Objective To explore the method,advantages and significance of optimizing the operation process in cryopreservation of cobalt-60 sterilized autologous skull for repairing skull defects in order to reduce the short-term(January) complications.
Methods From October 2018 to October 2020,46 patients with skull defect were treated in our hospital,all of them were treated with deep hypothermia preservation of autologous skull to repair skull defect.According to the different preoperative cranial treatment methods,they were divided into two groups,the experimental group 24 cases,80℃ sterile saline 1000ml+ dexamethasone 20mg was used,reheated for 30 minutes.The control group (22 cases) received traditional treatment.
Results In experimental group,there was 1 case of subcutaneous effusion.In control group,there were 2 cases of epidural hematoma,11 cases of subcutaneous effusion,including 1 case of severe subcutaneous effusion and 1 case of skull infection(reoperation).By improving and optimizing the original operation process,the short-term complications were greatly reduced,and the operation effect and patient comfort were improved.No bone flap collapse,osteomyelitis and subcutaneous effusion were found during follow-up.
Conclusion Improving and optimizing the operation process can greatly reduce the short-term complications of deep hypothermic preservation of autologous skull repair of skull defects,which has a wide application prospect.It is a simple,economic,safe and feasible method for the units that have the conditions to carry out autologous skull repair.

Objective To study the PCT(procalcitonin),CRP(C-reactive protein),TNF-α(tumor necrosis factor-α),IL-6(interleukin-6)and HBP(heparin-binding protein)combined examination in differential diagnosis of intracranial infection pathogens.
Methods 86 intracranial infection patients(2017.09-2019.09) in our neurology and neurosurgery departments were included in the study.According to pathogen types,38 bacterial infection patients were set as bacterial infection group;27 viral infection patients as viral infection group,21 mycobacterium tuberculosis patients as tuberculosis group.Diagnostic value of PCT,CRP,TNF-α,IL-6 and HBP combined examination in intracranial infection pathogens was analyzed.
Results Before and after treatment,PCT,CRP,TNF-α,IL-6 and HBP levels among groups were significantly different(P＜0.05);relevant indicators in bacterial infection group were better than before;except for PCT,the other indicators in tuberculosis group were better than before;CRP and HBP levels in viral infection group were better than before(P＜0.05);the diagnosis accuracy,sensitivity and specificity based on combined examination were higher than those of single examination(P＜0.05).
Conclusion Cerebrospinal fluid PCT,CRP,TNF-α,IL-6 and HBP combined examination plays an important role in the differential diagnosis of intracranial infection pathogens so as to analyze the pathogen types,evaluate the treatment effectiveness,and increase the diagnosis sensitivity and specificity.

Objective To evaluate the safety,feasibility and short-term efficacy of laparoscopic Laparoscopic Mesangial full excisionfor patients with esophageal cancer.
Methods Retrospective analysis was performed on the clinical data of 143 patients with esophageal cancer who underwent the thoracoscopic McKeown esophago-gastrectomy from September 2018 to June 2021.According to the different modes of esophageal dissociation under thoracoscopy,the patients in the conventional dissociation group were divided into two groups. Total esophageal mesangectomy was performed in 81 cases of free group.
Results All surgical margins were negative,R0 resection rate was 100%,no death and incision related complications occurred,and the overall incidence of postoperative complications was 24.47%.Total meso-esophageal excision showed an advantages of lymph node dissection,similar results regarding the bleeding,and time consuming of thoracic operation,compared to non-ME group.There were no statistically significant differences between the 2 groups in terms of postoperative complications.
Conclusion Laparoscopic Esophageal Mesangial full excisionfor is safe and feasible for elderly patients with esophageal cancer,and the short-term results are satisfactory.

