Objective:To investigate the effect of anterior and posterior selective fusion strategy on evolution of coronal pattern in patients with Lenke 5C adolescent idiopathic scoliosis (AIS) and whether upper end vertebra (UEV)-1 strategy in anterior surgery would have an effect on postoperative coronal balance.Methods:A total of 108 Lenke 5C AIS patients with at least 2 years follow-up who underwent anterior or posterior selective thoracolumbar fusion surgery from January 2005 to December 2020 were enrolled, with 51 patients in the anterior group and 57 patients in the posterior group. The patients were categorized into three groups (type A, C 7PL-CSVL<20 mm; type B, C 7PL-CSVL ≥20 mm with C 7PL toward the concave side of the main curve; and type C, C 7PL-CSVL≥20 mm with C 7PL toward the convex side of the main curve) to investigate the evolution of coronal balance of each preoperative coronal pattern at the anterior and posterior groups. Parameters such as thoracolumbar Cobb angle, rate of coronal imbalance, and SRS-22 score were recorded at preoperative, 1 week postoperatively, and final follow-up in both groups. Results:The differences of basic date between the two groups were not statistically significant except for the fusion level (5.2±0.7 vs. 5.6±0.9, t=2.497, P=0.014). In the anterior group, a total of 27 patients with preoperative type A, 23 patients with preoperative type A maintained type A at the 1 week postoperatively, and 2 of them were converted to type C at the final follow-up. Four patients with preoperative type A converted to type C at the 1 week postoperatively, and all of them returned to type A at the final follow-up. A total of 23 patients with preoperative type C, four patients with preoperative type C maintained type C at the 1 week postoperatively, and one of them maintained type C at the final follow-up. Nineteen patients with preoperative type C converted to type A at the 1 week postoperatively, and all of them maintained type A at the final follow-up. In the posterior group, a total of 26 patients with preoperative type A, 22 patients with preoperative type A maintained type A at the 1 week postoperatively, and only 2 of these patients converted to type C at the final follow-up. Four of the preoperative type A patients converted to type C at the 1 week postoperatively, and all of them returned to type A at the final follow-up. A total of 29 patients with preoperative type C, thirteen patients with preoperative type C maintained type C at the 1 week postoperatively, and 7 of them maintained type C at the last follow-up. Sixteen patients with preoperative type C converted to type A at the 1 week postoperatively, of whom two converted to type C at the final follow-up. For patients with preoperative type C the rate of coronal imbalance was significantly lower in the anterior group than in the posterior group both in the immediate postoperative period (17% vs. 45%, P<0.05) and at the final follow-up (4% vs. 31%, P=0.038). The rate of coronal imbalance at final follow-up was significantly lower in the UEV-1 group than in the UEV group in the posterior approach (3% vs. 38%, P<0.05), and there was no difference between the two groups in the anterior approach. There were no significant differences in radiographic parameters and SRS-22 scores between the two groups, except for the thoracic Cobb angle at the final follow-up, which was greater in the anterior group than in the posterior group at the final follow-up (19.5±7.3 vs.16.4±5.6, t=2.427, P=0.017). Multivariate logistic regression analysis revealed that anterior surgery and Risser were risk factors for postoperative CIB of preoperative type C ( OR=21.138, P=0.030 and OR=0.406, P=0.048 respectively). Conclusion:For patients with preoperative type A, both anterior and posterior procedures lead to a satisfactory reconstruction of coronal balance. In patients with preoperative type C, anterior surgery acquire a better reconstruction of coronal balance. The strategy of proximal UEV-1 was similar to the strategy of UEV in terms of restoring coronary balance in anterior approach and it was unable to lower the rate of postoperative coronal imbalance. In contrast, UEV-1 strategy in posterior surgery was effective in reducing the rate of postoperative coronal imbalance.

