Objective To investigate the effect of low nitrogen and low calorie parenteral nutrition combined with enteral nutrition support on inflammatory factors and immune function in patients with gastric cancer .Methods From May 2013 to May 2015,ninety patients with gastric cancer underwent surgical treatment in the Affiliated Hospital of Yanbian University were selected in the research ,and they were divided into control group and observation group according to different methods of nutritional support ,with 45 cases in each group.The control group received total parenteral nutrition support,the observation group was given low nitrogen and low calorie parenteral nutrition and enteral nutrition support, and supplemented by targeted nursing measures.The changes of levels of inflammatory factors and immune proteins in the two groups before operation and 7d after operation were compared.All patients were followed up for 6 months,and the quality of life and nursing satisfaction rate were compared between the two groups.Results At 7d after operation,the levels of immunoglobulin IgA ,IgM and IgG in the observation group were (2.62 ±0.43)g/L,(1.93 ±0.52)g/L,(14.58 ±3.32)g/L,respectively,which were significantly higher than those before operation [(2.01 ±0.30)g/L,(1.22 ±0.40) g/L,(12.42 ±5.64) g/L,t＝7.805,7.260,2.214,all P＜0.05] and those of the control group [(2.12 ±0.52) g/L,(1.53 ±0.41) g/L,(12.86 ±4.34) g/L,t＝4.971, 4.052,2.112,all P＜0.05].At 7d after operation,the levels of C reactive protein(CRP),tumor necrosis factor -α (TNF-α) in the observation group were (108.52 ±17.53)mg/L,(135.63 ±28.51)ng/L,respectively,which were lower than those before operation [(142.35 ±15.82) mg/L,(156.65 ±25.54) ng/L,t ＝9.611,3.684,all P＜ 0.05] and those of the control group[(135.68 ±14.54)mg/L,(145.52 ±27.53)ng/L,t＝8.000,3.824,all P＜0.05],the level of interleukin-2(IL-2) was higher than those before operation [(65.71 ±10.23)ng/L vs.(54.32 ± 7.83)ng/L,t ＝5.931,P ＜0.05] and that of control group [(57.62 ±5.86) ng/L,t ＝4.603,P ＜0.05].At 6 months after operation,the quality of life scores of the observation group were higher than those of the control group (t＝7.444,6.892,4.884,5.957,7.784,12.992,3.851,6.706,all P＜0.05).The nursing satisfaction rate of the observation group was 97.78%,which was higher than 82.22% of the control group ( χ2＝6.049,P ＜0.05). Conclusion Low nitrogen and low calorie parenteral nutrition combined with enteral nutrition support can effectively improve the immune function of patients with gastric cancer ,reduce the inflammatory response and ensure the quality of life of the prognosis,which is suitable for clinical application.

Objective:To study the feasibility of laparoscopic anatomical hepatectomy of segment VII for hepatocellular carcinoma (HCC) with dorsal-ventral combined approach.Methods:Clinical data of 23 patients with HCC undergoing laparoscopic anatomical hepatectomy of segment VII with dorsal-ventral combined approach in Jiangnan University Affiliated Hospital from December 2020 to April 2023 were retrospectively collected, including 11 males and 12 females, aged (58.5±7.9) years old. The patient's perio-perative data, postoperative complications, and follow-ups were analyzed.Results:All patients underwent the surgery successfully without conversion to laparotomy. The operation time was (286.7±63.4) min, the amount of intraoperative blood loss [ M( Q1, Q3)] was 200(150, 400) ml without blood transfusion. There were no major complications such as abdominal bleeding, bile leakage, liver failure or abdominal infection. Two cases had right pleural effusion and were managed with thoracic drainage. The patients could ambulate on postoperative day 2, and the postoperative hospital stay was (9.36±1.72) d. The diameter of the lesion was (4.38±1.42) cm. The serum level of alpha fetoprotein (AFP) three months after surgery was (3.26±0.93) ng/ml, lower than the preoperative baseline (46.75±9.43) ng/ml ( t=38.24, P=0.008). All patients showed normal serum levels of AFP and there were no tumor recurrence or metastasis during postoperative follow-ups. Conclusion:Laparoscopic anatomical hepatectomy of segment VII for HCC with dorsal-ventral combined approach is feasible and worth spreading.

BACKGROUND:The plantarflexor weakness is a common muscle defect in patients with spastic cerebral palsy and Charcot-Marie-Tooth,which clinically manifests abnormal gaits,and the relationship between plantarflexor weakness and abnormal gaits is unclear. OBJECTIVE:To explore the biomechanical behavior of the lower limb under the action of a single factor of plantarflexor weakness to reveal the mechanism of abnormal gait induced by plantarflexor weakness and to provide guidance for the rehabilitation training of patients with plantarflexor weakness. METHODS:A predictive framework of musculoskeletal multibody dynamics in the sagittal plane was established based on OpenSim Moco to predict lower limb joint angles and muscle activation changes during walking in normal subjects.The validity of the framework was verified by combining the inverse kinematics and electromyogram activation time of the experimental data.Reduced isometric muscle forces were used to model plantarflexor weakness and to compare predicted lower extremity joint angles,joint moments,and muscle energy expenditure with normal subjects to analyze the effects of plantarflexor weakness on lower extremity biomechanics. RESULTS AND CONCLUSION:(1)The Moco-based prediction framework realistically predicted the biomechanical changes of the lower limbs during walking in normal subjects(joint angles:normalized correlation coefficient≥0.73,root mean square error≤7.10°).(2)The musculoskeletal model used a small stride support phase to increase the"heel-walking"gait during plantarflexor weakness.When the plantarflexor weakness reached 80%,the muscle energy expenditure was 5.691 4 J/kg/m,and the maximum activation levels of the gastrocnemius and soleus muscles were 0.72 and 0.53,which might cause the plantarflexor weakness patients to be more prone to fatigue when walking.(3)Muscle energy expenditure was significantly higher when the weakness of plantarflexors exceeded 40%,and the joint angles and moments of the lower limbs deteriorated significantly when the weakness of plantarflexors exceeded 60%,suggesting that there may be a"threshold"for the effect of plantarflexor weakness on gait,which may correspond to the point at which health care professionals should intervene in the clinical setting.