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Objective:To investigate the efficacy of the nutrient vessel of medial and lateral sural subcutaneous nerve chimeric tissue flap based on posterior perforating branch of peroneal artery to repair the composite tissue defect in the Achilles tendon area.Methods:From January 2016 to June 2021, 12 patients suffering from infectious wound with defect of Achilles tendon were treated in the Department of Trauma and Microscopic Orthopaedics, 988th Hospital of the Joint Logistics Support Force of PLA. The area of soft tissue defect around Achilles tendon was 2.5 cm× 4.5 cm-8.0 cm×12.5 cm, and the length of the defect of Achilles tendon was 3.0-7.0 cm. The defect around the Achilles tendon were repaired with the nutrient vessel of medial and lateral sural subcutaneous nerve chimeric Achilles tendon flap (ATF) and the posterior perforating branch of peroneal artery was used as the vessel of blood supply. The size of flap was 3.0 cm×5.0 cm-9.0 cm×13.0 cm, and the size of the ATF was 3.0 cm×4.0 cm-3.0 cm×8.0 cm. The donor sites were sutured directly (8 cases) or repaired with skin graft (4 cases). External fixation were put on for 6 weeks after surgery. Then the external fixation was removed and the functional exercise gradually started. Outpatient clinic follow-ups were carried out regularly. Thermann Achilles tendon function assessment system was used to evaluate the last follow-up.Results:The chimeric ATF was harvested and the blood supply of each flap was good during the operation. There was no vascular crisis after surgery. The flaps survived smoothly and the wound achieved grade A healing. All patients were entered follow-up that lasted for 10-24 months. There was good appearance of flaps with minor bloating, and the colour of flaps was similar to the skin around the receiving site. The texture was soft with normal function of the lower legs and ankle. Tendon function was evaluated by Thermann Achilles tendon function assessment system, the result were 8 cases in excellent and 4 cases in good.Conclusion:The nutrient vessel of medial and lateral sural subcutaneous nerve chimeric tissue flap based on posterior perforating branch of peroneal artery can accurately repair a composite tissue defect in the Achilles tendon area, and it is one of the effective methods for the repair of a composite soft tissue wound with Achilles tendon defect.
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Objective:To evaluate the validity of adventitial collagen cross-linking by glutaraldehyde(GA) to reduce intimal hyperplasia of vein graft in a rabbit carotid artery bypass graft model.Methods:Harvesting 36 segments of the external jugular vein and 6 segments of the internal carotid artery with 3 cm length from the New Zealand white rabbits. The veins were randomly divided into 6 groups and underwent adventitial collagen cross-linking by 0.3% glutaraldehyde for 0 min, 1 min, 2 min, 3 min, 4 min, and 5 min, respectively. All vessel segments were subjected to biomechanical tests and pathological tests. Carotid artery bypass graft models were established in 24 New Zealand white rabbits including crosslinked group(n=12) and non-crosslinked group(n=12). The vein grafts were obtained for pathological examination 4 weeks after models feeding, and the intimal hyperplasia of vein graft was evaluated.Results:Adventitial cross-linking increased fiber density of adventitia significantly, and increased the stiffness of the veins as the time of cross-linking increased. And in the high strain region(strain ratio 1.4-1.8), the mechanical curve of veins receiving 3min cross-linking was similar to that of the carotid artery. The patent rate of the vein grafts of rabbit models was 100% after 4 weeks. Comparing with non-crosslinked group, the intimal and medial thickness of vein grafts in crosslinked group were reduced remarkably[(78.83±9.02)μm vs.(140.19±19.90)μm, (43.75±5.05)μm vs.(58.35 ± 8.61) μm, P<0.01). Conclusion:Adventitial collagen cross-linking by GA can enhance the mechanical strength of the jugular vein, and reduce the intimal hyperplasia of the jugular vein grafts in rabbit models.
