Association of normalization of postoperative carbohydrate antigen 125 levels with treatment failure following uterine artery embolization for adenomyosis.

OBJECTIVE: To investigate the association between carbohydrate antigen 125 (CA125) level and adenomyosis treatment failure (TF) after uterine artery embolization (UAE). METHODS: We evaluated 224 patients with symptomatic adenomyosis who underwent UAE between January 2016 and December 2020. Improvements in dysmenorrhea and menorrhagia were assessed on the basis of symptom relief criteria. The factors associated with TF were investigated using a multivariate logistic regression model. Patients were analyzed for preoperative CA125 levels, postoperative CA125 levels, and the normalization of postoperative CA125 levels. Long-term symptom relief and quality of life after UAE were compared between the groups. RESULTS: During the 24-month follow-up, 50 patients (22.3%) experienced TF. Compared to patients in the non-TF group, those in the TF group had significantly higher preoperative and postoperative CA125 levels (p < 0.05). Multivariate analysis revealed that failure to normalize postoperative CA125 levels was independently associated with an increased risk of TF (34.7% vs. 8.5%, p < 0.001; hazard ratio 3.953, 95% confidence interval 1.567-9.973, p = 0.004). After a 3-month follow-up period, patients who normalized their CA125 levels were more likely to achieve complete necrosis on magnetic resonance imaging than those who did not (82.1% vs. 56.8%, p < 0.001). Normalization of postoperative CA125 levels was significantly associated with fewer symptoms and better quality of life 12 months after UAE (p < 0.05). CONCLUSIONS: Following UAE, normalization of postoperative CA125 levels, rather than absolute values, was the strongest predictive marker of TF.

Analysis of Patient-Reported Outcomes After Breast Reconstruction: A Retrospective Study.

OBJECTIVE: This study aimed to investigate the effects of surgical timing, procedure, and age, on complication rates, health-related quality of life, and postoperative satisfaction, in patients who underwent breast reconstruction. METHODS: The data of 80 patients who underwent breast reconstruction surgery between August 2004 and June 2018 were reviewed. Patients were grouped according to surgical timing, procedure, and age. The evaluation indicators included complications and BREAST-Q scores. The statistical methods used included the Mann-Whitney U test and analyses of variance and covariance. RESULTS: The incidence of complications was 15.0% (12/80). The complication rates were similar in each group ( P > 0.05). The postsurgical scores of patient satisfaction with breast, psychosocial well-being, and sexual well-being were higher than the presurgical scores ( P < 0.05). The postoperative psychosocial and sexual well-being scores of patients in the immediate group were higher than those in the delayed group ( P < 0.05). The satisfaction with the outcome in the abdominal flap group was higher than that in the other group, whereas the sexual well-being score of the abdominal flap group was lower than that of the other group ( P < 0.05). The scores of the postoperative physical well-being of the chest and abdomen in the younger group were higher than that in the older group ( P < 0.05). CONCLUSIONS: Breast reconstruction can significantly improve patients' health-related quality of life and satisfaction. Immediate breast reconstruction can reduce the adverse psychological and physical effects that breast loss exerts on patients, leading to better postoperative satisfaction. Patients who underwent breast reconstruction with abdominal flaps had higher postoperative satisfaction. Breast reconstruction in elderly patients was associated with considerable postoperative satisfaction.

Eco-Environmental Effect Evaluation of Tamarix chinesis Forest on Coastal Saline-Alkali Land Based on RSEI Model.

Taking representative Tamarix chinensis forest in the national-level special protection zone for ocean ecology of Changyi city in Shandong province of China as the objective, this research studied how to use remote sensing technology to evaluate natural eco-environment and analyze spatiotemporal variation. In the process of constructing the index system of ecological environment effect evaluation based on RSEI (Remote Sensing Ecological Index) model, AOD (Aerosol Optical Depth), Salinity, Greenness, Wetness, Heat and Dryness, which can represent the ecological environment of the reserve, were selected as the corresponding indexes. In order to accurately obtain the value of the RSEI of the study area and to retain the information of the original indexes to the greatest extent, the SPCA (spatial principal components analysis) method was applied in this research. Finally, the RSEI was applied to evaluate the ecological and environmental effects and to analyze the spatial characteristics and spatiotemporal evolution of the study area. The results not only provide scientific evidence and technical guidance for the protection, transformation and management of the Tamarix chinensis forest in the protection zone but also push the development of the universal model of the ecological environment quality with a remote sensing evaluation index system at a regional scale.

