Objective To explore the application value of single-port robotic surgery in infant urological surgery by using the Da Vinci Xi system.Methods From August 2020 to October 2022,18 infants who underwent single-port robotic surgery in our center with at least 6 months’ follow-up were selected.11 cases completed pyeloplasty,including 1 case of bilateral pyeloplasty;3 cases underwent uretero-ureteral anastomosis;1 case followed Lich-Gregoir technique;2 cases underwent nephrectomy of renal hypoplasia;1 case underwent capsulectomy of the prostate;9 in 18 cases were combined with patent processus vaginalis,including 3 cases with bilateral patent processus vaginalis;The operating experience and follow-up treatment effect were analyzed.Results All 18 children successfully completed the operation without converting to laparotomy through a single incision under the umbilicus;the postoperative hospital stay was （7.9±3.8 ）days,and the postoperative follow-up was （16.3±8.6 ）months.1 case occurred anastomotic leakage after the operation,and it was cured after the drainage tube was used for 9 days;1 case developed urinary tract infection 2 weeks after the operation,and was cured after taking antibiotics without recrudescence;there was no mid-and-long-term complications;the surgical incision healed well,and there were no complications such as infection,scar proliferation or incisional hernia.Postoperative appearance satisfaction was great.Conclusion It is feasible to perform urological surgery on infants through single-port robotic technology using the Da Vinci Xi system.Although it exists certain technical difficulties in application,it can bring better minimally invasive experience and cosmetic effect for infants.

Objective To summarize the clinical features and surgical outcomes of idiopathic trigeminal neuralgia (TN) caused by sole arterial and venous compression.Methods Between Jan 2010 and Dec 2016,335 TN patients caused by sole arterial and venous compression were applied to microvascular decompression (MVD) treatment in our department.The patient data were retrospectively analyzed.Results Compared to arterial compression,V3 branch of the trigeminal nerve was more frequently involved,while V1 was rarely affected in venous compression (P<0.05).The most frequently offending vessel was the superior cerebellar artery (SCA,87.8%) in arterial compression and the transverse pontine vein (TPV,80.6%) in venous compression.The most common compression site was the root entry zone (REZ,78.6%) for arterial compression and cisternal (74.2%) for venous compression.Compared to arterial compression,the neuro-vascular compression grade was significantly lower in venous compression (P<0.05); the short-term outcomes were relatively worse in the venous compression group (P<0.05); however,the long-term outcomes were similar (P>0.05).No statistical differences were established regarding the rate of postoperative complications and recurrence between both groups(P>0.05).Conclusions Our results suggest that venous compression is more prone to involve V3 distribution of the trigeminal nerve.3D-TOF-MRA is preferred in identifying venous compression.MVD is still effective and safe for TN caused by venous compression and only small intraneural veins could be sacrificed.A relative long-term follow-up (1 year) is mandatory to monitor delayed pain relief and recurrence.

Objective To explore the dynamic variation rule of serum calcium levels,serum parathyroid hormone levels and central drainage fluid parathyroid hormone levels after total thyroidectomy,To investigate the clinical significance of monitoring the above indexes in evaluating parathyroid function.Methods From January 2018 to January 2021,112 patients who received total thyroidectomy and bilateral central lymph node dissection in general Surgery Department of Qinghai provincial People's Hospital were chosen as the research objectve,According to the number of parathyroid glands(0, 1, 2) retained in situ,patients were divided into group A0,group A1 and group A2,Serum calcium,blood PTH and central drainage fluid PTH levels were detected before surgery and 1 to 4 days after surgery,Then we did a statistical analysis.Results There were 23 cases of hypocalcemia in 112 patients,including 15 cases in group A0,6 cases in group A1 and 2 cases in group A2.The level of postoperative serum calcium were lower than those before operative,And the most obvious decrease was  group A0,There was no significant increase in postoperative 1～4 days,However,group A1 and A2 showed a trend of gradual increase,and group A2 showed a faster increase.The level of postoperative serum PTH were lower than those before operative,And the most obvious decrease was group A0,There was no significant increase in postoperative 1～4 days,The level of serum PTH in group A1 and group A2 showed an upward trend,But the level of serum PTH in the two groups did not increase to the preoperative level within 4 days after operation.The level of postoperative drainage fluid PTH was significantly different among all groups,With group A2 having the highest mean value,Group A1 followed by group A0 having the lowest.With the passage of time,there was no significant change in group A0,And the PTH level of drainage fluid in group A1 and group A2 showed a general downward trend,As well,The decrease of group 1 was faster than that of group A2.Conclusion By monitoring serum calcium,serum PTH and drainage fluid PTH,the functional recovery of orthotopic parathyroid gland can be effectively evaluated after thyroidectomy,The central drainage fluid PTH can directly reflect the activity of the in-situ retained parathyroid gland,The maintenance of a high level of postoperative drainage is direct evidence of orthotopic parathyroid survival.

