In recent years, the number of patients with vaginal relaxation has increased year by year, and the minimally invasive vaginal contraction has been carried out more and more widely in clinical practice, but the treatment normalization and safety have not been thoroughly studied. We summarized six cases of characteristics and treatment measures for patients with various complications after minimally invasive vaginal contraction surgery from September 2021 to December 2023 at Department of Plastic and Aesthetic Surgery, Peking Union Medical College Hospital. The patients' age ranged from 26 to 44 years. Two cases accepted vaginal contraction with embedded vaginal thread, and four accepted vaginal contraction with acellular allogenic dermis. One patient showed vaginal hyper-tightness, one patient showed subcutaneous suture nodules, two patients showed explosion of acellular allogenic dermis, and three patients showed vaginal infection symptoms such as yellow leucorrhea and peculiar smell. All patients had sexual pain and discomfort. One patient underwent vaginal orifice dilation, one patient underwent suture extraction and secondary vaginal contraction, one patient underwent acellular allogenic dermis extraction and immediate vaginal contraction, two patients underwent acellular allogenic dermis extraction and secondary vaginal contraction, and one patient underwent secondary vaginal contraction. The symptoms of all six patients were relieved after treatment. Despite the short operation time and fast postoperative recovery of minimally invasive vaginal contraction, there are still complications after surgery, causing physical and mental damage to patients. Plastic surgeons, therefore, should be cautious in the treatment process to avoid collateral damage, so that patients get the best treatment effect.

In recent years, the number of patients with vaginal relaxation has increased year by year, and the minimally invasive vaginal contraction has been carried out more and more widely in clinical practice, but the treatment normalization and safety have not been thoroughly studied. We summarized six cases of characteristics and treatment measures for patients with various complications after minimally invasive vaginal contraction surgery from September 2021 to December 2023 at Department of Plastic and Aesthetic Surgery, Peking Union Medical College Hospital. The patients' age ranged from 26 to 44 years. Two cases accepted vaginal contraction with embedded vaginal thread, and four accepted vaginal contraction with acellular allogenic dermis. One patient showed vaginal hyper-tightness, one patient showed subcutaneous suture nodules, two patients showed explosion of acellular allogenic dermis, and three patients showed vaginal infection symptoms such as yellow leucorrhea and peculiar smell. All patients had sexual pain and discomfort. One patient underwent vaginal orifice dilation, one patient underwent suture extraction and secondary vaginal contraction, one patient underwent acellular allogenic dermis extraction and immediate vaginal contraction, two patients underwent acellular allogenic dermis extraction and secondary vaginal contraction, and one patient underwent secondary vaginal contraction. The symptoms of all six patients were relieved after treatment. Despite the short operation time and fast postoperative recovery of minimally invasive vaginal contraction, there are still complications after surgery, causing physical and mental damage to patients. Plastic surgeons, therefore, should be cautious in the treatment process to avoid collateral damage, so that patients get the best treatment effect.

