Diagnostic value of contrast-enhanced ultrasound in hepatic epithelioid hemangioendothelioma / 中华肝脏病杂志

Objective: To investigate the features of contrast-enhanced ultrasound (CEUS) in hepatic epithelioid hemangioendothelioma (HEHE) in order to improve the preoperative diagnosis rate. Methods: CEUS images of 32 pathologically-proven cases of hepatic epithelioid hemangioendothelioma from January 2004 to August 2021 were collected. Lesions were analyzed to observe the features of enhancement mode, enhancement intensity, and distinct enhancement phases. Results: Among the 32 cases, one had a solitary lesion, 29 had multiple lesions, and two had diffuse-type lesions. Contrast-enhanced ultrasound revealed a total of 42 lesions in 32 cases. In terms of arterial phase enhancement, 18 lesions had overall enhancement, six lesions had uneven dendritic enhancement, 16 lesions had rim-like enhancement, and two lesions had just slight peripheral spot enhancement around the lesions. Among the three cases, there were multiple lesions that had overall enhancement and ring enhancement. In terms of the enhancement phase, 20 lesions showed "fast progression", 20 lesions showed "same progression", and two lesions showed "slow progression". During the late arterial or early portal venous phases with rapid washout, all lesions manifested as hypoechoic. With peaked enhanced intensity, 11 lesions had a lower enhancement intensity than the surrounding normal liver parenchyma; 11 lesions had the same enhancement degree as the surrounding normal liver parenchyma; and 20 lesions had a higher enhancement degree than the surrounding normal liver parenchyma. All 16 ring-enhancing lesions had marked hyperenhancement. In the typical enhancing lesions, four showed hyperenhancement, five showed low enhancement, and nine showed isoenhancement. In the dendrite-enhancing lesions, there were two isoenhancing and four hypoenhancing. Contrast-enhanced ultrasound delineated the boundaries of all lesions more clearly than two-dimensional ultrasound. Conclusion: Contrast-enhanced ultrasound has certain value in the diagnosis of hepatic epithelioid hemangioendothelioma.

Inhibitory effect and significance of rapamycin on the mammalian target of rapamycin signaling pathway in osteosarcoma stem cells and osteosarcoma cells / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To observe the effect of rapamycin on the MG-63 osteosarcoma cells (OC), osteosarcoma stem cells (OSC) and on mTOR signaling pathway, and explore the feasibility of rapamycin as a novel therapeutic measure in osteosarcoma chemotherapy regimens.</p><p><b>METHODS</b>OC and OSC were cultured in vitro. Immunofluorescence assay was used to detect the expression of Nanog and Oct4 in OC and OSC. OC and OSC were treated with rapamycin in concentrations of 0, 20, 50 and 100 nmol/L. Semi-quantitative PCR and RT-PCR were used to detect the mTOR mRNA and CCK-8 assay was used to detect cell proliferation, and the cell morphology was observed under an inverted microscope.</p><p><b>RESULTS</b>The cores of MG-63 cellular spheres exhibited embryonic stem cell characteristics such as Nanog and Oct4 expession. The mTOR pathway was activated in the OSC and the expression of mTOR mRNA was higher in OSC (0.761 ± 0.080) than that in OS (0.406 ± 0.090, P < 0.05) by semi-quantitative PCR. RT-PCR showed that the expression of mTOR mRNA was lower in OSCs treated with 100 nmol/L rapamycin (0.961 ± 0.060) than that with 0 nmol/L rapamycin (1.654 ± 0.246, P < 0.05). Cell counting kit-8 (CCK-8) assay showed that the proliferation of OC treated with 20, 50 and 100 nmol/L rapamycin was significantly inhibited, compared with that with 0 nmol/L rapamycin (P < 0.05). Compared with 0 nmol/L rapamycin, the proliferation of OSC treated with 20 and 50 nmol/L rapamycin was not significantly inhibited (P > 0.05), but that with 100 nmol/L rapamycin was significantly inhibited (P < 0.05). The invert microscopic observation revealed that rapamycin inhibited the formation of OSC spheres.</p><p><b>CONCLUSIONS</b>Rapamycin can effectively inhibit cell proliferation and the ability of sphere formation of OSCs. It will provide a basis for a novel therapeutic approach in osteosarcoma chemotherapy regimens.</p>

Biomechanical comparison of internal fixations in osteoporotic intertrochanteric fracture. a finite element analysis