Inflammatory cytokines derived from peripheral blood contribute to the modified electroconvulsive therapy-induced cognitive deficits in major depressive disorder.

Little is known about the pathophysiology of memory deficits in patients with major depressive disorder (MDD) treated with modified electroconvulsive therapy (MECT). This study examined the profiles of cytokines, the memory function, and their association in MECT-treated MDD patients. Forty first-episode, drug-free MDD patients and 40 healthy controls were recruited. MECT was started with antidepressant treatment at a stable initial dose. The Wechsler Memory Scale (WMS) and Hamilton Rating Scale for Depression 17 (HRSD-17) were used to assess the cognitive function. MDD patients were divided into the memory impairment group (WMS < 50) and the non-memory impairment group (WMS ≥ 50) based on the total WMS scores after MECT. The levels of NOD-like receptor 3 (NLRP3) inflammasome, interleukin-18 (IL-18) and nuclear factor kappa-B (NF-κB) in the serum were measured. MDD patients showed significantly higher levels of NLRP3 inflammasome, IL-18 and NF-κB than that in the controls prior to MECT, and the levels also significantly increased after MECT. In MDD patients, the serum levels of these inflammatory cytokines were negatively associated with the total WMS scores and likely contributed to the scores independently. The receiver operating characteristic curve showed that the serum levels of these inflammatory cytokines may predict the cognitive impairment risk in MDD patients receiving MECT. Abnormal levels of NLRP3 inflammasome, IL-18 and NF-κB reflecting the disturbed balance of pro-inflammatory and anti-inflammatory mechanisms likely contribute to the MECT-induced cognitive deficits in MDD patients.

The role of BDNF exon I region methylation in the treatment of depression with sertraline and its clinical diagnostic value.

BACKGROUND: Brain-derived neurotrophic factor (BDNF) is considered to be one of the best candidate genes for depression. However, whether sertraline treatment affects the methylation level of this gene remains unknown. METHODS: Fifty-three patients with depression and 51 healthy controls were included in the study. The methylation level of BDNF exon I was determined in blood samples from these subjects. The Hamilton Depression Scale was used to evaluate the depression status of patients. Single nucleotide polymorphism detection was used for genotyping, and a receiver operating characteristic (ROC) curve was used to evaluate the predictive value of the methylation level of this locus in patients with depression. RESULTS: There was a significant difference in the methylation level of BDNF exon I between the control and depression groups. No effect of sertraline monotherapy on BDNF methylation was found in subjects with depression. Moreover, no interaction was found between BDNF genotype and the per cent methylation of BDNF exon I. However, methylation at this site was positively correlated with diurnal variation and retardation scores. Blood homocysteine concentrations were significantly reduced by sertraline treatment. No influence of genotype on serum BDNF concentration was found in subjects with depression. The ROC curve showed that methylation of BDNF exon I may be used to distinguish patients from healthy people, to a certain extent. CONCLUSION: Methylation of BDNF exon I may be used as a biomarker of depression and may be a therapeutic target for previously untreated depression.

Efficacy and Safety of Subcutaneous Temporal Autologous Micro-fat Augmentation.

