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1.
Chinese Journal of Orthopaedics ; (12): 350-358, 2021.
Article in Chinese | WPRIM | ID: wpr-884720

ABSTRACT

Objective:To explore the early learning curve of OrthoPilot navigation assisted total knee arthroplasty (TKA).Methods:Data of 40 consecutive cases of OrthoPilot navigation assisted TKA completed by the same surgical team in our department were retrospectively analyzed. According to the operation order, 40 cases were divided into the original phase group (the first 20 cases) and the subsequent phase group (the second 20 cases). In original phase group, the average age was 69.85±6.86 years with mean body mass index 24.10±2.88 kg/m 2, preoperative HSS score 48.80±5.33, preoperative knee ROM 87.05°±11.02° and preoperative alignment deviation of 7.40°±5.59°. In subsequent phase group, the average age was 66.65±7.92 years with mean body mass index 22.85±3.15 kg/m 2, preoperative HSS score 49.00±5.47, preoperative knee ROM 85.80°±11.65° and preoperative alignment deviation of 8.22°±5.21°. Perioperative data such as operative duration, incision length, hemoglobin drop and postoperative hospital stay, radiographic outcomes including hip-knee-ankle angle (HKAA), mechanical lateral distal femoral angle (mLDFA), mechanical medial proximal tibial angle (mMPTA), sagittal femoral component angle (sFCA), sagittal tibial component angle (sTCA), joint line convergence angle (JLCA), and functional scores were compared between the two groups. Results:All 40 cases were followed up for 24-33 months (mean, 27.38± 2.73 months). No severe postoperative complications such as infection and loosening occurred during the follow-up. The mean operative duration was 112.35±25.49 min in original phase group versus 82.10±10.96 min in subsequent phase group ( P< 0.05). The durations of tibial cutting was 11.95±3.27 min in original phase group versus 7.35±2.23 min in subsequent phase group ( P< 0.05); the femoral planning + cutting time was 20.95±6.91 min in original phase group versus 16.60±4.78 min in subsequent phase group, and trial + prosthesis implantation time was 39.65±7.72 min in original phase group versus 25.10±5.72 min in subsequent phase group,which was significantly higher in original phase group. There was no significant difference in other perioperative data such as incision length, hemoglobin drop and postoperative hospital stay between the two groups. As for radiographic outcomes, there was no statistical difference between the two groups in the postoperative angular deviation of HKAA (0.70°±0.80° vs. 0.80°±1.06°), mLDFA (0.89°±0.91° vs. 1.00°±0.86°), mMPTA (0.77°±0.53° vs. 0.76°±1.03°), sFCA (0.73°±0.48° vs. 0.87°±1.06°), sTCA (0.95°±0.58° vs. 1.16°±1.14°) and JLCA (0.27°±0.25° vs. 0.39°±0.18°). In original phase group, the HSS scores preoperative and 3 days postoperative were 48.80±5.33 and 60.05±5.10 respectively, and those in subsequent phase were 49.00±5.47 and 60.75±4.47 respectively, and both groups showed satisfactory functional recovery. There was no significant difference in HSS scores at all follow-up time points between two phases, as well as ROM (113.20°±9.82° vs. 113.50°±12.44°) and FJS-12 scores (78.00°±10.98° vs. 76.65°±10.29°) at 2 years postoperatively. Conclusion:In this study, we described a time-related early learning curve for OrthoPilot navigation-assisted TKA, in which the operative duration tended to be shorter after the first 20 cases. However, benefiting from good operative accuracy and repeatability, satisfactory radiographic and functional outcomes can be obtained in early stage of the learning curve.

2.
Article in English | WPRIM | ID: wpr-878305

ABSTRACT

Objective@#Several COVID-19 patients have overlapping comorbidities. The independent role of each component contributing to the risk of COVID-19 is unknown, and how some non-cardiometabolic comorbidities affect the risk of COVID-19 remains unclear.@*Methods@#A retrospective follow-up design was adopted. A total of 1,160 laboratory-confirmed patients were enrolled from nine provinces in China. Data on comorbidities were obtained from the patients' medical records. Multivariable logistic regression models were used to estimate the odds ratio ( @*Results@#Overall, 158 (13.6%) patients were diagnosed with severe illness and 32 (2.7%) had unfavorable outcomes. Hypertension (2.87, 1.30-6.32), type 2 diabetes (T2DM) (3.57, 2.32-5.49), cardiovascular disease (CVD) (3.78, 1.81-7.89), fatty liver disease (7.53, 1.96-28.96), hyperlipidemia (2.15, 1.26-3.67), other lung diseases (6.00, 3.01-11.96), and electrolyte imbalance (10.40, 3.00-26.10) were independently linked to increased odds of being severely ill. T2DM (6.07, 2.89-12.75), CVD (8.47, 6.03-11.89), and electrolyte imbalance (19.44, 11.47-32.96) were also strong predictors of unfavorable outcomes. Women with comorbidities were more likely to have severe disease on admission (5.46, 3.25-9.19), while men with comorbidities were more likely to have unfavorable treatment outcomes (6.58, 1.46-29.64) within two weeks.@*Conclusion@#Besides hypertension, diabetes, and CVD, fatty liver disease, hyperlipidemia, other lung diseases, and electrolyte imbalance were independent risk factors for COVID-19 severity and poor treatment outcome. Women with comorbidities were more likely to have severe disease, while men with comorbidities were more likely to have unfavorable treatment outcomes.


