Objective  To investigate the effect of early nerve interventional embolization after ruptured intracranial aneurysm (IA) and its effect on nerve function.Methods  A total of 100 patients with ruptured IA who underwent neurointerventional embolization in our hospital from January 2020 to January 2023 were selected and divided into two groups according to the timing of surgery.The control group (n=49) underwent surgery 24-72 hours after rupture of IA,while the study group (n=51) underwent surgery within 24 hours after rupture of IA.The success rate of embolization,serum inflammatory stress factor [interleukin-6 (IL-6),tumor necrosis factor-α (TNF-α),D-dimer (D-D),malondialdehyde (MDA)],cerebrovascular spasticity (CVS) related factors [hypoxia-inducing factor 1α (HIF-1α)],soluble intercellular adhesion molecule-1 (SICAM-1),cysteine aspartate proteolytic enzyme 3 (Caspase-3),neurological function (NIHSS score),capacity of daily living (BI score),complications (cerebral vasospasm) and short-term prognosis were compared between the two groups.Results  The success rate of embolization in the study group was 94.12%,which was higher than that in the control group (79.59%) (P<0.05).The serum IL-6 levels in the study group on day 1,3,and 7 after surgery were (18.06±5.11) ng/L,(17.15±4.60) ng/L,and (16.37±4.35) ng/L,respectively,while those in the control group were (23.18±5.92) ng/L,(21.23±5.54) ng/L,and (20.16±5.29) ng/L,respectively,the TNF-α levels were (32.01±7.19) ng/ml,(30.67±6.85) ng/ml,and (29.45±6.63) ng/ml,respectively,while those in the control group were (39.01±8.20) ng/ml,(36.22±7.53) ng/ml,and (35.01±7.12) ng/ml,respectively,the D-D levels were (27.19±4.89) μg/ml,(26.20±4.71) μg/ml,and (25.81±4.39) μg/ml,respectively,while those in the control group were (32.06±5.94) μg/ml,(31.18±5.49) μg/ml,and (30.26±5.61) μg/ml,respectively,the MDA levels were (2.81±0.83) μmol/ml,(2.53±0.75) μmol/ml,and (2.46±0.71) μmol/ml,respectively,while those in the control group were (4.02±1.01) μmol/ml,(3.84±0.91) μmol/ml,and (3.59±0.86) μmol/ml,respectively,and the differences between the two groups were statistically significant (P<0.05);on postoperative day 1,3,and 7,the serum HIF-1α levels in the study group were (95.16 ± 8.21) pg/ml,(93.25±7.94) pg/ml,and (92.54±7.80) pg/ml,respectively,while those in the control group were (102.31±8.56) pg/ml,(100.27±8.19) pg/ml,and (99.65±7.92) pg/ml,respectively,the SICAM-1 levels were (620.15±78.92) ng/ml,(616.37±75.28) ng/ml,and (610.92±73.69) ng/ml,respectively,while those in the control group were (683.19±80.24) ng/ml,(680.24±78.51) ng/ml,and (675.31±75.92) ng/ml,respectively,the caspase-3 levels were (645.13±88.61) mg/ml,(640.21±85.76) mg/ml,and (633.79±82.65) mg/ml,respectively,while those in the control group were (720.13±90.54) mg/ml,(717.03±88.65) mg/ml,and (712.81±85.04) mg/ml,respectively,and there were significant differences between the two groups (P<0.05);the NIHSS scores of the study group at 1 month and 3 months after surgery were (5.20±1.37) scores and (5.03±1.32) scores,respectively,while those of the control group were (6.31±1.50) scores and (6.17±1.45) scores,respectively,the BI scores were (78.01±5.73) scores and (79.12±5.81) scores,respectively,while those of the control group were (72.69±5.50) scores and (73.24±5.72) scores,respectively,and the difference between the two groups was statistically significant (P<0.05).The incidence of complications in the study group was 7.84%,which was lower than that of the control group (22.45%) (P<0.05).The good prognosis rate in the study group was 82.35%,which was higher than that of the control group (61.22%) (P<0.05).Conclusion   Neurological intervention and embolization within 24 hours after rupture of IA has significant therapeutic effects and can more effectively improve patients’ neurological function and prognosis.

Objective  To explore the clinical efficacy and prognostic factors of YL-1 type hard channel trepanation and drainage combined with stereotactic treatment for hypertensive intracerebral hemorrhage.Methods  A retrospective study was conducted on 110 patients with hypertensive intracerebral hemorrhage at the Cerebrovascular Disease Center of the First People’s Hospital of Suzhou from August 2019 to October 2022.The observation group(55 cases) received YL-1 type hard channel drilling and drainage combined with stereotactic treatment,while the control group(55 cases) received simple YL-1 type hard channel drilling and drainage.The perioperative indicators,neurological damage,and prognosis of the two groups of patients were compared;Using multiple Logistic regression analysis to identify the prognostic factors affecting patients.Results  The perioperative indicators,neurological damage,and prognosis of the observation group were better than those of the control group(P<0.05);The admission NIHSS score(OR=2.504,P<0.05),simple minimally invasive drilling and drainage(OR=1.881,P<0.05),disease duration>24 hours(OR=2.782,P<0.001),and ventricular rupture(OR=2.252,P<0.05) are risk factors for poor prognosis in patients.Conclusion  The prolongation of the patient’s disease course,ventricular rupture,and severe neurological damage are associated with poor prognosis.Combining stereotactic minimally invasive surgery has a positive significance for improving the prognosis of patients with cerebral hemorrhage.

