Objective:To explore the clinical effect of autologous pericardial tissue reconstruction of right ventricular outflow tractpulmonary artery connection in the treatment of PA/VSD and to summarize experience.Methods:41 cases of PA/VSD from January 2010 to June 2019 were analyzed retrospectively.Thirteen cases received first-stage palliative care and 28 cases received firststage radical treatment. Early postoperative results were analyzed, and the development of right ventricular outflow tract, left and right pulmonary artery, pulmonary artery and tricuspid regurgitation, right ventricular function and other indicators were followed up to evaluate the treatment effect.Results：3 patients died after operation,28 patients underwent primary radical operation,13 patients underwent palliative right ventricular outflow tract reconstruction.The CPB time was(121.2±84.7)min of 38 patients,ventilator assistance time was (184.5±79.3) hours,aortic occlusion time was(85.2±36.4)min,ventilat,ICU stay time was(16.6±7.4)d.Follow up 6 months11 years,1 case died,3 cases had relatively narrow of right ventricular outflow tract or pulmonary artery branch,9 cases had twostage radical operation.Compared with the early postoperative period,the diameter of left and right pulmonary arteries branches increased significantly(P<0.05),and the areas of pulmonary artery regurgitation[(2.46±0.46)cm2 vs(1.18±0.25)cm2 ,P<0.05] and tricuspid valve regurgitation[(1.48±0.26)cm2  vs(0.95±0.21)cm2 ,P<0.05] were larger.Conclusion：Autogenous pericardial reconstruction of right ventricular outflow tract pulmonary artery for PA/VSD shows satisfactory results.During the followup,the right ventricular outflow tract and pulmonary artery branches showed a growing trend,and the degree of pulmonary valve and tricuspid valve regurgitation tended to aggravate.

Objective：To explore the main points of diagnosis and treatment of mesenteric cyst in children.Methods：A retrospective analysis of the clinical manifestations,diagnosis and treatment data of 10 cases of mesenteric cysts confirmed by surgery and pathology in our hospital from 2011 to 2020.Results：The clinical symptoms of this disease are mostly abdominal masses,abdominal pain,and abdominal distension.Bultrasound and CT examinations can help diagnose and provide a definite location.In this group,1 case of acute abdomen was examined by emergency laparotomy,and 9 cases were clearly diagnosed before operation.There were 8 cases within 6 years of age and 2 cases within 9 years of age.During the operation,there were 7 cases of cysts located in the mesentery,3 cases of cysts were removed by surgery alone,7 cases of cysts and surrounding intestines were removed,of which 2 cases were operated with the aid of laparoscopic surgery.The postoperative pathological diagnosis was mesenteric cyst.Conclusion：In childhood,especially those under 6 years of age,the onset of abdominal masses,abdominal pain,and abdominal distension should be highly suspected.Cysts can be diagnosed with ultrasound,Xray,CT and other routine examination methods.Surgical treatment is the most effective treatment method.,Simple cyst resection is the most ideal surgical method,and laparoscopic surgery has advantages.

Objective：To explore the curative effect of therapeutic angiogenesis in hypospadias surgery.Methods：A total of 81 children with hypospadias admitted to our hospital from January 2017 to April 2020 were selected as research objects and divided into group A(41 cases,using vascular endothelial growth factor(VEGF) during hypospadias surgery) and Group B(40 cases,not using VEGF during hypospadias surgery) by random number table method.The two groups of related rehabilitation indicators,surgical success rate and postoperative complications were compared.Results：Wound healing time and hospital stay in group A were(8.61±1.16) d and(16.08±1.85)d,respectively,group B were(10.14±1.47)d and(17.92±2.24)d,respectively.The difference between the two groups was statistically significant(P＜0.05).The surgical success rate of group A was 90.24%,and group B was 82.50%.The success rates of the two groups were similar(P>0.05).The total postoperative complication rate was 14.63% in group A and 35.00% in group B.The difference between the two groups was statistically significant(P＜0.05).Conclusion：Therapeutic angiogenesis treatment in hypospadias surgery can promote the recovery of children,ensure the success rate of surgery,and reduce the occurrence of complications.

