Acupuncture Therapy ; Adult ; Humans ; Male ; Myelitis ; complications ; therapy

Objective To evaluate the clinical effectiveness of the treatment for the intramedullary broad dissemination of the malignant bone tumor of limbs by microwave heliotherapy combined with prosthesis replacement.Methods From June 2001 to April 2012,19 patients with intramedullary broad dissemination of malignant bone tumor of limbs were treated with microwave heliotherapy combined with prosthesis replacement.There were 12 males and 7 females,47 years old on the average (ranging from 11 to 65 years).The tumors involved:primary malignant tumor 11 cases,metastases of the scapula 8 cases.Locations of tumors involved:the distal femur 8 cases,the proximal tibia 6 cases,the proximal humerus 3 cases and the proximal femur 2 cases.After the patients were examined with MRI and the level of osteotomy was determined,the prostheses were custom-made.The exposures of the all tumors were via the conventional surgical approach.The lesions were heated at 50 ℃ for 20 min by 2 450 MHz microwave,with surrounding soft tissue protected by copper mesh.The level of osteotomy was determined by the result of preoperative imaging measurement.The prosthesis was installed after the microwave heliotherapy.Results The duration of surgery was from 60 min to 150 min (100 min on average).The blood loss was from 300 ml to 1200ml (600 ml on average).All patients were followed-up for 10 months to 5 years (2.7 years on average).1 case with chondrosarcoma relapsed 18 months after surgery,and survived with tumors.1 case with malignant fibrous histiocytoma died due to multiple metastases 8 months after surgery.1 case with Ewing sarcoma died due to pulmonary metastases 23 months after surgery.The remaining 7 cases with the primary malignant bone tumors did not recur or transfer during the follow-up period.6 cases with the metastases died due to metastases 5 to 20 months after surgery.The functions of shoulder joint of 3 proximal humerus tumor patients were restricted,while 16 patient's function weren't restricted.Conclusion The clinical results demonstrated that the microwave heliotherapy combined with prosthesis replacement was an ideal treatment for the intramedullary broad dissemination of the malignant bone tumor of limbs.

Objective To investigate the clinical outcomes of microwave heliotherapy in situ on the primary or metastatic malignant tumors of the pelvis.Methods From February 2000 to April 2009,18 patients with primary or metastatic malignant tumors of the pelvis were treated with microwave heliotherapy in situ,and followed a total or partial tumor resection.There were 11 males and 7 females with an average age of 45 years(range,16-72).Twelve cases were diagnosed as primary malignant tumor and 6 as metastases.Locations of tumors involved:the Ⅰ region 6 cases.the Ⅱ region 10 cases.and the Ⅲ region 2 cases.The exposures of all tumors were via aTtype or ilioinguinal approach.The lesions were heated at 50℃ for 20 min by 2450 MHz microwave,with surrounding soft tissue protected by copper.mesh.The necrotic tumor tissues were total or partial excised after treatment,with preservation of the anatomical continuity of the pelvic ring.Results The duration of surgery was 60-180 min (110 min on average).The blood loss was 400-800ml(480 ml on average).All patients were followed-up for 0.5-7 years(3.5 years on average).Tumor local recurred in 1 case with chondrosarcoma,and was survival in tumor-bearing after 6 months follow up.One case with malignant fibrous histiocytoma died due to brain,pulmonary,and all body metastases.One case with osteosarcoma died due to pulmonary metastases.Five cases with the metastases died due to non-pelvis metastases.Functions of hip joint in 18 patients were as follows:flexion 80°-130°,extension 0°-10°,abduction 25°-35°,and adduction 18°-23°.Conclusion The clinical result demonstrated that the advantages of microwave heliotherapy in situ were quick increase of temperature,sensitive responses,easy control of temperature,and effective inactivation of tumor cells in the malignant bone tumors of pelvis.

Objective To evaluate the clinical effectiveness of the treatment for hip osteoid osteoma by CT-guided percutaneous microwave ablation. Methods From August 2006 to January 2010, 8 patients with the osteoid osteomas of the hip were treated with CT-guided percutaneous microwave ablation, including 5 males and 3 females with an average age of 18.8 years (range, 12 to 25). The history of local pain was ranging from 2 months to 10 years, with aggravation of pain at night. The locations of the lesions contained: 4cases in the neck of femur, 2 in the lesser trochanter, 1 in the greater trochanter and 1 in the femoral intertrochanteric line. After localization of the nidus with CT, osseous access was established with a Gallini puncturatio needle. After scanning the nidus with CT, a trocar was used to obtain specimens for pathological examination. Subsequently, a microwave probe was introduced through the biopsy needle to the nidus. Microwave ablation was performed at 90 ℃ for 4 to 6 minutes. Prophylactic antibiotics were used two days postoperatively. Results Three patients were diagnosed as osteoid osteoma with the pathological confirmation after the operation, 5 cases were not diagnosed by the pathological confirmation. All the cases were followed up for 6 to 21 months. All the patients reported alleviated pain in the first 24 hours postoperation. One case with lesion in the right proximate femur retained mild pain without nonsteroidal antiinflammatory drugs 5 month after operation. The same procedure was done once more on this patient, and the outcome was good. No osteonecrosis of the femoral head and other complications were observed in all patients. Conclusion By CT-guided percutaneous microwave ablation for osteoid osteomas of hip reliably relieves pain with few complications and recurrences. The short-term efficacy is satisfactory. It is a safe and effective technique for treatment of osteoid osteoma.

