体外高频热疗治疗肿瘤患者的临床护理方法及效果研究

目的了解体外高频热疗治疗肿瘤患者的临床护理方法及效果。方法将我院2018年4月至2019年3月的120例体外高频热疗治疗肿瘤患者,随机分组,常规护理服务组对于体外高频热疗治疗肿瘤患者给予常规护理,临床全方位护理组对于体外高频热疗治疗肿瘤患者采取临床全方位护理。比较两组满意评分;体外高频热疗治疗原理认知水平、治疗依从性;护理前后生存质量指标、外周细胞免疫指标和心理指标;并发症发生率。结果临床全方位护理组满意评分、生存质量指标、外周细胞免疫指标和心理指标、体外高频热疗治疗原理认知水平、治疗依从性、并发症发生率对比常规护理服务组有优势,P <0.05。结论体外高频热疗治疗肿瘤患者实施临床全方位护理效果确切,可有效改善体外高频热疗治疗肿瘤患者的疾病认知和提高患者的治疗依从性,改善患者的免疫功能和生存质量,并改善患者的心理状态,减少治疗并发症的发生率。

慢性前列腺炎体外高频热疗与护理

目的 寻找治疗慢性前列腺炎的有效措施。方法 对 2 5 0例慢性前列腺炎患者采用体外高频热疗、按摩、口服及肛门给药等综合治疗。结果 全部病例均有效 ,其中治愈 199例 (79.6 % ) ,显效 30例 (12 .0 % ) ,好转 2 1例 (8.4 % )。结论 体外高频热疗加按摩等综合治疗慢性前列腺炎方便、安全、有效 ,不使用特殊药物 ,费用低。

Recent biological applications of corroles:From diagnosis to therapy

Corrole,a representative branch of porphyrin,has recently gained popularity.These molecules,viewed as ring‑contracted porphyrinoids containing direct pyrrole‑pyrrole linkages due to the absence of a meso‑carbon atom,exhibit significant photo‑physicochemical properties that make them attractive for various applications.Herein,this review comprehensively discusses the remarkable properties of corrole complexes,as well as related structures and chelation properties.It further explores the biological applications of corrole complexes for in vivo imaging and anticancer therapy.Additionally,it addresses common research bottlenecks and challenges,providing insights into future potential applications in disease diagnosis and treatment.Generally,this review aims to illuminate the significance of corrole complexes and their promising biological applications.

Suppression of pancreatic carcinoma growth by activating peroxisome proliferator-activated receptor γ involves angiogenesis inhibition

