Table of Content

01 April 2024, Volume 12 Issue 2

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An appraisal of pancreatic cancer prognosis, immune infi ltration based on cuproptosis-related long noncoding RNA model and forecasting of traditional Chinese medicine

Sun Guodong, Jiang Jingyi, Zhao Lei, Pu Weigao, Hu Jike, He Lijuan, Yun Zhangjun, Cheng Huijuan, Chen Hao,

2024, 12(2):  2. 

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Objective A prognostic model for pancreatic cancer(PC) based on cuproptosis-related long noncoding RNA (CRL) was constructed to predict the traditional Chinese medicine that regulates cuproptosis- related gene(CRG). Method A risk model for forecasting PC prognosis was constructed by utilizing Cox regression and Pearson correlation analysis, utilizing clinical data and RNA-seqs of 183 PC patients sourced from theTCGA. Screening CRL through LASSO regression, and the nomogram was formed by uniting the risk score and clinical features. To test the model's accuracy, receiver operator characteristic curve (ROC) and C-index were employed. An assessment was made of the correlation between risk scores and immunoinfi ltration and chemotherapy/targeted agents. The potential Chinese medicines for controlling CRG were predicted through the utilization of Coremine Medical database. Result The PC risk model was developed based on the risk scores of six CRLs (MIR1915HG, PRECSIT, AC004982.1, AC023043.4, AC010999.2, FOXCUT).The AUC for forecasting 1-year, 3-year and 5-year survival rates in PC patients was 0.782, 0.786 and 0.912 respectively, as revealed by the risk model, surpassing age, grade and TNM stage. A relationship was found between the risk score and the enrichment of tumor-infi ltrating lymphocytes, the presence of regulatory T cells, and the sensitivity of fourteen chemotherapeutic/targeted drugs. There are ninety-eight Chinese medicines that potentially regulate CRG; their eff ects primarily involve heat clearing and detoxifying properties attributed mainly to liver spleen and lung meridians. Traditional Chinese medicine Tenacissoside may have potential regulatory effects on key gene FDX1 involved in copper death mechanism. Conclusion A risk signature constructed based on six CRLs could assess the prognosis and immunity of PC, and Tenacissoside may have important regulatory effi cacy on the mechanism of coppercuproptosis.

Analysis of the effi cacy and postoperative recurrence rate of diff erent endoscopic minimally invasive treatments for rectal neuroendocrine neoplasms

He Youhao, Guan Xin, Jiang Xiangjun

2024, 12(2):  18. 

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Objective Exploring the comparison of the effi cacy and recurrence rate of endoscopic submucosal dissection (ESD), endoscopic mucosal resection (EMR), and endoscopic submucosal resection (ESE) in the treatment of rectal neuroendocrine tumors under the precise localization of tumor volume and level using endoscopic ultrasound. Method Retrospective analysis of clinical data of patients who received endoscopic minimally invasive treatment at Qingdao Municipal Hospital from October 2018 to July 2022 and were pathologically diagnosed with rectal neuroendocrine tumors. Analysis of preoperative imaging features, endoscopic ultrasound diagnosis, surgical data, pathological data, and postoperative follow-up of EMR, ESD, and ESE surgical methods for rectal neuroendocrine tumors. Result A total of 95 patients were included in the clinical data, including 52 who underwent ESD surgery, 30 who underwent EMR surgery, and 13 who underwent ESE surgery. The average maximum diameter of lesions removed in the ESD group was signifi cantly larger than that in the EMR group, and the ESD group had a larger tumor resection area compared to the EMR group, with signifi cant diff erences (P＜0.05). The surgical time of ESD group and ESE group was signifi cantly longer than that of EMR group, and the diff erence was signifi cant (P ＜ 0.05). There was no signifi cant diff erence among the three methods in terms of intraoperative surgical rescue, postoperative margin involvement rate, occurrence of postoperative complications, postoperative discharge time, and postoperative recurrence rate(P ＞ 0.05). Endoscopic ultrasound examination shows that most of the lesions are hypoechoic, with clear boundaries and intact tube walls. The lesions mainly originate from the submucosal layer and mucosal muscle layer. Conclusion Before surgery, the most suitable endoscopic minimally invasive surgery method is selected based on the localization of tumor volume and level by endoscopic ultrasound. By utilizing the advantages of EMR, ESD, and ESE, the surgical safety can be improved.

