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| 1 | 中国大陆肺炎发病率与死亡率:1985-2008年中英文文献的系统分析显示文摘目的肺炎是全球传染性疾病最主要的死因之一,但中国的肺炎疾病负担还知之甚少,因为很多数据资料都是以非英文文献的形式发表的。方法系统回顾了中国大陆关于肺炎发病率与死亡率的中文和英文文献,这些研究都是具有第一手数据的研究,1985-2008年有37篇论文符合纳入标准。结果各项研究的质量差异较大。5岁以下儿童肺炎发病率为(0.06~0.27)次/人年,肺炎死亡率为184/10万~1 223/10万人口。肺炎的发病率与死亡率随着时间稳定不变或者呈下降趋势,且农村高于城市。结论肺炎仍然是中国儿童的主要公共卫生问题之一。肺炎发病率与死亡率估计的变化差异大。继续降低发病率与死亡率需要可靠的监测数据和新的预防措施的实施,特别是在农村等高发地区。 | 官旭华 Benjamin J Silk Wenkai Li Aaron T. Fleishchauer 邢学森 蒋晓清 余宏杰 Sonja J. Olsen Adam L. Cohen | 2011 | 公共卫生与预防医学2011，22，1： | 54 |
| 2 | Apoptosis and DNA damage in human spermatozoa显示文摘DNA 损坏经常在 subfertile 男性的精子被遇到并且包括损害授精与不利临床的结果的一个范围被相关,破坏 preimplantation 胚胎的开发,流产的增加的率和在子孙的疾病的提高的风险。在人的精子的 DNA 破碎的病原学密切与氧化的底的外观被相关使内收并且损害精子形式的证据。我们假设那个氧化压力阻碍精子形式,与糟糕改变的染色质导致精子的产生。这些有缺点的房间有一个趋势默认到线粒体与活动性损失, caspase 激活, phosphatidylserine exteriorization 和免费激进的产生的激活联系的一条 apoptotic 小径。后者导致类脂化合物 peroxidation 和氧化 DNA 损坏,它然后导致 DNA 破碎和房间死亡。精子的物理体系结构阻止从获得存取到原子 DNA 并且导致它的破碎由于这 apoptotic 进程激活的任何核酸酶。是为这个原因在人的精子遇到的 DNA 损坏的一个多数似乎氧化。给氧化应力似乎在 DNA 损坏的病原学有的重要角色,应该为在这个条件的处理的抗氧化剂有一个重要角色。如果在精子的氧化 DNA 损坏正在提供全身的氧化应力的敏感读出,这些调查结果的含意能在我们试着作为一篇序言在精子最小化 DNA 损坏到帮助概念治疗的立即的目标以外拉长。 | R John Aitken Adam J Koppers | 2011 | Asian Journal of Andrology2011，13，1： | 46 |
| 3 | Mechanisms underlying feed intolerance in the critically ill: Implications for treatment显示文摘Malnutrition is associated with poor outcomes in critically ill patients. Although nutritional support is yet to be proven to improve mortality in non-malnourished critically ill patients, early enteral feeding is considered best practice. However, enteral feeding is often limited by delayed gastric emptying. The best method to clinically identify delayed gastric emptying and feed intolerance is unclear. Gastric residual volume (GRV) measured at the bedside is widely used as a surrogate marker for gastric emptying, but the value of GRV measurement has recently been disputed. While the mechanisms underlying delayed gastric emptying require further investigation, recent research has given a better appreciation of the pathophysiology. A number of pharmacological strategies are available to improve the success of feeding. Recent data suggest a combination of intravenous metoclopramide and erythromycin to be the most successful treatment, but novel drug therapies should be explored. Simpler methods to access the duodenum and more distal small bowel for feed delivery are also under investigation. This review summarises current understanding of the factors responsible for, and mechanisms underlying feed intolerance in critical illness, together with the evidence for current practices. Areas requiring further research are also highlighted. | Adam Deane Marianne J Chapman Robert J Fraser Laura K Bryant Carly Burgstad Nam Q Nguyen | 2007 | World Journal of Gastroenterology2007，13，29： | 18 |
| 4 | Effects of creep feeding and supplemental glutamine or glutamine plus glutamate (Aminogut) on pre- and post-weaning growth performance and intestinal health of piglets显示文摘Background: Creep feeding is used to stimulate piglet post-weaning feed consumption.L-Glutamine(GLN) is an important source of fuel for intestinal epithelial cells.The objective of this study was to determine the impact of creep feeding and adding GLN or AminoGut(AG;containing glutamine + glutamate) to pre-and post-weaning diets on pig performance and intestinal health.Litters(N = 120) were allotted to four treatments during 14–21 d of lactation: 1) No creep feed(NC,n = 45);2) creep fed control diet(CFCD,n = 45);3) creep fed 1% GLN(CFGLN,n = 15);4) creep fed.88% AG(CFAG,n = 15).After weaning,the NC and