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 diagnostic strategies and treatment options for gastrointestinal bleeding after aortic dissection surgery.Methods The clinical data and diagnosis and treatment results of patients with gastrointestinal bleeding after aortic dissection surgery admitted from January 2020 to June 2022 in the Affiliated Nanjing Hospital of Nanjing Medical University were analyzed retrospectively.Results A total of 10 cases of 14 patients with gastrointestinal bleeding after aortic dissection surgery were cured,7 cases were mainly based on basic support and drug therapy,1 case was treated with endoscopic therapy,and 2 cases were treated with surgical operations;In the untreated group,3 cases were basic support and medication,and 1 case died due to poor surgical treatment.Conclusion The diagnosis and treatment strategy of gastrointestinal bleeding after aortic dissection surgery should be comprehensively evaluated according to the amount,location and complications of bleeding,and the individualized treatment of patients should be strengthened.Timely surgical treatment is helpful to improve the prognosis and outcome of patients with gastrointestinal bleeding after aortic dissection surgery.

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.

Objective   To summarize the etiology,clinical features,treatment and prevention of internal abdominal hernia after gastric surgery(Petersen hernia) and improve the understanding of Petersen hernia.  Methods   A retrospective analysis in January 2018 to December 2021 jilin university fellowship between China and Japan hospital for treatment of 9 cases after gastrectomy Petersen hernia patients,7 cases underwent open Bie-ⅱ anastomosis and 2 cases underwent Roux-en-Y anastomosis due to the primary disease.The median duration of onset was 2 days.The percentage of neutrophils in blood routine was increased to varying degrees.Preoperative abdominal CT showed anastomotic wall thickening,proximal small bowel obstruction sign 4 cases,small intestine torsion signs in 2 cases,no special signs only 3 cases of small intestinal obstruction,has not been in patients with preoperative diagnosis for Petersen hernia,all patients underwent surgical treatment,intraoperative see output section of the small intestine to shift into the Petersen clearance and hernia in 5 cases,There were 3 cases without torsional herniation into Petersen space in the output segment and 1 case with torsional herniation into Petersen space in the input segment.Among them,4 patients underwent intestinal resection and anastomosis due to intestinal necrosis.  Results   One patient developed pleural and abdominal effusion after operation,and all patients were cured and discharged after treatment.  Conclusions   Petersen’s hernia is a relatively rare complication after gastrectomy.Preoperative abdominal CT can help to determine the criticality of the patient’s condition and can be the first choice of examination.A small number of patients with acute pancreatitis should pay attention to preoperative and postoperative amylase changes,and once the diagnosis is confirmed,surgery should be performed as soon as possible.

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   By optimizing and improving the traditional RAPT score,the screening accuracy of thrombosis tendency is improved,and the relevant basis for thrombosis prevention in patients with early traumatic fracture is provided,so as to select an efficient individualized anticoagulation therapy.  Methods   The clinical data of 300 patients with traumatic fracture admitted to Shiyan Taihe Hospital from January 2021 to December 2021 were retrospectively analyzed.According to whether venous thromboembolism (VTE) occurred during hospitalization,they were divided into thrombosis group(150 cases) and non-thrombosis group(150 cases).In addition to the four categories included in the traditional RAPT score,the history of smoking and drinking,diseases of vascular endothelial injury,time from injury to admission,preoperative prophylactic anticoagulation measures,upper limb fractures or simple lower limb fractures,type of anesthesia,emergency treatment,blood biochemical index,and dynamic data of D-dimer were also collected.The clinical data of the two groups were compared,and the independent risk factors were screened by univariate and multivariate logistic regression analysis to formulate the optimized RAPT score.The traditional and optimized RAPT scores during hospitalization were dynamically evaluated.The ROC curve was used to evaluate the efficacy of traditional and optimized RAPT scores in the evaluation of traumatic fracture thrombosis.  Results    Single factor analysis showed that there were statistically significant differences between the two groups in smoking history, time from injury to admission, anesthesia method, VTE history, vascular endothelial injury diseases (diabetes, coronary heart disease, hyperlipidemia, cerebrovascular diseases, varicose veins of lower limbs or arteriosclerosis oblast), no use of preventive antithrombotic measures before surgery, and central venous catheterization (P<0.05). Logistic regression analysis after adding age and gender factors showed that with the increase of age, people with smoking history, diabetes and cerebrovascular disease increased the incidence of thrombosis. Men with a history of smoking, diabetes, hyperlipidemia, and women with pre-operative anticoagulation and simple upper or lower limb fractures are increased risk of thrombosis.The AUC of traditional RAPT score at admission,before operation and after operation were 0.636 1,0.639 5 and 0.649 2,respectively.The optimized RAPT scores were 0.806 4,0.806 7 and 0.803 1.  Conclusion   In this study,the predictive value of the optimized RAPT score for thrombosis at admission,before operation and after operation was 15%-17% higher than that of the traditional RAPT score.The optimized RAPT score has a higher predictive value and is more conducive to early detection of thrombosis risk and early treatment than the traditional score.

