ObjectiveTo investigate the influencing factor of intraoperative hypothermia during laparotomy.MethodsA total of 81 patients underwent laparotomy in our hospital from October 1, 2018 to January 1, 2019 were enrolled. The difference of preoperative baseline data and surgical data between the hypothermia and non-hypothermia groups was compared, and the influencing factor of intraoperative hypothermia during laparotomy was explored.ResultsOf the 81 patients, 32 patients occurred hypothermia during operation. There were no significant differences in gender, age, BMI, HGB, WBC count, PLT count, TB, AST, ALT, ALB, PT, operation time, postoperative hospital stay, and Clavien-Dindo grade between the hypothermia group and the non-hypothermia group (P>0.05), but there were significant differences in intraoperative infusion volume, intraoperative blood loss, and surgical mode (P<0.05). The intraoperative infusion volume and intraoperative blood loss in the hypothermia group were higher than those in the non-hypothermia operation group, and the proportion of hepatectomy was higher than that in the non-hypothermia group. The multivariate analysis show that the intraoperative blood loss, intraoperative infusion volume, and kind of operation were the risk factors for the hypothermia during laparotomy (P<0.05).ConclusionsIntraoperative hypothermia is related to intraoperative bleeding volume, intraoperative fluid infusion volume, and the kind of operation. Therefore, for patients with less bleeding, the intraoperative hypothermia can be reduced by limiting the volume of intraoperative fluid infusion. For those patients with more intraoperative bleeding, warming fluid infusion may reduce the incidence of intraoperative hypothermia.
Objective To explore the effect of different nutrition on the immune function of patients with colorectal cancer. Methods A total of 640 colorectal cancer patients were randomized into the enteral nutrition and peripheral nutrition groups. The peripheral venous blood was sampled before operation and on the postoperative days 1 and 7 to determine the serum levels of IgG, IgA, IgM, the percentage of T lymph cell subgroups CD3, CD4, CD4/CD8 and CRP, PGE, α- antitrypsin etc. The patient’s general condition, side-effects, and complications were observed intimately after surgery. Results Compared with the control group, the IgG, IgA, IgM, CD3, CD4,CD4/CD8 levels of the trial group on postoperative day 7 were higher. But the levels of CRP, PGE, α- antitrypsin were decreased. Hospitalization time and anal exsufflation time were shorter as well. There was no significant difference in either the general conditions or complications between the two groups. Conclusion Application of enteral nutrition after colorectal cancer surgery is safe, ,effective, and can improve the patient’s immune function and prognosis.
ObjectiveTo review the application of omega-3 polyunsaturated fatty acids (Ω-3PUFAs) in patients with gastric cancer.MethodThe related literatures about the application of Ω-3PUFAs in patients with gastric cancer were reviewed by searching domestic and international databases.ResultsΩ-3PUFAs didn’t only improve the perioperative immune function and inflammatory response in patients with gastric cancer, but also prevent the occurrence of gastric cancer, inhibit the proliferation and promote the apoptosis of gastric cancer cells, increase the sensitivity of chemotherapy, and reduce the occurrence of chemotherapy-related adverse events.ConclusionsΩ-3PUFAsis an immunological nutrition, which can provide energy and also has functions of anti-inflammatory, anti-cancer, immunity regulation. It has been widely used in patients with gastric cancer, but the relevant mechanism needs further to be investigated.
