OBJECTIVE To compare the clinical efficacy of distal radius T-plate combined with suture anchor and distal clavicle anatomical locking plate combined with suture anchor in the treatment of Neer Ⅱb distal clavicle fracture. METHODS From June 2014 to June 2018, 42 patients with Neer Ⅱb distal clavicle fractures were retrospectively analyzed. According to different surgical methods, they were divided into the observation group (T-shaped plate combined with suture anchor) and the control group (anatomical locking plate combined with suture anchor). There were 22 patients in the observation group and 20 patients in the control group. In the observation group, there were 13 males and 9 females, aged from 22 to 70 (45.78± 14.44) years old, 12 cases on the left side and 10 cases on the right side, 8 cases of traffic accident injury and 14 cases of fall. In the control group, there were 12 males and 8 females, aged from 24 to 66 (44.17±15.58) years, 13 cases on the left side and 7 cases on the right side, 6 cases of traffic accident injuryand 14 cases of fall. The operation time, intraoperative blood loss and fracture healing time were compared between the two groups, and Constant Murley score was used to evaluate shoulder joint function. RESULTS The patients in both groups were followed up for 18 to 24 (20.96±2.02) months. The incisions of both groups were healed at stageⅠ. The fracture ends of both groups were bony healed at the last follow up. There was no significant difference in operation time, intraoperative blood loss and fracture healing time between two groups (P>0.05);there was no significant difference in shoulder joint function between two groups at 3 months after operation (P>0.05). CONCLUSION The two methods can obtain satisfactory results in the treatment of Neer Ⅱb distal clavicle fractures, especially suitable for patients with comminuted distal clavicle fractures or osteoporosis; the clinical effect of the treatment of NeerⅡb distal clavicle fractures with T type distal radius plate combined with suture anchor is satisfactory, which provides another feasible treatment scheme for clinic.

目的:观察腓骨远端解剖钢板治疗旋后-内收型Ⅱ度内踝骨折的临床疗效.方法:自2010年3月至2017年8月,对28例旋后-内收型Ⅱ度踝关节骨折患者,采用腓骨远端解剖钢板固定内踝骨折,术后评估其临床疗效.结果:本组28例患者均获得6～24个月随访,平均随访时间14个月.所有患者伤口均I期愈合,术后1,3,6及12个月复查踝关节X线片,28例患者骨折均获得愈合,平均愈合时间16.8周.根据AOFAS踝-后足评分系统评价:术后评分75～94分,优16例,良9例,可3例.结论:采用腓骨远端解剖钢板治疗旋后-内收型Ⅱ度内踝骨折,固定坚固,对软组织损伤较小,并发症少,临床效果满意.

目的 系统评价Ezrin表达水平预测骨与软组织肉瘤预后的价值.方法 计算机检索PubMed、EMbase、The Cochrane Library (2016年2期)、CNKI、CBM、VIP和WanFang Data数据库,搜集Ezrin表达对骨与软组织肉瘤相关性的队列研究,检索时限均为建库至2016年5月.由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析.结果 共纳入17个队列研究,共1 460例.Meta分析结果显示:在骨与软组织肉瘤患者中Ezrin高表达组的总生存率[HR=1.90,95％CI(1.70,2.13),P＜0.00001]、无事件生存率[HR=2.42,95％CI(1.53,3.84),P=0.0002]、无转移生存率[HR=2.09,95％CI(1.10,3.97),P=0.02]明显低于低表达组.进一步按肿瘤类型和种族对总生率进行亚组分析也得到相似的结果.结论 Ezrin高表达可作为骨与软组织肉瘤预后不良的预测因子.受纳入研究数量和质量限制,上述结论尚需开展更多高质量研究加以验证.

Objective To explore the expression and clinical significance of E-cadherin and β-catenin in osteosarcoma tissues.Methods From April 2012 to October 2015,54 specimens of osteosarcoma tissues and 22 specimens of osteochondroma tissues were enrolled.Immunohistochemistry was used to detect the expression of E-cadherin and β-catenin in those above tissues.The correlation of the expression of E-cadherin,β-catenin and clinical parameters of osteosarcoma were analyzed.Results In 54 specimens of osteosarcoma tissues,the positive rate of E-cadherin protein was 35.2％ (19/54),significantly lower than 68.2％ (15/ 22) in osteochondroma tissues (P＜0.05).However the positive rate of β-catenin protein was 68.5％ (37/54),significantly higher than 9.1％ (2/22) in osteochondroma tissues (P＜0.05).The expression of E-cadherin protein was associated with Enneking stage and metastasis (P＜0.05).The expression of β-catenin protein was associated with tumor size,Enneking stage and metastasis (P＜0.05).Moreover,the expression of E-cadherin and β-catenin was negatively correlated (r=-0.764,P＜0.05).Conclusion E-cadherin and β-catenin are abnormally expressed in osteosarcoma tissues,and they are correlated to Enneking stage and metastasis.Both of them play a role in the development and progression of osteosarcoma.