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.

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.

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.

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.

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

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: To evaluate if the administration of an enteral diet supplemented with glutamine, arginine and ? 3 fatty acids modulates inflammatory and immune responses after surgery. Methods: Forty eight patients with gastrointestinal cancer randomised into two groups, one of which was given an isocaloric and isonitrogenous standard diet and the other group was fed the supplemented diet with glutamine, arginine and ? 3 fatty acids. The feeding was started within 48 hours after operation, and continued until day 8. All variables were measured before operation and on postoperative day 1 and 8. Immune response was determined by phagocytosis ability, respiratory burst of polymorphonuclear cells, total lymphocytes lymphocyte subsets, nitric oxide, cytokine concentration, and inflammatory responses by plasma levels of C reactive protein and prostaglandin E 2. Results:Tolerance of both formula diets was excellent. There were significant differences in the immunological and inflammatory responses between the two groups. In supplemented group, phagocytosis and respiratory burst after surgery were higher and C reactive protein level was lower ( P