Hepatectomy has become the most important treatment method for hepatobiliary diseases.The perioperative management of hepatectomy is closely related to its safety and efficacy.Perioperative management includes systematic evaluation and management of the patient′s condition before,during,and after surgery,and its principles and methods have developed rapidly in recent years.In 2017,the Group of Liver Surgery of Surgical Society of Chinese Medical Association released the "Expert Consensus on Perioperative Management of Hepatectomy".On this basis,the editorial committee has reviewed existing evidence-based medicine research evidence,combined with the latest clinical practice experience of numerous liver surgery centers at home and abroad,organized a multidisciplinary expert team in relevant fields in China for discussion,and revised to formulate the guideline.This guideline covers a systematic assessment,treatment principles,and methods for relevant conditions before,during,and after hepatectomy,and provides specific recommendations.The revision of the guidelines aims to promote the standardization and refinement of clinical practice in this field,improve the safety and clinical efficacy of liver resection,and provide guidance and reference for clinical professionals related to liver surgery.

In recent years, clinical decision-making system has been developed and refined by incorporating patient's characteristics,tumor markers,clinlabomics and radiomics and has served a complementary role with classic hepatocellular carcinoma clinical staging systems among therapeutic choices of hepatocellular carcinoma during past decade.With the promotion of liver cancer screening programs, increasing patients with very early or early-stage hepatocellular carcinoma may attain upfront cure by partial liver resection,transplantation or local ablation.Advanced hepatocellular carcinoma with vascular invasion has been identified as inappropriate candidates of upfront curative therapies among several cohorts and clinical practice consensus.A heterogenous proportion of intermediate stage hepatocellular carcinomas have been reported to attain upfront cure with usually short recurrence-free survival (RFS) among several prospective cohorts.An unneglectable of patients with advanced stage hepatocellular carcinomas has been reported to subsequent curative resection after downstaging by conversion therapies.Subsequent resection after neoadjuvant therapies have improved the RFS and overall survival of patients with intermediate hepatocellular carcinoma.

Surgical resection remains the primary option for achieving radical cure and long-term survival in the treatment of liver cancer.In recent years,profound changes have taken place in the field of liver surgery:the surgical concept of liver resection for liver cancer has been constantly updated;Significant progress has also been made in many aspects such as liver imaging technology,liver resection techniques and equipment,and perioperative management.Liver resection for liver cancer has gradually developed into a more precise,minimally invasive and safer treatment model.However,liver resection for liver cancer still faces many new challenges up to now:the prevention strategies for recurrence and metastasis are limited;There is a lack of predictive indicators for the efficacy of targeted immunotherapy.Insufficient precision in individualized treatment,etc.

Hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT) have a short survival time and an extremely poor prognosis,with more than half of all HCC cases complicated by PVTT.In the past,various local therapies or direct surgical strategies were often adopted for HCC patients with PVTT,but ideal outcomes were difficult to achieve.Currently,there is a general consensus on the efficacy and safety of immune checkpoint inhibitors combined with tyrosine kinase inhibitors as a conversion therapy regimen for advanced HCC.Our team has explored and developed a sequential surgical treatment protocol combining immune targeting and conversion.We believe that compared to existing treatment approaches,this strategy significantly prolongs the overall survival of HCC patients with PVTT and has the potential to become a new treatment paradigm.This article details the efficacy of the sequential surgical treatment protocol combining immune targeting and conversion for HCC patients with PVTT,as well as key surgical considerations,with the aim of sharing relevant experience.

