[Abstract] Objective To evaluate the perioperative safety and long-term efficacy of preoperative in patients with simultaneous colorectal peritoneal metastasis before CRS+HIPEC.Methods This study retrospectively analyzed patients who received preoperative chemotherapy combined with CRS+HIPEC for simultaneous colorectal peritoneal metastasis in National Cancer Center and Huanxing Cancer Hospital from June 2017 to June 2019.A total of 52 patients were included in this study,and they were divided into preoperative chemotherapy group(n=20) and non-preoperative chemotherapy group(n=32) according to whether or not they had received preoperative chemotherapy.Results In the preoperative chemotherapy group,the proportion of patients with a peritoneal carcinomatosis index(PCI) >12 was significantly higher than in the non-preoperative chemotherapy group(80.0% vs.50.0%,P=0.031),while more patients achieved complete cytoreductives(80.0% vs 46.9%,P=0.018).There were no significant differences in the incidence of grade Ⅲ/Ⅳ complications,reoperation rates and mortality rates between the two groups(P>0.05).Platelet counts(151.9 ×10⁹/L和197.7×10⁹/L,P=0.036) and white blood cell count(4.7 ×10⁹/L和7.2×10⁹/L,P=0.030) were significantly lower on the first day after surgery in patients receiving preoperative chemotherapy.Patients in the preoperative group survived more than 2 years significantly more than those in the nonpreoperative group(67.4% vs 32.2%,P=0.044).Multivariate analysis showed that completeness of the cytoreduction score(HR,2.99;95% CI,1.14~7.84;P=0.026) was an independent risk factor for overall survival,but not preoperative chemotherapy.Conclusion For patients with peritoneal metastasis of colorectal cancer,preoperative chemotherapy before CRS+HIPEC is safe and feasible,with a relatively low incidence of complications and mortality.

Objective To investigate the characteristics of lymph node sorting and risk factors of metastasis in group No.6 lymph node of lower gastric carcinoma.To provide the data support for standardizing lymph node grouping and harvested in laparoscopic radical distal gastrectomy.Methods This study included 66 patients with lower gastric carcinoma who underwent laparoscopic D2 radical gastrectomy in the department of Gastrointestinal Surgery,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2017 to December 2017.Lymph node sorting of each gastric cancer sample was performed according to the scope of D2 dissection.The total number of harvested lymph nodes,total number of metastatic lymph nodes,proportion of patients with lymph node metastasis and lymph node metastasis rate were calculated in each group such as No.1、No.3、No.4sb、No.4d、No.5、No.6、No.7、No.8a、No.9、No.11p and No.12a.Clinicopathological data were recorded:gender,age,depth of invasion,tumor size,degree of differentiation,nerve invasion,vascular invasion,body mass index,HER2 expression,cancer nodule surrounding the tumor and tumor location.The characteristics of lymph node sorting in group No.6 were analyzed and concluded.Univariate and multivariate analysis of risk factors for lymph node metastasis in group No.6 were performed.Results The proportion of patients with lymph node metastasis in group No.6 was 18/66(27.3%),and the rate of lymph node metastasis was 60/233(25.8%).Univariate analysis showed that the depth of invasion(χ2=7.153,P=0.007),nerve invasion(χ2=8.503,P=0.004),vascular invasion(χ2=5.677,P=0.017),HER2 expression(χ2=4.979,P=0.026)and cancer nodule surrounding the tumor(χ2=5.408,P=0.020) were significantly associated with lymph node metastasis in group No.6(P< 0.05).Lymph node metastasis in group No.3(χ2=5.432,P=0.020),group No.7(χ2=12.726,P=0.000),group No.8a(χ2=10.615,P=0.001) and group No.9(χ2=7.787,P=0.005) were closely correlated with lymph node metastasis in group No.6(P<0.05).Multivariate Logistic regression analysis showed that cancer nodule(OR=15.648，95%CI:2.946~83.118)and HER2 expression(OR=11.706，95%CI:2.018~67.890) were independent risk factors for lymph node metastasis in group No.6(P<0.05).Conclusion The attention should be paid to lymph node metastasis and sorting in group No.6 in laparoscopic radical distal gastrectomy.According to the lymph node metastasis of group No.6,the scope of lymph node dissection should be appropriately expanded.

