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BACKGROUND: Three-column spinal osteotomies were developed to address severe and stiff kyphoscoliosis. However, the optimal choice of osteotomy in these patients is still unclear. This retrospective study aims to compare the outcomes and complications between grade 4 and grade 5 osteotomies in patients with severe and stiff thoracic kyphoscoliosis. METHODS: Forty-five patients with severe and stiff thoracic kyphoscoliosis who underwent 3-column osteotomy in the thoracic spine were classified into 2 groups according to the grade of osteotomy. The clinical data and radiologic parameters were collected and compared. RESULTS: Fourteen patients received grade 4 osteotomy, and 31 patients received grade 5 osteotomy. The spinal column shortening distances were similar between groups. The postoperative and latest follow-up radiologic parameters were not statistically significant between groups. Postoperative and follow-up results demonstrated greater correction of the regional kyphosis angle in the grade 4 osteotomy group, but did not reach significant level. The operative time and blood loss of grade 5 osteotomies were greater than those of grade 4, but showed no significant differences. Perioperative complication rates were also similar between groups. CONCLUSIONS: Similar clinical outcomes can be achieved with grade 4 and grade 5 spinal osteotomies. This may enrich the basis on moving down to a lower osteotomy grade when treating patients with severe and rigid thoracic kyphoscoliosis.

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Objective@#To study the relationship between the average hearing of different frequencies and the audiometry staging in patients with Meniere′s disease.@*Methods@#A total of 259 patients from 1996 to 2016 were collected .All patients underwent pure tone audiometry, of which 93 patients underwent 3 000 Hz audiometry. The patients were divided into five groups according to the frequencies of hearing(Ⅰ: 500, 1 000, 2 000, 3 000 Hz; Ⅱ: 250, 500, 1 000, 2 000, 3 000 Hz; Ⅲ: 250, 500, 1 000, 2 000; Ⅳ: 500, 1 000, 2 000, 4 000 Hz; Ⅴ: 500, 1 000, 2 000 Hz), then calculated the average audiometry and made the hearing staging. The obtained data were analyzed by chi-square test and Bonferroni correction was performed among the groups, P<0.05 was defined as a statistically significant criterion.@*Result@#There were no significant difference between the five groups(P=0.441>0.05).@*Conclusions@#The choice of different pure tone audiometry frequency has no significant effect on the hearing staging. It would be more likely upstaging when plus 250 Hz. There is no statistically significant difference in staging between the latest guidelines and the 1995 guidelines.500, 1 000 and 2 000 Hz are recommended when 3 000 Hz examine is not available.

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<p><b>OBJECTIVE</b>The objective of this study is to investigate the association between laryngeal carcinoma and laryngopharyngeal reflux.</p><p><b>METHODS</b>This was a case-control study with 31 laryngeal cancer patients who had undergone 24-hour ambulatory double pH monitoring and 76 in the control group which were divided into negative group (36 patients) and positive group (40 patients) by the score of RSI (reflux symptom index) and RFI (reflux findings index) scale. The results of reflux and parameters of 24-hour ambulatory double pH monitoring among the three groups were statistically analysed.</p><p><b>RESULTS</b>The smoking rate of 80.6% (25/31) in laryngeal carcinoma group was significantly higher than that of (36.1%, P < 0.0167) in the negative group while it did not vary in laryngeal carcinoma group and the positive group (65.0%, P > 0.0167). The drinking rate of 71.0% (22/31) in laryngeal carcinoma group was higher than that of (36.1%, P < 0.0167) in the negative group whereas there was no significant difference between laryngeal carcinoma group and positive group (50.0%, P > 0.0167). The positive rate of laryngopharyngeal reflux in laryngeal carcinoma group, the positive group, the negative group were 74.2% (23/31), 16.7% (6/36) and 52.5% (21/40) respectively, which was significantly different (P < 0.05). The positive rate of gastroesophageal reflux in the three groups above were 71.0% (22/31), 52.8% (19/36) and 75.0% (30/40), which had no significant difference (P > 0.05). The positive rate of laryngopharyngeal reflux differed in laryngeal carcinoma group and the negative group (P < 0.0167) while did not differ in laryngeal carcinoma group and the positive group (P > 0.0167). In the results of 24-hour ambulatory double pH monitoring, there was significant difference in the total and upright reflux number, the total reflux time, the percent times for the pH falling below 4, total reflux number which lasted more than 5 minutes and DeMeester Scores.</p><p><b>CONCLUSIONS</b>The positive rate of laryngopharyngeal reflux in laryngeal carcinoma group was very high while the drinking and smoking rate were also high. Therefore whether the laryngopharyngeal reflux is a risk factor of the laryngeal carcinoma, it needs further research.</p>

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Objective To explore the effect of the proximal femoral nail antirotation(PFNa) for the treatment of femoral intertrochanteric fracture.Methods 272 consecutive patients with femoral intertrochanteric fracture were treated with PFNa.Results The mean operative time was 55min(range 35 ～95)min.The mean blood loss was 85ml (range:20 ～200)ml.The mean follow-up was 15.6months( range:6 ～36)monthsand achieved bone healing with an average time of 14.5weeks.According to the Harris criterion for evaluation.Conclusion PFNa was more comfortable for human's biomechanism and more favorable for the healing of the fracture as well as the recovery of the hip function.It had the advantage of simple manipulation,fewer trauma,strong fixation,anti-rotation,less osclerotin.PFNa was an ideal treatment for intertrochanteric fracture,specially the unstable intertrochanteric fracture and senile osteoporosis.

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Objective To investigate the risk factors related to failure of proximal femoral nail anti-rotation(PFNA)internal fixation for intertrochanteric fracture of femur.Methods A retrospective research was done on 249 cases with intertrochanteric fracture of femur after PFNA internal fixation.The failure ratios related to sex,fat,fracture pattern,osteoporosis,replace condition in operation and tip-apex distance(TAD)were calculated.And the risk factors related to failure of PFNA were statistically analysed.Results Two hundred and forty-three cases were followed up ranged from 10 months to 3 years after operation.Plain AP and lateral radiographs were obtained at each follow-up patient,13 of 243 cases resulted in failing by PFNA internal fixation.The failure ratios in PFNA internal fixation with fat,unstable fracture,TAD≥25 mm and bad replace condition in operation were 8.5％(12/141),7.8％(12/153),18.5 ％(5/27)and 26.1％(6/23),respectively,which were higher than those in PFNA internal fixation with nonobese,stable fracture,TAD ＜ 25 mm and good replace condition in operation[1.0％(1/102),1.1％(1/90),3.7％(8/216)and 3.2％(7/220),respectively](P＜0.05 or ＜0.01).Conclusions Fat,unstable fracture,TAD≥25 mm and bad replace condition in operation are the relatively independent risk factors related to failure of PFNA internal fixation for intertrochanteric fracture of femur.Furthermore,it will prevent and reduce the ratio of complications to avoid these risk factors when PFNA internal fixation is selected for treatment intertrochanteric fracture of femur.