Objective To understand the current situation of preoperative sleep quality of surgical patients in a tertiary a hospital in Xizang and analyze its influencing factors, so as to provide basis for improving preoperative sleep quality of patients. Method A convenient sampling method was used to select 256 preoperative patients who planned to undergo surgery in the Xizang Autonomous Region People's Hospital from April to July 2022. The self-designed demographic sociological questionnaire and the Athens Insomnia Scale were used to investigate the sleep quality, and the influencing factors of sleep quality were analyzed. Result The rate of sleep disorder before surgery was 43.75% in a tertiary hospital in Xizang. The results of multiple linear regression analysis showed that

non-permanent high-altitude population, marriage, high surgical risk grade and high disease understanding were the main factors leading to sleep disorders before surgery (P ＜ 0.05), which could jointly explain 13.4% variance variation of sleep quality before surgery (F ＝ 9.689, R2 ＝ 0.134, P ＜ 0.001). Conclusion The sleep quality of patients before surgery was poor, patients with non-permanent high-altitude population, who were married, who had a high surgical risk rating and who knew more about the disease had worse sleep quality. Health care workers should actively take measures to improve sleep quality and promote wound healing and early recovery.

Objective To investigate the effect of exogenous cholecystokinin octapeptide (CCK-8) on acute pancreatitis and explore the mechanism of CCK-8 inhibiting inflammation through the cholinergic antiinflammatory pathway. Method SD rats were used to establish an acute pancreatitis model and randomly divided into four groups of 18 each: sham surgery group, model group, model preparation combined with CCK-8 group (CCK-8 group), model preparation combined with subphrenic vagus nerve transection and CCK-8 group (transection group). SD rats were euthanized in batches at 3, 6, and 9 hours in each group, and their serum interleukin-6 (IL-6) was detected using an enzyme-linked immunosorbent assay kit tumor necrosis factor (TNF)-α levels were

measured, and the pathological changes of pancreatic tissue in rats were observed. Result The serum IL-6 concentration in the sham surgery group rats was lower at various time points, while the serum IL-6 concentration in the model group rats reached a peak at 6 hours. The IL-6 concentration levels in the model group rats were higher than those in the sham surgery group rats at corresponding time points; The IL-6 concentration levels in CCK-8 group rats at 6h and 9h were significantly lower than those in the corresponding time points of the model group rats; The IL-6 concentration levels at 6h and 9h in the cut off group rats were significantly higher than those at the corresponding time points in the CCK-8 group rats, with significant differences (P ＜ 0.05). The concentration of serum TNF-α in sham operated group rats at 9 hours reaches a peak; The serum TNF-α concentration in model group rats reaches a peak at 6 hours. The concentration levels of TNF-α in model group rats at various time points were higher than the concentration levels of TNF-α in the sham surgery group rats at corresponding time points; The concentration levels of TNF-α in CCK-8 group rats is significantly lower than the concentration levels of  TNF-α in model group rats at 6h and 9h; At 6h and 9h points in the cut off group rats, the concentration levels of TNF-α is significantly higher than the concentration level of TNF-α in CCK-8 group rats at the corresponding time point, which the differences are significant(P ＜ 0.05). At 3, 6, and 9 hours, the pancreatic pathological changes in each subgroup of CCK-8 group were milder than those in the model group, while at 3, 6, and 9 hours, the pancreatic pathological changes in each subgroup of the amputation group were more severe than those in the CCK-8 group. The pancreatic tissue injury score of the sham surgery group rats was lower at various time points; The pancreatic injury score of the model group rats gradually increased over time, and the evaluation scores at each time point were higher than those of the sham surgery group rats at the corresponding time points (P ＜ 0.05); The pancreatic injury score of CCK-8 group rats showed a gradually increasing trend at various time points, and the pancreatic injury score at each time point was lower than the corresponding time point pancreatic injury score of the model group rats (P ＜ 0.05); The pancreatic injury scores of the cut off group rats were higher than those of the CCK-8 group rats at corresponding time points (P ＜ 0.05), but there was no significant difference in pancreatic injury scores compared to the model group at various time points. Conclusion CCK-8 can active the cholinergic anti-inflammatory pathway and promote the release of vagal acetylcholine, thus to participate in the regulation of inflammatory response, acute pancreatitis were reduced.

