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 risk factors of recurrence in patients with residual tumor after transurethral resection of bladder tumor (TURBT) for non muscle invasive bladder cancer.Methods The medical records of 100 patients with residual tumor after TURBT for non muscular invasive bladder cancer treated in our hospital from May 2020 to June 2021 were retrospectively analyzed.The patients were followed up for 12 months,and were divided into recurrence group(15 cases) and non recurrence group(85 cases).Multivariate logistic regression analysis was used to analyze the risk factors of recurrence in patients with non myometrial invasive bladder cancer after secondary resection.Nomogram nomogram model was established,and the working characteristic curve of subjects was drawn to analyze the predictive efficacy.Results 100 cases of non myometrial invasive bladder cancer were followed up for 12 months and 15 cases recurred.The 1-year recurrence rate was 15.00%.The proportion of multiple tumors,tumor stage T1 and low differentiation of tumor in the recurrent group before the first TURBT was higher than that in the non recurrent group,and the proportion of BCG perfusion after tumor pedicle and secondary resection was lower than that in the non recurrent group (P<0.05).The results of logistic regression analysis showed that multiple tumors,tumor stage T1 and low differentiation before the first TURBT were the risk factors for recurrence after the second resection (P<0.05).BCG infusion was the protective factor of recurrence after secondary resection (P<0.05).The area under the curve (AUC) of nomograph prediction model for predicting recurrence after secondary resection of non myometrial invasive bladder cancer was 0.759 (95%CI:0.641 ~ 0.827).Conclusion Multiple tumors before the first TURBT,tumor stage T1 and tumor low differentiation are the risk factors for recurrence after the second resection.BCG perfusion after the second resection is the protective factor for recurrence after the second resection.The establishment of nomogram model can be used to intuitively and comprehensively evaluate the risk of recurrence after the second resection.

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 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 study the method of ureteroscopy treatment on calculi displacement during laparoscopic ureterolithotomy(extraperitoneal approach,EPA).Methods To retrospectively study the clinical data of 12 cases of the auxiliary treatment on calculi displacement during operation for patients underwent laparoscopic ureterolithotomy(extraperitoneal approach,EPA)  for upper ureteral calculi in our hospital from October,2009 to October,2021.The clinical data included patients’ information,the condition of the displaced calculi,the duration of the auxiliary treatment on calculi removal during operation,the information whether there was an intraoperative ureteropelvic injury,whether there was a postoperative bleeding or infection,whether there were postoperative ureteral stricture and other complications.Result There were totally 333 cases of laparoscopic ureterolithotomy for upper ureteral calculi operated in our hospital,however,there were 12 of them where the ureteral calculi moving upward to the kidney.Flexible ureteroscope was adopt in lithotomy in three cases of them,and hard ureteroscope was adopted in lithotripsy and lithotomy in the other nine cases.Lithotomy was operated successfully in all the 12 cases with 100% success rate.The average duration of auxiliary treatment on calculi removal is 25 minutes.There were no obvious renal pelvis and ureter mucosal injury,no postoperative urinary leakage,no bleeding and infection,no ureteral stricture and other complications during follow-up for all the patients.Conclusion It is a safe and effective method of ureteroscopy to treat calculi displacement in laparoscopic ureterolithotomy.This method is simple,easy to operate.

Objective To explore the diagnosis and treatment of delayed renal subcapsular hematoma(DRSH) after retrograde intrarenal surgery(RIRS) for renal calculi and related factors. Methods Case data of 2 patients with DRSH after RIRS were retrospectively analyzed.The preoperative general situation,operative situation,diagnosis and treatment of subcapsular hematoma were evaluated.Results RIRS were performed successfully in 2 cases with renal calculi and the operation time were 55 min and 38 min respectively.Both patients were indwelled with F6 ureteral double J stent.Postoperative hemostasis and antibiotics were used.Postoperative re-examination of urinary ultrasound or CT showed no abnormalities and the patients were discharged,and the double J stent were removed 4 weeks and 2 weeks after operation respectively.One case developed DRSH more than 1 month after operation and the other one more than 2 weeks after operation.After hemostasis and anti-infection treatment,the hematoma in 2 cases were absorbed within more than 1 month and more than 5 months respectively.Conclusion DRSH may occur in the treatment of renal calculi by RIRS.The combination of basic diseases such as hypertension or diabetes,old age,the use of anticoagulant drugs may be some of the factors leading to DRSH.For patients with complete renal capsule and no combined infection,conservative treatment such as hemostasis and anti-infection should be given,and the hematoma can be gradually absorbed.

