Objective To observe the short-term clinical effect of compound sophora injection combined with Java brucea fruit oil emulsion injection for palliative treatment of advanced malignant tumors. Methods Totally 120 cases of advanced malignant tumor patients were randomly divided into treatment group and control group, each contains 60 cases. The control group was treated with Java brucea fruit oil emulsion, and the treatment group took compound sophora injection additionally by intravenous infusion one time daily. The cycle was 24 d. After 3 cycles, the curative effect, pain relief, improvement situation of quality of life and adverse reactions of the two groups were observed. Results Feasible curative effect evaluation of 112 patients showed:The disease control rate in the treatment group was 89.5% (51/57), and the control group was 74.5% (41/55). The total effective rate of cancer pain relief of the treatment group was 91.2%(52/57), and the control group was 70.9% (39/55). The improvement rate of life quality of the treatment group was 70.2% (40/57), and the control group was 49.1% (27/55). The differences between the two groups was significant (P<0.05). There was no difference in hematology toxicity, liver and kidney function, gastrointestinal adverse reactions and itchy skin incidence between the two groups (P>0.05). And the treatment group had a lower incidence of phlebitis than the control group (P<0.05). Conclusion Compound sophora injection combined with Java brucea fruit oil emulsion for palliative treatment can improve curative effect, significantly improve patients’ quality of life, it was a safe and effective way in treating advanced malignant tumors.

Objective To study the short-term clinical efficacy of treating patients with advanced gastrointestinal cancer with lentinan injection and javanica oil emulsion injection.Methods Clinical information of 42 patients with advanced gastrointestinal cancer were retrospectively collected.The 42 patients were divided into two groups according to treatments,with 21 case in the control group who were treated with javanica oil emulsion injection,as well as 21 case in the treatment group treated with lentinan injection and javanica oil emulsion injection.The efficacy,quality of life (QOL) and adverse effects were observed after treatment for 3 weeks.Results 81.0％ (17/21)of patients in the treatment group improved in QOL,which was much higher than that in the control group 47.6％ ( 10/21 ) ( x2 =5.081,P =0.024 ).The objective remission rate was 19.0％ (4/21)and 14.3％ (3/21)in the treatment group and the control group respectively,with no significant differece bwtween the two groups( x2 =0.171,P =0.679 ).the disease control rate was 85.7％ (18/21)in the treatment group,which was significantly higher than that of 61.9％ (12/21)in the control group( x2 =4.200,P =0.040 ).The incidence of adverse effect related to hematological toxicity,liver and kidney function,the digestive tract and itching of skin were similar between the two groups (Ps ＞ 0.05 ).Phlebitis in the treatment group was not as frequent as that in the control group(P ＜0.05).Conclusion Treating patients with advanced gastrointestinal cancer with lentinan injection and javanica oil emulsion injection had high efficacy than treating only with javanica oil emulsion injection,and it improved QOL signifiantly with safety.

Objective To explore the clinical efficacy of treating pains suffered from metastatic bone cancer with composite kushen injection and pamidronate disodium injection.Methods The clinical information of 60 cases of metastatic bone cancer patients suffered with pains was collected retrospectively.Thirty patients were assigned to the treatment group and 30 to the control group according to the treatment they underwent.The control group were treated with pamidronate disodium injection for 3 cycle,the treatment group were additionaly treated with composite kushen injection.The differences of two groups cases were compared in respect of the relief of pains and the changes of performance status (PS) and the incidence of adverse effects after treatment for 3 cycles.Results The objective remission rate of bone pain was 60.0％ (18/30) in the treatment group,which was significantly higher than that of 30.0％ (9/30) in the control group was higher( x2 =5.455,P=0.020 ).The incidence of adverse effect was 40.0％ (12/30) in the treatment group and 46.6％ (14/30) in the control group,with no significant difference between the two groups( x2 =0.271,P =0.602).In the treatment group the performance status of patients was( 2.30 ± 0.70 ) after treatment,which was better than that of( 1.80 ± 0.80 )before treatment(t =15.000,P =0.042),wheras there was no significant difference on performance status in the control group.Conclusion Kushen injection has synergistic effect with pamidronate disodium injection in treating pains with matstatic bone cancer.It could improve the short term efficacy,and significantly relief the pain and improve the quality of life.

