Comparative observation of the effectiveness and safety of remimazolam besylate versus dexmedetomidine in gastrointestinal surgery in obese patients

BACKGROUND Surgery for obese patients carries a higher risk of anesthesia complications compared with surgery for nonobese patients.Thus,a safe and effective anesthesia strategy is necessary to improve the medical experience of such patients and ensure their safety.AIM To compared the effectiveness and safety of remimazolam besylate versus dexmedetomidine(DEX)in gastrointestinal surgery in obese patients.METHODS The study cohort included 60 obese patients undergoing gastrointestinal surgery between July 2021 and April 2023,comprising 30 patients who received DEX intervention(control group)and 30 patients who received remimazolam besylate intervention(research group).Heart rate(HR),respiratory rate(RR),mean arterial pressure(MAP),blood oxygen saturation(SpO_(2)),safety(nausea and vomiting,bradycardia,hypotension,and apnea),anesthesia and examination indices[induction time,anesthesia recovery time,and postanesthesia care unit(PACU)discharge time],sedation effect(Ramsay Sedation Scale),and postoperative pain visual analog scale were comparatively analyzed before anesthesia(T0),during anesthesia(T1),and after anesthesia(T2).RESULTS At T1,the research group showed significantly smaller changes in HR,RR,MAP,and SpO_(2) than the control group,with a significantly lower adverse reaction rate and shorter induction,anesthesia recovery,and PACU discharge times.Additionally,the intra-and postoperative Ramsay Sedation Scale scores were statistically higher in the research group than in the control group.CONCLUSION Remimazolam besylate was significantly more effective than DEX in gastrointestinal surgery in obese patients and had a higher safety profile and value in clinical promotion.

Therapeutic effect of Wendan Decoction combined with mosapride on gastroesophageal reflux disease after esophageal cancer surgery

BACKGROUND Gastroesophageal reflux disease(GERD)is a common complication of esophageal cancer surgery that can affect quality of life and increase the risk of esophageal stricture and anastomotic leakage.Wendan Decoction(WDD)is a traditional Chinese herbal formula used to treat various gastrointestinal disorders,such as gastritis,functional dyspepsia,and irritable bowel syndrome.Mosapride,a prokinetic agent,functions as a selective 5-hydroxytryptamine 4 agonist,enhancing gastrointestinal motility.AIM To evaluate the therapeutic effects of WDD combined with mosapride on GERD after esophageal cancer surgery.METHODS Eighty patients with GERD were randomly divided into treatment(receiving WDD combined with mosapride)and control(receiving mosapride alone)groups.The treatment was conducted from January 2021 to January 2023.The primary outcome was improved GERD symptoms as measured using the reflux disease questionnaire(RDQ).The secondary outcomes were improved esophageal motility(measured using esophageal manometry),gastric emptying(measured using gastric scintigraphy),and quality of life[measured via the Short Form-36(SF-36)Health Survey].RESULTS The treatment group showed a notably reduced RDQ score and improved esophageal motility parameters,such as lower esophageal sphincter pressure,peristaltic amplitude,and peristaltic velocity compared to the control group.The treatment group showed significantly higher gastric emptying rates and SF-36 scores(in both physical and mental domains)compared to the control group.No serious adverse effects were observed in either group.CONCLUSION WDD combined with mosapride is an effective and safe therapy for GERD after esophageal cancer surgery.It can improve GERD symptoms,esophageal motility,gastric emptying,and the quality of life of patients.Further studies with larger sample sizes and longer follow-up periods are required to confirm these findings.

