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.

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.

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.

Objective To discuss the differential diagnosis and treatment of bursitis around the knee. Methods 32 patients with bursitis around the knee were treated from March 2000 to March 2002 in our hospital. Their diagnosis and treatment were reviewed. The arthroscopy of knee confirmed all the initial diagnosis of the patients made by the physical examination and complaints. We gave them conservative treatment and analyzed the clinical follow ups. Results All the patients were followed up for 8 to 40 weeks. 9 of them who had no internal knee lesions but only one kind of bursitis healed within 3 weeks. 23 of them who had more than two kinds of bursitis (including four who had internal knee lesions) healed within 3 to 5 weeks. Conclusions The differential diagnosis of the bursitis around the knee can be made on the basis of complaints and physical examination. These cases can be managed by conservative treatment.

Objective To study the results of an improved method of laparoscopic treatment of inguinal hernia in children. Methods Between January 1999and October 2003,94 inguinal hernias in 86 children between 2～14 years of age were treated by laparoscopic surgery using a single trocar hole. 54 children showed a right inguinal hernia, 32 a left hernia,and 8 cases presented bilateral hernias. Of the unitaleral hernias, 10 were occult hernias. All the patients were treated by purse-string suture around the internal ring under direct vision with laparoscopy. Results Operative time was from 10-30(average 16) minutes. There were no intra-or post-operative complications. All were followed up for 4-60 months, with no recurrences . Conclusions This method of laparoscopic hernia repair is less traumatic, postoperative recovery is fast and stitch removal is not necessary. It can also be used for the treatment of occult and bilateral inguinal hernias.

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.

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.

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.

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.