Objective:To explore the efficacy and safety of laparoscopy for acute appendicitis (AA)in kidney transplant(KT)recipients.Methods:From May 2016 to December 2022, retrospective review is conducted for 99 AA patients operated at Tianjin First Central Hospital.They are assigned into two groups of observation(kidney transplant recipients, 33 cases)and control(normal renal function patients, 66 cases). Laparoscopic perioperative data of white blood cell(WBC), neutrocyte percentage(NEUT%), C-reactive protein(CRP), procalcitonin(PCT), operative duration, intraoperative blood loss, postoperative drainage volume, postoperative hospitalization length, total hospitalization expense and morbidity of postoperative complications are compared.Results:After propensity score matching, no statistically significant inter-group difference existed in clinical profiles.WBC and NEUT% pre-operation are lower in observation group than those in control group[11.85(9.54~13.99)×10 9/L vs 13.74(12.42~14.66)×10 9/L, Z=-3.908, P<0.01; 85.00(73.65~89.60)% vs 88.20(83.85~90.20)%, Z=-2.522, P=0.012]. No significant inter-group difference existed in preoperative CRP/PCT(all P>0.05). No significant inter-group differences existed in WBC, NEUT, CRP or PCT at Day 3 post-operation(all P>0.05). No significant difference existed in creatinine level in observation group before and after operation( P>0.05). As compared with control group, operative duration was longer[86(74~99)vs 62(57~68)min, Z=-6.290, P=0.020], intraoperative blood loss greater[25(20~33)vs 15(15~20)ml, Z=-6.104, P<0.01], postoperative drainage volume larger[75(65~85)vs 35(25~36)ml, Z=-8.103, P<0.01], postoperative hospitalization time longer[7(6~9)d vs 5(4~5)d, Z=-7.064, P<0.01]and total hospitalization expense higher[(1.98±0.22)vs (1.73±0.22)ten thousand yuan, t=5.401, P<0.01]. No significant inter-group differences existed in time of postoperative passage of flatus( P=0.669). No significant inter-group difference existed in morbidity of postoperative complications( P=0.893). Conclusions:The efficacy of laparoscopic appendectomy in patients post-KT is basically comparable to that in counterparts with normal renal function.

Objective:To explore the efficacy and safety of laparoscopic colon cancer surgery for patients with end-stage renal disease .Methods:Thirty-one end-stage renal disease patients (continuous hemodialysis) underwent laparoscopic colon cancer surgery from Jan 2014 to May 2019 in Tianjin First Central Hospital compared to 35 colon cancer patients with normal renal function.Result:Compared with the control group, the operation time in laparoscopic group was longer[(187±20) min vs. (174±21) min, t=2.381, P=0.020], the intraoperative blood loss was more[90 (80-110) ml vs. 50(40-60) ml, Z=-6.580, P<0.001], the postoperative drainage volume was more[(417±89) ml vs.(208±67) ml, t=10.858, P<0.001], the postoperative hospitalization time was longer[(13.68±2.10) d vs.(9.09±1.65) d, t=9.918. P<0.001], and the total hospitalization costs were higher[9.2 (8.8-9.6) ten thousand yuan vs. 6.1 (5.8-6.5) ten thousand yuan, Z=-6.976, P<0.001]. There was no significant difference in overall morbidity between the two group (23% vs. 9%, P=0.170). Sixty-one patients (92%) were followed up for a median time of 6 months. One case of liver metastasis was found in each group. Conclusion:Laparoscopic colon cancer surgery can be a safe and effective procedure in patients with end-stage renal disease .

Objective To design a smoke purifier for laparoscopic surgery, and to test its application in reducing the use of carbon dioxide gas and reducing the concentration of harmful substances in laparoscopic surgery exhaust gas. Methods From April to September 2017, a total of 136 cases of hysterectomy and bilateral salpingo oophorectomy and pelvic lymph node dissection were divided into control group and experimental group by random number table method, with 68 cases in each group. Independent negative pressure suction pipeline was applied in the control group for direct suction. In the experimental group, the surgery exhaust gas first passed laparoscopic surgical smoke purifier, the intake pipe of which was transformed from an aseptic transfusion device. Gas would emit a sound alert when passing the double-valve one-way valve. After passing KP100 grade, KN100 grade filter element and a certain amount of protective coal pellet activated carbon, the smoke would be managed by the independent negative pressure suction pipeline. The amount of carbon dioxide gas used in the two groups and the concentration of harmful substances in the smoke of the experimental group before and after the operation were recorded. Results The amount of carbon dioxide gas used in the control group was (656.95±70.11) L, which was higher than that in the experimental group (613.70±75.63) L, and the difference was statistically significant (P< 0.01). In the experimental group, PM10, PM2.5, PM1.0, formaldehyde and total volatile organic compounds (TVOC) before the application of purifier were (206.90±30.48) μg/m3, (195.74±27.23) μg/m3, (220.22±37.60) μg/m3, (0.52±0.02) mg/m3 and (4.35±1.79) mg/m3, which were all higher than those after the application of purifier (4.26±1.02) μg/m3, (6.54±2.05) μg/m3, (7.89±3.38) μg/m3, (0.34±0.01) mg/m3and (0.31±0.17) mg/m3respectively, and the differences were statistically significant (P<0.01). Conclusions The purifier can reduce the amount of carbon dioxide gas used in laparoscopic surgery, reduce the harmful substances in surgical exhaust gas and reduce the harm to the environment and medical staff.