Objective  To investigate the expression levels of serum microRNA-33a-5p (miR-33a-5p) and Sirtuin6 (SIRT6) in patients with esophageal cancer,and their relationship with clinical pathological characteristics and prognosis.Methods  From March 2018 to March 2020,123 newly diagnosed patients with esophageal cancer (esophageal cancer group) and 94 patients with esophagitis (benign lesion group) admitted to our hospital were collected as the research subjects,another 72 healthy individuals who underwent physical examination were regarded as the health control group;the clinical and pathological characteristics of esophageal cancer patients were collected.Real-time fluorescence quantitative PCR method was applied to detect the expression of miR-33a-5p and SIRT6 mRNA in three groups of serum,the relationship between the expression levels of serum miR-33a-5p and SIRT6 mRNA in esophageal cancer patients and clinical pathological characteristics was analyzed;TargetScanHuman website was applied to predict the targeting relationship between miR-33a-5p and SIRT6;Pearson method was applied to analyze the correlation between serum miR-33a-5p and SIRT6 mRNA expression levels in esophageal cancer patients;Kaplan-Meier method was applied to analyze the relationship between the expression levels of serum miR-33a-5p and SIRT6 mRNA in esophageal cancer patients and their prognosis;Cox regression was applied to analyze the prognostic factors of esophageal cancer patients.Results  The expression level of serum miR-33a-5p in the esophageal cancer group was greatly higher than that in the benign lesion group and healthy control group (P＜0.05),the expression level of serum SIRT6 mRNA was greatly lower than that of the benign lesion group and healthy control group (P＜0.05);TargetScanHuman website predicts that there was a targeted binding site between miR-33a-5p and SIRT6,and there was a negative correlation between serum miR-33a-5p and SIRT6 mRNA expression levels in esophageal cancer patients (r=-0.468,P＜0.05);the expression levels of serum miR-33a-5p and SIRT6 mRNA in esophageal cancer patients were related to TNM staging,lymph node metastasis,and degree of differentiation;the 3-year survival rate of esophageal cancer patients with low expression of serum miR-33a-5p and high expression of SIRT6 mRNA was greatly higher than that of esophageal cancer patients with high expression of miR-33a-5p and low expression of SIRT6 mRNA (P＜0.05);Cox- regression analysis showed that high expression of miR-33a-5p and low expression of SIRT6 mRNA were independent risk factors for death in esophageal cancer patients (P＜0.05).Conclusion  The expression level of serum miR-33a-5p in esophageal cancer patients is greatly increased,while the expression level of SIRT6 mRNA is greatly reduced;the expression levels of both are closely related to the clinical pathological characteristics and prognosis of esophageal cancer patients.

Objective  To explore the diagnostic efficacy of magnetic resonance imaging(MRI) combined with serum carbohydrate antigen 125(CA125) and angiopoietin like protein 2(ANGPTL2) in breast cancer.Methods  From February 2020 to June 2022,152 patients with breast diseases diagnosed initially in our hospital were collected as the subjects of this study.According to the results of pathological tissue examination(breast cancer modified radical mastectomy operation or needle biopsy),they were grouped into breast cancer group(90 cases) and benign group(62 cases).All patients underwent MRI examination.Measurement of serum CA125 and ANGPTL2 levels;receiver Operating Characteristic curve (ROC) were analysed for the critical diagnostic points of breast cancer by MRI combined with serum CA125 and ANGPTL2;and four grid table was applied to analyze the diagnostic value of MRI combined with serum CA125 and ANGPTL2 in breast cancer.Results  The ring enhancement in breast cancer group was obviously higher than that in benign group(P<0.05),and the uniform enhancement in benign group was obviously higher than that in breast cancer group(P<0.05).The levels of serum CA125 and ANGPTL2 in breast cancer group were obviously higher than those in benign group(P<0.05).According to the ROC,the AUC of serum CA125 in the diagnosis of breast cancer was 0.870(95%CI:0.815~0.924) and the cut-off value was 29.574 U/ml,the AUC of serum ANGPTL2 CA125 in the diagnosis of breast cancer was 0.893(95%CI:0.843~0.942),the cut-off value was 6.085 ng/ml,and the AUC of MRI diagnosis of breast cancer was 0.891（95%CI:0.832~0.950）.The accuracy of MRI,CA125,ANGPTL2 and combination of three indexes in the diagnosis of breast cancer were 89.47%,84.87%,82.89%,93.42% respectively.Conclusion  MRI combined with serum CA125 and ANGPTL2 can improve the diagnostic efficacy of breast cancer.

