There are many methods of conservative treatment for early non-traumatic osteonecrosis of femoral head, but still lack of a mature and effective treatment. Gene therapy is a new treatment method for non-traumatic osteonecrosis of femoral head in recent years. This article showed that the non-traumatic osteonecrosis of femoral head related to progress and problems on pathogenesy, molecular biology foundation, exogenous theoretical gene,carrier selection and so on, discussed some problems and countermeasure and future applications.
Femur Head Necrosis ; therapy ; Genetic Therapy ; Humans

Humans ; Mucocutaneous Lymph Node Syndrome ; drug therapy ; Tumor Necrosis Factor-alpha ; antagonists & inhibitors ; Tumor Necrosis Factors

Transarterial chemoembolization (TACE) is the worldwide procedure performed for patients with various stage hepatoceullar carcinoma (HCC), but is not yet considered as curative treatment because of relatively high local recurrence rate. Moreover, many clinicians frequently experience treatment failure (incomplete necrosis or stage progression etc.) after repeated TACE, but no clear guidelines have been recommended about salvage treatment modalities for this situation. Recently, studies for combination of radiation therapy and TACE for HCC with TACE refractoriness have been tried and reported better therapeutic efficacy. Based on above suggestions, we herein offer our experience of a patient with macrovascular invasion developed after repeated TACE that achieve complete remission by stereotactic body radiation therapy. Further study, maybe regarding a combination of locoregional and systemic therapy, is necessary on how to manage HCC patients with TACE refractoriness.
Carcinoma, Hepatocellular* ; Humans ; Necrosis ; Recurrence ; Salvage Therapy ; Treatment Failure

No abstract available.
Drug Therapy, Combination* ; Necrosis* ; Radiotherapy* ; Small Cell Lung Carcinoma*

We report a clinical case of type Ⅲ dens invaginatus with endodontic-periodontal lesion in a maxillary lateral incisor. The palatal radicular anomaly predisposed the tooth to periodontal lesions. The caries along the palatal groove caused tooth pulp necrosis and periapical lesions. By means of microscopic root canal therapy, apical surgery, and guided periodontal tissue regeneration, the apical and periodontal infection were controlled, and the affected tooth was retained.
Dens in Dente ; Dental Pulp Necrosis ; Humans ; Incisor ; Root Canal Therapy

PURPOSE: The current study was designed to evaluate the ability of thallium-201 scintigraphy to predict the response to preoperative chemotherapy in osteosarcoma, by comparing changes in thallium uptake ratio after chemotherapy to the tumor necrosis ratio. MATERIALS AND METHODS: Twelve osteosarcoma patients were included in this study. Thallium-201 scintigraphy was performed before and after preoperative chemotherapy, and the degree of tumor necrosis was estimated by histologic mapping postoperatively. To quantitatively determine thallium uptake, we drew a region of interest on the tumor side and on the contralateral normal side as a mirror image, and calculated the uptake ratio with dividing the gamma count in the tumor side by that of the normal side. We calculated these percent changes of thallium uptake ratio in the early and delayed phases, and compared these to the corresponding tumor necrosis ratio. RESULTS: Percent changes in the thallium uptake ratio were found to be correlated with the tumor necrosis ratio (p<0.03). This correlation was found in both the early (p<0.03) and delayed phase (p<0.03); moreover the correlation coefficient in early phase (0.79) was greater than that in the delayed phase (0.67). CONCLUSION: Thallium-201 scintigraphy could be effective at predicting the response to preoperative chemotherapy in osteosarcoma.
Drug Therapy* ; Humans ; Necrosis ; Osteosarcoma* ; Radionuclide Imaging* ; Thallium

Chemotherapy has long been considered as one of useful strategies for cancer treatment. It is primarily based on the apoptosis that can selectively kill cancer cells. However, cancer cells can progressively develop an acquired resistance to apoptotic cell death, rendering refractory to chemo- and radiotherapies. Although the mechanism by which cells attained resistance to drug remains to be clarified, it might be caused by either pumping out of them or interfering with apoptotic signal cascades in response to cancer drugs. In case that cancer cells are defective in some part of apoptotic machinery by repeated exposure to anticancer drugs, alternative cell death mechanistically distinct from apoptosis could be adopted to remove cancer cells refractory to apoptosis-inducing agents. This review will mainly deal with harnessing of necrotic cell death, specifically, programmed necrosis and practical uses. Here, we begin with various defects of apoptotic death machinery in cancer cells, and then provide new perspective on programmed necrosis as an alternative anticancer approach.
Apoptosis ; Autophagy ; Cell Death ; Drug Therapy ; Necrosis* ; Radiotherapy

