骨水泥型人工双极股骨头置换治疗股骨近段骨转移瘤

目的:探讨骨水泥型人工双极股骨头置换治疗股骨近段转移瘤的临床疗效。方法:回顾性分析2012年1月至2019年6月华中科技大学同济医学院附属协和医院收治的54例行骨水泥型人工双极股骨头置换的股骨近段转移瘤患者的资料。采用疼痛视觉模拟评分(visual analogue scale,VAS)、国际骨肿瘤协会(musculoskeletal tumor society system,MSTS)功能评分、国际保肢学会(international society of limb salvage,ISOLS)影像评分、Harris髋关节功能评分量表(Harris hip score)、Karnofsky功能状态(Karnofsky performance status,KPS)评分和诺丁汉健康调查问卷(Nottingham health profile,NHP)评分评定患者疼痛、肢体功能和生存质量。Kaplan-Meier法分析生存情况。结果:患者随访时间为10~99个月,平均42.17个月。患者手术时间(79.68±6.17)min,术中出血量(524.00±39.25)mL。术后3、6和12个月,VAS评分和NHP评分分别较术前降低,MSTS评分、ISOLS评分、Harris评分和KPS评分分别较术前提高,差异均具有统计学意义(P<0.05)。术后3、6和12个月,每个随访点之间的VAS评分、相关功能评分和生存质量评分差异均无统计学意义(P>0.05)。随访期内6例发生并发症。患者平均生存时间19.46个月,6个月、1年和3年生存率分别为88.89%、70.37%和11.11%。结论:股骨近段骨转移瘤患者行骨水泥型人工双极股骨头置换可减轻患者疼痛,提高肢体功能,延长生存时间,提高生存质量。

The generation and use of animal models of osteosarcoma in cancer research

Osteosarcoma is the most common malignant bone tumor affecting children and adolescents.Currently,the most common treatment is surgery combined with neoadjuvant chemotherapy.Although the survival rate of patients with osteosarcoma has improved in recent years,it remains poor when the tumor(s)progress and distant metastases develop.Therefore,better animal models that more accurately replicate the natural progression of the disease are needed to develop improved prognostic and diagnostic markers,as well as targeted therapies for both primary and metastatic osteosarcoma.The present review described animal models currently being used in research investigating osteosarcoma,and their characteristics,advantages,and disadvantages.These models may help elucidate the pathogenic mechanism(s)of osteosarcoma and provide evidence to support and develop clinical treatment strategies.

LncRNA MEG3 promotes chemosensitivity of osteosarcoma by regulating antitumor immunity via miR-21-5p/p53 pathway and autophagy

This study aimed to investigate the role of long non-coding RNA maternally expressed gene 3(lncRNA MEG3)in chemosensitivity of osteosarcoma(OS),and to reveal the possible underlying mechanisms.In this study,we found that the expression of lncRNA MEG3 was significantly lower in OS tissues and cell lines.Furthermore,lncRNA MEG3 overexpression enhanced chemosensitivity of OS by inhibiting cell proliferation,migration,autophagy,and promoting antitumor immunity.LncRNA MEG3 functioned as miR-21-5 sponge to regulate p53 expression in OS.Mechanically,lncRNA MEG3 promoted OS chemosensitivity by regulating antitumor immunity via miR-21-5p/p53 pathway and autophagy.Collectively,this study provided the evidence that lncRNA MEG3 might be a promising therapeutic target for OS chemoresistance.

Implantable immune stents:a new opportunity for cancer treatment

clinical trials of solid tumours is mainly due to their highly immunosuppressive tumour microenvironment(TME).1 Regulatory T cells(Tregs),a subset of T cells that control the autoimmune response and are one of the main components of immunosuppressive TME,can regulate the immune response intensity and inhibit the function and activity of effector T cells,thus inducing immune tolerance and maintaining immune response homeostasis.In solid TME,Tregs mediate the immune escape of tumour cells by inhibiting the body’s immune response,affecting the efficacy of prognosis.

Ferroptosis as a novel form of regulated cell death:Implications in the pathogenesis,oncometabolism and treatment of human cancer

The treatment of cancer mainly involves surgical excision supplemented by radiotherapy and chemotherapy.Chemotherapy drugs act by interfering with tumor growth and inducing the death of cancer cells.Anti-tumor drugs were developed to induce apoptosis,but some patient’s show apoptosis escape and chemotherapy resistance.Therefore,other forms of cell death that can overcome the resistance of tumor cells are important in the context of cancer treatment.Ferroptosis is a newly discovered iron-dependent,non-apoptotic type of cell death that is highly negatively correlated with cancer development.Ferroptosis is mainly caused by the abnormal increase in iron-dependent lipid reactive oxygen species and the imbalance of redox homeostasis.This review summarizes the progression and regulatory mechanism of ferroptosis in cancer and discusses its possible clinical applications in cancer diagnosis and treatment.