Objective Investigate the application effect of 3D-CT imaging technology in thoracoscopic pulmonary surgery.
Methods The clinical data of 115 patients who underwent thoracoscopic lobectomy or segmentectomy and established three-dimensional reconstruction images of pulmonary vessels and bronchi before surgery in the Department of Thoracic Surgery in our hospital from January 2018 to February 2020 was analyzed,including 103 patients with lobectomy and 12 patients with segmentectomy.
Results All the operations were completed successfully,the operation time was (132.3±34.8)minutes,and the intraoperative blood loss was (112.9±136.4)ml.5 cases of thoracoscopic lobectomy patients were converted to thoracotomy,4 cases of postoperative lung air leakage,5 cases of postoperative pneumonia,4 cases of postoperative atelectasis,and 4 cases of postoperative atrial fibrillation.Preoperative 3D-CT images found 14 cases of variant pulmonary arteries,and 3 cases of variant pulmonary veins.The coincidence rate of preoperative 3D-CT images with intraoperative dissection of pulmonary artery branches was 97.9%.6 pulmonary artery branches were not shown on 3D-CT images,all with diameter ≤1mm.
Conclusion 3D-CT images can well show the branches of the pulmonary arteries，and have a good effect in making preoperative plans for thoracoscopic lobectomy and segmentectomy,and can improve the safety of the operation.

Objective To investigate the expression of TSPAN13 in breast cancer tissues and its correlation with clinicopathological features.
Methods A total of 96 cases patients with breast cancer who received radical mastectomy in our hospital from January 2017 to January 2019 were selected as the research objects.Breast cancer tissue was taken as the breast cancer group,and the adjacent normal breast tissue(>5 cm away from the cancer focus) was taken as the normal group.Ten cases of benign lesions(fibroadenoma) were served as control group.The expression of TSPAN13 mRNA was detected by real-time fluorescent quantitative PCR(qRT-PCR),and the expression of TSPAN13 protein was detected by Western blot.
Results The expression level of TSPAN13 mRNA in breast cancer tissues(0.25±0.04) was lower than that in adjacent breast cancer tissues(0.52±0.08) and benign lesions(0.48±0.05)(P<0.05).The level of TSPAN13 protein in breast cancer tissues(0.31±0.04) was lower than that in adjacent tissues(0.57±0.07) and benign lesions(0.56±0.02)(P<0.05).The expression of TSPAN13 mRNA was closely related to the degree of differentiation and lymph node metastasis of breast cancer.
Conclusion The low expression of TSPAN13 in breast cancer tissues is related to tumor stage,differentiation,invasion and molecular typing.

Objective To analyze the relationship between contrast-enhanced ultrasound(CEUS) parameters and the expression of golgi phosphoprotein 3(GOLPH3) in breast cancer.
Methods A total of 107 breast cancer patients confirmed by pathology were recruited，and the characteristic of CEUS were analyzed.The expression of GOLPH3 was detected by immunohistochemistry.The relationship betweenGOLPH3 positive and negative breast cancer and initial increasing time,peak acceleration time,initial increasing rate and enhancement rate was analyzed.
Results There were no significant differences in age and tumor size among patients with different expression levels of golph3(P=0.431,0.238),but there were significant differences in lymph node metastasis and clinical stage(P=0.011,0.005).The positive rate of VEGF expression was 81.21%(87/107).The characteristics of breast cancer contrast-enhanced ultrasound were mainly uneven partial enhancement and overall enhancement.The time-intensity curve was “fast in and out” or “fast in and out” type.The initial increase time,peak time and peak acceleration time of GOLPH3 positive breast cancer were lower than those of GOLPH3 negative breast cancer,and the enhancement rate of GOLPH3 positive breast cancer was higher than that of GOLPH3 negative breast cancer,the difference was statistically significant(P<0.05).The 5-year survival rates of breast cancer patients with different golph3 expression levels and CEUS parameters were statistically significant(P<0.05).
Conclusion The contrast-enhanced ultrasound parameters of breast cancer are closely related to the expression of GOLPH3,which may be valuable to diagnose breast cancer.

Objective To investigate the effect of OCA2 nucleotide rs4778137 polymorphism on neoadjuvant chemotherapy for triple negative breast cancer.
Methods A total of 72 patients diagnosed with triple negative breast cancer and treated with neoadjuvant chemotherapy in our hospital from February 2016 to March 2020 were selected as study subjects.DNA kit was used to extract total DNA from peripheral blood.DNA chip was used to detect rs4778137 polymorphism,and the correlation between rs4778137 polymorphism of OCA2 and pathological complete response rate(pCR) after neoadjuvant chemotherapy was analyzed.Logistic regression analysis was used to analyze the independent risk factors on the pCR rate.
Results The TNBC patients with pCR rate,disease course of more than 2 years,at T3 and T4,and with lymphatic metastasis was lower.The frequencies of CC,GC and GG genotypes at rs4778137 were 20.8%,29.2% and 50.0%,respectively,and the pCR rate was 20.0%,28.6% and 52.8%,respectively(P<0.05).T stage,lymphatic metastasis and rs4778137 polymorphism were independent risk factors on pCR rate of TNBC patients(P<0.05).
Conclusion rs 4778137 polymorphism is related to  pCR rate of neoadjuvant chemotherapy in TNBC patients,and the pCR rate is higher in GG genotypes.

