The metabolic change in patients with the malignent tumor differs from that of patients without cancer.The development in energy expenditure of cancer patient was reviewed.REE in cancer patients is higher than that in the normal,although some authors argued that there were no changes in cancer patients. REE is related with many factors,such as the tumor’s size,status,type,location.

Sarcopenia is a series of syndromes featured by the steady and involuntary loss of skeletal muscle mass and function with aging.It can lower the quality of life and increase the risk of disability and mortality.Deficiency in some nutrients such as amino acids and proteins and accordingly the decreased in the synthesis of muscle protein and changes in muscle tissues may contribute to the development of sarcopenia.Therefore,nutritional interventions may play a role in the prevention and treatment of sarcopenia.

Objective The gastrointestinal tract of neonate becomes colonized with microorganisms from environment and mother immediately after birth. Strong evidences suggested that early composition of the microflora in neonates play an important role for postnatal development of the immune system. This study was designed to investigate the effect of mode of delivery on the development of gut microflora and characteristics of the stool in breast-fed infants by molecular biology methods. Methods Sixty healthy breast-fed term infants were enrolled in the study(including vaginal delivery group and cesarean section delivery group,each group included 30 infants). Anthropometric measurements and stool study were done at 6-week,8-week,10-week,and 12-week. Fecal samples were subjected to quantitative fluorescence real-time polymerse chain reaction assays for the enumeration of lactobacili,bifidobacteria,and subtype of bifidobacteria(bifidobacterium longum and bifidobacterium breve). Results The numbers of lactobacilli and bifidobacterium longum species were less in cesarean delivery group than those in vaginal delivery group(P ＜ 0.05). Stool mean pH was lower in vaginal delivery group than that in cesarean section delivery group(P ＜ 0.05). There were no differences in stool characteristics and growth between two groups. Conclusions Cesarean section is associated with the decrease of bifidobacteria and lactobacilli in breast-fed term infants.

Objective To gather observational data on resting energy expenditure(REE)of children with newly diagnosed malignant solid tumor, and to examine factors that might be relevant to their energy expenditure change. Methods It is a retrospective study. Data from sixty-one patients with newly diagnosed malignant tumor admitted to department of pediatric surgery in Xinhua Hospital were reviewed in this study. Resting energy expenditure was measured by indirect calorimetry. Patients with benign tumor admitted during the same period were used as the control group. Results The difference of percentage of patients with normal, decreased, or increased REE between benign and malignant groups was not significant(χ2 = 0.466, P = 0.792). Patients with one or more gastrointestinal symptoms had higher percent of Pre-REE compared with patients without any gastrointestinal symptoms, but no significant difference existed(119.8±80.4 vs 91.1±27.2, Z = 0.746, P = 0.456). Different tumor types were associated with different effects on REE. There was no significant difference in REE levels between patients with decreased diet intake and those without(Z = 0.528, P = 0.598). Conclusions It is confirmed that not all patients with malignant tumor have an increased REE. Moreover, the tumor site might be an independent factor affecting patients' REE level.

Objectives To assess the clinical value of ultrasonography (US) and bioelectrical impedance analysis (BIA) in analyzing abdominal fat contents of obese children and adolescents through comparison with MRI. A correlation with other obese related metabolic parameters was conducted. Methods Ninety 7-17-y-old obese children and adolescents (60 boys and 30 girls with mean age of 9.6 ± 2.9 y and mean BMI of 24.5 ± 4.5 kg/m2) were recruited. Metabolic parameters were measured, and insulin resistance was estimated according to homeostasis model assess-ment (HOMA-IR). On the same day abdomen subcutaneous fat thickness (SFTUS) was measured by US. Body fat mass (FMBIA) and abdominal visceral fat area (VFABIA) were analyzed by bioelectrical impedance analysis (BIA). After obtaining informed consent, abdominal MRI was performed in 20 subjects. Each section of umbilicus level was analyzed by image threshold value segmentation using SigmaScan Pro 5 and abdominal subcutaneous fat area (SFAMRI) and visceral fat area (VFAMRI) were calculated. Results (1) A strong positive association was found between SFTUS and SFAMRI (P< 0.05), VFABIA and VFAMRI (P < 0.01) respectively. (2) FMBIA and SFAMRI, VFAMRI, SFTUS also showed significant correlations (P < 0.05). (3) VFAMRI showed extremely significant positive correlations with TG, Insulin,C-peptide and HOMA-IR (P < 0.01 ) ; SFAMRI was also correlated positively with them (P < 0.05). (4) SFTUS was correlated positively with UA (uric acid), Insulin, 2HIns (insulin measured at 2 hours after meal), C-peptide,2HC-peptide (C-peptide measured at 2 hours after meal) and HOMA-IR (P < 0.01). (5) VFABIA was correlated significant positively with UA, insulin, TG, 2HIns and HOMA-IR. FMBIA showed positive correlation with UA, Insulin,2HIns, C-peptide, 2HC-peptide and HOMA-IR. Conclusions abdominal subcutaneous and visceral fat of obese children and adolescents evaluated by US and BIA are correlated well with those assessed by MRI, and also correlated well with TG, insulin, C-peptide and other metabolic biochemical parameters. Our data support the value of using cost effective, simple and convenient methods such as BIA and US to evaluate the obese and related metabolic risk of children and adolescents in clinical practice.

