Long-term effect of active parenteral nutrition support regimen in preterm infants with a gestational age of <34 weeks / 中国当代儿科杂志

OBJECTIVES@#To study the long-term effect of active parenteral nutrition support regimen in preterm infants with a gestational age of <34 weeks.@*METHODS@#According to the different doses of fat emulsion and amino acids used in the early stage, the preterm infants with a gestational age of <34 weeks, who were admitted to the hospital within 24 hours after birth from May to December 2019, were divided into an active parenteral nutrition group and a conventional parenteral nutrition group (@*RESULTS@#At the age of 6 months, the active parenteral nutrition group (@*CONCLUSIONS@#For preterm infants with a gestational age of <34 weeks, an active parenteral nutrition support strategy with high doses of fat emulsion and amino acids within 24 hours after birth can improve their long-term neurodevelopment.

The effects of multiple trace elements injection (I) on the stability of fat emulsion in neonatal parenteral nutrition solutions / 中华临床营养杂志

Objective:To investigate the effects of multiple trace elements in neonatal parenteral nutrition (PN) on the stability of fat emulsion, and to assess the changes of stability indexes after filtration.Methods:With the standard body weight of 1.5 kg, seven groups of neonatal PN solutions with different concentrations of multiple trace elements were designed, including blank group (without multiple trace elements), normal dose group (1 ml/kg, i.e., 0.75 ml per 100 ml PN) and five experimental groups (i.e., 1.5 ml, 3 ml, 4.5 ml, 6 ml, and 7.5 ml per 100 ml PN respectively). Macroscopic observation was performed 0 h and 24 h after preparation. The mean droplet diameter (MDD) of lipid emulsion was determined with dynamic light scattering before and after filtration. The percentage of fat residing in globules larger than 5 μm (PFAT5) and the globule size distribution before and after filtration were determined with light blockage method.Results:Macroscopic examination of the 7 groups of PN solutions identified neither changes in color nor stratification within 24 hours after solution preparation. Within 24 hours after solution preparation, the MDDs of all PN solutions before filtration were between (338.67±6.11) nm and (370.00±15.13) nm, and the PFAT5 values before filtration ranged from (32.00±1.00) ×10 -3% to (85.67±6.81) ×10 -3%. The MDDs of all PN solutions after filtration were between (310.67±8.62) nm and (362.33±19.86) nm, and the PFAT5 values after filtration ranged from (4.67±1.15) ×10 -3% to (17.33±0.58) ×10 -3%. The concentration of multiple trace elements was positively correlated with PFAT5 ( P<0.05). There was statistically significant difference in PFAT5 values at 0 h and 24 h after preparation ( P=0.004). The difference of PFAT5 values before and after filtration was also statistically significant ( P=0.000). Conclusions:Within 24 hours after solution preparation at room temperature, the appearance of neonatal PN solutions with different concentrations of trace elements supplementation was unchanged, and the MDDs of fat emulsions were all within the safe range. However, when the concentration of monovalent cations (Na +, K +) was 38.9 mmol/L, the concentration of divalent cation (Ca 2+) was 5 mmol/L, and the concentration of trace elements (Zn 2+, Cu 2+, Mn 2+, and Se 4+) was higher than 0.063 mmol/L, the PFAT5 value was higher than 0.05%. In this case, filtration with a 1.2 μm filter was necessary, which could significantly reduce the PFAT5 value and the globule size distribution, and improve the safety and standardization of the clinical application of PN solutions. It is suggested that the neonatal PN solutions supplemented with multiple trace elements injection (I) may be administered through a terminal filter.

Detoxification effects of long-chain versus a mixture of medium- and long-chain triglyceride-based fat emulsion on propafenone poisoning