Objective:To examine the prognosis factors of postoperative cardiac complications in colorectal cancer patients co-morbidated with coronary artery disease.Methods:Clinical data of 449 patients colorectal cancer patients co-morbidated with coronary artery disease accepted redical surgery from April 2013 to April 2020 at Department of General Surgery, Peking Union Medical College Hospital were analyzed retrospectively. There were 306 males and 143 females, aging (68.7±8.9) years (range: 44 to 89 years). Postoperative acute coronary syndrome, new-onset arrhythmia and heart failure that causes clinical symptoms were recorded as cardiac complications. t test, χ 2 test and Fisher exact test were used for univariate analysis of prognosis factors of postoperative cardiac events. The variables with P<0.05 were included in the multivariate Logistic regression was used to determine the independent prognosis factors. Results:After surgery, 44 patients (9.8%) suffered from at least one cardiac event, including 30 patients with acute coronary syndrome, 19 patients with new-onset arrhythmia and 9 patients with heart failure. There were 3 deaths in the cohort within 30 days after surgery. Two patients died from cardiac-related complications, and one from septic shock due to postoperative anastomotic leaks. On Univariate analysis showed that cardiac complications were associated with age ≥80 years, co-morbidated diabetes, emergency surgery, re-operation, anastomotic leakage, intestinal flora disorder and elevation of preoperative neutrophil-lymphocyte ratio (χ 2: 4.308 to 12.219, all P<0.05). Multivariate Logistic regression analysis identified age ≥80 years ( OR=3.195, 95% CI: 1.379 to 7.407, P=0.007), co-morbidated diabetes ( OR=2.551, 95% CI: 1.294 to 5.025, P=0.007), emergency surgery ( OR=4.717, 95% CI: 1.052 to 20.833, P=0.043), and elevated preoperative neutrophil-lymphocyte ratio ( OR=1.114, 95% CI: 1.018 to 1.218, P=0.018) as independent prognosis factors for cardiac complications. Conclusions:Emergency surgery, advanced age, co-morbidated type 2 diabetes and elevated preoperative neutrophil-lymphocyte ratio may increase the risk of postoperative cardiac complications in colorectal cancer patients with coronary artery disease. Surgeons should strictly master surgical indications, pay attention to preoperative assessment, perioperative monitoring, and diagnosis and treatment of postoperative complications in order to reduce the risk of complications.

Objective:To examine the prognosis factors of postoperative cardiac complications in colorectal cancer patients co-morbidated with coronary artery disease.Methods:Clinical data of 449 patients colorectal cancer patients co-morbidated with coronary artery disease accepted redical surgery from April 2013 to April 2020 at Department of General Surgery, Peking Union Medical College Hospital were analyzed retrospectively. There were 306 males and 143 females, aging (68.7±8.9) years (range: 44 to 89 years). Postoperative acute coronary syndrome, new-onset arrhythmia and heart failure that causes clinical symptoms were recorded as cardiac complications. t test, χ 2 test and Fisher exact test were used for univariate analysis of prognosis factors of postoperative cardiac events. The variables with P<0.05 were included in the multivariate Logistic regression was used to determine the independent prognosis factors. Results:After surgery, 44 patients (9.8%) suffered from at least one cardiac event, including 30 patients with acute coronary syndrome, 19 patients with new-onset arrhythmia and 9 patients with heart failure. There were 3 deaths in the cohort within 30 days after surgery. Two patients died from cardiac-related complications, and one from septic shock due to postoperative anastomotic leaks. On Univariate analysis showed that cardiac complications were associated with age ≥80 years, co-morbidated diabetes, emergency surgery, re-operation, anastomotic leakage, intestinal flora disorder and elevation of preoperative neutrophil-lymphocyte ratio (χ 2: 4.308 to 12.219, all P<0.05). Multivariate Logistic regression analysis identified age ≥80 years ( OR=3.195, 95% CI: 1.379 to 7.407, P=0.007), co-morbidated diabetes ( OR=2.551, 95% CI: 1.294 to 5.025, P=0.007), emergency surgery ( OR=4.717, 95% CI: 1.052 to 20.833, P=0.043), and elevated preoperative neutrophil-lymphocyte ratio ( OR=1.114, 95% CI: 1.018 to 1.218, P=0.018) as independent prognosis factors for cardiac complications. Conclusions:Emergency surgery, advanced age, co-morbidated type 2 diabetes and elevated preoperative neutrophil-lymphocyte ratio may increase the risk of postoperative cardiac complications in colorectal cancer patients with coronary artery disease. Surgeons should strictly master surgical indications, pay attention to preoperative assessment, perioperative monitoring, and diagnosis and treatment of postoperative complications in order to reduce the risk of complications.

