ObjectiveTo investigate the clinical advantages of enteral nutrition (EN) for acute pancreatitis（AP）comparing with parenteral nutrition (PN) and its prospect. MethodsLiteratures using MESH Browser in Medline were collected and reviewed. ResultsBeing of much higher cost and complications, total parenteral nutrition (TPN) ever regarded as most importantly for AP nutritional support, is now challenged by EN. Clinical evidence suggests enteral (jejunal) nutrition may diminish intestinal permeability to endotoxin and diminish bacterial translocation, thus reducing the cytokine drive to the generalized inflammatory response and preventing organ dysfunction, as well as achieving “pancreatic rest” equivalent to the TPN. Conclusion Early enteral nutrition should be used preferentially for patients with severe acute pancreatitis without paralytic ileus.
Forty critical patients with respiratory failure in the intensive care unit were randomly divided into two groups,Group A with administration of parenteral nutritino(PN) and Group B,no parenteral nutrition given.Blood gas analysis and respiratory monitoring showed that the respiratory rate,pH、PaO2、PaCO2 and HCO3- had no marked difference between the two groups.But in Group A there was a slight decrease of Pao2/FiO2 and a marked increase of A-aDO2 and the pulmonary shunt.This study indicates that the content of fat emulsion and hydrocarbon in PN may be the main factor that affects the respiratory function.
1993年10月至1994年2月对中—长链脂肪乳剂(实验组，n=40)和长链脂肪乳剂(对照组，n=30)在静脉营养中的疗效进行了对比观察。从术后第1天起，除从周围静脉输注必需液体外，每日静滴中—长链或长链脂肪乳剂500～1000ml，连续3～5天。监测项目包括血压、脉搏、呼吸、体温、血红蛋白、白细胞、肝肾功能、血甘油三酯及血胆固醇。结果显示：两组均无全笛反应；在输脂肪乳剂后6小时，两组血甘油三酯含量均明显升高，并于12小时时达峰值，16小时时已明显下降，但对照组明显高于实验组(Plt;0.05)，24小时时仍维持较高水平。由此表明，中—长链肪乳剂较易从血清中清除；中链甘油三酯能快速进入线粒体被氧化供能，不依赖内毒碱的转运，能经肝脏生成更多的酮体，极少再脂化为脂肪贮存起来。
Experienc of nurtitional treatment to 7 patients with acute renal failure (ARF) and nitrogemia after biliarty (tract) surgery is reported in this article. Nittrogen source inn all cases was obtained from "Renal Amine" and "7% Vamin" etc,which are composed of 8 essential amino acids (EAA), and the nergery sources are mainly supplyed by Intralipid (20 or 10%) and suitable amount of glucose. The nutritional admicture of "all in one" were employed as parenteral nutrition (PN). Satisfactary curative effecs in these patients were obtained. The suthors consider that (a) the nutritional treatment of different casuses of ARF should be providing enough energy and more EAA requirments than in normal need to synthesizw non-essential amino acide (NEAA) and protein from excessive blood urea nitrogen (BUN) for redcuing pritein breakdown and nitrogemia, and (b) 20% Intralipid is an effective low-volume, highly calories nutritional agent specially in ARF patients with restiction of waterr.
Objective To study the manageable methods, effect of early use of enteral nutrition after operations on esophageal cancer patients. Methods By different way of nutritional support after operation, 209 cases of esophageal cancer were divided into two groups in which enteral nutrition（EN） group,146 cases, were managed with early use of nutritional support through intestine and parenteral nutrition（PN） group, 63 cases, were given nutrition by way of veins. Complications, general recovery and blood biochemical criteria after operation between those two groups were compared. Results No cases of anastomotic fistula occurred in the two groups. The incidence of complications in EN group was significantly lower than that in PN group（P〈0.01）, and the occurrence of diarrhea was higher in EN group （P=0. 000）. The time needed for recovery of bowel sounds, anal exsufflation, defecation and hospital stay was shorter and hospital fee lower in EN group than those in PN group（P=0. 000）. The total amount of gastrointestinal and closed thoracic drainages decreased more significantly in EN group （P= 0. 000） and the value of albumin, globulin and total protein was significantly higher also in EN group （P = 0. 000）. But the amount of BUN, creatinine and neutrophil was significantly lower in EN group （P = 0. 000）. Conclusion Early use of enteral nutrition after operation on esophageal cancer is safe, effective and practical, with more significant advantages than those of parenteral nutrition.