CFCD groups were sub-divided into three groups(n = 15 each),receiving either a control nursery diet(NC-CD,CFCD-CD) or a diet supplemented with either GLN(NC-GLN,CFCD-GLN) or with AG(NC-AG,CFCD-AG).Litters that were creep fed with diets containing GLN or AG also were supplemented with those amino acids in the nursery diets(CFGLN-GLN,CFAG-AG).Glutamine was added at 1% in all three post-weaning diet phases and AG was added at.88% in phase 1 and 2 and at.66% in phase 3.Results: Feed conversion(feed/gain) showed means among treatment means close to significance(P = 0.056) and Tukey's test for pairwise mean comparisons showed that Pigs in the CFGLN-GLN group had the best feed conversion(feed/gain) in the first three-week period post-weaning,exceeding(P = 0.044) controls(CFCD-CD) by 34%.The NC-AG group had(P = 0.02) the greatest feed intake in the last three week of the study,exceeding controls(CFCD-CD) by 12%.CFGLN-GLN,CFCD-GLN and sow reared(SR) pigs had the greatest(P = 0.049) villi height exceeding the CFCD-AG group by 18%,20% and 19% respectively.The CFAG-AG group had the deepest(P = 0.001) crypts among all treatments.CFGLN-GLN,CFCD-GLN and SR groups had the greatest(P = 0.001) number of cells proliferating(PCNA) exceeding those in the NC-CD group by 43%,54% and 63% respectively.Sow reared pigs showed the greatest(P = 0.001) intestinal absorption capacity for xylose and mannitol.Conclusion: Supplementation of creep feed and nursery diets with GLN and/or AminoGut in the first three week improved feed conversion possibly due to improved intestinal health. | Rafael A Cabrera James L Usry Consuelo Arrellano Eduardo T Nogueira Marianne Kutschenko Adam J Moeser Jack Odle | 2013 | Journal of Animal Science and Biotechnology2013，4，3： | 17 |
| 5 | Optimal timing and route of nutritional support after esophagectomy: A review of the literature显示文摘Some controversy surrounds the postoperative feeding regimen utilized in patients who undergo esophagectomy.Variation in practices during the perioperative period exists including the type of nutrition started,the delivery route,and its timing.Adequate nutrition is essential for this patient population as these patients often present with weight loss and have altered eating patterns after surgery,which can affect their ability to regain or maintain weight.Methods of feeding after an esophagectomy include total parenteral nutrition,nasoduodenal/nasojejunal tube feeding,jejunostomy tube feeding,and oral feeding.Recent evidence suggests that early oral feeding is associated with shorter LOS,faster return of bowel function,and improved quality of life.Enhanced recovery pathways after surgery pathways after esophagectomy with a component of early oral feeding also seem to be safe,feasible,and cost-effective,albeit with limited data.However,data on anastomotic leaks is mixed,and some studies suggest that the incidence of leaks may be higher with early oral feeding.This risk of anastomotic leak with early feeding may be heavily modulated by surgical approach.No definitive data is currently available to definitively answer this question,and further studies should look at how these early feeding regimens vary by surgical technique.This review aims to discuss the existing literature on the optimal route and timing of feeding after esophagectomy. | Richard Zheng Courtney L Devin Michael J Pucci Adam C Berger Ernest L Rosato Francesco Palazzo | 2019 | World Journal of Gastroenterology2019，25，31： | 11 |