In the present study, we aimed to compare the detoxifying effects of two fat emulsions containing either long-chain triglyceride or a mixture of medium-chain and long-chain triglycerides in the propafenone-poisoned rat model. Rats were randomly divided into 3 groups according to the fat emulsions used: long-chain triglyceride-based fat emulsion (LL) group; medium-chain and long-chain triglyceride-based fat emulsion (ML) group; normal saline (NS) group. Propafenone was continuously pumped (velocity=70 mg/kg per h) until the mean blood pressure dropped to 50% of basal level. Then, LL/ML fat emulsions or NS was intravenously infused instantly with a loading-dose (1.5 mL/kg) and a maintenance dose (0.25 mL/kg per min) for 1 h. Subsequently, the propafenone was added to plasma (3.5 μg/mL) in vitro, mixed with three doses of LL or ML (1, 2, or 4%). Finally, after centrifugation, the concentration of propafenone was measured. Rats treated with LL exhibited accelerated recovery, characterized by higher blood pressure and heart rate. Rats in both the LL and ML groups demonstrated decreased propafenone in plasma (time-points: 15, 25, and 60 min). However, rats that received LL showed lower propafenone in myocardial tissue at the end of detoxification treatment. Rats in the ML group had the lowest value of pH, the minimum content of HCO3-, and the highest production of lactic acid at the end. In the in vitro experiments, propafenone decreased more dramatically in the LL group compared to the ML group. Long-chain triglyceride fat emulsion had a better effect on treating propafenone poisoning in rats.

Research progress of parenteral nutrition associated liver damage in multiple organ dysfunction syndrome / 中国综合临床

Multiple organ dysfunction syndrome (MODS) patients or intestinal failure due to infection and other factors,intestinal dysfunction can not complete the absorption of nutrients and electrolytes.Progressive malnutrition in severe patients usually develops rapidly.Early parenteral nutrition can significantly improve the prognosis of MODS patients.PN is now widely used in all kinds of severe patients,but parenteral nutrition-associated liver disease (PNALD) caused by parenteral nutrition is prevalent in such patients.The emergence of PNALD increases the difficulty of curing patients' diseases.Many studies have found thatω-3fish oil fat emulsion in nutrient solution is an effective way to prevent and improve PNALD.

Fish oil fat emulsion nutritional support in the treatment of liver cirrhosis and portal hypertension in patients with pericardial devascularization with splenectomy: A randomized clinical trial / 中华临床营养杂志

Objective To explore the effect of fish oil fat emulsion as perioperative nutritional support on patients with liver cirrhosis and portal hypertension.Methods Randomized controlled clinical trial was performed between September 2011 and September 2017 in patients with liver cirrhosis and portal hypertension who underwent pericardial devascularization and splenectomy.Hypocaloric total parenteral nutritional support (TPN) started from the first day after the operation for 5 consecutive days.Patients were divided into experimental group and control group according to thetype of fat emulsion used.43 patients in experimental group were applied for fish oil fat emulsion injection (10％ Omegaven) + medium long chain structure fat emulsion (20％STG) and 42 patients in control group were applied for medium long chain structure fat emulsion (20％STG).Liver function (total bilirubin and alanine aminotransferase),nutrition index (serum albumin and prealbumin),inflammatory mediators (TNF-α,IL-6 and IL-10) were measured before and after the operation,and the clinical outcomes were observed.Results There was no statistically significant difference in liver function and nutritional indices between the experimental group and the control group (P＞0.05).The inflammatory mediators like TNF-u,IL-6 and IL-10 on the first day after surgery were significantly higher than those before surgery in both groups [experiment group:(225.54±54.78) vs.(61.49±16.47),(74.94±6.36) vs.(39.84±2.77),(77.53±11.4) vs.(46.05±6.13) ng/L;control group:(229.26±62.15) vs.(63.48±13.76),(77.23±7.83)vs.(40.64±3.34),(73.89±7.97)vs.(44.88±5.72) ng/L;P＜ 0.01].With the progress of time,the proinflammatory factors like TNF-α and IL-6 decreased after the operation and the range of decrease was higher in experiment group than in control group [d4-d 1:(-56.88± 31.63) vs.(-35.96±20.02),(-13.52±5.20) vs.(-6.38±2.84) ng/L;d7-d1:(-150.67±42.58) vs.(-132.79±53.35),(-27.04±8.97) vs.(-20.85±6.38) ng/L;P＜ 0.05].The range of increase in anti-inflammatory media IL-10 was higher in experiment group than in the control group (d4-d1:(14.22±13.08) vs.(5.64±3.58) ng/L;d7-d1:(17.78±5.58) vs.(-37.96±11.43) ng/L;P＜0.05).The incidence of grade Ⅲ complications and total complications (4.7％ vs.21.4％,23.3％ vs.45.2％) and hospitalization time [(10.12 ±1.48) vs.(12.33±2.04) d] in the experimental group were significantly lower than those in the control group (P＜0.05).Conclusions In patients with liver cirrhosis and portal hypertension,perioperative nutritional support of fish oil fat emulsion can reduce systemic inflammatory response and operative complications and promote rapid recovery through its two-way regulation of inflammatory mediators.

