Abstract:Objective To study the effect of da Vinci robotic surgical system(DVSS)assisted laparoscopic surgery for endometrial cancer(EC)and its impact on inflammatory factors.Methods Retrospective analysis was conducted on the clinical data of 48 EC patients in the Obstetrics and Gynecology Department of the Third Affiliated Hospital of Soochow University from January 2023 to January 2025.They were divided into two groups according to the treatment method,22 cases in the robot group and 26 cases in the conventional laparoscopy group.The robot group used DVSS to assist on the basis of laparoscopic surgery,while the conventional laparoscopy group was treated with traditional laparoscopic surgery.The surgical treatment indicators,inflammatory markers,and complications were compared between the two groups.Results There were no statistically significant differences in the surgical operation time,postoperative exhaust time,and drainage tube placement days between the two groups of patients(P>0.05).The intraoperative bleeding volume,average daily drainage volume,and postoperative hospital stay in the robot group were significantly lower than those in the conventional laparoscopy group(P<0.05).The levels of CRP,PCT and WBC in the robot group were lower than those in the conventional laparoscopy group(P<0.05).The incidence of short-term complications in the robot group was significantly lower than that in the conventional laparoscopy group(P<0.05).There was no statistically significant difference in the total incidence of long-term complications between the two groups(P>0.05).Conclusion DVSS assisted laparoscopic surgery has a significant effect on the treatment of EC and is worth promoting.

Abstract:Objective To evaluate the efficacy and safety of uvulopalatopharyngoplasty(UPPP)combined with radiofrequency ablation of the base of the tongue in the treatment of obese obstructive sleep apnea hypopnea syndrome(OSAHS).Methods 106 patients with OSAHS who were admitted to the Department of Otolaryngology of the First Affiliated Hospital of Soochow University from January 2022 to December 2024 were selected as the research subjects.The patients were randomly divided into observation group and control group,with 53 cases in each group.The control group was treated with UPPP,while the observation group was treated with UPPP combined with radiofrequency ablation of the tongue root.The therapeutic effects of the two groups,the sleep monitoring parameters[arterial oxygen saturation(MSpO2),nocturnal minimum arterial oxygen saturation(LSpO2),and apnea time],pulmonary function[forced vital capacity(FVC),forced expiratory volume in one second(FEV 1),and laryngopharyngeal reflux[reflux symptom index scale(RSI)and reflux symptom score scale(RFS)]before the operation and 6 months after the operation were compared between the two groups.The clinical symptoms[nasal resistance,Visual Analogue Scale for nasal congestion(VAS),and subjective score for daytime sleepiness Epworth sleepiness scale(ESS)]were compared before the operation,3 months after the operation,and 6 months after the operation.The incidence of complications in the two groups was also compared at discharge.Results The effective rate was 92.45%in the observation group,significanly higher than that in the control group(77.36%,P<0.05).At 6 months after operation,MSpO2 and LSpO2 in the observation group were higher(P<0.05),while apnea time was shorter(P<0.05).FEV1,FVC in the observation group were higher than those in the control group 6 months after operation(P<0.05).The RSI score and RFS score of the observation group were lower than those of the control group 6 months after operation(P<0.05).There was no difference in the incidence of complications between groups(P>0.05).Conclusion UPPP combined with radiofrequency ablation of the base of the tongue has a good effect in the treatment of obese OSAHS,can improve patients'lung function and clinical symptoms,and has a high safety.

