Objective:To analyze the reoperation rate and causes during the early adoption phase of unilateral biportal endoscopy (UBE).Methods:The clinical data of 180 patients who underwent UBE performed by a single surgeon at Beijing Friendship Hospital, Capital Medical University from October 2021 to June 2023 were retrospectively analyzed. Clinical and imaging data of patients who underwent reoperation were collected to analyze the causes of reoperation, and the clinical efficacy of the reoperations was also followed up. Measurement data were expressed as mean ± standard deviation ( ± s), and t-test was used before and after treatment. Results:A total of 180 patients who underwent UBE were included in this study, of which 6 patients underwent reoperation, and the reoperation rate was 3.33%. Among them, 3 cases occurred in the first 90 surgeries and the other 3 occurred in the subsequent 90 surgeries. The causes of reoperation were as follows: recurrent lumbar disc herniation at the same segment postoperatively in 2 cases, insufficient decompression in 2 cases, disc herniation following isolated decompression in 1 case, and immediate postoperative perianal numbness in 1 case. The time between the initial surgery and reoperation ranged from 0 to 187 days, with an average of 63.3 days. The average follow-up time after reoperation was 18.3 months. The visual analogue scale (VAS) and Oswestry disability index (ODI) scores of the patients at the last follow-up were significantly improved compared with those before operation (VAS score of low back pain: 5.2 ± 1.7 before operation, 1.2 ± 0.8 at the last follow-up, P<0.001; VAS score of leg pain: 7.2 ± 1.5 before operation, 1.2 ± 1.2 at the last follow-up, P<0.001; ODI score: 67.3 ± 5.7 before operation, 20.2 ± 8.2 at the last follow-up, P<0.001). The postoperative modified MacNab scores were generally satisfactory (4 cases were rated as excellent, accounting for 66.7%; 2 cases were rated as good, accounting for 33.3%). Except for one patient who experienced dural injury during open revision surgery, there were no serious complications such as nerve damage. Conclusions:In the early stages of UBE surgery, recurrent lumbar disc herniation and inadequate decompression are the primary reasons for reoperation, typically occurring within the first three months postoperatively. Reoperation does not significantly increase the risk of nerve injury. Enhanced early postoperative follow-up is recommended. For symptomatic patients, a second surgery with thorough decompression can yield satisfactory treatment outcomes.

Objective:To apply bioinformatics methods to screen and analyze differentially expressed genes and biological processes specific to peripheral blood mononuclear cells in postmenopausal women with osteoporosis.Methods:From the Gene Expression Omnibus database, GSE56814, GSE56815, and GSE2208 datasets were screened as the research objects. The limma package in R language was used to screen differentially expressed genes, and the multigene Meta-analysis function in Metascape platform was utilized to perform enrichment analysis of gene ontology and pathway. Protein-protein interaction network construction, module analysis, core gene, and enrichment analysis will be carried out.Results:In the GSE56814 dataset, there were 84 significantly up-regulated genes and 73 significantly down-regulated genes. In the GSE56815 dataset, there were 8 significantly up-regulated genes and 33 significantly down-regulated genes. In the GSE2208 dataset, there were 21 significantly up-regulated genes and 10 significantly down-regulated genes. The multigene Meta-analysis identified 3 modules and 19 core genes in the Metascape platform. The core genes of MCODE1 included STXBP2, EIF2S2, EIF3J, PTPN6, FLNA, HLA- DQA1, CTSD, HSPA6, HLA- DPB1, EIF3E, PLEC. They mainly enriched formation of cytoplasmic translation initiation complex, antigen processing and presentation of exogenous peptide antigen via major histocompatibility complex Ⅱ, cytoplasmic translational initiation, nsp1 from SARS-CoV-2 inhibits translation initiation in the host cell, programmed cell death 1 signaling pathway, allograft rejection reaction. The core genes of MCODE2 included FOS, FOSB, EGR1, EGR2, JUNB. They mainly enriched RNA polymerase Ⅱ-specific, DNA-binding transcription activator activity, cellular response to salt, nerve growth factor-stimulated transcriptional pathways, nuclear kinase and transcription factor activation activation pathways, neurotrophic receptor tyrosine kinase 1 signaling pathway. The core genes of MCODE3 included CEBPA, H2AC6, SPI1. They mainly enriched transcriptional regulation of granulopoiesis. Conclusion:This study obtained a total of 3 modules, 19 core genes, and enriched them in the biological processes related to postmenopausal osteoporosis, providing new ideas and biological targets for exploring its occurrence pathogenesis and drug treatment.

