Objective:To investigate the effect of early enteral nutrition combined with Bacillus in the treatment of patients with digestive tract perforation.Methods:59 patients with emergency digestive tract perforation were randomly divided into experimental group (EN plus Bacillus,n =31) and control group (TPN,n =28).The patients in the experimental group were given enteral nutrition plus Bacillus after first days (＜ 24 h),and the control group was treated with parenteral nutrition support on the first day after surgery.The average hospitalization time,length of ICU stay,incidence of complications,and serum C-reactive protein in the two groups were analyzed.Results:The average length of hospitalization time,ICU stay,recovery of bowel function and eating time were significantly shorter in the experimental group than in the control group(P ＜ 0.05).There was no significant difference in nutrition index between the two groups during the perioperative period (P ＞ 0.05).The C-reactive protein in the experimental group was significantly lower than that in the control group fourth days after operation (P ＜ 0.05).The incidence of postoperative wound infection in the experimental group was significantly lower than that of the control group (P ＜ 0.05).There was no significant difference in the incidence of other complications.Conclusion:Early administration of enteral nutrition combined with Bacillus can significantly shorten the intestinal function recovery time,decreasethe average hospitalization days,reduce the postoperative wound infection rate and thus improve the outcome of patients with digestive tract perforation.

Microflora extensively exist in the environment and are closely related to our health.Intestinal microflora have been concerned greatly,and have a profound effect on regulating the immune environment,metabolism and host physiological function.The purpose of this review was to describe the new progress of intestinal microflora on immune function and disease pathogenesis in recent years.

Objective:To study the eftect of plateau environment on the body compositions of soldiers.Methods:A total of 120 male soldiers were selected for the study.All of the study subjects received a physical examination between June and November in 2014.Bio-electrical impedance technique was used to measure the subjects' body composition including 33 parameters such as body mass index (BMI) and body fat mass.Results:Compared to that before entering into the plateau,the levels of 31 parameters were significantly lower after entering into plateau,except the distribution of muscles in left lower limb and ECW/TBW in right upper extremity.Conclusion:The body compositions of soldiers may decrease under plateau environment.This phenomenon need to be interfered purposefully to aTange scientific diets and training intensity.

Objective:To compare the nutritional status between alcoholic cirrhosis and viral cirrhosis,and to provide reference information for the nutritional support strategy.Methods:95 alcoholic cirrhosis and 260 viral cirrhosis patients were involved in the study.The patients were reviewed with NRS 2002 and SGA within 48 hours after admission.The general information and liver function parameters including gender,age,BMI,Child-Pugh score,ALB,PA and Hb were recorded.Results:The NRS 2002 nutritional risk rate of alcoholic cirrhosis and viral cirrhosis patients was 76.80％ and 65.00％,respectively.The SGA malnutrition rate of alcoholic cirrhosis and viral cirrhosis patients was 67.40％ and 61.90％,respectively.There was statistically significant difference between the two groups in gender,Child-Pugh A rate,ALB,PA,Hb and NRS 2002,while there was no significant difference in age,Child-Pugh B rate,Child-Pugh C rate,BMI and SGA.Conclusion:Nutritional dysfunction exists in both of the two types of liver cirrhosis.The nutritional risk rate and the anemia rate in alcoholic cirrhosis patients are significantly worse than those in viral cirrhosis patients.

Objective:The objective of this study was to evaluate the relationship between the adequacy of nutritional therapy and prognosis in trauma patients.Methods:217 trauma patients were included.The nutritional therapy interventions were divided into three groups:low energy therapy (＜50％),moderate energy therapy (50％ ～ 80％),high energy therapy (＞ 80％).General data,hospitalstay,ICU stay,infectious complications and mortality were compared among groups.Results:The protein intake of high energy group was higher than the other two groups (P ＜0.01).High energy therapy was associated with reduced mortality and decreased length of hospital stay.Kaplan-Meier survival analysis indicated that high energy therapy had a significantly higher 60 days cumulative survival rate compared with other groups.Conclusion:High energy therapy is more effective and associated with improved mortality and decreased length of stay.

Objective:To investigate the effects of two different routes of nutrition support on the treatment of severe pneumonia in elderly patients.Methods:From January 2015 to January 2016,84 elderly patients with severe pneumonia in our hospital were randomly divided into two groups,42 patients in each group.The enteral nutrition (EN) group was treated with nasogastric feeding and another group was defined as combined treatment group.After 4 weeks of treatment,the nutritional status of two groups of patients was compared.The incidence of complications during treatment were documented.Results:After treatment,the hemoglobin was (111.34 ± 20.33) g/L,and the albumin was (23.33 ± 5.09) g/L in the EN group.The hemoglobin was (132.13 ±24.39) g/L,and the albumin was (35.43 ±9.12)g/L.There was significant difference between the two groups (P ＜ 0.05).The cure rates of the two groups were 92.86％ and 95.24％,respectively,and there was no significant difference (P ＞ 0.05).Conclusion:For elderly patients with severe pneumonia,the combination of enteral and parenteral nutrition is more likely to improve the nutritional index,and has a lower incidence of adverse events.

