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 To observe the influencing factors of cerebrospinal fluid leakage after endoscopic transsphenoidal pituitary adenoma resection,and promote the early identification of high-risk patients with this complication. Methods Retrospective analysis was made on the clinical data of 176 patients with pituitary adenoma who underwent endoscopic transsphenoidal pituitary adenoma resection in Department of Neurosurgery,Second Affiliated Hospital of Nanjing Medical University from May 2019 to October 2022,and the cerebrospinal fluid leakage after operation was counted.Single factor analysis was used to screen the possible influencing factors of postoperative cerebrospinal fluid leakage,and logistic regression analysis was used to determine the independent risk factors. Results 12 of 176 patients with pituitary adenoma had cerebrospinal fluid leakage after operation,the incidence was 6.82% (12/176).Univariate analysis showed that tumor diameter,reoperation,intraoperative cerebrospinal fluid leakage,and intraoperative cerebrospinal fluid leakage classification were related to postoperative cerebrospinal fluid leakage (P＜0.05).Logistic regression analysis showed that tumor diameter (OR=3.843,95%CI=1.652～8.940),reoperation (OR=2.407,95%CI=1.094～5.298),intraoperative cerebrospinal fluid leakage (OR=4.552,95%CI=1.483～13.972),and intraoperative cerebrospinal fluid leakage classification (OR=3.516,95%CI=1.204～10.269) were independent risk factors for postoperative cerebrospinal fluid leakage (P＜0.05). Conclusion Tumor diameter,reoperation,intraoperative cerebrospinal fluid leakage,and intraoperative cerebrospinal fluid leakage classification are closely related to cerebrospinal fluid leakage after endoscopic transsphenoidal pituitary adenoma resection,we should pay close attention to the strategies of sellar floor reconstruction in the above patients,and strengthen the observation of the signs of cerebrospinal fluid leakage after surgery.

Objective Comparative analysis of the application effects of straight bipolar coagulation forceps,Focus ultrasonic equipment and high frequency electrosurgical equipment in thyroid cancer surgery. Methods Select 165 patients accept standard radical resection of thyroid cancer from May 2020 to April 2021.Divide randomly into bipolar electrocoagulation group,ultrasonic equipment group and electrosurgical equipment group,with 55 cases in each group.The general patient’s information of the three groups are operation time,intraoperative blood loss,postoperative drainage time,total drainage,preoperative and postoperative parathyroid hormone value,serum calcium ion value,postoperative complication rate and individual costs.This study conducts a comparative analysis of these indicators. Results The three groups of operations were successfully completed;the bipolar electrocoagulation group and the ultrasonic equipment group have significant differences in the postoperative parathyroid hormone value,serum calcium ion value,and postoperative complication rate,and they were statistically significant(P< 0.05),the rest of the indicators were not statistically significant(P>0.05).Among them,the single cost of the bipolar electrocoagulation group is higher than that of the ultrasonic equipment group.The first two groups are compared with the electrosurgical equipment group and find that the operation time,intraoperative blood loss,and postoperative Drainage time,total drainage volume,postoperative parathyroid hormone value,serum calcium ion value,and complication rate are all lower than those in the electrosurgical group,the difference was statistically significant(P<0.05),and the individual cost is higher than that in the electrosurgical group. Conclusion All three groups of energy devices can successfully complete the operation and achieve the treatment goals.In the operation time,intraoperative blood loss,postoperative drainage time,total drainage,postoperative parathyroid hormone value,serum calcium ion value and complications In terms of efficiency,straight bipolar coagulation forceps and Focus ultrasonic scalpel have advantages in higher frequency electrosurgical units.In terms of economy,straight bipolar coagulation forceps are slightly higher than high frequency electrosurgicals,but they have obvious advantages over Focus ultrasonic scalpels.Straight bipolar coagulation forceps has an absolute advantage in fine anatomy.

