ObjectiveTo systematically evaluate the effect of different enteral nutrition timing on patients with pancreaticoduodenectomy.MethodsPubMed, Embase, The Cochrane Library, Web of Science, CBM, CNKI, WanFang Data, and VIP databases were searched to collect RCTs for nutritional support in pancreaticoduodenectomy patients. The search time was established until March 1 2019. After two independent investigators conducted literature screening, data extraction, and evaluation of the risk of bias in the included studies, a meta-metabolic analysis was performed using the R 3.5.3 software gemtc package, JAGS 3.4.0, and Revman software.ResultsA total of 8 RCTs were included, for a total of 825 patients. The results of reticular meta-analysis showed that there was no significant difference in the duration of hospitalization for patients with pancreaticoduodenectomy, between the enteral nutrition supported at different timing. The results of the ranking probability map suggested that preoperative enteral nutrition was a better option for supporting nutrition in patients with pancreaticoduodenectomy, secondly, timing to give was 24–48 hours after operation.ConclusionsAccording to the results of mesh meta-analysis and probabilistic ranking, the nutritional status of patients is corrected before surgery, and the effect of enteral nutrition is better than other nutritional support methods. Secondly, enteral nutrition should be given at 24–48 hours after operation in combination with ESPEN and ERAS recommendations.
ObjectiveTo explore the feasibility of organoid culture derived from the patients with gastric cancer by suspension culture. MethodsThe fresh gastric cancer tissues of the 3 patients with gastric cancer were selected, which were digested with mixed enzymes and then made into cell suspensions, and were inoculated into ultra-low attachment plates to culture organoid by suspension. When the organoid growth was dense, the passage and freezing were carried out. The formation process of organoid was observed under the inverted microscope (IM). Further the consistency between the organoid and primary gastric cancer tissue was evaluated by hematoxylin-eosin (HE) and immunohistochemical (IHC) staining. ResultsIn this study, an organoid that could be passaged and frozen was successfully established in one patient. The results under the IM showed that the organoid was initially spherical in shape (cultured on day 5), then gradually became short rod-shaped on day 10, showed a branching like change on day 15, and formed irregular glandular tubular structures on day 20. The structures between the organoids and primary gastric cancer tissues were highly similar by HE staining. The IHC staining results showed that the expressions of low molecular weight cytokeratin (CK-LMW), p53, and Ki67 in the organoid and its corresponding primary gastric cancer tissue were basically the same. That was, the CK-LMW and p53 expressions were positive in the organoid and primary gastric cancer tissue, and the Ki67 was highly expressed (with a positive rate of approximately 70%). ConclusionBased on the preliminary research results of this study, it suggests that the suspension culture can be used to establish organoid derived from patients with gastric cancer, which is in accordance with primary tumor tissue at the tissue and cellular levels.