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.

Pancreatic cancer is a highly malignant tumor of the digestive system with poor prognosis.Due to the lack of effective early screening and diagnosis methods,the majority of patients with pancreatic cancer present with locally advanced or metastatic disease at diagnosis.For advanced pancreatic cancer,the major treatment strategy is still chemotherapy-based comprehensive treatment.The development of immunotherapy and targeted therapy gives us cause for optimism in our pursuit of better treatment.This article reviewed the advances in immunotherapy and targeted therapy of advanced pancreatic cancer.

Objective To investigate the effect of ureteroscopic lithotripsy on renal function and inflammatory factors in patients with renal stones with diameter of 2-3cm.Methods A total of 68 patients with nephrolithiasis admitted to Chongming Branch of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from June 2020 to January 2022 were selected and divided into microchannel percutaneous nephroscopy group and flexible ureteroscopy group by digital parity method,with 34 cases in each group.The operation time,intraoperative blood loss,postoperative hospital stay,renal function indexes [blood urea nitrogen(BUN),serum creatinine(sCr),24h urinary protein(24h Upro)],inflammatory factors [C-reactive protein(CRP),interleukin 6(IL-6),procalcitonin(PCT)] level and postoperative complications were compared between the two groups.Results There was no significant difference in the operation time between the two groups [(58.75±10.23)min vs(53.82±11.65)min](P＞0.05).The intraoperative blood loss in the flexible ureteroscope group was less than that in the percutaneous nephroscope group,which was(5.07±1.32)ml and(12.84±2.18)ml,respectively.The difference between the two groups was statistically significant(P＜0.05).The postoperative hospital stay of the the flexible ureteroscope group was shorter than that in the percutaneous nephroscope group[(2.94±0.87)days and(5.21±1.03)days,respectively],with a statistically significant difference between the two groups(P＜0.05).The BUN [(3.16±1.65)mmol/L vs(4.82±1.83)mmol/L],sCr [(60.48±12.74)μmol/L vs(72.85±15.36)μmol/L] and 24h Upro [(0.12±0.02)g vs(0.18±0.05)g] were lower than those in the percutaneous nephroscopy group(P＜0.05).Three days after operation,the flexible ureteroscopy group CRP [(21.65±4.63)mg/L vs(32.86±4.87)mg/L],IL-6 [(25.45±5.86)ng/L vs(32.21±7.21)ng/L] and PCT [(2.15±0.94)μg/L vs(3.68±1.32)μg/L] levels were lower than those in the percutaneous nephroscopy group(P＜0.05).There was no significant difference in the total incidence of postoperative complications between the two groups(5.88% vs 14.71%)(P＞0.05).Conclusion Flexible ureteroscopic lithotripsy for patients with 2-3cm kidney stones can reduce intraoperative blood loss,shorten hospital stay,improve renal function,and reduce the level of inflammatory factors.

Objective To explore the feasibility of improving the indwelling technique of drainage tube orifice after single-port thoracoscopic lung cancer surgery and analysis of drainage effect.Methods The clinical data of 80 patients who underwent single-port thoracoscopic radical resection of lung cancer who were admitted to Ningbo Huamei Hospital,University of Chinese Academy of Sciences from January to December 2021 were retrospectively analyzed,and they were divided into observation group and control group according to the different drainage tube indwelling techniques.Postoperative drainage tube indwelling time,postoperative hospital stay,postoperative total drainage volume,intraoperative blood loss,operative time,incision infection,postoperative pain score,and drainage port healing.Results The postoperative incision exudation,poor incision healing,incision infection,drainage tube indwelling time,and postoperative hospital stay in the observation group were better than those in the control group,and the differences were statistically significant(P<0.05).There were no significant differences in the total drainage volume,intraoperative blood loss,operation time,and secondary suture rate of the incision(P>0.05).Conclusion The single-port thoracoscopic surgery is beneficial to reduce the incidence of postoperative incision infection and incision exudation,shorten the indwelling time of the drainage tube,improve the safety of extubation,and shorten the hospitalization of patients.time.