BACKGROUND: Autologous fat grafting is a rapidly developing soft tissue filling technique that has been playing an increasingly important role in facial contouring and rejuvenation surgeries. However, this technique is accompanied by many side effects and risks. In particular, there is still much room for improvement in regard to the surgical method of temporal augmentation with autologous fat, which is highly popular among Chinese people. Better surgical methods can achieve better outcomes while curbing surgical risks. DESIGN AND METHODOLOGY: We reviewed 39 patients who consecutively underwent subcutaneous temporal autologous micro-fat argumentation surgery at Peking University People's Hospital from February 19, 2016, to May 13, 2019, to correct temporal hollowness. Each patient's Visual Analogue Scale (VAS) satisfaction score and Hollowness Severity Rating Scale (HSRS) score before and after surgery were precisely recorded, and any complaints about perioperative complications were meticulously collected to assess the efficacy and safety profile of the novel technique. RESULTS: All 39 patients included in this study were female. We performed 86 subcutaneous temporal autologous micro-fat argumentation surgeries, with an average follow-up of 20.4 ± 9.6 months. The average fat filling volume in the right temporal region was 6.29 ± 2.55 mL, and that in the left temporal region was 6.34 ± 2.71 mL. The average VAS satisfaction score increased from 4.44 ± 1.33 before the surgery to 8.08 ± 0.77 after the surgery, and the average HSRS score dropped from 1.82 ± 0.72 before the surgery to 0.36 ± 0.49 after the surgery. Four patients were encountered with minor complications of intraoperative bleeding and congestion, which were all completely ameliorated after conservative therapies. CONCLUSION: In the present study, we found that the reported surgical method of subcutaneous temporal autologous micro-fat augmentation successfully improved the temporal hollowness of the patients, boasting good surgical results and high patient satisfaction with minimal short- and long-term complications, illustrating that it is an effective, safe and promising novel surgical technique worthy of wider clinical application. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Character of Gluteal Region Morphology in Young Chinese Females.

BACKGROUND: The female gluteal morphology is an important secondary sexual characteristic and helps accentuate and define the female body shape. Despite the increasing prevalence of gluteal augmentations in our country, little data exist regarding the morphology of the gluteal region in young Chinese females. This study analyzed a convenience sample of Chinese females and their gluteal region. METHODS: Data, measurements, and photos of the following parameters were taken: age, weight, height, and body mass index (BMI). Morphology was classified into four types: A shape, V shape, round shape, and square shape. Aesthetic characteristics of each buttock were recorded. Height, weight, BMI, and gluteal projection ratio differences in different shape groups were analyzed. RESULTS: The study sample consisted of 103 women, with ages from 23 to 27 years. The V-shaped buttock was not found in this sample. The A shape, square shape, and round shape occupied 55.3%, 38.8%, and 5.8% accordingly. Short infragluteal fold, supragluteal fossettes, lateral depression, and V-shaped crease appeared in 42.7%, 14.6%, 11.7%, and 2.9% of samples, respectively. Of the 103 samples, 39 (37.9%) fulfilled the aesthetic gluteal projection(ratio ≥ 2). The average BMI was statistically significant between each gluteal shape (P = 0.009). Height, weight, and gluteal projection ratio showed no significant difference with the buttock shapes. CONCLUSIONS: We are the first to describe gluteal morphology in young Chinese woman using gluteal anthropometrics. The findings of the study may provide a guideline for plastic surgeons who perform gluteal augmentation in Asian patients.

Optimization of suspended particulate transport parameters from measured concentration profiles with a new analytical model.

The water body's suspended concentration reflects many coastal environmental indicators, which is important for predicting ecological hazards. The modeling of any concentration in water requires solving the settling-diffusion equation (SDE), and the values of several key input parameters therein (settling velocity ws, eddy diffusivity Ds, and erosion rates p(t)) directly determine the prediction performance. The time-consuming large-scale simulations would benefit if the parameter values could be estimated through available observations in the target sea area. The present work proposes a new optimization method for synchronously estimating the three parameters from limited concentration observations. First, an analytical solution to the one-dimensional vertical (1DV) SDE for suspended concentrations in an unsteady scenario is derived. Second, the near bottom suspended sediment concentration (SSC) profiles are measured with high-resolution observation. Third, the key parameters are optimized through the best fit of the measured SSC profiles and those modeled with the unsteady solution. Nonlinear least square fitting (NLSF) is introduced to judge the best fits automatically. The high-resolution concentration measurements in a specially-designed cylindrical tank experiment using the Yellow River Delta sediments test the proposed method. The method performs well in the initial period of turbulence generation when sediment resuspension is significant. It optimizes p(t), ws, and Ds with reasonable values and uniqueness of their combination. The proposed theory is a practical tool for quickly estimating key substance transport parameters from limited observations; it also has the potential to construct local parametric models to benefit the 3D modeling of coastal substance transport. Although the present work takes SSC as an example, it can be extended to any suspended particulate concentration in the water.

