Objective:To investigate the value of diameter of pulmonary nodules,radiological indicators,serum tumor markers(CEA,CYFRA21-1,and SCC),and methylation of HOXA7 and SOX17 in circulating tumor DNA(ctDNA)in the early diagnosis of lung can-cer.Methods:A total of 60 patients with malignant pulmonary nodules and 60 patients with benign pulmonary nodules who were admit-ted to our hospital from September 2021 to December 2022 were enrolled as lung cancer group and benign nodule group,respectively,and 80 healthy individuals who underwent physical examination in our hospital during the same period of time were enrolled as control group.The three groups were compared in terms of the diameter of nodules,spiculation sign,levels of serum tumor markers,and meth-ylation rates of HOXA7 and SOX17 in plasma ctDNA,and a multivariate regression analysis was performed to identify the independent risk factors for carcinogenesis and establish a predictive model.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic performance of the model.Results:Compared with the benign nodule group and the control group,the lung cancer group had significantly higher diameter of pulmonary nodules,proportion of patients with spiculation sign,CEA,ProGRP,CYFRA21-1,and methylation rates of serum HOXA7,and SOX17,and the lung can-cer group had a significantly higher level of SCC than the control group(all P<0.05).The diameter of pulmonary nodules,spiculation sign,and methylation rates of HOXA7 and SOX17 in serum ctDNA were independent risk factors for malignant pulmonary nodules(P<0.05),and a predictive model was established as Y=ex/(1+ex),where x=-7.233+(0.108×nodule diameter)+(3.860×spiculation sign)+(0.021×HOXA7 methylation rate)+(0.043×SOX17 methylation rate).The predictive model had an area under the ROC curve(AUC)of 0.981,with a significantly larger AUC than each indicator alone and the Mayo and LCBP models(P<0.05).Conclusion:The diameter of pulmonary nodules,spiculation sign,and methylation rates of HOXA7 and SOX17 in ctDNA have a relatively high value in the early diagnosis of lung cancer,and the predictive model based on these indicators can significantly improve diagnostic performance.

Objective To study the effect of surface physical properties of different materials for the artificial joint pros -thesis interface on Mycobacterium tuberculosis adhesion .Methods The surface polishing coating , titanium coating and hydroxyapatite coating were chosen as the experimental materials to analyze the surface topography and measure the surface roughness, contact angle and surface energy .The M.tuberculosis strains were used by in vitro cultivation method and ob-served by scanning electron microscopy (SEM) to study the morphology of M.tuberculosis and the material surface adhe-sion.The influence of surface physical properties of the interface of the artificial joint prostheses on the proliferation and ad -hesion of bacteria was evaluatd .Results The titanium coating and hydroxyapatite coating materials were hydrophobic , while the surface polishing coating was hydrophilic .The contact angle and surface energy were significantly different ( P<0.05).In the process of bacterial culture of the three types of materials , there was no significant difference (P>0.05)in the OD value of bacterial solution .The titanium coating had the largest amount of interface adhesion for M.tuberculosis, fol-lowed by the hydroxyapatite coating and the polishing coating .The difference between various materials was statistically sig-nificant (P<0.05).Conclusion The adhesion of M.tuberculosis in the surface of artificial joint prosthesis materials is closely related to the surface physical properties .A adhesiveness improves with surface roughness .

Objective To discuss the significance of the detection of interferon-γ in the diagnosis of active joint tuberculosis. Methods 5 kinds of specific proteins of mycobacterium tuberculosis were used as stimulating protein, the chemiluminescence enzyme immunoassay was used to test the content of interferon-γ. The interferon-γ of 35 cases of patients with active joint tuberculosis and 35 cases of healthy people were detected. The difference of the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio of 5 kinds of proteins to the diagnostic of active joint tuberculosis were compared. Results CFP10/ESAT6 fusion protein, Rv2041c protein, Rv0057/1352 fusion proteins, Rv1419 protein and Rv1656 protein were used as stimulating protein, the sensitivities of active joint tuberculosis by the whole blood interferon-γ assay were 77.1%, 68.6%, 71.4%, 74.3 % and 65.7%. The specificities were 65.7%, 54.3%, 57.1%, 60.0% and 62.9%. The positive predictive values were 62.9%, 60%, 62.5%, 65% and 63.9%. The negative predictive values were 74.2%, 63.3%, 66.7%, 70% and 64.7%. The positive likelihood ratios were 2.25, 1.5, 1.67, 1.86 and 1.77. The negative likelihood ratios were 0.348, 0.579, 0.5, 0.429 and 0.545. Conclusion The detection of interferon-γ has certain significance to joint tuberculosis. But it is not as an index of diagnosing joint tuberculosis.

BACKGROUNDTo investigate the efficacy of EP regimen combined with split-course hyperfractionated accelerated irradiation for locally advanced non-small cell lung cancer.

METHODSThe treatment was composed of 3 cycles of combined chemoradiotherapy at 4-week intervals. Chemotherapy with cisplatin ( 30 mg/m²) and etoposide (60 mg/m²) was administrated intravenously on days 1-3, followed by radiotherapy on days 4-8. A course of radiotherapy consisted of 1.5 Gy per fraction, twice a day (3 Gy per day) for 5 consecutive days, for a total dose of 15 Gy. In the third cycle, additional irradiotherapy consisted of 2 Gy once a day was performed on days 11-15, for a total dose up to 55 Gy during 10 weeks. After three cycles, patients were given 2 additional cycles of chemotherapy with MVP regimen.

RESULTSOf the 43 patients, 12 had a complete remission and 22 a partial response, resulting in an overall response rate of 79.1%. Of the 152 chemotherapeutic cycles administrated, there were 40 during which grade III-IV toxicities occurred, mainly consisting of leukopenia and vomiting. The 1- and 2-year survival rates were 66.7% and 57.2%, respectively.

CONCLUSIONSEP regimen combined with split-course hyperfractionated accelerated irradiation is effective and well tolerated for advanced locally non-small celll lung cancer. It should be investigated further.