Objective: To develop a facial image generation method based on a facial color-preserving generative adversarial network (FCP-GAN) that effectively decouples identity features from diagnostic facial complexion characteristics in traditional Chinese medicine (TCM) inspection, thereby addressing the critical challenge of privacy preservation in medical image analysis. Methods: A facial image dataset was constructed from participants at Nanjing University of Chinese Medicine between April 23 and June 10, 2023, using a TCM full-body inspection data acquisition equipment under controlled illumination. The proposed FCP-GAN model was designed to achieve the dual objectives of removing identity features and preserving colors through three key components: (i) a multi-space combination module that comprehensively extracts color attributes from red, green, blue (RGB), hue, saturation, value (HSV), and Lab spaces; (ii) a generator incorporating efficient channel attention (ECA) mechanism to enhance the representation of diagnostically critical color channels; and (iii) a dual-loss function that combines adversarial loss for de-identification with a dedicated color preservation loss. The model was trained and evaluated using a stratified 5-fold cross-validation strategy and evaluated against four baseline generative models: conditional GAN (CGAN), deep convolutional GAN (DCGAN), dual discriminator CGAN (DDCGAN), and medical GAN (MedGAN). Performance was assessed in terms of image quality [peak signal-to-noise ratio (PSNR) and structural similarity (SSIM)], distribution similarity [Fréchet inception distance (FID)], privacy protection (face recognition accuracy), and diagnostic consistency [mean squared error (MSE) and Pearson correlation coefficient (PCC)]. Results: The final analysis included facial images from 216 participants. Compared with baseline models, FCP-GAN achieved superior performance, with PSNR = 31.02 dB and SSIM = 0.908, representing an improvement of 1.21 dB and 0.034 in SSIM over the strongest baseline (MedGAN). The FID value (23.45) was also the lowest among all models, indicating superior distributional similarity to real images. The multi-space feature fusion and the ECA mechanism contributed significantly to these performance gains, as evidenced by ablation studies. The stratified 5-fold cross-validation confirmed the model’s robustness, with results reported as mean ± standard deviation (SD) across all folds. The model effectively protected privacy by reducing face recognition accuracy from 95.2% (original images) to 60.1% (generated images). Critically, it maintained high diagnostic fidelity, as evidenced by a low MSE (< 0.051) and a high PCC (> 0.98) for key TCM facial features between original and generated images. Conclusion The FCP-GAN model provides an effective technical solution for ensuring privacy in TCM diagnostic imaging, successfully having removed identity features while preserving clinically vital facial color features. This study offers significant value for developing intelligent and secure TCM telemedicine systems.

Objective:To investigate the surgical treatment effect and prognostic factors of hilar cholangiocarcinoma.Methods:This is an ambispective cohort study. From August 2005 to December 2022,data of 510 patients who diagnosed with hilar cholangiocarcinoma and underwent surgical resection at the Hepatobiliary Center of the First Affiliated Hospital of Nanjing Medical University were retrospectively collected. In the cohort,there were 324 males and 186 females,with an age of ( M (IQR)) 63(13)years (range:25 to 85 years). The liver function at admission was Child-Pugh A (343 cases,67.3%) and Child-Pugh B (167 cases,32.7%). Three hundred and seventy-two(72.9%) patients had jaundice symptoms and the median total bilirubin was 126.3(197.6) μmol/L(range: 5.4 to 722.8 μmol/L) at admission. Two hundred and fourty-seven cases (48.4%) were treated with percutaneous transhepatic cholangial drainage or endoscopic nasobiliary drainage before operation. The median bilirubin level in the drainage group decreased from 186.4 μmol/L to 85.5 μmol/L before operation. Multivariate Logistic regression was used to identify the influencing factors for R0 resection,and Cox regression was used to construct multivariate prediction models for overall survival(OS) and disease-free survival(DFS). Results:Among 510 patients who underwent surgical resection,Bismuth-Corlett type Ⅲ-Ⅳ patients accounted for 71.8%,among which 86.1% (315/366) underwent hemi-hepatectomy,while 81.9% (118/144) underwent extrahepatic biliary duct resection alone in Bismuch-Corlett type Ⅰ-Ⅱ patients. The