Objective:Proximal femur tumor resection often leads to hip joint instability and functional loss.Various methods have been clinically applied to repair hip joint soft tissue function,but deficiencies remain.This study aims to evaluate the advantages and disadvantages of the ligament advanced reinforcement system(LARS)tumor tube in assisting soft tissue function reconstruction in patients undergoing tumor type artificial hip replacement surgery. Methods:This study included 85 patients(41 males,44 females)with proximal femoral tumors treated at the Xiangya Bone Tumor Treatment Center from January 2012 to January 2022,aged 10 to 79(38.5±18.2)years.Among them,13 cases had benign aggressive tumors,45 had primary malignant bone tumors,and 27 had bone metastases.Clinical data,imaging data,and intraoperative photos were collected.Patients were followed up and postoperative functional evaluations were conducted using the Musculoskeletal Tumor Society(MSTS)scoring system and Harris hip joint scoring system to assess limb function and hip joint function. Results:Preoperative pathological fractures were present in 37 cases(43.5％),with a lesion length of(9.4±2.9)cm.Among non-metastatic tumor patients,7 experienced postoperative recurrence,including 6 cases of osteosarcoma and 1 case of fibrosarcoma.Pulmonary metastases occurred in 9 osteosarcoma patients.Five patients required reoperation due to postoperative complications,including 3 cases of deep vein thrombosis,1 case of giant cell granuloma,and 1 case of prosthesis infection.Postoperatively,5 patients exhibited Trendelenburg gait,and 6 had leg length discrepancies.The postoperative MSTS score was 26.7±1.4,and the Harris score was 89.6±5.3. Conclusion:The LARS tumor tube can effectively assist in reconstructing the soft tissue function of the hip joint and greatly reduce postoperative complications,making it an effective technical improvement in joint function reconstruction in tumor type artificial hip replacement surgery.

Objective:We aimed to develop a novel visualized model based on nomogram to predict postoperative overall survival.Methods:This was a multicenter, retrospective, observational cohort study, including participants with histologically confirmed gastric and colorectal cancer who underwent radical surgery from 11 medical centers in China from August 1, 2015 to June 30, 2018. Baseline characteristics, histopathological data and nutritional status, as assessed using Nutrition Risk Screening 2002 (NRS 2002) score and the scored Patient-Generated Subjective Global Assessment, were collected. The least absolute shrinkage and selection operator regression and Cox regression were used to identify variables to be included in the predictive model. Internal and external validations were performed.Results:There were 681 and 127 patients in the training and validation cohorts, respectively. A total of 188 deaths were observed over a median follow-up period of 59 (range: 58 to 60) months. Two independent predictors of NRS 2002 and Tumor-Node-Metastasis (TNM) stage were identified and incorporated into the prediction nomogram model together with the factor of age. The model's concordance index for 1-, 3- and 5-year overall survival was 0.696, 0.724, and 0.738 in the training cohort and 0.801, 0.812, and 0.793 in the validation cohort, respectively.Conclusions:In this study, a new nomogram prediction model based on NRS 2002 score was developed and validated for predicting the overall postoperative survival of patients with gastric colorectal cancer. This model has good differentiation, calibration and clinical practicability in predicting the long-term survival rate of patients with gastrointestinal cancer after radical surgery.

Objective:To analyze the distribution of pathogenic microorganisms of abdominal infection in patients after pancreaticoduodenectomy and the influencing factors of postoperative abdominal infection.Methods:The clinical data of 108 patients with pancreatic diseases, including ampullary tumors, pancreatic tumors, duodenal tumors, and malignant tumors of the common bile duct, who underwent pancreaticoduodenectomy in Mengchao Hepatobiliary Hospital of Fujian Medical University from May 2019 to December 2022 were retrospectively analyzed. Among them, 65 were males, 43 were females, aged (59.28±17.88) years old. Patients who underwent pancreaticoduodenectomy were categorized into two distinct cohorts based on the occurrence of abdominal infection within a 30-day postoperative period: the infected group ( n=37) and the non-infected group ( n=71).General data, laboratory test indicators, pathogen types and drug susceptibility test results of patients were collected. Logistic regression was used to analyze the influencing factors of postoperative pancreaticoduodenal abdominal infection. Results:The postoperative abdominal infection rate was 34.26% (37/108), and a total of 105 pathogenic bacteria were detected, including 43 gram-negative bacteria (40.95%), 36 gram-positive bacteria (34.29%) and 26 fungi (24.76%). The top five pathogens were Enterococcus faecium, Candida albicans, Stenotrophomonas maltophilia, Pseudomonas aeruginosa and Staphylococcus haemolyticus. The drug sensitivity results showed that no tigecycline and vancomycin-resistant Enterococcus faecium strains. The sensitivity rate of Candida albicans to amphotericin B was 100%, and the resistance rate to fluconazole was only 4.8%. The resistance rates of Stenotrophomonas maltophilia to cefoperazone-sulbactam and levofloxacin are 11.1% and 33.3%, respectively. The resistance rates of Pseudomonas aeruginosa to imipenem and meropenem are 71.4% and 28.6%, respectively. Multivariate logistic regression analysis showed that postoperative intra-abdominal bleeding ( OR=10.997, 95% CI: 1.995-13.840, P=0.004) and pancreatic fistula ( OR=16.832, 95% CI: 1.938-146.174, P=0.010) were risk factors for the occurrence of abdominal infection after pancreatoduodenectomy. Conclusion:Non-fermented gram-negative bacteria, enterococcus and Candida albicans were the main pathogenic microorganisms in abdominal infection after pancreatoduodenectomy, and postoperative abdominal hemorrhage and pancreatic fistula were independent risk factors.

