Osteoporotic vertebral compression fractures is a common type of osteoporotic fractures,often occurring with minimal external force or even without obvious trauma.They manifest as pain,deformity,and functional impairment,significantly impacting patients’ quality of life.Following reduction of vertebral compression fractures,bone defects often occur and typically require bone grafting for repair.Surgical treatments primarily include percutaneous vertebral augmentation and open surgery.Cement augmentation,appropriate bone implantation,and anti-pullout internal fixation are crucial components of bone repair therapy.Different types of cement materials and novel vertebral augmentation techniques offer more options for vertebral fracture repair.This consensus incorporates epidemiological characteristics of osteoporotic vertebral compression fractures,referencing literature search results and expert survey opinions,to address common controversies regarding commonly used vertebral bone repair materials,strategies,and postoperative considerations in clinical practice.It is hoped that this consensus will improve treatment outcomes,enhance patient prognosis,and promote standardized clinical management of osteoporotic vertebral compression fracture repair.

Objective The combined detection of serum angiopoietin-like protein 8 (ANGPTL8) and Vascular cell adhesion molecule-1 (VCAM-1) levels was analyzed for the predictive value of cerebral vasospasm (CVS) after intracranial aneurysm embolization. Methods A total of 196 patients who underwent intracranial aneurysm embolization in our hospital from March 2019 March 2022 were selected as the study subjects,99 patients with CVS were in the CVS group,and 97 patients without CVS were in the non CVS group.Serum ANGPTL8 and VCAM-1 levels were detected by ELISA;the correlation between serum ANGPTL8 and VCAM-1 levels was analyzed by Pearson method,Logistic regression was used to analyze the influencing factors of CVS in patients undergoing intracranial aneurysm embolization;ROC curve was used to analyze the serum levels of ANGPTL8 and VCAM-1 to predict the cutoff value of CVS in patients undergoing intracranial aneurysm embolization;four grid table method was used to analyze the predictive value of ANGPTL8,VCAM-1 and their combination on the occurrence of CVS in patients undergoing intracranial aneurysm embolization. Results The differences between CVS and non-CVS groups were statistically significant in hypertension, Hunt-Hess grade, and Glasgow coma (GCS) scores (P<0.05). The serum ANGPTL8 and VCAM-1 levels in the CVS group were significantly higher than those in the non-CVS group (P<0.05).There was a positive correlation between serum ANGPTL8 and VCAM-1 (r=0.468,P<0.05).Multivariate analysis showed that high level of ANGPTL8 (OR=3.652,95% CI:1.434-9.302),high level of VCAM-1 (OR=2.619,95% CI:1.212-5.658),Hunt Hess grade Ⅲ-Ⅳ (OR=1.927,95% CI:1.104-3.362),GCS score of 3-8(OR=2.813,95% CI:1.257-6.295) were independent risk factors for CVS in patients undergoing intracranial aneurysm embolization.The AUC of serum ANGPTL8 level in predicting CVS in patients undergoing intracranial aneurysm embolization was 0.844,and the cut-off value was 189.233U/L;the AUC of serum VCAM-1 level in predicting CVS in patients undergoing intracranial aneurysm embolization was 0.795,and the cutoff value was 17.984mg/L.The accuracy,sensitivity and specificity of the combined prediction for CVS were 89.81%,93.94% and 85.57%,respectively,which were obviously higher than those of the single prediction.Conclusion The serum levels of ANGPTL8 and VCAM-1 in CVS group are obviously higher than those in non CVS group.The combination of the two has a high predictive value for CVS after intracranial aneurysm embolization.

Objective To evaluate the clinical efficacy and safety of preoperative endovascular embolization of Solid Hemangioblastomas. Methods The data bases including Wan Fang,CNKI(China National Knowledge Infrastructure),VIP Database,PubMed、Medline、Springer were searched for the related studies.Two independent surgeons assessed trails for eligibility and quality,and all data marching the standards were abstracted for Meta-analysis by RevMan 5.3. Results 8 randomized controlled trails (RCT) were included.Selected analysis of embolized and non-embolized groups of Solid Hemangioblastomas were observed for variables of clinical efficacy in surgery time,number of blood loss and transfusions,complete resection,there were statistical difference.(P<0.000 01，WMD=-1.18, 95%CI[-1.16,-0.71];P<0.000 01，WMD=-464.17,95%CI[-492.17,-437.24];P<0.000 01， WMD=-238.81,95%CI[-282.84,-194.77];P<0.006，RR=1.17,95%CI[1.05，1.31]). Conclusion The preoperative endovascular embolization is beneficial for Hemangioblastomas because it can shorten the time of surgery,diminish the necessity of intra-operative blood loss and transfusion,it also raises the ratio of complete resection of Solid Hemangioblastomas.

