Purpose To investigate the correlation between molecular typing of urothelial carcinoma(UC)and its clinicopathologic features and prognosis,in order to explore the prognostic markers and therapeutic targets for UC.Methods 115 patients with UC were retrospectively analyzed.Immunohistochemical markers GATA-3,CK20,CK5/6 and CD44 were used for molecular typing of UC(luminal-like type,basal-like type and null).Correlations between molecular typing and clinicopathological features were analyzed using the Chi-square test and Fisher precise test.Sur-vival analysis was performed using the Kaplan-Meier test and Log-rank test.Results The expression of GATA-3 and CK20 was negatively correlated with the clinical stage of UC,while the expression of CD44 was positively correlated with the clinical stage of UC(both P＜0.05).CK20 was a marker of good prognosis(P=0.03).The proportion of clinically advanced UC with basal-like type was significantly higher than that of luminal-like type(78.4％vs 53.4％,P=0.033).Among the histologic variants,UC with neuroendocrine differentiation(100％),sarcomatoid carcinoma(80.0％)and squamous differentiation(77.8％)were basal-like type.All plasmacytoid and lymphoepithelioma-like types,as well as 81.8％of micropapillary UC.Among the null phenotypes,the differential variant predominated(66.7％).Compared with the luminal-like type,although the prognosis of basal-like UC was worse,there was no sta-tistically significant difference(P＞0.05).Conclusion Patients with CK20-expressing UC had a significantly better prognosis.The main histologic variants types of basal-like type and coelomofacial type are different.Molecular typing of UC using immunohistochemical markers is suggestive of clinical staging and prognosis of patients.

Objective:To explore the short-term clinical efficacy of arthroscopy-assisted surgical dislocation combined with autologous iliac bone graft for early and middle-stage femoral head necrosis in young and middle-aged patients.Methods:A retrospective study was conducted to analyze the clinical data of the 20 patients with early and middle-stage femoral head necrosis who had been treated by arthroscopy-assisted surgical dislocation combined with autologous iliac bone graft at Orthopaedic Medical Center, Haikou Hospital Affiliated to Xiangya School of Medicine, Central South University from January 2020 to December 2024. There were 12 males and 8 females, with an age of 31 (21, 46) years. The femoral head necrosis was due to hormones in 6 cases, to alcohol in 8 cases, to trauma in 3 cases, and to primary lesions in 3 cases. The International Bone Circulation Research Association staging: stage 2B in 2 cases, stage 2C in 5 cases, stage 3A in 7 cases, stage 3B in 3 cases, and stage 3C in 3 cases. The surgical time, intraoperative blood loss, and incidence of complications during follow-up were recorded in this cohort. The visual analogue scale (VAS) pain score, hip Harris score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) in this cohort were compared between pre-surgery, 3 months after surgery, and the last follow-up.Results:In this cohort, the surgical time was 134 (120, 160) minutes, the intraoperative blood loss 275 (250, 300) mL, and the follow-up duration (28.7±8.2) months. At pre-surgery, 3 months after surgery, and the last follow-up, respectively, the VAS pain scores were 6.0 (5.0, 7.0) points, 2.0 (1.0, 3.0) points, and 0.5 (0.0, 1.0) points; the WOMAC scores 45.5 (40.3, 46.8) points, 12.5 (10.5, 14.0) points, and 9.5 (8.3, 10.0) points; the Harris hip scores (58.1±4.8) points, (78.4±4.7) points, and (85.0±6.7) points. There were statistically significant differences in the pairwise comparisons between the 3 time points ( P<0.05). At the last follow-up, the therapeutic effects were evaluated according to the Harris hip score as excellent in 7 cases, as good in 10 cases, and as poor in 3 cases, giving an excellent and good rate of 85.0% (17/20). Two patients developed lower limb intermuscular vein thrombosis after surgery, 2 patients had delayed healing of greater trochanter osteotomy after nail removal, heterotopic ossification occurred in 2 patients, and further collapse of the femoral head occurred in 7 patients. No patient developed complications such as wound infection or nerve injury during the follow-up period. Conclusion:The arthroscopy-assisted surgical dislocation combined with autologous iliac bone graft can lead to good short-term clinical efficacy in the treatment of early and middle-stage femoral head necrosis in young and middle-aged patients, but complications such as femoral head collapse, delayed healing of greater trochanter osteotomy, heterotopic ossification, and lower limb intermuscular vein thrombosis still exist.

