【摘要】 目的 探讨125I粒子植入治疗中晚期胰腺癌的临床并发症及相关护理措施。 方法 回顾分析2006年10月-2010年4月121例行125I粒子植入治疗的胰腺癌患者的临床治疗及护理，采取积极有效的护理措施，预防及处理并发症，促进患者康复。 结果 121例患者接受放射性125I粒子植入治疗后，7例出现胰瘘，13例出现胃肠道反应，经对症处理和精心护理后均治愈。 结论 125I粒子组织间植入近距离治疗中晚期胰腺癌近期疗效好、安全、副反应少，良好的护理对改善中晚期胰腺癌患者预后具有重要意义。【Abstract】 Objective To observe the complications in patients with middle and advanced pancreatic carcinoma due to treatment of 125I particle implantation, and the investigate the proper nursing methods. Methods The clinical data including the therapy and nursing methods for the complications in 121 patients with middle and advanced pancreatic carcinoma due to treatment of 125I particle implantation from October 2006 to October 2010 were retrospectively analyzed. The treatment and care for complication were analyzed. Results In the 121 patients who had been treated by 125I particle, pancreatic fistula occurred in seven, and severe gastrointestinal upset was found in 13. The patients with the complications recovered after postoperative treatment and nursing. Conclusion 125I particle implantation for patients with middle and advanced pancreatic carcinoma is effective and safe with a few side reactions; proper nursing is important to improve the prognosis.
Objective To investigate the effect of TNF-related weak inducer of apoptosis/fibroblast growth Factor-inducible 14 (TWEAK/Fn14) on the cell proliferation by transfecting Fn14 shRNA to PANC-1 cells. Methods The shRNA gene targeting Fn14 gene was constructed and transfected into pancreatic cancer cell line PANC-1 to specifically silence the expression of Fn14 gene. The effect of shRNA interference sequence on the expression of Fn14 was detected by flow cytometry and immunofluorescence. CCK-8 was used to detect the cell proliferation of PANC-1 after blocking TWEAK-induced signal pathway. Western blotting method was used to detect the expressions of downstream factors such as nuclear factor-kappa B (NF-κB), TWEAK and caspase-3 to explore the pathway mechanism of TWEAK/Fn14. Results The absorbance value (A value) in the Fn14 shRNA group was significantly lower than the control groups in 24 hours after transfected (P<0.000 1). After the specific shRNA sequences transfected PANC-1 cells, NF-κB, TWEAK and caspase-3 protein expressions were also significantly lower than the control group (P<0.05), and the apoptosis of PANC-1 cells increased after inhibition of TWEAK/Fn14 signaling pathway. Conclusions TWEAK/Fn14 involved in the progression of pancreatic cancer. The Fn14 expression could influence the process of cell apoptosis.
ObjectiveTo evaluate the efficacy of intravenous glutamine on patients with severe acute pancreatitis. MethodsThe Cochrane Library, PubMed, EMbase, CNKI and CBM databases were searched up to January 2013. Randomized controlled trials (RCTs) that compared non-glutamine nutrition with intravenous glutamine supplemented nutrition in patients with severe acute pancreatitis were included. A method recommended by the Cochrane Collaboration was used to perform a meta-analysis of those RCTs. ResultsFour RCTs involving a total of 190 participants were included. Analysis of these RCTs revealed the presence of statistical homogeneity among them. Results showed that glutamine dipeptide had a positive effect on reducing the mortality rate[OR=0.26, 95%CI (0.09, 0.73), P=0.01], length of hospital stay[WMD=-4.85 d, 95%CI (-6.67, -3.03) d, P<0.001], and the rate of complications[OR=0.41, 95%CI (0.22, 0.78), P=0.006]. No serious adverse effects were found. ConclusionCurrent best evidence demonstrates that glutamine is effective for severe acute pancreatitis. Further high quality trials are required and parameters of nutritional condition and hospital cost should be considered in future RCTs with sufficient size and rigorous design.
Objective To evaluate and summarize the relevant evidence of early enteral nutrition in patients with severe acute pancreatitis (SAP), and provide evidence-based support for the clinical practice of early enteral nutrition in SAP patients. Methods The evidence on early enteral nutrition in SAP patients from relevant databases and websites was retrieved using computer. The retrieval deadline was from the establishment of the databases to December 31, 2024. Two researchers independently conducted literature screening and quality evaluation, extracted and summarized evidence. Results A total of 14 articles were included, including 6 systematic reviews, 7 guidelines, and 1 expert consensus. A total of 19 pieces of evidence were compiled and summarized from 9 aspects, including early enteral nutrition feeding assessment, start timing, feeding route, catheterization method, infusion method and speed, energy and protein targets, nutrient preparation selection, complication prevention and management, and health education. Conclusion The overall quality of evidence for early enteral nutrition in SAP patients is good and has strong generalizability. Medical staff should select evidence based on clinical contexts and develop safe, scientific, and personalized enteral nutrition plans for patients to promote their recovery.