Objective　To investigate the expression differences of serum endothelial nitric oxide synthase (NOS3) and glial cell-derived neurotrophic factor (GDNF) in patients with arteriosclerotic cerebral infarction and their role in the prognosis of patients.Methods　A total of 126 patients with atherosclerotic cerebral infarction admitted to our hospital from January 2021 to January 2022 and 130 healthy people in the same period were selected.Patients were divided into groups according to infarct volume,dysfunction and prognosis,and serum NOS3 and GDNF levels were compared between different groups.ROC curve was used to analyze the predictive value of NOS3 and GDNF for poor prognosis.Results　The proportion of diabetes and hypertension in patients with atherosclerotic cerebral infarction increased,and the serum levels of NOS3 and GDNF decreased (P<0.05).There was no significant difference in the levels of NOS3 and GDNF among patients with different infarct volumes (P>0.05).The levels of NOS3 and GDNF in mild dysfunction group,moderate dysfunction group and severe dysfunction group decreased successively (P<0.05).The AUC of NOS3 and GDNF levels in predicting poor prognosis were 0.858 and 0.779,respectively.Conclusion　The serum levels of NOS3 and GDNF in patients with atherosclerotic cerebral infarction are decreased,and their levels are related to the degree of neurological impairment and prognosis of patients,which is expected to be a biological indicator to evaluate the prognosis of patients.

The prognosis of hepatocellular carcinoma (HCC) is closely associated microvascular invasion (MVI), and in recent years, more and more clinical studies have been conducted on MVI, but there are few articles on the development of basic pathology and related controversies. As the basis of clinical research, it is of great significance to understand the definition of MVI and the controversy over pathological grading. With reference to related articles, this article reviews the development history of the definition of MVI, analyzes the current status of the research on the criteria for pathological grading of MVI, and assesses the value of different criteria in predicting postoperative recurrence of HCC, so as to provide a reference for the clinical research on MVI.

【Objective】 To study the clinical practice and early outcome of percutaneous full-endoscopic modified posterior lumbar interbody fusion（mPLIF）combined with pedicle screw fixation through paraspinal muscle clearance. 【Methods】 A retrospective study was conducted to analyze the clinical data of patients with lower lumbar spinal diseases treated from May 2019 to April 2020. All the enrolled patients received mPLIF combined with pedicle screw fixation through paraspinal muscle clearance. The follow-up period was more than 1 year； the general parameters included age， gender， duration of disease， diagnosis of disease， surgery segment， and postoperative hospitalization time. Operation parameters included operation time and blood loss. We obtained the clinical parameters such as visual analogue scale （VAS） score for back and lower extremity， Oswestry disability index （ODI） score， and Macnab satisfaction score at the last follow-up. We evaluated the imaging parameters including intervertebral disc height， segmental lordosis angle， lumbar lordosis angle， as well as fusion outcome of patients with single segmental lumbar disease. In addition， intraoperative and postoperative complications were recorded. 【Results】 Totally 18 patients met the inclusion criteria， among whom 8 were male and 10 were female， with the average age of （53.3±8.3） years old and the average duration of disease being （28.9±36.6） months. Among them 16 patients were diagnosed as lumbar degenerative disease and the other 2 had lumbar disc infection. One patient received L3-L4 and L4-L5 intervertebral fusion； the others had one-segmental fusion， among which 11 cases were L4-L5 and 6 cases were L5-S1. The average operation time was （207.8±31.7） min， and the average blood loss was （25.6±7.8） mL， and the mean postoperative hospitalization time was （6.56±2.30） days. VAS scores of back and lower extremities at postoperative 1 week， 6 months and the last follow-up were statistically significantly improved from the preoperative scores. ODI scores at postoperative 6 months and the last follow-up were also statistically significantly improved. The rate of excellent and good according to the Macnab criteria was 94.4%. For the 17 single-level fusion patients， intervertebral height was significantly higher postoperatively and at the last follow-up compared with that of the preoperative one （P<0.05）. Segmental lordosis angle was bigger postoperatively and at the last follow-up （P>0.05）， which was not statistically significant. Lumbar lordosis angle was significantly bigger postoperatively （P<0.05） and bigger at the last follow-up， but with no statistical significance （P>0.05）. The fusion rate at the last follow-up was 88.2%. The cage broke in the process of implantation in one patient. A cage retroposition occurred in one patient at the follow-up. 【Conclusion】 Percutaneous full-endoscopic modified posterior lumbar interbody fusion combined with pedicle screw fixation through bilateral paraspinal muscle clearance by one incision showed excellent clinical outcomes in treating many kinds of lower lumbar diseases. This operation should be an excellent option for lower lumbar fusion.