Table of Content

20 April 2021, Volume 21 Issue 02

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Discussion on application of combination therapy in conversion therapy of biliary tract cancer

YU Xiao-peng, TONG Huan-jun, TANG Zhao-hui

2021, 21(02):  133-137.  DOI: 10.3969/j.issn.1009-976X.2021.02.001

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Biliary tract cancer has insidious onset and rapid development thus most patients have lost the opportunity of surgery when they are found, so the prognosis is poorer. Conversion therapy can achieve the goal of making the tumor shrink or reduce its stage, so that patients have conditions for surgery and complete radical resection. Due to the occurrence and development of biliary tract cancer with great heterogeneity is the result of multiple elements and paths, combination therapy is becoming the main direction to improve the success rate of translational therapy and the prognosis currently. With the deepening understanding of the pathogenesis and development of biliary tract cancer, individualized and precise combination therapy will become the main direction of conversion therapy in the future.

Original Articles and Clinical Research

Clinicopathological analysis of 35 cases of hepatic neuroendocrine neoplasms

LIU Shao-ru, HUANG Yi-pei, PEI Xiao-shan, XU Lei-bo

2021, 21(02):  157-164.  DOI: 10.3969/j.issn.1009-976X.2021.02.006

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Objective Hepatic neuroendocrine neoplasm has a relatively low incidence and there are few relevant studies. This study analyzed and summarized the diagnosis and treatment of 35 cases of hepatic neuroendocrine neoplasms and discusses the pathogenesis, diagnosis and treatment in combination with relevant literatures. Methods Clinicopathological data of 35 hepatic neuroendocrine neoplasm patients treated in Sun Yat-sen Memorial Hospital of Sun Yat-sen University were analyzed retrospectively. Results According to the WHO classification standard of digestive system tumors in 2010, 3 cases with primary neuroendocrine tumor, 5 cases with primary neuroendocrine tumor, and 4 case with secondary neuroendocrine tumor G2 and 23 cases with secondary neuroendocrine carcinoma. Of 35 cases, 12 received hepatectomy, 3 received transcatheter arterial chemoembolization （TACE）, 15 received systemic chemotherapy, and 7 received radiofrequency ablation. Other treatment modalities involved anhydrous alcohol ablation, sunitinib and octreotide injection. All patients underwent long-term follow-up. By the date of the last follow-up, 28 patients died, 7 patients survived, and the median survival time of hepatic neuroendocrine neoplasm patients were 22 months. Conclusion Hepatic neuroendocrine neoplasm is a rare heterogeneous tumor, the diagnosis of which is mainly depended on histopathology and immunohistochemistry. Multidisciplinary comprehensive therapy can help prolong the survival time of patients.

Expression and clinical value of RNF24 in patients with hepatocellular carcinoma

WU Jun-hua, CHEN Yun-yang, ZHANG Xin, YU Jie-xiong, CUI En-ming, ZHANG Hui-ling

2021, 21(02):  165-170.  DOI: 10.3969/j.issn.1009-976X.2021.02.007

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Objective To investigate the expression of RNF24 gene in patients with hepatocellular carcinoma （HCC） and its clinical significance. Methods Using UALCAN and HPA database to analyze the expression of RNF24 in HCC. TIMER database was used to detect the correlation between RNF24 and immune infiltration and its impact on patient survival. The Kaplan-Meier plotter tool was used to analyze the effects of different expression levels of RNF24 on the clinical prognosis of patients with HCC. Finally, download the clinical data of HCC patients through Firebrowse, and Cox regression analysis predicts the prognostic value of RNF24 for HCC patients. Results The results of UALCAN analysis showed that the median expression of RNF24 mRNA in HCC （Median, M） was 0.712 （q1=0.376, q3=1.287）, which was significantly higher than the median value of normal liver tissue of 0.265 （q1=0.17, q3=0.371） （P<0.01）. HPA database analysis shows that RNF24 protein is higher in HCC tissues than the corresponding normal liver tissues. TIMER analysis indicated that the infiltration level of CD8⁺ T cells, B cells, dendritic cells, CD4⁺ T cells, neutrophils and macrophages was significantly positively correlated with the expression level of RNF24. Tumor staging, CD8⁺ T cells, dendritic cell infiltration levels, and RNF24 expression are all risk factors for the prognosis of HCC patients. Cox regression analysis was performed in 205 HCC patients with complete information from Firebrowse, and the results showed that RNF24 is an independent risk factor for the prognosis of HCC patients. Conclusion RNF24 can be used as a new marker for predicting the prognosis of HCC patients.