Objective To investigate the effects of neoadjuvant chemotherapy combined with transurethral resection of bladder tumor(TURBT) on tumor diameter,urine bladder tumor antigen(BTA) level and recurrence rate in patients with bladder cancer.Methods A retrospective analysis was conducted on the clinical data of 83 patients with myometrial invasion and bladder cancer(MIBC) admitted to our hospital from February 2017 to September 2018,and they were divided into group A(n=41) and group B(n=42) according to different treatment methods.Group A was treated with TURBT,group B was treated with neoadjuvant chemotherapy on the basis of group A,and all patients received intravesical chemotherapy after operation.The tumor diameters of group B before chemotherapy and after 3 cycles of chemotherapy were measured,the toxic and side effects of group B were counted,the operation indexes of the two groups were recorded,the levels of urinary bladder tumor antigen(BTA) and nuclear matrix protein 22(NMP-22) were detected when the two groups were enrolled and 6 months after the operation,and the long-term survival rate and recurrence rate of the two groups were understood.Results The maximum diameter and minimum diameter of the tumor [(2.68±0.73)cm,(1.53±0.47)cm] after chemotherapy in group B were significantly smaller than those before chemotherapy[(3.49±0.81)cm,(2.35±0.69)cm](P＜0.05).Patients in group B usually had blood system and digestive tract reactions after chemotherapy,mainly mild,which could be tolerated by patients,the operation time and blood loss[(47.11±6.03) min,(52.43±5.62) ml] in group B were significantly less than that in group A [(52.75±8.42) min,(61.16±7.58) ml](P＜0.05).The levels of urine BTA  and NMP-22 [group A:(6.86±1.50) U/L,(10.24±2.03) U/ml;group B:(4.61±1.27) U/L,(6.58±1.42) U/ml] in the two groups after operation were significantly lower than those at the time of entry[group A:(13.89±2.62) U/L,(26.57±2.71) U/ml;group B:(14.73±2.95) U/L,(27.26±3.92) U/ml](P＜0.05),and group B were significantly lower than group A(P＜0.05).The 1-year,2-year,and 3-year survival rates of group B were 95.24%,90.48% and 83.33%,respectively,which were significantly higher than the group A(80.49%,70.73% and 63.41%,P＜0.05).The 1-year,2-year,and 3-year recurrence rates in group B were were 4.76%,11.19% and 19.05%,respectively,which were significantly lower than the group A(21.95%,34.15% and 39.02% ,P＜0.05).Conclusion Firstly,neoadjuvant chemotherapy for MIBC patients can effectively shrink tumors,and then TURBT can significantly shorten the operation time,significantly reduce the amount of intraoperative blood loss,and help improve the long-term survival rate and reduce the recurrence rate.

Objective To analyze the effect of keyhole approach and craniotomy on the recovery of patients with traumatic brain injury and cerebral hemorrhage and the expression of D-dimer and Hcy levels.Methods According to the random envelope method,65 patients with craniocerebral trauma complicated with cerebral hemorrhage admitted to our hospital from January 2014 to June 2019 were divided into observation group (n=35) and control group (n=30).The control group received traditional craniotomy hematoma evacuation,and the observation group was treated with intracerebral hematoma evacuation via keyhole approach under general anesthesia;the clinical efficacy was assessed after 4 weeks of treatment,and the neurological deficit score of the patients was assessed before and after treatment;the D-dimer and Hcy levels of the patients were measured before and after treatment.Results The total effective rate of the observation group was higher than that of the control group significantly (P<0.05);the neurological deficit score,D-dimer and Hcy in the blood of the observation group was lower than the control group significantly (P<0.05).Conclusion Compared with craniotomy,keyhole microscopy can effectively improve the clinical effect and reduce the D-dimer and Hcy level.