Objective To investigate the mid-and long-term effect of arthroscopic percutaneous internal fixation for the treatment of tibial plateau fractures. Methods 31 patients with tibial plateau fractures treated by arthroscopic percutaneous internal fixation from May 2005 to May 2015 were followed up for a minimum of 3 years.The Lysholm score,Tegner motor level score,Rasmussen functional score,Rasmussen radiological score and Ahlback osteoarthritis classification of the knee joints were recorded at 6 months and the last follow-up. Results  Bone union was achieved in all patients,and no nonunion or malunion occurred.There were 3 cases of stiffness of knee joint after operation,2 cases of them were improved after physiotherapy combined with rehabilitation exercise,1 case underwent arthroscopic soft tissue release after 6 months of operation to confirm fracture healing,and the range of motion of knee joint was satisfactory after operation.All  patients were followed up,with a minimum follow-up of 3 years and an average followup time of (56.90±17.03) months.There was no significant difference in Lysholm score,Tegner score and Rasmussen score between the last followup and 6 months after operation in all patients(P＞0.05).At the last follow-up,the knee flexion and extension were (132.06±4.89)° and 1.55±2.84)°,respectively.There was significant difference in Rasmussen radiological score of knee joint and Ahlback osteoarthritis classification between the last follow-up and 6 months after operation(P＜0.05).Compared the affected side with the healthy side on the full-length weight-bearing X-ray film of lower extremity,it was found that the average rotation angle of the axial force line of lower extremity was significantly different between the last follow-up and 6 months after operation(P＜0.05).At the last follow-up,among the 31 patients,6 had valgus deflection and 2 had varus deflection.Age and intra-articular soft tissue injury were factors for osteoarthritis(P＜0.05). Conclusion For patients who received arthroscopic percutaneous reduction and internal fixation for lateral tibial plateau fractures,the Lysholm score,Tegner score and Rasmussen score in the mid-and long-term follow-up after the operation showed that the overall function of the knee joint was satisfactory.The incidence of arthritis was lower than that reported in the literature for those receiving open reduction and internal fixation,and the curative effect was not good enough for patients who were older(＞50 years) and those with fractures combined with intra-articular soft tissue injuries.

Objective To investigate the potential benefits of thoracic duct vein anastomosis in the management of recurrent and severe chylothorax. Methods According to the drainage volume and presence of thoracic duct injury，63 chylothorax patients admitted to our hospital from January 2014 to December 2021 were divided into two groups: A and B. Among them, a total of 37 patients in Group A had a daily thoracic drainage volume of <1000ml and no thoracic duct injury; a total of 26 patients in Group B had a daily drainage volume of >1000ml and had thoracic duct injury confirmed by lymphangiography. Different methods of intervention such as conservative treatment, thoracic duct ligation or thoracic duct and vein anastomosis are used to intervene, and the patient’s symptoms, the characteristics and amount of thoracic closed drainage fluid, postoperative recovery time and prognosis are observed. Results According to multifactor analysis, patients over the age of 60 (p<0.01), with a long history of smoking (p=0.04), prolonged alcohol consumption (p=0.03), and a history of malignancy (p=0.02) exhibited a higher incidence of Group B chylothorax. Most chylothorax cases in Group A were successfully treated using conservative methods. Among the 21 patients in Group B treated through thoracic duct ligation surgery, 3 cases showed recurrence of chylothorax. These 3 patients were cured by performing thoracic duct with venous anastomosis. Conclusion Chylothorax cases with a daily drainage volume exceeding 1000ml and accompanying thoracic duct injury should be treated promptly and aggressively with surgical intervention.Thoracic duct ligation has shown favorable treatment outcomes for typical chylothorax cases.However,in the event of persistent and recurrent severe chylothorax,a thoracic duct surgery with innominate or odd vein anastomosis may prove to be more effective.

