The National Comprehensive Cancer Network (NCCN) released the third version of Clinical Practice Guidelines in Gastric Cancer in 2025 (hereinafter referred to as the “updated guidelines”) on August 22,2025.Compared to the 2024 version,the updated guidelines integrate immune checkpoint inhibitors (ICIs) into the perioperative treatment of resectable gastric cancer,emphasize the early implementation of programmed death-ligand 1 (PD-L1) testing,and introduce new treatment regimens based on the results of multiple high-quality clinical studies published between 2024 and 2025.These updates signify a pivotal shift in the field of gastric cancer treatment toward a new developmental phase-one characterized by “biomarker-driven strategies,intensified combination therapies,and curative-intent approaches”.This article interprets the key updates in the guidelines by integrating recent research findings and revisions from other domestic and international guidelines.

Hepatocellular carcinoma (HCC) ranks as the fourth most common malignant tumor and the second leading cause of cancer-related deaths in China,posing a serious threat to public health.In recent years,with significant advances in systemic therapies and continuous refinement of local treatment techniques,HCC conversion therapy has become a crucial clinical strategy for improving the prognosis of patients with advanced disease and potentially achieving cure.Currently,conversion therapy regimens exhibit a diverse landscape,primarily encompassing systemic therapy,local therapy,and combination therapy.Through synergistic mechanisms,these approaches aim to enhance tumor response rates and surgical conversion success rates.With the deepening of precision medicine concepts and the rising demand for individualized treatment,HCC conversion therapy is evolving toward greater precision and standardization,offering the potential to deliver survival benefits to more patients.

Hepatocellular carcinoma (HCC) is a common malignant tumor worldwide,with diverse treatment strategies.Among them,Yttrium-90 microsphere selective internal radiation therapy (⁹⁰Y-SIRT) serves as an important locoregional treatment modality and plays an increasingly significant role in the comprehensive management of HCC.In recent years,substantial clinical evidence has accumulated regarding the use of ⁹⁰Y-SIRT in HCC treatment.Against this backdrop,several international authoritative organizations—including the National Comprehensive Cancer Network (NCCN),European Association for the Study of the Liver (EASL),European Society for Medical Oncology (ESMO),and British Society of Gastroenterology (BSG)—have updated their HCC clinical practice guidelines and incorporated ⁹⁰Y-SIRT into their treatment recommendations.This article will focus on the recommendations from these international guidelines and,by integrating the latest clinical research and practical experience,systematically elucidate the application value of ⁹⁰Y-SIRT in HCC management.

“Diagnostic and management guidelines for biliary atresia in 2025” was published online in Hepatobiliary Surgery and Nutrition on September 4,2025.This guideline integrates the opinions of 53 experts from Eastern and Western countries and finally formulates 23 recommendation items,covering aspects such as early screening,auxiliary examinations,surgical treatment,postoperative management,liver transplantation,and long-term follow-up of biliary atresia.

This article provides a systematic interpretation of the content related to pancreatic neuroendocrine neoplasms (pNENs) in the NCCN Clinical Practice Guidelines for Neuroendocrine (2025.V2). pNENs are highly heterogeneous, requiring multidisciplinary management. The guidelines reflect the concept of precision medicine, facilitating diagnosis and risk stratification through the integration of pathological grading, molecular characteristics, and functional imaging. In terms of treatment, an individualized approach is advocated: surgical decisions for localized disease should consider tumor size, grade, and patient condition; for advanced disease, systemic therapy selection depends on tumor biology and specific molecular targets. Additionally, the guidelines highlight genetic risk assessment and long-term follow-up, recommending germline testing for eligible patients and structured surveillance for over 10 years. Overall, these guidelines provide a systematic and evidence-based comprehensive framework for the clinical management of pNENs.

Diabetic foot disease has always been challenging to treat due to its diverse clinical symptoms and complex pathogenesis. The International Diabetic Foot Working Group, a pioneer in international diabetic foot research, has developed a series of clinical guidelines for the treatment of diabetic foot disease since 1999, which have had a significant impact on clinical practice. The 2023 edition of the guidelines has now been published. This article provides a concise and focused analysis of the 10 sections of these guidelines, comparing the differences between the old and new guidelines, and highlighting new viewpoints and theories. This will help clinicians quickly grasp the key points of the new guidelines and guide their clinical work.

