Ninety nine patients with trigeminal neuralgia (TN,n =59) or hemifacial spasm (HFS,n =40) underwent microvascular decompression (MVD) treatment in our hospital from January 2012 to December 2015,and were followed up for more than 1 year.Total 94 patients (94.9％) were cured after the surgery,including 55 TN cases (93.2％) and 39 HFS cases (97.5％).The 1-year follow up showed that total 98 patients (99.0％) were cured,including 58 TN cases (98.3％) and 40 HFS cases (100.0％).Among the HFS cases,1 patient got gentle spasm,1 patient got hearing deficit,1 patient got light facial palsy after the operation,and all recovered completely during the follow-up.Among the TN cases,4 patients got pain attack infrequently after the operation,3 of them recovered during the follow-up,and the symptoms were satisfactorily controlled by taking carbamazepine in rest 1 case.No cases had cerebrospinal fluid leakage or intracerebral infection.The results indicate that MVD is an effective treatment of HFS and TN with less surgical injury or complications.

Objective To investigate the expression and clinical significance of α-actinin-1 protein (ACTN1) in prostate cancer (PCa) and prostatic hyperplasia (BPH). Methods The clinical data of patients with PCa or BPH treated in our school affiliated hospital were collected between January 2007—October 2014, according to certain criteria. Immunohistochemistry method was used to detect the expression of ACTN1 in 30 samples of PCa and 30 samples of BPH tissues. Western blot assay was used to detect the relative expression of ACTN1 in 18 samples of PCa and 20 samples of BPH tissues in two groups. Results The result of immunohistochemistry showed that the positive expression rates of ACTN1 were 76.7%and 20%in PCa and BPH groups respectively. The difference was statistically significant (P<0.01). Western blot assay showed that the relative expression of ACTN1was significantly higher in PCa group (0.591±0.182) than that in BPH group (0.037 ± 0.052, P < 0.05). There was no significant difference in expression level of ACTN1 between different age groups. There was no significant difference in serum prostate specific antigen (PSA) level between patients with or without bone metastasis, and patients with or without lymph node metastasis (P > 0.05). There were significant differences in ACTN1 levels between different Gleason score and T staging groups (P<0.05). Conclusion The expression ofα-actinin-1 is significantly higher in PCa tissues than that in BPH tissues. There is the relationship between expression of ACTN1, Gleason scores and T staging.

Objective:To investigate the risk factors for overall survival in operable hepatocellular carcinoma with portal vein tumor thrombus (PVTT-HCC) patients and establish a scoring system.Methods:Survival data in 253 PVTT-HCC patients were retrospectively analyzed in Guangxi Medical University Affiliated Tumor Hospital. Survival curves were analyzed using the Kaplan-Meier method and log-rank test. Cox stepwise regression analysis was used to identify independent preoperative risk factors affecting overall survival. A prognostic scoring system based on independent risk factors and their relative coefficients was established to screen patients with greater hepatic resection benefits, and the identification ability of the model was based on ROC.Results:A total of 253 patients with PVTT-HCC were enrolled in this study, there were 222 males and 31 females, with a median age 44 years. The median survival time in all patients was (13.00±2.15) months. Rate of overall survival was 51.8% at 1 year, 25.0% at 3 years and 17.7% at 5 years. Multivariable Cox regression analyses showed four risk factors including: AST≥40 U/L, ALP (≥80 U/L), tumor number (>1), and incomplete tumor capsule. A prognostic scoring system was established based on these variables. The area under curve of the scoring system was 0.780 (95% CI: 0.715-0.845). Patients were classified as low- or high-risk group for hepatic resection depending on whether their score was <3 ( n=77) or ≥3 ( n=176), respectively. High-risk patients had a median survival of 10 months, compared to 29 months in low-risk patients. Low-risk patients also had better survival rates at 1 year (75.3% vs 41.5%), 3 years (47.6% vs 15.2%), and 5 years (34.7% vs 10.5%), P<0.05. Conclusion:A prognostic scoring system for hepatic resection in PVTT-HCC patients has been developed based entirely on preoperative variables. Using this system, patients belong to the low risk group have better prognosis after surgery, which can provide a basis for surgical treatment of PVTT-HCC patients.