Analysis of the Effect of the Comprehensive Nursing Model on Patients with Moyamoya Disease Undergoing Intracranial and Extracranial Revascularization Surgery

Objective:To explore the effect of a comprehensive nursing model on patients with Moyamoya disease who underwent intracranial and extracranial revascularization surgery.Methods:110 cases were divided into control and observation groups with 55 cases each.The control group received routine perioperative care,and the observation group received perioperative care along with comprehensive nursing care.The two groups’disease cognition levels,anxiety,symptoms,daily living ability scores,and postoperative complication rates were compared.Results:The anxiety score and total postoperative complications of the observation group upon discharge were lower than that of the control group,and the disease cognition level and daily living ability upon discharge were higher than that of the control group(P<0.05).Conclusion:Applying the comprehensive nursing model in conjunction with perioperative care for patients undergoing surgery can effectively improve their anxiety,strengthen activities of daily living,and reduce the risk of postoperative complications.

Practical effect of different teaching modes in teaching gastrointestinal surgery nursing

BACKGROUND With the continuous development and progress of medical technology,the position of surgical nursing in the field of clinical medicine is becoming in-creasingly prominent.As an important branch of the surgical field,the nursing requirements and difficulty of gastrointestinal surgery are also increasing.In order to improve the teaching quality of nursing care in gastrointestinal surgery,many educators and researchers are actively exploring new teaching methods.Among them,the teaching method case-based learning(CBL),scene-simulated learning(SSL),task-based learning(TBL),combining self-evaluation and training mode is considered as an effective method.This method aims to help students to better master knowledge and skills and improve their comprehensive quality by cultivating their self-evaluation ability.AIM To explore the practical effect of CBL-SSL-TBL combined with training mode and student self-assessment in nursing teaching of gastrointestinal surgery.METHODS Seventy-one nursing interns in our hospital from December 2020 to December 2021 were selected.According to different teaching modes,they were divided into observation group CBL-SSL-TBL combined with training mode combined with student self-assessment and control group(conventional teaching mode),of which 36 were in observation group and 35 were in control group.The results of operational skills,theoretical knowledge,nursing students'satisfaction,learning effectiveness questionnaire and teaching effect were compared between the two groups.RESULTS Compared between the two groups,the operational skills and theoretical knowledge scores of the observation group were higher than those of the control group,and the difference was statistically significant(P<0.05).Compared between the two groups,the total satisfaction ratio of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05).Compared between the two groups,the observation group was lower than the control group in the questionnaire results of learning efficacy,and the difference was statistically significant(P<0.05).Compared between the two groups,the proportion of thinking ability,subjective initiative and understanding of theoretical knowledge in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).CONCLUSION The use of CBL-SSL-TBL combined with training mode and student self-assessment in gastrointestinal surgery nursing teaching can improve the operational skills of nursing interns,theoretical knowledge and satisfaction scores of nursing students,improve the results of learning efficiency questionnaire and teaching effect,which can be popularized in clinical teaching.

Effects of lornoxicam combining with fentanyl on postoperative arrhythmia and platelet function in patients with coronary artery disease after abdominal surgery

