Objective To investigate the effects of artificial semi-shoulder joint replacement for humerus proximal fractures in the aged patients. Methods From January 2004 to February 2007, 42 elderly patients who had been diagnosed as three or four-part fractures of proximal humerus received humeral head replacement. The rotor cuffs were repaired during operation, and the lesser tuberosity and greater tuberosity were reconstructed. Early functional exercise was carried out according to the Neer rehabilitation principles. Results All the patients were followed up for 10 to 28 (mean, 12.7) months postopera-tively. Their shoulder functions were assessed by the ASES (American Shoulder and Elbow Surgeon) score. Obvious pain relief was observed. Eleven cases were excellent, 24 good, 4 fair and 3 poor. The good-to-excellent rate was 83.3%. No prosthetic loosening was noted in this group, but upward shift of the shoulder prosthesis occurred in 3 cases, slight limitation of upward movement in 1 case and absorption of lesser or greater tuberosity in 4 cases. Conclusion Artificial semi-shoulder replacement can be applied for three or four-part fractures of proximal humerus in the aged patients.

Objective To study the effect of polysaccharide of Cipangopaludina chinensis on gray human cervix cancer cells(Hela cells) in vitro. Methods Polysaccharide of Cipangopaludina chinensis gray was extracted by water extraction. MTT assay and microscope were used to observe its effect on the growth inhibition of Hela cells at different concentrations of the polysaccharide. Results Polysaccharide of Cipangopaludina chinensis could more significantly inhibit the growth of Hela cells. Conclusion Polysaccharide of Cipangopaludina chinensis could inhibit human cervix cancer cells in vitro

OBJECTIVE:To observe therapeutic efficacy and safety of tegafur,gimeracil and oteracil potassium combined with oxaliplatin assisting with radiofrequency ablation(RFA)in the treatment of liver metastases after radical operation of rectal cancer. METHODS:A total of 130 patients with liver metastases after radical operation of rectal cancer were randomly divided into control group and observation group,with 65 cases in each group. After RFA one week,control group was given Oxaliplatin injection 130 mg/m2 intravenously,d1,more than 3 h. Observation group was additionally given Tegafur capsule,for consecutive 14 d,drug with-drawal of 7 d,as a treatment course. A treatment course lasted for 3 weeks,and both groups received 2 courses of treatment. Short-term efficacies of 2 groups were observed as well as complete ablation rate,local recurrence rate,survival rate and the occur-rence of toxic reaction. RESULTS:The total remission rate,disease control rate,complete ablation rate,1-year,2-year and 3-year survival rates of observation group were significantly higher than those of control group,and local recurrence rate was significantly lower than control group,with statistical significance(P<0.05). There was no statistical significance in the incidence of toxic reac-tion between 2 groups(P>0.05). CONCLUSIONS:Tegafur,gimeracil and oteracil potas siucn combined with oxaliplatin assisting with RFA shows significant therapeutic efficacy for liver metastase after radical operation of rectal cancer,and can significantly de-lay disease progression,reduce local recurrence rate and prolong survival time,and does not increase the occurrence of toxic reac-tion.

Objective To discuss the application value of external fixator to treat the fractures of children according to the characteristics of the fracture of chidren. Methods 25 cases of different complicated fractures of children were treated with external fixator from Jan,1999 to Aug.2001, and given function exercises in the earlier periode after operation. Results The mean follow up time was 10 months. All the fractures healed.The recovery of function was excellent in 88%cases.The long effect is to be observed. Conclusions Using of external fixator to treat the complicated unstable fractures of children can make definite reduction,help to observe and manage the limb and skin after operation,and greatly meet the needs of the fractures of children.The external fixator has a great clinical application value in treating different complicated fractures of children.

