Objective To summarize the treatment and prognosis in 15 cases of soft tissue malignant tumors in the upper extermity in recent 5 years. Methods soft tissue upper limb 15 malignant tumors were involved in the study. The treatment included surgical excision of the tumor and its surrounding tissue. The limb function was kept as intact as possible for preservation of upper extremity. Chemotherapy was carried out between 5 ma-lignant fibrous histiocytoma( MFH) and 3 fibrosarcoma. Results The postoperative following check-up ranged from 6 months to 5 years with an average of 3. 5 years. Among them,1 cases of left elbow epithelioma died of lung metastasis 1 year after operation,no metastasis occured in other cases. The 5 year survival rate was 80%(12 cases) . Local recurrence was found in 10 cases with a recurrent rate of 67%. 2 cases received upper ex-tremity amputation dure to postoperative recurrence. The limb salvage rate was 86%. Conclusions The main treatments of upper extermity soft tissue malignant tumors are surgical excision combined with chemotherapy.

Ampelopsin (AMP), a novel flavonoid, has been shown to effectively inhibit the proliferation and induce apoptosis of some prostate cancer and breast cancer cell lines. Whether AMP has chemopreventive effects on the cell growth and apoptosis of human osteosarcoma MG-63 cells remains unknown. In the present study, MG-63 cells were exposed to different concentrations (0, 25, 50, 75, 100 μmol/L) of AMP for 24, 48, 72 and 96 h and then the cell viability was measured by CCK-8 assay. The AMP-induced apoptotic cells were identified by Hochest33258 staining and quantified by Annexin V-FITC/PI double staining using flowcytometry (FCM). The effect of ampelopsin (AMP) on cell cycle was evaluated using PI staining with FCM. The protein levels of cyclin A, CDK2 and p21(CIP1) were measured by Western blotting. The cell viability was reduced in a time- and dose-dependent manner after exposure to AMP atarangeof 20-100 μmol/L. For the treatment of AMP, increases of apoptotic index and rate were observed in MG-63 cells. The AMP blocked cells in the G0/G1 phase of the cell cycle. Furthermore, AMP increased p21(CIP1) expression but decreased cyclin A and CDK2 expression after AMP exposure. AMP inhibited cell growth and induced apoptosis and G0/G1 phase arrest in MG-63 cells in vitro, with the potential mechanism of the negative regulation of cell cycle-related protein.

OBJECTIVE To evaluate the erectile and ejaculatory function of sacral tumor patients after sacral nerve root resection and investigate the relationship of erectile and ejaculatory dysfunction (EED) with the level of sacral nerve injury. METHODS This retrospective study included 47 male patients aged 16 to 63 (32.6 +/- 6.8) years treated by sacral tumor resection between January 2008 and August 2013. According to the levels of the sacral nerve roots spared in surgery, the patients were divided into four groups: bilateral S1-S3 (n=16), unilateral S1-S3 (n=21), unilateral S1-S2 (n=6), and unilateral S1 (n=4). The patients were followed up for 12 to 41 (27.2 +/- 10.9) months by questionnaire investigation, clinic review, and telephone calls about their erectile and ejaculatory function at 3, 6 and 12 months after surgery and in August 2013. RESULTS In the bilateral S1-S3 group, the incidence rates of EED were 31.25% (5/16), 25% (4/16), and 12.5% (2/16) at 3, 6, and 12 months respectively after surgery, with recovery of erectile and ejaculatory function in August 2013. The incidence rates of EED in the unilateral S1-S3 group were 85.71% (18/21), 71.43% (15/21), 52.38% (11/21), and 42.86% (9/21) at 3, 6 and 12 months and in August 2013, respectively; those in the unilateral S1-S2 group were 100% (6/6), 83.33% (5/6), 83.33% (5/6), and 66.67% (4/6) at the four time points; and those in the unilateral S1 group were all 100% (4/4). No statistically significant differences were found in the incidence rate of EED among the patients of different ages or tumor types (P > 0.05). CONCLUSION The incidence of postoperative EED in male patients treated by sacral tumor resection is closely related to the mode of operation. Sparing the S3 nerve root at least unilaterally in sacral tumor resection is essential for protecting the erectile and ejaculatory function of the patient.

