Objective To analyse effects of zinc on immune function in children with infantile pneumonia .Methods A total of 96 children with infantile pneumonia selected from May to July 2014 were randomly divided into zinc supplementary treatment group and routine treatment group ,with 48 cases in each group .Routine treatment group was given conventional treatment ,while the zinc supplementary treatment group was received conventional treatment combined with zinc supplement .The serum level of zinc and immune function were detected before and after treatment ,respectively .Other 40 healthy infants received physical examination were contemporarily selected as healthy control group .Results Before treatment ,the levels of serum zinc ,IgA ,IgM and IgG ,percentages of CD3+ ,CD4+ cells and the CD4+ /CD8+ ratio in the two groups of children with infantile pneumonia were lower than those in the healthy control group ,while percentage of CD8+ cells was lower than that in the healthy control group ,had statistically significant differences(P<0 .05) .While no statistically significant differences of indicators mentioned above were found between the zinc sup‐plementary treatment group and routine treatment group before treatment(P> 0 .05) .After treatment ,the levels of serum zinc , IgA ,IgM and IgG ,percentages of CD3+ ,CD4+ cells and the CD4+ /CD8+ ratio in the zinc supplementary treatment group were higher than those in the routine treatment group ,and percentage of CD8+ cells was lower than that in the routine treatment group , had statistically significant differences(P<0 .05);while compared with the healthy control group ,levels of serum zinc ,IgA ,IgM , IgG were still lower ,had statistically significant differences(P<0 .05) .After treatment ,levels of serum zinc ,IgA ,IgM ,IgG ,per‐centages of CD3+ ,CD4+ cells and the CD4+ /CD8+ ratio in the routine treatment group were still lower than those in the healthy control group ,and percentage of CD8+ cells was still higher than that in the healthy control group ,had statistically significant differences(P<0 .05) .Conclusion Zinc can effectively improve the immune function of children with infantile pneumonia ,which might shorten treatment time and reduce adverse outcomes .

The adhesion in the gallbladder triangle is the most important factor influencing the conversion to laparotomy in laparoscopic cholecystectomy (LC).The degree of adhesion in the cholecystic triangle is closely related to the difficulty of LC operation.With the reduction of cholecystic triangle adhesion,the treatment of gallbladder during LC will be easy and the rate of conversion to laparotomy will decrease accordingly.In order to investigate the causes of cholecystic triangle adhesion and its influence on LC,this paper reviews the current research progress.

Objective To evaluate the use of Thymidine Kinase 1(TK1)in serum as proliferating tumor marker for gas-tric carcinoma and monitoring marker for the response to operation. Methods Serum level of TK1 expression were de-tected with sensitive chemiluminescence dot-blot assay in were available to detect the level of serum TK1 in 35 cases of normal healthy subject and 68 cases of patients with gastric carcinoma, compared with 43 cases of patients with gastric carcinoma pre-and post-operation. Results The level of serum TK1 were elevated in all subgroups of patients with gastric carcinoma compared to the normal healthy subject(P<0.01),serum TK1 was correlated with TNM stage and histological grade,and not with sex and age; the serum TK1 level in stage Ⅳwas higher in comparison with stage Ⅲ,in stage Ⅲit was higher than that in stage II, in stage IIit was higher than that in stage Ⅰ, and in stage Ⅰit was higher than that in normal healthy subject (P<0.01-0.05); Being lower in the well differentiated and moderately dif-ferentiated than the poorly differentiated (P<0.01-0.05), the level of serum TK1 was higher in the cases of poorly differentiated adenocarcinoma, signet ring cell carcinoma and mucoid adenocarcinoma than those in the cases of well differentiated and moderately differentiated adenocarcinoma (P<0.05), the serum TK1 levels remarkably reduced in patients with gastric carcinoma after operation(P<0.01). Conclusion Detection the level of serum TK1 may be larger clini-cal value for cancer diagnosis,predict disease progression and the curative effect in patients with gastric carcinoma.

