Objective:To examine the influence of sarcopenia on the mid-term clinical outcomes of percutaneous vertebroplasty(PVP) in the management of osteoporotic vertebral compression fractures(OVCF).Methods:A retrospective case analysis method was adopted to analyze the clinical data of 102 patients with OVCF who underwent PVP in Beijing Daxing District Hospital of Integrated Chinese and Western Medicine from September 2020 to September 2022. Among them, there were 19 males and 83 females; the patients was (74.31±6.99) years, aged from 61 to 89 years. Using the skeletal muscle index (SMI) at the L3 vertebral level as the basis for grouping, with the diagnostic criteria of SMI<24.4 cm 2/m 2 for males and SMI<23.3 cm 2/m 2 for females. The 102 patients were divided into the sarcopenia group ( n=42) and the non-sarcopenia group ( n=60). The visual analog scale(VAS) scores for low back pain were recorded before surgery and at 3 days, 6 months, 1 year, 3 years after surgery; The oswestry disability index(ODI) was recorded at 6 months, 1 year, and 3 years after surgery; Bone mineral density (BMD) T-scores were recorded at 1 year and 3 years after surgery, and complications such as adjacent vertebral fractures were recorded. Measurement data with normal distribution were expressed as mean±standard deviation( ± s), and comparisons between groups were performed using the t-test. Count data were expressed as case and percentage (%), and comparisons between groups were performed using the chi-square test or Fisher′s exact test. Results:All patients in this study successfully completed the surgery and were followed up for 3 years. Compared with the preoperative baseline levels, the VAS for low back pain and ODI of patients in both groups decreased significantly at all postoperative time points, with statistically significant differences ( P<0.05). For patients in the sarcopenia group, the VAS for low back pain at 3 days, 6 months, 1 year, and 3 years after surgery were (2.50±1.04), (2.45±0.80), (2.17±0.79), (1.90±0.76) points, respectively. Those in the non-sarcopenia group were(2.02±0.68), (1.85±0.80), (1.78±0.61), (1.57±0.62) points, respectively, with a statistically significant difference between the two groups ( P<0.05). The ODI scores of the sarcopenia group at 6 months, 1 year, and 3 years postoperatively were (23.76±3.88)%, (23.05±4.33)%, (22.51±4.49)%, while those of the non-sarcopenia group were (21.68±4.51)%, (20.78±4.60)%, (20.30±4.44)%. The difference between the two groups was statistically significant ( P<0.05). The T-scores of femoral neck bone mineral density in the sarcopenia group at 1 year and 3 years after surgery were (-2.78±0.38), (-2.71±0.41), and those in the non-sarcopenia group were (-2.63±0.35), (-2.53±0.34), with a statistically significant intergroup difference ( P<0.05). For the T-scores of lumbar spine bone mineral density, the sarcopenia group had (-3.36±0.58), (-3.47±0.68) at 1 year and 3 years postoperatively, compared with (-3.12±0.59), (-2.91±0.53) in the non-sarcopenia group. The difference between the two groups was statistically significant ( P<0.05). Regarding the incidence of postoperative complications such as adjacent vertebral fractures, the sarcopenia group had a significantly higher incidence (19.0%) than the non-sarcopenia group (3.3%), with a statistically significant difference between the groups ( P<0.05). Conclusions:OVCF patients with sarcopenia who undergo PVP have poorer mid-term postoperative efficacy than those without sarcopenia, and they also face an increased risk of postoperative complications. Early screening and active intervention for patients with sarcopenia will help improve their clinical efficacy.

Objective To investigate the safety and clinical effect of prophylactic ileostomy using right lower abdominal specimen extraction incision in laparoscopic rectal low anterior resection and its impact on ileos-tomy closure.Methods A retrospective analysis was conducted on 127 patients who underwent laparoscopic low anterior resection of rectal cancer combined with prophylactic ileostomy in Department of General Surgery in our hospital from January 2020 to December 2023.Patients were divided into observation group(n=60)and control group(n=67)based on whether with prophylactic ileostomy using the right lower abdominal specimen extraction incision or not.Relevant data and clinical data of ileostomy closure were compared between the two groups.Results(1)There was no significant difference in baseline clinical data between the two groups(P>0.05).(2)In terms of operation time,pain score within three days after surgery and postoperative first exhaust time,the observation group was better than the control group,showing statistical difference(P<0.05).In the observation group,the average length of the incision was longer than that in the control group,and it was significantly different between the two groups(P<0.05).There was no significant difference between the two groups in terms of blood loss,post-operative feeding time and postoperative hospital stay(P>0.05).(3)There was no significant difference between the two groups in postoperative and ostomy-related complication S(P>0.05).(4)The observation group was better than the control group in terms of postoperative pain score and postoperative first exhaust time,indicating statistical significance(P<0.05).There were no significant differences in surgical time,abdominal adhesion,blood loss,postoperative hospital stay and postoperative complications between the two groups(P>0.05).Conclusion The patients undergoing laparoscopic rectal low anterior resection who needs prophylactic ileostomy using right lower abdominal specimen extraction incision can improve the appearance of the incision,shorten operation time,reduce postoperative pain of the patients but does not increase postoperative complications and the difficulty of ileostomy closure.It is safe and feasible,which worthy for clinical promotion.

