PPy/SWCNTs-Modified Microelectrode Array for Learning and Memory Model Construction through Electrical Stimulation and Detection of In Vitro Hippocampal Neuronal Network.

The learning and memory functions of the brain remain unclear, which are in urgent need for the detection of both a single cell signal with high spatiotemporal resolution and network activities with high throughput. Here, an in vitro microelectrode array (MEA) was fabricated and further modified with polypyrrole/carboxylated single-walled carbon nanotubes (PPy/SWCNTs) nanocomposites as the interface between biological and electronic systems. The deposition of the nanocomposites significantly improved the performance of microelectrodes including low impedance (60.3 ± 28.8 k Ω), small phase delay (-32.8 ± 4.4°), and good biocompatibility. Then the modified MEA was used to apply learning training and test on hippocampal neuronal network cultured for 21 days through electrical stimulation, and multichannel electrophysiological signals were recorded simultaneously. During the process of learning training, the stimulus/response ratio of the hippocampal learning population gradually increased and the response time gradually decreased. After training, the mean spikes in burst, number of bursts, and mean burst duration increased by 53%, 191%, and 52%, respectively, and the correlation of neurons in the network was significantly enhanced from 0.45 ± 0.002 to 0.78 ± 0.002. In addition, the neuronal network basically retained these characteristics for at least 5 h. These results indicated that we have successfully constructed a learning and memory model of hippocampal neurons on the in vitro MEA, contributing to understanding learning and memory based on synaptic plasticity. The proposed PPy/SWCNTs-modified in vitro MEA will provide a promising platform for the exploration of learning and memory mechanism and their applications in vitro.

New Evidence for the Existence of Two Kiss/Kissr Systems in a Flatfish Species, the Turbot (Scophthalmus maximus), and Stimulatory Effects on Gonadotropin Gene Expression.

Seasonal reproduction is generally controlled by the hypothalamus-pituitary-gonadal (HPG) axis in fish. Previous studies have demonstrated that the kisspeptin (Kiss)/kisspeptin receptor (Kissr) system, a positive regulator of the HPG axis, mediates the responses to environmental cues. Turbot (Scophthalmus maximus), a representative species of Pleuronectiformes, is one of the most commercially important fish species cultured in Europe and North China. However, the mechanisms by which the Kiss/Kissr system regulates the reproductive axis of turbot according to seasonal changes, especially photoperiod, have not been clearly characterized. In the current study, the cDNA sequences of kiss2/kissr2, along with kiss1/kissr3 which was thought to be lost in flatfish species, were cloned and functionally characterized. The kiss1, kiss2, and kissr3 transcripts were highly detected in the brain and gonad, while kissr2 mRNA was only abundantly expressed in the brain. Moreover, kiss/kissr mRNAs were further examined in various brain areas of both sexes. The kiss1, kissr2, kissr3 mRNAs were highly expressed in the mesencephalon, while a substantial degree of kiss2 transcripts were observed in the hypothalamus. During annual reproductive cycle, both kiss and kissr transcript levels declined significantly from the immature to mature stages and increased at the degeneration stage in the brains of both sexes, especially in the mesencephalon and hypothalamus. The ovarian kiss1, kiss2, and kissr2 mRNA levels were highest at the vitellogenic stage (mature stage), while expression of kissr3 was highest at the immature stage. The testicular kiss and kissr transcripts were highest in the immature and degeneration stages, and lowest at the mature stage. In addition, intraperitoneal injection of Kiss1-10 and Kiss2-10 significantly stimulated mRNA levels of pituitary lhß, fhsß, and gthα. In summary, two Kiss/Kissr systems were firstly proven in a flatfish species of turbot, and it has a positive involvement in controlling the reproduction of the Kiss/Kissr system in turbot. The results will provide preliminary information regarding how the Kiss/Kissr system controls seasonal reproduction in turbot broodstock.

Sensitive detection of electrophysiology and dopamine vesicular exocytosis of hESC-derived dopaminergic neurons using multifunctional microelectrode array.

