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Protective effect of the combination of glutamine and arginine on intestinal barrier function in rats receiving fluorouracil chemotherapy

Fuming LEI ; Xuening DUAN ; Zhizhong PEN ; Shihua CUI

Chinese Journal of Clinical Nutrition.2009;17(6):354-358,illust 1. doi:10.3760/cma.j.issn.1674-635X.2009.06.011

Objective To investigate the protective effect of the combination of glutamine (Gln) and ar-ginine (Arg) on intestinal barrier function in rats receiving fluorouracil (5-FU) chemotherapy.Methods Totally 40 male SD rats receiving 5-FU chemotherapy were equally randomized into four groups:enteral nutrition group,Gln group (enteral nutrition+Gln),Arg group (enteral nutrition+Arg),and Arg+Gln group (enteral nutri-tion+Arg+Gln).Observe the changes post chemotherapy such as the changes of body weight and urine lactulose/mannitol ratio before and after chemotherapy were recorded.On the 8 th post-therapy day,the blood endotoxin level in portal vein was measured,and lymph nodes and blood in portal vein were taken for bacterial culture;colon and jejunum specimens were also taken to measure the height of jejunum villus and the thickness of colon and jejunum.Results Body weights of Gln group,Arg group,and Arg+Gln group significantly increased after chemotherapy (P<0.05).The change of body weight was significantly lower in Arg+Gln group than in Gln group (P=0.002),while no such difference was found when compared with that in Arg group (P>0.05).Lactulose/manni-tol ratio in each group significantly increased after chemotherapy (P<0.05),and the change of lactulose/mannitol ratio was significantly higher in the enteral nutrition group than those in other groups (P=0.000);however,no such difference was found among other groups (P>0.05).The blood endotoxin level in portal vein was signifi-cantly higher in enteral nutrition group than in other groups (P=0.000);the endotoxin level was significantly lower in Gln group than in Arg group (P=O.035) and Arg+Gln group (P=0.000);however,no such differ-ence was found between Arg group and Arg+Gln group (P=0.109).The height of jejunum villus and the thick-ness of jejunum were significantly lower in enteral nutrition group than those in the other groups (P=O.000);the thickness of colon was significantly lower in enteral nutrition group than those in Arg group and Arg+Gln group (P=0.000);however,no such difference was found when compared with Gln group (P=0.058).The thickness of colon (P=0.040) and jejunum (P=0.010) was significantly higher in Gln group than that in Arg group;but there was no significant difference in term of the height of jejunum villus (P=0.286).Compared with Arg+Gln group,the thickness of jejunum in Gln group was significantly higher,but there was no significant difference in terms of the height of jejunum villus (P=0.286) or the thickness of jejunum (P=0.190).The thickness of co-lon was significantly lower in Arg group than in Arg+Gln group (P=0.010),while no such significant difference was found in terms of the height of jejunum villus (P=0.803) or the thickness of colon (P=0.059) when com-pared with Arg+Gln group.The bacterial culture results were not significantly different among all groups.Conclu-sions The combination of Arg and Gln has protective effects on intestinal barrier in rats receiving 5-FU chemother-apy.The protective effect of Gln is superior to that of Arg.No synergistic effect exists between Arg and Gln.

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Effect of total nutrient admixture on lipid metabolism in acute hepatic failure rats

Yumei QI ; Ming ZHANG ; Yajun CHEN ; Jin XU ; Hui YANG

Chinese Journal of Clinical Nutrition.2009;17(1):41-44,后插1. doi:10.3760/cma.j.issn.1674-635X.2009.01.012