Objective:To study the risk factors of intra-abdominal infection after hepatectomy in patients with primary liver neoplasms.Methods:The clinical data of patients with primary liver neoplasms who underwent hepatectomy at the Department of Hepatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University from January 2019 to December 2021 were retrospectively analyzed. Of 1 229 patients who were enrolled, 48 patients developed postoperative abdominal infection. There were 45 males and 3 females, with age of 58.0 (45.0, 66.0) years old in the infected group. Forth-eight patients without postoperative abdominal infection were selected based on the random number formula to be allocated to the uninfected group to include 44 males and 4 females with age of 58.5 (48.5, 64.8) years old. The general data, preoperative and postoperative laboratory test results, types of liver neoplasms and hepatectomy, pathogenic infective microorganisms and their drug sensitivity tests were collected. Univariate analysis was used to analyze the related factors of intra-abdominal infection after hepatectomy, and significant factors were included in logistic multivariate regression analysis.Results:Of 24 pathogenic strains which were detected in the 143 samples of abdominal infection, the positive rate of culture was 16.78%(24/143). Multivariate logistic regression analysis showed that prealbumin <180 mg/L ( OR=3.757, 95% CI: 1.117-12.634), intraoperative blood transfusion ( OR=6.363, 95% CI: 1.301-31.113) and the time of drainage tube placement ≥7 d ( OR=31.098, 95% CI: 6.906~140.029) were independent risk factors of intra-abdominal infection after hepatectomy. Conclusion:Prealbumin <180 mg/L, intraoperative blood transfusion and the time of drainage tube placement ≥7 d were independent risk factors of intra-abdominal infection after hepatectomy for primary liver neoplasms.

Objective To investigate the effect of IGF1R β subunit mutants sb-IGF1R and ma-IGF1R on the biological behavior of osteosarcoma 143B cells. Methods We designed and constructed sb-IGF1R and ma-IGF1R fragments. They were cloned into adenovirus AdEasy shuttle plasmid, to obtain Ad-sbIGF1R and Ad-maIGF1R. We observed the proliferation, migration and apoptosis of the osteosarcoma cells transfected with Ad-sbIGF1R, Ad-maIGF1R and Ad-IGF1R. The Ad-sbIGF1R, Ad-maIGF1R and Ad-GFP nude mouse models were constructed to evaluate the tumor growth in vitro. Results By plasmid PCR, IGF-1R β subunit mutant was overexpressed in osteosarcoma cells. Ad-sbIGF1R and Ad-maIGF1R significantly inhibited the proliferation and migration of osteosarcoma cells, and promoted cell apoptosis, and inhibited tumor growth in subcutaneous tumor-bearing nude mouse models. Conclusion IGF1R β subunit mutants inhibit the proliferation and migration of osteosarcoma cells and induce cell apoptosis.

Diagnosis, Differential ; Humans ; Lung Neoplasms/genetics* ; Neoplasm Metastasis ; Neoplasms, Multiple Primary/diagnosis*

PURPOSE: The significance of neuroendocrine differentiation (NED) in gastric carcinoma (GC) is controversial, leading to ambiguous concepts in traditional classifications. This study aimed to determine the prognostic threshold of meaningful NED in GC and clarify its unclear features in existing classifications. MATERIALS AND METHODS: Immunohistochemical staining for synaptophysin, chromogranin A, and neural cell adhesion molecule was performed for 945 GC specimens. Survival analysis was performed using the log-rank test and univariate/multivariate models with percentages of NED (PNED) and demographic and clinicopathological parameters. RESULTS: In total, 275 (29.1%) cases were immunoreactive to at least 1 neuroendocrine (NE) marker. GC-NED was more common in the upper third of the stomach. PNED, and Borrmann's classification and tumor, lymph node, metastasis stages were independent prognostic factors. The cutoff PNED was 10%, beyond which patients had significantly worse outcomes, although the risk did not increase with higher PNED. Tumors with ≥10% NED tended to manifest as Borrmann type III lesion with mixed/diffuse morphology and poorer histological differentiation; the NE components in this population mainly grew in insulae/nests, which differed from the predominant growth pattern (glandular/acinar) in GC with <10% NED. CONCLUSIONS: GC with ≥10% NED should be classified as a distinct subtype because of its worse prognosis, and more attention should be paid to the necessity of additional therapeutics for NE components.
Adenocarcinoma ; Chromogranin A ; Classification ; Humans ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Neural Cell Adhesion Molecules ; Prognosis ; Stomach ; Stomach Neoplasms ; Synaptophysin

