Background:Inflammation-based indexes have been used to predict survival and recurrence in cancer patients.Systemic immune-inflammation index (SII) was reported to be associated with prognosis in some malignant tumors.In the present study,we aimed to explore the association between SII and the prognosis of patients with gastric cancer.Methods:We retrospectively analyzed data from 444 gastric cancer patients who underwent gastrectomy at the First Affiliated Hospital of Sun Yat-sen University between January 1994 and December 2005.Preoperative SII was calculated.The Chi square test or Fisher's exact test was used to determine the relationship between preoperative SII and clinicopathologic characteristics.Overall survival (OS) rates were estimated using the Kaplan-Meier method,and the effect of SII on OS was analyzed using the Cox proportional hazards model.Receiver operating characteristic (ROC) curves were used to compare the predictive ability of SII,NLR,and PLR.Results:SII equal to or higher than 660 was significantly associated with old age,large tumor size,unfavorable Borrmann classification,advanced tumor invasion,lymph node metastasis,distant metastasis,advanced TNM stage,and high carcino-embryonic antigen level,high neutrophil-lymphocyte ratio,and high platelet-lymphocyte ratio (all P ＜ 0.05).High SII was significantly associated with unfavorable prognosis (P ＜ 0.001) and SII was an independent predictor for OS (P =0.015).Subgroups analysis further showed significant associations between high SII and short OS in stage Ⅰ,Ⅱ,Ⅲ subgroups (all P ＜ 0.05).SII was superior to NLR and PLR for predicting OS in patients with gastric cancer.Conclusion:Preoperative SII level is an independent prognostic factor for OS in patients with gastric cancer.

Objective:To report the clinical effect of using polyfoliate anterolateral thigh perforator flap (ALTPF) in reconstruction of soft tissue defects of extremities.Methods:From April 2017 to January 2020, 21 cases of soft tissue defect in extremities were repaired by polyfoliate ALTPF, including 11 cases of traffic accident trauma, 8 of machine crush injury, and 2 of iatrogenic complications. There were 14 cases in calf and ankle, and 7 in hand and wrist. The area of defect was 17.0 cm×12.0 cm-20.0 cm×14.0 cm. Eight cases were complicated with fracture and bone exposure, 13 with tendon and nerve exposure. Thirteen cases had 2 adjacent wounds and 8 had large wound. The polyfoliate ALTPF was designed for wound repair. The patients entered follow-up regularly. The last follow-up included the colour, texture, shape, sensation of the flap and the scar of the donor area.Results:There was no infection in the recipient site of all 21 patients after operation, and all flaps survived. Two cases had venous crisis, with 1 was found in 5 hours after operation. Emergency exploration found that there were thrombosis in anastomosed veins. The flap survived completely after the thrombus removed and the embolized vein was anastomosed again. Another case was found with venous crisis at 1 lobe of flap in 2 hours after operation. Emergency exploration found that the anastomotic site between the superficial vein from the medial edge of the flap to the great saphenous vein and the superficial vein of the recipient area was embolised. The flap survived completely after the thrombus removed and the embolized veins was anastomosed again. The wounds of all donor sites healed in the first stage. All patients were followed-up for 6-30 (mean 12.3) months. All flaps had good colour and texture, with slightly bloated appearance and dull sensation. There was only a linear scar in the donor area, and the appearance evaluation was good.Conclusion:Polyfoliate ALTPF can be used to repair 2 large or adjacent wounds in 1 stage, reduce the damage of donor site. It is an ideal method to repair large or adjacent wounds of limb.

Objective:To evaluate the effect and mechanism of bone regeneration in distraction osteogenesis zone after the repair of sciatic nerve in rats.Methods:Between January 2021 and August 2021, 60 healthy adult male Sprague-Dawley rats were divided randomly into 3 groups: Group A, B, and C. In groups B and C, right sciatic nerve transection and anastomosis were performed. Then after 8 and 12 weeks, the 3 groups were treated with extension external fixation (Ilizarov technique) of right femur osteotomy to make distraction osteogenesis model. Electrophysiological changes of peripheral nerves were monitored by electromyography (EMG) pre-and postoperatively in all the femoral lengthening rats. The formation of callus was examined by X-ray every week after operation. The rats were sacrificed on 2nd, 4th, 6th weeks after the bone transport operation. Four-point bending test and histological staining examination were carried out to determine the osteogenesis in the distracted area. SPSS 21.0 was used for statistical analysis. Data of measurement were expressed as (Mean±SD). A non-parametric test was used to assess the statistical difference between groups. Graphs were plotted by GraphPad Prism 8.0 and considered statistically significant when P<0.05. Results:The results of Sciatic nerve function index (SFI), Compound muscle action potential (CMAP) and Motor nerve conduction velocity (MNCV) in group A were better than the group B and group C in both of before and after the surgery. At the 2nd and 4th weeks of the consolidation stage, X-ray showed that bone formation in group B was superior to groups A and C; HE and Safranin O staining showed that local capillary and cartilage formation in group B was significantly more than in groups A and C; Immunohistochemical staining showed that the expression levels of Osteopontin(Opn) and Osteocalcin(Ocn) in the distraction area of group B were higher than that of groups A and C. At the 6th week of the consolidation stage, the four-point bending test showed that the bone quality of group B was better than groups A and C. The differences of the results between groups shown above had statistical significance ( P<0.05). Conclusion:Bone regeneration in the distraction area of the bone lengthening group with sciatic nerve injury was better than that of the bone lengthening group without a never injury. This might be in relation to the fact that a distractive osteogenesis caused the secondary injury to the repaired nerve. The electrophysiological results showed that periodic changes took place in the repaired sciatic nerve caused by the stretch of femoral lengthening, and the injurious changes of sciatic nerve would be gradually relieved in 6th week after surgery.

Objective To evaluate the effect of manual massage on complications after endoscopic foam sclerotherapy injection for the treatment of internal hemorrhoids.Methods Consecutive 113 patients with grade Ⅰinternal hemorrhoids were prospectively enrolled and completed endoscopic foam sclerotherapy.The patients were randomly divided into a massage group(n=65)and a control group(n=68).Massage group performed manual perianal massage,Visual analogue scale(VAS)was used to evaluate perianal pain.The postoperative bleeding,short-term and long-term efficacy were also compared.Results The median VAS of 24 h postoperation was 1.0(0.0,3.0)in massage group,which was significantly lower than 2.0(1.0,4.0)in control group,the difference was statistically significant(P=0.014).The no bleeding rate of one week postoperation was 84.6％in massage group,which was significantly higher than 64.7％in control group,the difference was statistically significant(P=0.009).After 12 weeks,6 months and 12 months of follow-up,there were no significant differences in cure rate and remission rate between the two groups(P＞0.05).Conclusion Manual massage after endoscopic sclerosing agent injection is beneficial to relieve postoperative pain of grade Ⅰ internal hemorrhoids and reduce bleeding.