Objective To analyze the effect of preoperative nutritional risk screening on clinical outcomes, immune function and nutritional index in patients with colorectal cancer.Methods 140 cases with colorectal cancer between September 2015 and March 2016 were selected,according to the score of NSR 2002 screening scale,they were divided into A group (87 cases),which was less than 3 points,and B group (53 cases),which was more than 3 points.A group was divided into non nutrition support group (50 cases)and nutrition support group (37 cases), while B group was divided into non nutrition support group (21 cases)and nutrition support group (32 cases).The clinical outcomes,immune function,nutritional index and complication were compared.Results The clinical out-comes[(1.9 ±0.5)d vs.(1.3 ±0.4)d],immune function[(31.93 ±5.27)pg/mL vs.(31.46 ±4.68)pg/mL], nutritional index[(2.09 ±0.36)g/L vs.(2.01 ±0.32)g/L]of the non nutrition support group and nutrition support group of A group had no significant differences (t =0.992,0.981,0.991,all P >0.05 ).The clinical outcomes [(3.5 ±0.7)d vs.(2.2 ±0.6)d],immune function[(25.49 ±5.49)pg/mL vs.(56.41 ±9.52)pg/mL],nutritional index[(1.71 ±0.40)g/L vs.(1.94 ±0.35)g/L]of one week after operation of the non nutrition support group in B group were worse than nutrition support group (t =4.033,7.335,4.997,all P <0.05).The complication rate of non nutrition support group of B group was 16%,had no significant difference compared with nutrition support group (16.2%)(χ2 =1.926,P >0.05).The complication rate of non nutrition support group of A group was 21.7%, which was higher than that in nutrition support group (9.3%)(χ2 =7.299,P <0.05 ).Conclusion For newly admitted patients with colorectal cancer,nutritional risk screening in early admission,according to the physiological index test results such as nutritional index and screening results,get the nutritional status of patients,choose reasona-ble nutrition drug dosage and the infusion way on the need of nutritional support of patients in a timely and reasonable nutrition support,improve the postoperative nutritional status,and accelerate the postoperative recovery.

Objective:To evaluate and summarize the relevant evidence of comprehensive detumescence treatment of lower limb lymphedema in patients with gynecological malignant tumors, and to provide evidence-based basis for clinical intervention of comprehensive detumescence treatment of lymphedema.Methods:This study was an evidence - based nursing research. Databases such as BMJ Best Practice, UpToDate, PubMed, CNKI, Wanfang and other domestic and foreign databases, as well as websites such as the Australian Lymphology Society, the International Lymphedema, and the European Clinical Oncology Association were searched for relevant evidence and evaluation of comprehensive treatment of gynecological malignant tumor-related lower limb lymphedema. The search time was from the establishment of the database to April 1, 2022.Results:A total of 18 articles were included, including 2 guidelines, 5 systematic reviews, 4 expert consensus, 2 evidence summaries, 4 randomized controlled trials and 1 best practice. Twenty-eight evidence were summarized from 7 aspects : treatment cycle and edema stage, free-hand lymphatic drainage, graduated compression stockings, skin care, elastic socks, functional exercise and health education.Conclusions:The evidence summarized in this study can provide reference for clinical medical staff to formulate comprehensive treatment plans for lower limb lymphedema. Evidence-based practice should consider the individual status of patients and clinical scenarios, and provide personalized comprehensive treatment plans for patients with lower limb lymphedema of gynecological malignant tumors as soon as possible to improve the quality of life of patients.

