Critically ill patients have a variety of complex pathologies and are in a multifarious state of catabolism supplanted by external and internal factors.Early enteral nutrition(EEN)is defined as the initiation of enter...Critically ill patients have a variety of complex pathologies and are in a multifarious state of catabolism supplanted by external and internal factors.Early enteral nutrition(EEN)is defined as the initiation of enteral feeding within 24-48 hours of hospitalization.Previous studies show the benefits of EEN include supporting the healing process through preservation of the gut mucosa,modulation of the immune response,and suppression of inflammation.However,recent studies suggest the advantages of EEN may not be as robust as previously believed.This review aims to discuss the outcomes of EEN when used in different critical care settings while managing complex disease states such as burns,sepsis,pancreatitis,and upper gastrointestinal bleeding.Evidence indicates that EEN has a positive impact on patient outcomes,hospital costs,length of intensive care unit stay,and preventing complications.展开更多
Han-Ping Shi,M.D.,Ph.D.,FACS,Professor of Surgery,Oncology and Nutrition.He is the current Director of the Faculty of Clinical Nutrition,Capital Medical University.Dr.Shi received his M.D.degree at the School of Medic...Han-Ping Shi,M.D.,Ph.D.,FACS,Professor of Surgery,Oncology and Nutrition.He is the current Director of the Faculty of Clinical Nutrition,Capital Medical University.Dr.Shi received his M.D.degree at the School of Medicine,Wuhan University,Wuhan,and his Ph.D.degree at the Second Military Medical University,Shanghai,China.From 1999 to 2002,Dr.Shi was a postdoc fellow in School of Medicine,Johns Hopkins University,under the supervision of Adrian Barbul,M.D.,FACS,and then in New Jersey Medical School,Rutgers University,under the supervision of Edwin A.Deitch,M.D.,FACS.Dr.Han-Ping Shi was the Chairman of the Chinese Society for Parenteral&Enteral Nutrition(CSPEN)between 2018-2021.He is the founder Chairman of the Chinese Society of Nutritional Oncology(2012-2024),and the director of the Department of Academic,China Anti-Cancer Association(CACA)since 2017.Dr.Han-Ping Shi is currently the founder Editor-in-Chief of Electronic Journal of Metabolism and Nutrition of Cancer(Chinese),founder Editor-in-Chief of Journal of Nutritional Oncology(English)and founder Editor-in-Chief of Precision Nutrition(English).展开更多
Han-Ping Shi,M.D.,Ph.D.,FACS,Professor of Surgery,Oncology and Nutrition.He is the current Chairman of the Department of GI Surgery/Clinical Nutrition at Beijing Shijitan Hospital,Capital Medical University,Beijing,Ch...Han-Ping Shi,M.D.,Ph.D.,FACS,Professor of Surgery,Oncology and Nutrition.He is the current Chairman of the Department of GI Surgery/Clinical Nutrition at Beijing Shijitan Hospital,Capital Medical University,Beijing,China.Dr.Shi received his M.D.degree at the School of Medicine,Wuhan University,Wuhan,and his Ph.D.degree at the Second Military Medical University,Shanghai,China.展开更多
Objective:To study the application effects of the entire-course nutrition management model led by specialized nutrition nurses in patients with distant cholangiocarcinoma.Methods:Using convenience sampling,one hundred...Objective:To study the application effects of the entire-course nutrition management model led by specialized nutrition nurses in patients with distant cholangiocarcinoma.Methods:Using convenience sampling,one hundred and twenty patients with distant cholangiocarcinoma admitted from April 2023 to October 2024 were selected as the experimental subjects of this study.They were grouped using a random number table method.The intervention group consisted of 60 patients with distant cholangiocarcinoma who received the entire-course nutrition management led by specialized nutrition nurses,while the observation group consisted of 60 patients who received conventional management.The intestinal function,nutritional indicators,quality of life,and satisfaction were compared between the intervention and observation groups.Results:After intervention,the intestinal function,nutritional indicators,quality of life,and satisfaction of patients with distant cholangiocarcinoma in the intervention group were significantly better than those in the observation group,with statistically significant differences(P<0.05).Conclusion:The application of the entire-course nutrition management model led by specialized nutrition nurses in patients with distant cholangiocarcinoma has more prominent effects and can further improve prognosis,making it worthy of widespread clinical application.展开更多
BACKGROUND Malnutrition exacerbates the deterioration in patients with advanced gas-trointestinal tumors.AIM To analyze the effect of enteral nutritional support based on Nutrition Risk Screening 2002(NRS2002)risk ass...BACKGROUND Malnutrition exacerbates the deterioration in patients with advanced gas-trointestinal tumors.AIM To analyze the effect of enteral nutritional support based on Nutrition Risk Screening 2002(NRS2002)risk assessment on nutritional function in patients with gastrointestinal tumors.METHODS One hundred twelve patients from April 2022 to April 2024 were included for observation and were divided into a control group and an observation group by random number method,56 each.Both groups received treatment for four consecutive weeks.The control group received routine enteral nutrition support,while the observation group received enteral nutrition support based on the NRS2002 risk assessment.Nutritional function,intestinal mucosal barrier function,quality of life,and complication rate were compared between the two groups.Statistical analysis was completed using SPSS26.0 and Excel.RESULTS After nutritional intervention,transferrin,albumin,hemoglobin,and diamine oxidase levels in the observation group were higher than those in the control group,while C-reactive protein,tumor necrosis factorα,and quality of life scores were lower,with significant differences(P<0.05).There was no significant difference in complications between groups(P>0.05),but the complication rate was lower in the observation group.CONCLUSION Enteral nutritional support based on NRS2002 risk assessment for patients with gastrointestinal tumors positively impacts nutritional status and promotes intestinal mucosal barrier function recovery.Patients’quality of life improved,and the incidence of adverse reactions decreased,indicating clinical promotion and application value.展开更多
BACKGROUND Colorectal cancer(CRC)is a globally prevalent gastrointestinal malignant cancer,especially in elderly patients.Currently,surgery resection remains the primary treatment due to its favorable therapeutic outc...BACKGROUND Colorectal cancer(CRC)is a globally prevalent gastrointestinal malignant cancer,especially in elderly patients.Currently,surgery resection remains the primary treatment due to its favorable therapeutic outcomes.However,postoperative deterioration in nutritional status and quality of life(QoL)remains a concern.The geriatric nutritional risk index(GNRI),which is calculated based on serum albumin levels and the ratio of normal body weight to ideal body weight,is easily accessible and accurate,making it increasingly popular in clinical practice.AIM To investigate the impact of GNRI-guided tiered nutritional interventions on postoperative nutritional recovery and QoL in elderly CRC patients.METHODS A retrospective analysis was conducted on 135 elderly CRC patients undergoing radical resection at our hospital from September 2022 to December 2024.Participants were divided into two cohorts:The research group(n=61)received GNRI-based graded nutritional support,while the control group(n=65)received conventional nutritional intervention.Clinical indicators,such as postoperative passage of gas by anus,incidence/duration of postoperative fever,hospitalization length and costs,were compared between the two groups.Nutritional biomarkers,including hemoglobin,prealbumin,transferrin,and Patient-Generated Subjective Global Assessment scores were assessed on postoperative day 1 and post-intervention(day 1 after intervention).The Generic QoL Inventory-74 was employed to assess physical function,social function,material life,and psychological function in the two groups.Immunoglobulin(Ig)(IgG,IgA,IgM)and inflammatory markers[nuclear factor kappa B,interleukin(IL)-1,tumor necrosis factor-α,IL-8]were compared between groups.Complication rates were also monitored.RESULTS The research group showed significantly faster postoperative passage of gas by anus,fewer instances of fever,reduced fever duration,shorter hospitalization duration,and lower costs compared with the control group(P<0.05).Following intervention,the research group exhibited higher levels of hemoglobin,prealbumin,and transferrin,and lower Patient-Generated Subjective Global Assessment scores vs the control group(P<0.05).Scores for physical function,social function,material life,and psychological function showed substantial improvement(P<0.05).Levels of IgG,IgA,and IgM were significantly elevated in the research group(P<0.05),while nuclear factor kappa B,IL-1,tumor necrosis factor-α,and IL-8 levels were noticeably lowered vs the control group(P<0.05).The incidence of overall complications within the research group reached 24.59%,notably lower than that(43.08%)observed in the control group(P<0.05).CONCLUSION GNRI-based graded nutritional intervention in elderly CRC patients can significantly improve postoperative recovery,enhance their nutritional status and QoL,promote immune function recovery,attenuate inflammation,and lower the incidence of postoperative complications.This protocol represents a clinically viable strategy for optimizing postoperative care.展开更多
