Objective To explore the influencing factors and prognosis of epilepsy after operation for insular low-grade gliomas.Methods The clinical data of 120 patients with insular lowgrade gliomas with pre-operative seizure symptoms in the Chinese glioma Genome Atlas Project (CGGA) database from July 2008 to June 2014 were retrospectively analyzed.The seizure control and survival prediction information of the patients were followed up one year after operation.The risk factors affecting post-operative seizures were analyzed by Logistic multiple factor regression analysis,Kapla-Meier curve was used to analyze the effect of postoperative epilepsy control factors on progression free survival (PFS) and overall survival (OS).Results Before operation,36 cases (30.0%) had simple focal seizures,53 cases (44.2%) had focal seizures with different degrees of cognitive impairment,and 31 cases (25.8%) had generalized seizures.During the follow-up after one year of surgical treatment,72 patients (60%) had a complete improvement in epilepsy symptoms (Engel grade Ⅰ),33 patients (27.5%) had a significant improvement (Engel grade Ⅱ),11 patients (9.2%) had a significant improvement (Engel grade Ⅲ),and 4 patients (3.3%) had no improvement or deterioration (Engel grade Ⅳ).Larger tumor resection degree,no putamen involved,IDH1 mutation are favorable factors for postoperative control of epilepsy.Improvement of seizures was a favorable prognostic factor for PFS and OS.Conclusion Epilepsy is the most common symptom of insular gliomas.The improvement of postoperative epilepsy symptoms is related to the degree of tumor resection,involvement of putamen and IDH1 mutation status.Complete improvement of epilepsy symptoms can prolong the progression free survival time and overall survival time of patients.

Objective To explore the serum levels of VILIP-1 and Cav-1 in cases with severe craniocerebral injury undergoing decompression and their effects on the prognosis.Methods 108 patients with severe craniocerebral injury who were treated in our hospital from July 2019 to July 2022 were selected as the study group,and 120 healthy people who came to our hospital for physical examination were selected as the health group.All cases were followed up for 6 months,and were divided into good prognosis group (GOS=45 points,n=82) and poor prognosis group (GOS=13 points,n=26) according to GOS.The levels of serum VILIP-1 and Cav-1 were detected by ELISA.The diagnostic value of serum VILIP-1 and Cav-1 on the prognosis of patients was evaluated by the ROC curve.Multivariate logistic regression analysis was used to explore the prognostic factors of patients.Results The levels of serum VILIP-1 and Cav-1 in study group were higher than those in healthy group (P<0.05).The levels of serum VILIP-1 and Cav-1 in case with poor prognosis were higher than those in cases with good prognosis (P<0.05).The AUC (95%CI) of serum VILIP-1 and Cav-1 to predict the prognosis of patients was 0.848(0.797~0.899) and 0.817(0.766~0.868).The AUC(95%CI) of the combined detection was 0.905 (0.854~0.956).The time from injury to admission,admission GCS score,history of diabetes,admission pupillary reaction,preoperative brain midline displacement and postoperative complications in good prognosis group were different from those in poor prognosis group (P<0.05).Preoperative midline displacement≥5mm (OR=2.467,95%CI:1.619~3.760),postoperative complications≥ 2(OR=2.321,95%CI:1.544~3.489),VILIP-1≥10.37ng/ml (OR=3.367,95%CI:2.087~5.432),and Cav-1 ≥ 32.28μg/L (OR=2.770,95%CI:1.786~4.298) were risk factors for prognosis in patients(P<0.05).Conclusion Serum VILIP-1 and Cav-1 can be used as biological indicators to predict the prognosis of patients with severe brain injury after decompression,and the increase of serum VILIP-1 and Cav-1 levels are risk factors for prognosis.