晚期胃癌治疗选择有限，易发生化疗耐药。目前，包括免疫检查点抑制剂、过继细胞疗法、肿瘤疫苗、非特异免疫增强剂及细胞因子疗法在内的免疫疗法对胃癌显示出了良好的疗效。载体药物及3D打印技术也在临床前实验中取得了疗效。临床试验采用免疫肿瘤学单一疗法或联合免疫化学疗法来提高胃癌病人的总体生存时间和客观反应率。根据初步证据，我们相信免疫治疗可以积极影响自然病史，改善胃癌病人的预后。

Objective  To explore and compare the efficacy of open reduction Kirschner-wire internal fixation and closed reduction Herbert screw internal fixation in the treatment of fresh unstable scaphoid lumbar fracture. Methods 72 patients with fresh unstable scaphoid lumbar fracture admitted to our hospital from January 2020 to January 2022 were selected and randomly divided into the experimental group(36 cases,open reduction Kirschberg wire internal fixation) and the control group(36 cases,closed reduction Herbert screw internal fixation).The operation time,fracture healing time,healing rate at 12 weeks,complication rate,scaphoid osteonecrosis rate,wrist functional recovery 6 months and 1 year after surgery were observed and compared within 2 groups,including wrist range of motion,improved Mayo wrist function score,pain index using visual analog scale(VAS).Results There were no significant differences in operation time,fracture healing time,healing rate and complication rate in 2 groups(P>0.05).6 months after surgery,the wrist motion of ulnar deviation,radial deviation,dorsalis extension and palmaris flexion in 2 groups were significantly improved compared with before surgery(P＜0.05).There was no significant difference in wrist motion in 2 groups after surgery(P＞0.05).Compared with 6 months after surgery,Mayo score of experimental group was significantly improved at 12 months after surgery(95.36±3.34) vs.(78.52±5.62)(P＜0.05),and VAS was significantly decreased(1.04±2.24) vs.(3.25±1.62)(P＜0.05),but there was no significant difference in Mayo score and VAS between 2 groups(P＞0.05).Conclusions Compared with closed reduction and Herbert screw internal fixation,open reduction and Kirschner wire internal fixation can also achieve satisfactory results.However,the operation cost and difficulty of Kirschner wire internal fixation are relatively low.

Objective To compare the clinical efficacy of a new low notch plate system (Carmen synchronous adaptive cervical fusion system) and Zero-p in the treatment of single level cervical spondylotic radiculopathy (CSR). Methods Retrospective analysis was made on 48 patients with single level cervical spondylosis of nerve root type admitted from January 2015 to January 2020,including 26 patients with new low notch steel plate system (observation group) and 22 patients with Zero-P (control group).The operation duration,intraoperative blood loss,incidence of postoperative dysphagia,preoperative and postoperative JOA scores,cervical dysfunction index (NDI) Visual analog score of pain (VAS) and Cobb angle and intervertebral space height of postoperative imaging.Results There was no significant difference between the two groups in terms of operation time,intraoperative blood loss and the incidence of postoperative dysphagia (P>0.05).All patients were followed up for 12-15 months,with an average of (12.6±0.7) months.There was no significant difference in JOA score,NDI index and VAS score of pain between the two groups before and 3 and 12 months after operation (P>0.05). Conclusion The clinical efficacy of the new low notch plate system in the treatment of single segment cervical spondylotic radiculopathy is equivalent to Zero-P,and it is a reliable new type of anterior cervical internal fixation system.

Objective To explore the application value of medial caudal approach combined with middle page-turning lymphadenectomy in laparoscopic radical right hemicolectomy. Methods Eighty-six patients with right hemicolon cancer admitted to our hospital from May 2019 to May 2020 were selected as the research objects,and they were divided into an observation group of 43 cases and a control group of 43 cases by random drawing.The control group adopts the intermediate approach,and the observation group adopts the medial caudal approach combined with middle page-turning lymphadenectomy.The surgical recovery index,complication rate,serum tumor markers and survival index were compared between the two groups to evaluate the clinical efficacy and safety. Results There were no significant differences between the two groups in the number of lymph nodes removed,the length of the intestinal tube removed,extubation,fluid feeding and hospitalization time,the incidence of postoperative complications (P>0.05),but the operation time and intraoperative bleeding in the observation group were significantly lower,and the postoperative exhaust time was shorter (P<0.05).The serum CA19-9 and CEA levels of the two groups after one year decreased， and the serum CA19-9 and CEA levels of the observation group were lower than those of the control group (P<0.05).The disease-free progression period was prolonged in the observation group (P<0.05),but there was no difference in survival time. Conclusion The medial caudal approach combined with the middle page-turning lymphadenectomy has higher clinical application value in the laparoscopic radical right hemicolectomy,which is conducive to shortening the operation time and postoperative exhaust time,reducing the amount of intraoperative bleeding and postoperative serum CA19-9 and CEA levels,and improving the disease-free progression period with high safety.

