OBJECTIVEThe purpose of this study was to observe the behavior of bone formation around the titanium-hollow porous cylinder implant composed of bovine bone morphogentic protein(bBMP).

METHODSPorous-hollow cylinder titanium implant composed of bBMP was implanted into mandibule of dogs. Multiple fluorescent was labeled at different times and then LSCM was used to observe the newly formed bone around the complex implant.

RESULTSThe newly formed bone around the complex implant in experimental group was more obvious than that in other groups.

CONCLUSIONEarlier, longer and more new-bone formation can be induced by porous-hollow cylinder titanium implant composed of bBMP, and LSCM is an effective method to observe new bone formation around implant.

Animals ; Bone Morphogenetic Proteins ; pharmacology ; Cattle ; Dogs ; Female ; Implants, Experimental ; Male ; Mandible ; physiopathology ; surgery ; Osseointegration ; Osteogenesis ; drug effects ; Porosity ; Random Allocation ; Titanium

Objective To explore the best approach to treatment of cesarean scar pregnancy (CSP). Methods A total of 138 patients with CSP treated between January and December, 2013 were retrospectively analyzed. The patients were treated with conservative drug therapy, direct curettage, uterine curettage after embolization, or open or transvaginal surgery. The amount of blood loss, proportion of patients with blooding loss greater than 50 mL, hospitalization days, and hospitalization expenses were compared among the groups. Results The median volume of blood loss was 370 mL in the conservative treatment group, 59 mL in direct curettage group, 67 mL in interventional therapy group, and 1425 mL in the surgical group, and the proportion of patients with blood loss over 50 mL was 76.9%, 38.8%, 27.5%, and 100%in the 4 groups, respectively. The midian hospital stay of the 4 groups was 9.0, 4.0, 6.0 and 10.0 days, with median hospitalization expenses of 12281.0, 3843.5, 14805.0, and 17202.2 RMB Yuan, respectively. All these data were significantly different among the 4 groups (P<0.05). Conclusions Direct curettage surgery should be encouraged for treatment of CSP. Embolization therapy can reduce the risk of bleeding but is associated with potential complications and more costly, and should be performed with caution. Open or trasnvaginal surgery can be considered in difficult cases of CSP, and its combination with interventional therapy is an option to better preserving the uterus.

Objective To explore the best approach to treatment of cesarean scar pregnancy (CSP). Methods A total of 138 patients with CSP treated between January and December, 2013 were retrospectively analyzed. The patients were treated with conservative drug therapy, direct curettage, uterine curettage after embolization, or open or transvaginal surgery. The amount of blood loss, proportion of patients with blooding loss greater than 50 mL, hospitalization days, and hospitalization expenses were compared among the groups. Results The median volume of blood loss was 370 mL in the conservative treatment group, 59 mL in direct curettage group, 67 mL in interventional therapy group, and 1425 mL in the surgical group, and the proportion of patients with blood loss over 50 mL was 76.9%, 38.8%, 27.5%, and 100%in the 4 groups, respectively. The midian hospital stay of the 4 groups was 9.0, 4.0, 6.0 and 10.0 days, with median hospitalization expenses of 12281.0, 3843.5, 14805.0, and 17202.2 RMB Yuan, respectively. All these data were significantly different among the 4 groups (P<0.05). Conclusions Direct curettage surgery should be encouraged for treatment of CSP. Embolization therapy can reduce the risk of bleeding but is associated with potential complications and more costly, and should be performed with caution. Open or trasnvaginal surgery can be considered in difficult cases of CSP, and its combination with interventional therapy is an option to better preserving the uterus.

OBJECTIVETo explore the best approach to treatment of cesarean scar pregnancy (CSP).

METHODSA total of 138 patients with CSP treated between January and December, 2013 were retrospectively analyzed. The patients were treated with conservative drug therapy, direct curettage, uterine curettage after embolization, or open or transvaginal surgery. The amount of blood loss, proportion of patients with blooding loss greater than 50 mL, hospitalization days, and hospitalization expenses were compared among the groups.

RESULTSThe median volume of blood loss was 370 mL in the conservative treatment group, 59 mL in direct curettage group, 67 mL in interventional therapy group, and 1425 mL in the surgical group, and the proportion of patients with blood loss over 50 mL was 76.9%, 38.8%, 27.5%, and 100% in the 4 groups, respectively. The midian hospital stay of the 4 groups was 9.0, 4.0, 6.0 and 10.0 days, with median hospitalization expenses of 12281.0, 3843.5, 14805.0, and 17202.2 RMB Yuan, respectively. All these data were significantly different among the 4 groups (P<0.05).