Purpose To investigate the relationship between the expression of POSTN and NECTIN-3 in urothelial carcinoma(UC)and its clinicopathologic features and prognosis.Methods Clinical data of 115 UC patients were col-lected.EnVision two-step method was used for immunohistochemical analysis to determine the expression of POSTN and NECTIN-3 in UC and their correlation with clinicopathological features and prognosis.Transcriptomic data from TCGA database were used to analyze the correlation between the expression of POSTN and NECTIN-3 in bladder cancer and the pathological stage and prognosis of bladder cancer.qPCR and Western blot were used to detect the expression levels of POSTN and NECTIN-3 in tumor tissues and adjacent tissues of patients.Results TCGA database analysis showed that the expression level of NECTIN-3 in urinary bladder urothelial carcinoma(UBUC)was significantly lower than that in paracancer tissues,and POSTN expression was positively correlated with pathological stage.Prognostic a-nalysis showed that POSTN expression was negatively correlated with the overall survival of UBUC(P＞0.05),and NECTIN-3 expression was negatively correlated with disease-free survival of UBUC(P＞0.05).The experimental re-suits showed that patients with positive POSTN expression were more prone to perineural invasion[25 cases(86.2％)vs 4 cases(13.8％),P=0.019],vascular invasion[36 cases(83.7％)vs 7 cases(16.3％),P=0.007],and lymph node metastasis[24 cases(88.9％)vs 3 cases(11.1％),P=0.033].Additionally,the positive expression rate of POSTN in UBUC was significantly higher than that in upper tract urothelial carcinoma(UTUC)(75.0％vs 54.3％,P=0.028).Higher expression levels of POSTN and NECTIN-3 were associated with shorter overall survival,but the difference was not statistically significant(P＞0.05).Conclusion There is no significant correlation between NECTIN-3 and the clinicopathological features and prognosis of urothelial carcinoma,while the expression of POSTN is correlated with the invasive clinicopathological features of UC,which has certain suggestive significance for clinical stage and prognosis.

Purpose To investigate the clinical pathological features and treatment strategies of adult pineoblasto-ma(PB).Methods The clinical data of 11 cases of adult PB were retrospectively analyzed.Their imaging,histologi-cal morphology,and immunohistochemical characteristics were evaluated,and the relevant literature was reviewed.Re-sults Among the 11 PB cases,5 cases were female and 6 were male,aged 18-63 years with a median age of 39 years.Microscopically,the tumors were composed of dense small to medium-sized cells,showing a diffuse and sheet-like distribution.Rosette-like structures could be seen in some cases.The tumor cell nuclei were round or irregular with a high nuclear-cytoplasmic ratio.The mitotic figures and apoptosis were extremely common to see,and necrosis was observed in some cases.The tumor cells were uniformly positive for CD56(11/11),Syn(11/11),and CgA(11/11),with retained expression of INI-1(11/11).Some cases were positive for CD99(3/11)and S-100(1/11),while negative for BCOR,CKpan,GFAP,PLAP,CD3,and CD20.The Ki67 proliferation index ranged from 20％to 80％.Five patients were followed up for 2 to 39 months:1 patient developed spinal metastasis 26 months after postop-erative chemotherapy;1 patient had spinal metastasis 4 months after postoperative radiotherapy and temozolomide treat-ment;and 3 patients died.Conclusion PB is a rare,highly malignant tumor in the pineal gland region,even rarer in adults.Its morphology is similar to that of childhood PB,and its prognosis is slightly better than that in children.