Pulmonary mucinous adenocarcinoma is a subtype of lung adenocarcinoma, among which invasive mucinous adenocarcinoma (IMA) is the most common subtype and is easily misdiagnosed as pneumonia. Its etiology and pathogenesis are unclear and may be related to gene mutations and other factors. Due to its relative rarity and few related studies, guidelines do not provide advices on its treatment. KRAS mutations are common in IMA patients, and Sotorasib may be effective against KRAS G12C mutated IMA. NRG1 fusion is considered to be an important driver of IMA, and afatinib may be effective in treating IMA with NRG1 fusion/rearrangement. PD-L1 expression is very low in IMA patients, while B7-H3 expression is high, so B7-H3 may be a potential immunotherapeutic target.

Objective:To investigate the clinical effect and mechanisms of ceftriaxone combined with ranitidine on the acute pancreatitis.Methods:92 cases of patients with acute pancreatitis were selected and randomly divided into the control group (n=46) and experimental group (n=46),the control group was treated with ceftriaxone,and the experimental group was treated with ranitidine based on the control group,the serum levels of intedeukin-6 (IL-6),c-reactive protein(CRP),platelet activating factor (PAF),superoxide dismutase (SOD),propylene glycol (MDA),gastric secrete element,stomach,heart rate (HR),mean arterial pressure (MAP),and the relief time of clinical manifestation and the clinical efficacy were observed and compared between the two groups.Results:After treatment,the serum levels ofIL-6,CRP,PAF,MDA,gastric secrete element and HR of experimental group were significantly lower than those of the control group (P＜0.05).The serum levels of SOD,stomach motion element and MAP of experimental group were higher than those of the control group (P＜0.05).The relief time of clinical manifestation and total efficiency of experimental group were better than those of the control group (P＜0.05).Conclusions:Ceftriaxone combined with ranitidine could effectively enhance the clinical efficacy of acute pancreatitis,which might be related to the anti-oxidation and anti-inflammation.

Objective To investigate severe complications of inferior vena cava filter (IVCF) applying for preventing pulmonary embo-lism after spinal cord injury. Methods From December 2014 to July 2015, 95 patients with acute spinal cord injury (SCI) in our hospital were retrospected. Results Deep venous thrombosis (DVT) appeared in 23 cases, in which 15 cases placed IVCF. All patients accepted anti-coagulant therapy, except 10 cases with contraindication. 3 cases had severe complication, in which 2 cases had comprehensive DVT distal to IVCF, with both lower limbs severe swelling, acute renal inadequacy and hypertension;1 case had continuous hyperpyrexia. Conclusion Although the IVCF placement was widely used in acute SCI for preventing pulmonary embolism in patients with DVT, however, the selec-tion of IVCF and complication prevention should be taken into account.

Objective To explore the method and evaluate the effect of locking compression plate (LCP)fixation of intraarticular unstable distal radial fractures.Methods Thirty patients with intraarficular unstable distal radial fractures were treated with LCP.According to AO/ASIF classification,there were 6 cases of type B2 fractures,7 cases of type B3,7 cases of type C1,8 cases of type C2,2 cases of type C3.Results After 6 to 24 months(average 12 months)following up,there were 15 cases graded as excellent,10 eases as good,3 cases as fair,and 2 cases as poor,according to X ray and wrist function assessment.The overall satisfaction rate was 83.3％.Conclusion Volar LCP fixation is a safe and effective treatment for intraarticular unstable distal radial fractures.It could effectively prevent loss of reduction,avoid tendon irritation and other complications if selecting implant angle for locking screw according to the specific intraoperative circumstances.

Objective To investigate the therapeutic methods and curative effect of combined interven-tional therapy on hepatic metastasis from colorectal cancer. Methods Hepatic artery angiography and port-calheter-system( PCS) were undertaken in 35 cases of liver metastasis from colorectal cancers. Therapeutic measare were divided into transcatheter arterial infusion(TAl) in 10 cases and transcatheter arterial emboliza-tion(TAE) in 25 cases according to their angiographic features. Drugs included oxalic acid platinum, CPT11 , MMC and 5-Fu + CF. Laser ablation under the CT guidance was taken after 2-3 courses of treatment, including 9 cases of ethanol ablation besides laser ablation. The curative effects were determined after laser ablation by checking with CT and CEA one month later. Results The lesions shrank in 17 cases, while 13 remained the same and enlarged in other 5 after 2-3 courses of TAE or TAI. CEA reduced in 6 cases, with no change in other 5 and increas in another 3 among the 14 positive CEA cases. CT scan showed spotty gasification in 29 cases and whole gasification in 6 after additional ablation treatment. Among them, the foci dwindled in 8 cases treated by solely laser ablation, with no change in 5 and increase in 7. The foci dwindled in 5 cases, 2 remainal the same and increase in 2 of 9 cases treated by the combination of laser ablation and percutaneous ethanol injection (PEI). Among 8 unchanged or increased CEA cases after TAE or TAI, showed decrease in 3 cases, other 4 remained the same and another increased after ablation. Conclusions 1. The blood supply of hepatic metastastic foci from coloreclal cancer is mainly fed by hepatic artery and subselective transcatheter angiography showed tumor stain clearly. 2. By means of PCS and TAI or TAE, using oxalic acid platinum, CPT11 and 5-Fu regular chemical therapy provided a better curative effect for metastasis. But 3. TAI or TAE can not eliminate all foci laser combining with ethanol ablation would be the effective complement.