Long non-coding RNA TSI inhibited the metastasis induced by TGF-β1 in breast cencer cell MCF-7 and BT474

TAN Zi-cong, ZHANG Yang-fan, HUANG Xiao-yan, YANG Hao-jie, CAO Ming-hui

2021, 21(02):  171-176.  DOI: 10.3969/j.issn.1009-976X.2021.02.008

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Objective To uncover the function of long non-coding RNA TSI （Lnc-TSI） in the TGF-β₁ induced metastasis of breast cancer cell MCF-7 and BT474. Methods We treated the MCF-7 and BT474 cells with TGF-β1 and investigated the morphological changes. Epithelial-mesenchymal transition （EMT） associated proteins were measured with western blot and cell invasion were tested with transwell assay. And then qPCR was used toverify the expression of Lnc-TSI in MCF-10A cells, compared with MCF-7 and BT474 cells with or without TGF-β1 treatment. After knocking out and overexpressing Lnc-TSI in MCF-7 and BT474 cells respectively, we conducted transwell assay to see the changes of cellmigration and invasion. Results Morphology scale showed highly possible EMT changes in MCF-7 and BT474 cells. Also, EMT associated protein E-cadherin were down-regulated while N-cadherin and Vimentin were up-regulated, consisting with the enhanced invasion after treating with TGF-β1. Compared with MCF-10A cells, Lnc-TSI level was much higher in MCF-7 and BT474 cells. TGF-β1 dramatically up-regulated the expression of Lnc-TSI in MCF-7 and BT474 cells. Knocking out and overexpressing Lnc-TSI in MCF-7 and BT474 cells were able to enhanced and inhibited the cell migration and invasion respectively, which were both more obvious with TGF-β1 treatment. Conclusion Lnc-TSI was up-regulated following the metastasis mediated by TGF-β1 in MCF-7 and BT474 cells. Lnc-TSI suppressed the metastasis of MCF-7 and BT474 cells.

Effect of protein disulfide isomerase family A member 4 silencing on apoptosis of glioma cell

ZHU Chuan-hua, XIE Lin, LIU An-min

2021, 21(02):  177-181.  DOI: 10.3969/j.issn.1009-976X.2021.02.009

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Objective To investigate the expression of protein disulfide isomerase family A member 4（PDIA4） in glioma and the effect on apoptosis. Methods The RNAseq data was downloaded from CGGA database. Glioblastoma cell lines（U251,U87） and human normal astrocyte cell line HA1800 were used in the study. The relative expression of PDIA4 in glioma cell lines was detected by RT-qPCR. U251 cells were transfected with siRNA, transfected with siPDIA4 as si#768 group and si#1829 group, untransfected as negative control group, and transfected with siNC as blank control group. Then alarma blue assay and colony formation assay were used to examine the proliferation of U251 cells, the apoptosis rate was detected by flow cytometry, and Western blotting was used to detect the expression of cleaved-caspase3、cleaved-caspase7 protein. Results In CGGA database, the expression level of PDIA4 were different in gliomas of different grades （P<0.05）, the five-year survival rates of the high PDIA4 expression group was lower than the low expression group, and Log-rank test（Log-rank=264.32, P<0.001）. Compared with normal astrocyte cell line HA1800, the relative expression levels of PDIA4 was increased in U251 and U87（F=58.44, P<0.05）. Compared with blank group and negative control group, proliferation and colony formation ability of si#768 group and si#1829 group were inhibited（P<0.01）, and apoptosis rates （17.67±0.11%, 19.50±2.30% vs. 3.72±2.11%, 6.53±0.13%, F=51.06, P<0.01） were significantly increased. Compared with the negative control group, the protein expression of cleaved-caspase-7 were increased up to 218.53%and 169.68% （F=12.61, P<0.05）. Conclusion Knockdown of PDIA4 may promotes the apoptosis of glioma cells by activating caspase pathway.