BACKGROUND Postoperative nutritional management of gastric cancer(GC)remains a problem that needs to be solved in clinical treatment.AIM To develop an early graded nutrition management plan and evaluate its impact on ...BACKGROUND Postoperative nutritional management of gastric cancer(GC)remains a problem that needs to be solved in clinical treatment.AIM To develop an early graded nutrition management plan and evaluate its impact on feeding tolerance,nutritional status,and prognosis.METHODS In total,142 patients who underwent laparoscopic radical gastrectomy at Jiujiang University Affiliated Hospital between August 2021 and August 2022 were included in this study.Based on postoperative nutritional management and feeding,the patients were divided into observation and control groups.The general information questionnaire,Visual Analog Scale,and Pittsburgh Sleep Quality Index were used to evaluate pain and sleep of patients,respectively.Independent sample t-test andχ2 test were used to analyze differences between groups.RESULTS The feeding intolerance rates in the control and observation groups were 13.2%and 4.1%,respectively.Hospitalization time and first defecation times in the observation group were shorter than those in the control group.Hemoglobin,prealbumin,transferrin,and immunological indices in the observation group were significantly higher than those in the control group 7 days after surgery,whereas calcitonin levels were significantly lower than those in the control group(P<0.05).In general,the nutritional status of the observation group was better than that of the control group,and pain and sleep quality scores improved.CONCLUSION Compared with the conventional postoperative feeding,early stepwise nutritional management can significantly enhance the nutritional status of patients with GC after surgery,improve their feeding tolerance,and reduce postoperative complications.展开更多
BACKGROUND Gastric cancer(GC)is the fifth most common cancer and the third leading cause of cancer-related deaths in China.Many patients with GC frequently experience symptoms related to the disease,including anorexia...BACKGROUND Gastric cancer(GC)is the fifth most common cancer and the third leading cause of cancer-related deaths in China.Many patients with GC frequently experience symptoms related to the disease,including anorexia,nausea,vomiting,and other discomforts,and often suffer from malnutrition,which in turn negatively affects perioperative safety,prognosis,and the effectiveness of adjuvant therapeutic measures.Consequently,some nutritional indicators such as nutritional risk index(NRI),prognostic nutritional index(PNI),and systemic immune-inflammatorynutritional index(SIINI)can be used as predictors of the prognosis of GC patients.AIM To examine the prognostic significance of PNI,NRI,and SIINI in postoperative patients with GC.METHODS A retrospective analysis was conducted on the clinical data of patients with GC who underwent surgical treatment at the Guangxi Medical University Cancer Hospital between January 2010 and December 2018.The area under the receiver operating characteristic(ROC)curve was assessed using ROC curve analysis,and the optimal cutoff values for NRI,PNI,and SIINI were identified using the You-Review-HTMLden index.Survival analysis was performed using the Kaplan-Meier method.In addition,univariate and multivariate analyses were conducted using the Cox proportional hazards regression model.RESULTS This study included a total of 803 patients.ROC curves were used to evaluate the prognostic ability of NRI,PNI,and SIINI.The results revealed that SIINI had superior predictive accuracy.Survival analysis indicated that patients with GC in the low SIINI group had a significantly better survival rate than those in the high SIINI group(P<0.05).Univariate analysis identified NRI[hazard ratio(HR)=0.68,95%confidence interval(CI):0.52-0.89,P=0.05],PNI(HR=0.60,95%CI:0.46-0.79,P<0.001),and SIINI(HR=2.10,95%CI:1.64-2.69,P<0.001)as prognostic risk factors for patients with GC.However,multifactorial analysis indicated that SIINI was an independent risk factor for the prognosis of patients with GC(HR=1.65,95%CI:1.26-2.16,P<0.001).CONCLUSION Analysis of clinical retrospective data revealed that SIINI is a valuable indicator for predicting the prognosis of patients with GC.Compared with NRI and PNI,SIINI may offer greater application for prognostic assessment.展开更多
Traditional tumor-node-metastasis staging overlooks key prognostic factors such as inflammation and nutrition,limiting individualized treatment in colorectal cancer.Integrating biochemical markers with artificial inte...Traditional tumor-node-metastasis staging overlooks key prognostic factors such as inflammation and nutrition,limiting individualized treatment in colorectal cancer.Integrating biochemical markers with artificial intelligence can significantly improve survival prediction and treatment personalization by analyzing complex,multimodal data.This evolving approach holds transformative potential for precision oncology.展开更多
BACKGROUND Sepsis exacerbates intestinal microecological disorders leading to poor prognosis.Proper modalities of nutritional support can improve nutrition,immunity,and intestinal microecology.AIM To identify the opti...BACKGROUND Sepsis exacerbates intestinal microecological disorders leading to poor prognosis.Proper modalities of nutritional support can improve nutrition,immunity,and intestinal microecology.AIM To identify the optimal modality of early nutritional support for patients with sepsis from the perspective of intestinal microecology.METHODS Thirty patients with sepsis admitted to the intensive care unit of the General Hospital of Ningxia Medical University,China,between 2019 and 2021 with indications for nutritional support,were randomly assigned to one of three different modalities of nutritional support for a total of 5 d:Total enteral nutrition(TEN group),total parenteral nutrition(TPN group),and supplemental parenteral nutrition(SPN group).Blood and stool specimens were collected before and after nutritional support,and changes in gut microbiota,short-chain fatty acids(SCFAs),and immune and nutritional indicators were detected and compared among the three groups.RESULTS In comparison with before nutritional support,the three groups after nutritional support presented:(1)Differences in the gut bacteria(Enterococcus increased in the TEN group,Campylobacter decreased in the TPN group,and Dialister decreased in the SPN group;all P<0.05);(2)different trends in SCFAs(the TEN group showed improvement except for Caproic acid,the TPN group showed improvement only for acetic and propionic acid,and the SPN group showed a decreasing trend);(3)significant improvement of the nutritional and immunological indicators in the TEN and SPN groups,while only immunoglobulin G improved in the TPN group(all P<0.05);and(4)a significant correlation was found between the gut bacteria,SCFAs,and nutritional and immunological indicators(all P<0.05).CONCLUSION TEN is recommended as the preferred mode of early nutritional support in sepsis based on clinical nutritional and immunological indicators,as well as changes in intestinal microecology.展开更多
BACKGROUND The incidence of malignant tumors in the digestive system is increasing and is a threat to human health.However,the long duration from tumor detection to radical resection,stress responses due to surgical t...BACKGROUND The incidence of malignant tumors in the digestive system is increasing and is a threat to human health.However,the long duration from tumor detection to radical resection,stress responses due to surgical trauma,and insufficient nu-tritional intake increases the risk of malnutrition,immune function reduction,postoperative complications,and intestinal dysfunction among patients.AIM To systematically investigate the association of parenteral nutrition enriched with n-3 polyunsaturated fatty acids(PUFAs)with the nutritional status of patients after gastrointestinal treatment.METHODS Randomized controlled trials associated with PUFA-enriched parenteral nutrition administration in patients with digestive system malignancies were retrieved from online databases such as PubMed,EMBASE,ScienceDirect,Cochrane Li-brary,China Knowledge Network,China VIP,Wanfang,and China Biomedical Literature Database,with the retrieval time from database inception to present.Two researchers independently extracted data.Each article’s bias risk was ass-essed by referring to the Cochrane Handbook version 5.3 criteria and RevMan5.4 was used for data analysis.RESULTS This meta-analysis involved six randomized controlled trials involving a total of 505 cases.Random-effects model analysis indicated remarkably better impro-vements in various inflammatory factors in the study group(P<0.05).Meta-analysis of nutritional indicators revealed that the study group had higher total protein,albumin,and prealbumin levels,as well as lower transferrin levels compared to the control group(P<0.05).Meanwhile,meta-analysis of T-cell subsets revealed no remarkable inter-group difference in post-treatment CD8+cells(P>0.05).Moreover,the meta-analysis identified a notably lower incidence of adverse reactions in the study group(P<0.05).CONCLUSION Administration of PUFAs helps improve the nutritional status of patients with digestive malignancies in the perioperative period.It promotes immune function recovery,reduces the inflammatory response,and decreases the risk of adverse effects.These beneficial effects make it worth investigating and promoting their use in ap-propriate patient populations.However,further validation via high-quality studies with long intervention time and extended follow-up periods is required.展开更多
