Sarcomas are tumors of mesenchymal origin that account for approximately 1%of human cancers. There are at least 60 dif-ferent subtypes of soft tissue sarcoma (STS). However, most tumor types are highly malignant tumors that lack an optimal therapeutic agent. Although gastrointestinal stromal tumor (GIST) responds well to imatinib, other types of STSs remain challenging because of their heterogeneous genetic and clinical features and poor prognosis. In recent years, the field of molecular targeted therapy has pro-gressed rapidly. Patients with advanced disease can receive individualized treatment to improve their quality of life. This review focus-es on the targeted therapies that have been evaluated for advanced non-GIST STS. Other promising novel therapeutic agents that are currently in the early phases of investigation are also presented.

BACKGROUND:As the epiphyseal plate has an important role in the growth and development of femur, the design of internal fixation should avoid the damage to the epiphyseal plate. Therefore, the positioning of pediatric femoral epiphyseal plate is particularly important.
OBJECTIVE:To investigate the biomechanical property of the new femur neck screw internal fixation in treatment of children femoral neck fracture.
METHODS:Twelve femurs were col ected from six fresh children cadavers provided by Dissecting Room of University of South China. After exclusion of bone disease with X-ray film, three new children femoral neck screws and three Kirschner wires with the diameter of 2.0 mm were used for fixation. The biomechanical tests were conducted to detect the axial compression and torsion stiffness.
RESULTS AND CONCLUSION:In the children femoral neck screw group, the axial compression stiffness and torsion stiffness under the torsional torque of maximum 3 N?m were (190.74±20.88) N/mm and (0.18±0.045) N?m/° respectively;(138.95±15.19) N/mm and (0.120±0.036) N?m/° respectively in the Kirschner wire group;there were significant differences in the axial compression stiffness and torsion stiffness between two groups (P<0.05). The results showed that the compressive strength and torsional capacity of the children femoral neck screw were strong than those of Kirschner wire. The experiment suggested that the femoral neck screw for children is a new type of ideal internal fixation device which consist with the anatomical features of children proximal femur and can meet the requirement of children femoral neck fracture with good biomechanical property.

Objective To compare the myocardial protective effect between off pump coronary artery bypass(OPCAB) and on pump coronary artery bypass in the aged. Methods Four five patients were randomly divided into 3 groups:off pump coronary artery bypass (n=15),tepid blood cardioplegia group(n=15) and cold blood cardioplegia group (n=15).There was no statistical difference in heart function,sex,age and lesion of coronary artery .Venous blood samples were taken for determineing the serum concentration of creatine kinase MB isoenzyme(CK MB),troponin I perioperatively and the clinical situations were observed postoperatively. Results CK MB,troponin I release in beating group during and after bypass was lower than that in on pump groups( P

Objective To observe the effects of differentiation of mature islet cells of mice on marrowmesenchymal stem cells (mMSCs). To provide transplant source for islet cell transplantation in the treatment of diabetes. Methods The culture, isolation and passage of mMSCs was performed by using patch wall, cell shape was observed by confocal microscope, and flow cytometry analysis was used to determine their biological characteristics. The type Ⅳ collagenase was injected into common bile duct to digest the pancreas, and then gradient centrifugation was used to isolate islet cells. The transwell co-culture system was used for third generation of mMSCs and isolated islet cells, then inversion microscope was used to observe the cell growth and morphological changes, immunochemistry methods was applied to detect the expression of insulin in mMSCs, and insulin release test was performed to determine the secretion of insulin. The control group consisted of cultured mMSCs alone. Results The cells from mouse bone marrow were found to be in long spindle shape with large volume after 48 hours in culture. One week later the cells grew in the form of colony with serial subcultivation. The cell surface molecules including Sca-l, CD29, CD44, CD105 were positive with high level of expression;while the cell surface molecules including CD34, CD45 were negative, all of these results confirmed that the ceils were mMSCs. After 7 days of coculture with mice islet cells, part of mMSCs cells were positively stained by insulin immunohistochemisty, the insulin secretion was (16.83±0. 15)μIU/ml.Conclusions After cocultured with islet cells, mMSCs isolated from mouse bone marrow could differentiate into islet like cells. These cells may be used in the islet cells transplantation in the treatment of diabetes, which provided a solution to the problems of donor-shortage and immunologic rejection.