Objective The periacetabular tumor has a low rate of incidence,but its special location poses a challenge to clinical treatment. The aim of this study was to discuss the methods,effects,and complications of surgical treatment of periacetabular tumors. Methods We retrospectively analyzed the clinical data of 36 cases of periacetabular tumor surgically treated in our department,including 21 males and 15 females,aged 15 to 64( 45. 2 ± 6. 3) years. Among them,there were 8 cases of benign tumor( 4 cases of simple bone cyst,1 case of desmoplastic fibromas,1 case of osteofibrous dysplasia,and 2 cases of hemangioma) and 28 cases of malignant tumor( 5 cases of osteosarcomas,12 cases of chondrosarcomas,2 cases of giant cell tumor of the bone,1 case of malignant chondroblastoma,2 cases of malignant fibrohistiocytoma,and 5 cases of metastatic tumor of the bone). The benign cases received simple tumor resection plus bone graft and steel plate system internal fixation,while malignant cases underwent reconstruction by combined pedicle screw fixation system with bone cement. Results No patients died perioperatively and controllable complications occurred in5 cases after operation. All the patients were followed up for 5 to 96 months except for 1 case of benign tumor. None of the benign cases experienced recurrence,and all of them achieved normal hip function. Lung metastases occurred in 10 malignant cases( 4 cases of osteosarcomas and 6 cases of chondrosarcomas),who died of respiratory failure,and the other 18 remained tumor-free after surgery. Of the 2 patients with malignant fibrohistiocytoma,1 died 2 years postoperatively and the other survived with tumor. Neither local recurrence nor lung metastasis was found in the patients with chordoma and malignant chondroblastoma till the end of follow-up. The 5 patients with metastases died within 3 years after operation. At 3 months after surgery,the Harris scores after total hip replacement were 90 in the 7 benign cases,70-79 in 9 malignant cases,and 70 in the other 19 malignant cases. Conclusion For the treatment of malignant tumors,reconstruction by combined pedicle screw fixation system with bone cement does not affect the general daily activities of the patients. Preoperative embolization of the internal iliac artery can reduce bleeding and improve operation safety,and measures should be taken to minimize postoperative complications.

Objective The incidence rate of sacrococcygeal tumor is low , however , due to its special position , clinical symptoms are inclined to be more severe .The aim of the article was to explore the methods and therapeutic effects of operative treat-ment for sacrococcygeal tumors . Methods A retrospective analysis was made on 44 cases of sacrococcygeal tumors treated in our hospital from January 2008 to December2012 .Of all the cases , there were 11 chordomas , 9 neurinoma , 4 malignant fibrous histioto-ma, 4 giant cell tumor, 7 metastases tumors and 9 others.All the patients had definite pathological diagnosis after operation .Operative treatments involved simple resection of rumors , simple resection of lesions and resection of lesions plus screw-rod system internal fixa-tion. Res ults No patients died in perioperative period .Follow-up was made in all patients for the average time of 3.3 years(4 months to 59 months).Except for 4 patients'delayed healing of incision operation and 1 patient′s healing of operation incision after de-bridement , all the other patients healed after enhancing the wound dressing , among which there are 3 cases of chordoma recurrence , 1 case of giant cell tumor recurrence , 3 death cases of malignant fibrous histiotoma in 2 years and 1 case alive with tumor .All patients with metastases tumor died in 3 years.Except 1 patients with osteosarcoma alive with tumor , all patients′symptoms had been alleviated after operation. Conclusion Chordoma and giant cell tumor still have a high recurrence rate after operation . The extent of rumor resection and nerve preservation are determined by the range of tumors.Preoperative embolization of the internal iliac artery can clearly reduce bleeding and improve the operation safety .

