Objective:To evaluate a transhiatal tunnel flap designed to reconstruct the cardiac functional structure in proximal gastric cancer patients in our center.Methods:A descriptive case study method was used to select the data of 11 patients undergoing surgery for upper gastric cancer from Jan to Jul 2024. After laparoscopic dissection is completed, the esophagus is transected 2 cm from the upper edge of the tumor and the specimen is removed. The distance from the lower edge of the tumor is 5 cm. The cutting width is 4 cm, and the length of sleeve distal stump stomach is 20 cm. A seromuscular flap tunnel was made with a length of 2 cm and a width of 2 cm, 2 cm away from the top of the remnant stomach. The digestive tract was reconstructed using the Overlap hybridization method.Results:The median operation time was 175 (139-285) minutes. The median muscle flap production time and reconstruction time was 10.5 (5.5-21.0) minutes and 15.0 (11.8-33.6) minutes, respectively. The median blood loss is 50 (20-100) ml. The median postoperative hospitalization was 8 (6-25) days. The median tumor size was 2.5 (1.0-4.0) cm, and 31 (15-52) lymph nodes were dissected. The median follow-up after surgery was 3.5 (0.7-6.0) months, and no tumor recurrence or metastasis was found. Postoperative anastomotic leakage (Clavien-Dindo grade Ⅱ) occurred in one case, and there was no perioperative death. The Visick score of the whole group was 1 point in 8 cases and 2 points in 3 cases, and there was no anastomotic stenosis. Reflux esophagitis (Los Angeles classification grade B) was found in 1 case after gastroscopy, and the symptoms were relieved by conservative treatment.Conclusion:The transhiatal tunnel flap arthroplasty method has high surgical safety, low reconstruction difficulty, and an reliable anti-reflux effect.

Objective:To evaluate a transhiatal tunnel flap designed to reconstruct the cardiac functional structure in proximal gastric cancer patients in our center.Methods:A descriptive case study method was used to select the data of 11 patients undergoing surgery for upper gastric cancer from Jan to Jul 2024. After laparoscopic dissection is completed, the esophagus is transected 2 cm from the upper edge of the tumor and the specimen is removed. The distance from the lower edge of the tumor is 5 cm. The cutting width is 4 cm, and the length of sleeve distal stump stomach is 20 cm. A seromuscular flap tunnel was made with a length of 2 cm and a width of 2 cm, 2 cm away from the top of the remnant stomach. The digestive tract was reconstructed using the Overlap hybridization method.Results:The median operation time was 175 (139-285) minutes. The median muscle flap production time and reconstruction time was 10.5 (5.5-21.0) minutes and 15.0 (11.8-33.6) minutes, respectively. The median blood loss is 50 (20-100) ml. The median postoperative hospitalization was 8 (6-25) days. The median tumor size was 2.5 (1.0-4.0) cm, and 31 (15-52) lymph nodes were dissected. The median follow-up after surgery was 3.5 (0.7-6.0) months, and no tumor recurrence or metastasis was found. Postoperative anastomotic leakage (Clavien-Dindo grade Ⅱ) occurred in one case, and there was no perioperative death. The Visick score of the whole group was 1 point in 8 cases and 2 points in 3 cases, and there was no anastomotic stenosis. Reflux esophagitis (Los Angeles classification grade B) was found in 1 case after gastroscopy, and the symptoms were relieved by conservative treatment.Conclusion:The transhiatal tunnel flap arthroplasty method has high surgical safety, low reconstruction difficulty, and an reliable anti-reflux effect.

Objective:To evaluate the safety and feasibility of the laparoscopic indocyanine green (ICG) fluorescence imaging during the sentinel node navigational surgery for the early gastric cancer.Methods:Patients with <4 cm early gastric cancer were chosen. 0.5 ml ICG (2.5 mg/ml) was preoperatively injected into submucosa around the lesion in four points by the endoscopy. The sentinel lymph node basin including the stained tissue and lymph node (LN) were completely resected guided by the fluorescence mapping under ICG laparoscopy. The specimen was inspected by frozen pathology section. The radical gastrectomy was dependent on the pathology result.Result:Between 2019 and 2021, a total of 18 patients were included in the final analysis. Most tumors (16/18) located in the middle or distal stomach. Median tumor size was 2.0 cm. Lymph vessel invasion was revealed in five cases and perineural invasion in three cases. According to AJCC tumor grading system, tumor depth was classified as Tis in 2 cases, T1a in 5 cases and T1b in 11 cases. Lymph node metastasis (LNM) was revealed in four patients (4/18, 22%). Median sentinel lymph node basins per patient were 2 (range, 1-5). An average 6 (range, 2-13) LNs were harvested in each case, including 6 (1-13) ICG stained LNs and 1 (0-5) non stained LNs. All of four LNM patients were detected by sentinel node navigational surgery. The rate of the sensitivity and accuracy were 100% and 100%, respectively. The median follow-up for the entire group was 58.3 months (0.3-59.9 months), with no recurrence or metastasis observed in any patient.Conclusion:The sensitivity and accuracy of the laparoscopic indocyanine green fluorescence imaging during the sentinel node navigational surgery were satisfactory.

