髋骨性关节炎滑膜组织中钙结合蛋白（S100A12）的表达及意义

目的观察髋骨性关节炎患者血液及滑膜组织中钙结合蛋白S100A12的表达,以探讨它在髋骨性关节炎致病过程中的作用,为揭示髋关节骨性关节炎发病机制提供理论和实验依据。方法收集行髋关节置换的27例髋骨性关节炎患者(OA组)与35例股骨颈骨折患者(对照组);对OA组患者的髋关节X片分析,根据Kellgren-Lawrence(K-L)分级标准对患者进行分级;对两组患者静脉采血,术中取滑膜组织,采用ELISA法定量和免疫组化技术检测S100A12的表达,并采用IPP软件半定量分析免疫组化S100A12的表达量。结果 OA组的血清中S100A12水平(94.20±49.85)ng/m L显著高于对照组含量(25.32±16.87)ng/m L,有统计学差异(P0.01);滑膜组织OA组与对照组S100A12含量分别为(3.73±1.97)ng/mg总蛋白和(1.67±1.21)ng/mg总蛋白(P0.01),差异有统计学意义;免疫组化分析S100A12阳性反应在滑膜微血管内中性粒细胞胞浆中,以及部分滑膜细胞的胞浆内。OA组平均光密度MOD(0.21±0.06)较对照组MOD(0.13±0.05)有显著性差异(P0.01);OA组K-L分级4级患者的血清中S100A12水平(104.81±46.68)ng/m L显著高于3级血清含量(86.85±52.46)ng/m L,有统计学差异(P0.01)。4级患者滑膜组织含量(4.62±1.95)ng/mg总蛋白显著高于3级患者水平(3.13±1.82)ng/mg总蛋白(P0.01)。结论 S100A12在髋骨关节炎患者的滑膜组织表达量显著增加;S100A12的表达与患者髋骨关节炎严重程度相关;S100A12的检测有助于骨性关节炎的诊断,为临床治疗提供参考。     

骨关节炎滑膜组织中uPA、uPAR、PAI-1mRNA及蛋白的表达及其临床意义

目的 检测尿激酶型纤溶酶原激活物（uPA）、其受体（uPAR）、其抑制剂（PAI-1）mRNA及蛋白在骨关节炎（OA）滑膜中的表达,探讨uPA、uPAR及PAI—1在OA细胞外基质降解中的作用。方法采用RT—PCR及免疫组化检测36例OA（实验组）和21例正常（对照组）滑膜组织中uPA、uPAR、PAI-1mRNA及蛋白的表达情况。结果经RT—PCR及免疫组化实验,实验组与对照组间3种mRNA及蛋白表达差异均有显著性（P〈0．05）;再将实验组按年龄及软骨破坏程度分组,按年龄分组3种mRNA及蛋白表达差异均无显著性（P〉0．05）;按软骨破坏程度分组3种mRNA及蛋白表达差异均有显著性（P〈0．05）。结论OA滑膜组织存在高水平uPA、uPAR、PAI—1mRNA及蛋白的表达,提示在OA的发生发展过程中,uPA、uPAR及PAI-1起着重要作用,为骨关节炎的治疗提供了一个崭新的思路。     

血清和关节液中钙结合蛋白（S100A12)的水平与膝关节骨关节炎严重程度的相关性分析

目的探讨患者关节液和血清中钙结合蛋白(S100A12)浓度和膝关节骨性关节炎严重程度相关性,以评估它在骨性关节炎(osteoarthritis,OA)发病中的作用。方法 40例骨性关节炎(OA组)与40例需关节镜手术的半月板、韧带损伤的患者及行髓内钉固定的股骨及胫骨骨折患者(对照组);对两组患者静脉采血及取关节液,采用ELISA法测S100A12含量;采用Kellgren-Lawrence(K-L)标准对膝关节X线片进行评估分级。结果 OA组的血清中S100A12水平(35.10±26.43)ng/ml显著高于对照组含量(22.13±15.67)ng/ml,有统计学差异(P=0.026);OA组关节液S100A12含量(14.09±8.08)ng/ml显著高于对照组关节液中的含量(9.30±6.85)ng/ml(P=0.02)。OA组血清中的S100A12水平显著高于关节滑液中的水平(P0.01)。关节液中的S100A12含量和血液中的S100A12水平显著正相关(r=0.42,P=0.02),但相关关系并不密切。OA组关节滑液中S100A12与K-L分级成正相关(r=0.65,P0.01)。血清中的S100A12与K-L分级关联不显著(r=0.29,P=0.24)。结论 S100A12在OA患者的血液及关节液中都有表达;关节液的S100A12表达与患者骨关节炎严重程度成正相关;检测关节液中的S100A12有助于骨性关节炎的早期诊断,提示病变严重程度,为临床治疗提供参考。     

