Objectives:To investigate the clinical efficacy of robot-assisted(RA)unilateral biportal endoscopic lumbar interbody fusion(UBE-LIF)in the treatment of single-level lumbar spinal stenosis(LSS).Methods:A retrospective analysis was conducted on the clinical data of 90 patients with LSS admitted to the Spine De-partment of Foshan Hospital of Traditional Chinese Medicine from August 2023 to February 2024.The pa-tients were divided into an observation group(42 patients,treated with RA-UBE-LIF)and a control group(48 patients,treated with UBE-LIF).The patients' baseline information and clinical data were collected,including age,gender,duration of illness,and lesion segments.The number of fluoroscopic exposures,operative time,intraoperative blood loss,postoperative drainage volume,length of hospital stay,screw placement accuracy(based on the Gertzbein criteria),and the occurrence of complications were compared between the two groups.The visual analogue scale(VAS)score and Oswestry disability index(ODI)were used to quantitatively assess the improvement in back and leg pain and the recovery of lumbar function in patients before surgery and at 1 week,3 months,and 6 months postoperatively.Results:All the patients successfully completed the surgery and were followed up for a period ranging from 6 to 12 months.Compared with the control group,the obser-vation group had significantly fewer fluoroscopic exposures(4.40±0.83 vs 9.92±1.62),less intraoperative blood loss(90.76±13.27mL vs 121.21±16.75mL),postoperative drainage volume(75.93±14.43mL vs 93.02±17.04mL),and length of hospital stay(4.43±1.52d vs 7.19±1.79d)(all P＜0.05).There was no significant difference in oper-ative time between the two groups(118.24±8.91min vs 120.67±10.43min)(P＞0.05).The accuracy rate of RA percutaneous screw placement in the observation group was 97.62％,which was significantly different from that of the control group(89.58％)(P＜0.05).The complication rate in the observation group was 2.38％,which was not significantly different from that of the control group(6.25％)(P＞0.05).The VAS scores for back and leg pain and ODI of both groups at each postoperative time point were significantly lower than those at the previ-ous time point(P＜0.05).There were no significant differences between the two groups preoperatively(P＞0.05),but the improvements in VAS scores and ODI at each postoperative time point(1 week,3 months,6 months)were better in the observation group compared to the control group(P＜0.05).Conclusions:Orthopedic RA-UBE-LIF for the treatment of LSS is accurate and safe,which has satisfactory therapeutic effects.

Objectives:To investigate the clinical efficacy of robot-assisted(RA)unilateral biportal endoscopic lumbar interbody fusion(UBE-LIF)in the treatment of single-level lumbar spinal stenosis(LSS).Methods:A retrospective analysis was conducted on the clinical data of 90 patients with LSS admitted to the Spine De-partment of Foshan Hospital of Traditional Chinese Medicine from August 2023 to February 2024.The pa-tients were divided into an observation group(42 patients,treated with RA-UBE-LIF)and a control group(48 patients,treated with UBE-LIF).The patients' baseline information and clinical data were collected,including age,gender,duration of illness,and lesion segments.The number of fluoroscopic exposures,operative time,intraoperative blood loss,postoperative drainage volume,length of hospital stay,screw placement accuracy(based on the Gertzbein criteria),and the occurrence of complications were compared between the two groups.The visual analogue scale(VAS)score and Oswestry disability index(ODI)were used to quantitatively assess the improvement in back and leg pain and the recovery of lumbar function in patients before surgery and at 1 week,3 months,and 6 months postoperatively.Results:All the patients successfully completed the surgery and were followed up for a period ranging from 6 to 12 months.Compared with the control group,the obser-vation group had significantly fewer fluoroscopic exposures(4.40±0.83 vs 9.92±1.62),less intraoperative blood loss(90.76±13.27mL vs 121.21±16.75mL),postoperative drainage volume(75.93±14.43mL vs 93.02±17.04mL),and length of hospital stay(4.43±1.52d vs 7.19±1.79d)(all P＜0.05).There was no significant difference in oper-ative time between the two groups(118.24±8.91min vs 120.67±10.43min)(P＞0.05).The accuracy rate of RA percutaneous screw placement in the observation group was 97.62％,which was significantly different from that of the control group(89.58％)(P＜0.05).The complication rate in the observation group was 2.38％,which was not significantly different from that of the control group(6.25％)(P＞0.05).The VAS scores for back and leg pain and ODI of both groups at each postoperative time point were significantly lower than those at the previ-ous time point(P＜0.05).There were no significant differences between the two groups preoperatively(P＞0.05),but the improvements in VAS scores and ODI at each postoperative time point(1 week,3 months,6 months)were better in the observation group compared to the control group(P＜0.05).Conclusions:Orthopedic RA-UBE-LIF for the treatment of LSS is accurate and safe,which has satisfactory therapeutic effects.

