Objective To investigate the effect of programmed death receptor-1(PD-1)/pro-grammed death receptor-ligand-1(PD-L1)inhibitor combined with chemotherapy on gastrointestinal function and inflammatory markers in peripheral blood of patients with advanced gastric cancer(AGC).Methods The clinical data of 128 AGC patients treated in our hospital from February 2022 to August 2023 were retrospectively analyzed,and they were divided into control group(64 cases re-ceived conventional chemotherapy)and study group(64 cases received PD-1/PD-L1 inhibitor treat-ment+conventional chemotherapy)according to different treatment schemes.The short-term curative effect,gastrointestinal function level and inflammatory markers in peripheral blood before and after three cycles of treatment were recorded between the two groups,and the adverse reactions of the two groups were counted.Results The objective response rate(ORR)and disease control rate(DCR)in the study group were higher than those in the control group(P＜0.05).After three cycles of treatment,the levels of vasoactive intestinal peptide(VIP)and somatostatin(SS)decreased in both groups,while the levels of gastrin(GAS),motilin(MTL),and cholecystokinin(CCK)increased com-pared with those before treatment.The VIP and SS levels in the study group were lower than those in the control group,while the GAS,MTL,and CCK levels were higher(P＜0.05).After three cy-cles of treatment,the neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)decreased,and the lymphocyte-to-monocyte ratio(LMR)level increased in both groups compared with those before treatment.The NLR and PLR levels in the study group were lower than those in the control group,while the LMR level was higher(P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the study group and the control group(P＞0.05).Conclusion PD-1/PD-L1 inhibitors combined with chemotherapy for AGC can improve short-term efficacy,enhance gastrointestinal function,reduce NLR and PLR levels in peripheral blood,increase LMR levels in peripheral blood,and do not increase adverse reactions.The combi-nation therapy is relatively safe.

Objective:To explore the effect of alcohol abstinence intervention based on timing theory on patients with alcoholic liver disease.Methods:A total of 106 patients with alcoholic liver disease hospitalized in the Department of liver disease of Taian Medical District, 960th Hospital of Chinese PLA from July 2018 to June 2019 were selected by convenience sampling method and divided into observation group and control group by random digits table method, 53 cases in each group. The control group received routine nursing, and through the improvement of patients' cognition and support system, implemented short abstinence intervention during hospitalization; the observation group received abstinence intervention based on timing theory on the basis of the control group intervention. At 1 month and 6 months after discharge, the differences of rehydration rate, alcohol dependence and physical and mental status between the two groups were compared.Results:Finally, 49 cases in the control group completed the study, and 51 cases in the observation group completed the study. The rehydration rates of the observation group were 21.57%(11/51) and 15.69%(8/51) respectively at 1 month and 6 months after discharge, while those of the control group were 40.82%(20/49) and 36.73%(18/49) respectively at 1 month and 6 months after discharge. The difference was statistically significant ( χ2 values were 4.328, 5.754, P<0.05). The alcohol dependence scores were 0(2,3), 0(1,2) in the observation group and 2(0,3), 3(1,4) in the control group at 1 month and 6 months after discharge, and the difference was statistically significant ( Z values were -6.719, -7.345, P<0.01). There was no significant difference in the score of Symptom Checklist-90(SCL-90) before intervention and 1 month after discharge between the two groups ( P>0.05). Six months after discharge, the score of SCL-90 was 8.26 ± 1.37 in the observation group and 10.11 ± 1.68 in the control group, and the difference was statistically significant( t value was 6.046, P<0.01). Conclusions:The application of timing theory in alcohol abstinence of patients with alcoholic liver disease can significantly reduce the relapse rate and the degree of alcohol dependence of patients with alcoholic liver disease, improve the physical and mental state of patients.

Objectives: To evaluate the safety and feasibility of ultra-low anastomosis for anal preservation in laparoscopic rectal can-cer surgery. Methods: The clinical data of 54 patients with low rectal cancer admitted to The Affiliated Hospital of Southwest Medical University from July 2014 to June 2017 were retrospectively analyzed. The short-term effect and complications were analyzed. Results:All patients underwent successful operations; conversion to laparotomy or death was not observed in any of the patients. The mean operative time was (165 ± 31) minutes, and the intraoperative bleeding volume was (12 ± 5) mL. There was no prophylactic ileostomy in all patients. Postoperative anastomotic bleeding and anastomotic leakage occurred in 2 and 3 cases, respectively; these complica-tions were managed with conservative treatment. Postoperative urination and sexual functions of the patients remained good, and most patients were satisfied with their anal function 1 year post-operation. No local recurrences or deaths were noted after follow-up for more than 2 years. However, liver metastases were detected in 3 patients 1 year post-surgery. Conclusions: Laparoscopic transab-dominal ultra-low anastomosis for rectal cancer has a good short-term effect; however, the long-term effect remains to be evaluated.

Objective To evaluate the safety and efficacy of laparoscopic distal pancreatectomy in treatment of insulinoma.Methods Clinical data of 8 cases of insulinoma treated by laparoscopic distal pancreatectomy from Apr.2015 to Apr.2017 were retrospectively reviewed.Results Locations of the insulinoma in distal pancreas were all identified preoperatively by enhanced CT,MRI or somatostatin receptor scintigraphy (SRS).Laparoscopic distal pancreatectomy was applied to 8 cases,including combined splenectomy to 1 case.The operation time,bleeding volume,and postoperative hospital stay was (159±44) min,(125±119) ml and (5.5±1.4) days,respectively.Grade B fistula happened to one patient after surgery.The level of postoperative blood glucoses was normal in all cases.Conclusion Laparoscopic distal panreatectomy is safe,effective,and less invasive in treating insulinoma,with quick recovery and high efficacy in spleen preservation.