To evaluate the features of carotid web (CW) by ultrasonography.

A total of 66 patients with CW were retrospectively enrolled from January 2018 to June 2019 at Xuanwu Hospital, Capital Medical University. All patients were examined by both ultrasonography and CTA, and were divided into either a<50% stenosis group (54 cases) or a ≥50% stenosis group (12 cases). The ultrasonographic characteristics of CW, including the length, thickness, direction (forward or backward to the flow), acute angle between the web and carotid wall, and thrombus between the web and carotid wall were compared between the two groups. The stenosis degrees of carotid artery were compared between patients with and without ischemic stroke.

Forty-two (42/66, 63.6%) patients were diagnosed with CW by initial CDFI examination, of whom 21 (21/66, 31.8%) were diagnosed with ulcerative plaque and 3 (3/66, 4.5%) were diagnosed with carotid dissection at first but confirmed by second examination. There were no differences in the web length, thickness, direction, or thrombus detected between the two groups (P>0.05). The angle between the web and carotid wall in the<50% stenosis group was significantly smaller than that of the ≥50% stenosis group (median angel 39o vs 73o, P=0.002), and the percentage of patients with an angle≤ 60o in the<50% stenosis group was significantly higher than that of the ≥50% stenosis group (74.1% vs 41.7%, P=0.042). The diameter of the residual carotid artery at CW location in the<50% stenosis group was significantly larger and peak systolic velocity was significantly higher in the<50% stenosis group than in the≥50% stenosis group (P<0.001). The stenosis degrees of carotid artery were not statistically different between patients with and without ischemic stroke (P=0.321).

Ultrasonography can be used to evaluate the characteristics of carotid web in 2D and color mode. When the angle between the CW and carotid wall is large, the carotid artery stenosis ≥ 50% is more likely to happen, but carotid artery stenosis is not the main cause of ischemic stroke.

The aim of the present study was to evaluate the efficiency of sling exercise, therapeuticultrasound, therapeuticultrasound and sling exercise in patients to alleviate pain and improve lumbar function with lumbar disc herniation.

Individuals were selected from a list of patients being followed at the department of Rehabilitation in the third hospital of Hebei Medical University. 30 patients who were diagnosed with lumbar disc herniation were collected, the diagnoses were established upon medical history, physical examination, and results of imaging studies. The patients were randomly divided into three groups: therapeuticultrasound group received 14 sessions of ultrasonic therapy to the lumbar region, Sling exercise group received 14 sessions of sling exercise, and therapeuticultrasound and sling exercise group received therapeuticultrasound and sling exercise therapy 14 sessions of therapeuticultrasound to the lumbar region,7 sessions per week, 2 weeks. The VAS and ODI were compared with the assessment of the patients before and at the end of the therapy.

At the end of treatment, three groups VAS scores (F=3.069, P=0.043) and ODI scores (t=12.676, P<0.001) was lower than that at the beginning of treatment (P<0.05), at the end of treatment the VAS scores (F=59.400, P<0.001) and of the ODI scores (t=12.737, P<0.001) of ultrasonic and sling exercise therapy group was lower than the other group, the difference is significantly.

All three groups could reduce pain and improve lumbar function, and the ultrasonic and sling exercise therapy was most effective for lumbar disc herniation treatment in the three groups.

To analyze the treatment of different types of traumatic cerebral infarction in children, and explore its pathogenesis in combination with literature so as to improve the cure rate and reduce disability rate.

The clinical data of 42 cases of traumatic cerebral infarction in children were retrospectively analyzed in The Hospital of 81^st Group Army PLA from January 2015 to December 2019. The diagnosis of traumatic cerebral infarction in children was made by CT scan and MRI scan. According to different conditions, children with traumatic cerebral infarction were classified, and different treatment strategies were selected. Children with lacunar infarction were treated with calcium antagonists and neurotrophic drugs, supplemented by hyperbaric oxygen and exercise rehabilitation. The children of focal cerebral infarction and complex cerebral infarction treated by junior dehydrant and hormone also included the calcium antagonist and nutritional nerve drugs. The therapeutic regimen perhaps adjusted by the evolution of the disease. The children of extensive cerebral infarction underwent emergency cranial decompression, and was treated by reducing intracranial pressure and preventing complications after operation. The treatment results and recovery were observed.