median OS time was 22.8 months, and the OS rates at 1-,3-,5-and 10-year were 72.2%,35.6%,24.8% and 11.0%,respectively. The median DFS time was 15.2 months,and the DFS rates was 66.0%,32.4%,20.9% and 11.0%,respectively. The R0 resection rate was 64.5% (329/510), and the OS rates of patients with R0 resection at 1-,3-,5-and 10-year were 82.5%, 48.6%, 34.4%, 15.2%,respectively. The morbidity of Clavien-Dindo grade Ⅲ-Ⅴ complications was 26.1%(133/510) and the 30-day mortality was 4.3% (22/510). Multivariate Logistic regression indicated that Bismuth-Corlett type Ⅰ-Ⅲ ( P=0.009), hemi-hepatectomy and extended resection ( P=0.001),T1 and T2 patients without vascular invasion (T2 vs. T1: OR=1.43 (0.61-3.35), P=0.413;T3 vs. T1: OR=2.57 (1.03-6.41), P=0.010;T4 vs. T1, OR=3.77 (1.37-10.38), P<0.01) were more likely to obtain R0 resection. Preoperative bilirubin,Child-Pugh grade,tumor size,surgical margin,T stage,N stage,nerve infiltration and Edmondson grade were independent prognostic factors for OS and DFS of hilar cholangiocarcinoma patients without distant metastasis. Conclusions:Radical surgical resection is necessary to prolong the long-term survival of hilar cholangiocarcinoma patients. Hemi-hepatectomy and extended resection,regional lymph node dissection and combined vascular resection if necessary,can improve R0 resection rate.

Objective:To investigate the midterm and long-term efficacy of flow-diverter device in treating intracranial aneurysms (IAs) and analyze its clinical outcomes in anterior circulation aneurysms and posterior circulation aneurysms.Methods:This is a retrospective case series study. The data of 566 intracranial aneurysm patients (681 aneurysms) treated with the flow-diverter device at Department of Neurosurgery, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University from January 2018 to January 2021 were retrospectively analyzed. There were 205 males and 361 females, with an age ( M(IQR)) of 55 (14) years (range:18 to 77 years). Twelve patients (12 aneurysms) had ruptured aneurysms before surgery, and 75 patients (172 aneurysms) had multiple aneurysms. Preoperative modified Rankin scale (mRS) >2 points in 16 patients.There were 444 patients (552 aneurysms) in the anterior circulation group and 122 patients (129 aneurysms) in the posterior circulation group. Postoperative follow-up was conducted via outpatient visits or telephone calls at 3 to 12 months after the procedure. Baseline aneurysm parameters, surgical information, and imaging and clinical outcomes were collected. Univariate and multivariate Logistic regression analyses were used to identify independent factors associated with long-term incomplete aneurysm occlusion. Results:Intraoperative use of flow diverter-assisted coil embolization was performed in 221 patients (226 aneurysms), and balloon assistance was used in 20 patients (22 aneurysms).The intraoperative rupture rate was 0.5% (3/566), and the intraoperative thrombosis rate was 0.7% (4/566). The in-hospital mortality rate was 1.2% (7/566). Postoperative complications included subarachnoid hemorrhage in 5 patients (0.9%), intracerebral hemorrhage in 2 patients (0.4%), ischemic stroke in 19 patients (3.6%), and transient ischemic attack in 16 patients (3.0%). Imaging follow-up was available for 447 patients (548 aneurysms) with a follow-up duration of (16.7±6.7) months (range:3 to 45 months). Incomplete aneurysm occlusion occurred in 79 patients (95 aneurysms), accounting for 17.3% (95/548). Parent artery stenosis was observed in 63 patients (72 aneurysms), accounting for 13.1% (72/548). Clinical follow-up was available for 530 patients (644 aneurysms) with a follow-up duration of (29.4±11.3) months (range:3 to 54 months). One case of mRS score >2 points was observed in 18 patients, accounting for 3.4% (18/530). Among them, the rate of incomplete occlusion in the anterior and posterior circulation group was 16.9% (76/450) and 19.4% (19/98), respectively, and the rate of parent artery stenosis was 10.9% (49/450) and 23.5% (23/98), respectively; the rate of mRS score>2 points was 2.4% (10/415) and 7.0% (8/115), respectively. Univariate and multivariate Logistic regression analysis showed that aneurysm neck size ( β=0.075, OR=1.08, P=0.028) and coil use ( β=-1.070, OR=0.034, P=0.001) were independent factors influencing long-term aneurysm occlusion. Conclusions:The flow-diverter device demonstrates good safety and efficacy in the midterm and long-term treatment of overall IAs. However, further research is needed to focus on the midterm and long-term treatment outcomes of aneurysms with relatively wide neck and posterior circulation aneurysms.