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Objective To investigate the pathogenesis of type-B aortic dissection by using morphological analysis and computational fluid dynamics (CFD) method, so as to provide evidence for the effective prediction of type-B aortic dissection. Methods Six primary type-B dissection cases scanned by CT (dissection group) and six normal cases applied to black-blood MRI (control group) were included in this study and patient-specific three-dimensional (3D) models of aorta were established through image segmentation and 3D reconstruction. The pre-type-B dissection aortas were constructed by applying the scaling algorithm to shrink the dissection and then compared with subjects in control group. The differences between morphological parameters and hemodynamic parameters of the two groups were compared. Results Compared with the normal cases, the area of the descending aorta increased dramatically in dissection group ［(892.03±263.78) mm2 vs (523.67±64.10) mm2, P=0.036］. A significant decrease in angle of the left subclavian artery occurred (66.62°±20.11° vs 100.40°±15.35°, P=0.036). The tortuosity of the aorta also had an obvious increase (0.37°±0.07° vs 0.21°±0.51°, P=0.011). The time-averaged wall shear stress (TAWSS) in dissection group was obviously higher than that in control group; the flow in the dissection region was vortex flow at low speed and the oscillating shear index (OSI) was higher. Conclusions The results of this study can be used to provide guidance for the early diagnosis and treatment of type-B aortic dissection.
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Objective:To reconstruct and repair forearm and foot injuries with soft tissue defect using medial sural artery perforator flap (MSAP), and to evaluate the curative effects.Method:From May, 2015 to September, 2017, 13 patients (9 males and 4 females) with soft tissue defect on forearm and foot underwent MSAP reconstruction operations. The age was ranged from 19 to 57 (mean 41) years. Six wounds located in forearms and 7 in foot. Ipsilater- al shank was used as donor for the repair of foot. The donor sites were directly sutured. The area of flaps was ranged from 3.0 cm×4.0 cm-7.0 cm×15.0 cm. All cases were followed-up for flap appearance, sensation and donor healing by visit of clinic and WeChat reviews.Results:All 13 flaps survived well without any vascular crisis nor necrosis. Postoperative superficial infections were found in 3 cases, and the wound healed gradually after daily dress changing and anti-infection treatment. Eleven patients were followed-up for 4 to 18 months (average 12 months). Two provincial patients lost to follow-up. No obvious disfunction was found from the donor shanks. The appearance and texture of flaps were in excellent condition and satisfactory. The sensation of 7 flaps was recovered to S 2-S 3. TPD was 6-9 mm. Conclusion:The free MSAP is rational therapeutic strategy for repairing the soft tissue defect of forearm and foot. It has advantages of long vascular pedicle, constant perforation and relatively thin subcutaneous fat.
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Objective To investigate the treatment and prognosis of spinal giant cell tumors recurrence after total spondylectomy.Methods Between February 2001 and February 2016,five female patients suffered from spinal giant cell tumors recurrence after total spondylectomy were retrospectively analyzed.They underwent total spondylectomy with an age ranging from 17 to 63 years old (average 32.6 years).Four cases were primary cases and 1 was recurrent case at the first time of visit.Tumors were located in the thoracic vertebrae in 3 cases,including 1 case in T10 and 2 cases in T11.Tumors were involved in lumbar vertebrae in 2 cases,which were L2 and L5,respectively.According to Tomita spinal tumor classification,all cases were type 5.The Frankel classification for spinal cord injury was grade A in 1 case,grade C in 1 case,grade D in 1 case and grade E in 2 cases.Reoperation was introduced to treat the recurrent tumors after total spondylectomy with adjuvant radiotherapy and drug.The effect of tumor therapy,postoperative complications,nerve function and so on were observed in follow-up.Results One patient was treated with total en bloc spondylectomy (TES) and 4 patients was treated with piecemeal total spondylectomy.The operative approach was onestage posterior approach in 4 patients and combined antero-posterior approach in 1 patient.One patient received radiotherapy and 1 patient was treated with bisphosphonate post operation.The spinal cord function recovered to grade D in 1 patient and grade E in 4 patients.The average interval of recurrence after total spondylectomy was 12-57 months (average 29.6 months).At the second visit,the Frankel classification was grade C in 1 patient.Grade D and grade E were in 2 patients,respectively.Three patients were treated with reoperation to resect the tumors.One patient received radiotherapy and another one was untreated.All 5 patients were followed up with 47-196 months (average 108 months).Four patients survived without tumor and 1 patient without treatment for recurrence survived with tumor.Two patients occurred internal fixation fractures were treated with revision surgery.One of the patients had postoperative spinal canal infection and was cured after internal fixation removal,irrigating and drainage,and antibiotic treatment.The loosening screw in 1 patient was fixed again.Two patients suffered from obvious titanium mesh subsidence (＞ 5 mm).In the last follow-up,there were 1 patients with Frankel grade A,1 with grade D and 3 with grade E.Conclusion Active reoperation combined with radiotherapy and drugs therapy can significantly improve the prognosis of patients with recurrent spinal giant cell tumors after total spondylecmy.