Application value of ω-3 fish oil fat emulsion in the parenteral nutritional support treatment following radical gastrectomy for gastric cancer / 中华消化外科杂志

Objective@#To investigate the application value of ω-3 fish oil fat emulsion in the parenteral nutritional support treatment following radical gastrectomy for gastric cancer.@*Methods@#The retrospective cohort study was conducted. The clinical data of 60 patients who underwent radical gastrectomy for gastric cancer in Nanjing Medical University Affiliated Wuxi Second Hospital between January 2018 and December 2018 were collected. There were 37 males and 23 females, aged from 28 to 78 years, with an average age of 64 years. Thirty patients who received parenteral nutrition containing 100 mL of ω-3 fish oil fat emulsion after radical gastrectomy and 30 patients who received parenteral nutrition containing routine fat emulsion after radical gastrectomy were allocated into experimental group and control group, respectively. Observation indicators: (1) nutritional indicators in the perioperative period; (2) inflammatory indicators in the perioperative period; (3) immune indicators in the perioperative period; (4) postoperative complications. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was evaluated using the independent-sample t test. Count data were described as absolute numbers and percentages, and comparison between groups was analyzed using the chi-square test. Repeated measurement data were analyzed by the repeated measures ANOVA.@*Results@#(1) Nutritional indicators in the perioperative period: the levels of total protein, albumin, prealbumin, and transferrin from preoperative day 1 to preoperative day 6 were respectively changed from (60.2±3.0)g/L to (57.2±3.1)g/L, from (35.3±3.1)g/L to (37.0±1.8)g/L, from (186±24)mg/L to (172±17)mg/L, from (3.0±0.7)g/L to (2.4±0.4)g/L in the experimental group and from (60.6±2.4)g/L to (55.7±4.2)g/L, from (35.0±3.8)g/L to (36.0±3.8)g/L, from (184±18)mg/L to (173±25)mg/L, from (3.1±0.6)g/L to (2.2±0.8)g/L in the control group, with no significant difference in the changing trends between the two groups (F=0.79, 2.14, 0.03, 0.36, P>0.05). (2) Inflammatory indicators in the perioperative period: the levels of white blood cells, C-reactive protein, interleukin 6, and tumor necrosis factor-α from preoperative day 1 to preoperative day 6 were respectively from (7.2±1.1)×109/L to (10.2±0.9)×109/L, from (7.2±2.3)mg/L to (25.5±6.3)mg/L, from (16±3)ng/L to (24±4)ng/L, from (17±4)ng/L to (22±5)ng/L in the experimental group and from (7.4±0.8)×109/L to (13.0±1.3)×109/L, from (6.9±2.4)mg/L to (41.6±18.9)mg/L, from (17±4)ng/L to (45±8)ng/L, from (16±4)ng/L to (43±7)ng/L in the control group, respectively, with significant differences in the changing trends between the two groups (F=63.05, 51.65, 127.82, 104.91, P<0.05). (3) Immune indicators in the perioperative period: the levels of immunoglobulin A, immunoglobulin G, immunoglobulin M, CD4+, CD8+, and ratio of CD4+ /CD8+ from preoperative day 1 to preoperative day 6 were respectively from (1.5±0.4)g/L to (2.8±0.5)g/L, from (11.1±1.7)g/L to (14.0±1.2)g/L, from (0.77±0.28)g/L to (1.61±0.31)g/L, from 42%±6% to 46%±5%, from 23%±4% to 24%±3%, from 1.82±0.42 to 2.11±0.24 in the experimental group and from (1.4±0.4)g/L to (2.3±0.6)g/L, from (10.7±1.8)g/L to (11.9±1.4)g/L, from (0.69±0.23)g/L to (1.19±0.33)g/L, from 40%±5% to 39%±4%, from 24%±3% to 23%±3%, from 1.75±0.34 to 1.81±0.35 in the control group, respectively, showing significant differences in the changing trends of the levels of immunoglobulin A, immunoglobulin G, immunoglobulin M, CD4+, and ratio of CD4+ /CD8+ between the two groups (F=18.39, 15.20, 38.42, 9.55, 5.50, P<0.05), showing no significant difference in the changing trend of the levels of CD8+ between the two groups (F=0.89, P>0.05). (4) Postoperative complications: 5 patients had postoperative complications, with a incidence rate of 16.7%(5/30), including 1 of abdominal infection, 1 of incisional infection, and 3 of pulmonary infection, and all the 5 patients were cured after symptomatic treatment. Nine patients had postoperative complications, with a incidence rate of 30.0%(9/30), including 2 of abdominal infection, 2 of incisional infection, and 5 of pulmonary infection, and all the 9 patients were cured after symptomatic treatment. There was no significant difference in the incidence of postoperative complications between the two groups (χ2=1.491, P>0.05).@*Conclusion@#For patients who receive gastric cancer surgery, ω-3 fish oil fat emulsion can reduce the inflammatory response, improve their immune function and not increase postoperative complications.

