[Objective]To investigate the outcomes of cementless metasul metal-on-metal total hip arthroplasty.[Method]Metasul metal-on-metal total hip arthroplasty of 30 hips in 25 patients was performed from August 2003 to December 2005.There were 11 males and 14 females with an average age of 47 years(28-72 years).Harris hip scores were determined before surgery and at the last follow-up examination.Standardized radiographs were obtained to evaluate component conditions.Blood samples were taken to determine serum chromium levels with use of atomic absorption spectrometry.[Result]Twenty-three patients(28 hips)were followed up with a mean period of 3.6 years(2.5-4.8 years).The mean Harris hip score improved from 49.5(17-78)points preoperatively to 93.4(55-99)points at the time of final follow-up.Twenty-two hips(85%)had an excellent result.Radiolucent lines were found in 3 hips.Focal femoral osteolysis was seen only in one patient.Sciatic nerve was injured in one case,which showed rehabilitation after 2.5 years.One hip had periprothetic infection because of diabetes 4 years after operation.There was no measurable wear by X-rays.No dislocation or fracture was found.The median serum chromium concentration was 0.082 ?g/mL(0.020～0.140 ?g/mL).No patient was diagnosed with renal insufficiency or hematologic malignancy during the study period.[Conclusion]The outcomes of Metasul metal-on-metal total hip arthroplasty are satisfactory.However,additional follow-up is necessary to determine any possible long-term deleterious effects.

[Objective]To discuss the cementless revision for postoperative infection after hip arthroplasty.[Methods]From November 1997 to December 2006,7 patients(7 hips) with infection after hip arthroplasty were treated,including 3 males and 4 females,with a mean age of 58 years(36～73 years).In the 7 hips,4 hips underwent a revision of total hip arthroplasty,2 hips only received new acetabular components and 1 hip underwent stem revision.One-stage revision was performed in 4 cases,two-stage revision was performed in 3 cases.Consecutive radiographs were compared to evaluate component conditions.Harris hip scores were determined before surgery and at the final follow-up examination.The erythrocyte sedimentation rate and C-reactive protein were detected.[Results]All patients were followed up with a mean period of 3.6 years(1.5～10.6 years).The mean Harris hip score improved from 35(18-63) points preoperatively to 89(60～99) points at the time of final follow-up.No re-infection was found.Femoral component exsertion was found in 1 patient but without any symptom.Pain of hip joint disappeared in 5 cases,and 2 patients had mild pain when walking long distance.At the time of final follow-up,5 patients still had slight limp.Heterotopic ossification developed in 1 hip.The mean polyethylene liner wear was 0.08 mm per year at final follow-up.Deep vein phlebothrombosis and nerve injury were not found.[Conclusion]It is possible to have satisfactory clinical outcome by one-stage or two-stage revision using cementless prothesis for postoperative infection after total hip arthroplasty.Whether the original prothesis can be saved when fixed tightly with femur or acetabular bone needs more experiences to confirm.

[Objective]To evaluate the clinical and radiographic results of revision hip arthroplasty with cementless prothesis.[Method]Revision hip arthroplasty of 41 hips in 36 patients was performed from November 1997 to August 2007 using cementless prothesis.In the 41 hips,29 hips underwent a revision total hip arthroplasty,8 hips underwent new acetabular components,and 4 hips underwent stem revision.Consecutive radiographs were compared to evaluate component conditions.The value of AAOS and Paprosky classification was used.Harris hip scores(HHSs)were determined before surgery and at the most recent follow-up examination.The Kaplan-Meier survivorship analysis was used to estimate the probability of survival of the prothesis.[Result]Twenty-two patients(26 hips)were available for complete clinical and radiographic analysis.The mean follow-up period was 4.6 years(range,1-11 years).The mean preoperative Harris hip score of 38(range,11-76)points improved to 88(range,60-99)points at the time of final follow-up.The pain and function socre improved from 16.9 and 17.3 points to 40.4 and 39.9 points,respectively.All patients had moderate to severe limp before revision.At the time of final follow-up,8 patients still had slight limp and 4 patients had moderate limp.Twenty-one hips(75%)had an excellent result.A 1mm width radiolucent line was found in 1 femoral component without any symptom.Osteolysis and migration were seen in 4 hips(3 in acetabular and 1 in femoral component),which needed re-revision(12.5% failure).Heterotopic ossification developed in 8 hips(31%).The mean polyethylene liner wear was 0.27 mm(range,0.02-0.87 mm)in all and 0.08 mm(range,0-0.25 mm)per year.The wear rate was only correlated with changes of abduction angle of the acetabulum.The coincidence of bone defect classification in AAOS is better than Paprosky.Kaplan-Meier survivorship at 4.6 years was 89% with repeat revision for any reason as the end point and 81% with repeat revision or radiographic loosening as the end point.[Conclusion]Cementless prothesis appears to be a good alternative to other revision systems in revision total hip arthroplasty.Careful intraoperative evaluation of bone deficiency are needed to choose an appropriate prothesis in order to obtain a good outcome.