Objective:To investigate the surgical treatment effect and prognostic factors of hilar cholangiocarcinoma.Methods:This is an ambispective cohort study. From August 2005 to December 2022,data of 510 patients who diagnosed with hilar cholangiocarcinoma and underwent surgical resection at the Hepatobiliary Center of the First Affiliated Hospital of Nanjing Medical University were retrospectively collected. In the cohort,there were 324 males and 186 females,with an age of ( M (IQR)) 63(13)years (range:25 to 85 years). The liver function at admission was Child-Pugh A (343 cases,67.3%) and Child-Pugh B (167 cases,32.7%). Three hundred and seventy-two(72.9%) patients had jaundice symptoms and the median total bilirubin was 126.3(197.6) μmol/L(range: 5.4 to 722.8 μmol/L) at admission. Two hundred and fourty-seven cases (48.4%) were treated with percutaneous transhepatic cholangial drainage or endoscopic nasobiliary drainage before operation. The median bilirubin level in the drainage group decreased from 186.4 μmol/L to 85.5 μmol/L before operation. Multivariate Logistic regression was used to identify the influencing factors for R0 resection,and Cox regression was used to construct multivariate prediction models for overall survival(OS) and disease-free survival(DFS). Results:Among 510 patients who underwent surgical resection,Bismuth-Corlett type Ⅲ-Ⅳ patients accounted for 71.8%,among which 86.1% (315/366) underwent hemi-hepatectomy,while 81.9% (118/144) underwent extrahepatic biliary duct resection alone in Bismuch-Corlett type Ⅰ-Ⅱ patients. The median OS time was 22.8 months, and the OS rates at 1-,3-,5-and 10-year were 72.2%,35.6%,24.8% and 11.0%,respectively. The median DFS time was 15.2 months,and the DFS rates was 66.0%,32.4%,20.9% and 11.0%,respectively. The R0 resection rate was 64.5% (329/510), and the OS rates of patients with R0 resection at 1-,3-,5-and 10-year were 82.5%, 48.6%, 34.4%, 15.2%,respectively. The morbidity of Clavien-Dindo grade Ⅲ-Ⅴ complications was 26.1%(133/510) and the 30-day mortality was 4.3% (22/510). Multivariate Logistic regression indicated that Bismuth-Corlett type Ⅰ-Ⅲ ( P=0.009), hemi-hepatectomy and extended resection ( P=0.001),T1 and T2 patients without vascular invasion (T2 vs. T1: OR=1.43 (0.61-3.35), P=0.413;T3 vs. T1: OR=2.57 (1.03-6.41), P=0.010;T4 vs. T1, OR=3.77 (1.37-10.38), P<0.01) were more likely to obtain R0 resection. Preoperative bilirubin,Child-Pugh grade,tumor size,surgical margin,T stage,N stage,nerve infiltration and Edmondson grade were independent prognostic factors for OS and DFS of hilar cholangiocarcinoma patients without distant metastasis. Conclusions:Radical surgical resection is necessary to prolong the long-term survival of hilar cholangiocarcinoma patients. Hemi-hepatectomy and extended resection,regional lymph node dissection and combined vascular resection if necessary,can improve R0 resection rate.

