Background:Malnutrition is common in inflammatory bowel disease,especially in Crohn' s disease (CD).Combined partial enteral and parenteral nutrition is effective for nutritional support in patients with severe CD.Aims:To investigate the effect of combined enteral and parenteral nutritional support on body composition and disease activity in severe active CD patients.Methods:A total of 72 patients with severe active CD admitted from July 2015 to August 2016 at Shanghai Tenth People' s Hospital were enrolled.In addition to conventional antibacterial and remission induction therapy,a combined partial enteral and parenteral nutritional support was given after admission.The nutritional status,body composition parameters and disease activity were evaluated and compared on admission and week 1,week 2 and week 3 of hospitalization.Results:The malnutrition rate was 100％ on admission,of which 90.3％ were severe malnutrition.After a 3-week combined enteral and parenteral nutritional support,the proportion of severe malnutrition decreased from 90.3％ to 34.7％ (P ＜0.05).Meanwhile,the body weight,body mass index,muscle mass,fat mass,protein content,and basal metabolic rate gradually increased and the disease activity index gradually decreased (P all ＜ 0.05).Conclusions:Combined enteral and parenteral nutritional support can improve the nutritional status and body composition parameters,reduce disease activity and induce remission effectively in severe active CD patients.

Objective:To investigate the related mechanism of IL-17B in regulating host immune response by studying the role and mechanism of IL-17B in the infection of Listeria monocytogenes in mice. Methods:Eighteen male C57BL/6 mice were randomly divided into three groups with six in each group: control group, PBS group and wild-type (WT) group. The control group was not given any treatment. The mice in the PBS group were injected with 100 μl of sterile PBS, while C57BL/6 mice in the WT group and IL-17B deficient (IL-17B -/-) male mice were injected intravenously with 100 μl of Listeria monocytogenes 19115 (2×10 4 colony forming unit). The mice were sacrificed 48 h after infection and then peripheral blood, spleen and liver samples were collected. Bacterial colonization in mouse spleen and liver was detected by plate count method; HE staining was used to evaluate histopathological damages; flow cytometry was used to detect the immune cells in different tissues. ELISA and qRT-PCR were used to detect the levels of IL-1β, IL-6, IL-12p40, TNF-α, IFN-γ and iNOS in serum and spleen. qRT-PCR were used to detect the expression of IL-17B and IL-17RB. Results:Bacterial colonization in mouse spleen was reduced in the IL-17B -/- group as compared with that in the WT group ( P<0.05). Compared with the PBS group, Listeria monocytogenes infection increased the expression of IL-17B and IL-17RB in mouse spleen ( P<0.05, P<0.01). There was no significant difference in the pathological damages in spleen between WT and IL-17B -/- groups. Moreover, compared with the WT group, the IL-17B -/- group showed increased macrophages, M1 macrophages ( P<0.01) and NK cells ( P<0.05) in spleen, up-regulated macrophages ( P<0.05) and M1 macrophages ( P<0.01) in the peripheral blood, enhanced expression of IL-6 in serum and spleen ( P<0.05), and promoted expression of IL-6, IL-12, IL-1β, TNF-α, IFN-γ and iNOS in spleen. Conclusions:IL-17B might inhibit Listeria monocytogenes clearance by inhibiting macrophage infiltration and the secretion of IL-6.