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.

Osteoporotic vertebral compression fractures is a common type of osteoporotic fractures,often occurring with minimal external force or even without obvious trauma.They manifest as pain,deformity,and functional impairment,significantly impacting patients’ quality of life.Following reduction of vertebral compression fractures,bone defects often occur and typically require bone grafting for repair.Surgical treatments primarily include percutaneous vertebral augmentation and open surgery.Cement augmentation,appropriate bone implantation,and anti-pullout internal fixation are crucial components of bone repair therapy.Different types of cement materials and novel vertebral augmentation techniques offer more options for vertebral fracture repair.This consensus incorporates epidemiological characteristics of osteoporotic vertebral compression fractures,referencing literature search results and expert survey opinions,to address common controversies regarding commonly used vertebral bone repair materials,strategies,and postoperative considerations in clinical practice.It is hoped that this consensus will improve treatment outcomes,enhance patient prognosis,and promote standardized clinical management of osteoporotic vertebral compression fracture repair.

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 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.

Congenital scoliosis is a failure of vertebral formation，segmentation，or a combination of the 2 arising from abnormal vertebral development.Hemivertebral deformity caused by the former is the main cause of congenital scoliosis.Its etiology is complex and may be related to genetic and environmental factors.The diagnosis depends on clinical manifestations and imaging findings.Currently，imaging examinations include fetal spinal ultrasound and MRI，postnatal spinal ultrasound in infants，whole spine X-rays，CT，and MRI.At the same time，the genitourinary and cardiac ultrasound should be performed.Conservative treatment includes plaster，brace，the therapeutic effect is not good enough to completely correct deformity，so early surgical treatment is needed.The operative methods include in situ fusion，convex epiphysis arrest，hemivertebral resection，spinal fusion and spinal non-fusion.

Objective To compare the effectiveness of multi-layer compression therapy and biological ice pack in alleviating edema after total knee arthroplasty.Methods 100 patients who underwent total knee arthroplasty in our department from January 2020 to January 2022 were selected.They were randomly divided into two groups,50 cases in each group.The observation group was treated with multi-layer compression therapy,while the control group was treated with biological ice pack.The degree of swelling at 1d,2d,3d and 7d after surgery was evaluated,the time of swelling subtraction was recorded,and the pain and comfort at 1d and 3d after surgery were evaluated.Results On postoperative day 1,3,5 and 7,the circumference of lower limb swelling in the control group was (43.51±1.88)cm、(41.97±1.74)cm、(40.60±1.82)cm and (37.93±1.49)cm,respectively.The circumference of lower limb swelling in the observation group was (42.78±1.29)cm,(40.36±1.62)cm,(38.25±1.51)cm and (37.52±1.18)cm,respectively,which were significantly lower than those in the control group P<0.05).Besides,the swelling degree scores were significantly reduced at 1d,2d and 3d (P<0.05)and the swelling regression time was reduced compared to the control group (P<0.05),while the pain scores and comfort scores of observation group were not significantly different at 1d and 3d after operation (P>0.05).Conclusion Multi-layer compression therapy was more effective than ice pack cold compress in alleviating edema after total knee arthroplasty.

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.

Esophageal cancer is one of the most common malignancies in the digestive tract.Different from that adenocarcinoma is much more common in the West,squamous cell carcinoma is the predominate pathological type in more than 90% patients with esophageal cancer in China,majority of which had the cancer located in the middle and lower thoracic esophagus.Radical resection is still the important treatment for resectable esophageal cancer by now.Based on the anatomy of esophagus and staging of esophagus cancer,surgical treatment for the disease includes endoscopic submucosal dissection,transhiatal esophagectomy,transthoracic esophagectomy,and minimally invasive esophagectomy.The aim of this study was to analysis the “best” surgical treatment for middle and lower esophageal cancer,and to help surgeons for treatment decisionmaking.

Rectus abdominis diastasis (RAD) is a phenomenon in which the rectus abdominis muscles on both sides of the white line of the abdomen separate from each other,causing a series of physiological dysfunction.It is commonly seen in pregnant women and obese individuals.Currently,RAD has gradually attracted the attention of relevant surgeons.There is relatively little research on RAD both domestically and internationally,and there is no unified standard for diagnosis and treatment.This article will summarize the research progress on the diagnosis and treatment methods of rectus abdominis separation by combining domestic and foreign literature.

Objective To analyze the genomic alterations of papillary thyroid carcinoma(PTC) by nextgeneration sequencing(NGS),and to explore the relationship between mutation frequency and clinicopathological features. Methods  The tissue samples and clinical data from 34 PTC patients were collected in our hospital from May 2015 to May 2021.The 70 gene sequencing instrument was used for the detection of gene variations.Then we analyzed the relationship between BRAF mutation frequency and clinicopathological characteristics. Results  A total of 5 genes and 7 variant sites were identified in 34 PTC patients,among which BRAF V600E was the most common(80.77%).BRAF V600E and NCOA4-RET were present in both primary and recurrent lesions.BRAF mutation frequency ranged from 1.14% to 34.24% in the primary focus,subjects with high-frequency mutation(> 15%) mostly were a single larger tumor(>2 cm),but ones with low-frequency mutation(≤15%) was multiple smaller lesions(≤2 cm). Conclusion NGS is helpful to reveal the multigenic variation of PTC.BRAF mutation frequency,may contribute to diverse clinical biological features.

