ABSTRACT
Objective:TTo evaluate the nutritional status,immune function and clinical effectiveness of early enteral immunonutrition in patients receiving totally endoscopic esophagectomy.Methods:There were 90 patients receiving totally endoscopic esophagectomy enrolled in Department of Thoracic Surgery of The Fourth Hospital of Hebei Medical University between May 2015 and October 2016.The patients were randomly divided into three groups,enteral immunonutrition group (EIN group,n =30),common enteral nutrition group(EN group,n =30)and parenteral nutrition group (PN group,n =30).The levels of nutritional indexes,immune indexes,C-reactive protein (CRP) were measured preoperation and 1day,3days,7days after surgery.We also observed the first postoperative anal exhaust time,infectious complications and the length of hospital stay.Results:There were no significant differences in age,gender,tumor location,clinical stage,CRP,the nutritional indexes and immune indexes between the three groups before operation.On the first day after operation,the nutritional indexes and immune indexes of the three groups were significantly lower than those before operation,then all the indexes began to recover.Otherwise,CRP of the three groups were significantly higher than those before operation,then fell down in the following days,the rate of EIN group and EN group was faster than that of PN group on the day 3 after surgery and the EIN group was the fastest on the day 7 after surgery.There were significant differences in the first postoperative anal exhaust time,pneumonia and the length of hospital stay.And there was no significant difference in the incidence of anastomotic fistula between the three groups(x 2=1.071,P =0.585).Conclusions:Postoperative early enteral immunonutrition can improve the nutritional status and the immune response,promote the rapid recovery in the patients receiving totally endoscopic esophagectomy.
ABSTRACT
Objective To investigate the relationship of carotid intimal-medial wall thickness(IMT) and the expression of IL-6 and Fetuin-A in two type diabetes.Methods 80 patients with two type diabetes were chosen,and 60 cases healthypeople of examination for the control group.The levels of IL-6 and Fetuin-A were measured,and measured the intimal-medial thickness (IMT) of internal carotid artery by carotid duplex ultrasonography scanning simultaneously.Results The level of IL-6 was significantly higher in two type diabetes than those in control group,and the level of Fetuin-A was declind (t=8.34 ～15.65,all P＜0.05).IL-6 level in normal IMT (A group,20 cases) was 2.24±0.21 pg/L,Fetuin level was 5.41±0.32 ng/ ml.IL-6 level in abnormal IMT (B group,18 cases) was 3.44±0.18 mm,and Fetuin level was 3.86±0.42 ng/ml.Relatively,IL-6 level in IMT with plaque (C group,22 cases) was 4.95-±-0.31 ng/ml,Fetuin-A level was 2.41±0.32 ng/ml.IL-6 level in lumen narrow (D group,20 cases) was 5.35±0.31 ng/ml,and Fetuin-A level was 2.02 ± 0.08 ng/ml.There were obvious differences for four groups to detect IL-6 was Fetuin-A levels (F=8.69 ～ 11.02,all P＜ 0.05).The level of IL-6 were rised little by little from A group to D group.There were obvious differences for comparison among groups (t=5.32～9.01,all P＜0.05).The level of Fetuin-A were declined little by little from A group to D group,there were obvious differnce for comparison among groups (t=6.14～11.53,all P＜0.05).Conclusion There was a close correlation between IL-6,Fetuin-A level and carotid intimal-medial wall thickness(IMT) in two type diabetes.To detection IL-6 and Fetuin-A levels is a target to distinguish two type diabetes whether or not with atherosclerosis.