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 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 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 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
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 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
Continuously increasing reports in the international medical literature,along with current guidelines from international societies,support the view that perioperative enteral nutrition(EN)and immunonutrition offer sig...Continuously increasing reports in the international medical literature,along with current guidelines from international societies,support the view that perioperative enteral nutrition(EN)and immunonutrition offer significant benefits to patients with benign and/or malignant digestive disorders,including reduction of postoperative infections and hospital stay.A vital component of the rehabilitation of patients after major gastrointestinal surgery is a comprehensive nutritional rehabilitation program.It has been shown that implementing an integrated nutritional support program significantly improves patients’immune responses,accelerates wound healing processes,reduces pain and accompanying anxiety,and decreases hospital length of stay.It appears that,in addition to the efforts of rehabilitation,prehabilitation,i.e.the return to the presurgery level of physical fitness,is or should be a vital objective of the team responsible for rehabilitating patients undergoing gastrointestinal surgery.The present review summarized the most up-to-date data on the role of perioperative nutritional support(EN and immune EN)in the rehabilitation and prehabilitation of patients undergoing major digestive surgery.Systematic and comprehensive perioperative nutritional support for these patients should become a daily clinical practice element of paramount importance.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
BACKGROUND Gastrointestinal(GI)perforation(GP)repair is a surgical procedure to promptly seal perforations in the GI tract to prevent further leakage.After surgery,patients often experience a high metabolic state due ...BACKGROUND Gastrointestinal(GI)perforation(GP)repair is a surgical procedure to promptly seal perforations in the GI tract to prevent further leakage.After surgery,patients often experience a high metabolic state due to trauma,infection,and posto-perative stress.In the Enhanced Recovery After Surgery(ERAS)protocol,early enteral nutrition is a key strategy for promoting postoperative recovery.Com-pared with parenteral nutrition,enteral nutrition more effectively meets the physiological needs of the GI system,promotes the recovery of gut function,and reduces the risk of GI infections.AIM To evaluate the clinical efficacy of early enteral nutrition support in patients undergoing GP repair within the ERAS protocol.METHODS This retrospective study analyzed 66 patients who underwent GP repair.Patients were divided into a control group(n=32),managed with a traditional nutritional regimen,primarily consisting of total parenteral nutrition;and an observation group(n=34),which included those who received early enteral nutrition support as part of the ERAS protocol.This study examined the time to first postoperative flatus and bowel movement,changes in nutritional and immune function,inflam-matory markers on postoperative days 1 and 5,and adverse reactions.RESULTS The observation group had significantly shorter times to the first postoperative flatus and bowel movement than the control group(P<0.05).On postoperative day 5,the observation group demonstrated higher nutritional and immune function levels than the control group(P<0.05),while C-reactive protein levels were significantly lower(P<0.05).The overall incidence of adverse reactions in the observation group was 8.82%(3/34),which was lower than the 28.13%(9/32)observed in the control group(P<0.05).CONCLUSION Early enteral nutritional support facilitates GI recovery after GP repair.It improves nutritional status,enhances immune function,and attenuates inflammatory responses while also demonstrating a favorable safety profile.展开更多
Objective:To investigate the impact of progressive effect nutritional care on uremia patients undergoing dialysis.Methods:A total of 101 uremia patients undergoing dialysis admitted from January 2024 to March 2025 wer...Objective:To investigate the impact of progressive effect nutritional care on uremia patients undergoing dialysis.Methods:A total of 101 uremia patients undergoing dialysis admitted from January 2024 to March 2025 were selected as the study subjects and divided into two groups by lottery method.The control group(55 cases)received routine care,while the observation group(56 cases)received a combination of routine care and progressive effect nutritional care.Results:After 4 weeks of care,the observation group demonstrated higher treatment adherence(P<0.05),better quality of life(P<0.05),and improved nutritional status(P<0.05)compared to the control group.Conclusion:Progressive effect nutritional care can significantly enhance treatment adherence,quality of life,and nutritional status in uremia patients undergoing dialysis.展开更多
