Objective:To explore the clinical efficacy of percutaneous balloon compression (PBC) in the treatment of trigeminal neuralgia (TN) based on the double difference (DID) model.Methods:A retrospective case - control study method was adopted to analyze the general data of 130 patients with trigeminal neuralgia (TN) who were treated in the Department of Neurosurgery of Hebei General Hospital from January 2022 to October 2023. Among them, 49 were males and 81 were females. The age was (53.28±11.67) years, ranging from 25 to 80 years old. According to different treatment methods, the patients were divided into an experimental group ( n=63) and a control group ( n=67). Patients in the experimental group were given percutaneous balloon compression (PBC) treatment, while those in the control group were treated with conservative drug therapy. Propensity score matching method was used for 1∶1 matching. After matching, there were 52 cases in each group. The general data of the two groups were compared. The visual analogue scale (VAS), 36-item short form health survey (SF-36) score, Hamilton depression rating scale (HAMD) score, Hamilton anxiety rating scale (HAMA) score, 5-hydroxytryptamine, neuropeptide P, inflammatory factor interleukin-1 (IL-1), tumor necrosis factor-α (TNF-α) before and after treatment, as well as the clinical efficacy of the two groups of patients were comparatively analyzed. Meanwhile, the incidence of postoperative complications in the two groups was compared. The generalized estimating equation (GEE) model was used to analyze the influencing factors of clinical efficacy, and the difference-in-differences (DID) model was used to evaluate the efficacy before and after treatment. Measurement data conforming to the normal distribution were expressed as mean±standard deviation ( ± s), and the t-test was used for comparison between groups; the chi- square test was used for comparison between count data. Results:After treatment, the VAS, SF-36 score, HAMD score, HAMA score, 5-hydroxytryptamine level, neuropeptide P level, IL-1 level, and TNF-α level in the experimental group were (2.98±0.83) points, (75.56±1.18) points, (7.2±0.83) points, (7.15±0.85) points, (76.34±5.47) ng/mL, (50.95±11.01) pg/mL, (29.45±7.08) ng/L, and (21.18±3.55) ng/L respectively. In the control group, there were (3.63±0.95) points, (73.23±1.13) points, (7.98±0.80) points, (8.04±0.84) points, (186.31±11.61) ng/mL, (86.52±13.32) pg/mL, (34.47±6.58) ng/L, and (26.36±5.80) ng/L, respectively. The differences between the two groups were statistically significant ( P<0.05).The cure rate and the total incidence of postoperative complications in the experimental group were 55.77% and 13.46% respectively, while in the control group, they were 40.38% and 30.77% respectively. The differences between the two groups were statistically significant ( P<0.05).The results of the GEE model analysis showed that age, course of disease, VAS, SF-36 score, HAMA score, HAMD score, 5-hydroxytryptamine level, neuropeptide P level, IL-1 level, TNF-α level, treatment method, and the long - diameter ratio of FO significantly affected the clinical efficacy of patients ( P<0.05).The results of the DID model showed that the experimental group was superior to the control group in improving the VAS, SF-36 score, HAMD score, HAMA score, 5-hydroxytryptamine level, neuropeptide P level, IL-1 level, and TNF-α level( P<0.05). Conclusion:PBC can significantly improve the VAS, SF-36 score, HAMD score, HAMA score, 5-hydroxytryptamine, neuropeptide P, IL-1, TNF-α, and incidence of complications in patients with TN. It can also improve the psychological status and quality of life of patients.

Objective To investigate the value of radiomics nomogram model based on enhanced CT for predicting postoperative pancreatic fistula(POPF)in patients undergoing pancreaticoduodenectomy(PD).Methods The clinical and abdominal imaging data of 82 patients who underwent PD were analyzed retrospectively.They were divided into training set and validation set at a ratio of 3∶2.In the venous phase of CT,the maximum slice of the pancreatic duct was selected to delineate the region of interest(ROI),and the features were extracted and screened to construct the radiomics model.The independent risk factors associated with POPF were screened by univariate and multivariable logistic regression analyses to construct the clinical model.A nomogram model was created by combining Radiomics score(Radscore)and clinical risk factors.The diagnostic performance of the model was verified by the vali-dation set.Results The nomogram model demonstrated significant predictive power,with an area under the curve(AUC)of 0.862 and 0.806 in the training set and validation set,respectively.Conclusion The nomogram model exhibits excellent predictive performance and outperforms the clinical model and radiomics model in predicting POPF,which can provide important guidance for clinical deci-sion-making.

