Résumé
Objective To investigate the relationships between the expression levels of tumor necrosis factor receptor associated factor 4 (TRAF4) and ribosomal S6 protein kinase 4 (RSK4) protein in gastric cancer tissues and the recurrence after laparoscopic radical gastrectomy. Methods In total, 176 patients were divided into the recurrence and non-recurrence group, and the expression levels of TRAF4 and RSK4 protein in cancer and adjacent tissues and in gastric cancer tissues in the recurrence and non-recurrence group were compared. The influencing factor of recurrence and the efficacy of TRAF4 and RSK4 protein expression in predicting recurrence were analyzed. Results The positive expression rate of TRAF4 protein in gastric cancer tissues was higher than that in adjacent tissues (P < 0.05) and that in the recurrence group was higher than that in the non-recurrence group (P < 0.05). The positive expression rate of RSK4 protein in gastric cancer tissues was lower than that in adjacent tissues (P < 0.05) and that in the recurrence group was lower than that in non-recurrence group (P < 0.05). The largest tumor diameter 5 cm, poor differentiation, TNM Ⅲ stage, depth of invasion T3-T4, lymph node metastasis, absence of adjuvant chemotherapy after operation, positive expression of TRAF4 and RSK4 protein, and regular diet w influenced the post-operative recurrence (all P < 0.05). The accuracy of TRAF4 and RSK4 protein in gastric cancer tissues in combined predicting the recurrence was 83.52%. Conclusion The expression of TRAF4 protein is high, and the RSK4 protein is low in gastric cancer tissue, which are related to recurrence.
Résumé
Objective:To explore the application effect of three mode pre-rehabilitation strategy in gastric cancer patients after laparoscopic radical operation and its effect on the recovery of physical function and quality of life after operation.Methods:Totally 96 patients undergoing elective laparoscopic-assisted radical gastric cancer surgery admitted in the Second Affiliated Hospital of Anhui Medical University from January 2019 to September 2020 were divided into control group (48 cases) and observation group (48 cases) by the random number table. Finally two cases in control group were excluded. The control group received gastric cancer regular preoperative health guidance, the observation group received trimodal pre-habilitation strategy for 6-8 days on the basis of the control group. The perioperative indicators and complications were compared between the two groups. The 36-item Health Survey Summary (SF-36) scores were measured before and after intervention.Results:The first postoperative exhaust time, first out of bed time, first oral meal time, hospital stay in the observation group were (61.49 ± 6.71) hours, (19.54 ± 6.13) hours, (71.23 ± 6.79) days, (5.62 ± 1.03) days, which lower than (79.21 ± 8.15) hours, (22.95 ± 7.19) hours, (78.95 ± 7.21) days, (6.64 ± 1.17) days in the control group, and the differences were statistically significant between the two group ( t values were 2.48-11.53, all P<0.05). The incidence of complications was 6.25% (3/48) in the observation group and 21.74% (10/46) in the control group, and the difference was statistically significant between the two groups ( χ2=8.72, P<0.05). At 1 d before operation and 30 d after operation, the average scores of SF-36 were (68.74 ± 8.02), (65.85 ± 7.44) points in the observation group and (60.73 ± 7.43), (61.04 ± 6.85) points in the control group, and the differences were statistically significant ( t=5.02, 3.26, both P<0.05). Conclusions:Preoperative three mode pre-rehabilitation training for gastric cancer patients is beneficial to improving the state of exercise, nutrition and immune function, speeding up postoperative gastrointestinal function and overall rehabilitation, reducing the incidence of postoperative complications and improving the quality of life of patients.
Résumé
Objective To explore the effect of general anesthesia combined with epidural block for patients with gastric cancer undergoing laparoscopic radical operation.Methods Totally 62 patients with gastric cancer who received laparoscopic radical operation were randomly and equally divided into combined group(n =31) and control group (n =31).Combined group and control group was given pure general anesthesia and general anesthesia combined with epidural block,respectively.The perioperative related indicators,hemodynamics and occurrence of POCD in both groups were compared.Results The dosage of propofol in combined group was significantly lower than that in control group (P ＜ 0.05).From T2 moment,the HR was significantly increased,and MAP was reduced in control group compared with T0 moment (P ＜ 0.05).The level of MAP in combined group was significantly higher than that in control group at T2-T4 moment(P ＜ 0.05).At 1 day after operation,MMSE score in control group was significantly reduced compared with before operation,and lower than combined group (P ＜ 0.05).The incidence of POCD in combined group was significantly lower than that in control group (P ＜ 0.05).Conclusion General anesthesia combined with epidural block for patients with gastric cancer undergoing laparoscopic radical operation can reduce the dosage of anesthetic drug,maintain hemodynamic stability,and improve postoperative cognitive ability.