tiRNA-Gly-GCC-001 in major depressive disorder: Promising diagnostic and therapeutic biomarker.

BACKGROUND AND PURPOSE: In major depressive disorder (MDD), exploration of biomarkers will be helpful in diagnosing the disorder as well as in choosing a treatment and predicting the treatment response. Currently, tRNA-derived small ribonucleic acids (tsRNAs) have been established as promising non-invasive biomarker candidates that may enable a more reliable diagnosis or monitoring of various diseases. Herein, we aimed to explore tsRNA expression together with functional activities in MDD development. EXPERIMENTAL APPROACH: Serum samples were obtained from patients with MDD and healthy controls, and small RNA sequencing (RNA-Seq) was used to profile tsRNA expression. Dysregulated tsRNAs in MDD were validated by quantitative real-time polymerase chain reaction (qRT-PCR). The diagnostic utility of specific tsRNAs and the expression of these tsRNAs after antidepressant treatment were analysed. KEY RESULTS: In total, 38 tsRNAs were significantly differentially expressed in MDD samples relative to healthy individuals (34 up-regulated and 4 down-regulated). qRT-PCR was used to validate the expression of six tsRNAs that were up-regulated in MDD (tiRNA-1:20-chrM.Ser-GCT, tiRNA-1:33-Gly-GCC-1, tRF-1:22-chrM.Ser-GCT, tRF-1:31-Ala-AGC-4-M6, tRF-1:31-Pro-TGG-2 and tRF-1:32-chrM.Gln-TTG). Interestingly, serum tiRNA-Gly-GCC-001 levels exhibited an area under the ROC curve of 0.844. Moreover, tiRNA-Gly-GCC-001 is predicted to suppress brain-derived neurotrophic factor (BDNF) expression. Furthermore, significant tiRNA-Gly-GCC-001 down-regulation was evident following an 8-week treatment course and served as a promising baseline predictor of patient response to antidepressant therapy. CONCLUSION AND IMPLICATIONS: Our current work reports for the first time that tiRNA-Gly-GCC-001 is a promising MDD biomarker candidate that can predict patient responses to antidepressant therapy.

Regenerative peripheral nerve interface reduces the incidence of neuroma in the lower limbs after amputation: a retrospective study based on ultrasound.

BACKGROUND: Amputees suffer from symptomatic neuroma and phantom limb pain. Regenerative peripheral nerve interface (RPNI) has recently been regarded as an effective method to prevent neuroma after amputation. However, the verifications of RPNI efficacy are mostly based on subjective evaluation, lacking objective approaches. This study aims to unveil the effect of RPNI on preventing neuroma formation and provide evidence supporting the efficacy of RPNI based on ultrasound. METHODS: Amputees of lower limb at Peking University People's Hospital from July 2020 to March 2022 were analyzed retrospectively. The clinical data collected consisted of general information, pathology of primary disease, history of limb-salvage treatment, amputation level of nerve, pain scales such as the Numerical Rating Scale (NRS) and the Manchester Foot Pain and Disability Index (MFPDI). Three months after amputation, the transverse diameter, anteroposterior diameter, and cross-sectional area of neuromas in stump nerves at the end of residual limbs were measured using ultrasound and compared to adjacent normal nerves. RESULTS: Fourteen patients were enrolled in the study, including 7 in the traditional amputation group (TA group) and 7 in the RPNI group. There was no significant difference in basic information and amputation sites between the two groups. The NRS and MFPDI scores of patients in RPNI group were significantly lower than those in TA group, and decreased with the follow-up time increasing, indicating that RPNI could reduce symptomatic neuroma pain. The comparison of preoperative ultrasound and postoperative pathology showed ultrasound could reflect the size of neuroma in vivo. Independent-sample t tests indicated that the ratios of anteroposterior diameter, transverse diameter and area of the cross section of both the neuroma and adjacent normal nerve obtained via ultrasound were significantly reduced in the RPNI group. CONCLUSION: This study suggested that RPNI can effectively prevent the formation of symptomatic neuroma after amputation using ultrasound.