Objective  To investigate the correlation between the expression of hsa_circ_0001785 in triple negative breast cancer(TNBC) and the efficacy of neoadjuvant chemotherapy(NAC).Methods  A total of 129 patients with triple negative breast cancer who were admitted to our hospital from October 2021 to February 2023 were regarded as the study group，and 125 patients with benign breast lesions who underwent surgery in our hospital were served as the control group.The influencing factors of NAC efficacy in TNBC patients were analyzed by multivariate  logistic  regression model;receiver operating characteristic(ROC) curve was applied to analyze the predictive value of hsa_circ_0001785 level for NAC efficacy in triple negative breast cancer patients.Results  Compared with the control group(1.05±0.16)，the expression level of hsa_circ_0001785 in the study group(2.47±0.39) increased(P＜0.05);compared with the effective group(2.34±0.35)，the expression level of hsa_circ_0001785 in the ineffective group(3.48±0.56) increased(P＜0.05);hsa_circ_0001785 was highly expressed in triple negative breast cancer patients with tumor diameter＞2cm，lymph node metastasis and high tissue grade(P<0.05);high expression of hsa_circ_0001785，tumor diameter＞2cm，occurrence of lymph node metastasis and high histological grade were risk factors for NAC efficacy in triple negative breast cancer patients(P<0.05).Hsa_circ_0001785 level has certain predictive value for NAC efficacy in TNBC patients.Conclusion  Hsa_circ_0001785 is highly expressed in triple negative breast cancer,and the level of hsa_circ_0001785 has a certain predictive value for the efficacy of NAC in patients.

Objective  To investigate the relationship between gene mutation characteristics and immunological markers in patients with small cell lung cancer.Methods  From January 2019 to 2020, 155 patients with small cell lung cancer were admitted.Gene mutations were detected in these patients using target gene capture and sequencing method.Moreover,the tumor mutational burden(TMB)and expression of PD-L1 in some patients were detected.Results A total of 326 gene mutations were detected in the patients,the most significant of which were TP53 and RB1.Among the 8 genes with mutation frequency higher than 15%,patients with KMT2D,KMT2C,FAT1 and NOTCH1 mutations had higher TMB than those without mutation,and the difference was statistically significant(P<0.05).Conclusion The most common mutated genes in patients with small cell lung cancer are TP53 and RB1.KMT2D,KMT2C,FAT1 and NOTCH1 may be potential markers for the efficacy of immunotherapy in small cell lung cancer.

Objective  To investigate the expression of Follistatin-like 3(FSTL3) protein in lung adenocarcinoma(LUAD) tissue and its association with clinical pathological indicators and prognosis.Methods  A total of 268 LUAD patients who underwent radical resection of lung cancer were collected,and the expression of FSTL3 protein in LUAD and paired paracancerous normal tissues was detected using immunohistochemistry.The clinical pathological indicators and overall survival(OS) rate were compared among patients with different levels of FSTL3 expression.Cox- regression model was used to analyze the influencing factors of postoperative OS in LUAD patients.Results The high expression rate of FSTL3 protein in LUAD tissue(55.97%) was significantly higher than that in paracancerous tissues(33.21%)(χ2=28.098,P<0.001).The expression level of FSTL3 protein showed significant differences among LUAD patients with different degrees of differentiation,lymph node metastasis,distant metastasis,and TNM stage(all P<0.05).The OS rate of patients with high FSTL3 protein expression was significantly lower than that of patients with low expression(χ2=4.706,P=0.030).Cox- regression analysis indicated that lymph node metastasis,distant metastasis,TNM stages Ⅲ,and high expression of FSTL3 were independent risk factors affecting postoperative OS in LUAD patients(all P<0.05).Conclusion The expression of FSTL3 protein significantly increased in LUAD tissue,and it was associated with tumor differentiation,lymph node metastasis,distant metastasis,and TNM stage.High expression of FSTL3 was an independent risk factor affecting the postoperative prognosis of LUAD patients.FSTL3 protein has the potential to become a biomarker for early diagnosis and prognostic prediction of LUAD.

Objective  To investigate the relationship between the expression of programmed death ligand 1(PD-L1) and hypoxia inducible factor-1α(HIF-1α) with the clinical pathological characteristics and prognosis of gastric cancer patients.Methods The cancer tissues of 100 gastric cancer patients who underwent radical gastrectomy at the First Hospital of Handan City from July 2019 to July 2020 were selected as the research subjects,and their adjacent tissues（normal tissues≥5cm from the cancer tissues） were as the control group.Immunohistochemical detection of PD-L1 and HIF-1α was performed by SP method.Spearman correlation analysis was used to analyze PD-L1 and HIF-1α in gastric cancer tissues.Kaplan-Meier method was used to analyze the 3-year survival relationship of gastric cancer patients.The influencing factors of prognosis and death in patients with gastric cancer were analyzed by univariate and multivariate Cox regression.Results  Among 100 gastric cancer patients,52 were PD-L1 positive and 48 were negative;67 were HIF-1α positive and 33 were HIF-1α negative,the positive expression rates of PD-L1 and HIF-1α in gastric cancer tissues were 52.00% and 67.00%,respectively,which were obviously higher than those in adjacent tissues(11.00%、18.00%)，the difference was statistically significant (P<0.05).Spearman correlation analysis showed that the expression of PD-L1 was positively correlated with that of HIF-1α in gastric cancer tissues (r=0.730, P<0.001). The expressions of PD-L1 and HIF-1α in patients with gastric cancer were correlated with TNM stage, lymph node metastasis and local invasion (P<0.05).The 3-year overall survival rate of gastric cancer patients was 48.00% after surgery, and the 3-years survival rate of patients with positive expression of PD-L1 and HIF-1α were 28.85% and 31.34%, which were lower than those of patients with negative expression of PD-L1 and HIF-1α (68.75% and 81.82%)(Log rank χ2=25.155,P<0.001.Log rank χ2=24.552,P<0.001).Moreover,positive expression of PD-L1 and HIF-1α,TNM staging of Ⅲ-Ⅳ,lymph node metastasis,and local infiltration were independent risk factors for prognosis and death in gastric cancer patients(P<0.05).Conclusion Both PD-L1 and HIF-1α are highly expressed in cancer tissues of gastric cancer patients,and they are positively correlated.They are also associated with clinical pathological features such as TNM staging,lymph node metastasis,and poor prognosis.