To investigate the effects of patient-controlled intravenous analgesia (PCIA) with lornoxicam and fentanyl on arrhythmia and the expression of platelet membrane glycoproteins in patients with coronary artery disease (CAD) after abdominal surgery.Methods Eighty ASA Ⅱ or Ⅲ patients with CAD aged 51～66 yrs weighing 59～68 kg presenting for abdominal surgery participated in this study.CAD was diagnosed by clinical symptoms and ischemic changes on ECG.The patients were premedicated with intramuscular henobarbital 0.1 g and scopolamine 0.3 mg.Anesthesia was induced with fentanyl,droperidol,propofol and vecuronium and maintained with propofol,fentanyl and vecuronium.The patients received PCIA after operation.The PCIA solution contained fentanyl 0.9 mg and droperidol 5 mg in 100 ml of normal saline (N.S.) in group A (n=40) or lornoxicam 56 mg,fentanyl 0.2 mg and droperidol 5 mg in 100 ml N.S. in group B (n=40).In group A the loading dose was fentanyl 0.05 mg and group B lornoxicam 4 mg.PCIA included a background infusion at 2 ml·h -1 and a bolus of 0.5 ml with a 15 min lock-out.VAS(0=no pain,10= worst pain) was used to measure pain intensity.In addition to BP,HR and SpO2 monitoring ECG was continuously monitored with a Holter monitor after operation.Blood samples were taken from peripheral vein before and 6 h after operation and on the 1st,2nd,7th and 8th postoperative days for determination of the expression of CD 62p ,CD 63 and CD 41 /CD 61 on the platelet membrane,platelet count,prothrombin time (PT) thrombin time (TT) and partial thromboplastin time (PTT).Results The two groups were comparable with respect to sex,age,body weight,severity of CAD,duration of operation and intraoperative blood loss.The patients received no blood transfusion during operation.There was no significant difference in VAS score,platelet count,PT,TT and PTT between the two groups.The incidence of atrial and ventricular premature beat on ECG and the expression of CD 41 /CD 61 ,CD 62p and CD 63 on the platelet membrane were significantly lower in group B than in group A on the 7th and 8th postoperative days(P<0.05 or 0.01).Conclusion Postoperative PCIA with lornoxicam and fentanyl can more effectively reduce the incidence of postoperative arrhythmia in patients with CAD.Suppression of activation of platelets by lornoxicam may contribute to the mechanism.10 refs,3 tabs.

Long-term effectiveness,outcomes and complications of bariatric surgery

Dietary imbalance and overeating can lead to an increasingly widespread disease-obesity.Aesthetic considerations aside,obesity is defined as an excess of adipose tissue that can lead to serious health problems and can predispose to a number of pathological changes and clinical diseases,including diabetes;hypertension;atherosclerosis;coronary artery disease and stroke;obstructive sleep apnea;depression;weight-related arthropathies and endometrial and breast cancer.A body weight 20%above ideal for age,gender and height is a severe health risk.Bariatric surgery is a set of surgical methods to treat morbid obesity when other treatments such as diet,increased physical activity,behavioral changes and drugs have failed.The two most common procedures currently used are sleeve gastrectomy and gastric bypass.This procedure has gained popularity recently and is generally considered safe and effective.Although current data show that perioperative mortality is low and better control of comorbidities and short-term complications is achieved,more randomized trials are needed to evaluate the long-term outcomes of bariatric procedures.This review aims to synthesize and summarize the growing evidence on the long-term effectiveness,outcomes and complications of bariatric surgery.

Evaluation of the Clinical Efficacy of Full Femtosecond Laser Surgery in the Treatment of Myopia

Objective:To evaluate the clinical effect of full femtosecond laser surgery in the treatment of myopia patients.Methods:120 myopia patients admitted to our hospital from January 2022 to June 2023 were selected.According to the random number table method,60 patients in the observation group underwent full femtosecond laser surgery,and 60 patients in the control group underwent femtosecond laser-assisted in situ keratomileusis(FS-LASIK)surgery.The clinical effects of the two groups were compared.Results:10 days postoperatively and 6 months after operation,the visual acuity level of the observation group was higher than that of the control group,the postoperative corneal asphericity coefficient and corneal full-thickness were lower than those of the control group,and the total effective rate 6 months after operation was higher than that of the control group(P<0.05).Conclusion:Full femtosecond laser surgical treatment can improve the postoperative visual acuity of patients with myopia,enhance the corneal asphericity coefficient(Q)and corneal full-thickness,and exert significant clinical effects.

The Effectiveness of Group Cooperative Learning Method in Badminton Teaching in Colleges and Universities

In college badminton teaching,teachers utilize the group cooperative learning method,which not only helps to improve students’badminton skill level but also cultivates their teamwork spirit,communication skills,and self-management ability unconsciously.In view of this,this paper mainly describes the significance of applying the group cooperative learning method in college badminton teaching,analyzes the current problems in college badminton teaching,and aims to discover effective development strategies for group cooperative learning method in college badminton teaching in order to improve the effectiveness of college badminton teaching.

