Pediatric intracranial non-germinoma Tous germ cell tumors (NGGCTs) are a group of rare,highly heterogeneous malignant tumors,encompassing subtypes such as immature teratoma,embryonal carcinoma,yolk sac tumor,choriocarcinoma,and mixed germ cell tumors.The management of NGGCTs requires the integration of multidisciplinary approaches including surgery,chemotherapy,and radiotherapy;however,significant controversies persist regarding treatment sequence,surgical timing,and the selection of chemoradiotherapy regimens.Currently,most international mainstream strategies recommend platinum-based chemotherapy combined with postoperative radiotherapy.In contrast,Asian researchers have proposed an individualized surgery-prioritized strategy based on clinical practice,emphasizing that tumors containing teratomatous components or measuring ≤3 cm should undergo direct surgical resection.

Pediatric glioma,the most common central nervous system tumor in children,has undergone transformative changes in diagnosis and treatment due to advances in molecular biology.The 2021 WHO classification now recognizes pediatric gliomas as distinct entities,highlighting differences in driver mutations,epigenetics,and tumor microenvironment compared to adults.This review summarizes recent progress in molecular subtyping,surgical management,targeted therapy,and immunotherapy.Molecular profiling of BRAF,H3K27M,IDH,and other alterations enables prognostic stratification and guides targeted interventions.Surgical innovations,including advanced imaging and intraoperative monitoring,have improved resection rates and safety for thalamic and brainstem tumors.Targeted agents such as tovorafenib and vorasidenib are expanding treatment options for young children and delaying radiation.Emerging immunotherapies,including GPC2-CAR T cells,show promising efficacy.However,challenges such drug delivery barriers,resistance mechanisms,and research on rare subtypes remain.Multidisciplinary collaboration and precision medicine are steadily enhancing survival and quality of life for young patients.

Objective  Traditional classification systems for skull base lesion surgeries fail to accurately reflect the differences in surgical difficulty.This study aims to establish and validate a multi-dimensional grading sclae for skull base tumor surgical difficulty,to guide clinical decision-making and resource optimization.Methods A total of 131 patients with skull base tumors who underwent surgery at West China Hospital of Sichuan University in 2018 were included in this study.Based on the selfdeveloped “grading scheme for surgical difficulty of skull base tumors” (encompassing nine dimensions such as involved regions,arteries,nerves,and tumor characteristics),patients were categorized into grades Ⅰ-Ⅳ.The baseline data,imaging features,surgical indicators and postoperative outcomes of each group were analyzed to verify the clinical applicability of the scale.Results The surgical difficulty increased progressively from grade Ⅰ to Ⅳ,with significant differences observed in core dimensions such as involved regions,arteries,and nerves (all P<0.05).As the difficulty level increased,the intraoperative blood transfusion rate (0→38.1%),operation time [(1.6±1.5)h →(7.3±4.2)h],hospital stay [(7.6±2.7)d→(15.9±15.2)d],and postoperative complication rates (15.5→52.4%) also increased significantly (all P<0.05).Conclusion This system enables quantitative evaluation-based surgical difficulty gradient classification,compensating for the limitations of the traditional classification system.It provides a scientific foundation for personalized surgical approach selection,DRG-based fine payment,physician training,and promotes the standardized development of the skull base subspecialty.

Objective  To analyze the clinical effect of conservative treatment of 218 cases of simple epidural hematoma (SEDH) in children and establish the prediction model of hematoma absorption.Methods The clinical data of 218 children with SEDH who were treated conservatively in our hospital from August 2023 to March 2025 were analyzed retrospectively.According to the status of hematoma absorption after conservative treatment,the patients were divided into slow hematoma absorption group (n=82) and fast hematoma absorption group (n=136).The clinical data of children with slow hematoma absorption group and fast hematoma absorption group were compared.Logistic regression analysis was used to explore the risk factors of hematoma absorption in children with conservative treatment of SEDH.A nomogram model based on the prediction of hematoma absorption in children with SEDH treated conservatively was constructed and verified internally by Bootstrap method.To analyze the predictive efficacy of risk nomogram model for hematoma absorption in children with SEDH treated conservatively.Results 21 days after injury,37.61%（82/218） of SEDH patients had a hematoma absorption rate of < 0.62ml/d after conservative treatment.The  slow hematoma absorption  group had an average age of (10.43±1.93)years,hematoma volume of (22.09±3.96 )ml,maximum hematoma thickness of (5.92±1.48) mm,admission Glasgow Coma Scale (GCS) score of (13.33±0.55),activated partial thromboplastin time (APTT) of （30.96±8.94） seconds,and fibrinogen level of （2.14 ± 0.58 ）g/L.In contrast,the fast absorption group showed corresponding values of （7.60±1.53 ）years,（12.30±4.13 ）ml,（3.18±1.06） mm,（14.48±0.48）,（28.63±7.46） seconds,and （2.33±0.62 ）g/L.The differences between the two groups were statistically significant (P<0.05).Logistic regression analysis identified age,hematoma volume,and maximum hematoma thickness as risk factors influencing hematoma absorption (P<0.05).According to the results of multi-factor analysis,the nomogram model was constructed,and the calibration curve shows that the model has good fitting degree.The sensitivity of the nomogram model for predicting hematoma absorption in children with SEDH was 89.02% (95%CI:79.71%94.55%),the specificity was 91.91% (95%CI:85.65%~95.69%),and the area under curve (AUC) was 0.958 (95%CI:0.923~0.981).Conclusion The nomogram model based on factors such as age,hematoma volume,and maximum hematoma thickness of hematoma has a good predictive effect on hematoma absorption in SEDH children.