Clinical transplantation of human embryonic stem cells derived dopaminergic neurons (hESC-DDNs) is expected to be a potential therapy for treating neurodegenerative diseases. However, the assessment of the physiological functions, including electrophysiology and dopamine (DA) vesicular exocytosis of hESC-DDNs are not impeccable currently, which deeply limits the clinical application of hESC-DDNs. To overcome this challenge, we developed a multifunctional microelectrode array (MEA) which can detect both electrophysiological signals and DA vesicular exocytosis. The reduced oxidation graphene, poly(3,4-ethylenedioxythiophene) and poly (sodium-4-styrenesultanate) nanocomposites (rGO/PEDOT:PSS) were electrochemically deposited on the MEAs to improve their electrical characterizations with low impedance and small phase delay, and electrochemical characterizations with low oxidation potential, low detection limit, high sensitivity, wide linear range and high sensitivity. In the hESC-DDNs experiment, the modified MEA could detect electrophysiological signals with low noise (25 µV) and high signal-to-noise ratio (>5.4), and the weak current signals generated by DA vesicular exocytosis with high sensitivity (∼pA), high time resolution (sub-millisecond) and low noise (3 pA). Moreover, due to increased accuracy, the MEA could clearly distinguish two typical kinds of exocytosis spike events ("Spikes with foot" and "Spikes without foot") and found that the slow and low release through the fusion pore was an important mode of DA vesicular exocytosis in hESC-DDNs. Our work proved that the hESC-DDNs had the basic physiological functions as human dopaminergic neurons, which would be beneficial to the clinical application of the hESC-DDNs.

The HVEM-BTLA Immune Checkpoint Restrains Murine Chronic Cholestatic Liver Injury by Regulating the Gut Microbiota.

The herpes virus entry mediator (HVEM) is an immune checkpoint molecule regulating immune response, but its role in tissue repair remains unclear. Here, we reported that HVEM deficiency aggravated hepatobiliary damage and compromised liver repair after 3,5-diethoxycarbonyl-1,4-dihydrocollidine (DDC)-induced injury. A similar phenotype was observed in B and T lymphocyte attenuator (BTLA)-deficient mice. These were correlated with impairment of neutrophil accumulation in the liver after injury. The hepatic neutrophil accumulation was regulated by microbial-derived secondary bile acids. HVEM-deficient mice had reduced ability to deconjugate bile acids during DDC-feeding, suggesting a gut microbiota defect. Consistently, both HVEM and BTLA deficiency had dysregulated intestinal IgA responses targeting the gut microbes. These results suggest that the HVEM-BTLA signaling may restrain liver injury by regulating the gut microbiota.

Successful Spermatogonial Stem Cells Transplantation within Pleuronectiformes: First Breakthrough at inter-family Level in Marine Fish.

As a promising biotechnology, fish germ cell transplantation shows potentials in conservation germplasm resource, propagation of elite species, and generation of transgenic individuals. In this study, we successfully transplanted the Japanese flounder (P. olivaceus), summer flounder (P. dentatus), and turbot (S. maximus) spermatogonia into triploid Japanese flounder larvae, and achieved high transplantation efficiency of 100%, 75-95% and 33-50% by fluorescence tracking and molecular analysis, respectively. Eventually, donor-derived spermatozoa produced offspring by artificial insemination. We only found male and intersex chimeras in inter-family transplantations, while male and female chimeras in both intra-species and intra-genus transplantations. Moreover, the intersex chimeras could mature and produce turbot functional spermatozoa. We firstly realized inter-family transplantation in marine fish species. These results demonstrated successful spermatogonial stem cells transplantation within Pleuronectiformes, suggesting the germ cells migration, incorporation and maturation within order were conserved across a wide range of teleost species.

SWCNTs/PEDOT:PSS-Modified Microelectrode Arrays for Dual-Mode Detection of Electrophysiological Signals and Dopamine Concentration in the Striatum under Isoflurane Anesthesia.

Accurate detection of the degree of isoflurane anesthesia during a surgery is important to avoid the risk of overdose isoflurane anesthesia timely. To address this challenge, a four-shank implantable microelectrode array (MEA) was fabricated for the synchronous real-time detection of dual-mode signals [electrophysiological signal and dopamine (DA) concentration] in rat striatum. The SWCNTs/PEDOT:PSS nanocomposites were modified onto the MEAs, which significantly improved the electrical and electrochemical performances of the MEAs. The electrical performance of the modified MEAs with a low impedance (16.20 ± 1.68 kΩ) and a small phase delay (-27.76 ± 0.82°) enabled the MEAs to detect spike firing with a high signal-to-noise ratio (> 3). The electrochemical performance of the modified MEAs with a low oxidation potential (160 mV), a low detection limit (10 nM), high sensitivity (217 pA/µM), and a wide linear range (10 nM-72 µM) met the specific requirements for DA detection in vivo. The anesthetic effect of isoflurane was mediated by inhibiting the spike firing of D2_SPNs (spiny projection neurons expressing the D2-type DA receptor) and the broadband oscillation rhythm of the local field potential (LFP). Therefore, the spike firing rate of D2_SPNs and the power of LFP could reflect the degree of isoflurane anesthesia together. During the isoflurane anesthesia-induced death procedure, we found that electrophysiological activities and DA release were strongly inhibited, and changes in the DA concentration provided more details regarding this procedure. The dual-mode recording MEA provided a detection method for the degree of isoflurane anesthesia and a prediction method for fatal overdose isoflurane anesthesia.

