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Objective To evaluate the effect of nutritional risk screening and interventions on postoperative nutritional status in patients with oral cancer. Methods A total of 83 oral cancer patients with mild or moderate nutritional risk rated by patient-generated subjective global assessment(PG-SGA) from January 2015 to June 2017 were randomized into an experimental group(43 cases) and a control group (40 cases). The patients in the experimental group received 2-week nutritional intervention before the operation,while the patients in the control group received routine preoperative treatment and diet guidance. The biochemical measurements of postoperative nutritional indicators, peripheral blood immunoglobulin indicators, postoperative complications and hospital stays were compared between the two groups. Results The levels of prealbumin, retinol- binding protein, total lymphocyte count and transferrin were (218.5±34.6) mg/L, (23.5±4.3)μg/L, (1.82±0.45)×109/L, (2.07±0.63 )μg/L on the day of admission in the experimental group, and at 1 day before the operation were (237.3±36.5) mg/L, (27.7±4.8)μg/L, (2.02±0.39)×109/L, (2.43±0.54)μg/L, there was no significant difference(P<0.05). IgM, IgG, IgA at 1 day before the operation were significantly higher than those on the day of admission in the experimental group(P<0.05), and the levels of prealbumin, retinol-binding protein, total lymphocyte count,transferrin, IgM, IgG, IgA and body mass index at 8 days after the operation in the experimental group were significantly higher than those in the control group(t=1.574-3.418, P<0.05). The total rate of postoperative complications was 11.6％(5/43) in the experimental group, 30.0％(12/40) in the control group, and there was significant difference between the two groups (χ2=6.840, P<0.01). The incidence of infection-associated complications such as pneumonia and incision infection was 7.0％(3/43) in the experimental group, 20.0％(8/40) in the control group, and there was significant difference between the two groups (χ2=5.096, P<0.05). Conclusions Preoperative nutritional support can effectively improve the perioperative nutritional status,decrease postoperative complications and operative risk in esophageal cancer patients with mild or moderate nutritional risk.
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Objective To investigate the expression level of hypoxia-inducible factor-lot (HIF-1ot) in gastric cancer and its relationship with clinicopathological characteristics and prognosis of patients with gastric cancer.Methods From March 3,2011 to September 28,2012,49 patients with gastric adenocarcinoma tissue chips were selected from pathology department of our hospital.They were matched with paracancerous tissues.The expression levels of HIF-1α were measured by immunohistochemistry method in gastric cancer tissues and paracancerous tissues chips.Kaplan-Meier was used to evaluate the progression-free survival (PFS) and overall survival (OS),and the Cox proportional hazards model was used to analyze whether HIF-1α was a prognostic factor.Results The high expression rate of HIF-1α protein in gastric cancer was significantly higher than that in paired para-carcinoma group (42.9％ vs.4.1％,x2 =20.509,P ＜ 0.001).The expression of HIF-1 α protein was related to TNM stage (x2 =4.601,P =0.032),vascular invasion (x2 =6.766,P =0.009) and degree of differentiation (x2 =7.969,P =0.005).Compared with patients with low expression of HIF-1α,the median PFS (16.2 months vs.27.3 months) and median OS (34.8 months vs.43.8 months) were shorter in the patients with high expression of HIF-1 α,and the differences were statistically significant (median PFS:x2 =4.661,P =0.002;median OS:x2 =6.903,P =0.009).The results of single factor analysis showed that overexpre-ssion of HIF-1α was correlated with PFS and OS (PFS:HR =4.461,95％ CI:1.969-10.802,P ＜0.001;OS:HR =3.109,95％CI:1.274-7.588,P =0.013).The results of Cox multivariate analysis showed that overexpression of HIF-1α was the independent risk factor that affected the survival and prognosis of patients with gastric cancer (PFS:HR =4.747,95％ CI:2.175-10.230,P ＜0.001;OS:HR =3.171,95％ CI:1.358-7.404,P =0.008).Conclusion The high expression rate of HIF-1α protein in gastric cancer tissues is significantly higher than that in paracancerous tissues.The expression of HIF-1α is associated with TNM stage,vascular invasion,degree of differentiation in patients with gastric cancer.The high expression of HIF-1α is associa-ted with the shorter median OS and PFS.The high expression of HIF-1α is an independent risk factor for the survival and prognosis of patients with gastric cancer,which is expected to be an independent marker of poor prognosis.
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Objective To conclude the nursing experience in a patient with chronic pyogenic osteomyelitis of the mandible caused by multidrug-resistant bacteria. Methods Through the nursing process of patients, detailing the points of disinfection and isolation management, vacuum sealing drainage (VSD) care, drug therapy, hyperbaric oxygen therapy, strengthening primary care, psychological care of the patients with chronic pyogenic osteomyelitis of the mandible caused by multidrug-resistant bacteria. Results Illness was cured after 24 days in the hospital. Conclusions Through the nursing of a patient with chronic pyogenic osteomyelitis of the mandible caused by multidrug-resistant bacteria, reinforces the basic knowledge of nurses, improve nursing skill, which increases the theoretical basis and practical experience in clinical work.
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Objective To compare the clinical effects and characteristics between hypertensive intracerebral hemorrhage (HICH) and haematoma clearance by craniotomy for basal ganglia.Methods Clinical data of 50 patients with HICH in basal ganglia were collected,including operation duration,amount of intraoperative bleeding,cleared amount of haematoma,postoperative intracranial infection,and GOS at the sixth month after operation.The patients were divided into endoscopic group and craniotomy group.Clinical effects were analyzed by using GOS at the sixth month as a prognosis index.Results Preoperatively,the two groups showed no significant difference in any type of clinical materials(all P ＞ 0.05).Operation durations were (1.5 ± 0.8) h and (3.5 ± 1.1) h (P ＜ 0.05),respectively; amounts of intraoperative bleeding were (40.0 ± 19.7) rnl and (40.6 ± 13.2) ml (P ＜ 0.05),respectively; clearance rates of haematoma were (92.6 ± 9.4) ％ and (73.1 ± 21.1) ％ (P ＜ 0.05),respectively; cases of postoperative intracranial infections were 0 and 3 (P ＜ 0.05),respectively,for the endoscopy group and the craniotomy group.GOS prognosis at 6 months showed 7 cases of good recovery,12 cases of slight disability,2 cases of severe disability,1 case of vegetative state,and 1 death in the endoscopy group;6 cases of good recovery,9 cases of slight disability,6 cases of severe disability,3 case of vegetative state,and 1 death in the craniotomy group.Prognosis was better in the endoscopy group than in the craniotomy group(P ＜ 0.05).Conclusion Endoscopic surgery is an efficient and minimally invasive and operating technique for the treatment of hypertensive basal ganglia intracerebral hemorrhage.