In 42 cases of traumatic cerebral infarction in children, 35 cases (83.3%) were good recovery, 4 cases (9.5%) were moderate disability, 2 cases (4.8%) were severe disability, 1 case (2.4%) died, and no vegetative state. The good recovery rate of lacunar infarction was 100%, that of focal cerebral infarction was 62.5%, that of mixed cerebral infarction was 60%, and that of extensive cerebral infarction was 50%.

It is of great significance to improve the therapeutic effect and prognosis of children with traumatic cerebral infarction to adopt different treatment schemes for different types of cerebral infarction.

To characterize the patients with supratentorial hypertensive intracerebral hemorrhage (ICH) in the Tibetan Plateau over an altitude of 4000 meters.

A total of 68 cases with supratentorial hypertensive ICH were retrospectively included in Ali Regional People’s Hospital from January 2017 to September 2018. The clinical and laboratory data were collected. A simple linear correlation analysis was applied to analyze the correlation between the amount of bleeding and sex, age, nationality, time from onset , systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), serum triglyceride (TG), and cholesterol. According to computed tomography (CT) findings, 68 cases were divided into the basal ganglia ICH group (33 cases) and the lobar ICH group (35 cases). The characteristics between two groups were analyzed using t-test or χ² test.

The data of sex, age, nationality, time from onset, SBP, DBP, Hb, TG, and cholesterol of 68 cases on admission did not show any definitive correlation with the hematoma volumes (P＞0.05). The SBP and DBP of patients in the basal ganglia ICH group were significantly higher than that in the lobar ICH group, respectively [(184.9±28.5) mmHg vs (164.6±24.4) mmHg; (113.0±18.1) mmHg vs (103.0±18.4) mmHg] (t=0.499, 0.486; P=0.002, 0.033).

The relevant factors of hematoma volumes in patients with ICH in plateau area were not yet clear. Diastolic and systolic blood pressure of patients in the basal ganglia ICH group was higher than that in those in lobar ICH group.

To compare the efficacy evaluation of electrospun composite biomaterials and a porcine small intestine submucosa mesh for hernia repair.

A randomized, single-blind, controlled multicenter trial was performed in 3 hospitals in Shanghai. Eligible adult patients with primary unilateral reducible groin hernias were randomly assigned (1∶1) to electrospun composite biomaterials (experimental group) or porcine small intestine submucosa (control group) mesh groups. Patients were treated with the tARB technique and assessed at 1,3 and 6 months after the surgery. The primary endpoint was hernia recurrence. The secondary endpoints were postoperative complications including groin pain and operative site infections.

172 patients were assigned to experimental (n=86) and control (n=86) groups. At 6 months follow-up, postoperative complications occurred in 5 patients (5/86, 5.95%) and 2 (2/86, 2.35%) patients in the control and experimental groups, respectively (P>0.05). There was no significant difference in VAS or SVS score between the two groups.

We demonstrate that electrospun composite biomaterial mesh can be used as a ideal choice for inguinal hernia repair. Electrospun composite biomaterial has the characteristics of low recurrence rate, absorbability and long-term comfort.It can be further applied in clinical practice in the future.

Pancreaticoduodenectomy(PD)remains one of the most complicated hepatobiliary operations. The development of minimally invasive surgery for PD has always been an hot spot. Laparoscopic pancreaticoduodenectomy(LPD) has not been widespread carried out due to its difficulty and long learning curve. LPD accounts for 9% of all PD, according to the National Cancer Data base. Compared with laparoscopic surgery, robotic surgery system has significant advantages in the field of minimally invasive PD, including stereotactic amplified vision, filtering hand tremor and simulating the wrist. The article would review the surgical techniques and notes, which could provide clinical reference for other surgeons.

To investigate the clinical characteristics and outcomes of post-transplant lymphoproliferative disorder (PTLD) in adult kidney transplant recipients.

