Objective  To evaluate the clinical efficacy of locking plate with cable hole and greater trochanteric union device in the treatment of Vancouver type B1 periprosthetic femoral fractures. Methods A retrospective analysis of the clinical data of 27 patients(27 hips) who underwent internal fixation with locking plates combined with cable loops for periprosthetic femoral fracture in Renmin Hospital of Wuhan University from January 2016 to September 2021.The surgery time,intraoperative bleeding volume,hospitalization days,complete weight bearing time,Harris hip functional score,and VAS pain score were recorded.Prosthesis and internal fixation plate stability and fracture healing were assessed by digital radiographs.Results All 27 patients were followed up for 12-58 months,with a mean of(21.74±15.42) months.All patients achieved fracture healing without infection,dislocation,loosening,non-union or malunion,and the mean preoperative HHS functional score and VAS pain score were(31.84±3.92) and(7.63±0.97) points.The mean HHS and VAS pain scores at the final postoperative follow-up were(85.43±4.73) and(2.00±0.78),and the clinical outcomes of HHS scores and VAS pain scores were significantly better after treatment with locking plates combined with cable ring internal fixation,with statistically significant differences(P<0.05).ConclusionThe treatment of periprosthetic femoral fractures of Vancouver B1 type with a locking plate with a cable hole and a greater trochanteric union device can achieve satisfactory clinical outcomes.

Objective  To observe the effect of CT three-dimensional reconstruction technique in the treatment of unstable pelvic fractures with anterior sacroiliac joint plate. Methods  From January 2020 to January 2022, Eighty patients with unstable pelvic fracture(treated in our hospital) were selected and divided into control group(40 cases) and combined group(40 cases) according to the random number table method.The control group was given anterior sacroiliac joint plate treatment,combined with CT three-dimensional reconstruction technology on the basis of the control group.Intraoperative and postoperative related indicators,pain degree,fracture reduction,fracture functional recovery and complications were compared.Results  There was no obvious difference in the amount of bleeding,fracture healing time,and preoperative VAS score between the two groups(P>0.05).Compared between the control group with the combined group,the time of getting out of bed [(4.52±0.57)w vs(5.14±0.63)w],weight bearing time [(9.75±1.12)w vs(11.53±1.26)w],hospital stay [(10.35±1.26)d vs(12.78±1.31)d] and operation time [(65.78±6.62)min vs(85.49±8.67)min],1 week [(4.72±0.64) vs(5.11±0.78)],2 weeks [(4.01±0.57) vs(4.65±0.64)],4 weeks [(2.31±0.27) vs(3.45±0.36)]VAS scores were lower than those of the control group(P<0.05).The excellent and good rate of fracture reduction(97.50%) and the excellent and good rate of fracture function recovery(95.00%) in the combined group were greatly higher than those in the control group(80.00%,75.00%)(P<0.05); the incidence of complications such as osteonecrosis in the combined group(7.50%) was greatly lower than that in the control group(27.50%)(P<0.05). Conclusion   CT three-dimensional reconstruction technology applied to the treatment of unstable pelvic fracture injury with anterior sacroiliac joint plate can effectively shorten the operation time,reduce the pain of patients,and promote postoperative recovery,which is safe and effective.

