Neoadjuvant chemotherapy combined with endocrine therapy for hormone receptor-positive breast cancer: A systematic review and meta-analysis.

BACKGROUND: This study aimed to conduct a comparative analysis of the efficacy and safety of neoadjuvant chemotherapy combined with endocrine therapy against the backdrop of single neoadjuvant chemotherapy or endocrine therapy, specifically in the context of hormone receptor-positive (HR+) breast cancer treatment. METHODS: We conducted a thorough literature search across several databases, including China National Knowledge Infrastructure, Wanfang, Weipu, Chinese Journal Full-text Database, PubMed, Web of Science, Cochrane Library, and EMBASE, adhering to the guidelines outlined in the PRISMA statement. Our specific focus was on identifying randomized controlled trials that directly compared the combined approach of neoadjuvant chemotherapy and endocrine therapy with single chemotherapy or endocrine therapy in the context of treating HR+ breast cancer. Subsequently, we utilized statistical packages implemented in R software to perform comparative analyses of key clinical indicators, encompassing the complete response, objective response rate (ORR), disease control rate, pathological complete response (pCR), and adverse reactions. RESULTS: A total of 11 randomized controlled trials, involving 1359 patients, all of whom met our inclusion criteria and were thus included in our comprehensive analysis. Within this cohort, 688 patients (50.63%) administered neoadjuvant chemotherapy combined with endocrine therapy (NCET), 642 patients (47.24%) received neoadjuvant chemotherapy (NCT) alone, while 29 patients (2.13%) underwent neoadjuvant endocrine therapy (NET) alone. The results of our meta-analysis revealed that NCET exhibited a statistically significant enhancement in both ORR and pCR (P < .05). Nonetheless, when compared to NCT or NET, NCET did not yield a significant impact on complete response, disease control rate, and safety (P > .05). In addition, NCET demonstrated a significant improvement in ORR among patients with HR+, HER2-negative breast cancer (P < .05). However, it was also linked to a heightened incidence of serious adverse reactions within this particular patient subgroup (P < .05). CONCLUSION: The combination of Neoadjuvant chemotherapy and endocrine therapy stands out as a significant contributor to enhancing the ORR and pCR for HR+ breast cancer patients. For breast cancer patients with HER2- status, NCET demonstrates a remarkable improvement in ORR but is also associated with the emergence of adverse reactions.

A simple and successful treatment for rupture and defect of the posterior third superior sagittal sinus caused by open depressed skull fracture: A case report.

It is extremely dangerous to treat the posterior third of the superior sagittal sinus (PTSSS) surgically, since it is usually not completely ligated. In this report, the authors described the case of a 27-year-old man with a ruptured and defective PTSSS caused by an open depressed skull fracture, which was treated by ligation of the PTSSS and the patient achieved a positive recovery. The patient's occiput was hit by a height-limiting rod and was in a mild coma. A CT scan showed an open depressed skull fracture overlying the PTSSS and a diffuse brain swelling. He underwent emergency surgery. When the skull fragments were removed, a 4 cm segment of the superior sagittal sinus (SSS) and the adjacent dura mater were removed together with bone fragments. Haemorrhage occurred and blood pressure dropped. We completed the operation by ligating the severed ends of the fractured sagittal sinus. One month after the operation, apart from visual field defects, he recovered well. In our opinion, in primary hospitals, when patients with severely injured PTSSS cannot sustain a long-time and complicated operation, e.g., the bypass using venous graft, and face life-threatening conditions, ligation of the PTSSS is another option, which may unexpectedly achieve good results.

High GP73 Expression Correlates with Poor Response to Neoadjuvant Chemotherapy and Survival in Gastric Cancer: A Tissue Microarray Study.

Golgi protein 73 (GP73) is a type II Golgi transmembrane protein which is overexpressed in several cancers, however, its role in gastric cancer is still unclear. The aim of this study is to investigate if high GP73 expression is associated with pathological tumor response to neoadjuvant chemotherapy and prognosis for patients with gastric cancer. A total of 348 patients with gastric cancer, who had undergone surgery between 1999 and 2011 were retrospectively reviewed, GP73 expression was examined in tumor tissues using tissue microarray and the correlations between its expression and pathological response to neoadjuvant chemotherapy as well as patients prognosis were analyzed. We found that GP73 expression was not associated with clinicopathologic features including tumor size, differentiation and TNM stage. High expression of GP73 was associated with less pathological tumor response to neoadjuvant chemotherapy and poor survival in gastric cancer, multivariate analysis showed GP73 expression was an independent predictive factor for pathological response to neoadjuvant chemotherapy and for prognosis in patients with gastric cancer. Our results suggest that GP73 expression correlates with the effect of neoadjuvant chemotherapy and is a promising biomarker to identify patients with poor prognosis.

