Objective To evaluate the influence of the alendronate treatment in early-stage adult nontraumatic avascular necrosis of femoral head. Methods The 83 patients with nontraumatic avascular necrosis of femoral head were enrolled in this study. They were given oral alendronate 70 mg weekly, and evaluated with Harris criteria before and after treatment. Results In the patients with ARCO Ⅰ necrosis, the scores of pain and function were higher after treatment than before [(41.45±3.55) scores vs. (38. 48± 5.55) scores, t = 3. 70, P = 0. 001; (45.06 ± 1.50) scores vs. (43.97 ±2.31) scores, t= 3.76, P= 0. 001]. In the patients with ARCO Ⅱ necrosis, the scores of pain,function and activity were also higher after treatment than before [(40. 40±4.31 ) scores vs. (37.32±6. 65) scores, t=4.06, P=0.00; (42.90±2.70) scores vs. (41.66±3.35) scores, t=3.15, P=0.003; (4.76±0.47) scores vs. (4.42±0.70) scores, t=3.35, P=0.002]. Conclusions Alendronate is effective in treatment of early-stage adult nontraumatic avascular necrosis of femoral head, in particular for ARCO Ⅱ patients. But its long-term effect is worth researching in future.

Objective To investigate effect of tuberosity reduction and fixation during humeral head replacement for treatment of complex proximal humeral fractures on functional recovery of the shoul-der ioint and on decrease and prevention of complieaitons. Methods From January 2004 to August 2007,42 elderly patients(at average age of 78.5 years)with three-or four-part fractures and dislocations of proximal humerus received humeral head replacement.Cable-needle interual implant cerclage T-shape compression fixation was done in 14 patients.classic Dacron needle fixation in 13 and classic Dacron nee-die fixation plus metal band extemal implant cerclage fixation in 15.Postoperative exercises were carried out according to Neer's rehabilitation principles. Results All patients were reviewed with the Ameri-can Shoulder and Elbew Surgeons(ASES)score at the mean follow.up of 8 months postoperatively.Sta-tisticaI difierence of ASES score was found between the postoperative iniured shoulder and the preoperative ipsilateral side as well as the uninjured side.Tuberosity complication was found postoperatively at X-P in ll patients including 5 with absorption of tuberosity.4 with lateral displacement(2 posterior-lateral posi-tion and 2 anterior lateral position)and 2 with supra.subluxation of the head of prosthesis. Conclu-sions Cable-needle internaI implant cerclage T-shape compression fixation during humeral head replace-ment is better than other two methods and brings about earlier postoperative rehabilitation.which is help-ful for functional recovery of the shoulder as soon as possible.prevention of tuberosity complications and improvement of shoulder funotion rehabilitation level.

Objective To observe the effects of fosamax on the fracture healing and the bone mineral density(BMD)in postmenopausal women with radius distal osteoporotic fracture(RDOF).Methods All the 62 patients with RDOF were randomly divided into 2 groups after the fracture was fixed manually.Thirty-two patients in treated group took fosamax 1 tablet(70 mg)per week for 12 weeks and caltrate D 600 mg per day,while the other 30 patients in control group took caltrate D 600 mg per day only.The BMD and the fracture healing time were detected after 12 weeks' treatment.Results The fracture healing time was(9.31±2.50)weeks in treated group and was(13.0±2.8)weeks in control group(t=5.54,P＜0.01).BMD was significantly increased after treatment in treated group[(0.615±0.075)g/cm2 vs.(0.665±0.085)g/cm2,t=2.50,P＜0.05],while there was no obvious change of BMD in control group[(0.620±0.085)g/cm2 vs.(0.617±0.075)g/cm2,P＞0.05].BMD was higher in treated group than in control group after treatment(t=2.46,P＜0.05). Conclusions Fosamax can promote formation of bony callus,increase BMD and shorten external fixation time of radius distal osteoporotic fracture in postmenopausal women.