Objective：To retrospectively analyze the clinical efficacy of ultrasoundguided microwave ablation and percutaneous ethanol injection in the treatment of benign cystic and solid thyroid nodules.Methods：A retrospective analysis of 140 patients with benign cystic and solid thyroid nodules in our hospital was selected.The patients were divided into 2 groups according to different surgical methods,observation group(percutaneous microwave ablation treatment group) 80 cases,control group(percutaneous absolute alcohol injection treatment group) 60 cases.Compared the two groups of treatment methods 1 day postoperative complications,1 day postoperative stress inflammatory response indicators(CRP,IL6),thyroid function indicators(TSH,FT3,FT4),nodule volume reduction rate at 1,3,6,9 and 12 months postoperative followup,cure rate and total effective rate of treatment at 1 year followup.〖WTHZ〗Results〓〖WTBZ〗The incidence of complications in the observation group(8.75%) was lower than that in the control group(35%),respectively(P＜0.05);the observation group and the control group Postoperative CRP and IL6 both increased,but the observation group had a smaller increase,and the stress inflammatory response was lighter than that of the control group(P<0.05).The incidence of hypothyroidism in the observation group(6.25%) was lower than that of the control group(23.33%) one day after surgery(P<0.05).At 1,3,6,9 and 12 months postoperative followup,the reduction rate of nodule volume in the observation group was greater than that in the control group(P<0.05).The cure rate(72.50%) and total effective rate of treatment(90%) in the observation group during the 1year followup were higher than those in the control group(20.00%) and total effective rate(68.33%),with statistically significant difference(P<0.05).Conclusion：Ultrasoundguided percutaneous microwave ablation is currently a minimally invasive method for the treatment of benign solidcystic thyroid nodules with less damage and safety.

Objective：To investigate the diagnosis and treatment of tracheal lipoma.Methods：Clinical data of 6 patients treated in the First Affiliated Hospital of Xinjiang Medical University were collected for a metaanalysis of 90 cases reported in domestic and foreign literature.Results：A total of 96 patients with endobronchial lipoma were included in this study,among whom the incidence was higher in males than females,most of whom were middleaged.There were more lesions in the right lung than in the left lung,and more lesions in the lower bronchus.In the first 10 years from 2001 to 2010 and the second 10 years from 2011 to 2020,a total of 31 cases published in the first 10 years were treated by surgical resection,accounting for 81.6%.Among the cases published in the following 10 years,38 cases(65.6%) were resected under bronchoscope compared with surgical resection.Conclusion：The preferred treatment for endobronchial lipoma is interventional bronchoscopy,but surgical treatment is still indispensable for some special cases.If the preoperative diagnosis of endobronchial lipoma,chest imaging findings and the microscopic characteristics can be used as diagnostic basis,should carry out the multidisciplinary consultation discussion at the same time,avoid the limitations of a single department treatment,reduce the misdiagnosis rate of endobronchial lipoma,determine the optimal treatment,moreover in the postoperative followup is necessary.

Objective：To investigate the difference of shortterm and midterm efficacy and risk factors of complications between hybrid operation and Bracket Elephant trunk technique in the treatment of complex type B aortic dissection.Methods：A retrospective analysis was made on 72 patients with complex type B aortic dissection treated in our hospital from January 2011 to January 2018.47 patients underwent hybrid operation and 25 patients underwent Bracket Elephant trunk technique.The differences of perioperative clinical indexes,shortterm curative effect,mediumterm curative effect and risk factors of complications between the two groups were compared.Result：The operation time,intraoperative bleeding volume,contrast medium usage and hospitalization time in the hybridization group were significantly lower than those in the Bracket Elephant trunk technique group;the aortic pseudocavities of the two groups decreased significantly after operation and one month after operation(P<0.05);Complication rate(17.02%) in the hybridization group was significantly lower than that in the Bracket Elephant trunk technique group(56.00%);Complication group and noncomplication group had significant differences in refractory hypertension,smoking history and aortic maximum diameter before operation(P< 0.05).Refractory hypertension,refractory hypertension,and aortic maximum diameter before operation(P<0.05).Smoking history and preoperative aortic maximum diameter can be used as independent risk factors for postoperative complications.Conclusion：Hybridization for complex type B aortic dissection has the same shortterm effect as Bracket Elephant trunk technique,and the longterm effect is better than the latter.At the same time,smoking history,preoperative aortic diameter and refractory hypertension history are highrisk factors for postoperative complications.

