Objective To explore the feasibility and safety of using indocyanine green combined with autologous blood and methylene blue for localization of small lung nodules during thoracoscopic wedge resection. Methods Patients who underwent CT-guided percutaneous lung puncture injection of localization agents to locate lung nodules at the First Affiliated Hospital of Fujian Medical University from November 2023 to January 2024 were selected. Under thoracoscopy, lung nodules were located by white light mode, fluorescence mode, or near-infrared mode and wedge resection was performed. The feasibility of using indocyanine green combined with autologous blood and methylene blue for localization of small lung nodules was preliminarily verified by evaluating whether the localization agent concentrated around the nodules, and the safety of this method was verified by analyzing the incidence of adverse reactions during patient puncture and surgery. Results A total of 30 patients with lung nodules were included, including 10 males and 20 females, with an average age of (55.5±11.2) years. In 26 patients, the amount of localization agent used was moderate, the localization agent concentrated around the nodules, and successful precise localization of small lung nodules was achieved. In 4 patients, due to excessive use of localization agent, the marker was diffuse with pleural staining. The overall localization success rate was 86.7%, and when the injection volume of localization agent was 0.2-0.5 mL, the localization success rate was 100.0%. All patients successfully completed thoracoscopic wedge resection and found nodule lesions, with negative margins and a distance from the margin to the lesion that met the requirements. There were no complications. Conclusion Thoracoscopic surgery using indocyanine green combined with autologous blood and methylene blue for localization of small lung nodules is safe and feasible.

Objective To investigate the prognosis and satisfaction of the R2 intervention procedure and develop related predictive models. Methods The clinical data of 64 patients with primary craniofacial hyperhidrosis who underwent R2 intervention surgery at the First Affiliated Hospital of Fujian Medical University from November 2018 to October 2022 were retrospectively analyzed. By statistically analyzing the risk factors for compensatory hyperhidrosis (CH) and satisfaction, and conducting feature screening, a relevant prediction model was established. Results Finally, 51 patients were collected, including 43 (84.3%) males and 8 (15.7%) females, with an average age of (30.27±7.22) years. Overall postoperative satisfaction was high, with only 5.9% of patients expressing regret about the surgery. However, 92.2% of patients experienced CH. The onset of postoperative CH was most prominent within the first 3 months postoperatively, with the incidence rate stabilizing thereafter. Preoperative heart rate and R2 sympathetic nerve clipping were identified as independent risk factors for severe CH. The preoperative body mass index, the degree of sweating in the chest and abdomen, are significantly correlated with postoperative satisfaction. Conclusion The R2 intervention surgery effectively alleviates the symptoms of primary craniofacial hyperhidrosis, and patient satisfaction is high.

Background: s/Aims: Distal pancreatectomy with splenectomy (DPS) is a common surgical procedure for pancreatic body cancer.However, spleen-preserving distal pancreatectomy (SPDP) utilizing the Warshaw technique (WT) in malignancies is generally not favored due to concerns about inadequate resection. This study aims to assess the feasibility and oncologic outcomes of employing SPDP with WT in pancreatic body cancer. Methods: We conducted a retrospective analysis comparing 21 SPDP patients with 63 DPS patients matched by propensity score from January 2018 to November 2022. Clinical outcomes and follow-up data were analyzed using R. Results: Both groups exhibited similar demographic, intraoperative, and pathological characteristics, with the exception of a reduced number of total lymph nodes (p = 0.006) in the SPDP group. There were no significant differences in the rates of postoperative complications, recurrence, or metastasis. Local recurrence predominantly occurred in the central region as opposed to the spleen region.There were no cases of isolated recurrences in the splenic region. Median overall survival and recurrence-free survival times were 51.5 months for SPDP vs 30.5 months for DPS and 18.7 months vs 16.8 months, respectively (p > 0.05). The incidence of partial splenic infarction and left-side portal hypertension in the SPDP group was 28.6% (6/21) and 9.5% (2/21), respectively, without necessitating splenic abscess puncture, splenectomy, or causing bleeding from perigastric varices. Conclusions SPDP did not negatively impact local recurrence or survival rates in selected pancreatic body cancer patients. Further studies are necessary for validation.

Background: s/Aims: Distal pancreatectomy with splenectomy (DPS) is a common surgical procedure for pancreatic body cancer.However, spleen-preserving distal pancreatectomy (SPDP) utilizing the Warshaw technique (WT) in malignancies is generally not favored due to concerns about inadequate resection. This study aims to assess the feasibility and oncologic outcomes of employing SPDP with WT in pancreatic body cancer. Methods: We conducted a retrospective analysis comparing 21 SPDP patients with 63 DPS patients matched by propensity score from January 2018 to November 2022. Clinical outcomes and follow-up data were analyzed using R. Results: Both groups exhibited similar demographic, intraoperative, and pathological characteristics, with the exception of a reduced number of total lymph nodes (p = 0.006) in the SPDP group. There were no significant differences in the rates of postoperative complications, recurrence, or metastasis. Local recurrence predominantly occurred in the central region as opposed to the spleen region.There were no cases of isolated recurrences in the splenic region. Median overall survival and recurrence-free survival times were 51.5 months for SPDP vs 30.5 months for DPS and 18.7 months vs 16.8 months, respectively (p > 0.05). The incidence of partial splenic infarction and left-side portal hypertension in the SPDP group was 28.6% (6/21) and 9.5% (2/21), respectively, without necessitating splenic abscess puncture, splenectomy, or causing bleeding from perigastric varices. Conclusions SPDP did not negatively impact local recurrence or survival rates in selected pancreatic body cancer patients. Further studies are necessary for validation.

