Table of Content

28 December 2024, Volume 13 Issue 4 Previous Issue   

Commentary

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Application of biodegradable vascular stents in peripheral blood vessels XU Zhiheng, FAN Weijian, TAN Jinyun 2024, 13 (4):  273-278.  doi: 10.3969/j.issn.2095-378X.2024.04.001 Abstract ( 130 )   PDF (1248KB) ( 205 )   Save Peripheral vascular diseases seriously affect the quality of life. The relatively mature technology of traditional stents still has some defects, while the emergence of biodegradable stents using various materials with different characteristics, advantages and disadvantages, and development progresses brings new opportunities. In this paper, the characteristics, current status, and challenges of biodegradable stents were analyzed in order to conduct in-depth research in multiple aspects in the future and better apply them in the treatment of peripheral vascular diseases. References | Related Articles | Metrics

Original article

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Application of radiomics machine learning models in predicting hepatic fibrosis progression and preventing surgical risk in patients with type 2 diabetes mellitus and non-alcoholic fatty liver disease FAN Yi, WANG Shuo, PANG Yanping, WANG Xiuyan 2024, 13 (4):  279-284.  doi: 10.3969/j.issn.2095-378X.2024.04.002 Abstract ( 86 )   PDF (5263KB) ( 178 )   Save Objective To develop a machine learning （ML） model based on shear wave elastography （SWE） radiomics for predicting the risk of hepatic fibrosis progression in patients with type 2 diabetes mellitus （T2DM） and non-alcoholic fatty liver disease （NAFLD）, aiming to reduce the necessity for surgery through early non-surgical interventions. Methods A retrospective analysis was performed on SWE image data of 218 patients with T2DM and NAFLD. Liver region image segmentation and radiomics feature extraction were conducted using the 3D Slicer software. After feature selection, random forest, support vector machine, and extreme gradient boosting （XGBoost） were employed to build ML predictive models. The performance of the models was evaluated using receiver operating characteristic （ROC） curves, calibration curves, and decision curve analyses （DCA） to determine the optimal ML predictive model. Results Among the 218 patients, 40 （18.3%） had an initial liver stiffness ≥ 6.5 kPa, indicating a risk of hepatic fibrosis. A total of 849 radiomics features were extracted from each segmented SWE image. After data standardization and feature selection, five radiomics features closely associated with hepatic fibrosis were identified. Three ML models were constructed based on these radiomic features, and the XGBoost model demonstrated optimal discriminatory ability, achieving an area under the ROC curve of 0.864. The calibration curve and DCA curve indicated that the model accurately predicted the risk of hepatic fibrosis when the predicted probability was within the range of 0.4-0.7. Conclusion This study has successfully trained and validated an XGBoost model based on hepatic SWE radiomics features, demonstrating its potential applicability in predicting the risk of hepatic fibrosis progression in T2DM patients with NAFLD. References | Related Articles | Metrics

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Effects of ultrasound-guided lung recruitment strategy on vital signs and incidence of postoperative adverse reactions in patients undergoing laparoscopic sleeve gastrectomy WU Ning, LUO Yuefeng, LIN Shaofeng 2024, 13 (4):  285-288.  doi: 10.3969/j.issn.2095-378X.2024.04.003 Abstract ( 73 )   PDF (1285KB) ( 132 )   Save Objective To observe the effect of ultrasound-guided lung recruitment strategy on vital signs and incidence of postoperative adverse reactions in patients undergoing laparoscopic sleeve gastrectomy. Methods Using a random number table,a total of 80 patients who underwent laparoscopic sleeve gastrectomy from March 2020 to March 2024 were selected and divided into two groups, with 40 patients in each group. Both groups received combined intravenous and inhalational anesthesia during surgery. On this basis, the control group received traditional lung recruitment maneuver during anesthesia recovery, while the observation group received ultrasound-guided lung recruitment strategy. Comparisons were conducted for the blood oxygen saturation （SpO2）, mean arterial pressure （MAP）, heart rate （HR）, and arterial oxygen partial pressure/fraction of inspiratory oxygen （PaO2/FiO2） of the two groups at 5 min before anesthesia induction （T0）, before lung recruitment at the end of surgery （T1）, after lung recruitment （T2）, 30 min after extubation （T3）, and 1 d after surgery （T4）. The incidences of postoperative adverse reactions （atelectasis, pneumonia, pleural effusion, hypoxemia） were analyzed in the two groups. Results The incidence rates of postoperative adverse reactions were lower in the observation group than in the control group （P<0.05）. At T0 and T1, the SpO2 levels between the two groups were not different （P>0.05）. At T2, T3, and T4, the SpO2 levels in the observation group were higher than those in the control group （P<0.05）. At T1 and T2, both groups showed a decrease in MAP and HR compared to T0 （P<0.05）. At T2 and T3, there was no significant difference in MAP and HR between the observation group and the control group （P>0.05）. At T2, T3, and T4, the PaO2/FiO2 levels in the observation group were higher than those in the control group （P<0.05）. Conclusion The ultrasound-guided lung recruitment strategy for patients undergoing laparoscopic sleeve gastrectomy does not affect the stability of vital signs, and can improve oxygenation and reduce postoperative adverse reactions. References | Related Articles | Metrics

