Objective To identify the prognostic serum markers of closed craniocerebral injury,and provide a new basis for early prediction of the prognosis of closed craniocerebral injury.Methods Bioinformatics analysis of the Gene Expression Omnibus(GEO) GSE123336 dataset revealed a potentially valuable miRNA-miR-125b-2-3p.To redict possible dysregulation mechanisms,enrichment analysis and miRNA target gene prediction were performed using the mirPATH database.Quantitative reverse transcription polymerase chain reaction(qRT-PCR) was used to detect the expression of miR-125b-2-3p in the serum samples of patients with closed head injury collected in our hospital.Anlysis of expression of miR-125b-2-3p to verify whether the differential expression exist and relationship with Glasgow coma scale(GCS)/Glasgow Outcome Scale(GOS).Results The top3 differential genes in the GEO GSE123336 database were miR-125b-2-3p,miR-10b-5p,and miR-99b-5p.The enrichment analysis of differential miRNAs suggested that miR-125b-2-3p was closely associated with the MAPK pathway and the sphingolipid signaling pathway.The expression of miR-125b-2-3p increased significantly after head injury(23.79±24.96) than before(5.35±6.28)(P<0.05).The expression of miR-125b-2-3p in samples from our hospital increased with the severity of the brain injury(mild head injury 1.02±0.36,moderate injury 2.23±0.53,severe injury 3.33±0.90,extra severe injury 3.74±1.06),P<0.05.The expression of miR-125b-2-3p is negatively correlated with the patient's Glasgow Coma Scale,and significantly positively correlated with the severity of injury.Further analysis indicated that the serum expression of miR-125b-2-3p was negatively correlated with GOS(Glasgow Outcome Scale)(Ⅰ/Ⅱ 4.12±0.74，Ⅲ 3.45±0.51，Ⅳ 2.40±0.66，Ⅴ 1.34±0.71,P<0.05).Conclusions Serum miR-125b-2-3p is a potential prognostic marker of closed head injury.The high expression of serum miR-125b-2-3p indicates a poor prognosis.

Objective To evaluate the value of intravoxel incoherent motion(IVIM) parameters in a group of patients with pre-operative gliomas,predicting tumor grade in the solid tumor area and peritumoral edema areas,and its correlation with the expression of Ki-67.Methods A retrospective analysis of 51 patients with histopathologically confirmed gliomas was performed.All patients underwent brain MRI scan,enhanced and IVIM examination before operation,and the Ki-67 marker index of glioma was obtained by immunohistochemistry after operation.The IVIM parameters of the largest solid area of the tumor and the peritumoral edema area were measured respectively to obtain ADC,pure water diffusion coefficient(D),pseudo-diffusion coefficient(D*),and perfusion fraction(perfusion).fraction,f) value,Kruskal-Wallis test and Mann-Whitney U test were used to compare the differences of four quantitative parameters of tumor body area and peritumoral edema area between grades Ⅱ,Ⅲ,and Ⅳ and between high and low grade groups.The ROC curve was used to evaluate the diagnostic performance of each parameter in differentiating high and low grades of glioma.Spearman's method was used to analyze the correlation between IVIM quantitative parameters and Ki-67 labeling index.Results The ADC value of grade Ⅱ was higher than that of grade Ⅲ and Ⅳ,and that of low-grade glioma was higher than that of high-grade glioma;The D value of grade Ⅱ was higher than that of grade Ⅳ,and the low-grade glioma was higher than that of high-grade glioma;The D*value of grade Ⅱ and III is lower than grade Ⅳ.The f value of grade Ⅱ is lower than grade Ⅳ.In the peritumoral edema area,the ADC value of grade Ⅲ is higher than that of grade Ⅳ;The D value of grade Ⅱ glioma is higher than grade Ⅲ,and the D value of grade III glioma is lower than grade Ⅳ;There is no significant difference between the levels of D* value;The f value of grade Ⅱ glioma was lower than grade Ⅳ;Level Ⅱ f value is lower than level Ⅳ.There was no significant difference in the parameters of edema area between low and high-grade gliomas.Ki-67 was significantly correlated with ADC,D and D* of the solid tumor area.There was no significant correlation between Ki-67 and peritumoral edema parameters.Conclusions IVIM parameters of glioma solid tumor area can evaluate tumor grade non invasively and correlate with Ki-67.

