BACKGROUND:Less Invasive Stabilization System (LISS) has been shown to hold the same biomechanical strength to proximal femoral nail anti-rotation.OBEJCTIVE:To investigate the safety and effectiveness of the reversed LISS plates for senile femoral intertrochanteric fractures.METHODS:Thirty elderly patients with femoral intertrochanteric fractures were treated with reversed LISS plates.The operation time,incision length and total blood loss (intraoperative plus volume of drainage 1 day postoperative) were recorded.Physiologic and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM) and modified POSSUM scoring systems were used to predict the incidence of complications and mortality,and then the real incidence of complication and mortality was compared to evaluate the safety of reversed LISS plates.The clinical effectiveness was evaluated by fracture healing time and Harris scores at the last follow-up.RESULTS AND CONCLUSION:(1) The incidence of complications showed significant difference between predicted (46.05％) and real (13.3％) results (P=0.05),but the mortality did not differ significantly between predicted (3.93％) and real (0％) results (P=1).(2) The fracture healing time was 21-32 weeks,and the excellent and good rate in Harris scores at the last follow-up was 83.3％.(3) These results indicate that the reversed LISS plates are easy to operate,safe and obtain good efficacy in the treatment of senile femoral intertrochanteric fractures.

Objective To observe the effects of erythropoietin-α administered before the total knee arthroplasty (TKA) on the blood transfusion in patients with mild anemia. Methods 60 patients with mild anemia, who were arranged to receive TKA , from 2010-2012 , were assigned to received either 40 000U of erythropoietin-αfor 3 times (once a week) 3 weeks before the surgery (intervention group, n=30) or not (control group, n=30). Then the hemoglobin levels , transfusion ratio , inpatient length of stay and duration of surgery between the 2 groups were analyzed. Results The hemoglobin level was increased from 11.5 g/dL to 14.3 g/dL in intervention group before the surgery (P<0.01). The blood transfusion rate was decreased from 96.6%to 56.6% (P=0.013) during the surgery. And the length of hospital stay was similar between the 2 groups. Conclusion Erythropoietin-αadministered 3 weeks before the TKA surgery could reduce the blood transfusion rate of patients with mild anemia.

Objective To investigate the risk factors of hypersensitivity induced by compound sulfamethoxazole (Co-SMZ)in patients with human immunodeficiency virus (HIV)infection.Methods A retrospective study was performed in 111 patients with HIV infection receiving prophylactic Co-SMZ at the Department of Infectious Diseases,the Third People′s Hospital of Nantong City,Jiangsu Province from January 2014 to December 2014.Data including age,gender,interval time from diagnosis of HIV infection to hospitalization,history of drug allergy,and the counts of CD3 + T cell,CD4 + T cell,CD8 + T cell and natural killer (NK)cell on the day when the medicine was administrated for the first time were recorded. All the patients were followed up for two months.Student t test was used in data with normal distribution or approximate normal distribution.Rank sum test was used in data with skew distribution.The count materials were examined byχ2 test.Results Among the 111 patients with HIV infection,there were 107 males and 4 females with average age of (45 .7±11 .1)years old.The interval time from taking Co-SMZ to hypersensitivity was (14.0±7.6)d.There were differences in the counts of CD4 + T cell and NK cell between patients with hypersensitivity and without hypersensitivity (both P <0.05).Multivariate analysis showed that NK cell was a risk factor for inducing hypersensitivity (OR=1 .010,95 %CI :1 .005 -1 .017, P =0.001).The area under of receiver operating characteristic curve predicting hypersensitivity induced by Co-SMZ was 0.748 (95 %CI :0.647-0.850,Z =4.701 ,P =0.001).The best predictor was 109.80/μL with sensitivity of 63.2% and specificity of 84.7%.Conclusion In patients with HIV infection,NK cell might be associated with hypersensitivity induced by Co-SMZ.

