Most Read articles

Published in last 1 year |  In last 2 years |  In last 3 years |  All

All

Please wait a minute...


For Selected: Download Citations EndNote Ris BibTeX Toggle Thumbnails

Select

Progress in the treatment of high and complex anal fistulas by transanal opening of intersphincteric space GUO Shuo-hao, SONG Shun-xin Lingnan Modern Clinics In Surgery    2025, 25 (01): 70-78.   DOI: 10.3969/j.issn.1009-976X.2025.01.012 Abstract （1124）      PDF（pc） （963KB）（93）       Knowledge map    Save Surgical treatment of anal fistulas faces the dual challenge of achieving wound healing while preserving anal function. High or complex anal fistulas represent a closed-space, non-functional cavity within the perianal musculature, predominantly occurring in the posterior deep space of the anal sphincter complex. Effective management requires complete opening of this space and ensuring adequate drainage to control infection and promote healing. Traditional fistulotomy with seton placement is primarily suitable for simple fistulas, but its application in complex cases often results in high incontinence rates. In the era of sphincter-preserving techniques, surgeons must select appropriate surgical approaches that prioritize the anatomical integrity of the anal sphincter system. Current literature and guidelines propose multiple therapeutic options, including mucosal advancement flap （MAF）, laser therapy, video-assisted anal fistula treatment （VAAFT）, ligation of intersphincteric fistula tract （LIFT）, over-the-scope clip closure （OTSC）, and radiofrequency ablation （RAF）, however, up to the present moment, no single method has demonstrated substantial and promising potential. The transanal opening of intersphincteric space （TROPIS） technique, introduced in recent years, offers a unique approach. Instead of closing the internal fistula opening, TROPIS enlarges it by incising the fistula tract along the intersphincteric plane. This method fully preserves the external anal sphincter （EAS） and facilitates secondary healing through sustained drainage. Transanal opening of intersphincteric space （TROPIS） is a novel technique developed in recent years for high or complex anal fistulas. Instead of closing the internal fistula opening, it enlarges the opening by incising the fistula tract along the intersphincteric plane, completely preserving the external anal sphincter （EAS） and allowing secondary healing through drainage. First reported in 2017, TROPIS has demonstrated good efficacy and safety in treating complex high anal fistulas and is gaining wider adoption. This article reviews the clinical outcomes and future prospects of TROPIS. Reference | Related Articles | Metrics

Select

A clinical research on endoscopic breast reconstruction with modified retractor ZHAN Yong-tao, HUANG Wan-yi, AO Xiang, XIA Hao-ming, JIANG Ming, LI Hong-sheng Lingnan Modern Clinics In Surgery    2025, 25 (01): 31-35.   DOI: 10.3969/j.issn.1009-976X.2025.01.006 Abstract （622）      PDF（pc） （6790KB）（75）       Knowledge map    Save Objective To investigate the clinical application,effect,complication and satisfaction of patients between endoscopic breast reconstruction with suspension and traditional open breast reconstruction. Methods A total of 116 patients undergoing breast reconstruction in the Cancer Hospital of Guangzhou Medical University from 2019 to 2024 were divided into two groups： suspensory endoscopic breast reconstruction （n=60） and open breast construction （n=56）. The general data and surgical incision length, operation duration, surgical blood loss, surgical complications （infection, skin margin necrosis, prosthesis expose, nipple and areola necrosis）, and breast satisfaction （BREAST-Q score） were compared between the two groups. Results There was no significant difference in the operative time（178.5±18.2 min vs. 171.0±40.3 min）, blood loss（47.3±13.3 ml vs. 44.2±17.7 ml and infection （1.67% vs. 5.3%）, between the two methods. The length of incision was significantly shorter in suspension versus open breast construction （6.5±0.9 cm vs. 12.8±3.7 cm,P<0.05）. The patient satisfaction is higher （82.1±2.5 vs. 78.4±2.4, P<0.05）. Conclusion Endoscopic breast reconstructionwith modified retractor is safe. The surgical incision length is shorter, the incidence of postoperative complications is lower, and the patient satisfaction is higher. Reference | Related Articles | Metrics

Select

Clinical and pathological characteristics of 52 cases of pulmonary invasive adenocarcinoma and analysis of risk factors for hilar and mediastinal lymph node metastasis WANG Dao-du, ZHAO Qi-jiong, ZHOU Zhi-biao, CHEN Xin Lingnan Modern Clinics In Surgery    2025, 25 (01): 36-40.   DOI: 10.3969/j.issn.1009-976X.2025.01.007 Abstract （265）      PDF（pc） （936KB）（75）       Knowledge map    Save Objective This study aims to retrospectively analyze the clinicopathological characteristics and risk factors for hilar and mediastinal lymph node metastasis in non-small cell lung adenocarcinoma. Methods We conducted a retrospective analysis of 52 patients with invasive adenocarcinoma who underwent initial surgery and had postoperative pathology reports from October 2018 to October 2023 at the Oncological Surgery Department of Shanwei Second People's Hospital. We investigated the risk factors for hilar mediastinal lymph node metastasis, and used chi-square tests and logistic regression models to find the threshold points of risk factors through the ROC curve. Results Regarding clinicopathological characteristics, the male-to-female ratio was 0.92∶1, with 6 patients （11.5%） developing lymph node metastasis. Univariate analysis revealed that a primary tumor diameter ≥2 cm and CEA ≥5 ng/mL increased the risk of hilar and mediastinal lymph node metastasis （P<0.05）. Multivariate logistic analysis demonstrated that a tumor maximum diameter of ≥2 cm was a statistically significant risk factor for lymph node metastasis （P<0.05）. Conclusion In patients with invasine adenocarcinoma of the lung, a tumor mass larger than 2 cm and aserum CEA level of 5 ng/mL are risk factors for lymph node metastasis Reference | Related Articles | Metrics

Select

Establishment and validation of a clinical prediction model for the risk of lateral lymph node metastasis in follicular thyroid cancer CAI Li-si, XU Ming, ZHENG Yan-ling, LIE Yang-yang, LI Jie, XIE Xiao-yan Lingnan Modern Clinics In Surgery    2025, 25 (01): 24-30.   DOI: 10.3969/j.issn.1009-976X.2025.01.005 Abstract （230）      PDF（pc） （1663KB）（146）       Knowledge map    Save Objective This study aimed to create a clinical predictive model to assess the probability of lateral lymph node metastasis in patients diagnosed with PTC. Methods A retrospective analysis was conducted on 336 patients with pathologically confirmed PTC with cervical lymph node metastasis at our hospital from January 2022 to January 2024, including 189 cases of central cervical lymph node metastasis and 147 cases of central + lateral lymph node metastasis. Clinical, imaging, and histopathological data were gathered. The cohort was randomly divided into a training group （n=235） and a validation group （n=101）. Independent risk factors were identified through univariate and multivariate logistic regression analyses to develop a nomogram model, with its performance assessed using the receiver operating characteristic （ROC） curve, consistency index （consistency-index, C-index）, and calibration curve. Results The multivariate logistic regression analysis identified significant predictors of LNM, which included the number of lesions （single or multiple）, composition, the presence of fine calcification, invasion of the thyroid envelope, and low or very low echogenicity. A nomogram was constructed based on these five indicators, and the C-index for the training and validation groups was 0.836（95%CI：0.783-0.890）, 0.839（95%CI：0.761-0.917）, respectively. Calibration curves demonstrated good agreement of the model. Conclusion The clinical prediction model developed in this study serves as a valuable instrument for forecasting lateral lymph node metastasis in patients with PTC. This model aids in the effective monitoring of lateral lymph node metastasis in this patient population. Reference | Related Articles | Metrics

Select

Study on the risk factors associated with refracture after PVP for osteoporotic vertebral compression fractures LIU Si-ding, WANG Yun Lingnan Modern Clinics In Surgery    2025, 25 (01): 41-46.   DOI: 10.3969/j.issn.1009-976X.2025.01.008 Abstract （196）      PDF（pc） （957KB）（39）       Knowledge map    Save Objective This study aimed to explore the relevant risk factors for recurrent fractures after percutaneous vertebroplasty （PVP） in patients with osteoporotic vertebral compression fractures. Methods A retrospective analysis was conducted on the clinical data of patients with OVCF who underwent PVP at Shuangfeng County People's Hospital between April 2021 and June 2023. Relevant information from 409 patients was collected and categorized into a re-fracture group and a non-re-fracture group. Univariate analysis was performed on factors such as patient age, gender, time to surgery after fracture, number of initially fractured vertebrae, surgical puncture method, bone cement injection volume, presence of bone cement leakage, total protein level, globulin level, prognostic nutritional index （PNI）, albumin/fibrinogen ratio （AFR）, CT value, body weight, and whether regular anti-osteoporosis treatment was administered. Influential factors were then included in a multivariate logistic regression analysis to identify associated risk factors. Results Univariate analysis revealed significant associations between factors such as time to surgery after fracture, globulin level, albumin level, absolute lymphocyte count, fibrinogen level, PNI, AFR, CT value, surgical puncture method, and regular anti-osteoporosis treatment with the occurrence of re-fracture （P<0.05）. Multivariate logistic regression analysis showed significant relationships between unilateral puncture as the surgical puncture method （OR=2.181, 95% CI： 1.249-3.809）, PNI （OR=0.876, 95%CI： 0.821-0.934）, CT value （HU） （OR=0.961, 95%CI： 0.948-0.974）, globulin level （OR=1.078, 95% CI： 1.013-1.147）, and lack of regular anti-osteoporosis treatment （OR=1.816, 95% CI： 1.029-3.206） with the occurrence of re-fracture （P<0.05）. Conclusion Based on our findings, surgical puncture method, PNI, CT value, globulin level, and whether regular anti-osteoporosis treatment is administered are independent risk factors for re-fracture after PVP for OVCF. Assessing these factors may help predict the risk of re-fracture among patients and provide a reference for clinical intervention and treatment strategy formulation. Reference | Related Articles | Metrics