Objective The aim of this study is to explore the impact of early enteral nutrition (EN) on postoperative prognosis of patients with hypertensive intracerebral hemorrhage (HICH),with a special focus on postoperative secondary hydrocephalus.
Methods The clinical data of 46 HICH patients who underwent surgical treatment in our department between Jan 2018 and Dec 2020 were retrospectively analyzed.Patients were divided into two groups: early EN group (EN administration within 48 h after operation) and delayed EN group (EN administration later than 48h after operation).The incidence of postoperative hydrocephalus was evaluated according to postoperative imaging data,and the postoperative Glasgow coma score (GCS) and Glasgow Outcome score (GOS) were used to comprehensively evaluate the prognosis of patients.Besides,the age,gender and other relevant clinical data were collected to analyze the risk factors of postoperative hydrocephalus in patients with HICH.Results Of 46 patients,8 patients  suffered from acute hydrocephalus,while 6 cases  experienced chronic hydrocephalus.Compared with the delayed EN group,patients in the early EN group had a lower incidence of chronic hydrocephalus (4.3% vs.33.3%,P=0.029),higher postoperative GCS score (10.8±2.1 vs.9.4±2.0,P<0.05) and GOS score (4.1±0.5 vs.3.6±1.1,P<0.05).The incidence of acute hydrocephalus had no significant difference between two groups (8% vs.28.6%,P<0.05.In addition,chronic hydrocephalus was also closely associated with low preoperative GCS score and intraventricular hemorrhage (P<0.05),while acute hydrocephalus was only associated with intraventricular hemorrhage (P<0.05).Conclusion Early EN administration could remarkably decrease the occurrence of postoperative chronic hydrocephalus and improve the prognosis of HICH patients.

Objective To explore the clinical value of image defined risk factors(IDRFs) in the surgical guidance and postoperative complication prediction of abdominal neuroblastoma in children.Methods A retrospective analysis of clinical data of 77 cases of abdominal neuroblastoma without chemotherapy and undergoing surgical treatment in our hospital from January 2018 to February 2020 was performed.The children were evaluated by IDRFs staging method,and the efficacy of IDRFS staging method in guiding the surgery of abdominal neuroblastoma in children and predicting postoperative complications was explored.Results According to INSS staging method,the 77 children were divided into stage Ⅰ(n=24),stage Ⅱ(n=41) and stage Ⅲ(n=12).According to the IDRFs staging method,there were 26 cases in stage L1 and 51 cases in stage L2.The complete surgical resection rates in stage L1 and L2 were 80.77% and 49.02%,respectively(P＜0.05).Intraoperative blood transfusions in stage L1 and stage L2 were recorded in 3 cases(11.54%) and 20 cases(39.22%) respectively(P＜0.05).The operation time in stage L2 was significantly longer than that in stage L1.The incidence of organ damage,invasive organ resection and intraoperative hemorrhage in stage L2 was significantly higher than that in stage L1(P＜0.05).The frequency of intraoperative complications in stage L2 was significantly higher than that in stage L1(P＜0.05).The incidence of incision effusion and hematoma in stage L2 was significantly higher than that in stage L1(P＜0.05).The frequency of postoperative complications in stage L2 was significantly higher than that in stage L1(P＜0.05).In Spearman’s correlation analysis,there was a medium correlation between stage L1 and postoperative complications(r=0.416,P＜0.05),and a strong correlation between stage L2 and postoperative complications(r=0.711,P＜0.05).ROC curve analysis showed that the AUC of stage L1 was 0.702,the sensitivity was 67.2%,and the specificity was 65.1%.Stage L2 AUC was 0.887,sensitivity was 86.2%,and specificity was 80.3%.Conclusion IDRFs staging is valuable to evaluate and guide the surgical treatment of pediatric abdominal neuroblastoma before surgery,and is important for predicting postoperative complications.

