Objective To explore the nutritional status of radical gastrectomy patients during the late course of chemotherapy and its main influencing factors, providing reference for the development of targeted nursing intervention. Methods The Scored Patient-Generated Subjective Global Assessment, The Chemotherapy Side Effects of Patients with Gastric Cancer Questionnaire were used to collect clinical data that received complete chemotherapy after radical surgery from September 2014 to March 2016. Results A total of 103 cases finally involved in this study. The incidence of malnutrition in patients during pre-chemotherapy and late course of chemotherapy was 45.63%(47/103) and 73.79%(76/103) respectively, and there was significant difference (χ2=16.97, P<0.05). The nutritional assessment score, the hemoglobin levels and body mass index of patients pre-chemotherapy was (3.64±0.78) points, (124.11± 21.78) g/L, (21.29±2.77) kg/m2 , (8.07±3.75) points, (108.54±11.68) g/L, (20.29±2.68) kg/m2 late course of chemotherapy and there were significant differences(t =-11.74, 6.39, 2.63, all P<0.05). The symptom of depression was at a higher level 65.05%(67/103), patients with anorexia in late course of chemotherapy accounted as much as 75.73%(78/103). Logistic regression analysis showed that educational level, loss of appetite and parenteral nutrition were the main factors which influenced the nutritional status of patients during the late course of chemotherapy. Conclusions With the increase in the number of chemotherapy, the nutritional status of the patient is getting worse. The study suggests medical personnel should pay more attention to the patients with low educational level, give patients and their families targeted diet counseling, correct the mistaken conceptions thus enhance their understanding of dietary knowledge. Strengthening the management of complications during chemotherapy, reducing the adverse factors that affect the patient′s nutritional status to improve the nutritional status of patients.

Objective To investigate the nutritional status of patients with chemotherapy after radical gastrectomy and to provide dietary guidance and nutritional support for patients in time. Methods Patients who received chamotherary after radical gastrectomy inthe Gastrointestinal Surgery of the First Affiliated Hospital of Zhengzhou University from September 2014 to March 2016 were included in the study. The nutritional status was assessed by unified training investigators within 48 h after hospitalization. The questionnaires of Scored Patient-Generated Subjective Global Assessment (PG-SGA) and the Chemotherapy Side Effects of Patients with Gastric Cancer Questionnaire were used to investigatethe patients by trained investigators. Results The scores of the nutritional status of patients with different stages of chemotherapy were 6.107 ± 2.947, 6.505 ± 3.134, 8.068 ± 3.748, which was statistically significant (F=10.202, P<0.01). The incidence of anorexia was the highest rate of diet-related symptoms, the rate of early, mid-term and later chemotherapy rates were 34.95%(36/103), 56.31%(58/103), and 75.73%(78/103) respectively. Patients acquired the diet knowledge mainly from medical staff. The proportions of early, middle and later stages of chemotherapy were 92.23% (95/103), 79.61% (82/103), 75.73%(78/103). Conclusions With the increase of chemotherapy times, the nutritional status of patients with radical gastrectomy is getting worse. The results suggested that medical staff should provide an effective basis dietary guidance in time, improving the patients′nutritional status and clinical outcomes.

Objective To explore the correlation between ITGA6 gene (rs12621278, G), MSMB gene (rs10993994, T), chromosome 8q24 (rs10086908, T) and prostate cancer (PCa) in Beijing residents, and to explore the correlation between genotype and phenotype in PCa patients. Methods PCa patient phenotypes were collected including clinical, genetic, dietary habits, hobbies and blood samples. ITGA6 gene (rs12621278, G), chromosome 8q24 (rs10086908, T) and MSMB gene (rs10993994, T) compared the allele distribution between 112 PCa and 91 healthy control age matched patients. The genotype and phenotype analysis was conducted in the 2 groups. Results Between the case and control groups, only rs10993994, T of MSMB gene (case 56.4%,control 46.2%) was significantly different (P=0.001; OR=1.97, 95%CI:1.28-3.04). The rs10086908, T of 8q24 (case 83.5%, control 79.2%) and rs12621278, G of ITGA6 gene (case 27.2%, control 27.0%) were not significantly associated with PCa in the study sample (P>0.05). Quantitative trait analysis showed that the disease duration of ITGA6 risk genotypes (G/G,1.40±0.55 years) in PCa patients was significantly shorter (P=0.003) than the other genotype carriers (A/G, 4.38±3.10 years; A/A, 2.37±1.84 years). Conclusion The genetic variation in MSMB is possibly associated with PCa susceptibility, suggesting that MSMB genes might be associated with PCa in a Chinese population.