Background:Oral health issues persistently affect the overall health and well-being of rural populations.Village health volunteers(VHVs)play a crucial role in advancing oral health literacy in their community.This stu...Background:Oral health issues persistently affect the overall health and well-being of rural populations.Village health volunteers(VHVs)play a crucial role in advancing oral health literacy in their community.This study aimed to examine the factors related to nutritional literacy for oral health among VHVs.Methods:This was a mixed-methods study employing an explanatory sequential design.The quantitative data were gathered through questionnaires distributed to a cohort of 10,514 VHVs registered in Health Region 1.A stratified random sampling technique was used to ensure adequate representation of various subgroups within the VHV population,considering factors such as age,education level,and geographical distribution across the region.This approach allowed for a more representative sample that accurately reflects the diversity of the VHV population.Qualitative data were obtained through semi-structured interviews with a purposive sampling of 20 participants based on specific criteria.Quantitative data were analyzed using descriptive statistics and biserial correlation techniques,while qualitative data were analyzed using content analysis.Results:The study found that the sample group possessed a moderate level of knowledge of health literacy principles and nutrition for oral health.However,their self-assessed skills in nutritional literacy for oral health were rated as high.A statistically significant negative correlation was found between knowledge of nutrition for oral health and skills in nutritional literacy for oral health.VHVs equated health literacy with knowledge because their public health training had focused more on imparting knowledge rather than developing skills based on health literacy principles.Conclusion:There is a need to emphasize skill-based health literacy training and to use effective skill development techniques that are tailored to the specific roles and responsibilities of health volunteers.It is also recommended to continuously monitor and evaluate the outcomes of these efforts.展开更多
Objective:To analyze body composition measurements and explore their correlation with the nutritional risk screening score and neutrophil-to-lymphocyte ratio(NLR;an index of inflammation)to provide a basis for the per...Objective:To analyze body composition measurements and explore their correlation with the nutritional risk screening score and neutrophil-to-lymphocyte ratio(NLR;an index of inflammation)to provide a basis for the perioperative and nutritional management of patients with gynecologic malignancy.Methods:This study included 77 patients with gynecologic malignancies confirmed by surgical pathology between December 2021 and January 2023.Preoperative body composition data were obtained using bioelectrical impedance analysis.Nutritional risk screening and assessment were performed.Differences in body composition by age,nutritional status,International Federation of Gynecology and Obstetrics(FIGO)stage,systemic inflammatory response,and type of gynecologic malignancy were compared.Results:The extracellular water ratio was significantly higher in patients with a high FIGO stage than in those with a low FIGO stage(t=4.047,P<0.001).Other body composition parameters were lower in patients with a high FIGO stage than in those with a low FIGO stage(P<0.05).Regarding the NLR,the extracellular water ratio was significantly higher in patients with a high NLR than in those with a low NLR(t=2.929,P=0.005).As the nutritional condition worsened,the extracellular water ratio increased(H=12.291,P=0.002),with no significant difference in other body composition parameters between patients with different nutritional conditions(H=5.118,P=0.077).Other body composition parameters decreased with the nutritional condition,which was statistically significant(P<0.05).Conclusions:Bioelectrical impedance analysis is an easy-to-perform,noninvasive,and reproducible measurement technique that can assess changes in body composition.Body composition analysis can effectively determine an individual’s nutritional and metabolic status,providing a reference for the management of patients with gynecologic malignancy,and potentially providing predictive biomarkers to stratify these patients.展开更多
This minireview synthesizes literature on the use of feeding jejunostomy tubes(FJTs)in the postoperative management of gastroesophageal cancer patients.Gastrectomy and esophagectomy remain the primary curative treatme...This minireview synthesizes literature on the use of feeding jejunostomy tubes(FJTs)in the postoperative management of gastroesophageal cancer patients.Gastrectomy and esophagectomy remain the primary curative treatments for gastric and esophageal cancers,respectively,but are frequently accompanied by significant postoperative malnutrition,which adversely impacts surgical and oncological outcomes as well as patients’quality of life.To address this,the European Society for Clinical Nutrition and Surgery and the National Comprehensive Cancer Network recommend early enteral feeding through FJT placement following major surgery.While previous studies have demonstrated that FJT is an effective and reliable route for nutritional support,its placement is invasive and carries associated risks.Consequently,many clinicians opt for less invasive alternatives such as total parenteral nutrition or nasogastric tube feeding,although these approaches yield variable results.This review explores the benefits and potential complications of FJT placement,identifies variability in clinical adoption and the absence of standardized protocols,and highlights areas for future research to optimize patient care in this challenging context.展开更多
Objective The geriatric nutritional risk index(GNRI)is widely used for nutritional assessment.Poor nutritional status is associated with complications and poor survival in cirrhotic patients.We aimed to investigate th...Objective The geriatric nutritional risk index(GNRI)is widely used for nutritional assessment.Poor nutritional status is associated with complications and poor survival in cirrhotic patients.We aimed to investigate the value of the GNRI in predicting outcomes in cirrhotic patients.Methods This retrospective study included 420 cirrhotic patients from three centers between 2013 and 2017.Patients were divided into the high GNRI group(≥92)and low GNRI group(<92).Overall survival(OS)in the two groups was evaluated via the Kaplan‒Meier method.Cox proportional hazards model was used to estimate the value of the GNRI in predicting outcomes.Restricted cubic spline model was used to intuitively display the dose‒response associations between the GNRI and OS.A nomogram was constructed to predict OS.Results During the 2-year follow-up period,58(13.81%)patients died,and 262(62.38%)patients experienced episodes of complications.Compared with patients in the low GNRI group,those in the high GNRI group had lower mortality rates(18.73%vs.5.23%,P<0.001).The GNRI was an independent predictor of OS(hazard ratio[HR]=0.958,95%confidence interval[CI]0.929–0.988,P=0.007).The GNRI was associated with the cumulative incidence of ascites(HR=0.954,95%CI 0.940–0.969,P<0.001),spontaneous bacterial peritonitis(HR=0.928,95%CI 0.891–0.966,P<0.001),hepatic encephalopathy(HE;HR=0.944,95%CI 0.920–0.968,P<0.001),and hepatorenal syndrome(HRS)(HR=0.916,95%CI 0.861–0.974,P=0.005).Furthermore,6 independent factors were included to construct the nomogram for OS prediction,including GNRI,age,total bilirubin,serum sodium,history of HE and HRS.The C statistics of our model were 0.83(95%CI 0.75–0.90)and 0.80(95%CI 0.73–0.86)at 1 and 2 years,respectively.Patients whose GNRI score decreased within 3 and 6 months had poorer outcomes(P<0.001).Conclusions The lower GNRI score was associated with the higher cumulative incidence of complications and poorer OS of cirrhotic patients.The GNRI could be a helpful tool for assessing nutritional status and prognosis of these patients.展开更多
BACKGROUND Congenital short bowel syndrome(CSBS)is a rare disorder characterized by a congenital shortage in the length of the small intestines,resulting in compromised intestinal functionality,frequently accompanied ...BACKGROUND Congenital short bowel syndrome(CSBS)is a rare disorder characterized by a congenital shortage in the length of the small intestines,resulting in compromised intestinal functionality,frequently accompanied by congenital intestinal malrotation.This study summarizes the experience of enteral and parenteral nutrition(PN)schemes for two cases of CSBS accompanied by intestinal malrotation to provide a reference for this condition.CASE SUMMARY Case 1 underwent surgical intervention 23 days after birth,but experienced postoperative intolerance to oral feeding.Consequently,the patient was transitioned to nasal feeding for 6 months while concurrently receiving round-the-clock PN.Despite ongoing adjustments to the caloric intake of enteral and PN throughout the treatment,cholestatic liver injury persisted.Furthermore,this child developed malnutrition by the age of 1 year.Case 2 received surgical intervention on 2 days after birth,demonstrating favorable tolerance for enteral feeding and intermittent PN.The child exhibited satisfactory growth and development without any associated complications.CONCLUSION CSBS is rarely encountered in clinical practice and is often accompanied by congenital intestinal malrotation.It can be improved with early diagnosis and active surgical intervention.Thus,we recommend early initiation of total PN,which is a highly effective measure in promoting early growth and development.展开更多