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Effect of pre-rehabilitation combined with lung protective ventilation strategy on pulmonary complications after esophagectomy for esophageal cancer LIU Jinfeng, JI Yuling, LANG Bao, GUO Guangquan 2024, 13 (4):  289-293.  doi: 10.3969/j.issn.2095-378X.2024.04.004 Abstract ( 85 )   PDF (1278KB) ( 94 )   Save Objective To evaluate the effect of lung pre-rehabilitation program combined with lung protective ventilation strategy on postoperative pulmonary complications in patients with esophageal cancer. Methods A total of 85 patients underwent endoscopic surgery （McKeown） in Weifang People's Hospital from June 2022 to December 2023 were enrolled in the study, and according to the method of random number table, divided into two groups. The control group （n=42） received routine preoperative health education, postoperative respiratory training, and complication prevention, with no specific recommendations for psychology, diet, and exercise. The pre-rehabilitation group （n=43） received a multimodal intervention program two weeks before surgery on the basis of the control group, including psychological counseling, nutritional guidance, respiratory training, and aerobic exercise. The primary endpoint was the incidence of pulmonary complications （pneumonia, atelectasis） within 7 d after surgery, and the secondary endpoints included lung function, thoracic drainage tube indwelling time, and length of hospital stay. Results There were no significant differences in age, gender, American Society of Anesthesiologists （ASA） classification, intraoperative blood loss, and operation time between the two groups. Compared with the control group, the incidence of postoperative pneumonia was lower in the pre-rehabilitation group （t=4.435, P=0.035）, while there was no significant difference in the incidence of atelectasis. The thoracic drainage tube indwelling time （P=0.006） and length of hospital stay （P=0.009） were shorter in the pre-rehabilitation group than in the control group. The forced vital capacity （FVC） was higher in the pre-rehabilitation group than in the control group 7 d after surgery （P=0.023）, but there was no significant difference in forced expiratory volume in one second （FEV1） （P>0.05）. The platform pressure （Pplat） after artificial pneumothorax during surgery was significantly lower in the pre-rehabilitation group than in the control group （P<0.01）. Conclusion A two-week pre-rehabilitation combined with intraoperative lung protective ventilation strategy has significant benefits for patients with McKeown surgery, reducing postoperative pulmonary complications, thoracic drainage tube indwelling time, and hospitalization time. References | Related Articles | Metrics

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Effect of preemptive analgesia with flurbiprofen ester on immune suppression in patients undergoing laparoscopic hysterectomy SU Jie 2024, 13 (4):  294-297.  doi: 10.3969/j.issn.2095-378X.2024.04.005 Abstract ( 70 )   PDF (1274KB) ( 123 )   Save Objective To study the efficacy advantages of flurbiprofen ester preemptive analgesia. Methods A total of 78 patients who underwent laparoscopic hysterectomy in Jin'an District Hospital of Fuzhou City from April 2023 to April 2024 were selected and divided into a control group （39 cases, with an equal amount of saline intervention） and an observation group （39 cases, with intravenous injection of 1 mg/kg flurbiprofen ester diluted to 10 mL of normal saline before anesthesia） by random number table method. Baseline data were comparable between the two groups. Analgesic effect and safety were compared between the two groups. Results The mean arterial pressure and heart rate of patients in the observation group were significantly lower than those of the control group at the time of intubation and extubation （P<0.05）. The pain scores [visual analogue scale （VAS） scores] of patients in the observation group were significantly lower than those of the control group at 1 min after extubation, 5 min after extubation, and the time of leaving the anesthesia room （P<0.05）. The level of inflammatory factors in peripheral blood of the observation group was significantly lower than that of the control group on postoperative day 1 （P<0.05）, and the level of T cell subsets was significantly higher （P<0.05）. The overall postoperative incidence rate of adverse reactions of patients in the observation group was significantly lower than that of the control group （P<0.05）. Conclusion The administration of flurbiprofen ester preemptive analgesia to laparoscopic hysterectomy patients is able to improve patients’ mean arterial pressure and heart rate, alleviate pain, reduce inflammatory factor levels, increase cellular immunity, and reduce the incidence of adverse reactions. It is worthy of clinical promotion. References | Related Articles | Metrics