BACKGROUND The correlation between geriatric nutritional risk index(GNRI)and the prognosis of patients with osteoporosis or osteopenia has not been studied.This study aims to explore the relationship between GNRI and ...BACKGROUND The correlation between geriatric nutritional risk index(GNRI)and the prognosis of patients with osteoporosis or osteopenia has not been studied.This study aims to explore the relationship between GNRI and the cardiovascular disease(CVD)and all-cause mortality rates in elderly patients with osteoporosis or osteopenia.METHODS This study included 4756 patients with osteoporosis and osteopenia from five cycles of the National Health and Nutrition Examination Survey(NHANES).We used multivariable Cox regression and subgroup analyses to investigate the correlation between GNRI and mortality rates.The restricted cubic spline analysis was used to assess the dose-response relationship between GNRI and mortality risk.Mediation analysis was conducted to examine the mediating effect of chronic kidney disease on the relationship between nutritional risk and mortality.RESULTS During a median follow-up period of 114 months,a total of 1241 deaths(26.09%)occurred,including 300 deaths due to CVD(6.31%).In the fully adjusted Model 3,compared to the no-risk group,the risk group showed significantly increased all-cause mortality risk(HR=2.05,95%CI:1.74–2.40)and CVD mortality risk(HR=1.88,95%CI:1.30–2.71).The restricted cubic spline analysis indicated a non-linear association between GNRI and all-cause mortality risk as well as CVD mortality risk.The mediation analysis results indicated that chronic kidney disease mediates 16.9%of the effect of nutritional risk on all-cause mortality and 25.3%on CVD mortality risk.CONCLUSIONS GNRI can serve as a predictive factor for all-cause and CVD mortality rates in elderly patients with osteoporosis or osteopenia.展开更多
Sea cucumber Apostichopus japonicus is a crucial aquatic species known for its nutritional value.However,the genetic basis and regulatory mechanisms underlying its nutritional quality remain underexplored.This study i...Sea cucumber Apostichopus japonicus is a crucial aquatic species known for its nutritional value.However,the genetic basis and regulatory mechanisms underlying its nutritional quality remain underexplored.This study investigates the nutritional quality of A.japonicus from different geographical regions and identifies genetic markers associated with these traits through a genome-wide association study(GWAS).We observed significant regional variations in the nutritional content of A.japonicus.Samples collected from Nanhuangcheng Island displayed the highest levels of saponins,whereas those from Laizhou exhibited the highest concentrations of glycosaminoglycans.Lingshan Island samples were the richest in amino acids,while samples from Rizhao contained the highest levels of polyunsaturated fatty acids.Through GWAS,265 candidate genes and related single nucleotide polymorphisms(SNPs)were identified as being significantly associated with essential nutritional traits,including genes like ubiquitin domain-containing protein 1(UBTD1),inactive pancreatic lipase-related protein 1,protein arginine N-methyltransferase 5(PRMT5)and GDP-fucose protein O-fucosyltransferase 1(POFUT1).This study advanced our knowledge of the genetic mechanisms underlying the nutritional quality of A.japonicus.The genetic markers identified herein o ffer crucial insights for breeding initiatives aimed at optimizing the nutritional profile of sea cucumbers.展开更多
BACKGROUND Hypertension is a common chronic disease in the elderly population,and its association with cognitive impairment has been increasingly recognized.Cognitive impairment,including mild cognitive impairment and...BACKGROUND Hypertension is a common chronic disease in the elderly population,and its association with cognitive impairment has been increasingly recognized.Cognitive impairment,including mild cognitive impairment and dementia,can significantly affect the quality of life and independence of elderly individuals.Therefore,identifying risk factors for cognitive impairment in elderly hypertensive patients is crucial for developing effective interventions and improving health outcomes.Nutritional status is one of the potential factors that may influence cognitive function in elderly hypertensive patients.Malnutrition or inadequate nutrition can lead to various health problems,including weakened immune system,increased susceptibility to infections,and impaired physical and mental function.Furthermore,poor nutritional status has been linked to increased risk of cognitive decline and dementia in various populations.In this observational study,we aimed to investigate the nutritional status of elderly hypertensive patients and its relationship to the occurrence of cognitive impairment.By collecting baseline data on general information,body composition,and clinical indicators,we hope to identify risk factors for cognitive impairment in this patient population.The results of this study are expected to provide more scientific basis for the health management of elderly patients with hypertension,particularly in terms of maintaining good nutritional status and reducing the risk of cognitive impairment.AIM To explore the differences between clinical data and cognitive function of elderly hypertensive patients