Clinical observation of laparoscopic cholecystectomy for the treatment of complex cholecystitis

Yin Changsheng, Zhang Zhiwei, Kou Kejian

2024, 12(2):  25. 

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Objective To explore the feasibility and clinical application value of laparoscopic cholecystectomy in the treatment of complex cholecystitis. Method A retrospective analysis was conducted on the clinical data of 80 patients with complex cholecystitis admitted to Jimo People's Hospital Affi liated to Binzhou Medical College from March 2020 to March 2023. According to diff erent surgical methods, they were divided into a control group and an experimental group, with 40 cases in each group. The experimental group patients underwent laparoscopic cholecystectomy, while the control group underwent percutaneous transhepatic gallbladder puncture and drainage followed by laparoscopic cholecystectomy in the second phase during the same period. Compare the diff erences between two groups of patients in terms of surgical time, intraoperative bleeding, postoperative bile leakage, incision infection, residual bile duct stones, bile (intestinal) duct injury, treatment effectiveness, and length of hospital stay. Result There were no perioperative deaths in either group of patients. The experimental group had a longer surgical time and more surgical bleeding compared to the control group, with signifi cant diff erences (P ＜ 0.05). There was no signifi cant diff erence in the conversion rate to open surgery, intraoperative biliary injury rate, intestinal injury, postoperative hospital stay, and postoperative bleeding between the two groups of patients(P ＞ 0.05). Conclusion Laparoscopic cholecystectomy for complex cholecystitis can shorten the treatment cycle.

Research progress on continuous care after modifi ed radical mastectomy for breast cancer

Ciren Yangjin, Pu Yue, Yang Lijun, Li Bowen, Wang Jie, Zhang Wenzhuo

2024, 12(2):  30. 

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Breast cancer has become one of the most common malignant tumors in women, and its incidence is increasing year by year and getting younger. Modified radical mastectomy is a common surgical method for breast cancer. The continuous care can improve the quality of life and nursing satisfaction of patients after modifi ed radical mastectomy, and reduce the cost of medical services and the recurrence rate of breast cancer. This paper reviews the concept of the continuous care, and the stage, content and method of the continuous care in breast cancer patients with modifi ed radical surgery, so as to provide the theoretical basis for future study.

Evaluation of the eff ect of abdominal compression on the prevention of hypoxemia during painless gastroscopy

Liu Jiuyue, Jin Xianglan , Wang Huazhen, Wang Yang, Bi Hehui, Wang Shiyan,

2024, 12(2):  34. 

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Objective To observe the effect of abdominal compression operation in preventing hypoxemia in painless gastroscopy anesthesia. Method 188 patients who underwent painless gastroscopy examination in the outpatient and inpatient departments of Yanbian University Affi liated Hospital from September 2021 to November 2022 were randomly divided into an observation group and a control group, with 94 patients in each group, using a random number table method. The control group was treated with nasal cannula oxygen inhalation, while the observation group was assisted with abdominal compressions on the basis of the control group. The lowest pulse oxyhemoglobin saturation (SpO2) level, incidence of hypoxemia, gastroscopy examination time, incidence of withdrawal and suspension of examination, total amount of propofol used, awakening time, and incidence of postoperative adverse reactions were compared between the two groups of patients. Result The lowest SpO2 level of the observation group patients was higher than that of the control group, and the gastroscopy examination time was shorter than that of the control group. The incidence of dropout and hypoxemia were both lower than those of the control group, and the diff erences were signifi cant (P ＜ 0.05). However, there was no signifi cant diff erence in heart rate and incidence of adverse reactions between the two groups of patients when they reached the lowest SpO2 level (P ＞ 0.05). Conclusion Abdominal compression operation can eff ectively prevent the occurrence of hypoxemia in painless gastroscopy, maintain a high SPO2 level, shorten the time of gastroscopy, and improve the effi ciency of gastroscopy.

The application eff ect of fi ve tiered nutritional intervention in perioperative chemotherapy for gastrointestinal tumor patients

Liang Quanjiang

2024, 12(2):  38. 

