Objective To compare the clinical effects of 2 common installation positions of the helical blade in the treatment of senile intertrochanteric fractures with proximal femoral nail antirotation (PFNA).Methods From January 2010 to December 2012,166 old patients with intertrochanteric fracture were treated by PFNA.According to the installation position of the helical blade in the femoral head on the postoperative X-ray films,they were divided into a C/C group (87 cases) where the helical blade was at the center of the femoral head in both anteroposterior and lateral views and an I/C group (79 cases) where the helical blade was at the inferior one-third of the femoral head in anteroposterior view and at the center in lateral view.There were no significant differences between the 2 groups in general data preoperation (P ＞ 0.05).The 2 groups were compared in terms of reduction quality,tip-apex distance (TAD),full weight bearing time,fracture healing time,and Harris Hip Score(HHS) at the last follow-up.Results C/C group had 83 patients followed for an average of 13.6 months and I/C group had 76 patients followed for an average of 13.3 months.There were no significant differences between the 2 groups regarding the good-to-excellent reduction rate [94.0％ (78/83) versus 94.7％ (72/76)],full weight bearing time (9.4 ± 1.5 weeks versus 9.3 ± 1.3 weeks),fracture healing time (17.8 ±2.3 weeks versus 17.2 ±2.3 weeks),or HHS (89.6 ±4.6 points versus 89.3 ±4.7 points) (P ＞ 0.05).There was a significant difference in TAD (21.14 ± 3.17 mm versus 24.96 ± 3.48 mm) between the 2 groups(t =-7.242,P =0.000).No infection or cut-out or other related complications of the helical blade occurred in either group.Conclusion The helical blade may lead to satisfactory clinical effects in the treatment of senile intertrochanteric fractures with PFNA no matter at which of the 2 positions it is installed.

Objective To analysis the effective ingredients in Huanglianjiedu decoction under different decocting conditions. Methods The detecting method of HPLC was established and the ingredients in Huanglianjiedu decoction under different decocting time and times were analyzed. Result Water- soluble glycoside of gardenoside and baicalin reached balance of dissolution within 20 min and their dissolution rate were about 82% and 60% respectively. Water-soluble alkaloids of berberine and palmatine reached balance of dissolution within 30 min and their dissolution rate were about 45%. The dissolution rate of wogonin was 31% at 60 min. The dissolution rate of Crocin-Ⅰ reached top at 20 min and fell down after 20 min. Decocting times for fat-soluble constitutes was more important than water-soluble constitutes. Conclusion The decocting condition has effect on the dissolution rate and stability of the ingredients in Huanglianjiedu decoction. The decocting condition is very important to the quality control of decoction.

Objective To investigate features of the clinical and pathology of the 32 cases adolescent patients with carcinoma of esophagus.Methods Analysis of 32 cases with esophageal carcinoma by case -control study was carried out ,40 cases of up -50 years old patients,as control group.Results Compared with those in the control group,the adolescent patients rarely was found in early stage ,the pathological differentiation were worse,the more higher malignant degree,the more shorter survival time.Conclusion The clinical symptoms of adolescent patients with esophageal carcinoma is ocult, its early diagnosis rate is low ,and so the worse prognosis.

Objective To investigate the correlation of Cathepsin D and P selectin expression with the clinico-pathologic features and prognosis of non-small cell lung cancer (NSCLC). Methods Immunohistochemistry (S-P method) was applied to detect the expression of Cathepsin D and P selection in 30 NSCLC specimens. Results The positive rates of cathepsin D and P selectin were 66 7% and 76 7% respectively. Cathepsin D expression in NSCLC was positive relation with the tumor size, TNM stage and lymph node metastasis(P0 05). The 3 years survival rate of the patients with the expression of both the Cathepsin D and P selectin was much lower than that of the patients with negative expression of both the Cathepsin D and P selectin(P

Objective: To investigate the effectiveness of anatomical locking plate internal fixation combined with coracoclavicular ligament reconstruction in treatment of the Neer type Ⅱb distal clavicle fractures by comparing with the simple anatomical locking plate internal fixation. Methods: The clinical data of 40 patients with Neer type Ⅱb distal clavicle fractures who met the criteria between February 2013 and January 2017 were analyzed. Eighteen cases were treated with anatomical locking plate internal fixation and coracoclavicular ligament reconstruction by using a suture anchor (reconstruction group), and 22 cases were treated only with anatomical locking plate internal fixation (non-reconstruction group). There was no significant difference in gender, age, injured side, causes of injury, associated injuries, time from injury to operation between 2 groups ( P>0.05). The operation time, medical expense, postoperative coracoclavicular distance, Constant-Murley scores of injured side, and complications were recorded and compared between 2 groups. Results: All patients were followed up 12-27 months (mean, 16.3 months). One patient in reconstruction group had superficial wound infection. One patient in non-reconstruction group had pullout of screws from the distal fragment and reduction loss at 1 month postoperatively. The operation time and medical expense in reconstruction group significantly increased when compared with those in non-reconstruction group ( P<0.05). All fractures in 2 groups achieved bony union at last follow-up. The rate of coracoclavicular distance increase of injured side in non-reconstruction group was significantly higher than that in reconstruction group ( t=2.371, P=0.023). The Constant-Murley scores at 1 month, 3 months after operation, and last follow-up were significantly improved when compared with preoperative values in 2 groups ( P<0.05), but no significant difference was observed between 2 groups ( P>0.05). Conclusion: Both anatomical locking plate internal fixation with and without coracoclavicular ligament reconstruction can achieve good effectiveness for the Neer type Ⅱb distal clavicle fractures. Therefore, the coracoclavicular ligament reconstruction does not need, except for comminuted fractures with the length of lateral fragment less than 1 cm or the patients with poor compliance.

