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.

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.

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。

Bile reflux is a common physiological phenomenon in the body,which is caused by the retrograde movement of bile into the stomach and above.Long-term bile reflux causes bile reflux gastritis.It can also lead to intestinal metaplasia,Barrett’s esophagus,and even gastric cancer,esophageal cancer,pharyngeal cancer risk factors.Therefore,long-term frequent bile reflux should be regarded as pathological bile reflux.bile reflux is divided into primary bile reflux and secondary bile reflux.The common clinical symptoms of bile reflux include abdominal distension,bitter mouth,upper abdominal pain,nausea and vomiting.Primary bile reflux can occur without transgastric surgery,whereas secondary bile reflux often occurs after gastrointestinal surgery.This article reviews the pathogenesis,diagnosis and corresponding treatment progress of bile reflux,so as to provide reference for further research on bile reflux.

Objective To explore the effects of intracavitary radiofrequency ablation combined with sclerotherapy injection on symptom improvement and lower limb hemodynamics in patients with lower limb varicose veins.Methods Clinical data of 100 patients with lower extremity varicose veins treated in our hospital from January 2022 to January 2023 were retrospectively selected.According to the surgical method,the patients were divided into R group and S group,50 cases in each group.Traditional high ligation of great saphenous vein+exfoliation was performed in group S,intracavity radiofrequency ablation closure+ultrasound guided injection of foam sclerosing agent+spot exfoliation was performed in group R.The clinical status, lower extremity hemodynamic indexes before and after surgery, therapeutic effect 3 months after surgery, venous clinical severity score (VCSS), venous classification system (CEAP) grading before, 3 months after and 6 months after surgery, and the occurrence of complications 6 months after surgery were compared between the two groups.Results Three months after surgery,the total effective rate in group R (90.00%) was obviously higher than that in group S (74.00%) (P＜0.05).The hospital stay,bedtime,and intraoperative bleeding in group R were obviously lower than those in group S,and the VAS score within 72 hours after surgery was obviously higher than that in group S (P＜0.05).Compared with preoperative,postoperative blood flow velocity of femoral deep vein,popliteal vein and external iliac vein in 2 groups was significantly increased (P＜0.05).The R group was higher (P＜0.05).The difference of VCSS score and CEAP score 3 months and 6 months after surgery between the two groups was statistically significant (P＜0.05).There was no statistically obvious difference in the incidence of adverse reactions between group R and group S at 6 months after surgery(P>0.05).Conclusion Intraluminal radiofrequency ablation combined with hardener injection has a good therapeutic effect on patients with lower limb varicose veins,which can effectively improve the patient’s condition,reduce hemodynamic effects,maintain hemodynamic stability,and have high safety.

Immune cells are closely related to the progression and treatment of tumors.Single-cell RNA sequencing (scRNA-seq) is widely used in analyzing the biological behavior,mechanisms,and relationship between tumor-infiltrating immune cells and the body at the single-cell level.The Results show that scRNA-seq can comprehensively dissect tumor-infiltrating immune cells and promote personalized and precise clinical treatment.

Objective To investigate the effect of laparoscopic Roux-en-Y gastric bypass surgery (LRYGB) in the treatment of obese diabetes.Methods The clinical data of 20 obese diabetic patients who received LRYGB from 2012 to 2018 in the Minimally Invasive and Herniac Abdominal Surgery Center of Xinjiang People’s Hospital were retrospectively analyzed.Result The all 20 surgeries were successfully completed,and 1 case was converted to open surgery.The surgical time ranged from 60 to 420 minutes, with an average of (150±105.64) minutes,the intraoperative blood loss ranged from 20 to 100, with an average of (37.5 ± 20.99) ml,and the postoperative hospital stay ranged from 5 to 15, with an average of (8.25 ± 2.51) days.Complications occurred in 7 cases (35.00%) within 5 years after surgery,all of which were Clavien Dindo grade Ⅱ.The body weight,BMI,glycosylated blood glucose,fasting blood glucose,and the percentage of total weight loss (TWL%) at 1,3,and 5 postoperatively improved compared with those before surgery (P＜0.05).15 cases (75.00%) of type 2 diabetes were completely relieved by LRYGB 5 years after operation.Conclusion Laparoscopic gastric bypass surgery is an effective way to reduce weight and blood sugar in obese patients with type 2 diabetes.

