This case report describes a 68-year-old male patient diagnosed with primary hepatocellular carcinoma (HCC). After receiving Yttrium-90 microsphere selective internal radiation therapy (⁹⁰Y-SIRT), the tumor significantly reduced in size, and tumor markers alpha fetoprotein (AFP) and abnormal prothrombin (PIVKA-Ⅱ) decreased. Postoperative pathological results showed minimal residual tumor cells, indicating that ⁹⁰Y-SIRT has good efficacy and safety in downstaging and conversion of HCC, thereby facilitating subsequent surgical resection.

Objective:To study the predictive role of tumor burden score (TBS) for tumor recurrence after radical resection in patients with hepatocellular carcinoma (HCC).Methods:Clinical data of 202 patients with HCC undergoing radical surgery at the 900th Hospital of Joint Logistics Support Force of the Chinese People's Liberation Army, between January 2015 and December 2017 were retrospectively analyzed, including 128 males and 74 females, aged (53.66±11.93) years old. The receiver operating characteristic (ROC) curve was used to assess the accuracy of TBS in predicting postoperative tumor recurrence. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors influencing postoperative tumor recurrence. A nomogram was established and validated using calibration curves and the C-index. Kaplan-Meier survival analysis was utilized to compare survival differences between the two patient groups.Results:The area under the ROC curve for TBS in predicting postoperative tumor recurrence in HCC patients was 0.779 (95% CI: 0.717-0.842), with an optimal cutoff value of 6.2. Univariate analysis revealed that factors such as hepatitis B virus DNA level >500 IU/ml, larger maximum tumor dia-meter, and TBS>6.2 were significant risk factors for postoperative tumor recurrence (all P<0.05). Multivariate analysis further indicated that TBS>6.2 ( OR=3.60, 95% CI: 1.081-12.012, P=0.037) and maximum tumor diameter ( OR=1.240, 95% CI: 1.034-1.487, P=0.020) were independent risk factors for postoperative recurrence. Based on these risk factors, a nomogram model was established, achieving a C-index of 0.788. Kaplan-Meier survival analysis showed a better postoperative overall survival and recurrence-free survival of the low TBS group compared to those of the high TBS group (all P<0.05). Conclusion:TBS can serve as a predictive indicator for the recurrence after radical resection in patients with HCC. Both TBS and tumor size are independent risk factors for postoperative recurrence. The nomogram model can be used for predicting recurrence following radical resection in HCC patients.

Objective:To investigate whether prophylactic use of metal clips is necessary after cold snare polypectomy (CSP) of colorectal polyps of 6-10 mm.Methods:A total of 200 patients with 6-10 mm polyps that met the criteria of cold snare resection in Chengdu Third People's Hospital from 15 February 2022 to 30 May 2022 were randomly divided into two groups: a group that received preventive metal clip treatment and an observation group. Age, gender, body mass index (BMI), Boston score, endoscopy entry time, wound size, operation time, intraoperative bleeding time, postoperative delayed bleeding rate and cost between the two groups were compared and analyzed.Results:Ninety-eight patients in the metal clip group had 122 polyps removed, and 97 patients in the observation group had 119 polyps removed. There was no significant difference in the age, gender, BMI, Boston score, endoscopy entry time or wound size between the two groups. There were significant differences in the operation time (171.03±90.78 s VS 69.81±43.26 s, t=2.266， P=0.010), intraoperative bleeding time (19.98±17.37 s VS 29.16±17.56 s, t=-2.875， P=0.006) and surgery cost (571.63±110.92 yuan VS 366.32±13.2 yuan, t=18.102， P<0.001) between the metal clip group and the observation group. There was no significant difference in the delayed bleeding incidence［0.0%（0/98）VS 1.0%（1/97）， P=0.497］between the two groups. Conclusion:For patients with continuous bleeding time <60 seconds after CSP of 6-10 mm colonic polyps, the prophylactic use of metal clips may reduce the bleeding time, but may increase the operation time and cost. Metal clips have little effect on preventing postoperative complications.