Objective To explore the predictive effect of serum Stromal cell-derived factor 1 (SDF-1)and C-X-C chemokine receptor type 4(CXCR4)on early hematoma enlargement in hypertensive intracerebral hemorrhage(HICH).Methods The clinical data of 79 patients with HICH in our hospital from January 2020 to June 2022 were retrospectively analyzed.According to the results of head CT reexamination after admission,the patients were divided into hematoma enlargement group and hematoma non enlargement group.The hematoma location of the first head CT examination,hematoma shape,systolic blood pressure level after admission,hematoma density uniformity,admission GCS score and serum SDF-1 and CXCR4 were compared between the two groups.Receiver operator characteristic curve (ROC) was used to evaluate the predictive value of SDF-1 and CXCR4.Results Among 79 patients with HICH,21 patients had increased bleeding.Univariate analysis showed that there were significant differences in hematoma shape,admission GCS score,systolic blood pressure and hematoma density between the two groups (all P<0.05).Logistic multivariate analysis showed that SDF-1 and CXCR4 were independent risk factors for hematoma enlargement in early stage of hypertensive intracerebral hemorrhage (respectively OR:1.460,1.362,respectively 95%CI:1.056 ~ 2.018,1.200 ~ 1.547,all P<0.05).ROC curve analysis showed that AUC of SDF-1 was 0.868 (95%CI:0.688-1.000,P<0.005),specificity was 0.875,sensitivity was 0.778.The AUC of CXCR4 was 0.758 (95%CI:0.557-0.948,P<0.05),the specificity was 0.750,and the sensitivity was 0.733.Conclusion The expression of SDF-1 and CXCR4 in patients with HICH is significantly increased,which is related to the early hematoma enlargement.SDF-1 and CXCR4 have high sensitivity and specificity in predicting the early hematoma enlargement in HICH.

Methods  The information of 108 patients who was diagnosed with esophageal foreign body from January 2014 to June 2021 and accepted multiple-discipline cooperated diagnosis and treatment consisted of cardiothoracic surgery department,digestive system department,emergency department,imaging department and anesthesiology department was collected.Then,we compared the difference of clinic time,foreign body type,endoscopic findings,position of incarnation,complications,postoperative hospital stay between surgical treatment and medical treatment.Results Patients in medical treatment were older than surgical treatment [(59.21±13.12 ）years VS.(52.65±12.66)years,P＜0.05].Clinic time shew a skewed distribution,clinic time was longer in surgical treatment compared with medical treatment by rank sum test (P＜0.05).There were statistical differences in foreign body type,esophageal injury and complications between the two groups(P＜0.05).The white blood cell count of endoscopic treatment group and surgical treatment group was (7.89±3.08)×10⁹/L and(11.69±6.98)×10⁹/L,respectively(P<0.05),neutrophil counts were(6.16±2.96)×10⁹/L and(9.97±6.97)×10⁹/L,respectively(P<0.05),proportion of neutrophils were (76.11±8.75)% and(81.52±12.52)%,respectively(P<0.05), and C-reactive protein level were (43.26±56.87)mg/L and(111.37±102.86)mg/L,respectively(P<0.05).Conclusion Multiple-discipline cooperated diagnosis and treatment is safe,rapid and effective in the diagnosis and treatment of esophageal foreign bodies.Patients with longer clinic time,higher white blood cell counts,higher neutrophil counts,higher proportion of neutrophils,and higher C-reactive protein level were more likely to require surgical treatment.

Objective To explore the safety and efficiency of sequential operation of Tirelizumab combined with chemotherapy in neoadjuvant therapy for locally advanced esophageal cancer.Methods A retrospective analysis was conducted on 60 patients with locally advanced esophageal cancer admitted to Renmin Hospital of Wuhan University from August 2018 to June 2022.The immunotherapy combined with chemotherapy sequential surgery patients were selected as the observation group(29 cases) and the chemotherapy sequential surgery patients were selected as the control group(31 cases) according to the treatment method.The study aimed to analyze whether there were differences in efficacy and safety between the two groups. Results There are 28 patients with R0 resection in the observation group,and 14 case reached ORR.In the control group,29 cases were resected with R0,and 7 cases reached ORR.The proportion of ORR patients in the observation group was significantly higher than that in the control group,which was statistically significant(P<0.05).There were 9 patients with pCR in the observation group and 2 patients with pCR in the control group,and the proportion of pCR patients in the two groups was significantly different(P<0.05).There were no significant differences between the two groups for preoperative and postoperative adverse events.Conclusion Immune checkpoint inhibitors combined with chemotherapy sequential surgery are safe and reliable in patients with locally advanced esophageal cancer,with significant short-term efficacy,and long-term efficacy remains to be observed.

