Adrenomedullin (ADM) has wide distribution in the body and has many biological effects,which participates in many physiological and pathological processes.What's more,it is closely related to the degree of malignancy,prognosis and metastasis of tumors.ADM has different effects on different types of cells via one or more signal pathways,so that can product various effects.It also provides a new treatment strategy for preventing or slowing the progress of the cancer.

BACKGROUND: The quality of life(QOL) of patients with lung cancer is ffected due to depression, reduced lung function, subjective reduced body force, fatigue, and poor stamina, etc., and the survival of the patientswould be affected by complications or advanced stage cachexia.OBJECTIVE: To investigate the relationship between three gene proteins including p53, p27 and bcl-2 and the pathological characters of non-small cell lung cancer (NSCLC).DESIGN: An experimental trial by employing pathological specimens as subjects.SETTING: Department of respiration of a university affiliated hospital and the Central laboratory of a university.PARTICIPANTS: Totally 76 specimens of NSCLC after surgical resection between June 1997 and December 2002, which were all primary lung cancer without any other therapy.METHODS: The expression of three gene proteins in 76 NSCLC specimens was detected by SP immunohistochemical analysis.MAIN OUTCOME MEASURES: Positive expression of p53, p27 and bcl-2.RESULTS: Among 76 specimens, 28 cases(37%, 28/76) with excessive expression of p53, 34 cases(45%, 34/76) with excessive expression of p27, 37 cases(49%, 37/76) with excessive expression of bcl-2, and 7 cases with excessive expression in all three proteins. The positive expression of p53 elevated with the reduced gradation in differentiation; bcl-2 and p27positive expressions reduced with the reduced gradation in differentiation and there was significant difference between high-differentiation group and low-differentiation group( P ＜ 0. 05) . However, there was no significant relationship between the positive expressions of three proteins and the histological classification, lymph node metastasis, and pathological aging of lung cancer( P ＞ 0.05).CONCLUSION: The excessive expression of p53, p27 and bcl-2 genes might be related with the occurrence and development of NSCLC.

Objective To synthesize 4 kinds of 111 In?TPP cations and evaluate their properties as tumor cationic radiotracers in vivo and in vitro. Methods DO3A?xy?TPP, DO3A?xy?mTPP, DO3A?xy?dmTPP and DO3A?xy?tmTPP were radiolabeled with 111 In;their lipid?water partition coefficients and in vivo and in vitro stability were evaluated. The binding affinities of 4 kinds of 111 In?radiotracers were determined in cell uptake and cell efflux assay using U87MG tumor cells. Biodistribution studies and γ imaging studies were performed using the athymic nude mice bearing U87MG human glioma xenografts to explore the biologi?cal properties of 4 kinds of 111 In?radiotracers. One?way analysis of variance was used. Results The labeling yields of 4 kinds of 111 In?radiotracers were all above 85%, and the radiochemical purity were all greater than 99% after purification. Binding assay in U87MG cells showed that 4 kinds of radiotracers had great binding affinity and cell retention ability, and 111In?DO3A?xy?mTPP had the best binding ratio (1?49%;F=177.8, P<0.05) . Gamma imaging and biodistribution results showed that the U87MG tumors could be clearly visualized by 111In?DO3A?xy?mTPP, 111In?DO3A?xy?dmTPP and 111In?DO3A?xy?tmTPP, and the liver uptake of the 3 tracers was lower than that of 111In?DO3A?xy?TPP. In particular, 111In?DO3A?xy?mTPP had the best tumor/liver ratio (0.13±0.05, 2 h postinjection;F=9.4, P<0?05). Conclusions The tumor?targeted ability of 111In?DO3A?xy?mTPP is better than those of 111In?DO3A?xy?dmTPP, 111In?DO3A?xy?tmTPP and 111In?DO3A?xy?TPP, suggesting that it has the potential to be a promising tumor cationic radiotracer.