人骨肉瘤中S100A6蛋白的表达及其意义

目的观察人骨肉瘤中S100A6蛋白的表达,探讨其与肿瘤转移的关系以及对预后的影响。方法采用免疫组织化学技术对30例骨软骨瘤和60例骨肉瘤石蜡包埋标本进行检测,对9例骨软骨瘤和7例骨肉瘤泳冻标本进行Western-blot检测,分析其表达与转移和预后的关系。结果与骨软骨瘤（10％）相比,S100A6蛋白显著表达于人骨肉瘤（85％）中（P〈0．01）,其表达与性别、肿瘤的分期、分型无关（P〉0.05）,而与肿瘤的转移（P〈0．05）和术后生存时间（P〈0．01）密切相关。结论S100A6蛋白选择表达于骨肉瘤中,可作为肿瘤的早期诊断标志之一,也是判断骨肉瘤转移和预后的重要指标。     

不同阶段骨关节炎滑膜组织中肾素、血管紧张素转换酶及血管紧张素受体1、2的表达研究

目的研究不同阶段骨关节炎滑膜组织中的肾素(Renin)、血管紧张素转换酶(angiotensin converting enzyme,ACE)、血管紧张素受体1(angiotensin receptor 1,AT1R)和AT2R的表达差异。方法以2018年1月-12月因创伤行膝上截肢术、骨关节炎行人工全膝关节置换术的患者作为研究对象。共32例患者符合选择标准纳入研究,根据Kellgren-Lawrence(K-L)X线分级标准分为正常滑膜组(A组,9例)、中度骨关节炎滑膜组(B组,11例,K-L 3级)及晚期骨关节炎滑膜组(C组,12例,K-L 4级)。采用实时荧光定量PCR及Western blot检测各组滑膜组织中Renin、ACE、AT1R、AT2R mRNA及蛋白相对表达量。结果B、C组Renin、ACE、AT1R mRNA及蛋白相对表达量明显高于A组,C组ACE、AT1R mRNA及蛋白相对表达量以及Renin蛋白相对表达量明显高于B组;而B、C组AT2R mRNA及蛋白相对表达量明显低于A组,C组低于B组;上述指标组间比较差异均有统计学意义(P<0.05)。结论随骨关节炎严重程度增加,关节滑膜组织中Renin、ACE、AT1R表达明显高于正常人群,AT2R表达量呈下降趋势,提示上述指标与骨关节炎发展相关。     

胃肠道间质瘤组织S100A4、Slingshot-1表达与临床病理特征及预后关系

目的 ：探讨胃肠道间质瘤组织S100钙结合蛋白A4(S100A4)、弹弓酶-1(Slings hot-1)表达情况及与患者临床病理特征及预后的关系。方法：2010年1月至2014年6月，胃肠道间质瘤患者115例切除的瘤组织和瘤旁正常组织样本，采用实时定量PCR(RT-PCR)检测组织样本中S100A4、Slings hot-1的表达，分析其与临床病理特征的关系，Kaplan-Me ie r生存曲线评估S100A4、Slings hot-1表达与患者术后5年总生存率的关系，Cox回归模型分析胃肠道间质瘤患者预后的影响因素。结果：胃肠道间质瘤组织S100A4、Slingshot-1相对表达量均高于瘤旁正常组织（P均<0.05）；胃肠道间质瘤组织S100A4表达与肿瘤直径、浸润深度、NIH危险度、远处转移有关（P均<0.05）,Slings hot-1表达与浸润深度、NIH危险度、远处转移有关（P均<0.05）。Kaplan-Meier生存分析表明，S100A4高表达者、Slings hot-14高表达者的术后5年总生存率均分别低于S100A4低表达者、Slings hot...     

