Objective To evaluate the value of three-dimensional scanning technology in the preoperative design of tissue expansion procedures,with the expectation of making objective and accurate judgments regarding the timing of the second-stage expanded flap transfer surgery for patients,in order to avoid insufficient or excessive expanded flap areas.Methods From April 2024 to September 2024,we treated 10 patients who planned to undergo local tissue expansion for head and neck reconstruction.We utilized the Vectra WB360 three-dimensional imaging device to measure the wound defect area,the base area of the expander,and the expanded flap area in these patients,and compared these measurements with intraoperative results to assess the accuracy of this technology in guiding tissue expansion surgery.Results In 10 cases,the surface area of the expander(expansion skin area),the base area of the expander,and the lesion area were measured using the Vectra WB360 3D imaging device,with average measurements of (539.3±268.4)cm²,(157.0±78.13)cm²,and (252.8±141.6)cm².Intraoperative actual measurements were (470.7±230.4)cm²,(159.9±83.2)cm²,and (241.7±134.1)cm².Statistical analysis revealed no significant differences between the device-measured base area of the expander and lesion area compared to the intraoperative actual measurements (P>0.05).The device-measured expanded skin area was greater than the intraoperative flap area(P<0.05),which is associated with the retraction of the expanded skin after the removal of the expander.During the opearation,the flaps were able to completely cover the wound,and all flaps survived postoperatively.Follow-up at 1 to 6 months indicated good recovery of the surgical site’s appearance and function,with a high level of patient satisfaction.Conclusion The Vectra WB360 three-dimensional imaging device significantly improves the accuracy of preoperative flap area estimation,optimizes surgical planning,and thereby enhances the success rate of expanded skin flap surgery.

Objective To observe the effect of vacuum sealing drainage on the healing quality of cosmetic suture incision for large body surface masses.Methods From January 2020 to June 2023,60 patients with large surface mass hospitalized in the Department of Burns and Plastic Surgery of Northern Jiangsu People’s Hospital were recruited as participants,and they were divided into study group and control group by block random method.Patients in the control group were treated with cosmetic suture technique to suture the surgical incision,while patients in the study group were treated with vacuum sealing drainage technique on the basis of cosmetic suture to further improve the quality of incision healing.The postoperative numerical rating scale (NRS) score,visual analogue scale (VAS) score,Vancouver Scar Scale (VSS) score,Patient Scar Assessment Scale (PSAS) score and other indicators were compared between the two groups.Results One week after surgery,the NRS score in the study group was (2.15±0.46)points,significantly lower than that in the control group (3.79±0.68)points,and the pain in the study group was less than that in the control group(P<0.05).Two week after surgery,the VAS score in the study group (1.57±0.63)points was also lower than that in the control group (3.62±0.96)points(P<0.05).The incision in the study group was smoother,and patients reported higher satisfaction with the incision compared to the control group.Six months post-operation,the VSS score in the study group (2.31±1.13)points was lower than that in the control group (3.49±1.46)points,while the PSAS score in the study group (7.68±1.65)points was significantly lower than that in the control group (11.33±1.92)points(P<0.05).In the study group, the incision scar was lighter and the scar condition was better.Conclusion The application of vacuum sealing drainage technology in the cosmetic suture incision for large body surface masses can further improve the quality of incision healing,reduce incision scar,and improve patient satisfaction.