Objective  To analyze the influencing factors of hyponatremia in patients with non-severe traumatic brain injury (sTBI).Methods  A prospective study was conducted to select 82 non-STBI patients who were admitted to our hospital from January 2017 to December 2022,and divided them into a group with hyponatremia (30 cases) and a group without hyponatremia (52 cases) according to whether they developed hyponatremia within 7 days of admission.The influencing factors of hyponatremia in patients with non-sTBI were analyzed by multivariate stepwise logistic regression.Results Multivariate stepwise logistic regression analysis showed that GCS ≤12 points,skull base fracture,subarachnoid hemorrhage,fever,vomiting,and use of diuretics were all risk factors for hyponatremia in patients with non-sTBI (P<0.05).Conclusion GCS ≤12 points,skull base fracture,subarachnoid hemorrhage,fever,vomiting and use of diuretics are all risk factors for hyponatremia in patients with non-sTBI.

Objective  To investigate the efficacy and safety of flow diverter (FD) in the treatment of blood blister-like aneurysms(BBAs).Methods A retrospective analysis was conducted on the clinical data of 13 patient with BBAs treated with FD in our department from January 2020 to december 2024 including general information,clinical manifestations,imaging data,operation data and prognosis,etc.Results 13 FDs were implanted successfully in 13 patients.There were 4 patients with ischemic complications intra and postoperation.There was no bleeding complication or operation related death.The first DSA follow-up after discharge was completed within 3-6 months after operation,and all BBAs were cured.There were 4 patients of mild to moderate stenosis in the stent.13 patients were followed up for 6-18 months ,with an average of (10±3) months and without BBAs bleeding again.6 months after operation,12 patients had mRS score of 0,1 patient had score of 2.Conclusion Treatment of BBAs with flow diverter is safe and effective,and has a good prognosis,but ischemic complications cannot be ignored.

Objective To analyze the curative effects of Da Vinci robot-assisted thoracoscopic surgery for 99 cases with mediastinal tumor in children and summarize the experience.Methods The clinical date of 99 cases of robot-assisted mediastinal mass in Wuhan Children's Hospital from December 2020 to December 2023 were retrospectively analyzed.Tumor type,size,incision selection,operation time,intraoperative blood loss,postoperative complications and follow-up were summarized and analyzed.Results  All the operations were successfully completed without perioperative death and 3 cases were converted to thoracotomy.The duration was (86.5±21.7) min,the intraoperative blood loss was (8.5±1.6) ml,and the postoperative hospital stay was (7.4±3.2) d.The postoperative complications included chylothorax (n=4),Horner's syndrome (n=3) ,and 1 case of tracheal injury.During the follow-up of 1 year,1 case of poorly differentiated neuroblastoma recurred and underwent second operation 6 months later.The other children recovered well without death.Conclusion Da Vinci robot-assisted mediastinal tumor resection surgery in children is safe and feasible.Preoperative surgical plans should be fully prepared,and the conversion to thoracotomy should be timely and decisive.