Abstract:Objective To explore the application of comfortable operating room nursing under the concept of enhanced recovery after surgery(ERAS)in patients undergoing laparoscopic gastric volume reduction surgery.Methods 100 patients who underwent laparoscopic gastric volume reduction surgery in Wuxi Second People's Hospital from January 2024 to April 2025 were selected as the research subjects and were divided into an observation group and a control group by the random number table method,with 50 cases in each group.Until the patients were discharged,the control group received routine operating room nursing,while the observation group was given comfortable operating room nursing under ERAS concept on the basis of the routine nursing in the control group.The two groups were compared in terms of the postoperative recovery time(postoperative awakening time,ambulation time,anal exhaust time,time to normal food intake and hospitalization time),the psychological status before nursing and at discharge[Hamilton anxiety scale(HAMA)and Hamilton depression rating scale(HAMD)],as well as the 36-Item Short Form Health Survey scores(SF-36,including physiological status,social/family status,emotional status,functional status)and the levels of interleukin-6(IL-6),IL-8 and IL-10 before nursing,5 days after nursing and at discharge.Satisfaction with nursing was also compared between the two groups before discharge.Results The postoperative awakening time,ambulation time,anal exhaust time,time to normal food intake and hospitalization time were all shorter in the observation group than in the control group(P<0.05).At discharge the HAMA and HAMD scores of observation group were lower than those of control group(P<0.05).In the observation group the scores of physiological status,social/family status,emothinal status and functional status after 5 days of nursing and at discharge were all higher than those in the control group(P<0.05).After 5 days of nursing and at discharge,the levels of IL-6 and IL-8 in the observation group were lower than those in the control group(P<0.05),while the level of IL-10 was higher than that in the control group(P<0.05).Patients in the observation group was more satisfied with nursing intervention than patients in the control group(P<0.05).Conclusion The comfortable operating room nursing under the ERAS concept has a significant effect on patients undergoing laparoscopic gastric volume reduction surgery,which can improve the psychological state of patients and enhance their quality of life.

Abstract:Objective To assess and compare the efficacy and safety of AngioJet mechanical thrombectomy with catheter-directed thrombolysis(CDT)for treating acute deep vein thrombosis(DVT)in the lower extremities.Methods Clinical data were gathered from 60 patients with acute lower limb DVT who were admitted to the Department of Vascular Surgery at Changzhou Second People's Hospital from January 2022 to October 2024.Among these patients,32 underwent AngioJet mechanical thrombectomy(AngioJet group),whereas 28 received catheter-directed thrombolysis(CDT group).A retrospective analysis was carried out on the general clinical data,vein patency rate,limb swelling reduction rate,urokinase dosage,thrombolysis duration,hospital stay,hospitalization costs,and complications in both groups.Results The technical success rate was 100%in both groups.Compared with the CDT group,the AngioJet group had higher rates of venous patency and limb swelling reduction,required lower urokinase dosage,had a shorter thrombolysis duration,and had a reduced hospital stay,although the hospitalization costs were higher,and all these differences were statistically significant(P<0.05).The overall complication rate was slightly higher in the AngioJet group than in the CDT group,but there was no significant statistical difference(P>0.05).However,the incidence of bleeding-related complications was significantly higher in the CDT group than in the AngioJet group,and this difference was statistically significant(P<0.05).Conclusion For the treatment of acute DVT in the lower extremities,AngioJet mechanical thrombectomy shows better short-term efficacy than CDT.It effectively enhances the vein patency rate and limb swelling reduction rate,requires lower urokinase dosage and shorter thrombolysis duration,reduces hospital stay,and exhibits high clinical safety.If economic conditions allow,AngioJet can be given priority as the preferred treatment option.

Abstract:Objective To explore the application effect of COM-B model based modified narrative nursing combined with health education in patients after PCI for coronary heart disease.Methods 110 patients with coronary heart disease who underwent PCI treatment from May 2023 to April 2025 were selected.Patients were randomly divided into two groups by the random number method,55 cases each group.The control group was given conventional nursing,while the observation group was given the COM-B model based modified narrative nursing combined with health education.The 6-minute walking distance(6 MWD),left ventricular ejection fraction(LVEF),coronary heart disease self-management behavior(CSMS),health-promoting lifestyle(HPLP-Ⅱ),quality of life of Chinese cardiovascular patients(CQQC),and the incidence of MACE after surgery were compared between two groups.Results Two months after the operation,in both groups the 6 MWD was longer and LVEF was higher than those one day before the operation,and the 6 MWD and LVEF of observation group were greater than those of control group(P<0.05).Two months after the operation,the scores of each dimension of CSMS,HPLP-Ⅱ and CQQC in both groups were higher than those 1 day before the operation,and the scores of each dimension of CSMS,HPLP-Ⅱ and CQQC in observation group were higher than those in control group(P<0.05).The incidence of MACE after surgery in observation group was lower than that of control group(P<0.05).Conclusion The COM-B model based modified narrative nursing combined with health education can effectively improve the cardiac function of patients after PCI for coronary heart disease,enhance self-management behaviors and quality of life,promote patients to cultivate a healthy lifestyle,and reduce the incidence of MACE.

