Objective To evaluate the surgical techniques and clinical outcomes of treating osteoporotic fracture of proximal humerus with Spatial Subchondral Support (S3) locking plate of proximal humerus.Methods From July 2010 to July 2011,21 patients with osteoporotic fracture of proximal humerus,12 males and 9 females,were treated in our department.They were 66.0 years old on average (from 58 to 80 years old).According to the Neer classification system,13 cases were 3-part fractures,8 4-part fractures,and 2 combined with shoulder dislocation.All cases were evaluated carefully with routine CT scans pre-operatively to define the type of fracture and the involvement of articular surface.Open reduction and internal fixation with S3 locking plate of proximal humerus was performed 2 to 7 days after injury (average,4.0 days).Regular X-ray follow-ups were taken and complications recorded as well.Overall function evaluation was carried out according to the modified Constant-Murley score system (CMS) and visual analogue scale (VAS).Results The 18 cases were followed up for a mean duration of 18.0 months (from 12 to 24 months).No complications of wound infection,implant failure or impingement were observed during the follow-ups.Bone union was achieved after an average of 12.0 weeks (from 10 to 14 weeks).On average,the Modified CMS score was 80.2 and the VAS score 1.5.At the post-operative 10th and 13th months,X-ray manifested avascular necrosis of the humeral head respectively in 2 cases of 4-part fractures,who suffered from moderate pain which was relieved after conservative treatment.Conclusion Fixation with S3 locking plate of proximal humerus is a safe and effective treatment of osteoporotic fracture of proximal humerus,because it is rigid and avoids plate-related impingement.

Objective Discuss the efficacy of pantoprazole and octreotide in treatment of gastrointestinal hemorrhage.Methods Selecting 220 cases patients with gastrointestinal hemorrhage.They were divided into two groups randomly.The observation group (115 cases) was given pantoprazole combined with octreotide.The observation group (105 cases) was given pantoprazole.The efficacy of pantoprazole and octreotide in treatment of gastrointestinal hemorrhage was evaluated by efficacy,perioperative index,SF-36 scores and adverse reaction during 1 month follow-up.Results The effective rate of observation group was significantly higher than that of the control group (P ＜ 0.05).The bleeding time of observation group was shorter than that of control group (P ＜ 0.05).The blood transfusion of observation group was less than that of control group (P ＜ 0.05).The hemoglobin level and pH value observation group was higher than that of control group (P ＜ 0.05).Before treatment,there were no statistical significance on SF-36 scores.After 1 months treatment,physiological function,physical function and pain scores of observation group was higher than that of control group(P ＜ 0.05).During 1 months follow-up,there were no statistical significance on adverse reaction between two groups.Conclusion The pantoprazole combined with octreotide had a good therapeutic effect on gastrointestinal hemorrhage.It could stop bleeding quickly,reduce blood loss and blood transfusion.It could improve the quality of life and use safely with worthy of clinical use.

OBJECTIVE To prevent occurrence of infection in clinical laboratory. METHODS The biosafety system was continuously improved and complet step by step and amplifed rules and regulation,done well protection of person,making the operating process of laboratory more norma,enforcing the air and environment,sterilizeing the equipment,detecting implement,disinfecting the used material and medical garbage and inspecting. RESULTS The hospital infection in laboratory was effectly controlled,the staff′s safety and health were addressd when they worked in an infected area of laboratory. CONCLUSIONS Amplifying the rules and regulation,and insisting the principle of work without slacking could effecttively prevent the occurring of hospital infection in clinical laboratory.