Objective：To compare the clinical effect and safety of subxiphoid singlepore videoassisted thoracoscopy and intercostal singlepore videoassisted thoracoscopy in the treatment of bilateral bullae.Methods：320 patients with bilateral pulmonary bulbar admitted to the department of thoracic and cardiac surgery of the air force hospital of the western theater command from September 2014 to September 2019 were selected.All cases were divided into subxiphoid group and intercostal group according to the random number table,160 cases each.In the subxiphoid group,videoassisted thoracoscopy was performed with single hole of subxiphoid.The intercostal group was treated with videoassisted thoracoscopic surgery with single intercostal foramina,followed up for 3 months,and the operation,hospitalization and complications of the patients in the two groups were observed.Results：There was significant difference in the intraoperative blood loss,total blood loss,operation time,drainage tube retention time and hospitalization time of the patients between the subxiphid process group and the intercostal group(P<0.05).The VAS score and comfort score of patients in the subxiphoid group were significantly better than those in the intercostal group,and the difference was statistically significant(P<0.05).There were no death complications caused by thoracoscopic surgery in the two groups,and the incidence of complications in the subxiphoid group was significantly lower than that in the intercostal group,with a statistically significant difference(P<0.05).Conclusion：Compared with traditional intercostal singlehole videoassisted thoracoscopy,single hole videoassisted thoracoscopy under xiphoid has the advantages of less bleeding,less pain,more comfort and less complication rate,which is safe and reliable and worthy of clinical promotion and application.

Objective：To investigate the predictive role and clinical significance of control nutritional status score (COUNT score) in postoperative complications and mortality in adults undergoing cardiopulmonary bypass.Methods：A total of 98 adult patients undergoing cardiopulmonary bypass in our hospital were retrospectively analyzed.According to the median 2 of count score,they were divided into low nutritional risk group(≤2) and high nutritional risk group(≥3).The perioperative conditions of the two groups were compared,the risk factors of early complications were analyzed,and the diagnostic value of count score for early postoperative complications and hospital death was evaluated.Results：The incidence of postoperative infection and acute kidney injury was higher in the high nutritional risk group(P<0.05),and the time of postoperative mechanical ventilation,ICU stay and postoperative hospital stay were also higher in the high nutritional risk group(P<0.05).Multivariate analysis showed that count score and coronary heart disease were independent risk factors for early postoperative complications(P<0.05).ROC curve showed that count score could predict early postoperative complications(AUC=0.677,the best cutoff point was 2.5) and inhospital death(AUC=0.873,the best cutoff point was 4.5).Conclusion：Count score may be an effective preoperative nutritional assessment tool for predicting early adverse clinical outcomes in patients undergoing cardiac surgery with cardiopulmonary bypass.

