ABSTRACT
There are postoperative trauma and complications associated with the esophageal resection, and patients with esophageal cancer often have different degrees of malnutrition. Therefore, nutritional support after esophagectomy is very important. Oral feeding is regarded as a symbol of successful esophagectomy and initial recovery. As a hot spot of clinical research, early oral feeding plays an important part of accelerating recovery from gastrointestinal surgery, but there is no unified clinical strategy. This review checks the relevant clinical trials at home and abroad, and summarizes the strategies of oral feeding after esophagectomy, including the timing of feeding, pre-eating inspection, dietary content, chewing methods and appetite stimulating drugs.
ABSTRACT
Objective:To evaluate the levels of interleukin 18(IL-18) mRNA in peripheral blood mononuclear cells(PBMCs),livers and spleens in monkey endotoxic shock models.Methods:Cynomolgus monkeys were injected i.v. with lipopolysaccharide(LPS) (2.8 mg/kg) to prepare the endotoxic shock models. The mRNA levels of IL-18 in PBMCs,livers and spleens were tested by fluorescence semi-quantitative realtime reverse transcription(RT)-PCR and compared with that of TNF-? and IL-1?.Results:IL-18 mRNA expression in PBMCs remarkably increased at 120 min after LPS administration, so did in livers and in spleens at the same time. mRNA levels of TNF-? in PBMCs peaked at 60 min after LPS injection, and also increased markedly at 120 min in livers and spleens. IL-1? mRNA levels peaked at 60 min in PBMCs, and did not change so much in livers and in spleens.Conclusion:IL-18 mRNA expression in PBMCs can be up-regulated by LPS, but changed latterly than TNF-? and IL-1? in endotoxic shock cynomolgus monkeys. It is presumed that IL-18 can be produced by PBMCs and liver Kupffer cells(maybe splenic macrophages),and TNF-? is produced by a variety of cells, but IL-1? in bloodstream mainly come from PBMCs after LPS challenge.