OBJECTIVETo compare clinical outcomes of locking plate for proximal humeral fracture whether application of inferomedial screws.

METHODSFrom January 2012 to July 2013, 46 patients with proximal humeral fracture underwent locking plates were retrospectively analyzed. There were 25 males and 21 females aged from 29 to 80 years old with an average of 55.1 years old. Among them, 25 patients were treated with inferomedial screws (support group), including 13 males and 12 females aged from 38 to 80 years old with an average of (55.8 ± 11.8) years old; 8 cases were part two fracture,10 cases were part three fracture and 7 cases were part four fracture according to Neer classification. Twenty-one patients were treated without inferomedial screws (non-support group), including 12 males and 9 females aged from 29 to 79 years old with an average of (54.2 ± 14.8)years old; 6 cases were part two fracture, 9 cases were part three fracture and 6 cases were part four fracture according to Neer classification. Operative time, fracture healing time and complications were observed and compared, Neer scoring of shoulder joint were used to evaluate clinical effect.

RESULTSAll patients were followed up from 12 to 41 months with an average of 15.6 months. Operative time and fracture healing time in support group was (1.6 ± 0.4) h and (3.0 ± 0.6) months, and (1.5 ± 0.4) h and (3.1 ± 0.6) months in non-support group, while there was no statistical difference in operative time and fracture healing time between two groups. There was significant differences in Neer score between support group (89.7± 4.9) and non-support group (83.1 ± 7.1). No complication occurred in support group,while 4 cases occurred complications in non-support group.

CONCLUSIONLocking plate with inferomedial screws for proximal humeral fracture has advantages of stable fixation, less complications, quick recovery of function and satisfied clinical effect.

Adult ; Aged ; Aged, 80 and over ; Bone Plates ; Bone Screws ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Humeral Fractures ; physiopathology ; surgery ; Male ; Middle Aged ; Shoulder Fractures ; physiopathology ; surgery ; Shoulder Joint ; physiopathology ; surgery ; Treatment Outcome

Objective To investigate the clinical features, therapy and prognosis of elderly patients with newly diagnosed acute promyelocytic leukemia (APL). Methods The clinical features of 21 elderly patients and 89 patients aged ＜60 with newly diagnosed APL were retrospectively analyzed. Additionally,elderly patients were divided into different groups according to the count of white blood cell (WBC). Results There were no significant differences between elderly patients and patients aged ＜60 in the aspect of sex (male/female: 11/10 vs 47/42), WBC count (high initial WBC: 23.8 % vs 16.9 %), the percentage of bone marrow blasts plus promyelocytes (0.83±0.11 vs 0.83±0.12), complete remission (CR) rate (71.4 % vs 84.3 %),the time of CR occurrence (35.7±10.1 vs 39.1±13.5), the occurrence of retinoic acid syndrome(RAS) (14.3 % vs 22.5 %), disseminated intravascular coagulation (DIC) (52.4 % vs 34.8 %) as well as 2 years overall survival rate (72.7 % vs 80.0 %) (P ＞0.05). Of the 21 elderly patients who received inductive treatment, 5 with high initial WBC and 16 without high initial WBC. The incidences of DIC, early death in high initial WBC group were 80 %, 60 % respectively, which were higher than the group without high initial WBC (43.8 %,18.8 % respectively), whereas CR rate for the group with high initial WBC (40.0 %) was lower than that for the group without high initial WBC (81.3 %). Conclusion Elderly patients with APL could have fine prognosis as well as patients aged ＜60. The results of inductive treatment of elderly patients in high initial WBC group were poor as compared with the group without high initial WBC.

The result of medical licensing examination is an objective reflection of the quality of medical education. The average scores and pass rates of medical licensing examination of the military medical university including The Third Military Medical University, were under the national average levels, which made us find the problems, therefore, reflection on curriculum structure, teaching method, administration mode and continuing education should be integrated to the requirement of the medical licensing examination, so as to let the students meet the complex demand of the society, as well as the special requirement of military service.