Objective To explore the expression and significance of the Crk SH3-domain-binding guanine-nucleotide exchange factor(C3G) in the gastric cancer tissue.
Methods Using Oncomine to analyze the differences in expression of C3G in tumor tissues and para-carinoma tissues.Collecting 121 postoperation gastric cancer patients' clinical data who is up to standard,from December 2012 to December 2015.And detecting the expression of C3G protein in their cancerous tissues and para-carinoma tissues by immunohistochemistry.Then analyzing the relationship between C3G protein expression and clinicopathological characteristics and prognosis in these patients.
Results Bioinformatics analysis results showed C3G was high expression in gastric cancer tissue than normal tissue(P<0.05),and in immunohischemistry,the positive expression rate in cancerous tissues and para-carinoma tissues was 70% and 31%.Through Kaplan-Meier survival curve analysis,the survival rate of the patients,who the C3G expression whether positive,was significative(χ2=4.384,P<0.05).And the expression of C3G was related to the T stage of the tumor and lymph nodes metastasis(P<0.05),but was not to the age,sex and differentiated degree of tumor(P>0.05).
Conclusion C3G is highly expressed in gastric cancer tissues,and its high expression is related to the development of gastric cancer and its poor prognosis.

Objective To investigate the effect of fish oil fat emulsion on clinical outcome of laparoscopic assisted radical operation for gastric cancer.
Methods From June 2018 to September 2019,undergoing laparoscopic assisted radical resection of gastric cancer patients were randomly divided into experimental group and control group.From the first day after operation,10% fish oil fat emulsion 100 mL was added to parenteral nutrition in the experimental group,and the patients in the control group were treated with routine treatment after operation.The occurrence of postoperative recovery index,the actual nasal feeding volume of postoperative intestinal nutrition and related complications,and the complications related to postoperative surgery were compared.
Results A total of 80 patients completed the study.There were 40 cases in the experimental group and 40 cases in the control group.There was no statistical difference in the first ventilation time,the first defecation time,the postoperative hospitalization time and the total hospitalization cost between the two groups(P＞0.05).On the 4st,5rd and 6th day after operation,the actual amount of enteral nutrition nasal feeding in the experimental group was higher than that in the control group,the difference was statistically significant(all P<0.05);compared with the control group,the incidence of nausea [17.5%(7/40) and 37.5%(15/40)],abdominal distension were lower [27.5%(11/40) and 70.0%(28/40)],the differences were statistically significant(all P<0.05).The incidence of total infectious complications in the experimental group was significantly lower than that in the control group(P<0.05),but there was no significant difference in the incidence of total non-infectious complications between the experimental group and the control group(P>0.05).
Conclusion Using fish oil fat emulsion after laparoscopic assisted radical resection of gastric cancer can improve tolerance to enteral nutrition,and reduce the occurrence of postoperative total infectious complications.

Objective To explore the application value of laparoscopic technique in incarcerated inguinal hernia.
Methods The clinical data of 42 adult patients with incarcerated inguinal hernia admitted to our hospital from June 2015 to October 2020 were selected.According to the treatment methods, they were divided into two groups.There wer 18 cases in observation group,which underwent transabdominal preperitoneal prosthetic(TAPP) surgery.24 patients underwent open surgery.The operative time,length of hospital stay,postoperative pain score and postoperative complications were recorded.
Results The application of laparoscopic technique in incarcerated inguinal hernia has the advantages of less pain and shorter hospitalization time,which is more conducive to exploring the abdominal cavity.There was no significant difference in operative time and postoperative complications between the two groups(P>0.05).
Conclusion The application of laparoscopic technique in incarcerated inguinal hernia is convenient to fully explore the abdominal cavity,has the advantage of large operating space,and is more conducive to restoring the contents of the hernia and judging the vitality of the intestine.