Abstract:Objective To construct and validate a column chart prediction model for the risk of chronic back pain in patients with osteoporotic lumbar vertebral fractures(OLVCF)undergoing percutaneous kyphoplasty(PKP).Methods A retrospective analysis was conducted on 310 patients who received PKP treatment in the Department of Orthopedics at First People's Hospital of Zhangjigang from August 2022 and August 2024.Based on VAS scores 12 months after surgery,the patients were divided into a chronic back pain risk group(n=70)and a non-chronic back pain risk group(n=240).Clinical data of patients were collected,univariate and multivariate analysis of chronic low back pain was conducted,risk factors related to chronic low back pain were screened,a column chart prediction model was constructed,and its application was validated.Results Multivariate logistic regression demonstrated that low preoperative bone mineral density(BMD),paraspinal fascia injury,vertebral fissure sign,and incomplete coverage of the fracture line by bone cement were independent risk factors for chronic low back pain after PKP(P<0.05).The nomogram model showed good discrimination with a concordance index(C-index)of 0.871,indicating favorable predictive performance and clinical utility.Conclusion The nomogram model of chronic low back pain risk after PKP constructed in this study can effectively evaluate the risk of chronic low back pain,provide preoperative individualized assessment tools,optimize clinical management,and improve patient prognosis.

Abstract:Objective To explore the clinical efficacy and safety of the Huatan Sanjie formula in the treatment of intermediate-risk pulmonary nodules of Qi stagnation and phlegm accumulation type that meet the criteria for non-essential surgery.Methods A retrospective analysis was conducted and the data of 82 patients,who had intermediate-risk pulmonary nodules of Qi stagnation and phlegm accumulation type and met the criteria for non-essential surgery in our hospital from February 2021 to February 2024,were collected.Among them,the observation group(42 cases)was treated with the formula for resolving phlegm and dispersing nodules,while the control group(40 cases)was followed up regularly.The treatment course for both groups was 3 months.The therapeutic effects on the diameter reduction of pulmonary nodules,the TCM syndrome,the maximum diameter of pulmonary nodules before treatment and 3 months after treatment,the TCM syndrome score and the safety were compared between the two groups.Results The total effective rate of nodule diameter reduction in patients with intermediate-risk pulmonary nodules of Qi stagnation and phlegm accumulation type in the observation group(23.81%)was not different from that in the control group(17.5%,P>0.05).The total effective rate of TCM syndrome treatment in patients with intermediate-risk pulmonary nodules of Qi stagnation and phlegm accumulation type in the observation group(80.95%)was higher than that in the control group(22.50%,P<0.05).Three months after treatment,the maximum diameter of pulmonary nodules in patients with intermediate-risk pulmonary nodules of Qi stagnation and phlegm accumulation type in the observation group was smaller than that in the control group(P<0.05).The TCM syndrome score of patients with intermediate-risk pulmonary nodules of Qi stagnation and phlegm accumulation type in the observation group was lower than that in the control group(P<0.05).No serious adverse reactions occurred in the two groups of patients with intermediate-risk pulmonary nodules of Qi stagnation and phlegm accumulation type.Conclusion The formula for resolving phlegm and dispersing nodules can effectively reduce or stabilize intermediate-risk pulmonary nodules of Qi stagnation and phlegm accumulation type,improve clinical symptoms,and provide a safe and effective conservative treatment option for patients who meet the criteria for non-essential surgery.

Abstract:Objective To investigate the effectiveness of combining problem-based learning(PBL)with case-based learning(CBL)in the training of general surgery residents,and to provide practical guidance for clinical education.Methods From October 2021 to May 2022,fifty residents undergoing rotation training in the Department of General Surgery at Shanghai Xuhui District Central Hospital(Xuhui Hospital,Fudan University)were enrolled and randomized into a control group(n=25)and an experimental group(n=25).The control group received conventional lecture-based teaching while the experimental group received the integrated PBL-CBL instructional program.Outcomes included theory examinations(full score 100),comprehensive clinical skills assessment covering medical record writing,case analysis,practical operations and clinical reasoning(each item scored out of 50),and a self-administered questionnaire assessing perceived clinical problem-solving ability,confidence,self-learning capacity and teaching satisfaction(each item scored out of 30).Results Compared with the control group,the experimental group achieved significantly higher theory scores in department exit exam and better performance in multiple clinical skill domains(P<0.05).Questionnaire feedback indicated significant improvements in clinical problem solving(P<0.05),confidence(P<0.05),self-learning ability(P<0.05)and overall teaching satisfaction(P<0.05).Conclusion The combined PBL-CBL teaching mode can effectively enhance theoretical knowledge,clinical competence and self-directed learning among general surgery residents,and is worthy of broader application in residency training programs.