BACKGROUND Gastrointestinal(GI)surgery can significantly affect the nutritional status and immune function of patients.This study aimed to investigate the effects of personalized nutritional care on the recovery of im...BACKGROUND Gastrointestinal(GI)surgery can significantly affect the nutritional status and immune function of patients.This study aimed to investigate the effects of personalized nutritional care on the recovery of immune function in patients who underwent postoperative GI surgery.AIM To study examines personalized nutritional care’s impact on immune function recovery,nutritional status,and clinical outcomes after GI surgery.METHODS This observational study included 80 patients who underwent GI surgery between 2021 and 2023.Patients received personalized nutritional care based on their individual needs and surgical outcomes.Immune function markers including lymphocyte subsets,immunoglobulins,and cytokines were measured preoperatively and at regular intervals postoperatively.Nutritional status,clinical outcomes,and quality of life were assessed.RESULTS Patients receiving personalized nutritional care showed significant improvements in immune function markers compared to baseline.At 4 weeks postoperatively,CD4+T-cell counts increased by 25%(P<0.001),while interleukin-6 levels decreased by 40%(P<0.001).Nutritional status,as measured by prealbumin and transferrin levels,improved by 30%(P<0.01).Postoperative complications reduced by 35%compared to historical controls.The quality-of-life scores improved by 40%at 3 months postoperatively.CONCLUSION Personalized nutritional care enhances immune function recovery,improves nutritional status,and reduces complications in patients undergoing postoperative GI surgery,highlighting its crucial role in optimizing patient outcomes following such procedures.展开更多
Chicken meat quality directly influences consumer acceptability and is crucial for the economic success of the poultry industry.Genetics and nutrition are key determinants of the meat quality traits in broilers.This r...Chicken meat quality directly influences consumer acceptability and is crucial for the economic success of the poultry industry.Genetics and nutrition are key determinants of the meat quality traits in broilers.This review summarizes the research advances in this field,with a focus on the genetic and nutritional foundations that regulate intramuscular fat(IMF)deposition and meat quality in chickens over the past decade.The effects of embryonic nutrition,both maternal nutrition and in ovo feeding(IOF),on skeletal muscle development,the IMF content,and meat quality traits in broilers are also discussed.In genetics,single-cell RNA sequencing revealed that de novo lipogenesis predominantly occurs in myocytes,which is key to the formation of IMF in chicken muscle tissue.Fatty acid synthase(FASN)is the key enzyme involved in this process.This discovery has reshaped the traditional understanding of intramuscular lipid metabolism in poultry.Key genes,proteins,and pathways,such as FASN,FABP4,PPARG,C/EBPα,SLC27A1;LPL,APOA1,COL1A1;PPAR and ECM–receptor interactions signaling,have been identified to regulate IMF content and distribution by modulating fatty acid metabolism and adipogenesis.LncHLFF was innovatively found to promote ectopic IMF deposition in chickens via exosome-mediated mechanisms without affecting abdominal fat deposition.MiR-27b-3p and miR-128-3p were found to inhibit adipogenic differentiation by targeting PPARG,thereby affecting IMF formation.In nutrition,nutrigenomics research has shown that fructose enhances IMF deposition by activating ChREBP,providing new targets for nutritional interventions.Adjusting dietary components,including energy,protein,amino acids,fatty acids,and phytochemicals(e.g.,rutin),has been shown to significantly improve meat quality in broilers.Maternal nutrition(e.g.,intake of energy,amino acids,vitamins,and trace elements)and IOF(e.g.,N-carbamylglutamate)have also been confirmed to significantly impact offspring meat quality,opening new avenues for improving embryonic nutrition.Based on these significant advancements,this review proposes strategies that integrate genetic and nutritional approaches.These strategies aim to modulate the differentiation fate of paraxial mesenchymal stem cells toward myogenic or adipogenic lineages and the interaction between muscle and adipose tissues.These insights would help to improve meat quality while ensuring the growth performance of broiler chickens.展开更多
BACKGROUND Postoperative malnutrition,systemic inflammation,and immune dysfunction significantly impair recovery and survival in gastric cancer patients undergoing radical gastrectomy.The Prognostic Immune Nutritional...BACKGROUND Postoperative malnutrition,systemic inflammation,and immune dysfunction significantly impair recovery and survival in gastric cancer patients undergoing radical gastrectomy.The Prognostic Immune Nutritional Index(PINI)enables immune-nutritional risk stratification;however,its utility in guiding perioperative nutritional support remains underexplored.AIM To evaluate whether risk-stratified perioperative nutritional support based on PINI scores improves postoperative recovery,quality of life,and long-term outcomes in gastric cancer patients.METHODS In this prospective,randomized controlled trial,195 patients undergoing radical gastrectomy were stratified into low-(PINI≤1.5),moderate-(1.5<PINI≤3),and high-risk(PINI>3)groups.Patients received standard,intensive,or immuneenhancing nutritional support,respectively.Outcomes were assessed at 1 week,1 month,and 1 year postoperatively and included body mass index(BMI),serum albumin,PINI scores,Pittsburgh Sleep Quality Index(PSQI),Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),Visual Analog Scale(VAS)for pain,EORTC QLQ-C30 for quality of life,complication rates,hospital stay,and survival.RESULTS At 1 year,the high-risk group receiving immune-enhancing nutrition demonstrated the greatest improvements,with higher serum albumin(47.5±3.8 g/L)and stabilized BMI(+0.1±0.2 kg/m^(2) vs-0.2±0.2 kg/m^(2) in the low-risk group,P<0.01).Sleep quality(ΔPSQI:-8.5±2.7),anxiety(ΔSAS:-12.9±3.1),and depression(ΔSDS:-12.6±4.2)improved significantly(all P<0.01).Pain scores were lowest(VAS:2.1±1.3),and quality of life was highest(78.2±8.0,P<0.01).The high-risk group also had the lowest complication rate(3.3%),shortest hospital stay(9.8±2.4 days),and highest 1-year survival(98.5%,P<0.05).CONCLUSION PINI-based graded nutritional support significantly enhances postoperative recovery,reduces complications,and improves long-term outcomes following radical gastrectomy.These findings support its integration into precision perioperative care strategies for gastric cancer.展开更多
Objective:To study the application effect of early postoperative enteral nutrition in the nursing care of elderly patients with gastric cancer.Methods:Sixty elderly patients with gastric cancer admitted to the hospita...Objective:To study the application effect of early postoperative enteral nutrition in the nursing care of elderly patients with gastric cancer.Methods:Sixty elderly patients with gastric cancer admitted to the hospital from January 2022 to January 2024 were selected and divided into groups according to the random number table method.The control group(n=30)received routine nursing after surgery,while the observation group(n=30)received early enteral nutrition nursing after surgery.The perioperative indexes,nutritional indexes before and after nursing,humoral and cellular immune indexes before and after nursing,gastrointestinal hormone levels before and after nursing,and the incidence of postoperative complications were compared between the two groups.Results:The perioperative indexes of the observation group were better than those of the control group(P<0.05).Before nursing,there was no significant difference in the nutritional indexes between the two groups(P>0.05).After nursing,the nutritional indexes of the observation group were better than those of the control group(P<0.05).Before nursing,there was no significant difference in the humoral and cellular immune indexes between the two groups(P>0.05).After nursing,the humoral and cellular immune indexes of the observation group were better than those of the control group(P<0.05).Before nursing,there was no significant difference in the gastrointestinal hormone levels between the two groups(P>0.05).After nursing,the gastrointestinal hormone levels of the observation group were better than those of the control group(P<0.05).The incidence of postoperative complications in the observation group was lower than that in the control group(P<0.05).Conclusion:For elderly patients with gastric cancer,early enteral nutrition nursing after surgery can improve their nutritional indexes and gastrointestinal hormone levels,enhance their immune ability,and prevent the incidence of postoperative complications,with good effects.展开更多
文摘Critically ill patients have a variety of complex pathologies and are in a multifarious state of catabolism supplanted by external and internal factors.Early enteral nutrition(EEN)is defined as the initiation of enteral feeding within 24-48 hours of hospitalization.Previous studies show the benefits of EEN include supporting the healing process through preservation of the gut mucosa,modulation of the immune response,and suppression of inflammation.However,recent studies suggest the advantages of EEN may not be as robust as previously believed.This review aims to discuss the outcomes of EEN when used in different critical care settings while managing complex disease states such as burns,sepsis,pancreatitis,and upper gastrointestinal bleeding.Evidence indicates that EEN has a positive impact on patient outcomes,hospital costs,length of intensive care unit stay,and preventing complications.