Subject(s)
Adult , Aged , COVID-19/virology , China/epidemiology , Comorbidity , Female , Humans , Male , Middle Aged , Retrospective Studies , Severity of Illness Index , Treatment Outcome
3.
Article in Chinese | WPRIM | ID: wpr-876249

ABSTRACT

Objective To ascertain the short-term effects of traditional Chinese medicine(TCM) auricular magnetic beads application for treatment of poor vision in primary school students. Methods In 2017, a randomized sampling method was adopted in this study.A total of 458 students with a naked eye visual acuity ≤4.9 were screened from a primary school in the jurisdiction.Of them, 230 students were informed by the parent′s informed consent to receive the TCM ear acupoint application, and the remaining 228 students served as the control group. Results The average eyes visual acuity of intervention group was 4.842, increasing to 4.848 or 4.859 after 6 or 12 weeks′ treatment by auricular magnetic bead application.After statistically analysis, there is a significant difference in short-term effect of auricular magnetic bead application on eyesight improvement for primary school students. Conclusion The TCM auricular magnetic bead application proves to have a short-term effect on the poor eyesight of the students, and the operation is simple and safe.It is conducive to improving students′ participation in poor eyesight control and achieving family and school participation in TCM prevention and treatment of myopia.

4.
Article in English | WPRIM | ID: wpr-828976

ABSTRACT

Objective@#To screen the differentially expressed proteins (DEPs) in human bronchial epithelial cells (HBE) treated with atmospheric fine particulate matter (PM ).@*Methods@#HBE cells were treated with PM samples from Shenzhen and Taiyuan for 24 h. To detect overall protein expression, the Q Exactive mass spectrometer was used. Gene ontology (GO), Kyoto encyclopedia of genes and genomes (KEGG), and Perseus software were used to screen DEPs.@*Results@#Overall, 67 DEPs were screened in the Shenzhen sample-treated group, of which 46 were upregulated and 21 were downregulated. In total, 252 DEPs were screened in the Taiyuan sample-treated group, of which 134 were upregulated and 118 were downregulated. KEGG analysis demonstrated that DEPs were mainly enriched in ubiquitin-mediated proteolysis and HIF-1 signal pathways in Shenzhen PM samples-treated group. The GO analysis demonstrated that Shenzhen sample-induced DEPs were mainly involved in the biological process for absorption of various metal ions and cell components. The Taiyuan PM -induced DEPs were mainly involved in biological processes of protein aggregation regulation and molecular function of oxidase activity. Additionally, three important DEPs, including ANXA2, DIABLO, and AIMP1, were screened.@*Conclusion@#Our findings provide a valuable basis for further evaluation of PM -associated carcinogenesis.


Subject(s)
Air Pollutants , Bronchi , Metabolism , Computational Biology , Epithelial Cells , Metabolism , Gene Expression , Humans , Mass Spectrometry , Particle Size , Particulate Matter , Proteomics
5.
Article in Chinese | WPRIM | ID: wpr-871162

ABSTRACT

Objective:To investigate the effects of 24 weeks of aerobic exercise on inflammatory factors, insulin resistance and endothelial function among overweight or obese children.Methods:Eighty overweight or obese children were randomly divided into a control group and an exercise group, each of 40. Both groups took part in physical activity organized by a school (twice/week, 45 min/time), while the exercise group performed an additional 24-week aerobic exercise program. Blood pressure, heart rate, body weight, body mass index (BMI), body composition, flow-mediated dilation (FMD) of the brachial artery, serum C-reactive protein (CRP), lipids, glucose and insulin were monitored. Insulin resistance indices (IRIs) were estimated from a homeostatic model assessment.Results:A baseline positive correlation was found between serum CRP and IRI which remained significant after adjusting the baseline variables. After the intervention, the average FMD of the exercise group had increased significantly while no significant improvement was found in the control group. However, after the intervention, no significant differences were found between the two groups in terms of the other measurements.Conclusions:The serum CRP of overweight/obese children is independently associated with IRI. Twenty-four weeks of aerobic exercise can improve vascular endothelial function.

