Objective To investigate the clinical effect and prognosis of laparoscopic tension-free hernia repair for the treatment of the patients with abdominal incisional hernia. Method The clinical data of 72 patients with abdominal incisional hernia were retrospectively analyzed in Affiliated Jiaozhou Hospital of Tongji University from June 2018 to June 2021. These patients with abdominal incisional hernia were randomly divided into the experimental group and the control group according to different operation methods including laparoscopic tensionfree repair and open hernia repair. Thirty patients underwent open hernia repair operation in the control group and 42 did laparoscopic tension-free repair in the experimental group. The operation time, intraoperative blood loss,
length of hospital stay and pain score at 24 hours after operation, incidence of complications and recurrent incisional hernia after operation were observed to evaluate the surgical outcome. Result The operation time, intraoperative blood loss, length of hospital stay and pain score at 24 hours after operation in the experimental group were better than those of in the control group (P ＜ 0.05). The postoperative complication rate (9.52%) in the experimental group was significantly lower than that in the control group (30.00%) (P ＜ 0.05).2 patients had recurrence of incisional hernia in the experimental group after 1 year with a recurrence rate was 4.76% (2/42) and 3 patients did recurrence of incisional hernia in the control group after 1 year with a recurrence rate was 10.00% (3/30). There was no obviously significant difference in the recurrence rate of incisional hernia between the experimental group and the control group (P ＞ 0.05). Conclusion Compared with traditional open surgery, laparoscopic tension-free repair for the treatment of the patients with abdominal incisional hernia has many advantages of shorter operation time, less intraoperative blood loss, lower incidence of postoperative complications and lower recurrence rate of abdominal incisional hernia. Laparoscopic tension-free repair for the treatment of the patients with abdominal incisional hernia is a safe and effective minimally invasive technique and has good recent and long-term clinical efficacy at the same time.
Objective To investigate the clinical efficacy and safety of laparoscopic total mesorectal excision (LME) for rectal cancer. Method From August 2020 to March 2022, 69 rectal cancer patients in Shuyang Hospital Affiliated to Xuzhou Medical University were selected and analyzed. The control group (blue ball, 34 cases) and the observation group (red ball, 35 cases) were randomly divided by red blue ball. The control group was treated by open total mesorectal excision, and the observation group was treated by laparoscopic total mesorectal excision, Record and compare the difference of operation indexes and recovery time of patients in each group, and observe and count the probability of postoperative complications of patients in the two groups. Result The total operation time (181.23 ± 15.21) min in the observation group was longer than that in the control group (t=15.285, P ＜ 0.05),
and the number of lymph node dissection (14.02 ± 4.02) had no significant difference compared with the control group (t=0.113, P ＞ 0.05). In addition, the total probability of postoperative complications in the observation group was 2.86% lower than that in the control group (χ2= 4.803，P ＜ 0.05）. Conclusion Laparoscopic total mesorectal excision is the first choice for clinical treatment of rectal cancer, which has the advantages of less damage to patients, rapid recovery, fewer complications and ideal safety.
Objective To study the ultrasonographic features of papillary thyroid carcinoma nodules (PTC) with lymph node metastasis (LNM). Method The data of patients with PTC who underwent thermal ablation from July 2019 to December 2020 were retrospectively studied. The patients were divided into LNM group and non-LNM group. The imaging features and parameters between the two groups both on conventional ultrasound and contrast-enhanced ultrasound were compared. Result A total of 91 patients with PTC were included, including 31 cases in the LNM group and 60 cases in the non-LNM group. In the LNM group, the proportion of nodules with length/width ratio larger than 1.0 or with microcalcification were higher than those in the non-LNM group, and the difference were statistically significant (P ＜ 0.05); The peak intensity (PI)difference was lower than that in the non-LNM group (P ＜ 0.05). ROC curve analysis was performed to test the diagnostic efficiency of PI difference to diagnose PTC with LNM. The area under the curve was 0.63, the optimum critical value was -7.3, the sensitivity was 42% and the specificity was 43%. Conclusion The imaging features and parameter showed significant differences between the LNM group and non-LNM group. The above results may be helpful to predict the biological characteristics of PTC.
Objective To investigate the risk factors of lymph node metastasis in the central region of cN0 thyroid micropapillary carcinoma. Method The clinical data of 106 patients with cN0 thyroid micropapillary carcinoma in Jiangmen Xinhui District People's Hospital from May 2020 to November 2021 were retrospectively analyzed. According to the lymph node metastasis in the central region, they were divided into two groups: metastatic group (49 cases) and non-metastatic group (57 cases). The risk factors of lymph node metastasis in the central region of patients were analyzed. Result Of the 106 patients, 49 had lymph node metastasis in the central region and 57 had no metastasis. The proportion of males, tumor location, microcalcification and invasion of capsule
in the metastatic group was higher than that in the non-metastatic group (P ＜ 0.05), the proportion of patients with age ＜ 55 years old and tumor diameter ＜ 5 mm was lower than those without metastasis (P ＜ 0.05), however, there was no significant difference in the proportion of patients with nodular goiter and Hashimoto's thyroiditis between the two groups (P ＞ 0.05). Multivariate logistic regression analysis showed that the risk factors of lymph node metastasis in the central region of 106 patients included male, microcalcification and capsule invasion (P ＜ 0.05). Conclusion The risk factors of lymph node metastasis in the central region of cN0 thyroid micropapillary carcinoma include male, microcalcification, and invasion of capsule. Preventive and therapeutic dissection of lymph nodes in the central region is recommended.
Objective To investigate the effect of laparoscopic cholecystectomy on stress response indicators in patients with gallstones. Method 78 patients with gallstones who were treated in Jurong People's Hospital from January 2020 to March 2022 were divided into control group (39 cases) and observation group (39 cases) according to random number table. The changes of stress indexes were observed before and after surgery in the two groups. The recovery time of gastrointestinal function and comparing the changes of gastrointestinal hormone levels were also observed. Result The levels of endothelin and cortisol in the
observation group were significantly lower than those in the control group, and the levels of serum superoxide dismutase were higher than those in the control group (P ＜ 0.05). The postoperative recovery time of patients in the observation group was shorter than that in the control group, and the monitoring concentrations of motilin and gastrin were higher than those in the control group, with significant differences (P ＜ 0.05). Conclusion Laparoscopic cholecystectomy for patients with gallstones can effectively reduce postoperative stress response and promote the recovery of gastrointestinal function.
