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 summarize the clinical experience of laparoscopic transabdominal preperitoneal hernia repair(TAPP).
Methods：Retrospective analysis was made on the clinical data of 102 inpatients with inguinal hernia who underwent laparoscopic transabdominal preperitoneal hernia repair(TAPP) in the first ward of general Surgery department,the First Affiliated Hospital of Baotou Medical College from November 2016 to November 2019.
Results：All the 102 cases of TAPP were successfully completed without transferring to open surgery.The operative time was(46.87±4.94)min,the intraoperative blood loss was(5.4±1.64)ml,and the postoperative hospital stay was(4.18±1.09)d.Postoperative analgesics were used in 18 patients(17.65%),with pain score(0.93±1.53) and abdominal incision satisfaction score(4.58±0.62).Postoperative followup(6～42 months) showed good recovery and no recurrence.8 cases of postoperative inguinal seroma,accounting for 7.8%,were relieved after treatment.There were no longterm chronic pain,mesh infection,incision infection,intestinal obstruction and other serious complications.TAPP puncture site has small scar,high incision satisfaction,low postoperative pain,and short postoperative hospital stay.Conclusion：Laparoscopic transabdominal preperitoneal hernia repair(TAPP) in the treatment of inguinal hernia is minimally invasive,safe and effective,without obvious scar and other characteristics,is one of the reliable clinical treatment options for inguinal hernia.

Objective:To research the MRI examination and diagnostic value of intervertebral space infection after nucleus pulposus extraction in patients with lumbar disc herniation.Methods:86 cases of intervertebral space infection after lumbar disc herniation in our hospital were selected as the research objects.All patients were given MRI examination，and gave positive treatment after diagnosis.Analyzed the MRI diagnostic results，and observed the changes of WBC count，ESR and C reactive protein levels before and after treatment.Result:The location of infection in 86 cases of intervertebral disc infection was mostly located in L4～L5 or L5～S1 intervertebral space.The intervertebral disc showed varying degrees of intervertebral disc fragmentation，smaller，disappeared，and uneven edge.MRI examination showed that the intervertebral disc space of lesion lost normal shape and signal，a 77 cases with long and low T1 signal，9 cases with equal T1 signal，82 cases with long and high T2 signal，4 cases with short and short T2 signal.The lesions in 86 cases of intervertebral disc infection showed different degrees of damage to the vertebral endplate and the adjacent vertebral spongy bone around the intervertebral disc.The surrounding part of adjacent vertebral bodies had abnormal signal appears（75 cases），the whole vertebral body signal was abnormal（11 cases）.Most of them were characterized by long T1 signal and long T2 signal，while a few of the lesions showed mixed signals dominated T2 signal.The soft tissue adjacent to the vertebral body showed swelling and thickening，and T1 showed equal signal，slightly higher signal or mixed signal，and T2 showed high signal.MRI enhanced scan was performed in 21 cases，the pathological changes of intervertebral disc，adjacent vertebral body and paravertebral soft tissue were obviously enhanced.After 6 months of followup，A total of 63 patients with complete disappearance of clinical symptoms，accounting for 73.26%.All the patients had significantly lower WBC counts，ESR and C reactive protein levels than before treatment（P<0.05）.Conclusion:In the diagnosis of lumbar disc herniation discectomy intervertebral space infection after MRI，check to fully display the lesion site of infection，it is important for early diagnosis and treatment of intervertebral space infection.

 

Objective To compare the therapeutic effect of silver ion antibacterial dressing and povidone iodine gauze on the incision and drainage of the abscess.
Methods From March 2019 to November 2019,62 patients were included in this study,and divided randomly into the observation group and the control group with 31 cases in each group.The patients in the observation group were treated with silver ion antibacterial dressing,while the patients in the control group were treated with povidone iodine gauze.The patients in the two groups were recorded in detail.The infection control time of abscess incision was compared before treatment,the third day and the second week after the first treatment,the number of dressing changes and wound healing time of the two groups,and the clinical effect of the patients was evaluated.
Results .The time of wound control in the observation group was (13.9±1.81)d,shorter than that in the control group (23.4±2.32)d(P<0.05);the BWATBWAT(Bates-Jensen Wound  assessment tool，BWAT) score of the observation group in the second week after the first treatment was (14.98±1.51),lower than that in the control group (19.78±2.46)(P<0.05);the times of drug change and wound healing in the Observation group were significantly shorter than that in the control group(P<0.05).
Conclusion Compared with the traditional povidone iodine gauze,the silver ion antibacterial dressing can control the wound infection and improve the wound healing more quickly,and the dressing change times are less,the wound healing time is obviously shortened.