Male chronic pelvic pain is a clinical syndrome in the field of urology and andrology characterized by complex etiology and a significant negative impact on patients' quality of life.Its treatment options are numerous yet often yield uncertain results.To address these challenges,the American Urological Association released the 2025 Guideline "Diagnosis and Management of Male Chronic Pelvic Pain." This guideline proposes a more refined classification system:(1) chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS);and (2) chronic scrotal content pain (CSCP).Furthermore,it emphasizes the importance of differentiating these conditions from interstitial cystitis/bladder pain syndrome (IC/BPS) and identifying the presence of pelvic floor myalgia.The guideline systematically organizes all current treatment modalities based on evidence-based medicine,encompassing behavioral/non-pharmacological interventions,pharmacological therapies,physical treatments,and surgical procedures.Notably,it provides a detailed overview of several surgical options for CSCP.

Emorrhagic complications associated with regional anesthesia are extremely rare,they can occur and may result in catastrophic outcomes.The fifth edition of the American Society of Regional Anesthesia and Pain Medicine’s Evidence-Based Guidelines on regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy systematically reviews and updates management recommendations and strategies for various antithrombotic agents since 2018,with the aim of minimizing the risk of serious hemorrhagic complications like neuraxial hematoma.

Obesity greatly increases the risk of airway complications and makes airway management more difficult. In all existing guidelines,recommendations relating specifically to airway management in patients living with obesity are an addendum or subsection. There are no other recommendations specific to the airway management of patients living with obesity. In June 2025,the Society for Obesity and Bariatric Anaesthesia (SOBA) UK published the guidelines for airway management in patients living with obesity:best practice recommendations from the Society for Obesity and Bariatric Anaesthesia. The guideline provides recommendations for pre-operative assessment,planning,facemask ventilation and peroxygenation,tracheal intubation,supraglottic airway devices,tracheal extubation,organisational responsibilities and training and special circumstances,aimed at reducing the risks of airway management in obese patients and improving the prognosis.

Objective To investigate the distribution of pathogenic bacteria in intracranial infections after severe traumatic brain injury (STBI) surgery and the clinical value of serum Clara cell protein 16 (CC16) and suppressor of cytokine signaling-3 (SOCS-3) levels.Methods A total of 102 STBI patients attending our hospital between May 2019 and June 2023 were selected as study subjects and divided into infected group (38 cases) and uninfected group (64 cases) according to their postoperative intracranial infection status.Automated bacterial tester was used to detect the distribution of pathogenic bacteria in patients in the infected group;clinical data of patients were collected and analyzed;ELISA was used to detect CC16 and SOCS-3 expression in the serum of STBI patients.Multivariate Logistic regression was used to analyze the factors influencing postoperative intracranial infection in patients with STBI.ROC curve was used to analyze the predictive value of serum CC16 and SOC-S adjuvant 3 levels for postoperative intracranial infection in patients with STBI.Results Among the 38 intracranial infections after STBI,48 pathogenic strains were isolated,including 30 gram-positive bacteria,accounting for 62.50% of the total pathogens and 18 gram-negative bacteria,accounting for 37.50% of the total pathogens.Among them,Staphylococcus aureus,coagulase-negative Staphylococcus,Acinetobacter bausoni,and Pseudomonas aeruginosa accounted for 33.33%,16.67%,14.58% and 10.42% of the total pathogens.NC,WBC,and SOCS-3 levels in the postSTBI infected group were significantly higher than those in the uninfected group (P<0.05),and CC16 levels were significantly lower than those in the uninfected group (P<0.05).Elevated levels of NC,WBC,and SOCS-3 were risk factors affecting postoperative intracranial infection in STBI patients,and increased CC16 level was a protective factor affecting postoperative intracranial infection (P<0.05).Serum CC16,SOCS-3 levels and combined AUC for postoperative intracranial infection in patients with STBI were 0.830,0.762 and 0.900,respectively,the combined prediction was better than the respective predictions alone (_Zcombined-CC16=2.372,_Zcombination-SOCS-3=2.882,P=0.018,0.004).Conclusion With the high distribution of gram-positive bacteria in patients with intracranial infection after STBI,and decreased serum CC16 levels and increased SOCS-3 level,the combination had a high predictive value of postoperative intracranial infection in patients with STBI.