Application value of ω-3 fish oil fat emulsion in the parenteral nutritional support treatment following radical gastrectomy for gastric cancer / 中华消化外科杂志

Objective To investigate the application value of ω-3 fish oil fat emulsion in the parenteral nutritional support treatment following radical gastrectomy for gastric cancer.Methods The retrospective cohort study was conducted.The clinical data of 60 patients who underwent radical gastrectomy for gastric cancer in Nanjing Medical University Affiliated Wuxi Second Hospital between January 2018 and December 2018 were collected.There were 37 males and 23 females,aged from 28 to 78 years,with an average age of 64 years.Thirty patients who received parenteral nutrition containing 100 mL of ω-3 fish oil fat emulsion after radical gastrectomy and 30 patients who received parenteral nutrition containing routine fat emulsion after radical gastrectomy were allocated into experimental group and control group,respectively.Observation indicators:(1) nutritional indicators in the perioperative period;(2) inflammatory indicators in the perioperative period;(3) immune indicators in the perioperative period;(4) postoperative complications.Measurement data with normal distribution were represented as Mean±SD,and comparison between groups was evaluated using the independent-sample t test.Count data were described as absolute numbers and percentages,and comparison between groups was analyzed using the chi-square test.Repeated measurement data were analyzed by the repeated measures ANOVA.Results (1) Nutritional indicators in the perioperative period:the levels of total protein,albumin,prealbumin,and transferrin from preoperative day 1 to preoperative day 6 were respectively changed from (60.2±3.0)g/L to (57.2± 3.1)g/L,from (35.3±3.1)g/L to (37.0±1.8)g/L,from (186±24)mg/L to (172±17)mg/L,from (3.0± 0.7) g/L to (2.4 ± 0.4) g/L in the experimental group and from (60.6± 2.4) g/L to (55.7 ± 4.2) g/L,from (35.0±3.8)g/L to (36.0±3.8) g/L,from (184±18)mg/L to (173±25)mg/L,from (3.1±0.6)g/L to (2.2± 0.8)g/L in the control group,with no significant difference in the changing trends between the two groups (F=0.79,2.14,0.03,0.36,P＞0.05).(2) Inflammatory indicators in the perioperative period:the levels of white blood cells,C-reactive protein,interleukin 6,and tumor necrosis factor-α from preoperative day 1 to preoperative day 6 were respectively from (7.2±1.1) ×109/L to (10.2±0.9) ×109/L,from (7.2±2.3) mg/L to (25.5±6.3) mg/L,from (16± 3) ng/L to (24± 4) ng/L,from (17± 4) ng/L to (22± 5) ng/L in the experimental group and from (7.4±0.8) × 109/L to (13.0±1.3) × 109/L,from (6.9±2.4) mg/L to (41.6± 18.9) mg/L,from (17±4) ng/L to (45±8)ng/L,from (16±4)ng/L to (43±7)ng/L in the control group,respectively,with significant differences in the changing trends between the two groups (F=63.05,51.65,127.82,104.91,P＜0.05).(3) Immune indicators in the perioperative period:the levels of immunoglobulin A,immunoglobulin G,immunoglobulin M,CD4+,CD8+,and ratio of CD4+/CD8+ from preoperative day 1 to preoperative day 6 were respectively from (1.5±0.4)g/L to (2.8±0.5)g/L,from (11.1±1.7)g/L to (14.0±1.2)g/L,from (0.77± 0.28)g/L to (1.61±0.31)g/L,from 42％±6％ to 46％±5％,from 23％±4％ to 24％±3％,from 1.82±0.42 to 2.11±0.24 in the experimental group and from (1.4±0.4) g/L to (2.3±0.6) g/L,from (10.7± 1.8) g/L to (11.9± 1.4)g/L,from (0.69±0.23)g/L to (1.19±0.33)g/L,from 40％±5％ to 39％±4％,from 24％±3％ to 23％±3％,from 1.75±0.34 to 1.81±0.35 in the control group,respectively,showing significant differences in the changing trends of the levels of immunoglobulin A,immunoglobulin G,immunoglobulin M,CD4+,and ratio of CD4+/CD8+ between the two groups (F=18.39,15.20,38.42,9.55,5.50,P＜0.05),showing no significant difference in the changing trend of the levels of CD8+ between the two groups (F =0.89,P ＞ 0.05).(4)Postoperative complications:5 patients had postoperative complications,with a incidence rate of 16.7％ (5/30),including 1 of abdominal infection,1 of incisional infection,and 3 of pulmonary infection,and all the 5 patients were cured after symptomatic treatment.Nine patients had postoperative complications,with a incidence rate of 30.0％(9/30),including 2 of abdominal infection,2 of incisional infection,and 5 of pulmonary infection,and all the 9 patients were cured after symptomatic treatment.There was no significant difference in the incidence of postoperative complications between the two groups (x2 =1.491,P＞0.05).Conclusion For patients who receive gastric cancer surgery,ω-3 fish oil fat emulsion can reduce the inflammatory response,improve their immune function and not increase postoperative complications.

