Objective To investigate the anatomical foundation of endoscopic surgical approach of transmandibular angle to jugular foramen region.Methods Five wet cadaveric head specimens were collected and dissected through the endoscopic surgical approach of transmandibular angle to jugular foramen region.The relevant anatomical structures were observed and the depth and angle of operation were measured.Results A pedicled mandibular angle bone flap was formed by this surgical approach,and the length was(23.74±0.95)mm,the width was(18.95±0.56)mm.The operative depth after displacement of the mandibular angle bone flap was(8.54±0.55)mm,the operative depth after reduction of the mandibular angle bone flap was(24.94±0.90)mm,and the difference was statistically significant(P<0.05).The operative angle after displacement of the mandibular angle bone flap was(69.60±3.30)°,and the operative angle after reduction of the mandibular angle bone flap was(26.20±2.20)°,and the difference was statistically significant(P<0.05).Conclusion The endoscopic surgical approach of transmandibular angle to jugular foramen region forms pedicled mandibular angle bone flap,which can increase the operation angle,shorten the operation depth and improve the freedom of operation.This surgical approach is worthy of further study and discussion in clinical practice.

Objective To investigate the clinical efficacy of dual-layer artificial dermis combined with vacuum sealing drainage and autologous split-thickness skin graft in the treatment of chronic refractory wounds.Methods A total of 60 patients with chronic refractory wounds were prospectively selected and divided into the control group(30 cases)and the observation group(30 cases)according to random number table method.In the control group,patients were treated with simple vacuum sealing drainage in the first phase and autologous split-thickness skin graft in the second phase.In the observation group,patients received dual-layer artificial dermis combined with vacuum sealing drainage in the first phase and autologous split-thickness skin graft in the second phase.The survival of autologous split-thickness skin,the incidence of adverse reactions,and the degree of scarring[Vancouver scar scale(VSS)score]of patients in the two groups were observed.The degree of pain before and after treatment[visual analogue scale(VAS)score],serum matrix metalloproteinase 13(MMP-13)level,serum tissue inhibitor of metalloproteinase 1(TIMP-1)level,and MMP-13/TIMP-1 ratio of patients in the two groups were compared before and after treatment.Results After treatment,the survival rate of autologous split-thickness skin in the observation group was better than that in the control group,the incidence of adverse reactions,the VSS score of the graft site and the donor site,and the pain degree in the observation group was lower/lighter than those in the control group,and the above differences were statistically significant(P<0.05).After treatment,the serum MMP-13 level and MMP-13/TIMP-1 ratio of patients in the two groups were lower than those before treatment,and the serum TIMP-1 level was higher than that before treatment,and the changes in the observation group were greater than that in the control group,and the differences were statistically significant(P<0.05).Conclusion Dual-layer artificial dermis combined with vacuum sealing drainage and autologous split-thickness skin graft have significant effects in the treatment of chronic refractory wounds,which can increase the survival rate of autologous split-thickness skin,reduce adverse reactions,alleviate scar conditions and pain degree,and regulate serum MMP-13 and TIMP-1 levels.