多囊肾组织中P21蛋白的表达及其临床意义

目的:研究P21蛋白在正常肾组织、重度积水肾组织及多囊肾组织中的表达,探讨P21蛋白与卵巢上皮性癌临床病理特征的关系。方法:选取手术切除的组织标本,其中正常肾组织组10例、重度积水肾组织组10例和多囊肾组织组38例。采用免疫组织化学法染色,检测上述3组患者组织中P21蛋白的表达情况。结果:P21蛋白在多囊肾组织中的表达率明显低于在正常肾组织、重度积水肾组织(P<0.05)。结论:P21蛋白的低表达可能是诱发多囊肾的发生发展原因之一。     

前列腺癌组织中PTEN、E-Cadherin蛋白的表达及意义

目的　探讨与张力蛋白在 10号染色体同源缺失的磷酸酶 (PTEN)、上皮细胞钙黏素 (E Cad)在前列腺癌组织中的表达及其临床意义。方法　应用免疫组织化学 (SP)方法检测 4 2例前列腺癌、3例正常前列腺组织和 7例良性前列腺增生组织中PTEN、E Cad蛋白的表达。结果　前列腺癌组织中PTEN蛋白表达的阳性率为 2 6 .1% (11/ 4 2 ) ,E Cad蛋白表达的阳性率为 5 0 .0 %(2 1/ 4 2 ) ;随肿瘤细胞病理分级、临床分期程度的增高 ,癌细胞表达PTEN、E Cad蛋白阳性率降低 ,各组间比较差异有显著性 (P<0 .0 1或P <0 .0 5 ) ;正常前列腺组织和良性前列腺增生组PTEN、E Cad蛋白均呈阳性免疫反应。结论　PTEN、E Cad蛋白异常表达在前列腺癌的恶性进展中起重要作用 ,检测PTEN、E Cad蛋白表达有利于判断病期及预后。     

食管、贲门癌组织中P53基因蛋白过度表达及其生物学意义

目的研究食管癌、贲门癌组织中Ｐ５３基因蛋白表达情况及其意义。方法采用免疫组织化学ＡＢＣ法检测了６０例食管癌、贲门癌组织中Ｐ５３基因蛋白表达情况，并结合肿瘤的某些病理特点如分化程度、ＴＮＭ分期等进行了分析。结果Ｐ５３基因蛋白过度表达的阳性率高分化组（７５％）与中（９６．９％）、低（１００％）分化组之间差异显著（Ｐ＜０．０１）。食管癌，Ⅱ期与Ⅲ期的Ｐ５３基因蛋白过度表达的阳性率分别为９５．７％和９２．３％；贲门癌，Ⅰ期、Ⅱ期、Ⅲ期阳性率分别为６６．７％、１００％和９３．３％，经检验，食管癌、贲门癌组织中Ｐ５３基因蛋白过度表达与肿瘤ＴＮＭ分期之间无差异（Ｐ＞０．０５）。结论随着肿瘤分化程度的降低，Ｐ５３基因蛋白过度表达的阳性率将增高，Ｐ５３基因蛋白有可能成为判断食管癌、贲门癌恶性程度的指标之一；ｐ５３基因突变及Ｐ５３基因蛋白过度表达不仅出现在食管癌、贲门癌发生、发展的晚期阶段，而在早期阶段就已存在并起作用。     

A型肉毒素对大鼠皮肤中神经肽SP、CGRP及创面组织表达TGF-β1和α-SMA的影响

目的研究A型肉毒素（BTA）对皮肤神经末梢释放的神经肽SP、CGRP的影响及其对皮肤创伤愈合的意义。方法40只SD大鼠随机分为C组（空白对照组）和E组（肉毒素注射组）,20只／组。肉毒素A预注射后7d,在鼠背部建立以4个注射点为中心的创面模型,面积1cm×1cm。测量术后3d和7d的创面面积。实时定量PCR（Real—time PCR）检测BTA注射后第7天（术前）和创面愈合后（术后14d）的皮肤组织中感觉神经肽P物质（SP）、降钙素基因相关肽（CGRP）以及创伤愈合中的重要分子TGF—β1和α—SMA的mRNA表达。结合免疫组化和图像分析技术检测切片中上述4种物质阳性染色的积分光密度OD值。结果①各组创面于术后14d基本愈合。与C组相比,E组术后3d、7d的创面面积无差异（P〉0．05）;②E组术前和术后14d的皮肤组织中SP、CGRP、TGF—β1和α—SMA的mRNA表达和OD值较C组明显降低,差异有统计学意义（P〈0．05）。结论①局部皮下注射BTA不影响创面愈合的时间和速度;②BTA能减少创面愈合过程中皮肤神经末梢对SP、CGRP的释放和创面愈合过程中TGF—β1和α-SMA的表达。     