A retrospective analysis was conducted on the clinical data of 41 kidney transplant recipients diagnosed with PTLD at the First Affiliated Hospital, Zhejiang University School of Medicine from September 1, 2013, to August 30, 2024. Intergroup comparisons of normally distributed measurement data were performed using group t-test; non-normally distributed measurement data were compared using the Kruskal-Wallis test; categorical data were compared using the chi-square test or the Fisher′s exact test. Kaplan-Meier survival curves were plotted with recipient death as the endpoint, and intergroup survival rates were compared using the log-rank test. Cox proportional hazards model was used to analyze risk factors affecting recipient survival. Cutoff values for continuous variables were determined by receiver operating characteristic curves. A P-value <0.05 was considered statistically significant.

As of November 30, 2024, 14 recipients had died, and 27 were alive. Significant differences were observed between the survival and death groups in the time from transplantation to PTLD diagnosis and the situation of presence of multi-organ involvement (all P <0.05). At the time of PTLD diagnosis, serum creatinine levels were 111.0 (86.0-177.0) μmol/L in the survival group and 142.5 (123.8-171.8) μmol/L in the death group, with a statistically significant difference (H=4.694, P<0.05). The average overall survival period after PTLD diagnosis in the 41 kidney transplant recipients was (83±11) months (1-132 months). Recipients with a time from transplantation to PTLD diagnosis >1 year had a lower survival rate than those with≤1 year (χ²=4.044, P<0.05); recipients with multi-organ involvement had a lower survival rate than those without (χ²=4.368, P<0.05). Multivariate Cox proportional hazards regression analysis showed that a time from transplantation to PTLD diagnosis>1 year (HR=0.108, 95%CI: 0.013-0.992), lactate dehydrogenase>285 U/L (HR=0.171, 95%CI: 0.034-0.874), and multi-organ involvement (HR=0.182, 95%CI: 0.039-0.856) were independent risk factors affecting the survival of PTLD recipients (all P<0.05). There was no significant difference in survival rates between recipients receiving R-sequential therapy and those receiving R-CHOP or other R-containing chemotherapy regimens (χ²=0.001, P>0.05); recipients who achieved lymphoma remission after treatment had a higher survival rate than those who did not (χ²=15.859, P<0.05). Epstein-Barr virus (EBV) and CMV infections were more common in the early-onset PTLD group (all P<0.05).

Adult kidney transplant recipients who diagnosed with PTLD have a poor prognosis, EBV and CMV infections are more common in early-onset PTLD. Time of diagnosis >1 year post-transplantation, multi-organ involvement, and elevated lactate dehydrogenase levels are risk factors for survival.

To systematically evaluate the clinical characteristics and treatment prognosis of patients with moderate-to-severe transplant renal artery stenosis (TRAS), and to explore the risk factors of TRAS after kidney transplantation, providing the basis for early prevention, diagnosis, and treatment.

The clinical data of 16 patients who underwent kidney transplantation in Northern Theater Command General Hospital from January 2022 to July 2024 and were diagnosed with moderate-to-severe TRAS during follow-up were retrospectively analyzed, and recipients who received the other kidney from the same donor were selected as the control group. The basic information, clinical manifestations, laboratory test results, treatment methods, and prognosis of the patients were collected. Independent sample t-test, Mann-Whitney U test, or paired sample t-test were used for comparative analysis of measurement data, while chi-square test or Fisher′s exact probability method were applied to count data. Cox proportional hazards regression was used to analyze risk factors for moderate-to-severe TRAS. The receiver operating characteristic curve (ROC) was used to evaluate the predictive performance of risk factors for TRAS.

The incidence of moderate-to-severe TRAS after kidney transplantation was 4.5%, with a median time of 157 days post-transplantation. At the time of TRAS diagnosis, the TRAS group had significantly higher neutrophil ratio, serum urea nitrogen, creatinine, and cystatin levels, and lower hemoglobin levels compared to the control group (all P<0.05). Univariate analysis showed that the TRAS group had a lower body mass index, higher proportion of re-transplantation, more frequent use of mizoribine, and higher serum lipoprotein a levels compared to the control group, with statistically significant differences (all P<0.05). Cox proportional hazards regression analysis showed that re-transplantation (HR=5.772, 95%CI: 1.227-26.684, P<0.05) and high lipoprotein a levels (HR=1.008, 95%CI: 1.002-1.013, P<0.05) were independent risk factors for moderate-to-severe TRAS. ROC curve analysis for lipoprotein a showed that the area under the curve was 0.771 (95%CI: 0.597-0.946, P<0.05), and the optimal cutoff value was 74.95 nmol/L. In the TRAS group, 9 patients were stented, 2 patients were treated with balloon dilatation alone, and 5 patients were treated with balloon dilatation combined with stent implantation; serum creatinine at 3, 7, 14, 28 days and 2, 3 months after interventional therapy was significantly different from that before surgery (t=2.959, 3.354, 2.795, 3.148, 3.040, and 3.721, P<0.05).