Objective：To explore the influence of the placement of gastric tube and no gastric tube after thoracoscopic laparoscopic radical resection of esophageal cancer on complications.Methods：150 patients with esophageal cancer admitted to our hospital from January 2017 to December 2019 were selected as the research objects,and they were divided into group A by random number table(75 cases,no gastric tube was placed after thoracoscopic laparoscopic esophageal cancer radical resection),Group B(75 cases,gastric tube was placed after thoracoscopic laparoscopic radical resection of esophageal cancer).The results of related recovery indicators,postoperative gastrointestinal function and complications of the two groups were compared.Results：The postoperative chest tube removal time in group A was(3.19±0.65)d and the hospital stay was(7.98±1.01)d,group B was(5.32±0.74)d and(12.54±1.35)d,respectively.The chest tube removal time and hospital stay in group A were shorter than group B,and the difference was statistically significant(P＜0.05).The first postoperative time of the anus in group A was(45.11±5.16)h,the time of first defecation was(48.19±5.67)h,the time of first eating was(1.46±0.11)d.The data of group B were (62.84±6.21)h,(55.32±6.94)h,(3.24±0.45)d,respectivly.The time of first air exhaust,first defecation and first eating time of the anus in group A were shorter than group B,the difference was statistically significant(P＜0.05).The total postoperative complications in group A was 24.00%,and the total postoperative complications in group B was 26.67%.There was no significant difference in the total postoperative complications between the two groups(P>0.05).Conclusion：The absence of a gastric tube after thoracolaparoscopic radical resection of esophageal cancer can speed up the patient's recovery,promote the recovery of gastrointestinal function,and will not increase the occurrence of postoperative complications.

Objective：Based on SEER database,to explore the effect of primary tumor resection on the prognosis of patients with liver metastases from colorectal cancer(CRLM) who are not feasible to remove metastases and to analysis the related factors of prognosis.Methods：Collecting the clinical and prognostic data of patients with colorectal cancer liver metastases between 2010 and 2015 from the SEER database.According to the criteria,about 3,920 cases of highvalue clinical data were finally obtained,including 3232 patients in the chemotherapy combined primary resection group(combination group) and 688 patients in the systemic chemotherapy alone group(chemotherapy group).Propensity score matching(PSM) method was used to balance the clinicopathological baseline characteristics of the two groups of patients,and the overall survival rate(OS) and cancerspecific survival rate(CSS) difference between the two groups of patients were compared.Analysis of risk factors for prognosis of patients in the combined group.Results：Before matching through PSM,the OS and CSS in the combination group were significantly higher than those in the chemotherapy group(P＜0.05),but the clinicopathological characteristics of the two groups showed significant imbalance,such as gender,tumor grade,tumor site,tumor size,race,marital status,T stage,N stage and CEA.After matching through PSM,1168 patients were finally effectively screened,including 584 patients in the combination group and chemotherapy group.The differences in clinical pathological characteristics of the two groups were significantly reduced,the baseline distribution characteristics were significantly improved(P>0.05),including gender,tumor grade,tumor size,race,marital status,and CEA.The OS and CSS of the combined group were still significantly higher than those of the chemotherapy group(P＜0.05).After analyzing of the COX risk regression model,it was found that age,tumor location,tumor N stage,radiotherapy,and marital status were independent risk factors that affected the prognosis of patients in the combined group.Conclusion：For the CRLM patients who are not feasible to remove metastases,a treatment strategy based on systemic chemotherapy combined with primary resection should be adopted.

Objective：To explore the relationship between the expression of hypoxiainducible factors and clinical features and prognosis of patients with gastric cancer in plateau areas.Methods：62 cases of patients who underwent radical gastric cancer surgery in our hospital from September 2015 to July 2017 were randomly selected.Immunohistochemical staining methods were used to detect the expression of HIF1α protein in gastric cancer tissues and adjacent tissues.Correlation analysis between chemical results and clinical features,using high performance liquid chromatography to detect HIF1α DNA methylation level,and then analyzing the correlation between HIF1αproteinand DNA methylation expression,and then using KaplanMeier Method to analyze the effect of HIF1α proteinexpression on the survival time of patients after surgery.Results：Among the 62 cases of gastric adenocarcinoma and adjacent parts collected,44 cases(70.97%) of gastric cancer parts had upregulated HIF1α factor manifestation levels.The manifestation levels of normal parts and cancer parts were(4.80±0.29) and(3.09±0.09),respectively.There was a imparity between the two(P＜0.05).Statistics of immunohistochemical results showed that the expression level of HIF1α proteinin gastric cancer tissue was not significantly related to the patient's age and gender(P＜0.05).The higher the expression rate of HIF1αmRNA,the larger the tumor,and the high expression rate of HIF1α proteinin gastric body tumors is significantly higher than that of gastric antrum and cardia.Comparing DNA methylation,the expression levels of normal and cancer tissues were(0.158±0.010) and(0.362±0.009),respectively.There was a imparity between the two(t=6.806,P＜0.001).The rate of survivors(HR=0.601,P=0.002) and recurrencefree rate of survivors(HR=0.498,P=0.003) of the HIF1α low manifestation group were dramaticlly higher than these in the HIF1α high manifestation group.onclusion：HIF1α is highly expressed in gastric cancer tissues.It is speculated that it may accelerate the differentiation,expression and metastasis of gastric cancer,and can be used as a reference for determining the prognosis of patients.

