Objective: To investigate the mechanism that glutamine downregulates the cytokine expression in lipopolysaccharide-stimulated human peripheral blood mononuclear cells.Methods:PMBC were extracted from healthy volunteer by density gradient centrifugation,and stimulated by lipopolysaccharide.The release of TNF-α and IL-10 was analyzed via enzyme-linked immunosorbent assay and p-P38 via western blot. Results:Gln led to an increase in HSP70 expression,and decreased TNF-α、IL-10 release at 4 h after LPS stimulation.The expressions level of TNF-α、IL-10 and P-P38 were decreased after using SB203580.Conclusion:These results indicate that the effect of Gln could attenuate cytokine release in PBMC and might may be related to the inhibition of P38 MAPK.

Objective To analyze the nutritional status of premature neonates first fed with extensively hydrolyzed protein formula.Methods From January 2013 to December 2014, 157 premature neonates hospitalized in Neonatal Intensive Care Unit of Shanghai Children's Medical Center who were first fed with extensively hydrolyzed protein formula were enrolled.Clinical data were recorded, including related diseases, birth weight and gestational age, nutrients intake, and growth charts.Two groups were divided according to the existence or absence of feeding intolerance, and three groups were divided based on birth weight (＜ 1 500 g, 1 500 ～ 2 500 g,and ≥2 500 g).Results A total of 60 (38.2％) premature infants had feeding intolerance.The lower the birth weight and gestational age, the higher the frequency of feeding intolerance, and the incidence of feeding intolerance in ＜ 1 500 g group was 71.1％.Compared with the feeding tolerance group, the feeding intolerance group had significantly smaller birth weight [(1 620 ±440) g vs.(1 980 ±421) g, P =0.000], gestatonal age [(31.3 ±2.6) weeks vs.(33.0 ±2.1) weeks, P =0.000], birth head circumference [(28.9 ±2.2) cm vs.(30.4±1.9) cm, P=0.000], and birth length [(41.1 ±3.9) cmvs.(43.2±3.4) cm, P=0.000],but significantly longer time before transfer formula [(26.4 ± 17.6) d vs.(7.9 ± 5.3) d, P =0.000] and time before reaching sufficient feeding [(21.5 ± 10.0) d vs.(13.8 ± 6.2) d, P =0.000].The time of first feeding [＜ 1 500 g group (6.1 ±5.1) d, 1 500 ～2 500 g group (3.8 ±2.5) d, ≥2 500 g group (3.3 ± 1.2) d,P =0.002], time before transfer formula [＜ 1 500 g group (28.7 ± 18.3) d, 1 500 ～ 2 500 g group (9.7 ± 8.1) d, ≥2 500 g group (7.0 ±3.8) d, P =0.000] and time before reaching sufficient feeding [＜ 1 500 g group (24.0±10.4) d, 1 500～2 500 g group (14.3±6.0) d, ≥2 500 g group (11.4±3.5) d, P=0.000] increased along with the decrease of birth weight.The proportions of infants receiving parenteral nutrition in the feeding intolerance group (93.3％) and ＜ 1 500 g group (97.8％) were higher, with more calorie intake from parenteral nutrition [＜ 1 500 g group (325.9 ± 59.4) kJ/ (kg · d), 1 500 ～ 2 500 g group (281.2±64.8) kJ/ (kg·d), ≥2 500 g group (269.9 ±43.9) kJ/ (kg·d),P=0.001] and longer duration [＜ 1 500 g group (27.1 ± 14.5) d, 1 500 ～2 500 g group (13.0 ±7.0) d, ≥2 500 g group (8.7 ± 3.4) d, P =0.000].In terms of growth indicators, the increase in head circumference was significantly higher in the feeding intolerance group than in the feeding tolerance group [(0.7 ± 0.6) cm/week vs.(0.6 ± 0.5) cm/week, P =0.045].The increases in body weight and head circumference in the ＜ 1 500 g group were significantly higher than in the other 2 birth weight groups [body weight: ＜ 1 500 g group (21.8 ± 9.5) g/d, 1500～2500ggroup(4.2±7.6) g/d, ≥2 500 g group (4.9 ±11.9) g/d,P=0.000;head circumference : ＜ 1 500 g group (0.8 ± 0.4) cm/week, 1 500 ～ 2 500 g group (0.5 ± 0.4) cm/week, ≥ 2 500 g group (0.6 ± 0.8) cm/week, P =0.005].After controlling the variable of feeding intolerance,weight gain was negatively associated with gestational age (r =-0.666, P =0.035), birth weight (r =-0.700, P =0.024), head circumference (r =-0.846, P =0.002), and the day of returning to birth weight (r =-0.697, P =0.025), while positively associated with head circumference gain (r =0.672, P =0.033).There were no relationship between weight gain and birth length, the day of first feeding, time before transfer formula, time before reaching sufficient feeding, parenteral nutrition calorie and duration, days of hospital stay and complications.Conclusions First fed with extensively hydrolyzed protein formula, the growth in feeding intolerant premature infants may be similar to the feeding tolerant ones, which is associated with parenteral nutrition support.Premature infants with lower gestational age, birth weight, and head circumference may be more suitable for extensively hydrolyzed protein formula feeding.

