Objective To investigate the effect of early enteral nutrition.Methods 248 patients with esophageal and gastric carcinoma were randomly divided into two groups,and received enteral nutrition(EN)and parenteral nutrition(PN)each continuously for 6 days after operation.The body weight,blood routine test,liver function,and postoperative day 8 were compared with those before operation.Results The body weight,red blood cell count,and the levels of hemoglobin,serum albumin and transaminase decreased less in EN group than those in PN group(P＜0.01).The complication rates of anastomotic fistula,pulmonary infection,and delayedincision healing and average volume of pleural effusion were 0,13.8%,0,780ml in EN groups,while 3.2%,28.2%,7.2%,1842ml in PN group.Conclusion Early postoperative enteral nutirtion after esophageal carcinoma surgery can improve nutritional status and reduce complications in comparision with parenteral nutrition.

Objective:To investigate the clinical efficacy of Tofacitinib combined with leflunomide in the treatment of rheumatoid arthritis (RA) and its effects on Janus Kinase (JAK)/signal transduction and activator of transcription (STAT) signaling pathway-related proteins and Matrix metalloproteinase levels in serum of patients with RA.Methods:This was a prospective case-control study. A total of 80 patients with RA in our hospital from March 2020 to September 2021 were included into the study. They were divided into observation group and control group by random number table method, with 40 cases in each group. The patients in observation group were treated with Tofacitinib combined with leflunomide, while the patients in control group were treated with leflunomide alone. After 12 weeks of continuous treatment, the curative effect of the two groups was observed. Typical clinical manifestation [including Visual analogue scale (VAS) score of joint pain, number of tenderness joints, number of swollen joints, time of morning stiffness], disease activity score uses 28 joint counts (DAS28) scores, the MOS item short from health survey (SF-36) total scores and serum JAK3, STAT3, interleukin (IL)-6, IL-17 and matrix metalloproteinase (MMPs) levels were compared between the two groups before and after treatment. The adverse effects of the two groups were also analyzed. Chi-square test, paired sample t test, independent sample t test and Fisher exact probability method were used for statistical analysis. Results:After 4, 8 and 12 weeks of treatment, the american college of rheumatology (ACR)20 compliance rates in the observation group were 37.5%(15/40), 62.5%(25/40) and 80.0%(32/40), respectively, which were significantly higher than those in the control group at the same period [17.5%(7/40), 37.5%(15/40), 57.5%(23/40); χ2=4.01, P=0.045; χ2=5.00, P=0.025; χ2=4.71, P=0.030]. After 8 and 12 weeks of treatment, the ACR50 compliance rates in the observation group were [35.0%(14/40) and 47.5%(19/40), respectively, which were significantly higher than those in the control group at the same period 15.0%(6/40) and 20.0%(8/40), χ2=4.27, P=0.039; χ2=6.76, P=0.009]. After treatment, the joint pain VAS score, number of tenderness joints, number of swollen joints, DAS28 scores and SF-36 total scores in the observation group were lower than those in the control group( t=5.55, P<0.001; t=9.98, P<0.001; t=11.77, P<0.001; t=4.50, P<0.001; t=5.28, P<0.001), and time of morning stiffness was shorter than that in the control group ( t=4.76, P<0.001). After treatment, The serum levels of JAK3, STAT3, IL-6, IL-17, MMP-3, MMP-9 and MMP-13 in the obser vation group were (2 354±476) pg/ml, (1.04±0.17) ng/ml, (12.4±2.8) pg/ml, (30±5) pg/mL, (65±14) μg/L, (76±12) μg/L, (11.5±1.8) μg/L, which were lower than those in control group [(2 715±584) pg/ml (1.22±0.29) ng/mL, (16.8±3.6) pg/ml, (40±7) pg/ml, (98±15) μg/L, (123±20) μg/L, (14.9±2.8) μg/L, t=3.03, P<0.05; t=3.39, P<0.05; t=6.10, P<0.05; t=7.35, P<0.05; t=10.17, P<0.05; t=12.74, P<0.05; t=6.46, P<0.05]. The adverse reaction rate of the observation group [35.0%(14/40)] had no statistically significant difference compared with that in the control group [27.5%(11/40)]( χ2=0.52, P=0.469). Conclusion:The overall effect of Tofacitinib com bined with leflunomide in the treatment of RA is satisfactory and it is a safe and effective way to improve the clinical manifestation, disease activity and quality of life of patients with RA. The effect may be related to the significant down-regulation of the expression levels of Serum JAK/STAT signaling pathway-related Proteins and MMPs.

Drug Resistance, Neoplasm ; Humans ; Lymphoma, Non-Hodgkin ; drug therapy ; Tumor Microenvironment

Objective:To summarize the experience of five hospitals in Guangdong Province on successfully transporting retained passengers by chartered flights during the outbreak of the COVID-19.Methods:We retrospectively evaluated the operation and management, cabin arrangement, isolation requirements, and personnel protection in the aspect of epidemic prevention and control.Results:In 11 charter missions, over one thousand "healthy" passengers with potential risk of infections were transported back to China. The medical delivery team and flight crew were kept free of infection, passengers maintained zero cluster infections and no unexpected adverse events during the air transport.Conclusions:Our results indicate how to carry passengers in a scientific and orderly way is crucial for avoiding the transmission risks of the epidemic of COVID-19 among working staffers and passengers during air transportation.

OBJECTIVETo evaluate the clinical characteristics and prognostic factors of patients with primary gastro-intestinal marginal zone lymphoma (MALT).

METHODSRetrospective analysis was performed in 90 patients diagnosed with primary gastro-intestinal MALT lymphoma clinical characteristics and survival analyses.

RESULTSAmong 90 patients, 78 cases were originated from the stomach and 12 cases with extra-gastric origin. Eighty patients were classified as low-risk (IPI score 0-2), and 10 patients high-risk (IPI score 3-5). Compared to gastric MALT patients, extra-gastric cases presented with higher IPI score (7.7% vs 33.3%, P=0.025) and higher Hp infection rate (50.0% vs 87.2%, P<0.01). Treatment options for low risk patients (IPI score 0-2) included Hp eradication, surgery, radiotherapy and chemotherapy. Chemotherapy could improve progression-free survival (PFS) in low-risk patients. For high-risk patients, those receiving chemotherapy had 100% 3-year overall survival (OS). Univariate analysis revealed that ECOG (P=0.006), Mussh-off staging (P=0.008), IPI score (P=0.000), elevated LDH (P=0.019) and chemotherapy (P=0.026) were correlated with PFS. Multivariate analysis showed that higher IPI score (IPI 3-5) (OR=8.325, 95% CI 3.171-21.853, P=0.000) and chemotherapy (OR=0.319, 95% CI 0.121-0.838, P=0.020) were independent prognostic factors for PFS. ECOG (≥ 2) was independent prognostic factor for OS (OR=5.092, 95%CI 1.005-25.788, P=0.049).

CONCLUSIONPrimary gastro-intestinal MALT lymphoma was an indolent subtype of non-Hodgkin's lymphoma. Patients usually had low risk IPI and achieved long-term survival. Frontline therapy for low-risk patients was radiotherapy or Hp eradication, and chemotherapy for high-risk ones.

Disease-Free Survival ; Humans ; Intestinal Neoplasms ; Lymphoma, B-Cell, Marginal Zone ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; Survival Analysis