[Objective]To analyze the clinical effect of microwave hyperthermia in limb salvage surgery for malignant bone tumor of extremities. [Methods]From July 1999 to July of 2005, 309 patients with malignant or bone tumors of extremities were treated by heat necrosis of tumor-bearing bone in situ for limb salvage.The most common diagnosis was osteosarcoma. The first step of the traditional limb salvage was en bloc resection of the tumor-bearing bone. For the novel method, the tumor bearing bone was just separated from surrounding normal tissues, and was devitalized by hyperthermia in situ.After re-strengthening the dead bone, its mechanical property became strong enough to support the body weight.[Results]The beyond 3 years survival rate was 60.2% for high-grade malignancy. In great majority of the patients, cosmetic and useful limbs were preserved. The complication rate was lower than that in the literature reports.[Conclusion]The long term experience has proved that the new method has made its way in the field of orthopedic oncology. The applying of hyperthermia for treatment of bone tumors is an effective, simple, and inexpensive method. The oncological and functional results are encouraging. Hyperthermia should deserve more attention than it has in the clinical practice.

[Objective] To analyze the treatment of malignant of highly aggressive bone tumors of pelvis by microwave-induced hyperthermia.[Methods]A novel surgical model was devised:after careful dissection of the tumor-bearing bone from surrounding normal tissues,the microwave antennae array was inserted into the tumor mass for emitting electromagnetic microwave which produced tumor cellular death via thermo-coagulation.No special reconstruction procedure was necessary,excepting the strengthening measures.[Results]From May 1994 to December 2005,152 patients with pelvic malignant or highly aggressive tumors received radical thermotherapy.Among 67 patients with stage IB tumors,48 patients achieved local and systematic control.Among 61 patients with stage IIB tumors,19 patients died from lesion,and the remaining 42 patents did not developed either metastasis or local recurrence after 3 to 11 years.Of 24 patients with pelvic metastatic lesions,11 patients collapsed during six months to three years,and 13 patients still lived without evidence of disease within one to seven years.In the majority of the patients,functional and cosmetic acceptable limbs were reserved.[Conclusion]The results revealed that the novel and greatly simplified method is justified from both oncological and functional standpoints.Hyperthermia should deserve more attention than it has in this field.

Objective To observe the protective effect of 11,12-epoxyeicosatrienoic acid(11,12-EET)on immature isolated rabbit hearts.Methods Forty-eight isolated immature rabbit hearts were randomly assigned to two groups: Control group,the hearts were arrested with St.Thomas No.2 solution and stored in the same solution ( n =24);EET group,the hearts were arrested with St.Thomas No.2 plus 11,12-EET solution and stored in the same solution ( n =24). All rabbit hearts were stored for 8,16 and 24 h with 4 ℃ hypothetmia, and underwent 30 min reperfusion ( 37 ℃ ). On the Langendorff perfusion apparatus,left ventricle developed pressure (LVDP),left ventricle end-diastolic pressure (LVEDP),+dp/pt max ,coronary blood effluent (CBE) and arrhythmias score were measured before and after ischemia. Myocardial water content,the value of creatine kinase (CK) and lactic dehydrogenase (LDH) were also measured,and myocardial ultrastructure observed. Results Postischemic recovery of myocardial function and myocardial edema were significantly better in EET group at different time points. The changes of arrhythmias score,CK,LDH and myocardial ultrastructure in EET group were superior to those in control group. After the hearts were preserved for 16 h ,the recovery of myocardial function and arrhythmias score in EET group were basically close to the measured values before heart preservation,while those in control group were significantly decreased. After the hearts were stored for 24 h ,all hearts in EET group beated again during reperfusion,but 5 hearts in control group could not beat anymore.Conclusion Addition of 11,12-EET into the St.Thomas No.2 cardioplegic solution could prolong the storage time and enhance the myocardial protective effect to the isolated immature hearts.

