BACKGROUND: There are disputes concerning limb salvage and reconstruction in treating pelvis malignant tumor.OBJECTIVE: To study the surgical treatment following resection of tumor at acetabular region in order to restore pelvic stability with less damage or recurrence.METHODS: Thirty-three patients diagnosed with pelvic tumor at Department of Orthopaedics, First Affiliated Hospital of Second Military Medical University from April 2002 to June 2008 were selected. All patients were received tumor resection and computer-aided prosthetic replacement, 18 patients (8 cases with chondrosarcoma, 2 cases with Ewing sarcoma, 2 cases with osteosarcoma, and 6 cases with malignant fibrous histiocytoma) were combined with antitumor drug treatment. Functional assessment of therapeutic efficacy was divided into 4 levels: excellent, good, moderate, and inferior.RESULTS AND CONCLUSION: Two patients died at months 4 and 6 after prosthetic replacement; 31 cases were followed-up for 8-32 months, mean 12.5 months. Seven cases were recurred chondrosarcoma, the recovery of other patients were as follow: 18 cases were excellent, 4 cases were good, 2 cases were moderate and no case was inferior. Most of limb function and pelvic stability was preserved. The results suggested that malignant fibrous histiocytoma and Ewing sarcoma can receive a high rate of limb preservation if treated by effective chemotherapy with low recurrence; the recurrence of chondrosarcoma was high. Tumor resection combined with computer-aided prosthetic replacement can maximatily reserve limb function and raise life quality.

Objective To investigate the therapeutic effect of intravascular embolization of carotid-cavernous fistulation.Methods 5 cases were examined by DSA of brain to find out the sites of fistulation.The detachable balloon or GDC(Guglielmi Detachable Coil)were employed in embolotherapy.Results 1 cases were embolized successful with detachable balloon and kept free circulation of ICASs;The embolism of ICA involved side were performed in 2 cases for patient with pseudoaneurysm and 1 patients cavernous involved were embolized with GDC for small mouth of the fistula.Another case balloon raptured two times when it was detached to cavernous after one free balloon was dept in cavernous,the patient didn't want to embolized the ICA involved,the trentment was stoped,the patients symptoms was disappeated after one week of therapy.Conclusion The site and size of carotic-cavernous fistulation can be detected by DSA of brain intravascular embolization is the first-choise method of therapy for it.

Objective To investigate the surgical indication,approach,resection methods and complications of total sacrectomy via posterior approach for primary malignant sacral tumors involving high level (S1,S2).Methods 5 cases of primary malignant sacral tumors treated by total sacrectomy via posterior approach and iliolumbar reconstruction from March 2010 to March 2011 were analyzed retrospectively.There were 3 males and 2 females.The mean age was 41,ranging from 32 to 55.The imageology examination showed osteolytic destruction,among which there were 4 cases of obvious soft tissue mass,1 case of obvious sacral foramina expansion with bone damage.MRI showed 1 case of the tumors in S1-S5,1 case of the tumors in S1 、S2,1 case of the tumors in S1-S3.The smallest tumor was 9.2 cm×7.6 cm×4.1 cm,while the largest was 22.0 cm× 19.0 cm× 16.0 cm.Preoperative TTNB were done on the 5 patients.Pathological diagnosis:2 cases of chordoma,1 case of malignant neurilemmoma,1 case of chondrosarcoma and 1 case of malignant hemangioendothelioma.5 patients had sacrococcygeal pain or lumbocrural pain before the surgery.Visual analogue scale (VAS):2 cases of 2,2 cases of 6 and 1 case of 8.Ilium stability reconstructions were all performed on 5 patients with spine pedicle screw-rod system.Results The mean operation time was 6.5 hours (range,4.5-11 hours),with the mean intraoperative blood loss of 3 700 ml (range,2 000-7 200 ml).There was no perioperative death.The mean follow-up time was 17 months (range,9-23 months).There were 2 cases of wound complications 2 weeks after surgery and healed by second intention with washing and drainage after debridement.There was no deep infection.1 case of rectal injury,which was performed with colostomy during the operation,and stoma returned 12 weeks after surgery.4 cases of sciatic nerve symptom of lower limbs and plantar flexion dyskinesia after bilateral S1 nerve roots resection.The patients walked with ankle brace fixed after the surgery.There was 1 case of implant breakage and no obvious spine down.5 patients had functional disability in sphincter after surgery.1 case of hemangioendothelioma recurred locally 9 months later.Local radiotherapy was performed since there was no reoperation indication.The patient is currently on the 13th month follow-up and survives with tumors.Compared with combined approach,the selection of posterior approach alone has relatively strict surgery indications.Conclusion Total sacrectomy via posterior approach is an effective way to treat the primary high-level malignant sacral tumors.The good surgical resection boundary is important to achieve the good oncology prognosis.The occurrence rate of postoperative complication is high,which has great influence on patients' postoperative neurological function.