Objective To observe the clinical effect of ventriculoscopy combined with laparoscopy-assisted ventriculo-peritoneal shunt in the treatment of hydrocephalus.Methods A total of 72 patients with hydrocephalus admitted from February 2016 to May 2021 were divided into two groups according to different treatment methods.42 patients who underwent ventriculoscopy combined with laparoscopic assisted ventriculoperitoneal shunt in our hospital were used as the observation group and 30 patients who underwent traditional operation were used as the control group.The therapeutic effects of the two groups were evaluated and compared.Results  The operation time(57.32±5.61)min,blood loss(40.52±3.58)ml,ventilation time(1.51±0.42)d and postoperative hospital stay(7.83±0.58)d in the observation group were less than those in the control group[(70.58±8.42)min,(50.38±5.53)ml,(2.93±0.83)d,(8.95±0.67)d,P<0.05].The total incidence of adverse complications in the observation group(2.38%)was lower than that in the control group(26.67%)(P<0.05).After one year of follow-up,the incidence of shunt failure in the two groups was compared(13.33%,9.52%).The difference was not statistically significant(P>0.05).Conclusion Ventriculoscopy combined with laparoscopy assisted ventriculoperitoneal shunt in the treatment of hydrocephalus has less complications,minimally invasive and safe.

Objective To investigate the long-term visual and olfactory prognosis and recurrence rate of patients with tuberculum sellae meningioma(TSM) operated by the ipsilateral or contralateral transcranial approach.Methods Retrospective analysis was made on 44 patients with unilateral TSM who received surgical treatment in neurosurgery department of our hospital from March 2012 to April 2018.The ipsilateral or contralateral approach was selected according to the main compressed side of the optic nerve.The surgical outcome,visual acuity,visual field improvement and complications were evaluated.Results The visual acuity decreased in 40 cases before operation,recovered completely in 18 cases,improved in 10 cases,remained unchanged in 8 cases,and deteriorated further in 4 cases.Among 42 cases with visual field defect before operation,20 cases were completely recovered,12 cases were significantly improved,2 cases had stable visual field,and 4 cases had long-term visual impairment after operation.The contralateral approach was more conducive to the improvement of visual field defect in patients with TSM after surgery(OR=0.379,95% CI=0.125~0.954,P=0.038).However,the rate of olfactory nerve injury after contralateral approach was higher(45.0% vs.12.5%,P=0.016).94.4%(17/18) of patients with contralateral approach and 50.0%(6/12) of patients with ipsilateral approach achieved gross total resection of tumors invading the optic canal(P=0.005).During the follow-up period,5 cases(10.6%) recurred,all of them were Simpson Grade Ⅳ subtotal resection(including 2 WHO Grade Ⅱ).Conclusion Resection of TSM via contralateral approach seems to provide better visual field improvement rate and overall tumor resection rate,but increases the risk of olfactory nerve injury.

Objective To investigate the expression of lncRNA PCAT6 and miR-16 in human glioma and their relationship with clinicopathological features and prognosis.Methods 94 glioma tissues frozen in the pathology department of Xi’an First Hospital from June 2016 to June 2018 were selected as the study group,and 100 brain tissues removed during craniocerebral injury decompression in the same period were selected as the control group.The relative expression levels of lncRNA PCAT6 and miR-16 were measured by real-time fluorescence quantitative PCR(qRT-PCR),and the patients were followed up for 3 years.Results The expression of lncRNA-PCAT6 in glioma tissue of the study group was significantly higher than that of the control group(P<0.05),while the expression of miR-16 was significantly lower than that of the control group(P<0.05).The proportion of patients with high WHO grade in lncRNA-PCAT6 high expression group and miR-16 low expression group was significantly higher than that in lncRNA-PCAT6 low expression group and miR-16 high expression group(P<0.05).The 3-year overall survival rate in lncRNA-PCAT6 high expression group and miR-16 low expression group was significantly lower than that in lncRNA-PCAT6 low expression group and miR-16 high expression group(P<0.05).High WHO grade,lncRNA-PCAT6 high expression and miR-16 low expression were independent risk factors affecting the poor prognosis of glioma patients(P<0.05).Conclusion lncRNA-PCAT6 is highly expressed in gliomas and miR-16 is low expressed in gliomas.Its expression level is significantly correlated with the prognosis of patients.