Analysis of the characteristics and causations of surface deformation based on TS-InSAR: a case study of Jimo district, China.

Due to the rapid economic development and urban construction and the high exploitation rate of groundwater and geothermal resource, Jimo district existed a potential threat of surface deformation. To clarify the characteristics and causations of surface deformation, this study firstly used SBAS-InSAR (Small Baseline Subset-Interferometric Synthetic Aperture Radar) technology to analyze the surface defor-mation distribution in the whole research area. Then, three areas with different surface cover conditions were selected to analyze the causations of surface deformation. Lastly, taking central urban area as the key research area, surface deformation causations were analyzed in detail based on PS-InSAR (Persistent Scatter-Interferometric Synthetic Aperture Radar) technology. The study found that, in coastal mollisol area, farmland area, and hot spring area, the maximum subsidence velocity reached up to 46.8 mm/a, 24 mm/a, and 19.1 mm/a, respectively. The factors, including surface loading, precipitation, and the groundwater level, were the causations of surface deformation in different research areas. The trend of the surface deformation curve was consistent with that of the groundwater level curve in the central urban area, but the response time of surface deformation lagged behind the change of groundwater level by approximately 4 months.

Spatial distribution and sources of heavy metals in the sediment and soils of the Yancheng coastal ecosystem and associated ecological risks.

Studies of heavy metal pollution are essential for the protection of coastal environments. In this study, positive matrix factorization (PMF) and a GeoDetector model were used to evaluate the sources of heavy metal contamination and associated ecological risks along the Yancheng Coastal Wetland. The distribution of heavy metals was shown to be greatly affected by clay content, except for Cr in shoal. Components from 6.5 to 9φ have the strongest ability to absorb heavy metals, where the effects of Cd and Zn sequestration in the wetlands were most apparent. The abilities of various wetland environments to sequester heavy metals were shown to be Spartina alterniflora wetland > woodland > Phragmites australis wetland > aquaculture pond > shoal > paddy > meadow > dry land. The sources of the heavy metals included parent soil material (59%), agriculture (15%), and industrial pollutants (26%). According to the single-factor pollution index, there was no evidence of pollution except Cr and Pb. In general, the heavy metal pollution was insignificant. The order of pollution loading index was shoal > paddy field > dry land > Spartina Alterniflora wetland > aquaculture ponds > woodland > meadow > Phragmites australis wetland. The ecological harm of heavy metal exposure was slight except for Cd and Hg, where vehicle emissions appeared to be the main cause of heavy metal pollution.

Effectiveness of fat grafting in scar reduction: A systematic review and meta-analysis.

BACKGROUND: Scar brings great physical and mental pain to patients. Fat grafting may be a new and simple way to treat scar. This review aimed to systematically evaluate the correlation between fat grafting and scar reduction. METHODS: The author searched Chinese and English literature databases such as CNKI, Wanfang Data, Cqvip, Pubmed, Web of Science, Embase, CBM, etc. for articles published in the period from 2011 to 2021 about the randomized controlled trials (RCTs) to assess the effect of fat grating on scar reduction, and then performed meta-analysis with Review Manager 5.4. RESULTS: A total of nine articles were included in the assessment of the effect of fat grafting on scar reduction, with meta-analysis suggesting statistical significance (OR = 5.63, 95% CI: 3.01-10.53, p < 0.01). There was statistical significance in the difference observed between the simple fat grating group (p = 0.004) and the group of existing therapies combined with fat grafting (p < 0.0001). CONCLUSION: Fat grafting may be a good method for scar treatment, especially when it's combined with other therapies. Still, due to the limitations of included RCTs, more large-scale high-quality RCTs must be carried out before solid conclusions can be drawn.

