局灶治疗；局限性前列腺癌；多参数磁共振成像；前列腺癌治疗

Objective To investigate the correlation between serum nicotinamide adenine dinucleotide phosphate oxidase 2 (NOX2) level and cerebral blood supply and prognosis in patients with aneurysm al subarachnoid hemorrhage (aSAH).Methods 150 patients with aSAH admitted to our hospital from January 2021 to December 2023 were selected retrospectively as the observation group (150 cases),and 65 healthy people in our hospital were selected as the control group (65 cases) during the same period.Pearson correlation coefficient was used to analyze the correlation between serum NOX2 level and blood flow velocity of middle cerebral artery (MCA) and anterior cerebral artery (ACA).After 90 days of follow-up,according to the prognosis of aSAH patients,they were divided into good prognosis group (98 cases) and poor prognosis group (52 cases).Multivariate Logistic regression was used to analyze the related factors of poor prognosis in aSAH patients,and ROC curve was drawn to analyze the predictive efficacy of related factors.Results The serum NOX2 of the observation group and the control group were (2 185.20±231.15)pg/ml and (1 025.31±98.24)pg/ml,the Vm of MCA was (64.30±8.22)cm/s and (89.16±9.14)cm/s,and the Vm of ACA was (39.20±3.04)cm/s and (51.03±9.35)cm/s,respectively.The difference between the two groups was statistically significant(P<0.05).Pearson correlation coefficient analysis showed that the serum NOX2 level of aSAH patients was negatively correlated with the Vm of MCA and ACA (r=-0.512/-0.219,P<0.05).The WBC of the poor prognosis group and the good prognosis group were (9.96±2.76)×10⁹/L and (8.35±2.51)×10⁹/L,the blood sugar level was (8.16±2.05)mmol/L and (7.18±1.89)mmol/L,the NOX2 level was (2 278.30±215.26)pg/ml and (1 985.36±221.34)pg/ml,the improved Fisher score was (3.02±0.98) and (2.12±0.61),the WFNS score was (4.01±0.84) and (2.16±0.72),and the proportion of acute hydrocephalus was 25.00% and 9.18%,respectively.The difference between the two groups was statistically significant(P<0.05).Multivariate Logistic regression analysis showed that NOX2 level (OR=1.008) and improved Fisher score (OR=6.329) were independent risk factors for poor prognosis of aSAH patients (P<0.05).The ROC curve shows that the NOX2 level and the area under curve (AUC) of the improved Fisher score are 0.844 (95%CI: 0.776~0.898) and 0.691 (95%CI: 0.611~0.764) respectively.Conclusion aSAH patients have higher serum NOX2 level,which is closely related to the blood supply of brain tissue.Serum NOX2 level and improved Fisher score are independent risk factors for poor prognosis of patients with aSAH,and serum NOX2 level has better predictive efficacy,which needs to be used as an effective index to predict poor prognosis of patients with aSAH.