As the incidence of thyroid disease continues to rise，the need for surgical treatment is increasing.Total thyroidectomy and central lymph node dissection are important methods for clinical treatment of thyroid cancer.However，the incidence of postoperative complications of hypoparathyroidism and hypocalcemia is still relatively high.The main reason for the complications is the inaccurate identification of the parathyroid glands during the surgical procedure.In recent years，many scholars at home and abroad have reported a variety of new parathyroid gland recognition techniques during surgery，and this article reviews and analyzes these technological advances.

Pancreatic cancer has always been called the “king of cancer” due to its extremely high mortality.In recent years,the global incidence rate of pancreatic cancer has risen rapidly.Furthermore,pancreatic cancer is lack of effective therapeutic strategies and has seriously harmed human health.With the rapid development of precision therapy,targeted therapy for pancreatic cancer has also progressed rapidly.Although targeted therapy for pancreatic cancer has improved the prognosis of only a few patients,it has brought light to pancreatic cancer.This article reviews the research progress of therapeutic targets and related drugs for pancreatic cancer.

Thymic malignancies are relatively incident solid tumors.And Lymph node metastasis in thymic malignancies used to be considered a rare phenomenon.Recently，increasing studies have shown that the lymph node metastasis in thymic malignancies is much more common than previously recognized.Yet，impact of lymph node metastasis in thymic tumor on prognosis and the strategy for surgical dissection of lymph nodes in thymic tumors need to be further explored.This paper focus on pattern of nodal involvement，its prognosis impact，and lymph node dissection in thymic malignancies.

Objective:To study the feasibility and safety analysis of intercostal brachial nerve preservation in modified radical mastectomy for breast cancer.Methods:The data of sixty patients with modified radical mastectomy were retrospectively analyzed.Thirtyfour patients who underwent intraoperative intercostobrachial nerve preservation were set as the study group.Twentysix patients who did not had intercostal brachial nerve preservation during the operation were set as the control group.The situation of operation and hospitalization，the quantitative score of sensory dysfunctions，the location of postoperative sensory changes，quality of life score（QOL），complications and recurrence rate of one year followup for cancer patients were compared between the two groups.Results:The operation time of the experimental group（110.45±27.53）min，intraoperative blood loss（115.76±23.13）ml，lymph node dissection（12.65±2.77）and control group was（102.37±26.15）min，（108.55±21.49）ml and （11.78±2.52），respectively（P>0.05）.The length of hospital stays in the experimental group[（7.49±1.32）d] was significantly lower than that in the control group[（8.42±1.45）d]（P<0.05）.The quantitative scores of sensory dysfunctions in the experimental group at 1 month，3 months，and 6 months were（2.04±0.71），（2.87±0.84），and（3.25±1.06），respectively，which were significantly higher than those in the control group[（1.63±0.54），（2.12±0.72） and （2.56±0.93），respectively]（P<0.05）.The sensory change rates of the axilla，anterior，posterior，medial and lateral sides of the experimental group were 14.71%，5.88%，11.76%，8.82%，and 2.94%，respectively，which were significantly lower than those of the control group[34.62%，26.92%，23.08%，30.77%，15.38%]（P<0.05）.The total score of QOL in the experimental group（41.35±6.84）was significantly higher than that in the control group（32.45±5.67）（P<0.05）.The incidence of complications in the experimental group was 14.71%，which was not significantly different from the complication rate in the control group（11.54%）（P>0.05）.The recurrence rate of the experimental group was 8.82% with one year，and the recurrence rate of the control group was 7.69%.The difference was not statistically significant（P>0.05）.Conclusion:Retaining the intercostal brachial nerve during modified radical mastectomy for breast cancer can effectively improve postoperative sensory function，and has no significant effect on the surgical outcome and complications.It has high feasibility and safety，and can be based on the degree of tumor progression to flexible use.

