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The effect of laparoscopic radical resection of colorectal cancer on perioperative immune function and serum inflammatory factors in patients with colorectal cancer LI Yaowen Journal of General Surgery for Clinicians    2023, 11 (4): 6-.   Abstract （21）            Knowledge map    Save Objective To colorectal cancer patients for laparoscopic colorectal cancer radical, discuss the therapeutic effect and its influence on the immune function, serum inflammatory factors. Method Retrospective analysis the clinical data of 80 patients with colorectal cancer, according to the operation method of divided into open and laparoscopic group, open colorectal surgery treatment group received laparotomy, a total of 40 cases, treated by laparoscopic colorectal cancer radical laparoscopic group, a total of 40 cases. Compared to two groups of immune function in patients with [cellular immune index (CD3+, CD4+, CD8+ , CD4+/CD8+), humoral immune index (IgA, IgM and IgG)], serum inflammatory factors [serum tumor necrosis factor alpha (TNF alpha), interleukin 6 (IL-6), C reactive protein (CRP)] and complications. Result The laparoscopic group after treatment of CD3+, CD4+ group and CD4+/CD8+is significantly higher than laparotomy, CD8+, significantly lower than laparotomy group, the differences are significant (P ＜ 0.05). After treatment, there was no significant difference in IgA and IgG levels between the laparoscopic group and the open group (P ＞ 0.05), but IgM levels were higher than those in the open group, with a significant difference (P ＜ 0.05). After treatment, the TNF-α of both groups of patients, the levels of IL-6 and CRP were significantly increased compared to before treatment, with significant differences (P ＜ 0.05). The incidence of complications in the laparoscopic group was significantly lower than that in the open group (P ＜ 0.05). Conclusion For patients with colorectal cancer can reduce inflammation in patients with laparoscopic colorectal cancer radical stress reaction, on the immune function of patients with smaller, less complications. Related Articles | Metrics

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Clinical effect of transcatheter arterial chemoembolization combine with 125I implantation in the treatment of primary liver cancer LIU Jinwen, LI Yongqiang Journal of General Surgery for Clinicians    2023, 11 (4): 2-.   Abstract （14）            Knowledge map    Save Objective To study the effect of transcatheter arterial chemoembolization (TACE) combine with 125I implantation in the treatment of primary liver cancer. Method A total of 70 patients with primary liver cancer admitted to Guangzhou RoyalLee Cancer Hospital from October 2022 to August 2023 were selected as the study subjects. They were divided into a control group (TACE treatment) and a study group (TACE combined with 125I implantation treatment) based on a randomized number table method, with 35 patients in each group. The disease remission rate, adverse reaction rate, recurrence rate, and T cell subsets (CD4+, CD8+) and inflammatory factor levels before and after treatment were compared between the two groups. Result Compared with the control group, the remission rate of disease in the study group was higher (91.43%), the recurrence rate was lower (5.71%), the difference was statistically significant (P ＜ 0.05). Before treatment, there was no significant difference in the levels of T cell subsets and inflammatory factors between the two groups (P ＞ 0.05). After treatment, the levels of CD4+ and interleukin-8 in the study group were lower than those in the control group, while the levels of CD8+ and interferon-γ were higher than those in the control group (P ＜ 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P ＞ 0.05). Conclusion TACE combined with 125I implantation in the treatment of primary liver cancer has significant efficacy, safety, and effectiveness. Related Articles | Metrics

