Radiotherapy is frequently employed as part of the multimodal treatment of cancers.Despite recent advances in ir-radiation techniques, radiation-induced side effects are more common.Radiation enteritis is a term traditionally used to define injury to the small intestine resulting from radiotherapy.The radiotherapy could induce damage of pelvic normal tissue.The most patients with radiation enteritits may also have co-existing radiation-induced damage of pelvic other tissue or organ.The radiation enteritis was man-aged, however, the therapy of pelvic damaged tissue or organ were ignored.Therefore, in 2015, we proposed the concept of radiation pelvicopathy which is most accurate description of the disease process and pathological characteristics.The purpose is to emphasize the interdisciplinary approach of pelvic radiation damage.

Injuries in the choledocho-pancreatico-duo-denal junction are rare, and are frequently associated with other severe vascular and visceral injuries. Interventions during early operation may aggravate the condition of patients, while proper application of damage control surgery (DCS) is helpful in raising the survival rate. Therefore, for most of the patients with choledocho-pancereatico-duodenal junction injury, definite opera-tion should be performed after removal of necrotic tissues, control of infection and adequate drainage. However, DCS should be applied with caution, and the indications of DCS should be strictly followed, because reoperation will increase the chance of injury and infection after DCS.

The fat emulsion in parenteral nutrition is very important.Fish oil has immunomodulation,intestinal mucosa barrier improvement and liver protective effects.Fewer postoperative complications and shorter ICU and hospital stay could be obtained through perioperative supplemention of fish oil.

Metabonomics is a method of understanding metabolic regulation by studying small molecules,which has been widely used in toxicology and pharmacology.But nutritional metabonomics is relatively new.The application of metabonomics to nutritional research still has many challenges,such as the development of small molecular libraris,and the deletion of signal noise.However,with the development of pattern-recognition techniques,scientists are optimistic with nutritional metabonimics development.

Organ transplantation is the treatment of choice for patients with end stage organ disease, many organ transplant patients with malnutrition are at high risk for developing postoperative complications, and causing death. Nutritional support can improve outcome of organ transplant patients.

Chemotherapy has been shown to be effective in the treatment of patients malignancies, however, anticancer drugs, particularly high-dose, also damage other chemosensitive tissues such as the intestinal mucosa, and these adverse effects can impair intestinal mucosal barrier. The derangement in the barrier function plays a central role in the pathophysiology of systemic infection, shock, and sepsis syndrome. The chemotherapy-induced intestinal barrier dysfunction and its prevention and treatment had been reviewed.

There have appeared many new insulin analogues in recently years. Two of them are rapid-acting insulin analogues(aspart,lispro).The regions between the insulin analog molecules were modified,which have shorter time than regular human insulin in onset of action,peak,duration of acting,and are better in decreasing postprandial glucose and opportunity of hypoglycemia before next meal.The another insulin analogues were galargine and detemir.They were obtained from changing insulin isoelectric point and increasing molecular weight,which lengthen time for disintegration,absorption and action and have little absorption variation and no overt peak.They can simulate physiological base insulin excretion.

Glutamine is the most abundant amino acid in mammalian plasma and involved in the metabolism and tissue homeostasis of some important substance under physiological and pathological situations.Function of glutamine should be based on its transport into or out of the functional cells via transporters located in cytomembrane.As the liver is the primary center of amino acids homeostasis in the body,it is helpful to learn structure and function of those transporters in hepatic plasma membrane to having a better understanding of the metabolism and function of glutamine.

Fast-track surgery is a new concept in general surgery nowadays.Fluid therapy,one part of fast-track surgery,is an important part,which go through with the whole perioperative process.Fluid therapy includes short time of fasting,no bowel preparation,appropriate postoperative fluid management,new monitoring technologies of hemodynamics,and so on.This new approach benefits preventing postoperative complications such as postoperative insulin resistance and cardiopulmonary failure.Still,this is a new concept which needs to be examed in clinical practices.In the future,the challenges lie within procedure-specific approaches,goaldirected therapy,the balance between the amount and composition of colloid vs crystalloid and the developments of the optimal techniques to monitor intra-and post-operative hemodynamics.

Vitamin D ( VD) has been stated clearly in maintaining the balance of serumcalcium and phosphorus in human . Whereas, more and more evidences show VD has a considerable range of other physiological functions .VD has also been proposed to have vital functions controversially including adjusting immunity, antitumor, enhancing barrier in the intestine .The patients of short bowel syndrome are at particularly high risk of vitamin D deficiency .It has a significance in prevention and treatment of diseases to fur-ther clearly clarify the relationship and mechanisms of VD and the diseases .