Purpose To investigate the clinical pathological features and treatment strategies of adult pineoblasto-ma(PB).Methods The clinical data of 11 cases of adult PB were retrospectively analyzed.Their imaging,histologi-cal morphology,and immunohistochemical characteristics were evaluated,and the relevant literature was reviewed.Re-sults Among the 11 PB cases,5 cases were female and 6 were male,aged 18-63 years with a median age of 39 years.Microscopically,the tumors were composed of dense small to medium-sized cells,showing a diffuse and sheet-like distribution.Rosette-like structures could be seen in some cases.The tumor cell nuclei were round or irregular with a high nuclear-cytoplasmic ratio.The mitotic figures and apoptosis were extremely common to see,and necrosis was observed in some cases.The tumor cells were uniformly positive for CD56(11/11),Syn(11/11),and CgA(11/11),with retained expression of INI-1(11/11).Some cases were positive for CD99(3/11)and S-100(1/11),while negative for BCOR,CKpan,GFAP,PLAP,CD3,and CD20.The Ki67 proliferation index ranged from 20％to 80％.Five patients were followed up for 2 to 39 months:1 patient developed spinal metastasis 26 months after postop-erative chemotherapy;1 patient had spinal metastasis 4 months after postoperative radiotherapy and temozolomide treat-ment;and 3 patients died.Conclusion PB is a rare,highly malignant tumor in the pineal gland region,even rarer in adults.Its morphology is similar to that of childhood PB,and its prognosis is slightly better than that in children.

Purpose To investigate the correlation between molecular typing of urothelial carcinoma(UC)and its clinicopathologic features and prognosis,in order to explore the prognostic markers and therapeutic targets for UC.Methods 115 patients with UC were retrospectively analyzed.Immunohistochemical markers GATA-3,CK20,CK5/6 and CD44 were used for molecular typing of UC(luminal-like type,basal-like type and null).Correlations between molecular typing and clinicopathological features were analyzed using the Chi-square test and Fisher precise test.Sur-vival analysis was performed using the Kaplan-Meier test and Log-rank test.Results The expression of GATA-3 and CK20 was negatively correlated with the clinical stage of UC,while the expression of CD44 was positively correlated with the clinical stage of UC(both P＜0.05).CK20 was a marker of good prognosis(P=0.03).The proportion of clinically advanced UC with basal-like type was significantly higher than that of luminal-like type(78.4％vs 53.4％,P=0.033).Among the histologic variants,UC with neuroendocrine differentiation(100％),sarcomatoid carcinoma(80.0％)and squamous differentiation(77.8％)were basal-like type.All plasmacytoid and lymphoepithelioma-like types,as well as 81.8％of micropapillary UC.Among the null phenotypes,the differential variant predominated(66.7％).Compared with the luminal-like type,although the prognosis of basal-like UC was worse,there was no sta-tistically significant difference(P＞0.05).Conclusion Patients with CK20-expressing UC had a significantly better prognosis.The main histologic variants types of basal-like type and coelomofacial type are different.Molecular typing of UC using immunohistochemical markers is suggestive of clinical staging and prognosis of patients.

