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。     

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。     

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.     

Insults to the body civil: Mistreatment of elderly in two Plains Indian tribes

The mistreatment of elderly is subject to various social constructions. On two geographically distinct Plains Indian Reservations which we call Lone Mountain and Abundant Lands, the abuse or neglect of elderly is construed as a health problem which is a dysfunction of the community as a whole. Both physical abuse and neglect are more common on the Lone Mountain Reservation, occurring in association with other indicators of community disorganization such as unemployment and substance abuse. On the Abundant Lands Reservation physical abuse was categorically denied and what neglect existed appeared to be a function of role strain, geographic dispersal, climate and terrain. We attribute differences in the prevalence of mistreatment of elders to variations in economic opportunities for younger residents. Examining the historical and present contexts of intergenerational relationships on the reservations, we discuss the implications of this study for social exchange theory and policy applications.This research was supported by the Gerontological Society of America AppliedThis research was supported by the Gerontological Society of America AppliedThis research was supported by the Gerontological Society of America AppliedThis research was supported by the Gerontological Society of America AppliedThis research was supported by the Gerontological Society of America AppliedThis research was supported by the Gerontological Society of America Applied     

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。