Objective: A marked deficiency of glutamine in clinical critical illness is correlated with mortality in the intensive care unit, and intestinal glutamine transport was reported to be impaired in late sepsis. Berberine was reported to protect against the intestine injury, and improve the survival rate in sepsis. We designed this study to gain further knowledge of the intestinal glutamine transport in early and late sepsis, and to find out whether beberine pretreatment has some effect on glutamine transport in sepsis. Methods: Berberine (50 mg/kg) was given intragastrically once a day for 5 days, and sepsis was induced by cecal ligation and puncture on day 5. The small intestinal samples were collected at 0, 2, 6, 12, 24 h. Intestinal brush border membrane vesicles were prepared by Mg~(2+) aggregation-differential centrifugation techniques, and brush border glutamine transport was studied by a rapid filtration technique. Results: Under control condition, Na~+-dependent glutamine transport accounted for about 90% of the total transport. The relative contributions of ATA2, ATB~(0,+), B~0AT1 were about 12, 25, 63%, respectively. Septic rats showed an early increase and a late decrease in intestinal glutamine transport. ATA2 had an earlier increase in the early stage, while B0AT1 had no significant increase. Berberine pretreated group had a relative less increase in early phase and a less decrease in late phase compared to sepsis group. Conclusion: Rat intestinal glutamine transport showed an early increase and a late decrease in sepsis, and berberine pretreatment could attenuate the impairment of glutamine transport in sepsis. It may provide some information for sepsis treatment.

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.

Objective: The aim of this study was to evaluate the impact of fast track surgery on host cell-mediated immunology and inflammatory responses in colorectal cancer patients.Methods: Sixty colorectal cancer patients were prospectively divided into fast track surgery(FTS)group(n=30)and conventional perioperative care group(n=30).In addition to clinical parameters(recovery of gastrointestinal function,complication rates and postoperative length of stay), the parameters of perioperative cell-mediated immunology function,and the serum level changes of CRP and IL-6 were determined.Results: FTS group was associated with a significantly shorter postoperative hospital stay compared with conventional care group(P<0.05).Serum concentration of CRP and IL-6 in FTS group were lower(P<0.05) than in the conventional care group on postoperative day(POD) 1 and POD 3(P<0.05).CD4/CD8 ratio in FTS group were higher(P<0.05) than in the conventional care group on postoperative day(POD)1 and POD 3(P<0.05).Conclusion: Fast track surgery for colorectal cancer patients can preserve cell-mediated immunity and control inflammatory responses when compared with conventional postoperative care.

Objective: The aim of our work was to investigate the effects of n-3 polyunsaturated fatty acids on apoptosis, granzyme B and perforin expression of intestinal epithelial cells of chronic rejection after small intestinal transplantation. Methods: Small bowel transplantation was performed and rats were divided into three groups: Group 1, Lewis-to-Lewis, group 2, F344-to-Lewis, dietary corn oil, Group 3, F344-to-Lewis, dietary fish oil. All recipients were killed after 16 weeks of posttransplantation. The apoptosis rate of mucosal cells were evaluated by flow cytometry. The expressions of granzyme B and perforin were analyzed by reverse transcriptase RT-PCR. Results: A high apoptotic rate was observed when the allografts demonstrated one or more histological features of chronic rejection. N-3 polyunsaturated fatty acids decreased the rate of the apoptosis and inhibitted the expressions of granzyme B and perforin. Conclusion: N-3 polyunsaturated fatty acids can suppress the chronic rejection in small intestinal transplantation.

Objective: To investigate the effects of recombinant human growth hormone (rhGH) and 5-fluorouracil(5-Fu) on human colon carcinoma LOVO cells in vitro. Methods: The LOVO cells during exponential growth stage were harvested and divided into control group,GH group, 5-Fu group and GH + 5-Fu group. According to the dose of GH, the GH group was separated into two sub-groups(50 ng/mL and 100 ng/mL) and the GH +5-Fu group was separated into two sub-groups. With different concentrations of rhGH and/or 5-Fu , the cell survive rates were analyzed by MTT assay after 24 h , 48 h and 72 h and cell cycle and proliferation index (PI) were analyzed by flow cytometry after 24 h. Results: Compared with the control group, the survive rates in 5-Fu and GH +5-Fu groups were decreased significantly (P <0. 05). The significant effects of rhGH on cell cycle kinetics were found in the cell line. Compared with the control group, percentage of S phase and proliferation index (PI) significantly increased (P <0.05)and percentage of G_0/G_1 phase decreased (P <0. 05) in GH groups. Percentages of cells of S phase and PI significantly decreased in GH + 5-Fu groups (P < 0. 05). Rate of apoptosis increased in 5-Fu and GH +5-Fu groups (P <0.05). Compared with the 5-Fu group, there were no statistically significant differences in percentages of cells of S phase and PI and rate of apoptosis between two GH+5-Fu groups(P >0. 05). Conclusion-. rhGH does not stimulate the LOVO cells proliferation in vitro, and its use is safe when combined with 5-fluorouracil.