Objective To investigate the effect of intraperitoneal chemotherapy with lobaplatin on liver function in patients with primary liver cancer after operation. Method 92 patients with primary liver cancer admitted to our hospital from July 2021 to February 2022 were randomly into the control group (n=46) and the observation group (n=46), the observation group was given intraperitoneal chemotherapy with lobaplatin on the basis of the control group. All patients were followed up for 6 months. The levels of serum alpha-fetoprotein (AFP), alanine aminotransferase (ALT), aspartate transaminase (AST), total bilirubin (TBIL) were compared between the two groups before operation, 7 days after operation, 1 month and 2 months after operation. Result Two months
after operation, the serum AFP level of patients in the two groups gradually decreased with time, and the serum AFP level in the observation group was lower than that in the control group 7 days, 1 month and 2 months after operation (P ＜ 0.05). Two months after operation, the levels of serum ALT and AST in the two groups were significantly lower than those before operation (P ＜ 0.05); However, there was no significant difference in serum ALT, AST and TBIL levels between the two groups at 7d, 1 month and 2 months after operation (P ＞ 0.05). Within 6 months after operation, the incidence of poor prognosis in the observation group was significantly lower than that in the control group (P＜ 0.05); The mortality rates of the observation group and the control group were 0.00% and 2.17% respectively, with no significant difference (P ＞ 0.05). Conclusion Intraperitoneal chemotherapy with lobaplatin does not significantly increase the risk of liver injury in postoperative patients with primary liver cancer, can improve the prognosis of patients with liver cancer, clinical application of safety, and the survival was good within
6 months.
Objective To study the clinical curative effect of trioxygen combined with traditional Chinese medicine sticking for the treatment of the patients with chronic wounds. Method 80 patients with chronic wounds in Jiaozhou Hospital of Tongji University from January 2021 to September 2022 were randomly divided into two groups according to the random number table method. Forty cases in the control group were treated with the method of routine debridement, anti-infection and dressing change. Forty cases in the study group were treated with the method of trioxygen combined with traditional Chinese medicine stricking on the basis of routine curative method treatment with a curative time 3 weeks in these two groups. The wound healing time, symptom score, clinical
efficacy, inflammatory factors and oxidative stress indexes of the two groups were observed and the treatment safety of the two groups was also evaluated. Result The total effective rate in the study group (95.00%) was higher than those of the control group (72.50%), but the wound healing time in the study group was shorter than those of the control group (P ＜ 0.05). After 3 weeks of treatment, The levels of various parameters including edema, pain, hemorrhage, secretion score, serum interleukin-1, interleukin -6, tumor necrosis factor-α, malondialdehyde, advanced oxidation protein products were significantly decreased, especially in the study group , the level of superoxide dismutase was significantly higher in the study group (P ＜ 0.05). There were no adverse reactions and abnormal laboratory indexes in both groups. Conclusion Trioxygen combined with traditional Chinese medicine was effective in treating chronic wounds and could effectively promote wound healing, relieve symptoms, inhibit
inflammatory reaction and reduce oxidative stress.
Objective To explore the short-term clinical efficacy of total laparoscopic and laparoscopic assisted radical gastrectomy for gastric cancer. Method The data of 80 patients with gastric cancer treated by complete laparoscopic surgery and laparoscopic surgery in Qiqihar Public Security Hospital from May 2020 to May 2021 were retrospectively analyzed. The patients were treated by complete laparoscopic surgery as the observation group (n=40), and the patients were treated by laparoscopic surgery as the control group (n=40). The postoperative effects of the two groups were compared and statistically analyzed. Result The VAS scores of patients in the observation group were higher than those of patients in the control group at 1, 2 and 3 days after operation (P ＜ 0.05); The
first scheduling time, the incidence of complications, the length of abdominal incision and the first postoperative fluid diet time in the observation group were significantly better than those in the control group (P ＜ 0.05); The operation time of patients in the control group was significantly better than that of patients in the observation group (P ＜ 0.05); There was no significant difference in the number of lymph nodes and application of analgesics, between the two groups（P ＞ 0.05）. Conclusion Compared with laparoscopy, although the operation time of complete laparoscopic assisted surgery is longer, its first scheduling time and the first liquid diet time are shorter, which is more conducive to the early rehabilitation of patients and can be selectively used in clinical practice.
Objective To investigate the effect of three-scope combined with transabdominal nasobiliary drainage in the treatment of extrahepatic bile duct stones. Method 80 patients with choledocholithiasis admitted to the Second People's Hospital of Xinhui District of Jiangmen City from March 2021 to August 2022 were retrospective analysis and randomly divided into observation group and control group with 40 cases each. Both groups of patients underwent laparoscopic cholecystectomy, bile duct exploration, transabdominal nasobiliary duct drainage, and primary suture. The observation group underwent antegrade placement of nasobiliary duct through the abdomen, and the control group underwent oral placement of nasobiliary duct drainage. The general
information, preoperative bilirubin, diameter of common bile duct, number of common bile duct stones, and other systemic diseases were compared between the two groups. The operation time, intraoperative blood loss, whether duodenal papillectomy was needed, catheterization time, catheterization success rate, postoperative intestinal recovery and exhaust time, abdominal drainage tube removal time, nasobiliary tube removal time, hospital stay and complications were compared between the two groups, and statistical analysis was performed. Result The operation time of patients in the observation group was longer than that in the control group, and the incision rate of duodenal papilla was significantly lower than that in the control group (P ＜ 0.05), there was no significant difference in intraoperative bleeding between the two groups (P ＞ 0.05). The intubation time, gastrointestinal recovery time, extraction time of abdominal drainage tube and nasobiliary duct in the observation group were shorter than those in the control group (P ＜ 0.05), however, there was no significant difference between the two groups in the success rate of intubation and the length of stay (P ＞ 0.05). The incidence of complications in the observation group was
significantly lower than that in the control group (P ＜ 0.05). Conclusion The application of three-scope combined with transabdominal nasobiliary drainage in the treatment of extrahepatic bile duct stones is effective and high security.
