The Efficacy of Radiofrequency Ablation for Bone Tumors Unsuitable for Radical Excision

BackgroundBone tumors can cause severe pain and poor quality of life due to recurrence and non-achievement of complete remission after surgery, chemotherapy, or radiotherapy. Radiofrequency ablation (RFA) can be considered for minimally invasive treatment of bone tumors that are difficult to radically excise. In this study, RFA was performed for bone tumors that were difficult to radically excise and did not respond to surgery, chemotherapy, or radiotherapy due to their large sizes and/or locations. The purpose of this study was to retrospectively analyze the clinical characteristics and survival rates of bone tumors after RFA and provide one more treatment option for the future.MethodsThere were 43 patients with bone tumors who underwent percutaneous RFA at our hospital from April 2007 to October 2017. The median age of the patients was 59 years (range, 31–75 years), and the median follow-up duration was 67.2 months (range, 10.2–130.5 months). Of the 43 patients, 26 were male and 17 were female. Thirty-four cases were metastatic bone tumors, 5 were chordomas, 3 were osteosarcomas, and 1 was a giant cell tumor. Pain and functional ability of the patients were evaluated using a visual analog scale (VAS) and the Musculoskeletal Tumor Society (MSTS) functional scoring system, respectively. Scores were recorded preoperatively, 1 week postoperatively, and 4 weeks postoperatively. The 1-year, 2-year, and 5-year survival rates were evaluated using the Kaplan-Meier method.ResultsThe mean VAS score was 8.21 preoperatively. The mean VAS score at 1 week, 4 weeks, 12 weeks, and 24 weeks postoperatively were 3.91, 3.67, 3.31, and 3.12, respectively. The mean preoperative MSTS score was 64.0% (range, 32%–87%). The mean postoperative MSTS score was 71.0% (range, 40%–90%). The 1-year, 2-year, and 5-year survival rates were 95.3%, 69.8%, and 30.2%, respectively.ConclusionsAs per our study findings, RFA was effective in reducing pain and improving functional ability of patients with bone tumors that were difficult to radically excise.     

计算机辅助组织工程在组织支架仿生建模和设计中的应用

计算机辅助组织工程(CATE)可以帮助进行复杂组织支架的建模,设计和制造,使很多用于改善替代材料力学及生物学性能的新方法得以实施。CATE通过获取组织的生物学、生物力学及生物化学信息,进行界面的设计、模拟和组织的制作。本文将讲述CATE在骨组织工程支架仿生设计中的应用:介绍运用CATE进行仿生建模,解剖结构重建,组织支架设计,定量CT分析,有限元分析和支架的自由挤压沉积制作。     

Anaplastic large cell Ki-1 lymphoma with bone involvement: Report of two cases

Two cases of anaplastic large cell Ki-1 lymphoma involving bone as the most prominent and initial manifestation are reported. The first patient was a 20-year-old male who had back pain and incomplete paraparesis due to vertebral involvement. The second was a 14-year-old girl, whose first clinical signs were fever of unknown origin and sternal bone pain. Radiologically, skeletal lesions were lytic and destructive. Histopathologically, the tumour cells had pleomorphic bizarre nuclei and abundant basophilic cytoplasm. Immunohistochemically, Ki-1 (CD30) reactivity was strongly positive in both cases. Tumour cells were also CD3, CD4, epithelial membrane antigen and interleukin-2 receptor positive in the first case, and CD10, HLA-DR positive in the second case. The former tumour was considered to be of T-cell lineage and the latter of lymphoid progenitor cell origin. Radiation and chemotherapy were temporarily effective. However, both patients died 14 and 7 months after diagnosis, respectively, due to systemic lymph node involvement. These observations suggest that the prognosis for Ki-1 lymphoma involving bone is poorer than indicated in previous reports.     

Morphology of the mineral phase of bone

Department of Experimental Morphology, Research Laboratory of Biological Structures, Ministry of Health of the USSR, Moscow. (Presented by Academician of the Academy of Medical Sciences of the USSR S. S. Debov.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 109, No. 6, pp. 614–616, June, 1990.     

Response to the Distilled spirits Industry Council of Australia Inc. position paper 'Alcohol Availability'

A critique is offered of the Distilled Spirits Industry Council position paper 'Alcohol Availability'. It is argued that this position paper presents a simple-minded analysis of the complex relationship between the availability of alcohol and its consumption which pays no attention to the importance of price in determining consumption. As a consequence, it misconstrues the lessons to be drawn from the Victorian experiment in liberalization and fails to consider its implications for the incidence of alcohol related problems.     