Objective：To investigate the effect of miR711 on the characteristics of stemness in gastric cancer stem cells(GCSCs) and its targeted regulation on CD44.ethods：We examined the expression of miR711 in gastric cancer tissues and normal gastric tissues using TCGA database.Human gastric cancer stem cell CSCG and human gastric cancer cell line MKN45 were selected.CSCG were transfected and divided into miRNC group(transfected with miRNC),miR711 group(transfected with miR711mimics) and CSCG group(no transfected).qRTPCR was used to detect the expression of miR711,Bmi1,Sox2,Oct4 and CD44 mRNA.Western blot was used to detect the protein expression of Bmi1,Sox2,Oct4,and CD44.Tumor ball formation test was used to detect the cell stemness.The target effect of miR711 and CD44 was confirmed by bioinformatics methods and the luciferase reporter assay.Results：The expression of miR711 was significantly lower in the gastric cancer tissues than in the normal gastric tissues(P＜0.01).The expression of miR711 in miR711 group was higher than that in miRNC group,CSCG group and MKN45 group(P＜0.01).The mRNA level of Bmi1,Sox2,Oct4 and CD44 in miR711 group were lower than those in miRNC group and CSCG group(P＜0.01).The expression level of Bmi1,Sox2,Oct4,CD44 in miR711 group were lower than those in miRNC group and CSCG group(P＜0.01).At 7 and 14 days,the percentage of suspended cell ball in miR711 group was lower than that in miRNC group and CSCG group(P＜0.01).Compared with WTCD44 group,the luciferase activity of miR711+WTCD44 group significantly decreased(P＜0.01).Conclusion：The overexpression of miR711 can inhibit the stemness of the GCSCs,which may be achieved by downregulating the expression of CD44 gene.

Objective：To explore the safety and efficacy of laparoscopic cholecystectomy in different time points after endoscopic retrograde cholangiopancreatography in elderly patients with cholecystolithiasis and choledocholithiasis.Methods：99 elderly patients(≥60 years old) with cholecystolithiasis and choledocholithiasis treated by sequential LC after ERCP in the Department of Hepatobiliary and Pancreatic surgery in our hospital from January 2015 to June 2020 were analyzed.According to different time points after ERCP,LC was divided into experimental group(within 1 day after ERCP) and control group(within 27 days after ERCP).The complications were followed up by telephone within 3 months after operation.Results：After analysis,the difference between the experimental group and the control group in the total length of hospitalization［(13.0±4.6)d  vs(15.1±4.4)d］ and total hospitalization expenses［(38 172.5±12 448.9)  vs(42 535.4±8 814.6)］ was statistically significant(P＜0.05).However,there was no significant difference in the conversion rate of LC to laparotomy,the total postoperative complications,the length of hospital stay after LC,the amount of blood loss during LC and the time of LC operation between the two groups(P>0.05).Conclusion：For elderly patients with cholecystolithiasis and choledocholithiasis,LC within 1 day after ERCP does not increase the difficulty of operation and postoperative complications,but shortens the hospitalization time,and it is economical and safe at the same time.