Objective  To investigate the characteristics of the three-dimensional gait changes of the knee joint after the single bundle anatomical reconstruction of autologous hamstring tendons after the rupture of the anterior cruciate ligament (ACL) of the knee. Methods  From August 2018 to June 2020，twenty five patients with ACL rupture of the lateral knee joint were selected as the injury group.During the operation,ACL rupture was confirmed by arthroscopy and the autologous hamstring tendon anatomical reconstruction was performed.Then 25 healthy people were selected as the control group.The three-dimensional gait data of normal knee joints were recorded with the three-dimensional motion capture system and compared with the injury group.In addition,the injury group was followed up before and after surgery and Lysholm knee joint function score was performed. Results  In the control group,the flexion and extension angle was - 2 °~66 °,the internal and external rotation angle was - 5 °~9 °,and the internal and external rotation angle was - 4 °~8 °.After ACL injury,the flexion and extension angle is - 5 °~52 °,the internal and external rotation angle is - 3 °~24 °,and the internal and external rotation angle is - 13 °~14 °.Three months after ACL autologous hamstring tendon reconstruction,the flexion and extension angle was - 2 °~47 °,the internal and external rotation angle was - 5 °~9 °,and the internal and external rotation angle was - 6 °~10 °.Six months after ACL reconstruction,the flexion and extension angle was - 2 °~59 °,the internal and external rotation angle was - 4 °~8 °,and the internal and external rotation angle was - 5 °~8 °.Nine months after ACL reconstruction,the flexion and extension angle was - 2 °~64 °,the internal and external rotation angle was - 2 °~9 °,and the internal and external rotation angle was - 2 °~8 °.12 months after ACL reconstruction,the flexion and extension angle was - 2 °~65 °,the internal and external rotation angle was - 1 °~9 °,and the internal and external rotation angle was - 1 °~8 °.After ACL rupture,the variation range of knee joint from flexion to extension,internal and external rotation,and internal and external turnover angle became larger than that of the control group,and there was significant difference in statistics(P<0.05).The angle range of each motion direction of knee joint after reconstruction was significantly improved compared with that before surgery（P＜0.05）,the difference at each time point after reconstruction was statistically significant compared with that before reconstruction(P<0.05).The gait at 9 and 12 months after reconstruction was significantly improved compared with that at 3 months after reconstruction (P<0.05).The Lysholm score increased from (62.35±3.45) before operation to (93.62±3.51) at 12 months after operation,and the difference was significant (P<0.05).  Conclusion  ACL reconstruction surgery has played a role in stabilizing the knee joint and improved the Lysholm knee joint function score,and with the passage of time after the operation,the Lysholm knee joint function score gradually improved,and basically returned to normal 9 months after the operation.

Objective  To analyze the safety and effectiveness of combined anterior and posterior knee approach in the treatment of complex hyperextension tibial plateau fractures. Methods  92 patients with complex hyperextension tibial plateau fractures treated in the department of trauma and orthopedics of our hospital from February 2015 to February 2020 were analyzed retrospectively.The patients in the combined group received combined anterior and posterior knee approach (48 cases),and the patients in the central group received traditional anterior and median knee approach (44 cases).The perioperative conditions,follow-up indexes and imaging evaluation in 2 groups were recorded and compared.Results  The perioperative indicators such as intraoperative blood loss,radiation exposure time,postoperative drainage volume and hospital stay in the combined group were significantly lower than those in the median group (P＜0.05).At the last follow-up,the incidence of adverse reactions in the combined group was significantly lower than that in the median group (6.82% vs.13.16%,P＜0.05).At 3 months after operation and at the last follow-up,the hospital for special surgery (HSS) score of the knee joint [(64.57±0.47) vs.(56.39±0.46)] and Rasmussen score[(16.42±0.46) vs.(12.39±0.41)] in the combined group was safe than the median group(both P＜0.05).At the last follow-up,the improvement of tibial plateau imaging indexes such as varus angle[(84.16±4.89)° vs.(89.14±6.78)°],femoral tibial angle[(176.64±4.21)° vs.(167.65±3.83)°] and posterior dip angle[(11.54±0.79)° vs.(9.65±0.83)°] in the combination group was significantly lower than that in the median group (P<0.05). Conclusion The combined approach in the treatment of complex hyperextension tibial plateau fractures has satisfactory curative effect in restoring knee function,alleviating pain symptoms,promoting fracture healing,reducing perioperative indicators and avoiding the impact of surgical trauma on rehabilitation as much as possible.

Objective  To observe the clinical effect of shoulder abduction brace combined with trigen interlocking intramedullary nail in the treatment of proximal humeral fractures.  Methods  55 patients with proximal humeral fractures treated in our hospital from January 2020 to January 2021 were divided into two groups according to different treatment schemes.The control group:26 patients were treated with trigen interlocking intramedullary nail.Study Group:29 cases were treated with shoulder abduction brace combined with trigen interlocking intramedullary nail.The results of reduction evaluation,clinical healing time of fracture,bone healing time of fracture,constant Murley shoulder function score and shoulder range of motion were compared.  Results  The reduction assessment of the study group were significantly better than those of the control group.The clinical healing time of fracture in the study group was shorter than that in the control group,and the bone healing time of fracture was shorter than that in the control group(P＜0.05).One year after operation,the constant Murley shoulder function score of the control group and the study group were were higher than 1 month after surgery(P＜0.05).One year after operation,the constant Murley shoulder function score of the study group was not significantly different from that of the control group(P＞0.05).Following up for 1 year,there was no significant difference between the two groups in the activities of flexion and lifting,external rotation and abduction(P＞0.05).  Conclusion  The shoulder abduction brace combined with trigen interlocking intramedullary nail is conducive to the reduction of proximal humeral fractures,shorten the clinical healing time and bone healing time of fractures,and it is conducive to improving the early shoulder joint function and range of motion.

