Application of microbiological and immunological enteral nutrition in patients with gastrointestinal cancer complicated with diabetes mellitus / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the effects of microbiological and immunological enteral nutrition using composition of probiotics, glutamine, fish oil, and peptisorb on patients with gastrointestinal cancer complicated with diabetes mellitus.</p><p><b>METHODS</b>From January 2007 to October 2010, 67 patients with gastrointestinal cancer complicated with diabetes mellitus were admitted to the Liaocheng People's Hospital of Shandong Province and were randomized into the treatment group(n=33, enteral nutrition with probiotics, glutamine, and fish oil) and the routine group(n=34, regular enteral nutrition). Fasting blood glucose(FBG), insulin(FINS), number of lymphocytes(including CD3(+)T cell, CD4(+)T cell, CD8(+)T cell, CD4(+)/CD8(+)) and natural killer (NK) cells of the two groups were detected on the day before surgery and postoperative day 3 and 7. Insulin resistance index (InHOMA-IR) was calculated by using the homeostasis model assessment(HOMA). The incidence of nosocomial infections and intestinal function recovery time, and length of hospital stay were collected.</p><p><b>RESULTS</b>On postoperative day 7, FINS[(8.4±3.7) mU/L vs. (13.7±5.4) mU/L, P<0.05] and InHOMA-IR(1.11±0.23 vs. 1.68±0.39, P<0.05) were lower in the treatment group than that in the routine group. The number of CD4(+)[(45.2±5.4)% vs. (38.1±2.9)%, P<0.05], CD4/CD8 (2.05±0.27 vs. 1.58±0.16, P<0.05), and NK cells [(19.5±6.6)% vs. (15.4±5.6)%, P<0.05] were higher in the treatment group. There were no significant differences in nosocomial infection [6.1%(2/33) vs. 17.6%(6/34), P>0.05] and intestinal function recovery time[(69.3±9.5) h vs. (70.1±11.6) h, P>0.05] between the two groups. However, the length of hospital stay [(17±3.8) d vs. (21±4.2) d, P<0.05] was significantly shorter in the treatment group.</p><p><b>CONCLUSION</b>For patients with gastrointestinal cancer complicated with diabetes mellitus, microbiota enteral nutrition can reduce insulin resistance, improve the immune status, and promote postoperative recovery.</p>

Preoperative evaluation on lymphatic metastasis of gastric cancer / 国外医学(肿瘤学分册)

Evaluating lymph node metastasis of gastric cancer preoperatively can help surgeons to choose the optimal extent of surgical lymph node resection. The diagnostic accuracy of computed tomography for lymph node metastasis of gastric cancer is about 70% , which is less accurate than endoscopic ultrasonography,and more accurate than magnetic resonance and positron emission tomography. Many molecular markers can predict the lymph node metastasis. The prognostic role of gene expression profiles is better than that of a marker. Sentinel lymph node and mathematical methods (Maruyama software, artificial neural network) may be useful in predicting the lymph node metastasis. Laparoscopy and quantum dots technique are potential methods in predicting lymph node metastasis.