Perioperative mortality of metastatic spinal disease with unknown primary: A case report and review of literature.

BACKGROUND: Spinal metastases are common in patients with malignancies, but studies on those metastasized from unknown primaries are scarce due to the difficulty in treatment and the relatively poor prognosis. Knowledge of surgical complications, particularly perioperative mortality, in patients with spinal metastases from unidentified sources is still insufficient. CASE SUMMARY: A 54-year-old man with chest-back pain was diagnosed with spinal metastasis in the seventh thoracic vertebra (T7). Radiographic examinations, as well as needle biopsy and immunohistochemical tests were performed to verify the characteristics of the lesion, resulting in an inconclusive diagnosis of poorly differentiated cancer from an unknown primary lesion. Therefore, spinal surgery was performed using the posterior approach to relieve symptoms and verify the diagnosis. Postoperative histologic examination indicated that this poorly differentiated metastatic cancer was possibly sarcomatoid carcinoma. As the patient experienced unexpectedly fast progression of the disease and died 16 d after surgery, the origin of this metastasis was undetermined. We discuss this case with respect to reported perioperative mortality in similar cases. CONCLUSION: A comprehensive assessment prior to surgical decision-making is essential to reduce perioperative mortality risk in patients with spinal metastases from an unknown origin.

Paeoniflorin induces G2/M cell cycle arrest and caspase-dependent apoptosis through the upregulation of Bcl-2 X-associated protein and downregulation of B-cell lymphoma 2 in human osteosarcoma cells.

Paeoniflorin (PF), extracted from the peony root, has been proved to possess antineoplastic activity in different cancer cell lines. However, it remains unclear whether PF has an antineoplastic effect against osteosarcoma cells. The present study investigated the effects and the specific mechanism of PF on various human osteosarcoma cell lines. Using the multiple methods to detect the activity of PF on HOS and Saos­2 human osteosarcoma cell lines, including an MTS assay, flow cytometry, transmission electron microscopy and western blotting, it was demonstrated that PF induces inhibition of proliferation, G2/M phase cell cycle arrest and apoptosis in the osteosarcoma cell lines in vitro, and activation of cleaved­caspase­3 and cleaved­poly (ADPribose) polymerase in a dose­dependent manner. Furthermore, the pro­apoptotic factors Bcl­2 X­associated protein and BH3 interacting domain death agonist were uregulated, while the anti­apoptotic factors B­cell lymphoma 2 (Bcl­2) and Bcl­2­extra large were downregulated. In conclusion, these results demonstrated that PF has a promising therapeutic potential in for osteosarcoma.

Licochalcone A Inhibits MMPs and ADAMTSs via the NF-κB and Wnt/ß-Catenin Signaling Pathways in Rat Chondrocytes.

BACKGROUND: Osteoarthritis (OA) is a joint disease in which cartilage degradation is the central pathological change. In this study, we investigated the anti-osteoarthritic effects of licochalcone A (Lico A) in rat chondrocytes. METHODS: Polymerase chain reaction and Western blotting were performed to evaluate the expression of a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS)-5, ADAMTS-4, collagen II, matrix metalloproteinase (MMP)-13 and MMP-1 at both the gene and protein levels, respectively. In addition, the wnt/ß-catenin and nuclear factor kappa B (NF-κB) signaling pathways were also analyzed by Western blotting. RESULTS: Lico A downregulated ADAMTS-5, ADAMTS-4,MMP-13 and MMP-1 expression, and diminished the IL-1ß-induced inhibition of collagen II. In addition, the activation of ß-catenin and phosphorylation of p65 and IKKα/ß were suppressed by Lico A. CONCLUSIONS: Our results suggest that Lico A inhibits MMPs and ADAMTS partly via the NF-κB and wnt/ß-catenin signaling pathways in rat chondrocytes. Thus, Lico A may have therapeutic effects in OA.

[Effects of shading on endogenous hormones regulation in kernel development of summer maize in the field].

