Chordoma is a rare low and moderate-grade malignant tumor originated in the embryonic period residual notochord tissue.Due to its critical location, local aggressive nature, and high recurrence, chordoma is not sensitive to radiotherapy and chemo-therapy with poor prognosis .Surgery is the main treatment method .Here we present a review focusing on basic and clinical research progress of chordoma .

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 depart-ment, 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 ca-ses 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 sim-ple 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 in 5 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 os-teosarcomas 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 recur-rence nor lung metastasis was found in the patients with chordoma and malignant chondroblastoma till the end of follow-up.The 5 pa-tients 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 malig-nant tumors, reconstruction by combined pedicle screw fixation system with bone cement does not affect the general daily activities of the pa-tients.Preoperative embolization of the internal iliac artery can reduce bleeding and improve operation safety, and measures should be taken to minimize postoperative complications.

Objective:To observe the protective effect of deproteinized extract of calf blood (DECB) on the kidney injury of the diabetic rats, and to discuss its mechanism preliminarily.Methods:The male Wistar rats were intraperitoneally injected with STZ (65 mg·kg-1) to establish the diabetes models, then the model rats were randomly divided into model (M)group, and metformin (MMet, 105 mg·kg-1) group , low dose of combined administration (ML,105 mg·k-1 metformin+94.5 mg·kg-1 ,DECB) group, medium dose of combined administration(MM, 105 mg·kg-1 metformin+ 189 mg·kg-1 DECB) group, high dose of combined administration(MH, 105 mg·kg-1 metformin +378 mg·kg-1,DECB) group, another ten Wistar rats were selected as normal control(NC)group.The rats were intragastrically administed with metformin and intraperitoneally injected with DECB, once a day, total of 8 weeks.The rats in NC group and M group were given normal saline solution.The weights and blood glucose levels of the rats in various groups were determined;the levels of serum high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), blood urea nitrogen (BUN), urinary albumin (UAlb), urine creatinine (UCR), serum creatinine (SCr), total cholesterol (TC), triglyceride (TG), uric acid (UA), glutathione (GSH), and malondialdehyde (MDA) were detected;the activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) were determined.The pathological changes of kidney tissue of the rats in various groups were detected by HE staining.Results:Compared with NC group, the weight of the rats in M group was reduced(P<0.05),and the levels of blood glucose,UAlb,UCr,SCr,UA,BUN,LDL-C,TC,TG,and MDA were increased(P<0.05);the levels of HDL-C and GSH were obviously reduced(P<0.05),and the activities of SOD adn GSH-Px were obviously reduced(P<0.05).Compared with M group,the weights of the rats in MM and MH groups were increased (P<0.05), and the levels of blood glucose,UAlb,UCr,SCr,UA,BUN,LDL-C,TC,TG, and MDA were decreased (P< 0.05);the levels of HDL-C and GSH were increased (P<0.05),and the activities of SOD and GSH-Px were increased (P<0.05).The pathological observation of kidney tissue showed that the rats in M group had obvios kidney tissue lesions with glomerular congestion and renal tubular edema compared with NC group;compared with M group,the pathological changes of the kidney tissue of the rats in drug administration groups were significantly improved, the renal tubular vacuoles were reduced, and the interstitial hyperplasia was not obvious.Conclusion:DECB combined with metformin can reduce the blood glucose level, regulate blood lipid, improve the pathological changes of kidney tissue in the diabetic rats, reduce the renal damage, and enhance the antioxidant capacity of the body.

Objective To measure the pressure-volume changes and uroflow rate,and assess the function of upper urinary tract in sigmoidorcctal pouch patients.Methods Between 2007 and 2011,a to-tal of 10 patients who had a radical cystectomy because of muscle-invasive bladder tumor underwent a Mainz pouch Ⅱ procedure were evaluated.The ureters were implanted into the post walls of the detubularized sigmoid segment at least 30 cm in length.In all cases,sigmoidoscopy was done and the anal pressure was measured preoperatively,and video urodynamic study of sigmoidorectal pouch as well as the intravenous pyelography was conducted after 3 to 6 months postoperatively.Results Video urodynamic study of sigmoidorectal pouch revealed that no reflux up to an average volume of 360 ml (270-532 ml) of the descending colon.The sigmoidal colon pressure was 26 cm H2O during the 3 to 6 months post-operative follow-up.The anal sphincter pressure was 90 cm H2O on average preoperatively and did not change postoperatively.The renal function and upper urinary tract were preserved well.The Qmax was 30 ml/s and the average uroflow rate was 8 ml/s under abdominal strain.All the patients suffered slight incontinence in the first two months and became continent since the 3 month postoperatively with nocturnal voiding one to four times.Conclusions The sigmoidorectal pouch provides a reservoir with a higher capacity,lower pressure without reflux to the upper urinary tract and descending colon and lower metabolic acidosis problem.It is also a good alternative diversion procedure that would preserve upper urinary tract and good quality of life.