with different nutritional status,analyze the internal relationship between nutritional statuses and cognitive impairment,and build a nomogram model for predicting nutritional status in elderly hypertensive patients.METHODS The present study retrospectively analyzed 200 elderly patients admitted to our hospital for a hypertension during the period July 1,2024 to September 30,2024 as study subjects,and the 200 patients were divided into a modeling cohort(140 patients)and a validation cohort(60 patients)according to the ratio of 7:3.The modeling cohort were divided into a malnutrition group(26 cases),a malnutrition risk group(42 cases),and a normal nutritional status group(72 cases)according to the patients’Mini-Nutritional Assessment Scale(MNA)scores,and the modeling cohort was divided into a hypertension combined with cognitive impairment group(34 cases)and a hypertension cognitively normal group(106 cases)according to the Montreal Cognitive Assessment Scale(MoCA)scores,and the validation cohort was divided into a hypertension combined with cognitive impairment group(14 cases)and hypertension cognitively normal group(46 cases).The study outcome was the occurrence of cognitive impairment in elderly hypertensive patients.Univariate and multivariate logistic regression was used to explore the relationship between the general information of the elderly hypertensive patients and the influence indicators and the occurrence of cognitive impairment,the roadmap prediction model was established and validated,the patient work receiver operating characteristic curve was used to evaluate the predictive efficacy of the model,the calibration curve was used to assess the consistency between the predicted events and the actual events,and the decision curve analysis was used to evaluate the validity of the model.Pearson correlation analysis was used to explore the relationship between nutrition-related indicators and MoCA scores.RESULTS In this research,the modeling cohort comprised 140 cases,while the verification cohort consisted of 60 cases,with no notable discrepancy in the data between the two groups.In the modeling cohort,there were significant differences in body mass index(BMI),albumin(ALB),hemoglobin(Hb)and homocysteine levels among the malnourished group,the malnourished risk group and the normal nutritional status group.The results of univariate and multivariate analysis showed that BMI[odds ratio(OR)=0.830,P=0.014],ALB(OR=0.860,P=0.028),Hb(OR=0.939,P=0.035)and MNA score(OR=0.640,P=0.000)were independent protective factors for patients without cognitive impairment,and alkaline phosphatase(ALP)(OR=1.074,P=0.000)was an independent risk factor for patients with cognitive impairment.In this study,the prediction nomogram tailored for cognitive deterioration in elderly patients with hypertension demonstrated robust predictive power and a close correspondence between predicted and observed outcomes.This model offers significant potential as a means to forestall cognitive decline in hypertensive elderly patients.ALP was negatively correlated with MoCA score,while BMI,MNA score,Hb and ALB were positively correlated with MoCA score.CONCLUSION BMI,MNA score,Hb and ALB were independent protective factors for cognitive impairment in elderly hypertensive patients and were positively correlated with MoCA score.ALP was an independent risk factor for cognitive impairment in elderly hypertensive patients and was negatively correlated with the MoCA score.The column line graph model established in the study has a good predictive value.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 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.
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 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.
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 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Continuously increasing reports in the international medical literature,along with current guidelines from international societies,support the view that perioperative enteral nutrition(EN)and immunonutrition offer significant benefits to patients with benign and/or malignant digestive disorders,including reduction of postoperative infections and hospital stay.A vital component of the rehabilitation of patients after major gastrointestinal surgery is a comprehensive nutritional rehabilitation program.It has been shown that implementing an integrated nutritional support program significantly improves patients’immune responses,accelerates wound healing processes,reduces pain and accompanying anxiety,and decreases hospital length of stay.It appears that,in addition to the efforts of rehabilitation,prehabilitation,i.e.the return to the presurgery level of physical fitness,is or should be a vital objective of the team responsible for rehabilitating patients undergoing gastrointestinal surgery.The present review summarized the most up-to-date data on the role of perioperative nutritional support(EN and immune EN)in the rehabilitation and prehabilitation of patients undergoing major digestive surgery.Systematic and comprehensive perioperative nutritional support for these patients should become a daily clinical practice element of paramount importance.
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.