Objective:To investigate the midterm and long-term efficacy of flow-diverter device in treating intracranial aneurysms (IAs) and analyze its clinical outcomes in anterior circulation aneurysms and posterior circulation aneurysms.Methods:This is a retrospective case series study. The data of 566 intracranial aneurysm patients (681 aneurysms) treated with the flow-diverter device at Department of Neurosurgery, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University from January 2018 to January 2021 were retrospectively analyzed. There were 205 males and 361 females, with an age ( M(IQR)) of 55 (14) years (range:18 to 77 years). Twelve patients (12 aneurysms) had ruptured aneurysms before surgery, and 75 patients (172 aneurysms) had multiple aneurysms. Preoperative modified Rankin scale (mRS) >2 points in 16 patients.There were 444 patients (552 aneurysms) in the anterior circulation group and 122 patients (129 aneurysms) in the posterior circulation group. Postoperative follow-up was conducted via outpatient visits or telephone calls at 3 to 12 months after the procedure. Baseline aneurysm parameters, surgical information, and imaging and clinical outcomes were collected. Univariate and multivariate Logistic regression analyses were used to identify independent factors associated with long-term incomplete aneurysm occlusion. Results:Intraoperative use of flow diverter-assisted coil embolization was performed in 221 patients (226 aneurysms), and balloon assistance was used in 20 patients (22 aneurysms).The intraoperative rupture rate was 0.5% (3/566), and the intraoperative thrombosis rate was 0.7% (4/566). The in-hospital mortality rate was 1.2% (7/566). Postoperative complications included subarachnoid hemorrhage in 5 patients (0.9%), intracerebral hemorrhage in 2 patients (0.4%), ischemic stroke in 19 patients (3.6%), and transient ischemic attack in 16 patients (3.0%). Imaging follow-up was available for 447 patients (548 aneurysms) with a follow-up duration of (16.7±6.7) months (range:3 to 45 months). Incomplete aneurysm occlusion occurred in 79 patients (95 aneurysms), accounting for 17.3% (95/548). Parent artery stenosis was observed in 63 patients (72 aneurysms), accounting for 13.1% (72/548). Clinical follow-up was available for 530 patients (644 aneurysms) with a follow-up duration of (29.4±11.3) months (range:3 to 54 months). One case of mRS score >2 points was observed in 18 patients, accounting for 3.4% (18/530). Among them, the rate of incomplete occlusion in the anterior and posterior circulation group was 16.9% (76/450) and 19.4% (19/98), respectively, and the rate of parent artery stenosis was 10.9% (49/450) and 23.5% (23/98), respectively; the rate of mRS score>2 points was 2.4% (10/415) and 7.0% (8/115), respectively. Univariate and multivariate Logistic regression analysis showed that aneurysm neck size ( β=0.075, OR=1.08, P=0.028) and coil use ( β=-1.070, OR=0.034, P=0.001) were independent factors influencing long-term aneurysm occlusion. Conclusions:The flow-diverter device demonstrates good safety and efficacy in the midterm and long-term treatment of overall IAs. However, further research is needed to focus on the midterm and long-term treatment outcomes of aneurysms with relatively wide neck and posterior circulation aneurysms.