AIM： TO Study the possible actions and mechanisms or peroxisome proliferator-activated receptor γ （PPARγ）, a ligand-activated transcription factor, in pancreatic car- cinogenesis, especially in angiogenesis. METHODS： Expressions of PPARy and retinoid acid receptor （RXRα） were examined by reverse-transcription polymerase chain reaction （RT-PCR） with immunocyto- chemical staining. Pancreatic carcinoma cells, PANC-1, were treated either with 9-cis-RA, a ligand of RXRα, or with 15-deoxy-△12,14 prostaglandin J2 （15d-PGJ2）, a ligand of PPART, or both. Antiproliferative effect was evaluated by cell viability using methyltetrazolium （MTT） assay. A pancreatic carcinoma xenograft tumor model of nude mice was established by inoculating PANC-1 cells subcutaneously. Rosiglitazone, a specific ligand of PPARy, was administered via water drinking in experimental group of nude mice. After 75 d, all mice were sacrificed. Expression of proliferating cell nuclear antigen （PCNA） in tumor tissue was examined with immunohistochemical staining. Expression of vascular endothelial growth factor （VEGF） mRNA in PANC-1 cells, which were treated with 15d-PGJ2 or 9-cis-RA at various concentrations or different duration, was detected by semi-quantitative RT-PCR. Effects of Rosi- glitazone on changes of microvascular density （MVD） and VEGF expression were investigated in xenograft tumor tissue. Neovasculature was detected with immu- nohistochemistry staining labeled with anti-Ⅳ collagen antibody, and indicated by MVD. RESULTS： RT-PCR and immunocytochemical stain- ing showed that PPARγ and RXRα were expressed in PANC-1 cells at both transcription level and translation level. MTT assay demonstrated that 15d-PGJ2, 9-cis-RA and their combination inhibited the growth of PANC-1 cells in a dose-dependent manner. 9-cis-RA had a com- bined inhibiting action with 15d-PGJ2 on the growth of pancreatic carcinoma. In vivo studies revealed that Rosiglitazone significantly suppressed the growth of pancreatic carcinoma as compared to control group （0.48 ± 0.23 cm^3 vs 2.488 ± 0.59 cm^3, P 〈 0.05）, and the growth inhibition rate was 80.7%. Immuno- histochemistry study showed that PCNA was down regulated in Rosiglitazone-treated group compared to the control group. 15d-PGJ2, 9-cis-RA and their com- bination inhibited the expression of VEGF mRNA in PANC-1 cells in a dose- and time-dependent manner. MVD was decreased more significantly in Rosiglitazone- treated mice （10.67±3.07） than in the control group （31.44±6.06） （P 〈 0.01）. VEGF expression in xeno- graft tumor tissue was also markedly down-regulated in Rosiglitazone-treated mice. CONCLUSION： Activation of PPARγ, inhibits the growth of pancreatic carcinoma both in vitro and in vivo. Sup- pression of tumor angiogenesis by down-regulating the expression of VEGF may be one of the mechanisms by which PPARγ, activation inhibits the growth of pancre- atic carcinoma.

Antiviral efficacy of adefovir dipivoxil versus lamivudine in patients with chronic hepatitis B sequentially treated with lamivudine and adefovir due to lamivudine resistance

AIM： To compare the antiviral efficacy of adefovir （ADV） in lamivudine （LMV）-resistant patients with LMV treatment in nucleoside-naive patients, using serum samples collected sequentially during the course of treatment progressing from LMV to ADV.METHODS： Forty-four patients with chronic hepatitis B （CHB） were included. The patients were initially treated with LMV and then switched to ADV when LMV resistance developed. Antiviral efficacy was assessed by measuring the following： reduction in serum HBV DNA from baseline, HBV DNA negative conversion （defined as HBV DNA being undectable by the hybridization assay）, and HBV DNA response （either HBV DNA level ≤ 10^s copies/mL or a ≥ 2 log10 reduction from baseline HBV DNA level）.RESULTS： After two and six months of treatment, HBV DNA reduction was greater with LMV compared to ADV treatment （P = 0.021）. HBV DNA negative conversion rates were 64% and 27% after one month of LMV and ADV treatment respectively （P = 0.001）. Similarly, HBV DNA response rates were 74% and 51% after two months of LMV and ADV treatment respectively （P = 0.026）. The time taken to HBV DNA negative conversion and to HBV DNA response were both delayed in ADV treatment compared with LMV.CONCLUSION： The antiviral efficacy of ADV in LMV-resistant patients is slower and less potent than that with LMV in nucleoside-naive patients during the early course of treatment.

Surgical solutions to the problem of massive weight loss

In response to the global rise in obesity, bariatric surgery has become increasingly more popular and successful As a result, the demand for body contouring following massive weight loss is rapidly growing. Although bariatric procedures may produce impressive weight loss, people who achieve massive weight loss are often unhappy with the hanging folds of skin and subcutaneous tissue that remain. This review examines the nature of the post-bariatric deformity in each body region and briefly reviews common approaches to their treatment.

