Long-term survival case of a non-small cell lung cancer bone metastasis patient treated with bone cement, radiation and gefitinib.

OBJECTIVE: We explore the treatment of bone metastases in advanced non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: We reported a 76-year-old female patient, who was diagnosed with NSCLC with bone metastasis eight years ago (stage IVA). Due to unbearable diarrhea, she refused chemotherapy, and we adopted local treatment, including local radiotherapy 50 Gy and bone cement to lumbar spinal metastases, 62 Gy local radiotherapy of primary lung tumor, TKI inhibitor gefitinib and zoledronic acid. RESULTS: She survived more than eight years and is still in follow-up. CONCLUSIONS: The median survival time for NSCLC patients with bone metastases is often less than 1 year. We reported the patient with more than eight years of survival, showed that some special cases can adopt the methods of local treatment including bone cement, treatment benefit patients, radiation therapy and targeted therapy in clinic to expand the survival.

Progress in the study of markers related to glioma prognosis.

OBJECTIVE: In the era of precision medicine, molecular and genetic biomarkers act as the key indicators for glioma patients' recurrence and prognosis. MATERIALS AND METHODS: We summarize the biomarkers of glioma prognosis from molecular level, gene level and microRNA level. RESULTS: In molecular biomarkers, cyclinD1 high expression/P16 low expression, MIF high expression and VEGF high expression were all related to glioma patients' poor prognosis; in genetic biomarkers, MGMT promoter methylation absence, IDH1 wild type, HIF-α high expression, Chromosome 1p/19q non-deletion and TERT promoter mutation were associated with poor prognosis for glioma; in microRNA biomarkers, miR-524-5p, miR-586, miR-433, miR-619, miR-548d-5p, miR-525-5p, miR-301a, miR-210, miR-10b-5p, miR-15b-5p and miRNA-182 high expression, miR-124, miR-128, miR-146b and miR-218 low expression were commonly seen in glioma poor prognosis patients. CONCLUSIONS: With the continuous development of science and technology, the diagnosis of glioma will tend to the gene and molecular level. Finding specific markers is helpful for the early diagnosis and accurate prognosis of glioma, which provides the possibility for individualized treatment.

Mechanistic understanding of compression-compression fatigue behavior of functionally graded Ti-6Al-4V mesh structure fabricated by electron beam melting.

In recent years, mesh structures have attracted significant interest for structural and functional applications. However, the mechanical strength and energy absorption ability of uniform mesh structured materials degrade with density. To address this challenge, we propose the concept of functionally graded mesh structures. The objective of the proposed research is to fundamentally understand the compressive behavior of graded mesh structures. The compression-compression fatigue behavior of functionally graded Ti-6Al-4V mesh structure under identical bulk stress condition is studied here. During cyclic deformation, it was observed that the local stress distribution in the struts was not uniform because of inhomogeneous mechanical properties of the constituents. Fatigue cracks first initiated in the lowest strength constituent, and then propagated until structural failure occurred. However, no obvious damage was observed in other constituents during the entire process. In contrast with iso-strain state, the fatigue life of graded structure is mainly determined by the constituent with the lowest strength.

The influence of cell morphology on the compressive fatigue behavior of Ti-6Al-4V meshes fabricated by electron beam melting.

Additive manufacturing technique is a promising approach for fabricating cellular bone substitutes such as trabecular and cortical bones because of the ability to adjust process parameters to fabricate different shapes and inner structures. Considering the long term safe application in human body, the metallic cellular implants are expected to exhibit superior fatigue property. The objective of the study was to study the influence of cell shape on the compressive fatigue behavior of Ti-6Al-4V mesh arrays fabricated by electron beam melting. The results indicated that the underlying fatigue mechanism for the three kinds of meshes (cubic, G7 and rhombic dodecahedron) is the interaction of cyclic ratcheting and fatigue crack growth on the struts, which is closely related to cumulative effect of buckling and bending deformation of the strut. By increasing the buckling deformation on the struts through cell shape design, the cyclic ratcheting rate of the meshes during cyclic deformation was decreased and accordingly, the compressive fatigue strength was increased. With increasing bending deformation of struts, fatigue crack growth in struts contributed more to the fatigue damage of meshes. Rough surface and pores contained in the struts significantly deteriorated the compressive fatigue strength of the struts. By optimizing the buckling and bending deformation through cell shape design, Ti-6Al-4V alloy cellular solids with high fatigue strength and low modulus can be fabricated by the EBM technique.

Influence of cell shape on mechanical properties of Ti-6Al-4V meshes fabricated by electron beam melting method.

Ti-6Al-4V reticulated meshes with different elements (cubic, G7 and rhombic dodecahedron) in Materialise software were fabricated by additive manufacturing using the electron beam melting (EBM) method, and the effects of cell shape on the mechanical properties of these samples were studied. The results showed that these cellular structures with porosities of 88-58% had compressive strength and elastic modulus in the range 10-300MPa and 0.5-15GPa, respectively. The compressive strength and deformation behavior of these meshes were determined by the coupling of the buckling and bending deformation of struts. Meshes that were dominated by buckling deformation showed relatively high collapse strength and were prone to exhibit brittle characteristics in their stress-strain curves. For meshes dominated by bending deformation, the elastic deformation corresponded well to the Gibson-Ashby model. By enhancing the effect of bending deformation, the stress-strain curve characteristics can change from brittle to ductile (the smooth plateau area). Therefore, Ti-6Al-4V cellular solids with high strength, low modulus and desirable deformation behavior could be fabricated through the cell shape design using the EBM technique.