Objective To evaluate the basic characteristics and treatment effects of elderly patients with acute traumatic intracranial hematoma,and analyze the factors related to the prognosis.Methods This study retrospectively analyzed the clinical data of 328 elderly patients with acute traumatic intracranial hematoma from January 2019 to December 2021.The Glasgow Outcome Scale is used to evaluate the clinical prognosis,and they are divided into a good prognosis group and a poor prognosis group according to the scores.Logistic regression is used to analyze independent predictors of poor prognosis.Results 328 patients with acute traumatic intracranial hematoma were enrolled in the study.Two hundred and eleven patients had a good prognosis,117 patients had a poor prognosis,and 75 of them died.One hundred and ten cases  were treated surgically,62 caseshad a good prognosis,and 48 cases  had a poor prognosis.Multivariate Logistic analysis showed that male,pupil abnormality,GCS≤8，compressed or closed cisternand ICU stay≥3 days were independent predictors of poor prognosis.Surgical treatment was an important factor that negatively predicts poor prognosis.Conclusion The prognosis of elderly patients with severe head injury is very poor.Male,pupils with abnormal light reflex,GCS≤8,and compressed or closed cisterns and longer ICU stay(≥3 days) are the risks of poor prognosis.Administrating operation for the elderly patients with intracranial hematoma who need surgery might improve the outcome.

Objective To compare the clinicopathological characteristics and survival outcomes of elderly(≥60 years old) and younger(<60 years old) patients with anaplastic thyroid cancer(ATC).Methods The information about clinicopathological characteristics and prognostic in patients with diagnosed ATC was from 1998~2016 was extracted from the Surveillance,Epidemiology,and End Results(SEER) database.A total of 516 eligible patients and divided into the elderly group(n=391) and the younger group(n=125).Compared the clinicopathological characteristics between the two groups by using chi-square test.The Kaplan-Merrier and Cox regression methods were used to determine the prognostic factors of ATC.Finally,analyzed the mortality risk of two groups in the tumor staging subgroups.Results The younger group was more likely to receive radiotherapy(75.9% vs.55.5%) and chemotherapy(66.7% vs.39.5%).In addition,the specific survival rate and overall survival rate of young patients were significantly higher(P<0.05).Multivariate Cox regression analysis revealed that age<60-years-old was significantly associated with the better prognosis（OS:HR=0.69,95%CI=0.56~0.86,P=0.001;CSS:HR=0.73,95%CI=0.59~0.92,P=0.007）.And age<60-year-old was an independent predictor of prognosis in ATC patients with distant metastasis.Conclusion The prognosis of elderly ATC patients is worse than that in younger patients and age may be a prognostic factor for anaplastic thyroid cancer.

Objective To study the protective effect of nerve detection technique(IONM) on recurrent laryngeal nerve(RLN) in Miccoli endoscopic assisted complex thyroid surgery.Methods The clinical data of one hundred and two patients who underwent complex thyroidectomy in our hospital from February 2019 to February 2020 were collected retrospectively.They were divided into two groups according to the time of admission,of which the patients selected from February 2019 to August 2019 were the control group and the patients selected from September 2019 to February 2020 were the observation group,with fifty-one cases in each group.The control group was treated with conventional RLN exposure combined with endoscopic assisted surgery in Miccoli mode,and the observation group was treated with endoscopic assisted surgery in IONM combined with Miccoli mode.The operation conditions(operation time,bleeding volume,RLN exploration time,drainage volume and hospital stay) of the two groups were compared,the pain degree [visual analog score(VAS score)] at 6 h,12 h and 24h after operation were compared,and the voice condition [voice disorder index(VHI score)] and the incidence of postoperative recurrent laryngeal nerve injury(RLNi) at 3 months after operation were evaluated.Results The bleeding of observation group was  ( 24.20 ±3.23)ml, volume of drainage was (30.52 ±4.36)ml, length of hospital stay was (4.26 ±0.58) days, while the data in the control group were (25.12±3.14)ml,(31.10±4.41)ml,(4.31±0.62)d, respectively.There was no significant difference between the two groups(P>0.05).The operation time(96.52±11.03)min and RLN exploration time(7.59±1.02)min in the observation group were shorter than those in the control group[(141.26±13.47)min and(13.10±2.23)min,P<0.05].The VAS scores at 6h,12h and 24h in the observation group were(4.36±1.07),(3.59±0.84) and(1.89±0.46),respectively,and the VAS scores at 6h,12h and 24h in the control group were(4.56±1.18),(3.66±0.95) and(1.93±0.52),respectively.The VAS score of the two groups decreased gradually after operation(P<0.05).However,there was no significant difference in VAS score between the two groups(P>0.05).The VHI score of the observation group(13.38±2.52) was lower than that of the control group(17.99±3.46) 3 months after operation(P<0.05).The total incidence of RLNi in the observation group was 3.92%,which was lower than the control group(17.65%,P<0.05).Conclusion IONM can shorten the exploration time and operation time of RLN in Miccoli endoscopic assisted complex thyroid surgery,improve the voice condition,reduce the incidence of RLNi,and improve the operation effect.