[Objective]To evaluate the midterm clinical and radiographic results of revision hip arthroplasty by acetabular reinforcement ring (ARR) with impaction bone grafting. [Methods]Revision hip arthroplasty by ARR with impaction bone grafting of 8 hips was performed from May 2001 to December 2006. There were 5 males and 3 females with an average age of 53 years (range, 36~70 years).The mean BMI was 20 (range, 15~28). The mean interval between the primary arthroplasty and revision was 5 to 20 years (mean 6.7 years). The causes for revision were infective loosing in 2 and aseptic loosening in 6. In the 8 hips, 6 hips underwent a revision total hip arthroplasty, 2 hips received replacement of the acetabular component. Consecutive radiographs were compared to evaluate component conditions and the influence of bone deficiency to fix the prothesis was analyzed. Harris hip scores (HHSs) were determined before surgery and at the most recent follow-up examination. The Kaplan-Meier survivorship analysis was used to estimate the probability of survival of the prothesis.[Results]Seven hips were available for complete clinical and radiographic analysis. One patient died for myocardial infarction. The mean follow-up period was 4.5 years (range, 1.5~7.1 years).The mean preoperative Harris hip score of 30(range, 20~64) points improved to 88 (range, 74~94) points at the time of final follow-up, the pain and function socre improved from 13.8 and 11.5 to 40.3 and 39.9 respectively. All patients had severe limp before revision. At the time of final follow-up, 5 patients still had slight limp and 1 patients had moderate limp.Five hips had an excellent result. Infective osteolysis and migration were seen in 2 hips, which need re-revision. Heterotopic ossification developed in 2 hips . Kaplan-Meier survivorship at 4.5 years was 63% with repeat revision or radiographic loosening.[Conclusion]ARR with impaction bone grafting is an effective approach to treat massive acetabular bone defect in revision hip arthroplasty, the midterm result is acceptable, but any possible reason for infection must be monitored.

Objective To observe the inhibitory effect of tumstatin related peptide T3 mediated by short peptide to osteosarcoma vascular. Methods Through MTS assay, wound healing assay, the inhibitory effect of targeting-T3 peptide and T3 peptide on the human umbilical veil endothelial cell was studied in vitro. After the preparation of 50 nude mice model bearing osteosarcoma, the nude mice bearing too large or too small tumors were eliminated and the left ones were divided into 4 groups (6 animals for each group: T3 peptide, targeting-T3 peptide, CTX, PBS) randomly. Through weight of tumor, histopathologicol slice and immunohistochemical methods. The inhibitory action of targeting-T3 peptide and T3 peptide on the neoge-netic vascular of osteosarcoma implanted in nude mouse was studied. Results In vitro, both T3 peptide and targeting-T3 peptide effectively inhibited the proliferation of human umbilical veil endothelial cell. In the experiment of vivo, the average weight of tumor of targeting-T3 peptide group was (1.104?.247) g, the average weight of the T3 peptide group was (1.484?.369) g. There was the statistical difference in tumor inhibition on the osteosarcoma betweent the targeting-T3 group and T3 group (F=16.353, P=0.000). The positive rate of vascular endothelial growth factor and metastasis in the lung in the targeting-T3 peptide group all descended than the T3 peptide group. Conclusion Because of the short peptide to osteosarcoma vascular, targeting-T3 peptide could significantly restrain the development of osteosarcoma. Coupling short peptide to T3 peptide increase the selective binding of T3 peptide to osteosarcoma vascular.