Objective To investigate the effect of membrane dissection in radical gastrectomy for gastric cancer.Methods From August 2018 to October 2020,146 cases of patients with gastric cancer who were diagnosed and treated in our hospital were selected as the research objects.All the patients were divided into membrane anatomy group and control group with 73 cases each groups accorded to the 1∶1 random envelope drawing principle.The membrane anatomy group were underwent laparoscopic radical gastric cancer surgery under the guidance of membrane anatomy theory,and the control group were received traditional vascular guided laparoscopic radical gastric cancer surgery,and were to record and follow-up the prognosis of patients. Results The operation time,intraoperative blood loss,number of lymph nodes dissected,postoperative exhaust time,postoperative time to get out of bed and postoperative hospital stay in the membrane anatomy group were less than those of the control group(P<0.05).The incidence of complications such as incision infection,lung infection,abdominal hemorrhage,and anastomotic leakage in the membrane anatomy group were 2.7%,which were lower than 21.9% in the control group at 7 d after operation(P<0.05).The pain visual analogue scale(VAS) scores of the membrane anatomy group at 1 d,3 d,and 7 d were lower than those of the control group(P<0.05).The levels of serum high mobility group protein B1(hMGB1) in the membrane anatomy group at 1d,3d and 7d after operation were lower than those of the control group(P<0.05).All patients were followed up until October 1,2021.The recurrence rate and mortality rate of the membrane anatomy group were 16.4% and 8.2%,which were lower than those of the control group,31.5% and 20.5%(P<0.05). Conclusion The application of membrane anatomy in radical gastric cancer surgery can effectively reduce the occurrence of complications,reduce surgical trauma,and promote patient recovery.It can also effectively relieve pain and inhibit the release of hMGB-1,thereby reducing the follow-up recurrence rate and mortality of patients.

Objective To investigate the relationship between the expression of RORα and MAPLC3 in gastric cancer and long-term prognosis. Methods A total of 82 patients admitted to our hospital from January 2018 to June 2018 who were diagnosed with gastric cancer by pathological examination were selected as the research subjects.The expression of Retinoic acid-associated orphan receptor α(RORα) and microtubule associated protein light chain 3(MAPLC3) in gastric cancer tissues and adjacent tissues was detected by immunohistochemical staining,and their correlation with pathological factors was analyzed.Patients were divided into the death group(n=32) and the survival group(n=50),and the long-term prognosis of RORα and MAPLC3 expression in gastric cancer tissues of the two groups were analyzed and compared. Results The positive expression rates of RORα(42.68%) and MAPLC3(43.90%) in cancer tissues were significantly lower than those in adjacent tissues(84.15% and 91.46%),with statistical significance(P<0.05).The positive expressions of RORα and MAPLC3 in gastric cancer tissues had no significant differences with gender,age,tumor size,cancer cell type and pathological grade(P>0.05).The positive expression of RORα was related to T stage and lymphatic metastasis(P<0.05),and the positive expression of MAPLC3 was related to T stage,differentiation degree and lymphatic metastasis(P<0.05).Univariate analysis of long-term prognosis of gastric cancer patients showed that T stage,degree of differentiation,lymphatic metastasis,RORα expression,MAPLC3 expression and other factors were closely correlated with long-term prognosis of gastric cancer patients(P<0.05).Multivariate COX regression analysis showed that T stage(OR=1.779,95%CI:1.109~5.656) and differentiation degree(OR=1.621,95%CI:1.029~2.554),lymphatic metastasis(OR=1.876,1.020~3.451),RORα(OR=2.815,95%CI:1.401~5.656),MAPLC3(OR=3.080,95%CI:1.305~7.268) were independent risk factors for long-term prognosis of gastric cancer patients(P<0.05).The area under the curve for evaluating the prognosis and survival of gastric cancer patients was 0.67(95%CI:1.024~3.216),with a sensitivity of 72.34% and specificity of 64.58%.The area under the curve of MAPLC3 positive expression in gastric cancer tissues was 0.65(95%CI:1.023~2.547),with a sensitivity of 74.52% and specificity of 65.13%.Conclusion The expressions of RORα and MAPLC3 were lower in gastric cancer tissues.The positive expressions of RORα and MAPLC3 are independent risk factors for long-term prognosis of gastric cancer patients.

