Objective To evaluate the efficacy of transposition of the medial gastracnemius muscle flap in the limbsalvage operation of the proximal tibial tumors. Methods From January 2001 to September 2005, 13 patients (8 males,5 females; aged 14-57 years, averaged 29.7 years) suffering from the proximal tibial tumors were treated with a limbsalvage operation. Among them, there were 4 patients with osteosarcoma, 6 with malignant fibrous histocytoma, 1 with malignant giant cell tumor, 1 with synovial sarcoma, and 1 with Ewing’s sarcoma. According to the Enneking staging system, 1 case was in Stage ⅠB, 9 in Stage ⅡA, and 3 in Stage ⅡB. One or two cycles of neo-adjuvant chemotherapy were used to each of the patients before operation. All of the patients underwent the medial head of the gastrocnemius muscle flap transposition to reconstruct the soft tissues after resection of the tumors and reconstruction of the bone defect by prothesis or bone-graft or the two methods combined. Results The follow-up for 7-47 months (average, 19.2 months) in all the patients revealed that. there was no flap necrosis, no skin necrosis at the incision margins, and no infection or fracture of the implanted bone. The patient with malignant fibrous histocytoma died of systemic metastasis 20 monthsafter operation. The patient with Ewing’s sarcoma had a local tumor recurrence 18 months after operation; though treated with the focal cleaning and the bone cement filling, the patient still developed lung metastasis of the tumor 26 months after operation. The patient with osteosarcoma underwent amputation 12 months after operation because of the tumor recurrence. According to the function assessment by the Mankin system, there were 6 patients who had an excellent result, 4 had a good result, and 3 had a poor result, with a satisfaction rate of 77%. Conclusion The flap transposition of the medial head of the gastrocnemius muscle can reconstruct the soft tissue defect, decrease the local complication rate and improve the clinical outcome of the limb salvage for the proximal tibia malignant tumor.
目的:探讨头面部皮肤恶性肿瘤采用Mohs手术和整形技术联合应用的治疗效果。方法:37例皮肤恶性肿瘤分为Mohs治疗组12例,普通手术组25例,并对切取肿瘤创面采用肌皮瓣、皮瓣、游离皮片,或直接缝合方式修复。结果: Mohs治疗组病例伤口Ⅰ期愈合,皮瓣全部成活,随访2年无复发。普通手术组病例伤口及皮瓣愈合好,但在2年随访中有4例复发(16%)。结论: Mohs手术和整形技术联合应用是治疗皮肤恶性肿瘤的最佳方法。
ObjectiveTo summarize the research progress of constitutive photomorphogenesis 9 signalosome (CSN) in malignant tumor in recent years. MethodsLiteratures about the relationship between CSN and maglinant tumor which were published in recent years were collected to make a review. ResultsMany malignant tumors were found to have high expression level of CSN, and CSN could degrade various tumor suppressor genes, such as p53 gene, mainly through regulating the ubiquitin protein degradation pathway, which played an role in promoting tumor growth. CSN5 was the deneddylation active center of CSN, and the activity of CSN was based on the integrity of CSN, which meant CSN6 (CSN core scaffold structure) have to exist. Current study found that CSN6 could promote tumorigenesis and development through a variety of signaling pathways, and CSN5 was mainly involved in cell cycle regulation and DNA damage repair to promote tumor growth. ConclusionsThe research of CSN in malignant tumors has lay a foundation of targeted therapies for cancer. However, the specific function of each of its subunit still remains unclear, and its upstream regulatory factors also need to be further explored.