Select

Fatty acid metabolism regulated by FATP1 promotes lymph node colonization in cholangiocarcinoma LI Xiu-xian, SONG Zhi-xiao, ZHANG Hong-hua, LIU Chao Lingnan Modern Clinics In Surgery    2025, 25 (02): 75-83.   DOI: 10.3969/j.issn.1009-976X.2025.02.001 Abstract （177）      PDF（pc） （8591KB）（24）       Knowledge map    Save Objective To investigate the mechanism and therapeutic strategy of fatty acid transport protein 1 （FATP1） on lymph node colonization of cholangiocarcinoma （CCA）. Methods Subcutaneous tumor-bearing mouse models and lymph node orthotopic tumor-bearing mouse models were established. Tumor tissues at different tumor stages were collected, and proteomics was used to screen key proteins in cholangiocarcinoma colonization in lymph nodes. Immunohistochemical staining was used to evaluate the correlation between FATP1 expression in lymph node metastases of cholangiocarcinoma and poor prognosis of patients. CCK-8 cell proliferation assay and Nile red staining were used to detect the changes in lipid metabolism and proliferation ability of cholangiocarcinoma cells （HUCCT1, HCCC9810） before and after knockdown or overexpression of FATP1. In vitro and in vivo experiments were used to verify that FATP1 inhibitor （FATP1-IN-1） inhibited cholangiocarcinoma colonization in lymph nodes by targeting lipid metabolism. Results Proteomic screening results suggested that FATP1 played a key role in the process of cholangiocarcinoma colonization of lymph nodes. Immunohistochemical staining showed that FATP1 was more highly expressed in lymph node metastases and was associated with poor prognosis of patients. In vitro experiments showed that knocking down FATP1 inhibited cholangiocarcinoma proliferation and lipid accumulation, while overexpression of FATP1 enhanced the above phenotypes. FATP1 inhibitor （FATP1-IN-1） significantly inhibited cancer cell proliferation in vitro and reduced tumor burden and lipid accumulation in an in vivo model. Conclusion Fatty acid metabolism regulated by FATP1 promotes cholangiocarcinoma colonization in lymph nodes, and targeting FATP1 can effectively inhibit the progression of lymph node colonized tumors. Reference | Related Articles | Metrics

Select

Conservative and surgical treatment strategies for degenerative scoliosis ZHU Ming-xi, JIN Song Lingnan Modern Clinics In Surgery    2025, 25 (02): 146-150.   DOI: 10.3969/j.issn.1009-976X.2025.02.010 Abstract （168）      PDF（pc） （933KB）（162）       Knowledge map    Save Degenerative scoliosis, a prevalent spinal disorder among the elderly, presents scoliosis resulting from spinal degeneration and associated nerve compression symptoms, which influences the quality of life of patients. The therapeutic approaches are mainly categorized into conservative treatment and surgical treatment. Conservative treatment encompasses drug therapy, orthotic therapy, and physical therapy, and etc., which is appropriate for patients with mild symptoms, aiming to alleviate pain, reduce inflammation, and enhance function. Surgical treatment is applicable to patients with ineffective conservative treatment or severe symptoms. Common surgical methods include simple decompression surgery, spinal fusion and internal fixation surgery, and minimally invasive surgery. With the advancement of technology, minimally invasive surgery has gradually emerged as the mainstream due to its advantages of minor trauma and rapid recovery. Future research should be concentrated on optimizing treatment plans, reducing complications, exploring novel minimally invasive technologies, and personalized treatment to enhance the therapeutic effect and the quality of life of patients. Reference | Related Articles | Metrics

Select

Research progress on the role of ganglioside GD2 in triple-negative breast cancer WEI Tian-tian, SUN Zhu-sheng Lingnan Modern Clinics In Surgery    2025, 25 (02): 135-139.   DOI: 10.3969/j.issn.1009-976X.2025.02.008 Abstract （160）      PDF（pc） （940KB）（83）       Knowledge map    Save Triple-negative breast cancer is a subtype of breast cancer with stronginvasiveness and poor prognosis. At the same time, it has found that ganglioside GD2 is abnormally expressed in many malignant tumors. In recent years, the research on GD2 in triple negative breast cancer has made some progress. It was found that GD2 was highly expressed on the surface of triple negative breast cancer cells, which was closely related to the proliferation, invasion and metastasis of tumor cells. GD2 may be a potential therapeutic target for triple negative breast cancer. It is believed that the research around GD2 will open up a new way for the prevention and treatment of triple negative breast cancer. This article reviews the biological characteristics of GD2 and the research progress in triple-negative breast cancer. Reference | Related Articles | Metrics

Select

Endoluminal treatment of Stanford type B aortic dissection and its optimal timing of intervention LI Zi-yi, ZHANG Yang-yi, WU Chun-hua, LIU Da-wei Lingnan Modern Clinics In Surgery    2025, 25 (02): 140-145.   DOI: 10.3969/j.issn.1009-976X.2025.02.009 Abstract （147）      PDF（pc） （3564KB）（100）       Knowledge map    Save Stanford B aortic dissection is an aortic disease with a high mortality rate, and its treatment is extremely important. With the advancement of TEVAR technology, an increasing number of clinicians perform endovascular treatment for patients with aortic dissections beyond the traditional scope of type B. However, no study has yet clarified the optimal time window for endovascular treatment of patients with StanfordB aortic dissection. The current mainstream view is that intervention during the acute phase is more conducive to patient prognosis, while intervention during the subacute phase is safer. However, how to choose the timing of the operation remains inconclusive. Reference | Related Articles | Metrics

Select

Study on the internal fixation with suture anchors and locking plate in the treatment of the greater tuberosity fracture LIU Jun-bo, CHEN Tai-qiu, ZHENG Chao-shun, QIU Xue-li Lingnan Modern Clinics In Surgery    2025, 25 (01): 54-59.   DOI: 10.3969/j.issn.1009-976X.2025.01.010 Abstract （145）      PDF（pc） （2067KB）（68）       Knowledge map    Save Objective This study aimed to explore the therapeutic effect of internal fixation with high strength suture, anchors and locking plate on greater tuberosity fracture, and provided a safer and more effective treatment. Methods A total of 40 patients diagnosed with greater tuberosity fracture in the Department of Orthopedics of Jieyang People's Hospital, Guangdong Province,were included from September 2016 to June 2024. They were divided into the locking plate fixation group and combined group with high strength suture, anchors and locking plate randomly. Statistical analysis will be conducted to compare the baseline data, preoperative, postoperative, and 3-month follow-up clinical indicators between the two groups. Results All patients in this study were followed up, and there was no statistically significant difference in preoperative data between the two groups P>0.05. Compared with the locking plate fixation group, the combined group had a smaller displacement distance, a greater range of motion on shoulder （P<0.05）. The Constant-Murley score in the combined group was higher during the 3-month follow-up, and there were fewer post-operative complications （P<0.05）. Conclusion Compared with the locking plate fixation, the combined group has more satisfactory clinical efficacy, with faster postoperative recovery, less impact on shoulder motions, and fewer post-operative complications. Reference | Related Articles | Metrics

Select

Bioinformatics of key genes in hepatocellular carcinoma after incomplete radiofrequency ablation using the GEO database ZHANG Zhou, HUANG Bi, ZHAO Hui-ying Lingnan Modern Clinics In Surgery    2025, 25 (01): 12-18.   DOI: 10.3969/j.issn.1009-976X.2025.01.003 Abstract （144）      PDF（pc） （3280KB）（77）       Knowledge map    Save Objective The aim of this study was to identify differentially expressed genes associated with IRFA-treated HCC and to provide potential therapeutic targets by comparing the gene expression profiles of hepatocellular carcinoma （HCC） patients after incomplete radiofrequency ablation （IRFA） with those of HCC. Methods The GSE212604 dataset was downloaded from the GEO database and divided into IRFA and control groups according to whether they received IRFA treatment or not, and analysed and screened for differentially expressed genes. Potential key biological functions and pathways were identified using functional pathway enrichment analysis （GO, KEGG）. We also downloaded the GSE186280 dataset and constructed the co-expressed gene modules of HCC by weighted gene co-expression network analysis （WGCNA） to screen the core genes in the key modules. Results A total of 263 differentially expressed genes were identified, including 179 up-regulated genes and 84 down-regulated genes, and GO and KEGG analyses showed that these genes were mainly enriched in metabolic remodelling, cytoskeletal regulation, immune regulation and neural-related mechanisms. In addition, WGCNA analysis identified gene modules closely related to HCC after IRFA, and further screened 15 core genes, including LOC112268313, RNA5-8SN3 and so on. Conclusion In this study, key genes associated with IRFA-treated HCC were identified by bioinformatics analysis, suggesting that immune signalling and pathways such as p53 and PPAR may play an important role in its occurrence and progression. These key genes and pathways are expected to be new targets for the treatment and diagnosis of HCC. Reference | Related Articles | Metrics