Objective To investigate the effect of drug-coated balloon(DCB) percutaneous transluminal angioplasty(PTA) on clinical indicators and prognosis of patients with long-segment occlusion of lower extremity arteries.Methods A total of 91 patients with long-segment occlusion of lower extremity arteries admitted to the hospital from October 2020 to October 2022 were selected and divided into DCB group(n=46) and ordinary balloon(POB) group(n=45) according to different treatment methods.POB group underwent POB-PTA,DCB group underwent DCB-PTA.The vascular endothelial function indexes [ nitric oxide(NO),endothelin-1(ET-1),P-selectin ] were compared between the two groups before operation,6 h and 2 weeks after operation.The patients were followed up for 1 year.The primary patency rate,restenosis rate,target lesion revascularization rate,incidence of postoperative complications and the degree of target vessel stenosis,minimum lumen diameter(MLD),ankle brachial index(ABI),Rutherford vascular surgery(Rutherford) classification were measured before operation,6 months,12 months after operation were compared between the two groups.Results The serum NO levels at 6 h and 2 weeks after operation in the DCB group were(30.83±3.95) pg/ml and(33.62±4.20) pg/ml,which were higher than(26.70±3.58) pg/ml and(29.96±3.82) pg/ml in the POB group.The levels of ET-1 and P-selectin were(70.25±7.24) pg/ml,(67.29±7.05) pg/ml,(30.12±3.68) μg/L and(25.61±3.32) μg/L,which were lower than(75.98±7.63) pg/ml,(70.73±7.31) pg/ml,(37.03±3.90) μg/L and(27.29±3.50)(P< 0.05).The primary patency rate of the DCB group(82.61 %) was higher than that of the POB group(55.56 %),and the restenosis rate(10.87 %) was lower than that of the POB group(31.11 %)(P<0.05).There was no difference in the rate of target lesion revascularization between the two groups(P> 0.05).The degree of target vessel stenosis and Rutherford grade in DCB group were(18.07±5.25) %,(25.68±4.35) %,(2.05±0.64) grade and(2.24±0.81) grade at 6 months and 12 months after operation,which were lower than those in POB group (41.20±5.86) %,(57.36±5.18) %,(2.60±0.72) grade and(2.75±0.94) grade.MLD and ABI were(3.37±0.68) mm,(3.02±0.59) mm,(0.85±0.19) grade,(0.82±0.15) grade,which were higher than those in POB group(1.59±0.41) mm,(1.46±0.38) mm,(0.65±0.15) grade,(0.62±0.11) grade(P< 0.05).There was no difference in postoperative complications between the two groups(P> 0.05).Conclusion The application of DCB-PTA can significantly reduce vascular endothelial injury,improve primary patency rate,increase vascular diameter,relieve lower limb ischemia symptoms,reduce restenosis rate,and has good safety.

Objective To evaluate the safety and feasibility of primary endoscopic retrograde cholangiopancreatolithiasis (ERCP) plus laparoscopic cholecystectomy (LC) in patients with choledocholithiasis combined with cholecystolithiasis.Methods From January 2023 to August 2024,185 patients with common bile duct stones combined with gallbladder stones were treated at our hospital.Patients who underwent ERCP+LC during the same surgical period were assigned to Group A(94 patients),and those who underwent LC+ERCP in separate sessions during the same hospital stay were assigned to Group B(91 patients).The gender,age,total hospitalization costs,number and size of stones,whether a drainage tube was left in place,intraoperative blood loss,duration of anesthesia,time to postoperative bowel gas passage,length of hospital stay,incidence of postoperative cholangitis,incidence of postoperative pancreatitis(PEP),rate of residual stones in the bile ducts,and changes in preoperative and postoperative neutrophils,neutrophil percentage,total serum bilirubin,indirect serum bilirubin,alanine aminotransferase,aspartate aminotransferase,and γ-glutamyl transferase were recorded for both groups of patients.Results Compared to Group B[(9.7±2.0)d],the hospital stay duration for patients in Group A[(8.6±2.6)d] was significantly reduced(P<0.05).The duration of anesthesia for patients in Group A[(2.5±0.8)h] was also significantly shorter than that for Group B[(3.7±0.5)h],with a statistically significant difference(P<0.05).Similarly,the total hospitalization costs for patients in Group A[(23969±7421)yuan] were lower than those for Group B[(25427±5236)yuan],and this difference was statistically significant(P<0.05).Conclusion The one-stage ERCP combined with LC treatment protocol for common bile duct stones with gallbladder stones is safe and feasible,with the potential advantages of reducing hospital stay,costs,and duration of anesthesia.

Objective To improve the level of diagnosis and treatment through analyzing the clinical characteristics,treatment and prognosis with testicular torsion in children.Methods We conducted a retrospective analysis of 221 boys with testicular torsion,who received trearment from May 2003 to May 2023 at the Children's Hospital of Chongqing Medical University and Guizhou Provincial People's Hospital.Data analysed included:clinical characteristics,treatment progress and outcome.Results The peak onset age of testicular torsion in children was infancy and prepuberty (71%).The incidence of left side (77%) was higher than that of right side (23%).The first symptoms were mainly scrotal pain and swelling (62%),but some cases mainly manifested lower abdominal pain and inguinal pain (11%).The rate of misdiagnosis and mistreatment of patients in basic hospitals was high.Scrotal color Doppler ultrasonography is the first choice for assistant examination,and mainly showed none or dramatically decrease of blood supply in testis,and abnormal axial direction.The golden time for testicular torsion diagnosis was within 8 hours.The chief pathological manifestation were interstitial hyperemia,edema and seminiferous tubules degeneration within 8 hours,and hemorrhagic necrosis or infarction over 8 hours.Conclusions Children Testicular torsion occurs more frequently in infancy and prepuberty,torsion position in the left side is more than that in right side.The main symptoms are scrotal pain and swelling,as well as lower abdominal or inguinal pain.Testicular pathological lesion is closely associated with the diagnosis time and degree of torsion.