Objective:To compare the anterior cervical discectomy and fusion (ACDF) and posterior cervical fusion (PCF) in the sagittal plane reconstruction for unstable Hangman fractures.Methods:A retrospective study was conducted to analyze the clinical data of 43 patients who had been surgically treated at Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital for unstable Hangman fractures from January 2007 to December 2022. There were 32 males and 11 females aged (47.9±14.2) years. They were divided into 2 groups according to their surgical methods: an anterior group of 23 cases who were subjected to ACDF and a posterior group of 20 cases who were subjected to PCE. The 2 groups were compared in terms of operation time, intraoperative bleeding, hospitalization time, and the C 2 subluxation, occipitocervical angle, C 2-C 3 angle, cervical lordosis (CL), and cervical sagittal vertical axis (cSVA) measured on the lateral cervical spine X-rays over the time points of hospital admission, immediate postoperation, and the final follow-up, as well as in terms of the visual analog scale (VAS) for pain and neck disability index (NDI) over the time points of hospital admission and the final follow-up. The American Spinal Injury Association (ASIA) classification was used to assess the neurological status of the patients before surgery and at the final follow-up, and complications were documented. Results:The differences in preoperative general data between the 2 groups were not statistically significant, indicating comparability ( P>0.05). The operation time [(90.3±13.6) min] and hospitalization time [(13.1±2.4) d] in the anterior group were significantly shorter than those in the posterior group [(153.9±26.1) min and (18.5±1.9) d], and the intraoperative bleeding volume in the anterior group [(57.2±15.9) mL] was significantly less than that in the posterior group [(123.2±22.5) mL] ( P<0.05). Compared with the preoperative period in both groups, the C 2 subluxation and C 2-C 3 angle were significantly corrected at immediate postoperation, and well maintained at the final follow-up. The C 2-C 3 angle was significantly better corrected in the anterior group than in the posterior group at immediate postoperation and the final follow-up. The VAS scores and NDI at the final follow-up in both groups were significantly lower than those at admission ( P<0.05), while the differences between the 2 groups were not statistically significant ( P>0.05). Four cases in the anterior group and 2 cases in the posterior group all had their preoperative ASIA grade D improved to grade E at the final follow-up. Three patients in the anterior group developed postoperative hoarseness, which returned to normal at the 3-month follow-up. There was no hoarseness or dysphagia at the final follow-up. Both groups achieved fine fusion at the final follow-up, showing no complications like loosening or fracture of internal fixation. Conclusion:In the sagittal plane reconstruction for unstable Hangman fractures, both ACDF and PCF can lead to satisfactory clinical and radiological outcomes, but the former shows a significant advantage in reconstruction of C 2-C 3 lordosis.

Objective:To investigate the effect of anterior and posterior selective fusion strategy on evolution of coronal pattern in patients with Lenke 5C adolescent idiopathic scoliosis (AIS) and whether upper end vertebra (UEV)-1 strategy in anterior surgery would have an effect on postoperative coronal balance.Methods:A total of 108 Lenke 5C AIS patients with at least 2 years follow-up who underwent anterior or posterior selective thoracolumbar fusion surgery from January 2005 to December 2020 were enrolled, with 51 patients in the anterior group and 57 patients in the posterior group. The patients were categorized into three groups (type A, C 7PL-CSVL<20 mm; type B, C 7PL-CSVL ≥20 mm with C 7PL toward the concave side of the main curve; and type C, C 7PL-CSVL≥20 mm with C 7PL toward the convex side of the main curve) to investigate the evolution of coronal balance of each preoperative coronal pattern at the anterior and posterior groups. Parameters such as thoracolumbar Cobb angle, rate of coronal imbalance, and SRS-22 score were recorded at preoperative, 1 week postoperatively, and final follow-up in both groups. Results:The differences of basic date between the two groups were not statistically significant except for the fusion level (5.2±0.7 vs. 5.6±0.9, t=2.497, P=0.014). In the anterior group, a total of 27 patients with preoperative type A, 23 patients with preoperative type A maintained type A at the 1 week postoperatively, and 2 of them were converted to type C at the final follow-up. Four patients with preoperative type A converted to type C at the 1 week postoperatively, and all of them returned to type A at the final follow-up. A total of 23 patients with preoperative type C, four patients with preoperative type C maintained type C at the 1 week postoperatively, and one of them maintained type C at the final follow-up. Nineteen patients with preoperative type C converted to type A at the 1 week postoperatively, and all of them maintained type A at the final follow-up. In the posterior group, a total of 26 patients with preoperative type A, 22 patients with preoperative type A maintained type A at the 1 week postoperatively, and