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ABSTRACT: To evaluate the value of intraoperative radiation therapy with electrons (ELIOT) in treatment of malignant bone or soft tissue tumors around the joints.
From October 2008 to April 2012, nineteen patients with malignant bone or soft tissue tumors around the joints were treated with ELIOT. The tumors were located around the knee joint in 8 patients, around the hip joint in 6 patients, around the elbow joint in 4 patients and around the shoulder joint in one patient. All of the patients underwent limb salvage surgeries. R0 resections were performed in 18 patients, while R1 resection was performed in one patient. The doses of intraoperative radiation ranged from 10 Gy to 22 Gy. The median dose was 19 Gy. More than one ELIOT fields were used in 10 patients because of the large tumor size.
Seven patients suffered wound complications. No grade ≥ 3 acute toxicities were observed. One patient developed radiation ulcer and arterial fistula 15 months after surgery and ELIOT, and resulted in amputation finally (grade 4 late toxicity). The mean Musculoskeletal Tumor Society (MSTS) 93 score was 26.26 ± 4.04 (87.5% ± 13.5%), with excellent to good extremity functions in 18 patients (94.7%). Four patients had local recurrences. The estimated locoregional control rates at 1, 2, and 3 years were 81.9%, 73.7%, and 73.7%, respectively. Seven patients died of the diseases. The estimated overall survivals of the entire group of patients at 1, 2, and 3 years were 76.3%, 61.2%, and 51.0%, respectively.
ELIOT is a safe and well-tolerable technique and could be widely used for patients with malignant bone or soft tissue tumors around the joints with acceptable rates of acute and late toxicity. There is positive significance for controlling the tumor local recurrence, preserving the joint function and improving survival quality.
Zhonghua zhong liu za zhi [Chinese journal of oncology] 12/2012; 34(12):923-6.
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ABSTRACT: Alcohol abuse and addiction is not only a severe social problem, but also an important biological medical issue. Studies in neuropsychopharmacology and molecular neurobiology indicate that neurotransmitters and its receptors play important roles in alcohol abuse and addiction, and post-receptor signal transduction pathways, including cyclic adenosine 3', 5'-monophosphate (cAMP)-protein kinase A (PKA), phosphoinositide (PI), Ca2+ -calmodulin (CAM), phospholipase D (PLD) and tyrosine kinase Fyn signaling cascade. In this review, works on post-receptor signal transduction involved in alcohol addiction are systematically presented and summarized.
Sheng li ke xue jin zhan [Progress in physiology] 11/2008; 39(4):319-24.
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ABSTRACT: To explore the clinical features, prognosis, and optimal treatment strategy of clear cell sarcoma (CCS).
Nineteen patients, 12 males and 7 females, aged 30. 9, with histologically confirmed CCS, 3 with tumors > or =5 cm and 16 with tumors <5 cm, 5 tumors being located in the upper extremity, 2 in the hand, 6 in the lower extremity, 2 in the foot, 3 in the trunk, and 1 in the head, were hospitalized from March 1973 to March 2007. The primary tumors of all the cases were marginally excised before admission and 10 cases had local relapse at admission. Two presented local lymph node metastasis and 2 presented distant metastasis. Ten patients with tumor relapse underwent re-operation. Eight patients received chemotherapy, 8 radiotherapy and 1 combined chemotherapy and radiotherapy. The patients were followed up for 51.4 months (3-144 months).
Tumor recurrence occurred in 1 of the 10 patients who received re-operation. 3 patients developed lymph node metastasis and 2 developed pulmonary metastasis. Of the 9 patients who did not undergo re-operation 7 developed lymph node metastasis, 6 developed pulmonary metastasis and 6 died. The overall 5-year survival rate was 75.2% and the 10-year survival rate was 37.5%.
CCS is a rare and high grade soft tissue sarcoma with high incidence rates of local recurrence and metastasis, and poor prognosis. The role of chemotherapy and radiotherapy for CCS should be investigated further. The best choice after local recurrence is re-operation.
Zhonghua yi xue za zhi 06/2008; 88(21):1458-61.