Objective  To analyze the efficacy of the expression of POK erythroid myeloid carcinogenic factor (Pokemon),mitochondrial autophagy receptor protein FUNDC1,and p27 in predicting the 5-year tumor free survival of non-small cell lung cancer (NSCLC) patients after surgery.Methods A prospective study was conducted on 189 patients with NSCLC who underwent surgical treatment in our hospital from January 2018 to September 2019.According to whether there was tumor free survival after 5 years,patients were divided into tumor-free group and non-tumor-free group.The propensity score matching (PSM) method using the nearest neighbor matching method was applied to reduce selection bias between groups.The general information,surgical specimens Pokemon,FUNDC1,and p27 expression were compared between the two groups before and after PSM.Multivariate Logistic regression analysis was used to analyze the factors associated with 5-year tumor free survival after surgery in NSCLC.The value of the receiver operating characteristic (ROC) curve analysis of the expression of Pokemon,FUNDC1,and p27 in surgical specimens for predicting 5-year tumor free survival in NSCLC patients was investigated.The Kappa value was used to test the consistency between the combined prediction results and the actual clinical results.Results There were significant differences in clinical stage,lymph node metastasis,and vascular tumor thrombus between the first two groups of PSM (P＜0.05),while there were no significant differences in age,gender,BMI,family history of cancer,past medical history,tumor diameter,tumor location,and pathological type (P>0.05),there were no significant differences in baseline data between the two groups after PSM (P>0.05),making them comparable.The expression of Pokemon and FUNDC1 in non-tumor group was higher than that in tumor group,while the expression of p27 was lower than that in tumor group (P＜0.001).Multivariate Logistic regression analysis showed that after correcting for clinical data such as age and gender,Pokemon and FUNDC1 were still independent risk factors for 5-year tumor free survival after NSCLC surgery,while p27 was an independent protective factor for 5-year tumor free survival after NSCLC surgery (P＜0.05).The ROC curve shows that the AUC of Pokemon,FUNDC1,p27,and the combined prediction of 5-year tumor free survival after NSCLC surgery are 0.744,0.783,0.755,and 0.907,respectively (P＜0.001).Comparing the AUC of different schemes,the combined AUC is higher than that of Pokemon,FUNDC1,and p27 (Z=3.297,2.673,3.100,P=0.001,0.008,0.002).The external dataset test showed that the consistency between the joint prediction and the actual clinical results was 90.00%,with a Kappa value of 0.769 (P＜0.001).Conclusion The expression of Pokemon,FUNDC1,and p27 in surgical specimens is associated with 5year tumor free survival after NSCLC surgery,showing a certain predictive ability.Combined detection can further improve the prognosis after NSCLC resection.

Objective To investigate the predictive value of plasma four and a half LIM domains protein 2 (FHL2),pulmonary surfactant-associated glycoprotein A1 (SFTPA1),and solute carrier family 31 member 1 (SLC31A1) for diagnosis and prognosis of lung cancer.Methods From January 2018 to June 2022,96 lung cancer patients treated in our hospital were included as the lung cancer group.Another 108 patients with benign lung diseases and 120 healthy subjects who underwent physical examinations were regarded as the benign lesion group and control group,respectively.QRT-PCR was applied to detect the expression level of FHL2.ELISA was applied to detect SFTPA1 and SLC31A1 levels.ROC curve was applied to analyze the diagnostic value of FHL2,SFTPA1,and SLC31A1 for lung cancer.Kaplan-Meier method was applied for survival analysis.COX regression was applied to analyze the influencing factors of poor prognosis in lung cancer patients.Results The levels of FHL2 and SLC31A1 gradually decreased in the control group,benign lesion group,and lung cancer group,while the level of SFTPA1 gradually increased (P＜0.05).The Area Under the Curve (AUC) of the combined diagnosis of lung cancer by was 0.940,which was better than their individual diagnoses (all P＜0.05).The expression of FHL2,SFTPA1,and SLC31A1 was correlated with TNM staging,distant metastasis,and differentiation degree (P＜0.05).The 2 year cumulative survival rates of FHL2 and SLC31A1 high expression groups were 92.31% and 89.09%,respectively,which were higher than those of the low expression groups (63.64% and 65.85%).The 2 year cumulative survival rate of SFTPA1 high expression group was 67.39%,which was lower than that of the low expression group (90.00%) (both P＜0.05).TNM staging,distant metastasis,and levels of FHL2,SFTPA1,and SLC31A1 were influencing factors for mortality in lung cancer patients (P＜0.05).Conclusion The levels of FHL2 and SLC31A1 in the plasma of lung cancer patients are decreased,while SFTPA1 is increased.These three factors have certain value for diagnosis of lung cancer.Low expression of FHL2 and SLC31A1,and high expression of SFTPA1 are influencing factors for mortality of lung cancer patients.

