Perioperative nutrition optimization:a review of the current literature

Objective:This article aims to elaborate the recent research status of perioperative nutrition optimization,in order to help clinical practice.Methods:This study employed a comprehensive and systematic method to search prominent databases,including PubMed and Web of Science,using carefully selected keywords.Following meticulous screening,the inclusion of high-quality studies was prioritized,and a thorough review of the references was conducted to comprehensively analyze the latest evidence on perioperative nutrition optimization.Results:The main contents include preoperative nutritional risk screening and assessment,nutritional support pathway,immune enhancing nutrition,preoperative and postoperative nutritional management,as well as personalized nutrition optimization strategies for specific populations(such as children,bariatric surgery patients,and cancer patients).Conclusions:In clinical practice,the importance of perioperative nutrition should be emphasized,and personalized nutrition management plans should be developed based on the characteristics and needs of patients.Further research and promotion of perioperative nutrition optimization strategies will help improve the overall prognosis and quality of life of surgical patients.

Detection and management of perioperative blood glucose abnormalities

Diabetes mellitus is a common chronic disease.With the improvement of living standards,the prevalence of diabetes mellitus in China is increasing.There are now more people with diabetes in China(>100 million)than in any other country.About half of these people with diabetes need to undergo at least one procedure in their lifetime.Diabetic patients have a much higher probability of perioperative dysglycemia than the normal population,which has a great impact on their prognosis.In addition,non-diabetic patients may also have abnormal blood glucose levels due to various reasons during the perioperative period,which will also lead to a series of adverse consequences.This ar ticle reviews the perioperative blood glucose management of patients to provide a reference for improving their health status.

Perioperative nursing principles guided by the concept of enhanced recovery after surgery

Objective:To explore the clinical effect of perioperative nursing guided by the concept of enhanced recovery after surgery and summarize them.Methods:Pubmed,Chinese National Knowledge Infrastructure(CNKI),Chinese Biomedical Literature Database(CBM),Wanfang Database,and VIP Database were searched to obtain the relevant literature involving enhanced recovery after surgery(ERAS)guidance,obtain the effective clinical data,review the reports in literature,and obtain the effective scheme.Results:Compared with the traditional nursing program,perioperative nursing principles guided by the concept of ERAS provide more accurate nursing care to patients and reduce the occurrence of intraoperative stress events through comprehensive nursing measures such as preoperative pre-rehabilitation measures,intraoperative body temperature and fluid management,postoperative analgesia,prevention of nausea and vomiting,early mobilization,catheter nursing,and better out-of-hospital follow-up.Conclusions:Perioperative nursing principles guided by the concept of ERAS can significantly reduce the incidence of perioperative complications,shorten the hospital stay of patients,and promote postoperative rehabilitation of patients.The transformation and implementation of this concept can bring significant benefits to hospitals,medical care,and patients.

Application of a perioperative nursing strategy in the surgical treatment of elderly patients: a narrative review

With the steady increase of older people in society, a progressively greater number of patients belonging to the geriatric group need surgical treatment. Since elderly patients with reduced physiological reserve and organ failure often have chronic diseases, geriatric syndrome, and other clinical problems, the perioperative nursing of elderly patients is more complicated. Therefore, we need to comprehensively consider clinical issues, such as patients’ preoperative status, surgical risks, and postoperative quality of life and life expectancy, and conduct comprehensive evaluations and holistic, individualized, and continuous nursing and therapy through the participation of interdisciplinary teams to achieve better curative effects. Here, the perioperative nursing of elderly patients is reviewed, including preoperative evaluation and nursing, intraoperative management, and postoperative nursing.

Bilateral occurrence of sperm granulomas in the left spermatic cord and on the right epididymis:A case report

BACKGROUND Sperm granuloma is a rare disease in clinical andrology and its incidence is still unclear worldwide.According to the existing literature,sperm granuloma often occurs unilaterally.Clinical and ultrasound features are similar to epididymal tuberculosis,chronic epididymitis and other diseases.Sperm granuloma is usually diagnosed based on postoperative histopathological and immunohistochemical examination.CASE SUMMARY A 46-year-old man was admitted to the hospital due to the presence of a left scrotal mass for 3 mo and aggravation of pain for 1 wk.The lesions at both sites were surgically resected.Postoperative pathological examination showed that the left spermatic cord mass and the right epididymal mass were consistent with sperm granuloma.The sperm granulomas then recurred 3 mo after surgery.There is little change in the local mass so far.CONCLUSION The case report is helpful for our understanding of this disease.In clinical diagnosis,it should be distinguished from epididymal tuberculosis,chronic epididymitis and other diseases.Color Doppler ultrasound can be used as a preferred examination method but postoperative pathological examination is still needed for diagnosis.

Penile aseptic abscess in the cavernous body at the base of the penis:a case report

We report a case of aseptic abscess in the cavernous body at the base of the penis.In our clinical observation,the patient underwent puncture and drainage of the corpus cavernosum abscess,followed by surgical resection of the abscess wall,with the incisions closed layer by layer with primary suture.In addition,we paid attention to strengthening the postoperative management by using elastic bandages to wrap the penis intermittently to prevent edema;the incision would not be covered with dressings from the third day after the operation,so as to keep the incision site dry in an open way.During the period of indwelling of the catheter after the operation,we noticed the care of the external orifice of the urethra to reduce the occurrence of catheter-related infections.Finally,the patient was diagnosed with a penile aseptic abscess in the cavernous body at the base of the penis.The patient recovered well after surgery and was discharged 1 week later.At 1.5 years after the operation,the shape of the penis returned to normal,and the erectile function was normal.It was seen that good nursing concept is of great help for prognosis,which could avoid infection and edema,and is conducive to wound healing.