Objective To explore the value of peripheral blood stress disorder related indexes in the differential diagnosis of acute abdomen.Methods  300 patients with acute abdominal pain admitted from January 2018 to June 2020 (abdominal pain group).Proline peptidase activity, total oxidant status level (TOS), total antioxidant status level (TAS) and oxidative stress index(OSI) in peripheral blood were detected upon admission.According to the treatment outcome, the patients were divided into surgical treatment group (ST group,99 cases), non-surgical treatment group (MT group,102 cases) and non-specific abdominal pain group (NSAP group,99 cases).100 volunteers who underwent physical examination in our hospital were the control group.Univariate and multivariate Logistic regression were used to analyze the independent predictors of surgical treatment.Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of TOS and proline peptidase levels in surgical abdominal pain.Results (1)Peripheral blood TAS level [(36.84±10.08)μmol Trolox equiv./L VS(25.51±7.34)μmol Trolox equiv./L], OSI level [(3.68±1.77) VS (2.48±0.89)] and proline peptidase activity [(1013.58±296.84)U/L vs.(842.65±147.25)U/L] in patients with abdominal pain group were higher than those in control group Group (P>0.05).There was no significant difference in TOS level in peripheral blood between abdominal pain group and control group [(1.10±0.22)μmol H_2O2 equiv./L vs.(1.06±0.24)μmol H_2O2 equiv./L] (P> 0.05).(2) TAS level [(41.06±9.75)μmol Trolox equiv./L vs.(34.81±10.50)μmol Trolox equiv./L vs.(26.95±6.57)μmol Trolox equiv./L] and proline peptidase activity [(1207.58±254.12)U/L vs.(998.65±248.96)U/L vs.(873.65±132.04)U/L] in ST group were significantly higher than those in MT group And NSAP group.The OSI level of ST group was significantly higher than that of NSAP group [(3.90±3.87) vs.(2.42±0.65)], with statistical significance (P>0.05), but there was no statistical significance compared with MT group (3.85±1.08) (P>0.05).(3) Multifactorial Logistic regression analysis showed that plasma TOS level (OR=1.383) and proline peptidase level (OR=1.235) were independent predictors of surgical treatment in patients with emergency abdominal pain.The higher the plasma TOS level and proline peptidase level, the higher the risk of surgical treatment.(4)ROC curve analysis showed that the area under ROC curve (AUC) of plasma TOS for diagnosing surgical abdominal pain was 0.652, and the optimal diagnostic value was 39.65μmol H_2O2 equiv./L.The AUC of proline peptidase was 0.664, and the best diagnostic value was 1696.58U/L.The AUC of combined diagnosis was 0.813, the sensitivity was 78.25%, and the specificity was 59.65%.Conclusion In emergency, plasma proline protease activity and TOS levels have certain reference significance for determining whether patients need urgent surgical treatment.

Objective  To investigate the expression of RNFT2,MFAP2,and AF4/FMR2 family member 3 (AFF3) in gastric cancer(GC) tissues,and to analyze their correlation with tumor pathological features and prognosis.Methods GC tissue specimens and adjacent tissue specimens were collected from 98 GC patients who underwent surgery in our hospital from May 2018 to January 2020,clinical data were also collected.Immunohistochemical methods were applied to detect the expression of RNFT2,MFAP2,and AFF3;Kaplan-Meier method was applied to analyze the relationship between the expression of RNFT2,MFAP2,and AFF3 and the prognosis of GC patients;multivariate Cox regression was applied to analyze the influencing factors of prognosis in GC patients.Results  Compared with adjacent tissues,the positive rates of RNFT2 and MFAP2 proteins in GC tissue were obviously higher（75.51% vs. 29.59%,70.41% vs.19.39%),while the positive rate of AFF3 protein was obviously lower (26.53% vs. 68.37%,P<0.05).The expression of RNFT2,MFAP2,and AFF3 proteins was obviously correlated with TNM staging and differentiation degree (P<0.05);Kaplan-Meier method showed that the 3 year survival rates of RNFT2 and MFAP2 positive expression patients were lower than those of RNFT2 and MFAP2 negative expression patients,respectively,the 3year survival rate of AFF3 positive expression patients was higher than that of AFF3 negative expression patients (P<0.05).Multivariate Cox regression analysis showed that RNFT2,MFAP2,AFF3,TNM staging,and differentiation degree were prognostic factors for GC patients.Conclusion RNFT2 and MFAP2 are obviously upregulated in GC tissue,while AFF3 is obviously downregulated,which is closely related to clinical pathological features (such as TNM staging and differentiation) and prognosis,and has important value for the prognosis and survival of GC patients.

Objective To study the change of common bile duct pressure after laparoscopic common bile duct exploration in patients with common bile duct stones.Methods Clinical data of 17 patients with common bile duct stones treated in our hospital from January 2022 to December 2022 were collected. All patients underwent laparoscopic common bile duct exploration and common bile duct pressure measurement. The patients were followed up for 8 weeks after operation, and the common bile duct pressure was measured by indwelling T tube at 2, 3, 4 and 8 weeks.Results Among the 17 patients, 1 patient showed persistent high common bile duct pressure due to residual common bile duct stones. In the remaining 16 patients, there were no significant difference between the initial common bile duct pressure (19.7 cm H₂O) and the common bile duct pressure at postoperative (17.0 cm H₂O) and week 1 (15.5 cm H₂O) (P> 0.05). There were significant differences between the initial common bile duct pressure and the common bile duct pressure at week 2 (13.5 cm H₂O), 3 (12.2 cm H_2O), 4 (11.1 cm H₂O) and 8 (10.0 cm H₂O) (P < 0.05).Conclusion Compared to initial common bile duct pressure,the pressure of common bile duct began to decrease significantly from 2 weeks after laparoscopic common bile duct exploration in patients with common bile duct stones.