Analgesic Effect of Combined Spinal-Epidural Anesthesia and its Effect on TNF-α and CRP Levels in Elderly Patients with Hip Fracture During Surgical Treatment

Objective:To observe the analgesic effect of combined spinal and epidural anesthesia on older patients undergoing hip fracture surgery.Method:One hundred and twenty elderly hip fracture surgery patients treated in our hospital from January 2021 to December 2022 were selected and randomly divided into two groups,with 60 cases in the experimental group and 60 in the control group.The experimental group was given combined spinal-epidural anesthesia intervention measures,while the control group was given epidural anesthesia intervention measures.The analgesic effect,tumor necrosis factor-alpha(TNF-α),C-reactive protein(CRP)levels,and other observation indicators were analyzed after anesthesia intervention.Result:After the intervention,the analgesic effect and the evaluation results of the subjects in the experimental group were better than those in the control group(P<0.05);the obtained values of TNF-αand CRP levels in the experimental group were higher than those of the control group(P<0.05).Conclusion:The combined spinal-epidural anesthesia intervention demonstrated positive outcomes.The analgesic effect of patients during surgery and their inflammatory factor levels improved,which makes this intervention worthy of clinical application and promotion.

Impact of taxes on the 2030 Agenda for Sustainable Development:Evidence from Organization for Economic Cooperation and Development(OECD)countries

Multiple ecological and socioeconomic problems have occurred worldwide,raising the awareness of sustainability.This study aims to examine the impact of taxes on Sustainable Development Goals(SDGs)in the context of Organization for Economic Co-operation and Development(OECD)countries.This research used effective average tax(EAT),tax on personal income(TPI),tax on corporate profits(TCP),and tax on goods and services(TGS)as the variables of taxes,and employed secondary data from 38 OECD countries covering 2000–2021.The study also used Breusch-Pagan Lagrange Multiplier(LM),Pesaran Scaled LM,Bias-Corrected Scaled LM,and Pesaran Cross-sectional dependence(CSD)tests to analyze the existence of crosssectional dependency.Then,we established the stationarity of variables through second-generation panel unit root tests(Cross-sectional Augmented Dickey-Fuller(CADF)and Cross-sectional Im,Pesaran,and Shin(CIPS)),and confirmed the long-run cointegration of the variables by using secondgeneration panel cointegration test(Westerlund cointegration test).The results showed that EAT,TPI,TCP,and TGS are positively associated with SDGs.However,the change in TPI has a smaller effect on SDGs than the change in EAT or TCP or TGS.The result of panel causality indicated that EAT,TPI,and TGS have a unidirectional causal relationship with SDGs.The study also found that TCP has a bi-directional causal relationship with SDGs.Moreover,the finding indicated that the OECD countries need to focus on tax policies to achieve the 2030 Agenda for Sustainable Development.This study is based on the theory of optimal taxation(TOT),which suggests that tax systems should be designed to maximize social welfare.Finally,we suggests the importance of taking a comprehensive approach for the managers and policy-makers when analyzing the impact of taxes on SDGs.

Plasma MMP-2 and MMP-7 levels are elevated first month after surgery and may promote growth of residual metastases

