Objective To explore the effects of preoperative transcatheter arterial chemoembolization(TACE)on early postoperative recurrence in the China liver cancer(CNLC)staging Ⅰb-Ⅱa patients with primary hepatocellular carcinoma.Methods The data of patients with CNLC Ⅰb-Ⅱa stage hepatocellular carcinoma who underwent curative liver resection in Xiangyang Central Hospital from May 2017 to May 2022 were retrospectively analyzed.A total of 76 patients were included,patients were divided into preoperative TACE group(n=32)and surgery group(n=44)according to whether they underwent preoperative TACE.Observe the postoperative recovery of patients.Combined with the postoperative pathological results,adjuvant TACE treatment is performed.Regular reexamination and follow-up are conducted after discharge.The Kaplan-Meier method was used to estimate survival time,calculate 95％CI,and plot the Disease-free(DFS)survival curve.The Cox proportional risk model was used for univariate and multivariate analysis.Results The 1-year disease-free survival rate in the preoperative TACE group was higher than that in the direct surgery group(96.9％vs.84.1％,P＞0.05).The 2-year disease-free survival rate in the preoperative TACE group was higher than that in the direct surgery group(90.6％vs.70.5％,P＜0.05).The disease-free survival of the preoperative TACE group was higher than the direct surgery group(23.03 months vs.20.14 months,P＜0.05).The incidence of treatment-related adverse events after surgery in the preoperative TACE group was higher than that in the direct surgery group(34.4％vs.20.5％,P＞0.05).Multivariate Cox regression analysis showed that different treatment methods,tumor number ≥ 2,and tumor microvascular invasion were prognostic factors affecting tumor recurrence.No severe adverse reactions occurred in either group,and no deaths caused by adverse reactions were observed.Conclusion Compared with direct surgery,preoperative TACE can help improve early postoperative recurrence,prolong patients'disease-free survival,and do not lead to serious adverse events.

Objective To investigate the clinical efficacy of wrapping the hepatic artery with the hepatogastric ligament for preventing bleeding of the hepatic artery and its branches following pancreaticoduodenectomy(PD).Methods 194 patients who underwent PD in Xiangyang Central Hospital from January 2017 to November 2024 were enrolled and categorized into two groups based on whether the hepatic artery was enwrapped with the hepatogastric ligament during the operation.The wrapped group consisted of 95 cases where the hepatic artery was wrapped,while the non-wrapped group had 99 cases without such wrapping.Intraoperative parameters(intraoperative blood loss and operative time)and postoperative complications(pancreatic fistula,abdominal cavity infection,biliary fistula,delayed gastric emptying,postoperative bleeding,and bleeding of the hepatic artery and its branches)were compared between the two cohorts.Univariate and multivariate Logistic regression analyses were conducted to identify the independent risk factors for postoperative bleeding.Results PD was accomplished successfully in both groups.There was no remarkable difference in intraoperative indices like blood loss and operative time between the two groups(P＞0.05).Similarly,no significant disparities were noted in postoperative complications such as pancreatic fistula,abdominal infection,biliary fistula,and delayed gastric emptying(P＞0.05).Nevertheless,the incidence of postoperative bleeding in the wrapped group was lower than that in the non-wrapped group(3.16％vs.12.12％,P=0.019),and the incidence of bleeding of the hepatic artery and its branches after surgery was also significantly decreased in the wrapped group(0 vs.10.10％,P=0.004).Logistic regression analysis revealed that the operation time(OR=1.013,P=0.011),pancreatic fistula(OR=9.006,P=0.006)and celiac infection(OR=7.930,P=0.014)are independent risk factors of postoperative bleeding,Hepatogastric ligament encapsulation of hepatic artery was an independent protective factor for postoperative hemorrhage of PD(OR=0.084,P=0.006).Conclusion Wrapping the hepatic artery with the hepatogastric ligament reduces PD postoperative bleeding,especially that of the hepatic artery and its branches,without adding other complications.