[Analysis on application value of Fu's subcutaneous needling for intercostal pain after surgery of osteoporotic thoracic vertebral compression fracture].

OBJECTIVE: To observe the effect of Fu's subcutaneous needling therapy on pain degree, quality of life, serum 5-hydroxytryptamine (5-HT) and neuropeptide Y (NPY) in patients with intercostal pain after surgery for osteoporotic thoracic vertebral compression fracture (OVCF) and explore the application value of Fu's subcutaneous needling in treatment of post-operative intercostal pain. METHODS: A total of 60 patients with intercostal pain after OVCF surgery were divided into a medication group and a Fu's subcutaneous needling therapy group, with 30 cases in each group. In the medication group, zoledronic acid injection, salmon calcitonin injection, calcitonin D tablets and mecobalamin tablets were prescribed. The duration of treatment was 8 weeks. In the Fu's subcutaneous needling therapy group, on the base of treatment as the medicine group, Fu's subcutaneous needling therapy was provided for 2 weeks，once every other day. The needle is inserted 6 cm away from the most painful point. Separately, in 2, 4 and 8 weeks of treatment, as well as in 16 weeks after treatment, the visual analogue scale (VAS) and the generic quality of life inventory-74 (GQOLI-74) were adopted to evaluate intercostal pain and quality of life in the patients of both groups and analyze the incidence of adverse reaction. Radioimmunoassay was used to measure the levels of serum 5-HT and NPY. RESULTS: Compared with the results before treatment, in 2, 4 and 8 weeks of treatment as well as in 16 weeks after treatment, VAS scores of both groups were all reduced (P<0.05), GQOLI-74 scores increased obviously (P<0.05) and the levels of serum 5-HT and NPY increased obviously (P<0.05) in the two groups. In 2, 4 and 8 weeks of treatment as well as in 16 weeks after treatment, VAS score in the Fu's subcutaneous needling therapy group was lower than that in the medication group (P<0.05), GQOLI-74 score and the levels of serum 5-HT and NPY were higher than those in the medication group (P<0.05). During the treatment and in 16 weeks after treatment, the difference was not significant in the incidence of adverse reaction between the two groups (P>0.05). CONCLUSION: Fu's subcutaneous needling therapy can relieve intercostal pain and improves the quality of life in the patients after surgery for OVCF.

Expression profile and localization of vitellogenin mRNA and protein during ovarian development in turbot (Scophthalmus maximus).

Egg yolk generation is a common physiological process in oviparous animals. To understand oogenesis and reproductive capacity, it is necessary to characterize vitellogenins (Vtgs), which are the precursors of major egg yolk proteins (Yps). Therefore, to improve our understanding of the entire process of egg yolk generation in female turbot (Scophthalmus maximus), we obtained full-length cDNAs of vtg genes, examined gene expression in the female liver and ovary, and analyzed Vtg synthesis in the ovary. Three distinct complete polypeptide sequences were identified and designated as VtgAa, VtgAb, and VtgC, which confirmed the multiplicity of the vtg gene in turbot and showed that it follows a "three vtg model". The expression of these three vtg genes in the female liver was far higher than that in other tissues, including the ovary. The expression of all three vtg genes was extremely low before vitellogenesis, and then increased and was maintained at a high level until the degradation stage, which was in accordance with changes in the concentration of estradiol-17ß (E2) and the gonadosomatic index. Compared with the liver, the ovary had a higher E2 level and lower vtg expression, suggesting that some other factors limit high vtg expression in the ovary of turbot. Transcripts of vtgAb and the Yps derived from them were both detected in oogonia and primary oocytes, which showed that these might possess the ability to perform autosynthesis of yolk. These findings add to our understanding of the reproductive physiology of Vtg synthesis in turbot.