Objective  To investigate the relationship between the levels of high mobility group protein A2(HMGA2) and a disintegrin and metalloproteinase with thrombospondin motifs 8(ADAMTS8) in papillary thyroid carcinoma(PTC) tissue with clinical pathological parameters and prognosis.Methods Cancer and adjacent tissues of 128 PTC patients who underwent thyroidectomy in our hospital from December 2018 to December 2020 were collected,and clinical and pathological characteristics of the patients were collected.Immunohistochemical staining was applied to detect the expression levels of HMGA2 and ADAMTS8 proteins in tissues,and their relationship with clinical pathological parameters was analyzed.Kaplan-Meier curve was applied to analyze the relationship between HMGA2 and ADAMTS8 expression and the prognosis of PTC patients.Multivariate Cox regression was applied to analyze the impacts of HMGA2 and ADAMTS8 expression on the prognosis of PTC patients.Results The positive expression rates of HMGA2 protein in PTC tissues and adjacent tissues were 64.84% and 32.03%,respectively,and the positive expression rates of ADAMTS8 procoprotein were 61.72% and 34.38%,respectively.There was a statistically significant difference between the two groups (P < 0.001).The expression levels of HMGA2 and ADAMTS8 proteins in PTC tissue were related to vascular invasion,TNM staging,lymph node metastasis,and differentiation degree(P<0.05).The 3-year survival rate of HMGA2 and ADAMTS8 positive expression patients was lower than that of negative expression patients(χ2=4.807,4.236,P<0.05).Positive expression of HMGA2(HR=1.752,95%CI=1.129~2.718) and positive expression of ADAMTS8(HR=1.497,95%CI=1.113~2.013) were risk factors for mortality in PTC patients(P<0.05).Conclusion The positive expression rates of HMGA2 and ADAMTS8 proteins are relatively high in PTC tissues,and their expression levels are related to clinical pathological parameters and prognosis,which has certain clinical value.

Objective To investigate the effect of Ferroptosis-related gene expression levels in breast cancer tissues on the treatment responsiveness of neoadjuvant chemotherapy(NAC),to construct a prediction model of chemotherapy responsiveness based on Ferroptosis-related genes and to evaluate its efficacy.Methods One hundred and forty breast cancer patients admitted to our hospital who received NAC from April 2021 to September 2023 were selected.All patients were collected by pathological puncture biopsy before chemotherapy,and the expression of Ferroptosis-related genes FSP1,ACSL4,GPX4,and p53 in breast cancer tissues was determined by reverse transcription-fluorescence quantitative PCR.After NAC,the chemotherapy reactivity of the patients was determined according to the Miller-Payne criteria,and they were divided into the histological significant response group (group R) and the histological non-significant response group (group NR) accordingly.The clinical data of the two groups were compared,and the related factors of low response to NAC were analyzed using the Logistic regression equation.The NAC reactivity model was constructed through the R language ggrisk software package,and the ROC curve was drawn to evaluate the model efficacy.Results Fifty-six patients out of 140 patients were evaluated for histologically significant response,and so there was 56 patients in R group,84 patients in NR group.comparison of clinical data showed no statistical difference between the two groups in terms of general clinical data and positive expression of ER,PR,HER-2 and Ki-67(P>0.05);in terms of Ferroptosis-related gene expression,FSP1,GPX4,ACSL4 and p53 gene relative expression in R group were 0.28±0.06,0.52±0.21,1.59±0.21,2.09±0.31 respectively;FSP1,GPX4,ACSL4 and p53 gene relative expression in NR group were 0.42±0.09、0.64±0.23、1.28±0.17、1.81±0.23 respectively,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that FSP1(OR＜0.001),GPX4 gene(OR=0.008),ACSL4(OR=24 721.186),p53 gene(OR=225.671) were independently correlated with neoadjuvant chemotherapy responsiveness in breast cancer patients(P<0.05).ROC curve analysis showed that the predictive risk model constructed from the above genes had good predictive value in early assessment of NAC responsiveness(AUC=0.979,P＜0.001),and the sensitivity was 98.21% and the specificity was 89.29%.Conclusion The expression levels of Ferroptosis-related genes FSP1,ACSL4,GPX4,and p53 were correlated with the responsiveness of breast cancer NAC treatment,and the constructed prediction model based on the expression of Ferroptosis-related genes was able to assess the responsiveness of breast cancer NAC treatment at an early stage.