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Application of enhanced recovery after surgery concept in perioperative nursing of laparoscopic choledocholithotomy and primary suture ZHANG Shenya, XIA Jing, LU Xian, TANG Xueqin Journal of General Surgery for Clinicians    2023, 11 (4): 37-.   Abstract （13）            Knowledge map    Save Objective To explore the application effect of enhanced recovery after surgery(ERAS) concept in the perioperative nursing of laparoscopic choledocholithotomy and primary suture. Method The clinical data of 60 patients with common bile duct stones and gallbladder stones admitted to Kunshan Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine from October 2019 to June 2023 were retrospectively analyzed. According to different nursing concepts, they are divided into an accelerated rehabilitation group (ERAS group) and a traditional nursing method group (control group), with 30 cases in each group. The control group was in accordance with the perioperative routine nursing plan, while the ERAS group was combined with psychological intervention, perioperative nutritional supporting, and traditional Chinese medicine therapy based on routine nursing. The operation-related indexes and postoperative complications of the two groups were observed and compared. Result The postoperative anal exhaust time, defecation time, postoperative abdominal drainage time and hospital stay in ERAS group were significantly shorter than those in control group (P ＜ 0.05). The postoperative incision pain score was lower in the ERAS group (P ＜ 0.05). The incidence of postoperative complications in the ERAS group was 10.0% (3/30), which was slightly lower than 16.7% (5/30) in the control group, there was no difference between two groups(P ＞ 0.05). Conclusion The application of ERAS concept nursing in the perioperative period of laparoscopic common bile duct lithotomy and primary suture is effective and safe, which can accelerate the recovery of postoperative gastrointestinal function, reduce the time of drainage tube indwelling and shorten the length of hospital stay. Related Articles | Metrics

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The current status and progress of Global Leadership Initiative on Malnutrition application in the elderly population of general surgery Dai Yao, Ji Yudong, Zhu Qing, Ma Jie, Pang Mingquan, Fan Haiming, Cui Hongyuan, Journal of General Surgery for Clinicians    2024, 12 (1): 26-.   Abstract （11）            Knowledge map    Save 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. Related Articles | Metrics

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Journal of General Surgery for Clinicians    2024, 12 (1): 68-.   Abstract （11）            Knowledge map    Save Related Articles | Metrics

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Research progress on the delayed gastric emptying after pancreaticoduodenectomy SHI Haowei, XING Cheng, SONG Jinghai, Journal of General Surgery for Clinicians    2023, 11 (4): 11-.   Abstract （10）            Knowledge map    Save Pancreaticoduodenectomy (PD) has become the standard treatment for malignant tumors of the periampullary malignancies, and some benign pancreatic diseases and pancreatic injuries. Due to the large number of digestive organs involved in the surgery and the complexity of the operation, there are many postoperative complications, among which gastric emptying disorder is one of the most common complications after PD surgery. At present, the etiology and pathogenesis of gastric emptying disorders have not been fully elucidated. Some studies suggest that gastric emptying disorders after PD surgery may be related to the individual condition of the patient before surgery and surgical methods such as retaining or not retaining pyloric PD and gastrojejunostomy. Non surgical treatment is still the main treatment for gastric emptying disorders. Most of the patients recovered after receiving conservative treatment such as nutritional support treatment, gastrointestinal decompression， gastroprokinetic agent, acupuncture and moxibustion, gastric electrical stimulation, etc. This article mainly discusses the related factors of gastric emptying disorder after pancreatoduodenectomy and provide theoretical basis for prevention and treatment of gastric emptying disorder. Related Articles | Metrics

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Research progress on the correlation between inflammatory response, insulin resistance and nutritional status in patients with gastric cancer Kong Yu, Zhou Houmin, Lin Wen, Zhou Shaofei Journal of General Surgery for Clinicians    2024, 12 (1): 14-.   Abstract （9）            Knowledge map    Save 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. Related Articles | Metrics

