Objective:To analyze the effect of laparoscopic cholecystectomy on quality of life index and liver function in patients with cholecystolithiasis.Methods:The clinical data of 160 patients with cholecystolithiasis in Zhejiang Wenzhou Tianning Hospital from January 2015 to January 2018 were retrospectively analyzed. Among them, 80 patients were treated with small incision cholecystectomy (control group), and 80 patients were treated with laparoscopic cholecystectomy (observation group). The operation time, bowel movement recovery time, visual analogue score (VAS) 24 h after operation, quality of life index, total bilirubin (TBIL), direct bilirubin (DBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST), C reactive protein (CRP) and tumor necrosis factor α (TNF-α) were compared between 2 groups.Results:The operation time, bowel movement recovery time and VAS 24 h after operation in observation group were significantly lower than those in control group: (57.8 ± 8.4) min vs. (89.8 ± 10.5) min, (25.3 ± 4.8) h vs. (38.8 ± 6.2) h and (7.33 ± 1.05) scores vs. (9.18 ± 1.85) scores, and there were statistical differences ( P<0.05). The quality of life index 1, 6 and 12 months after operation in observation group was significantly higher than that in control group: (113.2 ± 8.9) scores vs. (108.6 ± 7.4) scores, (126.9 ± 10.2) scores vs. (115.9 ± 9.3) scores and (134.3 ± 10.1) scores vs. (123.0 ± 8.1) scores, and there was statistical difference ( P<0.05). The CRP, TNF-α, DBIL, TBIL, AST and ALT 3 and 7 d after operation in observation group were significantly lower than those in control group, and there were statistical differences ( P<0.05). Conclusions:Laparoscopic cholecystectomy is effective in treating cholecystolithiasis and can effectively reduce the quality of life index and liver function.

Objective To investigate the effect of endoscopic minimally invasive surgery on thyroid tumors,and its influence on serum interleukin-6 (IL-6),cortisol (Cor) and norepinephrine (NE).Methods Eighty-two patients with thyroid tumors admitted to Tianning Hospital of Wenzhou from January 2016 to January 2019 were randomly divided into laparoscopic group (41 cases) and traditional group (41 cases) according to the digital table.Traditional thyroidectomy was performed in the traditional group,and laparoscopic minimally invasive surgery was performed in the laparoscopic group.The operative indicators and complications,pain at 24 and 48 hours after operation,and serum levels of IL-6,Cor and NE before and after operation were compared between the two groups.Results The amount of bleeding during operation [(25.46 ±7.82)mL] and the amount of drainage after operation[(73.24 ± 13.25) mL] in the laparoscopic group were less than those in the traditional group [(53.21 ± 9.97) mL and (107.38 ± 16.52)mL],the length of incision [(3.04 ± 0.45) cm] in the laparoscopic group was shorter than that in traditional group [(7.18 ±0.76) cm],and the operation time [(67.84 ± 15.46) min] in the laparoscopic group was shorter than that in traditional group [(98.73 ±25.31) min],the differences were statistically significant(t =14.023,10.323,30.014,6.669,all P ＜ 0.05).The incidence of postoperative complications in the laparoscopic group (4.88 ％) was lower than that in the traditional group (26.83 ％) (x2 =7.405,P ＜ 0.05).The VAS scores of the laparoscopic group at 24h [(3.64 ±0.82) points] and 48h [(2.53 ±0.57) points] after operation were lower than those of the traditional group [(5.37 ± 1.29) points and (3.70 ± 0.81) points] (t =7.247,7.564,all P ＜0.05).The serum levels of IL-6,Cor and NE in the two groups at 24 hours after operation were higher than those before operation (all P ＜ 0.05).The serum levels of IL-6 [(49.98 ± 10.21) ng/L],Cor [(125.63 ±17.68)ng/mL] and NE [(167.86 ± 13.42) ng/L] in the laparoscopic group 24 hours after operation were lower than those in the traditional group [(83.25 ± 14.62) ng/L,(167.51 ± 25.47)ng/mL and (209.81 ± 17.86) ng/L](t =11.947,8.649,12.024,all P ＜ 0.05).Conclusion Endoscopic minimally invasive surgery is effective in the treatment of thyroid neoplasms,which has little effect on stress response and can relieve pain and reduce postoperative complications.

Background: Acute pancreatitis (AP) is a common acute abdominal disease in clinical practice. Severe AP (SAP) usually progresses rapidly, leading to systemic inflammatory response syndrome, multiple organ failure, and even death. Early identification of severe cases with timely and effective treatment can improve patient's prognosis and reduce mortality. Aims: To explore the value of single and combined detection of C-reactive protein (CRP), interleukin-6 (IL-6) and procalcitonin (PCT) in the early assessment of severity of AP. Methods: A total of 472 AP patients hospitalized in Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine from January 2018 to December 2020 were enrolled retrospectively. The laboratory data within 48 h of admission were extracted, and the patients were allocated into mild AP (MAP) group and SAP group (including moderately severe and severe AP) according to the 2012 revised Atlanta classification. The differences of CRP, IL-6 and PCT between the two groups were statistically analyzed, and the value of single and combined detection of the three indicators for predicting the disease severity was determined by ROC curve analysis. Results: The levels of CRP, IL-6 and PCT in SAP group were significantly higher than those in MAP group (all P< 0.05). ROC curve analysis revealed that the area under the curve (AUC) of single, two and three indicators combined for predicting SAP was all higher than 0.7, which represented a moderately diagnostic accuracy. Three indicators combined demonstrated the highest diagnostic accuracy (AUC=0.826); with an optimal cut-off value, the sensitivity and specificity were 71.4% and 79.3%, respectively. Conclusions: CRP, IL-6 and PCT are meaningful in early assessment of severity of AP. The overall diagnostic value of combined detection of three indicators is superior to single and two indicators combination in predicting SAP.