Objective：To investigate the effect of onestage laparoscopic cholecystectomy(LC) combined with laparoscopic common bile duct exploration(LCBDE) in the treatment of gallbladder stones combined with common bile duct stones.Methods：Select 110 patients with gallbladder stones and choledocholithiasis who were admitted from February 2018 to February 2020,and were divided into control group(n=55 cases) and observation group(n=55 cases) according to different methods of stone removal.The control group was treated with LC combined with papillary sphincterotomy(EST) or endoscopic retrograde cholangiopancreatography(ERCP),and the observation group was treated with LC combined with LCBDE.The patient's effect was evaluated 7 days after surgery,and the two groups were compared with related surgical indicators and immune cells.Level,complications and effect of stone removal.Results：After treatment,the operation time,intraoperative blood loss,pain degree score,anal exhaust time,bed time,hospitalization time,and hospitalization expenses in the observation group were lower than those in the control group(P<0.05);after treatment in the observation group The 7 d CD3+,CD4+,CD8+ and CD4+/CD8+ levels were slightly lower than those of the control group;the incidence of biliary hemorrhage,infection,bile leakage and blood amylase elevation in the observation group after treatment was lower than that of the control group(P<0.05),the observation group The success rate of stone retrieval and complete stone removal rate after treatment were higher than those of the control group(P<0.05).Conclusion：Onestage LC combined with LCBDE for treatment of gallbladder stones with choledocholithiasis has a better effect.The removal of gallstones is more thorough,reduces the risk of complications,and obtains a good therapeutic effect.

Objective：To observe the occurrence of sepsis after percutaneous nephrolithotomy(PCNL) and the predictive value of soluble triggering receptor expressed on myeloid cells1(sTREM1) combined with highsensitivity Creactive protein(hsCRP) and neutrophil to lymphocyte ratio(NLR).Methods：A retrospective analysis was performed on the clinical data of 358 PCNL patients admitted to the hospital from September 2015 to September 2020.According to presence or absence of sepsis after PCNL,they were divided into sepsis group and nonsepsis group.The influencing factors of sepsis after PCNL and the predictive value of sTREM1,hsCRP and NLR were analyzed.Results：Among the 358 patients,there were 31 cases(8.66%) with sepsis after PCNL.There were significant differences between the two groups in gender,stone diameter,staghorn stone,preoperative sTREM1,hsCRP and NLR levels,and operation time(P<0.05).AUC values of sTREM1 and NLR were 0.886 and 0.851,significantly higher than that of hsCRP(0.647)(P<0.05).AUC of sTREM1 combined with hsCRP and NLR was as high as 0.973,significantly higher than that of single index(P<0.05).The results of Logistic regression analysis showed that female gender,stone diameter not shorter than 2.5cm,staghorn stone,preoperative sTREM1 level not lower than 1.02 μg/L,preoperative hsCRP level not lower than 5.37 mg/L,preoperative NLR level not lower than 2.66 and operation time not shorter than 90 min were all independent risk factors of sepsis after PCNL(P<0.05).Conclusion：The occurrence of sepsis after PCNL is related to many factors.The combined detection of sTREM1,hsCRP and NLR is of important value for predicting the occurrence of sepsis after PCNL.

Objective：To explore the feasibility and effect observation of nonretrograde ureteral catheterization in ultrasound guidedpercutaneous nephrolithotomy.Methods：The clinical data of 42 cases of nonretrograde ureteral  catheterization in ultrasound guided percutaneous nephrolithotomy in our hospital from April 2017 to September 2020 were retrospectively analyzed.None of the 42 patients underwent retrograde ureteral catheterization during surgery.24 patients with moderate to severe hydronephrosis were directly guided by ultrasound to puncture the target renal calyces fornix,and 18 patients with mild hydronephrosis,We were Intravenous infusion of furosemide 40mg for irritating diuresis,about 10 minutes,we to puncture the target renalcalyces fornix,successful established a channel of percutaneous nephrolithotomy.Clinical data includingThe success rate of puncture the target renal calices,nephrostomy tract creation time,overall opration time,reand postoperative hemoglobin value,the tonefree rateand complications were recorded and evaluated.Results：All the 42 patients had successful onetime puncture successfully established skinto renal calyx channels,and performed percutaneous nephrolithotomy.Among mean tract creation time(6.7±1.9)min,overall operation time(46.4±11.5)min,reand postoperative hemoglobin value was(137.0±10.1)g/L and(132.7±12.3)g/L,difference value was(5.6±5.2)g/L,the tonefree rate was 92.8%,no major complications,such as tract loss,massive bleeding,pleura and colon injure and transfusion cases.Conclusions：Outcomes of clinical practice demonstrate that nonretrograde ureteral catheterization in ultrasound guided percutaneous nephrolithotomy is safe and efficacious abaut mild hydronephrosis is by stimulate diuretics and moderate to severe hydronephrosis renal ureteral calculi patients,but it must be accomplished by seasoned doctors and grasp certain ultrasound technology.

