[Purpose]To analyze and evaluate the application effect of quantitative fecal immuno-chemical test(FIT)in the opportunistic screening of colorectal cancer(CRC)in health examination population.[Methods]10 025 healthy individuals who completed quantitative FIT at the Health Management Cancer of Sichuan Cancer Hospital from January 1,2021 to December 31,2023 were included.Participants with positive FIT results were recommended for diagnostic colonoscopy.Quantitative FIT positivity rate,colonoscopy screening compliance rate,and colorectal lesion de-tection rate in the queue population were analyzed,the detection rate of colorectal lesions and colonoscopy resource load between quantitative FIT positive and negative colonoscopy screening groups at all levels were compared and the diagnostic efficacy of quantitative FIT for non progres-sive lesions and progressive lesions were explored.[Results]The positive rate of quantitative FIT was 6.24％(95％CI:5.77％～6.71％).The compliance rate of colonoscopy screening was 20.93％(95％CI:17.74％～24.12％).Among 284 colonoscopy patients,7 cases were detected with CRC,21 cases with advanced adenomas,52 cases with non advanced adenomas,40 cases with non adenomatous polyps,51 cases with other benign lesions,and 113 cases without abnormalities.The detection rates of non advanced adenomas,advanced adenomas,colorectal cancer,non pro-gressive lesions and progressive lesions in the quantitative FIT positive group were significantly higher than those in the quantitative FIT negative group.The detection rates of those without obvi-ous abnormalities were significantly lower than those in the quantitative FIT negative group,and the differences were statistically significant(all P＜0.05).The resource burden of colonoscopy in the quantitative FIT positive and negative groups was 5.46(95％CI:1.56～9.34)and 38.25(95％CI:30.55～45.95),respectively.The level of FIT measurement gradually increases with the severity of the lesion,and the difference between groups is statistically significant(H=48.308,P＜0.001).Quan-titative FIT has high sensitivity and negative predictive value for non progressive lesions and pro-gressive lesions,with values of 71.15％,85.71％and 90.20％,97.39％,respectively.The AUC values for quantitative FIT screening of non progressive lesions and progressive lesions were 0.653(95％CI:0.572～0.734,P=0.001)and 0.720(95％CI:0.631～0.808,P＜0.001),respectively.[Conclusion]Quantitative FIT,as a suitable technique for CRC opportunistic screening in health check-up population,has good diagnostic efficacy for non progressive lesions and progressive le-sions.Performing colonoscopy on FIT positive individuals can improve lesion detection rates while reducing colonoscopy resource consumption,aligning with China's healthcare resource landscape.

[Purpose]To analyze and evaluate the application effect of quantitative fecal immuno-chemical test(FIT)in the opportunistic screening of colorectal cancer(CRC)in health examination population.[Methods]10 025 healthy individuals who completed quantitative FIT at the Health Management Cancer of Sichuan Cancer Hospital from January 1,2021 to December 31,2023 were included.Participants with positive FIT results were recommended for diagnostic colonoscopy.Quantitative FIT positivity rate,colonoscopy screening compliance rate,and colorectal lesion de-tection rate in the queue population were analyzed,the detection rate of colorectal lesions and colonoscopy resource load between quantitative FIT positive and negative colonoscopy screening groups at all levels were compared and the diagnostic efficacy of quantitative FIT for non progres-sive lesions and progressive lesions were explored.[Results]The positive rate of quantitative FIT was 6.24％(95％CI:5.77％～6.71％).The compliance rate of colonoscopy screening was 20.93％(95％CI:17.74％～24.12％).Among 284 colonoscopy patients,7 cases were detected with CRC,21 cases with advanced adenomas,52 cases with non advanced adenomas,40 cases with non adenomatous polyps,51 cases with other benign lesions,and 113 cases without abnormalities.The detection rates of non advanced adenomas,advanced adenomas,colorectal cancer,non pro-gressive lesions and progressive lesions in the quantitative FIT positive group were significantly higher than those in the quantitative FIT negative group.The detection rates of those without obvi-ous abnormalities were significantly lower than those in the quantitative FIT negative group,and the differences were statistically significant(all P＜0.05).The resource burden of colonoscopy in the quantitative FIT positive and negative groups was 5.46(95％CI:1.56～9.34)and 38.25(95％CI:30.55～45.95),respectively.The level of FIT measurement gradually increases with the severity of the lesion,and the difference between groups is statistically significant(H=48.308,P＜0.001).Quan-titative FIT has high sensitivity and negative predictive value for non progressive lesions and pro-gressive lesions,with values of 71.15％,85.71％and 90.20％,97.39％,respectively.The AUC values for quantitative FIT screening of non progressive lesions and progressive lesions were 0.653(95％CI:0.572～0.734,P=0.001)and 0.720(95％CI:0.631～0.808,P＜0.001),respectively.[Conclusion]Quantitative FIT,as a suitable technique for CRC opportunistic screening in health check-up population,has good diagnostic efficacy for non progressive lesions and progressive le-sions.Performing colonoscopy on FIT positive individuals can improve lesion detection rates while reducing colonoscopy resource consumption,aligning with China's healthcare resource landscape.