CONCLUSIONDirect curettage surgery should be encouraged for treatment of CSP. Embolization therapy can reduce the risk of bleeding but is associated with potential complications and more costly, and should be performed with caution. Open or trasnvaginal surgery can be considered in difficult cases of CSP, and its combination with interventional therapy is an option to better preserving the uterus.

Cesarean Section ; adverse effects ; Cicatrix ; complications ; Curettage ; Female ; Humans ; Length of Stay ; Pregnancy ; Pregnancy, Ectopic ; drug therapy ; etiology ; surgery ; Retrospective Studies ; Treatment Outcome ; Uterine Artery Embolization ; Uterus ; surgery

Purpose: The risk stratification of pediatric anaplastic large cell lymphoma (ALCL) has not been standardized. In this study, new risk factors were included to establish a new risk stratification system for ALCL, and its feasibility in clinical practice was explored. Materials and Methods: On the basis of the non-Hodgkin’s lymphoma Berlin–Frankfurt–Munster 95 (NHL-BFM-95) protocol, patients with minimal disseminated disease (MDD), high-risk tumor site (multiple bone, skin, liver, and lung involvement), and small cell/lymphohistiocytic (SC/LH) pathological subtype were enrolled in risk stratification. Patients were treated with a modified NHL-BFM-95 protocol combined with an anaplastic lymphoma kinase inhibitor or vinblastine (VBL). Results: A total of 136 patients were enrolled in this study. The median age was 8.8 years. The 3-year event-free survival (EFS) and overall survival of the entire cohort were 77.7% (95% confidence interval [CI], 69.0% to 83.9%) and 92.3% (95% CI, 86.1% to 95.8%), respectively. The 3-year EFS rates of low-risk group (R1), intermediate-risk group (R2), and high-risk group (R3) patients were 100%, 89.5% (95% CI, 76.5% to 95.5%), and 67.9% (95% CI, 55.4% to 77.6%), respectively. The prognosis of patients with MDD (+), stage IV cancer, SC/LH lymphoma, and high-risk sites was poor, and the 3-year EFS rates were 45.3% (95% CI, 68.6% to 19.0%), 65.7% (95% CI, 47.6% to 78.9%), 55.7% (95% CI, 26.2% to 77.5%), and 70.7% (95% CI, 48.6% to 84.6%), respectively. At the end of follow-up, one of the five patients who received maintenance therapy with VBL relapsed, and seven patients receiving anaplastic lymphoma kinase inhibitor maintenance therapy did not experience relapse. Conclusion This study has confirmed the poor prognostic of MDD (+), high-risk site and SC/LH, but patients with SC/LH lymphoma and MDD (+) at diagnosis still need to receive better treatment (ClinicalTrials.gov number, NCT03971305).

Purpose: The risk stratification of pediatric anaplastic large cell lymphoma (ALCL) has not been standardized. In this study, new risk factors were included to establish a new risk stratification system for ALCL, and its feasibility in clinical practice was explored. Materials and Methods: On the basis of the non-Hodgkin’s lymphoma Berlin–Frankfurt–Munster 95 (NHL-BFM-95) protocol, patients with minimal disseminated disease (MDD), high-risk tumor site (multiple bone, skin, liver, and lung involvement), and small cell/lymphohistiocytic (SC/LH) pathological subtype were enrolled in risk stratification. Patients were treated with a modified NHL-BFM-95 protocol combined with an anaplastic lymphoma kinase inhibitor or vinblastine (VBL). Results: A total of 136 patients were enrolled in this study. The median age was 8.8 years. The 3-year event-free survival (EFS) and overall survival of the entire cohort were 77.7% (95% confidence interval [CI], 69.0% to 83.9%) and 92.3% (95% CI, 86.1% to 95.8%), respectively. The 3-year EFS rates of low-risk group (R1), intermediate-risk group (R2), and high-risk group (R3) patients were 100%, 89.5% (95% CI, 76.5% to 95.5%), and 67.9% (95% CI, 55.4% to 77.6%), respectively. The prognosis of patients with MDD (+), stage IV cancer, SC/LH lymphoma, and high-risk sites was poor, and the 3-year EFS rates were 45.3% (95% CI, 68.6% to 19.0%), 65.7% (95% CI, 47.6% to 78.9%), 55.7% (95% CI, 26.2% to 77.5%), and 70.7% (95% CI, 48.6% to 84.6%), respectively. At the end of follow-up, one of the five patients who received maintenance therapy with VBL relapsed, and seven patients receiving anaplastic lymphoma kinase inhibitor maintenance therapy did not experience relapse. Conclusion This study has confirmed the poor prognostic of MDD (+), high-risk site and SC/LH, but patients with SC/LH lymphoma and MDD (+) at diagnosis still need to receive better treatment (ClinicalTrials.gov number, NCT03971305).

