Object To investigate clinical features,surgical strategy and prognostic factors of bone metastasis from thyroid cancer.Methods A total of 46 patients with bone metastasis from thyroid cancer,who had undergone surgical treatment from January 1999 to July 2011 and had complete follow-up data,were enrolled in this retrospective study.There were 20 males and 26 females,aged from 40 to 87 years (average,56.87 years).Forty two (91.3％) cases of metastatic lesion located in axial skeleton,while 4 (8.7％) in limbs.The tumor histology type was well-differentiated in 35 patients and poorly differentiated in 11 cases.Nineteen patients (41.3％) had an isolated metastatic bone lesion,while other 27 patients (58.7％) had multiple lesions.Kaplan-Meier survival curve and Cox regression model were performed to identify prognostic factors among 19 factors including gender,age,tumor subtype,number of bone metastasis,site of bone metastasis,visceral metastasis,skeletal-related events,timing of metastasis,whether metastatic lesion was detected when thyroid cancer was diagnosed,whether thyroid surgery was performed,whether 131Ⅰ therapy was performed,whether chemotherapy or radiotherapy were performed,preoperative general condition (good or poor),surgical type (excisional surgery or palliative surgery),characteristics of metastatic lesion (osteolytic or mixed),intraoperative blood loss,whether measures were applied to prevent intraoperative bleeding,perioperative complications and long-term complications.Results Excisional surgery was performed in 36 patients (78.3％),while palliative surgery in other 10 patients (21.7％).The average amount of blood loss was 2603.26ml.The postoperative 5-year survival rate and 10-year survival rate were 37.3％ and 12.4％,respectively.Univariate analysis showed the significant prognostic factors include tumor subtype,number of bone metastasis,whether 131Ⅰ therapy was performed,and preoperative general condition (good or poor).Multivariate analysis showed the independent prognostic factors were number of bone metastasis (solitary or multiple) and whether 131Ⅰ therapy was performed.Conclusion For patients with bone metastasis from thyroid cancer,the prognostic factors are useful for determining indications for operation and improving treatment outcome.

Objective To evaluate the surgical procedures and both oncological and functional outcome in patients with bone tumors of the shoulder girdle.Methods Seventy-one patients including 61.pts with malignant tumor and 10 pts with giant cell tumors of the shoulder girdle treated in our department from July 1998 to July 2006 were studied retrospectively.According to the location,there were 15 pts with scapula tumor and 56 pts with proximal humeral tumor.Forty-two male pts and 29 female pts were included in this study with an average age of 36.5 years old ranging from 11.to 62 years old.Surgical procedures:forequarter amputation in 10 pts;Scapulectomy in 3 pts;Scapulectomy and artificial scapular replacement in 3pts;partial scapulectomy and proximal humerus resection with prosthetic reconstruction in 8 pts;proximal humerus resection and prosthesis replacement in 47 pts.Results Due to adequate soft tissue was preserved,the mean functional score was 28 for the pts with giant cell tumor according to MSTS functional scoring system,compared with the functional score 23 for the pts with malignant tumor because the deltoid muscle insertion was resected in the latter group.Among the thirty-seven patients with osteosarcoma,local recurrence occurred in four cases(10.8%),lung metastasis in five and bone metastasis in two.The seven patients died of disease.One patient iagnosed of malignancy in giant cell tumor died after distal metastasis.thtee patients with Ewing sarcoma died of the disease.No recurrence Wag observed in both five humeral chondrosarcoma and five scapular chondrosarcoma.Conclusion Tumot resection and proximal humeral prostbesis replacement is the optimal method for the sarcoma of shoulder girdle in term of preservation of elbow and hand function.Preservation of abductor insertion is necessary for good abduction function.The metastatic rate of proximal humeral osteosarcoma was lower than that of lower extremities.also the prognosis of oncological outcome.Intra-articular and extra-atticular tumor resection produced similar local recurrence rate in the present study,which suggested intra-articular resection may be an altemafive procedure.

Objective:To clarify the effects of the BMP receptor inhibitor LDN-193189 in the dedifferentiated chondrosarcoma (DDCS) cell line NDCS-1 and to explore the anti-tumor mechanism of LDN-193189 in DDCS. Methods:NDCS-1 was treated with 5 nmol/L of LDN-193189. MTT assay and clone formation experiments were used to verify that LDN-193189 suppressed cel proliferation. Transwel and wound healing tests were performed to demonstrate that LDN-193189 inhibited cell invasion. Western blot detection was used to show that LDN-193189 inhibited the suppression of BMPR2, p-Smad1/5, and RUNX2 protein expression. Results:The BMPR2 signaling pathway was inhibited by LDN-193189;thus, cell viability and invasion were significantly suppressed. Conclusion:LDN-193189 induces the inhibition of progression in vitro via the BMPR2-p-Smad1/5-RUNX2 signaling pathway in the human DDCS cell line NDCS-1.

Objective To culture human pituitary adenoma cells to provide some useful experimental foundations to practice pituitary adenoma cells as donor cells in the extracranial implantation. Methods Human pituitary adenoma cells obtained by operation were cultured in vitro, and their growth state was dynamically observed. Immunohistochemical staining and RIA were used to evaluate their functional status. Results The cultured pituitary adenoma cells still had secretory function in vitro. 6 cases of GH adenoma cells secreted a large amount of GH, 5 cases of PRL adenoma cells secreted a large amount of PRL, and 3 cases of pituitary adenoma cells without function could also secrete a small quantity of FSH, LH and PRL. Conclusion 14 cases of cultured human pituitary adenoma cells had secretory function in vitro, which provides the useful experimental data to perform extracranial implantation with pituitary adenoma cells as donor cells.

