Objectives To investigate the clinical efficacy of health education intervention on chronic gastritis nursing. Methods A total of 142 patients with chronic gastritis in our hospital were recruited from February 2016 to June 2017. All patients were randomly assigned into two groups. The control group received conventional therapy and routine nursing, whereas the case group was offered with extra health education based on control group. Then related disease knowledge, nursing efficiency, nursing satisfaction, and nursing quality were compared. Results A total of 71 patients were in the case group, while 71 patients in the control group. Compared with the control group, the case group achieved better related disease knowledge, nursing satisfaction, total nursing efficiency, psychological status, sleep quality, exercise training, and daily diet (all P value<0.05). Conclusions Health education intervention not only can enhance disease knowledge of patients with chronic gastritis but also improve nursing quality, clinical effects and nursing satisfaction. Thus, it is worthy of further popularization in clinics.
Objective To review the current status and advances of the correlation between traumatic brain injury (TBI) and fracture healing. Methods The related domestic and abroad literature about the correlation between TBI and fracture healing was extensively reviewed and analyzed. Results There are a variety of studies on the correlation between TBI and fracture healing, which can be divided into two major aspects: revascularization and osteogenesis; the local and systemic changes of the neuropeptide and hormone after TBI. Conclusion TBI facilitates callus formation, the further research is needed to clarify the exact mechanism.
Objective To assess the outcome of harmonic scalpel (HS) in esophageal cancer surgery and to provide evidence for the role of HS in the enhanced recovery after surgery (ERAS) and short-term prognosis after esophageal cancer surgery. Methods We collected the clinical data of 81 esophageal cancer patients receiving surgery by HS between January 1 and December 31, 2016 and successfully followed up in our department. There were 67 males and 14 females with an average age of 64.07±7.52 years. Sweet approach was adopted in 16 patients, Ivor-Lewis approach in 23 and McKeown approach in 40. Intrathoracic anastomosis was completed in 41 patients and cervical anastomosis in 40. The length of total hospital stay and postoperative hospital stay, operation time, intraoperative blood loss, duration and volume of thoracic drainage and perioperative complications were recorded and compared in patients with different surgical approaches and anastomosis sites. Results For these 81 patients, the operation time was 276.7±70.4 min, and the intraoperative blood loss was 115.9±69.7 ml. The postoperative duration of thoracic drainage, postoperative complication rate and the drainage volume were 12.3±5.3 d, 35.80% and 1 411.9±1 199.5 ml, respectively. During the follow-up, 15 patients died and the cumulative survival rate was 81.48%. There was no obvious HS-related complication. The operation time of Sweet approach was shorter than that of Ivor-Lewis or McKeown approach (P=0.012) and the dissected lymph nodes were less in Sweet approach (P=0.035). There was no significant difference in perioperative indexes and postoperative short-term prognosis between intrathoracic anastomosis and cervical anastomosis. Conclusion HS is widely used in the surgery for esophageal cancer with safety and effectiveness, which is worthy of clinical application.
ObjectiveTo explore the safety and feasibility of spleen-preserving distal pancreatectomy for children with distal pancreatic injures.MethodsClinical data of 10 patients with severe distal pancreatic injures in The Second Affiliated Hospital of Guilin Medical University from January 2012 to July 2017 were retrospectively analyzed. The intraoperative and postoperative situation including operation time, intraoperative blood loss, postoperative blood platelet count, and perioperative complications were observed.ResultsAll the 10 patients underwent spleen-preserving distal pancreatectomy successfully. The median operation time was 3 h (2–6 h), the median intraoperative blood loss was100 mL (50–300 mL), the postoperative blood platelet count ranged from 75×109/L to 260×109/L with the median postoperative blood platelet count was 175×109/L. Two patients suffered from pancreatic leakage, one patient suffered from subphrenic infection, and one patient suffered from pulmonary infection. All patients suffered from complication recovered after symptomatic treatments. All patients were followed up in the outpatient department, the follow-up time was 4–60 months with a median of 30 months. Reexamination of abdominal ultrasound and blood routine (every 3 months after surgery) showed that, no abnormalities in blood supply, morphology, and structure of spleen, and platelet counts fluctuated within the normal range. During the follow-up period, none of the children suffered from severe infection due to hyposplenic function.ConclusionSpleen-preserving distal pancreatectomy is a safe and effective method for children with distal pancreatic injures.