Encapsulated papillary carcinoma (EPC) of the breast is a rare,low grade malignant tumor which is more common in postmenopausal women.The clinical manifestations of EPC are nonspecific and easily confused with other benign breast tumors,leading to misdiagnosis and delayed diagnosis.There is currently no consensus on the diagnosis and treatment plan for EPC,and few clinical trials have been conducted on it.Therefore,this article reviews the diagnostic characteristics and therapeutic approaches of EPC.

Objective   To explore the effect of Endoanal advancement flap (ERAF) and transanal opening of interphincteric space (TROPIS) in the treatment of complex anal fistula and their impact on anorectal pressure,so as to provide a reference for clinical selection of surgical methods.Methods   Eighty-four patients with complex anal fistula admitted from October 2018 to October 2022 were divided into group E received ERAF treatment (n=48) and group T received TROPIS treatment (n=36).The clinical efficacy,operation,wound surface and anorectal pressure of the two groups were compared.Results   The effective rate of treatment in Group T was 97.22%,which was higher than that in Group E(87.50%),with no statistically significant difference (P＞0.05).The surgical time [(31.53±7.29) minutes],intraoperative bleeding volume [(29.56±7.37) ml],and wound area [(10.03±0.96) cm²,(8.76±0.87) cm²,(6.20±0.77) cm²] on the day of surgery,7 and 14 days after surgery in Group T were all smaller than those in Group E[（35.36±8.54）min,（36.86±8.04)ml,（12.09±1.23）cm²,（10.52±1.09）cm² and（7.36±0.85）cm²] (P<0.05).After surgery,the VAS score and Wexner incontinence score of Group T were (1.38±0.27) and (0.21±0.08),respectively.Group E was (1.56±0.29) and (0.33±0.09),respectively.In group T, the anorectal systolic pressure at 20mm and 30mm and the anorectal resting pressure at 20mm and 30mm were(138.18±29.58) mmHg,(136.22±35.41) mmHg,(35.47±6.58) mmHg,and (32.97±8.01) mmHg,respectively.In Group E, the data was (152.78±31.53) mmHg,(156.29±32.74) mmHg,(38.29±7.62) mmHg and (36.41±7.63) mmHg,respectively.Both groups showed a decrease in score and anorectal pressure,and group T was lower than group E (P<0.05).The incidence of adverse reactions in Group E was 20.83% ,which was higher than that in Group T(11.11%),but the difference was not statistically significant (P＞0.05).Conclusion   TROPIS has a better effect in the treatment of complex anal fistula,which can shorten the operation time,reduce intraoperative bleeding,reduce postoperative pain,and protect anal function.

Esophageal cancer (EC) is most commonly diagnosed in our country as an advanced esophageal cancer.With the continuous exploration and innovation of treatment methods,the comprehensive treatment scheme based on surgery is gradually improved.Immunotherapy is a new way to treat tumors in recent years.How to make better use of it in neoadjuvant therapy to create a better prognosis for EC is worth discussing.

The unilateral biportal endoscopic spinal surgery(UBE) technique is an emerging endoscopic technique,mainly used as treatment for lumbar degenerative disease.The procedure is characterized by two working channels,one being endoscopic,the second to be employed as an operating channel.Through the use of such dual-channel-technology,it allows the operating instruments to be unrestricted in size.Therefore,it is a highly efficient surgical technique for minimally invasive spinal surgery(MISS).However,the clinical complications of UBE technology must be taken into consideration.Possible side effects include dural injury,epidural hematoma,occult blood loss,postoperative headache,nerve root injury and insufficient decompression.This article reviews the causes,prevention and management of UBE-related complications.            

Objective To explore the application of laparoscopic anatomic right anterior lobectomy based on anterrior pedicle-posterior pedicle-right hepatic(APR) triangle approach and laparoscopic ultrasound assisted localization.Methods The clinical data of 28 patients who received laparoscopic anatomic right anterior lobectomy at the Hepatobiliary and Pancreatic Surgery Center of Shiyan Taihe Hospital from January 2018 to August 2022 were retrospectively analyzed.Among them,14 patients were set as the experimental group based on the APR triangle approach and 14 patients were set as the control group who underwent the traditional anterior approach.The basic information,operation time,intraoperative blood loss,intraoperative blood transfusion,postoperative complications,postoperative liver function and postoperative hospital stay were compared between the experimental group and the control group,and statistical analysis was carried out.Results The two laparoscopic anatomical hepatectomy Methods of right anterior lobectomy were successfully completed.In terms of intraoperative indexes,the operation time of the experimental group [(340.71±45.82) min] and hilar occlusion time [(56.07±11.47) min] were both shorter than those of the control group [(428.92±90.00) min and (68.36±15.96) min],and the differences were statistically significant (P＜0.05).In the experimental group,Serum levels of ALT was (236.51±78.65) U/L at 1 day after surgery, AST was (216.82±95.66)U/L at 1 day after surgery,ALT was (177.23±84.76)U/L at 3 days after surgery,AST was (125.63±55.48) U/L at 3 days after surgery,TBil was (23.57±7.58) μmol/L at 3 days after surgery,which were significantly lower than that in the control group[(658.73±361.55)U/L,(688.88±241.52)U/L,(383.42±199.01)U/L,(232.59±168.5)U/L and (31.46±11.95)μmol/L,respectively](P＜0.05).Compared with the control group[(9.86±2.44)d],the experimental group had shorter postoperative hospital stay[(7.79±1.19)d],the difference were statistically significant(P＜0.05).There was no recurrence or death in the two groups at 90 days after the operation.Conclusion The Glisson pedicle approach based on APR triangle and abdominal ultrasound assisted localization of laparoscopic anatomical right anterior lobectomy have the advantages of shorter operation time,shorter hilar occlusion time,faster postoperative enzymatic recovery of liver function and shorter postoperative hospital stay.There was no significant difference in postoperative complications between the two groups.