The antimicrobial effects of edta in propofol fat emulsion injection: an in vitro study / 中国药学杂志

OBJECTIVE: To research and compare the antimicrobial effects of propofol fat emulsion injection (PFEI) which contains disodium edetate (EDTA) or not. METHODS: According to the requirements of Antimicrobial Effectiveness in 2015 edition of Chinese Pharmacopoeia (Ch. P volume 4, 1121), Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Aspergillus niger and Candida albicans were used as the test microorganisms, the number of viable microorganisms in 3 batches of PFEI with and without EDTA was determined at 12 h after inoculation. RESULTS: Compared with zero hour, the number of viable microorganisms in PFEI which contains EDTA didn't increase at 12 h, therein the number of Pseudomonas aeruginosa, Escherichia coli and Candida albicans increased by about 0.5 lg; however, the number of Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli and Candida albicans in the samples without EDTA increased by 0.5, 0.4, 0.6 and 1.6 lg respectively, except for Aspergillus niger which did not increase. CONCLUSION: Compared with PFEI without EDTA, the samples containing EDTA may reduce the risk of infection caused by accidental contamination. However, it cannot reduce all pathogenic threats for propofol preparations.

A systemic review on efficacy and safety of multi-oil fat emulsion injection in premature infant parenteral nutrition support based on the meta-analysis / 中华临床营养杂志

Objective To systemically analyze the efficacy and safety of multi-oil fat emulsion injection (SMOF) in the premature infant parenteral nutrition support.Methods Databases including EMbase,PubMed,Cochrane Library,CNKI,VIP and Wanfang,were searched from libraries establishment to November 2017 for randomized controlled trials (RCTs) focusing on the efficacy and safety of SMOF in the premature infant parenteral nutrition support.All the literatures were retrieved and screened according to inclusion and exclusion criteria by two researchers.The software RevMan 5.3 was used for meta-analysis after the evaluation of methodology of quality.Results A total of 7 articles including 7 RCTs were enrolled.Meta-analysis showed that there were no significant differences in body length (OR=-0.25,95％ CI=-1.80-1.30,P=0.75),weight (OR=-0.12,95％ CI=-0.20-0.04,P=0.14),head circumference (OR=0.07,95％ CI=-0.83-0.96,P=0.88),lowdensity lipoprotein,high-density lipoprotein,direct bilirubin,serum creatinine (OR=-0.16,95％ CI=-0.59-0.26,P=0.45) between the infants receiving SMOF or Intralipid.But compared with the infants receiving Intralipid,hemoglobin (OR=-0.75,95％ CI=-1.49-0.00,P=0.05),red blood cells (OR=-0.23,95％ CI=-0.45-0.00,P=0.05) decreased in the infants receiving SMOF,and white blood cells (OR=1.91,95％ CI=0.46-3.37,P =0.01) increased.Conclusions SMOF can control the hemoglobin content in serum,reduce the risk and degree of jaundice in premature infant,with better safety.