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Influencing factors of blood pressure after laparoscopic adrenalectomy among patients with adrenal hypertension NONG Yi, LI Bijun, XIANG Xiaoyao, LI Jianchang 2024, 13 (4):  298-302.  doi: 10.3969/j.issn.2095-378X.2024.04.006 Abstract ( 75 )   PDF (1307KB) ( 124 )   Save Objective To analyze the effect of laparoscopic adrenalectomy on blood pressure in patients with adrenal hypertension, and to explore the related influencing factors of postoperative hypertension, so as to improve the clinical effect of the treatment of adrenal hypertension. Methods The clinical data of 100 patients with adrenal hypertension and laparoscopic adrenalectomy screened in the Second Affiliated Hospital of Guangdong Medical University from January 2021 to December 2023 were retrospectively analyzed. They were divided into a normal blood pressure group （n=50） and a hypertension group （n=50） according to blood pressure. All patients received adrenal CT examination, primary aldosteronism （PA） screening test, and adrenal venous blood sampling （AVS）. After half a year of follow-up, the general information, preoperative and postoperative blood pressure, antihypertensive drug use, blood potassium level, aldosterone level of the patients were collected, and the differences between the normal blood pressure group and the hypertension group were analyzed. Results The patients in the hypertension group were mostly male, with smoking history, drinking history, high body mass index （BMI）, bilateral tumors, PA and pheochromocytoma, large tumor, long operation time, large intraoperative blood loss, and poor medication compliance. Before operation, there was no significant difference in blood pressure, serum potassium level, and recumbent aldosterone level between the two groups （P>0.05）.Half a year after operation, the diastolic blood pressure, systolic blood pressure, and recumbent aldosterone levels in the normal blood pressure group were lower than those in the hypertension group, and the serum potassium was higher in the normal blood pressure group （P<0.05）. Multivariate analysis showed that the patients who were elderly, high BMI, smoking history, drinking history, bilateral tumors, PA and pheochromocytoma in tumor tissue, and poor medication compliance had a higher risk of postoperative hypertension （P<0.05）. Conclusion Laparoscopic adrenalectomy has a significant impact on the blood pressure of patients with adrenal hypertension. The control of postoperative hypertension is related to a variety of factors, including age, BMI, smoking history, drinking history, the location and number of tumors, and medication compliance. Therefore, for these high-risk patients, postoperative monitoring and personalized management should be given more closely. References | Related Articles | Metrics

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Effectiveness and safety of holmium laser prostatectomy for large volume benign prostatic hyperplasia XU Jiadong, BAO Wenping, YANG Fan, YU Feng, CHEN Ke, LIU Xiangen 2024, 13 (4):  303-305.  doi: 10.3969/j.issn.2095-378X.2024.04.007 Abstract ( 127 )   PDF (1287KB) ( 123 )   Save Objective To evaluate the effectiveness and safety of holmium laser prostatectomy for the treatment of large volume benign prostatic hyperplasia （BPH）. Methods A retrospective analysis was conducted on the clinical data of 73 patients with large volume BPH admitted from March 2021 to March 2024. According to different treatment methods, they were divided into an electric resection group and a holmium laser group. Among them,36 patients who underwent transurethral bipolar plasma resection of the prostate were assigned to the electric resection group, and 37 patients who underwent transurethral holmium laser prostatectomy were assigned to the holmium laser group. Surgical related indicators, prostate improvement, and postoperative complications were compared between the two groups of patients. Results The surgery related time indicators in the holmium laser group were shorter than those in the electric resection group, and the intraoperative bleeding was less （P<0.05）. After treatment, the maxmium urine flow rate （Qmax） of patients in the holmium laser group was higher than that in the electric resection group, while the postvoid residual （PVR） and international prostate symptom score （IPSS） were lower （P<0.05）. After designed surgery, the incidence of complications in the holmium laser group was 8.11% （3/37）, which was not significantly different from the 13.89% （5/36） in the electric resection group （P>0.05）. Conclusion The use of holmium laser prostatectomy for the treatment of large volume BPH can shorten surgical time, reduce intraoperative bleeding volume, improve prognosis, and reduce the risk of postoperative complications. It is recommended to application. References | Related Articles | Metrics

