Objective To study the indication of pelvic autonomic nerve preservation(PANP)for patients undergoing rectal carcinoma resection and evaluate the operative procedure and post-operative urine function.Methods Materials of 18 cases of middle and lower rectum carcinoma,receiving PANP radical resection from Jan. 2000 to Nov. 2002 were reviewed. The perioperative urodynamic index and postoperative long-term sexual function were analyzed.Result Pelvic autonomic nerve was preserved in all 18 patients and they have normal urine function and satisfactory long-term sexual function.Conclusion Male patients aged younger than 60 yrs., with rectal carcinoma of Ducks A to C are suitable for receiving PANP radical resection for better maintenance of the urinal and sexual function.

Objective To compare and analyze the advantages and disadvantages of the application of self-fixing and plain polypropylene mesh in open inguinal hernia repair.Methods A study of 83 patients who underwent open inguinal hernia repair patients from June 2014 to June 2016 in the Department of General Surgery,AnHui No.2 Provincial People's Hospital Patients were divided into two groups according to the use of different patches,42 cases were applicated self-fixating mesh (observation group) and 41 cases were applicated the ordinary polypropylene patch (control group).The operation time,average postoperative hospitalization time,postoperative complications and Visual Analogue Score of postoperative pain were compared.The measurement data were expressed by mean standard deviation (~ ± s),and using t test,Count data were represented by frequency and percentage,and chi-square test was used for comparison between groups.Results The operation time of the observation group and the control group was (49.9 ± 6.4) minutes and (67.9 ± 6.1) minutes,and there was significant difference(P ＜ 0.05).The postoperative hospitalization time of observation group and control group was (2.5 ± 1.4) days and (2.6 ± 1.8) days,there was no significant difference (P ＞ 0.05).In the complications of the two groups,there were 1 case of scrotal edema in the observation group,and 2 cases of scrotal edema in the control group,the difference was no statistically significance.The Visual Analogue Score in two groups was (4.0 ± 0.8) score and (4.1 ± 0.7) score,there was no significant difference between the two groups (P ＞ 0.05) within 12 hours after operation.The Visual Analogue Score was (2.6 ± 0.7) score,(1.4 ± 0.5) score within 24 hours and 48 hours after operation in the observation group,and was (3.1 ± 0.6) score,(2.7 ± 0.5) score in the control group.There was a significant difference between the two groups (P ＜ 0.05).There was no obvious local pain for the observation group and had a better sense of comfort in one month follow-up after the operation.Conclusions The application of self-fixing suture free patch can reduce the operation time of patients and relieve the discomfort of postoperative pain,and has a high clinical value.

Objective To assess the impact of statins combined with sorafenib(SRF)therapy on survival outcomes in patients with metastatic renal cell carcinoma(mRCC).Methods Clinical data of mRCC patients treated in the 908th Hospital of the Joint Security Force from November 2019 to November 2023 were retrospectively analyzed.They were categorized into statin group and non-statin group according to whether they used statins or not,and the differences in the primary endpoint of overall survival(OS),secondary endpoints of progression-free survival(PFS),objective response rate(ORR),and disease control rate(DCR)were compared between the two groups.Results A total of 80 patients were included in the study,with 27 in the statin group and 53 in the non-statin group.There were no statistically significant differences in partial remission,stable disease,disease progression,and DCR between the two groups(P＞0.05);complete remission and ORR were significantly higher in the statin group than in the non-statin group(P＜0.05).Kaplan-Meier analysis showed that,compared with the non-statin group,the median PFS and OS of the statin group were prolonged,and the difference in median PFS between the two groups was statistically significant(P＜0.05).In terms of safety,the incidence of other adverse events was similar in both groups(P＞0.05).Conclusion Statins combined with SRF treatment regimen can improve ORR and DCR and prolong median PFS and OS in patients with mRCC.

Objective To investigate the intra- and interobserver repeatability of coronary artery disease (CAD) diagnosis based on invasive coronary angiography (ICA) and CT coronary angiography (CTCA).Methods Two readers with comparable experience ( over 10 years) independently evaluated ICA results of 42 consecutive patients with a blind method. After 30 days,one of them reviewed the same patients again.Another two comparable-experience (over 10 years) readers evaluated the results of CTCA (prospectively ECG-triggering) from the same 42 patients in the same way.The inter-reader and intra-reader repeatability of ICA and CTCA were analyzed by performing Kappa test and calculating the percentage of the segments with agreement on stenotic degree.Using ICA as reference,the accuracy of CTCA in diagnosing CAD was studied by comparing the area under ROC. Results The Kappa between readers for ICA and CTCA were 0.91 and 0.81.Intra-reader Kappa were 0.92 and 0.83 respectively (x2 =509.4 and 432.5,all P ＜0.01 ).The percentage of the segments with agreement between readers on the degree of stenosis were 80.8％ (494/611) in ICA and 75.2％ (469/624) in CTCA ( x2 =2.75,P =0.10),and within the same reader,86.9％ (531/611)in ICA and 81.9％ (511/624) in CTCA(x2 =3.76,P =0.053).With≥ 50％narrowing as a CAD diagnosis criterion,the agreement rates for two readers were 96.6％ (590/611 ) in ICA and 94.4％ (589/624) in CTCA( x2 =3.36,P =0.07),and for the same reader,97.4％ (595/611) in ICA,95.4％ (595/624) in CTCA ( x2 =3.62,P =0.06).Using ICA as reference,two readers of CTCA results achieved a sensitivity and specificity of 84.9％ (530/624)and 98.1％ (612/624).The area under ROC was 0.94 (95％ CI 0.91-0.97).Conclusions Both ICA and CTCA demonstrate good repeatability in diagnosing CAD.The repeatability of ICA is superior to that of CTCA.A certain discrepancy exists in two readings from the same reader or two readers.