Objective To explore the short-term and long-term efficacy of sentinel lymph node biopsy combined with breast conserving surgery and modified radical mastectomy in the treatment of stage Ⅰ-Ⅱ breast cancer and its impact on post-traumatic stress disorder(PTSD).Methods Between January 2016 and may 2019,220 breast cancer patients admitted to Qidong people's hospital were divided into two groups according to the treatment scheme,of which 135 patients in the radical cure group received modified radical surgery and 85 patients in the breast conservation group received sentinel lymph node biopsy combined with breast conservation surgery.The surgical indexes,breast aesthetic effect,PTSD level,serum tumor marker level,postoperative complications,3year overall survival rate and recurrence rate were compared between the two groups.Results The operation time,intraoperative bleeding volume,postoperative drainage volume and hospital stay in the breast conserving group were less than those in the radical group(P<0.05).The cosmetic effect of breast conserving group was better than that of radical mastectomy group(P<0.05).One week after operation,the levels of serum carcinoembryonic antigen(CEA) and carbohydrate antigen 153(CA153) in both groups were lower than those before operation(P<0.05).The scores of PTSD checklist version(PCL-C) in breast conserving group and radical therapy group were [(33.67±7.89) points and [(46.82±6.15) points],respectively,the PCL-C of the breastconserving group were lower than those of the radical treatment group in a week after operation,and both groups were higher than those before operation(P<0.05).There were no serious complications such as severe infection and flap necrosis in both groups.The incidence of postoperative complications in radical group was higher than that in breast conserving group(P<0.05).The 3-year survival rates of breast conserving group and radical operation group were 98.78% and 100.00% respectively,and the recurrence rates were 6.10% and 3.10% respectively,there was no significant difference in the 3-year survival rate and recurrence rate between the two groups(P>0.05).Conclusion The application of sentinel lymph node biopsy combined with breast conserving surgery in the treatment of stage Ⅰ-Ⅱ breast cancer patients is more helpful to shorten the operation time,hospital stay and other operation indicators,improve the postoperative breast aesthetic effect,reduce the incidence of postoperative complications and PTSD level,and the adjustment level of short-term tumor markers,long-term survival rate and recurrence rate after operation are equivalent to that of modified radical mastectomy.

Objective To introduce a new method of totally implantable venous access ports(TIVAP)  via cephalic vein venotomy.(CVV-Port).Methods The clinical and follow-up data of 32 patients who received TIVAP from October 2019 to December 2020 were summarized and analyzed. During the same period, the 47 patients who underwent CVV-Port were compared and analyzed in terms of operation time and complications.Results 28 patients received TIVAP successfully , the average operation time was (25.93±4.77)min, while the CCV-port group was (28.73±5.16)min, with no statistical difference (p＜0.05). There was no thrombosis in the TIVAP group, and thrombosis in the CCV-port group in 13 cases, the difference was significant (p＜0.05). Catheterization related adverse events were 1 case in TIVAP group and 3 cases in CCV-port group. There were statistically significant differences in the increase of treatment time and treatment cost between the two groups [0 vs.(16.7±2.1)d; 0 vs.(1233±166.7)yuan, both p＜0.05].Conclusion TIVAP via cephalic vein section does not increase the operation time and has fewer complications.

