BACKGROUND Colorectal cancer(CRC)is a common malignant tumor of the digestive system that poses a serious threat to human health.During the perioperative period,patients with CRC are prone to nutritional risks and mal...BACKGROUND Colorectal cancer(CRC)is a common malignant tumor of the digestive system that poses a serious threat to human health.During the perioperative period,patients with CRC are prone to nutritional risks and malnutrition.Compared with traditional nutritional support,immunostimulatory nutrients,including glutamine(Gln),have attracted increasing attention.Although many previous studies have reported that perioperative Gln supplementation can improve short-term clinical outcomes in patients with CRC,some studies have not demonstrated a benefit.Resolution of Gln supplementation value thus requires further exploration.AIM To clarify the influence of perioperative Gln-enhanced nutritional support on postoperative outcomes including nutritional status,immune function,inflammation levels,morbidity due to complications,and length of hospital stay(LOS).METHODS A comprehensive literature search was conducted(inception to June 2025).PubMed,EMBASE,Web of Science,Cochrane Library,China Biomedical Database,CNKI,VIP,and the Wanfang Electronic Database were searched.This meta-analysis ultimately included 27 studies with a total of 1643 patients;827 patients received perioperative Gln treatment and 816 received conventional nutritional therapy.A random-effects model was used to pool relative risks(RR)and mean differences(MD)with 95%confidence intervals(CI).RESULTS Pooled analysis showed that Gln intervention reduced morbidity associated with postoperative infectious complications(RR=0.36;95%CI:0.24-0.54)and non-infectious complications(RR=0.32;95%CI:0.19-0.55)and shortened the LOS by 2.31 days(MD=-2.31;95%CI:-3.21 to-1.41)in CRC patients.Gln supplementation also increased serum albumin,prealbumin,peripheral blood lymphocyte count,and nitrogen balance levels and improved humoral and cellular immune function.We also found that postoperative tumor necrosis factor-αand C-reactive protein levels were lower in Gln-supplemented patients.By contrast,Gln supplementation did not improve CD8+and CD4+/CD8+levels.CONCLUSION Gln supplementation effectively improved short-term clinical outcomes in patients with CRC.展开更多
BACKGROUND Tourette syndrome(TS)is a neurodevelopmental disorder characterized by the presence of motor and vocal tics,typically beginning in childhood.Despite signifi-cant research efforts,the exact pathophysiology o...BACKGROUND Tourette syndrome(TS)is a neurodevelopmental disorder characterized by the presence of motor and vocal tics,typically beginning in childhood.Despite signifi-cant research efforts,the exact pathophysiology of TS remains incompletely understood.Recent studies suggest that inflammation may play a role in the severity and progression of TS,pointing to the potential influence of dietary and lifestyle factors on the condition.Currently,research on the specific connection between dietary inflammatory index(DII)and TS is still in its early stages,requir-ing additional clinical and epidemiological studies to validate the strength and specific mechanisms of this connection.METHODS A total of 207 children diagnosed with TS in the pediatric department of Qingdao Chengyang People’s Hospital from January 2022 to January 2023 were selected.They were divided into stable and unstable groups based on follow-up condi-tions.Before enrollment,general information of the children[age,gender,body mass index(BMI),guardian’s education level,DII score,medical history,family history,academic stress,electronic device usage,medication,and disease progression]was assessed,and serum inflammatory levels were measured during follow-up visits.DII scores and Yale Global Tic Severity Scale(YGTSS)scores were calculated.Furthermore,based on YGTSS scores,the children were classified into mild,moderate,and severe groups.The DII,interleukin-6(IL-6),C-reactive protein(CRP),and tumor necrosis factor-alpha(TNF-α)levels in each group were compared.RESULTS Follow-up surveys were completed by 207 children and their guardians.Among them,117 children were in the stable group,and 90 were in the recurrent group.We found no statistically significant differences in age,gender,comorbidities,BMI,and disease duration between the two groups(P>0.05).However,academic stress,electronic device usage,medication,guardian’s education level,and DII scores showed statistically significant differences between the groups(P<0.05).Multifactorial regression analysis revealed that guardian’s anxiety level,DII score,medication,academic stress,and family history were statistically significant factors(P<0.05)affecting the recurrence of TS in children.Therefore,anxiety level,DII score,medication status,electronic device usage,and academic stress were identified as factors influencing the recurrence of TS in children.Among them,DII score,academic stress,and family history had odds ratios(OR)greater than 1,indicating risk factors,whereas medication status and guardian’s education level had OR values less than 1,indicating protective factors.According to the YGTSS scores,children were categorized into mild,moderate,and severe groups.Comparative analysis of DII and inflammatory levels in children with different degrees of tic disorders revealed that the severe group had the highest DII and inflammatory levels,followed by the moderate group,and the mild group had the lowest levels.The trend of TS progression was consistent with the DII results.Receiver operating characteristic curves were plotted to predict disease progression in patients with TS via inflammatory markers.The areas under the curve for IL-6,CRP,and TNF-αwere 0.894(95%CI:0.817-0.969),0.793(95%CI:0.694-0.893),and 0.728(95%CI:0.614-0.843)respectively,with statistically significant differences(P<0.05).According to the Youden index,the optimal cutoff values were IL-6=3.775 ng/L(sensitivity 68.1%and specificity 68.4%),CRP=6.650 mg/L(sensitivity 60.6%and specificity 68.4%),and TNF-α=0.666(sensitivity 60.6%and specificity 71.1%).CONCLUSION We found a certain correlation between DII and the severity,recurrence,and inflammatory levels of TS in children.Reasonable reduction in the intake of pro-inflammatory foods may be beneficial in reducing the risk of disease progression in children with TS.展开更多
基金Supported by National Natural Science Foundation of China,No.81960105Medical Research Union Fund for High-quality Health Development of Guizhou Province,No.2024GZYXKYJJXM0155.
