[Objective]To discuss the clinical and the biological significance of the expression of residual tumor cells MTA1 in the occurrence and progression of osteosarcoma after chemotherapy,and to investigate the correlation between MTA1 expression and the prognosis in osteosarcoma patients.[Method]SP immunohistochemical technique was used to detect the expression of MTA1 in the residual tumor cells from 31 osteosarcoma patients after chemotherapy.[Result]Among 17 patients with positive MTA1 expression,6 had good prognosis(35.29%);and among 14 patients with negative MTA1 expression,11 had good prognosis(78.57%).There were significant differences between groups(P

PDCA cycle was applied in special rectification activities for medical instrument clinical trial, with quality criteria of implementation made. Completed medical instrument clinical trial from January 2011 to December 2012 was believed as control group, from January 2013 to December 2014 as PDCA group, the scores of clinical trial and the score rate of items were compared and analyzed. Results show quality scores of clinical trial in PDCA group are higher than that in control group (51 vs. 81, P < 0.001), score rate of items increased except adverse events (P < 0.001). The special rectification activities with PDCA applied in our department are feasible and effective. It significantly improves implement quality of medical instrument clinical trial.
Clinical Trials as Topic ; Equipment and Supplies ; standards ; Humans ; Research Design

PDCA cycle was applied in special rectification activities for medical instrument clinical trial, with quality criteria of implementation made. Completed medical instrument clinical trial from January 2011 to December 2012 was believed as control group, from January 2013 to December 2014 as PDCA group, the scores of clinical trial and the score rate of items were compared and analyzed. Results show quality scores of clinical trial in PDCA group are higher than that in control group (51 vs. 81, P < 0.001), score rate of items increased except adverse events (P < 0.001). The special rectification activities with PDCA applied in our department are feasible and effective. It significantly improves implement quality of medical instrument clinical trial.
Clinical Trials as Topic ; standards ; Equipment and Supplies ; standards ; Humans ; Research Design ; standards

[Objective]To study the clinical matters of inactivated bone replantation with preservation of the epiphysis in children limb salvage with osteosarcoma.[Method]Eleven children(mean age 7.6 years old,5 male and 6 female)with osteosarcoma underwent inactivated bone replantation with preserving epiphysis following chemotherapy during 6 years.All lesions located in the distal femur.Seven were in Ⅰ type on MRI classification,4 in Ⅱ type.Two courses of the same protocol as preoperative chemotherapy were administered postoperatively.[Result]The operative time were 3~4 hours.The bleeding amount were about 300~500 ml.No complications occurred in operation and incisions healed well in all patients.Eleven patients were done follow-up from 10 to 72 months.Functions of the affected limbs were satisfatory.Local tumor recurrence was seen in one case and lung metastasis in two,3 patients died of the disease.Blot became flexible and inactivated bone fractured in one,respectively.[Conclusion]Inactivated bone replantation with preserving epiphysis for osteosarcoma in children is propitious to recover limb function and keep limb length.The main measures of preventing complications include no-touch technique in operation,incision drain completely,prolonging time of affected limb external fixation and safeguarding the affected limb during postoperative function exercise.

Purpose: To explore the relationship between the amount of lymphocyte containing adhesion molecules(CD_(44)) and the development and postoperative metastasis of bone tumors. Method: The percentage of peripheral blood CD_(44) positive lymphocyte's(PB CD_(44) + L) in 45 patients with bone tumor and the tissue CD_(44) content in 7 malignant bone tumors were determined with the flow cytomentric immunological method. Results: The PB CD_(44) + L in benign tumor group(BG) and malignant tumor group(MG) were much higher than that of the control, and the PB CD_(44) + L in MG was higher than that in BG. No difference was found in the content of PB CD_(44) + L between the mahgnant non-metastatic group (MNG) and the malignant metastatic group(MMG). The postoperative PB CD_(44) + L in the BG and MNG was decreased, but CD_(44) was unchanged pre-and postoperatively in the MMG. The patients with high CD_(44) content in the tumor tissues were liable to postoperative lung metastasis. Conclusions: The determination of CD_(44) in PBL and tumor tissue can be helpful to determine the nature of the neoplasm and to predict its prognosis.

[Objective]To analyze the causes of revision for bone tumor salvage limb operations and to explore the therapies.[Method]There were 4 cases of male,1 of female and with the mean age of 41.2 years old.The time between the first operation and revision was from 3 to 29 years.The common reason for revision was aseptic loosening,2 patients with sinus and 1 with fracture of prosthesis.During revision,the old prosthesis were implanted in 2 cases,the new one were used in the others.[Result]All patients were followed up with the mean time of 28 months,no patient died.The mean score of limb function was 21.5.[Conclusion]Revision should be performed as soon as the prosthesis aseptic loosening has been determined,and the satisfactory limb function could be obtained.

