Objective To evaluate the actual displacement of a femoral neck fracture following close reduction under the C-arm X-ray perspective.Methods From June, 2006 to June, 2009, we managed 12 patients with femoral neck fracture by open reduction and internal fixation.They were 8 males and 4 females, aged from 23 to 65 (average, 42.3) years old.We tried close reduction of their fractures under the C-arm X-ray perspective before a temporary fixation.Next we performed open reduction, readjusted the fracture ends, and placed internal fixation.The actual displacement of the fracture measured after open reduction was carefully compared with the close reduction under the X-ray perspective.Results A substantial displacement was found after open reduction in 7 patients who had achieved anatomic reduction under the X-ray perspective.In the other 5 patients who presented with a slight displacement after close reduction under X-ray perspective, the actual displacements were larger than the X-ray observations but completely reduced after open reduction.The actual measurements after open reduction were significantly larger (3.21 ± 0.96 mm on average) in the anteroposterior displacement ( t = 11.540, P = 0.000), but insignificantly larger (0.58 ±0.93 mm on average) in the superior-inferior displacement ( t = 2.184, P = 0.346) than those after close reduction.Conclusions In general, anatomic reduction can not be achieved for a femoral neck fracture under the C-arm X-ray perspective.Consequently, open reduction may be better than close reduction in the treatment of femoral neck fracture in that improper reduction can block blood supply to the femoral neck and dissection of the capsula articularis coxae can improve blood supply as well as help decompression.

Objective To evaluate the use of the kite flap (als o known as subcutaneous pedicled V-Y advancement flap)for the repair of moderate -sized anterior lamellar skin defects of eyelid. Methods Since 1994, kite flaps have been used to repair anterior lamellar skin defects of eyelids in 14 patients. Six patients were male and eight female, with a mean age of 43 years (range 15-64 years). The diameter of the largest defect reache d 1/3 length of the eyelid. The flaps were designed adjacent to the defects and the incision line corresponding to natural winkle lines on the eyelid. We underm ined the flap under the orbicular muscle, and advanced the flap to cover the def ect. The incisions were closed with 7-0 suture. Results After operation, all flaps survived with primary healing. Follow-up for 3 to 12 months showed that all cases had achieved satisfactory cosmetic effects without secondary deformity. Conclusions It is a simple, safe, an d reliable method to use kite flap for the repair of moderate-sized anterior la mellar eyelid skin defects that are too large to achieve primary approximation. Because kite-flap covers the defect through a direct advancement way without ro tation and twist, there are no dog-ear deformitys present at the pedical area a nd the repaired area looks smoothly. Because of its widely based muscle pedicle which incorporates venous and lymphatic drainage over most of its length, the un desirable pigment deposition is avoided.

Subglottic pleomorphic adenoma is a rare disease . Surgery is the main curative treatment. To review some clinical cases and to summarize the characteristics and treatment experience of this disease,it is expected that we can provide more clinical thought and therapeutic strategy for subglottic pleomorphic adenoma.
Adenoma, Pleomorphic ; therapy ; Humans ; Hypothermia, Induced ; Rare Diseases

Objective To understand tigecycline and commonly used anti-bacterial agents resistance in Gram-positive cocci and Acinetobacter baumannii .Methods 445 strains of Gram-positive cocci and 83 strains of Acinetobacter baumannii were collected . VITEK 2 Compact automated bacterial identification and susceptibility analysis system was employed to identify Gram-positive coc-ci and Acinetobacter baumannii and their bacterial sensitivities toward tigecycline and commonly used anti-bacterial agents were de-tected by broth microdilution method for antimicrobial susceptibility testing (MIC assay) and Kirby-Bauer disk diffusion susceptibil-ity test(K-B) ,respectively .Results 155(34 .8% ) strains of Staphylococcus aureus ,78(17 .5% ) Enterococcus feces ,56(12 .6% ) Staphylococcus haemolyticus ,45(10 .1% ) Staphylococcus epidermidis ,43(9 .7% ) Enterococcus faecalis ,18(4 .1% ) human Staphy-lococcus ,16(3 .6% ) Wolfowitz Staphylococcus ,8(1 .8% ) birds Enterococci and 26(5 .8% )other strains were found in 445 cases of Gram-positive cocci .The rate of penicillin-resistant Staphylococci was 92 .4% and the rates of Staphylococci′s resistance to eryth-romycin ,clindamycin ,oxacillin and ciprofloxacin were all over 50% .Enterococci ,which was sensitive to linezolid and tigecycline ,was resistant naturally to many drugs .The tigecycline sensitive rate ,intermediate rate and resistance rate acquired by MIC assay for multi-drug resistant and pan-resistant Acinetobacter baumannii were 57 .1% (47/83) ,42 .9% (36/83) and 0 .0% (0/83) ,respec-tively ,while those by K-B methods were 2 .4% (2/83) ,40 .5% (34/83) and 57 .1% (47/83) ,respectively .Conclusion Tigecycline showes good antibacterial activity toward Gram -positive cocci and Acinetobacter baumannii .