Objective To analyze the expression of miR-144,lung cancer metastasis-associated transcript 1 (MALA T1) and testis proteoglycan (SPOCK1) in bladder cancer tissues and their diagnostic efficacy.Methods A total of 96 bladder cancer patients who were treated in our hospital from January 2018 to January 2021 were selected.Fresh tumor tissue from bladder cancer patients (tumor group) and normal tissue adjacent to the tumor > 2 cm away from the tumor edge (paracancerous group) were collected during surgery.5 mg each.The relative expression levels of miR-144,MALAT1 and SPOCK1 in different tissues were detected by polymerase chain reaction (PCR),and the expressions of miR-144,MALAT1 and SPOCK1 in different pathological features of bladder cancer were analyzed.The ROC curve was drawn to test the diagnostic effect of miR-144,MALAT1 and SPOCK1 on bladder cancer.96 patients underwent surgery + postoperative adjuvant chemotherapy in our hospital,and the patients were followed up by telephone and outpatient followup.Followup ended on January 30,2022,and the expressions of miR-144,MALAT1 and SPOCK1 were compared in patients with different prognosis.Results The relative expressions of MALAT1 and SPOCK1 in the tumor group were significantly higher than those in the paracancerous group,while the relative expression of miR-144 was significantly lower than that in the control group (P<0.05).The expression of miR-144 in stage Ⅲ-Ⅳ patients with lymph node metastasis was significantly lower than that in stage Ⅰ-Ⅱ patients without lymph node metastasis（P＜0.05）.MALAT1 and SPOCK levels in stage Ⅲ-Ⅳ,poorly differentiated,and lymph node metastasis were significantly higher than those in stage Ⅰ-Ⅱ,moderately and well differentiated,and no lymph node metastasis (P<0.05).The ROC curve was drawn,and the AUC value was calculated.The AUC values of miR-144,MALAT1 and SPOCK1 for the diagnosis of bladder cancer were 0.643 and 0.557,respectively,and the AUC value for the diagnosis of SPOCK1 was 0.717 (95%Cl:0.688-0.845).the highest AUC value was diagnosed with SPOCK1 (P＜0.05).Follow-up data showed that 85 of 96 patients had good prognosis and 11 had poor prognosis.The miR-144 in the poor prognosis group was significantly lower than that in the good prognosis group,and MALAT1 and SPOCK1 were significantly higher than those in the good prognosis group (P<0.05).Conclusion The abnormal expression of miR-144,MALAT1 and SPOCK1 in bladder cancer tissue has a certain relationship with the pathological characteristics of patients,and may be used as potential diagnostic markers for bladder cancer.

Objective To explore diagnostic strategies and treatment options for gastrointestinal bleeding after aortic dissection surgery.Methods The clinical data and diagnosis and treatment results of patients with gastrointestinal bleeding after aortic dissection surgery admitted from January 2020 to June 2022 in the Affiliated Nanjing Hospital of Nanjing Medical University were analyzed retrospectively.Results A total of 10 cases of 14 patients with gastrointestinal bleeding after aortic dissection surgery were cured,7 cases were mainly based on basic support and drug therapy,1 case was treated with endoscopic therapy,and 2 cases were treated with surgical operations;In the untreated group,3 cases were basic support and medication,and 1 case died due to poor surgical treatment.Conclusion The diagnosis and treatment strategy of gastrointestinal bleeding after aortic dissection surgery should be comprehensively evaluated according to the amount,location and complications of bleeding,and the individualized treatment of patients should be strengthened.Timely surgical treatment is helpful to improve the prognosis and outcome of patients with gastrointestinal bleeding after aortic dissection surgery.

Objective To investigate the expression and prognostic value of HILPDA gene in hepatocellular carcinoma,and further explore the potential clinical application value of HILPDA. Methods The bioinformatics method was used to download the mRNA sequencing data of hepatocellular carcinoma and the clinical data of patients from the TCGA database.The differences of HILPDA expression in hepatocellular carcinoma and adjacent tissues were analyzed.Univariate Cox regression and multivariate Cox regression were used to analyze the relationship between HILPDA expression level and prognosis of patients.The possible mechanism of HILPDA was investigated by GESA enrichment method.TIMER database was used to analyze the relationship between HILPDA gene expression and immune cell infiltration.Results The expression level of HILPDA gene in hepatocellular carcinoma tissues was higher than that in corresponding paracancer tissues.The expression level of HILPDA was correlated with tumor size(P<0.001),lymph node metastasis(P<0.01),pathological grade(P<0.05) and serum AFP level(P<0.01).Univariate and multivariate Cox regression analysis showed that HILPDA expression level was an independent prognostic factor in hepatocellular carcinoma patients,and patients with high expression level had a poor prognosis.Using TIMER database,the expression level of HILPDA is correlated with immune invasion of Th1 and Macrophage cells(P<0.001).Conclusion HILPDA may be a prognostic factor and a potential molecular therapeutic target for hepatocellular carcinoma.

