[Objective]To evaluate the reliability of proximal femoral nail anti-rotation(PFNA) in treatment of intertrochanteric fracture using K-wire apex distance(KAD) intraoperatively to control tip apex distance(TAD).[Method]From January 2007 to January 2009,44 cases of intertrochanteric fractures were treated by closed reduction internal fixation with PFNA.Intra-operative KAD and post-operative TAD were measured and analyzed for their correlation.[Result]Follow-up was given to 42 patients for 6-18 months(averaged,10 months).Bone union was achieved after 11-23 weeks(averaged,13 weeks).Intra-operative KAD were 13-31 mm,with an average of 21.75 mm.Post-operative TAD were 18-35 mm,with an average of 24.61 mm.Recurrence of cerebral infarction was found in 1 case.No infection,deep vein thrombosis,intramedullary nailing rupture,screw broken or femoral fracture was found.[Conclusion]With the help of intra-operative fluoroscopy,the distance from the end of Kirschner's wire to joint surface(KAD) plays an important role in controlling TAD,and it could prevent relative complications such as helical blade cutting-out of femoral head.

Objective To study the clinical characteristics and effects of surgical treatment of children with thalamic tumors.Methods The clinical data of 22 cases were retrospectively studied and followed-up 6 months to 9 years.Results There were 13 boys and 9 girls,their ages ranging from 3 to 13 years.The average duration of symptoms before diagnosis about 2 months.Headache and papilledem were the most symptoms and signs,respectively.Most children′s thalamic tumors were low grade tumors with clear verge.In this group,good results were obtained that total remove 9 cases,subtotal remove 8 cases,partial remove 3 cases,biopsy 2 cases and no surgical death.Conclusions Clinical character of children thalamic tumors is distinct and good surgical results in the nearly future.The long results are determined by type of pathology.

Objective: To develop the Chinese version of the Neuropsychiatric Inventory Questionnaire (NPI-Q) and evaluate its reliability and validity. Methods: Three investigators assessed 10 dementia cases together with the NPI-Q to evaluate the inter-rater reliability. Eighty-six dementia cases and 30 healthy controls were assessed with the Behavioral Pathology in Alzheimer's Disease (BEHAVE-AD), the Brief Psychiatric Rating Scale (BPRS) and NPI-Q to evaluate the criterion validity. A subgroup of 30 dementia cases was tested with the NPI-Q again 24 h later to evaluate the test-retest reliability. Results: (1) Internal consistency. Cronbach's a coefficient of the severity subscale was 0.589, mean inter-item correlation coefficient of the severity subscale was 0.107. Cronbach's α coeffi-cient of the distress subscale was 0.612, and the mean inter-item correlation coefficient of the distress subscale was 0.114. (2) Inter-rater reliability. Intraclass correlation coefficient (ICC) of the severity subscale was 0.97, and ICC of the distress subscale was 0.94. (3) Test-retest reliability. The test-retest correlation coefficient of the severi-ty subscale was 0.89, and the test-retest correlation coefficient of the distress subscale was 0.86. (4) Criterion va-lidity. The severity subscale total score was correlated significantly with BEHAVE-AD (r=0.70, P <0.001) and BPRS(r=0.40, P<0.001) total score; the distress subscale total score was correlated significantly with the global ratings in part 2 of BEHAVE-AD (r=0.76, P<0.001) . (5) The severity subscale total score in demen-tia group was significantly higher than that in control group (median: 10 vs.1.5, P <0.001). The distress sub-scale total score in dementia group was significantly higher than that in control group (median: 10 vs 0; P< 0.001) . (6) Exploratory factor analysis identified 4 common factors, including psychosis, abnormal behavior,discontrol and affective symptoms, which explained 58.3% of total variance. All of the items loaded were between 0.596 and 0.803 on their conrresponding factor. Conclusion: The reliability and validity of the Chinese version of NPI-Q meet the psychometrics properties, and deserves to conduct further study in larger samples.

