Objective To investigate the safety and effectiveness of percutaneous nephrostomy in the treatment of obstructive urinogenic sepsis complicated with thrombocytopenia.Methods  Clinical data of 116 patients with urogenic sepsis complicated with thrombocytopenia admitted to Xiaogan Hospital of Wuhan University of Science and Technology from October 2017 to May 2021 were collected.There were 23 patients with abnormal renal function indexes (serum creatinine >500mmol/ L).Preoperative urinary tract CT or ultrasound were performed to confirm hydronephrosis. According to the number of platelets in preoperative blood routine,they were divided into study group (platelet <50×10⁹/L) and control group (platelet ≥50×10⁹/L).Percutaneous nephrostomy was performed under ultrasound guidance in both groups.The outcome indexes included the success rate of operation,body temperature,routine white blood cell count,the time to return to normal of procalcitonin,postoperative bleeding,shock,and side injury.Results In the study group, preoperative fever time was (6.9±2.2) days, platelet count was (35±10.2)×109/L, preoperative procalcitonin (PCT) was (36±6.2)ng/ml, and serum creatinine increased by 30%. While, the data in control group were (4.2 + 2.0) days,(115±58.9)×10⁹/L, (20±2.6)ng/ml and 12%,respectively.The difference between the two groups was statistically significant(P<0.05).The recovery time of PCT in study group and control group was (6.9±2.8) days and (4.8±1.5) days, respectively. The normal recovery time of body temperature was (36.2±3.5) hours and (28.5±2.3) hours, respectively. The recovery time of white blood cell count was (5.3 ±1.2) days and (3.2±2.5) days, respectively. The recovery time of platelet was (6.0 ±2.3) days and (3.5±2.0) days, respectively. The difference between the two groups was statistically significant(P<0.05).There was no significant difference in surgical success rate, postoperative collateral injury, massive hemorrhage, shock and other complications between the two groups (P>0.05).Conclusion Percutaneous nephrostomy (PCN) is effective and safe in the treatment of urogenic sepsis with thrombocytopenia,and it is worth popularizing. 

Objective To investigate the clinical efficacy of transurethral plasma electrotomy with rod electrode and end-to-end urethral anastomosis in the treatment of short urethral stricture.Methods 125 male patients with short urethral stricture (<2 cm) who were admitted to our hospital from January 2014 to December 2020 were retrospectively analyzed.According to different surgical methods,they were divided into transurethral plasma resection with rod electrode (minimally invasive group) and urethral end-to-end anastomosis (open group).According to the length of urethral stricture,the minimally invasive group was divided into minimally invasive group 1 (stricture length ≤1cm),minimally invasive group 2 (stricture length12cm),open group 1 (stricture length ≤1cm) and open group 2 (stricture length 12cm).The four groups were compared with each other,and the surgical success rates were compared between the four groups.Results The success rate of the minimally invasive group 1 and the open group 1 was 88.57% and 93.10%,respectively.There was no significant difference between the two groups (P>0.05).The surgical success rate of the minimally invasive group 2 and the open group 2 was 67.86% and 90.91%,respectively.The surgical success rate of the minimally invasive group 2 was significantly lower than that of the open group 2.The difference was statistically significant (P＜0.05).The surgical success rate of minimally invasive group 1 and minimally invasive group 2 was 88.57% and 67.86%,respectively,the difference was statistically significant (P＜0.05).The success rate of operation in the open group 1 and the open group 2 was 93.10% and 90.91%,respectively,and there was no significant difference between the two groups (P>0.05).Conclusion Transurethral plasma resection with rod electrode is preferred for urethral stricture with length ≤1cm,because the success rate of this surgery is the same as that of open surgery,and the surgical trauma is small and the recovery is fast.For 12cm urethral stricture,minimally invasive surgery has less trauma and faster recovery,but open surgery has a higher success rate.The choice of surgical method needs to weigh the advantages and disadvantages and take comprehensive consideration.

