With the developing of three-dimensional (3D) printing technology, it is widely used in the treatment of bone tumors in the clinical orthopedics. Because of the great individual differences in the location of bone tumor, resection and reconstruction are difficult. Based on 3D printing technology, the 3D models can be prepared to show the anatomical part of the disease, so that the surgeons can create a patient-specific operational plans based on better understand the local conditions. At the same time, preoperative simulation can also be carried out for complex operations and patient-specific prostheses can be further designed and prepared according to the location and size of tumor, which may have more advantages in adaptability. In this paper, the domestic and international research progress of 3D printing technology in the treatment of limb bone tumors in recent years were reviewed and summarized.
Since November 1974 to December 1993, 110 cases with malignant tumors of the extremities were treated by en bloc resection and limb salvage procedure in our hopsital. There were 57 males and 53 females. Their ages ranged from 14 to 70 years. The diagnosis of all patients were confirmed by pathology. Among them, 68 cases were malignant bone tumor, 42 cases were malignant tumor of soft tissue. If the soft tissue was involved by the malignant tumors, the tumor was resected radically and myocutaneous or skin flap was transferred to covered the defect. Among the 42 cases, 5 were free vascularized and 37 were pediculated flaps. The maximal size of the flap was 15×25 cm and the minimal was 6×8 cm. For the malignant bone tumors, en bloc resection was performed and the bone defect was reconstructed with autogenous free vascularized fibular graft, autograft of massive bone with fusion or allograft of cryogenic massive bone. If the joint was involved, limited excision with replacement of prosthesis was recommended. When both soft tissue and bone were involved, segmental resection of tumor was indicated in 17 cases. The patients were followed up for 2 to 9 years, the results of 53 cases were still alive with a survival rate of 48.2%. We emphasized that the local extensive resection should be performed with a safety margin of 3 to 5 cm beyond the tumor. A djuvant chemotheapy and radiotherapy had definite value in the treatment of some malignant tumors, so that preoperative or postoperative chemotherapy or radiotherapy was necessary. Sometimes radical resection of regional lymph rodes was necessary. The indications and causes of recurrence were discussed.
Objective To understand the role and mechanism of tumor associated macrophages (TAM) on the occurrence and development of primary liver cancer, and its application in the treatment. MethodThe related literatures about the researches of relation between TAM and primary liver cancer at home and abroad in recent years were collected, sorted out, and made a review. Results Under different stimulating factors, TAM could be polarized to anti-tumor type 1 TAMs or tumor-promoting type 2 TAMs, and type 2 TAMs was the main part in the tumor microenvironment. Through some mechanisms such as vascularity-promoting, invasion-promoting, and immunosuppression to promote the occurrence and development of tumors, and potential treatment plans for primary liver cancer could be found by targeting TAM from different perspectives. Conclusion TAM has a wide range of effects on primary liver cancer, and their mechanisms are complex, understanding the relation between them and make an effective control of TAM could provide new therapeutic ideas and plans for clinical treatment of primary liver cancer.
ObjectiveTo summarize the application status and prospect of laparoscopic pancreaticoduodenectomy (LPD).MethodThe relevant literatures about studies of LPD at home and abroad were reviewed.ResultsLPD was a difficult operation, mainly suitable for pancreatic head and periampullary benign and malignant tumors. With the development of laparoscopic techniques in recent years, LPD combined the superior mesenteric vein and portal vein resection and reconstruction, or combined multi-visceral resection was feasible, but the survival benefit of LPD with arterial resection and reconstruction and extended lymph node dissection remained to be discussed. At present, there was no clear requirement on the way to reconstruct the pancreatic fluid outflow tract, but the pancreaticojejunostomy for digestive tract reconstruction was chose by the most surgeons. The most studies had confirmed that LPD was minimally invasive and had a short-term prognosis that was not inferior to that of open pancreaticoduodenectomy. However, the results of large sample analysis about long-term survival rate and oncology results were lacking, so it was difficult to judge the advantages and disadvantages of long-term prognosis of the two methods.ConclusionsLPD is a safe, feasible, reasonable, and effective surgical method. With improvement of laparoscopic technology, LPD is expected to become a standard operation method for treatment of pancreatic head cancer and periampullary carcinoma, and oncology benefits of LPD will be further confirmed in future by large-sample clinical randomized control trials and studies of long-term prognosis follow-up.