Sorption of Local Anesthetics by Fat Emulsion with Different Content of Lipid / 医药导报

Objective To research sorption of local anesthetic by fat emulsion with different content of lipid in vitro and then to discuss the mechanism of action of fat emulsion for treatment of local anesthetic toxicity. Methods 10%,20%,30% fat emulsion was added to the bupivacaine hydrochloride and ropivacaine hydrochloride.After the mixture was vortexed for 10 mins,it was vibrated in thermostatic water bath at 37 ℃ for 15 h,then centrifugated and got the aqueous phase to HPLC test.The chromatography was carried on a C18column(4.6 mm×250 mm,5 μm ),the mobile phase was composed of acetonitrile-natrium biphosphoricum(25:75),the flow rate was 1 mL·min-1,the column temperature was 30 ℃ and the detection wavelength was set at 210 nm. Results Under the condition of this test,the linear ranges and linear equations for bupivacaine hydrochloride and ropivacaine hydrochloride were 0.3-3.0 μg·mL-1,Y=0.093 6X-0.017 3(r=0.999 6),and 0.3-3.0 μg·mL-1,Y=0.086 6X-0.022 3(r=0.999 1) respectively.The lowest limit of quantitation were both 0.05 μg·mL-1(S/N>3),and the ingredients showed good relationships between the peak area and the concentration.Sample reproducibility was good because the test sample was stable in 5 h.The extraction rates of bupivacaine hydrochloride by 10%,20%,30% fat emulsion were 46.0%,70. 4%,89.2% respectively.The extraction rates of ropivacaine hydrochloride by 10%,20%,30% fat emulsion were 51.3%,71.6%, 90.7% respectively. Conclusion Electric potential and the pH value of the 10%,20%,30% fat emulsion are similar,while the particle size increase slightly.Free bupivacaine hydrochloride and ropivacaine hydrochloride can be absorbed and with the increase of fat content,the extraction of local anesthetic is increased.The mechanism of action of fat for the treatment of local anesthetic toxicity maybe related to that fat emulsions can provided lipid,so that the excessive local anesthetic or those which had already distributesd in tissue can re-dispersed in lipid,and then the plasma concentration of local anesthetic is reduced,the toxicity is also reduced.

Research advances in liver diseases associated with parenteral nutrition / 中华肝脏病杂志

For patients with gastrointestinal dysfunction or failure, although parenteral nutrition can maintain nutrition and save their lives, lack of food stimulus during the fasting period can cause abnormal secretion of gastrointestinal fluid, bile, and pancreatic juice, which may result in the abnormal secretion of a series of enzymes and lead to the development of various liver diseases. Recent research has focused on the prevention and treatment of such diseases, and this article reviews the research advances in recent years.

Determination of glycerol in propofol medium and long chain fat emulsion injection by HPLC / 中国生化药物杂志

Objective A high performance liquid chromatographic (HPLC) method was established for the determination of glycerol in propofol medium and long chain fat emulsion injection.MethodsThe chromatographic conditions were as follows: Kromasil 100-5-NH2 column(4.6×250mm,5μm) with the column temperature was 40℃,acetonitrile-water(8515)as mobile phase with flow rate of 1.0mL/min.Glycerol was detected by refractive index (RI) detector at 40℃.ResultsThe linear range of glycerol was 455.3916-2276.9580μg/mL(r=0.9999,n=7),the average recovery rate was 99.5%,RSD was 0.6%(n=9),the limit of detection(LOD) was 121ng and the limit of quantification(LOQ)was 364ng.ConclusionThe method was simple, rapid, strong specifity and accurate with good reproducibility, which is suitable for the content determination of glycerol in propofol medium and long chain fat emulsion injection.

Clinical analysis of nutritional support for patients with esophageal cancer after operation with fat emulsion amino acids (17) and glucose (11%) injection / 中国生化药物杂志