Purpose: The risk stratification of pediatric anaplastic large cell lymphoma (ALCL) has not been standardized. In this study, new risk factors were included to establish a new risk stratification system for ALCL, and its feasibility in clinical practice was explored. Materials and Methods: On the basis of the non-Hodgkin’s lymphoma Berlin–Frankfurt–Munster 95 (NHL-BFM-95) protocol, patients with minimal disseminated disease (MDD), high-risk tumor site (multiple bone, skin, liver, and lung involvement), and small cell/lymphohistiocytic (SC/LH) pathological subtype were enrolled in risk stratification. Patients were treated with a modified NHL-BFM-95 protocol combined with an anaplastic lymphoma kinase inhibitor or vinblastine (VBL). Results: A total of 136 patients were enrolled in this study. The median age was 8.8 years. The 3-year event-free survival (EFS) and overall survival of the entire cohort were 77.7% (95% confidence interval [CI], 69.0% to 83.9%) and 92.3% (95% CI, 86.1% to 95.8%), respectively. The 3-year EFS rates of low-risk group (R1), intermediate-risk group (R2), and high-risk group (R3) patients were 100%, 89.5% (95% CI, 76.5% to 95.5%), and 67.9% (95% CI, 55.4% to 77.6%), respectively. The prognosis of patients with MDD (+), stage IV cancer, SC/LH lymphoma, and high-risk sites was poor, and the 3-year EFS rates were 45.3% (95% CI, 68.6% to 19.0%), 65.7% (95% CI, 47.6% to 78.9%), 55.7% (95% CI, 26.2% to 77.5%), and 70.7% (95% CI, 48.6% to 84.6%), respectively. At the end of follow-up, one of the five patients who received maintenance therapy with VBL relapsed, and seven patients receiving anaplastic lymphoma kinase inhibitor maintenance therapy did not experience relapse. Conclusion This study has confirmed the poor prognostic of MDD (+), high-risk site and SC/LH, but patients with SC/LH lymphoma and MDD (+) at diagnosis still need to receive better treatment (ClinicalTrials.gov number, NCT03971305).

Purpose: The risk stratification of pediatric anaplastic large cell lymphoma (ALCL) has not been standardized. In this study, new risk factors were included to establish a new risk stratification system for ALCL, and its feasibility in clinical practice was explored. Materials and Methods: On the basis of the non-Hodgkin’s lymphoma Berlin–Frankfurt–Munster 95 (NHL-BFM-95) protocol, patients with minimal disseminated disease (MDD), high-risk tumor site (multiple bone, skin, liver, and lung involvement), and small cell/lymphohistiocytic (SC/LH) pathological subtype were enrolled in risk stratification. Patients were treated with a modified NHL-BFM-95 protocol combined with an anaplastic lymphoma kinase inhibitor or vinblastine (VBL). Results: A total of 136 patients were enrolled in this study. The median age was 8.8 years. The 3-year event-free survival (EFS) and overall survival of the entire cohort were 77.7% (95% confidence interval [CI], 69.0% to 83.9%) and 92.3% (95% CI, 86.1% to 95.8%), respectively. The 3-year EFS rates of low-risk group (R1), intermediate-risk group (R2), and high-risk group (R3) patients were 100%, 89.5% (95% CI, 76.5% to 95.5%), and 67.9% (95% CI, 55.4% to 77.6%), respectively. The prognosis of patients with MDD (+), stage IV cancer, SC/LH lymphoma, and high-risk sites was poor, and the 3-year EFS rates were 45.3% (95% CI, 68.6% to 19.0%), 65.7% (95% CI, 47.6% to 78.9%), 55.7% (95% CI, 26.2% to 77.5%), and 70.7% (95% CI, 48.6% to 84.6%), respectively. At the end of follow-up, one of the five patients who received maintenance therapy with VBL relapsed, and seven patients receiving anaplastic lymphoma kinase inhibitor maintenance therapy did not experience relapse. Conclusion This study has confirmed the poor prognostic of MDD (+), high-risk site and SC/LH, but patients with SC/LH lymphoma and MDD (+) at diagnosis still need to receive better treatment (ClinicalTrials.gov number, NCT03971305).