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。     

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.     

Intravenous feeding with medium chain triglycerides. Effect on blood gases and the complement system in critically ill patients

Critically ill patients are usually in a catabolic state and may require total parenteral nutrition; this often includes lipid emulsions. Any adverse effects of constituents on pulmonary function, white cell function or the haemocoagulation system could have disastrous consequences in such patients. We have investigated the effects of a new intravenous lipid preparation containing medium chain triglycerides, which, in severely ill malnourished patients are theoretically a preferable energy source to conventional drug chain triglycerides. In a pilot study 17 critically ill patients whose lungs were artificially ventilated were given this lipid emulsion; no adverse effects were observed. Arterial oxygen and carbon dioxide tensions, ratio of inspired oxygen fractional concentration to arterial oxygen tension, platelet and white cell counts all remained constant and the complement system was not activated.     

针刺导管空肠造口术肠内营养在胰十二指肠切除术病人中的应用

目的探讨针刺导管空肠造口术(NCJ)肠内营养(EN)在胰十二指肠切除术病人中的应用效果。方法32例病人,16例术后肠外营养(PN)(对照组),16例术后行导管空肠造口术(NCJ)肠内营养(EN)治疗(实验组)。结果术后实验组的胃肠动力比对照组的恢复早(P<0.05)。治疗前两组病人血蛋白指标(白蛋白、前白蛋白、转铁蛋白)无明显差异。治疗后两组均升高,而实验组血蛋白指标的水平明显高于对照组(P<0.05),二者差异显著。结论导管空肠造口术(NCJ)肠内营养(EN)应用于胰十二指肠切除术病人中比肠外营养(PN)具有更多的优点。     

Influence of individually estimated portion size on the assessment of nutritional risk in colorectal cancer in Portugal

We evaluated the influence of individually estimated portion sizes on the estimate of nutrient related risk of colorectal cancer, using data from a Portuguese hospital based case-control study on diet and colorectal cancer. A total of 100 patients with colorectal adenocarcinoma (aged 15-92 years) and 211 controls (aged 36-89 years) were included. Two data sets were created for nutrient analysis, the first one allowed estimates of food intake using data on portion size as collected with visual aids during the interview. The second estimate substituted respondents' estimate with a standard portion size, as used in the semi-quantitative (SQ) food frequency approach. The two analytic approaches yielded similar energy and nutrient intakes in cases and controls. The percent range of concordance is acceptable, in the same quartile varying from 44 to 82% (mean: 56%) and very good in the same or adjacent (+/-1) quartile (mean: 91%, range: 85-97%). The two estimates lead to a similar pattern of multivariate odd's ratio, however the SQ estimates resulted in more significant findings. We conclude that little extra information is gained by including individual portion size information when assessing diet-related risk of colorectal cancer.     

Impact of early dietary gamma-linolenic acid supplementation on atopic eczema in infancy

Polyunsaturated fatty acids (PUFAs) are components of cell membranes and may play an immunomodulating role in the pathogenesis of atopic dermatitis (AD). The goal was to determine the impact of PUFAs on AD by dietary supplementation of infants. Based on the parents' decision on their babies' primary feeding, mothers and newborns were randomized to the supplementation with gamma-linolenic acid (GLA) or placebo for up to 6 months. Breastfed infants received GLA by supplementing their mothers. Formula diet was commercial whey hydrolysate unsupplemented with PUFAs. Of 131 eligible infants, 24 developed AD within the first year of life. Of these, nine belonged to the exclusively breastfed group (n = 58), 14 to the combined-fed group (n = 53), and one to the never breastfed group (n = 20). We could not find an influence of GLA on the development of AD. In subjects with AD, at 1 yr of age the serum-immunoglobulin E (IgE) was the lowest in the GLA-supplemented group A-subjects. In the GLA-supplemented group, GLA-levels in breast milk were similar in atopic and non-atopic infants. In the non-supplemented group the GLA-content of breast milk was 0.07% of total fatty acids in atopic infants vs. 0.17% in non-atopic infants (p < 0.01). Dietary GLA-supplementation could not prevent AD. Interestingly, the number of infants developing AD was the lowest in never breastfed children. In infants suffering from AD, GLA-supplementation seemed to reduce total IgE in the first year of life.     

食管贲门癌术后早期肠内营养支持的应用研究

目的研究食管贵门癌切除术中放置鼻肠营养管进行早期肠内营养，在维持机体营养、促进恢复履在防治术后并发症的作用。方法将90例管责门癌病人随机分为A、B两组，A组术后常规静脉输液，B组术中放置鼻肠营养管，术后第1天给予肠内营养。两组病人监测术前、术后第10天的体重、肠功能恢复排气时间、疲劳评分，吻合口瘘反感染并发症的发生率。结果两组病人在体重、肠功能恢复方面存在明显差异（P〈0．05），在术后并发症方面差异明显（P〈0．01）。结论鼻肠营养管进行早期肠内营养具有易于维持机体营养，促进机体康复，尽快恢复正氮平衡，减少术后并发症的优点。