[Objective]To introduce the technique important points of intramedullary fixation with bone cement add the plate fixation for treated the unstable proximal humeral fractures in elderly patients,and proceed the analysis to the principle of bone cement fix.[Method]Ten cases of the unstable proximal humeral fractures were treated with open reduction,intramedullary fixation with bone cement first,then fix with the plate.Three days after operation functional trainings were began.The radiographic outcome and shoulder joint functions were observed postoperatively at 1 month,3 months,6 months and 12 months.[Result]The results were excellent in 5 cases,good in 4 cases,fair in 1 case according to the JOA function standard.The rate of excellent and good clinical results was 90%.Radiography showed that the fractures dissects to reply in 7 patients,fractures still had 3～5 mm moving in 3 cases.All plates were fixed dependable,with no loosening.All fractures had bone fusion.[Conclusion]The intramedullary fixation with bone cement add fixation with plate for the unstable proximal humeral fractures in the elderly can proceed the functional training of the earlier period,acquire the satisfactory function instauration.

AIM: Study results are various in the mechanism and influential factors of backleg pain in patients with lumber intervertebral disc protrusion. This study aimed to explore the correlation of sagittal index and changes in nucleus pulposus inflammatory factor to low back and leg pain. METHODS: The patients with single unilateral prolapse of lumbar intervertebral disc who were non-central type lumbar disc herniation (L3-4, L4-5 or L5-S1) and non-lumbar spondylolisthesis accompanied with spinal canal stenosis and intraspinal canal disease surgically treated with limited laminectomy from October 1999 to February 2005. The total number of subjects was 41 including 30 men and 11 women and the patients ranged from 28 to 72 years old in age. Of them, 12 were the type of bulge, 15 were the type of protrusion and 14 were the type of free disc herniation of the lumbar spine. Another 17 involved intervertebral discs obtained in the decompression of lumbar bursting fractures were taken as a control group, in which were 10 males and 7 females aged 19-73 years. A questionnaire survey of painful symptoms to evaluate degree of low back and leg pain with visual analogue scale (VAS) was performed by the same non-experimental physician on admission. The ratio of the maximum sagittal diameter of protrusion and the sagittal diameter of the same level vertebral canal was sagittal index to describe degree of protrusion. The matrix metalloproteinase (MMP)-3 and interleukin (IL)-1 contents were determined. Backleg pain degree of the protrusion was analyzed. RESULTS: All patients were included in the final results. The MMP-3 and IL-1 contents and the sagittal index of the protrusion in patients with lumbar intervertebral disc herniation were higher than in the control group (P