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Curative effects and influencing factors of PVP and PKP on osteoporosis complicated with thoracolumbar fracture ZHANG Biao, DOU Yalong, YANG Junlin 2024, 13 (4):  306-310.  doi: 10.3969/j.issn.2095-378X.2024.04.008 Abstract ( 67 )   PDF (1318KB) ( 94 )   Save Objective To compare the effects of percutaneous vertebroplasty （PVP） and percutaneous kyphoplasty （PKP） on osteoporosis combined with thoracolumbar fracture, and to analyze the incidence rates and factors affecting postoperative low back pain. Methods A total of 133 patients with osteoporosis combined with thoracolumbar fracture from January 2018 to January 2023 were selected as study subjects. In accordance with the surgical methods, they were divided into PKP group （n=70） and PVP group （n=63）. Postoperative rehabilitation indicators were compared between the two groups, including first off-bed time, hospitalization time, visual analogue scale （VAS） score at 1 d postoperatively, Cobb's angle at 3 months after operation, vertebral height at 3 months after operation and the incidence rate of low back pain at 3 months postoperatively. The spinal function index （SFI） and the Japanese Orthopaedic Association （JOA） were used to assess the lumbar spine function of the two groups of patients before surgery and at 3 months after operation. Among the 133 patients, 40 cases （30.08%） had pain after surgery, and the factors influencing the postoperative low back pain were analyzed. Results The differences in first off-bed time, hospitalization time, VAS score at 1 d postoperatively, Cobb's angle at 3 months after operation, vertebral height at 3 months after operation, and incidence rate of low back pain at 3 months postoperatively between patients in the PVP group and the PKP group were not statistically significant （P>0.05）.The differences in preoperative SFI and JOA scores between the two groups were not statistically significant （P>0.05）; the SFI and JOA scores of the two groups at 3 months postoperatively were significantly higher compared with preoperative scores （P<0.05）, but the differences between the groups were not statistically significant （P>0.05）. There were no significant differences in gender, age, body mass index （BMI）, surgical method, affected body part, anesthesia mode, combined hypertension, hyperlipidemia, other underlying diseases, and combined soft tissue injury between the non-low back pain patients and the low back pain patients （P>0.05）, but there were significant differences in preoperative bone mineral density （BMD）, Cobb's angle, combined diabetes mellitus, VAS scores, and fracture history between the non-low back pain patients and the low back pain patients （P<0.05）. The results of logistic regression showed that preoperative BMD, preoperative Cobb's angle, combined diabetes mellitus, and fracture history were independent risk factors for osteoporosis combined thoracolumbar fracture. Conclusion Both PVP and PKP treatments for osteoporosis combined thoracolumbar fractures can improve patients' lumbar spine function. Preoperative BMD, preoperative Cobb's angle, combined diabetes mellitus, and fracture history are the independent risk factors for postoperative low back pain in patients with osteoporotic thoracolumbar fracture. Therefore, timely measures should be taken to prevent postoperative low back pain in such patients. References | Related Articles | Metrics

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Clinical characteristics and efficacy evaluation of minimally invasive neuroendoscopic surgery and craniotomy hematoma removal surgery for hypertensive intracerebral hemorrhage LI Weixiong, WANG Guangming, LIU Lan, LI Wei 2024, 13 (4):  311-314.  doi: 10.3969/j.issn.2095-378X.2024.04.009 Abstract ( 86 )   PDF (1294KB) ( 162 )   Save Objective To analyze and compare the therapeutic effects of minimally invasive neuroendoscopic surgery and craniotomy hematoma removal surgery in patients with hypertensive intracerebral hemorrhage. Methods A total of 46 patients with hypertensive intracerebral hemorrhage admitted from April 2021 to April 2024 were selected and divided into two groups according to different surgical methods. The control group （n=30） underwent craniotomy hematoma removal surgery, while the observation group （n=16） underwent minimally invasive neuroendoscopic surgery. Improvement in clinical efficacy, surgical time, intraoperative bleeding volume, and degree of neurological damage [assessed by the National Institutes of Health stroke scale （NIHSS）], and postoperative complications were compared between the two groups. Results The total effective rate of treatment in the observation group was higher than that in the control group （P<0.05）. The operation time was shorter and the intraoperative blood loss was less in the observation group than that in the control group （P<0.05）. There was no significant difference in the neurological function score （NIHSS） between the two groups before treatment （P>0.05）. After treatment, the NIHSS scores in both groups decreased compared to those before treatment, and the observation group had a lower score （P<0.05）. Compared with the control group, the observation group had a lower incidence of complications （P<0.05）. Conclusion Neuroendoscopic minimally invasive surgery for hypertensive intracerebral hemorrhage can achieve the desired effect in a short period of time, with high safety and neurological function benefits. It is worth promoting and applying. References | Related Articles | Metrics

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Therapeutic effect of uterine compression suturing surgery on postpartum hemorrhage ZHONG Ping, ZOU Lili 2024, 13 (4):  315-318.  doi: 10.3969/j.issn.2095-378X.2024.04.010 Abstract ( 72 )   PDF (1289KB) ( 90 )   Save Objective To analyze the clinical effect of uterine compression suturing surgery on intractable uterine bleeding after cesarean section. Methods A retrospective study was conducted among 85 patients with intractable uterine bleeding after cesarean section at the Obstetrics and Gynecology Department of Hanjiang Hospital in Putian from January 2020 to June 2023. Based on different treatment plans, 42 patients underwent B-Lynch suturing surgery were classified into the control group, and 43 patients underwent multi U-shaped uterine compression suturing surgery were classified into the study group. Surgical treatment indicators, uterine artery blood flow indicators, laboratory indicators, hemostatic efficacy, postoperative bleeding volume, menstrual recovery time, uterine involution rate, and incidence of poor prognosis were compared between the two groups. Results Compared with the control group, the study group who underwent multiple U-shaped uterine compression suturing treatment had significantly reduced surgical time, intraoperative bleeding volume, number of red blood cell （RBC） units transfused, volume of plasma transfused, postoperative hemostasis, hospital stay, bleeding volume at 2 h and 24 h after surgery, and postoperative menstrual recovery time （P<0.05）; reduced postoperative activated partial thromboplastin time （APTT）,and increased RBC count and hemoglobin （Hb） （P<0.05）; increased postoperative hemostasis rate and uterine involution rate, while decreased hysterectomy rate and postpartum infection rate （P<0.05）. Conclusion Compared with B-Lynch suture, multi U-shaped uterine compression suture for patients with intractable uterine bleeding after cesarean section can complete the surgery in a short time, control bleeding, and achieve effective hemostasis. References | Related Articles | Metrics

