Anterior cruciate ligament (ACL) reconstruction yields favorable outcomes for restoring anteroposterior stability of the knee joint in patients with ACL tears. However, some patients still exhibit positive knee pivot shift after ACL reconstruction. Currently, combined ACL and anterolateral ligament(ALL) reconstruction has been accepted by most scholars. This surgical technique can restore the rotational stability of the knee joint in patients postoperatively and facilitate the early besumption of sports training after surgery. This article reviews the anatomical research, isometry-like point research, and reconstruction indications of the anterolateral ligament, as well as the surgical approaches, graft tunnel convergence, and reconstruction outcomes of combined anterior cruciate ligament and anterolateral ligament reconstruction.

Objective To establish the regression equation for the maximum oxygen uptake(VO2max)of male young endurance athletes at altitudeby modeling relevant indicators.Methods A total of 81 young male endurance athletes(long-distance runner,marathoner,and race walker)aged 15～18 years old were selected as the research subjects.The VO2max,3000-meter timed run,400-meter timed run,body morphology,body composition,hematological indicators,and cardiac function of the ath-letes were tested in Kunming,Yunnan Province(1890 meters altitude high)in four consecutive days.The testing sequence of the exercise was randomly arranged.The data of the first 65 athletes were used for multiple linear regression modeling,while those of the rest 16 were employed for the verifica-tion of the established model.Results Based on the data of 65 athletes,the multiple linear regression equation of VO2max was:VO2max=2616.661+60.389×lean body mass(kg)-3.108×3000-meter run-ning time(s)-16.665×lower limb length A(cm)+6.356×maximum heart rate(bpm),R2=0.858,and that of the relative VO2max was:relative VO2max=119.685-0.058×3000-meter running time(s)-0.224×body weight(kg)-0.452×Achilles tendon length(cm),R2=0.681.Accord-ing to the data of the rest 16 athletes,there was no significant difference in the calculated values of VO2max and relative VO2max.Moreover,the calculated values and the direct test values of VO2max and rel-ative VO2max were positively correlated(r=0.735,P=0.001;r=0.509,P=0.044).Conclusion A regression model of VO2max and relative VO2max for young male endurance athletes at altitude(1890 meters altitude high)was established and verified through direct testing.The model established is worth popularization and application,and can provide references for indicators selection of young male endurance athletes at altitude(1890 meters altitude high).

Purpose To investigate the correlation between B4GALT1 and PD-L1 expression in lung adenocarci-noma and lung squamous cell carcinoma,and to assess their clinicopathological significance.Methods The EnVision immunohistochemical method was used to detect B4GALT1 and PD-L1 protein expression in 195 cases of lung adeno-carcinoma,105 cases of lung squamous cell carcinoma,and 300 cases of non-cancer lung tissue.The relationships be-tween these protein expression levels and the clinicopathological features of both tumor types,as well as the correlation between B4GALT1 and PD-L1 expression were analyzed.Additionally,bioinformatics approaches were employed to ex-amine the correlation of B4GALT1 and PD-L1 gene expression and to evaluate their impact on patient prognosis in both cancer subtypes.Results The positive rate of B4GALT1 protein in lung adenocarcinoma(66.7％,130/195)was significantly higher than that in lung squamous cell carcinoma(25.7％,27/105),whereas PD-L1 positivity was grea-ter in squamous cell carcinoma(63.8％,67/105)than that in adenocarcinoma(37.9％,74/195).The difference betweenthe two groups was statistically significant(P＜0.05).Both proteins were undetectable in non-cancer lung tis-sues.In lung adenocarcinoma,the expression of both B4GALT1 and PD-L1 was significantly correlated with TNM stage,maximum tumor diameter,pathological subtype,and lymph node metastasis(P＜0.05);And PD-L1 expression was also correlated with distant metastasis(P＜0.05).In lung squamous cell carcinoma,B4GALT1 expression showed no significant association with sex,age,TNM stage,maximum tumor diameter,differentiation,lymph node metastasis,distant metastasis and smoking history(P＞0.05),while PD-L1 expression correlated with TNM stage(P＜0.05).A positive correlation between B4GALT1 and PD-L1 protein expression was observed in adenocarcinoma(r=0.438,P＜0.05).Bioinformatics analysis confirmed a positive correlation at the gene-expression level(r=0.32,P＜0.05).Ad-enocarcinoma patients exhibiting high B4GALT1 and PD-L1 expression experienced lower overall survival(P＜0.05),while in lung squamous cell carcinoma,high PD-L1 expression was associated with prolonged overall survival(P＜0.05).Conclusion B4GALT1 and PD-L1 are positively correlated in lung adenocarcinoma and were significantly in-volved in its tumorigenesis,progression,invasiveness,and clinical prognosis.B4GALT1 may represent a promising therapeutic target in future lung cancer treatment.