Select

Machine learning-based NETs gene signature predicts recurrence in non-muscle-invasive bladder cancer HUANG Xiao-dong, WANG Bo, HUANG Jian Lingnan Modern Clinics In Surgery    2025, 25 (02): 91-100.   DOI: 10.3969/j.issn.1009-976X.2025.02.003 Abstract （138）      PDF（pc） （10193KB）（8）       Knowledge map    Save Objective Neutrophil extracellular traps （NETs） can be stimulated by various factors, including drug perfusion and tumor cell stimulation, thereby influencing the prognosis of cancer patients. However, the prognostic impact and key functional genes of NETs in the recurrence of non-muscle-invasive bladder cancer （NMIBC） remain unclear. This study aims to identify critical NETs-related genes associated with NMIBC recurrence and provide a reliable predictive tool for clinical recurrence assessment. Methods Transcriptomic data and clinical information from bladder cancer patients were obtained from the GEO database （GSE13507, GSE128959, GSE19423, GSE154261, GSE31684, GSE169455）, and somatic copy number variation （CNV） data were retrieved from TCGA. Using machine learning algorithms and weighted gene co-expression network analysis （WGCNA）, we identified 153 NETs-related genes and constructed a recurrence prediction score （NRG）, which was validated in a training cohort. We comprehensively analyzed the impact of this score on gene expression, the immune microenvironment, and functional pathways in bladder cancer. Additionally, we explored potential sensitivities to NRG-associated small-molecule compounds to identify therapeutic targets for clinical intervention. Results This study identified three NETs-related genes （G0S2, CCL5, and CLEC7A） as independent prognostic predictors for postoperative recurrence in NMIBC patients. The NRG score effectively predicted recurrence outcomes in the training cohort, demonstrating diagnostic AUC values of 0.671 and 0.645 in two independent NMIBC datasets, with significant prognostic stratification （P=0.039）. Genomic and immune infiltration analyses revealed that high-NRG patients exhibited more frequent PIK3CA mutations and increased infiltration of immunosuppressive cell subsets. Functional enrichment indicated hyperactivation of immune checkpoint pathways in high-NRG cases. Drug sensitivity analysis suggested that targeting NRG may reduce recurrence risk by inhibiting the PI3K-mTOR and ERK signaling axes, providing potential therapeutic strategies for NMIBC. Conclusion This study established a NETs-derived recurrence prediction signature （NRG） for NMIBC and elucidated its immunomodulatory effects within the tumor microenvironment, functional pathway alterations, and potential small-molecule therapeutic targets. Reference | Related Articles | Metrics

Select

Research on the role of cancer-associated fibroblasts-secreted IGF-1 in regulating macrophage GGT5 expression within the tumor microenvironment of esophageal squamous cell carcinoma ZHANG Xiao-ping, LI Lei Lingnan Modern Clinics In Surgery    2025, 25 (02): 101-111.   DOI: 10.3969/j.issn.1009-976X.2025.02.004 Abstract （136）      PDF（pc） （19908KB）（14）       Knowledge map    Save Objective This research focuses on identifying a subset of macrophages that specifically and highly express the GGT5 gene. To date, there have been no reports on the GGT5+ macrophage subset. Our objective is to elucidate the role of GGT5+ macrophages in the progression of ESCC and the mechanisms regulating their expression. Methods Using TCGA, we conducted differential gene expression analysis to identify key genetic changes. Subsequently, with the aid of the TIMER database, we conducted an in-depth analysis of the relationship between GGT5 expression levels and immune cell infiltration, with a particular focus on macrophages.To further validate these analytical results, we employed immunohistochemical and immunofluorescence techniques to visually confirm the expression of GGT5 at the sample level. Finally, through Western blotting experiments, we conducted thorough exploration and validation of the regulatory mechanisms of GGT5. Results Bioinformatics analysis revealed that GGT5 exhibits significantly high expression characteristics in ESCA, and its expression level was closely related to the activity of macrophages. Immunohistochemical and immunofluorescence experiments showed that GGT5 was specifically highly expressed mainly in M2-macrophages and its expression was also significantly increased in LNM. In the study of regulatory mechanisms, it was found that CAFs significantly regulate the expression of GGT5 in macrophages by secreting the IGF-1 cytokine, leading to a marked upregulation of GGT5 expression levels. Conclusion The results indicate that CAFs in the TME regulate the expression of GGT5 in macrophages by secreting the IGF-1 cytokine, thereby participating in the initiation and progression of ESCC. This discovery provides important insights for understanding the pathogenesis of ESCC and exploring new therapeutic strategies. Reference | Related Articles | Metrics

Select

Effect of laparoscopic sleeve gastrectomy on thyroid function in obese patients REN Xue-kang, LI Rong-zhen, ZHU Shao-gong, XIA Yun-zhan Lingnan Modern Clinics In Surgery    2025, 25 (02): 112-117.   DOI: 10.3969/j.issn.1009-976X.2025.02.005 Abstract （135）      PDF（pc） （950KB）（97）       Knowledge map    Save Objective To explore the effects of laparoscopic sleeve gastrectomy （LSG） on thyroid function in obese patients and the potential factors affecting thyroid function after surgery. Methods Sixty-seven obese patients who received standardized LSG in Zhengzhou People's Hospital from October 2019 to October 2021 and completed 1-year follow-up were selected as the study objects. The height, weight, thyroid function indexes （TSH、FT3、FT4）, LDL, HDL and other clinical data before and 1 year after LSG were retrospectively collected. The changes of parameters before and after operation were calculated. The related indexes of thyroid function were compared before and 1 year after surgery, and the potential factors affecting the changes of TSH, FT3 and FT4 after surgery were explored. Results TSH level decreased from （2.84±1.60） mIU/L to （1.45±0.71） mIU/L 1 year after surgery （P<0.001）. FT3 decreased from （5.51±0.58） pmol/L to （5.16±0.51） pmol/L （P<0.001）, and there was no significant difference in FT4 level 1 year after operation. Postoperative BMI （P<0.001） and LDL （P=0.013） were important factors affecting TSH changes. The change of postoperative LDL （P=0.004） was an important factor affecting the change of postoperative FT3. Conclusion LSG has a significant effect on thyroid function in obese patients, and the changes of body mass index （BMI） and LDL are important parameters to predict thyroid function after surgery. Reference | Related Articles | Metrics

Select

The correlational study of different surgical approaches on anxiety and depression in breast cancer patients WU Chun-hua, ZHAO Chen, ZHU Zi-peng, YONG Guo-zhong, LI Zi-yi, QIAN Hao Lingnan Modern Clinics In Surgery    2025, 25 (02): 118-126.   DOI: 10.3969/j.issn.1009-976X.2025.02.006 Abstract （132）      PDF（pc） （988KB）（46）       Knowledge map    Save Objective To explore the current status of anxiety and depression among breast cancer surgery patients and their influencing factors, providing a basis for clinical diagnosis and treatment. Methods Patients who underwent surgical treatment in the Breast and Thyroid and Rectal Surgery Department of Chengde City Central Hospital from November 2022 to April 2024 were selected as the research subjects. They were divided into lumpectomy group （n=32） and mastectomy group （n=52） based on the surgical method. A longitudinal study was conducted using the Self-Rating Depression Scale （SDS） and Self-Rating Anxiety Scale （SAS） to assess the patients before surgery, three months after surgery, and six months after surgery. The general information and clinical characteristics of the patients were collected to analyze the occurrence of depression and anxiety among breast cancer surgery patients and their influencing factors. Results There was no significant difference in SAS and SDS scores between the two groups before surgery （P=0.770）. Three months after surgery, both groups showed a significant increase in SAS and SDS scores, with the lumpectomy group showing a more significant increase in anxiety scores （an increase of 7.6 points on average, P<0.001）, and the mastectomy group showing a more significant increase in depression scores （an increase of 7.2 points on average, P=0.010）. Six months after surgery, the anxiety and depression scores of the lumpectomy group returned to preoperative levels, while the depression scores of the mastectomy group were still higher than before surgery （P=0.048）, but there was no significant difference in depression scores between the two groups （P>0.05）. The analysis of the influencing factors on their psychological status showed that being young, having a low level of education, and having a low family monthly income were the main independent risk factors for anxiety and depression at all three time points （P<0.05）. Conclusion Breast cancer surgery patients have a high incidence of depression and anxiety, and the surgical method can directly affect patients′ depressive and anxious emotions. Compared to preoperative levels, anxiety increases more significantly in the lumpectomy group, and depression increases more significantly in the mastectomy group three months after surgery. Six months after surgery, the psychological state of the lumpectomy group recovers better, while the improvement in depression in the mastectomy group is relatively delayed. Medical staff should strengthen psychological care for breast cancer patients at all stages, especially three months after surgery. Different intervention strategies should be implantated for different groups to mitigate patients′ anxiety and depression. Reference | Related Articles | Metrics

Select

Application of nanoscale carbon lymph node tracer technique in complicated laparoscopic cholecystectomy BAI Jie, WU Jin-Xiang, ZHAO Jia-Feng, CHEN Hai-Min, WANG Gui-Fu, WU Qing-Song Lingnan Modern Clinics In Surgery    2025, 25 (01): 6-11.   DOI: 10.3969/j.issn.1009-976X.2025.01.002 Abstract （131）      PDF（pc） （1345KB）（160）       Knowledge map    Save Objective To investigate the feasibility and application value of carbonnanoscale lymph node tracing technique in complex and difficult cholecystectomy. Methods This study was a single-center, single-blind, randomized controlled clinical trial. Patients diagnosed with cholecystolithiasis with cholecystitis admitted to the Department of Hepatobiliary Pancreatic Minimally Invasive Surgery of Yuebei People's Hospital from January 2022 to December 2022 were recruited. Sixty subjects were collected according to the inclusion and exclusion criteria, and were divided into the study group and the control group with 30 cases in each group by random number table method. The study group received laparoscopic cholecystectomy （LC） combined with carbon nanoscale lymph node tracer, and the control group received conventional LC. Gender, age and other general basic data of the two groups were compared, and the incidence of postoperative complications, exposure time of the gallbladder triangle, and intraoperative blood loss were used as outcome indicators. Results Among the two groups, the study group was not inferior to the control group in terms of postoperative exhaust time, intraoperative bleeding, exposure time of gallbladder triangleand total hospitalization cost, but had no significant difference with the control group. The total complication rate of the study group （6.66%） was as that of the control group （13.33%）, with no significant difference. Conclusion Nano-carbon tracer technology can assist in locating the anatomical relationship of gallbladder triangle in complex and difficult cholecystectomy, with strong feasibility and safety. Compared with LC alone, it has advantages in reducing bleeding and reducing complication rate, and is worth promoting and applying in clinical practice. Reference | Related Articles | Metrics

