Objective To investigate the efficacy of treating adhesive small intestinal obstruction using blind insertion of a nasal ileus catheter in combination with continuous enteral nutrition.Methods The data of patients with adhesive small intestinal obstruction admitted to our department from January 2022 to December 2023 were retrospectively collected.Group A was treated with blind insertion of a nasal jejunal decompression catheter,whereas Group B was managed with a nasogastric tube.Continuous enteral nutrition was initiated after the resolu-tion of intestinal obstruction in both groups.The nutritional indices,abdominal improvement,inflammatory markers,and complication rates were compared between the two groups before and after treatment.Results In terms of nutritional indices,the scores for Alb,Pa,and NRS2002 in Group A were significantly higher than those in Group B on the 7th day(P<0.05).Regarding abdominal improvement indices,Group A demonstrated significantly better outcomes than Group B in daily average decompression drainage volume,daily average reduction in abdominal circumference,relief time for abdominal distension and pain,recovery time for exhaust,defecation,time to resump-tion of enteral nutrition,and total hospitalization duration(P<0.05).Concerning inflammatory indices,CRP,IL-6,and WBC levels in Group A were significantly lower than those in Group B on both the 4th and 7th days post-treatment(P<0.05).With regard to complications,Group A exhibited fewer cases of EN intolerance,reflux,and conversion due to conservative treatment ineffectiveness compared to Group B(P<0.05).Conversely,Group B had fewer instances of water and electrolyte imbalance compared to Group A(P<0.05).Conclusion Adhesive small intestinal obstruction treated with blind insertion of a nasal ileus catheter combined with continuous enteral nutrition is a safe and effective approach,making it worthy of promotion in clinical practice.

Objective To investigate the efficacy of treating adhesive small intestinal obstruction using blind insertion of a nasal ileus catheter in combination with continuous enteral nutrition.Methods The data of patients with adhesive small intestinal obstruction admitted to our department from January 2022 to December 2023 were retrospectively collected.Group A was treated with blind insertion of a nasal jejunal decompression catheter,whereas Group B was managed with a nasogastric tube.Continuous enteral nutrition was initiated after the resolu-tion of intestinal obstruction in both groups.The nutritional indices,abdominal improvement,inflammatory markers,and complication rates were compared between the two groups before and after treatment.Results In terms of nutritional indices,the scores for Alb,Pa,and NRS2002 in Group A were significantly higher than those in Group B on the 7th day(P<0.05).Regarding abdominal improvement indices,Group A demonstrated significantly better outcomes than Group B in daily average decompression drainage volume,daily average reduction in abdominal circumference,relief time for abdominal distension and pain,recovery time for exhaust,defecation,time to resump-tion of enteral nutrition,and total hospitalization duration(P<0.05).Concerning inflammatory indices,CRP,IL-6,and WBC levels in Group A were significantly lower than those in Group B on both the 4th and 7th days post-treatment(P<0.05).With regard to complications,Group A exhibited fewer cases of EN intolerance,reflux,and conversion due to conservative treatment ineffectiveness compared to Group B(P<0.05).Conversely,Group B had fewer instances of water and electrolyte imbalance compared to Group A(P<0.05).Conclusion Adhesive small intestinal obstruction treated with blind insertion of a nasal ileus catheter combined with continuous enteral nutrition is a safe and effective approach,making it worthy of promotion in clinical practice.

【Objective】 To study the blood group serology and molecular biology of patients with RhD--, so as to guide clinical blood use. 【Methods】 The EDTA-K2 anticoagulant blood of the patient was detected for Rh antigens and antibodies. Meanwhile, DNA was extracted, and the 1-10 exon of RHCE and RHAG gene was sequenced by Sanger sequencing. 【Results】 The serological test showed O type RhD--, and all spectral cells were positive. RHCE gene sequencing showed RHCE^*02/RHCE^*02, RHAG gene sequencing showed mutations at site 808 G > A and site 861 G > A of exon 6. 【Conclusion】 When patients were with RhD--, and related immune conditions such as pregnancy and/or transfusion history were present, autologous blood transfusion or plasma exchange could be an option for emergency blood use.

Objective To investigate the expression of immunophenotype in gastrointestinal stromal tumors and analyze its clinical value in the diagnosis and prognosis of gastrointestional stromal tumors.Methods Reviewed the clinical data of 323 patients with gastrointestinal stromal tumors in Fuzhou General Hospital of PLA from January 2004 to January 2014.Detected expressions of CD-117,DOG-1,CD-34,alpha-SMA,S-100.Desmin and Ki-67 by immunohistochemical S-P method,frequency statistics,independent sample t test and correlation analysis was carried out with SPSS 20.Results The positive rates of CD-117,DOG-1 and GIST in the group CD-34 were 97％,95.6％ and 86％ respectively,the positive rates of alpha-SMA,S-100 and Desmin were 59.8％,27.7％ and 17％ respectively,the positive expression of CD-117,CD-34,alpha α-SMA and Desmind in intestinal gastrointestinal stromal tumors and gastric gastrointestinal stromal tumors were significantly different,among them (P ＜ 0.05),the positive rates of gastrointestinal stromal tumors and alpha-SMA in intestinal CD-117 were significantly higher than those in gastric gastrointestinal stromal tumors (3.37 vs 2.99,P =0.002;1.59 vs 1.09 P =0.005).The positive expression of CD-34 and Desmin was significantly lower than that of gastric gastrointestinal stromal tumors (1.90 vs 3.02,P =0.000;0.12 vs 0.50,P =0.001).The expression of CD-117 was significantly correlated with location and risk grade (P =0.000,0.002).The expression of DOG-1 was significantly correlated with the risk grade,and the overall survival (P ＜0.05).The expression of CD-34 was significantly correlated with location,size,risk grade,status,and overall survival (P =0.000,0.007,0.016,0.001).There was a significant correlation between the expression of alpha-SMA and location (P =0.036).There was a significant correlation between the expression of S-100 and the overall survival (P =0.036).The expression of Desmin was significantly correlated with the age and location of the first visit (P =0.001).Conclusion In the diagnosis of gastrointestinal stromal tumors,CD-117,DOG 1 and CD-34 combined alpha-SMA and Desmin have good complementation,it is also helpful to judge the location of the intestine and stomach of gastrointestinal stromal tumors,if necessary,it can also be detected by gene mutation,with reference to the level of mitotic figures,which can reduce the misdiagnosis rate and increase the detection rate.

Objective To investigate the cause,therapeutic strategy,methods of treatment and clinical results for the rectovaginal fistulas(RVF)after rectal cancer operations.Methods The clinical data of 14 female patients with RVF after rectal cancer operations were examined retrospectively.According to therapeutic strategy,all patients were divided into two groups,A group and B group,which were seperately performed traditional treatment,and progynova in combination with non-operative treatment.Results Among 10 patients in A group,8 patients were performed feacal diversion stoma,and 7 patients with RVF cured naturally,then performued colostomy reversal and restoration of bowel continuity,the other 2 cases were performed non-operative treatment for refusing feacal diversion stoma.Among 4 patients in B group,3 cases with RVF healed naturally during 1.5 to 2 months,one case secondary to rectal anastomosis was performed feacal diversion stoma for rectovaginal fistula without signs of healing.Conclusion RVF is a rare but serious complication after resection of rectal carcinoma,which is taken by the treatment strategy of progynova in combination with non-operative treatment,not only can promote the natural healing of RVF obviously,but also can shorten the healing time greatly.Feacal diversion stoma can be used while the treatment is failure.