Taking 3 maize hybrids, Zhenjie 2 (ZJ2), Denghai 605 (DH605) and Zhengdan 958 (ZD958) as test materials, the effects of shading on the physiological function of endogenous hormones during grain formation of summer maize were investigated in the field. The ambient sunshine treatment was used as the control (CK) and 3 shading treatments with a shading degree of 60% were designed in growth periods ranging from tasseling to maturity (S1), from jointing to tasseling stage (S2) and whole growing period (S3), respectively. Results showed that the total floret number, filament number and pollination floret number decreased after shading in comparison with CK, and aborted seeds increased accordingly. The kernels per ear showed an order of CK > S2 > S > S3, and those of S1, S2 and S3 were 18.9%, 43.7% and 80.8% lower than that of CK. The IAA, GA and ZR contents of normal grain in the shading treatments were lower than in CK, while the ABA content was opposite. The same hormone change with grain growth in all treatments presented a similar trend. Compared to normal grains, the maximum value of IAA content in aborted grains shifted from the 20th day to the 10th day after pollination, with less IAA accumulation and rapid reduction, and the contents of GA and ZR decreased significantly, while that of ABA was still high at the 20th day after pollination. Therefore, the effects of shading on hormone contents in grains might lead to grain abortion and yield reduction.

[Effects of shading on dry matter accumulation and nutrient absorption of summer maize].

Taking summer maize cultivars Zhenjie 2 (ZJ2), Denghai 605 (DH605), and Zhengdan 958 (ZD958) as test materials, a field trial was conducted to study the effects of shading on the dry matter accumulation and nitrogen (N), phosphorus (P) and potassium (K) absorption of summer maize. Four treatments were installed, i. e., shading from flowering stage to maturity stage (S1), shading from six-leaf stage to flowering stage (S2), shading all through the growth season (S3), and no shading (CK). After shading, the grain yield and dry matter accumulation decreased significantly, and the decrement was related to shading period, showing S3 > S1 > S2. The grain yield in treatments S1, S2, and S3 was averagely 61.6%, 25.3%, and 92.8% lower than that of CK, respectively, indicating that the effects of shading after flowering were greater than those of shading before flowering. The responses of different cultivars to shading presented a similar trend. The nutrient absorption of summer maize before flowering stage showed K > N > P, and the nutrient absorption amount of whole plant showed N>K>P. After shading, the N and P absorption decreased significantly. The plant relative N and P absorption in different treatments had somewhat increase, because the decrement of dry matter accumulation after shading was larger than that of N and P absorption, as compared with the control. After shading, the plant K absorption decreased significantly, and the decrement in S2 was larger than that of dry matter accumulation. Shading before flowering stage had larger effects on the plant K absorption than on the N and P absorption.

Total hip arthroplasty with cementless cups and femoral head autografts for patients with hip dysplasia and osteoarthritis.

OBJECTIVE: To evaluate the outcome of total hip arthroplasty (THA) with cementless cups and femoral head autografts for patients with hip dysplasia and osteoarthritis. METHODS: Between 1995 and 2002, we implanted 23 cementless cups and femoral head autografts in 20 patients with hip dysplasia and osteoarthritis. In this study, a retrospective study was made on 21 hips in 20 patients (18 females and 2 males, aged 50 years on an average) with developmental hip dysplasia treated by THA with a cementless cup and femoral head autograft. The acetabular cup was placed at the level of the true acetabulum and all the patients required autogenous femoral head grafts due to acetabular deficiency. The average rate of the acetabular cup covered by the femoral head autograft was 31% (ranging from 10% to 45%). Eight hips had less than 25% cup coverage and thirteen between 25% and 50%. The average follow-up period was 4.7 years (range, 1-8 years). The replacing outcome was evaluated by modified Harris hip score. Preoperative and follow-up radiographs were made. RESULTS: All the autografts were united to the host bones. No autograft was collapsed or no component from the hip was loosed in all the patients. According to the modified Harris hip score, the average hip score increased from 46 before operation to 89 at the final review. Before operation, the leg-length discrepancy was greater than 2 cm in all the patients except one with bilateral hip dysplasia. After operation, only 2 out of 20 patients had a leg-length discrepancy greater than 1 cm. Three hips showed minor bone resorption in the lateral portion of the graft, which did not support the cup. Three hips developed Grade 1 Brooker heterotopic ossification and one developed Grade 2. CONCLUSIONS: THA with a cementless cup and a femoral head autograft for patients with osteoarthritis resulted from hip dysplasia can result in favorable outcomes. This method can provide reliable acetabular fixation and restore the acetabular bone stock in patients with developmental hip dysplasia when the cementless cup covered by the graft does not exceed 50%.