[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.

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 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 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 action mechanism of Rukang oral liquid in rats with hyperplasia of mammary glands. Meth-ods:The rats were randomly divided into six groups:the normal group, the model group, tamoxifen group, low, medium and high dose of Rukang oral liquid groups. The model of hyperplasia of mammary glands was induced by estradiol benzoate injection and progester-one injection. After the administration, ELISA was used to detect the serum concentrations of ER, PR, P53 and Oct4, Western blot was used to detect the expression of ER, PR, P53 and Oct4 in breast tissue, a fluorescence quantitative PCR method was used to de-tect the expression of GnRH, GnRHR, and the expression of telomerase in breast tissue was detected by in situ hybridization. Results:Rukang oral liquid could reduce the expression of ER and PR in serum and breast tissue(P<0. 01), reduce the expression of P53, te-lomerase and Oct4(P<0. 01), and decrease the expression of GnRH in hypothalamus and pituitary, which could reverse the hyperpla-sia of mammary glands and played the role effectively(P<0. 01). Conclusion: Rukang oral Liquid can reduce the expression of ER and PR in serum and breast tissue, and decrease the expression of GnRH in hypothalamus and pituitary to play the role in the treatment of hyperplasia of mammary glands. Rukang oral Liquid may prevent breast hyperplasia from developing into breast cancer through re-ducing the expression of three related markers P53, telomerase and Oct4.

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.

This paper described the progress in therapeutics of drug dependence by opioids, involved in usages of opiate receptor agitations, non-opiate receptor agitations, non-drug treatment, and immunosuppressive therapy.

AIM: To explore the effects of Compound Yi-Zhi (YZC) on learning and memory capacity and free radical metabolism in D-galactose induced mice dementia model. METHODS: The mice dementia model was induced by a daily D-galactose 0.15 g?kg -1 sc for 45 d and after 5 d D-galactose injection, the mice were treated with three doses of YZC once a day for 40 d. In order to find out the influence of YZC on the models learning and memory capability and free radical metabolism system, Y-maze test was introduced for the former and superoxide dismutase (SOD) and malondialdehyde (MDA) tests for the latter. RESULTS: Compared with the D-galactose model group, three doses of YZC administration ( 0.108, 0.217, 0.433 g?kg -1) were all shown to significantly reduced the times of learning/memory in Y-maze test from 31.35? 8.97/ 17.12? 5.57 to 19.67? 8.07/ 11.27? 6.65, to 14.00? 6.84/ 8.29? 5.95, and to 11.41? 5.99/ 6.24? 4.97, respectively. For SOD, the administrations of 0.108 and 0.433 g?kg -1 YZC could increase the activity of SOD from 17.69? 3.14 to 26.94? 4.46, and to 21.33? 3.63 nU?mg -1 pro. While for MDA, all the three doses of YZC could decrease the level of MDA from 4.08? 0.88 to 2.82? 0.75, to 2.10? 0.42, and to 2.35? 0.39 nmol?mg -1 pro in the mice brain tissue, respectively. CONCLUSION: YZC can improve the D-galactose induced learning and memory dysfunction, and the action may be related to the improvement of antioxidase activity in the model mice brains.