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OBJECTIVE: To explore the therapeutic effects of internal fixation with Herbert screws for the treatment of Pipkin type I and type II femoral head fractures. METHODS: From January 2008 to December 2012, 23 patients with Pipkin type I and type II femoral head fractures were treated with open reduction and internal fixation by Herbert screws through Kocher-Langenbeck approach. Twenty-three patients (aged 18 to 52 years with a mean of 35.5 years, including 18 males and 5 females patients, 8 left hips and 15 right hips) with femoral head fractures and posterior hip dislocation. The fracture was classified according to Pipkin classification based on the radiographic findings, 5 patients had type I and 18 had type II fractures. The duration time from admission to the operation ranged from 6 to 72 h (averaged 32 h). The clinical and radiographic outcomes of the patients were measured using Thompson-Epstein scoring scale. The Harris hip score(HHS) was used to evaluate and compare hip functions at the latest follow-up between affected and healthy sides. RESULTS: All the patients were followed up, and the duration ranged from 20 to 48 months (averaged 30 months). According to Thompson-Epstein system, 12 patients got an excellent result, 6 good, 4 fair and 1 poor. The average HHS at the finial follow-up was 87.80 ± 8.46 (ranged from 66 to 95), which is similar to that in the healthy side 90.10 ± 6.35 (ranged from 72 to 98) (t = 1.044, P = 0.302). The complications such as deep infection, and deep vein thrombosis were not found. At the 3rd year during follow-up,4 patients had avascular necrosis of femoral head. At the 1st year of follow-up, 1 patient had hip pain after walking,screws loosening and shift after trauma,and serious complications of traumatic arthritis. All the 5 patients were treated with total hip arthroplasties. CONCLUSION: The treatment of internal fixation with Herbert screws through the Kocher-Langenbeck approach is effective for Pipkin type I and type II femoral head fracture. The method is reliable and valuable for recommendation. However, such fracture may have avascular necrosis of femoral head and complication of traumatic arthritis, which should be observed carefully in clinic with preparation of the prevention and treatment measures.

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Nasopharyngeal Carcinoma (NPC) patients' end-of-treatment survival status has drawn more attention in recent years. Telephone follow-up, as a most operative approach among all the clinical follow-ups, is an effective means to extend medical service to patients' home and is thus widely used in clinical practice. This study aimed to analyze the post-radiotherapy NPC patients' phone response rate and its factors, and to discuss the independent prognostic factors of NPC patients' radiotherapy. We prospectively designed a nurses-led telephone follow-up to include 2520 NPC patients who received simple radical radiotherapy between Jan. 2007 and Jun. 2012 at Sun Yat-sen University Cancer Center. The patients' response rate and its factors were calculated. Survival analysis was used to estimate the patients' survival and the influencing factors. The overall response rate was 90.5%; Patients with reserved contact type of mobile + landlinephone or landline phone had higher follow-up response rate than patients with mobile contact only; patients with 2 or more reserved contacts, and family cancer history had higher response rate than patients with only 1 number and those without family history. Patients' cumulative survival rate of 1, 3 and 5 years were 98.9%, 75.3%, 50.3%, respectively. T-staging, N-staging, higher clinical staging, with basicranial invasion were the influencing factors of the patients' poor prognosis. The telephone follow-up response was affected by reserved contact type, number of contacts and family medical history; T-staging, N-staging, higher clinical staging, with basicranial invasion were the influencing factors of the patients' poor prognosis. This study provides a scientific basis for increasing the NPC patients' end-of-treatment response and promoting the individualized clinical treatment.

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More than 60% nasopharyngeal carcinoma patients receiving the radical radiotherapy treatment will develop moist desquamation skin reaction at some time during the course of treatment. The purpose of this study was to compare the effectiveness of Mepilex Lite dressings and the usual care in the healing of postirradiation dermatitis in nasopharyngeal carcinoma patients. This was a randomized controlled trial, and a sample of 88 nasopharyngeal carcinoma patients who had developed radiation dermatitis was assessed. Comparisons were made regarding parameters related to wound healing, including healing time and wound pain, and also regarding the impact of wound on the patient, including restriction of neck movement, sleep problem, and disturbance in body image. The results showed that radiation-induced dermatitis in the study group (Mepilex Lite, 43 patients) healed in a median of 16 days, which was significantly different from the healing time in the control group (median 23 days, 45 patients; P = 0.009). No statistically significant differences were detected between the 2 groups with respect to neck mobility and appearance disturbance. However, Mepilex significantly improved patients' sleep (P = 0.005). The researchers conclude that Mepilex Lite dressing provides a promising alternative to radiation dermatitis of nasopharyngeal carcinoma patients and is worthy of further research.

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OBJECTIVE: To investigate the clinical outcomes of surgical treatment of fracture of the fifth metatarsal base combined with degree III lateral ligament injury of ankle. METHODS: From January 2008 to December 2011, 32 patients with fracture of the fifth metatarsal base combined with degree III lateral ligament injury of ankle were treated with surgery. Fractures were fixed with compressed canulated screw and ligaments were repaired with suture anchors. After operation, ankle joints were fixed in neutral position and slightly valgus position by plaster slab. Taking out stitch was performed at 2 weeks after operation and non-weight loading walking by double crutches support started; after the 6 weeks, remove the gypsum and part-weight loading walking by brace protection; at the 8 weeks after operation, completely weight loading walking was permitted. American Orthopaedic Foot and Ankle Society (AOFAS) was used to evaluate the clinical effect. RESULTS: Thirty-two patients were followed up from 8 to 18 months with an average of 12 months. All fractures obtained healing with an average time of 12.5 weeks (ranged, 8 to 24 weeks). According to the standard of AOFAS, 18 cases got excellent results and 14 good. CONCLUSION: The method that fracture fixation with compressed canulated screw and ligament repair with suture anchors can obtain satisfactory effects in treating fracture of the fifth metatarsal base and degree III lateral ligament injury of ankle.

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This retrospective study investigated the effect of modifications presented in the seventh edition of the American Joint Committee on Cancer (AJCC) Manual for staging esophageal cancer on the characterization of the effectiveness of post-operative chemotherapy and/or radiotherapy, as measured by overall and disease-free survival. The seventh edition of the AJCC Manual classifies the number of lymph nodes (N) positive for regional metastasis into three subclasses. We used the AJCC classification system to characterize the cancers of 413 Chinese patients with esophageal cancer who underwent radical resection plus regional lymph node dissection over a 10-year period. The 10-year survival rate was 14.3% for stage N1 patients and 6.1% for stage N2 patients. Only one stage N3 patient was followed >4 years (53.4 months). The 10-year disease-free rate was 13.6% for stage N1 patients. Patients with stage N2 or N3 cancer were more likely to have tumor recurrences, metastases or death than patients with stage N1 cancer. Post-operative radiotherapy provided no survival benefit, and may have had a negative effect on survival. In this study, the N stage of esophageal cancer was an independent factor affecting overall and disease-free survival. Our results did not clarify whether or not radiotherapy after radical esophagectomy offers any survival benefit to patients with esophageal cancer.

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