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World Journal of Pediatrics 2022年第2期18卷 100-108页

作者： Si-Ying Liu Li-Wen Chang Jing Wang Min Xie Lei-Lei Chen Wei Liu Department of Pediatrics Tongji HospitalTongji Medical CollegeHuazhong University of Science and Technology1095 Jiefang AvenueWuhan 430030HubeiChina

Background Preterm infants with long-term parenteral nutrition(PN)therapy are at risk for cholestasis associated with total parenteral nutrition(PNAC).This study examined the safety and efficacy of ursodeoxycholic acid(UDCA)in preventing PNAC in preterm *** research aimed to investigate the prophylactic effect of preventive oral UDCA on PNAC in preterm *** We compared oral administration of UDCA prophylaxis with no prophylaxis in a randomized,open-label,proof-of-concept trial in preterm neonates with PN *** low-birth-weight preterm infants(<1800 g)who were registered to the neonatal intensive care unit(NICU)within 24 hours after birth were *** main endpoint was the weekly values of direct bilirubin(DB)of neonates during the NICU *** Eventually,a total of 102 preterm neonates from January 2021 to July 2021 were enrolled in this prospective study(42 in the UDCA group and 60 in the control group).Notably,the peak serum level of DB[13.0(12-16)vs.15.2(12.5-19.6)μmol/L,P<0.05]was significantly lower in the UDCA group than that in the control group without *** peak serum level of total bilirubin(101.1±34 vs.116.5±28.7μmol/L,P<0.05)was also significantly lower in the UDCA group than in the control ***,the proportion of patients who suffered from neonatal cholestasis(0.0%vs.11.7%,P<0.05)in the UDCA group was significantly *** UDCA prophylaxis is beneficial in preventing PNAC in NICU infants receiving prolonged PN.

关键词： Cholestasis parenteral nutrition Preterm infant Ursodeoxycholic acid

Influence of L-methionine-deprived total parenteral nutrition with 5-fluorouracil on gastric cancer and host metabolism

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World Journal of Gastroenterology 2001年第5期7卷 698-701页

作者： Hong-Bing Xiao~1 Wei-Xin Cao~2 Hao-Ran Yin~2 Yan-Zhen Lin~2 Shi-Hui Ye~1 1 Department of Surgery,Affiliated Railway Hospital,Tongji University,Shanghai 200072,China2 Department of Surgery,Affiliated Ruijin Hospital,Shanghai Second Medical University,Shanghai 200025,China Department of Surgery Affiliated Railway Hospital Tongji University Shanghai 200072 China. xhawbin@***

AIM: To investigate the influence of L-methionine-deprived total parenteral nutrition with 5-FU on gastric cancer and host metabolism. METHODS: N-methyl-N'-nitro-nitrosoguanidine (MNNG) induced gastric cancer rats were randomly divided into four groups: Met-containing TPN group (n=11), Met-deprived TPN group (n =12), Met-containing TPN+5-FU group (n=11) and Met-deprived TPN+5-FU group (n=12). Five rats in each group were sacrificed after 7 days of treatment and the samples were taken for examination. The remaining rats in each group were then fed separately with normal diet after the treatment until death, the life span was noted. RESULTS: The tumors were enlarged in Met-containing group and shrank in Met-deprived group markedly after the treatment. The DNA index (DI) of tumor cells and the body weight (BW) of rats had no significant change in the two groups, however, the ratio of tumor cells'S phase was increased. The ratio of G2M phase went up in Met-containing group, but down in Met-deprived group. In the other two groups that 5-FU was added, the BW of rats, and the diameter of tumors, the DI of tumor cells, the S and G2M phase ratio of tumor cells were all decreased, particularly in Met-deprived plus 5-FU group. Pathological examination revealed that the necrotic foci of the tumor tissue increased after Met-deprived TPN treatment, and the nucleoli of tumor cells enlarged. In MetTPN+5-FU group, severe nuclear damage was also found by karyopyknosis and karyorrhexis, meanwhile there was slight degeneration in some liver and kidney cells. The serum free Met and Cysteine decreased markedly (P<0.001), while other amino acids, such as serum free serine and glutamine increased significantly (P<0.005). All the rats died of multiple organ failure caused by cancer metastasis. The average survival time was 18.6 days in Met-containing TPN group, 31 days in Met-deprived TPN group, 27.5 days in Met-containing TPN+5-FU group, and 43 days in Met-deprived TPN+5-FU group (P&