Objective To analyze the effect of LINC00894 on the malignant biological behavior of liver cancer cells by regulating the microRNA(miR)-495-3p/RAS associated binding protein 23(Rab23) axis.Methods Cancer and adjacent tissues of 53 patients with liver cancer who undergoing surgery from January 2023 to November 2023 were collected.Real-time fluorescence quantitative polymerase chain reaction(qRT-PCR) was used to detect the expression of LINC00894,miR-495-3p and Rab23 in tissues and in vitro cultured cells Huh7,SMMC-7721,HepG2 and L-02.Cells Huh7 were randomly separated into Huh7 group,NC group,si-LINC00894 group,anti-NC group,and anti-miR-495-3p group.CCK-8,flow cytometry and Transwell were used to compare the cell proliferation, apoptosis,migration and invasion of each group.Western blot was used to detect the expression of Rab23 and proliferation-related proteins in cells.The relationship between LINC00894 and miR-495-3p,miR-495-3p and Rab23 was analyzed and verified by dual luciferase reporter gene assay.Results The mRNA and protein expression of LINC00894 and Rab23 were higher in cancer tissues and cells of liver cancer patients,while the mRNA expression of miR-495-3p was lower(P<0.05).The apoptosis rate of si-LINC00894 group was higher than that of Huh7 group and NC group,and the absorbance at 24 h,48 h,and 72 h,numbers of migrating and invading cells,and expression of Rab23 in cells were lower than those in Huh7 group and NC group(P<0.05);the absorbance at 24 h,48 h,and 72 h,numbers of migrating and invading cells,and expression of Rab23 in cells in the anti-miR-495-3p group were higher than those in the anti-NC group and si-LINC00894 group,the apoptosis rate of cells was lower than that in the anti NC group and si-LINC00894 group(P<0.05).The luciferase activity in the WT-LINC00894+miR-495-3p group was lower than that in the WT-LINC00894+miR-NC group(P<0.05),the luciferase activity in the WT-Rab23+miR-495-3p group was lower than that in the WT-Rab23+miR-NC group(P<0.05).Conclusion Downregulation of LINC00894 can promote the expression of miR-495-3p,inhibit the expression of Rab23,and thus exert the inhibitory effect on the malignant biological behavior of liver cancer cells.

Objective To investigate the expression and clinical significance of serum microRNA-144-3p (miR-144-3p) and microRNA-126-3p (miR-126-3p) in patients with intracerebral hemorrhage (ICH).Methods From February 2022 to April 2023,120 ICH patients who underwent treatment at our hospital were recruited as the ICH group.They were separated into a good prognosis group and a poor prognosis group based on the modified Rankin Scale (mRS) score After 6 months treatment Additionally,110 healthy individuals who underwent physical examination at our hospital were included as the control group.Clinical data of patients were collected and analyzed.Enzyme linked immunosorbent assay (ELISA) was applied to detect serum levels of tumor necrosis factor-α (TNF-α) and vascular endothelial growth factor (VEGF) indicators.Real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was applied to detect the expression levels of serum miR-144-3p and miR-126-3p.Pearson method was applied to analyze the correlation between serum miR-144-3p,miR-126-3p,TNF-α,and VEGF levels in ICH patients.Multivariate Logistic regression was applied to analyze the factors affecting the prognosis of ICH patients.ROC curve was applied to analyze the predictive value of serum miR-144-3p and miR-126-3p for the prognosis of ICH patients.Results In the control group, the serum miR-144-3p was 1.02±0.02, the TNF-α was (19.15±6.79) pg/ml, the VEGF level was (1.05±0.18) ng/ml, and the serum miR-126-3p level was 1.04±0.05. The values in the ICH group were 2.12±0.23, (48.32±8.43) pg/ml, (6.56±1.49) ng/ml, and (0.53±0.12), respectively. There was a statistically significant difference between the two groups (P< 0.05).Pearson analysis results showed that serum miR-144-3p was positively correlated with TNF-α and VEGF levels in ICH patients (r=0.496,0.542,P<0.05),while serum miR-126-3p was negatively correlated with TNF-α and VEGF levels (r=-0.493,-0.526,P<0.05).There were significant differences in the serum levels of miR-144-3p,miR-126-3p,TNF-α,VEGF,and NIHSS score between different prognostic groups (P<0.05).Multivariate Logistic analysis revealed that serum miR-144-3p,miR-126-3p,TNF-α,and VEGF were all factors affecting the poor prognosis of ICH patients (P<0.05).The area under the curve (AUC) of serum miR-144-3p,miR-126-3p,and combined prediction of prognosis in ICH patients was 0.851,0.886,and 0.952,respectively,the combined prediction of the two was more valuable (Z_{combination-miR-144-3p}=3.371,Z_{combination-miR-126-3p}=2.791,P<0.05).Conclusion The expression of miR-144-3p in the serum of ICH patients increases,while the expression of miR-126-3p decreases.The two may serve as biological markers for predicting the prognosis of ICH patients,and the combination of the two is more valuable in predicting the prognosis of ICH patients.