Objective To explore and evaluate the feasibility of ultrasound-guided improved dynamic needle tip positioning (DNTP) in infant arterial catheterization.Methods A total of 60 children aged from 1 month to 36 months who were admitted to our hospital from June 2022 to November 2022 and who needed artery puncture and catheterization were selected as subjects.They were randomly divided into two groups,namely DNTP group (D group) and improved DNTP group (G group),with 30 cases in each group.The depth of the radial artery was measured by ultrasound in both groups before operation.In the DNTP group,the depth of the radial artery was less than 2mm as the puncture point.In the improved DNTP group,the shallow radial artery depth was increased to 2-4mm by subcutaneous injection of normal saline under the guidance of ultrasound before puncture.The operation time of the two groups were recorded respectively,and the success rate of the first puncture,the total success rate,the time of the first puncture success,the total puncture time and the incidence of hematoma were compared between the two groups.Results The success rate of first puncture was 90.0% and the total success rate was 96.7% in group G,while 66.7% and 80.0% in group D.There were statistically significant differences between the two groups (P<0.05).The first successful time of group G was (135.2±12.2)s and the total puncture time was (165.3±38.5)s,which was significantly shorter than the first successful time of group D (227.4±23.3)s and the total puncture time of group D (258.3±45.1)s,and the difference was statistically significant (P<0.05).There were 1 case of failure of radial artery puncture caused by local hematoma in group G,and 6 cases of failure of radial artery puncture caused by vasospasm and local hematoma in group D,with statistical significance between the two groups (P<0.05).Ultrasound-guided puncture was successful after changing the puncture site.Conclusion During radial artery catheterization in infants and young children,the ultrasound-guided modified dynamic needle tip positioning technique by subcutaneous injection of normal saline can significantly improve the success rate of puncture,shorten the puncture time and reduce the complications related to puncture.

Objective To investigate the efficacy and safety of transumbilical single-port laparoscopic appendicectomy in acute complicated appendicitis. Methods Retrospective analysis was conducted for the data of 1104 patients with complicated appendicitis who underwent emergency laparoscopic appendectomy at the Department of General Surgery of Aerospace Center Hospital from April 2014 to August 2022;among them,788 patients underwent transumbilical single-port laparoscopic appendectomy (SILA) and 316 cases underwent traditional three-port laparoscopic appendectomy (LA)；the operation time,intraoperative blood loss,leukocyte value on the first day after surgery,postoperative exhaust time,hospital stay,postoperative pathology and postoperative complications were statistically analyzed. Results The surgical duration of the single hole laparoscopic appendectomy (SILA) group was (68.26±22.29) minutes,intraoperative blood loss was (15.93±13.10) ml,postoperative exhaust time was (2.29±0.52) days,and white blood cells were (11.12±1.67)×10⁹/L on the first day after surgery,and the surgical duration of the hree hole laparoscopic appendectomy (LA) groupwas (66.47±20.40) minutes,intraoperative blood loss was (16.65±12.98) ml,postoperative exhaust time was (2.23±0.58) days,and white blood cells were (11.35±1.54)×10⁹/L on the first day after surgery,there was no statistically significant difference in the data between each group（P>0.05）.After 1 month of follow-up,no incisional hernia and other complications occurred in the two groups,the cosmetic effect of abdominal incision in SILA group was satisfactory,the hospitalization time of SILA group was (4.60±1.18) days,which was shorter than that in the traditional LA group (4.93±1.71) days,and the difference was statistically significant（P<0.05）.Conclusion Based on proficiency in traditional LA operations,SILA is safe and viable;in addition to the hidden aesthetic function of scars,it does not prolong the operation time and increase the risk of postoperative complications.