Objective To investigate the clinical value of estrogen and combined detection with common lung cancer biomarkers in the diagnostic efficiency of male lung cancer patients.Methods This study included 141 male patients with lung disease who have tested the serum E2 level between January,2019 and May,2021.The serum levels of carcinoembryonic antigen (CEA),cancer antigen 125 (CA125) and neuron specific enolase (NSE) were measured and statistically analyzed for comparing with estrogen.Results The study included 28 patients with benign lung lesions (BPL) and 113 patients with lung cancer.The results showed that the level of E2 in patients with lung cancer was significantly increased (P=0.003 4) and positively correlated with TNM staging (P=0.002 2).Patients with stage Ⅰ~Ⅱ and N0-N1 showed a decline in E2 postoperatively,while most patients with stage Ⅲ~Ⅳ and N2 showed an increase in E2 level after surgery.With BPL group as control,E2 showed the highest sensitivity and accuracy in the diagnosis of lung cancer compared with CEA,CA125 and NSE.Combined detection of E2,CEA and CA125 showed the best diagnostic ability (AUC=0.837).Conclusions Estrogen is a potential biomarker for the diagnosis of male lung cancer.

Objective  To explore the expression change and clinical implication of apolipoprotein H(ApoH) in aortic dissection(AD).Methods Fifteen patients with Stanford type A aortic dissection(TAAD) in Tongji Hospital from August 2015 to January 2020 were included,and the ascending aortic tissue extracted during the operation was used as the TAAD group.Normal ascending aortic wall clipped during heart transplantation or cardiopulmonary transplantation was selected as the control group（9 cases）.The protein levels of ApoH were detected in the two groups,and Pearson correlation analysis was used to analyze the relationship between the protein levels of ApoH and the aortic diameters of patients with TAAD.Results Western blot and immunohistochemical staining showed that the expression levels of ApoH in the aortic wall of TAAD group was significantly higher than that of the control group(P<0.05).However,there was no significant correlation between the protein levels of ApoH and the aortic diameters of TAAD(P>0.05).Conclusion The protein expression of ApoH is significantly upregulated in aortic wall of patients with TAAD,suggesting that ApoH may be involved in the pathogenesis of AD.Targeting ApoH may be a potential new strategy for delaying AD.

Objective  To explore the application value of in-bed bicycle exercise in early postoperative rehabilitation of patients with severe acute pancreatitis.Methods A retrospective analysis of 161 patients with severe acute pancreatitis admitted to the ICU of the Xijing Hospital,Affiliated Air Force Medical University from January 2016 to December 2020.A total of 89 cases were divided into the observation group(in-bed bicycle exercise) and 72 cases in the control group(traditional in-bed exercise).Record the implementation rate of exercise,inflammation indicators,defecation time,muscle strength classification of both lower limbs,ECOG score,first time to get out of bed,abdominal distension score,deep vein catheterization displacement,abdominal drainage tube dislodged and other adverse events.Results There was no statistical difference in the implementation rate of exercise within 72 h between the two groups(P>0.05).Two groups had no statistical difference in deep vein catheterization displacement,abdominal drainage tube dislodged(P>0.05).The observation group’s abdominal distension score,defecation time,and the first time to get out of bed were significantly earlier than the control group(P<0.05).The muscle strength of both lower limbs and ECOG scores were significantly higher than those of the control group at 1 week after surgery(P<0.05) and inflammation indicators decreased.Conclusion Patients with severe acute pancreatitis have better compliance with in-bed bicycle exercise in the early postoperative period,without increasing the incidence of postoperative adverse events.It is worthy of clinical promotion while promoting the rehabilitation of patients without increasing the burden of nursing.