Objective  To investigate the correlation between serum osteoblastin (OPN) and angiopoietin-like protein 8 (ANGPTL8) levels and hepatic fibrosis (HF) after interventional therapy-transcatheter arterial chemoembolisation (TACE) in patients with primary hepatocellular carcinoma (PHC). Methods 166 patients with PHC admitted between March 2021 and June 2023 were selected and divided into 92 cases with HF (observation group) and 74 cases without HF (control group) according to whether or not HF occurred after interventional therapy; enzyme-linked immunosorbent assay (ELISA) was used to determine the serum OPN and ANGPTL8 levels and to analyse the predictive value of the OPN and ANGPTL8 levels on HF.Pearson correlation was used to analyze the correlation between OPN and ANGPTL8 levels and biochemical indexes.The factors influencing the occurrence of HF were analyzed by multi-factor Logistics- regression. ROC curve was used to analyze the predictive value of OPN and ANGPTL8 for HF. Results  Serum OPN [(74.56±11.56) ng/ml], ANGPTL [(42.78±5.23) ng/ml], ALT [(62.24±9.56) U/L], AST [(42.88±8.23) U/L], HA [(252.98±52.44) ng/L], LN [(152.64±26.45) ng/L], PCⅢ[(16.54±3.46)ng/L] and Ⅳ-C[(152.78±21.23)ng/L] in observation group were significantly higher than the control group[(57.89±9.68)ng/ml,(35.46±4.78)ng/ml,(49.46±7.46)U/L,(31.48±7.26)U/L,(192.56±23.88)ng/L,(124.48±11.23)ng/L,(11.26±2.23)ng/L and (126.45±18.56)ng/L].The differences between the two groups were statistically significant (P<0.05). The AUC of serum OPN, ANGPTL8 and the combination of the two in predicting the occurrence of HF were 0.914, 0.920 and 0.978, respectively, and the AUC of OPN combined with ANGPTL8 in predicting the occurrence of HF was higher than the AUC of the two separately (P<0.05). Conclusion  The levels of serum OPN and ANGPTL8 of patients with PHC are closely associated with the occurrence of HF, and the two are HF occurrence influencing factors and can be used as indicators to predict the occurrence of HF.

Objective  To investigate the effects of laparoscopic radiofrequency ablation (LRFA) and percutaneous radiofrequency ablation (PRFA) on anti-tumor immunity, complication rate and recurrence rate in patients with primary liver cancer.Methods A total of 81 patients with primary liver cancer treated in Dazhou Central Hospital from January 2020 to August 2022 were selected and divided into observation group (LRFA, n=42) and control group (PRFA, n=39) according to the treatment plan. Compare the total ablation rate, postoperative complication rate, recurrence rate of the two groups, as well as tumor necrosis factor-α (TNF-α), carbohydrate antigen 199 (CA199), interleukin-6 (IL-6), Golgi protein 73 (GP73), Creactive protein (CRP), alpha-fetoprotein (AFP) and peripheral blood T lymphocyte subpopulation levels before and after surgery.Results There was no significant difference between the observation group (95.24%) and the control group (92.31%) (P>0.05). At 1 d postoperatively, IL-6 was (124.63±45.41) pg/ml and (168.28±51.26) pg/ml, CRP was (19.14±5.03) ng/L and (28.26±7.47) ng/L, and TNF-α was (94.32±18.49) pg/ml and (108.41±20.11) pg/ml; at 3 d postoperatively, IL-6 was (92.37±24.11) pg/ml and (105.83±27.45) pg/ml in the observation group and the control group, respectively, CRP was (14.87±4.37) ng/L and (17.25±5.06) ng/L, and TNF-α was (75.41±12.10) pg/ml and (82.64±16.83) pg/ml, which were all higher than that of preoperative period (P<0.05). At 7 d postoperatively, CD3+ in the observation group and control group were (66.27±7.82)% and (65.14±7.63)%, AFP was (156.23±30.27)μg/ml and (160.84±32.33)μg/ml, GP73 was (65.21±10.26)μg/L and (67.44±11.03) μg/L, CA199 was (44.89±11.41) U/L and (45.12±13.07) U/L, CD4 was (32.02±6.03)% and (31.53±6.11)%, and CD4+/CD8+ was (1.31±0.39) and (1.29±0.37) respectively; at 14 d postoperatively, CD3+ was (71.25±6.83)% and (70.89±6.76)%, AFP was (48.52±18.31)μg/ml and (50.11±19.12)μg/ml, GP73 was (48.25±8.46)μg/L and (49.12±10.12)μg/L, CA199 was (19.27±5.16)U/L and (20.07±5.39)U/L, and CD4 was (38.25±7.7)U/L and (20.07±5.39)U/L, respectively, in the observation and control groups. g/L, CA199 was (19.27±5.16)U/L and (20.07±5.39)U/L, CD4 was (38.25±7.45)% and (37.61±7.92)%, and CD4+/CD8+ was (1.49±0.42) and (1.47±0.45), respectively, which were higher than that of preoperative period (P<0.05), but the difference between the two groups was not statistically significant (P>0.05). The postoperative complication rate of 42.86% and recurrence rate of 2.38% in the observation group were lower than 66.67% and 17.95% in the control group (P<0.05). The 12month postoperative survival rate of 97.62% in the observation group was not statistically significant compared with 94.87% in the control group (P>0.05).Conclusion  The efficacy of LRFA and PRFA in the treatment of primary hepatocellular carcinoma is comparable, which can effectively improve the body’s anti-tumor immunity and reduce the release of serum tumor markers; however, LRFA has less stressful reaction, reduces the occurrence of postoperative complications, and has a lower recurrence rate, which is especially advantageous in the treatment of hepatocellular carcinoma at special sites.

