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Effectiveness of enteral nutrition support and growth hormone treatment in critically ill patients

Ruixiang ZHOU ; Fangzhong WENG ; Jun YAN ; Xuepeng FAN

Chinese Journal of Clinical Nutrition.2009;17(5):275-279. doi:10.3760/cma.j.issn.1674-635X.2009.05.005

Objective To explore the effectiveness of early enteral nutrition (EN) support and growth hormone (GH) treatment in critically ill patients.Methods Seventy critically ill patients were randomly divided into early EN support group and early EN support plus GH treatment group.The nutrition intakes were isonitrogenic and isocalorie in these two groups.Body weight,blood biochemistry,nutritional statues,and lactulose/mannitol levels were measured or analyzed before and after nutrition support.Immunologic functions were analyzed after ten days.Nitrogen balance was measured daily.Results The changes of body weight,albumin level,and transferrin level were more obvious in the EN + GH group than those in the EN group without significant difference (P ＞0.05).The changes of prealbumin and fibronectin in the EN + GH group were significantly higher than those in the EN group (P ＜ 0.05).The level of IgA in the EN + GH group was significantly lower than that in the EN group,while the levels of CD4 and NK in the EN + GH group was significandy higher than those in the EN group (P ＜0.05).The gut barrier function in the EN + GH group was superior to that in the EN group during nutrition support (P ＜0.05).Nitrogen balance was positive in the EN + GH group and negative in the EN group (P ＜ 0.05).Conclusions Early EN can improve the nutritional status and reduce complications in critically ill patients.GH treatment may strengthen the immune function and remarkably decrease the disability and mortality in critically ill patients.

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Impact of enteral nutrition or parenteral nutrition in post-operative colorectal cancer patients on viscera organ functions and "passing wind" time

Huizhi YU ; Xiang LONG ; Chongmei LIU ; Yanli CAO ; Sixin LI ; Xiaoqiu WU

Chinese Journal of Clinical Nutrition.2009;17(5):268-270. doi:10.3760/cma.j.issn.1674-635X.2009.05.003

Objective To study the impact of enteral nutrition (EN) or parenteral nutrition (PN) in postoperative colorectal cancer patients on viscera organ function and "passing wind" time.Methods Totally 30 patients with colorectal cancer joined this study with informed consent.Patients were randomly divided into EN group and PN group.Both two groups were given nutritional support from the first post-operative day to the 7th post-operative day.The pre-operative and post-operative viscera organ functions and the recovery time of gastrointestinal functions are observed.Results Total bilirubin was significantly lower in EN group than in PN group (P ＜ 0.05).The length of post-operative hospital stay was significantly shorter in EN group than in PN group (P ＜0.01).The post-operative complications were not significantly different between two groups (P ＞ 0.05).Conclusion Postoperative EN support is beneficial for colorectal cancer patient in terms of lower bilirubin levels,shorter post-operative hospital stay,and lower cost.

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Perioperative clinical care of parenteral and enteral nutrition supports in post-hepatectomy patients

Jifang MEN ; Lei LI ; Shenling FU ; Danjing ZHANG ; Xianghui JIN ; Hongyuan CUI ; Mingwei ZHU ; Junmin WEI

Chinese Journal of Clinical Nutrition.2009;17(5):264-267. doi:10.3760/cma.j.issn.1674-635X.2009.05.002

Objective To summarize the perioperative clinical care experience of parenteral and enteral nutrition supports in post-hepatectomy patients.Methods The clinical data of 146 consecutive post-hepatectomy patients in Beijing Hospital were collected and analyzed.For these patients,nutritional risk screening (NRS) 2002 was performed after admission,enteral nutrition support was provided before operation,and enteral and parenteral nutrition supports were provided after operation.Nutritional parameters,clinical outcomes,and nursing methods were evaluated.Results Among these 146 patients,91 patients had≥3 NRS2000 scores,and the remaining 55 patients scored ＜ 3.A total of 118 patients were administrated with enteral and pareteral nutrition;the average enferal nutrition time was 9.6 days,and the average pareteral nutrition time was 5.4 days.The average onset time of passage of gas by anus afar operation was (70.7±17.1) hours.Three patients died,15 patients suffered from infections after operation,and 13 patients experienced other complications.The median hospital stay was 25.5 days.Conclusions Post-hepatectomy patients need take nutritional risk screening after admission and receive appropriate nutritional supports in the perioperative period.It is equally important to strengthen clinical nursing for nutrition support.

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Advances in epidemiological studies of vitamin D deficiency

Yue CHEN ; Jianlie ZHOU

Chinese Journal of Clinical Nutrition.2009;17(5):316-320. doi:10.3760/cma.j.issn.1674-635X.2009.05.016

Factors that may influence vitamin D nutritional status include latitude,season,age,sex,race,skin color,clothing,cultural practices,dietary nutrition,and living conditions.This article reviews the effects of these factors on vitamin D status and recommends that any high-risk people of vitamin D deficiency should take vitamin D supplementation.