Objective To summarize the key surgical points of subxiphoid thoracoscopic thymectomy and compare its clinical efficacy with lateral thoracic approach thymectomy.Methods Clinical data of 93 patients who underwent thoracoscopic thymectomy for thymic tumors at Wuhan Tongji Hospital from February 2021 to March 2023 were collected.The patients were divided into the subxiphoid group (n=40) and the lateral thoracic group (n=53) according to the surgical approach.Surgical outcomes,perioperative indicators,and postoperative pain were compared between the two groups.Results Both groups of patients underwent complete or extended thymectomy via thoracoscopy without conversion to open surgery.The subxiphoid group had significantly shorter operation time for complete thymectomy [(60.32±1.53)minutes],operation time for extended thymectomy [(114.52±11.63)minutes],duration of chest tube placement [(3.20±0.91)days],and length of hospital stay [(4.00±0.16)days] compared to the lateral thoracic group [(66.62±1.45)minutes,(138.76±6.35) minutes,(4.00±1.22)days and (4.70±0.18)days,respectively],with statistical significance (P＜0.05).The subxiphoid group also had lower VAS scores at 24 hours (3.8±0.8),48 hours (3.0±0.7),and 72 hours (2.6±0.9) postoperatively,compared to the lateral thoracic group [(5.7±0.9),(4.7±0.8),(3.2±0.8),respectively],with statistical significance (P＜0.05).There were no significant differences between the two groups in terms of intraoperative blood loss,hospital costs,complication rates,and abnormal sensations after 30 days postoperatively (P＞0.05).Conclusion Modified modular subxiphoid thoracoscopic thymectomy is safe and reliable,and offers significant perioperative advantages,especially for patients with Masaoka stage I and II thymomas accompanied by myasthenia gravis (MG).

Objective To investigate the effect of upper rectal artery (SRA) embolization on clinical treatment,intraoperative blood loss and pain in patients with stage Ⅱ to Ⅲ hemorrhoids.Methods A total of 84 patients diagnosed with stage Ⅱ to Ⅲ hemorrhoids in our hospital from January 2021 to January 2022 were selected.According to different surgical interventions,PPH group and SRA group were established,with 42 cases in each group.The PPH group was treated with hemorrhoid mucosa ring resection and nailing operation,and the SRA group was treated with upper rectal artery embolization.The clinical efficacy,perioperative indicators,anal symptoms,postoperative pain,anorectal dynamics indicators,and incidence of postoperative complications were compared between the two groups.All patients received a 6-month follow-up survey after the operation,and the recurrence of hemorrhoids during the follow-up period was collected,and Kaplan-Meier curve was used for comparative analysis.Results The total effective rates of SRA group and PPH group at 12 months after operation were 92.86% and 76.19%,operation time was (17.23±4.26) min and (43.16±9.37) min,hospital stay was (5.52±1.89)d and (8.25±2.67)d,wound healing time was (7.36±2.23)d and (17.83±4.04)d, the intraoperative blood loss was (10.03±2.38) ml and (16.22±3.11) ml,and the operative cost were (14327.36±892.23) yuan and (2762.83±524.04) yuan, postoperative anal incontinence was (0.45±0.02) points and (0.60±0.09) points,anal pain score was (3.04±0.14) points and (5.15±1.68) points,anal bleeding scores was (0.43±0.08) points and (0.61±0.19) points,symptom scores of anal border edema was (0.29±0.09)points and (0.52±0.16)points,respectively.The difference between the two groups was statistically significant (all P<0.05).Postoperative rectal resting pressure (RRP) [(2.41±0.35) kPa vs. (2.95±0.29) kPa] and anal canal resting pressure (ARP) [(13.14±1.51) kPa vs. (14.67±1.59) kPa] levels between the SRA group and PPH group were statistically significant at 12 months after surgery（P＜0.05).Postoperative maximum systolic blood pressure (AMCP) of anal canal in SRA group [(14.22±0.28) kPa] was significantly higher than that in PPH group [(13.35±0.23) kPa] ( P<0.05).The total incidence of complications 12 months after operation in SRA group was significantly lower than that in PPH group (4.76% vs. 21.43%) (P＜0.05).After surgery,both groups were followed up for 12 months.In SRA group,13 cases (30.95%) recurred internal hemorrhoids.In the PPH group,10 patients (23.81%) had internal hemorrhoid recurrence,and there was no significant difference between the two groups (P＞0.05).Conclusion SRA can effectively improve clinical efficacy in the treatment of stage Ⅱ to Ⅲ hemorrhoids patients,and has positive significance in promoting rapid recovery of patients and improving adverse symptoms such as pain degree.