Objective:To understand the current situation of physicians′ innovative behavior and its influencing factors in Beijing municipal hospitals, for reference in improving their innovation ability and encouraging high-quality development of public hospitals.Methods:A stratified sampling was conducted with 22 practicing (assistant) physicians in Beijing municipal hospitals as subjects. From October to November 2022, a questionnaire survey was conducted to understand the innovative behavior, innovative self-efficacy and innovative atmosphere of such practicing (assistant) physicians. SPSS 25.0 was used for descriptive analysis of the data, while t-test, variance analysis and linear regression were used for univariate analysis. Furthermore, multiple linear regression was adopted to explore the influencing factors of innovative behavior of such practicing(assistant) physicians. Results:A total of 2 178 questionnaires were distributed in this study, and 1 906 valid ones were recovered, with effective recovery of 87.51%. Scores of innovative behavior, innovative self-efficacy and innovative atmosphere of 1 906 practicing (assistant) physicians scored (4.00±0.70) points, (3.85±0.74) points and (3.98±0.66) points respectively. The results of univariate analysis showed scores of statistical significance regarding the innovative behavior of practicing (assistant) physicians with different marital status, educational background, professional title, position, department type, innovative self-efficacy level and innovative atmosphere level. Multiple linear regression results showed that position, innovation self-efficacy score, innovation atmosphere score and subordinates′ incentive mechanism, as well as teamwork and resource security had statistical significance on innovation behavior score.Conclusions:The practicing (assistant) physicians in Beijing municipal hospitals are highly enthusiastic for innovation, but their innovative behavior is expected to be upgraded. In this regard, public hospitals should improve their innovation incentive mechanism, strengthen resource assurance, encourage cooperation and exchange, and create a desirable atmosphere for innovation. Furthermore, greater supply of continuing education resources is expected, supporting these physicians in their further study, advanced education, and promotion of professional titles.

BACKGROUND: Lung cancer is the malignant tumor with the highest incidence and mortality in China, among which non-small cell lung cancer (NSCLC) accounts for about 80%. Epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) targeted therapy has been playing an important role in treatment of NSCLC. However, unavoidable therapeutic resistance significantly limits the clinical efficacy of EGFR-TKI. As a key member of the forkhead box protein family, FOXC1 is aberrantly expressed in NSCLC and involved in NSCLC progression. The aim of this work is to investigate the effect and potential mechanism of FOXC1 on gefitinib resistance in NSCLC. METHODS: Western blot was performed to assess the expression of FOXC1 protein in HCC827/GR cells. Immunohistochemistry (IHC) assays were performed in human NSCLC tissues with gefitinib resistance. HCC827/GR cells were transfected with shRNA specifically targeting FOXC1 mRNA and stable cell lines were established. The effects of FOXC1 on cell viability and apoptosis were analyzed using a new methyl thiazolyl tetrazolium assay (MTS assay) and flow cytometry. Self-renewal ability was determined by mammosphere-formation analysis. Quantitative real-time PCR (qRT-PCR) and Western blot were employed to detect the expression of SOX2, Nanog, OCT4 and CD133. Flow cytometry analysis were further used to detect the level of CD133. IHC assays were used to detect the levels of SOX2 and CD133 in NSCLC tissues with genfitiinb resistance. Correlations of the expressions of FOXC1, CD133 and SOX2 with each other in lung adenocarcinoma samples were analyzed based on The Cancer Genome Atlas (TCGA) database. RESULTS: The expression of FOXC1 is significantly increased in HCC827/GR cells compared with HCC827 cells (P<0.05). IHC results showed FOXC1 was highly expressed in NSCLC tissues with gefitinib resisitance. Knockdown of FOXC1 significantly increased the sensitivity of HCC827/GR cells to gefitinib. The cell viability was decreased and the apoptosis was promoted (P<0.05). Moreover, FOXC1 knockdown apparently inhibited the expression of SOX2 and CD133, and decreased the mammosphere-formation capacity in HCC827/GR cells. In NSCLC tissues with gefitinib resistance, the expressions of SOX2 and CD133 were significantly higher compared with gefitinib-sensitive tissues (P<0.01). Meanwhile, the expressions of FOXC1, CD133 and SOX2 with each other were positively correlated (P<0.05). CONCLUSIONS FOXC1 could increase gefitinib resitance in NSCLC, by which mechanism is related to the regulation of cancer stem cell properties.