| 6 | Implications of preoperative hypoalbuminemia in colorectal surgery显示文摘Serum albumin has traditionally been used as a quantitative measure of a patient's nutritional status because of its availability and low cost. While malnutrition has a clear definition within both the American and European Societies for Parenteral and Enteral Nutrition clinical guidelines, individual surgeons often determine nutritional status anecdotally. Preoperative albumin level has been shown to be the best predictor of mortality after colorectal cancer surgery. Specifically in colorectal surgical patients, hypoalbuminemia significantly increases the length of hospital stay, rates of surgical site infections, enterocutaneous fistula risk, and deep vein thrombosis formation. The delay of surgical procedures to allow for preoperative correction of albumin levels in hypoalbuminemic patients has been shown to improve the morbidity and mortality in patients with severe nutritional risk. The importance of preoperative albumin levels and the patient's chronic inflammatory state on the postoperative morbidity and mortality has led to the development of a variety of surgical scoring systems to predict outcomes efficiently. This review attempts to provide a systematic overview of albumin and its role and implications in colorectal surgery. | Adam Truong Mark H Hanna Zhobin Moghadamyeghaneh Michael J Stamos | 2016 | World Journal of Gastrointestinal Surgery2016，8，5： | 9 |
| 7 | 应用组织型纤溶酶原激活物行静脉溶栓治疗急性缺血性卒中的时间窗延长——美国心脏协会/美国卒中协会的科学建议显示文摘美国心脏协会卒中委员会发布了关于急性缺血性卒中的现行治疗指南,其中包括应用重组组织型纤溶酶原激活物(rt—PA)行静脉溶栓的建议。尽管该药对改善神经功能预后有一定的疗效,但由于患者通常在发病3h后方能到达医院,往往已经超过了用药的时间窗。因此,大部分缺血性卒中患者未能接受rt—PA治疗。目前研究认为,增加rt—PA治疗例数的最可能方法就是延长治疗时间窗。 | del Zoppo G J Saver J L Jauch E C Adams H P Jr. | 2009 | 中国脑血管病杂志2009，6，8： | 8 |
| 8 | Malnutrition in cirrhosis:More food for thought显示文摘Malnutrition is highly prevalent in liver cirrhosis and its presence carries important prognostic implications.The clinical conditions and pathophysiological mechanisms that cause malnutrition in cirrhosis are multiple and interrelated.Anorexia and liver decompensation symptoms lead to poor dietary intake;metabolic changes characterised by elevated energy expenditure,reduced glycogen storage,an accelerated starvation response and protein catabolism result in muscle and fat wasting;and,malabsorption renders the cirrhotic patient unable to fully absorb or utilise food that has been consumed.Malnutrition is therefore a considerable challenge to manage effectively,particularly as liver disease progresses.A high energy,high protein diet is recognised as standard of care,yet patients struggle to follow this recommendation and there is limited evidence to guide malnutrition interventions in cirrhosis and liver transplantation.In this review,we seek to detail the factors which contribute to poor nutritional status in liver disease,and highlight complexities far greater than“poor appetite”or“reduced oral intake”leading to malnutrition.We also discuss management strategies to optimise nutritional status in this patient group,which target the inter-related mechanisms unique to advanced liver disease.Finally,future research requirements are suggested,to develop effective treatments for one of the most common and debilitating complications afflicting cirrhotic patients. | Brooke Chapman Marie Sinclair Paul J Gow Adam G Testro | 2020 | World Journal of Hepatology2020，12，11： | 8 |
| 9 | The role of cysteine-rich secretory proteins in male fertility显示文摘充满半胱氨酸的能分泌的蛋白质(CRISPs ) 是 CRISP,的亚群抗原 5 并且 Pr-1 (帽子) 蛋白质总科,并且仅仅在脊椎动物被发现。他们显示出强壮的表示偏爱到哺乳动物的男繁殖的道和有毒的爬行动物的毒液。在男繁殖的道以内, CRISPs 在跨越 haploid 细菌房间开发, epididymal 成熟, capacitation,活动性和授精的实际进程的男细菌房间生物学的许多方面被含有。在结构的水平, CRISPs 由二个领域,一个帽子领域,它在房间鈥揷e ll 粘附被含有,和一个松脆的领域组成,它被显示了越过多重种类调整离子隧道的几个班。此处,我们将在男富饶在 CRISPs 的角色上考察当前的文学,并且由到相关非哺乳动物的蛋白质的推理,推断潜在的生物化学的功能。 | Adam J Koppers Thulasimala Reddy Moira K O'Bryan | 2011 | Asian Journal of Andrology2011，13，1： | 8 |