Objective:To explore the independent risk factor for in-hospital mortality of patients with multiple trauma, and to construct a prediction model of risk of death and validate its efficacy.Methods:A retrospective cohort study was performed to analyze the clinical data of 1 028 patients with multiple trauma admitted to Affiliated Hospital of Jiangsu University from January 2011 to December 2021. There were 765 males and 263 females, aged 18-91 years[(53.8±12.4)years]. The injury severity score (ISS) was 16-57 points [(26.3±7.6)points]. There were 153 deaths and 875 survivals. A total of 777 patients were enrolled as the training set from January 2011 to December 2018 for building the prediction model, while another 251 patients were enrolled as validation set from January 2019 to December 2021. According to the outcomes, the training set was divided into the non-survival group (115 patients) and survival group (662 patients). The two groups were compared in terms of the gender, age, underlying disease, injury mechanism, head and neck injury, maxillofacial injury, chest injury, abdominal injury, extremity and pelvis injury, body surface injury, damage control surgery, pre-hospital time, number of injury sites, Glasgow coma score (GCS), ISS, shock index, and laboratory test results within 6 hours on admission, including blood lactate acid, white blood cell counts, neutrophil to lymphocyte ratio (NLR), platelet counts, hemoglobin, activated partial thromboplastin time (APTT), fibrinogen, D-dimer and blood glucose. Univariate analysis and multivariate Logistic regression analysis were performed to determine the independent risk factors for in-hospital mortality in patients with multiple trauma. The R software was used to establish a nomogram prediction model based on the above risk factors. Area under the receiver operating characteristic (ROC) curve (AUC), calibration curve and clinical decision curve analysis (DCA) were plotted in the training set and the validation set, and Hosmer-Lemeshow goodness-of-fit test was performed.Results:Univariate analysis showed that abdominal injury, extremity and pelvis injury, damage control surgery, GCS, ISS, shock index, blood lactic acid, white blood cell counts, NLR, platelet counts, hemoglobin, APTT, fibrinogen, D-dimer and blood glucose were correlated with in-hospital mortality in patients with multiple trauma ( P<0.05 or 0.01). Logistic regression analysis showed that GCS≤8 points ( OR=1.99, 95% CI 1.12,3.53), ISS>25 points ( OR=7.39, 95% CI 3.50, 15.61), shock index>1.0 ( OR=3.43, 95% CI 1.94,6.08), blood lactic acid>2 mmol/L ( OR=9.84, 95% CI 4.97, 19.51), fibrinogen≤1.5 g/L ( OR=2.57, 95% CI 1.39,4.74) and blood glucose>10 mmol/L ( OR=3.49, 95% CI 2.03, 5.99) were significantly correlated with their in-hospital mortality ( P<0.05 or 0.01). The ROC of the nomogram prediction model indicated that AUC of the training set was 0.91 (95% CI 0.87, 0.93) and AUC of the validation set was 0.90 (95% CI 0.84, 0.95). The calibration curve showed that the predicted probability was consistent with the actual situation in both the training set and validation set. DCA showed that the nomogram prediction model presented excellent performance in predicting in-hospital mortality. In Hosmer-Lemeshow goodness-of-fit test, χ2 value of the training set was 9.69 ( P>0.05), with validation set of 9.16 ( P>0.05). Conclusions:GCS≤8 points, ISS>25 points, shock index>1.0, blood lactic acid>2 mmol/L, fibrinogen≤1.5 g/L and blood glucose>10 mmol/L are independent risk factors for in-hospital mortality in patients with multiple trauma. The nomogram prediction model based on these 6 predictive variables shows a good predictive performance, which can help clinicians comprehensively assess the patient′s condition and identify the high-risk population.

Objective:To explore the application effect of intelligent nursing information system in health education for patients with brain glioma.Methods:Using the convenient sampling method, a total of 100 patients with brain glioma who were admitted to Beijing Tiantan Hospital, Capital Medical University from December 2018 to December 2019 were selected as the research objects. According to the random number table method, they were divided into the observation group and the control group, with 50 cases in each group. The control group adopted the conventional model for health education, while the observation group adopted intelligent nursing information system for health education. The cognition level of disease, quality of life and nursing satisfaction were compared between the two groups.Results:The cognition level of disease, quality of life and nursing satisfaction of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The application of intelligent nursing information system in health education for patients with brain glioma can improve cognition level of disease and nursing satisfaction of patients and improve the quality of life of patients so as to provide a new health education model for clinical nursing work.

