[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

BACKGROUND:Lumbar pedicle screw placement technique is a very mature technology in spinal surgery.There are many methods for determining the screw entry points and direction in the clinic.However,for patients with severe lumbar facet degeneration,severe osteophytosis can be found in the surgical area.Smooth and accurate screw placement has some difficulties.OBJECTIVE:To observe the effects of screw placement simulation using Mimics software on pedicle screw fixation before repair of severe lumbar facet joint degeneration.METHODS:A total of 78 cases of severe lumbar zygapophysial degeneration evaluated by CT and MR,who received single-segment lumbar pedicle screw fixation,were enroled in this study.They were randomly dividedinto two groups,including simulation screw group (n=39) and control group (n=39).Totaly 312 pedicle screws were implanted in the two groups.In the simulation screw group,Mimics software was used to perform 3D reconstruction before surgery and to simulate vertebral pedicle screw operation.In the 3D images,screw entry points and surrounding bony landmarks of pedicle screw were observed.The angle and depth of screw placement were measured.During the operation,pedicle screw placement was conducted in accordance with above results of observation and measurement.In the control group,pedicle screw was implanted according to the conventional method.After treatment,an X-ray CT examination was performed in the evaluation of the accuracy of pedicle screw placement.RESULTS AND CONCLUSION:No postoperative complication occurred in the simulation screw group.153 of 156 screws were located in vertebral pedicle in the postoperative examination.The correct rate of screw placement was significantly higher in the simulation screw group than in the control group (98.1％,88.5％,χ2=11.49,P＜0.05).The operation time,amount of bleeding and radiation exposure time were significantly shorter in the simulation screw group than in the control group (P＜0.05).These findings indicate that the lumbar facet joint degeneration accounted for a large proportion in patients with lumbar pedicle screw fixation.Facet joint degeneration increases the difficulties on distinguishing anatomical landmarks of insertion point,which brings a great difficulty for screw placement.The simulation of Mimics software in screw placement can improve accuracy in pedicle screw fixation in patients with severe lumbar facet joint degeneration,reduce complications,operation time,amount of bleeding,and radiation exposure time.

Objective To investigate the safety and efficacy of 177Lu-prostate specific membrane antigen (PSMA)-617 in the treatment of metastatic castration-resistant prostate cancer (mCRPC).Methods From August 2017 to September 2018,11 patients(average age 70.6 years) with mCRPC who underwent 177Lu-PSMA-617 therapy in Nanjing First Hospital were studied.All patients underwent 68Ga-PSMA-11 PET/CT before therapy to assess the tumor radioactive uptake.Blood routine examination and renal function test results were documented before and after therapy to assess the safety.The efficacy was reflected by the changes of prostate specific antigen (PSA) levels and maximum standardized uptake value (SUVmax) on 68Ga-PSMA-11 PET/CT imaging.Paired t test and Wilcoxon's sign rank test were used to analyze the data.Results No acute side effects were observed after therapy of 177Lu-PSMA-617.There were no statistically significant differences after therapy in WBC counts,RBC counts,and PLT,as well as Hb levels (t values:-0.28-1.11,all P＞ 0.05).No kidney toxicity was found.The PSA level after 177Lu-PSMA-617 therapy was significantly lower than that before therapy (80.70 (14.29,1 538.00) μg/L vs 604.60 (88.41,3 980.00) μg/L;u =59,P =0.023).Of the 11 patients,only 2 had elevated PSA levels and disease progression,while the other 9 patients had varying decreases,of which 2/11 decreased by ＞30％ and 7/11 decreased by ＞50％.After therapy,SUVmax of metastatic lesions and metastatic lymph nodes were decreased in 9 and 2 patients respectively.Conclusions 177Lu-PSMA-617 has a good therapeutic value for mCRPC.It is safe and has no obvious side effects.