Objective:To investigate the feasibility and clinical efficacy of using the mirror technique, which involves overlapping the distance between the center of rotation of the femoral head and the posteromedial edge of the greater trochanter, combined with the injured side and the posterior edge of the contralateral femoral medial and lateral condyles, to correct rotational displacement of the femur during closed reduction and intramedullary nail fixation for multi-level comminuted femoral shaft fractures.Methods:This study included 52 adult patients with unilateral comminuted femoral shaft fractures treated with closed reduction and antegrade interlocking intramedullary nail fixation at the Trauma Center of Liuzhou Workers' Hospital from January 2020 to December 2022. The cohort consisted of 37 males and 15 females, with an average age of 44.4±3.5 years (range 19-68 years). During the operation, C-arm fluoroscopy was used to confirm the standard lateral position of the knee joint, identified by overlapping the posterior edges of the medial and lateral femoral condyles. With this position maintained, X-ray fluoroscopy was performed on the hip joint in the anteroposterior view to identify the rotation center of the femoral head (point O) and the intersection point of the arc projection between the posteromedial edge of the greater trochanter and the upper edge of the femoral neck (point Y). The distance from point O to point Y (OY) was measured and recorded. The rotational deformity of the femoral shaft fracture was corrected by internally or externally rotating the main screw sight frame to match the OY distance between the injured and healthy sides. Postoperative CT was used to measure bilateral femoral neck anteversion (FNA), and the difference in FNA between the two sides was compared to verify the accuracy of rotation control. Clinical efficacy was evaluated based on fracture healing rate, lower extremity functional scale (LEFS) score, Harris score, Lysholm knee score, hip and knee joint range of motion, and complications.Results:The postoperative FNA was 14.45°±3.23° on the healthy side and 14.21°±3.28° on the injured side. The mean FNA difference between the two sides was 0.79°±0.58° (range 0°-2.5°). In 3 cases, the difference exceeded 2°, with a maximum difference of 2.5°. In 10 cases, the difference ranged from 1° to 2°, and in 39 cases, the difference was ≤1°, including 2 cases with no difference. There was no significant difference in postoperative FNA between the two sides ( t=1.063, P=0.168). At the last follow-up, there were no significant differences in LEFS score, Harris score, or Lysholm score between the injured and healthy sides ( P>0.05). The range of motion (ROM) of the hip joint at the last follow-up was 117.0°±2.2° in flexion, 24.3°±3.2° in extension, 33.4°±3.1° in abduction, 20.8°±2.7° in adduction, 19.4°±3.5° in internal rotation, and 38.2°±1.5° in external rotation. The ROM of the healthy side was 122.0°±2.4° in flexion, 25.4°±2.8° in extension, 35.6°±2.0° in abduction, 23.4°±1.6° in adduction, 21.0°±2.2° in internal rotation, and 38.4°±1.8° in external rotation, with no significant differences ( P>0.05). The knee flexion ROM was 135.0°±2.8° on the injured side and 138.4°±1.2° on the healthy side, with no significant difference ( P>0.05). The fracture healing time was 10.6±2.3 months (range 6-13 months). One patient developed fat embolism syndrome on the third postoperative day and recovered after 2 weeks of hormone therapy and respiratory support. No other complications, such as vascular or nerve injury, infection, deep vein thrombosis, or joint dysfunction, were observed in the remaining 51 patients. Conclusion:The method of using the vertical projection distance between the center of rotation of the femoral head and the posteromedial edge of the greater trochanter, combined with the overlap of the injured side and the posterior edge of the medial and lateral femoral condyles, is a new quantitative approach. This technique accurately determines and corrects the rotational displacement of femoral fractures, offering an effective and quick intraoperative correction method.