Bone marrow mesenchymal stem cell-derived exosomes treat sciatic nerve injury recovery by promoting axonal regeneration

ZENG Di-fan, ZHONG Mei, LI Wei, WANG Qi-you

2021, 21(02):  182-187.  DOI: 10.3969/j.issn.1009-976X.2021.02.010

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Objective To explore the effect and mechanism of bone marrow mesenchymal stem cell-derived exosomes （BMSC-EXOs） on repair of sciatic nerve injury. Methods The bone marrow mesenchymal stem cells （BMSCs） of Sprague Dawley（SD）rats were extracted and cultured. BMSCs-EXOs were extracted by ultracentrifugation and identified by fluoroscopic electron microscopy, particle size analysis, and western blotting. Culture PC12 cells, divide the PC12 cells into the blank contral group, 30 μg exosomes group, and 60 μg exosomes group. Observe the phagocytic effect of PC12 cells and PC12 cells axon regeneration by immunofluorescence. The expression of cellular neurofilament protein （NF-200） and growth-related protein （GAP-43） were detected by Western blotting. The SD rat sciatic nerve crush injury models were divided into injury group and treating group. The sciatic nerve of each group was observed by immunofluorescent staining. Results BMSC-EXOs were successfully extracted from the supernatant of BMSCs by ultracentrifugation, which conformed to the definition of particle size, fluoroscopic electron microscopic morphology, and Western blotting. The phagocytosis of BMSC-EXOs by PC12 cells was detected by immunofluorescence, and the axon regeneration of PC12 cells was increased. The increase of axon-related protein synthesis was detected by Western blotting, and the effect increased with increasing dose. There were statistically significant differences in axon length and axon-related protein expression in the three groups of PC12 cells（P<0.01）. In the sciatic nerve injury model, histological observation of the injury area was reduced and the nerve was reconnected. Conclusion BMSC-EXOs can play a role in the treatment of sciatic nerve injury by promoting the regeneration of nerve axons.

Effect of streptozotocin induced diabetic model mice on inflammatory arthritis

LIU Li-xuan, LI Li, CHEN Yu-ying, HU Xing-yun, SONG Wei-dong, YANG Chuan

2021, 21(02):  188-191.  DOI: 10.3969/j.issn.1009-976X.2021.02.011

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Objective To observe the effect of type I diabetes induced by streptozotocin （STZ） on inflammatory arthritis in mice. Methods Sixteen SPF grade 6 weeks old male C57BL/6J mice were randomly divided into two groups, with 8 mice in each group. At the age of 6 weeks, the diabetic mice model was established by intraperitoneal injection of 150 mg/kg streptozotocin, while the control group was injected with the same volume of citrate buffer. At the age of 7 weeks, mouse arthritis model of two groups was established by foot pad injection of 0.5 ml complete emulsifier of bovine type Ⅱ collagen and Freund's adjuvant at both sides of hide foots. The electronic vernier caliper was used to measure the thickness of foot. The mRNA expression levels of OPG and RANKL genes in ankle joints of two groups of mice were detected by real-time qPCR. The protein expression levels of OPG and RANKL in ankle joints were detected by Western blot. Results Compared with CON group, fasting blood glucose increased in STZ group （P<0.001）, and a diabetes model was successfully established. After the establishment of CIA model, red, swelling and joint movement disorder were observed in both hind feet of mice, and arthritis developed faster in CON+CIA group, and the difference was statistically significant at week 2 and 3 （P<0.05）. RT-qPCR and Western blot results showed that compared with CON+CIA group, the expressions of OPG and RANKL in joint tissues of mice in STZ+CIA group were significantly increased （P<0.01）. The RANKL/OPG ratio >1 indicated that the process of bone resorption was significantly higher than that of bone formation. Conclusion In the collagen-induced inflammatory arthritis model mice, although the non-diabetic mice developed faster arthritis and more severe swelling, the diabetic mice had longer duration of arthritis and more severe bone resorption. However, the specific mechanism of hyperglycemia on arthritis remains to be further researched.