6.
Article in Chinese | WPRIM | ID: wpr-860877

ABSTRACT

Objective:To observe the value of transabdominal bowel ultrasound (TBUS) in diagnosis of complications of small bowel Crohn disease (SBCD). Methods: Imaging manifestations on 42 times ultrasonic examinations of 25 SBCD patients during 10 years were retrospectively analyzed, including 26 times in active phase (active group) and 16 times in remission stage (remission group). The consistency between ultrasound and Harvey Bradshaw index (HBI) for evaluation on disease activity was observed. Results: There was high consistency between ultrasound and HBI for evaluation on disease activity of SBCD (Kappa=0.897). Fistula, abscess and inflammatory mass all appeared in active stage. The incidence of stenosis, creeping fat sign, lymphadenitis and ascites in active group were significantly higher than those in remission group (all P<0.05). The thickness of intestinal wall and creeping fat in active group were significantly greater than those in remission group (all P<0.05). Among all 42 times examinations, stenosis was observed in 15 times, fistula was found in 8 times, while inflammatory hyperplasia of adipose tissue around the diseased intestinal wall, multiple mesenteric lymphadenitis and ascites were noticed in 31,20 and 16 times, respectively. Abdominal masses were detected in 9 times, including 5 with abscess. Perforated Intestinal wall was found in 1 time, while inflammatory hypertrophy and diverticulum formation were detected in 8 and 3 times, respectively. Conclusion: TBUS could accurately show the abdominal complications of SBCD,therefore being able to be used as a routine imaging method for evaluation on complications of SBCD.

7.
Article in Chinese | WPRIM | ID: wpr-779533

ABSTRACT

Objective To conduct metal elements analysis and risk assessment of carcinogenicity on Particulate Matter 2.5 ( PM2.5) collected from Shenzhen and Taiyuan. Methods PM2.5 samples were collected in Shenzhen and Taiyuan from 2017 to 2018. Ten heavy metal elements in PM2.5 samples were detected by inductively coupled plasma mass spectrometry (ICP-MS). Health risk assessment was conducted using the recommended United States Environmental Protection Agency (EPA) model. Results Metal elements found in PM2.5 samples from Shenzhen included (in decreasing order of concentration) Al, Pb, Mn, Cr, Cu, V, As, Ni, Cd and Co. Their levels were 1 807.67, 31.02, 30.63, 17.37, 17.32, 11.59, 6.98, 4.76, 2.24, 2.20 ng/m3, respectively. Metal elements in PM2.5 samples from Taiyuan included Al, Mn, Pb, Cr, Cu, As, Ni, V, Cd and Co. Their levels were 2 817.64, 91.04, 63.33, 26.56, 24.69, 11.82, 10.39, 4.46, 3.42, 1.01 ng/m3, respectively. There were significant differences among Pb, Mn, As, Ni levels between Shenzhen and Taiyuan (all P1.00×10-4), then followed by As, Ni and Cd (1.00×10-6-1.00×10-4). Pb had the lowest risk (<1.00×10-6). Conclusion Some of the metal elements in PM2.5 samples collected from Shenzhen and Taiyuan have carcinogenicity risk. Further researches and measures for prevention and control should be considered.

8.
Acta Physiologica Sinica ; (6): 555-561, 2019.
Article in Chinese | WPRIM | ID: wpr-777156

ABSTRACT

The aim of the present study was to establish a cell model of volume-regulated anion channel subunit LRRC8A and investigate the physiological characteristics of LRRC8A. The eukaryotic expression vectors of LRRC8A and YFP-H148Q/I152L were constructed and transfected into Fischer rat thyroid (FRT) cells by Lipofectamine 2000. The FRT cell lines co-expressing LRRC8A and YFP-H148Q/I152L were obtained by antibiotic screening. The expression of LRRC8A and YFP-H148Q/I152L in FRT cells was detected by the inverted fluorescence microscope. The fluorescence quenching kinetic experiment was done to verify the function and effectiveness of the cell model. Then the cell model was utilized to study the physiological characteristics of LRRC8A, such as the characteristics of anion transport, the opening of LRRC8A by osmotic pressure, the effect of anion transport velocity, and the effect of chloride channel inhibitors on LRRC8A anion channel. The results of the inverted fluorescence microscope showed that LRRC8A was expressed on the cell membrane and YFP-H148Q/I152L was expressed in the cytoplasm. The results of fluorescence quenching kinetic test showed that under the condition of low osmotic state, LRRC8A could transport some kinds of anions, such as iodine and chloride ions. Osmotic pressure played a key role in the regulation of LRRC8A volume-regulated anion channel opening. Chloride channel inhibitors inhibited ion transport of LRRC8A channel in a dose-dependent manner. It is suggested that LRRC8A has the characteristics of classic volume-regulated anion channels by using the cell model of FRT cells co-expressing LRRC8A and YFP-H148Q/I152L.