The significance and contents of regional medical cloud construction based on information sharing were summarized according tothe three-circle theory, and the status quo and difficulties of the first diagnosis system, with the implementation of health information system for Xiamen residents as an example, and suggestions were pro-posed for the development of regional medical big data.

Objective:To construct a retroviral vector carrying both enhanced green fluorescent protein(EGFP) and human insulin gene for transfecting the bone marrow mesenchymal stem cells (BMSCs),and to observe the treatment effect of transfected BMSCs after transplanted into diabetes mice.Methods:Two gene segments of insulin-IRES-EGFP and IRES-EGFP were obtained by overlap extension PCR technology,and then the 2 segments were cloned into retroviral vector (pMSCV).The vectors were used to transfect BMSCs after packaged with PT67 cells.The expression of EGFP was observed by inverted fluorescence microscope and the expression of insulin gene was examined by RT-PCR in the infected BMSCs.The transfected BMSCs with 2 viruses were transplanted into diabetic mice separately.The blood glucose levels and body weights of mice were examined in 2 groups,and the results were compared with those of normal control group.Results:The recombinant retroviral vectors pMSCV-insulin-IRES-EGFP and pMSCV-IRES-EGFP were successfully constructed.The BMSCs infected by both vector stably gave out green fluorescence under microscope; the cells infected with pMSCV-insulin-IRES-EGFP also stably expressed human insulin gene.The blood glucose level of the mice transplanted with BMSCs transfected with pMSCV-insulin-IRES-EGFP was significantly lower than that transplanted with BMSCs transfected with pMSCV-IRES-EFGP (P

Objective To investigate the discrepancy of anorectal function in patients of Parkinson's disease (PD) with constipation and functional constipation (FC).Methods Fifteen consecutive male PD patients with constipation and 45 male FC patients were recruited for the study.All subjects underwent colonoscopy or barium enema in order to exclude organic colon diseases.Every patient underwent anorectal manometry and was categorized into subgroups of either dyssynergic defecation (F3a) or inadequate defecatory propulsion (F3b).Results The ages of PD with constipation and FC patients were (70 ± 11) and (68 ± 11) years old respectively.The rectal resting pressure in PD with constipation was higher than that in FC group without statistical significance [9.0 (4.0,15.0) mm Hg vs 6.0 (3.0,9.5) mm Hg,P=0.082,1 mm Hg =0.133 kPa].The anal resting pressure in PD group was not different from FC group [(51.2±17.2) mm Hg vs (59.7 ± 20.4) mm Hg,P =0.152].During anal squeezing,the maximal contraction pressure and area under the squeeze curve in PD with constipation group were both significantly lower than FC patients [maximal contraction pressure:(136.9 ± 43.8) mm Hg vs (183.0 ± 62.1) mm Hg,P=0.010; area under the squeeze curve:(823.5 ±635.7) mm Hg · s vs (1392.4± 939.9) mm Hg · s,P =0.033].During forced defecation,both of the defecation rectal pressure and defecation anal pressure in PD with constipation group were significantly lower than that of FC patients [22.0(15.0,30.0) vs42.0(31.0,55.0)mm Hg,P=0.000; and (46.3 ±23.3) vs (77.9 ±35.1) mm Hg,P =0.002].The proportions of F3a subtype were 10/15 and 46.7％ (21/45) in PD with constipation and FC patients respectively.There was no significant difference in the constituent ratio (P =0.120).Initial rectal sensory volumes were (91.3 ± 56.9) ml and (67.2 ± 38.9) ml in PD with constipation and FC patients respectively.Even both volumes were higher than the normal controls,there was no significant difference between the two groups (P =0.074).Conclusions Both PD with constipation and FC patients have abnormal anorectal motility and sensation comparing to the FC group,the parameters of anal contraction and defecation are significantly lower,F3b is dominant,and rectal sensory threshold is higher in PD with constipation patients.These parameters could possibly characterize the anorectal manometry for PD with constipation patients,which is helpful to understand the pathogenesis of PD and differentiate from other diseases.