only 2 of these patients converted to type C at the final follow-up. Four of the preoperative type A patients converted to type C at the 1 week postoperatively, and all of them returned to type A at the final follow-up. A total of 29 patients with preoperative type C, thirteen patients with preoperative type C maintained type C at the 1 week postoperatively, and 7 of them maintained type C at the last follow-up. Sixteen patients with preoperative type C converted to type A at the 1 week postoperatively, of whom two converted to type C at the final follow-up. For patients with preoperative type C the rate of coronal imbalance was significantly lower in the anterior group than in the posterior group both in the immediate postoperative period (17% vs. 45%, P<0.05) and at the final follow-up (4% vs. 31%, P=0.038). The rate of coronal imbalance at final follow-up was significantly lower in the UEV-1 group than in the UEV group in the posterior approach (3% vs. 38%, P<0.05), and there was no difference between the two groups in the anterior approach. There were no significant differences in radiographic parameters and SRS-22 scores between the two groups, except for the thoracic Cobb angle at the final follow-up, which was greater in the anterior group than in the posterior group at the final follow-up (19.5±7.3 vs.16.4±5.6, t=2.427, P=0.017). Multivariate logistic regression analysis revealed that anterior surgery and Risser were risk factors for postoperative CIB of preoperative type C ( OR=21.138, P=0.030 and OR=0.406, P=0.048 respectively). Conclusion:For patients with preoperative type A, both anterior and posterior procedures lead to a satisfactory reconstruction of coronal balance. In patients with preoperative type C, anterior surgery acquire a better reconstruction of coronal balance. The strategy of proximal UEV-1 was similar to the strategy of UEV in terms of restoring coronary balance in anterior approach and it was unable to lower the rate of postoperative coronal imbalance. In contrast, UEV-1 strategy in posterior surgery was effective in reducing the rate of postoperative coronal imbalance.

Objective:To investigate the heterogeneity of tumor density-enhancement complex (TDEC) based on MRI parameters in predicting the treatment response and prognosis for recurrent glioblastoma (rGBM) to guide the formulation of personalized clinical treatment strategies.Methods:A prospective cohort study was performed; 66 patients with postoperative rGBM were enrolled from Department of Neurosurgery, Affiliated Hospital of Jiangsu University. Multi-sequence MRI was performed, and diffused and enhanced data of the rGBM were utilized to construct TDEC as intratumoral sub-regions via pixel co-localization technique. Correlations among rGBM with different volume proportions of TDEC types and correlations of rGBM with different volume proportions of TDEC types with rGBM volume were analyzed in rGBM after bevacizumab (BEV) combined with radiotherapy. A pixel co-localization decoupling method was applied to assess the treatment response efficiency in individual TDEC subcomponents. The rGBM imaging phenotypes were identified through unsupervised clustering analysis, and progression-free survival (PFS) and overall survival (OS) between patients with different phenotypes were compared. The predictive value of TDEC heterogeneity in PFS and OS of rGBM patients under BEV plus radiotherapy was assessed. Results:Four distinct TDEC sub-regions (TDEC1-4) were identified; a significant negative correlation was observed between volume proportions of TDEC2 and TDEC3 ( r s=-0.558, P<0.001), as well as between volume proportions of TDEC3 and TDEC4 ( r s=-0.782, P<0.001), while TDEC composition (volume proportions of TDEC2-4) showed no significant correlation with tumor volume ( P>0.05). Following BEV combined with radiotherapy, significant sub-region-specific TDEC volume changes were observed (tumor volume minification rate of TDEC1[ΔV TDEC1]: 16.7% [13.8%, 20.1%]; ΔV TDEC2: 25.4% [21.9%, 29.0%]; ΔV TDEC3: 27.6% [23.5%, 31.2%]; ΔV TDEC4: 8.4% [6.1%, 10.7%], P<0.05); volume proportion of TDEC3 was positively correlated with tumor volume minification ( r s=0.702, P<0.001), whereas volume proportion of TDEC4 was negatively correlated tumor volume minification ( r s=-0.933, P<0.001). The volume reduction of TDEC1-3 was driven by combined effects of tumor cellular and enhancement components, while volume reduction of TDEC4 was primarily attributed to changes in tumor cellularity (ΔV ADC: 9.3%; ΔV T1C: 0.8%). Two distinct TDEC phenotypes with different survival outcomes were identified in rGBM patients (silhouette coefficient=0.584; TDEC type I: n=23; type II: n=43); significant difference in PFS and OS was noted between patients with TDEC type I and type II (PFS: χ2=11.191, P=0.001; OS: χ2=9.733, P=0.002). TDEC phenotype was an independent influencing factor for survival of rGBM patients under BEV combined with radiotherapy (PFS: HR=2.738, 95% CI: 1.815-3.938 , P=0.003; OS: HR=2.507, 95% CI: 1.851-3.660, P=0.007). Conclusion:TDEC sub-region helps efficiently characterize the rGBM heterogeneity; rGBM imaging phenotypes identified based on TDEC sub-region can independently predict the clinical outcomes: the prognosis of TDEC type I patients is better than that of TDEC type II patients.