Abstract:The patient was an elderly male diagnosed with high rectal cancer,and underwent laparoscopic radical resection using the natural orifice specimen extraction surgery(NOSES)IV approach.According to the principles of total mesorectal excision(TME),the dissection was performed with a distal margin of at least 10 cm beyond the inferior border of the tumor.Following transanal irrigation of the rectal lumen with povidone-iodine solution,the distal rectum was ligated and transected 5 cm below the tumor using an endoscopic linear stapler.A sterile specimen retrieval bag was introduced through the distal rectal opening and advanced to the anal verge,establishing a sterile intracorporeal pathway within the distal intestinal lumen.Proximally,the colon was skeletonized 10 cm above the superior tumor margin,ligated,and divided.The specimen was then extracted through the rectal lumen using the sterile retrieval system.A laparoscopic purse-string suture was placed at the proximal colon to embed the anvil of the circular stapler,followed by transanal anastomosis.For patients with high rectal cancer,the NOSES IV technique is both safe and feasible,offering significant advantages,including reduced postoperative pain and accelerated recovery.

Abstract:Objective To assess the predictive value of the albumin-to-fibrinogen ratio(AFR),neutrophil-to-lymphocyte ratio(NLR),and platelet-to-lymphocyte ratio(PLR)as prognostic predictors for locally advanced gastric cancer after laparoscopic radical gastrectomy.Methods The study employed a retrospective cohort design,from May 2019 to May 2022,107 patients with locally advanced gastric cancer treated by laparoscopic radical gastrectomy were selected from Taizhou People's Hospital Affiliated to Nanjing Medical University,and their peripheral blood AFR,NLR and PLR were detected within one week before operation.Identification of the optimal AFR,NLR and PLR cut-off values for 3-year mortality prediction was performed via receiver operating characteristic(ROC)curve analysis.Based on the optimal cut-off values,patients were stratified into high-and low-risk groups for AFR,NLR and PLR,respectively.Subsequently,the associations of these stratified groups with patient survival and prognosis were analyzed,followed by assessment of independent factors influencing postoperative prognosis.Results ROC curve analysis showed that the optimal cut-off values of AFR,NLR and PLR were 14.80,2.67 and 186.18,respectively.Cox univariate and multivariate analysis showed that age,tumor size,pathological differentiation,AFR,NLR and PLR were all influencing factors for the prognosis of patients with locally advanced gastric cancer after laparoscopic radical surgery(P<0.05).Conclusion Preoperative AFR,NLR and PLR demonstrate significant prognostic value and may serve as potential biomarkers for locally advanced gastric cancer patients undergoing laparoscopic radical gastrectomy.

Abstract:Under the background of our country's full implementation of the two-child policy and the rising proportion of advanced maternal age and high-risk pregnancies in obstetric clinical practice,as of 2025,the rate of cesarean sections in China still remains high.According to recent statistics,the national average rate of cesarean sections is approximately 46.5%,with some regions even reaching 60%to 80%.In Changzhou,the rate of cesarean sections is also over 40%.During cesarean sections,The ingenious application of the large S hook combined technique to assist in the delivery of the fetal head is a practical technique,and has significant advantages,especially when the fetal head is high and floating,deeply embedded,or when it is difficult to expose the surgical field.Compared with the traditional single technique,forceps delivery and fetal aspiration in cesarean section,it has been optimized in reducing fetal head delivery time,intraoperative bleeding,distal uterine incision dilation,and fetal birth injury.By using the 3/8 arc of the large S hook,the surgeon and assistant can flexibly adjust the pressure direction according to the specific situation during the operation,ensuring that the fetal head is delivered along the optimal path.The surgeon needs to precisely control the depth and angle of the S hook to avoid excessive pulling and reduce the risk of uterine incision extension.This technique is particularly applicable to obese parturients with BMI>28,and those with complex conditions,such as high fetal head,repeated or multiple cesarean sections,poor elasticity of scar tissue,etc.It can significantly enhance surgical safety and optimize maternal and infant outcomes.