DLL4和S100A4在不同分子亚型乳腺癌组织中的表达及意义

目的 分析Delta样配体4(Delta-like ligand 4,DLL4)及S100钙结合蛋白A4 (S100 calcium binding protein A4,S100A4)在不同乳腺癌分子亚型组织中的表达并讨论其临床意义.方法 采用免疫组织化学SP法检测十堰市太和医院Luminal A型乳腺癌组织51例、Luminal B型乳腺癌组织26例、HER-2过表达型乳腺癌组织17例、基底细胞样型乳腺癌组织14例和乳腺癌癌旁组织40例中DLL4和S100A4的表达情况,并分析其与乳腺癌临床病理特征之间的关系.结果 在乳腺癌组织中,DLL4和S100A4的表达阳性率分别为67.6％ (73/108)和62.0％ (67/108),均高于其在癌旁组织中的表达阳性率[22.5％ (9/40),45.0％ (18/40)],P＜0.05.在不同乳腺癌分子亚型组织中,HER-2过表达型和基底细胞样型乳腺癌组织中DLL4和S100A4的表达阳性率均高于LuminalA型和LuminalB型(P＜0.05).有淋巴结转移的乳腺癌患者,DLL4和S100A4呈高表达(P＜0.05).乳腺癌组织中DLL4表达与S100A4表达呈正相关关系(rs=0.217,P＜0.01).结论 DLL4和S100A4在基底细胞样型和HER-2过表达型乳腺癌组织中呈高表达,与预后相关.DLL4和S100A4共同参与乳腺癌的发生、发展以及浸润转移过程.临床联合检测两种蛋白表达可评估乳腺癌的潜在转移和预后.     

Aggrecan and Cartilage Oligomeric Matrix Protein in Serum and Synovial Fluid of Patients with Knee Osteoarthritis

Aggrecan and cartilage oligomeric matrix protein (COMP) which are important degradation products of articular cartilage may be promising diagnostic markers in serum and/or synovial fluid for diagnosis of knee osteoarthritis (OA). Our objective was to measure serum and synovial fluid levels of aggrecan and COMP in patients with OA of the knee joint to find out if they could be of diagnostic value in OA and if their levels correlate with the clinical and radiological manifestations of the disease. Sixty-six patients suffering from primary knee OA with effusion (26 males and 40 females) were studied. Twenty individuals (six males and 14 females) with recent traumatic knee effusion matched for age and sex were chosen to serve as a control group. All subjects had thorough clinical and radiological (X-ray and MRI) evaluation. Aggrecan and COMP in serum and synovial fluid were measured by ELISA. Serum and synovial fluid aggrecan and COMP levels were significantly higher than the control. Serum and synovial fluid aggrecan and COMP levels were positively correlated with age, body mass index, disease duration, plain X-ray and MRI scores. In OA, serum and synovial fluid aggrecan and COMP levels are elevated and represent useful markers in the diagnosis. Moreover, these elevated levels positively correlated with radiological joint damage but not with clinical disease parameters. These markers have the potential to be used for monitoring articular cartilage destruction and response to different therapeutic modalities.     

玻璃酸钠对骨关节炎患者膝关节液中miR-140表达的影响

目的玻璃酸钠治疗不同Kellgren-Lawrence分级骨关节炎患者,了解治疗前后膝关节液中微小RNA-140(microRNA-140,miR-140)的表达变化,为更好的论证miR-140与骨关节炎之间的因果关系打下基础。方法分别收集玻璃酸钠治疗不同Kellgren-Lawrence分级膝关节骨关节炎患者前、后关节液各40例,共80例(Ⅰ级组治疗前后各10例、Ⅱ级组治疗前后各10例、Ⅲ级组治疗前后各10例、Ⅳ级组治疗前后各10例),所有患者治疗前后均进行HSS评分。应用实时荧光定量聚合酶链反应,检测玻璃酸钠治疗前、后关节液中miR-140的表达。以U6snRNA为内参,求出每个样本的Ct值。结果与治疗前相比,HSS评分、miR-140表达量均升高,Ⅰ级组、Ⅱ级组、Ⅲ级组治疗前后HSS评分、miR-140表达量差异有统计学意义(P0.05),Ⅳ级组治疗前后HSS评分、miR-140表达量差异无统计学意义(P0.05),Ⅳ级组HSS评分、miR-140的表达量与前三组比较,差异有统计学意义(P0.05);骨关节炎的不同分级与miR-140的表达量增加水平呈负相关(r=-0.825,P0.05)。结论轻中度骨关节炎通过关节腔注射玻璃酸钠治疗,疗效肯定;玻璃酸钠对不同分级骨关节炎患者治疗前后膝关节液中的miR-140表达水平上调,并且和骨关节炎不同分级呈负相关,miR-140可能作为新的治疗手段以及判断预后,可能参与骨关节炎的发病机制中起着重要作用。     