Purpose To investigate the clinicopathologic significance of VISTA and Foxp3 expression in triple-negative breast cancer(TNBC).Methods The expression of VISTA mRNA,Foxp3 mRNA in TNBC,along with their correlations with patient prognosis,were analyzed using GEPIA2 based on TCGA bioinformatics database.Sam-ples of 160 TNBC tissues and 160 normal breast tissues were collected.Immunohistochemical detection was proformed using the MaxVision 3HRP method to detect the expression of VISTA in both tumor cells and immune cells,and Foxp3 in tumor-infiltrating lymphocytes(TILs).Their differential expression,as well as the relationships with the clinico-pathological characteristics and prognosis in TNBC,were analyzed.Results Database analysis results showed that the expression level of VISTA mRNA in TNBC was lower than that in normal breast tissue(P＜0.05),while the expres-sion level of Foxp3 mRNA in TNBC was higher than that in normal breast tissue(P＜0.05).The expression of VISTA mRNA and Foxp3 mRNA in breast cancer tissues were positively correlated(rs=0.45,P＜0.001),and the expres-sion of VISTA mRNA was related to the overall survival.Immunohistochemical results showed that in TNBC,the posi-tive expression rate of VISTA in tumor cells was 15％(24/160),and 72.5％(116/160)in immune cells.The infil-tration density of Foxp3+TILs was higher than that in normal breast tissue(P＜0.001).The expression of VISTA in immune cells was positively correlated with Foxp3+TILs(rs=0.244,P=0.002).Moreover,the expression of VIS-TA in immune cells was related to the TNM stage of patients,and the infiltration density of Foxp3+TILs was related to the histological grade.Cox univariate and multivariate analyses indicated that TNM stage was an independent risk factor affecting the prognosis of TNBC patients.Conclusion In TNBC,VISTA is mainly expressed in immune cells and an increased infiltration density of Foxp3+TILs is observed.Both VISTA expression in immune cells and high infiltration density of Foxp3+TILs are correlated with clinicopathologic features indicative of poor prognosis,suggesting that they may act synergistically in the progression of TNBC.

Objective To establish the regression equation for the maximum oxygen uptake(VO2max)of male young endurance athletes at altitudeby modeling relevant indicators.Methods A total of 81 young male endurance athletes(long-distance runner,marathoner,and race walker)aged 15～18 years old were selected as the research subjects.The VO2max,3000-meter timed run,400-meter timed run,body morphology,body composition,hematological indicators,and cardiac function of the ath-letes were tested in Kunming,Yunnan Province(1890 meters altitude high)in four consecutive days.The testing sequence of the exercise was randomly arranged.The data of the first 65 athletes were used for multiple linear regression modeling,while those of the rest 16 were employed for the verifica-tion of the established model.Results Based on the data of 65 athletes,the multiple linear regression equation of VO2max was:VO2max=2616.661+60.389×lean body mass(kg)-3.108×3000-meter run-ning time(s)-16.665×lower limb length A(cm)+6.356×maximum heart rate(bpm),R2=0.858,and that of the relative VO2max was:relative VO2max=119.685-0.058×3000-meter running time(s)-0.224×body weight(kg)-0.452×Achilles tendon length(cm),R2=0.681.Accord-ing to the data of the rest 16 athletes,there was no significant difference in the calculated values of VO2max and relative VO2max.Moreover,the calculated values and the direct test values of VO2max and rel-ative VO2max were positively correlated(r=0.735,P=0.001;r=0.509,P=0.044).Conclusion A regression model of VO2max and relative VO2max for young male endurance athletes at altitude(1890 meters altitude high)was established and verified through direct testing.The model established is worth popularization and application,and can provide references for indicators selection of young male endurance athletes at altitude(1890 meters altitude high).