Site of bone density measurement may affect therapy decision

Summary The purpose of this study was to determine whether bone mineral density (BMD) measurements at the lumbar spine and femoral neck provided comparable information to women planning to use that knowledge to help them make a decision about hormone replacement therapy. Eighty-eight healthy Caucasian women, aged 44–59 and within 0 to 5 years of menopause, participated in the study. BMD measurements were performed at the lumbar spine (L1-L4) and the femoral neck by dual energy X-ray absorptiometry (DXA). Criteria suggested by the National Osteoporosis Foundation were used to categorize women as at risk for osteoporosis, bone density more than one standard deviation (SD) below the young adult mean, or as low risk, bone density at or above this level. The re that 46 women would be classified into the low risk category on the basis of spinal BMD alone. However, 28 of these 46 women would fall into the at risk category when the femoral neck BMD was measured. Sixty-one percent of women informed they were at low risk on the basis of spinal BMD would be considered at risk based on femoral neck BMD. When femoral neck BMD was used as the primary risk indicator, 14% of the women classified as low risk would be at risk if spinal BMD were added. These results suggest that both lumbar spine and proximal femur measurements should be made when women are using bone density measurements as an aid in deciding whether or not to use hormone therapy in their postmenopausal years.     

直接法与统计法测试松质骨孔隙率的比较研究

目的 探讨松质骨孔隙率的测试方法。方法 对15根猪胫骨分别采用“直接法”与“统计法”测试松质骨孔隙率或其表观密度和材料密度。结果 （1）孔隙率与表观密度呈非常显著负相关,而与材料密度相关不显著;（2）孔隙率沿轴向靠近密质量骨逐渐减小,而沿横向基本不变;（3）统计法可测出松质骨各个层面的孔隙率大小。结论 直接法和统计法均能检测松质骨孔隙率,但统计法较直接法更能反映孔隙率的分布与变化规律。     

冷冻同种异体骨段移植修复股骨近段大块骨缺损

为观察大块冷冻同种异体骨移植后免疫功能的改变及预后,对13例恶性骨肿瘤瘤段切除后的骨缺损10.8～19.4cm(平均为14.6cm),分别采用冻冷异体松质骨段移植的髋关节加压融合术(6例)和异体股骨近段半关节移植成形术(7例)修复.10例分别于术前4天及术后14和28天检测其空腹外周血各项免疫学指标,以及术后3、6、9、12、24、48个月进行99mSPECT骨扫描(5例)和X-线片检查(12例),以观察宿主的免疫反应和异体骨愈合情况.结果:①外周血T淋巴细胞亚群(OKT3+,OKT4+,OKT8+)及血清补体(C3,C4)和循环免疫复合物(CiC)手术前后比较无显著性差异(P>0.05).②99mTe SPECT骨扫描显示:术后3～6个月移植的异体骨两端及髓腔内同位素浓集明显低于正常,而异体骨两端所对应的自体骨端同位素浓集明显高于正常,此现象于植入后9个月开始减弱,可达数年.X线片显示:异体骨愈合率为92.3%(12/13),2例移植的异体松质骨段于术后4～6年完全成活替代.以上可见:①冻冷异体骨段移植后宿主的全身免疫机能改变不明显,其反应是以局部炎症为主的细胞免疫过程;②异体骨可做为修复大块骨缺损的良好材料.     

磷脂对HDL3介导大鼠皮肤成纤维细胞内胆固醇流出能力的影响

目的　研讨磷脂对HDL3 介导大鼠皮肤成纤维细胞内胆固醇流出能力的影响。方法　在卵磷脂 (PC)或鞘磷脂 (SPM )存在条件下 ,观察HDL3 介导细胞胆固醇流出量的变化、细胞内磷脂含量变化及游离胆固醇 /胆固醇酯平衡的变化。结果　①BSA组 (对照组 )、HDL3 组、PC组、SPM组、PC HDL3 组和SPM HDL3 组分别介导 4.70 %、31.5 5 %、7.35 %、8.0 6 %、42 .95 %和 46 .98%细胞胆固醇流出 ;②BSA、HDL3 、HDL3 SPM和HDL3 PC组细胞培育后胞内卵磷脂磷含量 (PC p)和鞘磷脂磷含量 (SPM p)分别为 2 0 .0 2、5 .5 6 ,17.5 6、5 .2 8,18.6 2、7.0 0和 2 2 .5 0、5 .5 2 μg/皿 ;③PC和SPM与细胞培育后 ,胞内游离胆固醇 /总胆固醇比值分别为 49.6 5和 5 9.5 7。培育前此比值为 48.6 4。结论　①PC和SPM本身无介导细胞胆固醇流出能力 ,但它们能显著提高HDL3 介导的细胞胆固醇流出能力 ,且后者强于前者 ;②随着细胞胆固醇流出 ,部分胞内PC也流出胞外 ,而胞内SPM无明显变化 ;③SPM促进细胞内胆固醇酯向游离胆固醇转化。