Risk factors and establishment of a nomogram prediction model for hypoproteinemia after hip revision / 中国组织工程研究

BACKGROUND:The high rate of postoperative hypoproteinemia in patients undergoing hip revision is associated with severe trauma,which affects the rapid recovery of patients. OBJECTIVE:To investigate the risk factors of perioperative hypoproteinemia in patients with hip revision,and to provide guidance for early screening of high-risk patients with postoperative hypoproteinemia. METHODS:According to the inclusion and exclusion criteria,161 patients who underwent hip revision were divided into hypoproteinemia group(76 cases)and normal group(85 cases).The rate of hypoproteinemia was 47.2%.Data such as age,gender,body mass index,osteoporosis,operation time,preoperative erythrocytes,preoperative hemoglobin,preoperative leukocytes,preoperative platelets,preoperative fibrinogen,preoperative C-reaction protein,preoperative sedimentation rate,preoperative blood calcium,preoperative albumin,postoperative drainage tube placement,American Society of Anesthesiologists score,and postoperative hypoproteinemia were collected.SPSS software was used to analyze the independent risk factors of hypoproteinemia after hip revision using multivariate binary logistic regression analysis.R software was used to construct the nomogram prediction model.Receiver operating characteristic curve and calibration curve and decision curve were drawn to evaluate the model. RESULTS AND CONCLUSION:(1)Univariate analysis results showed that body mass index,preoperative erythrocytes,preoperative hemoglobin,preoperative platelets,preoperative fibrinogen,preoperative C-reaction protein,and operation time were significantly different between the two groups(P<0.05).(2)Multivariate binary Logistic regression analysis results showed that body mass index(OR=0.859,P=0.021),operation time(OR=1.010,P=0.002),preoperative erythrocytes(OR=0.424,P=0.036),and preoperative C-reaction protein(OR=1.043,P=0.032)levels were independent risk factors for postoperative hypoproteinemia in patients with hip revision.(3)Based on four independent risk factors:body mass index,operation time,preoperative erythrocytes and preoperative C-reaction protein,the nomogram can effectively predict the risk of hypoproteinemia after hip revision.This nomogram prediction model has good differentiation and accuracy,and may lead to better clinical net benefits for patients.

Early enteral nutrition in postoperative patients of gastric cancer / 肠外与肠内营养

Objective:To investigate the effects of early postoperative enteral nutrition on recovery of patients with gastric cancer.Methods:Sixty-five cases of patients with gastric cancer were randomized into early enteral nutrition (EEN) group and enteral nutrition (EN) group.Serum total protein (TB),albumin(ALB),Prealbumin,white blood cell count (WBC),C-reactive protein (CRP),immunoglobulin,peripheral T-lymphocyte subsets,gastrointestinal recovery time,hospital stay and cost were recorded.The nutritional and cellular immunity parameters of the EEN group on 7th day after operation were higher than those of the EN group.Inflammatory response of the EEN group on 3th day after operation was lower than EN group.EEN group showed better immunological response and clinical recovery than the EN group (P ＜ 0.05).Conclusion:Early enteral nutrition in postoperative gastric cancer patients can improve early postoperative nutritional status and immune function,alleviate inflammatory response,promote the recovery of intestinal function and shorten hospital stay.