Subject(s)
Animals , Anions , Cells, Cultured , Chloride Channels , Ion Transport , Membrane Proteins , Physiology , Microscopy, Fluorescence , Rats , Rats, Inbred F344 , Thyroid Gland , Cell Biology , Transfection
9.
Article in Chinese | WPRIM | ID: wpr-805677

ABSTRACT

Objective@#To study the effect of particulate matter 2.5 (PM2.5) on oncogene expression in human bronchial epithelial (HBE) cells.@*Methods@#HBE cells were selected as the study subjects, and PM2.5 treatment group (10 μg/ml and 50 μg/ml) , negative control group and positive control group (10 μmol/L Cr6+) were set. CCK8 assay was used to test the IC50 value of PM2.5. HBE cells were treated with PM2.5 for 24 h at 10 μg/ml and 50 μg/ml, additionally, cells were treated with blank as negative control, 10 μmol/L Cr6+ as a positive control for 24 h. After the treatment, mRNA expression of oncogenes including c-myc, c-fos, k-ras and p53 were detected by fluorescent quantitative RT-PCR, the protein expression of oncogenes were detected with western blot.@*Results@#The IC50 value of PM2.5 in HBE cells is 70.12 μg/ml. The qRT-PCR data showed that compared with the control group, the expression level of c-myc gene increased by respectively 500.1%、780.7%、305.3% after exposure to 10、50 μg/ml PM2.5 and positive control group; c-fos gene increased respectively 34.0%、76.7%、131.3% after exposure to 10、50 μg/ml PM2.5 and positive control group; k-ras gene increased respectively 50.3%、107.0%、49.7% after exposure to 10、50 μg/ml PM2.5 and positive control group; p53 gene decreased by 28.3%、28.7%、59.7% after exposure to 10、50 μg/ml PM2.5 and positive control group. The western blot results showed that compared with the control group, c-myc protein increased respectively 29.7%、77.3% after exposure to 50 μg/ml PM2.5 and positive control group; c-fos protein increased respectively 200.3%、137.0% after exposure to 50 μg/ml PM2.5 and positive control group; k-ras protein increased respectively 106.3%、130.3%、116.7% after exposure to 10、50 μg/ml PM2.5 and positive control group; p53 protein decreased by 43.7%、53.3%、52.1% after exposure to 10、50 μg/ml PM2.5 and positive control group.@*Conclusion@#PM2.5 could promote the expression of oncogenes in HBE cells, the carcinogenicity of haze might be related to promotion of oncogenes expression induced by PM2.5.

10.
Article in Chinese | WPRIM | ID: wpr-804568

ABSTRACT

Objective@#To construct 3β-HSD gene shRNA lentivirus interference vecto, then transfect into human MCF-7 cells, and construct cell line with 3β-HSD gene silencing, finally to study the effects of 3β-HSD on apoptosis induced by di- (2-ethylhexyl) phthalate (DEHP) .@*Methods@#According to the mRNA sequence of 3β-HSD gene provided by GenBank, three interference sequences were designed and connected to PLVX-shRNA2-puro after annealing. The recombinant lentivirus vector was transfected into 293FT cells, the virus supernatants were collected and infected with MCF-7 cells. After puromycin screening, MCF-7 cells with 3β-HSD gene silencing were constructed. The cells with 3β-HSD gene silencing were identified by real-time quantitative PCR and western blot. Then the 3β-HSD gene silencing cells and MCF-7 cells were treated at various doses of DEHP for 24 hours to detect the gene expression and protein expression of apoptosis genes including Bax, Caspase-3 and Caspase-8.@*Results@#The interference sequence of 3β-HSD gene inserted into lentivirus vector PLVX-shRNA2-puro is consistent with the designed sequence. 3β-HSD gene expression level in MCF-7 cells with 3β-HSD gene silencing was 77% lower than than that of control MCF-7 cells. 3β-HSD protein level in MCF-7 cells with 3β-HSD gene silencing was 74% lower than that of control MCF-7 cells. After DEHP treatment in MCF-7 cells with 3β-HSD gene silencing and control MCF-7 cells, qRT-PCR results showed that Bax gene expression levels increased by 28%-54%, Caspase-3 gene increased by 13%-49%, Caspase-8 gene increased by 21%-70% in MCF-7 cells when compared with the control group. Additionally, in the 3β-HSD gene silencing cells, Bax gene expression level decreased by 11%-28%, Caspase-3 gene expression decreased by 12%-23%, Caspase-8 gene expression decreased by 11%-34%, compared with the same treatment group of MCF-7 cells. Western blot results showed that Bax protein expression level increased by 28%-61%, Caspase-3 protein expression level increased by 40%-48%, Caspase-8 protein increased by 31%-84% in MCF-7 cells when compared with the control group. In 3β-HSD gene silencing cells, Bax protein expression level increased by 11%-27%, Caspase-3 protein increased by 21%-40%, Caspase-8 protein increased by 12%-25%, compared with the same treatment group of MCF-7 cells.@*Conclusion@#The stable 3β-HSD gene silencing cell line are successfully constructed in this study. DEHP can induce increased expression of apoptotic gene and protein. Silencing of 3β-HSD gene can inhibit the activation of apoptotic gene by DEHP in a certain degree.