Objective To explore the early diagnostic value of serum heat shock protein 70 (HSP70),periosten combined with low-dose spiral CT (LDCT) for lung cancer.Methods From July 2022 to June 2024,103 lung cancer patients admitted to our hospital were regarded as the lung cancer group,and 87 patients with benign pulmonary nodules were selected as the benign group.ELISA kit was used to measure serum HSP70 and Periostin.Multivariate Logistic regression was applied to analyze the influencing factors of lung cancer.Four grid table method was applied to calculate the sensitivity,specificity,and accuracy of LDCT combined with serum HSP70 and Periostin in the diagnosis of lung cancer.Kappa test was applied to evaluate the consistency between LDCT,serum HSP70,Periostin combined with LDCT and pathological diagnosis of lung cancer.Results Compared with the benign group,the lung cancer group had greatly higher levels of serum HSP70 and Periostin (P<0.05).Compared to the benign group,the lung cancer group had higher proportions of lobulation and spiculation signs (P<0.05).Multivariate Logistic regression showed that HSP70 (OR=1.569),Periostin (OR=1.427),lobulation sign (OR=2.015),and spiculation sign (OR=1.946) were all independent risk factors for lung cancer (P<0.05).The sensitivity,specificity,and accuracy of LDCT in diagnosing lung cancer were 85.44%,88.51%,and 86.84%,respectively;the sensitivity,specificity,and accuracy of serum HSP70 and Periostin combined with LDCT in diagnosing lung cancer were 93.20%,80.46%,and 87.37%,respectively.Kappa test showed that the consistency between serum HSP70,Periostin combined with LDCT had high consistency with pathology in the diagnosis of lung cancer (Kappa value=0.743).Conclusion The serum levels of HSP70 and Periostin are higher in lung cancer patients.The combination of serum HSP70 and Periostin with LDCT has better diagnostic efficacy for lung cancer.

Objective To explore the effects of preoperative transcatheter arterial chemoembolization (TACE) on early postoperative recurrence in the China liver cancer (CNLC) staging Ⅰb-Ⅱa patients with primary hepatocellular carcinoma.Methods The data of patients with CNLC Ⅰb-Ⅱa stage hepatocellular carcinoma who underwent curative liver resection in Xiangyang Central Hospital from May 2017 to May 2022 were retrospectively analyzed.A total of 76 patients were included,patients were divided into preoperative TACE group (n=32) and surgery group (n=44) according to whether they underwent preoperative TACE.Observe the postoperative recovery of patients.Combined with the postoperative pathological results,adjuvant TACE treatment is performed.Regular reexamination and follow-up are conducted after discharge.The Kaplan-Meier method was used to estimate survival time,calculate 95%CI,and plot the Disease-free (DFS) survival curve.The Cox proportional risk model was used for univariate and multivariate analysis.Results The 1-year disease-free survival rate in the preoperative TACE group was higher than that in the direct surgery group (96.9% vs. 84.1%,P>0.05).The 2-year disease-free survival rate in the preoperative TACE group was higher than that in the direct surgery group (90.6% vs. 70.5%,P<0.05).The disease-free survival of the preoperative TACE group was higher than the direct surgery group (23.03 months vs. 20.14 months,P<0.05).The incidence of treatment-related adverse events after surgery in the preoperative TACE group was higher than that in the direct surgery group (34.4% vs. 20.5%,P>0.05).Multivariate Cox regression analysis showed that different treatment methods,tumor number ≥ 2,and tumor microvascular invasion were prognostic factors affecting tumor recurrence.No severe adverse reactions occurred in either group,and no deaths caused by adverse reactions were observed.

