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| 1 | Effects of early enteral nutrition on immune function of severe acute pancreatitis patients显示文摘AIM:To investigate the effects of early enteral nutrition (EEN) on the immune function and clinical outcome of patients with severe acute pancreatitis (SAP).METHODS:Patients were randomly allocated to receive EEN or delayed enteral nutrition (DEN).Enteral nutrition was started within 48 h after admission in EEN group,whereas from the 8 th day in DEN group.All the immunologic parameters and C-reactive protein (CRP) levels were collected on days 1,3,7 and 14 after admission.The clinical outcome variables were also recorded.RESULTS:Sixty SAP patients were enrolled to this study.The CD4+ T-lymphocyte percentage,CD4+/CD8+ ratio,and the CRP levels in EEN group became significantly lower than in DEN group from the 7 th day after admission.In contrast,the immunoglobulin G(IgG) levels and human leukocyte antigen-DR expression in EEN group became significantly higher than in DEN group from the 7 th day after admission.No difference of CD8+ T-lymphocyte percentage,IgM and IgA levels was found between the two groups.The incidences of multiple organ dysfunction syndrome,systemic inflammatory response syndrome,and pancreatic infection as well as the duration of intensive care unit stay were significantly lower in EEN group than in DEN group.However,there was no difference of hospital mortality between the two groups.CONCLUSION:EEN moderates the excessive immune response during the early stage of SAP without leading to subsequent immunosuppression.EEN can improve the clinical outcome,but not decrease the hospital mortality of SAP patients. | Jia-Kui Sun Xin-Wei Mu Wei-Qin Li Zhi-Hui Tong Jing Li Shu-Yun Zheng | 2013 | World Journal of Gastroenterology2013，19，6： | 106 |
| 2 | 营养不良的五阶梯治疗显示文摘营养不良(本文特指营养不足)无论在住院患者、还是社区人群都是一个严重问题,老年人、恶性肿瘤及其他良性慢性消耗性疾病患者是营养不良的高发人群。营养不良的严重后果众所周知,而营养不良的规范治疗仍然是一个有待讨论的问题。我们认为:营养不良治疗的基本要求应该是满足能量、蛋白质、液体及微量营养素的目标需要量,即要求四达标;最高目标是调节异常代谢、改善免疫功能、控制疾病(如肿瘤)。 | 石汉平 许红霞 李苏宜 曹伟新 李薇 巴一 陈公琰 王昆华 齐玉梅 陈子华 于康 江华 胡雯 丛明华 陈俊强 李增宁 方玉 葛声 王新颖 林源 管文贤 罗琪 | 2015 | 肿瘤代谢与营养电子杂志2015，2，1： | 268 |
| 3 | Enteral nutrition in acute pancreatitis:A review of the current evidence显示文摘The use of enteral feeding as part of the management of acute pancreatitis dates back almost two decades.This review describes the indications for and limitations of enteral feeding for the treatment of acute pancreatitis using up-to-date evidence-based data.A systematic review was carried out to analyse current data on the use of enteral nutrition in the management of acute pancreatitis.Relevant literature was analysed from the viewpoints of enteral vs parenteral feeding,early vs delayed enteral nutrition,nasogastric vs nasojejunal feeding,and early oral diet and immunonutrition,particularly glutamine and probiotic supplementation.Finally,current applicable guidelines and the effects of these guidelines on clinical practice are discussed.The latest meta-analyses suggest that enteral nutrition significantly reduces the mortality rate of severe acute pancreatitis compared to parenteral feeding.To maintain gut barrier function and prevent early bacterial translocation,enteral feeding should be commenced within the first 24 h of hospital admission.Also,the safety of nasogastric feeding,which eases the administration of enteral nutrients in the clinical setting,is likely equal to nasojejunal feeding.Furthermore,an earlylow-fat oral diet is potentially beneficial in patients with mild pancreatitis.Despite the initial encouraging results,the current evidence does not support the use of immunoenhanced nutrients or probiotics in patients with acute pancreatitis. | Attila Oláh Laszlo Romics Jr | 2014 | World Journal of Gastroenterology2014，20，43： | 81 |
| 4 | Modulation of postoperative immune and inflammatory response by immune-enhancing enteral diet in gastrointestinal cancer patients显示文摘AIM To evaluate if the administration of anenteral diet supplemented with glutamine,arginine and ω-3-fatty acids modulatesinflammatory and immune responses aftersurgery.METHODS A prospective randomized double-blind, clinical trial was performed. Forty-eightpatients with gastrointestinal cancer wererandomized into two groups, one group wasgiven an isocaloric and isonitrogenous standarddiet and the other was fed with the supplementeddiet with glutamine, arginine and ωo-3-fattyacids. Feedings were started within 48 hoursafter operation, and continued until day 8. Allvariables were measured before operation andon postoperative day 1 