Objective To investigate the prognostic value of optic nerve sheath diameter(ONSD)measured by critical care ultrasound combined with serum biomarkers[S100 calcium-binding protein β(S100β)and neuron-specific enolase(NSE)]in patients with severe traumatic brain injury.Methods A total of 103 adult severe traumatic brain injury patients admitted to the intensive care unit of this hospital from A-pril 1,2023,to April 1,2024 were enrolled.All patients underwent invasive intracranial pressure monitoring after admission,alongside bedside critical care ultrasound measurement of ONSD at 3 mm behind the globe and serum biomarker testing.Baseline data and Glasgow outcome scale(GOS)scores at 90 days after dis-charge were recorded.Patients were divided into the survival and the non-survival groups based on GOS scores.Receiver operating characteristic(ROC)curve analysis and area under the curve(AUC)were used to evaluate the predictive performance of ONSD and serum biomarkers for poor prognosis in severe traumatic brain injury patients.Results Ninety-six patients were ultimately included,with 52(54.1％)in the survival group and 44(45.9％)in the non-survival group.Significant differences were observed in blood glucose,Glas-gow coma scale(GCS)score,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,ONSD,NSE,and S100β levels(P＜0.05)between the two groups.Multivariate analysis identified ONSD(OR=4.962,95％CI:3.473-6.254),NSE(OR=2.704,95％CI:1.987-3.033),S100β(OR=2.983,95％CI:1.843-4.571),and APACHE Ⅱ score(OR=3.726,95％CI:2.837-4.592)as independent predictors of mortality in severe traumatic brain injury patients(P＜0.05).The combination of ONSD,NSE,and S100β yielded an AUC of 0.840 for predicting poor prognosis,with a specificity of 88.3％and sensitivity of 98.6％.Conclusion ONSD and serum brain injury biomarkers(NSE,S100β)are associated with in-hospital prognosis in severe traumatic brain injury patients.Their combined detection can effectively predict a poor outcome.

With the prevalence of atrial fibrillation and the increasing use of intracardiac pacemakers, the incidence of isolated tricuspid regurgitation is gradually increasing. Severe isolated tricuspid regurgitation has a seriously negative effect on the survival rate and life quality of patients. As the major invasive therapy, surgery is not routinely carried out due to high perioperative mortality. This article attempts to summarize the etiology, natural course and adverse consequences of isolated tricuspid regurgitation, current treatment strategies, surgical indications and techniques, efficacy evaluation, prognostic factors and transcatheter treatment progress of isolated tricuspid regurgitation, aiming to provide references for cardiologists and further researches.

Objective To assess the validity of transanal local excision for stage Ⅰ low rectal carcinoma.Methods The clinical data of 93 patients with stage Ⅰ low rectal carcinoma who underwent transanal excision (group A,n=45)or radical resection(group B,n=48)were retrospectively analyzed.Twenty-four T1 patients and 21 T2 patients in group A received postoperative adjuvant radiation therapy and adjuvant chemoradiotherapy,respectively.All patients in group B received radical surgery only.The 5-year survival rates,recurrence rates,and postoperative complications between the 2 groups were compared.Results The 5-year survival rates were 100%(24/24)for T1 patients,86%(18/21)for T2 patients in group A,and 100%(18/18)for T1 patients,93%(28/30)for T2 patients in group B,with no significantly statistical difference between the 2 groups(P＞0.05).The recurrence rates were 4%(1/24)for T1 patients,19%(4/21)for T2 patients in group A,and 0(0/18)for T1 patients,7%(2/30)for T2 patients in group B,with no significance between the 2 groups(P＞0.05).The incidence of postoperative complications in group A was 2%(1/45),which was significantly lower than that of 15%(7/48))in group B(P＜0.05).Conclusions Transanal local excision of early low rectal carcinoma,combined with postoperative chemotherapy for T1 patients or chemoradiotherapy for T2 patients, results in a low complication rate and good sphincter function,and provides satisfactory local control and 5-year survival rates.