Immunomodulatory and chemopreventive effects of resveratrol on the digestive system cancers

Resveratrol(RSV),the primary polyphenol found in grapes,has been revealed to have anti-inflammatory properties by reducing the capacity of the peripheral blood mononuclear cells to produce pro-inflammatory cytokines,including IL-1β,IL-6,IL-1ra and TNFα.Considering the close association between chronic inflammation and cancer development,RSV’s immunomodulatory properties are one way by which the polyphenol may inhibit cancer initiation,proliferation,neovascularization,and migration.Resveratrol influences the generation of microtumor environment which is one of the key factors in cancer progress.In addition to immunomodulation,RSV inhibits cancer development by expressing anti-oxidant effects,causing cell cycle arrest,stimulating the function of certain enzymes,and activating cell signaling pathways.The end outcome is one of the various forms of cell death,including apoptosis,pyroptosis,necroptosis,and more,as it has been observed in vitro.RSV has been shown to act against cancer in practically every organ,while its effects on colon cancer have been documented more frequently.It is remarkable that longer-term clinical studies that may have established the potential for this natural substance to serve as a therapeutic adjuvant to traditional anti-cancer medications were not prompted by the encouraging outcomes seen with cancer cells treated with non-toxic doses of resveratrol.The current review aims to assess the recent findings about the immunological and anti-cancer characteristics of RSV,with a particular emphasis on cancers of the digestive tract,as a challenge for future clinical research that may contribute to the better prognosis of cancer.

Impact of comorbid anxiety and depression on quality of life and cellular immunity changes in patients with digestive tract cancers

AIM:A study was performed to investigate the impact of comorbid anxiety and depression (CAD) on quality of life (QOL) and cellular immunity changes in patients with digestive tract cancers. METHODS: One hundred and fifty-six cases of both sexes with cancers of the digestive tract admitted between March 2001 and February 2004 in the Department of Medical Oncology, First Affiliated Hospital of Xi'an Jiaotong University were randomly enrolled in the study. Depressive and anxiety disorder diagnoses were assessed by using the Structured Clinical Interview for DSM-IV. All adult patients were evaluated with the Hamilton depressive scale (HAMD, the 24-item version), the Hamilton anxiety scale (HAMA, a modified 14-item version), quality of life questionnaire-core 30 (QLQ-C30), social support rating scale (SSRS), simple coping style questionnaire (SCSQ), and other questionnaires, respectively. In terms of HAMD ≥ 20 and HAMA ≥ 14, the patients were categorized, including CAD (n = 31) in group A, anxiety disorder (n = 23) in group B, depressive disorder (n = 37) in group C, and non-disorder (n = 65) in group D. Immunological parameters such as T-lymphocyte subsets and natural killer (NK) cell activities in peripheral blood were determined and compared among the four groups. RESULTS: The incidence of CAD was 21.15% in patients with digestive tract cancers. The average scores of social support was 43.67±7.05 for 156 cases, active coping 20.34±7.33, and passive coping 9.55±5.51. Compared with group D, subjective support was enhanced slightly in group A, but social support, objective support, and utilization of support reduced, especially utilization of support with significance (6.16 vs7.80, P<0.05); total scores of active coping decreased, while passive coping reversed; granulocytes proliferated, monocytes declined, and lymphocytes declined significantly (32.87 vs 34.00, P<0.05); moreover, the percentage of CD3, CD4, CD8 and CD56 in T lymphocyte subsets was in lower level, respectively, and CD56 showed a significant decline in group A (26.02 vs 32.20, P<0.05), however, CD4/CD8 ratio increased. Physical function, role function, fatigue, sleeplessness and constipation had significant changes among different groups by one-way ANOVA, and group A was in poor QOL. It revealed that global health-related quality of life (QL) were positively correlated with active coping and CD56; CAD was negatively correlated with QL, active coping and CD56. Furthermore, the step-wise regression analysis suggested that utilization of support, CD56, active coping, fatigue, sleeplessness and depression were significant factors contributing to QOL. CONCLUSION: CAD, which can impair QOL and cellular immunity, occurs with a higher incidence in patients with digestive tract cancers. Hence, it is essential to improve mental health for them with specifically tailored interventions.