Objective:To explore the symptom clusters, core symptoms and bridging symptoms in the symptom network of early postoperative patients with laryngeal cancer.Methods:From January 2021 to April 2024, convenience sampling was used to select early postoperative patients with laryngeal cancer admitted to the Department of Otolaryngology at the First Affiliated Hospital of the University of Science and Technology of China as participants. The General Information Questionnaire and M.D. Anderson Symptom Inventory-Head & Neck were used for the survey. R language software was used to analyze symptom clusters, core symptoms, and bridging symptoms in early postoperative patients with laryngeal cancer.Results:A total of 300 questionnaires were distributed and 287 valid questionnaires were collected, with a valid response rate of 95.7%. Network analysis extracted three symptom clusters (oropharyngeal specific symptom cluster, shortness of breath and fatigue symptom cluster, and sleep emotion symptom cluster), among which the oropharyngeal specific symptom cluster was the most severe. Symptom network analysis showed a strong correlation between oropharyngeal pain and swallowing difficulties, distress and fatigue, and restless sleep and sadness. Shortness of breath exhibited the highest intensity centrality ( rs=1.29) and mediation centrality ( rb=96) in the symptom network. It was the core symptom and bridging symptom in the symptom network of early postoperative patients with laryngeal cancer. Conclusions:Early postoperative patients with laryngeal cancer have a severe oropharyngeal-specific symptom cluster, with shortness of breath being the core symptom and bridging symptom in the symptom network. Medical and nursing staff should focus on the mutual influence between early symptoms of patients after laryngectomy and correctly identify core symptoms and bridging symptoms to improve symptom management accuracy.

Objective:To explore the symptom clusters, core symptoms and bridging symptoms in the symptom network of early postoperative patients with laryngeal cancer.Methods:From January 2021 to April 2024, convenience sampling was used to select early postoperative patients with laryngeal cancer admitted to the Department of Otolaryngology at the First Affiliated Hospital of the University of Science and Technology of China as participants. The General Information Questionnaire and M.D. Anderson Symptom Inventory-Head & Neck were used for the survey. R language software was used to analyze symptom clusters, core symptoms, and bridging symptoms in early postoperative patients with laryngeal cancer.Results:A total of 300 questionnaires were distributed and 287 valid questionnaires were collected, with a valid response rate of 95.7%. Network analysis extracted three symptom clusters (oropharyngeal specific symptom cluster, shortness of breath and fatigue symptom cluster, and sleep emotion symptom cluster), among which the oropharyngeal specific symptom cluster was the most severe. Symptom network analysis showed a strong correlation between oropharyngeal pain and swallowing difficulties, distress and fatigue, and restless sleep and sadness. Shortness of breath exhibited the highest intensity centrality ( rs=1.29) and mediation centrality ( rb=96) in the symptom network. It was the core symptom and bridging symptom in the symptom network of early postoperative patients with laryngeal cancer. Conclusions:Early postoperative patients with laryngeal cancer have a severe oropharyngeal-specific symptom cluster, with shortness of breath being the core symptom and bridging symptom in the symptom network. Medical and nursing staff should focus on the mutual influence between early symptoms of patients after laryngectomy and correctly identify core symptoms and bridging symptoms to improve symptom management accuracy.

Objective:To explorethe effect of acceptance and commitment therapy on self-disclosure, coping style and post-traumatic growth in patients with ovarian cancer undergoing chemotherapy after surgery.Methods:A total of 84 patients with ovarian cancer undergoing chemotherapy after surgery were recruited from the gynecology ward of the First Affiliated Hospital of University of Science and Technology of China for randomized controlled trial, from February 2022 to October 2022. All participants were divided into the intervention group and the control group with 42 patients in each group by random number table method. The patients in control group received routine care. The intervention group was given acceptance and commitment therapy (ACT) on the basis of the control group and intervened for three cycles of chemotherapy. The scores of Distress Disclosure Index (DDI), Cancer Coping Modes Questionnaire (CCMQ), and Post-Traumatic Growth Inventory (PTGI) were compared between the two groups before and after intervention.Results:There was no significant difference in the scores of DDI, CCMQ and PTGI between the two groups before intervention ( P>0.05). After intervention, DDI scorein intervention group was (38.81 ± 5.96) points, significantly higher than that in control group (34.43 ± 4.79) points, the difference was statistically significant ( t = 3.71, P<0.01). In terms of coping styles, after intervention, the scores of five dimensions of fantasy, resignation, avoidance, catharsis and confrontation were 6.00(6.00, 8.00), 9.00(8.00, 12.00), 9.00(8.75, 11.00), 7.00(6.00, 8.00) and 20.00(16.00, 21.00) points in the invention group, compared with the control group of 8.00(7.75, 9.00), 11.00(9.75, 13.00), 11.00(9.00, 13.00), 9.00(8.00, 12.00) and 16.00(13.00, 18.50) points, the differences were statistically significant ( Z = 2.86 to 5.11, all P<0.01). The total PTGI score in intervention group was (71.43 ± 8.68) points, significantly higher than that in control group(63.98 ± 6.92) points, the difference was statistically significant ( t = 4.35, P<0.01). Conclusions:ACT can increase self-disclosure, enhance positive coping, and promote post-traumatic growth in ovarian cancer patientsundergoing chemotherapy after surgery.