目的 分析生存素(survivin)在骨肉瘤细胞中的表达,并制备针对骨肉瘤MG-63细胞系的生存素反义寡核苷酸(ASODN)转染细胞株.方法 体外培养MG-63细胞,分为空脂质体(A)组、脂质体介导的正义寡核苷酸(B)组和脂质体介导的ASODN(C)组,采用Western blot法检测各组MG-63细胞转染后生存素蛋白的表达.结果 Western blot检测结果证实MG-63细胞裂解液中有特异性的生存素蛋白条带.转染后C组生存素蛋白表达弱于A组和B组(P＜0.05).结论 靶向生存素的ASODN可以显著抑制骨肉瘤细胞中生存素的蛋白表达,这种转染细胞株的制备为进一步研究奠定了理论基础.

Osteosarcoma is a common malignant tumor of bone, but mechanisms underlying its development are still unclear. At present, it is believed that the inhibition of normal apoptotic mechanisms is one of the reasons for the development of tumors, so specific stimulation of tumor cell apoptosis can be considered as an important therapeutic method. Livin, as a member of the newly discovered inhibitor of apoptosis proteins (IAPs) family, has specifically high expression in tumor tissues and can inhibit tumor cell apoptosis through multiple ways, which can become a new target for malignant tumor treatment (including osteosarcoma) and might of great significance in the clinical diagnosis of tumors and the screening of anti-tumor agents and carcinoma treatment.

Objective To investigate the clinical effects of hip arthroplasty plus composite reconstruction for periacetabular tumors. Methods The hip joint was reconstructed with total artificial hip, reconstruction plate, screws, wire and bone cement. The patients were followed up postoperatively. The functional assessment was conducted with the Musculoskeletal Tumor Society Rating Scale( MSTS) . Results Despite of 1 patient with sudden death due to bilateral pulmonary embolism, the rest were successfully opera-ted. Twenty-three patients could basically walk properly with 11 cases of normal hip function and 10 cases of hip flexion function par-tially restored. There were 5 patients of delayed wound healing. Out of 2 patients with peroneal nerve injure, one got recovery at 6th month postoperative and one did not restore during the follow-up with the use of protective brace. The follow-up ranged 12 to 84 months with the median of 40?0 month and the follow-up rate reached 100?0%. Two patients died and four recurred( 2 patients died) , while 21 patients survived(13 cases of tumor-free survival, 8 cases survived with tumor). The MSTS score was(23?8±9?2) with excellent rate of 87?0%( 20/23) . Conclusion The hip function was good in patients with periacetabular tumors after hip arthroplasty plus composite reconstruction during short-time follow-up.

Objective:To analyze the effect of self-management education for maintenance hemodialysis patients on their healthy status. Methods:Twenty-six patients who had received maintenance hemodialysis for at least 6 months and whose condition were stable in the past 6 months were enrolled in this stud-y. They were taught the knowledge about hemodialysis and the methods to solve the problem in daily life. After 6 months′ education,we compared the pa-tients′nutritional status quality of life,rehabilitation status,self-management capacity. Results:After 6 months,nutritional status quality of life and ability of self-management were improved. Conclusions:Self-management education can improve continuous maintenance hemodialysis patients′self-management capacity,to find the students′shortages in the field and accordingly improve their holistic healthy status.