and 8. Immune responseswere determined by phagocytosis ability,respiratory burst of polymorphonuclear cells,total lymphocytes lymphocyte subsets, nitricoxide, cytokines concentration, andinflammatory responses by plasma levels of C-reactive protein, prostaglandin E2 level.RESULTS Tolerance of both formula diets wasexcellent. There were siagnificant differences inthe immunological and inflammatory responsesbetween the two groups. In supplementedgroup, phagocytosis and respiratory burst aftersurgery was higher and C-reactive protein levelwas lower (P<0.01) than in the standard group.The supplemented group had higher levels ofnitric oxide, total Iymphocytes, T lymphocytes,T-helper cells, and NK cells. Postoperativelevels of IL-6 and TNF-α were lower in thesupplemented group ( P < 0.05).CONCLUSION It was clearly established in thistrial that early postoperative enteral feeding issafe in patients who have undergone majoroperations for gastrointestinal cancer.Supplementation of enteral nutrition withglutamine, arginine, and ω-3 fatty acidspositively modulated postsurgicalimmunosuppressive and inflammatoryresponses. | Guo Hao Wu Yan Wei Zhang Zhao Han Wu Department of General Surgery.zhongshan Hospital,ShangHai Medical University.ShangHai 200032.China | 2001 | World Journal of Gastroenterology2001，7，3： | 67 |
| 5 | 肿瘤营养治疗通则显示文摘肿瘤营养疗法(cancer nutrition therapy,CNT)是计划、实施、评价营养干预,以治疗肿瘤及其并发症或身体状况,从而改善肿瘤患者预后的过程,包括营养诊断(筛查/评估)、营养干预、疗效评价(包括随访)三个阶段[1]。其中营养干预的内容包括营养教育和人工营养(肠内营养、肠外营养)。肿瘤营养疗法是与手术、化疗、放疗、靶向治疗、免疫治疗等肿瘤基本治疗方法并重的另外一种治疗方法,它贯穿于肿瘤治疗的全过程, | | 2016 | 肿瘤代谢与营养电子杂志2016，3，1： | 49 |
| 6 | Early Enteral Combined with Parenteral Nutrition Treatment for Severe Traumatic Brain Injury:Effects on Immune Function,Nutritional Status and Outcomes显示文摘Objective To compare the conjoint effect of enteral nutrition (EN) and parenteral nutrition (PN)with single EN or PN on immune function, nutritional status, complications and clinical outcomes of patientswith severe traumatic brain injury (STBI).Methods A prospective randomized control trial was carried out from January 2009 to May 2012 inNeurological Intensive Care Unit (NICU). Patients of STBI who met the enrolment criteria (Glasgow ComaScale score 6~8; Nutritional Risk Screening ≥3) were randomly divided into 3 groups and were administratedEN, PN or EN+PN treatments respectively. The indexes of nutritional status, immune function,complications and clinical outcomes were examined and compared statistically. | Ming-chao Fan Qiao-ling Wang Wei Fang Yun-xia Jiang Lian-di Li Peng Sun Zhi-hong Wang | 2016 | Chinese Medical Sciences Journal2016，31，4： | 37 |
| 7 | Effect of early enteral combined with parenteral nutrition in patients undergoing pancreaticoduodenectomy显示文摘AIM:To investigate the effect of early enteral nutrition(EEN)combined with parenteral nutritional support in patients undergoing pancreaticoduodenectomy(PD).METHODS:From January 2006,all patients were given EEN combined with parenteral nutrition(PN)(EEN/PN group,n=107),while patients prior to this date were given total parenteral nutrition(TPN)(TPN group,n=67).Venous blood samples were obtained for a nutrition-associated assessment and liver function tests on the day before surgery and 6 d after surgery.The assessment of clinical outcome was based on postoperative complications.Follow-up for infectious and noninfectious complications was carried out for 30 d after hospital discharge.Readmission within 30 d afterdischarge was also recorded.RESULTS:Compared with the TPN group,a significant decrease in prealbumin(PAB)(P=0.023)was seen in the EEN/PN group.Total bilirubin(TB),direct bilirubin(DB)and lactate dehydrogenase(LDH)were significantly decreased on day 6 in the EEN/PN group(P=0.006,0.004 and 0.032,respectively).The rate of gradeⅠcomplications,gradeⅡcomplications and the length of postoperative hospital stay in the EEN/PN group were significantly decreased(P=0.036,0.028and 0.021,respectively),and no hospital mortality was observed in our study.Compared with the TPN group(58.2%),the rate of infectious complications in the EEN/PN group(39.3%)was significantly decreased(P=0.042).Eleven cases of delayed gastric emptying were noted in the TPN group,and 6 cases in the EEN/PN group.The rate of delayed gastric emptying and hyperglycemia was significantly reduced in the EEN/PN group(P=0.031 and P=0.040,respectively).CONCLUSION:Early enteral combined with PN can greatly improve liver function,reduce infectious complications and delayed gastric emptying,and shorten postoperative hospital stay in patients undergoing PD. | Xin-Hua Zhu Ya-Fu Wu Yu-Dong Qiu Chun-Ping Jiang Yi-Tao Ding | 2013 | World Journal of Gastroenterology2013，19，35： | 34 |