Objective To study the clinical effect of a self-made single-hole device assisted by abdominal wall puncture suture needle in appendectomy.Methods A retrospective analysis of the clinical data of 80 patients undergoing laparoscopic appendectomy admitted to the Department of General Surgery,Taikang Xianlin Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,from July 2018 to July 2021,36 of them were self-made with abdominal wall puncture needles.Single-port device treatment(puncture needle group),44 cases were treated with traditional three-port laparoscopic treatment(traditional group),the operation time,blood loss,anal exhaust time,hospital stay,pain score and postoperative wound infection were compared between the two groups Situation and other indicators. Results There was no significant difference between the puncture needle group and traditional group of patients in terms of median operative time(35min vs.35min),median blood loss(12.5ml vs.15ml),median anal exhaust time(1 day vs.1 day),median hospital stay(5 days vs.5 days) and postoperative wound infection(0 case vs.2 cases)(P>0.05).The puncture needle group had significantly lower pain scores[3(2,3)] than the traditional[3(2,4)] on the first postoperative day(P<0.05).Conclusion The use of abdominal wall puncture suture needle to assist self-made single-hole device for appendectomy is safe and effective.Postoperative pain is significantly improved,hospitalization time is short,postoperative scars are small,and more beautiful.

Objective To construct a prediction model based on the expression of long noncoding RNA (long non-coding,LncRNA) and analyze its predictive power in predicting the risk of early postoperative recurrence in patients with gastric cancer.Methods A total of 121 patients who underwent gastric cancer resection in our hospital from June 2016 to January 2019 were prospectively enrolled.They were followed up by outpatient clinic or telephone for 2 years after surgery.According to the follow-up of patients,the patients were divided into recurrence group and non-recurrence group.Group.The lncRNAs of patients were measured based on the genomic map of postoperative recurrence of gastric cancer,the differentially expressed long non-coding RNAs (DEL) were screened by edgeR,and the LncRNAs associated with early recurrence were screened by COX and Lasso-Logistic regression equation,and the ROC curve was applied.to evaluate the effectiveness of the model.Results After 2 years of follow-up,a total of 21 patients were lost to follow-up,and 100 patients were finally included,of which 31 patients had recurrence as the recurrence group,and 69 patients without recurrence were regarded as the non-relapse group.In patients with gastric cancer surgery,a total of 992 DELs were screened by edgeR,of which 772 were up-regulated and 220 were down-regulated.Among them,univariate analysis showed that there were differences in the expression of 63 lncRNAs between the recurrence group and the non-recurrence group;Lasso-COX regression model analysis showed that 22 lncRNAs were risk factors for early postoperative recurrence of gastric cancer patients;22 lncRNAs were further included in the multivariate COX Regression analysis showed that AC007991.4,AC079385.3 and AL109615.2 were strong risk factors for early postoperative recurrence of gastric cancer patients,and the AUC of the three combined to predict early postoperative recurrence of gastric cancer patients was 0.879. Conclusion AC007991.4,AC079385.3 and AL109615.2 are factors that affect the early recurrence of gastric cancer patients after surgery.The construction of a risk prediction model can guide the detection of key populations and prolong the survival time of patients as much as possible.