The Chinese investigators separated bullet wounds into three zones in the beginning of 1980s: a primary wound tract, a contusion zone adjacent to prinary wound tract, and a concussion zone neighboring the contusion zone. Basing on the research results by MRI scan and pathological observation, the author and his coworkers recently proposed that the gunshot wounds should be divided into four consecutive zones: a primary wound tract, a zone of coagulative necrosis, a zone of muscle disruption, and a zone of muscle distortion. A zone of coagulative necrosis plus a zone of muscle disruption equals to a contusion zone, they are separately named because the former is irreversibly devitalized and the latter still has the ability to recover. The sectionalized method shows the range of debridement and provide reference for the conservative treatment or thoroughly debridement. However, the mechanism of each zone need to be further studied.
Debridement ; Humans ; Necrosis ; Wounds, Gunshot ; pathology ; surgery ; therapy

OBJECTIVETo analyze the clinical character, diagnosis and treatment of badly necrotic pyogenic infection in cervical part with pneumatosis of vomica.

METHODSThe clinical character, diagnosis and treatment of badly necrotic pyogenic infection in cervical part with pneumatosis of vomica of 46 cases were investigated retrospectively.

RESULTSLateral and bilateral neck infection cases were 38 and 8 respectively. 30 cases formed primary pyogenic infection in cervical part with pneumatosis of vomica, and 16 did from adjacent sites. Besides the characters of the acute infection, gas storage in deep cervical part abscess was notable. CT and B Ultrasonic examination provided useful informations such as sizes, shapes, capacity, extents of abscess and the relationship between the abscess and vessel or vital organ. Diagnosis puncture and germiculture were performed before and after operation. The results showed that 25 of 46 cases were infected by staphylococcus or streptococcus, and 21 cases did by other bacterium. Exploration and drainage treatments were performed. All cases were cured except 2 died.

CONCLUSIONDiagnostic puncture, CT and/or B Ultrasonic examination are essential for diagnosis and presurgical planning. Germiculture provides reliable evidence for finding pathogeny and therapy. The most possibilities of pyogenic infection with pneumatosis of vomica in cervical part are the action of aerogenic bacterium, infection both in cervical part and chest or swallowing movement of pharynx.

Abscess ; diagnosis ; microbiology ; therapy ; Cysts ; diagnosis ; microbiology ; therapy ; Humans ; Neck ; pathology ; Necrosis ; diagnosis ; microbiology ; therapy