Objective：To investigate the Changes of high mobility group protein B1(HMGB1) and Triggering Receptor Expressed on Myeloid Cells1(TREM1) in patients with arteriosclerosis obliterans after interventional therapy and Their Predictive Value.Methods：Seventy patients with cerebral infarction admitted to our hospital from January 2014 to October 2017 were enrolled.The clinical data of the patients were collected and divided into recurrent group(n=31) and nonrecurrent group(n=39) according to whether restenosis occurred within 2 years after operation.The clinical data of patients were collected,the levels of serum HMGB1 and TREM1 before and 1month after operation were measured,and the evaluation value of serum HMGB1 and TREM in predicting restenosis after operation was analyzed.Results：The levels of serum HMGB1,TREM1,LDL,hs CRP levels,and bilateral lesions were higher in the restenosis group than in the control group(P＜0.05).Spearman correlation analysis showed that serum HMGB1 and TREM1 before and 1month after operation were positively correlated with LDL and hsCRP levels of patients with cerebral infarction(P＜0.05).Multivariate logistic regression showed that preoperative serum HMGB1(>11.56ng/L) and preoperative TREM1(>203.47ng/L) as well as 1month postoperatively HMGB1(>16.08ng/L),TREM1(>266.41ng/L),LDL(>2.99mmol/L) and hsCRP(>1.96mg/L) were the risk factors for restenosis in patients with lower extremity arteriosclerosis occlusive interventional therapy(P＜0.05).The diagnostic efficiency of combined serum HMGB1 and TREM1(AUC=0.884) 1 month after operation was higher than that of combined detection before operation(AUC=0.784)(P＜0.05).Conclusion：Serum HMGB1 and TREM1 1 month after operation were highly expressed in patients with arteriosclerosis obliterans of the lower extremities,and the combination of the two at 1 month after surgery has a good predictive value for the occurrence of postoperative restenosis.

Objective：To observe and investigate the clinical efficacy and safety of mezobamo injection in the perioperative analgesia of severe trauma and fracture.Methods：A total of 200 patients with severe trauma and fracture diagnosed and treated in the hospital from September 2018 to July 2019 were selected in a randomized and controlled study.100 cases in the experimental group and 100 cases in the control group.All patients were treated with nonsteroidal antiinflammatory and analgesic drugs after admission.On this basis,the patients in the experimental group were given mezobamo injection(1g dissolved in 100ml of normal saline) intravenously,twice a day and three days as a course of treatment.VITAL SIGNS,such as blood pressure,respiration,heart rate and body temperature,quality of life scores and exacerbations of acute pain at 24 h after surgery were compared between the two groups.The pain scores within 72 hours after surgery were recorded and compared continuously between the two groups,and the efficacy and safety were evaluated.Results：There were no significant differences in average blood pressure and respiration between the two groups.Heart rate(73.4±2.4),body temperature(37.0±0.1)℃,acute pain aggravation times(1.8±0.6) in the experimental group were significantly lower than those in the control group within 72 hours(P<0.05).Experimental life quality score(70.611.3) and overall efficient analgesic(89%) were significantly better than that of control group(P<0.05).Conclusion：For perioperative patients with severe trauma and fractures on the basis of conventional selfcontrol analgesia with methocarbamol injection can improve effective and safe analgesic effect,in the interest of early functional exercise,improve the joint activity.