Objective:To introduce our experience in the treatment of infection related to lower long bone fracture in adults.Methods:From January 2017 to December 2020, 31 adult patients with infection related to lower long bone fracture were treated at Department of Orthopaedics, the 7th Medical Center, General Hospital of the People's Liberation Army. They were 20 males and 11 females with an age of (35.7±16.7) years. There were 9 cases of acute infection, 3 cases of delayed infection and 19 cases of late infection. They were treated according to their stage of infection, respectively, by retaining or removing the internal fixation, debridement, bone grafting and bone lengthening. They were followed up regularly for at least 12 months to observe their symptoms, signs, indexes of imaging and blood tests. Paley score for fracture union was recorded at the last follow-up.Results:All the 31 patients were followed up for 13.0(13.0, 31.0) months. Of the 9 patients with acute infection, 6 retained the implant, 1 removed the implant for dressing change due to intolerability and 2 removed the implant due to unsatisfactory infection control. Of the 3 patients with delayed infection, 1 retained the implant and 2 removed the implant because of unsatisfactory infection control. Of the 19 patients with delayed infection, 5 were treated with local bone graft, 6 with Masqulet technique and 8 with bone transfer following debridement and implant removal. All patients were cured without recurrence of infection. According to Paley's scoring, 25 cases were excellent, 5 were good, and 1 was fair.Conclusions:Treatment of infection related to lower long bone fracture in adults should be carried out according to its clinical stage. For acute and delayed infection, implants should be preserved as much as possible; for chronic infection, implants should be removed to perform bone and soft tissue reconstruction after thorough debridement. Personalized diagnosis and treatment protocols can lead to satisfactory clinical results.

ObjectiveTo observe the clinical efficacy of Qiju Dihuangtang combined with Chinese medicine fumigation in the treatment of dry eye and its effect on the levels of interleukin-6 （IL-6） and matrix metalloproteinase-9 （MMP-9） in tears. MethodA total of 120 patients with dry eye of liver-kidney Yin deficiency syndrome who were treated in the Department of Ophthalmology， The Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine（TCM） from october 2019 to october 2021 were randomized into the observation group and control group. The control group was given sodium hyaluronate eye drops， and the observation group was treated with sodium hyaluronate eye drops， Qiju Dihuangtang， and Chinese medicine fumigation. The treatment lasted 30 days for both groups. The changes of ocular surface disease index （OSDI）， TCM syndrome score， tear secretion （SIT）， tear film breaking up time （BUT）， corneal fluorescein staining （FL）， and tear interleukin-6 （IL-6） and matrix metalloproteinase-9 （MMP-9） were observed. ResultAfter the treatment， the total effective rate was 90.0% （54/60） in the observation group and 75.0% （45/60） in the control group （χ²=4.675， P<0.05）. After treatment， the OSDI score and TCM syndrome score were lower than those before treatment in both groups （P<0.05）， and lower in the observation group than in the control group （P<0.05）. After treatment， the SIT and BUT were higher （P<0.05） and FL score was lower （P<0.05） than those before treatment in both groups. After treatment， the improvement of the above indicators in the observation group was better than that in the control group （P<0.05）. After treatment， the levels of IL-6 and MMP-9 were lower than those before treatment in both groups （P<0.05）， and lower in the observation group than in the control group （P<0.05）. ConclusionQiju Dihuangtang combined with Chinese medicine fumigation can effectively improve subjective symptoms， promote tear secretion， prolong BUT， enhance corneal epithelial repair， and reduce the levels of tear IL-6 and MMP-9 in the treatment of dry eye.

