Objective To study the reparative and reconstructive for proximal humerus defect due to the excision of bone tumor with noninternal fixation non-vascularised fibular autografts. Methods From June 1991 toDecember 2003, 26 non-vascularised fibular grafts were used as substitutes for repair and reconstruction after resection for bone tumors on proximal humerus. Fifteen cases were given curettage and fibular supporting internal fixation, the other 11 cases were given tumor resection and joint reconstruction with proximal fibular graft. The age ranged from 6 to 41 years. Out of 26 patients, 5 had giant cell tumor, 9 had bone cysts, 8 had fibrous dysplasia and 4 had enchondroma. Results Twenty-six patients were followed up from 1 to 12 years (3.4 years on average). Local recurrence was found in 2 cases, and 1 of them died of lung metastasis. Both outlook and function of the reconstructed joints have good results in 15 proximal humeral joint surface reserved cases. Of them, 3 children gained normal shoulder function 3 weeks after operation. Part function were obtained in the other 11 fibular grafts substituted proximal humeral defect. Conclusion Non-vascularised fibular grafts is an appropriate treatment option for proximal humerus bone defect due to excision of bone tumor.
It is extremely necessary to find an ideal filling material for the treatment of benign bone defect, particularly those benign osteolytic defect in children with a comparatively large cavity. From July, 1995 to December, 1996, 10 cases of benign osteolytic bone defects were treated, in which 5 cases of benign osteolytic defects, 3 cases of bone cysts, 1 case of fibrous dysplasia of bone and 1 case of non-ossifying fibroma. After through curettage of the cavity, the natural non-organic bone in cube-shaped was used to fill the prepared cavity. The results showed that the activities of the patients resumed normal in 3 to 6 months after operation. The roentgenographic examination after operation showed that the lucent spaces between NNB cubes disappeared with obvious new bone formation and the bony cavity was obliterated with newly-formed bone. There was no recurrence of the lesion during a follow-up of 7 to 24 months. It was concluded that to treat the osteolytic defect of bone with NNB was a method of choice. The new bone formation appeared early in large amount and increased rapidly.
ObjectiveTo explore the effectiveness of propeller facial artery perforator flap to repair the defect after resection of skin malignant tumor at upper lip.MethodsBetween July 2012 and January 2017, 17 cases with skin malignant tumor at upper lip underwent tumor resection and the remained defect was repaired with propeller facial artery perforator flap. Among the 17 patients, 3 were male and 14 were female, with an average age of 57 years (range, 35-82 years). There were 5 cases of squamous cell carcinoma and 12 cases of basal cell carcinoma. The disease duration ranged from 4 months to 11 years with an average of 20 months. The tumor size ranged from 1.4 cm×0.3 cm to 3.1 cm×1.4 cm. The extended resection of the tumor tissue was performed according to the characters of tumor. According to the location, size, and shape of the defect and the position of facial artery perforator explored with Doppler ultrasonography, the propeller facial artery perforator flap was designed to repair the defect and partial donor site. The flap size ranged from 5 cm×2 cm to 7 cm×3 cm. The length of the perforator pedicle was 0.5–1.0 cm with an average of 0.8 cm. The defect at donor site was directly closed.ResultsCyanosis occurred in 3 cases of the distal flap after operation, then healing after symptomatic treatment. The remaining flaps survived successfully and the wound healed by first intention. Primary healing was obtained in the donor site. All the patients were followed up 6-36 months with an average of 18 months. The shape of the patient’s upper lip was good and the scar on the donor site was unconspicuous. There was no lip deformity, ala nasi deflection, facial tension, entilation dysfunction, or recurrence of tumor during follow-up. At last follow-up, the results of self-evaluation were very satisfactory in 13 cases and satisfactory in 4 cases.ConclusionBased on multiple advantages of good blood supply, large rotation range, aesthetic outcome, and slight injury of the donor site, propeller facial artery perforator flap is not only an optimal choice for repairing upper lip defect after resection of skin malignant tumors, but also can achieve good functional and cosmetic effectiveness.
In order to restore the function of shoulder joint in patient with tumor of upper end of humerus, artificial humeral head replacement was performed. The materials included resinene, nylon-6 and large molecular polyethylene from 1978 to 1993, 14 patients were treated. The tumors involved in this group were giant cell tumor, synviosarcoma, bone cyst, osteochondroma, osteoblastoma, osteofibrosarcoma, osteosarcoma, chondrosarcoma, parosteosarcoma and malignant giant cell tumor. After resection of the tumor, the artificial prosthesis was implanted with bone cement. After 1 to 16 years follow-up, functions of the shoulder joint were reserved in 86% of the patients.