Select

Impact of the ultrasonographic assessment of lung and diaphragmatic function on postoperative respiratory function in patients undergoing abdominal surgery HUANG Wei-hong, YAO Zhi-xiong Lingnan Modern Clinics In Surgery    2025, 25 (02): 127-134.   DOI: 10.3969/j.issn.1009-976X.2025.02.007 Abstract （120）      PDF（pc） （7328KB）（8）       Knowledge map    Save Objective To observe whether lung ultrasound （LUS） and diaphragm ultrasound can be used to evaluate and intervene in lung ventilation and diaphragm function in patients undergoing abdominal surgery during the recovery period of general anesthesia. Methods This study included a total of 130 patients who underwent elective abdominal surgery in our hospital and were planned to be sent to the post-anaesthesia care unit （PACU）. The patients were randomized into ultrasound group （group U） and control group （group N）. In group U, LUS and diaphragm ultrasonography were performed at admission in operating room （T0）, at admission in PACU （T1）, 15 minutes after extubation （T2）, and at discharge of PACU （T3）. LUS score and the diaphragm thickening fraction （DTF） at each time point were recorded and intervention based on the ultrasound results were performed in group U, Conventional resuscitation without ultrasound assessment was used in group N. Arterial blood gas analysis and oxygenation index were recorded at T3 of patients in both groups. The all patients were followed up for seven days after operation for pulmonary complications（PPCs）. Results Compared with T0, DTF decreased significantly （P<0.01） and LUS score increased significantly （P<0.01） after T1, T2, and T3 in the U group, and did not return to the preoperative level at T3 （P<0.01）. Compared with group N, the total number of intervention measures in group U and the number of taking intervention measures in group U at T1 increased （P<0.05）. Compared with group N, the incidence of postoperative hypoxemia,extubation time,and PACU lengthofstay at T3 in the group U were significantly reduced （P<0.01）. Conclusion Ultrasound evaluation of lung and diaphragm function can dynamically monitor the ventilation status and diaphragm function recovery degree of patients during anesthesia recovery, enabling timely interventions to improve the recovery of respiratory function in patients undergoing general anesthesia after abdominal surgery. Reference | Related Articles | Metrics

Select

Distribution and drug resistance analysis of pathogenic bacteria in abdominal infections in patients with primary liver cancer after liver resection, transarterial chemoembolization（TACE） and liver transplantation PENG Xu-jian, LUO Ling, LIN Xiang-hua, WANG Xiao-chen, ZHONG Run-qiang, CAI Meng-shan Lingnan Modern Clinics In Surgery    2025, 25 (03): 156-161.   DOI: 10.3969/j.issn.1009-976X.2025.03.002 Abstract （120）      PDF（pc） （984KB）（3）       Knowledge map    Save Objective To investigate the distribution and drug resistance analysis of pathogenic bacteria in abdominal infection after liver resection, transarterial chemoembolization（TACE） and liver transplantation in primary liver cancerpatients. Methods The clinical data of 158 primary liver cancer patients with abdominal infection after liver resection, TACE or liver transplantation in our hospital from Jan 2018 to May 2023 were retrospectively analyzed, to investigate their pathogenic bacteria distribution and drug resistance. Results From samples of patients with abdominal infection after liver resection, TACE, and liver transplantation, 204, 69, and 34 strains of pathogenic bacteria were cultured, respectively. Gram-negative bacteria accounted for 51.96%, 62.32% and 52.94%; Gram-positive bacteria for 40.20%, 30.43%, and 32.35%; and fungi for 7.84%, 7.25%, 14.71%, respectively. The most common pathogenic bacteria were Escherichia coli（14.71%）, Escherichia coli（18.84%） and Klebsiella pneumoniae（11.76%） among primary liver cancer patients with abdominal infection after liver resection, TACE and liver transplantation. According to the results of drug susceptibility, Escherichia coli and Klebsiella pneumoniae had a high rate of resistance to Cephalosporins, Quinolones and Sulfonamides. Among Escherichia coli and Klebsiella pneumoniae, the detection rate of strains producing extended-spectrum beta-lactamases （ESBLs） were 56.8% and 27.8% and meanwhile, the detection rate of strains with carbapenem resistance were 2.3% and 16.2%. Conclusion Among the primary liver cancer patients with abdominal infection after liver resection, TACE or liver transplantation, the main pathogenic bacteria is enterobacteriaceae and the multi-drug resistance strains have a high rate of detection. While choosing the postoperative prophylactic antibiotics, the antibiotics which are effective to the enterobacteriaceae are the first choice. Reference | Related Articles | Metrics

Select

Comparative study of 3D gradient spin echo and 3D volumetric scanning based on compressed sensing technology in MRCP CHEN Wen-shi, ZHU Yin-he, ZHONG Jing-lian Lingnan Modern Clinics In Surgery    2025, 25 (02): 84-90.   DOI: 10.3969/j.issn.1009-976X.2025.02.002 Abstract （117）      PDF（pc） （4720KB）（24）       Knowledge map    Save Objective To study the image quality of three-dimensional gradient spin echo （3D-BH-GraSE-MRCP） and three-dimensional volumetric scan based on compressed sensing technology（3D-CS-MRCP） in magnetic resonance cholangiopancreatography（MRCP）. Methods A retrospective analysis was performed on 81 patients who underwent MRCP examination in Sun Yat-sen Memorial Hospital, Sun Yat-sen University from July 2023 to November 2023, and 3D-BH-GraSE-MRCP sequence and 3D-CS-MRCP sequence were used to scan the same patient. Image contrast noise ratio （CNR）, signal-to-noise ratio （SNR） and scanning time in common bile duct, pancreatic duct, cholecystic duct, hepatic duct and secondary bile duct were analyzed and compared according to the obtained images. The image quality of gallbladder, cholecystic duct, common bile duct, pancreatic duct and hepatic duct were subjectively scored. Results The scanning time of 3D-BH-GraSE-MRCP and 3D-CS-MRCP sequences was equal（P>0.05）. There was no significant difference in CNR and SNR of common bile duct, cholecystic duct and hepatic duct between the two images. The CNR（19.73, 13.71） and SNR（27.19, 18.52） of pancreatic duct and secondary bile duct in 3D-BH-GraSE-MRCP sequence image were higher than those in 3D-CS-MRCPsequence image （11.60, 8.76） and SNR（15.23, 12.28）（P<0.05）. 3D-BH-GraSE-MRCP sequence in the gallbladder, cystic duct, common bile duct, the overall image quality rating of intrahepatic duct, background suppression effect and image pseudo reviews points （4.32, 4.46, 4.46, 4.56, 4.79, 4.83） were higher than 3D-CS-MRCP sequence （3.65, 3.79, 4.12, 4.16, 4.48, 4.31） （P<0.05）. Conclusion Compared with 3D-CS-MRCP sequence, 3D-BH-GraSE-MRCP sequence has better image quality and no difference in scanning time in MRCP inspection. Reference | Related Articles | Metrics

Select

ILEOSTOMY for abdominal compartment syndrome YE Yi-biao, XU Yun-xiu-xiu, CHEN Jie, SONG Jing-lin, PENG Lin-hui, ZHOU Rui, YAO Ting-ting, ZHONG Guo-ping, LING Xiao-juan, LUO Xing-xi, ZHANG He-yun, XU Yun-yao, YE Hua, CHEN Ya-jin, WANG Jie, CHEN Tao Lingnan Modern Clinics In Surgery    2025, 25 (01): 1-5.   DOI: 10.3969/j.issn.1009-976X.2025.01.001 Abstract （109）      PDF（pc） （936KB）（75）       Knowledge map    Save Objective To investigate new treatment method “ILEOSTOMY” for abdominal compartment syndrome （ACS）. Methods Retrospectively reviewed clinical data of patients with ACS from May, 2017 through to March, 2022 admitted in Department General Surgery, and Department of Obstacles and Gynecology, Sun Yat-sen memorial hospital, Sun Yat-sen University. Patients included 6 cases of SAP（severe acute pancreatitis, SAP）, 2 cases of pancreas trauma, and 7 cases of abdominal or pelvic surgical complications. All patients received routine treatment plus with “ILEOSTOMY” aimed for quickly decreasing the Intra-abdominal Hypertension （IAH）. Clinical data of Intra-abdominal pressure （IAP）, urine output, heart rate, breath rate and survival were collected and analyzed. Results IAH in most patients （13/15, 86.67%） were adjusted to normal level soon postoperatively. Twelve cases survived while other 3 cases who suffered MOF （Multiple Organ Failure, MOF） or MODS（multiple organ dysfunction syndrome, MODS） dead postoperatively. Conclusion “ILEOSTOMY” along with routinely suggested operation modality for selected ACS patient might be a good choice. More clinical data should be needed in the future. Reference | Related Articles | Metrics