Objective To study the effect of total nutrient admixture (TNA) on lipid metabolism in rats with acute hepatic failure (AHF). Methods Fifty-six male Wistar rats were randomly divided into four groups: normal diet group, nitrogen-free diet group, fat-free nutrient admixture group, and TNA group. All rats were injected with D-galac- tosamine to induce AHF model Meanwhile, 6 healthy Wistar rats were used as control group. TNA provided energy 221.75 kJ (1 kcal=4.184 kJ), nitrogen 0.365 g, nitrogen to energy ratio 1:145, amino acids 2.28 g (including branched-chain amino acid 0.70 g), glucose 7.85 g, and fat 1.25 g on a daily basis. After 10 days of the operation of Jugular vein puncture tube, blood glucose, blood lipid, liver and renal function were determined. Results The blood glucose level was significantly higher in TNA group than that in fat-free nutrient admixture group (P < 0.05). The levels of serum triglyceride and cholesterol were highest in fat-free nutrition admixture group, and triglyceride level was signif- icantly higher than that in normal diet group and nitrogen-free diet group (P <0.05). The levels of serum triglyceride and cholesterol were significantly higher in TNA group than those in normal diet group (P <0.05). The levels of ala- nine aminotransferase, alkaline phosphatase, total bilirubin and blood urea nitrogen were lower in TNA group than those in fat-free nutrient admixture group (P < 0.05). Conclusion The nutritional proportion of TNA is suitable for the metabolism disorder of hepatic failure, and therefore TNA can reasonably promote the anabolism and reverse the deteri- oration of hepatic failure in rats.

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Effects of recombinant human growth hormone on vascular endothelial growth factor expression of human gastric carcinoma xenografts in nude mice

Lu CHENG ; Yan LIN ; Peng CAO ; Suyu JIANG ; Suyi LI

Chinese Journal of Clinical Nutrition.2010;18(2):101-105,illust 1. doi:10.3760/cma.j.issn.1674-635X.2010.02.009

Objective To investigate the effects of recombinant human growth hormone (rhGH) on tumor growth and vascular endothelial growth factor (VEGF) expression of human gastric carcinoma xenografts in nude mice with different expressions of growth hormone receptor (GHR). Methods Immunocytochemical method was used to pick out one GHR-positive and one GHR-negative cell line. Then the cells were subcutaneously injected into 24 nude mice separately. The nude mice bearing two different kinds of human gastric caicinoma were equalges of body weight and tumor volume of nude mice were recorded. Serum concentrations of VEGF in peripheral blood were analyzed by ELISA. VEGF protein and mRNA expression in tumor tissue were detected by immunohistochemistry and RT-PCR, respectively. Results We chose SGC-7901 as GHR positive group, and MKN-45 as the negative one. For nude mice bearing GHR + SGC-7901 xenografts, the tumor volumes were significantly larger in rhGH groups than in control group (P ＜ 0.05), and the high-dose rhGH group revealed greater effect (P ＜ 0. 05).Body weights were not significantly different among three groups (P ＞ 0. 05). Serum VEGF concentration was (252.94 ± 15.32) ng/L in the high-dose rhGH group, which was significantly higher than that in control group [(49.94 ± 5.73) ng/L] and low-dose rhGH group [(167.60 ± 9.54) ng/L] (P ＜ 0.05). Moderate positive staining with VEGF was observed in the control group, while VEGF staining was strong in rhGH administration groups. The relative expression of VEGF mRNA for the high-dose rhGH group was 0. 6470 ± 0. 0447, which was significantly higher than that in control group (0. 3230 ± 0. 0258)and low-dose rhGH group (0. 412 ± 0. 0351)(P ＜ 0.05). While for nude mice bearing GHR-MKN-45 xenografts, the body weights of the rhGH-administrated groups were significantly higher than that of control group (P ＜ 0.05), while tumor growth, serum VEGF concentration, and the expressions of VEGF mRNA and protein in tumor tissue were not significantly different (P ＞ 0.05).Conclusions rhGH can promote tumor growth and increase the expression of VEGF in the GHR-highly-expressed SGC-7901 xenograft tumor model. However, such effects do not exist in GHR-negatively-expressed MKN-45 xenograft tumor model. The existence of GHR may be a key target where rhGH influences the secretion of VEGF.