Objective To explore the role and mechanism of warm malate ringer's solution(MR)in resuscitation of the lethal triad caused by severe trauma.Methods A rat model of severe trauma was established in SPF-grade SD rats(half male and half female,weighing 200～220 g)using combined multiple injuries and hemorrhagic shock,and the rats were randomly divided into 8 groups(n=8):Sham group,only arterial and venous catheterization;Trauma(Tra)groups with different time points(10,30,60,90,120,180 min)and a Trauma group that were observed without any treatment for 180 min after model establishment.The changes of activated clotting time(ACT),reaction time(R),maximum amplitude(MA),and rate of blood clot formation(Angle)at different time points were detected by using thromboelastography,and tail bleeding,core body temperature and arterial blood gas parameters,were also observed and detected.The plasma von Willebrand Factor(vWF)level,mitochondrial respiratory control ratio in pulmonary venous endothelium,and expression levels of vascular endothelial cadherin(VE-Cadherin),peroxisome proliferator activating receptor gamma coactivator 1α(PGC1α),dynamin-related protein 1(Drp1),p-Drp1,and mitofusin 2(Mfn2)were detected to evaluate the vascular endothelial injury and mitochondrial dysfunction.Another group of SD rats were randomly divided into severe trauma group(no treatment for 180 min after injury),and MR solution at room temperature and at 37 ℃ groups.MR solution at room temperature or at 37 ℃ was given to the rats using a medical blood transfusion apparatus at 60 min post-trauma.Above indicators were observed and detected to investigate the resuscitation effect of the MR solution.Results Compared with the Sham group,the severely traumatic rats at 180 min after injury had significantly prolonged ACT and R values(P＜0.05),shortened MA and decreased Angle values(P＜0.05),extended tail bleeding time(P＜0.05),lower partial pressure of carbon dioxide(PCO2)and HCO3-and base excess(BE)levels(P＜0.05),and continuously increasing K+(P＜0.05)and decreasing Na+(P＜0.05)and Ca2+levels(P＜0.05).Additionally,plasma vWF level(P＜0.05)and protein levels of VE-cadherin,PGC1α and Mfn2 in pulmonary vein endothelium were significantly reduced(P＜0.05),the expression of p-Drp1 was enhanced and the mitochondrial respiration control rate was declined in the rats at 180 min after injury(P＜0.05).MR solution resuscitation shortened tail bleeding time(P＜0.05),increased core body temperature(P＜0.05),elevated plasma vWF level(P＜0.05),increased protein levels of VE-cadherin,PGC1α and Mfn2(P＜0.05),and decreased that of p-Drp1 protein expression(P＜0.05)when compared with the rats at 180 min after severe traumatic injury.The above effects were more significant in the rats infused with the solution at 37 ℃ than those at room temperature.Conclusion Warm MR solution significantly improves the lethal triad in rats after severe trauma,which may be associated with its improving mitochondrial function and attenuating vascular endothelial damage.