Objective:To compare the application effects of the solution-focused nursing model (SFNM) and conventional care in the perioperative care for patients with pelvic fractures.Methods:A retrospective cohort study was conducted to analyze the clinical data of 62 patients with pelvic fractures admitted to the Third Affiliated Hospital of Southern Medical University between February 2023 and July 2023, including 41 males and 21 females, aged 26-63 years [(44.1±15.7)years]. All the patients underwent open or closed reduction and internal fixation. According to different perioperative nursing intervention, 31 patients were treated with conventional care (conventional care group) and 31 with SFNM intervention based on conventional care (SFNM group). A comparative analysis was conducted between the two groups regarding general self-efficacy scale (GSES) score, Barthel index (BI) score, self-rating anxiety scale (SAS) score, and self-rating depression scale (SDS) score preoperatively, at discharge, and at 6 months postoperatively. The excellent-to-good rate of Majeed pelvic function score and nursing satisfaction at the final follow-up and perioperative complication incidence were compared between the two group.Results:All the patients were followed up for 12-15 months [(13.5±0.9)months]. No significant differences were observed between the two groups in GSES, BI, SAS or SDS scores ( P>0.05). At discharge, the GSES and BI scores in the SFNM group were (29.0±3.8)points and (37.4±8.7)points, significantly higher than (20.9±3.0)points and (31.5±12.1)points in the conventional care group ( P<0.05); the SAS and SDS scores were (41.9±5.1)points and (40.6±4.9)points in the SFNM group, significantly lower than (53.7±9.1)points and (42.9±7.5)points in the conventional care group ( P<0.01). At 6 months postoperatively, the SFNM group achieved GSES and BI scores of (34.0±4.0)points and (40.3±9.0)points, significantly higher than (25.2±3.7)points and (35.7±10.5)points in the conventional care group ( P<0.05); the SAS and SDS scores were (45.8±5.0)points and (38.2±3.0)points in the SFNM group, significantly lower than (50.0±8.5)points and (40.7±6.5)points in the conventional care group ( P<0.01). At the final follow-up, the excellent-to-good rate of Majeed pelvic function score was 90% (28/31) in the SFNM group and 87% (27/31) in the conventional care group ( P>0.05). At the final follow-up, nursing satisfaction rate was 100% (31/31) in the SFNM group, significantly higher than 77% (24/31) in the conventional care group ( P<0.05). The perioperative complication rate was 6% (2/31) in the SFNM group, significantly lower than 38% (12/31) in the conventional care group ( P<0.05). Conclusion:Compared with conventional care, perioperative intervention with SFNM for patients with pelvic fractures can enhance self-efficacy and daily living self-care ability, reduce negative emotions such as anxiety and depression, improve nursing satisfaction, and lower the incidence of complications, making it worthy of clinical promotion.