Objective  To investigate the characteristics of the three-dimensional gait changes of the knee joint after the single bundle anatomical reconstruction of autologous hamstring tendons after the rupture of the anterior cruciate ligament (ACL) of the knee. Methods  From August 2018 to June 2020，twenty five patients with ACL rupture of the lateral knee joint were selected as the injury group.During the operation,ACL rupture was confirmed by arthroscopy and the autologous hamstring tendon anatomical reconstruction was performed.Then 25 healthy people were selected as the control group.The three-dimensional gait data of normal knee joints were recorded with the three-dimensional motion capture system and compared with the injury group.In addition,the injury group was followed up before and after surgery and Lysholm knee joint function score was performed. Results  In the control group,the flexion and extension angle was - 2 °~66 °,the internal and external rotation angle was - 5 °~9 °,and the internal and external rotation angle was - 4 °~8 °.After ACL injury,the flexion and extension angle is - 5 °~52 °,the internal and external rotation angle is - 3 °~24 °,and the internal and external rotation angle is - 13 °~14 °.Three months after ACL autologous hamstring tendon reconstruction,the flexion and extension angle was - 2 °~47 °,the internal and external rotation angle was - 5 °~9 °,and the internal and external rotation angle was - 6 °~10 °.Six months after ACL reconstruction,the flexion and extension angle was - 2 °~59 °,the internal and external rotation angle was - 4 °~8 °,and the internal and external rotation angle was - 5 °~8 °.Nine months after ACL reconstruction,the flexion and extension angle was - 2 °~64 °,the internal and external rotation angle was - 2 °~9 °,and the internal and external rotation angle was - 2 °~8 °.12 months after ACL reconstruction,the flexion and extension angle was - 2 °~65 °,the internal and external rotation angle was - 1 °~9 °,and the internal and external rotation angle was - 1 °~8 °.After ACL rupture,the variation range of knee joint from flexion to extension,internal and external rotation,and internal and external turnover angle became larger than that of the control group,and there was significant difference in statistics(P<0.05).The angle range of each motion direction of knee joint after reconstruction was significantly improved compared with that before surgery（P＜0.05）,the difference at each time point after reconstruction was statistically significant compared with that before reconstruction(P<0.05).The gait at 9 and 12 months after reconstruction was significantly improved compared with that at 3 months after reconstruction (P<0.05).The Lysholm score increased from (62.35±3.45) before operation to (93.62±3.51) at 12 months after operation,and the difference was significant (P<0.05).  Conclusion  ACL reconstruction surgery has played a role in stabilizing the knee joint and improved the Lysholm knee joint function score,and with the passage of time after the operation,the Lysholm knee joint function score gradually improved,and basically returned to normal 9 months after the operation.

Objective To explore diagnostic strategies and treatment options for gastrointestinal bleeding after aortic dissection surgery.Methods The clinical data and diagnosis and treatment results of patients with gastrointestinal bleeding after aortic dissection surgery admitted from January 2020 to June 2022 in the Affiliated Nanjing Hospital of Nanjing Medical University were analyzed retrospectively.Results A total of 10 cases of 14 patients with gastrointestinal bleeding after aortic dissection surgery were cured,7 cases were mainly based on basic support and drug therapy,1 case was treated with endoscopic therapy,and 2 cases were treated with surgical operations;In the untreated group,3 cases were basic support and medication,and 1 case died due to poor surgical treatment.Conclusion The diagnosis and treatment strategy of gastrointestinal bleeding after aortic dissection surgery should be comprehensively evaluated according to the amount,location and complications of bleeding,and the individualized treatment of patients should be strengthened.Timely surgical treatment is helpful to improve the prognosis and outcome of patients with gastrointestinal bleeding after aortic dissection surgery.