Objective  To reveal the expression and underlying mechanism of LINC01197 in lung adenocarcinoma(LUAD).  Methods   The expression of LINC01197 was detected by real-time fluorescence quantitative PCR(qRT-PCR),and the expression of Notch signaling molecules(Notch1 and Hes1) were detected by Western blot.Cell proliferation and invasion ability were analyzed by MTT,colony formation and Transwell assays.The effect of LINC01197 on tumor growth was examined in a xenograft tumor assay.  Results  LINC01197 was down-regulated in LUAD,and the protein levels of Notch1 and Hes1 were both up-regulated(P<0.05).Overexpression of LINC01197 inhibited LUAD cell proliferation and invasion,while knockdown of LINC01197 had the opposite effect(P<0.05).Interestingly,LINC01197-induced changes in cell behavior could be reversed by Notch1 modulators(P<0.05).Furthermore,LINC01197 overexpression inhibited tumor growth and Notch signaling in vivo(P<0.05).  Conclusion  LINC01197 can exhibit anti-proliferation and anti-invasion effects in LUAD by inhibiting Notch signaling pathway.

Objective   To evaluate the application effect of no-touch saphenous vein grafting（NT-SVG） versus conventional saphenous vein grafting（CV-SVG） in coronary artery bypass grafting（CABG）.  Method   From January 2018 to December 2020,the clinical data of NT-SVG group（112 cases） and CV-SVG group(126 cases)  were retrospectively analyzed,and post-complications and patency of SVG were evaluated.  Result   Venous graft occlusion was 2.5% in the NT-SVG group and 6.5% in the CV-SVG group at 3 months postoperatively(P<0.05),and 4.2% versus 9.0% at 12 months,respectively(P<0.05).There were no significant differences in the incidence of mortality(0.9% vs 0.8%),hemostasis rate of secondary thoracotomy(0.9% vs1.6%),myocardial infarction(0 vs0.8%),brain complications(0.9% vs 0),pulmonary infection(6.25% vs 6.3%),renal failure requiring dialysis(1.8% vs 2.4%),and gastrointestinal bleeding(0.9% vs 1.6%) between the two groups within 30 days after surgery(P>0.05).The incidence of delayed wound healing in the NT-SVG group was 7.1%,and paresthesia in the legs was 18.8%,which were higher than those in the CV-SVG group(1.6% and 9.5%,respectively,P<0.05).  Conclusion   Compared with the CV-SVG group,the patency rate of SVG was significantly improved in the NT-SVG group at 3 months and 12 months after the operation,and there was no significant increase in major postoperative complications.

Objective  To investigate the effect of obesity on perioperative complications in patients with acute Stanford A aortic dissection(TAAD).  Methods   According to BMI,the patients were divided into obese group (BMI ≥28kg/m²) and non-obese group (BMI < 28kg/m²) .The obese group included 55 cases,the non-obese group included 78 cases,133 cases in total.The differences of postoperative hypoxemia, ventilator assistance time, pulmonary infection, nervous system complications, acute kidney injury, poor wound healing, blood transfusion volume, hospital mortality and length of stay were compared between the two groups.  Results   The proportion of hypoxemia,extubation time ≥96 hours,poor wound healing,CSICU(Cardiac Surgery Intensive Care Unit) ≥7 days and total hospital stay ≥20 days in obese group were significantly higher than those in non-obese group (P＜0.05),there was no significant difference in postoperative acute renal injury,pulmonary infection,neurological complications and in-hospital mortality between the two groups(P>0.05).BMI≥28km²,extubation time ≥96h,and pulmonary infection were the main independent risk factors for hospital stay ≥7 days in CSICU after Type A aortic dissection.Patients with BMI ≥28kg/m² had 2.45 times more CSICU hospital days (≥7 days) than non-obese patients.  Conclusion   Obesity increases the incidence of perioperative complications in patients with acute Stanford A aortic dissection and is an independent risk factor for hospital stay of ≥7 days in CSICU,but there is no significant difference in in-hospital mortality.

