ObjectiveTo investigate the influencing factor of intraoperative hypothermia during laparotomy.MethodsA total of 81 patients underwent laparotomy in our hospital from October 1, 2018 to January 1, 2019 were enrolled. The difference of preoperative baseline data and surgical data between the hypothermia and non-hypothermia groups was compared, and the influencing factor of intraoperative hypothermia during laparotomy was explored.ResultsOf the 81 patients, 32 patients occurred hypothermia during operation. There were no significant differences in gender, age, BMI, HGB, WBC count, PLT count, TB, AST, ALT, ALB, PT, operation time, postoperative hospital stay, and Clavien-Dindo grade between the hypothermia group and the non-hypothermia group (P>0.05), but there were significant differences in intraoperative infusion volume, intraoperative blood loss, and surgical mode (P<0.05). The intraoperative infusion volume and intraoperative blood loss in the hypothermia group were higher than those in the non-hypothermia operation group, and the proportion of hepatectomy was higher than that in the non-hypothermia group. The multivariate analysis show that the intraoperative blood loss, intraoperative infusion volume, and kind of operation were the risk factors for the hypothermia during laparotomy (P<0.05).ConclusionsIntraoperative hypothermia is related to intraoperative bleeding volume, intraoperative fluid infusion volume, and the kind of operation. Therefore, for patients with less bleeding, the intraoperative hypothermia can be reduced by limiting the volume of intraoperative fluid infusion. For those patients with more intraoperative bleeding, warming fluid infusion may reduce the incidence of intraoperative hypothermia.
ObjectiveTo review the application of omega-3 polyunsaturated fatty acids (Ω-3PUFAs) in patients with gastric cancer.MethodThe related literatures about the application of Ω-3PUFAs in patients with gastric cancer were reviewed by searching domestic and international databases.ResultsΩ-3PUFAs didn’t only improve the perioperative immune function and inflammatory response in patients with gastric cancer, but also prevent the occurrence of gastric cancer, inhibit the proliferation and promote the apoptosis of gastric cancer cells, increase the sensitivity of chemotherapy, and reduce the occurrence of chemotherapy-related adverse events.ConclusionsΩ-3PUFAsis an immunological nutrition, which can provide energy and also has functions of anti-inflammatory, anti-cancer, immunity regulation. It has been widely used in patients with gastric cancer, but the relevant mechanism needs further to be investigated.
Objective To explore the effect of different nutrition on the immune function of patients with colorectal cancer. Methods A total of 640 colorectal cancer patients were randomized into the enteral nutrition and peripheral nutrition groups. The peripheral venous blood was sampled before operation and on the postoperative days 1 and 7 to determine the serum levels of IgG, IgA, IgM, the percentage of T lymph cell subgroups CD3, CD4, CD4/CD8 and CRP, PGE, α- antitrypsin etc. The patient’s general condition, side-effects, and complications were observed intimately after surgery. Results Compared with the control group, the IgG, IgA, IgM, CD3, CD4,CD4/CD8 levels of the trial group on postoperative day 7 were higher. But the levels of CRP, PGE, α- antitrypsin were decreased. Hospitalization time and anal exsufflation time were shorter as well. There was no significant difference in either the general conditions or complications between the two groups. Conclusion Application of enteral nutrition after colorectal cancer surgery is safe, ,effective, and can improve the patient’s immune function and prognosis.
Objective To compare the clinical effect between alginate calcium dressing and radix yarn dressing after anal fistula surgery. Methods A survey of 128 patients with anal fistula from April to October 2008 were studied. Patients were divided into two groups using a simple random method: 64 cases in therapy group which were treated with alginate calcium dressing and 64 cases in control group which were treated with traditional radix yarn dressing. The difference of the wound recovery indexes between two groups was compared.Results With regard to age, gender, anal fistula type, the proportion of preoperative diabetes and the diameter of wound, there was no statistical significance between therapy group and control group (Pgt;0.05). The proportion of slight pain during dressing change in therapy group (45.32%, 29/64) was more than control group (25.00%, 16/64), which had statistical significance (Pgt;0.05). The incidence of skin allergy was significantly different between two groups (29.69% vs. 60.94%, P＜0.05). Also, the rotten tissue and the soakage disappears with a shorter period, which both had statistical significance 〔(8.60±2.37) d vs. (12.22±3.29) d， (16.96±5.83) d vs. (22.02±5.90) d〕， Plt;0.05.Conclusion With the shorten of inflammatory and increment stage of the wound recovery, alginate calcium dressing is an ideal material for the postoperative duration of surgery of anal fistula.
ObjectiveTo summarize the changes of gut microbiota after cholecystectomy, the mechanisms of changes, and the relation with colorectal cancer, nonalcoholic fatty liver disease and post-cholecystectomy syndrome after cholecystectomy, in order to provide new ideas for the perioperative management of patients undergoing cholecystectomy. MethodThe studies related to gut microbiota after cholecystectomy at home and abroad were searched and analyzed for review. ResultsThe cholecystectomy disrupted the liver–bile acid–gut flora axis of the patients, and the composition and diversity of the gut microbiota of the patients were altered, and the alteration might lead to the occurrence of colorectal cancer, nonalcoholic fatty liver disease, and post-cholecystectomy syndrome, but the exact mechanism remained unclear. ConclusionsThe balance of intestinal microecology is disrupted after cholecystectomy, and the relation between cholecystectomy and gut microbiota may provide new ideas for the perioperative management of cholecystectomy patients and the prevention and treatment of diseases or symptoms after cholecystectomy, but the effect of cholecystectomy on gut microbiota and the relation with diseases or symptoms still need to be further studied.