Objective To investigate the clinical effect of laparoscopic hernioplasty in the treatment of elderly indirect inguinal hernia. Method 40 elderly patients with indirect inguinal hernia who were admitted to Xingpu Hospital in Suzhou Industrial Park from January 2019 to April 2022 were selected to undergo hernia repair. They were divided into control group and observation group with 20 patients each according to different operation methods. The control group was treated with traditional open tension-free hernioplasty, and the observation group was treated with laparoscopic hernioplasty. Result The patients in the observation group had less intraoperative bleeding, shorter incision length, shorter time to get out of bed and stay in hospital, and the incidence of
postoperative complications was significantly lower than that in the control group (P ＜ 0.05). Conclusion Laparoscopic hernioplasty for the treatment of indirect inguinal hernia in the elderly has higher safety, less damage and is more conducive to the recovery of patients.
Objective To explore the clinical characteristics, diagnosis and treatment of postsigmoidostomic hernia after colostomy for rectal cancer. Method The clinical data of 6 patients with postsigmoidostomic hernia developed after colostomy for rectal cancer in Linyi Central Hospital from January 2018 to December 2021 were retrospectively analyzed. Result The sigmoid mesocolon at the stoma and the left parietal abdominal wall were continuously sutured and fixed in 6 patients. The operation took 46 ～ 210 minutes, the amount of bleeding was not much, there were no complications related to the operation, and there was no hernia of the groove beside the sigmoid colostomy. Conclusion Postsigmoidostomic hernia is a rare complication after colostomy. It is important to perform abdominal CT scanning as early as possible from the clinical history and physical findings, and to determine the surgical indication.
Objective To investigate the effect of neoadjuvant chemotherapy combined with laparoscopic radical resection of rectal cancer. Method 60 patients with rectal cancer from January 2018 to January 2020 were selected,30 patients in the control group received laparoscopic radical resection of colorectal cancer, and did not receive neoadjuvant chemotherapy before surgery. 30 patients in the observation group received neoadjuvant chemotherapy before laparoscopic radical resection of colorectal cancer, the resection effect and prognosis were compared between the two groups. Result The positive rate of peripheral incisal margin, the rate of abdominal implant metastasis, the rate of anastomotic recurrence and the rate of distant metastasis in the observation group were lower than those in the control group, and the progression-free survival and total survival were significantly higher than those in the control group (P ＜ 0.05); There was no significant difference in the levels of carcinoembryonic antigen, CA19-9 and CA242 between the two groups before treatment (P ＞ 0.05). The levels of carcinoembryonic antigen, CA19-9 and CA242 in the observation group were lower than those in the control group after treatment (P ＜ 0.05).Conclusion Neoadjuvant chemotherapy before laparoscopic radical resection of colorectal cancer can improve the resection effect, prolong the survival time of patients, and reduce the expression level of tumor markers.
Objective To investigate the effects of slag-free enteral nutritional powder on intestinal cleanliness, incidence of discomfort symptoms and patients experience. Method 128 patients undergoing electronic colonoscopy were randomly divided into the experimental group and the control group, 64 cases in each group. The experimental group began to take slag-free enteral nutritional powder before microscopic examination, and the control group took low-residue or no-residue diet to compare the intestinal cleanliness of the two groups and the incidence of discomfort symptoms. Result The intestinal cleanliness of the experimental group was better than that of the control group, and the difference was statistically significant, the incidence of discomfort symptoms in the experimental group was lower than that in the control group, the bowel preparation experience of the experimental group was better than that of the control group, the difference is significant(P ＜ 0.05). Conclusion One days
enteral nutritional powder before colonoscopy can not only provide adequate bowel preparation, but also reduce the incidence of discomfort symptoms caused by dietary restriction, and improve the experience of bowel preparation.
Objective To explore the occurrence and influencing factors of post-traumatic stress disorder (PTSD) in patients with severe trauma. Method Take the patients with severe trauma who were revisited in the outpatient department from June 2020 to May 2021 as the subjects of investigation, and carry out cross-sectional investigation and research. After obtaining their consent, the hospital information management system will first collect the cause of injury, trauma site, trauma time, and trauma severity score (ISS); They were given the social demographic data questionnaire, the posttraumatic stress disorder self-rating scale (PTSD-SS), the Chinese version of the selfrating scale of sleep (SRSS) and the positive psychological capital questionnaire (PPQ) to investigate their social demographic data, the degree of post-traumatic stress disorder, sleep status and positive psychological status. Result
A total of 187 cases were included in the final analysis. The PTSD-SS scale score ranged from 5 to 78 points, with an average of (47.27±11.60) points. 53 cases (28.34%) were diagnosed with PTSD (PTSD group), and 134 were non-PTSD (non-PTSD group). There were statistically significant differences between the PTSD group and the Non-PTSD group in terms of education level, family income level, trauma time, ISS total score, SRSS total score and PPQ total score (P ＜ 0.05); Logistic regression analysis showed that high family income level, long trauma time and high PPQ score were protective factors for PTSD in severely traumatized patients (P ＜ 0.05). Conclusion The risk of PTSD after severe trauma is higher. Family income level, trauma time and positive psychological status are the influencing factors of PTSD after severe trauma.
Objective To analyze the intervention effect of manual lymphatic drainage nursing on relieving postoperative lymphedema and axillary reticulum syndrome of breast cancer. Method From January 2018 to January 2020, 50 patients with lymphedema and axillary reticulum syndrome after breast cancer surgery were selected from Zhanjiang Maternal and Child Health Care and Family Planning Service Center. They were randomly divided into two groups by double-blind method. The control group was 25 patients, receiving routine care; 25 patients in the observation group were treated with manual lymphatic drainage based on the control group; The intervention effect and symptom relief of the two groups were compared. Result The effective rates of the patients
in the observation group were 72.0%, 80.0% and 100.0% respectively after 3, 6 and 12 months of intervention, which were higher than 44.0%, 56.0% and 72.00% in the control group (P ＜ 0.05). The decrease of the difference in circumference of the patients in the observation group after 3, 6 and 12 months of intervention was higher than that in the control group, and the abduction angle of the shoulder joint of the affected limb at 1, 3, 6 and 12 months after intervention was higher than that in the control group, and the time for the postoperative tightness, cord structure, numbness and pain of the affected limb was shorter than that in the control group (P ＜ 0.05). After 1 month of intervention, the scores of daily social function, upper limb activity function and upper limb symptoms in the observation group were lower than those in the control group (P ＜ 0.05). Conclusion Manual lymphatic drainage nursing can alleviate the clinical symptoms of lymphedema and axillary reticulum syndrome after breast
cancer surgery, increase the range of motion of the affected limb, and have a good intervention effect.