文摘Han-Ping Shi,M.D.,Ph.D.,FACS,Professor of Surgery,Oncology and Nutrition.He is the current Director of the Faculty of Clinical Nutrition,Capital Medical University.Dr.Shi received his M.D.degree at the School of Medicine,Wuhan University,Wuhan,and his Ph.D.degree at the Second Military Medical University,Shanghai,China.From 1999 to 2002,Dr.Shi was a postdoc fellow in School of Medicine,Johns Hopkins University,under the supervision of Adrian Barbul,M.D.,FACS,and then in New Jersey Medical School,Rutgers University,under the supervision of Edwin A.Deitch,M.D.,FACS.Dr.Han-Ping Shi was the Chairman of the Chinese Society for Parenteral&Enteral Nutrition(CSPEN)between 2018-2021.He is the founder Chairman of the Chinese Society of Nutritional Oncology(2012-2024),and the director of the Department of Academic,China Anti-Cancer Association(CACA)since 2017.Dr.Han-Ping Shi is currently the founder Editor-in-Chief of Electronic Journal of Metabolism and Nutrition of Cancer(Chinese),founder Editor-in-Chief of Journal of Nutritional Oncology(English)and founder Editor-in-Chief of Precision Nutrition(English).
文摘Han-Ping Shi,M.D.,Ph.D.,FACS,Professor of Surgery,Oncology and Nutrition.He is the current Chairman of the Department of GI Surgery/Clinical Nutrition at Beijing Shijitan Hospital,Capital Medical University,Beijing,China.Dr.Shi received his M.D.degree at the School of Medicine,Wuhan University,Wuhan,and his Ph.D.degree at the Second Military Medical University,Shanghai,China.
文摘Objective:To study the application effects of the entire-course nutrition management model led by specialized nutrition nurses in patients with distant cholangiocarcinoma.Methods:Using convenience sampling,one hundred and twenty patients with distant cholangiocarcinoma admitted from April 2023 to October 2024 were selected as the experimental subjects of this study.They were grouped using a random number table method.The intervention group consisted of 60 patients with distant cholangiocarcinoma who received the entire-course nutrition management led by specialized nutrition nurses,while the observation group consisted of 60 patients who received conventional management.The intestinal function,nutritional indicators,quality of life,and satisfaction were compared between the intervention and observation groups.Results:After intervention,the intestinal function,nutritional indicators,quality of life,and satisfaction of patients with distant cholangiocarcinoma in the intervention group were significantly better than those in the observation group,with statistically significant differences(P<0.05).Conclusion:The application of the entire-course nutrition management model led by specialized nutrition nurses in patients with distant cholangiocarcinoma has more prominent effects and can further improve prognosis,making it worthy of widespread clinical application.
文摘BACKGROUND Malnutrition exacerbates the deterioration in patients with advanced gas-trointestinal tumors.AIM To analyze the effect of enteral nutritional support based on Nutrition Risk Screening 2002(NRS2002)risk assessment on nutritional function in patients with gastrointestinal tumors.METHODS One hundred twelve patients from April 2022 to April 2024 were included for observation and were divided into a control group and an observation group by random number method,56 each.Both groups received treatment for four consecutive weeks.The control group received routine enteral nutrition support,while the observation group received enteral nutrition support based on the NRS2002 risk assessment.Nutritional function,intestinal mucosal barrier function,quality of life,and complication rate were compared between the two groups.Statistical analysis was completed using SPSS26.0 and Excel.RESULTS After nutritional intervention,transferrin,albumin,hemoglobin,and diamine oxidase levels in the observation group were higher than those in the control group,while C-reactive protein,tumor necrosis factorα,and quality of life scores were lower,with significant differences(P<0.05).There was no significant difference in complications between groups(P>0.05),but the complication rate was lower in the observation group.CONCLUSION Enteral nutritional support based on NRS2002 risk assessment for patients with gastrointestinal tumors positively impacts nutritional status and promotes intestinal mucosal barrier function recovery.Patients’quality of life improved,and the incidence of adverse reactions decreased,indicating clinical promotion and application value.
文摘BACKGROUND Colorectal cancer(CRC)is a globally prevalent gastrointestinal malignant cancer,especially in elderly patients.Currently,surgery resection remains the primary treatment due to its favorable therapeutic outcomes.However,postoperative deterioration in nutritional status and quality of life(QoL)remains a concern.The geriatric nutritional risk index(GNRI),which is calculated based on serum albumin levels and the ratio of normal body weight to ideal body weight,is easily accessible and accurate,making it increasingly popular in clinical practice.AIM To investigate the impact of GNRI-guided tiered nutritional interventions on postoperative nutritional recovery and QoL in elderly CRC patients.METHODS A retrospective analysis was conducted on 135 elderly CRC patients undergoing radical resection at our hospital from September 2022 to December 2024.Participants were divided into two cohorts:The research group(n=61)received GNRI-based graded nutritional support,while the control group(n=65)received conventional nutritional intervention.Clinical indicators,such as postoperative passage of gas by anus,incidence/duration of postoperative fever,hospitalization length and costs,were compared between the two groups.Nutritional biomarkers,including hemoglobin,prealbumin,transferrin,and Patient-Generated Subjective Global Assessment scores were assessed on postoperative day 1 and post-intervention(day 1 after intervention).The Generic QoL Inventory-74 was employed to assess physical function,social function,material life,and psychological function in the two groups.Immunoglobulin(Ig)(IgG,IgA,IgM)and inflammatory markers[nuclear factor kappa B,interleukin(IL)-1,tumor necrosis factor-α,IL-8]were compared between groups.Complication rates were also monitored.RESULTS The research group showed significantly faster postoperative passage of gas by anus,fewer instances of fever,reduced fever duration,shorter hospitalization duration,and lower costs compared with the control group(P<0.05).Following intervention,the research group exhibited higher levels of hemoglobin,prealbumin,and transferrin,and lower Patient-Generated Subjective Global Assessment scores vs the control group(P<0.05).Scores for physical function,social function,material life,and psychological function showed substantial improvement(P<0.05).Levels of IgG,IgA,and IgM were significantly elevated in the research group(P<0.05),while nuclear factor kappa B,IL-1,tumor necrosis factor-α,and IL-8 levels were noticeably lowered vs the control group(P<0.05).The incidence of overall complications within the research group reached 24.59%,notably lower than that(43.08%)observed in the control group(P<0.05).CONCLUSION GNRI-based graded nutritional intervention in elderly CRC patients can significantly improve postoperative recovery,enhance their nutritional status and QoL,promote immune function recovery,attenuate inflammation,and lower the incidence of postoperative complications.This protocol represents a clinically viable strategy for optimizing postoperative care.
