Necroptosis is a newly discovered form of programmed cell death, which is activated by the binding of death receptors and their ligands and executed through specific path ways. At present, this form of cell death has been proved to be involved in a variety of diseases,such as cancer, autoimmune diseases, traumatic brain injury and brain ischemia-reperfusion injury.

20?, ranging from 21? to 75?(average, 35?), and 59 cases 20?. Results Successful decompression in which the distance from the middle point of connecting line between bilateral transverse processes to the posterior wall of vertebral body was more than 8 mm, was achieved in 59 cases (85.5%); satisfied correction of kyphosis was noticed in 10 cases. Post-operatively the mean angle of kyphosis deformity was 10.8? ranging from 0? to 40?. During the mean follow-up period of 12.5 months, neurological functional recovery was noticed in 63.8% of total cases. For complete spinal cord injury, 17.6% of cases recovered partially(sensory function), whereas neurological function recovery was noted in 78.8% of cases with incomplete spinal cord injury, the statistical difference was significant between the incomplete and complete spinal cord injury cases. Conclusion The old thoracolumbar fracture with incomplete spinal cord injury could be treated with transpedicular anterior decompression and osteotomy, neurological functional recovery is expected.

Ojective The improve laparoscopic treatment of inguinal hernia in children. Methods 40 children aged from 2 to 14 years were treated by single port laparoscopic surgery for inguinal hernia between January 1999 and December 2000. Twenty four children manifested a right inguinal hernia, 12 a left hernia, and four cases a bilateral hernia. All the patients were treated by purse-string suture around the internal ring under laparoscopy. Results The duration of operation were from 10 to 30 minutes. There was no intra-or postsurgical complication. Conclusions The single port laparoscopic surgery is a simple, conveninet, quick and safe and minimal invasive procedure for the treatment of inguinal hernia in children.

OBJECTIVE: To summarize literature on clinic research of locking compression plate (LCP) on fracture of distal radius, proximal humeral fracture, tibia fracture and other fracture.DATA SOURCE: The first author retrieved literatures from PubMed database (http://www.ncbi.nlm.nih.gov/PubMed and CNKI database (www.cnki.net/index.htm) published between June 1992 and May 2009 with the key words of "LCP, Fracture, Therapy,Review".DATA SELECTION: Inclusion criteria: cases undergoing LCP internal fixation; clinical of LCP internal fixation. Repetitive studies were excluded.MAIN OUTCOME MEASURES: A total of 127 literatures were selected and primarily collected by reading titles and abstract. A total of 51 literatures unrelated to study objective, and 35 studies of repetitive contents were excluded. Finally, 41 literatures were included for analysis, containing review, commentary, treatise and clinical report.RESULTS: LCP internal fixation was applied in clinical broadly in recent years. Therapeutic efficacy was significantly better than common internal fixation system. LCP internal fixation depended on minimal invasion LCP internal fixation, with characteristics of small wound, simple operation, stable internal fixation and fracture anatomical reduction. It could replace external fixation to some extents. The stability was bigger compared with the external fixation. However, intramedullary pin fixation should be firstly selected for lower limb cadre fracture. There were few studies on this aspect. Controlled studies should be performed in the future.CONCLUSION: LCP was invented as a new technology which was transition from mechanics of machinery to biomechanics. The method makes good contribution to orthopaedics by advocating elasticity, reducing hurt and promoting callus.

65 years,Type A in 1,Type B in 1).Radial nerve injury resulted from operation obtained complete recovery 3 months post-operation;1 case that transient ulnar nerve palsy recovered 3 days after operation;elbow heterotopic ossification in 1 case;there were no radial nerve injury in 23 cases where the plate was removed in same approach.Elbow function evaluated by Mayo Score system were excellent in 18,good in 8,fair in 4,bad in 3.At the last follow-up,the strength of triceps was about 4～5 grade.[Conclusion]The fracture of middle and lower humeral shaft can be exposed and fixed safely by triceps-splitting approach,the rate of complications was acceptable.

Objective To discuss the clinical effects of open reduction and internal fixation with locking compression plate(LCP)to treat elderly women with comminuted distal radius fracture.Methods 32 elderly women(35 sides)with comminuted distal radius fractures were treated by open reduction and internal fixation with LCP from March 2002 to October 2004 in our department.Their mean age was 65 years old.According to AO classification,11 sides were type A3,15 sides type C2 and nine sides type C3.Volar approach was used in 32 sides and dorsal approach in three sides.Bone graft was applied for five sides.Results The follow-up period was 10 to 41 months(mean 21.5 months)and the union period was three to five months.According to Dienst criteria of joint functions,the result s showed that 13 sides were excellent,19 sides good,two sides fair and one side poor.Complications included wound dehiscence and superficial infection in five sides and median nerve injury in two sides.Conclusion The LCP method in this study is one of the good options to treat elder women with comminuted distal radius fractures.