Objective  Comparison of therapeutic effects between retrograde island flap of the intrinsic artery and dorsal perforator island flap for repairing skin defects at the distal phalanx of the finger.Methods  A total of 128 patients with skin defects at the distal phalanx of the finger were enrolled from August 2020 to September 2022 at Huai’an Second People’s Hospital.These patients had 128 affected fingers.Using a random number table,they were divided into two groups:collateral group (64 case) and dorsal branch group (64 case).The collateral group underwent retrograde island flap surgery using the intrinsic artery,while the dorsal branch group underwent repair surgery using the dorsal perforator island flap of the intrinsic artery.Surgical time and intraoperative blood loss were recorded.Follow-up was conducted for 12 months postoperatively,evaluating graft survival rate,finger joint function,sensory function of the transplanted flap at the distal phalanx,degree of wound scar,and postoperative complications.Results The surgical time for the collateral branch group and the dorsalis branch group was (50.03±12.41) minutes and (54.78±15.65) minutes,respectively.The intraoperative blood loss was (22.65±10.03) ml in the collateral branch group and (26.52±12.61) ml in the dorsalis branch group.There was no statistically significant difference in surgical time or intraoperative blood loss between the two groups (P＞0.05).At the 12month follow-up,all patients in both groups had normal healing of the distal defect,and the success rate of flap transplantation was 100.00% in both groups.There was no statistically significant difference between the groups in terms of flap transplantation success rate (P＞0.05).At the 12month postoperative period,the Vancouver Scar Scale (VSS) score was (3.15±0.69) in the collateral branch group and (3.17±0.62) in the dorsalis branch group,with no statistically significant difference between the two groups (P＞0.05).The Tangibility,Appearance,and Mobility (TAM) score was (9.71±0.65) in the collateral branch group and (10.93±0.71) in the dorsalis branch group.The TAM score was significantly lower in the collateral branch group compared to the dorsalis branch group (P<0.05).The two-point discrimination of the flaps was (8.93±2.05) mm in the collateral branch group and (7.51±1.64) mm in the dorsalis branch group.The two-point discrimination was significantly higher in the collateral branch group compared to the dorsalis branch group (P<0.05).There were 2 cases of venous reflux disorder and 1 case of cold intolerance in the collateral branch group,while no complications occurred in the dorsalis branch group.There was no statistically significant difference in complications between the two groups (P＞0.05).Conclusion  Compared to the reverse island flap repair using the intrinsic arterial system,the dorsal island flap repair using the intrinsic arterial system for treating distal skin defects of the finger provides better postoperative functional recovery of the finger and relatively lower risk of venous congestion.

Objective  To investigate the association between recurrent low back pain(RLBP) and postoperative weight gain(PWG) after recurrent low back pain(TLIF) at three-month follow-up.Methods  We analyzed 254 patients at three-month after TLIF from September 2020 to September 2022.Data such as age, gender, height and weight before surgery, smoking status, Pfirrmann grade of preoperative intervertebral disc degeneration, visual analogue scale (VAS) before surgery and 7 days, 1 month and 2 months after surgery were collected.RLBP was defined for patients with low back pain with VAS score ≤3 on the 7th, 1st and 2nd month after surgery, but ≥4 on the 3rd month after surgery.Three months after surgery, PWG was divided into 4 groups: <0kg group, 0~<5kg group, 5~<10kg group, and ≥10kg group. Multivariate Logistic regression analysis of odds ratio (ORs).Results The prevalence of persistent RLBP was 18.5%(n=47).Compared to patients with a PWG of <0 kg,patients with a PWG of 5 kg to <10 kg and ≥10 kg had a higher prevalence of RLBP(OR=2.48 and 4.19,respectively);the difference was statistically significant (P<0.05).However,no significant difference was found for patients with a PWG of 0 kg to <5 kg.In addition,Logistic regression analysis also showed female,higher preoperative body mass index(BMI) and higher preoperative Pfirrmann grade were other three independent risk factors of RLBP.Conclusion  PWG in TLIF patients is one of the independent risk factors for RLBP. Postoperative weight intervention for patients can reduce the incidence of RLBP and improve patient satisfaction with the surgery.