Objective To construct and validate a multimodal imagebased prediction model for the efficacy of neoadjuvant chemotherapy in breast cancer.Methods  The 121 patients with breast cancer with ipsilateral axillary lymph node metastasis admitted to the hospital from January 2020 ~ April 2024 were reviewed.The patient underwent surgical resection after neoadjuvant chemotherapy and the pathological complete response (pCR) was counted.High-resolution MRI,breast ultrasound and mammography were performed before and after neoadjuvant chemotherapy.Logistic regression was used to analyze the influencing factors of the neoadjuvant chemotherapy effect in breast cancer patients,and a multimodal imaging based on multimodal imaging was constructed to predict the effect of neoadjuvant chemotherapy for breast cancer,and the model was verified and evaluated for efficacy.Results  Twenty-eight cases achieved pCR.Logistic regression analysis showed that tumor stage (OR=4.899,95%CI:2.016~11.909),△apparent diffusion coefficient (ADC) (OR=4.419,95%CI:1.818~10.741),and △ time to peak (TTP) (OR=3.644,95%CI:1.499~8.855) were the factors affecting the effect of neoadjuvant chemotherapy in breast cancer patients (P<0.05).The nomogram prediction model was established with the above influencing factors as predictors,and the risk rate ranged from 0.56~0.68.The results of nomogram model validation showed that the calibration curve for predicting the effect of neoadjuvant chemotherapy for breast cancer was close to the ideal curve (P>0.05).The ROC curve showed that the nomogram model had a sensitivity of 78.57%,a specificity of 83.87%,and an AUC of 0.851 (95%CI:0.767~0.927) in predicting the effect of neoadjuvant chemotherapy in breast cancer.Conclusion Tumor stage,△ADC and △TTP are closely related to the effect of neoadjuvant chemotherapy in breast cancer patients,and the prediction model of neoadjuvant chemotherapy effect based on multimodal imaging has good predictive performance.

Objective To investigate the changes in thyroid-stimulating hormone (TSH) in obese patients with subclinical hypothyroidism following symmetric three-port laparoscopic sleeve gastrectomy.Methods Clinical data of 60 cases of obese patients who underwent symmetric three-port laparoscopic sleeve gastrectomy between July 2019 and July 2022 were collected.Based on preoperative thyroid function,the patients were divided into an observation group(15 cases,with subclinical hypothyroidism) and a control group(45 cases,with normal thyroid function).Thyroid function was not intervened in the observation group either before or after surgery.Changes in body weight,body mass index (BMI),and thyroid function were compared between the two groups preoperatively and at 6 months postoperatively.Results Preoperative weight and BMI in the observation group were (107.53±10.27) kg and (37.53±3.44) kg/m2,respectively,which decreased to (90.85±10.23) kg and (31.33 ±2.48) kg/m2 at 6 months postoperatively.In the control group,preoperative weight and BMI were (106.77±10.49) kg and (37.89±3.35) kg/m2,respectively,decreasing to (86.79±9.49) kg and (31.02±2.53) kg/m2 at 6 months postoperatively.There were no statistically significant differences in weight or BMI between the two groups at the same time points (preoperatively or at 6 months postoperatively) (P>0.05).However,both groups showed significant reductions in weight and BMI at 6 months postoperatively compared to their preoperative levels (P<0.05).Preoperative TSH levels were (6.07±1.68)μIU/ml in the observation group and (2.22±1.02)μIU/ml in the control group,with a statistically significant difference between the groups (P<0.05).At 6 months postoperatively,TSH levels in the observation group decreased significantly compared to preoperative levels [(2.88±0.56)μIU/ml vs(6.07±1.68) μIU/ml,P<0.05].There were no statistically significant differences in free T4 (FT4) or free T3 (FT3) levels between the two groups either preoperatively or at 6 months postoperatively(P>0.05).Conclusion Laparoscopic sleeve gastrectomy has a beneficial therapeutic effect on obesity combined with subclinical hypothyroidism,which can significantly reduce TSH levels.

Objective To explore the influencing factors of postoperative defecation dysfunction in children with anorectal malformations(ARM),and to construct a risk prediction model of postoperative defecation dysfunction after ARM.Methods 150 cases ARM children who underwent surgery in our department of general surgery between March 2021 and April 2024 were enrolled.The children were divided into the training set (120 cases) and the internal validation set (30 cases) at a ratio of 8∶2 by the retention method..Children in the training set were collected and divided into obstacle groups (n=36,children with postoperative defecation dysfunction) and barrier-free group (n=84) according to whether postoperative defecation dysfunction occurred.The demographic data,clinical characteristics,surgical approaches,pelvic-floor muscle strength,and other variables were collected.influencingfactors were identified by univariate and multivariate logistic regression analyses.A nomogram was developed with R software.The discrimination (C-index),calibration curves,and decision-curve analysis were assessed in both the internal and external validation sets.Results The incidence of postoperative defecation dysfunction was 30.00 % (36/120) in the training set,33.33% (10/30) in the internal validation set,and 32.00 % (16/50) in the external validation set.There was no significant difference in 3 sets (χ2=0.261,P=0.877).In the training set,variables showing significant differences between the dysfunction and non-dysfunction groups were preterm birth,hypoglycaemia,irregular diet,artificial feeding,associated congenital anomalies,cardiac malformations,poor defecation habits,lower-extremity manual muscle testing(MMT) grade 3,lower-extremity MMT grade 5,Oxford pelvic-floor muscle grade 4,Oxford pelvic-floor muscle grade 5 and bowel function score(BFS)＜17.Stepwise Logistic regression revealed that BFS score < 17,preterm birth,Oxford pelvic-floor muscle grade,hypoglycaemia,cardiac malformations and poor defecation habits were independent predictors of postoperative defecation dysfunction (P＜0.05).The Oxford pelvic-floor muscle grade was a protective factor.In the training set,the area under the curve (AUC) was 0.69(0.60~0.77),accuracy 0.62(0.52~0.72),sensitivity 0.86(0.75~0.97),specificity 0.91(0.84~0.99) and a cutoff value of 0.223.AUC of the validation set 0.70(0.61~0.78),accuracy 0.62(0.52~0.72),sensitivity 0.89(0.79~0.99),specificity 0.93(0.86~0.99).Both the internal and external validation sets confirmed good predictive performance and stability of the model.Conclusion The risk prediction model,incorporating BFS＜17points,preterm birth,Oxford pelvic-floor muscle grade,hypoglycaemia,cardiac malformations,and poor defecation habits,accurately predicts the risk of postoperative defecation dysfunction in children with ARM and has been internally and externally validated.

