Distinct molecular phenotype and the potential prognostic value of immune prognostic index and tumor infiltrating lymphocytes in hepatoid adenocarcinoma of stomach.

Hepatoid adenocarcinoma of the stomach (HAS) is a particular subtype of Gastric cancer (GC) with distinct pathological characteristics and genetic profile, but most HAS patients were received identical regimens as common GC. To date, only a few studies has been conducted to investigate the molecular characteristics of HAS, which may prevent the rational application of new anticancer strategies. To further obtain the genetic features and potential predictive and prognostic biomarkers of HAS, our current study evaluated the clinical implications of spectrum molecular markers in 36 surgical resection specimens. None Epstein-Barr virus (EBV) positive and/or micro-satellite instable high (MSI-h) tumors occurred in our study implies that the molecular classification of HAS should be mainly categorized into genomic stable (GS) and chromosomal instability (CIN) phenotypes, and wild type P53 status predicts better prognosis. More importantly, although the prognosis and clinical characteristics were independent of programmed cell death-ligand 1 (PD-L1), the presence of tumor infiltrating lymphocytes (TILs) still suggested that a portion of the enrolled HAS patients are potentially appropriate candidates for immune checkpoint blockade therapy. Additionally, the immune prognostic index (IPI) and derived neutrophil to lymphocyte ratio (dNLR) demonstrated their potential as reliable and economic indicators for predicting prognosis of HAS. We hope this first systematic evaluation will help in deciphering the molecular characterization and potential individualized regimens for this particular subtype of GC.

Locking plate for treating traumatic sternoclavicular joint dislocation: a case series.

BACKGROUND: Traumatic sternoclavicular joint dislocations are rare; closed reduction is the primary treatment. The failure of closed reduction or a prominent insult to the skin may require surgery to ensure the best possible outcome. METHODS: The records of 5 patients operated at our institution for sternoclavicular joint dislocation were reviewed. All patients were treated with open reduction and single 3.5-mm locking plate was used for fixation. Outcomes were evaluated with the Constant Shoulder Score (CSS) and Disability of the Arm, Shoulder, and Hand (DASH) questionnaire. Intraoperative and postoperative complications were recorded. RESULTS: All the patients had an average follow-up of 14 months (range, 11-16 months). At the final follow-up, the mean CSS score was 89.5 (range, 78-98) and the mean DASH score was 9.0 (range, 4-16). There were no early complications, including wound infection or neurologic or vascular deficits; there were also no broken or loosened screws or plates. No case of redislocation or arthrosis was observed. CONCLUSION: Our study indicates that open reduction and fixation with a single locking plate for the treatment of traumatic sternoclavicular joint dislocation is a safe, relatively simple surgical procedure that can lead to satisfactory outcomes.

Finite element analysis of intramedullary nailing and double locking plate for treating extra-articular proximal tibial fractures.

BACKGROUND: Proximal tibia fractures are one of the most familiar fractures. Surgical approaches are usually needed for anatomical reduction. However, no single treatment method has been widely established as the standard care. Our present study aims to compare the stress and stability of intramedullary nails (IMN) fixation and double locking plate (DLP) fixation in the treatment of extra-articular proximal tibial fractures. METHODS: A three-dimensional (3D) finite element model of the extra-articular proximal tibial fracture, whose 2-cm bone gap began 7 cm from the tibial plateau articular surface, was created fixed by different fixation implants. The axial compressive load on an adult knee during single-limb stance was imitated by an axial force of 2500 N with a distribution of 60% to the medial compartment, while the distal end was fixed effectively. The equivalent von Mises stress and displacement of the model was used as the output measures for analysis. RESULTS: The maximal equivalent von Mises stress value of the system in the IMN model was 293.23 MPa, which was higher comparing against that in the DLP fixation model (147.04 MPa). And the mean stress of the model in the IMN model (9.25 MPa) was higher than that of the DLP fixation system in terms of equivalent von Mises stress (EVMS) (P < 0.0001). The maximal value of displacement (sum) in the IMN system was 8.82 mm, which was lower than that in the DLP fixation system (9.48 mm). CONCLUSIONS: This study demonstrated that the stability provided by the locking plate fixation system was superior to the intramedullary nails fixation system and served as an alternative fixation for the extra-articular proximal tibial fractures of young patients.

Single lateral versus medial and lateral plates for treating displaced scapular body fractures: a retrospective comparative study.

BACKGROUND: This study compared the outcomes and complications of single lateral plating vs. dual plating for treating displaced scapular body fractures. METHODS: Open reduction and internal fixation using locking plates was performed in 45 patients with displaced scapular fractures. A single lateral plate fixed in the lateral border was used in 22 patients (group A), and dual plates fixed in both the lateral and medial borders were used in 23 (group B). RESULTS: The average follow-up duration in both groups was 20 months. A remarkable difference was seen between the 2 groups in mean operative time and blood loss, although the Disabilities of the Arm, Shoulder and Hand and Constant Shoulder scores at the final follow-up were similar. The prominence rate of the hardware was 27.3% (6 of 22) in group A and 65.2% (15 of 23) in group B. The plate removal rate was 31.8% (7 of 22) in group A and 78.3% (18 of 23) in group B. CONCLUSIONS: Open reduction using a single plate on the lateral border for treating displaced scapular body fractures can lead to good functional outcomes, shorter operative time, less blood loss, and fewer plate-related complications compared with the dual-plating technique.

A fluorescence biosensor for VEGF detection based on DNA assembly structure switching and isothermal amplification.

Vascular endothelial growth factor (VEGF) is an important biomarker in cancer angiogenesis. Here, we develop a aptasensor method for VEGF detection based on DNA assembly structure switching and isothermal amplification. The design employs a DNA assembly made of a isothermal amplification template, a aptamer, a primer and a protector chain. The DNA assembly is unable to undergo isothermal amplification in the absence of target. The presence of the target, however, triggers a structure switching event that causes hybridization of primer with template to facilitate isothermal amplification. Whereafter, toehold-mediated DNA strand displacement reaction between the generated (single-stranded DNA) ssDNA and fluorescent/quencher labeled probe are performed. Then, the increase in fluorescence provides an analytical signal. This strategy opens up a sensitive, selective and simple sensing platform for detection of VEGF. The system was also implemented to analyze the VEGF in human serum samples with satisfactory results.

Acromial approach for treating glenoid fractures: A report of two cases and a literature review.

Surgery is usually recommended for displaced glenoid fractures, with open reduction and internal fixation as the standard operative treatment. Three approaches have been recommended in the reduction of glenoid fractures: Anterior, posterior and combined; however, a traditional approach may be difficult due to a high position or a comminuted Ideberg type III fracture. The combined approach results in a longer incision and more soft tissue injury when associated with an acromial fracture. The present study describes two complicated glenoid fractures: One case was a comminuted Ideberg type III fracture associated with an Ogawa type II acromial fracture; the second case was an Ideberg type IV fracture with associated superior shoulder suspensory complex injuries. In these cases, the acromial approach was modified to achieve satisfactory exposure and fixation of the complicated fracture. After a 1-year follow-up, the patients had a satisfactory outcome.