Objective:To summarize the clinical characteristics and genetic etiology of infants with D-bifunctional protein deficiency (DBPD).Methods:This study involved two DBPD newborns who were hospitalized in the Second Affiliated Hospital of Wenzhou Medical University in August 2020 and November 2020. Clinical data including manifestations, radiographic findings and genetic testing results were retrospectively analyzed. Relevant articles up to November 2022 were retrieved from various databases including CNKI, Wanfang, CQVIP, Online Mendelian Inheritance in Man and PubMed using the terms of "D-bifunctional protein deficiency" and " HSD17B4" in both Chinese and English. Clinical data of the cases diagnosed with DBPD by genetic testing within two years of age were collected. Clinical features and genetic etiology of the children with DBPD were summarized by descriptive statistical analysis. Results:Both neonates in this report presented with dyspnea, hypotonia, intractable epilepsy, poor response, absence of primitive reflexes, and craniofacial malformation. Whole-exome sequencing revealed that patient 1 carried heterozygous variations of c.972+1G>T and c.727T>A (p.W243R) in the HSD17B4 gene, which were inherited from his father and mother, respectively. A homozygous variation of c.1333+4A>G in the HSD17B4 gene was identified in patient 2. All these mutations were pathogenic. Thirteen papers (12 in English and one in Chinese) involving 19 patients from 16 pedigrees were retrieved. Altogether 21 patients (eight males and 13 females) were included, and among them, four from two pedigrees were born to consanguineous parents. There were 21 patients with hypotonia, 20 with epileptic seizures (17 presenting with epileptic seizures within 5 d after birth) and 12 with craniofacial deformities including high forehead, long philtrum and high palatine arches. Genetic tests showed that 13 patients carried compound heterozygous variations in the HSD17B4 gene and eight patients had homozygous variations. Twenty-six variations in the HSD17B4 gene were detected, including 16 missense mutations, seven splicing mutations, two nonsense mutations and one frameshift mutation. Conclusion:DBPD should be considered and genetic tests should be given when newborns have dystonia and intractable epilepsy complicated by appearance deformity.

Objective:To explore surgical approaches to preserve fertility and assisted reproductive technology strategies for pregnancy in patients with recurrent borderline ovarian tumors.Methods:A case of recurrent borderline ovarian tumor was retrospectively analyzed. The patient was admitted several times and underwent right adnexectomy and cysts debulking in the left ovary for recurrent borderline tumors. The patient was infertile for 3 years without contraception. Considering the patient's strong desire for childbearing, ovulation treatment was performed with a microstimulation protocol. The left ovarian tumor enlarged significantly during the process of assisted reproductive technology for pregnancy assistance, left oophorectomy was carried by laparoscopic and healthy ovarian cortex was frozen to preserve fertility.Results:The patient underwent 5 times of controlled ovulation cycles, acquired 7 available embryos. The patient had a successful pregnancy and delivered a live baby on the third frozen embryo cycle transfer. The patient still had 2 embryos and 3 pieces of ovarian tissue frozen.Conclusion:Patients with borderline ovarian tumors who are young and have fertility needs can undergo fertility preserving surgery and assisted reproductive technology to help them get pregnant, which may lead to a higher risk of disease recurrence to a certain extent, but it does not affect the quality of patients' survival and allows the patient to achieve her fertility aspirations.

