Objective Reported and analyzed a case of “Spinal cord hypertension syndrome” in percutaneous intervertebral endoscopic surgery,with a view to early diagnosis and early treatment of this complication in future surgery.
Methods Retrospectively analyze the clinical data of a patient with lumbar disc herniation during the operation in the first hospital of Wuhan City in December 2019.
Results The main clinical manifestations of “Spinal cord hypertension syndrome” are sudden and severe pain in the head and neck,chest tightness,and tinnitus.Signs of sexual numbness,abdominal distension,increased intracranial pressure,or a sudden rise in blood pressure and increased heart rate.The patient in this case improved after active treatment such as lowering perfusion pressure and oxygen sedation.
Conclusion “Spinal cord hypertension syndrome” focuses on prevention,advocates early identification and discovery,and should be promptly and appropriately dealt with after the occurrence.

Objective:To explore the corresponding measures to prevent anastomotic stenosis after esophagectomy for esophageal and cardiac cancers.Methods:Retrospective analysis was made on the clinical data of 315 patients with esophageal and cardia cancers with oesophagectomy performed in the department of Thoracic Surgery of the Nanyang central hospital from January 2013 to January 2018.In the experimental group(146 cases),oral gentamicin saline was taken before operation,anastomosis was performed after intraoperative gastric wall pouch suture,and anastomotic tension was reduced.Solid food and oral acidinhibiting drugs were taken as early as possible after operation.The control group(169 cases) only adopted stapler anastomosis directly.Postoperative followup has been conducted for two years,and the incidence of anastomotic stenosis in the two groups was compared.Results:The incidence of anastomotic stenosis in the control group was 11.0%,while the incidence of anastomotic stenosis in the experimental group was 3.8%.The difference was statistically significant（P＜0.05）.Conclusion:Preoperative oral administration of gentamicin saline,intraoperative pursestring suture of the stomach wall before anastomosis,and reduction of anastomotic tension can actively prevent anastomotic stenosis.

Objective To analyze the related factors of pulmonary changes and fever after cervical lymph node dissection for thyroid cancer.
Methods A total of 46 patients with thyroid cancer undergoing cervical lymph node dissection were collected.The effects of gender,age,smoking history,body mass index(BMI),surgical method and other factors on postoperative pulmonary changes and fever were analyzed statistically.
Results There were 10 cases of left neck dissection,24 cases of right neck dissection,and 12 cases of bilateral neck dissection.There was statistical significance in the incidence of lung changes among patients with different dissection methods(P<0.05).Postoperative pulmonary changes were positive in 8 patients,including 4 patients with postoperative fever(50%),and negative in 38 patients,including 1 patient with postoperative fever(2.6%).There was statistically significant difference in the incidence of postoperative fever(P<0.05).There were 4 cases of thinness,25 cases of normal weight,13 cases of overweight and 4 cases of obesity.There was no statistically significant difference in the incidence of lung changes among patients with different body mass indexes(P>0.05),but there was statistically significant difference in the incidence of postoperative fever(P<0.05).
Conclusion Lung changes are more likely to occur after bilateral cervical lymph node dissection than after unilateral cervical lymph node dissection for thyroid cancer,and patients with lung changes are more likely to have postoperative fever.Patients who are lean or obese are more prone to pulmonary changes and postoperative fever.

Objective To preliminary discuss the application effect of “gunsight” skin flap technique compared with primary linear closure during the skin closure of the stoma reversal. Methods The clinical datas of 57 patients performed stoma reversal in the digestive center of Panyu central hospital during June of 2015 to May of 2018 were retrospectively analysed.Among them,41 patients were performed by “gunsight” closure technique,while 26 patients were performed by primary linear closure method.Finally,the clinical parameters,postoperative complications,healing time,the length of stay,pain score,satisfaction score were recorded and compared. Results The infection rate of the patients in the “gunsight” closure group were significantly lower than that of the primary liner closure group(4.88% vs 26.92%).The wound healing time and post operational hospital stay of the “gunsight” closure group was (9.61±2.82) and (10.29±3.87)days,which was significantly shorter than that of the primary linear closure group((12.65±5.69) and (14.58±9.35))days,The difference between the two groups was statistically significant( P ＜0.05). Conclusion Compared with the conventional suture method,“gunsight” skin flap technique appeared to be of more advantages.The “gunsight” suture method can not only reduce the wound infection rate,but also shorten hospital stays.