A comparative study on the minimally invasive resection and open resection after steroid hormone therapy for granulomatous mastitis

YANG Jian-min, YU Hai-yun, YU Hai-jing, WAN Yong-nan

2021, 21(02):  192-194.  DOI: 10.3969/j.issn.1009-976X.2021.02.012

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Objective To compare the clinical effect between the minimally invasive resection and traditional open resection after steroid hormone therapy for granulomatous mastitis. Methods The record of 166 patients with granulomatous mastitis were collected from March 2016 to December 2019. Eighty-six patients in observation group were treated by ultrasonic-guided vacuum-assisted resectionand 80 patients in control group were treated by traditional open resection, and those with larger cavities underwent free flap plasty and indwelling drainage tube. The recurrence rate, appearance satisfaction, hospitalization time and treatment cost between two groups were recorded. Results The recurrence rate of observation group was 3.49% （3/86） and 3.75% （3/80） in control group. There was no significant difference between two groups （P=0.93）, and the observation group have advantage in appearance satisfaction, hospitalization time and treatment cost compare to the control group. Conclusion The ultrasonic-guided vacuum-assisted resection is as effective as traditional open resection with economic advantages, which worth clinical application and promotion.

Preliminary analysis for the recurrence of comparing open surgery, endovenous ablation for great saphenous varicose veins

TU Xing-qiang, DU Guo-neng, XULI Xiao-zi, XU Yong-hui, XIAO Yu-gen, SHENG Xiao-yan

2021, 21(02):  195-199.  DOI: 10.3969/j.issn.1009-976X.2021.02.013

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Objective To investigate the factors and possible causes of recurrence for great saphenous varicose veins after operation. Methods PubMed, Wanfang data and CNKI database from January 2000 to May 2020 were researched, collecting randomized controlled study （RCT） literature on endovenous laser ablation （EVLA）, radio frequency ablation （RFA） and high ligation and stripping of GSV （HLS）about postoperative recurrence, using clinical and color Doppler ultrasonography to evaluate the anatomical location of recurrent venous reflux, possible causes of reflux, and recurrent symptomatic varicose veins （VVs） processing. Results Nine RCT documents on EVLA and HLS were included in the analysis. Among the 1765 lower extremities, 712 lower extremities underwent HLS surgery, 354 received RFA treatment, and 699 received EVLA treatment. The average age was 47 years, and the average follow-up was 3.4 years. The ratio of female patients reached 77%, with mild GSV varicose （C2-C3） close to 90%. In all RCTs, the thigh and calf are the most common anatomical sites for recurrence. The causes of recurrence include neovascularization, venous recanalization, presence of accessory saphenous vein, perforator formation, and surgical failure. The recurrence rate statistics varied greatly between groups. RFA： The total recurrence in the 2-year follow-up （one group） was 20.5%） the 3-year （two groups） were 53.3% and 17.1%, and the 5-year （one group） was 12.9%. HLS： The total recurrences in the 2-year follow-up （three groups） were 16.7%, 3.0%, and 17.5%, respectively, the 3-year （two groups） were 23.1% and 21.1%, and the 5-year （three groups） were 42.6%, 26.8% and 4.2%. EVLA： The total recurrences in the 2-year follow-up （two groups） were 17.0% and 28.6%, the 3-year （one group） was 28.6%, and the 5-year （three groups） were 47.8%, 29.6%, and 5.6%, respectively. Conclusion The literature reports that the location and cause of recurrence after GSV varicose surgery are basically the same, but the recurrence rate varies greatly in the literature. The three methods of EVLA, RFA, and HLA have higher recurrence rates.

