Objective To evaluate the efficacy of minimally invasive percutaneous plate osteosynthesis (MIPPO) in the treatment of Neer three-part fractures of the proximal humerus in young adults. Methods A retrospective analysis was performed of the 46 patients aged < 65 years with Neer three-part fracture of the proximal humerus from March 2010 to December 2016. MIPPO with locking proximal humerus plate ( LPHP ) was used in 23 of them who were 12 men and 11 women with an average age of 41. 6 ± 1. 2 years; open reduction and internal fixation ( ORIF ) with LPHP was used in the other 23 patients who were 14 men and 9 women with an average age of 42. 2 ± 1. 6 years. The 2 groups were compared in terms of operation time, intraoperative bleed-ing, fracture healing time and shoulder function by Neer scoring at the last follow-up. Results The average follow-up ( 13. 4 ± 1. 2 months ) for the MIPPO groups was not statistically different from that for the ORIF group ( 14. 2 ± 2. 4 months ) ( P > 0. 05 ) . The MIPPO group reported significantly shorter operation time ( 105 ± 15 min ) , significantly less intraoperative bleeding ( 140 ± 50 mL ) , significantly shorter fracture healing time ( 4. 2 ± 0. 6 months ) , and significantly higher shoulder Neer scores ( 88. 6 ± 3. 4 ) than the ORIF group ( 120 ± 20 min, 320 ± 40 mL, 5. 4 ± 1. 2 months, and 81. 6 ± 2. 2, respectively ) ( P <0. 05 ) . The complication rate ( 4. 3％, 1/23 ) for the MIPPO group was not significantly different from that for the ORIF group ( 17. 4％, 4/23 ) ( P >0. 05 ) . Conclusion MIPPO with LPHP may be obviously advantageous over ORIF with LPHP in the treatment of proximal humeral fractures in young adults.

Objective To evaluate low-weight mesh for tension-free repair of inguinal hernia in the elders. Methods 120 old patients ( age at 60 -97 years) underwent tension-free repair of inguinal hernia by using low-weight mesh. The early complications, time of up and about, hospital stay, postoperative chronic pain,foreign body feelings and hernia recurrence were analyzed. Results The operations were successful in all cases and the average time of operation was (43 ± 12 ) min. 9 cases suffered from edema of the scrotum, 5 cases suffered urine retention, 4 cases suffered from incision hematoma. The average time of outof-bed was ( 17.4 ± 1.8 ) h, the average hospital days was ( 7.4 ± 1.9) d. However, there were 1.7%(2/120) patients suffering from slight chronic pain and 9. 1% (11/120) patients complaining foreign body feelings. There was no recurrence after follow-up for 6 to 48 months. Conclusions The clinical application of low-weight mesh for tension-free repair of inguinal hernia in old age is safe and effective, with an additional advantage of low occurrence of chronic pain and foreign body feelings.

Objective To compare the clinical efficacy of robotic low anterior resection (R-LAR) and laparoscopic low anterior resection(L-LAR) for rectal cancer.Methods The case-control studies for comparing the clinical efficacy of R-LAR and LLAR for rectal cancer were retrieved from databases,including PubMed,OVID,Springer,Wanfang and VIP,till June 2016.The studies were selected in accordance with inclusion and exclusion critera,and the data were extracted and evaluated by two researchers.The RevManS.3 software was used for Meta-analysis.Results A total of 7 studies including 1 126 patients with rectal cancer were included,592 cases in the R-LAR group and 534 cases in the L-LAR group.Compared with the L-LAR group,in the R-LAR group the operation time was longer (MD=33.84,95％ CI:4.25-63.43,P =0.03),the conversion rate was lower (OR =0.10,95％CI:0.03-0.36,P=0.000 5),and more lymph nodes were dissected (MD=1.24,95％CI:0.31-2.17,P=0.009).No statistically significant difference was found in length of hospital stay,intraoperative blood loss,distance from distal margin to tumor and incidence rate of postoperative anastomotic leakage between the two groups (P ＞ 0.05).Conclusion Compared with L-LAR,RLAR is characterized by longer operation time,lower conversion rate and more thoroughly removing lymph nodes.And the length of hospital stay,intraoperative blood loss,distance from distal margin to tumor and incidence rate of postoperative anastomotic leakage of R-LAR are similar to those of L-LAR.

OBJECTIVETo investigate the relationship between aberrant methylation of Syk and Runx3 genes and recurrence and metastasis after resection of gastric cancer.

METHODSApplying methylation-specific polymerase chain reaction technique, promoter methylation of Syk and Runx3 genes in the tumor tissues and adjacent normal tissues of gastric cancer patients were detected to investigate the relationship between methylation status of the promoter region of Syk and Runx3 genes and postoperative recurrence and metastasis.

RESULTSIn the 70 cases of gastric cancer, the frequencies of promoter methylation of Syk and Runx3 genes were 45.7% (32/70) and 55.7% (39/70) in gastric cancer, and 0 (0/70) and 7.1% (5/70), respectively, in the adjacent normal tissues. The rates of promoter methylation of Syk and Runx3 genes in the gastric cancers were significantly higher than that in the adjacent normal tissues (P < 0.001 for all). The promoter methylation of Syk and Runx3 genes was significantly correlated with the degree of tumor differentiation, depth of invasion, lymph node metastasis and pathological staging (P < 0.05 for all). The frequency of postoperative recurrence and metastasis in 32 patients with Syk promoter methylation was 65.6% (21/32) and that in 38 cases with Syk promoter unmethylation was 18.4% (7/38), showing a significant difference between the two subgroups (χ(2) = 16.13, P < 0.001). The rate of postoperative recurrence and metastasis in 39 patients with Runx3 promoter methylation was 61.5% (24/39) and that in 31 patients with Runx3 promoter unmethylation was 12.9% (4/31, P < 0.001).

CONCLUSIONSThe methylation of Syk and Runx3 promoters plays an important role in postoperative recurrence and metastasis of gastric cancer. Combined detection of promoter methylation of Syk and Runx3 genes is helpful for early diagnosis and evaluation of prognosis of gastric cancer.

Adenocarcinoma ; genetics ; pathology ; surgery ; Adenocarcinoma, Mucinous ; genetics ; pathology ; surgery ; Adenocarcinoma, Papillary ; genetics ; pathology ; surgery ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Signet Ring Cell ; genetics ; pathology ; surgery ; Core Binding Factor Alpha 3 Subunit ; genetics ; DNA Methylation ; Female ; Follow-Up Studies ; Gastrectomy ; Humans ; Intracellular Signaling Peptides and Proteins ; genetics ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Promoter Regions, Genetic ; Protein-Tyrosine Kinases ; genetics ; Stomach Neoplasms ; genetics ; pathology ; surgery ; Syk Kinase ; Young Adult