Objective:To study the safety and efficacy of clinical application of autologous tumor infiltrating lymphocytes (TIL) after in vitro amplification，in combination with antiPD1 monoclonal antibody for the treatment of advanced hepatocellular carcinoma (HCC).Methods:The patients with postoperative recurrence or extrahepatic metastasis that are not operable were selected for the study.TIL were isolated from the tumor samples obtained through local resection under laparoscopy,and TIL were amplified up to 2×109 cells and administered intravenously to the patients.After TIL infusion,antiPD1 monoclonal antibody injection was followed every 21 days,and IL2 was continuously injected to maintain the activity of TIL for two weeks,and the adverse effects and treatment efficacy were evaluated.Results:TIL were successfully isolated,amplified and administered in 4 patients with advanced liver cancers.All 4 patients showed good tolerance and minor adverse effects.At present,the median followup period was 7.5 months,2 patients are under observation,one with lung metastatic lesion disappearing and the another with adrenal metastatic lesion partially necrotizing.The other 2 patients died due to high tumor load and advanced stage of tumor,and their survival time was 3 months and 6 months,respectively.Conclusion:TIL amplification and reinfusion combined with antiPD1 monoclonal antibody is safe and feasible in the treatment of advanced HCC,and the longterm efficacy requires further studies.Application of TIL amplified in vitro combined with antiPD1 monoclonal antibody is likely a hopeful new therapy for HCC.

Objective〖WTBZ〗〓To compare ligation and Hemolok in securing of appendix stump in laparoscopic  appendectomy.〖WTHZ〗Methods〖WTBZ〗〓There were 105 patients undergoing  laparoscopic appendectomy.They were treated by two different methods in securing of the base of the appendix：silk ligation of the stump was performed in 53 cases（ligation group）； while stump ligation by using Hemolok clips was performed in 52 cases（Hemlock group）.Two groups were compared in operation time and postoperative patient recovery.〖WTHZ〗Results〖WTBZ〗〓Between the both groups，postoperative complications and postoperative hospital stay had no significant differences（P>0.05）.The operation time of the ligation group was （55.5±7.8）min，which was significantly longer than that of the Hemolok group[（46.1±5.6）min，（P<0.05）].The cost of appendix root treatment in the ligation group was 0.3 yuan，while the cost in Hemolok group was 560 yuan.The difference between the two groups was statistically significant（P<0.05）.〖WTHZ〗Conclusion〖WTBZ〗〓Both methods are safe and effective in securing of the base of the appendix in laparoscopic appendectomy.Pursestring suture is more in line with traditional appendectomy requirements and cost effective，but requiring more skilled laparoscopic manipulation.Hemolok clipping of the appendix saves operation time and is easy to perform，which is more suitable for beginners.

Objective To compare the therapeutic effects of segmentectomy and lung wedge resection for lung cancer with a diameter ≤ 2cm and CT shows that ground glass nodules ≥ 50%.
Methods From January 2020 to July 2021,38 patients with lung adenocarcinoma who underwent segmental resection or pulmonary wedge resection at Zhongnan Hospital of Wuhan University were enrolled.Among them:16 cases in the segmental resection group(segmental resection group);22 cases in the wedge resection group(wedge resection group),compared the clinical data of the two groups of patients.
Results There was no perioperative death in both groups.Operation time [(131.6±40.2)min vs.(20.3±10.2) min],intraoperative blood loss [(67.2±49.1) ml vs.(9.9±5.1) ml],drainage tube extubation time[(3.5±1.5)d vs.(1.5±0.5)d] and hospitalization time [(4.5±3.5)d vs.(2.5±1.5)d] in the segmental resection group and the wedge resection group were statistically significant(P＜0.05).All these aspects,resection the wedge resection group was significantly better than the segment resection group.
Conclusion Pulmonary wedge resection is beneficial to the rapid recovery of patients with peripheral(1/3 of outside the lung parenchyma) and pulmonary adenocarcinoma with diameter ≤2cm.