Objective To investigate the high risk factors of vascular crisis(VC) after replantation of severed finger,and to construct the corresponding risk prediction model.Methods Data of the cases performed in two hospitals between January 2022 and February 2023 were collected,totaling 183 cases.The patients were divided into VC group (22 cases) and non-VC group (161 cases) according to the occurrence of VC.The risk factors were screened by univariate analysis and multivariate logistic regression analysis,and the corresponding risk prediction model was constructed.Results Univariate analysis showed that smoking history,degree of dissection,ischemic time,cause of injury,arterial repair and venous repair were related to the occurrence of vascular crisis(P＜0.05).Multivariate logistic regression analysis showed that smoking history,degree of detachment and ischemic time are the risk factors for vascular crisis(P＜0.05).Based on the risk factors of vascular crisis,a line graph model was established for the occurrence of vascular crisis after replantation of severed finger.The area under ROC curve was 0.963,the sensitivity was 91.7%,and the specificity was 96.0%,indicating that this model has a good risk prediction ability.Conclusion Smoking history,degree of amputation and ischemic time were independent risk factors for vascular crisis after finger replantation.The constructed risk prediction model can provide clinicians with postoperative risk assessment and prediction,which is helpful to formulate targeted treatment plans and reduce the incidence of postoperative complications.

Objective To apply gastrointestinal ultrasound to evaluate the gastrointestinal function of patients with acute gastrointestinal injury (AGI) and to determine the timing of starting enteral nutrition (EN) therapy to guide clinical enteral nutrition therapy.Methods One hundred and three critically ill patients with AGI level 2 (AGI Ⅱ) were prospectively screened at the Department of Intensive Care Medicine (ICU) of the Second People’s Hospital of Anhui Province from March 2022 to May 2023,and the following data were recorded,including ultrasound gastric sinus cross-sectional area (CSA),diameter of the descending or ascending colon (CD),peristaltic frequency (CPF),time of EN initiation,prealbumin (PA),EN dose and EN complications.Recovery of gastrointestinal function after EN treatment was judged as successful,and failure was judged if there were complications of EN treatment.Changes in gastrointestinal function after EN treatment were analyzed to determine the timing of enteral nutrition.Results There were 68 cases in the successful group and 35 cases in the failed group.There were no statistically significant differences between the two groups in terms of age,intra-abdominal pressure (IAP),Acute Physiology and Chronic Health Status Score Ⅱ (APACHE-Ⅱ),PA,and disease composition (all P>0.05).The EN initiation time [(14.71±8.89)h],CSA [(9.24±1.30)cm²] and CD [(2.86±0.41)cm] in the successful group were earlier or smaller than the failed group [(19.52±13.53)h,(10.82±1.96)cm² and (3.38±0.46)cm](all P<0.05),whereas the CPF [(2.84±0.96) times/min] in the successful group was faster than thefailed group [(2.32±0.98) times/min] (P<0.05).ROC analysis showed greater value for CSA,CD and CPF to predict EN success,with thresholds of CSA ≤ 9 cm² (AUC = 0.892),CD ≤ 2.8 cm (AUC = 0.858) and CPF > 3 times/min (AUC =0.744);when the combination of CSA,CD and CPF was predicted to generate PRE_1,the AUC was the largest (0.968) and had the highest predictive value,which could determine the best time to initiate EN.Conclusion Ultrasound monitoring of the cross-sectional area of the gastric sinus,the internal diameter of the colon,and the frequency of colonic peristalsis can predict the efficacy of enteral nutrition therapy in critically ill patients with grade Ⅱ acute gastrointestinal injury and guide the optimal timing of initiating enteral nutrition therapy.

Objective Exploring the effect of Percutaneous angular vertebroplasty (PCVP) on functional recovery in elderly patients with osteoporotic vertebral compression fractures (OVCF).Methods Retrospective selection of clinical data from 108 OVCF patients admitted to our hospital from August 2020 to December 2022.According to the different surgical methods,52 cases were divided into a control group (percutaneous vertebroplasty) and an observation group (percutaneous vertebroplasty) with 56 cases;Compare the recovery of vertebral body function,imaging related parameters,functional impairment and lumbar function,surgical related conditions,gait,and complications between the two groups.Results The intraoperative blood loss in the observation group was less than that in the control group[(10.65±3.52)ml vs.(13.11±3.66)ml,P＜0.05],the number of intraoperative fluoroscopy was less than that of control group[(14.21±4.27) vs.(17.04±4.25)，P＜0.05],there was no statistically significant difference in the total clinical effective rate between the observation group of 89.28% and the control group of 86.53% (P>0.05).After 2 months of surgery,the imaging related parameters,functional impairment,lumbar function,surgical and gait related conditions in the control group were better than those in the control group (P<0.05).There was no statistically significant difference in the incidence of incision infection,nerve root injury,and recurrent fractures between the two groups (P>0.05),but the leakage rate of bone cement in the observation group was lower than that in the control group (P<0.05).Conclusion Both surgeries can effectively improve the level of lumbar vertebral function in OVCF patients.PVCP has advantages in increasing the height of the anterior and posterior edges of the vertebral body,reducing the Cobb angle,and relatively fewer intraoperative fluoroscopy times and bleeding.The incidence of bone cement leakage is lower,making it more safe.

