Objective To compare the clinical curative effect of percutaneous endoscopic lumbar discectomy (PELD) and unilateral biportal endoscopic discectomy (UBED) on lumbar disc herniation (LDH).Methods A retrospective analysis was performed on the case data of 102 patients with LDH undergoing percutaneous endoscopic lumbar discectomy in the hospital between June 2019 and June 2022,including 51 cases undergoing PELD in PELD group and 51 cases undergoing UBED in UBED group.The operation time,intraoperative blood loss,hospitalization time and other surgical related indicators,postoperative spinal canal cross-sectional area,sagittal diameter of intervertebral foramen,intervertebral foramen area and other imaging indicators,visual analogue scale (VAS),Oswestry disability index (ODI) and surgical efficacy were compared between the two groups.The complications such as dural tear and hematoma were recorded in the two groups.Results The operation time,postoperative bed time and hospitalization time in PELD group were similar to those in UBED group(P>0.05).The times of intraoperative fluoroscopy in PELD group were more than those in UBED group [(6.62±1.11) times vs. (3.24±0.72) times],and intraoperative blood loss was less than that in UBED group [(21.56±4.79) ml vs. (38.59±7.82) ml;P<0.05].After surgery,VAS and ODI scores in both groups were decreased (P<0.05).After surgery,imaging indexes (cross-sectional area of spinal canal,sagittal diameter in the middle of intervertebral foramen,intervertebral foramen area) in both groups were significantly improved (P<0.05),but the PELD group were similar to those in UBED group (P>0.05).The good rates of surgery in both groups were high,but the PELD group were similar to those in UBED group (P>0.05).The incidence of surgical related complications in PELD group were similar to those in UBED group (Fisher exact probability=1.000).Conclusion The clinical curative effect of PELD and UBED is comparable on LDH.However,the former has less intraoperative blood loss,while the latter has fewer times of intraoperative fluoroscopy and less radiation.

Objective To explore the risk factors of knee stiffness after minimally invasive arthroscopic percutaneous plate fixation (MIPPO) for tibial plateau fracture.Methods A retrospective study was conducted on the clinical data of 185 patients who underwent arthroscopic MIPPO treatment for tibial plateau fracture admitted to the Department of Orthopedics of the First Affiliated Hospital of Air Force Medical University from December 2020 to December 2022.The group was categorized according to the occurrence of joint stiffness at 1 year postoperatively into the no joint stiffness group (n=157 cases) and the joint stiffness group (n=28 cases).The relevant data of the two groups before,during and after operation were collected for univariate analysis,and the statistically significant indicators in the analysis were incorporated into binary Logistic regression analysis to analyze whether they were risk factors for knee stiffness after MIPPO arthroscopic treatment of tibial plateau fracture.Results Univariate analysis of preoperative indicators showed that the differences between the two groups were not statistically significant when comparing age,gender,body mass index,smoking history,diabetes mellitus,occupation as a worker,Schatzker typing of fractures,timing of surgery,and high-energy injuries (P>0.05),but there was a statistically significant difference in the comparison of the two groups in the combination of heterotopic ossification and combination of extensor device injuries (P<0.05).One-way analysis of intraoperative indicators showed that the differences between the two groups in the placement of drains,operation time,intraoperative bleeding,and incision length were not statistically significant (P>0.05).Single-factor analysis of postoperative indicators showed that the differences between the two groups were not statistically significant when comparing postoperative analgesia,hospitalization time,incision healing time,lower extremity deep vein thrombosis,and incision infection (P>0.05),but the differences were statistically significant when comparing standardized rehabilitation training (P<0.05).Binary logistic regression analysis showed that the combination of heterotopic ossification,the combination of knee extension device injury,and the lack of standardized rehabilitation training were all risk factors for postoperative knee stiffness in the treatment of tibial plateau fracture by arthroscopic MIPPO (P<0.05).Conclusion Combined heterotopic ossification,combined knee extension device injury,and lack of standardized rehabilitation training are all risk factors for postoperative knee stiffness in arthroscopic MIPPO for tibial plateau fracture,and clinical attention should be paid to patients with these factors.

