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.

ObjectiveTo evaluate the results of a novel operative procedure of spleen and pancreas preserving clearance of lymph nodes on spleen hillus and along the splenic artery in gastric resection for gastric carcinoma.Methods The postoperative complications and survival rates were observed in 61 patients of gastric carcinoma undergoing gastrectomy with preservation of the spleen and pancreas (PSP) and clearance of lymph nodes on spleen hillus and along splenic artery.Results were compared with those undergoing traditional operations. Results The postoperative complications and mortality were lower and survival rates higher in patients with preservation of spleen and pancreas than those with spleen and a portion of the pancreas resected.Conclusions Spleno-pancreas preserving lymph node clearance on the splenic hillus and along pancreatic artery is safe and effective procedure in radical gastrectomy for patients with gastric carcinoma.

The association between colorectal cancer and gut microbiota imbalance has became a hot research topic along with the increase of its irevalance.In this article, we search for the potential specific carcinogenic strainand their metabolite markers in the development of colorectal cancer, with an attempt to provide an important basisfor early diagnosis and primary prevention of colorectal cancer, elucidate the potential roles and mechanisms of in-testinal microbioecological preparation and improve the management of colorectal cancer.

Many peptide transporters have been identified in mammals, among which PepT1 has been widely studied. PepT1, a member of proton-coupled oligopeptide transporter (POT) superfamily, is a peptide transporter of low affinity and high capacity and is mainly expressed in the brush border membrane of intestinal epithelial cells. PepT1 plays an important role in the absorption of di/tri-peptide (the degradation products of protein in intestinal tract). Meanwhile, it mediates the transport of peptide-like drugs and the bacterial products. Therefore,the changes of the functional expression of PepT1 in the gastrointestinal tract may dramatically affect the internal and external environmental stability and drug absorption. This paper reviews the structural features and function,distribution, transport mechanisms, and regulatory factors of PepT1.

Objective　To study the influence of Lipofundin vs Intralipid on lipid energy metabolism of cirrhotic patients undergoing surgery.Methods　Twenty-five patients with liver disease were randomly assigned to two PN groups:LCT group(n=12) and MC/LCT group (n=13).Fat energy in group LCT was supplied by 20%-Intralipid,Group MCT/LCT was supplied by 20%-Lipofundin.All patients were on parenteral nutrition for 7 days.Intravenous fat tolerance test (IVFTT) was measured at pre-op,post-op d1、post-op d7.Carnitine （CNT） level in serum and urine,and AKBR were tested at the pre-op、post-op d1、d7.Results　The elimination rate of the MCT was faster than that of LCT at pre-op and post-op d7,the elimination rate of LCT at post-op d1 was faster than that of at pre-op and post-op d7.Serum CNT increased in both groups,urine CNT markedly decreasd at postoperation,but in LCT group CNT was at lower level as compared with MCT group at post-op d7,P＜0.05.AKBR was markedly decreased in both groups post-op,but at post-op d7,AKBR in MCT group was higher than in LCT group,P＜0.01.Conclusions　These results indicated that Lipofundin was an ideal energy source for the cirrhotic patients.

Intestinal ischemia is a severe and life-threatening acute abdomen. Although its incidence is low,early diagnosis remains relatively difficult. The efficiencies of conventional laboratory biochemical tests are low. In recent years, many new markers for the early diagnosis of intestinal ischemia have been developed. In this article,we summarize their diagnostic efficiencies and relevant factors.

The tight junction of intestinal epithelium plays an important role in maintaining the function of intestinal barrier and regulating the cell differentiation. The intestinal epithelial cells interact with neighboring cells and the extracellular matrix and then affect the epithelial barrier as well as the proliferation, polarization, and apoptosis of cells. As an important cell junction, the tight junction of intestinal epithelium participates in a series of signal transduction pathways including the classic cyclic adenosine monophosphate-protein kinase A-cyclic adenosine monophosphate response element-binding, inositol trisphosphate, Ras-mitogen-activated protein kinase, phosphatidylinositol 3-kinase, and in some special pathways including zonula occludents protein 1-associated Y-box factor,cyclin related protein, phosphorylation, and methylation. Furthermore, regulations of gene and protein expression of the tight junction are also complex, while disorders of such regulations may lead to clinical diseases, such as disruption of the intestinal barrier, refractory infection, and even cancers. This article reviews the research advances in gene expressions, related signal transduction, and self-regulation in the tight junction of intestinal epithelium.

Probiotics modulate the biological functions (and even cell apoptosis) of intestinal epithelial cells,intestinal macrophages,intestinal dendritic cells,and T cells via cell signaling pathways including nuclear factor-kappa B (NF-κB) and mitogen-activated protein kinase (MAPK) pathways.Peroxisome proliferator-activated receptor γ (PPARγ) and heat shock protein (hsp) are targets for probiotics or their products.

Colorectal cancer (CRC) is a malignant digestive tract tumor resulted from genetic and environmental factors and can be accompanied by a series of gene mutations.The etiology of CRC,particularly the role of gut microbiota imbalance,has became a hot research topic along with the increase of its prevalance.In this article,we elucidate the potential roles and mechanisms of streptococcus gallolyticus,fusobacterium,Escherichia coli,Bacteroides fragilis,and helicobacter wlori in the development of CRC,with an attempt to further understand the functions of microbiota,search for possible specific carcinogenic strains,and improve the management of CRC.

Human guts harbor abundant microbes that regulate many aspects of host physiology.However,bacterial imbalance or dysbiosis in the gut due to the dietary or environmental changes may cause colorectal cancer (CRC).Therefore,it is theoretically and clinically important to explore the correlation between possible carcinogenic bacteria and CRC and thus reduce CRC incidence by regulating intestinal microecological balance through the application of microecological preparations.