Objective To analyze MRI features of real tears and pseudotears of posterior horn of the lateral meniscus (PHLM) at the insertion site of meniscofemoral ligament(MFL), and to discuss main points of differential diagnosis. Methods MR images of 32 patients with PHLM tears and 30 patients with anterior cruciate ligament tears but without PHLM tears confirmed by arthroscopy were analyzed retrospectively. Another 20 asymptomatic volunteers as controls underwent MR examination and analyzed. The number of consecutive slices displaying longitudinal increased signal in sagittal images and the length in axial images were evaluated. The one?way analysis of variance, χ2 test and ROC curve were used to analyze diagnostic value of different MRI findings. Results Longitudinal line with abnormal increased signal (pseudotear) was found in 82.0% (41/50) normal insertion site of MFLs. The typical MRI finding of real tears was peripheral longitudinal linear high signal in PHLM which reached the margin of articular surface. In sagittal images, longitudinal linear high signal was shown in (5.8 ± 1.2) slices in knees of real tears, which was more than (2.6±1.1) slices and (2.7±1.4) slices in pseudo?tear groups (F=60.9, P<0.01). The area under ROC curve was 0.96 for differentiating real tear from pseudo-tear using the number of consecutive slices displaying longitudinal increased signal in sagittal images. With a threshold of five or more consecutive images with abnormal longitudinal increased signal as the positive standard of continuous?line sign, the overall sensitivity, specificity and accuracy for diagnosing real tear were 90.6%(29/32), 90.2%(37/41) and 90.4%(66/73), respectively. The axial images showed that the length of increased signal line in the outer of PHLM was (16.4±4.9) mm in patients with real tears, which was longer than pseudo?tear groups with length of (8.1 ± 3.2) mm and (6.0 ± 3.1) mm (F=17.0, P<0.01). The area under ROC curve was 0.92 for differentiating real tear from pseudo?tear using the length in axial images. The zip sign was defined when its length was not less than 10 mm. The sensitivity, specificity and accuracy of the zip sign was 84.4%(27/32), 90.2%(37/41) and 87.7%(64/73) respectively. In coronal images, high signal of MFL attachment insertion was shown in 71.9%(23/32), 60.0%(15/25) and 10/16 cases, there was no significant difference (χ2=0.98, P=0.61). Conclusion The continuous?line sign and zip sign are characteristic findings of PHLM tears at the insertion site of MFL attachment, which are valuable for differential diagnosis with pseudotears at the insertion site of MFL.

Objective To evaluate the effect of comprehensive schistosomiasis control in Changzhou City in recent 10 years, so as to provide the evidences for formulating the future prevention and control strategy. Methods The work reports and the da?ta of the schistosomiasis comprehensive control projects in Changzhou City from 2004 to 2014 were collected,the infection sta?tus of residents and livestock as well the Oncomelania hupensis snail situation were analyzed,and the implementation effect of the comprehensive control projects was evaluated. Results From 2004 to 2014,totally 215 368 person?times were examined, and the positive rate of the blood examinations of the population was 0.24%(478/198 356),and there were no positive cases de?tected out by using the miracidium hatching method. Totally 11 935 domestic animals were detected and no positives were found. From 2004 to 2014,the total area with snails was 92.27 hm2,and marshland,inland and mountain environments accounted for 34.75%,34.82%and 30.43%,respectively. The newly discovered area with snails was 34.40 hm2,and marshland,inland and mountain environments accounted for 2.62%,71.22% and 26.16%,respectively. Totally 8 511 snails were dissected and no schistosome infected snails were found. From 2004 to 2014,a total of 242 600 harmless toilets were built,2 704 700 domestic animals were reared in pens,5.82 km?long rivers were dredged,2 250.11 hm2 of protective forests were constructed,a total area of 625.79 hm2 were controlled with molluscicides,and an area of 149.58 hm2 were environmentally transformed. Totally 5.4 mil?lion people received health education. The awareness rate of knowledge on schistosomiasis control of residents was 96.00% in 2014. Conclusions There exists the risks of snails import and diffusion and schistosomiasis resurrection in Changzhou City, but under the condition of continuous implementation of comprehensive control measures,the endemic situation of schistosomia?sis is stable and the control achievement is consolidated in this city.

ObjectiveTo investigate the affection of Shujinxi external granule on the knee joints function after meniscus suture.Methods60 patients who undertook meniscus suture were randomly recruited into two groups,30 cases in each group.The control group accepted conventional rehabilitation training,while the treatment group received Shujinxi external granule on the basis of the conventional rehabilitation training.Both groups were treated for two weeks for a therapeutic course,and statistics analysis was made after 3～4therapeutic courses.ResultsThe average postoperative knee activity after 8 weeks and 12 weeks was [ (114.1 ±18.6)° and [(129.6±10.3)° ],in thetreatment group,comparing to [(89.7±t2.5 )° and (112.7±16.6)° ]in the control group,the difference was statistically significant (P＜0.05).the IKDC score and the Lysholm score of treatment group after 12 weeks was [(84.76±5.21) and (92.54±3.22)],while the control group was [(79.63±4.67) and (85.61±4.92)],the difference was significant (P＜0.05).ConclusionShujinxi external granule can promote the recovery of knee joints function after the operation of meniscus suture.

Objective To understand the current state of staff for Plasmodium microscopy examinations in Changzhou City in the early stage of eliminating malaria action,so as to provide the evidence for achieving the target of malaria elimination. Methods The staff for Plasmodium microscopy examinations from medical institutions and centers for disease control and prevention at differ-ent levels were investigated by questionnaires and tests of the malaria related theory and microscopic operation. Results Totally 95 people were investigated,and among them,40.0%had college degree and 45.3%were university educated. There were 18.9%of them working on Plasmodium microscopy examinations for less than 1 year,40.0%for 2-5 years,18.9%for 6-10 years and 22.1%for more than 10 years. The numbers of person-time of provincial and municipal level training,district-level training,and unit-level training in the last year were 0.57,0.59,and 0.14,respectively. Totally 18.9%of them had the experience of finding Plasmodium at work,and 97.9% of them considered it was necessary or very necessary to do Plasmodium microscopy examina-tions. However,57.9%and 8.4%of them considered Plasmodium microscopy examinations increased their work load and work dif-ficulty,respectively. The average correct rates of knowledge tests on malaria before and after training were 72.5%and 91.6%re-spectively(P<0.05). The average mark of Plasmodium microscopic tests was 25.3 points(full mark being 50 points),and the passing rate(≥30 points)was 58.9%. Conclusion The working experience of staff for Plasmodium microscopy examinations in Changzhou City is relatively poor,and the related training should be enhanced.