Objective To investigate the predictive value of urinary exosomal microRNA(miR)-29c in the clinical outcome of organ- and non-organ-confined bladder urothelial carcinoma(BUC).Methods From January 2017 to March 2022,152 patients with BUC were recruited from the Department of Urology in our hospital as a validation set.In addition,126 non-cancer controls were selected from the physical examination center of our hospital.The expression level of urinary exosomal miR-29c was detected by real-time quantitative PCR.Results In the validation set,urinary exosomal miR-29c level in BUC patients was significantly lower than that in non-cancer control group(P＜0.05),while urinary exosomal miR-17-5p level and miR-590-5p level were not significantly different(P>0.05).The area under ROC curve of urinary exosomal miR-29c for the diagnosis of BUC was 0.969(95%CI:0.953~0.986),and the corresponding sensitivity and specificity were 92.1% and 90.2%,respectively.In subtype analysis,urinary exosomal miR-29c levels were further reduced in patients with non-organ-confined BUC compared with patients with organ-confined BUC(P=0.009).Overall survival(OS),disease-free survival(DFS) and disease-specific survival(DSS) were longer in the urinary exosomal miR-29c high expression group(P＜0.05).Conclusion Low levels of urinary exosomal miR-29c are an adverse prognostic factor for survival in patients with BUC,and are promising as a predictor of adverse clinical outcomes of organ-and non-organ-confined BUC.

Objectiv To analyze the expression of serum procalcitonin (PCT),pentraxin 3 (PTX3) and high mobility group protein B1 (HMGB-1) in children after open gastrointestinal surgery and their application value in early infection prediction.Methods A retrospective analysis was performed on 206 children with open gastrointestinal surgery admitted to the hospital from January 2020 to January 2023.They were divided into infection group (27 case) and non-infection group (179 case) according to whether they had postoperative infection.The levels of serum PCT,PTX3 and HMGB-1 before operation,1 d and 3 d after operation were compared between the two groups.The predictive value of single and combined detection of serum indexes 1 d and 3 d after operation for postoperative infection in children with open gastrointestinal surgery was observed.The influencing factors of postoperative infection were analyzed by multivariate Logistic regression.Results The levels of serum PCT,PTX3 and HMGB-1 in the infection group were (2.42±0.39) μg/L,(3.74±0.53)μg/L,(2.07±0.66) μg/L,(3.06±0.75) μg/L,(18.35±2.74) μg/L,and (26.09±4.16) μg/L at 1d and 3d after operation,which were higher than those in the non-infection group (1.71±0.35) μg/L,(2.29±0.36) μg/L,(1.48±0.52) μg/L,(1.73±0.59) μg/L,(13.04±2.26) μg/L,and (15.75±2.83) μg/L(P<0.05).Receiver operating characteristic curve showed that the area under the curve (AUC) of combined detection of serum PCT,PTX3 and HMGB-1 in predicting postoperative infection in children with open gastrointestinal surgery was the largest (0.989) at 3 days after operation; Multivariate Logistic regression analysis showed that age was an independent protective factor for postoperative infection in children,and Intraoperative blood loss,operation time,serum PCT,PTX3 and HMGB-1 at 1d and 3d after operation were independent risk factors (P < 0.05);  The levels of serum PCT,PTX3 and HMGB-1 in children with moderate to severe infection were  (2.63±0.34) μg/L,(4.12±0.56) μg/L,(2.31±0.69) μg/L,(3.39±0.81) μg/L,(19.86±2.91) μg/L,and (28.84±4.40) μg/L at 1-d and 3-d after operation,which were higher than those in children with mild infection (2.11±0.28) μg/L,(3.19±0.49) μg/L,(1.72±0.60) μg/L,(2.58±0.73) μg/L,(16.15±2.39) μg/L,and (22.09±3.96) μg/L (P<0.05).Conclusion The expression of serum PCT,PTX3 and HMGB-1 in children after open gastrointestinal surgery was significantly increased,and its expression was related to early postoperative infection and the severity of infection,and the combined predictive value of the three was higher,which could provide reference for early infection prediction.

