Volume 98  ·  Issue 03  ·  2018

Antibody-mediated rejection (AMR) is the most important risk factor affecting the long-term survival of transplanted kidneys. The key is the production and effect of donor-specific antibodies (DSA), especially the newborn DSA (dnDSA) after surgery. Recently, some new progress has been made in international research on risk stratification of dnDSA, the relationship between postoperative dnDSA and postoperative diagnosed AMR, the relationship between intragraft dnDSA and rejection, and how to prevent dnDSA.

Rehabilitation medicine is an important part of modern medicine, and it plays a significant role in the functional recovery of skeletal and muscular diseases. A large number of studies have proved that orthopedic rehabilitation can effectively speed up the rehabilitation process of patients, improve their function and significantly reduce the disability rate^[1,2,3,4]。 Of the 135 common diseases in humans, 106 are associated with bones and joints^[5]。 The incidence of orthopedic diseases is high, which is extremely harmful to human health and brings a great burden to society and families. Strengthening the clinical and rehabilitation treatment of orthopedic diseases is extremely important for restoring the body function of patients and improving their quality of life.

Virus infection is a common complication of transplantation.With the research and application of exosome is becoming more popular, this study focused on whether the virus particles and nucleic acids exist in the exosomes extracted from the plasma of recipients with virus infection after renal transplantation.

A total of 10 independent transplantation recipients at Institute of Organ Transplantation, 309th Hospital of Chinese People′s Liberation Army from January 2015 to July 2017 were studied in this study.5 cases of positive or suspected positive in granulocytes HCMV pp65 antigen detection and positive in plasma HCMV DNA test, and the other 5 cases of positive results in plasma BK DNA test were adopted.Exosomes were extracted from the collected plasma samples with SBI kit.Electron microscopy and nanoparticles tracing analyzer (NTA) were used for exosome analysis.Quantitative real-time PCR method was used to inspect and compare virus DNA copies number in plasma, exosome and effluent.

Typical exosome-like vesicle structure was observed.NTA put forward the sample concentration data from 1.2 to 4.5×10¹² particles/ml, and the particle diameters were 30-200 nm.In the qRT-PCR assays, the viral DNA quantitative results of exosome samples are lower but on the same magnitude compared with that of the plasma, and sharply decreased in effluent.

Virus DNAs in exosome samples of recipients with viral infection after transplantation were detected in great quantities.This not only hints the spread of the virus may take advantage of the biological formation process of exosomes, but also warns that the limitation of the existing way to extract exosmes from virus infected population may be a bottleneck in research.

To investigate the therapeutic efficacy of tonsillectomy for patients with recurrence of IgA nephropathy (IgAN) after kidney transplantation.

From May 2014, tonsillectomy was performed in 11 renal transplant patients with biopsy-proved recurrent IgAN. In a median follow-up of 14 (4-38) months, data of proteinuria, hematuria, estimated glomerular filtration rate (eGFR), and serum levels of IgA in these patients were compared before and after tonsillectomy.Patient′s survival and renal graft survival were also summarized.

A remission of proteinuria was observed in 8 patients after tonsillectomy, and this status maintained well in the subsequent follow-up.Three patients had no or minimal reduction of proteinuria after tonsillectomy and returned to dialysis within 1 year after tonsillectomy.Possible causes could be severe primary IgAN of crescentric glomerulonephritis, IgAN recurrence in kidney retransplantation, and late tonsillectomy after IgAN recurrence.Serum levels of IgA significant decreased and no patients developed acute rejection or infection after tonsillectomy.In the 1-year follow-up, no patients died and grafts survived well in 8 out of 11 patients.

Tonsillectomy may represent an effective and reliable way to treat recurrence IgAN after kidney transplantation, and may be applied widely in the future clinical management. However, early intervention is critical and effects may depend on the pathological features of primary IgAN.

To investigate the distribution and drug resistance of pathogens in infected organ donors from donation after the citizen death (DCD).

Clinical data of 217 DCD donors from January 2013 to June 2017 were retrospectively analyzed.The phlegm, urine, blood and drainage fluid from all of the donors were routinely cultured.The infection rate of the donors, the composition ratio of pathogens and the distribution of specimen sources were observed and the drug resistance was analyzed.