BACKGROUND MMP-2 also known as gelatinase A and MMP-7(matrilysin)are members of the zinc-dependent family of MMPs(Matrix metalloproteinase).MMP-2 and MMP-7 are remodeling enzymes that digest extracellular matrix;MMP-2 is extensively expressed during development and is upregulated at sites of tissue damage,inflammation,and in stromal cells of metastatic tumors.MMP-7 is expressed in the epithelial cells and in a variety of cancers including colon tumors.Plasma MMP-2 and MMP-7 levels were assessed before and after minimally invasive colorectal resection for cancer pathology.AIM To determine plasma MMP-2 and MMP-7 levels before and after minimally invasive colorectal resection for cancer pathology.METHODS Patients enrolled in a plasma bank for whom plasma was available were eligible.Plasma obtained from preoperative(Preop)and postoperative blood samples was used.Only colorectal cancer(CRC)patients who underwent elective minimally invasive cancer resection with preop,post-operative day(POD)1,3 and at least 1 late postop sample(POD 7-34)were included.Late samples were bundled into 7 d blocks(POD 7-13,14-20,etc.)and treated as single time points.Plasma MMP-2 and MMP-7 levels were determined via enzyme-linked immunosorbent assay in duplicate.RESULTS Total 88 minimally invasive CRC resection CRC patients were studied(right colectomy,37%;sigmoid,24%;and LAR/AR 18%).Cancer stages were:1,31%;2,30%;3,34%;and 4,5%.Mean Preop MMP-2 plasma level(ng/mL)was 179.3±40.9(n=88).Elevated mean levels were noted on POD1(214.3±51.2,n=87,P<0.001),POD3(258.0±63.9,n=80,P<0.001),POD7-13(229.9±62.3,n=65,P<0.001),POD 14-20(234.9±47.5,n=25,P<0.001),POD 21-27(237.0±63.5,n=17,P<0.001,)and POD 28-34(255.4±59.7,n=15,P<0.001).Mean Preop MMP-7 level was 3.9±1.9(n=88).No significant differences were noted on POD 1 or 3,however,significantly elevated levels were noted on POD 7-13(5.7±2.5,n=65,P<0.001),POD 14-20(5.9±2.5,n=25,P<0.001),POD 21-27(6.1±3.6,n=17,P=0.002)and on POD 28-34(6.8±3.3,n=15 P<0.001,)vs preop levels.CONCLUSION MMP-2 levels are elevated for 5 wk and MMP-7 levels elevated for weeks 2-6.The etiology of these changes in unclear,trauma and wound healing likely play a role.These changes may promote residual tumor growth and metastasis.

Analgesic effects of low -dose trama dol after arthroscopic knee surgery

Objective To investigate analgesic effect of i ntra -articular low -dose tramadol a fter arthroscopic knee surgery.Methods60patients undergoing arthroscopic k nee surgery under lumbar anesthesia were randomly divided into intra -ar ticular injection of tramadol(TJ group),mulscle injection of tramadol(TM)and saline control group.Vision analog scoring was conducted under exte nsion of knee joint 8h and24h after drugs administration.Follow -up was done to observe unwanted e ffects 48h after surgery.Results Score of TJ group was significantly lower than those of other groups(P <0.05).No unwanted effects were found.Conclusion Intra -articular tramadol in low -dose could relieve operative pain.

Reduction effect of bacterial counts by preoperative saline lavage of the stomach in performing laparoscopic and endoscopic cooperative surgery

AIM:To investigate the effects of gastric lavage with2000 mL of saline in laparoscopic and endoscopic cooperative surgery.METHODS:Twenty two patients who were diagnosed with a gastric gastrointestinal stromal tumor were enrolled.In former term,irrigations of the stomach were conducted whenever it was necessary,not systematically(Non systemic lavage group).In latter term,the stomach was thoroughly cleaned with 2000 mL of saline using an endoscope with a water jet,and Duodenal balloon occlusion was conducted to prevent refluxedbile and pancreatic juice(Systemic lavage+balloon occlusion group).The gastric wall was sprayed with 20mL of distilled water,and 20 mL of gastric juice was collected in a sterile tube and submitted for culture.20mL of ascites was also collected from the laparoscopic ports and submitted for culture.We compared WBC,CRP,BT between two groups,and verify the reduction effect of bacterial counts in Systemic lavage+balloon occlusion group.RESULTS:WBC count before,1 d after,and 3 d after laparoscopic and endoscopic cooperative surgery(LECS)were 5060(95%CI:4250-9640),12140(6050-14110),and 6910(5320-12520)in Non systemic lavage group,4400(3660-7620),8910(6480-10980),and 5950(4840-7860)in Systemic lavage+balloon occlusion group.Significant differences between two groups at the day after LECS(P=0.029)and the 3 d after LECS(P=0.042).CRP levels in Non systemic lavage group and in Systemic lavage+balloon occlusion group were significantly different at the day after LECS(P=0.005)and the 3 d after LECS(P=0.028).BTs(℃)in Non systemic lavage group and in Systemic lavage+balloon occlusion group were also significantly different at the day after LECS(P=0.004)and the 3 d after LECS(P=0.006).In a logarithmic comparison,bacterial load before gastric lavage,after lavage,and ascites culture were 6.08(95%CI:4.04-6.97),0.48(0-0.85),and 0.21(0-0.56).The bacterial counts before and after gastric lavage were significantly suppressed(P=0.007),but no significant difference between gastric juice culture after lavage and ascites(P=0.154).CONCLUSION:Pre-LECS lavage with 2000 mL of saline exhibited a bacteria-reducing effect equivalent to disinfectants and obtained favorable results in terms of clinical symptoms and data.

