Search

BACKGROUND Epithelioid sarcoma is rare, represents less than 1% of all sarcomas, usually occurs in the extremities, and rarely presents as a primary sarcoma of the spine. Publications are usually single reports or case series. We aimed to undertake a systematic review of publications of cases of primary epithelioid sarcoma of the spine to evaluate clinical presentation, diagnosis, management, and patient outcomes. MATERIAL AND METHODS We searched studies on spinal epithelioid sarcoma in the PubMed database. Only studies with secondary epithelioid sarcoma or without effective data for analysis were excluded. Cases in which epithelioid sarcoma first invaded other sites and then affected the spine were also excluded. RESULTS Twenty-three patients from 13 studies were included in the study, aged between 14 and 65 years, and the sex ratio of female to male was 1: 2.29. The survival time was 18.7±13.8 months. The survival time of males was longer than that of females (22.9±14.4 vs 9.0±4.6, P=0.027). The onset age was linearly correlated with the size of the lesion (size=-0.161*age+11.841).The lesions located in lumbar vertebra had the worst prognosis. Postoperative radiotherapy had a statistically significant effect on survival time (P=0.040). CONCLUSIONS This systematic review identified 23 published cases of primary epithelioid sarcoma of the spine. Pain was the main presenting symptom, and tumor size increased with patient age. Female sex and primary location in the lumbar spine were associated with poor survival. Although surgery was the first-line treatment, postoperative radiotherapy and chemotherapy may improve clinical outcomes.

Weiran Hu,1,2,&ast; Hongqiang Wang,1,2,&ast; Xiaonan Wu,1,3 Xinge Shi,1,2 Haohao Ma,1,2 Kai Zhang,1,2 Yanzheng Gao1,2 1Department of Spine and Spinal Cord Surgery, Henan Provincial People’s Hospital, Zhengzhou, People’s Republic of China; 2Department of Spine and Spinal Cord Surgery, People’s Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China; 3Department of Spine and Spinal Cord Surgery, People’s Hospital of Henan University, Zhengzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yanzheng Gao, Department of Spine and Spinal Cord Surgery, Henan Provincial People’s Hospital, No. 7, Wei Wu Road, Zhengzhou, 450003, People’s Republic of China, Email gaoyanzhengspine@163.comStudy Design: Retrospective cohort study.Objective: This study aimed to investigate the characteristics of microflora in patients with deep spinal surgical site infection (SSI) after prophylactic use of vancomycin powder (VP).Methods: A retrospective analysis was performed on patients after spinal surgery. Patients were grouped according to whether VP use and only patients with deep SSI were included in this study. General information of the patients, the dose of vancomycin, bacterial culture results, drug sensitivity test results, and SSI treatment methods were recorded. The differences of microflora between the two groups were analyzed, and the sensitivity of bacteria in the +VP group to antibiotics was analyzed.Results: The infection rate in the +VP group was 4.9% (56/1124) vs 6.3% (93/1476) in the No-VP group (P < 0.05). The proportion of Gram-positive bacteria (GPB) in the +VP SSIs was 55.4% vs.74.1% in the No-VP group (P < 0.05). The percentage of Gram-negative bacteria (GNB) in the +VP SSIs was 46.4% vs.30.1% in the No-VP group (P < 0.05). More dose of VP cannot decrease the SSI, but the proportion of GNB in VP > 1g SSIs was higher (59.0% vs 32.4%, P < 0.05). In the +VP SSIs, all of the GNB cultured were sensitive to meropenem, and linezolid covered most of the GPB cultured.Conclusion: Local use of vancomycin powder can reduce the incidence of SSI, but this may lead to changes in the bacterial flora. Once the SSI occurs, the case of GNB infection may be increased. The more dose of VP cannot decrease SSI but may increase the rate of GNB in the +VP SSIs. Once infections still occur after VP use, antibiotics covering GNB may be added. These findings may help guide choice of empiric antibiotics while awaiting culture data.Keywords: surgery site infection, microflora, spine, vancomycin

This work studies the thermal reaction of Maoming atmospheric residue at a temperature range 400–500 °C in sealed tube reactor. It is found that the CS2 insoluble (coke) is formed at 420 °C and above and it increases with time and temperature, which can be fitted with a combination of the second-order and autocatalytic kinetics. The loss of heteroatoms in the coke such as sulfur atom accompanied with the condensation of coke. The concentration, g value and linewidth of stable radicals in residue are measured by electron spin resonance (ESR) and discussed to explore the transformation of coke structure. The formation of stable radicals can be expressed by a combination of the two first-order kinetics including CS2 soluble (oil) cracking and coke condensation with activation energies of 168 and 98 kJ/mol, respectively. More than half of stable radicals exist in oil (or in the coke presented in oil) when the coke contents are no >3.4%, while about 90% of the total stable radicals can be found in the coke when coke contents are >8.0%. In addition, the variation of g value and linewidth of stable radicals in coke are also studied.