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Comparison of therapeutic effects between open surgery and laparoscopic low anterior rectal resection for elderly patients with rectal cancer LI Xiuqin, SHU Lingxia, SHI Zhangshi, WU Liang Journal of General Surgery for Clinicians    2023, 11 (4): 26-.   Abstract （8）            Knowledge map    Save Objective To compare the clinical efficacy of open and laparoscopic low anterior rectal resection in elderly patients with low rectal cancer. Method A total of 80 patients with low rectal cancer in the Airforce Hospital of Southern Theater Command from March 2020 to March 2022 were selected as the study subjects. Depending on the surgical method, they were divided into an observation group (laparoscopic low anterior rectal resection) and a control group (open low anterior rectal resection), with 40 patients in each group. Compare the surgical indicators, postoperative recovery, incidence of complications, and clinical efficacy between the two groups. Result There were statistically significant differences between the observation group and the control group in incision length [(6.13±0.94) cm vs. (15.82±1.54) cm], intraoperative bleeding volume [(56.14±10.35) ml vs. (118.33±12.74) ml], and surgical time [(135.32 ± 30.64) min vs. (173.62±15.36)min]. However, there was no statistically significant difference in the number of lymph node dissection between the two groups [(13.64±2.31) vs.(13.78± 2.26), P=0.231]. There were statistically significant differences between the observation group and the control group in postoperative exhaust time [(1.86 ± 0.58)d vs. (3.72 ± 1.34)d], hospital stay time [(5.27 ± 1.18)d vs. (7.36 ± 2.47)d], and intestinal function recovery time [(1.86 ± 0.35)d vs. (2.83 ± 0.44)d]. The total incidence of complications in the observation group (2.50%) was significantly lower than that in the control group (25.00%) (P ＜ 0.05). All patients were followed up for 12 months. In the observation group, 1 case had local recurrence (2.5%), 2 cases had distant metastasis to the liver (5%), and there were no deaths; There was 1 local recurrence (2.5%) in the control group, with no distant metastasis or death, and there was no statistically significant difference between the two groups (P ＞ 0.05). Conclusion Laparoscopic low anterior rectal resection for elderly rectal cancer patients has low trauma, low incidence of complications, and fast postoperative recovery. Related Articles | Metrics

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The impact of laparoscopic radical resection of rectal cancer with preservation of left colic artery on gastric function and complications in patients Cheng Zhigang Journal of General Surgery for Clinicians    2024, 12 (1): 41-.   Abstract （8）            Knowledge map    Save 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. Related Articles | Metrics

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Journal of General Surgery for Clinicians    2023, 11 (4): 41-.   Abstract （7）            Knowledge map    Save Related Articles | Metrics

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The effect and mechanism of exogenous cholecystokinin octapeptide on acute pancreatitis Zheng Gang, Qi Hongjun, Chen Shihui, Shang Aijun Journal of General Surgery for Clinicians    2024, 12 (1): 8-.   Abstract （7）            Knowledge map    Save 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. Related Articles | Metrics

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Journal of General Surgery for Clinicians    2023, 11 (4): 51-.   Abstract （6）            Knowledge map    Save Related Articles | Metrics

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Journal of General Surgery for Clinicians    2023, 11 (4): 54-.   Abstract （6）            Knowledge map    Save Related Articles | Metrics

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Study on the status and influencing factors of sleep quality of preoperative patients in a tertiary hospital in Xizang Cui Huihui, Yang Lijun, Li Bowen, Xu Mengwei, Pu Yue, Shang Xueni, Dan Zhen, Yang Mengyuan Journal of General Surgery for Clinicians    2024, 12 (1): 2-.   Abstract （6）            Knowledge map    Save 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. Related Articles | Metrics

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The clinical application of ertapenem in community-acquired intraabdominal infection and perioperative period LIU Min, YIN Hui, SUN Fusheng, GUO Yujin Journal of General Surgery for Clinicians    2023, 11 (4): 31-.   Abstract （6）            Knowledge map    Save Abdominal infection is one of the common acute and critical diseases in surgery, with a high incidence rate and mortality. In addition to symptomatic support treatment such as surgery and fluid resuscitation, anti-infection treatment is an important treatment method. As a carbapenem drug, although ertapenem has been recommended as a first-line treatment drug for community abdominal infection by major guidelines and consensus at home and abroad, However, when conducting empirical anti infection treatment in clinical practice, it is more inclined to choose other carbapenems, as well as third-generation cephalosporins and/or nitroimidazoles, fluoroquinolones and other antibacterial drugs, and less to choose ertapenem for treatment. This article aims to review the effects of ertapenem on bacterial resistance, the advantages of its safety, effectiveness, and economy in treating community abdominal infections, as well as the impact of perioperative prophylactic use on the incidence of postoperative infections, in order to provide reference for its widespread clinical application. Related Articles | Metrics