Objective To explore the application effect of enhanced recovery after surgery concept in perioperative nursing of laparoscopic appendectomy. Method A total of 280 patients with acute appendicitis diagnosed and treated in Kunshan Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine from January 2020 to December 2021 were retrospectively selected as the research objects and they were randomly divided into observation group (n=140) and control group (n=140). The control group was given routine surgical nursing, while the observation group was given rapid rehabilitation surgical nursing.
The postoperative related indexes and recovery of the patients in the two groups were compared. Result The postoperative anal exhaust time, the first time to get out of bed, the postoperative defecation time, the postoperative knife pain score and the length of hospital stay in the observation group were significantly better than those in the control group, and the differences were statistically significant (P ＜ 0.05). The total incidence of postoperative complications in the observation group was 4.28%, which was lower than 10.71% in the control group, and the difference was statistically significant (P ＜ 0.05). Conclusion The perioperative implementation of fast track surgical nursing in laparoscopic appendectomy can accelerate the recovery of postoperative gastrointestinal function, reduce the length of hospital stay and the incidence of postoperative complications, which is worthy of clinical surgical nursing promotion and application.
Objective To analyze the influence of positive circulating tumor cell (CTC) in peripheral blood of operable breast cancer patients on coagulation function in perioperative period. Method 80 cases of breast cancer patients who underwent surgical treatment in Zhanjiang Central People's Hospital from July 2019 to March 2020 were selected for the study. According to the level of tumor cells in their peripheral blood circulation, they were divided into positive group (preoperative CTC positive) and negative group (preoperative CTC negative). Before operation, on the 1st, 3rd, 7th and 14th day after operation, the patients were tested by routine coagulation function indexes and thromboelastogram. The results of coagulation function and thrombelastography were compared between the two groups. Result Among the 80 patients, 12 were positive for CTC, with a positive detection rate
of 15.00%. There were no significant difference in FIB and DD levels between positive group and negative group at different time before and after operation (P ＞ 0.05). The prothrombin time, activated partial thrombin time, thromboelastogram reaction time, and coagulation time in the positive group were significantly lower than those in the negative group, and the platelet count, thromboelastogram maximum amplitude, and Angle angle were significantly higher than those in the negative group, with significant differences (P ＜ 0.05). Conclusion Patients with operable breast cancer who have positive circulating tumor cells before operation have abnormal coagulation function during the perioperative period and have potential risk of deep vein thromboembolism.
Objective To explore the choice and efficacy of treatment for elderly patients with choledocholithiasis combined with cholecystolithiasis. Method The elderly patients with cholecystolithiasis and choledocholithiasis diagnosed in Pingdu People's Hospital hospital from February 2017 to November 2019 were selected and randomly divided into the observation group (n=34) and the control group (n=32). The observation group was treated with step-by-step endoscopic sphincteropapillotomy(EST) combined with laparoscopic cholecystectomy (LC), and the control group was treated with LC combined with laparoscopic common bile duct exploration T-tube choledochotomy (LCBDE). The total operation time, indwelling time of drainage tube after operation, intraoperative bleeding, postoperative hospital stay, conversion from laparoscopy to laparotomy, stone removal rate, and postoperative complications (including fever, bile leakage, pancreatitis) were compared between the two groups. Result The total operation time, drainage tube retention time, and postoperative hospitalization time of patients in the observation group were shorter than those in the control group, with less intraoperative bleeding and lower conversion rate to laparotomy in the observation group (P ＜ 0.05). There was no significant difference between the two groups in stone removal rate and postoperative complication rate (P ＞ 0.05). Conclusion Both EST+LC and LC+LCBDE can effectively treat the elderly patients with cholecystolithiasis and choledocholithiasis, but in county hospitals with both technology and equipment, EST+LC is more beneficial for elderly patients with choledocholithiasis and choledocholithiasis.
Objective To explore the efficacy of linaclotide in treating colonic obstruction in patients with functional constipation. Method From June 2019 to June 2022, 80 patients with colonic obstruction caused by functional constipation who were diagnosed and treated by the Eighth People's Hospital of Qingdao City were randomly divided into a control group and an observation group, with 40 patients in each group. The patients in the control group received routine treatment, including general treatment, anal exhaust, and enema. The observation group was treated with linaclotide on the basis of the control group. Compare the efficacy, frequency of defecation, stool characteristics, abdominal distension, sense of difficulty in defecation, abdominal pain scores, constipation
specific quality of life scores, and the occurrence of adverse reactions between the two groups. Result The efficacy of the observation group was 95.00%, significantly higher than that of the control group (77.50%), with a significant difference (P ＜ 0.05). Before treatment, there was no significant difference between the two groups in stool characteristics, defecation frequency, abdominal distension, sense of difficulty in defecation, abdominal pain scores, and constipation specific quality of life scores (P ＞ 0.05); After treatment, the stool characteristics, defecation frequency, and abdominal distension, defecation exertion, abdominal pain scores, and constipation specific quality of life scores of the two groups of patients were significantly increased, and the range of change in the observation group was significantly higher than that in the control group (P ＜ 0.05). During the treatment period, the incidence of adverse reactions was 12.50% in the observation group and 10.00% in the control group, with no significant
difference (P ＞ 0.05). The recurrence rate in the observation group was 2.50%, significantly lower than that in the control group (15.00%), with a significant difference (P ＜ 0.05). Conclusion Linaclotide is effective in improving the clinical outcomes of patients with functional constipation and colonic obstruction.
Pancreatic cancer is one of the malignant tumors with the worst prognosis, with a five-year survival rate of less than 10%, and surgical resection is currently the main treatment method. However, due to the lack of typical clinical manifestations in the early stage of pancreatic cancer, it is usually diagnosed in the late stage of the disease, and most patients lose the opportunity of surgical treatment, while other treatments bring poor efficacy, therefore, early diagnosis of pancreatic cancer is more and more important in clinical practice, and early diagnosis will greatly improve the prognosis of pancreatic cancer patients. More and more studies have shown that the occurrence of pancreatic cancer is related to the alteration of microflora in human body. In this paper, we summarize the current research on human microflora and pancreatic cancer development, and explore the changes of human
microflora in the development of pancreatic cancer and the possible mechanisms of action. Human microbes are expected to be markers for early diagnosis of pancreatic cancer, which may open a new pathway for biomarkers and targeted therapy.