Objective To investigate the expression of long non-coding RNA(lncRNA)brain-derived neurotrophic factor-antisense(BDNF-AS)and semaphorin 3B-antisense 1(SEMA3B-AS1)in patients with gastric cancer and the application value of combined ultrasound in the diagnosis of gastric cancer.Methods From January 2021 to February 2023,118 gastric cancer patients admitted to our hospital were retrospectively selected as the gastric cancer group,another 113 cases with benign gastric lesions in our hospital were as the benign lesion group.Real-time fluorescence quantitative PCR(qRT-PCR)was applied to detect the expression levels of serum BDNF-AS and SEMA3B-AS1,and patients were divided into BDNF-AS high expression group(n=55)and BDNF-AS low expression group(n=63),SEMA3B-AS1 high expression group(n=57),and SEMA3B-AS1 low expression group(n=61)based on the average value;Kappa test was applied to analyze the consistency between ultrasound diagnosis and clinical pathological diagnosis;receiver operating characteristic curve(ROC)was applied to analyze the diagnostic value of serum BDNF-AS and SEMA3B-AS1 combined with ultrasound for gastric cancer.Results Compared with the benign lesion group,the serum levels of BDNF-AS and SEMA3B-AS1 in the gastric cancer group were obviously lower(t=10.205,t=9.590,P＜0.05);the expression levels of BDNF-AS and SEMA3B-AS1 were obviously lower in gastric cancer patients with tumor diameter≥3 cm,deeper infiltration depth,lower differentiation,and lymph node metastasis(P＜0.05);Kappa test results showed a high consistency between ultrasound diagnosis and clinical pathological diagnosis(Kappa value=0.723,P＜0.05);ROC results showed that the AUC of serum levels of BDNF-AS,SEMA3B-AS1,and ultrasound in diagnosis of gastric cancer was 0.848,0.835,and 0.861,respectively,the AUC(0.949)diagnosed by the combination of the three was obviously higher than that diagnosed by serum BDNF-AS alone(Z=4.713,P=0.000),serum SEMA3B-AS1 level alone(Z=4.112,P=0.001 5),and ultrasound diagnosis(Z=3.350,P=0.000 8),the sensitivity and specificity of the combined diagnosis were superior to those diagnosed by the three alone.Conclusion The combination of serum BDNF-AS and SEMA3B-AS1 ultrasound has high practical value in the diagnosis of gastric cancer.

Objective:To investigate the correlation between 25-hydroxyvitamin D3 (25 (OH) D3), insulin-like growth factor 1 (IGF-1) and glycolipid metabolism in patients with diabetes 2 mellitus (T2DM), as well as their predictive value in retinopathy.Methods:A total of 120 T2DM patients admitted to Linyi Central Hospital of Shandong Province from Oct. 2020 to Oct.r 2023 were selected as the study objects (defined as the study group). Another 120 healthy volunteers who underwent physical examination in our hospital during the same period were selected as the control group. Serum 25 (OH) D3, IGF-1, fasting blood glucose (FBG), 2 h plasma glucose (2 hPG) ) and lipid levels (triglycerides) were compared between the two groups. The levels of TG, total cholesterol (TC) and serum 25 (OH) D3 and IGF-1 were analyzed by Pearson correlation analysis. At the same time, the patients in the study group were divided into diabetic group with retinopathy (DR Group, 40 cases) and non-retinopathy group (NDR group, 80 cases) according to the status of retinopathy. Multivariate analysis was used to analyze the risk factors affecting the occurrence of retinopathy in T2DM patients, and receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of serum 25 (OH) D3 and IGF-1 levels in the occurrence of retinopathy in T2DM patients.Results:The level of serum 25 (OH) D3 was (36.15±4.25) nmol/L in the study group, lower than that in the control group (51.24±5.32) nmol/L ( P<0.05), and the level of IGF-1 was (30.26±4.52) mg/L was in the study group, higher than that in the control group ( P<0.05). The levels of FBG, 2 hPG, TG and TC in the study group were (8.67±2.52) mmol/L, (11.36±2.43) mmol/L, (2.05±0.72) mmol/L, (5.05±1.54) mmol/L respectively, higher than those in the control group [ (5.02±0.42) mmol/L, (6.32±0.54) mmol/L, (1.21±0.32) mmol/L, (3.42±0.68) mmol/L] ( P<0.05). Pearson correlation analysis showed that serum 25 (OH) D3 levels were negatively correlated with FBG, 2 hPG, TG and TC levels in T2DM patients ( r=-0.762, -0.782, -0.736, -0.721, P<0.05). Serum IGF-1 levels were positively correlated with the levels of FBG, 2 hPG, TG and TC in T2DM patients ( r=0.741, 0.756, 0.715, 0.698, P<0.05). Family history of diabetes in DR group, FBG, 2 hPG, TG, TC, IGF-1 levels was 35.00%, (9.31±2.49) mmol/L, (12.52±2.34) mmol/L, (2.76±0.61) mmol/L, (5.92±1.42) mmol/L, (37.89±4.41) mg/L respectively, higher than those in NDR group [16.25%, (8.35±2.15) mmol/L, (10.78±1.75) mmol/L, (1.69±0.52) mmol/L, (4.62±1.31) mmol/L, (26.45±4.06) mg/L] ( P<0.05). 