Objective To investigate the relationship between the expression of human ubiquitin-conjugating enzyme E2C(UBE2C),non-metastatic cell gene 2(NME2) and the clinicopathological features of breast cancer and its prognostic value.Methods The expression of UBE2C and NME2 in 1085 cases of breast cancer tissues and 291 cases of normal tissues were analyzed by GEPIA online website.The Kaplan-Merier Plotter online website was used to analyze the expression of UBE2C and NME2 and the survival of 1070 patients with breast cancer.Furthermore,one hundred and twenty-seven breast cancer patients admitted to our hospital from January 2018 to December 2019 were selected as the study subjects,and 51 healthy women who underwent physical examination in our hospital during the same period were selected as the normal control group.The levels of UBE2C and NME2 were detected,and the relationship between the levels of UBE2C and NME2 in patients with breast cancer and clinicopathological characteristics was analyzed.Multivariate Cox regression model was used to analyze the prognostic risk factors of breast cancer.The receiver operating characteristic curve was used to evaluate the efficacy of the model in predicting the poor prognosis of breast cancer.Results  GEPIA online website data showed that the expression levels of UBE2C and NME2 protein in breast cancer tissues were higher than those in the normal group,with a statistically significant difference(P＜0.05).Survival curve analysis showed that with the increase of UBE2C and NME2 expression levels,the survival rate of patients decreased(P=0.029,0.013,respectively).The positive expression rates of UBE2C and NME2 in breast cancer tissues were significantly different among patients with lymph node metastasis,clinical stage and pathological grade(χ2=7.826,4.116,5.460,P=0.005，0.042，0.019;χ2=4.400,6.211,11.63;P=0.036，0.013，0.001).Cox regression analysis showed that lymph node metastasis,clinical stage Ⅲ~Ⅳ,pathological grade G3 and UBE2C positive expression,NME2 positive expression were the risk factors for poor prognosis of breast cancer patients(P=0.031,0.018,0.016,0.019,0.001).Area under curve was 0.835,and the sensitivity was 0.740 3,the specificity was 0.941 2.The AUC of the validation group is 0.826,the sensitivity was 0.8800,and the specificity was 0.840 0.Conclusion The levels of UBE2C and NME2 in breast cancer patients are increased,and their expression is related to lymph node metastasis,clinical stage,pathological grade and poor prognosis of breast cancer.The constructed prediction model of breast cancer has an important clinical value for predicting the poor prognosis of breast cancer patients.

Objective To explore the clinical efficacy and safety of modified PPH combined with partial internal anal sphincterotomy in the treatment of circular mixed hemorrhoids.Methods Patients with annular mixed hemorrhoids were divided into two groups by a completely randomized controlled method.54 patients in the experimental group were treated with modified PPH combined with partial internal anal sphincterotomy,while 51 patients in the control group were treated with conventional PPH.The postoperative indicators,perioperative and long-term complication rates of the two groups were compared,and the clinical efficacy and safety were observed.Results The operation time in the experimental group was (48.35±4.37) minutes,which was higher than that in the control group (36.42±6.21) minutes（P＜0.05）.The incidence of postoperative anastomotic stenosis in the experimental group was 1.9%,lower than 15.6% in the control group (P＜0.05). Anal pain,urinary retention,first defecation time,long-term anal distention,the experimental group was significantly better than the control group,the difference was statistically significant (P＜0.05); The hospitalization time in the experimental group (4.8±0.62) days was not significantly different from that in the control group (5.1±0.54) days (P>0.05).The amount of intraoperative bleeding and anastomotic bleeding in the experimental group [(17.28±2.22)ml,3.7%] were not significantly different from those in the control group [(16.75±2.13)ml,3.9%] (P>0.05).Conclusion Compared with conventional PPH,the modified PPH combined with partial internal anal sphincterotomy slightly increases the operation time,but does not increase the risk of anastomotic bleeding,the incidence of rectal fistula,the amount of surgical bleeding,and the length of hospital stay.It can significantly improve postoperative anal pain,urinary retention,long-term distention symptoms,shorten the time of first defecation,ease the difficulty of defecation,and significantly reduce postoperative anastomotic stenosis,The long-term efficacy and safety are good.