LncRNA NORAD/miR-202-5p regulates the drug resistance of A549/DDP to cisplatin by targeting P-gp.

In this study, we established the DDP-resistant NSCLC cell line A549/DDP to detect the effect of NORAD on cisplatin resistance of A549/DDP cells. NORAD was highly expressed in A549/DDP cells compared with A549 cells. The MTT data showed that knockdown of NORAD enhanced the inhibition rate of cisplatin on the A549/DDP cells and decreased IC50 value. The colony formation and MTT assay suggested that cisplatin inhibited cell proliferation, and knockdown of NORAD enhanced the inhibitory effect of cisplatin on A549/DDP cells. Besides, we found that NORAD silence reduced the P-gp expression but not BCRP, LRP and MRP. Moreover, NORAD could directly bind to miR-202-5p, and ABCB1 was a target of miR-202-5p. The MTT assay found that miR-202-5p inhibitor reversed the effects of NORAD silence on cisplatin resistance of A549/DDP cells. Then, the Western blot data showed that knockdown of NORAD reduced P-gp expression, and miR-202-5p inhibitor enhanced P-gp expression. ABCB1 overexpression reversed the inhibitory effect of NORAD knockdown on A549/DDP cells. Moreover, NORAD could directly bind to miR-202-5p, and ABCB1 was a target of miR-202-5p. Inhibition of miR-202-5p and overexpression of ABCB1 eliminated the effects of NORAD silence on cisplatin resistance of A549/DDP cells. Overexpression of miR-202-5p suppressed P-gp expression in A549/DDP cells. Collectively, our data showed that NORAD could enhance the DDP resistance of A549/DDP cells and potentially increased P-gp expression by sponging the miR-202-5p.

Low level of serum high-density lipoprotein cholesterol in gastric cancer correlates with cancer progression but not survival.

BACKGROUND: The clinical significance of lipid profile in gastric cancer remains unclear. The aim of the present study was to investigate the correlation between serum lipid profiles and patient clinical parameters as well as prognosis in gastric cancer. METHODS: The preoperative plasma lipid profile levels of 358 gastric cancer patients, who were operated in between 2001 and 2009, were retrospectively evaluated, and the correlation between these factors and patient clinical parameters as well as survival were analyzed. RESULTS: There was a significant association between serum high-density lipoprotein cholesterol level (HDL-C <54.2 mg/dL) and cancer progression, Logistic regression analysis revealed that lower level of serum HDL-C was an independent risk factor for deeper cancer invasion, nodal metastasis as well as late stage in patients with gastric cancer. However, no significant association was reported between other lipid markers [triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein (VLDL) and apolipoprotein A (apoA)] and lymph node involvement as well as stage of disease. In univariate analysis and multivariate analyses regarding patient's survival, there was no significant association between the groups in terms of TG, TC, HDL-C, LDL-C, VLDL and apoA. CONCLUSIONS: Low level of serum HDL-C in gastric cancer correlates with cancer progression but not patient's survival.

[Effect of Simulated Climate Warming on Microbial Community and Phosphorus Forms in Wetland Soils].

Microbial community and phosphorus forms in response to simulated climate warming were studied by high-throughput sequencing and 31P nuclear magnetic resonance(31P-NMR) respectively, which were from wetland soils in constructed microcosm columns. The results revealed that relative abundances of Firmicutes, Clostridia, Clostridiales, Clostridiaceae and Clostridium were significantly decreased by 65%-98%, 69%-87%, 67%-87%, 73%-97% and 74%-93% under warming condition respectively, suggesting warming had a significant inhibitory effect on the bacterial lineage from Firmicutes to Clostridium at different taxonomic level. Particularly, principal coordinate analysis and cluster analysis also demonstrated warming had a significant effect on microbial community structure with obvious separation of samples between control and warmed groups from each wetland column site. Phosphorus forms were dominated by phosphomonoester and orthophosphate in each wetland column soil, which were significantly increased and decreased by 275% and 20% in XX wetland column soil respectively. Similarly, phosphomonoester and polyphosphate were also found to be increased and decreased by 85% and 49% in JH wetland column soil respectively, indicating that phosphorus forms in response to warming had soil heterogeneity. Canonical correspondence analysis showed that obvious changes in microbial community composition had significant effects on phosphorus forms under warming condition.

