Objective To compare the short-term clinical outcomes of hand-assisted laparoscopic surgery(HALS),laparoscopic-assisted surgery (LAS)and open surgery(OS)for colorectal cancer treatment. Methods The clinical data of 74 patients underwent HALS,LAS and OS for colorectal cancer treatment between October 2011 and December 2015 were assessed retrospectively. All the surgeries were performed by the same surgical team. The intraoperative details,postoperative recovery,postoperative complications,oncologic results and cost were compared among the three groups. Results A total of 24 patients in HALS group,25 patients in LAS group and 25 patients in OS group were finally included. The gen-eral data and oncologic baseline were comparable among the three groups. The comparative results showed that the operative time increase d and in-cision length shortened gradually in OS group,HALS group and LAS group(P<0.05). HALS group was favor of less number of trocars used com-pared with LAS group(P<0.05),but there was no statistical difference of the conversion rate between the two groups(P>0.05). In terms of post-operative recovery,postoperative complications and oncologic results,there was no statistical difference between the three groups(P>0.05). As for cost,the total cost and operative cost of OS group were lower than HALS group and LAS group(P<0.05),but there was no significant differ-ence between HALS group and LAS group(P>0.05). The material cost increase gradually in OS group ,HALS group and LAS group(P<0.05), and there was no significant difference on the part of other cost among the three groups(P>0.05). Conclusion HALS,LAS and OS are compen-satory with each other,and clinicians can choose the reasonable procedure according to personal proficiency and situation of patients.

Objective To investigate the treatment effection of cranial decompression under temporal muscle in very-low position with large bone flap for severe cranial trauma.Methods 53 cases of severs cranial traumatic brain herniation were derided into two groups.22 cases with unilateral dilated pupil,and 31 cases of bilateral dilated pupil,all the patients were treated with cranial decompression under temporal muscle in very low position with large bone-flap.The ICP,appearance rate of cisternal,pupil contraction rate and GCS evaluation were observed,recorded and statistiely analysised.Results According to the intraeranial pressure monitoring,the rate of 24h ICP＜20mmHg was increased significantly,and the rate of 72h ICP＞40mmHg was decreased in both groups.The occurance rate of cisternal:81.82% in unilateral dilated pupil group,and 51.61% in bilateral dilated pupil group.The recoverance rate of pupil in 24h:77.2% in unilateral dilated pupil group,and 32.26% in bilateral dilated pupil group.GCS evaluation:All of the patient's average mark of GCS after operation wag(8.02±3.03)which increased(3.92±2.21)compared with the mark of GCS before operation,which was(4.10±0.82),with a significant difference(P＜0.01).Treat outcome:well/moderate disability:64.15%,severe/long-term coma:7.55%,and death:28.30%.Conclusion Cranial decompression under temporal muscle in very-low position with large bone-flap for severe cranial trauma can enlarge the cranial capacity effectively,increase the decompression space in dorsolateral cranium,which can alleviate the intracranial pressure in axial centre of brain truak,promote the effeetion of the brain herniation restore and the recover of the brain trauma.

Objective To study the surgical techniques of the extended subfrontal epidual approach to resect chordoma in skull base.Methods 18 cases of chordoma in skull base treated mierosurgically were analyzed retrospectively.Results Total resection were achieved in 15 patients(83%),gross resection in 3 patients(17%).There was no complication in all cases.Conclusion The microsurgery for chordoma in skull base via the extended subfrontal epidual approach is of the benefits such as clear and wide fields of vision,and minimize brain trauma.Lumber drain placement and the skull base reconstruction could improve the rate of total tumor removal and reduce complications.