Objective:To explore surgical approaches to preserve fertility and assisted reproductive technology strategies for pregnancy in patients with recurrent borderline ovarian tumors.Methods:A case of recurrent borderline ovarian tumor was retrospectively analyzed. The patient was admitted several times and underwent right adnexectomy and cysts debulking in the left ovary for recurrent borderline tumors. The patient was infertile for 3 years without contraception. Considering the patient's strong desire for childbearing, ovulation treatment was performed with a microstimulation protocol. The left ovarian tumor enlarged significantly during the process of assisted reproductive technology for pregnancy assistance, left oophorectomy was carried by laparoscopic and healthy ovarian cortex was frozen to preserve fertility.Results:The patient underwent 5 times of controlled ovulation cycles, acquired 7 available embryos. The patient had a successful pregnancy and delivered a live baby on the third frozen embryo cycle transfer. The patient still had 2 embryos and 3 pieces of ovarian tissue frozen.Conclusion:Patients with borderline ovarian tumors who are young and have fertility needs can undergo fertility preserving surgery and assisted reproductive technology to help them get pregnant, which may lead to a higher risk of disease recurrence to a certain extent, but it does not affect the quality of patients' survival and allows the patient to achieve her fertility aspirations.

ObjectiveTo explore the intervention effect and mechanism of Buzhong Yiqiwan （BZYQ） on colitis mice. MethodSixty-four C57BL/6 mice were randomly divided into 2 weeks blank group， 2 weeks model group， 2 weeks high-dose BZYQ （12 g·kg^-1） group， 2 weeks low-dose BZYQ （6 g·kg^-1） group， 4 weeks blank group， 4 weeks model group， 4 weeks high-dose BZYQ （12 g·kg^-1） group， and 4 weeks low-dose BZYQ （6 g·kg^-1） group. The colitis model was induced in mice by feeding 3% dextran sodium sulfate （DSS） for 7 days. The mice received BZYQ （12 and 6 g·kg^-1） by gavage on the 8^th day after modeling， once per day， and sacrificed on the 2^nd and 4^th weeks， correspondingly. The colon length and weight of mice in each group were measured. Hematoxylin-eosin （HE） staining was used for pathological observation and colonic mucosal inflammation was scored. The mRNA and protein expression of NOD-like receptor thermoprotein domain 3 （NLRP3）， apoptosis-associated speck-like protein containing a CARD （ASC）， and cysteinyl aspartate-specific protease-1 （Caspase-1） was detected by real-time quantitative polymerase chain reaction （Real-time PCR） and Western blot， respectively. Enzyme-linked immunosorbent assay （ELISA） was used to detect the content of inflammatory cytokines， such as interleukin （IL）-1β， IL-18， and IL-33 in colonic tissues. ResultCompared with the 2 weeks blank group， the 2 weeks model group showed shortened colon length， increased colon weight （P<0.05）， loss of epithelial cells， destruction of gland structure， infiltration of a large number of inflammatory cells in mucosa and submucosa， local crypt abscess， and increase in mucosal inflammation score （P<0.01） as revealed by light microscopy， elevated levels of IL-1β， IL-18， and IL-33 in colonic tissues （P<0.05）， and increased mRNA and protein expression of NLRP3， ASC， and Caspase-1 （P<0.05）. The intervention of BZYQ （12 g·kg^-1） restored colon length， alleviated mucosal injury （P<0.05）， down-regulated the content of IL-18 （P<0.05）， reduced the mRNA expression of NLRP3 and ASC as well as the protein expression of ASC and Caspase-1 compared with the conditions in the 2 weeks model group. Compared with the 4 weeks blank group， the 4 weeks model group showed decreased colon length， increased colon weight （P<0.05）， decreased glands in the mucosal layer， expansion of glandular cavity， atrophy of crypt， local connective tissue hyperplasia and lymphocyte infiltration， increased inflammation score （P<0.01） as revealed by the light microscopy， increased expression of IL-1β， IL-18， and IL-33 （P<0.05）， and elevated mRNA and expression of NLRP3 inflammasome complex （P<0.05）. Compared with the conditions in the 4 weeks model group， the intervention of BZYQ （12 and 6 g·kg^-1） could improve colon length and weight （P<0.05）， and the intervention of BZYQ （12 g·kg^-1） could also improve the inflammation score of the colon （P<0.05）. Different from the acute stage， the intervention of BZYQ （12 and 6 g·kg^-1） increased the content of IL-33 in the intestinal mucosa and up-regulated the mRNA and protein expression of NLRP3 inflammasome complexes ASC and Caspase-1 （P<0.05）. ConclusionBZYQ can relieve the injury of colitis induced by DSS in mice. The mechanism is related to the regulation of intestinal immune response mediated by NLRP3 inflammasome， and it has different regulatory effects in acute and chronic inflammation stages.

