Objective:To compare the efficacy and safety of minimally invasive puncture and drainage for hypertensive cerebral hemorrhage at different time windows.Methods:A total of 98 patients with spontaneous cerebral hemorrhage underwent minimally invasive puncture and drainage in our hospital from January 2016 to December 2019 were chosen. These patients were divided into 3 groups in accordance with operation time: an ultra-early-stage group (accepted surgery within3 h of onset), an early-stage group (accepted surgery within 3-24 h of onset), an acute-stage group (accepted surgery within 24-72 h of onset); the clinical data of these patients were retrospectively analyzed. The hematoma clearance, muscle strength improvement 14 d after surgery, consciousness improvement 14 d after surgery, National Institutes of Health Neurological Deficit Scale (NIHSS) scores 14 d after surgery, and re-hemorrhage were compared among the 3 groups.Results:In the ultra-early-stage group, there were 11 patients (84.6%), 2 patients (15.4%) and 0 patients (0%) with low, medium and high hematoma clearance rates. In the early-stage group, there were 20 patients (33.9%), 32 patients (54.2%) and 7 patients (11.9%) with low, medium and high hematoma clearance rates. In the acute-stage group, 8 patients (30.8%), 14 patients (53.8%) and 4 patients (15.4%) had low, medium and high hematoma clearance rates. The hematoma clearance rate in the early group and the acute group was higher than that in the ultra-early group. Fourteen d after surgery, the proportion of patients with muscle strength improvement in the early-stage group and acute-stage group was significantly higher than that in the ultra-early-stage group ( P<0.05); the proportion of patients with consciousness improvement in the early-stage group was significantly higher than that in the ultra-early-stage group and acute-stage group ( P<0.05); NIHSS scores of patients in the early-stage group were significantly lower than those in the ultra-early stage group and acute-stage group ( P<0.05). There were 4 patients with postoperative re-hemorrhage, including one from the ultra-early-stage group and 3 from the early group. Conclusion:In patients with cerebral hemorrhage, hematoma clearance is relatively good and postoperative recovery is good when minimally invasive puncture and drainage is performed within 3-24 h of onset.

Objective To compare the clinical efficacy of laparoscopic wedge resection and open wedge resection in the treatment of gastrointestinal stromal tumor. Methods Fifty?five patients with gastrointestinal stromal tumor who underwent laparoscopic wedge resection and 61 cases underwent open wedge resection in Tongji Hospital from January 2009 to December 2014 were included into this study. The perioperative, surgical operative and postoperative data of the patients were documented and analyzed. Results The operation time of laparoscopic group was significantly shorter than that of the open group [(108.2±27.2) min versus (139.9±75.3) min, P=0.021], the amount of intraoperative blood loss was overtly reduced in the laparoscopic group [(57.1±48.7) ml versus (100.6±45.8) ml, P=0.011], the time to postoperative exhaust or defecation was (2.2±1.4) d in the laparoscopic group and (3.5±1.8) d in the open group (P=0.028), and the length of hospital stay was (5.7±1.3) d versus (6.9±2.1) d (P=0.044). There were intraoperative complication in one case and postoperative complications in 5 cases, while neither tumor rupture nor obvious perioperative complication was observed in the laparoscopic group. During the period of follow?up ( mean, 15.3 months) , only one case of replase occurred in the laparoscopic group while four cases of relapse were observed in the open group. Conclusions With experienced skills and to strictly comply with the surgical indications, laparoscopic wedge resection is prior to tranditional open wedge resection for the treatment of gastrointestinal stromal tumor. The laparoscopic wedge resection can achieve the standard of R0 resection, keep the resected tumor with an intact capsule, reduce the operating time and operative trauma, promote the postoperative recovery and get a better prognosis. Therefore, it is a feasible, safe, minimally invasive surgical procedure associated with a rapid postoperative recovery.

Objective To compare the clinical efficacy of laparoscopic wedge resection and open wedge resection in the treatment of gastrointestinal stromal tumor. Methods Fifty?five patients with gastrointestinal stromal tumor who underwent laparoscopic wedge resection and 61 cases underwent open wedge resection in Tongji Hospital from January 2009 to December 2014 were included into this study. The perioperative, surgical operative and postoperative data of the patients were documented and analyzed. Results The operation time of laparoscopic group was significantly shorter than that of the open group [(108.2±27.2) min versus (139.9±75.3) min, P=0.021], the amount of intraoperative blood loss was overtly reduced in the laparoscopic group [(57.1±48.7) ml versus (100.6±45.8) ml, P=0.011], the time to postoperative exhaust or defecation was (2.2±1.4) d in the laparoscopic group and (3.5±1.8) d in the open group (P=0.028), and the length of hospital stay was (5.7±1.3) d versus (6.9±2.1) d (P=0.044). There were intraoperative complication in one case and postoperative complications in 5 cases, while neither tumor rupture nor obvious perioperative complication was observed in the laparoscopic group. During the period of follow?up ( mean, 15.3 months) , only one case of replase occurred in the laparoscopic group while four cases of relapse were observed in the open group. Conclusions With experienced skills and to strictly comply with the surgical indications, laparoscopic wedge resection is prior to tranditional open wedge resection for the treatment of gastrointestinal stromal tumor. The laparoscopic wedge resection can achieve the standard of R0 resection, keep the resected tumor with an intact capsule, reduce the operating time and operative trauma, promote the postoperative recovery and get a better prognosis. Therefore, it is a feasible, safe, minimally invasive surgical procedure associated with a rapid postoperative recovery.

In recent years， the research method of Mendelian randomization based on genome-wide association studies has been widely used for etiological exploration in the medical field， which can effectively overcome the confounding biases and interference of reverse causalities in traditional observational researches with its unique advantages of the distributive randomness and timing priority of genetic variants. This article reviews the method of Mendelian randomization and its application in liver cancer， in order to provide new ideas for the research on causal association in liver cancer.