Objective To explore the relationship between systemic immune-inflammation index(SⅡ)at admission and occurrence of early neurological deterioration(END)in patients with branch atheromatous disease(BAD).Methods A retrospective analysis was performed on 326 BAD patients admitted in Department of Neurology of Handan Central Hospital from October 2021 to February 2024.Based on occurrence of END or not,they were divided into END group(97 cases)and non-END group(229 cases).Clinical data of the patients were collected,and multivari-ate logistic regression analysis was used to identify the END risk variables in BAD patients.ROC curve was plotted to evaluate the value of NIHSS score,hs-CRP and SⅡ in predicting the inci-dence of END in the patients.Results Significantly advanced age,higher NIHSS score at admis-sion,and elevated hs-CRP level,neutrophil count and SⅡ,but lower platelet and lymphocyte counts were observed in the END group than the non-END group(P＜0.05,P＜0.01).Multi vari-ate logistic regression analysis indicated that NIHSS score at admission(OR=1.134,95％CI:1.050-1.226,P=0.001),hs-CRP(OR=1.131,95％CI:1.024-1.249,P=0.015),and SⅡ(OR=1.001,95％CI:1.001-1.002,P=0.003)were independent risk factors for END in BAD patients.The AUC value of SⅡ in the prediction of END was 0.660,which was significantly higher than that of NIHSS score and hs-CRP in BAD patients(P＜0.05).Conclusion SⅡ is an independent risk factor for END in BAD patients,and SⅡ at admission has a certain predictive value for the oc-currence of END in these patients.

Objective To explore the relationship between systemic immune-inflammation index(SⅡ)at admission and occurrence of early neurological deterioration(END)in patients with branch atheromatous disease(BAD).Methods A retrospective analysis was performed on 326 BAD patients admitted in Department of Neurology of Handan Central Hospital from October 2021 to February 2024.Based on occurrence of END or not,they were divided into END group(97 cases)and non-END group(229 cases).Clinical data of the patients were collected,and multivari-ate logistic regression analysis was used to identify the END risk variables in BAD patients.ROC curve was plotted to evaluate the value of NIHSS score,hs-CRP and SⅡ in predicting the inci-dence of END in the patients.Results Significantly advanced age,higher NIHSS score at admis-sion,and elevated hs-CRP level,neutrophil count and SⅡ,but lower platelet and lymphocyte counts were observed in the END group than the non-END group(P＜0.05,P＜0.01).Multi vari-ate logistic regression analysis indicated that NIHSS score at admission(OR=1.134,95％CI:1.050-1.226,P=0.001),hs-CRP(OR=1.131,95％CI:1.024-1.249,P=0.015),and SⅡ(OR=1.001,95％CI:1.001-1.002,P=0.003)were independent risk factors for END in BAD patients.The AUC value of SⅡ in the prediction of END was 0.660,which was significantly higher than that of NIHSS score and hs-CRP in BAD patients(P＜0.05).Conclusion SⅡ is an independent risk factor for END in BAD patients,and SⅡ at admission has a certain predictive value for the oc-currence of END in these patients.

OBJECTIVETo compare the short-term efficacy of laparoscope-assisted transanal total mesorectal excision (LA-taTME) and conventional laparoscopic TME (LTME) for rectal cancer by meta-analysis.

METHODSClinical studies that compared clinical outcomes of LA-taTME and LTME were searched from form PubMed, Embase, Ovid, CNKI and Wanfang database before January 2016. Two reviewers independently screened the articles and assessed the quality of the included studies by using the MINORS standard which involves 12 items. The score is 0-2 for each item and the maximum score is 24, and the ideal global score should be above16. RevMan 5.3 software was used for meta-analysis and outcome measures included operation time, hospital stay, number of harvested lymph node, rate of conversion, positive rate of circumferential resection margin and the rate of incomplete mesorectum.

RESULTSSeven studies were included in the analysis, and the score of all the studies was more than 16 points. A total of 479 patients (208 in LA-taTME, 271 in LTME) were enrolled. There were no significant differences in terms of age, sex, tumor location and clinical stage between two groups (all P>0.05). Results of meta-analysis showed that LA-taTME had lower rate of incomplete mesorectum (OR=0.29, 95% CI:0.10 to 0.84, P=0.02), lower rate of complications (OR=0.59, 95% CI:0.35 to 0.97, P=0.04) and shorter hospital stay (MD=-1.66, 95% CI:-3.22 to -0.11, P=0.04) than those of LTME, with significant differences. In terms of operation time (MD=-14.49, 95% CI:-37.87 to 8.90, P=0.22), number of harvested lymph node (MD=-0.45, 95% CI:-1.98 to 1.08, P=0.56), the rate of conversion (OR=0.31, 95% CI:0.08 to 1.24, P=0.10) and positive rate of circumferential resection margin (OR=0.43, 95% CI:0.17 to 1.04, P=0.06), there were no significant differences between two groups.

CONCLUSIONCompared to LTME, LA-taTME has similar short-term efficacy for rectal cancer, but it can reduce the rate of complications and rate of incomplete mesorectum.

Abdomen ; Digestive System Surgical Procedures ; methods ; Humans ; Laparoscopes ; Laparoscopy ; Length of Stay ; Operative Time ; Rectal Neoplasms ; surgery