【Objective】 To perform quantitative analysis on the sample provincial laws and regulations for voluntary blood donation, and provide reference for further revision of laws and regulations. 【Methods】 31 study samples were current provincial laws and regulations for voluntary blood donation that can be collected from open sources. The issue date and the revision date of each sample were recorded. With "The Blood Donation Law of the People’s Republic of China" as reference, 5 categories were formed and additional clauses in samples were coded and rated following content analysis procedures. Sample provinces were divided into two groups based on donation rate and their differences in evaluation scores of categories were examined using rank sum test. 【Results】 Until December, 2021, 31 sample provinces had issued and implemented provincial laws and regulation for voluntary blood donation, and 14 of which had been revised. Many detailed clauses (total score 9.32±3.09) were added in sample provincial laws and regulations, more clauses were added in the categories of 'related government agencies and their responsibilities’, 'management of clinical blood use’ and 'rewards and punishment’. Sample provinces were divided into two groups according to the donation rate per 1 000 people recommended by World Health Organization(10‰). Compared to lower donation rate group, the total score and sub score in the categories of 'basic principles’, 'management of blood collection and supply’ were significantly higher in higher donation rate group. 【Conclusion】 In revision and improvement of provincial laws and regulations, 'basic principles’ and 'management of blood collection and supply’ could be considered. This assay mainly tries to provide a new research perspective and perform quantitative analysis on content of sample provincial laws and regulation for voluntary blood donation, the actual effect of the results in this study need longer time to be examined, and we will keep following its new advances.

【Objective】 To investigate the establishment of multi-center haemovigilance (HV) and the monitoring of adverse reactions to blood donation (ARBD), in order to provide basis for the management of blood donors. 【Methods】 The operation of HV was investigated by questionnaire. The total number of blood donations (including plateletpheresis) and ARBD cases occurred in each blood center from 2014 to 2018 were analyzed. 【Results】 Among the 24 blood centers in this survey, only nine got HV operated. The incidence of ARBD of 19 blood centers that fulfilled the questionnaire was in the range of (0.003~1.151) %. The change trend of number and incidence of ARBD cases were indeterminate. 【Conclusion】 Most blood centers did not got HV established. The incidence of ARBD varied greatly and was indeterminate. The application of HV should be further improved to strengthen ARBD management.

【Objective】 To explore the recruitment and retention strategy of blood donors by investigating the age composition of blood donors in some areas of China, so as to promote blood donation and enhance clinical blood supply. 【Methods】 Through the working platform of Practice Comparison Working Group of China’s Mainland Blood Collection and Supply Institutions, the average age and age composition of blood donors from 22 blood centers were collected, and statistical analysis was conducted after eliminating invalid data. 【Results】 The median average age of blood donors during the survey year was 30.02.The median age in 2.89% of the blood centers was lower than 25. The average age of different genders was statistically significant only in 2018(P<0.05). Fot first-time blood donors, the median constituent ratio of donors <25 and ≥25 years old was 54.53% and 44.28%, with median retention rate at 10.30% and 9.61%, respectively. The median overall participation rate of blood donors was 2.7%, with median participation rate of blood donors <25 years old at 5.1%. 【Conclusion】 The recruitment and retention of blood donor is crucial to enhance clinical blood supply. Blood donors <25 years old, with a longer period for future donation, should be the main target of blood donation recruitment. Meanwhile, the revision of upper age limit for blood donation is another important initiative to grow the blood donor pool.

Objective:To evaluate salvage surgery in patients with early gastric cancer after noncurative endoscopic resection .Method:A total of 56 cases with early gastric cancer receiving salvage surgery after noncurative endoscopic resection were enrolled and the clinicopathological and follow-up information were analyzed to evaluate the necessity and safety of salvage surgery.Results:Among the 44(79%)patients with submucosal invasion, 38 (68%) were with SM2 (invasion submucosal invasion≥500 μm) according to the pathological results after endoscopic resection. 33 (59%)cases had positive margin. The rate of lymph node metastasis and positive residual tumor as found by salvage gastrectomy were 11% (6/56) and 25% (14/56) . In the multivariate analysis, deeper submucosal invasion resulted as independent risk factor for residual tumor( OR=1.001, 95% CI=1.000-1.002, P=0.036). Among the 12(21%)cases with postoperative complications, 3 (5%)underwent unplanned reoperations because of anastomotic or intra-abdominal bleeding. There was no difference in the number of retrieved lymph nodes and rate of postoperative complications between laparoscopic and open surgery(all P>0.05). Conclusion:For patients with the risk factors of lymph node metastasis after noncurative endoscopic resection, salvage surgery was necessary and laparoscopic approach was safe and feasible.