Objective To discuss the effects, indications and methods of π-shaped locking com-pression plates plus open reduction for Barton fractures. Methods From January 2006 to January 2007, 21 cases of Barton fractures were treated by open reduction from dorsal incision and fixation by π-shaped locking compression plates. Of them, 14 also had bone grafting and 6 had protection by a plaster brace. Results Follow-ups for 6 to 18 (average, 10) months showed all the patients got bone union. The differences between preoperative and postoperative measurements in palmar inclination, ulnar deviation and relative length of distal radius were statistically significant (P < 0.05). At the last follow-up, the affected wrist showed no significant difference from the opposite side in dorsal extension, palmar flexion and ulnar deviation (P > 0.05) except in ulnar deviation (P < 0.05). According to the improved Gartland and Werkey grading system, the wrist function was evaluated as excellent in 15 eases, good in 4, and fair in 2. The good to excellent rate was 90. 5%. Conclusion Open reduction from dorsal incision and fixation by π-shaped locking compression plate is an effective treatment for Barton fractures.

BACKGROUND: Short-form-36 health survey(SF-36) has good reliability and validity, which is applicable to assess quality of life (QOL) in European and American population.OBJECTIVE: To study the reliability, validity and feasibility of SF-36 scale in the rural elder and evaluate their QOL.DESIGN: It is a cross-sectional study, all participants are sampled by two-phase random sampling.SETTING: Institute of Epidemiology and Hygienic Statistics, China Union Medical University and institute of epidemiology and hygienic statistics in a university.PARTICIPANTS: Totally 687 old people were randomly selected from six villages in Bao' an District of Shenzhen from May to July 2002. Inclusion criteria: All the people were residents and aged 60 years or above. Exclusion criteria: People with severe auditory or mental obstacles were excluded. Totally 666 questionnaires were valid, among them 264 were male and 402 were female.METHODS: All participants were interviewed face to face with SF-36 questionnaire by trained investigators. The feasibility, reliability and validity were the main measures of SF-36 scale.MAIN OUTCOME MEASURES: Split-half reliability, internal consistency, criterion-related validity, discriminant validity and construct validity.RESULTS: SF-36 scale had a good internal consistency, and all Cronbach' α coefficients were equal or more than 0. 8 in 8 dimensions. The split-half reliability of every dimension was preferable and Pearson correlation coefficients were 0.7 or higher except mental health(MH) . Discriminant validity and criterion related validity were obtained and satisfied. Two factors were got by factor analysis, which could account for 63.14% of total variance. Every dimension held a moderate loading in its relevant factor except role-emotion (RE) dimension(≥0.4).CONCLUSION: SF-36 scale is applicable for QOL assessment in the rural elder after some item revisions. The vulnerable elder should be given more attention and care.

BACKGROUND:The traditional treatment for thoracolumbar vertebral fractures is posterior short-segment pedicle screw fixation. This method uses vertebral soft tissue stretch through distraction reduction mechanism, makes shift bone reset, and restores shape and height of vertebral body. Long-term folow-up found that part of cases experience complications such as vertebral height loss, loss of spinal correction of Cobb angle, the pedicle screw breakage and loosening. OBJECTIVE:To explore clinical effects of pedicle screw fixation combined with the implantation of artificial bone composite for the treatment of thoracolumbar fractures, and to compare with conventional pedicle screw. METHODS: A total of 80 patients with thoracolumbar fractures, who were treated in the Yantaishan Hospital from March 2011 to May 2014, were randomly divided into two groups. In the experimental group, patients received pedicle screw fixation combined with the implantation of artificial bone composite. In the control group, patients received routine pedicle fixation. Pain visual analog scale score was evaluated before treatment and at 6 months after treatment in patients of both groups, and easement of pain was evaluated after treatment. Vertebral body height (normal anterior flange height and up and down the front cone height and the ratio of the average multiplied by 100%) and sagittal Cobb angle (sagittal measurements of X-ray film) were measured in patients of both groups before treatment and at 1 and 12 months after treatment. According to conventional hierarchical evaluation criteria used al over the world, prognosis was assessed at 6 months after treatment, including basic cure, powerfuly, effectively, and invalid. RESULTS AND CONCLUSION: At 6 months after treatment, significant differences in pain visual analog scale scores were detected in the experimental group (2.4 points) and control group (3.7 points) (P < 0.05). No significant difference in height of the injured vertebra and Cobb angle was detected between the two groups before treatment (P> 0.05). The height of the injured vertebra and Cobb angle were better in the experimental group compared with the control group at 1 and 12 months after treatment (P < 0.05). Significant differences in treatment efficiency were detectable between the experimental group (90%) and the control group (73%) at 6 months after treatment (P < 0.05). These data indicate that pedicle screw fixation combined with the implantation of artificial bone composite in the treatment of thoracolumbar fractures can be used to fix fracture reduction, effectively restore height of injured vertebral body, prevent postoperative Cobb angle loss, and improve the treatment efficiency.