目的 探讨Survivin在骨肉瘤细胞中的表达及Survivin反义寡核苷酸(ASODN)对骨肉瘤MG-63细胞增殖和凋亡的影响.方法 设计针对Survivin的ASODN和正义核苷酸(SODN)序列,制备脂质体-寡核苷酸复合物并转染MG-63细胞,分为空脂质体(Lip)组、脂质体介导的SODN(Lip-SODN)组和脂质体介导的ASODN (Lip-ASODN)组.采用免疫细胞染色法检测MG-63细胞中Survivin的表达情况,Western blotting检测各组转染48h后的Survivin蛋白水平,MTT法检测转染24、48和72h后MG-63细胞的增殖情况,流式细胞仪检测转染48h后MG-63细胞的凋亡情况.结果 Survivin主要表达于MG-63细胞的胞核.Lip-ASODN组的Survivin蛋白水平均低于Lip-SODN组和Lip组.不同浓度Survivin ASODN对MG-63细胞的增殖抑制程度不同,Lip-ASODN组的细胞增殖抑制率高于Lip组,且呈浓度依赖性;而Lip-SODN组的增殖抑制率与Lip组的差异无统计学意义(P＞0.05).Lip-ASODN组的凋亡率为(88.47±0.79)％,高于Lip组的(10.01±0.90)％和Lip-SODN组的(4.12±0.25)％,差异有统计学意义(P＜0.05).结论 靶向Survivin的ASODN可以显著抑制骨肉瘤MG-63细胞的增殖能力,并促进其凋亡.

Objective To explore the influence of bevacizumab ( Avastin) on the growth and angiogenesis of RFP-tagged os-teosarcoma orthotopic nude mice model of human osteosarcoma. Methods Twenty-one nude mice inoculated with human osteosarcoma cell line 143-B-RFP were randomly divided into three groups:control group, low dose Avastin group ( Avastin-L) and high dose Avas-tin group ( Avastin-H) . Avastin-L group and Avastin-H group received continuous 0. 2ml injection of 2. 0mg/kg or 5. 0mg/kg Avastin twice a week for 3 weeks, while control group was given an equal volume of saline. The body weight was recorded every 3 days. The in situ tumor size was measured to calculate the volume and the tumor inhibition rate every 7 days by fluorescence imaging system. Immu-nohistochemical En Vision method was used to detect the expression of CD34 in tumor tissue to evaluate the microvessel density ( MVD) . The vascular endothelial growth factor ( VEGF) levels of plasma and tumor tissue were measured by ELISA method. Results No significant difference was observed on body weight and lung metastasis rate among 3 groups ( P>0. 05) . Compared with control group, there were higher tumor inhibition rate, and lower tumor volume, MVD and VEGF levels of plasma and tumor tissue in both Avastin-L group and Avastin-H group (P<0. 05).The improvement effect of the above indexes were stronger in Avastin-H group versus Avastin-L group ( P<0. 05) . Conclusion Avastin can inhibit the growth and angiogenesis of human osteosarcoma, and reduce the VEGF level without influences on lung metastasis.

Cancer treatment-related bone loss has become growing problematic, especially in breast and prostate cancer treated with hormone/endocrine therapy, chemotherapy and radiotherapy. However, bone loss caused by targeted therapy in cancer patients is largely unknown yet. In present study, a kinase inhibitors screen was applied for MC3T3-E1, a murine osteoprogenitor cell line, and seven kinase inhibitors (GSK1838705A, PF-04691502, Dasatinib, Masitinib, GDC-0941, XL880 and Everolimus) were found to suppress the cell viability with dose- and time-dependent manner. The most interesting is that many kinase inhibitors (such as lapatinib, erlotinib and sunitinib) can promote MC3T3-E1 cell proliferation at 0.01 μM. 4 out of 7 inhibitors were selected to perform the functional study and found that they lead to cell cycle dysregulation, treatments of PF-04691502 (AKT inhibitor), Dasatinib (Src inhibitor) and Everolimus (mTOR inhibitor) lead to G1 arrest of MC3T3-E1 cells via downregulation of cyclin D1 and p-AKT, whereas XL880 (MET and VEGFR inhibitor) treatment results in increase of sub-G1 and G2/M phase by upregulation of p53 protein. Our work provides important indications for the comprehensive care of cancer patients treated with some targeted drugs.