Objective To investigate sensitivity of colon cancer cells to 5-fluorouracil after downregulation of XIAP gene expression. Method Colon cancer cells HCT-8 and HCT116 were transfected with a short hairpin RNA targeted to XIAP by liposome, cells viability were examined.5-fluorouracil was applied into two kinds of colon cancer cells. Tumor cells sensitiviy to chemotherapeutic drug was evaluated. Caspase-3 activity in tumor cells was examined by Western blot. Result After downregulation of XIAP expression, cell growing viability of these two kinds of colon cancer cells was restricted, HCT-8 resistance to 5-fluorouracil was reversed ( P ＜ 0. 01 ), HCT116 sensitivity to 5-fluorouracil was enhanced (P ＜ 0.05), caspase-3 expression in colon cancer cells was highly activated, apoptosis inducing activity of 5-fluorouracil was increased significantly. Conclusions XIAP expression was a important mechanism in colon cancer cells HCT-8 and HCT 116 resistant to 5-fluorouracil, sensitivity to 5-fluorouracil of HCT-8 and HCT-116 was increased by downregulation of XIAP expression.

Objective To investigate the clinical efficacy of complete mesogaster excision in the radical gastrectomy for gastric cancer.Methods The clinical data of 100 patients with distal gastric cancer who were admitted to the First Affiliated Hospital of Harbin Medical University from January 2011 to December 2012 were retrospectively analyzed.All the patients underwent complete mesogaster excision in D2 radical gastrectomy for gastric cancer.The operation quality was evaluated according to operation time,volume of intraoperative blood loss,mean number of lymph nodes dissected,time to flatus,volume of drainage and duration of postoperative hospital stay.Patients were followed up by outpatient examination and telephone interview till May 2014.Results Complete mesogaster excision in the radical gastrectomy for gastric cancer was successfully carried out on all the 100 patients.The operation time,volume of intraoperative blood loss,mean number of lymph nodes dissected,time to flatus,volume of drainage and duration of postoperative hospital stay were (118 ± 34) minutes (range,90-160 minutes),(80±25)mL (range,45-135 mL),38± 10 (range,25-52),(3.0 ± 1.2)days (range,1.5-4.5 days),(62±15)mL (range,15-85 mL) and (7.0±1.5)days (range,4.0-11.5 days),respectively.According to the postoperative pathological results,there were 36 patients with high differentiated gastric carcinoma,38 with moderate and/or low differentiated gastric carcinoma,17 with low differentiated gastric carcinoma and 9 with signet ring cell carcinoma.After operation,3 patients had gastroplegia,2 with poor healing of abdominal incision,2 with duodenal stump fistula,1 with pancreatic fistula,and all of them were cured by conservative treatment.All the 100 patients were followed up for a mean time of 25.6 months (range,17.6-39.2 months).There was no tumor recurrence.Conclusions Complete mesogaster excision in the radical gastrectomy for gastric cancer is safe and feasible,with the advantage of minimal trauma,low morbidity and quick recovery during the follow up.

Objective To evaluate No.16a2b1 lymphadenectomy for D2 gastrectomy of advanced gastric cancer.Methods In this study,we retrospectively analysed the data of 100 patients with advanced gastric cancer from April 2004 to April 2005.All the patients were in stage T3-4.50 patients underwent D2 plus No.16a2b1 lymphadenectomy while the other 50 patients underwent standard D2 operation.Results The metastatic rate of No.16a2b1 lymph node was 18％ ;The bleeding volume,operation time,postoperative intestinal function recovery time and the incidence of postoperative complications between D2 plus No.16a2b1 lymphadenectomy group and standard D2 operation group were [(351 ± 121) ml vs.(305 ±-105) ml,t=2.03],[(192±50) vs.(172±40),t=2.22],[(5 ±2) days vs.(4±-2) days,t=3.33],and [10％ (5/50) vs.8％ (4/50)] respectively.All differences were not statistically significant (P ＞0.05).While 5 year survival rates were 24％ (12/50) vs.6％ (3/50) respectively,the difference was statistically significant (P ＜ 0.05).Conclusions No.16a2b1 lymphadenectomy is necessary,feasible and prolongs survival for advanced gastric cancer patients,especially in stage T3 and T4 undergoing D2 operation.