Objective To analyze the risk factors of soft tissue complications after closed calcaneal fractures,and to construct and evaluate a nomogram prediction model.Methods 218 patients with closed calcaneal fracture admitted to our hospital from January 2016 to June 2021 were retrospectively analyzed and divided into complication group (n=43) and non-complication group (n=175) according to whether postoperative soft tissue complications occurred.Logistic regression was used to analyze the risk factors of soft tissue complications after calcaneal closed fracture.A nomogram model was constructed to predict the occurrence of soft tissue complications after closed calcaneal fracture.The nomogram model was validated by receiver operating characteristic (ROC) curve and calibration curve.Results There was no significant difference between the group with postoperative soft tissue complications and the group without postoperative soft tissue complications in terms of gender,hypertension,antibiotic application time,and bone grafting methods (P >0.05),and there was no significant difference in age,smoking history,diabetes,the time from injury to operation,whether a drainage tube was placed,whether non-contact technology was used to protect the soft tissue during the operation,the operation time,the type of fracture,and the type of incision (P<0.05).Logistic regression analysis showed that:a history of smoking,no drainage tube,no non-contact technique to protect soft tissue during operation,operation time ≥1.5h,and incision type of “traditional L” were risk factors for soft tissue complications after closed calcaneal fractures (P<0.05).ROC results showed that the area under the curve for predicting the occurrence of soft tissue complications after closed calcaneal fractures was 0.874 (95%CI:0.805 to 0.943).The slope of the calibration curve of the nomogram model of soft tissue complications after closed calcaneal fractures was close to 1,Hosmer-Lemeshow goodness of fit test showed χ²=6.158,P=0.291.Conclusion A history of smoking,no drainage tube,no non-contact technique to protect soft tissue during operation,operation time ≥1.5h,and incision type of “traditional L” are all risk factors for soft tissue complications after closed calcaneal fractures.The nomogram prediction model constructed based on the above risk factors can individually predict the risk of soft tissue complications after closed calcaneal fractures.

Objective To investigate the effect of V-Y plasty combined with transposition of gastrocnemius aponeurosis on the repair of old rupture of Myerson Ⅲ Achilles tendon and the recovery of posterior Achilles tendon function and ankle joint.Methods 82 cases of old rupture of Achilles tendon of Myerson Ⅲ type treated in our hospital from January 2020 to January 2022 were selected as the research objects.According to the random number table,they were divided into the observation group (41 cases were treated with V-Y plasty combined with transposition of gastrocnemius aponeurosis) and the control group (41 cases were treated with V-Y plasty).The clinical effects of the two groups after treatment were observed [evaluated with Arner Lindholm efficacy evaluation standard] Achilles tendon function [evaluated by Achilles tendon rupture score (ATRS)],ankle joint function,pain [evaluated by pain rating index (PRI)],and complications.Results After treatment,the effective rate of observation group was 85.37%,which was higher than that of control group (60.98%) (P<0.05).Before operation,there was no difference in Achilles tendon function scores between the two groups (P>0.05).The scores of posterior Achilles tendon function in observation group were higher than those in control group 1,3 and 6 months after operation (P<0.05).The ankle joint function scores of observation group were higher than those of control group at 1,3 and 6 months after operation (P<0.05).Before surgery,there was no difference in pain scores between the two groups (P>0.05).The pain scores of the observation group were lower than those of the control group at 1,3 and 6 months after operation (P<0.05).After treatment,the total complication rate of observation group was 9.76%,which was lower than that of control group 31.71% (P<0.05).Conclusion V-Y plasty combined with transposition repair of gastrocnemius aponeurosis can improve the clinical efficacy of patients with Myerson Ⅲ old achilles tendon rupture,improve the function of posterior Achilles tendon and ankle joint,and reduce pain.

Objective To compare the curative effect of bridging combined internal fixation system and locking compression plate in the treatment of comminuted femoral shaft fractures.Method The comminuted femoral shaft fractures admitted to our hospital from January 2017 to June 2021 were retrospectively analyzed.A total of 97 patients were included,of which 42 underwent internal fixation with locking compression plates (plate group),and 55 underwent internal fixation with Bridge-link combined fixation (bridge group),followed up for at least 12 months,The perioperative data,follow-up data and complications of the two groups were collected and compared.Results Compared with the plate group,the bridging group had shorter operation time[（95.37±19.31）min vs.（77.83±15.32）min],less intraoperative bleeding[(425.37±47.56）ml vs.（398.72±43.29）ml],less postoperative drainage[(123.42±19.87）ml vs.（106.39±14.20）ml],and shorter hospital stay[(19.31±4.26）d vs.（16.24±3.79)d];the one-year follow-up found that the bridging group had better hip joint and knee joint mobility[hip：（125.35±17.11）°vs. （132.31±15.47）°;knee：（131.49±18.24）° vs. （139.68±16.69）°] and faster fracture healing[（6.28±1.07）m vs. （5.42±0.87）m],and the Harris score[（77.57±6.39） vs. (83.49±9.31）] and HSS score [（80.32±7.79） vs. （85.35±6.90）] were higher than those in the steel plate group（all P<0.05）.There were no significant differences in incision length and complications between the two groups (P>0.05).Conclusion Compared with locking plate,bridging combined internal fixation in the treatment of comminuted femoral shaft fractures has less surgical trauma,faster fracture healing and better postoperative function.

