Sonographic Diagnosis of Bone Tumors

This paper presents the results of sonographic and radiographic exami nations in 48 patients clinically diagnosed as having bone tumors. Sonography revealed bone destruction in all 48 cases, elevated periosteum in 26 cases and soft tissue mass in 34 cases. The results obtained in this series demonstrate that mostbone tumors have their characteristic sonographic features such as giant cell tu-mors, malignant bone tumors, bone cysts, as well as metastatic lesions. Studyshowed that sonography has equally high accuracy in the diagnosis of these tumorscompared with radiography.

Analysis of therapeutic efficacy of Aredia in treating pain caused by advanced malignant metastatic bone tumors

Objective To study therapeutic efficacy of Aredia in treating malignant metastatic bone tumors. Method 60～90 mg Aredia was administrated iv in 31 cases with malignant metastatic tumors,once each week. Results Pain in 12 cases was significantly relieved.14 cases acquired relif.Total effective rate was 83.9%.Activity ability was improved by 80.6%.No apparent toxicological and adverse effects as well as fever and cold symptoms were observed.Conclusion Aredia is a kind of ideal drugs for treatment of pain caused by malignant metastatic bone tumors.It is convenient in use and could be endured by patients.

Profile of Malignant Bone Tumors among Rheumatology Inpatients in Lome (Togo)

Background: The reel impact of malignant bone tumors in adults seems unclear in Black Africa. Aim: The aim of this study is to determine the epidemiological and the semiological profile of malignant bone tumors in rheumatology inpatients at Hospital University Center Sylvanus Olympio in Lome. Methods: It was a retrospective study of recorded cases conducted over a period of 19 years in the rheumatology department at Hospital University center Sylvanus Olympio in Lome, Togo. Results: One hundred and sixty-six patients (68 women and 98 men) suffered from a bone tumor. The average age of patients was 55 years old with some extremes cases of 14 and 98 years old. The most affected age group was the one between 46 and 55 years old (40 cases, 24.1%). The disease’s average duration was 17 months. These tumors were primary in 43 cases (26%) and secondary in 123 (74%). Metastases were those of prostate (44 cases, 35.7%), breast (12 cases, 9.7%), bronchus (7 cases, 5.7%), cervix (5.7%), and liver (2 cases, 1.6%). Myeloma (34 cases;79.0%) and osteosarcoma (9 cases;20.9%) were the main primary malignant bone tumors. However, 41 cases (33.3%) of malignant bone tumors had not been able to label. The spine was the predilection part for all above-mentioned tumors. Conclusion: This study shows the significant part occupied by malignant bone tumors in musculoskeletal diseases within the sub-Saharan population in general and Togo in particular.

Prototyping: Major Advance in Surgical Planning and Customizing Prostheses in Patients with Bone Tumors of the Head and Neck

Major resections of bone tumors of the head and neck, owing to their small dimensions and their proximity to the organs in this region, cause important functional and aesthetic problems that significantly compromise patients’ quality of life. Therefore, therapeutic planning should always extend beyond the resection to include functional and aesthetic reconstruction, preferably immediately. Microsurgical reconstruction represents a significant advance, but has not yet been perfected. Rapid prototyping (RP) comes as a new technology for the purpose of assisting the surgeon in the visual and tactile aspects of surgery, providing diagnostic accuracy and increasing the success of surgical planning. The authors demonstrate the technological advances in the manufacture of customized mandibular prostheses with the assistance of RP and practical applications of these methods.