Objective To explored the operation opportunity，operation skill and therapeutic effect of emergency pancreaticoduodenectomy for severe pancreaticoduodenal trauma.Methods Seven patients with severe pancreaticoduodenal trauma underwent emergency pancreatoduodenectomy，one with liver rupture repair and right hemicolectomy，and one with left  kidney and splenectomy resection.Results All the operations were successfully completed.Two patients had bile leakage after operation，recovered after the conservative treatment.No evere intraabdominal infection，pancreaticointestinal anastomotic leakage，postoperative bleeding and other complications occurred.There were no reoperations and postoperative death occurred.All patients returned to normal diet and discharged from hospital.Conclusions Emergency pancreatoduodenectomy can be considered as an effective treatment for patients with severe pancreaticoduodenal trauma which can not be cured by other methods.

Objective To investigate the efficacy and safety of negative pressure suction sheath lithotriptic for incarcerated ureteral calculi. Methods Ninety-eight patients with ureteral embedded stones admitted to our hospital were selected for the study.They were divided into 2 groups according to the differences in surgical methods.Forty-five patients in the study group were treated with negative pressure suction sheath ureteral lithotripsy,while 53 patients in the control group were treated with conventional ureteroscopic lithotripsy,comparing the clinical efficacy and other differences between the two groups.Results The operation time and renal pelvis pressure in the study group were lower than those in the control group,and the stone clearance rate was higher than that in the control group(P<0.05).There was no difference in the relevant test indexes between the two groups before surgery(P>0.05),while the relevant test indexes in the study group improved significantly after surgery than those in the control group(P<0.05).Postoperative day 1,the complication rate of patients in the study group was significantly lower than that of the control group(P<0.05).After surgery,the prognosis of patients in the study group was significantly better than that of patients in the control group(P<0.05).Conclusion The efficacy of negative pressure suction sheath ureterolithotripsy in patients with incarcerated decrease the occurrence of postsurgical complications,which not only significantly improves the stone removal rate,but also reduces the inflammatory response of patients to surgery and ultimately improves their prognosis.

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.

At present,the most direct method for preoperative diagnosis of thyroid cancer is ultrasound-guided fine needle biopsy,but it cannot achieve high accuracy.There are many molecular markers in the thyroid,such as BRAF gene,RAS gene,thyroglobulin,thyroid antibody,etc.This article reviewed some studies and found that some common gene mutations or changes in the level of circulating markers are related to the judgment of benign and malignant thyroid nodules,the aggressiveness of thyroid cancer,and even the prognosis,recurrence,or metastasis of thyroid cancer after surgery.We will analyze some common molecular markers in differentiated thyroid cancer,including genetic markers and circulating markers,analyze their value and significance in the diagnosis of disease,and discuss whether these molecular markers can provide different diagnostic methods for patients with thyroid nodule.

Articular cartilage is a major tissue distributed at the joint surface;it plays a role in loadbearing and lubricating.The articular cartilage of the joints in the extremities mainly consists of hyaline cartilage composed of collagen II.Fibrocartilage formation is easily observed when the cartilage is injured or degenerated,which has abundant type I collagen.In this study,a new viewpoint and concept,focusing on the modification of fibrocartilage in situ approach and regeneration of hyaline cartilage,namely “fibrocartilage hyalinization”,was proposed as a practical clinical strategy.We conducted preliminary discussions and prospects on the feasibility and potential mechanisms of fibrocartilage hyalinization.It is hoped that the strategy will be helpful to the development and clinical transformation of cartilage regeneration research.