Of all the 217 donors, 128 were infected and the infection rate was 59%.A total of 218 pathogens were isolated from these infected donors, including 55.5% (121/218) of gram-negative pathogens, 33.5% (73/218) of gram-positive pathogens followed by 11.0% (24/218) of fungi.The pathogenic specimens were mainly derived from sputum samples (72.5%), followed by urine (15.6%). The mainly two gram-negative pathogens were Klebsiella pneumonia and Acinetobacter baumannii.Klebsiella pneumonia exhibited varying degree of resistance to commonly used antibiotics, whereas susceptible to imipenem and meropenem.Acine-tobacterbaumannii was highly resistant to most of the antibiotics, and the drug resistance rate of imipenem and meropenem was over 60%, displaying a tendency of multi-drug resistance.Staphylococcus aureus, as the mainly gram-positive pathogen, was generally resistant to penicillin and clindamycin, but still sensitive to tovancomycin, teicoplanin and linezolid.

DCD donors have a high infection rate, and respiratory infection is most common. Gram-negative pathogens are the primary pathogens causing infection in DCD donors.Klebsiella pneumonia maintain susceptible to imipenem and meropenem, while Acinetobacter baumannii reveals a tendency of multi-drug resistance.Gram-positive pathogens are still sensitive to vancomycin, teicoplanin and linezolid.

To summarize the clinical data of pre-implantation biopsy donors in our hospital and explore the clinical characteristics of those donors in pathological high-risk, and to provide references for the selective histological evaluation of extended criteria donor kidneys.

We retrospectively reviewed the clinical data and pre-implantation renal pathologic score of donors from January 1, 2015 to May 1, 2017.During this period, 247 cases of donation after citizen′s death (DCD) occurred.After clinical evaluation and selective machine perfusion( Lifeport) evaluation, 30 cases of pre-implantation pathological evaluation were performed.According to Remuzzi scores, donors were divided into low-risk and high-risk group.Nine cases of low-risk group (bilateral kidney′s Remuzzi score ≤3) and 16 cases of high-risk group (bilateral or unilateral kidney′s Remuzzi score ≥4, severe glomerular micro-thrombi or severe tubular necrosis) were included.Five cases of donors were excluded due to only unilateral renal pathological result available.Both high-risk and low-risk groups′ clinical data, including sex, age, height, body weight, body mass index, proteinuria, hematuria, urinary glucose, baseline or admission serum creatinine, serum creatinine before procurement, history of hypertension and/or diabetes mellitus, cardiopulmonary resuscitation or not, with or without the history of shock, urine output prior to acquisition, macroscopical manifestations of donor kidney, cause of death were statistically analyzed.

The donors′ baseline serum creatinine/upper limit of normal serum creatinine range in high-risk group were significantly higher than that in low-risk group [(129.8±42.2)% vs(92.4±30.5)%, P=0.029]. The poor macroscopical manifestations of donor kidneys were significantly more frequent in high-risk group than that in low-risk group (12/16 vs 0/9, P= 0). No significant differences between two groups were found regarding their age, height, weight, BMI, proteinuria, hematuria, urine glucose, pre-procure creatinine level, history of hypertension and/or diabetes mellitus, cause of death and so on (P>0.05).

After clinical evaluation and selective Lifeport evaluation, donor grafts of whose baseline serum creatinine levels increased beyond normal range and of whose grafts′ macroscopical manifestations were poor, should undergo pre-implantation pathological evaluation further.Also, it is reasonable to perform pre-implantation biopsy in cases of equivocal results after Lifeport evaluation.This will be beneficial to identify histological high-risk donors and also be predictive to allocate the grafts.

To explore the relationship of serum level of homocysteine (Hcy) and insulin resistance with cognitive function in first-episode drug-free schizophrenics.

A total of 80 first-episode drug-free schizophrenics (schizophrenia group) from the First Affiliated Hospital of Zhengzhou University and 70 healthy individuals (control group) were enrolled.The serum concentration of Hcy was measured by the enzymatic cycling assay, the concentration of serum fast blood-glucose(FPG) by glucose oxidase method and fast insulin (FINS) by electrical chemiluminescence immunoassay.Then insulin resistance index was calculated in the form of HOMA-IR.Positive and Negative Syndrome Scale (PANSS) was used to evaluate the mental symptoms and Matrics Consensus Cognitive Battery (MCCB) was used to evaluate the cognitive function.