Objective To study the expression and relationship between adrenomedullin (ADM )and integrinαvβ3 in different pathological grades ,clinical stages and histologic subtypes of human osteosarcoma .Methods The expression positiverate ,intensity , the average optical density (ALD) of ADM and integrinαvβ3 in 30 osteosarcomacases was detected with immunohistochemical SABC technique and image analysis system .Each pathological section observed by two pathologists respectively in the case of unknown clinical and pathological information .At least five representative high field of vision counting 100 cells observed at random ,in this way the degree of tumor grade ,stage and cell staining were determined by two pathologist who unknown clinical and pathological data .Results The positive rate and intensity of ADM and integrinαvβ3 were significantly increased with the increase of osteosarco-ma stage(P<0 .05) and the difference was significant in each stage(P<0 .05) .The expression of ADM was positive correlated with the expression of integrinαvβ3 .Conclusion The expression of ADM and integrinαvβ3 in different clinicopathological grades osteosar-coma are positive associated with malignant degree of tumor ,which suggest that both of them play an important role in malignant biological behaviors of human osteosarcoma .

BACKGROUNDTo study the relationship between the expression of p53, p27, bcl-2 protein and the clinical pathological characteristics of non-small cell lung cancer (NSCLC).

METHODSExpression of p53, p27 and bcl-2 protein was detected in 76 NSCLC samples by immunohistochemistry.

RESULTSThe positive rate of p53, p27 and bcl-2 protein was 36.84% (28/76), 44.74% (34/76) and 48.68% (37/76) respectively, and 7 cases were positive for p53, p27 and bcl-2 protein. Positive rate of p53, p27 and bcl-2 protein was not related to the pathological type, lymph node metastasis, and TNM stage. The positive rate of p53 in higher differentiation group was significantly lower than that in lower differentiation group (P < 0.05). The positive rate of p27 and bcl-2 in higher differentiation group was significantly higher than that in lower differentiation group (P < 0.05).

CONCLUSIONSOverexpression of p53, p27 and bcl-2 genes may play an important role in the oncogenesis and development of NSCLC.

Objective:To investigate the effect of fat mass index (FMI) on early recovery after total knee arthroplasty (TKA).Methods:Patients who underwent primary unilateral TKA in Xi'an Honghui Hospital from July 2020 to July 2021 were retrospectively analyzed. The preoperative body composition was measured by dual energy X-ray absorptiometry and the FMI was calculated. Patients were divided into normal group (male: 3.0-6.0 kg/m 2; female: 5.0-9.0 kg/m 2), overweight group (male: 6.1-9.0 kg/m 2; female: 9.1-13.0 kg/m 2), and obese group (male: >9 kg/m 2; female: >13 kg/m 2) according to level of FMI, and the operation time, blood loss, and incidence of postoperative complications were collected. Multifactorial analysis of the effect of FMI on early recovery after TKA was performed using a generalized linear model. Draw the receiver operating characteristics (ROC) curve of BMI and FMI on the predicted effect of postoperative Western Ontario and McMaster Universities (WOMAC) osteoarthritis index scores and Knee Society Score (KSS) to compare the effect of FMI with BMI on early recovery after TKA. Results:A total of 100 patients were included in the study, 24 males and 76 females, aged 65.0±8.2 years (range, 42-81 years). There were 15 cases in normal group, 55 cases in overweight group and 30 cases in obese group. All patients successfully completed the operation and were followed up for 3.15±0.72 months (range, 2.8-3.2 months). The WOMAC scores of the obese group at 2 weeks, 1 and 2 months postoperative were 34.57±3.68, 22.03±2.79, and 15.77±2.96, which were greater than those of the normal group (28.73 ±2.58, 19.07±2.71, 12.27±3.10), as well as the overweight group (30.05±4.09, 19.33±2.42, 14.84±2.42), with statistically significant differences ( P<0.05). The KSS scores of the obese group at postoperative 1 and 2 months were 68.83±5.52 and 81.17±4.49, which were lower than those of the normal group (77.33±5.63, 87.33±4.17), as well as the overweight group (72.64±5.43, 83.73 ±5.02), with statistically significant differences ( P<0.05). The WOMAC score, KSS score, and postoperative complications at 2 months postoperatively were selected as outcome indicators to plot the ROC curve, and the ROC curve for the WOMAC score at 2 months postoperatively showed an area under the curve corresponding to FMI of 0.744 (95% CI: 0.54, 0.82), which was greater than that of BMI [0.624 (95% CI: 0.51, 0.74)], and the difference was statistically significant ( Z=2.19, P=0.021). The ROC curve for the KSS score at 2 months postoperatively showed an area under the curve corresponding to FMI of 0.718 (95% CI: 0.62, 0.82), which was greater than that of BMI [0.612 (95% CI: 0.52, 0.74)], with a statistically significant difference ( Z=2.58, P=0.016). The ROC curve for postoperative complications showed an area under the curve of 0.639 (95% CI: 0.41, 0.88) for FMI and 0.605 (95% CI: 0.37, 0.84) for BMI, with no statistically significant difference ( Z=0.48, P=0.632). Conclusion:The greater the FMI the poorer the early functional recovery after initial TKA, and FMI is more valuable than BMI in predicting the early functional recovery.

