Objective To investigate the effects of enteral nutrition support with glutamine combined with dietary fibre and fructo oligosaccharide (GFO) on nutritional status, gastrointestinal function and outcome in elderly patients with mechanical ventilation.Methods Totally 90 patients were randomly divided into three group: the control group without additives (group A), enteral nutrition group with glutamine (group B) or with GFO (group C).Fasting blood samples were collected on day 1, 7 and 14 after the initiation of study, and then the indicators including hemoglobin, albumin, transferrin and prealbumin were determined.In addition, the gastrointestinal complications including bloating, diarrhea, and gastric retention were observed, and the mechanical ventilation time, length of intensive care unit (ICU) stay and extubation time were recorded.Results The serum transferrin and prealbumin levels were significantly improved on the 7th day (P=0.023 and 0.047),and the hemoglobin was significantly improved on the 14th day (P=0.003).4 cases in group B and 3 cases in group C underwent successful implementation of enteral nutrition, and 25 cases in group B and 27 cases in group C achieved the target volume of enteral nutrition, which were more than those in group A (P=0.008 and 0.000 respectively).The incidence of gastrointestinal complication was less in groups B and C than in group A.The mechanical ventilation time, length of ICU stay and extubation time were shorter in groups B and C than in group A.Conclusions Enteral nutrition with glutamine and GFO can improve nutritional status and reduce gastrointestinal complications in elderly patients with mechanical ventilation.Enteral nutrition with GFO has an advantage to the enteral nutrition and the outcome.

A 29-year-old male patient with extranodal NK/T-cell lymphoma,a nasal type lymphoma with involvement of skin as the first symptom,was reported.The patient presented with swelling in the left side of the nose and suffered intermittent fever for 1 month.The fester in the oral mucosa and skin under the left nostril and redness,and the swelling on the orbit of the left eye lasted for 1 week.Physical examination showed that the left side of nose was swelling,and the skin below the left nostril was anabrotic and crusted.There were different ulcers in his jaws and buccal mucosa.Bilateral eyelid was redness and swelling,especially in the left side.Binocular conjunctival was congestive.The diagnosis of extranodal NK/T-cell lymphoma (nasal type) was confirmed by biopsy and immunohistochemistry.

Morita therapy has been bom for more than 100 years.Inpatient Morita therapy is highly oper-able and easy to master.It can improve many refractory neuroses through four-stage treatment.But more neuroses are treated in outpatient clinics,and Morita therapy cannot be used in hospitalized patients.Therefore,the formula-tion of expert opinions on outpatient operations is particularly important.This paper is based on domestic and for-eign references,and after many discussions by domestic Morita therapy experts,and then drew up the first version of the expert opinions on operation of outpatient Morita therapy.Meanwhile the operation rule of Morita therapy in three stages of outpatient treatment was formulated:in the etiological analysis stage,under the theoretical guidance of Morita therapy,analyze the pathogenic factors,to improve treatment compliance and reduce resistance;during the operating stage,guide patients to engage in constructive and meaningful actions,realizing the achievement of letting nature take its course principle;in the cultivating character and enriching life stage,pay attention to positive infor-mation,expanding the scope and content of actions,improving the ability to adapt to complex life,and preventing recurrence caused by insufficient abilities.It will lay a foundation for the promotion of Morita therapy in domestic outpatient clinics,so that more patients with neurosis and other psychological diseases could receive characteristic Morita therapy treatment in outpatient clinics.