The lateral wall,a new concept in the study of trochanteric hip fractures,has a great influence on the choice of internal fixation methods,stability of the fracture and prognosis of the patients.Currently,the research on the lateral wall focuses on the factors leading to its rupture,its anatomical features and its effect on internal fixation,but results in controversial views which are mostly influenced by the subjective and experimental factors.This review deals with how the concept of lateral wall was proposed,the importance and anatomical features of lateral wall,the causes for lateral wall rupture and current treatment perspectives of trochanteric hip fractures,aiming at increasing the awareness of the lateral wall among orthopedic surgeons and related researchers.

Objective To investigate the rehabilitation needs of people with disabilities in Wuxi. MethodsRehabilitation demands of 74387 people with disabilities in Wuxi were surveyed.ResultsThere were significant differences in rehabilitation needs of the disabled from age and different types of disabilities.ConclusionDisability community-based rehabilitation system should be improved according to different demands of disability.

Objective Based on the educational concept of competency based education,this paper analyzed the present situation and problems of nursing occupational protection education and occupational protection in china,and explored the necessity of setting up the nursing occupational toxicology and nursing occupational protection in the nursing colleges.Methods The whole tentative plan was presented through the analysis of the course description,teaching method,curriculum content and objectives,curriculum evaluation of nursing occupational toxicology and nursing occupational protection in colleges.Results Students will be able to really aware of the health dangers of various toxic and harmful substances,to set up the correct ideas of occupational protection,to actively taken effective protective measures,to avoid personal injury accidents by studying in this program.Conclusions A course of occupational toxicology study and nursing occupational protection in nursing colleges is suggested to enhance the students' ability of occupational protection.It is imperative for nursing students to complete the degree program.

Objective:To investigate the association of human leucocyte antigen-DRB1 alleles with chronic hepatitis B and hepatic cirrhosis in Han population of Jilin area.Methods:HLA-DRB1 alleles in 61 patients with chronic hepatitis B,44 patients with hepatic cirrhosis,32 spontaneous rehabilitees after HBV infectin,and 50 healthy controls were analyzed by using polymerase chain reaction/sequence specific primer technique.Results:The frequency of HLA-DRB1*1201-3 allele in chronic hepatitis B group was higher than that in healthy control group(17.21% vs.8.00%,P=0.0427,RR=2.391).The frequency of HLA-DRB1*0701 allele in chronic hepatitis B group and hepatic cirrhosis group was markedly higher than that in healthy controls group(11.48 % vs.2.00%,P=0.006 6,RR=6.35;12.50% vs.2.00%,P=0.004 6,RR=7.00)and in spontaneous rehabilitee group (11.48% vs.1.56%,P=0.0183,RR=8.17;12.50% vs.1.56%,P=0.0136,RR=9.00).No significant differences frequencies of the other HLA-DRB1 alleles were observed among the four groups.Conclusion:Alleles of HLA-DRB1*1201-3 and HLA-DRB1*0701 are closely associated with chronic hepatitis B and maybe susceptible genes or linkage genes of chronic hepatitis B.HLA-DRB1*0701 is also closely associated with hepatic cirrhosis and maybe a susceptible gene or linkage gene-posthepatitis B-cirrhosis in Han population of Jilin area.

Objective To investigate the genetic diversity of Plasmodium vivax transmission_blocking vaccine candidate antigen (TBV) Pvs25, with P.vivax isolates from Hubei and Zhejiang Provinces, and to compare the genetic polymorphism of Pvs25 with that from Bangladesh. MethodsThe parasite DNA used for the genetic polymorphism assay was obtained from dried filter paper blood spots. The genes were PCR amplified and the products were purified and sequenced directly. Results 45 complete new sequences were analyzed. Only 3 nucleotide changes were found that would result in amino acid substitutions in Pvs25 in comparison with the sequence from P.vivax Sal_I strain. The measurement of nucleotide diversity (?) was remarkably similar for the two populations, indicating that DNA sequences and deduced amino acid sequences were highly homologous among the geographically dispersed isolates or isolates from the same geographical region.Conclusion The results suggest that Pvs25 has limited antigenic polymorphism, especially compared with candidate antigens expressed by hepatic and erythrocytic stage, which may support the development and application of Pvs25_based transmission_blocking vaccine in China.

Objective To investigate the clinical value of anatomic M-mode echocardiography (AMM)for pristine diagnosis of myocardial ischemia in patients with coronary heart diseases (CAD).Methods 44 inner patients who were suspected as CAD were detected.Ordinary ultrasound was performed first.The ventricular segmental wall thickness and amplitude were measured by AMM.Then,we got the ventricular wall thickening fractions.All subjects should take the coronary angiography after the ultrasound examination in 1 -3 days.Patients with the vascular stenosis rate≥50% were defined as the CAD group,patients with the completely normal angiographic results were included in the normal control group according to the results of angiography.The parametric differences between the patients and the normal control subjects were compared.Results In the normal control subjects,the ventricular segmental wall amplitude >5mm accounted for 78.67%,the ventricular wall thickening fractions >30% accounted for 99.13%.But in CAD group,the ventricular segmental wall amplitude <4mm accounted for 61.14%,<5mm accounted for 93.47%,the abnormal ventricular wall thickening fractions <30% accounted for 88.43%.The sensitivity, specificity,accuracy of AMM were 77.47%,90.00%,77.39% respectively.Conclusion The ventricular wall thickening fractions of AMMhas quite significant correlation with morbid blood vessel in patients with CAD,they are effective reference indicators to evaluate the left ventricular wall motion quantitatively.