The technical combination of artificial intelligence (AI) and thoracic surgery is increasingly close, especially in the field of image recognition and pathology diagnosis. Additionally, robotic surgery, as a representative of high-end technology in minimally invasive surgery is flourishing. What progress has been or will be made in robotic surgery in the era of AI? This article aims to summarize the application status of AI in thoracic surgery and progress in robotic surgery, and looks ahead the future.
ObjectiveTo evaluate clinical feasibility and safety of total laparoscopic pancreaticoduodenectomy (TLPD).MethodThe clinical data of 51 consecutive cases who underwent TLPD, admitted in this department of pancreatic surgery of the Affiliated Hospital of Xuzhou Medical University from August 2016 to August 2018, were analyzed retrospectively.ResultsThe TLPDs were successfully completed in the 51 patients. The operative time was (375.5±75.2) min, the pancreaticojejunostomy time was (45.2±8.3) min and bilioenteric anastomosis time was (25.6±7.5) min. The intraoperative blood loss was (337.8±164.4) mL. The length of surgical incision was (6.0±1.2) cm. The duration of flatulence was (3.5±1.0) d. The time for liquid diet was (5.2±2.1) d, the postoperative first ambulation time was (2.0±1.2) d. The duration of postoperative hospital stay was (14.8±5.3) d. The total postoperative complication rate was 34.3% (17/51), with 19.6% (10/51) of B or C postoperative pancreatic fistula and 9.8% (5/51) of bleeding. The postoperative pathology showed that there were 45 cases of malignant tumor and there was no positive incisal margin. The maximum tumor size was (2.8±1.2) cm and the number of lymph nodes harvested was 12.6±7.8. All the patients were followed up for 2–24 months with a median time of 17 months. The 1-year overall survival rate and progression-free survival rate of the patients with malignant tumors were 84.4% (38/45) and 77.8% (35/45), respectively.ConclusionTLPD is safe and feasible in cases of clinical practice under skilled hand and there are advantages such as faster postoperative recovery and shorter hospital stay.
ObjectiveTo summarize the experience of minimally invasive anterior mediastinal tumor resection in our center, and compare the Da Vinci robotic and video-assisted thoracoscopic approaches in the treatment of mediastinal tumor.MethodsA retrospective cohort study was conducted to continuously enroll 102 patients who underwent minimally invasive mediastinal tumor resection between September 2014 and November 2019 by the single medical group in our department. They were divided into two groups: a robotic group (n=47, 23 males and 24 females, average age of 52 years) and a thoracoscopic group (n=55, 29 males and 26 females, average age of 53 years). The operation time, intraoperative blood loss, postoperative thoracic drainage volume, postoperative thoracic drainage time, postoperative hospital stay, hospitalization expense and other clinical data of two groups were compared and analyzed.ResultsAll the patients successfully completed the surgery and recovered from hospital, with no perioperative death. Myasthenia gravis occurred in 4 patients of the robotic group and 5 of the thoracoscopic group. The tumor size was 2.5 (0.8-8.7) cm in the robotic group and 3.0 (0.8-7.7) cm in the thoracoscopic group. Operation time was 62 (30-132) min in the robotic group and 60 (29-118) min in the thoracoscopic group. Intraoperative bleeding volume was 20 (2-50) mL in the robotic group and 20 (5-100) mL in the thoracoscopic group. The postoperative drainage volume was 240 (20-14 130) mL in the robotic group and 295 (20-1 070) mL in the thoracoscopic group. The postoperative drainage time was 2 (1-15) days in the robotic group and 2 (1-5) days in the thoracoscopic group. There was no significant difference between the two groups in the above parameters and postoperative complications (P>0.05). The postoperative hospital stay were 3 (2-18) days in the robotic group and 4 (2-14) in the thoracoscopic group (P=0.014). The hospitalization cost was 67 489(26 486-89 570) yuan in the robotic group and 27 917 (16 817-67 603) yuan in the thoracoscopic group (P=0.000).ConclusionCompared with the video-assisted thoracoscopic surgery, Da Vinci robot-assisted surgery owns the same efficacy and safety in the treatment of mediastinal tumor, with shorter postoperative hospital stay, but higher cost.