Objective To investigate the tolerance of elderly patients to early oral nutrition after gastrectomy. Methods 117 patients with gastric cancer who underwent indirect gastrectomy from January 2017 to December 2020 were analyzed retrospectively.All patients received oral diet on the first day after operation.Patients were divided into older(>70 years) and younger(≤70 years) adult groups to compare short-term results and oral nutritional intolerance. Results Among 117 patients,21cases(17.9%) were intolerant to early oral nutrition,including 14 cases≤70 years old and 7 cases>70 years old.The most common symptom of intolerance is abdominal distension.The mean fasting time after intolerance was (2.8±2.4)days.The incidence of intolerance was 17.1% in the elderly group and 18.4% in the young group(P>0.05).There was no significant increase in intolerance in gender,surgical methods,lymph node dissection and tumor staging subgroups.The incidence of systemic complications was higher in the elderly group;There was no significant difference in anastomotic complications between the two groups(P>0.05). Conclusion There was no significant difference in oral nutrition intolerance between elderly and young adult patients.It shows that early oral nutrition can be safely used in elderly patients undergoing gastrectomy.

Objective To investigate the clinical efficacy of enhanced recovery after surgery(ERAS) combining with laparoscopy operation in gastric cancer and liver cirrhosis patients. Methods  From January in 2016 to December in 2020,46 patients of gastric cancer and liver cirrhosis were analyzed retrospectively，and divided into the conrtol group of 23 cases,perioperative management according to traditional methods,23 cases of accelerated recovery group(ERAS group),perioperative management with ERAS in Jingzhou central hospital.AST,ALT,d dimmers,White blood cell(WBC) count,C reaction protein(CRP) and IL-6 in the 46 patients were assayed preoperatively and at day 1,3,7 postoperatively.The operation time,intraoperative blood loss,pain scores,time to flatus,time to get out of bed,duration of hospital stay and postoperative complications were recorded and compared respectively. Results The leukocyte,C-reactive protein,interleukin-6,D- dimer and postoperative pain scores of ERAS group were significantly lower than those of control group at 1,3 and 7 days after surgery,and the differences were statistically significant(P＜0.05).The postoperative exhaust time,ambulation time and discharge time were all earlier than those of the control group,and the differences were statistically significant(P＜0.05).There was no significant difference in the incidence of postoperative alanine aminotransferase,aspartate aminotransferase and complications(P>0.05).Conclusion ERAS can decrease postoperative stress level,shorten the duration of hospital stay and postoperative complication for gastric cancer and liver cirrhosis.It is safe and feasible for the perioperative treatment of patients with gastric cancer and liver cirrhosis.

Objective To investigate the expression and clinical significance of microRNA(miR)-370-3p and Toll-like receptor 4(TLR4) in colorectal cancer.Methods The cancer tissues were collected from 146 patients with colorectal cancer in the Anorectal Surgery of our hospital.qRT-PCR was used to detect the expression levels of miR-370-3p and TLR4 mRNA in colorectal cancer tissues,immunohistochemical method was used to detect the expression level of TLR4 protein;the clinicopathological data of 146 patients were collected and and the patients were followed up for 3 years after operation,the relationship between the expression levels of miR-370-3p,TLR4 and clinicopathological characteristics and prognosis was analyzed;Pearson method was used to analyze the correlation between miR-370-3p and TLR4.ResultsThe expression level of miR-370-3p in colorectal cancer tissues(1.20±0.23) was lower than that in adjacent tissues(1.94±0.32)(P＜0.05);the level of TLR4 mRNA in cancer tissues(2.46±0.56) was significantly higher than that in adjacent tissues(1.39±0.25)(P＜0.05);the high expression rate of TLR4 protein in cancer tissues 40.41%(59/146) was higher than 13.01%(19/146) in adjacent tissues(P＜0.05);the expression levels of miR-370-3p and TLR4 in cancer tissues were related to lymph node metastasis,TNM staging,and tumor differentiation(P＜0.05);miR-370-3p was negatively correlated with TLR4 in colorectal cancer tissue(r=-0.760,P=0.000);miR-370-3p,lymph node metastasis,TLR4,TNM staging,and degree of differentiation were related factors affecting the prognosis of patients(P＜0.05);when miR-370-3p was highly expressed and TLR4 was lowly expressed,the cumulative survival rate of patients was higher.Conclusion miR-370-3p and TLR4 are low and high expression in colorectal cancer,respectively,and they are negatively correlated.Their expression level is related to colorectal cancer stage,invasion,differentiation and poor prognosis.

