ObjectiveTo review the application of omega-3 polyunsaturated fatty acids (Ω-3PUFAs) in patients with gastric cancer.MethodThe related literatures about the application of Ω-3PUFAs in patients with gastric cancer were reviewed by searching domestic and international databases.ResultsΩ-3PUFAs didn’t only improve the perioperative immune function and inflammatory response in patients with gastric cancer, but also prevent the occurrence of gastric cancer, inhibit the proliferation and promote the apoptosis of gastric cancer cells, increase the sensitivity of chemotherapy, and reduce the occurrence of chemotherapy-related adverse events.ConclusionsΩ-3PUFAsis an immunological nutrition, which can provide energy and also has functions of anti-inflammatory, anti-cancer, immunity regulation. It has been widely used in patients with gastric cancer, but the relevant mechanism needs further to be investigated.
ObjectiveTo investigate the influencing factor of intraoperative hypothermia during laparotomy.MethodsA total of 81 patients underwent laparotomy in our hospital from October 1, 2018 to January 1, 2019 were enrolled. The difference of preoperative baseline data and surgical data between the hypothermia and non-hypothermia groups was compared, and the influencing factor of intraoperative hypothermia during laparotomy was explored.ResultsOf the 81 patients, 32 patients occurred hypothermia during operation. There were no significant differences in gender, age, BMI, HGB, WBC count, PLT count, TB, AST, ALT, ALB, PT, operation time, postoperative hospital stay, and Clavien-Dindo grade between the hypothermia group and the non-hypothermia group (P>0.05), but there were significant differences in intraoperative infusion volume, intraoperative blood loss, and surgical mode (P<0.05). The intraoperative infusion volume and intraoperative blood loss in the hypothermia group were higher than those in the non-hypothermia operation group, and the proportion of hepatectomy was higher than that in the non-hypothermia group. The multivariate analysis show that the intraoperative blood loss, intraoperative infusion volume, and kind of operation were the risk factors for the hypothermia during laparotomy (P<0.05).ConclusionsIntraoperative hypothermia is related to intraoperative bleeding volume, intraoperative fluid infusion volume, and the kind of operation. Therefore, for patients with less bleeding, the intraoperative hypothermia can be reduced by limiting the volume of intraoperative fluid infusion. For those patients with more intraoperative bleeding, warming fluid infusion may reduce the incidence of intraoperative hypothermia.
Objective To explore the effect of different nutrition on the immune function of patients with colorectal cancer. Methods A total of 640 colorectal cancer patients were randomized into the enteral nutrition and peripheral nutrition groups. The peripheral venous blood was sampled before operation and on the postoperative days 1 and 7 to determine the serum levels of IgG, IgA, IgM, the percentage of T lymph cell subgroups CD3, CD4, CD4/CD8 and CRP, PGE, α- antitrypsin etc. The patient’s general condition, side-effects, and complications were observed intimately after surgery. Results Compared with the control group, the IgG, IgA, IgM, CD3, CD4,CD4/CD8 levels of the trial group on postoperative day 7 were higher. But the levels of CRP, PGE, α- antitrypsin were decreased. Hospitalization time and anal exsufflation time were shorter as well. There was no significant difference in either the general conditions or complications between the two groups. Conclusion Application of enteral nutrition after colorectal cancer surgery is safe, ,effective, and can improve the patient’s immune function and prognosis.
ObjectiveTo analyze the relationship between preoperative pulmonary function indexes and postoperative pneumonia (POP) in patients undergoing upper gastrointestinal surgery.MethodsThe clinical data of 303 patients who underwent lung function examination and upper gastrointestinal surgery in West China Hospital, Sichuan University from September 2020 to January 2021 were prospectively collected and analyzed. There were 217 males and 86 females, with an average age of 61.61±10.42 years. Pulmonary function was evaluated from four aspects including ventilatory function, pulmonary volume, diffusion function and airway resistance. Relevant pulmonary function indicators were displayed as the percentage of actual measured value to predicted value (%pred). The outcome index was pneumonia within 30 days after the surgery. Logistic regression was used to analyze the relationship between preoperative pulmonary function indicators and POP.ResultsA total of 196 patients with gastric cancer and 107 patients with esophageal cancer were included, and the incidence of POP in patients undergoing upper gastrointestinal surgery was 26.7% (81/303). Patients with preoperative low peak expiratory flow (PEF%pred) had a 3.094 times higher risk of developing POP than those with normal PEF%pred [OR=3.094, 95%CI (1.362, 7.032), P=0.007]. The incidence of POP had no correlation with the other preoperative indicators.ConclusionPreoperative PEF%pred may be an important indicator for predicting the occurrence of POP in patients undergoing upper gastrointestinal surgery.