Objective:To compare the application effects of the solution-focused nursing model (SFNM) and conventional care in the perioperative care for patients with pelvic fractures.Methods:A retrospective cohort study was conducted to analyze the clinical data of 62 patients with pelvic fractures admitted to the Third Affiliated Hospital of Southern Medical University between February 2023 and July 2023, including 41 males and 21 females, aged 26-63 years [(44.1±15.7)years]. All the patients underwent open or closed reduction and internal fixation. According to different perioperative nursing intervention, 31 patients were treated with conventional care (conventional care group) and 31 with SFNM intervention based on conventional care (SFNM group). A comparative analysis was conducted between the two groups regarding general self-efficacy scale (GSES) score, Barthel index (BI) score, self-rating anxiety scale (SAS) score, and self-rating depression scale (SDS) score preoperatively, at discharge, and at 6 months postoperatively. The excellent-to-good rate of Majeed pelvic function score and nursing satisfaction at the final follow-up and perioperative complication incidence were compared between the two group.Results:All the patients were followed up for 12-15 months [(13.5±0.9)months]. No significant differences were observed between the two groups in GSES, BI, SAS or SDS scores ( P>0.05). At discharge, the GSES and BI scores in the SFNM group were (29.0±3.8)points and (37.4±8.7)points, significantly higher than (20.9±3.0)points and (31.5±12.1)points in the conventional care group ( P<0.05); the SAS and SDS scores were (41.9±5.1)points and (40.6±4.9)points in the SFNM group, significantly lower than (53.7±9.1)points and (42.9±7.5)points in the conventional care group ( P<0.01). At 6 months postoperatively, the SFNM group achieved GSES and BI scores of (34.0±4.0)points and (40.3±9.0)points, significantly higher than (25.2±3.7)points and (35.7±10.5)points in the conventional care group ( P<0.05); the SAS and SDS scores were (45.8±5.0)points and (38.2±3.0)points in the SFNM group, significantly lower than (50.0±8.5)points and (40.7±6.5)points in the conventional care group ( P<0.01). At the final follow-up, the excellent-to-good rate of Majeed pelvic function score was 90% (28/31) in the SFNM group and 87% (27/31) in the conventional care group ( P>0.05). At the final follow-up, nursing satisfaction rate was 100% (31/31) in the SFNM group, significantly higher than 77% (24/31) in the conventional care group ( P<0.05). The perioperative complication rate was 6% (2/31) in the SFNM group, significantly lower than 38% (12/31) in the conventional care group ( P<0.05). Conclusion:Compared with conventional care, perioperative intervention with SFNM for patients with pelvic fractures can enhance self-efficacy and daily living self-care ability, reduce negative emotions such as anxiety and depression, improve nursing satisfaction, and lower the incidence of complications, making it worthy of clinical promotion.

Objective:To investigate the effectiveness of the modified Bikini approach in the fixation of acetabular fracture with an integrated wing-shaped anatomical locking plate.Methods:A retrospective study was conducted to analyze the data of 54 patients with acetabular fracture who had been treated at Department of Trauma Orthopedics, Orthopedic Medical Center, The Third Hospital Affiliated to Southern Medical University from May 2017 to June 2021. The patients were divided into 2 groups based on different surgical approaches: an observation group [26 cases, 6 males, 20 females; aged 40.0 (29.8, 46.8) years] treated with fixation with an integrated wing-shaped anatomical locking plate through the modified Bikini approach, and a control group [28 cases, 10 males, 18 females; aged 34.5 (24.0, 43.5) years] treated with fixation with an integrated wing-shaped anatomical locking plate through the lateral-rectus approach. The incision length, operation time, intraoperative bleeding, length of hospital stay, quality of postoperative fracture reduction, visual analog scale (VAS) for pain, hip function, Vancouver Scar Scale (VSS) and Patient and Observer Scar Assessment Scale (POSAS) were compared between the 2 groups.Results:The differences in the preoperative general data between the 2 groups were not statistically significant, indicating comparability ( P>0.05). There were no statistically significant differences between the 2 groups either in terms of incision length, operation time, intraoperative bleeding, or hospital stay ( P>0.05). The 2 groups were not significantly different in the excellent/good rate of fracture reduction [100.0% (26/26) versus 92.9% (26/28)], VAS at 1 month postoperation [2.0(1.0, 3.0) versus 2.0(1.0, 3.0)], or the modified Merle d'Aubigné and Postel hip score at 12 months postoperation [13.5(12.3, 14.8) versus. 14.0(13.0, 15.0)] ( P>0.05). However, the VSS [4.50(4.00, 6.00)] and POSAS (29.85±10.05) at 12 months postoperation in the observation group were significantly lower than those in the control group [6.50(5.00, 8.25) and 37.11±11.75] ( P<0.05). Conclusion:In the fixation of acetabular fracture with an integrated wing-shaped anatomical locking plate, the modified Bikini approach can not only achieve as fine early clinical efficacy as the lateral-rectus approach, but also demonstrate the aesthetic advantages of smaller incision scar and more hidden incision.