Objective To research the effect of ω-3 polyunsaturated fatty acid (PUFA) on promoting the postoperative rehabilitation of patients with gastrointestinal malignancies in order to decrease the incidence of postoperative complications and the days of postoperative hospital stay. Methods Forty patients with gastrointestinal malignancies in West China Hospital of Sichuan University from February 1st, 2009 to June 1st, 2009 were included and allocated to experimental group (20 cases) and control group (20 cases) randomly. Seven days parenteral nutrition was provided to them after operation. Compared with control group, ω-3 PUFA with a dose of 10 g was given to experimental group every day additionally. Blood samples were gained before operation, on the morning of day 2 and day 8 after operation respectively to measure hepatorenal and immune indexes. Temperature before and 1-7 d after operation, time of passing flatus to normal, postoperative complications and the postoperative hospital stay were recorded. Results There was no statistical difference in the baselines between experimental group and control group （Pgt;0.05）. The level of total bilirubin in experimental group was lower and the levels of NK cell and B cell in experimental group were higher than those in control group on day 2 after operation, there were statistical differences between them (Plt;0.05). The levels of ALT, AST and blood urea mitrogen in experimental group were lower and the levels of CD4+ cell and NK cell in experimental group were higher than those in control group on day 8 after operation, there were statistical differences between them, too (Plt;0.05). The time of passing flatus to normal and days of staying in hospital after operation in experimental group were shorter than those in control group, there were statistical differences between them (Plt;0.05). There was no statistical difference in postoperative average temperature and incidence of complications between two groups （Pgt;0.05）. Conclusions ω-3 PUFA has positive influence on the recovery of hepatorenal, immune and gastrointestinal function, and can shorten the days of postoperative hospital stay; but there is no effect on incidence of complications after operation.
【Abstract】ObjectiveTo investigate the effects of rhGH on hypoalbuminemia in cirrhotic rats after partial hepatectomy. MethodsThirty rats were randomly divided into normal control group (n=6), liver cirrhosis group (LC group, n=6), liver cirrhosis and hepatectomy group (LCH group,n=6), PN (parenteral nutrition) group (n=6， given PN after hepatectomy) and rhGH+PN group (n=6,given rhGH and PN after hepatectomy). Liver function and blood glucose were measured. The expression of ALB mRNA was detected by RTPCR. Liver Ki67 immunohistochemistry was studied. ResultsCompared with PN group, serum ALP was lower; serum ALB and blood glucose were higher in rhGH+PN group. The expression of hepatic ALB mRNA was higher, and hepatic Ki67 labeling index was higher as well in this group. ConclusionrhGH can improve hypoalbuminemia after partial hepatectomy in cirrhotic rats with partial hepatectomy.
ObjectiveTo observe the effect of health education on hand, foot and mouth disease knowledge of the parents and their psychological status, in order to provide a reference for regulating clinical intervention measures. MethodsBetween October 2011 and February 2013, self-made questionnaire was used to survey the parents of 286 children with hand, foot and mouth disease for their knowledge about the disease. We promoted health education including distributing pamphlets, holding lectures, and carrying out psychological counseling. Then, parents' knowledge and their psychological status were compared before and after the implementation of health education. ResultsAfter health education, parents' suspicion, anxiety, fear, indulgence in children and other negative psychological scores were significantly lower than those before intervention (P<0.05). Their knowledge on the disease was also significantly enhanced (P<0.05). Gender, age and educational background were the main influence factors for health education. ConclusionMulti-form comprehensive health education can enhance parents' knowledge on hand, foot and mouth disease effectively and alleviate various negative psychological situations, which assists them to participate in the treatment work actively, thus greatly promotes early rehabilitation of the child patients.
ObjectiveTo investigate the medical knowledge and treatment compliance of parents of asthma children in Gaoming District, Foshan City. MethodOne hundred consecutive parents of asthma children who sought pediatric service in Gaoming People's Hospital from January to December in 2012 were surveyed by the use of Knowledge-Belief-Behavior Questionnaire developed by Capital Research Center of Pediatrics. ResultsNinety-five of the one hundred questionnaires provided useful data for analysis. Among these parents, 63.18% understood the nature of asthma being hyperactive inflammatory disease of the airways; 78.91% believed it to be controllable by regular treatment; only 21.05% of asthma children under parental guidance received inhaled corticosteroids on a regular basis; 14.74% considered their children fit for physical exercises when stabilized; 22.10% chose inhaled β2 agonists as "relievers" during attacks; 61.05% were concerned about the side effects on growth of inhaled corticosteroids and 48.42% discontinued its use against physician's instruction; 82.11% of asthma children had not been evaluated by Asthma Control Questionnaire. ConclusionsParents of asthma children in Gaoming District, Foshan City have weak links in the understanding of this condition. Though most believe it to be controllable under regular treatment, the overall compliance is unsatisfactory. Therefore, knowledge of asthma should be propagated at various public fronts in order to better improve the treatment compliance and consequently the disease control, of asthma children.
ObjectiveTo investigate the psychological states and their influencing factors in parents of congenital defect neonates admitted to Intensive Care Unit (ICU). MethodsThe self-designed general information questionnaire was used to collect the demographic data, and self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to evaluate the states of anxiety and depression of the parents of congenital defect neonates admitted to ICU between June 1 and November 29, 2013. ResultsA total of 152 parents were included in this investigation. The average score of SAS was 39.45±8.53. The average score of SDS was 43.28±10.76. Univariate analysis found that parents with lower educational level, poorer family income, positive family history and countryside residence might have higher score of SAS, while parents with Han nationality, poorer family income and family history would have higher score of SDS. Multivariate analysis discovered that living condition and family history were related to anxiety status. However, depression state was influenced by nationality, family income and family history. ConclusionA considerable number of parents of congenital defect neonates admitted to ICU have anxiety or depression. And nationality, family income, family history and living condition are the major risk factors.