Pharmacokinetics and tissue distribution of intraperitoneal 5-fluorouracil with a novel carrier solution in rats

AIM: To compare the pharmacokinetics and tissue distribution of 5-fluorouracil administered intraperitoneally with two isotonic carrier solutions: HAES-steri (neotype 6% hydroxyethyl starch), a novel carrier solution with middle molecular weight and physiologic saline (0.9% sodium chloride solution), a traditional carrier solution for intraperitoneal chemotherapy, in rats. METHODS: A total of 60 Sprague Dawley rats were randomized into groups according to the carrier solution administered. Each group was further randomized according to the intraperitoneal dwell period (1, 3, 6, 12, 18 and 24 h). At the end of the procedure the rats were killed, the peritoneal fluid was withdrawn completely and quantitated. Drug concentrations in peritoneal fluid, plasma, and tissues were determined by high- performance liquid chromatography. RESULTS: The mean volumes remaining in the peritoneal cavity were significantly higher with HAES- steri than those with physiologic saline at 1, 6, 12, 18, and 24 h (P = 0.047, 0.009, 0.005, 0.005 and 0.005 respectively, the percentages of remaining peritoneal fluid volume were 89.9 ± 5.6 vs 83.4 ± 4.9, 79.9 ± 2.8 vs 56.2 ± 15.7, 46.8 ± 5.5 vs 24.7 ± 9.7, 23.0 ± 2.8 vs 0.0 ± 0.0 and 4.2 ± 1.7 vs 0.0 ± 0.0 respectively). Mean concentrations in peritoneal fluid were significantly higher with HAES-steri than those with physiologic saline at 3, 12 and 18 h (P = 0.009, 0.009 and 0.005 respectively, the concentrations were 139.2768 ± 28.2317 mg/L vs mg/L, 11.5427 ± 3.0976 mg/L vs 0.0000 ± 0.0000 mg/L and 4.7724 ± 1.0936 mg/L vs 0.0000 ± 0.0000 mg/L respectively). Mean plasma 5-fluorouracil concentrations in portal vein were significantly higher with HAES-steri at 3, 12, 18 and 24 h (P = 0.009, 0.034, 0.005 and 0.019 respectively, the concentrations were 3.3572 ± 0.8128 mg/L vs 0.8794 ± 0.2394 mg/L, 0.6203 ± 0.9935 mg/L vs 0.0112 ± 0.0250 mg/L, 0.3725 ± 0.3871 mg/L vs 0.0000 ± 0.0000 mg/L, and 0.2469 ± 0.1457 mg/L vs 0.0000 ± 0.0000 mg/L respectively), but significantly lower at 1 h (P = 0.009, the concentrations were 4.1957 ± 0.6952 mg/L vs 7.7406 ± 1.2377 mg/L). There were no significant differences in the plasma 5-fluorouracil in inferior caval vein at each time-point. 5-fluorouracil concentrations were significantly greater with HAES-steri at 18 h in gastric tissue (P = 0.016, the concentrations were 0.9486 ± 0.8173 mg/L vs 030392 ± 0.0316 mg/L), at 18 h in colon (P = 0.009, the concentrations were 0.1730 ± 0.0446 mg/L vs 0.0626 ± 0.0425 mg/L), at 3, 6, 12 and 24 h in liver (P = 0.009, 0.013, 0.034 and 0.013 respectively, the concentrations were 0.6472685 ± 0.5256 mg/L vs 0.1554 ± 0.1043mg/L, 0.8606826 ± 0.7155 mg/L vs 0.0014 ± 0.0029 mg/L, 0.0445 ± 0.0330 mg/L vs 0.0797 ± 0.1005 mg/L and 0.0863 ± 0.0399 mg/L vs 0.0034 ± 0.0075 mg/L respectively) and at 18 h in lung (P = 0.009, the concentrations were 0.0886 ± 0.0668 mg/L vs 0.0094 ± 0.0210 mg/L). There were no differences in 5-fluorouracil concentrations in renal tissue at each time-point. CONCLUSION: The use of intraperitoneal 5-fluoro- uracil with HAES-Steri carrier solution provides a pharmacokinetic advantage for a local-regional killing of residual tumor cells and improve the accumulated penetrability of 5-fluorouracil with decreased systemic toxicity. Further clinical feasibility studies on the use of HAES-steri as carrier solution for intraperitoneal chemotherapy with 5-fluorouracil are warranted.