Objective To analyze the incidence and risk factors of intraperitoneal infection in patients with hepatocellular carcinoma combined with cirrhosis and portal hypertension undergoing laparoscopic surgery.Methods The clinical data of 105 consecutive cases of laparoscopic devascularization combined with hepatectomy or radiofrequency ablation were retrospectively analyzed.The factors that may cause intraperitoneal infection were recorded.The postoperative recovery was observed and the incidence of intraperitoneal infection was recorded.Single factor and logistic regression multivariate analysis were used to screen independent risk factors for intraperitoneal infection.Results The incidence of intraperitoneal infection was 17.14%.Diabetes,MELD score,intraoperative bleeding and postoperative ascites were independent risk factors for intraperitoneal infection (P＜0.05).Conclusion  It is necessary to strengthen liver function maintenance,intraoperative bleeding control,reduce the third space effusion and blood sugar management of patients with diabetes to reduce intraperitoneal infection.

Objective To investigate the correlation of fibulin 5(FBLN5) and Rho GTPase activating protein 4(ARHGAP4) in gastric cancer tissues and their relationship with the prognosis of patients.Methods One hundred gastric cancer patients admitted to the Department of General Surgery of Shijiazhuang First Hospital were selected for the study,and gastric cancer tissues >1cm from the tumor margin and paracancerous tissues 5cm from the tumor margin were collected.Retrospective analysis of the relationship between FBLN5 and ARHGAP4 expression profiles and clinicopathological indices of gastric cancer,as well as their effects on survival,was performed with univariate and Cox regression analyses of the patients’ clinical data.Immunohistochemical staining was used to detect the expression of FBLN5 and ARHGAP4.The relationship between the expression levels of different FBLN5 and ARHGAP4 and the survival time of patients.Results The positive expression rate of ARHGAP4 was lower than that of paracancerent tissues,and the positive expression rate of FBLN5 was higher than that of paracancerent tissues(P<0.05).ARHGAP4 expression was associated with tumor site,Lauren’s staging,lymph node metastasis,TNM stage,differentiation degree,CE,CA19-9,CA125,and immune score(P<0.05);FBLN5 expression was associated with Lauren’s staging,lymph node metastasis,TNM stage,differentiation degree,CE,CA19-9,CA125,and immune score(P<0.05);Kaplan-Meier analysis showed that the 3-year cumulative survival rate of FBLN5 positive group was,which was lower than that of negative group(P=0.044).The 3-year cumulative survival rate of ARHGAP4 positive patients was higher than that of negative patients(P=0.021).Cox results showed that positive ARHGAP4 was protective factor for survival(P<0.05).Conclusion The prognosis of patients in the FBLN5-positive group is worse than that in the negative group,high expression of FBLN5 is a risk factor for survival,and the prognosis of patients with ARHGAP4 negative group is better than that in the positive group,which are closely related to the development and prognosis of gastric cancer patients.

Objective To explore the efficacy of lapatinib combined with trastuzumab in the treatment of patients with human epidermal growth factor receptor-2 (HER2)-positive breast cancer and its effects on survival prognosis.Methods 86 patients with HER2-positive breast cancer who were treated with neoadjuvant chemotherapy from April 2016 to June 2018 were selected as the research subjects,and they were divided into observation group (lapatinib combined with trastuzumab treatment) and control group (trastuzumab treatment) by means of the random number table method,with 43 cases in each group.The therapeutic efficacy of the two groups was compared,and the changes in levels of vascular endothelial growth factor,inflammatory factors and apoptotic factors were recorded before and after treatment.All patients were followed up for 3 years or until their death,and the cumulative survival rate was compared between the two groups,and the occurrence of adverse events during treatment were counted.Results There were no significant differences in objective response rate (ORR) and disease control rate (DCR) between observation group and control group (72.09% vs 58.14%,86.07% vs 74.42%,P>0.05).After treatment,the levels of vascular endothelial growth factor A (VEGFA),vascular endothelial growth factor B (VEGFB),vascular endothelial growth factor C (VEGFC),tumor necrosis factor-α (TNFα),interleukin-1β (IL-1β),interleukin-6 (IL-6) and interleukin-8 (IL-8) in observation group were lower than those in control group,and the expression levels of decoy receptor 3 (DcR3) and cyclooxygenase-2 (COX-2) after treatment were also lower than those in control group (P<0.05).The 3 year survival rates in observation group and control group were 46.51% (20/43) and 30.23% (13/43),and the median survival times were 34.5 months and 26.7 months (P>0.05).There were no significant differences between the two groups in terms of incidence rates of adverse events (P>0.05).Conclusion Lapatinib combined with trastuzumab in the treatment of patients with HER2-positive breast cancer can reduce the levels of vascular endothelial factors and inflammatory factors and inhibit the releases of apoptotic factors,but has little effect on the 3-year survival rate of patients.