Objective To explore the relationship between the expression levels of serum long chain non coding RNA Kinectin 1 antisense RNA 1 (LncRNA KTN1-AS1) and retinoblastoma binding protein 4 (RBBP4) with postoperative recurrence and metastasis in esophageal cancer patients.Methods From May 2018 to May 2021,119 patients with esophageal cancer who underwent surgical treatment in our hospital were included as the study group.They were separated into an occurrence group (n=51) and a non occurrence group (n=68) based on whether there was recurrence or metastasis during a 3-year follow-up.Additionally,100 patients with benign esophageal tumors treated at the same stage were selected as the control group.ELISA method was applied to detect the expression levels of serum LncRNA KTN1-AS1 and RBBP4.Multivariate Logistic regression was applied to analyze the influencing factors of postoperative recurrence and metastasis in esophageal cancer patients.ROC curve was applied to analyze the predictive value of serum LncRNA KTN1-AS1 and RBBP4 for postoperative recurrence and metastasis in esophageal cancer patients.Results The expression levels of serum LncRNA KTN1-AS1 and RBBP4 in the study group were obviously higher than those in the control group (P<0.05).The expression levels of serum LncRNA KTN1-AS1 and RBBP4,and the proportions of mucosal/submucosal infiltration depth,and low differentiation degree and proportion of lymph node metastasis in the occurrence group were obviously higher than those in the non occurrence group (P<0.05).Serum LncRNA KTN1-AS1,RBBP4,proportion of lymph node metastasis,degree of differentiation,and depth of infiltration were influencing factors for postoperative recurrence and metastasis in esophageal cancer patients (P<0.05).The area under the curve (AUC) of the combined prediction of serum LncRNA KTN1 AS1 and RBBP4 for postoperative recurrence and metastasis in esophageal cancer patients was 0.912,which was better than their individual predictions (Z_{combination-LncRNA} KTN1 AS1=2.470,Z_{combination-RBBP4}=1.994,P=0.014,P=0.046),the sensitivity and specificity of the combined prediction were 90.20% and 85.29%,respectively.Conclusion The expression levels of serum LncRNA KTN1-AS1 and RBBP4 in esophageal cancer patients are obviously increased,which is closely related to postoperative recurrence and metastasis.The combined detection of the two has good predictive value for postoperative recurrence and metastasis in patients.

Objective To analyze the influencing factors of lymph node metastasis (DLN) metastasis in patients with differentiated thyroid carcinoma (DTC) and construct a column chart.Methods A total of 245 DTC patients who underwent surgical treatment in our hospital from January 2018 to December 2023 were selected.They were separated into two groups based on whether DLN metastasis occurred:the DLN metastasis group (119 cases) and the non DLN metastasis group (126 cases).Logistic regression analysis was applied to screen for risk factors for DLN metastasis in DTC patients.R software was applied to draw a nomogram prediction model for predicting DLN metastasis in DTC patients.Receiver operating characteristic(ROC) curves,calibration curves,and Hosmer-Lemeshow goodness of fit tests were applied to evaluate column charts.Results Logistic regression analysis revealed that gender of "male",multiple lesions,capsule invasion,intranodular calcification,and antithyroglobulin antibodies(TGAb) positivity were independent risk factors for DLN metastasis in DTC patients(P<0.05).The area under the ROC curve was 0.807 (95%CI:0.753 - 0.861).The slope of the calibration curve was close to 1,and the Hosmer-Lemeshow goodness of fit test showed χ²=8.983,P=0.344.Conclusion A column chart constructed based on five independent risk factors,including male,multiple lesions,capsule invasion,intranodular calcification,and TGAb positive,can effectively predict the risk of DLN metastasis in DTC patients.