Objective To construct a prediction model of postoperative poor anastomotic healing in colorectal patients based on LASSO variable selection,and analyze the prediction efficiency of this model for anastomotic prognosis.Methods 215 patients with colorectal cancer who were treated in our hospital from March 2018 to January 2023 were prospectively included as the research object.All patients underwent laparoscopic radical resection of colorectal cancer,and all patients were followed up for 30 days after operation.They were divided into the poor healing group(24 cases) and the good healing group(191 cases) according to whether there was anastomotic malunion.The general data and clinical data of all patients were collected,and the characteristic factors with non-zero coefficient were screened by using LASSO regression model.Lasso-Logistics regression model was constructed to analyze the related factors leading to poor anastomosis healing,and the receiver operating characteristic curve (ROC) was drawn to calculate the area under receiver operating characteristic curve curve (AUC),sensitivity and specificity.Bootdtrap method was used to carry out 500 repeated sampling for verification.Results The number of male cases in poor healing group was significantly higher than that in good healing group.The levels of white blood cell WBC and C-reactive protein CRP in poor healing group were higher than those in good healing group (P<0.05).The operation time in the group with poor healing was longer than that in the group with good healing,the tumor diameter was more than 4cm,the distance between the lower edge of the tumor and the perianal region was less than ≤7cm,there were neoadjuvant chemotherapy before operation,and the number of patients with Ⅲ - Ⅳ was significantly higher than that in the group with good healing (P<0.05).Logistics regression screen showed that the operation time,preoperative neoadjuvant chemotherapy,the distance between the lower margin of tumor and perianal region and the growth of peripheral tumor were the predictive factors of poor anastomosis healing.According to Logistics regression,the ROC curve was drawn,and the AUC was 0.892 (95% CI:0.813 ~ 0.945),the sensitivity was 75.81%,and the specificity was 89.47%.Youden index is 0.6528;Using Bootdtrap technology to draw the calibration curve of the model shows that the model has good prediction efficiency.Conclusion Long operation time,preoperative neoadjuvant chemotherapy,the distance between the lower edge of tumor and perianal region < 7cm,and the growth of peripheral tumor are the risk factors for postoperative patients with colorectal cancer with poor anastomotic healing.The prediction model can be used to screen people with poor anastomotic healing and has good prediction efficiency.

Congenital breast anomalies mainly include polythelia，nipples inversion，accessory breasts，gynecomastia，hypertrophic abnormalities of the breast，tubular breasts，Poland syndrome and other breast deficiencies，dysplasia and displacement.Breast dysplasia may exist alone，but sometimes it coexists with other congenital syndromes，especially tending to affect the urinary system and limb girdles.Breast，as the second sex characteristic of women，is an important manifestation of female beauty.However，congenital breast deformity not only brings  psychological burden to patients，but causes a series of complications，which seriously threaten the physical and mental health of patients.

Objective To assess the assess the utility of the Nottingham Hip Fracture Score(NHFS) as a predictor of postoperative complications in elderly patients undergoing hip surgery.
Methods NHFS was retrospectively calculated for 820 patients who had undergone hip fracture surgery between January 1st 2016 and November 30th 2019.Patients’ gender,age,height,weight,Body Mass Index,ASA class,fracture type,type of surgery and anesthesia,postoperative visual analogue score,intraoperative blood loss and urine output,history of blood transfusion,history of dementia,preoperative hospital stay,postoperative hospital stay,length of hospital stay,admission to ICU,preoperative coexistent diseases,and postoperative complications were compared.According to the NHFS,patients were divided into two groups:NHFS≤5 scores group and NHFS>5 scores group.
Results Compared with patients in NHFS≤5 scores group,the patients with NHFS>5 scores group showed significantly higher age and ASA class,lower BMI,and larger proportion of subcephalic fracture and combined spinal-epidural anesthesia(P＜0.05).There were significant differences in postoperative anemia,deep vein thrombosis(DVT),delirium,arrhythmia,pulmonary infection,cerebral infarction,electrolyte disturbance,hypoxemia,renal dysfunction,heart failure,and admission to ICU between the two groups(P＜0.05).
Conclusion Postoperative complications are more likely to occur in patients with higher NHFS,which might delay the hospital length of stay with poor total outcome.The NHFS is a reliable tool for predicting prognosis.It may be useful for discharge planning,and for the design of future research trials.