New utility of an old marker: serum low-density lipoprotein predicts histopathological response of neoadjuvant chemotherapy in locally advanced gastric cancer.

BACKGROUND: Although the correlation between metabolic abnormality and gastric cancer has been extensively investigated, the question of whether metabolic parameters might influence the efficacy of chemotherapy in locally advanced gastric cancer is still unanswered. In our present study, we investigated the relationship between serum fasting glucose, lipid levels, and histopathological response of neoadjuvant chemotherapy (NAC) in locally advanced gastric cancers. PATIENTS AND METHODS: A total of 128 patients were identified from a prospectively maintained database of patients with locally advanced gastric cancer who received NAC between July 2004 and December 2012. Histopathological response after NAC was analyzed according to Becker's tumor-regression grade. Univariate analyses and multivariable regression analyses were performed to determine the correlation between tumor size, differentiation, fasting glucose, lipid levels, and tumor histopathological response after NAC. RESULTS: Univariate analysis revealed that low-density lipoprotein level and total cholesterol, as well as tumor size and differentiation, correlated significantly with histopathological response. Low-density lipoprotein levels and tumor size were found to be independent predictors for histopathological response, according to multivariable regression analyses. CONCLUSION: In this observational, hypothesis-generating study, serum low-density lipoprotein measurement was found to be useful in predicting chemosensitivity to locally advanced gastric cancer patients undergoing NAC. Incorporation of serum low-density lipoprotein levels into individualized treatment protocols could be considered in clinical practice.

Afzelin exhibits anti-cancer activity against androgen-sensitive LNCaP and androgen-independent PC-3 prostate cancer cells through the inhibition of LIM domain kinase 1.

Prostate cancer presents high occurrence worldwide. Medicinal plants are a major source of novel and potentially therapeutic molecules; therefore, the aim of the present study was to investigate the possible anti-prostate cancer activity of afzelin, a flavonol glycoside that was previously isolated from Nymphaea odorata. The effect of afzelin on the proliferation of androgen-sensitive LNCaP and androgen-independent PC-3 cells was evaluated by performing a water soluble tetrazolium salt-1 assay. In addition, the effect of afzelin on the cell cycle of the LNCaP and PC-3 prostate cancer cell lines was evaluated. Western blot analysis was performed to evaluate the effect of afzelin on the kinases responsible for the regulation of actin organization. Afzelin was identified to inhibit the proliferation of LNCaP and PC3 cells, and block the cell cycle in the G0 phase. The anticancer activity of afzelin in these cells was determined to be due to inhibition of LIM domain kinase 1 expression. Thus, the in vitro efficacy of afzelin against prostate cancer is promising; however, additional studies on different animal models are required to substantiate its anticancer potential.

[Comparative analysis of population genetic structure of Potato virus Y from different hosts].

Nucleotide sequences of P3 and pipo genes of Potato virus Y (PVY) from potato and tobacco were compared to investigate the effect of hosts on the population genetic structure. Meanwhile, mutation, natural selection and gene flow were evaluated to determine evolutionary forces responsible for the population genetic dynamics. The fixation indices of population differentiation (FST) of PVY from tobacco and potato were 0.116 and 0.120, respectively with significant difference, suggesting a moderate genetic differentiation between the two populations. Genetic variation analysis showed that nucleotide identities in P3 and pipo genes among the viral isolates from tobacco were respectively in the range of 85.2%-100% and 76.5%-100% while that from potato were respectively in the range of 95.7%-100% and 93.0%-100%, indicating higher genetic variation in PVY from tobacco than that from potato. Moreover, purifying selection was detected on the majority of polymorphic sites within P3 gene, suggesting that most of mutations in the gene were harmful and consequently being eliminated by natural selection. Conversely, positive selection was detected on two polymorphic sites, suggesting that these two mutations were beneficial to PVY. Neither purifying nor positive selection was detected in pipo gene, indicating neutral evolution of the gene. The values of gene flow (Nm) between PVY populations from tobacco and potato in P3 and pipo genes were 1.91 and 1.83, respectively, suggesting strong gene flow also contributes significantly to the population genetic dynamics of PVY population. In summary, this study indicates there was a significant genetic variation in PVY hosted by tobacco and potato, and mutation, natural selection and gene flow all contribute to the genetic diversity and population dynamic of the virus.

FOXA1 Expression Significantly Predict Response to Chemotherapy in Estrogen Receptor-Positive Breast Cancer Patients.