Objective To explore the clinical effect of whey protein and vitamin D combined with anti-resistance exercise in improving sarcopenia in elderly patients with esophageal cancer.Methods Retrospective analysis of clinical data from 76 patients with esophageal cancer and sarcopenia treated at Yancheng Third People's Hospital between June 2023 and August 2024 was conducted.The patients were divided into a control group (38 cases) and an observation group (38 cases) based on different nutritional support regimens.The control group received conventional nutritional support,while the observation group was subjected to a combined intervention of whey protein,vitamin D,and resistance exercise.The nutritional status of patients in the two groups was assessed using the patient Subjective Global Assessment Scale (PG-SGA),the quality of life of patients in the two groups was assessed using the esophageal cancer Specific Scale (QLQ-OES18),and the levels of serum albumen(ALB),hemoglobin(Hb) and C-reactive protein(CRP),skeletal muscle mass index,grip strength and walking speed were compared between the two groups.And complication rates in both groups.Results Three month after operation,the PG-SGA score of the observation group was 11.54±2.03,which was significantly lower than that of the control group （13.11±1.97）(P<0.05).The QLQ-OES18 scale showed that the scores of swallowing function in the observation group (67.43±4.89) were significantly higher than those in the control group(64.69±4.26)(P<0.05),while the scores of eating discomfort,pain and reflux (56.47±4.69,57.28±5.18 and 54.94±4.87) were significantly lower than those in the control group（59.51±4.75,60.44±5.05,57.29±5.03） (P<0.05).In addition,the plasma ALB and Hb of the observation group were （42.26±2.99）g/L and（127.53±10.11）g/L,respectively,which were significantly higher than those of the control group[（34.09±4.61）g/L and（112.81±15.87）g/L] (P<0.05),and the CRP was （7.67±2.93）mg/L,which was significantly lower than that of the control group[（12.78±3.14）mg/L] (P<0.05).The skeletal muscle mass index,grip strength and walking speed of observation group were（6.35±0.92）kg/m

Objective To explore the impact of hidden lymph node metastasis of patients with thoracoscopy lung cancer,and build risk prediction model construction.Methods From April 2022 to August 2024,93 patients undergoing thoracoscopic radical resection of lung cancer were accepted.According to the case of hidden lymph node metastasis,the patient was divided into a group (n=28) and the uncomfortable group (n=65 ),Compare the clinical data of the two groups of patients,Logistic regression analysis affects the factors that occur in hidden lymph node metastasis,and use this to establish a risk predictive model.Internal verification,the consistency of the calibration diagram evaluation model is adopted.Results Multi-factor analysis shows that surrounding tumors,maximum diameter of tumor,≥2.5 cm,clinical staging in phase Ⅲ,tumor components are solid,burr signs,and vascular infiltration is hidden in patients with thoracoscopy lung cancer root treatment Risk factor for lymph node transfer (P<0.05).The ROC curve results showed that this model had a curve of hidden lymph node metastasis in patients with thoracoscopy lung cancer root treatment,with 0.906 and 95%CI:0.829~0.983,85.72%sensitivity,and 90.75% of the specific degree.The calibration diagram of the bootstrap method verification predictive model shows that the calibration curve is close to the ideal curve,the number of self -sampling=1 000,and the average absolute error=0.043.Conclusion The maximum diameter of the surrounding tumor,the maximum diameter of the tumor,the clinical stage of the clinical stage Ⅲ,the tumor component is solid,the burr signs,and the vascular infiltration is the risk factors of hidden lymph node metastasis in patients with thoracoscopy lung cancer.The risk prediction model established accordingly has high accuracy and reliability.

Objective To investigate the expression of silencing information regulatory factor 3 (SIRT3) in lung cancer tissues and its effects on lung cancer cell proliferation,invasion and migration.Methods The tumor tissues and adjacent normal lung tissues of 80 lung cancer patients admitted from October 2022 to October 2024 were randomly selected,then positive expression rate and protein expression of ,IL-6,STAT3 and SIRT3 were detected by immunohistochemistry staining and Western blot,respectively.Lung cancer cell lines A549 and SK-MES-1 were selected,SIRT3 over-expression,low-expression and empty vector lentiviruses in vitro were constructed,then were transfected to cells for 48 hours.MTT assay was used to detect cell proliferation,Transwell assay was used to detect cell invasion and cell scratch assay was used to detect cell migration.Results Compared with normal tissues adjacent to cancer,positive expression rate and protein expression of SIRT3,IL-6 and STAT3 in tumor tissues were significantly lower(P<0.05).Compared with empty vector group,over-expression group showed significant decreases in cell proliferation,invasion and migration,while low-expression group showed significant increases(P<0.05).Conclusion Low expression of SIRT3 may be involved in the occurrence and development of lung cancer,which may be related to inhibition of IL-6/STAT3 signaling pathway.