Objective To investigate the clinical and pathological characteristics of multifocal and multicentric breast cancer.Methods We collected data of 56 cases of multifocal and multicentric breast cancer and 150 cases of unifocal breast cancer（control group）to analyze the clinicopathological features of multifocal and multicentric breast cancer.Results In both the multifocal and multicentric breast cancer and the unifocal breast cancer group，we found the histological type which was invasive lobular carcinoma accounted for 8.9% and 2.0%，respectively.The lymph node metastasis rate was 69.6% and 51.3%，respectively.The lymphatic vessel invasion rate was 35.7% and 13.3%，respectively.The mastectomy and breast-conserving surgery accounted for 92.9%，77.3% and 7.1%，22.7%，respectively.The differences were statistically significant（all P＜0.05）.The detection rate of ultrasonography in multifocal and multicentric breast cancer was 73.2%，and that was 51.8% of mammography.There was a significant difference between the two imaging methods（P＜0.05）.The sensitivity of the two imaging examinations combined to detect this type of patient was 82.1%.Conclusion Compared to unifocal breast cancer，our findings suggest that the risk of axillary lymph node metastasis and lymphatic vascular invasion in multifocal and multicentric breast cancer was higher，and that had a high proportion of invasive lobular carcinoma.Preoperative ultrasonography combined with mammography can increase the accuracy of diagnosis of multifocal and multicentric breast cancer.Multifocal breast cancer can be treated with breast conserving surgery on the premise of negative margin.

Objective:To investigate the causes and treatment of anastomotic leakage after resection of esophageal carcinoma.Methods:3815 cases of esophageal and cardiac cancer were treated by operation.320 cases of anastomotic leakage were diagnosed after operation，and the causes and related factors of anastomotic leakage were analyzed.According to the conservative treatment of anastomotic leakage，they were divided into 2 groups：the internal drainage group（endoscopic direct drainage under the drainage tube），and the external drainage group（closed thoracic drainage）were 38，282 cases，respectively.The time of extubation，the time of hospitalization and the mortality in the perioperative period were compared between the two groups.Results:The incidence of anastomotic leakage after esophageal cancer resection was 8.39%，and the mortality was 1.88%.Anastomotic leakage was related to age，location of anastomotic position，average gastric flow of 3 days after operation（P＜0.05）.The extubation time[（23.50±18.64）d vs.（30.60±14.08）d] and hospitalization time [（32.45±20.60）d vs.（54.12±25.08）d] of the internal drainage group were significantly shorter than those of the external drainage group （P＜ 0.05），and there was no significant difference in the mortality rate （0 vs.2.13%）（P＞0.05）.Conclusion:The incidence of anastomotic leakage in patients with younger than 60 years，Inferior anastomosis of the aortic arch and more average gastric flow of 3 days after operation was low.The placement of internal drainage through the fistula in endoscopic vision can rapidly improve the symptoms，shorten the extubation and hospitalization time，and is worthy of popularization.

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 effect of silver ion antibacterial dressing and povidone iodine gauze on the incision and drainage of the abscess.
Methods From March 2019 to November 2019,62 patients were included in this study,and divided randomly into the observation group and the control group with 31 cases in each group.The patients in the observation group were treated with silver ion antibacterial dressing,while the patients in the control group were treated with povidone iodine gauze.The patients in the two groups were recorded in detail.The infection control time of abscess incision was compared before treatment,the third day and the second week after the first treatment,the number of dressing changes and wound healing time of the two groups,and the clinical effect of the patients was evaluated.
Results .The time of wound control in the observation group was (13.9±1.81)d,shorter than that in the control group (23.4±2.32)d(P<0.05);the BWATBWAT(Bates-Jensen Wound  assessment tool，BWAT) score of the observation group in the second week after the first treatment was (14.98±1.51),lower than that in the control group (19.78±2.46)(P<0.05);the times of drug change and wound healing in the Observation group were significantly shorter than that in the control group(P<0.05).
Conclusion Compared with the traditional povidone iodine gauze,the silver ion antibacterial dressing can control the wound infection and improve the wound healing more quickly,and the dressing change times are less,the wound healing time is obviously shortened.

晚期胃癌治疗选择有限，易发生化疗耐药。目前，包括免疫检查点抑制剂、过继细胞疗法、肿瘤疫苗、非特异免疫增强剂及细胞因子疗法在内的免疫疗法对胃癌显示出了良好的疗效。载体药物及3D打印技术也在临床前实验中取得了疗效。临床试验采用免疫肿瘤学单一疗法或联合免疫化学疗法来提高胃癌病人的总体生存时间和客观反应率。根据初步证据，我们相信免疫治疗可以积极影响自然病史，改善胃癌病人的预后。