Objective To study the postoperative recovery of different surgical approaches for patients with cardia cancer.Methods From January 2011 to March 2016,174 cases of patients with cardia cancer were selected and divided into observation group (76 cases) and control group (98 cases).The patients of control group received via thoracic approach surgery,while those of observation group were given abdominal approach surgery.The operationtime,intraoperative blood loss,dissected lymph node numbers,postoperative hospital stay,hospitalization expense,positive rate of surgical margin,radical operation rate,perioperative mortality,pulmonary complications,operative incision infection rate and anastomotic fistula rate of two groups were compared.Results There were no significant differences of intraoperative blood loss and operation time,positive rate of surgical margin,radical operation rate,perioperative mortality,postoperative pneumothorax rate,hydropneumothorax rate,pyothorax rate,operative incision infection rate and anastomotic fistula rate between two groups (P ＞ 0.05).There were significant differences of the dissected lymph node numbers,postoperative hospital stay,hospitalization expense,postoperative hydrothorax rate,postoperative pneumonia rate,total pulmonary complications rate and total complications rate between two groups (P ＜ 0.05).Conclusions Abdominal approach for patients with cardia cancer,compared to via thoracic approach surgery,presents advantages in terms of dissected lymph nodes,postoperative hospital stay,hospitalization expense,postoperative pneumonia rate,hydrothrax rate,total pulmonary complications rate and total postoperative complications rate.

The article is study about principle of lower extremities on Guides to the Evaluation of Permanent Impairment. We reviewed the latest concept in lower extremities evaluation of GEPI, such as regional impairment, diagnosis based impairment and grade modifier. We also introduced maximum medical improvement and conversion from lower extremities impairment to whole person impairment. To provide advice for construction of disability evaluation system in China.

The article is comparative study about spine and extremities on clause for the identification of the body injured and The classification of the body impairment. We reviewed the terms and provisions about spine and extremities as follows, amputation impairment, function impairment, and amputation impairment combined function impairment. This paper provides a comprehensive access and analysisofthe similarities and differences between the two standards.

The article is study about range of motion on lower extremities on Guides to the Evaluation of Permanent Impairment. We reviewed the latest range of motion concept about lower extremities evaluation of GEPI. We also introduced measurement and procedure of range of motion evaluation. To provide advice for construction of disability evaluation system in China.

Objectives:We aimed to compare the impact of dissection and re-entry(DR)recanalizing pattern with non-DR on the in-hospital results and prognostic outcomes of patients treated successfully by percutaneous coronary intervention(PCI)of chronic total occlusion(CTO)and examine the benefit of DR in CTO PCI. Methods:A total of 815 consecutive patients with CTO meeting the inclusion criteria in the Department of Cardiology of the First Affiliated Hospital of PLA Air Force Military Medical University from January 2018 to December 2020 were enrolled and divided into DR group(n=239)and non-DR group(n=576)according to whether DR recanalizing pattern was used in the procedure.The clinical characteristics,coronary angiographic characteristics,procedure results,and complications were collected,and the prognostic outcomes within one year after the procedure were observed.Propensity score matching by the clinical and coronary angiographic characteristics was performed and results were compared with 208 matched patients in each group.The endpoints were the major adverse cardiovascular events(MACE)consisting of all-cause death and myocardial infarction,clinically driven target vessel revascularization(TVR)one year after the procedure,and in-hospital outcomes. Results:The mean age of all patients was(60.9±10.9)years old,and 87.4%were male.As compared with the non-DR group,the proportion of blunt cap,ambiguous,calcification,angle＞45°,and diseased landing zone,as well as mean J-CTO score was higher in the DR group(all P＜0.05).The mean stent length and median procedure time were longer in the DR group,median guidewires and consumed contrast volume was also higher in the DR group(all P＜0.001).Incidence of in-hospital death,myocardial infarction,perforation,side branch loss,bleeding of BARC 3rd grade and above,and contrast-related impairment of renal function were similar between the two groups(all P＞0.05).However,peripheral vascular complications occurred more frequently in the DR group(P=0.007).One year after the procedure,the incidence of MACE(2.9%vs.2.4%,log-rank P=0.750)and clinically driven TVR(5.8%vs.3.9%,log-rank P=0.365)as well as all-cause death(2.9%vs.1.0%,log-rank P=0.154)and myocardial infarction(0.5%vs.1.9%,log-rank P=0.184)were similar between the two matched groups.Multivariate Cox regression analysis showed no significant association between DR and MACE(HR=1.129,95%CI:0.427-2.979,P=0.807)and TVR(HR=0.606,95%CI:0.213-1.722,P=0.347).LVEF≤40%(HR=2.775,95%CI:1.137-6.774,P=0.025)and elevated residual SYNTAX score(HR=1.089,95%CI:1.032-1.150,P=0.002)were risk factors for MACE,and diseased landing zone(HR=2.144,95%CI:1.019-4.513,P=0.045),rescued ADR(HR=3.479,95%CI:1.109-10.919,P=0.033),and prolonged procedure time(HR=1.007,95%CI:1.002-1.013,P=0.007)were risk factors for TVR. Conclusions:CTO lesion recanalized with PCI utilizing DR operation pattern was associated with more complex characteristics,more devices and time consumed,and longer stent length,while no significant association was observed between DR operation pattern and MACE and TVR one year after the procedure,as well as in-hospital complication..