Objective To explore the experience of parathyroid function protection during endoscopic surgery in papillary thyroid cancer. Methods The clinical data (the number of recognized and misdissected parathyroid glands;the number of preserved in situ and autotransplantated parathyroid glands;Ca²⁺ and PTH) of 198 patients with PTC were retrospectively analysed:open surgery was performed in 104 cases;endoscopic surgery was performed in 94 cases;all the cases used carbon nanoparticles during operation. Results No statistically significant difference was observed between the identification rates of type A1,A2,or B1,and the preservation in situ rates of type A1 in the two groups (P>0.05).Significant differences were found between the identification rates of type A2,B1 and total parathyroid glands,and the preservation in situ rates of type A2,B1,and total parathyroid glands in the 2 groups (P<0.05).There was no significant differences of the levels of Ca²⁺ and PTH before operation,and the levels of Ca²⁺ on postoperative day was found between the two group(P＞0.05).The PTH level in endoscopic surgery was significantly lower than that in open surgery,and decreased significantly compared with that before surgery(P＜0.05).Conclusion The negative development technique of carbon nanoparticles can effectively protect the parathyroid function during the operation of PTC,but surgeons should pay more attention to injection methods and accurate dissection.

Objective To investigate the clinical value of body mass index(BMI) in guiding femoral artery incision or puncture for aortic dissection. Methods From January 2020 to December 2020, 449 patients with aortic dissection were admitted to our hospital. Clinical data and imaging data were collected.The correlation between BMI and subcutaneous fat thickness at cross section under femoral artery branch and intra-femoral artery track was analyzed.Results There was a relatively strong positive correlation between BMI and bilateral femoral subcutaneous fat thickness,as the correlation coefficient was 0.654 on the left and 0.635 on the right.The results were statistically significant(P<0.05).The correlation between BMI and bilateral femoral artery diameter was very weak with the correlation coefficient 0.11 on the left side and 0.108 on the right side.The results were statistically significant(P<0.05). Conclusion There was a relatively strong correlation between BMI and bilateral femoral subcutaneous fat thickness.Thus,BMI can act as an important reference for intraoperative femoral artery incision or puncture,that suitable for predicting femoral artery depth in patients who suffer aortic dissection.

目的 研究细丝蛋白B(FLNB)在钙化性心脏瓣膜中的表达及其临床意义。方法 2021年8月～2022年1月在我院手术切除的钙化性主动脉瓣标本9例，同期因主动脉夹层行手术切除的正常主动脉瓣膜标本8例作为对照。组织切片茜素红染色观察瓣膜钙化结节。采用免疫组化分析方法对瓣膜中细丝蛋白B的表达进行分析。利用冰冻组织标本进行蛋白质免疫印迹检测，验证相应分子表达水平间差异。结果 钙化瓣膜切片经茜素红染色可以看见明显钙化结节。免疫组化检查显示细丝蛋白B表达于细胞质，钙化瓣膜高于正常瓣膜，钙化组平均光密度为(6.57±1.65)%；对照组为(0.91±0.52)%，两组比较差异有统计学意义（P<0.05），蛋白质免疫印迹结果与之一致。结论 细丝蛋白B在钙化瓣膜中表达增高，可能参与了瓣膜钙化的病理进程。