Objective To monitor the changes of resting energy expenditure in ventilated critically ill children,to compare the results of standard equations and indirect calorimetry (IC) in predicting energy expenditure,and to investigate the possible influence factors of the metabolic status of the critically ill children.Methods From September 2012 to September 2013,56 critically ill children on assisted ventilation and fitting the requirements of IC in pediatric intensive care unit of Shanghai Children's Medical Center were enrolled in this prospective study.IC measurements were performed using metabolic cart on day 1,4,7,10 after trachea intubation.General clinical data of these children were recorded.Results 130 IC measurements were performed in the 56 children.The measured resting energy expenditure (MREE) did not exhibit significant differences among day 1,4,7,and 10 (P =0.379).Although there were no significant differences between MREE and energy expenditure predicted with Schofield and WHO equations (P =0.917,P =0.995),the agreement was poor between the measured and predicted values (R2 =0.185,R2 =0.322).The metabolic status of the children on day 1 of ventilation was only correlated with age (P =0.000) and height (P =0.027),not with severity of underlying diseases or clinical outcomes.Conclusions MREE of IC method in ventilated critically ill children did not significantly change over time in this study.A poor agreement was observed between equationpredicted energy expenditure and MREE.IC measurement of resting energy expenditure is recommended for guiding individual nutritional support among critically ill children so as to improve clinical outcome.

Objective: To investigate whether ω-3 fatty acid supplementation affects immune function, infection and surgery ratio in severe acute pancreatitis patients. Methods: Fifty-six severe acute pancreatitis patients were prospectively enrolled and were randomly assigned to receive total parenteral nutrition (TPN) for 5 days in a double-blinded manner with either soybean oil (SO) or fish oil (FO) supplementation. The level of IL-10 and HLA-DR expression were measured before TPN and on the sixth day after starting TPN. The clinical outcomes such as infection and surgery ratio were recorded. Results % Patients treated with ω-3 FA had significantly higher IL-10 concentration and better HLA-DR expression during the observation period. Although there was no significant difference between two groups, the ratio of infection and surgery ratio had a trend to decrease in the study group. Conclusion: TPN supplemented with ω-3 FA improves anti-inflammatory cytokine and immune function in SAP patients. It also leads to the attenuated risk of infection and surgery ratio.