Primary liver cancer lacks obvious typical clinical manifestations in the early stage, once obvious symptoms or signs appear, the disease has mostly entered the middle and advanced stages, most of them have lost the opportunity for surgery when they are diagnosed, and some operable patients have early recurrence after surgery and have a poor prognosis. Therefore, non-surgical treatments such as targeted therapy, immunotherapy, radiofrequency ablation, vascular interventional therapy, and traditional Chinese medicine therapy have significant effects on the treatment of liver cancer in the middle and advanced stages, especially targeted therapy for liver cancer is a hot topic now. In this paper, this article reviews the current research progress of targeted therapy for liver cancer and the research status of combination with other treatments.
With the increasing incidence of colorectal cancer, the number of enterostomy patients is increasing. The psychological problems of enterostomy patients become increasingly prominent. As an important part of positive psychology, benefit discovery can change patients' health behaviors and improve their mental state and quality of life to some extent. In this paper, the research progress of benefit finding in enterostomy patients was summarized from the concept of benefit finding, measurement tools, influencing factors and intervention strategies of benefit finding in enterostomy patients, to provide reference for domestic research on benefit finding in enterostomy patients.
Objective To explore the application value of laparoscopic hernioplasty in the treatment of inguinal hernia, observe the prognosis of patients, and evaluate the treatment effect. Method 80 patients with inguinal hernia admitted to the First People's Hospital of Guannan County, Lianyungang City from May 2021 to May 2022 were randomly divided into two groups by digital table method. The control group (n=40) adopted open tension-free inguinal hernia repair. The study group (n=40) adopted laparoscopic hernia repair. The operation and postoperative related indicators, quality of life scores, pain and sleep scores, and complications of the two groups were compared. Result The operation time of the patients in the study group was longer than that in the control group, the time of getting out of bed and hospitalization were shorter after operation, and the amount of intraoperative bleeding
was less than that in the control group, with significant difference (P ＜ 0.05); The pain score, sleep quality score and complication rate in the study group were significantly lower than those in the control group (P ＜ 0.05). Conclusion Laparoscopic hernioplasty for inguinal hernia can improve the clinical symptoms, relieve postoperative pain, improve the quality of life and clinical safety.
Objective To investigate the effect of high ligation of hernia sac for oblique inguinal hernia and three-dimensional laparoscopic water injection hernia needle. Method Sixty children with indirect inguinal hernia admitted to the People's Hospital of Lianshui County, Huai'an City from January 2018 to April 2022 were randomly divided into a control group (30 cases treated with conventional laparoscopy) and an observation group (30 cases treated with 3D laparoscopy) using a digital table method. The surgical related indicators, C reactive protein (CRP), interleukin(IL)-10, and other inflammatory indicators before and after treatment in the two groups were compared, The incidence of complications in the two groups of patients was statistically analyzed and compared. Result The intraoperative diagnostic time and surgical time in the observation group were shorter than those in the control group (P ＜ 0.05). There was no significant difference between the two groups in terms of hospitalization
expenses and time, as well as in the levels of CRP and IL-10 after surgery (P ＞ 0.05),however, the levels of CRP and IL-10 in both groups of patients after surgery were significantly improved compared to those before surgery (P ＜ 0.05). There was no significant difference in the incidence of complications between the two groups (P ＞ 0.05). Conclusion High ligation with a hernia needle assisted by three-dimensional laparoscopy in the treatment of children with indirect inguinal hernia is simple and minimally invasive, and does not increase hospital stay.
Objective To explore the preventive effect of predictive nursing on postoperative nausea and vomiting in patients undergoing thyroid surgery. Method 90 patients who received thyroid surgery in Taixing People's Hospital from April 2020 to April 2021 were selected. According to the results of random odd and even lot drawing, the observation group (odd lot, 45 cases) and the control group (even lot, 45 cases) were divided. The control group took routine care. The observation group implemented predictive care. The incidence of adverse reactions such as nausea and vomiting after surgery in the two groups were observed and counted, The changes of quality of life scores before and after nursing were evaluated. Result The incidences of nausea, vomiting, cough and
other adverse reactions in the observation group were significantly lower than those in the control group (P ＜ 0.05); At the same time, the scores of the corresponding items of the quality of life of the patients in the observation group after nursing were higher than those in the control group, with a significant difference (P ＜ 0.05). Conclusion Predictive nursing intervention combined with thyroid surgery can effectively prevent postoperative adverse reactions such as nausea and vomiting, and improve the quality of life of patients.
Objective To discuss the effect of Newman's nursing on the postoperative quality of sleep and life of patients with colon cancer. Method 82 patients with colon cancer who were admitted to Nanjing Liuhe District People's Hospital from January 2020 to February 2022 were selected and divided into the control group and the test group according to the random number table. The patients in the control group received routine nursing after operation, and the patients in the test group received Newman nursing after operation. The sleep quality and quality of life of the patients in the two groups were compared before and after nursing. Result In the comparison of sleep quality and quality of life scores, there was no significant difference between the two groups before nursing (P ＞ 0.05); After nursing, the sleep quality score of patients in the test group was lower than that of patients in the control group, and the quality of life score was higher than that of patients in the control group, with a significant difference
(P ＜ 0.05). Conclusion Newman nursing can improve the sleep quality and life quality of patients with colon cancer after operation.
Objective To explore the effect of systematic holistic nursing on postoperative wound edema and quality of life in patients with perianal abscess. Method From January 2019 to January 2020, there were 64 patients with perianal abscess surgery treated in Municipal Hospital of Qingdao. They were divided into observation groups and control groups according to the random digital table method. The control group is given conventional nursing, and the observation group gives systematic overall care. By investigating the wound edema situation, patient satisfaction, and quality of life of the two groups after nursing, the perianal wound edema score and health survey scale 36 were used to compare the nursing effects of the two groups. Result The edema scores of the observation group were significantly lower than the control group, and the difference was statistically significant (P ＜ 0.05).
The nursing satisfaction rate in the observation group was significantly higher than that in the control group; the physiological function, psychological function, and sleep quality of the observation group Self -care scores are higher than the control group, the differences were significant (P ＜ 0.05). Conclusion Systematic overall care for patients with perianal abscess can effectively improve the effect of surgery, reduce surgical wound edema, improve the quality of life of patients, and improve patient prognosis.