文摘BACKGROUND Postoperative nutritional management of gastric cancer(GC)remains a problem that needs to be solved in clinical treatment.AIM To develop an early graded nutrition management plan and evaluate its impact on feeding tolerance,nutritional status,and prognosis.METHODS In total,142 patients who underwent laparoscopic radical gastrectomy at Jiujiang University Affiliated Hospital between August 2021 and August 2022 were included in this study.Based on postoperative nutritional management and feeding,the patients were divided into observation and control groups.The general information questionnaire,Visual Analog Scale,and Pittsburgh Sleep Quality Index were used to evaluate pain and sleep of patients,respectively.Independent sample t-test andχ2 test were used to analyze differences between groups.RESULTS The feeding intolerance rates in the control and observation groups were 13.2%and 4.1%,respectively.Hospitalization time and first defecation times in the observation group were shorter than those in the control group.Hemoglobin,prealbumin,transferrin,and immunological indices in the observation group were significantly higher than those in the control group 7 days after surgery,whereas calcitonin levels were significantly lower than those in the control group(P<0.05).In general,the nutritional status of the observation group was better than that of the control group,and pain and sleep quality scores improved.CONCLUSION Compared with the conventional postoperative feeding,early stepwise nutritional management can significantly enhance the nutritional status of patients with GC after surgery,improve their feeding tolerance,and reduce postoperative complications.
基金Supported by the Scientific Research Project of Hospital Pharmacy of Guangxi Pharmaceutical Association in 2022,No.GXYXH1-202202.
文摘BACKGROUND Gastric cancer(GC)is the fifth most common cancer and the third leading cause of cancer-related deaths in China.Many patients with GC frequently experience symptoms related to the disease,including anorexia,nausea,vomiting,and other discomforts,and often suffer from malnutrition,which in turn negatively affects perioperative safety,prognosis,and the effectiveness of adjuvant therapeutic measures.Consequently,some nutritional indicators such as nutritional risk index(NRI),prognostic nutritional index(PNI),and systemic immune-inflammatorynutritional index(SIINI)can be used as predictors of the prognosis of GC patients.AIM To examine the prognostic significance of PNI,NRI,and SIINI in postoperative patients with GC.METHODS A retrospective analysis was conducted on the clinical data of patients with GC who underwent surgical treatment at the Guangxi Medical University Cancer Hospital between January 2010 and December 2018.The area under the receiver operating characteristic(ROC)curve was assessed using ROC curve analysis,and the optimal cutoff values for NRI,PNI,and SIINI were identified using the You-Review-HTMLden index.Survival analysis was performed using the Kaplan-Meier method.In addition,univariate and multivariate analyses were conducted using the Cox proportional hazards regression model.RESULTS This study included a total of 803 patients.ROC curves were used to evaluate the prognostic ability of NRI,PNI,and SIINI.The results revealed that SIINI had superior predictive accuracy.Survival analysis indicated that patients with GC in the low SIINI group had a significantly better survival rate than those in the high SIINI group(P<0.05).Univariate analysis identified NRI[hazard ratio(HR)=0.68,95%confidence interval(CI):0.52-0.89,P=0.05],PNI(HR=0.60,95%CI:0.46-0.79,P<0.001),and SIINI(HR=2.10,95%CI:1.64-2.69,P<0.001)as prognostic risk factors for patients with GC.However,multifactorial analysis indicated that SIINI was an independent risk factor for the prognosis of patients with GC(HR=1.65,95%CI:1.26-2.16,P<0.001).CONCLUSION Analysis of clinical retrospective data revealed that SIINI is a valuable indicator for predicting the prognosis of patients with GC.Compared with NRI and PNI,SIINI may offer greater application for prognostic assessment.
文摘Traditional tumor-node-metastasis staging overlooks key prognostic factors such as inflammation and nutrition,limiting individualized treatment in colorectal cancer.Integrating biochemical markers with artificial intelligence can significantly improve survival prediction and treatment personalization by analyzing complex,multimodal data.This evolving approach holds transformative potential for precision oncology.
基金Supported by Ningxia Natural Science Foundation Project,No.2022AAC03488the National Key Research and Development Program of China,No.2016YFD0400605.
文摘BACKGROUND Sepsis exacerbates intestinal microecological disorders leading to poor prognosis.Proper modalities of nutritional support can improve nutrition,immunity,and intestinal microecology.AIM To identify the optimal modality of early nutritional support for patients with sepsis from the perspective of intestinal microecology.METHODS Thirty patients with sepsis admitted to the intensive care unit of the General Hospital of Ningxia Medical University,China,between 2019 and 2021 with indications for nutritional support,were randomly assigned to one of three different modalities of nutritional support for a total of 5 d:Total enteral nutrition(TEN group),total parenteral nutrition(TPN group),and supplemental parenteral nutrition(SPN group).Blood and stool specimens were collected before and after nutritional support,and changes in gut microbiota,short-chain fatty acids(SCFAs),and immune and nutritional indicators were detected and compared among the three groups.RESULTS In comparison with before nutritional support,the three groups after nutritional support presented:(1)Differences in the gut bacteria(Enterococcus increased in the TEN group,Campylobacter decreased in the TPN group,and Dialister decreased in the SPN group;all P<0.05);(2)different trends in SCFAs(the TEN group showed improvement except for Caproic acid,the TPN group showed improvement only for acetic and propionic acid,and the SPN group showed a decreasing trend);(3)significant improvement of the nutritional and immunological indicators in the TEN and SPN groups,while only immunoglobulin G improved in the TPN group(all P<0.05);and(4)a significant correlation was found between the gut bacteria,SCFAs,and nutritional and immunological indicators(all P<0.05).CONCLUSION TEN is recommended as the preferred mode of early nutritional support in sepsis based on clinical nutritional and immunological indicators,as well as changes in intestinal microecology.
基金Supported by the Guangxi Medical and Health Key(Cultivation)Discipline Construction ProjectGuilin Scientific Research and Technology Development Program Project,No.20210227-7-8.
文摘BACKGROUND The incidence of malignant tumors in the digestive system is increasing and is a threat to human health.However,the long duration from tumor detection to radical resection,stress responses due to surgical trauma,and insufficient nu-tritional intake increases the risk of malnutrition,immune function reduction,postoperative complications,and intestinal dysfunction among patients.AIM To systematically investigate the association of parenteral nutrition enriched with n-3 polyunsaturated fatty acids(PUFAs)with the nutritional status of patients after gastrointestinal treatment.METHODS Randomized controlled trials associated with PUFA-enriched parenteral nutrition administration in patients with digestive system malignancies were retrieved from online databases such as PubMed,EMBASE,ScienceDirect,Cochrane Li-brary,China Knowledge Network,China VIP,Wanfang,and China Biomedical Literature Database,with the retrieval time from database inception to present.Two researchers independently extracted data.Each article’s bias risk was ass-essed by referring to the Cochrane Handbook version 5.3 criteria and RevMan5.4 was used for data analysis.RESULTS This meta-analysis involved six randomized controlled trials involving a total of 505 cases.Random-effects model analysis indicated remarkably better impro-vements in various inflammatory factors in the study group(P<0.05).Meta-analysis of nutritional indicators revealed that the study group had higher total protein,albumin,and prealbumin levels,as well as lower transferrin levels compared to the control group(P<0.05).Meanwhile,meta-analysis of T-cell subsets revealed no remarkable inter-group difference in post-treatment CD8+cells(P>0.05).Moreover,the meta-analysis identified a notably lower incidence of adverse reactions in the study group(P<0.05).CONCLUSION Administration of PUFAs helps improve the nutritional status of patients with digestive malignancies in the perioperative period.It promotes immune function recovery,reduces the inflammatory response,and decreases the risk of adverse effects.These beneficial effects make it worth investigating and promoting their use in ap-propriate patient populations.However,further validation via high-quality studies with long intervention time and extended follow-up periods is required.