Objective: To investigate the protective effect of 11,12-EET(11,12-epoxyeicosatrienoic acid)on myocardium of immature rabbit hearts from ischemic reperfusion injury. Methods: 16 isolated immature rabbit hearts were performed to ischemic reperfusion model in a Langendorff perfusion apparatus and randomlyassigned to on two groups. Control group, the hearts were arrested with St.Thomas No.2 solution and stored in the same solution (n=8). EET group, the hearts were arrested with St.Thomas No.2 plus 11,12-EET solution and stored in the same solution (n=8). These isolated rabbit hearts were stored for 8 hours at 4℃ hypothermia , and underwent 30 minutes of reperfusion (37℃). We measured the preischemia and postreperfusion indexes of left ventricle developed pressure (LVDP), left ventricle end-diastolic pressure (LVEDP), ?dp/pt_ max , myocardial water content (MWC), coronary blood effluent (CBE) and arrhythmia score (AS). The myocardial ultrastructure and value of creatine kinase (CK) and lactic dehydrogenase (LDH) were also observed. Results: (1) After 30 minutes reperfusion, the indexes of CK, LDH, CBE, AS,and the recovery rate of heart function were significantly better in EET group compared with controls. At the same time, no ultrastructural changes were found in the EET group while the capillary endothelial base membrane edema and mitochondrion edema was observed in the control group. (2) In EET group, compared with preischemia, there were no significantly changes of myocardial function at the end of 30-minutes reperfusion. Conclusion: These data suggest that 11,12-EET add to the St.Thomas No.2 solution could offer more little myocardial injury and little arrhythmia and provide better preservation of the isolated immature hearts.

Objective To evaluate the effectiveness of transurethral holmium laser treatment for multiple complex bladder pathological changes.Methods Clinical data of 507 cases of transurethral holmium laser resection for multiple complex bladder pathological changes under endoscope from 2001 to 2005 were retrospectively reviewed.A total of 17 types of bladder pathological changes were encountered,and 2 or more types of pathological changes occurred simultaneously in 111 cases,including 36 cases of 3 types of coexisting changes.Results Primary operation was performed in 505 patients,and two-stage operation was performed in 2 patients.The operation time was 5~35 min(mean,20 min).No obturator nerve reflex and other complications were seen.The operation was accomplished in 3 patients with cardiac pacemaker and 3 patients with coronary stent.Follow-up examinations in all the cases for 12~24 months revealed no relapse.Conclusions Transurethral holmium laser resection for multiple complex bladder pathological changes is safe and reliable.During the procedure,the degree of resection depth in the bladder wall can be precisely controlled.It can be used as the first choice for minimally invasive treatment of multiple complex bladder pathological changes.

Objective To evaluate the role and surgical curative effect of the holmium laser under minor-caliber ureteroscope (F4.5) for the treatment of incarcerated ureteral calculus. Methods The holmium laser under minor-caliber ureteroscope (F4.5) was used to treat the incarcerated ureteral calculus with the course more than 2 months in 286 cases (334 sides) . Results 262 patients (304 sides) were successful in operation of single cavity treatment, with success rate of 91.6%. Conclusion Long course incarcerated ureteral calculus often associated with ureteral obstruction lesions (narrow,polyp,granulation hyperplasia,ureter cyst,etc.). Compared with thick ureteroscopy, minor-caliber ureteroscope has high single success rate for the treatment of incarcerated ureteral calculus with high safety, less complications, high gravel and platoon stone rates, and simultaneous treatment of the ureteral obstruction lesions.

Objective As a classical approach for hyperthermic ablation,microwave ablation (MWA) has been widely used in the treatment of tumors that cannot be removed by traditional surgery.MWA devitalizes the neighboring tissue and kills tumor cells by thermal diffusion.In the last two decades,this technique has been improved for treating malignant bone tumor in our institute.In situ ablation has already replaced en bloc resection and achieved satisfactory treatment outcomes.This study explores whether tumor cell death induced by MWA would cause the release of immunogenic tumor antigens and tumor-specific immune responses.Methods Three models of MWA were established using osteosarcoma cell lines from the mouse,rat,and human,respectively.The expression of immunogenic molecules was measured during in vitro and in situ ablation with different ablation time and group design.Results The injection of tumor vaccines made from tumor cells or supernatant treated with in vitro ablation resulted in substantial inhibition of tumor cell growth in tumor-bearing animal models.The CDs + T cells induced by vaccines played a key role in the process.The effector cells released cytokines,IFN-γand TNF-α,to inhibit tumor cell growth and also trigger Fas/FasL-mediated apoptosis.Conclusions MWA-treated osteosarcoma cells can be used to induce specific antitumor immunogenic effects.Therefore,in situ MWA combined with immunotherapy provides an alternative treatment method for patients who have trouble due to their insensitivity to chemotherapy.

