Objective To investigate the effect and mechanism of growth factors on intestinal compensation after massive intestinal resection， and understand the progress of growth factors in nutrition support treatment for short bowel syndrome （SBS）. Method The related literatures about the application and effect of growth factors in the patients with SBS were reviewed. Results Different kinds of growth factors had different effects on intestinal adaptation after massive intestinal resection. The application of growth factors according to the specific circumstances of the patients with SBS could shorten the residual small intestine compensatory time and improve the nutrition status of the patient with SBS. Conclusions Growth factors play important role in promoting the intestinal adaptation after resection. Different kinds of growth factors have their effects and it’s helpful for getting rid of the total parenteral nutrition early. However， much work still remains to be done.
Objective To review the biologic characteristics and biologic effect of cholecystokinine (CCK) on the central nervous system. Methods The literatures of recent years on research advancement of cholecystokinine as neurotransmitters/peptides in signal transduction, neuron protection and pain management in the central nervous system are reviewed. Results CCK possesses the ability to suppress the convulsant effects of convulsants. CCK8 is able to reduce the neural damage caused and delay the neural aging. CCK antagonists play an important role in human pain transduction. Conclusion CCK has been proven to be one of the richest neurotransmitters/neuropeptides as well as an important signal factor in the brain, and its important biologic effect is being confirmed.
Objective To investigate the feature of c-kit gene mutation in gastrointestinal stromal tumor （GIST） and its correlation with clinicolpathology， molecular targeted therapy，and prognosis. Methods The related literatures about the molecular genetic mechanism of GIST were reviewed. Results The c-kit gene mutation， which is prevalent in GIST， may be the early genomic events， and they are not the independent prognostic factor. However， different molecular subtype as a new indicator to regulate biological behaviors and assess prognosis of GIST is still controversial. Conclusions The study of genotype in GIST has advanced our understanding of pathogenesis， evaluating the prognosis and conducting treatment optimization. However， subsequent work remains to be done.
【Abstract】Objective To understand the features of lymphatic vessel, and to summarize the foundation and mechanism of the promotion and inhibition of tumor lymphangiogenesis recorded on the current studies of animal experiments and clinical researches. Methods The related literatures of the structural features of lymphatic vessel, lymphatic endothelial molecular markers, the origin of lymphatic tumors, the molecular mechanisms and regulatory factors were reviewed, and the relationship between tumor lymphangiogenesis and lymphatic metastasis, the treatment targeting at the formation of the anti-tumor lymphatic vessel and its existing problems were also analyzed. Results Hyperplasia of lymphatic vessels occurred during the process of tumor formation and progression. The structural features of the lymphatic vessels in the tumor were conducive to tumor lymphatic metastasis. In recent years, methods of anti-lymphangiogenesis and inhibition of tumor lymphatic metastasis had achieved considerable success in animal experiments. However, there were still a lot of problems need to be solved. Conclusion Tumor lymphangiogenesis has a significantly positive correlation between tumor lymphatic metastasis and patients’ prognosis, which may indicate that treatment against the formation of tumor lymphatic vessel maybe effective.
ObjectiveTo investigate the effect of omega-3 polyunsaturated fatty acids on delirium in elderly patients after taking gastric cancer surgery.MethodsA prospective study was conducted. Elderly patients with gastric cancer undergoing radical gastrectomy in West China Hospital of Sichuan University from June 2015 to June 2018 were divided into experimental group and control group for the purpose of research. All patients were operated by the same group of surgeons and anesthesiologists. Patients in the experimental group received intravenous infusion of 10% fish fat emulsion (Ewing) 100 mL daily from the first day after operation extra to routine treatment; patients in the control group received routine treatment after operation. The postoperative delirium, inflammation, complications, hospital stay, andre-admission on 30 days were compared between the two groups.ResultsA total of 205 patients were under research. The results were as follows. ① There were 47 delirium patients in the control group and 22 delirium patients in the experimental group. The difference between the two groups was statistically significant (P<0.001). There were 32 cases and 19 cases discovered with delirium in the control group and the experimental group during 1-3 days after operation; there were 19 cases and 6 cases were detected with delirium in the control group and the experimental group during 4-7 days after operation, respectively. The difference was considered statistically significant (P<0.05). ② Inflammation indexes of the experimental group were significantly lower than those of the control group on the 3rd and 7th day after operation, including count of WBC, C-reactive protein, interleukin-6, tumor necrosis factor-α, and platelet crit, and the difference were statistically significant (P<0.05). ③ Postoperative fever occurred in 46 patients in the experimental group, while 71 patients in the control group. The difference was statistically significant (P<0.01). ④ There were 2 cases of incision liquefaction in the control group and 1 case of mild chylous leakage in the experimental group. There was no significant difference in incision liquefaction rate and chylous leakage rate between the two groups (P>0.05). ⑤ The average hospitalization time of the experimental group was shorter than that of the control group ［(8±1) d vs. (9±2) d］. The difference was considered statistically significant (P<0.01).Conclusionω-3 polyunsaturated fatty acids can reduce postoperative delirium and improve short-term prognosis in elderly patients with gastric cancer by controlling inflammation and stress response.