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Nutrition metabolism and nutrition support in end-stage liver disease

Dongxia HAN ; Qinghua MENG

Chinese Journal of Clinical Nutrition.2016;24(4):246-250. doi:10.3760/cma.j.issn.1674-635X.2016.04.011

Liver plays a central role in regulation of nutrition.Due to metabolic abnormalities,patients with end-stage liver disease often demonstrate undernutrition,which has a close relationship with the prognosis of the patients.Correct nutritional assessment and nutrition support is therefore very important.Dietary intake alone could not meet the nutritional needs of patients with end-stage liver disease.In recent years,the use of enteral and parenteral nutrition formulation has significantly improved the nutritional status of such patients,but there still lacks a gold standard. How to develop appropriate nutrition support regimens is a challenge for clinicians.This paper summarizes nutrition-related issues in patients with end-stage liver disease,aiming to provide a reference for individualized nutritional intervention for patients with end-stage liver disease.

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Research progress in relationship between vitamin D and inflammatory bowel disease

Shan TIAN ; Weiguo DONG

Chinese Journal of Clinical Nutrition.2016;24(4):251-256. doi:10.3760/cma.j.issn.1674-635X.2016.04.012

Inflammatory bowel disease (IBD) is a group of chronic inflammatory diseases of the intestine mediated by abnormal immunological mechanism caused by multiple etiological factors.The main treatment at present is anti-inflammation and immunosuppression,but with severe side effects and poor efficacy.Vitamin D3 has immunoregulatory,anti-inflammatory,and antineoplastic functions.Vitamin D,as a novel immunoregulator,may provide a new treatment option for patients with IBD.This article will review the research progress on the following four aspects:the relationship of vitamin D with innate immunity,adaptive immunity,and pathogenesis of IBD,and vitamin D supplement in IBD patients.

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Comparison of respiratory indirect calorimetry and Harris-Benedict coefficient in guiding energy target in patients with sepsis

Xiaojuan YANG ; Guorong MA ; Lijuan WANG ; Xigang MA

Chinese Journal of Clinical Nutrition.2016;24(4):193-198. doi:10.3760/cma.j.issn.1674-635X.2016.04.001

Objective To compare the measured resting energy expenditure (MREE) in patients with sepsis calculated using respiratory indirect calorimetry and Harris-Benedict (HB) coefficient method,and to investigate the influence of different energy target on the prognosis of patients with sepsis.Methods This was a prospective comparative study.60 patients with sepsis who were suitable for nutrition support and respiratory indirect calorimetry in the Intensive Care Unit (ICU) of the General Hospital of Ningxia Medical University from January to October 2015 were selected.(1) MREE was measured simultaneously with respiratory indirect calorimetry and HB coefficient (Harris-Benedict equation × stress coefficient) in the 60 patients on the 0,3rd,7th,and 14th days of nutrition support.The MREE calculated with the two methods were compared to detect difference.(2) The septic patients were randomly divided into two groups according to the random number table:respiratory indirect calorimetry group (n =30),in which the nutrition support was given according to the MREE measured using respiratory indirect calorimetry as the energy target;HB coefficient method group (n =30),in which the nutrition support energy target was the MREE measured using HB coefficient method.The clinical data of the patients in both groups were recorded and compared,which included the baseline characteristics,nutrition-related complications,and prognostic indicators.Results (1) Within 2 weeks during nutrition support,the dynamic MREE in the respiratory indirect calorimetry group was significantly higher than that in the HB coefficient method group (P ＜0.05).There was no significant difference in MREE on the 0,3rd,7th,and 14th days of nutrition support measured by respiratory indirect calorimetry (P ＞ 0.05).(2) There were no significant differences between the two groups in incidence of liver function damage and abnormal blood glucose within 2 weeks of nutrition support (both P ＞ 0.05).Compared with the HB coefficient method group,the length of ICU stay and 28-day mortality were significantly lower in the respiratory indirect calorimetry group [193.5 (172.2,289.7) h vs.247.5 (194.7,393.2),Z=-2.061,P=0.039;3.3％ vs.23.3％,x2 =5.129,P=0.023],but there was no significant difference between the two groups in mechanical ventilation time (P ＞ 0.05).Conclusions The MREE of septic patients may be considerably high and with little fluctuation in a short period.Respiratory indirect calorimetry may be more suitable to guide the energy intake target in septic patients.