Select

Application of disc region localization and classification method in percutaneous endoscopic lumbar discectomy and its predictive role on postoperative prognosis LI Tao, YE Ji-chao, LI Shuang-xing, XIE Tian-yu, OU Mao-ta, WANG Zhen-bo, LI Min, FAN Ji, TANG Yong Lingnan Modern Clinics In Surgery    2025, 25 (01): 47-53.   DOI: 10.3969/j.issn.1009-976X.2025.01.009 Abstract （106）      PDF（pc） （2470KB）（142）       Knowledge map    Save Objective This study aims to improve the accuracy of preoperative evaluation for percutaneous endoscopic lumbar discectomy （PELD） through a modified regional localization and classification method for intervertebral discs, providing a new basis for individualized prediction of postoperative functional recovery and recurrence risk for patients. Methods This is a retrospective cohort study including 113 patients with LDH who underwent PELD treatment at Shenshan Medical Center, Sun Yat-sen Memorial Hospital,Sun Yat-sen University, between January 1, 2022, and September 30, 2023. The regional localization and classification method was applied based on imaging data to record the position and most protruding point of the intervertebral disc in the sagittal, transverse, and coronal planes. Through preoperative imaging data and clinical evaluations （VAS score, JOA score, ODI score, etc.）, the impact of regional localization and classification on postoperative recovery and prognosis was systematically analyzed. Results L5/S1 and L4/5 were the most commonly affected segments among LDH patients. Furthermore, the most protruding point of the intervertebral disc could effectively predict patients' functional recovery at 1 year postoperatively, as indicated by VAS score （P=0.039）, JOA score （P=0.031）, and ODI score （P=0.045）. Additionally, PELD surgery reduced intraoperative blood loss, shortened hospital stay, and contributed to rapid recovery for patients. Conclusion This study suggests that the modified regional localization and classification method can provide a new predictive approach for different patients with intervertebral disc herniation undergoing PELD surgery, thereby assessing prognostic differences and potential recurrence probabilities among various patients. Reference | Related Articles | Metrics

Select

USP10 promotes the maglignant proliferation of glioblastoma by enhancing the stability of DNMT1 YANG Chao-ye, XIAO Song-hua Lingnan Modern Clinics In Surgery    2025, 25 (01): 60-69.   DOI: 10.3969/j.issn.1009-976X.2025.01.011 Abstract （101）      PDF（pc） （12269KB）（15）       Knowledge map    Save Objective In order to investigate the role of the deubiquitinating enzyme USP10 in the malignant progression of glioblastoma and elucidate its underlying mechanisms. Methods The GEPIA2 database was used to analyze the mRNA expression of USP10 in glioblastoma samples and its relationship with the prognosis of patients compared with normal tissue samples. The CRISPR-Cas9 plasmid was designed to knock out the expression of USP10 in glioma cells.Cellular proliferation was assessed through clonal formation assays, EdU incorporation experiments, and flow cytometry analysis. Coimmunoprecipitation （Co-IP） assay combined with mass spectrometry was used to identify USP10 interacting proteins. Two siRNAs were designed to knock down the expression of endogenous USP10 in glioma cells, and RNA-Seq analysis was used to compare the different RNA between before and after knockdown, and signaling pathway enrichment analysis was performed. Western blot （WB） analysis was conducted to evaluate protein expression levels in cells. Results Compared with adjacent tissues （n=207）, USP10 was significantly higher expressed in glioma cells （n=163, P<0.05）, and its high expression was significantly associated with poor prognosis. Knockout of USP10 led to a significant reduction in the proportion of glioma cells in the S phase （P<0.05）, decreased clonal formation （P<0.05）, and an even more pronounced decrease in colony formation under the same doses of ionizing radiation and TMZ （P<0.05）. RNAseq results indicated that USP10 affected multiple metabolic pathways related to cell proliferation. USP10 interacted with DNMT1 and was positively correlated with the expression level in glioma samples. WB analysis revealed a significant decrease in DNMT1 protein levels and a shortened half-life following USP10 knockdown; The growth kinetics of USP10 and DNMT1 proteins, as determined by the HU release assay, were found to be synchronized with those of Cyclin E1. Flow cytometry analysis showed that USP10 knockout increased the proportion of cells in the G1 phase （P<0.05）, decreased the proportion in the S phase （P<0.05）, and increased the proportion in the G2 phase （P<0.05）. Additionally, the number of colony formation decreased when USP10 and DNMT1 were knocked down in glioma cells, and the proportion of colony formation decreased higher with the increase of IR and TMZ doses. Conclusion The deubiquitinating enzyme USP10 is overexpressed in glioblastoma and is linked to an unfavorable prognosis. USP10 promotes the transition of glioblastoma from G1 to S phase by enhancing the stability of DNMT1, thereby promoting the proliferative capacity of glioblastoma cells. Reference | Related Articles | Metrics

Select

Effect of percutaneous transhepatic gallbladder drainage combined with laparoscopic cholecystectomy in patients ≥65 years old with moderate acute cholecystitis ZHUANG Hong-cai, LUO Dan-dan, HE Chao Lingnan Modern Clinics In Surgery    2025, 25 (01): 19-23.   DOI: 10.3969/j.issn.1009-976X.2025.01.004 Abstract （92）      PDF（pc） （2364KB）（124）       Knowledge map    Save Objective To investigate the effect of percutaneous transhepatic gallbladder drainage （PTGBD） combined with laparoscopic cholecystectomy （LC） versus direct LC in patients ≥65 years old with moderate acute cholecystitis. Methods The clinical data of 97 patients ≥65 years old with moderate acute cholecystitis admitted to our hospital from November 2020 to November 2023 were analyzed retrospectively. They were divided into PTGBD+LC group （41 cases） and LC group （56 cases） according to the different surgical procedures. The preoperative general condition, intraoperative bleeding, operation time, intra-operative transit open rate, time of first exhaustion, postoperative pain level, postoperative abdominal drain time, postoperative hospitalization time, total hospitalization cost, total hospitalization time and surgical complications were compared between the two groups. Results The proportion of ASA grade >Ⅱ in PTGBD+LC group was higher than that in LC group （P<0.05）. Intraoperative bleeding in PTGBD+LC group was less than that in LC group. The operation time, time of the first exhaustionand time of the postoperative hospital stay were shorter than that in LC group.The postoperative VAS score of 24 h was lower than that in LC group, but the total hospitalization cost and total hospital stay were greater than those in LC group （P<0.05）. There was no statistically significant difference in the intra-operative transit open rate between two groups, with 0 cases in PTGBD+LC group and 4 casesin LC group. There was a statistically significant difference in the comparison of the rate of complications between the two groups （P<0.05）, with 5 cases（12.2%） of complications in PTGBD+LC group and 17 cases （30.4%） in LC group. Conclusion PTGBD combined with LC can significantly reduce the difficulty and risk of surgery, improve the safety of LC, and accelerate postoperative recovery, making it a worthwhile option to consider for patients ≥65 years old with moderate acute cholecystitis. Reference | Related Articles | Metrics

Select

Value of MR-DWI combined with PSAD on differentiation degree of prostate cancer ZHANG Li-hua, ZHANG Ke, YUAN Jia-jun Lingnan Modern Clinics In Surgery    2025, 25 (03): 196-201.   DOI: 10.3969/j.issn.1009-976X.2025.03.009 Abstract （90）      PDF（pc） （1214KB）（0）       Knowledge map    Save Objective To investigate the value of 3.0T magnetic resonance diffusion weighted imaging （MR-DWI） parameters combined with prostate-specific antigen density （PSAD） on predicting the differentiation degree of prostate cancer. Methods 80 patients with prostate cancer in the hospital from August 2021 to August 2024 were included in this study. According to the results of clinical and pathological examination, they were divided into 32 cases in highly differentiated group （Gleason score<7 points） and 48 cases in moderately and poorly differentiated group （Gleason score≥7 points）. The MR-DWI signs, apparent diffusion coefficient （ADC） under different b values （0 s/mm2, 1000 s/mm2） and PSAD were analyzed and compared. The correlation between ADC, PSAD and Gleason score was analyzed. Receiver operating characteristic （ROC） curve was used to analyze the evaluation value of ADC and PSAD on differentiation degree of prostate cancer. Results Compared with highly differentiated group, the proportions of cases with blurred lesion boundary and lesion located in peripheral zone by MR-DWI were more in moderately and poorly differentiated group （P<0.05）. The ADCs under different b values in moderately and poorly differentiated group were smaller than those in highly differentiated group, and PSAD was higher than that in highly differentiated cancer group （P<0.05）. ADC was negatively correlated with Gleason score （P<0.05）, and PSAD was positively correlated with Gleason score （P<0.05）. The results of the ROC curve analysis for assessing the risk of low-to-intermediate-grade prostate cancer showed that the areas under the curve （AUCs） for the ADC value （b=50 s/mm2）, the ADC value （b=1200 s/mm2）, the PSAD level, and the combined model were 0.747, 0.704, 0.700, and 0.890, respectively. Statistical comparison indicated no significant difference in diagnostic performance among the three individual indicators （P>0.05）. However, the diagnostic performance of the combined model was significantly superior to that of any single indicator （Z-scores=2.662, 3.190, and 2.593, respectively; all P<0.05）. Among all assessment models, the combined model demonstrated the highest diagnostic efficacy, with a sensitivity of 66.67% and a specificity of 96.87%. Conclusion Both ADC values and PSAD levels are effective biomarkers for assessing the differentiation grade of prostate cancer. A multiparametric model, constructed by combining MR-DWI-derived ADC values with serum PSAD levels, demonstrates superior diagnostic performance in the preoperative prediction of low-to-intermediate-grade prostate cancer risk compared to each individual indicator. Reference | Related Articles | Metrics

