Dedifferentiated chondrosarcoma(DDCS)comprises approximately 10%of all chondrosarcomas and has the worst outcome with a 5-year survival of 10%.The preferred localizations are the femur,humerus and pelvis.DDCS represents a special form of chondrosarcoma characterized by the presence of well-differentiated cartilaginous component in juxtaposition with malignant mesenchymal tumor of high-malignancy grade.The diagnosis of DDCS is highly complicated,requiring detailed radiological and histopathological evaluation as well as precise bioptic technique.The dedifferentiated component is typically a high-grade sarcoma(usually grade 3 or 4),which can be either an osteosarcoma,a malignant fibrous histiocytoma or an anaplastic spindle cell sarcoma.In approximately one-third of the radiographs,one-third of the MR images,and one-half of the CT scans, the tumors demonskates bimorphic features.Recently,array-based comparative genomic hybridization(array-CGH)studies have been performed on frozen chondrosarcoma(including DDCS)specimens.There is a statistically significant association between high-grade tumor(grade Ⅲ and dedifferent ated)and the recurrent genetic deletions at 5q14.2～q21.3,6q16～q25.3,9p24.2～q12,and 9p21.3.One of the most commonly deleted regions of DDCS involved chromosome 9.Earlier investigations of DDCS showed p53 mutation and p53-LOH in the anaplastic component.It is also accompanied by Rt-LOH.P161NK4 and E-cadherin promotor methylation were observed in the low grade chondroid compartment of DDCS.While p161NK4,FHIT,and E-cadherin were methylated in highly malignant osteosarcomatous compartment of the tumor.Surgical resection of the tumor within wide or radical margins is the most important treatment.The value of neoadjuvant or adjuvant therapy remain uncertain.Several new drug targets have been identified and phase Ⅱ studies are currently ongoing.Current phase Ⅱ trials open for DDCS patients used the following medicine:apomab(proapoptotic selective agonist of Ap02L/TRAIL death receptor),perifosine(serine/threonine kinase Akt inhibitor),dasatinib(multitargeted small-molecule tyrosine kinase inhibitor),and the combination of gemcitabine and docetaxel.More recently,several phase Ⅰ studies have reported incidental responses of DDCS to newer targeted agents,such as histone deacetylase and vascular endothelial growth factor antisense oligodeoxynucleotide.The prognosis for patients with DDCS remains poor. The poor prognosis of the DDCS is determined by nonchondroid high grade component caused by invasive growth and formation of metastases.Therefore,early diagnosis and prompt surgical treatment may improve the outcome.

Objective To detect the different expression of Runx2 in dedifferentiated chondrosarcoma and conventional chondrosarcoma, and to investigate the role of Runx2 in the occurrence and development of dedifferentiated chondrosarcoma. Methods Dedifferentiated chondrosarcoma cell line NDCS-1 and normal chondrosarcoma cell line SW1353 were cultured, then mRNA and total cellular protein were extracted.RT-PCR Western blotting, and immunocytochemistry were used to detect the expression of Runx2.Immunohistochemistry was used to test Runx2's expression in the dedifferentiated chondrosarcoma specim ens that confirmed by pathology. Results Runx2 was high expression in dedifferentiated chondrosarcoma cell line and high-grade component of dedifferentiated chondrosarcoma tissues. Conclusion The high expression of Runx2 in dedifferentiated chondrosarcoma is involved in the occurrence and development of dedifferentiated chondrosarcoma.

