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Objective:To investigate the impact of the clinicopathological characteristics of anorectal malignant melanoma (ARMM) on the prognosis.Methods:The clinicopathological data of 40 ARMM patients undergoing surgery at the Department of Colorectal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences from Apr 2012 to Apr 2022 were collected, and the impact of different clinicopathological factors and treatment modalities on the overall survival of ARMM patients was investigated using Kaplan-Meier survival analysis and multifactorial Cox proportional risk model analysis.Results:Among 40 ARMM patients , 16 were male and 24 were female. The median age of onset was 61 yr. The median follow-up period for all patients was 47 (25-69) months, with a median survival of 19 (15-23) months and 1-year and 3-year survival rates of 74.3% and 21.7%, respectively. There was no statistically significant difference in survival time between the two groups of patients receiving wide local excision and abdominoperineal resection( χ2=1.281, P=0.258). Univariate analysis showed that overall survival in patients with ARMM was related to tumour diameter, depth of infiltration, specimen margin and lymph node metastasis ( χ2=1.281, P=0.039; χ2=3.760, P=0.042; χ2=6.581, P=0.010; χ2=21.683, P<0.001), and multivariate analysis suggested that lymph node metastasis was an independent risk factor for overall survival in patients with ARMM. Conclusion:Tumour diameter, depth of infiltration, specimen margin and lymph node metastasis were important prognostic influences in ARMM, and lymph node metastasis was an independent risk factor for overall survival in ARMM patients.
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BACKGROUND: Because of the non-homology of protein and gene between human and animals, to promote osteogenesis or spinal fusion of animals by construction of tissue-engineered bone with the human gene has influenced the experimental validation.OBJECTIVE: To construct the seed cell line for bone tissue engineering with stable expression of human bone morphogenetic protein 2 (hBMP2).METHODS: The full-length hBMP2 gene was cloned from human muscle tissues by nested RT-PCR and transfected to human bone marrow mesenchymal stem cells (hBMSCs) with lipidosome. The transfected hBMSCs were cultured with G418 in vitro to screen and purify the cells. A series of analyses such as RT-PCR, dot-ELISA, immunohistochemstry and alkaline phosphatase activity analysis were performed to evaluate the situation of hBMP2 expression and secretion at 48 hours and 3 weeks after the transduction. hBMSCs transduced with empty plasmid and the normal hBMSCs served as positive control and blank control groups, respectively, which were used for observation of cell growth, proliferation and biological characteristics of transfected cells. RESULTS AND CONCLUSION: The transfected hBMSCs appeared in small groups or clusters, and had a good proliferation after subculture in vitro. Some G418-resistance cell clones and calcium nodules were found when cultured with G418 in vitro. No significant difference was noted in the cell proliferation between the hBMP2 transfection group and two control groups. The ALP activity in the hBMP2 transfection group remained significantly higher than that in the two control groups (P < 0.01). At 48 hours and 3 weeks after transduction, hBMSCs could express actively hBMP2 by RT-PCR monitoring, and had a positive reaction of dot-ELISA and immunohistochemical analysis. The expression of hBMP2 gene in the experiment group at 48 hours was significantly higher than that at 3 weeks after transduction while there was no expression of hBMP2 gene in the two control groups. The above results show that the hBMSCs transfected by hBMP2 gene not only have potentials of normal proliferation and osteogenic differentiation, but also can stably express hBMP2.
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The present study retrospectively analyzed 13 patients with fibrous dysplasia of the adult proximal femur who received treatment at the Department of Orthopedics,Shenzhen Hospital,Peking University between March 2000 and June 2006.These patients comprised 6 males and 7 females,with an age of 21-35 years.Among 11 patients suffering from mild hip pain,6 presented with mild limping due to worsened pains,and 2 exhibited obvious manifestations of bone fracture.All patients underwent X-ray,CT examinations,and 3 were subjected to MRI examinations,prior to bone grafting and internal fixation.Monostotic lesion was observed in 10 patients and polystotic lesion in 3 patients,but endocrine disturbance was not observed in any patient.Nine patients suffered from lesions in the femoral neck and 4 from lesions in the femoral rotator.Curettage,autogenous and allogeneic bone grafting,and internal fixation with dynamic hip screws and proximal femoral nails were successfully performed in each patient.Internal fixation time averaged 165 minutes (range 120-210 minutes).During the early stage after surgery,weight-bearing activities were not permitted.Bone fracture healed after an average of 3 months.Eighteen to forty-eight months of follow-up demonstrated that clinical symptoms were relieved,with good hip joint function and basically normal gait.X-ray plains showed thickened cortical bone,as well as compacted ossification shadow in bone grafting region.In addition,partial bone absorption,but not recurrent clinically,was observed in 4 patients.These findings imply that thorough curettage,autogenous and allogeneic bone grafting,and internal fixation with dynamic hip screws and proximal femoral nails is a reliable method to treat fibrous dysplasia of the adult proximal femur and it can acquire satisfactory curative effects.
ABSTRACT
The bioactive materials, such as biological glass, hydroxyl apatite, glass ceramics which contains the hydroxyl apatite and wollastonite, are possible to unify with the bone tissue together. However, many questions like whether the materials contact and unify directly with the bone, whether the speeds of unification have the differences, and whether materials themselves simultaneously have abilities to promote the bone formation are not clear and wait for the exposition. The researches have been made to observe the contact surface between biological material and bone, as well as the relationship among the apatite level and the bioactivity of materials through the transmission electron microscopy. In addition, in vivo hybridization has been used to discuss the mRNA expression and its influence in the cell around materials. The conclusion is that the bioactivity of glass ceramics is higher than that of hydroxyl apatite, with the easy unification with bone tissue.