Objective To explore the impact of enhanced recovery after surgery (ERAS) nursing on self-care ability and pain in patients undergoing permanent colostomy for rectal cancer. Method From October 2019 to February 2022, 74 patients with permanent colostomy after rectal cancer surgery admitted to Nanjing Liuhe District People's Hospital were randomly divided into two groups using the digital table method. The control group had 37 patients receiving routine care, and the experimental group had 37 patients receiving ERAS care. Compare the self care ability and pain level of the two groups of patients. Result Before nursing, there was no significant difference in self care ability between the two groups (P ＞ 0.05); after nursing, the score of self care ability of patients in the experimental group was higher than that in the control group, with a significant difference (P ＜ 0.05). The VAS scores at 24h and 48h after surgery in the experimental group were (7.13±0.54) points and (4.30±0.29) points, respectively. The VAS scores at 24h and 48h after surgery in the control group were (7.20±0.41) points and (6.47±0.65) points, respectively. There was no significant difference in VAS scores between the two groups at 24 hours after surgery (t=0.628, P=0.532), but the VAS scores in the experimental group at 48 hours after surgery were significantly lower than those in the control group, with a significant difference (t=18.545, P ＜ 000.1). Conclusion ERAS nursing can significantly improve the self care ability of patients with permanent colostomy after rectal cancer surgery, and reduce their postoperative pain. The nursing effect is significant.
Objective The purpose of this study was to detect the expression of programmed death-ligand 1(PD-L1) in triple negative breast cancer, and to explore the relationship between the expression of PD-L1 and the clinicopathological features and prognosis of triple negative breast cancer. Method From May 2010 to October 2020, 269 paraffin sections of triple negative breast cancer tissue collected by Beijing Chaoyang Hospital Affiliated to Capital Medical University, were used for immunohistochemical staining to detect the expression of PD-L1 in breast cancer tissue. Analyze the relationship between PD-L1 positive expression and clinical pathological characteristics and prognosis of patients. Result The expression rate of PD-L1 in tumor cells and infiltrating
lymphocytes around tumor was 7.8%（21/269） and 17.84%（48/269）. The total expression rate of PD-L1 in tumor cells and infiltrating lymphocytes around tumor was 21.19%（57/269）.The total expression of PD-L1 in tumor and peritumor infiltrating lymphocytes was correlated with histological grade, nerve invasion, vascular tumor emboli, lymph node metastasis, and Ki-67 high proliferation index. Multivariate regression analysis showed that lymph node metastasis was risk factor for the expression of PD-L1. The expression of PD-L1 was associated with RFS in the prognosis of triple negative breast cancer. Conclusion The high expression of PD-L1 in the tumor cells of triple negative breast cancer and the infiltrating lymphocytes around the tumor is related to the tumor progression and poor prognosis, which can be used as the target of triple negative breast cancer immunotherapy.
Objective This study retrospectively analyzed the clinical data of patients with papillary thyroid carcinoma (PTC) to explore the risk factors for central lymph node metastasis (CLNM) in the neck of PTC. Method The clinical data of 161 hospitalized patients who underwent thyroid surgery for the first time and were pathologically confirmed as PTC in Yingcheng People's Hospital from July 2020 to July 2021 were collected. The patients were divided into metastasis group and non metastasis group according to whether they had CLNM. Compare general information such as gender, age, and preoperative ultrasound imaging data between two groups to analyze the risk factors for CLNM in PTC patients. Result Univariate analysis showed that CLNM was associated with age, gender, ultrasound examination of tumor diameter, microcalcification, and presence of blood flow signals (P＜ 0.05), but not with factors such as tumor palpation results and tumor number (P ＞ 0.05). Multivariate analysis showed that age<45 years old, male, tumor diameter ＞ 1.0cm, ultrasound display of tumor microcalcification, and detection of blood flow signals within the tumor are risk factors for CLNM in PTC patients. Conclusion Men, age ＜ 45 years old, tumor size ＞ 1cm, microcalcifications, and internal blood flow signals within the lesion have a higher risk of developing CLNM. It is recommended that such PTC patients undergo preventive central lymph node dissection.
Objective To explore the potential categories of benefit findings in colorectal cancer enterostomy patients, and to analyze the influencing factors of different benefit findings in colorectal cancer enterostomy patients. Method A total of 216 patients with colorectal cancer enterostomy who were hospitalized or outpatients in Qingdao Municipal Hospital from January 2022 to September 2022 were selected as subjects by convenience sampling method. The survey was conducted using the General Information Questionnaire, the Benefit Finding Rating Scale, the Medical Coping Style Questionnaire, the Perceptive Social Support Inventory, the Revised Life Orientation Test Scale, and the Rumination Rumination Questionnaire. The potential profile analysis method was used to analyze the characteristics of benefit discovery of the research object, and the factors influencing the
potential categories of benefit discovery were discussed by univariate analysis, variance analysis and ordered multiple Logistic regression analysis. Result The benefit findings in colorectal cancer enterostomy patients could be divided into three potential categories: low benefit findings-coping fatigue group (16.7%), moderate benefit findings-lack of exercise group (52.3%) and high benefit findings - healthy and loved group (31.0%). Facing and yielding, family support and other support, optimistic tendency, retirement, and never or almost no communication with health care workers were factors influencing the potential categories of beneficial findings. Conclusion There is significant group heterogeneity in the benefit finding of colorectal cancer enterostomy patients. Medical staff should identify the characteristics and influencing factors of different potential categories of benefits and formulate targeted intervention strategies to improve the level of benefit finding in patients.
This study reviewed the intestinal preparation quality assessment tools for colonoscopy patients developed at home and abroad, summarized the application status and characteristics of the intestinal preparation quality assessment tools for colonoscopy patients, and analysed the advantages and disadvantages of the existing assessment tools, so as to provide reference for the correct assessment of the bowel preparation quality in patients.
Seroma is a sterile inflammatory reaction occurring in tissue spaces, potential cavities, and surgical cavities. Exudate in the cavities gather to form liquid lumps, causing pain, cellulitis, infection, and other complications. Almost all patients with laparoscopic Inguinal hernia repair will have seroma after operation. This article summarizes and analyzes the literature on the influencing factors of seroma after laparoscopic Inguinal hernia repair for reference.