MR perfusion and diffusion imaging for the diagnosis of benign and malignant bone tumors

Objective： MR-PWI and MR-DWI were supplementary functional methods to differentiate benign from malignant bone tumors. The aim of this study was to assess the diagnostic potential of MR-PWI conjunction with MR-DWI in differentiating benign from malignant bone tumors. Methods： MR-PWI and MR-DWI were performed on 39 patients by using a 1.5 T MR imager. Perfusion imaging was started with GRE-EPI sequence as soon as the bolus administration commenced. With b value as 300 s/mm^2, diffusion imaging was performed with SE-EPI sequence. Type of TIC, peak enhancement, steepest slope, signal difference between 2 baselines and ADC were compared between benign and malignant bone tumors. The data were analyzed with soft-ware （SPSS, version 13.0）. Subjective overall performance of two techniques was evaluated with Receiver Operating Characteristic （ROC） analysis. Results： 1. MR-PWI： （1） The Patterns of TIC of most benign bone tumors （17/21） were type Ⅰ and Ⅱ, and all malignant bone tumors were type Ⅲ and Ⅳ. （2） There were significant differences in peak enhancement （17.52 ± 2.37 vs. 52.42 ± 5.74） %, steepest slope （4.69 ± 2.84 vs. 9.63 ± 4.05）%/s and signal difference between 2 baselines （6.87 ±3.34 vs. 31.75 ± 11.09） % between benign and malignant groups. And their diagnosis accuracy was 82.1%, 79.5% and 87.2%, respectively. （3）. 4 highly vascularized benign bone tumors were mistaken in diagnosis as malignant ones according to their perfusion characteristics. 2. MR-DWI： There was significant difference between ADC of benign and malignant groups [（1.86 ± 0.38） vs. （1.44± 0.26）] ×10^-3 mm^2/s when b value was 300 s/mm^2. The diagnosis accuracy was 79.5% when ADC value less than 1.63 × 10^-3 mm^2/s was considered as malignant ones. 3. The diagnosis accuracy of M R-PWI and MR-DWI were 89.7% and 79.5%, respectively. Conclusion： MR-PWI is the better valuable technique than MR-DWI in differentiation benign from malignant bone tumors. To suspicious highly vascularized bone tumors, MR-PWI combining with MR-DWI lead to higher diagnosis accuracy.

Limb salvage surgery for malignant bone tumors of the extremities in children and adolescents