Objective To investigate the predisposing factors carried out in patients with secondary primary esophageal cancer and the related factors affecting its prognosis.Methods Patients with pathologically definite esophageal cancer diagnosis from 2000~2019 in the Surveillance/Epidemiology and End Results (SEER) database were selected,from which the data of patients with other malignancies as the first and esophageal cancer as the second primary (Secondary Primary Esophageal cancer-SPE) were screened,and logistic regression was used to analyze the independent risk factors in patients with secondary primary esophageal cancer,and the independent risk factors affecting the prognosis of such patients were analyzed by Cox proportional hazard model.Results A total of 13520 patients with multiple primary malignancies with esophageal cancer,including a total of 8308 patients with secondary primary esophageal cancer.Multiple logistic analysis showed that age,tumor site,tumor differentiation,pathological examines,SEER neoplasm invasiveness and regional lymph node adoption were independent factors influencing the occurrence of SPE,while multiple Cox risk proportion analysis suggested that age,year of diagnosis,race,tumor differentiation,SEER neoplasm invasiveness,surgery,chemotherapy,radiotherapy,and triple therapy were independent risk factors influencing SPE.Conclusion This study identified risk factors for secondary primary esophageal cancer,and surgery may be an effective treatment for SPE,which clinicians can use as a reference for diagnosis and treatment.

Objective To explore the diagnostic value of serum ficolin3 (FCN3) and collagen triple helix repeat containing-1 (CTHRC1) in non-small cell lung cancer (NSCLC) and their relationship with clinicopathological characteristics.Methods From July 2021 to August 2022,73 patients with NSCLC who were admitted to the our Hospital were selected as the study group,and 55 healthy people who came to our hospital for physical examination were regarded as the control group.the serum levels of FCN3 and CTHRC1 were measured by enzyme-linked immunosorbent assay (ELISA);Pearson method was applied to analyze the correlation of serum FCN3 and CTHRC1 levels in NSCLC patients;Logistic regression analysis was applied to analyze the influencing factors of NSCLC;the diagnostic value of serum FCN3 and CTHRC1 levels on the occurrence of NSCLC was analyzed by the ROC curve.Results The levels of serum FCN3 and CTHRC1 in the study group were obviously higher than those in the control group (P<0.05);the levels of serum FCN3 and CTHRC1 were correlated with the degree of cancer cell differentiation,TNM stage and lymph node metastasis in NSCLC patients (P<0.05);Pearson method analysis showed that there was a positive correlation between serum FCN3 and CTHRC1 levels in NSCLC patients (r=0.258,P=0.028);Logistic regression analysis showed that serum FCN3 and CTHRC1 were the influencing factors of NSCLC (P<0.05);the area under the ROC curve of serum FCN3 and CTHRC1 levels in diagnosis of NSCLC was 0.869 and 0.810,respectively,the area under the ROC curve of NSCLC was 0.881,which were better than those of serum FCN3 and CTHRC1.Conclusion The levels of serum FCN3 and CTHRC1 in patients with NSCLC increase,which are related to the degree of cancer cell differentiation,TNM stage and lymph node metastasis,they are risk factor for NSCLC,and the combination of the two is more valuable in diagnosis of NSCLC.

