Spinal giant cell tumor of bone (GCTB) is a kind of primary benign bone tumors in the spine. It is rich in blood supply,aggressive,and easily recurring and lung metastasizing. So the benign GCTBs of the spine remains a challenge to treat.This article reviews the therapeutic methods in spinal GCTBs,including surgery,radiation therapy,arterial embolization. The treatment for the tumor with lung metastasis is also covered in this review. It is established that En bloc resection with wide margins is the most effective method to spinal GCTBs. To eliminate the residual tumor cells,adjuvant radiation should be done when complete resection is not available. Arterial embolization can be used to treat the huge sacral GCTBs.For those with lung metatasis,they can be controlled by lobectomy and /or chemotherapy.

BACKGROUND: Cytokine abnormality, nerve function abnormality and hormone levels may contribute to osteoporosis occurrence following spinal cord injury (SCI), many papers are about cytokine and hormone, but fewer is related to abnormal nerve function on bone accommodation.OBJECTIVE: To innovatively apply blood biochemistry and immunohistochemistry on the observation of change of calcitonin gene-related peptide distributing in trabecular bone of SCI rats, and to analyze its significance in the osteoporosis. DESIGN, TIME AND SETTING: Randomized control animal trials were performed from September 2008 to December 2008 at the laboratory of Orthopedic Institute in the Fourth Military Medical University of Chinese PLA,MATERIALS: Forty-eight Sprague Dawley rats aged 3 months, weighing (210:1:16) g, were divided into SCI group and control group equally. METHODS: Rats in the SCI group underwent spinal cord transection at the tenth thoracic vertebrae. Control rats underwent laminectomy without any spinal cord lesion. MAIN OUTCOME MEASURES: Each 8 rats were sacrificed at 1, 3, 6 weeks postoperatively. The serum concentrations of bone-specific alkaline phosphotase and serum cross-linked N-telopeptide of type Ⅰ collagen were determined. The stain intensity of calcitonin gene-related peptide in trabacular bone was determined with use of quantitative immunohistochemistry technique and computer image analysis system.RESULTS: The cross-linked N-telopeptida of type Ⅰ collagen significantly increased in SCI group at defferent interval compared with control group (P <0.05 or 0.01 ), serum concentrations of bone-specific alkaline phosphotase was lower than control group,without significant difference (P > 0.05). Immunoreactivity of calcitonin gene-related peptide in trabecular bone was strongly positive in control group, while weakened in SCI group (P < 0.05 or 0.01).CONCLUSION: Reduced calcitonin gene-related peptide in trabecular bone of SCI rats may be related to the occurrence of osteoporosis following SCI.

Objective To investigate the effects of internal plating with high and low moduli of elasticity on the stress and its distribution on the femoral shaft fracture. Methods A femur from a normal Chinese adult male was scanned by 64-detector row helical CT at 0. 5 mm interval. The CT images were used to establish a finite element model of the femur by software. The mid-femoral fracture was simulated in the model and fixated by eight-hole plates of Ti-6Al-4V (high modulus group, E = 110 GPa) and of Ti2448 (low modulus group, E = 30 GPa). When the femur was in axial compression, flexion and torsion loads, the stress and its distribution on the bone fracture site were analyzed to compare the biomechanics of the plates with high and low moduli. Results Under axial compression load, the contact stress between fracture ends in the low modulus group was larger than that in the high modulus group, while the max stress at the hole (11.47MPa) was smaller than that in the high modulus group (13.89 MPa) . Under four-point bending load, the contact stress in the low modulus group was still larger, while the bending movement was smaller. Under the torsion load, stress on the femur was well-distributed in both groups, but the max stress at the hole in the low modulus group (11.47 MPa) was smaller than that in the high modulus group (31.24 MPa). Conclusions Under internal fixation by plates of low modulus, the stress stimulus at the fracture site may be increased,while the stress concentrated at the hole may be decreased. The stress shielding of the low modulus plate may also be modified.

Cytoskeletal Proteins ; biosynthesis ; genetics ; physiology ; Humans ; Neoplasm Metastasis ; Neoplasms ; pathology ; Signal Transduction

OBJECTIVE: To evaluate the clinical outcomes of medical supporting bone graft following posterior approach and bone cement implantation in the hip joint in treating intertrochanteric fracture.METHODS: A computer-based online search of Science Direct, Ei databases was performed for English articles published between January 1960 and October 2009, with the key words "bone cement, intertrochanteric fracture". In addition, CNKI and CBM were searched for related Chinese articles published between January 1994 and October 2009, with the key words "intertrochanteric fracture, coxa vara, posterior approach of hip joint, bone cement implantation in major screw hole". Moreover,related books were manually searched. Treatment of intertrochanteric fracture, basic and clinical experiment of intertrochanteric fracture treated by bone cement was included.RESULTS: Intertrochanteric fracture treatment includes lateral or anterior approach for dynamic hip plate system, dynamic hip screw, and femoral proximal intramedullary screw internal fixation. Dynamic hip screw is standard internal fixation to treat intertrochanteric fracture, with strong anti-rotation function, and meets the biomechanical requirements. However, screw loosening,extraction and breakage frequently occur. Cancellous bone screw track enhanced by bone cement increases screw retention force,benefits screw compression, enhances bone-screw interface to transfer the stress to screw-bone regions, which significantly increases the anti-flexion and anti-torsion strength of dynamic hip screw and improves fracture stability. The mechanism involves the integral formation of cancellous bone, bone cement and screw by the micro-interlocking of bone trabecula and surrounding cancellous bone.CONCLUSION: Dynamic hip screw filled by bone cement significantly enhances the anti-flexion and anti-torsion strength of internal fixation and improves fracture stability.