| 10 | Therapy-refractory gastrointestinal motility disorder in a child with c-kit mutations显示文摘Constipation and fecal impaction are frequent and distressing complaints in pediatric gastroenterology. Especially in neurologically handicapped children, treatment of severe forms of slow-transit constipation (STC) can be difficult. In the majority of cases, STC is of unknown etiology. However, in recent years, there is growing evidence that interstitial cells of Cajal (ICCs), which serve as electrical pacemakers and generate spontaneous electrical slow waves in the gastrointestinal tract, might play an important role in the pathophysiology of STC. It remains unclear whether morphological ICC alterations seen in affected patients are based on congenital developmental anomalies, or whether they are a consequence of long-term constipation with secondary damage of the gastrointestinal nervous system. To the best of our knowledge, we present the first case of a patient with histological alterations in ICC morphology who displayed multiple alterations of c-kit at the level of mRNA. The protein encoded by c-kit is the receptor tyrosine kinase Kit (CD117), which is crucial for development and function of ICCs. Therefore, these findings provide a new explanation for congenital alterations of ICC development that result in gastrointestinal motility disorders. | Christian Breuer Jun Oh Gerhard J Molderings Michael Schemann Birgit Kuch Ertan Mayatepek Rüdiger Adam | 2010 | World Journal of Gastroenterology2010，16，34： | 7 |
| 11 | Adipose derived stem cells and nerve regeneration显示文摘Injuries to peripheral nerves are common and cause life-changing problems for patients alongside high social and health care costs for society. Current clinical treatment of peripheral nerve injuries predominantly relies on sacrificing a section of nerve from elsewhere in the body to provide a graft at the injury site. Much work has been done to develop a bioengineered nerve graft, precluding sacrifice of a functional nerve. Stem cells are prime candidates as accelerators of regeneration in these nerve grafts. This review examines the potential of adipose-derived stem cells to improve nerve repair assisted by bioengineered nerve grafts. | Alessandro Faroni Richard JP Smith Adam J Reid | 2014 | Neural Regeneration Research2014，9，14： | 7 |
| 12 | Dementia and osteoporosis in a geriatric population: Is there a common link?显示文摘AIM To determine the existence of a common pathological link between dementia and osteoporosis through reviewing the current evidence base. METHODS This paper reviews the current literature on osteoporosis and dementia in order to ascertain evidence of a common predisposing aetiology. A literature search of Ovid MEDLINE(1950 to June 2016) was conducted. The keywords 'osteoporosis', 'osteoporotic fracture', 'dementia' and 'Alzheimer's disease'(AD) were used to determine the theoretical links with the most significant evidence base behind them. The key links were found to be vitamins D and K, calcium, thyroid disease, statins, alcohol and sex steroids. These subjects were then searched in combination with the previous terms and the resulting papers manually examined. Theoretical, in vitro and in vivo research were all used to inform this review which focuses on the most well developed theoretical common causes for dementia(predominantly Alzheimer's type) and osteoporosis.RESULTS Dementia and osteoporosis are multifaceted