Objective To analyze the clinical effect of nutritional support for postoperative patients with esophageal cancer with fat emulsion and amino acids (17) and glucose (11%) injection (Calvin injection). Methods A total of 68 patients with esophageal cancer treated in the chest surgery in our hospital from December 2014 to December 2016 were selected and randomly divided into two groups with 34 cases in each group. All patients were treated with surgery for esophageal cancer. The patients in the study group were treated with Calvin injection after operation while patients in the control group were treated with conventional fluid replacement therapy. Subjective comprehensive assessment (SGA) was used to assess the nutritional status of the patients and the weight, serum total protein (TSP), serum albumin (Alb), transferrin (TF) content, urea nitrogen content in on one week, malnutrition improvement and complications of the patients in two groups were recorded and compared. Results The weight of the patients with esophageal cancer in the two groups after operation was decreased, and the weight loss of the patients in the study group was lower than that of the control group and the difference was statistically significant (P<0.01). The decrease degree of TSP, Alb and TF in the study group was lower than that in the control group, and the difference was statistically significant (P<0.05). The negative nitrogen balance of the two groups was improved, and the improvement of the negative nitrogen balance in the study group was better than that in the control group, and the difference was statistically significant (P<0.01). The postoperative malnutrition in the patients with esophageal cancer was improved. The improvement degree of malnutrition in the study group was better than that in the control group, and the difference was statistically significant (P<0.05). The incidence of complications in the study group was lower than that in the control group, and the difference was statistically significant (P<0.05). Conclusion Compared with the traditional method of postoperative fluid replacement, Calvin injection can improve the recovery of the body function of the patients with esophageal cancer after operation, improve the patient's negative nitrogen balance and nutritional status, reduce the incidence of complications, and improve the clinical prognosis. This treatment is safer and more effective and it is worth popularizing in clinical practice.

Analysis of rational use of Fat Emulsion Injection in 1500 tumor patients / 药物评价研究

Objective To evaluate the clinical application of Fat Emulsion Injection in tumor patients and provide references for rational drug use.Methods A total of 1500 cases administered with Fat Emulsion Injection during January and December 2016 in Affiliated Cancer Hospital of Zhengzhou University were collected randomly and evaluated with the relevant standards.Results From the investigation of a total of 1 500 patients with cancer,fat Emulsion Injection was mainly used in the surgery department (68.2％).Of 1500 cases,unreasonable medical records accounted for 35.2 ％;inappropriate indication accounted for 16.1％,inappropriate selection of drugs accounted for 44.5％,incorrect dosage accounted for 50.6％,and incompatibility accounted for 18.3％.Conclusion Unreasonable use of Fat Emulsion Injection in the hospital is prevalent,therefore,measures should be taken to strengthen the standard use of this kind of drugs.

Determination of Bacterial Endotoxin in Fat Emulsion(10%)/Amino Acid (15)/Glucose (20%) Injection by Gel Method / 中国药房

OBJECTIVE:To adopt gel method for the determination of bacterial endotoxin in Fat emulsion(10%)/amino acid (15)/glucose (20%) injection. METHODS:According to the gel method in term ofbacterial endotoxin test methodin Chinese Pharmacopeia(2015 edition),the maximal valid dilution(MVD)of samples were determined through interference test and the vali-dated. The results were compared with chromogenic method. RESULTS:In gel method,the interference to agglutination reaction of TAL and bacterial endotoxin can be excluded when samples were diluted 24 times or less. In chromogenic method,the samples should be diluted 76 times or less. CONCLUSIONS:Gel method can be used for bacterial endotoxin test of Fat emulsion(10%)/amino acid(15)/glucose(20%)injection.

The research development of oil fat emulsion in severe acute pancreatitis / 肠外与肠内营养

The incidence of severe acute pancreatitis (SAP) is increasing year by year,and the mortality is high,which poses a great threat to the life of patients.In recent years,the immune nutrition therapy has become the focus in the treatment of SAP,among which,fish oil lipid emulsion as a novel type of fat emulsion,has the multi-effects of anti-inflammatory,anti-oxidative,immunomodulatory,promoting signal transduction and protecting organ function apart from providing nutrition and regulating metabolism.It can prevent the deterioration of the whole body from systemic inflammatory response syndrome (SIRS) to multiple organ dysfunction syndrome (MODS and ultimately improve the prognosis of patients.

Pharmaceutical Care of Parenteral Nutrition Therapy in A Patient with Hyperemesis Gravidarum / 医药导报

Objective To explore the role of clinical pharmacists in nutrition support therapy in the patients with hyperemesis gravidarum. Methods The clinical pharmacist played a positive role in nutrition support care of a patient with hyperemesis gravidarum by analysising disease characteristics and adverse drug reactions, providing suggestion on the selection of fat emulsion and offering an individualized pharmaceutical care. Results The clinical pharmacist recognized the potential risk in nutrition support plan, took modifications timely, and prevented the occurrence of unfavorable clinical outcomes. Conclusion The participation of clinical pharmacists in nutrition support therapy of the patients with hyperemesis gravidarum is beneficial to improve the efficacy and safety of nutrition support and promote the rational use of drugs.

