[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 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.

Objective To understand the resistant characteristics of staphylococcusaureus and the relationship between eryth-romycin,clindamycin resistance phenotypes and its resistance mechanism.Methods 7 6 Saphylococcus aureus isolated from clinical specimens was identified and antimicrobial susceptibility tested by BD all-automatic microbiology analysis system.U-sing the D-test method to analyzed Erythromycin induced by clindamycin resistance.Genes (ermA,ermB,ermC and msrA) were detected by PCR methods.Results In 76 staphylococcus aureus straims gene ermA,ermB and ermC was found in 29 strains.The msrA gene was present in the 2 strains.The coincidence rate of ermA,ermB,ermC and msrA gene detection with erythromycin was 82.9%.The coincidence rate of ermA,ermB,ermC and msrA gene detection with chindamycin was 89.5%.Conclusion Clindamycin and erythromycin resistance of Staphylococcusaureus is related to the encoding of gene er-mA,ermB,ermC and msrA.

Objective To compare the effectiveness of supraclavicular brachial plexus block guided by ultrasound with that guided by nerve stimulator or anatomical landmarks. Methods One hundred and twenty ASA Ⅰ-Ⅲ patients (81 male, 39 female) aged 16-62 yrs weighing 40-75 kg scheduled for upper extremity operation under brachial plexus block via supraclavicular approach were randomized into 3 groups ( n = 40 each) : In group U block was guided by ultrasound; in group N nerve stimulator was used to locate the brachial plexus and in group T block was performed in the traditional way based on anatomical landmarks. A mixture of equal volumes of 0.75% ropivacaine and 2% lidocaine (0.4 ml?kg-1) was injected in the 3 groups. The onset and intensity of sensory block of musculocutaneous, median, radial and ulnar nerves were measured and analgesia was rated as excellent, effective and failure.Results The rate of satisfactory block of ulnar nerve was significantly lower than that of musculocutaneous and radial nerves in group N and T ( P

OBJECTIVE:To explore the effects of levothyroxine on the follicular helper T lymphocyte level of patients with Hashimoto's thyroiditis. METHODS:51 patients with Hashimoto's thyroiditis were selected as levothyroxine group,and another 30 healthy people were control group. Levothyroxine group was orally given 25-50 ug Levothyroxine sodium tablet,once a day,the dose was adjusted based on thyroid function,and the dose maintained when thyroid function turned normal,for continuous 90 d. Free triiodothyronine(FT3),free thyroxine(FT4),thyroid stimulating hormone(TSH)and the percentage of Th17 cells account-ed for peripheral blood CD4+ T cells(Th17/CD4+)in levothyroxine group before and after treatment were observed and compared with control group,the correlation of Th17/CD4+ and thyroid function. RESULTS:After treatment,Th17/CD4+ level in levothyrox-ine group were significantly lower than before and higher than control group,the differences were statistically significant(P<0.05). TSH in levothyroxine group were significantly lower than before,FT3 and FT4 were significantly higher than before,the differenc-es were statistically significant(P<0.05);compared with control group,the differences were not statistically significant(P>0.05). Th17/CD4+ showed positive correlation with thyroid function in levothyroxine group. CONCLUSIONS:Levothyroxine can signifi-cantly reduce the Th17/CD4+ and TSH,increase FT3 and FT4,and Th17/CD4+ is involved in the occurrence and progression of Hashimoto's thyroiditis.

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.

1. Microsurgical relationships of the arteries at the base of the brain and the trigeminal nerve were studied bilaterally on 30 brains. Twenty seven trigeminal nerves made contact with the arteries 33 times which represents 55 percent of the cases. Six of 27 trigeminal nerves had double contact.2. Of 33 arteries in contact with 27 nerves, seventeen involved the superior cerebellar arteries (SCA) (28.33?5.82%), seven the anterior inferior cerebellar arteries (AICA) (11.67?4.15%) and nine the middle inferior cerebellar arteries (MICA) (15.0?4.61%).3. The outer diameter of the superior cerebellar artery is the largest averaging 1.41?0.20 mm; the anterior inferior cerebellar artery comes next averaging 1.06?0.36 mm and the middle inferior cerebellar artery the smallest, averaging 0.62?0.14 mm.4. 27 trigeminal arteries arising from the upper or middle segement of the basal artery were found on the ventral surface of the trigeminal nerves in 17 brains, and 16 trigeminal branches arising from the AICA. MICA. and PICA were also found at the roots of 16 trigeminal nerves. Anastomoses were noted between the trigeminal arteries and the trigeminal branches in four cases of 16 trigeminal nerves.5. The association between the neurovascular contact and the trigeminal neuralgia are discussed. It is suggested that the neurovascular contact either from dorsal or ventral aspects may be the anatomical cause of the trigeminal neuralgia.6. The neurovascular contact of the trigeminal nerve with the SCA was usually on the dorsal or dorsalmedial aspect of the nerve, but the point of contact with AICA or MICA was mainly on the ventral aspect of the nerve. Besides, there are trigeminal arteries and trigeminal branches at the ventral surface of the nerve. All these topographic observations provide microsurgical information for neurosugeons.

Objective To study the relationship between infection and hypokalemic paralysis and its clinical features.Methods A systemic analysis was made on the infection courses,clinical manifestations, serum levels of potassium and creatine phosphokinase,the results of electrophysiological and virological examinations in present 34 patients and 115 cases reported in literature with hypokalemic paralysis.Results There were differences in the clinical manifestations and denominations among the present and reported cases. No definite evidences for virus infections were found among patients who were characterized by acute flaccid paralysis accompanied with hypokalemia in the infection curses. The prognosis of the disorder was better after the patients were given potassium, and most of them didn't recur.Conclusion No enough evidences showed that this disorder was an independent disease.It should be named as "concomitant infectious hypokalemic paralysis" appropriately. It was probably a syndrome accompanied by infection on the base of hereditary susceptibility.