Objective To understand the quality of blood smears for Plasmodium detection in Changzhou City,so as to pro?vide the technical support for malaria surveillance in the post?elimination period. Methods The blood smears of fever patients from each cities(districts)in Changzhou City in 2014,including more than 3%of the negatives and all the positives,were se?lected. The quality of the blood smear making,dyeing,cleanliness and results were reviewed by the experts from the municipal malaria microscopy station,and the data were analyzed statistically. Results Totally 996 negative blood smears were reviewed in 2014,with a review rate of 4.52%. The qualified rates of blood smear making,dyeing and cleanliness were 92.87%,93.27%and 94.48%,respectively. A total of 34 positive blood smears were reviewed,and there were no false detections and leak detec?tions. The qualified rates of blood smear making and dyeing were more than 90%in all the seven cities(districts). As for quali?fied rate of cleanliness,except the rate in Qishuyan District(81.36%),those in the other six cities(districts)were all above 90%. The qualified rates of blood smear making,dyeing and cleanliness were all more than 90%in first?class,second?class and third?class hospitals. The major quality defects of the blood smears were sediment,abnormal making and thick membrane shed?ding,and the proportions were 25.91%,21.76%and 19.17%,respectively. Conclusions The quality of blood smears for Plas?modium detection in Changzhou City is satisfying. In the future,the training and supervision still should be strengthened to guar?antee the capacity of microscopic examinations for Plasmodium detection in the surveillance of post?elimination period.

Objective To investigate the current situation of iodine deficiency disorders and the effect of control measures in Changzhou City, Jiangsu Province, and to provide a basis for making up targeted control measures for iodine deficiency disorders. Methods In 2012, proportional probability sampling method(PPS) was used to select 30 primary schools in seven counties of Changzhou City;50 students aged 8-10 in each school were randomly selected to examine thyroid, and their urine and household salt samples were collected to detect iodine. Thirty pregnant and 15 lactation women were selected to detect their urine iodine in the town where the school was located in. Two drinking water samples were collected to detect iodine in the village where the school was located in. The questionnaire survey of health education was carried out among the children and the housewives. Results A total of 1 500 children were surveyed, and the rate of goiter was 0.07%(1/1 500); the median of urinary iodine was 224.81 μg/L. Five hundred and seventy-two pregnant women and 328 lactation women were surveyed, and the median of urinary iodine was 148.93 μg/L and 147.48 μg/L, respectively. Fifteen hundred salt samples were detected, and the coverage rate of iodized salt was 99.47%(1 492/1 500); the edible rate of qualified iodized salt was 97.67%(1 465/1 500); and the median of salt iodine was 25.46 mg/kg. Sixty water samples were collected, and the median of water iodine was 3.63 μg/L. The health education awareness rates were 77.8%(2 100/2 700) and 88.0%(396/450) of students and housewives, respectively. Conclusion The control effect of iodine deficiency disorders is significant in Changzhou City, and monitoring of iodine nutrition level of special populations should be strengthened.

Objective To analyze the Oncomelania hupensis snail distribution and the changes of snail situation in Chang-zhou City from 2013 to 2016,so as to provide the evidence for formulating the schistosomiasis prevention and control interven-tions. Methods The data of snail monitoring in Changzhou City from 2013 to 2016 were collected and statistically analyzed. Re-sults The total area with snails was 40.17 hm2 and the newly discovered area was 30.63 hm2 in Changzhou City from 2013 to 2016. In the four years,3454 snails were dissected,and no schistosome infected snails were found. There were totally 51 spots with snails,and the areas with snails of different types of marshland,inland and mountain were 12.13(30.19％),25.54 hm2 (63.57％)and 2.51 hm2(6.24％),respectively. In the newly discovered snail environment,the areas of types of marshland and inland were 8.00 hm2(26.12％)and 22.63 hm2(73.88％),respectively. The main causes for snail existence were external input and adjacent diffusion. In the past four years,the total snail control area with molluscicides was 71.74 hm2,the consolidated snail control area with molluscicides was 155.15 hm2,and the total environmental modification areas in the current snail spots and historic snail spots were 15.90 hm2 and 11.30 hm2 respectively. Conclusion The diffusion of snails in inland rivers is the key of the newly discovered snail areas in Changzhou City in recent years,and the snail monitoring and control measures should be strengthened in the future.