Objective To investigate the indications and complications of onlay island flap urethroplasty in hypospadias.Methods Retrospective analysis 51 cases who received the onlay urethroplasty from Mar.2005 to Sep.2012 at the First Affiliated Hospital of Guangxi Medical University.Their ages were from 2 years to 12 years,the median age was 4 years and 3 months.Forty-three cases received the operation for the first time,8 cases were re-operation.The prepuce island flaps were implemented in all cases.Factors which contributed to the successful operation ratio were compared,such as the levels of penile curvature,the lengths of urethral defects,first operation or reoperation,the size of glans.Results The operation achievement ratio was 82.4％ (42/51 cases).There were 7 cases urethrocutaneous fistula(6 cases were then cured by reoperation,1 case healed naturally).One case had urinary meatus had retraction.There was another case with persisting penile curvature.Some differences in factors had no statistical significance,such as the levels of penile curvature,the lengths of urethral defects,first operation or reoperation (x2 =0.249,0.287,1.208 ; all P ＞ 0.05).The difference in glans size had statistical significance (x2 =3.393,P ＜ 0.05).Conclusions Onlay urethroplasty was suitable for the cases of coronary sulcus of penis and extremitas anterior penis,but for proximal cases,this therapy must be applied very carefully because of persisting penile curvature.For some reconstruction cases,Onlay urethroplasty was suitable,but the island flap must be designed flexibly.Urethrocutaneous fistula was the most complication,especially in some small flat glans.

Objective To observe the influence of nutrition cognition and behavior intervention of family caregivers on nutritional status of gastric cancer patients during chemotherapy. Methods We selected 100 patients who received complete chemotherapy at the Department of gastrointestinal surgery from September 2015 to February 2017.Each patient selected 1 family caregiver.It was divided into the control group and the intervention group by the draw method.The control group carried out routine nursing measures.The intervention group carried out nutritional cognitive behavior intervention.The effects of cognitive behavior intervention were investigated by observing the scores of PG-SGA,albumin, prealbumin in gastric cancer patients and the scores of nutrition knowledge,attitude and practice in family caregivers. Results The scores of nutrition knowledge, attitude and practice of the control group and the intervention group were respectively 44.17 ± 9.35 and 46.50 ± 9.32, and the difference was statistically significant(t=15.02, P<0.05).There was significant difference in PG-SGA score, hemoglobin and BMI in patients with gastric cancer patients (P<0.05). There was no significant difference in the incidence of malnutrition and prealbumin in patients with gastric cancer patients (P>0.05). Conclusion Nutrition cognition and behavior intervention can effectively improve the nutritional cognition of family caregivers, improve the nutritional status of gastric cancer patients during chemotherapy, and promote the rehabilitation of patients with gastric cancer and improve their quality of life.

Objective To investigate and analyze the nutritional knowledge needs and cognitive level of the main family caregivers of patients with gastric cancer. Methods A total of 208 patients who underwent radical resection of gastric cancer and received complete chemotherapy at the Department of gastrointestinal surgery from September 2015 to February 2017 were selected.Each patient selected 1 family caregivers.A questionnaire survey was conducted among 208 family caregivers, including general information, nutritional knowledge needs questionnaire, nutrition knowledge, attitude and practice and so on. Results The total score of nutrition knowledge, attitude and practice among the family caregivers of patients with gastric cancer was (41.11 ± 9.33) points. The score of nutrition knowledge was (6.26 ± 1.87) points. The score of nutrition attitude was (15.45±4.75) points.The score of nutrition practice was (17.47± 4.45) points .There was a significant positive correlation between nutrition knowledge and attitude(r=0.88, P<0.05), knowledge and practice (r=0.766, P<0.01), attitude and practice (r=0.186, P<0.01) by using Pearson correlation.Family caregivers had a strong demand for nutrition knowledge. 37.5％(78/208) of family caregivers chose to cooperate with doctors and nurses to carry out nutrition knowledge. 51.4％(107/208) of family caregivers preferred bedside individualized guidance. Conclusions Family caregivers have a strong demand for nutrition knowledge,but the nutrition cognition level is poor. Health care providers should strengthen the education on patients and family caregivers' knowledge of nutrition, improve the nutrition knowledge level of caregivers and care ability.