ObjectiveTo explore the feasibility and application value of laparoscopic pancreaticoduodenectomy (LPD) in elderly patients.MethodsThe clinical data of patients who underwent LPD from August 2016 to July 2019 were retrospectively analyzed. The patients were allocated into the elderly group (≥65 years old) and non-elderly group (<65 years old). The early surgical outcomes and postoperative complications of the two groups were compared.ResultsIn this study, 69 cases of LPD were collected, including 42 cases in the elderly group and 27 cases in the non-elderly group. Compared with the non-elderly group, the proportion of patients complicated comorbidities was higher (P<0.05), albumin level was lower (P<0.05), and American Society of Anesthesiologists classification was higher (P<0.05) in the elderly group. There were no significant differences in the intraoperative conditions, postoperative recovery, and postoperative complications between the two groups (P>0.05), and there were no significant differences in the pathological results of postoperative malignant tumor between the two groups (P>0.05).ConclusionsFor elderly patients with over 65 years old, LPD is a safe and feasible surgical procedure for clinical practice. Meanwhile, early surgical outcomes are satisfactory, postoperative complications are not increased, and tumor cure effect can be achieved.
ObjectiveTo observe expressions of E3 ubiquitin ligase—mitsugmin53 (MG53) protein, MG53 mRNA, and insulin receptor substrate 1 (IRS-1) mRNA in skeletal muscle of non-obese type 2 diabetic mellitus (T2DM) rats after gastric bypass operation (GBP), and to investigate possible mechanism of GBP in improving insulin resistance.MethodsTwenty-four healthy male GK rats were randomly divided into diabetic operation group, diabetic sham operation group, and diabetic control group, 8 rats in each group; besides, 8 male Wistar rats were served as normal control group. The expressions of MG53 protein in skeletal muscle tissue were detected by using Western blot method on week8 after operation. The mRNA levels of IRS-1 and MG53 in skeletal muscles tissue were measured by RT-PCR methods on week 8 after operation.Results① The expressions of MG53 protein and MG53 mRNA in the diabetic sham operation group and diabetic control group were significantly higher than those in the diabetic operation group and the normal control group on week 8 after operation (P<0.05), respectively, which had no significant differences between the diabetic operation group and the normal control group (P>0.05), and between the diabetic sham operation group and the diabetic control group (P>0.05) on week 8 after surgery. ② Compared with the normal control group, the expression of IRS-1 mRNA was significantly decreased in the diabetic operation group, the diabetic sham operation group, and the diabetic control group (P<0.05), while there were no significant differences between the diabetic operation group, diabetic sham operation group, and the diabetic control group on week 8 after operation (P>0.05).ConclusionExpression of E3 ubiquitin ligase—MG53 protein in skeletal muscle tissue in T2DM rats following GBP is decreased, thus reduces the IRS-1 ubiquitin-degradation, increase the expression of IRS-1 protein in insulin signaling pathway of skeletal muscle tissue, and improve insulin resistance of skeletal muscle.
ObjectiveTo explore the risk factors of lymph node metastasis (LNM) in patients with early gastric cancer (EGC), and try to establish a risk prediction model for LNM of EGC.MethodsThe clinicopathologic data of EGC patients who underwent radical gastrectomy and lymph node dissection from January 1, 2015 to December 31, 2019 in this hospital were retrospectively analyzed. Univariate analysis and logistic regression analysis were used to determine the risk factors for LNM of EGC, and the risk prediction model for LNM of EGC was established based on the multivariate results.ResultsA total of 311 cases of EGC were included in this study, and 60 (19.3%) cases had LNM. Univariate and multivariate analysis showed that age (younger), depth of tumor invasion (submucosa), vascular invasion, and undifferentiated carcinoma were the risk factors for LNM of EGC (P<0.05). The optimal threshold for predicting LNM of EGC was 0.158 (area under the receiver operating characteristic curve was 0.864), the sensitivity was 80.0%, and the specificity was 79.3%.ConclusionsFrom results of this study, risk factors for LNM of EGC have age, depth of invasion, vascular invasion, and differentiation degree. Risk prediction model for LNM of EGC established on this results has high sensitivity and specificity, which could provide some references for treatment strategy of EGC.