BACKGROUND:With more and more research available,there are different classification systems for intertrochanteric fracture,from Evans and Boyd-Griffin classification to Evans-Jensen and AO/OTA classification,all providing guidance for choosing an appropriate treatment scheme.OBJECTIVE:To review the advance in the treatment of senile unstable intertrochanteric fractures.METHODS:PubMed,Web of Science,WanFang and CNKI databases were searched with the keywords of intertrochanteric fracture,intramedullary nail,hip arthroplasty in English and Chinese,respectively.1 535 literatures were retrieved firstly,and finally 47 articles were included in accordance with the inclusion and exclusion criteria.RESULTS AND CONCLUSION:The therapy conception of intertrochanteric fractures has been changed from conservative traction to early surgical treatment.With the development of technology,the internal fixators have been improved continuously.Screw-plate system has been developed from Jewett plate,AO/ASIF plate to dynamic hip screw.Intramedullary nails such as Gamma,proximal femoral and proximal femoral antirotation nails have been successfully applied in clinic.Senile patients with unstable intertrochanteric fractures also obtain favorable prognosis through active internal fixation,but the high incidence of complications appears because of osteoporosis,osteogenesis deficiency and accompanied by degenerative hip diseases.Thereafter,hip arthroplasty is recommended to treat senile unstable intertrochanteric fractures so as to achieve rapid functional recovery,desired efficacy and low incidence of complications.However,it still remains controversial to choose internal fixation or hip arthroplasty.

Objective To explore the accuracy and feasibility of infrared computer navigation for femur,tibia tunnel positioning in arthroscopic anterior cruciate ligament (ACL) reconstruction.Methods Data of patients who had undergone ACL reconstruction using infrared computer navigation from January 2012 to June 2013 were retrospectively analyzed.There were 26 males and 9 females,with an average age of 26.8 years old.35 patients were with concomitant meniscal injury 21 cases,and 3 cases with medial collateral ligament injury.All patients were treated with gracilis and semitendinosus knit stitch as grafts,and bone ends were made with hydroxyapatite extrusion screws,door-shaped nails and porous plate.Results The mean follow-up time was 16 months.The rate of postoperative femoral tunnel site measurements was 63.8％±6.6％,and tibial tunnel site measurements was 45.7％±4.2％.1 patient appeared heterotopic ossification in tibia tracker pinhole 3 months after surgery,and the joint activities was normal.Lachman test:there were 1 case with Ⅱ degree,30 with Ⅲ degree,and 4 with Ⅳ degree before operation,and 33 with Ⅰ degree,1 with Ⅱ degree,1 with Ⅲ degree after operation.The KT-1000 test was from 6.47±0.75 mm preoperatively to 1.01±1.14 mm postoperatively.Preoperative knee laxity differences was more than 5 mm in 32 cases,3-5 mm in 3,and after operation they were 0-3 mm in 31,3-5 mm in 2,and less that 0 mm in 2 cases.Lysholm score and Tegner scores were from preoperative 52.74± 10.91 points and 4.64± 1.34 points to postoperative 93.97±4.13 and 6.56±0.81 points.ROM was from 85.6°± 11.2° to 118.3°±5.7°;33 cases were without flexion and extension limited; two cases had knee flexion,extension limitation less than 10°.After straight leg raising training and proprioception functional training for 6 months,the knee ROM returned to normal.Conclusion Infrared computer assisted navigation system for arthroscopic ACL reconstruction is to navigate through the use of anatomical landmarks and kinematic data,kinematic data by detecting and recording the knee,selected a secure tunnel site,viable surgical method,you can make femur,tibia tunnel position more accurately,good curative effect evaluation.