Objective： The aim of the study was to analyze the clinical features of limb salvage surgery with epiphyseal preservation in children and adolescents, and to evaluate the recurrence rate, metastasis, complications, and the joint functional results after tumor resection. Methods： Between December 1995 and January 2003, 33 cases of preserving epiphysis procedure had been done. In this group, the tumor located in distal femur in 24 cases and in proximal tibia in 9 cases. There were 23 osteosarcomas, 6 Ewing＇s sarcomas, 2 chondrosarcomas, and 2 aggressive osteoblastomas. The patients received 2-4 cycles of preoperative adjuvant chemotherapy, and another 6 cycles after surgery. The modified protocol T10 was taken. Radiography and MRI were used to determine the margins of the tumors preoperatively and histological examination was used to corroborate the evidence intraoperatively. The tumors were staged clinically. Among them, there were 2 cases in ⅠA, 2 cases in ⅠB, 17 cases in ⅡA, and 12 cases in liB. According to the MRI analysis, the metaphyseal tumors in children were classified into 3 types. Type Ⅰ, with the tumor close to but not contacting epiphyseal plate, and the distance between the two over 2 cm, was taken as absolute indication for the technique. Type Ⅱ, with the tumor near or contacting epiphysis plate, and the distance between the two less than 1 cm, was taken as relative indication for the surgery. For type Ⅲ, the tumor contacted the epiphyseal plate partially, and was over 2 cm beyond the joint. In the cohort, 18 cases were categorized as type Ⅰ, 13 as type Ⅱ, and 2 as type Ⅲ. The size of the residual epiphyseal bone segment differed after different excision protocols which were taken according to the clinical classifications. Bone defects after tumor resections were repaired with massive intercalary allograft bone, followed by internal fixation by intramedullary nails and cancellous screws. Results： Among the 33 cases, 3 cases were lost to follow up. 29 cases had complete clinical data. Postoperative follow-up was 12-72 months. Recurrences were seen in 3 cases, with one local recurrence in type Ⅲ cases one year post tumor resection, other 2 recurrences around the femoral vessels in type Ⅱ cases 15 months and 30 months after the tumor resection respectively. The recurrence rate accounted for 10.34%. Amputation was performed for the cases with recurrences. But pulmonary metastasis developed and the patients died. In this cohort, 9 cases died. Five-year survival rate constituted 57.94% demonstrated by Kaplan-Meier survival analysis. The median survival time for male patients was 64.36 months, and that for female patients was 56.00 months （P = 0.0403）. The sites, stages and types were not associated with the survival time. Four cases reported 5 complications （17.24%）. The complications included fracture of the allograft, limb length discrepancy, nerve injury, breakage of nails, and loosening of the screws. No patient reported skin necrosis, hematoma, infection, rejection to the allograft, and nonunion at the end of the follow-up. According to the functional evaluation criteria after surgical treatment of malignant tumors of the extremities introduced by Enneking, excellent functional results were reported in 11 cases, good in 13 cases, fair in 3 cases, and poor in 2 cases. The excellent or good result rate was 83%. The excision interface involved partial epiphysis in 4 cases, involved the epiphyseal plate in 8 cases. Intact epiphysis was preserved in 17 cases. Five cases with poor postoperative functional results were in types II and III. Average time of bone union was 2.5 months for epiphyseal end and 3.8 months for diaphyseal end. According to the International Society of Limb Salvage （ISOLS） radiological implants evaluation system, excellent reconstruction was observed in 23 cases, good reconstruction in 4 cases, fair reconstruction in 1 case, and poor reconstruction in 1 case. All patients in the group had satisfactory joint stability. No patient reported joint dislocation, valgus or varus deformity, and osteoarthritis. The average limb length discrepancy was 3.2 cm, ranging 2-6 cm. Conclusion： The limb salvage surgery with preservation of epiphysis for malignant bone tumors in children and adolescents guarantees the patient＇s satisfactory postoperative limb functional results. Preoperative effective adjuvant chemotherapy and prevention of postoperative complications deserve great attention.

Efficacy of DR, CT and MRI in bone tumors

Objective: The aim of the study was to investigate the efficacy of digital radiography(DR), computed tomography(CT) and magnetic resonance imaging(MRI) in bone tumors. Methods: Fifty-five patients with histologically confirmed bone tumors underwent imaging examinations. Fifty-five patients were performed DR, 21 CT and 20 MRI. Results: DR of 51 patients clearly revealed bone changes. DR of 40 patients well showed marginal. Twenty tumors appeared periosteal reaction on DR and 19 calcification on DR. CT scan of 21 patients clearly depicted bone changes, marginal and calcification and CT scan of 8 revealed periosteal reaction. MRI scan of 20 patients all showed marginal and soft-tissue mass and bone marrow edema was prominent in 8 patients. Conclusion: DR is the first imaging approach for born tumors. CT well reveal the extent and minute structure of the bone tumors, the extent, soft-tissue mass and bone marrow edema are more dramatically demonstrated on MRI imaging. DR integrates with CT and MRI, is helpful in diagnosis of bone tumors.

Clinical Outcomes of Artificial Total Hip Arthroplasty for Proximal Femoral Bone Tumors

Objective:To investigate the clinical outcome of artificial hip replacement for proximal femoral bone tumors.Methods:One hundred patients with proximal femur bone tumors admitted to the hospital for treatment from June 2018 to May 2020 were selected and divided into a control group and an experimental group of 50 patients each using central randomization.The control group received conventional treatment and the experimental group underwent artificial total hip arthroplasty,and the results of treatment were compared between the two groups.Results:The operative time and hospitalization time of the experimental group were shorter than that of the control group,and the blood loss was less than that of the control group;after the replacement surgery,the range of flexion and extension,internal and external rotation activity and abduction activity scores were better than those of the control group;and the total incidence of adverse reactions in the experimental group was 6.0%,which was significantly lower than that of the control group(14.0%).By comparing the treatment effects of the two groups,the differentiation was significant,and P<0.05 was statistically significant.Conclusion:Artificial hip arthroplasty can effectively treat proximal femoral tumors,shorten operative time,hospitalization time and intraoperative bleeding,and alleviate patients’therapeutic pain,which has good promotion value in clinical practice.