ObjectiveTo investigate the safety and efficacy of re-hepatic resection (rHR) versus radiofrequency ablation (RFA) in the treatment of recurrent hepatocellular carcinoma (RHCC) in Asia through a meta-analysis. MethodsPubMed, CNKI, and Wanfang Data were searched for related studies published up to June 15, 2020. Two reviewers independently searched for the articles and extracted related data, and RevMan 5.4.1 was used to perform the meta-analysis. ResultsA total of 2 randomized controlled trials and 18 retrospective cohort studies met the inclusion criteria and involved 2903 patients with RHCC from Asian countries. The mortality rate in the perioperative period was 2% in the rHR group and 0 in the RFA group, and the incidence rate of perioperative complications was 22.4% in the rHR group and 3.3% in the RFA group. The 1-, 3-, and 5-year overall survival rates were 92.3%, 66.3%, and 51.1%, respectively, in the rHR group and 91.4%, 69.2%, and 39.9%, respectively, in the RFA group. The 1-, 3-, and 5-year disease-free survival rates were 67.9%, 48.3%, and 34.4%, respectively, in the rHR group and 57.5%, 27.9%, and 14.0%, respectively, in the RFA group. The Meta-analysis showed that there was no significant difference in overall survival rate between the two groups (hazard ratio ［HR］=089, 95% confidence interval ［CI］: 0.77-1.02, P=0.10), while the rHR group had a significantly higher disease-free survival rate than the RFA group (HR=0.79, 95% CI: 0.72-0.87, P＜0.001). ConclusionCurrent evidence shows that rHR may help to achieve a higher disease-free survival rate than RFA in the treatment of RHCC, while rHR and RFA have a similar overall survival rate.

Objective To study the correlation between serum prealbumin level before liver resection and prognosis of patients with primary hepatocellular carcinoma (HCC).Methods The clinical data of patients with HCC who underwent liver resection at the Affiliated Tumor Hospital of Guangxi Medical University from August 2007 to October 2016 were retrospectively analyzed.The previous albumin of 200 mg/L and the pre-albumin as predicted by the maximum selection rank statistic method were used as the bounding group,and reduced groups and the correlation between pre-operative serum pre-albumin levels and clinicopathological characteristics were analyzed.The Kaplan-Meier method was used to calculate the overall survival rate of patients with the different cutoff levels.The Cox proportional regression model was used to analyze,and cirrhosis,alpha-fetoprotein levels and Barcelona Clinic Liver Cancer staging were used to adjust the relationship between serum prealbumin and prognosis of liver resection for HCC patients.Analysis of stratified variables was performed and their interactions with serum prealbumin were analyzed.Results Of the 2 022 patients included in this study,there were 1 739 males and 283 females.Their age was 49.5 ± 11.2 years.The median follow-up was 37.4 months.The optimal cutoff value of prealbumin predicted by the maximum selection rank statistic method was 166 mg/L.Regardless of the cutoff values of previous albumin 200 mg/L or prealbumin 166 mg/L,multivariate analysis showed that preoperative serum prealbumin level was an independent prognostic risk factor for patients (P ＜0.05).The prognosis of patients with ＞200 mg/L (＞ 166 mg/L) serum prealbumin before surgery was significantly better than that of patients with ≤200 mg/L (≤166 mg/L) prealbumin,the differences were significant (all P ＜ 0.05).After adjusting for confounding factors,the prealbumin level correlated with prognosis of patients with HCC [cutoff value 200 mg/L:HR (95％ CI) was 1.59 (1.35-1.86),cutoff value 166 mg/L:HR (95％ CI) was 1.69 (1.44-1.98),all P ＜ 0.05].The results of stratified analysis showed that the relationship between prealbumin levels and the prognosis of HCC patients became more robust.Conclusions Preoperative serum prealbumin was an independent risk factor for prognosis of HCC patients,and it had predictive value on prognosis of HCC patients.