(1) The serum level of Hcy in schizophrenia group [(24±6) μmoL/L]was significantly higher than that in control group[(16±4) μmoL/L] ( P<0.001). And the serum level of FINS in schizophrenia group [(8.0±2.1) mU/L] was significantly higher than that in control group[(6.0±1.3) mU/L] (P<0.001). The HOMA-IR of schizophrenia group (1.6±0.5) was higher than that of control group (1.3±0.4) (P<0.001). The serum level of Hcy in schizophrenia group had positive correlations with serum FINS level, HOMA-IR and negative symptoms (r=0.365, 0.354 and 0.233, all P<0.05). In comparison with the control group , scores were significantly lower in the seven domains of cognitive function in the schizophrenia group (allP<0.05). (2) In schizophrenia group, the serum level of Hcy had a negative correlation with Information processing rate P points, Attentional facilitating P points , and Verbal learning P points (r=-0.231, -0.339, -0.255, all P<0.05); the serum level of FINS was negatively related to Attentional facilitating P points, Working memory P pointsand Visual memory P points (r=-0.317, -0.309, -0.318, all P<0.05); HOMA-IR had a negative correlation with Attentional facilitating P points, Working memory P points, and Visual memory P points (r=-0.286, -0.224, -0.266, all P<0.05). After the influencing factors were adjusted by multiple regression, the associations of serum Hcy level with Information processing rate P points, Attentional facilitating P points and Verbal learning P points were still evident, and HOMA-IR was still related with Attentional facilitating P points and Visual memory P points (allP<0.05).

The increase of serum Hcy and insulin resistance in first-episode schizophrenics, both have some relevance with cognitive dysfunction.

To explore the changes of the brain regional homogeneity (ReHo) in the patients of irritable bowel syndrome (IBS) complicated with depression by using resting-state functional magnetic resonance imaging (rs-fMRI) and to investigate the relation between abnormal brain function and depression in those patients.

A total of 35 patients with IBS were included in this study, collected in Gastroenterology Department of Affiliated Hospital of Hangzhou Normal University from June 2015 to June 2017.According to Hamilton′s Depression Scale (HAMD)-17 score, the IBS patients was divided into two groups: IBS with depression group, 21 cases and non-depression group, 14 cases.Thirty-six healthy controls were recruited at the mean time (gender, age and years of education were matched with the patients). Rs-fMRI and 3D T1 data were acquired with 3.0 T scanners.For all subjects, ReHo, a method measuring the synchronism of regional spontaneous activities, was calculated and one-way ANOVA was performed to assess the group effects.For those regions with significant group effects, correlation between ReHo values and GSRS and HAMD scores was analyzed too.

Significant group effects were found in multiple regions: the right pons, the left inferior temporal gyrus (ITG)/fusiform, the left superior temporal gyrus (STG)/temporal pole, the right inferior frontal gyrus (IFG), the right middle occipital gyrus (MOG), the right caudate nucleus, the left posterior cingulate cortex/precuneus (pCC/pC), the left postcentral gyrus, the right inferior parietal lobule (IPF). Compared with control group, all the two patient groups had increased ReHo values in the left pCC/pC, the right IPF, the left postcentral gyrus and the left STG/temporal pole; all the two patient groups had decreased ReHo values in the right MOG and the right IFG.Compared with non-depression group, depression group had increased ReHo values in the right caudate nucleus, and decreased ReHo values in the right pons, the left pCC/pC, the right IPF, the left postcentral gyrus.Particularly, there was no significant difference in the ReHo value in the right caudate nucleus between the control group and the non-depressed IBS group.In the depression group, significantly positive correlations were observed between ReHo values and HAMD scores in the left pCC/pC (r=0.599, P=0.011), and significantly positive correlations were observed between ReHo values and GSRS in the left postcentral gyrus (r=0.547, P=0.023).

IBS patients have abnormal ReHo regions in default network and pain regulation-associated brain area.IBS with depressed patients has its own characteristics in the brain regions which related with pain perception and self-regulation.IBS could has an abnormal self-regulation of visceral pain, which is associated with the occurrence of depression.Depression can aggravate the disorders of pain perception and other functions of IBS patients.

To classify different causes of cavernous sinus lesion in patients with ophthalmoplegia and analyze their clinical and imaging features.

We confirmed the etiological diagnosis of 137 hospitalized ophthalmoplegia patients with cavernous sinus lesion retrospectively from January 2005 to January 2014 in the Department of Neurology of Beijing Tongren Hospital.The diagnosis was made according to clinical feature, laboratory test, imaging studies and pathology.The clinical data of these patients were analyzed and compared among different groups.