Objective To investigate the prevalence of overweight and obesity and the nutritional status of dietary calcium intake in school-age children in Shanghai and to analyze the relationship between dietary calcium and bone mineral density (BMD).Methods A cross-sectional study was conducted in the second and third grade students of 10 primary schools in Yangpu District and Baoshan District in Shanghai. Food frequency questionnaire was used tu estimate the relative intake of dietary calcium of students in 6 primary schools in Baoshnn District. Quantitative ultrasound bone density examination was used to estimate the calcaneal BMD.The relation-ship between calcium intake and BMD was analyzed.Results The average calcium intake was 647 mg/d among ested students.BMD was not significantly different among different age groups (F=1.595,P=0.173),while Z-score was significantly different among different age groups (F=16.02,P=0.000).The total calcium intake was not correlated with BMD or Z-score.The percentage of dairy calcium intake was positively correlated with BMD (r=0.097,P=0.015)and Z-score (r=O.117,P=0.003),the percentage of non-dairy calcium intake and the non-dairy calcium intake were negatively correlated with BMD (r=-0.097,P=0.015) and Z-score(r=-0.110,P=0.006).When the total dietary calcium intake was ≥600 mg/d,BMD and Z-score significantly higherin students with high dairy calcium intake than those with low dairy calcium intake (P<0.05).When the total dietary calcium intake was <600mg/d,BMD and Z-score were higher in students with high dairy calcium in-take than in those with low dairy calcium intake,although no statistical significance was noted (P>0.05).Conclusions BMD and Z-score increase along with the increase of dairy calcium intake.Such effect becomes even more obvious when the total dietary calcium intake is ≥600 mg/d.

In recent years,obesity is becoming one of the focus problems of social public concern.Maternal obesity may pose a threat on maternal health,for examble the increase of obstetrical complications,it may also affect the short-term and long-term health of the offspring.Maternal obesity may affect children's mental disorder,no review to date has discussed it systematically in China.Now,the health hazards of maternal obesity for the offspring including childhood autism spectrum disorder,attention deficit hyperactivity disorder,neural tube defects,neurobehavioral development disorders and so forth were reviewed,and to provide a reasonable guidance of obesity management.

Objective To test and validate the comprehensiveness,usability and reliability of the questionnaire we made for publicity efforts of biobanking activities in China.We aim to learn public attitudes toward biobanking donation of biological materials,collection and long-term storage for biomedical research.Methods In the cross-sectional study,292 participants were interviewed with the self-administered questionnaire.The survey questionnaire presents an extensive battery of questions on demographic information,participation of previous studies,cognition of biobank and related concepts,opinions on biobank-related issues and trust on healthcare system.Different statistic methods were taken to do item analysis,reliability and validity evaluation.Results The Cronbach's α coefficient of the whole questionnaire was 0.850 and the cognition and attitude were the two factors with the highest internal reliability.All the Spearman correlation coefficients were large than 0.5 (p＜0.01) . Three factors explained 59.2％ of the questionnaire structure found by factor analysis,and all factors could be regarded as cognition factors,attitude factors and behaviors factors.Conclusions The survey questionnaire is evaluated to be reliable and applicable to gathering data on publicity efforts to assess the public attitude towards biobanking activities in China.