背景:目前常用的泡沫或海绵生物合成封闭负压引流创面敷料材料临床堵管率高,对于高能损伤所致四肢毁损伤后期创面渗出多、坏死组织多的情况,需反复更换该设备.目的:观察基于生物材料创面敷料的封闭负压引流在四肢毁损伤治疗中的临床效果.方法:选择四肢毁损伤患者36例,在损伤控制性外科手术后,根据患者自愿选择生物材料创面敷料封闭负压引流治疗、合成敷料封闭负压引流治疗、常规传统换药治疗.结果与结论:与常规传统换药组比较,生物材料创面敷料组、合成敷料组采用封闭负压引流能明显缩短住院日,提高二期封闭创面前肉芽组织新鲜度,且生物材料创面敷料组较合成敷料组临床效果更优(P < 0.05).说明新型生物材料创面敷料能有效引流,避免反复多次清创换药对患者身心的损伤,为二期封闭创面提供良好的软组织床.

Objective Metacarpal and phalangeal fractures are common traumatic diseases in hand surgery.Metacarpal and phalangeal bones are involved in the carpometacarpal joints,metacarpophalangeal joints and interphalangeal joints and,if improperly treated,will seriously affect the function of the hand.This study was to compare the clinical effects of miniature plate fixation,K-wire fixation,and traction plaster in the treatment of metacarpal and phalangeal fractures.Methods We equally assigned 60 patients with 95 metacarpal and phalangeal fractures to three groups to be treated with miniature plate fixation,K-wire fixation and traction plaster,respectively.We followed up the patients for 6-12(8.1±1.5) months and evaluated the clinical effects of the three methods using the total active flexion system(TAFS).Results The excellence rates of treatment were 90.9% in the miniature plate group,71.4% in the K-wire group and 55.6% in the traction plaster group,with statistically significant differences among the three(P0.05).The miniature plate method achieved the shortest healing time as compared with the other two(P0.05).The infection rate of open reduction was significantly lower in the miniature plate fixation than in the K-wire fixation group(0.0% vs 15.4%,P0.05).Conclusion Miniature plate fixation is a preferable option for the management of metacarpal and phalangeal fractures for its obvious advantages faster joint function recovery,shorter fracture healing time,and easier postoperative infection prevention.

Objective The purpose of this study is to evaluate the effect of volar declining T-shaped plate internal fixation combined with Kirschner-wire technique in the treatment of distal fracture of radius.Methods This study included 41 patients with distal radial fracture,23 males and 18 females,aged 40-63(mean 51) years,treated by volar declining T-shaped plate internal fixation combined with Kirschner-wire technique.The effects were evaluated by the remodified Steward-Sarmiento scoring and Fernandez grading systems for the wrist function.Results All the patients were followed up for an average of 12 months.The postoperative and follow-up imaging parameters were significantly different from the preoperative ones(P0.05),and the patients were satisfied with their wrist function after surgery.Conclusion Volar declining T-shaped plate internal fixation combined with Kirschner-wire technique is safe and effective for the treatment of distal radial fracture,which can achieve anatomical reattachment and protect the wrist function of the patient.

OBJECTIVE To investigate the clinical manifestation of thoracolumbar vertebral osteoid osteoma and to evaluate the surgical procedure and effectiveness of transpedicular tumor resection and spine reconstruction with posterior pedicle screw system and bone graft. METHODS Between January 2001 and June 2010, 8 cases of thoracolumbar vertebral osteoid osteoma underwent one-stage transpedicular intralesional excision and bone graft combined with spine reconstruction with pedicle screw system through posterior approach. There were 5 males and 3 females with a median age of 15.5 years (range, 6-27 years). Affected segments included T8 in 1 case, T10 in 1 case, L2 in 2 cases, L3 in 1 case, L4 in 1 case, and L5 in 2 cases. All of the cases had back pain, 1 had radiating pain of lower extremity, and 4 patients presented with scoliosis. The mean diameter of lesions was 1.6 cm (range, 0.9-2.0 cm). RESULTS The mean operation time was 110 minutes (range, 70-170 minutes) and the mean blood loss was 720 mL (range, 300-1 400 mL). The postoperative pathologic examination showed osteoid osteoma in all cases. All patients achieved healing of the incisions by first intention. Immediate relief of pain was observed after operation in all patients without complication. The patients were followed up 12-58 months (mean, 39 months). No local recurrence or spinal deformity was observed during the follow-up. CONCLUSION CT can show a low attenuation nidus with central mineralization and varying degrees of perinidal sclerosis, so it has great value for final diagnosis of thoracolumbar vertebral osteoid osteoma. One-stage transpedicular intralesional excision supplemented by impaction bone graft and combined posterior pedicle screw stabilization is a safe and effective treatment.