关键词： parenteral nutrition Animals Antimetabolites, Antineoplastic Body Weight DNA, Neoplasm Fluorouracil Male Methionine Rats Rats, Wistar Research Support, Non-U.S. Gov't S Phase Stomach Neoplasms

Early enteral nutrition vs parenteral nutrition following pancreaticoduodenectomy: Experience from a single center

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World Journal of Gastroenterology 2016年第14期22卷 3821-3828页

作者： Jian-Wen Lu Chang Liu Zhao-Qing Du Xue-Min Liu Yi Lv Xu-Feng Zhang Department of Hepatobiliary Surgery and Institute of Advanced Surgical Technology and Engineering the First Affiliated Hospital of Xi'an Jiaotong University Xi'an 710061 Shaanxi Province China Shaanxi Provincial Regenerative Medicine and Surgical Engineering Research Center Xi'an 710061 Shaanxi Province China Department of Health Statistics the First Affiliated Hospital of Xi'an Jiaotong University Xi'an 710061 Shaanxi Province China

AIM: To analyze and compare postoperative morbidity between patients receiving total parenteral nutrition (TPN) and early enteral nutrition supplemented with parenteral nutrition (EEN + PN).METHODS: Three hundred and forty patients receiving pancreaticoduodenectomy (PD) from 2009 to 2013 at our center were enrolled retrospectively. Patients were divided into two groups depending on postoperative nutrition support scheme: an EEN + PN group (n = 87) and a TPN group (n = 253). Demographic characteristics, comorbidities, preoperative biochemical parameters, pathological diagnosis, intraoperative information, and postoperative complications of the two groups were ***: The two groups did not differ in demographic characteristics, preoperative comorbidities, preoperative biochemical parameters or pathological findings (P > 0.05 for all). However, patients with EEN + PN following PD had a higher incidence of delayed gastric emptying (16.1% vs 6.7%, P = 0.016), pulmonary infection (10.3% vs 3.6%, P = 0.024), and probably intraperitoneal infection (18.4% vs 10.3%, P = 0.059), which might account for their longer nasogastric tube retention time (9 d vs 5 d, P = 0.006), postoperative hospital stay (25 d vs 20 d, P = 0.055) and higher hospitalization expenses (USD10397 vs USD8663.9, P = 0.008), compared to those with ***: Our study suggests that TPN might be safe and sufficient for patient recovery after PD. Postoperative EEN should only be performed scrupulously and selectively.

关键词： Pancreaticoduodenectomy Postoperative complications Enteral nutrition parenteral nutrition Delayed gastric emptying

The association between weight stability and parenteral nutrition characteristics and survival in patients with colorectal cancer

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Gastroenterology Report 2019年第6期7卷 419-425,I0002页

作者： Wenli Liu Aiham Qdaisat Eric Lee Jason Yeung Khanh Vu Jun-Zhong Lin Todd Canada Shouhao Zhou Lorenzo Cohen Eduardo Bruera Sai-Ching J.Yeung Department of Palliative Rehabilitation and Integrative MedicineThe University of Texas MD Anderson Cancer CenterHoustonTXUSA Department of Emergency Medicine The University of Texas MD Anderson Cancer CenterHoustonTXUSA McGovern Medical School HoustonTXUSA Biomedical Science Texas A&M UniversityCollege StationTXUSA Department of General Internal Medicine The University of Texas MD Anderson Cancer CenterHoustonTXUSA Department of Colorectal Surgery Sun Yat-sen University Cancer CenterGuangzhouGuangdongP.R.China Division of Pharmacy The University of Texas MD Anderson Cancer CenterHoustonTXUSA Department of Public Health Sciences Pennsylvania State University School of MedicineHersheyPAUSA Department of Endocrine Neoplasia and Hormonal Disorders The University of Texas MD Anderson Cancer CenterHoustonTXUSA

Objective:Knowledge about the impact of metabolic disturbances and parenteral nutrition(PN)characteristics on the survival of cancer patients receiving PN is *** aimed to assess the association between clinical and PN characteristics and survival in colorectal-cancer patients receiving PN ***:Our study included 572 consecutive colorectal-cancer patients who had received PN support between 2008 and *** characteristics,body mass index,weight,medical/surgical history,indication for PN,PN data and survival were *** between clinical and PN characteristics and survival were analysed with important confounding ***:The final cohort included 437 evaluable patients,with a mean age of 57 ***-one percent of the study population had advanced stage of colorectal *** weight(weight change≥2.5%)prior to PN initiation[hazard ratio(HR)=1.41,P=0.023]was adversely associated with survival after adjusting for multiple factors including cancer *** obstruction(HR=1.75,P=0.017)as a PN indication was associated with worse survival when compared with without bowel *** PN amino acid by ideal body weight(g•kg^(-1))(HR=0.59,P=0.029)was associated with longer survival,whereas a higher percentage of non-PN intravenous calories(HR=1.04,P=0.011)was associated with shorter survival independently of confounding ***:Body mass index and weight stability can be useful nutritional indices for survival prediction in cancer patients receiving *** planning should take into account of non-PN calories to achieve optimal energy support and *** research is needed to define optimal PN amino-acid requirement and energy balance.