Objective:To investigate the clinical effect of percutaneous curved kyphoplasty in the treatment of old osteoporotic vertebral body with endplate fracture.Methods:Clinical data of 58 patients suffering from old osteoporotic vertebral bodies with endplate fractures from January 2018 to January 2020 were analyzed retrospectively. All patients had a single vertebral body fracture and were treated with bilateral injection of bone cement with percutaneous kyphoplasty (PKP). According to the shape of the puncture device, the patients were divided into a curved needle group and a ordinary group. There were 28 cases in the curved needle group, including 7 males and 21 females, aged 60-84 years old, with an average age of 71.8±7.8 years. The distribution of vertebral bodies with fractures: T 11 3 cases, T 12 5 cases, L 1 6 cases, L 2 5 cases, L 3 3 cases, L 4 4 cases, and L 5 2 cases. In the ordinary group, there were 30 cases, 8 males and 22 females, with an average age of 73.2±8.4 years (range, 61-88 years). The vertebral body distribution of fracture: T 11 3 cases, T 12 5 cases, L 1 7 cases, L 2 4 cases, L 3 4 cases, L 4 5 cases, and L 5 2 cases. The surgery time, amount of bone cement injection, and bone cement leakage rate were compared between the two groups, as well as the visual analogue scale (VAS) and Oswestry disability index (ODI) at 1 week, 6 months, and 1 year after surgery. Preoperative and postoperative vertebral midpoint height and kyphosis Cobb angle were measured. Results:All patients were followed up for 12-24 months, with an average of 14.7±2.9 months. The bone cement leakage rate in curved needle group (18%, 5/28) was lower than that in ordinary group (23%, 7/30), but there was no significant statistical difference (χ 2=0.27, P=0.607). The amount of bone cement injection and surgery time in curved needle group (5.0±0.5 ml, 55.2±6.9 min) were significantly higher than those in ordinary group (3.4±0.6 ml, 42.9±3.6 min, P<0.05) . The scores of VAS (2.3±1.0, 2.6±1.5) and ODI (27.5%±9.7%, 28.7%±11.3%) in curved needle group were lower than those in ordinary group (2.7±1.0, 4.5±1.1 and 31.8%±10.5%, 43.1%±13.4%) at 6 months after surgery and at the last follow-up after surgery. In the curved needle group, the Cobb angle was 25.5°±3.5° preoperatively, 18.4°±1.6° postoperatively, and 20.5°±4.9°at the last follow-up. The height of the vertebral body was 14.2±1.9 mm before surgery, 21.5±2.2 mm after surgery, and 20.1±3.6 mm at the last follow-up. Compared with the preoperative results, the kyphosis Cobb angle decreased and the height of the fractured vertebral body increased at the last follow-up, and the differences were statistically significant ( P<0.05). In the ordinary group, the Cobb angle was 24.4°±3.6° preoperatively, 23.1°±4.0° postoperatively, and 27.8°±2.9° at the last follow-up. The height of the vertebral body was 14.5±1.8 mm before surgery, 15.4±2.0 mm after surgery, and 12.7±1.0 mm at the last follow-up. At the last follow-up, the kyphosis Cobb angle increased and the height of the fractured vertebral body decreased compared with preoperative and postoperative 1 week, and the differences were statistically significant ( P<0.05). At 1 week after surgery, 6 months after surgery and the last follow-up, the Cobb angle of curved needle group was lower than that of ordinary group ( P<0.05), the height of vertebral body was higher than that of ordinary group ( P<0.05). Conclusion:Flexible application of percutaneous curved kyphoplasty in the treatment of old osteoporotic vertebral body with endplate fractures can effectively increase the riveting force of bone cement in the vertebral body, restore the height of endplate, and reduce the occurrence of kyphosis and chronic low back pain.