Animals ; Gene Expression ; Hypoxia ; metabolism ; Prefrontal Cortex ; metabolism ; Rats ; Somatomedins ; metabolism

Objective To evaluate the clinical effectiveness of the treatment for the proximal femur malignant bone tumor by conducting intercalary diaphyseal endoprosthetic reconstruction.Methods Form June 2011 to July 2014,7 patients who had proximal femur malignant bone tumor were treated with intercalary diaphyseal endoprosthetic reconstruction.There were 3 males and 4 females,61.8 years old on the average (ranging from 28 to 76 years).The tumors involved:4 case of the limbs primary malignant tumor,1 case of osteosarcoma,1 case of juxtacortical osteosarcoma,1 case of malignant lymphoma with pathological fracture,and 1 case of malignant fibrous histiocytoma with pathological fracture,as well as 3 cases of the Metastatic breast cancer of the proximal femur.All patients were evaluated by plain radiography,CT and MRI before operation.After these 7 patients were examined with MRI and the level of osteotomy was determined,prosthesis fitting is ready.The exposures of all the tumors were via the femur lateralis surgical approach.According to the general principles of tumor surgery,expose the tumor segment and soft tissue tumors.The segment of involved bone was then removed,with a surrounding cuff of normal tissue overlying the tumor.The level of osteotomy was determined as the result of preoperative imaging measurement.The proximal and distal femur intramedullary canals are reamed.The prosthesis is assembled and installed after the cement used.Results The duration of surgery was from 45 min to 120 min (90 min on average).The blood loss was from 200 ml to 800 ml (400 ml on average).All patients were followed-up for 6 months to 2 years (14 months on average).1 case with osteosarcoma died due to pulmonary metastases 18 months after surgery.The remaining 3 cases with the primary malignant bone tumors did not recur or transfer during the follow-up period.1 case with the metastases was comprehensive treated in another hospital,and survival with tumors.The remaining 2 cases with the metastases did not recur or transfer during the follow-up period.Conclusion The clinical results demonstrated that the intercalary diaphyseal endoprosthetic reconstruction was an ideal treatment for the proximal femur malignant bone tumor.

Objective:To systematically evaluate the therapeutic efficacy of tuina therapy for primary insomnia.Methods:Nine Chinese and English databases were searched from the inception to May 2017 to identify randomized controlled trials (RCTs) studying tuina therapy for insomnia.The enrolled articles were all RCTs with tuina as the monotherapy or major therapy in the experiment group,with clear diagnostic criteria for primary insomnia well recognized worldwide or in China,and Pittsburgh sleep quality index (PSQ I) as one of the outcome measures.Two researchers evaluated the risk of bias and quality of the enrolled studies by following Cochrane Handbook version 5.1.0.The meta-analysis was performed by RevMan version 5.3.Results:Eleven studies were included with a total of 1 076 participants.The Western medication adopted in the control groups were benzodiazepine receptor agonists.The studies were all assessed as high risk of bias for blinding since blinding method was unable to be performed due to the specificity of tuina therapy;no study reported the support of fund or potential interest conflict,so they were all rated unclear for selective reporting.The meta-analysis showed that compared with other traditional Chinese medicine therapies,tuina worked more effectively in reducing the PSQI score (MD=-4.11＜0,95％ confidence interval (CI)-6.01 to-2.22,P＜0.0001);compared with oral administration of Western medication,tuina showed more significant efficacy in reducing the PSQI score (MD=-3.42＜0,95％CI-5.19 to-1.66,P＜0.0001).Subgroup analysis showed that head tuina alone showed no significant difference compared with oral administration of Western medication regarding the change of PSQI score (MD=-4.19＜0,95％CI-8.87 to 0.50,P＞0.05);a combination of head and back tuina could more effectively reduce the PSQI score compared with oral administration of Western medication (MD=-2.08＜0,95％CI-3.09 to-1.06,P＜0.0001).Conclusion:Tuina can produce more significant efficacy in treating primary insomnia compared with other traditional Chinese medicine therapies and oral administration of Western medication,especially the combination of head and back tuina.