Objective To investigate the effect of hemorrhagic shock on intestinal epithelial tight junction and expression of protein Occludin.Methods Twenty-four SD rats were allocated to sham operation group,hemorrhagic shock 0.5-hour,2-hour,and 4-hour groups according to random number table,with 6 rats per group.A model of hemorrhagic shock in the rat was induced by the improved Wiggers method.Blood samples were drawn from abdominal aorta.Activity of plasma diamine oxidase (DAO) was determined by active colonmetric method; content of plasma D-lactic acid (D-LA) by spectrophotometer method; plasma endotoxin levels by turbidimetry; bacterial translocation by bacterial culture of mesenteric lymph nodes and liver tissues; pathological changes of intestinal mucosa by light microscope; ultrastructure of intestinal epithelial cells by electron microscopy; Occludin mRNA expression in small intestinal mucosa by RT-PCR; Occludin expression by Western blot and imnmnohistochemical method.Results Levels of DAO [(72.68-± 10.24) mg/ml],D-LA [(9.28 ± 0.53) μg/ml] and endotoxin [(41.25 ±3.68) pg/L] in hemorrhagic shock 0.5-hour group increased markedly as compared with those in sham operation group (P ＜0.05).Bacteria were cultivated from the liver tissues and mesenteric lymph nodes in hemorrhagic shock 2-hour group and much more colonies of bacteria were observed in hemorrhagic shock 4-hour group (P ＜ 0.01).Morphology and ultrastructure of the small intestinal epithelium manifested immediate damage in hemorrhagic shock 0.5-hour group and much worse detriment was obsevved with a prolonged bleeding time.Occludin mRNA expression in small intestinal mucosa decreased in hemorrhagic shock 0.5-hour group,followed by a further reduction in hemorrhagic shock 2-hour group (P ＜0.05).Localized expression of Occludin in hemorrhagic shock O.5-hour group was weakly positive.Occludin content in hemorrhagic shock 2-hour group showed significant reduction when compared with that in hemorrhagic shock O.5-hour group (P ＜ 0.01) and its localized express was negative as well.Conclusion Occludin expression in intestinal epithelial cells decreases obviously with a prolonged bleeding time,which is presumed to be an important basis for disruption of cellular tight junction.

Objective:To explore the outcome of soft tissue sarcoma (STS) on patients with soft tissue metastasis. Methods:We ana-lyzed 25 STS patients with soft tissue metastasis primarily localized on extremity and trunk. The study was conducted from June 2010 to June 2016 by retrospective analysis of the clinical and pathological characteristics of the patients. The assessed endpoints were overall survival. Results:Six patients (24%) had synchronous soft tissue metastasis, and 19 patients (76%) had metachronous metasta-sis. The average time for primary tumor recession of metastatic lesions was 45.3 months. Metastases were most common in parts of the trunk in 18 patients (72%), followed by the head and neck in 5 patients (20%). Eleven patients (44%) with lung metastasis had poor prognosis. Conclusion:STS occurred more rarely in soft tissue metastasis than in pulmonary metastasis. Neoadjuvant chemotherapy and surgical treatment were the major therapies employed. Targeted therapy as a new treatment rendered good results.

BACKGROUND: Nitric oxide plays an important role in bone metabolism. However, the effects of different doses of L-arginine, nitric oxide substrate, on the healing of osteoporotic fractures remain unclear. OBJECTIVE: To investigate the influence of different doses of L-arginine on the healing of osteoporotic fractures and blood biochemistry in rats. METHODS: A total of 50 female Wistar rats, aged 6-month-old, were randomly divided into sham-surgery (n=10) and osteoporosis (bilateral ovariectomy, n=40). After osteoporosis model was established, left middle femoral fractures were made in al 50 rats, and the osteoporosis group was further divided into four groups, low, middle and high dose of L-arginine, and control groups. The L-arginine groups were intraperitoneal y injected with 1, 3, and 5 mg/kg L-arginine at the second day fol owing surgery, while the control and sham-surgery groups were injected with the same volume of normal saline. At 8 weeks, the lumbar and cal us bone mineral density, serum nitric oxide, and nitric oxide synthase were detected. Meanwhile, the bone cal us histological examination was conducted. RESULTS AND CONCLUSION: During fracture healing, osteoporosis rats showed a low level of serum nitric oxide and nitric oxide synthase compared with normal fractured rats (P < 0.05). L-arginine can improve the concentration of serum nitric oxide and nitric oxide synthase in osteoporosis rats. Moreover, middle dose of L-arginine can increase the cal us and lumbar spine bone mineral density of osteoporosis rats, so the number and continuity of bone trabecula were enhanced. These findings suggest that middle dose of L-arginine (3 mg/kg) can promote healing process of osteoporotic fractures and improve osteoporosis.