Objective:Small bowel IRI models in rats were established to explore the effect of glutamine enriched parenteral nutrition on mucosal barrier,and to discuss the probable mechanisms.Methods:Thirty Wistar rats were randomly assigned into 3 groups:The control group(N group,n=10) ,conducted fictitious operation and fed with common forage,TPN group(n=10) and TPN+Glu group(n=10) .The morphous of mucous,serum and intestinal mucosal Gln concentration,levels of D-lactate,endotoxin,TNF-?,IL-6,HO-1 positive ratio and HO-1 mRNA were detected.Results:Glutamine obviously improved the structure of intestinal mucosal and decreased the expressions of D-lactate,endotoxin,TNF-?and IL-6.And enhanced the expressions of HO-1 mRNA and HO-1.Conclusion:Glutamine enriched parenteral nutrition can alleviate small intestinal IRI and inflammatory reaction and enhance the HO-1 and HO-1 mRNA expressions.HO-1 and its metabolin's anti-oxygen,anti-apoptosis,anti-inflammator action may be the mechanism of the protective action of Gln on mucosal barrier of small bowel.

Objective:To investigate the independent correlation between serum IL-6 level and delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH) and to evaluate its predictive value for DCI.Methods:Consecutive patients with aSAH admitted to the Affiliated Hospital of Jining Medical University from June 2017 to June 2019 were enrolled retrospectively. They were divided into DCI group and non-DCI group according to the diagnostic criteria of DCI. Multivariate logistic regression analysis was used to determine the independent correlation between serum IL-6 and DCI. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of serum IL-6 level for DCI. Results:A total of 160 patients with aSAH were enrolled. They aged 66.1±8.1 years, and 98 were males (61.3%); 76 patients (47.5%) had DCI. Multivariate logistic analysis showed that after adjusting for smoking, hypertension, systolic blood pressure, hyperlipidemia, and drug treatment, serum IL-6 (the first quartile as a reference, and the third quartile: odds ratio[ OR] 3.885, 95% confidence interval [ CI]1.361-7.189; the fourth quartile: OR 9.706, 95% CI 3.412-18.344), Glasgow Coma Scale score ( OR 2.174, 95% CI 1.325-4.538) and Fisher grade ( OR 3.267, 95% CI 1.638-6.725) were independently associated with DCI. The ROC curve showed that the area under the curve of serum IL-6 for predicting DCI was 0.777 (95% CI 0.706-0.849), and the optimal cut-off value was 13.01 ng/L. The sensitivity and specificity of predicting DCI were 72.4% and 71.4%, respectively. Conclusions:Serum IL-6 is an independent risk factor for DCI after aSAH, and has certain predictive value for DCI.