[Objective]To analyze the biomechanics of different positions of femoral head-and-neck nail in fixation of proximal femoral fracture.[Method]Stable and unstable fracture models were made from 24 fresh femur specimens,and fixed with r-nail and DHS.Head-and-neck nails were placed in different positions to test their mechanical properties of anti-compression,anti-bending,anti-shearing and anti-torsion,and compared with each other.[Result]Mechanical properties of the femoral strength,stiffness,stability and loading capacity were tested and compared.To the stable fracture group,head-and-neck nail should be placed in middle-lower and posterior 1/3 of femoral neck,which leads to the best loading capacity.To the unstable fracture group,it should be placed between femoral head and neck,which lead to strong obliquity mechanics and valuable for bone union.[Conclusion]Confirm of the best position of femoral head-and-neck nail could improve the effect of fixation and enhance the surgical treatment of proximal femoral fracture.

Objective To improve understanding of the clinical manifestations, diagnosis and treatment of childhood Kasabach-Merritt phenomenon (KMP). Methods The clinical data of 13 patients admitted for KMP to XXX from January 2010 to January 2016 was retrospectively analyzed, with a review of relevant literature. Results The patients were 10 males and 3 females. The age of presentation varied from newborn to 5 months. 12 patients had cutaneous manifestations, like petechiae, ecchymosis, jaundice, skin masses, etc, 1 patient had pleural effusion. The location of lesions varied. The laboratory hallmark consists of profound thrombocytopenia and hypofibrinogenemia with elevated D-dimers. The median time from initial presentation to diagnosis was 60 days. After approaches like surgery, corticosteroids, propranolol, interferon, sirolimus, etc, 10 patients got remission while 3 patients died. 6 patients treated with sirolimushad complete response. Conclusions KMP is characterized with vascular tumor, severe thrombocytopenia and consumptive coagulopathy. Clinically, KMP often presents with early-onset and delay in diagnosis. Surgery is an effective approach for KMP. Sirolimus appears to be a promising treatment for KMP.

Objective To evaluate the outcomes of children with stage Ⅳ malignant extracranial germ cell tumors. Methods Twenty-five patients were enrolled in the retrospective analysis. Event-free survival (EFS) and overall survival (OS) rates were estimated by Kaplan-Meier method with SPSS 13.0. Results Of the 25 children, there were 13 males and 12 females. The mean age at diagnosis was 2 years old (ranged 1 to 11). Five patients receiving chemotherapy in another hospital before (n=1), or giving up treatment after confirmed diagnosis (n=1), or giving up effective treatment after received less than 2 cycles (n=3) were excluded from this analysis. Of the 20 patients, 90.0% (18/20) achieved complete remission and 5.0% (1/20) achieved partial remission after treatment. The 5-year EFS rate and 5-year OS rate were 70.0%±10.2% and 82.4%±9.2% respectively. There was no death occurred due to complications. Conclusions The effect of this treatment program is positive. The cumulative dose of the drugs is not high, compared with other schemes such as PEB, but there are more drugs involved. Whether these drugs may cause long-term adverse reactions needs further research.

Taking the scope of outpatient special disease,the level of protection and the fixed-point management as the entry point.Under the"N+X"policy background,it reviewed the policies related to outpatient special diseases in 13 co-ordinated districts of Jiangsu Province to explore the similarities and differences and the existing problems,and provide relevant suggestions.Jiangsu Province has issued a guiding document to establish a unified outpatient special disease system,the differences in the scope of outpatient special disease and the medical insurance benefit level in the 13 cities should not be ignored.These differences may affect the fairness of patients and hinder the establishment of a unified outpatient special disease system in the province.In addition,there are still some problems in the selection of diseases,hierarchical medical,and disease identification.It is recommended to establish a dynamic selection mechanism for outpatient special diseases,to fully utilize the role of primary healthcare institutions in providing outpatient services for special diseases,and to develop objective and unified criteria for identifying outpatient special diseases.

Taking the scope of outpatient special disease,the level of protection and the fixed-point management as the entry point.Under the"N+X"policy background,it reviewed the policies related to outpatient special diseases in 13 co-ordinated districts of Jiangsu Province to explore the similarities and differences and the existing problems,and provide relevant suggestions.Jiangsu Province has issued a guiding document to establish a unified outpatient special disease system,the differences in the scope of outpatient special disease and the medical insurance benefit level in the 13 cities should not be ignored.These differences may affect the fairness of patients and hinder the establishment of a unified outpatient special disease system in the province.In addition,there are still some problems in the selection of diseases,hierarchical medical,and disease identification.It is recommended to establish a dynamic selection mechanism for outpatient special diseases,to fully utilize the role of primary healthcare institutions in providing outpatient services for special diseases,and to develop objective and unified criteria for identifying outpatient special diseases.