Multimodal imaging in the diagnosis of bone giant cell tumors:A retrospective study

BACKGROUND Giant cell tumor of bone is a locally aggressive and rarely metastasizing tumor,and also a potential malignant tumor that may develop into a primary malignant giant cell tumor.AIM To evaluate the role of multimodal imaging in the diagnosis of giant cell tumors of bone.METHODS The data of 32 patients with giant cell tumor of bone confirmed by core-needle biopsy or surgical pathology at our hospital between March 2018 and March 2023 were retrospectively selected.All the patients with giant cell tumors of the bone were examined by X-ray,computed tomography(CT)and magnetic resonance imaging(MRI),and 7 of them were examined by positron emission tomography(PET)-CT.RESULTS X-ray imaging can provide overall information on giant cell tumor lesions.CT and MRI can reveal the characteristics of the internal structure of the tumor as well as the adjacent relationships of the tumor,and these methods have unique advantages for diagnosing tumors and determining the scope of surgery.PET-CT can detect small lesions and is highly valuable for identifying benign and malignant tumors to aid in the early diagnosis of metastasis.CONCLUSION Multimodal imaging plays an important role in the diagnosis of giant cell tumor of bone and can provide a reference for the treatment of giant cell tumors.

Genetic characteristics and molecular diagnostics of bone tumors

The diagnosis of primary tumors of bone relies heavily on clinicopathological and radiological correlation and is often best performed in a multidisciplinary setting.Bone tumors comprise a heterogenous category of human lesions ranging from benign to malignant neoplasms.These tumors affect a wide age range and can become problematic for diagnosis when less common entities are encountered.Traditionally the pathological diagnosis of many bone tumors has been based primarily on the evaluation of hematoxylin and eosin-stained glass slides,sometimes combined with ancillary diagnostic techniques such as immunohistochemistry,conventional cytogenetics,fluorescence in situ hybridization,and polymerase chain reaction-based assays.More recently,the advent of massively parallel sequencing-based techniques has opened new avenues for diagnostic testing in bone tumors;however,these new testing modalities are sensitive to traditional decalcification procedures that are commonly used in the routine processing of bony specimens.Herein we provide a focused review concentrating on the molecular genetic features of bone tumors with specific,recurrent genetic alterations that make them appealing targets for directed ancillary testing by conventional or molecular techniques.In addition,specimen handling with regards to decalcification procedures are discussed and the different types of testing modalities available are reviewed.

Magnetic Resonance Imaging for the Assessment of Long Bone Tumors

Background： Wide resection margins of osseous tumors are associated with a low incidence of local recurrence, making accurate measurement of the intraosseous extent of primary malignant long bone tumors is crucial. We compared the intraosseous tumor extent assessed by magnetic resonance imaging （MRI） with the gross specimen to evaluate the accuracy of MRI. Methods： A total of 255 patients with primary malignant tumors in the long bones were included. Using MRI, we defined the length of tumor as the distance from the articular surface to the boundary between abnormal and normal marrow signal. The extent of the abnormal intraosseous signal was measured on unenhanced T1-weighted （T1WI） magnetic resonance images after chemotherapy. All gross surgical specimens were sectioned, and tumor extent was measured. Wilcoxon signed-rank test was used to test the differences between MRI and gross specimen findings. Spearman＇s correlation analysis was used to test the correlation between groups. Results： Median tumor length by gross specimen （112 mm; range, 45–300 mm） was longer than that by MRI （108 mm; range, 45–304 mm;Z = -6.916, P 〈 0.001）. Of 255 images, tumor length was accurately represented on 27 T1WI magnetic resonance images, overestimated on 79 images, and underestimated on 149 images. The median difference between imaging and gross specimen measurements was 2.0 mm （range： 1.0–15.0 mm） for the 79 cases where tumor length was overestimated, and 5.0 mm （range： 1.0–18.0 mm） for the 149 cases where tumor length was underestimated. The Spearman correlation demonstrated a high correlation of tumor length on gross specimen with the tumor length on MRI （R = 0.99, P 〈 0.01）. Conclusions： We conclude that preoperative MRI could be a useful method in determining intramedullary malignant bone tumor boundaries and may serve as an accepted assessment method of long bone tumors before limb-sparing surgery.