Objective To study clinical application of femoral head exclusion after resection of pelvic tumors around acetabulum with less limb damage and complications.Methods From October 1999 to August 2009,18 patients with pelvic tumors around acetabalum (zone Ⅱ of Ennekingl were treated with tumor resection and femoral head exclusion,including 16 males and 2 females with an average age of 54 years(range,18-72).The diagnosis were chondrosarcoma(4 cases),osteosarcoma(2),giant cell tumor of bone(4),synoviosareoma(1),malignant fibrous histiocytoma(1),Ewing sarcoma(1),and metastatic carcinoma(5).Throe cases were treated by selective arterial embolization before operation and 4 cases by temporary block of lower abdominal aorta or common iliac arte.Regular follow-up in clinic was done to observe function of joint and radiographic imaging.Results All patients were followed up for 55 months(range,3-118).The mean surgical time was 170 min(range,120-350 min).The mean blood loss was 1200 ml(range,600-2200 ml).All wounds were healed without infection.One patient with osteosarcoma and 3 with metastatic carcinoma died of multiple organ metastases during 6 months to 2 years after operation.The others had no local relapse.The mean limb discrepancy was 5.0 cm (range,2.0-7.5 cm).The mean Enneking score was 23 (range,20-27).All patients needed custom-made shoes with heightened heel of 2-3 cm.Osteonecrosis of the femoral head was not found in radiographic images.Eight cases had formed artificial acetabulum.One case had gentle lumbar scoliosis.Conclusion The clinical application of femoral head exclusion after resection of pelvic tumors around acetabulum had low complications,less pain,low relapse,better function in the recent period.

Objective To explore and evaluate the clinical significance of pressure-controlled discography in diagnosis of discogenic low back pain.Methods From July 2008 to October 2009,pressurecontrolled discography under C-arm guidance was taken in 52 patients with suspected discogenic low back pain,including 83 degenerative discs and 52 good discs.Based on the pressure of discography inducing pain,the discs were divided into 4 groups:pressure ≤ 30 psi,30 psi＜pressure ≤50 psi,50 psi＜pressure≤70psi,and pressure＞70 psi.By using SPSS 11.0 statistical software,the correlation of pressure of discography and morphologic representation was analyzed.Results Among 83 degenerative discs,positive discography was detected in 46 discs.During discography,the pressure of positive degenerative discs was (36.5±15.7)psi; the pressure of negative degenerative discs was (50.5±26.2) psi,and the normal discs’ pressure was (98.6±3.7) psi.A significant difference could be found between the mentioned three groups.Among different pressure groups,the positive rate were analyzed by x2 test,and a significant difference was found as well.But no significant difference was found between the group of less than 30 psi and group of 30 to 50 psi.According to Adams’ morphological classification of discography,the pressure of disc varied from 30 to 50 psi in grade Ⅲ,while less than 30 psi in grade Ⅳ.There was a significant difference of discography pressure between discography positive grade Ⅲ and grade Ⅳ.Conclusion The pressure-controlled discography is valuable for clinical diagnosis of discogenic low back pain.The morphological classification of discs could indicate the degree of the disruption of annular fibrosus.

BACKGROUND:Segmental bone defects resulting from osteoporotic fractures, trauma, congenital bone dysplasia and progressive bone disorder are very common, and bone tissue engineering provides a new approach to bone defect repair. Growth factors related to bone tissue engineering bone have been reported a lot and have achieved some results. How to mimick the natural timing of different growth factors with different bioactivities has become the current hotspot in bone repair. OBJECTIVE: To review the new developments in vascular endothelial growth factor and bone morphogenetic protein in bone tissue engineering. METHODS: The first author searched CNKI (1990/2015) and Medline database (1990/2015) for related articles using the key words of “osteogenic factors, angiogenic factors, tissue engineering bone, bone repair, vascularization, vascular endothelial growth factor, bone morphogenetic protein, sequential release, seed cels, cytoskeleton” in Chinese and English, respectively. Mechanism of action and research direction about vascular endothelial growth factor and bone morphogenetic protein were summarized. RESULTS AND CONCLUSION:Totaly 313 papers were searched initialy, and finaly 87 papers were enroled in result analysis. The results show that different growth factors play different roles in bone repair. Vascularization and osteogenesis are the most important processes in bone repair. The osteogenic factors play an important role in maintaining bone structure and bone formation. The angiogenic factors can provide oxygen and nutrients for tissue growth, differentiation and functionalization. The combination of osteogenic and angiogenic factors has a better osteogenic effect than osteogenic or angiogenic factors used alone. However, the most important problem is how to control the exogenous osteogenesis and the release dosage of angiogenic factors in bone repair.