Objective To explore the mechanism of baicalin mediating inflammatory response in rats with inflammatory bowel disease through microRNA(miR-21)/signal transducer and activator of transcription 3(STAT3)signaling pathway.Methods A total of 60 SD rats were selected to construct inflammatory bowel disease rat model by trinitro-benzene-sulfonic acid(TNBS)colon perfusion method,and randomly divided into 6 groups,with 10 rats in each group.They were divided into model group,low-dose group(gavage of 20 mg/kg baicalin),high-dose group(gavage of 80 mg/kg baicalin),high-dose+agomiR-NC group(gavage of 80 mg/kg baicalin+tail vein injection of 80 mg/kg miRNA negative control vector agomiR-NC),high-dose+agomiR-21 group(gavage of 80 mg/kg baicalin+tail vein injection of 80 mg/kg miR-21 agonist agomiR-21)and high-dose+agomiR-21+colivelin group(gavage of 80 mg/kg baicalin+tail vein injection of 80 mg/kg agomiR-21,along with intraperitoneal injection of 1 mg/kg STAT3 activator colivelin).Another 10 SD rats were selected as control group without any treatment.The body mass of rats in each group was measured every two days during administration,and the status of rats in each group was observed after administration.Hematoxylin and eosin(HE)staining was used to evaluate the pathological damage.The myeloperoxidase(MPO)activity,inflammatory factors and oxidative stress indexes were detected by the test kit.The mRNA levels of miR-21,STAT3 were detected by qRT-PCR.The expression of STAT3 and p-STAT3 protein was detected by Western blot.Results Compared with model group,the status of inflammatory bowel disease and pathological damage degree of colon tissue in low-dose group and high-dose group were significantly improved,the levels of interleukin-13(IL-13),superoxide dismutase(SOD)and glutathione peroxidase(GSH)were increased(P<0.05),while the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),malondialdehyde(MDA),reactive oxygen species(ROS),and miR-21 mRNA,STAT3 mRNA,p-STAT3/STAT3 protein expression were decreased(P<0.05)in a dose-dependent manner.Compared with high-dose+agomiR-NC group,the status of inflammatory bowel disease and pathological damage degree of colon tissue were aggravated in high-dose+agomiR-21 group,the levels of IL-13,SOD and GSH were decreased(P<0.05),while the levels of TNF-α,IL-6,MDA,ROS,and miR-21 mRNA,STAT3 mRNA,P-STAT3/STAT3 protein expression were increased(P<0.05).Compared with high-dose+agomiR-NC group,the status of inflammatory bowel disease and pathological damage degree of colon tissue were aggravated in high-dose+agomiR-21+colivelin group,the levels of IL-13,SOD and GSH were decreased(P<0.05),while the levels of TNF-α,IL-6,MDA,ROS,and miR-21 mRNA,STAT3 mRNA and P-STAT3/STAT3 protein expression were increased(P<0.05).Conclusion Baicalin reduces inflammatory factors and oxidative stress levels through miR-21/STAT3 signaling pathway,and thereby ameliorates colonic injury in rats with inflammatory bowel disease.

Objective To investigate the expression of serum long non-coding RNA X-inactive specific transcript(lncRNA XIST)and microRNA-126-3p(miR-126-3p)in patients with non-small cell lung cancer(NSCLC),and their relationship with recurrence after radical surgery.Methods A total of 108 NSCLC patients who underwent radical surgery and were admitted to General Hospital of Southern Theater Command of the People's Liberation Army of China from February 2019 to October 2020 were selected as the NSCLC group,and 52 healthy volunteers who underwent physical examination in this hospital were selected as the control group.qRT-PCR method was used to detect the relative expression levels of serum lncRNA XIST and miR-126-3p.Pearson method was used to analyze the correlation between serum lncRNA XIST and miR-126-3p expression.Logistic regression analysis was used to analyze the influencing factors of postoperative recurrence in NSCLC patients.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of serum lncRNA XIST and miR-126-3p on postoperative recurrence in patients.Results The expression level of serum lncRNA XIST in the NSCLC group was higher than that in the control group(P<0.05),while the expression level of miR-126-3p was lower than that in the control group(P<0.05).The expression levels of serum lncRNA XIST and miR-126-3p were related to TNM staging and lymph node metastasis(P<0.05).Bioinformatics website predicted that there was a targeted binding site between lncRNA XIST and miR-126-3p,and serum lncRNA XIST was negatively correlated with miR-126-3p expression(r=-0.579,P<0.05).Compared with the non-recurrent group,the expression level of serum lncRNA XIST in the recurrent group increased(P<0.05),while the expression level of miR-126-3p in the recurrent group decreased(P<0.05).Logistic regression analysis results showed that lncRNA XIST,miR-126-3p,lymph node metastasis,and TNM staging were the influencing factors for postoperative recurrence in NSCLC patients(P<0.05).The area under the curve(AUC)of serum lncRNA XIST,miR-126-3p,and the combination of the two in prediction of postoperative recurrence in NSCLC patients were 0.750,0.886,and 0.933,respectively,the combined prediction of the two was superior to individual prediction(Zcombination vs.lncRNA XIST=4.076,Zcombination vs.miR-126-3p=2.065,P<0.05).Conclusion The expression of serum lncRNA XIST is increased and miR-126-3p is decreased in NSCLC patients,both of which have certain predictive value for recurrence after radical surgery in patients.