| 8 | Implications of butyrate and its derivatives for gut health and animal production显示文摘Butyrate is produced by microbial fermentation in the large intestine of humans and animals.It serves as not only a primary nutrient that provides energy to colonocytes, but also a cellular mediator regulating multiple functions of gut cells and beyond, including gene expression, cell differentiation, gut tissue development, immune modulation, oxidative stress reduction, and diarrhea control.Although there are a large number of studies in human medicine using butyrate to treat intestinal disease, the importance of butyrate in maintaining gut health has also attracted significant research attention to its application for animal production, particularly as an alternative to in-feed antibiotics.Due to the difficulties of using butyrate in practice(i.e., offensive odor and absorption in the upper gut), different forms of butyrate,such as sodium butyrate and butyrate glycerides, have been developed and examined for their effects on gut health and growth performance across different species.Butyrate and its derivatives generally demonstrate positive effects on animal production, including enhancement of gut development, control of enteric pathogens, reduction of inflammation, improvement of growth performance(including carcass composition), and modulation of gut microbiota.These benefits are more evident in young animals, and variations in the results have been reported.The present article has critically reviewed recent findings in animal research on butyrate and its derivatives in regard to their effects and mechanisms behind and discussed the implications of these findings for improving animal gut health and production.In addition, significant findings of medical research in humans that are relevant to animal production have been cited. | ANDrea Bedford Joshua Gong | 2018 | Animal Nutrition2018，，2： | 31 |
| 9 | The compelling link between physical activity and the body's defense system显示文摘This review summarizes research discoveries within 4 areas of exercise immunology that have received the most attention from investigators :(1) acute and chronic effects of exercise on the immune system,(2) clinical benefits of the exercise—immune relationship,(3) nutritional influen?ces on the immune response to exercise, and(4) the effect of exercise on immunosenescence. These scientific discoveries can be organized into distinctive time periods: 1900-1979, which focused on exercise-induced changes in basic immune cell counts and function; 1980-1989, during which seminal papers were published with evidence that heavy exertion was associated with transient immune dysfunction, elevated inflammatory biomarkers,and increased risk of upper respiratory tract infections; 1990-2009, when additional focus areas were added to the field of exercise immunology including the interactive effect of nutrition, effects on the aging immune system, and inflammatory cytokines; and 2010 to the present, when technological advances in mass spectrometry allowed system biology approaches(i.e., metabolomics, proteomics, lipidomics, and microbiome characterization) to be applied to exercise immunology studies. The future of exercise irmmunology will take advantage of these technologies to provide new insights on the interactions between exercise, nutrition, and immune function, with application down to the person?alized level. Additionally, these methodologies will improve mechanistic understanding of how exercise-induced immune perturbations reduce the risk of common chronic diseases. | David C.Nieman Laurel M.Wentz | 2019 | Journal of Sport and Health Science2019，8，3： | 32 |
| 10 | Using probiotics to improve swine gut health and nutrient utilization显示文摘To maintain a healthy gut is definitely key for a pig to digest and absorb dietary nutrients efficiently. A balanced microbiota(i.e., a healthy micro-ecosystem) is an indispensable constituent of a healthy gut.Probiotics, the live microorganisms which, when administered in adequate amounts, confer good health benefits onto the host, are a category of feed additives that can be used to replenish the gut microbial population while recuperating the host immune system. Besides their antitoxin and diarrhea reduction effects, dietary supplementation of probiotics can improve gut health, nutrient digestibilities and,therefore, benefit nutrient utilization and growth performance of pigs. Current knowledge in the