Objective To investigate the regulatory effect of leucine-rich-alpha2-glycoprotein 1(LRG1) on the proliferation,migration and invasion of non-small cell lung cancer(NSCLC) cellsvia the Runt-related transcription factor 1(RUNX1)/osteopontin(OPN) axis. Methods To determin the expression of LRG1,RUNX1 and OPN in cultured human type II alveolar epithelial cells and human NSCLC cell lines A549,NCI-H838 and NCI-H1650.The human NSCLC cell line A549 cultured in vitro was randomly divided into control group,LRG1 knockdown group,negative control group,RUNX1 overexpression group,LRG1 knockdown + RUNX1 overexpression group by random number table method,after cells were grouped and transfected with plasmids,to detect the proliferation,apoptosis,migration,invasion,the expression of apoptosis proteins(Bcl-2,caspase-3,Bax) and epithelial-mesenchymal transition marker proteins(N-cadherin,E-cadherin),the expressions of LRG1,RUNX1 and OPN in A549 cells in each group.〖WTHZ〗Results Compared with human type II alveolar epithelial cells,the mRNA and protein expressions of LRG1,RUNX1 and OPN in human NSCLC cell lines A549,NCI-H838 and NCI-H1650 higher(P<0.05).Compared with the control group,the positive rate of EdU,the migration rate,the number of invasion,the mRNA and protein expressions of LRG1,RUNX1 and OPN,and the protein expression of Bcl-2 and N-cadherin in the LRG1 knockdown group were decreased(P<0.05),and the apoptosis rate and the protein expression of caspase-3,Bax,and E-cadherin were increased(P<0.05);The changes of various indicators in RUNX1 overexpression group were contrary to those in LRG1 knockdown group,and the overexpression of RUNX1 could reverse the effects of LRG1 knockdown on various indicators of cells.Conclusion Knockdown of LRG1 can inhibit the proliferation,migration and invasion of NSCLC cells and promote their apoptosis by down-regulating the expressions of RUNX1 and OPN.

Objective   To compare the efficacy of three different surgical methods in the treatment of common bile duct stones after cholecystectomy:open common bile duct exploration (OCBDE),endoscopic retrograde cholangiopancreatography and papillary sphincterotomy (ERCP/EST),and laparoscopic common bile duct exploration (LCBDE). Methods   The clinical data of 109 cases of recurrent choledocholithiasis after cholecystectomy treated in our hospital from July 2016 to July 2020 were analyzed retrospectively.Among them,33 cases were ERCP,40 cases were OCBDE group,and 36 cases were LCBDE.The influence of confounding factors among the groups was balanced by the tendentious score matching method (PSM),and the clinical efficacy and complications of the three groups after matching were compared.  Results   28 patients were included in each group by PSM method,and the baseline data of the three groups were not statistically significant(P>0.05).No statistical difference was found in the success rate of operation and stone clearance rate among three groups (P>0.05).The specific amount of bleeding,specific duration of operation,specific duration of anal exhaust and specific duration of hospitalization after operation in ERCP group were lower/shorter than those in OCBSE group and LCBDE group,with obvious difference (P<0.05),while the specific amount of bleeding,specific duration of operation,specific duration of anal exhaust and specific duration of hospitalization after operation in LCBDE group were lower/shorter than those in OCBSE group,with obvious difference (P<0.05).The incidence rate of perioperative complications of ERCP group showed no obvious difference with that of other 2 groups (P>0.05),while the incidence rate of postoperative complications in LCBDE group was lower than that in OCBDE group,with statistical difference (P<0.05).Postoperative follow-up showed that the recurrence rate of common bile duct stones in ERCP group was higher than OCBDE and LCBDE groups,with statistical difference (P<0.05),while the recurrence rate yielded no statistical difference between OCBDE group and LCBDE group (P>0.05). Conclusion   ERCP,OCBDE and LCBDE can effectively remove common bile duct stones after gallbladder surgery.ERCP surgery is less traumatic,but it is prone to severe complications such as acute pancreatitis and hyperamylasemia after surgery,and the residual rate of stones after surgery is high.LCBDE has the advantage of micro-invasive surgery than OCBDE,but it is not suitable for patients with severe abdominal adhesion.It is recommended that the operator select an appropriate surgical method according to the specific situation of the patient.