The ?-radioactive seed brachytherapy source has been widely employed in the implantation therapy for the prostatic carcinoma and the ophthalmic lesions.In this study the dosimetric parameters for characterization of a low-energy interstitial brachytherapy source 125I were calculated according to dose calculation formalism recommended by AAPM TG-43U1.For data processing,a 0.28 cm active length was used for the geometry function.The dosimetry parameter air-Kerma strength,dose rate constant,radial dose function and anisotropy function were estimated by means of the EGS5 Monte Carlo code.The results obtained from this study are in good agreement with the corresponding values recommended by TG-43U1 and with the data reported by Dolan,et al.

Objective Investigate the surgical resection,reconstruction technique and follow-up of partly defect by primary bone malignancy in acetabulum.Methods Retrospective analysis 20 cases clinical data of partly defect by primary bone malignancy in acetabulum patients from January 2009 to January 2015.Resect the tumor and reconstruct the acetabulum based on the type of acetabulum tumor:type A,excise pubis and partial acetabulum,use self-femoral-head transplantation and pelvis reconstruct steels to reconstruct the bone defection of acetabulum leading edge,then transplant biological type acetabular cup;type B,excise ischium and trailing edge of acetabulum,transplant self-femoral-head and fixed with cancellous screw,for those can't maintain the acetabulum stabilization,apply acetabulum enhance ring to immobilize;type C,excise partial ilium and acetabulum superior margo to interrupt its discontinuity,self-femoral-head transplant to reconstruct acetabulum,then use enhance ring and cemented cup to rebuild hip joint.Results Total 20 cases,13 males and 7 females;the age ranges 23-69 years old,average 48 years;followed up 13-56 months,mean 34 months.Pathology types:17 cases of chondrosarcoma and 3 cases of malignant bone giant cell tumor.After surgery,3 cases of chondrosarcoma recurred (15％),1 case of malignant bone giant cell tumor relapsed and developed to pulmonary metastasis.2 cases of acetabulum prosthesis incipient dislocation performed closed replacement then fixed 6 weeks with hip joint brace.1 cases of prosthesis losing performed hip joint revision.1 case occurred deep hip infection,which performed debridement and taking out prosthesis.2 cases self-femoral-head transplant and biological total hip replacement healed well.Postoperative functional MSTS 93 score showed excellent in 13 cases,good in 6 cases,poor in 1 case.Conclusion According to the tumor type and range,determine the resection method and boundary,which is the key to acquire well oncological prognosis.On the premise of sufficient tumor resection,reconstruct function individually based on the type of acetabulum tumor,which is the key to acquire well functional prognosis and prosthesis survival rate.