Objective To evaluate the safety and feasibility of utilizing Kirschner wires (K-wires) in single-incision laparoscopic sleeve gastrectomy (SILSG).Methods Clinical data were retrospectively collected from 148 patients who underwent SILSG between May 2023 and May 2025,including 112 cases in which K-wires were used and 36 cases in which they were not.The two groups were compared in terms of operative duration,total length of hospital stay,hospitalization costs,postoperative complication rates (including anastomotic leakage and intra-abdominal hemorrhage),as well as pre- and postoperative changes in liver function and C-reactive protein (CRP) levels.Results The mean operative time in the K-wire-assisted group was （89.08±7.88） minutes,significantly shorter than that in the non-K-wire-assisted group [(109.72±10.36）minutes] (P<0.05).No statistically significant differences were observed between the two groups regarding gender,age,preoperative body mass index,postoperative complication rates,total hospital stay,or hospitalization costs (all P>0.05).There was no statistically significant difference between the two groups of preoperative alanine aminotransferase, aspartate aminotransferase, total bilirubin, direct bilirubin, C reactive protein (P>0.05).However,within each group,postoperative levels of alanine aminotransferase (ALT) and CRP were significantly elevated compared to preoperative values (all P<0.05).The laboratory test results obtained during the 7-day postoperative follow-up showed no statistically significant differences compared to preoperative values (all P>0.05).Conclusion The use of K-wires in SILSG is safe and feasible,while also taking into account both surgical effectiveness and aesthetics.

Objective To investigate the expression,function and molecular mechanism of lncRNA TONSL-AS1 in gastric cancer.Methods Collect cancer tissues and adjacent tissues(tissues which were 5 cm away from the lesion) from 71 patients with gastric cancer treated in our hospital.12 female nude mice weighing 18-22g were divided into NC group and mimic-TONSL group,with 6 mice in each group,and to prepare gastric cancer model.In gastric cancer cells,lncRNA TONSL-AS1 was overexpressed,and its effects on cell migration,proliferation,and invasion were assessed using Transwell experiments and a xenograft tumor model in nude mice.RNA pull down experiments coupled with protein mass spectrometry were employed to identify proteins interacting with lncRNA TONSL-AS1.By viral infection,the expression of lncRNA TONSL-AS1 binding protein was downregulated in gastric cancer cells.In vitro cell experiments and in vivo nude mouse tumorigenesis experiments were conducted to detect whether the binding protein affects the proliferation,migration,invasion,and in vivo tumorigenesis ability of gastric cancer cells.Candidate miRNAs(miRs) that potentially bind to lncRNA TONSL-AS1 were screened using bioinformatics analysis.By constructing cells with high expression of recombinant lentivirus miRNA and their control cells,and conducting in vivo and in vitro functional experiments,the ability of these cells to migrate and invade in vitro,as well as vivo tumorigenesis ability,was observed to evaluate the function of lncRNA TONSL-AS1 competitively binding miRNA.Results lncRNA TONSL-AS1 is lowly expressed in gastric cancer.High expression of lncRNA TONSL-AS1 can inhibit the proliferation of gastric cancer cells.YTH domain N6-methyladenine RNA binding protein 2(YTHDF2) has been identified as a binding protein of lncRNA TONSL-AS1.And YTHDF2 can promote the invasion and proliferation of gastric cancer cells by interacting with lncRNA TONSL-AS1.MiR-144 can regulate the expression of lncRNA TONSL-AS1 through competitive binding and inhibit the proliferation and invasion of gastric cancer cells.Conclusion lncRNA TONSL-AS1 can inhibit the proliferation of gastric cancer,while YTHDF2 can promote the invasion and proliferation of gastric cancer cells by interacting with lncRNA TONSL-AS1;miR-144 competitively binds to lncRNA TONSL-AS1 to inhibit the proliferation and invasion of gastric cancer cells.