PURPOSE: Most estrogen receptor (ER)-positive breast cancer responds poorly to chemotherapy and no single cost-effective biomarker capable of selecting chemosensitive ones has been found yet. We investigated FOXA1 for its role in predicting chemosensitivity of this subgroup in neoadjuvant chemotherapy settings. METHODS: We reviewed pathologic slides of 123 patients who were diagnosed with ER-positive breast cancer on core needle biopsy and underwent neoadjuvant chemotherapy at our institution between 2002 and 2012. FOXA1 expression and pathologic response were evaluated. We then statistically analyzed FOXA1 expression and its relationship with chemosensitivity. RESULTS: FOXA1 expression before NAC was correlated with poor chemoresponse in ER-positive as well as luminal A and luminal B breast cancer patients (p = 0.002, 0.001, and 0.049 respectively). Significant association between change of FOXA1 staining position after NAC and chemosensitivity also was observed (p = 0.024). Multivariate analysis identified FOXA1 expression before NAC as an independent predictor of chemosensitivity in ER-positive and luminal A breast cancer patients [p = 0.002; relative risk (RR) 0.163; 95 % confidence interval (CI) 0.053-0.500, and p = 0.002; RR 0.055; 95 % CI 0.008-0.353, respectively]. Additionally, change of FOXA1 staining position after NAC was shown to be an independent predictor of chemoresponse in luminal B subtype breast cancer patients (p = 0.012; RR 0.153; 95 % CI 0.035-0.665). CONCLUSIONS: FOXA1 expression can independently predict chemosensitivity of ER-positive breast cancer patients.

The transcription factor KLF4 as an independent predictive marker for pathologic complete remission in breast cancer neoadjuvant chemotherapy: a case-control study.

BACKGROUND: To identify whether a stem cell biomarker, KLF4, may predict the pathologic tumor response to neoadjuvant chemotherapy for patients with locally advanced breast cancer. METHODS: Twelve locally advanced breast cancer patients who achieved pathologic complete remission (pCR) after neoadjuvant chemotherapy were identified and for each, three non-pCR breast cancer patients - matched for age, clinical tumor-node-metastasis stage, and neoadjuvant chemotherapy cycles - were selected. The relationship between KLF4 expression in the core needle biopsied cancer tissue and patient pCR rate was assessed using univariate and multivariate analysis. RESULTS: Receiver operating characteristic curve analysis showed that the patients with a histoscore of KLF4 expression >0.18 had a lower pCR rate. Multivariable analysis showed that higher KLF4 expression (odds ratio 0.013; 95% confidence interval 0.013-0.444; P=0.004) was independently correlated with a lower pCR rate after neoadjuvant chemotherapy. CONCLUSION: KLF4 overexpression was associated with lower pCR in locally advanced breast cancer patients undergoing neoadjuvant chemotherapy. This study suggests that KLF4 may serve as a predictor for pCR in patients with breast cancer after neoadjuvant chemotherapy.

The relationship between Lin28 and the chemotherapy response of gastric cancer.

OBJECTIVE: The aim of the study reported here was to identify whether a stem cell biomarker, Lin28, may predict the pathologic tumor response to neoadjuvant chemotherapy for patients with locally advanced gastric cancer. METHODS: The study enrolled 47 patients with gastric cancer who underwent neoadjuvant chemotherapy followed by surgery between July 2004 and March 2012. Cancer tissue was biopsied by gastroscopy and Lin28 expression in the tissue was measured by immunohistochemistry. Statistical analyses were performed to identify the relationship between Lin28 expression and tumor regression grade. RESULTS: Of the 47 cases, pathologic nonresponse was observed in 29 (61.7%) and pathologic response in 18 (38.3%). Receiver-operating characteristic curve analysis showed that the histoscore of Lin28 expression with 0.325 as a cutoff value could differentiate between pathologic response and nonresponse. Multivariable analysis showed that Lin28 expression was an independent predictive factor for pathologic response to neoadjuvant chemotherapy (P = 0.006). CONCLUSION: Lin28 expression was associated with pathologic tumor response in locally advanced gastric cancer patients undergoing neoadjuvant chemotherapy. This may suggest that Lin28 can serve as a predictive biomarker for neoadjuvant chemotherapy in patients with gastric cancer.

[Prognostic effect of postoperative resection-margin status for intraoperative positive resection margins in patients with advanced gastric cancer].