Background: s/Aims: Distal pancreatectomy with splenectomy (DPS) is a common surgical procedure for pancreatic body cancer.However, spleen-preserving distal pancreatectomy (SPDP) utilizing the Warshaw technique (WT) in malignancies is generally not favored due to concerns about inadequate resection. This study aims to assess the feasibility and oncologic outcomes of employing SPDP with WT in pancreatic body cancer. Methods: We conducted a retrospective analysis comparing 21 SPDP patients with 63 DPS patients matched by propensity score from January 2018 to November 2022. Clinical outcomes and follow-up data were analyzed using R. Results: Both groups exhibited similar demographic, intraoperative, and pathological characteristics, with the exception of a reduced number of total lymph nodes (p = 0.006) in the SPDP group. There were no significant differences in the rates of postoperative complications, recurrence, or metastasis. Local recurrence predominantly occurred in the central region as opposed to the spleen region.There were no cases of isolated recurrences in the splenic region. Median overall survival and recurrence-free survival times were 51.5 months for SPDP vs 30.5 months for DPS and 18.7 months vs 16.8 months, respectively (p > 0.05). The incidence of partial splenic infarction and left-side portal hypertension in the SPDP group was 28.6% (6/21) and 9.5% (2/21), respectively, without necessitating splenic abscess puncture, splenectomy, or causing bleeding from perigastric varices. Conclusions SPDP did not negatively impact local recurrence or survival rates in selected pancreatic body cancer patients. Further studies are necessary for validation.

Parkinson's disease (PD) is a chronic neurodegenerative disease. At present, levodopa and other drugs are mainly used for dopamine supplementation therapy. However, the absorption of levodopa in the gastrointestinal tract is unstable and its half-life is short, and long-term use of levodopa will lead to the end-of-dose deterioration, dyskinesia, the "ON-OFF" phenomenon and other symptoms. Therefore, new preparations need to be developed to improve drug efficacy, reduce side effects or improve compliance of patients. Based on the above clinical needs, this review briefly introduced the preparation modification strategies for the treatment of PD through case analysis, in order to provide references for the research and development of related preparations.

Objective:To evaluate the effect of the impaction of posterior wall on the prognosis following open reduction and internal fixation for fractures of acetabular posterior wall.Methods:A retrospective study was conducted to analyze the data from the 83 patients with fracture of acetabular posterior wall who had been consecutively treated by open reduction and internal fixation at Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital from January 2017 to December 2020. The patients were divided into 2 groups based on involvement of posterior wall impaction. In the impaction group of 33 cases, there were 26 males and 7 females with an age of (47.4±11.6) years; in the non-impaction group of 50 cases, there were 43 males and 7 females with an age of (41.3±12.0) years. The quality of postoperative fracture reduction, the function of the affected hip at the last follow-up, and the complication rate during follow-up were compared between the 2 groups. Multifactorial binary logistic regression and age subgroups were used to analyze the effects of posterior wall impaction on functional outcomes.Results:The age, rate of associated injuries in other body parts, and rate of posterior wall comminution in the impaction group were significantly higher than those in the non-impaction group ( P<0.05), but there was no statistically significant difference in other general data of patients between the 2 groups ( P>0.05). All patients were followed up for (44.5±13.3) months after surgery. The rate of anatomical reduction in the non-impaction group (96.0%, 48/50) was significantly higher than that in the impaction group (57.6%, 19/33) ( P<0.05), and the good and excellent rate by the modified Merle d'Aubigné & Postel scale at the last follow-up in the non-impaction group (84.0%, 42/50) was significantly higher than that in the impaction group (51.5%, 17/33) ( P<0.05). There was no significant difference in the incidence of complications between the 2 groups ( P>0.05). After adjusting for age and gender, the difference in hip function was still significantly different between the 2 groups ( OR=0.23, 95% CI: 0.06 to 0.79, P=0.020). The effect of posterior wall impaction on functional outcomes was statistically significant in patients aged ≥50 years ( P=0.008), whereas the difference was not statistically significant in patients aged <50 years ( P=0.194). Conclusions:Compared with non-impaction ones, acetabular fractures of posterior wall impaction tend to lead to poorer quality of reduction, which in turn affects the postoperative recovery of hip joint function. The impact of impaction fractures on functional recovery is more significant in patients aged 50 years and above.