Objective To explore the relationship between thrombospondin 2 (THBS2) and secreted protein acidic and rich in cysteine (SPARC) expression and oxidative stress,clinicopathological features and prognosis of gastric cancer.Methods The expression of THBS2,SPARC,xanthine oxidase (XOD) and myeloperoxidase (MPO) in 60 cases of gastric cancer and adjacent tissues collected from February 2021 to September 2022 were detected by immunohistochemical SP method.Spearman correlation test,binary Logistic regression and Kaplan-Meier method were used to analyze the impacts of THBS2 and SPARC on oxidative stress,clinicopathological features and prognosis.Results The high expression rates of THBS2,SPARC,XOD and MPO in gastric cancer tissues were 53.3%,71.7%,60.0%,70.0%,which were higher than adjacent tissues (33.3%,21.7%,38.3%,26.7%) (P<0.05).THBS2 and SPARC were positively correlated with XOD and MPO in gastric cancer (P<0.05).THBS2 expression was correlated with invasion depth,lymph node metastasis and TNM stage;SPARC expression was correlated with lymph node metastasis and TNM stage (P<0.05).Invasion depth was an independent factor affecting THBS2 expression in gastric cancer tissues (P<0.05).The median survival of high THBS2 expression group was shorter than low THBS2 expression group (P=0.029).The median survival of high SPARC expression group was longer than low SPARC expression group (P<0.001).Conclusion THBS2 and SPARC are highly expressed in gastric cancer,which are closely related to oxidative stress,clinicopathological features and prognosis.

Objective To explore the predictive value of preoperative lymphocyte,C-reactive protein (CRP) and their ratio (LCR) on complications after laparoscopic radical resection of colorectal cancer.Methods The clinical data of 120 patients with colorectal cancer who received laparoscopic radical resection from October 2021 to October 2024 were retrospectively analyzed.Clavien-Dindo grading was used to evaluate the occurrence of postoperative complications.The patients were divided into complication group and control group.Multivariate logistic regression analysis of factors influencing the risk of postoperative complications.The predictive value of receiver operating characteristic (ROC) curve detection of influencing factors for postoperative complications.Results According to the follow-up results,there were 51 patients with Clavien-Dindo grade≥ Ⅱ within 30 days after surgery.The lymphocyte and LCR in complication group were lower than those in control group (P<0.05) while the CRP level was higher than that in control group (P<0.05).The results of univariate analysis showed that the LCR of the complication group was lower than that of the control group (P<0.05),the age and operation time of the complication group were higher than that of the control group (P<0.05),and the number of patients with diabetes and hypertension in the complication group was more than that in the control group (P<0.05).Multivariate logistic regression analysis,LCR、Age,diabetes and operation time were independent risk factors for postoperative complications (P<0.05).ROC curve analysis showed that the AUC of preoperative LCR index,age,diabetes,hypertension,and operation time were 0.934,0.645,0.604,0.631,0.821,respectively,the sensitivity was 92.75%,52.94%,41.18%,39.22%,80.39%,and the specificity was 88.24%,66.67%,79.71%,86.96%,75.36%,respectively.Conclusion The decrease of LCR is related to the occurrence of postoperative complications in patients undergoing laparoscopic radical resection of colorectal cancer.

Objective To evaluate the clinical efficacy and influencing factors of revision hip arthroscopy in patients with femoroacetabular impingement syndrome (FAIS). Methods A retrospective analysis was conducted on 40 patients (41 hips) admitted to our hospital for revision hip arthroscopy between October 2011 and October 2020.Demographic characteristics,surgical procedures,preoperative and postoperative imaging,and functional scores were recorded.Statistical analysis was performed using SPSS 27.0.Compare the Visual Analog Scale (VAS) scores and modified Harris Hip Score (mHHS) before and after the operation.Spearman correlation analysis was performed to explore potential factors influencing postoperative outcome improvements. Results The mean follow-up period was 4.1 years.The VAS score decreased from 6 (2~9) preoperatively to 2 (0~8) at the final follow-up (P<0.05).The mean mHHS increased from (55.4±11.2) points before the operation to (72.0±16.9) points at the last follow-up (P<0.05).No patients underwent a second revision arthroscopic surgery or total hip arthroplasty.The improvement of VAS score was significantly negatively associated with the Tnnis grade (r=-0.430,P=0.005). Conclusion Residual FAIS and labral lesions are main causes of revision surgery.Revision hip arthroscopy can significantly improve clinical symptoms and hip function.The degree of degenerative changes is an important factor influencing prognosis.