ObjectiveTo explore the effect of different methods of drainage tube and catheter drainage in the treatment of intraventricular hematoma.MethodsThe analysis was conducted in 83 cases,who were randomly divided into two groups,the treatment group with 48 cases adopting lateral venticle catheterization combined with bulletshaped tube,and the control group with 35 cases adopting conventional catheterization.The contrasted study was conducted on the clearance rate of cerebroventricular hematoma and the effect of the different drainages.ResultsThe clearance rate in treatment group was 27.1％ ( 13/48 ),50.0％ (24/48),14.6％ (7/48),at the time of ＜ 24h,24 ～72h,＞ 72h after the operation,and 5.7 ％ ( 2/35 ),17.1％ ( 6/35 ),48.6％ ( 17/35 ) in the control group.It showed statistical significance(x2 =6.2425,9.4678,11.3757,all P ＜0.01 ).The cases with type Ⅰ of ADL stage in treatment group (47.9％)were more than control group( x2 =6.8347,P ＜0.01 ).The morbidity in treatment group was 12.5％,which was lower than control group( x2 =6.9636,P ＜0.01 ).ConclusionThe lateral venticle catheterization drainage combined with bullet-shaped tube could avoid the obstruction,reduce the morbidity,and improve the therapeutic effect.

Objective To assess the efficacy and safety of drug therapy alone and stenting for symptomatic intracranial atherosclerotic stenosis (sICAS) in order to provide the best evidence for clinical practice.Methods PubMed,EMbase,Cochrane Library,CBM,CNKI,and Wanfang database were retrieved.The randomized controlled trials (RCTs) on the efficacy and safety of drug therapy and stent-assisted therapy for sICAS were enrolled.The RevMan 5.3 software was used for the meta-analysis.Results A total of 6 RCTs and 782 patients were enrolled.The results of meta-analysis showed that there were no significant differences in stroke or death (odds ratio [OR] 1.61,95％ confidence interval [CI] 0.89-2.91;P=0.12) and fatal stroke within l year (OR 1.60,95％ CI 0.96-2.67,P=0.07) between the stenting group and the drug therapy group.The risks of symptomatic intracerebral hemorrhage (OR 9.51,95％ CI 2.89-31.29;P＜0.01) and any stroke or death (OR 2.15,95％ CI 1.21-3.82;P＜0.01) in the stenting group were higher than those in the drug therapy group.The subgroup analysis showed the risks of any stroke or death within 30 d in the stenting group were significant higher than those in the drug therapy group (OR 2.94.95％ CI 1.55-5.60;P ＜0.01),and there were no sig-nificant differences in anv stroke or death within 1 year (OR 1.90,95％ CI 0.50-7.61;P=0.35) and 2 years (OR 1.38,95％ CI 0.91-2.08;P=0.13);the risks of symptomatic intracerebral hemorrhage within 30 d (OR 10.15,95％ CI 1.92-53.64,P ＜0.01) and within 1 year (OR 8.80,95％ CI 1.60-48.25,P =0.01) in the stenting group were higher than those of the drug therapy group.Conclusions The risks of symptomatic intracerebral hemorrhage and any stroke or death in the stenting group were significantly higher than those in the drug therapy group,therefore,the preferred stenting was not recommended in patients with sICAS.However,stenting still can be considered in patients who failed regular drug therapy and who may benefit greater from stenting.

Objective: To assess the perioperative safety of preoperative restricted fluid administration and liberal fluid administration for pancreatic surgery. Methods: The randomized controlled trials comparing restricted and liberal in pancreatic surgery were collected by searching the databases of PubMed, Embase and the Cochrane Library.Two reviewers independently selected studies according to the inclusion and exclusion criteria, then extracted the data and assessed the quality of included studies.Meta-analysis was performed by RevMan 5.3 software. Results: A total of 4 studies involving 785 patients were finally included, with 396 cases in restricted group and 389 cases in liberal group.Results of Meta-analysis showed that there was no statistically significant difference between the two groups in terms of intraoperative blood loss, postoperative complications, mortality, reoperation in-hospital and length of stay(all P>0.05). Conclusion With regard to pancreatic surgery, restricted fluid administration do not have outstanding advantages.