Objective  To investigate the risk factors of postoperative vertebral body refracture after percutaneous vertebroplasty(PVP) in the treatment of thoracolumbar osteoporotic compression fracture.Methods  The radiological and clinical data of 1258 patients who underwent single-level PVP surgery for thoracolumbar vertebral compression fracture in our hospital from January 1,2015 to December 31,2020 were retrospectively analyzed.Gender,age,body mass index(BMI),bone mineral density(BMD),surgical approach,injection amount of cement,diffusion state of,leakage,vertebral height restores,kyphotic angle reduction,wedge angle reduction of vertebral body,postoperative anti-osteoporosis drug application and other radiological and clinical data of patients were collected and analyzed by univariate and multivariate analysis.The differences of these parameters in the refracture group and the nonrefracture group were compared to evaluate the correlation between these factors and postoperative vertebral refracture.Results  A total of 247 patients were included in this study.The incidence of refracture was 3.90% in 49 patients.Univariate analysis showed that large kyphotic angle,intravertebral cleft sign,endplate cortical disruption,small injection amount of bone cement,non-contact between bone cement and endplate,and high reduction rate of vertebral body were risk factors for vertebral refracture after PVP.Multivariate analysis of these factors showed that large injection amount of bone cement(OR=0.37，95%CI：0.190.55，P=0.018) was a protective factor for vertebral refracture after PVP,and preoperative endplate cortical disruption(OR=2.86，95%CI：1.14~7.53，P=0.026),preoperative intravertebral cleft sign(OR=18.15，95%CI：3.07~44.79，P=0.003),large vertebral reduction rate(OR=3.58，95%CI：1.38~8.40，P=0.007),and poor contact between bone cement and endplate(OR=3.01，95%CI：1.92~10.65，P=0.004) were independent risk factors for vertebral refracture after PVP.Conclusion  In this study,it was found that small injection amount of bone cement,endplate cortical disruption before surgery,intravertebral cleft sign,large vertebral reduction rate,and poor contact between bone cement and endplate were independent risk factors for postoperative refracture after PVP treatment of osteoporotic compression fractures in the elderly thoracolumbar spine.

Objective  To analyze the relationship between plasma mitochondrial DNA(mtDNA),macrophage inflammatory protein-1α(MIP1α) and monocyte chemotactic protein 1(MCP-1) in vastus lateralis tissues and postoperative muscle atrophy,recovery of hip function in patients with hip fractures.Methods A total of 86 patients with hip fractures and 43 patients with coxitis in Jinan Eighth People’s Hospital were enrolled as hip fracture group and coxitis group between October 2020 and October 2022,respectively.The lateral muscle tissues were collected as samples during surgery.The level of plasma mtDNA was detected by real-time fluorescence quantitative polymerase chain reaction.Before surgery,levels of serum interleukin-6(IL-6) and tumor necrosis factor α(TNF-α) were detected by enzyme-linked immunosorbent assay.Before surgery,cross-sectional areas of types I and II vastus lateralis fibers were detected by immunofluorescence method.Before surgery,expression levels of MIP1α and MCP-1 proteins in lateral muscle tissues were detected by Western blot.All patients with hip fracture were effectively followed up for 6 months after surgery.At 3 and 6 months after surgery,total lean mass(TLM) and unaffected limb lean mass(ULLM) were detected by DXA.Results  The level of plasma mtDNA in hip fracture group was higher than that in coxitis group before surgery [(4.12±0.53) vs(2.37±0.36),P<0.05],levels of serum IL-6 and TNF-α were higher than those in coxitis group [(34.68±6.14)pg/ml,(21.54±4.12)pg/ml vs(12.74±3.06)pg/ml,(10.81±2.71)pg/ml,P<0.05],cross-sectional areas of types I and II vastus lateralis fibers were smaller than those in coxitis group [(4321.45±441.36) μm²,(2384.38±247.11) μm² vs(5417.63±553.27) μm²,(3569.24±368.22) μm²,P<0.05],and expression levels of MIP1α and MCP-1 proteins were higher than those in coxitis group [(2.34±0.25),(2.47±0.28) vs(1.18±0.15),(1.95±0.23),P<0.05].In patients with hip fracture after 6 months of follow-up,there were 53 cases with good prognosis and 33 cases with poor prognosis.The level of plasma mtDNA in poor prognosis group was higher than that in good prognosis group before surgery [(4.53±0.52) vs(3.87±0.44),P<0.05],levels of serum IL-6 and TNF-α were higher than those in good prognosis group [(35.97±5.32)pg/ml,(20.74±4.27)pg/ml vs(33.51±5.16)pg/ml,(22.83±4.33)pg/ml,P<0.05],cross-sectional areas of types I and II vastus lateralis fibers were smaller than those in good prognosis group [(4174.26±434.60) μm²,(2309.56±246.18) μm² vs(4394.42±450.12) μm-2,(2430.97±250.72) μm-2,P<0.05],and expression levels of MIP1α and MCP-1 proteins were higher than those in good prognosis group [(2.47±0.28),(1.95±0.23) vs(2.26±0.24),(1.82±0.21),P<0.05].TLM and ULLM at 6 months after surgery were lower than those at 3 months after surgery in good prognosis group and poor prognosis group(P<0.05).At 3 and 6 months after surgery,there was no significant different in TLM or ULLM between good prognosis group and poor prognosis group(P>0.05).Conclusion  Traumatic stress injury will increase level of plasma mtDNA in patients with hip fracture,which will induce the increase of systemic inflammatory indexes(serum IL-6,TNF-α) and inflammatory factors(MCP-1,MIP1α) levels,aggravate muscle atrophy and cause postoperative decline of hip function.