Age-related macular degeneration (AMD) has become a leading cause of irreversible visual loss in senior population with serious influence to their ability of living independently.Epidemiological researches have revealed various risk factors of AMD,some of which are not controllable such as age,heredity and race ;while others are modifiable such as lifestyle,eye conditions and other systemic diseases.However,the awareness of AMD risk factors is alarmingly low in public.Meanwhile,the understanding of AMD risk factors among ophthalmologists is also unsatisfactory.Therefore,the risk factors of AMD are reviewed here in order to improve the understanding of the ophthalmologists and better guide the clinical management of AMD.

Objective: To study the effect of laboratory menta l stress on serum levels of glucose and insulin Methods: 48 heal thy male college students were recruited Fasting serum glucose test and insuli n measurement were done before and after mental arithmetic test Result s: Glucose level increased after arithmetic test (434?079/477?0 70, t=381, p

Objective To evaluate the value of color Doppler flow imaging(CDFI) in the diagnosis of congenital coronary artery fistula (CAF).Methods Thirteen consecutive patients ranging in age from 8 to 68 years underwent conventional transthoracic echocardiography,which depicts their origin, course, and drainage site. Results Right CAFs were detected in 8 patients: four of them had drainages to the left ventricle, two to the main pulmonary artery, one to the right ventricle(RV) and the other to the right atrium(RA). CAFs arising from the left coronary artery were noted in five patients: three of them had drainages to the main pulmonary, and the other two to the RA and RV respectively. The origin and the course were precisely defined and the drainage site was clearly depicted in all thinteen patients. The diagnosis of the thirteen patients was confirmed by coronary angiography, and eight of them received surgical treatment. Conclusions CDFI offers a simple, useful and reliable technique in diagnosis of CAF.

Kinematical alignment during total knee arthroplasty is an emerging process, and draws more and more attentions from scholars. Knee joint is close to normal joint after TKA through kinematical alighment, which has good clinical results and functional scores, and not increase failure probility. Thus, it may increase joint stress of patella-femur joint, lead to patellar maltracking and increase abrasion. The paper summarized defination and basical principle, operative method, clinical outcomes and deficiency of kinematical alignment during total knee arthroplasty, in order to choose a better way for kinematical alignment during total knee arthroplasty.
Arthroplasty, Replacement, Knee ; methods ; Biomechanical Phenomena ; Humans

Objective To observe the effects of physical agents therapy on serum hs-CRP, TNF-α andadiponectin in patients with cerebral infarction and the possible underlying mechanisms. Methods Sixty patientswith cerebral infarction were randomly and equally divided into two groups: 30 cases were treated with physical a-gents therapy ( physical therapy group) , and 30 with drugs only ( drug treated group). Thirty normal subjectsserved as the control group. The level of hs-CRP in the serum was determined by latex agglutination reaction, TNF-and adiponectin were determined by using ELISA before and after therapy. Results The levels of serum hs-CRP and TNF-α of patients with cerebral infarction before therapy were much higher than those of the control group,but adiponectin was significantly lower than those of the control group( P < 0.01 ). After therapy, the levels of ser-um hs-CRP and TNF-α were decreased and adiponectin was increased significantly in both treated groups ( P <0.01 ). Comparison with two treated groups showed that the levels of hs-CRP and TNF-α were lower and adiponec-tin was obviously higher in physical agents therapy group than those in the drug treated group ( P < 0.05 ). Con-clusion The patients with cerebral infarction have low level of serum adiponectin. Physical therapy might exertbeneficial effects on patients with cerebral infarction by the decreasing serum hs-CRP and TNF-α, as well as by ele-vating adiponectin.