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

Objective To explore the value of high-resolution CT combined with serum epidermal growth factor receptor (EGFR) and metastasis associated gene 1 (MTA1) in distinguishing multiple primary lung adenocarcinoma and lung adenocarcinoma with intrapulmonary metastasis.Methods From October 2020 to October 2022,56 patients with multiple primary lung adenocarcinoma accepted by our hospital were regarded as the multiple primary lung adenocarcinoma group,47 patients with lung adenocarcinoma and intrapulmonary metastasis admitted to our hospital were as the lung adenocarcinoma and intrapulmonary metastasis group,and 50 healthy individuals were as the control group.The basic data of multiple primary lung adenocarcinoma patients and lung adenocarcinoma patients with intrapulmonary metastasis were collected,organized,and compared;the serum EGFR and MTA1 levels were compared between the control group,multiple primary lung adenocarcinoma patients,and lung adenocarcinoma patients with intrapulmonary metastasis;the imaging matching types of multiple primary lung adenocarcinoma patients and lung adenocarcinoma patients with intrapulmonary metastasis were compared;the imaging features of the main and accompanying lesions in the two groups were compared;receiver operating characteristic (ROC) curve was applied to analyze the value of high-resolution CT combined with serum EGFR and MTA1 in distinguishing multiple primary lung adenocarcinoma and lung adenocarcinoma with intrapulmonary metastasis.Results There was no significant difference in age between patients with multiple primary lung adenocarcinoma and those with lung adenocarcinoma with intrapulmonary metastasis (P>0.05),however,the proportion of males and those with a history of smoking in lung adenocarcinoma and intrapulmonary metastasis group was obviously higher than that in multiple primary lung adenocarcinoma group (P<0.05);the levels of serum EGFR and MTA1 in patients with lung adenocarcinoma and intrapulmonary metastasis were obviously higher than those in the multiple primary lung adenocarcinoma group and control group (P<0.05);in the imaging matching types,there were significant differences between multiple primary lung adenocarcinoma group and lung adenocarcinoma with intrapulmonary metastasis group in pure ground glass nodules,mixed ground glass nodules,solid nodules,pure ground glass nodules+mixed ground glass nodules,pure ground glass nodules+solid nodules,and mixed ground glass nodules+solid nodules (P<0.05);there was a significant difference in the presence or absence of ground glass components and vacuoles in the main lesion between the group of multiple primary lung adenocarcinoma and the group of lung adenocarcinoma with intrapulmonary metastasis (P<0.05),the shape,clear boundary,presence or absence of ground glass components,lobulation,and vacuoles in the accompanying lesions of patients in two groups had a significant impact on the accompanying lesions (P<0.05);ROC curve showed that the area under the curve (AUC) of high-resolution CT,serum EGFR,and MTA1 for distinguishing multiple primary lung adenocarcinoma and lung adenocarcinoma with intrapulmonary metastasis was 0.819,0.778,0.826,and 0.908,respectively,the combined identification value of the three was superior to individual identification (Z_{three combination-high-resolution Ct}=3.026,P=0.003,Z_{three combination-EGFR}=3.057,P=0.002,Z_{three combination-MTAI}=2.361,P=0.018).Conclusion Serum EGFR and MTA1 levels,and high-resolution CT have certain clinical reference value for distinguishing multiple primary lung adenocarcinoma and lung adenocarcinoma with intrapulmonary metastasis,and the combination of the three has a good differentiation effect.

Objective To explore the effect of individualized lung rehabilitation training on rapid postoperative rehabilitation intervention in lobectomy patients with concomitant high-risk factors.Methods A total of 102 patients with high-risk factors undergoing pulmonary lobectomy admitted to our hospital from February 2021 to December 2022 were selected and divided into experimental group(51 cases) and control group(51 cases) by random number table method.The reference group received traditional standardized lung rehabilitation training,while the experimental group received individualized lung rehabilitation training.The clinical hospitalization time,chest tube removal time,lung function,motor function indicators,quality of life,and incidence of complications were compared between the two groups after intervention.Results After intervention,the hospitalization days[(10.34±2.06) d] and the chest tube removal time[(3.86±0.55)d] of the experimental group were significantly shorter than those of the control group[(13.23±2.21) d and (4.65±0.62)d](P<0.05)]; the forced vital capacity [FVC,(2.52±0.42)L],maximum air volume [MVV,(66.82±7.32)L] and 1s forced expiratory volume [FEV₁,(1.35±0.24)L] of experimental group were significantly higher than those of control group[（2.11±0.36）L,（62.02±6.59）L,（1.24±0.22）L](P<0.05); the FMA scores[(81.86±8.36)points] and 6min walking distance[(221.66±25.24)m] were significantly higher than those of control group [(72.43±7.51)points and (183.23±20.75)m](P<0.05); the SF-36 score of the experimental group[(85.36±9.11)points] was significantly higher than that of the control group[(79.43±8.68)points](P<0.05); the incidence of complications in the experimental group was obviously lower than that in the reference group(5.88% vs 21.57%,P<0.05).Conclusion Individualized lung rehabilitation intervention training can effectively improve lung ventilation function and exercise tolerance in lobectomy patients with concomitant high-risk factors.