Objective To prepare a new osteoinduction hydroxyapatite crystal material using sintered bovine bone combined with bone morphogenetic protein(BMP2)-derived peptide and type Ⅰ collagen,and to study their biological characteristics for developing biomaterials for orthopaedic tissue engineered bone.Methods Sintered bovine bone combined with BMP2-derived peptide and type Ⅰ collagen was as experimental group.and Sintered bovine bone combined with Type Ⅰ collagen Wag as control group.Formation of hydmxyapatite crystals was inveati gated under environmental scanning electron microscopy(ESEM),energy-dispersive spectroscopy(EDS)and X-ray diffraction(XRD).The ceil-material complex Wag observed and cell adhesion rate on each materials WaS calculated using the method of indirect cell count to evaluate the interaction between cells and materials.Results By ESEM,formation of hydroxyapatite crystals in collagen surface was observed in experimental group but none was observed in control group.By EDS and XRD,the contents of calcium and phosphorus elements from mineralized bone surface were 16.23% and 7.76%respectively.The atom percentages of calcium and phosphorus elements were 6.34%and 3.88%respectively.The cell adhesion rate of experimental group after 24 hours co-culture was significantly higher than that of control group (α＜0.05).Conclusion BMP2-derived peptide can induce the formation of hydroxyapatite crystals at the surface of sintered bovine bone combined with type Ⅰcollagen.It can also elevate the osteoinduction and cell adhesion rate and is an ideal scaffold material by combining with sintered bovine bone for the bone tissue engineering.

Objective The aim of the study was to investigate the diabetic neuro-degeneration and its changes in neuroreaction to myocardial ischemia and reperfusion,by evaluation of the altera-tion of noxious thermal threshold and expression of substance P (SP),calcitonin gene related peptide (CGRP)in dorsal root ganglia in upper thoracic segments (T1-5 )in diabetic rats.Methods Thirty two male Sprague-Dawley rats,weighing 180-200g,were randomly divided into control group (group C)and diabetic group (group DM),1 6 rats in each group.rats in DM group were fed with high sug-ar-fat diet for 14 weeks and were given streptozotocin (STZ,35 mg/mg,i.p.)at the end of the 4 th week,to set up diabetes experimental model.The animals in control group were fed with standard la-boratory diet.Tail flick latency to thermal stimulation was measured weekly.At the end of 10 weeks after administration of STZ,diabetic rats (and rats in control group)were further divided into myo-cardial ischemia-reperfusion group (group IR)and sham operation group (group Sham).The left an-terior descending branch of coronary artery was occluded for 30 min followed by reperfusion for 120 min,establishing myocardial ischemia-reperfusion.The histological immunofluorescence assay and Enzyme-linked immunosorbent assay (ELISA)were carried out to evaluate the changes of the expres-sions of CGRP and SP in the dorsal root ganglia.Results The tail flick latency was significantly in-creased in group DM,compared to the group C (P < 0.01).The immunoreactive materials for CGRP and SP in the sensory neurons in dorsal root ganglia of upper thoracic segments (T1-5 )were markedly declined in group DM (P <0.01 or P < 0.05).Furthermore,levels of SP and CGRP were signifi-cantly lower in the DRG of the group IR after myocardial ischemia-reperfusion,compared to that in the group sham (P <0.01).Conclusion Diabetes causes sensory denervation and obvious reduction of expression of SP and CGRP in the sensory neuron innervating heart during myocardial ischemia-reper-fusion,indicating impairment of adaptive reactivity of neuro-endocrine function of cardiac sensory nerves.