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Objective Exploring the effect of using five-tiered nutritional intervention in perioperative chemotherapy patients with gastrointestinal tumors. Method 88 patients with perioperative chemotherapy gastrointestinal tumors admitted to the Brain Hospital of Guangxi Zhuang Autonomous Region from February 2021 to February 2024 were selected. They were randomly divided into a reference group and a study group, with 44 cases in each group, using a random number table method. The reference group patients received routine dietary intervention, while the study group implemented fi ve-tiered nutritional intervention. The nutritional status, immune function indicators, tumor marker levels, improvement in nutritional levels, and bone marrow suppression results of the two groups of patients were observed before and after intervention. Result Before intervention, there was no signifi cant diff erence in nutritional related biochemical indicators, immune function indicators, tumor marker levels, and nutritional levels between the two groups of patients (P ＞ 0.05). After intervention, the nutritional related biochemical indicators, immune function indicators, tumor marker levels, and nutritional levels of the two groups of patients were signifi cantly improved (P ＜ 0.05). In addition, the levels of albumin, hemoglobin, transferrin, and prealbumin, CD3+, CD4+ T lymphocytes, IgM, IgA, and IgG in the study group were higher than those in the control group, and the PG-SGA score, CEA, and CA19-9 levels were lower than those in the control group, with signifi cant diff erences (P ＜ 0.05). After intervention, there was no signifi cant diff erence in the incidence of platelet and hemoglobin inhibition between the two groups of patients (P ＞ 0.05), but the incidence of white blood cell and granulocyte inhibition in the study group was lower than that in the control group, with a signifi cant diff erence (P ＞ 0.05). Conclusion Gastrointestinal tumor chemotherapy patients can be intervened with a fi ve-tiered nutritional guidance program during the perioperative period, which not only improves the patient’s nutritional level, but also improves their immune function, reduces the level of tumor markers, enhances anti-tumor ability, reduces bone marrow suppression, and alleviates chemotherapy adverse reactions during the perioperative period. It has a good nutritional intervention eff ect.

The eff ect and impact of placing drainage tubes after laparoscopic cholecystectomy for the treatment of acute suppurative cholecystitis

Song Yunpeng

2024, 12(2):  43. 

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Objective To explore the eff ect of placing drainage tubes or not after laparoscopic cholecystectomy (LC) on the treatment of acute suppurative cholecystitis and its impact on traumatic inflammatory response. Method 86 patients with acute suppurative cholecystitis admitted between January 2022 and September 2023 were all treated with LC. They were divided into groups based on whether to place a drainage tube after surgery. Group A had 43 patients who did not place a drainage tube after surgery, while Group B had 43 patients who placed a drainage tube after surgery. The perioperative indicators, infl ammatory indicators, and postoperative complications between two groups were compared. Result The postoperative anal exhaust time, mobilization time, and hospitalization time of Group A patients were shorter than those of Group B, with signifi cant diff erences (P＜ 0.05). There was no signifi cant diff erence in preoperative C-reactive protein, white blood cell count, and interleukin-6 levels between the two groups of patients (P ＞ 0.05); 3 days after surgery, the levels of the above indicators in Group A were better than those in Group B, with signifi cant diff erences (P ＜ 0.05). The incidence of postoperative incision pain, infection, bile leakage, and shoulder pain in Group A patients was signifi cantly lower than that in Group B (P ＜ 0.05). Conclusion Patients with acute suppurative cholecystitis who undergo LC without placement of drainage tubes can shorten their postoperative recovery time and reduce the risk of complications.

Clinical application of bevacizumab combined with chemotherapy in targeted treatment of colorectal cancer

Zeng Guowei

2024, 12(2):  47. 