Objective〓〖WTBZ〗To explore the application effect of arthroscopic knotless suture bridge technique in the treatment of patients with large rotator cuff tear.〖WTHZ〗Methods〓〖WTBZ〗Retrospective analysis of clinical data from 213 patients with large rotator cuff tear in first department of orthopedics of Qinhuangdao Military Hospital from January 2022 to October 2023.According to different treatment methods,they were divided into conventional knot group (n=77) and knotless group (n=136).The conventional knot group was treated with arthroscopic knot suture bridge technique,while the knotless group was given arthroscopic knotless suture bridge technique.The treatment effects were compared.Postoperative complications were recorded and the occurrence of rotator cuff retear was followed up.Results At 6 months after treatment,the SF-MPQ pain scores in conventional knot group and knotless group significantly reduced (P<0.05),and the Constant score,UCLASS score and ASES shoulder joint score and the angles of shoulder anteflexion,abduction,internal rotation and external rotation in both groups were significantly improved at 6 months after treatment (P<0.05).However, there was no significant difference in SF-MPO scores, Constant, UCLASS and ASES scores between the two groups compared with those before surgery (P>0.05).The incidence of complications and retear were 4.41% and 1.47% in the no-nodule group, and 11.69% and 6.49% in the conventional nodule group, respectively, and there was statistical significance between the two groups (P<0.05).Conclusion Arthroscopic knot and knotless suture bridge techniques can promote joint function recovery of large rotator cuff tear,and both have high minimally invasive value.However,knotless suture bridge technique has greater advantages in reducing complications and retear rate.

Objective  Analyze the changes in serum levels of fibrinogen monomer (FM),high-density lipoprotein (HDL-C),homocysteine (Hcy),D-dimer (D-D) in patients with lower limb fractures before and after surgery,and analyze their correlation with deep vein thrombosis (DVT) .Methods 187 patients with lower limb fractures admitted from July 2020 to June 2023 were divided into DVT group (53 cases) and non DVT group (134 cases) according to the presence or absence of DVT after surgery. Independent sample ttests were used to compare the levels of serum FM, HDL-C, Hcy, and D-D between the two groups on the day before and after surgery. Spearman correlation analysis was used to investigate the correlation between serum FM, HDL-C, Hcy, D-D and DVT on the day before and after surgery. Receiver operating characteristic (ROC) curves were used to analyze the effects of serum FM, HDL-C, Hcy, and D-D on lower limbs on the day after surgery. The predictive value of postoperative DVT in fracture patients.Results Compared with 1 day before surgery,the serum FM,HDL-C,Hcy,and D-D levels in both groups increased on the day after surgery (P<0.05),and compared with the non DVT group,the DVT group had higher serum FM,HDL-C,Hcy,and D-D levels on the day after surgery (P<0.05).According to Spearman correlation analysis,there was no correlation between preoperative serum FM,HDL-C,Hcy,D-D and DVT on day 1 (P>0.05),while postoperative serum FM,HDL-C,Hcy,D-D were positively correlated with DVT on day 1 (P<0.05).ROC curve analysis showed that the AUC of FM,HDL-C,Hcy,D-D,and their combined prediction of postoperative DVT in patients with lower limb fractures on the 1st day after surgery were 0.781,0.756,0.754,0.781,and 0.879,respectively.The sensitivity and specificity corresponding to the optimal critical value were:After 1 day of surgery,the FM was 45.3% and 100.0%,the HDL-C was 100.0% and 49.3%,the Hcy was 49.1%/100.0%,and the D-D was 100.0% and 49.3%,respectively.The combined rates of the four were 83.0% and 86.6%.Conclusion Compared with patients with lower limb fractures who did not experience DVT after surgery,patients with lower limb fractures experienced elevated serum levels of FM,HDL-C,Hcy,and D-D.There was a correlation between preoperative and postoperative serum levels of FM,HDL-C,Hcy,and D-D.The combination of serum levels of FM,HDL-C,Hcy,and D-D at 1 day after surgery has a high predictive value for postoperative DVT in patients with lower limb fractures.

