[Objective]To evaluate the outcomes of treatment of unstable pelvic fractures with complex fixation.[Method]Twenty-eight cases of patients with unstable pelvic fracture from January 2000 to June 2007 were treated and followed-up.Eighteen cases were male,10 cases were female,aged from 22 to 68 years old,with the average of 38-years-old.The types of fracture were classified by Tile classification:Type B2 9 cases,Type B3 8 cases,Type C1 6 cases,Type C2 2cases,Type C3 3 cases.The 28 cases had different complicated injury,all the patients were treated with complex fixation.[Result]After being evaluated by the Matta scale and the functional outcome,the outcomes of reduction were excellent in 18 cases,good in 7,fair in 2 and poor in 1,with an excellent and good rate of 85%.[Conclusion]External fixation can win the time for the rescue,choose internal fixation after stable condition,the complex fixation technology is a good way to treat unstable pelvic fractures.

Objective To study the correlation between osteoporosis and degeneration of intervertebral disc in the aging rat.Methods Fifty healthy SD rats were fed for twenty-two months in order to build the model of aging rats,the histology of femoral bone,tibial bone and lumbal vertebra was used to observe,then we evaluated the indexes which reflect the degeneration of intervertebral disc including the quantity of collagen type Ⅱ,Ⅹ of intervertebral disc by the immunohistochemistry methods,the relative area of vascular bud,the thickness of calcified layer and un-calcified layer on cartilage endplate and the indexes which reflect the osteoporosis including the thickness ratio of cortical bone,the relative area of bone trabecula,the bone density,the max stress and straining of bone.Results There was moderate or strong negative correlation among the indexes of the degeneration of intervertebral disc including the relative area of vascular bud,the ratio of the un-calcified and the calcified layer,the quantitation of collagen type Ⅱand the indexes of osteoporosis including the thickness ratio of cortical bone,the relative area of bone trabecula,the density of femoral bone and vertebral body bone,the max stress and straining of bone.However,there was moderate or strong positive correlation with the quantitation of collagen type Ⅹ,of which the bone density of vertebral body had the strongest dependablity with collagen type Ⅹ.And the indexes of bone biomechanics including the max stress and straining had no correlation with the indexes of degeneration of intervertebral disc.Conclusion Osteoporosis has negative correlation with the degeneration of intervertebral disc,which is not distributed to the environment factors;but the indexes of bone biomechanics including the max stress and straining have no correlation with the indexes of degeneration of intervertebral disc.

Objective To investigate the expressions of tyrosine kinase receptor (Trk)B and brain-derived neurotrophic factor (BDNF) protein in human gastric careinoma and compare them with those in epithelial cells of normal mucous, in order to evaluate their clinicopathological significance. Method The expressions of TrkB and BDNF protein in tumor tissues, matched with para-tumor mueosal tissues from 64 cases with gastric carcinoma and normal mucous of 20 cases were observed immunohistochemically and related to some of the clinicopathological parameters. Results The positive rates of TrkB and BDNF protein in tumor tissues were 60.9% and 59.4% respectively, but there was negative in matched para-tumor mueosal tissues and normal mucosal tissues. TrkB and BDNF protein expressions were related to invasive depth,lymph node metastasis and TNM stage of cancer, but not to sex, age and degrees of cancerous differentiation.The positive rates of TrkB and BDNF protein in cases with serosal infiltration, lymph node metastasis and TNM stage Ⅲ - Ⅳ were significantly higher than those in cases without serosal infiltration, lymph node metas-tasis, and TNM stage Ⅰ - Ⅱ (P< 0.01 ). In group with metastasis the positive rates of TrkB and BDNF protein were lower in metastatic foci (76.5%, 26/34, 70.6%, 24134) than those in primary tumor (85.3%, 29134,82.4%, 28/34 ), but statistically there was no significant difference between them (P > 0.05 ). Conclusions The expressions of TrkB and BDNF protein are closely relatedto tumorigenesis and progression of gastric carcinoma. The increased expression of TrkB and BDNF may promote the occurrance of local invasion and metastasis of gastric carcinoma.

