Objective:To investigate the effectiveness of target energy-based oral nutritional support in the nutritional management of postoperative Crohn′s disease (CD) patients.Methods:A retrospective analysis was conducted. CD patients who underwent laparoscopic ileocecal and colonic resection and were managed with a conventional diet at the First Affiliated Hospital of Sun Yat-sen University from January 2020 to December 2020 were defined as conventional diet group. Another group of CD patients who underwent the same surgery from January 2021 to December 2021 and were managed with a target energy-based oral nutrition support model were defined as gradient diet group. The intestinal nutritional tolerance on the 4th day after surgery, body mass index (BMI) and serum albumin levels at 4 weeks after surgery, as well as prealbumin levels at 1st and 4th weeks after surgery, and length of hospital stay were compared between the two groups.Results:A total of 61 CD patients were included, with 31 in the conventional diet group and 30 in the gradient diet group. The gradient diet group showed significantly better intestinal nutritional tolerance, BMI, albumin levels at 4th weeks after surgery, as well as prealbumin levels at 1st and 4th weeks after surgery compared to the conventional diet group, with all differences being statistically significant ( P<0.01). The gradient diet group also had a significantly shorter length of hospital stay compared to the conventional diet group, with a statistically significant difference ( P<0.05) . Conclusions:The target energy-based oral nutrition support model for CD patients after surgery demonstrats better intestinal nutritional tolerance, more pronounced improvement in nutritional status, and more specific and feasible dietary guidance compared to the conventional diet management model. It also results in a shorter length of hospital stay for CD patients after surgery, suggesting its potential for clinical application and promotion.

Objective:To investigate the effectiveness of target energy-based oral nutritional support in the nutritional management of postoperative Crohn′s disease (CD) patients.Methods:A retrospective analysis was conducted. CD patients who underwent laparoscopic ileocecal and colonic resection and were managed with a conventional diet at the First Affiliated Hospital of Sun Yat-sen University from January 2020 to December 2020 were defined as conventional diet group. Another group of CD patients who underwent the same surgery from January 2021 to December 2021 and were managed with a target energy-based oral nutrition support model were defined as gradient diet group. The intestinal nutritional tolerance on the 4th day after surgery, body mass index (BMI) and serum albumin levels at 4 weeks after surgery, as well as prealbumin levels at 1st and 4th weeks after surgery, and length of hospital stay were compared between the two groups.Results:A total of 61 CD patients were included, with 31 in the conventional diet group and 30 in the gradient diet group. The gradient diet group showed significantly better intestinal nutritional tolerance, BMI, albumin levels at 4th weeks after surgery, as well as prealbumin levels at 1st and 4th weeks after surgery compared to the conventional diet group, with all differences being statistically significant ( P<0.01). The gradient diet group also had a significantly shorter length of hospital stay compared to the conventional diet group, with a statistically significant difference ( P<0.05) . Conclusions:The target energy-based oral nutrition support model for CD patients after surgery demonstrats better intestinal nutritional tolerance, more pronounced improvement in nutritional status, and more specific and feasible dietary guidance compared to the conventional diet management model. It also results in a shorter length of hospital stay for CD patients after surgery, suggesting its potential for clinical application and promotion.

Objective:To correlate multiphase CT angiography (mCTA), serum lipid peroxidation (LPO) and thrombus precursor protein (TpP) levels with recurrence of acute cerebral infarction (ACI) in older adults and investigate the value of these indicators in the predication of ACI recurrence.Methods:A total of 128 older adult patients with ACI who received treatment in Ningbo Medical Center Lihuili Hospital, China between January 2019 and January 2020 were included in this study. All of them were followed up for 1 year. They were divided into ACI recurrence group ( n = 29) and no ACI recurrence group ( n = 99) according to whether they had recurrent cerebral infarction. All patients underwent mCTA. Maas system and Tan score were used according to mCTA images. Serum TpP level was measured using enzyme-linked immunosorbent assay. Serum LPO level was measured using Yagi's fluorescence method. Multiple linear regression analysis was used for correlation analysis. The receiver operating characteristic (ROC) curve was used to evaluate the efficacy of mCTA and serum LPO and TpP levels in the diagnosis of ACI. Results:Tan score in the ACI recurrence group was significantly lower than that in the no ACI recurrence group [(1.06 ± 0.26) points vs. (1.89 ± 0.82) points, t = 5.35, P < 0.05]. Serum TpP and LPO levels in the ACI recurrence group were (7.22 ± 1.35) mmol/L and (11.23 ± 2.58) nmol/mL, respectively, which were significantly higher than those in the no ACI recurrence group [(3.06 ± 0.28) mmol/L, (7.23 ± 0.37) nmol/mL, t = 28.86, 15.04, both P < 0.001]. ACI recurrence in older adult patients was correlated with Tan score and serum LPO and TpP levels (both P < 0.05). The sensitivity of mCTA combined with serum LPO and TpP levels in the diagnosis of ACI in older adults was 93.10%-96.60% and its specificity was 100.00%. The ROC curve analysis showed that the area under the ROC of mCTA, LPO and TpP in the prediction of ACI recurrence in older adults was 0.986 (95% CI = 0.966-1.000), 0.976 (95% CI = 0.930-1.000) and 0.968 (95% CI = 0.905-1.000), respectively. Conclusion:ACI recurrence in older adults is correlated with Tan score and serum LPO and TpP levels. mCTA, Tan score, and serum LPO and TpP levels have high sensitivity and specificity in the diagnosis of ACI recurrence in older adults, and therefore have a high diagnostic value.

Objective To retrospectively compare the efficacy and toxicity between intensity?modulated radiotherapy ( IMRT ) combined with chemotherapy plus targeted therapy and IMRT combined with chemotherapy in the treatment of patients with locally advanced nasopharyngeal carcinoma ( NPC) , and to preliminarily evaluate the necessity of adding targeted drugs to standard chemoradiotherapy . Methods Forty?two patients with stage Ⅲ?Ⅳb NPC who received IMRT combined with concurrent ± adjuvant chemotherapy plus targeted molecular therapy from January 2007 to December 2012 were assigned to experiment group,while 168 patients who received IMRT combined with concurrent ±adjuvant chemotherapy within the same period were assigned to control group. The experiment group was paired with the control group at a ratio of 1vs.4.The survival rates were caculated using Kaplan?Meier method and analyzed using log?rank method,other comparison was perfomed by χ2?test. Results The follow?up rate was 100%.The sample size of experiment group and control group were 42 patients and 168 patients. There were no significant differences in the 3?year OS, LRFS, or DMFS rates between the experiment group and the control group (94?3% vs. 87?3%, P=0?647;100?0% vs. 94?6%,P=0?193;92?2% vs. 89?1%, P=0?744).There were also no significant differences in the incidence rates of grade Ⅲ?Ⅳ gastrointestinal reaction or marrow suppression between the two groups ( 7?1%( 3/42 ) vs. 3?6%( 6/168 ) , P=0?388;26?2%( 11/42 ) vs. 17?3%(29/168),P=0?272).However,the experiment group had significantly higher incidence of grade Ⅲ?Ⅳoral mucositis than the control group ( 40?5%( 17/42 ) vs . 14?9%( 25/168 ) , P=0?000 ) . Conclusions The preliminary results indicate that IMRT combined with chemotherapy plus targeted molecular therapy is not able to substantially improve the OS, LRFS, or DMFS rates in patients with locally advanced NPC. Moreover, it may aggravate radiochemotherapy?induced oral mucositis.