Effect of enteral nutrition on liver function and inflammatory response after abdominal operation in patients complicated with liver dysfunction / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of enteral nutrition(EN) on liver function and inflammatory response after abdominal operation in patients with liver dysfunction.</p><p><b>METHODS</b>A prospective multicenter study was conducted. Patients requiring EN for at least 5 days after abdominal surgery with at least 1 abnormal liver function index were included. After operations, EN suspensions(TPF-FOS) were administered for 5 days after the return of bowel function with targeted content of 125.52 kJ(30 kcal)·kg(-1)·d(-1) maintained for a minimum of 3 days. Levels of serum pre-albumin, C-reaction protein(CRP), and liver function index were measured and the incidence of systemic inflammatory response syndrome(SIRS) was recorded before operation and 6 days after EN. Occurrence of gastrointestinal discomfort was monitored during the treatment.</p><p><b>RESULTS</b>No statistically significant difference was found in pre-albumin between preoperative level and post-EN level[(175.94±71.79) mg/L vs.(192.22±91.26) mg/L, P=0.162]. Patients with abnormal level of γ-glutamyl transpeptidase were less after EN compared to the preoperative period(30 vs. 40, P=0.041), as was total bilirubin (3 vs. 9, P=0.034). No significant differences in other indices of liver function were found. Total bilirubin and direct bilirubin decreased after EN support(P=0.000 and P=0.015, respectively). CRP was notably reduced after EN support [(48.74±65.16) mg/L vs.(25.79±23.63) mg/L, P=0.009] and the incidence of SIRS largely declined after EN support(19.0% vs. 10.3%, P=0.059). The incidence of gastrointestinal discomfort was 22.4% on postoperative day 1 and declined to 19.0% on postoperative day 5.</p><p><b>CONCLUSION</b>For patients with liver dysfunction, enteral nutrition support with TPF-FOS after abdominal operation can reduce inflammatory response, improve liver function, and maintain serum protein level.</p>

Effect of bowel preparation with probiotics on intestinal barrier after surgery for colorectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To study the effect of bowel preparation with probiotics on intestinal barrier function after surgery for colorectal cancer.</p><p><b>METHODS</b>A total of 60 patients undergone colonic surgery were randomly divided into two groups:the trial group and the control group. One-day bowel preparation with probiotics was administered in trial group, while 3-day conventional bowel preparation in control group. Quality of the preparation was estimated during operation and the structure of intestinal epithelium in the colon was observed by microscope. Levels of transmembrane binding protein(occludin) and IgA in the colon were detected by immunohistochemistry method. White blood cell counts, microbial DNA, and C-reactive protein were measured before surgery and 1, 7 days after surgery. Postoperative systemic inflammation response syndrome(SIRS) and infection were evaluated.</p><p><b>RESULTS</b>Good and excellent bowel preparation were achieved in 88% in the trial group and 92% in the control group(P=0.072). The expression levels of occludin and IgA of colon were significantly higher in the trial group[(19.32 + or - 2.40)% and (7.60 + or - 1.48)%, respectively] compared with those of the control group [(16.21 + or - 2.54)% and (5.29 + or - 1.57)%,respectively]. The number of microbial DNA PCR-positive patients in the trial group was significantly less than that in the control group after operation. There were no significant differences in the rates of SIRS or complications between the two groups.</p><p><b>CONCLUSION</b>One-day bowel preparation with probiotics can maintain the intestinal barrier function after surgery of colorectal cancer,which is suitable for elective colorectal surgery.</p>

Study on specific metabonomic profiling of serum from colorectal cancer patients by gas chromatography-mass spectrometry / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To study the specific metabonomic profiling of serum from colorectal cancer patients to find out the low molecule metabolites associated intimately with colorectal cancer,and to establish specific metabolic model for the diagnosis of colorectal cancer.</p><p><b>METHODS</b>The metabonomic profiles of the serum samples from colorectal cancer(CRC) patients(n =31) and healthy adults(n =8) were investigated by gas chromatography-mass spectrometry (GC-MS) technique combined with a commercial mass spectral library for the peak clustering based on metabolites.</p><p><b>RESULTS</b>Thirty-four endogenous metabolites including some amino acids, carbohydrates, fatty acids and other intermediate metabolites were identified. By t test statistics with P<0.05, P<0.01 respectively, L-valine, L-threonine, 1-deoxyglucose, glycine and ribitol levels were decreased significantly, but 3-hydroxybutyric acid level was increased significantly in the CRC patient group as compared with healthy adult group. PLS-DA based on these metabolites discriminated two groups for each other. Hierarchical clustering based on above 6 significant differential metabolites revealed that the prediction accuracy of colorectal cancer group was 93.5%.</p><p><b>CONCLUSION</b>GC-MS technique is an alternative tool for the metabonomic study and would be certainly beneficial to the pathological research, early diagnosis and therapy evaluation of CRC.</p>