Objective To study and analyze the expression of the cluster of differentiation 74,CD74 in tissues of gallbladder cancer and its correlation of the expression of EGFR.Methods We used the immunohistochemistry to analyze the expressions of CD74 and EGFR in tissues of gallbladder cancer from 54 patients.The clinicopathological characters of gallbladder cancer patients and the expression of CD74 was also studied.We used the western blot to analyze the expression of CD74 in the fresh gallbladder cancer tissues.The Spearman rank correlation was used to analyze the association between CD74 and EGFR.
Results The expression of CD74 had no difference between men and women,and the expression of CD74 had no correlation with the age of patients(P>0.05).The expression of CD74 in poorly differentiated gallbladder cancer tissues was significantly higher than that in moderately and well differentiated gallbladder cancer(P<0.05).The expression of CD74 with highly invasion depth was significantly higher than that in low invasion depth(P<0.05),but there was no significant difference with the N stage of tumor tissue(P>0.05).There was significant difference in the expression of CD74 between gallbladder carcinoma with early TNM stage and gallbladder carcinoma with poor TNM stage(P<0.05).Spearman rank correlation analysis showed that the IOD value of IHC of CD74 was positively correlated with the IOD value of EGFR.
Conclusion CD74 is highly expressed in poorly differentiated gallbladder cancer,and it is positively correlated with EGFR.It is a potential target for the treatment of gallbladder cancer.

Objective To compare the efficacy and safety of built-in 4F ureteral catheter and built-in 5F ureteral catheter combined with holmium laser lithotripsy in the treatment of ureteral calculus.Methods The clinical data of 68 calculus patients treated in our hospital from January 2020 to March 2021 were collected.Two groups were divided according to the different diameters built into ureteroscope,32 patients underwent ureteroscope built-in 4F ureteral catheter drainage lithotripsy (4F group),and 36 patients underwent ureteroscope built-in 5F ureteral catheter drainage lithotripsy (5F group).The perioperative results,calculus removal rate,and postoperative complication rate were compared between the two groups.Results The highest renal pelvic pressure(21.5±3.0)mmHg in the 5F group were lower than those in the 4F group(24.3±3.9)mmHg,ureteral catheter drainage temperature(26.4±2.9)℃，were lower than those in the 4F group(31.3±3.6)℃,number of tube blockages(2.1±0.3)were lower than those in the 4F group(2.9±0.5),and maximum calculus displacement distance(1.6±0.3)cm were lower than those in the 4F group(2.2±0.4cm),and the differences between the two groups were statistically significant (P<0.05).However,there was no statistical difference in operation time,calculus removal rate,and fever rate between the two groups (P>0.05).There was no ureteral perforation or mucosal avulsion in both groups after operation.Conclusion The ureteroscopy built-in 5F ureteral catheter and built-in 4F ureteral catheter lithotripsy are safe and effective for the treatment of ureteral calculus.However,the built-in 5F ureteral catheter can reduce the maximum intraoperative renal pelvic pressure and the temperature of the ureteral catheter drainage fluid,and reduce the distance of the calculus moving up.

Objective To analyze influencing factors of efficacy of Kirschner wire combined with proximal locking plate double row raft technique(PLPDRRT) in patients with lateral tibial plateau fractures(LTPF).Methods The data were collected from 212 LTPF patients admitted to the hospital between January 2017 and March 2021.Efficacy evaluation and grouping were conducted.The factors influencing efficacy of Kirschner wire combined with PLPDRRT were analyzed by multivariate Logistic regression analysis.Results  Follow-up results showed that there were 102 cases(48.11%) with excellent,68 cases(32.08%) with good,26 cases(12.26%) with common and 16 cases(7.55%) with poor efficacy.Therefore,there were 170 cases in good group and 42 cases in poor group.Differences in age,fracture types,other knee injuries operation time,intraoperative bleeding and postoperative complications between the two groups were statistically significant(P<0.05).Type Ⅵ fracture,combined injury around knee,operation time ≥150min and postoperative complications were independent risk factors of good efficacy(P<0.05).Conclusion There are many factors influencing efficacy of Kirschner wire combined with PLPDRRT in LTPF patients,which may be closely related to fracture types,other injuries around the knee,operation time and postoperative complications.