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。

Pancreatic cancer is a highly malignant tumor of the digestive system with poor prognosis.Due to the lack of effective early screening and diagnosis methods,the majority of patients with pancreatic cancer present with locally advanced or metastatic disease at diagnosis.For advanced pancreatic cancer,the major treatment strategy is still chemotherapy-based comprehensive treatment.The development of immunotherapy and targeted therapy gives us cause for optimism in our pursuit of better treatment.This article reviewed the advances in immunotherapy and targeted therapy of advanced pancreatic cancer.

Hepatocellular carcinoma (HCC) is a common malignant tumor.Patients often lose the opportunity for surgery because of the middle and late stage when they are diagnosed,and the prognosis is extremely poor.In recent years,anti-PD immunotherapy has made a breakthrough in the treatment of advanced liver cancer.Immunotherapy has achieved good results in some patients,but there are still many patients with poor response to immunotherapy.Therefore,there is an urgent need to find clinical or biological indicators that can be used to predict the efficacy of immunotherapy in order to maximize clinical benefits while avoiding adverse effects.This article aims to summarize the relevant indicators and potential predictive mechanisms that can be used to predict the efficacy of liver cancer immunotherapy,so as to provide help for guiding clinical treatment.

Objective To investigate the treatment,clinical effect and prognosis of subdural effusion after decompressive craniectomy in patients with severe brain injury.Method A retrospective analysis was performed on the clinical data of 54 patients with severe craniocerebral injury secondary to subdural hydrops after decompression after craniectomy admitted to the First Affiliated Hospital of Xinxiang Medical College from January 2015 to December 2020.According to clinical symptoms and fluid accumulation,34 patients were treated conservatively,and 20 patients were treated surgically.3 months after treatment,head CT was re-examined to evaluate fluid absorption.After 6 months of treatment,the daily living ability of patients was assessed by the Daily Living Ability Assessment Scale(ADL).Result The effective rate was 85%(29/34) in the non-surgical group and 90%(18/20) in the surgical group.There was no significant difference in effective rate between the two groups(P>0.05).After 6 months of follow-up,the ADL score of 2 groups was higher than that of the corresponding group before treatment,and the difference was statistically significant(P<0.05). Conclusion For patients with subdural effusion after decompression after craniocerebral decompression,individualized treatment can achieve satisfactory results according to the amount of effusion and clinical symptoms.

Objective  Through retrospective analysis of the case data of infusion port implantation by various approaches,tried to find out the best approach for infusion port implantation. Methods  104 patients who underwent infusion port implantation from January 2019 to December 2021 in our department were retrospectively analyzed.Including internal jugular vein approach in 55 cases (group A),subclavian vein approach in 49 cases (group B),compared the differences in operative time,puncture time,catheter length,intraoperative and postoperative complications.Results  Compared with group B,the puncture time of the group A was shorter[(8.84±3.10)min vs. (11.22±3.86)min],,less bleeding[(12.64±5.63)ml vs (15.71±7.07)ml],the incidence of catheters heterotopia was low(0 vs 8.16%,all P＜0.05).There was no significant difference in intraoperative complications such as pneumothorax and postoperative complications between the two groups（P>0.05). Conclusion  The puncture time of the internal jugular vein is shorter,the success rate is higher,and the incidence of complications such as catheter heterotopia is lower,therefore,the first choice should be the right internal jugular vein.

Cholangiocarcinoma is a malignant tumor originating from the epithelium of the bile ducts,and its incidence is increasing year by year,especially intrahepatic bile duct carcinoma that originates from the bile duct branches above the second level in the liver.Due to the insidious early symptoms and the lack of effective screening methods,most patients have lost the opportunity for radical surgery by the time they present.Over the past few years,several drugs have been developed that target genetic alterations with the detection of the cholangiocarcinoma genome.The molecular targets with clinical significance mainly include fibroblast growth factor receptor(FGFR),isocitric acid dehydrogenase(IDH),RAS-RAF-MEK-ERK,ERBB,VEGF and NTRK.Drugs targeting their targets show encouraging response rates and survival data as second-line therapies,and are characterized by high specificity and low toxicity.Therefore,targeted therapy is gradually emerging in the treatment of cholangiocarcinoma.In this review,we discuss the latest advances in targeted therapies for cholangiocarcinoma.

