Testicular proteoglycan 1 ( SPOCK1 ) , a kind of extracellular matrix glycoprotein, can inhibit the activity of cathepsin and promotes the combination of low affinity for calcium.SPOCK1 is essential to the de-velopment of mammals.It not only regulates cell,and the interactions between cells and matrix are also related to cell migration and proliferation.Currently,SPOCK1is confirmed that expression can promote the occurrence and development of tumor,suggesting it could be a new anti-tumor target.This article is to review SPOCK1 molecular structure,biological function and its relationship with tumor.

Objective:To study the clinicopathological characteristics, treatment and prognosis in lupus nephritis (LN) patients with renal thrombotic microangiopathy (TMA), so as to provide more theoretical basis for clinicians to recognize and treat this disease.Methods:The clinical data of LN patients who underwent renal biopsy in the First Affiliated Hospital of Zhengzhou University from January 1, 2012 to May 31, 2019 were retrospectively collected and analyzed. According to renal clinicopathological examination, the patients were divided into renal TMA group and non-renal TMA group. The clinical data, laboratory examination, renal pathological examination, therapeutic measures and prognostic between the two groups were compared. Follow-up end points were defined as composite ends, including all-cause death, entry into end-stage renal disease, and estimated glomerular filtration rate decrease>50% of baseline. Kaplan-Meier survival curve and log-rank test were used to compare the difference of survival rate between the two groups, and multivariate Cox regression equation was used to analyze the risk factors of endpoint events in LN patients.Results:A total of 1 133 patients with LN were enrolled in this study. Patients with renal TMA were more likely to have hypertension ( χ2=16.310, P<0.001), higher baseline serum creatinine ( Z=-6.918, P<0.001) and 24-hour urine protein ( Z=-2.232, P=0.026), and higher renal pathology activity index (AI) score ( Z=1.957, P=0.001)and chronic index (CI) score ( Z=1.836, P=0.002). The proportions of hormone shock ( P<0.001) and plasma exchange ( P<0.001) in the renal TMA group were higher than those in non-renal TMA group. After treatment of (12±2) months, patients in the renal TMA group had a lower complete response rate ( χ2=10.455, P=0.001) and a higher non-response rate ( χ2=6.047, P=0.014) than those in non-renal TMA group, and were associated with worse prognosis (Log-rank test χ2=26.490, P<0.001). Renal TMA was an independent risk factor for poor prognosis ( HR=2.347, 95% CI 1.210-4.553, P=0.012). Conclusions:Compared with LN patients without renal TMA, LN patients with renal TMA are more likely to have hypertension, with higher serum creatinine, 24-hour urinary protein, AI and CI, suggesting poorer treatment response and renal prognosis. Moreover, renal TMA is an independent risk factor for poor prognosis in patients with LN.

Objective:To investigate the influencing factors for textbook outcome (TO) after hepatectomy for hepatolithiasis.Methods:The retrospective case-control study was conducted. The clinicopathological data of 216 patients with hepatolithiasis who were admitted to The First Affi-liated Hospital of Anhui Medical University from January 2015 to March 2023 were collected. There were 69 males and 147 females, aged 61(range, 22-85)years. Observation indicators: (1) treatment situations; (2) TO after hepatectomy; (3) Influencing factors for TO after hepatectomy. Measurement data with normal distribution were represented as Mean± SD. Measurement data with skewed distribution were represented as M(range). Count data were expressed as absolute numbers. Logistic regression models were used for univariate and multifactorial analyses. Results:(1) Treatment situations. All the 216 patients underwent hepatectomy, including 45 cases of laparoscopic hepatectomies and 171 cases of open hepatectomies, 161 cases of anatomical hepatectomies and 55 cases of non-anatomical hepatectomies. All the 216 patients underwent intraoperative choledochoscopy exploration and lithotripsy. There were 170 patients with normal Oddi sphincter function and 46 patients with Oddi sphincter dysfunction. All the 216 patients underwent biliary drainage, including 198 cases of external T-tube drainage and 18 cases of internal bile-intestinal drainage. The operation time was (226±75)minutes and volume of intraoperative blood loss was (106±82)mL. There were 29 patients with perioperative blood transfusion and 14 patients with intraoperative severe adverse events. There were 189 patients achieved immediate stone clearance. Of 183 patients with intraoperative bile cultures, 76 cases were positive for bacteria culture. (2) TO after hepatectomy. Of 216 patients, 93 cases had postoperative complications, all of which were successfully discharged after active treatment. One patient had surgery-related death within 90 days after surgery, and the cause of death was liver failure. Five patients were readmitted within 90 days after surgery, and 18 patients had postoperative stone residual. Of 216 patients, 164 cases achieved TO postoperatively and 52 cases did not achieve TO postoperatively. (3) Influencing factors for TO after hepatectomy. Results of multivariate analysis showed that cholangitis, stone distribution, surgical approaches, anatomical hepatectomy, immediate stone removal and postoperative review of choledochoscopy were independent influencing factors for TO after hepatectomy in patients with hepatolithiasis ( P<0.05). Conclusion:Cholangitis, stone distribution, surgical approaches, anatomical hepatectomy, imme-diate stone removal and postoperative review of choledochoscopy are independent influencing factors for TO after hepatectomy in patients with hepatolithiasis.

