BACKGROUND:Studies have shown that malnutrition was associated with death of elder people after fracture of hip, but there were no above-mentioned reports in China.
OBJECTIVE: To retrospectively analyze the relationship of blood albumin, total lymphocyte count and hemoglobin levels to prognosis when elder patients with fracture of hip were on admission.
METHODS:130 elderly patients with hip fractures aged ≥ 70 years were included underwent either total hip arthroplasty or bipolar arthroplasty. Admission serum albumin, total lymphocytecount and hemoglobin levels were recorded. The patients were fol owed up for 1 year or til the death. Survival data were available in 92 patients. Rates of survival were calculated by the Kaplan-Meier method and the Log-Rank test. Cox proportional hazard regression model received prognostic multivariate analysis.
RESULTS AND CONCLUSION:Of the 92 patients, albumin<35 g/L in 20 cases (22%), total lymphocyte count<1.5×106/L in 67 cases (73%), and hemoglobin<120 g/L in 56 cases (61%). Kaplan-Meier method showed that the survival rate of patients with normal albumin (≥ 35 g/L) was significantly higher than those with reduced albumin (<35 g/L) (P<0.01). No significant difference was detected in the survival rate of patients with normal total lymphocyte count (≥ 1.5×106/L) and reduced total lymphocyte count (<1.5×106/L) (P>0.05). The survival rate of patients with normal hemoglobin (≥ 120 g/L) was significantly higher than those with decreased hemoglobin (<120 g/L) (P <0.05). Cox multivariate analysis displayed that albumin decrease is an independent prognostic factor for death of patients with hip fracture. Results indicated that the prognosis of elder patients with hip fracture was strongly associated with their nutritional conditions. Albumin and hemoglobin levels at admission can be considered as important indexes for judging patient’s prognosis.

Background and purpose:High expression of excision repair cross-complementing 1 (ERCC1) is related to resistance in patients treated with platinum-containing regimens. The ERCC1 antibody 8F1 was usually used in past studies, but it was found to have no-speciifcity recently. This study aimed to investigate the predictive role of a new ERCC1 antibody 4F9 to platinum chemotherapy in non-small cell lung cancer (NSCLC) patients. Methods:Expression of ERCC1 was detected using antibody 4F9 by immunohistochemistry (IHC) in 72 NSCLC tissues. The relationship between the expression of ERCCl and the clinical pathological parameters, the efficacy of platinum chemotherapy and overall survival of patients were explored by statistical analysis. Results: The high expression of ERCCl protein was 55.5%in 72 cases. There was no signiifcant correlation between the ERCC1 expression with gender, age, pathological type, clinical stage and lymphatic metastasis (P>0.05). Patients with low expression of ERCC1 had signiifcantly higher response rates to platinum chemotherapy, longer median survival time and 2-years survival rate comparing with those with high expression of ERCC1 (62.5%vs 37.5%;22.9 vs 18.4 month;46.9%vs 37.5%), respectively (P<0.05). Conclusion:The expression analysis of ERCC1 using new ERCC1 antibody 4F9 by IHC method is helpful to assign chemotherapeutic regimen, and guide individual platinum chemotherapy for post-operation patients.