Taking the scope of outpatient special disease,the level of protection and the fixed-point management as the entry point.Under the"N+X"policy background,it reviewed the policies related to outpatient special diseases in 13 co-ordinated districts of Jiangsu Province to explore the similarities and differences and the existing problems,and provide relevant suggestions.Jiangsu Province has issued a guiding document to establish a unified outpatient special disease system,the differences in the scope of outpatient special disease and the medical insurance benefit level in the 13 cities should not be ignored.These differences may affect the fairness of patients and hinder the establishment of a unified outpatient special disease system in the province.In addition,there are still some problems in the selection of diseases,hierarchical medical,and disease identification.It is recommended to establish a dynamic selection mechanism for outpatient special diseases,to fully utilize the role of primary healthcare institutions in providing outpatient services for special diseases,and to develop objective and unified criteria for identifying outpatient special diseases.

Taking the scope of outpatient special disease,the level of protection and the fixed-point management as the entry point.Under the"N+X"policy background,it reviewed the policies related to outpatient special diseases in 13 co-ordinated districts of Jiangsu Province to explore the similarities and differences and the existing problems,and provide relevant suggestions.Jiangsu Province has issued a guiding document to establish a unified outpatient special disease system,the differences in the scope of outpatient special disease and the medical insurance benefit level in the 13 cities should not be ignored.These differences may affect the fairness of patients and hinder the establishment of a unified outpatient special disease system in the province.In addition,there are still some problems in the selection of diseases,hierarchical medical,and disease identification.It is recommended to establish a dynamic selection mechanism for outpatient special diseases,to fully utilize the role of primary healthcare institutions in providing outpatient services for special diseases,and to develop objective and unified criteria for identifying outpatient special diseases.

Taking the scope of outpatient special disease,the level of protection and the fixed-point management as the entry point.Under the"N+X"policy background,it reviewed the policies related to outpatient special diseases in 13 co-ordinated districts of Jiangsu Province to explore the similarities and differences and the existing problems,and provide relevant suggestions.Jiangsu Province has issued a guiding document to establish a unified outpatient special disease system,the differences in the scope of outpatient special disease and the medical insurance benefit level in the 13 cities should not be ignored.These differences may affect the fairness of patients and hinder the establishment of a unified outpatient special disease system in the province.In addition,there are still some problems in the selection of diseases,hierarchical medical,and disease identification.It is recommended to establish a dynamic selection mechanism for outpatient special diseases,to fully utilize the role of primary healthcare institutions in providing outpatient services for special diseases,and to develop objective and unified criteria for identifying outpatient special diseases.

Taking the scope of outpatient special disease,the level of protection and the fixed-point management as the entry point.Under the"N+X"policy background,it reviewed the policies related to outpatient special diseases in 13 co-ordinated districts of Jiangsu Province to explore the similarities and differences and the existing problems,and provide relevant suggestions.Jiangsu Province has issued a guiding document to establish a unified outpatient special disease system,the differences in the scope of outpatient special disease and the medical insurance benefit level in the 13 cities should not be ignored.These differences may affect the fairness of patients and hinder the establishment of a unified outpatient special disease system in the province.In addition,there are still some problems in the selection of diseases,hierarchical medical,and disease identification.It is recommended to establish a dynamic selection mechanism for outpatient special diseases,to fully utilize the role of primary healthcare institutions in providing outpatient services for special diseases,and to develop objective and unified criteria for identifying outpatient special diseases.

Taking the scope of outpatient special disease,the level of protection and the fixed-point management as the entry point.Under the"N+X"policy background,it reviewed the policies related to outpatient special diseases in 13 co-ordinated districts of Jiangsu Province to explore the similarities and differences and the existing problems,and provide relevant suggestions.Jiangsu Province has issued a guiding document to establish a unified outpatient special disease system,the differences in the scope of outpatient special disease and the medical insurance benefit level in the 13 cities should not be ignored.These differences may affect the fairness of patients and hinder the establishment of a unified outpatient special disease system in the province.In addition,there are still some problems in the selection of diseases,hierarchical medical,and disease identification.It is recommended to establish a dynamic selection mechanism for outpatient special diseases,to fully utilize the role of primary healthcare institutions in providing outpatient services for special diseases,and to develop objective and unified criteria for identifying outpatient special diseases.