To compare the biomechanical characteristics of dynamic hip screw [DHS] and proximal femoral nail anti-rotation [PFNA] for the treatment of 3 types of osteoporotic femoral intertrochanteric fracture [OFIF] by modeling, and virtual reduction with finite element analysis, and to provide some theoretical basis and reference to select the best internal fixation for clinical treatment of OFIF. The experiment was conducted at the Laboratory of Biomechanics, Shanghai Institute of Orthopedics and Traumatology, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China from February to December 2011. The CT scan was performed in 3 cases with different types of OFIF [Evans-Jensen II, III, and IV]. Upon validation, fracture models with different internal fixations were developed to simulate and analyze. Under the conditions of 7 different apparent bone densities and 3 different loads, the Von Mises stresses, and the failure rates were calculated, and the stress distribution patterns were compared. The PFNA internal fixation system has better stress distribution than DHS. The former has smaller maximum Von Mises stress of femur and internal fixation, and the femoral element failure rate, as well. The safety range of osteoporosis in PFNA is wider than the DHS. The experiment verifies, from the view of biomechanics, that PFNA should be taken into consideration firstly for OFIF [Evans-Jensen II, III, and IV]

Manipulative reduction for lumbar intervertebral disc herniation: a controlled clinical trial / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the effects of manipulative reduction on pain and clinical curative effect in patients with lumbar intervertebral disc herniation.</p><p><b>METHODS</b>Eleven thousands one hundred and twenty-eight patients with lumbar intervertebral disc herniation from our hospital were enrolled from November 1986 to June 2007. They were randomly divided into control group and treatment group. Patients of the control group received lumbar traction and various physiotherapies. Patients of the treatment group received manipulative reduction, besides the treatment in the control group. The treatment was performed once a day,ten times as a course. Curative effects were assessed three courses later. Pain was evaluated by visual analogue scale before and after the treatment.</p><p><b>RESULTS</b>No significant difference in the score of visual analogue scale was found before the treatment in the two groups (P > 0.05). As compared with the score before treatment,it was decreased by 4.73 points after treatment in the control group, and decreased by 6.37 points in the treatment group. The decrease was more significant in the treatment group than the control group (P < 0.01). The healing rate was 47.28% and total effective rate was 96.37% in the control group; The healing rate was 73.44% and total effective rate was 98.61% in the treatment group (P < 0.01).</p><p><b>CONCLUSION</b>Manipulative reduction for lumbar intervertebral disc herniation can remarkably relieve lumbar pain and improve clinical curative effect.</p>

Effects of androgen on microstructure and mechanics nature of bone in orchiechtomied male rats / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the effect of androgen on microstructure and mechanics nature of bone in orchiechtomied (ORX) male rats and reveal its mechanism by using the Micro CT analysis, bone biomechanics test, bone histomorphometric parameter test, and total body bone mineral density (BMD) measured by dual-energy X-ray absorptiomery (DXA).</p><p><b>METHODS</b>Thirty 12-month-old male Wister rats were randomly divided into three groups including ORX, sham-operated (Sham) and androgen (AD) group, ten rats in every group. Total body BMD was measured by DXA. Femurs and vertebrae were then harvested at the 12 th week after ORX for micro-computed tomography (Micro CT), histology and biomechanical were tested.</p><p><b>RESULTS</b>The administration of testosterone may reverse the decreasing BMD of total body and may prevent the decreasing weight. The biomechanical values of Maximum load, Enery, Maximum stress, Elastic Modulus of AD group significantly enhanced compared with ORX group (P < 0.05). The results of histomorphometric parameters showed that cancellous bone volume, osteoblast-osteoid interface, linear extent of bone formation, mineralizing surfaces, mineral apposition rate increased in the therapy group.</p><p><b>CONCLUSION</b>Androgen can accelerate cancellous bone formation and bone turnover, improve bone microstructure and enhance bone intensity and BMD.</p>

Analysis of the results of hemiarthroplasty in the treatment of proximal humeral fractures / 中华外科杂志