Objective To investigate the effect of pelvic floor stabilized structure preservation (PPSS) during robot-assisted laparoscopic radical prostatectomy (RARP)on postoperative continence recovery.Methods From October 2017 to April 2018,86 patients with prostatic cancer who underwent traditional RARP and RARP plus PPSS were included.There were 31 patients in non-PPSS group and 55 patients in PPSS group.In non-PPSS group,patients age was (68.48 ± 7.79) years old,BMI was (24.79 ± 3.05) kg/m2,median prostate volume was 63.54 (53.00-99.36) cm3,clinic T-stage T1-T2,T3,T4 accounted for 49.39％,22.58％,6.45％ and ISUP grade 1,2,3,4,5 accounted for 22.58％,22.81％,12.90％,12.90％,19.35％ respectively.In PPSS group,patients age was (69.53 ± 6.81)years old,BMI was (23.95 ± 3.03) kg/m2,median prostate volume was 73.39 (54.88-94.23) cm3,clinic T-stage T1-T2,T3,T4 accounted for 72.73％,7.27％,3.64％ and ISUP grade 1,2,3,4,5 accounted for 21.82％,18.18％,23.64％,18.18％,10.91％ respectively.The preoperative PSA,BMI,clinical T-stage,ISUP grade,and postoperative hospital days had no significant differences (P ＞ 0.05)between the two groups.Both groups were operated via transperitoneal approach.In the non PPSS group,endo-pelvic fascia and pubic prostate ligament was cut,and dorsal vessel complex was ligated.In PPSS group,the partial endo-pelvic fascia was bluntly pushed to the pelvic wall to preserve tendon arch,and pubic prostate ligament also was preserved without suturing and ligating dorsal vascular complex.The catheter was removed 7 d after RARP.The continence recovery were compared between the two groups,including pad number on the day of I,7,14,30,90 and ICI-Q-SF scores on the day of 30 and 90 after catheter removal.Results There was no significant difference in pad numbers used between the two groups on the day of 1,7,14,30 after catheter removal.On the 90th day,the proportions of using pad ≥4 in PPSS group were significantly lower than those in non-PPSS group (1.89％ vs.20.69％,P =0.004).No significant difference was found in ICI-Q-SF scores on the 30th and 90th day between the two groups.Univariate analysis showed that PPSS group used less pads than non-PPSS group on the 90th day [OR =0.07(95％ CI 0.01-0.65),P =0.019];T3 patients used more pads than T1-T2 patients [OR =9.19 (95％ CI 1.32-63.87),P =0.025].After adjusting for age,ISUP grading,T staging,and PSA,multivariate regression analysis showed that the risk of using pad ≥ 4 in PPSS group compared with non-PPSS group was 0.46,0.34,0.27,0.25,and 0.03 on the day of 1,7,14,30 and 90 after catheter removal,respectively.The PPSS approach didn't increase the risk of positive surgical margin.Conclusions Preservation of pelvic stabilized structure in RARP is very efficient in term of continence rate after RARP,and it does not increase the risk of positive surgical margin.

Objectives:To examine the functional outcomes of robot-assisted radical prostatectomy (RARP) with preservation of pelvic floor stabilized structure and early elevated retrograde liberation of the neurovascular bundle (PEEL).Methods:This study was a retrospective cohort study. Between June 1, 2022, and March 20, 2023, 27 cases of RARP with PEEL and 153 cases of RARP with preservation of pelvic floor stabilized structure (PPSS) were included in this study. All patients were males, aged (62.5±5.2) years (range: 50 to 73 years). There were 18 cases of ≤T2b stage and 9 cases of T2c stage. After 1∶1 propensity score matching, the postoperative functional outcomes of 27 cases of RARP with PEEL and 27 cases of RARP with PPSS were compared. All surgeries were performed by a single surgeon and included patients were clinically staged as cT1-2N0M0 without preoperative urinary incontinence or erectile dysfunction. In RARP with PEEL, the prostate was cut near the midline at the front when dissecting the neurovascular bundle, dissection was performed between the visceral layer of the pelvic fascia and the prostatic fascia, preserving the parietal layer and the visceral layer of the pelvic fascia, and the neurovascular bundle was retrogradely released from the apex. The cumulative probability curve was plotted using the Kaplan-Meier method and the Log-rank test was used to compare the differences in functional outcomes between the two groups. Univariate and multivariate analysis with the Cox proportional hazards model was used to compare postoperative urinary continence and sexual function.Results:The recovery time of continence and potency was significantly longer in the PPSS group than in the PEEL group (all P<0.05). The continence rate of the PEEL group was significantly higher than that of the PPSS group (92.59% vs. 68.10%, P=0.026) at 3 months after surgery. The potency rate of the PEEL group was also significantly higher than that of the PPSS group (40.70% vs. 15.10%, P=0.037) at 3 months after surgery. In the univariate analysis, compared to the PPSS technique, the PEEL technique was associated with a shorter recovery time of continence ( HR=1.94, 95% CI: 1.08 to 3.48, P=0.027) and a shorter recovery time of potency ( HR=2.06, 95% CI: 1.03 to 4.13, P=0.042). In the multivariate analysis, the PEEL technique was an independent prognosis factor for postoperative recovery of continence ( HR=2.05, 95% CI: 1.01 to 4.17, P=0.047) and potency ( HR=3.57, 95% CI: 1.43 to 8.92, P=0.007). All the cases of the PPSS group and the PEEL group were performed successfully with negative surgical margins. Conclusion:Compared with PPSS, PEEL may be more conducive to the recovery of urinary continence and sexual function after RARP.