Fifty-one cases (37.2%) were confirmed as inflammatory diseases of cavernous sinus, which were the most common cause in 137 patients.Early stage pain (OR 5.591, 95%CI 1.703-18.401) and involvement of oculomotor nerve (OR 4.902, 95%CI 1.015-24.630) were independently associated with inflammatory diseases.Forty-three cases (31.3%) were confirmed to have tumor, which was the second cause of cavernous sinus lesions, and meningioma was the most common tumor.The second branch of trigeminal nerve involvement was independently correlated (OR 1.017, 95%CI 1.005-1.071) with tumor.The percentage of male (OR 3.506, 95%CI 1.362-8.765) was significantly higher in 28 cases (20.4%) with cavernous sinus vascular lesions.Cavernous sinus infectious diseases were seen in 15 cases (10.9%), and fungal infection was the most common, mostly secondary to sinus infection.

The common causes of cavernous sinus lesion include cavernous sinus inflammatory diseases, neoplastic diseases, vascular diseases and infectious diseases, and inflammatory diseases is the most commonly seen cause in this group of patients.Obvious facial sensory disturbances and the second branch of trigeminal nerve involvement are independent associated with tumor.The early course of pain and involvement of oculomotor nerve are associated with inflammatory diseases.Optimization of MRI examination method can better identify the cavernous sinus lesions.

To further evaluate the clinical value of epicardial adipose tissue volume (EATV) in predicting the prognosis of coronary heart disease (CHD) after percutaneous coronary intervention (PCI).

From July 2013 to July 2016 in TEDA International Cardiovascular Disease Hospital, a total of 474 patients diagnosed with CHD were included in this study.According to the result of EATV, patients were divided into three groups, group A (EATV≤75 ml), group B (75 ml<EATV<150 ml), and group C (EATV≥150 ml). Then the level of body mass index (BMI), hypersensitive c-reactive protein (hs-CRP), interleukin (IL)-6 and tumor necrosis factor (TNF)-α were tested for all the three groups.All the patients were followed up for 1 year for major adverse cardiovascular events (MACE). The clinical value of EATV in predicting the occurrence of MACE events was evaluated.

The BMI, level of hs-CRP, TNF-α in group B were higher than group A, group C were significantly higher than group B, with statistically significant difference across all the comparisons (P<0.05). Spearman correlation analysis showed EATV was positively correlated with hs-CRP, IL-6, TNF-α (r=0.675-0.700, P<0.01). The incidence of MACE in the three groups were 8.50% in group C, 5.26% in group B, 3.13% in group A, and the differences were all significant (P<0.01). ROC curve showed the cut-off value of EATV level was 120.39 ml to predict MACE (area under cure: 0.751, 95%CI: 0.634-0.868, P<0.01), and the sensitivity was 72.7%, the specificity was 61%.EATV>120.39 ml can be used as an independent risk factor for predicting the occurrence of MACE.

The level of EATV is closely related to the occurrence of MACE events, and EATV>120.39 ml is an independent risk factor for MACE in patients with CHD after PCI.

To evaluate the safety and efficacy of diagnosis and treatment of pleuroperitoneal communication in patients on peritoneal dialysis by computerized tomography (CT) peritoneography and thoracoscopic surgery.

The records of 8 pleuroperitoneal communication patients treated by thoracoscopic surgery in Peking University First Hospital from January 2012 to March 2017 were retrospectively reviewed.CT peritoneography was performed before surgical treatment. Iopamiro (50 ml∶15 g) was mixed with 2 L of peritoneal dialysate solution, and then was instilled into the peritoneal cavity through the Tenckhoff catheter. After dwelling for 1 hour, CT scan was taken from thorax to upper abdomen.The thoracic cavity was filled with sterile saline, and then carbon dioxide was inflated to the peritoneal cavity via Tenckhoff catheter.Air bubbles leaking from the diaphragmatic defect were identified during thoracoscopic operation.Then defect was repaired and pleurodesis was performed.

The CT value of pleural effusion increased to (155±57) HU.Pleuroperitoneal communication was clearly diagnosed.The diaphragmatic defects in 5 cases were detected and repaired.However, defects in the other 3 cases were not found.The mean operative time was (152±50) minutes. All patients had uneventful recovery and reinstated normal peritoneal dialysis 3 weeks after the operation.The median follow-up time was 14.5 months (1-68 months) and no recurrence occurred.

CT peritoneography could identify pleuroperitoneal communication clearly. Thoracoscopic surgery is a safe and reliable method for pleuroperitoneal communication and could restore patients to peritoneal dialysis.

To evaluate the value of hysteroscopy in the diagnosis and treatment of cesarean scar pregnancy (CSP) incomplete abortion.