Objective To investigate the clinical efficacy of proactive percutaneous catheter drainage(PCD) in the treatment of infected pancreatic necrosis(IPN).Methods The clinical data of 21 IPN patients treated with proactive PCD in our hospital from July 2019 to October 2020 were retrospectively analyzed and compared with 53 patients treated with step-up approach from January 2017 Results In the proactive PCD group,more drainage tubes were inserted,more patients increased drainage tubes in the treatment,and the size of the inserted drainage tubes was significantly larger than that in the step-up approach group(P<0.05).The hospitalization time of patients in the step-up approach group was longer,the number of patients in intensive care unit(ICU) was larger,and the duration of continuous drainage of drainage tube was longer(P<0.05).There was no significant difference in mortality and surgical rate between the two groups.Conclusion Proactive PCD treatment can not only shorten the hospitalization time,but also effectively treat IPN.

Objective To explore the predictive effect of preoperative blood inflammation indicators in postoperative infection,and to analyze the related risk factors for infection after liver transplantation.Methods The clinical data of 90 orthotopic liver transplantation patientsin People’s Hospital of Wuhan University from January 2016 to February 2022 were retrospectively analyzed and divided into infection group (n=20) and non-infection group (n=70).Univariate analysis was performed on perioperative related factors that may lead to infection,and then factors with significant differences were included in Logistic regression multivariate analysis.Results Univariate analysis showed that preoperative neutrophil to lymphocyte ratio (NLR),preoperative total bilirubin,intraoperative blood loss,MELD score≥18,preoperative diabetes and postoperative biliary complications were single factors of postoperative infection (P<0.05);Multivariate Logistic regression analysis showed that elevated NLR and preoperative diabetes were risk factors for postoperative infection.The ROC curve analysis showed good sensitivity and specificity at NLR=3.07,with an area under the ROC curve of 0.702.Conclusion NLR levels are abnormally elevated in patients with infection after liver transplantation,and the risk of postoperative infection can be assessed by testing the above index levels.In addition,preoperative diabetes mellitus is independent risk factors for postoperative infection,and more attention should be paid to such patients.

Objective To investigate the effect of a new balloon catheter modified by the author in the protection of rectal anastomosis with high risk factors in Transcecum tube ileostomy(TTI).Method From December 2019 to December 2021, 61 patients underwent prophylactic ostomy due to high risk factors of anastomosis after surgical resection of colorectal malignant tumor in our hospital.According to the different way of colostomy into the cecum terminal ileum intubation colostomy groups(TTI,29 cases) and traditional end ileostomy group(Loop ileostomy,32 cases).The gender,age,preoperative comorbidities,distance between tumor and anal margin,operation time,stoma operation time,postoperative anastomose-related complications,postoperative stoma/stoma tube drainage volume,stoma/stoma tube related complications,hospitalization costs and other related indicators were compared and analyzed between the two groups.Results The operation time of TTI group and LI group were (16.31±2.64)min and (27.84±4.85)min,respectively,and the operation cost was (4.84±0.50)thousand yuan and (5.85±1.19)thousand yuan,respectively.In LI group,the incidences of ostomy/ostomy tube related complications were 34% and 6%,respectively,and the difference was statistically significant(P<0.05).In the TTI group,there were no reoperation cases,while in the LI group,18 cases were reoperation,including 1 case of stoma reconstruction and the rest of them were ostomy reduction.The incidence of complications after reoperation was 55.56%(10/18),and disuse enteritis was the most common,and one case of ISREC grade B leakage was found,which was cured by symptomatic treatment such as fasting water and nutritional support.There were significant differences in reoperation rate and complication rate between the two groups(P < 0.05).There were 2 cases of ISREC grade A leakage in both groups,and 1 case of anastomotic stenosis in the LI group,which was improved after 2 weeks of continuous expansion.There was no significant difference in the incidence of anastomotic complications between the two groups(P>0.05).There were no significant differences in operation time,blood loss,distance between anastomosis and anal margin,postoperative hospital stay,tumor size,and daily drainage volume of stoma/stoma tube(P>0.05).Conclusion This new modified balloon catheter is safe and reliable for TTI surgery.It has similar effect to traditional terminal ileostomy in protecting rectal anastomosis with high risk factors,but has fewer complications and the operation is simple.