Objectives:To analyze the clinical efficacy of Cheneau brace in adolescent idiopathic scoliosis(AIS)patients and to discuss the changes of curve type during the treatment.Methods:75 patients with AIS treated with Cheneau brace from October 2016 to November 2021 were included.There were 69 females and 6 males,averaged 11.9±1.0 years old when starting to wear the brace,with a mean initial main curve Cobb angle of 29.8°±8.5° and an initial Risser's sign ≤2.Clinical and imaging data were collected,including age,gender,menarche age,time of daily wear,and full-length radiographs of the spine before initial treatment and at the final follow-up.All the patients were followed up for 1 year after finishing brace treatment.The curve types of the patients were counted using the main curve type and the modified Lenke classification system(mLenke),and changes in curve types and the efficacy of bracing in patients with different curve types were analyzed.Results:After 25.7±10.8 months of brace treatment,the patients averaged 14.2±1.2 years old when finishing brace treatment,and the mean main Cobb angle was 27.6°±12.0°.Among the patients,scoliosis was controlled in 63 while progressed in 12,and 23 patients were treated surgically.The rates of success of brace and control of curve were higher in patients with main lumbar curve than those in patients with main thoracic curve(P=0.043,P=0.003).There was a difference in the rate of brace success and control of curve in patients with each mLenke classification(P＜0.001,P=0.005).The highest rates of brace success and control of curve were found in patients of mLenke type Ⅴ,while mLenke type Ⅳ patients had the lowest success rate of brace treatment success and mLenke type Ⅱ patients had the lowest rate of control of curve.Before and after brace treatment,there was a difference in the proportion of patients with each main curve type(P=0.019),and the proportion of patients with each mLenke classification had no statistical difference(P=0.071).There were differences in the rate of change of curve type in each main curve type and each mLenke classification both(P＜0.001,P=0.020).No significant differences were seen in the rates of success of brace treatment and control of curve between patients with and without change in curve type under the two curve type classifications.Conclusions:The efficacy of Cheneau brace varies among AIS patients with different curve types.Patients with a main thoracic curve tend to have a poor response to bracing compared with patients of main lumbar curve;During the treatment with Cheneau brace,the patient's curve types may change,and the overall trend of curve type change is upward shifting of the main curve.The rate and outcome of curve type changes vary among patients with different curve types,and curve type changes may also occur in curve controlled or corrected patients.

Objective:To evaluate the safety and efficacy of intravenous tirofiban in stent-assisted embolization of acute ruptured intracranial aneurysms.Methods:A total of 286 patients with acute ruptured intracranial aneurysms who received stent-assisted embolization in Department of Neurosurgery, Linyi People's Hospital from January 2020 to September 2022 were enrolled. According to different preoperative antiplatelet regiments, they were divided into aspirin combined with double resistant group (preoperatively taking orally loading dose of aspirin and clopidogrel, n=167) and tirofiban group (intravenously injecting tirofiban, n=119). Propensity score matching (PSM) was used to adjust for potential differences in age, gender, Hunt-Hess grading, hypertension history, diabetes history, smoking history, aneurysm location, aneurysm neck, aneurysm body-neck ratio, and stent types; incidences of perioperative hemorrhagic and ischemic complications, and neurological recovery status at discharge (scores of modified Rankin scale [mRS]≤2 as good recovery) were compared between the two groups. Results:After 1:1 PSM, 96 patients were included in each group. No significant difference in incidence of hemorrhagic complications was noted between the double resistant group (2.1%) and tirofiban group (0.0%, P>0.05). No significant difference in incidence of ischemic complications was noted between the double resistant group (9.3%, including 8 with intraoperative thrombosis and 1 with postoperative infarction) and tirofiban group (7.2%, including 6 with intraoperative thrombosis and 1 with postoperative infarction, P>0.05). No significant difference in good recovery rate at discharge was noted between double resistant group (86.4%) and tirofiban group (90.6%, P>0.05). Conclusion:In stent-assisted embolization therapy for acute ruptured intracranial aneurysms, preoperative intravenous tirofiban enjoys the same safety and efficacy compared with preoperative oral loading dose of aspirin and clopidogrel.