Prognostic Value of Sox2 Expression in Digestive Tract Cancers: A Meta-analysis

The aim of the present study was to accurately evaluate the association of Sox2 expression with the survival of patients with digestive tract cancers. Relevant literatures were identified by comprehensively searching databases including the Pubmed, Embase, CBMdisc, and Wanfang（up to October 2014）. A meta-analysis was performed to clarify the association between Sox2 expression and overall survival or clinicopathological parameters of patients with digestive tract cancers（esophageal, gastric, and colorectal cancers）. The results showed a significant association between high Sox2 expression and poor overall survival in patients with digestive tract carcinomas（HR=1.55, 95% CI=1.04–2.31）, especially for patients with esophageal cancer（HR=2.04, 95%CI=1.30–3.22）, colorectal cancer（HR=1.40, 95% CI=1.04–1.89）, and digestive tract adenocarcinoma（HR=1.80, 95% CI=1.12–2.89）, for Europeans（HR=1.98, 95% CI=1.44–2.71） or patients who did not receive neoadjuvant treatment（HR=1.73, 95% CI=1.10–2.72）. Furthermore, Sox2 over-expression was highly correlated with vascular invasion（OR=1.86, 95% CI=1.25–2.77） and poor differentiation（OR=1.88, 95% CI=1.14–3.08）, especially in esophageal and colorectal cancers. In conclusion, Sox2 expression may serve as a novel prognostic factor for patients with digestive tract cancers. Over-expression of Sox2 that is correlated with vascular invasion and poor differentiation suggests poor outcomes of patients with digestive tract cancers.

HIF-1α-1790G>A polymorphism significantly increases the risk of digestive tract cancer:A meta-analysis

AIM:To investigate the association between hypoxiainducible factor-1α(HIF-1α) polymorphisms(-1772C>T and-1790G>A) and the risk of digestive tract cancer.METHODS:A total of 13 eligible studies were retrieved from Pub Med,EMBASE,and the ChinaNational Knowledge Infrastructure database.The odds ratios(ORs) and 95% confidence intervals(CIs) were calculated to estimate the strength of the associations.RESULTS:By pooling the eligible studies,we found that the HIF-1α-1772C>T polymorphism was not associated with the risk of developing digestive tract cancer(dominant comparison,OR:1.156; 95%CI:0.839-1.593; P heterogeneity = 0.007),and no significant association was found in the Asian population or the Caucasian population.However,for the-1790G>A polymorphism,carriers of the variant-1790 A allele had a significantly increased risk of digestive tract cancer compared with those with the wildtype-1790 G allele(dominant comparison,OR:3.252; 95%CI:1.661-6.368; P heterogeneity < 0.001).Additionally,this increased risk of digestive cancer was only detected in Asians; there was no significant association in Caucasians.CONCLUSION:This meta-analysis demonstrates that the HIF-1α-1790G>A polymorphism is associated with a significantly increased risk of digestive tract cancer,while the-1772C>T polymorphism is not.

Digestive tract reconstruction options after laparoscopic gastrectomy for gastric cancer

In addition to the popularity of laparoscopic gastrectomy(LG),many reconstructive procedures after LG have been reported.Surgical resection and lymphatic dissection determine long-term survival;however,the election of a reconstruction procedure determines the postoperative quality of life for patients with gastric cancer(GC).Presently,no consensus exists regarding the optimal reconstructive procedure.In this review,the current state of digestive tract reconstruction after LG is reviewed.According to the determining influence of the tumor site on the procedures of surgical resection and reconstruction,we divide these reconstruction procedures into three categories consistent with the resection procedures.We focus on the technical tips of every reconstruction procedure and examine the surgical outcomes(length of surgery and blood loss)and postoperative complications(anastomotic leakage and stricture)to facilitate gastrointestinal surgeons to understand the merits and demerits of every reconstruction procedure.