Objective:To explore the distribution characteristics of brachial-ankle pulse wave velocity (BaPWV) in adolescents.Methods:Cross sectional survey research.A total of 1 607 adolescents aged 12-17 years from 5 middle schools in the Haidian District, Beijing from June 2020 to May 2021 were enrolled for measuring their blood pressure, weight, height and the body mass index (BMI), including 782 males and 825 females.BaPWV was measured using an arteriosclerosis detector.They were divided by the age, sex and obesity.Differences of measurement data among multiple groups were compared by one-way ANOVA, followed by the LSD test, and those between groups were compared by the two-sample t-test.The correlation between BaPWV and other indexes was assessed by the Pearson correlation analysis. Results:The median level of BaPWV in adolescents aged 12-17 years increased with age, which was 982.50 cm/s in adolescents aged 12 years, and maximum 1 113.50 cm/s those aged 17 years.BaPWV in adolescents aged 12-17 years was positively correlated with age ( r=0.936, P=0.006). Subgrouped by the sex, the median BaPWV of male and female adolescents aged 12 years was 962.25 cm/s and 997.50 cm/s, respectively, which reached 1 122.50 cm/s and 1 096.00 cm/s in those aged 17 years, respectively.BaPWV of male and female adolescents was positively correlated with the age ( r=0.903, P=0.014; r=0.945, P=0.004). In male adolescents, BaPWV was positively correlated the systolic and diastolic blood pressure, age, weight, height, BMI( r=0.308, P<0.001; r=0.289, P<0.001; r=0.478, P<0.001; r=0.190, P<0.001; r=0.315, P<0.001; r=0.109, P=0.002). In female adolescents, BaPWV also was positively correlated the systolic and diastolic blood pressure, age, weight, height, BMI( r=0.340, P<0.001; r=0.285, P<0.001; r=0.379, P<0.001; r=0.115, P=0.001; r=0.170, P=0.001; r=0.097, P=0.014). In the overall population, BaPWV was statistically significant between the obese and normal groups ( t=-3.428, P=0.001). No significant difference in BaPWV between male and female adolescents aged 12-13 years was identified ( t=0.123, P=0.902 ), but it was significantly lower in female adolescents aged 14-15 years and 16-17 years than those of age-matched males( t=2.315, P=0.021; t=2.152, P=0.032). Conclusions:The median BaPWV level in adolescents aged 12-17 years, increases with the age.Systolic blood pressure, diastolic blood pressure, body weight, BMI, age and height are positively correlated with BaPWV in adolescents.Obesity can increase the stiffness of blood vessels, which is influenced by the sex.

The technique of prenatal diagnosis before embryo implantation has been greatly developed in assisted reproduction, especially for the people with abnormal genetic material to provide the technical possibility of eugenics and eugenics. As an emerging sequencing technology, single-cell sequencing can analyze the genome and transcriptome of cells from the level of a single cell, and reflect the heterogeneity between cells, thus helping to reveal the mechanism of the occurrence and development of diseases. Through prenatal diagnosis before embryo implantation and high-throughput sequencing of single cells obtained from embryo biopsy, euploidy of embryonic chromosomes can be effectively detected, and SNPs and chromosomal copy number variation, insertion, deletion and other variations can also be better detected. It can conduct the comprehensive detection and research of genomic polymorphism and mutation of individual and other species. In this paper, the single-cell sequencing technology and relevant methods was introduced, and the application scenarios of single-cell sequencing in genetic reproduction diagnosis were summarized. The applications of the technology in the field of genetic reproduction were described, and the future directions of the technology were discussed.

【Objective】 To explore the clinical effect of unilateral double-channel endoscope-assisted bone graft fusion and internal fixation (ULIF) in the treatment of recurrent lumbar disc herniation. 【Methods】 The clinical data of 22 patients with recurrent lumbar disc herniation treated by ULIF in our hospital from August 2020 to October 2020 were analyzed retrospectively. The study indicators included intraoperative blood loss, operation time, bed rest time, and hospital stay. The follow-up data included visual analogue score (VAS) of low back pain, Japanese Orthopaedic Association score (JOA), OSwestry disability index (ODI) score, as well as 36 concise health status survey (SF-36) scores before operation, and 1 week and 6 months after operation. 【Results】 The average operation time was (179.15±42.06) minutes, the average intraoperative blood loss was (132.67±41.92) mL, the average bed rest time was (1.51±0.42) days, and the average hospital stay was (4.82±1.13) days. The VAS score of low back pain at 1 week after operation was lower than that before operation (all P<0.000 1), and further decreased during the follow-up. The ODI score, JOA score and SF-36 score of postoperative follow-up were significantly different from those before operation (P<0.05). The satisfaction rate was 86.4% at 1 week after operation and 95.4% at 6 months after operation. The proportion of significant clinical efficacy at 1 week after operation and postoperative 6 months was 18.2% and 63.6%, respectively. 【Conclusion】 ULIF has the advantages of short-term recovery, less intraoperative blood loss, short bed rest and hospital stay, and good medium-term clinical effect. It is a safe and reliable minimally invasive technique for spinal surgeons in the treatment of recurrent lumbar disc herniation.