Purpose:To explore the relationship between genetic polymorphisms of p53 codon72 and the risk of gastric cancer.Methods:A population based case control study was conducted in Taixing, Jiangsu Province, China, and 204 gastric cancer cases and 415 controls were collected. Results:Distribution of Pro/Pro genotype in cancer cases was significantly higher than controls. The OR and 95%CI of Pro/Pro or Pro/Arg genotype was 1.5 (1.01～2.23) compared with Arg/Arg genotype. Pro/Pro or Pro/Arg genotype may interact with cigarette smoking, alcohol drinking, river water drinking and high salt food intake. Conclusions:Pro genotype may be related with the risk of gastric cancer and may also interact with environmental risk factors to increase the risk of gastric cancer.

Objective To study the apoptosis-inducing effect of recombinant adeno-associated virus serotype 8 with soluble TRAIL gene on human colon cancer cell line HCT116. Method Recombinant adeno-associated virus serotype 8 with TRAIL gene was generated by triple plasmid transfection of HEK293 cells with phosphate calcium precipitation. After infected by recombinant virus, cell growth assay was carried out by counting alive cells after trypan blue exclusion. Alternations of cell morphology was examined by microscopy. Cell apoptosis was detected by DNA laddering. The protein expressions of apoptosis-3 and apoptosis-8 were detected by Western blotting. Result The growth rate of the AAV8-sTRAIL infected HCT116 cells was significantly inhibited. Recombinant virus induced apoptosis in colon tumor cells by triggering caspase cascade, but not in normal human hepatocytes. Conclusion AAV8-sTRAIL efficiently suppresses the growth of human colon cancer cell line HCT116 by inducing apoptosis, with no evident toxicity to normal cell.

Objective To evaluate the clincal therapeutic efficacy of mesh-plug tension-free hernia repair in elder patients with inguinal hernia.Methods The clinical data of 127 elder patients with inguinal hernia treated with mesh-plug tension-free hernia repair in our hospital were analyzed retrospectively.Results All cases were treated by tension-free hernia repair with mesh-plug case-hardened products which manufactured by American Bard Company.All the patients were cured.Average operation time was 40 min,and average(hospital) stay was 4.6d.The patients were followed up for 6~24 months,only 1 case had recurrence of(hernia)(recurrence rate 0.8%).Conclusions Mesh-plug tension-free hernia repair is a perfectly sound physiologic and anatomic operation.It is a simple,minitraumatic procedure,with advantages of quick (recovery),low recurrence rate and wide indications.It is especially suitable to elder patients or patients with the type II or larger hernial.

Objective:To measure vertical axis length of humerus head in patients with proximal hu-meral fractures and to evaluate the use of structure screws in proximal humerus internal locking osteosyn-thesis system ( PHILOS) .Methods:From January 2007 to February 2014,117 patients with proximal hu-merus fracture were treated by PHILOS plate.Preoperatively, all the patients tookanteroposterior X-ray of shoulder, and the vertical axis length of humerus head were measured, and the use of structure screws in PHILOS plate was observed.Results: There were 40 male and 77 female patients; The vertical axis length of humerus head in male patients was (47.64 ±3.44) mm, and the rate of structure screw use was 52.5%;The vertical axis length of humerus head in female patients was (42.46 ±3.21) mm, and the rate of structure screw use was 32 .5%.The vertical axis length of humerus head and the rate of structure screw use had significant difference in the male and female groups (P<0.05).Conclusion:The rate of structure screw use was low in the treatment of proximal humerus fracture by PHILOS plate, especially for women.We should improve the design of plate according to the anatomical characteristics of Chinese.