ABSTRACT
Objective To explore the effect and safety of CT-guided percutaneous splanchnic nerves block in treatment of advanced pancreatic cancer pain. Methods Thirty patients with advanced pancreatic cancer pain were treated with CT-guided percutaneous splanchnic nerves block. The complications, such as pneumothorax, intractable hypotension, diarrhea, during operation and hospitalization were evaluated using CTCAE v3.0 grading system, and the clinical efficacy was evaluated 1 week after operation. Visual analogue pain scale (VAS) and daily dosage of morphine were assessed before operation and 1 week, 1 month and 3 months after operation, respectively. Results Percutaneous splanchnic nerves block were successfully completed in all 30 patients without pneumothorax, intractable hypotension or arrhythmia during operation and hospitalization. or Ⅱ diarrhea occurred in 6 cases and then cured after symptomatic treatment. There were 5 cases of clinical cure, 21 cases of obvious effect, 4 cases of effective effect 1 week after operation. Postoperative pain relief more than 50% was observed in 26 patients (26/30, 86.67%). VAS and daily dosage of morphine were significantly reduced at 1 week, 1 month and 3 months after treatment compared with those pre-operation (all P<0.05). And VAS at 3 months after treatment was higher than that at 1 week after treatment. Conclusion CT-guided percutaneous splanchnic nerves block has definite efficacy and high safety in treatment of advanced pancreatic cancer pain.
ABSTRACT
In recent years, conventional targeting of chemotherapeutic drugs on colorectal tumor tissue is poor in the clinical application. Due to the multidrug resistance of colorectal tumors, penetration and cytotoxicity of conventional drugs greatly reduced on tumor tissue. With the advent of tumor-penetrating peptides, a new and highly effective antitumor drug delivery system has become a research topic of international scholars. This article will briefly describe the research progress of iRGD peptides with the modified nanomicelles drug delivery system on targeted drug delivery and resistance to drug-resistant colorectal tumors in recent years. These studies show that iRGD peptide-modified nanomicelles will be a highly potential anti-drug delivery system.
ABSTRACT
Objective Bone cement joint prosthetic aseptic loosening always occurs in the bone cement-bone interface, while the mechanical strength of the interface mainly depends on the microstructure and adhesive strength.The aim of this study was to ex-plore the bone microstructure and the cement bone interfacial biomechanics of osteoarthritis(OA) and rheumatoid arthritis(RA), and also discuss the correlation. Methods Twenty trabecular bone specimens of tibial plateaus were taken from OA and RA patients who underwent total knee arthroplasty( TKA) .The microstructural parameters of the trabecular bone specimens were measured by Skyscan1176 microcomputed tomography.The bone specimens were made into cementbone models, which were tested by INSTRON strength tester.The association of bone microstructure and interfacial shear stress was analyzed subsequently. Results ①Bone volume fraction ( BV/TV) ( r=-0.313) , trabecular thickness ( Tb.Th) ( r=-0.340) ,trabecular spacing ( Tb.Sp) ( r=0.345) of OA had obvious correlation to shear strength (P<0.05).The cement-bone interfacial strength of medial tibial plateaus[(87.45±52.50)N] was lower than lateral tibial plat-eaus[(177.25±71.11)N] of OA (P<0.05).②Bone volume fraction (BV/TV)(r=0.343), trabecular number (Tb.N)(r=0.391) of RA had obvious correlation to shear strength (P<0.001).The cement-bone interfacial strength of lateral tibial plateaus[(62.23±46.22) N] was lower than medial tibial plateaus[(79.20±56.37N)] of RA (P<0.05).③The interfacial strength of OA[(132.35±76.64)N] was higher than RA[(71.05±51.55)N] (P<0.05). Conclusion There are differences of microstructure between OA and RA, which lead to the distinction of strength of cement -bone interface.And it has a certain guiding role of analyzing the biomechanics in TKA.
ABSTRACT
Objective The periacetabular tumor has a low rate of incidence, but its special location poses a challenge to clinical treatment.The aim of this study was to discuss the methods, effects, and complications of surgical treatment of periacetabular tumors. Methods We retrospectively analyzed the clinical data of 36 cases of periacetabular tumor surgically treated in our depart-ment, including 21 males and 15 females, aged 15 to 64 (45.2 ±6.3) years.Among them, there were 8 cases of benign tumor (4 ca-ses of simple bone cyst, 1 case of desmoplastic fibromas, 1 case of osteofibrous dysplasia, and 2 cases of hemangioma) and 28 cases of malignant tumor (5 cases of osteosarcomas, 12 cases of chondrosarcomas, 2 cases of giant cell tumor of the bone, 1 case of malignant chondroblastoma, 2 cases of malignant fibrohistiocytoma, and 5 cases of metastatic tumor of the bone).The benign cases received sim-ple tumor resection plus bone graft and steel plate system internal fixation, while malignant cases underwent reconstruction by combined pedicle screw fixation system with bone cement. Results No patients died perioperatively and controllable complications occurred in 5 cases after operation.All the patients were followed up for 5 to 96 months except for 1 case of benign tumor.None of the benign cases experienced recurrence, and all of them achieved normal hip function.Lung metastases occurred in 10 malignant cases (4 cases of os-teosarcomas and 6 cases of chondrosarcomas) , who died of respiratory failure, and the other 18 remained tumor-free after surgery.Of the 2 patients with malignant fibrohistiocytoma, 1 died 2 years postoperatively and the other survived with tumor.Neither local recur-rence nor lung metastasis was found in the patients with chordoma and malignant chondroblastoma till the end of follow-up.The 5 pa-tients with metastases died within 3 years after operation.At 3 months after surgery, the Harris scores after total hip replacement were >90 in the 7 benign cases, 70-79 in 9 malignant cases, and <70 in the other 19 malignant cases. Conclusion For the treatment of malig-nant tumors, reconstruction by combined pedicle screw fixation system with bone cement does not affect the general daily activities of the pa-tients.Preoperative embolization of the internal iliac artery can reduce bleeding and improve operation safety, and measures should be taken to minimize postoperative complications.