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ABSTRACT: To investigate the clinical feature, suitable treatment and prognosis of alveolar soft part sarcoma.
The clinical data of 58 such patients treated at our hospital from 1967 to 2006 were retrospectively analyzed. Fifty-three patients except 6 with distant metastasis underwent surgical resection including 33 extensive resection and 19 local resection. Furthermore, 19 patients received postoperative adjuvant radiotherapy or chemotherapy.
Eleven of 50 patients who underwent complete resection developed local recurrence. Thirty-One (53.4%) was found to have lung metastasis. The overall 3-, 5-, 10-year survival rate was 89.5%, 74.1% and 57.7%, respectively. The median survival time of the patients was 125 months. The 3-, 5-, 10-year survival rate was 100.0%, 81.6% and 65.3% for female patients, but it was 79.6%, 67.2% and 49.7% for male patients, respectively.
Alveolar soft part sarcoma usually grows slowly. Though local recurrence is rarely seen, distant metastasis is frequently observed. Lung is the most common organ of metastasis. However, survival can still be long even with lung metastasis. To achieve microscopically complete resection is quite critical to localized alveolar soft part sarcoma. No survival advantage was observed when adding adjuvant radiotherapy and/or chemotherapy. The phenomena of female patient or patient with X chromosome translocation showing better prognosis than the male or other patients needs further investigation.
Zhonghua zhong liu za zhi [Chinese journal of oncology] 11/2007; 29(10):778-80.
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ABSTRACT: Epithelioid sarcoma is a rare soft tissue sarcoma with a high propensity for aggressiveness, regional nodal spread, and distant metastases. This study was to investigate the clinical features, diagnosis, treatment, and prognosis of epithelioid sarcoma.
The clinical data of 14 patients with epithelioid sarcoma, admitted to our hospital from 1990 to 2005, were analyzed. All of the 14 patients received initial operations at other hospitals. Eleven patients received extensive excision (9 patients) or amputation (2 patients), and 4 of them also received local lymph node dissection at our hospital; 3 patients received another local excision or extensive excision at other hospitals again. Nine patients received adjuvant radiotherapy and 3 of them also received adjuvant chemotherapy.
All diagnoses of epithelioid sarcoma were confirmed by pathology. Of the 14 patients, 12 (85.7%) had local recurrence and 4 (28.6%) had local lymph node metastasis, 9 (64.3%) died within 3 years after initial operation. The overall 1-, 2-, 5-, 10-year survival rates were 71.43%, 55.56%, 27.78%, 13.89%, respectively.
The prognosis of epithelioid sarcoma is poor because of a high propensity for local recurrence, node metastases, and distant metastases. Extensive excision or radical excision combined local lymph node dissection is effective for epithelioid sarcoma.
Ai zheng = Aizheng = Chinese journal of cancer 08/2007; 26(7):782-4.
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ABSTRACT: To investigate the perioperative and early-term efficacy of bilateral total knee arthroplasty (BTKA) in one-stage procedure.
Totally 93 patients operated with BTKA in one-stage procedure from 2003 June to 2005 June were followed up and the curative effect was determined with Hospital for Special Surgery knee-rating system (HSS). The complications were then analyzed.
The mean postoperative HSS score was 89. 6 (55 approximately 96 scores) and the excellence/good rate reached 95. 7% (excellent in 74 cases, good in 15 cases, moderate in 2 cases, and poor in 2 cases). Except for the muscle power, the pain, joint function, range of joint movement (ROM) , deformity, and stability were significantly improved after operation (P < 0. 05). The average ROM of knee was improved to 99. 8 (75-135 ) degrees after operation from 88.9 (25-110) degrees before operation (P < 0. 01). Complications included deep vein thrombosis (n = 2) , incision fat liquidation (n = 2) , deep infection ( n = 1) , urinary infection ( n = 1) , and peroneal nerve palsy (n = 1). No death was documented.
Bilateral total knee arthroplasty in one-stage procedure under secure conditions can be performed with good outcomes in selected patients without a definite increase in perioperative risk.