Purpose To investigate the clinicopathologic significance of VISTA and Foxp3 expression in triple-negative breast cancer(TNBC).Methods The expression of VISTA mRNA,Foxp3 mRNA in TNBC,along with their correlations with patient prognosis,were analyzed using GEPIA2 based on TCGA bioinformatics database.Sam-ples of 160 TNBC tissues and 160 normal breast tissues were collected.Immunohistochemical detection was proformed using the MaxVision 3HRP method to detect the expression of VISTA in both tumor cells and immune cells,and Foxp3 in tumor-infiltrating lymphocytes(TILs).Their differential expression,as well as the relationships with the clinico-pathological characteristics and prognosis in TNBC,were analyzed.Results Database analysis results showed that the expression level of VISTA mRNA in TNBC was lower than that in normal breast tissue(P＜0.05),while the expres-sion level of Foxp3 mRNA in TNBC was higher than that in normal breast tissue(P＜0.05).The expression of VISTA mRNA and Foxp3 mRNA in breast cancer tissues were positively correlated(rs=0.45,P＜0.001),and the expres-sion of VISTA mRNA was related to the overall survival.Immunohistochemical results showed that in TNBC,the posi-tive expression rate of VISTA in tumor cells was 15％(24/160),and 72.5％(116/160)in immune cells.The infil-tration density of Foxp3+TILs was higher than that in normal breast tissue(P＜0.001).The expression of VISTA in immune cells was positively correlated with Foxp3+TILs(rs=0.244,P=0.002).Moreover,the expression of VIS-TA in immune cells was related to the TNM stage of patients,and the infiltration density of Foxp3+TILs was related to the histological grade.Cox univariate and multivariate analyses indicated that TNM stage was an independent risk factor affecting the prognosis of TNBC patients.Conclusion In TNBC,VISTA is mainly expressed in immune cells and an increased infiltration density of Foxp3+TILs is observed.Both VISTA expression in immune cells and high infiltration density of Foxp3+TILs are correlated with clinicopathologic features indicative of poor prognosis,suggesting that they may act synergistically in the progression of TNBC.

Purpose To investigate the correlation between B4GALT1 and PD-L1 expression in lung adenocarci-noma and lung squamous cell carcinoma,and to assess their clinicopathological significance.Methods The EnVision immunohistochemical method was used to detect B4GALT1 and PD-L1 protein expression in 195 cases of lung adeno-carcinoma,105 cases of lung squamous cell carcinoma,and 300 cases of non-cancer lung tissue.The relationships be-tween these protein expression levels and the clinicopathological features of both tumor types,as well as the correlation between B4GALT1 and PD-L1 expression were analyzed.Additionally,bioinformatics approaches were employed to ex-amine the correlation of B4GALT1 and PD-L1 gene expression and to evaluate their impact on patient prognosis in both cancer subtypes.Results The positive rate of B4GALT1 protein in lung adenocarcinoma(66.7％,130/195)was significantly higher than that in lung squamous cell carcinoma(25.7％,27/105),whereas PD-L1 positivity was grea-ter in squamous cell carcinoma(63.8％,67/105)than that in adenocarcinoma(37.9％,74/195).The difference betweenthe two groups was statistically significant(P＜0.05).Both proteins were undetectable in non-cancer lung tis-sues.In lung adenocarcinoma,the expression of both B4GALT1 and PD-L1 was significantly correlated with TNM stage,maximum tumor diameter,pathological subtype,and lymph node metastasis(P＜0.05);And PD-L1 expression was also correlated with distant metastasis(P＜0.05).In lung squamous cell carcinoma,B4GALT1 expression showed no significant association with sex,age,TNM stage,maximum tumor diameter,differentiation,lymph node metastasis,distant metastasis and smoking history(P＞0.05),while PD-L1 expression correlated with TNM stage(P＜0.05).A positive correlation between B4GALT1 and PD-L1 protein expression was observed in adenocarcinoma(r=0.438,P＜0.05).Bioinformatics analysis confirmed a positive correlation at the gene-expression level(r=0.32,P＜0.05).Ad-enocarcinoma patients exhibiting high B4GALT1 and PD-L1 expression experienced lower overall survival(P＜0.05),while in lung squamous cell carcinoma,high PD-L1 expression was associated with prolonged overall survival(P＜0.05).Conclusion B4GALT1 and PD-L1 are positively correlated in lung adenocarcinoma and were significantly in-volved in its tumorigenesis,progression,invasiveness,and clinical prognosis.B4GALT1 may represent a promising therapeutic target in future lung cancer treatment.