文摘Background:Oral health issues persistently affect the overall health and well-being of rural populations.Village health volunteers(VHVs)play a crucial role in advancing oral health literacy in their community.This study aimed to examine the factors related to nutritional literacy for oral health among VHVs.Methods:This was a mixed-methods study employing an explanatory sequential design.The quantitative data were gathered through questionnaires distributed to a cohort of 10,514 VHVs registered in Health Region 1.A stratified random sampling technique was used to ensure adequate representation of various subgroups within the VHV population,considering factors such as age,education level,and geographical distribution across the region.This approach allowed for a more representative sample that accurately reflects the diversity of the VHV population.Qualitative data were obtained through semi-structured interviews with a purposive sampling of 20 participants based on specific criteria.Quantitative data were analyzed using descriptive statistics and biserial correlation techniques,while qualitative data were analyzed using content analysis.Results:The study found that the sample group possessed a moderate level of knowledge of health literacy principles and nutrition for oral health.However,their self-assessed skills in nutritional literacy for oral health were rated as high.A statistically significant negative correlation was found between knowledge of nutrition for oral health and skills in nutritional literacy for oral health.VHVs equated health literacy with knowledge because their public health training had focused more on imparting knowledge rather than developing skills based on health literacy principles.Conclusion:There is a need to emphasize skill-based health literacy training and to use effective skill development techniques that are tailored to the specific roles and responsibilities of health volunteers.It is also recommended to continuously monitor and evaluate the outcomes of these efforts.
基金funded by the Jiangsu Graduate Student Practice and Innovation Program(No.SJCX23_0665).
文摘Objective:To analyze body composition measurements and explore their correlation with the nutritional risk screening score and neutrophil-to-lymphocyte ratio(NLR;an index of inflammation)to provide a basis for the perioperative and nutritional management of patients with gynecologic malignancy.Methods:This study included 77 patients with gynecologic malignancies confirmed by surgical pathology between December 2021 and January 2023.Preoperative body composition data were obtained using bioelectrical impedance analysis.Nutritional risk screening and assessment were performed.Differences in body composition by age,nutritional status,International Federation of Gynecology and Obstetrics(FIGO)stage,systemic inflammatory response,and type of gynecologic malignancy were compared.Results:The extracellular water ratio was significantly higher in patients with a high FIGO stage than in those with a low FIGO stage(t=4.047,P<0.001).Other body composition parameters were lower in patients with a high FIGO stage than in those with a low FIGO stage(P<0.05).Regarding the NLR,the extracellular water ratio was significantly higher in patients with a high NLR than in those with a low NLR(t=2.929,P=0.005).As the nutritional condition worsened,the extracellular water ratio increased(H=12.291,P=0.002),with no significant difference in other body composition parameters between patients with different nutritional conditions(H=5.118,P=0.077).Other body composition parameters decreased with the nutritional condition,which was statistically significant(P<0.05).Conclusions:Bioelectrical impedance analysis is an easy-to-perform,noninvasive,and reproducible measurement technique that can assess changes in body composition.Body composition analysis can effectively determine an individual’s nutritional and metabolic status,providing a reference for the management of patients with gynecologic malignancy,and potentially providing predictive biomarkers to stratify these patients.
文摘This minireview synthesizes literature on the use of feeding jejunostomy tubes(FJTs)in the postoperative management of gastroesophageal cancer patients.Gastrectomy and esophagectomy remain the primary curative treatments for gastric and esophageal cancers,respectively,but are frequently accompanied by significant postoperative malnutrition,which adversely impacts surgical and oncological outcomes as well as patients’quality of life.To address this,the European Society for Clinical Nutrition and Surgery and the National Comprehensive Cancer Network recommend early enteral feeding through FJT placement following major surgery.While previous studies have demonstrated that FJT is an effective and reliable route for nutritional support,its placement is invasive and carries associated risks.Consequently,many clinicians opt for less invasive alternatives such as total parenteral nutrition or nasogastric tube feeding,although these approaches yield variable results.This review explores the benefits and potential complications of FJT placement,identifies variability in clinical adoption and the absence of standardized protocols,and highlights areas for future research to optimize patient care in this challenging context.
基金supported by grants from the Joint Tackling Project of Pudong Health Committee of Shanghai(PW2022D08)Medical Discipline Construction Project of Pudong Health Committee of Shanghai(PWZxq2022-6)+1 种基金Health and Family Planning Research Project of Pudong Health Committee of Shanghai(PW2021A-38)Youth Scientific Research Cultivation Fund Project of Shanghai Oriental Hospital(DFPY2022020).
文摘Objective The geriatric nutritional risk index(GNRI)is widely used for nutritional assessment.Poor nutritional status is associated with complications and poor survival in cirrhotic patients.We aimed to investigate the value of the GNRI in predicting outcomes in cirrhotic patients.Methods This retrospective study included 420 cirrhotic patients from three centers between 2013 and 2017.Patients were divided into the high GNRI group(≥92)and low GNRI group(<92).Overall survival(OS)in the two groups was evaluated via the Kaplan‒Meier method.Cox proportional hazards model was used to estimate the value of the GNRI in predicting outcomes.Restricted cubic spline model was used to intuitively display the dose‒response associations between the GNRI and OS.A nomogram was constructed to predict OS.Results During the 2-year follow-up period,58(13.81%)patients died,and 262(62.38%)patients experienced episodes of complications.Compared with patients in the low GNRI group,those in the high GNRI group had lower mortality rates(18.73%vs.5.23%,P<0.001).The GNRI was an independent predictor of OS(hazard ratio[HR]=0.958,95%confidence interval[CI]0.929–0.988,P=0.007).The GNRI was associated with the cumulative incidence of ascites(HR=0.954,95%CI 0.940–0.969,P<0.001),spontaneous bacterial peritonitis(HR=0.928,95%CI 0.891–0.966,P<0.001),hepatic encephalopathy(HE;HR=0.944,95%CI 0.920–0.968,P<0.001),and hepatorenal syndrome(HRS)(HR=0.916,95%CI 0.861–0.974,P=0.005).Furthermore,6 independent factors were included to construct the nomogram for OS prediction,including GNRI,age,total bilirubin,serum sodium,history of HE and HRS.The C statistics of our model were 0.83(95%CI 0.75–0.90)and 0.80(95%CI 0.73–0.86)at 1 and 2 years,respectively.Patients whose GNRI score decreased within 3 and 6 months had poorer outcomes(P<0.001).Conclusions The lower GNRI score was associated with the higher cumulative incidence of complications and poorer OS of cirrhotic patients.The GNRI could be a helpful tool for assessing nutritional status and prognosis of these patients.
