The impact of prophylactic antibiotics on postoperative infection following laparoscopic cholecystectomy remains controversial. This meta-analysis and trial sequential analysis aims to assess the efficacy of prophylactic antibiotics in reducing the risk of postoperative infection following laparoscopic cholecystectomy. Multiple databases including PubMed, Cochrane Library, EMBASE, and Web of Science were systematically searched to identify relevant randomized controlled trials (RCTs) published from inception to January 23, 2024. This study analyzed endpoints such as infection complications (IC) and surgical site infections (SSI). RCTs comparing prophylactic antibiotics versus placebo or no treatment in patients undergoing laparoscopic cholecystectomy were included. Data extraction and meta-analysis were performed. Additionally, trial sequential analysis was conducted to assess the robustness of evidence in meta-analysis. Thirty-six RCTs with 9386 patients were included. The IC and SSI in prophylactic antibiotics group were significantly lower [pooled log risk-ratio (log RR): 0.37, 95 % confidence interval (CI):(−0.60, −0.14), p = 0.0017; pooled log RR: 0.30, 95 % CI (−0.51, −0.09), p = 0.01]. Trial sequential analysis revealed relative risk reductions of 33.09 % for IC and 27.96 % for SSI. Trial sequential analysis suggesting that the current evidence is robust. Studies involving low-risk patients and those with acute cholecystitis inclusion did not demonstrate a clear advantage in SSI reduction with prophylactic antibiotics. Prophylactic antibiotics significantly reduces the risk of postoperative infection in patients undergoing laparoscopic cholecystectomy. Moreover, the lack of research on the impact of prophylactic antibiotics on postoperative infections in patients with acute cholecystitis undergoing laparoscopic cholecystectomy underscores the importance of further investigation.

Objective To study the effect of transversus abdominis plane (TAP) block under direct vision with acupoint injection on the rapid recovery of patients after laparoscopic cholecystectomy. Methods Ninety-three patients undergoing laparoscopic cholecystectomy at Hangzhou Hospital of Traditional Chinese Medicine from January 2023 to December 2023 were selected and divided into control, TAP block under direct vision (TAP-DV), and TAP-DV with acupoint injection (TAP-DVA) groups using a random number table method. Postoperative VAS, Ramsay score, IL-6, CRP, and postoperative rehabilitation indices were compared among the three groups. Results The VAS pain score at 6 h after surgery was significantly lower in the TAP-DV and TAP-DVA groups than in the control group (P < 0.05). The VAS pain score at 24 h after surgery was significantly lower in the TAP-DV and TAP-DVA groups than in the control group (P < 0.05) and was significantly lower in the TAP-DVA group than in the TAP-DV group (P < 0.05). The VAS pain score 48 h after surgery was significantly lower in the TAP-DVA group than in the control and TAP-DV groups (P < 0.05). The mean IL-6 level was significantly lower in the TAP-DVA and TAP-DV groups than in the control group (P < 0.05). The postoperative nausea and vomiting rate was significantly lower in the TAP-DVA group than in the control group (P < 0.05). The postoperative exhaust time was earlier in the TAP-DV and TAP-DVA groups than in the control group (P < 0.05) and was earlier in the TAP-DVA group than in the TAP group (P < 0.05). The postoperative hospitalization days and total cost were significantly lower in the TAP-DV and TAP-DVA groups than in the control group (P < 0.05). Conclusion TAP-DVA has a stable and good analgesic effect and can promote rapid recovery after laparoscopic cholecystectomy.

Infected wounds present a significant clinical challenge due to persistent inflammation, bacterial infection, and hindered tissue regeneration. In this study, we developed a composite bioactive scaffold by combining PLGA-modified small intestinal submucosa (SIS) with astragaloside IV (AS-IV)-preconditioned bone marrow mesenchymal stem cells (BMSCs). We evaluated its physicochemical characteristics and therapeutic effectiveness both in vitro and in a infected wound model. The composite scaffold exhibited enhanced mechanical strength and facilitated the adhesion and proliferation of the BMSCs. Pretreatment with AS-IV significantly enhanced BMSC survival and boosted the secretion of pro-regenerative factors such as VEGF and TGF-β, potentially contributing to the observed enhanced regenerative effects in this study. In vivo, the PABS group exhibited markedly accelerated wound closure compared to the control groups, along with reduced infiltration of inflammatory cells and increased collagen deposition (~ 50%) and epidermal thickness (~ 154 μm). Furthermore, enhanced angiogenesis and controlled expression of inflammatory cytokines (reduced TNF-α, IL-1β, and IL-6; increased IL-10) were observed, suggesting a potentially improved modulation of the wound microenvironment. This multifunctional scaffold facilitated wound healing by combining antibacterial, anti-inflammatory, and pro-regenerative effects, offering a promising approach for managing chronic and infected wounds.