Objective   To explore the value of preoperative fibrinogen and the prognosis of non metastatic gastric cancer.  Methods   From the start of the library to May 31, 2022,by searching PubMed、EMBASE、Web of Science、Cochrane Library to determine the studies to evaluate the prognostic role of Fib in GC.Revman software(version 5.4) was used for data analysis.The hazard ratio(HR) with 95% confidence interval(CI) was used to evaluate the correlation between Fib and overall survival(OS) and recurrence free survival(RFS) in GC patients.  Results   This study included 8 retrospective studies,including 3999 patients.Meta analysis showed that the higher Fib value was associated with the shorter OS and RFS(HR=1.73,95%CI:1.32-2.26,P<0.001;HR=2.12,95%CI:1.50-2.99,P<0.001).Subgroup analysis according to the country,sample size,Fib critical value and NOS score showed that the higher level of Fib before operation was related to the shortening of OS in gastric cancer(all P<0.05).  Conclusion   The increase of preoperative Fib can be used as a prognostic index for patients with non metastatic gastric cancer.A higher level of Fib indicates that the prognosis of patients with gastric cancer is poor.

Objective   To explore the impacts of different abdominal auxiliary incisions on postoperative gastrointestinal function and quality of life in patients with laparoscopic radical rectal cancer surgery.  Methods   The clinical data of  180 cases of patients who underwent laparoscopic radical rectal cancer surgery in our hospital from January 2015 to October 2021 were retrospectively analyzed.According to different abdominal auxiliary incisions,60 patients with subumbilical median incision(group A) were randomly selected,and 60 patients with supraumbilical longitudinal incision were selected.Patients(group B),60 patients with oblique incision in the left lower abdomen(group C).The operation-related indicators,postoperative gastrointestinal function,postoperative pain score,postoperative 3-day quality of life,and complications were compared among the three groups.  Results   The auxiliary incision length in group A was greater than that in groups B and C(P<0.05).Compared with group C,group A and group B had advantages in the time of first getting out of bed,the time of first flatus,the recovery time of bowel sounds,the VAS score of pain,and the levels of gastrin,motilin,and quality of life QLQ-CR38 scale score 3 days after operation, the difference was statistically significant (P<0.05).The incidence of incisional hernia in groups A and B was significantly lower than that in group C, and the difference was statistically significant (P<0.05).  Conclusion   Compared with the left lower abdominal oblique incision,the supraumbilical longitudinal incision and the subumbilical median incision have positive short-term curative effects in patients with laparoscopic radical rectal cancer surgery,and they have the advantages of lower pain,higher quality of life,and faster recovery of intestinal function.

Objective   To summarize the etiology,clinical features,treatment and prevention of internal abdominal hernia after gastric surgery(Petersen hernia) and improve the understanding of Petersen hernia.  Methods   A retrospective analysis in January 2018 to December 2021 jilin university fellowship between China and Japan hospital for treatment of 9 cases after gastrectomy Petersen hernia patients,7 cases underwent open Bie-ⅱ anastomosis and 2 cases underwent Roux-en-Y anastomosis due to the primary disease.The median duration of onset was 2 days.The percentage of neutrophils in blood routine was increased to varying degrees.Preoperative abdominal CT showed anastomotic wall thickening,proximal small bowel obstruction sign 4 cases,small intestine torsion signs in 2 cases,no special signs only 3 cases of small intestinal obstruction,has not been in patients with preoperative diagnosis for Petersen hernia,all patients underwent surgical treatment,intraoperative see output section of the small intestine to shift into the Petersen clearance and hernia in 5 cases,There were 3 cases without torsional herniation into Petersen space in the output segment and 1 case with torsional herniation into Petersen space in the input segment.Among them,4 patients underwent intestinal resection and anastomosis due to intestinal necrosis.  Results   One patient developed pleural and abdominal effusion after operation,and all patients were cured and discharged after treatment.  Conclusions   Petersen’s hernia is a relatively rare complication after gastrectomy.Preoperative abdominal CT can help to determine the criticality of the patient’s condition and can be the first choice of examination.A small number of patients with acute pancreatitis should pay attention to preoperative and postoperative amylase changes,and once the diagnosis is confirmed,surgery should be performed as soon as possible.