Gastric cancer is one of the most common malignant tumors in the world, which possessed high morbidity and mortality. The long-term prognosis of patients with gastric cancer is still not ideal. Inflammatory response and insulin resistance of host affect nutritional status and prognosis of patients with gastric cancer. This article aims to analyze the relationship between the level of inflammatory response, insulin resistance and nutritional status in patients with gastric cancer by reviewing relevant literature, and to explore the application value of inflammatory insulin resistance indicator C reactive protein-serum triglycerides and glucose index(CRP-TyG) in clinical evaluation of nutritional status with Gastric cancer, so as to provide references for early detection and

intervention of gastric cancer-related malnutrition.

Micro ribonucleic acid (miRNA) refer to a highly conserved class of endogenous non-coding RNA, each composed of approximately 22 nucleotides. Numerous studies have demonstrated that miRNAs play a crucial role in the initiation and progression of hepatocellular carcinoma (HCC). MiRNAs function as regulatory molecules in the context of gene expression related to HCC. Some miRNAs also participate in the activation of cellular signaling pathways, and these pathways contribute to the occurrence and development of hepatocellular carcinoma. The review provides an overview of the research progress on the role of miRNAs in hepatocellular carcinoma, aiming to contribute insights into the identification of diagnostic markers for HCC and the exploration of moleculartargeted therapies.

The incidence of malnutrition in the elderly population is increasing year by year. It can lead to a decline in physical function, susceptibility to infection, and delayed recovery in elderly people, seriously affecting their quality of life and disease prognosis. Therefore, early identification and diagnosis of malnutrition are of great significance for elderly patients in general surgery. At present, the diagnosis of malnutrition in the elderly population mainly includes the Global Leadership Initiative on Malnutrition (GLIM), Subjective Global Assessment (SGA), and so on. GLIM entered clinical application relatively late, and there is still controversy over whether it can comprehensively reflect the nutritional status of the elderly surgical population. This article mainly explores the current application status of GLIM in diagnosing malnutrition in the elderly population of general surgery, aiming

to provide reference for the diagnosis of malnutrition in the elderly.

Objective To explore the value of multidimensional preoperative and intraoperative evaluation in complex laparoscopic liver cancer resection. Method Sixty patients who underwent complex laparoscopic liver cancer resection and were hospitalized at the People's Hospital of Gaozhou City from January 2020 to January 2022 were selected. They were divided into groups in the order of admission, with an odd numbered group as the control group and an even numbered group as the observation group, with 30 cases in each group. The control group underwent laparoscopic liver cancer resection surgery using traditional preoperative and intraoperative evaluations, while the observation group underwent laparoscopic liver cancer resection surgery based on multidimensional preoperative and intraoperative evaluations. Compare the surgical conditions, postoperative 7d liver function,

and incidence of complications between two groups of patients. Result The intraoperative blood transfusion volume and blood loss of the patients were significantly lower than those of the control group, and the surgery time and hospitalization time were shorter than those of the control group. The postoperative 7d levels of alanine aminotransferase, total bilirubin, and aspartate aminotransferase in the observation group were lower than those of the control group, and the albumin level was higher than that of the control group, with significant differences (P ＜ 0.05). The postoperative 7d complications in the control group and observation group were 20.00% and 3.33%, respectively, and the incidence of postoperative complications was significantly lower than that in the control group (P ＜ 0.05). Conclusion Multidimensional preoperative and intraoperative evaluations are performed on patients undergoing complex laparoscopic liver cancer resection, and the overall effect is good, which is beneficial for

patient recovery.

Objective To evaluate the application effect of laparoscopic assisted radical gastrectomy in patients undergoing gastric cancer surgery. Method Sixty hospitalized patients with gastric cancer admitted to Donghai County Traditional Chinese Medicine Hospital in Lianyungang City from September 2022 to August 2023 were selected and divided into a control group and an observation group based on different surgical methods. The control group received conventional gastric cancer radical surgery treatment, while the observation group received laparoscopic assisted gastric cancer radical surgery treatment. Compare the levels of adrenaline, cortisol, adrenocorticotropic hormone, as well as interleukin-6 and tumor necrosis factor-α between two groups of patients before and after surgery, compare the levels of high sensitivity C-reactive protein surgical situation, and the incidence of postoperative complications between the two groups of patients. Result Prior to surgery, levels of adrenaline, cortisol, adrenocorticotropic hormone, as well as interleukin-6 and tumor necrosis factor-α were measured in both groups of patients, the levels of high sensitivity C-reactive protein were all low and there was no significant difference (P ＞ 0.05). After surgery, the levels of adrenaline, cortisol, adrenocorticotropic hormone, as well as interleukin-6 and tumor necrosis factor-α in both groups of patients, the levels of high sensitivity C-reactive protein were all elevated, and the control group was significantly higher than the observation group.The surgical duration and first postoperative exhaust time of the observation group patients were shorter than those of the control group, and the intraoperative bleeding was less than that of the control group, with significant differences(P＜0.05). The total incidence of postoperative complications in the observation group was 3.33%, significantly lower than that in the control group (26.67%), with significant differences (P ＜ 0.05). Conclusion Laparoscopic assisted radical gastrectomy is less stressful for patients undergoing gastric cancer surgery and has a lower incidence of postoperative complications.