Objective To compare and analyze the clinical effects of endoscopic thyroidectomy via areola approach and open thyroidectomy in patients with benign thyroid diseases. Method A total of 82 patients with benign thyroid lesions admitted to our hospital from February 2020 to January 2022 were selected and divided into two groups according to the willingness of patients to operate, 42 patients were in the control group and 40 patients were in the test group. The patients in the control group were treated with open thyroidectomy, and the patients in the test group were treated with endoscopic resection through the areola approach. The perioperative indicators, pain degree, postoperative complications, and cosmetic effects of the two groups were statistically compared. Result The operation time, extubation time and hospitalization time in the test group were significantly shorter than those in the control group, and the intraoperative bleeding volume and postoperative drainage volume were significantly
less than those in the control group (P ＜ 0.05). The pain scores of the test group at 6h, 1d and 2d after operation were significantly lower than those of the control group (P ＜ 0.05). The incidence of postoperative complications in the test group was significantly lower than that in the control group (P ＜ 0.05). The score of beauty satisfaction in the test group was significantly higher than that in the control group (P ＜ 0.05). Conclusion The advantages of endoscopic thyroidectomy via areola approach in patients with benign thyroid diseases are obvious, such as short operation time, quick recovery after operation, less pain and low complication rate, which is worthy of clinical application.
Objective To investigate the effect of laparoscopic cholecystectomy through different anatomical approaches of gallbladder triangle in the treatment of cholecystolithiasis with chronic cholecystitis. Method From June 2020 to December 2021, 150 in-patients with gallstones and chronic cholecystitis admitted to Xinghua Hospital of Traditional Chinese Medicine were selected. They were randomly divided into the control group (n=75) and the observation group (n=75). The patients in the control group used the triangular approach to the gallbladder, and the patients in the observation group used the posterior triangular approach to the gallbladder. Compare the levels of C-reactive protein (CRP), tumor necrosis factor (TNF)-α, interleukin-6 (IL-6) before and after treatment between two groups of surgical related indicators, as well as the incidence of complications and conversion to
open surgery. Result The surgery time, gastrointestinal function recovery time, and hospitalization time of the observation group patients were shorter than those of the control group, and the bleeding volume was smaller than that of the control group, with significant differences (P ＜ 0.05). After surgery, the average levels of CRP, TNF-α, and IL-6 in the observation group were lower than those in the control group, and the incidence of complications and conversion to laparotomy were also lower than those in the control group, with significant differences (P＜0.05). Conclusion Laparoscopic cholecystectomy for the treatment of gallstones with chronic cholecystitis can reduce the injury of patients, help patients recover, reduce the inflammatory reaction of the body, and reduce the risk of complications and conversion to laparotomy.
Objective To analyze the clinical efficacy of laparoscopic inguinal hernia repair. Method 58 patients with laparoscopic hernia repair admitted to the 926th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from March 2020 to January 2021 were selected as the laparoscopic group, and 58 patients treated with traditional hernia repair during the same period were selected as the traditional group. Compare the surgical conditions, postoperative complications, and recurrence rates between the two groups of patients. Result Surgery time, bedtime, and hospitalization time of the laparoscopic group were shorter than those of the traditional group, with less intraoperative bleeding and lower pain scores at different postoperative periods
compared to the traditional group (P ＜ 0.05). There was no significant difference in surgical efficacy between the two groups of patients, and the total incidence of complications in the laparoscopic group was lower than that in the traditional group, with a significant difference (P＜0.05). However, there was no significant difference in the 2-year postoperative recurrence rate between the two groups of patients (P ＞ 0.05). Conclusion Laparoscopic hernia repair surgery has fewer complications compared to traditional hernia repair surgery, and can shorten the surgical time and promote patient recovery.
Objective To investigate the efficacy of transabdominal preperitoneal prosthesis(TAPP) versus flat plate tension-free hernia repair(Lichtenstein) surgery in bilateral inguinal hernia repair. Method A retrospective analysis of 75 patients with bilateral inguinal hernia admitted to the hospital from January 2019 to April 2022, of which 40 were treated with Lichtenstein surgery and 35 were treated with TAPP. The perioperative condition, shortterm treatment effect, recurrence rate and complication rate of the two groups were compared. Result The surgical time in the TAPP group was higher than that in the Lichtenstein group, The postoperative 24-hour pain score, postoperative bedtime, postoperative exhaust time, and hospital stay in the TAPP group were significantly lower than those in the Lichtenstein group, The hospitalization expenses of the TAPP group were higher than those of the Lichtenstein group, the differences are significant (P ＜ 0.05). On the 1st postoperative day, white blood cell count in the TAPP group was (4.98±1.02)×109/L, tumor necrosis factor-α lever was(35.13±4.52)pg/L, and C-reactive protein lever was (3.78±0.62) mg/L, which were all lower than those in the Lichtenstein group [(5.63±1.38)×109/L, (42.17±4.31)pg/L, and (4.83±0.70)mg/L, respectively], the differences are significant (P ＜ 0.05). The recognition rate of patients in the TAPP group was 91.43%, higher than that in the Lichtenstein group (85.00%), but there was no statistically significant difference between the groups (P ＞ 0.05). 3 patients in the TAPP group experienced complications, with a total incidence rate of 8.5%;6patients in the Lichtenstein group experienced complications, with a total incidence rate of 15.0%. There was no statistically significant difference between the two groups(P ＞ 0.05). All cases were followed up for 19 months after surgery, In the TAPP group, 2 cases (5.71%) recurred at 7 and
17 months respectively; 1 case (2.50%) in the Lichtenstein group relapsed 13 months after surgery. There was no statistically significant difference in the recurrence rate between the two types of surgery (P ＞ 0.05). Conclusion TAPP and Lichtenstein surgery have a definite clinical effect on bilateral inguinal hernia, and the complication rate is equivalent, but patients treated with TAPP recover faster after surgery.
Objective To analyze the therapeutic effect of daytime operation on patients with inguinal hernia and cyst of round ligament of uterus. Method 68 patients with inguinal hernia combined with uterine round ligament cyst admitted to Huangshi Industrial and Mining Hospital from August 2018 to August 2019 were selected and divided into a control group and an observation group using the envelope method, with 34 cases in each group. The control group underwent non day surgery, while the observation group underwent day surgery. The treatment effect and hospitalization status of the two groups of patients were compared. Result On the 1st and 3rd day after surgery, there was no significant difference in pain scores between the observation group and the control group at two times. There was no significant difference in intraoperative bleeding volume, surgical time, and incidence of
complications between the two groups of patients (P ＞ 0.05). The hospitalization time of the observation group patients was shorter than that of the control group, and the hospitalization cost was significantly lower than that of the control group (P ＜ 0.05). After a 3-year follow-up, there was no significant difference in the recurrence rate between the two groups (P ＞ 0.05). Conclusion The safety of daytime operation for inguinal hernia combined with round ligament cyst of uterus is equivalent to that of non-daytime operation, and the cost of daytime operation is low, and the patient's hospitalization time is short.
