Objective:To investigate risk factors for permanent hypoparathyroidism (PHPP) after total thyroidectomy in patients with differentiated thyroid carcinoma (DTC).Methods:The clinical data of 316 DTC patients who underwent total thyroidectomy at our hospital from Jan 2020 to Jan 2023 were retrospectively analyzed. Patients were divided into normal parathyroid function group (284 cases) and hypoparathyroidism group (32 cases) according to whether parathyroid function was decreased. The clinical examination, intraoperative conditions and postoperative pathological data of the two groups were statistically analyzed.Results:Logistic regression analysis showed that: serum calcium on the first postoperative day ( OR=0.163, P<0.05), parathyroid hormon (PTH) on the first postoperative day ( OR=0.958, P<0.05), bilateral lymph node dissection ( OR=3.138, P<0.05), accidental resection of parathyroid (PG) ( OR=2.614, P<0.05), posterior capsule tumor invasion ( OR=3.336, P<0.05) and multiple cancer foci ( OR=2.664, P<0.05) were independent risk factors for PHPP after total thyroidectomy. Conclusion:Postoperative day 1 serum calcium, postoperative day 1 PTH, bilateral lymph node dissection, accidental resection of PG, posterior capsule invasion and multiple cancer foci are independent risk factors for PHPP after total thyroidectomy.

Objective:To investigate the factors influencing the metastasis of right-sided lymph nodes posterior to right recurrent laryngeal nerve (LN-prRLN) in patients with papillary thyroid microcarcinoma (PTMC) at cN 0 stage, to construct a nomogram prediction model for metastasis of right-sided LN-prRLN in patients with PTMC at cN 0 stage and to provide the decision reference for the dissection of right-sided LN-prRLN. Methods:A retrospective case-controlled study was conducted. The clinical data of patients receiving right-sided LN-prRLN dissection in Baoding No.1 Central Hospital between January 2023 and June 2024 were collected. All patients were divided into the metastatic group and the normal group according to whether metastasis of right-sided LN-prRLN would happen after the postoperative pathological examination. The differences in the clinicopathological characteristics between the 2 groups were compared, and multivariate logistic regression model was used to screen out the independent risk factors influencing right-sided LN-prRLN. A nomogram prediction model for metastasis of right-sided LN-prRLN based on independent risk factors was built; taking the postoperative pathological examination results as the gold standard, the receiver operating characteristic (ROC) curve was used to evaluate the efficacy of the model in determining the metastasis of right-sided LN-prRLN. Bootstrap internal validation method was used for random sampling to calculate the consistency index (CI) of the model. The calibration curves and clinical decision curves were drawn to respectively verify the calibration degree of the model and the clinical application ability of the model.Results:All 235 patients included 57 males (24.3%) and 178 females (75.7%). The age was (39±13) years old and 47 cases (20.0%) out of 235 patients had the metastasis of right-sided LN-prRLN. The proportion of patients characterized by male, right-sided tumors, tumor diameter > 0.5 cm, extrathyroidal invasion, metastasis of right-sided lymph nodes anterior to right recurrent laryngeal nerve (LN-arRLN) in the metastatic group was higher than that in the normal group, and the differences were statistically significant (all P < 0.05). Multivariate logistic regression analysis showed that male ( OR = 3.705, 95% CI: 1.133-12.116, P = 0.030), right-sided tumors ( OR = 5.610, 95% CI: 1.811-17.381, P = 0.003), the increased tumor diameter ( OR = 3.504, 95% CI: 1.169-10.507, P = 0.025), extrathyroidal invasion ( OR = 2.812, 95% CI: 1.026-7.708, P = 0.044) and right-sided LN-arRLN metastasis ( OR = 10.522, 95% CI: 3.237-34.199, P < 0.001) were independent risk factors of the metastasis of LN-prRLN in PTMC patients at cN 0 stage; based on the above independent risk factors, a nomogram prediction model was established. The ROC curve showed that the area under the curve of the nomogram prediction model for determining the metastasis of right-sided LN-prRLN in PTMC patients at cN 0 stage was 0.864 (95% CI: 0.794-0.935), Youden index was 0.735, the optimal cut-off value was 4.562, the corresponding sensitivity was 87.0%, and the corresponding specificity was 86.5%, which indicated a high predictive value of the nomogram model. Bootstrap test internal validation showed that the CI was 0.810 (95% CI: 0.763-0.917). Calibration curves showed that bias-corrected line was close to the ideal line, indicating a good consistency ( P = 0.347). Decision curve showed a good clinical efficacy. Conclusions:Male, right-sided tumors, the increased tumor diameter, extrathyroidal invasion and right-sided LN-arRLN metastasis are independent risk factors for right-sided LN-prRLN metastases in patients with PTMC at cN 0 stage. The nomogram prediction model based on the above factors has a good predictive performance, which is helpful for surgeons to make clinical decisions.