RELATIONSHIP BETWEEN DRINKING WATER,VEGETABLES AND CANCER DEATH IN THE HIGH INCIDENCE AREA OF DIGESTIVE TRACT CANCER

The Paper analyzed of investigation datas on thedeath causes of digestive tract cancer in high-incidencearea between 70s and 80s. The results showed that thecancer-adjusted mortalities were 224.14/100000 and226.66/100000: it was 7 times as high as low-incidence(31.19/100000 and 29.82/100000). In 70s, the cancer deathof esophagus, stomach and liver (87.41/100000,73.93/100000 and 8.59/100000) were 28 times, 10 timesand 4 times as high as low-incidence area (3.70/100000,10.57/100000 and 1.94/100000), respectively (P<0.001). In80s, the cancer death of esophagus, stomach and liver(68.26/100000, 109.39/100000 and 23.89/100000) were 17times, 10 times and 4 times as high as low-incidence area(4.54/100000, 10.84/100000 and 6.35/100000), respectively(P<0.001). In high-incidence area, the cancer death ofesophagus was lower, of stomach and liver were higherin 80s than 70s, respectively (P<0.01)- The result alsoshowed that the nitrate content of drinking water andvegetables were 21.45mg/1 and 1185.27mg/kg in high-incidence area; it were significant higher than that in low-incidence area (2.14mg/1 and 41.6omg/kg), the nitritecontent (0.01mg/l) of drinking water in high-incidencearea was significant higher than that in low-incidencearea (0.004mg/l), but the nitrite content among vegetableswas no significant difference between the two regions(N0.05). Our results suggest that the nitrate and nitritecontents increase in drinking water and vegetables maybe an important risk factor of upper alimentary cancer inhigh-incidence area.

Tumor circulome in the liquid biopsies for digestive tract cancer diagnosis and prognosis

Digestive tract cancer is one of the main diseases that endanger human health.At present,the early diagnosis of digestive tract tumors mainly depends on serology,imaging,endoscopy,and so on.Although tissue specimens are the gold standard for cancer diagnosis,with the rapid development of precision medicine in cancer,the demand for dynamic monitoring of tumor molecular characteristics has increased.Liquid biopsy involves the collection of body fluids via noninvasive approaches,and analyzes biological markers such as circulating tumor cells,circulating tumor DNA,circulating cell-free DNA,microRNAs,and exosomes.In recent years,liquid biopsy has become more and more important in the diagnosis and prognosis of cancer in clinical practice due to its convenience,non-invasiveness,high specificity and it overcomes temporal-spatial heterogeneity.Therefore,this review summarizes the current evidence on liquid biopsies in digestive tract cancers in relation to diagnosis and prognosis.

A meta-analysis of caspase-8-652 6N del polymorphism and digestive tract cancer risk

Caspase-8(CASP8) is one key regulator of apoptosis of T lymphocytes and is encoded by the CASP8 gene. It has been reported that the six-nucleotide deletion polymorphism(-652 6 N del) of the CASP8 gene had effect on some cancer risk. Few studies explored the association between CASP8 gene polymorphism and digestive tract cancer risk.To evaluate the association between the CASP8-652 6 N del polymorphism and the risk of digestive tract cancer, we conducted this meta-analysis. We found that CASP8-652 6 N del polymorphism was associated with a significantly reduced risk of digestive tract cancer in the co-dominant model(del/del vs. ins/ins: OR= 0.82, 95%CI= 0.72-0.95;del/ins vs. ins/ins: OR = 0.92,95%CI = 0.87-0.97;dominant model(del/ins + del/del vs. ins/ins: OR = 0.91,95%CI =0.87-0.96, recessive model: del/del vs. del/ins + ins/ins: OR = 0.85, 95%CI = 0.75-0.97). In the stratified analysis by cancer types, we found that all genetic models had protective effect on gastric cancer. Similar results were observed for colorectal cancer under heterozygote comparison and dominant model, but not under homozygote comparison or recessive model. In addition, a significantly decreased risk was found on esophageal cancer for most genetic models,except heterozygote comparison. When stratified by ethnicity and source of control, an evidently decreased risk was identified in the Asian populations and population-based studies. In conclusion, there exists an association between the CASP8-652 6 N del polymorphism and reduced digestive cancer risk, especially among Asians and populationbased studies.

