Objective To review the research progress of the treatment of osteosarcoma, and to thoroughly understand its current state of research and prospect so as to lay a sol id foundation for the cl inical treatment. Methods The cl inical and experimental research l iteratures about treatment of osteosarcoma were extensively reviewed and analyzed. Results The present treatment of osteosarcoma is still need to comprehensive therapy which combine chemotherapy and surgical treatment. There are some progresses in gene therapy and molecular targeting therapy which can improve survival rate. Furthermore, well-designed studies and cl inical trials are needed to evaluate the potential therapeutic impact before they are used in cl inical. Conclusion Advancement in chemotherapeutic regimens has improved survival and l imb-sparing surgery in the treatment of osteosarcoma, but the progress of gene therapy and molecular targeting therapy gives new hope for osteosarcoma patients.
Objective To summarize the current progress in the genetic modification of vascular prostheses and to look forward to the future of genetic modification in vascular prostheses. Methods PubMed onl ine search with the key words of “vascular prostheses, gene” was undertaken to identify articles about the genetic modification of vascular prostheses. Then these articles were reviewed and summarized. Results To improve long-term patency of vascular prostheses, various genes were transfected into seeded cells. The antithrombosis activity of local vessels increased. Conclusion Progresses in tissue engineering and molecular biology make possible endothel ial ization and genetic modification of vascular prostheses. However, because most relevant researches are still basic experiments, further study is needed before cl inical appl ication.
Objective To review the latest progress in classification system of thoracolumbar fractures and its surgical treatment with posterior approaches. Methods Recent l iterature about classification system of thoracolumbar fractures and its surgical treatment was reviewed. Results For the treatment of thoracolumbar fracture, the surgeon first should decide whether the surgical treatment was necessary. Recently, a new classification system had been developed to help the surgeon make the right decision. The surgical methods included short segment internal fixation and long segment internalfixation with or without fusion, and minimally invasive internal fixation. Conclusion The progress in the surgical treatmentof thoracolumbar fracture will help spinal surgeon decide the necessary surgery beneficial for the patients. The most appropriate and effective surgical method with the minimum damage should be used to treat the fracture. The advantages of non-fusion surgical treatment still need a further study.
Hybrid cardiovascular surgical procedure is an emerging concept that combines the skills and techniques of minimally invasive surgery and interventional catheterization. It allows surgeons to use interventional equipment and techniques during operations, which are traditionally used by physicians, in order to reduce the magnitude of therapeutic interventions and to increase therapeutic effectiveness. This review provides a snapshot of the main application and progress of current hybrid procedures in the field of cardiovascular surgery, including the hybrid therapy of coronary artery disease, congenital heart disease and thoracic aortic aneurysm, also discusses the precondition with which the hybrid procedure should ideally be performed.
ObjectiveTo discuss the relationship between angiogenesis and the clinical pathological characteristics, prognosis in primary gallbladder carcinoma (PGC ). MethodsThe specimens of 42 patients with PGC who underwent operation during 1993 and 1996 were collected. The immunohistochemical staining was performed in these specimens through SABC manner. Angiogenesis was represented by intratumor microvessel count (MVC ) and expression of vascular endothelial growth factor (VEGF ).ResultsIn all the patients, the average MVC was 70.4±20.7, and the VEGF positive expression rate was 69.0%. The mean MVC was 57.9±15.4 in the tumor of histograde Ⅰ and Ⅱ, and was 88.8±11.5 in another group of grade Ⅲ and Ⅳ respectively. The mean MVC was 45.0±17.0 in the cases of Nevin stage Ⅰ, Ⅱ and Ⅲ, and was 77.2±16.0 in the other cases of Nevin stage Ⅳ and Ⅴ. There were significant differences between two groups. VEGF expression positive rate was correlated with grade and stage, in the patients with poordifferentiated grade and late stage the MVC was significant higher. The expression of VEGF was markedly correlated with MVC. The 3year survival rate was significant lower in the group of high MVC or VEGF positive expression. Conclusion Manifold VEGF secretion in PGC may increase the MVC value, and accelerate the tumor advance and metastasis. Angiogenesis may be considered as an effective predictor to the prognosis of the primary gallbladder carcinoma.
Total hip arthroplasty is an end-stage treatment for hip diseases such as hip osteoarthritis and osteonecrosis of the femoral head. Traditional surgery models are still mostly used in China, and related day surgery models abroad have shown that day surgery for total hip arthroplasty is as safe and feasible as traditional pattern without increase in complications and readmission. It can also shorten the length of hospitalization for patients, reduce hospitalization costs, thereby speeding up bed turnover and increasing the utilization of medical resources. This article reviews the patient admission, perioperative management, anesthesia and surgical techniques, post-discharge rehabilitation and nursing care of patients undergoing day surgery for total hip arthroplasty, and aims to providea reference for the development of day surgery for total hip arthroplasty in China.
The earliest record of chest trauma surgery was B.C 3000 years. Before 15th century, chest trauma surgery only focused on simple wound treatment of the chest wall. At the beginning of 20th century, treatment of organ injury in the thoracic cavity appeared. In the 50's-80's of the 20th century, complete structure and knowledge of modern chest trauma surgery came into being. Since the 90's of the 20th century, development of new techniques such as minimally invasive surgery, new concepts such as fast-track surgery and damage control surgery, new materials, multidisciplinary cooperation, Internet technology, and translational medicine all have contributed to outcome improvement of patients with chest trauma, and will contribute to the development of chest trauma surgery in the future.
At present, interventional therapy for structural heart disease is in a period of vigorous development. Among them, transcatheter aortic valve replacement, as a representative of the interventional treatment of heart valve disease, has made rapid progress, which is a bright spot in the field of cardiovascular disease. The future development of transcatheter tricuspid valve repair/replacement is also promising. With the availability of important clinical evidence, the indications of transcatheter aortic valve replacement have been extended to the full risk range of severe aortic stenosis. More and more data showed that transcatheter mitral and tricuspid valve interventions could effectively alleviate patients’ symptoms and improve their prognosis. Transcatheter valve interventions have developed rapidly and have made tremendous progress in China. This article will review and interpret the important progress in the field of transcatheter valve interventions.
Objective To introduce the current development of periodontal regeneration. Methods The recent l iterature about advances in the regeneration of periodontium using tissue engineering was extensively reviewed and new technologies that will lead to further advances in periodontal therapy was investigated. Results The cells, appropriate signals,scaffold and blood supply play fundamental roles in periodontal regeneration. Furthermore, interreaction of these factors, such as cells modified by growth factor gene or growth factor del ivered by scaffold, will enhance their effects in tissue regeneration. Conclusion Periodontal tissue engineering have great potential and promising future in periodontal regeneration and therapy.
ARDS 是引起重症患者呼吸衰竭的主要原因, 尽管医疗技术有了很大的进步, 但对ARDS 的治疗只局限在器官支持层面, 其病死率仍高达40% [ 1] 。ARDS的主要病理改变为肺泡上皮细胞和毛细血管内皮细胞受损, 通透性增加, 富含蛋白质的液体渗出积聚于肺间质和肺泡。因此促进损伤肺毛细血管内皮细胞和肺泡上皮细胞的有效修复可能是ARDS治疗的关键所在。随着干细胞工程学的发展, 间充质干细胞( MSC) 作为一种理想的组织修复来源, 在ARDS 治疗中的应用受到越来越多的关注, 这可能为ARDS 的治疗开辟一条新的途径。