Objective To investigate the impacts of butorphanol on the proliferation,apoptosis and migration of esophageal cancer cells and its regulation on CCL2-CCR2 axis.Methods Human esophageal cancer KYSE30 cells were treated with 0~400ng/ml of butorphanol gradient concentration,and the cell proliferation was detected by MTT method;KYSE30 cells were grouped into control group,butorphanol L group,butorphanol M group,butorphanol H group and butorphanol H+CCL2 group,EdU method was applied to detect cell proliferation;cell apoptosis was detected by Hoechst method;cell migration was detected by cell scratch test;Transwell method was applied to detect cell invasion;Western blot was applied to verify the expression of CC chemokine ligand 2 (CCL2) and CC chemokine receptor 2 (CCR2).Results Butorphanol at the concentrations of 50ng/ml,100ng/ml,200ng/ml and 400ng/ml obviously inhibited the proliferation of KYSE30 cells;compared with the control group,the proliferation,migration and invasion of KYSE30 cells and the expression of CCL2 and CCR2 proteins in butorphanol L,M,H groups and butorphanol H+CCL2 groups were obviously decreased (P<0.05);compared with butorphanol H group,the cell proliferation,migration,invasion abilities and the expression levels of CCL2 and CCR2 proteins in butorphanol H+CCL2 group were obviously increased (P<0.05).Conclusion Butorphanol can obviously inhibit the proliferation,migration and invasion of esophageal cancer KYSE30 cells and promote cell apoptosis,which may be related to its inhibition of CCL2-CCR2 axis.

Objective To investigate the effects of simple topical anesthesia and intravenous general anesthesia on the occurrence of pancreatitis after ERCP.Methods 400 Patients who underwent ERCP due to pancreaticobiliary duct disease in our hospital from January 2021 to March 2023 were selected and divided into two groups:Simple topical anesthesia group and intravenous general anesthesia group,200 cases in each group.The levels of venous pancreatic amylase and abdominal symptoms and signs were recorded in the two groups before operation and 3h and 24h after operation.The observation results were hyperamylaseemia and postoperative pancreatitis at 3h and 24h after operation.Results The incidence of postoperative pancreatitis after ERCP was higher in the superficial anesthesia group than in the intravenous general anesthesia group (7.5% and 2.0%,respectively;P<0.05),there was statistical significance;The level of serum pancreatic amylase (198±216)U/L in intravenous general anesthesia group was significantly lower than that in superficial anesthesia group (379±327)U/L at 3h after surgery (P<0.05).The level of serum pancreatic amylase (129±98)U/L in intravenous general anesthesia group was lower than that in superficial anesthesia group (187±156) at 24h after surgery (P<0.05).The incidence of hyperamylasemia was 15.5% (31/200 cases) in the 3h postoperative intravenous general anesthesia group,lower than that in the simple surface anesthesia group (34.5%）(69/200 cases),and 5.5%(11/200 cases) in the 24h postoperative intravenous general anesthesia group,lower than that in the simple surface anesthesia group (19.0%) (38/200 cases)(P<0.05).Conclusion Compared with simple surface anesthesia,intravenous general anesthesia can reduce the level of serum amylase after ERCP,and can reduce the occurrence of pancreatitis after ERCP.