Select

Study on the feasibility of improving the timeliness of diagnosis and treatment of tumors through multi-project and multi-sample hybrid gene sequencing technology HUANG Jing-hua, LUO Jia-huan, SUN Xi, XIAO Xiao-qin, JIANG Yuan-ling, HUANG Yong-sheng, LIAO Jian-wei Lingnan Modern Clinics In Surgery    2025, 25 (03): 184-189.   DOI: 10.3969/j.issn.1009-976X.2025.03.007 Abstract （88）      PDF（pc） （993KB）（2）       Knowledge map    Save Objective To conduct a retrospective analysis of multi-project and multi-sample sequencing in tumor samples, and to explore the feasibility of improving the timeliness of clinical tumor diagnosis and treatment. Methods This study mainly verified the feasibility of improving the timeliness of tumor diagnosis and treatment through multi-project mixed gene sequencing by analyzing the sequencing quality control data and detection results when WES libraries and tumor gene sequencing libraries were sequenced on the NovaSeq 6000dx sequencing platform. Results In 24 batches of pooled sequencing, the average cluster pass rate was 77.92%, the average expected data output was 633.22 Gb, and the average Q30 was 91.33%, all of which met the quality control standards. For the 753 whole exome sequencing （WES） libraries and 164 tumor multi-gene sequencing libraries, the individual sample data volume, average sequencing depth, and the proportion of sequencing depth >20× all met the quality control standards. No statistically significant differences were found in the detection results of the same sample in different batches of hybrid sequencing （P=0.125）. The turnaround time for clinical gene test reports was significantly shortened after adopting hybrid gene sequencing, mainly characterized by a reduced sequencing frequency. Conclusion Multi-project and multi-sample libraries can be sequenced using hybrid sequencing to improve the timeliness of gene testing reports in tumor diagnosis and treatment. Reference | Related Articles | Metrics

Select

Research progress of Mendelian randomized analysis of osteonecrosis PANG Yin-quan, YANG Xi-cheng, ZHAO Li-li Lingnan Modern Clinics In Surgery    2025, 25 (03): 210-215.   DOI: 10.3969/j.issn.1009-976X.2025.03.012 Abstract （88）      PDF（pc） （1000KB）（12）       Knowledge map    Save Mendelian randomization analysis is a data analysis technique used to evaluate etiological inference in epidemiological studies. It uses genetic variation strongly correlated with disease-related exposure factors as instrumental variables to evaluate the causal relationship between disease exposure factors and outcomes, aiming to reduce the interference of confounding factors and improve the accuracy of causal inference. There is a causal relationship between osteonecrosis and inflammatory cytokines, immunocyte phenotype, telomere length, intestinal flora and micronutrients, while there is no causal relationship between diabetes and osteonecrosis. This can more accurately reveal the etiology and pathogenesis of osteonecrosis in clinical practice, and provide new ideas and directions for the prevention and treatment of osteonecrosis. The literature of Mendelian randomization analysis of osteonecrosis was extensively reviewed in recent years, and the causal association between osteonecrosis and inflammatory cytokines, immunocyte phenotype, telomere length, intestinal flora, micronutrients and diabetes was analyzed and summarized. Reference | Related Articles | Metrics

Select

Application of small dose of esketamine on patient-controlled intravenous analgesia in children after concealed penile correction surgery GAO Ning-yang, YUAN Chao, ZHOU Lin, ZHANG Li-bin Lingnan Modern Clinics In Surgery    2025, 25 (03): 190-195.   DOI: 10.3969/j.issn.1009-976X.2025.03.008 Abstract （86）      PDF（pc） （995KB）（0）       Knowledge map    Save Objective To investigate the effect of low-dose esketamine combined with sufentanil on patient-controlled intravenous analgesia （PCIA） in children after allergic penile correction surgery. Methods In this study, a total of 90 children aged 4 to 12 years who were scheduled to undergo corrective surgery for concealed penis were selectedand divided equally into SE0, SE1 and SE2 groups. All children received anethesia induction with sufentanil and esketamine, while a sacral block was performed under ultrasound guidance and intraoperative anaesthesia was maintained with 1.3 MAC sevoflurane. The postoperative self-administered intravenous analgesia regimen was： 1 μg/（kg·24 h） of sufentanil in group SE0, 1 μg/（kg·24 h）of sufentanil + esketamine 0.5 mg/（kg·24 h）in group SE1 and 1 μg/kg of sufentanil + esketamine 1 mg/kg in group SE2, all diluted with 0.9% saline to 200 ml. Heart rate, mean arterial pressure, delirium score during anesthesia awakening, Wong-Baker analgesia score, Ramsay sedation score, number of postoperative analgesic pump presses, sufentanil dosage and occurrence of adverse effects were recorded in the three groups of children. Results The SE1 and SE2 groups experienced fewer postoperative analgesic pump presses and less sufentanil than the SE0 group （P<0.0165）. The SE2 group achieved fewer analgesic pump presses and less sufentanil consumption than the SE1 group, and had higher Ramsay sedation scores at T4 than the SE1 and SE0 groups （P<0.05）. At remaining moments, there were no significant differences between the groups in terms of delirium scores, analgesia, sedation scores, heart rate, mean arterial pressure and incidence of adverse reactions during the awakening period of paediatricanaesthesia （P>0.05）. Conclusion Low-dose esketamine combined with sufentanil PCIA achieves satisfactory postoperative analgesia in children undergoing hidden penis correction surgery, reduces total sufentanil dosage, and avoids emergence delirium or other significant adverse reactions. Reference | Related Articles | Metrics

Select

Clinical efficacy of longitudinal fixation with a single Kirschner pin in closed reduction for severely displaced juxta-epiphyseal fracture of the proximal phalanx in children WANG Shuai-yin, HUANG Zi-long, LI Jia-hui, LIU Shi-zhe, FU Gui-bing Lingnan Modern Clinics In Surgery    2025, 25 (03): 174-178.   DOI: 10.3969/j.issn.1009-976X.2025.03.005 Abstract （86）      PDF（pc） （1729KB）（2）       Knowledge map    Save Objective To explore the clinical efficacy of longitudinal fixation with a single Kirschner pin in closed reduction for severely displaced juxta-epiphyseal fracture of the proximal phalanx in children. Methods A retrospective analysis of 24 cases of juxta-epiphyseal fracture of the proximal phalanx in children were performed, in whom treated with closed-displacement single Kirschner pin longitudinal fixation from January 2018 to December 2020. All of them were acute closed fractures, diagnosed by X-ray before operation, and of them were severely displaced （type Ⅱ） juxta-epiphyseal fracture according to the Campbell's line, all were successfully closed-displaced and single Kirschner pin longitudinally fixated, and followed up regularly after operation. The function and growth of the affected fingers were observedduring regular follow-up after operation. Results The follow-up period ranged from 40 to 69 months, with an average of 51.23 months. All the children had healed the fracture at outpatient review, and the average healing time was 3.5 weeks. All cases were rated as excellent according to the hand function evaluation criteria in the trial standards for upper limb functional assessment by the Hand Surgery Society of the Chinese Medical Association, with no complications such as infection, skin necrosis, nonunion, premature physeal closure, or severe malunion of fingers. Conclusion Close dreduction longitudinal fixation with a single Kirschner pin can achieve satisfactory results in treating severely displaced juxta-epiphyseal fracture of the proximal phalanx in children. Reference | Related Articles | Metrics

Select

Clinical retrospective analysis of non-drainage in transoral endoscopic thyroidectomy vestibular approach AI Qing, HUANG Zhi-heng, JIANG Jiang, WENG Yu-jing Lingnan Modern Clinics In Surgery    2025, 25 (03): 168-173.   DOI: 10.3969/j.issn.1009-976X.2025.03.004 Abstract （79）      PDF（pc） （1038KB）（9）       Knowledge map    Save Objective To investigate the feasibility and safety of not placing a drainage tube during transoral endoscopic thyroidectomy vestibular approach （TOETVA）. Methods A retrospective analysis was conducted on 416 cases of TOETVA performed at our hospital from August 2021 to April 2024. After exclusions, 386 cases were included and divided into two groups based on the presence or absence of drainage： the no-drainage group （145 cases） and the drainage group （241 cases）. Postoperative hospital stays, pain scores, postoperative bleeding, seroma, and infection rates were compared between the two groups. Results No significant differences were observed in surgery time or postoperative pain scores.Postoperative complications, including bleeding, seroma, infection, hoarseness, and permanent hypoparathyroidism, showed no significant differences between the two groups. The proportion of patients who underwent total thyroidectomy was significantly higher in the drainage group than in the no-drainage group （25/241 vs. 1/145, P=0.01）. Intraoperative predicted bleeding was higher in the drainage group than in the no-drainage group [10（5,10） mL vs. 5（5,5） mL, P<0.01]. Postoperative hospitalization was significantly shorter in the no-drainage group than in the drainage group [2（2,2） vs. 3（2,3） d; P<0.01]. After excluding total thyroidectomy patients, when comparing only unilateral lobectomy cases, significant differences were found in intraoperative blood loss and hospital stay. In the no-drainage group, intraoperative bleeding was less （P<0.001） and postoperative hospitalization was shorter （P<0.001）, while other indicators showed no statistical differences. Conclusion Routine non-drainage in TOETVA is safe and feasible, not increasing the risk of postoperative bleeding, seroma, or infection. Reference | Related Articles | Metrics