文摘BACKGROUND Gastrointestinal(GI)perforation(GP)repair is a surgical procedure to promptly seal perforations in the GI tract to prevent further leakage.After surgery,patients often experience a high metabolic state due to trauma,infection,and posto-perative stress.In the Enhanced Recovery After Surgery(ERAS)protocol,early enteral nutrition is a key strategy for promoting postoperative recovery.Com-pared with parenteral nutrition,enteral nutrition more effectively meets the physiological needs of the GI system,promotes the recovery of gut function,and reduces the risk of GI infections.AIM To evaluate the clinical efficacy of early enteral nutrition support in patients undergoing GP repair within the ERAS protocol.METHODS This retrospective study analyzed 66 patients who underwent GP repair.Patients were divided into a control group(n=32),managed with a traditional nutritional regimen,primarily consisting of total parenteral nutrition;and an observation group(n=34),which included those who received early enteral nutrition support as part of the ERAS protocol.This study examined the time to first postoperative flatus and bowel movement,changes in nutritional and immune function,inflam-matory markers on postoperative days 1 and 5,and adverse reactions.RESULTS The observation group had significantly shorter times to the first postoperative flatus and bowel movement than the control group(P<0.05).On postoperative day 5,the observation group demonstrated higher nutritional and immune function levels than the control group(P<0.05),while C-reactive protein levels were significantly lower(P<0.05).The overall incidence of adverse reactions in the observation group was 8.82%(3/34),which was lower than the 28.13%(9/32)observed in the control group(P<0.05).CONCLUSION Early enteral nutritional support facilitates GI recovery after GP repair.It improves nutritional status,enhances immune function,and attenuates inflammatory responses while also demonstrating a favorable safety profile.
文摘Objective:To investigate the impact of progressive effect nutritional care on uremia patients undergoing dialysis.Methods:A total of 101 uremia patients undergoing dialysis admitted from January 2024 to March 2025 were selected as the study subjects and divided into two groups by lottery method.The control group(55 cases)received routine care,while the observation group(56 cases)received a combination of routine care and progressive effect nutritional care.Results:After 4 weeks of care,the observation group demonstrated higher treatment adherence(P<0.05),better quality of life(P<0.05),and improved nutritional status(P<0.05)compared to the control group.Conclusion:Progressive effect nutritional care can significantly enhance treatment adherence,quality of life,and nutritional status in uremia patients undergoing dialysis.
文摘BACKGROUND The correlation between geriatric nutritional risk index(GNRI)and the prognosis of patients with osteoporosis or osteopenia has not been studied.This study aims to explore the relationship between GNRI and the cardiovascular disease(CVD)and all-cause mortality rates in elderly patients with osteoporosis or osteopenia.METHODS This study included 4756 patients with osteoporosis and osteopenia from five cycles of the National Health and Nutrition Examination Survey(NHANES).We used multivariable Cox regression and subgroup analyses to investigate the correlation between GNRI and mortality rates.The restricted cubic spline analysis was used to assess the dose-response relationship between GNRI and mortality risk.Mediation analysis was conducted to examine the mediating effect of chronic kidney disease on the relationship between nutritional risk and mortality.RESULTS During a median follow-up period of 114 months,a total of 1241 deaths(26.09%)occurred,including 300 deaths due to CVD(6.31%).In the fully adjusted Model 3,compared to the no-risk group,the risk group showed significantly increased all-cause mortality risk(HR=2.05,95%CI:1.74–2.40)and CVD mortality risk(HR=1.88,95%CI:1.30–2.71).The restricted cubic spline analysis indicated a non-linear association between GNRI and all-cause mortality risk as well as CVD mortality risk.The mediation analysis results indicated that chronic kidney disease mediates 16.9%of the effect of nutritional risk on all-cause mortality and 25.3%on CVD mortality risk.CONCLUSIONS GNRI can serve as a predictive factor for all-cause and CVD mortality rates in elderly patients with osteoporosis or osteopenia.
基金Supported by the Key Research and Development Program of Shandong(Nos.2021LZGC029,2023LZGC019)the National Natural Science Foundation of China(No.42076093)+1 种基金the Special Funds for the Central Government to Guide Local Science and Technology Development(No.YDZX2023043)the Taishan Scholars Program(No.tsqn202306279)。
文摘Sea cucumber Apostichopus japonicus is a crucial aquatic species known for its nutritional value.However,the genetic basis and regulatory mechanisms underlying its nutritional quality remain underexplored.This study investigates the nutritional quality of A.japonicus from different geographical regions and identifies genetic markers associated with these traits through a genome-wide association study(GWAS).We observed significant regional variations in the nutritional content of A.japonicus.Samples collected from Nanhuangcheng Island displayed the highest levels of saponins,whereas those from Laizhou exhibited the highest concentrations of glycosaminoglycans.Lingshan Island samples were the richest in amino acids,while samples from Rizhao contained the highest levels of polyunsaturated fatty acids.Through GWAS,265 candidate genes and related single nucleotide polymorphisms(SNPs)were identified as being significantly associated with essential nutritional traits,including genes like ubiquitin domain-containing protein 1(UBTD1),inactive pancreatic lipase-related protein 1,protein arginine N-methyltransferase 5(PRMT5)and GDP-fucose protein O-fucosyltransferase 1(POFUT1).This study advanced our knowledge of the genetic mechanisms underlying the nutritional quality of A.japonicus.The genetic markers identified herein o ffer crucial insights for breeding initiatives aimed at optimizing the nutritional profile of sea cucumbers.
