Objective To investigate the clinical efficacy of internal fixation through posterior minimally invasive approach in treating unstable scapula fractures.Methods A retrospective case control study was conducted on the clinical data of 36 patients with scapular fractures admitted between May 2011 and August 2016.There were 30 males and six females,with average age of 51.5 years (range,46-64 years).According to Hardegger classification,there were 18 patients with scapular body fracture,14 with scapular neck fracture,and four with glenoidal fracture.According to operation method,the patients were divided into Group A (n =24) which adopted internal fixation through posterior minimally invasive approach and Group B (n =12) which adopted the conventional Judet approach for internal fixation.The incision length,operation time,intraoperative bleeding,fracture healing time,Hardegger standard of clinical effects,and complications in two groups were compared.Results All patients were followed up for average 18 months (range,6-24 months).The total length of surgical incision was (12.50 ± 4.50) cm in Group A and (27.95 ± 5.20) cm in Group B (P ＜ 0.05);the operation time was (86.5 ± 1 1.5) minutes in Group A and (120.6 ± 10.9) minutes in Group B (P ＜ 0.05);the intraoperative bleeding was (200.0 ± 20.0)ml in Group A and (420.0 ± 20.0)ml in Group B (P ＜ 0.05);fracture healing time was (10.0 ± 1.0) weeks in Group A (12.0 ± 1.5) weeks in Group B (P ＜ 0.05).According to Hardegger standard,in Group A,15 patients were excellent,six good,and two fair,with an excellent and good rate of 91％;while in Group B,six patients were excellent,three good,two fair,and one poor,with an excellent and good rate of 75％ (P ＜ 0.05).No complications were observed in Group A.In Group B,one patient with hematoma and one patient with nonunion of incision area were observed,both of which recovered after drainage and dressing change.One patient with superior scapular nerve injury was found and recovered after treatment.The incidence of complications was 25％ in Group B,higher than 0 in Group A (P ＜ 0.05).There was no internal fixation fracture or nonunion in two groups.Conclusion Compared with the conventional Judet approach,minimally invasive internal fixation approach in the treatment of unstable scapula fracture demonstrates the advantages of mild trauma,faster functional restoration,and fewer complications.

Objective: To observe the effects of music electro-acupuncture and pulsed electro-acupuncture on locomotor avtivity and hippocampal astrocytes in fast-aging (SAMP8) mice, and to compare the anti-dementia mechanism.Methods: Thirty 8-month-old male SAMP8 mice were randomly divided into model group (group M), music electroacupuncture group (group MA), pulsed electro-acupuncture group (group EA) (n=10), with homologous normal aging SAMR1 mice as control group (group C) (n=10) . Acupuncture stimulation was applied to"Baihui" (GV20) 、"Yintang" (GV29) and"Renzhong" (DU26) for 20 min per day for 15 days. The Morris water maze was used to assess learningmemorize ability. Immunohistochemical DAB staining was used to observe GFAP exptession in hippocampus. Detect GFAP protein levels by Western blot in hippocampus. Results: The Morris water maze test showed: Compared with group C, the escape latency were increased (P ＜ 0.01), swimming distance were increased in space exploration experiment in group M (P ＜ 0.01) . Compared with group M, the escape latency were reduced in group MA and EA (P ＜ 0.01, P ＜ 0.05) and the swimming distance were shortened (all P ＜ 0.05) . The immunohistochemical DAB staining showed: Compared with group C, the average optical density of GFAP in the hippocampal CA1 area of group M increased significantly (P ＜0.01); the optical density of GFAP in CA1 area of hippocampus in both groups MA and EA was significantly decreased (all P ＜ 0.01), while the optical density of GFAP in MA group was lower than that of EA group (P ＜ 0.05) . Western blot test showed: Compared with group C, the expression of GFAP protein obviously increased (P ＜ 0.01) . Compared with group M, the expression of GFAP protein obviously decreased and had a downregulation tendency in group MA and EA (all P ＜ 0.05), while the expression of GFAP protein decreased in MA group compare with EA group (P ＜ 0.05) .Conclusion: Both music electro-acupuncture and pulsed electro-acupuncture can improve the learning and memory abilities of SAMP8 mice and decrease the expression of GFAP, which may be related to its mechanism of reducing neuroinflammatory reaction, improving apoptosis and eventually protecting neurons, and music electro-acupuncture has a better tendency than pulsed electro-acupuncture.