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Objective To explore the application effect of bevacizumab combined with chemotherapy in targeted therapy for colorectal cancer. Method A retrospective analysis was conducted on the clinical data of 68 patients with colorectal cancer admitted to Guangzhou Baiyunshan Hospital from June 2022 to June 2023. They were divided into a control group (chemotherapy, 33 cases) and a study group (bevacizumab+chemotherapy, 35 cases) based on diff erent treatment plans. The therapeutic effi cacy, tumor marker levels, and incidence of adverse reactions were compared between the two groups of patients. Result The disease control rate of the study group patients was 94.29%, higher than that of the control group (72.73%), with a significant difference (P ＜ 0.05). Before treatment, there was no signifi cant diff erence in the levels of carbohydrate antigen (CA) 19-9, CA 72-4, and carcinoembryonic antigen between the two groups (P ＞ 0.05); After treatment, the average levels of CA 19-9, CA 72-4, and carcinoembryonic antigen in the study group were signifi cantly lower than those in the control group (P ＜ 0.05). There was no signifi cant diff erence in the total incidence of adverse reactions between the two groups of patients (P ＞ 0.05). Conclusion Bevacizumab combined with chemotherapy can signifi cantly improve the disease control rate of colorectal cancer patients, reduce the level of tumor markers in the body, and there is no increase in the risk of adverse reactions.

The impact of laparoscopic radical resection of colorectal cancer on liver and kidney function

Liao Lingzhou, Mo Yuandong

2024, 12(2):  52. 

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Objective To analyze the impact of laparoscopic radical resection of colorectal cancer on liver and kidney function in patients. Method 120 patients with colorectal cancer who received treatment at Rong’an County People’s Hospital in Liuzhou City from March 2021 to March 2023 were selected and randomly divided into a control group and an experimental group (each with 60 cases) using a random number table method. The control group received traditional open surgery, while the experimental group received laparoscopic radical resection for colorectal cancer. The liver and kidney function indicators and postoperative complications of the two groups of patients were compared. Result On the fi rst day before surgery, there was no signifi cant diff erence in liver and kidney function indicators between the two groups of patients (P ＞ 0.05). Three days after surgery, the lactate dehydrogenase levels in the experimental group patients increased signifi cantly compared to the fi rst day before surgery (P ＜ 0.05); The total protein, cholinesterase, and albumin levels of the experimental group patients were signifi cantly lower than those of the control group, and the uric acid level was signifi cantly lower than that of the control group, with signifi cant diff erences (P ＜ 0.05). The incidence of postoperative complications in the experimental group was signifi cantly lower than that in the control group (5.00% vs. 16.67%; P=0.040). Conclusion Laparoscopic radical surgery for colorectal cancer can impose a burden on the liver function of patients and have a smaller impact on their renal function. Compared to traditional open surgery, the risk of complications is lower.

Clinical eff ect analysis of improved totally extraperitoneal laparoscopic hernia repair in the treatment of inguinal hernia

Li Qibiao, Li Dawei

2024, 12(2):  57. 

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Objective Analyze the clinical effi cacy of totally extraperitoneal laparoscopic hernia repair (TEP) in the treatment of inguinal hernia patients. Method Eighty male patients with initial inguinal hernia admitted to the Dongting Branch of Xishan People's Hospital in Wuxi from January 2018 to May 2023 were selected and divided into a control group (n=40, who underwent open tension-free hernia repair surgery) and an observation group (n=40, who underwent modifi ed TEP) based on diff erent surgical procedures. Analyze perioperative indicators, spermatic vein diameter, spermatic vein blood flow velocity, incidence of complications, and Nottingham health profile (NHP) scores for two groups of patients. Result The surgical time, hospitalization time, and anal exhaust time of the observation group patients were shorter than those of the control group, and the incidence of postoperative complications was lower than that of the control group, with signifi cant diff erences (P ＜ 0.05). Before surgery, there was no signifi cant diff erence in the diameter and blood fl ow velocity of the spermatic vein between the two groups of patients (P ＞ 0.05); Two weeks after surgery, the diameter of the spermatic vein in the observation group was smaller than that in the control group, and the blood fl ow velocity of the spermatic vein was faster than that in the control group, with a signifi cant diff erence (P ＜ 0.05). Before surgery, there was no signifi cant diff erence in NHP scores between the two groups of patients (P ＞ 0.05); Two weeks after surgery, the NHP scores in all dimensions of the two groups of patients decreased compared to before surgery, but the observation group was signifi cantly lower than the control group, with a signifi cant diff erence (P ＜ 0.05). Conclusion The improved TEP treatment for inguinal hernia patients has shown good therapeutic eff ects, minimal damage to the spermatic vein, and faster postoperative recovery.