Objective To study the effect of perioperative nutritional support on protein metabolism and immunity in patients underwent liver transplantation. Methods A total of 80 patients who underwent liver transplantation in our hospital from March 2015 to March 2016 were collected retrospectively, and then the 80 patients were divided into control group (n=40) and observation group (n=40) according to the type of perioperative nutritional support. Patients of control group didn’t receive preoperatively nutritional support, and received total parenteral nutrition support before postoperative exhaust, then received enteral nutrition support after anal exhaust. Patients of observation group receive preoperatively nutritional support before surgery, and received parenteral nutrition and enteral nutrition support before postoperative exhaust. The several parameters about nutritional status and immune function were observed on 7 days and 14 days after liver transplantation, and comparison of the 2 group in these parameters was performed. Results On the protein metabolism, the levels of serum transferrin, prealbumin, and nitrogen balance on 14 days after liver transplantation were higher than those of other time points (before liver transplantation and 7 days after liver transplantation),P<0.05, both in control group and observation group. There was no significant difference in the levels of serum transferrin, prealbumin, and value of nitrogen balance between the 2 groups before liver transplantation (P>0.05). But on 7 days and 14 days after liver transplantation, the levels of serum transferrin, prealbumin, and value of nitrogen balance of the observation group were higher than those of control group (P<0.05). On the immunity, the total number of lymphocytes, value of IgG and CD4/CD8 on 14 days after liver transplantation, were superior to other time points (before liver transplantation and 7 days after liver transplantation),P<0.05, both in control group and observation group. There was no significant difference in the total number of lymphocytes, value of IgG and CD4/CD8 between the 2 groups before liver transplantation (P>0.05). But on 7 days and 14 days after liver transplantation, the levels of the total number of lymphocytes, value of IgG and CD4/CD8 in the observation group were superior to those of control group (P<0.05). Conclusion Perioperative nutritional support can improve the nutritional status and immune function in patients underwent liver transplantation.
ObjectiveTo summarize the current status of research in nutritional support for glutamine after hepatectomy.MethodThe literatures on nutritional support of glutamine after hepatectomy in recent years were reviewed by searching domestic and foreign literatures.ResultsThe administration of glutamine up-regulated the expression of liver regeneration genes after partial hepatectomy in malnourished rats, and then stimulated cell mitosis by paracrine and endocrine cells, affecting the uptake of amino acids by hepatocytes and intestinal cells, and promoting hepatocyte proliferation. In clinical applications, glutamine could improve postoperative liver function and immune function, reduce the incidence of infectious complications, then relatively shorten the length of hospital stay, and improve the clinical outcome of patients.ConclusionGlutamine is beneficial to the recovery of liver function and has clinical application value.
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 summarize the current status and progress of nutritional support therapy for pancreatic cancer in order to improve the understanding of the impact of nutritional support treatment on pancreatic cancer and guide clinical work.MethodThe literatures about nutritional support and chemotherapy for pancreatic cancer at home and abroad were read and reviewed.ResultsFor most patients with malignant pancreatic tumors, nutritional risk or malnutrition might accompany them for a lifetime. Regular nutritional risk screening, timely nutritional assessment and necessary nutritional treatment played an extremely important role in the process of comprehensive anti-tumor treatment.ConclusionAlthough there are still some core problems to be solved in nutritional support therapy and chemotherapy for pancreatic cancer, its efficacy is gradually recognized and widely used by clinical workers, which might be helpful to improve the prognosis of patients with pancreatic cancer.
Objective To study the effect of indirect calorimetry-guided nutritional support on energy metabolism, cellular immunity and oxidative stress in patients with colorectal cancer after laparoscopic surgery. Methods A total of 96 patients with colorectal cancer after laparoscopic surgery in our hospital from December 2019 to December 2021 were selected and randomly divided into the control group (used the formula prediction method to guide enteral nutrition support, n=48) and the observation group (used indirect calorimetry to guide enteral nutrition support, n=48). The target resting energy expenditure (REE) value and nutritional support energy intake were compared between the two groups. The cellular immune indexes (CD3+, CD4+, CD8+, CD4+/CD8+) and oxidative stress indexes [serum superoxide dismutase (SOD), malondialdehyde (MDA), the changes of glutathione peroxidase (GSH-Px)], and the changes of REE at different time points (1 day before operation and 1, 2 and 3 days after operation) of the two groups were compared. The incidence of complications in the two groups were observed. Results The target REE value of the observation group was lower than that of the control group (P＜0.05), and there was no significant difference in the enteral energy intake and parenteral energy intake compared with the control group (P＞0.05). After treatment, CD3+, CD4+ and CD4+/CD8+ in the two groups were lower than those before treatment (P<0.05), and CD8+ was higher than before treatment (P<0.05). The levels of CD3+, CD4+ and CD4+/CD8+ in the observation group after treatment were higher than those in the control group (P<0.05) , while the level of CD8+ in the observation group was lower than that in the control group (P<0.05). After treatment, the levels of SOD and GSH-Px in the two groups were lower than those before treatment (P<0.05), and the levels of MDA were higher than those before treatment (P<0.05). The levels of GSH-Px and SOD in the observation group were higher than those in the control group (P<0.05), while the level of MDA in the observation group was lower than that in the control group (P<0.05). There was no significant difference in the REE value between the two groups at 1 day before operation (P>0.05); compared with the 1 day before operation, the REE values of the two groups at 1, 2, and 3 days after operation were significantly increased, and there was a statistically significant difference between the two groups at each time point (P<0.05), but the REE value at 3 days after operation was significantly lower than that at 1 and 2 days after operation (P<0.05). The REE values in the observation group were lower than those in the control group at 1, 2 and 3 days after operation (P<0.05). The incidence of complications in the observation group was 6.25%, which was lower than 20.83% in the control group (P<0.05). Conclusion Enteral nutrition support guided by indirect calorimetry in colorectal cancer patients after laparoscopic surgery can help reduce postoperative energy consumption, improve cellular immune function and oxidative stress response, and reduce the risk of postoperative complications, which is worthy of promotion.
Sarcopenia is a syndrome associated with reduced strength, mass and function of skeletal muscles. Aging of gastric cancer patients, lack of nutritional intake, and pathological mechanisms of gastric cancer increase the likelihood of sarcopenia. Sarcopenia is associated with the development of gastric cancer and may be a risk factor for the formation of gastric cancer. Sarcopenia is closely related to the prognosis and treatment of gastric cancer. At present, the treatment of sarcopenia is still in the exploratory stage, and more research is needed to obtain better treatment plans and improve the quality of life of patients. This article reviews the research status of sarcopenia and gastric cancer in order to provide evidence for clinical research.