11.
Article in Chinese | WPRIM | ID: wpr-817751

ABSTRACT

@#【Objective】 To examine a potential correlation between corneal biomechanical properties with lamina cribrosa thickness.【Methods】Thirty-two patients with POAG,20 with NTG,15 with OHT and 26 healthy controls were included in the cross- sectional study. The parameters of corneal biomechanical properties and lamina cribrosa thickness were compared among POAG,NTG,OHT and healthy subjects by mixed-model analysis of variance(ANOVA). Spearman′ s coefficient of rank correlation analysis was used to assess the association between parameters of deformation response and clinical factors. 【Results】 The Cronbach′ s α of lamina cribrosa thickness was 0.911,and ICC was more than 0.8. Laminar thickness was thinner in the POAG and NTG groups than in the OHT group and Normal group(P < 0.05). There were no significant differences between OHT and normal groups(P = 0.653). Correlation analysis showed that LCT and some important corneal biomechanical properties had significant correlation (P = 0.000). 【Conclusions】 LCT showed different characteristic in glaucoma,and it may be an important factor for glaucoma progression. LCT and corneal biomechanical properties showed significant correlation ,and corneal biomechanical properties may be used to evaluate the biomechanical properties of optic nerve.

12.
Journal of Practical Radiology ; (12): 693-698, 2019.
Article in Chinese | WPRIM | ID: wpr-752418

ABSTRACT

Objective ToinvestigatethepatternsofbrainactivityabnormalitiesinpatientswithParkinson’sdisease(PD)with freezingofgait(FOG),andtoexploretheneuropathologicalmechanismofFOG.Methods Resting-statefunctionalMRI(rs-fMRI) scanswereobtainedfrom31PDpatientsand16healthycontrols(HCs).Accordingtothefreezingofgaitquestionnaire(FOG-Q),31 PDpatientsweredividedinto15PDFOG(+)and16PDFOG(-).ANCOVAandPost-Hocttestwereperformedtoassessinter groupdifferenceofbrainactivityabnormalitybasedonregionalhomogeneity.Results ComparedtoHCs,PDFOG(+)showeddecreased ReHointheleftinferiortemporalgyrus,rightlingual,bilateralfusiform,rightoccipitalgyrus,rightcalcarine,andrightcerebellum, whileincreasedReHointherightmiddlefrontalgyrus,rightsuperiorfrontalgyrus,rightprecentralgyrus,andrightsupplementary motorarea(SMA).ComparedtoPDFOG(-),PDFOG(+)exhibitedincreasedReHointherightprecentralgyrus,rightmiddle frontalgyrus,rightinferiorfrontalgyrus,andrightSMA,whiledecreasedReHoinleftfusiform.Conclusion Thisstudysuggests thatFOGinPDisassociatedwithabnormalitiesincerebellum,frontallobeandvisualnetwork,whichishelpfultounderstandthe neuralmechanismsunderlyingFOGinPD.

13.
Article in Chinese | WPRIM | ID: wpr-807696

ABSTRACT

Objective@#To study the effect of Kangai injection combined with GP chemotherapy in the treatment of patients with advanced non-small cell lung cancer(NSCLC) and its influence on quality of life (QOL).@*Methods@#Eighty-five patients with advanced NSCLC were selected, and they were divided into control group(42 cases) and observation group (43 cases) according to the digital table.All patients were under the control of basic diseases and routine care.The control group was treated with GP regimen: gemcitabine combined with cisplatin, 21d as a course of treatment, continuous treatment for 4 courses.The observation group was treated with Kangai injection on the basis of the control group, and synchronized with chemotherapy.The immune function, QOL, curative effect and adverse reactions were compared between the two groups before and after treatment.@*Results@#After treatment, the CD3+ , CD4+ , NK and CD4+ /CD8+ of the control group decreased, the CD8+ increased, and the CD3+ , CD4+ , NK and CD4+ /CD8+ of the observation group increased, the CD8+ decreased, the differences were statistically significant(t=6.704, 7.340, 11.080, 13.832, 5.033, all P<0.05). After treatment, the QOL scores of the observation group were higher than those of the control group(t=4.100, 6.698, 8.217, 4.146, 5.790, all P<0.05). The effective rate of the control group was 28.57%, which of the observation group was 41.86%, there was no statistically significant difference(χ2=1.643, P=0.200). The clinical control rate of the control group was 66.67%, which was lower than 86.05% of the observation group, the difference was statistically significant(χ2=4.435, P<0.05). The main side effects were myelosuppression and gastrointestinal reactions, and the incidence rates of WBC, thrombocytopenia and nausea and vomiting in the control group were higher than those in the observation group, the differences were statistically significant(χ2=8.880, 4.170, 0.553, 5.409, all P<0.05).@*Conclusion@#Kangai injection combined with GP chemotherapy in the treatment of patients with advanced NSCLC can improve the clinical control rate, QOL and immune function of patients, reduce the toxic and side effects, and it is worthy of promotion.