Spermatogonial stem cells differentiation and testicular lobules formation in a seasonal breeding teleost: The evidence from the heat-induced masculinization of genetically female Japanese flounder (Paralichthys olivaceus).

Germ cells undergo a series of cellular changes including differentiation, mitosis, meiosis and maturation, and eventually develop into a large number of functional gametes. The available data regarding teleost gametogenesis in seasonal batch spawners is limited. In this study, we investigated spermatogenesis with special attention on spermatogonia differentiation using heat-induced masculine juveniles of genetically female Japanese flounder. Meanwhile, the Nanos2 expression had been detected by immunohistochemistry for analysis of spermatogonial stem cells (SSCs) distribution. Spermatogonia began mitosis at 35 dph, and basement membrane firstly appeared and gradually surrounded and separated the spermatogonia (type A) into single and paired status. At this period, the spermatogonia continuously maintained mitotic proliferation. As a result, the number of spermatogonia including isolated and clusters (2-8 spermatogonia) significantly increased in the presumptive testes. From 85 dph to 120 dph, with the mitosis of spermatogonia, germline acinar-clusters formed. In the clusters, type A spermatogonia differentiated into type B, and multi-spermatogonia surrounded by several sertoli cell formed cysts，which represented the formation of lobular precursors. After that, type B spermatogonia began meiosis, which indicated the initiation of spermatogenesis. In adult testes, most type A spermatogonia distributed in the peripheral region and a few clung to a basement membrane in the internal germinal epithelium. Various spermatogenic cysts with germ cells in different developmental stages existed in a testicular lobules, moreover the germ cells in earlier stages resided in the distal termini, and the advanced stages were adjacent to the spermatic duct of testes. Therefore, the testes of Japanese flounder belonged to an intermediated distribution of SSCs, which might contribute greatly to multiple spermiation during breeding season. These findings would improve the understanding the mechanisms of SSCs differentiation and testicular development, and may be of great value in future studies of the spermatogenesis regulation.

Gonadogenesis analysis and sex differentiation in cultured turbot (Scophthalmus maximus).

As a flatfish, the turbot (Scophthalmus maximus) is one of the most important farmed fish species with great commercial value, which has a strong sexual dimorphism on growth rate and sexual maturity. In this study, using histology, the basic information on proliferation and migration of germ cells and early gonadal development during sex differentiation in turbot were described in detail. There were six to nine individual primordial germ cells (PGCs) with large nuclei until 15 days post-hatching (dph). The PGCs located under the mesonephric ducts undergo migration along the dorsal mesentery toward the region of the genital ridge from 0 to 15 dph. During migration, the number of PGCs was constant, and the expression of vasa had no significant changes. At 20 dph, the aggregation of somatic cells at genital ridge indicated the formation of primary gonad. Furthermore, the number of PGCs was increased to 60 and the expression of vasa was upregulated for the first time. The undifferentiated gonads with no morphological indications of sex differentiation grew larger with the increase in germ cells and somatic cells number/size from 20 to 35 dph. During 36-52 dph, cytological gonadal differentiation was observed. In presumptive testes of type I gonadal tissue (with a lance shape), the number of germ cells increased steadily and the germ cells had the same characteristics as before. Meanwhile, in presumptive ovaries of type II gonadal tissue (with a club-like shape), the germ cells proliferated and induced in two different populations of germ cells. One type had the morphological characteristics as undifferentiated germ cells, while the other type of germ cells underwent mitosis exhibiting smaller size and mottled nuclei. At 60 dph, ovarian cavity was present in the gonad of type II, which would develop into ovaries. However, spermatogonial cysts were not noticed in the gonad of type I until 90 dph, which indicated the formation of the testes.

Medial approach to treat humeral mid-shaft fractures: a retrospective study.