Objective Explore the effect of percutaneous minimally invasive locking plate internal fixation combined with intra-articular injection of sodium hyaluronate on the postoperative comprehensive stress state of tibial plateau comminuted fractures.Methods A prospective study was conducted on 84 patients with tibial plateau comminuted fractures from June 2020 to June 2021.They were randomly divided into a minimally invasive group and a combination group,with 42 patients in each group.The minimally invasive group underwent percutaneous minimally invasive locking plate internal fixation(group A),while the combined group received intra-articular injection of sodium hyaluronate on the basis of the minimally invasive group(group B).Compare the efficacy of two groups of indicators.Results After 3 months of follow-up,the weight bearing time and healing time in the group B were significantly shorter than those in the group A (P＜0.05).The knee joint motion and Rasmussen score of group B at the 1st and 4th week after surgery were higher than those of group A, and the difference between the two groups was statistically significant (P＜0.05).The visual analogue scale (VAS) of the group B on the 3rd and 7th day after surgery was significantly lower than that of the group A (P＜0.05).On the 3rd and 7th day after surgery,the levels of interleukin-6 (IL-6),peripheral blood sedimentation rate (ESR),and serum C-reactive protein (CRP) in the group B were lower than those in the group A (P＜0.05).On the 3rd and 7th day after surgery,the levels of catalase (CAT),total antioxidant capacity (SOD),and superoxide dismutase (TAC) in the group B were higher than those in the group A (P＜0.05).Conclusion The combination of percutaneous minimally invasive locking plate internal fixation and intra-articular injection of sodium hyaluronate for the treatment of tibial plateau fractures has a good therapeutic effect.

Objective To investigate the predictive value of trauma index (TI) score combined with C-reactive protein/albumin ratio (CAR) on the prognosis of elderly patients with femoral intertrochanteric fracture.Methods From December 2017 to December 2022,182 elderly patients with femoral intertrochanteric fracture in our hospital were retrospectively selected.According to the survival situation at 1 year after operation,they were divided into survival group and death group.The clinical data of the two groups were compared,and the TI score and CAR value were measured.To determine the independent influencing factors of postoperative death,and to observe the predictive effect of TI score and CAR value on postoperative death.Results Among the 182 elderly patients with femoral intertrochanteric fractures,24 cases (13.19 %) died one year after operation.Multivariate Logistic regression analysis showed that age,number of preoperative basic diseases,TI score and CAR value were independent risk factors for death at 1 year after operation,and self-care ability before injury was an independent protective factor (P<0.05).The receiver operating characteristic (ROC) curve showed that both TI score and CAR value had a certain predictive effect on postoperative death.The area under curve (AUC) was the highest when the two were combined,which was 0.905.The predictive sensitivity was 83.33 % and the specificity was 94.94 %.Conclusion TI score and CAR value have good predictive efficacy for the prognosis of elderly patients with femoral intertrochanteric fracture,and can be used as reference indicators to evaluate the prognosis of patients.

Objective To analyze the clinical effect of neuroendoscopic transfrontal keyhole approach in the treatment of hypertensive intracerebral hemorrhage (HICH) in the basal ganglia.Methods 92 patients with moderate basal ganglia HICH admitted to our hospital from January 2018 to February 2023 were prospectively selected,including 90 patients who met the inclusion criteria,and 44 patients in the control group (microscopically treated via temporal approach) and 46 patients in the endoscopic group (neuroendoscopically treated via frontal keyhole approach) were randomly divided by digital table method.The parameters related to surgery (intraoperative blood loss,operation time,hospital stay and hematoma clearance rate),National Institutes of Health Stroke Scale (NIHSS),Chinese Stroke Scale (CSS),daily living ability score (ADL),short-term prognosis at 60 days and complications were recorded and compared between the two groups.Results In the endoscopic treatment group,the intraoperative blood loss was (63.16±13.59) ml,the operative time was (84.59±13.22) min,and the clearance rate of hematoma was (96.87±1.60) %,in the control group,the amount of blood loss during operation was (89.26±13.65) ml,the operation time was (113.26±23.60) min,and the clearance rate of hematoma was (94.71±1.34) %,the difference was statistically significant between the two groups (P< 0.05),and the length of hospitalization was not significantly different between the two groups (P>0.05); after treatment,the scores of NIHSS and CSS were decreased,and the scores of ADL were increased (P<0.05),while the scores of NIHSS,CSS and ADL were (18.71±2.31),(10.19±2.46) and (63.58±6.66) in the endoscopic treatment group after treatment,while in the control group,the NIHSS was (23.16±2.15),CSS (15.21±2.31) and ADL (59.97±6.94),and the difference between the two groups was statistically significant (P<0.05); the prognosis of endoscopic treatment group was 91.30%,which was higher than that of control group 68.18% (P<0.05); the incidence of complications was 6.52% in the endoscopic treatment group and 11.36% in the control group,and there was no difference (P>0.05).Conclusion Endoscopic frontal keyhole approach in the treatment of moderate amount of basal ganglia HICH has significant clinical efficacy,is conducive to the recovery of neurological function,and is safe.