Objective To investigate the relationship between serum interleukin-6 (IL-6),interleukin-17 (IL-17),tumor necrosis factor-α (TNF-α),C-reactive protein (CRP),matrix metalloproteinase-9 (MMP-9) and osteoporosis (OP) in elderly patients with chronic obstructive pulmonary disease (COPD).Methods 135 elderly patients with COPD admitted to our hospital from April 2017 to January 2022 were retrospectively selected as the study object,according to whether the elderly COPD patients were complicated with OP,they were divided into OP group (75 cases) and non OP group (60 cases).The general data,25-hydroxyvitamin D [25 (OH) D] and other clinical biochemical indexes of the two groups were compared.The serum LEVELS of IL-6,IL-17,TNF-α,CRP and MMP-9 were compared between the two groups.Multivariate Logistic regression analysis was used to evaluate whether the above serum inflammatory factors were independent risk factors for OP in elderly COPD patients.Results The age of OP group was (73.87±9.70) years,which was higher than that of non-OP group (70.00±7.70) years,the difference was statistically significant (P<0.05); The proportion of women in OP group was 32.00%,higher than 16.67% in non OP group,the difference was statistically significant (P<0.05); The BMI of OP group was (21.05±3.21) kg/m2,which was lower than that of non OP group (24.95±2.93) kg/m²,the difference was statistically significant (P<0.05); The proportion of type 2 diabetes mellitus in the OP group was 17.33%,which was lower than 35.00% in the non-OP group,and the difference was statistically significant (P<0.05).Blood calcium and 25 (OH) D in OP group were (2.10±0.16) mmol/L and (15.83±4.02) ng/ml,respectively,lower than those in non-OP group (2.18±0.13) mmol/L and (17.96±5.00) ng/ml,and the difference was statistically significant (P<0.05).In OP group,IL-6,IL-17,TNF-α,CRP and MMP-9 were (76.85±9.26) ng/L,(27.18±4.52) pg/ml,(41.20±4.40) μg/L,(6.25±1.12) mg/L,(84.60±6.25) μg/L,respectively.It was higher than that in non-OP group [(52.91±7.07) ng/L,(10.50±3.50) pg/ml,(30.54±3.73) μg/L,(3.62±1.10) mg/L,(33.74±7.12) μg/L],and the difference was statistically significant (P<0.05).Multivariate Logistic regression analysis showed that age ,sex,IL-6 ,IL-17 ,TNF-α,CRP,MMP-9  were independent risk factors for OP in elderly patients with COPD (P<0.05),BMI,blood calcium,25 (OH) D were independent protective factors affecting OP in elderly patients with COPD (P<0.05).Conclusion IL-6,IL-17,TNF-α,CRP and MMP-9 are all abnormally high expression in serum of elderly patients with COPD complicated with OP,which are independent risk factors affecting elderly patients with COPD complicated with OP.

Objective To investigate the value of preoperative systemic immune-inflammation index (SII) in predicting postoperative urosepsis after flexible ureteroscopic lithotripsy,and establish a preoperative nomogram prediction model.Methods The clinical data of 329 patients who underwent flexible ureteroscopic lithotripsy in Shanghai Fourth People’s Hospital affiliated to Tongji University from August 2020 to October 2021 were retrospectively analyzed.According to the occurrence of urinary sepsis, the patients were divided into sepsis group and non-sepsis group.The independent risk factors of postoperative urosepsis for upper urinary calculi were evaluated by univariate and multivariate Logistic regression analysis.We drew receiver operating characteristic (ROC) to find the cut-off value of risk factors and calculated the area under curve (AUC) to evaluate its diagnostic power.The R software was used to establish a nomogram model for predicting the occurrence of postoperative urosepsis and calculate the c-index.And its accuracy was evaluated by the calibration curve.