Objective To explore the clinical value of microsatellite instability(MSI) combined with tumor mutation load(TMB) in evaluating postoperative recurrence and metastasis in patients with non-small cell lung cancer(NSCLC).Methods A retrospective selection was performed on the 80 patients with NSCLC undergoing radical surgery in the hospital between March 2020 and March 2021.All underwent maintenance therapy after surgery.According to presence or absence of recurrence and metastasis at 1 year after surgery,they were divided into recurrence-metastasis group (47 cases) and non-recurrence-metastasis group (33 cases).The clinical data in both groups were collected.MSI and TMB detection of pathological tissues were conducted.The value of MSI and TMB in predicting recurrenceand metastasis of NSCLC patients after surgery was analyzed and compared.Results The univariate Logistic regression analysis showed that the recurrence and metastasis of lung cancer after radical resection were related to smoking history,high tumor staging,medium and low differentiation,lymph node metastasis,MSI negative,and high TMB(P<0.05).The results of multivariate Logistic regression analysis showed that lymph node metastasis and high TMB were independent risk factors of postoperative recurrence and metastasis(P<0.05),while positive MSI was a protective factor(P<0.05).Both MSI and TMB were of evaluation value for postoperative recurrence and metastasis(P<0.05).There was no significant difference in AUC between MSI and TMB(P>0.05).There were significant differences in AUC between combined detection and MSI(P>0.05),but there was no significant difference between combined detection and TMB(P<0.05).Conclusion Both MSI and TMB have evaluation value for postoperative recurrence and metastasis.There are differences between combined detection and MSI,but there is no significant difference between combined detection and TMB,which indicates that single TMB has good detection value.

Objective  To investigate the clinical treatment of patients with refractory plasma cell mastitis by fistulectomy combined with nipple correction,observe its clinical efficacy,and analyze its clinical practicability.Methods Nine patients with refractory plasma cell mastitis were treated from August in 2020 to March in 2022.Before operation,fistulectomy and nipple correction were performed after the local inflammation was controlled by oral Chinese medicine.After operation,routine surgical dressing changes were performed,and the clinical efficacy,satisfaction evaluation of postoperative breast appearance and recurrence rate were observed.Results All the nine patients were cured after operation and they were satisfied with their breast shape,and there was no recurrence within one year after operation.Conclusion Fistulectomy combined with nipple correction is a safe and effective method for the treatment of patients with refractory plasma cell mastitis.