Objective To study the effects and mechanisms of major immune nutrients and to introduce the progresses of clinical applications about enteral immunonutrition. Methods The related literatures about the effects and clinical applications of enteral immunonutrition were reviewed. Results Infection rate can be reduced and the hospitalization can be shortened as a result of the improved nutritional status and immune competence of patients which can be enhanced by reasonable enteral immune nutrition. Most of the patients suffering from serious diseases can benefit from enteral immunonutrition, such as gastrointestinal cancers, post-transplantation complications, chronic liver disorders, acute pancreatitis and so on. However, as a new nutrition therapy, the clinical use of enteral immunonutrition in critically ill patients is still controversial. Conclusions Enteral immunonutrition plays an important role in the nutritional support of patients with serious diseases, such as gastrointestinal cancers, organ failures. However, much work remains to be done.
Objective To investigate the role of rehabilitation therapy both on nutritional status and intestinal adaptation of patients with short bowel syndrome (SBS). Methods The literatures about rehabilitation therapy for SBS were reviewed. Results Intestinal rehabilitation refers to the process of restoring enteral autonomy, in order to get rid of parenteral nutrition, usually by means of dietary, medical, and surgical treatment. Recent researches showed that medication and the use of specific nutrients and growth factors could stimulate intestinal absorption and might be useful in the medical management of SBS. Conclusion Intestinal rehabilitation is of benefit in the treatment of SBS and would play a greater role in the future.
Objective To summary the pathological classification， clinical manifestations， diagnosis， and treatments of gastrointestinal neuroendocrine tumors （GE-NETs）. Methods Domestic and international literatures were collected to summary the status of clinical researches and treatments of GE-NETs. Results GE-NETs derived from enterochromaffin cells throughout the gut which had the function of amine precursor uptake decarboxylase （APUD）. These tumors secreted discrete bioactive substances and produced characteristic immunohistochemical patterns， making patients to manifest endocrine syndrome. But there were no unified standards on the diagnosis， grade， TNM classification， and prognosis of GE-NETs. Early diagnosis rate of GE-NETs was low， and most of tumors were asymptomatic and detected at late stage， with a tendency to metastasize to the liver. Imaging examation was important in early diagnosis of GE-NETs. Surgery was the traditional first-line therapy and the only possible curative approach. Somatostatin analogues， such as long-term-release （LAR） octreotide， could relieve the hormonal symptoms， slow down the tumor growth， and had shown synergistic antiproliferative activity in combination with biological agent everolimus. Conclusions The lack of standardized classification and an incomplete understanding of this disease are some of the impediments to the progress of treatment. Individualized comprehensive therapy is the aim of the future treatment.
ObjectiveTo investigate the current status and hotspots in researches of gastrointestinal stromal tumor.MethodsThe literatures related to gastrointestinal stromal tumor and published from 2000 to 2019 were extracted from Web of Science Core Collection. Visualization analysis was conducted by utilizing CiteSpace and VOSviewer software based on bibliometrics methods.ResultsA total of 3 226 articles and reviews were retrieved. The number of publications increased from 2000 to 2019, from the initial 34 publications gradually increased to 241 in 2019, and the maximum number of publications was 265 in 2015. The most productive five countries in terms of publication number were: 907 in the United States, 540 in China, 522 in Japan, 219 in Germany, and 214 in Italy. Co-occurrence networks of keywords were divided into three clusters: targeted therapy, clinical management, and pathogenesis research. Co-citation analysis of literatures contained 9 clusters, and cluster #0 prognosis was the latest cluster, indicating the research frontier and tendency.ConclusionsThe United States and its domestic institutes are the pioneers. Targeted therapy, clinical management, and pathogenesis researches are the main research filed. Prognosis research may be the new research tendency, and clinical and basic researches are still hotspots in medical research.
Objective To analyze clinical value of early enteral nutrition following radical resection of gastric cancer. Methods Seventy-six patients with gastric cancer underwent radical resection from May 1, 2016 to July 1, 2016 in the West China Hospital of Sichuan University were included according to the inclusion criteria and exclusion criteria, then were randomly divided into observation group (36 cases) and control group (40 cases). The patients in the observation group received the enteral nutrition on day 2 following the surgery, in the control group received the conventional management. The gastrointestinal recovery and the adverse reaction were compared in these two groups. The preoperative and postoperative laboratory indicators and the body weight of the patients in both groups were analyzed. Results ① The general data such as age, gender, and body weight had no significant differences in these two groups (P>0.05). ② The first anus exhaust time and the first defecation time of the observation group were significantly shorter than those of the control group (P<0.05). ③ The adverse reaction rate of the observation group was significantly lower than that of the control group (P<0.05). ④ On admission, the serum albumin, urea nitrogen, creatinine, and lymphocyte count had no significant differences in these two groups (P>0.05). On day 5 after the operation, the serum albumin of the observation group was significantly higher than that of the control group (P<0.05). ⑤ The body weight had no significant difference in these two groups before the operation (P>0.05), which in the observation group was significantly heavier than that of the control group on day 30 after the operation (P<0.05). Conclusion Preliminary results of limited cases in this study show that early enteral nutrition following radical resection of gastric cancer is safe and effective, it could promote gastrointestinal function resumption and effectively improve nutritional status.