25 (OH) D3 in DR group was (30.21±3.51) nmol/L, lower than that in NDR group (39.12±3.85) nmol/L ( P<0.05). Logistic regression analysis showed that family history of diabetes mellitus, duration of diabetes mellitus, 25 (OH) D3, IGF-1, FBG, 2hPG, TG and TC levels were all risk factors for the occurrence of retinopathy in elderly T2DM patients ( P<0.05). ROC curve analysis showed that AUC and sensitivity of 25 (OH) D3 and IGF-1 combined to predict retinopathy in elderly T2DM patients were 0.854 and 92.50%, respectively, higher than that of 25 (OH) D3 and IGF-1 alone ( P<0.05) . Conclusion:Serum 25 (OH) D3 and IGF-1 levels are abnormally expressed in elderly patients with T2DM, and there is a close relationship between glucose and lipid metabolism in elderly patients with T2DM, and the combined detection of these indicators has a higher predictive value for the occurrence of DR In elderly patients with T2DM.

Ankylosing spondylitis(AS)is a typical spinal arthritis characterised by inflammatory back pain,which seriously affects the health and quality of life of patients.The clinical efficacy of Chinese medicine in the treatment of ankylosing spondylitis is clear,but the mechanism is not clear,and the existing animal models cannot be well applied to the evaluation of Chinese medicine in the treatment of ankylosing spondylitis.Therefore,this paper summarizes the existing animal models based on Chinese and Western medicine clinical diagnosis,disease characteristics,etiology and Chinese medicine evidence,and finds that among the existing animal models,the proteoglycan-induced arthritis mouse model has a higher Chinese and Western medicine clinical fit than the other models,but lacks the corresponding Chinese medicine evidence model evaluation.The other animal models had a higher Western clinical match,but lacked the characteristics of the Traditional Chinee Medicine(TCM)syndrome.As ankylosing spondylitis is a chronic inflammatory autoimmune disease with complex pathogenic factors,the existing animal models cannot better simulate the clinical symptoms.Therefore,the establishment of animal models of ankylosing spondylitis with the characteristics of Chinese and Western clinical evidence is a future research priority for AS TCM.

Objective To investigate the effects of remazolam on melatonin secretion,sleep rhythm and postoperative delirium(POD)in elderly patients undergoing spinal surgery.Methods A total of 160 elderly patients,76 males and 84 females,aged 65-80 years,BMI 18.5-24.0 kg/m2,ASA physical status Ⅱ or Ⅲ,from November 2023 to January 2024 undergoing spinal surgery(lumbar interbody fusion,posterior approach)under general anesthesia were selected.The patients were divided into two groups by random number table method:the remazolam group(group R)and the propofol group(group P),80 pa-tients in each group.Group R was given remazolam 0.3 mg/kg for anesthesia induction,and then continued to pump remazolam 0.3-0.8 mg·kg-1·h-1 for anesthesia maintenance.Group P was given propofol 2.0 mg/kg for anesthesia induction,and then continued to pump propofol 4-6 mg·kg-1·h-1 for anesthesia maintenance.The levels of melatonin and cortisol were recorded at 04:00 a.m.on the day of surgery,1 day,2 and 3 days after surgery.Pittsburgh sleep quality index(PSQI)and VAS pain scores at rest were recorded 1 day before surgery,1 day and 2 days after surgery and before discharge.The occurrence of POD and post-operative sleep disorder(POSD)were recorded.The duration of extubation,PACU stay time,total analgesia pump compressions,effective analgesia pump compressions,number of remedial analgesia cases,intraoperative hypotension,postoperative nausea and vomiting,dizziness,respiratory depression and other adverse events were recorded.Results Compared with group P,the extubation time and PACU residence time in group R were significantly shortened(P＜0.05),the level of melatonin was significantly increased while the level of cortisol was significantly decreased at 4:00 a.m.,and the PSQI was significantly decreased 1 day after surgery(P＜0.05),the incidence of POD,POSD,and intraoperative hypotension were signifi-cantly decreased(P＜0.05).There were no significant differences in extubation time,total and effective times of analgesic pump,rate of remedial analgesia,intraoperative hypotension,postoperative nausea,vom-iting,dizziness and respiratory depression between the two groups.Conclusion Remazolam has little effect on the secretion rhythm of melatonin and cortisol and the sleep rhythm after spinal surgery in elderly pa-tients,and the recovery is faster,which can reduce the incidence of POD and alleviate the sleep disorder af-ter spinal surgery.