Efficacy of Surgical Therapy for Carotid Body Tumors

Objective To evaluate the efficacy of surgical therapy for carotid body tumors. Methods A retrospective analysis was conducted, covering the diagnosis, surgical procedure, postoperative complications, and prognosis of 120 cases of carotid body tumors in Peking Union Medical College Hospital from 1949 to May, 2011. Results Surgical excision was successfully performed in 111 cases with 117 tumors. In all those cases, 50 underwent simple tumor resection, 42 underwent resection of tumors and ligation of the external carotid arteries, 7 underwent co-resection of tumors and common carotid arteries, internal carotid arteries, as well as external arteries without vascular reconstruction, and the other 12 cases experienced tumor resection and vascular reconstruction as internal carotid arteries were involved. After operation, 3 cases developed cerebral infarction, 30 cases showed cranial nerve palsy, including 15 cases of hypoglossal nerve damage, 10 cases of vagus paralysis, and 5 cases of Horner's syndrome. Conclusion It is essential to make a proper surgical strategy, which can reduce postoperative com- plications.

Radiotherapy in Non-Functioning Pituitary Macroadenoma： Mansoura Experience

OBJECTIVE The current retrospective study aims to evaluate the management of non-functioning the assessment of experience on pituitary macroadenoma through clinical, biochemical, radiological features, and treatment outcome of patients, and to identify prognostic factors affecting progression-free survival （PFS）. METHODS Data of 55 patients macroadenoma presented to the with non-functioning pituitary Clinical Oncology and Nuclear Medicine department between 1998 and 2009 were investigated. RESULTS The most common symptom was visual disturbance （38.2%） followed by headache （27.3%）. The presence of male predominance was observed （1.4：1）. Ten patients received radio-therapy （RT） only. Extrasellar extension was the more common treatment. The overall response rate was 72.8% with completed response at 16.4%. Memory and intellectual sequelae were the most common late complications of treatment （14%）. The ten-year PFS was at 84.6%. PFS was found to be significantly better with higher dose of RT （up to 54 Gy）, treatment by both surgery and RT, absence of visual field defect, and tumor localized to sella, whereas it was not significantly affected by age and sex. CONCLUSION The data confirmed that the prevalence of mass effect and hypopituitarism in patients with non-functioning pituitary macroadenoma is elevated. Conventional external RT up to 54 Gy is safe and effective in controlling non-functioning pituitary macro- adenoma with tolerable and acceptable morbidity.

The potential for liquid biopsies in the precision medical treatment of breast cancer

Currently the clinical management of breast cancer relies on relatively few prognostic/predictive clinical markers(estrogen receptor, progesterone receptor, HER2), based on primary tumor biology. Circulating biomarkers, such as circulating tumor DNA(ctDNA) or circulating tumor cells(CTCs) may enhance our treatment options by focusing on the very cells that are the direct precursors of distant metastatic disease, and probably inherently different than the primary tumor's biology. To shift the current clinical paradigm, assessing tumor biology in real time by molecularly profiling CTCs or ctDNA may serve to discover therapeutic targets, detect minimal residual disease and predict response to treatment. This review serves to elucidate the detection,characterization, and clinical application of CTCs and ctDNA with the goal of precision treatment of breast cancer.

Resection of Hilar Liver Cancer, Close to Major Vessels

Objective To study the surgical experience with resection of a hilar liver cancer close to major vessels and how to improve the therapeutic result.Methods From January 1990 to June 1997, 58 hilar liver tumors (segment I , IV , V , VI ) were resected. The tumors in these 58 patients were within a distance of 1 cm to major hepatic vessels (retrothepatic inferior vena cava, root of hepatic veins, and left or right trunk of portal vein) . The diameter of the tumors was > 5 cm in 42 cases and < 5 cm in 16 cases, respectively. The size of the largest tumor was 20 cm ×18 cm×18 cm. The surgical techniques are summarized, and the prevention and treatment of postoperative complications are discussed.Results All operations have been carried out successfully and had a regular follow-up until now with 1-, 3- and 5-year survival rate of 71%, 38% and 25%, respectively.Conclusion While hilar liver surgery is quite difficult and risky, the safety and therapeutic results of surgery could be improved by observing a meticulous surgical technique, and by preventing and treating postoperative complications by multimodal measures.