Objective To systematically evaluate the association between IL-6 gene rs1800796 polymorphism and febrile seizures(FS)susceptibility.Methods The related literatures on IL-6 gene rs1800796 polymorphism and febrile seizures(FS)susceptibility were retrieved from PubMed,Web of Science Embase,Cochrane Library,CNKI,WanFang,VIP and CBM Databases by computer.OR and its 95％CI were taken as the pooled effects.The RevMan 5.2 software was adopted to conduct the statistical analysis.The publication bias analysis was performed by using the STATA12.0 software.Results Seven independent case-control studies were included according to the inclusion and exclusion standard,involving 516 accumulated cases and 528 controls.The results showed that IL-6 gene rs1800796 polymorphism had a significant association with FS susceptibility in Chinese population(GG+CG vs.CC:OR=2.22,P=0.05;G vs.C:OR=2.44,P<0.01;GG vs.CC:OR=3.69,P=0.03;GG vs.CG+CC:OR=3.43,P<0.01).The subgroup analysis was conducted according to possible important confounding factors,and the results showed that this gene polymorphism had a significant association with FS susceptibility in Chinese population(GG+CG vs.CC:OR=3.32,P<0.01;G vs.C:OR=3.23,P<0.01;GG vs.CC:OR=7.27,P<0.01;GG vs.CG+CC:OR=5.17,P<0.01:CG vs.CC:OR=2.56,P=0.02).But in other populations,except recessive model(GG vs.CG+CC:OR=2.40,P<0.01),all other genetic models did not display obvious correlation.The subgroup analysis was conducted by FS diagnostic standard,and the results showed that this gene polymorphism had a significant correlation with infantile FS onset in diagnosing FS by the Chinese standard(GG+CG vs.CC:OR=4.57,P<0.01;G vs.C:OR=4.36,P<0.01;GG vs.CC:OR=12.75,P<0.01;GG vs.CG+CC:OR=8.60,P<0.01:CG vs.CC:OR=3.40,P<0.01).Conclusion IL-6 gene rs1800796 polymorphism may be associated with infantile FS susceptibility and allele G may be a risk factor for FS onset.

AIM: To determine the optimal operation method and reduce operative complications by retrospective analysis of outcomes of different operative manipulation for patients with congenital ectopia lentis ( CEL) .
●METHODS: A retrospective study ranged from Jan. 1, 2010 to Jan. 1, 2015 was conducted and 31 CEL patients (57 eyes) treated with different operations were taken into this study. The postoperative outcome, operation related complications was analyzed in terms of different operative manipulations.
● RESULTS: The most common types of CEL are idiopathic and Marfan - related CEL. All eyes ( 98%) benefited from operation except 1 Marchesani syndrome eye concurrent with optic atrophy induced by glaucoma. A total of 3 eyes ( 5%) were treated by phacoemulsification combined with intraocular lens implantation; 8 eyes ( 14%) were treated by phacoemulsification, capsular tension ring implantation combined with intraocular lens implantation, among these 8 eyes, 1 eye was treated with capsular tension ring implantation combined with suture fixation; 39 eyes ( 68%) were treated by lens excision and anterior vitrectomy through corneal incision combined with intraocular lens implantation with suture fixation, among these 39 eyes, 2 eyes were treated with trabeculectomy , but not combined with intraocular lens implantation; 5 eyes ( 9%) were treated by intracapsular cataract extraction and anterior vitrectomy combined with intraocular lens implantation with suture fixation; 2 eyes ( 4%) were treated by lens excision and vitrectomy through pars plana combined with silicon oil injection.
● CONCLUSION: Almost all patients can obtain satisfactory outcomes through various operative manipulations. Phacoemulsification combined with intraocular lens implantation was the first choice for patients with lens dislocation range less than 90°. Phacoemulsification, capsular tension ring implantation combined with intraocular lens implantation was recommended for 90° - 180°, and lens excision and anterior vitrectomy through corneal incision combined with intraocular lens implantation with suture fixation was more suitable for lens dislocation range more than 180°. The appropriate operative methods for different types of CEL patients is the key to success.

