Objective To study the value of combined parenteral and enteral nutrition support with chemotherapy for advanced gastrointestinal cancer in elder patients.Methods Totally 79 patients admitted from 2006 to 2011 were randomly divided into two groups using random number table:the treatment group (n=42) was provided with combined parenteral and enteral nutrition support and chemotherapy,the control group(n =37) was treated with chemotherapy only.Nutritional risks were screened at admission.After two cycles of chemotherapy,the nutritional status,Karnofsky performance score,toxic reaction,and nosocomial infection rate were compared betweeen these two groups.Results After 2 cycles of chemotherapy,the body mass index[(19.00±3.31) kg/m2 vs.(18.24±1.98) kg/m2,P=0.04],albumin [(33.90±1.50) g/Lvs.(29.90±2.38) g/L,P=0.02],prealbumin [(28.19±1.50) g/Lvs.(25.51 ±8.38) g/L,P=0.01],hemoglobin [(107.0 ± 6.90) g/L vs.(104.20 ± 9.70) g/L,P =0.02],and lymphocyte levels [(2.99 ±0.55) × 109/L vs.(2.63 ±0.20) × 109/L,P =0.03] were all significantly higher in the treatment group.The incidence of myelosuppression in the treatment group was 28.57％,significantly lower than that in the control group (83.78％,P =0.00) ; such difference was also detected in patients with nutritional risk in the 2groups (31.03％ vs.95.45％,P =0.00).The incidences of nosocomial infection in the treatment group were significantly lower than in the control group after both the first and the second cycle of chemotherapy (0 vs.10.81％,P=0.03; 2.38％ vs.27.03％,P=0.02).Conclusions Combined enteral and parenteral nutrition support with chemotherapy in elderly patients with advanced gastrointestinal caner could improve nutritional status,reduce toxic reaction,and prevent nosocomial infection.Therefore combined nutrition support is a safe and effective approach for elderly patients with advanced gastrointestinal cancer.

Objective To investigate the effect of Bmal1 on proliferation in gastric cancer cells and the molecular mechanism, and to provide theoretical and experimental basis for further research targeting circadian therapy for gastric cancer. Methods Applying RNAi technique to silence Bmal1 gene in BGC823 was regarded as experimental group. The normal BGC823 was as control group. The inhibitory effect of the cell line was measured by MTT assay. The mRNA expression of p53, c-Jun and c-Fos was evaluated by real-time RT-PCR. Results Comparing with the data of control group,the inhibitive rates of cell growth in experimental group after 6 h,12 h,24 h were 5.78%(P=0.001),9.20%(P=0.00)and 83.08%(P=0.00)respectively. Down-regulation of Bmal1 decreased p53 (P<0.05), while increased c-Fos and c-Jun expression (P > 0.05). Conclusion RNAi targeting Bmal1 has effects on gastric cancer proliferation by down-regulating p53 mRNA.

Objective To investigate the relationship between the cell cycle blocked by hyperthermia and the expression of rhythm gene Bmall in gastric cancer MKN28 cells so as to provide the academic evidence in hyperthermia therapy for gastric cancer.MethodsThe MKN28 cells were resuscitated and cultured in vitro.In control group MKN28 cells were cultivated at 37 ℃.In experimental groups MKN28 cells were heated at 43 ℃ for different durations.The cell morphology was observed by microscopy.Methylthiazdyl tetrazolium (MTT) assay was adopted to evaluate the inhibitory effect of the cell line.The flow-cytometry was adopted to observe the influence on the cell cycle.The Bmall mRNA expression was investigated by real-time quantitative reverse transcription-polymerase chain reaction ( RT-PCR).ResultsThe remarkable changes of cell morphology were observed by microscopy after exposure to heating.According to the data of MTT assay,37 ℃ heating could not inhibit the proliferation of MKN28.The inhibitive rates of cell growth after 0.5 h,1 h,l.5 h at 43 ℃ was (21.76±5.46)％,(25.30 ±4.36)％ and (27.62 ± 3.78 )％,respectively.Results from flow-cytometry showed that G0/G1 phase cells in lh at 43 ℃ were remarkably less than those in the control group.However G2/M cells were significantly more than those in the control group.The mRNA expression of Bmall was the lowest when heating lh at 43 ℃ as compared to the control group.ConclusionsHyperthermia could induced the cell cycle changes and the expression of Bma11 in gastric cancer MKN28 cells.

Objective This study aims to explore the formation of the dilemma of"giving care"for disabled elderly people in nursing homes from the perspective of active health.Methods Purposive sampling was used to select caregivers and disabled elderly people from a nursing home in Chongqing as research subjects from July 2022 to December 2022.One-on-one in-depth interviews were conducted and Colaizzi's 7-step thematic analysis method was employed to collect and analyze the interview data.Results 4 themes were identified:①the dominance of the"giving"care concept,including the cultural thoughts of filial piety,passive acceptance of care characteristics and consumer psychology regarding paid services;②insufficient"participation"care ability,including lack of knowledge regarding active health and a weakening of skills to promote participation;③the hindrance to"transformation"of care models,including objective limitations in terms of human resources and delays in adapting aging environments;and ④the decline in"utilization"of internal abilities,including excessive avoidance of potential risks,a heavy workload of care and poor quality of individual care.Conclusion The formation of the dilemma of"giving care"for disabled elderly people in nursing homes is affected by multiple factors such as social background,service system,supply resources,and management mode.Transforming disabled elderly individuals from a state of"passive giving care"to"active participation in their health"is an important measure to realize the concept of positive aging and healthy aging.