Objective To investigate the clinical effect of transhepatic arterial chemoembolization (TACE) combined with tyrosine kinase inhibitors (TKIs) and programmed death receptors-1 (PD-1) inhibitors (TACE+TKIs+PD-1 antibody) in the treatment of moderate advanced unresectable hepatocellular carcinoma (HCC).Methods The clinical data of 65 patients with moderate advanced unresectable hepatocellular carcinoma admitted to the Affiliated Hospital of North Sichuan Medical College from January 2020 to January 2022 were analyzed retrospectively.65 patients were treated with TACE+TKIs+PD-1 antibody.The observation indexes were tumor response,objective response rate (ORR),disease control rate (DCR),total survival time,progression free survival time,conversion operation rate and adverse drug reaction.Results The ORR of 65 patients with hepatocellular carcinoma was 49.2% (32/65),and the DCR was 89.2% (58/65).Among them,there were 2 patients with complete remission(CR),30 patients with partial remission(PR),26 patients with stable disease(SD),and 7 patients with progression disease(PD).Among 65 patients with hepatocellular carcinoma,18 patients were transformed into resectable hepatocell-ular carcinoma and underwent RO surgery.The conversion rate was 27.6% (18/65).65 patients were followed up for 3 to 22.4 months,The median follow-up time was 16.5 months.The median overall survival time and median disease progression free survival time of 65 patients were 14.5 months (95% CI:12.3~16.6 months) and 8.8 months (95% CI:6.9~10.6 months),respectively.After treatment,65 patients all had post embolism syndrome (abdominal pain,fever,nausea,vomiting and other symptoms),and some patients had transient abnormal liver function.Adverse drug reactions below grade 3 recovered within a few days.Some patients were associated with multiple adverse drug reactions.1 patient (1.5%)  stopped using TACE because of stubborn vomiting,and 5 patients (7.6%) stopped using Lenvatinib because of severe liver function damage during treatment,2 patients (3%) stopped using Camrelizumab because of severe reactive capillary hyperplasia,one patient (1.5%) stopped using Tislelizumab because of severe hypothyroidism,one patient (1.5%) stopped the treatment of Lenvatinib and Sintilimab due to severe gastrointestinal bleeding.The adverse drug reactions of grade 3~4 occurred in other patients were alleviated after drug reduction,symptomatic treatment and hormone treatment.Conclusion TACE+TKIs+PD-1 antibody can obtain reliable clinical efficacy and anti-tumor activity in the treatment of moderate advanced unresectable hepatocellular carcinoma.

Objective To construct a nomogram to predict the prognosis of patients with gallbladder cancer (GBC).Methods The clinicopathological data of GBC patients were extracted from the SEER database,and the independent prognostic factors of GBC patients were analyzed by Cox regression,and a nomogram was constructed.Finally,the column diagrams in the training queue and validation queue are verified.Results Age,T stage,M stage,histological grade,radiotherapy,surgery and tumor size were independent prognostic factors in GBC patients,and the differences were statistically significant (P<0.05).In the training cohort,the C index was 0.735 (95%CI=0.721~0.749),and the AUC values at 1,3 and 5 years were 0.821,0.820 and 0.833,respectively.In the verification group,the C index was 0.733 (95%CI=0.711~0.755),and the AUC values for 1,3 and 5 years were 0.816,0.807 and 0.827,respectively.The calibration curve shows that the predicted values of the nomogram are in good agreement with the observed values.The decision curve shows that the nomogram model has better prediction ability than TNM staging system.Conclusion The constructed dynamic prognosis nomogram of GBC patients has high accuracy and reliability.