Objective  To investigate the clinical effect of elastic fixation of Endobutton plate with loop in the treatment of lower tibiofibular combined injury.Methods A total of 326 patients with lower tibiofibular joint injury combined with ankle fracture underwent surgical treatment from June 2019 to June 2021 were randomly divided into experimental group (163 cases) and control group (163 cases) by using a random number table. The control group was fixed with traditional steel plate screw, and the experimental group was fixed with elastic steel plate with loop Endobutton.Hospitalization and operation related indexes were compared between the two groups. The American Association of Foot and Ankle Surgery Ankle Function Score (AOFAS) was performed on the two groups at 2 and 6 months after surgery, respectively, and the reseparation rate of the lower tibiofibular union was evaluated and compared between the two groups at 6 months after surgery.Results There were no significant differences in operation time, blood loss, incision length, getting out of bed time and hospital stay between experimental group and control group (P>0.05). The incidence of postoperative complications in experimental group was 2.45%, lower than that in control group (7.98%), and the difference between the two groups was statistically significant (P<0.05).The incidence of postoperative complications in experimental group was 2.45%, lower than that in control group (7.98%), and the difference was statistically significant between the two groups (P<0.05). The AOFAS scores of control group were (74.5±9.2) and (81.3±4.3) at 2 months and 6 months, respectively, and the excellent and good rate was 76.0%.AOFAS of experimental group were (82.3±5.3) points and (91.2±3.8) points at 2 months and 6 months after surgery, respectively, and the excellent and good rate was 93.2%, the above indexes of experimental group were higher than those of control group, and the difference between the two groups was statistically significant (P<0.05).Reexamination 6 months after surgery the reseparation rate of lower tibiofibular combination was 12.8% in the control group and 2.4% in the experimental group, and the risk of reseparation in the experimental group was lower than that in the control group, with statistical significance (P<0.05).Conclusion Elastic fixation using Endobutton plate with loop could be used in the treatment of ankle fracture with distal tibiofibular syndesmosis injury,which has a better effect of traditional internal fixation with plate and screws.

Objective  To investigate the application of operation plan based on injury stress sequence in the treatment of degree Ⅲ and Ⅳ ankle fractures with Lange-Hansen classification of pronation and external rotation.Methods From May 2019 to May 2022,80 eligible patients of degree Ⅲ and Ⅳ ankle fractures with Lange-Hansen classification were selected prospectively and randomely divided into 2 groups:40 patients in the study group were treated with surgical reduction according to the sequence of injury stress,and the other 40 patients in the control group were treated with traditional reduction sequence.The operative time, intraoperative blood loss, fracture healing time, full weight-bearing time, Ankle dorsoextension Angle, plantar flexion Angle, and American Orthopaedic Foot and Ankle Association were compared between the two groups Society,AOFAS) Ankle and posterior foot function scores and complications.Results The surgical time [(44.80±5.12) min vs.(47.61±6.42) min] and surgical bleeding volume [(43.81±9.02) ml vs.(51.50±12.01) ml] between the study group and the control group were statistically significant(all P＜0.05).Before surgery,there had no significant differences in ankle joint dorsiflexion angle,plantar flexion angle,AOFAS ankle and hind foot function score in 2 groups(all P＞0.05).The ankle dorsiflexion angle at 3 months after surgery [(16.84±1.77) ° vs.(15.50±1.65) °],plantar flexion angle at 3 months after surgery [(45.64±4.10) ° vs.(42.58±3.86) °] and at 6 months after surgery [ (52.38±3.03) °vs.(50.64±3.74) °],the maximum walking distance score [(3.50±0.64) vs.(3.16±0.60)],ground walking score [(2.06±0.56) vs.(1.72±0.48)] and ankle joint anteroposterior activity score at 3 months after surgery [(4.96±1.38) vs.(4.16±1.07)] of the study group were all higher than those in the control group(all P＜0.05).There was no statistically significant difference in terms of fracture healing time,complete weight-bearing time,postoperative pain score,ankle joint function autonomous activity support score,abnormal gait score,maximum walking distance score at 6 months after surgery,ground walking score,ankle joint anterior and posterior activity score and surgical complications between 2 group(all P＞0.05).Conclusion According to the sequence of injury stress,surgical reduction for the treatment of grade Ⅲ and Ⅳ ankle fractures of Lange-Hansen classification of middle pronation and external rotation can shorten the operation time and promote the early recovery of joint function.