Objective To summarize the application of seven-stitch definitive suture in total laparoscopic total gastrectomy with esophagojejunostomy. Methods From March 2021 to July 2022, 14 patients with early and advanced upper gastric cancer were treated with total laparoscopic total gastrectomy, esophagojejunal anastomosis to reconstruct digestive tract, and manual anastomosis was optimized by seven-stitch definitive suture method for anastomosis. The operative time, intraoperative blood loss, intraoperative anastomosis reconstruction cost, postoperative complications, postoperative pathology and prognosis were analyzedResults The average operation time of the 14 patients was 300 minutes, the average intraoperative blood loss was 110ml, and the average cost of consumables for resection and reconstruction was 16767 yuan. Of the 14 patients, 3 had perioperative complications. Conclusion Compared with instrument anastomosis, seven-stitch definitive suture avoids the risk of excessive tissue anastomosis tension and tissue compression caused by individual differences, does not increase the incidence of postoperative complications, reduces the medical cost of patients, and safely and effectively optimizes the process of endoscopic manual anastomosis.

Objective To investigate the correlation between cholinesterase(ChE) level and the risk of sarcopenia and postoperative infection in patients with gastric cancer.Methods 125 patients with gastric cancer in our hospital from June 2022 to July 2023 were selected as the study objects,all of whom received radical gastrectomy.Serum ChE levels were detected 1 day before surgery and 5 days after surgery,relevant infectious agents were detected on the 5th day after surgery.The incidence of postoperative sarcopenia and postoperative infection were recorded in the two groups according to the dichotomous ChE level.Pearson correlation was used to analyze the correlation between serum ChE level and sarcopenia and postoperative infection.Results After operation,the serum ChE level of 125 patients with gastric cancer was(263.86±51.57) U/L.According to the dichotomous number of serum ChE level,62 cases were divided into high level group(ChE≥267.03U/L) and 63 cases were divided into low level group(ChE<267.03 U/L).The incidence of sarcopenia in high level group was lower than that in low level group,and the walking speed,grip strength and muscle mass levels were higher than those in low level group(P<0.05).The incidence of sarcopenia in high level group was lower than that in low level group,and the levels of C-reactive protein(CRP),interleukin(IL-6) and procalcitonin(PCT) were lower than those in low level group(P<0.05).Pearson correlation analysis showed that ChE level was positively correlated with walking speed,grip strength and muscle mass(r=0.479,P<0.05;r=0.606,P<0.05;r=0.513,P<0.05),CRP,IL-6 and PCT were negatively correlated with postoperative infection(r=-0.545,P<0.05;r=-0.836,P<0.05;r=-0.468,P<0.05).Conclusion Serum ChE is associated with the risk of postoperative sarcopenia and postoperative infection for gastric cancer.

Objective To explore the correlation between the diameter of patients’ autologous tendon and the prognosis of anterior cruciate ligament (ACL) reconstruction surgery.Methods From October 2018 to October 2023,82 patients who underwent anterior cruciate ligament reconstruction surgery at Wuxi No.904 Hospital were selected.Based on whether complications occurred after the anterior cruciate ligament reconstruction surgery,they were divided into a group with good prognosis (n=64) and a group with poor prognosis (n=18).Performing univariate analysis on the prognosis of anterior cruciate ligament reconstruction surgery.Pearson correlation analysis was used to analyze the relationship between tendon diameter and prognosis.A multifactorial Logistic regression model was applied to analyze the factors influencing the prognosis of ACL reconstruction and construct a nomogram.The diagnostic efficacy of tendon diameter on the prognosis of ACL reconstruction was analyzed using the receiver operating characteristic (ROC) curve.Results The results of the univariate analysis showed that there were statistically significant differences in gender and age between the two groups (P<0.05).The tendon diameter and cross-sectional area in the group with a good prognosis were higher than those in the group with a poor prognosis (P<0.05).Post-treatment,the Lysholm,Tegner,and IKDC scores in the group with a good prognosis were higher than those in the group with a poor prognosis(P<0.05).Pearson correlation analysis showed a significant positive correlation between the patient’s tendon diameter and Lysholm,Tegner,and IKDC scores(r=0.417,0.411、0.446，P<0.05).Logistic analysis indicated that gender,age,tendon diameter,and tendon cross-sectional area are factors affecting the prognosis of ACL reconstruction (P< 0.05).The ROC curve results showed that the combined diagnostic effect of gender,age,tendon diameter,and cross-sectional area is significantly better than any single factor alone.Conclusion There is a significant correlation between the patient’s autologous tendon diameter and the prognosis of ACL reconstruction surgery.An increase in autologous tendon diameter enhances knee joint function and improves patient prognosis.

