OBJECTIVETo explore the clinical features and operative treatment of floating shoulder injuries.

METHODSThe clinical data of 25 patients with floating shoulder injuries that had been admitted to the hospital from July 2000 to May 2011 were retrospectively analyzed. There were 18 males and 7 females,wirh an average age of (36.2 +/- 2.3) years ranging from 17 to 56 years. The scapular neck fractures associated with clavicle fractures were in 21 cases and acromioclavicular joint dislocation in 4 cases. All cases were accompanied by associated injuries. Among of them, 7 cases were conservative treatment, 7 cases were fixed clavicle only, 11 cases were clavicle and scapular. All datum were rated according to Herscovici, Constant and Murley, Rowe rate system.

RESULTSAll patients were followed up for 4.6 years (range 11 months to 10 years). All fractures were healed except for 1 clavicle was delay healed. There were not infections and fixation fracture,2 of conservative treatment were dropping shoulder, 2 of 3 brachial plexus injuries were recovered 3 months later, 1 was 6 months. Suprascapular nerve injury was recoved 1 year later. Herscovici evaluation: 18 excellent, 5 good, 1 fair, 1 poor;Constant and Murley shoulder score: (83.2 +/- 5.7), pain score (12.1 + 2.5), activities of daily living score (17.2 +/- 3.2), range of motion score (32.1 +/- 3.5), strength score (18.5 +/- 2.1); Rowe evaluation: 18 excellent, 5 fair, 2 poor.

CONCLUSIONFloating shoulder injuries is high energy injury, destroy superior shoulder suspensory complex stability ,appropriate treatment should be choosen according to fractures displacement and smash level, patients' professional and anticipation

Adolescent ; Adult ; Clavicle ; injuries ; physiopathology ; Female ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Range of Motion, Articular ; Retrospective Studies ; Scapula ; injuries ; physiopathology

OBJECTIVETo look for the evidences of motilin receptor expression on interstitial cells of Cajal (ICC) of the rabbit.

METHODSmooth muscle segments with ICC were isolated from the small intestine of 10-day old rabbits. The tissue segments equilibrated in Ca(2+)-free Hanks' solution were dispersed with an enzyme solution containing collagenase type II and then Ficoll density centrifugation was used to dissociate ICC. The cells were suspended and cultured in the M199 medium. The c-kit antibody was applied to distinguish the cultured ICC. The motilin receptor was identified by immunocytochemical assay with GPR38 antibody, c-kit antibody and hoechst 33342 combined to label ICC. Cells cultured for a few days were sorted for ICC with c-kit stained green fluorescent through flow cytometry. The total RNA and proteins extracted from the sorted ICC were respectively used to verify motilin receptor on the ICC by reverse-transcriptase polymerase chain reaction (RT-PCR) and Western blotting.

RESULTWe had successfully dissociated and cultured ICC of rabbit small intestine in vitro. Fluorescent staining with c-kit antibody confirmed that the culture ICC was successful. Triple-labeled immunofluorescent staining had detected the motilin receptor on membrane of ICC. Flow cytometry analysis showed that the ratio of c-kit positive cell in the cultured cells was 64.3%. The number of sorted ICC was 6.7 × 10(5) and 5.6 × 10(6). The results of RT-PCR and Western blot confirmed that the ICC had motilin receptor expression.

CONCLUSIONOur study demonstrated presence of motilin receptor on ICC of the rabbit. The present results may suggest that ICC play an important role in gastrointestinal movement induced by motilin.

Animals ; Cells, Cultured ; Interstitial Cells of Cajal ; metabolism ; Intestine, Small ; cytology ; Rabbits ; Receptors, Gastrointestinal Hormone ; metabolism ; Receptors, Neuropeptide ; metabolism

OBJECTIVETo evaluate the clinical outcome of surgical treatment of the posterior dislocation of the elbow with coroniod and radial head fractures.