Objective:To evaluate the efficacy of unilateral puncture techniques in high-viscosity cement percutanueous vertebroplasty (PVP) in treatment of type I chronic symptomatic osteoporotic vertebral compression fracture (CSOVCF).Methods:A retrospective case control study was conducted to analyze the clinical data of 119 patients with type I CSOVCF admitted to Honghui Hospital affiliated to Xi'an Jiaotong University School of Medicine from December 2013 to December 2016. There were 42 males and 77 females, aged 58-95 years [(79.2±15.6)years]. All patients had bone mineral density of -4.5--2.5 SD [(-3.9±0.2)SD] (T score). The fractured segments included L 1-L 2 in 56 patients and L 3-L 5 in 63. All patients were treated by high-viscosity cement PVP with the unilateral puncture of transverse process and superior articular process in unilateral group ( n=60) and by the bilateral puncture approach with the Magerl method in bilaleral group ( n=59). The operation time, cement injection volume, and intraoperative fluoroscopy frequency were recorded. The visual analogue scale (VAS), Oswestry dysfunction index (ODI), anterior height ratio of injured vertebrae and Cobb angle were measured before operation, at postoperative 1 day and at the last follow-up. The adjacent vertebral fracture, cement leakage and other complications were recorded. Results:All patients were followed up for 12-48 months [(24.1±5.6)months]. The operation time in unilateral group [(21.5±6.5)minutes] was significantly shorter than that in bilateral group [(37.8±7.4)minutes] ( P<0.05). The cement injection volume in unilateral group [(4.2±0.7)ml] was less than that in bilateral group [(6.5±1.1)ml]( P<0.05). The intraoperative fluoroscopy frequency in unilateral group [(14.2±3.0)times] was less than that in bilateral group [(31.4±6.4)times] ( P<0.05). Both groups showed significant improvements in VAS, ODI, anterior height ratio of injured vertebrae and Cobb angle at postoperative 1 day and at the last follow-up compared with these before operation ( P<0.05), but there were no significant differences after operation between the two groups ( P>0.05). The incidence of adjacent vertebral fracture was 5%(3/60) in unilateral group and 8% (5/59) in bilaleral group ( P>0.05). Four patients (7%) had cement leakage in unilateral group and 11 patients (19%) in bilateral group ( P<0.05). No complications of wound infection, nerve injury or pulmonary embolism occurred. Conclusion:Compared with Magerl bilateral puncture approach, high-viscosity cement PVP with unilateral puncture of transverse process and superior articular process in treatment of type I CSOVCF has advantages of shorter operation time, less trauma, less radiation exposure and lower cement leakage rate.

Objective:To compare the clinical efficacy between puncture assisted by a "TINAVI" orthopaedic robot versus freehand puncture in vertebroplaty for osteoporotic vertebral compression fracture(OVCF) of the upper thoracic vertebra.Methods:A retrospective study was conducted of the 19 patients (20 vertebral bodies) with OVCF of the upper thoracic vertebra who had been treated at Department of Spine Surgery, Honghui Hospital from January 2018 to March 2019 by robotic vertebroplasty (robot group) and of another 21 counterpart patients (21 vertebral bodies) who had been treated by conventional vertebroplasty from January 2016 to December 2017 (freehand group). Puncture was conducted by a "TINAVI" orthopaedic robot in the robotic vertebroplasty but freehand in the conventional vertebroplasty. The robot group had 5 males and 14 females, aged from 62 to 88 years; the freehand group had 6 males and 15 females, aged from 64 to 83 years. The 2 groups were compared in terms of operation time, bone cement volume, postoperative complications (cement leakage, infection and embolism), visual analogue scale (VAS), Oswestry disability index (ODI), anterior height (AH) and kyphosis angulation (KA) of the injured vertebra at day 1 and last follow-up after surgery.Results:The 2 groups were comparable because there were no significant differences between them in the preoperative general data ( P>0.05). Vertebroplasty via unilateral puncture approach was completed uneventfully in the 19 patients (20 vertebral bodies) in the robot group and in the 21 patients (21 vertebral bodies) in the freehand group. The 40 patients were followed up for 6 to 12 months (mean, 8.3 month). The operation time [(37.9±8.2) min], bone cement volume [(2.3±0.9) mL] and rate of cement leakage (10.0%, 2/20) in the robot group were all significantly less or lower than those in the freehand group [(46.2±9.4) min, (4.2±1.3) mL and 42.9% (9/21)] ( P<0.05). No infection or embolism was observed in either group. There were no significant differences between the 2 groups in VAS, ODI, AH or KA of the injured vertebra at day 1 or last follow-up after surgery ( P>0.05). Conclusion:In vertebroplaty for OVCF of the upper thoracic vertebra, compared with conventional freehand puncture, puncture assisted by a "TINAVI" orthopaedic robot can lead to satisfactory clinical efficacy because it reduces operation time, volume of bone cement injection, and thus incidence of bone cement leakage.