OBJECTIVE: To compare the effectiveness of posterior axillary edge approach and arthroscopic assisted reduction in the treatment of Ideberg type Ⅰ and Ⅱ glenoid fracture of the scapula. METHODS: The clinical data of 26 patients with fresh Ideberg type Ⅰ and Ⅱ scapular fractures admitted between June 2021 and September 2024 who met the selection criteria were analyzed retrospectively. The patients were divided into two groups according to different treatment methods. Ten cases in the posterior axillary edge group were fixed by open reduction plate through the posterior axillary edge approach, and 16 cases in the arthroscopy group were treated with suture anchor fixation under arthroscopy. There was no significant difference in baseline data between the two groups ( P>0.05), such as gender, age, surgical side, Ideberg type, cause of injury, time from injury to operation, rotator cuff injury, and superior labrum anterior posterior (SLAP) injury, etc. The operation time and fracture healing time were recorded and compared between the two groups, and the shoulder pain was evaluated by visual analogue scale (VAS) score at 1 week, 1 month, and 3 months after operation. At 3 and 6 months after operation, the range of motion of shoulder joint in anteflexion, abduction, external rotation, internal rotation, and backward extension was evaluated, the upper limb dysfunction was evaluated by the Disability Assessment Scale of Arm, Shoulder, and Hand (DASH), and the shoulder joint function was evaluated by the Constant-Murley score. The differences between 6 months and 3 months after operation (changes) were statistically analyzed. RESULTS: Patients in both groups were followed up 11-13 months, with an average of 12.5 months. The operation time and fracture healing time in the posterior axillary edge group were significantly shorter than those in the arthroscopy group ( P<0.05). There was no complication such as wound infection, vascular and nerve injury, loss of reduction, bone nonunion, or glenohumeral instability in both groups. At 1 week after operation, the VAS score in the posterior axillary edge group was significantly higher than that in the arthroscopy group ( P<0.05); there was no significant difference in the VAS score between the two groups at 1 and 3 months after operation ( P>0.05). At 6 months after operation, the changes of shoulder joint in anteflexion, internal rotation range of motion and DASH scores in the posterior axillary edge group were significantly lower than those in the arthroscopy group ( P<0.05), while the changes of abduction, external rotation, backward extension range of motion and Constant-Murley scores were not significantly different between the two groups ( P>0.05). CONCLUSION For Ideberg type Ⅰ and Ⅱ glenoid fracture of the scapula, the posterior axillary edge approach for internal fixation has a short operation time, fast fracture healing, and is beneficial for early functional recovery; arthroscopic assisted reduction has minimal trauma and can handle joint injuries simultaneously. Both surgical procedures are safe and effective, and individualized selection should be made based on soft tissue conditions and combined injuries.
Humans ; Arthroscopy/methods* ; Scapula/surgery* ; Male ; Female ; Retrospective Studies ; Adult ; Fracture Fixation, Internal/instrumentation* ; Fractures, Bone/surgery* ; Middle Aged ; Treatment Outcome ; Bone Plates ; Suture Anchors ; Fracture Healing ; Range of Motion, Articular ; Young Adult ; Shoulder Joint/surgery* ; Operative Time

Objective To explore transplanted human neural stem cells(hNSCs)for the treatment of moderate and severe hypoxic-ischemic encephalopathy(HIE)in neonatal rats and its mechanisms of neuroprotection during the sequela peri-od.Methods Eighty 7-day-old male SD rats were randomly selected.Among them,55 rats were randomly selected to make HIE model by Rice-Vannucci method.After modeling for 24 h,the surviving rats with moderate and severe injury were screened out by Longa score and randomly divided into HIE+PBS group(PBS group,n=23)and HIE+hNSCs group(NSC group,n=23).Twenty-three rats were randomly selected from the remaining 25 rats as Sham operation group(Sham group,n=23).In Sham group,there was only the isolation of the right common carotid artery without dissection or hypoxia.Simultaneous drug adminis-tration was conducted to suppress rejection reactions took place in all three groups.Three days after modeling,the PBS and NSC groups were administered with 5 μL of PBS solution or hNSCs suspension via right intraventricular transplantation,respective-ly.Ten days post-transplantation,15 rats from each group were randomly selected for an enzyme-linked immunosorbent assay(ELISA)to measure the levels of vascular endothelial growth factor(VEGF)and brain-derived neurotrophic factor(BDNF),im-munofluorescent staining was used to observe the distribution of the two factors.Twelve weeks after transplantation,immuno-fluorescent staining was used to observe the migration and differentiation of hNSCs in the brains of the NSC group rats,and the remaining 8 rats from each group underwent a water maze test to assess neural function.Results Ten days after transplanta-tion,the levels of VEGF and BDNF were the highest in the NSC group,followed by the PBS group and the Sham group,and the levels of both factors were higher in the NSC group than in the Sham group(all P＜0.05).Twelve weeks after transplantation,hNSCs migrated to both hemispheres of HIE rats,mainly to the right side,and the mature neuron differentiation rate was about 30％.Twelve weeks after transplantation,the latency of the PBS group was longer than that of the Sham and NSC groups in the water maze test,and the times of platform crossing of the PBS group were shorter than that of the Sham and NSC groups(all P＜0.05),but there was no significant difference between the Sham and NSC groups(P＞0.05).Conclusion Ventricular trans-plantation of hNSCs can enhance the paracrine effect of VEGF and BDNF in the brain of HIE rats and the substitution effect of migration and differentiation into neurons,thus promoting the repairment of nerve injury in the sequela of HIE rats and provi-ding new ideas for the treatment of HIE.