14.
Chinese Journal of Orthopaedics ; (12): 1097-1107, 2018.
Article in Chinese | WPRIM | ID: wpr-708632

ABSTRACT

Objective To investigate the clinical and epidemiological characteristics of osteosarcoma in China and analyze the incidence and clinical treatment of osteosarcoma.Methods The clinical data of 1 593 patients with osteosarcoma in 7 bone cancer treatment centers from January 2000 to February 2017 were analyzed.We retrieved large samples of documents in the database,extracted the relevant data and compared the data with this study.SPSS 13 software was used for statistical analysis and each factor was tested by x2.Results Of 1 593 patients,984 were males and 609 were females.The ratio of male to female was 1.62∶ 1.The average age was 23.2 years (range from 3-80 years).The peak age of onset was 11-20 years (52.4%).There were 217 elderly patients (> 40 years old).The tumors occurred in 1 524 limbs and 69 in axial bone.The most common sites of disease were distal femur 706 cases,proximal tibia 375 cases,distal humerus 117 cases and others 395 cases.There were 1 154 cases (71%) around the knee joint.The axial bone included 18 cases of spine,49 cases of pelvis and 2 cases of rib.Preoperative biopsy was performed in 1 111 cases and incisional biopsy in 280 cases.Preoperative diagnosis could be made in 1 345 cases (84.4% of all patients,accounting for 96.7% of biopsy patients).There were 79 cases with metastasis at first visit,accounting for 5%.Preoperative chemotherapy was performed in 1 185 cases (74.4%).With the DIA preoperative chemotherapy 271 cases,DIA+MTX 251 cases,AP 149 cases.220 cases of tumor cell necrosis rate was evaluated after operationaccording to the Huvos classification.There were78 cases of grade Ⅰ,105 cases of Ⅱ grade,35 cases of Ⅲ and 2 cases of grade Ⅳ.There were 1 299 cases undergoingpostoperative chemotherapy (81.5%),1 306 patients undergoinglimb salvage surgery (82%).Thespecific operation with prosthetic replacement is the most common (911 cases,69.8%).The postoperative chemotherapy included DIA+MTX regimen 471 cases,DIA regimen 266 cases and AP regimen 98 cases.Before and after the operation,379 cases were treated with the same chemotherapy regimen and 666 cases were changed.A total of 18 large sample documents were retrieved in Chinese data base (5 684 cases).The sex ratio,age range,peak incidence and location of the disease were similar to those of this study.The average age was 1-2 years old younger.The percentage of lung metastases associated with initial visits washigher.The rate of preoperative and postoperative chemotherapy and limb salvage waslowand the rate of tumor necrosis wasbetter after chemotherapy.A total of 22 large sample literatures were searched in foreign database (12 850 cases).The ratio of men and women is 1.30∶1 and the proportion of women is higher than the domestic data.The average age was 1-2 years older.The ratio of the knee joint was lower.The percentage of lung metastases associated with initial visits washigher.The rate of preoperative and postoperative chemotherapy and limb salvage were similar to that of this study and the rate of tumor necrosis was better after chemotherapy.Conclusion The general situation of the incidence of osteosarcoma (sex,age,location of the disease) is not significantly different from the previous reports both at home and abroad.In the treatment,preoperative and postoperative chemotherapy rate and limb salvage surgery rate have improved significantly compared with the past.The chemotherapy program from the coexistence of various programs,gradually to the DIA+MTX and DIA program as the mainstream program.