目的 探讨CT引导下髂骨成形术在治疗恶性肿瘤晚期髂骨转移中的价值。 方法 对2009年3月－2011年8月收治的12例经病理活检证实为恶性肿瘤髂骨转移患者共，分别行CT引导下骨水泥注入髂骨成形术并观察该组患者治疗后的疼痛缓解、生活质量改善及生存期等。 结果 该组患者手术后24 h内，疼痛与术前相比差异无统计学意义（t=2.433，P＞0.05），手术后3 d和7 d进行再次评估，与治疗前相比差异有统计学意义（t=3.123，3.124；P＜0.05）；术后该组患者在躯体功能、心理功能、社会功能、物质生活状态方面的生活质量评分显著高于手术前（t=2.341，2.354，3.567，3.124；P＜0.05）。该组总有效率为82.5%。且治疗后癌胚抗原（CEA）含量为（2.9 ± 0.9）μg/L，显著低于治疗前的（15.5 ± 3.2）μg/L（P＜0.01）。所有患者随访1年，其6、10、12个月的总生存率分别为15.2%、32.8%、52.0%，平均生存时间10.4个月。该组患者治疗后并发症情况发生率58.3%，均为出现了无症状的骨水泥渗漏现象，注射治疗后持续时间为0.5～3 h，平均1.87 h。 结论 髂骨成形术短期内可明显减轻恶性肿瘤髂骨转移所致的疼痛症状。CT引导下髂骨成形术安全、可靠、近期疗效确切，是姑息性治疗恶性肿瘤髂骨转移的有效方法之一。
ObjectiveTo describe the cancer incidence and mortality in Henan cancer registries in 2014.MethodsRegistration data (including incidence, mortality and population data) were evaluated according to the criteria of quality control of cancer registry. The incidence, mortality, and cumulative rate (0 to 74 years old) were calculated and stratified by area (urban/rural), gender, and age. Chinese Population Census in 2000 and Segi’s Population were used for age-standardized incidence and mortality rates.ResultsThe total covered population of the 27 cancer registries in 2014 was 21 044 835, accounting for 19.73% of Henan's total population at the end of 2014. The crude incidence rate in Henan cancer registration areas was 252.79/100 000 (males 273.55/100 000, females 230.70/100 000). Age-standardized incidence rates by Chinese standard population and by world standard population were 205.27/100 000 and 203.78/100 000 with the cumulative incidence rate (0 to 74 years old) of 24.17%. The cancer mortality in Henan was 156.58/100 000 (188.10/100 000 in males and 123.02/100 000 in females). The age-standardized incidence rates by Chinese standard population and by world standard population were 123.94/100 000 and 123.80/100 000, and the cumulative incidence rate (0 to 74 years old) was 14.30%. Lung cancer, gastric cancer, esophageal cancer, liver cancer, breast cancer, colorectal cancer, cervical cancer, encephala, leukemia and thyroid cancer were the most common cancers, accounting for approximately 83% of all cancer cases in urban and rural areas. Lung cancer, gastric cancer, esophageal cancer, liver cancer, colorectal cancer, breast cancer, encephala, leukemia, pancreatic cancer and cervical cancer accounted for approximately 88% of all cancer deaths.ConclusionsThe age-standardized incidence and mortality in Henan are above the national level. The common cancers in Henan are lung cancer, female breast cancer and digestive system cancers. The strategy of cancer prevention and control in Henan should be implemented depending on pratical situations.
Soft tissue expander has been improved to perfection in recent ten years. Many excellent works have been accomplished for the patients who suffered from either soft tissue malformation or defects following traumatism, infection or benign tumors. But the reconstruction of soft tissue defects cause by malignant tumor hasbeen less studied.Four patients suffering from malignant tumour localized in the scalp and face, 1women and 3 men ranging from 65 to 75 years of age, have been operated on since1986. Their major deficits have been reconstructed with radican tissue expander, by the flap of the same colour and texture and also, similar thickness and sensation. There is no relapse in all the patients operated on reported until today.The surgical technique was discribed. The clinical results and the indication of tissue expander in the surgical treatment of malignant tumour are discussed.
In order to avoid lesion of adjacent organs which were often occurred after routine cryotherapy of pancreanoduodinal area, a new cryosurgical method of isolated pancreano-duodinal area was designed for treatment of neoplasm in this area, the feasibility of this method was tried in four pigs.After bile common duct, tail of pancreas, stomach, and jejunum were divided and protected by dry cotton pad, the isolated pancreano-duodinal area was twice fozen to -170℃, maintaining ten minutes with LCS 2000 cryogenic surgical system, then alimentary tract was reconstructed with cholecystojejunostomy and gastroenterostomy. Animals were observed for 1-4 weeks. There was only transient elevation of amylase postoperation and the liver function and blood sugar remained normal. No any complication was seen except a small pseudocyst in lesser omentum. Thorough destruction of pancreatic tissue by enough deep and time course of cryotherapy was emphasized and some technic problem also were discussed. Based on our experiment, cryosurgery of isolated pancreano-duodenum will be considered as a safe and effect therapy of pancreano-duodinal neoplasm.
Objective o explore the effect and mechanisms of transmembrane 4 super family (TM4SF) in digestive system cancer. Methods Articles were reviewed to discuss the biological characteristics of TM4SF in digestive system cancer. Results TM4SF played an important role in migration and invasion of digestive system cancer, including pancreatic cancer, gastric cancer, colorectal cancer, hepatic cancer, esophageal cancer, and so on. TM4SF modulated the cell biological activities by microdomains which were fixed on cell membrane, such as adhesion, migration, invasion, and proliferation. Conclusion TM4SF may be used to predict the metastasis and prognosis of digestive system cancer and may be the targets of therapy of it in the future.