Triple negative breast cancer: 5 years follow-up

Objective： The aim of the study was to investigate the long-term therapeutic effects of triple negative breast cancers （TNBCs） and find a standardized treatment. Methods： The clinical data and survival status of 69 patients with TNBC were collected, who were treated from 2003 to 2007 at Chongqing Cancer Institute, China. Results： Median observation for 61 months showed the local recurrence rate was 13.0% （9/69）, the overall survival （OS） rate was 76.8% （53/69） and the disease free survival （DFS） rate was 59.4% （41169）. Log-rank univariate survival analysis showed the OS and DFS rates of TNBCs with axillary lymph node metastasis were 38.1% and 23.8%, respectively, and the OS and DFS rates of triple negative breast cancer with axillary lymph node non-metastasis were 93.6% and 75.0%, respectively. There were significant differences comparing with two groups. Indictor analysis of age, menstruation status, tumor size, TNM stage, histological type, neoadjuvant chemotherapy and p53 did not show any prognostic influence. Conclusion： The axillary nodes metastasis is associated with DFS and OS in triple negative breast cancers. Cisplatin-based chemotherapy may be good choice for triple negative breast cancers with metastasis or local recurrence, who received Anthracycline and Taxane-based chemotherapy. Targeted therapies strategies such as EGFR-targeted therapy may be necessary.

Clinical study on gefitinib combined with γ-ray stereotactic radiotherapy for senile patients with adenocarcinoma of lung as the first-line regimen

Objective: The aim of our study was to evaluate the efficacy and safety of gefitinib combined with γ-ray stereo-tactic radiotherapy for senile patients with adenocarcinoma of lung as the first-line regimen. Methods: The 153 senile patients with adenocarcinoma of lung were divided into 4 groups according to the therapy method. Group A was the 35 patients treated with gefitinib combined with γ-ray stereotactic radiotherapy. Group B was the 45 patients treated with γ-ray stereotactic radio-therapy. Group C was the 42 patients treated with gefitinib. Group D was the 31 patients treated with best supportive therapy. The patients received gefitinib of 250 mg/d from the first day until disease progression or other reasons. The patients were treated with γ-ray stereotactic radiotherapy from the second day. Dose curve of this group of cases was 50%-80%. Encircled dose was 4.0-6.5 Gy per fraction and the range of total dose was 36-48 Gy. The total number of treatment was 8-12 and treated six times every week. Results: All the patients were examined by enhanced double helix CT at the second month. The tumor response rate (RR) of group A was 68.6% (24/35). Disease control rate (DCR) was 88.6% (31/35). The median survival time (MST) was 13.4 months (range 3-34 months ) and the progression-free survival (PFS) was 7.8 months. The overall 1-year survival rate was 40.0% (14/35). The main side effects included skin rash and diarrhea. The RR of group B was 51.1% (23/45). DCR was 71.1% (32/45). MST was 9.6 months (range, 3-18 months ) and PFS was 5.3 months. The overall 1-year survival rate was 15.6 % (7/45). The RR of group C was 40.5 % (17/42). DCR was 61.9% (26 /42). MST was 10.3 months (range, 3-26 months ) and PFS was 5.1 months. The overall 1-year survival rate was 35.7 % (15/42). The main side effects included skin rash and diarrhea. The MST of group D was 5.6 months (range, 2-11 months ) and PFS was 1.7 months. The overall 1-year survival rate was 0. The short-term therapeutic effects (RR) of group A was higher than group C (P = 0.014 < 0.05, χ2 = 6.053) but has no significant difference with group B (P = 0.116 > 0.05, χ2 = 2.477). The long-term therapeutic effects (overall 1-year survival rate) of group A was higher than group B (P = 0.014 < 0.05, χ2 = 6.077) but has no significant difference with group C (P = 0.642 > 0.05, χ2 = 0.216). Conclusion: Gefitinib combined with γ-ray stereotactic radiotherapy is feasible and effective for treatment in senile patients with adenocarcinoma of lung as the first-line regimen.