15.
Chinese Journal of Orthopaedics ; (12): 867-874, 2018.
Article in Chinese | WPRIM | ID: wpr-708605

ABSTRACT

Objective To investigate the clinical value of segmental prosthesis in the repair of diaphyseal defect.Methods The clinical data and follow-up information of 40 patients who accepted segmental prosthesis reconstruction of long bone defects in limbs were collected from June 2010 to June 2017 in General Hospital of Jinan Military Commanding and Tianjin Hospital.The parameters for outcome evaluation including general information,surgical complications,Musculoskeletal Tumor Society (MSTS) functional score,survival and prostheses status were analyzed.Results Forty patients were underwent segmental prosthesis surgery,including 18 males and 22 females,with a median age of 64 years and the age range of 13-83 years.The surgery was performed on 28 cases of femur,8 cases of humerus,3 cases of tibia,and 1 cases of ulna.There were 5 cases of primary tumor,3 cases of multiple myeloma and 32 cases of metastatic tumor of bone,in which lung cancer,breast cancer,kidney cancer,liver cancer and colorectal cancer are common.Pathological fracture of surgical site occurred in 32 cases.The average osteotomy length was 93.5 mm.The shortest osteotomy was 60 mm and the longest osteotomy was 190 mm.The average operation time was 104.6 minutes.The median bleeding volume was 600 ml.The least bleeding was 200 ml and the most bleeding was 2 800 ml.The patients median survival time was 8.5 months from 3 to 79 months.The prosthesis median survival time was 8 months from 3 to 79 months.According to the Henderson tumor prosthesis complications classification,there were 3 cases of type Ⅰ including 2 cases of incision delayed healing and 1 case of radial nerve paralysis.There was 1 case of type Ⅱ with humeral prosthesis aseptic loosening.There was 1 case of type Ⅲ with angulation deformity between femoral prosthesis force line and biological force line.There were 2 cases of type Ⅴ with tumor recurrence followed by amputation.The limb function score of MSTS was 20.4±4.1 points.Except for two patients with tumor recurrence and amputation,38 patients got stable prosthesis function until the death or follow-up cut-off.The similar tendency of patients survival curve and prosthesis survival curve indicated that survival was the main factor affecting postoperative prosthesis survivorship.Although the use rate of humeral plate (4/8,50.0%) was higher than that of femoral plate (5/28,17.9%),the difference was not statistically significant (F=3.426,P=0.064).The results of statistical analysis of complications showed that the type of tumor was an independent risk factor for complications (x2=7.446,P=0.024).The postoperative complications rate of primary tumor was significantly higher than that of multiple myeloma and bone metastasis.Patients with no complications have better limb function after surgery (F=9.709,P=0.003).Multivariate linear regression analysis showed that age,tumor type,preoperative pathologic fracture,surgery,osteotomy length did not affect limb functions after operation.The longer survival time mean better limb function (t=4.228,P=0.000).Conclusion Segmental prosthesis is a reliable method for the repair of bone metastases with defects.Combined with bone plate fixation,it can effectively reduce the occurrence of prosthetic complications.

16.
Chinese Journal of Orthopaedics ; (12): 620-626, 2018.
Article in Chinese | WPRIM | ID: wpr-708579

ABSTRACT

Objective To analyze the efficacy of total claviculectomy in the treatment of Ewing's sarcoma and to discuss the impact of clavicular reconstruction on the outcome.Methods The clinical records of a 13-year-old male patient with left clavicular Ewing's sarcoma were reviewed.The subject received 2 cycles (at an interval of 2 weeks) of neoadjuvant chemotherapy comprising cisplatin 120 mg/m2 (1 d),adriomycin 30 mg/m2 (3 d),and ifosfamide 2.0 g/m2 (5 d).Total claviculectomy was carried out without clavicular reconstruction and the patient underwent 9 cycles of subsequent chemotherapy.The appearance and function of the operated limb,radiological examinations of the surgical site,ECT bone scans and pulmonary CT were followed up.The literatures regarding the total and subtotal excision of the clavicle were reviewed to investigate the importance of clavicular reconstruction.Results After 23-months of follow-up,the patient was subjectively free of limb function compromise.Physical examinations indicated drooping of the operated shoulder by 2 cm,whereas the appearance was similar between both shoulders.Functionality of the operated limb was recovered.The motion of the left shoulder:abduction 90°,adduction 40°,anterior flexion 90°,extension 45°,internal rotation 80°,external rotation 60°,and no restriction of limb elevation.Manual muscle strength tests showed V/V muscle strength of the operated limb.American Shoulder and Elbow Surgeons' form (ASES) and Musculoskeletal Tumor Society (MSTS) score were 96 and 30,respectively.Postoperative X-ray films demonstrated mild thoracic scoliosis.The patient did not appear recurrence and metastasis.Conclusion Total claviculectomy is efficacious for treating clavicular Ewing's sarcoma.Clavicular reconstruction may not be imperative for treatment of clavicular malignancy because of the increased technical difficulty and great risk of complications.

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Chinese Medical Journal ; (24): 2541-2546, 2017.
Article in English | WPRIM | ID: wpr-248948

ABSTRACT

<p><b>BACKGROUND</b>Intralesional excision with curettage is the standard method of giant cell tumor (GCT) treatment, but the ideal filling material after curettage remains controversial. The purpose of this study was to compare the oncological and functional outcomes which underwent cementation or bone grafting after GCT curettage around the knee.</p><p><b>METHODS</b>We reported 136 cases with GCTs in distal femur or proximal tibia who accepted curettage from five clinical centers during the last 15 years. All patients were divided into two groups according to filling materials. Recurrence-free survival proportions were used to evaluate oncological outcomes while the Musculoskeletal Tumor Society (MSTS) 93 functional score was used to evaluate functional outcomes. Other parameters including surgical complication, general condition, and radiological classification had been analyzed. The valid statisitical data was analyzed using SPSS 13.0 software.</p><p><b>RESULTS</b>After GCT curettage, 86 patients (63.2%) accepted bone grafting while 50 patients (36.8%) accepted cementation. There was no statistical difference in age, gender, tumor location, radiological classification, fixation, follow-up time, and MSTS 93 functional score between cementation group and bone grafting group. The recurrence-free survival proportions showed that the recurrence rate in bone grafting group was higher than it in cementation group (P = 0.034). Surgical complication was lower in cementation group than that in bone grafting group but without statistically significant difference (P = 0.141).</p><p><b>CONCLUSIONS</b>Parameters including patients' age, gender, tumor location, and radiological classification did not affect surgeons' treatments in cavity filling after GCT curettage. Cementation should be recommended because of easy usage, the similar postoperative knee function with bone grafting, and the better local tumor control than bone grafting.</p>

