This review examines the effects of parenteral nutrition(PN) or enteral nutrition(EN) on pancreatic exocrine secretion and severe acute pancreatitis(SAP). There is no evidence that PN support in SAP affects the underlying disease process,but it may prevent the malnutrition and complications.In recent years,EN is considered to be used in that it preserves gut barrier function.PN,in contrast,may result in mucosal atrophy,bacterial translocation and increased rates of catheter related sepsis.The effects of EN on pancreatic exocrine secretion and natural course of SAP are discussed.The safety and feasibility of EN in SAP have been established. EN may even be superior to PN.Some patients,however,cannot tolerate enteral feeding and PN still has a role.

Objective To study the effect of probiotics on the change of intestinal permeability and inflammatory reaction after surgery of colorectal cancer.Methods Sixty patients who underwent colonic surgery were randomly divided into two groups:probiotic group and control group,with 30 cases in each group.Each group received nutritional support of the same nitrogen and calorie from day 3 to day 7 after operation.The patients in probiotic group were orally administrated probiotic(2 g/d)from the first day after surgery for 7 days.Every patient's body temperature and heart rate were observed after operation,and white blood cell counts were observed before operation and on day 1,5,8 after operation.The levels of microbial DNA in whole blood and plasma D-lactate,and urine lactulose/mannito(L/M)ratio were measured before operation and on day 1 and day 8 after operation,respectively.In addition,the occurrence of postoperative systemic inflammatory response syndrome(SIRS)and complications of inflammation were closely observed.Results The average heart rate in postoperative 5 days was significantly lower in probiotics group than that in control group(P0.05).Conclusion Probiotics can decrease intestinal permeability and maintain the intestinal barrier function after operation.It may be helpful for the recovery of patients with early inflammatory response after surgery of colorectal cancer.

Objective: To assess the effect of preoperative carbohydrate fluid intake on immediate postoperative insulin resistance. Methods: 32 patients for elective colorectal cancer resection were recruited to this randomized controlled study. These patients were randomly assigned to control group and test group. Control group were fasted before surgery, while test group were given oral carbohydrate 3 h before surgery. Patient's wellbeing scores on a visual analogue scale(VAS) were recorded at 3 PM the day before operation and 2 h after consuming carbohydrate fluid respectively. Blood sample were collected to measure the level of blood glucose and the serum concentrations of insulin 4 h before surgery and immediately after surgery, respectively. Homeostasis model assessment (HOMA) was applied to assess the status of insulin resistance (HOMA-IR), basic function of pancreatic ? cell (HOMA-? cell) and insulin sensitivity index (ISI). Results: Patients consumed carbohydrate-rich beverage before surgery reduced thirst, hunger and anxiety compared with fasting before surgery. Whole body insulin sensitivity decreased by 33% in the test group vs. 38% in the control group(P

Objective:To evaluate the stability of fat emulsion in TNA prepared by automated compounding device and compare it with the manual method.Methods:A total of 20 TNA were prepared by the automated compounding device and the conventional manual method.The TNA were stored at 25℃ for 1 day,4℃ for 7days and again 25℃ for 1 day to observe the stability of fat emulsion by electron scanning microscopy measurement and to measure the pH,osmolality.Results:Time required for TNA prepared by automated compounding device was less than the manual method.At the 1st day,the particle size of fat emulsion in TNA prepared by the automated compounding device was smaller than the manual method;After 7 days storing at 4℃ and 1 day at 25℃,the particle size,pH and osmolality were also stable in automated compounding device group.Conclusion:Automated compounding device reduced time requirements for TNA preparation.The stability and compatibility of TNA prepared by automated compounding device is better than the manual method.

Acquired growth hormone resistance(AGHR) in critical illness may be defined as the combination of a raised serum growth hormone concentration,low serum insulin-like growth factor-1 concentration and a reduced anabolic response to exogenous GH.GH given to reverse catabolism in critical illness increased mortality.Therefore,it has the theoretical significance and clinical value for better understanding of the mechanism of AGHR.The mechanism of AGHR and its prevention and cure are reviewed.

Tight junctions(TJ) are the basic structure of intestinal barrier,which serve as the rate-limitting barrier to passive movement across intestinal epithelial cell and the maintenance of epithelial cell polarity.Recently some progress has been achieved in the structure of TJ proteins.This review is about the regulating mechanisms of TJs response to common enteric pathogens and other factors.

This review introduces the basal elements and structures of Ussing chamber and it′s applications in the field of intestinal barrier function research.

Abjective:To investigate the effect of Lactobacillus plantarun Onlly regulating the intestine epithelial permeability and tight junction proteins of enterocyte-like Caco-2 cells in responsing to Enteroinvasive Escherichia coli.Methods:In the model of Caco-2 monolayer cells,The cells were divided into four groups: normal group,infection group,Lactobacillus group and gentamicin group.The TER was measured by Milicell ERS and the transmissivity of mannitol was determined by HPLC.The distribution and structure of tight junction proteins,such as Claudin-1,Occludin,ZO-1,JAM-1 were examined by indirect IHC.Results: The TER and the transmissivity of mannitol increased after infected with EIEC,but the increase was decreased after dealing with Lactobacillus plantarun Onlly(P

Currently,the popular notions on the mechanisms of gut-derived-infection are described as follows.The stress may cause the damage of intestinal mucosal barrier and dysfunction of intestinal immune response,which leads to the alteration of intestinal flora,abnormal proliferation of opportunistic pathogen as well as the translocation of alive bacteria and their toxin into systemic compartment.As a result,the proinflammatory cytokines are released to induce the outbreak of intestinal inflammation or systemic inflammatory response syndrome,even the MODS.This review focuses on the relationship between biological behavior of intestinal bacteria and gut-derived-infection.

The aetiology of inflammatory bowel diseases(IBD) is still unknown at the present time.However,along with more and more experimental models of IBD developed in recent ten years,the therapeutic effect of probiotics on IBD and the possible mechanisms were widely explored.A lot of experiments have shown that probiotics administration can significantly ameliorate the IBD in many kinds of animal models and this beneficial effect of probiotics may be associated with inhibiting microbial growth,enhancing gut-barrier function,modulating immune response of intestinal mucosa and decomposing luminal pathogenic antigens.