Select

Study on the significance of PCT combined with amylase measurement of peritoneal drainage fluid in the early diagnosis and prognosis evaluation of intestinal fistula after colorectal cancer surgery LIN Liang-xue, DENG Hai-mei, CAI Hai-jing, PANG Shao-chun, DENG Zhi-an, LI Yi-ting, WANG Guan, WU Guo-zhong Lingnan Modern Clinics In Surgery    2025, 25 (03): 162-167.   DOI: 10.3969/j.issn.1009-976X.2025.03.003 Abstract （77）      PDF（pc） （1103KB）（2）       Knowledge map    Save Objective To analyze the application value of serum procalcitonin（PCT） combined with amylase measurement of peritoneal drainage fluid in the early diagnosis and prognosis evaluation of intestinal fistula after colorectal cancer surgery. Methods Patients who underwent surgical treatment for colorectal cancer at the hospital from March 2023 to October 2024 were selected for the study. Peritoneal drainage tubes were inserted post-operation, and serum PCT and amylase levels in the peritoneal drainage fluid were measured on the 1st, 3rd, 5th, and 7th days post-surgery. The patients were categorized into the intestinal fistula group and the non-intestinal fistula group based on the presence of an intestinal fistula, and a cohort observational study was conducted to compare and analyze the serum PCT and amylase levels in the peritoneal drainage fluid between the two groups. Results There were significant differences （P<0.05） in serum PCT and amylase levels in peritoneal drainage fluid between the intestinal fistula group and the non-intestinal fistula group at different postoperative time periods. ROC curve analysis revealed that the AUC and sensitivity of the combined diagnosis of serum PCT and peritoneal drainage amylase were relatively high. There were significant differences （P<0.05） in serum PCT levels between the micro-fistula group and the non-micro-fistula group on postoperative days 1, 3, 5, and 7. ROC curve analysis revealed that serum PCT had an AUC of 0.907 and a sensitivity of 86.67% for predicting the prognosis of postoperative intestinal fistula in colorectal cancer. Conclusion The combined detection of amylase in peritoneal drainage fluid and serum PCT can improve the early diagnostic efficiency of postoperative intestinal fistula in colorectal cancer, and changes in serum PCT levels can be used to evaluate the prognosis of patients. Reference | Related Articles | Metrics

Select

The predictive value of serum choline acetyltransferase combined with DCE-MRI parameters for postoperative femoral head necrosis in patients with femoral neck fractures LI De, CHEN Wu-lin, SUN Rui-bo, LIU You-wen Lingnan Modern Clinics In Surgery    2025, 25 (03): 179-183.   DOI: 10.3969/j.issn.1009-976X.2025.03.006 Abstract （72）      PDF（pc） （1099KB）（0）       Knowledge map    Save Objective To analyze the predictive value of serum choline acetyltransferase（ChAT） combined with dynamic contrast-enhanced magnetic resonance imaging（DCE-MRI） parameters for postoperative femoral head necrosis in patients with femoral neck fractures. Method 120 patients with femoral neck fractures who underwent surgery at Luoyang Orthopedic Hospital Luoyang district, Henan Province from January 2020 to June 2023 were selected as the research subjects.They were divided into an occurrence group and a non-occurrence group based on whether they developed femoral head necrosis after surgery. Both groups underwent DCE-MRI examination, and the relevant examination parameters and serum ChAT levels were compared between the two groups. The receiver operating characteristic（ROC） curve was used to analyze the value of serum ChAT and DCE-MRI parameters in the prognosis of femoral neck fractures. Results The serum ChAT level in the occurrence group was lower than that in the non-occurrence group, and the volume transfer constant（Ktrans）, rate constant（Kep）, and area under the initial time concentration curve（iAUC） values were all higher than those in the non-occurrence group（P<0.05）. The range of serum ChAT, DCE-MRI parameters, and area under the curve（AUC） values for combined examination was 0.765~0.962, indicating high sensitivity and specificity. Conclusion The combination of serum ChAT and DCE-MRI parameters has certain predictive value for postoperative femoral head necrosis in patients with femoral neck fractures. The use of a combined examination plan is expected to provide a basis for clinical treatment selection. Reference | Related Articles | Metrics

Select

Clinicopathological features of gastric cancer with familial aggregation: a single-center retrospective study LI Sen-mao, HE Xuan, WANG Peng-liang, WU Xian-rui, LIAO Yi Lingnan Modern Clinics In Surgery    2025, 25 (05): 281-287.   DOI: 10.3969/j.issn.1009-976X.2025.05.001 Abstract （61）      PDF（pc） （1110KB）（6）       Knowledge map    Save Objective To investigate the clinicopathological characteristics of familial clustering gastric cancer and compare the differences among probands with different types of family history, providing clues for exploring the unique genetic background of familial gastric cancer in Chinese, particularly East Asian populations. Methods Data from 282 gastric cancer patients who underwent surgery at the Sixth Affiliated Hospital of Sun Yat-sen University between January 1 and December 31, 2018, were retrospectively collected. Valid family history of malignant tumors was obtained via telephone follow-up, with 184 patients ultimately included in the analysis. Probands were divided into five cohorts based on family history： overall positive/negative family history, positive/negative family history of gastric cancer, positive/negative family history of colorectal cancer, HDGC/non-HDGC （according to 2015 IGCLC criteria）, and FIGC/non-FIGC （according to 1999 IGCLC criteria）. The epidemiological and clinicopathological characteristics of probands across cohorts were compared. Results Among the 184 probands, 58 （31.5%） had a positive family history of malignant tumors. Gastric cancer was the most commonly clustered malignancy within these families （15/58, 25.9%）. Cohort analysis revealed that probands in the overall positive family history group （P=0.026）, the positive gastric cancer family history group （P=0.011）, and families meeting the FIGC criteria （P=0.004） had a significantly higher rate of HER2 positivity on immunohistochemistry compared to their respective negative or non-FIGC groups. Additionally, the positive gastric cancer family history group had a higher number of tumor deposits （P=0.042）. Probands from HDGC families exhibited characteristics including younger age and a higher proportion of poorly differentiated and diffuse-type gastric cancers. Conclusion Significant familial clustering of gastric cancer exists in the patient population from Southern China. Probands with a family history of gastric cancer, particularly those meeting FIGC criteria, exhibit a distinct feature of HER2 protein overexpression. This suggests that the underlying genetic mechanism may differ from the CDH1 mutation-associated HDGC common in Western populations or Lynch syndrome. The HER2-related signaling pathway may play an important role in the pathogenesis of familial clustering gastric cancer in the Chinese population. Reference | Related Articles | Metrics

Select

Lingnan Modern Clinics In Surgery    2025, 25 (03): 151-155.   DOI: 10.3969/j.issn.1009-976X.2025.03.001 Abstract （58）      PDF（pc） （3981KB）（6）       Knowledge map    Save Reference | Related Articles | Metrics

Select

CT hypoperfusion intensity ratio before endovascular thrombectomy is associated with clinical prognosis in patients with anterior circulation large vessel occlusion RUAN Xin-lei, CHEN Rui, HUANG Zhong-run, XIANG Chun, CHEN Pei-sheng, SHI Zhong-song Lingnan Modern Clinics In Surgery    2025, 25 (05): 318-324.   DOI: 10.3969/j.issn.1009-976X.2025.05.006 Abstract （58）      PDF（pc） （2854KB）（2）       Knowledge map    Save Objective Parenchymal hematoma （PH） is a severe type of hemorrhagic transformation and is associated with poor outcomes in patients with acute ischemic stroke after endovascular thrombectomy treatment. This study explores the relationship between hypoperfusion intensity ratio （HIR） from CT perfusion imaging with postoperative PH and clinical outcomes. Methods We analyzed the clinical and imaging data of patients with acute anterior circulation large vessel occlusion treated with endovascular intervention in our stroke center from December 2020 to December 2022. HIR was calculated as the ratio of severe hypoperfusion area volume （Tmax>10 seconds） to hypoperfusion area volume （Tmax>6 seconds） from head CT perfusion imaging. The type of hemorrhagic transformation after endovascular thrombectomy treatment was determined according to Heidelberg grading criteria. We analyzed the relationship between clinical, and imaging data with postoperative HT and clinical outcomes at discharge. Results Fifty-five patients with acute anterior circulation large vessel occlusion were included in the study. Twenty-one patients （38.2%） developed HT after thrombectomy treatment, including nine with PH. HIR at admission was significantly higher in the PH group than in the non-PH group （0.58 vs. 0.33, P=0.010）. HIR was significantly higher in the poor clinical outcome group （modified Rankin Scale 3~6 points） than in the good outcome group （0.47 vs. 0.25, P<0.001）. In addition, atrial fibrillation, NIHSS score at admission, blood glucose, neutrophil-to-platelet ratio, cerebral blood flow <30%, Tmax>10 seconds, and PH after endovascular thrombectomy were significantly associated with poor clinical outcomes. HIR（OR=1132.791, 95%CI： 7.979~160 828.706, P=0.005）was one ofthe independent factors for poor clinical outcomes. Conclusion HIR at admission is significantly associated with PH after endovascular thrombectomy, and it is an effective imaging marker for poor clinical outcomes after endovascular thrombectomyfor patients with acute anterior circulation large vessel occlusion. Reference | Related Articles | Metrics

Select

Analysis of factors affecting stigma in patients with breast cancer wounds and construction of a prediction model LIN Ai-yi, WANG Xiu, LI Ling, QIU Liang-zhi, WU Xian-rong Lingnan Modern Clinics In Surgery    2025, 25 (05): 330-336.   DOI: 10.3969/j.issn.1009-976X.2025.05.008 Abstract （54）      PDF（pc） （911KB）（2）       Knowledge map    Save Objective To explore the factors influencing stigmatization in patients with malignant breast cancer wounds, identify its core predictive factors, and construct and validate a clinical predictive model for stigmatization. Methods A cross-sectional survey was conducted on 67 patients using the following instruments： general information questionnaire, Stigma Scale for Chronic Illnesses 8-item version （SSCI-8）, Toronto Wound Symptom Assessment System-Wounds（TSAS-W）, Self-Rating Anxiety Scale （SAS）, Self-Rating Depression Scale （SDS）, Social Support Rating Scale （SSRS）, and Quality of Life Instruments for Cancer Patients-Breast Cancer（QLICP-BR）. Data analysis was performed using univariate analysis, Pearson correlation, and multiple linear regression analysis. Results The overall score for stigmatization was 13.3±5.76 points. Correlation analysis showed that stigmatization was significantly positively correlated with anxiety （r=0.537） and depression （r=0.464）, and wound symptoms （r=0.389） （all P<0.05）, strongly negatively correlated with quality of life （r=-0.718, P<0.01）, and marginally significantly negatively correlated with social support （r=-0.229, P=0.062）. Multivariate linear regression analysis showed that： Quality of life （β=-0.666, P<0.01） was the strongest negative predictor of stigma, while anxiety （β=0.234, P=0.088） and depression （β=-0.251, P=0.095） had marginal predictive effects. The final model explained 51.5% of the variance in stigmatization （adjusted R3=0.515, F=15.003, P<0.01）. Conclusion Stigmatization in patients with breast cancer wounds has a significant statistical association with quality of life, and a marginally significant association with anxiety and depression levels. Wound management can be combined with a focus on enhancing patient quality of life and alleviating anxiety and depression, in order to reduce patients' level of stigmatization. Reference | Related Articles | Metrics