literature pertinent to the beneficial effects of utilizing various probiotics for swine production has been comprehensively reviewed, and the safety and the risk issues related to probiotic usage have also been discussed in this paper. Considering that the foremost cost in a swine operation is feed cost, feed efficiency holds a very special, if not the paramount, significance in commercial swine production. Globally,the swine industry along with other animal industries is moving towards restricting and eventually a total ban on the usage of antibiotic growth promoters. Therefore, selection of an ideal alternative to the in-feed antibiotics to compensate for the lost benefits due to the ban on the antibiotic usage is urgently needed to support the industry for profitable and sustainable swine production. As is understood, a decision on this selection is not easy to make. Thus, this review paper aims to provide some much needed up-to-date knowledge and comprehensive references for swine nutritionists and producers to refer to before making prudent decisions and for scientists and researchers to develop better commercial products. | Shengfa F.Liao Martin Nyachoti | 2017 | Animal Nutrition2017，，4： | 29 |
| 11 | Gestational diabetes mellitus: Challenges for different ethnic groups显示文摘Ethnicity is defined as'belonging to a social groupthat has a common national or cultural tradition'.Membership of certain ethnic groups has long been associated with increased risk of gestational diabetes mellitus(GDM).Studies that examined ethnic differences amongst women with GDM were often conducted in western countries where women from various ethnic backgrounds were represented.The prevalence of GDM appears to be particularly high among women from South Asia and South East Asia,compared to Caucasian,African-American and Hispanic communities.For some,but not all ethnic groups,the body mass index is a risk factor for the development of GDM.Even within a particular ethnic group,those who were born in their native countries have a different risk profile for GDM compared to those born in western countries.In terms of treatment,medical nutrition therapy(MNT)plays a key role in the management of GDM and the prescription of MNT should be culturally sensitive.Limited studies have shown that women who live in an English-speaking country but predominantly speak a language other than English,have lower rates of dietary understanding compared with their English speaking counterparts,and this may affect compliance to therapy.Insulin therapy also plays an important role and there appears to be variation as to the progression of women who progress to requiring insulin among different ethnicities.As for peri-natal outcomes,women from Pacific Islander countries have higher rates of macrosomia,while women from Chinese backgrounds had lower adverse pregnancy outcomes.From a maternal outcome point of view,pregnant women from Asia with GDM have a higher incidence of abnormal glucose tolerance test results post-partum and hence a higher risk of future development of type2 diabetes mellitus.On the other hand,women from Hispanic or African-American backgrounds with GDM are more likely to develop hypertension post-partum.This review highlights the fact that management needs to be individualised and the clinician should be mindful of the impact that differences in ethnicity may have on the clinical characteristics and pregnancy outcomes inwomen affected by GDM,particularly those living in Western countries.Understanding these differences is critical in the delivery of optimal antenatal care for women from diverse ethnic backgrounds. | Lili Yuen Vincent W Wong | 2015 | World Journal of Diabetes2015，6，8： | 29 |
| 12 | Effects of early enteral nutrition on Th17/Treg cells and IL-23/IL-17 in septic patients显示文摘BACKGROUND The imbalance of Th17/Treg cells and the IL-23/IL-17 axis have been confirmed to be associated with sepsis and various inflammatory diseases. Early enteral nutrition (EEN) can modulate the inflammatory response, improve immune dysfunction, and prevent enterogenic infection in critically ill patients;however, the precise mechanisms remain unclear. Considering the important roles of Th17 and Treg lymphocytes in the development of inflammatory and infectious diseases, we hypothesized that EEN could improve the immune dysfunction in sepsis by maintaining a balanced Th17/Treg cell ratio and by regulating the IL- 23/IL-17 axis. AIM To investigate the effects of EEN on the Th17/Treg cell ratios and the IL-23/IL-17 axis in septic patients. METHODS In