A study of the clinical characteristics in patients with digestive tract cancer related cognitive impairment

Objective:The aims of this study was to explore the clinical characteristics of patients with digestive tract cancer-related cognitive impairment(CRCI),and provide reference for the comprehensive clinical understanding,early prevention and treatment.Methods:164 patients with digestive tract cancer were divided into CRCI group and non-CRCI impairment group based on the Montreal Cognitive Assessment Scale(MOCA)and the Minimal Mental State Scale(MMSE).Baseline features,blood biochemical indexes,anxiety and depression were compared.Statistical analysis were carried out by SPSS software(version 20.0).Results:Among all the patients with CRCI,males were more common.Also,there were statistically differences in marital status,liver metastasis,hypertension,ferritin(FER),high density lipoprotein-cholesterol(HDL-C),low density lipoprotein-cholesterol(LDL-C),NK cells,anxiety and depression(P<0.05).Conclusion:Part of patients with digestive tract cancer have varied degrees of cognitive dysfunction.Marital status,hypertension,immune function,liver metastasis and serum lipid metabolism were the risk factors for patients with digestive tract CRCI.Early identification of CRCI is of great significance to ensure the integrity of treatment,improve the quality of life and prognosis for patients with digestive tract CRCI.

中医药辨治消化道早癌的思路与方法

总结对消化道早癌的中医认识,治疗方法及用药思路;认为消化道早癌病位在脾胃,与肝肾密切相关,中医考虑多与脾胃虚弱,升降失常,肝失疏泄,肾气化失司,水湿代谢输布失常,气机阻滞,络脉瘀滞,邪有所留;或湿阻郁热;或阳气生化不足,阴气凝聚,痰湿、瘀、寒热、毒邪互结而成,辨证时需辨别寒热虚实,治疗上以调脾胃,复升降为先,清热为标,温阳为本,疏肝畅机、祛湿化痰、化瘀散结为辅,酌加解毒药,同时强调分阶段治疗。有症状时辨病论治以治标,症状缓解后三因治宜以治本,同时强调及时筛查,注重饮食生活调养,定期复查。

两种腔内吻合方法在机器人辅助远端胃切除术后毕Ⅱ式消化道重建中的应用比较

目的:初步探讨两种腔内吻合方法在机器人辅助远端胃切除术后毕Ⅱ式消化道重建中的安全性及优缺点。方法:回顾性分析2019年11月—2021年9月在南京中医药大学附属医院普外科行达芬奇机器人辅助远端胃癌根治术的64例患者的临床资料。根据吻合方法不同将其分为手工缝合吻合组(n=35)和器械辅助吻合组(n=29)。收集患者围手术期的临床资料,对比两种吻合方法在机器人辅助远端胃切除术后毕Ⅱ式消化道重建中的优缺点。结果:64例患者均顺利完成手术,所有患者均在机器人镜下完成腔内消化道重建,无中转开腹。两组患者在手术时间、术中出血量、术后首次肛门排气时间、术后首次下床活动时间、术后首次进食流质时间及术后住院时间方面无明显统计学差异。器械辅助吻合组胃肠吻合时间较手工缝合吻合组短,而手工缝合吻合组的吻合耗材费用较低,差异具有统计学意义。两组患者术后均恢复良好,无并发症发生。结论:两种腔内吻合方法在机器人辅助远端胃切除术后毕Ⅱ式消化道重建中的应用都是安全可行的,器械辅助吻合的时间更短,手工缝合吻合的费用更低。