Objective The purpose of the study was to explore the clinical value of postoperative adjuvant immunotherapy for huge hepatocellular carcinoma (HCC) in China liver cancer staging (CNLC) Ⅲa.Methods Data of patients diagnosed as huge HCC in CNLC Ⅲa treated by liver resection at our center during June 2017 and July 2022 was retrospectively collected and divided into the treatment group and the control group according to whether underwent postoperative adjuvant treatment.48 cases included 20 cases in the treatment group while 28 cases in the control group were enrolled in this study.The endpoints of the study were recurrence-free survival (RFS) and overall survival (OS).Independent prognostic risk factors for OS and RFS were confirmed by Cox regression analysis.Results The median RFS in the treatment group compared to the control group was 6.8 vs. 2.8 months (P<0.05) and median OS was 17.2 vs. 7.2 months(P<0.05).The 1-year and 2-year RFS in the treatment group were 35.0% and 25.0% respectively while in the control group were 7.1% and 0.0%(P<0.05).The 1-year and 2-year OS in the treatment group were 65.0% and 30.0% respectively while in the control group were 42.9% and 14.3%(P<0.05).Multivariable analysis showed that preoperative aspartate transaminase (AST) >40U/L,multiple tumors and postoperative adjuvant immunotherapy were significant prognostic factors related to RFS while postoperative adjuvant immunotherapy and intraoperative blood transfusion were significant prognostic factors related to RFS.Conclusions Postoperative adjuvant immunotherapy can effectively improve the RFS and OS of huge HCC patients in CNLC Ⅲa.

Objective To explore the effectiveness of two surgical methods,primary suture of the common bile duct and T-tube drainage,in laparoscopic choledocholithotomy and choledochoscopy for stone extraction.〖WTHZ〗Method The prospectively selected 90 patients with laparoscopic lithotomy were treated from January 2019 to May 2023.They were divided into two groups.45 patients in the control group was treated with T tube drainage,and 45 patients in the observation group were treated with primary suture.Surgery-related indicators,IL-1 β level,liver function level,and postoperative complication rate were compared.The residual stone rate was compared after 3 months.Results Intraoperative blood loss,postoperative exhaust time,drainage tube removal time,postoperative complication rate and stone residual rate were not statistically different between the two groups (P>0.05).The stone removal time and hospitalization time of the observation group were shorter than those of the control group,and the total hospitalization cost was less than that of the control group,with statistical significance (P<0.05).The TBil,ALT,TBil and ALT of 1 day after surgery were all lower than those of control group,and the difference was statistically significant (P<0.05).Conclusion One-stage suture of common bile duct after laparoscopic choledochotomy and choledochoscopy can shorten the time of lithotomy,reduce the liver damage,improve the quality of life and accelerate the recovery of the disease.

Objective To investigate the clinical feasibility and safety of the method of external pancreatic duct drainage in laparoscopic pancreaticoduodenectomy(LPD).Results The clinical data of 13 patients with LPD who underwent external pancreatic duct drainage at the Jingzhou Hospital Affiliated to Yangtze University from December 2021 to December 2022 were retrospectively analyzed.The surgical process and postoperative complications of the patients participating in this study were observed,and the clinical effect of external pancreatic duct drainage on improving various postoperative complications in patients with LPD were analyzed.Results All the 13 patients underwent laparoscopic surgery successfully and discharged from the hospital smoothly.The incidence of postoperative biochemical fistula was 15.38% (2/13).No complications of grade B and above pancreatic fistula and intraperitoneal hemorrhage occurred.The average postoperative hospital stay was (14±8.5) d,reoperation and mortality within 30 days after operation were 0.Conclusion External pancreatic duct drainage can effectively improve the occurrence of postoperative complications such as pancreatic fistula and hemorrhage in patients with LPD,and improve the safety of perioperative surgery,and is especially suitable for the early stage of LPD low-volume operation center.