Exosomes are cell-derived nanovesicles with diameters from 30 to 150 nm, released upon fusion of multivesicular bodies with the cell surface. They can transport nucleic acids, proteins, and lipids for intercellular communication and activate signaling pathways in target cells. In cancers, exosomes may participate in growth and metastasis of tumors by regulating the immune response, blocking the epithelial-mesenchymal transition, and promoting angiogenesis. They are also involved in the development of resistance to chemotherapeutic drugs. Exosomes in liquid biopsies can be used as non-invasive biomarkers for early detection and diagnosis of cancers. Because of their amphipathic structure, exosomes are natural drug delivery vehicles for cancer therapy.

Colorectal cancer is the fourth most malignant tumors in China, among which the left hemicolon cancer accounts for about 5%?6%. Due to the complex anatomy around the left hemicolon, being adjacent to the pancreas, spleen, kidney, ureter and other important organs, its vascular and nerve distribution is variably distributed, leading difficulties in laparoscopic radical surgery for left hemicolon cancer. In surgical practice, the 4K laparoscopic system has shown its features of high-definition amplification, good color reproduction, and clear anatomy, etc. However, there is still no clear consensus on its application in the radical resection for the left hemicolon cancer. The authors summarize clinical practice, explore the technique key points of 4K laparoscopic D 3 resection with complete mesocolic excision for the left hemicolon cancer.

Glioblastoma multiforme (GBM) in the central nervous system is the most lethal advanced glioma and currently there is no effective treatment for it. Studies of sinomenine, an alkaloid from the Chinese medicinal plant,

Objective:To explore the application value of neurovascular three-dimensional (3D) reconstruction with 3D-slicer software in the preoperative diagnosis of neurovascular relations and offending arteries in patients with vertebrobasilar dilatation (VBD) complicated with facial muscle spasm (HFS).Methods:The clinical data of 42 patients with VBD complicated with HFS accepted microvascular decompression (MVD) in our hospital from January 2016 to February 2019 were retrospectively analyzed. The data of skull 3D-TOF MR angiography and 3D-FiESTA MR imaging were imported into 3D-slicer software to establish 3D models of the blood vessels, brain stem and facial auditory nerves of the patients before surgery. The neurovascular relations and offending arteries found during surgery were compared with those diagnosed by 3D-TOF MR angiography combined with 3D-FiESTA MR imaging and 3D models.Results:The consistencies of neurovascular relations and offending arteries found during surgery and those showed by 3D models were good ( Kappa=0.889, P=0.000; Kappa=0.869, P=0.000). The consistency of neurovascular relations showed by 3D models and those diagnosed by 3D-TOF MR angiography combined with 3D-FiESTA MR imaging was good( Kappa=0.809, P=0.000); there was no significant difference between the two methods in diagnosing neurovascular relations ( McNemar-Bowker=5.000, P=0.082). The consistency of offending arteries showed by 3D models and those diagnosed by 3D-TOF MR angiography combined with 3D-FiESTA MR imaging was poor ( Kappa=0.336, P=0.000); there was significant difference between the two methods in diagnosing offending arteries ( McNemar-Bowker=23.000, P=0.000). Conclusion:The 3D-slicer software is used to perform 3D simultaneous reconstruction of blood vessels, nerves and brain stem in the cerebellopontine angle, and the results are highly consistent with surgical findings; 3D-slicer software is more helpful than 3D-TOF MR angiography combined with 3D-FiESTA MR imaging in identification of offending arteries, surgical risk assessment and surgical strategy formulation in patients with VBD complicated with HFS.