Objective:To investigate the current situation of the use of transjugular intrahepatic portosystemic shunt (TIPS) for portal hypertension, which should aid the development of TIPS in China.Methods:The China Portal Hypertension Alliance (CHESS) initiated this study that comprehensively investigated the basic situation of TIPS for portal hypertension in China through network research. The survey included the following: the number of surgical cases, main indications, the development of Early-TIPS, TIPS for portal vein cavernous transformation, collateral circulation embolization, intraoperative portal pressure gradient measurement, commonly used stent types, conventional anticoagulation and time, postoperative follow-up, obstacles, and the application of domestic instruments.Results:According to the survey, a total of 13 527 TIPS operations were carried out in 545 hospitals participating in the survey in 2021, and 94.1% of the hospital had the habit of routine follow-up after TIPS. Most hospitals believed that the main indications of TIPS were the control of acute bleeding (42.6%) and the prevention of rebleeding (40.7%). 48.1% of the teams carried out early or priority TIPS, 53.0% of the teams carried out TIPS for the cavernous transformation of the portal vein, and 81.0% chose routine embolization of collateral circulation during operation. Most of them used coils and biological glue as embolic materials, and 78.5% of the team routinely performed intraoperative portal pressure gradient measurements. In selecting TIPS stents, 57.1% of the hospitals woulel choose Viator-specific stents, 57.2% woulel choose conventional anticoagulation after TIPS, and the duration of anticoagulation was between 3-6 months (55.4%). The limitation of TIPS surgery was mainly due to cost (72.3%) and insufficient understanding of doctors in related departments (77.4%). Most teams accepted the domestic instruments used in TIPS (92.7%).Conclusions:This survey shows that TIPS treatment is an essential part of treating portal hypertension in China. The total number of TIPS cases is far from that of patients with portal hypertension. In the future, it is still necessary to popularize TIPS technology and further standardize surgical indications, routine operations, and instrument application.

As China's manned space missions gradually develop towards long-term residence and deep space exploration,astronauts will face increasingly severe psychological challenges.As a psychological adjustment method involving multiple disciplines such as music,psychology,and medicine,music therapy has the advantages of being convenient to implement,cost-effective,and highly personalized.This paper integrates the concept of music therapy and explores the research progress of music therapy in regulating psychological states in aspects such as physiology,emotional regulation,cognitive ability,and interpersonal relationships.Combined with the mechanism of action of music therapy and the practical situation in the field of manned spaceflight,it aims at the future development trends and problems to be solved,to construct a music therapy system for astronauts during on-orbit flight and ground daily training.This will help astronauts achieve healthy physical and mental development and promote the completion of missions.

Objective:To investigate the efficacy of intelligent visualization system (HoloSight Intelligent Visualization System) assisted reduction and screw fixation in the treatment of elderly pelvic fragility fracture.Methods:From January 2016 to December 2022, clinical data of 18 elderly patients aged over 75 years with pelvic fragility fractures surgically treated by our team were retrospectively analyzed. Among them, 11 cases were treated with closed reduction and hand-inserted percutaneous screw fixation to fix the posterior pelvic ring (control group), and 7 cases were treated with the assistance of the HoloSight intelligent visualization system for reduction and minimally invasive fixation (experimental group). In the control group, there were 3 males and 8 females with an age range of 75-94 years (mean age, 82±12 years). The pelvic fractures were classified as FFP type IIIa in 5 cases, IIIb in 2 cases, IIIc in 3 cases, and IV in 1 case. In the experimental group, there were 1 male and 6 females with an age range of 76-100 years (mean age. 83±14 years). The pelvic fractures were classified as FFP type IIIa in 4 cases, IIIc in 2 cases, and IV in 1 case. The surgical time, blood loss, effective intraoperative fluoroscopy times, fracture reduction quality (according to Matta standards), visual analogue scale (VAS), limb function rehabilitation (Majeed score) and postoperative complications were recorded and evaluated in both