Objective  To investigate the predictors of chronic pain after inguinal hernia surgery.Methods A total of 400 patients with inguinal hernia surgery in our hospital from August 2018 to May 2023 were selected as the study objects.Visual analog scoring (VSA) was used to evaluate postoperative acute pain within 24 h after surgery.The patients were divided into chronic pain group and nonchronic pain group according to whether chronic pain occurred after surgery.Thirty-seven patients with postoperative pain lasting more than 3 months were in the chronic pain group, and the remaining 363 patients were in the non-chronic pain group.Lasso-Logistic regression was used to analyze the predictors of acute and chronic pain after inguinal hernia surgery.ResultsUnivariate analysis showed that there were significant differences in age,BMI,smoking history,preoperative groin pain,intraoperative nerve tension or injury,wound infection and postoperative acute pain between the chronic pain group and the non-chronic pain group (P<0.05).The data were regularized by Lasso regression,and three representative risk factors of chronic postoperative pain,namely preoperative groin pain,intraoperative nerve pulling or injury,and postoperative acute pain,were selected.Multivariate Logistic regression analysis showed that:Preoperative groin pain (OR=2.548,95%CI1.150~5.647),intraoperative nerve tension OR injury (OR=4.435,95%CI2.084~9.436) and postoperative acute pain (OR=2.242,95%CI1.041~4.829) was the factor of chronic pain after operation (P<0.05).Conclusion  Preoperative groin pain,intraoperative nerve pulling or injury,and postoperative acute pain are the factors affecting chronic pain after inguinal hernia.Identifying high-risk groups and taking targeted measures are helpful to prevent and treat chronic pain after inguinal hernia.

Objective  To explore the relationship between the expression of microRNA-433-3p (miR-433-3p) and β microtubule V (TUBB6) in bladder cancer tissue and its pathological characteristics,and its predictive value for postoperative recurrence.Methods From August 2021 to August 2022, 116 patients with bladder cancer underwent surgery for cancer tissue and adjacent tissue,and which were divided into recurrence group (43 cases) and non recurrence group (73 cases) according to whether there was local recurrence or distant recurrence and metastasis after surgery.The quantitative real-time polymerase chain reaction(qRT-PCR) was used to detect the mRNA levels of miR-433-3p and TUBB6.The influencing factors of postoperative recurrence of bladder cancer were analyzed by logistic- regression. The predictive value of miR-433-3p and TUBB6 in postoperative recurrence of bladder cancer was analyzed by receiver operating characteristic (ROC) curve.Results  The level of miR-433-3p in cancer tissue was obviously lower than that in adjacent tissue (P<0.05),and the level of TUBB6 was obviously higher than that in adjacent tissue (P<0.05).The level of miR-433-3p was significantly reduced (P<0.05) in patients with TNM stage Ⅲ+Ⅳ,histological differentiation to low differentiation,and tumor infiltration,while the level of TUBB6 mRNA was significantly increased (P<0.05).The serum miR-433-3p level in the recurrent group was significantly lower than that in the non recurrent group,,The level of TUBB6 mRNA was higher in the non recurrent group,and the difference was statistically significant (P<0.05).TNM stage Ⅲ+Ⅳ,tumor infiltration,and high expression of TUBB6 are independent risk factors for postoperative recurrence in patients (P<0.05),while high expression of miR-433-3p is an independent protective factor (P<0.05).ROC curve analysis shows that,,the area under curve (AUC) predicted by serum miR-433-3p and TUBB6 levels in combination was significantly higher than that predicted by a single index (miR-433-3p=2.323,TUB6=1.961,P=0.020,0.048),sensitivity of 95.35%,specificity of 82.19%.Conclusion The expression of miR-433-3p and TUBB6 in bladder cancer tissues is closely related to pathological features,and the combination of the two tissues has a higher predictive value for postoperative recurrence.

