Intestinal permeability plays a pivotal role in the gut-liver axis and has emerged as a critical target for the prevention and treatment of liver diseases. Based on recent studies in China and globally， this article reviews the definitions and interrelationship of intestinal barrier function and intestinal permeability， the methods for assessing intestinal permeability， and the mechanism of action and clinical significance of intestinal permeability in the development and progression of various liver diseases. Studies have shown that increased intestinal permeability is a significant hallmark and an important driving factor for multiple liver diseases， and this state leads to the translocation of bacteria and harmful substances， trigger a systemic inflammatory response， and thus exacerbates liver injury， fibrosis， and metabolic dysregulation. Therefore， it is closely associated with the development and progression of metabolic associated fatty liver disease， alcoholic liver disease， autoimmune liver diseases， and their end-stage events， including liver cirrhosis， liver failure， and hepatocellular carcinoma. Future research should focus on the standardization of assessment methods， the exploration of underlying mechanisms， and the clinical translation of these findings.

Objective To compare the clinical efficacy and safety of transarterial chemoembolization(TACE)plus apatinib(Apa)and camrelizumab(Cam)and TACE plus Apa in treating CNLC stage Ⅲ hepatocellular carcinoma(HCC).Methods A total of 54 patients in Affiliated Yancheng No.1 People's Hospital,School of Medicine,Nanjing University with CNLC stage Ⅲ HCC were enrolled in this study.The patients were divided into triple treatment group(n=25,receiving TACE plus Apa and Cam)and dual treatment group(n=29,receiving TACE plus Apa).The overall survival(OS)and progression-free survival(PFS)were compared between the two groups.Univariate analysis and multivariate analysis were used to determine the independent influencing factors for OS and PFS.The target immunotherapy-related adverse reactions(TRAE)were analyzed.Results The median OS and PFS in the triple treatment group were 23.2 months and 10.9 months respectively,which were higher than 15.2 months and 5.8 months respectively in the dual treatment group(both P＜0.001).Multivariate analysis indicated that the therapeutic regimen and the type of portal vein tumor thrombosis(PVTT)were the independent factors affecting OS,while only the therapeutic regimen was the independent factor affecting PFS.The incidence of≥grade Ⅲ TRAE in the triple treatment group and the dual treatment group was 20％(5/25)and 17.2％(5/29)respectively,the difference between the two groups was not statistically significant(P＞0.05).Conclusion For the treatment of patients with CNLC stage Ⅲ HCC,TACE plus Apa and Cam is superior to TACE plus Apa in OS and PFS,and the type of PVTT and the therapeutic regimen are the independent prognostic factors associated with patient's survival.

This paper reports a case of reparing the tissue defect after resection of a malignant tumor in the glabellar nasion with bilateral modified horizontal advancement flaps. The patient, a 20-year-old female, was admitted to the hospital because of a mass on the nasion between the eyebrows for more than 5 years, with enlargement and ulceration for 5 months. Surgical resection of the tumor was performed. Intraoperative rapid frozen sections showed that the tumor was basal cell carcinoma, and there were no cancer cells at the margins. Bilateral modified horizontal advancement flap repair was performed. At three months after the operation, the incision area healed well, the appearance and eyelid function were normal, and there was no sign of recurrence of basal cell carcinoma. Bilateral modified horizontal advancement flap was effective in repairing the tissue defect after resection of glabellar nasal root basal cell carcinoma.