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.

With the rapid development of molecular nutrition, the urgent demand of rationalizing and individual clinical enternal nutrition support was realized. The enteral nutrition was added with special nutrition substrate. The application of carbohydrate in enteral nutrition and the status of comprehensive use of polysaccharides were summarized in this article. Based on the study of traditional fiber in enteral nutrition(EN) , the application of marine polysaccharides on the diseases oriented EN was analyzed and discussed. So, new nutrition substrate from marine polysaccharides is proposed for exploitation of various diseases oriented EN. Therefore, the individual nutrition support becomes possible.

Objective: To observe the effect of the combinative supplementation of Formoterol, Indomethacin and Roxithromycin on cancer cachexia (CC) and to study the mechanism. Methods: Male BALB/c mice bearing colon 26 adenocarcinoma for 9 days were served as models of cancer cachexia. The mice were divided into nine groups. Physiological conditions, body weight and food intake were documented every day. Serum levels of cytokine and nutritional markers were detected 7 days after treatment. Results: Tumor-bearing caused a wasting of non-tumor body weight and gastrocnemius muscle. Serum tumor necrosis factor-α, (TNF-α) and interleukin-6 (IL-6) levels were significantly elevated accompanied with nutrition depletion in tumor-bearing mice. After treatment with combinative supplementation of Formoterol, Indomethacin and Roxithromycin, left gastrocnemius weight and serum glucose were improved and the levels of TNF-α and triglyceride were down-regulated. Conclusion: Formoterol, Indomethacin and Roxithromycin had their own positive effects to CC mice. Drugs combinationin in tumor-bearing mice with cancer cachexia could produce synergistic action.

Objective:To investigate the risk factors and prognostic effects of intolerance of early enteral nutrition after surgery for gastric cancer.Methods:The clinical data of 75 patients with gastric cancer who were admitted in the Shoukang hospital and received early enteral nutrition after surgery were retrospectively retrived and analyzed.Patients were divided into the tolerance group and the non-tolerance group according to whether the patients developed the symtoms of nausea,vomiting,abdominal pain,distention and diarrhea after early enteral nutrition.Results:51 patients (68％) showed enteral nutrition intolerance after early enteral nutrition postoperatively,whereas 24 (32％) were in the tolerance group.The activity time out of bed on the first postoperative day,the time of initiation of enteral nutrition,and nutrition pump were significantly different between two groups.Logistic analysis revealed that the activitity time and nutrition pump were independent favourable factors.Besides,patients with intolerance had longer time to exhaust and defecation,and postoperative hospital stay.Conclusion:Insufficient postoperative activity time and nonuse of nutrition pump are risk factors of intolerance of early enteral nutrition,which may slow the recovery of patients.

Objective:To investigate the influence of clinical outcomes and the risk factors of poor prognosis for preoperative nutritional risk in gastric cancer patients.Methods:A prospective study was performed in 140 patients with gastric cancer and the nutritional risk screening 2002 (NRS 2002) was done.The influence of preoperative nutritional risk on postoperative complications,hospital stay,ICU stay,hospital expenses,60 days readmission and mortality was analyzed,and the risk factors of perioperative complication were identified by univariate and multivariate analysis.Results:The significant difference (NRS 2002 ≥ 3 group vs.NRS 2002 ＜ 3 group) was observed in the rates of overall postoperative complications,pulmonary infection,overall hospital stay and postoperative hospital stay (P ＜ 0.05).The rates of anastomotic fistula,pleural effusion,60 days readmission,60 days mortality and hospitalization expenses in NRS 2002 ≥ 3 group were higher than that of NRS 2002 ＜ 3 group,but there were no differences between the two groups (P ＞ 0.05).By univariate and multivariate analysis,preoperative high cholesterol levels and preoperative nutritional risk are the risk factors of poor prognosis and postoperative complications.Conclusion:Preoperative high cholesterol levels and preoperative nutritional risk are independent risk factors of postoperative complications.