Objective To construct the bFGF/Math1 f usion gene expression vector and to investigate its expression in the cochlea of rat. Methods Using the recombinant DNA technique to construct the bFGF/Math1 gene expression vector and the restriction enzyme analysis to ide ntify the correct construction. The mRNA expression was detected by the RT-PCR m ethod after being transfected into the cochlea of rat using lipofectin reagent. Results The recombinant was correct and the bFGF/Math1 wa s expressed in the cochlea of rat.Conclusion The PRK5-bFGF-Math1 eukaryotic expression plas mid was successfully constructed and the bFGF/Math1 was expressed in the mammali an cochlea.

To observe the morphological changes in hair cell nuclei in guinea pigs following noise exposure, guinea pigs were exposed to 4 kHz narrow band noise at 115 dB SPL for 4h. The cochleae were collected for the examination of the hair cell nuclei 14 days after the noise exposure. A fluorescent dye, Hoechst 33342,a fluorescent dye, was used to label the nuclear DNA and the specimens were examined under a fluorescence microscope for quantitative assessment of hair cell nuclear damage. There were three types of morphological changes in the damaged hair cell nuclei: nuclear swelling, nuclear condensation (karyopyknosis) and nuclear missing. Nuclear swelling was more frequent than nuclear missing. Nuclear condensation was less frequently found. The results suggested that complicated, long term and non synchronous biological processes might be involved in noise induced hair cell damage. A large number of hair cells with swollen nuclei, which might recover afte wards,still could be seen in the cochlea two weeks after noice exposure.

To construct a cDNA library of gerbil′s cochlea, the mRNA was separated from the cochlea of gerbil and the first strand cDNA was synthesized through reverse transcription by a modified oligo(dt) primer. The double strand cDNA was amplified by Ld pcR. After cDNA size fractionation , the ds cDNA was ligated in the ? TripIEx2 vector . The cDNA library was identified with special primers of prestin genes of cochlea by PCR .The results showed that the titer of library was 1.8?10 6 pfu and the percentage of recombinant clones was 80% . Prestin gene was contained in the library , the size of the fragment was 863bp . The results suggest that the established cDNA library has a high titer, recombinant percentage and large insert fragments of genes . The study lays the foundation of molecular biological study of the cochlea.

[Objective]To evaluate the diagnostic strategy for bone metastasis from unknown primary. [Method]One hundred and twenty five patients with unknown primary bone metastasis were treated from June 2003 and December 2006.The distribution of bone metastasis while initial diagnosis mainly focused on spine,sacrum,pelvis,femur and humerus.The diagnostic strategy contained a series of physical examination,laboratory test,imaging study and pathological examination.[Result]The primary tumor was found in 70.4% cases,while 40% was in the lung,8% in kidney,5.6% in prostate,4.8% in liver,4% in breast,both 2.4% in thyroid and gastric,and 3.2% in other visceras.The physical examination revealed the occult primary site of the malignant tumor in only 9.6% cases.Although,43.2% patients had higher level of tumor antigen,but most of them were non-specific.Sixty percent of primary tumor was found by various imaging studies including plain radiograph,computed tomography and ultrasound.The pathological result after biopsy or operation identified or suggested the primary tumor in 66.4% cases.The one year survival rates after diagnosis were 58.57% and 22.93% in patients of bone metastasis with known and unknown origin,respectively.[Conclusion]The primary tumor can be diagnosed in most bone metastasis patients with no cancer history after careful examination,and patients will get benefit on survival time for targeted treatment.

[Objective] To discuss the surgical treatment strategy of spinal hemangioma.[Methods]Data on 33 patients with spinal hemangioma treated from October 1997 to October 2008 were reviewed.There were 19 females and 14 males.The average age was 54 years old.Chief complaints were pain(n=13),myelopathy(n=12),radiculopathy plus local pain(n=8).Nine patients without spinal cord and radial nerve compression underwent percutaneous vertebroplasty(PVP),and 24 patients with spinal cord and radial nerve compression,paravertebral soft tissue mass or spinal unstability were treated by operation.Anterior,anteroposterior and posterior approaches were used in 9,12,and 3 patients respectively.Transarterial embolization was done in 3 patients.[Results]No perioperative complication was observed in 9 patients after PVP,with a mean follow-up of 41 months.Pain was relieved.There was no perioperative death among the 24 patients who received operation.The blood loss during operation was 2739 ml and 1619 ml for anterior and posterior approaches,respectively(P=0.12).One case of paravertebral hematoma,one case of spinal canal hematoma,and one case of wound infection were observed in this group.Pain was relieved in 89%(17/19)of the patients.According to the Frankel Scale,the neurologic situation was improved in all the 12 patients with myelopathy.By a mean follow-up of 48 months,no internal fixation failure was seen.Tumor recurrence or growth was found in 4 patients,two had no symptoms and one underwent radiotherapy for pain.Repeated operation was performed in one patient with myelopathy.[Conclusion]Most patients with symptomatic spinal hemangioma could be treated successfully by surgery.Individual surgical plan should be made according to the reason causing symptoms and the general condition of the patient.