Objective To analyze the clinical effects of sodium bicarbonate ringer’s solution in patients undergoing controlled low central venous pressure hepatectomy.Methods 80 Patients undergoing hepatectomy in our hospital from October 2021 to May 2022 were randomly divided into lactate ringer’s group (LR group) and sodium bicarbonate ringer’s group (BR group) according to the different types of intraoperative infusion.All patients with partial liver resection were treated with controlled low central venous pressure.The operation time,hilar block time,bleeding volume,infusion volume,urine volume,application of vasoactive drugs,postoperative eye opening time,extubation time,PACU residence time and the number of delayed recovery cases were compared between the two groups.The arterial blood gas and lactate values between the two groups were compared at the time before the induction of anesthesia (T-1),hepatectomy completed immediately (T-2) and the end of surgery (T-3).Results Lactate values  were significantly lower(P<0.05) while PH,HCO-3 and BE were significantly higher in the BR group than those in the LR group (P<0.05) at T-2 and T-3.Urine volume in the BR group was significantly excess in the LR group (P<0.05).Postoperative eye opening time,extubation time,PACU residence time and the number of delayed recovery cases in the BR group were significantly less than those in the LR group (P<0.05).Conclusion Sodium bicarbonate ringer’s solution can effectively maintain the acid-base balance stability of the body,reduce the lactate value,reduce the burden of the liver,increase the urine volume,and shorten the time of awakening and extubation in patiens undergoing controlled low central venous pressure hepatectomy.

Objective This article analyzes the clinical efficacy of silverhawk plaque cyclotomy,Drug-coated balloon(DCB)and bare metal stent in the treatment of patients with lower extremity arterial occlusion.Method A total of 101 patients with lower extremity arterial occlusion admitted to our hospital from January 2019 to December 2021 were prospectively selected and divided into group A for silverhawk plaque rotary cutting treatment by randomized controlled method.Group B was treated with domestic paclitaxel DCB + bare metal stent on the basis of group A,and then its clinical indicators,clinical target lesion revascularization rate,ET-1,NO and plasma P-selectin levels were compared.Results The clinical indexes of group B were significantly better than those of group A(P<0.05).The levels of plasma P-selectin and ET-1 in the two groups were significantly decreased at 12 h after treatment(P<0.05).The levels of NO in the two groups were significantly increased at 12 h after treatment(P<0.05),and the levels of plasma P-selectin,ET-1 and NO in group B were significantly better than those in group A(P<0.05).The revascularization rates at 6 months and 12 months after operation in group B were significantly lower than those in group A(P<0.05).Conclusion Application of silverhawk plaque rotary cutting + domestic paclitaxel DCB + bare metal stent combined treatment of lower extremity arterial occlusion of clinical curative effect is remarkable,improve the patient ’s vascular patency rate,ET-1,NO and plasma P-selectin level,improve the ankle brachial index,reduce the target lesion blood flow reconstruction rate,is worth promoting.

