A case control study on the treatment of distal radioulnar joint instability combined with distal radius fractures between fixation and non-fixation distal radioulnar joint / 中国骨伤

<p><b>OBJECTIVE</b>To explore the options on treatment of distal radioulnar joint instability combined with distal radius fracture.</p><p><b>METHODS</b>From June 2007 to December 2009, 264 patients with unstable distal radius fractures were treated with open reduction and internal fixation, in which 42 patients combined with distal radioulnar instability. Distal radioulnar joints of 20 patients were fixed with Kirschner wire or plaster cast at supinator position, and other distal radioulnar joints of 22 patients were not fixed. Range of motion of wrist joints and grip strength were observed; function of wrist were evaluated by modified Gartland-Werley scoring system (GW score); stability of distal radioulnar joints were tested at final follow-up.</p><p><b>RESULTS</b>Forty-one patients were followed up more than 1 year. All fractures obtained healing within 3 months after operation, and apposition of joints was good, no significant subluxation or dislocation were found. There were not statistical differences in grip strength, motion of joints and GW score between two groups (fixation and non-fixation). Only one patient occurred chronic distal radioulnar instability.</p><p><b>CONCLUSION</b>There was no significant difference between fixation and non fixation for the treatment of distal radius fractures with distal radioulnar joint instability. For this reason, if fractures can be satisfactory reduced, there is no need for the one-stage distal radioulnar joint fixation.</p>

Surgical strategy for presacral tumors: analysis of 33 cases / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Presacral tumors are highly infrequent tumors located in the space known as presacral or retrorectal space. Although there have been substantial improvements in the prognosis of patients with malignant presacral tumors, the development of newer surgical strategy is likely to further improve the oncologic outcomes of malignant presacral tumors. The aim of this article was to report our experience in 33 cases, and to review the surgical strategy, pathological features and the prevention of complications from our experience.</p><p><b>METHODS</b>A retrospective analysis was conducted on 33 cases (20 male and 13 female) with presacral tumors surgically treated in our hospital between January 1998 and April 2009. The surgical approaches included trans-abdominal in 10 cases (30%), trans-sacral in 18 cases (55%) and combined abdominal-sacral in 5 cases (15%). All patients got followed up (14 - 123 months, mean of 45.1 months). At last, the general information, clinical symptoms, histodiagnosis, surgical types and postoperative complications of all cases in our series were assessed.</p><p><b>RESULTS</b>Ages of 33 patients ranged from 18 to 71 years, with an average of 48.5 years.</p><p><b>PATHOLOGICAL FINDINGS</b>6 epidermoid cysts, 5 teratomas, 3 leiomyomas, 9 neurofibromas, 5 neurilemmomas, 1 enterogenous cyst, 1 liposarcoma, 1 leiomyosarcoma, 1 angiosarcoma, and 1 neurofibrosarcoma. All tumors were excised with no perioperative death. A colostomy was taken in one case with angiosarcoma involving the rectum because of the intraoperative injury of the rectum. Blood loss during surgery was 400 - 11 000 ml (mean of 2400 ml). Four (12%) cases had local recurrence during follow-up: 2 because of inadequate drainage after dermoidectomy, both of them were cured by surgical resection and drainage; recurrence occurred in a case of teratoma in 18 months after surgery, cured by a trans-sacral excision; local recurrence and lung metastasis occurred simultaneously in a case of angiosarcoma in 6 months postoperatively and the patient died one month later of respiratory failure.</p><p><b>CONCLUSIONS</b>The main treatment of most presacral tumors is surgical resection. Selection of surgical approach is very important for complete resection of the presacral tumors. The location, size and peculiarities of tumors, conditions of the skin and soft tissues and the patients' somatotype are all determinative factors. Multidisciplinary cooperation is also very necessary.</p>

Screening of serum marker proteins in osteosarcoma and preliminary bioinformatic analysis on POLR3F / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To screen potential serum marker proteins of osteosarcoma, and to make a preliminary bioinformatics analysis of RNA polymerase III polypeptide F (POLR3F).</p><p><b>METHODS</b>Gene chip and SELDI-TOF MS was used to screen genes differentially expressed in osteosarcoma. The associations of potential biomarkers from SELDI data and microarray analysis were further inferred by link-test to identify biomarkers that could likely be used for diagnosis. MATLAB was used to search transcription factors binding site in the promoter region and miRNAs binding site in 3'-UTR of POLR3F, respectively.</p><p><b>RESULTS</b>653 differentially expressed genes were found in osteosarcoma cells, while six differentially expressed protein peaks with significant statistical significances were detected by SELDI-TOF MS in patient's serum. 13 potential biomarkers for early diagnosis of osteosarcoma were screened by link-test. A conserved STAT3 binding site and a miRNA target site were found in proximal promoter regions and 3'-UTR region of POLR3F, respectively.</p><p><b>CONCLUSIONS</b>Link-test is a effective method to identify osteosarcoma biomarkers from both microarray and SELDI-TOF MS database. The results confirmed that POLR3F may be a promising biomarker for early diagnosis and a therapy target of osteosarcoma.</p>