this prospective clinical trial, patients were randomly divided into an EEN or delayed enteral nutrition (DEN) group. Enteral feeding was started within 48 h in the EEN group, whereas enteral feeding was started on the 4th day in the DEN group. The Th17 and Treg cell percentages and the interleukin levels were tested on days 1, 3, and 7 after admission. The clinical severity and outcome variables were also recorded. RESULTS Fifty-three patients were enrolled in this trial from October 2017 to June 2018. The Th17 cell percentages, Th17/Treg cell ratios, IL-17, IL-23, and IL-6 levels of the EEN group were lower than those of the DEN group on the 7th day after admission (P < 0.05). The duration of mechanical ventilation and of the intensive care unit stay of the EEN group were shorter than those of the DEN group (P <0.05). However, no difference in the 28-d mortality was found between the two groups (P = 0.728). CONCLUSION EEN could regulate the imbalance of Th17/Treg cell ratios and suppress the IL- 23/IL-17 axis during sepsis. Moreover, EEN could reduce the clinical severity of sepsis but did not reduce the 28-d mortality of septic patients. | Jia-Kui Sun Wen-Hao Zhang Wen-Xiu Chen Xiang Wang Xin-Wei Mu | 2019 | World Journal of Gastroenterology2019，25，22： | 27 |
| 13 | Nutritional and medicinal characteristics of Chinese giant salamander (Andrias davidianus) for applications in healthcare industry by artificial cultivation: A review显示文摘Andrias davidianus,i.e.Chinese giant salamander(CGS),is one of the largest and oldest amphibians existing in the world and is also one of the valuable biological resources of China.Wild CGS has been threatened with extinction in the past decades due to over capturing,deterioration of natural environment,the slow breeding and growth of the wild species in nature.However,in the past twenty years,with the breakthrough and progress of artificial breeding technology by artificial insemination,the number of artificially cultivated CGS has increased rapidly.Artificially cultivated CGS can either be released to the CGS living environment to increase the population in nature or legally applied in food and medicinal industry as a feedstock due to the unique nutritional and medicinal values of CGS as recorded historically.In this review,the nutritional components,bioactive components and medicinal activities of the artificially cultivated CGS will be summarized.The mucus,skin,meat and bone of CGS contain many different bioactive substances thereby having various medicinal activities including anti-aging,anti-fatigue,anti-tumor,therapy of burn and anti-infection and other physiological functions.This paper will further discuss the potential applications of the artificially cultivated CGS in healthcare industry and prospects of future technological development. | Dong He Wenming Zhu Wen Zenga Jun Lin Yang Ji Yi Wang Chong Zhang Yuan Lu Daoquan Zhao Nan Su Xin-Hui Xing | 2018 | Food Science and Human Wellness2018，7，1： | 28 |
| 14 | Nutrition management in acute pancreatitis: Clinical practice consideration显示文摘Acute pancreatitis(AP)is a common gastrointestinal disease and the leading cause of hospital admission and healthcare burden among gastrointestinal disorders in many countries.Patients can present with varying degrees of inflammation and disease severity,ranging from self-limiting mild AP to devastating and fatal severe AP.Many factors contribute to malnutrition in AP,especially abnormal metabolism and catabolism related to inflammation.The concept of“pancreatic rest”is not evidence-based.There is however,emerging evidence that supports the use of oral or enteral nutrition to improve nutrition status and to reduce local and systemic inflammation,complications,and death.In mild disease,patients are generally able to initiate solid oral diet and do not require specialized nutrition care such as enteral or parenteral nutrition.In contrast,nutrition interventions are imperative in moderately severe and severe AP.The current article aims to review the latest evidence and suggest practical nutrition interventions in patients with AP,including nutrition requirements,routes of nutrition treatment,types of formula,and the role of nutritional supplements,such as glutamine,probiotics,omega-3 fatty acids,and antioxidants. | Narisorn Lakananurak Leah Gramlich | 2020 | World Journal of Clinical Cases2020，8，9： | 25 |
| 15 | 补充谷氨酰胺增强肠源性败血症大鼠肠粘膜免疫功能的研究显示文摘1 前言败血症是临床上常见的大手术病人的术后并发症。败血症时,机体受到细菌毒素侵袭,可能会发生深部组织的破坏和代谢底物的改变。全肠外营养(total parenteral nutrition,TPN) | Yu-NiLai Sung-LingYeh Ming-TsanLin 刘艳妮 王劲 | 2004 | 营养健康新观察2004，0，3： | 26 |