Objective: To investigate the differential expression of Sox9 in conventional chondrosarcoma,dedifferentiated chondrosarcoma and normal cartilage. Methods: We reported 12 cases of chondrosarcomas,which were initially diagnosed as chondrosarcomas(6 cases of conventional chondrosarcoma and 6 cases of dedifferentiated chondrosarcoma)at Peking University People's Hospital between January 2003 and January 2007.We used genechip method to identify difierentially expressed genes involved in conventional chondrosarcoma,dedifferentiated chondrosarcoma and in normal cartilage(6 cases)and found thousands of differentially expressed genes after extensive statistical analysis.With Sox9 which played crucial roles in the process of both differentiation and maturation of chondrocyte as a candidate,we used Real-time PCR,Westem blot and immunohistochemistry to confirm the results found by gene chip. Results: DNA microarray results showed that Sox9 was up-regulated about 1.6 times in conventional chondrosarcoma compared with that in normal cartilage.But in dedifferentiated chondrosarcoma,the expression level of Sox9 was significantly down-regulated,0.082 times of that in normal cartilage.Real-time PCR results showed that the expression levels of Sox9 mRNA in conventional chondrosarcomas and dedifferentiated chondrosarcomas were 1.68±0.119 and 0.088±0.017,respectively.Sox9 protein level was significantly higher in humen conventional chondrosarcomas than that in normal cartilage.Sox9 protein level in dedifferentiated chondrosarcomas was significantly lower than that in normal cartilage tissue.All of the 6 cases of conventional chondrosarcomas showed diffuse and strong staining of Sox9.However,Only scattered staining was observed in dedifferentiated chondrosarcomas. Conclusion: Compared with that in normal cartilage,Sox9 expression is up-regulated in conventional chondrosarcomas and down-regulated in dedifferentiated chondrosarcomas.Decrease of Sox9 expression in dedifferentiated chondrosarcoma is correlated with poor survival,indicating that Sox9 may serve as a molecular prognostic marker for chondrosarcomas and disease progression.

Objective To evaluate the clinical efficacy and complications in the treatment of advance liver cancer under ultrasound guidance with percutaneous RFTI-1 TM-cold cycle RF tumor ablation apparatus produced by Nangjing TianMa high-tech Company limited. Methods 25 patients of advance liver cancer, including 8 cases of metastatic liver cancer, 17 of primary hepatic carcinoma, were treated with percutaneous RFA cool-tip electrode under Ultrasound guidance 1 to 2 times. Eight of the patients prior to RFA were treated with TACE of individually three times for each. The postoperative efficacy was evaluated by enhanced CT. Results 10 lesions were completely necrotized and the majority parts of another 15 lesions were also under necrosis. Follow-up of six months, all patients are still alive with marked improvement of life quality. Conclusion The short-term efficacy of percutaneous Ultrasound-guided RFA with cool-tip electrode for treating advance liver cancer is quite satisfied, worthy to be recommended.

Objective:To investigate the killing effect of nanoliposome encapsulated cisplatin(NLE-CDDP) on human osteosarcoma cell line Saos-2 and explore the distribution of platinum(Pt) in tumor-bearing mice.Methods: Saos-2 cells were cultured at different concentrations of NLE-CDDP.MTT assay,inverted microscopic observation and flow cytometry assay(FCM)were used to observe the antiproli-ferative effect of NLE-CDDP on the human osteosarcoma cells.Antitumor effect of NLE-CDDP was determined using the xenografts models of human osteosarcoma cell Saos-2 in nude mice.The Pt concentration in the tissues of tumor-transplanted mice was determined by atomic spectrophotometer.Results: When treated at different concentrations of NLE-CDDP for 24-96 hours,the survival rate of Saos-2 cells decreased significantly(P

ObjectiveTo learn the status quo of pre-job training,on-the-job training and the demands of training among community health service staff,and to provide evidence of continuing education.MethodsInvestigation was made by self-designed questionnaire in 335 community health service staff from ten service centers and seven service stations in four regions of Guangdong province.Results The rate of pre-job training and on-the-job training were lower than the training demands among community health service staff.The content of on-the-job training was varied and could meet the training needs.Training was maily done in superior hospitals and the main form of training was seminars and classroom teaching.ConclusionTraining efforts should be increased to meet the training demands.Training model should be innovated to improve the training effect.Hospital and community exchanges should be strengthened and the training system should be improved.

Objective To evaluate the value of percutaneous transhepatic angioplasty in treatment of portal vein stenosis (PVS) after pediatric liver transplantation.Methods The data of 8 pediatric patients with PVS after liver transplantation were retrospectively evaluated.All cases were confirmed by portal vein angiography,and were treated with percutaneous transluminal angioplasty and/or percutaneous transluminal stent angioplasty.The effect of endovascular interventional therapy in 8 cases was analyzed.Results A total of 12 times of 8 patients received endovascular interventional therapy.The success rate was 66.67％ (8/12).The clinical success rate of the first treatment was 62.50％ (5/8).Three cases were treated with balloon dilation after the first balloon dilation,and there was no recurrence of PVS after operation in 2 cases.After the treatment of balloon dilation,stent angioplasty was performed in 1 case.There were no complications related to treatment in 8 cases.Conclusion Endovascular interventional treatment is a safe and effective way for PVS after pediatric liver transplantation.