Clinical experience of local injection of lauromacrogol in the treatment of hemangioma in children

ZHOU Ke-yan, HU Jing-hui, LIU Dong-biao, WEN Jian-hui, GUAN Fei

2021, 21(02):  200-203.  DOI: 10.3969/j.issn.1009-976X.2021.02.014

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Objective To investigate the clinical efficacy of lauromacrogol injection in the treatment of hemangioma in children. Methods From June 2014 to June 2019, 90 patients diagnosed with superficial hemangioma in department of pediatric surgery, Jiangmen Maternal and Child Health Hospital were analyzed retrospectively. All of them were given lauromacrogol injection therapy. Achauer standard methods were applied to clinical effect assessment. The size of tumor, the clinical efficacy and side effects of the patient were recorded and analyzed. Results The total effective rate in the first course treatment of lauromacrogol was 95.56%, and the second course treatment was up to 100%. The superficial hemangioma in head and neck had better effects, and the younger children also had showed better therapeutic effects. The complications of hemangioma surgery in the extremities were the highest （5.56%）, in which swelling and pain were the most common. Conclusion Local injection of lauromacrogol in treatment of hemangioma in children has good clinical efficacy. The course of treatment is short and the incidence of complications is low. It can be widely used in the treatment of hemangioma in children.

Clinical observation and experience of three conservative methods in the treatment of breast fibroadenosis

FENG Rui-qing, FU Zhong-dai, CAO Lei, OU Yan-yan, HUANG Jian-dong

2021, 21(02):  204-208.  DOI: 10.3969/j.issn.1009-976X.2021.02.015

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Objective To compare short-term effects on fibroadenosis by three different methods. Methods The data of outpatients diagnosed with fibroadenosis from January 2018 to June 2020 were analyzed. A total of 85 patients with breast pain that affect daily life （60 patients with symptoms of cyclic mastalgia and 48 with noncyclic mastalgia） were assigned to three groups, galactophore lavage group （lavage group, n=25）, toral tamoxifen group （tamoxifen group, n=30） and topical NSAIDs group （topical NSAIDs group, n=30）, and treatment for 3 months. Visual analogue scale （VSA） was used to score pain, and color Doppler ultrasound was used to evaluate the changes in breast fibrocystic lesions after treatment. Results One month after treatment, mastalgia in patients of the three groups was relieved in varying degrees, and the lavage group and the tamoxifen group were significantly better than those before treatment and the topical NSAIDs group. VAS scores In the three groups decreased significantly at 1 month, 2 months, 3 months, 4 months and 6 months after treatment, but there was no significant change at 3 months, 4 months and 6 months. After 6 months of follow-up, color Doppler ultrasound showed that the lesions in lavage group shrank, especially the cysts shrank significantly, and most of the cysts became clear. In tamoxifen group, 13 cases of lesions shrank, including 11 cases of cysts shrank, 10 cases of cysts became clear. In NSAIDs group, 4 cases shrank, 3 cases increased, 6 cases of cysts became clear. There was no change in BIRADS grade among the three groups. Conclusion Breast lavage, drug and topical NSAIDs can significantly improve mastalgia in patients with fibroadenosis, but not effectively alleviate the lesions and pathological changes.