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Objecitve To evaluate the impact of adding methotrexate into DIA chemotherapy regimen (cisplatin,therarubicin and ifosfamide) on 3-year disease-free and overall survival of patients with ⅡB osteosarcoma in extremities.Methods Retrospectively analyzed 34 cases of ⅡB limb osteosarcoma according to the Musculoskeletal Tumor Society (MSTS) surgical staging system with pathologically diagnosed concurrent chemotherapy and comprehensive surgical treatment from May 2008 to April 2014.There were 20 males and 14 females,with an average age of 19.5±7.7 years (ranged from 9 to 44 years).28 patients underwent limb salvage surgery,and 6 patients received amputation.Tumor site included distal femur in 21 patients,proximal tibia in 9 patients,other sites in 4 patients.Seventeen patients underwent cisplatin,THP and ifosfamide (DIA) regimen of chemotherapy.The other 17 patients underwent cisplatin,THP,ifosfamide and methotrexate (MDIA) regimen.Patients charts were reviewed to get demographic data including age,gender,site,tumor size,surgery type,chemotherapy regimen,alkaline phosphatase,lactase dehydrogenase.The prognostic value of these factors on 3 years disease free survival and overall survival were calculated with KaplanMeier method and compared with Log-Rank test between different groups in univariate comparison and COX model for multivariate analysis was used to determine whether these demographic factors are independent prognostic factor for survival Results Two patients had local recurrence,7 patients had metastasis,and 2 patients had both local recurrence and metastasis..The 3-year survival of the whole group was 67.6％ (23/34).Seven patients died during follow-up.The overall survival was 79.4％ (27/34).The 3 -year disease-free survival in DIA group and MDIA group was 70.6％ (12/17) and 64.7％ (11/17),respectively.The 3-year overall survival was 82.4％ (14/17) and 76.5％ (13/17) in DIA group and MDIA group,respectively.Univariate analysis showed that there was no significant difference in either 3-year disease-free survival (x2=0.113,P=0.737) or overall survival (x2=0.197,P=0.657) between DIA and MDIA.Age was significantly correlated with prognostic in univariate analysis (x2=5.869,P=O.015),while gender,tumor site,tumor size,surgery type,ALP,LDH was not correlated with disease-free survival.Kaplan-meier analysis with LogRank test showed age (x2=6.134,P=O.013) and tumor size (x2=5.108,P=0.024) were statistically correlated with overall survival.Multivariate analysis with COX model showed that chemotherapy regimen was not an independent prognostic factor for 3-year disease-free survival or overall survival.Age was an independent prognostic factor for 3-year disease-free survival (HR=5.836,P=0.017).Conclusion The addition of MTX on the basis of DIA chemotherapy regimen did not significantly improve the 3-year disease-free survival and overall survival of stage ⅡB limb osteosarcoma.
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Objective: To observe the effect of moxibustion on the expressions of tumor necrosis factor-α (TNF-α) and nuclear transcription factor kappa B (NF-κB) proteins in ankle joints of rats with rheumatoid arthritis (RA), and to explore the anti-inflammatory mechanism of moxibustion in the treatment of RA.Methods: Adjuvant arthritis (AA) rat models were induced and used as rat models of RA. Rats were randomly divided into a normal group, a model group, a moxibustion group and a saline group. Rats in the normal and model groups were not treated; rats in the moxibustion group accepted treatment by moxibustion at Zusanli (ST 36) and Shenshu (BL 23) after modeling; rats in the saline group were injected with 0.15 mL saline to the bottom of the left hind paw and had no other treatments. Hematoxylin-eosin (HE) staining was used to observe the histopathological changes of rats' ankle joints under light microscope. Immunohistochemistry was used to observe the expressions of TNF-α and NF-κB in ankle joints of rats.Results: Compared with the normal group, the rats' ankle joints in the model group showed disorganization, joint surface defect, and significantly increased mean optical density (MOD) of TNF-α and NF-κB (allP<0.05). After moxibustion treatment, rats in the moxibustion group showed repaired ankle tissues, smooth joint surface without defects, decreased MOD of TNF-α and NF-κB than those in the model group (allP<0.05). Rats in the saline group had no damage to ankle joints, while TNF-α and NF-κB were significantly different from those in the model group (P<0.05).Conclusion: Moxibustion could down-regulate the expressions of NF-κB and TNF-α protein in ankle joints of RA rats, and produce an anti-inflammatory effect to promote tissue repair.