Background and purpose:For patients with advanced lung adenocarcinoma harboring an activating EGFR gene mutation, the current standard of care is EGFR-TKI alone. This study aimed to compare efficacy and safety of gefitinib plus chemotherapy with gefitinib or chemotherapy alone for treating advanced lung adenocarcinoma with an activatingEGFR gene mutation.Methods:This study included 61 patients with lung adenocarcinoma harboring an acti-vatingEGFR gene mutation (19 exons deletion and exon 21 L858R mutations) whose ECOG performance status was 0 or 1. Patients were randomly divided into 3 groups. Group A (n=20) were given carboplatin/pemetrexed of a 4-week cycle, six cycles at most, plus gefitinib (pemetrexed 500 mg/m2, d1; carboplatin AUC 5, d1; gefitinib 250 mg/d, d 5-21), and then re-ceived pemetrexed of a 4-week cycle plus gefitinib as maintenance therapy; Group B (n=20) were given carboplatin/peme-trexed of a 4-week cycle, six cycles at most (pemetrexed 500 mg/m2, d1; carboplatin AUC 5, d1), then received pemetrexed as maintenance therapy; Group C (n=21) were given gefitinib (gefitinib 250 mg/d). Patients continued to receive therapy until disease progression or unacceptable toxicity or death. The primary end point was middle PFS and 12 months PFS rate. The secondary end points included objective response rate and adverse events.Results:Groups A and C both lost 1 case during follow-up. Median PFS for patients was 20.1 months (95%CI:18.0-22.2) in group A, 5.5 months (95%CI:3.9-7.2) in group B, and 9.8 months (95%CI:6.8-12.8) in group C. PFS rates of 12 months for groups A, B and C were 78.9%, 15.0% and 40.0%, respectively. The overall objective response rates for groups A, B and C were 84.2%, 35.0% and 65.0%, respectively. Serious adverse events were reported by 36.8% for group A, 30.0% for group B, and 5.0% for group C. The most common grade 3/4 adverse events were neutropenia (3 cases in group A, 4 cases in group B), fatigue (2 cases in group A, 2 cases in group B) and liver function impairment (2 cases in group A, 1 case in group C).Conclusion:Among patients withEGFR mutant lung adenocarcinoma, combination of chemotherapy with gefitinib as first-line treatment demonstrates an improvement in PFS. Long-term survival results will be further followed up.

Some of the recombinant protein therapeutics with short half-life requires high frequent dose or injection, which results in poor patient compliance. This challenge has prompted the development of long-acting recombinant proteins in recent years. Four strategies and methods, including chemical modification, protein engineering, fusion proteins and protein glycosylation are used to modify protein molecule and finally obtain improved pharmacokinetics (PK) properties. This article reviews the four strategies of half-life extension and presents a detailed list of long-acting therapeutics on US, EU and China markets.

Objective To investigate the effect of prevascularized tissue-engineered bone graft on regeneration of femoral bone defects in rats.Methods Models of femoral bone defect were created at the bilateral hind limbs of 20 healthy female 10 week-old rats which were divided into 2 even groups randomly (n =10).In group A,conventional tissue-engineered bone grafts were transplanted into the femoral bone defects;in group B,tissue-engineered bone grafts and vascular bundles were implanted into the femoral defects.At 1,4 and 8 weeks after operation,3 rats were sacrificed each time in each group to harvest samples.The remaining one in each group served as a spare animal.Regeneration of bone defects and degradation of scaffolds were assessed by radiologic modality and hematein eosin staining.Results At week 1,the new bone ratio (BV/TV) was 5.47％ ± 1.90％ in group A and 8.49％ ± 1.26％ in group B,showing no significant difference (P ＞ 0.05);at weeks 4 & 8,the BV/TV were 17.54％ ±2.04％ and 39.73％ ± 4.01％ in group A,significantly lower than those in group B (25.32％ ± 2.15％ and 53.22％ ± 2.94％) (P ＜ 0.05).At weeks 1 & 4,the scaffold degradation ratios (RSV/SV) were 97.33％ ± 2.52％ and 80.60％ ±4.00％,showing no significant differences from those in group B (95.67％ ±3.51％ and 75.22％ ±6.20％) (P ＞ 0.05).At week 8,the scaffold degradation ratio in group A (65.46％ ±4.51％) was significantly higher than that in group B (50.19％ ±4.91％) (P ＜ 0.05).At week 8,hematein eosin staining showed better integration of scaffolds with the femur,faster degradation of the interior scaffolds and greater osteogenetic activity in group B.Conclusion Prevascularization of tissue-engineered bone graft may increase new bone volume and scaffold degradation rate,promoting repair of femoral bone defects in rats.