BACKGROUND:Elderly patients have more loose bone. After fractures, bones are mostly crushed. Simultaneously, many elderly patients experience many internal diseases. Various organs have dysfunction. Surgery tolerance is poor, which also brings difficulty in treatment with internal fixator, and increases the risk of therapy. Thus, the choice of internal fixation method is not uniform. OBJECTIVE: To compare and analyze the repair effects of proximal femoral nail anti-rotation blade and anatomic proximal femoral locking plate in treatment of unstable intertrochanteric fractures in the elderly. METHODS:A total of 100 elderly patients with unstable intertrochanteric fractures were selected from the Youyi Branch, Kunshan First People’s Hospital from April 2011 to June 2013. They were randomly assigned to two groups. Patients in the experimental group received internal fixation with proximal femoral nail anti-rotation blade. Patients in the control group received anatomic proximal femoral locking plate. After treatment, folow-up was conducted. Operative indexes, postoperative Harris score for hip function and incidence of complications were compared and analyzed in both groups. RESULTS AND CONCLUSION: No significant difference in various indexes was detected in both groups (P > 0.05). Harris scores were significantly better in the experimental group than in the control group (P < 0.05). Postoperative complications were significantly less in the experimental group than in the control group (P < 0.05). These results indicated that internal fixation of proximal femoral nail anti-rotation blade for unstable intertrochanteric fractures in the elderly achieved satisfactory results in the recovery of joint function and had the advantage of few complications.

Objective To investigate the correlation between the mutation in serum lipoprotein-associated phospholipase A2(Lp-PLA2) Ile198Thr, Val279Phe and cerebral infarction in Chinese Han population of Jiangsu Province. Methods One hundred fifty patients with cerebral infarction and 100 healthy controls in Chinese Han population of Jiangsu Province were recruited. The correlation between Val279Phe and Ilel98Thr mutation in Lp-PLA2 gene and cerebral infarction was analyzed using polymerase chain reaction and denaturing high performance liquid chromatography. Results The Val279Phe genotype and the mutant allele frequency in the cerebral infarction group were significantly higher than those in the control group (χ2 were 6. 31and 5. 32, respectively, all P ＜0. 05), and there was no significant difference between the Ile198Thr genotype and the mutant allele frequency in the control group (χ2 were 0. 039 and 0. 037, respectively, all P ＞0. 05). Conclusions The Val279Phe mutation in Lp-PLA2 gene may be a genetic risk factor for cerebral infarction in Chinese Han population of Jiangsu Province.

Objective To investigate the effect of low-dose hydrocortisone(HC)on hippocampus nuclear factor kappa B((NF-?B)),I?B expression in lipopolysaccharide(LPS)induced septic rats and the role of NF-?B signal transcription pathway in pathogenesis.Methods Fifty-four rats were randomly divided into 3 groups: control group(A group,n=6),model group(B group,n=24),low-dose HC treatment group(C group,n=24).The septic rat model was established by intraperitoneal injection LPS(1 mg/kg),as the intervention by caudal vein injection low-dose HC(6 mg/kg),each of B and C group was subdivied into 2,8,16,24 hours respectively after LPS injection(n=6).At serial time points,the animals in each group were sacrificed,brain tissue samples were harvested to determine NF-?B,I?B expression by immunhistochemistry in hippocampus.Results In B group: NF-?B expression was up regulated compared with A group(P

Objective To study the infection rate and sensitivity of genitourinary tract mycoplasma among the patients in the traditional Chinese medicine(TCM) hospital ,and its similarities and differences with the western medicine hospital ,thus to increase the therapeutic effect by combining with the related therapeutic measures of TCM .Methods The mycoplasma identification and drug susceptibility test results in 4 086 female genital tract specimens were performed the retrospective analysis .Then the medica‐tion strategy was investigated by combining with clinic .Results Of the 4 086 specimens ,1 891 cases were Mycoplasma positive with the total positive rate of 46 .3% ;in which the positive rate of ureaplasma urealyticum(UU) was higher(40 .7% ,1663 cases) , the most sensitive drugs were pyostacin and josamycin with the sensitive rates of 99 .11% and 99 .01% respectively ;mycoplasma hominis(M H) was less with the positive rate of 2 .7% (110 cases) ,josamycin and doxycycline were sensitive;the positive rate of UU and M H was 2 .9% (118 cases) ,doxycycline and pyostacin were sensitive with the sensitive rates of 95 .77% and 95 .26% re‐spectively .Conclusion Mycoplasma has higher infection rate in the genitourinary tract among gynecological patients ,the results are similar between the hospital of TCM and Western medicine hospital ;UU is mainly Mycoplasma type;the drug susceptibility test re‐sults reveal that the empirical medication for anti‐mycoplasma infection can select doxycycline and josamycin;it is recommended that the combined therapy with syndrome differentiation of traditional Chinese medicine by combining with the drug sensitivity test re‐sults has better clinical efficacy .

