The use of the Küntscher Y nail in the treatment of intertrochantertc and subtrochanteric fractures of the femur.

Conventional nail plates provide a relatively poor fixation of unstable and pathological fractures of the upper femur, and nail-plate failure is not uncommon. A two-part device, the Küntscher Y nail, provides a strong fixation in these cases and is not difficult ot insert if the method described is employed. The results in 91 patients treated with the Y nail are discussed. Since distal migration of the nail has been prevented by use of a flanged medullary nail, no mechanical failure has occurred. Early weight bearing can be permitted after operation.     

再论"超国民待遇合理合法性"

国民待遇是WTO的重要原则。中国入世已逾5年加之在税收优惠等超国民待遇方面显露出某些弊端，因此，学者疾呼超国民待遇已阻碍着我国经济健康发展。无论是从国际法角度还是从世界各国普遍做法来看，从目前国内亟需调整外资产业结构、地域分布和引进外国先进技术、经验的现状来看，超国民待遇应该被合理地改造、保留，其存在是合法、合理的。     

Purine metabolism in relation to leukemia and lymphoid cell differentiation

A number of inborn errors of purine metabolism have been associated with immunodeficiency diseases. From studies to the possible mechanism(s) leading to the defects in the immune system, it appeared that the accumulation of deoxyATP and deoxyGTP and the subsequent inhibition of ribonucleotide reductase played an important role. The inhibition of methylation pathways through the accumulation of s-adenosylmethionine seems to be a second valid concept. The amount to which certain subtypes of lymphoid cells were affected by the enzyme deficiencies was strongly related to the enzymatic make-up of the cells. Lymphoid cells from different maturation stages could be affected in a specific way, depending on the different enzyme activities of these cells. Studies on human lymphoblastic leukemias showed that, related to the immunological subtype, the different leukemias could be characterized by a different enzymatic make-up. In this paper we discuss the possibilities for a specific enzyme directed chemotherapy, directed against specific subtypes of human lymphoblastic leukemias. Experimental evidence indicates that for example the adenosine deaminase inhibitor 2'deoxycoformycin can be used as a specific drug against acute lymphoblastic leukemia with the T cell phenotype.     

Metabolic changes in liver of tumor-bearing mice

The hepatic contents of acetyl coenzyme A, free CoA, α-oxoglutarate, and citrate were determined in tumor-bearing mice. Significant decreases in acetyl CoA and free CoA, with a concomitant increase in citrate occurred 24 hr following inoculation of TLX-5 lymphoma cells. Similar changes occurred in mice bearing a C₃H mammary tumor, when the latter was just palpable in situ. There was some indication that in mice bearing Sarcoma 180, the size of the tumor was a factor in inducing these changes. Significant decreases in the α-oxoglutarate content of liver could only be detected in mice bearing the lymphoma or Sarcoma 180. The direction of change in the hepatic contents of acetyl CoA and citrate were opposite to those found in tumor-free animals under gluconeogenic conditions. However, significant increases in citrate would favor gluconeogenesis by inhibition of phosphofructokinase. Starvation of tumor-bearing mice failed to increase the acetyl CoA content of liver or decrease citrate. The data suggest a failure in lipolysis, as well as in the regulation of fatty acid synthesis in liver via changes in citrate.     

Maternal anxiety and neonatal wellbeing

The level of anxiety in 146 patients in their third trimester of pregnancy was established using the IPAT Anxiety Self-Analysis Form. The results were compared with physical status of the child as assessed by its five-minute apgar score. It was found that the apgar scores of babies born to highly-anxious mothers was significantly less than those born to mothers with normal anxiety scores. An association is proposed between maternal anxiety during pregnancy and future mental retardation and neurological abnormalities.     

Low-dose heparin in femoral neck fractures

Heparin in low doses was given by subcutaneous injection to 25 patients with femoral neck fractures; a further 26 patients acted as a control group. Deep-vein thrombosis was diagnosed by the ¹²⁵I-fibrinogen test. Thrombosis occurred in 68 per cent of patients in the heparin group and in 50 per cent of the controls. The incidence of deep-vein thrombosis was not increased when operative fixation of the fracture was delayed for more than 24 hours. It appears that the initial thrombosis may occur very soon after the fracture and as a direct response to the trauma, rather than to the operation itself.     

The effect of seat belt legislation on a district general hospital

The introduction of legislation making the use of seat belts compulsory was associated with a marked reduction in the number of patients coming to the Accident and Emergency Department of a district general hospital as a result of road traffic accidents. Those patients who were not wearing seat belts required hospital admission twice as often as restrained car occupants. The only deaths occurring during the period of study occurred in those not using seat belts. Rear seat passengers were found to suffer from more severe and more numerous injuries than restrained car occupants. Injuries caused by seat belts were seen, usually causing bruising of the chest wall or minor fractures, and, excluding the chest, those wearing seat belt were less likely to suffer an injury to any part of the body than those not protected by a belt.     

Heterotopic ossification enveloping the sciatic nerve following posterior fracture-dislocation of the hip: a case report

Heterotopic ossification developing around the hip and enveloping the sciatic nerve is described in a patient who underwent open reduction and fixation of a large posterior acetabular fragment to decompress and suture the sciatic nerve. The postoperative treatment and a 2-year follow up are also described.