Abstract:Objective To compare the application effect of scenario simulation with scenario simulation and micro-lesson hybrid teaching mode in Department of General Surgery antimicrobial management training.Methods A total of 62 general surgeons in the Affiliated Hospital of Xuzhou Medical University from January 2024 to January 2025 were selected as the research subjects,and were divided into observation group(31 surgeons)and control group(31 surgeons)by random number table method.The control group was given a simple scenario simulation teaching,while the observation group was given a scenario simulation and micro-lesson mixed teaching mode.The theoretical and practical assessments of the clinical application of antibacterial drugs were conducted on the two groups.The theoretical and practical assessment scores,prescription standardization rate,and clinical decision-making time of antibacterial drug application before,one week after,and one month after teaching were compared between the two groups.The satisfaction with the teaching methods after one month of teaching was also surveyed.Results After 1 week of teaching and 1 month of teaching,the theoretical and practical assessment scores of the surgeons in the observation group were higher than those in the control group(P<0.05),the prescription standardization rate was higher than that of the control group,the clinical decision-making time was shorter than that of the control group(P<0.05),and the satisfaction of the observation group was significantly higher than that of the control group after 1 month of teaching(P<0.05).Conclusion The hybrid teaching mode of scenario simulation and micro-lesson can more effectively improve the antimicrobial management ability of general surgeons,and is better than simple scenario simulation teaching in terms of theoretical mastery,standardized medication and clinical decision-making,which is worthy of popularization and application in clinical training.

Abstract:Objective To analyze the application of refined nursing based on the heart communication model in oral implant restoration.Methods 82 patients with oral implant restoration admitted to Suzhou Stomatological Hospital from March 2023 to May 2025 were selected and divided into the control group(receiving conventional care)and the study group(receiving refined care based on the heart communication model on the basis of the control group)by the random number table method(sealed envelope method),with 41 cases in each group.The Dental Anxiety Scale(DAS)and Dental Fear Survey Scale(DFS)of 30 minutes before the operation and immediately after the operation,the intraoperative cooperation and postoperative compliance,the modified bleeding index and modified plaque index at 1 month and 3 months after the operation,and the complications during therapy were compared between two group.Results Thirty minutes before the operation and immediately after the operation,the DAS score and DFS score of the study group were lower than those of the control group(P<0.05).The intraoperative cooperation degree of the study group was higher than that of the control group(P<0.05).The postoperative compliance of the study group was higher than that of the control group(P<0.05).One month and three months after the operation,the modified bleeding index and modified plaque index of the study group were lower than those of the control group(P<0.05).The incidence of complications in the study group was lower than that in the control group(P<0.05).Conclusion The refined nursing based on the heart communication model can improve the psychological state of patients undergoing oral implant restoration,and enhance intraoperative cooperation and postoperative compliance.

Abstract:Objective To explore the application effect of quality control circle activity in improving the recovery rate of gastrointestinal function within 48 hours after gynecological abdominal surgery.Methods A quality control circle team was formed with the theme of improving the 48-hour postoperative gastrointestinal recovery rate in patients undergoing gynecological abdominal surgery.A total of 100 patients with gynecological malignant tumors admitted to Liuzhou People's Hospital from January to October 2023 were selected.Patients from January to April,when quality control circle activity hadn't been performed,were assigned to the control group(n=50),while those from May to October,when quality control circle activity was being implemented,were assigned to the study group(n=50).The situation of gastrointestinal function recovery within 48 hours after surgery was analyzed,and corresponding strategies were formulated and implemented.Data before and after the intervention were compared.Results The gastrointestinal recovery rate 48-hour after gynecological abdominal surgery increased from 30.00%to 66.00%.Incidences of the intestinal obstruction and the nausea and vomiting were lower in the study group than in the control group,with statistically significant differences(P<0.05).In addition,the comprehensive abilities of the quality control circle team members were significantly enhanced.Conclusion The quality control circle activity can effectively improve the recovery rate of gastrointestinal function in patients after gynecological abdominal surgery,reduce postoperative complications,and enhance the comprehensive abilities of quality control circle team members,demonstrating significant clinical application value.