Objective To evaluate the efficacy of XELOX regimen as neoadjuvant chemotherapy in the treatment of stage Ⅱ and Ⅲ colon cancer.Methods The clinical data of 50 patients with clinical stage Ⅱ(T4)  Ⅲ colon cancer who underwent laparoscopic radical resection at general surgery department of our hospital from January 1,2012 to January 1,2021 were retrospectively analyzed.Patients were divided into neoadjuvant chemotherapy group (NACT) and adjuvant chemotherapy group (ACT) according to whether they received neoadjuvant chemotherapy with XELOX regimen.The general clinical data,adverse reactions of chemotherapy,surgical complications,operation time,intraoperative blood loss,hospitalization time,hospitalization cost,negative conversion rate of tumor markers,tumor remission rate,tumor downstaging rate,tumor response grade after chemotherapy,postoperative diseasefree survival curve,and overall survival curve were retrospectively analyzed and compared among the groups.Objective To evaluate the efficacy of XELOX regimen as neoadjuvant chemotherapy in the treatment of stage Ⅱ and Ⅲ colon cancer.Methods The clinical data of 50 patients with clinical stage Ⅱ(T4)  Ⅲ colon cancer who underwent laparoscopic radical resection at general surgery department of our hospital from January 1,2012 to January 1,2021 were retrospectively analyzed.Patients were divided into neoadjuvant chemotherapy group (NACT) and adjuvant chemotherapy group (ACT) according to whether they received neoadjuvant chemotherapy with XELOX regimen.The general clinical data,adverse reactions of chemotherapy,surgical complications,operation time,intraoperative blood loss,hospitalization time,hospitalization cost,negative conversion rate of tumor markers,tumor remission rate,tumor downstaging rate,tumor response grade after chemotherapy,postoperative disease-free survival curve,and overall survival curve were retrospectively analyzed and compared among the groups.Results There were no significant differences in operative complications,postoperative exhaust time and hospital stay between NACT group and ACT group (P>0.05).The adverse reactions of chemotherapy,the negative conversion rate of postoperative CEA and CA19-9,the duration of operation,the amount of bleeding,and the hospitalization cost in NACT group were significantly better than those in ACT group (P<0.05).In terms of DFS and OS survival curves,with the extension of time,the decline of the NACT survival curve was smaller than that of the ACT group,and there was a significant difference in DFS survival curve (P<0.05),but no significant difference in OS survival curve (P>0.05).Conclusion XELOX neoadjuvant chemotherapy is safe and effective in the treatment of stage Ⅱ (T4) and stage Ⅲ  colon cancer.There were no significant differences in operative complications,postoperative exhaust time and hospital stay between NACT group and ACT group (P>0.05).The adverse reactions of chemotherapy,the negative conversion rate of postoperative CEA and CA19-9,the duration of operation,the amount of bleeding,and the hospitalization cost in NACT group were significantly better than those in ACT group (P<0.05).In terms of DFS and OS survival curves,with the extension of time,the decline of the NACT survival curve was smaller than that of the ACT group,and there was a significant difference in DFS survival curve (P<0.05),but no significant difference in OS survival curve (P>0.05).Conclusion  XELOX neoadjuvant chemotherapy is safe and effective in the treatment of stage Ⅱ (T4) and stage Ⅲ  colon cancer.

Objective To investigate the viability and safety of laparoscopic sleeve gastrectomy (LSG) based on the TJ point at the junction of the posterior gastric wall and the apex of the medial edge of the left diaphragm.Methods A retrospective analysis of 135 patients with obesity or obesity with metabolic syndrome who underwent LSG from January 2019 to January 2022 were divided into two groups according to the different free modes of fundogastric body.68 patients underwent surgery using the TPOL model LSG.A control group of 67 patients was treated with conventional LSG surgery.To analyze and compare the duration of operation,gastric fundus free time,intraoperative blood loss time,hospital stay time,postoperative gastric fistula,bleeding rate,and occurrence of gastroesophageal reflux disease (GERD) between the two groups.Results All patients successfully completed LSG surgery and were safely discharged.They were followed for a period of 12 to 36 months.the duration of operation for the study group was (56.13±10.56) minutes,while for the control group it was (62.45±12.74) minutes.The gastric fundus was freed in (6.34±4.16) minutes for the study group and (12.58±6.37) minutes for the control group.The duration of hospitalization was (3.84±0.42) days for the study group and (4.06±0.69) days for the control group.The intraoperative blood loss was (10.87±1.28) ml for the study group and (15.56±3.39) ml for the control group.The incidence of postoperative GERD was 5 (7.35%) for the study group and 13 (19.40%) for the control group.The differences between the two groups were statistically significant (P<0.05).The decrease in excess weight at 12 months after surgery,as well as complications such as bleeding and gastric fistula,were not statistically significant (P> 0.05).Conclusion LSG (TPOL model) extends from the TJ point (the Tri-junction point where the gastric left mesangium,gastric posterior mesangium,and pancreatic mesangium meet) to the apex of the medial foot edge of the left diaphragm.LSG (TPOL model) can be efficiently and safely achieve tension-free anastomosis,resulting in a complete free gastric fundus.This method is feasible,and has clinical value for the standardized free gastric fundus of LSG.