Antibody drug conjugations (ADCs) are a new class of drugs with both targeted specificity and high activity of chemotherapy drugs, which has gradually become a novel generation of therapeutic models with great clinical application prospects. In recent years, ADCs composed of monoclonal antibodies against different tumor cell surface antigens and small molecule potent cytotoxic drugs have shown superior therapeutic effects on recurrent / metastatic breast cancer. This article reviews the clinical application and research progress of ADCs with different molecular targets in the field of breast cancer.

Objective:To compare the postoperative liver function injury condition in patients with intermediate-and advanced-stage hepatocellular carcinoma (HCC) treated with hepatic artery infusion chemotherapy (HAIC) and hepatic artery chemoembolization (TACE) combined with immune checkpoint inhibitors (ICIs) and multi-target tyrosine kinase inhibitors (TKIs).Methods:Patients with intermediate-and advanced-stage HCC who were admitted and treated with HAIC/TACE+ICIs+TKIs therapy at Nanfang Hospital of Southern Medical University from January 2019 to November 2021, with follow-up up to July 2023, were retrospectively enrolled. The results of liver function tests within one week before interventional surgery and on the first day after surgery were recorded. The degree of postoperative liver injury was graded according to the common terminology criteria for adverse events 5.0 (CTCAE 5.0). The treatment efficacy was evaluated according to RECIST 1.1 criteria. Measurement data were compared between groups using a t-test or a non-parametric rank sum test. Enumeration data were compared between the groups using the χ2 test or Fisher's exact probability method. The survival condition differences were analyzed by the log-rank method. Results:This study included 82 and 77 cases in the HAIC and TACE groups. There were no statistically significant differences between the two groups of patients in terms of gender, age, physical condition score, number of tumors, presence or absence of liver cirrhosis, Child-Pugh grade, albumin-bilirubin (ALBI) grade, and combined ICIs and TKIs . The HAIC group had later tumor staging, a greater tumor burden, poorer liver reserve function, and a larger proportion of patients in stage C (81.7% vs. 63.6%), χ2=6.573, P = 0.01). There were 53 cases (64.6% vs. 32.5%) with a maximum tumor diameter of ≥ 10cm, χ2=16.441, P < 0.001), and more patients had a retention rate of ≥ 10% for indocyanine green (ICG) at 15 minutes (68.3% vs. 51.9%, P = 0.035). The postoperative incidence rate of increased levels of alanine aminotransferase, aspartate aminotransferase, and total bilirubin was significantly lower in the HAIC group than that in the TACE group (28.0% vs. 63.6%, χ2=20.298, P < 0.001, 54.9% vs. 85.7%, χ2=17.917, P < 0.001;40.2% vs. 55.8%, χ2=3.873, P = 0.049). The number of patients with postoperative ALBI grade 3 was significantly lower in the HAIC group than that in the TACE group (6.1% vs. 16.9%, χ2=4.601, P = 0.032). There was no statistically significant difference in the incidence rate of postoperative hypoalbuminemia, activated partial thromboplastin time, or increased international standardized ratio between the two groups of patients. There was no statistically significant difference in median progression-free survival (7.3 months vs. 8.2 months, P = 0.296) or median overall survival (16.5 months vs. 21.9 months, P = 0.678) between the two groups of patients. Conclusion:The incidence rate of postoperative liver injury is higher in patients with intermediate-and advanced-stage HCC treated with TACE combined with ICIs and TKIs than in patients with HAIC combined with ICIs and TKIs.