【Abstract】 Objective To investigate the expression patterns of vascular endothelial growth factor (VEGF) mRNA as markers for isolated tumor cells in the peripheral blood of patients with hepatocellular carcinoma (HCC) following liver transplantation, and to evaluate the correlation between VEGF and the recurrence and metastasis of HCC following liver transplantation. Methods In this prospective study, 97 patients were divided into four groups according to the pathological results: HCC following liver transplantation group (HCC+LT group, n=53), advanced HCC group (n=8), benign liver diseases group (n=26) and healthy volunteers group (n=10), among which the 53 cases in HCC group were collected from April, 2002 to December, 2003. RNA was purified from the peripheral blood of the other 44 control patients and also from the patients in HCC group before, during and after liver transplantation in order to study the expression specificity of VEGF mRNA in HCC patients and its dynamic change during perioperative period. The correlation between VEGF and the tumor recurrence and metastasis was also analyzed by fluorescent quantitative reverse transcriptase and polymerase chain reaction (FQ RT-PCR). Results VEGF mRNA could be used as marker of isolated tumor cells for its high specificity. The positive rate of VEGF mRNA in HCC group and in advanced HCC group were 37.5% and 75.0%, respectively, which were significantly higher than that in benign liver diseases group (11.5%) and healthy volunteers group (10.0%), P＜0.01. The presence of preoperative VEGF mRNA and the consistent presence of postoperative VEGF mRNA might be relevant with the recurrence and metastasis HCC following liver transplantation （P＜0.01）. Conclusion The presence of preoperative VEGF mRNA and the consistent presence of postoperative VEGF mRNA may predict the recurrence and metastasis HCC following liver transplantation.
Objective To evaluate the feasibility and short-term effectiveness of three-dimensional (3D) printed titanium-alloy prosthesis reconstruction after the distal tibia tumor segment resection. Methods The clinical data of 6 patients with bone defect after distal tibia tumor segment resection treated with 3D printed titanium-alloy prosthesis reconstruction and tibiotalar joint fusion between January 2020 and December 2021 were retrospectively analyzed. There were 2 males and 4 females; the age ranged from 12 to 35 years, with an average of 18.5 years. Among them, 4 cases were osteosarcoma, 1 case was Ewing sarcoma, and 1 case was giant cell tumor of bone. The Enneking staging was stage ⅡA in 3 cases, stage ⅡB in 2 cases, and stage Ⅲ in 1 case. The disease duration was 2-5 months (mean, 3.2 months). All patients received preoperative neoadjuvant therapy, and patients with osteosarcoma and Ewing sarcoma started chemotherapy at3 weeks after operation. The systemic and local tumor conditions and prosthesis conditions were evaluated regularly after operation. The Musculoskeletal Tumor Society (MSTS) score and the American Orthopaedic Foot and Ankle Society (AOFAS) score were used to evaluate the lower extremity and ankle function. Results All patients were followed up 8-26 months, with an average of 15.6 months. There was no local recurrence and distant metastasis during the follow-up. The ankle joints of 5 cases were all in 90° functional position at last follow-up, and there was no complication such as prosthesis loosening and fracture; the ankle joint fusion was stable, the local bone ingrowth was good, and the daily activities could be completed, but the ankle range of motion was limited and the ankle joint was stiff. The MSTS score ranged from 22 to 26, with an average of 24, and 3 cases were evaluated as excellent and 2 cases were good; the AOFAS score ranged from 71 to 86, with an average of 80.6, and 4 cases were evaluated as good and 1 case was fair. One patient had severe periprosthetic infection at 2 months after operation, resulting in failure of prosthesis implantation, pain in limb movement, and poor ankle function; MSTS score was 12, AOFAS score was 50, and both were evaluated as poor; distraction osteogenesis was performed after removal of prosthesis and infection control, at present, it was still in the process of distraction osteogenesis, and local osteogenesis was acceptable. Conclusion Using 3D printed titanium-alloy prosthesis and tibiotalar joint fusion to reconstruct the bone defect after distal tibia tumor segment resection has satisfactory mechanical stability and function, and is one of the effective distal tibial limb salvage methods.
Objective To explore the value of chemosensitivity assay in vitro on breast cancer. Methods In vitro chemosensitivity of 6 species of chemotherapeutic agents applied to 38 cases of breast cancer patients were detected by tissue culture-end point staining-computer image analysis (TECIA). Results The sensitivity to chemotherapeutic agents commonly used in the breast cancer level from high to low was as follow: Doxorubicin (ADM), Paclitaxel (TAX), Vinorelbine (NVB), Cyclophosphamide (CTX), Cisplatin (DDP) and Fluorouracil (FU). Conclusion Drugs sensitivity experiment of cancer in vitro by TECIA has an important value to instruct clinical medication and individual chemotherapy for breast cancer.