Non-exposed endoscopic wall-inversion surgery with one-step nucleic acid amplification for early gastrointestinal tumors:Personal experience and literature review

BACKGROUND Laparoscopic and endoscopic cooperative surgery is a safe,organ-sparing surgery that achieves full-thickness resection with adequate margins.Recent studies have demonstrated the safety and efficacy of these procedures.However,these techniques are limited by the exposure of the tumor and mucosa to the peritoneal cavity,which could lead to viable cancer cell seeding and the spillage of gastric juice or enteric liquids into the peritoneal cavity.Non-exposed endoscopic wallinversion surgery(NEWS)is highly accurate in determining the resection margins to prevent intraperitoneal contamination because the tumor is inverted into the visceral lumen instead of the peritoneal cavity.Accurate intraoperative assessment of the nodal status could allow stratification of the extent of resection.One-step nucleic acid amplification(OSNA)can provide a rapid method of evaluating nodal tissue,whilst nearinfrared laparoscopy together with indocyanine green can identify relevant nodal tissue intraoperatively.AIM To determine the safety and feasibility of NEWS in early gastric and colon cancers and of adding rapid intraoperative lymph node(LN)assessment with OSNA.METHODS The patient-based experiential portion of our investigations was conducted at the General and Oncological Surgery Unit of the St.Giuseppe Moscati Hospital(Avellino,Italy).Patients with early-stage gastric or colon cancer(diagnosed via endoscopy,endoscopic ultrasound,and computed tomography)were included.All lesions were treated by NEWS procedure with intraoperative OSNA assay between January 2022 and October 2022.LNs were examined intraoperatively with OSNA and postoperatively with conventional histology.We analyzed patient demographics,lesion features,histopathological diagnoses,R0 resection(negative margins)status,adverse events,and follow-up results.Data were collected prospectively and analyzed retrospectively.RESULTS A total of 10 patients(5 males and 5 females)with an average age of 70.4±4.5 years(range:62-78 years)were enrolled in this study.Five patients were diagnosed with gastric cancer.The remaining 5 patients were diagnosed with early-stage colon cancer.The mean tumor diameter was 23.8±11.6 mm(range:15-36 mm).The NEWS procedure was successful in all cases.The mean procedure time was 111.5±10.7 min(range:80-145 min).The OSNA assay revealed no LN metastases in any patients.Histologically complete resection(R0)was achieved in 9 patients(90.0%).There was no recurrence during the follow-up period.CONCLUSION NEWS combined with sentinel LN biopsy and OSNA assay is an effective and safe technique for the removal of selected early gastric and colon cancers in which it is not possible to adopt conventional endoscopic resection techniques.This procedure allows clinicians to acquire additional information on the LN status intraoperatively.