Objective To explore the clinical significance of identification of low-density lipoprotein(LDL) and highd-ensity low lipoprotein(HDL) subclasses in the risk prediction of hepatitis B virus(HBV)-related liver cancer.Methods From January to December 2017,90 HBV carriers diagnosed and treated in the First Affiliated Hospital of the Air Force Military Medical University were prospectively included,and they were divided into liver cancer group(n=30),liver cirrhosis group(n=30) and chronic liver disease group(n=30).Serum LDL subtypes were analyzed by polyacrylamide gel electrophoresis,and serum HDL subtypes were determined by two-dimensional gel electrophoresis and western blotting.The clinical data of each group and the levels of serum LDL and HDL subtypes were compared,and the risk factors affecting the occurrence and prognosis of liver cancer were analyzed by Logistic regression model.The predictive efficacy of each index was analyzed by the receiver operating characteristic(ROC) curve.〖WTHZ〗Results Compared with the chronic hepatitis group,Small and dense(sd) LDL levels in patients with liver cirrhosis and liver cancer increased significantly,and serum HDL2 and HDL3 levels decreased significantly,both P<0.05.In addition,the serum sdLDL level of the liver cancer group was higher than that of the liver cirrhosis group,and the serum HDL2 and HDL3 levels were lower than that of the liver cirrhosis group,both P<0.05.Logistic regression analysis showed that the increase of serum sdLDL level and the decrease of HDL3 level are independent risk factors of liver cancer in patients with chronic liver disease,P<0.05.After ROC curve analysis,the area under the curve of serum sdLDL and HDL3 predicting the occurrence of liver cancer was 0.899(0.835~0.964) and 0.816(0.731~0.902),the specificities were 0.883,0.976,the sensitivities were 0.867,0.600.Conclusion Serum sdLDL and HDL3 levels are related to the risk of HBV-related liver cancer.Monitoring serum sdLDL and HDL3 levels is helpful for early diagnosis of liver cancer.

Objective To systematically evaluate the relationship between metabolic syndrome and prostate cancer progression. Methods Multiple databases were searched by computer,and the time was limited from establishment to November 2021.Case-control studies or cohort studies on the association between metabolic syndrome and prostate cancer progression were collected and meta-analyses were performed according to the results of heterogeneity.Results A total of 10 case-control studies and 1 cohort study were included,13207 patients were included.Meta-analysis showed that Gleason score(≥8) in patients with metabolic syndrome after radical prostatectomy was higher than that in patients with non-metabolic syndrome(OR=1.83,95%CI:1.44~2.33),and pathological T stage(≥T3) was higher than that in patients with non-metabolic syndrome(OR=1.95,95%CI:1.28~2.96),the incidence of pelvic lymph node metastasis was higher than that of non-metabolic syndrome patients(OR=1.96,95%CI:1.47~2.61),and the incidence of positive surgical margin was higher than that of non-metabolic syndrome patients(OR=1.17,95%CI:1.04~1.33).Conclusion Compared with patients without metabolic syndrome,patients with metabolic syndrome have higher Gleason score,higher pathological T-stage,higher risk of pelvic lymph node metastasis,and higher incidence of positive surgical margins,suggesting a certain correlation between metabolic syndrome and the progression of prostate cancer.