Abstract:Objective To study the application effect of systematic operating room nursing based on the zero-defect concept in elderly patients undergoing percutaneous vertebroplasty(PVP)for thoracolumbar fractures.Methods A total of 140 elderly patients undergoing PVP for thoracolumbar fractures and admitted to the Xuzhou Mine Hospital(Xuzhou Integrated Traditional Chinese and Western Medicine Hospital)from July 2022 to July 2025 were selected and divided into a study group and a control group,with 70 cases in each group,by the random number table method.The control group received routine care,while the study group received systematic operating room care based on the zero-defect concept on the basis of the routine care in the control group.The surgical indicators,the mean arterial pressure and heart rate at the time of puncture and bone cement injection were evaluated.The Visual Analogue Scale(VAS)score was evaluated 12 hours and 24 hours after the operation.The Self-Rating Anxiety Scale(SAS)score was evaluated on the day of the operation and 3 days after the operation.The above evaluations as well as the occurrence of complications and the Japanese Orthopaedic Association(JOA)score 5 days after the operation were compared between the two groups.Results In the study group the intraoperative fluid infusion volume was lower,and the time to get out of bed for the first activity and the hospital stay were shorter than those in the control group(P<0.05).The mean arterial pressure and heart rate at the time of puncture and bone cement injection in the study group were lower than those in the control group(P<0.05).The VAS scores at 12 hours and 24 hours after the operation,and the SAS scores on the day of the operation and 3 days after the operation in the study group were lower than those in the control group(P<0.05).The incidence of complications in the study group was lower than that in the control group(P<0.05).The JOA score of the study group 5 days after the operation was higher than that of the control group(P<0.05).Conclusion The systematic nursing in the operating room based on the zero-defect concept can reduce the hemodynamic fluctuations of patients during the operation,alleviate pain and negative emotions,and promote the recovery of lumbar function,which has significant clinical advantages.

Abstract:Objective To design an auxiliary rack for the internal heat acupuncture treatment apparatus and evaluate its clinical application value.Methods The auxiliary rack was mainly composed of retractable columns,cannula slide rails and snap clamps.A total of 119 patients with myofascial pain syndrome from June 2022 to September 2023 in the Xiaolan People's Hospital of Zhongshan were recruited and were assigned by the random number table method into an observation group(n=59)using the auxiliary rack and a control group(n=60)without the auxiliary rack.The pain score,comfort score,satisfaction score and other indicators were compared between the two groups.Results There was no significant difference in the pain score between the two groups before treatment(P>0.05),while the pain scores of both groups after treatment were significantly lower than those before treatment(P<0.05),and the pain score of the observation group after treatment was lower than that of the control group(P<0.05).Moreover,subgroup analysis showed that the use of the auxiliary rack could improve the treatment comfort and satisfaction of patients in all age groups and with pain at various sites(P<0.05),and enhance the treatment efficacy for patients with neck and shoulder(back)pain and for patients aged 18 to 45(P<0.05).Conclusion The use of the auxiliary rack in the pain treatment is beneficial to providing a better treatment experience and can help to improve the treatment efficacy.

Abstract:Objective To explore the application effect of intracoronary shockwave balloon combined with plaque rotational atherectomy in percutaneous coronary intervention(PCI)for severe coronary artery calcification.Methods Sixty patients with severe coronary artery calcification who underwent PCI in Pizhou Hospital of Traditional Chinese Medicine from March 2023 to January 2025 were selected as the research subjects.They were divided into the observation group and the control group,with 30 cases in each group.The control group was pretreated with plaque rotational atherectomy during the operation,while the observation group was pretreated with intracoronary shockwave balloon combined with plaque rotational atherectomy during the operation.The perioperative conditions,the incidence of intraoperative complications and the incidence of major adverse cardiac events(MACE)after the operation,the incidence of restenosis and vascular hyperplasia were compared between the two groups.Results There were no statistically significant differences in operation time,intraoperative stent implantation quantity and diameter between the two groups(P>0.05).The minimum lumen diameter and area after dilation in the observation group were larger than those in the control group(P<0.05).There were no statistically significant differences in intraoperative complications between the two groups(P>0.05).There were no statistically significant differences in the incidences of MACE at 30 days and 6 months after surgery between the two groups(P>0.05).There was no statistically significant difference in the total incidence of restenosis and vascular hyperplasia at 6 months after surgery between the two groups(P>0.05).Conclusion Intracoronary shockwave balloon combined with rotational atherectomy for lesion preparation in patients with severe coronary artery calcification undergoing PCI can achieve larger minimal lumen diameter and area without increasing the rate of complications.