Objective To evaluate the clinical outcome of surgical treatment of comminuted and intra articular fractures of the distal radius. Methods Forty two cases of comminuted and intra articular fractures of distal radius encountered from January 1999 to January 2001, were operated upon either with internal fixation with the Titanium screw plate or with external fixator according to the types of fracture. Patiens data: there were 14 male and 28 female patients with age of 21-69 years and an average of 36 years; fractures on the left side in 18 and right side in 24 cases. The fractures were categorized according to the AO classification of distal radial fractures: 3 cases of type B1; 8 cases of type B2(dorsal Barton fracture); 4 cases of type B3(volar Barton fracture); 14 cases of type C1; 8 cases of type C2 and 5 cases of type C3. Types B1, B2, B3 and C1 with unsatisfactory closed manipulation were treated primarily with open reduction and internal fixation with an oblique T shaped pure Titanium plate and screws; types C2 and C3 were primarily treated with external fixators; depending upon the condition of reduction during surgery; Kirshners wires were applied accordingly. Twenty six cases were treated with oblique T shaped pure Titanium plate and screws, 9 with open reduction and external fixator, 7 cases were treated with Kirshners wires and external fixator. According to the types of fracture, the pure Titanium plate and screws, simple internal fixation+external fixator, and only external fixator was used accordingly. Results All 42 patients were followed up regularly. According to AO evaluation of the wrist joint movement, 83.3%(35 cases) of the patients had satisfactory functional outcome, 14.3%(6 cases) had quite satisfactory results and only 2.4%(1 case) had unsatisfactory functional outcome. Conclusion The reduction of the distal radial fractures should include the maintenance of the relative length of the radius and ulna, the smoothness of the articular surface and the palmar and ulnar deviation angles. The shortening of the radius results in the pain with movement and the restriction of function, and hence is considered to be the most important factor affecting the joint function. The ulnar deviation is quite easy to restore, and its mal angulation is rare. The reduced palmar deviation angle results in the restriction of the wrist flexion. For the comminuted and intra articular distal radial fractures, the surgical reduction for the maintenance of the relative length of the radius and ulna, a good reduction of articular surface, reduction of palmar and ulnar deviation angle are the key points for a successful outcome. Early functional exercise is equally important for the best recovery of wrist function.

Objective To explore the surgical treatment of ankle fractures and observe the postoperative rehabilitation. Methods Of 120 cases (68 males and 52 females, age range 18-72 years, average 26.8 years), there were 55 cases with injury on the left ankle and 65 on the right. Eight cases had only medial malleolus fracture, 21 pure lateral malleolus fracture, 58 bimalleolar fracture and 33 trimalleolar fracture.According to Danis-weber's classification, there were eight cases belonging to type A, 78 type B and 34 type C. The lag cancellous screw and tension band were used for medial malleolus and the pure titanic plate and screw for lateral malleolus fractures. The compression screw for 4.5 mm was inserted from anterior part to fixate the posterior malleolus fractures with defects bigger than 1/4 of the joint surface. The criterion was anatomic reduction under naked eyes. Postoperative function exercise was performed with no plaster for external fixation. Results A followed up for 6-12 months showed that 113 cases (94.2%) could walk as normal, 7 (5.8%) felt ache at the culf and uncomfortable at the ankle when walking and 116 satisfied with the results with satisfaction rate of 96.7%. Conclusions Exact reduction,stable internal fixation and active postoperative rehabilitation can help the joint recover to normal function in most cases with ankle fractures.

Objective To evaluate the treatment method and clinical outcome of the aged distal radius fractures. Methods 171 cases with fractures of distal radius from January 1999 to March 2004 were analysed. There were 31 males and 140 females(mean age, 67.3 years; range, 60-76 years). The fractures were classified according to the AO classification of distal radial fracture: 7 B1, 12 B2, 8 B3, 27 C1, 22 C2 and 19 C3. The operation group included 95 patients, 19 males and 76 females(mean age, 69.1 years; range, 60-76 years). 45 were on the left side and 50 on the right side. The non-operation group included 76 patients, 12 males and 64 females(mean age, 65.1 years; range, 60-69 years). 34 were on the left side and 42 on the right side. The fractures type were the following: 35 A2, 24 A3, 5 B1, 4 B2, 3 B3, 2 C1, 1 C2 and 2 C3. For the type A fractures, the priority of treatment was the close reduction and plaster immobilization; for the type B and C1 fractures, it was the open reduction and "T" titanium plate fixation when the close manipulation failed; for the type C2 and C3 fractures, the "T" titanium plate fixation would take the precedence of other methods; and when the fractures were closed to the joints, the external fixator would take the place of plate. Furthermore, the locking compression plate could be selected for the severe osteoporosis. Results Only 22 cases of patients were followed-up in the non-operation group(mean 7 months; range, 4-22 months); but all of 95 operated patients were followed-up(mean 6.5 months; range, 3-20 months). The fractures all healed on X-ray. According to Aro's evaluation of the distal radial fracture, in the non-operation group, there were 11 excellent, 9 good, 1 fair and 2 poor, the good-excellent rate was 86.9%; while in the operation group there were 46 excellent, 40 good, 7 fair and 2 poor, the good-excellent rate was 90.6%. Conclusion The different methods of treatment should be used for distal radial fracture according to the patient types. In case of the fracture and deformity in the articular surface or severe comminuted fracture in the metaphysis of the distal radius, the operation is indicated; and the manipulation can be used in simple metaphysis fractures with a good bone quality.