Objective To explore a reasonable treatment for intertrochanteric hip fractures in the aged patients by comparing the fixation effects of cannulated compression screws and intramedullary fixation nails. Methods From January 1998 to December 2004, in our department 123 old patients with intertrochanteric hip fracture were fixed with cannulated compression screws or intramedullary nails. They were followed up and their complete clinic data kept. According to the Evans classification, of the 51 patients who received treatment with cannulated compression screws for their anterograde intertrochanteric hip fracture, 14 were type Ⅰ , 24 type Ⅱ , 10 type Ⅲ and three type Ⅳ , while of the 72 patients who received treatment with intramedullary nailing, 10 were type Ⅰ , 12 type Ⅱ , 28 type Ⅲ , 14 type Ⅵ , and eight retrograde intertrochanteric hip fractures. A retrospective comparison was made between the old patients treated with the two different fixation devices in terms of operative time, blood loss, transfusion, average hospitalization time, intraoperative and postoperative complications, functional recovery one year postoperatively and treatment expenses. Results The differences between the two groups in operative time, blood loss, transfusion, treatment expenses were of statistical significance (P0.05). Conclusions Cannulated compression screws should be chosen for old patients with anterograde intertrochanteric hip fractures of Evans types Ⅰ & Ⅱ or of Evans types Ⅲ & Ⅳ who are at a high risk, in a poor health or severely osteoporotic state. For patients with unstable Evans types Ⅲ & Ⅳ or with retrograde intertrochanteric hip fractures, intramedullary nails are suitable.

Objective To study the advantages and summerize the practice of laparoscopic appendectomy (LA) for elderly patients. Methods Forty one elderly patients with appendicitis aged from 60 to 76 were treated with LA. The operative procedure, surgical indications, recovery, postoperative pain, and complications, as well as the period and the cost for hospitalizing were studied. Results All 41 patients were comfirmed appendicitis through LA. Thirty nine patients undergone LA were operated smoothly. Only two patients were cured with exploratory laparotomy. The preoperative diagnosis was confirmed in 6 patients and the complication of other diseases were found in 5 cases by LA. Two cases were operated by abdominal incision during LA. Postoperative complications, such as infection of the incision and pain were less occurred. The concurred diseases with appendicitis need simple treating. The hospitalizing period was 4 days on the average and the cost was 20%～30% higher than other procedures. Conclusions Most of elderly patients can be early diagnosed and timely treated by LA. LA could be a more popular choice for the elderly patients with appendicitis since its advantages of safe and minimal invasion. It has been an outstandihg method in treating appendicitis compared to other traditional methods.

Objective To report our experience on video-assisted thoracoscopic surgery(VATS)and perioperative management for patients over 70 years old.Methods From May 1998 to May 2008,78 patients over 70 years old were treated by VATS.Operative risk was evaluated by measuring forced expiratory volume in first second(FEV1),diffuse capacity of carbon monoxide(DLCO),and left ventricular ejection fraction(LVEF),and artery blood gas analysis and exercise test before the operation.VATS(n=46)or video-assisted minithoracotmy(n=32)was carried out under general anesthesia with a double-lumen tube.Extubation was delayed in 11 patients after the procedures and mechanical ventilation was employed to smooth anesthesia recovery.Results Postoperative pathological examination showed primary lung cancer in 20 cases,benign pulmonary lesions in 26,pleural mesothelioma in 3,malignant pleural metastasis in 5,empyema in 5,benign mediastinal tumor in 15,hiatal hernia in 3,and esophageal leiomyoma in 1.Postoperative morbidity was 33.3%(26/78)in this series,none of the patients died during the operation;the perioperative mortality was 2.6%(2/78).Conclusions VATS is safe for elderly patients.Satisfying outcomes can be achieved through strict preoperative evaluation,proper operative method and active management for postoperative complications.

0.05). Sixteen patients in the video-assisted thoracic surgery group were followed up for a mean of 42.9 months (20-88 months), during which no recurrence was detected. In the minithoracotomy group, 18 patients received an 18-to 71-month follow-up (mean, 41.2 months), none of them had recurrence. Conclusions The outcomes of both the operations are satisfying for middle-aged or elderly patients with spontaneous pneumothorax. However, video-assisted thoracic surgery should be the first choice.