Objective To evaluate the clinical effect of ultrasound - guided sclerosing agent lauromacrogol injection in treating lymph leakage. Methods A total of 31 patients with postoperative lymph leakage were selected for this study. Of the 31 patients, successful conservative oppression treatment was accomplished in 16, and lauromacrogol injection had to be carried out in 15 as conservative oppression treatment failed. The patients were followed up and the results were analyzed. Results In 15 patients receiving lauromacrogol injection treatment, complete cure of lymph leak was obtained in 14 with a success rate of 93.33%. Among the 14 cases, the second lauromacrogol injection was employed in 3 at one week after the first injection. Infection occurred in another case one day after the injection , which was cured after dressing change for 15 days. Conclusion For the treatment of lymph leakage, ultrasound-guided sclerosing agent lauromacrogol injection is effective and safe.

Objective To compare intramedullary nailing assisted by minimally invasive cerclage with simple intramedullary nailing in the treatment of femoral long oblique subtrochanteric fractures.Methods From April 2010 to September 2015,our department treated 39 patients with femoral long oblique subtrochanteric fracture.Of them,16 were treated by cephalomedullary nailing combined with minimally invasive cerclage (observation group of 11 males and 5 females with an average age of 42.8 ± 13.2 years) and 23 by simple cephalomedullary nailing (control group of 17 males and 6 females with an average age of 46.2 ± 10.1 years).Their operation time,intraoperative blood loss,radiologic results (union time and alignment) and functional results [Visual Analog Scale (VAS) and Harris hip score] were compared between the 2 groups.Results The 39 patients were followed up from 12 to 30 months (average,15 months).For the observation group,the varus angle (2.2°± 1.4°) was significantly smaller than for the control group(4.1°±2.2°),the VAS scores at 1 and 3 months postoperatively (3.43 ± 1.54,1.13 ± 1.20) were significantly lower than for the control group (5.61 ± 1.41,3.34 ± 1.82),and the clinical union ratio at 3 months postoperatively(87.5％,14/16) significantly higher than for the control group (47.8％,11/23) (P ＜ 0.05).There were no significant differences between the 2 groups in terms of operation time,intraoperative blood loss,Harris hip score at one year postoperatively,VAS score at 6 months postoperatively,or clinical union ratio at 6 or 12 months postoperatively(P ＞ 0.05).Conclusions Cephalomedullary nailing is effective for the treatment of femoral long oblique subtrochanteric fractures no matter it is assisted by minimally invasive cerclage or not.However,since minimally invasive cerclage has the advantage of improving reduction and mechanical stability,combination of minimally invasive cerclage and cephalomedullary nailing may be more advantageous in early pain-relieving and functional recovery.

Objective:To compare the complications associated with various urinary flow diversion methods and identify the factors that contribute to the decline in renal function after radical total cystectomy for myoinfiltrating urothelial carcinoma.Methods:This study conducted a retrospective analysis on the clinical data of 46 patients with pathologically confirmed muscle-invasive bladder cancer.The patients underwent laparoscopic radical cystectomy with either ileal conduit diversion(n=21)or ureterocutaneous diversion(n=25)between January 2017 and December 2021.Perioperative data, postoperative pathology, postoperative complications, and follow-up results were compared between the two groups.Results:The study found significant differences between the two groups in terms of age[(67±6)years vs.(73±8)years, t=3.132, P=0.003], Charlson comorbidity index adjusted for age[(3.80±1.15) vs.(4.52±1.03), t=2.223, P=0.031], prognostic nutritional index[(48.81±5.74) vs.(43.64±4.74), t=3.347, P=0.002], operation time[(449±108)minutes vs.(326±130)minutes, P=0.001]], hospital stay[(20.1±11.1)days vs.(13.3±5.2)days, t=2.762, P=0.008], proportion of Clavien grade 3 or higher complications within 3 months after surgery(4/21 vs 0/25, χ2=2.105, P<0.05), and proportion of stoma-free patients(18/21 vs.5/25, χ2=6.373, P<0.01). According to Logistic multivariate analysis, perioperative blood transfusion and urinary tract infection were identified as independent risk factors for renal function decline 12 months after surgery.Escherichia coli was found to be the most common bacteria cultured from urinary tract infections in both groups after surgery. Conclusions:Laparoscopic radical cystectomy with ureterocutaneous diversion offers benefits such as shorter hospital stays and fewer perioperative complications for older and frail patients.However, a higher proportion of patients may require ureteral stenting.It is important to note that perioperative blood transfusion and urinary tract infection are major risk factors for renal function decline following radical cystectomy.