Objective:To explore the application value of Oxford nanopore technologies (ONT) in the diagnosis and treatment of periprosthetic joint infection (PJI).Methods:A prospective analysis was conducted on 32 patients with PJI admitted to the joint department of Xi'an Honghui Hospital from October 2021 to March 2023, who met the 2018 PJI diagnostic criteria of the American Skeletal Infection Society (MSIS), including 15 males and 17 females with an average age of 63.93±8.93 years. 32 revision patients who did not meet the 2018 MSIS PJI criteria during the same period were collected as controls (non PJI group), including 13 males and 19 females with an average age of 65.53±8.54 years. All patients underwent joint fluid puncture before or during surgery, and the specimens were tested by ONT, metagenomic next generation sequencing (mNGS), and general microbial culture. The receiver operating characteristic (ROC) curves were drawn for both groups, and the sensitivity, specificity, positive predictive value, negative predictive value, and Youden index of the three detection techniques were calculated and compared to evaluate the detection efficiency of different detection methods in PJI.Results:Among the 32 patients with PJI, 30 were positive for ONT, with a total of 30 pathogenic bacteria detected, and the detection time was 22.37±8.36 h. 31 were positive for mNGS, with a total of 33 bacterial species detected, and the detection time was 46.25±9.36 h. 17 were positive for microbial culture, with a total of 8 bacterial species detected, and the detection time was 96.23±15.62 h. Among the 32 patients with non PJI group, 1 was positive for ONT and 5 were positive for mNGS, with a total of 1 and 3 bacterial species detected, respectively. The results of microbial culture were all negative. The detection time and area under the curve (AUC) of ONT and mNGS were 22.37±8.36 h and 0.953[95% CI (0.901, 1.006)], 46.25±9.36 h and 0.906[95% CI (0.835, 0.977)], respectively, which were better than those of microbial culture 96.23±15.62 h and 0.766[95% CI (0.678, 0.853)], and the difference was statistically significant ( P<0.05). The sensitivity of ONT, mNGS, and microbial culture were 0.938, 0.969, and 0.531, respectively, and the specificity was 0.969, 0.844, and 1.000, respectively. The Jordan index was 0.906, 0.813, and 0.531, respectively. Conclusion:ONT testing has higher diagnostic efficacy than mNGS and microbial culture in the diagnosis of PJI, and also has advantages in detection time. It also suggests that some PJI are not caused by a single microbial infection.

Objective To analyze the plantar pressure distribution of knee osteoarthritis ( KOA) patients after medial opening wedge high tibial osteotomy ( MOWHTO), so as to provide biomechanical references for the surgical treatment and rehabilitation of patients. Methods A total of 31 patients with medial single compartmental KOA after unilateral MOWHTO treatment were selected as the experimental group, and 35 healthy subjects at same age were selected as the control group. The Pedomedic 40 􀅺 pressure measuring system was used to test dynamic plantar pressure. By comparing the maximum pressure ( pmax ), force-time integral ( FTI) and contact area (CA) of different plantar zones between the experimental group (operative side and unoperated side) and the control group during walking, the changes of plantar pressure in patients with medial single compartmental KOA after MOWHTO were evaluated. Results Compared with the unoperated side and the control group, the CA and FTI of the 1st metatarsal head (MH1) were higher (P<0. 05), the CA of the 4th metatarsal head (MH4)was smaller (P<0. 001), the pmax and FTI of the 5th metatarsal head (MH5) were smaller (P<0. 05), the CA of the lateral middle foot (MF-L) was smaller (P<0. 001), and the CA of the medial rear foot (RF-M) was larger (P<0. 05). Compared with the control group, the pmax of MH1 and MH2 was smaller (P<0. 05), the CA and FTI of MH5 were larger (P<0. 05), the pmax of MF-L was larger (P<0. 001), and the FTI of lateral rear foot (RF-L) was larger (P<0. 05). Conclusions Compared with healthy people, patients with medial single compartmental KOA have abnormal plantar pressure residual after MOWHTO. In clinical practice, targeted intensive rehabilitation therapy is necessary to restore the normal plantar distributions of patients.