Select

A case report of transoral endoscopic surgery via vestibular approach in treating benign mediastinal teratoma YUE Ning, YU Xing Lingnan Modern Clinics In Surgery    2025, 25 (03): 206-209.   DOI: 10.3969/j.issn.1009-976X.2025.03.011 Abstract （51）      PDF（pc） （8811KB）（2）       Knowledge map    Save This study reports a case of mediastinal benign teratoma treated with endoscopic resection via the transoral vestibular approach. We retrospectively analyzed the patient's clinical data, diagnostic and therapeutic process, intraoperative findings, and treatment outcomes. As a benign germ cell tumor, mediastinal teratoma is most effectively managed by surgical excision. We presented the case of a 16-year-old female patient with a preoperative diagnosis of an upper mediastinal benign tumor. Given the patients strong preference for cosmetic outcomes, a multidisciplinary team opted for an endoscopic transoral vestibular approach for tumor resection. The procedure was successfully completed with complete tumor removal. Intraoperative nerve monitoring effectively preserved critical structures such as the recurrent laryngeal nerve. Histopathology confirmed a benign teratoma, and no significant postoperative complications occurred. The patient expressed satisfaction with both the therapeutic and cosmetic results. The transoral vestibular approach may be considered a viable surgical option for mediastinal teratoma. Reference | Related Articles | Metrics

Select

Exploring the relationship between ETV4 and colorectal cancer LIU Jin-yu, GUO Qiang, MA Xing-yue, CHEN Hui-wen, XU Hong-chao Lingnan Modern Clinics In Surgery    2025, 25 (05): 288-296.   DOI: 10.3969/j.issn.1009-976X.2025.05.002 Abstract （51）      PDF（pc） （9430KB）（23）       Knowledge map    Save Objective To explore the relationship between ETS transcription factor 4 （ETV4） and colorectal cancer. Methods Colorectalcancer tissues and adjacent tissues from 40 cancer patients were collected. RT-qPCR and immunohistochemistry were used to detect ETV4 expression levels. Bioinformatics methods were applied： cBioPortal for ETV4 mutation analysis, String to extract its protein-protein interaction network, UALCAN to analyze the correlation between ETV4 expression and clinical data like cancer stage, lymph node metastasis, age, and gender, and Kaplan-Meier Plotter to analyze the relationship between ETV4 expression and patient prognosis. Results RT-qPCR and immunohistochemistry showed that ETV4 expression was significantly higher in cancer tissues than in adjacent tissues （P<0.01）. cBioPortal showed that ETV4 mutations in colorectal cancer mainly included missense and splice mutations. UALCAN analysis indicated that ETV4 expression was correlated with TNM stage, histological subtype, and TP53 mutation status （P<0.05）, but not with age, gender, race, or weight （P>0.05）. Kaplan-Meier analysis demonstrated that high ETV4 expression was associated with significantly improved overall survival （OS; Logrank P=0.031, HR=0.8, 95%CI： 0.66~0.98） and post-progression survival （PPS; Logrank P=0.05, HR=0.64, 95%CI： 0.47~0.88） in colorectal cancer patients. Conclusion The upregulation of ETV4 in colorectal cancer tissues correlates with a better prognosis, indicating its potential as a promising prognostic biomarker and a novel therapeutic target. Reference | Related Articles | Metrics

Select

Multivariate analysis of MVI-positivity in hepatocellular carcinoma HU Xiao, PENG Lin-hui Lingnan Modern Clinics In Surgery    2025, 25 (05): 297-301.   DOI: 10.3969/j.issn.1009-976X.2025.05.003 Abstract （50）      PDF（pc） （1037KB）（4）       Knowledge map    Save Objective To investigate the influencing factors of postoperative microvascular invasion （MVI） in hepatocellular carcinoma （HCC） patients and provide a theoretical basis for neoadjuvant therapy. Methods Clinical data of 995 HCC patients who underwent surgery at Sun Yat-sen Memorial Hospital between January 2020 and December 2023 were retrospectively analyzed. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for MVI positivity. Results A total of 995 patients were included, with an MVI positivity rate of 38.4% （382/995）. Univariate analysis revealed significant differences between MVI-positive and MVI-negative groups in tumor stage （P<0.001）, differentiation grade （P<0.001）, and proportion of preoperative adjuvant therapy （P=0.044）. Multivariate analysis demonstrated that advanced tumor stage （OR=3.171） and absence of preoperative adjuvant therapy （OR=3.312） were independent risk factors for MVI positivity, while well-differentiated tumors served as a protective factor （OR=0.275） （all P<0.05 ）. Conclusion Higher tumor stage, poorer differentiation, and absence of preoperative adjuvant therapy significantly increase the risk of postoperative MVI in HCC patients. Individualized preoperative adjuvant therapy based on tumor stage and differentiation grade may reduce MVI risk. Reference | Related Articles | Metrics

Select

Effect of simultaneous bi-atrial bipolar radiofrequency ablation during heart valve replacement in the treatment of valvular heart disease complicated with atrial fibrillation and the impact on echocardiographic parameters ZHAI Shao-feng, WANG Yong-sheng, AN Zhuo-yi Lingnan Modern Clinics In Surgery    2025, 25 (05): 312-317.   DOI: 10.3969/j.issn.1009-976X.2025.05.005 Abstract （48）      PDF（pc） （889KB）（0）       Knowledge map    Save Objective To compare the effects of simultaneous bi-atrialbipolar radiofrequency ablation and simultaneous unipolar radiofrequency ablation during heart valve replacement in the treatment of patients with valvular heart disease complicated with atrial fibrillation, and the impact on echocardiographic parameters. Methods Using random number table method, 90 patients with valvular heart disease complicated with atrial fibrillation who were scheduled to undergo surgical treatment in the hospital from February 2022 to January 2025 were assigned to the bipolar group and the unipolar group, with 45 cases in each group.Both groups underwent heart valve replacement, and bi-atrial bipolar radiofrequency ablation and unipolar radiofrequency ablation were performed in the same period, respectively. The situation of sinus rhythm conversion at different time points after surgery was compared between the two groups. Echocardiographic parameters [left atrial diameter （LAD）, left ventricular ejection fraction （LVEF）, left ventricular fractional shortening （LVFS）and right atrial diameter （RAD）] of the two groups before surgery and at 3 months after surgery were compared. Postoperative complications observed in the two groups were recorded. Results The ablation time in the monopolar group was shorter than that in the bipolar group （P<0.05）; the sinus rhythm conversion rate in the bipolar group was higher than that in the monopolar group at 1 and 3 months post-operation （both P<0.05）; at 3 months post-operation, there was no statistically significant difference in left ventricular fractional shortening （LVFS） between the two groups （P>0.05）; the bipolar group had lower left atrial diameter （LAD） and right atrial diameter （RAD） than the monopolar group, and higher left ventricular ejection fraction （LVEF） than the monopolar group （all P<0.05）; the postoperative complication rate in the bipolar group was lower than that in the monopolar group （P<0.05）. Conclusion Concomitant biatrial bipolar radiofrequency ablation during cardiac valve replacement surgery can significantly improve cardiac function in patients with valvular heart disease combined with atrial fibrillation, reduce postoperative complications, and increase the postoperative sinus rhythm conversion rate. Reference | Related Articles | Metrics

Select

A case of intrahepatic cholangiocarcinoma treated with radical surgery after conversion therapy and literature review ZHANG Ke-cheng, LUO Shu-li, XIA Jing, ZHAO Yong-yang, XING Xiang-lei, YANG Xin-wei Lingnan Modern Clinics In Surgery    2025, 25 (05): 337-340.   DOI: 10.3969/j.issn.1009-976X.2025.05.009 Abstract （46）      PDF（pc） （3428KB）（2）       Knowledge map    Save This paper presents a case of a 43-year-old male diagnosed with left lobe intrahepatic cholangiocarcinoma following the detection of a left hepatic mass during a routine physical examination. Imaging evaluations confirmed tumor invasion into the middle hepatic vein, inferior vena cava, and hilar lymph nodes, leading to an initial assessment of unresectable disease. Following a multidisciplinary team （MDT） discussion, the patient was initiated on neoadjuvant therapy consisting of Gemcitabine/Cisplatin/Albumin-bound paclitaxel chemotherapy combined with sintilimab immunotherapy. Following four cycles of conversion therapy, the tumor significantly shrank, and the tumor marker CA19-9 markedly decreased, creating an opportunity for curative surgery.Subsequently, the patient successfully underwent extended left hepatectomy, caudate lobectomy,and regional lymph node dissection. Postoperative pathological examination confirmed an R0 resection. The patient recovered well postoperatively and continued adjuvant therapy. Over a follow-up period exceeding 24 months, no evidence of tumor recurrence was identified, and the patient maintained a favorable quality of life. This case suggests that chemotherapy combined with immunotherapy as a neoadjuvant approach can effectively convert initially unresectable locally advanced intrahepatic cholangiocarcinoma, providing patients with an opportunity for curative surgery and survival benefits. Reference | Related Articles | Metrics