Objective To explore the predictive value of serum milk fat globule-EGF factor 8 protein (MFG-E8) and leucine rich alpha-2 glycoprotein 1 (LRG1) for acute kidney injury (AKI) in patients with severe pancreatitis.Methods A study was conducted on 100 patients with severe pancreatitis admitted to our hospital from January 2020 to August 2023.They were grouped into AKI group (43 cases) and non AKI group (57 cases) based on whether AKI occurred within 48 hours.Enzyme linked immunosorbent assay (ELISA) was applied to determine the levels of serum MFG-E8 and LRG1 in each group.Spearman correlation was applied to analyze the correlation between serum MFG-E8,LRG1 expression levels and Acute Physiological And Chronic Health Evaluation Ⅱ (APACHE Ⅱ).Logistic regression was applied to analyze the factors affecting AKI in patients with severe pancreatitis.Receiver operating characteristic (ROC) curve was applied to analyze the predictive value of serum MFG-E8 and LRG1 for AKI in patients with severe pancreatitis.Results Compared with the non AKI group,the expression level of LRG1 in the AKI group was obviously increased (P＜0.05),while the expression level of MFG-E8 was significantly reduced (P＜0.05).There was a negative correlation between serum MFG-E8 level and APACHE Ⅱ score in severe pancreatic patients (r=-0.444,P＜0.05),while there was a positive correlation between serum LRG1 level and APACHE Ⅱ score (r=0.655,P＜0.05).The results of multivariate Logistic regression analysis showed that serum MFG-E8 was a protective factor for AKI in patients with severe pancreatitis (P＜0.05).LRG1,serum creatinine,and uric acid were all risk factors for AKI in patients with severe pancreatitis (P＜0.05).The combination of serum MFG-E8 and LRG1 in predicting AKI in patients with severe pancreatitis was superior to MFG-E8 and LRG1 alone in predicting AKI (Z_{combination - MFG-E8}=2.952,P=0.003;Z_{combination-LRG1}=2.385,P=0.017).Conclusion The serum MFG-E8 expression level is significantly reduced and LRG1 expression level is significantly increased in severe pancreatitis patients with AKI.The combination of the two can be used for predicting AKI in severe pancreatitis patients.

Objective To investigate the expression levels and clinical significance of microRNA-383(miR-383),microRNA-4458(miR-4458),and microRNA-93(miR-93) in colorectal cancer tissue.Methods From October 2018 to October 2020,124 colorectal cancer patients who underwent surgical treatment in our hospital were regarded as the colorectal cancer group,and their adjacent normal tissues were as the adjacent control group.Real-time fluorescence quantitative polymerase chain reaction(qRT-PCR) method was applied to detect the expression levels of miR-383,miR-4458,and miR-93 in tissues;the relationship between the expression of miR-383,miR-4458,and miR-93 in colorectal cancer tissue and patient prognosis was analyzed using Kaplan-Meier curve;Cox regression was applied to analyze the prognostic factors of colorectal cancer patients.Results Compared with the adjacent control group,the expression levels of miR-383,miR-4458,and miR-93 in the colorectal cancer group were obviously lower(P＜0.05).The expression of miR-383,miR-4458,and miR-93 in colorectal cancer tissue was related to clinical and pathological features such as tumor diameter,TNM staging,lymph node metastasis,and depth of invasion(P＜0.05).The three-year survival rate of patients with high expression of miR-383 in colorectal cancer tissue(55/63,87.30%) was higher than that of patients with low expression of miR-383(41/61,67.21%)(χ²=7.650,P＜0.05);the three-year survival rate of patients with high expression of miR-4458 in colorectal cancer tissue(53/60,88.33%) was higher than that of patients with low expression of miR-4458(43/64,67.18%)(χ²=8.566,P＜0.05);the three-year survival rate of patients with high expression of miR-93 in colorectal cancer tissue(51/59,86.44%) was higher than that of patients with low expression of miR-93(45/65,69.23%)(χ²=5.612,P＜0.05).According to multivariate Cox regression analysis,miR-383,miR-4458,and miR-93 are protective factors for the prognosis of colorectal cancer patients(P＜0.05),while tumor diameter,TNM staging,lymph node metastasis,and depth of infiltration were risk factors for the prognosis of colorectal cancer patients(P＜0.05).The area under the curve(AUC) predicted by Cox regression model is 0.917,95%CI is 0.854~0.959(Z=12.338,P＜0.05),the sensitivity is 94.29%,and the specificity is 87.64%.Conclusion The expression levels of miR-383,miR-4458,and miR-93 in colorectal cancer tissue are obviously reduced,and their expression levels are related to the clinical pathological characteristics and prognosis of colorectal cancer patients.