Prostate cancer is the most prevalent tumor of the urinary system globally and represents the highest incidence of malignant tumors among males in Europe and the United States.For recurrent or metastatic disease,androgen deprivation therapy is currently recognized as the cornerstone of treatment.However,nearly all patients inevitably progress to an incurable castration-resistant prostate cancer stage.Although the approval of several new drugs over the past two decades has enhanced both survival time and quality of life for patients with advanced prostate cancer,there remains an urgent challenge to develop new strategies that can overcome drug resistance and further extend survival duration.Therefore,based on published or ongoing clinical studies,this review will focus on an overview of the significant advancements made in the field of prostate cancer drug therapy,as well as new drugs that are actively undergoing clinical trials to provide a reference for the clinical treatment of advanced prostate cancer.

Objective To explore the impact of clinical treatment decisions on the long-term survival of different molecular subtypes of locally advanced breast cancer(LABC),and to promote the development of more effective and individualized treatment regimens for LABC.Methods The cases of LABC diagnosed by pathology from 2010 to 2015 were searched in the database.Breast cancer-specific survival (BCSS) and overall survival (OS) were estimated by plotting Kaplan-Meier curves.The log rank test (Mantel-Cox) was used to analyze the difference between the groups,and the benefit population of LABC was determined after for age,TNM stage,grade,treatment methods.Results The 5-year OS and BCSS were 77.43% and 84.34% in breast-conserving,and 68.03% and 76.90% in mastectomy,respectively.The 5-year OS and BCSS of Luminal A LABC were 79.91% and 87.23% in breast-conserving,and 71.78% and 81.16% in mastectomy,respectively.The 5-year OS and BCSS of Luminal B LABC were 79.30% and 83.14% in breast-conserving,and were 70.37% and 76.92% in mastectomy,respectively.The 5-year OS and BCSS of triple-negative LABC were 60.77% and 68.13% in breast-conserving,and those of mastectomy were 47.13% and 55.94%,respectively.The 5-year OS and BCSS of HER2 positive were 75.42%,82.05% in breast-conserving,and were 67.05% and 75.01% in mastectomy,respectively;The 5-year OS and BCSS of triple-positive LABC were 86.12% and 91.63% in breast-conserving,and 74.54% and 82.56% in mastectomy,respectively.The 5-year OS and BCSS of well differentiated and N0 triple-positive LABC patients with chemotherapy were 88.24% and 76.91%,and those of patients without chmotherapy were 88.24% and 90.91%,respectively (BCSS:P=0.812;OS:P=0.311).Conclusion In the selective population,OS and BCSS of patients with LABC undergoing breast conserving surgery were significantly better than those of mastectomy.When OS and BCSS were compared for different molecular types and stages of LABC, breast-conserving surgery was still superior to total mastectomy.LABC could be considered for highly differentiated,N0 stage Triple positive without chemotherapy.

Osteoporotic vertebral compression fractures (OVCFs) are the most common fractures in the elderly population,significantly impacting patients’ health and quality of life.This article reviews the diagnostic and therapeutic advancements in the management of elderly patients with osteoporotic thoracolumbar vertebral compression fractures.In terms of diagnosis,clinical manifestations and imaging examinations are crucial.While X-ray remains the preferred imaging modality,MRI offers higher sensitivity in identifying OVCFs,with promising new MRI technologies expected to further enhance diagnostic accuracy.Regarding treatment,conservative management and minimally invasive surgery are commonly employed methods.In addition to traditional minimally invasive techniques such as PVP and PKP,novel approaches such as vertebral augmentation with implant-based systems and robot-assisted vertebral augmentation are continuously evolving.