Clinical observation of mineralized collagen bone grafting after curettage of benign bone tumors

Curettage of benign bone tumor is a common cause for bone defect.For such bone defect repair,autogenous bone,allogeneic bone and traditional artificial bone graft substitutes have many disadvantages.In recent years,a biomimetic mineralized collagen(MC)with similar composition and microstructures to the natural bone matrix was developed and used for treating various bone defects.In this work,a retrospective study analyzed clinical outcomes of patients treated with curettage of benign bone tumors and bone grafting with MC,in comparison to another group treated with the same surgical method and autogenous bone.Lane-Sandhu X-ray score of the autogenous bone group was superior to the MC group at 1 month after the operation,but the two groups had no statistical difference at 6 and 12 months.The MC group was better in Musculoskeletal Tumor Society scoring at 1 and 6 months after the operation,and the two groups had no statistical difference at 12 month.Therefore,the MC performed not as good as autogenous bone in early stage of bone healing but achieved comparable outcomes in long-term follow-ups.Moreover,the MC has advantages in function recovery and avoided potential complications induced by harvesting autogenous bone.

A simple,universal and multifunctional template agent for personalized treatment of bone tumors

Bone tumors occur in bone or its accessory tissues.Benign bone tumors are easy to cure and have good prognosis,while malignant bone tumors develop rapidly and have poor and high mortality.So far,there is no satisfactory treatment method.Here,we designed a universal template vector for bone tumor therapy that simultaneously meets the needs of bone targeting,tumor killing,osteoclast suppression,and tumor imaging.The template is composed of a polydopamine(PDA)core and a multifunctional surface.PDA has excellent biosafety and photothermal performance.In this study,alendronate sodium(ALN)is grafted to enable its general bone targeting function.PDA core can carry a variety of chemotherapy drugs,and the rich ALN group can carry a variety of metal ions with an imaging function.Therefore,more personalized treatment plans can be designed for different bone tumor patients.In addition,the PDA core enables photothermal therapy and enhanced chemotherapy.Through template drug Doxorubicin(DOX)and template imaging ion Fe(II),we systematically verified the therapeutic effect,imaging effect,and inhibition of bone dissolution of the agent on Osteosarcoma(OS),a primary malignant bone tumor,in vivo.In conclusion,our work provides a more general template carrier for the clinical treatment of bone tumors,through which personalized treatment of bone tumors can be achieved.

Clinical research on zoledronic acid in treatment of pain caused by bone metastasis of malignant tumors

Objective:To evaluate the efficacy and safety of zoledronic acid for the pain caused by metastatic tumor of bone.Methods:52 patients with metastatic tumor of bone were randomly divided into two groups.The zoledronic acid group received 4 mg zoledronic acid infusion for 30 minutes and the control group received 90 mg pamidronate infusion for 6 hours. Results:The effective rates in zoledronic acid group and control group were 73.08%and 69.23%respectively.No significant difference was observed between the two groups.The median pain relief onset at days 5 and 7,respectively,and no significant difference was observed.The ECOG scores on the 7th day after medication:the differences in the zoledronic acid group before and after medication and between the two groups were both significant(P<0.001 and P=0.0448).The adverse reac- tion was no significant difference between the two groups.Conclusion:Zoledronic acid is efficient and safe in the treatment of pain caused by metastatic tumor of bone and it has low adverse reaction rate and convenient shorter using time.