Objective The aim of the study is to investigate the therapeutic efficacy of next-generation anaplastic lynphoma kinase-tyrosine kinase inhibitor (ALK-TKI) in advanced non-small cell lung cancer (NSCLC).Methods The clinical data and outcomes of 22 patients with advanced non-small cell lung cancer who received the next generation of ALK-TKI from 2014 to 2017 in our hospital were retrospectively analyzed.Results 22 patients were included for survival analysis with 15 males and 7 females.The median age was 48 and all of them were adenocarcinoma patients.There were 12,2,7 and 1 patients received ceritinib,alectinib,brigatinib and lorlatinib,respectively.A total of 14 patients could be evaluated,including complete response (CR) in 2 cases,partial response (PR) in 3 cases,stable disease (SD) in 6 cases,progressive disease (PD) in 3 cases.The ORR and DCR were 35.7％ and 78.6％,respectively.The median progression free survival (PFS) of the 22 NSCLC patients was 8.7 months.Progression pattern can be analyzed in 17 patients.Among them,10 patients underwent primary progression (lung),occurring at the leading frequency (accounting for 58.8％) and followed by central nerve system (CNS) progression (accounting for 29.4％).Conclusions Next-generation ALK-TKI provide a reasonable choice for crizotinib-resistant patients.Primary progression (lung) is the leading cause for treatment failure.Multi-disciplinary integration may provide a potential choice for prolonging administration of next-generation ALK-TKI.

BACKGROUNDDendritic cell (DC)-based immunotherapy is a new approach and effective for some malignant tumors. The aim of this study is to observe the efficacy and toxicity of immunotherapy with carcinoembryonic antigen (CEA) peptide-pulsed DCs in patients with refractory advanced lung cancer.

METHODSLung cancer patients with high CEA expression were enrolled into this project. Autologous DCs were generated from patients' plastic-adherent peripheral blood mononuclear cells and loaded with CEA 5 days later. Cytokine-induced killer cells (CIK) were cultured from non-adherent peripheral blood mononuclear cells. DCs and CIK were transfused to patients. Responses and toxicities were observed.

RESULTSA total of 22 patients with lung cancer received DCs immunotherapy. DCs doses were 2.5×10⁶-9.6×10⁷ (5.03×10⁶). CIK doses were 3.4×10⁸-46×10⁸. CD3, CD8, NK and IFN-γ levels obviously increased after treatment (P < 0.05). The 1-year survival rate was 68.2% (15/22). Main toxicities were fever and rash.

CONCLUSIONSDCs-based immunotherapy is feasible and safe to patients with lung cancer.

Objective To systematically evaluate the biomechanical recovery of drilled holes in the femur in SD rats.Methods Eighteen female SD rats were randomized into 3 even groups (n =6).Models of 2-mm drilled holes in bilateral femurs were established in groups A and B with 2 holes on each side while no drilling was performed in group C.Samples were harvested in group A at postoperative 4 weeks,in group B at postoperative 8 weeks while at both 4 and 8 weeks in group C.The samples were evaluated in terms of linear elasticity (compression test),viscoelasticity (relaxation and creep tests) and durability (fatigue failure test).Micro-CT scan was performed to measure the bone volume fraction (BV/TV) and bone mineral density (BMD) of new bone.Sirus red staining was performed to measure regeneration of type Ⅰ collagen of new bone.Results The elasticity modulus,maximum load,compression strength and conditional yield limit in groups A were significantly lower than those in group B which were also significantly lower than those in group C (P ＜ 0.05).At 7,200 s,the relaxation (14.56 ±0.69 MPa) and creep variation (11.37％ ± 0.70％) in group A were significantly higher than those in group B (11.06 0.63 MPa and 8.98％ ± 0.40％) which were also significantly higher than those in group C (6.99 ±0.56 MPa and 5.10％ ±0.23％) (P ＜ 0.05).At the constant amplitude loads from 20 N to 200 N,from 20 N to 300 N and from 20 N to 400 N,the recycling numbers in group A (6,044.3 ±879.7,4,093.3 ±628.5 and 1,919.3 ±847.5) were significantly lower than those in group B (10,192.3 ± 1,109.1,6,750.6 ± 818.0 and 3,376.6 ± 671.3) which were also significantly lower than those in group C (28,068.3 ±2,702.6,11,788.3 ± 1,141.6 and 5,296.3 ± 735.0) (P ＜ 0.05).By micro-CT scan,the BVT and BMD in group A were significantly lower than those in group B which were also significantly lower than those in group C (P ＜ 0.05).The sirus red staining showed the type Ⅰ collagen in the bone defect area was completely regenerated in group B.Conclusion Systematic biomechanical measurements may actually detect the characteristics of biomechanical recovery of bone holes in SD rats,enriching the basic research on the bone damage repairing progress.