Patients with malignant tumors usually suffer from malnutrition. This condition increases morbidity and mortality, de-creases the efficacy of anticancer treatments, increases the risk of therapy-associated side effects, increases the length of hospital stay, and degrades the quality of life of patients. These effects of malnutrition highlight the need for adaptive nutritional support for each step of a multimodal cancer treatment.

Patients with gastrointestinal cancer usually suffer from malnutrition,which is associated with increased incidence of surgery-related complications and mortality,prolonged duration of hospital stay,reduced quality of life.The feasible and effective perioperative nutritional support therapy could improve nutritional status and immunologic function of patients,meanwhile,reduce incidence of infected complications,duration of hospital stay and mortality.

Parenteral nutritional support are used widely in clinical practice.Little is known about the effects of macronutrients on gastrointestinal motility and secretion.Several studies have provided evidence that nutrients during the circulatory phase of digestion influence gastrointestinal motility and secretion.Glucose exerts an inhibitory effect on gastrointestinal motility and secretion.The inhibitory effect of glucose is dose-dependent.Circulating amino acids at high concentrations stimulate gastric acid secretion,pancreatic enzyme secretion,gallbladder contraction and intestinal motility.Intravenous infusion of fat emulsions delays gastric emptying and interrupts the interdigestive intestinal motor pattern.

Evidence suggests that translocation of gut bacteria or their toxins is a major contributor to gut-derived sepsis and multisystem organ failure in critically ill patients.This review reevaluates the data from studies in animal models and humans on bacterial translocation.The new insights in mechanisms of bacterial translocation pathogenesis and its clinical relevance will help clinicians to make correct strategies to enhance gut function.

Objective To evaluate the quality of the randomized controlled trials (RCTs) published in two key Chineze journals on clinical nutrition.Methods The articles published in CHINESE JOURNAL OF CLIN-ICAL NUTRlTION and PARENTERAL & ENTERAL NUTRITION from 2000 to 2008 were reviewed and the RCTs were identified according to criteria of the handbook of Cochrane Collaboration.The Jadad scale was used to evalu-ate the quality of these RCTs.Results Totally 238 RCT articles were published in these two journals in this peri-od.The Jadad score of all RCT articles was 1.65±0.82.Twenty-eight articles (11.76%) were of high quality and only 5 articles (2.10%) were identified 5 points.There were some problems in the RCTs design,conduction and analyses included unclear randomization methods,poor comparison,lack of inclusion and exclusion criteria.less blinding employment,unclear withdrawals and dropouts,and improper sample size.Conclusion The design and quality control of Chinese clinical nutrition RCTs still have some problems and require further improvement.

The barrier function is an important characteristic of the gut and an important determinant in the outcome of critically ill patients. Its workings are complex and it consists of epithelial, molecular, and immune components. The pathogenesis of gut dysfunction among critically ill patients is multifactorial. The purpose of this literature review is to provide a better understanding of the normal defense mechanisms of the gut, alterations associated with ischemia reperfusion injury, risk of infection, starvation and malnutrition and severe trauma, and potential therapies for gut dysfunction in critically ill patients.

ObjectiveTo study the metabolic changes and complications of a patient on long term home parenteral nutrition (HPN). MethodsClinical data were summarized on a female patient with total small bowel plus right colon resection receiving home parenteral nutrition support for 16 years. ResultsThe patient became pregnant on the 5th year of HPN, and gave birth to a healthy baby. Her liver function remains almost normal during the 16 years. Each central vein catheter averagely lasted for 240 days, with the longest one more than 26 months. Catheter related sepsis rate was very low. Several complications occurred during the 16 years, including anaemia, zinc deficiency and increased serum iron level. Lipid peroxidation increased significantly. ConclusionsLong-term HPN support patient could suffer many metabolic abnormalities complications. Catheter related sepsis and occlusion should be prevented. The HPN formula should be adjusted according to the patient′s condition.

Objectives:The purpose of this study was to measure the body composition of malnourished patients by dual energy X ray absorptiometry. Methods:Body composition was measured by dual energy X ray absorptiometry in 56 manlnourished patients and 72 healthy subjects. Results:Compared with control,patients had lost?(on average)?17.8?kg of body weight (P0.05). Conclusions: Reduced body weight in malnourished patients was due to loss of fat tissue and lean body mass.

Objectives:The purpose of this study was to measure the body composition of malnourished patients by bioelectrical impedance analysis. Methods:Body composition was measured by bioelectrical impedance analysis in 68 malnourished patients and 78 healthy subjects. Results:The investigation showed that malnutrition patients were characterized by a depletion in fat mass,fat free mass, body cell mass,intracellular mass and an expansion of extracellular mass( P

Objective To evaluate the safety and effect of enteral nutrition support at early period after gastroenteric operation. Methods 62 patients with gastrointestinal cancer were divided into three groups randomly: control group, TPN group, and TEN group. Patients in TPN and TEN groups received 7 days nutritional support in isonitrogenous and isocaloric. The peripheral vein blood was sampled before operation and 7 day after that to observe nutritional status and T lymphocyte subsets, NK cells, and NK cell activity. Resalts There were no significant difference in the three groups in albumin and anthropomentric measurement, visceral proteins decreased in three groups in postoperative period, but the values of control group was more seriously than TPN or TEN groups (P<0.05). Mean nitrogen balance: - 8.6 ± 3.12g/day in control group, - 4.22 ± 2.02g/day in TPN group, - 3.88 ± 2.35g/day in TEN group (P<0.05). CD3 ,CD4 ,CD4/CD8, NK cells and NK cell activity decreased in postoperative period in three groups, but there are no significant ditference in three groups. Conelasions Enteral nutrition support at early period after gastroenteric operation is safety and effective.