Objective:To investigate the clinical value of laparoscopic-assisted natural orifice specimen extraction surgery (NOSES) in postoperative patients with stage Ⅲ colorectal cancer based on stress response indexes.Methods:A total of 86 patients with colorectal cancer treated in Mudanjiang Cancer Hospital and Hongqi Hospital Affiliated to Mudanjiang Medical College from January 2021 to January 2023 were retrospectively selected as the study objects, of which 43 patients underwent conventional laparoscopic radical resection of colorectal cancer (LCR) treatment (control group) and 43 patients underwent NOSES treatment (observation group). The changes of tumor markers, stress response indexes and humoral immunity indexes were compared between the two groups before and aftertreatment, and the incidence of postoperative complications were compared between the two groups.Results:The levels of carcinoembryonic antigen (CEA), carbohydrate antigen (CA)19-9, CA242 and CA125 in the two groups were decreased 2 weeks after surgery ( P<0.05), but there were no statistical differences between the two groups ( P>0.05). The level of superoxide dismutase (SOD) in the observation group was higher than that in the control group 3 d after operation: (68.45 ± 8.30) kU/L vs. (59.64 ± 8.18) kU/L; the level of malondialdehyde (MDA) was lower than that in the control group: (8.84 ± 2.03) mmol/L vs. (10.26 ± 2.11)mmol/L, there were statistical differences ( P<0.05). The levels of immunoglobulin (Ig)A, IgM and IgG in the observation group were higher than those in the control group 3 d after operation: (1.59 ± 0.40) g/L vs. (1.33 ± 0.36) g/L, (1.25 ± 0.31) g/L vs. (1.03 ± 0.26) g/L, (8.75 ± 2.12) g/L vs. (6.89 ± 2.05) g/L, there were statistical differences ( P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups ( P>0.05). Conclusions:Laparoscopic-assisted NOSES in the treatment of stage Ⅲ colorectal cancer can effectively improve the level of tumor markers of patients, reduce the stress reaction and immune damage caused by surgery to the patients and ensure the safety.

Objective:To investigate the clinical value of laparoscopic-assisted natural orifice specimen extraction surgery (NOSES) in postoperative patients with stage Ⅲ colorectal cancer based on stress response indexes.Methods:A total of 86 patients with colorectal cancer treated in Mudanjiang Cancer Hospital and Hongqi Hospital Affiliated to Mudanjiang Medical College from January 2021 to January 2023 were retrospectively selected as the study objects, of which 43 patients underwent conventional laparoscopic radical resection of colorectal cancer (LCR) treatment (control group) and 43 patients underwent NOSES treatment (observation group). The changes of tumor markers, stress response indexes and humoral immunity indexes were compared between the two groups before and aftertreatment, and the incidence of postoperative complications were compared between the two groups.Results:The levels of carcinoembryonic antigen (CEA), carbohydrate antigen (CA)19-9, CA242 and CA125 in the two groups were decreased 2 weeks after surgery ( P<0.05), but there were no statistical differences between the two groups ( P>0.05). The level of superoxide dismutase (SOD) in the observation group was higher than that in the control group 3 d after operation: (68.45 ± 8.30) kU/L vs. (59.64 ± 8.18) kU/L; the level of malondialdehyde (MDA) was lower than that in the control group: (8.84 ± 2.03) mmol/L vs. (10.26 ± 2.11)mmol/L, there were statistical differences ( P<0.05). The levels of immunoglobulin (Ig)A, IgM and IgG in the observation group were higher than those in the control group 3 d after operation: (1.59 ± 0.40) g/L vs. (1.33 ± 0.36) g/L, (1.25 ± 0.31) g/L vs. (1.03 ± 0.26) g/L, (8.75 ± 2.12) g/L vs. (6.89 ± 2.05) g/L, there were statistical differences ( P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups ( P>0.05). Conclusions:Laparoscopic-assisted NOSES in the treatment of stage Ⅲ colorectal cancer can effectively improve the level of tumor markers of patients, reduce the stress reaction and immune damage caused by surgery to the patients and ensure the safety.

Objective To compare the difference in recurrence rates between the endovenous laser therapy(EVLT) combined with percutaneous continuous circumsature (PCCS) and simplex EVLT following the treatment of great saphanous vein incompetence through the introduction of propensity score matching (PSM).Methods T the baseline data of 170 patients diagnosed with great saphanous vein incompetence who were treated in Punan Hospital in Pudong New District of Shanghai from 2009 to 2014 were retrospectively analyzed,of which underwent EVLT were 87 cases as EVLT group and EVLT combined with PCCS were 83 cases as EVLT +PCCS group.The groups covariate were balanced based on the PSM function of SPSS software using 1 ∶ 1 nearest neighbor matching method.The recurrence rates of the two groups were estimated by Kaplan-Meier method and the differences between the two groups were evaluated by Log-rank test.Results Sixty-seven pairs of patients were successfully matched.No significant difference between the two matched groups in the basic clinical features.Before PSM,the 1,2,and 3 year cummulative recurrence rates were 3.5％,5.4％ and 7.3％ in the EVLT group,and 0.9％,4.7％ and 4.7％ in the EVLT+PCCS group,respectively,there were no statistically significant differences between the two groups by Log-rank test (P =0.491).After PSM,the 1,2,and 3 year cummulative recurrence rates were 5.2％,5.2％ and 7.1％ in the EVLT group,and 0％,1.0％ and 1.0％ in the EVLT+PCCS group,there were statistically significant differences between the two groups (P =0.031).Conclusion The PSM methods can effectively balanced the covariates of groups in non-randomised study.EVLT combined with PCCS can effectively reduce the recurrence rate after the treatment of great saphanous vein incompetence.

Objective:To investigate the application of photoplethysmogram in analyzing the fingertip pulse amplitude volume (PAV)to evaluate the endothelial function in diagnosing coronary heart disease,and to clarify its relationship with the risk factors of cardiovascular diseases.Methods:Total 409 patients with chest pain accepted coronary angiography (CAG)were selected and diveded into positive group (CAG+)(n=288)and negative group (CAG-) (n = 121)according to angiographic results.Fingertip photoplethysmogram was used to analyze the fingertip PAV by the way of applying endothelial function diagnostic after reactive ischemia,and the relationship between the PAV value and the risk factors of coronary heart diseases was analyzed,and the critical reference value of prediction index of coronary heart disease was determined.The risk factors such as age,gender,serum total cholesterol (TC ), low density lipoprotein (LDL ), high density lipoprotein (HDL ), non-HDL, serum triglyceride (TG),hypertension,diabetes,smoking,family history of coronary heart disease,body mass index (BMI)of the subjects in various groups were analyzed,and the relationship between the risk factors of coronary heart disease and PAV was analyzed by Logistic regression analysis.Results:The PAV of patients in CAG+group was significantly lower than that in CAG-group (P <0.01).The peak point of PAV was<1.37,if PAV<1.37 was used to predict the coronary heart disease,the predictive sensitivity,the specificity,the positive prediction and the negative prediction were 74.65%,44.63%, 76.24%, and 42.52%.The Logistic regression analysis showed that PAV was negatively associated with hypertension,smoking history,TG (OR= 1.476,OR=2.002, OR = 1.844;P < 0.01 ). Conclusion: PAV is associated with coronary heart disease and its risk factors (hypertension,smoking history,TG),and PAV=1.37 can be used as the peak point to predict the coronary heart disease.