Regenerative Peripheral Nerve Interfaces Effectively Prevent Neuroma Formation After Sciatic Nerve Transection in Rats.

Objective: The disordered growth of nerve stumps after amputation leading to the formation of neuromas is an important cause of postoperative pain in amputees. This severely affects the patients' quality of life. Regenerative peripheral nerve interfaces (RPNIs) are an emerging method for neuroma prevention, but its postoperative nerve growth and pathological changes are yet to be studied. Methods: The rat sciatic nerve transection model was used to study the effectiveness of RPNI in this experiment. The RPNI (experimental) group (n = 11) underwent RPNI implantation after sciatic nerve transection, while the control group (n = 11) only underwent sciatic nerve transection. Autotomy behavior, ultrasonography, and histopathology were observed for 2 months postoperatively. Results: Compared to the control group, the incidence and size of the neuromas formed and the incidence and extent of autotomy were significantly reduced in the RPNI group. The axon density in the stump and degree of stump fibrosis were also significantly reduced in the RPNI group. Conclusion: RPNI effectively prevented the formation of neuromas.

A physics-informed statistical learning framework for forecasting local suspended sediment concentrations in marine environment.

An in-situ monitoring of water quality (suspended sediment concentration, SSC) and concurrent hydrodynamics was conducted in the subaqueous Yellow River Delta in China. Empirical mode decomposition and spectral analysis on the SSC time series reveal the different periodicities of each physical mechanism that contribute to the SSC variations. Based on this physical understanding, the decomposed SSC time series were trained separately with a newly-proposed augmented lncosh ridge regression, in which (1) a lncosh function was incorporated in traditional ridge regression for handling outliers in original data, and (2) the temporal auto-correlation in the decomposed SSC series was used for augmented regression. Finally, the trained sub-series were added up as the final prediction. The advantages of this decomposition-ensemble framework is that it depends on SSC only, superior to the normal process-based models which need the concurrent hydrodynamics for estimating bed shear stress. This will not only reduce the measurement uncertainties of the input when training the data-driven model, but also save the prediction cost as no other parameters than SSC need to be measured and input for running the model. The framework realized 6-hour-ahead high-accuracy forecasting with mean relative errors of 5.80-9.44% in the present case study. The proposed framework can be extended to forecast any signal that is superposed by components with various timescales (periodicities) which is common in nature.

Analysis on ecological status and spatial-temporal variation of Tamarix chinensis forest based on spectral characteristics and remote sensing vegetation indices.

The reserve of Tamarix forest, located in Changyi, China, is the only national marine special reserve taking Tamarix as the main object of protection. Compared with conventional monitoring technology, remote sensing technology can more comprehensively reflect the ecological environment status and spatial-temporal variation of monitoring objects. Based on spectral characteristics and remote sensing vegetation indices, the ecological status and spatial-temporal variation of Tamarix chinensis forest in the reserve deserve further exploration. Therefore, spectral characteristic, typical vegetation indices, comprehensive health index, VFC, and REP were analyzed based on Sentinel-2A images. Spatial-temporal variation analysis during 2014 to 2018 was analyzed based on GF-1 images. The research result indicated that ecological quality of protection zone showed an overall growth trend with the help of artificial ecological restoration, and it is possible to continuously implement ecological recovery towards the protection zone.

Plastic surgery for giant metastatic endometrioid adenocarcinoma in the abdominal wall: A case report and review of literature.

