Objective To explore how to decrease the incidence of anastomotic stricture after the operation of esophageal cancer by improving anastomosis.Methods Clinical data of 374 cases aged ＞ 60 years who had undergone left thoracotomy radical resection of esophagus cancer at our hospital from April 2013 to August 2015 were collected.Patients were divided into double-layers anastomosis group (n=187) and conventional anastomosis group (n=187).During process of stapling anastomosis,double purse string anastomosis on esophagus and gastric wall were performed in doublelayers anastomosis group,with no purse string suture in conventional anastomosis group.Incidence rate of anastomotic stricture was compared between the two groups.Results Conventional anastomosis group versus double-layers anastomosis group showed that a mild anastomotic stricture occurred in 17 cases (9.1 ％) versus 7 cases (3.7 ％) (x2 =4.452,P =0.035),a moderate anastomotic stricture in 12 cases(6.4 ％) vs.4 cases (2.1 ％) (x2 =4.179,P =0.041),a severe anastomotic stricture in 9 cases (4.8％)vs.3 cases(1.6％)(x2 =3.099,P=0.078),total number of anastomotic stricture in 38 cases vs.14 cases (x2 =12.866,P =0.000),showing that double-layers anastomosis was relatively superior to conventional anastomosis.Conclusions Double-layers anastomosis can effectively reduce the incidence of anastomotic stricture after surgery.

Objective To investigate the distribution of traditional Chinese medicine (TCM) syndrome types and elements in liver cirrhosis patients with dysplastic nodules (DN), and to provide a basis for exploring the connotation and pattern of TCM syndrome types of DN in liver cirrhosis. Methods A total of 138 patients who attended The First Affiliated Hospital of Henan University of Chinese Medicine from March 2013 to January 2021 and were diagnosed with liver cirrhosis and DN were enrolled. General data such as age of onset and sex were collected, as well as the data on etiology, TCM syndrome types, and Child-Pugh class for liver function, and the distribution characteristics of TCM syndrome types and elements were summarized. The chi-square test or the Fisher's exact test was used for comparison of categorical data between groups. Results The liver and the spleen were the main syndrome elements of disease location in liver cirrhosis patients with DN, accounting for 97.83% and 94.93%, respectively, followed by the kidney (23.91%); Qi deficiency and Qi stagnation were the main syndrome elements reflecting the nature of disease, accounting for 73.91% and 58.70%, respectively, followed by dampness (34.78%). The main TCM syndrome types included stagnation of liver Qi and spleen deficiency, damp-heat internal excess syndrome, blood stasis and toxin accumulation syndrome, and water-dampness retention syndrome, among which stagnation of liver Qi and spleen deficiency was more common and accounted for 58.70% ( P < 0.05). There were no significant differences in TCM syndrome types between the patients with different sexes, ages, and etiologies (all P > 0.05). There was a significant difference in Child-Pugh class between the liver cirrhosis DN patients with different TCM syndrome types ( χ 2 =34.320, P < 0.05), and Child-Pugh class A was more common in the patients with stagnation of liver Qi and spleen deficiency (59.8%), while Child-Pugh class C was more common in the patients with damp-heat internal excess syndrome (39.1%). Conclusion This article summarizes the distribution characteristics of common TCM syndrome types and elements of DN in liver cirrhosis, which provides a reference for the syndrome differentiation-based TCM treatment of DN in liver cirrhosis.