Objective To apply EP7‐A2 document for evaluating the interference of hemolysis the total bilirubin detection in clinic .Methods The interferent was affirmed according to thepaired‐differencetest required by the EP7‐A2 document .The rela‐tion between interferent concentration and interference degree was analyzed by using the dose‐effect test .Results The paired‐difference test results showed that 5 .00 g/L hemoglobin had negative interference effect on two kinds of total bilirubin reagents . But the reagent kit A had little interference degree of hemolysis;The dose‐effect test results showed that hemoglobin produced the linear negative interference effect on the reagent kit A of total bilirubin detection .The linear equation of low value sample was Y=-0 .146X+14 .1 ,r=0 .964 ,which of middle value sample was Y = -0 .546X+92 .24 ,r=0 .947 and which of high value sample was Y= -1 .153X+307 .2 ,r=0 .979 .Conclusion Hemolysis has a negative interference effect on total bilirubin detection in clinic . The total bilirubin value could be corrected by using the hemoglobin concentration of sample;the EP7‐A2 document has certain ap‐plication value in the aspect of analyzing interference and evaluation .

BACKGROUND: The shape and amount of bone regenerated depend on the existence and maintenance of hypolemmal space. Collapse and reduction of hypolemmal space will greatly inhibit bone regeneration. Therefore, the key to success of induced bone regeneration is to select membrane material.OBJECTIVE: This study is designed to investigate the feasibility of poly (hydroxybutyrate-hydroxyvalerate) (PHBV) membrane for guiding bone regeneration.DESIGN, TIME AND SETTING: This study, a self-control animal experiment, was performed at the Laboratory Animal Center, Third Hospital Affiliated to Sun Yat-sen University between May 2005 and October 2006.MATERIALS: PHBV membrane, (10×10×0.3)mm, was provided by Research of Biomaterials, College of Material Science and Engineering, South China University of Technology. Eight healthy hybrid dogs, aged 1 year old, weighing 10-12kg, were included for model of tibial defects.METHODS: Four bone defects were made on bilateral tibias in each dog. Bilateral proximal bone defects of all dogs were included as control group and only subjected to periosteal flap reduction. Bilateral distal bone defects of all dogs were included as experimental group and covered by PHBV membrane. Samples were harvested at weeks 2, 4, 8, and 12 post-surgery.MAIN OUTCOME MEASURES: In vivo degradation performance and ossific capability of PHBV copolymer as well as energy-dispersive X-ray analysis and elemental quantitative assay in bone defect regions.RESULTS: In the experimental group, at week 8 post-surgery, PHBV copolymer membrane had been gradually degraded, different sizes of hollows formed on its surface, bone defect surface was smooth and flat, and X-ray results showed increased bone density in the bone defect regions; at week 12 post-surgery, the PHBV copolymer was still not degraded completely, but bone defect regions had been completely fused with normal bone. Energy-dispersive X-ray analysis and elemental quantitative assay results demonstrated in the experimental group, peaks of Ca and P atom number of newly formed bone were predominant, and peaks of impurity were few. With time going, element Ca and P levels in the newly formed bone were increased, the ratio for Ca and P atoms approximated to that in the normal bone. There was significant difference between the. experimental group and the control group (P<0.05).CONCLUSION: PHBV copolymer membrane is a promising ideal natural membrane material for guiding bone regeneration.

Objective To report our experience with minimally invasive percutaneous nephrolithotomy (MPCNL) in treatment of renal calculi in solitary kidneys. Methods From August 2000 to August 2010, 242 patients with renal calculi in solitary kidneys were treated by MPCNL, the data were reviewed retrospectively. Results The mean operative time was 68 min, the clearance rates were 79.3% (192/242) after first session and 88. 0% (213/242) after second-look MPCNL and ESWL, respectively. Postoperative fever happened in 18 cases. Twenty-one cases required transfusion, 10 cases received angiography and embolization. One case experienced perirenal hematoma and 1 case had pneumatothorax. Conclusions MPCNL has the advantages of less bleeding, high clearance rate and short hospital stay. MPCNL is an effective and feasible treatment option for renal calculi in solitary kidneys and should be the first line choice.