Objective To evaluate the clinical value of 64-slice spiral computed tomography(CT) in detecting coronary artery disease. Methods Twenty-three patients with suspected coronary artery stenosis were analyzed by 64-slice spiral computed tomography coronary angiography and catheter coronary angiography. Results Two hundred and ninety -one segments of the two hundred ninety-nine coronary artery segments in twenty-three patients could be visualized by 64-slice spiral CT,eight segments couldn't be visualized because of calcification and exercising shadow. According to gold standard of selective coronary arteriongraphy,the sensibility,specificity,positive predictive value and negative predictive value to diagnose coronary artery stenosis by 64-slice spiral CT were 88.7%,98.2%,94.0% and 96.4%.Conclusion The coronary artery stenosis diagnosis by 64 -slice spiral CT is a potential detecting method and good clinical value but could not replace selective coronary arteriongraphy.

Objective: To study the reliability, validity and feasibility of SF-36 Health Survey Scales in elderly living in rural area around Shenzhen of south China. Method: 666 old people aged 60 or above were assessed with SF-36. Split-half reliability, internal consistency, criterion-related validity, discriminant validity and construct validity of the scale were tested. Result: All Cronbach alpha coefficients were 0.8 or above in eight subscales. The internal consistency was good. The split-half reliability of every subscale was preferable and Person correlation coefficients were 0.7 or higher, except that of Mental Health. Good discriminant validity and criterion related validity were obtained. Factor analysis showed two factors, which could account for 63% of total variance. Every subscale held moderate loading in its relevant facto, except that of Role-Emotion.Conclusion:SF-36 was applicable for life quality assessment in country-dwelling elderly population after some item revisions.

BACKGROUND:Ribbed anatomic femoral stem meets the biomechanical features of the femur, and has achieved satisfactory clinical efficacy with good initial stability, rapid bone growth and low stress shielding.
OBJECTIVE:To evaluate the design features and clinical results of the cementless anatomic Ribbed femoral stem (Ribbed stem) in total hip arthroplasty.
METHODWe retrospectively analyzed 52 patients (52 hips) with hip joint disease who were treated with Ribbed stem in total hip arthroplasty between March 2010 and March 2012. There were 20 males and 32 females. The mean age was 59 years (range 22-78 years). The mean fol ow-up was 3.1 years (range 2-4 years). The preoperative and postoperative Harris hip scores, the rate of postoperative thigh pain, the incidence of intraoperative femoral fracture, wound healing, dislocation and revision were recorded. Radiographic evaluation was used to evaluate the rate of stem fil , subsidence of femoral stem, periprosthetic radiolucent line, bone ingrowth, stress shielding, and osteolysis.
RESULTS AND CONCLUSION:The incidence of intraoperative femoral fracture was 6%. Al incisions were healed. There were no cases of hip dislocation and revision;the rate of thigh pain was 6%, no patient had thigh pain after 1 year postoperatively. The mean preoperative Harris hip score was 48 points, which improved to a mean of 96 points at the final fol ow-up. Postoperative X-ray showed that al patients had a satisfactory femoral fil in both planes and al of the femoral stems were wel-fixed at the final fol ow-up. The average fil ing rate was 91%, 88%and 86%by normotopia imaging, while 88%, 85%and 81%by lateral imaging, at the metaphysic, middle and distal ends respectively. At the final fol ow-up, 49 hips (92%) showed stable bone ingrowth, 3 hips showed stable fiber ingrowth. No osteolysis around the components at the femur or acetabulum was observed. 5 (10%) hips appeared the subsidence of femoral stems, which were<2 mm. The stress shielding phenomenon occurred in al patients, including first-degree in 31 hips, second-degree in 19 hips, third-degree in 2 hips, and fourth-degree in no case. Experimental findings indicate that, Ribbed stem with a rational design can achieve satisfactory clinical outcomes with good initial stability, rapid bone growth and low stress shielding.