Objective To assess the nutritional status of critically ill children and the nutritional intake during their stay in pediatric intensive care unit (PICU),and analyze the correlation factors of nutritional deftciencies.Methods One hundred and twenty-seven patients who met the PICU admission standards with a PICU stay of ＞72 h were recruited from June to October 2012 in Shanghai Children's Medical Center.Anthropometric measurements and all nutrition-related indicators of those patients were recorded from day 1 to day 10.Results 59 of the 127 patients (46.5％) showed malnutrition at admission,in which 49.2％ had severe malnutrition.65 of the 127 patients (51.2％) showed malnutrition at discharge,in which 63.1％ were severely malnourished.Median estimated energy requirements (EER) by American Society for Parenteral and Enteral Nutrition was 376.7 kJ/ (kg · d) [interquartile range,IQR:314.0～376.7 kJ/ (kg · d)],prescribed calories were 237.8 kJ/ (kg· d) [IQR:159.5 ～291.8 kJ/ (ks· d)],and delivered calories were 220.2 kJ/ (kg· d)[IQR:132.3 ～ 279.2 k J/ (kg · d)],showing significant difference (P =0.000).The delivered energy was ＜90％ of EER in 80.7％ of the 1021 recorded days and the prescribed energy was ＜90％ of EER in 74.3％of the 1021 recorded days.The cumulative calory deficiency from day 1 to day 10 in PICU was (933.5 ±745.5) kJ/ (kg · person),and the cumulative protein deficiency was (4.0 ±5.0) g/ (kg · person).83 patients (65.4％) experienced at least one feeding interruption.Altogether 170 times of feeding interruption were recorded,of which 117 (68.8％) could be explained by examination procedures.Conclusions There is a high prevalence of malnutrition in critically ill children at admission into PICU,and their nutritional status deteriorates during hospital stay.Discrepancies between required and delivered energy were mainly attributed to under-prescription,while discrepancies between prescribed and delivered energy were mainly attributed to feeding interruptions.Appropriate care for these children entails early nutritional risk screening and correct nutrition support to avoid nutritional deficiencies.

Objective To investigate the significantly elevated incidence of hepatitis C and mortality of cirrhosis and hepatocellular carcinoma (HCC) in Jianping county, and to explore the epidemiological features. Methods The data from database of death registry and infectious disease surveillance in Jianping county, Liaoning Province were analyzed. The distributions of incidence of hepatitis B and hepatitis C, mortality of cirrhosis and HCC in 23 villages and towns were investigated.Spearman's correlation was used to explore the correlations between hepatitis, cirrhosis and HCC.Results The standardized mortality of HCC in males and females in Jianping county were 77. 6/10~5and 22. 0/10~5, respectively, which were 2. 0 and 1. 7 times, respectively of the average levels of Liaoning rural areas. The incidence of hepatitis C was 58. 0/10~5 , which was 9. 5 times of the averagelevel of Liaoning Province. There were positive correlations between incidence of hepatitis C and mortality of cirrhosis (r=0. 495, P = 0. 008), and mortality of cirrhosis and HCC (r=0. 646, P<0.01). Conclusions The incidence of hepatitis C and mortality of cirrhosis and HCC in Jianping county are significantly higher than the average levels of Liaoning Province. Further investigations of the suspected causes are needed.

Objective To explore the change of dietary intake and nutritional status before and after hematopoietic stem cell transplantation (HSCT) in pediatric patients to assess the importance of nutritional interventions.Methods In this observational cohort study,65 children undergoing HSCT between January 2012 and November 2012 in the Department of Hematology and Oncology,Shanghai Children's Medical Center were enrolled.The data collected before preconditioning were considered as the baseline data.We also collected data twice a week between preconditioning and 30 days after HSCT,and once a week from 30 days to 100 days after HSCT.Dietary analysis and urea nitrogen analysis were conducted in parallel.Results The baseline level of energy intake was (5 844.9 ±2 490.4) kJ/d,protein intake was (56.4 ±28.6) g/d,fat intake was (49.7 ±38.9) g/d,and carbohydrate intake was (190.9 ± 91.1) g/d.With the hematopoietic reconstruction,the oral nutrients intake significantly decreased compared with the baseline levels (all P =0.000).During the recovery period after HSCT,the energy intake showed no significant difference when compared with the baseline level in the 6th postoperative week,protein in the 13th week,carbohydrate in the 4th week,and fat in the 6th week.The urine nitrogen was (3.9 ± 2.4) g/d before HSCT,which increased to (16.7 ± 11.0) g/d after preconditioning (P=0.000).In the 1st postoperative week,the weight (P =0.000),triceps skin fold thickness (P =0.003),mid-upper arm circumference (P =0.000),serum albumin (P =0.000) and prealbumin (P =0.000) of the patients all significantly decreased compared with the baseline levels.In the 9th postoperative week,the fat-free body weight percentage (P =0.010),muscle percentage (P =0.001) and protein percentage (P =0.000) were significantly lower than the baseline levels,while the body fat percentage was higher than the baseline level (P =0.002).Conclusions Children undergoing HSCT exhibit a marked reduction in nutrient intakes at the early stage of HSCT,which may gradually return normal during the recovery period.This process may be slow,especially for the protein,and therefore may affect the serum protein level in these pediatric patients.Thus,more careful nutrition guidance is necessary during HSCT for pediatric patients,emphasizing oral nutrients intakes,and high protein dietary or formula may be helpful.