Optimized utilization of clinical and laboratory parameters in the diagnosis of acute appendicitis

LI Yue, LV Guo-qing

2021, 21(02):  209-212.  DOI: 10.3969/j.issn.1009-976X.2021.02.016

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Objective To analyze the best combination of clinical and laboratory examinations for the diagnosis of acute appendicitis. Methods The data of 146 patients with acute appendicitis admitted to the emergency department of our hospital from July 2018 to June 2019 were collected for a retrospective study, and another 129 patients with acute abdomen as controls. Clinical parameters were recorded and analyzed by logistic regression,including nausea, vomiting, diarrhea, dysuria, signs of local peritonitis and pain migration; laboratory parameters： C-reactive protein （CRP）, complete blood count and urine test. Results Frequent vomiting, no change in appetite, diarrhea, and dysuria were not rare manifestations of acute appendicitis. Univariate logistic regression confirmed that WBC and negative urine test results were statistically significant predictors of acute appendicitis. Multiple regression analysis showed that vomiting （once or twice）, diarrhea, positive symptoms of local peritonitis, white blood cell count and negative urine test were significant predictors of AA. For simple, purulent, and gangrenous acute appendicitis, the predictability of a negative urine test decreases. Conclusion Compared with acute abdomen, no frequent vomiting, no diarrhea, no dysuria, localized peritonitis, elevated WBC, and negative urine test are important indicators for the diagnosis and differential diagnosis of acute appendicitis.

The predictive value of PI-RADS v2 based on multi-parameter magnetic resonance imaging combined with f/t PSA and PSAD in prostate cancer

CHEN Xiu-feng, BU Qing-feng, ZHANG Jie

2021, 21(02):  213-216.  DOI: 10.3969/j.issn.1009-976X.2021.02.017

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Objective To investigate the predictive value of PI-RADS V2 based on multi-parameter magnetic resonance imaging combined with f/t PSA and PSAD in prostate cancer. Methods All the clinical data of 289 patients with suspected prostate cancer were analyzed in the hospital of Yangchun city from January 2015 to December 2020, retrospectively. 123 patients with prostate cancer （PCa） were selected as PCa group, and 166 cases without PCa were selected as Non-PCa group. The receiver operator characteristic curve were performed to verify the diagnostic value of PI-RADS v2, the f/t PSA and PSAD, and the area under curve （AUC） were calculated. The sensitivity and specificity of the prostate cancer were analyzed by three diagnostic indicators and joint indicators. Results The consistency test between two groups showed that Kappa coefficient was 0.798, which indicated that the scoring results of the two physicians were highly consistent. The AUC of the diagnostic indexes of PI-RADS v2, f/t PSA, PSAD and the combined indexes were 0.633, 0.796, 0.785 and 0.908, respectively.The difference was statistically significant. Conclusion PI-RADS v2 combined with f/t PSA and PSAD can be used as Objective indicators for the early diagnosis of prostate cancer, and it is worthy of promotion.

The effect of setropium bromide on frequent acute exacerbations of COPD for improvement of lung function and immune factors regulation in the elective surgical patients with frequent acute exacerbations of COPD