ObjectiveTo study the effect of tumor associated neutrophil (TAN) releasing a proliferation-inducing ligand (APRIL) on the proliferation of pancreatic cancer cells in microenvironment.Methods① The expressions of APRIL in neutrophils (differentiated by HL-60 cell) and TAN cells were detected by use ELISA. ② The expressions of APRIL receptors B cell maturation antigen (BCMA) and trans-membrane activator and CAML interactor (TACI) in pancreatic cancer cell line PANC-1 were confirmed by use Western blotting. ③ Pancreatic cancer PANC-1 cells were co-cultured with TAN, and divided into a PANC-1 control group (referred to as the control group), a PANC-1+TAN treatment group (referred to as the PANC-1+TAN group), PANC-1+TAN+APRIL antibody treatment group (referred to as PANC-1+TAN+APRIL group), and PANC-1+rtificial recombinant APRIL protein (rAPRIL) treatment group (referred to as PANC-1+rAPRIL group). The CCK8 method was used to determine TAN release of APRIL on PANC-1 effect of cell proliferation activity.Results① The APRIL content in the culture medium of TAN cell group was higher than that of neutrophil group [(556.20±84.38) pg/mL vs. (377.17±57.07) pg/mL, P=0.038]. ② PANC-1 cells express the receptors BCMA and TACI of APRIL. ③ PANC-1 cell activity of PANC-1+TAN group and PANC-1+rAPRIL group [(126.80±1.42)%, (168.95±12.54)%] were significantly higher than the control group [(100 ± 0.00)%, P<0.05, P<0.001], the activity of PANC-1 cells in the PANC-1+TAN group was significantly higher than that in the PANC-1+TAN+APRIL group [(86.29 ± 12.20)%, P=0.003] and significantly lower than that of PANC-1+rAPRIL group (P=0.002), the activity of PANC-1 cells in PANC-1+rAPRIL group was significantly higher than that in PANC-1+TAN+APRIL antibody group (P<0.001).ConclusionIn the microenvironment of pancreatic cancer, the release of APRIL from TAN increases, which promotes the proliferative activity of PANC-1 in pancreatic cancer cells, which provides a new idea for the mechanism research and treatment of pancreatic cancer progression.
Objective To investigate the clinical therapeutic effects on malignant spinal tumors treated by percutaneous vertebroplasty(PVP) under the guidance of the digital subtraction angiography(DSA). Methods A retrospective analysis was performed in 196 patients (99 males and 97 females, aged 23-85 years, averaged 60.4 years) with malignant spinal tumors, who underwent the PVP treatment combined with standard chemotherapy and other comprehensive treatment from January 2002 to January 2005. The malignant spinal tumors had their origins as follows: lung cancer (66 cases), breast cancer (55 cases), liver cancer (19 cases), colon cancer (15 cases), stomach cancer (9 cases), prostate cancer (12 cases), multiple myeloma (16 cases), and malignant lymphoma of the spine (4 cases).The metastatic tumors involved the cervical vertebra (32 cases), thoracic vertebra (93 cases), lumbar vertebra (71 cases), and spinal column, including 1 vertebral segment (135 cases), 2 segments (50 cases), and more than 3 segments (11 cases). During the follow-up survey, changes in the visual analogue pain scale(VAS) and changes in the X-ray measurements of the average anterior height, midline height, and posterior height of the diseased vertebra were observed. Results The follow-up for 6 months to 3 years revealed that the percutaneous vertebroplasty on279 vertebral segments had a success with an operational success rate of 100%. Bone cement was injected into the lesions 1-9 ml per segment of the spine. The postoperative X-ray and CT evaluations revealed that spinal stabilization was obtained in all the patients. After operation, 193（98.5%）patients had an obvious decrease or disappearance of the pain in the lower back, and only 3 (1.5%) patients had no obvious improvement in the pain. There was a significant statist-ical difference in the VAS scores between before operation and after operation (Plt;0.05). There were also significant statistical differences in the average anterior height of the diseased vertebra between before operation and after operation（15.71±2.80 mm vs 16.61±3.01 mm）, in the midline height（13.65±2.93 mm vs 14.52±2.72 mm）, and in the posterior height（23.67±2.81 mm vs 23.70±3.13 mm,Plt;0.05). The patients with lung or liver cancer had a mean survival time of 9 monthsafter PVP; the patients with breast cancer, stomach cancer, prostate cancer, lymphoma, or other metastatic tumors had a mean survival time of 18 months. The patients with multiple myeloma had a mean survival time of 27 months. The differences were statistically different (Plt;0.01). Conclusion PVP under the guidance of the DSA is an easier operation witha small wound and few complications. It can effectively alleviate the patient’s pain due to metastatic spinal tumor, stabilize the spine, improve the patient’s quality of life, and reduce the incidence of paraplegia.
【Abstract】Objective To study the significance of expression of p27 in thyroid follicular tumors. Methods The tumor samples were obtained from 53 thyroid follicular tumors, and 10 normal thyroid tissues were used as a control group. p27 was detected by the immunohistochemical staining S-P method. Results The normal thyroid group had the highest expression of p27.There were significant differences in the expression of p27 between thyroid follicular adenomas (FA) and follicular carcinomas (FTC), FA had much higher expression of p27 than FTC did. There were no significant differences in the p27 staining indexes between minimally and widely invasive FTC nor between metastized and non-metastized FTC. Logistic regression showed that p27 were effective in distinguishing FA from FTC(P=0.0048). Conclusion It appears that p27 may be necessary for the malignant transformation of the thyroid follicular epithelium, which might relate to a decrease in p27. p27 detection may be helpful in distinguishing FA from FTC.