Objective To investigate the value of the expression levels of serum microRNA-325-3p (miR-325-3p) and fibroblast growth factor 10 (FGF10) in evaluating the severity and prognosis of acute pancreatitis.Methods A total of 265 patients with acute pancreatitis diagnosed and treated in our hospital from June 2021 to October 2022 were selected as the observation group,the patients were divided into mild acute pancreatitis group (100 cases),moderate severe acute pancreatitis group (70 cases) and severe acute pancreatitis group (95 cases) according to clinical severity;in the same period,260 healthy volunteers served as the control group A,and 260 patients with chronic pancreatitis as control group B.According to 28 d survival condition,the severe patients were divided into survival group (n=68) and death group (n=27).To compare miR-325-3p and FGF10 levels in each group of patients.Analysis of the correlation between serum miR-325-3p,FGF10 levels and Acute Physiology and Chronic Health Evaluation Ⅱ score and the correlation between serum miR-325-3p and FGF10 in patients with acute pancreatitis;Logistic regression analysis was used to analyze the factors affecting the prognosis of patients with severe acute pancreatitis;the prognostic value of serum miR-325-3p and FGF10 levels in patients with severe acute pancreatitis was analyzed by ROC curve.Results Compared with the control group A and B,the level of miR-325-3p in serum of patients with mild,moderate and severe acute pancreatitis decreased obviously in turn (P<0.05),and the levels of FGF10 increased obviously in turn (P<0.05);serum miR-325-3p in patients with acute pancreatitis was negatively correlated with FGF10 level and APACHE Ⅱ score (APACHE Ⅱ:r=-0.664,P<0.05;FGF10:r=-0.687,P<0.05),and FGF10 was positively correlated with APACHE Ⅱ score (r=0.676,P<0.05).Compared with the survival group,the body mass index,APACHE Ⅱ score and FGF10 level in the death group were obviously higher (P<0.05),and the miR-325-3p level was obviously lower (P<0.05);Logistic regression analysis showed that body mass index,APACHE Ⅱ score and FGF10 were risk factors affecting the prognosis of patients with severe acute pancreatitis (P<0.05),miR-325-3p was a protective factor affecting the prognosis of patients (P<0.05);the area under the ROC curve (AUC) of miR-325-3p combined with FGF10 to predict the prognosis of patients with severe acute pancreatitis was 0.972,which was better than their individual prediction (Z_{combination-miR-325-3P}=1.984,P=0.047;Z_{combination-FGF10}=2.219,P=0.027).Conclusion The level of serum miR-325-3p in patients with acute pancreatitis decreases,and the level of FGF10 increases,they are related to the severity and prognosis of patients,and have certain value in evaluating the prognosis of patients.

Objective To explore the effects of liver paste suspension,W-type suspension of left lobe of liver and V-type suspension of anterior abdominal wall of liver in laparoscopic radical gastrectomy.Methods The clinical data of 79 patients with gastric cancer who underwent laparoscopic radical gastrectomy in our hospital from October 2018 to October 2022 were retrospectively analyzed.According to the different treatment methods in the data,79 patients were divided into group A (26 cases),group B (26 cases),and group C (27 cases).In group A,the liver paste suspension method was used,and in group B,the left lobe suspension method was used,and in group C,the front abdominal wall liver V suspension method was used.All three groups were followed up to 6 months after operation.The general data,operation index,complication rate and liver function changes before and 7 days after operation were compared among three groups.Results The time of liver suspension and operation in group B[(16.23±2.52) min,(318.48±30.62)min] was longer compared with group A[(2.64±0.61）min,（233.64±20.67）min] and group C[(12.43±1.56）min,(270.81±25.77）min],and the time of liver suspension and operation in group C was longer than that in group A,and the amount of blood loss and blood transfusion in group B[(224.51±20.27)ml,5 cases] and group C[(223.54±21.87)ml,7 cases] were lower than those in group A[(324.54±30.51)ml,15 cases](P<0.05).The levels of serum glutamic-pyruvate transaminase (ALT),aspartate transaminase (AST) and Albumin (ALB) in group B[(27.52±3.62) U/L,(25.75±3.95) U/L,and (31.65±3.18) g/L] and group C[(26.54±3.73） U/L,(26.34±3.82） U/L and (32.06±3.09） g/L] were higher than those before operation 7 days after operation,and the levels of serum ALT,AST and ALB in group B and group C were higher than those in group A(P<0.05).The incidence of postoperative liver laceration and bleeding in group A (11.54%,7.69%) was higher,and the incidence of intraoperative peritoneal bleeding in group B (11.54%) was higher,but the difference was no significant among three groups(P>0.05).Conclusion The liver paste suspension method is simple and time-saving,but it is not suitable for left liver hypertrophy,and postoperative degumming may cause liver surface tear and bleeding.W-type suspension has good effect and takes a little longer and is suitable for patients with obesity and hypertrophy of left lobe of liver.The suspension effect of V-shaped gauze is moderate and the time consumption is moderate.