A total of 42 patients with incomplete cesarean circumcision from January 2014 to March 2017 were retrospectively analyzed.Twenty-one patients underwent bilateral uterine artery embolization.Twenty patients underwent hysteroscopy Electrocardiose resection of pregnancy tissue and coagulation hemostasis, the control group of 22 patients underwent conventional uterine artery embolization surgery.

One patient in the study group was changed to laparoscopic surgery.In the control group, 2 patients were changed to laparoscopic surgery and 2 patients underwent laparotomy.The duration of hospitalization, the amount of postoperative bleeding and the duration of bleeding were significantly lower in the study group than in the control group.The recovery time of HCG in the study group was significantly shorter than that in the control group.

Compared with traditional uterine artery embolization, hysteroscopic resection of cesarean section scar residual tissue less bleeding, higher success rate of surgery, less trauma, faster recovery, treatment Cesarean section scar scar pregnancy abortion is the ideal method.

To study the expression of IRX1 (Iroquois homeobox gene) in cervical cancer and its correlation with clinical stage of cervical cancer.

A total of 61 patients with cervical cancer from January 2015 to January 2017 were enrolled in this study, of which 15 were classified as phase Ⅰ of cervical cancer, 22 patients were classified as phase Ⅱ, 19 cases were classified as phase Ⅲ, 5 cases were classified as phase Ⅳ followed FIGO staging criteria.The expression of IRX1 protein in Hela, C4-1 and Siha cell lines were detected by Western blot compared with the normal human cervical epithelial cells HCerEpiC.Collected cancerous tissue of cervical cancer as experimental samples, the expression of IRX1 mRNA in cancer tissues and paracancerous tissue were detected by qPCR.Immunohistochemistry was used to detect the expression of IRX1 in different stages of cervical cancer, the correlation between IRX1 expression and clinical stage was analyzed.

The results of Western blot showed that IRX1 expression in cervical cancer cells were higher than that in normal cervical epithelial cells, and the results of qPCR also showed that the expression of IRX1 increased with the stage of cancer at the gene level.The difference was statistically significant.The expression of IRX1 in the nucleus and cytoplasm were detected by immunohistochemistry.Immunohistochemical results showed that the higher the stage of cancer was, the higher the expression rate of IRX1 was.

IRX1 expression is associated with the clinical stage of cervical cancer, suggesting that IRX1 may be involved in the development and progression of cervical cancer.IRX1 is expected to be a new molecular target for the diagnosis and treatment of cervical cancer. This study will provide a new theoretical basis for the treatment of cervical cancer.

The patient was a 54-year-old female. He was admitted to hospital for "repeated epigastric pain for 3 months and another week". The patient developed pain under the xiphoid process of the upper abdomen 3 months ago, which was severe. The pain did not radiate to the lower back, there was no nausea and vomiting, and there was no fear of cold and fever. It improved after symptomatic treatment. Thereafter, abdominal pain recurred and no further treatment was performed. One week ago, the pain under the xiphoid process appeared again, the nature was the same as before, and the degree was significantly worse than before, accompanied by chills and fever. Physical examination: body temperature 38.5 ℃, heart rate 100 beats/min, breathing: 19 beats/min, blood pressure 115/75 mmHg (1 mmHg =0.133 kPa), slight abdominal swelling, mild tenderness on the right side of the xiphoid process in the upper abdomen, no rebound pain, and no obvious mass. Laboratory test: white blood cell count 11.9×10⁹/L, neutrophils 77.8%, lymphocytes 12.9%, hemoglobin 108 g/L, high-sensitivity C-reactive protein 128.7 mg/L. Upper abdominal enhanced CT examination: plain scan showed a patchy low-density shadow in the S3 segment of the liver, about 3.4 cm ×3.7 cm in size, with unclear boundary, linear osteoid dense shadow at the edge of the lesion, blurred fat space between liver and stomach, unclear structure of gastric antrum (large curved side), slight localized thickening of gastric wall, and no clear free gas accumulation shadow in the abdominal cavity; The edge of the lesion showed thin line-like annular continuous enhancement, and a low-density ring was seen between the lesion and the normal liver parenchyma. There was no obvious enhancement in the low-density area inside the lesion. Maximum density projection (MIP) and volume reconstruction (VR) techniques clearly showed the morphology of fish bone, the relationship with abscess cavity and the vague liver-stomach fat space (Figure 1、Figure 2、Figure 3)。 Two days after admission, laparoscopic exploration was performed: a local abscess was formed in the left lateral lobe of the liver and the round ligament, with an area of about 5 cm ×8 cm. The abscess cavity was incised and the pus was washed. A bone fish bone about 3 cm long was seen in the abscess cavity. After the foreign body was removed, part of the abscess cavity wall was removed, a drainage tube was placed, and suture closed. The patient recovered well after surgery and was discharged on day 9.