Objective: To compare the effects of three treatment options: emergency surgery, stent-surgery, and stent-neoadjuvant chemotherapy-surgery, on the pathological characteris- tics of surgically-resected specimens from patients with completely obstructive colorectal cancer. Methods: This was a retrospective cohort study analyzing clinicopathological data of patients with complete obstructive colorectal cancer who were admitted to the General Surgery Department of Beijing Chaoyang Hospital, Capital Medical University, between May 2012 and August 2020. The inclusion criteria were diagnosed with complete colorectal obstruction, pathologically confirmed as adenocarcinoma, resectable on imaging assessment, and without distant metastasis, combined with the patients' clinical manifestations and imaging examination findings. Patients with multiple colorectal cancers, refusal to undergo surgery, and concurrent peritonitis or intestinal perforation before stenting of the intestinal obstruction were excluded. Eighty-nine patients with completely obstructive colorectal cancer were enrolled in the study and were divided into emergency surgery group (n=30), stent-surgery group (n=34), and stent-neoadjuvant chemotherapy- surgery group (n=25) according to the treatment strategy. Differences in the pathological features (namely perineural infiltration, lymphovascular infiltration, tumor deposits, specimen intravascular necrosis, inflammatory infiltration, abscesses, mucus lake formation, foreign body giant cells, calcification, and tumor cell ratio) and biomolecular markers (namely cluster of differentiation (CD)34, Ki67, Bcl-2, matrix metalloproteinase-9, and hypoxia-inducible factor alpha) were recorded. Pathological evaluation was based on the presence or absence of qualitative evaluation of pathological features, such as peripheral nerve infiltration, vascular infiltration, and cancer nodules within the specimens. The evaluation criteria for the pathological features of the specimens were as follows: Semi-quantitative graded evaluation based on the proportion of tissue necrosis, inflammatory infiltrates, abscesses, mucus lake formation, foreign body giant cells, calcification, and tumor cells in the field of view within the specimen were classified as: grade 0: not seen within the specimen; grade 1: 0-25%; grade 2: 25%-50%; grade 3: 50%-75%; and grade 4: 75%-100%. The intensity of cellular immunity was classified as none (0 points), weak (1 point), moderate (2 points), and strong (3 points). The two evaluation scores were then multiplied to obtain a total score of 0-12. The immunohistochemical results were also evaluated comprehensively, and the results were defined as: negative (grade 0): 0 points; weakly positive (grade 1): 1-3 points; moderately positive (grade 2): 4-6 points; strongly positive (grade 3): 7-9 points; and very strong positive (grade 4): 10-12 points. Normally-distributed values were expressed as mean±standard deviation, and one-way analysis of variance was used to analyze the differences between the groups. Non-normally-distributed values were expressed as median (interquartile range: Q1, Q3). A nonparametric test (Kruskal-Wallis H test) was used for comparisons between groups. Results: The differences were not statistically significant when comparing the baseline data for age, gender, tumor site, American Society of Anesthesiologists score, tumor T-stage, N-stage, and degree of differentiation among the three groups (all P>0.05). The differences were not statistically significant when comparing the pathological characteristics of the resected tumor specimens, such as foreign body giant cells, inflammatory infiltration, and mucus lake formation among the three groups (all P>0.05). The rates of vascular infiltration were 56.6% (17/30), 41.2% (15/34), and 20.0% (5/25) in the emergency surgery, stent-surgery, and stent- neoadjuvant chemotherapy-surgery groups, respectively, with statistically significant differences between the groups (χ²=7.142, P=0.028). Additionally, the rate of vascular infiltration was significantly lower in the stent-neoadjuvant chemotherapy-surgery group than that in the emergency surgery group (P=0.038). Peripheral nerve infiltration rates were 55.3% (16/30), 41.2% (14/34), and 16.0% (4/25), in the emergency surgery, stent-surgery, and stent-neoadjuvant chemotherapy-surgery groups, respectively, with statistically significant differences (χ²=7.735, P=0.021). The infiltration peripheral nerve rates in the stent-neoadjuvant chemotherapy-surgery group were significantly lower than those in the emergency surgery group (P=0.032). The necrosis grade was 2 (1, 2), 2 (1, 3), and 2 (2, 3) in the emergency surgery, stent- surgery, and stent-neoadjuvant chemotherapy-surgery groups, respectively, with statistically significant differences (H=10.090, P=0.006). Post hoc comparison revealed that the necrosis grade was higher in the stent-surgery and stent-neoadjuvant chemotherapy-surgery groups compared with the emergency surgery group (both P<0.05). The abscess grade was 2 (1, 2), 3 (1, 3), and 2 (2, 3) in the emergency surgery, stent-surgery, and stent-neoadjuvant chemotherapy-surgery groups, respectively, with statistically significant differences (H=6.584, P=0.037). Post hoc comparison revealed that the abscess grade in the emergency surgery group was significantly lower than that in the stent-surgery group (P=0.037). The fibrosis grade was 2 (1, 3), 3 (2, 3), and 3 (2, 3), in the emergency surgery, stent-surgery, and stent-neoadjuvant chemotherapy-surgery groups, respectively, with statistically significant differences (H=11.078, P=0.004). Post hoc analysis revealed that the fibrosis degree was higher in both the stent-surgery group and the stent- neoadjuvant chemotherapy-surgery group compared with the emergency surgery group (both, P<0.05). The tumor cell ratio grades were 4 (3, 4), 4 (3, 4), and 3 (2, 4), in the emergency surgery, stent-surgery, and stent-neoadjuvant chemotherapy-surgery groups, respectively, with statistically significant differences (H=8.594, P=0.014). Post hoc analysis showed that the tumor cell ratio in the stent-neoadjuvant chemotherapy-surgery group was significantly lower than that in the emergency surgery group (P=0.012). The CD34 grades were 2 (2, 3), 3 (2, 4), and 3 (2, 3) in the emergency surgery, stent-surgery, and stent-neoadjuvant chemotherapy-surgery groups, respectively, and the difference was statistically significant (H=9.786, P=0.007). Post hoc analysis showed that the CD34 grades in the emergency surgery, stent-surgery, and stent-neoadjuvant chemotherapy-surgery groups were 2 (2, 3), 3 (2, 4), and 3 (2,3), respectively. Post hoc analysis revealed that the CD34 concentration was higher in the stent-surgery group than that in the emergency surgery group (P=0.005). Conclusion: Stenting may increase the risk of distant metastases in obstructive colorectal cancer. The stent-neoadjuvant chemotherapy-surgery treatment model promotes tumor cell necrosis and fibrosis and reduces the proportion of tumor cells, vascular infiltration, and peripheral nerve infiltration, which may help decrease local tumor infiltration and distant metastasis in completely obstructive colorectal cancer after stent placement.
Humans ; Neoadjuvant Therapy/methods* ; Abscess ; Retrospective Studies ; Intestinal Obstruction/etiology* ; Stents ; Colorectal Neoplasms/therapy* ; Necrosis