Objective To investigate the incidence of neonatal intrahepatic cholestasis caused by citrin deficiency (NICCD)in neonates with idiopathic neonatal cholestasis (INC)in Nanjing,China,SLC25A13 gene mutations in these neonates,and clinical features.Methods A total of 152 neonates with INC,who were admitted to the Affiliated Nanjing Children's Hospital of Nanjing Medical University from Sep-tember 2009 to August 2013,underwent gene analysis for detecting SLC25A13 gene mutations.The neonates were divided into NICCD group,who had been diagnosed definitely,and INC group at a ratio of 1∶2,considering the age and gender.Several biochemical indices were compared between the two groups.Comparison of continuous data between the two groups was made by Mann-Whitney U test after Bonferroni correction.Results There were 21 confirmed cases of NICCD (21/152,13.82%)among the 152 neonates with INC;five types of SLC25A13 mutations were identified in the 21 neonates with NICCD,including 851_854del (27/42,64.29%),IVS6+5 G→A (7/42, 16.67%),1638ins23 (5/42,11.90%),IVS11 +1 G→A (2/42,4.76%),and Q259X (1/42,2.38%).The alanine aminotransferase (ALT)level,aspartate aminotransferase (AST)level,bile acid concentration,albumin level,fasting blood glucose,blood ammonia,and prothrombin time for the NICCD group were 39.42 ±23.40 U/L,124.85 ±92.65 U/L,142.43 ±24.34μmol/L,30.66 ±2.70 g/L,2.79 ± 0.54 mmol/L,117.57 ±27.88 μmol/L,and 14.03 ±2.79 s,respectively,versus 136.02 ±113.67 U/L,226.12 ±129.26 U/L,80.47 ± 31.53 μmol/L,36.87 ±4.96 g/L,3.14 ±0.45 mmol/L,76.43 ±20.80 μmol/L,and 11.40 ±1.55 s for the INC group.The NICCD group had significantly lower ALT and AST levels than the INC group (Z=-5.02,P=0.000;Z=-3.66,P=0.000);the NICCD group had a significantly higher bile acid concentration than the INC group (Z=-5.58,P=0.000);the NICCD group had significantly lower albumin level and fasting blood glucose than the INC group (Z=-4.52,P=0.000;Z=-2.56,P=0.010);the NICCD group had a significantly higher blood ammonia level than the INC group (Z=-4.75,P=0.000);the NICCD group had a significantly longer prothrombin time than the INC group (Z=-4.10,P=0.000).Conclusion Citrin deficiency due to SLC25A13 gene mutations is an im-portant cause of INC in Nanjing.The three most common mutations are 851_854del,IVS6+5 G>A,and 1638_1660dup23,which account for 92.86% of the SLC25A13 gene mutations.More attention should be paid to clinical analysis and detection of SLC25A13 gene mutations to confirm the diagnosis of NICCD.

20 yrs were screened in 5 communities of Daqing.Results The prevalent rate of diabetes was 5.10%,and its standardized prevalent rate was 5.20%,thereinto 91.89% of it was type 2 diabetes and 2.12% was IFG.With Logistic regression analysis,the results showed that the risk factors for type 2 diabetes included family history of diabetes(OR=2.133,95%CI: 1.210～3.760),hypertension(OR=3.669,1.966～5.833),high intake of sweetmeat(OR=1.770,95%CI:1.214～3.090),high intake of lipids(OR=3.222,95%CI:1.667～5.235),addiction for animal viscera(OR=2.292,95%CI:1.033～4.587),ratio of waistline vs hip circumference,coronary heart disease(OR=4.818,95%CI:2.246～6.336),history of cerebrovascular disease(OR=2.196,95%CI:1.864～5.583),hyperlipidemia(OR=2.882,95%CI:1.458～5.968),cigarette smoking(OR=1.642,95%CI:1.197～2.088),civil servant(OR=2.046,95%CI:1.722～3.633) and occupation of education & clinics(OR=2.742,95%CI:1.924～3.742). Conclusion The diabetes is related with many factors.Its harm to health of Daqing citizens is becoming more and more serious.It should be important to take efficient measures for the prevention and treatment of chronic diseases in community.

Objective To evaluate the significance of suPAR,SCC-Ag in plasma and HPV16,18 in cervical secretion for monitoring pathogenetic condition and prognosis in patients with cervical cancer.Methods 206 cervical cancer patients blood and cervical secretion were collected.Plasma level of suPAR and SCC-Ag were measured by enzyme linked immunosorbent assay (ELISA) in health women and patients with cervical cancer.The expression of HPV16,18 of cervical secretion in control group and patients with cervical cancer were detected by fluorescence quantitative PCR.The correlations of the three indexes were analyzed.Results The plasma level of suPAR and SCC-Ag,the expression of HPV16,18 of cervical secretion in cervical cancer patients were obviously higher than those in health controls with statistical significance ((1.072 5±0.305 2) ng/ml vs (0.501 7±0.179 3) ng/ml,(0.980 6±0.162 7) μg/ml vs (0.261 4± 0.006 3) μg/ml and 53.89 ％ (90/167),46.15 ％ (18/39) vs 6.67 ％ (4/60),P ＜ 0.05).There was a positive correlation between plasma suPAR level and SCC-Ag level in invasive carcinoma of cervix patients (r =0.564,P ＜ 0.05).The plasma level of suPAR between in HPV16,18 positive group and in HPV16,18 negative group did not show difference (P ＞ 0.05).Conclusions In invasive carcinoma of cervix patients,there is a positive correlation between plasma suPAR level and SCC-Ag level.But it's not yet to conclude that plasma suPAR level of cervix invasive carcinoma patients is related to infection of HPV16,18.