基金Supported by the Wuxi Science and Technology Plan Project Plan,No.BJ21008.
文摘BACKGROUND Hypertension is a common chronic disease in the elderly population,and its association with cognitive impairment has been increasingly recognized.Cognitive impairment,including mild cognitive impairment and dementia,can significantly affect the quality of life and independence of elderly individuals.Therefore,identifying risk factors for cognitive impairment in elderly hypertensive patients is crucial for developing effective interventions and improving health outcomes.Nutritional status is one of the potential factors that may influence cognitive function in elderly hypertensive patients.Malnutrition or inadequate nutrition can lead to various health problems,including weakened immune system,increased susceptibility to infections,and impaired physical and mental function.Furthermore,poor nutritional status has been linked to increased risk of cognitive decline and dementia in various populations.In this observational study,we aimed to investigate the nutritional status of elderly hypertensive patients and its relationship to the occurrence of cognitive impairment.By collecting baseline data on general information,body composition,and clinical indicators,we hope to identify risk factors for cognitive impairment in this patient population.The results of this study are expected to provide more scientific basis for the health management of elderly patients with hypertension,particularly in terms of maintaining good nutritional status and reducing the risk of cognitive impairment.AIM To explore the differences between clinical data and cognitive function of elderly hypertensive patients with different nutritional status,analyze the internal relationship between nutritional statuses and cognitive impairment,and build a nomogram model for predicting nutritional status in elderly hypertensive patients.METHODS The present study retrospectively analyzed 200 elderly patients admitted to our hospital for a hypertension during the period July 1,2024 to September 30,2024 as study subjects,and the 200 patients were divided into a modeling cohort(140 patients)and a validation cohort(60 patients)according to the ratio of 7:3.The modeling cohort were divided into a malnutrition group(26 cases),a malnutrition risk group(42 cases),and a normal nutritional status group(72 cases)according to the patients’Mini-Nutritional Assessment Scale(MNA)scores,and the modeling cohort was divided into a hypertension combined with cognitive impairment group(34 cases)and a hypertension cognitively normal group(106 cases)according to the Montreal Cognitive Assessment Scale(MoCA)scores,and the validation cohort was divided into a hypertension combined with cognitive impairment group(14 cases)and hypertension cognitively normal group(46 cases).The study outcome was the occurrence of cognitive impairment in elderly hypertensive patients.Univariate and multivariate logistic regression was used to explore the relationship between the general information of the elderly hypertensive patients and the influence indicators and the occurrence of cognitive impairment,the roadmap prediction model was established and validated,the patient work receiver operating characteristic curve was used to evaluate the predictive efficacy of the model,the calibration curve was used to assess the consistency between the predicted events and the actual events,and the decision curve analysis was used to evaluate the validity of the model.Pearson correlation analysis was used to explore the relationship between nutrition-related indicators and MoCA scores.RESULTS In this research,the modeling cohort comprised 140 cases,while the verification cohort consisted of 60 cases,with no notable discrepancy in the data between the two groups.In the modeling cohort,there were significant differences in body mass index(BMI),albumin(ALB),hemoglobin(Hb)and homocysteine levels among the malnourished group,the malnourished risk group and the normal nutritional status group.The results of univariate and multivariate analysis showed that BMI[odds ratio(OR)=0.830,P=0.014],ALB(OR=0.860,P=0.028),Hb(OR=0.939,P=0.035)and MNA score(OR=0.640,P=0.000)were independent protective factors for patients without cognitive impairment,and alkaline phosphatase(ALP)(OR=1.074,P=0.000)was an independent risk factor for patients with cognitive impairment.In this study,the prediction nomogram tailored for cognitive deterioration in elderly patients with hypertension demonstrated robust predictive power and a close correspondence between predicted and observed outcomes.This model offers significant potential as a means to forestall cognitive decline in hypertensive elderly patients.ALP was negatively correlated with MoCA score,while BMI,MNA score,Hb and ALB were positively correlated with MoCA score.CONCLUSION BMI,MNA score,Hb and ALB were independent protective factors for cognitive impairment in elderly hypertensive patients and were positively correlated with MoCA score.ALP was an independent risk factor for cognitive impairment in elderly hypertensive patients and was negatively correlated with the MoCA score.The column line graph model established in the study has a good predictive value.