Objective   To explore the diagnosis and treatment of synchronous colorectal carcinoma(SCC).  Methods   The clinical data of 6 cases of SCC treated with surgery in our hospital from March 2021 to July 2021 were retrospectively analyzed.  Results   All 6 patients with SCC underwent one-stage surgical resection and anastomosis successfully.The patients recovered smoothly without serious complications such as anastomotic leakage.  Conclusion   The treatment effect is satisfactory for patients with SCC by choosing the appropriate surgical method according to the tumor location.

Objective   To compare the efficacy and safety of single pig-tail biliary stent placement under choledochoscopy followed by primary common bile duct closure with traditional T-tube drainage after laparoscopic common bile duct exploration.   Method  A total of 98 cases who underwent laparoscopic common bile duct exploration in our hospital from June 2019 to June 2022 were included retrospectively.They were divided into bile duct stents group (BD-stent group,40 cases) and the T-tube drainage group (TTD group,58 cases) according to the surgery type.The general conditions,intraoperative indicators,postoperative recovery and complications in two groups were statistically compared.   Result   In terms of surgery,the BD-stent group had significantly less surgery time,bile-duct-operation time,bleeding volume,postoperative VAS index and Caprini score than the TTD group (P<0.05).Both groups had no mortality or reoperation.There were no significant differences in first-day serum total bilirubin,γ-GT and total analgesia usage between two groups(P>0.05).But the first-day serum albumin,anal ventilation time,antibiotic usage,leukocyte recovery days,drain-tube removal days,bile duct drainage days,postoperative hospital stay and total costs in BD-stent group were significantly better than those in TTD group (P<0.05).As for postoperative complications,the rate in BD-stent group and TTD group were respectively 5.0% and 6.9%,without significant differences (P>0.05).  Conclusion   Single pig-tail biliary stent placement under choledochoscopy followed by primary common bile duct closure has unique advantages in safety and rapid recovery.It avoids long-term drainage.

Objective   To investigate the postoperative complications of laparoscopic transabdominal preperitoneal hernia repair(TAPP) for inguinal hernia in elderly men,and to analyze the related influencing factors.  Methods   A total of 86 elderly male patients with inguinal hernia who underwent laparoscopic TAPP treatment in the hospital from March 2020 to November 2021 were selected,Complications were counted 6 months after the operation,and the patients were divided into a complication group and an uncomplicated group accordingly.The baseline data of the two groups were collected,and the univariate and Logistic multivariate regression analysis of the influencing factors of complications after laparoscopic TAPP for inguinal hernia in elderly men was performed,and a prediction model was established based on the selected independent risk factors.The receiver operating characteristic(ROC) curve was used to observe the predictive value of independent risk factors and predictive models for postoperative complications in patients,and cross-validation was used to test the predictive performance of the predictive models.  Results   Of the 86 patients in this group,76 had no complications,10 had complications,and the complication rate was 11.63%.Univariate analysis showed that the age,body mass index(BMI),the proportion of chronic obstructive pulmonary disease(COPD),and the proportion of hernia sac diameter ≥ 5cm in the complication group were higher than those in the uncomplicated group(P<0.05).Logistic multivariate regression analysis showed that age,BMI,COPD,and diameter of hernia sac were independent risk factors for postoperative complications(P<0.05).Drawing the ROC curve showed that age,BMI,COPD,and hernia sac diameter had good predictive value for postoperative complications,and the areas under the curve(AUC) were 0.757,0.689,0.688,and 0.732,respectively.A prediction model was established based on independent risk factors,The ROC curve showed that the AUC of the prediction model was 0.887,the SE was 0.045,and the 95%CI was 0.799-0.974,P<0.001.Using cross-validation test,it was found that the classification accuracy of the prediction model was 80.23%(69/86).  Conclusion   Elderly men have a higher risk of complications after TAPP for inguinal hernia,and the risk factors include age,BMI,COPD,diameter of hernia sac,The predictive model established on this basis has a good predictive effect on the occurrence of complications,and clinical preventive measures can be taken accordingly.