Purpose To investigate the relationship between the expression of POSTN and NECTIN-3 in urothelial carcinoma(UC)and its clinicopathologic features and prognosis.Methods Clinical data of 115 UC patients were col-lected.EnVision two-step method was used for immunohistochemical analysis to determine the expression of POSTN and NECTIN-3 in UC and their correlation with clinicopathological features and prognosis.Transcriptomic data from TCGA database were used to analyze the correlation between the expression of POSTN and NECTIN-3 in bladder cancer and the pathological stage and prognosis of bladder cancer.qPCR and Western blot were used to detect the expression levels of POSTN and NECTIN-3 in tumor tissues and adjacent tissues of patients.Results TCGA database analysis showed that the expression level of NECTIN-3 in urinary bladder urothelial carcinoma(UBUC)was significantly lower than that in paracancer tissues,and POSTN expression was positively correlated with pathological stage.Prognostic a-nalysis showed that POSTN expression was negatively correlated with the overall survival of UBUC(P＞0.05),and NECTIN-3 expression was negatively correlated with disease-free survival of UBUC(P＞0.05).The experimental re-suits showed that patients with positive POSTN expression were more prone to perineural invasion[25 cases(86.2％)vs 4 cases(13.8％),P=0.019],vascular invasion[36 cases(83.7％)vs 7 cases(16.3％),P=0.007],and lymph node metastasis[24 cases(88.9％)vs 3 cases(11.1％),P=0.033].Additionally,the positive expression rate of POSTN in UBUC was significantly higher than that in upper tract urothelial carcinoma(UTUC)(75.0％vs 54.3％,P=0.028).Higher expression levels of POSTN and NECTIN-3 were associated with shorter overall survival,but the difference was not statistically significant(P＞0.05).Conclusion There is no significant correlation between NECTIN-3 and the clinicopathological features and prognosis of urothelial carcinoma,while the expression of POSTN is correlated with the invasive clinicopathological features of UC,which has certain suggestive significance for clinical stage and prognosis.

Objective:To explore the short-term clinical efficacy of arthroscopy-assisted surgical dislocation combined with autologous iliac bone graft for early and middle-stage femoral head necrosis in young and middle-aged patients.Methods:A retrospective study was conducted to analyze the clinical data of the 20 patients with early and middle-stage femoral head necrosis who had been treated by arthroscopy-assisted surgical dislocation combined with autologous iliac bone graft at Orthopaedic Medical Center, Haikou Hospital Affiliated to Xiangya School of Medicine, Central South University from January 2020 to December 2024. There were 12 males and 8 females, with an age of 31 (21, 46) years. The femoral head necrosis was due to hormones in 6 cases, to alcohol in 8 cases, to trauma in 3 cases, and to primary lesions in 3 cases. The International Bone Circulation Research Association staging: stage 2B in 2 cases, stage 2C in 5 cases, stage 3A in 7 cases, stage 3B in 3 cases, and stage 3C in 3 cases. The surgical time, intraoperative blood loss, and incidence of complications during follow-up were recorded in this cohort. The visual analogue scale (VAS) pain score, hip Harris score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) in this cohort were compared between pre-surgery, 3 months after surgery, and the last follow-up.Results:In this cohort, the surgical time was 134 (120, 160) minutes, the intraoperative blood loss 275 (250, 300) mL, and the follow-up duration (28.7±8.2) months. At pre-surgery, 3 months after surgery, and the last follow-up, respectively, the VAS pain scores were 6.0 (5.0, 7.0) points, 2.0 (1.0, 3.0) points, and 0.5 (0.0, 1.0) points; the WOMAC scores 45.5 (40.3, 46.8) points, 12.5 (10.5, 14.0) points, and 9.5 (8.3, 10.0) points; the Harris hip scores (58.1±4.8) points, (78.4±4.7) points, and (85.0±6.7) points. There were statistically significant differences in the pairwise comparisons between the 3 time points ( P<0.05). At the last follow-up, the therapeutic effects were evaluated according to the Harris hip score as excellent in 7 cases, as good in 10 cases, and as poor in 3 cases, giving an excellent and good rate of 85.0% (17/20). Two patients developed lower limb intermuscular vein thrombosis after surgery, 2 patients had delayed healing of greater trochanter osteotomy after nail removal, heterotopic ossification occurred in 2 patients, and further collapse of the femoral head occurred in 7 patients. No patient developed complications such as wound infection or nerve injury during the follow-up period. Conclusion:The arthroscopy-assisted surgical dislocation combined with autologous iliac bone graft can lead to good short-term clinical efficacy in the treatment of early and middle-stage femoral head necrosis in young and middle-aged patients, but complications such as femoral head collapse, delayed healing of greater trochanter osteotomy, heterotopic ossification, and lower limb intermuscular vein thrombosis still exist.