社区消化道恶性肿瘤患者生活质量的影响因素及患者自我倾注对生活质量的影响研究

目的探讨社区消化道恶性肿瘤患者生活质量的影响因素并分析患者自我倾注对生活质量的影响。方法采用便利抽样的方法,选取2021年1月至2022年1月河北省石家庄市5家社区卫生服务中心记录的,在我国肿瘤登记信息系统中诊断为食管癌、胃癌以及结直肠癌的消化道恶性肿瘤患者作为研究对象。采用问卷方式调查其生活质量及自我倾注情况,调查表包括欧洲癌症研究与治疗组织生活质量问卷(EORTC QLQ-C30)、自我倾注量表(SFAS)及自行设计的一般情况问卷调查表。结果本研究共调查社区消化道恶性肿瘤患者190例,回收有效问卷185份,有效回收率为97.4%。生活质量测定量表调查显示,社区消化道恶性肿瘤患者总健康状况得分为(50.7±18.3)分,功能领域中认知功能得分最高为(87.1±13.4)分,社会功能得分最低为(69.8±23.8)分;症状领域中疲倦得分最高为33.3(33.3,55.6)分。SFAS调查显示,社区消化道恶性肿瘤患者的自我倾注总得分为(59.2±10.2)分。Spearman相关性分析显示,社区消化道恶性肿瘤患者的自我倾注得分与总健康状况得分以及功能领域中躯体、角色、认知、情绪和社会功能5个维度得分均呈负相关,与症状领域中疲倦、恶心与呕吐得分及单一条目中食欲丧失、经济困难得分呈正相关(均P<0.05)。多元线性回归分析结果显示,婚姻状况、文化程度、主要照顾者、家庭月收入以及自我倾注均是社区消化道恶性肿瘤患者总健康状况得分的影响因素(均P<0.05)。受试者工作特征曲线显示,自我倾注得分预测患者总健康状况得分的曲线下面积为0.716(95%置信区间:0.642~0.789),敏感度为61.9%,特异度为73.6%。结论社区消化道恶性肿瘤患者的生活质量受婚姻状况、文化程度、主要照顾者等多种因素影响,其中自我倾注状况与社区消化道恶性肿瘤患者生活质量水平密切相关,对生活质量的高低有一定的预测作用。

腹腔镜下远端胃癌切除后消化道不同重建方式对患者预后影响分析

目的:探究腹腔镜下远端胃癌切除后消化道不同重建方式对患者预后的影响。方法:回顾性分析107例腹腔镜下远端胃癌切除后消化道重建患者的临床资料,术后均随访1年。根据患者消化道重建方式不同分为Ⅰ组(n=30)、II组(n=28)和R组(n=49),Ⅰ组采取Billroth-Ⅰ式吻合;Ⅱ组患者采取Billroth-Ⅱ式联合布朗吻合;R组患者采取Roux-en-Y吻合。探究各组围术期情况,比较各组术后3周内及术后1年时并发症发生情况。结果:Ⅰ组患者手术时间低于Ⅱ组及R组(P<0.05);各组患者术后3周内并发症发生率比较,差异均无统计学意义(P>0.05);术后1年,R组患者胆汁反流、反流性胃炎发生率低于Ⅰ组及Ⅱ组(P<0.05)。结论:Billroth-Ⅰ式吻合有助于缩短手术时间,但Roux-en-Y吻合在术后远期效果更具优势。

中日两国上消化道癌症筛查研究现状热点文献可视化分析

目的探索上消化道癌症筛查相关研究的现况,分析研究的演变规律,寻找中日两国关于上消化道癌症筛查研究的趋势及热点方向。方法检索Web of Science核心合集数据库及中国知网至2023年2月13日已发表的上消化道癌症筛查相关的中日两地区文献。运用CiteSpace 6.1软件对机构、关键词进行聚类分析,对上消化道癌症筛查领域的文献进行可视化研究。结果目前上消化道癌症筛查领域中我国相关研究与其他国家的合作相对较少,合作网络较为松散;中日两国在该领域都关注胃癌的早诊早治;国内的研究倾向于筛查方案的总体设计和成本效益评估,而日本的研究多集中于上消化道癌症筛查手段;国内研究的热点与前沿主要侧重于筛查对象的心理情绪方面,而日本更加关注筛查技术的进步。结论我国上消化道癌症筛查已经探索出独有的发展模式,即研究符合中国国情的筛查策略的同时推动筛查技术进步,但相较于日本仍然具有很大的发展潜力。

