Table of Content

01 October 2023, Volume 11 Issue 4

Previous Issue   

Clinical effect of transcatheter arterial chemoembolization combine with 125I implantation in the treatment of primary liver cancer

LIU Jinwen, LI Yongqiang

2023, 11(4):  2. 

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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.

The effect of laparoscopic radical resection of colorectal cancer on perioperative immune function and serum inflammatory factors in patients with colorectal cancer

LI Yaowen

2023, 11(4):  6. 

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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.

Research progress on the delayed gastric emptying after pancreaticoduodenectomy

SHI Haowei, XING Cheng, SONG Jinghai,

2023, 11(4):  11. 

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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.

The relationship between immune cells and microenvironment of colorectal cancer

ZHANG Zheng, JIANG Rong,

2023, 11(4):  17. 

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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.

Analysis of application of information management in quality control of pancreatic cancer specimen collection

ZHANG Yanjun, GONG Zengfeng, WU Jiaying, QI Na

2023, 11(4):  22. 

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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.

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

2023, 11(4):  26. 

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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.

The clinical application of ertapenem in community-acquired intraabdominal infection and perioperative period

LIU Min, YIN Hui, SUN Fusheng, GUO Yujin

2023, 11(4):  31. 

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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.

Application of enhanced recovery after surgery concept in perioperative nursing of laparoscopic choledocholithotomy and primary suture

ZHANG Shenya, XIA Jing, LU Xian, TANG Xueqin

2023, 11(4):  37. 

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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.