ABSTRACT
Objective:To evaluate the therapeutic effect and safety of microwave ablation plus curettage.Methods:Clinical data of a single group of 12 patients admitted to our hospital from June 2015 to June 2019 who underwent microwave ablation for bone metastasis were retrospectively analyzed. There were 7 males and 5 females, with an average age of 59.5±10.1 (range from 43 to 79) years old. Curettage plus bone cement after microwave ablation was performedand when the lesion involved the sacroiliac joint surface and impaired the bearing arch, the internal fixation was performed with plate and screws. 8 among the 12 patients underwent curettage, bone cement and metal internal fixation after microwave ablation. After microwave ablation, and 4 patients underwent curettage and reconstruction with bone cement alone. The patients were followed up aftersurgery. The observational indicators included: patient survival rate, local recurrence rate, perioperative complications, Operation time, intraoperative blood loss, VAS score, SF-36 score, and MSTS function score. VAS scores and SF-36 scores were recorded before surgery, 1 week after surgery and 3 months after surgery.Results:12 patients were followed up for 4-27 months, with an average follow-up time of 14.2 months and a median follow-up time of 9 months. During the follow-up, 7 patients died and 5 survived, with a 6-month survival rate of 81.8%, a 1-year survival rate of 40.9% and a 2-year survival rate of 27.3%. The mean survival time of the dying patients was 8.8 months (5-18 months), and the median survival time was 7 months. Operation time was 101±21 min and intraoperative blood loss was 295±108 ml. During the follow-up period, local recurrence rate was 8.3% (1/12), and the average postoperative time to recurrence was 4 months. There were no complications such as wound nonunion, wound infection, deep infection, vascular nerve heat injury and internal fixation failure. VAS score before surgery was 7.5 (7, 8) points, VAS score 1 week after surgery was 5 (4, 5) points, and VAS score 3 months after surgery was 5 (4, 5.75) points ( P<0.05). Preoperative SF-36 score was 23 (21, 24.75) points, 1 week after surgery SF-36 score was 47 (46, 54) points, and 3 months after surgery SF-36 score was 50.5 (47, 55.25) points ( P<0.05). 3 months after the operation, the MSTS score was 20.5 (16.25, 21.75) points, of which excellent 16.7% (2/12), good 50% (6/12), medium 16.7% (2/12), poor 16.7% (2/12), and the overall excellent and good rate was 66.7% (8/12). Conclusion:Microwave ablation plus curettage for pelvic metastasis of malignant tumor can significantly relieve local pain, rebuild limb function and improve patients' quality of life, and it`s an alternative treatment for pelvic metastases.
ABSTRACT
Combined effects of ?-chlorohydrin and glycidol on the ultrastructure of theinitial segment and the tail region of the rat epididymis have been studied by ultra-thin sections under electronmicroscope.Individual effects of the both drugs on thesame tissues were also examined simultaneously.The major results are as follows.1.Numbers of swollen and degenerated mitochondria were observed in principalcells,clear cells,apical cells and basal cells of epididymal epithelium,as well as insmooth muscle cells of the ductus epididymidis and in endothelial cells of the capil-laries in epididymal interstitium during a period of 3～30 days after administrationof low dose of ?-chlorohydrin combined with glycidol(5 mg ?-chlorohydrin plus75mg glycidol/kg/day?2),which previously has been proved to be effective inmale rat antifertility.Additionally,Golgi vacuoles,pinocytotic vesicles,multivesicularbodies,stereocilia and smooth endoplasmic reticulum in the apical cytoplasm of someprincipal cells occasionally were found to decrease in number.No Morphologicalchanges of the nuclei were found in these affected cells.The number of morphologi-cally unchanged mitochondria appears to become more with extended time after drugswithdrawal.2.In the group treated with the large combined dose of the drugs(20 mg ?-chlorohydrin plus 100 mg glycidol/kg/day?2),apart from the changes mentionedabove,necrosis and exfoliation of some epididymal epithelial cells could be found.Some lesions of the sperm,such as the destruction of the cytoplasmic membrane,swelling of mitochondria and pyknosis of nucleus were present in a few specimenstaken from this group.3.Effects similiar to that of the combined use of the drugs were also found ingroups using ?-chlorohydrin or glycidol alone,but a less degree of lesions revealed.These observations suggested that the antifertile effects of ?-chlorohydrin andglycidol either used in combination or alone could result injury of mitochondria inepididymal epithelial cells,which should lead to the decrease of the function ofepididymis,hence to interfere with the maturation of the sperm in it.