment for gallbladder cancer or other tumors which lead to the hilar and intrahepatic bile duct obstruction and abnormal digestive anatomy.In a word,the proper selection of the drainage should be based on the patients' condition with minimal trauma and maximum therapeutic effect.

Neuroendocrine tumor liver metastases (NETLM) is a uncommon advanced tumor disease.Patients with unresectable NETLM have a poor outcome.The management of unresectable NETLM is a clinical dilemma.However,Yttrium-90 radioembolization is a safe and effective treatment for NETLM patients.The median disease control rate is 87.1％ (64.7％ ～ 100％);the median overall survival time is 34.4 months;and the median overall survival rate of 1,2,and 3 years are 79.8％ (63％～100％),62％ (57％ ～62.5％),45.5％ (45％ ～ 46％),respectively.Although there is good result of Yttrium-90 radioembolization in treatment of unresectable NETLM,the safety and effectiveness should be further verified.

Objective To explore the effect of bio-resonance on walking efficiency in healthy youths. Methods Ten young male participants were involved in this study (age 16 ± 2 years, height 1.73 ±:0. 1 m and weight 56. 1 ± 7 kg). The time-space data were collected using a motion analysis system, and oxygen cost was meas-ured with a Cosmed K4b2 portable gas analysis system. Walking at a self-selected, comfortable walking frequency was recorded through three dimensional gait analysis. Each participant walked at 100% , 80% and 120% of their comfortable walking frequency. Results The average 100% , 80% and 120% comfortable walking frequencies were 107.60 ± 1.78, 85.80 ± 7.45 and 128.60 ±10.46 steps/min, respectively. Oxygen consumption at the three frequencies was significantly different (P≤0.01), and the oxygen costs were 0. 140 ± 0.011, 0. 193 ± 0. 049 and 0. 192 ± 0. 035 ml/m/kg, respectively. Above or below the self-selected pace, oxygen cost increased significantly (P ≤0.05). Conclusion There is an inherited bio-resonance in human walking, and walking with this natural rhythm is reflected in the lowest oxygen cost. Any change from the natural walking rhythm may result in increased en-ergy expenditure and decreased efficiency.

Objective To explore the effect of applying phase changing theory mode on reducing depression occurrence of pregnant women after delivery. Methods 89 cases of pregnant women suffered from pre-delivery depression were separately divided into the intervention group (45 cases) and the control group (44 cases) at random.The intervention group accepted the intervention measure of the phase changing theory mode but the control group accepted the routine instruction of the nursing.The EPDS and self-designed ordinary situation questionnaire were used to investigate the two groups.The depression pre and post-delivery and general situation post-delivery were separately compared between the two groups. Results The depression degree of the pregnant women of the intervention group was evidently reduced compared with before intervention and the contemporaneous results of the control group.Postpartum recovery,ability of attending babies and developmental condition of the babies were better in the intervention group than those of the control group. Conclusions The application of the phase changing mode in nursing of parturients can reduce the occurrence of postpartum depression,so as to help them set up a healthy living manner,supply appropriate feeding and attendance for babies and improve the living quality of them.

ObjectiveTo compare the effect of the neurosurgical clipping and endovascular for treating intracranial aneurysm.MethodsRetrospectively analyzed the clinical data of 110 cases with intracranial aneurysms.The patients were divided into intervention group(55 patients with endovascular treatment) and surgery group(55 patients with neurosurgical clipping treatment) according to different methods,followed forup 1 ～4 months,and immediately evaluated the efficacy.The Chinese stroke scale(CSS) and activities of daily living(ADL) score were used for prognostic evaluation.ResultsThe immediate effect:the marked efficacy in 40 cases,efficacy in 10 cases and inefficacy in 5 cases,and the total effective rate in the intervention group was 90.9％,while the surgery group were 32 cases,10 cases,13 cases,and the total effective rate was 76.4％.There was significantl differences between the two groups ( x2 =3.96,P ＜ 0.05 ) ; the CSS and ADL scores significantly lower than pre-treatment ( t =9.12,8.05,P ＜0.05).ConclusionEndovascular treatment for intracranial aneurysms could improve the clinical efficacy and improve patients self-care ability,and significantly improve the prognosis.

Objective To characterize 15 months later the quality of life (QOL) and depression of those with spinal cord injury (SCI) suffered during the Wenchuan earthquake,and to identify the influence factors.MethodsA sample of 27 individuals who sustained SCI during the Wenchuan earthquake were surveyed using face- to-face interviews.QOL was measured using the brief version of the World Health Organization's Quality of Life Assessment instrument.Depression was measured using the patient health questionnaire depression module 9.Stepwise multiple linear regression was employed to determine the factors most closely related with QOL and depression. ResultsStepwise linear regression showed a significant correlation of overall QOL with literacy and age.The younger or illiterate victims showed a lower overall QOL.General health was also associated with ability in the activities of daily living and with pain.Victims with better daily ability and less pain may have had better general health.Depression correlated with literacy and secondary condition.Illiterate patients or patients influenced more by a secondary condition displayed more serious depression than the others.Additionally,social participation was significantly associated with the physical health,psychological health and social relationships domains of QOL.ConclusionThe QOL of long-term SCI victims caused by the earthquake is closely related to age,literacy,pain,participation and physical independence.Depression is associated with illiteracy and secondary conditions.Attention should be paid to these correlations in designing long-term rehabilitation strategies.