Proximal femur consists of femoral head, femoral neck and trochanter. The neck and trochanteric parts of femur are easy to get fractured under conbolution forces. As the conservative treatment tends to cause high rates of complication and mortality, more and more surgeons vote for early internal fixation in recent years. The best treatment for femoral neck fracture is now internal fixation with cannulate screws, especially for the patients with good bone density, fundus and intertrochanteric fractures as well as the type I, type Ⅱand part of type Ⅲfractures in Gardon's classification. Although intertrochanteric fractures are relatively stable, but internal fixation is necessary for good results and prevention of complications. DHS(dynamic hip screw)are advisable for A1, part of A2 and A3 intertrochanteric fractures in AO classification, especially for A1 cases. PFN (proximal femoral nail) is designed for intertrochanteric fractures, inversion and elevation intertrochanteric fractures. In order to get better prognosis in patients older than 70 years and with serious osteoporosis and A2 3, A3 3 fractures, we designed a special kind of prosthesis for them and therefore get satisfactory results.

Both pretreatment of lignocellulose and its saccharification process are treated with ultrasonic wave.The morphology,structure and crystal performance of the original and treated lignocellulose sample were characterized by SEM and FTIR.Moreover,the changes of raw materials caused by different pretreatment ways and the affect of saccharification rate brought about by ultrasonic wave were also studied.The result shows that the ultrasonic wave decreases the crystallinity of lignocellulose destroying the intermolecular hydrogen bonding effectively and improves the degradation rate of lignin and the saccharification rate of zymohydrolysis availably.The mechanism of activation of ultrasonic wave in zymohydrolysis process was discussed primarily.

Objective To investigate the prognostic outcome of open reduction and internal fixation(ORIF)with radial head resection in treatment of comminuted radial head fractures so as to discuss the corresponding operation options.Methods A series of 23 patients with Mason type Ⅲ or Ⅳ radial head fractures were enrolled in the study including 11 males and 12 females.Eight patients(three with Mason type Ⅲ and five with Mason type Ⅳ)underwent radial head resection and 15(seven with Mason type Ⅲ and eight with Mason type Ⅳ)received open reduction and internal fixation including nail and plate fixation in eight and screw and K-wire fixation in seven.The outcomes were assessed in regard of range of motion,radiographic findings,visual analogous scale(VAS)of pain,patient satisfaction degree,disabilities of the arm,shoulder and hand score system(DASH)and the Broberg & Morrey elbow performance score system.Results The follow-up period ranged from 12 to 65 months(mean 35 months),which showed fracture healing in all patients,with no traumatic arthritis happened.The mean range of flexion and extension arc at the elbow of ORIF group and resection group was 132°and 79.4°(P＜0.01)and the patient satisfaction was 9.1 and 8.0(P ＜0.05)respectively.According to the Broberg & Money elbow performance score system,the score was average 93.9 in the ORIF group,with excellent result in nine patients,good in five and fair in one,while the score was average 80.6 in the resection group,with excellent result in two patients,good in two and fair in four.There was statistical difference between two groups(P ＜0.01).The DASH score of the ORIF and resection group was 2.9 and 18.1 respectively(P＜0.05).Conclusions ORIF has better elbow motion,elbow function,daily living and satisfactory outcomes than radial head resection and is recommended for treatment of Mason type Ⅲ or Ⅳ radial head fractures for repair of the radial head as far as possible.