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Objective@#To investigate the clinicopathologic and prognostic features of Claudin-low breast cancers (CLBC).@*Methods@#Tissue microarray sections were scored semiquantitatively for the immunohistochemical expression of claudin-1, -3, -4, -7 and -8 in 233 cases of invasive breast cancers collected from Qingdao Central Hospital from January 2010 to December 2011.@*Results@#The expression rate of Claudin-3 (72/212, 33.9%) and -4 (56/212, 45.2%) was most similar, and Claudin-4 showed the highest expression. Twenty one cases (21/212, 9.0%) were diagnosed as CLBC, with triple-negative breast cancer (TNBC) accounted for the highest proportion (11/21, 52.4%). Among the CLBC cases, the invasive carcinoma no special type (66.7%, 14/21) and metaplastic carcinoma (14.3%, 3/21) were mostly seen, while metaplastic squamous carcinoma did not show Claudin-low pattern. Compared to the non CLBC in this cohort, CLBC had higher proportion of histologic grade 3 and tumors larger than 2 cm, and the proportions were slightly lower than TNBC. Patients with CLBC had lower 5 year disease-free(P>0.05) and overall survival rates(P=0.018).@*Conclusion@#CLBC shows distinct clinicopathologic and prognostic features comparing to other subtypes, and is associated with poor prognosis.
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Objective To introduce a new method of limited revision for the extramedullary stem fracture of the custommade tumor prostheses and evaluate its clinical effect.Methods There were 3 patients with extramedullary stem fracture after custom-made tumor prostheses replacement,2 male and 1 female.The age was 25,51 and 52 years old respectively.The pathological diagnosis and involved locations were osteosarcoma of distal femur,recurrent giant cell tumor of distal femur,and chondrosarcoma of proximal femur.The interval between replacement operation and extramedullary stem fracture were 11 months,34 months and 28 months respectively.The fracture occurred when they were walking without obvious history of trauma.The fracture sites located at the conjunction of the extramedullary stems in distal femoral prostheses and femoral neck basis in proximal femoral prosthesis.According to the firm fixation of the intramedullary stem and the enough length of the residual extramedullary stem,the revision prosthesis for limited revision operation was designed in order to avoid removing the firmly fixed intramedullary stem and bone cement which is very difficult.The revision prosthesis consists of sleeve part and joint part with the same material as former prosthesis,which is sleeved to the residual extramedullary stem and fixed by bone cement and interference screws in limited revision operation.The wearing fittings were replaced at the same time.Patients took regularly functional exercises postoperatively.The stability of revision prosthesis and the function of the involved limbs were observed in follow-up.Results The reasons of prosthesis fracture were fatigue fractures at the conjunction of extramedullary stem in one distal femur prosthesis,at the basis of femoral neck in one proximal femur prosthesis and conjunction loosening and locked screw breakage in the other distal femur prosthesis.The follow-up times were 1 month,103 months and 1 10 months respectively.One patient with giant cell tumor underwent tumor resection due to tumor recurrence in soft tissue.The revision prostheses were fixed firmly without loosening.According the MSTS scoring system,the scores of involved extremities function were 66.7％、86.7％ and 83.3％ respectively.Conclusion The fracture of custom-made tumor prosthesis could occur due to metal fatigue and conjunction failure.The newly designed revision prosthesis allows a limited revision operation with preserving the firmly fixed intramedullary stem,which reduces the difficulty of operation and makes the recovery of the limb function as soon as possible.