Objective To evaluate the efficacy of transanal opening of intersphincteric space(TROPIS) for the treatment of complex anal fistula. Methods 41 patients with complex anal fistula were randomly divided into two groups by random envelope method:21 patients in the treatment group were treated with TROPIS;20 patients in the control group were treated with traditional low incision and high thread drawing surgery.The curative effect,postoperative pain score,wound healing time,treatment failure rate,anal sphincter function and postoperative complications were compared between the two groups.Results The visual analoguescale scores (VAS) of anal pain in the treatment group and the control group 8 hours,24 hours,3 days,7 days and the first defecation after operation were (1.81±1.12) vs.(5.00±1.49),(1.10±1.14) vs.(4.35±1.42),(0.86±1.01) vs.(4.35±1.27),(0.81±1.08) vs (4.25±1.41),(3.05±1.56) vs (6.70±1.17),respectively,with significant differences (P＜0.01).The VAS of anal pain in the treatment group and the control group 14 days after operation were (0.67±1.07) vs (0.80±1.11),respectively,with no significant difference (P＞0.05).1 case in the treatment group (4.76%) and 1 case in the control group (5.00%) had wound infection after surgery,there was no significant difference in the rate of wound infection between the two groups (P＞0.05).2 cases (9.52%) in the treatment group and 3 cases (15.00%) in the control group underwent postoperative catheterization,there was no significant difference in urinary retention between the two groups (P＞0.05).In the treatment group,16 cases were cured,3 cases were markedly effective,and the total effective rate was 90.48%,while in the control group,16 cases were cured,2 cases were markedly effective,and the total effective rate was 90.00%,there was no significant difference between the two groups (P＞0.05).The wound healing time of the treatment group and the control group were (37.31±3.42) days vs (48.13±4.08) days,respectively,with a statistically significant difference (P＜0.01).12 months after operation,2 patients in the treatment group and 1 patient in the control group lost the follow-up.12 months after operation,the ST Marks anal incontinence scores in the treatment group and the control group were (0.53±1.07) and (1.74±2.77),respectively,with a statistically significant difference (P＜0.05).There were 6 patients (31.58%) in the treatment group and 4 patients (21.05%) in the control group who failed in treatment,there was no significant difference in the rate of treatment failure between the two groups (P＞0.05).Conclusion The TROPIS is reliable in treating anal fistula,and has the advantages of less pain,quick recovery and less damage to anal function.

Objective In the patients with calcaneal fractures,the surgical method with intact peroneal tendon sheath was used to treat them,and compared with the traditional surgical method with dynamic retraction of the peroneal tendon,to analyze the influence of the surgical method on the posterior foot movement.Methods A retrospective analysis was made on 60 patients with calcaneal fracture admitted to the Department of Orthopaedics of our hospital from December 2016 to December 2020.The patients were divided into two groups according to the surgical method.The patients in the distraction group received the surgical treatment of traditional dynamic distraction of peroneal tendon (28 cases),and the patients in the preservation group received the surgical treatment of preserving the integrity of peroneal tendon sheath (32 cases).The outcome measures included perioperative indicators, Maryland score of foot function 12 months after surgery, AOFAS score of posterior foot and imaging indicators (Boler Angle and Gissane Angle) 12 months after surgery.Results The surgical time (89.34±12.21 minutes) and hospitalization time (5.26±1.47 days) of the retention group were significantly better than those of the traction group[（124.22±11.56）min,(11.59±2.43)d] (P<0.05).At the last follow-up,the AOFAS score (70.56 ± 3.62) and Maryland’s excellent and good rate (87.5%) of patients in the retention group were better than those in the traction group（81.37±3.58，71.4%）(P<0.05).The difference in imaging indicators between the two groups was relatively small (P>0.05).Conclusion The surgical method of keeping the peroneal tendon sheath intact in the treatment of patients with calcaneal fracture has definite clinical effects,and can also effectively reduce the adverse effects of surgical trauma on posterior foot activity.

Objective To investigate the clinical efficacy of bone filling mesh bag combined with pedicle anchoring for the treatment of Stage III reducible Kummell disease.Method The 35 paients with Stage Ⅲ  reducible Kummell disease were treated with bone filling mesh bag combined with pedicle anchoring from January 2018 to December 2022.The operation Time,intraoperative blood lose,bone cement injection volume and surgical complications were recorded.The VAS score,ODI value,kyphosis Cobb angle and midline height of the injured vertebral were compared at preoperative,postoperative 1 day and last follow-up.Results  All patients were followed up for 12-24months[(15±3.5)months].Operation time was 35-63min[(45±5.8)min],intraoperative blood loss was 10-35ml[(20±5)ml],bone cement injection volume was 4.5-7.8ml[(5.5±1.8)ml].There were 4 cases of bone cement leakage,there were 1 case of intervertebral leakage, 2 cases of lateral leakage，1 case of anterior leakage and no patient with intracanal leakage.All bone cement leakage did not lead to clinical symptoms, bone cement poisoning and pulmonary embolism. No cement mass slip. All patients were followed up for 12 to 24 months[(15±3.5)months].VAS scores and Oswestry Disability Index (ODI) values were significantly lower on the first day after surgery than before surgery, with statistical significance (P<0.05).The 3-month follow-up was slightly higher than that on the first day after surgery, and the difference was not statistically significant(P>0.05).The midline height and Cobb Angle of the injured vertebra were measured by imaging. The height of the injured vertebra recovered significantly on the first day after operation, and the Cobb Angle decreased significantly, the difference was statistically significant(P<0.05).The midline height of the injured vertebrae decreased and the Cobb Angle increased slightly at 3 months after the operation, but the difference was not statistically significant(P>0.05).Conclusion In the the treatment of Stage III reducible Kummell disease，Bone filling mesh bag combined with Pedicle anchoring have good clinical efficacy,which can significantly reduce the pain of patients,relieve clinical symptoms,improve spinal function,improve quality of life,and reduce the incidence of bone cement leakage and slippage.