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 .

Objective Microenvironment plays important roles in the proliferation , viability, and apoptosis of tumor cells. This study was to investigate the effects of different functional groups on the biological characteristics of the osteosarcoma Saos -2 cell line in vitro. Methods Using self-assembled monolayers of alkanethiols on gold , we prepared different terminal chemical groups , including methyl (-CH3 ) , amino (-NH2 ) , hydroxyl (-OH) , and carboxyl (-COOH ) .We determined the similar density of different functional groups by contact angle measurement and x-ray photoelectron spectroscopy , and observed the effects of different functional groups on the adhesion , proliferation, viability, and apoptosis of the osteosarcoma Saos-2 cells by fluorescence microscopy , CCK-8 as-say, flow cytometry, and scan electron microscopy (SEM). Results The surface of -COOH and -NH2 promoted the adhesion and proliferation of the of the Saos-2 cells, with a good compatibility , while that of -CH3 was unfavorable for their adhesion and proliferation and even increased their apoptosis . The promoting effects of the functional groups on the adhesion and proliferation of the cells were listed in the following order: -COOH ≥ -NH2 >-OH -CH3 , while their toxicity and apoptosis-increasing effect ranked as -CH3 -OH >-NH2 >-COOH. Conclusion The-CH3 group inhibits the adhesion and proliferation and promotes the apoptosis of Saos-2 cells, which has provided some evidence for the surface design of biomaterials.

Objective To evaluate effect and safety of first-line chemotherapy regimen combined with rh-endostatin for osteosarcoma of the extremities.Methods Sixty three patients with osteosarcoma were randomly divided into experiment group and control group.There were 32 patients in experiment group,and 31 patients in control group.Nine patients 9 were rejected because they did not meet the standard.Finally,54 patients were enrolled in this study,including 29 patients in experiment group,and 25 patients in control group.In the experiment group,the patients were treated with rh-endostatin combined with MTX,IFO,DDP,and ADM,while patients in control group were treated with MTX,IFO,DDP,and ADM.Several indexes including median progression-free survival time,clinical benefit rate,progression-free survival rate,limb salvage rate,and survival rate were used to assess clinical effect.The safety of rh-endostatin was evaluated by comparing incidence of adverse events in the two groups.Results The median progression-free survival time of experiment group and control group was 18.9 months and 13.1 months,respectively; there was no significant difference.In the experiment group,the clinical benefit rate,progression-free survival rate,survival rate and limb salvage rate were 89.7％,37.9％,65.5％,and 89.7％,respectively; while in the control group,the clinical benefit rate,progression-free survival rate,survival rate,and limb salvage rate were 88.0％,36.0％,68.0％,and 96.0％,respectively.There was no significant difference in 4 indexes mentioned above between two groups.Conclusion After being combined with first-line chemotherapy regimen,rh-endostatin doesn't show significant advantage in controlling tumour progression and improving survival rate.No more toxicity and new side effects are found after using rh-endostatin.

Objective:To observe the protective effect of deproteinized extract of calf blood (DECB)on the ethanol-induced liver injury of the mice,and to preliminaryly discuss its mechanism. Methods:Sixty healthy ICR mice were divided into control group,model group,positive drug group,low,medium and high doses of DECB groups (n=10).By intragastric administration,the mice in control group were given 20 mL·kg-1 saline solution, the mice in low,medium and high doses of DECB groups were administrated with 0.125,0.250,0.500 g·kg -1 DECB,and the mice in positive drug group were administrated with 0.63 g·kg -1 Hugan Tablets;once a day for 30 d. 1 h after the last administration,except control group,the mice in other groups were administrated with one-time grant of 50% ethanol 14 mL·kg -1 ,and fasted for 16 h to establish the models of acute alcohol liver injury.The endurance alcohol time and drunk time of the mice were determined,the activities of aspartate aminotransferase (ALT)and alanine transaminase (AST)activity in serum of the mice were detected,the levels of triglyceride (TG),glutathione (GSH)and malonic dialdehyde (MDA)in liver tissue were determined,and the pathological changes of liver tissue were detected.Results:Compared with model group,the drunk symptoms of the mice in different doses of DECB groups were obviously reduced,the endurance time of the mice in high dose of DECB group and positive drug group was prolonged (P <0.05),and the drinking time was shortened (P <0.05);the ALT and AST activities in serum in mediun and high doses of DECB groups were significantly lower than those in model group (P <0.05).Compared with model group,the MDA and TG levels in liver tissue of the mice in medium and high doses of DECB groups and positive drug group were obviously reduced,and the GSH levels were increased (P <0.05);compared with model group,the pathological damages of liver tissue of the mice in high dose of DECB group caused by ethanol were significantly reduced.Conclusion:DECB can improve ethanol-induced liver injury which may be related to the inhibition of hepatic oxidative stress response.