Introduction. This study aimed to compare and analyze the effect of preoperative zoledronic acid (ZOL) administration on pain intensity after percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fracture (OVCF). Methods. The study included 242 patients with OVCFs who underwent PVP in our hospital between January 2015 and June 2018. The patients were randomly assigned to either a ZOL group (n = 121) or a control group (n = 121). The patients in the ZOL group were treated preoperatively with intravenous infusion of 5 mg ZOL. Those in the control group were treated without ZOL. All the patients were followed up for 1 year. Results. No statistically significant differences in age, sex, weight, and body mass index (BMI) were found between the two groups. During the follow-up period, the visual analog scale score and Oswestry dysfunction index score in the ZOL group were lower than those in the control group. The bone mineral density at 6 or 12 months after treatment was significantly higher and the levels of the bone metabolism markers were significantly lower in the ZOL group than in the control group (P<0.05 for both). Two patients in the treatment group had new vertebral fractures, whereas 13 patients in the control group had new vertebral fractures, which translate to recompression vertebral fracture incidence rates of 1.7% and 10.7%, respectively. The incidence rate of mild adverse reactions was significantly higher in the ZOL group than in the control group, but all the cases were endurable. Conclusion. Intravenous infusion of ZOL before PVP can effectively reduce postoperative pain intensity, reduce bone loss, increase bone density, reduce the risk of refracture, and improve patient quality of life.

Coke deposition on hydrotreating catalysts is one of the main reasons of deactivation. In situ coke removal is advantageous compared to the off-site coke removal. This paper studies tetralin (THN) ...

As a global health problem, cardiovascular disease threatens the lives of human beings. It has been reported that microRNAs (miRs) are important in regulating coronary atherosclerosis. In the present study, the expression levels of miR-370 in peripheral blood mononuclear cells of patients with coronary atherosclerosis were significantly increased compared with healthy patients, as demonstrated by reverse transcription-quantitative polymerase chain reaction analysis. Additionally, the target of miR-370 was predicted as Forkhead Box 1 (FOXO1) with bioinformatics, and was confirmed by a dual luciferase assay. The mRNA and protein expression levels of FOXO1 were inhibited by miR-370. Furthermore, the invasion and proliferation of human umbilical vein endothelial cells were promoted by miR-370 via inhibiting the expression of FOXO1. The results obtained in the present study demonstrated that miR-370 served an important role in regulating coronary atherosclerosis via targeting FOXO1. The present data also indicated that miR-370 may be a promising molecular target for treating coronary atherosclerosis.

This work studies thermal reaction of a heavy oil at temperatures of 250–500 °C in sealed capillaries. The samples are extracted by chlorobenzene and toluene, and the insoluble matters are quantified in mass and in radical concentration. It is found that the chlorobenzene insolubles (CI) forms at temperatures of and higher than 440 °C while the toluene insolubles (TI) forms at temperatures higher than 350 °C. Both of these insoluble matters increase with time and temperature, and approach to similar asymptotic values. The CI formation can be fitted with a combination of the second-order and autocatalytic kinetics while the TI formation can be fitted with the second-order kinetics. Both CI and TI contain stable radicals measurable by electron spin resonance (ESR), and the radical concentration in CI is higher than that in TI. The kinetics of stable radical concentration in CI and TI are different from that in mass, except that of TI at a low temperature range (350–440 °C). The changes in ESR line width of CI and TI are also studied. The above data are also discussed in terms of hard coke (CI insoluble matters) and soft coke (the difference between TI and CI), and in activation energy.

Coking on catalyst during hydroprocessing of petroleum residues is an important issue that should be addressed for better catalyst performance. This paper studies reaction and coking behaviors of Maoming atmospheric residue (AR) over a sulfided commercial NiMo/γ-Al 2 O 3 catalyst in the presence and absence of a hydrogen donor solvent, tetrahydronaphthalene (THN), in a micro-reactor at temperatures of 400–460 °C and reaction time of 0–60 min. It reports the changes in yields of CS 2 soluble matter (CS 2 -S), CS 2 insoluble matter (coke) and gas, as well as the changes in quantity of coke on the catalyst and in radical concentration of the reaction system, coke on catalyst and CS 2 -S. It is found that compared with the changes in yields, which are significant at temperatures higher than 420 °C, the changes in radical concentration are significant at 400 °C. The catalyst promotes hydrogen donation of THN, which lowers the amounts of coke formed in the liquid phase, on the catalyst, and the activation energy of coking on the catalyst.