疾病高发区饮食行为的社会文化机制研究——以广东省消化道肿瘤为例

以广东省消化道肿瘤高发区——潮汕地区为例,援引路径依赖与场域-惯习理论,应用定量和定性混合研究的方法,从社会文化机制的视角,通过对潮汕人工夫茶与腌制食品饮食习惯的分析,解释为何非健康的地方性饮食行为仍然具有强大的文化惯性。研究认为:潮汕人对工夫茶香味的追求、传统特殊茶艺文化的日常化以及功夫茶所附加的现代社交属性等因素,不断锁定与强化了以热饮为特征的工夫茶品饮方式;民间食用杂咸的传统习俗、快节奏现代生活下对快捷饮食的需求以及本地人对海鲜食材原始风味的追求,是腌制食品在潮汕地区持续风行的直接因素。在潮汕饮食场域中,惯习是一种社会化的主观性,具有强大的无意识、结构化力量。这种社会力量型塑了集体性饮食行为的路径,让社会行动者自觉进入一个自然的、充满意义的生活空间。既往医学或健康地理观点大多聚焦于地理环境、疾病、饮食习惯三者之间的联系,本研究所揭示的饮食行为路径依赖中的社会文化机制,对这种联系的理解具有较好的拓展意义,也有助于为疾病预防提供新的思路和建议。

裤形吻合与RY吻合方式在胃癌全胃切除后的应用价值比较

目的:比较裤形吻合与Roux-en-Y(RY)吻合方式在胃癌全胃切除后的应用价值。方法:选取2020年1月至2023年5月我院收治的行全胃切除术治疗的胃癌患者108例作为研究对象,分为RY吻合组54例、裤形吻合组54例,两组均接受全胃切除术治疗,RY吻合组、裤形吻合组分别于胃癌全胃切除术后以RY吻合方式、裤形吻合方式行消化道重建。比较两组手术指标、术后并发症、营养指标[总蛋白(TP)、血红蛋白(Hb)、血清白蛋白(ALB)及预后营养指数(PNI)]、生命质量(QLQ-C30)及远期不良事件发生率。结果:两组患者手术指标比较无意义(P>0.05)。RY吻合组术中1例由于肠管尺寸原因更换吻合器,RY吻合组术中吻合器更换率高于裤形吻合组,但两组比较无意义(P>0.05)。裤形吻合组术后并发症总发生率低于RY吻合组(P<0.05)。裤形吻合组远期不良事件总发生率低于RY吻合组(P<0.05)。与术前比较,两组患者术后3个月、6个月营养评价指标TP、Hb、ALB、PNI均升高,且随着术后时间的延长逐渐升高(P<0.05),在两组术后指标比较中,裤形吻合组TP、Hb、ALB、PNI高于RY吻合组(P<0.05)。与术前比较,两组患者术后3个月、6个月生命质量QLQ-C30评分均升高,且随着术后时间的延长逐渐升高(P<0.05),在两组术后指标比较中,裤形吻合组生命质量QLQ-C30评分高于RY吻合组(P<0.05)。结论:与RY吻合的胃癌全胃切除后消化道重建方式比较,裤形吻合所带来的并发症较低,且裤形吻合在抗胆汁反流、反流性食管炎、食物排空障碍方面优于RY吻合,患者术后可获得更好的营养支持,患者生命质量显著提高,应用价值较高。

Uncut Roux-en-Y吻合与Billroth Ⅱ+Braun吻合在腹腔镜远端胃癌根治术中的疗效比较

目的评价腹腔镜远端胃癌根治术Uncut Roux-en-Y、BillrothⅡ+Braun这两类消化道重建途径的临床效果.方法回顾性分析江苏省苏北人民医院胃肠中心2020年1月—2022年4月治疗的102名腹腔镜远端胃癌根治术(LDG)病人的临床资料.其中42人采用Uncut Roux-en-Y吻合术,被归入URY组,60人采用BillrothⅡ联合Braun吻合术,被归入B2B组.对比两组研究对象的基本信息、围手术期相关参数、术后近期并发症与营养情况,以及术后12个月胃镜检查结果,同时采用QLQ-STO 22量表对其术后生活质量展开评估.结果两组皆顺利完成LDG手术,无1例中转开腹与围术期死亡情况.两组在手术用时、吻合时间、术中出血量、术后首次排气时间、进食流质时间、拔除引流管时间、术后住院天数上,差异无统计学意义(P>0.05).两组在术后近期并发症(含吻合口瘘、十二指肠残端瘘、切口感染、肠梗阻等)发生率上,差异无统计学意义(P>0.05).随访1年,URY组1例患者出现肝转移;B2 B组2例出现肿瘤复发,其中1例为肝转移,另1例并发腹腔广泛转移死亡.术后1年91例完成胃镜检查,其中URY组37例,B2 B组54例.URY组出现胃潴留5例(13.5%),B2 B组18例(33.3%),差异有统计学意义(χ^(2)=4.567,P=0.033);发生胆汁反流分别有3例(8.1%)、16例(29.6%),差异有统计学意义(χ^(2)=6.156,P=0.013);发生反流性胃炎分别为1例(2.7%)、12例(22.2%),差异有统计学意义(χ^(2)=6.832,P=0.009);发生反流性食管炎分别为1例(2.7%)、3例(5.6%),差异无统计学意义(χ^(2)=0.017,P=0.895).术后1年评估病人营养情况,两组血淋巴细胞计数(LC)、血红蛋白(Hb)、总蛋白(TP)、血清白蛋白(Alb)、预后营养指数(PNI)等指标比较,无明显统计学差异(P>0.05).术后1年64例完成胃癌(GC)病人生活质量调查问卷(QLQ-STO 22),URY组28例,B2B组36例.结果显示与B2B组比较,URY组减少了反流,差异有统计学意义(P<0.05).结论Uncut Roux-en-Y吻合术减少了胃潴留、胆汁反流和反流性胃炎的发生,改善了患者的生活质量.Uncut Roux-en-Y吻合术途径在LDG消化道重建方面为理想之选.