Objective To know the ability of rural health doctors, find out the scope of job satis-faction and desire of training and extending for chosen extending rural health doctors. Methods Various factors were analyzed, which affect the appropriate health technology extension in rural areas based on the study in Liaoning province with the method of the questionnaire and the categorical data statistics. Results The quality of medical human resources in rural area was low. The main influencing factors for training were practicality of the training, rescannable time and whether increasing income. Meanwhile, The appropriate health technology extension was affected by the rationality, validity, safety of techniques, acceptance degrees of patients as well as the individual professional basis. Conclusion It was necessary to focus on continued medical education to improve the rural doctor's ability. Some tactics was also put forward to promote the technology extension effect. This study provided some suggestions which could be used as references for the government making decision.

Objective To explore the mediating effects of resilience between family function and geriatric depression. Methods By convenient sampling, 212 elderly people who were from the communities in Yuexiu, Guangxhou city were analyzed by using Geriatric Depression Scale (GDS-30) and Family Concern Index Questionnaire (APGAR) and Connor-Davidson Resilience Scale (CD-RISC) and the self-designed General Condition Questionnaire, and a mediating model was proposed and the impacts of resilience on family function and geriatric depression were tested. Results The incidence rate of depression among the community elderly was 23.6% (50/212), and the average score of APGAR was 7.87 ± 2.83, and the average score of CD-RISC was 83.66 ± 12.88. The scores of GDS-30 showed significantly negative correlation with the scores of APGAR (r=-0.582,P<0.01)and the scores of CD-RISC (r=-0.425, P<0.01), and there was positive correlation between the scores of APGAR and the scores of CD-RISC (r=0.335, P < 0.01). The mediating model had high degree of fitting, and level of path had statistical significance (P < 0.01). Resilience was the mediator between family function and geriatric depression. Family function had direct effects (0.50) on geriatric depression and indirect effects (0.11) through resilience, and the combined effects of family function and resilience determined 45%changing range of geriatric depression. Conclusions Family function was a direct predictor of geriatric depression, and resilience had mediating effects between family function and geriatric depression. Community mental health work should pay enough attention to the effects of family function on the life of the aged, and increased the care to the elderly with family dysfunction, while promote and develop family-centered mental health education, propaganda and psychological guidance, so that improves resilience of the aged and help the aged positively coping and maintain good mental health status.

PURPOSE: The cancer survival was characterized by following up sampled subgroups of cancer cases from three population-based cancer registries in Northeast China. MATERIALS AND METHODS: Survival analysis was used to analyze 6,871 patients, who had one of the 21 most common cancers based on sampling from the population-based cancer registries of three cities in Liaoning Province. All patients were diagnosed between 2000 and 2002 and were followed up to the end of 2007 by active and passive methods. The 5-year age standardized relative survival rates (ASRS) were estimated for all cancers combined and each of the 21 individual cancers. RESULTS: The survival status was traced for 80.8% of 8,506 sampled cancer cases. The 5-year ASRS for all 21 cancers combined was 41.5% (95% confidence interval, 40.3 to 42.7), the highest ASRS was observed for thyroid cancer (85.2%), breast cancer (78.9%), uterine corpus cancer (75.9%), and urinary bladder cancer (70.2%); the lowest 5-year ASRS was noted in pancreatic cancer (8.8%), liver cancer (11.0%), esophageal cancer (18.8), and lung cancer (19.6%). The cancer survival rates in Liaoning cities were similar to those of urban areas in mainland China, but significantly lower than those in Hong Kong, Korea, and Japan. CONCLUSION: The strikingly poor cancer survival rates in three cities of Liaoning Province and in other places in China highlight the need for urgent investment in cancer prevention, early detection, and standardized and centralized treatment.
Breast Neoplasms ; China* ; Esophageal Neoplasms ; Hong Kong ; Humans ; Investments ; Japan ; Korea ; Liver Neoplasms ; Lung Neoplasms ; Pancreatic Neoplasms ; Registries* ; Survival Rate ; Thyroid Neoplasms ; Urinary Bladder Neoplasms