Objective To investigate the effect of two chemotherapeutic regimens suitable for elderly ad -vanced non-small cell lung cancer(NSCLC).Methods A total of 58 elderly advance nonsmall cell lung cancer pa-tients randomized into two group:single-agent group and combined group .Single-agent group received gemcitabine 1 000mg/m2 at Days 1 and 8 for a 21 day cycle.Combined group received gemcitabine 1 000mg/m2 at Days 1 and 8 in combination earboplatin AUC 5 at Day 2 for a 21 day cycle .All patients in the two groups received 3 cycles of chemotherapeutic regimens.Results Of the single-agent group,complete remission (CR) in 1 cases,partial remis-sion (PR) in 12 cases, the effective rate was 46.4%,and of the combined group,CR in 1 cases,PR in 13 cases,the effective rate was 50.0%,there was no statistically significant difference between the two groups (P>0.05).Of the single-agent group,the median survival time was 9.7 months,1-and 2-year survival rates were 31.3%,12.5%,re-spectively,and of the combined group ,the median survival time was 10.1 months,1-and 2-year survival rates were 33.8%,15.6%,respectively,there were no statistically significant difference between the two groups (χ2 =1.743, 1.529,1.739,all P>0.05).The leutropenia and thrombocytopenia incidence of 3 to 4 grade in the combined group was 50.0%,46.4%,respectively,which were significantly higher than 28.6%and 18.0%in the single-agent group (χ2 =4.41,4.69,all P<0.05).Lung Cancer Symptom Scale scores showed:after the treatment,the anorexia,fatigue and pain scores of the single-agent group improved significantly compared with pre-treatment ( t =2.687,2.789, 2.603,all P<0.05),whereas no significant improvement in the combined group;After the treatment,three symptom scores of the single-agent group were significantly higher than those of the combined group (t=2.986,3.569,2.764, all P<0.05).Conclusion Single-agent gemeitabine regimen efficacy is comparable with that of combined regimen for elderly advanced NSCLC with less adverse effects .

Objective To evaluate the necessity of indwelling gastrointestinal decompression after gastrectomy. Methods Eight publications on the necessity of gastrointestinal decompression after gastrecomy were colleted, data on recovery time of gastrointestinal function and hospital stay, complications,and motality were Meta-analyzed using fixed effect model and random effect model. Results Eight randomized trails including 975 patients were qualified and included in this study. The differences in time to oral intake ( WMD =0. 61, 95% CI: 0. 17 - 1.05, P ＜ 0. 05 ) and hospital stay ( WMD = 1.20, 95% CI:0. 05 -2. 36, P ＜ 0. 05 ) between the decompression group and non-decompression group were statistically significant, but the difference in time to flatus (WMD = 0. 31,95% CI: -0. 07- 0. 69, P ＞ 0. 05 ) was not significant. There were no significant differences in complications such as nausea and vomiting ( OR = 1.43,95% CI: 0. 61 - 3.31, P ＞ 0. 05 ), pulmonary infection and atelectasis ( OR = 1.43, 95 % CI: 0. 82 - 2. 49,P＞0.05), anastomotic leakage (OR = 1.17, 95%CI: 0.54-2.49, P ＞0.05), abdominal abscess ( OR = 1.08, 95% CI: 0. 50 - 2. 34, P ＞ 0. 05 ), wound dehiscence ( OR = 1.47, 95% CI: 0. 43 - 4. 95,P ＞ 0. 05 ) between the two groups, except for fever ( OR = 1.76, 95% CI: 1.11 - 2. 78, P ＜ 0. 05 ), which was found more frequent in decompression group than in non-decompression group. Conclusions Routine gastrointestinal decompression after gastrectomy was not conductive to the recovery of gastrointestinal function, and could not reduce the incidence of postoperative complications. Postoperative GI decompression increased fever incidence rate and prolonged hospital stay.

