Objective To measure the extent of malrotation of femur fractures with CT scan after fixation with interlocking intramedullary nailing , and to discuss the methods which can help to correct the malrotation of femur fracture during the operation. MethodWith CT scan, the anteversion of femur fracture after the close reduction and fixation with interlocking intramedullary nailing in 56 cases was measured, and the difference of anteversion between the fracture side and the contralateral side was evaluated. The increase of anteversion represented internal rotation of the distal fragment, whereas the decrease of anteversion meaned external rotation. According to AO classification system, the type A of infratrochanteric fractures happened in 9 cases, type A of femoral shaft fractures happened in 12 cases, type B in 15 cases,type C in 7 cases,and 13 cases of femoral supercondyle fractures were type A. ResultThe results of measurement showed that the femoral anteversion after fixation with interlocking intramedullary nailing was changed in all patients. The anteversion of the femoral shaft fracture ranged from 13.35?to 47.21?. The aneversion of infrotrochanteric fractures ranged from -7.12?to 36.35?, and the supercondyle fracture of femur from -11.10?to 39.22?. For the extent of malrotation of distal femoral fracture, the internal rotation was more obvious than the external rotation. The number of Internal rotation cases accounted for 60.71%, and the external cases accounted for 39.29%. The maximum internal malrotation happened in femoral shaft fracture, from 1.37?to 29.82?with average malrotation 12.34?. and the minimum internal malrotation happened in infratrochanteri fracture, from 0.81?to 23.21?,with the average malrotation 8.32?. The medium internal malrotation was femoral supercondyle fracture, from 1.72?to 27.11? with the average malrotation 8.38?. The maximum external malrotation happened in femoral shaft fracture, from 1.11?to 21.12?with the average of them 9.33?. The minimum external malrotation happened in infratrochanteri fracture, from 1.31?to 16.23?with the average 7.71?. The medium external malrotation was seen in femoral supercondyle fracture, from 0.97?to 17.96?with average 8.22?. For these three parts of femoral fracture, the partnership T test was done between the fracture side and the contralateral side, the results showed that there were significant differences among of them,P

[Objective] To compose carbonated hydroxyapatite cement with chemica l materials,and by adding the pore agent to develop a new bone substitute,which can be solidified in situ to form porous carbonated hydroxyapatite.[Method](1)A new type of carbonated hydroxyapatite cement(CHC)was prepared.The powder of cement was composed of calcium carbonate,tricalcium phosphate and calcium phosphate dibasic.The liquids were prepared by 0.2mol/L sodium phosphate buffer,solide phase to liquid phase was 1g to 0.4 ml;(2)To prepare an in situ setting porous carbonated hydroxyapatite cement,add the pore agent into the powder of cement,pore generate CO2 during situ setting of cement;(3)The chemcial composition,chemcial constitution mechanical property,setting time,interval porosity of the PCHA were tested.and then the physio-chemical character,manipulatity,histocompatibility were evaluated.[Result]Addition of pore agent could succeed to prepare a new bone substitute which could set in situ and transform into porous carbonated hydroxyapatite.The setting time was 13~15 minutes which was suitable to clinical application.The pore size and porosity character could be controlled by adjustment of the component.The checking results demonstrated that the self-setting composition of this cement was carbonated hydroxyapatite which was similar with the mineral phase of natural cancellous bone,the carbonic acid radical was 5.6% in the solidify production.Contain of the porosity was 36% with interconnect pore,the compressive strength was 5.6?2.2 MPa which was equal to strength of cancellous bone,and the cytotoxicity tests showed an exellent biocompatibility.[Conclusion]The porous carbonated hydroxyapatite cement is a good bone substitute which seems to be the cancellous bone with good porosities,exellent biocompatibility.

[Objective]To treat the femoral neck fracture using cannulated screw and BMP release system in animals,and to evaluate the possibility of treating femoral neck fracture and provide experimental basis for clinical application.[Method]Eighteen mongeral were used in this study.The model of bilateral femoral neck dislocation fracture was established.The control side was fixed using cannulated screw,and the experiment side was fixed with cannulated screw and injectable BMP release system.At 4,8,12 weeks,6 animals were sacrificed at one time point respectively.Results were obtained through histology,radiography,scintimetry and gross observation.[Result]The fracture line was vague at four weeks,and at eight weeks the fracture line almost disappeared.It was healed completely at twelve weeks.Radiological study showed that the healing of the fracture in experimental side was better than that of the control side.There was the same result of observation in histology.[Conclusion]The cannulated screw combined with BMP used in the experiment is effective and feasible.It may not only provide strong internal fixation but also infuse growth factor into site of fracture.It would accelerate the reconstructing of the vascular supply to the femoral head after the fracture and promote the restoration of bone.

