BACKGROUND:Locking compression plate and dynamic hip screw are the two major extramedul ary fixations for the femoral intertrochanteric fractures, however, the comparison of the clinical efficacy between two methods is stil controversial. OBJECTIVE:To systematical y evaluate the clinical efficacy of locking compression plate versus dynamic hip screw in the treatment of femoral intertrochanteric fractures, and provide a theoretical basis for clinical application. METHODS:Authors searched for control ed studies on locking compression plate and dynamic hip screw in the treatment of femoral intertrochanteric fractures in PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, VIP periodical database, Wanfang resource database, Chinese Biomedical Literature service systems published from January 1999 to April 2014. The inclusion and exclusion criteria were made, and the literature meeting the criteria was screened, and the methodological quality of the included studies was evaluated. Meta-analysis was carried out using the RevMan 5.2 software. RESULTS AND CONCLUSION:Ultimately 682 patients from 8 studies met the inclusion criteria, including 336 patients in the locking compression plate group and 346 patients in the dynamic hip screw group. Meta-analysis results showed that:there were no statistical y significant differences in operating time [MD=-12.07, 95%CI (-29.85, 5.71), P=0.18], peri-operative bleeding loss [MD=-15.01, 95%CI (-87.85, 57.83), P=0.69], post-operation drainage [MD=-13.62, 95%CI (-28.49, 1.26), P=0.07], ambulation time [MD=-0.14, 95%CI (-0.68, 0.41), P=0.63], length of hospitalization [MD=-0.74, 95%CI (-2.29, 0.82), P=0.35], bone union time [MD=-1.18, 95%CI (-2.78, 0.42), P=0.15] between locking compression plate and dynamic hip screw groups. The excellent and good rate of postoperative hip function reduction [OR=2.03, 95%CI (1.23, 3.36), P=0.006] was significantly higher in locking compression plate group than in the dynamic hip screw group. The incidence of coxa vara was lower in the locking compression plate group than in the dynamic hip screw group [OR=0.34, 95%CI (0.12, 0.96), P=0.04]. There were no significant differences in looseness, breakage, withdrawal of internal fixation [OR=1.20, 95%CI (0.59, 2.45), P=0.61] and the incidence of total complications [OR=0.55, 95%CI (0.24, 1.28), P=0.16] between locking compression plate and dynamic hip screw groups. However, the included studies have high possibility of selection bias and measurement bias, and wil affect proof strength of results. Therefore, more clinical randomized control ed studies with compact design are needed for verification.

The trehalose-6-phosphate synthase gene tps1 was amplified from yeast S. cerevisiae AS2. 1416 cDNA library by polymerase chain reaction. This 1.5 kb fragment was cloned into Pst I and Bam HI sites of pGEM-T easy vector and the sequence of the gene indicated the cloned tps1 gene contained 1485 nucleotides encoding for 495 amino acid and shared a sequence homology of 99.6 % with that from S. cerevisiae S288C.

Objective:To investigate the feedback of residents after their using of clinical thinking training and assessment system.Methods:4 559 questionnaire results of clinical thinking training and assessment system of 44 residents standardized training hospitals in Shanghai in 2016 were analyzed.Results:Only less than 8% of the respondents admitted that the system interface was not easy to operate,7.5% of the respondents believed that it was ineffective to evaluate the ability of clinical thinking,3.5% of the respondents thought it was unbeneficial to improve the ability of clinical thinking,and 3.8%were unwilling to receive the system.Conclusions:The clinical thinking training and assessment system is a system platform which can be accepted by a large majority of residents,and it is helpful to improve the residents' clinical thinking,it is worthwhile to further promote the application in the standardized training of residents.

Comparative analysis of the variations in HA 1 gene of the influenza A (H3N2) virus and the vaccine recommended were conducted in Shangluo city of China,during the surveillance year of 2014-2015.In this study,we collected the samples of H3N2 subtype strain from the Shanglou City of China during the surveillance period of 2014-2015.The strain was cultured in MDCK cells,HA gene fragment was amplified by RT-PCR and the nucleotide sequence was determined.Sequence alignment was performed using the clustax2.1 software.The phylogenetic tree was constructed by Mega6.0 software and was analyzed by Neighboring-joining method.Results showed that the homology of isolated strain during 2014-2015 was 97.2 ％-99.9％ and homology with the recommended vaccine strain A/Texas/50/2012 was 97.3％-98.5％.The amino acid sequence of the HA 1 gene of the isolated strain was compared with that of the vaccine strain.The major antigenic determinants of the isolates in 2014,having mutations were section B,Y159F,S198P,while the major antigenic determinants of isolates in 2015,having amino acid mutations were A zone G142R,B region S159F,S198P.These results indicated that the key antigenic determinant of influenza H3N2 subtype strain in Shangluo City has changed in 2014-2015 and A/Texas/50/2012 vaccine component is no more effective.Hence,there is an urgent need to update the influenza H3N2 subtype vaccine components and in future we should be deeply concerned about the evolution ofinfluenza H3N2 gene trends.

Objective:To summarize the clinical characteristics of 4 cases of mixed pituitary adenomas involving growth hormone(GH), prolactin(PRL), and thyroid stimulating hormone(TSH), and explore the standardized management approaches.Methods:The clinical data of four GH/PRL/TSH mixed pituitary adenoma patients diagnosed by Peking Union Medical College Hospital were retrospectively analyzed, including clinical manifestations, biochemical parameters, radiographic characteristics, as well as treatment and prognosis. Then literature review was conducted.Results:Among the 4 patients, 3 were male, with onset ages ranging from 15 to 38 years. All patients presented with coarse facial features as initial symptom. Three patients had visual impairment or visual field defects. All 4 patients had significantly elevated levels of GH and insulin-like growth factor-Ⅰ(IGF-Ⅰ). GH was not inhibited by oral glucose tolerance test. PRL concentration was over 100 ng/mL. Triiodothyronine(T 3)and thyroxine(T 4)were also elevated, while TSH was not inhibited. All pituitary adenomas in four cases were macroadenomas or giant adenomas, all of which were invasive growth, and one case developed pituitary stroke. Except for one patient who did not receive treatment in our hospital due to medical expenses, the remaining three patients underwent a combined treatment of medication and transnasal transsphenoidal pituitary adenoma resection. Among them, one patient had relief of central hyperthyroidism and hyperprolactinemia, but GH/IGF-Ⅰ did not meet the remission criteria. The other two patients had persistent non-resolution of at least 2 hormone axes. Conclusions:Patients with GH/PRL/TSH mixed pituitary adenoma were mainly characterized by coarse facial features, GH/PRL/TSH hyperfunction, large adenoma volume, low biochemical remission after surgery combined with drug treatment, and poor clinical prognosis.