早期肠道营养对烧伤后肠源性高代谢的影响

从８０年代末起，通过对６００只大（豚）鼠、６０只兔和６０头小香猪所建立的４种烧伤后早期营养的动物模型，以及２１例严重烧伤病人对比分析，发现烧伤后早期肠道喂养可改善胃肠道血流供应，减轻肠道缺血再灌流损伤；可维护肠粘膜结构以及吸收、分泌、运动功能，降低门脉、中心静脉血内毒素水平，减少肠道内毒素易位；可降低伤后枯否细胞获得数、吞噬墨汁枯否细胞数和面积，以及其培养上清中肿瘤坏死因子（ＴＮＦ）量，对伤后枯否细胞的活化有刺激作用；可降低血胰高糖素、皮质醇、儿茶酚胺、ＴＮＦ、ＩＬ－８前列腺素Ｅ２（ＰＧＥ２）等递质的水平，降低高代谢，使烧伤４５％成人静息能量消耗（ＲＥＥ）在烧伤后４、８、１４ｄ的均值降低２８．６％。通过相关分析发现ＲＥＥ与血丙二醛（ＭＤＡ）、内毒素、分解激素、ＴＮＦ均呈显著正相关（ｒ＝０．７３８６～０．９９２２，Ｐ＜０．０５～０．０１）。     

深静脉高营养（TPN）预防食管癌切除术后吻合口瘘的临床研究

本研究收集食管癌行食管癌切除胃代食管术病例２６５例，分为未用深静脉高营养组（ＮＴＰＮ）和深静脉高营养组（ＴＰＮ）。分别对各组临床资料进行比较分析，结果显示：ＴＰＮ组葡萄糖供给量（８．３７±２．１２ｇ／ｋｇ／２４小时）显著高于ＮＴＰＮ组（２．７７±０．７１ｇ／ｋｇ／２４小时）（Ｐ＜０．０１），（０．３０±０．１４ｇ／ｋｇ／小时）Ｐ＜０．０５。吻合口瘘发生率ＴＰＮ组（２．１％）则显著低于ＮＴＰＮ组（１５．２％）Ｐ＜０．００１。结果提示ＴＰＮ组可明显降低吻合口瘘发生率。作者于ＴＰＮ促进吻合的愈合，预防吻合口瘘发生的有关机理进行了讨论。     

表皮生长因子对全胃肠外营养大部小肠切除大鼠肠适应的实验研究

目的：观察应用表皮生长因子(EGF)对全胃肠外营养(TPN)大部小肠切除大鼠残存小肠黏膜的代偿作用。方法：30只大鼠切除80％小肠后分为对照组、常规TPN组、TPN EGF组，观测体重、小肠黏膜形态学改变，流式细胞仪分析肠黏膜细胞增殖活性。结果：术后3组大鼠体重逐渐降低，1周后渐增加。3组间差异无显著性。TPN组小肠肠壁各层均变薄，黏膜萎缩。TPN EGF组肠黏膜厚度、绒毛高度、隐窝深度较TPN组均增加，S期细胞比率系数、增殖指数TPN EGF组较TPN组高，而TPN捐与对照绸差异无昂著件。结论：TPN联合EGF可晟著地增讲肠黏膜的适应性代偿。     

全肠外营养对老年晚期消化系统恶性肿瘤病人生存期的影响

目的:评估全肠外营养(TPN)对老年晚期消化系统恶性肿瘤病人生存期的影响。方法:回顾性分析121例老年晚期消化系统恶性肿瘤病人TPN治疗后的生存期。结果:TPN治疗后,患者生存期不同程度延长,为9～126天,平均68.1天,多数在两月左右。结论:TPN可延长老年晚期消化系统恶性肿瘤病人的生存期。     

