This paper highlights the specific nursing experiences in an early inflammatory bowel obstruction of a patient after the surgery for abdominal cocoon syndrome.Immediately after the surgery,the nursing care focused on prevention of postoperative metabolic disorders,including dynamic monitoring and correction of refeeding syndrome and goal-oriented sequential nutritional support management.Over the period of postoperative recovery,the nursing care shifted to prevention and treatment of early postoperative inflammatory bowel obstruction,including dynamic monitoring and identification of an early postoperative inflammatory bowel obstruction,goal-oriented early postoperative inflammatory small bowel obstruction(EPISBO)fluid therapy together with the traditional Chinese medicine to promote bowel movement and control inflammation,the auricle copper-blade Gua Sha combined with auricular point sticker compression to regulate qi and reduce bowel flatulence,as well as a goal-oriented early mobilisation to prevent a re-obstruction of bowel.The patient discharged at 28 days after surgery without an event.At the 6 months of postoperative follow-up,the patient was found in continuous improvement of relevant indicators and increase of body weight.

This paper highlights the specific nursing experiences in an early inflammatory bowel obstruction of a patient after the surgery for abdominal cocoon syndrome.Immediately after the surgery,the nursing care focused on prevention of postoperative metabolic disorders,including dynamic monitoring and correction of refeeding syndrome and goal-oriented sequential nutritional support management.Over the period of postoperative recovery,the nursing care shifted to prevention and treatment of early postoperative inflammatory bowel obstruction,including dynamic monitoring and identification of an early postoperative inflammatory bowel obstruction,goal-oriented early postoperative inflammatory small bowel obstruction(EPISBO)fluid therapy together with the traditional Chinese medicine to promote bowel movement and control inflammation,the auricle copper-blade Gua Sha combined with auricular point sticker compression to regulate qi and reduce bowel flatulence,as well as a goal-oriented early mobilisation to prevent a re-obstruction of bowel.The patient discharged at 28 days after surgery without an event.At the 6 months of postoperative follow-up,the patient was found in continuous improvement of relevant indicators and increase of body weight.

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 investigate the incidence of high-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangement in Chinese diffuse large B-cell lymphoma (DLBCL) .Methods:From January 2013 to August 2020, 922 DLBCL cases were collected. C-MYC and BCL2 protein expression levels were analyzed by immunohistochemistry staining. Fluorescence in situ hybridization was used to detect the structural abnormalities of MYC, BCL2, and BCL6, including gene breaks and copy number changes.Results:MYC and BCL2 and/or BCL6 gene breaks were found in 29 out of 922 DLBCL cases (3.15%) , including 25 cases of double-hit lymphoma (DHL; 14 cases involving MYC and BCL2 rearrangements and 11 cases involving MYC and BCL6 rearrangements) and four cases involving MYC, BCL2, and BCL6 rearrangements, referring to triple-hit lymphoma. According to the threshold of C-MYC ≥40% and BCL2 ≥50%, 541 cases (58.68%) overexpressed C-MYC and BCL2 proteins, including 22 DHL cases. Moreover, according to the threshold of C-MYC ≥70% and BCL2 ≥50%, 52 cases (5.64%) overexpressed C-MYC and BCL2 proteins, including nine DHL cases. The P53 protein expression was detected by immunohistochemistry staining. The mutant P53 expression pattern was shown in 101 out of 709 cases (14.25%) , whereas 13 cases (1.83%) were negative, likely indicating P53 gene fragment deletion.Conclusion:The incidence of high-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements was low in DLBCLs, and no significant correlation between gene abnormality and protein overexpression was shown. The correct diagnosis of DHL depends on molecular genetic detection.