1.Surgical techniques for the safe and rapid resection of primary or secondary sacral tumors located between the second and fourth sacral vertebrae
Gangcheng WANG ; Chongqing GAO ; Tao WANG ; Gaohua NIU ; Shijia ZHANG ; Zhi ZHANG ; Wanchao AI ; Lingjuan LI ; Liangliang DING ; Zhen ZHANG ; Guixiang ZHANG ; Lili GUO
Chinese Journal of Oncology 2025;47(10):1050-1056
Objective:To investigate the methods and skills required for the safe and swift removal of primary or secondary sacral tumors located between the second (inclusive) and fourth sacral vertebrae.Methods:The clinical images, pathology reports, surgical procedures, operation durations, intraoperative bleeding volumes, and postoperative functional follow-up data of 26 patients undergoing sacral tumor resection at the First Affiliated Hospital of Zhengzhou University and Xinjiang Production and Construction Corps Hospital between May 2020 and February 2025 were retrospectively examined. Additionally, the safety measures for sacral tumor resection and techniques for expedited specimen removal were evaluated.Results:According to magnetic resonance imaging (MRI) findings, all 26 patients presented with sacral tumors located between the second (inclusive) and fourth sacral vertebrae. Specifically, 9 patients were diagnosed with primary sacral tumors, pathologically confirmed as chordomas, while 17 patients had secondary sacral tumors. Among the secondary tumor cases, 12 were attributed to recurrent rectal cancer invading the sacrum, and 5 were due to malignant teratomas invading the sacrum. The 26 patients underwent a treatment strategy that began with managing the relationship between the internal iliac artery, vein branches, and the tumor, followed by the resection of the sacrum. During surgery, the bilateral sciatic foramina were accurately positioned, and the presacral fascia was dissected subsequent to the fracture of the sacrum. Among the 26 patients, 9 underwent sacral tumor resection directly through the posterior sacral approach. The average operation time for these patients was (71.1±4.9) minutes, with average blood loss of (186.7±72.8) milliliters. On the other hand, 17 patients underwent sacral tumor resection by transitioning from the supine position to the prone knife position through a combined abdominal and sacral approach. The average operation time for this group was (213.5±19.3) minutes, with average blood loss of (480.0±93.0) milliliters, significantly longer than that of the posterior sacral approach. The follow-up period ranged from 1 to 48 months, with a median of 20 months, ending on March 31, 2025. During this time, 26 patients achieved autonomous defecation with the aid of medication. None of the patients reported any functional movement disorders or pain in their lower limbs. It was observed that two out of the 26 patients developed distant metastasis, while the remaining 24 patients survived without any tumors.Conclusion:By pretreated the relationship between the internal iliac vessels and sacral tumors prior to resecting sacral tumors, utilizing the approach of initially fracturing the sacrum followed by rupturing the presacral fascia, the tumor can be entirely eliminated, resulting in a brief surgical procedure, reduced intraoperative bleeding, and minimal postoperative complications.
2.Surgical techniques for the safe and rapid resection of primary or secondary sacral tumors located between the second and fourth sacral vertebrae
Gangcheng WANG ; Chongqing GAO ; Tao WANG ; Gaohua NIU ; Shijia ZHANG ; Zhi ZHANG ; Wanchao AI ; Lingjuan LI ; Liangliang DING ; Zhen ZHANG ; Guixiang ZHANG ; Lili GUO
Chinese Journal of Oncology 2025;47(10):1050-1056
Objective:To investigate the methods and skills required for the safe and swift removal of primary or secondary sacral tumors located between the second (inclusive) and fourth sacral vertebrae.Methods:The clinical images, pathology reports, surgical procedures, operation durations, intraoperative bleeding volumes, and postoperative functional follow-up data of 26 patients undergoing sacral tumor resection at the First Affiliated Hospital of Zhengzhou University and Xinjiang Production and Construction Corps Hospital between May 2020 and February 2025 were retrospectively examined. Additionally, the safety measures for sacral tumor resection and techniques for expedited specimen removal were evaluated.Results:According to magnetic resonance imaging (MRI) findings, all 26 patients presented with sacral tumors located between the second (inclusive) and fourth sacral vertebrae. Specifically, 9 patients were diagnosed with primary sacral tumors, pathologically confirmed as chordomas, while 17 patients had secondary sacral tumors. Among the secondary tumor cases, 12 were attributed to recurrent rectal cancer invading the sacrum, and 5 were due to malignant teratomas invading the sacrum. The 26 patients underwent a treatment strategy that began with managing the relationship between the internal iliac artery, vein branches, and the tumor, followed by the resection of the sacrum. During surgery, the bilateral sciatic foramina were accurately positioned, and the presacral fascia was dissected subsequent to the fracture of the sacrum. Among the 26 patients, 9 underwent sacral tumor resection directly through the posterior sacral approach. The average operation time for these patients was (71.1±4.9) minutes, with average blood loss of (186.7±72.8) milliliters. On the other hand, 17 patients underwent sacral tumor resection by transitioning from the supine position to the prone knife position through a combined abdominal and sacral approach. The average operation time for this group was (213.5±19.3) minutes, with average blood loss of (480.0±93.0) milliliters, significantly longer than that of the posterior sacral approach. The follow-up period ranged from 1 to 48 months, with a median of 20 months, ending on March 31, 2025. During this time, 26 patients achieved autonomous defecation with the aid of medication. None of the patients reported any functional movement disorders or pain in their lower limbs. It was observed that two out of the 26 patients developed distant metastasis, while the remaining 24 patients survived without any tumors.Conclusion:By pretreated the relationship between the internal iliac vessels and sacral tumors prior to resecting sacral tumors, utilizing the approach of initially fracturing the sacrum followed by rupturing the presacral fascia, the tumor can be entirely eliminated, resulting in a brief surgical procedure, reduced intraoperative bleeding, and minimal postoperative complications.
3.The Research Status of Anti-tumor Effects of Artemisinin and its Derivatives
International Journal of Traditional Chinese Medicine 2009;31(2):174-175,184
Artemisinin is a traditional anti-malarial drug. In recent years, many researches indicated that artemisinin and its derivatives have obvious anti-tumor effects. Its mechanisms of anti-tumor lies in cytotoxicity, direct destruction of tumor cells due to oxidative stress reaction, inducing apoptosis, inhibiting of tumor cell proliferation, restraining tumor angiogenesis and performing immunological regulation. Compared with the traditional anti-cancer drugs, artemisinin can selectively inhibit tumor cells and manifestating no cross-resistance with traditional chemotherapeutic agents. Besides it can reverse the phenomenon of multi-drug resistant of tumor cells. Therefore, artemisinin, as an new type of anti-cancer drug, will be applied to a wide range of clinical practice.
4.Relationship between Emotion, Severity of Illness and the Effect on IL-8 in Asthmatic Children
Yi NIU ; Zhili CHENG ; Gaohua WANG
Chinese Journal of Clinical Psychology 1993;0(02):-
Objective: To examine the emotional states of asthmatic children with different degrees of severity, as well as the effects of emotion on change of cytokines in airway. Methods: Asthmatic children were divided into two groups according to the degrees of severity: moderate and mild. Their emotional states were measured and results were compared. Correlation analysis was conducted between scores on emotional scales and sputum levels of IL-8.Results: Total scores on anxiety and depression were higher in the moderate group than in the mild group. Negative correlation was found between levels of anxiety and IL-8 during acute exacerbation of asthmatic condition. Conclusion: Emotional distress was found to be increased with severity of asthmatic condition in children. Anxiety contributed to the decreased concentration of IL-8 in asthmatic children's airway.

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