Patients with moderate-to-severe TRAS after kidney transplantation exhibit higher neutrophil ratios, more severe anemia, and significantly elevated serum urea nitrogen, creatinine, and cystatin levels. Interventional therapy can significantly improve renal function in such patients. Patients with re-transplantation and lipoprotein a levels >74.95 nmol/L were at higher risk of moderate-to-severe TRAS.

To establish a fluorescence quantitative PCR (qPCR) assay for detecting Torque teno virus (TTV) in human blood and evaluate its role in assessing immune function in kidney transplant recipients.

Based on the TTV standard nucleic acid sequence published in the NCBI (the national center for biotechnology information) database, primers and probes were designed for the UTR region.This region was artificially synthesized and integrated into a plasmid as a detection standard. Reaction conditions, including annealing temperature, primer concentration, and probe concentration, were optimized to establish a standard curve for TTV qPCR detection. Clinical blood samples from 108 kidney transplant recipients and candidates awaiting transplantation were collected from the Transplant Medicine Center of Wuhan University and divided into stable, rejection, pre-transplant, and infection groups based on clinical status. TTV load was measured, and the diagnostic value of TTV copy number for post-transplant infection and rejection was evaluated using receiver operating characteristic (ROC) curve analysis.

The optimized qPCR conditions were determined as an annealing temperature of 56 ℃, with 1 μL each of primers and probes. Under these conditions, a standard curve was generated using standard templates ranging from 9 to 3 log copies/μL, yielding a coefficient of determination R²=0.999, slope=-3.320, intercept=42.28, amplification efficiency=100.1%, and a lower detection limit of 1 log copies/μL. qPCR testing of 108 patient plasma samples revealed correlations between TTV load and infection or rejection. The TTV load in the stable group was 5.125 (4.550, 5.491) log copies/μL, increased in the infection group to 5.888 (5.135, 6.506) log copies/μL, decreased in the rejection group to 4.167 (3.459-4.869) log copies/μL, and was lowest in the pre-transplant group at 2.885 (2.636, 3.233) log copies/μL, with statistically significant differences (P<0.05). The area under the ROC curve (AUC) for TTV load in diagnosing rejection was 0.7875 (P<0.05), with an optimal cutoff value of 4.999 log copies/μL at the maximum Youden index. For diagnosing infection, the AUC was 0.7458 (P<0.05), with an optimal cutoff value of 5.770 log copies/μL.

The established TTV qPCR assay demonstrates good sensitivity and specificity for detecting TTV in human whole blood. A TTV load below 9.98×10⁴ copies/μL indicates a higher risk of rejection, while a load above 5.89×10⁵ copies/μL suggests a higher risk of infection.

With the increasing treatment demands of patients with type 1 diabetes mellitus, pancreatic islet transplantation has emerged as a promising curative therapeutic approach. However, the expansion of donor pools remains a critical challenge for its clinical application. Based on the latest research findings both domestically and internationally, this study systematically explores the application prospects of human-derived islet cells, xenogeneic islet cells, artificial islet cells, and islet organoids in donor pool expansion. Research indicates that human-derived cardiac islet cells, autologous islet cells, and live donors offer diverse options; gene-edited pig islet cells exhibit significant potential in xenotransplantation; stem cell differentiation technologies and direct reprogramming strategies have made the generation of artificial islet cells feasible; and islet organoids, through 3D bioprinting and tissue engineering technologies, further optimize the structure and function of islet-like constructs. However, challenges such as immune rejection and the long-term maintenance of graft functionality remain major obstacles to current technologies. By optimizing donor cell sources, improving immunotolerance strategies, and integrating gene editing with regenerative medicine technologies, the clinical translation prospects of these emerging approaches are becoming increasingly clear. Future research should focus on technological optimization and safety evaluation to provide novel pathways for expanding donor pools and enhancing the clinical efficacy of islet transplantation.