Objective To explore the influencing factors of external stent reduction of radius fractures combined with K-Fiber for wrist joint function.
Methods A follow-up of 116 patients with radius fractures treated with external stent reduction combined with Kirschner wire fixation in the orthopedics department of our hospital from January 2016 to December 2018 were followed up.First,the age,gender,bone density,fracture type,and whether it was complicated Comminuted fracture,swelling,combined with ulnar styloid process fracture,and long time of external fixation were performed by χ2 test.After the statistically significant variables were screened out,multivariate logistic regression analysis was performed to influence the reduction of external stent combined with K-Flag For the influencing factors of wrist joint function.
Results According to the wrist scores of Gartland-Werley external stent reduction combined with Kirschner wire treatment,there were 92 cases in the good group,accounting for 79.31%,and 24 cases in the poor group,accounting for 20.69%.After logistic regression analysis,age(OR=1.699,95%CI:1.621-1.781),bone density(OR=2.387,95%CI:2.342-2.433),fracture type(OR=2.117,95%CI:1.988- 2.254),whether it is a complex comminuted fracture(OR=1.522,95%CI:1.501-1.543) is statistically significant.
Conclusion Age,bone mineral density,fracture type,and whether the fracture is severely comminuted are independent risk factors that affect the function of the wrist joint with external stent reduction in radius fractures.

Objective To investigate the clinical effect of patella steel plate and gram needle tension band fixation on patella fracture.
Methods The study subjects were 67 patients with eligible patella fractures admitted in the hospital from January 2015 to October 2020.After excluding the late follow-up of the lost patients,30 cases each of the steel plate group and the tension band group were selected to facilitate the statistical comparison.Among them,the steel plate group is a patella steel plate,the tension band group is a modified gram needle titanium cable tension band.The operation time,bleeding volume,incidence of complications and the function of the knee joint were analyzed and evaluated.
Results Operation time,steel plate group(63.53±7.07) min,tension band group(76.53±4.16)min.Cut-out length,steel plate group(6.28±0.57)cm,tension band group(7.73±0.77)cm.The knee activity was measured 6 months after surgery,steel plate group(124.07±4.35),tension band group(118.40 ± 4.55).Surgical bleeding volume,steel plate group(118.42±10.39)ml,tension band group(133.77±12.43)ml.The relative statistical comparison differences between the two groups have statistical significance(P<0.05).
Conclusion Compared with the steel plate group and the tension band group,t he operation time was shortened,and the incision length was also overall shorter than the tension band group;and the satisfaction of postoperative knee activity in the steel plate group was also stronger than that of the tension band group.The treatment of patella fracture has good biomechanical stability and is significantly better than that of tension-band fixation.Worth the promotion in the clinical work.

Objective To investigate short and medium term therapeutic effect of Castor single-branch aortic covered-stent in treating Stanford type B aortic dissection(TBAD)with insufficient anchorage zone.
Methods 122 cases of tbad patients with insufficient anchoring area were selected and treated with castor branched covered stent.The stent patency rate,aortic remodeling and complication rate were evaluated at 2 weeks,3 months,6 months and 12 months after operation.
Results 2 weeks,3 months,6 months and 1 year after operation,the patency rates of LSA branch stents were 100%,100%,99.18%and 97.54%respectively.Aortic remodeling indexes were improved 2 weeks after operation.With the extension of time after operation,the improvement degree of aortic remodeling indexes was gradually increased,and the difference was statistically significant compared with 2 weeks after operation(P＜0.05).There were 3 cases of internal leakage,1 case of cerebral infarction and 1 case of refractory hypertension;During the follow-up,2 cases of endoleak disappeared and 1 case of retrograde type A dissection appeared.
Conclusion Castor single-branch aortic covered-stent has a good clinical effect in treating aortic dissection of Stanford type B with insufficient anchorage zone,with good long-term stent patency rate and low complication rate.

