Objective To compare the difference between self-made retractor and thyroid suspension in laparoscopic thyroidectomy,as well as exploring the feasibility and efficacy of self-made retractor.Methods Fifty nine thyroid patients were included in this study from Jan.2012 to Jun.2013 in our hospital.30 cases of laparoscopic thyroidectomy were completed by the help of self-made retractor while 29 cases were completed with thyroid suspension.The owration time,blood loss,drainage flow,hospital stays and short term effect were compared.Result The average operation time of retractor group (71.57 ± 9.56) min was shorter than the suspension group (79.90 ±10.61) min (P =0.002) The blood loss of retractor group (11.83 ±6.76) mL was less than the suspension group (17.24 ± 9.41) mL (P =0.014).The hospitalization time of retractor group (4.07 ± 0.45) days was similar with the suspension group (4.14 ± 0.52) min (P =0.573),The retractor group had shorter operation time,blood loss.There was statistical significance between them.There was no significance difference of hospital stays and discomfort.Neither group appeared of hoarseness,bucking,angulus oris numbness and other symptom.Conclusion Self-made retractor can reduce the operation time,blood loss.It is worth of clinical extension.

Operation robot has 3D vision and 7 activity degrees of freedom,also has vibration elimination system and operation scale system.These can ensure its operative precise in limited space.Meanwhile the console meets vito dynamics can relieve fatigue of doctors.Operation robot has great effect in many subjects.But it still needs to be improved because it lacks of feedback system,mechanical failure and software failure.Furthermore,its price demands to decrease.The newest progress was reviewed for better use of operation robot.

Objective To investigate the damage control surgery(DCS)in the treatment of severe abdominal trauma and the clinical value of learning from experience.Method Forty-severl cases of severe abdominal trauma patients treated with DCS were analyzed retrospectively.Results Forty-one cases (87.23%)were cured,liver abscess after re-operation was 3 cases(6.38%),intestinal fistula,biliary fistula,pancreatic fistula was 1 case(each 2.13%),they were cured by conservative treatment,6 cases(12.77%)were died,the causes of death were nothing to do with the surgery.Conclusion For patients with severe abdominal trauma actively adopt DCS,is safe and effective,with clinical value.

Objective:To evaluate the trend and hotspots of the research on cognitive frailty in China and abroad through literature visualization analysis.Methods:Literature related to cognitive frailty were retrieved from the databases of CNKI, Wanfang, VIP and Web of Science from January 1, 2013 to August 31, 2022 with"cognitive frailty""cognitive decline"and"cognitive impairment"as retrieval terms. Based on the visualization software CiteSpace and VOSviewer, the network map analysis was conducted on the number of publications, journal distribution, country distribution and cooperation, institution distribution and cooperation and research hotspots.Results:A total of 2 500 literatures were retrieved, including 151 in Chinese and 2 349 in English. The number of publications showed an increasing trend with time. Among Chinese journals, Chin J Mod Nurs published the most literature (10 articles), while BMC Geriatr published the most literature (105 articles) in English journals. The top 5 countries in the number of English literature published were the United States (608 articles), the United Kingdom (295 articles), Italy (271 articles), China (252 articles) and Canada (195 articles). The top 5 institutions in the number of Chinese literature published were Fudan University (12 articles), Capital Medical University (10 articles), Zhengzhou University (7 articles), Central South University (5 articles) and Huazhong University of Science and Technology (5 articles). The National Center For Geriatrics Gerontology in Japan published the most English articles (74 articles). A total of 22 Chinese keywords and 44 English keywords were included. The nodes of the network analysis diagram were closely connected and highly centralized. The Chinese and English keywords“cognitive frailty”“elderly”and“frailty”were all in the core position. The Chinese emergent words were“cognitive frailty”“heart failure”“chronic disease”and“risk prediction”. The English burst terms were“cognitive frailty”“questionnaire”“cohort study”“social isolation”and“prevention”. Conclusions:The research popularity in the field of cognitive frailty is increasing year by year, and the number of articles published in English is higher than those in Chinese. At present, the main research focus is cognitive frailty, the elderly and frailty with great differences between China and abroad.