Objective To investigate the effect of modified Kessler suture,early rehabilitation combined with platelet rich plasma (PRP) on functional rehabilitation of patients with acute Achilles tendon rupture (AATR).Methods From April 2021 to July 2023,92 patients with AATR admitted to our hospital were gathered and using a random number table method,assigned into a control group (n=46) and an auxiliary PRP group (n=46).The efficacy,Achilles tendon healing,ankle-hindfoot condition,ankle mobility,and postoperative complications were compared between the two groups.Results The total effective rate and excellent rate of Achilles tendon healing in the auxiliary PRP group were 95.35% and 100%,respectively,which were higher than the control group's (79.55% and 88.64% )(P<0.05).One year after surgery,the AOFAS scores (93.47±3.19,90.45±5.16) of both groups were higher than that at 6 months after surgery (81.21±8.35,76.52±9.06) (P<0.05).The angles of dorsiflexion [(20.78±2.67) °,(18.26±2.33) °] and plantarflexion [(42.52±5.61) °,(38.73±4.24) °] of the affected ankle were greater than at 6 months after surgery [(13.03±2.15) °,(11.16±2.29) °,(32.56±3.35) °,(29.79±3.58) °] (P<0.05).Six months after the operation,the AOFAS scores of both groups were higher than those before the operation (44.45±6.79,44.21±8.36).The dorsiflexion of the affected ankle [(10.23±1.21)°,(10.20±1.08)°] and the plantar flexion Angle [(19.56±2.43)°,(20.03±2.58)°] were all greater than those before the operation (P<0.05).In addition,the AOFAS scores of the auxiliary PRP group were higher than those of the control group at 6 months and 1 year after surgery (P<0.05),and the angles of dorsiflexion and plantarflexion of the affected ankle were greater than those of the control group (P<0.05).The total incidence of postoperative complications was not greatly different between the auxiliary PRP group (4.65%) and the control group (11.36%) (P>0.05).Conclusion The application of modified Kessler suture and early rehabilitation combined with PRP treatment can greatly improve the efficacy of Achilles tendon and effectively promote the recovery of ankle-hind foot function in AATR patients.

Objective To investigate the clinical predictive value of neutrophil extracellular trap (NETs) in diagnosis of postoperative pneumonia in elderly patients with hip fracture.Methods A total of 168 elderly patients with hip fracture hospitalized in our hospital from February 2021 to February 2023 were selected and divided into pneumonia group (52 cases) and non-pneumonia group (116 cases) according to whether they developed pneumonia after surgery.The clinical data and postoperative neutrophils (NEU),lymphocytes (LYM),platelets (PLT),NLR (ratio of NEU to LYM),N/LPR (ratio of NEU to LYM to PLT) and plasma myeloperoxidase DNA (MPO-DNA) representing the level of NETs were compared between the two groups.Multivariate Logistic regression was used to analyze the risk factors for postoperative pneumonia,and the predictive value of statistically significant variables for postoperative pneumonia was evaluated.Results The contents of age,NLR,N/LPR and MPO-DNA in pneumonia group were significantly higher than those in non-pneumonia group (P<0.05).Multivariate Logistic regression analysis showed that the increase of N/LPR and MPO-DNA indexes was an independent risk factor for postoperative pneumonia in elderly patients with hip fracture.ROC curve results showed that N/LPR and MPO-DNA indexes were of high predictive value in elderly patients with postoperative hip fracture pneumonia,and the curve area (AUC) of MPO-DNA indexes was higher than that of N/LPR indexes.Conclusions The level of NETs in elderly patients with postoperative pneumonia after hip fracture is significantly increased,and the increase of NETs is an independent risk factor for postoperative pneumonia in patients,and the content of NETs is of high diagnostic value for postoperative pneumonia.

