[Objective]To compare the therapeutic effect on femoral intertrochanteric fractures with dynamic hip screw(DHS) and proximal femoral nail antirotation(PFNA).[Method]A retrospective study of 483 patients with femoral intertrochanteric fractures in Changhai Hospital from December 2001 to January 2008 were carried out.Totally 109 patients were treated with PFNA,while 374 patients were treated with DHS.The data of operative time,blood loss,walking time,union time and hip function scores were recorded.[Result]All the patients were followed up for 6～38 months(15.3 months in average).There were significant differences in operative time,blood loss and walking time between two groups.There were no significant difference in union time.There were no significant difference in the excellent rate between the two groups in stable femoral intertrochanteric fractures.The excellent rate of PFNA group was significantly higher than DHS group in unstable femoral intertrochanteric fractures.[Conclusion]Each of them have its own advantages and indications.Both are effective ways to treat stable femoral intertrochanteric fractures.PFNA has more advantages to treat unstable femoral intertrochanteric fractures.

Objective To compare the therapeutic effect of intraarticular injection with sodium hyaluronate (SH) and SH combined with triamcinolone acetonide for osteoarthritis (OA) of knee joint.Methods Eighty-two patients with OA of knee joint were divided into two groups by toss a coin from March 2010 to March 2011.Forty-two patients simplely accepted SH injection (SH group),40 patients accepted SH combined with triamcinolone acetonide (combination group).Intraarticular injection was taken once a week,a total of 5 times.Efficacy measurements included visual analog scale (VAS) for pain and safety.Results After treatment for 1 week,the measured value of VAS for up and down stairs in combination group was significantly lower than that in SH group [ (22.6 ± 6.1 ) mm vs.(63.9 ± 5.8 ) mm] (P ＜ 0.05 ).After treatment for 3,6 months,the measured value of VAS for up and down stairs in two groups had no significant difference [ (42.2 ± 6.6) mm vs.(41.1 ± 5.3) mm,(48.5 ± 5.5) mm vs.(49.3 ± 6.2) mm] (P ＞ 0.05).Function of the knee joint after treatment was better than before treatment in two groups.Adverse effects were minimal. Conclusions Intraarticular injection of SH and SH combined with triamcinolone acetonide OA of knee joint is a safe and effective method.SH combined with triamcinolone acetonide can improve the efficacy in early period.

Objective To discuss the tympanic membrane puncture or tympanostomy tube under endotoscope combined with adenoidectomy under nasal endoscopy on the influence of invalid conservative treatment of pediatric secretory otitis media.Methods A total of 112 cases of secretory otitis media with invalid conservative treatment were selected in the department of otorhinolaryngology of children′s hospital of Nanjing Medical University from July 2013 to August 2015.They were divided into three groups,the group A of 38 cases(68 ears)underwent transnasal endoscopic pure adenoidectomy;the group B of 37 cases(60 ears)underwent transnasal endoscopic adenoidectomy combined with tympanocentesis;the group C of 37 cases(59 ears)underwent tympanostomy tube insertion.The clinical treatment effect,the period of middle ear effusion,postoperative recurrence and complication were observed and compared.Results The total effective rate of the 3 groups was improved after 3 months(P<0.05);the total effective rate in group B and group C at one week and 3 months after operation were higher than those of group A(P<0.05);and the total effective rate in group C at 3 months after operation was significantly higher than that of group B(P<0.05).The level of auditory brainstem evoked potential(ABR)and the latency of ABR wave Ⅰ latency were decreased at 1 year after operation(P<0.05);the ABR changes in group B and group C at 1 week and 1 year after operation were lower than those in group A(P<0.05).The incidence of recurrence rate and the period of middle ear effusion in group C were lower than those in group A and B(P<0.05).The incidence of complication of group A was lower than those of group B and group C(P<0.05).Conclusion Using tympanostomy tube combined with adenoidectomy under endoscope can improve the children with hearing,which not only can shorten the time of the middle ear effusion,but also effectively reduce the recurrence rate.

Objective To observe the effect of artemether in the control of prevalence and acute infection of Schistosoma japonicum in humans in high endemic areas. Methods During the transmission season (May-October), the residents in the pilot village took artemether with a 15- day interval to prevent the infection of S. japonicum. Results By the end of the transmission season, the egg positive rate was 0.83% and no acute case occurred in the artemether group, while 15.01% and 3 acute cases were observed in the placebo group. Conclusions Oral administration of artemether at a 15-day interval shows an effective protection from infection of S. japonicum, with a protection rate of 94.47% in residents of a high endemic area and it also shows marked effect to prevent acute schistosomiasis.

According to the requirement of the national assessment for achieving the infection control criteria, 42 villages (among them,25 villages belonged to the first stratum, and 17 villages belonged to the second stratum) in 14 counties from 5 provinces, including Hunnan, Hubei, Jiangxi, Anhui and Yunnan, were selected as sampling villages for the assessment.The results from the field assessment showed that 154 out of 9 067 people were found infected with Sckistosoma japonicum, with an average infection rate of 1.7% ranged from 0.31 % to 4.10% , and only Yongping Village from Weishan County and Tenglong Village from Eryuan County were not found any case. A total of 46 out of 3 323 head of cattle were infected with S. japonicum, with an average infection rate of 1.38% ranged from 0.26% to 3.79% , and no any infected individual detected in Nanling County. No outbreak occurred in those sampling villages. Therefore, it is indicated that the five sampling provinces have reached the national criteria on infection control of schistosomiasis.

Objective To investigate the risk factors of repeated episodes of child otitis media with effusion(OME).Methods One hundred and twenty-one children cases of repeated OME within 1 year in the Affiliated Children's Hospital of Nanjing Medical University from February 2013 to August 2015 were selected as the repeated group and contemporaneous 125 cases of non-repeated OME were selected as the control group.The repeated OME related factors were performed the univariate and multivariate analysis.Furthermore the occurrence rates of main risk factors and annual onset frequency of nasal disease were compared among different age groups.Results The Logistic multivariate regression analysis results indicated that younger age,allergic rhinitis,recurrent upper respiratory tract infections,tonsil hypertrophy Ⅳ°,adenoid hypertrophy Ⅲ °and Ⅳ ° and poor mastoid gasification were major risk factors for recurrence of OME.The incidence rate of repeated upper respiratory tract infections in the 3-＜7 years old group and ＜3 years old group was obviously higher than that in the7-14 years old group(P＜0.05),adenoid hypertrophy in the ＜3 years old group and 7-14 years old group was lower than that in the 3-＜7 years old group(P＜0.05).The annual onset frequency of nasal disease in the repeated group was significantly higher than that in the control group(P=0.000).Conclusion Child OME is the results of multivariate factors combined action.The smaller the age,the more the annual onset frequency and the higher the possibility of OME repeated onset.