Zhongguo yi xue ke xue yuan xue bao. Acta Academiae Medicinae Sinicae 12/2006; 28(6):808-12.
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ABSTRACT: To construct a subtractive cDNA library from the spinal facets of adolescent idiopathic scoliosis (AIS) patient with suppression subtractive hybridization (SSH) technique and clone differentially expressed genes related to AIS in spinal facet.
mRNA was isolated separately from the convex side and concave side apical facets of an adolescent idiopathic scoliosis patient. Moreover, single-strand (ss) and double-strand (ds) cDNAs were synthesized in turn using SMART PCR cDNA synthesis technology. (ds) cDNAs then were digested with Rsa I and divided into two groups, and ligated to the specific adaptor 1 and adaptor 2R, respectively. After cDNAs were hybridized with each other twice and underwent two rounds of nested PCR, the PCR products were ligated with pDrive Cloning Vectors to set up the subtractive library. Sequence analysis was performed and the acquired data were aligned against the GeneBank nucleotide database. Furthermore, the spinal facets of 11 IS patients were collected. The techniques of immunohistochemistry and in situ hybridization were adopted in order to approve the gene expression difference. The images of immunohistochemistry and in situ hybridization were input to the image analysis system and were analyzed semi-quantitatively.
A cDNA subtractive library of AIS in spinal facet was set up successfully with high subtractive efficiency. Beta2 Microglobulin (beta 2M) and calgranulin A (S100A8) were identified as highly differentially expressed genes in this study.
All results confirm the effectiveness and sensitivity of SSH in detecting differentially expressed genes from a small amount of clinical samples. Information about such alterations in gene expression can be useful for elucidating the genetic events in the development of AIS.
Zhonghua yi xue za zhi 10/2006; 86(33):2328-33.
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ABSTRACT: To investigate the expression of calmodulin in the articular process of vertebrae of adolescent idiopathic scoliosis (AIS) patients and congenital scoliosis (CS) patients and its possible effects on the pathogenesis of AIS.
Nine AIS patients aged 13 - 17, and 10 patients of CS, aged 11 - 18, underwent orthopedic surgery. Specimens of the inferior articular process from the apical vertebrae and upper end vertebrae discarded during operation were collected from the AIS patients and specimens of the. Inferior articular process from the upper end vertebrae wee collected from the CS patients. Immunohistochemistry was used to detect the protein expression of calmodulin, and in situ hybridization was adopted to examine the mRNA expression of calmodulin.
Calmodulin were expressed in the bone cells. There was no difference between the expression of calmodulin at the concave side and convex side, or between the apical vertebrae and end vertebrae. The expression of calmodulin of the AIS group was significant lower than that of the CS group (P < 0.05). The result of immunohistochemistry and that of in situ hybridization corresponded with each other.
The expression of calmodulin in the articular process of vertebrae of AIS patients is low, suggesting that it plays a role in the development and progression of AIS.
Zhonghua yi xue za zhi 08/2006; 86(29):2017-20.
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ABSTRACT: To explore the causes, methods and outcomes of reoperative treatment after lumbar disc surgery.
Nine hundred and twenty eight patients with lumbar disc herniation were treated surgically from January 1995 to January 2004, of whom 43 patients (4.6%) underwent reoperation due to persistent pain or recurrence of symptoms. Forty patients were followed up from 3 months to 84 months (mean 30 months).
According to Macnab's criteria, outcomes were excellent in 11 cases (27.5%), good in 16 cases (40%), fair in 8 cases (20%), and poor in 5 cases (12.5%).
The major causes of reoperation after lumbar disc surgery included incomplete removal of herniating discs and recurrent disc herniation of primary interspace, secondary lumbar canal stenosis, and adhesion of nerve roots. Prior to primary surgical treatment of lumbar disc herniation, operative indications must be strictly accurate, surgical methods should be correctly selected, and improved and refined surgical skills should be guaranteed. Satisfactory outcomes can be gained with reoperation for patients who still requiring treatment.
Zhongguo yi xue ke xue yuan xue bao. Acta Academiae Medicinae Sinicae 05/2005; 27(2):160-4.