Ardisia Crenata Radix is a traditional Chinese medicinal plant that belongs to the Myrsinaceae family,and its main active components are coumarins,saponins,flavonoids,and volatile oil.Bergenin,ardisicrenoside A,ardisicrenoside B,ardisiacripin A,ardisiacripin B,and embelin were identified as active anticancer compounds in in-depth studies into the anti-tumor effects of Ardisia Crenata Radix.They show high therapeutic potential in oral cancer,nasopharyngeal carcinoma,liver cancer,colon cancer,bladder cancer,cervical cancer,and leukemia,mainly by inducing tumor cell apoptosis,increasing tumor cytotoxicity,inhibiting cell proliferation,inhibiting tumor cell metastasis and migration,and inducing cell regulatory enzyme cascade reactions.However,most preclinical experimental data on cinnabar root's anti-tumor mechanism have not been verified in high-quality,multi-sample,and repeated randomized controlled trials,and there are a lack of clinical research data on tumor prognosis,pharmacodynamics,and pharmacokinetics.Accurate research experiments and clinical trials should be designed to further explore the pharmacological effects of Ardisia Crenata Radix.

Objective To summarize the prescription characteristics and medication rules for the treatment of dia-betic kidney disease(DKD)from professor LIANG Xiaochun and to inherit professor LIANG Xiaochun's academic anamnesis.Methods Using the retrospective real world research(RWS)method and the electronic medical record of Peking Union Medical Union Hospital Information System(HIS),the clinical records of DKD outpatient treatment by professor LIANG Xiaochun's from 2020 to 2022 was collected to built a database with the support of Traditional Chinese Medicine inheritance computing platform(V3.5)software.Correlation analysis,cluster analysis and other methods were used to analyze the frequency of medication performance and the medication's four natures,five flavors,meridian tropism,and the combination of commonly used drugs in the treatment of DKD were re-viewed.Results A total of 205 cases covering 193 traditional Chinese medicines were collected.The most fre-quent use of drugs were Cuscutae Semen,Mori Cortex,Ligustri Lucidi Fructus,Achyranthes aspera Linn,Commelinae Herba,Smilacis Glabrae Rhizoma,Radix Et Rhizoma Rumei,Ramulus Euonymi Alati and Astmgali Radix.The four natures shared by them are cold and the five flavors are mostly sweetness.The meridian tropism belongs to the liver,spleen,and kidney.The analysis of drug association showed that the core drug combination was:Cuscutae Semen-Ligustri Lucidi Fructus,Cuscutae Semen-Achyranthes aspera Linn,Ligustri Lucidi Fructus-Achyranthes aspera Linn,Achyranthes aspera Linn-Smilacis Glabrae Rhizoma,Cuscutae Semen-Smilacis Glabrae Rhizoma etc.The four core prescriptions were obtained by cluster analysis:Cuscutae Semen-Ligustri Lucidi Fruc-tus-Mori Cortex-Achyranthes aspera Linn-Smilacis Glabrae Rhizoma-Radix Et Rhizoma Rumei,Cuscutae Semen-Commelinae Herba-Mori Cortex-Achyranthes aspera Linn-Ligustri Lucidi Fructus-Smilacis Glabrae Rhizoma,Cuscutae Semen-Ligustri Lucidi Fructus-Mori Cortex-Commelinae Herba-Achyranthes aspera Linn-Radix Et Rhizoma Rumei,Mori Cortex-Ligustri Lucidi Fructus-Cuscutae Semen-Astmgali Radix-Smilacis Glabrae Rhizoma-Commelinae Herba.Conclusions Professor LIANG Xiaochun treated DKD with the principle of tonifying the spleen and kid-ney,promoting blood circulation,and removing turbidity.The experience of medication embodies the academic anamnesis the combination of tonifying kidney and solidifying astringency,the combination of removing turbidity and detoxifying supplemented by activating blood and water circulation in human body.