AIM: To prepare m 1AChR-G 11 and m 4AChR-G 16 fusion protein in Baculovirus-Sf9 cell system and detect the effects of various muscarinic ligands on the interaction between m 1AChR and G 11 and m 4AChR and G 16 ,and screen different kinds of ligands specific for m 1 and m 4. METHODS: To prepare fused DNA of m 1AChR-G 11 and m 4AChR-G 16 in two PCR, then expressed in Sf9 cells and detect the pharmacological function of m 1AChR-G 11 fusion protein and m 4AChR-G 16 fusion protein by [ 3H]QNB and [ 35 S]GTP?S binding experiments; To expore the way of the activation of m 1AChR-G 11 and m 4AChR-G 16 fusion protein by various ligands includingcetylcholine (ACh), Pilocarpine (Pilo), 4-hydroxy-2-butynyl-1-trimethylammonium-m-chloro-carbanilatechloride (McN-A-343),tetrandrine, pirenzepine (PZ), alcuronium, atropine,R-(+)-hyoscyamine and gallamine by displacement by GDP on [ 35 S]GTP?S binding experiments. RESULTS: The expression levels of m 1AChR-G 11 and m 4AChR-G 16 fusion protein were (45 39?2 62) nmol?g -1 protein, (47 04?1 58) nmol?g -1 protein. The affinity of GDP to G 11 and G 16 partner changed in the presence of different muscarinic ligands. CONCLUSION: The m 1AChR-G 11 and m 4AChR-G 16 showed the pharmacological specificity to m 1 and m 4 receptor and the efficient signaling of the two partners. Ligands of m 1AChR and m 4AchR mediated different signal transduction by changing the affinity of G 11 /G 16 and GDP. So m1AChR-G 11 fusion protein and m 4AChR-G 16 fusion protein can be taken as a tool to screen ligands specific for m 1AChR and m 4AChR.

Objective Create patient-derived xenograft (PDX) model of bone and soft tissue sarcoma,and analyze the success rate of PDX model,observe the effects of chemotherapy on PDX models and its coincidence,and provide a theoretical basis for screening sensitive second and third line drugs.Methods Collected 31 cases of bone and soft tissue sarcoma from January 2015 to May 2016,which included 12 male and 19 female,with an average age of (28.5±19.9) y.The tumor tissue was obtained the day of operation,and it was cut into 2 mm3 pieces and injected into the flank of BAL B/C nude mice or SCID mice.Tumor was passaged when the diameter reached 1-2 cm and the P0 tissue was froze.If there was no obvious tumor mass grows out for 3 months,the model creation will be stopped.We inoculated the mice with patients sample with or without chemotherapy,observed the effect of chemotherapy on the success rate of PDX modeling and the success rate of modeling of different pathological types,and also observed the relationship between the success rate of PDX modeling and the prognosis of patients.For the drug sensitivity test,3 mice was used in each group,and chemotherapy was given,T/C was used to evaluate the inhibition ratio after drug treatment.Results 31 PDX models were inoculated.The total success rate is 45.2％.Pathology of the PDX models and their success rates:24 osteosarcoma models,success rate is 37％;2 leiomyosarcoma models,success rate is 100％;2 chondrosarcoma models,success rate is 50％;1 Ewing sarcoma model successed;1 fibrosarcoma model and 1 synovial sarcoma model,were not successed.Post chemotherapy model success rate is 33％ (4/12),compared with 53％(10/19) of model success rate that without chemotherapy.And there is relationship between success rate of PDX model creation and patient outcome.The faster the PDX model creation,the worse the outcome.The drug sensitivity of PDX model coincides the clinical situation.Conclusion The success rate of creating PDX model of bone and soft tissue sarcoma is around 30％-40％,and it is related to the pathology and whether got chemotherapy or not,PDX models coincide sarcomas clinical situation,and it is hopefully to use PDX model in selecting personalized drugs.

Objective:To compare the efficacy of volar and dorsal approach in the treatment of distal radius fractures by open reduction and internal fixation .Methods :Sixty‐eight patients with distal radius fractures ,who were admitted in Tenth People’s Hospital of Tongji University from 2013 January to 2014 January ,were chosen .The patients were randomly divided in to volar approach group and dorsal approach group ,with 34 cases in each group .The wrist joint function at three months after the operation ,surgical situation ,postoperative complications were compared between the two groups .Results:The excellent and good rate of wrist joint function at three months after the operation in volar approach group was 97 .1% ,while that in dorsal approach group was 70 .6% .The difference was statistically significant (P< 0 .05) .Compared to those in dorsal approach group ,the surgical time and hospitalization time were significantly shorter in volar approach group ,while the time to start the activity was earlier and the amount of bleeding in operation was smaller .American Spinal Injury Association(ASIA) score was higher in volar approach group .All the differences showed statistical significance (P<0 .05) .Conclusions :Volar approach ,in treatment of distal radius fractures with open reduction and internal fixation ,can effectively improve postoperative function of w rist joint .