Objective To explore the effects of preserving the left colic artery (LCA) in laparoscopic radical resection of rectal cancer on gastric function and complications in patients. Method 57 patients who underwent laparoscopic radical resection of rectal cancer admitted to Dunhua Hospital from December 2020 to November 2023 were randomly divided into a control group (28 cases) and an observation group (29 cases). The control group did not retain LCA during surgery, while the observation group retained LCA during surgery. Compare the incidence of complications, gastric function, urinary function, and anorectal dynamics between two groups. Result Compared with preoperative, the levels of gastrin, motilin, pepsinogen Ⅰ , and calcitonin gene related peptide

(CGRP) in both groups of patients increased 30 days after surgery, and the levels of gastrin, motilin, pepsinogen Ⅰ , and CGRP in the observation group were higher than those in the control group. Compared with preoperative data, the resting pressure and maximum systolic pressure of the anal canal in both groups of patients decreased 30 days after surgery, and the resting pressure and maximum systolic pressure of the anal canal in the observation group were higher than those in the control group, with significant differences (P ＜ 0.05). On the 7th day after surgery, the overactive bladder symptom scale (OABSS) scores of both groups of patients decreased compared to before surgery, and the OABSS scores of the observation group were lower than those of the control group, with significant differences (P ＜ 0.05). The total incidence of postoperative complications in the observation group was lower than that in the control group, with a significant difference (P ＜ 0.05). Conclusion Preserving LCA during laparoscopic radical surgery can improve the anorectal motility indicators of rectal cancer patients, quickly restore their gastric and urinary functions, and reduce the risk of complications.

Objective To explore the clinical efficacy of ligation of intersphincteric fistula tract in the treatment of low simple anal fistula. Method 46 patients with low simple anal fistula admitted to Donghai County Traditional Chinese Medicine Hospital in Lianyungang City from February 2020 to February 2023 were selected. Divided into a control group and an observation group using a random number table method, with 23 cases in each group. The control group underwent traditional anal fistula incision surgery, while the observation group underwent LIFT surgery. The clinical efficacy and postoperative recovery of the two groups of patients were compared. Result There was no significant difference in the total effective rate between the two groups (P ＝ 0.310). The wound healing time and hospitalization duration of the observation group were shorter than those of the control group, and the VAS

score was lower than that of the control group, with significant differences (P ＜ 0.05). There was no significant difference in preoperative anal incontinence Wexner scores between the two groups of patients. After 1 month and 3 months of surgery, the observation group had lower anal incontinence Wexner scores than the control group, and the difference was significant (P ＜ 0.05). Conclusion The treatment of low position simple anal fistula with LIFT surgery can alleviate patient pain to a certain extent, preserve the function of the patient's sphincter, and lead to faster recovery.

Objective To explore the therapeutic value of microwave therapy in the treatment of hemorrhoids. Method 128 inpatients with hemorrhoids admitted to Baiyunshan Hospital in Guangzhou from February 2022 to January 2023 were selected and randomly divided into an experimental group and a control group, with 64 cases in each group, using a random number table method. The control group received automatic hemorrhoid ligation surgery, while the experimental group received microwave therapy. The treatment effects and incidence of complications were compared between the two groups. Result The treatment duration, first defecation time, and wound healing time of the experimental group were significantly shorter than those of the control group (P

＜ 0.05). After treatment, the visual analogue scale (VAS) scores of the experimental group patients were lower than those of the control group at 12 and 48 hours, and their VAS scores gradually decreased with the prolongation of treatment time (P ＜ 0.05). Compared with the control group, the experimental group had a higher total effective rate of treatment (87.50% compared to 96.88%), and a significantly lower overall incidence of symptoms, with significant differences (P ＜ 0.05). Conclusion The application of microwave therapy in hemorrhoid patients can improve the degree of pain, enhance treatment effectiveness, reduce the incidence of complications, and promote the improvement of the condition.