Objective To investigate the influencing factors of postoperative gastroparesis syndrome (PSG) after laparoscopic right hemicolon cancer resection.Methods A total of 1070 patients with laparoscopic right hemicolon cancer resection (complete right hemicolon mesoresection) were selected from Wuhan General Hospital of Yangtze River Shipping and Wuhan Union Hospital Cancer Department from December 2012 to June 2022. According to whether the patients got postoperative gastroparesis, were divided into the postoperative gastroparesis syndrome (PSG) group or the normal control group. Univariate and multivariate Logistic regression analysis were used to analyze the risk factors of PGS after right hemicolon resection. Results There were 29 patients in the gastroparesis group and 1041 patients in the normal control group. Univariate analysis showed that age, perioperative blood glucose level, surgical resection range, and surgical approach were related to the occurrence of PGS (P<0.05). Multivariate Logistic analysis showed that age, high perioperative blood glucose level, caudal approach plus combined approach, and large surgical resection range were independent influencing factors of PGS (P<0.05).Conclusions Age, high perioperative blood glucose level, caudal approach plus combined approach, and large surgical resection range are influencing factors of PGS.

Objective To investigate the potential value of miR-141 as a diagnostic blood biomarker expression level in patients with colorectal cancer(CRC) and its change after radical CRC resection.Methods 75 CRC patients admitted to Affiliated to Medical College of Xi’an Jiaotong University 3201 Hospital from April 2019 to March 2021 were included in the experimental group,and 20 patients who received planned surgery for inguinal hernia during the same period were used as non-cancer control group.Surgical tissue and serum samples of these patients were collected.Microarray analysis was performed for miRNAs with significant expression differences in CRC tissues and serum.Real-time quantitative PCR(qRT-PCR) was used to verify the expression level of miR-141 in serum samples of the patients before surgery and at the 3rd day after surgery,and the relationship between miR-141 and clinicopathological characteristics of CRC patients was analyzed.Results By miRNA microarray analysis, we confirmed that 12 miRNAs were up-regulated simultaneously in tissue and serum samples of CRC patients,among which miR-141 was the most significantly up-regulated.Meanwhile,the relative expression level of miR-141 in serum of CRC group was significantly higher than that of non-cancer control group after qRT-PCR verification[2.50(1.06，3.12)vs.0.97(0.68，1.21)，Z=-5.842，P＜0.05].According to ROC curve analysis, the AUC value of preoperative serum miR-141 for the diagnosis of CRC was 0.927(95%CI:0.862～0.992).When serum miR-141≥1.418, the accuracy of distinguishing between CRC and non-cancer control groups was 90.53%.Combined detection of serum miR-141 could increase the diagnostic AUC value of carcinoembryonic antigen and carbohydrate antigen 199 to 0.944(95%CI：0.899～0.998).For CRC patients, the relative expression level of serum miR-141 after radical resection was significantly lower than that before surgery[1.85(1.29，2.22) vs.2.55(2.07，3.18)，Z=-5.416，P＜0.001].For those who did not receive radical resection, the relative expression level of serum miR-141 after surgery was slightly lower than that before surgery[2.28(1.72，2.74)vs.2.45(2.06，2.85)],but the difference was not statistically significant(Z=-1.917，P=0.055).The expression level of Mir- 141 in serum of CRC patients was correlated with UICC stage and histological grade(P＜0.05).Conclusion Serum miR-141 reflects the pathological changes of CRC patients and can be used as a biomarker for noninvasive diagnosis of CRC.