Objective To investigate the clinical value of serum exosome hsa_circ_0008035 in early gastric cancer (GC) and premalignant gastric lesions (Pre).Methods The peripheral blood samples of 90 GC patients (GC group) and 89 premalignant gastric lesions (Pre group) who visited our hospital from January 2012 to December 2017 were collected.At the same time,45 healthy volunteers were included as the control group (NC group).And quantitative real-time fluorescence polymerase chain reaction (qRT-PCR) was used to detect serum exosomal hsa_circ_0008035 Horizontal.Receiver operating characteristic (ROC) curve was drew to evaluate serum exosomal hsa_circ_0008035.Follow up the disease progression of Pre group patients through endoscopic examination.Finally,Based on circBase and RegRNA 2.0 target prediction software to seek the potential microRNA (miRNA) targets of hsa_circ_0008035.Results Compared with NC group,the expression level of serum exosomal hsa_circ_0008035 in GC group or Pre group were significantly increased,with the most pronounced increase in the GC group (P＜0.05).Compared with traditional tumor markers detection,the area under curve (AUC),sensitivity and accuracy of exosomal hsa_circ_0008035 in the diagnosis of GC and Pre were significantly increased,and the false negative rate and false positive rate were significantly decreased (P＜0.05).The AUC was 0.681 ,a sensitivity and specificity were 66.35% and 83.31% of exosomal hsa_circ_0008035 in distinguishing between patients with early GC and Pre.For the Pre group patients,a median follow-up of 5.3 years was observed,during which 21 patients experienced disease progression.These patients were diagnosed with a significant increase in serum exosome hsa_circ_0008035 expression level compared to baseline (P＜0.001).Moreover,the serum exosome hsa_circ_0008035 expression level at baseline was generally higher than that of patients without disease progression (P=0.005).For patients in the GC group,the expression level of serum exosomal hsa_circ_0008035 in patients with middle and advanced GC (TNM stage Ⅲ-Ⅳ) was higher than that in patients with early GC (P＜0.05).Hsa_circ_0008035 target pathway prediction results showed that hsa_circ_0008035 contained hsa-miR-599,hsa-miR-17-3p,hsa-miR-1256 and hsa-miR-375 seed sequences and related common downstream targets.Conclusion The expression of serum exosomal hsa_circ_0008035 is generally increased in the patients with early GC and premalignant gastric lesions,which has has certain clinical significance for the diagnosis of early GC and premalignant gastric lesions,and evaluation of disease progression.

Objective To analyze the expression of forkhead box protein M1(FOXM1) and programmed cell death receptor 1 ligand(PD-L1) in gastric cancer and their correlation with clinical prognosis.Methods From July 2017 to July 2019,124 patients with gastric cancer who received surgical treatment in our hospital were selected to have their gastric cancer tissues and corresponding adjacent tissues removed during the operation.FOXM1 and PD-L1 mRNA expression was detected by qRT-PCR;the expression of FOXM1 and PD-L1 proteins was detected by immunohistochemistry.The Kaplan-Meier survival curve was used to analyze the relationship between FOXM1 and PD-L1 and prognosis;COX regression was applied to analyze the risk factors affecting the prognosis of patients with gastric cancer.Results The expression levels of FOXM1 and PD-L1 mRNAs and the positive expression rates of proteins in gastric cancer tissue were obviously higher than those in adjacent tissues (P<0.05).The expression of FOXM1 and PD-L1 in gastric cancer was related to TNM stage and depth of invasion (P<0.05).According to Kaplan-Meier method,the 3-year survival rate of patients with FOXM1 and PD-L1 positive expression in gastric cancer tissue(39.47%) was lower than that of patients with negative expression(62.50%) (P<0.05).According to COX regression analysis,FOXM1 positive expression and PD-L1 positive expression were risk factors affecting the prognosis of gastric cancer patients (P<0.05).Conclusion The increased expression of FOXM1 and PD-L1 in gastric cancer is closely related to the clinicopathological characteristics and prognosis of patients,and is also a risk factor affecting the prognosis of patients with gastric cancer.

Objective To investigate the expression of matrix metalloproteinase-9 (MMP-9) and stromal cell-derived factor-1 (SDF-1) in serum of patients with abdominal trauma infection and their diagnostic value.Methods From July 2021 to July 2022,100 patients with abdominal trauma infection admitted in our hospital were regarded as the case group,100 patients with abdominal trauma without infection were regarded as the control group.Serum levels of MMP-9 and SDF-1 were detected by enzyme-linked immunosorbent assay (ELISA);correlation between serum MMP-9, SDF-1 and SIRS score and length of hospital stay were analyzed by Spearman method;the diagnostic value of serum MMP-9 and SDF-1 levels in patients with abdominal trauma infection was analyzed by ROC curve;the levels of serum MMP-9 and SDF-1 in patients with abdominal trauma infection before and after treatment were analyzed in matched samples t;multivariate Logistic regression analysis was applied to analyze the factors affecting the occurrence of abdominal trauma infection.Results The levels of serum MMP-9,SDF-1,CRP,WBC,TNF-α,diabetes and trauma types in the case group were higher than those in the control group (P<0.05).The level of serum MMP-9 in patients with abdominal trauma infection was positively correlated with SIRS score,CRP,WBC and TNF-α (r=0.505,0.471,0.423,0.416,P<0.05).Serum SDF-1 level was also positively correlated with SIRS score,CRP,WBC and TNF-α (r= 0.469,0.439,0.518,0.469,P<0.05).ROC analysis showed that the area under the curve (AUC) of serum MMP-9 and SDF-1 for predicting infection in abdominal trauma was 0.850 (95%CI:0.799-0.902) and 0.806 (95%CI:0.746-0.866),respectively.The AUC of combined detection was 0.914 (95%CI:0.876-0.951),which was significantly higher than that of MMP-9 and SDF-1 alone (Z=1.987,2.97,P<0.05).The expression levels of serum MMP-9 and SDF-1 after treatment were lower than those before treatment (P<0.05).Logistic analysis showed that diabetes,trauma type,serum levels of MMP-9 and SDF-1 were risk factors for abdominal trauma infection (P<0.05).Conclusion The levels of serum MMP-9 and SDF-1 in patients with abdominal trauma infection are increased,they may be involved in the occurrence and development of abdominal trauma infection,and have important significance for the diagnosis of abdominal trauma infection.