Effectiveness of enhanced recovery after surgery in the perioperative management of patients with bone surgery in China

BACKGROUND Enhanced recovery after surgery(ERAS)was introduced in China in 2007.Over time,the scope of ERAS has expanded from abdominal surgery to orthopedics,urology and other fields.Continuous development and research has contributed to progress of ERAS in China.In 2019,to promote the application of ERAS in bone tumor surgery,we formed the“Consensus of Experts on Perioperative Management of Accelerated Rehabilitation in Major Surgery of Bone Tumors in China”.AIM To evaluate the effect of enhanced recovery after bone tumor surgery in perioperative management in China.METHODS One hundred and seven patients who underwent bone tumor surgery at the Second Affiliated Hospital of Xi’an Jiaotong University between May 2019 and April 2021 were randomized into a study group(53 cases)and a control group(54 cases).The study group adopted the ERAS protocol and the control group adopted conventional care.Main outcome measures included postoperative length of stay(LOS),postoperative complications,mortality,and 30-d readmission rates.Secondary outcomes included postoperative visual analog scale(VAS)score of pain,number of blood transfusions,drainage volume in 24 h after operation,patient satisfaction 30 d after discharge,VAS score at 30 d after discharge,and daily standing walking time.RESULTS There were no significant differences in the baseline data,clinical features and surgical site between the two groups.The LOS in the study group with the ERAS protocol was 7.72±3.34 d compared with 10.28±4.27 d in the control group who followed conventional care.The incidence of postoperative nausea and vomiting(PONV)in the study group was 19%and 37%in the control group.The VAS scores of pain on postoperative day 1(POD1)and POD3 in the study group were 4.79±2.34 and 2.79±1.53 compared with 5.28±3.27 and 3.98±2.27 in the control group.The drainage volume in 24 h after the operation was 124.36±23.43 mL in the study group and 167.43±30.87 mL in the control group.The number of blood transfusions in the study group was also lower.The patient satisfaction rate was higher in the study group than in the control group.CONCLUSION The ERAS protocol in the perioperative period of bone tumor surgery can decrease LOS,PONV,and postoperative pain,blood transfusion and 24-h drainage,improve patient satisfaction and accelerate recovery.

Establishment and application of eye surgery preparation room

This paper aims to discuss the application of eye surgery preparation room( ESPR),also called eye preoperative holding area,in nursing safety assessment and the surgery preparation before ophthalmologic operation. The establishment and application of ESPR optimizes the process of ophthalmologic surgery as w ell as decreases the surgery-w aiting time of patients and turnover period of surgical operations,w hich improves the utilization efficiency of surgery operating room. In addition,the application of ESPR also guarantees the safety of patients during surgical operations and enhances the doctors' satisfaction of cooperation and coordination in surgery operating room.

Poverty Reduction Effects of China’s Aid and Investment to Developing Countries

The Chinese approach to poverty reduction is a government-led and marketbased approach that gives priority to infrastructure and combines fiscal subsidy with development as an antidote to poverty.These characteristics are also evident in China’s cooperation with other developing countries on poverty reduction.China supports other developing countries to reduce poverty via aid and investment mainly in the field of infrastructure.While the government and SOEs take the lead in foreign aid and investment,China also invites other sources of capital to participate in market-based development in partnership with recipient countries.Our empirical research finds that aid and investment from China are generally conducive to reducing poverty incidence in recipient developing countries,but their poverty reduction effects vary across different types of aid and investment.The elements characteristic of the Chinese approach to poverty reduction proved to be effective in helping other developing countries reduce poverty as well.Nevertheless,the effectiveness of aid and investment in reducing poverty is subject to the governance and market efficiency of recipient countries.In order for the Chinese experience to work in less developed countries,future cooperation on poverty reduction must put a premium on governance and market systems.