Objective To investigate the relationship between serum levels of glial fibrillar acidic protein (GFAP) and insulin-like growth factor-1 (IGF-1) and neurological function and prognosis in patients with spinal fractures and traumatic spinal cord injury.Methods A total of 92 patients with spinal fractures and traumatic spinal cord injuries from October 2021 to October 2023 were prospectively selected as the observation group and divided into mild,moderate,and severe subgroups based on neurological function.They were also categorized into good and poor prognosis groups.Another 92 patients with only spinal fractures were selected as the control group.Serum GFAP and IGF-1 levels were measured using enzyme-linked immunosorbent assay (ELISA).Forward stepwise multivariable Logistic regression analysis was used to identify prognostic factors,and receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive performance of GFAP and IGF-1 for patient prognosis.Result The GFAP of the control group was (16.86±3.25)μg/L, and the IGF-1 was (146.24±31.47)μg/L, while those of the observation group were (32.57±7.21)μg/L and (97.81±22.43)μg/L, respectively. There was a statistically significant difference between the two groups (P< 0.05 ).These levels were correlated with the severity of neurological injury (mild group:GFAP=22.15±4.75 μg/L,IGF-1=116.27±22.31 μg/L;moderate group:GFAP=36.24±9.64 μg/L,IGF-1=92.14±17.68 μg/L;severe group:GFAP=55.68±13.54 μg/L,IGF-1=51.78±14.64 μg/L,P<0.05).Compared with the good prognosis group (GFAP=26.48±5.86 μg/L,IGF-1=112.23±24.15 μg/L),patients in the poor prognosis group (GFAP=42.05±8.79 μg/L,IGF-1=75.39±15.62 μg/L) exhibited higher GFAP levels and lower IGF-1 levels (P<0.05).Multivariable Logistic regression analysis indicated that Frankel grade,GFAP,and IGF-1 levels were independent risk factors for poor prognosis (Frankel grade OR=2.460,GFAP OR=1.926,IGF-1 OR=0.548,P<0.05).ROC showed that the area under the curve of serum GFAP and IGF-1 combined to predict poor prognosis of patients was 0.983,which was significantly greater than that of single prediction (Z=2.087,2.398,P=0.037,0.016).Conclusion In patients with spinal fractures and traumatic spinal cord injuries,serum GFAP levels are elevated and IGF-1 levels are reduced,which are associated with neurological injury severity.GFAP is a risk factor for poor prognosis,while IGF-1 is a protective factor.

Objective To explore the risk factors of relapse in patients with arteriosclerosis obliterans after interventional therapy,and to construct a recurrence risk prediction model based on the risk factors.Methods Eighty patients with arteriosclerosis obliterans were selected as the research subjects and all were admitted to our hospital from January 2021 to January 2023.All the research subjects were followed up for one year after interventional therapy.According to the follow-up results,they were divided into the recurrence group and the non-recurrence group.The clinical data and biochemical indicators of the two groups of patients were collected,the risk factors were screened,a nomogram model of recurrence risk was constructed based on the risk factors and verified.Results Age ≥60 years old,smoking history,hypertension,diabetes,complete occlusive lesions,and hs-CRP≥8.00 mg/L are all risk factors affecting the recurrence of patients with arteriosclerosis obliterans after interventional therapy (P<0.05).The area under the ROC curve (AUC),95% confidence interval (CI),sensitivity and specificity of the nomogram risk model for predicting recurrence in patients with arteriosclerosis obliterans after interventional therapy were 0.873,0.654-0.987,96.40% and 74.50% respectively (P<0.05),indicating that the predictive efficacy of this model was good.The C-index of the nomogram prediction model was 0.832 (95%CI 0.787-0.991).Both the predicted values and the actual predicted values were near the ideal curve.The Hosmer-Lemeshow goodness-of-fit curve test χ²=2.641,P=0.659.Conclusion The nomogram model constructed based on six risk factors,namely age ≥60 years old,smoking history,hypertension,diabetes,complete occlusive lesions,and hs-CRP≥8.00 mg/L,has a good predictive efficacy for the recurrence risk of patients with arteriosclerosis obliterans after interventional therapy.

Objective To present a management protocal of extensive and deep space macrocystic LMs with percutaneous catheter bleomycin therapy and evaluate the clinical outcomes of children.Methods Four hospitalized children with deep space and gaint LMs were enrolled in the study conducted from Journal 2020 through May 2024 at Wuhan children’s hospital of Huazhong University of Science ＆ Technilogy (Wuhan China).Cases 1 and 2 were retropharyngeal lymphangiomas,cases 3 was extraperitoneal lymphangiomas with hemorrhage,and cases 4 were mesenteric lymphangiomas.They were all treated with bleomycin infusion for 2-3 times after subcutaneous catheterization and drainage of lymphatic fluid.Results Only case 4 had suffered a fever after bleomycin injection and improved after anti-infection.No complications occurred in the rest of the children.All the children were followed up for 3 to 12 months after the operation, and the tumors all shrank.Conclusion All of the patients were response good in deep space LMs with the treatment approach through percutaneous indwelling catheter sclerotherapy and repeated drug injection through the catheter can be used for treatment.