Objective To investigate the clinical value of watershed analysis to anatomical sublobectomy in the treatment of early peripheral Non-Small-Cell Lung Carcinoma(NSCLC) characterized by Ground Glass Nodules(GGN) through fluorescence thoracoscopy. Method A total of 81 cases of early peripheral GGN-like non-small-cell lung carcinoma treated by thoracic surgery in our hospital from September 2021 to September 2022 were retrospectively studied.According to the different methods of fluorescence thoracoscopic surgery,the patients were divided into two groups.The group of anatomical sublobectomy with the watershed analysis(hereinafter,referred to as the watershed group) including 42 cases,and the anatomical pulmonary segmental resection group(hereinafter,referred to as the pulmonary segmental resection group) including 39 cases.The general surgical data,perioperative indexes and postoperative complications were compared between the two groups. Results The operations of the patients were successfully completed for both groups,without any perioperative death.For the watershed group,there were no cases that switched to thoracotomy or changed the operation style,and no cases of incision or missed incision were observed.For the pulmonary segmental resection group,there were 2 cases that changed the operation style.The surgical margin distance of the watershed group[(26.24±3.87)mm] was slightly smaller than that of the pulmonary segmental resection group[(26.62±3.32)mm].But the difference was not statistically significant(P>0.05).The amount of blood loss[32.14(20.00,50.00)ml vs 85.38(30,100)ml],operative time[(146.76±41.51)min vs (184.944±50.42)min] and postoperative drainage time[2.43(2.00,3.00)d vs 4.05(3.00,5.00)d] of the watershed group were lower than those of the pulmonary segmental resection group.And the differences were statistically significant(P<0.05).The complication rate of the watershed group(11.91%) was lower than that of the pulmonary segmental resection group(30.77%).And the difference was statistically significant(P<0.05).Totally,25 patients(64.12%) in the pulmonary segmental resection group underwent the preoperative puncture localization,but none in the watershed group.For both groups,there was no tumor recurrence during the follow-up.Conclusion The application of watershed analysis to anatomical sublobectomy in the treatment of early peripheral NSCLC by fluorescent thoracoscopy can simplify the surgical procedure,accurately remove the lesion,and ensure the curative effect of oncology.The clinical practices have proved that the approach is scientifically reasonable,safe and feasible.

Prolonged Postoperative Ileus (PPOI) often occurs after abdominal surgery,and it is still one of the common complications in the field of surgery,which not only results in the prolongation of postoperative recovery time and hospital stays but also one of the main reasons for the increase of patients’ economic burden and the waste of medical resources.It has been paid more and more attention by scholars because of its special clinical manifestations and the lack of recognized treatment and preventive measures.This review intends to make a summary and prospect of the related mechanisms of PPOI,the auxiliary diagnostic methods of PPOI,and the treatment methods that show a certain curative effect on PPOI.

Objective To detect the correlation between the clinical imaging features and the degree of invasion of pulmonary pure ground-glass nodules (pGGNs) (≤ 3cm). Methods The  clinical data of 886 patients who underwent minimally invasive surgery from June 2013 to June 2016 for pulmonary nodules were collected. Among these, 72 patients had complete clinical data and isolated pulmonary GGN resection, and the  diameter of the pulmonary GGN was ≤ 3cm.Logistic regression analysis was used to analyze the independent risk factors for invasiveness of pure ground glass  nodules. Receiver operating characteristic curve (ROC curve) was used to determine the optimal cut-off value for preinvasive and invasive lesions. Results Univariate analysis demonstrated that there were significant differences in carcinoembryonic antigen,maximum diameter,and area of pGGNs in patients with pre-invasive and invasive lesions (P<0.05).Multivariate logistic regression analysis showed that there were only statistical differences in the maximum diameter of nodule pre-invasive and invasive lesions.The optimal cut-off value for CT-maximal diameter to predict pre-invasive lesions or invasive lesions was 1.08cm. Conclusion Therefore,predicting the pathological types of nodules (pre-invasive or invasive) by measuring the maximum diameter of pGGNs is reliable,with the most reliable cut-off value as 1.08cm.