Proper animal experimental designs for preclinical research of biomaterials for intervertebral disc regeneration

Low back pain is a vital musculoskeletal disease that impairs life quality,leads to disability and imposes heavy economic burden on the society,while it is greatly attributed to intervertebral disc degeneration(IDD).However,the existing treatments,such as medicines,chiropractic adjustments and surgery,cannot achieve ideal disc regeneration.Therefore,advanced bioactive therapies are implemented,including stem cells delivery,bioreagents administration,and implantation of biomaterials etc.Among these researches,few reported unsatisfying regenerative outcomes.However,these advanced therapies have barely achieved successful clinical translation.The main reason for the inconsistency between satisfying preclinical results and poor clinical translation may largely rely on the animal models that cannot actually simulate the human disc degeneration.The inappropriate animal model also leads to difficulties in comparing the efficacies among biomaterials in different reaches.Therefore,animal models that better simulate the clinical charateristics of human IDD should be acknowledged.In addition,in vivo regenerative outcomes should be carefully evaluated to obtain robust results.Nevertheless,many researches neglect certain critical characteristics,such as adhesive properties for biomaterials blocking annulus fibrosus defects and hyperalgesia that is closely related to the clinical manifestations,e.g,low back pain.Herein,in this review,we summarized the animal models established for IDD,and highlighted the proper models and parameters that may result in acknowledged IDD models.Then,we discussed the existing biomaterials for disc regeneration and the characteristics that should be considered for regenerating different parts of discs.Finally,well-established assays and parameters for in vivo disc regeneration are explored.

Three-dimensional-printed titanium prostheses with bone trabeculae enable mechanical-biological reconstruction after resection of bone tumours

Reconstruction after resection has always been an urgent problem in the treatment of bone tumours.There are many methods that can be used to reconstruct bone defects;however,there are also many complications,and it is difficult to develop a safe and effective reconstruction plan for the treatment of bone tumours.With the rapid development of digital orthopaedics,three-dimensional printing technology can solve this problem.The three-dimensional printing of personalised prostheses has many advantages.It can be used to print complex structures that are difficult to fabricate using traditional processes and overcome the problems of stress shielding and low biological activity of conventional prostheses.In this study,12 patients with bone tumours were selected as research subjects,and based on individualised reverse-engineering design technology,a three-dimensional model of each prosthesis was designed and installed using medical image data.Ti6Al4V was used as the raw material to prepare the prostheses,which were used to repair bone defects after surgical resection.The operation time was 266.43±21.08 minutes(range 180-390 minutes),and intraoperative blood loss was 857.26±84.28 mL(range 800-2500 mL).One patient had delayed wound healing after surgery,but all patients survived without local tumour recurrence,and no tumour metastasis was found.No aseptic loosening or structural fracture of the prosthesis,and no non-mechanical prosthesis failure caused by infection,tumour recurrence,or progression was observed.The Musculo-Skeletal Tumour Society(MSTS)score of limb function was 22.53±2.09(range 16-26),and ten of the 12 patients scored≥20 and were able to function normally.The results showed that three-dimensional printed prostheses with an individualised design can achieve satisfactory short-term clinical efficacy in the reconstruction of large bone defects after bone tumour resection.

Endogenous repair theory enriches construction strategies for orthopaedic biomaterials:a narrative review

The development of tissue engineering has led to new strategies for mitigating clinical problems;however,the design of the tissue engineering materials remains a challenge.The limited sources and inadequate function,potential risk of microbial or pathogen contamination,and high cost of cell expansion impair the efficacy and limit the application of exogenous cells in tissue engineering.However,endogenous cells in native tissues have been reported to be capable of spontaneous repair of the damaged tissue.These cells exhibit remarkable plasticity,and thus can differentiate or be reprogrammed to alter their phenotype and function after stimulation.After a comprehensive review,we found that the plasticity of these cells plays a major role in establishing the cell source in the mechanism involved in tissue regeneration.Tissue engineering materials that focus on assisting and promoting the natural self-repair function of endogenous cells may break through the limitations of exogenous seed cells and further expand the applications of tissue engineering materials in tissue repair.This review discusses the effects of endogenous cells,especially stem cells,on injured tissue repairing,and highlights the potential utilisation of endogenous repair in orthopaedic biomaterial constructions for bone,cartilage,and intervertebral disc regeneration.