LIU Lin-sheng, YAO Wei-ping, CHEN Di-lun, CAI Di, LIU Xiao-li

2021, 21(02):  217-221.  DOI: 10.3969/j.issn.1009-976X.2021.02.018

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Objective To explore the effect of Tiotropium Bromide onon the clinical efficacy and immune factors in patients with frequent acute exacerbations of COPD. Methods A total of 118 frequent acute COPD patients from January 2018 to June 2020 were selected as the research objects, and they were divided into a combination group and a routine group with 59 cases in accordance with the order of treatment. The routine group was treated with anti-infection, supportive treatment and Fluticasone propionate/terbutaline; Tiotropium Bromide was added to the conventional group in the combination group. The differences in pulmonary function, blood gas parameters, peripheral blood programmed death-1 （PD-1）, programmed cell death-ligand 1 （PD-L1）, exhaled breath condensate inflammation-related indicators, and serum CC16 levels before and after treatment were compared between the two groups. Results Before treatment, there was no significant difference in various pulmonary function indicators, blood gas indicators, the serum levels of PD-1/PD-L1/CC16, and the inflammatory mediators in exhaled breath condensate （IL-17, IL-10, and 8-iso-PG） between the two groups （P>0.05）. After treatment, the FVC, FEV1 and PEF in the combined group were statistically significantly higher than those in the conventional group （P<0.05）, and the PaCO₂ value in the combined group was lower than that in the conventional group （P<0.05）. After treatment, the PD-1 and PD-L1 levels in the peripheral blood of the combined group were lower than those in the conventional group. In additional, the IL-17 and 8-iso-PG of exhaled breath condensation in the combined group were lower than those in the conventional group （P<0.05）, but IL-10 of exhaled breath condensation in the combined group was higher than that in the conventional group （P<0.05）. Meanwhile, the efficacy was evaluated after treatment, and the efficacy of the patients in the combined group was better than that in the conventional group （P<0.05）. Conclusion The combination of Tiotropium Bromide/Fluticasone Propionate/Terbutaline and basic methods in the treatment of frequent acute exacerbations COPD patients is beneficial to alleviate the degree of inflammatory response, improve lung function and blood gas level, and expects to help reduce the contraindications of surgery.

Granular cell tumor of the ascending colon treated by endoscopic submucosal excavation： a case report and review of the literature

WANG Bo-zhi, ZHENG Yi-jin, WANG Peng-hao, LI Wen-fang, LI Ting-jian

2021, 21(02):  222-225.  DOI: 10.3969/j.issn.1009-976X.2021.02.019

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Colonic granulosa cell tumor is a rare submucous tumor of colon. Since most patients have no clinical symptoms, with the popularization of endoscopic physical examination, the tumor was accidentally found. Endoscopic resection of colonic granulosa cell tumor is a safe and effective method. For larger granular cell tumors, tumors can be removed by the ways of assisted traction, endoscopic excavation. This article reported on the diagnosis and treatment process of a patient and reviewed the literature to discuss the characteristics of colonic granulosa cell tumor and the skills of endoscopic excision.

The standardized mobilization training accelerates rehabilitation of patients after total hip arthroplasty

FENG Gui-lian, WEN Wen-xian, LUO Cheng, LIANG Hua-ning, LI Wan-shi

2021, 21(02):  229-232.  DOI: 10.3969/j.issn.1009-976X.2021.02.021

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Objective To develop a standardized mobilization training management for patients after hip replacement, and observe its impact on postoperative rehabilitation of patients. Methods Sixty-eight patients who underwent total hip arthroplasty in 2019 were assigned to standardized mobilization training management group （observation group, n=36） and control group （common rehabilitation group, n=32）. The differences in VAS score, Harris score, Barthel index at discharge, single walking distance, and quality of life 3 months after operation were compared between the two groups during follow-up. Results Two weeks after the operation, Harris score was 81.5±6.2 points in the observation group and 78.1±7.5 points in the control group （P<0.05）. The single walking distance was 126.5±24.3 m in the observation group and 102.8±29.26 m in the control group （P<0.05）. Barthel index assessment at discharge in the observation group and the control group were 90.04±6.16 and 85.31 ±8.02 （P<0.05）. The EuroQoL Five-dimension Questionnaire （EQ-5D） in the experimental group was 62.96 points and 59.90 points in the control group（P<0.05）. There was no difference in postoperative VAS score （P>0.05）. Conclusion The model of standardized mobilization training management helps accelerate the recovery of patients after hip replacement

Review

Advances in the selection of therapeutic modalities for BCLC stage-B hepatocellular carcinoma based on enhanced CT radiomics model