Objective To explore the value of inflammatory load index(IBI) in the diagnosis and prognosis of gastric cancer patients.Methods Clinical data of patients who underwent gastric cancer surgery in the Department of General Surgery of the Second Hospital of Lanzhou University from January 2016 to December 2018 were retrospectively analyzed,and the patients were divided into the high IBI group and the low IBI group based on the optimal cut-off value of IBI.ROC curve was used to determine the optimal cut-off value of IBI,and the survival curve was constructed using the Kaplan-Meier method,and the differences between groups were examined using the Log-rank test.Cox regression analysis was performed to study the prognostic factors of gastric cancer patients.Results The best cut-off value for IBI diagnosis was 8.796,and the best cut-off value for prognosis was 28.75.IBI was related to the clinical case characteristics of gastric cancer patients,such as surgical access,the degree of differentiation,CK7,CK20,LMP-1,and Ki-67（P＜0.05）.The results of univariate analysis showed that intraoperative bleeding,preoperative CEA,preoperative CA125,preoperative CA199,IBI,tumor diameter size,margins of incision,vascular invasion,nerve invasion,pT stage and pN stagewere the influencing factors on the prognosis of gastric cancer patients(P<0.05) .The results of multifactorial regression analysis showed that intraoperative bleeding,preoperative CEA,preoperative CA199,IBI,tumor diameter size,pT stage and pN stagewere independent risk factors affecting the prognosis of gastric cancer patients(P<0.05) .The median OS of patients in the high IBI group and low IBI group were 32.9 months and 74.8 months,respectively,with statistically significant differences(P＜0.001).Conclusion IBI is an independent risk factor for poor prognosis of patients with gastric cancer,and it has a good predictive value in diagnosis and prognosis.

Objective Compare the clinicopathological factors of microsatellite unstable(dMMR) and microsatellite stable(pMMR) in right colon cancer and analyze the factors affecting overall survival(OS) and disease-free survival(DFS) between the two groups.Methods Clinical data with right colon cancer of patients who underwent radical resection from January 1,2016 to December 31,2023 were retrospectively analyzed(a total of 247 patients were included,including 43 dMMR and 204 pMMR).Through propensity score matching,the baseline difference between the two groups was matched 1∶1,and a total of 86 cases were obtained,43 cases in dMMR and 43 cases in pMMR.The difference of relevant indicators between the two groups was analyzed,and univariate and multivariate Cox analysis was performed for OS and DFS.The survival curve was plotted, and the comparison of survival rates was conducted using the Log-rank test.Results According to age,location,tumor length,shape,histological type,T,N,TNM stage,nerve invasion,and differentiation degree with 1∶1 matching(P<0.05),there was no statistical difference in baseline data between dMMR and pMMR patients with right colon cancer(P>0.05).It was found that 5-year OS of dMMR patients with right colon cancer was significantly better than pMMR(P<0.05),and 5-year DFS dMMR was better than pMMR(P<0.05).Protective factors affecting OS of dMMR right colon cancer included tumor length<5cm,T₁-3,M₀,Stage Ⅰ-Ⅲ,absence of intravascular cancer thrombi and absence of nerve invasion(P<0.05).In survival analysis,M₀ was compared with M₁(95% vs. 60%,P<0.05).Stage Ⅰ-Ⅲ compared with stage Ⅳ(95% vs. 54%,P<0.05);No vascular cancer thrombus vs. cancer thrombus(94% vs.88%,P<0.05).Protective factors affecting DFS of dMMR right colon cancer included age < 50 years,no mucous or sig-ring cells,M₀,Stage Ⅰ-Ⅲ,and no intravascular cancer thrombus(P<0.05).In survival analysis,M₀ was compared with M₁(90% vs. 63%,P<0.05).Stage Ⅰ-Ⅲ compared with stage Ⅳ(92% vs. 57%,P<0.05);There was a significant difference between non-vascular cancer thrombus and vascular cancer thrombus(91%vs. 77%,P<0.05).Conclusion The patients with dMMR had higher OS and DFS than pMMR,which were not affected by clinical factors.

