Objective:To investigate the effect of visceral obesity on the short-term curative effect of Da Vinci robotic-assisted radical resec-tion for rectal cancers.Methods:Clinical and pathological data of patients with rectal cancer undergoing Da Vinci robotic-assisted surgery,admitted to People's Hospital of Zhengzhou University and Cancer Hospital of Zhengzhou University from November 2019 to June 2022 were retrospectively analyzed.Visceral fat area(VFA)≥100 cm2 was used as the standard to define visceral obesity.Patients were categorized in-to visceral and non-visceral obesity groups.The short-term efficacy of the two groups was evaluated,and the influencing factors of post-operative complications were analyzed using univariate and multivariate Logistic regression.Results:Among a total of 169 patients,93 were included in the visceral obesity group and 76 in the non-visceral obesity group.There was no significant difference in the baseline data between the two groups(P>0.05).There was no conversion to laparotomy in the non-visceral obesity group,and the conversion rate was 1.1%(1/93)in the visceral obesity group.The second operation rate was 2.2%(2/93)in the visceral obesity group and 1.3%(1/76)in the non-visceral obesity group with no statistical difference between the two groups.There were no significant differences in the operation dur-ation,intraoperative blood loss,number of lymph node dissections,and total postoperative complication rate between the two groups(P>0.05).Multivariate Logistic regression analysis revealed that an NRS≥3 independently contributed as a risk factor for postoperative com-plications(OR=3.190,95%CI:1.240-8.210,P=0.016).Conclusions:An NRS≥3 is an independent risk factor for complications post-robotic rad-ical rectal cancer surgery.The robotic surgical platform can overcome obesity-related limitations and is equally safe and effective for pa-tients with visceral obesity presenting with rectal cancer.

Humans ; Consensus ; Pancreatic Neoplasms/therapy* ; Neuroendocrine Tumors/therapy*

Objective To study the clinical efficacy of autologous cartilage following unilateral cleft lip and palate repair on correction of secondary complex deformity.Methods 17 patients with complex secondary cleft palate were enrolled in this study from December 2004 to December 2014.Correction of nasal and lip deformity and oronasal fistula were achieved at the same time.The therapeutic efficacy was evaluated after follow-up from 3 months to 2 years after operation.Results All 17 patients received satisfactory results,of which 14 patients were satisfied and three cases of general satisfaction.Conclusions Satisfactory results are received by using autologous rib cartilage to repair secondary complex deformity of unilateral cleft lip and palate.

Objective To study the use of the quality control circle(QCC)for patients suf-fering from sleep apnea hypopnea syndrome(OSAHS).Methods The control group was given rou-tine nursing interventions after surgery.The observation group was carried by QCC method.Re-sults The days of staying in hospital,medical costs,and complications in the observation group were lower in the control group,health knowledge score,degree of satisfaction and curative effect were all higher than that in the control group P <0.01).Conclusion The standardized man-agement based on QCC can improve the quality of nursing and promote mental rehabilitation of pa-tients with 0SAHS.

Objective To study the use of the quality control circle(QCC)for patients suf-fering from sleep apnea hypopnea syndrome(OSAHS).Methods The control group was given rou-tine nursing interventions after surgery.The observation group was carried by QCC method.Re-sults The days of staying in hospital,medical costs,and complications in the observation group were lower in the control group,health knowledge score,degree of satisfaction and curative effect were all higher than that in the control group P <0.01).Conclusion The standardized man-agement based on QCC can improve the quality of nursing and promote mental rehabilitation of pa-tients with 0SAHS.

Objective To investigate the application of multiple dilators for excessive expansion of scalp with hair covering and integrated use of expanded flap to repair cicatricial alopecia in a large area.Methods stage Ⅰ surgery was performed as follows:multiple dilators were chosed and embedded below the galea aponeurotica of the scalp with hair covering according to the bald hair shape,size of the alopecia area.Excessive expansion was conducted for 3 to 6 months to get the extra hair scalp.Stage Ⅱ surgery was as follows:Dilators were removed and scar areas were resected,followed by combined use of sliding advancement flap,rotation flap and translocation flap to repair scalp alopecia.Resluts The postoperative effect of all patients was ideal with satisfied appearance.Conclusions Multiple dilator excessive expansion may obtain a large number of additional expansion scalp,combined by reasonable use of skin flap transfer technology,which can be used to repair the large scarring alopecia and get a good clinical effect.