Objective:To investigate the risk factors for abdominal infection after liver transplantation (LT).Methods:The retrospective case-control study was conducted. The clinical data of 356 patients who underwent LT in the First Affiliated Hospital of Xi′an Jiaotong University from January 2015 to December 2018 were collected. There were 273 males and 83 females, aged from 21 to 67 years, with the median age of 46 years. Observation indications: (1) abdominal infec-tion after LT and distribution of pathogens; (2) analysis of risk factors for abdominal infection after LT; (3) follow-up and survival. Follow-up was performed using outpatient examination and tele-phone interview to detect postoperative 1-year survival rate and cases of death up to June 2020. Measurement data with normal distribution were represented as Mean±SD. Measurement data with skewed distribution were described as M(range). Count data were expressed as absolute numbers or percentages. Univariate analysis was conducted using the chi-square test, t test, Mann-Whitney U test and Fisher exact probability. Multivariate analysis was done using the Logistic regression model. The Kaplan-Meier method was used to calculate sruvival time and survival rates. Log-Rank test was used for survival analysis. Results:(1) Abdominal infection after LT and distribution of pathogens: 63 of 356 recipients had abdominal infection after LT, with the overall incidence of 17.70%(63/356). Of the 63 recipients, 41 cases had abdominal infection within postoperative 2 weeks, 17 cases had multi-drug resistant organism infection. A total of 116 strains of bacteria were isolated from 63 recipients with abdominal infection, 52 of which were gram-negative bacteria, 48 were gram-positive bacteria, 16 were fungi. (2) Analysis of risk factors for abdominal infection after LT: results of univariate analysis showed that preoperative model for end-stage liver disease (MELD) score, preoperative serum albumin, preoperative leukocytes, preoperative prothrombin time, preoperative alanine aminotransferase, preoperative aspartate aminotransferase, operation time, volume of intraoperative blood loss, days of postoperative antibiotic use, postoperative renal failure, postoperative delayed graft function,duration of postoperative intensive care unit stay were related factors for abdominal infection after LT ( Z=-2.456, t=-1.982, Z=-3.193, -2.802, -2.336, -2.276, -2.116, -3.217, χ2=15.807, 10.395, 6.750, Z=-4.468, P<0.05). Liver retransplantaiton and postoperative bile leakage were related factors for abdominal infection after LT ( P<0.05). Results of multivariate analysis showed that preoperative MELD score>20 and liver retransplantation were independent risk factors for abdominal infection after LT ( odds ratio=2.871, 12.875, 95% confidence interval as 1.106-7.448, 1.290-128.521, P<0.05). (3) Follow-up and survival: 356 recipients were followed up for 1-66 months, with a median follow-up time of 32 months. The postoperative 1-year overall survival rate of 63 recipients with abdominal infection and 293 recipients without abdominal infection were 84.60% and 97.03%, respectively, showing a significant difference ( χ2=11.660, P<0.05). During the follow-up, 58 recipients died. Conclusion:Preoperative MELD score>20 and liver retransplantation are independent risk factors for abdominal infection after LT.

Objective To investigate the effects of inverse ratio ventilation on pulmonary function and ce-rebral oxygen saturation in elderly patients with single lung ventilation.Methods Sixty patients scheduled for elec-tive radical resection of esophageal cancer were divided into 2 groups(n=30 for each group)using a random num-ber table:the experiment group(group A)and the control group(group B). During the two lung ventilation,the ventilator parameters were set as tidal volume(VT)7 mL/kg,inspiratory to expiratory ratio 1:2. During one lung ventilation,the I:E ratio was 1.5:1 in the group A and 1:2 in the group B. At 15 min after two lung ventilation (T1),20 min after one lung ventilation(T2),60 min after one lung ventilation(T3)and 15 min after restarting two-lung ventilation(T4),the blood gas analysis was measured and recorded for the hemodynamics,respiratory me-chanics index and cerebral oxygen saturation respectively. Results Compared with the B group,the Ppeak and VD/VT at T2~T4in the group A were lower while PaO2,Pmean and Cdyn were higher(P<0.05).During one lung ventilation,the incidence of rSO2< 50% or rSO2decreased more than 20% in the group A was lower than that in the group B(P<0.05).The PaO2,Cdyn and rSO2of the two groups at T2~T4were significantly lower and Ppeak, Pmean,PaCO2,VD/VT were significantly higher than the baseline(T1)(P < 0.05). Conclusion During one-lung ventilation,prolonged inspiratory time can improve pulmonary function and lung compliance without increas-ing peak airway pressure,reduce the decline of rSO2 at the same time.