disease processes with similar epidemiology and a marked increase in prevalence in elderly populations. The existence of a common link between the two has been suggested despite a lack of clear pathological overlap in our current understanding. Research to date has tended to be fragmented and relatively weak in nature with multiple confounding factors reflecting the difficulties of in vivo experimentation in the population of interest. Despite exploration of various possible mechanisms in search for a link between the two pathologies, this paper found that it is possible that these associations are coincidental due to the nature of the evidence available. One finding in this review is that prior investigation into common aetiologies has found raised amyloid beta peptide levels in osteoporotic bone tissue, with a hypothesis that amyloid beta disorders are systemic disorders resulting in differing tissue manifestations. However, our findings were that the most compelling evidence of a common yet independent aetiology lies in the APOE4 allele, which is a well-established risk for AD but also carries an independent association with fracture risk. The mechanism behind this is thought to be the reduced plasma vitamin K levels in individuals exhibiting the APOE4 allele which may be amplified by the nutritional deficiencies associated with dementia, which are known to include vitamins K and D. The vitamin theory postulates that malnutrition and reduced exposure to sunlight in patients with AD leads to vitamin deficiencies. CONCLUSION Robust evidence remains to be produced regarding potential links and regarding the exact aetiology of these diseases and remains relevant given the burden of dementia and osteoporosis in our ageing population. Future research into amyloid beta, APOE4 and vitamins K and D as the most promising aetiological links should be welcomed. | Candice L Downey Adam Young Emily F Burton Simon M Graham Robert J Macfarlane Eva-Maria Tsapakis Eleftherios Tsiridis | 2017 | World Journal of Orthopedics2017，8，5： | 6 |
| 13 | Determinants of the impact of blood pressure variability on neurological outcome after acute ischaemic stroke显示文摘Introduction: Increased blood pressure variability (BPV) is detrimental after acute ischaemic stroke, but the interaction between BPV and neuroimaging factors that directly influence stroke outcome has not been explored. Methods: We retrospectively reviewed inpatients from 2007 to 2014 with acute anterior circulation ischaemic stroke, CT perfusion and angiography at hospital admission, and a modified Rankin Scale (MRS) 30- 365 days after stroke onset. BPV indices included SD, coefficient of variation and successive variation of the systolic blood pressure between 0 and 120 hours after admission. Ordinal logistic regression models were fitted to MRS with predictor variables of BPV indices. Models were further stratified by CT perfusion volumetric measurements, proximal vessel occlusion and collateral score. Results: 110 patients met the inclusion criteria. The likelihood of a 1-point rise in the MRS increased with every 10 mm Hg increase in BPV (OR for the 3 BPV indices ranged from 2.27 to 5.54), which was more pronounced in patients with larger ischaemic core volumes (OR 8.37 to 18.0) and larger hypoperfused volumes (OR 6.02 to 15.4). This association also held true for patients with larger mismatch volume, proximal vessel occlusion and good collateral vessels. Conclusions: These results indicate that increased BPV is associated with worse neurological outcome after stroke, particularly in patients with a large lesion core volume, concurrent viable ischaemic penumbra, proximal vessel occlusion and good collaterals. This subset of patients, who are often not candidates for or fail acute stroke therapies such as intravenous tissue plasminogen activator or endovascular thrombectomy, may benefit from interventions aimed at reducing BPV. | Adam de Havenon Alicia Bennett Gregory J Stoddard Gordon Smith Lee Chung Steve O’Donnell J Scott McNally David Tirschwell Jennifer J Majersik | 2017 | Stroke & Vascular Neurology2017，2，1： | 6 |