Objective   To compare the efficacy and safety of single pig-tail biliary stent placement under choledochoscopy followed by primary common bile duct closure with traditional T-tube drainage after laparoscopic common bile duct exploration.   Method  A total of 98 cases who underwent laparoscopic common bile duct exploration in our hospital from June 2019 to June 2022 were included retrospectively.They were divided into bile duct stents group (BD-stent group,40 cases) and the T-tube drainage group (TTD group,58 cases) according to the surgery type.The general conditions,intraoperative indicators,postoperative recovery and complications in two groups were statistically compared.   Result   In terms of surgery,the BD-stent group had significantly less surgery time,bile-duct-operation time,bleeding volume,postoperative VAS index and Caprini score than the TTD group (P<0.05).Both groups had no mortality or reoperation.There were no significant differences in first-day serum total bilirubin,γ-GT and total analgesia usage between two groups(P>0.05).But the first-day serum albumin,anal ventilation time,antibiotic usage,leukocyte recovery days,drain-tube removal days,bile duct drainage days,postoperative hospital stay and total costs in BD-stent group were significantly better than those in TTD group (P<0.05).As for postoperative complications,the rate in BD-stent group and TTD group were respectively 5.0% and 6.9%,without significant differences (P>0.05).  Conclusion   Single pig-tail biliary stent placement under choledochoscopy followed by primary common bile duct closure has unique advantages in safety and rapid recovery.It avoids long-term drainage.

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 investigate the characteristics of the three-dimensional gait changes of the knee joint after the single bundle anatomical reconstruction of autologous hamstring tendons after the rupture of the anterior cruciate ligament (ACL) of the knee. Methods  From August 2018 to June 2020，twenty five patients with ACL rupture of the lateral knee joint were selected as the injury group.During the operation,ACL rupture was confirmed by arthroscopy and the autologous hamstring tendon anatomical reconstruction was performed.Then 25 healthy people were selected as the control group.The three-dimensional gait data of normal knee joints were recorded with the three-dimensional motion capture system and compared with the injury group.In addition,the injury group was followed up before and after surgery and Lysholm knee joint function score was performed. Results  In the control group,the flexion and extension angle was - 2 °~66 °,the internal and external rotation angle was - 5 °~9 °,and the internal and external rotation angle was - 4 °~8 °.After ACL injury,the flexion and extension angle is - 5 °~52 °,the internal and external rotation angle is - 3 °~24 °,and the internal and external rotation angle is - 13 °~14 °.Three months after ACL autologous hamstring tendon reconstruction,the flexion and extension angle was - 2 °~47 °,the internal and external rotation angle was - 5 °~9 °,and the internal and external rotation angle was - 6 °~10 °.Six months after ACL reconstruction,the flexion and extension angle was - 2 °~59 °,the internal and external rotation angle was - 4 °~8 °,and the internal and external rotation angle was - 5 °~8 °.Nine months after ACL reconstruction,the flexion and extension angle was - 2 °~64 °,the internal and external rotation angle was - 2 °~9 °,and the internal and external rotation angle was - 2 °~8 °.12 months after ACL reconstruction,the flexion and extension angle was - 2 °~65 °,the internal and external rotation angle was - 1 °~9 °,and the internal and external rotation angle was - 1 °~8 °.After ACL rupture,the variation range of knee joint from flexion to extension,internal and external rotation,and internal and external turnover angle became larger than that of the control group,and there was significant difference in statistics(P<0.05).The angle range of each motion direction of knee joint after reconstruction was significantly improved compared with that before surgery（P＜0.05）,the difference at each time point after reconstruction was statistically significant compared with that before reconstruction(P<0.05).The gait at 9 and 12 months after reconstruction was significantly improved compared with that at 3 months after reconstruction (P<0.05).The Lysholm score increased from (62.35±3.45) before operation to (93.62±3.51) at 12 months after operation,and the difference was significant (P<0.05).  Conclusion  ACL reconstruction surgery has played a role in stabilizing the knee joint and improved the Lysholm knee joint function score,and with the passage of time after the operation,the Lysholm knee joint function score gradually improved,and basically returned to normal 9 months after the operation.