S100A12在重症急性胰腺炎治疗中的潜在作用

目的探讨钙结合蛋白S100A12在小鼠重症急性胰腺炎治疗中的潜在作用。方法采用连续7次腹腔注射雨蛙素50μg/kg(每次间隔1 h)及脂多糖建立小鼠急性胰腺炎模型。将160只SPF级雌性ICR小鼠随机分为对照组(A组,生理盐水)、轻型组(B组,雨蛙素)、重症组(C组,雨蛙素+脂多糖)、干预组(D组,S100A12重组抗体+雨蛙素+脂多糖),每组40只。在首次注射雨蛙素后8 h、12 h和24 h采血,分别检测各时段血清中S100A12、淀粉酶(AMY)、C反应蛋白(CRP)、白介素(IL-1β、IL-6)、肿瘤坏死因子(TNF-α)的含量,观察小鼠胰腺的病理形态并进行评分。结果与C组相比,D组各时段血清中AMY、CRP、IL-1β、IL-6、TNF-α、S100A12含量明显降低(P0.05);与B组相比,D组各时段血清S100A12浓度明显降低(P0.05),胰腺病理形态也有明显改善。结论 S100A12重组抗体能够有效降低小鼠急性胰腺炎的严重程度,S100A12可以作为重症急性胰腺炎治疗的一个有效靶点。     

Cellular and epigenetic features of a young healthy and a young osteoarthritic cartilage compared with aged control and OA cartilage

Osteoarthritis (OA) is generally a disease of the elderly population, but can occur in young patients in exceptional cases. This study compares the cellular and epigenetic features of primary old‐age OA with those of secondary OA in a 23‐year‐old patient with developmental dysplasia of the hip. In addition, control cartilage from a 14‐year‐old was compared with that from patients with a fracture of the neck of femur (#NOF) to establish to what extent the latter is a useful control for OA. Articular cartilage was obtained from discarded femoral heads after hip arthroplasty. MMP‐3, MMP‐9, MMP‐13, and ADAMTS‐4 were immunolocalized and the methylation status of specific promoter CpG sites was determined. Both primary and secondary OA were characterized by loss of aggrecan, formation of clones, and abnormal expression of the proteases that correlated with epigenetic DNA demethylation. The latter indicated that the abnormal expression of the cartilage‐degrading proteases was not due to a short‐term up‐regulation, but a heritable, permanent alteration in gene expression. Comparing cell densities in young and old control cartilage estimated an age‐related cell loss of ∼1% per year. In aged #NOF cartilage, some superficial‐zone chondrocytes expressed the proteases, but the majority of cells were immunonegative and their promoters were hypermethylated. The cellular and epigenetic features of the intermediate and deep zones of #NOF cartilage are thus similar to those of young healthy cartilage, justifying the use of #NOF cartilage as control cartilage for OA, providing the superficial zone is removed. © 2008 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 27: 593–601, 2009     

SP和CGRP在大鼠牙髓组织中的分布及意义

目的：研究大鼠牙髓组织中神经肽SP和CGRP免疫阳性神经纤维的分布及意义。方法：利用免疫组织化学方法对大鼠牙髓组织切片进行染色，在显微镜下观察SP和CGRP免疫阳性神经纤维的分布。结果：SP阳性神经纤维分布在牙髓组织，并主要伴随在血管周围，CGRP阳性神经纤维与SP阳性神经纤维分布类似，但数量较多。结论：CGRP与SP在牙髓组织中分布类似，可能包含在同一种神经纤维中，二者协同作用，调节牙髓血管的血流分布。     

组织芯片检测Claudin-3在前列腺癌中的表达

目的：检测Claudin-3在前列腺癌中的表达情况,探讨其与前列腺癌发生发展的关系。方法：采用组织芯片技术构建包含64例前列腺癌和39例前列腺增生组织的64点阵石蜡组织芯片,用免疫组化sP法检测该芯片中Claudin-3的表达,分析其与前列腺癌Gleason评分和临床分期的关系。结果：前列腺癌Claudin-3阳性表达率为60．94％（39／64）,前列腺增生表达率17．95％（7／39）（P〈0．05）;Claudin-3与前列腺癌Gleason评分和临床分期明显相关。结论：Claudin-3异常表达与前列腺癌发生发展有密切关系。     

Diagnostic and Prognostic Significance of Serum and Tissue Galectin 3 Expression in Patients with Carcinoma of the Bladder

Background

Galectins are group of proteins found in the cytoplasm, nucleus, cell surface and extracellular matrix. Galectin 3 (Gal-3) displays pathological expression in a variety of processes such as tumorigenesis.

