Objective To evaluate the clinical efficacy of vertebral pedicle screw internal fixation for thora-columbar fractures without neurological damage,and to provide guidance and assistance for the treatment.Methods The thoracolumbar fracture patients during our inpatient treatment without neurological damage clinical data of 76 cases were selected,patients were randomly assigned into the observation group and the control group,each within 38 cases. The observation group were treated by vertebral pedicle screw fixation technique in the treatment and control group for cross -vertebral fixation treatment.Patients before surgery,one week after surgery,three months after surgery and 12 months after surgery were followed up,and the perioperative parameters,radiographic parameters,visual analog scale (VAS)and back disability index (ODI)were compared.Results Perioperative parameter comparison and difference of the accuracy of pedicle screw no significant showed no statistically significance.Preoperative VAS,ODI, Vobb angle and vertebral anterior height ratio in the two groups showed no significant difference.After 12 months of observation group ODI score was (10.3 ±2.8)points,which was significantly lower than that (13.5 ±2.5)points in the control group,the difference was statistically significant (t =3.287,P <0.05).In addition,the observer group in VAS,surgery after Cobb angle and vertebral degree of restoration of vertebral height compared with control group,the differences were statistically significant (all P <0.05).Conclusion By using vertebral pedicle screw fixation for the treatment of thoracolumbar fractures without neurological damage shows efficacy,good prominent vertebral body height restoration,fewer complications,safety and reliable,which is worthy of clinical application.

With the improved understanding of driver mutations in non-small cell lung cancer (NSCLC), expanding the targeted therapeutic options improved the survival and safety. However, responses to these agents are commonly temporary and incomplete. Moreover, even patients with the same oncogenic driver gene can respond diversely to the same agent. Furthermore, the therapeutic role of immune-checkpoint inhibitors (ICIs) in oncogene-driven NSCLC remains unclear. Therefore, this review aimed to classify the management of NSCLC with driver mutations based on the gene subtype, concomitant mutation, and dynamic alternation. Then, we provide an overview of the resistant mechanism of target therapy occurring in targeted alternations ("target-dependent resistance") and in the parallel and downstream pathways ("target-independent resistance"). Thirdly, we discuss the effectiveness of ICIs for NSCLC with driver mutations and the combined therapeutic approaches that might reverse the immunosuppressive tumor immune microenvironment. Finally, we listed the emerging treatment strategies for the new oncogenic alternations, and proposed the perspective of NSCLC with driver mutations. This review will guide clinicians to design tailored treatments for NSCLC with driver mutations.
Humans ; Carcinoma, Non-Small-Cell Lung/genetics* ; Lung Neoplasms/genetics* ; Mutation ; Tumor Microenvironment/genetics*