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Chinese Journal of Orthopaedics ; (12): 321-328, 2017.
Article in Chinese | WPRIM | ID: wpr-514118

ABSTRACT

Objective To retrospectively analyze clinical features,treatment methods and efficacy of giant cell tumor of bone in proximal tibia,and to investigate risk factors affecting tumor recurrence and functional outcomes.Methods A total of 250 patients with giant cell tumor of bone in proximal tibia confirmed by pathology,who had undergone surgical treatment from March 2000 to July 2014,were enrolled in this study.There were 132 males and 118 females,with an average age of (34.59±12.86) years.A total of 140 patients who were followed up for more than 3 years were included in this study,and there were 72 males and 68 females,with an average age of (34.46± 11.96) years.There were 11 cases of Campanacci grade Ⅰ,58 cases of grade Ⅱ,71 cases of grade Ⅲ and pathological fracture of 47 cases.According to surgical methods,they were divided into bone grafting group (49 cases),bone cement filling group (34 cases),prosthesis group (46 cases) and others group (11 cases).The epidemiology,clinical and radiographic features and risk factors affecting tumor recurrence and functional outcomes were analyzed.Results A total of 140 patients were followed up,the follow-up period was 36-324 months,with an average of 95.4 months,and the median follow-up time was 88 months.Recurrence was found in 26 cases,and recurrence rate was 18.57%,with an average recurrence interval of 25.85 months.Recurrence was found in 17 cases in the first 2 years.The 5-year free survival rate was 77.60%.The recurrence rates were 18.37% in bone grafting group,20.59% in bone cement filling group,15.22% in prosthesis group and 27.27% in the others group,no statistically difference was found on recurrence rate and free survival rate (P=0.805,P=0.558).Recurrence was not related to all kinds of factors.A variety of related factors affecting postoperative recurrence were analyzed,sex,the first diagnosis of the original recurrence,left and right side,whether the eccentricity,fracture,cortical bone destruction,soft tissue mass,surgical methods,high-speed grinding,auxiliary application,and there was no significant correlation between recurrence and these factors.The MSTS 93 score was 25.26±4.31.Function of the primary patients was better than that of recurrence (P=0.044).Function of the patients treated with curettage with or without internal fixation was better than that with segmental resection (P=0.011).Function of the patients treated with grafting or bone cement filling was better than that with prosthesis or allograft-prosthesis reconstruction (P=0.004).There were no significant correlation between MSTS function score and gender,left and right side,whether the eccentricity,whether fractures,cortical bone destruction (Campanacci grade),whether there is soft tissue mass,whether the use of assisted inactivation,whether the use of grinding or internal fixation.Conclusion Various surgical methods had no significant effect on the recurrence of proximal tibial GCT,as for GCT in proximal tibia,there is no relation between recucrrence and related factors.Whether primary tumor and surgical methods are two important factors affecting limb function.

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Article in Chinese | WPRIM | ID: wpr-607405

ABSTRACT

The clinical teaching of geriatrics is difficult to arouse the students' interest. The flipped classroom teaching method can improve it through the interaction. We used WeChat as a platform for flipped classes and designed a variety of micro lessons. The participation and study interests of students were obvi-ously increased through exchanging teaching, answering questions and discussing. The teaching efficiency was also improved after strengthening practice. The preliminary practice shows that this teaching method can provide students a virtual teaching platform. It not only can enhance the teaching effect, but also can share teaching resources in network even for the long-term cross hospital and cross school exchange promotion.

20.
Article in Chinese | WPRIM | ID: wpr-498451

ABSTRACT

Interleukin-17A (IL-17A) is one of the proinflammatory cytokines produced by a subset of CD4+T cells named Th17 cells. It plays a crucial role in both host innate and adaptive immune responses against colonization and infection of respiratory tract bacteria. Studies in animal models have demonstrated that IL-17A can induce the expressions of various chemokines, inflammatory factors and adhesion molecules via multiple intracellular signaling pathways and recruit neutrophils to infection sites. Moreover, recent stud-ies have shown that single nucleotide polymorphisms (SNPs) of IL-17A coding gene can regulate the produc-tion of IL-17A in serum, resulting in individual difference in colonization rate by Streptococcus pneumoniae. This review presents recent data related to the structure, functions and signaling pathways of IL-17A, sum-marizes its roles in host defense based on studies in animal models and discusses the effects of genetic varia-tion of IL-17A on colonization, susceptibility, clinical characteristics and disease prognosis of human respira-tory tract bacteria.

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