Patients and Method

70 patients classified into the control group, cystitis group, transitional cell carcinoma group, and squamous cell carcinoma group were enrolled in this study which aimed to detect the serum level and the intensity of tissue expression of Gal-3.

Results

Both serum level and tissue expression of Gal-3 were statistically higher in bladder cancer patients compared to the other groups. Gal-3 level expression increased from low to high grade urothelial tumors, with a statistically significant increase of its level and expression between muscle invasive and non-muscle invasive Ta urothelial tumors.

Conclusion

The serum Gal-3 level is sensitive and specific for the diagnosis of bladder cancer. The prognostic significance of tissue expression is to be confirmed.Key Words: Galectin 3, Bladder cancer, Transitional cell carcinoma, Squamous cell carcinoma, Schistosomiasis     

S100钙结合蛋白A13和人成纤维细胞生长因子-1在甲状腺肿瘤中的表达及临床意义

目的 检测S100钙结合蛋白A13(S100A13)和人成纤维细胞生长因子-1(FGF-1)在甲状腺癌、甲状腺腺瘤、正常甲状腺组织中的表达,探讨两者与甲状腺癌发生发展的关系.方法 采用免疫组织化学链霉菌抗生物素蛋白-过氧化物酶(SP)方法检测甲状腺癌、甲状腺腺瘤、正常甲状腺组织中两者的表达,比较两者在两种不同组织中的表达.结果 甲状腺癌组织中,S100A13的表达阳性率为93.3％(56/60),在甲状腺腺瘤组织中S100A13的表达阳性率为66.7％ (20/30),在正常甲状腺组织中的表达阳性率为60.0％(12/20),S100A13在甲状腺癌组织的表达阳性率明显高于甲状腺腺瘤及正常甲状腺组织,差异有统计学意义(P＜0.05),但是在甲状腺腺瘤及正常甲状腺组织中其表达差异无统计学意义(P＞0.05);FGF-1在甲状腺癌组织中的表达阳性率为81.7％(49/60),在甲状腺腺瘤组织中FGF-1的表达阳性率为63.3％(19/30),在正常甲状腺组织中的表达阳性率为55.0％(11/20),FGF-1在甲状腺癌组织的表达阳性率明显高于甲状腺腺瘤及正常甲状腺组织,差异有统计学意义(P＜0.05),但是在甲状腺腺瘤及正常甲状腺组织中其表达差异无统计学意义(P＞0.05);S100A13与FGF-1表达阳性与甲状腺癌的淋巴结转移相关(P＜0.05).结论 S100A13与FGF-1与甲状腺癌的发生及发展密切相关.     

Development of a DDH Care Pathway for India: A Study Methodology to Guide Similar Efforts in Other Countries and for Other Conditions

PurposeIn India and other Global South countries, developmental dysplasia of the hip (DDH) is often diagnosed after walking age, leading to more invasive surgeries and long-term disability. DDH care pathways aim to enhance early detection and must be tailored to meet a country’s needs and diverse practice settings. We describe a multi-phase methodology for context-specific DDH care pathway development, demonstrating its use in India.MethodsIn Phase I, Orthopaedic surgeons, Pediatricians/Neonatologists, and Radiologists in India were surveyed regarding DDH screening. Seven relevant Indian organizations partnered together and assembled a multidisciplinary working group, which then met fortnightly to establish an evidence base and prepare for the subsequent consensus-building phase. During Phase II, panelists participated in a modified Delphi process to reach consensus on a list of DDH screening statements. Phase III applied the statements to develop the care pathway.ResultsThe Delphi process concluded after a preliminary survey and two Delphi rounds, reaching consensus on 47 statements, which were condensed into 35. The developed care pathway for India features periodic clinical hip examinations integrated with the country’s immunization schedule and selective imaging screening, providing flexibility in the timing and modality of imaging.Discussion/ConclusionIn Global South countries, there is a need for DDH care pathways specific to local contexts. Successful care pathway development requires accounting for cultural differences in healthcare and strategies to facilitate engagement and to address country-specific barriers. This methodology was feasible in India and can be applied to other conditions and/or countries wishing to establish care pathways.Level of EvidenceLevel III.