Objective To investigate the clinical characteristics of upper respiratory tract infection in hospita-lized children with mental disorders,and to analyze the risk factors for nosocomial infection,so as to provide reference for clinical treatment and prevention and control of nosocomial infection(NI). Methods The NI of 1 587 hospitalized children at the Second Affiliated Hospital of xinxiang Medical University from January to December 2016 was investiga-ted and a retrospective study was conducted on 78 hospitalized children with nosocomial upper respiratory tract infec-tion. In a ratio of 1: 2,the patients with mental disorders during the same time at hospital,without the occurrence of hospital infection,with same gender and same age group,were selected as the control group,then the univariate regres-sion analysis and multivariate conditional Logistic regression analysis were carried out. Results Of the 1 587 cases,86 cases were NI,and the incidence of NI infection was 5. 42%. Among them,the upper respiratory tract infection accoun-ted for 83. 87%(78 cases). Univariate conditional Logistic regression analysis indicated that the type of disease,hospi-talization days,insight,rehabilitation activities,hand hygiene habits,self -support ability,eating habits,management mode,seasonal and environmental conditions were the risk factors for upper respiratory tract infection in hospitalized children with mental disorders(all P<0. 05). Multivariate analysis showed that the odds ratio( OR)of autumn and winter,poor self-support ability,no insight,poor hand hygiene habits,longer hospitalization days( over 14 d),severe mental illness were 19. 627( 5. 391 -23. 518 ),12. 835( 3. 436 -18. 715 ),5. 427( 1. 879 -16. 921 ),3. 752 (1. 743-16. 864),3. 618( 1. 659 -12. 671 ),3. 361( 1. 478 -10. 527 ),respectively,which were significantly associated with the occurrence of upper respiratory infection,and the differences were statistically significant( all P<0. 05). Conclusions The season,self-support ability,insight,hand hygiene habits,days hospitalization,and disease type are the independent risk factors for upper respiratory infection in hospitalized children with mental disorders,posi-tively controlling and eliminating of independent risk factors for upper respiratory tract may reduce its incidence in the inpationt children.

Objective To compare the safety and efficacy of the medial approach (MA) and the lateral approach (LA) in the treatment of colorectal disease. Methods Studies published from January 1994 to April 2013 that compared MA to LA in laparoscopic colorectal resection were collected. Publications in English were mainly identified from Medline, Embase, Cochrane Library, and those in Chinese from Wanfang database and CNKI database. Conversion rate, operative time, blood loss, number of harvested lymph nodes, hospital stay, complication, mortality, recurrence, and hospitalization costs of MA and LA were meta-analyzed using fixed-effect and random-effect models. Results Five cohort studies (2 randomized controlled trials and 3 retrospective studies) including 881 patients were enrolled and analyzed. Of these patients, 416 and 465 underwent laparoscopic colorectal resection with MA and LA respectively. As compared to LA, MA had significantly lower conversion rate (OR=0.42, 95%CI:0.25-0.72,P=0.001), shorter operative time(WMD=-52.62, 95%CI:-63.23--42.01, P<0.01), less number of harvested lymph nodes (WMD=-1.17, 95%CI:-1.89--0.45, P=0.001), while blood loss was less and hospitalization cost lower. Significant differences in intraoperative complications and postoperative complications were not found between the two group (OR:0.57, 95%CI:0.15-2.18, P=0.41;OR:0.78, 95%CI:0.52-1.17, P=0.23). Conclusions Compared with LA, MA has the advantages of shorter operative time and lower conversion rate with similar safety. Differences in blood loss, hospitalization cost and oncological safety between the two approaches warrant further investigation.

