60 cases of Giant-cell tumor of bones are reported in this paper.Of the 60 cases, 37 were males and 23 females. Their age was 16-67 andthe average age was 31. 75%. 75% was in the age of 21-40 5 were undertwenty and 4 out of them were females. The knee region was the commonest site. In 16 patients tumors werein the distal part of the femur, 13 in the proximal part of the tibia, 7 inthe proximal part of the femur. According to the different forms of the stromatic cells of the tumor.they were divided into spindle cell type(F) and ovalcell type (H). Thesurvial rate for five years of type F were obviously higher than that of typeH. However, lung metastasis were found in type H than in type F. Onthe other hand, in the pathological pattern of the metastatic cases of thelung 75% got plentiful blood sinusoid structures. All of this group underwent different opeations. Four cases were givenbiopsy. Sixteen cases were curetted and packed with bone chips with therecurrence rate 13. 3%. Sixteen cases were enbloc removal of the tumorand arthrodesis with the recurrence rate 13. 3%. Six cases (grade Ⅲ) wereamputated. All of them died within two and a half years. Fifty-five cases were followed and in two yaers seven out of themdied, and local recurrence was present in one case and lung metastasis wasfound in one case. Fourty-six cases were followed for 2 to 20 yearsand the average period was 7 years. There were 2 deaths, 2 local recurre-nces and one lung metastasis. The total recurrence-death rate was 25. 45%.

BACKGROUND:Studies have shown that suberoylanilide hydroxamic acid (SAHA) has protective effects in some vital organs in animals after hemorrhagic shock, and 7.5% hypertonic saline (HS) exerts significant effects on stabilizing the hemodynamics of hemorrhagic shock animals. OBJECTIVE:To evaluate the effect of SAHA combined with HS on the hemodynamics of hemorrhagic shock rats. METHODS: Fifty rats were randomly and equaly divided into five groups: sham, shock non-resuscitation, SAHA, 7.5% HS, and 7.5% HS + SAHA. Each group contained 10 rats. Except the sham group, rats in the remaining four groups were applied to establish hemorrhagic shock models. In the sham group, rats were given anesthesia catheter, not bleeding; in the shock non-resuscitation group, the bleeding was found, but rats were not resuscitated and were kiled after 60 minutes of observations; in the other three groups, rats were respectively resuscitated at 60 minutes after bleeding, through intravenous administration of SAHA within 5 minutes, 7.5% HS and SAHA + 7.5% HS within 20 minutes. Heart rate, mean arterial pressure and left ventricular systolic pressure were monitored through the femoral artery and the right common carotid artery catheter in each group. RESULTS AND CONCLUSION:At 3 hours after resuscitation, the heart rate was the highest in the 7.5% HS + SAHA group, compared with the SAHA and 7.5% HS groups (P < 0.05). After resuscitation, the mean arterial pressure and left ventricular systolic pressure were increased, with long-lasting effect and less fluctuation (P < 0.05). Experimental results show that 7.5% HS combined with SAHA has a superiority than traditional HS and simple drugs for resuscitation after hemorrhagic shock.

Objective To explore the value of Montreal Cognitive Assessment (MoCA) in the diagnosis of mild cognitive impairment. Methods Mini-mental state examination (MMSE) was used in 532 elderly persons aged 60 years and over in Xuzhou city Gulou county. The 69 healthy people and patients with mild cognitive impairment were chosen to undergo MoCA. Then the sensitivity and specificity of MoCA were analyzed. Results According to MMSE, there were 19 patients with mild cognitive impairment (27. 5 %), 50 healthy persons (72.5 %). While according to MoCA, there were 58 patients with mild cognitive impairment (84.1%), 11 healthy persons (15.9 %). The consistency of the two scales was not good. And compared with MMSE, the sensitivity of MoCA was 94.7%, and the specificity was 20. 1%. Conclusions In the diagnosis of mild cognitive impairment, MoCA is more sensitive than MMSE.