Objective  To observe the effect of postoperative local injection of platelet-rich plasma(PRP) on patients’ early inflammatory response and functional recovery in ankle fractures with lower tibiofibular injuries.Methods  Fifty ankle fracture patients with lower tibiofibular injuries admitted to our hospital from January 2017 to December 2022 with postoperative local injection of PRP were selected as the PRP group,and 50 ankle fracture patients with lower tibiofibular injuries undergoing surgical treatment with ligament repair protocols in the same time period with their matched gender and age were selected as the conventional group.We compared the postoperative conditions,postoperative 3-d swelling,postoperative pain visual analogue(VAS) scores and levels of platelet-derived growth factor(PDGF),transforming growth factor β1(TGF-β1),and inflammatory mediators in the two groups,and counted the 24-week postoperative good rate,ankle plantarflexion-dorsiflexion mobility,the quality of the restoration,and the complications in the two groups.Results  The swelling grading in the PRP group was lower than that in the conventional group(28 cases of grade I,20 cases of grade II,and 2 cases of grade III) in the 3-d postoperative period(15 cases of grade Ⅰ,23 cases of grade Ⅱ,and 12 cases of grade Ⅲ),and the VAS scores in the 3-d and 7-d postoperative period [(3.24±0.61) and(2.40±0.42) points] were lower than those in the conventional group [(3.78±0.74) and(2.96±0.55)],and the lower limb weight-bearing activity time(4.01±0.65) weeks,fracture healing time(3.05±0.42) months,and postoperative return to normal work time(3.17±0.47) months were shorter than those in the conventional group [weight-bearing activity time of lower limbs(4.29±0.74) weeks,fracture healing time(3.23±0.48) months,and postoperative return to normal work time(3.40±0.59) months].While the operation time(106.53±19.77) min,number of intraoperative fluoroscopies(14.47±3.23) times,and intraoperative blood loss(84.07±25.60) ml were not statistically different from those of the conventional group [operation time(108.20±18.41) min,number of intraoperative fluoroscopies(14.53±3.06) times,and intraoperative blood loss(86.23±22.17)ml ] were not statistically different when compared(P＞0.05).There was no statistical difference in the comparison of preoperative inflammatory mediators,PDGF,and TGF-β1 between the two groups(P＞0.05).In both groups,PDGF was higher and interleukin-6(IL-6),TGF-β1,Creactive protein(CRP),and tumour necrosis factor-α(TNF-α) were lower at 12 weeks postoperatively compared with the preoperative period(P＜0.05).In the PRP group,the postoperative PDGF was higher than that of the conventional group,and the inflammatory mediators and TGF-β1 were lower than those of the conventional group at 12 weeks postoperatively(P＜0.05).In the PRP group,the postoperative 24 week good rate and ankle plantarflexion-dorsiflexion mobility were higher than that of the conventional group,and the inferior tibiofibular coalition anterior spacing(ITFACS) and inferior tibiofibular coalition posterior spacing(ITFPCS) were lower than that of the conventional group,and there was no statistically significant difference in the rate of complications when comparing the rate with that of the conventional group(P＞0.05).Conclusion  Local PRP injection combined with ligament repair protocol for treatment of ankle fractures with lower tibial fibula injuries accelerates patients’ early functional recovery and improves the quality of anatomical repositioning,which may be related to the inhibition of inflammatory mediator release and the promotion of bone repair.

Objective  To compare the application of multifunctional ureterostomy stent and traditional ureterostomy internal stent in patients with total ureterostomy.Methods  Prospectively,102 patients with bladder cancer and undergoing elective radical cystectomy with urinary diversion admitted to our hospital from March 2019 to March 2023 were selected for the study.According to the random number rank method,the patients were divided into the study group (51 cases) and the control group (51 cases).The control group was given a traditional singleJ ureteral stomy stent drainage device,and the research group was given a multifunctional ureteral stomy stent drainage device.The differences of OAI score,renal function index (eGFR),recent complications,long-term complications and quality of life (FACT-BL score) were compared between the two groups.Results  OAI scores 1 month,3 months and 6 months after surgery (study group:49.33±4.07,57.29±3.90,68.25±3.76;control group:44.25±4.61,52.31±4.58,59.06±4.37) and before surgery (study group:32.71±4.32;control group:33.18±4.74) compared with higher levels (P<0.05),but the study group was higher than the control group (P<0.05).Repeated measurement ANOVA results showed that eGFR at 3 months and 6 months after surgery (study group:86.07±4.07,88.01±3.01;control group:83.09±3.06,85.06±5.09) and before surgery (study group:82.05±6.04;control group:81.03±5.06) compared with higher levels (P<0.05),but the study group was higher than the control group (P<0.05).The total rate of recent complications in the study group was lower than that in the control group (7.84% VS 23.53%,P<0.05).The total incidence of long-term complications in the study group was lower than that in the control group (43.14% VS 78.43%,P<0.05).Emotional status score,physical status score,functional status score,social and family status score,BSS score,FACT-BL total score of the two groups 6 months after surgery (study group:20.25±2.36,24.92±1.87,25.65±1.11,26.02±1.14,32.75±1.76,129.59±5.74;Control group:18.65±3.10,20.18±3.02,23.51±1.29,21.51±2.24,30.26±3.07,114.10±10.37) and preoperative (study group:14.27±3.56,16.57±3.58,17.27±2.35,17.49±2.64,23.41±5.25,89.02±13.62;Control group:14.39±3.44,16.47±3.25,17.22±2.34,17.55±2.59,23.43±5.25,89.25±13.62) were increased (P<0.05),and the study group was higher than the control group (P<0.05).Conclusion  The application of multifunctional ureteral stent in patients with ureteral cutaneous stomy with total cystotomy can effectively improve the adaptability of stomy,promote the recovery of renal function,reduce the risk of short-term and long-term complications,and improve the quality of life of patients.