Objective To investigate the relationship between the levels of serum soluble CD105(S-CD105),CC chemokine ligand 20(CCL20) and CC chemokine ligand 5(CCL5) and the prognosis of patients with lung cancer surgery.Methods A total of 86 lung cancer patients who received radical mastectomy in our hospital from March 2018 to March 2019 and were followed up until March 2022 were selected as the research subjects,and were set up as the observation group.They were divided into a good prognosis group(n=54) and a poor prognosis group(n=32).During the same period,43 healthy subjects were selected as the control group.The levels of S-CD105,CCL20 and CCL5 were compared,and the recurrence rate,metastasis rate and mortality of different levels of S-CD105,CCL20 and CCL5 were observed;the binary logistic regression model was used to analyze the effect of SCD105,CCL20 and CCL5 on the prognosis of patients with lung cancer surgery;ROC curve pattern analysis of AUC value,sensitivity and specificity of S-CD105,CCL20 and CCL5 in predicting the prognosis of patients with lung cancer surgery.Results The SCD105[(4.55±0.86) ng/ml],CCL20[(71.97±13.69)ng/ml] and CCL5[(49.50±5.17)ng/ml] in the observation group were higher than those in the control group [(3.38±0.52) ng/ml,(53.52) ±7.52) ng/ml,(17.52±2.02) ng/ml](all P＜0.05).There was no significant difference in S-CD105,CCL20 and CCL5 between the two groups before surgery,30-d and 90-d after surgery(P＞0.05).At 180 days after operation,the S-CD105[(7.85±1.52) ng/ml],CCL20[(88.25±19.65) ng/ml] and CCL5[(54.74±6.96) ng/ml] in the poor prognosis group were higher than those in the good prognosis group [(5.01±1.05) ng/ml,(65.38±11.74) ng/ml,(43.02±4.11) ng/ml(all P＜0.05).The recurrence rate,metastasis rate and mortality rate of serum S-CD105,CCL20,CCL5 high expression group were higher than those of low expression group(P＜0.05).Binary Logistic regression analysis showed that the levels of SCD105,CCL20 and CCL5 were risk factors affecting the prognosis of patients with lung cancer surgery(P＜0.05).Kendall's tau-b correlation analysis showed that SCD105,CCL20,and CCL5 were negatively correlated with the prognosis of patients with lung cancer surgery(r=-0.606,-0.437,-0.619,P＜0.05).ROC curve analysis showed that the AUC values of serum SCD105,CCL20,and CCL5 for predicting poor prognosis in patients with lung cancer surgery were 0.937,0.817,0.949(P＜0.05);the sensitivities were 90.60%,50.00%,and 93.80%,respectively;the specificities were 92.60%,100.00%,92.60%.Conclusion Serum levels of S-CD105,CCL20,and CCL5 are highly expressed in lung cancer patients,and their levels will change with postoperative recurrence or metastasis.Dynamic monitoring of their changes is helpful to provide an important reference for prognosis evaluation.

Objective To investigate the role of total polarization imaging and machine learning in the differential diagnosis of hepatocellular carcinoma and cholangiocarcinoma.Methods Polarization imaging was performed on 8 cases of poorly differentiated hepatocellular carcinoma and 8 cases of poorly differentiated cholangiocarcinoma.Pathologists selected three Regions of interest(ROIs) according to HE slices,measured the mueller matrix polarimetry of each ROI,and calculated a series of polarization basic parameters according to the mueller matrix  extraction analysis method.The polarization basic parameters were input into the artificial neural Network(ANN) model,and the 8-fold cross-validation method was used to train and verify the model in three categories.Results ANN model showed that the The precision and sensitive of differentiating hepatocellular carcinoma cells,Cholangiocarcinoma cells and other tissues based on mueller matrix polarimetry was 0.846-3 and 0.810-7.Conclusion The diagnostic model of hepatocellular carcinoma and intrahepatic cholangiocarcinoma based on polarized imaging and machine learning is of great value in pathological auxiliary diagnosis,which can provide help for clinical accurate diagnosis and treatment.

Objective To explore the effect of enhanced recovery after surgery(ERAS) multi-step management system in patients undergoing thoracoscopic pneumonectomy.Methods A total of 302 patients undergoing thoracoscopic pneumonectomy admitted to our hospital from January 2019 to December 2021 were selected as the research objects.They were divided into the ERAS group(164 cases) and the control group(138 cases).The ERAS group applied ERAS multi-step management system,the control group applied traditional perioperative management.The general data and clinical indicators of the two groups were compared.Results There was no significant difference between the ERAS group and the control group in operation time[(163.7±55.42 )min vs (157.9±53.25) min],intraoperative blood loss[(68.48±52.35) ml vs (74.19±51.28) ml],surgical method,lesion location,postoperative pathology,chest tube indwelling time[(2.44±0.65) d vs( 2.38±0.57) d] and hospitalization cost[(4.67±0.57) wan yuan vs (4.55±0.62) wan yuan)(P>0.05).The total incidence of postoperative complications in the ERAS group was lower than that in the control group(12.00% vs 26.09%),but the difference was not statistically significant(P<0.05).The NRS pain scores at different time points after operation in ERAS group were lower than those in control group(P<0.05).The hospitalization time of the ERAS group was shorter than that of the control group[(7.55±2.31) d vs (8.31±2.43) d],and the medical satisfaction score was higher[(8.24±1.68) points vs (7.72±1.83）points](P<0.05).Conclusion For patients undergoing thoracoscopic pneumonectomy,the application of ERAS multi-step management system can accelerate the rehabilitation of patients,reduce their pain.