Objective To study the clinical application of Multi-slice spiral CT angiography (MSCTA) in renal arterial stenosis. Methods 36 patients clinically suspected of renovascular hypertension were examined by 16 slice or 64 slice spiral CT angiography. After scanning , three dimensional reconstruction of the blood vessels were operated. 28 cases were detected diseases of renal vessels and perivascular, and then compared with DSA. Results In the 36 cases, MSCTA showed 19 renal areterial stenosis, 3 adrenal gland neoplasms, 2 adrenal hyperplasia, 1 polycystic kidney disease. In 19 cases with MSCTA , there were 2 double renal areterial stenosis and 2 renal areterial anatomical variants. DSA showed 21 renal areterial stenosis with various degree, the accordant rate of MSCTA and DSA exceeded 90%. Conclusion MSCTA play an important role in clinical application in diagnosis of renal arterial stenosis.

Objective To evaluate the value of Bolus chase technology for angiography of lower extremity. Methods 12 cases with diabetes foot or leg pain were examined with Bolus chase technology. Results Low extremity artery thrombosis was found in 12 cases. Conclusion Bolus chase technology is better than standard DSA in the display of lower extremity vessel.

Thirty Kunming mice were randomly divided into three groups named as dihydroartemisining roup (A) , dihydroartemisinin and azithromycin group (B) , and controlgroup (C) . Each mouse was infected intraperitoneally with 2?103 Toxoplasma gondii tachyzoites. Eight hours after infection, the mice of groups A and B were treated twice a day for 4 days with 75 mg/kg of dihydroartemisinin. At 24 hours post infection, those in group B were treated once daily for 4 days with 200 mg/kg of azithromycin. At 96 hours post infection, ascites was taken from one mouse each group and the tachyzoites were collected. The ultrastructure of tachyzoites was observed by conventional transmission electron microscopy. It was found that the tachyzoites in groups A and B showed edema and enlarged, the cell membrane became indistinct, broken or damaged; fat droplets in the cytoplasm increased, and vacuoles were formed. Similar changes were not seen in the control group.

Objective To discuss the clinical characteristics and treatment methods of lumbar disc herniation in adolescent and to in-crease the awareness of lumbar disc herniation among orthopedists.Methods Retrospectively reviewed the clinical data of 201 adolescent pa-tients(aged 20 years or less)with lumbar disc herniation who were admitted in General Hospital of Shenyang Military Area Command from January 2001 to December 2010.Analyzed the clinical characteristics and treatment methods,and compared the VAS score and ODI score be-fore operation,one week after operation and at the last follow up.Meanwhile,the complications were observed and compared.Results Among the 201 patients,187 patients(93.0%)presented with low back pain with or without radiating pain,20 patients(10.0%)presented with leg pain for the first symptom.There were only 97 patients(48.3%)were diagnosed with lumbar disc herniation for their first diagnosis in other hospital.Totally 70 patients(34.8%)had a history of trauma before the onset.The most common segments were L4 /L5 (101 cases,50.2%) and L5 /S1 (70 cases,34.8%).There were 140 patients treated by microendoscopy discectomy(MED),25 patients treated by percutaneous endoscopic lumbar discectomy(PELD),and 36 patients treated by open lumbar discectomy(OLD).All the patients were followed up for more than 12 months with averagely followed up for(22.9 ±11.7)months.There was significant improvement one week after operation and at the last follow up compared with the preoperative VAS score and ODI score,and the differences were statistically significant(P <0.05).The rate of postoperative complications was 3.6%,4.0%,8.3% in patients with MED,PELD and OLD respectively.Conclusion Diagnosis of LDH in adolescent is usually delayed.Increase the awareness of lumbar disc herniation could help orthopedists to get a exact medical history,per-form a directed physical examination,and order appropriate imaging studies.Minimally invasive surgery is an effective method to treat lumbar disc herniation in adolescent.

Objective: To investigate the efficacy of horizontal acupuncture with sticking needles plus plucking manual technique in treating scapular, dorsal and lumbar myofascitis.Methods: One hundred and seventy-eight patients with scapular, dorsal and lumbar myofascitis were randomly allocated to observation group treated by horizontal needling with sticking needles plus plucking manual technique and control group treated by perpendicular acupuncture at the pain point. Results and conclusion: The cure rate, and the total effective rate in the observation group were 69.6%, and 100% respectively and those in the control group were 13.1%, and 82.5% respectively. Statistical analysis showed a very significant difference in curative effect between the two groups (P＜0.01), indicating that the effect was significantly better in the observation group than in the control group.