Objective To study the effect of femoral offset reconstruction ON the Harris hip score and the hip ROM (range of motion) after artificial hip replacement in femoral neck fractures. Methods Follow-ups were conducted for 47 patients who had undergone artificial hip replacements for their unilateral femoral neck fractures. We took X-ray pictures to compare the femoral offsets at the affected and unaffected hips. The operated hips were evaluated by the Harris hip score. Statistical analyses were performed with SPSS l2.0 software. Results The Harris hip score of the operated hip was positively related to femoral offset reconstruction(t=7.25,P＜0.001).There was a significant and positive correlation between femoral offset and the hip abductor ROM(r=0.80,P＜0.001).The rate of femoral offset reconstruction had no significant difference between total hip arthroplasty and bipolar hip arthroplasty (χ2=0,P＞0.05).Conclusions Reconstruction of femoral offset after artificial hip replacement in the femoral neck fractures can improve funetional recovery and ROM of the hip. Femoral offset reconstruction is uncorrelated to the selection of total hip arthroplasty or bipolar hip arthroplasty.

AIM: To evaluate the relationship between axial length ( AL ) , corneal and lens refractive power, and the refractive error in children.
METHODS:Totally 44 children 88 eyes with refractive error who underwent retinoscopy with cycloplegia, to be measured spherical equivalent refractive error. Axial length was measured by a noncontact optical biometry ( ZEISS IOL-Master) , and corneal K and anterior chamber depth ( ACD) were also measured by the same machine. The refractive power of the lens was calculated by using the SRK formula. The patients were divided into 3 groups, myopia (SE<0), hyperopia (SE>+0. 50D) and emmetropia ( 0 to + 0. 50D ). Linear Correlation and Regression were used to evaluate the correlation among the optical parameters.
RESULTS:Totally 44 subjects, 88 eyes, average 9. 04±2.39 years, spherical equivalent (SE) -3. 50D to +8. 75D. Hyperopic AL was shorter than the other two groups ( P<0.05), same trend in lens power. No significant differences among the 3 groups in corneal K and ACD. There was a negative correlation between age and SE, SE and AL, SE and lens refractive power, and there was a positive correlation between age and AL, age and lens power.
CONCLUSION:As the children's growing up, SE trends to myopia, and AL becomes longer, and lens power is stronger.

? AlM: To observe the clinical curative effect of intravitreal Bevacizumab injection combined duplex technique in treatment of neovascular glaucoma ( NVG) .
?METHODS:Totally 25 eyes of 25 patients with NVG who underwent intravitreal Bevacizumab injection of 1. 0mg (0. 05mL), after the regression of iris neovascularization, 5 eyes with anterior chamber paracentesis fluid auxiliary controlled intraocular pressure. After 2wk, patients were treated by trabeculectomy and phacomulsification (9 eyes were implanted intraocular lens ) . The changes and complications of intraocular pressure, visual acuity, corneas and neovessels were observed after surgery, and followed up 12mo.
?RESULTS:After injection Bevacizumab in 25 eyes, iris neovascularization of 20 eyes subsided in 3 ~ 5d, and 5 eyes subsided in 7d. After controlling intraocular pressure, count of the corneal endothelial cell were 1 629±226mm2 , and none suffered decompensation of corneal endothelium after two- surgery of trabeculectomy and phacomulsification. After followed up 12mo, intraocular pressure of 20 eyes were controlled in normal range; 2 eyes could control in normal range after treated by a kind of anti-glaucoma medicine and 3 eyes was 34 ~38mmHg after treated by anti- glaucoma medicine. 9 eyes had improved vision after implanted intraocular lens.
?CONCLUSlON:lntravitreal Bevacizumab injection can subside iris and anterior chamber angle neovascularization effectively in a short time and reduce intraocular pressure. lt can also reduce the risk of bleeding during operation or after operation. lntravitreal Bevacizumab injection combined with two- surgery of trabeculectomy and phacomulsification can treat neovascular glaucoma effectively.

Objective:To observe the clinical efficacy of the three-step modified shoulder joint mobilization in treating scapulohumeral periarthritis (SP).Methods:Totally 80 subjects were recruited and divided into a treatment group and a control group by using the random number table, 40 in each group. The treatment group was intervened by the three-step modified shoulder joint mobilization; the control group was by oral administration of Celebrex. After successive 4-week treatment, the improvement of shoulder pain and motor function was observed.Results:The total effective rate was 87.5% in the treatment group versus 80.0% in the control group, and the difference was statistically significant (P<0.05).Conclusion:The three-step modified shoulder joint mobilization is easy-to-operate and effective in treating SP.

