【摘要】 目的 调查胃癌患者的营养风险及营养支持应用现状。 方法 2009年9月-2010年1月,对某三甲医院普外科收治的120例胃癌住院患者营养情况进行营养风险筛查2002(nutritional risk screening 2002,NRS 2002)评估,并就营养支持应用方式进行分析。 结果 所有患者中营养不足和营养风险的发生率分别为11.7%和27.5%;在33例有营养风险患者中,有26例(78.8%)接受了营养支持;在无营养风险的87例患者中,有30例(34.5%)接受了营养支持。 结论 对有营养风险的患者进行必要的营养支持,对于减少患者住院期间感染性并发症或其他不良临床结局的发生有积极作用。NRS 2002的方法简便,适用于胃癌患者的营养风险筛查,但医护人员需要进一步加强对肠外、肠内营养指南的认识。【Abstract】 Objective To investigate the clinical situation of nutritional risk screening for hospitalized patients with gastric cancer. Methods From September 2009 to January 2010, we applied nutrition risk screening 2002 (NRS 2002) to investigate the nutritional status of 120 hospitalized gastric cancer patients in the surgery department of a tertiary hospital, and analyzed the way of nutritional support for these patients. Results Among all the patients, the incidences of undernutrtion and nutritional risk were respectively 11.7% and 27.5%. Twenty-six out of the 33 nutritional risk patients received nutrition support, and 30 out of the 87 patients without nutritional risk received nutrition support. Conclusions Nutritional support for patients with nutritional risk is important in decreasing the occurrence of in-hospital infectious complications and other bad clinical outcomes. NRS 2002 is a simple and easy tool for predicting the nutrition risk in hospitalized gastric cancer patients, but the guideline of enteral nutrition and parenteral nutrition must be reinforced among doctors and nurses.
Objective To observe the change of retinal artery angle in eyes with idiopathic epiretinal membrane (ERM) and to analyze the relationship between retinal artery angle, ERM classification based on optical coherence tomography (OCT), and visual acuity. MethodsA retrospective cross-sectional clinical study. A total of 187 eyes in 187 patients diagnosed with monocular idiopathic ERM (IERM group) in Department of Ophthalmology of Zhejiang Provincial People's Hospital and the Affiliated Eye Hospital of Wenzhou Medical University at Hangzhou from November 2018 to January 2023 were included in the study. The contralateral healthy eyes were included as the control group. All patients underwent best corrected visual acuity (BCVA), fundus photography, spectral-domain OCT, OCT angiography (OCTA) and axial length (AL) measurement. BCVA examination was performed using the standard logarithmic visual acuity chart, which was converted to the logarithm of the minimum angle of resolution (logMAR) visual acuity. The foveal avascular zone (FAZ) area was measured by OCTA. The central macular thickness (CMT) was measured by spectral domain OCTaccording to the grading criteria of ectopic inner foveal layer (EIFL) was divided into stages 1 to 4 with 42, 45, 62, and 38 eyes, and the IERM group was subdivided into stage 1, stage 2, stage 3, and stage 4 groups accordingly. Image J was used to measure the retinal artery angle and the 1/2 retinal artery angle on fundus images. Multiple linear regression analysis was used to analyze the correlation between BCVA and artery angle, 1/2 artery Angle, CMT, FAZ area and AL. ResultsCompared with the control group, eyes in IERM group had worse BCVA (t=9.727), thicker CMT (t=12.452), smaller FAZ area (t=-14.329), smaller artery angle (t=-9.165) and smaller 1/2 artery angle (t=-9.549). The differences were statistically significant (P<0.001). With the increase of IERM stage, the artery angle and 1/2 artery angle decreased significantly (F=21.763, 12.515; P<0.001). There was no significant difference in artery angle and 1/2 artery angle between stage 1 group and stage 2 group, and 1/2 arterial angle between stage 2 group and stage 3 group (P>0.05). There were significant differences in artery angle and 1/2 artery angle between the other groups (P<0.05). There were significant differences in CMT and logMAR BCVA among different classification subgroups in IERM groups (P<0.05). There was no significant difference in FAZ area between grade 3 group and grade 4 group (P>0.05). There were significant differences in FAZ area between the other groups (P<0.05). Correlation analysis showed that decreased artery angle (P=0.013) and increased CMT (P<0.001) were associated with decreased BCVA. ConclusionsCompared with healthy eyes, the artery angle decreases significantly with the increase of ERM stage. Decreased retinal artery angle is associated with decreased visual acuity in IERM eyes.