烧伤后早期应用中/长链甘油三酯对患者免疫功能的影响

目的　探讨烧伤后早期肠内喂养中链甘油三酯 (MCT) /长链甘油三酯 (LCT)对机体免疫功能的影响及其可能机制。　方法　选取 30例烧伤面积 >30 %TBSA的患者 ,随机分为两组 (每组 15例 )。F组 ,饲以含MCT/LCT的肠内营养制剂Fresubin 75 0MCT ;N组 ,饲以只含LCT的肠内营养制剂Nutrison。于伤后 2 4h内进行完全肠内营养支持 ,共持续 10d。于伤后 1、4、7、10d检测两组患者血浆白细胞介素 (IL) 2、IL 4、前列腺素 (PG)E2 及外周血T淋巴细胞转化率的改变。　结果　伤后各时相点F组患者血浆IL 2水平与N组相比 ,无明显差异 (P >0 .0 5 ) ;伤后 4dF组PGE2 水平较N组明显降低 (P <0 .0 1) ;伤后 4、7、10dF组IL 4水平及外周血T淋巴细胞转化率均明显高于N组 (P <0 .0 5～ 0 .0 1)。　结论　在改善烧伤后机体的免疫功能方面 ,含MCT/LCT的肠内营养制剂较单纯LCT制剂更具优势。     

早期肠内营养及其输注方式对大鼠重症急性胰腺炎病理和肠道功能的影响

目的:观察早期肠内营养及其不同输注方式对重症急性胰腺炎的影响。方法:采用胰管逆行注射建立大鼠重症急性胰腺炎(SAP)模型,假手术组用生理盐水,SAP组随机分为持续、间隙和未行肠内营养3个亚组(每组12只),假手术组同样分为3个亚组(每组8只)。各组于48 h后启动肠内营养,72 h后再次麻醉大鼠,收集组织及血液标本;检测指标包括肠道转运系数、血淀粉酶、器官细菌移位率、血清细胞因子TNF-α、胰腺病理评分及血浆D-乳酸等。结果:①、SAP后48h进行肠内营养并未加重胰腺炎;肠内营养组与未行肠内营养组在血淀粉酶、胰腺病理评分方面,差异无统计学意义(P>0.05);然而早期肠内营养可以促进肠蠕动,减少肠道细菌移位率,两组间在肠道转运系数、脏器细菌移位率及血清TNF-α水平方面,差异有统计学意义(P<0.05)。②、SAP行肠内营养的两种方式间,各项指标比较无显著差异。结论:SAP大鼠在早期行肠内营养是可行的,其可保持肠道生理的完整性、减少了脏器细菌移位率,但未改善预后;持续和间隙二种肠内营养输注方式间无显著差异。     

Toward affordable,sustainable eye care

Adapted from Keynote Addresses to the 5th General Assembly of the International Agency for the Prevention of Blindness, Berlin, Germany, May 9, 1994, and to the International Congress of Ophthalmology, Toronto, Canada, June 29, 1994.     

STUDIES ON NUTRITION AND PRECANCEROUS LESIONS OF THE ESOPHAGUS IN THE ADOLESCENTS

This paper reports the prevalence of chronic esophagitis and nutritional status among 538 young persons aged 15 to 26 years from the high risk area for esophageal cancer. Of these subjects, 166 were from households with history of esophageal cancer and 372 were from households without history of esophageal cancer. The Incidences of chronic esophagltis among male and female adolescents were 37. 6% and 36% respectively, which was significantly higher than those in the low risk area (17%). The frequency of chronic esophagltis in the adolescents in the households with history of esophageal cancer was aiso higher than in those In the households without history of esophageal cancer. The deficiencies of vitamins, especially of riboflavin and ascorbate, are prevalent and severe among these adolescents. Ascorbate deficiency Is correlated with the severity of the chronic esophagltis. These results indicate that chronic esophagltis may be involved in the natural history of esophageal carclnogenesis. Nutrient defic     

脂肪乳剂在重症急性胰腺炎营养治疗中的安全性及有效性分析

目的 :探讨脂肪乳剂应用于重症急性胰腺炎的安全性和有效性。　方法 :回顾分析重症急性胰腺炎病人肠外营养治疗期间 ,应用脂肪乳剂的影响。 74例重症急性胰腺炎病人行肠外营养治疗 ,按静脉营养液是否含脂肪乳剂分为脂乳组和非脂乳组。　结果 :脂乳组肠外营养治疗后清蛋白、前白蛋白改善显著 (P <0 .0 1 ) ,非脂乳组则无显著变化 (P >0 .0 5 ) ,脂乳组较非脂乳组改善明显 (P <0 .0 1 ) ;血清肌酐、尿素氮等在脂乳组治疗后下降明显 (P <0 .0 5 ) ,较非脂乳组改善显著 (P <0 .0 5 ) ;营养治疗结束后 ,脂乳组高血糖症状明显得到控制 (P <0 .0 1 ) ,而非脂乳组效果不佳 (P >0 .0 5 ) ,脂乳组优于非脂乳组 (P <0 .0 5 ) ;血淀粉酶均有下降 ,脂乳组未见异常增高。　结论 :重症急性胰腺炎病人输注脂肪乳剂安全有效 ,有助于恢复正氮平衡     

Microbial aspects of home enteral nutrition–a discussion

Factors that might contribute to the microbial contamination of enteral feeds prepared and administered in the home are reviewed and the significance of this contamination discussed. Numbers, types and sources of micro-organisms, and possible routes for contamination of home enteral feeds, are outlined and the role of cleaning and disinfection in reducing the microbial load is discussed. Some preliminary guidelines are suggested for the handling of enteral feeds in the home.     

Nutrition et fonction immunitaireNutrition and immune function

A deficiency of total energy or of one or more essential nutrients, including vitamins A, B₆, B₁₂, C, and E, folic acid, zinc, iron, copper, selenium, essential amino acids and essential fatty acids, will impair immune function and increase susceptibility of the host to infectious pathogens. This is most likely because these nutrients are involved in the molecular and cellular responses to challenge of the immune system. Providing these nutrients to deficient individuals restores immune function and improves resistance to infection. Thus, appropriate nutrition is required in order for the host to maintain adequate immune defences towards bacteria, viruses, fungi, parasites and tumour celîs. Although the intakes of several nutrients which result in greatest enhancement of immune function appear to be greater than recommended intakes, excess intake of certain nutrients also impairs immune responses. Some nutrients (e.g. glutamine, arginine) may become limiting in critical illness and there is mounting evidence that provision of these will aid patient recovery.     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

膀胱肿瘤化学防治的研究进展

膀胱癌是泌尿外科最常见的恶性肿瘤织一 ,由于复发率较高 ,死亡率逐年上升 ,防止肿瘤发生、发展和侵袭转移是降低膀胱癌高复发率和死亡率的关键。随着人们对膀胱肿瘤发生的分子生物学机制研究的深入 ,相关生物学标志物的相继问世以及某些化学药品和食品防癌作用的发现 ,尤其是癌症化学防治取得的一定的成功 ,使得防止和逆转膀胱肿瘤癌前病变成为可能 ,为此 ,本文对膀胱肿瘤化学防治近年的研究进展进行综述 ,为预防和控制膀胱肿瘤提供指导