OBJECTIVES: To investigate prognostic effect of postoperative resection-margin status for intraoperatively positive resection margin in advanced gastric cancer and discuss the treatment choice for intraoperatively positive resection margins. METHODS: A retrospective study was investigated in 64 advanced gastric cancer patients with positive resection margin after potentially curative resection. The survival between 50 patients who was re-excised to a negative resection margin (NR group) and 14 patients who were left with positive resection margin (PR group) was compared. Prognostic factors were analyzed using univariate and multivariate Cox regression model analysis. RESULTS: The median survival in the PR group was 17.0 months (95%CI: 11.6 - 22.4) as compared with 23.0 months (95%CI: 20.5 - 25.5) in the NR group (P = 0.045). However, resection-margin status lost significance on multivariate analysis. In the subgroup of D2 lymphadenectomy, the median survival in the PR group and NR group were 17.0 months (95%CI: 12.0 - 22.0) and 24.0 months (95%CI: 19.8 - 28.1) respectively; multivariate analysis further identified resection margin status as an independent prognostic factor. CONCLUSIONS: Re-excision for intraoperatively positive margin to negative margin improves the prognosis of the patients with advanced gastric cancer, and re-excision is the first choice when intraoperative frozen section detects a positive margin. Routine frozen section of resection margin should be mandatory in all advanced gastric cancer undergoing potentially curative surgery.

Complete genome sequence of narcissus late season yellows virus infecting Chinese narcissus in China.

The complete genome sequence of a Chinese narcissus isolate of narcissus late season yellows virus from Zhangzhou, China (NLSYV-ZZ), was determined to be 9,651 nucleotides in length, excluding the 3'-terminal poly (A) tail, by amplification and sequencing of virus RNA. The viral genome contains a single long open reading frame of 9,315 nucleotides encoding a polyprotein of 3,105 amino acids. The polyprotein was predicted to be cleaved into ten mature proteins by three viral proteases. Complete genome sequence comparison and phylogenetic analysis indicated that NLSYV-ZZ was most closely related to narcissus yellow stripe virus (NYSV), which was also isolated from narcissus. These viruses shared 69.9 % identity in their complete nucleotide sequences and 77.0 % identity in their polyprotein amino acid sequences.

Sentinel lymph node biopsy predicts lymph node metastasis in early gastric cancer: a retrospective analysis.

BACKGROUND/AIMS: Minimally invasive treatments have emerged as the frontline therapy for patients with early gastric cancer (EGC). However, some cT1N0 patients with EGC may have lymph node metastasis because of inadequate evaluation. This study aimed to investigate the diagnostic accuracy of sentinel lymph node (SLN) and tried to find out feasible criteria for SLN-guided minimally invasive surgery for EGC. METHODS: A solitary metastasis lymph node was taken as SLN, the features of lymph node metastasis were analyzed retrospectively in 255 patients with EGC, and the result was then compared with a SLN biopsy in 23 patients with EGC. RESULTS: Depth of invasion and tumor size were independent risk factors for lymph node metastasis in EGC. The lymph node metastasis rate for mucosal carcinoma with a diameter <4 cm was 2.5%, and it was 13.3% when the diameter was ≥ 4 cm (p = 0.040). For submucosal carcinoma, it was 25.4% when the tumor diameter was <3 cm and 50.5% when the diameter was ≥ 3 cm (p = 0.003). The accuracy, sensitivity, and specificity of SLN biopsy in EGC was 100%, respectively. The distribution characteristics of SLN were consistent with those of lymph node metastasis in EGC. CONCLUSIONS: SLN-guided minimally invasive surgery could be safely performed in EGC according to feasible criteria.

Dystroglycan is associated with tumor progression and patient survival in gastric cancer.

Previous reports had indicated that there was a possible correlation of dystroglycan (DG) with biological behavior of cancer cells and cancer patients' survival. However, the role of DG expression in gastric cancer was rarely studied. In this study, α-DG and ß-DG expression were determined by immunohistochemistry in specimens of primary cancer, metastatic lymph node, distal metastatic lesion, and their normal counterpart tissues in 20 gastric cancer patients. Correlations between α-DG and ß-DG expression and prognosis were retrospectively analyzed. Our results found that positive expression of α-DG in normal mucosa, paired primary tumor, metastatic lymph node and distal metastatic site was detected in 95%, 70%, 25%, and 5% specimens, individually. Regarding ß-DG,it was 70%, 55%, 10%, and 10%, individually. Patients who had lower α-DG expression in tumors than in normal counterparts showed poor survival (p = 0.002), whereas such a correlation was not found in the case of ß-DG (p = 0.079). Difference of α-DG between primary tumor and its normal counterparts was an independent prognostic factor in gastric cancer with distal metastasis. This study showed DG expression was gradually reduced during tumor progression. Different expression of α-DG, but not ß-DG, between primary tumor and normal specimen, correlated with patient survival, implicating a potential marker for gastric cancer prognosis.

