[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 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.

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.

Objective:To establish a mouse model with the main characteristics of asthma and to study the pathogenesis of its airway inflammation.Methods:Mice were given latex by the intraperitoneal sensitization/intranasal challenge.BALF histology were examined 24 hours following tracheal challenge;cytokines and serum total and specific IgE were examined in one month and the expression of IL-5?IFN-? were performed by ELISA ?RT-PCR.Results:After the latex challenge,in experimental group,the number of total BALF cells and the percentage of eosinophils elevated;the histological analysis showed the elevation of mucus production and goblet cell development within bronchial epithelium,spasm and constraction of bronchia ,marked peribronchial infiltration of eosinophils and lymphocytes; the elevation of total and specific IgE;reduction of IFN-? and increase of IL-5 in the BALF and lung.Conclusion:Latex sensitization and challenge can lead to airway eosinophilia,allergen-specific IgE induction and production of Th2 type cytokines, which were the main characteristics of asthma.

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.

Chronic lymphocytic leukemia (CLL), the most frequent form of leukemia in Western countries, is characterized by the clonal proliferation and accumulation of neoplastic B lymphocytes in the blood,bone marrow,lymph nodes and spleen.During the past decades,important advances have been made in the understanding of the biology,pathology,diagnosis and treatment of CLL.In the 53rd ASH annual meeting,lots of new discoveries about the biology, prognosis, and treatment of CLL were introduced which lead us to further understand CLL and may provide more or better treatments for CLL patients.

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.

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.