| 16 | Enteral nutrition and immune modulation of acute pancreatitis显示文摘Enteral nutrition has been strongly recommended by major scientific societies for the nutritional management of patients with acute pancreatitis.Providing severe acute pancreatitis patients with enteral nutrition within the first 24-48 h of hospital admission can help improve outcomes compared to parenteral nutrition and no feeding.New research is focusing in on when and what to feed to best improve outcomes for acute pancreatitis patients.Early enteral nutrition have the potential to modulate the immune responses.Despite this consistent evidence of early enteral nutrition in patients with acute pancreatitis,clinical practice continues to vary due to individual clinician preference.Achieving the immune modulating effects of enteral nutrition heavily depend on proper placement of the feeding tube and managing any tube feeding associated complications.The current article reviews the immune modulating effects of enteral nutrition and pro-and prebiotics and suggests some practical tools that help improve the patient adherence and tolerance to the tube feeding.Proper selection of the type of the tube,close monitoring of the tube for its placement,patency and securing its proper placement and routine checking the gastric residual volume could all help improve the outcome.Using peptide-based and high medium chaintriglycerides feeding formulas help improving feeding tolerance. | Refaat A Hegazi Tiffany De Witt | 2014 | World Journal of Gastroenterology2014，20，43： | 24 |
| 17 | A study of preoperative methionine-depleting parenteral nutrition plus chemotherapy in gastric cancer patients显示文摘AIM To investigate the interference ofmethionine.free parenteral nutrition plus 5-Fu(-MetTPN+5-Fu)in gastric cancer cell kineticsand the side effects of the regimen.METHODS Fifteen patients with advancedgastric cancer were randomly divided into twogroups,7 patients were given preoperatively aseven-day course of standard parenteralnutrition in combination with a five-day courseof chemotherapy(sTPN+5-Fu),while the other8 patients were given methionine-deprivedparenteral nutrition and 5-Fu(-MetTPN+5-Fu).Cell cycles of gastric cancer and normal mucosawere studied by flow cytometry(FCM).Bloodsamples were taken to measure the serumprotein,methionine(Met)and cysteine(Cys)levels,and liver and kidney functions.RESULTS As compared with the resultsobtained before the treatment,the percentage ofG0/G1 tumor cells increased and that of S phasedecreased in the-MetTPN+5-Fu group,while thecontrary was observed in the sTPN+5-Fu group.Except that the ALT,AST and AKP levels wereslightly increased in a few cases receiving-MetTPN+5-Fu,all the other biochemicalparameters were within normal limits.Serum Cys level decreased slightly after the treatmentin both groups.Serum Met level of patientsreceiving sTPN+5-Fu was somewhat higher aftertreatment than that before treatment;however,no significant change occurred in the -MetTPN+5-Fu group,nor operative complications in bothgroups.CONCLUSION -MetTPN+5-Fu exerted asuppressive effect on cancer cell proliferation,probably through a double mechanism ofcreating a state of'Met starvation'adverse tothe tumor cell cycle,and by allowing 5-Fu to killspecifically cells in S phase.Preoperative short-term administration of -MetTPN+5-Fu had littleundesirable effect on host metabolism. | Cao WX Cheng QM Fei XF Li SF Yin HR Lin YZ | 2000 | World Journal of Gastroenterology2000，6，2： | 22 |
| 18 | Diet therapy for inflammatory bowel diseases: The established and the new显示文摘Although patients with inflammatory bowel diseases(IBD) have a strong interest in dietary modifications as part of their therapeutic management, dietary advice plays only a minor part in published guidelines. The scientific literature shows that dietary factors might influence the risk of developing IBD, that dysbiosis induced by nutrition contributes to the pathogenesis of IBD, and that diet may serve as a symptomatic treatment for irritable bowel syndrome-like symptoms in IBD. The role of nutrition in IBD is underscored by the effect of various dietary therapies. In paediatric patients with Crohn's disease(CD) enteral nutrition(EN) reaches remission rates similar to steroids. In adult patients, however, EN is inferior to corticosteroids. EN is not effective in ulcerative colitis(UC). Total parenteral nutrition in IBD is not superior to steroids or EN. The use of specific probiotics in patients with IBD can be recommended only in special clinical situations. There