Objective To construct and verify a risk prediction model for the poor prognosis after repair of traumatic perforation of gastrointestinal tract following emergency admission for acute and critical multiple injuries.Methods 183 patients with traumatic perforation of gastrointestinal tract due to acute and critical multiple injuries underwent treatment in emergency department of our hospital from January 2019 to December 2022 were enrolled.All were treated with symptomatic and reparative surgical protocols.Prognosis was recorded at 30d of the hospital follow-up,with death as the primary endpoint.Patient clinical data were collected.Logistic regression was used to screen the risk factors of poor prognosis,and a line graph model was established.Receiver Operating Curve (ROC) was used to test model differentiation.Calibration of models was evaluated with the Hosmer-Lemeshow goodness-of-fit test and calibration curve.Results After a follow-up of 30 days,28 cases died,and 38 cases had worsening clinical symptoms and signs compared to when they were admitted.The poor prognosis rate was 26.78%,and then divided into a poor prognosis group (49 cases) and a good prognosis group (134 cases).Multivariate Logistic regression analysis denoted that low GCS score,presence of shock,elevated D-dimer level,and high ISS score were risk factors affecting the poor prognosis after repair of traumatic perforation of gastrointestinal tract (P<0.05).The above risk factors were used to construct a line graph model for predicting the occurrence of poor prognosis after surgery,and the accuracy and differentiation of the model were verified showing an area under the curve of 0.986 and Hosmer-Lemeshow deviation test result of 0.984.Conclusion The low GCS score,presence of shock,elevated D-dimer level,and high ISS score are independent risk factors for poor prognosis after repair of traumatic perforation of gastrointestinal tract following emergency admission for acute and critical multiple injuries,and the predictive risk line graph model has high differentiation and precision,which is of great value for application in the prevention and treatment of traumatic perforation of gastrointestinal tract.

Objective To investigate the effect of upper rectal artery (SRA) embolization on clinical treatment,intraoperative blood loss and pain in patients with stage Ⅱ to Ⅲ hemorrhoids.Methods A total of 84 patients diagnosed with stage Ⅱ to Ⅲ hemorrhoids in our hospital from January 2021 to January 2022 were selected.According to different surgical interventions,PPH group and SRA group were established,with 42 cases in each group.The PPH group was treated with hemorrhoid mucosa ring resection and nailing operation,and the SRA group was treated with upper rectal artery embolization.The clinical efficacy,perioperative indicators,anal symptoms,postoperative pain,anorectal dynamics indicators,and incidence of postoperative complications were compared between the two groups.All patients received a 6-month follow-up survey after the operation,and the recurrence of hemorrhoids during the follow-up period was collected,and Kaplan-Meier curve was used for comparative analysis.Results The total effective rates of SRA group and PPH group at 12 months after operation were 92.86% and 76.19%,operation time was (17.23±4.26) min and (43.16±9.37) min,hospital stay was (5.52±1.89)d and (8.25±2.67)d,wound healing time was (7.36±2.23)d and (17.83±4.04)d, the intraoperative blood loss was (10.03±2.38) ml and (16.22±3.11) ml,and the operative cost were (14327.36±892.23) yuan and (2762.83±524.04) yuan, postoperative anal incontinence was (0.45±0.02) points and (0.60±0.09) points,anal pain score was (3.04±0.14) points and (5.15±1.68) points,anal bleeding scores was (0.43±0.08) points and (0.61±0.19) points,symptom scores of anal border edema was (0.29±0.09)points and (0.52±0.16)points,respectively.The difference between the two groups was statistically significant (all P<0.05).Postoperative rectal resting pressure (RRP) [(2.41±0.35) kPa vs. (2.95±0.29) kPa] and anal canal resting pressure (ARP) [(13.14±1.51) kPa vs. (14.67±1.59) kPa] levels between the SRA group and PPH group were statistically significant at 12 months after surgery（P＜0.05).Postoperative maximum systolic blood pressure (AMCP) of anal canal in SRA group [(14.22±0.28) kPa] was significantly higher than that in PPH group [(13.35±0.23) kPa] ( P<0.05).The total incidence of complications 12 months after operation in SRA group was significantly lower than that in PPH group (4.76% vs. 21.43%) (P＜0.05).After surgery,both groups were followed up for 12 months.In SRA group,13 cases (30.95%) recurred internal hemorrhoids.In the PPH group,10 patients (23.81%) had internal hemorrhoid recurrence,and there was no significant difference between the two groups (P＞0.05).Conclusion SRA can effectively improve clinical efficacy in the treatment of stage Ⅱ to Ⅲ hemorrhoids patients,and has positive significance in promoting rapid recovery of patients and improving adverse symptoms such as pain degree.