Gene profiling of MAPK pathway in human osteosarcoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the functional effects of MAPK pathway in the pathogenesis of human osteosarcoma.</p><p><b>METHODS</b>Gene microarray (Human Genome U133A, Affymetrix) was used to screen the differential expression of genes involved in MAPK pathway between osteosarcoma cell lines and 3 osteoblastic cell lines. KEGG metabolic pathway analysis was performed among significantly increased or decreased genes using the MATLAB software. Immunohistochemical technique was used to detect the expressions of ERK1/2, JNK and p38 proteins among 48 osteosarcoma and benign 24 osteoblastic tumor samples.</p><p><b>RESULTS</b>Using an entrance limit of > or = 2.0, 18 differentially expressed MAPK pathway-related genes were selected (10 up-regulated, 8 down-regulated) to mapped to the MAPK pathway of KEGG which are all important node genes. The positive rates of ERK1/2, JNK and p38 proteins were 83.3% (40/48), 72.9% (35/48) and 85.4% (41/48) in osteosarcomas,and 12.5% (3/24), 8.3% (2/24) and 16.7% (4/24) in the control group, respectively. The positive rates and expression intensities were statistically different between the 2 groups (P<0.01).</p><p><b>CONCLUSION</b>MAPK pathway plays an important role in the pathogenesis of osteosarcoma. ERK, JNK and p38 form an intercoordinating network and regulate the cell proliferation, differentiation, apoptosis, invasion and migration in osteosarcoma.</p>

Screening for pathogenesis-related genes of osteosarcoma using gene microarray / 中国肿瘤生物治疗杂志

Objective:To screen for the pathogenesis-related genes of osteosarcoma and to assess their roles for the de- velopment of osteosareoma.Methods:Total RNA was extracted from 3 ATCC osteosarcoma cell lines and an osteoblastic cell line and was used to synthesize biotinylated cRNAs;the latter were hybridized to Affymetrix~(?)GeneChip~(?)U133A ar- rays and a gene with more than 2 folds of change was selected.Ten of the differentially expressed genes were chosen and the primers were designed and the synthesized.Then SYBR~(?)Green real-time PCR(RT-PCR)method was used to detect the expression of the 10 genes in 9 fresh osteosarcoma specimens.ABI Prism 7 000 system was used to analyze the differ- ent expression between osteosarcoma cell line and osteoblastic cell line.Results:We identified 58 up-regulated and 142 down-regulated genes in the 3 osteosareoma cell lines.Many of the genes were firstly reported to be related to the patho- genesis of osteosarcoma.These differentially expressed genes were mainly involved in energy and material metabolism,on- cogene,signal transduction gene,transcription- related genes,cell cycle-related genes,cell apoptosis-related gene,im- mune response gene,tumor suppressor genes,etc.The array results of 10 randomly selected genes were further verified by the RT-PCR in 9 fresh osteosarcoma specimens.Conclusion:Many genes are involved in the pathogenesis of osteosarcoma. Gene microarray can help to discover the genes related to the pathogenesis of osteosarcoma,which may lay a foundation for studying the molecular mechanism of osteosarcom.

Knee replacement of the treatment of malignant tumor of the proximal tibia and early follow-up / 中华外科杂志

<p><b>OBJECTIVE</b>To discuss the clinical effects of using rotating hinge prosthesis in treating primary malignant tumor of the proximal tibia.</p><p><b>METHODS</b>After the malignant tumor of the proximal tibia was extensively resected or radically resected, rotating hinge prosthesis replacement was performed for reconstruction, while neoadjuvant chemotherapy was used in treating the osteosarcoma.</p><p><b>RESULTS</b>The average follow-up period was 4.2 years. There was no local recurrence and metastasis in 22 patients, though there was recurrence in 8 patients. The MSTS functional scores of all different items 4 years after the operations were above 3, which showed the clinical results were satisfactory.</p><p><b>CONCLUSIONS</b>It is an efficacious method for the treatment of malignant tumor of the proximal tibia by using rotating hinge prosthesis. It has the advantage of early recovery of joint function.</p>