Objective:To compare the anterior cervical discectomy and fusion (ACDF) and posterior cervical fusion (PCF) in the sagittal plane reconstruction for unstable Hangman fractures.Methods:A retrospective study was conducted to analyze the clinical data of 43 patients who had been surgically treated at Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital for unstable Hangman fractures from January 2007 to December 2022. There were 32 males and 11 females aged (47.9±14.2) years. They were divided into 2 groups according to their surgical methods: an anterior group of 23 cases who were subjected to ACDF and a posterior group of 20 cases who were subjected to PCE. The 2 groups were compared in terms of operation time, intraoperative bleeding, hospitalization time, and the C 2 subluxation, occipitocervical angle, C 2-C 3 angle, cervical lordosis (CL), and cervical sagittal vertical axis (cSVA) measured on the lateral cervical spine X-rays over the time points of hospital admission, immediate postoperation, and the final follow-up, as well as in terms of the visual analog scale (VAS) for pain and neck disability index (NDI) over the time points of hospital admission and the final follow-up. The American Spinal Injury Association (ASIA) classification was used to assess the neurological status of the patients before surgery and at the final follow-up, and complications were documented. Results:The differences in preoperative general data between the 2 groups were not statistically significant, indicating comparability ( P>0.05). The operation time [(90.3±13.6) min] and hospitalization time [(13.1±2.4) d] in the anterior group were significantly shorter than those in the posterior group [(153.9±26.1) min and (18.5±1.9) d], and the intraoperative bleeding volume in the anterior group [(57.2±15.9) mL] was significantly less than that in the posterior group [(123.2±22.5) mL] ( P<0.05). Compared with the preoperative period in both groups, the C 2 subluxation and C 2-C 3 angle were significantly corrected at immediate postoperation, and well maintained at the final follow-up. The C 2-C 3 angle was significantly better corrected in the anterior group than in the posterior group at immediate postoperation and the final follow-up. The VAS scores and NDI at the final follow-up in both groups were significantly lower than those at admission ( P<0.05), while the differences between the 2 groups were not statistically significant ( P>0.05). Four cases in the anterior group and 2 cases in the posterior group all had their preoperative ASIA grade D improved to grade E at the final follow-up. Three patients in the anterior group developed postoperative hoarseness, which returned to normal at the 3-month follow-up. There was no hoarseness or dysphagia at the final follow-up. Both groups achieved fine fusion at the final follow-up, showing no complications like loosening or fracture of internal fixation. Conclusion:In the sagittal plane reconstruction for unstable Hangman fractures, both ACDF and PCF can lead to satisfactory clinical and radiological outcomes, but the former shows a significant advantage in reconstruction of C 2-C 3 lordosis.

Objective:To investigate the heterogeneity of tumor density-enhancement complex (TDEC) based on MRI parameters in predicting the treatment response and prognosis for recurrent glioblastoma (rGBM) to guide the formulation of personalized clinical treatment strategies.Methods:A prospective cohort study was performed; 66 patients with postoperative rGBM were enrolled from Department of Neurosurgery, Affiliated Hospital of Jiangsu University. Multi-sequence MRI was performed, and diffused and enhanced data of the rGBM were utilized to construct TDEC as intratumoral sub-regions via pixel co-localization technique. Correlations among rGBM with different volume proportions of TDEC types and correlations of rGBM with different volume proportions of TDEC types with rGBM volume were analyzed in rGBM after bevacizumab (BEV) combined with radiotherapy. A pixel co-localization decoupling method was applied to assess the treatment response efficiency in individual TDEC subcomponents. The rGBM imaging phenotypes were identified through unsupervised clustering analysis, and progression-free survival (PFS) and overall survival (OS) between patients with different phenotypes were compared. The predictive value of TDEC heterogeneity in PFS and OS of rGBM patients under BEV plus radiotherapy was assessed. Results:Four distinct TDEC sub-regions (TDEC1-4) were identified; a significant negative correlation was observed between volume proportions of TDEC2 and TDEC3 ( r s=-0.558, P<0.001), as well as between volume proportions of TDEC3 and TDEC4 ( r s=-0.782, P<0.001), while TDEC composition (volume proportions of TDEC2-4) showed no significant correlation with tumor volume ( P>0.05). Following BEV combined with radiotherapy, significant sub-region-specific TDEC volume changes were observed (tumor volume minification rate of TDEC1[ΔV TDEC1]: 16.7% [13.8%, 20.1%]; ΔV TDEC2: 25.4% [21.9%, 29.0%]; ΔV TDEC3: 27.6% [23.5%, 31.2%]; ΔV TDEC4: 8.4% [6.1%, 10.7%], P<0.05); volume proportion of TDEC3 was positively correlated with tumor volume minification ( r s=0.702, P<0.001), whereas volume proportion of TDEC4 was negatively correlated tumor volume minification ( r s=-0.933, P<0.001). The volume reduction of TDEC1-3 was driven by combined effects of tumor cellular and enhancement components, while volume reduction of TDEC4 was primarily attributed to changes in tumor cellularity (ΔV ADC: 9.3%; ΔV T1C: 0.8%). Two distinct TDEC phenotypes with different survival outcomes were identified in rGBM patients (silhouette coefficient=0.584; TDEC type I: n=23; type II: n=43); significant difference in PFS and OS was noted between patients with TDEC type I and type II (PFS: χ2=11.191, P=0.001; OS: χ2=9.733, P=0.002). TDEC phenotype was an independent influencing factor for survival of rGBM patients under BEV combined with radiotherapy (PFS: HR=2.738, 95% CI: 1.815-3.938 , P=0.003; OS: HR=2.507, 95% CI: 1.851-3.660, P=0.007). Conclusion:TDEC sub-region helps efficiently characterize the rGBM heterogeneity; rGBM imaging phenotypes identified based on TDEC sub-region can independently predict the clinical outcomes: the prognosis of TDEC type I patients is better than that of TDEC type II patients.