Objective To investigate the clinical efficacy and safety of nivolumab(PD-1 inhibitor)in combination with lenvatinib and FOLFOX regimen[5-fluorouracil(5-FU),oxaliplatin(L-OHP),and calcium folinate(LV)]in the treatment of intermediate and advanced hepatocellular carcinoma(HCC)via hepatic arterial infusion chemotherapy(HAIC).Methods A total of 160 patients with intermediate and advanced HCC admitted to the Second Affiliated Hospital of Guilin Medical University from January 2021 to January 2023 were randomly divided into the control group and the observation group,with 80 patients in each group,using a random number table.The control group received once-daily oral lenvatinib and intravenous carrizumab infusions for 12 weeks as part of transcatheter arterial chemoembolization(TACE)therapy.The observation group was administered with FOLFOX regimen via HAIC chemotherapy,plus intravenous infusion of carrizumab for 12 weeks and once-daily oral lenvatinib.All the patients were followed up regularly.The clinical efficacy was evaluated using the mRECIST criteria.The objective response rate(ORR),disease control rate(DCR),overall survival(OS),progression-free survival(PFS),and incidence of adverse reactions were compared between the two groups.Results There were no significant differences in the objective response rate and incidence of adverse reactions between the groups.The disease control rate,overall survival,and progression-free survival in the observation group were significantly higher than those in the control group(P<0.05).Conclusions The FOLFOX-HAIC regimen in combination with nivolumab and lenvatinib is safe and effective for the treatment of intermediate and advanced HCC,without adverse reactions.It can prolong the overall survival and progression-free survival,and improve the patient's quality of life.

Background and Aims:Postoperative intra-abdominal infection(PIAI)is a common postoperative complication in abdominal surgery and a challenging issue worldwide,with a treatment failure rate of 68.3％and an in-hospital mortality rate as high as 40.8％.The key to managing this condition is early control of the infection source,debridement and adequate drainage.Delayed control of the infection source is an independent risk factor for predicting treatment failure.Many PIAI lesions are located deep within the abdominal cavity,lacking optimal routes for percutaneous drainage,and the risks and difficulties of reoperation are significant.Thus,controlling the infection source in PIAI is a difficult task.Here,the authors report the management of 4 PIAI patients treated with nephroscopic debridement and catheter irrigation and drainage via the sinus tract,aiming to provide clinical insights and references. Methods:The clinical data of 4 patients undergoing nephroscopic debridement,catheter irrigation and drainage for PIAI from October 2020 to September 2022 in the Department of Hepatobiliary and Pancreatic Surgery of the Second Affiliated Hospital of Guilin Medical University were retrospectively analyzed.Key techniques of nephroscopic management of PIAI were summarized and contextualized with relevant literature. Results:The 4 PIAI cases included a right-sided retroperitoneal abscess after catheter drainage for severe acute pancreatitis,a hepatic abscess at the liver raw surface after right hemihepatectomy,bile leakage and secondary duodenal fistula after laparoscopic choledocholithotomy and T-tube drainage,and a pancreatic abscess at the pancreatic raw surface after distal pancreatectomy with splenectomy.All patients underwent nephroscopic debridement and catheter irrigation and drainage via the sinus tract:guidewires were inserted into the drainage sinus tract,followed by a minimally invasive expansion drainage kit and nephroscopy;pus was irrigated out,and pus moss was clamped out with foreign body forceps under nephroscopy.Then,irrigation drainage tubes were placed under the guidance of the guidewire,and continuous irrigation and drainage were performed.The 4 patients underwent a total of 5 nephroscopic debridement and catheter irrigation and drainage procedures,with one case requiring two operations.The preoperative catheterization time ranged from 14 to 58 d,with an average of 38.4 d.One patient concurrently underwent choledochoscopy for stone extraction and biliary drainage via the T-tube sinus tract.The operative time ranged from 30 to 115 min,with an average of 67.4 min.Aside from one case of minor intraoperative bleeding,which stopped after injecting diluted norepinephrine solution into the sheath and blocking the sheath,there were no surgical complications in the other three cases.The postoperative drainage tube duration ranged from 7 to 30 d,with an average of 20.75 d.After treatment,all PIAI lesions disappeared,and no recurrence was observed during follow-up,which ranged from 16 to 40 months. Conclusion:Nephroscopic debridement and catheter irrigation and drainage via the sinus tract for PIAI is simple,feasible,and safe,allowing for direct visualization to avoid organ damage.It is effective in removing pus and necrotic tissue,replacing drainage tubes,and can be repeatedly performed with high efficiency and remarkable results.This method is particularly suitable for patients with postoperative abdominal drainage tube obstruction combined with encapsulated intra-abdominal fluid collections.