Objectives: Patients with schizophrenia are more likely to die prematurely than the general population. They have a higher risk of cardiovascular related morbidity and mortality. Antipsychotic medications are also known to be associated with the prolongation of the rate-corrected QT (QTc) interval, which is linked to dangerous arrhythmias. The primary objective of our study is to investigate the practice of electrocardiogram (ECG) monitoring for patients with schizophrenia who were hospitalised. The secondary objective is to evaluate the prevalence of QTc prolongation in this group of patients. Methods: We included patients with schizophrenia who were discharged from the acute general adult psychiatric wards of the Institute of Mental Health in Singapore from 1 July 2014 to 21 July 2014. A retrospective analysis of the medical records was carried out to assess if they had received ECG during their hospitalisation. We also analysed their risk of developing QTc prolongation. Results: We had a sample size of 107 patients. There were 31 patients (29·0%) who received ECG during their hospitalisation. Of the 95 patients who had moderate-to-high risk of developing QTc prolongation, 29 of them received ECG. Of the 31 patients who received ECG, 10 of them (32·3%) had QTc prolongation. Conclusion: The ECG monitoring in the study patients was inadequate, and as a result, we were unable to evaluate the prevalence of prolonged QTc interval with confidence. We recommend performing baseline ECGs for these patients and conducting ECG teachings for clinicians who work in the psychiatric service settings. ASEAN Journal of Psychiatry, Vol. 17 (2): July – December 2016: XX XX.

Objective To comparison of the quality of life in children with migraine and quality of life in children with primary epilepsy(EP)or Tourette's syndrome(TS).Methods There were 239 children with moderate migraine,the time of which lasted from 6 to 36(12.14?4.67)months,headache index 4-20(9.98?3.74).There were 250 cases and 424 cases with EP or TS,respectively,both team members were under good control with single drug therapy,the diagnosed according to the international classification of headache disorders-Ⅱ.The pediatric quality of life inventory,version 4.0,age 8-12 years,and child report forms were used to evaluate the quality of life in children with migraine and the other two kinds of samples by Bonferroni and Mann-Whitney tests.Results The scores of quality of life in children with moderate migraine were lower than those in children with EP(total score 69.06?10.48 vs 81.26?13.80;physical function scores 67.43?14.37 vs 83.14?14.70;psychological function scores 69.92?10.56 vs 80.26?14.32;emotional function scores 66.76?14.09 vs 80.90?18.93;social function scores 76.81?14.67 vs 83.36?17.40;school function scores 66.20?13.62 vs 76.52?13.80).The scores of quality of life in children with moderate migraine were lower than those in children with TS(total scores 69.06?10.48 vs 79.18?11.45;physical function scores 67.43?14.37 vs 81.52?12.61;psychological function scores 69.92?10.56 vs 77.90?12.28;emotional function scores 66.76?14.69 vs 74.07?16.34;social function scores 76.81?14.07 vs 89.06?16.23;school function scores 66.20?13.62 vs 70.35?16.96).Two sets of data between children with moderate migraine and those with EP,TS showed statistical significance(Pa