Objective:To compare the clinical effects of percutaneous curved vertebroplasty (PCVP) and unilateral percutaneous kyphoplasty (PKP) in the treatment of osteoporotic vertebral compression fracture (OVCF).Methods:A retrospective cohort study was used to analyze the clinical data of 104 patients with single vertebral OVCF treated in Tianjin Hospital from September 2019 to September 2020, including 21 males and 83 females; aged 50-91 years [(70.3±7.7)years]. AO classification of the fracture was type A1 in 65 patients and type A2 in 39. The patients received PCVP (PCVP group, n=51) or unilateral PKP surgery (unilateral PKP group, n=53). The operation time, bone cement injection volume, intraoperative fluoroscopy frequency, effective dispersion times of bone cement and excellent rate of bone cement distribution were compared between the two groups. In evaluation of the therapeutic effects of the two groups, visual analogue scale (VAS) and Oswestry dysfunction index (ODI) were measured preoperatively and at postoperative 24 hours, 3 months and 6 months; Beck index was measured preoperatively and at postoperative 24 hours and 3 months. The rate of bone cement leakage and rate of refracture of adjacent vertebral bodies were compared between the two groups. Results:All patients were followed up for 6-8 months [(6.4±0.7)months]. The operation time, bone cement injection volume and intraoperative fluoroscopy frequency in PCVP group was (12.15±1.63)minutes, (2.13±0.28)ml and (24.74±1.71)times, shorter or less than (22.09±1.62)minutes, (5.30±0.52)ml and (30.09±1.86)times in unilateral PKP group (all P<0.01). The effective dispersion times of bone cement in PCVP group was (1.42±0.04)times, higher than (1.18±0.02)times in unilateral PKP group ( P<0.01). The excellent rate of bone cement distribution in PCVP group was 94%, higher than 70% in unilateral PKP group ( P<0.01). There were no significant differences in VAS, ODI and Beck index between the two groups before operation and at 24 hours and 3 months after operation (all P>0.05). VAS and ODI in PCVP group were (1.20±0.49)points and 16.52±5.22 at 6 months after operation, lower than (1.49±0.58)points and 20.16±5.16 in unilateral PKP group (all P<0.01). VAS and ODI in the two groups were significantly improved at 24 hours, 3 months and 6 months after operation when compared with those before operation (all P<0.05). Beck index in the two groups detected at 24 hours and 3 months after operation was improved from that before operation (all P<0.05). Unilateral PKP group showed Beck index was 0.75±0.07 at 3 months after operation, significantly lower than 0.79±0.07 at 24 hours after operation ( P<0.05), but there was no significant change in PCVP group ( P>0.05). The leakage rate of bone cement in PCVP group was 16% (8/51), lower than 47% (25/53) in unilateral PKP group ( P<0.01). There was no significant difference in the incidence of refracture of adjacent vertebral bodies between the two groups during follow-up ( P>0.05). Conclusion:For OVCF, PCVP is superior to unilateral PKP in terms of operation time, amount of bone cement injection, intraoperative fluoroscopy frequency, dispersion effect of bone cement in vertebral body, pain, function improvement, maintenance of injured vertebral height and incidence of bone cement leakage.

Objective:To investigate the efficacy and safety of camrelizumab in the treatment of advanced hepatocellular carcinoma complicated with hepatitis B virus infection.Methods:One hundred cases of patients with advanced primary hepatocellular carcinoma complicated with hepatitis B virus infection admitted to the Fuyang Cancer Hospital from July 2020 to July 2021 were selected and divided into the observation group (48 cases) and the control group (52 cases) by the random number table method. The control group was treated with transhepatic arterial chemoembolization (TACE) and entecavir, and the observation group was treated with camrelizumab on the basis of the control group. After 3 months of treatment, the efficacy was evaluated, serum Alpha-fetoprotein (AFP) was determined, and the incidence of adverse reactions was counted. Progression-free survival (PFS) and overall survival (OS) were compared in follow-up visits.Results:After 3 months of treatment, the objective remission rates of the observation group and the control group were 47.92% (23/48) and 23.08% (12/52), respectively, and the disease control rates were 85.42% (41/48) and 65.38% (34/52), respectively, with statistically significant differences ( P<0.05); the AFP level in the observation group was significantly lower than that in the control group: (55.41 ± 10.22) μg/L vs. (78.52 ± 9.63) μg/L, with statistically significant differences ( P<0.05); the incidence of reactive skin capillary hyperplasia in the observation group was significantly higher than that in the control group: 83.33% (40/48) vs. 0, with statistically significant differences ( P<0.05); the median PFS and OS in the observation group were significantly longer than those in the control group: 8.00 (6.27, 9.73) months vs. 5.90 (4.70, 7.10) months and 15.50 (13.47, 17.00) months vs. 12.80 (10.21, 15.39) months, with statistically significant differences ( P<0.05). Conclusions:Camrelizumab combined with entecavir and TACE is effective in the treatment of patients with advanced hepatocellular carcinoma complicated with hepatitis B virus infection. Compared with the short-term efficacy and long-term survival of entecavir alone combined with TACE, camrelizumab combined with TACE is more advantageous, and the degree of adverse reactions is less. Therefore, this regimen may have better benefits when considering the efficacy and tolerability.