ObjectiveTo set up the new lab examination method for 1p, 19q and 10q loss of heterozygosity(LOH) in glioma.MethodsThirty-eight cases of oligodendroglioma were enrolled into the study. Real-time quantitative polymerase chain reaction-based microsatellite analysis was performed on tumor tissues in order to study the status of chromosomes 1p, 19q and 10q.ResultsAmong the 38 cases of oligodendroglioma, 25 cases (65.7%) showed 1p LOH, 26 cases (68.4%) showed 19q LOH, while 5 cases (13.2%) showed 10q LOH.ConclusionReal-time quantitative polymerase chain reaction-based microsatellite analysis is a rapid and specific for detecting LOH in glioma tissues.

BACKGROUND:Pathological examination and MRI have been widely used in clinic, but their combination is rarely reported in discrimination of early spine infections.
OBJECTIVE:To determine the accuracy of pathology and MRI for discrimination between early pyogenic spondylitis and brucella spondylitis.
METHODS:Twenty-two patients with pyogenic spondylitis and 20 patients with brucella spondylitis who had CT-guided percutaneous biopsy and MRI of the spine were retrospectively reviewed. Pathological observations included structure and activity of bone lesions, tissue cells and their main components;MRI observations included signal and sign changes at lesion sites. Statistical analysis was performed with the chi-square test.
RESULTS AND CONCLUSION:The patients with pyogenic spondylitis had a significantly higher incidence of pathological and MRI findings as fol ows (P<0.05):neutrophil infiltration;intervertebral disc abnormal signal, location of vertebral body lesions anterior+posterior, obviously shape change in the vertebral body, paraspinal abnormal signal, presence of intraosseous or paraspinal abscess. Pathological and MRI examination was accurate for early differentiation of pyogenic spondylitis from brucella spondylitis.

Objective: To investigate the relationship of loss of P16 expression with biologlical behaviors and prognosis of gastrointestinal stromal tumors(GISTs). Methods: The expression of P16 protein and mRNA was detected in GISTs tissues by immunohistochemistry,Western blot and RT-PCR.The prognosis was evaluated through follow up. Results: The expression rates of P16 protein and mRNA in GISTs were 53.8%(21/39，Frozen tissue)，51.3%(20/39，Frozen tissues)and 51.4%(37/72，Paraffin-embedded tissues)，respectively.The expression of P16 was significantly different among GISTs of different aggressive risk(P<0.05).With the incease of aggressive risk，the expression of P16 was deceased.The expression of P16 was negtively correlated with Ki-67 and patient survival(P<0.05). Conclusion: The loss of P16 expression has a positive correlation with the infiltration and progression of GIST.Detection of P16 protein and mRNA is helpful for the evalutaion of biological behaviors and prognosis of gastrointestinal stromal tumors.