Objective To investigate the efficacy of kinesio taping (KT) in the treatment of pain,function,range of motion and muscle strength in patients with knee articular osteoarthritis (OA).Method Forty patients with knee articular OA diagnosed in our hospital from January 2021 to January 2023 were selected.We randomly divided them into two groups,each with 20 cases.The observation group received KT therapy,while the control group received sham bandage therapy.Visual Analogue Scale/Score (VAS) was used to assess the degree of activity and nocturnal pain,KOOS score was used to assess the functional status of patients,digital goniometer was used to measure the range of activity and hand-held force meter was used to assess muscle strength.The evaluation time includes before treatment and on the 12th day of treatment.Result Compared with before treatment,the pain,function,range of motion,and muscle strength of patients in the control group and KT group were significantly improved after treatment.And compared with the control group,the KT group also significantly improved the above indicators after treatment.Conclusion KT therapy has significant efficacy in relieving short-term pain and improving functional limitations in knee osteoarthritis.

Objective To explore the effects of transurethral en-blocresection of bladder tumor (TeURBT) on urination function,serum chitinase protein 40 (YKL-40),bladder specific nuclear matrix protein-1 (BLCA-1),and poxyfossase-1 (PON-1) levels in patients with non-muscle invasive bladder cancer (NMIBC).Methods 74 patients with NMIBC admitted to our Hospital from January 2019 to May 2022 were divided into TeURBT group and transurethral resection of bladder tumor (TURBT) group by random lottery,with 37 cases in each group.The effective tumor clearance rate,surgery and urination function indexes were compared between the two groups.Blood samples were collected before surgery,3 months,6 months and 12 months after surgery to determine the levels of serum YKL-40,BLCA-1 and PON-1,and the recurrence rate was analyzed at 12 months of follow-up.Results The effective resection rate of bladder tumor was 100.00% in both groups.The operative time in TeURBT group was significantly longer than that in TURBT group (P<0.05),and the intraoperative blood loss,catheter indwelling/bladder irrigation/hospitalization time in TeURBT group were significantly less than those in TURBT group (P<0.05).Urinary output and maximum urinary flow per second in both groups significantly increased on postoperative day 14 (P< 0.05),but there was no statistically significant difference in the above indexes between the two groups on postoperative day 14 (P>0.05).The levels of serum YKL-40 and BLCA-1 in the two groups at 3,6 and 12 months after surgery significantly decreased (P<0.05),while the level of PON-1 significantly increased (P<0.05).There were no statistically significant differences in serum YKL-40 and PON-1 levels between the two groups at 3 and 6 months after surgery (P>0.05),while serum YKL-40 and BLCA-1 levels in the TeURBT group were significantly lower than those in the TURBT group at 12 months after surgery (P<0.05),and PON-1 levels were significantly higher than those in the TURBT group (P<0.05).The stages in the TeURBT group could be accurately diagnosed after operation,and the postoperative pathological stages were Ta stage in 24 cases and T1 stage in 13 cases.The total incidence of postoperative complications in TeURBT group and cumulative incidence of recurrence in 1-year follow-up were 5.40%,which was significantly lower than 24.32% and 21.62% in TURBT group (P<0.05).Conclusion The effective resection rate of TeURBT and TURBT in the treatment of NMIBC tumor is similar,which can effectively improve the urination function of patients,downregulation of serum YKL-40 and BLCA-1 levels,and up-regulation of PON-1 levels.Compared with TURBT,TeURBT has advantages of less intraoperative blood loss,fewer postoperative complications,faster recovery,and lower recurrence rate.