Objective To evaluate the clinical efficacy and safety of a new spiral thermo-expandable prostate stent(Memokath 028,Pnn Medical) in the treatment of patients with benign prostatic hyperplasia with moderate to severe lower urinary tract symptoms.Methods Retrospective analysis was peformed on 50 patients with benign prostatic hyperplasia who underwent implantation of prostatic stent from October 2020 to June 2021 in the Shanghai Fourth People’s Hospital of Tongji University.The urodynamic parameters of patients before operation and 1,3,6 and 12 months after operation were collected,including International Prostate Symptom Score(IPSS),Quality of Life(QOL),and maximum urinary flow rate(Qmax),residual urine parameter values,and records such as perioperative and postoperative complications.Results The average operation time was 19.8 minutes,and the average VAS score at 10 minutes after surgery was 1.8±0.6 points.Spontaneous urination was restored after the operation,and all patients were discharged on the first day after the operation.In terms of postoperative complications,there were 7(14%) cases of postoperative hematuria,6(12%) cases of urination urgency,and 4(8%) cases of painful urination.Acute urinary tract infection(UTI) occurred in 5 patients(10%).The first follow-up was conducted at 1 months after the operation.The average IPSS,QOL score and PVR were 13.9±3.2 points,2.4±0.5 points,and （52.7±22.5）ml，respectively,which were significantly lower than those before the operation(P＜0.05).Qmax was （11.9±1.6）ml/s,which was significantly higher than that before surgery(P＜0.05).As time went on,the above indicators remain stable.Conclusion The new spiral thermo-expandable prostate stent is easy to operate.It is safe and feasible for the treatment of urinary tract obstruction in the prostate.The short-term clinical efficacy is definite,and the early complications are few.

Objective To investigate the changes and clinical significance of microalbumin(mAlb),transferrin(TRF),immunoglobulin G(IgG),α1-MG and β2-MG in the drainage fluid of renal pelvis after percutaneous nephrostomy(PCN) for adult severe hydronephrosis.Methods The clinical data of 33 adults with unilateral severe hydronephrosis before and after PCN with glomerular filtration rate(GFR) ≤ 10ml / min were analyzed retrospectively.Including the biochemical indexes of renal GFR,PCN and drainage fluid before and 1 month after operation.Based on the recovery of GFR in the affected kidney one month after operation,33 subjects were divided into improved renal function group(n=18) and non improved renal function group(n=15).The contents of mAlb,TRF,IgG,α1-MG and β2-MG in drainage fluid between the two groups were analyzed whether there were differences during and after operation,and whether there was correlation with GFR in the affected kidney.Results One month after PCN,the contents of mAlb,TRF,IgG,α1-MG and β2-MG in the renal function improvement group were lower than those during operation(P＜0.05),and the postoperative GFR was higher than that before operation(P＜0.05).There were significant differences in intraoperative α1-MG,β2-MG and preoperative and postoperative GFR between the two groups(P＜0.05).There was a negative correlation between α1-MG,β2-MG,mAlb,IgG,TRF and GFR in the drainage fluid of renal pelvis retained by PCN.The r values were -0.86、-0.83、-0.75、-0.79、-0.72，respectively.Conclusion Severe hydronephrosis leads to the recovery of renal function in varying degrees after the damaged kidney is drained through PCN.PCN can improve the glomerular filtration function of adults with severe hydronephrosis and restore the reabsorption function of renal tubules to a certain extent.The contents of mAlb,TRF,IgG,α1-MG andβ2-MG in the drainage fluid of renal pelvis have a good correlation with the GFR measured by ect.Among them,α1-MG andβ2-MG can be used as sensitive indexes to evaluate the recovery of renal tubular function.The patient measured the protein content through PCN and retained the renal pelvis drainage fluid,evaluated the improvement of renal function,reduced unnecessary imaging examinations,and saved medical expenses.

Objective To explore the clinical efficacy and safety of modified PPH combined with partial internal anal sphincterotomy in the treatment of circular mixed hemorrhoids.Methods Patients with annular mixed hemorrhoids were divided into two groups by a completely randomized controlled method.54 patients in the experimental group were treated with modified PPH combined with partial internal anal sphincterotomy,while 51 patients in the control group were treated with conventional PPH.The postoperative indicators,perioperative and long-term complication rates of the two groups were compared,and the clinical efficacy and safety were observed.Results The operation time in the experimental group was (48.35±4.37) minutes,which was higher than that in the control group (36.42±6.21) minutes（P＜0.05）.The incidence of postoperative anastomotic stenosis in the experimental group was 1.9%,lower than 15.6% in the control group (P＜0.05). Anal pain,urinary retention,first defecation time,long-term anal distention,the experimental group was significantly better than the control group,the difference was statistically significant (P＜0.05); The hospitalization time in the experimental group (4.8±0.62) days was not significantly different from that in the control group (5.1±0.54) days (P>0.05).The amount of intraoperative bleeding and anastomotic bleeding in the experimental group [(17.28±2.22)ml,3.7%] were not significantly different from those in the control group [(16.75±2.13)ml,3.9%] (P>0.05).Conclusion Compared with conventional PPH,the modified PPH combined with partial internal anal sphincterotomy slightly increases the operation time,but does not increase the risk of anastomotic bleeding,the incidence of rectal fistula,the amount of surgical bleeding,and the length of hospital stay.It can significantly improve postoperative anal pain,urinary retention,long-term distention symptoms,shorten the time of first defecation,ease the difficulty of defecation,and significantly reduce postoperative anastomotic stenosis,The long-term efficacy and safety are good.