Objective:To analyze the impact of gender on prognosis in patients with primary hepatocellular carcinoma (HCC) after hepatectomy.Methods:The data of 1 796 patients with HCC who underwent liver resection at the Guangxi Medical University Cancer Hospital from January 2010 to December 2016 were retrospectively analyzed. There were 1 548 males and 248 females, the average age were 49.6 years. Patients were followed up for recurrence and survival. After propensity score matching, the postoperative survival rates of male and female patients were compared. Univariate and multivariate Cox regression was used to analyze independent factors affecting prognosis of patients with HCC after hepatectomy. The age and menopause were analyzed by subgroup analyses.Results:The 1-, 3- and 5-years cumulative overall and recurrence-free survival rates of male patients were significantly lower than that of female patients (all P<0.05). Multivariate analysis showed that female was an independent protective factor affecting postoperative recurrence ( HR=0.777, 95% CI: 0.615-0.982) and overall survival ( HR=0.669, 95% CI: 0.520-0.856). Using a cut-off value of 50 years old, the patients were divided into <50 years old ( n=915) and ≥50 years old ( n=881). In patients who were less than 50 years old, the 1-, 3- and 5-years cumulative overall and recurrence-free survival rates of male patients were significantly lower than those of female patients (all P<0.05). In patients ≥50 years old, there were no significant difference in the cumulative overall and recurrence-free survival rates between male and female patients (all P>0.05). Female patients were then divided into the postmenopausal group ( n=152) and the premenopausal group ( n=96). There were no significant differences in the cumulative overall and cumulative recurrence-free survival rates between the two groups ( P>0.05). Conclusion:The prognosis of female patients with HCC after hepatectomy was significantly better than that of male patients.

Objective:This study analyzes the expression level of miR-1180-3p and constructs the regulatory network of relevant ceRNA by integrating the DNA methylation and gene expression profile of hepatocellular carcinoma from the Cancer Genome Atlas (TCGA).Methods:Firstly, the expression level of miR-1180-3p in hepatocellular carcinoma and adjacent tissues was analyzed by TCGA database, and the differential expression of lncrna and mRNA was screened. Secondly, the LncBase database and the TargetScan database were used to predict the relationship between miR-1180-3p and lncRNA and mRNA, and the DNA methylation-mediated lncRNA was screened by the DNA methylation profile of lncRNA. Finally, Cytoscape software was used to construct miR-1180-3p relevant ceRNA network, and WebGestalt website was used to perform GO and KEGG analysis of related mRNA in ceRNA.Results:Compared with patients with low expression of miR-1180-3p (mean overall survival duration, 5.69 ± 0.35 years), patients with high expression of miR-1180-3p had shorter overall survival time (mean overall survival duration, 3.99 ± 0.47 years), indicating that the high expression of miR-1180-3p was hepatocellular carcinoma risk factor affecting the prognosis ( HR = 1.28, 95% CI = 1.1 ~ 1.5, P < 0.01). A miR-1180-3p related ceRNA regulatory network was constructed in this study, which contained 2 lncRNAs (F11-AS1 and LINC01511) and 37 mRNAs. Conclusion:This study has successfully constructed miR-1180-3p relevant ceRNA regulatory network, and DNA methylation-mediated F11-AS1 and F11-AS1/miR-1180-3p/C11of54 ceRNA regulatory axis has played an important role in the occurrence and development of hepatocellular carcinoma.