Objective To determine the persistence time of genotype 4 hepatitis E (HE) viremia after the onset of clinical symptoms in HE patients and provide essential data for study on HE epidemiologieal transmission, so that to evaluate potential contagiousness of HE patients after clinical stage. Methods The first serum samples from 162 HE patients after hospitalized in Eastern China were collected and tested for hepatitis E virus (HEV) RNA by nested reversed transcription- polymerase chain reaction (RT-PCR). The persistence time of HEV viremia after the onset of clinical symptoms was estimated with Kaplan-Meier survival analysis. Results HEV RNA was detectable in 101 out of 162 serum samples with positive rate of 62.35%, which was all grouped to genotype 4 by homology analysis. Furthermore, HEV RNA was detectable in 74 (64.91%) out of 114 male and 27 (56.25%) out of 48 female, which was not significantly different (χ2 = 1.08, P=0. 30). Kaplan-Meier survival analysis showed that the median persistence time of HEV genotype 4 viremia was 24 days after the onset of clinical symptoms (95% CI: 18-30 days), which meant that the viremia of 50% HE patients remaining detectable up to 24 days after the onset. The 75% and 25% percentiles were 14 days and 31 days, respectively. There was no significant difference of viremia persistence time between male and female (Breslow test: P=0.98, Tarone-Ware test: P=0.91). Conclusions The viremia of 75% patients with HEV genotype 4 infection could persistent until 2 weeks after the onset of clinical symptoms and that of some patients could persistent over 1 month. It is indicated that the viremia is still persistent and HE patient could be a reservoir even after the clinical symptoms disappeared and biochemical marks normalized.

BACKGROUND: The treatment of upper cervical spine disorders through a posterior pedicle fixation approach have been carried out in some domestic large hospitals, but this surgery is still considered as a difficulty of cervical spine surgery. In order to minimize the risk of surgery, the authors designed a program of individual operations, and combined with self-developed pedicle locating and directing speculum to determine precise intraoperative position of pedicle screws, and no report is found by searching related database in China.OBJECTIVE: To improve the one-time success rate of internal fixation screws, to investigate the biomechanical effect of the implant, to formulate a simple, practical, individual protocol for atiantoaxial pedicle screw-plate system based on related data. METHODS: A total of 31 patients were recruited from Department of Orthopaedics in the 251 Hospital of Chinese PLA, between January 2002 and September 2006. Under the guidance of self-made atlantoaxial locating and directing speculum, the entrance point and angle for screw insertion, as well as screw diameter and length were determined according to the results of X-ray and CT measurement. Atlas pedicle screw was inserted at left (19.93±1.32) mm, and right (19.16±1.3) mm; Atlas pedicle screw insertion angle to inside was left (23.72±2.09)°, and right (23.35±1.91)°; Atlas pedicle screw insertion angle to side of head was (9.00±1.20)°. Axis pedicle screw was inserted at left (13.14±0.82) mm, and right (13.85±0.79) mm; Axis pedicle screw insertion angle to inside was left (24.52±1.26)°, and right (20.42±1.42)°; Axis pedicle screw insertion angle to side of head was (25.00±3.00)°.RESULTS AND CONCLUSION: ①Totally 124 pedicle screws were implanted into 31 patients, and 122 screws were of one-time success. The precision rate was 98.39%. Two screws were secondly inserted because of cutting lateral cortical bone of pedicle for deviation of inward angle. ②Occipital neuralgia was found in 2 cases postoperatively and cured after one month of treatment;screws penetrated atlas left vertebral lateral wall in 2 cases, no spinal or vertebral artery injury was found. ③Radiographs showed that atlas was completely reduced in all patients, and apposition of dentoid process of axis fracture was good. CT films showed the screws a good location to the vertebrarterial spinal cord. ④The follow-up visit was averaged of 10.5 months. Bony fusion was found in all patients. No screw-plate breakage was found. No inflammatory or rejection reactions occurred.⑤By JOA scale, there were 16 cases of excellent, 12 cases of good, 2 cases of fine, and 1 case of poor. The excellent and good rate was 90%. It is suggested that the success rate of atlantoaxial pedicle screw-plate mplantation can be improved through a biomechanical angle.

The multidisciplinary synthetic therapy for the colorectal liver metastases has been a hot spot in clinical research,which includes operative therapy,tumor local therapy,conversion therapy,chemotherapy, molecular targeted therapy and so on. It is need to choose multiple therapies for the patients and make the whole treatment strategy in accordance with the condition of patients to maximize the survival benefit in clinical prac-tice. So,it is important to comprehend the newest research process of the clinical therapy to make a good choice for the colorectal liver metastases patients.

The incidence of colorectal cancer is high among the elderly. Traditional Chinese medicine (TCM) has been widely used in the treatment for colorectal cancer of old people. However, controlled trials with large sample size evaluating the effect of TCM are rare.