利多卡因用于放射性黏膜损伤所致口腔疼痛的疗效观察

目的观察利多卡因稀释液用于放射性黏膜损伤后口腔疼痛的疗效。方法首次诊断和初次治疗的头颈部放疗患者共90例，放射总剂量60—72Cy／30—35次，随机分为对照组44例和观察组46例；对照组患者放疗期间给予饮食指导和静脉营养支持，观察组患者除饮食指导和静脉营养支持以外，在口腔疼痛时和餐前给予利多卡因含漱液20ml含漱；当放射剂量达20、40、60Gy时比较两组患者的口腔疼痛分度状况和体重下降状况；所有资料采用秩和检验。结果观察组在放射剂量20、40、60Gy时，口腔疼痛和体重下降均明显少于对照组。结论利多卡因稀释液含漱能明显缓解放射性黏膜损伤所致的口腔疼痛，进而改善患者的进食和营养状况。     

A comparison of the effects of a macrobiotic diet and a western diet on drug metabolism and plasma lipids in man

Summary We have compared the effects of two dietary regimens with different macronutrient compositions — a macrobiotic diet and a Western diet — on drug metabolism and plasma lipids in seven healthy volunteers.The macrobiotic diet, high in carbohydrate, low in protein and fat, and devoid of animal food sources, was eaten for a ten day control period, as was the Western diet, high in calories, fat, and protein, as well as animal food sources. We determined the influences of these diets on the clearance of orally administered antipyrine, oxazepam, and methadone, as well as on plasma lipids.There was a statistically significant change in antipyrine clearance as well as in plasma LDL-cholesterol and HDL-cholesterol after the dietary periods. This suggests that the influence of dietary changes may have some effect on the clearance of therapeutic drugs. However, this is not universal and is probably important when the drug is highly dependent on the mixed-function oxidase system.     

静息能量消耗测定在慢性肝病中的应用

慢性肝病患者的静息能量消耗应采用开放式间接测热法测得,合理的能量代谢调整有助于肝功能改善并防止并发症发生,测定静息能量消耗可为慢性肝病患者营养支持治疗个体化提供依据。     

医学生营养知识与膳食状况调查

①目的了解医学生营养知识的掌握情况及对教育传播方式的需求意见，以加强营养知识教育，改善大学生的健康素质。②方法对762名在校大学生进行问卷调查。③结果医学院在校生对营养知识及常识掌握深度和广度都不够，但渴求得到营养知识的欲望比较高，对营养知识的重要性认识正确。有73．6％的学生认为营养知识对生活很重要。87．2％的学生愿意接受营养知识的教育，对营养知识教育的传播方式也表现出特有的需求意向。大学生的膳食结构不够合理，奶类、薯类、鱼虾禽类、豆制品摄入不足。④结论应加强医学生营养知识教育，使医学生做到科学合理的安排膳食，改善饮食行为，促进身体健康。     

DICOM通讯程序的设计

本文在研究DICOM协议的基础上，介绍了DICOM通讯的消息结构；从设计出发，分析了DICOM通讯过程的各个技术环节。     

Familial and socioeconomic influences on children''s well-being: An examination of preschool children in Kenya

As patterns of family formation change, it is important to know how children's lives are affected by their parents' marital and socioeconomic circumstances. Using data from the 1993 Kenya Demographic and Health Survey, this study shows that children of never married and formerly married mothers have significantly higher probabilities of polio dropout and acute undernutrition than those of monogamously married mothers. The number of male household members of working age greatly enhances the chances of full immunization and the nutritional status of children whose mothers were previously married. For children of never married mothers, the benefits of residing with males of working age are largely a function of ethnicity. The results also show that, although children are not disadvantaged nutritionally when their fathers have more than one wife, polygyny is associated with a higher probability of polio dropout and lower probability of full immunization than monogamy. Higher socioeconomic status is associated with a greater probability of full immunization and a lower probability of malnutrition but socioeconomic factors do not explain the effects of mothers' marital status. The findings underscore the complex realities of family interaction and the importance of the broader social context in accounting for variations in child welfare across diverse marital situations.