Objective To explore the predictive value of D-dimer (D-D)/platelet count (PLT) ratio (DPR) for lower extremity deep vein thrombosis (DVT) after radical resection of colon cancer.Methods The clinical data of 366 cases who underwent radical resection of colon cancer in our hospital from January 2021 to December 2023 were selected and divided into DVT group (n=63) and non-DVT group (n=303) according to the presence or absence of lower extremity DVT after colon cancer surgery.The clinical data of all subjects were collected and the DPR at admission was calculated.The predictive value of DPR for lower extremity DVT after radical resection of colon cancer was evaluated by ROC.The influencing factors of lower extremity DVT after radical resection of colon cancer were explored by multivariate Logistic stepwise regression analysis.Results D-D and DPR in DVT group were higher than those in non-DVT group,PLT was lower than that in non-DVT group (P<0.05).ROC analysis showed that the AUC (95%CI) of D-D,PLT and DPR in predicting lower extremity DVT after radical resection of colon cancer were 0.811(0.762~0.853),0.723(0.675~0.770),0.919(0.872~0.969),respectively.Preoperative adjuvant chemotherapy,operation time > 3 h,postoperative continuous bed time > 2 d,and blood transfusion history were significantly higher in the DVT group than in the non-DVT group (P<0.05).Operation time > 3 h (OR=2.347,95%CI:1.424~3.868),history of blood transfusion (OR=1.937,95%CI:1.217~3.082),DPR≥0.60 (OR=4.707,95%CI:2.099~10.554) were risk factors for lower extremity DVT after radical resection of colon cancer (P<0.05).Conclusion DPR has significant predictive value in predicting the risk of lower extremity DVT after radical resection of colon cancer.It is an effective preoperative evaluation index.

Objective To investigate the correlation and combined predictive efficacy of peripheral blood alkaline phosphatase/prealbumin (ALP/PA),systemic immune inflammatory index (SII),and alpha-fetoprotein variant ratio (AFP-L3%) with prognosis after radical resection of liver cancer.Methods A retrospective study was conducted on 157 patients who underwent radical resection for liver cancer and were admitted to our hospital from January 2020 to March 2023.Patients were divided into progression group and non-progression group according to whether their condition progressed 18 months after surgery.Prognosis status was conducted,and the clinical data of the two groups were compared with respect to preoperative peripheral blood ALP/PA,SII,and AFP-L3%.Logistic regression analysis was used to analyze the factors affecting the postoperative disease progression.Receiver operating characteristic (ROC) curve was used to analyze the predictive value of different schemes for postoperative disease progression.Results The recurrence and metastasis rate was 38.85% (61/157) in the 157 patients at 18 months after surgery.AFP,the percentage of patients with Chinese liver cancer stage (CNLC) III,the percentage of patients with vascular cancer embolism,and preoperative peripheral blood ALP/PA,SII,and AFP-L3% were higher in the progression group than in the non-progression group,and the differences were statistically significant (P<0.05).Logistic regression analysis showed that elevated AFP (OR=1.131),stage III CNLC (OR=3.501),vascular tumor thrombus (OR=3.418),elevated ALP/PA (OR=1.409),elevated SII (OR=1.230),and elevated AFP-L3% (OR=1.380) were all independent risk factors for postoperative disease progression (P<0.05).ROC analysis showed that the area under the curve (AUC) of the new indicators ALP/PA,SII,and AFP-L3% combined to predict postoperative disease progression was 0.907,which was the largest and superior to the predictive efficacy of each indicator alone and traditional indicators alone and combined.Conclusion The peripheral blood ALP/PA,SII,and AFP-L3% are closely related to the progression of liver cancer after radical resection,and combined detection has certain predictive value for postoperative disease progression.