Objective To explore the application and safety of neuroendoscopy in the surgical removal of intracranial extensive multicompartmental epidermoid cysts.Methods A retrospective analysis was conducted on the clinical data of 15 patients with intracranial extensive multicompartmental epidermoid cysts treated in the Neurosurgery Department of the First Affiliated Hospital of Xinjiang Medical University from August 2017 to December 2021.Among these patients,13 patients underwent surgery with suboccipital retrosigmoid approach,and 2 patients received surgery with a combination of the suboccipital retrosigmoid and infratemporal approaches.The surgical efficacy and incidence of complications of patients were observed.The patients were followed up to observe the recovery of symptoms and head MRI diffusion imaging.Results Complete tumor resection was achieved in 12 cases(80.0%),near-total resection in 2 cases(13.3%),and partial resection in 1 case(6.7%).Postoperative complications included diplopia in 2 cases,ipsilateral mydriasis in 1 case,aseptic meningitis in 1 case,and subcutaneous fluid accumulation in the surgical area in 1 case.The follow-up period ranged from 6 to 58 months,with an average of(30.5±16.0)months.At the last follow-up,no tumor recurrence was observed in the 12 patients who underwent complete resection,no significant tumor growth was noted in the 2 patients with near-total resection and the 1 patient with partial resection.Conclusion Neuroendoscopic-assisted microscopy technology can improve the complete resection rate of intracranial extensive multicompartmental epidermoid cysts.Retrograde third ventriculostomy via suboccipital retrosigmoid approach is safe and feasible.

Objective To compare the application effect of single perfusion technique and temperature gradient perfusion technique in balloon dilatation percutaneous kyphoplasty(PKP)in the treatment of osteoporotic vertebral compression fractures.Methods A total of 116 patients with osteoporotic vertebral compression fracture who underwent PKP in our hospital were selected and divided into the single perfusion group(n=57)and the temperature gradient perfusion group(n=59)according to different bone cement perfusion methods.The perioperative indicators,pain visual analogue scale(VAS)scores,Oswestry dysfunction index(ODI)scores,imaging indicators and incidence of bone cement leakage were compared between the two groups.Results The amount of bone cement injection of patients in the temperature gradient perfusion group was less than that in the single perfusion group(P<0.05).There was no significant difference in operation time,intraoperative blood loss or intraoperative fluoroscopy times of patients between the two groups(P>0.05).The VAS and ODI scores of patients in the temperature gradient perfusion group were lower than those in the single perfusion group 1 week after operation(P<0.05).At 1 week after operation and the last follow-up,the relative height of the anterior edge of the injured vertebrae in both groups were higher than those before operation(P<0.05),and the Cobb angle were smaller than those before operation(P<0.05).The incidence of bone cement leakage in the temperature gradient perfusion group was lower than that in the single perfusion group(P<0.05).Conclusion The application of temperature gradient perfusion technique in PKP for the treatment of osteoporotic vertebral compression fractures can achieve the same surgical treatment effect as single perfusion technique,and temperature gradient perfusion technique can reduce the amount of bone cement injection,reduce the incidence of bone cement leakage,and alleviate postoperative pain.