Objective:To explore the surgical effects of continuous trapezoidal suture method between subcutaneous and subconjunctival tissue in buried-suture double-eyelid blepharoplasty.Methods:A retrospective study was conducted on patients who underwent the operation of continuous trapezoidal suture method between subcutaneous and subconjunctival tissue in buried-suture double-eyelid blepharoplasty at the Department of Plastic and Aesthetic Surgery of Qingdao Municipal Hospital from September 2021 to September 2023. Six points were marked on the skin surface of the designed double eyelid line on patient' s upper eyelid, 8 points were marked on the corresponding conjunctival surface of the designed double eyelid line. A 6-0 nylon thread attached with one needle on each end was used for suturing, with two ends running through and between the subcutaneous and subconjunctival layers alternatively, forming a " trapezoidal" shape of path. Finally, two ends exited at the same point on the most lateral side of the designed double eyelid line on skin surface and were tied together with the knot hidden within the orbicularis oculi muscle. The morphology of the double eyelids and postoperative complications were observed and evaluated after surgery, the follow-up period was at least 6 months. At the last time of follow-up, the satisfaction rates were evaluated by patients themselves. Four aspects of the surgical effects of the double eyelids were put into the evaluation system, which were radian, width, smoothness and symmetry, with score from 0-5 points for each. The total score was 0-20 points, of which 17-20 points indicated high satisfaction, score of 13-16 points indicated relative satisfaction, ≤ 12 points indicated dissatisfaction.Results:A total of 52 female patients were included, aged 18 to 29 years old, with an average age of 22.5 years. Among all patients, 33 cases had shallow double eyelid lines while 19 cases had single eyelids. All patients’ upper eyelids were relatively thin and without obvious looseness. The surgical procedures were all done smoothly and successfully, with an average operation time of (0.72±0.13) h. Immediately after surgery, the radian of the double eyelid lines on both sides looked smooth, the widths of the double eyelids were also basically symmetrical. During the follow-up period of 6-12 months postoperatively, the morphologies of the double eyelids were relatively natural and realistic, the double eyelid lines and widths remained deep and stable, and the incision scars were left unobvious for all patients. Besides, no complications such as ptosis, incomplete upper eyelid closure and ectropion were observed. Among the 52 patients, 45 cases were highly satisfied with the surgical result (17-20 points) , 7 were relatively satisfied (13-16 points) , while none of them required reoperation.Conclusions:The continuous trapezoidal suture method between subcutaneous and subconjunctival tissue in buried-suture double-eyelid blepharoplasty has advantages of short operation time, good and stable surgical effects such as natural and realistic morphology of double eyelids, few complications, and high patients' satisfaction rate.

Objective:To explore the surgical effects of continuous trapezoidal suture method between subcutaneous and subconjunctival tissue in buried-suture double-eyelid blepharoplasty.Methods:A retrospective study was conducted on patients who underwent the operation of continuous trapezoidal suture method between subcutaneous and subconjunctival tissue in buried-suture double-eyelid blepharoplasty at the Department of Plastic and Aesthetic Surgery of Qingdao Municipal Hospital from September 2021 to September 2023. Six points were marked on the skin surface along the designed double eyelid line on patient’s upper eyelid, 8 points were marked on the corresponding conjunctival surface along the designed double eyelid line. A 6-0 nylon thread attached with one needle on each end was used for suturing, with two ends running through and between the subcutaneous and subconjunctival layers alternatively, forming a "trapezoidal" shape of path. Finally, two ends exited at the same point on the most lateral side of the designed double eyelid line on skin surface and were tied together with the knot hidden within the orbicularis oculi muscle. The morphology of the double eyelids and postoperative complications were observed and evaluated after surgery, the follow-up period was at least 6 months. At the last time of follow-up, the satisfaction rates were evaluated by patients themselves. Four aspects of the surgical effects of the double eyelids were put into the evaluation system, which were radian, width, smoothness and symmetry, with score from 0-5 points for each. The total score was 0-20 points, of which 17-20 points indicated high satisfaction, 13-16 points indicated relative satisfaction, ≤12 points indicated dissatisfaction.Results:A total of 52 female patients were included, aged 18 to 29 years old, with an average age of 22.5 years. Among all patients, 33 cases had shallow double eyelid lines while 19 cases had single eyelids. All patients’ upper eyelids were relatively thin and without obvious looseness. The surgical procedures were all done smoothly and successfully, with an average operation time of (0.72±0.13) h. Immediately after surgery, the radian of the double eyelid lines on both sides looked smooth, the widths of the double eyelids were also basically symmetrical. During the follow-up period of 6-12 months postoperatively, the morphologies of the double eyelids were relatively natural and realistic, the double eyelid lines and widths remained deep and stable, and the incision scars were unobvious for all patients. Besides, no complications such as ptosis, incomplete upper eyelid closure and ectropion were observed. Among the 52 patients, 45 cases were highly satisfied with the surgical result, 7 cases were relatively satisfied, while none of them required reoperation.Conclusion:The continuous trapezoidal suture method between subcutaneous and subconjunctival tissue in buried-suture double-eyelid blepharoplasty has advantages of short operation time, good and stable surgical effects such as natural and realistic morphology of double eyelids, few complications, and high patients’ satisfaction rate.