groups.Results:All patients underwent surgery successfully and were followed up for 6 months to 3 years(12 months on average), all pelvic fractures healed. Among the 7 cases of experimental group, a total of 13 screws were placed, and the adjustment times of guide pin for each screw were 3±1 times (range, 1-5 times), while 18 screws of the control group with the adjustment times of 7±2 times (range, 4-10 times), statistical difference was present ( t=6.99, P<0.001). The surgical time in experimental group (63±12 min) was shorter than that in control group 88±23 min, while effective intraoperative fluoroscopy times in experimental group (9±3 times) was less than that in control group (35±7 times), the difference were both statistically significant ( t=2.69, P=0.016; t=9.22, P<0.001). The intraoperative blood loss was 38±12 ml in the experimental group and 55±26 ml in control group, with no significant difference ( t=1.61, P=0.127). According to Matta's reduction criteria after surgery, the results of experimental group were excellent in 4 cases, good in 2, and fair in 1, while the result of control group were excellent in 5 cases, good in 3, fair in 2, and poor in 1. At the last follow-up, among the patients in experimental group, the Majeed score was 84±11, excellent in 3 cases, good in 2, and fair in 2. In control group, the score was 79±17, with excellent in 5 cases, good in 3, fair in 3. No statistical difference was observed in two groups ( t=0.69, P=0.501). The VAS was 6.4±2.6 preoperatively and 2.4±0.8 postoperatively in the experimental group, while in the control group was 6.9±3.1 preoperatively and 2.7±1.3 postoperatively, the data suggested an improvement in both groups ( t=3.89, P=0.002; t=4.14, P<0.001), while no statistical significant was observed in two groups at last follow-up ( t=0.55, P=0.593). Two cases of experimental group had loosening or withdrawal of the fixation screws in 9 and 12 months, but the fractures healed. Four cases of control group loose fixation screws in 4, 6, 9, and 12 months, two cases underwent revision surgery and other two cases healed. Conclusion:Intelligent visualization system assisted reduction and screw fixation in the treatment of elderly pelvic fragility fractures have the advantages of good reduction, accurate nail placement, less bleeding, less effective fluoroscopy, which improves the safety of surgery.

Objective:To investigate the clinical efficacy of pancreaticoduodenectomy with TRIANGLE operation in the treatment of pancreatic head cancer.Methods:The retrospective cohort study was conducted. The clinicopathological data of 51 patients with pancreatic head cancer who were admitted to the Sichuan Provincial People′s Hospital, Affiliated Hospital of School of Medicine of University of Electronic Science and Technology of China from January 2017 to July 2018 were collected. There were 33 males and 18 females, aged from 42 to 74 years, with a median age of 56 years. Of the 51 patients, 24 cases undergoing standard pancreaticoduodenectomy, in which No.12, 13 and 17 lymph nodes were dissected, combined with transcatheter arterial infusion chemo-therapy (TAI) were allocated into the standard group, and 27 cases undergoing pancreaticoduo-denectomy with TRIANGLE operation, in which No.7, 8, 9, 12, 13, 16, 17 lymph nodes were dissected, combined with TAI were allocated into the TRIANGLE group, respectively. Observation indicators: (1) intraoperative conditions of the two groups; (2) postoperative conditions of the two groups; (3) follow-up and survival. Follow-up was conducted using outpatient examination and telephone interview once three months to detect tumor recurrence and metastasis and survival of patients up to July 2021 or the death of patient. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was analyzed using the chi-square test or the Fisher exact probability. Comparison of ordinal data was analyzed using the rank sum test. Kaplan‐Meier method was used to calculate the survival rate and median survival time and draw survival curve. Log‐Rank test was used for survival analysis. Results:(1) Comparison of intraoperative conditions between the two groups. The operation time, volume of intraoperative blood loss, cases with intraoperative blood transfusion were (501±61)minutes, (563±278)mL, 4 in the standard group, versus (556±46)minutes, (489±234)mL, 6 in the TRIANGLE group, respectively. There was a significant difference in the operation time between the two groups ( t=3.62, P<0.05) but there was no significant difference in the volume of intraoperative blood loss or cases with intraoperative blood transfusion between the two groups ( t=1.03, χ2=0.25, P>0.05). (2) Comparison of postoperative conditions between the two groups. Of the 