Objective:To investigate the clinical features and prognosis of male with anti-melanoma differentiation-associated gene 5 (MDA5) autoantibody.Methods:The clinical data of 246 patients with DM and anti-MDA5 autoantibodies hospitalized by Jiangsu Myositis Cooperation Group from 2017 to 2020 were collected and retrospectively analyzed. Chi-square test was performed to compared between counting data groups; Quantitative data were expressed by M ( Q1, Q3), and rank sum test was used for comparison between groups; Single factor survival analysis was performed by Kaplan-Meier method and Log rank test; Cox regression analysis were used for multivariate survival analysis. Results:①The male group had a higher proportion of rash at the sun exposure area [67.1%(47/70) vs 52.8%(93/176), χ2=4.18, P=0.041] and V-sign [50.0%(35/70) vs 30.7%(54/176), χ2=8.09, P=0.004] than the female group. The male group had higher levels of creatine kinase [112(18, 981)U/L vs 57 (13.6, 1 433)U/L, Z=-3.50, P<0.001] and ferritin [1 500 (166, 32 716)ng/ml vs 569 (18, 14 839)ng/ml, Z=-5.85, P<0.001] than the female group. The proportion of ILD [40.0%(28/70) vs 59.7%(105/176), χ2=7.82, P=0.020] patients and the red blood cell sedimentation rate[31.0(4.0, 101.5)mm/1 h vs 43.4(5.0, 126.5)mm/1 h, Z=-2.22, P=0.026] in the male group was lower than that of the female group, but the proportion of rapidly progressive interstitial lung disease (PR-ILD) [47.1%(33/70) vs 31.3%(55/176), χ2=5.51, P=0.019] was higher than that of the female group. ②In male patients with positive anti-MDA5 antibodies,the death group had a shorter course of disease[1.0(1.0, 3.0) month vs 2.5(0.5,84) month, Z=-3.07, P=0.002], the incidence of arthritis [16.7%(4/24) vs 42.2%(19/45), χ2=4.60, P=0.032] were low than those in survival group,while aspartate aminotransferase (AST)[64(22.1, 565)U/L vs 51(14,601)U/L, Z=-2.42, P=0.016], lactate dehydrogenase (LDH) [485(24,1 464)U/L vs 352(170, 1 213)U/L, Z=-3.38, P=0.001], C-reactive protein (CRP) [11.6(2.9, 61.7) mg/L vs 4.95(0.6, 86.4) mg/L, Z=-1.96, P=0.050], and ferritin levels [2 000(681, 7 676) vs 1 125 (166, 32 716)ng/ml, Z=-3.18, P=0.001] were higher than those in the survival group, and RP-ILD [95.8%(23/24) vs 22.2%(10/45), χ2=33.99, P<0.001] occurred at a significantly higher rate. ③Cox regression analysis indicated that the course of disease LDH level, and RP-ILD were related factors for the prognosis of male anti-MDA5 antibodies [ HR (95% CI)=0.203(0.077, 0.534), P=0.001; HR (95% CI)=1.002(1.001, 1.004), P=0.003; HR (95% CI)=95.674 (10.872, 841.904), P<0.001]. Conclusion:The clinical manifestations of male anti-MDA5 antibody-positive patients are different from those of female. The incidence of ILD is low, but the proportion of PR-ILD is high. The course of disease, serum LDH level, and RP-ILD are prognostic factors of male anti-MDA5 antibody-positive patients.