Objective To analyse the risk factors for lymph node metastasis of early colorectal cancer and the therapeutic indication for endoscopy.Methods The clinical data of the 269 early colorectal cancer patients who underwent surgical treatments between January 2009 and December 2013 in the West China hospital of Sichuan University were analyzed retrospectively.Pathologic features were compared between different histological types and investigated by univariate and multivariate analysis of their possible risk factors for lymph node metastasis.Results Univariate analysis showed that tumor size (P =0.029),depth of tumor invasion (P =0.006),histological type (P =0.000) and lymphatic involvement (P =0.035) were correlated with lymph node metastasis.Multivariate analysis revealed that tumor size (OR =5.385,95％ CI:1.156-25.075,P =0.032)and histological type (OR =5.145,95％ CI:1.553-17.053,P =0.007) were independent risk factorsfor lymph node metastasis.Comprehensive analysis showed that lymph node metastasis could not be found in patients with tumor invading the mucous layer.However,lymph node metastasis occurred if the tumor invaded the submucous layer.The larger and less differentiated tumor was,the higher occurrence of lymph node matastasis would be (P ＜ 0.05).Conclusion Endoscopic resection is recommended for those with early colorectal cancer localized in the mucous layer and without lymph node metastasis.It is recommended that patients with submucosal carcinomas undergo a preoperative endoscopic ultrasonography or pathological screening for the most appropriate surgical treatment,as the larger and the lower differentiated the tumor is,the higher chance the lymphatic metastasis is.

Objective To study the value of parameters of Transit-Time Flow Measurement(TTFM) as predictor and judge for one-year after coronary artery bypass transplantation in patency rate of vessel grafts .Methods Parameters of quantity of blood flow and the value of PI( pulsation index) were measured and recorded by intraoperative TTFM in CABG .One-year of follow-ing up, coronary artery CT or coronary angiography examination were accomplished.Results Our study include artery grafts 46(including LIMA grafts 44, RIMA graft 1 and radial artery graft 1) with the patency rate of grafts 91.3％ for one-year after CABG, and vein grafts 48 with the patency rate of grafts 66.7％ .There exists statistically significant difference between above two groups(P<0.001).High PI is independent risk factor(P =0.037) in patency rate of vessel grafts for one-year after CABG by binary logistics regression analysis but no other parameters have the statistical significance (P>0.05) .The results from logistic regression were summarized using the area under the ROC curve(AUC) .The pulsation index has been found hav-ing moderate judgment ability(P=0.016) for the dysfunction of grafts after CABG for one-year with optimal cut-off value of 2. 45.Conclusion Intraoperative high value of PI is the independent risk factor in patency rate of vessel grafts for one-year after CABG.

Infectious bone defect is bone defect with infection or as a result of treatment of bone infection. It requires surgical intervention, and the treatment processes are complex and long, which include bone infection control,bone defect repair and even complex soft tissue reconstructions in some cases. Failure to achieve the goals in any step may lead to the failure of the overall treatment. Therefore, infectious bone defect has been a worldwide challenge in the field of orthopedics. Conventionally, sequestrectomy, bone grafting, bone transport, and systemic/local antibiotic treatment are standard therapies. Radical debridement remains one of the cornerstones for the management of bone infection. However, the scale of debridement and the timing and method of bone defect reconstruction remain controversial. With the clinical application of induced membrane technique, effective infection control and rapid bone reconstruction have been achieved in the management of infectious bone defect. The induced membrane technique has attracted more interests and attention, but the lack of understanding the basic principles of infection control and technical details may hamper the clinical outcomes of induced membrane technique and complications can possibly occur. Therefore, the Chinese Orthopedic Association organized domestic orthopedic experts to formulate An evidence-based clinical guideline for the treatment of infectious bone defect with induced membrane technique ( version 2023) according to the evidence-based method and put forward recommendations on infectious bone defect from the aspects of precise diagnosis, preoperative evaluation, operation procedure, postoperative management and rehabilitation, so as to provide useful references for the treatment of infectious bone defect with induced membrane technique.

Femtosecond laser small incision lenticule extraction (SMILE) with different residual stromal thicknesses (RST) is set to investigate its effect on corneal biomechanical properties of rabbits in vivo. In this study, 24 healthy adult Japanese rabbits were randomly divided into group A and B. The RST of group A was set 30% of the corneal central thickness (CCT), and the RST of group B was 50% of the CCT. The thickness of the corneal cap in both groups was set one third of CCT. Corneal visualization Scheimpflug technology (Corvis ST) and Pentacam three-dimensional anterior segment analyzer were used to determine corneal biomechanical and morphological parameters before surgery, and 1 week, 1 month and 3 months after surgery. Pearson correlation analysis was used to analyze factors affecting corneal biomechanical parameters after SMILE. The results showed that the corneal stiffness of group A was significantly higher than that of group B at 1 week and 1 month after surgery, and most biomechanical parameters returned to preoperative levels at 3 months postoperatively. The results of correlation analysis showed that postoperative CCT and RST were the main factors affecting corneal biomechanical parameters after SMILE. There was no significant difference in corneal posterior surface height (PE) between 3 months after surgery and before surgery in both two groups. It indicates that although the ability to resist deformation of cornea decreases in SMILE with thicker corneal cap and less RST, there is no tendency to keratoconus, which may be related to the preservation of more anterior stromal layer.
Animals ; Biomechanical Phenomena ; Cornea/surgery* ; Postoperative Period ; Rabbits