Objective To explore the 18F-FDG PET/CT features of sacral insufficiency fracture.Methods 18 F-FDG PET/CT imaging and clinical data of 8 patients with sacral insufficiency fracture were retrospectively analyzed.Results All 8 patients had different degrees of radioactivity uptake in sacra with the maximum standardized uptake value (SUVmax)from 2.7 to 7.2.Four patients had lesions in their left sacra,2 in the bilateral sacral wings and sacral promontories,1 in the bilateral sacral wings,and 1 in the left sacral wing and sacral promontory.There were 8 patients of longitudinal fractures in sacral wings,which of 6 patients involving S1-2 and 2 patients involving S3.Three patients had transverse fractures in sacral promontories,with 2 located at S2 and 1 at S3.The sacral bone density increased in 5 cases,and the density was not changed in 3 cases.Conclusion Sacral insufficiency fracture had specific 18F-FDG PET/CT characteristics.

Objective:To explore the predictive value of low-dose biphasic (inspiratory and expiratory) CT air trapping sign and semi-quantitative score in predicting abnormal blood gas parameters and progression to severe disease in COVID-19 patients.Methods:Patients with non-severe COVID-19 who were diagnosed by nucleic acid testing and hospitalized in designated hospitals in Wuxi City from January 23 to February 29, 2020 were prospectively and consecutively recruited. All patients received low-dose biphasic CT examination on admission and repeated CT examination at regular intervals during the course. On the inspiratory phase admission of the bipolar CT, the scope of the lesion was evaluated by semi-quantitative score, and the air trapping sign on bipolar CT was assessed. The differences of semi-quantitative score, the presence of the air trapping sign and other clinical factors were compared between the patients with abnormal and the normal blood gas index, as well as between the cases progressed to severe disease and cases without disease progression using the independent sample t-test or χ 2 test. The area under the curve (AUC) of receiver operating characteristic (ROC) and the comprehensive discriminant improvement index (IDI) were used to evaluate the predictive effectiveness of the semi-quantitative scores, air trapping sign, and combination of two factors in differentiating cases with abnormal and normal blood gas indexes, as well as in differentiating cases with and without disease progression to severe COVID-19 cases. Results:In total 51 non-severe COVID-19 cases were included, with 16 cases showed air trapping sign during the first biphasic CT examination on admission. During the course of the disease, there were 13 patients with abnormal blood gas index, and 9 cases displaying air trapping sign (9/13). All 7 cases with progression to severe cases showed air trapping sign (7/7). Patients with advanced age, air trapping sign and higher semi-quantitative score were found more likely to have abnormal blood gas index ( t=3.10, χ 2=9.38, t=3.34, P<0.05); patients with advanced age, underlying diseases, air trapping sign and higher semi-quantitative score were more likely to develop into severe disease ( t=2.68, χ 2=6.65, χ 2=4.25, t=4.33, P<0.05). The AUC of semi-quantitative score, air trapping sign and combination of two factors in distinguishing abnormal blood gas index from normal blood gas index was 0.803, 0.754 and 0.794 respectively. The AUC of semi-quantitative score, air trapping sign and combination of two factors in distinguishing cases with progression to severe cases from non-progression was 0.881, 0.898 and 0.932, respectively. Air trapping sign combined with semi-quantitative score significantly improved the prediction effectiveness of disease progression, compared with semi-quantitative score or air trapping sign (IDI=0.271, 0.117). Conclusion:Air trapping sign and semi-quantitative score might be used as effective indicators to predict the progression of COVID-19 cases, and the combination of these two factors might be more helpful to predict the disease progression.

Objective To compare the cumulative analgesic effects of electroacupuncture at Sanyinjiao (SP6), Xuanzhong (GB39) and non-acupoint in treating primary dysmenorrhea. Method By adopting a multi-centered randomized controlled study method, 501 patients recruited from Dongzhimen Hospital of Beijing University of Chinese Medicine, China-Japan Friendship Hospital, Beijing Hospital of Traditional Chinese Medicine of Capital Medical University, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Huguosi Hospital of Chinese Medicine of Beijing University of Chinese Medicine and the Outpatient of Shandong University of Traditional Chinese Medicine were randomized into a Sanyinjiao group, a Xuanzhong group, and a non-acupoint group, 167 subjects in each group. The electroacupuncture intervention was applied when dysmenorrhea flared up and the Visual Analogue Scale (VAS) ≥40 mm, with frequency at 2/100 Hz and intensity during patient’s endurance, 30 min each time, once a day, and for successive 3 d. Before the first treatment, 30 min after the first treatment, and respectively prior to the second and third treatment, VAS was used to measure the pain intensity. Meanwhile, the Retrospective Symptom Scale (RSS-COX 2) was investigated before the first treatment, right after the removal of needles for the first treatment, before the second and third treatment. Result The decrease of VAS in Sanyinjiao group was more significant than that in Xuanzhong group and non-acupoint group (MD=﹣2.92 mm, P=0.028; MD=﹣3.47 mm, P=0.009), while there was no significant difference between Xuanzhong group and non-acupoint group (MD=﹣0.56 mm, P=0.674); there were no significant differences in comparing the RSS-COX2 total score among the three groups (P=0.086). Conclusion Sanyinjiao (SP6) can produce a more significant cumulative analgesic effect for primary dysmenorrhea patient than Xuanzhong and non-acupoint, and the effects of Xuanzhong and non-acupoit are equivalent.