Abstract:Objective To explore the risk factors of perioperative neurocognitive impairment(PND)in elderly patients undergoing hip replacement surgery,and to construct a nomogram model based on the risk factors.Methods The clinical data of 200 elderly patients who underwent hip arthroplasty in the Internal Medicine Department of Beijing Delcony Orthopedic Hospital from March 2023 to March 2025 were retrospectively analyzed and divided into two groups:71 cases in the PND group and 129 cases in the non-PND group.The clinical relevant information(such as gender and age)of all research subjects was collected for analysis and comparison.Univariate and multivariate logistic regression analyses were conducted.A nomogram prediction model was constructed based on significant variables and verified.Results Gender,age,body mass index(BMI),respiratory diseases,operation time,anesthesia time,intraoperative blood loss,smoking history,drinking history,hypertension,hyperlipidemia,type of replacement,case number of different operation durations,intraoperative blood loss,nursing methods,red blood cell count(RBC),white blood cell count(WBC),neutrophil count(NEU),and lymphocyte count(LYM)were not associated with perioperative PND in elderly patients undergoing hip replacement surgery(P>0.05).Frailty score,diabetes,anesthesia method,analgesia plan,Visual Analogue Scale(VAS)score for postoperative pain,hemoglobin(HB)and albumin(ALB)were related to perioperative PND in elderly patients undergoing hip replacement(P<0.05).High frailty score,diabetes,general anesthesia,single analgesic regimen,and high VAS score were independent risk factors for perioperative PND in elderly patients undergoing hip replacement surgery(P<0.05).High levels of HB and ALB were protective factors for perioperative PND in elderly patients undergoing hip replacement surgery(P<0.05).The area under the curve(AUC)of the nomogram prediction model for perioperative concurrent PND in elderly patients undergoing hip replacement was 0.875(95%CI:0.812～0.901).Conclusion High frailty score,general anesthesia,single analgesia regimen,and excessively high VAS score are independent risk factors for perioperative PND in elderly patients undergoing hip replacement surgery.According to the constructed nomogram prediction model for perioperative concurrent PND in elderly patients undergoing hip replacement surgery,it has good discrimination and consistency.

Abstract:Cholecystectomy is the most effective treatment for benign gallbladder diseases.Laparoscopic cholecystectomy(LC)has become the standard surgical approach.With advancements in minimally invasive surgical concepts,techniques have evolved from"minimally invasive"toward"scarless"outcomes.Single-incision laparoscopic cholecystectomy(SILC)offers significant advantages over the traditional three-port method in terms of abdominal wall cosmesis and postoperative incisional pain.However,challenges such as technical difficulty(notably the"chopstick effect")and prolonged operation time have hindered its widespread adoption.To address the technical limitations of SILC,and based on the research indicating that abdominal wall injuries smaller than 2 mm do not leave scars,our team utilized a 1.4 mm ultra-minimally invasive retraction device(T-line)and 1.98 mm ultra-minimally invasive forceps to facilitate single-incision surgery.This approach preserves the benefits of SILC while resolving its technical challenges.Our team has termed this technique as"super-minimally invasive laparoscopic surgery"(SMLS),which is defined as a procedure that makes no more than two umbilical incisions,with the maximum diameter≥1.5 mm and the diameter of additional abdominal incision<2 mm,ensuring all incisions are concealed within the natural umbilical depression.Cholecystectomy performed with this method is referred to as"super-minimally invasive laparoscopic cholecystectomy"(SMLC).

Abstract:Objective To evaluate the safety and efficacy of interventional vascular recanalization in treating skin and deep tissue injuries caused by cosmetic filler injections in head and face.Methods From December 2022 to December 2024,40 patients from the Fourth Medical Center of the People's Liberation Army General Hospital with facial skin and deep tissue damage caused by cosmetic filler injection in head and face were enrolled.Interventional vascular recanalization was performed in the embolized vessels,and it was combined with commonly used clinical drugs and physical local treatments.The technical success rate,vascular recanalization status,technique-related complications,pain and local symptom recovery of the patients were evaluated.Results Technical success rate was 100%,and 42/42 occluded vessels were successfully recanalized using guidewire/catheter-based techniques.For symptom improvement,100%(40/40)local blood supply restoration was achieved.Recovery rate at 1-week follow-up was 97.5%(39/40),indicating significant recovery.Facial numbness and pain was resolved completely in all cases.For skin injury healing,39 cases healed without scarring,and 1 case developed deep tissue injury with residual scarring.For swelling resolution,injection site swelling subsided within 7 days.Conclusion Interventional vascular recanalization can rapidly restore blood perfusion to ischemic tissues,shorten the ischemic injury window,and provide a safe,effective and efficient solution for managing complications of cosmetic filler injections in head and face.