ObjectiveTo understand the status of application of Colorectal Cancer Predicted Risk Online (CRC-PRO) in colorectal cancer screening, and to analyze the possible practical value in our country.MethodsThe research literatures on the colorectal cancer risk prediction tool of CRC-PRO at home and abroad were searched. The overview and application status of this tool were reviewed.ResultsCRC-PRO could predict the 10-year risk rate of individuals developing colorectal cancer. It could quickly provide clinicians with accurate estimates of patient risk to help clinicians and patients identify screening programs and improve prevention strategies.ConclusionsCRC-PRO can not only give specific probability of risk, but also easy to operate. But based on regional differences, in the promotion of CRC-PRO, it is necessary to carry out multi-center research in more diverse populations for more extensive clinical analysis and verification, to further expand the scope of application of this tool.
ObjectiveTo systematically review the efficacy of enteral nutrition combined with parenteral nutrition (EN+PN) and enteral nutrition alone (EN) in gastric cancer patients undergoing gastrectomy. MethodsPubMed, EMbase, CNKI and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) of EN+PN and EN in gastric cancer patients undergoing gastrectomy from inception to September 25th, 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.3 software. ResultsA total of 23 RCTs were included. The results of meta-analysis showed that compared to EN group, EN+PN group had a shorter hospital stay (MD=?1.75, 95%CI ?2.45 to ?1.05, P<0.000 1) and a lower risk of postoperative complications (RR=0.55, 95%CI 0.46 to 0.66, P<0.000 1). However, there was no statistical difference in the first exhaust time between the two groups. ConclusionThe current evidence shows that EN+PN may contribute to reducing the incidence of postoperative complications and shortening the length of hospital stay in gastric cancer patients. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusions.
ObejectiveTo summarize the research progress of risk factors contributing to postoperative pulmonary infection in gastric cancer, so as to provide reference for medical decision-makers and clinical practitioners to effectively control the incidence of postoperative pulmonary infection in gastric cancer, ensure medical safety and improve the quality of life of patients. MethodThe researches at home and abroad on the factors contributing to pulmonary infection after gastric cancer surgery in recent years were reviewed and analyzed. ResultsThere was currently no uniform diagnostic standard for pulmonary infection. The incidence of postoperative pulmonary infection for gastric cancer varied in the different countries and regions. The pathogenic bacteria that caused postoperative pulmonary infection of gastric cancer was mainly gram-negative bacteria, especially Pseudomonas aeruginosa, Escherichia coli, Acinetobacter boulardii, and Klebsiella pneumoniae. The patient’s age, history of smoking, preoperative pulmonary function, preoperative laboratory indicators, preoperative comorbidities, preoperative nutritional status, preoperative weakness, anesthesia, tumor location, surgical modality, duration of surgery, blood transfusion, indwelling gastrointestinal decompression tube, wound pain, and so on were possible factors associated with postoperative pulmonary infection of gastric cancer. ConclusionsThe incidence of postoperative pulmonary infection for gastric cancer is not promising. Based on the recognition of related factors, it is proposed that it is necessary to develop a risk prediction model for postoperative pulmonary infection of gastric cancer to identify high-risk patients. In addition to the conventional intervention strategy, taking the pathogenesis as the breakthrough, finding the key factors that lead to the occurrence of postoperative pulmonary infection of gastric cancer is the fundamental way to reduce its occurrence.
目的 了解局部麻醉下腹股溝疝無張力修補術后患者排便變化的相關影響因素。 方法 采用自行設計的問卷調查表，對2010年5月－6月行無張力修補術的腹股溝疝患者術后排便情況及變化進行調查，并就相關影響因素采用logistic回歸方法進行統計分析。 結果 腹股溝疝無張力修補術后患者進食量減少、活動量減少、飲食成分變化、擔心排便引起復發是術后排便變化的影響因素。 結論 加強該病癥術后健康宣傳，指導患者正常進食、多活動，消除患者對腹股溝疝復發的焦慮，可促進其早期排便。Objective To research on the risk factors for change of defecation after inguinal hernia mesh-repairs under local anesthesia. Methods Self-made questionnaires were used to investigate the defecation change among patients having undergone inguinal hernia mesh-repairs from May to June 2010, and the correlated factors for change of defecation were analyzed by logistic regression analysis. Results Reduction of activity and food, changes of food ingredients, and worries about recurrence were risk factors for change of defecation. Conclusion In order to facilitate the recovery of the patients, nurses should promote patients’ knowledge on the surgery, guide them to eat as usual and do more exercises, and eliminate their anxiety on recurrence of the disease.
ObjectiveTo understand the current state of medical graduate student labor education in the new era and its effectiveness, to explore the mechanism by which labor education affects labor practices, and to identify intervention points for improving labor education. MethodsA questionnaire survey was conducted from July 3 to 13, 2022, on the labor education of 216 medical graduate students from 10 double-first-class universities. The relationship between labor education, labor awareness, labor ability, and labor practices was analyzed. ResultsDescriptive analysis results showed that medical graduate students received little labor education. The structural equation model results showed that labor education positively impacted labor awareness (γ=0.712) and labor ability (γ=0.755), and labor awareness and labor ability positively impacted labor practices (γ=0.400, γ=0.635), indicating that labor education has a positive impact on labor practices. ConclusionTo improve the weak state of medical graduate student labor education, it is necessary to increase related training and courses, enrich the types and content of labor education, strengthen the assessment mechanism of labor education, and strengthen the responsibilities of instructors.