Objective Explore the effectiveness of preventive ileostomy in the treatment of elderly rectal cancer patients and its impact on anal function. Method 40 rectal cancer patients admitted to Sheyang County People's Hospital from July 2018 to July 2022 were randomly divided into control group (n=20) and observation group (n=20). The control group was treated with laparoscopic radical resection of rectal cancer, and the observation group was treated with laparoscopic radical resection of rectal cancer plus a prophylactic terminal ileostomy protocol. The operation time, bleeding volume, length of resection lesion and number of lymph node dissection were compared between the two groups, and the anal tube resting pressure, rectal threshold sensory volume and maximum rectal tolerance volume before and after treatment were detected to evaluate anal function, and the complication rate and surgical safety were counted. Result Operation time, blood loss, tissue length and lymph node dissection between the two groups (P ＞ 0.05). Postoperative anal resting pressure, rectal threshold sensory capacity, and maximum rectal tolerance capacity were all less than those of the control group, the complication rate was lower in the observation group than in the control group (P ＜ 0.05). Conclusion Prophylactic terminal ileum stoma intervention is effective and can improve anal function and reduce complication rate.
Objective To investigate the effect of one-time radical operation on inflammatory factors and complications in patients with perianal abscess. Method A retrospective analysis was conducted on 94 patients with perianal abscess admitted to Xing'an County People's Hospital in Guilin City from June 2021 to June 2022. They were divided into an observation group and a control group, with 47 patients in each group, based on different surgical methods. The observation group patients were treated with one-time radical surgery, while the control group patients were treated with three gap drainage. Compare the clinical treatment efficacy, inflammatory factor levels, surgical indicators, and incidence of complications between the two groups of patients. Result The short-term efficacy of the observation group patients was significantly better than that of the control group, and the incidence of
complications and secondary surgery rates were lower than those of the control group, with significant differences (P ＜ 0.05). Although the incidence of anal fistula was lower than that of the control group, there was no significant difference (P ＞ 0.05). The surgery time of the observation group patients was longer than that of the control group, and the postoperative wound healing time was shorter than that of the control group. The intraoperative bleeding was less than that of the control group, and the average levels of C-reactive protein and interleukin-6 water were lower than those of the control group, with significant differences (P ＜ 0.05). Conclusion The one-time radical operation for the treatment of perianal abscess has good clinical effect and low complications.
目的 探讨AcoStream 血栓抽吸装置用于下肢深静脉血栓治疗的血栓清除率、显效消肿率以及安全性的影响。方法 选取2019 年1 月至2022 年9 月在化州市人民医院住院治疗的30 例下肢深静脉血栓患者，依据治疗方式的不同分为观察组与对照组，各15 例。观察组患者接受AcoStream 机械血栓抽吸治疗，对照组患者接受单纯导管接触溶栓治疗，比较两组患者术前及术后生活质量、手术相关指标，以及术后相关并发症。结果 观察组患者的术中尿激酶用量少于对照组，患者的小腿和大腿消肿率均高于对照组，且术中溶栓时间、患者住院时间均短于对照组，差异均有显著性（P ＜ 0.05）。但观察组的住院费用显著高于对照组，差异有显著性（P ＜ 0.05）。观察组患者的溶栓有效率以及Ⅱ级和Ⅲ级占比均高于对照组，差异有显著性（P ＜ 0.05）；同时，观察组并发症总发生率[6.67%（1/15）] 显著低于对照组[40.00%（6/15）]，差异有显著性（χ2=4.658，P=0.031）。结论 AcoStream 机械血栓清除装置用于下肢深静脉血栓治疗，安全有效，能提高患者术后生活质量。
Objective To explore the construction of sensitive indexes of enterostomy nursing，and discuss the application of quality management based on indexes in the nursing of enterostomy patients. Method 287 patients with enterostomy who underwent outpatient and inpatient procedures at Subei People's Hospital from January 2020 to December 2021 were selected and divided into two groups based on the time period. 149 patients with enterostomy who did not undergo indicator monitoring from January to December 2020 were selected as the control group, and 138 patients with enterostomy who underwent indicator monitoring from January to December 2021 were selected as the study group. Compare the accuracy of preoperative positioning, incidence of skin complications around the stoma, and changes in nursing satisfaction of stoma patients between two groups of patients. Result The preoperative positioning accuracy (92.75%) and nursing satisfaction (97.83%) of patients in the study group were higher than those in the control group (81.21% and 88.59%, respectively). The incidence of skin complications around the stoma (4.35%) was lower than that in the control group (10.74%), with significant differences (P ＜ 0.05). Conclusion The establishment and implementation of monitoring and management of sensitive indexes of enterostomy specialty nursing can improve the preoperative positioning accuracy of enterostomy，reduce the skin complications around enterostomy, and improve the nursing satisfaction of enterostomy patients.
Objective To study the effect of targeted nursing on elderly patients after laparoscopic appendectomy (LA). Method 72 elderly patients with LA acute appendicitis admitted from January 2020 to January 2022 were randomly divided into study group (36 cases) and control group (36 cases); The control group received routine nursing and the study group received targeted nursing; The levels of coagulation function indexes [fibrinogen (FIB), D-Dimer (D-D)] and the scores of quality of life were compared between the two groups before and after the intervention. Result Before the intervention, there was no significant difference in the level of coagulation function and the score of quality of life between the two groups (P ＞ 0.05); Compared with before the intervention, the level of coagulation function index was lower and the score of quality of life was higher in the two groups after the intervention (P ＜ 0.05); After the intervention, the level of coagulation function index and thrombosis rate in the study group were lower than those in the control group, and the score of quality of life and satisfaction were higher (P ＜ 0.05). Conclusion The application of targeted nursing in elderly patients with acute appendicitis can effectively improve the coagulation function and prevent lower extremity deep venous thrombosis, as well as improve their quality of life and satisfaction.
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.
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.
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.
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.
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.
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.
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.
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.