Objective To investigate the impacts of long non coding RNA (LncRNA)PH domain containing 5 antisense RNA 1 (FGD5-AS1) on the proliferation,migration,and invasion of colorectal cancer (CRC) cells by regulating the miR-299-5p/recombinant lysine specific demethylase 4B (KDM4B) axis.Methods The expressions of LncRNA FGD5-AS1,miR-299-5p,and KDM4B were detected by qRT-PCR in the surgically resected CRC tissues and adjacent tissues of 34 CRC patients CRC cells HCT116 were separated into si-NC group,si-FGD5-AS1 group,si-FGD5-AS1+inhibitor NC group,and si-FGD5-AS1+miR-299-5p inhibitor group.The levels of mRNA in each group were detected.CCK8,scratch assay,and Transwell assay were ap[plied to detect the proliferation,migration,and invasion of HCT116 cells in each group.Western blot was applied to detect the expression of proteins.Dual luciferase reporter gene assay verified the interaction mechanism between LncRNA FGD5-AS1 and miR-299-5p,and between miR-299-5p and KDM4B.Results LncRNA FGD5-AS1 and KDM4B were highly expressed in CRC tissue,while miR-299-5p was low expressed in CRC tissue (P<0.05).The expression of LncRNA FGD5-AS1 mRNA,KDM4B mRNA,OD450,scratch healing rate,invasion number,PCNA,MMP-2,MMP-9,KDM4B in the si-FGD5-AS1 group were lower than those in the si-NC group,the expression of miR-299-5p mRNA was higher than that in the si-NC group (P<0.05).Compared with the si-FGD5-AS1 group and si-FGD5-AS1+inhibitor NC group,the expression of miR-299-5p in the si-FGD5-AS1+miR-299-5p inhibitor group decreased (P<0.05),the KDM4B mRNA,OD450,scratch healing rate,number of invasions,and expression of PCNA,MMP-2,MMP-9,KDM4B increased (P<0.05).LncRNA FGD5-AS1 targeted negative regulation of miR-299-5p,while miR-299-5p targeted negative regulation of KDM4B.Conclusion Knocking down LncRNA FGD5-AS1 may inhibit the proliferation,migration,and invasion of CRC cells,and its mechanism may be achieved by regulating the miR-299-5p/KDM4B signaling axis.

Objective To compare the efficacy and complications of cupric ion electrochemical therapy and selective suprahemorrhoid resection and stapling surgery for the treatment of grade Ⅲ-Ⅳ hemorrhoids.Methods 204 patients with grade Ⅲ-Ⅳ mixed hemorrhoids admitted to our hospital from September 2022 to October 2023 were included as the study subjects.They were divided into two groups using numerical method,with 102 cases in each group.The observation group received copper ion electrochemical therapy,while the control group received selective hemorrhoid mucosal resection and stapling surgery.Compare the surgical outcomes,efficacy,pain scores,anal function scores,quality of life index scores,and incidence of complications between two groups.Results There was no statistically significant difference in gender,age,hemorrhoid grade,surgical time,and hospitalization period between the observation group and the control group(P＞0.05),but the intraoperative blood loss in the observation group was less than that in the control group [(11.37±5.32)ml and (26.72±14.24)ml], and the difference between the two groups was statistically significant (P<0.05).The severity of pain in the observation group was lower than that in the control group on the 1st and 7th day after surgery(P＜0.05);There was no statistically significant difference in the Wexner anal incontinence scores between the two groups at 1 and 8 weeks after surgery(P＞0.05).The observation group had a better gastrointestinal quality of life index(GIQLI) score than the control group at 2 weeks after surgery[(20.92±4.63) and (26.77±5.03) scores,P<0.05],and there was no statistically significant difference between the two groups at 8 weeks[(4.38±0.90) and (4.68±1.41)mm, P>0.05].The total incidence of postoperative complications in both groups was statistically significant(8.8% vs 20.6%,P＜0.05).An average follow-up of six months showed no recurrence.Conclusion Cupric ion electrochemical therapy for mixed hemorrhoids is safe,effective,and has no serious complications,providing a more convenient and minimally invasive treatment method.