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Objective To investigate technique of reservation and reconstruction of the extensor mechanism in extraarticular total knee resection.Methods There were 6 cases of fresh total knee joint specimen for anatomical observation.After meglumine diatrizoate was injected into the joint capsule and the deep infrapatellar bursa,the CT examination of the knee specimen was performed.The specimens were detached according to the requirement of extraarticular knee resection,after methylene blue was injected into the joints capsule.The relationships between articular capsule,infrapatellar fat pad and deep infrapatellar bursa were observed,as well as feasibility of extraarticular total knee resection.Four patients with malignant bone tumor around the knee were performed extraarticalar total knee resection.The patellar ligament was reserved completely in 2 patients whose infrapatellar fat pads were not be involved by tumor confirmed by deep infrapatellar bursa radiography.However,the patellar ligament was split along the coronal plane in 2patients who had not undergone deep infrapatellar bursa radiography.The patients were followed up to observe results of tumor control and function of the affected knees.Results Through anatomical observation,some bursas around the knee joints,such as the suprapatellar bursa and popliteal bursa,communicated with the joint cavity,while the deep infrapatellar bursa did not.Furthermore,the infrapatellar fat pad located between the patellar tendon and joint cavity to form a good barrier to tumor invasion.So the patellar tendon could be reserved completely if the infrapatellar fat pad was not involved.Four patients were followed up for 10 to 28 months (average,19 months).At final follow-up,there was no local recurrence and metastasis in all 4 patients.The range of flexion of the affected knees ranged from 95° to 118 ° (average,105 °),and the average extension lag was 22 ° (range,10° to 40 °).The MSTS score was 72.5％.Conclusion For patients with malignant bone tumor involving the knee,the deep infrapatellar bursa radiography should be performed routinely.The patellar ligament could be reserved completely in the extraarticular total knee resection when the deep infrapatellar bursa doesn't communicate with the joint cavity combined with presence of the infrapatellar fat pad.Sometimes,only reserving the superficial half of the patellar ligament also could meet the need of extension.The short-term result of tumor control and function of the affected knee are satisfactory.
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Acetylcholinesterase (AChE) plays a key role in the pesticide determination. However, the extraction of AChE from natural materials has the disadvantages of low yield, complex purification and poor stability. Therefore, the preparation of recombinant AChE with high performance becomes the hot topic of researchers in recent years. In this article we summarize the progress in the expression of recombinant AChE and the improvement of its analytical characteristic. Finally, we point out that the directed evolution strategy combined with surface display technology is the future trend on improving recombinant AChE activity.
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Acetylcholinesterase , Chemistry , Genetics , Baculoviridae , Genetics , Metabolism , Cell Surface Display Techniques , Cholinesterase Inhibitors , Evolution, Molecular , Genetic Vectors , Genetics , Pesticide Residues , Pichia , Genetics , Metabolism , Recombinant Proteins , GeneticsABSTRACT
Objective To investigate the spinal stability reconstruction and related complications after total spondylectomy for thoracolumbar tumors. Methods From January 1997 to December 2009, 34 cases with thoracolumbar tumors treated with total spondylectomy, including 20 males and 14 females with an average age of 43 years. The tumors were located in thoracic vertebra in 27 cases and lumbar vertebra in 7, including 6 spinal metastases and 28 primary tumors. The total spondylectomy was piecemeal in 23 cases and en bloc in 11. The reconstruction methods included posterior short-segment fixation in 19 cases, multi-segmental fixation in 13, anterior intervertebral fixation in 2, titanium mesh with auto-bone graft in 20 cases, titanium mesh with bone cement in 7, bone cement filling in 2, auto-bone strut graft in 2, titanium mesh with strengthened rings in 1, artificial vertebral body replacement in 2, posterior massive bone bridging graft in 8 and bone particles graft in 26. Results The mean follow-up time was 43 months. Seven patients died, 5 suffered recurrence. Poor grafted bone fusion was found in 5 cases. The intervertebral sagittal Cobb angle of adjacent vertebra was ??after operation, 9.3?at the end of follow-up or before revision operation. The average lost angle was 14.1?for cases with multi-segmental fixation, and 21.5?with short-segment fixation. Complications included internal fixation broken (5) and loosening (2), titanium mesh subsidence (6) and displacement (3). There were 5 revision surgeries. Conclusion There are relative more complications about spinal stability reconstruction after total spondylectomy. To achieve temporary stiff fixation and long-term fusion, the posterior multi-segment fixation and massive bone bridging graft combined with the anterior artificial vertebral body replacement are effective.