METHODSFrom January 2004 to March 2009, 9 patients with terrible triad of the elbow were reviewed. There were 7 males and 2 females (4 left elbows and 5 right elbows), with an average age of 41.2 years, ranged from 21 to 67 years. The radial head fractures were classified according to the Schatzker-Tile criteria: 4 patients had the fractures of type I, 3 patients had type II and 2 patients had type III. The ulnar coronoid fractures were classified according to the Regan-Morrey criteria: 2 patients had the fractures of type I, 5 patients had type II and 2 patients had type III. The general approach was used to repair the damaged structures sequentially from deep to superficial, through coronoid, anterior capsule, radial head, and lateral ligament complex to common extensor origin. If there was valgus instability in the elbow after the operation, the medial collateral ligament should be repaired with nonabsorption sutures. The plaster was applied for 7 to 10 days with elbow flexion in 90 degrees and the forearm in full pronation. Unrestricted motions and rehabilitation began at the 8th week after operation. Recovery of regular occupation depended on the degree of physical activity required, and it typically took 3 months for heavy physical laborers to return to work.

RESULTSAll the patients were followed up from 6 months to 5 years, with a mean duration of (31 +/- 6) months. At the 3rd month after operation, the mean rang of motion in flexion and extension of the elbow was (102 +/- 3) degrees (ranged from 80 degrees to 110 degrees), and the mean range of motion in pronation and supination of the forearm was (135 +/- 6) degrees (100 degrees to 150 degrees). According to the criteria of the Mayo scoreing system, the results were excellent in 5 cases, good in 3 cases, and fair in 1 case. Three patients had heterotopic ossification at the 6th month after operation. Among them, 2 patients had no effects on elbow function and were not treated, 1 patient had effects on flexion-extension of the elbow and was treated with resection of heterotopic ossification through lateral approach combined with early rehabilitation, the MEP score of the patient improved from fair to good.

CONCLUSIONThe key points for treating the terrible triad of the elbow are to restore the elbow normal anatomy and early rehabilitation to avoid the elbow stiff.

Adult ; Aged ; Elbow Joint ; injuries ; physiopathology ; Female ; Humans ; Joint Dislocations ; complications ; physiopathology ; surgery ; Male ; Middle Aged ; Radius Fractures ; complications ; physiopathology ; surgery ; Ulna Fractures ; complications ; physiopathology ; surgery

Objective: To investigate the response characteristics of patients with locally advanced/metastatic non-squamous non-small cell lung cancer (nsq-NSCLC) treated with tislelizumab in combination with chemotherapy in the first line. Methods: Patients with nsq-NSCLC who achieved complete or partial remission after treatment with tislelizumab in combination with chemotherapy or chemotherapy alone in the RATIONALE 304 study, as assessed by an independent review board, were selected to analyze the response characteristics and safety profile of the responders. Time to response (TTR) was defined as the time from randomization to the achievement of first objective response. Depth of response (DpR) was defined as the maximum percentage of tumor shrinkage compared with the sum of the baseline target lesion length diameters. Results: As of January 23, 2020, 128 patients treated with tislelizumab in combination with chemotherapy achieved objective tumor response (responders), representing 57.4%(128/223) of the intention-to-treat population, with a TTR of 5.1 to 33.3 weeks and a median TTR of 7.9 weeks. Of the responders (128), 50.8%(65) achieved first remission at the first efficacy assessment (week 6), 31.3%(40) at the second efficacy assessment (week 12), and 18.0%(23) at the third and subsequent tumor assessments. The percentages of responders who achieved a depth of tumor response of 30% to <50%, 50% to <70% and 70% to 100% were 45.3%(58/128), 28.1%(36/128) and 26.6%(34/128), respectively, with median progression-free survival (PFS) of 9.0 months (95% CI: 7.7 to 9.9 months), 11.5 months (95% CI: 7.7 months to not reached) and not reached (95% CI: 11.8 months to not estimable), respectively. Tislelizumab plus chemotherapy were generally well tolerated in responders with similar safety profile to the overall safety population. Conclusion: Among responders to tislelizumab in combination with chemotherapy for nsq-NSCLC, 82.0%(105/128) achieves response within the first two tumor assessments (12 weeks) and 18.0%(23/128) achieves response at later (18 to 33 weeks) assessments, and there is a trend toward prolonged PFS in responders with deeper tumor response.
Humans ; Antibodies, Monoclonal, Humanized/therapeutic use* ; Antineoplastic Combined Chemotherapy Protocols/adverse effects* ; Carcinoma, Non-Small-Cell Lung/pathology* ; Lung Neoplasms/pathology* ; Treatment Outcome