Objective  To investigate the  short-term and long-term effect of intersphincter approach to protect external anal sphincter via intersphincter sulcus approach in perianal abscess.Methods A total of 376 patients with perianal abscess were admitted from March 2020 to June 2022,including 298 patients in the control group and 78 patients in the observation group.The propensity score matching method was used to obtain baseline data balance in 45 patients in each group.The control group received traditional incision and thread drawing,while the observation group received external anal sphincter protection.Evaluate the short-term and long-term efficacy of both groups of patients based on postoperative pain scores,wound healing time,average hospital stay,anal function score at 1 month after surgery,and recurrence rate within 1 year.Results After matching,there was no statistically significant difference in baseline data between the two groups of patients (all P＞0.05).On the first day after surgery,there was a statistically significant difference in pain scores between the two groups of patients (3.51±1.547 VS 4.33±1.871,P<0.05),while there was no statistically significant difference in pain scores between the two groups on the 7th (5.07±1.250 vs 4.87±1.236)and 14th days (1.18±0.490 vs 1.22±0.599)after surgery (P＞0.05).There were significance among wound healing time(31.89±2.197 VS 35.60±3.934),average hospital stay(10.64±2.442 vs 12.16±3.548),and anal function score at 1 month after surgery(3.44±1.765 vs 6.00±3.303) (all P<0.05).The one-year recurrence rate in the observation group was 15.6%,while the control group was 8.9%,without statistically significant difference(P＞0.05).Conclusion To protect the external sphincter during the operation of perianal abscess can reduce the muscle injury during the operation,reduce the postoperative pain,accelerate the wound healing and protect the anal function on the premise of ensuring the cure rate.

Objective  To investigate the anesthesia effects of different concentrations of sevoflurane combined with propofol during primary liver cancer resection surgery,as well as the changes in immune function in patients.Methods  Using single-blind method,120 cases of primary hepatocellular carcinoma admitted to the Third Affiliated Hospital of Naval Military Medical University from January 2023 to September 2023 were prospectively selected as the study subjects,and the patients were randomly (using the randomized numerical table method) included in the control group (60 cases) and the observation group (60 cases).During hepatic cancer resection,the control group was given 0.5 alveolar minimum effective concentration (MAC) sevoflurane combined with propofol target-controlled infusion anesthesia,and the observation group was given 1.0 MAC sevoflurane combined with propofol target-controlled infusion anesthesia,and both groups were observed for 3 d postoperatively.The perioperative related indexes,the sedation and quality of awakening in the immediate moment of extubation,15 min after extubation,and 30 min after extubation,the cognitive function before and at 1 and 3 d postoperatively,vital signs before induction of anesthesia,after induction of anesthesia,at the moment of intubation,at the end of surgery,immune function before and 1 d postoperative,and adverse reactions during the observation period were compared between the two groups.Results The time for extubation,recovery of spontaneous respiration,recovery of orientation,and awakening in the observation group were (11.25±1.69) min,(9.76±1.34) min,(69.23±3.35) min,and (10.13±1.43) min,and the control group were (14.57±2.28) min,(13.55±2.76) min,(73.44±4.52) min,(14.26±2.25) min,all of which were shorter in the observation group than in the control group (P<0.05).The Ramsay sedation score at the immediate moment of extubation was (4.16±0.22) in the observation group,and (3.21±0.10) in the control group; the standardized (Aldrete) score in the awakening room of the observation group at the immediate moment of extubation,and 15 min after extubation were (9.56±0.12) and (9.77±0.20),respectively,and the control group was (9.02±0.13),respectively,(9.05±0.17) points; the scores of the brief mental state examination (MMSE) scale in the observation group were (26.23±1.12) points and (25.17±0.98) points in the control group in the 1 d postoperative period,which were higher than those of the control group (P<0.05).The heart rate (HR) at the moment of intubation and at the end of operation in the observation group were (73.08±4.10) beats/min,(75.27±6.03) beats/min,and the mean arterial pressure (MAP) was (81.56±4.49) mmHg and (86.07±5.48) mmHg,respectively,and in the control group the HR was (75.47±5.78) beats/min,(77.91±6.79) beats/min,and the MAP was (85.22±5.08) mmHg and (88.25±6.01) mmHg in the observation group,respectively,which were lower than those in the control group (P<0.05).The whole blood natural killer (NK) cells,CD4+ and CD4+/CD8+ in the observation group at 1 d postoperatively were (35.62±5.54)%,(50.09±3.32)%,and (1.42±0.25),the control group were (24.12±4.09)%,(43.17±4.20)%,and (1.20±0.19),the observation group was higher than the control group (P<0.05); whole blood CD8+ was (26.55±3.02)% in the observation group and (28.71±4.45)% in the control group,the observation group was lower than the control group (P<0.05).The total incidence of adverse reactions during the observation period was 16.67% in the observation group and 5.00% in the control group,which was higher than the control group (P<0.05).Conclusion Compared with 0.5 MAC sevoflurane combined with propofol target-controlled infusion anesthesia,1.0 MAC sevoflurane combined with propofol targetcontrolled infusion anesthesia had less effect on hemodynamics and immune function in patients undergoing resection for primary hepatocellular carcinoma,and it could improve the quality of patients’ awakening,cognitive function,and promote postoperative recovery,and the anesthesia was more effective,but it had more adverse effects.