Purpose Investigating the significance of ZO-1 different domains in the invasion and metastasis of gastric carcinoma (GC).Methods A tissue microarray that simulates the invasion and metastasis process of GC was created,and immunohistochemistry was performed to detect the expression of ZO-1 (α-pan),ZO-1 (α +) and ZO-1 (ZU5).Results The GC cell exhibited aberrant expression of ZO-1 (α-pan),ZO-1 (α +) and ZO-1 (ZU5) from membrane translocated to cytoplasm or no expression.The aberrant degree was increased with the invasion,however,was decreased in metastatic lymph node.The aberrant expression was associated with histological types.Conclusion The aberrant expression of ZO-1 (α-pan),ZO-1 (α +) and ZO-1 (ZU5),from membrane translocated to cytoplasm or no expression suggest that domains of PDZ3,GUK,SH3,ZU5 and alpha motif in ZO-1 might be involved in the invasion and metastasis of GC and maintaining of GC phenotype.The aberrant expression of these domains may be the one mechanism of ZO-1 involved in EMT or MET.

Objective To investigate the effect of resveratrol on murine macrophage cell line (RAW264 .7 cells) polarizing phenotype induced by lipopolysaccharide .Methods RAW264 .7 mouse macrophages seeded in a 6 well plate ,then randomly divided into phosphate buffer saline(PBS) control group ,LPS (100 ng/mL) group ,and LPS (100 ng/mL)+ resveratrol (30 μmol/L) group .In the LPS+ resveratrol group ,LPS was added after incubation with resveratrol for 12 h .Cells were harvested and superna‐tant were collected after incubation with LPS for 12 h .Both the mRNA expression levels of M1 associated markers iNOS and TNF‐αand M2 associated markers IL‐10 ,PPARγ and Arg‐1 were measured by real time quantitative PCR .Expression of iNOS ,Arg‐1 protein were detected by Western blot ,inflammatory factor IL‐12 p40 ,IL‐10 and TNF‐αprotein in the supernatant of were assayed by ELISA .Results PCR detection showed that the mRNA expression levels of M1 associated markers iNOS and TNF‐αin the LPS group were significantly higher than that of LPS+ resveratrol group(P<0 .05) ,but the mRNA expression levels of M2 associated markers IL‐10 ,PPARγand Arg‐1 were significantly lower than that of LPS+ resveratrol group(P<0 .05) .Compared with LPS+resveratrol group ,western blot assay showed that iNOS protein level in LPS group was significantly higher than it (P<0 .05) ,but Arg‐1 protein level was significantly lower than it(P<0 .05) .The levels of IL‐12 p40 and TNF‐αin LPS group were significantly higher than that in LPS+ resveratrol group(P<0 .05) ,but the levels of IL‐10 was significantly lower than it(P<0 .05) .Conclusion Resveratrol may promote LPS stimulated RAW264 .7 macrophage polarization to M2 phenotype .

Objective:To investigate the correlation of Mena protein expression with the invasion and metastasis of Mena SNPs with genetic susceptibility in gastric cancers (GC). Methods:A tissue microarray that simulates the invasion and metastasis process of GC was created, and immunohistochemistry was performed to detect the expression of Mena protein. The Mena gene 5 SNP loci geno-types of 188 healthy people and 389 GC patients were assayed using PCR-based LDR analysis. Results:The expression of Mena pro-tein in GC was significantly upregulated and greatly increased in the intestinal-type and mixed-type GC than that in the diffuse-type and was negatively related to the invasion and metastasis of GC. Patients with Mena overexpression had better prognosis. The frequen-cies of the A and G alleles, as well as the AA, AG, and GG genotypes, at the Mena SNP rs3795443 locus were significantly different be-tween patients with gastric carcinoma and the control groups (OR=2.1489,95%CI 1.4607~3.1613, P<0.01). The frequencies of these five Mena gene SNP loci were not significantly related with the survival of patients with gastric carcinoma. Conclusion:The upregula-tion of Mena expression is involved in maintaining the histological phenotype, invasion, metastasis, and prognosis of gastric adenocarci-noma. Individuals with GG and AG genotypes at the Mena rs3795443 locus have increased risk of gastric carcinoma, which suggests that screening for this genotype would be helpful in assessing the genetic susceptibility of gastric carcinoma.