Objective:To retrieve, obtain and summarize the best evidence for the prevention of recurrence in patients with diabetic foot, and to provide reference for clinical practice.Methods:According to the "6S" model of evidence-based resources, JBI, UpToDate, BMJ Best Practice, Cochrane Library, International Working Group on the Diabetic Foot, International Diabetes Federation, National Istitute for Health and Clinical Excellence, PubMed, EmBase, China National Knowledge Internet, Wanfang and China Biology Medicine disc were searched by computer for the prevention of recurrence of diabetic foot patients. The retrieval time limit was from the establishment of the database to April 2022. Two researchers independently evaluated the included literature and extracted the literature that met the quality standards.Results:Totally 12 articles were included at last, including 5 guidelines, 3 expert consensus and 4 Meta-analysis. From the six dimensions of the necessity and risk factors of recurrence prevention in diabetic foot patients, decompression brace prevention, surgery and wound management prevention, nutritional therapy prevention, health education and lifestyle prevention, monitoring and analysis, 18 pieces of best evidence were summarized.Conclusions:The best evidence for the prevention of recurrence of diabetic foot patients was summarized to provide evidence-based basis for management decision makers and decision implementers to prevent recurrence of diabetic foot. In the process of practice, medical workers should also fully evaluate the promoting factors and hindering factors in order to ensure that evidence can be better applied to clinical practice and serve patients.

OBJECTIVEMucopolysaccharidosis(MPS) is a congenital hereditary disease. Only a few patients with this disease can be controlled by enzyme replacement therapy. Most of them are short of effective interference. To exploit the effect of treatment with allogenic hematopoietic stem cell transplantation, two children were treated with the transplantation.

METHODSThe two patients included a 23 month MPS-IH and an 18 month old MPS-VI at the time of transplantation. Busulfan of 20 mg/kg plus 200 mg of Cyclophosphamide were used as the conditioning regimen. Peripheral stem cells were collected from a 9/10 high resolution matched unrelated donor and a matched sibling carrier donor, respectively. The heart and lung were affected in the patient with MPS-IH. Medium obstructed pulmonary impairment was found by pulmonary function test at the time of transplantation. Medium mitral valve countercurrent and patent ductus arteriosis(PDA) were found by Doppla examination.

RESULTSThe number of hematopoietic stem cells was comparative between the two donors with total nucleated cells and CD34+ cells of 11 x 10(8)/kg and 17 x 10(8)/kg, and 7.6 x 10(6)/kg and 7.2x 10(6)/kg respectively. Neutrophil engrafted at day 11. The process of transplantation in the MPS-VI patient went smoothly with grade II graft versus host disease(GVHD) briefly and only 1 U RBC and 2 U platelet were transfused. For the MPS-IH patient, the process of transplantation was tough with platelet reaching to 20 x 10(9)/L till day 40 and 5 U RBC and 7 U platelet were transfused during transplantation. Grade III GVHD was resolved by steroid, mycophenolate mofetil (MMF) and CD25 antibody. Pneumonia recurred 3 times with 2 times rescued by trachea intubation and mechanical ventilation because of accompanying acute heart failure. At day 14 the lymphocytes in both patients were 100% from donors as evidenced by short tandem repeat-PCR(STR-PCR). MPS associated enzyme activity was increased to 70 nmol/h.mg and 66 nmol/h.mg at 3 month and still remained 50.9 nmol/h.mg and 44.5 nmol/h.mg at 2 years post transplantation. Till now the 2 patients have been followed up for 25 months and 28 months with good general condition. The cardiac and pulmonary functions have improved obviously in the MPS-IH patient. The cornea became clear in this patient.

CONCLUSIONAllogeneic hematopoietic stem cell transplantation is an effective measure to treat patient with MPS-IH and MPS-VI. Transplantation at earlier stage of age can decrease transplant related complications. It requires longer time follow up for observing the clinical effects for these patients.

Female ; Follow-Up Studies ; Graft vs Host Disease ; drug therapy ; etiology ; Hematopoietic Stem Cell Transplantation ; adverse effects ; methods ; Humans ; Infant ; Intraoperative Complications ; drug therapy ; etiology ; Male ; Mucopolysaccharidoses ; enzymology ; pathology ; physiopathology ; surgery ; Recovery of Function ; Transplantation, Homologous