Objective To investigate the clinical application of skin bridge preopening window drainage in enhanced recovery of mixed hemorrhoids surgically treated with external dissection and internal ligation.Methods A total of 620 patients with mixed hemorrhoids surgically treated with external dissection and internal ligation were retrospectively analyzed from March 1, 2021-February 28, 2022.Patients were divided into the observation group (n=304) and the control group(n=316)  according to the single and even numbers randomly generated at the time of admission.In the observation group,on the basis of conventional operation and drug treatment in the control group,most of them chose to implement preopening window drainage of the skin bridge according to the intraoperative evaluation of the anal skin  bridge according to the unified evaluation criteria.Symptom sign scoring scale used to evaluate the anal edema and pain after the operation.To compare and analyze differences in anal edema,anal pain and the postoperative hospital stay between the observation group  and the control.Results The average daily edema scores of the observation group and the control group were 0.56 and 1.2 points,respectively.The average daily edema score of the observation group was lower than that of the control group ，with the statistically significant differences(P<0.05).The average daily pain scores of the observation group and the control group were 0.6 and 1.201+0.289 points,respectively.The average daily pain score of the observation group was lower than that of the control group，with the statistically significant differences（P<0.05).The average hospitalization days of the observation group and the control group were 8 days and 10 days,respectively.The average length of stay in the observation group was less than that in the control group,with the statistically significant differences(P<0.05).Conclusion Skin bridge preopening window drainage can effectively relieve the degree of anal edema and pain in patients with mixed hemorrhoids surgically treated with external dissection and internal ligation,improve clinical efficacy,shorten the postoperative hospital stay.It has practical value and clinical significance for enhanced recovery.

Objective  To evaluate the diffusion distribution of bone cement in the vertebral body by quadrant method,and to analyze and evaluate the correlation between the diffusion distribution type of bone cement and new vertebral fractures after vertebral augmentation.Methods  A total of 170 subjects who met the conditions from January 2020 to December 2021 were collected.According to the anteroposterior and lateral view of the spine,the injured vertebra was divided into four quadrants,and divided into homogeneous diffusion group and uneven diffusion group according to the postoperative diffusion distribution of bone cement in the injured vertebra.The incidence and types of refracture were followed up,and the VAS score and Cobb angle were compared between the two groups.Results 170 patients were followed up for at least 12 months,including 90 patients in homogeneous diffusion group and 80 patients in heterogeneous diffusion group.There were 33 cases of refracture(19.41%),12 cases of refracture(13.33%) in the diffuse homogeneous group,and 21 cases of refracture(26.25%) in the diffuse heterogeneous group,and the difference between the groups was statistically significant(P<0.05).The site of refracture in the diffuse homogeneous group was mainly the clinical vertebral fracture,while the probability of refracture in the diffuse heterogeneous clinical vertebra and the operated vertebra was similar.The incidence of postoperative bone cement leakage in the diffuse homogeneous group was significantly lower than that in diffuse heterogeneous group(P＜0.05).The VAS score and Cobb angle were significantly improved in both groups after surgery and at the last follow-up compared with those before surgery,but there was no significant difference between groups.Conclusion The incidence of new vertebral fractures after vertebroplasty is closely related to the type of cement diffusion,and the risk of refracture defined as uneven cement diffusion by quadrant method is high.

The therapeutic effect is not ideal for patients with colorectal cancer that has already metastasized.In recent years,it has been found that extracellular vesicles play an important role in various aspects of cancer cells,and their impact on the invasion and metastasis process of colorectal cancer has gradually been revealed.This review reviews and analyzes the role of extracellular vesicles in the invasion and metastasis of colorectal cancer,and briefly introduces the role of some extracellular vesicles in the treatment of colorectal cancer.

Severe open injury of lower limbs is complex and difficult to cure in a short time,which can lead to serious infection,amputation and so on.For the treatment of open injury,wound repair is extremely important.A variety of new technologies such as new dressings,platelet-rich plasma ( PRP ),and vacuum sealing drainage ( VSD ) have recently been applied to lower limb wound repair,which can not only improve the functional prognosis and aesthetic effect,but also improve the quality of wound healing.This review will summarize the research progress of wound repair methods for open injury of lower limbs,so as to further guide clinical application.