Objective To observe the value of endovascular treatment of portal vein stenosis (PVS) after pediatric liver transplantation for biliary artesia.Methods The data of 14 children with PVS after liver transplantation for biliary atresia were retrospectively evaluated.All children were confirmed by portal vein angiography,and were treated with 1-2 times of percutaneous transluminal angioplasty with or without percutaneous transluminal stent angioplasty.The effect of endovascular interventional therapy in 14 children was analyzed.Results A total of 14 children received 23 times of endovascular interventional therapy.The technical success rate of the first treatment was 82.61％ (19/23).Ten children were treated with balloon dilatation,and stent angioplasty was performed in 4 children after balloon dilatation.These stents were not narrowed after implantation.There were no complications related to treatment in 14 cases.Conclusion Endovascular treatment for PVS after liver transplantation for biliary atresia is safe and effective.

Objective To establish a prognostic model for lung adenocarcinoma(LUAD)based on genes associated with the disulfidptosis(DS)pathway,and to elucidate its potential biological mechanisms.Methods LUAD-related gene sequencing and clinical information were sourced from public databases.The correlation between results of gene set variation analysis(GSVA)and mRNA expression in The Cancer Genome Atlas(TCGA)dataset was used to screen genes that were signifi-cantly active in the disulfur death(DS)pathway.The Least Absolute Shrinkage and Selection Opera-tor(LASSO)analysis and Random Forest(RF)algorithm were employed to screen out DS pathway prognosis-related genes(DPRGs)and multivariate Cox regression analysis was used to construct risk score(RS)model,which was validated using external GEO datasets.The samples were divided into high and low-risk groups based on the median score of RS.A protein-protein interaction(PPI)net-work corresponding to 7 DPRGs was established,with LDHA identified as the protein with the most interactions,thereby further investigating its function and expression patterns.Results In this study,7 DPRGs were screened,including SLC2A1,LDHA,SNAI2 and ACO2,FGF12,ANP32B and ST13.The prognostic model constructed based on these genes exhibited high validation efficiency.Kaplan-Meier survival analysis revealed significant differences in overall survival of patients between high-risk group and low-risk group in four datasets.Differential expression gene enrichment analysis be-tween the high-risk and low-risk groups showed that these genes were enriched in pathways such as the p53 signaling pathway and cell cycle.Results of real-time quantitative polymerase chain reaction(qRT-PCR)and immunohistochemistry indicated that LDHA expression levels were elevated in LUAD tissue compared to normal tissues.Conclusion The LUAD model established based on DPRGs can effectively predict patients'prognosis,potentially offering insights into the treatment and prognosis of LUAD patients.

Objective To establish a prognostic model for lung adenocarcinoma(LUAD)based on genes associated with the disulfidptosis(DS)pathway,and to elucidate its potential biological mechanisms.Methods LUAD-related gene sequencing and clinical information were sourced from public databases.The correlation between results of gene set variation analysis(GSVA)and mRNA expression in The Cancer Genome Atlas(TCGA)dataset was used to screen genes that were signifi-cantly active in the disulfur death(DS)pathway.The Least Absolute Shrinkage and Selection Opera-tor(LASSO)analysis and Random Forest(RF)algorithm were employed to screen out DS pathway prognosis-related genes(DPRGs)and multivariate Cox regression analysis was used to construct risk score(RS)model,which was validated using external GEO datasets.The samples were divided into high and low-risk groups based on the median score of RS.A protein-protein interaction(PPI)net-work corresponding to 7 DPRGs was established,with LDHA identified as the protein with the most interactions,thereby further investigating its function and expression patterns.Results In this study,7 DPRGs were screened,including SLC2A1,LDHA,SNAI2 and ACO2,FGF12,ANP32B and ST13.The prognostic model constructed based on these genes exhibited high validation efficiency.Kaplan-Meier survival analysis revealed significant differences in overall survival of patients between high-risk group and low-risk group in four datasets.Differential expression gene enrichment analysis be-tween the high-risk and low-risk groups showed that these genes were enriched in pathways such as the p53 signaling pathway and cell cycle.Results of real-time quantitative polymerase chain reaction(qRT-PCR)and immunohistochemistry indicated that LDHA expression levels were elevated in LUAD tissue compared to normal tissues.Conclusion The LUAD model established based on DPRGs can effectively predict patients'prognosis,potentially offering insights into the treatment and prognosis of LUAD patients.