Objective:To investigate risk factors for permanent hypoparathyroidism (PHPP) after total thyroidectomy in patients with differentiated thyroid carcinoma (DTC).Methods:The clinical data of 316 DTC patients who underwent total thyroidectomy at our hospital from Jan 2020 to Jan 2023 were retrospectively analyzed. Patients were divided into normal parathyroid function group (284 cases) and hypoparathyroidism group (32 cases) according to whether parathyroid function was decreased. The clinical examination, intraoperative conditions and postoperative pathological data of the two groups were statistically analyzed.Results:Logistic regression analysis showed that: serum calcium on the first postoperative day ( OR=0.163, P<0.05), parathyroid hormon (PTH) on the first postoperative day ( OR=0.958, P<0.05), bilateral lymph node dissection ( OR=3.138, P<0.05), accidental resection of parathyroid (PG) ( OR=2.614, P<0.05), posterior capsule tumor invasion ( OR=3.336, P<0.05) and multiple cancer foci ( OR=2.664, P<0.05) were independent risk factors for PHPP after total thyroidectomy. Conclusion:Postoperative day 1 serum calcium, postoperative day 1 PTH, bilateral lymph node dissection, accidental resection of PG, posterior capsule invasion and multiple cancer foci are independent risk factors for PHPP after total thyroidectomy.

Objective:To investigate the factors influencing the metastasis of right-sided lymph nodes posterior to right recurrent laryngeal nerve (LN-prRLN) in patients with papillary thyroid microcarcinoma (PTMC) at cN 0 stage, to construct a nomogram prediction model for metastasis of right-sided LN-prRLN in patients with PTMC at cN 0 stage and to provide the decision reference for the dissection of right-sided LN-prRLN. Methods:A retrospective case-controlled study was conducted. The clinical data of patients receiving right-sided LN-prRLN dissection in Baoding No.1 Central Hospital between January 2023 and June 2024 were collected. All patients were divided into the metastatic group and the normal group according to whether metastasis of right-sided LN-prRLN would happen after the postoperative pathological examination. The differences in the clinicopathological characteristics between the 2 groups were compared, and multivariate logistic regression model was used to screen out the independent risk factors influencing right-sided LN-prRLN. A nomogram prediction model for metastasis of right-sided LN-prRLN based on independent risk factors was built; taking the postoperative pathological examination results as the gold standard, the receiver operating characteristic (ROC) curve was used to evaluate the efficacy of the model in determining the metastasis of right-sided LN-prRLN. Bootstrap internal validation method was used for random sampling to calculate the consistency index (CI) of the model. The calibration curves and clinical decision curves were drawn to respectively verify the calibration degree of the model and the clinical application ability of the model.Results:All 235 patients included 57 males (24.3%) and 178 females (75.7%). The age was (39±13) years old and 47 cases (20.0%) out of 235 patients had the metastasis of right-sided LN-prRLN. The proportion of patients characterized by male, right-sided tumors, tumor diameter > 0.5 cm, extrathyroidal invasion, metastasis of right-sided lymph nodes anterior to right recurrent laryngeal nerve (LN-arRLN) in the metastatic group was higher than that in the normal group, and the differences were statistically significant (all P < 0.05). Multivariate logistic regression analysis showed that male ( OR = 3.705, 95% CI: 1.133-12.116, P = 0.030), right-sided tumors ( OR = 5.610, 95% CI: 1.811-17.381, P = 0.003), the increased tumor diameter ( OR = 3.504, 95% CI: 1.169-10.507, P = 0.025), extrathyroidal invasion ( OR = 2.812, 95% CI: 1.026-7.708, P = 0.044) and right-sided LN-arRLN metastasis ( OR = 10.522, 95% CI: 3.237-34.199, P < 0.001) were independent risk factors of the metastasis of LN-prRLN in