BACKGROUND: Plate fixation is the gold standard for diaphyseal fracture management, and the anterolateral approach is widely used by reconstructive surgeons. However, the outcomes of humeral shaft fracture fixation using a medial approach are rarely reported. The aim of this study is to explore the management and outcomes of humeral mid-shaft fractures fixed through a medial incision. METHODS: Thirty-four patients who sustained a humeral mid-shaft fracture and underwent an open-reduction internal fixation (ORIF) in our department between January 2010 and January 2013 were included in this study. Sixteen patients had an ORIF performed through a medial approach, while the remaining 18 were fixed through an anterolateral approach. Postoperative clinical and radiographic results were reviewed. RESULTS: There were no significant differences in the blood loss and the range of motion of the shoulder and elbow between the anterolateral and medial fixation groups. One patient in the medial group and two patients in the anterolateral group had radial nerve dysfunction that improved after 8, 3 and 6 weeks, respectively. All patients healed radiographically except one from the anterolateral group who underwent grafting and re-fixation for a non-union. No vascular injuries, infections, malunions, broken plates or loose screws were noted in either group. CONCLUSIONS: The medial approach to the humerus had equivalent outcomes to anterolateral fixation. It is an available choice for humeral mid-shaft fracture fixation in cases where there is no need to expose the radial nerve. The medial approach does not require a pre-bent plate and creates a large operative exposure. A well-hidden incision can also be designed, improving cosmetic outcomes. However, the medial approach is not suitable to proximal or distal humerus fractures.

Epigallocatechin-3-gallate Protects against Hydrogen Peroxide-Induced Inhibition of Osteogenic Differentiation of Human Bone Marrow-Derived Mesenchymal Stem Cells.

Oxidative stress induces bone loss and osteoporosis, and epigallocatechin-3-gallate (EGCG) may be used to combat these diseases due to its antioxidative property. Herein, oxidative stress in human bone marrow-derived mesenchymal stem cells (BM-MSCs) was induced by H2O2, resulting in an adverse effect on their osteogenic differentiation. However, this H2O2-induced adverse effect was nullified when the cells were treated with EGCG. In addition, treatment of BM-MSCs with EGCG alone also resulted in the enhancement of osteogenic differentiation of BM-MSCs. After EGCG treatment, expressions of ß-catenin and cyclin D1 were upregulated, suggesting that the Wnt pathway was involved in the effects of EGCG on the osteogenic differentiation of BM-MSCs. This was also confirmed by the fact that the Wnt pathway inhibitor, Dickkopf-1 (DKK-1), can nullify the EGCG-induced enhancement effect on BM-MSC's osteogenic differentiation. Hence, our results suggested that EGCG can reduce the effects of oxidative stress on Wnt pathway in osteogenic cells, which supported a potentially promising therapy of bone disorders induced by oxidative stress. Considering its positive effects on BM-MSCs, EGCG may also be beneficial for stem cell-based bone repair.

MicroRNA-9 expression is a prognostic biomarker in patients with osteosarcoma.

BACKGROUND: The purpose of the present study was to examine the expression levels of microRNA-9 (miR-9) in osteosarcoma tissues and normal bone tissues, and investigate the relationships between miR-9 expression, clinicopathological features and the prognosis of patients with osteosarcoma. METHODS: The expression levels of miR-9 in osteosarcoma tissues and corresponding non-cancerous tissues were detected using a real-time quantitative assay. Differences in patient survival were determined using the Kaplan-Meier method and a log-rank test. A Cox proportional hazards regression analysis was used for univariate and multivariate analyses of prognostic values. RESULTS: Compared to non-cancerous bone tissues, the expression levels of miR-9 in osteosarcoma tissues were significantly elevated (P < 0.001). We found that the expression level of miR-9 was significantly associated with tumor size (P = 0.011), clinical stage (P = 0.009) and distant metastasis (P < 0.001). The Kaplan-Meier curve showed that patients with low miR-9 expression survived significantly longer than patients with high miR-9 expression (P = 0.0017). Multivariate analysis suggested that miR-9 expression level (P = 0.002) is an independent prognostic factors for overall survival. CONCLUSIONS: The findings of our study suggest that increased miR-9 expression has a strong correlation with the aggressive progression of osteosarcoma and its overexpression is a statistically significant risk factor affecting overall survival, suggesting that increased miR-9 expression could be a valuable marker of tumor progression and for prognosis of osteosarcoma.

An evaluation of three-dimensional image-guided technologies in percutaneous pelvic and acetabular lag screw placement.

