Proximal femoral nail antirotation and third-generation Gamma nail: which is a better device for the treatment of intertrochanteric fractures?

<p><b>INTRODUCTION</b>Proximal femoral nail antirotation (PFNA) and third-generation Gamma nail (Gamma 3) are widely used in the treatment of intertrochanteric fractures. However, it remains unclear which device achieves better clinical and radiographic outcomes when treating intertrochanteric fractures.</p><p><b>METHODS</b>This study comprised 239 patients with intertrochanteric fractures treated with either PFNA or Gamma 3 for a minimum of 12 months. During surgery, the operative time, image intensifier time and amount of blood loss were recorded. Following surgery, we assessed reduction quality and implant position. At the final follow-up, postoperative complications, including femoral shaft fracture, cutout, reoperation, pneumonia, urinary tract infection, cerebral infarction, cardiac infarction and decubital ulcer, were recorded. In addition, walking ability was assessed using the Parker-Palmer mobility score.</p><p><b>RESULTS</b>No difference was found in the operative time, image intensifier time and amount of blood loss between patients treated with PFNA and those treated with Gamma 3. The reduction quality of fractures treated with Gamma 3 was better than those treated with PFNA. However, there were no significant differences in implant position, walking ability and postoperative complications between the two groups. Although Gamma 3 resulted in better reduction quality, it did not provide any advantages in walking ability and postoperative complications when compared with PFNA.</p><p><b>CONCLUSION</b>Therefore, we conclude that both PFNA and Gamma 3 are safe and reliable devices for the treatment of intertrochanteric fractures.</p>

Diagnosis of 22q11 deletion and duplication in congenital heart disease by multiplex ligation dependent probe amplification / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the clinical utility of multiplex ligation-dependent probe amplification (MLPA) for detecting 22q11 deletion and duplication in congenital heart disease (CHD) cases and to study the incidence of 22q11 deletion and duplicaton in different kinds of CHD.</p><p><b>METHODS</b>Forty eight probes of which 25 located in 22q11 low copy number region (LCR 22s A-H), 7 in 22q11 surrounding region (CES, 22q13) and 16 in chromosomes 4, 8, 10 and 17 were selected to detect 22q11 deletion and duplication in 181 preoperative children with CHD and 14 fetuses with serious CHD or CHD with multiple malformations. In these cases, karyotype analysis was also performed.</p><p><b>RESULTS</b>MLPA demonstrated that 7 cases had 22q11 deletion [6 cases from CLTCL1 to LZTR1(LCR A-D) and 1 case from CLTCL1 to PCQAP (LCR A-C)] and that 1 case had 22q11 duplication,spanning from ZNF74 to LZTR1(LCR B-D). The phenotypes of heart defect included ventricular septal defect, atrioventricular septal defect, pulmonary stenosis and tetralogy of Fallot. Karyotype analysis showed that 1 case had 21q deletion [46, XY, 21q], 1 case had mosaic trisomy 8 [47,XY, +8/46, XY(1:2)] and 4 cases had trisomy 21. One of the 4 cases with trisomy 21 had concurrent 22q11 duplication.</p><p><b>CONCLUSIONS</b>MLPA is a rapid, sensitive, site specific and relatively inexpensive method for diagnosis of 22q11 deletion and duplication in CHD. 22q11 deletion and duplication may cause various kinds of CHD, suggesting that genetic detection should be performed routinely in CHD patients.</p>

Analysis of the unsuccessful cases of the porcelain-fused-to-metal-crowns and bridges / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To discuss the unsuccessful reasons and the preventive methods of the unsuccessful clinic cases.</p><p><b>METHODS</b>The retrospective analysis was carried on the 80 prosthesis in 70 patients from 1994 to 2001 which were suffered with unsuccessful results after the restoration of the metal crowns and bridges.</p><p><b>RESULTS</b>There were 68 teeth which had collapsed or broken. 20 teeth had the post loosing or shedding. Root breaking, food impaction, unharmony colors of porcelain and the changing color of gingival were 3, 3, 6 and 2 teeth.</p><p><b>CONCLUSION</b>It is necessary to select suitable repairing materials and operate correctly for preventing the occurring of the unsuccessful results in the porcelain-fused-to-metal-crowns and bridges.</p>