Objective To analyze the efficacy of three-cavity clearance,simple incision and drainage and incision thread drawing procedure in the treatment of patients with perianal abscess and its influence on postoperative pain,wound healing and anal function recovery.Methods 100 patients with perianal abscess in our hospital were included from June 2020 to June 2023.According to different surgical methods,they were divided into group A(n=34,three-cavity clearance),group B(n=33,simple incision and drainage) and group C(n=33,incision thread drawing procedure).The therapeutic effect and postoperative wound healing of the three groups were compared (completely shedding of carrion and wound healing).The pain status [visual analogue pain scale (VAS)] and anal function (Wexner Anal incontinence Scale score) of the 3 groups were compared at 1, 7 and 14 days after surgery.The total incidence of complications (infection, anal fistula and anal deformity) in the 3 groups were compared at 14 days after surgery.Results The total therapeutic efficacy rate in group A(94.12%) was significantly higher than that in group B(75.76%) and group C(69.70%)(P<0.05).The complete shedding of carrion and wound healing time with(15.41±2.07) d,(20.97±2.33) d in group A were significantly shorter than(17.29±2.13) d,(22.65±2.64) d in group B and(18.54±2.16) d,(23.99±2.61) d in group C(P<0.05).At 1,7 and 14 days after surgery,the VAS score and Wexner Incontinence scale score in group A were significantly lower compared with those in group B and group C(P<0.05).Within 14 days after surgery,the total incidence rate of infection,anal fistula and anal deformity in group A(8.82%) was lower compared to group B(21.21%) and group C(21.21%)(P>0.05).ConclusionThree-cavity clearance has a significant effect in the treatment of patients with perianal abscess,and it can relieve the postoperative pain,and promote the wound healing and anal function recovery.

Objective To analyze the curative effect of suspended airless laparoscopic surgery on inguinal hernia in children.Methods 180 children with inguinal hernia who received treatment at the Fourth Affiliated Hospital of Guangzhou Medical University from June 2020 to February 2023 were selected.Random number table method was used to divide the patients into two groups, 90 cases in each group.The control group underwent laparoscopic high ligation of hernia sac,the observation group was treated with suspended airless laparoscopic surgery,and the clinical efficacy and surgical situation,postoperative pain and stress index levels,as well as the impact on testicular volume and quality of life,complications,and recurrence rate were compared between the two groups.Results There was no statistically significant difference in clinical efficacy between the two groups of children (P>0.05).The surgical performance of the observation group was better than that of the control group (P＜0.05).The scores of the simplified McGill pain questionnaire were (23.23±5.11) points and (25.51±5.21) points in the observation group and control group 12 hours after surgery, and (20.02±4.55) points and (22.73±4.46) points on the first day after surgery, respectively. 3 days after surgery, the scores were (11.76±1.71) points and (12.63±1.82) points, respectively, and the difference between the two groups was statistically significant (P < 0.05).On the second day after surgery,the elevated levels of stress indicators such as interleukin-6 (IL-6),interleukin-10 (IL-10),cortisol (Cor),and malondialdehyde (MDA) in the observation group were lower than those in the control group [（29.03±4.21）ng/L vs （30.86±4.15）ng/L,（30.12±4.23）ng/L vs （32.02±4.41）ng/L,(47.11±6.63)mmol/L vs (50.17±6.71)mmol/L,(24.31±5.18)μmol/L vs (26.63±5.25)μmol/L](all P＜0.05).There was no statistically significant difference in testicular volume between the two groups (P>0.05),while the quality of life score of the observation group was lower than that of the control group (P＜0.05).The incidence and recurrence rates of complications such as scrotal edema and inguinal pain in the observation group were not statistically significant compared to the control group (P>0.05),but the subcutaneous emphysema rate in the observation group was lower than that in the control group (P＜0.05).Conclusion Suspended gasless laparoscopic surgery and laparoscopic high ligation of hernia sac have good therapeutic effects in treating pediatric inguinal hernia,while the former has advantages in reducing postoperative pain and stress response.