Objective: To investigate the clinical value of combined detection of serum miR-378 and miR-21 in gastric cancer (GC). Methods: Eighty-seven patients with GC and 78 patients with colorectal cancer(CRC) from National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences were selected, 83 individuals undergoing healthy physical examination were selected as the healthy controls. The levels of serum miR-378 and miR-21 were detected by quantitative real-time PCR (RT-qPCR) (result data were transformed as log2 for analysis). Results: Relative expression levels of miR-378 in the serum were -1.24, -3.25 and -2.73 in healthy controls, GC and CRC patients, respectively. Compared with the healthy controls, the levels of serum miR-378 were significantly decreased in GC and CRC patients (both P<0.05). Relative expression levels of miR-21 in the serum were 0.11, 2.34 and 2.47 in healthy controls, GC and CRC patients, respectively. Compared with the healthy controls, the levels of serum miR-21 were significantly up-regulated in GC and CRC patients (both P<0.05). Moreover, the serum level of miR-378 in GC patients was inversely associated with tumor clinical stage (P<0.05). However, the level of miR-21 showed no significant differences among patients with different clinical and pathological characteristics (all P>0.05). The area under the receiver operating characteristic curve (AUC), sensitivity and specificity of miRNA-378 to diagnose GC was 0.770, 82.0% and 66.0%, respectively, and were 0.900, 85.0%, and 88.0% of miR-21, respectively. The AUC, sensitivity and specificity of combined detection of serum miR-378 and miR-21 to diagnose GC were 0.930, 92.0% and 87.0%, respectively, while the AUC of combined detection of serum CEA and CA-199 was 0.767, the AUC of combined all of the four factors was 0.946. Conclusion The combined detection of serum miR-378 and miR-21 have a certain effect on diagnosis of GC.

Objective To study the optimum combination of orientation parameter of total hip prosthesis and acetabular safe zone on condition that the range of motion for activities of daily living (ADL) is fulfilled.Methods A three-dimensional generic parametric and visually kinematic simulation module of THA was developed.Range of motion ( ROM ) of hip flexion ≥ 110°,internal-rotation ≥30° at 90° flexion,extension ≥30° and external rotation ≥40° were defined as the normal criteria for ADL.ROM of hip flexion ≥ 120°,internal-rotation ≥45° at 90° flexion,extension ≥30° and external rotation ≥40° were as the severe criteria.The ranges of changes in general ratios (GRs) of head-neck,femoral neck antevemion ( FNA ),operative inclination (OI) and anteversion (OA) of acetabulur components were 2.0-2.92,0°-30°,10°-60°,and 0°-70° respectively.Within the limits of the upper two activity criteria,the synchronous OA of acetabulur components was calculated with every 5°change in OI of the cup,and the collodiaphyseal angle ( CDD ) was set as 135°.The safe-zone of combination of acetabulur operative anteversion (OA) and inclination (OI) was defined as the area that fulfilled the two mentioned criteria of ROM without cup-neck impingement.All parameters were analyzed by using SAS 6.12 software.Results The safe zone of acetabdar angle rose with the increase of GRs of head-neck and the safe zone of severe criteria was smaller than that of normal criteria.When the CDD angle was 135°,the sum of average aeetabular OA and acetahular OI plus 0.816 times of the FNA equaled to 84.76° innormal criteria; and the sum of average acetabular OA and acetabular OI plus 0.873 times of the FNA equaled to 92.04° in severe criteria.Conclusions A high GR of head-neck greatly increases the size of safe-zone of acetabular angle.The higher demand of ROM of hip joint requires the smaller safe zone of acetabular angle,as can be corrected by increasing the GR of head-neck.The optimum combination between the sum of average acetabular OA and acetabular OI ( Y) plus FA (X)in the normal criteria and severe criteria can be estimated by using the following formulae:Y1 =-0.816X1 + 84.76 (R2 =0.993 ),Y2 =-0.873X2 + 92.04( R2 =0.999) respectively.

Objective To investigate the feasibility and clinical effects of suture anchors technique for acute distal avulsion fracture of patella. Methods From January 2007 to July 2009, 33 patients(18males and 15 females, ranging from 28 to 72 years, with an average of 49.3 years) were treated with the suture anchors technique. The average time from injury to surgery was 3.5 days(2 to 7 d). Injury reason: traffic accident in 12 cases, injured in daily life in 11 cases, sports injury 9 cases, no clear trauma history in one case. The Bostman evaluation system, follow-up X-ray, and knee mobility were used to analyze the clinical effects of suture anchors technique. Results All patients obtained the follow-up and the average time was 16.5 months(12 to 23 months ). One patient suffered foreign body reaction, and his wound healing was good after operation. The remaining patient wound healing was good. No complications were found in all patients,such as popliteal fossa artery, tibial nerves or peroneal nerve complication. Bostman patella fracture functional score 27.3±2.3 points at the sixth months follow up, 28 cases were rated as excellent, 5 cases were good, and the excellent and good rate was 100%. Six months later, X-ray showed bone healing, knee activity recovered well. The Range of Motion was extension for -2.5°±2.1° and flexion for 122°±5.3°. Conclusion Suture anchors fixation in treatment of acute distal avulsion fracture of patella has a good efficacy, safety and reliability advantages, and without the second operation. This technique provides an alternative in lower pole patella fracture.