Objective To explore the efficacy and prognostic independent factors of modified island flap(OIF) and urethroplasty(tip) in the treatment of hypospadias in children.Methods The 164 children with hypospadias analyzed retrospectively were treated from February,2013 to February,2021.They were divided into two groups according to the operation method.82 patients in tip group were treated with tip and 82 patients in OIF group were treated with OIF.The treatment effects of the two groups were compared.Then they were divided into two groups according to the cure condition,namely,the good prognosis group(cured by operation,151 case) and the poor prognosis group(not cured by operation,13 case).Independent factors affecting the prognosis of children were analyzed by binary logistic regression.Results The cure rate of OIF group was 96.34% ,which was higher than that of the tip group(87.8%),and the incidence of postoperative complications in OIF group was 7.32%,which was lower than that of the tip group(23.17%,P<0.05).The operation time in tip group(95.95±12.35) min,which was shorter than that of the OIF group(P<0.05).At the same time,the binary logistic regression analysis showed that the degree of hypospadias and the classification of barcat were the prognostic factors of children with hypospadias.The degree of penis bending,the width of penis head and the method of operation were suspicious factors.Conclusion OIF and tip have good effects in the treatment of hypospadias in children.OIF has a higher success rate,tip has a shorter operation time and fewer postoperative complications.However,the independent factors affecting the prognosis of children are preoperative hypospadias classification and barcat classification.This operation method is not an independent factor affecting the prognosis.

Objective  To analyze the prognostic value of thrombin generation assay(TGA) and coagulation factor testing in postoperative deep venous thrombosis(DVT) of lower extremities in elderly patients with traumatic fracture.Methods A retrospective case-control study was conducted to collect traumatic patients older than 60 years old who underwent surgery in our department from March 2019 to March 2022.The number of patients was 104.According to the ultrasonic examination of DVT 5 days after operation,the patients were divided into DVT group and non-DVT group.The differences of general demographic data,previous chronic diseases,time from trauma to operation,related indexes of TGA and TF coagulation factors(F) between the two groups were analyzed.The indexes with statistical significance were analyzed by receiver operating curve(ROC);the indexes with statistically significant differences were analyzed by Logistic regression and the prediction probability was calculated by ROC curve analysis.Results The incidence of postoperative DVT was 21.12%.Compared with the non-DVT group,the time from trauma to operation was longer in the DVT group,and the peak value under 5 pmol/L TF activation was lower(258.13±40.88 vs 209.58±30.09).FⅤ,F Ⅷ and Fib were higher(141.25(125.38,158.18) vs 176.12(150.65,186.34),145.49(133.36,147.48) vs 165.96(153.07,180.65),3.25±0.55 vs 3.92±0.72,respectively).The differences were statistically significant(all P<0.01).ROC curve analysis showed that the time from trauma to operation,the peak value of 5 pmol/L TF activation,FⅤ,F Ⅷ and Fib combined had more predictive value for postoperative DVT,the AUC was 0.91(P＜0.01),the sensitivity was 0.82 and the specificity 0.92.Conclusion The time from trauma to operation,the peak value of TGA under the condition of 5 pmol/L TF activation,FⅤ,F Ⅷ and Fib have excellent prognostic value for the postoperative DVT of lower extremities in elderly patients with traumatic fracture,and the combined detection is more significative.

Moyamoya disease(MMD) is a bilateral stenosis occlusional disease that selectively affects the superior segment of clinoid of the internal carotid artery with secondary abnormal vascular network formation at the base of the skull.Intracranial and extracranial vascular reconstruction is the main treatment of moyamoya disease.However,moyamoya disease revasectomy still faces many challenges,with high requirements of surgical techniques and high risk of complications.In this paper,the perioperative management of cerebrovascular reconstruction in moyamoya disease was discussed in terms of surgical indications,surgical timing,patient management,surgical methods of cerebrovascular reconstruction and postoperative complications,so as to provide reference for improving the prognosis of patients.