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Application of compound Sanhuang liquid in wound bed preparation for chronic refractory wounds of damp-heat and blood-stasis syndrome LIANG Jianhua, LI Jiehui, ZHUANG Zhiyong, CAI Jinbiao, HUANG Ayong 2024, 13 (4):  319-322.  doi: 10.3969/j.issn.2095-378X.2024.04.011 Abstract ( 62 )   PDF (1307KB) ( 99 )   Save Objective To observe the clinical efficacy of compound Sanhuang liquid in wound bed preparation for chronic refractory wounds （CRW） of damp-heat and blood-stasis syndrome. Methods A total of 95 patients with CRW of damp-heat and blood-stasis syndrome from January 2018 to June 2022 were selected and randomly divided into an observation group （49 cases） and a control group （46 cases） by random number table method. Both groups received basic treatment and surgical debridement. After surgery, the control group received routine surgical dressing changes, and on this basis, the observation group received wound wet dressing with compound Sanhuang liquid. Ratios of wound to healing area and depth, the proportion of patients with complete wound healing, wound healing time, wound pathogen positive rate, reoperation rate, postoperative Bates-Jensen wound assessment tool （BWAT） score, and traditional Chinese medicine syndrome efficacy evaluation were compared between the two groups of patients. Results The ratios of wound to healing area and depth and the proportion of patients with complete wound healing in the observation group were higher than those in the control group （P<0.05）. The wound healing time, wound pathogen positive rate, and reoperation rate in the observation group were lower than those in the control group （P<0.05）. The observation group had better postoperative BWAT scores and traditional Chinese medicine syndrome efficacy than the control group （P<0.05）. Conclusion The application of compound Sanhuang liquid in the wound bed preparation for CRW of damp-heat and blood-stasis syndrome can effectively promote wound repair, shorten the course of disease, reduce the incidence of wound infection, and avoid multiple surgeries, showing good clinical efficacy. It is worthy of further promotion and application. References | Related Articles | Metrics

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Impact of vacuum sealing drainage technology combined with muscle flap transfer and free skin grafting on pain and appearance satisfaction of patients in repair of refractory wounds JIAN Youyuan, ZHANG Jiandan, LU Zhanzhou 2024, 13 (4):  323-326.  doi: 10.3969/j.issn.2095-378X.2024.04.012 Abstract ( 59 )   PDF (1291KB) ( 99 )   Save Objective To explore the impact of vacuum sealing drainage technology combined with muscle flap transfer and free skin grafting on the pain and appearance satisfaction of patients in the repair of refractory wounds. Methods A total of 88 patients with refractory wound repair admitted to the Second Hospital of Longyan from January 2022 to March 2024 were selected as research subjects. They were divided into an observation group and a control group according to the order of admission, with 44 patients in each group. Patients in the control group were treated with simple vaccum sealing drainage technology, while patients in the observation group were treated with a combination of vaccum sealing drainage technology, muscle flap transfer, and free skin grafting. After recording the data of the two groups during the study period, the clinical application value of each treatment method was compared and analyzed. Results During the treatment period, all indicators of the observation group were better than those of the control group （P<0.05）. The wound pain score of the observation group 1,3,7 d after treatment decreased compared to the control group （P<0.05）. Compared with the control group, the overall satisfaction with the appearance of the observation group increased （P<0.05）. Conclusion The combination of vaccum sealing drainage technology and free skin grafting with muscle flap transfer can improve clinical indicators, promote wound healing, reduce clinical pain, and increase appearance satisfaction in patients with refractory wound repair. References | Related Articles | Metrics