HU Zhi-peng, SUN Qiang, HU Ze-min, CHEN Wei-qiang

2021, 21(02):  233-238.  DOI: 10.3969/j.issn.1009-976X.2021.02.022

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Radiomics is a new field by mining high-throughput characteristic data from different medical images, screening potential markers that can reflect the heterogeneity of hepatocellular carcinoma and establishing corresponding models are helpful to the risk stratification,treatment response evaluation and prognosis prediction of BCLC stage-B （intermediate-stage） hepatocellular carcinoma,assist clinical decision-making, provide individualized treatment for patients with BCLC stage-B hepatocellular carcinoma, improve the survival rate and cure rate. This paper reviews the management strategy of BCLC stage-B hepatocellular carcinoma and the application of radiomics in hepatocellular carcinoma, then further discusses the great potential of radiomics model based on enhanced CT in the choice of treatment for BCLC stage-B hepatocellular carcinoma.

Research progress on the application of hydrogel in joint chronic sports injury

GUO Ming-yu, XU Lin

2021, 21(02):  239-243.  DOI: 10.3969/j.issn.1009-976X.2021.02.023

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Hydrogel is a kind of cross-linked polymer network material that absorbs a large amount of water and has excellent biocompatibility and mechanical properties. There are many kinds of hydrogels, which have many applications and worth developing potential in medical fields such as artificial joint replacement, biological filling materials, drug sustained release and tissue engineering. This paper mainly introduces the long-term isolation have joint support, drug release and used as tissue engineering scaffolds, and a series of hydrogel in joint research progress of chronic sports injuries, in detail elaborated the hydrogel with the function of the above properties, applications, and research on the application of the hydrogels in joint damage status quo and prospects are discussed.

Progress of "cocktail" therapy in total knee arthroplasty

ZHNAG LI-chao, Li Jian, XU Chuang, CAO Heng, WANG Wei-lin, HUANG Kai-yue, MA Ming-liang, LIU Min-ting

2021, 21(02):  244-247.  DOI: 10.3969/j.issn.1009-976X.2021.02.024

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Total knee arthroplasty （TKA） is the most effective way to treat end-stage osteoarthritis. However, because of extensive soft tissue exposure, massive synovectomy and large area osteotomy, during the operation, there will be severe postoperative pain and blood loss, which has a serious impact on postoperative rehabilitation and functional exercise. “Cocktail” therapy is mainly used to prevent and control postoperative pain by reducing the stimulation of surgical wound to pain, and with the improvement of “cocktail” formula, it also has a good effect on controlling bleeding. The clinical application of cocktail can effectively control the postoperative pain and bleeding volume of patients, and the control of pain and bleeding will further improve the postoperative functional exercise of patients, which is conducive to the rapid recovery of patients. In recent years, the research progress and efficacy of “cocktail” therapy in total knee arthroplasty at home and abroad are summarized as follows.

Research progress of different lumbar fusion methods in the treatment of lumbar degenerative diseases

LI Xiao-feng, JIANG Man, CHEN Ze, XIONG Fu-sheng

2021, 21(02):  248-253.  DOI: 10.3969/j.issn.1009-976X.2021.02.025

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Lumbar degenerative disease is a common disease,caused by intervertebral disc degeneration, intervertebral facet hyperplasia and disorder, lumbar ligament relaxation, and muscle strain, which is characterized by lumbar natural degeneration. In recent years, with the improvement of living standards and the intensification of the aging process, the clinical incidence of lumbar degenerative diseases is getting higher and higher, which has a serious impact on the quality of life and health of many elderly people. Lumbar fusion surgery is an important method for the treatment of lumbar degenerative diseases. Although there are various types of lumbar fusion in clinic, each type of lumbar fusion has its own indications, contraindications, advantages and disadvantages, and the results of different studies are different. As a result, clinicians have been controversial on the choice of different surgical methods, and it is difficult to reach a consensus. In this paper, the present situation of clinical research on all kinds of lumbar fusion is reported as follows.