To explore the application effect of modified pancreatic duct-jejunum bridge-type internal drainage in laparoscopic pancreaticoduodenectomy (LPD).

This study adopted a prospective design, enrolling 95 patients who underwent LPD from January 2021 to May 2023. Patients were divided into two groups using a random number table: 48 cases in the modified group received modified pancreatic duct-jejunum bridge-type internal drainage, and 47 cases in the control group underwent traditional pancreatic duct-jejunum mucosa anastomosis (including internal drainage). Measurement data such as intraoperative blood loss, operation time, and hospital stay were expressed as (±s), and compared between groups using independent sample t tests. Ranked data or enumeration data (e.g., total incidence of postoperative complications, Clavien-Dindo complication grading) were expressed as rates, and compared using the Rank Sum test or χ² test. Survival analysis curves were drawn by Kaplan-Meier, and survival differences between groups were compared by Log-Rank test.

There were no significant differences in intraoperative blood transfusion volume or hospitalization costs between the two groups (P>0.05). The cumulative overall survival rates showed no significant difference between the modified group and the control group (100.0% vs. 95.7%, Log-Rank χ²=1.887, P>0.05). Compared with the control group, the modified group had less intraoperative blood loss, shorter operation time, drainage tube indwelling time, anastomosis time, and hospital stay, as well as lower amylase levels in drainage fluid on the 1st postoperative day (all P<0.05). The total incidence of postoperative complications and Clavien-Dindo gradeⅠ-Ⅲcomplications in the modified group were lower than those in the control group (4.2% vs. 27.7%, P<0.05). The incidence of B/C-grade CR-POPF in the modified group was 2.1% (1/48), significantly lower than 17.0% (8/47) in the control group (P<0.05).

In LPD, modified pancreatic duct-jejunum bridge-type internal drainage optimizes anastomosis operations, shortens operation, anastomosis, and hospital stay durations, reduces intraoperative bleeding, and has a lower risk of postoperative complications. It is safer and more efficient than traditional pancreatic duct-jejunum mucosa anastomosis (including internal drainage).

To compare the clinical effects of modified double purse-string pancreaticojejunostomy and greater omentum-wrapped pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy (LPD).

A prospective analysis was performed on the clinical data of 86 patients who underwent LPD from April 2020 to December 2023. According to the random number table method, the patients were divided into a control group (receiving modified double purse-string pancreaticojejunostomy) and an observation group (receiving greater omentum-wrapped pancreaticojejunostomy), with 43 patients in each group. Data were processed using SPSS 27.0 statistical software. Measurement data such as intraoperative blood loss and drainage time were expressed as (±s) and analyzed by independent sample t test; enumeration data such as the total incidence of postoperative complications and pathological types were expressed as [cases (%)] and analyzed by χ² test; ordinal data such as Clavien-Dindo classification were expressed as frequencies and analyzed by Rank Sum test. P<0.05 was considered statistically significant.

There were no significant differences between the two groups in intraoperative blood loss, drainage time, exhaust time, hospital stay, hospitalization cost, total incidence of postoperative complications, or Clavien-Dindo complication classification (P>0.05). The pancreaticojejunostomy time and operation time in the observation group were shorter than those in the control group (P<0.05). There was no significant difference in the 2-year overall survival rate between the two groups (P>0.05).

In laparoscopic pancreaticoduodenectomy, compared with the modified double purse-string pancreaticojejunostomy, the greater omentum-wrapped pancreaticojejunostomy has shorter pancreaticojejunostomy and operation times, and is equally safe and effective.

This study aimed to explore the expression of BRAF-activated non-protein coding RNA (BANCR) in pancreatic cancer tissues and blood, and evaluate its potential as a biomarker for lymph node metastasis and prognosis.

Clinical data of 68 patients with pancreatic cancer who underwent radical surgery were retrospectively analyzed. Real-time fluorescent quantitative polymerase chain reaction (qRT-PCR) was used to detect BANCR expression levels in paired tumor tissues, adjacent normal pancreatic tissues, and serum samples. Microlymphatic vessel density (MLVD) in tumor tissues was evaluated by immunofluorescence. Paired sample t test was used for statistical analysis to compare differences between pancreatic cancer tissues and adjacent tissues, independent sample t test for differences between LNM(+) and LNM(-) groups, Spearman correlation analysis to assess the correlation between BANCR and MLVD, ROC curve analysis for diagnostic efficacy, and Kaplan-Meier method for survival analysis.