关键词： BMI weight loss non-parenteral calorie energy balance parenteral nutrition

Fish oil-based lipid emulsion:current updates on a promising novel therapy for the management of parenteral nutrition-associated liver disease

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Gastroenterology Report 2015年第2期3卷 110-114页

作者： Shishira Bharadwaj Tushar Gohel Omer J.Deen Robert DeChicco Abdullah Shatnawei Center for Human nutrition Department of Gastroenterology/HepatologyThe Cleveland Clinic FoundationClevelandOHUSA

Intestinal failure is characterized by loss of enteral function to absorb necessary nutrients and water to sustain *** nutrition(PN)is a lifesaving therapeutic modality for patients with intestinal *** PN is also needed for patients who have short bowel syndrome due to extensive resection or a dysmotility disorder with ***,prolonged PN is associated with short-term and long-term *** nutrition-associated liver disease(PNALD)is one of the long-termcomplications associated with the use of an intravenous lipid emulsion to prevent essential fatty acid deficiency in these *** affects 30–60%of the adult population on long-term ***,PNALD is one of the indications for isolated liver or combined liver and intestinal *** is no consensus on how to manage PNALD,but fish oil-based lipid emulsion(FOBLE)has been suggested to play an important role both in its prevention and *** is significant improvement in liver function in those who received FOBLE as lipid supplement compared with those who received soy-based lipid *** have also demonstrated that FOBLE reverses hepatic steatosis and reduces markers of inflammation in patients on long-term *** prospective studies with larger sample sizes are needed to further strengthen the positive role of FOBLE in PNALD.

关键词： intestinal failure parenteral nutrition parenteral nutrition-associated liver disease fish oil-based lipid emulsion

Effects of parenteral nutrition with and without GH on the GH/IGF-1 axis after hepatectomy in hepatocellular carcinoma with liver cirrhosis

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Frontiers of Medicine 2007年第3期1卷 287-293页

作者： CAO Jie LUO Shimin LIANG Lijian LAI Jiaming CHEN Shanming Department of General Surgery Affiliated Guangzhou First Municipal People’s HospitalGuangzhou Medical CollegeGuangzhou 510180China Department of Hepatobiliary Surgery The First Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510180China Department of Scientific Research and Education Affiliated Guangzhou First Municipal People’s HospitalGuangzhou Medical CollegeGuangzhou 510180China

Postoperative hepatic insulin-like growth factor-1(IGF-1)production may be severely disturbed in patients with liver *** alterations in the GH/IGF-1 axis are thought to play an important role in the protein catabolism that complicates major surgical *** aim of this study was to explore the effects of parenteral nutrition(PN)with and without growth hormone(GH)on the GH/IGF-1 axis after hepatectomy for hepatocellular carcinoma(HCC)with cirrhosis and evaluate the potential roles of recombinant human GH(rhGH)***-four patients with HCC with cirrhosis who underwent hepatectomy were randomly divided into two groups:a PN group(n=12)and an rhGH+PN group(n=12).Liver function,serum GH,IGF-1 and IGFBP-3 were measured before the operation and at postoperative days(POD)1 and ***-like growth factor-1 and IGFBP-3 mRNA in the liver tissue was detected by *** liver Ki67 immunohistochemistry staining was *** the same time,12 patients with cholelithiasis or liver hemangioma who underwent operation served as normal control *** POD 6,serum prealbumin,GH,IGF-1,IGFBP-3,hepatic IGF-1 mRNA,IGFBP-3 mRNA and liver Ki67 LI were higher in the rhGH+PN group than in the PN *** was no significant difference in the 6-and 12-month tumor-free survival rate and the median tumor-free survival time between the PN group and the rhGH+PN group(P>0.05).These data indicate that rhGH+PN could ameliorate the changes in the GH/IGF-1 axis after hepatectomy for HCC in the setting of cirrhosis.