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Clinical application of recurrent laryngeal nerve monitoring in bilateral total thyroidectomy YIN Chenglong, MO Qifei, OUYANG Junguang, LI Jiaxing 2024, 13 (4):  327-329.  doi: 10.3969/j.issn.2095-378X.2024.04.013 Abstract ( 78 )   PDF (1286KB) ( 91 )   Save Objective To investigate the clinical effect of recurrent laryngeal nerve monitoring in bilateral total thyroidectomy. Methods The study subjects were 80 patients with thyroid cancer who underwent bilateral total thyroidectomy in Jiangmen People's Hospital from March 2022 to March 2023. They were evenly divided into two groups according to whether recurrent laryngeal nerve monitoring was used during the operation, namely, 40 patients who did not undergo recurrent laryngeal nerve monitoring during the operation were classified into the control group, and the other 40 patients with recurrent laryngeal nerve monitoring during the operation were classified into the observation group. Clinical indicators and recurrent laryngeal nerve injury were compared between the two groups. Results There was no significant difference （P>0.05） in intraoperative bleeding volume and drainage volume between the two groups. The exploration time and surgical time of recurrent laryngeal nerve of the observation group [（6.73±2.46） min and （102.35±18.48） min] were significantly shorter than those of the control group [（9.17±3.54） min and （113.27±16.85） min] （P<0.05）. Compared with the control group, the observation group had significantly lower incidence rates of temporary recurrent laryngeal nerve injury and permanent recurrent laryngeal nerve injury （P<0.05）. Conclusion For patients with thyroid cancer, monitoring of recurrent laryngeal nerve during bilateral total thyroidectomy can not only effectively shorten the exploration time and operation time of recurrent laryngeal nerve, but also effectively reduce the occurrence of temporary and permanent recurrent laryngeal nerve injury. References | Related Articles | Metrics

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Clinical application of lateral cervical approach for radical thyroidectomy LIU Xiaohua, CHEN Jinjian, GAO Guide, CHEN Fudeng 2024, 13 (4):  330-333.  doi: 10.3969/j.issn.2095-378X.2024.04.014 Abstract ( 67 )   PDF (1282KB) ( 89 )   Save Objective To explore the effectiveness and safety of lateral cervical approach for radical thyroidectomy in clinical application, evaluate its clinical value in thyroid cancer radical surgery, and provide a scientific basis for clinical decision making. Methods A total of 160 patients who underwent unilateral thyroid cancer radical surgery from January 2023 to December 2023 were selected and randomly divided into two groups. The control group included 80 patients who underwent traditional anterior cervical median approach surgery, and the study group included 80 patients who underwent lateral cervical approach surgery. Treatment efficacy and safety were compared between the two groups. Results The study group had significantly longer surgical time, less intraoperative blood loss, shorter postoperative extubation time, better thyroid function, higher satisfaction with incision aesthetics, and lower postoperative complications compared to the control group （P<0.05）. Conclusion Lateral cervical approach radical thyroidectomy is a safe and effective surgical method, which is of great significance for the treatment of thyroid cancer. It features small surgical trauma and low incidence of postoperative complications, improves thyroid function while ensuring the effect of tumor treatment, and also takes into account the aesthetic needs of patients. References | Related Articles | Metrics

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Effect of modified Roux-en-Y gastrojejunostomy on postoperative gastrointestinal function in patients with gastric cancer surgery WANG Jian 2024, 13 (4):  334-337.  doi: 10.3969/j.issn.2095-378X.2024.04.015 Abstract ( 81 )   PDF (1270KB) ( 102 )   Save Objective To explore the application of modified Roux-en-Y gastrojejunostomy in gastric cancer surgery and its impact on gastrointestinal function. Methods A retrospective study was conducted on 152 gastric cancer patients admitted to the General Surgery Department of Xiangzhou District People's Hospital in Xiangyang City from January 2020 to January 2023. They were divided into two groups with 76 patients in each group based on different surgical methods. The control group was treated with open surgery and Billroth Ⅰ anastomosis, while the observation group was treated with open surgery and modified Roux-en-Y anastomosis. The serum tumor marker levels [carcinoembryonic antigen （CEA）, carbohydrate antigen 19-9 （CA19-9）, carbohydrate antigen 125 （CA125）, alpha-fetoprotein （AFP）] before and after surgery, postoperative gastrointestinal function indicators, and incidence of complications 6 months after surgery were compared between the two groups. Results After treatment, the serum levels of tumor markers CEA, CA19-9, CA125, and AFP in the two groups were lower than those before treatment （P<0.05）, but no differences were found between the two groups （P>0.05）. After treatment, the observation group had longer postoperative exhaust, bowel sound recovery, first meal intake, and first bowel movement time than the control group （P<0.05）. There was no statistically significant difference in the overall incidence rate of complications such as anastomotic leakage, infection, gastric bleeding, intestinal obstruction, gastric paralysis, physical deterioration, and poor surgical incision healing between the two groups of patients （P>0.05）. Conclusion The modified Roux-en-Y gastrojejunostomy for patients undergoing gastric cancer surgery does not increase the incidence of adverse reactions. However, it has a greater impact than Billroth Ⅰ anastomosis on the gastrointestinal tract of patients. In clinical practice, appropriate surgical methods should be selected based on the patient's condition to improve prognosis. References | Related Articles | Metrics