Objective To investigate the differential effects of the optimization of anesthesia protocols on intestinal barrier function,oxidative stress,and inflammatory response in patients with intestinal obstruction.Methods Ninety-three patients receiving intestinal obstruction surgery in our hospital from January 2019 to January 2022 were enrolled,and classified into two groups according to different anesthesia methods.Control group(n=53) received routine general anesthesia,while experimental group(n=40) received  general anesthesia combined with transverse abdominal plane(TAP) + rectus sheath block block.Then comparison was conducted on intestinal barrier function [diamine oxidase(DAO) activity and endotoxin(ETX)],oxidative stress [catalase(CAT) and epinephrine],inflammatory response [tumor necrosis factor-α(TNF-α) and interleukin6(IL-6)],along with the postoperative time of first anal exhaust,defecation and out-of-bed activity.Results Compared with control group,experimental group had lower intraoperative sufentanil consumption,and shorter postoperative time of first anal exhaust and defecation(all P<0.05).Compared with baseline data,an increase in DAO activity,ETX,TNF-α,IL-6 and epinephrine levels along with a decrease in CAT were observed in both groups at postoperative 1 d and 3 d(all P<0.05).Compared with control group,experimental group had higher DAO activity,ETX,TNF-α,IL-6 and epinephrine levels,and lower CAT levels at postoperative 1 d and 3 d,with statistical difference(all P<0.05).Conclusion Compared with other anesthesia protocol,general anaesthesia combined with TAP + rectus sheath block is more effective for patients receiving intestinal obstruction surgery,which cause less impact on intestinal barrier function and oxidative stress,and can attenuate the inflammatory response.

Objective To compare the curative effect of postoperative sphincter fistula ligation and incision and suture for postoperative pain，anal function and wound healing time of sphincter anal fistula.Methods The date of 124 patients with sphincter anal fistula were retrospectively analyzed.Among them，60 patients who underwent sphincter fistula ligation were set as the study group，and 64 patients who underwent incision and suture were set as the control group.Anal incontinence score，anal function，postoperative pain，wound healing time and clinical efficacy were compared between two groups.Results The total score of anal incontinence in the control group（8.68±1.65）was significantly higher than that（7.03±1.46）in the study group，and the difference was statistically significant（P<0.05）.The total anal function score of the control group（6.71±0.93）was significantly lower than the total anal function score of the experimental group（8.04±1.11），and the difference was statistically significant（P<0.05）.The postoperative pain score of the control group（6.22±1.24）was significantly higher than that of the experimental group（3.52±1.06），the difference was statistically significant（P<0.05）.The wound healing time of the control groupand the test There was no significant difference in the wound healing time（5.78±1.43）between control group [（5.31±1.32）d]  and study group[（5.78±1.43）d](P>0.05）.The total effective rate of the control group was 95.31%，which was not significantly different from the total clinical effective rate of the experimental group（88.33%）（P>0.05）.Conclusion Ligation of sphincter fistula can significantly alleviate postoperative pain in patients with sphincter anal fistula and promote the improvement of anal function.There is no significant difference between clinical efficacy and incision and suture.It can flexible used as an ideal procedure for anal fistula in clinical practice.

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.

Inguinal hernia is a common long-term complication after prostatectomy,which may be related to low BMI,patent sheath process,different surgical methods and other factors.Postoperative inguinal hernia significantly affects the long-term quality of life of patients undergoing prostate cancer surgery,and patients with severe inguinal hernia need reoperation.Some doctors use preventive measures such as tension-free repair and spermatic cord separation in prostate surgery for patients with multiple risk factors or(and) complicated with inguinal hernia,in order to reduce the incidence of postoperative inguinal hernia.Lichtenstein repair and TAPP can be used for patients with postoperative inguinal hernia.