Objective To study the surgical treatment of tracheal and main bronchial tumors. Methods We retrospectively analyzed the clinical data of 30 patients with tracheal and main bronchial tumors treated in Shengjing Hospital of China Medical University from January 2000 to December 2015. There were 12 males and 18 females with the age ranging from 22 to 80 years. Results Ten patients were treated with enucleation, 12 patients tracheal tumor resection and end-to-end anastomosis, 1 patient window resection, 1 patient wedge resection, 5 patients tumor resection and tracheal reconstruction by using pulmonary tissue flap with alloy stent and 1 patient left pneumonectomy. One patient died of sudden massive hemoptysis 26 d after operation. Intraoperative complications were found in 2 patients. Others had a good recovery after operation. Patients were followed up for 11 months to 14 years. Eight patients were followed up less than 5 years postoperatively, one patient died of sudden massive hemoptysis 14 months after operation, while others survived; 21 patients were followed up more than 5 years and 5 patients were lost to follow-up. Conclusion Surgical resection is recommended for tracheal and main bronchial tumors. Patients with small benign tumor may choose local tracheal resection; tracheal segmental resection and end-to-end anastomosis is the most common surgical treatment. Patients with more than half of the whole length of tracheal defects or in the risk of anastomotic ischemic necrosis may be suggested to receive tracheal reconstruction.
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.
【Abstract】 Objective To review the progress in the treatment of bone defect by porous tantalum implant. Methods Recent l iterature was extensively reviewed and summarized, concerning the treatment method of bonedefect by porous tantalum implant. Results By right of their unique properties, porous tantalum implants have achievedvery good results in the treatment of certain types of bone defects. Conclusion Porous tantalum implants have their ownadvantages and disadvantages. If the case is meet to its indications, this method can obtain a good effect. Porous tantalum implants provide a new way for the cl inical treatment of bone defects.
Objective To compare the long-term results of vascularised fibulargraft and simple autologous fibular graft for reconstruction of wrist after distal bone tumor resection.Methods From January 1979 to September2002, 15 patients with wrist defects due to distal bone tumor resection were treated with vascularised fibular graft or simple autologous fibular graft and followed up 1 year. The results were graded with Enneking’s system and evaluated radiographicallyaccording to the “International Symposium on Limb Salvage”. The grade system included limb function, radiological examination and the function of ankle. Results The limb function of 8 patients with vascularised fibular graft restored to 80% of normal function and the bone union was achieved within 6 months. The limbfunction of 6 patients with simple autologous fibular graft restored to 67% of normal function. The bony union was achieved within 6 months in 4 cases with thebone graft less than 5 cm and in the 13th and 16th months in 2 cases with the bone graft more than 12 cm. Conclusion It is suitable to use the headof fibular boneas a substitute for the distal radius. The healing of vascularised fibular graft is very quick and haven’t the bone resorption. So in the procedure for reconstruction and limb salvage after bone tumor resection of distal radius, the free vascularised fibular graft with fibular head is an ideal substitute.
Tumor chemotherapy is a treatment method that employs chemotherapeutic drugs to eradicate cancer cells. These drugs are cytotoxic, meaning they can affect both tumor cells and normal cells. In recent years, there has been a gradual increase in chemotherapy-induced liver injury. Chemotherapy-induced parenchymal liver injury often manifests as diffuse lesions, although focal lesions can occasionally be observed. There is a diversity in the pathogenesis and pathological changes of chemotherapy-induced focal liver disease. Radiologically, there is often challenging in differentiating chemotherapy-induced focal liver disease from hepatic metastases. Therefore, early and accurate diagnosis of this condition poses a certain challenge in clinical practice. This article presents the radiological findings of a case of chemotherapy-induced focal liver disease induced by chemotherapy for gastric cancer, and summarizes the radiological features and differential diagnostic points of chemotherapy-induced focal liver disease, aiming to enhance the understanding of this type of lesion among radiologists and clinicians and reduce related missed diagnoses and misdiagnoses.
After freatment of prosthesis replacement for 12 malignant tumer of the proximal humoral werereported. The operation were performed after the indications and methods of treatment had beendefined. All of the 12 cases were followed-up, in the average of 8 yeare. On functional evaluation , 8cases had satisfactory result , but per in 1 cases and 3 cases died from recurrence or metastasis withinfive years. The indieation of the procthetic replantation, the complications, and revision weredisecused.