Objective To evaluate the effect of thoracoscope assisted intercostal nerve block combined with nalbuphine for postoperative multimodal analgesia after lung segment resection surgery.  Methods From April 2022 to September 2022,60 patients scheduled for thoracoscopic lung segment resection surgery were selected and divided into two groups according to the random number table,with 30 patients in each group.The patients in the observation group received intercostal nerve block under thoracoscope before closing the chest,and the postoperative analgesia pump was Naborphine combined with sufentanil for patient-controlled intravenous analgesia;In the control group,the thoracic cavity was closed directly,and sufentanil was used for patient-controlled intravenous analgesia.The visual analog pain score(VAS),the number of PCIA effective pressing,the situation of rescue analgesia and the occurrence of related adverse reactions were recorded 2h,4h,8h,24h and 48h after surgery.Results The VAS scores at rest of the observation group at 2h,4h,8h,24h and 48h after operation 1.8±0.8,1.9±0.8,2.1±0.9,2.3±0.9,2.1±0.8,compared with control group 3.3±1.1,3.5±1.0,2.8±0.9,2.7±0.7,2.6±0.8 were all significantly lower(P<0.05).The VAS scores during activity of the observation group at 2h,4h,and 8h after operation 2.2±0.6,2.3±0.6,2.5±0.9,compared with control group 3.9±1.9、3.9±1.7、3.3±1.7 were significantly lower(P<0.05).The effective press times of PCIA in the observation group within 24 hours and 48 hours after operation were 2.7±1.5 and 5.4±2.3 times,while those in the control group were 5.2±3.4 and 10.2±6.0 times.The difference between the two groups was statistically significant(P<0.05).The number of patients in the observation group receiving postoperative analgesia was less than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).The satisfaction rate of patients in the observation group was higher than that in the control group,with a statistically significant difference(P<0.05).Conclusion Thoracoscope assisted intercostal nerve block combined with nalbuphine can be a good choice for postoperative multimodal analgesia in lung segment resection surgery.

Objective To summarize the clinical experience in the treatment of postoperative upper gastrointestinal cancer of esophageal cancer. Methods The clinical data of 16 patients with postoperative upper gastrointestinal malignancies treated in our hospital from January 2018 to June 2022 were retrospectively analyzed. Results All the 16 patients successfully completed the operation,and no perioperative death occurred.The cumulative length of hospitalization was 18-38 days.After operation,2 cases of pulmonary infection,1 case of respiratory failure,and 1 case of cervical anastomotic fistula were cured after conservative treatment.All patients could eat normally during postoperative follow-up,and no tumor recurrence and metastasis was found. Conclusion For patients with recurrent upper gastrointestinal cancer after esophageal cancer surgery,if the lesion is relatively limited,surgical treatment is reliable and an optional treatment plan.

Objective To study the sensitivity and specificity of Lymphoedema Functioning,Disability and Health Questionnaire for Lower Limb Lymphoedema (Lymph ICF-LL) and Lymphoedema Quality of Life Questionnaire (LYMQOL),and to explore the optimal cutoff score of the scales,in order to better identify secondary lower limb lymphoedema.Methods 62 patients with secondary lower limb lymphoedema and 37 patients without lymphedema after gynecological cancer operation was collected.Spearman test was used to evaluate the correlation between the scores of the two scales and the Lower Extremity Lymphedema Index (LEL index).Receiver operating characteristic (ROC) was used to evaluate the predictive diagnostic efficacy of the two scales.Results Correlation analysis showed that Lymph ICF-LL score was positively correlated with LEL index (r=0.478,P<0.05),and LYMQOL score was positively correlated with LEL index (r=0.346,P<0.05).Both scales had high accuracy,sensitivity and specificity in detecting secondary lymphedema of lower limbs.The area under the ROC curve of Lymph ICF-LL score in predicting was 0.926 (P<0.05),the optimal cut-off value was 20.1 points,the sensitivity was 83.9% and the specificity was 91.9%.The area under the ROC curve of LYMQOL score in predicting was 0.883 (P<0.05),the optimal cut-off value was 1.9 points,the sensitivity was 80.6%,and the specificity was 83.8%.Conclusion Lymph ICF-LL and LYMQOL have high specificity and sensitivity in the diagnosis of secondary lower limb lymphoedema.The two scales can be used as one of the diagnostic Methods for secondary lower limb lymphoedema.