Objective To investigate the efficacy of different Uncut Roux-en-y surgical approaches on patients with gastric cancer and the effect on their test indicators and prognosis.Methods 96 patients with distal gastric cancer admitted to our hospital from March 2018 to February 2021 received laparoscopic assisted radical gastrectomy for distal gastric cancer.According to surgical methods,96 patients were divided into 2 groups.Among them,46 patients in the study group were treated with modified U-RY anastomosis,while 50 patients in the control group were treated with U-RY anastomosis.Perioperative indicators (operation time,intraoperative blood loss,first ventilation time,hospital stay and drainage volume on the first day after operation),tumor-related indicators (CEA,CA199) before and after operation,postoperative complications and prognosis one year after operation were compared between the two groups.Results Except for the drainage volume on the first day after surgery, the other indexes (operation time, intraoperative blood loss, first ventilation time and hospital stay) of the study group were better than those of the control group（P<0.05）.The tumor-related indexes (CA199,CEA) were not different between the two groups before surgery (P>0.05),while the tumorrelated indexes (CA199,CEA) were lower in both groups after surgery compared with those before surgery (P<0.05);after surgery,the overall complication rate was lower in the study group than in the control group (8.7% vs.30.0%,P<0.05);one year after surgery,there was no difference in the survival and recurrence rates between the two groups (97.8% vs.96.0%;4.3% vs.6.0%;P>0.05).Conclusion The application of modified U-RY anastomosis in LADG significantly shortens the operative time of patients,accelerates their recovery,and reduces their postoperative complication rate,which ultimately does not affect their prognosis.

Objective   To study the clinical effects of automatic hemorrhoidal banding (RPH) combined with sclerosing agent injection in the treatment of second- and third-degree internal hemorrhoids.  Methods   A total of 156 cases of second-degree and third-degree internal hemorrhoids were randomly divided into three groups,namely hemorrhoidal ligation group,RPH group,and (RPH + sclerotherapy injection) group,with 52 cases in each group,and the three groups underwent hemorrhoidal ligation,RPH surgery,and (RPH + sclerotherapy injection) respectively.The surgical effect was evaluated by the three groups such as operation time,hospital stay,hemorrhoidal lump shedding time,postoperative bleeding,postoperative swelling,postoperative margin edema,and postoperative stenosis.  Results   After treatment,the effective rate of all three groups reached 100%.In terms of operation time,hospital stay and hemorrhoidal lump shedding time,the hemorrhoidal ligation group was (34.13±5.80)min,(8.65±0.96)d,(5.94±0.46)d,the RPH group was (22.81±1.95)min,(6.58±0.75)d,(8.02±0.43)d,the (RPH + sclerotherapy injection) group was (23.73±2.02)min,(6.46±0.75)d,(8.00±0.56)d,RPH and (RPH + sclerotherapy injection) group compared with hemorrhoidal ligation group,hemorrhoidal mass shedding time,surgery time and hospital stay shortened,and all were statistically significant (P＜0.05),and the (RPH + sclerotherapy injection) group had less hospital stay than RPH group (P<0.05）. In terms of postoperative bleeding,the hemorrhoidal ligation group was (177.40±30.45)ml,the RPH group was (105.44±15.92)ml,the (RPH + sclerotherapy injection) group was (59.46±14.99)ml,the amount of blood loss in the RPH group and the (RPH + sclerotherapy injection) group was less than that in the hemorrhoidal ligation group (P<0.05),and the blood loss in the (RPH + sclerotherapy injection) group was significantly less than that in the RPH group (P<0.05）. In terms of postoperative swelling,the hemorrhoidal ligation group was 15 cases,the RPH group was 10 cases,the (RPH + sclerotherapy injection) group was 7 cases,the swelling in the RPH group and the (RPH + sclerotherapy injection) group was significantly less than that in the hemorrhoidal ligation group (P<0.05)。 In terms of postoperative edema and stenosis,the hemorrhoidal ligation group was 3 cases and 0 case,RPH group was 2 cases and 0 case,and (RPH + sclerotherapy injection) group was 3 cases and 0 case,and there was no significant difference between the three surgical methods (P>0.05).  Conclusion   RPH combined with sclerosing injection can significantly reduce the postoperative bleeding,hospital stay,and postoperative swelling,and the postoperative effect is satisfactory,which provides a reliable basis for the clinical treatment of Ⅱ and Ⅲ.degree internal hemorrhoids.