Background: Genetic defects in the human thyroid-stimulating hormone (TSH) receptor (TSHR) gene can cause congenital hypothyroidism (CH). However, the biological functions and comprehensive genotype–phenotype relationships for most TSHR variants associated with CH remain unexplored. We aimed to identify TSHR variants in Chinese patients with CH, analyze the functions of the variants, and explore the relationships between TSHR genotypes and clinical phenotypes. Methods: In total, 367 patients with CH were recruited for TSHR variant screening using whole-exome sequencing. The effects of the variants were evaluated by in-silico programs such as SIFT and polyphen2. Furthermore, these variants were transfected into 293T cells to detect their Gs/cyclic AMP and Gq/11 signaling activity. Results: Among the 367 patients with CH, 17 TSHR variants, including three novel variants, were identified in 45 patients, and 18 patients carried biallelic TSHR variants. In vitro experiments showed that 10 variants were associated with Gs/cyclic AMP and Gq/11 signaling pathway impairment to varying degrees. Patients with TSHR biallelic variants had lower serum TSH levels and higher free triiodothyronine and thyroxine levels at diagnosis than those with DUOX2 biallelic variants. Conclusions We found a high frequency of TSHR variants in Chinese patients with CH (12.3%), and 4.9% of cases were caused by TSHR biallelic variants. Ten variants were identified as loss-of-function variants. The data suggest that the clinical phenotype of CH patients caused by TSHR biallelic variants is relatively mild. Our study expands the TSHR variant spectrum and provides further evidence for the elucidation of the genetic etiology of CH.

Objective To investigate the changes and clinical significance of serum pro-gastrin-releasing peptide (ProGRP), squamous cell carcinoma-related antigen (SCC), and carbohydrate antigen 72-4 (CA72-4) levels in patients with gastric cancer. Methods A total of 68 patients with gastric cancer (gastric cancer group), 37 patients with benign gastric lesions (benign gastric lesion group), and 30 healthy subjects (non-gastric disease group) were selected as the study participants. Serum ProGRP, SCC, and CA72-4 levels were compared among the three groups on admission. The relationships of serum ProGRP, SCC, and CA72-4 levels with pathological parameters were analyzed in the gastric cancer group. Patients in the gastric cancer group were followed up for 24-month after discharge. Multivariate Logistic regression analysis was used to identify the influencing factors of prognosis in gastric cancer patients. Receiver operating characteristic (ROC) curves were plotted and the area under the curve (AUC) was calculated to analyze the predictive value of serum ProGRP, SCC, and CA72-4 for death during follow-up in gastric cancer patients. Results The serum levels of ProGRP, SCC, and CA72-4 in the gastric cancer group were higher than those in the benign gastric lesion group and the non-gastric disease group, and the serum levels of ProGRP and CA72-4 in the benign gastric lesion group were higher than those in the non-gastric disease group (P < 0.05). In the gastric cancer group, patients with TNM stage Ⅲ to Ⅳ, moderately-lowly differentiated histological grade, and lymph node metastasis had higher serum levels of ProGRP and CA72-4 than those with stage Ⅰto Ⅱ, high differentiation, and no lymph node metastasis. Patients with moderately-lowly differentiated histological grade had higher serum levels of SCC than those with high differentiated histological grade (P < 0.05). After 24 months of follow-up, 49 patients survived (survival group) and 19 patients died (death group) in the gastric cancer group. The serum levels of ProGRP, SCC, and CA72-4 in the death group were higher than those in the survival group on admission (P < 0.05). Multivariate Logistic regression analysis showed that serum ProGRP, SCC, and CA72-4 were independent influencing factors for the prognosis of gastric cancer patients (P < 0.05). Serum ProGRP, SCC, and CA72-4 had good predictive efficacy for death during follow-up in gastric cancer patients (AUC=0.766, 0.705, 0.828), and their combined predictive efficacy was better (AUC=0.899). Conclusion The serum levels of ProGRP, SCC, and CA72-4 that are related to TNM stage, histological grade, and lymph node metastasis in patients with gastric cancer are abnormally elevated, and their combined detection has good predictive efficacy for death during follow-up.

Compensatory hyperhidrosis (CH) is a severe side effect that occurs after endoscopic thoracic sympathotomy (ETS) for the treatment of palmar hyperhidrosis. CH significantly interferes with daily activities such as work, study, and social interactions, leading to a substantial decrease in the quality of life for patients. Preventing and treating CH are currently important and challenging issues in minimally invasive surgery for palmar hyperhidrosis. In this report, we presented a 29-year-old male patient who experienced severe CH for 8 years following ETS. The patient underwent staged unilateral endoscopic expanded sympathotomy (ES) at our hospital on December 11, 2023 and January 3, 2024, targeting the R4-R10 levels. After a 3-month follow-up, the patient experienced significant improvement in clinical symptoms and quality of life, with no recurrence of palmar hyperhidrosis or other complications. The treatment outcome was satisfactory.