BACKGROUND: Percutaneous stabilization using three-dimensional (3D) navigation system is a promising treatment for pelvic and acetabular fractures. However, there are still some controversies regarding the use of 3D navigation to treat pelvic and acetabular fractures. The purpose of this study was to compare the Iso-C(3D) fluoroscopic navigation, standard fluoroscopy, and two-dimensional (2D) fluoroscopic navigation in placing percutaneous lag screws in pelvic specimens to better understand the merits of 3D navigation techniques. METHODS: Fifty-four instrumentation procedures were performed in this study using six cadaveric pelvic specimens. Three groups were designated for different procedures and tests: group I, standard fluoroscopy; group II, 2D fluoroscopic navigation; and group III, Iso-C(3D) fluoroscopic navigation. Nine screws were placed in each pelvis, including four screws placed bilaterally through the ilium into S1 and S2 vertebrae, four screws placed bilaterally through anterior and posterior columns of acetabulum, and one screw placed through the pubic symphysis. 3D fluoroscopic techniques were evaluated to determine the accuracy of screw position, instrumentation time, and fluoroscopic time. The data were statistically analyzed using SPSS 13.0. RESULTS: The malposition rate was 38.89%, 22.22%, and 0% in standard fluoroscopy, 2D fluoroscopic navigation, and Iso-C(3D) fluoroscopic navigation groups, respectively. There was no significant difference between standard fluoroscopy and 2D fluoroscopic navigation. Compared with Iso-C(3D) fluoroscopic navigation, there were significant differences (analysis of variance [ANOVA], P < 0.05). The mean instrumentation operating time using Iso-C(3D) fluoroscopic navigation technique was 15.4 ± 4.5 min. There were significant differences compared with standard fluoroscopy (31.5 ± 6.2 min) and 2D fluoroscopic navigation (26.3 ± 7.5 min; ANOVA, post hoc Scheffe, P < 0.01). The mean fluoroscopic time of Iso-C(3D) fluoroscopic navigation was 66 ± 4.8 min. Compared with standard fluoroscopy (132.8 ± 7.3 min) and 2D fluoroscopic navigation (47.7 ± 5.6 min), there were significant differences (ANOVA, post hoc least significant difference, P < 0.01). CONCLUSIONS: In the present study, we compared Iso-C(3D) fluoroscopic navigation, 2D fluoroscopic navigation, and standard fluoroscopy. Iso-C(3D) fluoroscopic navigation showed a higher accuracy rate in positioning and a shorter instrumentation operating time. The fluoroscopic time was longer in Iso-C(3D) fluoroscopic navigation than that in standard fluoroscopy, indicating that radiation exposure can be moderately reduced in Iso-C(3D) fluoroscopic navigation operation, although the fluoroscopic time was the shortest in 2D fluoroscopic navigation.

CO2 emission free co-generation of energy and ethylene in hydrocarbon SOFC reactors with a dehydrogenation anode.

A dehydrogenation anode is reported for hydrocarbon proton conducting solid oxide fuel cells (SOFCs). A Cu-Cr(2)O(3) nanocomposite is obtained from CuCrO(2) nanoparticles as an inexpensive, efficient, carbon deposition and sintering tolerant anode catalyst. A SOFC reactor is fabricated using a Cu-Cr(2)O(3) composite as a dehydrogenation anode and a doped barium cerate as a proton conducting electrolyte. The protonic membrane SOFC reactor can selectively convert ethane to valuable ethylene, and electricity is simultaneously generated in the electrochemical oxidative dehydrogenation process. While there are no CO(2) emissions, traces of CO are present in the anode exhaust when the SOFC reactor is operated at over 700 °C. A mechanism is proposed for ethane electro-catalytic dehydrogenation over the Cu-Cr(2)O(3) catalyst. The SOFC reactor also has good stability for co-generation of electricity and ethylene at 700 °C.

[Operative treatment of the scapular fractures through modified Judet approach].

OBJECTIVE: To investigate the effect of operative treatment of scapular fractures through modified Judet approach. METHODS: From January 1997 to October 2005, 21 patients (15 females, 6 males; mean age 34 years) of scapular fractures were treated by open reduction and internal fixation through the modified Judet approach. According to Hardegger classification system, there were 11 patients of scapular body fractures, 10 patients of scapular neck fractures, 8 patients of glenoid rim fractures, 7 patients of glenoid fossa fractures, 9 patients of scapular spine fractures, and 6 patients of scapular acromion fractures. RESULTS: Eighteen patients were followed up with an average of 21 months (range 6 months-4 years). According to Rowe scores system, 12 patients showed excellent, 3 showed good, 2 showed fair, and 1 showed poor. CONCLUSIONS: The modified Judet approaches have the advantages of wide exploration, safety, and easy fixation. It is a good choice to the operation for most types of scapular fractures through the modified Judet approach.