Objective Hepatitis C virus patients are often accompanied by insulin resistance and diabetes.To probe the relative factors of abnormal glycometabolism in chronic HCV infections.Methods A total of 1 039 treatment-naive patients that were confirmed chronic HCV infected were enrolled in the study.The demographics,biochemical index parameters and other data about liver function and HCV viral load were got from infectious disease department of Jurong Pepole's Hospital in China.Results A total of 140 (13.5％) patients were diagnosed with some forms of abnormal glycometabolism.The body mass index (BMI) (x2 =9.231,P =0.010),waist circumference (x2 =7.984,P =0.018),systolic blood pressure (x2 =16.366,P ＜0.001),diastolic blood pressure (x2 =13.970,P =0.001),alanine aminotransferase(ALT) (x2 =4.809,P =0.028),HCV-RNA viral load (t =-3.818,P ＜0.001) were significantly different between non-diabetic HCV patients and abnormal glycometabolism patients.Multivariate logistic regression analysis showed that ALT(OR =2.986,95％ CI:1.171-7.615) and HCV-RNA viral load (OR =2.061,95％ CI:1.165-3.644) were found as risk factors in multivariate regression analysis for patients with chronic hepatitis C who had abnormal glucose metabolism.Conclusions Chronic hepatitis C patients with higher ALT and HCV-RNA level were more probably to suffer from abnormal glycometabolism.In order to find potentially novel risk factors of HCV with abnormal glucose metabolisn,further studies about genetic and other clinical factors need to be processed.

Objective To analyze the correlation between subjective symptoms and function of nasal ventila-tion in nonallergic rhinitis with eosinophilia syndrome ( NARES) ,in order to provide the basis for the clinical diagno-sis.Methods 44 patients with NARES were selected as the NARES group ,and 50 healthy people were selected as the control group at the same time .The total nasal resistance ( TNR ) , MCA of the two groups were compared , and Pearson or Spearman correlation was used to analyze the subjective symptoms and objective test indexes in patients with NARES.Results Before contraction,the TNR values of NARES group in 75Pa and 150Pa were higher than those of the control group (Mann-Whiteny Z=7.365,8.125,all P<0.05).After contraction,the differences of TNR values in 75Pa and 150Pa,MCA,the correlation analysis in 8 subjective symptoms and 7 objective index of NARES had no statistically significant differences between the two groups ( all P >0.05).Conclusion The correlation between subjective symptoms and function of nasal ventilation in NARES patients is not obvious .Clinical diagnosis should be comprehensive ,in case of missed diagnosis and misdiagnosis .

Objective To establish a new multiplex-PCR assay to improve the detection rate of mutations in the DMD gene in Chinese patients. Methods A retrospective review of DMD deletion spectrum of 355 DMD patients with deletions all over the gene was performed. All deletions were confirmed by " one-step approach" diagnostic procedure and MLPA analysis. The exons with high frequency of mutations were identified to constitute the amplification system and the PCR conditions were optimized. Results Two new multiplex-PCR assays were established. Assay one was used to detect 10 exons including exon 5, 8, 17, 44, 45, 47, 49, 50, 51 and 52 of DMD gene, in two PCR sets. The theoretical detection rate would be 92% (326/355). Assay two was used to detect 5 exons including exon 12, 19, 35, 43 and 54, which could be used to screen additional 5% (17/355) deletion cases. The method was validated in other 22 DMD patients. Multiplex-PCR results were completely identical to the MLPA results in all 22 DMD patients. Conclusions The two multiplex-PCR assays were established based on the analysis of 355 Chinese DMD patients with gene deletions. It is believed that the new approach would be more applicable for deletion detection on the Chinese DMD patients since the DMD cases involved were from the whole country.