PTMC patients at cN 0 stage; based on the above independent risk factors, a nomogram prediction model was established. The ROC curve showed that the area under the curve of the nomogram prediction model for determining the metastasis of right-sided LN-prRLN in PTMC patients at cN 0 stage was 0.864 (95% CI: 0.794-0.935), Youden index was 0.735, the optimal cut-off value was 4.562, the corresponding sensitivity was 87.0%, and the corresponding specificity was 86.5%, which indicated a high predictive value of the nomogram model. Bootstrap test internal validation showed that the CI was 0.810 (95% CI: 0.763-0.917). Calibration curves showed that bias-corrected line was close to the ideal line, indicating a good consistency ( P = 0.347). Decision curve showed a good clinical efficacy. Conclusions:Male, right-sided tumors, the increased tumor diameter, extrathyroidal invasion and right-sided LN-arRLN metastasis are independent risk factors for right-sided LN-prRLN metastases in patients with PTMC at cN 0 stage. The nomogram prediction model based on the above factors has a good predictive performance, which is helpful for surgeons to make clinical decisions.

OBJECTIVE To investigate the related factors of central lymph node metastasis(CLNM)in papillary thyroid carcinoma(PTC)with capsular invasion,and to construct a clinical nomogram prediction model.Its purpose is to provide theoretical basis for clinical diagnosis and treatment.METHODS The clinical data of PTC patients with capsule invasion admitted to the Department of General Surgery,Baoding First Central Hospital from October,2020 to October,2023 were retrospectively analyzed.The data included gender,age,body mass index(BMI),aspect ratio,tumor location,multifocality,microcalcification,Hashimoto thyroiditis(HT)and tumor diameter.According to the presence or absence of CLNM,the patients were divided into the normal group(107 cases)and the metastasis group(108 cases).Univariate and multivariate analysis of the data were performed to construct a visual nomogram prediction model,and the receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic efficacy of the model.The nomogram model was internally verified using a Bootstrap test with 1000 repeated samples.Consistency index(C-index)and calibration curve were used to describe the prediction performance and prediction accuracy of the model.Finally,the clinical decision curve(DCA)was drawn to determine the clinical application ability of the model.RESULTS A total of 215 PTC patients with capsular invasion were included,of whom 108(50.23%)had CLNM.Univariate analysis showed that the occurrence of CLNM was associated with tumor diameter,aspect ratio>1,tumor located in the lower pole,multifocality,and HT(P<0.05).Multivariate regression analysis showed that tumor diameter,aspect ratio>1,tumor located in the lower pole and multifocus were independent risk factors for CLNM(OR=1.401,1.875,2.291,2.303,P<0.05),and HT was a protective factor for CLNM(OR=0.501,P<0.05).Based on the above risk factors,a nomogram prediction model for CLNM in patients with PTC with capsule invasion was constructed.The ROC curves showed that the area under the curve(AUC)was 0.859(95%CI:0.792-0.925,Yoden Index was 0.734,the sensitivity was 0.878,a specificity was 0.856),and the model had higher predictive value.Internal validation consistency index(C-index)was 0.83(95%CI,0.748 to 0.959).The calibration curve showed that the predictive value was close to the ideal curve,and it had good consistency.The DCA curve showed that the model had good clinical efficacy.CONCLUSION Larger tumor size,aspect ratio>1,tumor located in the lower pole and multifocality suggest higher risk of CLNM in PTC with capsular invasion,while HT is a protective factor for CLNM.The nomogram model based on the above risk factors has high discrimination and calibration,which is helpful for clinicians in preoperative evaluation and intraoperative exploration,so that high-risk patients can be prevented and treated as soon as possible.