Objective To detect the expression of translationally-controlled tumor protein 1(TPT1)in renal cell carcinoma(RCC)and to explore its role in RCC.Methods Microarray dataset GSE15641(including 23 normal kidney tissue samples and 32 RCC tissue samples)was downloaded from the Gene Expression Omnibus,and differentially expressed genes between RCC tissue and normal kidney tissue were screened using R 4.3.0 software.The TPT1 expression in RCC tissue and adjacent non-tumor tissue of 90 patients diagnosed and treated at Affiliated Hospital of Nantong University,as well as in human RCC cells(769-P,786-O,ACHN,and Caki-1)and human embryonic kidney 293 cell(HEK293)was detected by quantitative polymerase chain reaction(qPCR)and Western blotting.The relationship between TPT1 expression and clinical pathological characteristics of RCC patients was analyzed by χ2 test.The clinical data of 522 RCC patients were derived from The Cancer Genome Atlas,and the correlation between TPT1 expression and prognosis of RCC patients was analyzed by receiver operating characteristic(ROC)curve and Kaplan-Meier survival curve.After in vitro transfection of TPT1 small interfering RNA(siRNA)and its negative control(NC)into 786-O and Caki-1 cells,the TPT1 expression was detected by qPCR and Western blotting;the proliferation,migration,and invasion were detected by cell counting kit 8 assay,scratch assay,and Transwell assay,respectively;and the expression of apoptosis-related proteins was detected by Western blotting.Results TPT1 expression was significantly upregulated in the RCC tissue and cells compared with the normal kidney tissue and HEK293 cells(all P＜0.05).The RCC patients with low TPT1 expression levels had significantly smaller tumor size and lower metastasis rate than those with high TPT1 expression levels(both P＜0.05).The ROC curve analysis results indicated that TPT1 had high diagnostic value for RCC(area under curve was 0.856 9,95%confidence interval was 0.804 5-0.909 3,P＜0.001).The Kaplan-Meier survival analysis results showed that the overall survival of RCC patients in the low TPT1 expression group was significantly longer than that in the high TPT1 expression group(P=0.018 4).In the cell experiment,compared with the siRNA NC group,the proliferation activity,scratch healing rate,and invading transmembrane cell number of 786-O and Caki-1 cells were significantly decreased after transfection with TPT1 siRNA(all P＜0.01);the expression levels of B-lymphoma gene 2(Bcl-2)and matrix metalloproteinase-9 were significantly decreased,while the expression of Bcl-2 associated X protein was significantly increased(all P＜0.05).Conclusion TPT1 is involved in the progression of RCC and may be a potential therapeutic target for RCC.

