Objective: To investigate the laboratory,clinical and economic results of early postoperative enteral nutrition(EEN) in patients with gastrointestinal cancer.Methods: 120 patients with gastrointestinal cancer were randomly divided into three groups: EEN,early postoperative parenteral nutrition(PN), and traditional nutrition(CON)groups.The 1/3 and 2/3 target volumes were administered on the first and second postoperative days(1POD,2POD),and the full volume was given from 3POD to 8POD in EEN and PN groups.The routine formula was offerd from 1POD to 8POD in CON group.The nutritional and immune parameters were detected one day before surgery and 9POD, and the clinical and economic results were collected in three groups.Results: The levels of ALB,TF,PA,CD3,CD4,CD4/CD8 were significantly higher in EEN and PN groups than those in CON group(both P＜0.01),and the CD3,CD4,CD4/CD8 were better in EEN group than those in PN group(P＜0.05).The side effects of EEN group were similar to those of PN group(P>0.05). The recovery of bowel function was quicker in EEN group than that in PN and CON groups(both P＜0.05).The complication rate, cost of nutrition support,and cost of complication treatment were lower in EEN group than those in PN group(P＜0.05, P＜0.01, P＜0.01).Although the cost of nutrition support was lowest but the complication rate and cost of complication treatment were all highest in CON group.Conclusion: EEN is better in immune function, recovery of bowel function,complication rate, and cost-effectiveness than those in PN, and from our multiple angular viewpoints EEN is the first choice for patients with gastrointestinal cancer.

Objective To investigate the clinical value and adverse reactions of indwelling ureteral stentsinthepreventionofureteralinjurybeforecomplexpelvictumorsurgery.Methods 145casesofpatients with rectal cancer ,cervical cancer ,ovarian cancer and pelvic sarcomas were retrospectively analyzed ,and 53 pa-tients with complex pelvic tumor surgery ,preoperative were under cystoscope unilateral or bilateral ureteral stent tube,pulled out according to the intraoperative situation after surgery or lien ,92 patients as control group .Results Ureteral injury was found in 10 of the 145 patients,2 cases in ureteral catheter group and 8 cases in control group .3 cases of postoperative ureteral fistula occurred in the control group .Indwelling ureteral stents could cause adverse reactions such as hematuria ,osphyalgia and urinary irritation ,and the adverse reactions of catheter group was obviously higher than that of control group (P<0.05).Conclusion Cystoscopic ureteral stent placement has important clinical significance for prevention of ureteral injury despite certain adverse reactions ,which can be used in operation of complex pelvic tumor .

BackgroundQuality of life， as a major criterion for judging the clinical outcome of ovarian cancer patients， can be affected by adverse psychological symptoms of patients. Meanwhile， fear of disease progression， as a frequent psychological symptom among cancer survivors， is significantly influenced by metacognition， while there is a paucity of research into the specific correlation among the three in patients with ovarian cancer. ObjectiveTo explore the correlation among fear of disease progression， metacognition and quality of life in patients with ovarian cancer， and to test the role of fear of disease progression in the relationship between metacognition and quality of life， so as to provide references for improving the quality of life in patients with ovarian cancer. MethodsA total of 135 patients with ovarian cancer hospitalized in Cangzhou People's Hospital of Hebei Province from January 2019 to December 2022 were selected. All subjects were requested to complete the Functional Assessment of Cancer Therapy-Ovarian Cancer （FACT-O）， Fear of Progression Questionnaire-Short Form （FoP-Q-SF） and Metacognition Questionnaire （MCQ） to assess their quality of life， fear of disease progression and metacognitive level. Pearson correlation analysis was adopted to examine the correlation among the above scales. Process v3.5 macro program was utilized to determine the mediating effect of fear of disease progression on the relationship between metacognition and quality of life， and nonparametric Bootstrap with bias-correction was used to test the mediating effect. ResultsA total of 122 patients （90.37%） with ovarian cancer completed the effective questionnaire survey. Patients scored （90.52±17.13） on FACT-O， （68.52±16.31） on MCQ， and （37.72±8.91） on FoP-Q-SF. Pearson correlation analysis denoted that FoP-Q-SF score was negatively correlated with FACT-O score （r=-0.412， P<0.05） and positively correlated with MCQ score （r=0.241， P<0.05）， and MCQ score was negatively correlated with FACT-O score （r=-0.453， P<0.05）. Analysis demonstrated that the total effect of metacognition on quality of life was -0.298 （95% CI： -0.402~-0.186）. The direct effect of metacognition on quality of life was -0.219 （95% CI： -0.504~-0.277）， accounting for 73.49% of the total effect， and the indirect effect of metacognition on quality of life via fear of disease progression was -0.079 （95% CI： -0.162~-0.037）， accounting for 26.51% of the total effect. ConclusionQuality of life is reduced in patients with ovarian cancer， and fear of disease progression plays a partial mediating role in the relationship between metacognition and quality of life.

End-stage renal disease is the final stage of chronic kidney disease, and research on palliative care for end-stage renal disease patients in China is still in its infancy. The research content of palliative care for end-stage renal disease at home and abroad mainly includes identification and management of symptoms, advance care planning, psychosocial and spiritual support, and ethical issues in dialysis decision-making. However, practical experience is still insufficient. By focusing on the overview, development status, patient needs, as well as implementation forms and models of palliative care for endstage renal disease patients, this paper summarized the research progress and application status of related research, with a view to providing references for future domestic research and clinical practice in this field.