文摘BACKGROUND Congenital short bowel syndrome(CSBS)is a rare disorder characterized by a congenital shortage in the length of the small intestines,resulting in compromised intestinal functionality,frequently accompanied by congenital intestinal malrotation.This study summarizes the experience of enteral and parenteral nutrition(PN)schemes for two cases of CSBS accompanied by intestinal malrotation to provide a reference for this condition.CASE SUMMARY Case 1 underwent surgical intervention 23 days after birth,but experienced postoperative intolerance to oral feeding.Consequently,the patient was transitioned to nasal feeding for 6 months while concurrently receiving round-the-clock PN.Despite ongoing adjustments to the caloric intake of enteral and PN throughout the treatment,cholestatic liver injury persisted.Furthermore,this child developed malnutrition by the age of 1 year.Case 2 received surgical intervention on 2 days after birth,demonstrating favorable tolerance for enteral feeding and intermittent PN.The child exhibited satisfactory growth and development without any associated complications.CONCLUSION CSBS is rarely encountered in clinical practice and is often accompanied by congenital intestinal malrotation.It can be improved with early diagnosis and active surgical intervention.Thus,we recommend early initiation of total PN,which is a highly effective measure in promoting early growth and development.
文摘BACKGROUND Gastrointestinal(GI)surgery can significantly affect the nutritional status and immune function of patients.This study aimed to investigate the effects of personalized nutritional care on the recovery of immune function in patients who underwent postoperative GI surgery.AIM To study examines personalized nutritional care’s impact on immune function recovery,nutritional status,and clinical outcomes after GI surgery.METHODS This observational study included 80 patients who underwent GI surgery between 2021 and 2023.Patients received personalized nutritional care based on their individual needs and surgical outcomes.Immune function markers including lymphocyte subsets,immunoglobulins,and cytokines were measured preoperatively and at regular intervals postoperatively.Nutritional status,clinical outcomes,and quality of life were assessed.RESULTS Patients receiving personalized nutritional care showed significant improvements in immune function markers compared to baseline.At 4 weeks postoperatively,CD4+T-cell counts increased by 25%(P<0.001),while interleukin-6 levels decreased by 40%(P<0.001).Nutritional status,as measured by prealbumin and transferrin levels,improved by 30%(P<0.01).Postoperative complications reduced by 35%compared to historical controls.The quality-of-life scores improved by 40%at 3 months postoperatively.CONCLUSION Personalized nutritional care enhances immune function recovery,improves nutritional status,and reduces complications in patients undergoing postoperative GI surgery,highlighting its crucial role in optimizing patient outcomes following such procedures.
基金funded by the Regional Innovation and Development Joint Fund of National Natural Science Foundation of China(Project No.U21A20253)2115 Talent Development Program of China Agricultural University.
文摘Chicken meat quality directly influences consumer acceptability and is crucial for the economic success of the poultry industry.Genetics and nutrition are key determinants of the meat quality traits in broilers.This review summarizes the research advances in this field,with a focus on the genetic and nutritional foundations that regulate intramuscular fat(IMF)deposition and meat quality in chickens over the past decade.The effects of embryonic nutrition,both maternal nutrition and in ovo feeding(IOF),on skeletal muscle development,the IMF content,and meat quality traits in broilers are also discussed.In genetics,single-cell RNA sequencing revealed that de novo lipogenesis predominantly occurs in myocytes,which is key to the formation of IMF in chicken muscle tissue.Fatty acid synthase(FASN)is the key enzyme involved in this process.This discovery has reshaped the traditional understanding of intramuscular lipid metabolism in poultry.Key genes,proteins,and pathways,such as FASN,FABP4,PPARG,C/EBPα,SLC27A1;LPL,APOA1,COL1A1;PPAR and ECM–receptor interactions signaling,have been identified to regulate IMF content and distribution by modulating fatty acid metabolism and adipogenesis.LncHLFF was innovatively found to promote ectopic IMF deposition in chickens via exosome-mediated mechanisms without affecting abdominal fat deposition.MiR-27b-3p and miR-128-3p were found to inhibit adipogenic differentiation by targeting PPARG,thereby affecting IMF formation.In nutrition,nutrigenomics research has shown that fructose enhances IMF deposition by activating ChREBP,providing new targets for nutritional interventions.Adjusting dietary components,including energy,protein,amino acids,fatty acids,and phytochemicals(e.g.,rutin),has been shown to significantly improve meat quality in broilers.Maternal nutrition(e.g.,intake of energy,amino acids,vitamins,and trace elements)and IOF(e.g.,N-carbamylglutamate)have also been confirmed to significantly impact offspring meat quality,opening new avenues for improving embryonic nutrition.Based on these significant advancements,this review proposes strategies that integrate genetic and nutritional approaches.These strategies aim to modulate the differentiation fate of paraxial mesenchymal stem cells toward myogenic or adipogenic lineages and the interaction between muscle and adipose tissues.These insights would help to improve meat quality while ensuring the growth performance of broiler chickens.
文摘BACKGROUND Postoperative malnutrition,systemic inflammation,and immune dysfunction significantly impair recovery and survival in gastric cancer patients undergoing radical gastrectomy.The Prognostic Immune Nutritional Index(PINI)enables immune-nutritional risk stratification;however,its utility in guiding perioperative nutritional support remains underexplored.AIM To evaluate whether risk-stratified perioperative nutritional support based on PINI scores improves postoperative recovery,quality of life,and long-term outcomes in gastric cancer patients.METHODS In this prospective,randomized controlled trial,195 patients undergoing radical gastrectomy were stratified into low-(PINI≤1.5),moderate-(1.5<PINI≤3),and high-risk(PINI>3)groups.Patients received standard,intensive,or immuneenhancing nutritional support,respectively.Outcomes were assessed at 1 week,1 month,and 1 year postoperatively and included body mass index(BMI),serum albumin,PINI scores,Pittsburgh Sleep Quality Index(PSQI),Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),Visual Analog Scale(VAS)for pain,EORTC QLQ-C30 for quality of life,complication rates,hospital stay,and survival.RESULTS At 1 year,the high-risk group receiving immune-enhancing nutrition demonstrated the greatest improvements,with higher serum albumin(47.5±3.8 g/L)and stabilized BMI(+0.1±0.2 kg/m^(2) vs-0.2±0.2 kg/m^(2) in the low-risk group,P<0.01).Sleep quality(ΔPSQI:-8.5±2.7),anxiety(ΔSAS:-12.9±3.1),and depression(ΔSDS:-12.6±4.2)improved significantly(all P<0.01).Pain scores were lowest(VAS:2.1±1.3),and quality of life was highest(78.2±8.0,P<0.01).The high-risk group also had the lowest complication rate(3.3%),shortest hospital stay(9.8±2.4 days),and highest 1-year survival(98.5%,P<0.05).CONCLUSION PINI-based graded nutritional support significantly enhances postoperative recovery,reduces complications,and improves long-term outcomes following radical gastrectomy.These findings support its integration into precision perioperative care strategies for gastric cancer.
文摘Objective:To study the application effect of early postoperative enteral nutrition in the nursing care of elderly patients with gastric cancer.Methods:Sixty elderly patients with gastric cancer admitted to the hospital from January 2022 to January 2024 were selected and divided into groups according to the random number table method.The control group(n=30)received routine nursing after surgery,while the observation group(n=30)received early enteral nutrition nursing after surgery.The perioperative indexes,nutritional indexes before and after nursing,humoral and cellular immune indexes before and after nursing,gastrointestinal hormone levels before and after nursing,and the incidence of postoperative complications were compared between the two groups.Results:The perioperative indexes of the observation group were better than those of the control group(P<0.05).Before nursing,there was no significant difference in the nutritional indexes between the two groups(P>0.05).After nursing,the nutritional indexes of the observation group were better than those of the control group(P<0.05).Before nursing,there was no significant difference in the humoral and cellular immune indexes between the two groups(P>0.05).After nursing,the humoral and cellular immune indexes of the observation group were better than those of the control group(P<0.05).Before nursing,there was no significant difference in the gastrointestinal hormone levels between the two groups(P>0.05).After nursing,the gastrointestinal hormone levels of the observation group were better than those of the control group(P<0.05).The incidence of postoperative complications in the observation group was lower than that in the control group(P<0.05).Conclusion:For elderly patients with gastric cancer,early enteral nutrition nursing after surgery can improve their nutritional indexes and gastrointestinal hormone levels,enhance their immune ability,and prevent the incidence of postoperative complications,with good effects.