| 14 | 内皮Notch信号的抑制阻碍脂肪酸转运并导致成年心脏的代谢和血管重塑显示文摘营养成分在被肌肉细胞代谢利用之前通过内皮细胞转运。然而,对于内皮运输过程的调节知之甚少。Notch信号传导是发育过程中代谢和血管生成的关键调控因子。在该研究中,Jabs等研究了成年小鼠内皮Notch信号的遗传和药理学调控如何影响内皮脂肪酸转运、心脏血管生成和心脏功能。 | 刘青 叶鹏 Jabs M Rose AJ Lehmann LH Taylor J Moll I Sijmonsma TP Herberich SE Sauer SW Poschet G Federico G Mogler C Weis EM Augustin HG Yan M Gretz N Schmid RM Adams RH Gr9ne HJ Hell R Okun JG Backs J Nawroth PP Herzig S Fischer A | 2018 | 中华高血压杂志2018，26，3： | 6 |
| 15 | Detection,Occurrence,and Survey of Rice Stripe and BlackStreaked Dwarf Diseases in Zhejiang Province,China显示文摘The major viral diseases that occur on rice plants in Zhejiang Province, eastern China, are stripe and rice black-streaked dwarf diseases. Rice stripe disease is only caused by rice stripe tenuivirus(RSV), while rice black-streaked dwarf disease can be caused by rice black-streaked dwarf fijivirus(RBSDV) and/or southern rice black-streaked dwarf fijivirus(SRBSDV). Here we review the characterization of these viruses, methods for their detection, and extensive surveys showing their occurrence and spread in the province. | ZHANG Heng-mu WANG Hua-di YANG Jian Michael J ADAMS CHEN Jian-ping | 2013 | Rice science2013，20，6： | 4 |
| 16 | 星萼金丝桃的化学成分和抗氧化活性研究显示文摘星萼金丝桃Hypericum stellatum是中国西南地区特有种,也是当地一种重要的民族药用植物。采用UPLC-Q-TOF-MS分析星萼金丝桃的化学成分,初步鉴定了17个化合物,通过DPPH自由基清除法测定抗氧化活性,Folin-Ciocalteu法测定总酚含量,星萼金丝桃乙酸乙酯萃取层显示出较强的抗氧化活性和较高的总酚含量。选定抗氧化活性强和总酚含量较高的乙酸乙酯层进行化学成分研究,利用正相硅胶、Sephedex LH-20、循环制备高效液相等多种色谱手段对地上部位提取物进行分离纯化,通过一维,二维核磁共振波谱数据对所得化合物进行结构鉴定,在该层萃取物中分离得到10个化合物,分别鉴定为槲皮素(Ⅰ),槲皮素-3-O-β-D-葡萄糖苷(Ⅱ),1,3,6,7-四羟基口山酮(Ⅲ),1,3,5,6-四羟基口山酮(Ⅳ),1,3,7-三羟基口山酮(Ⅴ),3,6,7-三羟基-1-甲氧基口山酮(Ⅵ),calycinoxanthon D(Ⅶ),咖啡酸酸乙酯(Ⅷ),绿原酸(Ⅸ),绿原酸乙酯(Ⅹ)。该研究首次报道我国特有植物星萼金丝桃的化学成分和生物活性,初步明确星萼金丝桃清除自由基、抗氧化活性的物质基础。 | 纪圆圆 Adam Negrin Edward J Kennelly 龙春林 | 2018 | 中国中药杂志2018，43，18： | 4 |
| 17 | Acute effects of rotavirus and malnutrition on intestinal barrier function in neonatal piglets显示文摘AIM: To investigate the effect of protein-energy malnutrition on intestinal barrier function during rotavirus enteritis in a piglet model.METHODS: Newborn piglets were allotted at day 4 of age to the following treatments:(1) full-strength formula(FSF)/noninfected;(2) FSF/rotavirus infected;(3) half-strength formula(HSF)/noninfected;or(4) HSF/rotavirus infected.After one day of adjustment to the feeding rates,pigs were infected with rotavirus and acute effects on growth and diarrhea were monitored for 3 d and jejunal samples were collected for Ussingchamber analyses.RESULTS: Piglets that were malnourished or infected had lower body weights on days 2 and 3 post-infection(P < 0.05).Three days post-infection,marked diarrhea and weight loss were accompanied by sharp reductions in villus height(59%) and lactase activity(91%) and increased crypt depth(21%) in infected compared with non-infected pigs(P < 0.05).Malnutrition also increased crypt depth(21%) compared to full-fed piglets.Villus:crypt ratio was reduced(67%) with viral infection.There was a trend for reduction in transepithelial electrical resistance with rotavirus infection and malnutrition(P = 0.1).3H-mannitol flux was significantly increased(50%;P < 0.001) in