ObjectiveTo explore the correlation between readiness for hospital discharge and short-term quality of life among colorectal cancer (CRC) patients following enhanced recovery after surgery (ERAS) mode.MethodsSurveys of 127 CRC patients following ERAS mode were conducted in the West China Hospital of Sichuan University. The Readiness for Hospital Discharge Scale and EORTC QLQ-C30 Scale were issued at the discharge and 1 month after the operation, respectively.ResultsThe total score of RHDS was 149.43±33.25. The score of global quality of life was 66.80±18.84. Correlation analysis showed that the total score of RHDS was positively correlated with the score of global quality of life (r=0.220, P=0.013), and negatively correlated with the scores of fatigue, nausea and vomiting, pain, loss of appetite (r=–0.304, P=0.001; r=–0.189, P=0.033; r=–0.257, P=0.004; r=–0.254, P=0.004). The score of personal status dimension were positively correlated with the score of global quality of life and emotional function (r=0.213, P=0.016; r=0.197, P=0.027), and negatively correlated with scores of fatigue, pain and insomnia (r=–0.311, P=0.000; r=–0.264, P=0.003; r=–0.257, P=0.004). The score of knowledge dimension was negatively correlated with nausea and vomiting, pain and loss of appetite (r=–0.212, P=0.017; r=–0.182, P=0.040; r=–0.239, P=0.007). The score of coping ability dimension was positively correlated with the score of global quality of life and physical function (r=0.204, P=0.021; r=0.204, P=0.021), while negatively correlated with scores of fatigue, pain, insomnia and loss of appetite (r=–0.349, P=0.000; r=–0.240, P=0.007; r=–0.202, P=0.022; r=–0.201, P=0.024). The score of expected support was positively correlated with the score of global quality of life (r=0.220, P=0.013), and negatively correlated with scores of fatigue and loss of appetite (r=–0.249, P=0.005; r=–0.227, P=0.010).ConclusionsThe short term quality of life among CRC patients following ERAS keeps at upper middle level, and positively correlated with the readiness for hospital discharge. It is suggested that discharge preparation service is of great significance to improve the quality of life of patients.
Objective To analyze the research status of immunonutrition in China based on Chinese databases, and to provide a reference for clinical practice and future research. Methods Literatures about the application of immunonutrition in nutrition support were searched in China National Knowledge Infrastructure, SinoMed, Chongqing VIP and Wanfang databases using bibliometrics methods. The retrieval time was up to August 2022, and the document characteristics such as the number of publications, the institutions and the citation frequency and other features were analyzed. Results A total of 725 literatures were included, with the highest number of literatures issued in 2015 and 2020, both 62. The areas with the most published literatures were Jiangsu (10.6%) and Guangdong (8.4%). The institutions with the most published literatures were General Hospital of Eastern Theater Command (4.8%) and West China Hospital of Sichuan University (3.9%). There were 78 dissertations and 647 journal articles in total. The most published journal was Parenteral & Enteral Nutrition (6.5%). The top three citations were all reviews. The degree of cooperation was 2.7, and the co-authorship rate was 70.1%. A total of 121 articles reported the supporting funds and projects. The research types included 499 original studies (68.8%) and 226 secondary studies (31.2%). The analysis of the subjects showed that immunonutrition was mostly applied to gastrointestinal diseases, especially gastrointestinal cancer patients, accounting for 42.5%. Nutritional support was divided into enteral nutrition and parenteral nutrition. Enteral nutrition was adopted in most literatures, accounting for 88.4%. Conclusions The research content of immunonutrition in Chinese database in China is relatively simple. Most of them focus on the comparison between immunonutrition and general nutrition support. The selection of immune nutrients and the application of immunonutrition in critically ill patients such as sepsis need further research.
ObjectiveTo systematically review the efficacy of enteral nutrition combined with parenteral nutrition (EN+PN) and enteral nutrition alone (EN) in gastric cancer patients undergoing gastrectomy. MethodsPubMed, EMbase, CNKI and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) of EN+PN and EN in gastric cancer patients undergoing gastrectomy from inception to September 25th, 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.3 software. ResultsA total of 23 RCTs were included. The results of meta-analysis showed that compared to EN group, EN+PN group had a shorter hospital stay (MD=−1.75, 95%CI −2.45 to −1.05, P<0.000 1) and a lower risk of postoperative complications (RR=0.55, 95%CI 0.46 to 0.66, P<0.000 1). However, there was no statistical difference in the first exhaust time between the two groups. ConclusionThe current evidence shows that EN+PN may contribute to reducing the incidence of postoperative complications and shortening the length of hospital stay in gastric cancer patients. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusions.