Bicondylar tibial plateau fractures pose a significant challenge for treating surgeons. If the articular surface of the medial plateau has a second split component in the posterior coronal plane, it is difficult to get direct visualization and ensure plate fixation when the patient is in the supine position. Using a technique in which a single preparation and draping of both legs is needed, patients were operated on using a healthy floating supine position maneuver through dual posteromedial and anterolateral incisions and triple plate fixations. By flexing and adducting the contralateral healthy hip over the injured leg, more lateral rotation of the fractured knee can be achieved, providing better access and visualization of the posterior medial plateau using a posteromedial gastrocnemius approach.

The role of 18F-fuorodexoyglucose-positron emission tomography/computed tomography (18F-FDG-PET/CT) in the staging of Hodgkin lymphoma (HL) and aggressive B-cell non-Hodgkin lymphomas (NHL) has been demonstrated extensively. Nevertheless, the role of PET/CT in the diagnosis, staging, prognosis, and treatment evaluation of natural killer (NK)/T-cell lymphoma remains indeterminate.To systematically review and meta-analyze the publications on the value of 18F-FDG-PET/CT in the diagnosis and staging of NK/T-cell lymphoma.Pubmed, Embase, Cochrane Library, and some other database were searched for initial studies (last updated on May 8th, 2014).The eligibility criteria were studies assessing the usefulness of PET/CT in the staging of NK/T-cell lymphoma, patients were diagnosed as NK/T-cell lymphoma through pathology, or clinical and imaging follow-up.Sensitivities and specificities of 18F-FDG-PET/CT in individual studies were assessed. The summary receiver operating characteristic curve (sROC) and the area under the curve (AUC) were calculated. The “Meta-Disc 1.4” software was used for data analysis.Eight studies, with a total of 135 NK/T-cell lymphoma patients, were included in this meta-analysis. In terms of the 6 studies with patient based data, the pooled sensitivity and specificity of PET/CT in the diagnosis of NK/T-cell lymphoma were 0.95 (95% CI: 0.89–0.98) and 0.40 (95% CI: 0.09–0.78), respectively. For lesion-based analysis, with 1546 lesions included, the pooled sensitivity and specificity of PET/CT in the staging of NK/T-cell lymphoma were 0.98 (95% CI: 0.96–0.99) and 0.99 (95% CI: 0.99–1.00), respectively. For the patient based data, the AUC and ∗Q index were 0.8537 and 0.7847, respectively. For lesion based data, the AUC and ∗Q index were 0.9959 and 0.9755, respectively.The results of this current meta-analysis indicated that PET/CT could be used as a valuable diagnostic and staging tool for NK/T-cell lymphoma.

TRAF4, or tumor necrosis factor receptor-associated factor 4, is overexpressed in several cancers, suggesting a specific role in cancer progression. However, its functions in osteosarcoma are unclear. This study aimed to explore the expression of TRAF4 in osteosarcoma tissues and cells, the correlation of TRAF4 to clinical pathology of osteosarcoma, as well as the role and mechanism of TRAF4 in osteosarcoma metastasis. The protein expression levels of TRAF4 in osteosarcoma tissues and three osteosarcoma cell lines, MG-63, HOS, and U2OS, were assessed. Constructed TRAF4 overexpression vectors and established TRAF4 overexpression of the U2OS cell line. Cell proliferation, cell invasion, protein levels, and TRAF4 phosphorylations were assessed following TRAF4 transfection, as well as the effects of TRAF4 siRNA on cell proliferation and invasion. The results show that TRAF4 protein levels in osteosarcoma tissues were significantly higher than that in normal bone tissues. Importantly, an obvious upregulation of TRAF4 was found in carcinoma tissues from patients with lung metastasis compared with patients without lung metastasis. Consistently, a similar increase in TRAF4 mRNA and protein was also demonstrated in the osteosarcoma cell lines MG-63, HOS, and U2OS compared to normal bone cells, hFOB1.19. When TRAF4 was overexpressed in U2OS cells, cell proliferation was significantly enhanced, accompanied by an increase in Ki67 expression and colony formation. Compared with the control and vector-treated groups, TRAF4 transfection increased the invasion potential of U2OS cells (p < 0.05). Interestingly, TRAF4 transfection significantly enhanced the phosphorylation of Akt. After blocking Akt with its specific siRNA, TRAF4-induced cell proliferation and invasion were dramatically attenuated. In summary, our findings demonstrated that TRAF4 enhances osteosarcoma cell proliferation and invasion partially by the Akt pathway. This work suggests that TRAF4 might be an important target in osteosarcoma.