A 34-year-old woman was admitted due to intermittent numbness of both lower limbs for 3 months, aggravated with numbness of both upper limbs for 20 d. Physical examination: The muscle tone of the limbs was normal, the superficial sensation of both lower limbs was reduced, and the physical examination of the remaining nervous system showed no obvious abnormalities, and there was no family history. MRI of cervical vertebra showed: multiple clockwork-shaped and nodular abnormal signals were seen in the spinal cord at the level of cervical 5 and 6 vertebrae bodies, cervical 7 to thoracic 1 discs to thoracic 4 to 5 discs, T₁WI showed isointensity, slightly high intensity and high intensity, T₂WI and lipid pressure images showed high and low signal, and the intraspinal lesions at the level of thoracic vertebral body were enhanced after enhanced scan (Figure 1)。 The preoperative diagnosis was: cervical intramedullary cavernous hemangioma complicated by syringomyelia. Posterior median approach was used for surgery. Metal markers on body surface were examined by MRI to locate the corresponding segments before operation, and the tumor was completely resected under electrophysiological monitoring. Syringomyelia was not intervened, and no obvious abnormalities were found in intraoperative electrophysiological monitoring. Pathological diagnosis: spinal cord cavernous hemangioma (Figure 2)。 Postoperative physical examination: numbness of the limbs was relieved, and the upper limbs were relieved more obviously. MRI reexamination within 72 h after surgery showed complete resection of the lesion and remission of syringomyelia. MRI of cervical spine was performed 5 months after operation (Figure 3), syringomyelia was largely relieved, and there was no numbness in the limbs during physical examination.

Epilepsy is a clinical syndrome of abnormal synchronous discharge of brain neurons caused by various reasons, which is characterized by episodic, transient and repetitive. There are about 10 million people with epilepsy (PWE) in China, and about 400,000 new cases are added every year. With the development of urbanization, China's motor vehicles have grown rapidly. According to the statistics of the Traffic Management Bureau of the Ministry of Public Security (January 2017), by the end of 2016, there were 290 million motor vehicles and more than 310 million car drivers in China. More and more PWE and clinicians will face the confusion of epilepsy and driving. This article combines the latest research and national regulations to elaborate on epilepsy and driving.

Kidney transplantation is the best choice for the treatment of end-stage renal disease, but the shortage of donors greatly troubles clinicians and patients with end-stage renal disease^[1]。 At present, the source of organ transplant donors in China is mainly organ donation (DCD) after citizens' death, which has long thermal ischemia time^[2,3]It is easy to cause delayed recovery of renal function (DGF) after renal transplantation. DGF is a common complication after renal transplantation, and the main clinical manifestations are oliguria, anuria, and serum creatinine continuously or slowly decreases. The diagnostic criteria for DGF were: oliguria or anuria after surgery, requiring resumption of hemodialysis within the first week; Or serum creatinine value>400 μ mol/L on postoperative day 7 although hemodialysis was not resumed^[4]。 Therefore, how to effectively reduce the incidence of DGF and reduce the postoperative cost of patients is an urgent problem to be solved.

Pelvic and/or para-abdominal aortic lymph node dissection is an indispensable and important part of gynecological tumor staging surgery or tumor cytoreduction surgery. Lymphocyst is one of the most common complications after lymph dissection. Although most lymphocyst is asymptomatic but found during postoperative follow-up, larger lymphocyst often produces compression symptoms and affects the postoperative quality of life of patients. Once complicated with infection, it may be complicated with sepsis, hydronephrosis, thrombosis and other serious complications, which are life-threatening, and delay the related adjuvant treatment after surgery, which affects the prognosis. The occurrence of lymphocyst is related to various factors such as the scope and number of lymph node resection during operation, the operation mode and the application of energy instruments, the management of pelvic floor peritoneum and drainage during operation, and postoperative adjuvant therapy. This article reviews the relevant progress at home and abroad, aiming at exploring the risk factors and protective factors of lymphocyst. By strengthening the prevention and treatment measures of lymphocyst, it is beneficial to reduce the incidence of lymphocyst after gynecological tumor operation, reduce related complications, and enable timely and standardized postoperative adjuvant therapy, so as to improve the survival rate and quality of life of gynecological tumor patients.