Operable cancer patients should receive nutritional risk screening or/and nutritional assessment before surgery.Perioperative nutrition support therapy should be planned and implemented for the patients with nutritional risk or malnutrition,but not necessarily following special nutritional formula.Reducing the time of preoperative fasting,providing reasonable preoperative nutrition support,and early postoperative feeding in combination may be the preferred strategy for perioperative nutritional intervention and management.Because the disease of cancer patients is complicated and changeable,perioperative nutrition support is not only a technology,but also an “art”.The guidelines,disease information,and clinical experience should be “cleverly tailored and combined” to promote the outcome-improving effect of nutrition support therapy.

Many malignant tumor have methionine dependency. Methionine restriction can inhibit proliferation of tumors cells by decreasing the level of methionine with depriving methionine, methioninase, homocysteine, and its analogs.Methionine restriction may act synergistically with chemotherapies to increase their efficiency and /or reduce their toxic side effects.Therefore, methionine restriction would become a new cancer treatment.

Methionine dependence is one of characteristic metabolism deficiency in cancer cells.Recently a series of researches focusing on key enzymes of methionine metabolism demonstrated that several molecular events might relate with cancer cell methionine dependence(i.e.,methionine synthasesingle nucleotide polymorphism,methythioadenosine phophorylasegene deletion,down regulation of thymidylate synthase translation;up regulation of methylenetetrahydrofolate reductase expression).Cell apoptosis induced by intracellular signal transduction dysfunction might be another potential mechanism.

Glutamine is the most abundant free amino acid in the body,which is regarded as a conditionally essential amino acid under the conditions of stress and hypermetabolism.It has been proved that glutamine can enhance the proliferation of immune cells and the repair of impaired mucosa and can also improve the nitrogen balance and skeletal muscle protein synthesis.Therefore,it is now more and more widely used in the bone marrow transplantation.The roles of glutamine in the prevention and treatment of bone marrow transplantation-related mucositis and veno-occlusive disease are reviewed in this article.

Sepsis may result in a high mortality.Fish oil,which riches in ω-3 polyunsaturated fatty acids.has anti-inflammatory and immune regulatory functions.ω-3 fatty acids,which are special immune nutrient substrates,participate in the energy provision as well as improve organ function and regulate proinnammatory/anti-inflammatory cytokines.The ideal function of fish oil is associated with dosage,time of initiation and duration of application.

Objective To establish a comprehensive nutritional assessment scale for hospitalized patients with objective and subjective nutritional assessment indicators. Methods The hierarchical structure model was established to evaluate the nutritional status of hospitalized patients by analytic hierarchy process,and the weight coefficients of various assessment indicators were worked out by Satty product method,then the comprehensive nutritional assessment scale for hospitalized patients was established. ResuIts The newly established comprehensive nutritional assessment scale included 11 subjective and objective indicators,and the weight coefficients of indicators varied.The leading three important indicators for nutritional assessment were serum prealbumin(2.3),serum albumin(2.3)and degree of weight loss(1.6).Conclusion With both snbjective and objective indicators,the new comprehensive nutritional assessment scale established with analytic hierarchy process transforms the qualitative indicator into the quantitative one.It is a new attempt to apply the mathematical theory into the area of clinical medicine.

The Subjective Global Assessment(SGA) is widely applied in the clinic.The usage and the clinical purpose of SGA is quite different among the various studies.In some studies,SGA proved to be a good screening tool for nutritional risk or a prognostic indicator for poorer outcomes.In several clinical setting,SGA was employed as a "gold standard" method against which new nutritional assessment methods were validated.At present,the different indicators of nutritional assessment reflect the different characteristics of the body's nutritional status changes.The different indicators and methods should be incorporated according to the patient in order to objectively and correctly assess the patient's nutritional status.

Oxidative stress induced injury mediated by active oxygen radicals(AOR) is one of important pathophysiologic characteristics in critical illness such as severe trauma,shock,sepsis and pancreatitis.Large amounts of AOR can be generated and the function of antioxidant system will be severely compromised with the result of an imbalance between oxidative and anti oxidative.Supplementation with anti oxidant via nutrition supports may be an important way to reduce oxidative stress induced injury in critical care.But there are some problems such as the timing,methods,dosage,safety and effectiveness of this regime.

n 3 fatty acids belong to essential fatty acids. It includes linolenic acid, eicosapentaenoic acid ( EPA ) and docosahexaenoic acid ( DHA ). Many researches proved that n 3 fatty acids can suppress many kinds of tumor cells, and defense the occurrence of tumor. This article reviewed the effects and mechanism of n 3 fatty acids in defension and suppression of tumor.

Objective To investigate the relationship between absent end-diastolic velocity of fetal umbilical artery (AEDV) and perinatal outcome. Methods The color Doppler ultrasound result of maximum flow velocity waveforms at the cardiac level (aorta, pulmonary artery) and the peripheral level (fetal umbilical artery, middle cerebral artery) in 27 cases with Umbilical artery AEDV were analyzed. Fetal heart rate monitoring was performed and perinatal outcome was followed up. Results All of the 27 cases presented with remarkable pulmonary artery contraction. The result of velocity time integral (VTI)?fetal heart rate (FHR) and right cardiac output declined significantly. Among 22 cases with continuous monitoring, 10 cases showed reduced PI of middle cerebral artery (MCA) without changes of left cardiac output; 12 cases had biphasic changes of the MCA PI which consisted of decrease followed by increase and showed significant reduction of VTI?FHR of aorta and left car-(diac) output. The interval between the first detection of AEDV and the presentation of abnormal FHR patterns was 2 to 7 days. Conclusions Umbilical artery AEDV usually precedes the presentation of abnormal FHR under fetal hypoxia. Delivery before decompensation may improve the perinatal morbidity and mortality.