Data of 55 patients with duodenal mass lesions treated by endoscopic submucosal dissection (ESD) were retrospectively analyzed. Risk factors of delayed bleeding after ESD were explored by univariate analysis and multivariate unconditional logistic regression analysis. Duodenal delayed bleeding occurred in 5 patients (9.09%). No closure treatment under endoscopy( P=0.035) was significantly different between the delayed bleeding group and the non-delayed bleeding group. Multivariate non-conditional logistic regression showed no closure treatment under endoscopy was an independent risk factor for delayed bleeding after ESD in duodenal mass lesions ( P=0.029, OR=0.079, 95% CI: 0.008-0.776). Patients older than 60 years and who did not take endoscopic closure treatment have higher incidences of delayed bleeding after ESD. No closure treatment under endoscopy is directly related to postoperative delayed bleeding.

AIM:To compare the difference between diopter of refration measured after cycloplegic mydriasis with retinoscopy and hand-held autorefractor so as to explore the feasibility of using hand - held autorefractor for refraction screening in cadet candidates.
METHODS:Respectively using hand-held autorefractor and streak retinoscope to do optometry examination in 317 cadet candidates students ( 634 eyes ) after mydriasis. Main index of refraction values ( spherical, cylindrical mirror degree and axial) were analyzed by difference test and correlation analysis. And the elimination rate was comparatively analyzed.
RESULTS: Diopters of sphere and cyclic refraction measured by hand-held autorefration were significantly higher than those by retinoscopy ( P< 0. 05 ), but the correction analysis showed that there was high correlation (r=0. 733, 0. 694), axial of refration measured by these two methods were non - significant ( P > 0. 05 ). The disqualifying rate using autorefraction was much higher than that using retinoscopy. It was easy to be wrongly eliminated.
CONCLUSION:Because of the high correlation between diopters of autorefraction measured by retinascopy and autorefractor, autorefraction has application value in refraction screening in cadet candidates with normal vision.

This paper deals with the ultrastructure of the body wall of adult Pagumogonimus skrjabini by transmission electron microscopy. Infected crabs were collected from Siyen, Hubei Provine, and adult worms were obtained from the lungs of experimentally infected dogs 90 days post-infection.The normal structure of body wall of the P. skrjabini is composed of tegument, tegument cell, musele, muscle cell and protoplasmic tubules, all of which form together syncytium.The tegument contains external plasma membrane, tegument matrix and basal plasma membrane. The cell coat in fine granules is distributed over the whole external plasma membrane surface. The tegument matrix contains various secretory bodies, vesicles and mitochondria. The tegument cell is irregular in shape. Golgi complex, ribosome, autoly-sosome are seen in the cytoplasm. There are two layers of muscle, the external circular muscle and the inner longitudinal muscle layers. The nucleus of immature muscle cell has many heterochromatins, while the nucleus of mature muscle cell is large and round in shaps. Mitochondria and glyco-gen granules are transmitted from muscle cell proper to the muscle by protoplasmic tubules (Figs. 1-7).

