Objective To evaluate the long-term effect of surgical procedures for congenital choledochal cyst (CCC).Methods From 1986 to 2000, 120 cases of CCC were admitted and 73 of them underwent the primary operations in General Hospital of PLA. Three types procedures were performed,type I: external drainage of CCC in 7 cases; type II:cystojejunal Roux-en-Y anastomosis in 5 cases; type III: cyst excision with cystojejunal Roux-en-Y anastomosis or cystoduodenostomy in 57cases,and other procedures in 4 cases.Results 68 cases were followed-up for 6 months to 5 years (median 2.7 years). Three cases undergoing type I operations accepted reoperations;two cases undergoing type II operations accepted reoperations due to severe complications as cholongitis and hepatolithiasis; 57 cases treated by type III operation with the good results 88.7% and none reoperation.Conclusions External drainage is only a first-aid management on emergency basis. Internal drainage should never be done,because the effect is temporary,and severe complications result in reoperations. Cyst excision with biliary tract reconstruction is recommended as the optimal treatment of CCC.

Objective To observe the clinical efficacy of shugan yishen recipe in the treatment of postmenopausal estrogen receptor-positive breast cancer patients during endocrine therapy.Methods A total of 110 postmenopausal breast cancer patients undergoing aro-matase inhibitor endocrine therapy at Shanghai Municipal Hospital of Traditional Chinese Medicine from July 2021 to September 2023 were divided into observation group and control group by random number table method,with 55 patients in each group..Both groups received standard treatment;the observation group also took shugan yishen recipe,while the control group also took shugan yishen recipe placebo,treatment for 12 weeks.The clinical efficacy,traditional Chinese medicine syndrome scores,bone metabolism,tumor markers,T-cell subsets(CD4+,CD8+,CD4+/CD8+)of the two groups were observed,and the safety was evaluated.Results A total of 106 patients completed the experiment,with 53 patients in each group.After treatment,the total clinical effective rate was 75.5％in the observation group,and 58.5％in the control group,the clinical effect of the observation group was better than that of the control group(P＜0.01).Compared with before treatment,TCM syndrome scores in both groups were decreased(P＜0.01).After treatment,β-c-terminal te-lopeptide of type-Ⅰ collagen(β-CTX),carbohydrate antigen 125(CA125),carbohydrate antigen 153(CA153)and CD8+were all decreased compared with those before treatment(P＜0.05);N-mid osteocalcin(N-MID),CD4+,CD4+/CD8+were higher than those before treatment(P＜0.01).After treatment,β-CTX,N-MID,CA153,CD8+and CD4+/CD8+in the observation group were significantly better than those in the control group(P＜0.01).Conclusion Shugan yishen recipe can improve bone metabolism abnor-malities caused by endocrine treatment in postmenopausal patients with estrogen receptor-positive breast cancer,reduce serum tumor marker levels,enhance immune function of patients,and is safe and effective.

The current treatment strategy for rectal cancer is a comprehensive treatment centered on surgery. The application of total mesorectal excision (TME) has significantly reduced the local recurrence rate and improved the survival prognosis, but a series of pelvic organ dysfunction caused by pelvic autonomic nerve injury during the operation will reduce the postoperative quality of life of patients. Pelvic autonomic nerve preserving (PANP) radical proctectomy has emerged, but the biggest challenge in the implementation process of this technology is the accurate identification of nerves. A series of studies have shown that pelvic intraoperative autonomic monitoring (pIONM) can effectively assist surgeons to identify nerves, The purpose of this article is to introduce the function of pelvic autonomic nerve, the clinical manifestation of postoperative pelvic dysfunction and its relationship with nerve injury, the key points of implementing PANP, and the current situation and research progress of pIONM technology application.

The current treatment strategy for rectal cancer is a comprehensive treatment centered on surgery. The application of total mesorectal excision (TME) has significantly reduced the local recurrence rate and improved the survival prognosis, but a series of pelvic organ dysfunction caused by pelvic autonomic nerve injury during the operation will reduce the postoperative quality of life of patients. Pelvic autonomic nerve preserving (PANP) radical proctectomy has emerged, but the biggest challenge in the implementation process of this technology is the accurate identification of nerves. A series of studies have shown that pelvic intraoperative autonomic monitoring (pIONM) can effectively assist surgeons to identify nerves, The purpose of this article is to introduce the function of pelvic autonomic nerve, the clinical manifestation of postoperative pelvic dysfunction and its relationship with nerve injury, the key points of implementing PANP, and the current situation and research progress of pIONM technology application.