Background and Aims:The Octoparms filter is a newly introduced domestically manufactured umbrella-shaped retrievable inferior vena cava (IVC) filter. A multicenter,parallel-controlled trial demonstrated its non-inferiority to the Celect filter. This study was performed to compare the clinical outcomes of the placement and retrieval of the Octoparms filter with those of the Denali filter to assess its safety and efficacy further.Methods:From May 2021 to May 2024,289 Denali filters (Denali group) and 78 Octoparms filters (Octoparms group) were placed and attempted to be retrieved at Beijing Shijitan Hospital,affiliated with Capital Medical University. After propensity score matching (PSM) of baseline characteristics,the incidence of filter tilt,wall apposition,vein wall penetration,retrieval success rates,and other relevant variables were compared between the two groups.Results:After PSM,77 patients were included in each group. Following matching,except for the significantly lower placement cost in the Octoparms group (P<0.05),all baseline characteristics (e.g.,gender,age,surgical indications,filter insertion route,IVC diameter,and angle) showed no statistically significant differences between the two groups (all P>0.05). The average indwelling time of the filter was longer in the Denali group compared to the Octoparms group (58 d vs. 47 d,P=0.004). There was no significant difference in the average filter tilt angle between the two groups (4.4° vs. 4.8°,P=0.71). While wall apposition or significant tilt was more frequent in the Octoparms group,the difference was not statistically significant (P>0.05). Both groups achieved a 100.0％ technical success rate for filter retrieval,with no complications such as filter fracture or vascular rupture during retrieval. Other retrieval-related variables (surgical approach,retrieval duration,retrieval techniques,and costs) also showed no significant differences between the two groups (all P>0.05).Conclusion:As a newly launched domestic filter,the Octoparms filter demonstrates comparable stability and retrieval rate to the Denali filter,and it is a safe and reliable choice.

Background and Aims:The Octoparms filter is a newly introduced domestically manufactured umbrella-shaped retrievable inferior vena cava (IVC) filter. A multicenter,parallel-controlled trial demonstrated its non-inferiority to the Celect filter. This study was performed to compare the clinical outcomes of the placement and retrieval of the Octoparms filter with those of the Denali filter to assess its safety and efficacy further.Methods:From May 2021 to May 2024,289 Denali filters (Denali group) and 78 Octoparms filters (Octoparms group) were placed and attempted to be retrieved at Beijing Shijitan Hospital,affiliated with Capital Medical University. After propensity score matching (PSM) of baseline characteristics,the incidence of filter tilt,wall apposition,vein wall penetration,retrieval success rates,and other relevant variables were compared between the two groups.Results:After PSM,77 patients were included in each group. Following matching,except for the significantly lower placement cost in the Octoparms group (P<0.05),all baseline characteristics (e.g.,gender,age,surgical indications,filter insertion route,IVC diameter,and angle) showed no statistically significant differences between the two groups (all P>0.05). The average indwelling time of the filter was longer in the Denali group compared to the Octoparms group (58 d vs. 47 d,P=0.004). There was no significant difference in the average filter tilt angle between the two groups (4.4° vs. 4.8°,P=0.71). While wall apposition or significant tilt was more frequent in the Octoparms group,the difference was not statistically significant (P>0.05). Both groups achieved a 100.0％ technical success rate for filter retrieval,with no complications such as filter fracture or vascular rupture during retrieval. Other retrieval-related variables (surgical approach,retrieval duration,retrieval techniques,and costs) also showed no significant differences between the two groups (all P>0.05).Conclusion:As a newly launched domestic filter,the Octoparms filter demonstrates comparable stability and retrieval rate to the Denali filter,and it is a safe and reliable choice.