Objective To explore the risk factors of “difficult pelvis” in laparoscopic middle and low rectal cancer surgery,and to construct and validate a nomogram prediction model.Methods 143 patients with middle and low rectal cancer who underwent laparoscopic radical resection in our hospital from May 2020 to May 2022 were selected as the training set,and 129 patients treated from June 2022 to June 2024 were selected as the validation set,analyzed its clinical data,and used multi-factor Logistic regression analysis to explore the factors affecting the “difficult pelvis” in laparoscopic middle and low rectal cancer surgery.Based on these risk factors,a nomogram prediction model was constructed and verified.Results Multivariate Logistic regression analysis showed that age,pubic symphysis height,and pelvic depth were independent risk factors for difficult pelvis in patients undergoing laparoscopic surgery for low-lying colon cancer,while the diameter between ischial spines,AB line,A angle,and B angle were independent protective factors for difficult pelvis.Based on The nomogram prediction model was constructed from the above factors.The receiver operating characteristic curve results showed that the areas under the curve of the training set and validation set were 0.870 and 0.843 respectively,and the sensitivity and specificity of the validation set were respectively 81.23%、80.06%,the prediction performance was good.Conclusion The prediction model for “difficult pelvis” in laparoscopic middle and low rectal cancer surgery constructed in this study has good prediction performance

Objective To explore surgical treatment efficacy for PAES.Methods A retrospective analysis was done on 12 PAES patients' surgery in our hospital from March 2018 to December 2023.Surgical plans included double popliteal artery exploration and repositioning with tendon transplantation,popliteal artery and vein release plus arterial thrombus removal,popliteal fossa exploration with popliteal artery release,and autologous vein patch angioplasty plus abnormal muscle bundle resection.Results Follow-up was 3 months to 5 years.11 patients had good affected limb skin temperature and blood supply,no symptom recurrence.One patient had left lower limb skin temperature decrease and pallor 2 years post-op (diagnosed as left popliteal fossa traumatic neuroma compressing popliteal artery),with blood supply restored after tumor removal.Conclusion Open surgery(tendon transplantation,vein patch) for PAES is effective.

Objective To investigate the correlation between the expression of serum microRNA-21-5p (miR-21-5p),microRNA-1224-5p (miR-1224-5p),and microRNA-181a-5p (miR-181a-5p) with postoperative delayed healing in patients with femoral neck fracture (FNF).Methods From October 2021 to April 2024,371 patients with FNF admitted to our hospital were included as subjects.The patients were assigned into a study group (delayed healing,68 cases) and a control group (normal healing,303 cases) based on whether the fracture ends healed 4 months after surgery.Real-time fluorescence quantitative PCR (qRT-PCR) was applied to detect the expression levels of serum miR-21-5p,miR-1224-5p,and miR-181a-5p.Multivariate Logistic regression was applied to analyze the influencing factors of postoperative healing delay in FNF patients.ROC curve was applied to analyze the predictive value of serum miR-21-5p,miR-1224-5p,and miR-181a-5p for postoperative healing delay in FNF patients.Results The levels of serum miR-21-5p,miR-1224-5p,and miR-181a-5p in the study group were lower than those in the control group (P<0.05).Multivariate Logistic analysis showed that age ≥60 years old,diabetes,and smoking were risk factors for postoperative delayed healing in FNF patients (P<0.05),and miR-21-5p,miR-1224-5p and miR-181a-5p were protective factors for postoperative delayed healing in FNF patients (P<0.05).ROC curve showed that the AUC values of miR-21-5p,miR-1224-5p,and miR-181a-5p for predicting postoperative healing delay in FNF patients were 0.845,0.809,and 0.797,respectively.When the three were combined for prediction,the AUC increased to 0.933.The combined detection effect of the three indicators was better than that of any individual indicator (Z_combination vs. miR-21-5p=3.444,Z_combination vs. miR-1224-5p=4.401,Z_combination vs. miR-181a-5p=4.279,P<0.05).Conclusion The levels of serum miR-21-5p,miR-1224-5p,and miR-181a-5p are reduced in FNF patients with postoperative delayed healing.The combined detection of the three may have a certain predictive value for postoperative delayed healing in FNF patients.