51 patients, 30 had 50 times of postoperative complications, including 18 times of grade Ⅰ complications of Clavien-Dindo classification, 29 times of grade Ⅱ complications of Clavien-Dindo classification, 2 times of grade Ⅲa complications of Clavien-Dindo classification, 1 time of grade Ⅲb complications of Clavien-Dindo classification, respectively. Cases with postoperative complications, cases with delayed gastric emptying, cases without or with pancreatic fistula as class A or class B, cases with biliary fistula, cases with bleeding, cases with diarrhea were 15, 4, 13, 7, 4, 4, 2, 2 in the standard group, versus 15, 6, 14, 10, 3, 4, 1, 3 in the TRIANGLE group, respectively. There was no significant difference in cases with postoperative complications, cases with delayed gastric emptying, cases with pancreatic fistula between the two groups ( χ2=0.16, 0.02, Z=-0.04, P>0.05) and there was no significant difference in cases with biliary fistula, cases with bleeding, cases with diarrhea between the two groups ( P>0.05). Cases with complications as Clavien-Dindo grade Ⅰ, grade Ⅱ, grade Ⅲ were 10, 11, 2 in the standard group, versus 8, 18, 1 in the TRIANGLE group, showing no significant difference between the two groups ( Z=-0.67, P>0.05). The duration of postoperative hospital stay was (23±8)days in both of the standard group and the TRIANGLE group, showing no significant difference between the two groups ( t=0.31, P>0.05). (3) Follow-up and survival. All the 51 patients were followed-up for 6 to 54 months, with a median follow-up time of 17 months. The postoperative 1-year overall survival rate was 75.0% and 81.5% in the standard group and the TRIANGLE group, respectively. The postoperative 3-year overall survival rate was 12.5% and 22.2% in the standard group and the TRIANGLE group, respectively. The median postoperative survival time was 15.00 months (95% confidence interval as 12.63 to 17.37 months) and 21.00 months (95% confidence interval as 15.91 to 19.62 months) in the standard group and the TRIANGLE group, respectively. There was a significant difference in survival of patients between the two groups ( χ2=4.30, P<0.05). Cases with tumor recurrence during post-operative 1 year and 3 year were 9 and 20 in the standard group, versus 6 and 15 in the TRIANGLE group, respectively. There was no significant difference in cases with tumor recurrence during postoperative 1 year between the two groups ( P>0.05) and there was a significant difference in cases with tumor recurrence during postoperative 3 year between the two groups ( P<0.05). Conclusion:Compared with standard pancreaticoduodenectomy, pancreaticoduodenectomy with TRIANGLE operation can prolong the median survival time of patients with pancreatic head cancer without increasing surgical related complications.

Objective:To investigate clinical efficacy of conformal sphincter preservation operation (CSPO) versus intersphincteric resection (ISR) in the treatment of low rectal cancer.Methods:The retrospective cohort study was conducted. The clinicopathological data of 183 patients with low rectal cancer who were admitted to two medical centers (117 in the Changhai Hospital of Naval Medical University and 66 in the Huashan Hospital of Fudan University) from August 2011 to April 2020 were collected. There were 110 males and 73 females, aged (57±11)years. Of 183 patients, 117 cases undergoing CSPO were allocated into CSPO group, and 66 cases undergoing ISR were allocated into ISR group, respectively. Observation indicators: (1) surgical situations of patients with low rectal cancer in the two groups; (2) postoperative complications of patients with low rectal cancer in the two groups; (3) follow-up; (4) influencing factors for prognosis of patients with low rectal cancer; (5) influencing factors for satisfaction with the anal function of patients with low rectal cancer. Follow-up was conducted using outpatient examination, questionnaire and telephone interview to determine local recurrence, distal metastasis, survival, stomal closure, satisfaction with the anal function of patients. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M (range). Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test. Comparison of ordinal data was analyzed using the rank sum test.The Kaplan-Meier method was used to draw survival curves, and life table method was used to calculate survival rates. Log-rank test was used for survival analysis. Univariate analysis was performed using the linear regression. Variables with P<0.10 in the univariate linear regression analysis were included for multivariate analysis. Multivariate analysis was performed using the COX stepwise regression model and linear regression analysis. Results:(1) Surgical situations of patients with low rectal cancer in the two groups: cases with laparoscopic surgery, operation time, volume of intraoperative blood loss, distance from tumor to distal margin, cases with postoperative chemotherapy, duration of postoperative hospital stay were 44, (165±54)minutes, (142±101)mL, (0.6±0.4)cm, 76, (6.6±2.5)days for the CSPO group, respectively, versus 55, (268±101)minutes, (91±85)mL, (1.9±0.6)cm, 9, (7.9±4.7)days for the ISR group, showing significant differences between the two groups ( χ2=35.531, t=8.995, -3.437, -3.088, χ2=44.681, t=2.267, P<0.05). (2) Postoperative complications of patients with low rectal cancer in the two groups: 19 patients in the CSPO group had complications. There were 6 cases with grade Ⅰ complications, 12 cases with grade Ⅱ complications, 1 case with grade Ⅲb complication. Fourteen patients in the ISR group had complications. There were 4 cases with grade Ⅰ complications, 7 cases with grade Ⅱ complications, 1 case with grade Ⅲa complication, 2 cases with grade Ⅲb complications. There was no significant difference in the postoperative complications between the two groups ( χ2=0.706, P>0.05). Patients with complications in the two groups were improved after symptomatic and supportive treatment. There was no perioperative death in the postoperative 30 days of the two groups. (3) Follow-up: 183 patients received follow-up. Patients of the CSPO group and ISR group were followed up for (41±27)months and (37±19)months, respectively, showing no significant difference between the two groups ( t=-1.104, P>0.05). There were 2 cases with local recurrence and 9 cases with distal metastasis of the CSPO group, respectively, versus 3 cases and 4 cases of the ISR group, showing no significant difference between the two groups ( χ2=1.277, 0.170, P>0.05). The 3-year disease-free survival rate and 3-year total survival rate were 84.0% and 99.0% for the CSPO group, versus 88.6% and 92.8% for the ISR group, showing no significant difference between the two groups ( χ2=0.218, 0.002, P>0.05). The stomal closure rate was 92.16%(94/102) and 96.97%(64/66) for 102 patients of CSPO group and 66 patients of ISR group up to postoperative 12 months,respectively, showing no significant difference between the two groups ( χ2=1.658, P>0.05). Of the 8 cases without stomal closure in the CSPO group, 2 cases refused due to advanced age, 4 cases subjectively refused, and 2 cases were irreducible due to scar caused by radiotherapy. Two cases in the ISR group had no stomal closure including 1 case of postoperative liver metastasis and 1 case of subjective refusal. There were 92 and 61 patients followed up to 12 months after stomal closure, of which 75 cases and 38 cases completed questionnaires of satisfaction with the anal function. The satisfaction score with the anal function was 6.8±2.8 and 5.4±3.0 for CSPO group and ISR group, respectively, showing a significant difference between the two groups ( t=-2.542, P<0.05). Fifty-four cases in the CSPO group and 21 cases in the ISR group had satisfaction score with the anal function >5, showing no significant difference between the two groups ( χ2=3.165, P>0.05). (4) Influencing factors for prognosis of patients with low rectal cancer: results of COX stepwise regression analysis showed that gender and pT staging were independent influencing factors for disease-free survival rate of patients with low rectal cancer ( hazard ratio=2.883, 1.963, 95% confidence interval as 1.090 to 7.622, 1.129 to 3.413, P<0.05). Gender and pT staging were independent influencing factors for total survival rate of patients with low rectal cancer ( hazard ratio=10.963,3.187, 95% confidence interval as 1.292 to 93.063, 1.240 to 8.188, P<0.05). (5) Influencing factors for satisfaction with the anal function of patients with low rectal cancer: results of univariate analysis showed that surgical method and tumor differentiation degree were related factors for satisfaction with the anal function of patients with low rectal cancer (partial regression coefficient=1.464, -1.580, 95% confidence interval as 0.323 to 2.605, -2.950 to -0.209, P<0.05). Results of multivariate analysis showed that surgical method, tumor differentiation degree and preoperative radiotherapy were independent influencing factors for satisfaction with the anal function of patients with low rectal cancer (partial regression coefficient=1.637, -1.456, -1.668, 95% confidence interval as 0.485 to 2.788, -2.796 to -0.116, -2.888 to -0.447, P<0.05). Conclusion:Compared with ISR, CSPO can safely preserve the anus in the treatment of low rectal cancer, without increasing the incidence of postoperative complications, which can also guarantee the oncological safety and improve the postoperative anal function.