Objective To explore the effect of opioid-free anesthesia(OFA)combined with quad-ratus lumborum block(QLB)in laparoscopic radical colorectal cancer resection.Methods Sventy patients were selected for undergoing laparoscopic radical colorectal cancer resection from March to December 2023,49 males and 21 females,aged 18-75 years,BM1 18.5-28.0 kg/m2,ASA physical status Ⅱ or Ⅲ.The patients were divided into two groups using random number table method:the OFA group(group OFA)and the conventional opioid anesthesia group(group OA),35 patients in each group.Group OFA underwent bi-lateral posterior QLB under ultrasound guidance before anesthesia induction(0.25％ropivacaine 30 ml on each side),and anesthesia induction and maintenance were performed using opioid-free anesthesia regimen.And group OA cannot undergo QLB,and anesthesia induction and maintenance were carried out using opioid containing regimen.The patient's HR and MAP were recorded before anesthesia induction(T0),1 minute after endotracheal intubation(T1),before pneumoperitoneum establishment(T2),1 minute after pneumo-peritoneum establishment(T3),1 hour after surgery(T4),the end of surgery(T5),and leaving the oper-ating room(T6).The time from the patient's anesthetic discontinuation to extubation,the length of stay in the PACU,and the Steward and VAS pain scores when the patient leaves the operating room,which were recorded.NRS scores at rest and in the motor state 6,12,24,and 48 hours after surgery,time to first ex-haust,time to first ambulation,and length of postoperative hospital stay,effective PCIA pressing times and use of additional analgesic drugs within 48 hours after the operation,and postoperative adverse reactions(nausea,vomiting,hallucinations)were also recorded.Results Compared with T0,the MAP of the two groups decreased significantly at T1,T2,T4,and T5(P＜0.05),the HR in group OFA increased signifi-cantly at T1 and slowed down at T4 and T5(P＜0.05),and the HR in group OA decreased significantly at T1-T5(P＜0.05).Compared with group OA,the HR in group OFA increased significantly at T1-T3,and the MAP increased significantly at T1(P＜0.05).Compared with group OA,the extubation time and PACU residence time were significantly delayed(P＜0.05),and the Steward score when leaving the oper-ating room was significantly lower in group OFA(P＜0.05).Compared with group OA,NRS score was sig-nificantly deceased 6,12,24,and 48 hours after the surgery(P＜0.05),time to first exhaust,time to first ambulation,and length of postoperative hospital stay were significantly shartened(P＜0.05),and ef-fective PCIA pressing times and additional analgesia times were significantly decreased(P＜0.05),inci-dence of intraoperative hypotensionand postoperative nausea and vomiting(P＜0.05).Conclusion OFA combined with QLB can safely and effectively complete laparoscopic radical colorectal cancer surgery.Pa-tients with such anesthetic methods are hemodynamically more stable during anesthesia induction and intrao-peratively.These patients have better postoperative analgesia and less need for additional analgesics,and less incidence of postoperative nausea and vomiting.This approach is more beneficial for the recovery of the patient's gastrointestinal function.