Objective To investigate the outcome and affecting factors of patients with osteosarcoma after recurrence.Methods Retrospective analysis was used to analyze the achieved data and prognosis-related factors of 72 patients with extremity osteosarcoma after recurrence from June 2000 to September 2012 through multicenter joint treatment.37 males and 35 females were included.The overall age was 7 to 61 years old (average age22.2 years old).Classification based on the tumor recurrent parts:42 cases (58.3％) on femur,18 cases (25％) on tibia,7 cases (9.7％) on humerus and 5 cases (6.9％) on fibula.Classification based on metastases:14 cases of simple recurrence (19.4％),58 cases (80.6％) of recurrence with metastasis:29 cases (40.3％) of recurrence occurred first,9 cases (12.5％) of metastasis occurred firstly,20 cases (27.8％) of simultaneous recurrence with metastasis;12/14 patients (16.7％) of simple recurrence had long-term survival,but 2 died (2.8％).Six of 58 patients (8.3％) of recurrence with metastasis had long-term survival but 52 died (72.2％).Results The overall 10-year postrelapse survival rate of the 72 patients was 25％.Kaplan-Meier univariate analysis revealed that postrelapse survival was significantly influenced by the continued treatment after recurrence and the number of postoperative chemotherapy,but it was not significantlyinfluenced by age,gender and the number of preoperative chemotherapy.Multivariate analysis revealed that the continued treatment after recurrence and the number of postoperative chemotherapy were independent prognostic factors (P=0.002,P=0.007).At the same time,according to the survival curve grouped by different indicators,the number of chemotherapy after recurrence has no significant effect on TFS.However,the continued treatment after recurrence has obvious statistical significance on improving TFS and OS of patients (P=0.026,P=0.002).Conclusion Resection and standard postoperative chemotherapy had significant effects on the postrelapse survival in patients with osteosarcoma.There are good prospects for further multimodal therapy and multicenter cooperation for osteosarcoma after recurrence.

Objective:To analyze the value of peritumoral vascular invasion (PVI) on the prognosis of patients with osteosarcoma.Methods:A total of 232 patients with primary osteosarcoma from 2007 to 2016 were retrospectively analyzed, including 142 males and 90 females. The average age was 17.9±8.2 years (range, 3-39 years). There were 22 positive and 210 negative cases of PVI, 94 deaths and 138 survivals. Univariate survival analysis (Log-rank test and univariate Cox regression) was used to evaluate the effects of age, gender, PVI status, tumor location, surgical method, sensitivity to chemotherapy, and chemotherapy regimen on the prognosis of osteosarcoma. The indicators with statistically significant differences were included in the multivariate Cox regression model to finally determine the risk factors affecting the prognosis of osteosarcoma. The relationship between PVI status and 5-year survival and the incidence of recurrence or metastasis was evaluated using the Kaplan-Meier method.Results:All patients were followed up for 7.6±4.5 years (range, 0.1-15 years). The differences in sensitivity to chemotherapy (χ 2=9.52, P=0.002), choice of chemotherapy regimen (χ 2=8.87, P=0.012), choice of surgical modality (χ 2=13.50, P<0.001), tumor metastasis rate (χ 2=8.51, P=0.004) and mortality rate (χ 2=5.39, P= 0.020) of PVI positive group and PVI negative group had statistically significant differences. Univariate survival analysis was performed on 232 patients with osteosarcoma (gender, age, PVI status, site of tumor development, surgical modality, sensitivity to chemotherapy, and chemotherapy regimen). Indicators with statistically significant differences were included in a multifactorial Cox regression model. The results showed PVI positive [5-year survival rate: HR=2.02, 95% CI (1.61, 2.79), P=0.010; 5-year recurrence or metastasis rate: HR=2.25, 95% CI (1.55, 3.14), P<0.001], surgical procedure as amputation [5-year survival rate: HR=1.22, 95% CI (0.94, 1.78), P=0.037; 5-year recurrence or metastasis rate: HR=1.58, 95% CI (1.11, 2.23), P=0.026] and poor sensitivity to chemotherapy [5-year survival rate: HR=2.71, 95% CI (1.84, 3.98), P=0.001; 5-year recurrence or metastasis rate: HR=2.52, 95% CI (1.88, 3.45), P<0.001] was associated with poor prognosis. Kaplan-Meier curve showed that the 5-year survival rate of PVI positive group was 34%, which was lower than 68% of PVI negative group. The 5-year recurrence or metastasis rate was 72% in the PVI negative group, which was significantly higher than 38% in the PVI negative group ( P<0.05). Conclusion:The 5-year survival rate of PVI positive group was lower than that of PVI negative group, and the 5-year recurrence or metastasis rate was higher than that of PVI negative group. The presence of microvascular angiosarcoma plugs infiltrating the peritumoral tissue in surgical specimens of osteosarcoma after neoadjuvant chemotherapy is a useful indicator to assess the prognosis of patients with osteosarcoma.