Objective To investigate the clinical significance of dynamic changes in the expression levels of tumor associated autoantibody(TAAB),including tumor protein 53(p53),protein gene product 9.5(PGP9.5),SRY-box containing gene 2(SOX2),G antigen 7 ATP-dependent RNA helicase(GAGE7),ATP-dependent RNA helicase(GBU4-5),melanoma antigen A1(MAGE A1),cancer/testis antigen(CAGE)in non-small cell lung cancer(NSCLC)patients before and after surgery.Methods Forty-one patients with NSCLC who underwent surgical treatment at the Department of Thoracic Surgery of Li Huili Hospital,Ningbo Medical Center,were selected from January 2019 to August 2022.Enzyme linked immunosorbent assay(ELISA)was used to detect the expression levels of seven TAAB markers in the serum of 41 NSCLC patients undergoing surgical treatment.Results The expression levels of PGP9.5 were found to be significantly higher in the squamous cancer group than in the adenocarcinoma group(P<0.05),while the expression levels of GAGE7 were found to be significantly higher in the adenocarcinoma group than in the squamous cancer group(P<0.05).The expression level of GBU4-5 was found to be significantly higher in the squamous carcinoma group than in the adenocarcinoma group at one week after surgery(Z=-2.095,P=0.036).Within the adenocarcinoma group,the expression levels of GBU4-5(P=0.027)and CAGE(P=0.042)were found to be significantly lower at one week after surgery compared with those before surgery.The expression levels of PGP9.5(P=0.004),GAGE7(P<0.001),and GBU4-5(P=0.014)were found to have decreased significantly at six months postoperatively in comparison to their preoperative levels.In the squamous cancer group,no statistically significant differences were observed in the expression levels at one week after surgery.The expression level of SOX2(P=0.011)exhibited a statistically significant decrease at six months postoperatively in comparison to the preoperative levels.Similarly,the expression level of GBU4-5 was found to be significantly decreased at one week postoperatively in comparison to the preoperative levels(P=0.009).The expression levels of PGP9.5(P=0.003),GAGE7(P=0.001),and GBU4-5(P=0.013)were found to have decreased significantly at six months postoperatively.Conclusion Surgical intervention can reduce the expression level of 7 TAABs in NSCLC patients.Monitoring 7 TAABs before and after surgical treatment is helpful to predict the surgical efficacy and postoperative disease progression of NSCLC patients.

Objective To investigate the relationships of serum angiopoietin-like protein 4 (ANGPTL4) and fibroblast growth factor-23 (FGF-23) levels with the severity and prognosis of patients with diabetic nephropathy. Methods A total of 120 patients (diabetic nephropathy group) with diabetic nephropathy were selected from July 2018 to July 2020 and divided into mild group (n=62) and severe group (n=58) according to the staging criteria of diabetic nephropathy; based on the prognosis within 3 years, they were also divided into good prognosis group (n=94) and poor prognosis group (n=26). Additionally, 102 diabetic patients were enrolled as diabetic group, and 81 healthy volunteers were selected as control group. The serum levels of ANGPTL4 and FGF-23 in diabetic nephropathy patients were detected by enzyme-linked immunosorbent assay (ELISA). Logistic regression analysis was used to analyze the influencing factors of prognosis, and receiver operating characteristic (ROC) curves were drawn to analyze the values of ANGPTL4, FGF-23 and their combination in assessing the severity and prognosis of diabetic nephropathy. Results The levels of ANGPTL4 and FGF-23 in the diabetic nephropathy group and simple diabetic group were significantly higher than those in the control group (P < 0.05); compared with the simple diabetic group, the levels of ANGPTL4 and FGF-23 in the diabetic nephropathy group were significantly increased (P < 0.05); the levels of ANGPTL4 and FGF-23 in the severe group were significantly higher than those in the mild group (P < 0.05); the ROC curve analysis revealed that the areas under the curve (AUCs) for assessing disease severity of ANGPTL4, FGF-23 and their combination were 0.748, 0.781 and 0.858 respectively, and the combined diagnosis was significantly better than FGF-23 (Z=2.149, P=0.032) and ANGPTL4 (Z=2.886, P=0.004) alone; the levels of ANGPTL4 and FGF-23 in the good prognosis group were significantly lower than those in the poor prognosis group (P < 0.05); significant differences were observed in diabetes duration, blood urea nitrogen (BUN), serum creatinine (Scr), fasting blood glucose (FBG), glycated hemoglobin (HbA1C), hypertension, ANGPTL4 and FGF-23 levels between diabetic nephropathy patients with different prognoses (P < 0.05); the Scr, ANGPTL4 and FGF-23 levels were all risk factors affecting the prognosis of diabetic nephropathy (P < 0.05); the ROC curve analysis for prognosis assessment showed that the AUCs of ANGPTL4, FGF-23 and their combination were 0.774, 0.795 and 0.874 respectively; the combined diagnosis was significantly better than FGF-23 (Z=2.385, P=0.171) and ANGPTL4 (Z=2.317, P=0.021) alone. Conclusion The serum levels of ANGPTL4 and FGF-23 are significantly increased in diabetic nephropathy patients, and they have certain reference value for the clinical diagnosis and prognosis assessment of diabetic nephropathy patients.