Objective To analyze the research status of immunonutrition in China based on Chinese databases, and to provide a reference for clinical practice and future research. Methods Literatures about the application of immunonutrition in nutrition support were searched in China National Knowledge Infrastructure, SinoMed, Chongqing VIP and Wanfang databases using bibliometrics methods. The retrieval time was up to August 2022, and the document characteristics such as the number of publications, the institutions and the citation frequency and other features were analyzed. Results A total of 725 literatures were included, with the highest number of literatures issued in 2015 and 2020, both 62. The areas with the most published literatures were Jiangsu (10.6%) and Guangdong (8.4%). The institutions with the most published literatures were General Hospital of Eastern Theater Command (4.8%) and West China Hospital of Sichuan University (3.9%). There were 78 dissertations and 647 journal articles in total. The most published journal was Parenteral & Enteral Nutrition (6.5%). The top three citations were all reviews. The degree of cooperation was 2.7, and the co-authorship rate was 70.1%. A total of 121 articles reported the supporting funds and projects. The research types included 499 original studies (68.8%) and 226 secondary studies (31.2%). The analysis of the subjects showed that immunonutrition was mostly applied to gastrointestinal diseases, especially gastrointestinal cancer patients, accounting for 42.5%. Nutritional support was divided into enteral nutrition and parenteral nutrition. Enteral nutrition was adopted in most literatures, accounting for 88.4%. Conclusions The research content of immunonutrition in Chinese database in China is relatively simple. Most of them focus on the comparison between immunonutrition and general nutrition support. The selection of immune nutrients and the application of immunonutrition in critically ill patients such as sepsis need further research.
ObjectiveTo assess the effect of chewing gum on the recovery of postoperative gastrointestinal function in patients with colorectal cancer. MethodsA comprehensive search for relevant randomised controlled trials (RCTs) was conducted in domestic and international databases such as PubMed, The Cochrane Library, Web of Science, Chinese Science and Technology Journal Full-text Database, Chinese Periodicals Full-text Database, Wanfang data, and other databases, with a timeframe up to September 2023. The literature was screened according to the inclusion and exclusion criteria. Simultaneously, the literature quality evaluation and data extraction were performed. The continuous variables were described using mean difference (95% confidence interval) and the binary variables were described using odds ratio (95% confidence interval). Test level was α=0.05. ResultsA total of 28 RCTs covering 2 523 postoperative colorectal cancer patients were included. The meta-analysis results showed that the postoperative chewing gum could shorten the time of the first flatus [–11.99 (–14.45, –9.53)], the first defecation [–18.79 (–23.58, –14.00)], the first bowel sounds [–6.35 (–6.64, –6.06)] or the first starvation [–5.20 (–10.11, –0.28)], and the hospital stay [–1.35 (–1.99, –0.70)], as well as could increase the serum gastrin level [23.70 (14.88, 32.53)]. Furthermore, it also could decrease the incidence of postoperative complications, such as nausea [0.66 (0.48, 0.91)], abdominal distension [0.48 (0.35, 0.67)], and intestinal obstruction [0.34 (0.20, 0.59)]. However, there was a non-significant effect on vomiting [0.81 (0.60, 1.09)] or time of the first oral intake [–0.67 (–1.99, 0.65)]. ConclusionsFrom the results of this meta-analysis, postoperative gum chewing aids to promote the recovery of gastrointestinal function and reduce the risk of postoperative complications in colorectal cancer patients. Although further studies are needed to verify the long-term effects and the feasibility of clinical application, the results of this study provide an important empirical support for the utilize of chewing gum in the management of postoperative gastrointestinal function.
ObjectiveTo analyze the research status of mini-clinical evaluation exercise (Mini-CEX) in medical and nursing education in the mainland of China, so as to provide a basis for optimizing medical and nursing teaching evaluation tools and promoting the reform of medical and nursing personnel training mode.MethodsPubMed, Embase, Wanfang, CQVIP, China National Knowledge Infrastructure, and China Biomedical Literature Database were searched. The key words were “mini-clinical evaluation exercise” or “mini-CEX” or “CEX” or “mini clinical exercise evaluation”. The languages were limited to Chinese and English. The address of the first author was in the mainland of China. The retrieval time was from the establishment of the databases to December 31st, 2020. The literature was analyzed bibliometrically after screening and duplicate removal.ResultsA total of 536 articles were included for analysis and summary. The articles originated from 28 provincial-level administrative divisions in China, among which Shanghai, Xinjiang, Guangxi, Liaoning, and Guangdong were the top five in terms of the number of papers published. The annual number of papers published exceeded 60 in 2017, and reached 112 in 2019 and 113 in 2020, respectively. A total of 397 hospitals and universities contributed to the literature, among which 49 institutions published more than 2 papers. The maximum number of articles published by a same author was 5. There were 530 journal papers published in 169 journals. Only 228 articles (42.54%) were supported by funds, and the research type was mainly experimental and quasi experimental research (56.71%). Under the key words co-occurrence network analysis, a total of 321 nodes and 1 013 connections were obtained, with an average of 3.21 connections per node. In addition to “mini-CEX” and “mini-clinical exercise evaluation”, the most prominent research directions were “clinical teaching” “standardized training” “resident” “scenario simulation” and “clinical ability”.ConclusionsThe number of mini-CEX-related medical and nursing articles is increasing year by year, but the distribution of research areas and institutions is uneven, the research quality needs to be improved, the application scope and research types need to be enriched, and the research content needs to be expanded. In the future, teachers and research teams of medical colleges and universities should be mobilized to apply Mini-CEX teaching method to the cultivation of medical and nursing talents in a whole and continuous way, so as to further standardize the localization application of mini-CEX in the mainland of China, and promote the in-depth development of formative evaluation of medical education.