Objective  To reveal the expression and underlying mechanism of LINC01197 in lung adenocarcinoma(LUAD).  Methods   The expression of LINC01197 was detected by real-time fluorescence quantitative PCR(qRT-PCR),and the expression of Notch signaling molecules(Notch1 and Hes1) were detected by Western blot.Cell proliferation and invasion ability were analyzed by MTT,colony formation and Transwell assays.The effect of LINC01197 on tumor growth was examined in a xenograft tumor assay.  Results  LINC01197 was down-regulated in LUAD,and the protein levels of Notch1 and Hes1 were both up-regulated(P<0.05).Overexpression of LINC01197 inhibited LUAD cell proliferation and invasion,while knockdown of LINC01197 had the opposite effect(P<0.05).Interestingly,LINC01197-induced changes in cell behavior could be reversed by Notch1 modulators(P<0.05).Furthermore,LINC01197 overexpression inhibited tumor growth and Notch signaling in vivo(P<0.05).  Conclusion  LINC01197 can exhibit anti-proliferation and anti-invasion effects in LUAD by inhibiting Notch signaling pathway.

Objective   To summarize the etiology,clinical features,treatment and prevention of internal abdominal hernia after gastric surgery(Petersen hernia) and improve the understanding of Petersen hernia.  Methods   A retrospective analysis in January 2018 to December 2021 jilin university fellowship between China and Japan hospital for treatment of 9 cases after gastrectomy Petersen hernia patients,7 cases underwent open Bie-ⅱ anastomosis and 2 cases underwent Roux-en-Y anastomosis due to the primary disease.The median duration of onset was 2 days.The percentage of neutrophils in blood routine was increased to varying degrees.Preoperative abdominal CT showed anastomotic wall thickening,proximal small bowel obstruction sign 4 cases,small intestine torsion signs in 2 cases,no special signs only 3 cases of small intestinal obstruction,has not been in patients with preoperative diagnosis for Petersen hernia,all patients underwent surgical treatment,intraoperative see output section of the small intestine to shift into the Petersen clearance and hernia in 5 cases,There were 3 cases without torsional herniation into Petersen space in the output segment and 1 case with torsional herniation into Petersen space in the input segment.Among them,4 patients underwent intestinal resection and anastomosis due to intestinal necrosis.  Results   One patient developed pleural and abdominal effusion after operation,and all patients were cured and discharged after treatment.  Conclusions   Petersen’s hernia is a relatively rare complication after gastrectomy.Preoperative abdominal CT can help to determine the criticality of the patient’s condition and can be the first choice of examination.A small number of patients with acute pancreatitis should pay attention to preoperative and postoperative amylase changes,and once the diagnosis is confirmed,surgery should be performed as soon as possible.

Common Bile Ducts(CBDS),also called choledocholithiasis,is more common in adults than in children.The incidence of children increased with the change of life style and the improvement of diagnostic techniques.Choledocholithiasis is often associated with common bile duct dilatation.Adult treatment includes laparotomy,laparoscopic and endoscopic retrograde cholangiopancreatography(ERCP).In order to avoid repeated inflammation and canceration of dilated bile duct,it is considered that choledocholithiasis and dilatation to a certain extent in children need radical operation.In recent years,with the development of ERCP in children,choledocholithiasis and dilatation have been relieved by ERCP treatment.In order to provide some reference for selecting appropriate treatment methods and exploring individualized treatment,this paper reviews the diagnosis and treatment of choledocholithiasis complicated with choledochal dilatation in children.