Objective To study retrospectively the efficacy and complications of complete tumor resection via a posterior midline approach used to treat primary spinal schwannomas.Methods The patients' clinical presentations,operative findings and follow-up were reviewed in 39 patients,over the period from 2001 to 2010.There were 25 males and 14 females with a mean age of 41.5 years(range 14-72 years).Affected segments included thoracic vertebral canal in 17 cases,thoracolumbar vertebral canal in 4 case,lumbar vertebral canal in 15 cases,and lumbosacral vertebral canal in 3 cases.A posterior midline incision approach with laminectomy and facetectomy for single-stage complete resection of intraspinal and paraspinal components of tumor were used.Spine reconstruction with pedicle screw system was also carried out in relevant cases.Results Total excision was achieved in all patients.The patients were followed up for a mean of 35 months(range 10-69 months).Local recurrence was observed in one case of benign schwannoma.One patient with malignant nerve sheath tumor had local recurrent and lung metastasis,who died in 17 months after operation.ASIA sensory scores increased 1.6 in average after operation in 22 patients with paresthesia and ASIA motor scores increased 2.5 in average in 7 of 10 patients with paraparesis.Segmental instability occurred in 2 of 6 cases without spinal instrumentation after surgery.Conclusion Optimizing operative exposure is an important prerequisite for a safe and complete resection of thoracic and lumbar spinal schwannoma.This surgical exposure allows for facetectomy and costotransversectomy when necessary.Leaving the affected nerve root behind can result in a potential recurrence with the attendant difficult problems of reoperation.Spinal instrumentation was required except for patinets with the tumor mass located in midthoracic region.

Objective Osteosarcoma is a malignant tumor which frequently occurs in adolescents.It has a poor prognosis,and chemotherapy cannot improve the five-year survival of the patients.This study was to evaluate the short-term efficacy and safety of rh-endostatin(endostar) in the treatment of osteosarcoma.Methods We assigned 17 patients with confirmed osteosarcoma to an experimental group(n=10) and a control group(n=7),the former treated with endostar in combination with chemotherapy,and the latter by chemotherapy only.We observed and compared the clinical benefit response(CBR),quality of life scores and adverse reactions in the two groups.Results The CBR rates were 100% and 71.4% in the experimental and the control group,respectively.There were no statistically significant differences in adverse effects between the two groups(P0.05),nor were there any unexpected adverse events.Conclusion Endostar exhibited anti-tumor activity with high clinical benefit response for osteosarcoma patients.

目的 探讨脊柱血管瘤合并脊髓压迫的外科手术方式及手术效果.方法 回顾性分析6例脊柱血管瘤合并脊髓压迫病人的临床资料.6例均经后正中入路,采用不同手术方式进行肿瘤切除,结合减压和(或)内固定进行治疗.结果 随访6例,时间4～36个月,2例病人出现进行性神经功能障碍,予以射波刀治疗后,改善1例,无效1例.其余病人恢复良好.结论 椎管内肿瘤切除+椎板减压术+椎弓根螺钉内固定术是治疗脊柱血管瘤合并脊髓压迫的基本手术方式,椎体部分切除术对于脊髓前方压迫的部分病人具有重要作用.