Objective To identify the multidimensional needs of postoperative gastric cancer patients for home-based nutritional management based on patient journey maps,and to provide a reference for carrying out nutritional management interventions.Methods Using descriptive qualitative research methods,we facilitated semi-structured in-depth interviews with 9 pairs of postoperative gastric cancer homebound patients and their primary caregivers from a tertiary general hospital in Yichang City,China,from September 2024 to January 2025,and analysed the data and drew the patient journey maps by content analysis.Results Totally 24 sub-themes were summarised from 4 aspects,namely tasks,emotions,pain points and opportunity points,and journey maps involving the acute recovery period,the transitional adaptation period and the nutritional reconstruction period were formed.Conclusion The nutritional needs of homebound patients after gastric cancer surgery are complex and variable,and their needs for dietary guidance,eating-related symptom management,and real-time counselling are highlighted.In the future,appropriate intervention strategies can be developed based on the journey maps to meet the multidimensional nutritional needs of patients.

Objective To identify the multidimensional needs of postoperative gastric cancer patients for home-based nutritional management based on patient journey maps,and to provide a reference for carrying out nutritional management interventions.Methods Using descriptive qualitative research methods,we facilitated semi-structured in-depth interviews with 9 pairs of postoperative gastric cancer homebound patients and their primary caregivers from a tertiary general hospital in Yichang City,China,from September 2024 to January 2025,and analysed the data and drew the patient journey maps by content analysis.Results Totally 24 sub-themes were summarised from 4 aspects,namely tasks,emotions,pain points and opportunity points,and journey maps involving the acute recovery period,the transitional adaptation period and the nutritional reconstruction period were formed.Conclusion The nutritional needs of homebound patients after gastric cancer surgery are complex and variable,and their needs for dietary guidance,eating-related symptom management,and real-time counselling are highlighted.In the future,appropriate intervention strategies can be developed based on the journey maps to meet the multidimensional nutritional needs of patients.

Objective To explore the mechanism of protective effect of Jianpi Yichang Powder on intestinal mucosa by observing its effect on the expression of autophagy-related molecules in colon of ulcerative colitis(UC)model rats.Methods SD rats were randomly divided into normal group,model group,Jianpi Yichang Powder group and sulfasalazine group.UC rat model was established by 2,4,6-trinitrobenzene sulfonic acid/ethanol solution.After the model was successfully reproduced,the rats were given drugs orally once a day for 14 days.The general condition of rats was observed and the disease activity index(DAI)score was calculated.The pathological morphology of colonic tissue in all groups was observed by hematoxylin eosin(HE)staining.Autophagy of colonic epithelial cells was examined by transmission electron microscope.The expressions of myosin-like BCL2 interacting protein(Beclin1)and microtubule-associated protein 1 light chain 3(LC3)in colonic tissue were detected by immunofluorescence staining and Western Blot.The mRNA expressions of autophagy protein 5(Atg5),autophagy protein 7(Atg7)and ubiquitin-binding protein 62(p62)were detected by real-time quantitative polymerase chain reaction(Real-time PCR).Results Compared with the normal group,the general situation of the model group was worse,and the DAI score increased significantly(P<0.000 1).There was obvious epithelial cell damage in colonic tissue,and the number of autophagosomes decreased obviously under electron microscope.The expressions of Beclin1 and LC3-Ⅱ/LC3-Ⅰ protein as well as Atg5 and Atg7 mRNA in colonic tissue decreased significantly(P<0.000 1),while the expression of p62 mRNA increased significantly(P<0.000 1).Compared with the model group,the general condition of rats in Jianpi Yichang Powder group had recovered significantly,and the DAI score decreased significantly(P<0.000 1).Pathological damage of colonic tissue has been improved in different degrees,and the number of autophagosomes increased significantly under electron microscope.The expressions of Beclin1 and LC3-Ⅱ/LC3-Ⅰ protein as well as Atg5 and Atg7 mRNA in colonic tissue were significantly increased(P<0.01,P<0.001,P<0.000 1),while the expression of p62 mRNA was significantly decreased(P<0.01).Conclusion Jianpi Yichang Powder can protect UC colon mucosa from injury by up-regulating the expression of autophagy-related molecules including Beclin1,LC3,Atg5 and Atg7,down-regulating the expression of p62 and enhancing autophagy.

Objective To investigate the safety of preoperative hepatic and regional arterial infusion chemotherapy in the prevention of liver metastasis and improving survival after curative colorectal cancer resection.Methods Patients admitted from 2001 to 2007 with Stage Ⅱ or Stage Ⅲ colorectal cancer were randomly assigned to receive preoperative hepatic and regional arterial infusion chemotherapy (PHRAIC group,n=256)or surgery alone(control group,n=253).Toxity of liver,hematology,immunology and post-operative complication of PHRAIC and the control were evaluated.Results Grade Ⅲ hepatic toxity,leukemia,anemia and platelet decrease in PHRAIC group was 3.1%(8/256),5.5% (14/256),7.4%(19/256)and 6.6%(17/256).There were no grade Ⅳ toxities,and all the patients in PHRAIC group received surgery.Morbidity rate in PHRAIC and the control group was 9.8%(25/256)vs 8.3%(21/253)(X2=1.86,P＞0.05).All patients were followed up,with mean follow up of 42±14 months until Oct 30.2007.For stage Ⅲ patients,5-year overall survival and liver metastasis rate were 81.0% in PHRAIc group vs.60.4% in control group(X2=5.15,P＜0.05)and 18.9%(28/148)vs 27.3%(41/150)(X2=5.41,P＜0.05),respectively.Conclusion Preoperative hepatic and regional arterial infusion chemotherapy 7 days before surgery was safe and could reduce liver metastasis and improve survival rate in patients with Stage Ⅲ colorectal cancer.