Objective To analyze the predictive value of dynamic changes of multiple inflammatory factors in early screening of sepsis risk in patients with abdominal trauma.Methods A total of 360 patients with abdominal trauma admitted to the Department of Surgery of Jiangsu Provincial Corps Hospital of the Chinese People’s Armed Police Force from January 2018 to January 2022 were studied.Patients were divided into sepsis group and control group according to whether sepsis occurred.The general data and dynamic changes of inflammatory indicators were compared between the two groups.Multivariate Logistic regression was used to analyze the related factors of sepsis in patients with abdominal trauma,and ROC curve was used to analyze the value of dynamic changes of multiple inflammatory factors in predicting sepsis in patients with abdominal trauma.Results Among the patients included in the study,13 cases fell out,leaving 347 cases,of which 51 patients with sepsis were classified as sepsis group,and the remaining 296 cases were classified as control group.The incidence of sepsis was 14.70%.There was no significant difference in age,blood glucose and white blood cell at admission between the two groups(P>0.05).But the SOFA score in sepsis group(1.86±0.45) was higher than that in control group(1.54±0.36).In sepsis group, the difference of C-reactive protein (CRP) was (5.67±1.17)mg/L, the PCT was (0.12±0.05)ng/ml, the PCT variation rate was (36.43±8.02)%, and the difference of serum amylase A protein (SAA) was (8.62±1.05)m g/L,the difference of neutrophil percentage was (9.31±1.09)%, which was higher than that of control group[(4.79±0.63) mg/L,(0.10±0.04) ng/ml,(28.04±6.21)%,(7.11±0.84) mg/L,(8.41±0.92)%],the difference was statistically significant (P<0.05).Multivariate Logistic regression analysis showed that:SOFA score(OR=1.648),CRP change difference(OR=2.338),PCT variation rate(OR=1.096),SAA change difference(OR=6.043),neutrophil percentage change difference(OR=3.355) were independent risk factors for sepsis in patients with abdominal trauma.ROC curve showed that SAA difference was more effective in predicting the risk of sepsis in patients with abdominal trauma than CRP difference,PCT variation rate,neutrophil percentage change difference and SOFA score.Conclusion Dynamic analysis of multiple inflammatory factors is valuable for early screening of sepsis risk in patients with abdominal trauma,and monitoring the changes of inflammatory factors is helpful for early adjustment of treatment.

Objective To explore the experience of robot-assisted laparoscopic surgery in the treatment of residual malformation of urachus with children.Methods The clinical date of 10 children with urachal remnants malformation treated by Da Vinci Robot Assisted Laparoscopic Surgery in Wuhan Children’s Hospital from July 2021 to July 2023 were retrospectively analyzed.Robot-assisted laparoscopic surgery was used to analyze the intraoperative situation, postoperative complications, surgical effect and pathological results.Results All 10 cases were treated by Da Vinci Robot Assisted Laparoscopic Surgery without Laparotomy and complete excision,while maintain the umbilical integrality,8 cases with symptoms were resected after preoperative imaging diagnosis,1 case was asymptomatic and resected due to continuous enlargement of the cyst,and 1 case was found to be resected during other operations.The average operation time was (140.70±17.66) min,the median blood loss was 7.5 (4.5,27.5) ml,the postoperative urethral catheterization was (6.2±1.26) d,the hospital stay was (9.9±0.94) d and the average cost was (46378.92±2777.13)yuan.All the urachal remnants were confirmed by Pathology as 9 cases of urachal cysts and 1 case of urachal fistula.Conclusion Robot-assisted laparoscopic surgery is safe and effective in the treatment of urachal remnants malformation in children,the surgical procedure for resected repair of the anterior abdominal wall has unique advantages.

