ABSTRACT
BACKGROUND: Patients with gastrointestinal tumors often suffer from poor nutritional status during treatment. Surgery is the main treatment for these patients, but the long postoperative recovery period is often accompanied by digestive and absorption dysfunction, leading to further deterioration of the nutritional status. Early enteral nutrition support is hypothesized to be helpful in improving this situation, but the exact effects have yet to be studied in depth. AIM: To observe the effect of early enteral nutritional support on postoperative recovery in patients with surgically treated gastrointestinal tract tumors, with the expectation that by improving the nutritional status of patients, the recovery process would be accelerated and the incidence of complications would be reduced, thus improving the quality of life. METHODS: A retrospective analysis of 121 patients with gastrointestinal tract tumors treated in our hospital from January 2020 to January 2023 was performed. Fifty-three of these patients received complete parenteral nutrition support as the control group for this study. The other 68 patients received early enteral nutritional support as the observation group of this study. The clinical indicators comparing the two groups included time to fever, time to recovery of postoperative bowel function, time to postoperative exhaustion, and length of hospital stay. The changes in immune function and nutritional indexes in the two groups were compared. Furthermore, we utilized the SF-36 scale to compare the changes in the quality of life between the two groups of patients. Finally, the occurrence of postoperative complications between the two patient groups was also compared. RESULTS: The postoperative fever time, postoperative bowel function recovery time, postoperative exhaustion time, and hospitalization time were all higher in the control group than in the observation group (P < 0.05). The levels of CD3+, CD4+, immunoglobulin (Ig) A, IgM, and IgG in the observation group were significantly higher than those in the control group at 1 d and 7 d postoperatively, while CD8+ was lower than in the control group (P < 0.05). Total protein, albumin, prealbumin, and transferrin levels were significantly higher in the observation group than in the control group at 7 d postoperatively (P < 0.05). The SF-36 scores of patients in the observation group were significantly higher than those in the control group (P < 0.0001). The overall incidence of adverse reactions after the intervention was significantly lower in the control group than in the observation group (P = 0.021). CONCLUSION: We found that patients with gastrointestinal tumors are nutritionally vulnerable, and early enteral nutrition support programs can improve the nutritional status of patients and speed up postoperative recovery. This program can not only improve the immune function of the patient and protect the intestinal function, but it can also help to improve the quality of life of the patient. However, this program will increase the incidence of complications in patients. Caution should be taken when adopting early enteral nutrition support measures for patients with gastric cancer. The patient's condition and physical condition should be comprehensively evaluated and closely monitored to prevent possible complications.
ABSTRACT
Many uncertainties such as variable irregular structure and complex flow conditions bring difficulties to the design of a nature-like fishway. This study defines the main factors and parameters affecting flow conditions such as permeability ratio, offset ratio, bottom slope and pool length to simplify and generalize the irregular geometry of the nature-like fishway. According to the engineering requirements of the Mopiling nature-like fishway, the effect of the above parameters of pool geometry on the flow structure is investigated through a 3D turbulent numerical simulation, and the parameter thresholds are summarized according to the optimization of the flow conditions. The results show that under the same conditions, the maximum velocity of the control section increases with the increase in permeability ratio, bottom slope and pool length, and the offset ratio has limited effect on the maximum velocity of the control section. It is recommended that when the bottom slope is 1/250 and the pool length is 10 m, the permeability ratio should not be greater than 0.30 and the offset ratio should be located between 0.15 and 0.60. When the bottom slope is adjusted to 1/200, it is recommended to control the permeability ratio below 0.20, the offset ratio between 0.30 and 0.60, and the pool length can be adjusted to 8 m. Within the above threshold range of the design parameters, the maximum velocity in the fishway can be basically controlled at about 1.0 m/s. The mainstream in the pool is clear and the flow pattern is good, which can basically satisfy the requirements of fish passing. The relevant design parameters and optimization strategies can provide reference for similar projects.
