Objective To investigate the association between cavitary pulmonary tuberculosis and im-munonutritional status in the Kangbei Plateau and construct a prediction model.Methods A total of 121 pa-tients with active pulmonary tuberculosis treated at Ganzi County People's Hospital from June 2023 to June 2024 were retrospectively enrolled and divided into cavitary group(n=53)and non-cavitary group(n=68)based on imaging findings.Clinical and laboratory data were collected.Influencing factors for pulmonary cavi-tation in tuberculosis were screened using univariate and multivariate logistic regression analysis to construct a prediction model.The model's performance was evaluated using receiver operating characteristic(ROC)curve analysis and the Hosmer-Lemeshow test.Results The cavitary group had higher proportions of smokers,spu-tum-positive cases,patients with disease duration>6 months,and patients with respiratory symptoms at ini-tial diagnosis,as well as higher neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),neutrophil count,and platelet count than the non-cavitary group(P<0.05).Conversely,the prognostic nutri-tional index(PNI),lymphocyte count,and albumin(ALB)level were lower in the cavitary group(P<0.05).Multivariate analysis identified disease duration,NLR,and ALB as influencing factors for pulmonary cavitation in tuberculosis patients(P<0.05).The prediction model yielded an area under the curve(AUC)of 0.909,and the Hosmer-Lemeshow test indicated good model fit(χ2=10.740,P=0.217).Conclusion Pulmonary cavitation in high-altitude tuberculosis patients is associated with disease duration,ALB,and NLR.The com-bined predictive value of these three indicators is high.

Objective To provide the anatomical basis for detecting distal outflow tract in late atherosclerosis obliteration in lower extremities.Methods Ten lower extremities that were amputated above knees because of late atherosclerosis obliteration were used in this experiment.The blood vessels in the residual bodies were perfused to run blood vessel cast mould to observe the anatomical and pathological change of the popliteal artery,the anterior and posterior tibial arteries and their collateral vessels.The number and distribution of those collateral vessels were also observed.Results The popliteal artery,anterior and posterior tibial arteries were all occluded due to atherosclerosis.However,there were three types of those collateral arteries:① Atheromatous plaque in bole stretched into collateral arteries and led to occlusion.② Obliteration was only observed at the initial segment,with no obstruction at the distal end but extenuated.③ The collateral arteries originated from the bole artery symmetrically,keeping communicative with each other through punctiform interspaces.The last two types were mainly distributed at the inferior segment of popliteal artery,the superior segment of anterior and posterior tibial arteries,forming vascular anastomosing network in the whole cnemis muscle group.Conclusion Un-obstructed collateral arteries in certain places can be still found,though atherosclerosis obliteration is formed in popliteal artery,anterior and posterior tibial arteries in lower extremities.Therefore,it may be possible to construct collateral outflow tracts if endo-membrane stripping operation is performed.

AIM: To summarize the effect of femoral popliteal arterial graft operation and the influence of construction of bypass circuit outflow tract.METHODS: A retrospective study was performed in 15 cases of femoral popliteal arterial bypass.RESULTS: A femoral popliteal embolism occurred in one patient undergoing simple femoral-popliteal arterial bypass in the early postoperative period and in 2 patients in the long-term followed up.However,the effects of constructing bypass circuit in the same time were very well,and only one patient had chill on the limbs.CONCLUSION: The operative results are better when the construction of bypass circuit is performed in the femoral-popliteal arterial graft operation,further more,a new method is provided for construction of distal end outflow tract.