Objective To evaluate the efficacy,adverse events of gemcitabine vs.5-FU with radiotherapy for locally advanced pancreatic carcinomas.Methods Between January 2007 and January 2011,a total of 56 patients with locally advanced pancreatic carcinomas was included and clinical data were retrospectively analyzed.All patients received 3-DCRT radiotherapy with individual dose of 1.8 ～ 2 Gy,5 times per week,and total dose of 45 ～ 50.4 Gy for 25 ～ 28 fractions,and received concurrent chemotherapy (5-FU or gemcitabine).The patients (n =30) in gemcitabine group were treated with gemcitabine (500 rng/m2 at the 1st,8th,15th,22nd day,at 10 mg · (m2)-1 · min-1,through micro-pump) during radiotherapy; 3 weeks after radiotherapy the patients received gemcitabine infusion at a dose of 800 mg · (m2)-1 · d-1,one time per week,for 3 or 4 cycles.The patients (n =26) in 5-FU group were treated with 5-FU (500 mg/m2 at the 1 ～ 5th day per week,IV),the cycle was repeated every 2 weeks during radiotherapy; 3 weeks later the patients received 5-FU infusion at a dose of 800 mg · (m2)-1 · d-1,the 1st ～5th day per week,the cycle was repeated every 2 weeks ; with a total of 3 or 4 cycles.The efficacy and adverse events were observed,and the patients were followed until June 2013,and the median survival,1 year and 2 year survival was calculated.Results Of the 56 patients,the overall response (CR + PR) rate was 73.2％,and it was 65.3％ in radiotherapy with 5-FU group,80.0％ in radiotherapy with gemcitabine group (P ＜ 0.05).The overall one and two year survival rate was 48.2％ and 14.3％,while median survival was 15.2 months,and the corresponding values were 42.3％,11.5％,13.3 months in radiotherapy with 5-FU group,and 53.3％,16.7％,16.6 months in radiotherapy with gemcitabine group,and the survival difference between the two groups was not statistically significant (P =0.071).At the end of treatment,the pain-relief rate (VAS score ＜4) of the 56 patients was 83.3％,it was 75.0％ in 5-FU group and 90.0％ in gemcitabine group.In radiotherapy with gemcitabine group,the incidence of 3～ 4 grade myelosuppression was significantly higher than that in radiotherapy with 5-FU group,and the difference between the two groups was statistically significant (20.0％ vs 7.6％,P ＜ 0.05).Conclusions For the locally advanced pancreatic carcinomas,radiotherapy with gemcitabine can improve pain-relief and prolong survival compared with radiotherapy with 5-FU,but the incidence of adverse event of myelosuppression is higher.

Objective To explore the clinical characteristics and diagnostic criteria of migraine in children.Methods The migraine cli-nical characteristics of patients that consistent with the chronic headache diagnostic criteria, excluding other diseases,were analyzed.ICHD-Ⅱ childhood migraine diagnostic criteria was used as gold standard to explore the migraine diagnostic criteria in children.Results 1.In 346 patients, 157 fitted ICHD-Ⅱchildhood migraine diagnostic criteria.2.Type of migraine: probable migraine was the most common(68.8%), the most commonly unfulfilled criterion was associated gastroenteritis symptoms; migraine without aura was the second (19.7%).3.The migraine diagnostic criteria: the most important single-variable was headache associated symptoms,with sensitivity of 70.7%,specificity of 83.6%,the positive predictive value(PPV) was 78.2%,positive likelihood ratio (PLR) was 4.31 and area under curve(AUC) was 0.771.The most important three-variables was headache duration of 1-72 hours, moderate-severe headache and headache associated symptoms, with the sensitivity of 52.2%,specificity of 96.2%,the PPV was 90.1%, the PLR was 13.7 and the AUC was 0. 657.Conclusions The most important single-variable is headache associated symptoms,the most important three-variables are headache duration 1-72 hours, moderate-severe headache and headache associated symptoms.

Objective To explore the value of axillary MRI in differential diagnosis of metastatic axillary lymph nodes in patients with breast cancer.Methods Axillary MRI was performed in 44 breast cancer patients proved by pathology.Long axis,short axis,cortex thickness,ADC value,hilus,margin,perifocal fat gap,signal intensity on DWI,enhancement pattern and time-signal intensity curve were analyzed.The diagnostic ability of long axis,short axis,cortex thickness and ADC value were analyzed with ROC curves.Results Twenty-four patients (24/44,54.55 ％) were proved with metastases axillary lymph nodes,the other 20 patients (20/44,45.45％) were negative.Long axis,short axis,cortex thickness,ADC value,hilus absence,irregular margin,fuzzy perifocal fat gap,high signal intensity on DWI and heterogeneous enhancement showed statistically significant between patients with metastatic and without metastatic axillary lymph nodes (all P＜0.05).The area under ROC curve of long axis,short axis,cortex thickness and ADC value were 0.797,0.765,0.848,0.749 respectively.Conclusion MRI plays an important role in differential diagnosis of axillary lymph nodes me tastasis.The cortex thickness larger than 0.54 cm can help to predict metastatic axillary lymph nodes.