Objective:To compare the efficacy of lower extremity three dimensional CT venography (CTV) and lower extremity ascending phlebography in evaluating recurrent varicose veins.Methods:A retrospective analysis was conducted on clinical data from 235 patients with unilateral recurrent varicose veins who were treated at the Department of Vascular Surgery,Beijing Shijitan Hospital,Capital Medical University, between January 2015 and December 2020.There were 112 males and 123 females, with an age of (62.5±11.4)years (range:24 to 75 years).Patients were stratified into two groups based on preoperative imaging examination:the CTV group (utilizing lower extremity venous ultrasound+lower extremity CTV) and the control group (employing lower extremity venous ultrasound+lower extremity ascending phlebography).The two groups were matched in a 1∶1 ratio using propensity score matching, resulting in 43 cases per group.Comparative analyses between the groups at the one-year postoperative follow-up were performed using independent sample t tests, Wilcoxon rank-sum tests, χ2 tests, and linear regression analysis. Results:One year post-surgery,the CTV group exhibited a lower venous clinical severity score (VCSS) compared to the control group( M(IQR),3.0(4.3) vs.4.0(5.8), Z=-2.038, P=0.040).Additionally, the chronic venous insufficiency patients′ quality of life questionnaire (CIVIQ-20) scores were significantly higher in the CTV group than in the control group (89.0(8.0) vs.82.5(17.0), Z=-2.627, P=0.010).Patients in the CTV group also experienced a shorter ulcer healing time compared to the control group (4.0(4.0) weeks vs.12.0(7.0) weeks, Z=-3.217, P<0.01).Both groups showed no clinically symptomatic recurrent varicose veins or ulcers.However, they exhibited ultrasound-detectable varicose vein recurrence, with no statistically significant difference ( χ2=0.453, P=0.500).The number of diseased vessels requiring management based on ultrasound supplemented by CTV was 16, while the number supplemented by ascending phlebography was 7,with a statistically significant difference ( χ2=4.800, P=0.030).Linear regression analysis demonstrated that clinical-etiology-anatomy-pathology clinical grading and the preoperative imaging examination method exerted independent influences on VCSS and CIVIQ-20 during the one-year postoperative assessment. Conclusions:CTV-assisted ultrasound enables a direct and comprehensive evaluation and localization of diseased veins in patients with recurrent varicose veins.The utilization of lower extremity vein ultrasound combined with CTV-guided management of lower extremity vessels in minimally invasive treatment significantly improves patient prognosis, surpassing the assessment provided by ascending phlebography.

Objective:To evaluate the diagnostic evaluation process and the effectiveness and safety of intracavitary therapy for pelvic congestion syndrome (PCS).Methods:A retrospective analysis was conducted on 38 patients admitted to Beijing Shijitan Hospital affiliated to Capital Medical University from March 2019 to February 2022. Combined with the patient′s symptoms, PCS was diagnosed by color Doppler ultrasound, computed tomography venography (CTV), and venography. The ovarian vein was embolized with controllable spring coil and polydocanol foam sclerosing agent. The patients were followed up 1, 3 and 6 months after operation.Results:The total surgical success rate of 38 patients was 100%, and the incidence of complications was 5.3%(2/38); Spring coils (2.8±0.3)per person; The dosage of hardener was (7.0±2.1)ml/person. The improvement rate of patient symptoms was 97.4%(37/38); After 1, 3, and 6 months of surgery, color Doppler ultrasound was reexamined and no recanalization was observed in the embolized ovarian veins; The diameter of the parauterine vein was (2.8±0.5)mm, which was significantly lower than the preoperative (7.5±1.9)mm ( P<0.05); The Visual Analogue Scale (VAS) score was significantly lower than the preoperative score [(2.12±1.87)points vs (7.58±0.82)points, P<0.001]. Conclusions:Process based assessment is helpful in identifying and diagnosing PCS patients who urgently need treatment; Endovascular treatment based on embolization of ovarian vein with controllable spring coil and foam sclerosing agent is minimally invasive, safe and effective.

Objective:To investigate the classification of main pancreatic duct and treatment strategy after linear stapler closure of pancreatic neck in laparoscopic pancreaticoduodenectomy (LPD).Methods:The records of 51 consecutive patients with LPD who were treated by linear staple closure technique of pancreatic neck from February to December 2022 from Binzhou Second People′s Hospital, Shijingshan Campus, Beijing Chaoyang Hospital, Capital Medical University, Rizhao Hepatobiliary-Pancreatic-Splenic Surgery Research Institute, Chaoyang Central Hospital, Shandong Juxian People′s Hospital, Weihai Municipal Hospital, Binzhou Central Hospital, and Affiliated Hospital of Chifeng University were retrospectively reviewed. According to the visibility, position and diameter of the main pancreatic duct at the stump of the pancreas, the type of main pancreatic duct was divided into type I, type Ⅱ, type Ⅲa and type Ⅲb. The number of cases in each main pancreatic duct classification and the corresponding treatment strategies were examined.Results:A total of 51 cases of LPD were successfully completed. Of these patients, the males comprised 56.9%(29/51), and females comprised 43.1%(22/51), with age ranging from 31 to 88 years old. The type of the main pancreatic duct at the stump of the pancreas included 7 cases (13.7%) of type Ⅰ, 39 cases (76.5%) of type Ⅱ, 2 cases (3.9%) of type Ⅲa, and 3 cases (5.9%) of type Ⅲb. Corresponding treatment strategies were adopted according to different main pancreatic duct types, the main pancreatic duct was successfully found, and a support drainage tube was inserted.Conclusion:After linear stapler closure of pancreatic neck, corresponding treatment strategies should be adopted according to the classification of the main pancreatic duct, which would help to improve the success rate of finding the main pancreatic duct and placing a support drainage tube.