Clinicopathologic variables predicting tumor response to neoadjuvant chemotherapy in patients with locally advanced gastric cancer.

BACKGROUND AND OBJECTIVES: To identify clinicopathologic variables that could predict pathologic tumor response to neoadjuvant chemotherapy for patients with locally advanced gastric cancer. METHODS: The study enrolled 108 patients who underwent neoadjuvant chemotherapy followed by surgery between July 2004 and December 2010. Tumor responses to neoadjuvant chemotherapy were assessed in terms of tumor regression. Statistical analyses were performed to identify factors associated with pathologic tumor response. RESULTS: Tumor regression was found in 22.2% (24/108) patients, patients with tumor regression observed better overall survival as compared to that of patients without tumor regression. Univariate and multivariate analyses observed that both tumor differentiation and tumor size were independent predictors of tumor regression. CONCLUSIONS: This study suggests that both tumor differentiation and tumor size is the most important clinical predicator of pathologic tumor response, it may be of benefit in the selection of treatment options in locally advanced gastric cancer.

[Effect of static magnetic field on deep wound healing of SD rats].

OBJECTIVE: To investigate the effect of static magnetic field on deep wound healing of SD rats and VEGF during the wound healing and different strength static magnetic field on deep wound healing of SD rats. METHODS: Divided forty-eight SD rats into three groups: 0.16 T magnetic disk treatment (0.16 T group), 0.32 T magnetic disk treatment (0.32 T group), control group. General wounds healing situation was observated on the 3, 6, 9, 12 day. The area of every wound was calculated. The tissue of granulation was dyeing by immune tissue chemical decoration method, in which VEGF protein content with its range in tissue was measured. RESULTS: The healing index of 0.16 T magnetic group wounds were larger than that of control group on 6th and 9th day, there were statistical difference. The healing index of 0.32 T magnetic group wounds were larger than that of control group on 3rd, 6th, 9th and 12th day, there were statistical difference. The healing index of 0.32 T group wounds contrasted to that of 0.16 T group wounds had no statistical significance. Observation of VEGF at the course of wound healing:the expressing of VEGF in magnetic group wounds on 3rd and 6th was stronger than in control group wounds, there were statistical difference. While there were no obvious difference between them on 9th and 12th day (P>0.05). But the contrast between that in 0.32 T group and in 0.16 T group had no statistical difference. The expressing strength of VEGF in magnetic group reached the peak amplitude on the 6th day, and that in control group reached peak amplitude on 9th day. And the peak amplitude of magnetic group was stronger than that of control group. CONCLUSION: Static magnetic disc of 0.16T and 0.32 T can promote deep wound of SD rats heal. The mechanism of static magnetic field promoting wound heal may be relative to the expressing highly of VEGF during early and middle time.

[Treatment of fracture of the tubiform bone with domestic locking plate through minimal invasive incision and bridging reduction fixation].

OBJECTIVE: To study the therapeutic method and clinical effect of domestic locking plate for treating fracture of the tubiform bone through a minimal incision and bridging fixation. METHODS: Among 40 patients with fracture of the tubiform bone, 29 patients were male and 11 patients were female, aged from 29 to 69 years, with the average of 38.27 years. Among 34 patients with closed fracture, 7 cases were type A, 10 cases type B, 17 cases type C according to AO/ASIF classification. Among 6 patients with open fracture, 2 cases were type I, 4 cases were type II according to Gustilo classification. These patients were treated with a small incision after manipulative reduction. Locking plate and 3.5 mm diameter Kirschner wire were used to maintain the reduction and through the C-arm X-ray machine to check and adjust the position, screw were locked to bridging fixation at last. RESULTS: Forty cases were followed up in 6 months on average (ranging from 4 to 10 months). The average time of union of fracture was 4.6 months (ranging from 3 to 8 months). According to Ovadia typing, the results were excellent in 16 cases, good in 20 cases, fair in 3 cases,poor in 1 case. The excellent and good rate was 90%. CONCLUSIONS: The domestic locking plate is suitable for patients with osteoporosis and comminuted fracture because of the advantages of reliable fixation and low price. It could achieve the same effect of minimal invasive as LISS (less invasive stabilizing system) plate through the improvement of operative method.