Objective To compare the safety and efficacy of the medial approach (MA) and the lateral approach (LA) in the treatment of colorectal disease. Methods Studies published from January 1994 to April 2013 that compared MA to LA in laparoscopic colorectal resection were collected. Publications in English were mainly identified from Medline, Embase, Cochrane Library, and those in Chinese from Wanfang database and CNKI database. Conversion rate, operative time, blood loss, number of harvested lymph nodes, hospital stay, complication, mortality, recurrence, and hospitalization costs of MA and LA were meta-analyzed using fixed-effect and random-effect models. Results Five cohort studies (2 randomized controlled trials and 3 retrospective studies) including 881 patients were enrolled and analyzed. Of these patients, 416 and 465 underwent laparoscopic colorectal resection with MA and LA respectively. As compared to LA, MA had significantly lower conversion rate (OR=0.42, 95%CI:0.25-0.72,P=0.001), shorter operative time(WMD=-52.62, 95%CI:-63.23--42.01, P<0.01), less number of harvested lymph nodes (WMD=-1.17, 95%CI:-1.89--0.45, P=0.001), while blood loss was less and hospitalization cost lower. Significant differences in intraoperative complications and postoperative complications were not found between the two group (OR:0.57, 95%CI:0.15-2.18, P=0.41;OR:0.78, 95%CI:0.52-1.17, P=0.23). Conclusions Compared with LA, MA has the advantages of shorter operative time and lower conversion rate with similar safety. Differences in blood loss, hospitalization cost and oncological safety between the two approaches warrant further investigation.

Objective:To explore the application of psychological resilience intervention combined with prospective nursing in patients with free skin flap transplantation to repair skin and soft tissue defects of extremities.Methods:Using the convenient sampling method, a total of 65 patients with soft tissue injury in the skin of extremities after undergoing free skin flap transplantation who were admitted to Henan Provincial People's Hospital from October 2019 to October 2020 were selected. According to the admission time, they were divided into the observation group (34 cases) and the control group (31 cases) . Patients in the observation group received psychological resilience intervention combined with prospective nursing, while patients in the control group only received prospective nursing. The surgical success rate, flap necrosis rate, incidence of vascular crisis and complications were compared between the two groups. Symptom Checklist-90 (SCL-90) was used to evaluate treatment effects of patients in two groups before and after the intervention.Results:There was no statistically significant difference in the surgical success rate, flap necrosis rate and incidence of vascular crisis between the observation group (100.00%, 2.94%, 2.94%) and the control group (96.77%, 12.90%, 16.13%) ( P>0.05) . The observation group had 1 case of deep venous thrombosis (DVT) and 2 cases of other complications, and the control group had 3 cases of pressure injury, 1 case of infection, 2 cases of DVT and 3 cases of other complications. The complication rate in the observation group was 8.82%, which was lower than 29.03% in the control group, and the difference was statistically significant ( P<0.05) . After intervention, the scores of anxiety and paranoia in the observation group were lower than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Psychological resilience intervention combined with prospective nursing has a good application effect on patients with free skin flap transplantation to repair skin and soft tissue defects of extremities. The complication rate is reduced, and mental health of patients is good.

OBJECTIVETo compare the safety and efficacy of the medial approach(MA) and the lateral approach (LA) in the treatment of colorectal disease.

METHODSStudies published from January 1994 to April 2013 that compared MA to LA in laparoscopic colorectal resection were collected. Publications in English were mainly identified from Medline, Embase, Cochrane Library, and those in Chinese from Wanfang database and CNKI database. Conversion rate, operative time, blood loss, number of harvested lymph nodes, hospital stay, complication, mortality, recurrence, and hospitalization costs of MA and LA were meta-analyzed using fixed-effect and random-effect models.

RESULTSFive cohort studies (2 randomized controlled trials and 3 retrospective studies) including 881 patients were enrolled and analyzed. Of these patients, 416 and 465 underwent laparoscopic colorectal resection with MA and LA respectively. As compared to LA, MA had significantly lower conversion rate (OR=0.42, 95%CI:0.25-0.72, P=0.001), shorter operative time (WMD=-52.62, 95%CI:-63.23--42.01, P<0.01), less number of harvested lymph nodes (WMD=-1.17, 95%CI:-1.89--0.45, P=0.001), while blood loss was less and hospitalization cost lower. Significant differences in intraoperative complications and postoperative complications were not found between the two group (OR:0.57, 95%CI:0.15-2.18, P=0.41; OR:0.78, 95%CI:0.52-1.17, P=0.23).

CONCLUSIONSCompared with LA, MA has the advantages of shorter operative time and lower conversion rate with similar safety. Differences in blood loss, hospitalization cost and oncological safety between the two approaches warrant further investigation.