Objective:To investigate the short-term efficacy of left-sided three-port total laparoscopic distal gastrectomy (TPTLDG).Methods:The prospective randomized controlled study was conducted. The 68 patients undergoing laparoscopic distal gastrectomy in the First Affiliated Hospital of Air Force Medical University from March 2022 to March 2023 were collected. All patients were randomly assigned to the TPTLDG group with a double number, and to the five-port laparoscopic distal gastrectomy (FPLDG) group with a single number, respectively. Observation indicators: (1) grouping situations of the enrolled patients; (2) comparison of perioperative condition; (3) comparison of complications during postoperative 30 days; (4) comparison of pathological examination. Measure-ment data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test or continuous correction chi-square test. Comparison of ordinal data was analyzed using the non‐parameter rank sum test. Results:(1) Grouping situations of the enrolled patients. A total of 59 patients of gastric cancer were selected for eligibility. There were 40 males and 19 females, aged 59.00(52.00, 67.00)years. The gender (male, female), age, body mass index (BMI), Caprini score (≤2, ≥3), nutritional risk screening 2002 (<3, ≥3), Eastern Coopera-tive Oncology Group performance status (0, 1), preoperative hypersensitive C-reactive protein, preoperative IL-6, preoperative white blood cell count, preoperative albumin were 19, 11, 59.00(51.25,65.25)years, 21.92(20.93,22.73)kg/m 2, 7, 23, 24, 6, 18, 12, 0.78(0.78,1.46)mg/L, 3.07(1.50,10.56)μg/L, 6.07(4.94,7.19)×10 9/L, 44.30(40.83, 46.15) g/L in the 30 patients of TPTLDG group, versus 21, 8, 57.00(51.00, 67.00)years, 21.90(20.95, 23.35)kg/m 2, 11, 18, 24, 5, 17, 12, 1.13(0.78,11.40)mg/L, 5.56(1.88,15.12)μg/L, 5.54(4.71,6.70)×10 9/L, 43.55(40.25,44.88)g/L in the 29 patients of FPLDG group, showing no significant difference in the above indicators between the two groups ( χ2=0.557, Z=-0.444, -0.805, χ2=1.482, 0.074, 0.012, Z=-1.259, -1.262, -0.819, -1.199, P>0.05), confounding bias ensured comparability between the two groups. (2) Comparison of perioperative condition. The length of incision, time to removing drainage tube, IL-6 at postoperative day 3, cost of hospital stay were 6.65(6.48,6.93)cm, 3.00(0,3.00)days, 29.18 (13.67, 43.53)μg/L, 84 164.15(73 084.72, 96 782.14)yuan in the TPTLDG group, versus 8.00(7.50,8.35)cm, 3.00(3.00,4.00)days, 47.56(21.31,85.79)μg/L, 92 120.43(87 069.33, 113 089.74)yuan in the FPLDG group, showing significant differences in the above indicators between the two groups ( Z=-11.065, -2.141, -2.940, -2.220, P<0.05). (3) Comparison of complications during postoperative 30 days. The incidence rate of complications during postoperative 30 days was 30.00%(9/30) and 24.14%(7/29) in the TPTLDG group and FPLDG group, respectively, showing no significant difference between the two groups ( χ2=0.256, P>0.05). (4) Comparison of pathological examination. Cases with pathological N staging as 0 stage, 1 stage, 2 stage, 3 stage were 22, 2, 4, 2 in the TPTLDG group, versus 13, 7, 4, 5 in the FPLDG group, showing a significant difference between the two groups ( Z=-2.021, P<0.05). Conclusion:TPTLDG is safe and feasible for gastric cancer, with a good short-term efficacy.

（正）目前对于可切除食管癌的治疗方式是以手术为主的综合治疗[1]。微创食管癌手术经过多年的发展和普及，其远近期疗效已被广泛认可。目前对于中、下段食管癌，胸腹腔镜联合 Ivor-Lewis 已是主流术式[2]。相对微创 McKeown 手术，全腔镜下Ivor-Lewis 食管癌根治术在近期疗效（特别是在吻合口瘘、吻合口狭窄和喉返神经损伤）方面具有明显优势[3]。本视频旨在展示全腔镜下 Ivor-Lewis 食管癌根治术的手术入路及操作要点。