Protective Effect of ω-6 Soybean Oil Fat Emulsion on Folium Sennae-induced Diarrhea in Mice / 中国医科大学学报

Objective To investigate the protective effect of ω?6 soybean oil fat emulsion on folium sennae?induced diarrhea in mice. Methods Thirty?six Kunming mice were randomly divided into three groups,including control,diarrhea,ω?6 soybean oil fat emulsion group(12 mice in each group). Besides the mice in control group,other mice were administrated folium sennae by gavage for 15 days to establish the diarrhea model. Then mice in ω?6 soybean oil fat emulsion group received ω?6 soybean oil fat emulsion by intravenously administration at a dose of 15 mL/kg daily since 6th day after intragastric administration of folium sennae for 10 days. Animals in control group and diarrhea group were intravenously adminis?tered with same volume of saline. The body weight ,general state and diarrhea index of the mice in each group were dynamically assessed. Ten days after intravenous injection,mice in every group were sacrificed and tissues were collected. Morphology of intestine mucosa was observed after HE staining. Albumin(ALB)level in plasma was evaluated by biochemical method. Proliferating cell nuclear antigen(PCNA)expression in intestine mucosa were assessed by immunohistochemical method. Results Compared with that in the diarrhea group,the general status,body weight and diarrhea index of mice in ω?6 soybean oil fat emulsion group were improved significantly. Ten days after intravenously administration ,pathological change in intestine mucosa of mice in ω?6 soybean oil fat emulsion group was improved significantly ,ALB level in plasma and PCNA expression in intestine mucosa were significantly increased(P<0.05)compared with that in diarrhea group. Conclusion ω?6 soybean oil fat emulsion has a significant protective effect on the diarrhea of mice induced by folium sennae ,which may be related to the up?regulated expression of PCNA by ω?6 soybean oil fat emulsion.

Simultaneous Determination of Lysophophatidyl Choline and Lysophosphatidyl Ethanolamine in Nimodipine Fat Emulsion by HPLC / 中国药房

OBJECTIVE:To establish a method for simultaneous determination of lysophosphatidyl choline(LPC)and lysophos-phatidyl ethanolamine(LPE)in Nimodipine fat emulsion. METHODS:HPLC was performed on the column of Lichrosher Diol with detector of evaporative light scattering detector with mobile phase A of heptane- isopropyl alcohol solution(43∶57,V/V),mobile phase B n-heptane-isopropyl alcohol-water(29.5∶59∶11.5,V/V/V)(gradient elution)at a flow rate of 1.5 ml/min,column tempera-ture was 40℃,and the injection volume was 20 μl. RESULTS:The linear range was 0.020 0-0.400 0 mg/ml for LPC(r=0.999 0)and 0.010 0-0.200 0 mg/ml for LPE(r=0.999 6),and the logarithm value of concentration and peak area showed good linear relationship;the limit of quantitation was 0.013 4 mg/ml for LPC and 0.013 0 mg/ml for LPE;the limit of detection was 0.007 8 mg/ml for LPC and 0.007 6 mg/ml for LPE;RSDs of precision,stability and reproducibility tests were lower than 2%;recoveries were 95.96%-100.63%(RSD=1.83%,n=9)and 99.22%-101.76%(RSD=0.80%,n=9). CONCLUSIONS:The method is simple,and can be used for the determination of related substance in Nimodipine fat emulsion.

Application Evaluation of Clinical Parenteral Nutrition in Our Hospital / 中国药师

Objective:To establish the methods and standard for the evaluation of rational application of parenteral nutrition ( PN) in primary hospitals. Methods:Medical records with the use of fat emulsion, amino acids (17) and glucose (11%) injection were col-lected. The integrity of the medical records was analyzed, the compatibility of supplementary drugs was evaluated, and basal metabo-lism rate(BMR) was calculated for the relevant assessment. Results:Totally 66. 7% of the patients had incomplete basic parameters of nutritional risk assessment, the cases had different course of treatment but showed no significant difference in total usage of fat emul-sion, amino acids (17) and glucose (11%) injection,and the non-protein calories of fat emulsion, amino acids (17) and glucose (11%) injection accounted for 72. 1% of basal metabolism rate of an individual on average (S=8. 9). Supplementary usage of KCl accounted for 63. 0% of the cases, of which 70. 6% were overdosed;62. 9% of the cases used supplementary alanyl-glutamine with overdosage. Conclusion:In the PN application in our hospital, nutritional risk assessment is basically missed, and there is a great gap between the level of developing reasonable individual program and the requirements in guidelines. Clinical pharmacists should enhance the related monitoring and evaluation in PN application.