Objective：To investigate the efficacy and characteristics of plateletrich fibrin in the clinical application of chronic refractory wounds.Methods：A total of 105 patients with chronic refractory wounds diagnosed and treated in our hospital from March 2018 to September 2019 were selected.The medical records of all patients were retrospectively analyzed,and the efficacy of the patients was statistically analyzed.There were 44 males and 61 females.Age 2 to 76 years old,with an average of 42.6 years old.The course of illness is 3 weeks to 6 months.All patients received plateletrich fibrin treatment for 2 to 6 weeks,and the wound healing effect and prognosis were evaluated.Results：Of the 105 patients,92 had good wound healing,10 had normal healing,and 3 were ineffective.Conclusion：Plateletrich fibrin has the characteristics of simple operation,definite curative effect,and economical application in the treatment of chronic refractory wounds.

Solid pseudopapillary tumor of the pancreas(SPN) is a rare pancreatic disease that usually occurs in young women and usually has no or only nonspecific clinical manifestations.Due to the improvement of imaging technology and a better understanding of SPN,the detection rate of SPN is increasing.Although most patients with SPN have a good prognosis after radical resection,there may still be local recurrence or metastasis after operation.In recent years,it has been found that SPN accounts for the majority of pancreatic tumors in children.However,there is a lack of research on pediatric patients with SPN.By reviewing the literature reports of solid pseudopapillary tumor of pancreas in children at home and abroad,this paper reviews the progress of clinical treatment of pancreatic pseudopapilloma in children.

Hirschsprungassociated enterocolitis (HAEC) is the most common complication of Hirschsprung's disease (HSCR). The main clinical manifestations are diarrhea, bloating, fever and sepsis. Because the initial research was relatively simple, it was initially thought that HAEC was caused by the disturbance of the intestinal water and electrolyte balance in the digestive system. As the research continued to deepen, it was later considered that HAEC is a type of colon inflammation caused by mechanical obstruction. Studies over the past years have shown that the pathogenicity of HAEC is related to factors such as abnormal intestinal immune function, abnormal intestinal barrier function, changes in intestinal flora and intestinal mechanical obstruction.On the treatment of this disease method, surgical treatment is still the first choice. Therefore, this article summarizes the research progress of the pathogenesis and treatment of HAEC, and provides a certain reference for firstline clinical diagnosis and treatment.

Congenital chylous ascites is a rare disease in infants and young children,which is characterized with milky white ascites,but as a result of the relevant reports and study is less,and the lack of standardized diagnosis and treatment standards,clinical practitioners don't understand it deeply,and children can't get timely and effective treatment,which not only cause the prolonged course of the disease,but also bring great worries and troubles to parents and children.In severe cases,the children can die.In this paper,combined with the existing literature,the pathogenesis,clinical manifestations,diagnostic examination and treatment of congenital chylous ascites are systematically summarized,so as to provide clinicians with a perfect basis for the treatment of congenital chylous ascites,and provide suggestions for refractory chylous ascites,amd promote the early recovery of children.

The deficiency disease of 5αreductase 2 is a common genetic disease of AR,which karyotype is 46,XY.As the boy patients were born,some abnormity in various degrees would occur on the majority of their external genitalia.Blurring of external genitalia or being similar to female phenotype is the most common phenomenon.Also,being close to normal external genitalia of male phenotype could be found.Some patients would visit a doctor on account of diminutive penis or maldevelopment of gonad.The boy patients who have the deficiency disease of 5αreductase 2 with diminutive penis would be inclined to be misdiagnosed or never diagnosed.Thus,the time for treatment would always be delayed.The article is a summary of genotype characteristics、pathogenesis、clinical feature、diagnostic basis and progress of treatment in allusion to the deficiency disease of 5αreductase 2 with diminutive penis.