Objectives:To examine the functional outcomes of robot-assisted radical prostatectomy (RARP) with preservation of pelvic floor stabilized structure and early elevated retrograde liberation of the neurovascular bundle (PEEL).Methods:This study was a retrospective cohort study. Between June 1, 2022, and March 20, 2023, 27 cases of RARP with PEEL and 153 cases of RARP with preservation of pelvic floor stabilized structure (PPSS) were included in this study. All patients were males, aged (62.5±5.2) years (range: 50 to 73 years). There were 18 cases of ≤T2b stage and 9 cases of T2c stage. After 1∶1 propensity score matching, the postoperative functional outcomes of 27 cases of RARP with PEEL and 27 cases of RARP with PPSS were compared. All surgeries were performed by a single surgeon and included patients were clinically staged as cT1-2N0M0 without preoperative urinary incontinence or erectile dysfunction. In RARP with PEEL, the prostate was cut near the midline at the front when dissecting the neurovascular bundle, dissection was performed between the visceral layer of the pelvic fascia and the prostatic fascia, preserving the parietal layer and the visceral layer of the pelvic fascia, and the neurovascular bundle was retrogradely released from the apex. The cumulative probability curve was plotted using the Kaplan-Meier method and the Log-rank test was used to compare the differences in functional outcomes between the two groups. Univariate and multivariate analysis with the Cox proportional hazards model was used to compare postoperative urinary continence and sexual function.Results:The recovery time of continence and potency was significantly longer in the PPSS group than in the PEEL group (all P<0.05). The continence rate of the PEEL group was significantly higher than that of the PPSS group (92.59% vs. 68.10%, P=0.026) at 3 months after surgery. The potency rate of the PEEL group was also significantly higher than that of the PPSS group (40.70% vs. 15.10%, P=0.037) at 3 months after surgery. In the univariate analysis, compared to the PPSS technique, the PEEL technique was associated with a shorter recovery time of continence ( HR=1.94, 95% CI: 1.08 to 3.48, P=0.027) and a shorter recovery time of potency ( HR=2.06, 95% CI: 1.03 to 4.13, P=0.042). In the multivariate analysis, the PEEL technique was an independent prognosis factor for postoperative recovery of continence ( HR=2.05, 95% CI: 1.01 to 4.17, P=0.047) and potency ( HR=3.57, 95% CI: 1.43 to 8.92, P=0.007). All the cases of the PPSS group and the PEEL group were performed successfully with negative surgical margins. Conclusion:Compared with PPSS, PEEL may be more conducive to the recovery of urinary continence and sexual function after RARP.

Objective:To investigate the theoretical knowledge level of clinical nurses engaged in enterostomy nursing in secondary and tertiary general hospitals in Henan Province, so as to provide the basis for departments to carry out specialized training and improve the quality of enterostomy special nursing.Methods:On the basis of literature review and expert letter consultation, enterostomy knowledge test for clinical nurses was formed, including the dimensions of enterostomy special nursing and patient health education. Using the convenient sampling method, clinical nurses who engaged in enterostomy-related nursing work in 39 secondary and tertiary general hospitals in Henan Province were selected as the research objects from February to May 2019. The enterostomy knowledge test for clinical nurses was used to investigate enterostomy specialized knowledge of nurses, and their scores were analyzed by single factor analysis. In this study, a total of 420 tests were issued and 382 valid tests were effectively recovered, with an effective recovery rate of 90.95%.Results:The total score of the enterostomy knowledge test of 382 nurses was (65.80±13.84) , the total score of enterostomy special nursing dimension was (32.17±7.12) , and the total score of patient health education dimension was (33.64±7.66) . 62.83% (240/382) of nurses basically mastered the knowledge of enterostomy. In the enterostomy knowledge test for clinical nurses, the error rates of prevention and identification of complications, management of complications and clinical selection and application of stoma bag were relatively high. There were statistically significant differences in the scores of the enterostomy knowledge test among nurses of different hospital levels, highest educational background, technical title, working time limit and the time limit of engaging in enterostomy nursing work ( P<0.05) . Conclusions:Professional nurses engaged in enterostomy nursing do not have a comprehensive grasp of enterostomy related knowledge, so the departments should pay more attention to special nursing training of enterostomy and improve overall level of enterostomy nursing in the department.