Objective To investigate the safety and effectiveness of simultaneous transurethral resection of bladder tumor(TURBT) and transurethral resection of prostate(TURP) in treatment of non-muscle-invasive bladder cancer(NMIBC) patients complicated by benign prostatic hyperplasia(BPH).
Methods The clinical data of 120 cases of NMIBC patients complicated by BPH were analyzed retrospectively.53 patients underwent simultaneous TURBT and TURP as the observation group,and the remaining 67 patients underwent TURBT alone as the control group.The perioperative conditions of the two groups were compared.Residual urine volume(RUV),maximum urine flow rate(MFR),international prostate symptom score(IPSS),and quality of life(QOL) score before and 6 months after surgery were evaluated.The tumor recurrence,metastasis and progress were followed up and counted.
Results The operation time(125.44±25.43)min,intraoperative blood loss(110.21±11.84)ml,postoperative bladder irrigation time(30.21±6.85)h,catheter indwelling time(5.62±1.13)d and hospital stay(12.17±2.33)d,which were higher than those of the control group [(76.85±21.03) min,(76.85±9.43)ml,(22.79±5.61)h、(4.19±0.92)d,(9.01±2.14)d],the differences were statistically significant(P<0.05).At 6 months after surgery,the MFR of the observation group[(21.23±2.27)ml/s] was higher than the control group[(9.79±1.78)ml/s],the RUV(15.82±2.33)ml,IPSS score(5.14±1.02),QOL score(1.39±0.41) of the observation group were lower than the control group[(70.21±15.94)ml,(20.11±3.48),(3.25±0.72)](P<0.05).The incidence of postoperative complications was 15.09% in the observation group,which was no significant difference with 5.97% in the control group(P>0.05). The recurrence rate(24.53%),metastasis rate(1.89%),and tumor progression rate(11.32%) of the observation group were no statistically significant difference with the control group(24.53%,1.89%,11.32%)(P>0.05).
Conclusion Simultaneous TURBT and TURP is safe and effective for NMIBC with BPH,which can improve the BPH symptoms and quality of life of patients,and does not increase the risk of tumor recurrence,metastasis and progression.

Objective To evaluate the significance and reasonability of select in various types of circumcision in children of different ages.
Methods A retrospective analysis was performed for 1 440 children of different ages(3-15 years) between Jan 2019 and Sep 2019 in urological ward and ambulatory surgery area of our hospital.280 were preschool children,620 were school-age children,240 were adolescent children.In different ages,divide them into 4 groups by different types of circumcision：traditional circumcision group,circumcision group with ligation device,circumcision group with anastomoses device,circumcision group with stitching instrument.The indications such as blood loss、operating time、  pain duration、 shedding time、 short-term complication and long-term complication were compared.
Result Among the 4 surgical procedures,preschoolers had the shortest pain duration,shedding time and fewer short-term complication.School-age children had the lowest operative time and blood loss by circumcision with ligation device.Adolescent children had lower operative time,blood loss and the fewer long-term complication by circumcision with stitching instrument.
Conclusion With the development of circumcision apparatus,different surgical methods should be adopted for children's  circumcision in combination with different age.Traditional circumcision should be recommended for preschoolers,circumcision with ligation device for school-age children,circumcision with stitching instrument for adolescent children.

Objective To explore the clinicopathological features,immunophenotype,molecular mechanism,diagnosis and differential diagnosis of congenital neuroblastoma.
Methods The clinical manifestations,pathological features,and molecular mechanisms of 6 cases of congenital neuroblastoma were retrospectively analyzed,followed by telephone follow-up and literature review.
Results Among the 6 patients,4 were cystic and 2 were solid.Five cases were adrenal glands and one case was posterior mediastinum.The pathological feature under the microscope is that the tumor cells are divided into nests by fine fibers,the tumor cells are small and round,the chromatin is fine,and there may be small nucleoli.Immunohistochemistry showed PHOX2B,Syn,CgA and CD56 were all positive.
Conclusion The incidence of congenital neuroblastoma is low,and the biological behavior is heterogeneous.It can regress spontaneously or differentiate into a benign glioma.It can also rapidly deteriorate and metastasize rapidly.Analysis of its clinicopathological features helps In-depth understanding of the treatment and prognosis of this tumor.