Objective To observe the effect of percutaneous vertebroplasty (PVP) with single balloon bilateral sequential dilatation and high-viscosity cement in the treatment of osteoporotic vertebral compression fractures (OVCFs),and early to mid-term follow-up.Methods 120 patients with OVCFs were retrospectively selected from March 2022 to January 2024 in the hospital,and divided into control group (n=58,PVP with high-viscosity cement) and observation group (n=62,PVP with single balloon bilateral sequential dilatation and high-viscosity cement) according to different surgical methods.Surgical indicators,pain degrees,vertebral function,and early to mid-term follow-up results in both groups were observed.Results The operation time of the observation group was (41.84±7.47) minutes,which was longer than that of the control group (36.17±6.51) minutes.The amount of bone cement used was (5.60±1.21) ml,which was more than that of the control group (4.79±1.08) ml;the dispersion coefficient of bone cement was (3.48±0.36),which was higher than that of the control group [(3.30±0.33)],and the difference between the two groups was statistically significant (P<0.05).The Visual Analogue Scale (VAS) scores of both groups on day 3 after surgery were lower than those before surgery,and the VAS scores at 3 months after surgery were lower than those on day 3 after surgery (P<0.05).On day 3 after surgery,vertebral height of observation group was [(22.07±2.21)mm] greater than that of control group [(20.98±2.08)mm],and Cobb angle was [(10.76±1.22)°] smaller than that of control group [(12.29±1.31)°].Three months after surgery,Oswestry Disability Index (ODI) of observation group was [(21.47±4.13)%] lower than that of control group [(23.12±4.25)%] (P<0.05).Early follow-up found that the incidence of complications in the two groups was comparable (P>0.05).Mid-term follow-up found that the incidence of complications was significantly lower in observation group (3.23%) than in the control group (13.79%) (P<0.05).Conclusion PVP with single balloon bilateral sequential dilatation and high-viscosity cement for OVCFs can improve the injection volume and diffusion effect of cement,reduce pain,and facilitate vertebral function recovery.Moreover,the risk of complications during early to mid-term follow-up is relatively low.

Objective  To investigate the effect of preoperative imaging combined with intraoperative Nice knot technique in the treatment of comminuted fractures of the lateral ankle.Methods  A total of 123 patients with comminuted fractures of the lateral ankle were admitted to our hospital from June 2021 to July 2023.62 patients who underwent routine reduction techniques were included in the control group,and 61 patients who underwent preoperative imaging combined with intraoperative Nice knot reduction were included in the observation group.The surgical indicators of surgery,intraoperative reduction quality and complication rate were compared between the two groups,as well as range of motion of talus calf angle and ankle joint before and 1 year after surgery,the affected and healthy sides of the talus calf angle,ankle joint range of motion,and functional prognosis at 1 year after surgery.Results The operation time in the observation group was (62.10±17.58) minutes,which was shorter than that in the control group (78.45±20.29) minutes.The intraoperative reduction time was (29.59±8.45) minutes,which was shorter than that in the control group (35.74±10.28) minutes.The length of the lateral malleolus incision was (10.02±2.88) cm,which was shorter than that in the control group (15.11±3.67) cm.The incision healing time was (11.30±2.16) days,which was shorter than that in the control group (14.88±2.48) days.The hospitalization time was (12.30±2.48) days,which was shorter than that in the control group (15.99±2.57) days.The intraoperative blood loss was (38.74±12.08) ml,which was lower than that in the control group (65.86±17.11) ml.The satisfaction rate of reduction was 95.08%,which was higher than that in the control group's 77.42% (P<0.05).One year after surgery,the talus-leg angle,ankle dorsiflexion,and ankle plantar flexion in the observation group were higher than those in the control group,while the talus-leg angle,ankle dorsiflexion,and ankle plantar flexion on the affected side in the control group were lower than those on the healthy side (P<0.05).The excellent and good rate of functional prognosis in the observation group was 95.08%,which was higher than that in the control group's77.42% (P<0.05).There was no significant difference in the total incidence of complications between the two groups (P＞0.05).Conclusion Preoperative imaging combined with intraoperative Nice knot technique can optimize the surgical process for patients with comminuted fractures of the lateral ankles,reduce tissue damage,promote perioperative recovery,and improve the reduction effect.