This article reported the diagnosis and treatment process of a patient with diffuse infiltrating venous malformation on right lower extremity, perineum and buttock. This is a 14 years old female patient, presented with painless dark blue mass on right perineum, buttock, thigh and leg, after birth. The right perineum lost its normal appearance and the right lower extremity was thicker than contralateral. Imaging examination suggested venous malformations of perineum, buttock and right lower extremity. Anhydrous ethanol combined with lauromacrogol was used to embolize the venous malformations by several times. The patient was satisfied with the treatment outcome, and there was recurrence within a year.

Objective To explore the clinical application of antcrolateral thigh flap transplantation in repairing wound around the knee with descending genicular artery as the recipient vessel,when anterior or posterior tibial vessel could not be utilized.Methods From January,2015 to May,2017,free anterolateral thigh flaps obtained from anastomosis of descending genicular artery and great saphenous vein were transplanted to repair the skin soft tissue defect around the knee combined with tendon and bone exposure in 7 patients,after preoperative color Doppler sonography ultrasound (CDU) for precise positioning.There were 4 males and 3 females,with the flap area ranging from 18.0 cm×8.0 cm-38.0 cm×8.0 cm.All of the donor sites were sutured directly.Postoperative followedup was done termly.Results All the patients were followed-up for 6 to 14 months,with an average of 8.9 months.Typically,2 cases had large defect areas,with distal flap necrosis of 6.0 cm and 4.0 cm,respectively,which were resected and achieved secondary skin graft healing on the residual surface.Additionally,4 cases had completely survived flaps and achieved secondary skin graft healing on the residual surface.The remaining 1 case had completely survived flap,but the distal flap near the anteromedial tibia developed bone exposure as a result of the complicated osteomyelitis.As a result,the patient received gastrocnemius myocutaneous flap to repair the wound.Conclusion Anterolateral thigh flap transplantation in repairing skin soft tissue defect wound around the knee,with descending genicular artery as the recipient vessel,can achieve satisfactory clinical efficacy,which can serve as one choice for flap repair in wound around the knee.

Objective:To investigate the effect of the pedicled pericranial flap in the treatment of chronic cerebrospinal fluid leakage.Methods:A retrospective analysis was conducted based on the clinical data of patients with cerebrospinal fluid leakage after craniocerebral surgery who were admitted to the First People’s Hospital of Yichang from April 2016 to October 2020. The necrotic tissues were thoroughly removed. The dural defects were repaired with pedicled pericranial flaps, and soft tissue defects were repaired with local flaps. The incision was covered with negative pressure closed drainage dressing, and negative pressure was maintained at -50 to -80 mmHg (1 mmHg=0.133 kPa). Cerebrospinal fluid leakage, defect repair, and related complications were observed in postoperative follow-up.Results:A total of five patients (three males and two females, aged 49-65 years) were included. All patients had postoperative composite tissue defects with local infection after craniocerebral surgery, lasting two months to 12 years. The size of the postoperative dural defect ranged from 1.5 cm × 2.0 cm to 2.5 cm × 3.0 cm. The size of the scalp soft tissue defect ranged from 2.0 cm × 2.0 cm to 3.0 cm × 6.0 cm. The size of the pericranial flap ranged from 2.0 cm × 3.0 cm to 3.0 cm × 3.5 cm, and the local flap ranged from 8.0 cm × 13.0 cm to 12.0 cm × 16.0 cm. The cerebrospinal fluid leakage was still observed in one patient at 5 d after the surgery and was treated with continuous lumbar pool puncture for cerebrospinal fluid drainage, which healed one week later. One patient suffered from poor healing of the flap incision, which healed after two weeks of outpatient dressing changing. At the postoperative follow-up of 3 to 17 months, none had any further cerebrospinal fluid leakage, and no other complications such as intracranial infection, loss of frontal lines, scalp numbness, and necrosis occurred.Conclusions:Repair of dural defects by pedicled pericranial flaps can treat chronic cerebrospinal fluid leakage with less damage to the donor site and fewer complications.