Injuries in the choledocho-pancreatico-duo-denal junction are rare, and are frequently associated with other severe vascular and visceral injuries. Interventions during early operation may aggravate the condition of patients, while proper application of damage control surgery (DCS) is helpful in raising the survival rate. Therefore, for most of the patients with choledocho-pancereatico-duodenal junction injury, definite opera-tion should be performed after removal of necrotic tissues, control of infection and adequate drainage. However, DCS should be applied with caution, and the indications of DCS should be strictly followed, because reoperation will increase the chance of injury and infection after DCS.

Radiotherapy is frequently employed as part of the multimodal treatment of cancers.Despite recent advances in ir-radiation techniques, radiation-induced side effects are more common.Radiation enteritis is a term traditionally used to define injury to the small intestine resulting from radiotherapy.The radiotherapy could induce damage of pelvic normal tissue.The most patients with radiation enteritits may also have co-existing radiation-induced damage of pelvic other tissue or organ.The radiation enteritis was man-aged, however, the therapy of pelvic damaged tissue or organ were ignored.Therefore, in 2015, we proposed the concept of radiation pelvicopathy which is most accurate description of the disease process and pathological characteristics.The purpose is to emphasize the interdisciplinary approach of pelvic radiation damage.

Organ transplantation is the treatment of choice for patients with end stage organ disease, many organ transplant patients with malnutrition are at high risk for developing postoperative complications, and causing death. Nutritional support can improve outcome of organ transplant patients.

Chemotherapy has been shown to be effective in the treatment of patients malignancies, however, anticancer drugs, particularly high-dose, also damage other chemosensitive tissues such as the intestinal mucosa, and these adverse effects can impair intestinal mucosal barrier. The derangement in the barrier function plays a central role in the pathophysiology of systemic infection, shock, and sepsis syndrome. The chemotherapy-induced intestinal barrier dysfunction and its prevention and treatment had been reviewed.

The fat emulsion in parenteral nutrition is very important.Fish oil has immunomodulation,intestinal mucosa barrier improvement and liver protective effects.Fewer postoperative complications and shorter ICU and hospital stay could be obtained through perioperative supplemention of fish oil.

Metabonomics is a method of understanding metabolic regulation by studying small molecules,which has been widely used in toxicology and pharmacology.But nutritional metabonomics is relatively new.The application of metabonomics to nutritional research still has many challenges,such as the development of small molecular libraris,and the deletion of signal noise.However,with the development of pattern-recognition techniques,scientists are optimistic with nutritional metabonimics development.

As the rapid development of genomics , functional genomics and information technology , precision medicine came into being after evidence-based medicine .Precision medicine not only urges clinical doctors to analyze disease at a molecular level to a -chieve precision diagnosis , but also requires us to seek the best therapeutic targets according to the patient 's genetic information to a-chieve precision treatment .The United States and China have launched their precision medicine initiative in 2015 , thus the precision medicine era is coming .This review will focus on gene sequencing , big data integration , molecular pathology , non-invasive prenatal precision diagnosis , and precision cancer medicine to elucidate the application of precision medicine concept in clinical practice .

The human gastrointestinal tract is colonized by complex and diverse microbiota which maintains an ecological balance under normal circumstances.Short bowel syndrome causes damage to the normal flora which predisposes the patient to colonic dysbacteriosis and small intestine bacterial overgrowth.Small intestine bacterial overgrowth may lead to digestive and absoptive disfunctions, mucosal inflammation, and may delay or prevent weaning from total parenteral nutrition.Moreover, small intestine bacterial overgrowth may be one of the causes of intestinal failure-associated liver disease, and eventually lead to various body dysfunctions.In this review, the bacterial translocation in short bowel syndrome were summarized, providing the theoretic proofs to treatment and prevention.

Vitamin D ( VD) has been stated clearly in maintaining the balance of serumcalcium and phosphorus in human . Whereas, more and more evidences show VD has a considerable range of other physiological functions .VD has also been proposed to have vital functions controversially including adjusting immunity, antitumor, enhancing barrier in the intestine .The patients of short bowel syndrome are at particularly high risk of vitamin D deficiency .It has a significance in prevention and treatment of diseases to fur-ther clearly clarify the relationship and mechanisms of VD and the diseases .

Microfold cells or membraneous cells(M cell)are special differentiated cells of follicle associated epithelium(FAE) covered underlining lymphoid follicle,called organ-associated lymphoid tissue(OALT).M cells in the GI transport transcellularly antigens or organism selectively from the gut lumen and trigger the immune reaction.As doorkeepers,they manipulate the function channel of intestinal barrier.The features,and the important role in intestinal barrier of M cells are reviewed.