Clinical data of 15 patients diagnosed with acute renal infarction (ARI) in Affiliated Zhongshan Hospital of Dalian University from Jan 2011 to Dec 2021 were retrospectively analyzed. Of the included 15 patients, there were 14 cases of cardiac origin and 1 case of antiphospholipid syndrome. We found that there were 12 cases of atrial fibrillation, 2 cases of atrial premature beats, 12 cases of elevated level of D-dimer, 15 cases of elevated level of LDH, 11 cases of positive urine occult blood and positive urine protein. Among the 15 patients, catheter-directed thrombolysis was performed in 4 cases, of which 3 cases were revascularized successfully, intravenous thrombolysis in 2 cases and alone anticoagulation therapy in 9 cases. It is suggested that CECT or CTA can assist the early diagnosis of ARI especially in patients with acute onset and persistent abdominal pain with high risk factors of thromboembolism, high levels of LDH, microscopic hematuria and/or proteinuria. Despite prolonged embolic ischemia, try to reconstruct blood flow to save the kidney as much as possible. Late standardized anticoagulant therapy is of critical importance to prevent recurrent embolic episodes.

Objective: To systematically evaluate the diagnostic value of optical imaging combined with indocyanine green (ICG)-guided sentinel lymph node (SLN) biopsy in gastric cancer, and to identify potential factors that would influence diagnostic accuracy. Methods: Study was carried out by searching the electronic database of PubMed, Embase, Medline, Web of Science, and the Cochrane Library with keywords as "gastric/stomach" and "cancer/carcinoma/tumor/tumour/adenocarcinoma/neoplasm" and "sentinel lymph node" and "near-infrared/NIR or fluorescent imaging" and "indocyanine green/ICG" . Literature inclusion criteria: (1) gastric cancer clinical stage was cT0-3; (2) clinical stage determined by at least 2 kinds of imaging modalities; (3) optical imaging (near-infrared or fluorescence imaging) combined with ICG-guided SLN biopsy; (4) prospective study to predict lymph node metastasis; (5) intraoperative or postoperative pathology for all lymph nodes removed; (6) patients number in the literature >10 cases. Exclusion criteria: (1) patients with a history of ICG allergy or chemoradiotherapy; (2) previous history of endoscopic mucosal resection or endoscopic submucosal dissection; (3) patients with a variety of gastrointestinal tumor; (4) case reports, conference abstracts, clinical guidelines, editorials, reviews, meta-analysis and correspondence letters; (5) in vitro or animal experiments; (6) insufficient diagnostic efficacy data. The meta-analysis was performed in the Stata12.0 software using the "bivariate mixed-effects model" combined with the "midas" command to pool the data. Information such as true positive value, false positive value, false negative value, and true negative value of each included articles were extracted. The literature quality assessment map was drawn to describe the overall quality of the articles; the heterogeneity analysis was performed with the forest map, with P<0.01 considered as statistical significance; the funnel plot was used to describe publication bias, with P<0.1 considered as statistically significant. Area under curve (AUC) of summary receiver operator characteristic (SROC) was used to describe the diagnostic accuracy and the AUC closer to 1 indicated higher diagnostic accuracy. If there was heterogeneity (I²>50%) among studies, regression analysis and subgroup analysis were performed. P<0.05 was considered as statistically significant. Results: A total of 15 studies (1020 patients) were included. The optical imaging contained near-infrared (NIR) and fluorescent imaging (FI). The diagnostic value of optical imaging combined with ICG-guided SLN biopsy in gastric cancer was as follows: the pooled sensitivity (Sen) was 0.95 (95% CI: 0.82 to 0.99), specificity (Spe) was 1.00 (95% CI: 0.92 to 1.00), positive likelihood ratio (PLR) was 30.39 (95% CI: 9.14 to 101.06), negative likelihood ratio (NLR) was 0.05 (95% CI:0.01 to 0.20), diagnostic odds