U-Net Based Dual-Pooling Segmentation of Bone Metastases in Thoracic SPECT Bone Scintigrams

In order to enhance the performance of the CNN-based segmentation models for bone metastases, this study proposes a segmentation method that integrates dual-pooling, DAC, and RMP modules. The network consists of distinct feature encoding and decoding stages, with dual-pooling modules employed in encoding stages to maintain the background information needed for bone scintigrams diagnosis. Both the DAC and RMP modules are utilized in the bottleneck layer to address the multi-scale problem of metastatic lesions. Experimental evaluations on 306 clinical SPECT data have demonstrated that the proposed method showcases a substantial improvement in both DSC and Recall scores by 3.28% and 6.55% compared the baseline. Exhaustive case studies illustrate the superiority of the methodology.

Calculation of Electromagnetic Field and SAR Dis- tributions of Two Antenna Structures for Bone Tu- mors Microwave Hyperthermia

Objective: To investigate the electromagnetic field and specific absorptionrate (SAR) distribution of different structure applicators with different depths for treating bonetumors using microwave hyperthermia. Methods: The finite element method (FEM) was used to calculate,electromagnetic field and SAR distribution. Two different structure applicators were simulated. Theone is simple coaxial antenna, which has been successfully used in clinic treating bone tumors inTangdu hospital of the Forth Military Medical University several years. It was formed by a coaxialcable peeled off the out copper at end. The other applicator was coaxial- slot antenna, which waswidely used in microwave hyperthermia. The applicator inserted into the cylindrical bone withdifferent depths, and worked at the frequency of 2 450 MHz. Results: The electric field and SARgenerated by the simple coaxial applicator were mainly concentrated out the tissues, and were notuniform in the tissues, while the coaxial- slot applicator well transmits the electric field and SARinto the tissues, and can easily treat different position by adjusting the slat position.Conclusion: The results calculated by EFM, were well accordant with the experimental and clinicalresulls, and will be important for improving the clinical effects of microwave hyperthermia.

Primary Malignant Musculosqueletal Tumors of Members in Adult in Togo

Purpose: Primary malignant musculosqueletal tumors in adult are rare affections group and its treatment is still a real challenge today. The aim of this work was to describe the epidemiologic and treatment aspects of these tumors in the national reference center of our country. Materiel and Methods: It was a retrospective review of primary malignant musculosqueletal tumors treated in orthopedics and trauma unit of Sylvanus Olympio teaching hospital of Lomé, Togo from January 2000 to December 2014. Results: During the study period, 28 cases were selected and reviewed. There were 17 men (60.71%) and 11 women (39.29%). The average age was 32.7 years. There were 20 cases (71%) of primary malignant bone tumors (PMBT) and 8 cases (29%) of primary malignant soft tissues tumors (PMSTT). There were 6 (30%) of osteosarcoma. The tumor was located in the bones of the forearm and wrist/hand in 2 (10%) patients for each anatomical site;for the lower limb, around knee in 7 (35%) patients. Eight patients had PMSTT (28, 57%). There were three cases of rhabdomyosarcoma, 2 cases of fibrosarcoma. Tumors were located around knee in 4 cases and around ankle/foot in 3 cases. In the two groups of tumor, tumor resection was performed in 5 patients (17.86%) and limb amputation indicated in 23 patients (82.14%), was performed in 15 (53.57%) and 8 patients (37.78%), rejected it and left hospital against medical advice. Conclusion: Malignant musculoskeletal tumors are relatively rare in Togo. Their treatment is based on radical surgery which is often not supervised by adjuvant therapies. Ignorance, poverty of the population and embryonic state of diagnostic and treatment infrastructures are the obstacles to their care. Education and awareness must be integrated to care and fight against this group of diseases.