关键词： carcinoma,hepatocellular parenteral nutrition growth hormone insulin-like growth factor I insulin-like growth factor binding protein 3

ALTERATION IN ENTEROCYTE GENE EXPRESSION MAY EXPLAIN STRUCTURAL AND FUNCTIONAL CHANGES FOLLOWING GLUTAMINE SUPPLEMENTED parenteral nutrition

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Chinese Medical Sciences Journal 1999年第2期14卷 112-116页

作者： JiangZhuming,MD LiuYuewu,MD,PhD MaYongxian,MD BaiManxi,MD,PhD QiangBoqing,PhD RobertSmith,MD DepartmentofSurgery PekingUnionMedicalCollegeHospitalBeijing100730 MolecularBiologyLaboratoryofChineseAcademyofMedicalSciences Beijing100730 JoslinDiabeticCenter DepartmentofSurgeryMassachusettsGeneralHospitalandBrighamandWomen＇sHospitalHarvardMedicalSchool

Following extensive bowel resection, the intestinal tract undergoes a variety of adaptive responses to enhance bowel function. The purpose of this study was to determine the effect of glutamine-supplemented parenteral nutrition on mucosal cellularity and gut function. In addition, enterocyte gene expression of two relevant systems was also characterized and related to the structural and functional changes that occurred. Male Wistar rats underwent a 60% small bowel resection and jugular vein catheterization and were randomized into two groups. The control group (n = 10) received a standard intravenous nutritional solution and the study group (n = 10) received a similar solution but enriched with alanylglutamine dipeptide. After 7 days blood was taken for amino acid analysis, and bowel was harvested to determine mucosal morphology and expression of mucosal cell glutaminase and IGF-I mRNA. Mesentery lymphnodes were cultured to determine the presence of bacteria and thus access bacteria translocation. Serum glutamine concentration and mucosal architecture were maintained in the study group compared to the controls. Seventy percent of lymphnodes were cultured positive in control vs. only 20% in the study group (P

关键词： parenteral nutrition Animals Dipeptides Enterocytes Gene Expression Glutaminase Ileum Insulin-Like Growth Factor I Intestinal Mucosa Intestine, Small Jejunum Male RNA, Messenger Rats Rats, Wistar Research Support, Non-U.S. Gov't

EFFECTS OF ENTERAL AND parenteral nutrition ON GASTROENTERIC HORMONES AND GASTRIC MOTILITY AFTER SUBTOTAL GASTRECTOMY

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Chinese Medical Sciences Journal 2008年第2期23卷 113-116页

作者： Wei-ming Kang Jian-chun Yu Qun Zhang Mei-yun Ke Jia-ming Qian Department of General Surgery Peking Union Medical College Hospital Chinese Academy of Medical Sciences ＆ Peking Union Medical College Beijing 100730 Department of Gastroenterology Peking UnionMedical College Hospital Chinese Academy of Medical Sciences ＆Peking Union Medical College Beijing 100730

Objective To investigate the effects of enteral nutrition （EN） and parenteral nutrition （PN） on gastric motility and gastroentefic hormones after subtotal gastrectomy. Methods Forty-one patients underwent gastrectomy were randomly divided into EN group （n=20） and PN group （n=21 ）. From the first postoperative day to the seventh day, patients received either EN （EN group） or PN （PN group） with isocalofic （84.9kJ·kg^-1·d^-1） and isonitrogenous （0.11g·kg^-1·d^-1） intake. Serum gastrin （GAS）, plasma mofilin （MTL）, and plasma cholecystokinin （CCK） were measured on preoperative day, the first and seventh postoperative day. Electrogastrography （EGG） was measured on preoperative day and the seventh postoperative day. Results Compared with preoperafion, blood GAS, MTL, and CCK levels of 41 patients decreased significantly on the first day after subtotal gastrectomy （ P 〈 0. 001 ）, but returned to the preoperative levels one week later. EGG after gastrectomy showed that gastric basal electrical rhythm was significantly restrained （ P 〈 0. 001 ）. On the seventh day after subtotal gastrectomy, plasma MTL and CCK levels in EN group were higher than those in PN group （ P 〈 0.05 ）. There was no difference in GAS level between two groups. EGG in EN group was better than that in PN group postoper- atively. Conclusions The levels of gastroentefitic hormones and the gastric motility decrease significantly after subtotal gastrectomy. In contrast with PN, EN can accelerate the recovery of MTL, CCK, and gastric motility after subtotal gastrectomy.

关键词： enteral nutrition parenteral nutrition gastroenteric hormones gastric motility gastrectomy

parenteral nutrition Combined with Enteral nutrition for Severe Acute Pancreatitis

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Parenteral Nutrition Combined with Enteral Nutrition for Sev...