Uncertainties of ＂in v/vo＂ Dosimetry Using Semiconductors

The purpose of the present study is to evaluate the uncertainties of in vivo dosimetry measured with diode detectors for conformal radiation therapy techniques in order to define appropriate tolerance levels for pelvis and breast treatment in MEIH （Middle East Institute of Health）. The present work is carried out on 30-472 and 30-473 diode detectors irradiated by 4 and 15MV photon beams of a medical linear accelerator Synergy from ELEKTA. Dose computation is performed with Pinnacle 7.4 k treatment planning system. First, an estimation of the uncertainties in a simple geometric case, using a water-equivalent solid phantom is done. Secondly, each treatment parameter such as field size, beam angle, beam modifiers and source-skin distance is evaluated in order to simulate the conformal radiation treatments used in the present institution for the main anatomical sites. Interpretation of entrance dose in-vivo measurements requires the determination of appropriate tolerance levels. Indeed, the authors found that the 5% action level proposed in the literature underestimates the uncertainties in the treatment process. A method for the evaluation of tolerance/action levels related to the different anatomical sites is developed. By the end of the present study the authors have developed an integrated monitoring system that offers accurate information about the dose received by patients.

A brief history of human constitutionology

Human constitutionology studies human itself, which was proposed by Dr. Kuang. The study on human constitution in Chinese medicine has ever increased since the late 1970s. This review on the development of human constitutionology in Chinese Traditional Medicine （TCM） and western medicine is expected to give people with a different background to understand the establishment of this new subject, and its significance in promoting modernization of TCM and multi-disciplinary collaboration in human study and as an individualized model guiding the re-orientation of modern madicine.

Growth Inhibiton of Human Breast Cancer Cell Line MDA-MB-231 by Rosiglitazone through Activation of PPARγ

OBJECTIVE To investigate the anti-proliferative effect of rosiglitazone and its relationship to peroxisome proliferator-activated receptor γ （PPARγ） in human breast cancer cell line MDA-MB-231 and evaluate the potential application value of rosiglitazone for breast cancer therapy. METHODS The cytostatic effect of rosiglitazone on MDA- MB-231 cells was measured by the MTT assay. Cell-cycle kinetics was assessed by flow cytometry. Apoptotic cells were determined by the TUNEL assay. MDA-MB-231 cells were treated with rosiglitazone or in combination with the PPARy antagonist GW9662 to investigate the effect of rosiglitazone on cell proliferation and its relationship to PPARγ. RESULTS The results showed that rosiglitazone could inhibit growth of MDA-MB-231 cells in a dose- and time-dependent manner with an IC50 value of 5.2 μmol/L at 24 h after the drug was added into the culture. Cell cycle analysis showed that the percentage of G0/G1 phase cells increased, S phase cells decreased, and cells were arrested in G1 phase with increasing concentrations of rosiglitazone. Detectable signs of apoptotic cell death caused by rosiglitazone occurred at a concentration of 100 μmol/L and the apoptotic rate was （18 ± 3）%. PPARγ selective antagonist GW9662 could partially reverse the inhibitory effect of rosiglitazone on proliferation of MDA-MB-231 cells. CONCLUSION It was concluded that rosiglitazone can inhibit growth of MDA-MB-231 cells via PPARy activation and a high concentration of rosiglitazone can also induce MDA-MB-231 cell apoptosis. These results suggest that PPARy represents a putative molecular target for chemopreventive therapy and rosiglitazone may be effective in the treatment of breast cancer.