Objective To observe the dynamic level of platelet activation and to analyze the correlation between platelet activation and systemic inflammatory response syndrome(SIRS)in patients with acute ischemie stroke. Methods　Mean platelet component concentration(MPC)and white blood count(WBC)were serially determined in patients with acute isehemic stroke,and other parameters including initial plasma fibrinogen(FIB)and adenosine diphosphate(ADP)aggregative rate were also determined.All parameters were compared between the SIRS group and the non-SIRS group.Correlation was analyzed between initial MPC and SIRS score,WBC,FIB and ADP aggregative rate. Results MPC level was declined slightly on the first day,and was followed by a relatively low MPC level from the second day to the forty-fifth day.The average level was fluctuated between 229 g/L and 242 g/L.There was no significant difference in initial FIB(t=1.835,P=0.07)between the SIRS group and the non-SIRS group,but the differences of other parameters had statistical significance(all P＜0.01).In the first three days,MPC level was negatively correlated with SIRS score(r=-0.392,-0.376,-0.341,t=3.484,3.405,3.125 respectively,all P＜0.01),but not correlated with WBC,FIB and ADP aggregative rate(P＞0.05). Conclusions　Platelets maintain an activated state during the entire course of ischemic stroke.The initial level of platelet activation.WBC count and ADP aggregative rate are higher in SIRS patients than in non-SIRS patients.The initial level of platelet activation suggests the severity of SIRS,and may be one of the independent risk factors for SIRS.

Objective To investigate the efficacy of injectable osteoinductive material with fibrin sealant(FS) as a carrier compounded with bovine bone morphogenetic protein(bBMP) and bovine fibroblast growth factor(bFGF) for radial defect in dogs.Methods A total of 12 dogs were used in this study.The animals were randomly divided into treatment and control groups with 6 in each.We created a 20-mm bone defect at the upper radius of each dog,and then sutured the subcutaneous tissues and skin around the lesion.After the operation,FS(control) and FS+bFGF+bBMP were given to the two groups respectively by percutaneous injection.To compare the efficacy of the injections,we examined the animals by radiography in 4,8,16,and 24 weeks.The dogs were sacrificed in 24 weeks to obtain the specimens of the bone defect for histological examination and bone mineral density(BMD) determination.Results Radiography showed callus formation in 4 weeks and then osteoneogenesis in 24 weeks in the treatment group;whereas,in the control group,no callus was found around the defect in 24 weeks.In the treatment group,the mean BMD of the diseased radius was significantly higher than that of the healthy leg and that in the control group [(456.33?13.74) mg/cm2 vs(433.33?6.77) mg/cm2(t=2.57,P=0.00) and 0 mg/cm2].By histological examination,the new-formed bone in the treatment group was confirmed integral and dense with intact cortex and continuous marrow cavities in 24 weeks,while the bone defect of the controls were repaired with connective tissues without remodeling of the bone.Conclusion It is effective to repair bone defect in dogs by using injectable osteoinductive material with FS as a carrier compounded with bBMP and bFGF.

Exosomes are small membrane vesicles secreted into the extracellular medium by a broad array of cells in culture.Exosome proteic and lipid composition is unique and might shed some light into exosome biogenesis and functions.Exosomes secreted from professional antigen-presenting cells(i.e.dendritic cells) and tumor cells are enriched in MHC class Ⅰ and Ⅱ complexes,costimulatory molecules,Hsp70-90 chaperones and tumor antigen,and have therefore been more extensively studied for their immunomodulatory capacities in vitro and in vivo.In this review,we will describle the definition and composition of exsomes and the main biological features pertaining to tumor or DC-derived exosomes,and will also present the early clinical results and limitation of their implementation in cancer immunotherapy.

