ABSTRACT
Objective:To explore the application of standardized treatment process for early enteral nutrition combined with gastric retention after operation in patients with esophageal cancer.Methods:Using convenience sampling, 84 patients with gastric retention complicated by early enteral nutrition support after esophagectomy in Department of Thoracic Surgery, Third People′s Hospital of Dalian from July 2015 to June 2020 were selected as the subjects. They were divided into control group and experimental group according to admission time with 42 cases in each group. The control group received routine nursing, while the experimental group received early enteral nutrition and gastric retention standardized treatment process nursing. The differences between the two groups in nutritional status and immune indexes before and 7 days after operation, the standard feeding rate within 7 days after operation, incidence of postoperative complications and enteral nutrition-related complications, length of hospitalization time and hospitalization expenses were compared.Results:In the control group, 2 cases were lost to follow-up. There was no statistically significant difference in preoperative nutritional status and immune indexes between the two groups ( P<0.05); 7 days after operation, the body mass index, serum total protein, prealbumin, nitrogen balance, IgM, CD3, CD4, and CD4/CD8 of the experimental group were all higher than those of the control group, and the differences between the two groups were statistically significant ( t values were 2.228-5.332, P<0.05 or 0.01).The standard feeding rate within 7 days was (68.93±8.12)% in the experimental group and (51.19±6.96)% in the control group, respectively, and the difference between the two groups was statistically significant ( t value was -4.38, P<0.01). The incidence of postoperative nausea and vomiting, Ⅱ B healing, anastomotic fistula and aspiration was 2.38% (1/42), 2.38% (1/42) and 0 (0/42), 2.38% (1/42) in the experimental group and 15.00%(6/40), 7.50% (3/40) and 5.00% (2/40) and 10.00% (4/40) in the control group, respectively, and the differences were statistically significant ( χ2 values were 5.99 - 9.88, P< 0.05 or 0.01). The length of hospitalization time in the experimental group was (10.18±1.69) d, and the hospitalization cost was (53 268.46 ±3 651.56) yuan, both lower than (13.66 ± 2.18) d and (64 972.39 ± 4 029.81) yuan in the control group, and the difference was statistically significant ( t values were 2.14, 2.89, P< 0.05). Conclusions:The standardized treatment process of enteral nutrition combined with gastric retention can improve the feeding rate, nutritional index and immune index within 7 days after operation, reduce postoperative complications and incidence of enteral nutrition related complications, reduce the hospitalization time and reduce hospitalization expenses.
ABSTRACT
Objective Moderate autophagy helps improve the viability of neurocytes.This study aims to investigate the effect of SP600125 on the autophagy and loss of nerve cells in the hippocampus in rats with subarachnoid hemorrhage (SHA).Methods Forty healthy male SD rats were equally randomized into a sham operation, an DMSO group, an SAH model, and an SP600125 group.The SAH model was established by vascular puncture and the rats of the SP600125 group were injected with 10 μL of SP600125 (3 μg/μL) into the lateral cerebral ventricle at 30 minutes before modeling.Sham group and SAH group were injected with equal volume of normal saline, DMSO group was injected with the same amount of DMSO.The animals were sacrificed at 24 hours after modeling for observation of the changes in the morphology and the number of neurons in the hippocampus by HE staining and qualitative and quantitative determination of the expressions of the p-JNK protein and the autophagy markers beclin-1 and LC3-II by immunohistochemistry and Western blot.Results Compared with the sham operation group, the neurons exhibited a disordered arrangement and the cells were polygonal and decreased in number in the hippocampus of the SAH models, while milder neuronal injury and more cells were observed in the rats of the SP600125 group than in the SAH models.The mean optical density values of Beclin-1, LC3-II and p-JNK in the hippocampus were significantly higher in the SAH models (14.66±4.40, 12.62±3.46, and 12.82±3.68) and DMSO (13.85±3.85、11.59±4.52、13.03±3.53), and the SP600125 group (9.86±3.14, 6.78±2.56, and 5.60±2.42) than in the sham operation group (1.56±0.28, 1.60±0.30, and 1.58±0.32) (P<0.05), but markedly lower in the SP600125 than in the SAH model group (P<0.05).The expressions of Beclin-1, LC3-II and p-JNK were remarkably increased in the SAH models (0.474±0.122, 0.668±0.130, and 0.496±0.124) and DMSO (0.432±0.102、0.628±0.113、0.416±0.094) and the SP600125 group (0.264±0.106, 0.332±0.113, and 0.219±0.104) than in the sham operation group (1.56±0.28, 1.60±0.30, and 1.58±0.32) (P<0.05), but significantly decreased in the SP600125 group as compared with the SAH models (P<0.05).Conclusion SP600125 has a protective effect on the neurocytes in the hippocampus of SAH rats, which may be associated with SP600125 moderately activating neuronal autophagy by inhibiting the activity of the JNK signaling pathway.
ABSTRACT
Objective To explore the effect of extracellular regulated protein kinases (ERK) signaling pathway on early brain injury and autophagy of nerve cell in hippocampus area in rats with subarachnoid hemorrhage (SAH). Methods Forty-eight adult male Sprague-Daw-ley rats were randomly divided into sham group, SAH group, SAH+dimethyl sulfoxide (DMSO) group and SAH+U0126 group, with 12 rats in each group. The SAH model was established with puncture of internal carotid artery. The SAH+U0126 group was injected with U0126 0.05 mg/kg;the sham group and SAH group were injected with normal saline, and the SAH+DMSO group was injected with DMSO 30 min-utes before modeling. They were sacrificed 24 hours after modeling. The brain water content was measured with wet and dry method. The morphology changes of neural cells in hippocampus CA1 were observed by HE staining. The expression of phosphorylation ERK (p-ERK), Beclin-1 and LC3-Ⅱwere detected with immunohistochemical method and Western blotting. Results Compared with the sham group, the brain water content increased (P0.05). Conclusion The activation of ERK signaling pathway may alleviate early brain injury after SAH by regulation of autophagy.
ABSTRACT
Objective to investigate the current status of preoperative anxiety level and explore the influencing factors in elderly patients with pros-tatic hyperplasia. Methods A total of 124 patients with prostatic hyperplasia were selected for the study,and the State-trait Anxiety Inventory (StAI)was analyzed using the convenience sampling method. Results the score were 55.54±4.81 for SAI,34.60±2.09 for tAI,and 90.14±5.91 for StAI. the preoperative anxiety level of patients with prostatic hyperplasia varied in different demography(P < 0.05). According to multiple lin-ear stepwise regression equation,age,cultural level,place of residence,and the medical burden are the influence factors. Conclusion the preoper-ative anxiety level of elderly patients with prostatic hyperplasia is high,and more health education is needed. It is necessary to use different psycholog-ical persuasion according to their specific situation,so as to promote their physical and mental health,and to promote the effect of postoperative recov-ery.