This paper reports a case of reparing the tissue defect after resection of a malignant tumor in the glabellar nasion with bilateral modified horizontal advancement flaps. The patient, a 20-year-old female, was admitted to the hospital because of a mass on the nasion between the eyebrows for more than 5 years, with enlargement and ulceration for 5 months. Surgical resection of the tumor was performed. Intraoperative rapid frozen sections showed that the tumor was basal cell carcinoma, and there were no cancer cells at the margins. Bilateral modified horizontal advancement flap repair was performed. At three months after the operation, the incision area healed well, the appearance and eyelid function were normal, and there was no sign of recurrence of basal cell carcinoma. Bilateral modified horizontal advancement flap was effective in repairing the tissue defect after resection of glabellar nasal root basal cell carcinoma.

Objective:To explore the surgical effects of continuous trapezoidal suture method between subcutaneous and subconjunctival tissue in buried-suture double-eyelid blepharoplasty.Methods:A retrospective study was conducted on patients who underwent the operation of continuous trapezoidal suture method between subcutaneous and subconjunctival tissue in buried-suture double-eyelid blepharoplasty at the Department of Plastic and Aesthetic Surgery of Qingdao Municipal Hospital from September 2021 to September 2023. Six points were marked on the skin surface of the designed double eyelid line on patient' s upper eyelid, 8 points were marked on the corresponding conjunctival surface of the designed double eyelid line. A 6-0 nylon thread attached with one needle on each end was used for suturing, with two ends running through and between the subcutaneous and subconjunctival layers alternatively, forming a " trapezoidal" shape of path. Finally, two ends exited at the same point on the most lateral side of the designed double eyelid line on skin surface and were tied together with the knot hidden within the orbicularis oculi muscle. The morphology of the double eyelids and postoperative complications were observed and evaluated after surgery, the follow-up period was at least 6 months. At the last time of follow-up, the satisfaction rates were evaluated by patients themselves. Four aspects of the surgical effects of the double eyelids were put into the evaluation system, which were radian, width, smoothness and symmetry, with score from 0-5 points for each. The total score was 0-20 points, of which 17-20 points indicated high satisfaction, score of 13-16 points indicated relative satisfaction, ≤ 12 points indicated dissatisfaction.Results:A total of 52 female patients were included, aged 18 to 29 years old, with an average age of 22.5 years. Among all patients, 33 cases had shallow double eyelid lines while 19 cases had single eyelids. All patients’ upper eyelids were relatively thin and without obvious looseness. The surgical procedures were all done smoothly and successfully, with an average operation time of (0.72±0.13) h. Immediately after surgery, the radian of the double eyelid lines on both sides looked smooth, the widths of the double eyelids were also basically symmetrical. During the follow-up period of 6-12 months postoperatively, the morphologies of the double eyelids were relatively natural and realistic, the double eyelid lines and widths remained deep and stable, and the incision scars were left unobvious for all patients. Besides, no complications such as ptosis, incomplete upper eyelid closure and ectropion were observed. Among the 52 patients, 45 cases were highly satisfied with the surgical result (17-20 points) , 7 were relatively satisfied (13-16 points) , while none of them required reoperation.Conclusions:The continuous trapezoidal suture method between subcutaneous and subconjunctival tissue in buried-suture double-eyelid blepharoplasty has advantages of short operation time, good and stable surgical effects such as natural and realistic morphology of double eyelids, few complications, and high patients' satisfaction rate.