Objective To investigate the variation of the chromosomal karyotype of patients with congenital pseudarthrosis of the tibia(CPT) and its relation with the neurofibromatosis. Methods Ten patients with complete follow up records in 28 cases of CPT treated between 1982 and 1999 were included in this study. There were 7 males and 3 females. The age of the patients at the surgery ranged 4 to 17 years. Seven patients had skin caf?-au-lait spots. Peripheral venous blood (1-2 ml) of 10 patients was cultured in 1640 culture medium with 10%(v/v) fetal calf serum and phytahematoagglutinin(PHA) for 70-72 hours, and then colchicines was added (10 ?g/ml) in culture medium 4 hours before finishing the culture. The specimens were harvested and the chromosomal karyotype was analysed. Results The karyotype of the chromosomes were normal(46XY or 46XX) in all of the speciments, there were no chromosome aberration, chromosome loss and polyploid. Conclusion Neurofibromatosis has no relation with CPT, the genic location of the CPT may have some relation with the neurofibromatosis.

Objective To study the effect of injectable osteoinductive materials with fibrin sealant as the vehicle on the reconstruction of segmental radius defect in dog, and to provide an experimental foundation for its clinical application in the future. Methods 20mm bone defects were created in the radius 18 dogs, and in the experiment group b [FS+bFGF+bBMP (bovine BMP)] composite, and in experiment group r (FS+bFGF+rhBMP-2) were injected percutaneously into the defects. A control group (FS) with bone defect only was also included. The reconstruction effect on the segmental dog radius defects was evaluated by radiography, histology, bone mineral density (BMD) at 4, 8, 12, 16, 20 and 24 weeks after operation. Results In the experimental groups with bovine BMP as osteoinductive agent, higher repairing capability and osteogenesis rate were observed in experiment group b (FS+bFGF+bBMP) compared with that of control group (P

Objective To investigate the effect of the injectable osteoinductive material with fibrin glue(FG)as carrier compounded with rhBMP-2 and bFGF on the proliferation and differentiation of marrow matrix cells(MMCs)of rabbit,in order to lay an experimental foundation for clinical application in the future.Method MMCs were isolated and cultured from bone marrow of a 3-day-old rabbit.The effects of the material were investigated in experiment group(group A:FG+bFGF+rhBMP-2),with control groups consisting of control group 1(group B:FG),control group 2(group C:FG+bFGF),control group 3(group D:FG+rhBMP-2)and single control group(group E:free of material).The observation objects included proliferation rate,adhesive rates,expression of type I collagen and alkaline phosphatase,cell growth condition in the material and the ultrastructure of rabbit MMCs with the aid of electron microscopy,histochemistry and cell culturing.The concentration of rhBMP-2 and bFGF in all groups was uniform(1?g/ml).Results The proliferation rates and the adhesive rates of rabbit MMCs in group A was significantly higher than that in group B,group D and group E,but was lower than in group C(P

Objective To investigate the diagnostic value of preoperative real-time three-dimensional color Doppler transthoracic echocardiography on assessment of patients with structural heart disease (SHD). Methods A total of 111 pa?tients were assessed preoperatively using real-time three-dimensional color Doppler transthoracic echocardiography (RT-3D-CDTTE), which include 31 SHD patients and 80 patients without SHD that were designed as negative control. Conven?tional two-dimensional color Doppler transthoracic echocardiography (2D-CDTTE) were used to compared with RT-3D-CDTTE while cardiovascular angiography and intraoperative findings were used as“Golden Standard”simultaneously. First of all, preoperative echocardiographic examination were performed and diagnosis was given. Angiography and intraoperative findings were hired to verify the accuracy of echocardiographic diagnosis before operation. Results (1) The preoperative RT-3D-CDTTE displayed three-dimensional structure and hemodynamic status of SHD cardiac lesions clearly, which were consistent with cardiovascular angiography and intraoperative findings. (2) P value of McNemar test between 2D-CDTTE and“Golden Standard”was greater than 0.05, Kappa=0.654 (P<0.001). P value of McNemar test between RT-3D-CDTTE and“Golden Standard”was greater than 0.05, Kappa=0.932 (P<0.001). Conclusion RT-3D-CDTTE can provides essen?tial information for preoperative evaluation which is important for decision of SHD management.