Objective To investigate the expression of prostate specific membrane antigen(PSMA) in prostate cancer tissues and peripheral blood,and to analyze the relationship between PSMA and Gleason score and its value in early diagnosis and prognosis.Methods Clinical data of 270 patients with prostate cancer and 50 patients with BPH treated in our hospital from March 2015 to June 2020 were retrospectively analyzed.Immunohistochemical staining(IHC) was used to detect PSMA expression in tissues,and analyze the correlation between PSMA expression and Gleason score.Kaplan-meier method was used to compare Overall Survival(OS) and biochemical relapse-free Survival(BRFS) of PSMA positive and negative groups.Finally,enzyme linked immunosorbent assay(ELISA) was used to detect the content of PSMA in serum of the two groups,and receiver operating curve(ROC) was used to evaluate the value of PSMA as a diagnostic marker.Results PSMA expression was positive in 221 of 270(81.9%) prostate cancer tissues and was positive in 24 of 50(48.0%) prostatic hyperplasia tissues.The positive rate of prostatic hyperplasia tissues was lower than that of prostate cancer group(P＜0.05) the positive expression rate of PSMA in patients with Gleason score >7 was higher than that in patients with Gleason score ≤7(P＜0.05).The median OS was 24 months and the median BRFS was 17 months in the PSMA positive group,which were significantly lower than those in the PSMA negative group(median OS:52 months and median BRFS:45 months),with statistically significant differences(P＜0.05).The serum PSMA content of prostate cancer patients was (17.97±6.66)μg/L,which was higher than that of prostate hyperplasia group[(7.90±5.03)μg/L],and the difference was statistically significant(P＜0.05).ROC results showed that when serum PSMA > 17.50μg/L was used as the cut-off value,the area under the curve(AUC) was 0.845,the diagnostic sensitivity was 71.1%,and the specificity was 82%.Conclusion The high expression of PSMA in prostate cancer tissue is closely related to Gleason score,and its expression is associated with worse prognosis in patients.Serum PSMA level can be used as a diagnostic indicator of prostate cancer.

Objective To explore the related factors of pulmonary embolism(PE) in patients with deep venous thrombosis after fracture surgery.Methods 130 patients with deep venous thrombosis after fracture surgery treated in our hospital from January 2019 to July 2021 were retrospectively selected to analyze the incidence of PE and compare the clinical data of patients with and without PE,the influencing factors of PE were analyzed.Results The incidence of PE was 19.23%.The proportion of patients with concurrent PE,age over 60 years,smoking,diabetes and malignancy were significantly higher than those without PE(P<0.05).The D-dimer in patients with PE was significantly higher than that in patients without PE(P<0.05).Logistic regression analysis showed that age,smoking and malignant tumor were the influencing factors of deep venous thrombosis complicated with PE(OR=2.199,2.469 and 2.779,P<0.05).Logistic regression equation predicted that the area under the ROC curve of PE was 0.811,P<0.05,and its sensitivity and specificity were 83.00% and 80.00% respectively.Conclusion Deep venous thrombosis complicated with PE after fracture surgery is affected by patients’ age,smoking and malignant tumor,which is worthy of clinical attention.

Objective To evaluate the pharmacodynamics of target-controlled infusion of rocuronium in patients undergoing surgery for obstructive jaundice.Methods Sixty patients undergoing elective open biliopancreatic surgery under general anesthesia in our hospital from August 2020 to August 2021 were selected and randomly divided into two groups: 30 patients received targeted infusion of rocuronium(observation group),30 patients received intermittent intravenous injection of rocuronium(control group).The total intubation dose,onset time,muscle relaxation recovery time,maintenance dosage and total dosage of rocuronium during induction were compared between the two groups,and the muscle relaxation monitoring indexes during anesthesia maintenance were observed between the two groups.Results he induction time of target-controlled infusion rocuronium was significantly longer than that of intravenous infusion group,and the induction dose of rocuronium was significantly higher than that of intravenous injection group(P<0.01).The time of T1 recovery to 25%,75%,90% and recovery index in the target-controlled infusion group were significantly shorter than that of intravenous injection group after drug withdrawal(P<0.01).The amount of rocuronium per unit time maintenance and total amount of rocuronium during operation were significantly decreased in the target-controlled infusion group(P<0.01).Surgeons’ satisfaction with muscle relaxation was higher under target-controlled infusion(P<0.01).Conclusion Target-controlled infusion of rocuronium is not suitable for induction in patients with obstructive jaundice,but the maintenance of target-controlled infusion is more suitable for such patient,which may reduce the amount of intraoperative muscle relaxants,reduce postoperative residual muscle relaxants,and promote rapid recovery of patients.