Objective To explore the correlation of epicardial adipose tissue (EAT) volume with atrial fibrillation (AF) and its recurrence after radiofrequency ablation (RA).Methods Eighty-five AF patients (AF group) and 90 non-AF patients (control group) were chosen between January 2014 and May 2016.Their EAT volumes were measured by CT scanning.Patients in AF group after RA were followed up 6-18 months,and the recurrence of AF was recorded.The recurrence of AF within 3 months of RA was defined as blanking recurrence group (n =27) and non-blanking recurrence group (n =58),and that after 3 months of RA was defined as the 1 ong-term recurrence.Results The total EAT volume and left atrial EAT volume were significantly larger in blanking recurrence group than in non-blanking recurrence group [(118.71 ±28.94) cn3 vs (97.73 ±24.86)cm3,(29.98 ±8.09)cm3 vs (23.11 ±8.30)cm3,t =6.219,4.451,P ＜ 0.01].Multivariate logistic resgression analysis showed that total EAT volume and left atrial EAT volume were the independent risk factors for AF.All showed that total EAT volume and left atrial EAT volume were the independent risk factors for blanking recurrence.The incidence of long-term recurrence was significantly higher in blanking recurrence group [40.7％ (11/27)] than in non-blanking recurrence group [15.5 ％ (9/58)] (x2 =7.142,P ＜ 0.05).Conclusions The incidence of AF is higher in patients with a Iarger total EAT volume and a larger left atrial EAT volume and AF is easier to recur even though after RA.

Positron emission tomography-computed tomography (PET-CT) with both anatomic and functional information is now widely utilized for most lymphoma subtypes,among which,the pretreatment staging and response assessment of PET-CT in Hodgkin lymphoma (HL) and diffuse large B-cell lymphoma (DLBCL)have been well documented.Multiple clinical trials are ongoing using PET-CT for therapy monitoring.Additionally,factors interpreting interim PET (PET-i) like visual analysis using Deauville 5-PS,metabolic tumor volume at baseline (MTV0),and △ SUVmaxPET0-i show different prognostic values.However,the management of PET-CT in lymphoma is still elusive,further trials remain to be done to get evidences for the use of PET-CT in guiding therapeutic decisions.

Objective To study infection status of hepatitis C virus(HCV)in patients at a tertiary first-class hos-pital in Hubei Province.Methods Detection results of HCV-IgG in hospitalized patients with non-digestive system diseases and patients in infectious diseases department between May 2012 and April 2014 were collected,HCV in-fection rates in patients of different genders and age groups were analyzed statistically.Results A total of 104 487 patients were conducted HCV detection,1 619 (1 .55%)were positive for HCV;HCV infection rates in male and female patients were 1 .56% and 1 .54% respectively,HCV infection rate was not significantly different between different genders,and different age groups(both P >0.05 ).Conclusion Positive rate of HCV in this study is lower than average national level,prevention and control of healthcare-associated infection caused by HCV should be intensified.

Objective To study the relation of epicardial adipose tissue (EAT) thickness with 1eftventricular remodeling and dysfunction in dilated cardiomyopathy (DCM) patients.Methods One hundred and twenty DCM patients who received treatment from Febuary 2012 to February 2016 were served as DCM group,and 76 healthy subjects undergoing physical examination were served as control group.Their left ventricular end-diastolic diameter (LVEDD),left ventricular end systolic diameter (LVESD),left ventricular end diastolic volume (LVESV),left ventricular end systolic volume (LVEDV),left ventricular end diastolic volume index (LVEDVI),left ventricular end systolic volume index (LVESVI),sphericity index (SI),leftventricular ejection fraction (LVEF),and EAT thickness were measured by routine cardiac ultrasonography and compared between two groups.Results The levels of LVESD,LVEDD,LVESV,LVEDV,LVESVI,LVEDVI and EAT thickness in DCM group were significantly higher,and the levels of LVEF,SIS and SID in DCM group were significantly lower (P＜0.05).The EAT thickness in DCM group with NYHA class Ⅱ,Ⅲ,Ⅳ was (8.1 ± 1.8),(7.8 ± 2.0),(7.9 ± 1.7) mm,and there was significant difference (F=1.973,P＞ 0.05) Linear correlation analysis showed that the EAT thickness was positively related with the LVESD,LVEDD,LVESV,LVEDV,LVEDVI,LVESVI,SISand SID (r =0.247,0.231,0.256,0.267,0.293,0.281,0.261,0.237,P＜0.05).There was no relationship between EAT thickness and LVEF (r =0.132,P＞ 0.05).Logistic multifactor regression analysis showed that EAT thickness was an independent risk factor for left ventricular remodeling in DCM patients (OR =0.793,95％CI:0.431-1.734,P =0.039).Conclusions The EAT thickness is significantly related with the left ventricular remodeling and can be used as an independent risk factor for predicting left ventricular remodeling in DCM patients.

