Objective To investigate the expression of VEGF-D and MMP-2 and explore their relationship with tumor invasion and local metastasis in pancreatic carcinoma.Methods The expression of VEGF-D and MMP-2 in 30 patients with pancreatic carcinomas and 6 cases with normal pancreatic tissues were detected by SABC immunohistochemical method.Results The positive rates of VEGF-D and MMP-2 proteins were 60%(18/30)and 66.7%(20/30)respectively,no expression of VEGF-D and MMP-2 was detected in normal pancreatie tissues.The expression of VEGF-D was significantly correlated with lymph node metastasis(P＜0.05),and the expression of MMP-2 was significantly correlated with lymph node metastasis and tumor local invasion(P＜0.05).The expression of VEGF-D protein Was positively correlated with MMP-2 protein(rs=0.54,P＜0.01).Conclusions There is a significantly positive correlation between high expression of VEGF-D and MMP-2 proteins in pancreatic carcinoma,and they may contribute to the invasive properties of pancreatic cancer.

Objective To compare the clinical outcomes of mini-invasive plate osteosynthesis ( MIPO ) and conventional open plating for complex fractures of midshaft clavicle. Methods The authors retrospec-tively reviewed the data of complex fractures of midshaft clavicle ( AO/OTA types 15-B2 and 15-B3 ) which had been treated with MIPO or conventional open plating between January 2010 to February 2016. Forty-one patients were treated with MIPO and 43 with conventional open plating. The 2 groups were compared in terms of incision length, hospital stay, bone union time, postoperative Constant score and Disabilities of the Arm, Shoulder and Hand ( DASH ) score, patients'satisfaction and complications. Results The average follow-up was 21. 2 ± 9. 2 months for MIPO group and 23. 1 ± 11. 8 months for conventional open plating group. The incision length ( 4. 3 ± 0. 5 cm ) , hospital stay ( 7. 7 ± 1. 9 d ) and union time ( 10. 6 ± 3. 2 w ) in the MIPO group were signifi-cantly shorter than those in the conventional open plating group ( 8. 4 ± 1. 3 cm, 9. 6 ± 3. 1 d and 12. 3 ± 3. 9 w, respectively ) ( P <0. 05 ) . The MIPO group had significantly lower incidences of hypertrophic scarring and dysesthesia in the area of incision but significantly higher patients'satisfaction than the conventional open plating group ( P <0. 05 ) . There were no significant differences in the Constant score or DASH score at 3 months, 6 months and the final follow-up ( P > 0. 05 ) . Conclusion In the treatment of complex fractures of midshaft clavicle, although both MIPO and conventional open plating can lead to similar functional outcomes, MIPO may be advantageous over conventional open plating in smaller surgical incision, more rapid fracture union, shorter hospital stay and higher patients'satisfaction.

Objective To evaluate the clinical outcomes of split fractures of humeral greater tuberosity treated by our self-designed new type of anatomical locking plate.Methods From September 2012 to February 2017,23 patients were treated for acute split fracture of the humeral greater tuberosity using our self-designed new type of anatomical locking plate.They were 13 males and 10 females with a mean age of 52.8 years (range,from 25 to 81 years).Of them,6 were beyond 60 years old, 12 had comminuted fracture,10 were complicated with glenohumeral dislocation,and 12 with rotator cuff tear.The patients were evaluated clinically with Constant-Murley score,visual analog scale (VAS),range of motion and complications at the last follow-ups.Results This series were followed up for 12 to 30 months (mean,23.2 months).All the fractures healed after an average time of 10.6 weeks (range,from 8 to 12 weeks).Their mean Constant-Murley Score was 92.1 points (range,from 70 to 100 points),giving an excellent and good rate of 95.7％ (22/23);their VAS scores averaged 0.8 points (range,from 0 to 4 points).Their forward flexion averaged 160.6°,abduction 157.8°,external rotation 46.4°,and internal rotation up to the T11 level,respectively.Their complications rate was 17.4％ (4/23).One case of axillary nerve injury,one case of relapse of glenohumeral dislocation at sports,and 2 cases of stiff shoulder were observed.Conclusion Split fractures of the humeral greater tuberosity can be successfully treated with our new type of anatomical locking plate which serves as a new alternative treatment.

Radiocarpal fracture-dislocation (RFD) is a rare injury normally associated with the destruction of bones, joints and ligaments. The improper diagnosis and treatment of RFD will cause severe complications and affect the long-term function of wrist joints. The difficulties of clinical diagnosis and treatment lie in the accurate diagnosis, identification and reconstruction of the structure of specific injury. As the foreign and domestic literatures are mainly case analyses or systemic case reports rather than large-scale reports, there still lacks a systemic knowledge of the standard diagnosis and treatment of RFD clinically, thus leading to problems such as missed diagnosed or misdiagnosed, improper application of treatment methods and incomplete reconstruction. Therefore, the authors reviewed relevant literatures about the features, diagnosis and treatment of RFD, in order to provide references for the clinical diagnosis and treatment of RFD.