Objective To explore the surgical method and clinical effect of modified sewing-style buried suture double eyelid blepharoplasty.Methods From May 2023 to October 2024, 16 patients with single eyelids were admitted and treated with sewing-style buried suture double eyelid blepharoplasty,and the follow-up time was 6-23 months,and the morphology,stability and complications of the double eyelid after surgery were observed.And a patient satisfaction survey was conducted,and the proportion of very satisfied and satisfied was counted.Results One patient had a slight asymmetry between the left and right sides due to continuous eyelid shaking during surgery,which improved over time.In one patient,due to improper postoperative care and touching and rubbing the eyelids,local swelling at the line knot subsided within one week after treatment,and the final effect was not affected.After 6-23 months of follow-up,all patients had smooth and natural blepharoplasty,stable morphology,no disappearance or obvious shallowness of tarpabral line,and the patient satisfaction survey showed that 15 cases (93.8%) were very satisfied,1 case (6.2%) was satisfied,and the total satisfaction was 100%.Conclusion The sewing-style buried suture double eyelid blepharoplasty is simple to operate, causes less trauma, has a quick recovery, and the effect is natural and long-lasting.

With the increase of experience in expanding nasal endoscopic approaches and the updating of instruments and equipment,the application of endoscopy is developing towards larger and more complex skull base surgeries.These also lead to larger skull base defects,posing challenges for skull base repair.The larger skull base defects significantly increase the probability of postoperative cerebrospinal fluid leakage.These also promote higher requirements for skull base reconstruction technology.The review summarizes various methods and detailed treatments for skull base reconstruction,in order to clarify the repair techniques and optimal choices for skull base defects in nasal endoscopic surgery.

Biliary anatomical variations are common in hepatobiliary surgery and often lead to intraoperative errors and complications.Traditional imaging techniques provide information on biliary structures but have limitations in real-time intraoperative imaging and identifying subtle variations.Indocyanine green (ICG) fluorescence imaging,a real-time intraoperative tool,enhances the identification of biliary variations,improving surgical precision and safety.This review discusses the classification of biliary anatomical variations and explores the application,optimization,and future prospects of ICG fluorescence imaging in their identification.

This article reports a case of a 22-year-old female patient with intestinal pneumatosis cystoides who was admitted to the hospital due to recurrent abdominal distension. Abdominal CT showed multiple string-like and cluster-like gas density shadows within the intestinal wall. Under laparoscopic exploration, multiple grape-like emphysemas were observed, and multiple string-like gas cysts were visible to the naked eye. The diagnosis was confirmed based on the pathological results. The patient underwent surgical treatment, and the process was smooth. After 9 months of follow-up, the re-examination showed good recovery without any obvious abnormalities.

Extra gastrointestinal stromal tumor (EGIST) is a mesenchymal tumor located outside the gastrointestinal tract,with morphological,immunophenotypic,and molecular biology characteristics similar to gastrointestinal stromal tumors.On December 17,2024,the patient underwent a massive tumor resection surgery in the abdominal cavity.Pathological examination revealed a mass in the abdominal cavity,consistent with gastrointestinal stromal tumor (EGIST);The patient recovered well after surgery and was discharged smoothly.Re examination showed no recurrence.At present,surgery is the main treatment for stromal tumors,and postoperative oral imatinib is taken to prevent recurrence.

Splenic artery aneurysm (SAA) is a relatively common type of visceral artery aneurysm, typically resulting from localized permanent dilation of the splenic artery, most commonly found in the mid-to-distal segment. The condition often has an insidious onset and is frequently discovered incidentally during other examinations, with an autopsy incidence of 0.098% and an angiographic incidence of 0.78%. The incidence in females is four times that in males. Although most patients with SAA are asymptomatic, rupture can lead to severe retroperitoneal hemorrhage and hypovolemic shock. This article reports a rare case of a 49-year-old male patient who experienced spontaneous rupture of a splenic artery aneurysm complicated by shock. The patient was urgently taken to the operating room due to persistent abdominal pain and shock and was successfully rescued.