Objective  To investigate the effects of laparoscopic radiofrequency ablation (LRFA) and percutaneous radiofrequency ablation (PRFA) on anti-tumor immunity, complication rate and recurrence rate in patients with primary liver cancer.Methods A total of 81 patients with primary liver cancer treated in Dazhou Central Hospital from January 2020 to August 2022 were selected and divided into observation group (LRFA, n=42) and control group (PRFA, n=39) according to the treatment plan. Compare the total ablation rate, postoperative complication rate, recurrence rate of the two groups, as well as tumor necrosis factor-α (TNF-α), carbohydrate antigen 199 (CA199), interleukin-6 (IL-6), Golgi protein 73 (GP73), Creactive protein (CRP), alpha-fetoprotein (AFP) and peripheral blood T lymphocyte subpopulation levels before and after surgery.Results There was no significant difference between the observation group (95.24%) and the control group (92.31%) (P>0.05). At 1 d postoperatively, IL-6 was (124.63±45.41) pg/ml and (168.28±51.26) pg/ml, CRP was (19.14±5.03) ng/L and (28.26±7.47) ng/L, and TNF-α was (94.32±18.49) pg/ml and (108.41±20.11) pg/ml; at 3 d postoperatively, IL-6 was (92.37±24.11) pg/ml and (105.83±27.45) pg/ml in the observation group and the control group, respectively, CRP was (14.87±4.37) ng/L and (17.25±5.06) ng/L, and TNF-α was (75.41±12.10) pg/ml and (82.64±16.83) pg/ml, which were all higher than that of preoperative period (P<0.05). At 7 d postoperatively, CD3+ in the observation group and control group were (66.27±7.82)% and (65.14±7.63)%, AFP was (156.23±30.27)μg/ml and (160.84±32.33)μg/ml, GP73 was (65.21±10.26)μg/L and (67.44±11.03) μg/L, CA199 was (44.89±11.41) U/L and (45.12±13.07) U/L, CD4 was (32.02±6.03)% and (31.53±6.11)%, and CD4+/CD8+ was (1.31±0.39) and (1.29±0.37) respectively; at 14 d postoperatively, CD3+ was (71.25±6.83)% and (70.89±6.76)%, AFP was (48.52±18.31)μg/ml and (50.11±19.12)μg/ml, GP73 was (48.25±8.46)μg/L and (49.12±10.12)μg/L, CA199 was (19.27±5.16)U/L and (20.07±5.39)U/L, and CD4 was (38.25±7.7)U/L and (20.07±5.39)U/L, respectively, in the observation and control groups. g/L, CA199 was (19.27±5.16)U/L and (20.07±5.39)U/L, CD4 was (38.25±7.45)% and (37.61±7.92)%, and CD4+/CD8+ was (1.49±0.42) and (1.47±0.45), respectively, which were higher than that of preoperative period (P<0.05), but the difference between the two groups was not statistically significant (P>0.05). The postoperative complication rate of 42.86% and recurrence rate of 2.38% in the observation group were lower than 66.67% and 17.95% in the control group (P<0.05). The 12month postoperative survival rate of 97.62% in the observation group was not statistically significant compared with 94.87% in the control group (P>0.05).Conclusion  The efficacy of LRFA and PRFA in the treatment of primary hepatocellular carcinoma is comparable, which can effectively improve the body’s anti-tumor immunity and reduce the release of serum tumor markers; however, LRFA has less stressful reaction, reduces the occurrence of postoperative complications, and has a lower recurrence rate, which is especially advantageous in the treatment of hepatocellular carcinoma at special sites.

Objective To study the sensitivity and specificity of Lymphoedema Functioning,Disability and Health Questionnaire for Lower Limb Lymphoedema (Lymph ICF-LL) and Lymphoedema Quality of Life Questionnaire (LYMQOL),and to explore the optimal cutoff score of the scales,in order to better identify secondary lower limb lymphoedema.Methods 62 patients with secondary lower limb lymphoedema and 37 patients without lymphedema after gynecological cancer operation was collected.Spearman test was used to evaluate the correlation between the scores of the two scales and the Lower Extremity Lymphedema Index (LEL index).Receiver operating characteristic (ROC) was used to evaluate the predictive diagnostic efficacy of the two scales.Results Correlation analysis showed that Lymph ICF-LL score was positively correlated with LEL index (r=0.478,P<0.05),and LYMQOL score was positively correlated with LEL index (r=0.346,P<0.05).Both scales had high accuracy,sensitivity and specificity in detecting secondary lymphedema of lower limbs.The area under the ROC curve of Lymph ICF-LL score in predicting was 0.926 (P<0.05),the optimal cut-off value was 20.1 points,the sensitivity was 83.9% and the specificity was 91.9%.The area under the ROC curve of LYMQOL score in predicting was 0.883 (P<0.05),the optimal cut-off value was 1.9 points,the sensitivity was 80.6%,and the specificity was 83.8%.Conclusion Lymph ICF-LL and LYMQOL have high specificity and sensitivity in the diagnosis of secondary lower limb lymphoedema.The two scales can be used as one of the diagnostic Methods for secondary lower limb lymphoedema.

Objective To explore the effectiveness and recurrence rate of oncoplastic breast surgery in the treatment of early-stage breast cancer.Methods A retrospective study was conducted on 50 patients who underwent oncoplastic breast surgery (observation group) and 50 patients who underwent conventional breast-conserving surgery (control group) for early-stage breast cancer between January 2017 and June 2019,selected according to admission order and inclusion/exclusion criteria.The surgical time,intraoperative blood loss,length of hospital stay,immune function indicators,postoperative complication rate,excellent appearance rate of the breast,quality of life score,survival rate,and recurrence rate were compared between the two groups.Results The average intraoperative blood loss in the observation group was (40.27±11.35) ml,which was lower than that in the control group (74.65±21.84) ml.The observation group had shorter surgical time (51.28±6.79) min and hospital stay (7.41±1.87) days compared to the control group (P<0.05).CD3+ and CD4+/CD8+ levels were higher in the observation group than in the control group after surgery (P<0.05).The observation group had a lower incidence of postoperative complications compared to the control group (2.00% vs 14.00%,P<0.05).The excellent appearance rate of the breast was higher in the observation group than in the control group (100% vs 90%,P<0.05).After surgery,the quality of life scores in all factors were higher in the observation group than in the control group (P<0.05).There was no significant difference in postoperative survival rate and recurrence rate between the observation and control groups (P＞0.05).Conclusion Oncoplastic breast surgery,compared to conventional breast-conserving surgery,can effectively improve the appearance of the breast,reduce surgical trauma and immune function damage,decrease postoperative complications,and enhance the quality of life of patients with early-stage breast cancer without affecting their long-term prognosis or increasing the recurrence rate.