Objective To analyze the effect of arthroscopic acromioplasty on subacromial impingement syndrome.Methods 100 SIS patients admitted to our joint surgery department from August 2018 to August 2022 were selected as the observation group, all of whom underwent shoulder arthroscopic acromioplasty. Additionally, 100 patients who underwent conservative treatment during the same period were selected as the control group. Compare the University of California Shoulder Score(UCLA), American Association of Shoulder and Elbow Surgeons Score(ASES), Fudan University Shoulder Function Score(FUSS), incidence of complications, and short-term efficacy between the control and observation groups at different times before and after surgery in the observation group.Results All patients will undergo a follow-up period of 12 months. The incidence of postoperative complications in the observation group was relatively low; The short-term efficacy of the observation group was significantly higher than that of the control group(P＜0.05); At 1 month, 6 months, and 12 months after surgery, the UCLA, ASES, and FUSS scores of the observation group patients were significantly higher than the preoperative scores of the above indicators(P＜0.05).Conclusion Arthroscopic acromioplasty in the treatment of subacromial impingement syndrome has a good short-term effect.

Objective analyze the clinical efficacy of percutaneous endoscopic lumbar posterior fusion(PE-PLIF) in the treatment of lumbar spondylolisthesis and evaluate its safety and effectiveness.Methods From January 2018 to December 2021,46 patients with grade Ⅰ degenerative lumbar spondylolisthesis underwent PE-PLIF surgery in the Department of Orthopedics of our hospital.General data such as age,gender,body mass index(BMI),operative time,blood loss and fluoroscopy were collected.Visual analogue scale(VAS) and Oswestry Disability Index(ODI) scores were compared before surgery,3 days and 12 months after surgery to analyze the efficacy.Macnab was used to evaluate patient satisfaction,and Lenke was used to evaluate fusion.Follow-up was 1.2 to 3.3 years.Results The average operative time of the patients was (143.76±34.39)min,the average intraoperative fluoroscopy was (6.98±0.75)times,and the average hospitalization was (9.13±3.68)days.The VAS scores before low back pain ranged from 2 to 9, with an average of (6.14±2.79). The VAS score at 3 days after operation was 0-5, with an average of (2.02±1.52) points, and the difference was statistically significant compared with that before operation (P <0.05).The VAS score at 12 months after surgery was 0 to 3, with an average of (1.09±0.92) points, which was significantly improved compared with 3 days after surgery, and the difference was statistically significant (P<0.05). VAS scores of patients before lower extremity pain ranged from 4 to 9 points, with an average of (6.58±2.20) points. The VAS score at 3 days after surgery was 0-5, with an average of (1.72±1.45) points, and the difference was statistically significant compared with that before surgery (P<0.05). The VAS score at 12 months after surgery was 0~3, with an average of (1.13±0.95), and the difference was statistically significant compared with 3 days after surgery (P<0.05).ODI score of patients decreased from (77.25±9.82)% before surgery to (15.73±9.86)% after 12 months of follow-up, with statistical significance (P<0.05).Postoperative complications included cerebrospinal fluid leakage in 3 cases, radiculopathy in 2 cases, incomplete reduction in 1 case, and open surgical revision of internal fixation rupture in 1 case. According to Macnab criteria, 27 patients were excellent (58.7%), 15 were good (32.6%), and 4 were average (8.7%), with no adverse evaluation.Conclusion The results of this study indicate that PE-PLIF is a safe and effective treatment for mild lumbar spondylolisthesis.