Objective To evaluate the effect of target oriented infusion guided by stroke volume variation (SVV) in elderly lumbar surgery.Method  From January to December 2023, 80 elderly patients undergoing elective general anesthesia for prone lumbar surgery were divided into two groups by random number table method: SVV guidance target-oriented infusion group (SVV group) and conventional infusion group (conventional group), with 40 cases in each group.The amount of infusion, blood loss, urine volume and use of vasoactive drugs in the two groups were recorded. MAP, HR, blood lactate concentration (Lac), base residual value (BE), and PaO-2 were recorded at the time of entry (T₁), before cuticle (T₂), 1- hour after prone position (T₃), and after surgery (T₄).Pulmonary ultrasound examinations were performed at 4, 8, 12 and 24 hours after surgery, and Bline scores were calculated, as well as the incidence of cardiac insufficiency, nausea, vomiting, delirium and hospital stay at 24 hours after surgery.Result Compared with normal group, in group SVV, intraoperative infusion volume [(1123 + 532)ml], vascular active drug utilization rate (15.0%), postoperative each point B line score [(1.55±1.32), (1.22±0.94), (1.01±0.93), (1.07±0.90)] were reduced (P<0.05).HR at T₂～T₄ [(67±8,71±11,73±12) times/min]、PaO₂ at T₃,T₄ [(438±41,423±44) mmHg] were increased,Lac and BE at T₂～T₄ were (0.3±0.5,1.4±0.5,1.4± 0.3) mmol/L.(0.3±0.6,0.3±1.0,0.3± 1.1)was decreased (P<0.05).There were no significant differences between the two groups in cardiac dysfunction,nausea,vomiting,delirium and hospital stay after a 24-hour postoperative period (P>0.05).Conclusion SVV guided target oriented infusion in elderly lumbar surgery is beneficial to circulation stability and tissue perfusion, and reduces the production of lung water.

Prostate cancer (PCa) is the most common malignant tumor of the male urinary and reproductive systems,with its incidence and mortality rates steadily increasing worldwide.Enhancing early detection of PCa and refining surgical treatment methods are crucial for improving cure rates,extending survival,and enhancing quality of life.Prostate biopsy remains the gold standard for diagnosing PCa,utilizing approaches such as transrectal,transperineal,and multi-imaging guided fusion-targeted techniques.Surgical intervention is a key treatment modality for PCa,with radical prostatectomy (RP) serving as the gold standard for managing localized disease.This paper reviews recent advancements in surgical techniques for prostate cancer,aiming to provide clinical practitioners with updated guidance.

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

Esophageal scar stenosis following chemical burns is a common and complex clinical issue. According to the Zargar classification, approximately 90% of patients with third-degree burns and 15%~30% of those with second-degree burns will develop esophageal or pyloric stenosis. Personalized treatment strategies tailored to the specifics of esophageal stenosis are particularly important.This review focuses on the selection of anastomotic sites during esophageal reconstruction following chemical burns and summarizes perioperative evaluations and timing of surgery. Overall, the treatment strategy for esophageal scar stenosis emphasizes personalized medicine, taking into account the characteristics of the stenosis and carefully selecting the most suitable surgical approach to achieve optimal therapeutic outcomes.

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

Sports medicine is often associated with soft tissue injuries,with tendon and ligament injuries being the most common sports injuries accounting for 30%~40% of all injuries.Mesenchymal stem cell exosomes have the ability to escape phagocytosis and realize long-term circulation,and can also be used as drug carriers of biological materials.The use of exosomes derived from mesenchymal stem cells for cell-free treatment of soft tissue injury is the current research direction in sports medicine.In this paper,the origin of exosomes in soft tissue regeneration is summarized,with emphasis on the biological mechanism of exosomes in soft tissue injury and the progress of diagnosis and treatment related to biomaterial.