Cholangiocarcinoma is a malignant tumor originating from the epithelium of the bile ducts,and its incidence is increasing year by year,especially intrahepatic bile duct carcinoma that originates from the bile duct branches above the second level in the liver.Due to the insidious early symptoms and the lack of effective screening methods,most patients have lost the opportunity for radical surgery by the time they present.Over the past few years,several drugs have been developed that target genetic alterations with the detection of the cholangiocarcinoma genome.The molecular targets with clinical significance mainly include fibroblast growth factor receptor(FGFR),isocitric acid dehydrogenase(IDH),RAS-RAF-MEK-ERK,ERBB,VEGF and NTRK.Drugs targeting their targets show encouraging response rates and survival data as second-line therapies,and are characterized by high specificity and low toxicity.Therefore,targeted therapy is gradually emerging in the treatment of cholangiocarcinoma.In this review,we discuss the latest advances in targeted therapies for cholangiocarcinoma.

Surgical treatment is still the most important means of breast cancer treatment,but in recent years,with the continuous development of systemic treatment level of breast cancer,the surgical treatment concept of breast cancer is also changing.Including surgical treatment strategy of ductal carcinoma in situ,sentinel lymph node micrometastases or macro metastasis of axillary processing strategy,Safety of sentinel lymph node biopsy and breast conserving after neoadjuvant therapy,the timing of surgery after neoadjuvant therapy,surgical treatment of young breast cancer，Surgical treatment of stage Ⅳ breast cancer,radiation time to implant breast reconstruction,etc.,in the face of these problems, Breast surgeons are often confused.In this paper,ten hot issues in the surgical treatment of breast cancer are summarized based on the latest progress in the surgical treatment of breast cancer in recent years and guidelines at home and abroad,so as to make the surgical treatment of breast cancer more standardized and individualized. 

Objective To investigate the expression and prognostic value of HILPDA gene in hepatocellular carcinoma,and further explore the potential clinical application value of HILPDA. Methods The bioinformatics method was used to download the mRNA sequencing data of hepatocellular carcinoma and the clinical data of patients from the TCGA database.The differences of HILPDA expression in hepatocellular carcinoma and adjacent tissues were analyzed.Univariate Cox regression and multivariate Cox regression were used to analyze the relationship between HILPDA expression level and prognosis of patients.The possible mechanism of HILPDA was investigated by GESA enrichment method.TIMER database was used to analyze the relationship between HILPDA gene expression and immune cell infiltration.Results The expression level of HILPDA gene in hepatocellular carcinoma tissues was higher than that in corresponding paracancer tissues.The expression level of HILPDA was correlated with tumor size(P<0.001),lymph node metastasis(P<0.01),pathological grade(P<0.05) and serum AFP level(P<0.01).Univariate and multivariate Cox regression analysis showed that HILPDA expression level was an independent prognostic factor in hepatocellular carcinoma patients,and patients with high expression level had a poor prognosis.Using TIMER database,the expression level of HILPDA is correlated with immune invasion of Th1 and Macrophage cells(P<0.001).Conclusion HILPDA may be a prognostic factor and a potential molecular therapeutic target for hepatocellular carcinoma.

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.