Objective:To investigate the clinical efficacy of electroacupuncture therapy for critical ill patients with acute gastrointestinal injury (AGI).Methods:77 patients were randomly allocated to the treatment group (38 cases) and control group(39 cases).The control group received conventional medical treatment.In the treatment group,electroacupuncture therapy combined with conventional medical treatment was adopted.Treatment was given for seven days.The clinical therapeutic effects were evaluated using the quantity of enteral nutrition (EN) and abdominal cavity pressure changes in 1,3,5,7 days.After the treatment,the percentage of patients with early enteral nutrition (EEN),total enteral nutrition (TEN),parenteral nutrition (PN) supplementedas and the length of ICU stay were also observed.Results:The amount of daily EN in treatment group was significantly higher than that in control group(P ＜ 0.05) and the abdominal cavity pressure was significantly lower in the treatment group (P ＜ 0.05).After treatment,the proportion of EEN and TEN of the treatment group were both higher than control group (P ＜ 0.05) and the percentage of combined EN and PN therapy in the treatment group decreased significantly (P ＜ 0.05).Meanwhile,the mechanical ventilation period and the length of ICU stay in the treatment group were shortened (P ＜ 0.05).Conclusion:Electroacupuncture therapy can effectively improve the intestinal function and have remarkable therapeutic effect in treating critical illpatients with AGI.

Objective:To investigate the effects of enteral immunonutrition on the intestinal barrier function and immune function in patients with severe pneumonia.Methods:Ninety patients with severe pneumonia were randomly divided into experimental group (n =45) and control group (n =45).All patients were received conventional therapy.In addition,patients in experimental group were given enteral immunonutrition,while patients in control group were given regular enteral nutrition.The changes of general conditions,intestinal barrier function index and immune function index were determined before treatment,on day 5 and 10 after treatment.The time of invasive mechanical ventilation,APACHE Ⅱ score and clinical effects of two groups were determined on day 10 after treatment.Results:Compared with those before treatment,in both groups,body temperature,respiration,heart rate,white blood cell count were all significantly decreased on day 5 and 10 after treatment (P ＜ 0.05).The above parameters were significantly lower in experimental group than control group on day 10 after treatment (P ＜ 0.05).The levels of serum ET,DAO were significantly decreased on day 5 and 10 after treatment in two groups compared with those before treatment (P ＜ 0.05),and these parameters were significantly lower in experimental group than control group(P ＜0.05).The number of CD3 and CD4 positive cell and the ratio of CD4 +/CD8 + were significantly increased on day 5 and 10 after treatment in two groups when compared with those before treatment (P ＜ 0.05),and these parameters were higher in experimental group than those in control group(P ＜ 0.05).The time of invasive mechanical ventilation,APACHE Ⅱ score were lower in experimental group than those in control group on day 10 after treatment (P ＜ 0.05).The rate of clinical response were higher in the experimental group than that in the control group on day 10 after treatment (P ＜ 0.05).Conclusion:Enteral immunonutrition is more effective in protecting the intestinal barrier function,improving the immune status,enhancing the immunity,reducing the time of invasive mechanical ventilation,and achieving the clinical effects of patients with severe pneumonia.

Objective:To investigate the complications of using central venous catheters ports.Methods:From March 2005 to September 2008,103 patients under the fluoroscopy were placed with central venous catheters port through the right subclavian vein puncture.The reasons of complications were retrospectively analyzed and managements were explored.Results:Among the 103 patients,101 cases were successfully implantated.The technical success rate was 98.06%(101/103).The complications were 19 cases(18.45%,19/103).Conclusion:Improved perioperative management and strengthening the clinical nursing can effectively reduce the incidence of complication of central venous cathethers ports.

Objective: To explore the protective effect of salvia miltiorrhiza for enteral nutrition in S-MODS model rats.Methods: 70 Wistar rats were randomly divided into four groups: control group (n=10), model group (n=20), nutrition fibre group (n=20) and salvia miltiorrhiza for enteral nutrition group (n=20) . The experiment period was 12 days. At the end of experiment, blood routine, biochemistry index (ALB, AST, ALT, BUN, Cr, CK and CK-MB), the concentrations of IL-6,TNF-α and IL-1β were measured. Results: The model was successful by clinical manifestation,blood routine and pathology. The clinical symptom was improved, blood routine and pathology damage were relieved in salvia miltiorrhiza group. The concentrations of IL-6, TNF-α and IL -1 in salvia miltiorrhiza group were lower than model group and nutrition fibre group(P<0.05).Conclusions: Salvia miltiorrhiza for enteral nutrition could prevent gut function damage,protect intestinal mucosa and decrease the concentrations of pro-inflammatory cytokines.