Proteomic research of biomarker of colorectal cancer metastasis / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the potential markers of colorectal cancer metastasis and the influence of 5-FU on differentially expressed proteins by using proteomic technology, and to elucidate the mechanism of colorectal cancer metastasis.</p><p><b>METHODS</b>Human colorectal carcinoma cell lines of different metastatic potential, Lovo and SW480 were conventionally cultured, and the protein was extracted. 50% inhibitory concentration (IC(50)) of 5-FU to these two cell lines was measured by MTT assay. Proteins of these two cell lines after intervention by 5-FU at IC(50) were extracted, then 2-dimensional gel electrophoresis was conducted for the proteins. The differential protein spots were examined by mass spectrometry and analyzed by bioinformatics. Difference of expressed proteins in two cell lines before and after the intervention of 5-FU was validated by Western blot and immunofluorescence.</p><p><b>RESULTS</b>Eleven differentially expressed proteins were identified by 2-dimensional gel electrophoresis and mass spectrometry. The hnRNP K protein and PDI were selected to be examined by Western blot and immunofluorescence. Results revealed that the expression of hnRNP K in Lovo was higher than that in SW480, while the expression of PDI was lower in Lovo. After intervention by 5-FU at IC(50), the expression of hnRNP K in Lovo decreased more as compared to SW480, while the expression of PDI in SW480 increased more as compared to Lovo.</p><p><b>CONCLUSION</b>There are significant differences in expression of hnRNP K and PDI proteins between Lovo and SW480 cell lines, and the proteins alter regularly after 5-FU intervention.</p>

Influences of enteral nutrition combined with probiotics on the gut microecology and barrier function of the rats with abdominal infection / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the influences of enteral nutrition (EN), parenteral nutrition (PN) and probiotics supplement on the intestinal microecology, and barrier function of the rats with abdominal infection.</p><p><b>METHODS</b>Twenty-one Sprague-Dawley (SD) rats with abdominal infection were randomly divided into three groups, and received PN (PN group, n=7), PN+ EN (PN+ EN group, n=7) or PN+ EN+ probiotics (probiotics group, n=7) respectively with isonitrogen and isocaloric nutrition. The rats were sacrificed after six days. The feces in cecum were cultured for anaerobic bacterial growth and DNA fingerprint spectrum was analyzed by randomly amplified polymorphic DNA technique. The transmembrane binding protein (occludin) and IgA levels in colon and terminal ileum were detected by immunohistochemistry method. The bacterial translocation rate and endotoxin level were also measured.</p><p><b>RESULTS</b>The germ numbers of different species were both higher in PN+ EN and probiotic group than those in PN group. The bands of DNA fingerprint spectrum were significantly decreased in PN group, but the bands in both PN+ EN group and probiotic group were similar to that in the normal rats. The expression levels of occludin and IgA in the intestine and colorectum were higher in both PN+ EN group and probiotic group compared with those of PN group (P< 0.05, P< 0.01, respectively), the expression level of occludin was higher in probiotic group than that in PN+ EN group (P< 0.05). The overall bacterial translocation rates and endotoxin levels were significantly reduced in both probiotic and PN+ EN group (P< 0.05), but there was no difference between probiotic group and EN group.</p><p><b>CONCLUSION</b>EN combined with probiotics can increase occluding and IgA expressions, improve the intestinal microecology,maintain the gut barrier function, and decrease the incidence of gut bacterial translocation.</p>

Effects of enteral nutrition on uptake of amino acid and enzyme-protein synthesis of pancreatic acinar cell in acute pancreatic dogs / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the effect of intrajejunal nutrition on uptake of amino acid and enzyme-protein synthesis in pancreatic acinar cell and subcellular fractionation and zymogen granules in dogs with acute pancreatitis.</p><p><b>METHODS</b>Fifteen dogs were induced acute pancreatitis by retrograde injection of 5% sodium-taurocholate into the pancreatic duct. Radioactive tracing and electron microscope were used to evaluate the change of amino acid uptake, enzyme-protein synthesis in acinar cell, subcellular fractionation, the quantitative analysis of mean zymogen granule number and mean zymogen granule area after injection L-(3)H-phenylalanine 30, 60, 120 1nd 180 min on the 7(th) day.</p><p><b>RESULTS</b>The radioactivity of L-(3)H phenylalanine uptake by pancreatic acinar cells and incorporations of L-(3)H phenylalanine into newly synthesized enzyme-protein peaked at 60 min. In enteral nutrition (EN) group it was higher that that in parenteral nutrition (PN) group (P < 0.05), and then gradually declined. The radioactivity peaked at 60 min in zymogen granule, lysosomal-mitochondria and microsomal subcellular fractionation. The latter two decreased, bat there was no significant difference (P > 0.05). The change of the mean number and mean area of zymogen granules were not significant different between the EN group and PN group (P > 0.05).</p><p><b>CONCLUSION</b>EN or PN do not stimulate pancreatic acinar uptake amino acid and enzyme-protein synthesis in acinar cell and subcellular fractionation.</p>