BANCR expression in tumor tissues was significantly higher than that in adjacent normal tissues, and was positively correlated with lymph node metastasis. Peripheral blood BANCR levels were significantly elevated in patients with lymph node metastasis. Preoperative high expression of peripheral blood BANCR showed stronger predictive efficacy for poor prognosis than CA199.

Peripheral blood BANCR expression in pancreatic cancer patients with lymph node metastasis is significantly higher than that in patients without metastasis, suggesting that BANCR may serve as a novel biomarker for predicting lymph node metastasis and evaluating prognosis in pancreatic cancer.

To construct an individualized chemotherapy response scoring system using artificial intelligence technology to provide decision support for precision treatment of gastric cancer patients.

A retrospective analysis was performed on 11 478 patients diagnosed with gastric cancer and treated with radical surgery in the SEER database between 2000 and 2021. The DeepSurv neural network model was used to integrate the clinicopathological characteristics of patients and establish a prognostic prediction model. Survival analysis was applied to evaluate the predictive performance of the model, and a permutation-based method was used to quantify the importance of each input feature for the model’s predictive results.

Patients with high model risk scores showed significantly better prognosis than those with low scores (HR=6.19, 95% CI: 5.83-6.58, Log-Rank P<0.01). The patient group following the model’s chemotherapy recommendations (n=7 367) had significantly better prognosis than those not following the recommendations (n=4 111) (HR=0.46, 95% CI: 0.44-0.49, Log-Rank P<0.01). Variable importance analysis showed that the proportion of positive lymph nodes, T stage, and age were the three most important factors affecting prognosis and chemotherapy recommendations. The proportion of chemotherapy recommended by the model increased with the progression of tumor stage, while it also increased with patient age.

The DeepSurv model constructed based on the SEER database can not only accurately predict the prognosis of gastric cancer patients but also provide valuable guidance for precision chemotherapy decision-making.

To explore the effect of real-scene teaching based on tracer imaging technology on the standardized training of gastrointestinal surgery.

Three-dimensional (3D) CT was used to construct real preoperative vascular imaging scenarios, tracer navigation was applied for real intraoperative scene teaching during surgery observation, and fresh specimens were utilized for real postoperative lymph node identification training. Sixty trainees undergoing standardized training in gastrointestinal surgery were selected and evaluated using a self-controlled before-after comparison method. Paired t tests were used to compare the score differences in theoretical knowledge, 3D gastric CT interpretation, key node interpretation of surgical videos, and postoperative specimen identification ability before and after training.

The average scores of the four abilities before training were (18.5±2.4), (17.1±2.6), (17.6±3.2), and (18.7±2.6), respectively. After training, the scores were (21.2±2.0), (18.6±2.0), (19.7±2.3), and (19.9±1.7), respectively, with statistically significant differences in all items (all P<0.05).

Real-scene teaching based on tracer imaging can effectively improve the teaching effect in standardized training of gastrointestinal surgery.

To investigate the clinical effect of totally laparoscopic distal gastrectomy (TLDG) in the treatment of locally advanced gastric cancer (LAGC).

A retrospective analysis was performed on the clinical data of LAGC patients from May 2021 to May 2023. Patients were divided into the TLDG group and the laparoscopic-assisted distal gastrectomy (LADG) group according to different surgical methods. Propensity score matching was used for 1:1 matching based on general data, with 60 patients enrolled in each group. Data were analyzed using SPSS 25.0 software. Measurement data such as perioperative indicators were expressed as (±s), and independent sample or paired sample t tests were used; enumeration data such as differentiation degree were expressed as (cases), and χ² test was applied; survival analysis was performed by Kaplan-Meier method with Log-Rank test. P<0.05 was considered statistically significant.

The TLDG group had less intraoperative blood loss and shorter incision length than the LADG group (P<0.05). The time to postoperative anal exhaust, feeding, ambulation, postoperative analgesic use, and hospital stay in the TLDG group were all shorter than those in the LADG group (P<0.05). The drainage tube removal time in the TLDG group was earlier than that in the LADG group, and the postoperative drainage volume was smaller (P<0.05). One day after surgery, the serum levels of IL-6, CRP, and WBC in both groups increased compared with those before surgery, but were lower in the TLDG group than in the LADG group (P<0.05). There was no significant difference in 1-year survival rate between the two groups (P>0.05).