ratio (DOR) was 225.54 (95% CI: 88.81 to 572.77), AUC was 1.00 (95% CI: 0.99 to 1.00), threshold value was sensitivity=0.95 (95% CI: 0.82 to 0.99) and specificity=1.00 (95% CI: 0.92 to 1.00). Deeks method revealed DOR funnel plot of SLN biopsy was not asymmetrical obviously with significant difference (P=0.01), which indicated remarkable publishing bias. Meta-subgroup analysis showed that compared to FI, NIR imaging had higher sensitivity (0.98 vs. 0.73); compared to 0 minutes, optical imaging performed 20 minutes after ICG injection had higher sensitivity (0.98 vs. 0.70); compared to mean detected number of SLN of 4, mean detected number≥4 had higher sensitivity (0.96 vs. 0.68); compared to HE stain, immunohistochemistry + HE had higher sensitivity (0.99 vs. 0.84); compared to subserous injection of ICG, submucosa injection of ICG had higher sensitivity (0.98 vs. 0.40); compared to injection of 5 g/L ICG, 0.5 g/L and 0.05 g/L had higher sensitivity (0.98 vs. 0.83); compared to cT2-3 tumor, early stage (cT1) tumor had higher sensitivity (0.96 vs. 0.72); compared to ≤ enrolled 26 cases in the study, > 26 cases had higher sensitivity (0.96 vs. 0.65); compared to papers before 2010, papers after 2010 had higher sensitivity (0.97 vs. 0.81); whose differences were all significant. Sensitivity differences between mean tumor diameter of ≤30 cm and >30 cm, open surgery and laparoscopic surgery, lymph node regional dissection and retrieved dissection were not significant (all P>0.05). Conclusions Optical imaging combined with ICG-guided SLN biopsy is clinically feasible, and especially suitable for early gastric cancer. However, the ICG being used in current studies may be overdosed. Higher sensitivity may be achieved from NIR imaging when compared with FI method.

Objective To systematically evaluate the diagnostic value of optical imaging combined with indocyanine green (ICG)?guided sentinel lymph node (SLN) biopsy in gastric cancer, and to identify potential factors that would influence diagnostic accuracy. Methods Study was carried out by searching the electronic database of PubMed, Embase, Medline, Web of Science, and the Cochrane Library with keywords as"gastric/stomach"and"cancer/carcinoma/tumor/tumour/adenocarcinoma/neoplasm"and"sentinel lymph node"and"near?infrared/NIR or fluorescent imaging"and"indocyanine green/ICG". Literature inclusion criteria: (1) gastric cancer clinical stage was cT0?3; (2) clinical stage determined by at least 2 kinds of imaging modalities; (3) optical imaging (near?infrared or fluorescence imaging) combined with ICG?guided SLN biopsy; (4) prospective study to predict lymph node metastasis; (5) intraoperative or postoperative pathology for all lymph nodes removed; (6) patients number in the literature >10 cases. Exclusion criteria: (1) patients with a history of ICG allergy or chemoradiotherapy; (2) previous history of endoscopic mucosal resection or endoscopic submucosal dissection; (3) patients with a variety of gastrointestinal tumor; (4) case reports, conference abstracts, clinical guidelines, editorials, reviews, meta?analysis and correspondence letters; (5) in vitro or animal experiments; (6) insufficient diagnostic efficacy data. The meta?analysis was performed in the Stata12.0 software using the "bivariate mixed?effects model"combined with the "midas" command to pool the data. Information such as true positive value, false positive value, false negative value, and true negative value of each included articles were extracted. The literature quality assessment map was drawn to describe the overall quality of the articles; the heterogeneity analysis was performed with the forest map, with P<0.01 considered as statistical significance; the funnel plot was used to describe publication bias, with P<0.1 considered as statistically significant. Area under curve (AUC) of summary receiver operator characteristic (SROC) was used to describe the diagnostic accuracy and the AUC closer to 1 indicated higher diagnostic accuracy. If there was heterogeneity (I2>50%) among studies, regression analysis and subgroup analysis were