Objective To explore the related factors of early hematoma enlargement in patients with spontaneous intracerebral hemorrhage.Methods The clinical data of 142 patients with spontaneous intracerebral hemorrhage were analyzed.The first CT was performed within 6 h of onset and the second within 24 h of onset.Single factor analysis and multiple Logistic regression analysis were performed to determine the related factors of early hematoma enlargement.Results The incidence of early hematoma enlargement was 24.6％ (35/142).Multiple Logistic regression analysis revealed that the following four factors were independently associated with early hematoma enlargement:age (OR =1.069,P =0.003),systolic pressure (OR =1.865,P =0.026),sharp of hematoma (OR =2.712,P =0.028),using mannitol (OR =2.939,P =0.020).Location of hemorrhage and volume of hemorrhage were not associated with early hematoma enlargement (P ＞ 0.05).Conclusions Age,systolic pressure,sharp of hematoma and using mannitol are the important predictors of early hematoma enlargement with spontaneous intracerebral hemorrhage.In patients with older age,higher systolic pressure,irregularly shaped hematoma,close observation of hematoma enlargement should be made CT-scanning check.And the caution in the early use of dehydrating agent should be careful.

Objective To study the recent clinical efficacy of compound matrine injections combined with three-dimensional conformal intensity modulated radiotherapy in the treatment of locally advanced pancreatic cancer.Methods 48 cases of untreated locally advanced pancreatic cancer were randomly divided into treatment group (compound matrine injections combined with three-dimensional conformal intensity modulated radiotherapy) and control group (three-dimensional conformal intensity modulated radiationtherapy),there were 24 cases in each group.Three-dimensional conformal intensity modulated radiation therapy used 95 ％ isodose coverage PTV.Using 6 MV X-ray irradiation,2 Gy/day,5 times/week,the total radiation dose was 50 Gy/25 times/5 weeks to complete.Treatment group:one week before treatment infusion of compound matrine injections 20 ml/time,l/d,21-day was one cycle.Control group:simple intensity modulated radiotherapy.Results After treatment,the clinical benefit response rate of the treatment group was 87.5 ％ (21/24),the control group was 70.83 ％ (17/24),the difference was statistically significant (P =0.045).Term efficacy rate of the treatment group was 79.17 ％ (19/24),the control group was 50.00 ％ (12/24),the difference was statistically significant (P =0.035).Adverse reactions were hematologic toxicity,leukopenia occurred in the treatment group was 16.67 ％ (4/24),but the control group was 45.83 ％ (11/24),the difference was statistically significant (P =0.029).Conclusion The effects of compound matrine injections combined with three-dimensional conformal intensity modulated radiotherapy for locally advanced pancreatic cancer are good,they can relieve pain,improve short-term efficacy,reduc side effects,and improve the quality of life.

Chronic lymphocytic leukemia (CLL) is a kind of malignant B-cell chronic lymphoproliferative disorder with highly heterogeneous clinical courses. Due to the recent advances in immunology, cellular genetics and molecular biology, several prognostic markers based on genetic, phenotypic, and molecular biology characteristics of CLL cells have emerged in the past decade. This article reviews the reports from the 57th American Society of Hematology (ASH) annual meeting on the progress of the prognosis of CLL.