Comparison of laparoscopic and open surgery for pyogenic liver abscess with biliary pathology

AIM:To investigate the feasibility and therapeutic effect of laparoscopic surgery for pyogenic liver abscess(PLA) with biliary pathology.METHODS:From January 2004 to October 2010,31 patients with PLA combined with biliary pathology meeting entry criteria received surgical management in our hospital.Of the 31 patients,13 underwent laparoscopic surgery(LS group) and 18 underwent open surgery(OS group).Clinical data including operation time,intraoperative blood loss,postoperative complication rate,length of postoperative hospital stay,and abscess recurrence rate were retrospectively analyzed and compared between the two groups.RESULTS:All patients received systemic antibiotic therapy.Four patients underwent ultrasound-guided percutaneous catheter drainage before operation.Postoperative complications occurred in 5 patients(16.1%,5/31) including 2 in the LS group and 3 in the OS group.One patient had retained calculus in the common bile duct and another had liver abscess recurrence in the OS group.No retained calculus and liver abscess recurrence occurred in the LS group.In the two groups,there was no mortality during the perioperative period.There were no significant differences in operation time,intraoperative blood loss and transfusion,postoperative complication rate and abscess recurrence rate between the two groups.Oral intake was earlier(1.9 ± 0.4 d vs 3.1 ± 0.7 d,P < 0.05) and length of postoperative hospital stay was shorter(11.3 ± 2.9 d vs 14.5 ± 3.7 d,P < 0.05) in the LS group than in the OS group.CONCLUSION:Laparoscopic surgery for simultaneous treatment of PLA and biliary pathology is feasible in selected patients and the therapeutic effect is similar to that of open surgery.

The Effects of Humanized Psychological Nursing Model in General Surgery Nursing

Objective:To analyze and comprehensively study the clinical effects of humanized psychological nursing model in general surgery nursing.Methods:The study period was from January 2018 to December 2020.A sample of 200 patients who were admitted to The Second People's Hospital of Taizhou City for general surgery were selected.Random lottery grouping was used to divide the subjects into a study group and a control group.The sample within each group was n=100.The patients in the control group were provided with conventional general surgery nursing plan whereas the patients in the study group received the same nursing plan but with addition of the humanized psychological nursing model.The indicators of the two groups were compared and analyzed.Results:Comparing the scores from Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale(HAMD)after nursing intervention,postoperative visual analog scale(VAS),hospital stay,and patient satisfaction with the nursing services between the two groups,the study group was better(P<0.05).Conclusion:The implementation of humanized psychological nursing model in general surgery nursing had a significant effect in which there were improvements in regard to the patientsJ mental state and their satisfaction with the nursing services.Hence,it is worthy of promotion.

Present situation of minimally invasive surgical treatment for early gastric cancer

Minimally invasive surgery is a kind of surgical operation,which is performed by using professional surgical instruments and equipment to inactivate,resect,repair or reconstruct the pathological changes,deformities and wounds in human body through micro-trauma or micro-approach,in order to achieve the goal of treatment,its surgical effect is equivalent to the traditional open surgery,while avoiding the morbidity of conventional surgical wounds.In addition,it also has the advantages of less trauma,less blood loss during operation,less psychological burden and quick recovery on patients,and these minimally invasive techniques provide unique value for the examination and treatment of gastric cancer patients.Surgical minimally invasive surgical techniques have developed rapidly and offer numerous options for the treatment of early gastric cancer(EGC):endoscopic mucosal resection(EMR),underwater EMR(UEMR),endoscopic submucosal dissection(ESD),endoscopic full-thickness resection(EFTR),endoscopic submu-cosal excavation(ESE),submucosal tunnel endoscopic resection,laparoscopic and endoscopic cooperative surgery(LECS);Among them,EMR,EFTR and LECS technologies have a wide range of applications and different modific-ations have been derived from their respective surgical operations,such as band-assisted EMR(BA-EMR),conven-tional EMR(CEMR),over-the-scope clip-assisted EFTR,no-touch EFTR,the inverted LECS,closed LECS,and so on.These new and improved minimally invasive surgeries are more precise,specific and effective in treating different types of EGC.