is no evidence for efficacy of probiotics in CD. By contrast, studies in UC have shown a beneficial effect in selected patients. For patients with pouchitis, antibiotic treatment followed by probiotics, like VSL#3 or Lactobacillus GG, is effective. When probiotics are used, the risk of bacterial translocation and subsequent bacteremia has to be considered. More understanding of the normal intestinal microflora, and better characterization of probiotic strains at the phenotypic and genomic levels is needed as well as clarification of the mechanisms of action in different clinical settings. A FODMAP reduced diet may improve symptoms in IBD. | Franziska Durchschein Wolfgang Petritsch Heinz F Hammer | 2016 | World Journal of Gastroenterology2016，22，7： | 22 |
| 19 | Implementation of enteral feeding protocol in an intensive care unit: Before-and-after study显示文摘AIM To determine the effects of implementing an enteral feeding protocol on the nutritional delivery and outcomes of intensive care patients.METHODS An uncontrolled, observational before-and-after study was performed in a tertiary mixed medical-surgical intensive care unit(ICU). In 2013, a nurse-driven enteral feeding protocol was developed and implemented in the ICU. Nutrition and outcome-related data from patients who were treated in the study unit from 2011-2012(the Before group) and 2014-2015(the After group) were obtained from a local electronic database, the national Population Registry and the hospital's Infection ControlService. Data from adult patients, readmissions excluded, who were treated for at least 7 d in the study unit were analysed. RESULTS In total, 231 patients were enrolled in the Before and 249 in the After group. The groups were comparable regarding demographics, patient profile, and severity of illness. Fewer patients were mechanically ventilated on admission in the After group(86.7% vs 93.1% in the Before group, P = 0.021). The prevalence of hospitalacquired infections, length of ICU stay and ICU, 30-and 60-d mortality did not differ between the groups. Patients in the After group had a lower 90-d(P = 0.026) and 120-d(P = 0.033) mortality. In the After group, enteral nutrition was prescribed less frequently(P = 0.039) on day 1 but significantly more frequently on all days from day 3. Implementation of the feeding protocol resulted in a higher cumulative amount of enterally(P = 0.049) and a lower cumulative amount of parenterally(P < 0.001) provided calories by day 7, with an overall reduction in caloric provision(P < 0.001). The prevalence of gastrointestinal symptoms was comparable in both groups, as was the frequency of prokinetic use. Underfeeding(total calories < 80% of caloric needs, independent of route) was observed in 59.4% of the study days Before vs 76.9% After(P < 0.001). Inclusion in the Before group, previous abdominal surgery, intraabdominal hypertension and the sum of gastrointestinal symptoms were found to be independent predictors of insufficient enteral nutrition.CONCLUSION The use of a nurse-driven feeding protocol improves the delivery of enteral nutrition in ICU patients without concomitant increases in gastrointestinal symptoms or intra-abdominal hypertension. | Martin Padar Gerli Uusvel Liis Starkopf Joel Starkopf Annika Reintam Blaser | 2017 | World Journal of Critical Care Medicine2017，6，1： | 22 |
| 20 | Management of necrotizing pancreatitis显示文摘Infection complicating pancreatic necrosis leads to persisting sepsis, multiple organ dysfunction syndrome and accounts for about half the deaths that occur following acute pancreatitis. Severe cases due to gallstones require urgent endoscopic sphincterotomy. Patients with pancreatic necrosis should be followed with serial contrast enhanced computed tomography (CE-CT) and if infection is suspected fine needle aspiration of the necrotic area for bacteriology (FNAB) should be undertaken. Treatment of sterile necrosis should initially be non-operative. In the presence of infection necrosectomy is indicated. Although traditionally this has been by open surgery, minimally invasive procedures are a promising new alternative. There are many unresolved issues in the management of pancreatic necrosis. These include, the use of antibiotic prophylaxis, the precise indications for and frequency of repeat CE-CT and FNAB,and the role of enteral feeding. | John Slavin Paula Ghaneh Robert Sutton Mark Hartley Peter Rowlands Conall Garvey Mark Hughes John Neoptolemos | 2001 | World Journal of Gastroenterology2001，7，4： | 21 |
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