Progress in targeted therapy for metastatic renal cell carcinoma

In recent years, with the deepening of research on the pathogenesis of renal cell carcinoma, anti-VEGF receptor inhibitors and mTOR inhibitors have been produced, making metastatic renal cell carcinoma into the era of targeted therapy. This article analyzes the latest research results at home and abroad. For patients with metastatic renal cell carcinoma, sunitinib and pizopanib are the first choice for targeted drugs. The drug dose starts from the standard dose, and the disease can be increased as appropriate when the disease progresses;When responding, it should be treated or reduced in time. When using an anti-VEGF inhibitor, the patient's blood pressure should be closely monitored. When the patient has high blood sugar or diabetes, anti-VEGF inhibitors should be preferred.

Research progress of new conservative treatment for female stress urinary incontinence

The new conservative treatment methods of female stress urinary incontinence mainly include laser therapy, magnetic stimulation therapy and stem cell therapy. Laser therapy and magnetic stimulation therapy can improve the urodynamic parameters, clinical symptoms, quality of life and sexual life of female stress urinary incontinence patients, with higher compliance and less side effects. Stem cell therapy can improve histological changes, urodynamic parameters of stress urinary incontinence rats, and clinical symptoms and quality of life of patients with stress urinary incontinence, but it has not been widely used in clinical practice, and the successful experience is mainly accumulated in the animal experiment stage. In order to make it easier for medical workers to understand and promote these three new conservative treatment methods, this article reviews the treatment principles and treatment effects of these new conservative treatment methods.

Research progress of of RNA m6 A methylation in urogenital tumors

TRNA m6A methylation is a kind of dynamic reversible modification commonly existing in eukaryotes. It is involved in three proteins, namely m6A methyltransferase, m6A demethylase and m6A binding protein, which regulate RNA shearing, transport, stability and translation into proteins. It is closely related to many physiological processes, especially in tumors. However, there are few studies on RNA m6A methylation in urogenital tumors. Therefore, this article reviews the role of RNA m6 A methylation in tumors and its research progress in the urogenital system.

Giant retroperitoneal hemolymphangioma:A case report and review of literature

BACKGROUND Hemolymphangioma is a very rare benign tumor in clinical practice caused by abnormalities of the vasculature.Its clinical features are often atypical,and it is easy to miss and misdiagnose.When the time of nuclear magnetic T1 is significantly reduced,the diagnosis of hemangioma should be considered.Therefore,we report this case in the hope of raising clinicians'awareness of the disease.CASE SUMMARY A 37-year-old man presented with a giant retroperitoneal hemolymphangioma.Computed tomography and magnetic resonance imaging indicated the possibility of a large perirenal lymphatic cyst.The postoperative pathological diagnosis is retroperitoneal hemolymphangioma.The patient underwent surgical excision after adequate drainage.The postoperative recovery was smooth and there were no complications.There was no recurrence during half a year of follow-up.CONCLUSION This case reiterates that large retroperitoneal cystic masses with significantly shortened nuclear T1 time should be considered hemolymphangioma.Specific clinical basis and experience for the diagnosis and treatment of these diseases is necessary.

Mediating function of heart failure in the causal relationship between diastolic blood pressure and hypertensive renal disease with renal failure:a mediated Mendelian randomization study

Objective:To study the causality relationship between diastolic blood pressure(DBP)and hypertensive renal disease with renal failure(HRDRF)and the mediating role of hear t failure(HF)in the causality relationship by network Mendelian randomization(MR).Methods:Genome-wide analysis of DBP,HRDRF,and HF was downloaded from the public database(Genome-Wide Analysis Study[GWAS])and was used to analyze the results and to conduct mediated MR analysis.Results:Analysis showed that DBP was positively correlated with HRDRF(OR=1.0002,95%CI:1.0001–1.0003,P=1.8076e-05)and DBP was positively correlated with HF(OR=1.0295,95%CI:1.0221–1.0370,P=2.5292e-15).HF and HRDRF had a positive causal effect(OR=1.0001,95%CI:1.0000–1.0001,P=0.0152).Mediation analysis showed that the contribution ratio of HF to the combined effect of DBP and HRDRF was 24.69%.Conclusions:DBP can increase the risk of renal disease with renal failure,and HF may play an impor tant role in mediating this causal relationship.

Valproic acid reduces autophagy and promotes functional recovery after spinal cord injury in rats

Secondary damage is a critical determinant of the functional outcome in patients with spinal cord injury （SCI）, and involves multiple mechanisms of which the most important is the loss of nerve cells mediated by multiple factors. Autophagy can result in cell death, and plays a key role in the development of SCI. It has been recognized that valproic acid （VPA） is neuroprotective in certain experimental animal models, however, the levels of autophagic changes in the process of neuroprotection by VPA treatment following SCI are still unknown. In the present study, we determined the extent of autophagy after VPA treatment in a rat model of SCI. We found that both the mRNA and protein levels of Beclin-1 and LC3 were significantly increased at 1, 2, and 6 h after SCI and peaked at 2 h; however, Western blot showed that autophagy was markedly decreased by VPA treatment at 2 h post-injury. Besides, post-SCI treatment with VPA improved the Basso-Beattie-Bresnahan scale, increased the number of ventral horn motoneurons, and reduced myelin sheath damage compared with vehicle-treated animals at 42 days after SCI. Together, our results demonstrated the characteristics of autophagy expression following SCI, and foundthat VPA reduced autophagy and enhanced motor function.