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Objective To evaluate the effect of nutrition support on nutritional status and clinical outcome of patients at nutritional risk in internal medical departments.Methods 148 patients at nutritional risk as identified by Nutritional Risk Screening 2002 were numbered according to the order of admission and divided into standard care group (control group,odd numbers,n =75) and individualised nutrition support group (intervention group,even numbers,n =73).Intervention consisted of encouraging food intake,designing food plan,and assuring implementation of food prescription.Energy and protein intake,body weight,length of hospital stay,hospitalization expenses and complications were compared between the two groups.Results In the interventions group,protein intake was significantly higher than that in the control group [(45.1 ± 2.2) g/d vs.(54.8±2.5) g/d,P=0.004],and energyintake higher than that in the control group [(4 180.0± 227.4) kJ/d vs.(4 589.6 ± 150.5) kJ/d,P =0.135] but without statistical significance.Intervention led to an intake of ≥75％ of requirements in 46.6％ patients in the intervention group,significantly higher than the proportion in the control group (30.7％) (P =0.047).The change of body weight was significantly smaller in the intervention group than in the control group [(-0.4 ± 0.2) kg vs.(-1.1 ± 0.2) kg,P =0.025].The length of hospital stay,hospitalization expenses,and incidence of complications showed no significant differences between the control group and the intervention group [(13.5 ±0.9) d vs.(12.4 ±0.6) d,P=0.310;(17834±1824) yuanvs.(16099±1243) yuan,P=0.435;12.8％ vs.8.1％,P=0.184].Conclusions Patients at nutritional risk in internal medical departments could benefit from nutrition support in terms of protein intake and body weight maintenance.A large-scale randomized controlled trial is necessary to confirm the effect of nutrition support on clinical outcomes of patients at nutritional risk.
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Objective To explore the therapeutical effects of enteral nutrition (EN) combined with panaxoside Rb1 on mouse modles of postoperative fatigue syndrome. Methods Totally, 72 male Sprague-Dawley mice were randomly divided into control group, model group, EN group, EN associated with high/middle/low dose panaxoside Rb1 groups (EHP group, EMP group, and ELP group, n = 12 in each group). Changes in body weight were measured before and after interventions. Learning and memory playback abilities, physical strength,and vim state were evaluate by Morris Water Maze test and Improved Tail Suspension test. Serum transferrin, prealbumin, fibronectin, and interleukin-2 levels were measured with ELISA. Serum albumin level was assayed with Bromcresol Green colorimetric technique. CD4 + and CD8 + proportions were assayed by flow cytometry. Results The body weight grew alternately in each group without significant differences ( P ＞ 0.05 ) except for model group.The latency period was significantly shorter in EN combined with panaxoside Rbl group than that in model group ( P ＜ 0. 05 ) , and the frequencies of crossing platform in EHP group and EMP group were significantly higher than those in model group ( P ＜ 0. 01 ). The areas of struggling above domain in EHP group and EMP group were significantly larger than those in model group ( P ＜ 0. 05 ), and the accumulated static time of rest in EHP group, EMP group, and ELP group was significantly shorter than that in model group ( P ＜ 0.05 ). Serum transferrin, prealbumin, fibronectin levels in EN combined with panaxoside Rb1 group were significantly higher than those in model group ( all P ＜ 0.05 ). The CD4 + T proportion and interleukin-2 level in EHP group, EMP group, and ELP group were significantly higher than those in model group (both P ＜0.05 ); however, CD8 + T proportion was not significantly different between three panaxoside Rbl groups and model group (P ＞ 0. 05 ). Conclusion EN combined with panaxoside Rb1 can improve postoperative fatigue syndrome in a dose-dependent way, which may be explained by the fact that it can strengthen the postoperative nutrition, restrain hypermetabolism, and increase immunity.
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Objective: To observe the changes of blood coagulation factors and inflammatory factors and the regulatin effect of Omegaven.Methods: Thirty ICU patients were randomly allocated into two groups: Omegaven group and control group.Serum concentrations of NF-κB、PGF1α、Eselectin、sICAM-1、TAT、D-dimer、TMD、PF1+2 were measured before and after parenteral nutrition.Results: Patients in control group had significantly higher NF-κB、Eselectin、sICAM-1、TAT、D-dimer、TMD、PF1+2 concentration,lower PGF1α concentration.Patients treated with Omegaven had significantly lower NF-κB、Eselectin、sICAM-1、TAT、D-dimer、TMD、PF1+2 concentration,higher PGF1α concentration.Conclusion: Omegaven can suppress inflammatory reaction and improve coagulopathy.
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Objective To explore the best therapeutic methods for acute mesenteric venous thromboses(AMVT)with different degrees of intestinal ischemic lesions. Methods 6 cases of acute abdomen were preoperatively diagnosed as AMVT with imaging. After laparotomy, patients were classified as congestive lesion(n=3)and necrotic lesion(n=3)according to the degree of intestinal sichemia and were treated with mesenteric thrombectomy and bowel resection, respeetively. All cases received heparin and urokinase perioperatively. Results Of the 3 patients receiving mesenteric thrombectomy, 2 were cured and the other one with ischemic ascending colon was cured after right hemicolectomy due to the complication of colic dynamic ileus and perforation 10 days after thrombectomy. The other 3 patients recovered after bowel resection. Follow-up from 8 months to 6 years showed no recurrence. Conclusion Combined with anti-coagulation therapy, thrombectomy and bowel resection are rational and effective protocol for congestive lesion and necrotic lesion, respectively in AMVT patients.
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0.05).Conclusion: Enteral nutrition may improve the nutrition status.The naso-jejunum tube feeding has no advantage to nasogastric tube feeding in our patients.The route of enteral nutrition should be selected according to the individual condition and local nosocomial experience.