文摘BACKGROUND Colorectal cancer(CRC)is a common malignant tumor of the digestive system that poses a serious threat to human health.During the perioperative period,patients with CRC are prone to nutritional risks and malnutrition.Compared with traditional nutritional support,immunostimulatory nutrients,including glutamine(Gln),have attracted increasing attention.Although many previous studies have reported that perioperative Gln supplementation can improve short-term clinical outcomes in patients with CRC,some studies have not demonstrated a benefit.Resolution of Gln supplementation value thus requires further exploration.AIM To clarify the influence of perioperative Gln-enhanced nutritional support on postoperative outcomes including nutritional status,immune function,inflammation levels,morbidity due to complications,and length of hospital stay(LOS).METHODS A comprehensive literature search was conducted(inception to June 2025).PubMed,EMBASE,Web of Science,Cochrane Library,China Biomedical Database,CNKI,VIP,and the Wanfang Electronic Database were searched.This meta-analysis ultimately included 27 studies with a total of 1643 patients;827 patients received perioperative Gln treatment and 816 received conventional nutritional therapy.A random-effects model was used to pool relative risks(RR)and mean differences(MD)with 95%confidence intervals(CI).RESULTS Pooled analysis showed that Gln intervention reduced morbidity associated with postoperative infectious complications(RR=0.36;95%CI:0.24-0.54)and non-infectious complications(RR=0.32;95%CI:0.19-0.55)and shortened the LOS by 2.31 days(MD=-2.31;95%CI:-3.21 to-1.41)in CRC patients.Gln supplementation also increased serum albumin,prealbumin,peripheral blood lymphocyte count,and nitrogen balance levels and improved humoral and cellular immune function.We also found that postoperative tumor necrosis factor-αand C-reactive protein levels were lower in Gln-supplemented patients.By contrast,Gln supplementation did not improve CD8+and CD4+/CD8+levels.CONCLUSION Gln supplementation effectively improved short-term clinical outcomes in patients with CRC.
文摘BACKGROUND Tourette syndrome(TS)is a neurodevelopmental disorder characterized by the presence of motor and vocal tics,typically beginning in childhood.Despite signifi-cant research efforts,the exact pathophysiology of TS remains incompletely understood.Recent studies suggest that inflammation may play a role in the severity and progression of TS,pointing to the potential influence of dietary and lifestyle factors on the condition.Currently,research on the specific connection between dietary inflammatory index(DII)and TS is still in its early stages,requir-ing additional clinical and epidemiological studies to validate the strength and specific mechanisms of this connection.METHODS A total of 207 children diagnosed with TS in the pediatric department of Qingdao Chengyang People’s Hospital from January 2022 to January 2023 were selected.They were divided into stable and unstable groups based on follow-up condi-tions.Before enrollment,general information of the children[age,gender,body mass index(BMI),guardian’s education level,DII score,medical history,family history,academic stress,electronic device usage,medication,and disease progression]was assessed,and serum inflammatory levels were measured during follow-up visits.DII scores and Yale Global Tic Severity Scale(YGTSS)scores were calculated.Furthermore,based on YGTSS scores,the children were classified into mild,moderate,and severe groups.The DII,interleukin-6(IL-6),C-reactive protein(CRP),and tumor necrosis factor-alpha(TNF-α)levels in each group were compared.RESULTS Follow-up surveys were completed by 207 children and their guardians.Among them,117 children were in the stable group,and 90 were in the recurrent group.We found no statistically significant differences in age,gender,comorbidities,BMI,and disease duration between the two groups(P>0.05).However,academic stress,electronic device usage,medication,guardian’s education level,and DII scores showed statistically significant differences between the groups(P<0.05).Multifactorial regression analysis revealed that guardian’s anxiety level,DII score,medication,academic stress,and family history were statistically significant factors(P<0.05)affecting the recurrence of TS in children.Therefore,anxiety level,DII score,medication status,electronic device usage,and academic stress were identified as factors influencing the recurrence of TS in children.Among them,DII score,academic stress,and family history had odds ratios(OR)greater than 1,indicating risk factors,whereas medication status and guardian’s education level had OR values less than 1,indicating protective factors.According to the YGTSS scores,children were categorized into mild,moderate,and severe groups.Comparative analysis of DII and inflammatory levels in children with different degrees of tic disorders revealed that the severe group had the highest DII and inflammatory levels,followed by the moderate group,and the mild group had the lowest levels.The trend of TS progression was consistent with the DII results.Receiver operating characteristic curves were plotted to predict disease progression in patients with TS via inflammatory markers.The areas under the curve for IL-6,CRP,and TNF-αwere 0.894(95%CI:0.817-0.969),0.793(95%CI:0.694-0.893),and 0.728(95%CI:0.614-0.843)respectively,with statistically significant differences(P<0.05).According to the Youden index,the optimal cutoff values were IL-6=3.775 ng/L(sensitivity 68.1%and specificity 68.4%),CRP=6.650 mg/L(sensitivity 60.6%and specificity 68.4%),and TNF-α=0.666(sensitivity 60.6%and specificity 71.1%).CONCLUSION We found a certain correlation between DII and the severity,recurrence,and inflammatory levels of TS in children.Reasonable reduction in the intake of pro-inflammatory foods may be beneficial in reducing the risk of disease progression in children with TS.