A Cleanert Alumina-N-SPE column (0.5 g/6 mL) chromatograpy with 5 mL of chloroform-methanol (7: 3) as eluent, instead of aluminum oxide column (100-200 mesh, 5 g, 1 cm) chromatograpy eluted successively with chloroform and the chloroform-methanol (7:3) (20 mL each), was applied to enrich matrine and oxymatrine in Sophora flavescens. Also, the optimization of the HPLC determination conditions with acetonitrile-ethanol absolute-3% phosphoric acid solution (84: 6: 10) as mobile phase, instead of acetonitrile-ethanol absolute -3% Phosphoric acid solution (80: 10: 10) recorded in Chinese Pharmacopoeia 2010 Edition, was more suitable for determination of matrine and oxymatrine in S. flavescens. This method has advantage of reducing sample handling time and solvent volume and increasing the accuracy and feasibility, which can simplify the procedure for determination of matrine and oxymatrine in S. flavescens.
Alkaloids ; analysis ; isolation & purification ; Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; analysis ; isolation & purification ; Quinolizines ; analysis ; isolation & purification ; Solid Phase Extraction ; methods ; Sophora ; chemistry

Objective:To investigate the mid-to-long term therapeutic effects of allogeneic bone composite prosthesis reconstruction in patients with large bone defects after the resection of distal femoral tumors.Methods:From June 2013 to December 2018, a total of 19 patients with malignant tumors of the distal femur who underwent reconstruction with allogeneic bone composite prosthesis in the Department of Bone Tumor, Shanghai General Hospital were retrospectively collected. There were 10 males and 9 females, aged 22.3±11 years (range, 11-42 years). The mean body mass index was 19.3±3.4 kg/m 2 (range, 14-27 kg/m 2). There were 18 cases of osteosarcoma and 1 case of Ewing's sarcoma. According to Ennecking staging, there were 17 cases of stage IIB and 2 cases of stage III. The intraoperative blood loss and operation time were recorded, and the prosthesis and patient survival conditions and postoperative complications were observed. The limb function was evaluated by the Musculoskeletal Tumor Society (MSTS) 93 function score. Results:All patients successfully completed the operation. The operation time was 187.3±39.8 min (range, 110-260 min), the intraoperative blood loss was 284.9±87.0 ml (range, 200-500 ml), and the blood transfusion volume was 327±213 ml (range, 100-800 ml). The remaining length of the proximal femur was 153.7±26.6 mm (range, 93-190 mm), and the length of allogeneic bone was 84.1±24.6 mm (range, 39-134 mm). Among the 19 patients, 9 patients (47%) achieved bony union with an average healing time of 16.7±4.8 months (range, 10-25 months), and 7 patients had delayed healing with an average healing time of 18.4±4.0 months (range, 15-25 months). The remaining 10 cases were nonunion between allogeneic bone and host bone. All patients were followed up for 80.7±20.2 months (range, 56-121 months). During the follow-up, 3 cases died due to pulmonary metastasis of bone tumors, and the time of death was 57 months, 63 months, and 59 months after surgery, respectively. At the last follow-up, the patient survival rate was 84% (16/19), and the MSTS 93 function score of the 16 patients was (24.3±2.4) points (range, 21-28 points), with an excellent rate of 100% (16/16). Seven patients underwent revision surgery, 3 cases were aseptic loosening, 3 cases were prosthesis stem fracture at the junction of the allograft bone and the host bone, and 1 case was periprosthetic infection, among which the patient with periprosthetic infection had poor local soft tissue conditions due to preoperative radiotherapy, and the infection was controlled after two revision surgeries. Five cases were revised with allogeneic bone composite prosthesis, and 2 cases were revised with short-stem giant prosthesis with cortical steel plate or locking nail. After revision, the remaining length of the proximal femur was 143.4±31 mm (range, 91-175 mm), and the length of the allograft bone was 92.6±26.6 mm (range, 61-123 mm). The 7 revised patients were still in follow-up. There were no cases of pulmonary infection, nerve injury, deep vein thrombosis or other complications after surgery.Conclusion:The survival period of patients after the surgery to reconstruct large bone defects following the resection of malignant tumors at the distal end of the femur using allogeneic bone composite prosthesis is satisfactory, and the limb function is good. However, the incidence of prosthesis complications is high, which can be reconstructed through revision.