[摘 要] 目的：探讨甲基转移酶样蛋白7B（METTL7B）在胶质瘤组织中的表达及其与患者临床病理特征和预后的相关性。方法：基于CGGA数据库胶质瘤数据和GTEx数据库正常脑组织数据，分析METTL7B基因在胶质瘤与正常脑组织中的表达差异，并用GEPIA数据库数据和免疫组织化学染色法进行验证。用Kaplan-Meier生存分析、单因素Cox分析、多因素Cox分析及ROC曲线分析等评估METTL7B在胶质瘤患者预后中的价值，用CGGA数据库数据分析METTL7B表达与胶质瘤患者临床病理特征的相关性，用CIBERSORT及TIMER数据库进行肿瘤免疫细胞浸润分析，进行KEGG通路富集分析及GO功能富集分析，通过基因共表达分析确定与METTL7B相关的基因。结果：METTL7B在胶质瘤组织中明显上调（均P<0.05），METTL7B表达是胶质瘤患者独立的不良预后因素。METTL7B高表达与高龄（>41岁）、肿瘤分级增加、肿瘤复发或继发性肿瘤、IDH野生型、1p19q非共缺失以及肿瘤的恶性病理学有关联（均P<0.01）；METTL7B表达与B细胞、CD4+ T细胞、CD8+ T细胞、单核细胞、中性粒细胞、巨噬细胞、活化肥大细胞等免疫细胞有关联（均P<0.05）。KEGG通路富集及GO功能分析结果显示，肿瘤相关信号通路及多种免疫反应在METTL7B高表达表型中显著富集。基因共表达分析结果表明，METTL7B与TNFRSF12A、CHI3L1、EMP3表达呈正相关（r=0.807、0.804、0.783，均P<0.01），与ELFN2、REPS2、SHANK2表达呈负相关（r=-0.642、-0.627、-0.602，均P<0.01）。结论：METTL7B在胶质瘤组织中的表达上调是预后不良的指标，且与肿瘤免疫浸润相关。

Objective To compare the biomechanical stabilities among different combinations of anterior and medial cortical supports after intramedullary nailing for unstable intertrochanteric fractures.Methods Twenty-seven synthesized femur specimens were used to create models of unstable intertrochanteric fracture of type 31A2.1 according to AO/ASIF classification.They were divided into 9 groups (n =3) according to 9 combinations of anterior and medial cortical supports on the anteroposterior and lateral X-ray films:positive-positive,positive-neutral,positive-negative,neutral-positive,neutral-neutral,neutral-negative,negative-positive,negative-neutral,negative-negative groups.After all the fractures were fixated with the newly adapted femoral intertrochanteric nails (FITN),static loadings were applied for tests of fatigue and destruction to investigate the relative displacements and yield loads of the head-neck fragments.Results For the positive-positive,positive-neutral,positive-negative,neutral-positive,neutral-neutral,neutral-negative,negative-positive,negative-neutral,negative-negative groups,the vertical displacements of the head-neck fragments under fatigue loading were respectively 5.33 ±0.58 mm,7.83 ±0.29mm,7.73 ±0.15 mm,8.17 ± 0.29 mm,8.33±1.15 mm,8.83±0.29 mm,9.33±0.58 mm,9.67±1.15 mm and 12.0±1.0 mm,showing significant differences (P ＜ 0.05).The smallest displacement was observed in the positive-positive group,significantly smaller than that in any other groups (P ＜ 0.05).For the above 9 groups,the yield loads were respectively 4,967 ± 153 N,4,467 ± 58 N,3,717 ± 76 N,2,767 ± 58 N,2,533 ± 58 N,2,267 ± 58 N,1,833 ± 58 N,1,667 ± 58 N and 1,333 ± 58 N,showing significant differences between any 2 groups (P ＜ 0.05).In the destruction test,bone interface loosening in the femoral head happened in 2 cases,bone interface loosening in the intertrochanteric zone in 15 cases,split fracture at the zone of distal locking nail in 2 cases,and loosening and breakage of the internal fixator in the distal femur in 8 cases.Conclusions The medial cortical support plays a major role and the anterior cortical support plays a secondary role in the stability of unstable intertrochanteric fracture.In the surgical procedure,surgeons should avoid the medial cortical negative support as much as possible.