Objective To investigate the risk factors of infection after hepatectomy for liver cancer, and to establish and validate a risk prediction model. Methods The clinical data of 167 patients with primary liver cancer who underwent hepatectomy in People's Hospital of Wuhan University from January 2020 to March 2022 were retrospectively collected. All patients were divided into postoperative infection group ( n =28) and non-infection group ( n =139) according to whether postoperative infection complications occurred. The t -test or Mann-Whitney U test was used for comparison of continuous data between two groups and the chi-square test was used for comparison of categorical data between two groups. Univariate analysis and logistic regression analysis were used to screen the risk factors of infection after hepatectomy for hepatocellular carcinoma, and a nomogram risk prediction model for postoperative infection was established. All patients were randomly divided into training cohort ( n =119) and the validation cohort ( n =48) according to the ratio of 7∶ 3, the Bootstrap method was used for internal validation of the model, and the model calibration curve and ROC curve were used to evaluate the calibration and discrimination of the nomogram model. Results Postoperative infection occurred in 28 of 167 patients (16.8%). Logistic regression analysis showed that diabetes, CONUT score ≥4 points, preoperative NLR, operation time, intraoperative blood loss, and drainage tube placement time > 7 d were independent risk factors for infection after hepatectomy for liver cancer (all P < 0.05). Based on the nomogram constructed from the above six risk factors, the area under the ROC curve of the training cohort and the validation cohort was 0.848, and 0.853, respectively. The calibration curve of the nomogram model shows that the predicted value is basically consistent with the actual observed value, indicating that the accuracy of the nomogram model prediction is better. Conclusion The individualized nomogram risk prediction model based on diabetes, CONUT score ≥4 points, preoperative NLR, operation time, intraoperative blood loss, and drainage tube placement time > 7 d has good predictive performance and has high predictive value for high-risk patients.

OBJECTIVE: To establish logistic regression model for prostate cancer and provide basis for prostate biopsy.
 METHODS: A total of 117 cases of prostate biopsy were retrospectively analyzed in chronological sequence. All cases were assigned into a model group (n=78) and a validation group (n=39). Logistic regression model was established and its value was estimated by receiver operating characteristic (ROC) curve. 
 RESULTS: Digital rectal examination(DRE), transrectal ultrasound(TRUS), MRI, prostate-specific antigen density (PSAD), and free PSA/total PSA (fPSA/tPSA) were the influential factors for prostate biopsy (P<0.01). The established logistic regression model for prostate cancer by regression coefficient was: logit P=-2.362+2.561×DRE+1.747×TRUS+2.901×MRI+1.126×PSAD-
2.569×fPSA/tPSA and area under curve was 0.907. When the cutoff aimed at 0.12, the sensitivity and specificity were 81.80% and 89.30%, respectively.
 CONCLUSION Logistic regression model for prostate cancer can provide sufficient basis for prostate biopsy. Prostate biopsy should be performed when P value is more than 0.12.
Biopsy ; Humans ; Logistic Models ; Male ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; diagnosis ; pathology ; ROC Curve ; Retrospective Studies ; Sensitivity and Specificity ; Urologic Surgical Procedures