Objective To explore the efficacy of precise surface positioning method in percutaneous screw fixation for Jones fracture.Methods Data of 46 patients with Jones fractures admitted to our hospital from September 2021 to December 2023 were retrospectively analyzed.According to the different treatment methods,the patients were divided into screw groups (24 patients fixed by percutaneous screws) and tension band groups (22 patients fixed by incision and reset tension band).The general conditions,follow-up time,surgical time,hospitalization time,fracture reduction quality,postoperative complete weight-bearing time,fracture healing time,and complications in the two groups were recorded and compared.The American Association of Foot and Ankle Surgery (AOFAS) system was used to assess the recovery of foot function.Results There was no statistically significant difference in the general data before the operation between the two groups of patients (P>0.05).The follow-up time of the two groups was 6 to 24 months.Compared with the tension band group,the screw group had shorter operation time[(32.96±5.35)min vs.(47.27±9.42)min],shorter hospitalization time [(5.75±1.18)d vs.(7.68±2.05)d],earlier postoperative complete weight-bearing time[(6.47±0.73)w vs.(7.29±1.66)w],faster fracture healing time[ (3.31±0.68)months vs.(4.29±1.29)months ],higher AOFAS score[(89.13±2.62)vs.(79.59±4.49)](all P<0.05).The tension band group of fracture reduction quality was better than the screw group(P<0.05).The quality of fracture reduction during the operation in the tension band group was better than that in the screw group (P < 0.05).In terms of complications:no complications occurred in the screw group,one patient in the tension band group developed infection,and one patient had a loose Kirchner needle.Conclusion Precise surface positioning method in percutaneous screw fixation for Jones fracture is a safe and effective method with precise positioning,simple operation,small trauma,and rapid rehabilitation,which is worthy of clinical promotion,but the indications need to be strictly controlled according to the type of fracture.

Objective To compare the safety and feasibility of laparoscopic total extraperitoneal herniorrhaphy (TEP) and laparoscopic transabdominal preperitoneal prosthesis(TAPP) in the treatment of inguinal hernia.Methods This study adopts retrospective cohort study method.The clinical data of 107 cases of inguinal hernia treated by laparoscopic inguinal hernia repair in Minimally Invasive Surgery,Hernia and Abdominal Surgery of Xinjiang Uygur Autonomous Region People's Hospital from January 2014 to May 2024 were collected.According to the surgical methods, they were divided into two groups: 38 cases in the TEP group and 69 cases in the TAPP group.Compare and analyze the differences between TEP group and TAPP group in basic situation,operation,postoperative recovery,operation cost,postoperative inflammation index,liver and kidney function evaluation index.Results The time to start getting out of bed after surgery in the TEP group and the TAPP group was (14.55±1.95) h and (16.12±3.11) h, respectively (P=0.006). The recovery times of gastrointestinal function were (22.11±4.94) h and (24.61±4.88) h respectively (P=0.013). There was a statistically significant difference between the two groups (P<0.05).There was no significant difference in postoperative inflammation,liver and kidney function,postoperative complications and recurrence (P>0.05).Conclusion Both TEP and TAPP are safe and feasible in the treatment of inguinal hernia.After TEP,the time to get out of bed was shorter and the intestinal function recovered faster.

Anorectal malignant melanoma is a rare and highly aggressive malignant tumor,often misdiagnosed as benign conditions such as rectal polyps or thrombosed hemorrhoids.In this case,the patient underwent 3D laparoscopic abdominoperineal resection for rectal cancer at our hospital on April 16,2024,with pathological examination confirming malignant melanoma.As of August 9,2024,contrast-enhanced computed tomography of the chest and abdomen and magnetic resonance imaging of the whole abdomen suggested multiple systemic metastases.This underscores that patients with malignant melanoma are often at an advanced stage at the time of clinical presentation.Current treatment primarily involves surgery combined with various adjuvant therapies;however,the prognosis remains poor.The cornerstone of management lies in early recognition and timely intervention.

This article presents the treatment of a complex solitary kidney stone(>2.5 cm) with infection.The operation proceeded successfully with a tip-bendable ureteral access sheath combined with flexible ureteroscopic lithotripsy，there were no serious complications and no residual stones.