BACKGROUND: Nutritional support has become one of the most important therapeutic measures for malnutrition patients with chronic obstructive pulmonary disease (COPD), but some of the patients may fail to respond to nutritional treatment, which might be attributed to excessive inflammatory reaction that increases energy expenditure. Current nutritional support strategies have primarily focused on immunonutrition and metabolic support.OBJECTIVE: To study the effect of glutamine (Gln) on immunomodulation and metabolic support for patients with COPD.DESIGN: Randomized controlled trial.SETTING: Xinhua Hospital Affiliated to Shanghai Second Medical UniversityPARTICIPANTS: Totally 44 male patients with acute episode of COPD aged (75±9) years admitted between February and July 2002 were recruited in this study and randomly divided into treatment group (n=14) and control group (n=18).INTERVENTIONS: Only nutritional support was given in the control group while the treatment group received also glutamine treatment. All the patients received nutritional support with the total calorie intake of 1.5times of resting energy expenditure and dietary counseling for a regular diet (20% protein, 30% fat, and 50% carbohydrate) provided by a nutritionist. In the treatment group, the protein intake was reduced by 30 g and replaced by 30 g of Gln given at 10 g each time for three times a day via oral therapy. The nutritional indices were measured including body mass,body mass index, triceps skinfold thickness (TSF), creatinine-height index (CHI), prealbumin (PAlb), albumin (ALB), transferrin (TRF), fat mass (FM)]and the immune indices examined including immunoglobulin, complements, T cell subsets, interleukin (IL)-2, tumor necrosis factor-α (TNF-α),and C-reactive protein etc with also measurement of resting energy expenditure.MAIN OUTCOME MEASURES: Changes in nutritional and immune indices of patients before and after treatment.RESULTS: Thirty-two patients all entered the result analysis. [1] TSF: In the treatment group, TSF increased significantly from (6.3±1.8) mm before treatment to (8.7±1.6) mm after treatment (P ＜ 0.05), which was significantly greater than that in the control group after treatment [(7.3±1.3) mm,P ＜ 0.05]. [2]Palb: Palb was significantly increased after treatment in the treatment group from (0.15±0.04) to (0.23±0.05) g/L (P ＜ 0.01), which was significantly higher than that in the control group [(0.22±0.08) g/L, P＜ 0.05)]. [3]T cell subsets: in the treatment group, CD3 in creased significantly from 59±10 before treatment to 72±10 after treatment (P ＜ 0.01), a level significantly higher than that in the control group after treatment (62±9, P ＞ 0.01). [4] TNF-α :TNF-α in the treatment group before treatment was significantly higher than that after treatment [(72±7) vs (56±5) ng/mL,P ＜ 0.05)], and after treatment TNF-α in the treatment group was significantly lower than that in the control group [(67±11) ng/mL, (P ＜ 0.05)]. [5]Immunoglobin: IgG increased slightly after treatment in the treatment group[(12±3) vs (13±3) g/L, P ＜ 0.05)], which was higher than that in the control group [(12±4) g/L], but the difference was not significant (P ＜ 0.05).CONCLUSION: Gln treatment in addition to nutritional support can promote cellular immune function, depress excessive inflammatory reaction and lower energy expenditure in patients with COPD, and such strategy also further enhance the effect of nutritional support.

Objective To assess the clinical outcomes of glutamine supplementation in neonates.Methods The study was designed as a double-blind randomized controlled trial.Totally 100 infants were randomly divided into 5 groups with 20 infants in each group:control group:standard parenteral nutrition (PN);PNI group:PN supplemented with 0.3 g/ (kg·d) glutamine;enteral nutrition (EN) 1 group:EN supplemented with 0.3 g/ (kg·d) glutamine;PN2 group:PN supplemented with 0.3 g/ (kg·d) glutamine;and EN2 group:EN supplemented with 0.3 g/ (kg·d) glutamine,The primary endpoints were the time to establish full enteral nutrition [defined as receiving 120 ml/ (kg·d) enterally],episodes of gastric residuals,total duration of PN,and mortality.The second endpoints were weight gain and head circumference gain,liver function,renal function,days on ventilator,and length of hospitalization.Results Time to achieve full enteral nutrition,incidence of gastric residuals,duration of PN,weight gain (g/d) ,head circumference gain (cm/w),liver function,renal function,and length of hospitalization were not significantly different among all five groups.Days of mechanical ventilation were significantly decreased in PN1 group and PN2 group when compared with the control group (P ＜ 0.05).Intention-totreat analyses showed that,when compared with the control group,PN1 group:RR:1.053;95% CI:0.952-1.164;ENI group:RR:1.333,95% CI:1.035-1.717;PN2 group:RR:1.053,95% CI:0.952-1.164;EN2 group:RR:1.25,95% CI:1.004-1.556.Conclusions Glutamine supplementation may not be able to decrease the time to achieve full enteral nutrition,the incidence of gastric residuals,and the duration of PN.However,pareneral glutamine supplementation does reduce the days on ventilator in neonates.Also,parenteral glutamine supplementation has no obvious influence on mortality.