Objective:To explore the surgical effects of continuous trapezoidal suture method between subcutaneous and subconjunctival tissue in buried-suture double-eyelid blepharoplasty.Methods:A retrospective study was conducted on patients who underwent the operation of continuous trapezoidal suture method between subcutaneous and subconjunctival tissue in buried-suture double-eyelid blepharoplasty at the Department of Plastic and Aesthetic Surgery of Qingdao Municipal Hospital from September 2021 to September 2023. Six points were marked on the skin surface along the designed double eyelid line on patient’s upper eyelid, 8 points were marked on the corresponding conjunctival surface along the designed double eyelid line. A 6-0 nylon thread attached with one needle on each end was used for suturing, with two ends running through and between the subcutaneous and subconjunctival layers alternatively, forming a "trapezoidal" shape of path. Finally, two ends exited at the same point on the most lateral side of the designed double eyelid line on skin surface and were tied together with the knot hidden within the orbicularis oculi muscle. The morphology of the double eyelids and postoperative complications were observed and evaluated after surgery, the follow-up period was at least 6 months. At the last time of follow-up, the satisfaction rates were evaluated by patients themselves. Four aspects of the surgical effects of the double eyelids were put into the evaluation system, which were radian, width, smoothness and symmetry, with score from 0-5 points for each. The total score was 0-20 points, of which 17-20 points indicated high satisfaction, 13-16 points indicated relative satisfaction, ≤12 points indicated dissatisfaction.Results:A total of 52 female patients were included, aged 18 to 29 years old, with an average age of 22.5 years. Among all patients, 33 cases had shallow double eyelid lines while 19 cases had single eyelids. All patients’ upper eyelids were relatively thin and without obvious looseness. The surgical procedures were all done smoothly and successfully, with an average operation time of (0.72±0.13) h. Immediately after surgery, the radian of the double eyelid lines on both sides looked smooth, the widths of the double eyelids were also basically symmetrical. During the follow-up period of 6-12 months postoperatively, the morphologies of the double eyelids were relatively natural and realistic, the double eyelid lines and widths remained deep and stable, and the incision scars were unobvious for all patients. Besides, no complications such as ptosis, incomplete upper eyelid closure and ectropion were observed. Among the 52 patients, 45 cases were highly satisfied with the surgical result, 7 cases were relatively satisfied, while none of them required reoperation.Conclusion:The continuous trapezoidal suture method between subcutaneous and subconjunctival tissue in buried-suture double-eyelid blepharoplasty has advantages of short operation time, good and stable surgical effects such as natural and realistic morphology of double eyelids, few complications, and high patients’ satisfaction rate.

Objective To investigate the safety and effectiveness of digital subtraction angiography (DSA) in the surgical treatment of intracranial arteriovenous malformations (AVMs) in children.Methods Between December 2015 and February 2017,the clinical and imaging data of 9 children with AVM (2-14 years) underwent hybrid surgery at the Department of Neurosurgery,Xuanwu Hospital,Capital Medical University were analyzed retrospectively.According to the Spetzler-Martin grade,there were 2 patients with grade Ⅰ,3 with grade Ⅱ,2 with grade Ⅲ,and 2 with grade Ⅳ.All the children were treated with microsurgery,and their AVMs were removed by real-time assistance using DSA technique during the operation.The imaging cure rate of surgical treatment and the complications of intraoperative angiography of the children were analyzed.The children were followed up clinically after procedure.According to the modified Rankin scale (mRS) score,their prognoses were evaluated.Results Intraoperative angiography revealed that the AVMs in 8 of 9 children were resected completely,and 1 had a residual lesion,then it was resected completely.Immediately after the resection of the nidi,the angiography confirmed that the nidi of 9 children were resected completely.No related complications caused by intraoperative angiography were observed.Nominal aphasia occurred in 1 child after procedure,and he recovered gradually after 6 months.Pulmonary infection occurred in 2 children,and they were cured after anti-infection treatments.Postoperative follow-up mRS scores were 0-1 in 8 children,2 in 1 child,and no rebleeding was observed.Conclusions In children undergoing AVM surgery,initial observation of DSA is safe and effective.Intraoperative angiography can guide the complete resection of the lesions in real time,improve the surgical cure rate of AVMs,and improve the prognosis of children.

Objective To evaluate 64-slice CT angiography in diagnosing spinal vascular malformations. Methods Fifteen patients,who were suggestive of spinal vascular malformations bv clinical manifestation and MRI,underwent CT angiography with a 64-slice spiral CT(GE lightspeed VCT).DSA were performed later within 1 week in all the patients and four of them were treated with operation as well.We evaluated CTA images in displaying the lesions according to the following aspects:the type of malformation,lesion range,feeding artery,draining vein and possible fistula.and compared those details with DSA and operation findings.Results All 15 patients acquired their final diagnosis by DSA and operation,which were intramedullary axteriovenous malformation in 6 cases,perimedullary arteriovenous fistula in 2,spinal dural arteriovenous fistula in 3 and Cobb syndrome in 4 cases. CTA was consistent with DSA in the classification of lesions and in the determination of the involved regions and it reveaIed the main feeding arteries and draining veins in all patients.CTA showed four arteriovenous fistulae confinned bv DSA.but it failed in a complex arteriovcnous fistula.In Cobb syndrome patients,not only the intramedullary but also paravertebral and subcutenous vascular malformation could be clearly seen on CTA images.Conclusion 64-slice CT angiography can be a preliminary method in spinal vascular malformation because it can determine the classification and reveal almost all the main lesions quickly,atraumatically.