Objective To explore the ultrasonic cleaning effect and influencing factors of emergency laparoscopic surgical instruments at night.Methods A total of 698 emergency laparoscopic surgical instruments cleaned by ultrasound at night were selected as the research subjects,and the unqualified ultrasonic cleaning of instruments was statistically analyzed.Univariate and multivariate binary Logistic regression equations were used to analyze the factors that may lead to unqualified ultrasonic cleaning.Results Among 698 ultrasonic cleaning sessions for emergency laparoscopic surgical instruments at night,a total of 55 times(7.88%)were unqualified.The results of univariate and multivariate binary Logistic regression analysis showed that the time from cleaning to the end of surgery≥10 hours,luminal surgical instruments,nonstandard pretreatment,unqualified cleaning water quality,and unqualified cleaning medium were the risk factors that lead to the occurrence of unqualified ultrasonic cleaning of emergency laparoscopic surgical instruments at night(OR>1,P<0.05),while manual+ultrasonic cleaning was the protective factor to avoid the occurrence of unqualified ultrasonic cleaning of emergency laparoscopic surgical instruments at night(OR<1,P<0.05).Conclusion The unqualified rate of ultrasonic cleaning of emergency laparoscopic surgical instruments at night is relatively high,so it should be cleaned as early as possible after the surgery.Before ultrasonic cleaning,manual clean-ing should be carried out as much as possible,especially for luminal surgical instruments that are difficult to clean,standardized pretreatment should be carried out,and qualified cleaning water quality and medium should be selected.

Objective To explore the risk factors for noncontiguous spinal fractures(NSFs)in the elderly.Methods The clinical data of 614 elderly patients with spinal fracture from January 2013 to December 2019 were analyzed retrospectively.Patients were divided into the NSFs group and the Non-NSFs group according to whether NSFs occurred or not.Univariate analysis and multivariate Logistic regression analysis were used to screen the risk factors of NSFs.Results Univariate analysis showed that female(P=0.003),high-energy violent injury(P=0.032),osteoporosis(P=0.004),fracture in spring(P=0.020),and previous spinal fracture history(P<0.001)were associated with the occurrence of NSFs.Multivariate Logistic regression analysis showed that fracture in spring(P=0.024),previous spinal fracture history(P<0.001)and high-energy violent injury(P=0.038)were the independent risk factors for the occurrence of NSFs in the elderly.Conclusion High-energy violent injury,fracture in spring and previous spinal fracture history are the independent risk factors for the occurrence of NSFs in the elderly.Therefore,elderly patients with the above risk factors should be examined more carefully and comprehensively to avoid missed diagnosis and delayed diagnosis.In order to reduce the incidence of this disease,corresponding measures should be taken according to the preventable risk factors.

support the diagnosis.The treatment of PHCC is mainly based on surgery.Due to the characteristics of intact capsule,surgical resection is relatively easy and the cure rate is higher than that of ordinary hepatocellular carcinoma,and the postoperative survival rate is relatively ideal.For unresectable PHCC,palliative treatment based on transcatheter arterial chemoembolization can be used.This article reviews the progress on diagnosis and treatment of PHCC in order to provide reference for clinical practice.

Rectal cancer is one of the most common gastrointestinal malignant tumors,and patients with early rectal cancer can achieve radical tumor resection by surgical treatment alone,while most patients with rectal cancer are in the locally advanced stage when admitted to hospital.For this group of people,it is difficult to obtain a good prognosis through surgical treatment alone,and interventional chemoradio-therapy before surgery is of important clinical significance.A large number of clinical studies have proved that preoperative neoadjuvant therapy can effectively reduce tumor stage,increase pathological complete response(pCR)rate,thereby greatly improving the prognosis of patients.At present,the core methods of neoadjuvant therapy for locally advanced rectal cancer are radiotherapy and chemotherapy,as well as the emerging targeted therapy and immunotherapy,while the optimal combination order of various treatments remains in dispute.This article summarizes various neoadjuvant therapy regimens in recent years,in order to provide evidence for the multidisciplinary and comprehensive treatment of rectal cancer.