Objective To explore the role of spinal monocyte chemoattractant protein?1 ( MCP?1) ?extracellular signal?regulated protein kinase ( ERK)?kinesin superfamily motor protein 17 ( KIF17)∕N?methyl?D?aspartate receptor subunit 2B ( NR2B) signaling pathway in the maintenance of type 2 diabetic neuropathic pain (DNP) in rats. Methods Type 2 diabetes mellitus was induced by a high?fat and high?sucrose diet and intraperitoneal streptozotocin ( STZ) 35 mg∕kg, and confirmed by fasting blood glucose level≥16?7 mmol∕L 3 days later in male Sprague?Dawley rats aged 6 weeks. Type 2 DNP was confirmed when the mechanical paw withdrawal threshold ( MWT ) and thermal paw withdrawl latency ( TWL ) measured on day 14 after STZ administration decreased to< 80% of the baseline value. The rats with type 2 DNP were randomly divided into 4 groups ( n=36 each) using a random number table: type 2 DNP group (group DNP), type 2 DNP +MCP?1 neutralizing antibody group (group DM), type 2 DNP +ERK inhibi?tor group (group DE) and type 2 DNP + dimethyl sulfoxide group ( group DD). In DM, DE and DD groups, 0?1 ng∕μl MCP?1 neutralizing antibody 10 μl, 0?5 μg∕μl U0126 10 μl and 5 % dimethyl sulfoxide 10 μl were injected intrathecally, respectively, once a day for 14 consecutive days starting from 14 days after administration of STZ. Another 36 normal rats fed a common forage diet were adopted as con?trol group ( group C) . MWT and TWL were measured before STZ injection and at 1, 3, 7 and 14 days after STZ injection ( T0-4 ) . Nine rats were sacrificed after measurement of pain thresholds at T1-4 , and the lumbar segments ( L4-6 ) of the spinal cord were removed for determination of the expression of phosphoryla?ted ERK (p?ERK), KIF17 and phosphorylated NR2B (p?NR2B) by Western blot. Results Compared with group C, the MWT was significantly decreased, the TWL was shortened, and the expression of p?ERK, KIF17 and p?NR2B was up?regulated at T1-4 in DNP, DM, DE and DD groups. Compared with group DNP, the MWT at T3-4 in group DM and at T2-4 in group DE was significantly increased, the TWL at T3-4 in group DM and at T2-4 in group DE was prolonged, and the expression of p?ERK, KIF17 and p?NR2B was down?regulated at T2-4 in DM and DE groups, and no significant changes were found in the pa?rameters mentioned above in group DD. Conclusion Spinal MCP?1?ERK?KIF17∕NR2B signaling pathway is involved in the maintenance of type 2 DNP in rats.

BACKGROUND: Much attention has been focused on mandibular condyle fracture, which has long been considered as a severe injury to the temporomandibular joint(TMJ). Restricted by diagnostic methods, many studies have been conducted on transverse fracture whereas little attention has been paid to longitudinal fracture of the mandibular condyle. Even less is known about longitudinal fracture in young children.OBJECTIVE: To evaluate the effects of childhood longitudinal fracture of the mandibular condyle on secondary ankylosis of TMJ.DESIGN: A randomized controlled study.SETTING: Department of Stomatology, General Hospital of Chinese PLA.MATERIALS: The experiment was completed in the Center for Experimental Animals, General Hospital of Chinese PLA. Twelve young Chinese experimental miniature pigs bred by the Institute of Experimental Animals, Beijing Agriculture University, aged 2 -3 months and weighing(5 -5.5) kg, were used and raised with mixed feed, and then divided into 3 groups randomly.METHODS: Food and water was forbidden for the miniature pigs 12 hours before operation. Under anesthesia with(5.0 - 15.0) mg/kg ketamine/xylazine abdominally injected, conventional disinfection was performed in the right lateral decubitus position and layer-by-layer preauricular incisions were made on the left side of the miniature pigs. The joint cyst was incised transversely and the lower cavity of TMJ was exposed and dragged downwards. The mandibular condyle was cleaved into two vertically along the inner 1/3 part of it with a 5.0 mm-wide bone chisel to cause inferior and posterior sagittal fractures. The miniature pigs were executed 3 months and 6 months after operation, and their condyles were cut for observation.MAIN OUTCOME MEASURES:①The morphological changes of mandibular condyle specimens in the three groups observed with the naked eyes.②The pathological changes of mandibular condyle specimens under light microscope.RESULTS: The articular disc was adhered to the mandibular condyle after 3months. Temporal fossa adhered to the articular disc and mandibular condyle could still be observed in one specimen. Bifid condylar deformity was found in two specimens and no disc perforation was found. The adhesions became more severe after 6 months and bifid condylar deformity was formed in all the 3 specimens, with distinctly thickened discs. Light microscope observation:Three months after fracture, the adhesion between disc and condyle was obvious. There was no clear boundary between the surrounding tissues. The adhesion was composed of fibro-connective tissues, with a large number of chondrocytes in it. Fibro-connective tissues tightly adhered to the trabeculae were found in some adhesions. The fiber of disc became deranged and blood vessels and fatty cells were seen. Six months after fracture, blood vessels, a large number of fibroblasts and sparse chondrocytes were seen in the adhesions. The collagen fibers of the discs were arranged in whirlpool shape. There were a large number of fatty cells and blood vessels within it. The fiber-cartilage of the condylar surface was found thickened and the fiber deranged in the unadhered tissues. Proliferative changes were seen on disc surfaces.CONCLUSION: Childhood longitudinal fracture of the mandibular condyle causes severe secondary injury to TMJ, suggesting a close correlation between longitudinal fracture of the mandibular condyle and TMJ ankylosis.