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Carnitine deficiency and its related diseases

Yuehui FANG ; Meiqin CAI

Chinese Journal of Clinical Nutrition.2009;17(5):311-315. doi:10.3760/cma.j.issn.1674-635X.2009.05.015

L-carnitine plays an essential role in the beta-oxidation of fatty acids by transporting long chain acyl-coenzyme A into the mitochondrial matrix.Carnitine deficiency may lead to various diseases,including lipid storage myopathies,systemic carnitine deficiency syndrome,cardiomyopathy,obesity,and infertility.This article summarizes the causes of carnitine deficiency and elucidates the clinical features and treatment strategies of its related diseases.

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Reasons of non-planned decannulation of peripheraly inserted central catheters and their prevention

Jinxin SHEN ; Hongli SU ; Yan LIU ; Xiangyu WEN ; Yuhua LIU ; Jing WANG

Chinese Journal of Clinical Nutrition.2009;17(5):306-307. doi:10.3760/cma.j.issn.1674-635X.2009.05.013

Objective To analyze the reasons of non-planned decannulation (NPD) of peripheraly inserted central catheter (PICC) and explore the applicable prevention strategies.Methods We retrospectively analyzed the clinical data of 432 patients who underwent PICC cannulations maintenance between July 2005 and June 2008.The reasons of 26 cases of NPD were analyzed.Results The main reasons of NPD included cannulation occlusion,cannulation ectopia or translocation,cannulation exfoliation,cannulation-related infections,mechanical phlebitis,and thrombus formation.The complications usually were caused by the poor cannulation material,incorrect fixation,top of canuulation not reaching superior vena cava,lack of management measures for outpatients,accidents,and others.Effective measures for preventing NPD included:use silica gel cannulation;ensure the top of canuulation reach the superior vena cava;and improve the communications between outpatients and nurses.Conclusion NPD of PICC may be caused by various reasons and effective prevention measures should be taken.

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Genechip technology and its application in molecular nutrition

Shasha ZHANG ; Yuhong ZHANG ; Suchun LIU

Chinese Journal of Clinical Nutrition.2009;17(5):302-305. doi:10.3760/cma.j.issn.1674-635X.2009.05.012

The gene chips have been extensively studies and widely applied.Gene chip technology provides a powerful tool for molecular nutrition.This article reviews the rationales,classification,characteristics of gene chips,and their application in molecular nutrition.

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Malnutrition and stroke

Feng TIAN ; Jie HAN

Chinese Journal of Clinical Nutrition.2009;17(5):297-301. doi:10.3760/cma.j.issn.1674-635X.2009.05.011

Malnutrition is significantly correlated with the high mortality and other poor outcomes of stroke;in turn,stroke can increase the incidence of malnutrition.Old age and swallowing dysfunction are independent risk factors of post-stroke malnutrition.The sequential nutritional support with enteral nutrition and parenteral nutrition can reduce or avoid the complications of both malnutrition and stroke,and therefore should be considered for stroke patients,especially those who are critically ill.

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Prevention and nursing of intravnscular central catheter related bloodstream infections in tumor departments

Lijuan HE

Chinese Journal of Clinical Nutrition.2009;17(5):308-310. doi:10.3760/cma.j.issn.1674-635X.2009.05.014

The peripherally inserted central catheter (PICC) provides a safe,painless,and durable intravenous pathway for the treatment of cancer patients.However,risk of intravascular catheter related bloodstream infections (CRBSI) exists during the catheter indwelling period.In this review,the definition,diagnostic criteria,characteristic of pathogens,and risk factors of CRBSI in tumor departments are analyzed and some effective prevention and nursing strategies are postulated.

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Low plasma total cholesterol concentration:may be related to malnourished hospitalized patients

Zhongxin HONG ; Jia WANG ; Zhihua LIU ; Li WU ; Lihong ZHANG

Chinese Journal of Clinical Nutrition.2009;17(5):290-293. doi:10.3760/cma.j.issn.1674-635X.2009.05.008

Objective To investigate low plasma total cholesterol concentration in hospitalized patients,which is associated with malnourishment.Methods A total of 358 inpatients who were treated in our hospital from January 1 to February 1,2009,were enrolled.The relationships between low plasma total cholesterol (TC) level and other parameters were analyzed.Results Irrespective of women or men,the morbidities of low plasma TC,low plasma albumin,low plasma total proteins,low plasma triglyceride (TG) and low hemoglobin (Hb) levels were highly consistent with the result of subjective global assessment (SGA) (P ＜0.05).Plasma TC concentration was positively correlated with albumin,TG,Hb,lymph cells number,and body mass index (P＜0.05).TC levels were different between men and women (P ＜0.0001).Meanwhile,low plasma TC level was not correlated with age,but it was correlated with total parenteral nutrition.Conclusion Low plasma TC concentration may relate to malnourished hospitalized patients.

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