作者： Akanand Singh 重庆医科大学

学位级别：硕士

Background&Aims:nutritional support in severe acute pancreatitis (SAP) is mandatory but there is controversy concerning the merits of enteral or parenteral nutrition in the management of patients with severe acute pancreatitis. In this study, we assess the therapeutic efficacy of gradually combined treatment of parenteral nutrition with enteral nutrition for SAP.Methods:The clinical data of130cases of SAP were analyzed retrospectively. Of them,59cases were treated by general method of nutritional support (Group Ⅰ) and other71cases were treated by parenteral nutrition gradually combined with enteral nutrition (Group Ⅱ). The score of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), IL-6, serum albumin level, complication rate, mortality, cure rate, length of hospitalization and treatment cost were observed.Results:As the treatment went on, the APACHE Ⅱ score and the level of IL-6in group Ⅱ decreased significantly in comparison to Group Ⅰ (Pparenteral nutrition with enteral nutrition not only can improve the prognosis of SAP but also reduce the complications, mortality, hospital stay and the cost of hospitalization in the patients with SAP.

关键词： Severe Acute Pancreatitis Combined nutritional Support Therapy Enteralnutrition parenteral nutrition

Impact of postoperative omega-3 fatty acid-supplemented parenteral nutrition on clinical outcomes and immunomodulations in colorectal cancer patients

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World Journal of Gastroenterology 2008年第15期14卷 2434-2439页

作者： Bin Liang, Shan Wang, Ying-Jiang Ye, Xiao-Dong Yang, You-Li Wang, Jun Qu, Qi-Wei Xie, Mu-Jun Yin, Division of Surgical Oncology and Division of Gastroenterological Surgery, Peking University People’s Hospital, Beijing 100044, China Author contributions: Liang B and Wang S contributed equally to this work Liang B and Wang S designed the research Liang B, Ye YJ, Yang XD, Wang YL, Qu J, Xie QW, Yin MJ performed the research and collected the data Wang S and Ye YJ supervised the research Liang B and Ye YJ analyzed the data Liang B wrote the paper and revised the manuscript. Division of Gastroenterological Surgery Peking University People's Hospital Beijing 100044 China. dr.wangshan@***

AIM: To investigate the effect of omega-3 fatty acid parenteral supplementation postoperatively on clinical outcomes and immunomodulation in colorectal cancer patients. METHODS: Forty-two patients undergoing radical colorectal cancer resection with an indication for total parenteral nutrition postoperatively were enrolled in this prospective, double-blind, randomized, controlled study. Patients received total parenteral nutrition supplemented with either soybean oil (LCT; Intralipid, Fresenius-Kabi, SO group, n = 21) or a combination of omega-3 fish oil and soybean oil (LCT:fish oil = 5:1, fish oil; Omegaven, Fresenius-Kabi, FO group, n = 21), up to a total of 1.2 g lipid/kg per day for 7 d postoperatively. A same volume calorie and nitrogen was administrated. Routine blood test, biochemistry, systemic levels of IL-6 and TNF-α, percentage of CD3+, CD4+, and CD8+ lymphocytes were evaluated preoperatively and on postoperative d 1 and 8. Patient outcome was evaluated considering mortality during the hospital stay, length of postoperative hospital stay, and occurrence of infectious complications. RESULTS: Both lipid regimens were well tolerated. No differences between the two groups were noticed in demographics, baseline blood test, biochemistry, serum levels of IL-6 and TNF-α, percentage of CD4+, CD8+ lymphocytes, and ratios of CD4+/CD8+. Compared with those on postoperative d 1, serum IL-6 levels onpostoperative d 8 were significantly depressed in the FO group than in the reference group (-44.43 ± 30.53 vs -8.39 ± 69.08, P = 0.039). Simultaneously, the ratios of CD4+/CD8+ were significantly increased in the FO group (0.92 ± 0.62 vs 0.25 ± 1.22, P = 0.035). In addition, depression of serum TNF-α levels (-0.82 ± 2.71 vs 0.27 ± 1.67, P = 0.125) and elevation of CD3+ and CD4+ lymphocyte percentage (12.85 ± 11.61 vs 3.84 ± 19.62, P = 0.081, 17.80 ± 10.86 vs 9.66 ± 17.55, P = 0.084, respectively) were higher in the FO group than in the reference group. Patients in the FO

关键词： Colorectal cancer parenteral nutrition Omega-3 fatty acids Immunomodulation Abdominalsurgery