食管癌术后居家病人营养现状及影响因素分析

目的:探究食管癌术后居家病人营养现状并分析其影响因素。方法:选取2022年7月至2023年10月就诊于东部战区总医院心胸外科并行手术治疗的153例食管癌病人,使用PG-SGA量表评估术后1月居家病人的营养状况,并分析其营养状况的影响因素。结果:本研究纳入的153例病人中,营养良好病人47例,营养不良病人106例,其中可疑或中度营养不良病人71例,重度营养不良病人35例,总体营养不良发生率为69.3%。二元Logistic回归分析结果显示,血红蛋白、白蛋白水平、营养途径、营养影响症状(NIS)、口服营养补充剂(ONS)及营养行为是病人营养状况的独立影响因素(P <0.05)。其中,NIS≥2个是病人发生营养不良的危险因素;血红蛋白、白蛋白水平正常、管饲营养、使用ONS、营养行为达标是避免营养不良发生的保护因素。结论:食管癌术后居家病人营养不良发生率较高,导致营养不良的因素较多,临床应针对相关因素采取措施并进行早期干预。

食管癌术后消化道模式重建及饮食训练方案的探讨

目的:探讨食管癌术后消化道模式重建及饮食训练方案。方法:选择2021年7月—2021年10月接受食管癌手术治疗患者70例,采用区组随机化分组方法随机分为对照组和观察组,每组35例。对照组给予常规饮食干预,观察组给予饮食训练干预。分别在干预前、干预2周后、出院时对比两组患者胃肠道症状评分、主观整体营养评估表(PG-SGA)评分、血生化指标及生活质量评分。结果;观察组患者干预2周后、出院时胃肠道症状评分、PG-SGA评分均优于对照组,血生化指标中总蛋白、白蛋白、血红蛋白指标均高于对照组,生活质量评分高于对照组,差异均有统计学意义(P<0.05)。结论:饮食训练方案能够明显减轻食管癌术后患者胃肠道症状,改善营养指标和血生化指标,提升患者生活质量。

护理路径在消化道早癌患者内镜下黏膜剥离术后的应用效果观察

目的 研究分析护理路径干预对消化道早癌患者内镜下黏膜剥离术后的应用效果。方法 选取2020年1月至2023年10月行内镜下黏膜剥离术的消化道早癌患者112例,采用随机数字表法分为对照组和研究组,对照组采用围手术期常规护理路径,研究组采用围手术期护理路径干预,每组各56例。对所有患者的围手术期各项用时、并发症概率、心理情绪变化情况、睡眠质量情况、生活质量改善情况及护理满意度进行对比分析。结果 与对照组相比,研究组患者恢复情况更好,围手术期各项用时更少,发生并发症的概率更小,心理情绪改善更好,睡眠质量和生活质量情况也更佳,并且患者对护理服务的满意程度更高,P <0.05,存在统计学意义。结论 对内镜下黏膜剥离术的消化道早癌患者,实施护理路径干预,其效果显著,值得在临床中推广利用、借鉴。