Objective To evaluate the accuracy of thoracic pedicle screw placement using the "funnel technique" and investigate its consistency in experimental study and clinical application.Methods The clinical data of three human cadavers and 11 patients with the installation of at least one thoracic pedicle screw at T1 -T12 from August 2006 to July 2008 were retrospectively analyzed. One junior spine surgeon lack of experience were responsible for placing these screws with the "funnel technique".The accuracy of screw placement and the complications related to the use of thoracic pedicle screws were analyzed by assessing postoperative CT scans. Results The mean follow-up time was 23.1 months,which showed no vascular or visceral complications, or iatrogenic neurological injury. The rate of unintended cortex perforations was 14% (10/72) in cadavers and 15% (8/55) in patients, respectively.The critical perforation occurred in two screws (3%) in cadavers and one screw (2%) in patients. There was no statistical difference between the percentage of cortex perforations in cadavers and patients. Of all the 11 patients, screw violation occurred laterally in six ( 11% ), medially in one ( 2% ) and superiorly in one (2%). No violations occurred inferiorly or anteriorly. For all patients, only one screw needed revision. The perforations made by the junior spine surgeon occurred in six screws in the first cadaver, three in the second cadaver and one in the third cadaver. Conclusions The "funnel technique" is a simple,safe, accurate and cost-effective technique for pedicle screw placement. The result of the experimental study is consistent with that of the clinical application. "funnel technique" is helpful for junior spine surgeons to master the technique of thoracic pedicle screw placement.

ObjectiveTo study the anatomic characteristic of the attachment of medial patellofemoral ligament and its function in patellar stability. MethodsThirty adult cadaver knees were used for anatomic study, and the attachments of medial patellofemoral ligament were observed and measured. Results The femoral attachment of medial patellofemoral ligament was anchored to the bone between the medial femoral epicondyle and the adductor tubercle. The fibers here were thin and narrow, and became thick and wide to the anterior. The patellar attachment was in the superior two-thirds of the medial margin of the patella. The fiber here were the thickest and the widest. Conclusion The anatomic characteristic of the attachment of medial patellofemoral ligament was revealed, providing anatomical bases for surgery.

Objective To investigate the feasibility and clinical effects of the pair ringer technology for bony avulsion of the posterior cruciate ligament under arthroscopy. Methods From January 2005 to July 2009, 23 patients were treated with the pair ringer technology for bony avulsion of the posterior cruciate ligament by arthroscopy. There were 15 male and 8 female, with an average of 39.3 years (ranging from 28 to 52 years). There were 4 cases of type Ⅱ, 14 type Ⅲ, and 5 type Ⅳ according to Meyer-Mckeever classification. The outcome measures were X-ray and MRI testing, Lysholm and Tegner knee function score. Results All the operations were finished in an hour. There were no complications as nerve injury or infection occurred in the study. The patients were followed-up for an average of 16.5 months (12-23 months). The Lysholm score rose from 50.3±6.1 preoperatively to 89.7±8.3 at the six months postoperatively (t=18.34, P=0.0007). The Tegner score rose from 1.7±0.5 preoperatively to 5.7±1.3 at the six months postoperatively (t=13.77,P=0.0008). All of the patients recover a functionally stable knee and have considerably improved knee function compared with their preoperative status. Conclusion The pair ringer technology under arthroscopy is a liable method for bony avulsion of the posterior cruciate ligament. This minimally invasive technology leads to rigid fixation, early rehabilitation.