Objective:To observe the effect of ultrasoundguided suprainguinal fascia iliaca compartment block on analgesia of unilateral great saphenous vein stripping surgery.Methods:Sixty patients who underwent elective unilateral great saphenous vein stripping operation from May 2019 to September 2020 were selected and divided into two groups according to the random number table(RNT) method,30 cases in each group.The operations in both groups were completed under general anesthesia.The observation group received a single ultrasoundguided suprainguinal fascia iliaca compartment block before the induction of general anesthesia;While the control group was not treated.Patient controlled intravenous sufentanil administration was used for postoperative analgesia.VAS pain scores,PCIA compression times,cumulative sufentanil consumption,salvage analgesia and related adverse reactions were recorded at 1h,4 h,8h,24h and 48h after operation.Results:The VAS scores of the observation group at 1h,4h,8h,24h and 48h after operation was 1.5±0.9,1.6±0.9,1.8±0.9,1.5±0.8,1.3±0.8,respectively.There were all significantly lowerthan control group（3.1±0.9,3.2±0.8,2.6±0.7,2.4±0.6,2.3±0.7 ） (P<0.05).The times of PCIA pressing at 1h,4h,8h,and 24h in the observation group were 0.6±0.8,1.3±1.1,1.6±1.3,0.9±1.1,respectively,while in control group were 2.2±0.9,3.2±1.4,3.4±1.5,2.6±1.7,respectively.There were significantly difference in the two groups(P<0.05).During 48h after the operation,the cumulative sufentanil consumption in the observation group [(98.5±2.2)μg] compared with control group [(102.3±1.9)μg] was significantly difference(P<0.05).There were no significant difference in terms of the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Ultrasoundguided suprainguinal fascia iliaca compartment block has a good analgesic effect for great saphenous vein stripping operation,and significantly reduces the amount of post operation opioid drugs consumption,which indicates that this block can be used as a good choice for multimode analgesia fo rgreat saphenous vein stripping surgery.

[Abstract]Objective；To investigate the influencing factors for failures of nonoperative management in adults with blunt splenic injury.Methods；A total of 96 adult patients with blunt splenic injury were selected.According to patient's condition，nonoperative management was performed in 51 patients.According to the treatment was successful or not，they were divided into nonoperative failure group and nonoperation group.Single factor and logistics regression analysis were used to analyze the influence factors of the success of nonoperative treatment.Results；The application rate of nonoperative treatment was 53.1%（51/96），of which the success rate of nonoperative treatment was 76.5%（39/51），while the remaining 23.5%（12/51）patients were converted to surgical treatment.Single factor analysis showed that the main influencing factors of success were ISS score，AAST classification，volume of ascites，the lowest systolic blood pressure，the fastest pulse，the fastest heart rate，the lowest hemoglobin，amount of transferred erythrocyte，hospitalization time and complication rate.Logistics regression analysis revealed that ISS score，AAST classification，volume of ascites，the lowest systolic blood pressure，the fastest pulse，the fastest heart rate，the lowest hemoglobin and amount of transferred erythrocyte were independent factors affecting the success of nonsurgical treatment.Conclusion；The success rate of nonoperative treatment for adult blunt splenic injury is high.Case inclusion must be strict，and the indication of converting to surgical treatment must be strictly mastered.
〖WTHZ〗[Key words]〖WTBZ〗〓adults；〓 blunt splenic injury；〓 nonoperative management；〓 influencing factors

Objective：To summarize five cases of hepatic splenosisin to improve diagnostic accuracy.Methods：Five hepatic splenosis cases confirmed by pathology from 2013 to 2018 were collected in our hospital.Clinical characteristics including age，gender，past history，physical examination，liver function as well as tumor markers，imaging，surgical findings，pathological examination and followups were analyzed.Results：All the patients with good performance status were male，aging from 33 to 52 years，average 45 years.All of them experienced trauma and splenectomy，time interval of which was 16.4 years on average，and left surgical scars on abdomen.ChildPugh was grading as A.No abnormality was found for tumor markers.Ultrasonography showed hypo or isoechoic lesion with clear boundaries.The lesions were presented as hypodensity mass in plain CT scan，enhanced in arterial phase and decreased to isodensity in delayed phase for contrastenhanced CT.MRI displayed long T1 and long T2，slight hyperintensity or unchanged in DWI.PWI was similar to that of CT.The patients underwent surgical treatments，four of them received laparoscopic partial hepatectomy with sufficient surgical margin.Six lesions with intact capsules were discovered in segment 2，4，6 and 8，ranging from 1.5 to 5cm in diameter.Average operation time was 186 minutes，and blood loss was 100 ml.No transfusion，lesion rupture and hepatic blood occlusion appeared.The patients discharged uneventfully，5 to 9 days after surgery.All tumors were identified as spleen tissues by histology examination.No recurrence was found during the followups.Conclusion：History of splenic trauma or splenectomy is helpful for the diagnosis of hepatic splenosis.Laparoscopic exploration is recommended for uncertain cases.