[Objective] To compare anatomical dynamic hip lock plate with Gamma nail internal fixation in terms of the early intermediate clinical effect of the unstable intertrochanteric femoral fractures. [Methods]From January 2003 to August 2008, 69 patients with unstable intertrochanteric femoral fractures were fixed with plate (n=34)and Gamma nail(n=35).They were randomized into two treatment groups.A retrospective comparison was made between the two differet fixation devices in terms of operation time,blood loss,intraoperative and postoperative complications,frequency of exposure to X-ray,healing time of fracture and functional recovery of hip-joint.[Results]Comparing with Gamma nail,cases with anatomical dynamic hip lock plate experienced fewer X-ray during operation and had fewer postoperative complications,and the differences had statistical significance(P

Objective To compare the clinical effect of vascularized fibular flap transplantation and vancomycin sulfate calcium on chronic osteomyelitis of the tibia and bone defects.Methods A total of 35 cases with chronic tibial osteomyelitis and bone defect were involved and divided into group A with 21 cases receiving anastomosis of vascularized fibular flap transplantation and group B with 14 cases recciving vancomycin sulfate calcium.Infection control rate and Enneking score were compared in both groups.Simultaneous detection of two groups preoperative,postoperative 2 weeks,1 month and 3 months of the levels of CRP and PCT were conducted.Results Postoperative CRP and PCT were under control in both groups.No statistical significance was found in the comparison of CRP and PCT preoperative and postoperative 2 weeks,1 month and 3 months.In terms of infection control rate,two groups had no signiticant difference (P ＞ 0.05) and there was statistical significance of the comparison of postoperative Enneking score (P ＜ 0.05).Conclusions The clinical results of the two methods are satisfied.The infection degree and the length of the bone defect are decisive factors in choosing the treatment method and sometimes the combination of two treatment methods may be a better choice.

Objective To investigate the efficacy of zoledronic acid in the treatment of senile unstable femoral intertrochanteric fractures with anatomical locking plate. Methods 67 patients were randomly divided into two groups. Five days after the operation, group A received one intravenous injection of 5 mg zoledronic acid, while patients in group B did not receive the injection. The two groups were compared in terms of hospitalization time, complications, limb weight-bearing time, fracture healing time, hip function score after operation, preoperative and postoperative serum calcium and serum ALP, bone mineral density of proximal femur before operation and 1 year after operation. Results There were no statistically significant differences between the two groups in age, type of fracture, hospital stay, partial weight-bearing time, fracture healing time, hip function at 1 month and 1 year after operation, preoperative bone mineral density and blood calcium. But the differences were statistically different in hip function at 3 months after operation , averaged bone mineral density of proximal femur and serum ALP 1 year after operation. Moreover, 5 patients in group A developed muscle pain or fever after intravenous injection of zoledronic acid. Conclusion The locking plate combined with zoledronic acid injection in treatment of elderly patients with unstable femoral intertrochanteric fracture could inhibit bone loss, increase bone mineral density, and accelerate limb function recovery after operation. On the other hand, Zoledronic acid has a high incidence of adverse reaction.

Objective : To estimate the risk threshold of route index（RI）and mosq-ovitrap index（MOI）based on Breteau index（BI）,as supplements for dengue fever risk monitoring in specific habitats. Methods : Two towns and two streets were selected from nine towns（streets）in Jiashan County,and then one village（community）was selected from each of them as a Aedes albopictus monitoring site. The BI,RI and MOI were employed at the same time and area from April to October in the year 2018. Linear regression models were built with RI,MOI and BI to calculate the dengue risk threshold of RI and MOI according to BI. Results : The linear regression model of BI（X）and RI（Y）was Y=0.145+0.662X（P<0.05）,of BI（X）and MOI（Y）was Y=3.423+0.524X（P<0.05）. If BI=5（having risk of transmission of dengue fever）,then RI=3.455（95%CI：1.717-5.198）,MOI=6.043（95%CI：-0.327-12.417）. If BI=10（having risk of outbreak）,then RI=6.765（95%CI：5.018-8.518）,MOI=8.663（95%CI：2.260-15.071）. If BI=20（having risk of epidemic）,then RI=13.385（95%CI：11.326-15.453）,MOI=13.903（95%CI：6.352-21.461）. Conclusion The dengue fever risk threshold of RI estimated by BI had a narrow 95%CI and could be applied for dengue fever risk assessment,while the risk threshold of MOI had a wide 95%CI and the application value needed further study.

Objective To observe the effect of medical ozone on the expression of IL1R,CXCL-13 and IL24 gene in synovial membrane of osteoarthritis of knee joint. Methods Sixty-five cases of knee osteoarthritis including 11 lost-cases were selected ,and randomly divided into combination group and arthroscopy group with 27 cases in each group. After arthroscopic surgery ,combination group performed intra-articular injection of 40μg/mL concentration of medical ozone 40 mL/week for 2 weeks but arthroscopic surgery group had no ozone injection. Differences of the expression of IL1R I,CXCL13 and IL24 gene and protein in synovium were compared before and after the treatment in two groups by RT-PCR and Western blot. Results Expression of IL1R I gene and protein in synovium of combination group was significantly lower than that of arthroscopy group and it showed statistical significance(P<0.01). Expression of CXCL13 gene and IL24 gene and protein in synovium of combination group was higher than those of arthroscopy group and it had statistical significance (P < 0.05). Conclusions Medical ozone can reduce the symptoms of arthritis and slow synovitis progress through influencing the expression of IL1R, CXCL-13 and IL24 gene. The effect of ozone combined with arthroscopic is better than that of simple arthroscopic debridement,but cannot stop and reverse the progression of the disease completely.