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Clinical diagnostic value of endocervical curettage applied in colposcopy for cervical cancer screening CHEN Jing 2024, 13 (4):  338-341.  doi: 10.3969/j.issn.2095-378X.2024.04.016 Abstract ( 69 )   PDF (1232KB) ( 103 )   Save Objective To predict cervical cancer patients by endocervical curettage （ECC） during colposcopy, and evaluate the accuracy and diagnostic efficacy of ECC. Methods A total of 631 patients who underwent colposcopy and cervical biopsy with simultaneous ECC due to abnormal results of cervical cancer screening between January 2020 and October 2023 were selected as study subjects, and the histopathological results and ECC results were analyzed. Results According to the histopathological results, 22 cases of cervical cancer, 4 cases of adenocarcinomas, 66 cases of low-degree lesions, and 59 cases of high-degree lesions were detected in the 631 patients. With histopathological results as the gold standard, the accuracy of ECC in cervical cancer screening was 97.78%, the sensitivity was 81.82%, the specificity was 98.36%, the positive predictive value was 64.29%, the negative predictive value was 99.34%, and the Kappa=0.709; the accuracy of ECC in cervical intraepithelial lesion screening was 92.23%, the sensitivity was 88.00%, the specificity was 93.33%, the positive predictive value was 77.46%, the negative predictive value was 96.76%, and the Kappa=0.774. The results suggested good agreement of ECC with pathological examination results. Conclusion The use of ECC in colposcopy has great application value in early screening of cervical cancer patients, and this method can improve the sensitivity of early screening and reduce the rate of missed diagnosis, thereby reduce the morbidity and mortality of cervical cancer. References | Related Articles | Metrics

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Clinical effect of one-time radical operation on perianal abscess in children LIN Bixian 2024, 13 (4):  342-344.  doi: 10.3969/j.issn.2095-378X.2024.04.017 Abstract ( 64 )   PDF (1259KB) ( 79 )   Save Objective To study the clinical effect of one-time radical operation on perianal abscess in children. Methods Seventy-five children with perianal abscess diagnosed and treated from January 2019 to December 2022 were selected and divided into a radical group （n=38） and a conservative group （n=37） according to random number table method. The conservative group was treated with conservative treatment, and the radical group was treated with one-time radical operation. The therapeutic effective rate, perianal function, complications, and other data were collected and analyzed. Results There was no significant difference in the therapeutic effective rate between the two groups （P>0.05）. There was no significant difference in perianal function scores before treatment, and after different treatments, the perianal function scores decreased in both groups, with no statistical difference between the two groups （P>0.05）. The complication incidence rate in the conservative group was lower than that in the radical group （P<0.05）. Conclusion In the treatment of children with perianal abscess, one-time radical surgery has the same effect as conservative treatment, but the risk of complications caused by conservative treatment is lower, so the conservative treatment is recommended to use in clinical treatment. References | Related Articles | Metrics

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Effect of sleeve gastrectomy on obesity-mediated male reproductive dysfunction CHEN Weiling, XIANG Jun, LE Wei, WANG Yanqiu 2024, 13 (4):  345-349.  doi: 10.3969/j.issn.2095-378X.2024.04.018 Abstract ( 67 )   PDF (3154KB) ( 72 )   Save Obesity is a major factor leading to hypertension, hyperlipidaemia and diabetes, as well as one of the causes of male reproductive dysfunction, such as male obesity secondary hypogonadism （MOSH）, reduced sperm quality, and reduced quality of sexual life. For practical reasons, bariatric surgery is becoming increasingly accepted, and it is most effective in severely obese patients. Sleeve gastrectomy, as the mainstay of minimally invasive bariatric surgery today, has the advantages of low perioperative risk and good postoperative weight loss effect. This paper reviewed the effect of sleeve gastrectomy on obesity-mediated male reproductive dysfunction, with the aim of providing more references for the clinical application of bariatric surgery. References | Related Articles | Metrics

Medical instrument

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Evaluation of reducing nurses' management time on medical consumables for laparoscopic cholecystectomy through quality control circle activities ZHANG Qiong, JING Zijie, QIAN Huan, SHAO Lei 2024, 13 (4):  350-353.  doi: 10.3969/j.issn.2095-378X.2024.04.019 Abstract ( 64 )   PDF (1441KB) ( 56 )   Save Objective To evaluate the application value of quality control circle （QCC） activities in reducing the management time of medical consumables for laparoscopic cholecystectomy （LC） among nurses. Methods A QCC project team consisting of 9 relevant personnel was established, and the theme of the QCC activities was “Reduce the management time of LC medical consumables among nurses”. Using the inspection method, the average management time of LC medical consumables among nurses was identified. Through the fishbone diagram, the causes were analyzed, and the true causes were identified. After formulating countermeasures, the Deming cycle method was used to implement corrective measures. Results The QCC activities improved the sense of responsibility, happiness, enthusiasm, cohesion, harmony, communication and cooperation, quality control methods, and problem-solving abilities of the team members. The management time of medical consumables in the operating room was reduced from 11.7 min to 5 min, a reduction of 52.3%. Conclusion Through QCC activities, the management time of LC medical consumables among nurses is significantly shortened, with enhanced ability to quality control. The application of QCC in the field of improving consumables management during surgery is relatively rare, and this article can provide a useful reference for solving similar problems. References | Related Articles | Metrics

