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find Author "江仁兵" 3 results
  • FEASIBILITY AND SHORT-TERM EFFECTIVENESS ANALYSIS OF MODIFIED RADICAL RESECTION AND RECONSTRUCTION SURGERY FOR MALIGNANT PROXIMAL HUMERUS TUMOR

    Objective To explore the feasibility and short-term effectiveness of the modified radical resection and reconstruction in the treatment of malignant proximal humerus tumor. Methods The relevant anatomic data from 30 normal adult shoulder joint MRI were measured to analyze the feasibility of modified radical resection and reconstruction surgery in the treatment of malignant proximal humerus tumor. Five patients with malignant proximal humerus tumor were treated by using the modified radical resection and reconstruction surgery between March 2012 and January 2016. There were 1 male and 4 females, aged from 9 to 69 years (median, 46 years). There were 4 cases of osteosarcoma (Enneking IIA in 2 cases and Enneking IIB in 2 cases) and 1 case of metastatic carcinoma (moderately differentiated adenocarcinoma). The disease duration was 7 to 12 months (mean, 9 months). Recurrence of tumor was observed after operation, and the shoulder function was assessed according to Enneking skeletal muscle tumor function scoring system. Results Radiographic results showed that modified radical resection and reconstruction surgery was feasible, which was in allowable range of the maximum longitudinal diameter ( < 29.8 mm) and depth ( < 4 mm). The operation was successfully completed in all 5 cases, and pathological examination suggested that purposes of radical resection had achieved. All patients were followed up 3 to 49 months (mean, 15.6 months). One patient had local recurrence at 12 months after operation, and a shoulder joint amputation was performed; the other 4 patients had good prosthesis survival. At last follow-up, the function of the shoulder joint was obviously recovered when compared with preoperative function; Enneking's skeletal muscle tumor function score was 25.8 points (range, 24 to 27 points). Conclusion Modified radical resection and reconstruction surgery is feasible for the treatment of proximal humerus tumor, and it can maintain a good early shoulder function.

    Release date:2016-11-14 11:23 Export PDF Favorites Scan
  • 足部复发恶性黑色素瘤术后创面修复

    目的 总结足部复发恶性黑色素瘤切除术后应用带血管蒂皮瓣修复创面的疗效。 方法 2005 年5 月- 2008 年6 月,收治7 例足部恶性黑色素瘤复发患者。男2 例,女5 例;年龄21 ~ 63 岁。足跟3 例,足内侧3 例,足外侧1 例。瘤体直径为2.0 ~ 4.5 cm,根据美国癌症联合会分期标准,均为Ⅰ~Ⅱ期。于外院行肿瘤局部切除手术术后3 ~ 48 个月复发。术中扩大切除黑色素瘤后,采用大小为8 cm × 4 cm ~ 14 cm × 10 cm 带足背动脉或带足底内侧动脉皮瓣修复创面。供区游离植皮修复。 结果 术后14 d 1 例带足底内侧动脉皮瓣边缘发生溃疡;供区2 例10 d 植皮部分坏死,均经相应处理后愈合;余皮瓣及植皮均成活,切口Ⅰ期愈合。患者均获随访,随访时间6 ~ 36 个月,平均26 个月。患者均无瘤生存,皮瓣均有感觉恢复,两点辨别觉15 ~ 20 mm;色泽同受区相似,耐磨,足部外形满意,足及足趾活动良好。 结论 带血管蒂皮瓣修复足部复发恶性黑色素瘤术后创面,愈合率高,血运与感觉良好,可获得较好外观和功能效果。

    Release date:2016-09-01 09:08 Export PDF Favorites Scan
  • High-dose Versus Moderate-dose Chemotherapy for Osteosarcoma: A Systematic Review

    Objective To assess the efficacy of high-dose chemotherapy versus moderate-dose chemotherapy in the treatment of osteosarcoma. Methods We searched MEDLINE, EMbase, OVID database, CBMdisc, Cochrane CENTRAL Register of Controlled Trials in The Cochrane Library, and handsearched Journal of Chinese Oncology, Journal of Chinese Clinical Oncology and Tumor. The search time was updated to Feburary 2006.The quality of the included studies was evaluated by two reviewers and meta-analyses were performed on the results of homogenous studies. Results Four studies involving 937 participants with primary, high-grade and non-metastatic extremity osteosarcoma were included. All the included studies were judged to be inadequate at reporting randomization and blinding, only one reported allocation concealment. All included studies reported the number of withdrawals and the reasons for these. The meta-analyses showed that there were no significant differences in 5-year event free survival (EFS) (RR 1.10, 95% CI 0.96 to1.25), 5-year overall survival (OS) (RR 1.08, 95% CI 0.97 to1.20), local recurrence rate (RR 0.92, 95% CI 0.54 to 1.57), proportion of good histological response (RR 0.93, 95% CI 0.81 to 1.07), proportion of limb salvage [RR 0.97, 95% CI 0.92 to 1.02) between the high-dose group and the moderate-dose group. The 5-year EFS of the good histological response group was significantly higher than in the poor histological response group [OR 2.45, 95% CI 1.76 to 3.39,Plt;0.00001 ). Conclusions No advantage is shown for high-dose chemotherapy over moderate-dose chemotherapy in 5-year EFS, 5-year OS, local recurrence rate, proportion of good histological response and proportion of limb salvage. Histological response to preoperative chemotherapy is an independent prognosis factor for osteosarcoma. Due to the potential risk of selection bias, performance bias and publication bias, the evidence is not b enough to judge whether high-dose chemotherapy is better than moderate-dose chemotherapy in the treatment of osteosarcoma. Our conclusion suggests that large-scale randomized trials should be performed.

    Release date:2016-09-07 02:17 Export PDF Favorites Scan
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