Objective To evaluate the expression of γ-synuclein protein （SNCG） in carcinoma of bile duct andnormal bile duct tissues， and its clinical significance. Methods The expressions of SNCG were detected by SP immuno-histochemical in 60 cases of cholangiocarcinoma and 34 cases of normal bile duct tissues， and to analysis its relationship with the clinical pathological characteristics of cholangiocarcinoma. Results The positive expression rate of SNCG in carcinoma of bile duct tissues was 73.33% （44/60）， which was higher than that in normal bile duct tissues （P＜0.01）. The positive expression of SNCG in carcinoma of bile duct tissues was correlated with the depth of tumor invasion and lymph node metastasis （P＜0.01）， but not related to patients’ age， gender， and the degree of tumor differentiation （P＞0.05）. Conclusions The expression of SNCG is correlated with the cholangiocarcinoma occurrence， development， invasion， and metastasis. SNCG plays an important role in the infiltration and metastasis of carcinoma of bile duct. SNCG is expected to become a new cancer tumor marker， which can provide a basis to prognosize and to formulate the corres-ponding therapy plan.
ObjectiveTo investigate the effectiveness of tibial transverse transport (TTT) combined with nose ring drain (NRD) in the treatment of severe diabetic foot ulcer.MethodsThe clinical data of 60 patients with severe diabetic foot (Wagner grade 3 or 4) ulcer who were admitted between April 2017 and August 2020 and met the selection criteria were retrospectively analyzed. Among them, 30 cases were treated with TTT combined with NRD (TTT+NRD group), and 30 cases were treated with TTT (TTT group). There was no significant difference in gender, age, diabetes duration, preoperative glycated hemoglobin, comorbidities, wound area, and duration, side, and grade of diabetic foot (P>0.05). The wound healing time, wound healing rate, amputation rate, recurrence rate, duration of antibiotic therapy, hospital stay, number of hospitalizations, and number of operations were recoreded and compared between the two groups.ResultsNo obvious surgical complications occurred in the two groups. Patients in both groups were followed up 3-13 months, with an average of 5.7 months. The duration of antibiotic therapy and hospital stay in the TTT+NRD group were significantly shorter than those in the TTT group (P<0.05). There was no significant difference in wound healing time, wound healing rate, number of hospitalizations, and number of operations between the two groups (P>0.05). During follow-up, there was no recurrence of ulcer in the TTT+NRD group while 2 recurrent cases (6.7%) in the TTT group. The difference in recurrence rate was not significant (P=0.492). One case (3.3%) in the TTT+NRD group underwent amputation due to acute lower extremity vascular embolism, and 1 case (3.3%) in the TTT group underwent amputation due to secondary necrosis. The difference in amputation rate was not significant between the two groups (P=1.000).ConclusionTTT combined with NRD is an effective method for the treatment of severe diabetic foot ulcers with deep infections or relatively closed cavities or sinuses. It can shorten the time of antibiotic use and the length of hospitalization; and the NRD has a good drainage effect without obvious comorbidities, procedure and the postoperative care are simple and easy to obtain materials.