Objective To investigate the effect of using Kirschner wire tension band plus titanium cable ring tie on the limb function and short-term efficacy of patients with complex patella fracture.Methods A total of 100 patients who underwent patella fracture surgery from December 2018 to December 2020 were selected and divided into the observation group and the control group,50 patients in each group according to the treatment method.The observation group was treated with Kirschner wire tension band plus titanium cable ring ligating,and the control group was treated with Kirschner wire tension band.The surgical conditions of the two groups were compared.Fracture healing;Excellent rate of joint function;The incidence of complications,pain score and satisfaction were compared between the two groups.Results The average postoperative length of hospital stay in the observation group was(8.62±2.69) d,shorter than the (10.54±3.54) d in the control group,and the average pain score was (2.51±0.24) points,which was less than the (5.52±0.72) points(P<0.05) in the control group.The average fracture healing time in the observation group was (10.74±1.58) weeks,which was shorter than that of the control group at (13.54±2.69) weeks,and the overall good rate of fracture healing was 88.00%,which was higher than that of the control group of 60.00%(P<0.05).The excellent rate of joint function in the observation group was 92.00%,which was higher than that of the control group(P<0.05).The complication rate in the observation group was 4.00%,lower than the 20.00(P<0.05) in the control group.The total satisfaction rate of the observation group was 86.00%,which was higher than that of the control group of 72.00%(P<0.05).Conclusion Kirschner wire tension band plus titanium cable ring ligating is effective in the treatment of complex patella fracture,which can improve the limb function of patients with less complications.

Objective To investigate the effect of unilateral dual-channel endoscopy on the recovery of lumbar spine function in patients with free lumbar disc herniation.Methods A total of 93 patients with free lumbar disc herniation who were admitted to the hospital from October  2020 to September  2021 were selected as the research objects.All patients received unilateral dualchannel endoscopic treatment.Surgery-related indicators of 93 patients(intraoperative blood loss,operative time,and postoperative bedtime) were counted.The modified MacNab efficacy evaluation standard was used to evaluate the efficacy 12 months after the operation.Visual analogue scale(VAS) and Oswestry dysfunction index(ODI) were compared before operation,1 month after operation,and 12 months after operation.The incidence of complications within 3 months after the operation and the recurrence rate within 12 months after the operation were recorded.Results The operation time,intraoperative blood loss,and postoperative bed rest time of 93 patients were(82.35±10.61)min,(48.47±6.59)ml,and (8.65±1.72)d,respectively.At 12 months after operation,the excellent and good rate of 93 patients was 92.47%.At 12 months after operation,the VAS score and ODI of the patients were lower than those at 1 month after operation and before operation(P<0.05).One month after operation,the VAS score and ODI of the patients were lower than those before operation(P<0.05).At 3 months after surgery,the overall complication rate among 93 patients was 6.45%.At 12 months after surgery,3 of the 93 patients had recurrence,and the recurrence rate was 3.23%.Conclusion The unilateral dual-channel endoscopy technique is effective in the treatment of free-type lumbar disc herniation,which can relieve the patient’s low back and leg pain,restore lumbar spine function.

Objective To evaluate the value of continuous renal replacement therapy in the maintenance of marginal donor lungs.Methods A retrospective analysis of 30 marginal donor lungs maintained by the Lung Transplantation Center of Wuxi People’s Hospital from January 1,2019 to October 31,2019,of which 12 cases(set as the experimental group) received routine and CRRT combined program for 48 hours,and 18 cases(set as the control group) received routine maintenance.Peripheral blood samples were collected every 24 hours.Chest X-ray exam and airway bronchoscopy were performed in both groups.Results After maintenance by two methods,the quality of the donor lungs in both groups improved when compared with the previous ones.The oxygenation index in the experimental group was significantly higher than that in the control group[(93.58±16.92)% vs.(57.72±11.41)%,P<0.001)].The inflammatory indexes(CRP,PCT) were significantly decreased[(CRP:(36.04±22.30 )mg/L vs.(18.01±6.78)mg/L,P＜0.05];[PCT:(1.09±0.45)ng/L vs.(0.59±0.82)ng/L,P＜0.05)].The exudation changes and airway mucosal edema in the experimental group were significantly improved.8 cases in the experimental group and 5 cases in the control group reached the donor criteria for transplant,and the utilization rate was significantly higher than that in the control group(P＜0.05).Conclusion CRRT can significantly improve the lung function of marginal donor lungs and improve the utilization rate of donor organs. 

Glioma is the most common intracranial malignant tumor,among which glioblastoma is the most malignant and still incurable.The main reasons for its recurrence include high heterogeneity of tumor,invasive growth,resistance to existing treatments,etc.Many genetic changes promote the occurrence and malignant progression of glioma.At present,great progress has been made in the molecular research of glioma.Individualized and precise treatment for genetic changes may be the hope of curing glioma in the future,but the results of many basic trials and clinical studies are still not ideal.In this article,based on relevant literature,we reviewed the progress of molecular research and targeted therapy of glioma.