Objective  To investigate the analgesic effect of multi-site multiple paravertebral nerve blocks on patients undergoing radical lung cancer surgery and the impact on their serum indices and prognosis.Methods Ninety-eight cases of patients undergoing thoracoscopic radical lung cancer surgery in our hospital were selected from March 2021 to January 2023 and divided into 2 groups according to the difference in anaesthesia.Among them,42 patients in the study group were treated with preoperative and postoperative multipoint paravertebral nerve block combined with general anaesthesia,while 56 patients in the control group were treated with preoperative multipoint paravertebral nerve block combined with general anaesthesia,and the analgesic effect and other differences between the two groups were compared.Results  In the study group, extubation time, recovery time, propofol dosage and postoperative VAS score were (150.2±15.2) min, (19.1±5.1) min, (738.2±36.5) mg and (4.2±0.7) points, respectively.The control group was (151.9±12.6) min, (22.6±7.3) min, (902.1±49.0) mg and (2.3±0.3) min, respectively, and the difference between the two groups was statistically significant (P<0.05).The differences of heart rate, mean arterial pressure and before and after half an hour after surgery in control group were higher than those in study group, and the differences of norepinephrine, epinephrine and before and after surgery were higher than those in study group, with statistical significance (P<0.05).The total complication rate of the study group was 7.2%, and that of the control group was 23.2%. The QoR score of the control group was lower than that of the study group, and the difference between the two groups was statistically significant (P<0.05).Conclusion  Preoperative and postoperative multi-point paravertebral nerve block combined with general anaesthesia has a better analgesic effect on patients undergoing radical lung cancer surgery,which can not only reduce the inflammatory reaction of the patients,but also have less impact on their haemodynamic indexes and lower rate of postoperative adverse reactions,and ultimately improve the quality of life of the patients.

Objective  The purpose of this study is to explore the clinical efficacy of laparoscopic transabdominal anterior peritoneal hernia repair(TAPP) in the treatment of inguinal hernia in elderly male patients,and to analyze the factors influencing postoperative recurrence. Methods  A retrospective analysis was conducted on the clinical data of 93 elderly male patients admitted to our hospital for TAPP from January 2020 to June 2023.They were divided into a recurrence group and a non-recurrence group based on postoperative recurrence.Risk factors for postoperative recurrence of TAPP were analyzed through univariate analysis and logistic regression analysis.Results  The proportion of hernia sac diameter≥3cm,lower abdominal surgery history,severe hernia ring adhesion and surgery time≥60min in the recurrent group were significantly higher than those in the non-recurrence group(P<0.05).Multivariate logistic analysis showed that hernia sac diameter≥3cm,history of lower abdominal surgery,and severe hernia ring adhesion were independent risk factors for postoperative recurrence of TAPP(P<0.05).Conclusion  TAPP is a safe and reliable treatment for inguinal hernia in elderly male patients.The diameter of the hernia sac≥3cm,a history of lower abdominal surgery,and severe hernia ring adhesion may increase the risk of postoperative recurrence in elderly male patients with TAPP.

Kidney transplantation remains the gold standard treatment for patients with end-stage renal disease.To address the growing demand for organs,there is an increasing reliance on organs from donors after cardiac death (DCD) and expanded criteria donors (ECD).These marginal organs are at a heightened risk of severe ischemia-reperfusion injury,which can lead to a higher incidence of primary nonfunction,delayed graft function,and reduced long-term graft survival rates following transplantation.Ex vivo machine perfusion (EVMP) provides superior protection for donor kidneys compared to traditional static cold storage.Additionally,EVMP can serve as a platform for the dynamic administration of drugs or gene therapies,further enhancing the efficacy of kidney transplantation.This review outlines innovative strategies for ex vivo kidney mechanical perfusion treatments,including mesenchymal stem cell therapy,gene therapy,nanotechnology,anti-infectives,gas therapy,thrombolytics,blood type conversion,and other therapeutic approaches.

Peritoneal adhesions are one of the most common postoperative complications.The formation of peritoneal adhesions is a complex process with multiple factors and stages.Various inflammatory cells and their secreted cytokines promote the chronicity of inflammatory response,the initiation of coagulation cascade reaction and excessive deposition of fibrin,ultimately leading to the formation of pathological peritoneal adhesions.Research in recent years has also highlighted the important role of non-coding RNA in peritoneal adhesions.