Objective To explore whether lncRNA SNHG16 could regulate the proliferation,migration,invasion and apoptosis of Wilms’ tumor WIT49 cells by targeting miR-22-3p.
Methods qRT-PCR was used to detect the expression levels of SNHG16 and miR-22-3p in Wilms’ tumor tissues and adjacent tissues.Human Wilms’ tumor WIT49 cells were cultured in vitro,and si-NC,si-SNHG16,miR-NC,miR-22-3p mmics,si-SNHG16 and anti-miR-NC,si-SNHG16 and anti-miR-22- 3p was transfected into WIT49 cells.The qRT-PCR method was used to detect the expression levels of SNHG16 and miR-22-3p in the cells.The CCK-8 method was used to detect cell proliferation.Transwell cell experiment was used to detect cell migration and invasion.Flow cytometry was used to detect the apoptosis rate.The dual luciferase reporter experiment detects the targeting relationship of SNHG16 and miR-22-3p.Western blot method was used to detect the protein expression of CyclinD1,MMP-2,MMP-9,Bcl-2,p21,Bax.〖WT5”HZ〗Results Compared with adjacent tissues,the expression level of SNHG16 in Wilms’ tumor tissue was significantly increased(P＜0.05),and the expression level of miR-22-3p was significantly decreased(P＜0.05).Transfection of si-SNHG16 or miR-22-3p mimics could significantly reduce the OD value and the protein levels of CyclinD1,MMP-2,MMP-9 and Bcl-2(P＜0.05),and reduce the number of migration and invasion cells(P＜ 0.05),increase the apoptosis rate and the levels of p21 and Bax protein(P＜0.05).The dual luciferase report experiment confirmed that SNHG16 could target miR-22-3p.Down-regulating the expression of miR-22-3p could significantly reverse the effect of inhibiting the expression of SNHG16 on the proliferation,migration,invasion and apoptosis of Wilms tumor WIT49 cells.
Conclusion Inhibition of SNHG16 expression could reduce the proliferation,migration and invasion ability of Wilms’ tumor WIT49 cells by up-regulating the expression of miR-22-3p,and induce cell apoptosis.

Objective To observe the influence of ultrasound-guided radial artery catheterization on vascular injury,complication rate and recovery.
Methods From September 1 2019 to September 1 2020,a total of 100 patients undergoing surgery in our hospital were randomly divided into two groups:ultrasound-guided radial artery catheterization group(group S),blind touch radial artery catheterization group(group M),both groups underwent radial artery catheterization to monitor invasive arterial blood pressure.Doppler ultrasound(Mindray,M9) was used to measure blood flow parameters of radial artery catheterization at 8 time points:T1(before arterial catheterization),T2(after successful arterial catheterization),T3(before removing artery catheterization),T4,T5,T6,T7,T8(15 min,1 h,2 h,6 h,12 h after removing artery catheterization),blood flow parameters include:Radial artery diameter(D),Time average maximum speed(TAMAX),Resistance index(RI),Pulsatility index(PI),Vascular cross-sectional area(Area),distal radial artery blood flow(F).Compare the changes of blood vessel diameter,blood flow,resistance index,and pulsatility index at each time point between groups and within groups,also the incidence of complications and recovery after extubation of arterial catheterization.
Results Compared with T1,The trend of changes in D,F in the two groups of patients from T2 to T8 was first decline,then rise,then fall,and then rise again,the RI and PI are first increase,then decrease,then increase,and then decrease.At the point T8,the F,RI,PI recovered to T1 level in Group S(P>0.05),and that have not recovered to T1 level in group M(P<0.05).Comparison between groups,there was no significant  difference in D,F,RI,PI in the two groups at T1(P>0.05).Compared with the group M,thegroup S had a larger D at T2-T5(P<0.05),a higher F at T2～T8(P<0.05),and a lower RI and PI at T2～T8(P<0.05),the incidence of complications after arterial extubation was  significantly reduced in group S(P<0.05).
Conclusion Compared with the blind radial catheterization,the ultrasound-guided method has less damage to the radial artery,less impacton the blood flow at the distal end of the catheterization site,reduced complication rate,and faster recovery from the injury.It is worthy of clinical promotion.

The global prevalence of obesity has risen sharply,and the prevalence of obesity-related complications is also increasing,including diabetes,hypertension,and dyslipidemia.Bariatric surgery is a treatment method for obese patients to obtain continuous weight loss.It also has a significant effect in improving and even treating type 2 diabetes mellitus(T2DM),and the effect is significantly better than traditional treatment.The purpose of this review is to summarize the literature on bariatric surgery and T2DM,and to summarize the relevant research evidence about the application of bariatric surgery in type 2 diabetes.