Objective To explore the effects of preoperative transcatheter arterial chemoembolization(TACE)on early postoperative recurrence in the China liver cancer(CNLC)staging Ⅰb-Ⅱa patients with primary hepatocellular carcinoma.Methods The data of patients with CNLC Ⅰb-Ⅱa stage hepatocellular carcinoma who underwent curative liver resection in Xiangyang Central Hospital from May 2017 to May 2022 were retrospectively analyzed.A total of 76 patients were included,patients were divided into preoperative TACE group(n=32)and surgery group(n=44)according to whether they underwent preoperative TACE.Observe the postoperative recovery of patients.Combined with the postoperative pathological results,adjuvant TACE treatment is performed.Regular reexamination and follow-up are conducted after discharge.The Kaplan-Meier method was used to estimate survival time,calculate 95％CI,and plot the Disease-free(DFS)survival curve.The Cox proportional risk model was used for univariate and multivariate analysis.Results The 1-year disease-free survival rate in the preoperative TACE group was higher than that in the direct surgery group(96.9％vs.84.1％,P＞0.05).The 2-year disease-free survival rate in the preoperative TACE group was higher than that in the direct surgery group(90.6％vs.70.5％,P＜0.05).The disease-free survival of the preoperative TACE group was higher than the direct surgery group(23.03 months vs.20.14 months,P＜0.05).The incidence of treatment-related adverse events after surgery in the preoperative TACE group was higher than that in the direct surgery group(34.4％vs.20.5％,P＞0.05).Multivariate Cox regression analysis showed that different treatment methods,tumor number ≥ 2,and tumor microvascular invasion were prognostic factors affecting tumor recurrence.No severe adverse reactions occurred in either group,and no deaths caused by adverse reactions were observed.Conclusion Compared with direct surgery,preoperative TACE can help improve early postoperative recurrence,prolong patients'disease-free survival,and do not lead to serious adverse events.

Objective To investigate the clinical efficacy of wrapping the hepatic artery with the hepatogastric ligament for preventing bleeding of the hepatic artery and its branches following pancreaticoduodenectomy(PD).Methods 194 patients who underwent PD in Xiangyang Central Hospital from January 2017 to November 2024 were enrolled and categorized into two groups based on whether the hepatic artery was enwrapped with the hepatogastric ligament during the operation.The wrapped group consisted of 95 cases where the hepatic artery was wrapped,while the non-wrapped group had 99 cases without such wrapping.Intraoperative parameters(intraoperative blood loss and operative time)and postoperative complications(pancreatic fistula,abdominal cavity infection,biliary fistula,delayed gastric emptying,postoperative bleeding,and bleeding of the hepatic artery and its branches)were compared between the two cohorts.Univariate and multivariate Logistic regression analyses were conducted to identify the independent risk factors for postoperative bleeding.Results PD was accomplished successfully in both groups.There was no remarkable difference in intraoperative indices like blood loss and operative time between the two groups(P＞0.05).Similarly,no significant disparities were noted in postoperative complications such as pancreatic fistula,abdominal infection,biliary fistula,and delayed gastric emptying(P＞0.05).Nevertheless,the incidence of postoperative bleeding in the wrapped group was lower than that in the non-wrapped group(3.16％vs.12.12％,P=0.019),and the incidence of bleeding of the hepatic artery and its branches after surgery was also significantly decreased in the wrapped group(0 vs.10.10％,P=0.004).Logistic regression analysis revealed that the operation time(OR=1.013,P=0.011),pancreatic fistula(OR=9.006,P=0.006)and celiac infection(OR=7.930,P=0.014)are independent risk factors of postoperative bleeding,Hepatogastric ligament encapsulation of hepatic artery was an independent protective factor for postoperative hemorrhage of PD(OR=0.084,P=0.006).Conclusion Wrapping the hepatic artery with the hepatogastric ligament reduces PD postoperative bleeding,especially that of the hepatic artery and its branches,without adding other complications.

Objective To analysis the change of hip joint in healthy infants by ultrasound,and establish the normal reference value of the developmental dysplasia of the hip(DDH). Methods A total of 8 000 healthy infants from 0 to 24 weeks were collected from the Multi-center study of 10 children′s medical centers. Among them,3 855 infants(2 065 females and 1 790 males) with complete data and follow-up were included in this study. All subjects were divided into 6 groups ( ＜4,4～7,8～11,12～15,16～19 and≥20 weeks group). α angle,femoral head length and width,femoral head coverage ratio by acetabulum ( FHC) were measured in the coronal view on the neutral position;distance from pubis to femoral head ( P-H) and distance from ischium to femoral head ( I-H ) were measured in the transverse view on neutral position;distance from femoral head topubis ( H-P) was measured in the posterolateraltransverse view on the flexion position. The results of each group changes with age were analysised. Results ① The α angle of healthy infants from 0 to 20 weeks were increased with age,the difference among the groups were statistically significant( P ＜0.05),but there was no significant difference between 16～19 and ≥20 weeks group( P ＞0.05). ②The femoral head length and width of all age groups were increased with age,the difference among all the groups was statistically significant( all P ＜0.05). ③ FHC from 0 to 20 weeks were increased with age,the difference among the groups were statistically significant( P ＜0.05) except between 16～19 and ≥20 weeks group( P ＞0.05). ④ The P-H and I-H in all age groups showed no statistically significant ( all P＞0.05). ⑤The H-P of all age groups were increased with age,the difference between the groups were statistically significant(all P ＜0.05).Conclusions The development of hip joints have the certain regular developmental pattern in healthy infants less than 5 months of birth and are relatively constant after birth more than 5 months. The ultrasound normal reference value of the hip joints can be used for the early diagnosis of the DDH.