Objective To study the glutamine combined with early enteral nutrition’s effects on severe acute pancreatitis’systemic inlfammation. Methods 150 Cases with severe acute pancreatitis were divided into total parenteral nutrtion group(TPN group), early enteral nutrition group(EEN group) and Glutamine and early enteral nutrition group(G+EEN group) according to their therapeutic methods. The curative effects, APACHEⅡscore and liver and kidney function were compared after treatment. Inlfammatory cytokines of hs-CRP, TNF-α, IL-1β, IL-6, IL-8 and IL-10 before and after treatment were detected and compared. Results The efifciency rate in G+EEN group was signiifcantly better than that in TPN and EEN group(P<0.05), with lower APACHEⅡscore and better liver and kidney function. The level of hs-CRP, TNF-α, IL-1β, II-6 and IL-8 after treatment in G+EEN group were signiifcantly lower than that in TPN and EEN group(P<0.05), except IL-10, which was signiifcantly higher than that in TPN and EEN group (P<0.05). Conclusion Glutamine combined with early enteral nutrition could signiifcantly ameliorate severe acute pancreatitis’systemic inlfammation, its curative effects is better than early enteral nutrition and total parenteral nutrition.

Objective To compare the characteristics,complications and outcomes of the modified lapa-roscopic Swenson(MLSw)and laparoscopic Soave(LS)procedures for children with short-segment Hirschsprung disease(HD). Methods Seventy-seven pediatric patients with HD who underwent surgery from March 2007 to December 2016 were enrolled in this retrospective study. Twenty-six patients were treated with LS and 51 cases un-derwent MLSw. The preoperative,operative and postoperative data was collected,with follow-up periods ranging from 12 to 48 months. The perioperative/operative characteristics,postoperative complications,and outcomes were compared between the two groups. Results On average,the patients in the LS group had a longer operating time than that in the MLSw group(P < 0.05). Blood loss was significantly less in the MLSw group than that in the LS group(P < 0.05). There was no significant difference in feeding time between the two groups(P > 0.05). The MLSw group was discharged after a shorter hospitalization time than that in the LS group(P < 0.05). The MLSw group had lower incidences of postoperative complications than those in the LS group in the early postoperative period,with no significant difference in the rate of complications during the late postoperative period was found between the two groups. Conclusions Both LS and MLSw are suitable for treatment of children with short-segment HD. However,the MLSw operation is much simpler,with less operating time,less intraoperative blood loss,shorter hospitalization time and better bowel control in the early postoperative period. We favor this approach because it allows complete removal of the entire original aganglionic bowel,without leaving behind a cuff.