Objective To explore the preventive effect of sufentanil on breakthrough pain after discontinuation of remifentanil in laparoscopic appendectomy. Method Seventy patients who underwent laparoscopic appendectomy and received remifentanil anesthesia at Jiaozhou Hospital Affiliated to Tongji University from November 2022 to May 2023 were selected. They were randomly divided into two groups, with 35 patients in each group. The study group and the control group were treated with different drugs to prevent breakthrough pain after remifentanil anesthesia. The study group received intravenous injection of 0.1mg/kg sufentanil 30 minutes

before skin suture, while the control group received intravenous injection of the same dose of physiological saline. Observe the pulse oxygen saturation (SpO2), heart rate, systolic blood pressure, diastolic blood pressure, and pain score of two groups of patients 5 minutes (T1), 15 minutes (T2), and 30 minutes (T3) after surgery, and record the postoperative complications such as nausea, vomiting, and irritability in both groups of patients. Result The pain scores of the study group at T1, T2, and T3 were significantly lower than those of the control group, while the heart rate, systolic blood pressure, and diastolic blood pressure were significantly lower than those of the control group, with significant differences (P ＜ 0.05). There was no significant difference in SpO2 levels between the two groups at different time points (P ＞ 0.05), and there was no significant difference in postoperative complications such as nausea, vomiting, irritability, and respiratory depression (P ＞ 0.05). Conclusion Intravenous injection of

0.1mg/kg sufentanil 30 minutes before the end of surgery can effectively prevent postoperative breakthrough pain after remifentanil anesthesia, with good analgesic effect and no impact on awakening quality.

Objective Exploring the impact of micro teaching method combined with 3H nursing on the perioperative period of patients undergoing laparoscopic cholecystectomy. Method 126 hospitalized patients who underwent laparoscopic cholecystectomy admitted to Yangzhou Hospital of Traditional Chinese Medicine from March to December 2022 were randomly divided into a control group and an observation group, with 63 patients in each group, using a random number table method. The control group received routine nursing intervention, while the observation group received micro teaching method combined with 3H nursing on the basis of the control group. Compare the disease awareness rate, perioperative situation, and incidence of complications between two groups of patients. Result The observation group had a higher disease knowledge awareness rate than the control group (87.30% vs. 50.79%); Postoperative C-reactive protein, interleukin-6, and tumor necrosis factor-α levels in patients

were all lower than those of the control group, and the differences were significant (P ＜ 0.05). After intervention, the Hamilton anxiety scale, self rating depression scale, and Pittsburgh sleep quality index scores of the observation group were lower than those of the control group, and the incidence of postoperative complications was lower than that of the control group (3.17% vs. 12.70%), with significant differences(P ＜ 0.05). Conclusion Microteaching combined with 3H nursing is beneficial to improve the excellent rate of patients' knowledge of disease, relieve the stress reaction and bad mood of patients, improve the sleep quality of patients, and reduce the possibility of complications.

Objective To observe the effect of perioperative refined nursing intervention on patients undergoing acute appendicitis surgery. Method Ninety hospitalized patients with acute appendicitis who underwent surgical treatment at Huangpu Hospital of Guangdong Second Traditional Chinese Medicine Hospital from July 2020 to August 2022 were selected. They were divided into a control group (receiving routine perioperative care) and an observation group (receiving refined perioperative care) according to different nursing methods, with 45 patients in each group. The perioperative nursing effects of the two groups were compared. Result The observation group had shorter first anal exhaust time, time to get out of bed, and length of hospital stay than the control group, and the nursing satisfaction rate was significantly higher than the control group, with significant differences (P ＜ 0.05). Two patients in the observation group experienced complications after surgery, including one respiratory infection and one incision infection, with a complication rate of 4.44% (2/45); There were 9 postoperative complications in the control group, including 4 cases of respiratory infection, 2 cases of incision infection and abdominal abscess, and 1 case of intestinal adhesion. The incidence of complications was 20.00% (9/45). The total incidence of complications in the observation group was significantly lower than that in the control group (χ2 ＝ 5.075, P ＝ 0.024). Conclusion When treating acute appendicitis patients with surgery in clinical practice, fine nursing during the perioperative period can significantly reduce postoperative complications, promote rapid postoperative recovery, and improve patient satisfaction with nursing.