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The relationship between immune cells and microenvironment of colorectal cancer ZHANG Zheng, JIANG Rong, Journal of General Surgery for Clinicians    2023, 11 (4): 17-.   Abstract （6）            Knowledge map    Save As an important digestive organ of human body, the intestinal microenvironment is a very complex environment, which plays an important role in regulating intestinal metabolism, immunity and protecting intestinal epithelial barrier. Tumor microenvironment (TME) of intestinal tumors is highly complex, which is composed of stromal cells, tumor cells, immune cells, fibroblasts and microorganisms, and deeply affects the occurrence, development and metastasis of tumors. This paper summarizes the relationship between immune cells (T cells, macrophages, neutrophils, natural killer cells) in TME and tumor cells, and analyzes the role of immune cells in TME in tumor (anti-tumor, promoting tumor growth, etc.) in order to fully understand the relationship between immune cells and tumors in TME and provide new strategies for clinical treatment of colorectal cancer patients. Related Articles | Metrics

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Analysis of application of information management in quality control of pancreatic cancer specimen collection ZHANG Yanjun, GONG Zengfeng, WU Jiaying, QI Na Journal of General Surgery for Clinicians    2023, 11 (4): 22-.   Abstract （5）            Knowledge map    Save Objective To explore and analyze the application of information management in quality control of pancreatic cancer test samples. Method A total of 40 patients with clinically confirmed digestive tract tumors, including gastric cancer, pancreatic cancer and colorectal cancer, were divided into control group and experimental group, with 20 patients in each group. From the aspects of pathology, blood, urine and stool sample collection methods and delivery of pre-test procedures, information management was applied to monitor the whole process of multiple departments and the whole link, and the causes of unqualified specimens were analyzed. Corresponding measures should be taken to reduce the incidence of unqualified specimens. Result The total number of substandard samples in the control group of 80 samples for examination was 26, with a failure rate of 32.5%; The main types of substandard specimen quality are improper fixation and processing methods before specimen submission, unreasonable specimen transportation methods, specimen contamination, incorrect specimen types, and incorrect specimen collection quantities. Out of the 80 samples submitted for testing in the experimental group, the total number of samples with substandard quality was 4, with a failure rate of 5.0%. The main types of substandard sample quality were non-standard sample collection and unreasonable sample transportation. The qualification rate of specimen quality in the experimental group was significantly higher than that in the control group (P=0.0001). Conclusion After the information management, the incidence rate of unqualified specimens decreased significantly. The information management has great application value in improving the quality control of examination specimens collected from patients with pancreatic cancer, which is worthy of clinical promotion. Related Articles | Metrics

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Journal of General Surgery for Clinicians    2023, 11 (4): 46-.   Abstract （4）            Knowledge map    Save Related Articles | Metrics

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The application effect of laparoscopic assisted radical gastrectomy in the treatment of gastric cancer Zhao Erkang Journal of General Surgery for Clinicians    2024, 12 (1): 36-.   Abstract （4）            Knowledge map    Save 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. Related Articles | Metrics

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Comparison of clinical efficacy between ligation of intersphincteric fistula and traditional anal fistula incision in the treatment of low simple anal fistula Yang Shilei Journal of General Surgery for Clinicians    2024, 12 (1): 46-.   Abstract （3）            Knowledge map    Save 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. Related Articles | Metrics