In order to solve the problems of quality control and traceability of medical test lung for meeting the calibration conditions of JJF 1234-2018 Calibration Specification for Ventilators, the calibration device and method are researched for compliance and airway resistance of medical test lung in this paper. A calibration device for medical test lung is designed using constant volume active piston technology to simulate human breathing. Through comparison experiment, the deviation between this device and the similar foreign device can be found. The deviation is lower than 0.4% for lung compliance and lower than 0.7% for airway resistance. The calibration of lung compliance and airway resistance can be completed by this device. This device has a clear and complete traceability path to ensure quality control from the source. The calibration of ventilator is improved. This paper provides a reference for related metrology departments and medical institutions to study on quality inspection of respiratory medical instruments.
Humans ; Calibration ; Ventilators, Mechanical ; Respiration ; Quality Control ; Lung

Purpose To investigate the correlation of PNCK and EGFR expression with EGFR gene mutation status in non-small cell lung cancer(NSCLC).Methods Immunohisto-chemical staining was used to detect the expression of PNCK and EGFR in 256 cases of invasive lung carcinoma,42 cases of inva-sive precancerous lesions and 40 cases of paracancerous lung tis-sues,EGFR gene amplification and mutation were detected by next-generation sequencing.The relationship between the ex-pression of PNCK and EGFR protein and the clinicopathological features of NSCLC,the mutation status of EGFR gene and the correlation between them were analyzed.GEPIA database was used to analyze the correlation between PNCK and EGFR gene expression in lung adenocarcinoma and lung squamous cell carci-noma,and Kaplan-Meier Plotter database was used to analyze the effect of PNCK on the prognosis of lung cancer.Results Expression of PNCK and EGFR in lung invasive carcinoma(53.5％,137/256;47.7％,122/256)was higher than those of pre-invasive lesions(47.6％,20/42;31.0％,13/42)and paracancer tissue(22.5％,9/40;7.5％,3/40),pair-to-pair comparison among the three groups had statistical significance(P＜0.05).The high expression of PNCK protein was correla-ted with the degree of cancer differentiation,TNM stage,lymph node metastasis and distant metastasis(P＜0.05).The high expression of EGFR protein was correlated with TNM stage,lymph node metastasis and distant metastasis(P＜0.05).There was a negative correlation between PNCK and EGFR pro-tein expression in NSCLC tissues(r=-0.208,P＜0.05).The expression of EGFR protein in NSCLC with EGFR gene mu-tation and amplification was higher than that of wild type(P＜0.05).There was no correlation between PNCK protein expres-sion and EGFR gene mutation and amplification(P＞0.05).Bioinformatics database showed that PNCK and EGFR gene ex-pression were positively correlated in lung adenocarcinoma and lung squamous cell carcinoma(r=0.15,P＜0.05;r=0.30,P＜0.05),PNCK high expression group had a shorter overall survival rate in lung cancer(HR:1.28,95％CI:1.09-1.51,P=0.003 1).Conclusion The high expression of PNCK is associated with the occurrence,development,and poor prognosis of NSCLC,and negatively correlated with EGFR pro-tein expression.It is expected to become a potential therapeutic target for EGFR mutations in NSCLC.

Objective:To evaluate the safety and feasibility of neoadjuvant chemotherapy (NACT) combined with radical surgery for elderly patients with locally advanced gastric cancer (LAGC).Methods:One hundred and fourty eight patients with LAGC after NACT and gastrectomy between 2012 and 2020 were retrospectively reviewed. They were divided into two groups: (1) <65 years old (111 cases) and (2) ≥65 years old (37 cases) and their clinicopathological and prognostic data were compared.Results:There was no significant difference between the two groups in the incidence of hematological complications such as anemia ( χ2=0.235, P=0.628), leukopenia ( χ2=0.613, P=0.434), neutropenia ( χ2=0.011, P=0.918) and thrombocytopenia ( χ2=0.253, P=0.615) and non-hematological complications such as nausea ( χ2=0.092, P=0.762), vomiting ( χ2=0.166, P=0.683), diarrhea ( χ2=0.015, P=0.902) and mucositis ( χ2=0.199, P=0.766) due to NACT. There were no statistical differences between the older patients and the younger in operation duration ( t=0.270, P=0.604), intraoperative bleeding ( t=1.140, P=0.250) and R 0 resection rate ( χ2=0.105, P=0.750). The incidence of postoperative complications was 25.2% and 37.8% in the younger patients and the olders ( χ2=2.172, P=0.141). Pleural effusion ( χ2=7.007, P=0.008) and pulmonary infection ( χ2=10.204, P=0.001) was significantly higher in the older patients than in the youngers. The 3-year progression-free survival rate ( t=0.494, P=0.482) and 3-year overall survival rate ( t=0.013, P=0.908) were comparable between the two groups. Conclusions:NACT combined with radical surgery is safe and effective in elderly patients with LAGC, except for higher perioperative pulmonary-related complications.