Objective To analyze the effect and safety of “cross” suture in the reconstruction of perineal incision and closure of enterostomy for rectal cancer. Methods A total of 107 patients with perineal incision reconstruction during combined abdominal perineal resection and abdominal incision reconstruction during enterostomy closure treated in our hospital from January 2019 to January 2022 were selected.They were divided into traditional stoma group (12 cases),stoma “cross” group (14 cases),traditional reconstruction group (37 cases) and reconstruction “cross” group (44 cases).Follow up for 30 days after operation to compare the effects of each group. Results The operation time,incision healing time,postoperative extubation time,and postoperative hospital stay in the ostomy “cross” group and the reconstruction “cross” group were shorter than those in the traditional ostomy group and the reconstruction traditional group,and the intraoperative blood loss was less than that in the traditional ostomy group and the reconstruction traditional group (P<0.05).The NRS score of the “cross group” and the  reconstruction“cross group” 1,2 and 3 days after surgery was lower than that of the traditional group and the traditional reconstruction group (P<0.05).The color,thickness,blood vessels,softness and total score of postoperative incision in the “cross group” and the reconstruction“cross group” were lower than those in the traditional group and the traditional reconstruction group (P<0.05).The incidence of postoperative complications in the reconstruction “cross” group was 6.82%,significantly lower than that in the traditional reconstruction group (24.32%) (P<0.05).There was no difference in the total incidence of complications between the traditional stoma group and the stoma “cross” group (P>0.05). Conclusion “Cross” suture can be used for incision reconstruction during combined abdominal perineal resection and enterostomy closure.It has the characteristics of “unobstructed drainage” and “reduced tension suture”,and can reduce the incidence of postoperative complications.

Objective  To investigate the effect of obesity on perioperative complications in patients with acute Stanford A aortic dissection(TAAD).  Methods   According to BMI,the patients were divided into obese group (BMI ≥28kg/m²) and non-obese group (BMI < 28kg/m²) .The obese group included 55 cases,the non-obese group included 78 cases,133 cases in total.The differences of postoperative hypoxemia, ventilator assistance time, pulmonary infection, nervous system complications, acute kidney injury, poor wound healing, blood transfusion volume, hospital mortality and length of stay were compared between the two groups.  Results   The proportion of hypoxemia,extubation time ≥96 hours,poor wound healing,CSICU(Cardiac Surgery Intensive Care Unit) ≥7 days and total hospital stay ≥20 days in obese group were significantly higher than those in non-obese group (P＜0.05),there was no significant difference in postoperative acute renal injury,pulmonary infection,neurological complications and in-hospital mortality between the two groups(P>0.05).BMI≥28km²,extubation time ≥96h,and pulmonary infection were the main independent risk factors for hospital stay ≥7 days in CSICU after Type A aortic dissection.Patients with BMI ≥28kg/m² had 2.45 times more CSICU hospital days (≥7 days) than non-obese patients.  Conclusion   Obesity increases the incidence of perioperative complications in patients with acute Stanford A aortic dissection and is an independent risk factor for hospital stay of ≥7 days in CSICU,but there is no significant difference in in-hospital mortality.

Objective To investigate the effect of single-hole thoracoscopy in the operation resection of early lung cancer with ground-glass nodules. Methods A total of 168 patients with early lung cancer mainly represented by ground-glass nodules who received surgical resection in our hospital from January 2015 to March 2021 were selected and divided into 2 groups according to different surgical methods.The observation group included 84 invalids were received single-hole thoracoscopic radical resection of early lung cancer,while the control group included 84 invalids were received traditional three-hole thoracoscopic radical resection.The pain,perioperative conditions,changes of inflammatory reaction indexes before and after operation,quality of life before and after surgery and the incidence of complications were compared between 2 groups. Results The visual analogue scale scores of(6.12±0.93) points,(5.12±0.73) points and(3.67±0.82) points in the observation group were lower than those of(6.53±0.91) points,(6.15±0.58) points and(4.36±0.91) points in the control group at 1 day,3 days and 5 days after operation(P＜ 0.05).The average incision length of(3.91±0.46) cm and drainage tube indwelling time of(2.85±0.71) d in the observation group were shorter than those of(6.63±0.86) cm and(3.69±0.87) d in the control group(P＜ 0.05).C-reactive protein(12.39±2.15) ng/L,procalcitonin(3.34±0.39) ng/ml and interleukin-6(148.57±18.52) pg/ml in the observation group were lower than those in the control group(24.09±3.41) ng/L,(4.78±0.51) ng/ml and(163.21±19.69) pg/ml at 5 days after operation(P＜0.05).The quality of life scale of lung cancer patients in the observation group(108.41±4.26) was higher than that in the control group(103.26±3.54) at 6 months after operation(P＜ 0.05).The incidence rate of complications in the observation group(17.86%) was not statistically significant compared with 22.62% in the control group(P>0.05). Conclusion The implementation of single hole thoracoscopic radical surgery for early lung cancer patients with ground glass nodules has significant clinical effect,which can reduce the trauma to patients,reduce the postoperative inflammatory reaction and promote the postoperative rehabilitation of patients.