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Effect of high-fat diet on the intestinal short-chain fatty acids in non-alcoholic fatty liver disease rats

Jing CHENG ; Fengling LI ; Bao ZHANG ; Shixia GUAN ; Lili HOU ; Jianhua JIANG

Chinese Journal of Clinical Nutrition.2016;24(4):236-240. doi:10.3760/cma.j.issn.1674-635X.2016.04.009

Objective To observe the changes of blood lipid and intestinal short-chain fatty acids in rats with non-alcoholic fatty liver disease (NAFLD) induced by high-fat diet,and to explore the role of intestinal short-chain fatty acids in the pathogenesis of NAFLD.Methods Male SD rats (n =12) were randomly divided into control group and high-fat group according to the random number table.The control group was fed with normal diet,while the high-fat group was fed with high-fat diet.The rats were sacrificed at the end of eighth week after experiment.HE staining was used to observe the pathological changes of the liver in the two groups,the changes in serum lipid profile were measured,and the changes of the contents of feces short-chain fatty acids in the two groups of rats were determined by gas chromatography.Results The levels of serum alanine transaminase [(139.6 ± 17.29) U/L vs.(37.67 ±5.28) U/L],aspartate transaminase [(367 ±49.36) U/Lvs.(97.67 ±13.92) U/L],triglyceride [(0.83±0.08) mmol/Lvs.(0.60± 0.04) mmol/L],totalcholesterol [(6.34±0.53) mmol/Lvs.(1.77±0.29) mmol/L],andvery-lowdensity lipoprotein [(0.31 ±0.03) mmol/L vs.(0.22 ±0.01) mmol/L] in the high-fat group were significantly higher than those in the control group (P ＜ 0.05).Compared with the control group,the contents of acetic acid,propionic acid and total short-chain fatty acids in the high-fat group were significantly lower [(0.16 ± 0.03) ng/μlvs.(0.21±0.04) ng/μl;(0.05±0.01) ng/μlvs.(0.08±0.01) ng/μl;(0.25±0.05) ng/μl vs.(0.33 ± 0.05) ng/μl;all P ＜ 0.05).Conclusions The level of intestinal short-chain fatty acids is reduced in the NAFLD rats induced by high-fat diet.Monitoring of feces short-chain fatty acids may play an important role in the diagnosis and treatment of NAFLD.

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Comparison of calculated and measured resting energy expenditure in patients with type 2 diabetes mellitus

Xueli SUN ; Yumei QI ; Suhong ZHOU

Chinese Journal of Clinical Nutrition.2016;24(4):226-229. doi:10.3760/cma.j.issn.1674-635X.2016.04.007

Objective To evaluate the accuracy of prediction equations in calculating energy expenditure in elderly patients with type 2 diabetes mellitus (T2DM).Methods In 75 elderly T2DM patients hospitalized in our hospital between August 2014 and August 2015,the resting energy expenditure (REE)measured with indirect calorimetry was compared with those calculated with six different prediction equations.Statistical analysis was performed with paired t-test,the percentage of individual coincidence,and BlandAltman method.Results The measured REE of the patients was (1 513.2 ± 240.6) kcal/d.There were statistically significant differences between the measured REE and the values predicted with Harris-Benedict,Owen,Mifflin,and Liu equations (all P ＜ 0.05),while no statistically significant differences were observed between the measured REE and the values predicted with FAO/WHO/UNU and Schofield equations (both P ＞0.05).FAO/WHO/UNU equation showed the smallest average difference from the measured value (-18.9 kcal/d),but the 95％ consistency limit (-363.3 kcal/d,325.5 kcal/d) was still beyond the acceptable clinical range.Conclusion The accuracy of prediction equations in estimating REE in elderly patients with T2DM may be dissatisfactory.