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 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 investigate the relationship between CDH13 gene expression and clinicopathologic features and prognosis in elderly patients with colon cancer.Methods From January 2018 to May 2021,a total of 63 elderly patients were received surgical treatment for colon cancer in our research center,They were divided into two groups according to the expression of CDH13.Firstly,the expression of CDH13 in colon cancer was analyzed by bioinformatics method,Then,detected the expression of CDH13 by immunohistochemistry,The Chi-square test was used to analyze the relationship with clinicopathological parameters,and the survival curve was analyzed by Kaplan-Meier method.Results According to the TCGA data,the expression of CDH13 protein was decreased in colon cancer tissues (P=1.07e-15).The low expression of CDH13 in the two groups was statistically significant in lymph node metastasis (P<0.01),TNM stage (P=0.022) and Dukes stage (P<0.01).There was no significant difference in CDH13 expression when compared with clinical data such as gender ratio of patients,tumor location,surgical method,pathological type and whether chemotherapy was used.Kaplan-Meier survival curve analysis showed that the survival rate of patients with negative CDH13 expression was lower than that of patients with positive CDH13 expression,and the difference was statistically significant (χ2=4.927,P=0.026).Conclusion In elderly patients with colon cancer,CDH13 shows the function of tumor suppressor gene,and its expression level was related to TNM stage,Dukes stage and lymph node metastasis of colon cancer.The expression level of CDH13 reduced the long-term survival and affected the prognosis in elderly patients.

Objective To  explore the effects of headless double compression screws and traditional open reduction and internal fixation on ankle joint function in patients with traumatic ankle fracture.Methods A total of 98 patients who were prospectively included in the study and were admitted to the Department of Orthopedics of our hospital from January 2017 to March 2020.They were divided into a study group and a control group by using the random number table,with 49 cases in each group.The patients in the control group were given the traditional open reduction and internal fixation treatment,while those in the research group were given the headless double compression screw internal fixation treatment.The differences of perioperative indicators,AOFAS score and GQOLI-74 score between the two groups were compared.Both groups were followed up for one year,and the differences in clinical effects were comprehensively analyzed by comparing the occurrence of postoperative complications between the two groups.Results The therapeutic efficacy rate of the study group was 93.88%,which was significantly higher than 71.43% in the control group P＜0.05).The mean operation time[(40.94±6.72)min],intraoperative blood loss[(41.77±8.26)ml] and fracture healing time[(10.72±1.66)weeks] in the study group were significantly lower than those in the control group[(57.93±13.18)min,(56.28±12.27)ml and (13.76±2.08) weeks,P＜0.05].The flexion[(28.19±5.23)°],extension[(8.89±1.52)°],pronation(19.09±2.69) and supination range of motion(16.81±2.83)°in the study group 12 months after surgery were greater than those in the control group[(24.87±4.75)°,(7.63±1.67)°,(17.28±2.45)° and (14.13±2.57)°,P<0.05].In addition,the improvement degrees of the scores of the QOL in each dimension in the research group[(72.55±8.83),(73.65±9.12),(68.69±7.01) and (73.18±9.23)] were significantly superior to those of the control group[(65.12±8.17),(68.35±8.73),(63.12±6.84) and (67.22±8.74)](P＜0.05).The incidence of postoperative complications in the research group was 2.04%,which was significantly lower than in the control group(16.33%,P<0.05).The VAS score of the research group was (0.83±0.23),which was significantly lower than that of the control group(2.14±0.71),and there was a statistical difference(P<0.05).Conclusion Headless double compression screw internal fixation has significant curative effect,which can effectively promote fracture healing of patients and improve ankle function and quality of life score.Moreover,it has less postoperative complications and good safety.

Many studies abroad have shown that surgical elective surgery for patients infected with COVID-19 may lead to a significant increase in postoperative mortality and complications.At present,the proportion of COVID-19 infection in China is high,and in the face of cases of COVID-19 infection,there is still a lot of confusion about how to perform elective surgery.Therefore,we review and analyze the latest research progress in this field abroad,combined with the guidelines and statements issued by relevant academic organizations in the United Kingdom and the United States,summarize the relevant experience of how to conduct preoperative assessment and how to choose the timing of surgery for patients infected with COVID-19,aiming to avoid and prevent the high complication rate of surgical operations in China under the COVID-19 epidemic.

Granulomatous lobular mastitis(GLM) is a benign breast disease for which the etiology and pathogenesis have not yet been elucidated.It often presents as a single painful mass on one side of the breast.Erythema nodosum is typically a subcutaneous nodule of red tenderness in the lower extremities,which can coexist with GLM as an extra-mammary symptom.This phenomenon is relatively rare.Erythema nodosum associated with GLM may have some special clinical features.This article reviews the diagnosis and treatment progress of GLM with erythema nodosum.