Objective To explore the effect of transcutaneous auricular vagus nerve stimulation(taVNS)on postoperative recovery of gastrointestinal function in gynecological laparoscopic surgery patients.Methods Ninety-six patients who underwent elective laparoscopic total hysterectomy were selected.According to the random number table method,patients were divided into the taVNS group(group T)and the sham stimulation group(group F)with 48 patients in each group.The conventional general anesthesia method was used in both groups.The group T received taVNS once before surgery and once in the anaesthesia recovery room with 30 min per stimulation,while the group F was given sham stimulation for 30 min each.Postoperative recovery time of anal gas and defecation,the I-FEED scores on the 1st,2nd and 3rd postoperative days,the GSRS score on the 3rd postoperative day were recorded.The NRS scores on the 1st and 2nd postoperative days,postoperative remedial analgesia,occurrence of postoperative adverse effects and duration of postoperative hospitalization were recorded.Results Compared with the group F,the time to first postoperative anal exhaust and defecation was significantly shorter in the group T.The I-FEED scores on the 1st,2nd and 3rd postoperative days,and the GSRS score on 3rd postoperative day were significantly decreased in the group T.The proportion of patients with postoperative gastrointestinal intolerance and postoperative gastrointestinal dysfunction were reduced in the group T(P＜0.05).NRS scores at postoperative days 1,and 2 were decreased and the incidence of postoperative nausea was lower(P＜0.05).There were no significant differences in postoperative remedial analgesia,the occurrence of postoperative vomiting,dizziness,bradycardia and hypotension,and duration of postoperative hospitalization in the two groups of patients(P＞0.05).Conclusion taVNS can improve the recovery of postoperative gastrointestinal function,reduce postoperative nausea and alleviate postoperative pain in laparoscopic total hysterectomy patients.

Objective To explore the effect of transcutaneous auricular vagus nerve stimulation(taVNS)on postoperative recovery of gastrointestinal function in gynecological laparoscopic surgery patients.Methods Ninety-six patients who underwent elective laparoscopic total hysterectomy were selected.According to the random number table method,patients were divided into the taVNS group(group T)and the sham stimulation group(group F)with 48 patients in each group.The conventional general anesthesia method was used in both groups.The group T received taVNS once before surgery and once in the anaesthesia recovery room with 30 min per stimulation,while the group F was given sham stimulation for 30 min each.Postoperative recovery time of anal gas and defecation,the I-FEED scores on the 1st,2nd and 3rd postoperative days,the GSRS score on the 3rd postoperative day were recorded.The NRS scores on the 1st and 2nd postoperative days,postoperative remedial analgesia,occurrence of postoperative adverse effects and duration of postoperative hospitalization were recorded.Results Compared with the group F,the time to first postoperative anal exhaust and defecation was significantly shorter in the group T.The I-FEED scores on the 1st,2nd and 3rd postoperative days,and the GSRS score on 3rd postoperative day were significantly decreased in the group T.The proportion of patients with postoperative gastrointestinal intolerance and postoperative gastrointestinal dysfunction were reduced in the group T(P＜0.05).NRS scores at postoperative days 1,and 2 were decreased and the incidence of postoperative nausea was lower(P＜0.05).There were no significant differences in postoperative remedial analgesia,the occurrence of postoperative vomiting,dizziness,bradycardia and hypotension,and duration of postoperative hospitalization in the two groups of patients(P＞0.05).Conclusion taVNS can improve the recovery of postoperative gastrointestinal function,reduce postoperative nausea and alleviate postoperative pain in laparoscopic total hysterectomy patients.

Objective:To investigate the efficacy and safety of a novel modified Blumgart pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy (LPD).Methods:Between May 2021 and January 2022, 13 successive cases from Lihuili Hospital Affiliated to Ningbo University who underwent LPD were enrolled in this retrospective study. The study retrospectively analyzed the demographic characteristics, perioperative outcomes, and pathological results of these cases.Results:Twenty patients underwent LPD success-fully and one required conversion to open surgery. The operative time was (308.6 ± 61.7) min. The duration for PJ was (26.7 ± 4.3) min. The estimated blood loss was (188.1 ± 94.2) ml. The postoperative hospital stay was (14.2 ± 3.5) d. There was one case of biochemical leakage and no case of grade B or grade C pancreatic fistula.Conclusions:The new method is safe, simple and feasible. The novel method could reduce the incidence of pancreatic fistula and other complications after LPD.

Objective:To investigate the expression of CXC chemokine ligand 11 (CXCL11) in gallbladder cancer (GBC) and its effect on cell proliferation and invasion.Methods:The surgically resected specimens of 47 GBC patients were collected in Lihuili Hospital Affiliated to Ningbo University from January 2017 to December 2020. There were 26 females and 21 males, with the age (62.0±8.2) years. The expression of CXCL11 protein in GBC tissues and corresponding paracancer tissues was detected by immunohistochemistry. Associations between CXCL11 expression and clinicopathological features were analyzed. After co-culturing of GBC-SD cells with exogenous CXCL11, cell counting kit-8 (CCK-8) and Transwell assays were performed to detect cell proliferation and invasion ability. The expression and phosphorylation level of phosphatidylinositol 3 kinase (PI3K) and protein kinase B (Akt) were also detected by Western blot.Results:The positive expression rate of CXCL11 in GBC tissues was significantly higher than that in adjacent paracancerous tissues [63.8% (30/47) vs 31.9% (15/47), χ 2=9.59, P=0.002]. Furthermore, CXCL11 expression was significantly associated with tumor stage (χ 2=6.64, P=0.010) and lymph nodal metastasis (χ 2=7.86, P=0.005). CCK-8 assay revealed that the proliferation ability of GBC-SD cells in CXCL11-treated group significantly increased than that in the control group (absorbance value: 0.59±0.06 vs 0.32±0.04, t=9.64, P<0.001). Transwell assay showed that the cell invasion ability in CXCL11-treated group significantly increased than that in the control group [number of transmembrane cells: (133.4±12.3) cells vs (38.6±4.4) cells, t=16.21, P<0.001]. Western blot analysis showed that the relative expression levels of phosphorylated PI3K (p-PI3K) and phosphorylated Akt (p-Akt) in CXCL11-treated group (0.88±0.06 and 0.83±0.04) were significantly higher than those in the control group (0.17±0.04 and 0.23±0.06), and the differences were statistically significant ( t=18.54, P<0.001 and t=15.21, P<0.001). Conclusion:CXCL11 is highly expressed in GBC and closely related to tumor progression. CXCL11 can promote the proliferation and invasion of GBC cells via PI3K/Akt signaling pathway.