Objective To comparison of clinical efficacy between mini-invasive transforminal lumbar interbody fusion(mis-TLIF) assisted by Quadrant system and open posterior lumbar interbody fusion (PLIF)treatment for lumber spondylolisthesis,to find a better treatment for lumbar spondylolisthesis.Methods A total of 65 cases who were under lumber spondylolisthesis were retrospectively selected from our hospital,26 cases in mini-invasive transforminal lumbar interbody fusion assisted by Quadrant system (mis-TLIF group).39 cases in open posterior lumbar interbody fusion(PLIF group).Record the incision length,intraoperative blood loss,opertive time,bed time,hospital time,pre-and post-operative visual analogue scale(VAS) and Oswestry disability index(ODI) score were recorded respectively.After surgery,the imaging(X-Ray) evalute the vertebral fusion status.Results There were no significant difference between mis-TLIF group and PLIF group in BMI [(22.77 ± 4.38) kg/m2 and (21.28 ± 5.24) kg/m2],preoperative VAS score [(6.46 ± 1.67) and (6.59 ± 1.56)],preoperative ODI score [(58.70 ± 7.19) ％ and (60.10 ± 9.56) ％] (all P ＞ 0.05).There were significant difference between two groups in incision length [(6.10 ± 0.95) cm and (11.12 ± 2.02) cm],intraoperative blood loss [(247.31 ± 36.72) ml and (340.51 ± 64.32) ml],opertive time[(179.96 ± 17.54) min and(151.85 ± 16.06) min],bed time[(3.62 ± 1.44) d and (4.98 ± 1.74) d],hospital time [(9.38 ± 2.60) d and (11.95 ± 3.61) d] (all P ＜ 0.05).Postoperatively VAS score was assesssd at 1 month [(3.15 ± 1.08]),3months [(1.58 ± 0.81)],6months [(1.08 ± 0.74)] and ODI score was(30.77 ± 6.45) ％,(25.54 ± 6.33) ％,(20.23 ± 7.05) ％,respectively in mis-TLIF group were lower than those of PLIF group (P ＜ 0.05).There were no significant difference between two groups in the fusion rate in 3 months,6 months after operation.Conclusion Mis-TLIF had a lot of advantages relative to PLIF in the treatment of lumber spondylolisthesis,be like less trauma,less bleeding,less hospital time,quick rehabilitation and good curative effect,provide a new minimally invasive method for lumber spondylolisthesis patient.

Objective To explore the echocardiography characteristics of non-compaction of ventricular myocardium(NVM),and assess its value in the diagnosis of NVM.Methods Philips SONOS 5500 color Doppler ultrasound system with 2-4 MHz transducers was used in 9 patients with NVM.Results In all 9 patients,the presence of multiple trabeculations and multiple deep intertrabecular Space communicating with the ventricular cavity was demonstrated by color Doppler imaging.Both ventricles were involved in 1 patient,only the left ventricle in 7 patients,and right ventricle in 1 patient.Conclusions NVM has typical ultrasonic appearance on echocardiography.It Can find out the NVM manifestations even if patients do not have any symptoms.It is a reliable and convenient way for diagnosing NVM.

Objective To explore the therapeutic effects of early short time venous-venous hemofiltration(SVVH) on severe acute pancreatitis(SAP) with acute lung injury(ALI).Methods Twenty-there patients with SAP and ALI were treated by routine project,and among them twelve patients accepted SVVH therapy.During the therapy,life sign、PaO2/FiO2 and APACHEII score were registered.Results Compared with control group,the clinical representation and organ function of SVVH group meliorated. PaO2/FiO2 were raised, APACHEII score and death risk were declined.Conclusions The early short time venous-venous hemofiltration(SVVH) on severe acute pancreatitis(SAP) with acute lung injury(ALI) could improve clinical symptom ,protect the organ dysfunction and decline the death risk.

Purpose:To compare the survival rates of hyperf ractionated radiotherapy plus concurrent chemotherapy with hyperfractionated rad iotherapy alone in the treatment of stage Ⅲ/Ⅳ nasopharyngeal carcinoma (NPC) a nd analyze the prognostic factors. Methods:Between December 1992 and December 1995, 144 NPC patien ts were randomized into hyperfractionated radiotherapy plus concurrent chemother apy (R +C) and hyperfractionated radiotherapy alone (R alone).Radiotherapy were similar in the two groups: 1.2 Gy/f, twice a day. Chemotherapy was given to R + C patients before and during the course of radiotherapy. Results:The 5-year overall survival rates of the R + C and R alone groups were 63.3% and 50.7%,repectively . The factors influencing the resu lts were N stage,chemotherapy and the peripheral blood hemoglobin concentration . Conclusions:Hyperfractionated radiotherapy plus concurrent chem otherapy can improve the survival rate, especially for the patients with N2-N3 stage.The negative prognostic factors for Ⅲ/Ⅳ NPC are N2-N3 stage, radiothera py alone and the reduction of hemoglobin during treatment.