rotavirus-infected piglets compared to non-infected piglets,but there was no effect of nutritional status.Furthermore,rotavirus infection reduced localization of the tight junction protein,occludin,in the cell membrane and increased localization in the cytosol.CONCLUSION: Overall,malnutrition had no additive effects to rotavirus infection on intestinal barrier function at day 3 post-infection in a neonatal piglet model. | Sheila K Jacobi Adam J Moeser Anthony T Blikslager J Marc Rhoads Benjamin A Corl Robert J Harrell Jack Odle | 2013 | World Journal of Gastroenterology2013，19，31： | 4 |
| 18 | Analysis of a Successful Immune Response against Hepatitis C Virus显示文摘 | Stewart Cooper Ann L Erickson Erin J Adams Joe Kansopon Amy J Weiner David Y Chien Michael Houghton Peter Parham Christopher M Walker | 1999 | Immunity1999，，4： | 3 |
| 19 | Targeting DNA Double-Strand Breaks with TAL Effector Nucleases显示文摘 | Christian Michelle Cermak Tomas Doyle Erin L Schmidt Clarice Zhang Feng Hummel Aaron Bogdanove Adam J Voytas Daniel F | 2010 | Genetics2010，，2： | 3 |
| 20 | Preoperative immunonutrition in patients undergoing liver resection:A prospective randomized trial显示文摘BACKGROUND Preoperative supplementation with immunonutrients, including arginine and n-3 fatty acids, has been shown in a number of systematic reviews to reduce infectious complications in patients who have undergone gastrointestinal surgery. Limited information, however, is available on the benefits of nutritional supplementation enriched with arginine and n-3 fatty acids in patients undergoing liver resection.AIM To evaluate the effects of preoperative nutritional supplementation enriched with arginine and n-3 fatty acids on inflammatory and immunologic markers and clinical outcome in patients undergoing liver resection.METHODS Thirty-four patients undergoing liver resection were randomized to either five days of preoperative Impact? [1020 kcal/d, immunonutrition(IMN) group], or standard care [no supplementation, standard care(STD) group]. Nutritional status was measured at study entry by subjective global assessment(SGA).Functional assessments(grip strength, fatigue and performance status) were carried out at study entry, on the day prior to surgery, and on postoperative day(POD) 7 and 30. Inflammatory and immune markers were measured at study entry, on the day prior to surgery, and POD 1, 3, 5, 7, 10 and 30. Postoperative complications were recorded prospectively until POD30.RESULTS A total of 32 patients(17 IMN and 15 STD) were analysed. All except four patients were SGA class A. The plasma ratio of(eicosapentaenoic acid plus docosahexaenoic acid) to arachidonic acid was higher in IMN patients on the day prior to surgery and POD 1, 3, 5 and 7(P < 0.05). Plasma interleukin(IL)-6 concentrations were elevated in the IMN group(P = 0.017 for POD7). No treatment effect was detected for functional measures, immune response(white cell count and total lymphocytes) or markers of inflammation(C-reactive protein,tumour necrosis factor-α, IL-8, IL-10). There were 10 patients with infectious complications in the IMN group and 4 in the STD group(P = 0.087). Median hospital stay was 9(range 4–49) d in the IMN group and 8(3-34) d in the STD group(P = 0.476).CONCLUSION In well-nourished patients undergoing elective liver resection, this study failed to show any benefit of preoperative immunonutrition. | Kylie Russell Han-Guang Zhang Lyn K GillANDers Adam SJR Bartlett Helena L Fisk Philip C Calder Peter J Swan Lindsay D Plank | 2019 | World Journal of Hepatology2019，11，3： | 3 |
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