Solvent extraction of coals has been practiced extensively for various purposes including the determination of coal structure. It is generally assumed that the extraction is mainly a physical process involving little change in covalent bonds. But different opinions were reported. This work studies the behavior of radicals during extraction of 3 low rank bituminous coals using 5 solvents, including hexane, toluene, tetrahydrofuran (THF), 1,2,3,4-tetrahydronaphthalene (THN), and N-methyl-2-pyrrolidinone (NMP), using electron spin resonance (ESR). The extractions are carried out at temperatures from the ambient temperature to temperatures somewhat higher than the boiling points of the solvents, as well as under ultrasound. It is found that the radical concentration of the coals changes during the extraction, and the change is influenced by temperature and varies with the solvent. The decrease in radical concentration in most solvents at temperatures lower than their boiling points is attribute to coupling of free radicals dissolved from the coals, while the increase in radical concentration at high temperatures and in NMP is attributed to the cleavage of weak bonds in coals by the solvents.

Additional file 3.

Additional file 2.

Additional file 1.

Coking of volatiles generated from coal in pyrolysis has been a focal issue in coal pyrolysis and upgrading of coal tar, but limited work can be found in the literature on evolution of coke in composition and structure under the pyrolysis conditions. This work characterizes the coke formed in reaction of a subbituminous coal tar at 300, 400, and 500 °C in 40 min in a semibatch system which allows natural evaporation of light fractions. The coke is categorized into two types, the one suspended in tetrahydrofuran (THF), coke-S, and the one deposited on the wall of tube reactor, coke-D. It is found that coke-D accounts for 70–85% of total coke. With increasing tar reaction temperature and time the quantity of coke increases from 1.0% to 16.3 wt % and the particle size of coke-S increases from a most probable size of approximately 0.1 to 700–800 μm. This change is accompanied by reduction in alkyl side chains and heteroatoms (O, N, and S), as well as the enrichment in the aromatic Car–Car bond, which lead to ...

Impressive responses have been observed in patients with cancer treated with checkpoint inhibitory anti-programmed cell death-1 (PD-1) or anti-cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) antibodies through disinhibiting the immune system. However, tumors possess complex immunosuppressive tumor microenvironment to present therapeutic obstacles and the response rates to immune checkpoint inhibition remain low. One significant barrier to the efficacy of anti-PD1 treatment is the recruitment of myeloid-derived suppressor cells (MDSCs) into the tumor. MDSCs dramatically increased in peripheral blood of patients with osteosarcoma and prohibited both T-cell activation and infiltration. Here we demonstrated functional inhibition of G-MDSCs with (S)-(-)-N-[2-(3-Hydroxy-1H-indol-3-yl)-methyl]-acetamide (SNA), a specific inhibitor of PI3Kδ/γ, could prime tumor microenvironment, resultantly enhancing the therapeutic efficacy of anti-PD1 treatment in a syngeneic osteosarcoma tumor model. Combining SNA with anti-PD1 dramatically slowed osteosarcoma tumor growth and prolonged survival time of tumor-bearing mice, at least in part mediated through CD8+ T cells. Our results demonstrated that addition of SNA to anti-PD1 significantly altered infiltration and function of innate immune cells, providing the rationale for combination therapy in patients with osteosarcoma through inhibiting the function of MDSCs with a selective PI3Kδ/γ inhibitor to enhance responses to immune checkpoint blockade. Key words: (S)-(-)-N-[2-(3-Hydroxy-1H-indol-3-yl)-methyl]-acetamide, MDSCs, Osteosarcoma, Anti-PD1

Cardiac myxoma is the most common type of human heart tumor, yet the molecular mechanism is still poorly understood. In the present study, we found that the level of myocyte enhancer factor 2D (MEF2D), a key regulatory protein for cardiac development, was elevated in specimens of cardiac myxoma, and was positively associated with the proliferation of myxoma cells. MEF2D suppression reduced the proliferation of myxoma cells and its tumorigenicity. Cell cycle progression was also inhibited by MEF2D suppression. miR-218, which is downregulated in myxoma, suppressed MEF2D expression by targeting its mRNA 3'UTR. Altogether, we found that miR-218/MEF2D may be an effective target for myxoma treatment.

