ABSTRACT
Objective:To investigate the nutritional risk, incidence of malnutrition, and intake of three major energy-supplying nutrients, analyze changes in their body composition and the possible influencing factors in patients with stomach neoplasms during perioperative period in order to provide a theoretical basis for the nutritional management of patients with stomach neoplasms during perioperative period.Methods:This was a cross-sectional study. A total of 105 patients who underwent gastric cancer radical surgery in the Gastrointestinal Department of Zhongshan Hospital Affiliated to Xiamen University from June 2021 to May 2023 were taken as the research subjects using fixed-point continuous sampling method. They were recruited for screening and assessment using Nutritional Risk Screening 2002 (NRS 2002) and Patient-Generated Subjective Global Assessment (PG-SGA). Nutrients intake during the perioperative period were investigated using the 24-h recall method and dietary diary method, etc. Body compositions were measured using the bioelectrical resistance method.Results:Among the 105 patients, there were 78 males and 27 females, with an average age of (61.5 ± 10.3) years. About 83.8% (88/105) gastric cancer patients were at nutritional risk and 82.9% (87/105) were malnourished. The preoperative and postoperative energy intake were (1 646.1 ± 321.5) and (1 317.2 ± 365.8) kcal (1 kcal=4.184 kJ), respectively, which were significantly lower than the target amount of (1 896.7 ± 262.9) kcal, the difference was statistically significant ( t=6.23, 8.29, both P<0.05).The preoperative body mass, muscle mass, skeletal muscle, fat mass, and skeletal muscle index were (51.5 ± 9.6), (40.8 ± 6.0), (23.6 ± 4.0), (8.3 ± 4.9) kg, and 6.7 ± 0.8 respectively, while the postoperative values were (50.0 ± 9.1), (39.8 ± 6.0), (22.8 ± 3.6), (7.8 ± 5.2) kg, and 6.5 ± 0.8 respectively, with statistically significant differences between the two groups ( t values were 2.89-10.61, all P<0.05). Logistic multivariate regression analysis showed that the operation time ( OR=3.984, 95% CI 1.433-11.080, P<0.05) and energy satisfaction ( OR=0.053, 95% CI 0.005-0.610, P<0.05) were independent influencing factors for the degree of skeletal muscle loss. Conclusions:During perioperative period, the gastric cancer patients had poor nutritional status with insufficient nutrient intake and accelerated loss of body muscle and fat. Therefore, it was necessary to conduct a comprehensive nutritional evaluation for patients with stomach neoplasms during perioperative period in time and take steps to promote recovery by providing individualized nutritional therapy.
ABSTRACT
Objective To investigate the clinical efficacy of Xinmailong on heart failure in coronary heart disease and on the levels of hs-C-reactive protein (hs-CRP)and N-terminal B-type natriuretic peptide (NT-proBNP).Methods 84 elderly patients diagnosed with heart failure in coronary heart disease were enrolled in this study at our hospital from October 2014 to October 2015.All patients were randomly divided into the control group with conventional treatment(n=42) and observation group with conventional plus Xinmailong treatment(n =42).The Lee's heart failure score,cardiac function grade,quality of life score and the changes of plasma hs-CRP and NT-proBNP after one week of therapy were compared between the two groups before versus after treatment.The adverse reactions were observed during the treatment.Results The clinical efficacy rate of heart failure after treatment was significantly higher in the observation group (83.3％,35 cases)than in control group(54.7 ％,23 cases) (x2 =8.016,P =0.033).The clinical efficacy of heart function after treatment was significantly higher in the observation group(80.9 ％,34 cases)than in the control group (59.5 ％,25 cases) (x2 =6.219,P =0.019).After treatment,the quality of life score was significantly lower in observation group (15.89 ± 3.39) than in the control group (23.80 ± 5.66) (t =7.266,P =0.026).The plasma levels of NT-proBNP and hs-CRP were significantly lower after than before treatment in NT-proBNP[(1 136.6±236.8)ng/L and (2 266.9±260.9)ng/L],and in hs-CRP[(3.06 ±0.26)mg/L and (3.56±0.29)mg/L] (t=6.608、5.106,P=0.019、0.009).There were no serious adverse reactions in both groups during the treatment.Conclusions Xinmailong can not only improve safely and effectively the quality of life of patients,but also block the atherosclerosis of the inflammatory response.