Objective The objective of this study was to investigate the impacts of sevoflurane on the proliferation,invasion and apoptosis of gastric cancer (GC) cells by regulating the expression of microRNA (miR)-96-5p/salt induced kinase 1 (SIK1) axis.Methods GC cell SGC7901 cells were treated with sevoflurane of 0%,1%,2%,3%,4%,5% v/v concentration,the proliferation of SGC7901 cells was detected by CCK-8 method;SGC7901 cells were randomly grouped into three groups:control group(Normal culture),sevoflurane group(3% v/v sevoflurane intervention),sevoflurane+miR-NC group(Transfected with miR-NC and then treated with sevoflurane at 3% v/v concentration for 48h),sevoflurane+miR-96-5p mimics group(After transfection with miR-96-5p mimics, intervention was performed at 3% v/v concentration of sevoflurane for 48h),RT-qPCR was applied to detect the expression of miR-96-5p in cells of each group;flow cytometry was applied to detect apoptosis;scratch test was applied to detect cell migration;Transwell cell test was applied to detect cell invasion;Western blot was applied to detect the expression of phosphorylate-induced kinase 1 (SIK1),matrix metalloproteinase-2 (MMP-2) and MMP-9;double luciferase reporter gene experiment was applied to verify the targeting relationship between miR-96-5p and SIK1.Results Compared with the 0% concentration group,the inhibition rate of SGC7901 cell proliferation was obviously increased in a dose-dependent manner under the treatment of 1%,2%,3%,4%,and 5% v/v concentration of sevoflurane (P<0.05),the 3% v/v concentration of sevoflurane was selected for subsequent experiments;compared with the control group,the expression level of miR-96-5p,migration,invasion,and the expression levels of MMP-2 and MMP-9 proteins in sevoflurane group were obviously decreased,the apoptosis rate and the expression level of SIK1 protein were obviously increased (P<0.05);activation of miR-96-5p expression weakened the inhibition of sevoflurane on the migration and invasion of SGC7901 cells,and decreased the apoptosis rate (P<0.05);the results of double luciferase reporter gene showed that miR-96-5p could target the expression of SIK1.Conclusion Sevoflurane may inhibit the proliferation,migration and invasion of GC SGC7901 cells and promote cell apoptosis by down-regulating miR-96-5p and up-regulating SIK1.

Osteoporotic vertebral compression fractures (OVCFs) are the most common fractures in the elderly population,significantly impacting patients’ health and quality of life.This article reviews the diagnostic and therapeutic advancements in the management of elderly patients with osteoporotic thoracolumbar vertebral compression fractures.In terms of diagnosis,clinical manifestations and imaging examinations are crucial.While X-ray remains the preferred imaging modality,MRI offers higher sensitivity in identifying OVCFs,with promising new MRI technologies expected to further enhance diagnostic accuracy.Regarding treatment,conservative management and minimally invasive surgery are commonly employed methods.In addition to traditional minimally invasive techniques such as PVP and PKP,novel approaches such as vertebral augmentation with implant-based systems and robot-assisted vertebral augmentation are continuously evolving.

Osteoporotic vertebral compression fractures is a common type of osteoporotic fractures,often occurring with minimal external force or even without obvious trauma.They manifest as pain,deformity,and functional impairment,significantly impacting patients’ quality of life.Following reduction of vertebral compression fractures,bone defects often occur and typically require bone grafting for repair.Surgical treatments primarily include percutaneous vertebral augmentation and open surgery.Cement augmentation,appropriate bone implantation,and anti-pullout internal fixation are crucial components of bone repair therapy.Different types of cement materials and novel vertebral augmentation techniques offer more options for vertebral fracture repair.This consensus incorporates epidemiological characteristics of osteoporotic vertebral compression fractures,referencing literature search results and expert survey opinions,to address common controversies regarding commonly used vertebral bone repair materials,strategies,and postoperative considerations in clinical practice.It is hoped that this consensus will improve treatment outcomes,enhance patient prognosis,and promote standardized clinical management of osteoporotic vertebral compression fracture repair.