Objective:To investigate the clinical treatment of large segmental humeral defects with unilateral external fixation and bone transport.Methods:A retrospective study was conducted of the 9 patients who had been treated at Department of Orthopedics, Shenzhen People's Hospital for large segmental humeral defects from September 2017 to June 2019. They were 5 males and 4 females with an average age of 29 years (from 21 to 41 years). Their defects were caused by trauma in 2 cases, by chronic osteomyelitis in 6 cases and by bone tumor in one case. The length of bone defect ranged from 4.2 to 9.0 cm, with an average of 5.9 cm. A unilateral external fixator was placed in operation, and adjusted regularly 7 to 10 days after operation for bone transport and bone lengthening to restore the length of humerus gradually. The external fixation bracket was removed after 3 to 4 layers of cortex were observed on X-ray films. Recorded were length and rate of humeral lengthening, fracture healing time, time for carrying external fixator and complications; the Disabilities of the Arm, Shoulder and Hand (DASH) scores were compared between preoperation and 15 months postoperation.Results:All the patients were followed up for 15 to 36 months (mean, 19 months). The length of lengthening averaged 5.9 cm (from 4.2 to 9.0 cm) with an average lengthening rate of 26%, the healing index 31 d/cm, the bone healing time 8.3 months, and the time for carrying external fixator 10.8 months(from 8.0 to 13.5 months). Their average DASH scores improved significantly from 25.0 ± 2.4 preoperation to 12.0 ± 1.8 at 15 months postoperation ( P<0.05). Good correction of large humeral defects was achieved in all but one case who reported temporary radial nerve paralysis. There were no such complications as neurovascular injury. The shoulder and elbow functions were basically normal after operation. Conclusions:In the treatment of large segmental humeral defects, unilateral external fixation plus bone transport can quickly repair the defects and recover the upper limb function of the patients.

BACKGROUND:Heterotopic ossification of skeletal muscle is a clinically serious complication.For heterotopic ossification of skeletal muscles,the cells involved in the process of heterotopic ossification remain unclear. OBJECTIVE:To investigate the involvement of myocytes,fascia cells,and endothelial cells in the process of heterotopic ossification in skeletal muscle and to observe the cell origin of heterotopic ossification in skeletal muscle induced by bone morphogenetic protein 4. METHODS:Both C2C12 cells and the myotubes formed by the C2C12 cells in the induction medium were cultured,and 500 ng/mL bone morphogenetic protein 4 was added to the medium respectively,and whether the C2C12 cells and myotubes continued to proliferate within 10 days under the treatment were observed under a microscope.Myogenic cells(L6,derived from rats)and fibroblast-derived cells(derived from human)were co-cultured.After treatment with 500 ng/mL bone morphogenetic protein 4 and 10 ng/mL transforming growth factor-β,osteogenic and chondrogenic differentiation potential within 21 days were observed using Safranine O staining and Alcian blue staining.Using transgenic animal FVB/N-TgN(TIE2-LacZ)182Sato mice,15 μL of adeno-associated virus-bone morphogenetic protein 4(5×1010 PFU/mL)were implanted in the thigh muscle space of genetic mice for 10 and 14 days.X-gal staining was used to observe the formation of new blood vessel endothelium in the differentiated bone. RESULTS AND CONCLUSION:(1)Bone morphogenetic protein 4 caused myotube breakdown and increased C2C12 cell proliferation.Compared with other groups,the pure fibroblast-derived cell group had a higher area of positive alcian blue and safarin O staining(P<0.05)and a lower area of alkaline phosphatase staining(P<0.05),while the pure L6 group had a bigger area of alkaline phosphatase staining(P<0.05)but a smaller area of positive alcian blue and safarin O staining(P<0.05).(2)Transplantation of adeno-associated virus-bone morphogenetic protein 4-adsorbed gelatin sponge into FVB/N-TgN(TIE2-LacZ)182Sato mice resulted in heterotopic ossification.(3)X-gal staining results demonstrated that there was no obvious staining in chondrocytes and differentiated bones and Tie2+ endothelial cells did not participate in the formation of the alienated bone.(4)These findings verify that fibroblasts are the primary source of osteoblasts during the adeno-associated virus-bone morphogenetic protein 4-induced ectopic endochondral ossification in skeletal muscle,but myogenic cells are the main source of osteoblasts.Tie2+ endothelial cells might not be the cell source for cartilage and bone.