Objective To investigate the effect of cervical manual stratified anastomosis and anastomosis with tube stapler on the recent complications in thoracic laparoscopy combined with radical resection of esophageal cancer．Methods From February 2019 to April 2022,a total of 196 patients who underwent endoscopic surgery for esophageal cancer who met the study criteria were divided into the manual group (87 cases) and the tubulostomy group (109 cases) according to the different ways of gastro-esophageal cervical anastomosis.The incidence of cervical surgery time,total operation time,postoperative anastomotic fistula,anastomotic stenosis and other complications of the two groups were evaluated,and the differences in treatment effects between the two groups were compared．Results The preoperative basic conditions of patients in the manual group and the tube kiss group were comparable,and the cervical anastomosis time in the tube kiss group[(23±3.57)min] was shorter than that in the manual group[(31±4.5)min] (P<0.05),but there was no statistical significance in the overall operation time between the two groups (P>0.05).The comparison of postoperative anastomotic fistula and anastomotic stenosis between the two groups showed that the manual group was significantly lower than the tube kiss group,and the difference was statistically significant (P<0.05)．Conclusion In thoracic laparoscopic combined with esophageal cancer surgery,cervical manual stratified anastomosis can reduce the incidence of postoperative anastomotic complications． 

The unilateral biportal endoscopic spinal surgery(UBE) technique is an emerging endoscopic technique,mainly used as treatment for lumbar degenerative disease.The procedure is characterized by two working channels,one being endoscopic,the second to be employed as an operating channel.Through the use of such dual-channel-technology,it allows the operating instruments to be unrestricted in size.Therefore,it is a highly efficient surgical technique for minimally invasive spinal surgery(MISS).However,the clinical complications of UBE technology must be taken into consideration.Possible side effects include dural injury,epidural hematoma,occult blood loss,postoperative headache,nerve root injury and insufficient decompression.This article reviews the causes,prevention and management of UBE-related complications.            

Objective To investigate the clinical effect of transhepatic arterial chemoembolization (TACE) combined with tyrosine kinase inhibitors (TKIs) and programmed death receptors-1 (PD-1) inhibitors (TACE+TKIs+PD-1 antibody) in the treatment of moderate advanced unresectable hepatocellular carcinoma (HCC).Methods The clinical data of 65 patients with moderate advanced unresectable hepatocellular carcinoma admitted to the Affiliated Hospital of North Sichuan Medical College from January 2020 to January 2022 were analyzed retrospectively.65 patients were treated with TACE+TKIs+PD-1 antibody.The observation indexes were tumor response,objective response rate (ORR),disease control rate (DCR),total survival time,progression free survival time,conversion operation rate and adverse drug reaction.Results The ORR of 65 patients with hepatocellular carcinoma was 49.2% (32/65),and the DCR was 89.2% (58/65).Among them,there were 2 patients with complete remission(CR),30 patients with partial remission(PR),26 patients with stable disease(SD),and 7 patients with progression disease(PD).Among 65 patients with hepatocellular carcinoma,18 patients were transformed into resectable hepatocell-ular carcinoma and underwent RO surgery.The conversion rate was 27.6% (18/65).65 patients were followed up for 3 to 22.4 months,The median follow-up time was 16.5 months.The median overall survival time and median disease progression free survival time of 65 patients were 14.5 months (95% CI:12.3~16.6 months) and 8.8 months (95% CI:6.9~10.6 months),respectively.After treatment,65 patients all had post embolism syndrome (abdominal pain,fever,nausea,vomiting and other symptoms),and some patients had transient abnormal liver function.Adverse drug reactions below grade 3 recovered within a few days.Some patients were associated with multiple adverse drug reactions.1 patient (1.5%)  stopped using TACE because of stubborn vomiting,and 5 patients (7.6%) stopped using Lenvatinib because of severe liver function damage during treatment,2 patients (3%) stopped using Camrelizumab because of severe reactive capillary hyperplasia,one patient (1.5%) stopped using Tislelizumab because of severe hypothyroidism,one patient (1.5%) stopped the treatment of Lenvatinib and Sintilimab due to severe gastrointestinal bleeding.The adverse drug reactions of grade 3~4 occurred in other patients were alleviated after drug reduction,symptomatic treatment and hormone treatment.Conclusion TACE+TKIs+PD-1 antibody can obtain reliable clinical efficacy and anti-tumor activity in the treatment of moderate advanced unresectable hepatocellular carcinoma.

Hepatocellular carcinoma (HCC),frequently diagnosed at advanced stages in China due to insidious onset,faces a dismal prognosis with limited surgical feasibility.The advent of immunotherapy,particularly immune checkpoint inhibitors (ICIs),introduces novel therapeutic prospects,albeit with variable efficacies.The combination of ICIs with various therapeutic strategies is increasingly recognized as a critical approach in the management of advanced HCC.This article reviews recent advances in ICIs for advanced hepatocellular carcinoma and discusses the future prospects of immunotherapy.