performed. P<0.05 was considered as statistically significant. Results A total of 15 studies (1020 patients) were included. The optical imaging contained near?infrared (NIR) and fluorescent imaging (FI). The diagnostic value of optical imaging combined with ICG?guided SLN biopsy in gastric cancer was as follows: the pooled sensitivity (Sen) was 0.95 (95% CI:0.82 to 0.99), specificity (Spe) was 1.00 (95% CI: 0.92 to 1.00), positive likelihood ratio (PLR) was 30.39 (95% CI: 9.14 to 101.06), negative likelihood ratio (NLR) was 0.05 (95% CI:0.01 to 0.20), diagnostic odds ratio (DOR) was 225.54 (95% CI: 88.81 to 572.77), AUC was 1.00 (95% CI: 0.99 to 1.00), threshold value was sensitivity=0.95 (95% CI: 0.82 to 0.99) and specificity=1.00 (95% CI: 0.92 to 1.00). Deeks method revealed DOR funnel plot of SLN biopsy was not asymmetrical obviously with significant difference (P=0.01), which indicated remarkable publishing bias. Meta?subgroup analysis showed that compared to FI, NIR imaging had higher sensitivity (0.98 vs. 0.73); compared to 0 minutes, optical imaging performed 20 minutes after ICG injection had higher sensitivity (0.98 vs. 0.70); compared to mean detected number of SLN of 4, mean detected number≥4 had higher sensitivity (0.96 vs. 0.68); compared to HE stain, immunohistochemistry+HE had higher sensitivity (0.99 vs. 0.84); compared to subserous injection of ICG, submucosa injection of ICG had higher sensitivity (0.98 vs. 0.40); compared to injection of 5 g/L ICG, 0.5 g/L and 0.05 g/L had higher sensitivity (0.98 vs. 0.83); compared to cT2?3 tumor, early stage (cT1) tumor had higher sensitivity (0.96 vs. 0.72); compared to ≤ enrolled 26 cases in the study, > 26 cases had higher sensitivity (0.96 vs. 0.65); compared to papers before 2010, papers after 2010 had higher sensitivity (0.97 vs. 0.81); whose differences were all significant. Sensitivity differences between mean tumor diameter of ≤30 cm and >30 cm, open surgery and laparoscopic surgery, lymph node regional dissection and retrieved dissection were not significant (all P>0.05). Conclusions Optical imaging combined with ICG? guided SLN biopsy is clinically feasible, and especially suitable for early gastric cancer. However, the ICG being used in current studies may be overdosed. Higher sensitivity may be achieved from NIR imaging when compared with FI method.

Objective To systematically evaluate the diagnostic value of optical imaging combined with indocyanine green (ICG)?guided sentinel lymph node (SLN) biopsy in gastric cancer, and to identify potential factors that would influence diagnostic accuracy. Methods Study was carried out by searching the electronic database of PubMed, Embase, Medline, Web of Science, and the Cochrane Library with keywords as"gastric/stomach"and"cancer/carcinoma/tumor/tumour/adenocarcinoma/neoplasm"and"sentinel lymph node"and"near?infrared/NIR or fluorescent imaging"and"indocyanine green/ICG". Literature inclusion criteria: (1) gastric cancer clinical stage was cT0?3; (2) clinical stage determined by at least 2 kinds of imaging modalities; (3) optical imaging (near?infrared or fluorescence imaging) combined with ICG?guided SLN biopsy; (4) prospective study to predict lymph node metastasis; (5) intraoperative or postoperative pathology for all lymph nodes removed; (6) patients number in the literature >10 cases. Exclusion criteria: (1) patients with a history of ICG allergy or chemoradiotherapy; (2) previous history of endoscopic mucosal resection or endoscopic submucosal dissection; (3) patients with a variety of gastrointestinal tumor; (4) case reports, conference abstracts, clinical guidelines, editorials, reviews, meta?analysis and correspondence letters; (5) in vitro or animal experiments; (6) insufficient diagnostic efficacy data. The meta?analysis was performed in the Stata12.0 software using the "bivariate mixed?effects model"combined with the "midas" command to pool the data. Information such as true positive value, false positive value, false negative value, and true negative value of each included articles were extracted. The literature quality assessment