<p><b>OBJECTIVES</b>To evaluate the clinical results of hemiarthroplasty in the treatment of severe proximal humeral fracture, and to analyze the influencing factors.</p><p><b>METHODS</b>Forty-two cases with mean age of 63 years old were included. Mean follow-up duration was 29 months (12 - 48 months). Subjective satisfaction, ROM, muscle strength, stability, smoothness of motion were all evaluated. Radiographs of anterio-posterior view and axial view of shoulder were taken. Total-length radiographs of bilateral humerus were taken for 27 cases and CT for 15 cases.</p><p><b>RESULTS</b>With Constant-Murley score 19 cases (45%) were excellent, 17 cases (40%) good, 6 cases (15%) poor, and the rate of total satisfactory was 85%. Post-operative active ROM, anterior flexion was (100 +/- 32) degrees , external rotation (16 +/- 11) degrees , external rotation and posterior extension to the level of L2.</p><p><b>CONCLUSIONS</b>The reasons for the poor results include improper restoration of humeral length, over retroversion of prosthesis, poor fixation of tuberosity, malunion, absorption of greater tuberosity and heterotopic ossification.</p>

Efficacy and safety evaluation of glucosamine hydrochloride in the treatment of osteoarthritis / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of glucosamine hydrochloride for the treatment of osteoarthritis.</p><p><b>METHODS</b>A multi-central, randomized, controlled clinical trial of glucosamine hydrochloride comparing glucosamine sulfate for the treatment of osteoarthritis was performed. One hundred and forty-three patients suffering from knee or hip osteoarthritis were randomized into study (glucosamine hydrochloride) or control (glucosamine sulfate) group. Patients in study group orally took glucosamine hydrochloride 2 times daily for 6 weeks, each time 1 capsule, and those in control group took glucosamine sulfate 3 times daily for 6 weeks also, each time 2 capsules.</p><p><b>RESULTS</b>The symptomatic improvement of joint pain at walking, at rest and stiffness after 6 week treatment with glucosamine hydrochloride was better than those with glucosamine sulfate. The results had significant difference (P < 0.05). Total effective rates of patients with glucosamine hydrochloride was 75.4% and 60.6% with glucosamine sulfate, but no statistical difference. The results suggested both glucosamine had the considerable efficacy in the treatment of osteoarthritis. Three cases in study group and 2 in control group reported mild adverse events. No severe adverse events (SAE) was observed.</p><p><b>CONCLUSION</b>Glucosamine hydrochloride is as effective and safe as glucosamine sulfate for the treatment of osteoarthritis.</p>

CT-guided percutaneous removal of osteoid osteoma / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the methods of CT-guided percutaneous removal of osteoid osteoma.</p><p><b>METHODS</b>From February 2003 to December 2003, there were 11 patients, at a mean age of 19.3 years old (from 14 to 32 years old). Seven cases were male, and 4 cases were female. Diagnosis was supported by the complete clinical and imaging file. Eleven cases with osteoid osteomas were treated with CT-guided percutaneous excision. The location involved were femoral neck (6 cases), acetabulum (4 cases), humeral neck (1 case). At first, CT scanning was done in the whole nidus with thin slices (2 mm thick), and the CT scan slice passing through the center of the nidus was selected. Then the whole nidus was removed by trephine along the guidewire which was inserted into the bone up to the nidus and was protected by the trocar. Finally complete lesion resection was checked with CT.</p><p><b>RESULTS</b>Nine cases had a final pathological diagnosis of osteoid osteomas. Complete pain relief was obtained in these patients after the day of operation. There were no complications, no recurrence and patients remained symptom free at follow-up of 8-18 months (mean, 15.2 months).</p><p><b>CONCLUSION</b>The methods of CT guided percutaneous removal of osteoid osteoma is a minimally invasive technique that represents the efficacy and safety.</p>

Open repair of Bankart lesion in the treatment of anterior instability of shoulder / 中华创伤骨科杂志

Objective To evaluate the outcome of open repair of Bankart lesion in the treatment of anterior instability of shoulder.Methods From March 2001 to June 2005,34 cases (36 shoulders) of anterior instability of shoulder underwent open repair of Bankart lesion.Twenty-seven shoulders with Bankart injury were diagnosed by CT scan.Nine shoulders were diagnosed as ALPSA(anterior labrum periosteal sleeve avulsion).Twenty-five shoulders presented with anterior instability only,and 11 combined anterior and inferior instability.Twenty-seven cases had a definite history of injury.Twelve cases presented with Hill-Sachs sign.We used open incision to repair lesions to the capsule glenoid labrum complex with suture anchors.Results The average duration of follow-up was 2.2 years (six months to four years).By Walch-Duplay score system,the good to excellent rate was 86.1%,the moderate rate 8.3%,and the poor rate 5.6%.Redislocation occurred in one case after operation due to injury.The rate of recurrence was 3%.Conclusion Open repair of Bankart lesion in the treatment of anterior shoulder in- stability can lead to good recovery of shoulder function,few complications and a low rate of recurrence.