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

Objective To explore the impact of ventricular arterial coupling on the prognosis of patients with traumatic hemorrhagic shock(HTS).Methods 60 HTS patients who were hospitalized in the emergency and critical care departments of Nanjing Drum Tower Hospital Group Suqian Hospital from January 2020 to December 2022 were included.They were divided into survival group(n=30) and death group(n=30) based on their prognosis.The acute physiological and chronic health score Ⅱ(APACHE Ⅱ),sequential organ failure(SOFA) score,lactate(Lac),and central venous oxygen saturation(ScvO₂) of the two groups of patients were monitored,respectively,Compare the central venous pressure(CVP),cardiac index(CI),stroke volume index(SVI),global end diastolic volume index(GEDVI),systemic vascular resistance index(SVRI),and mean arterial pressure(MAP) of two groups of patients under continuous monitoring of pulse indicator cardiac output(PiCCO),and calculate the left ventricular arterial coupling(VAC) index.Results The Lac levels in the survival group and death group were (2.31±1.29)mmol/L and (3.98 ±1.01)mmol/L,respectively,with statistical significance(P<0.05);The ScvO₂ values for the survival group and death group were (62.69±5.73)% and (60.3±5.35)%,respectively,with no significant statistical difference(P>0.05);The survival group showed a statistically significant decrease in APACHE Ⅱ score[(18.57±2.23)points vs (23.00±3.15)points] and SOFA score[(9.40±2.15)points vs (14.07±2.26)points] compared to the death group(P<0.05),with an increase in CI[(2.97±0.20)L/(min·m² )vs (2.73±0.27)L/(min·m²)],an increase in SVI[(50.11±4.31)ml/m² vs (46.53±3.49)ml/m²],and a decrease in VAC[(1.34±0.19) vs (1.69±0.28)],and a statistically significant difference(P<0.05),However,there was no significant statistical difference in CVP[(9.19±1.20)mmHg vs (9.35±1.53)mmHg)],GEDVI[(715.73±101.72)ml/m² vs (717.93±89.07)ml/m²],SVRI[(2 061.55±701.23)dyn·sec·cm^-5·m^-2 vs (2 164.31±732.16)dyn·sec·cm^-5·m^-2],and MAP[(92.21±10.81)mmHg vs (89.19±17.33)mmHg] between the survival and death groups(P>0.05);Logistic regression analysis showed that VAC(OR=1.41),Lac(OR=1.36),APACHE Ⅱ score(OR=1.25),SOFA score(OR=1.21),CI(OR=1.31),and SVI(OR=1.20) were risk factors for mortality in patients with traumatic hemorrhagic shock(P<0.05).Conclusion VAC has a certain impact on the prognosis of patients with traumatic hemorrhagic shock.

Breast implant surgery is a widely practiced cosmetic procedure,and while its safety and outcomes have improved with technological advancements,postoperative complications remain a major concern for both patients and physicians.Common complications associated with breast implants include pain,infection,bleeding/hematoma,seroma,prosthesis displacement,capsular contracture,and breast implant-associated anaplastic large cell lymphoma(BIA-ALCL).Furthermore,it summarizes the underlying mechanisms,risk factors,and prevention strategies of these complications,offering theoretical guidance for optimizing clinical practices.

Pathological scars,primarily including hypertrophic scars and keloids,have long been a challenge for dermatology and burn plastic surgery.Despite numerous treatment methods being applied to basic and clinical research on pathological scarring,there is still no definitive scheme for its prevention and treatment.Botulinum Toxin Type A(BoNT-A),widely used in dermatology and aesthetic surgery since 2000 for improving scar appearance.In recent years,there have been a large number of basic and clinical experiments investigating the role of BoNT-A in the prevention and treatment of scars.This article reviews the progress of BoNT-A research on pathological scars to provide new perspectives for their prevention and treatment.

Children short bowel syndrome (SBS) is a malabsorption with acquired reduction in length of the small intestine or congenital bowel anomalies which cannot meet the needs of normal growth and development,and requires parenteral nutrition to support longer than 42 days.Due to the changes of intestinal structure and function,long-term intravenous nutrition,and antibiotic use,the intestinal flora of children with SBS is often disordered.Maintaining the diversity and stability of intestinal flora in children with SBS plays an important role in protecting the intestinal mucosal barrier,enhancing intestinal adaptation,withdrawing PN early,and reducing complications such as intestinal failure-related liver damage.Probiotics play an important role in maintaining the stability of intestinal flora,regulating metabolism and immunity.However,the role of probiotics in SBS is still controversial.This article summarizes the characteristics of intestinal flora in children with SBS and its effects on the body,and the role of probiotics in maintaining the homeostasis of intestinal flora in children with SBS,hoping to provide reference for the clinical treatment of children with SBS.

Hepatocellular carcinoma is the fifth most common malignant tumor in our country,and hepatectomy is one of the main treatment methods for hepatocellular carcinoma.Pringle maneuver (PM) is widely used in hepatectomy to reduce bleeding,but the maneuver causes ischemia reperfusion injury.Prolonged use of PM may affect liver function and increase postoperative complications,especially in patients with cirrhosis.PM may also accelerate the growth of micrometastatic tumor cells in the liver and promote tumor metastasis.However,the safe duration and methods of PM usage,as well as whether it shortens the disease-free survival or overall survival of patients undergoing liver resection for hepatocellular carcinoma,remain controversial.This article summarizes the effect of Pringle maneuver on the prognosis of patients with hepatocellular carcinoma during hepatectomy.