Objective To investigate the clinical features and surgical treatment of cerebral amyloid angiopathy hemorrhage (CAAH) caused by cerebral vascular amyloidosis.Methods The clinical data,radiological diagnoses,pathology results and treatment efficacies of 76 patients with CAAH,admitted to and performed surgery in our hospital from August 2010 to September 2015,were retrospectively analyzed.Results The first preoperative CT indicated that prompt hematomas were located in the cerebral hemisphere brain cortex,forming lobulated or irregular shape;2 or more lesions of recurrent hemorrhage were noted in 14 (18.4％);34 (44.7％) were with subarachnoid hemorrhage,16 (21.1％) were with intraventricular hemorrhage.Histopathological examination supported the diagnosis.Sixteen patients (21.1％) underwent second operation during hospitalization due to large amount of bleeding.During hospitalization,18 (23.7％) died,and 20 (26.3％) had long-term coma.During the follow-up period,23 patients (30.3％) had recurrent intracranial hemorrhage,of which,6 patients (7.9％) underwent surgical treatment,and 17 patients (22.4％) died.Conclusion The bleeding sites of CAAH mainly locate in the lobes of the brain surface,with lobulated or irregular shape,which is easily complicated with subarachnoid hemorrhage or intraventricular hemorrhage,with multiple features;diagnostic rate of CAAH can be improved by pathological examination of brain tissues and blood vessels;CAAH after surgery has high relapse rate and poor surgical results.

Objective To observe the effect of Tingli-Dazao-Xiefei decoction combined with chemotherapy in the treatment of lung cancer with pleural effusion. Methods A total of 90 patients who met the inclusion criteria from January to June 2017, were randomly divided into treatment group and control group. All patients were treated with intrapleural administration of cisplatin chemotherapy once a week, while patients in treatment group received additional treatment of taking Tingli-Dazao-Xiefei decoction daily.Changes of clinical efficacy, traditional Chinese medical (TCM) symptom score and Karnofsky score were observed 4 weeks later. Results After 4 weeks of treatment, there was no difference in the total effective rate between the two groups (χ2=1.600, P=0.659). The total effective rate was 71.1% (32/45) in treatment group, including 11 cases of complete remission and 20 cases of partial remission, while it was 64.4% (29/45) in control group including 10 of complete remission and 19 of partial remission. After treatment, the TCM symptom scores in the treatment group(20.81 ± 1.92 vs.8.93 ± 1.27;t=34.619,P<0.001)and control group(20.28 ± 1.36 vs.13.22 ± 1.63; t=22.310, P<0.001) were significantly lower than those before the treatment. After treatment, the TCM symptom scores(8.93 ± 1.27 vs. 13.22 ± 1.63,t=13.927)in the treatment group were significantly lower than that in the control group(P<0.001).The Karnofsky score(95.6% vs. 80.0%,χ2=3.728)in the treatment group was significantly higher than that in the control group (P<0.05). There was no difference in the incidence of adverse reactions. Conclusions The theray of Tingli-Dazao-Xiefei decoction combined with chemotherapy could achieved the similar clinical effect of cisplatin chemotherapy treatment, while it showed the advantage of improving TCM syndrome score and the quality of life.

Head and neck squamous cell carcinoma (HNSCC), as the most common type (>90%) of head and neck cancer, includes various epithelial malignancies that arise in the nasal cavity, oral cavity, pharynx, and larynx. In 2020, approximately 878 ‍ 000 new cases and 444 000 deaths linked to HNSCC occurred worldwide (Sung et al., 2021). Due to the associated frequent recurrence and metastasis, HNSCC patients have poor prognosis with a five-year survival rate of 40%-50% (Jou and Hess, 2017). Therefore, novel prognostic biomarkers need to be developed to identify high-risk HNSCC patients and improve their disease outcomes.
Biomarkers, Tumor/genetics* ; Head and Neck Neoplasms/genetics* ; Humans ; Kaplan-Meier Estimate ; RNA ; Squamous Cell Carcinoma of Head and Neck ; Survival Analysis ; Survival Rate