Objective Ti study the applicatiin if the clinical nursing pathway in patients with sleep apnea hypipnea syndrime (OSAHS).Methods The patients were divided inti 2 griups.The cintril griup was applied riutine nursing interventiins after surgery while the ibser-vatiinal griup was cinducted by clinical nursing pathway.Results The average hispitalizatiin time and medical cists were much liwer in ibservatiinal griup while awareness if diseases if pa-tients and degree if satisfactiin were higher in the ibservatiinal griup.The difference was statisti-cally significant(P <0.01).Conclusion The standardized management based in clinical nursing pathway can imprive the quality if nursing and primite mental rehabilitatiin if patients with 0SAHS.

Objective Ti study the applicatiin if the clinical nursing pathway in patients with sleep apnea hypipnea syndrime (OSAHS).Methods The patients were divided inti 2 griups.The cintril griup was applied riutine nursing interventiins after surgery while the ibser-vatiinal griup was cinducted by clinical nursing pathway.Results The average hispitalizatiin time and medical cists were much liwer in ibservatiinal griup while awareness if diseases if pa-tients and degree if satisfactiin were higher in the ibservatiinal griup.The difference was statisti-cally significant(P <0.01).Conclusion The standardized management based in clinical nursing pathway can imprive the quality if nursing and primite mental rehabilitatiin if patients with 0SAHS.

Objective To explore the clinical effect of auricle reconstruction with expanded auricle posterior flap on mastoidea and auto rib cartilage bracket for repair of congenital microtia.Methods Twenty-one eligible patients with congenital auricle malformation and defect were recruited into this study and three-stage operation was performed.A 50 ml kidney-shaped expander was implanted at mastoid process area to expand skin in stage Ⅰ surgery,followed by a regular affusion to expand skin for 3 to 4 months.The average total waterflood was (80.51 ± 3.87) ml.The volume remained stable for 1 month,once up to the predetermined amount.In stage Ⅱ surgery autogenous costal cartilage was taken and carved into inverted conch shape.Auricle was reconstructed with the expanded flap to cover the auto rib cartilage bracket.The stage Ⅲ surgery was performed for details dressing of the auricle after 3 months.Results All 21 cases underwent operation successfully.Reconstructed ear auricles were similar to uninjured sides in size and shape.Both doctors and patients were contented with the auricles.Conclusions Expanded auricle posterior flap on mastoidea can cover the auto rib cartilage bracket.Autologous costal cartilage can be carved to four layers cartilage bracket that likes an inverted conch,and followed by realistic postoperative auricular shape and strong three-dimensional sense after operation.

Objective To compare the clinical features and endoscopic findings of Crohn's disease(CD) and intestinal tuberculosis(ITB) in order to differentiate CD from ITB. Methods The clinical and endoscopic data from 168 patients with CD and 156 patients with ITB between June 2003 and February 2009 were retrospectively analyzed. Results The salient features of CD were male patients in predominance (male : female was 108 :60) and high incidence of colectomy (CD 33.3% vs ITB 10.9%, P<0.01). Diarrhea (66.1%), hematochezia (32.1%), perianal disease (16.1%), intestinal obstruction (28.0%) were more frequent in CD patients than in ITB patients (47.0%, 7.7%, 3.4%, 9.4% respectively, all P values<0.05). The salient features of ITB were night sweating, pulmonary tuberculosis, ascites, hyperglobulin, increased erythrocyte sedimentation rate and the positive serum antibody to mycobacterium. The endoscopic examination showed that the fissure-shape ulcer, grid-shape ulcer, cobblestone sign and intestinal stricture were more frequent in CD patients than in ITB patients (all P values <0.05). Whereas the circular ulcer and involved ileocecal valve with fixed bouche shape were more common in ITB patients (P<0.05). Conclusions The clinical characteristics are different in CD and ITB patients. The endoscopic findings including fissure-shape ulcer, grid-shape ulcer, circular ulcer, cobblestone sign and the status of involved ileocecal valve are important in the differentiation of ITB from CD.