map was drawn to describe the overall quality of the articles; the heterogeneity analysis was performed with the forest map, with P<0.01 considered as statistical significance; the funnel plot was used to describe publication bias, with P<0.1 considered as statistically significant. Area under curve (AUC) of summary receiver operator characteristic (SROC) was used to describe the diagnostic accuracy and the AUC closer to 1 indicated higher diagnostic accuracy. If there was heterogeneity (I2>50%) among studies, regression analysis and subgroup analysis were performed. P<0.05 was considered as statistically significant. Results A total of 15 studies (1020 patients) were included. The optical imaging contained near?infrared (NIR) and fluorescent imaging (FI). The diagnostic value of optical imaging combined with ICG?guided SLN biopsy in gastric cancer was as follows: the pooled sensitivity (Sen) was 0.95 (95% CI:0.82 to 0.99), specificity (Spe) was 1.00 (95% CI: 0.92 to 1.00), positive likelihood ratio (PLR) was 30.39 (95% CI: 9.14 to 101.06), negative likelihood ratio (NLR) was 0.05 (95% CI:0.01 to 0.20), diagnostic odds ratio (DOR) was 225.54 (95% CI: 88.81 to 572.77), AUC was 1.00 (95% CI: 0.99 to 1.00), threshold value was sensitivity=0.95 (95% CI: 0.82 to 0.99) and specificity=1.00 (95% CI: 0.92 to 1.00). Deeks method revealed DOR funnel plot of SLN biopsy was not asymmetrical obviously with significant difference (P=0.01), which indicated remarkable publishing bias. Meta?subgroup analysis showed that compared to FI, NIR imaging had higher sensitivity (0.98 vs. 0.73); compared to 0 minutes, optical imaging performed 20 minutes after ICG injection had higher sensitivity (0.98 vs. 0.70); compared to mean detected number of SLN of 4, mean detected number≥4 had higher sensitivity (0.96 vs. 0.68); compared to HE stain, immunohistochemistry+HE had higher sensitivity (0.99 vs. 0.84); compared to subserous injection of ICG, submucosa injection of ICG had higher sensitivity (0.98 vs. 0.40); compared to injection of 5 g/L ICG, 0.5 g/L and 0.05 g/L had higher sensitivity (0.98 vs. 0.83); compared to cT2?3 tumor, early stage (cT1) tumor had higher sensitivity (0.96 vs. 0.72); compared to ≤ enrolled 26 cases in the study, > 26 cases had higher sensitivity (0.96 vs. 0.65); compared to papers before 2010, papers after 2010 had higher sensitivity (0.97 vs. 0.81); whose differences were all significant. Sensitivity differences between mean tumor diameter of ≤30 cm and >30 cm, open surgery and laparoscopic surgery, lymph node regional dissection and retrieved dissection were not significant (all P>0.05). Conclusions Optical imaging combined with ICG? guided SLN biopsy is clinically feasible, and especially suitable for early gastric cancer. However, the ICG being used in current studies may be overdosed. Higher sensitivity may be achieved from NIR imaging when compared with FI method.

From December 2011 to August 2017,56 patients with acute abdomen surgery were treated in Affiliated Zhongshan Hospital of Dalian University.The anatomical structure of ileocecal Treves folds was observed during operation,and 15 samples of Treves folds were taken for histological examination.The mean length of the fold was (5.56±0.18)cm for males and (5.22±0.05)cm for female,the width was (1.82± 0.04) cm for males and (1.78 ± 0.06) cm for females;the thickness was (0.18 ± 0.02) cm.HE and verhoeff staining showed that Treves fold was mainly composed of elastic fiber,collagen fiber and smooth muscle with abundant blood supply.Thirty patients were repaired with their own Treves folds,including the fixation with overlay suture to the stump of appendectomy in 26 cases,repairing for perforation of colonic diverticulum in 3 case,and repairing for perforation of colonic diverticulum in 1 case.There were no complications such as fecal fistula,intestinal obstruction and intussusception after operation.The Treves fold has a constant location,which can be used as a clear sign of ileal terminal.It has abundant blood supply,and is suitable for the repair and reconstruction in ileocecal operation.