Objective:To explore the therapeutic experience of early postoperative hemorrhage (EPOH) from pancreaticojejunal anastomosis after pancreaticoduodenectomy (PD).Methods:A retrospective review was conducted to summarize the clinical data of a typical case of EPOH from pancreaticojejunal anastomosis after PD in Binzhou Second People′s Hospital, and the main causes and treatment of EPOH were analyzed.Results:Due to reasons such as the slender pancreatic duct, the pancreatic duct was not found after twice transections of the pancreas during the surgery. To prevent poor pancreatic fluid drainage and related complications, the pancreatic stump was not effectively sutured, and a vertical mattress suture method was used for the pancreaticojejunal anastomosis. The patient developed severe EPOH on the surgery day. Due to the fact that the digestive tract reconstruction was a biliary pancreatic separation method, the cause of EPOH was diagnosed from pancreaticojejunal anastomosis through imaging and endoscopy. After active medical treatment, the patient recovered and was discharged.Conclusion:For the treatment of pancreatic stump after PD, precise suturing should be performed on the stump while ensuring smooth pancreatic duct drainage, in order to avoid EPOH from pancreaticojejunal anastomosis to the greatest extent possible.

Objective:To compare the efficacy of lower extremity three dimensional CT venography (CTV) and lower extremity ascending phlebography in evaluating recurrent varicose veins.Methods:A retrospective analysis was conducted on clinical data from 235 patients with unilateral recurrent varicose veins who were treated at the Department of Vascular Surgery,Beijing Shijitan Hospital,Capital Medical University, between January 2015 and December 2020.There were 112 males and 123 females, with an age of (62.5±11.4)years (range:24 to 75 years).Patients were stratified into two groups based on preoperative imaging examination:the CTV group (utilizing lower extremity venous ultrasound+lower extremity CTV) and the control group (employing lower extremity venous ultrasound+lower extremity ascending phlebography).The two groups were matched in a 1∶1 ratio using propensity score matching, resulting in 43 cases per group.Comparative analyses between the groups at the one-year postoperative follow-up were performed using independent sample t tests, Wilcoxon rank-sum tests, χ2 tests, and linear regression analysis. Results:One year post-surgery,the CTV group exhibited a lower venous clinical severity score (VCSS) compared to the control group( M(IQR),3.0(4.3) vs.4.0(5.8), Z=-2.038, P=0.040).Additionally, the chronic venous insufficiency patients′ quality of life questionnaire (CIVIQ-20) scores were significantly higher in the CTV group than in the control group (89.0(8.0) vs.82.5(17.0), Z=-2.627, P=0.010).Patients in the CTV group also experienced a shorter ulcer healing time compared to the control group (4.0(4.0) weeks vs.12.0(7.0) weeks, Z=-3.217, P<0.01).Both groups showed no clinically symptomatic recurrent varicose veins or ulcers.However, they exhibited ultrasound-detectable varicose vein recurrence, with no statistically significant difference ( χ2=0.453, P=0.500).The number of diseased vessels requiring management based on ultrasound supplemented by CTV was 16, while the number supplemented by ascending phlebography was 7,with a statistically significant difference ( χ2=4.800, P=0.030).Linear regression analysis demonstrated that clinical-etiology-anatomy-pathology clinical grading and the preoperative imaging examination method exerted independent influences on VCSS and CIVIQ-20 during the one-year postoperative assessment. Conclusions:CTV-assisted ultrasound enables a direct and comprehensive evaluation and localization of diseased veins in patients with recurrent varicose veins.The utilization of lower extremity vein ultrasound combined with CTV-guided management of lower extremity vessels in minimally invasive treatment significantly improves patient prognosis, surpassing the assessment provided by ascending phlebography.