Objective To observe the results of two surgical procedures,retrograde island fascia-tipped flap graft repair on the dorsum of the finger and retrograde island flap graft repair with the perforating branch of the finger web artery as the tip,in repairing skin defects at the end of the finger.Method From January 2020 to January 2023,100 patients with skin defects at the distal phalanges of the fingers were admitted.According to the survival status of the flaps,91 patients with surviving flaps were included and divided into two groups based on different repair methods,including 33 cases in the dorsal phalanx group and 58 cases in the webbed phalanges group.Compare the survival rate of flaps and the surgical outcomes of patients with surviving flaps in the two groups.Results The flap survival rate in the dorsal phalanx group (82.50%,33/40) was lower than that in the webbed phalanges group (96.67%,58/60),and the incidence of postoperative complications (27.27%) was higher than that in the webbed phalanges group (8.61%).There was a statistically significant difference between the two groups (P<0.05).The flap length and operation time [(6.02±1.20) cm,(61.27±7.15) min] in the dorsal finger group were shorter than those in the webbed finger group [(8.60±1.82) cm,(100.25±15.20) min],the wound healing time and hospital stay in the dorsal finger group were (18.02±3.50) days and (16.20±1.50) days respectively,which were longer than those in the webbed finger group [(13.50±2.77) days and (12.50±1.80) days],there was a statistically significant difference between the two groups (P< 0.05).The capillary filling times of the dorsal finger group at 7 days after the operation and on the day of discharge were (1.57±0.14) s and (1.12±0.08) s,respectively,which were longer than those of the webbed finger group [(1.13±0.10) s and (0.95±0.06) s],the sensory function scores were (2.51±0.34) points and (3.77± 0.38) points,respectively,which were lower than those of the webbing group [(3.34± 0.40) points,(4.12±0.21) points],and the difference between the two groups was statistically significant (P<0.05).The levels of IL-6 and TNF-α at 7 days after operation [(29.95±4.80) ng/L,(197.25±13.50) ng/L] were higher than those in the fingerweb group [(27.02±4.15) ng/L,(185.62±12.27) ng/L],the differences were statistically significant (P<0.05).The follow-up results showed that compared with the finger dorsal group,the hand function score of the finger web group was higher,the hand function recovery rate was higher（93.10% vs 81.82%）,and the two-point discrimination was shorter (P<0.05).Conclusion Different retrograde island flap repair methods can effectively repair the skin defect of the finger end and promote wound healing,among which the retrograde island flap repair with pedicled perforator of the finger web artery has the advantages of higher survival rate of the flap,more obvious improvement of hand function,and less postoperative inflammation,the retrograde island fascial flap transplantation repair of the dorsal finger is relatively short.

Tumor-associated hydrocephalus is one of the serious complications in patients with intracranial tumors,commonly seen in posterior cranial fossa tumors.Its pathogenesis is complex,clinical manifestations are diverse,and treatment strategies and prognosis vary greatly,which directly affects the treatment outcome and quality of life of patients.This article reviews the research progress of tumor-associated hydrocephalus from aspects such as pathogenesis,tumor types,treatment strategies,risk factors for hydrocephalus after tumor resection,and predictive models,aiming to provide ideas for  clinical research.

Pediatric chronic subdural effusion (PCE) is a prevalent neurosurgical condition in children,particularly among infants and young children.Classified into traumatic,infectious,and idiopathic types,it manifests clinically from asymptomatic to varying degrees of intracranial hypertension and neurological deficits.This systematic review examines diagnostic approaches,therapeutic strategies,and prognosis assessment for PCE,with particular focus on comparing conservative management versus surgical interventions (including burr hole drainage,subdural-abdominal shunt,and craniotomy) in terms of indications,technical nuances,and efficacy.Emerging modalities such as immunotherapy are also explored.

This article reports the experience of surgical treatment of two cases of retrosternal goiter combined with hyperthyroidism with tracheal tenderness.Case 1 was a 54-year-old woman and Case 2 was a 73-year-old woman,both diagnosed with retrosternal goiter on imaging,with Case 2 combined with hyperthyroidism.In both cases,total thyroidectomy and resection of the retrosternal mass were successfully completed through a low neck collar incision without sternal splitting.In response to the intraoperative finding of tracheomalacia,the anterior wall of the trachea was suspended and fixed with a No.4 silk thread in the shape of an "8" suture.Case 2 was pretreated with dexamethasone to prevent hyperthyroidism.There were no serious postoperative complications and follow-up showed a patent airway.

This article reports a case of subacute subdural hematoma that recurred after hematoma puncture and drainage.The patient was treated with middle meningeal artery (MMA) embolization (using Onyx gel to embolize the petrosquamous branch) combined with hematoma puncture and drainage.Postoperatively,he received supportive interventions including anti-infective therapy and treatments to promote hematoma absorption.The patient was discharged 3 days after surgery;follow-up evaluations showed complete hematoma absorption at 1 month postoperatively and no complications at the 3-month follow-up