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Difficulties and countermeasures in operating room medical equipment management SHEN Shixin 2024, 13 (4):  354-357.  doi: 10.3969/j.issn.2095-378X.2024.04.020 Abstract ( 123 )   PDF (1261KB) ( 84 )   Save Objective To analyze the problems existing in the daily management of surgical equipment and make relevant improvement plans to further strengthen the management of surgical equipment. Methods By analyzing the operation equipment failures in the past three years, the imperfections of the process of new equipment acceptance and use training were listed. At the same time, in view of the causes of equipment failure （such as human factors in daily use）, the failure rate of surgical equipment during surgery was reduced through management methods such as acceptance and use training of surgical equipment as well as subcontracted equipment management mode with room as a unit. Results The failure rates of all kinds of surgical equipment decreased obviously, and the annual maintenance and detection rates of the equipment increased gradually. Conclusion Strengthening the management of surgical equipment not only provides a strong guarantee for the smooth development of each operation, but also has positive significance for avoiding the occurrence of adverse events related to equipment. References | Related Articles | Metrics

Nursing

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Clinical effect of seamless nursing care based on mind mapping on patients undergoing renal stone surgery WANG Hongjin, TAN Xiao, LIU Junhong, XIAO Pengxia 2024, 13 (4):  358-361.  doi: 10.3969/j.issn.2095-378X.2024.04.021 Abstract ( 70 )   PDF (1297KB) ( 103 )   Save Objective To explore the clinical effect of seamless nursing on patients undergoing kidney stone surgery using mind mapping. Methods A total of 256 postoperative patients with kidney stones from January 2021 to December 2023 were selected and randomly divided into an observation group and a control group by random number table method, with 128 cases in each group. The control group received routine care, while the observation group received seamless care based on mind mapping. Clinical indicators, complications, quality of life, psychological resilience, and nursing evaluation were compared between the two groups. Results The five indicators including operation time in the observation group were lower than those in the control group （P<0.05）. The proportion of patients with five complications such as wound infection in the observation group was 2.34%, which was lower than that in the control group （8.59%）（P<0.05）. The eight scores of the Medical Outcomes Study 36-Item Short-Form Health Survey （SF-36） in the observation group were higher than those in the control group （P<0.05）. The three scores of the Connor-Davids on Resilience Scale （CD-RISC） in both the observation group and the control group increased after nursing compared with those before nursing, and the observation group was higher than the control group （P<0.05）. The five evaluation scores including basic nursing in the observation group were higher than those in the control group （P<0.05）. Conclusion The method for the observation group can accelerate the restoration of various indicators to normal after surgery, reduce the occurrence of complications, and improve overall quality of life, which is worthy of promotion and application. References | Related Articles | Metrics

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Impact of nursing quality management on infection control in digestive endoscopic therapy ZENG Chuyun 2024, 13 (4):  362-364.  doi: 10.3969/j.issn.2095-378X.2024.04.022 Abstract ( 64 )   PDF (1244KB) ( 82 )   Save Objective To evaluate the effect of nursing quality management on infection control in digestive endoscopic therapy. Methods A total of 50 patients from January to December 2023 were selected and divided into an observation group （25 cases） and a control group （25 cases） by random number table method. The patients in the control group received routine nursing intervention, and the patients in the observation group received nursing quality management on the basis of routine nursing. The infection rate and the pass rates of digestive endoscopy-related infection monitoring indicators after designed digestive endoscopic treatment were compared between the two groups. Results The infection rate in the observation group （0） was significantly lower than that in the control group （16%） after nursing quality management （P<0.05）. The pass rates of digestive endoscopy-related infection monitoring indicators in the observation group were significantly higher than those in the control group（P<0.05）. Conclusion The application of nursing quality management in digestive endoscopic therapy can reduce the infection rate of patients and further improve the efficiency and quality of medical intervention, which is worthy of promotion. References | Related Articles | Metrics

Case report

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A case of idiopathic mesenteric phlebosclerosis JIANG Yuanxi, TENG Shifeng, ZENG Yu, XU Jichong, XU Shuchang 2024, 13 (4):  365-368.  doi: 10.3969/j.issn.2095-378X.2024.04.023 Abstract ( 65 )   PDF (8849KB) ( 45 )   Save Idiopathic mesenteric phlebosclerosis is a rare intestinal ischemic disease with non-specific clinical manifestations. Colonoscopy typically shows ischemia in the right colon, and CT scans typically reveal linear calcification in the mesenteric veins and their branches. While the exact cause and mechanism of the disease are not yet clear, there is some evidence suggesting a link to the damage to the vessel wall caused by geniposide. Sharing the diagnostic and treatment experience of this patient can help raise clinical awareness of idiopathic mesenteric phlebosclerosis, leading to fewer misdiagnoses. References | Related Articles | Metrics