The efficacy of stereotactic body radiotherapy for patients with hepatocellular carcinoma

Objective:To evaluate efficacy of the stereotactic body radiotherapy for patients with hepatocellular carcinoma. Methods:Twenty-seven patients with hepatocellular carcinoma were treated by technique of stereotactic body radiotherapy. Planning of treatment was made and the prescribed dose was adjusted depending on the site of the tumor,clinical target volume(GTV),Kanofsky Performance and aim of treatment.Planning target volume received 50%–80%of the prescribed dose for 3.2–4.2 Gy per-fraction.Treatment total dose was 32–42 Gy(median dose 40 Gy)in daily fractions of 3.2–4.2 Gy for five fractions one week.Results:All the patients completed the planned radiotherapy.The tumor response rate was CR 25.9%,PR 55.6%,NR 18.59%;the response rate(CR+PR)was 81.5%.Half-year local recurrence-free survival rate was 75%;1-year local recurrence-free survival rate was 22%.There were no serious complications during radiotherapy and follow- up.Pain relieve rate in liver region was 83.3%.Conclusion:Stereotactic body radiotherapy can improve the local control and quality of life on the treatment of primary hepatic neoplasm while not increasing the treatment complication.

Neoadjuvant chemotherapy for osteosarcoma of the extremity: Outcome of the Chinese 1st protocol in a single institute

Objective： The aim of this study was to determine stand protocol for patients with extremity osteosarcoma by case following up after neoadjuvant chemotherapy and limb salvage operation. Methods： Between January 2000 and January 2007, 121 patients with extremity osteosarcoma were eligible for this analysis. After being graded according to Enneking classification, all patients were preoperative chemotherapy （methotrexate, cisplatin, doxorubicin, and ifosfamide. Some patients with liB tumors received extra interventional embolism）. And postoperatively, the same protocols were employed, but poor responders （tumor necrosis 〈 95%） received more treatment cycles than good responders and took some new medicine in place of the former one. Most of patients underwent limb salvage operation （99/121）, and the Musculoskeletal Tumor Society Score （MSTS） was used to evaluate the recovery of their limb functions. Results： The followed up last for average 37.3 months （range： 16-101 months）. Most patients （76/121） survived, and the overall survival （OS） was 62.8%. Forty-seven of the 121 patients underwent osteoarticular allografts, among which 12 cases of disunion between the host bone and graft bone, 4 cases of allograft absorption and 3 local recurrences appeared. The mean MSTS score was 22.6 ± 4.13, with an excellent limb function in 17 patients, good in 19 patients, fair in 6 patients and poor in 7 patients. The overall excellent and good function outcome was obtained in 76.6% of the patients. Fifty-two of 121 patients underwent custom-made or modular tumor endoprosthesis replacememt, among which 1 case of aseptic loosening, 1 case of peri-prosthesis infection and 4 local recurrences appeared. The mean MSTS was 24.32 ＋ 3.85, with an excellent limb function in 28 patients, good in 16 patients, fair in 5 patients and poor in 3 patients. The overall excellent and good function outcome was obtained in 84.6% of the patients. Conclusion： Neoadjuvant chemotherapy and limb salvage surgery are effective methods to treat osteosarcoma at present, although some patients still dying from postoperative metastases. Therefore, early diagnosis individualized treatment and exploring for new and effective therapeutic strategy should be the key to an ideal treatment for osteosarcoma.

Impact of the New Cooperative Medical Scheme on Health Care Service Utilization in Rural China

Using the 2000, 2004, and 2006 CHNS longitudinal survey data and econometric methods （random-effect probit regression model and DID methods）, this study conducted an empirical analysis to estimate the impact of NCMS. The major conclusions are as follows. First, predisposing factors, enabling factors, health care need factors, and lifestyle factors affect health care utilization. Second, results using DID methods indicate that NCMS did not affect health care service utilization （outpatient and inpatient） of individuals when ill, but it might increase the possibility of getting a health examination. Third, there is no difference in health care service utilization （both outpatient and inpatient） between the NCMS enrollment group and the non-enrollment group in both working age group （15-59） and the elderly group （60 and over）. Therefore, it can be said that NCMS did not affect the health care utilization in both the group. However, NCMS positively affects disease prevention behavior （visiting the hospital to receive a health examination） in the working age group, but the effect did not appear in the elderly group.