Objective To evaluate the efficacy of XELOX regimen as neoadjuvant chemotherapy in the treatment of stage Ⅱ and Ⅲ colon cancer.Methods The clinical data of 50 patients with clinical stage Ⅱ(T4)  Ⅲ colon cancer who underwent laparoscopic radical resection at general surgery department of our hospital from January 1,2012 to January 1,2021 were retrospectively analyzed.Patients were divided into neoadjuvant chemotherapy group (NACT) and adjuvant chemotherapy group (ACT) according to whether they received neoadjuvant chemotherapy with XELOX regimen.The general clinical data,adverse reactions of chemotherapy,surgical complications,operation time,intraoperative blood loss,hospitalization time,hospitalization cost,negative conversion rate of tumor markers,tumor remission rate,tumor downstaging rate,tumor response grade after chemotherapy,postoperative diseasefree survival curve,and overall survival curve were retrospectively analyzed and compared among the groups.Objective To evaluate the efficacy of XELOX regimen as neoadjuvant chemotherapy in the treatment of stage Ⅱ and Ⅲ colon cancer.Methods The clinical data of 50 patients with clinical stage Ⅱ(T4)  Ⅲ colon cancer who underwent laparoscopic radical resection at general surgery department of our hospital from January 1,2012 to January 1,2021 were retrospectively analyzed.Patients were divided into neoadjuvant chemotherapy group (NACT) and adjuvant chemotherapy group (ACT) according to whether they received neoadjuvant chemotherapy with XELOX regimen.The general clinical data,adverse reactions of chemotherapy,surgical complications,operation time,intraoperative blood loss,hospitalization time,hospitalization cost,negative conversion rate of tumor markers,tumor remission rate,tumor downstaging rate,tumor response grade after chemotherapy,postoperative disease-free survival curve,and overall survival curve were retrospectively analyzed and compared among the groups.Results There were no significant differences in operative complications,postoperative exhaust time and hospital stay between NACT group and ACT group (P>0.05).The adverse reactions of chemotherapy,the negative conversion rate of postoperative CEA and CA19-9,the duration of operation,the amount of bleeding,and the hospitalization cost in NACT group were significantly better than those in ACT group (P<0.05).In terms of DFS and OS survival curves,with the extension of time,the decline of the NACT survival curve was smaller than that of the ACT group,and there was a significant difference in DFS survival curve (P<0.05),but no significant difference in OS survival curve (P>0.05).Conclusion XELOX neoadjuvant chemotherapy is safe and effective in the treatment of stage Ⅱ (T4) and stage Ⅲ  colon cancer.There were no significant differences in operative complications,postoperative exhaust time and hospital stay between NACT group and ACT group (P>0.05).The adverse reactions of chemotherapy,the negative conversion rate of postoperative CEA and CA19-9,the duration of operation,the amount of bleeding,and the hospitalization cost in NACT group were significantly better than those in ACT group (P<0.05).In terms of DFS and OS survival curves,with the extension of time,the decline of the NACT survival curve was smaller than that of the ACT group,and there was a significant difference in DFS survival curve (P<0.05),but no significant difference in OS survival curve (P>0.05).Conclusion  XELOX neoadjuvant chemotherapy is safe and effective in the treatment of stage Ⅱ (T4) and stage Ⅲ  colon cancer.

Objective  To explore the risk factors of anal fistula after incision and drainage surgery for perianal abscess,and establish an individualized predictive nomogram model.Methods A retrospective analysis was conducted on the clinical data of 224 patients with perianal abscess who underwent incision and drainage surgery in Affiliated Hospital of Shanxi University of Chinese Medicine from May 2020 to January 2023,according to whether anal fistula occurred within 3 months after surgery,there were 169 cases in the non anal fistula group and 55 cases in the anal fistula group.Single factor method and multivariate Logistic regression analysis were applied to analyze the influencing factors of anal fistula after incision and drainage of perianal abscess,a nomogram risk model was constructed using independent risk factors to predict the occurrence of anal fistula after incision and drainage of perianal abscess,and the consistency and differentiation of the model were verified.Results The proportions of male,diabetes,deep abscesses,intestinal origin of pathogenic bacteria,and abscesses in anal fistula group were higher than those in non anal fistula group (P＜0.05).Male,diabetes,deep abscess,intestinal origin of pathogenic bacteria,and history of abscess were independent risk factors for anal fistula after incision and drainage of perianal abscess (P＜0.05).The ideal curve of the nomogram model fitted well with the correction curve,indicated that the measured values were basically consistent with the predicted values.The area under the receiver operating characteristic (ROC) curve was 0.946 (95%CI=0.914-0.979),indicated that the column plot model has good predictive discrimination.Conclusion The independent risk factors for anal fistula after incision and drainage surgery of perianal abscess include male,diabetes,deep abscess,intestinal origin of pathogenic bacteria,and history of abscess.The construction of related nomogram model can guide clinical screening of high-risk groups to a certain extent.