Objective To study the clinical significance and change law of the serum inflammatory factor in the elder patients with femoral neck fracture during perioperative period. Methods 62 patients with femoral neck fracture were selected as research object,and the serum IL-1,IL-6,IL-10,TNF-α,CRP and BGP of the patients at preoperative day and after the treatment at the first,third,seventh and fourteenth day were detected with ELISA. Results The serum IL-1 ,IL-6,IL-10,TNF-α and CRP went up first and then down,the levels were highest at the third day, and they were compared to the levels at preoperative day( t = 3.34,3.53,3.44,3.69, all P ＜ 0. 05 ), the levels at the fourteenth day returned to normal levels,but the serum BGP showed a rising trend,the level was highest at the fourteenth day, and it was compared to the level at preoperative day( t = 2. 87, P ＜ 0. 05 ). Conclusion The changes of the serum inflammatory factor in the elder patients with femoral neck fracture during periopearative period showed regular pattern, and it was meaningful for understanding the developing and prognosis.

Objective:To explore the effect and mechanism of miRNA sponge on the epithelial-mesenchymal transition (EMT) of gastric carcinoma cell lines SGC7901. Methods:Synthetic ZEB2 3'UTR plasmid and siRNA targeting ZEB2 were transfected into the SGC7901 cell line by Lipofectamine 2000. Real-time quantitative polymerase chain reaction was performed to evaluate the expres-sion levels of miR-200a/b/c. Finally, the migratory, invasive, and proliferative activities of the gastric carcinoma cells in vitro were ana-lyzed by the scratch test, the Transwell cell invasion, and the cell cloning assay. The expression of the target protein was detected by Western blot. Results:Compared with the control group, the expressions of miR-200a/b/c significantly decreased, and their migration, invasion, and proliferation capabilities were considerably higher after they were transfected with ZEB2 3'UTR. Although the expres-sions of miR-200a/b/c significantly increased, the migratory, invasive, and proliferative activities of SGC7901 cells also degraded after they were transfected with siRNA targeting ZEB2. The expression of ZEB2 increased, and that of E-cadherin decreased at the protein level after they were transfected with ZEB2 3'UTR. The protein expression of Vimentin in SGC7901 cells significantly increased. The indicators show the opposite trend when cells were transfected with siZEB2, and the differences between the control and mutation groups were insignificant. Conclusion:ZEB2 3'UTR can regulate EMT course by regulating the miR-200a/b/c expression in gastric car-cinoma, consequently regulating the invasion and migration of carcinoma cells.

AIM: To study apoptosis and bcl-2 mRNA gene expression of cardiomyocytes in donor hearts of immature rabbits underwent prolonged protection by 11, 12-epoxyeicosatrienoic acid (11, 12-EET), and further probe into the possible mechanisms. METHODS: 24 isolated immature rabbit hearts were performed to the model in a Langendorff perfusion apparatus and randomly assigned to normal control group,ST control group and EET group. The isolated rabbit hearts in ST control group and EET group were stored for 24 hours with 4 ℃ hypothermia, and underwent 30 minutes of reperfusion (37 ℃). TUNEL and in situ hybridization (ISH) methods were applied in the present study and apoptotic cells and bcl-2 mRNA gene expression were observed. RESULTS: The numbers of apoptotic cardiomyocytes in ST group and EET group were higher than that in normal control group, and the numbers of apoptotic cardiomyocytes were significantly decreased in EET group and bcl-2 mRNA positive expression were higher than that in ST control group, respectively. CONCLUSIONS: There were apoptosis during the prolonged protection of donor heart in our study, and we proved that: ①11,12-EET could decrease cardiomyocyte apoptosis significantly. ②Up-regulation of the bcl-2 mRNA expression in cardiomyocytes may be one of the mechanism responsible for inhibition of cardiomyocyte apoptosis by 11, 12-EET.