Objective   To retrospectively analyze the Clinical imaging findings,diagnosis and treatment process and prognosis of 11 cases of strangulated obturator hernia admitted to our hospital.  Methods   The medical records of 11 patients with strangulated obturator hernia admitted to Mindong Hospital affiliated to Fujian Medical University from January 2012 to December 2020 were retrospectively analyzed.One case gave up surgery and 10 cases received emergency surgery.  Results   All 11 patients were elderly women,all of whom presented with symptoms such as abdominal pain,abdominal distention and vomiting,all of whom presented with obturator hernia accompanied by strangulation ileus.One patient died due to the abandonment of surgical treatment.The other 10 patients were treated by emergency surgery and recovered well after operation.All patients discharged from  hospital after cure were followed up,and no recurrence of obturator hernia was found.  Conclusion   Obturator hernia should be considered in elderly female patients with small bowel obstruction of unknown cause.Emergency abdominal CT examination is conducive to early diagnosis and early operation of strangulated bowel and hernia repair,and all patients have a good prognosis.

Objective   To summarize the clinical and pathological features of incidental prostate cancer.  Methods   The clinical data of  9 cases admitted from Jan 2018 to Dec 2021 were retrospectively analyzed.All patients underwent surgical treatment, and postoperative pathological examination confirmed prostate adenocarcinoma. Summarize the clinical and pathological features of the patients.  Results   All patients were discharged after operation.Prostate adenocarcinoma was detected in 6 cases in cystectomy specimens.Adenocarcinoma of prostate was detected pathologically in 3 patients with hyperplasia of prostate.Gleason score was 6 in 7 and 7 in 2 of the 9 patients.During follow-up, 1 patient received robot-assisted laparoscopic radical prostatectomy with continuous PSA increase.  Conclusion   Outcome of incidental prostate cancer has limited relationship with incidental prostate cancer itself.Occasional prostate cancer usually requires no surgery, but active surveillance is required.A few of incidental prostate cancer.patients may undergo prostatectomy if necessary.

Objective   To explore the efficacy and safety of drug-loaded microspheres transarterial chemoembolization(DEB-TACE) and conventional hepatic arterial chemoembolization(cTACE) combined with sorafenib in the treatment of advanced hepatocellular carcinoma.   Methods   From March 2019 to March 2021,106 patients with advanced hepatocellular carcinoma were included in the study and were randomly divided into two groups according to the random number table method.The control group was treated with cTACE combined with sorafenib,and the study group was treated with DEB-TACE combined with sorafenib.The clinical efficacy,serum hypoxia-inducible factor 1α(HIF-1α),alpha-fetoprotein(AFP),total bilirubin(TBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST) levels,and adverse reactions and living conditions were compared in both groups.   Results   The objective remission rate in the study group was 64.15%, higher than that in the control group (43.40%)(P<0.05).After 3 months of treatment,serum HIF-1α and AFP levels in both groups were decreased,and the research group was lower(P<0.05).After 3 months of treatment,the levels of serum TBIL,ALT and AST in both groups were increased(P<0.05),and serum levels of TBIL,ALT and AST in the study group were lower than the control group(P<0.05).The difference in the incidence of adverse reactions was not significant in both groups(P>0.05).The median progression-free survival time of study group and control group was 12.11 months(95%CI 7.78-16.22) and 10.09 months(95%CI 7.67-12.33),respectively.There was no significant difference in the median progression-free survival curve between the two groups(χ²=2.293,P=0.130).  Conclusion   DEB-TACE combined with sorafenib in the treatment of patients with advanced hepatocellular carcinoma can improve the therapeutic effect,regulate the level of serum tumor markers,improve reduce liver damage.