Ultrasonographic Diagnosis of Bone Tumor of the Knee and Its Clinical Implication

In order to evaluate the value of the ultrasonography in the diagnosis of tumor of the knee and its clinical implication, 67 patients with clinically suspected bone tumor of the knee were examined by ultrasound. The ultrasonographic characteristics of different bone tumors were studied and compared with the results of pathologic characters after operation. Ultrasonography can readily visualize the bony destruction and the pathologic change of the periosteum and the soft tissue related to bone tumor. Fifty-two cases of malignant bone tumors and 15 cases of giant cell tumors were diagnosed by ultrasonography. Pathologically, there were 54 cases of malignant bone tumor and 13 cases of giant cell tumor. It was concluded that ultrasonographic examination might be a useful method for the diagnoses of bone tumor of the knee and play an important role in guiding needle biopsy and electing operative method and approach.

Effectiveness of enhanced recovery after surgery in the perioperative management of patients with bone surgery in China

BACKGROUND Enhanced recovery after surgery(ERAS)was introduced in China in 2007.Over time,the scope of ERAS has expanded from abdominal surgery to orthopedics,urology and other fields.Continuous development and research has contributed to progress of ERAS in China.In 2019,to promote the application of ERAS in bone tumor surgery,we formed the“Consensus of Experts on Perioperative Management of Accelerated Rehabilitation in Major Surgery of Bone Tumors in China”.AIM To evaluate the effect of enhanced recovery after bone tumor surgery in perioperative management in China.METHODS One hundred and seven patients who underwent bone tumor surgery at the Second Affiliated Hospital of Xi’an Jiaotong University between May 2019 and April 2021 were randomized into a study group(53 cases)and a control group(54 cases).The study group adopted the ERAS protocol and the control group adopted conventional care.Main outcome measures included postoperative length of stay(LOS),postoperative complications,mortality,and 30-d readmission rates.Secondary outcomes included postoperative visual analog scale(VAS)score of pain,number of blood transfusions,drainage volume in 24 h after operation,patient satisfaction 30 d after discharge,VAS score at 30 d after discharge,and daily standing walking time.RESULTS There were no significant differences in the baseline data,clinical features and surgical site between the two groups.The LOS in the study group with the ERAS protocol was 7.72±3.34 d compared with 10.28±4.27 d in the control group who followed conventional care.The incidence of postoperative nausea and vomiting(PONV)in the study group was 19%and 37%in the control group.The VAS scores of pain on postoperative day 1(POD1)and POD3 in the study group were 4.79±2.34 and 2.79±1.53 compared with 5.28±3.27 and 3.98±2.27 in the control group.The drainage volume in 24 h after the operation was 124.36±23.43 mL in the study group and 167.43±30.87 mL in the control group.The number of blood transfusions in the study group was also lower.The patient satisfaction rate was higher in the study group than in the control group.CONCLUSION The ERAS protocol in the perioperative period of bone tumor surgery can decrease LOS,PONV,and postoperative pain,blood transfusion and 24-h drainage,improve patient satisfaction and accelerate recovery.

PREPARATION OF BONE TUMOR THERAPEUTIC RADIOPHARMACEUTICALS ^(153)Sm-EDTMP

Samarium-153- EDTMP (ethylene diamine tetramethylene phosphonate), for its promising biological properties, has been proved as a palliating therapeutic agent for bone tumor in human beings. 153Sin with high radionuclear purity and specific activity of 5.18 GBq (140 mCi)/mg Sm2O3 was prepared by irradiating naturalSm2O3(152Sm, 26.7%) sample, replacing costly enriched samarium oxide target, at a flux of 4x 1013n.cm-2.s-1 for 110 h. The yield of 153Sm complexing with EDTMP is greater than 98% at PH 8￣10 in boiling water bath for 30 min, and not significantly decreases within one week after 153Sm-EDTMP complex formation.