Osteoarthritis (OA) is a joint disease caused by the breakdown of joint cartilage and underlying bone, and places great burdens to daily life of patients. Nuclear orphan receptor nuclear receptor subfamily 4, group A, member 1 (NR4A1) is vital for cell apoptosis, but little is known about its role in OA. This study aims to reveal the expression and function of NR4A1 during OA chondrocyte apoptosis. NR4A1 expression by qRT-PCR and western blot, and chondrocyte apoptosis by TUNEL assay were detected in normal and OA joint cartilage. NR4A1 was located in cartilage sections by immunohistofluorescence. Chondrocytes from normal joint cartilage were cultured in vitro for interleukin 6 (IL6) or tumor necrosis factor (TNF) treatment and si-NR4A1 transfection, after which the possible mechanism involving NR4A1 was analyzed. Results showed that NR4A1 expression and chondrocyte apoptosis were significantly elevated in OA cartilage (P < 0.05 and P < 0.01). NR4A1 was located in nuclei of normal cartilage chondrocytes, but was translocated to mitochondria and co-located with B-cell lymphoma 2 in OA chondrocytes. NR4A1 expression in cultured chondrocytes could be promoted by both IL6 and TNF treatment. si-NR4A1 partly reduced TNF-induced cell apoptosis. Inhibiting p38 by SB203580 could decrease TNF-induced NR4A1 to some extent, while inhibiting JNK could not. So NR4A1 is likely to facilitate OA chondrocyte apoptosis, which is associated with p38 MAPK and mitochondrial apoptosis pathway. This study provides a potential therapeutic target for OA treatment and offers information for regulatory mechanisms in OA.

To investigate the application value of intraoperative CT navigation in posterior thoracic pedicle screw placement for scoliosis patients.Between October 2009 and December 2011, 46 patients with scoliosis were treated with thoracic pedicle screw placement under intraoperative CT navigation in 21 cases (group A) or under C-arm fluoroscopy in 25 cases (group B). There was no significant difference in age, gender, type of scoliosis, involved segment, and Cobb angle of main thoracic curve between 2 groups (P0.05). A total of 273 thoracic pedicle screws were placed in group A and 308 screws in group B. The pedicle screw position evaluated and classified by intraoperative CT images according to the Modi et al. method; and the accurate rate, the safe rate, and the potential risk rate of pedicle screws were calculated on the upper thoracic spine (T1-4), the middle thoracic spine (T5-8), the lower thoracic spine (T9-12), and the entire thoracic spine (T1-2). The accuracy and security of thoracic pedicle screw placement were compared between 2 groups.On the entire thoracic spine, the accurate rate of group A (93.4%) was significantly higher than that of group B (83.8%), the safe rate of group A (98.9%) was significantly higher than that of group B (92.5%), showing significant differences between 2 groups (P0.05). However, the potential risk rate of group B (7.5%) was significantly higher than that of group A (1.1%) (P0.05). On the upper, the middle, and the lower thoracic spines, there was no significant difference in the accurate rate, the safe rate, and the potential risk rate of pedicle screws between 2 groups (P0.05). According to CT evaluation results, the potential risk pedicle screws were revised or removed during operation. The patients of 2 groups had no neurological deficits through physical examination of nervous system at 3 days after operation.Intraoperative CT navigation can improve the accuracy and security of posterior thoracic pedicle screw placement and it can ensure the safety of operation by finding and promptly removing or revising the potential risk pedicle screws.

To evaluate the effectiveness of arthroscopic treatment and nonsurgical treatment on ankle degenerative osteoarthropathy.Between July 2009 and June 2011, 58 patients (58 ankles) suffering from ankle degenerative osteoarthropathy underwent arthroscopic treatment (arthroscopic group, n=28) and routine treatment (control group, n=30). There was no significant difference in gender, age, body mass index, disease duration, and degree of ankle degenerative osteoarthropathy between 2 groups (P0.05). Mazur score, visual analogue scale (VAS), and Tegner activity scale were used to evaluate the effectiveness.Incision healed primarily in arthroscopic group. The patients of 2 groups were followed up 1-2 years, averaged 1.5 years in arthroscopic group and 1.6 years in control group. At last follow-up, Mazur, VAS, and Tegner scores were significantly improved when compared with the preoperative scores in 2 groups (P0.05), but no significant difference was found at last follow-up between 2 groups (P0.05). According to Mazur scoring, the results were excellent in 8 cases, good in 14 cases, fair in 5 cases, and poor in 1 case, with an excellent and good rate of 79% in arthroscopic group; the results were excellent in 6 cases, good in 15 cases, fair in 6 cases, and poor in 3 cases, with an excellent and good rate of 70% in control group; and no significant difference was observed between 2 groups (u=0.98, P=0.77). Moreover, there was no correlation between Outerbridge classification and Mazur score in patients undergoing arthroscopic treatment (r=0.18, P= 0.34).Arthroscopic and nonsurgical treatments of ankle degenerative osteoarthropathy can both achieve good effectiveness.