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Objective To retrospectively investigate the endoprosthetic survival and complications after custom-made tumor prosthesis replacement of knee joint.Methods From April 1996 to April 2007,85 patients with bone tumors around knee joints undergoing custom-prosthetic replacement were respectively analyzed,including 54 males and 31 females with an average of 31.33±15.3 years(range,11-72).The diagnoses were osteosarcoma(43 patients),giant cell tumor(31),chondrosarcoma(4),metastatic tumor(3),malignant fibrohistiocytoma(2),Ewing sarcoma(1),and fibrosarcoma(1).The distal femar was affected in 43 patients and the proximal tibia in 42.All patients in this group underwent wide resection and domestic custommade cemented endoprosthetic reconstruction.Results Mean following was 45.8 months.The overall complication rate was 27.1%(23/85),which was 25.6% in distal femar and 28.6% in proximal tibia.Thirteen complications occurred within 3 years after definite surgery,3 in 3-5 years,and 7 over 5 years.All of 6 operation-relation complications(wound dehiscence,periprosthetic infection,peroneal nerve injury,etc) occurred within 3 years.Seven prosthetic-related complications(prosthetic loosening or breaking,dislocation,periprosthetic fracture,etc)occurred within 3 years,3 occurred in 3-5 years,and 7 over 5 years after definite surgery.The overall endoprosthetic cumulative survival rate was 79.4%,67.7%and 62.3% after 3,5 and 7 years,respectively;which was 86.6%,79.2% and 73.5% in distal femur;66.1%,53.7% and 48.8% in proximal tibia.Conclusion All operation-related complications occurred within 3 years,prosthesis-related complications occurred mainly within 3 years and over 5 years postoperatively.Prosthesis-related complications could occur iu the early stage after using domestic custom-made prosthesis reconstruction.
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Objective To investigate the possible influence of Lewis B expression in Helicobacter pylori (H.pylori) on bacterial adhesion property, and determine the relationship between babA 2 gene in H.pylori and peptic ulcer. Methods The bacterial adhesion property in a total of 78 H.pylori strains was performed using adherence assay in vitro, and the frequency of babA 2 gene was determined by polymerase chain reaction (PCR). Results Among 47 H.pylori strains isolated from peptic ulcer patients, 18 (38.3%) were positive for babA 2 gene, while babA 2 was positive in 14 (45.2%) of 31 strains isolated from non ulcer dyspepsia patients ( P =0.427). Among 31 H.pylori strains expressing Lewis B, 24 (77.4%) were positive for adherence assay, compared with 38 (80.9%) of 47 H.pylori strains without expression of Lewis B ( P =0.463). Conclusions (1) There is no association between babA 2 status in H.pylori strain and peptic ulcer in our population; (2) The expression of Lewis B in H.pylori does not interfere with bacterial adhesion property, and thus supports that the gastric epithelium is the receptor for Lewis B of H.pylori.
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Objective To study the characteristics of 31P-MR spectroscopy(31P-MRS) of benign and malignant bone and soft tissue tumors at 3.0 Tesla MR scanner.Methods 41 patients with bone and soft tissue tumors confirmed pathologically were examined with31P-MRS at 3.0 Testa MR scanner using phosphorus surface coil.The areas under the peaks of various metabolites in spectra were measured.The ratios of the other metabolites to ?-ATP,NTP and phosphocreatine(Pcr) were calculated.Intercellular pH was calculated according to the chemical shift change of inorganic phosphours(Pi) relative to Pcr.Acoording the area under the peak,the ratios of other metabolite including phosphomonoester(PME)/?-ATP,phosphodiester(PDE)/?-ATP,?-ATP/Pi,PME/NTP,PDE/NTP,Pcr/Pi and Pcr/PME related to ?-ATP,NTP(NTP=ATP+Pi+Pcr) and Pcr were calculated and dealt with SPS11.5 for Windows software package statistically through the nonparameter test of several independent samples.Results The ratios of Pcr/PME and PME/NTP in benign and malignant tumors were significantly different from those of the normal group(P
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Objective To determine if in vivo detection of choline by1H-magnetic resonance spectroscopy(1H-MRS) could differentiate between benign and malignant bone and soft tissue tumors.Methods MR spectroscopy was performed in 28 cases, including 5 healthy subjects and 23 cases of extremital tumors. Examination was performed by using a point-resolved spectroscopic sequence with echo times of 35,144 and 288 ms.Results 1H-MRS spectrum was different among normal tissue, benign and malignant tumor.Conclusion Choline can be reliable detected in malignant tumor of bone and soft tissue by using1H-MRS.1H-MRS can help differentiate malignant tumor from benign tumor.