BACKGROUND:Clinical effects and the recovery of hip function after total hip arthroplasty via different approaches are quite different.
OBJECTIVE:To observe total hip arthroplasty through lateral approach and posterolateral approach, and to evaluate the difference in hip function during 2-year fol ow-up.
METHODS:Total y 93 patients who treated with total hip arthroplasty from March 2009 to March 2012 in the Department of Orthopedics, Yangjiang Municipal Traditional Chinese Medicine Hospital were enrol ed in this study. They were randomly divided into lateral approach group (45 cases, 60 hips) and posterolateral approach group (48 cases, 60 hips).
RESULTS AND CONCLUSION:Al patients were fol owed up for averagely 2 years. No significant difference in operation time, postoperative complications, and the recovery of hip function in the middle and late phases of replacement was visible (P>0.05). However, perioperative blood loss, operative length, blood transfusion rate, postoperative hemoglobin levels, and early postoperative hip joint functional recovery were better in the posterolateral approach group than in the lateral approach group (P<0.05). In the 2 years after replacement, no significant difference in therapeutic effects was detectable between the two groups (P>0.05). Moreover, no significant difference in the incidence of adverse reactions was visible such as postoperative infection, dislocation, loosening, bone cement reaction, intraoperative fractures of proximal end of the femur and venous thromboembolism between lateral approach and posterolateral approach groups (P>0.05). Results indicated that posterolateral approach in total hip arthroplasty is helpful to early recovery, but long-term effects are similar to lateral approach.

Objective To analyze the prevalent feature and variant tendency of Scrub Typhus in Guangdong Province from 2006 to 2012, and provide a basis of strategy and measure on prevention and protection of Scrub Typhus. Methods Clinical information of all individual cases was gained from China Information System for Disease Control and Prevention. Cochran-Armitage trend χ2 test was used to describe the variance of Scrub Typhus incidence and the clinical cases of 2013 were predicted by autoregressive integrated moving average (ARIMA) model, while descriptive epidemiological analysis was adopted to describe the endemic distribution, seasonal characteristics and population distribution of Scrub Typhus. Results A total of 8 163 Scrub typhus cases were reported in Guangdong Province from 2006 to 2012. Annual mean incidence of the disease was 1.15/100 000 with the incidence showing an upward tendency (χ2 = 3 191.976, P < 0.01). There were 14 dead clinical cases reported with a fatality rate to be 1.72‰(14/8 163). Totally 3 166 people were predicted to infect Scrub Typhus in 2013 by ARIMA model. The disease was prevalent from the end of May to early October and the peak time was in late August (Z = 2 303.71, P < 0.01). The top five cities developed Scrub Typhus were Zhaoqing, Guangzhou, Yunfu, Shaoguan and Qingyuan. Male-female ratio was 1.00 ∶ 1.08 in all reported cases in which 52.78%(4 309/8 163) of them aged from 40 to 65 years old and 59.30%(4 841/8 163) of them were farmers. Conclusions The incidence of Scrub Typhus is rising in Guangdong Province, with the prevalent peak in summer and autumn, and rural populations are at high risk. The most effective preventions are strengthening health education , enhancing individual protection and protecting key populations in special districts.

OBJECTIVE To know the present situation of management of endoscope disinfection in order to improve the disinfection quality.METHODS A questionnaire and on-spot-survey were sent to 8 hospitals equipped with endoscope.RESULTS Eight different grade hospitals had a system of endoscope management established and integrated into their quantity management system.One hospital had isolated cleaning and sterilizing rooms,of which 3 hospitals were well ventilated;6 hospitals had special storage cabinets for endoscope,for endoscope as well as cleaning and sterilizing troughs.All of the hospitals used multienzymes and timers when doing cleaning.CONCLUSIONS There are some problems in the present situation.The way of management monitoring and occupational protection must be further improved to reduce the nosocomial infection.

Objective:To explore the relation among depression, anxiety, coping styles and personality in patients with major depression.Method:88 patients with major depression were assessed on admission. The assessments included Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale(SAS),Eysenck Personality Questionnaire and Coping Styles Questionnaire. Nighty normal controls were assessed with the same instruments too.Results:The patients were found having higher scores in Neuroticism and Psychoticism, and lower scores in Extroversion and positive coping styles than normal controls.Higher scores in SDS, SAS, Neuroticism, and Psychoticism, and lower scores in positive coping styles, were found in the patients with anxiety. Significant relationship was found among depression, SAS, Extroversion, and positive coping styles.The last three accounted for 52.0% of the variance of depression.Conclusion:The patients with major depression have high scores in Neuroticism and Psychoticism, and low in Extroversion and positive coping styles.Those with anxiety scored even higher in SDS, SAS, Neuroticism, and Psychoticism, and lower in positive coping styles.The application of little positwe coping styles moy be a part of Extrovision in major depresion.