TLDG shows good efficacy in the treatment of LAGC patients, with less intraoperative blood loss, shorter incision length, milder postoperative inflammatory response, and less drainage volume. It can shorten the postoperative recovery time, analgesic use time, and drainage tube removal time.

To compare the clinical effects of laparoscopic-assisted radical distal gastrectomy via different approaches in the treatment of advanced distal gastric cancer.

The clinical data of 92 patients with advanced distal gastric cancer who underwent laparoscopic-assisted radical distal gastrectomy from April 2020 to April 2023 were retrospectively collected. According to different surgical approaches, they were divided into the right-sided group (n=47) and the left-sided group (n=45). SPSS25.0 statistical software was used for data analysis. Measurement data such as clinical data were described by (±s), and t test was performed; enumeration data such as gender were described by [cases (%)], and chi-square test was performed. The Kaplan-Meier curve was used to analyze the survival of patients 12 months after operation.

the operation time of the right-sided group was shorter than that of the left-sided group, and the number of lymph nodes dissected was more than that of the left-sided group (P<0.05); there was no significant difference in postoperative exhaust, out-of-bed activity, and hospital stay between the two groups (P>0.05). The tests of group, time point, and interaction effect between group and time point of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) in the two groups were statistically significant (P<0.05); CRP, TNF-α, and IL-6 in the right-sided group were lower than those in the left-sided group at 3 days and 7 days after operation (P<0.05). The levels of carcinoembryonic antigen (CEA), carbohydrate antigen 199 (CA199), and CA125 in the two groups were lower than those before operation at 1 week after operation, but there was no significant difference between the groups (P>0.05). There was no significant difference in the survival of the two groups (P>0.05).

The left-sided approach and the right-sided approach can achieve comparable survival at 12 months after operation, but compared with the left-sided approach, the right-sided approach can increase the number of lymph nodes dissected in laparoscopic-assisted radical distal resection, shorten the operation time, and reduce the degree of perioperative inflammatory response.

To compare the short-term clinical outcomes of totally laparoscopic proximal gastrectomy with double-channel anastomosis and total gastrectomy with Roux-en-Y anastomosis, and to explore the application effect of double-channel anastomotic reconstruction in the treatment of advanced Siewert typeⅡandⅢesophagogastric junction cancer (AEG).

The clinical data of 100 patients who underwent gastradenocarcinoma surgery were retrospectively analyzed. Propensity score matching (PSM) was performed using the 1:1 nearest neighbor matching method, and they were divided into the PG group (n=26) and the TG group (n=26) according to different resection scopes and anastomotic methods. R language software was used for data analysis. For measurement data, t test and Rank Sum test were used for intergroup comparison according to whether they conformed to normal distribution, and χ² test or Fisher’s exact probability method was used for intergroup comparison of categorical variables. Matching was performed by the 1:1 nearest neighbor matching method, and the caliper value was 0.25. P<0.05 was considered statistically significant.

Before PSM, there were statistically significant differences in age and antegrade/retrograde peristaltic anastomosis between the two groups (P<0.05). After PSM, 52 cases were successfully paired, 26 cases in each of the PG group and the TG group. There were no statistically significant differences between the two groups in intraoperative blood loss, time to first postoperative exhaust, T/N staging, intraoperative and postoperative complications, and nutritional indicators such as hemoglobin (Hb) and serum albumin (ALB) levels on the 1st, 3rd, 5th, 7th day and 1 month after surgery. The total number of lymph nodes dissected in the PG group was less than that in the TG group, (42.7±17.8) and (60.7±37.2), respectively, and the difference was statistically significant (P=0.032), but there was no statistically significant difference in the number of positive lymph nodes between the two groups (P>0.05).

Proximal gastrectomy for patients with advanced Siewert typeⅡandⅢAEG is safe and feasible in terms of oncology. Double-channel reconstruction after proximal gastrectomy is not inferior to total gastrectomy reconstruction in terms of postoperative nutritional status and quality of life.