Objective To explore the application of space sand as filling material in the prevention of pressure sore in the lateral position surgery in Neurosurgery Department.Methods A total of 130 cases of lateral decubitus position surgery in Second Hospital of Hebei Medical University from October 2016 to March 2017 were selected and randomly divided into control group (n=65) and observation group (n=65) by random number table method.The control group used traditional gel position pad for lateral decubitus position,while the observation group used self-made space sand position pad for lateral position.The incidence of pressure sores of patients with lateral decubitus surgery of two groups were compared.Results The incidence of pressure sores in the control group was 12.31％,while it was 3.07％ in the observation group.The difference was statistically significant (x2=3.900,P ＜ 0.05).Conclusions The use of space sand position pad can effectively prevent the occurrence of pressure sore in the lateral decubitus position in Neurosurgery Department.

Objective To find an effective and convenient restraint band for the upper limb of the non-compression side for the patients in the lateral decubitus operation in the Neurosurgery Department. Methods From August 2017 to March 2018, patients in the lateral decubitus operation in the Neurosurgery Department,who from the Second Hospital of Hebei Medical University, were selected as the research objects. The self-made posture restraint belt was made of professional exercise shoulder, forearm sheath, binding band and magic stick. By using random number table produced by SPSS 22.0 edition, 160 patients who underwent lateral decubitus operation in the Neurosurgery Department were randomly divided into the control group and the observation group, with 80 cases in each group. In the control group, the conventional shoulder straps and wrist restraint bands were used, while the self-made lateral decubitus upper limb restraint band was used in the observation group. The differences of the time of lateral decubitus placement, the incidence of pressure sore in the non-compression side of the upper limb and the efficiency of restraint were observed and compared between the two groups. Results The time of lateral decubitus placement (365.97±42.08) s and the incidence of pressure sore in the non-compression side upper limb (10.0%) were higher than those of the observation group[ (302.69± 38.25)s, 1.3%]. The differences were statistically significant (P＜0.05). The efficiency (100.0%) of the non-compression side upper limb restraint in the observation group was higher than that in the control group (91.3%). The difference was statistically significant (P＜0.05). Conclusions The self-made upper limb restraint band for neurosurgery lateral position can effectively expose the surgical field, improve the comfort degree of patients, and improve the efficiency of posture placement and restraint.

ObjectiveTo investigate the correlation between polymorphism of interleukin(IL)-1β genes and risk and pathological characteristics of gastric cancer in human.MethodsFrom January to December 2010,200 cases of gastric cancer(patient group) and 200 cases of chronic superficial gastritis (control group) were collected.DNA was extracted and IL-1β gene -511,-31,-1473,+3954 site were detected by gene chip technology.The correlation between IL-1β gene -511,-31,-1473,+3954 site and risk and pathological characteristic of gastric cancer was observed.ResultsThe genotype frequency of IL-1β gene -511,-31,-1473,+3954 site was 48.75％(195/400),55.25％(221/400),53.25％(213/400),50.75％ (203/400) in patient group,47.25％ (189/400),53.00％ (212/400),52.50％ (210/400),52.50％ (210/400) in control group,and there was significant difference between two groups (P ＜0.05).While IL-1β gene -511,-31 site T allelic with the lower degree of differentiation of gastric cancer,IL-1 β gene -511,-1473 site T allelic with the early age of gastric cancer.ConclusionsIL-1β gene -511,-31,-1473,+3954 site genotype increase the risk of gastric cancer.IL-1β gene -511,-31 site T allelic are related with the degree of differentiation of gastric cancer.IL-1β gene -511,-1473 site T allelic are related with age of gastric cancer patient.