Objective   To observe more cases and indexs of platelet rich fibrin (PRF) application on chronic wounds,which provide solid basis for the application of PRF on the treatment of chronic wounds.  Methods   86 patients with chronic wounds treated in our hospital from January 2014 to January 2022 were selected.The odd and even number grouping was used to guide the patients to draw numbers by themselves.The patients with odd numbers were classified as the control group (routine treatment),and the patients with even numbers were classified as the observation group (PRF treatment).The number of patients in each group was 43.The infection control,wound area change,VAS score,push score,quality of life score,cost and time after treatment were observed before and after treatment,and the therapeutic effect of PRF was summarized.   Results   Before treatment in the observation group and the control group TNF-α Level,IL-2,IL-8,granulation tissue score,wound area,VAS score,push score,negative emotion score and quality of life score were not statistically significant (P>0.05).There was significant difference between the two groups after treatment and before treatment (P<0.05).There was significant statistical significance between the two groups after treatment (P<0.05).There was significant difference in treatment cost and time between the two groups (P<0.05).The therapeutic effect of the two groups was statistically significant (P<0.05).  Conclusion   The application of PRF on the treatment of chronic wounds can effectively reduce the level of inflammatory factors in patients,control the degree of infection,reduce the wound area,alleviate the pain degree of patients and improve the quality of life.At the same time,it can effectively reduce the treatment cost and wound healing time.

Objective   To investigate the effect of continuous lumbar plexus block in postoperative analgesia in patients with hip arthroplasty and its effect on inflammatory factors.  Methods   A retrospective analysis of 114 patients who underwent hip arthroplasty from November 2018 to December 2019 was used as the object,and they were divided into the control group and the observation group according to the postoperative analgesia,there were 57 patients in each group.The control group received patient-controlled intravenous analgesia after operation,and the observation group received continuous lumbar plexus block.The effect of the patients was evaluated 3 days after operation,and the visual analog pain (VAS) scores,postoperative inflammatory factor levels,and cognitive function levels were compared between the two groups.and safety.  Results   The VAS scores of the observation group were lower than those of the control group on the 1st,2nd and 3rd days after operation.The levels of inflammatory factors TNF-ɑ and IL-6 in the observation group[（3.26±0.19）ng/L,（1.55±0.12）ng/L] were lower than the control group patients[（5.49±0.23）ng/L,（2.63±0.14）ng/L](P<0.05).In the observation group,the IL-10 level of the patients was (4.79±0.23) ng/L,which was higher than that of the control group [(2.48±0.19) ng/L,P<0.05].The MMSE scores of the observation group at 1d and 2d before surgery were (20.30±2.32) score and (21.35±2.33) score,which were higher than the MMSE score of the control group; the incidences of lower limb numbness,urinary retention,nausea and vomiting and respiratory depression in the observation group after analgesia were lower than those in the control group (P<0.05).  Conclusion   Continuous lumbar plexus block can reduce pain and reduce inflammatory factor levels in patients undergoing hip arthroplasty after analgesia.It has less effect on patients’ cognitive function and can reduce complications

Cholangiocarcinoma is a malignant tumor originating from the epithelium of the bile ducts,and its incidence is increasing year by year,especially intrahepatic bile duct carcinoma that originates from the bile duct branches above the second level in the liver.Due to the insidious early symptoms and the lack of effective screening methods,most patients have lost the opportunity for radical surgery by the time they present.Over the past few years,several drugs have been developed that target genetic alterations with the detection of the cholangiocarcinoma genome.The molecular targets with clinical significance mainly include fibroblast growth factor receptor(FGFR),isocitric acid dehydrogenase(IDH),RAS-RAF-MEK-ERK,ERBB,VEGF and NTRK.Drugs targeting their targets show encouraging response rates and survival data as second-line therapies,and are characterized by high specificity and low toxicity.Therefore,targeted therapy is gradually emerging in the treatment of cholangiocarcinoma.In this review,we discuss the latest advances in targeted therapies for cholangiocarcinoma.

Complete surgical removal of invasive pituitary tumors(APT) is extremely difficult,and forced complete removal may pose significant risks.In order to preserve neural function,ensure the safety of surgery,and reduce complications,tumor residues often occur after APT.Residual tumors can be treated with stereotactic radiosurgery(SRS),especially gamma knife stereotactic radiosurgery(GKRS).This article reviews the necessity,effectiveness,safety,and application prospects of GKRS as an important method for treating residual tumors after APT.