Objective To compare the long term efficacy of total hip arthroplasty and half hip arthroplasty in the treatment of elderly patients with femoral neck fracture .Methods 70 elderly patients with femoral neck fracture who needed hip replacement were randomly divided into the observation group and control group ,35 cases in each group.The observation group was given total hip arthroplasty ,while the control group was given half hip arthroplasty . The postoperative long term effect was compared between the two groups .Results The overall incidence rate of post-operative infection of the observation group was higher than the control group ,the postoperative revision rate of the ob-servation group was lower than the control group ,but the differences between the two groups were not statistically sig-nificant(P>0.05).The overall incidence rate of postoperative chronic pain in the control group was 22.86%,which was higher than 2.28%of the observation group,the difference was statistically significant (χ2 =5.130,P<0.05). The postoperative Harris score of the observation group was (93.25 ±4.51)points,which was significantly higher than (82.76 ±3.82)points of the control group,the difference was statistically significant (t=6.973,P<0.05).The ex-cellent and good rate of the observation group was 91.43%,which was significantly higher than 71.43%of the control group,the difference was statistically significant (χ2 =6.492,P<0.05).Conclusion Total hip arthroplasty in the treatment of femoral neck fracture can reduce the incidence of postoperative pain ,improve hip function of the patients , and its long-term effect is better than single hip replacement surgery ,which should be widely applied in clinical .

Objective To investigate technique and effect of reconstruction with alcohol-inactivated autograft-prosthesis composite after en bloc resection of giant cell tumor of bone around the knee.Methods From January 2007 to October 2008,8 patients with Campanacci grade Ⅲ giant cell tumor of bone around the knee underwent en bloc resection of tumor and reconstruction with alcohol-inactivated autograft-prosthesis composite in our hospital.There were 5 males and 3 females,aged from 20 to 43 years (average,31years).The tumor located in distal femur in 5 cases and proximal tibia in 3 cases.There were 4 cases of primary tumor and 4 cases of recurrent tumor.Two patients combined with pathological fracture.The Musculoskeletal Tumor Society (MSTS) score was used to evaluate limb function,and the International Society of Limb Salvage (ISOLS) score was used for radiographic evaluation.Results All patients were followed up for 38 to 67 months (average,54 months).No recunrence,metastasis,prosthesis loosening were found.The mean healing time of autograft and host bone was 5.5 months.At final follow-up,the MSTS score ranged from 25 to 29 [average,26.3 (88％)]; the ISOLS score ranged from 28 to 35 [average,32.8 (88.5％)].Creeping substitution was possibly the main way of bone union.The healing time in femoral lesion was faster than that in tibial lesion.Conclusion For Campanacci grade Ⅲ giant cell tumor of bone around the knee,en bloc resection and reconstruction with alcohol-inactivated autograft-prosthesis composite is an effective method,which can provide satisfactory results.

Objective To analyze the incidence of remaining symptoms after discectomy with different operation,and investigate its causes and clinical significance.Methods Two hundred and twentyfour patients were followed up.The incidence of remaining symptoms and clinicai situation after discectomy were observed with different operation:discectomy (110 patients,single group),discectomy with bone grafting internal fixation (70 patients,fusion group),and discectomy with dynamic fixation (44 patients,non-fusion group).The SPSS 19.0 software was used to analyze the data.Results One hundred and sixpatients (47.32％,106/224) occurred remaining symptoms in 224 patients.In single group was 69 patients (62.73％,69/110),in fusion group was 26 patients (37.14％,26/70),and in non-fusion group was 11 patients (25.00％,11/44).The incidence of remaining symptoms among three groups was significant difference(x2 =22.177,P =0.000).The incidence of remaining symptoms in single group was significantly higher than that in non-fusion group and fusion group (x2 =17.921,P =0.000;x2 =11.235,P =0.001).The incidence of remaining symptoms in non-fusion group and fusion group had no significant difference (x2 =1.817,P =0.178).Conclusions There is significantly different in the incidence of lumbar disc herniation with different surgery methods.Discectomy with bone grafting internal fixation and with dynamic fixation can effectively reduce the incidence of remaining symptoms.

Objective Preparing platelet rich gel through two-times centrifugal technique and co-culturing chondrocytes with PRG, then observing the proliferation and gene expression of chondrocytes, in order to provide a favorable way to prepare tissue engineering cartilage. Methods Centrifugating venous blood of rabbit through two-times centrifugal technique to obtain platelet rich plasma( PRP) ,then detecting the concentration of various growth factor in PRP. Admixing PRP with chondrocytes of rabbit and activating them with activator. After co-culti-vation,the proliferation of chondrocytes through MTT method and expression of ACAN,CollagenⅡand SOX-9 through realtime-PCR were ob-served,and compared with common cultured chondrocytes. Results The concentrations of PDGF-AB,TGF-β1,IGF-1 and VEGF in PRG were significantly higher than those in blood(P<0. 05). After co-cultivation, the proliferation rate of chondrocytes and the expression of ACAN,Collagen Ⅱ and SOX-9 were significantly higher than that of common cultured chondrocytes(P<0. 05). Conclusion Co-culturing chondrocytes with PRG is able to promote the proliferation and gene expression of chondrocytes. We considered that it is a excellent method to construct tissue engineering cartilage.