Objective To analyze the clinical effect of internal fixation of posterior orbital septum-levator muscle complex and orbicularis oculi in double eyelid surgery.Methods A total of 100 patients who received double blepharoplasty in the Third Affiliated Hospital of Chongqing Medical University from April 2020 to October 2021.They were randomly divided into experimental group(n=50) and control group(n=50) according to difffferent treatment methods.Surgery was performed by the same surgeon with two different surgical methods,the experimental group was treated with modified double eyelid surgery,and the control group was treated with traditional surgery.And the degree of postoperative swelling,eyelid scar,eye aesthetics and complications of the two surgical methods were analyzed and compared.Results The swelling score was 5.42±0.76 in the experimental group and 6.10±0.93 in the control group on the third day after operation.The swelling score was 3.40±0.75 in the experimental group and 4.00±0.99 in the control group one week after operation.The swelling score was 1.72±0.64 in the experimental group and 2.08±0.78 in the control group one month after operation.The differences were statistically significant(P<0.05).The scar score was 2.58±0.70 in the experimental group and 3.20±0.67 in the control group one month after operation.The scar score was 1.14±0.40 in the experimental group and 1.50±0.58 in the control group 6 months after operation,with statistical significance(P<0.05).Six months after operation,the double eyelid aesthetics score and self-satisfaction score of the experimental group respectively were 4.00±0.45,4.00±0.49.The results of the control group were 3.84±0.42,3.72±0.57,the differences were statistically significant(P<0.05).The incidence of complications such as the “stripped” or “stepped” appearance was 2%，lower than that in the control group 14%,and the difference was statistically significant(P<0.05).Symptoms of the two patients with mild ptosis was improved after surgery,and the effect was satisfactory.

Infantile hemangioma,the most common vasculogenic tumor in children,has self-regression properties but can develop serious complications during its active proliferative phase,including disfigurement,ulceration,pain,and dysfunction.Standardized diagnosis and treatment can prevent serious complications and avoid overtreatment or radical treatment.At present,the corresponding expert consensus on the diagnosis and treatment of pediatric hemangioma has been formulated in China.However,in recent years,many new progresses have been made in the diagnosis and treatment of infantile hemangioma.This review aims to summarize the new progress in the diagnosis and treatment of pediatric hemangioma.

Common Bile Ducts(CBDS),also called choledocholithiasis,is more common in adults than in children.The incidence of children increased with the change of life style and the improvement of diagnostic techniques.Choledocholithiasis is often associated with common bile duct dilatation.Adult treatment includes laparotomy,laparoscopic and endoscopic retrograde cholangiopancreatography(ERCP).In order to avoid repeated inflammation and canceration of dilated bile duct,it is considered that choledocholithiasis and dilatation to a certain extent in children need radical operation.In recent years,with the development of ERCP in children,choledocholithiasis and dilatation have been relieved by ERCP treatment.In order to provide some reference for selecting appropriate treatment methods and exploring individualized treatment,this paper reviews the diagnosis and treatment of choledocholithiasis complicated with choledochal dilatation in children.

Tracheoesophageal fistula (TEF) is a rare disease caused by the formation of abnormal channels between the trachea and the esophagus due to the congenital or acquired factors.It is often misdiagnosed as a respiratory or gastrointestinal disease because of the lack of specific clinical symptoms,resulting in delayed treatment.Surgical treatment is an effective radical cure for this disease.TEF often develop pneumonia due to the repeated aspiration,leading to the decline of lung compliance,tracheomalacia,bronchomalacia and other complications,which affects the quality of life and the prognosis of children.During the operation,the ventilation of the operative side is limited due to the surgical compression.Fistula ventilation during mechanical ventilation can elevate the diaphragm.Moreover,it restricts breathing and increases the incidence of intraoperative hypoxemia and the risk of gastric rupture during the operation.Therefore,Perioperative care of TEF is a challenging.This review will summarize the strategies and progress of Perioperative care of TEF,and provide reference for clinical treatment.

The cruciate ligament of knee joint is an important structure to maintain the biomechanical stability of knee joint.Knee cruciate ligament injury has always been one of the focuses of orthopaedic sports medicine.Its injury and fracture will affect the knee flexion,extension and rotation.Cruciate ligament reconstruction is the gold standard for the treatment of knee cruciate ligament loss.There are many surgical methods for knee cruciate ligament reconstruction,including single bundle reconstruction and double bundle reconstruction,isometric reconstruction and isotonic reconstruction,autologous tendon transplantation and allogeneic tendon transplantation.The selection of surgical methods is closely related to the rehabilitation and prognosis of patients.Finite element analysis plays a unique role in reconstructing the knee joint model,studying the biomechanics of the knee joint and improving the surgical methods of the knee joint because of its advantages of accuracy,digitization and visualization.In this paper,the authors reviewed the recent domestic and foreign literatures on the application of finite element analysis to the study of the operation of knee cruciate ligament injury and its impact on the biomechanics of the knee joint.