BACKGROUND: Endometrial cancer (EC) is a common gynecological malignancy, but metastasis to the abdominal wall is extremely rare. Therefore, an appropriate treatment approach for large metastatic lesions with infection remains a great challenge. CASE SUMMARY: We report the case of a 65-year-old woman who developed abdominal metastasis of endometrioid adenocarcinoma, as defined by International Obstetrics and Gynecology stage II, in which the lesion was complicated by infection. A right hemicolectomy was performed for colon metastasis in relation to her initial gynecological cancer 3 years ago. When admitted to our department, a complete resection of the giant abdominal wall lesion was performed, and a Bard composite mesh was used to reconstruct the abdominal wall. A local flap was used to close the resultant large defect in the external covering of the abdomen. The patient underwent chemotherapy following cytoreductive surgery. Pathology revealed metastasis of EC, and molecular subtyping showed copy number high of TP53 mutation, implying a poor prognosis. CONCLUSION: When EC patients develop giant abdominal wall metastasis, a plastic surgeon should be included before contemplating resection of tumors.

[Analysis of therapeutic strategies and prognostic factors of malignant fibrous histiocytoma of soft tissue].

OBJECTIVE: To assess the therapeutic strategies and risk factors of malignant fibrous histiocytoma of soft tissue. METHODS: The 78 cases with malignant fibrous histiocytoma of soft tissue treated at Muscular Skeletal Tumor Center of People's Hospital, Peking University from December 1999 and October 2010 were retrospected. Univariate and multivariate analyses were performed to determine the probable risk factors including sex, age, tumor location, tumor size and so on. RESULTS: All 60 cases were followed up ranged from 6 to 131 months (medium 35.5 months). The 1-, 3-, 5-year overall survival rate was 84.9%, 72.9% and 56.9% respectively. Local recurrence rate is 33.3% (20 cases) with a median time of 11.5 months (1 to 72 months) and metastatic rate is 15.0% (9 cases) with a median time of 7 months (1 to 26 months). Univariate analysis indicated that condition of presentation (primary case or recurrence case), tumor size and surgical margin were significantly related to survival rate (all P < 0.05, Kaplan-Meier Log-rank test), surgical margin and radiotherapy related to local recurrence rate (P value were 0.000 and 0.039 respectively), and surgical margin related to metastatic rate. Multivariate analysis showed that surgical margin was independent risk factors for survival rate (P = 0.002, OR = 5.753, 95%CI 1.904 - 17.386) and local recurrence rate (P = 0.000, RR = 0.044, 95%CI 0.010 - 0.188). CONCLUSIONS: Surgical margin was independent risk factors for survival rate and local recurrence rate. Comprehensive therapy of surgery followed by radiotherapy can improve survival rate, reduce local recurrence rate.

[An analysis of prognostic factors for malignant fibrous histiocytoma of bone].

OBJECTIVE: To study the risk factors related to the survival rate, recurrence and metastasis of malignant fibrous histiocytoma of bone. METHODS: From July 1997 and July 2010, 56 patients with malignant fibrous histiocytoma of bone were treated. Univariate and multivariate analysis were performed to determine the probable risk factors including gender, age, tumor location, tumor size and so on. RESULTS: Forty-four cases were followed up ranged from 2 weeks to 78 months (medium 33.3). The 5-year overall survival rate was 50.1%, local recurrence rate 40.9% with a median time of 12 months (3 to 60 months) and metastatic rate 27.5% (11/40) with a median time of 6.5 months (2 to 23 months). Univariate analysis indicated that gender, condition of presentation (primary case or recurrence case), tumor location, surgical margin and surgical stage were significantly related to survival rate (P < 0.05), and tumor location and surgical margin were related to local recurrence rate (P < 0.05), and important vessel or nerve invasion was related to metastatic rate (P < 0.05). Multivariate analysis showed that surgical margin and surgical stage were independent risk factors for survival rate, of which surgical margin was the independent risk factor for recurrence rate. CONCLUSIONS: Surgical margin and surgical stage are independent risk factors for survival rate, of which surgical margin is the independent risk factor for recurrence rate.