Objective To evaluate the clinical effectiveness of the treatment for the intramedullary broad dissemination of the malignant bone tumor of limbs by microwave heliotherapy combined with prosthesis replacement.Methods From June 2001 to April 2012,19 patients with intramedullary broad dissemination of malignant bone tumor of limbs were treated with microwave heliotherapy combined with prosthesis replacement.There were 12 males and 7 females,47 years old on the average (ranging from 11 to 65 years).The tumors involved:primary malignant tumor 11 cases,metastases of the scapula 8 cases.Locations of tumors involved:the distal femur 8 cases,the proximal tibia 6 cases,the proximal humerus 3 cases and the proximal femur 2 cases.After the patients were examined with MRI and the level of osteotomy was determined,the prostheses were custom-made.The exposures of the all tumors were via the conventional surgical approach.The lesions were heated at 50 ℃ for 20 min by 2 450 MHz microwave,with surrounding soft tissue protected by copper mesh.The level of osteotomy was determined by the result of preoperative imaging measurement.The prosthesis was installed after the microwave heliotherapy.Results The duration of surgery was from 60 min to 150 min (100 min on average).The blood loss was from 300 ml to 1200ml (600 ml on average).All patients were followed-up for 10 months to 5 years (2.7 years on average).1 case with chondrosarcoma relapsed 18 months after surgery,and survived with tumors.1 case with malignant fibrous histiocytoma died due to multiple metastases 8 months after surgery.1 case with Ewing sarcoma died due to pulmonary metastases 23 months after surgery.The remaining 7 cases with the primary malignant bone tumors did not recur or transfer during the follow-up period.6 cases with the metastases died due to metastases 5 to 20 months after surgery.The functions of shoulder joint of 3 proximal humerus tumor patients were restricted,while 16 patient's function weren't restricted.Conclusion The clinical results demonstrated that the microwave heliotherapy combined with prosthesis replacement was an ideal treatment for the intramedullary broad dissemination of the malignant bone tumor of limbs.

Objective To investigate prognostic factors for bloodstream infection in adult patients. Methods Clinical data of 131 adult patients with positive blood cultures during January 2002 to December 2003 in the Hospital were collected and 91 cases of them were retrospectively analyzed to understand their pathogen species and prognostic factors for it.Results Blood samples from 91 patients were cultured positive,53 cases(58.2%)with gram-negative bacteria mainly including Escherichia coli,Salmonella spp. and Klebsiella pneumoniae,28(30.8%)with gram-positive bacteria,mainly including Staphylococcus aureus and coagnlase-negative Staphylococci,eight(8.8%)with fungi and two(2.2%)with multiple infections.Case fatality ratio in this group of patients with septicemia was 30.8% during their hospitalization,and that in those with Pseudomonas aeruginosa,Staphylococcus aureus,Stenotrophomonas maltophilia and E.coli with extended-spectrum beta-lactamase was over 50%.Case fatality ratio was associated with severity of sepsis(OR=1.15)and inappropriately initial empirical treatment with antibiotics (OR=6.77).Conclusions Pathogen causing bloodstream infection in adults were mainly gram-negative bacteria and severity of infection and inappropriate initial antibiotics treatment could increase their fatality.

Objective To evaluate the efficacy and safety of Caspofunjin on invasive fungal infections in patients refractory to Fluconazole in ICU.Methods The open clinical trial was conducted in 44 invasive fungal infections patients who was refractory to Fluconazole,including 7 cases of confirmed,28 cases of suspected and 9 cases for empire treatment.They were treated with Caspofunjin in a dose of 70 mg in the first day,and then in a dose of 50 mg/d for 10～40 d.Results The cure rate of patients was 42.86%,the effective rate was 76.19%,and the eradication rate was 65.22%.All patients were well tolerated.Conclusion Caspofunjin is effective and safe in the treatment of severe invasive fungal infections.

0.05).The side effects of thiamphenicol was more little than the other.CONCLUSIONS The treatment bacterial vaginosis with thiamphenicol is effective and safe and the side effects is a little.