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The effect of comprehensive intervention on the quality of life of esophageal cancer patients treated with radiotherapy

Jieyun DING ; Xiaojuan CAI ; Mei CHEN

Chinese Journal of Clinical Nutrition.2016;24(4):230-235. doi:10.3760/cma.j.issn.1674-635X.2016.04.008

Objective To discuss the effect of comprehensive intervention on the quality of life of esophageal cancer patients receiving radiotherapy.Methods 100 patients with esophageal carcinoma treated with radiotherapy for the first timewere selected between October 2012 and December 2014 in Nantong Tumor Hospital in Jiangsu Province and randomly divided into control group and observation group (n =50 in each group) with a random number table.In the control group,routine dietary instruction,fluid infusion support and symptomatic intervention were used;comprehensive intervention was added in the observation group.Scores of core quality of life questionnaire (QLQ-C30) and nutritional indexesbefore and after radiotherapy in the two groups were compared.Results There were no statistically significant differences in QLQ-C30 scores and nutritional indexes between the two groups before radiotherapy (all P＞0.05).After radiotherapy,the physical [(75.6 ±13.1) vs.(63.8 ± 12.4)] and emotional function [(61.9 ± 14.3) vs.(52.5 ± 13.7)],fatigue [(36.6 ± 13.2) vs.(45.8±15.0)],pain [(34.8±16.1) vs.(44.3±17.0)],insomnia [(49.2±15.7) vs.(57.2±14.3)],loss of appetite [(50.2 ± 16.2) vs.(59.0 ± 15.8)],nausea and vomiting [(21.5 ± 10.3) vs.(29.9 ±11.3)],general health status [(68.8 ± 13.4) vs.(58.2 ± 12.8)] inthe observation group were significantly better than in the control group (all P ＜0.05).Innutritional status,body weight [(59.3 ± 8.5) kg vs.(54.4 ± 7.3) kg],body mass index [(21.9 ±2.1) kg/m2 vs.(18.4 ±2.8) kg/m2],hemoglobin [(125.9 ± 8.9) g/Lvs.(107.3±9.5) g/L],albumin [(35.1±6.9) g/Lvs.(29.0±5.3) g/L],and prealbumin [(213.54 ±37.47) mg/L vs.(174.56 ±36.26) mg/L] in the observation group were all higher than thosein the control group after radiotherapy (all P ＜ 0.01).Conclusion Comprehensive intervention for esophageal cancer patients receiving radiotherapymay improve nutritional status,reduce esophagitis,thirsty,fatigue,loss of appetite and other symptoms,improve the quality of life,ensure the completion of radiotherapy.

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Safety of nasogastric tube versus nasojejunal tube feeding in early enteral nutrition in acute pancreatitis: a Meta-analysis

Jie YANG ; Fachun ZHOU ; Xin LIU

Chinese Journal of Clinical Nutrition.2016;24(4):203-208. doi:10.3760/cma.j.issn.1674-635X.2016.04.003

Objective To evaluate the safety of nasogastric tube feeding and nasojejunal tube feeding in early enteral nutrition treatment of acute pancreatitis.Methods Using key words,subject headings,and citation tracing,we searched literatures reporting randomised controlled trials on early enteral nutrition treatment of acute pancreatitis through nasojejunal tube and nasogastric tube in the following databases:PubMed,Embase,Cochrane library,Wanfang,China National Knowledge Infrastructure (CNKI),and VIP published since the founding of the databases up to 2016.Meta-analysis was performed with the selected literature.Results Seven randomised controlled trials with 367 patients were included.Meta-analysis showed that the nasogastric tube group was not inferior to the nasojejunal tube group in the incidence of recurrent abdominal pain,gastrointestinal adverse reaction,the total length of hospital stay,and mortality.Conclusion Enteral nutrition via nasogastric tube is safe and well tolerated,may be a safe approach of nutrition treatment for acute pancreatitis.

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