1993年10月至1994年2月对中—长链脂肪乳剂(实验组，n=40)和长链脂肪乳剂(对照组，n=30)在静脉营养中的疗效进行了对比观察。从术后第1天起，除从周围静脉输注必需液体外，每日静滴中—长链或长链脂肪乳剂500～1000ml，连续3～5天。监测项目包括血压、脉搏、呼吸、体温、血红蛋白、白细胞、肝肾功能、血甘油三酯及血胆固醇。结果显示：两组均无全笛反应；在输脂肪乳剂后6小时，两组血甘油三酯含量均明显升高，并于12小时时达峰值，16小时时已明显下降，但对照组明显高于实验组(Plt;0.05)，24小时时仍维持较高水平。由此表明，中—长链肪乳剂较易从血清中清除；中链甘油三酯能快速进入线粒体被氧化供能，不依赖内毒碱的转运，能经肝脏生成更多的酮体，极少再脂化为脂肪贮存起来。
Objective To explore the relationship of self-efficacy and coping styles with parenting styles in patients with schizophrenia, and provide the theory and practical basis for family-interventions of rehabilitation of patients with schizophrenia. Methods From January to June 2015, General Self- Efficacy Scale, Simplified Coping Style Questionnaire and Egma Minnen av Bardndosnauppforstran were used to evaluate 60 inpatients with schizophrenia and in good rehabilitation in a grade A tertiary general hospital. Results The scores of self-efficacy, parental emotional warmth and father’s over protection were lower in patients with schizophrenia than the norms (P<0.01). The scores of parental punishment and rejection and father’s over intervention were higher in patients with schizophrenia than the norms (P<0.01). In patients with schizophrenia, the active coping domain was positively correlated to parental emotion warmth (P<0.05); the negative coping domain was positively correlated to parental rejection, father’s over protection and mother’s over intervention (P<0.05); self-efficacy was positively correlated to father’s emotion warmth and preference of parents (P<0.05). Conclusions Active family-interventions is important in the rehabilitation of patients with schizophrenia. The parents should be instructed to correctly educate the children, to improve the patients’ general self-efficacy, and help the patients successfully solve the problem with good coping style.
ObjectiveTo explore the clinical efficacy and security of early enteral nutrition (EN) on patients with gastric cancer after radical operation. MethodsSeventy cases who treated in Affiliated Hospital of Inner Mongolia Medical University from Dec. 2008 to Apr. 2013 were randomly divided into EN group (n=35) and parenteral nutrition (PN) group (n=35), analysis and comparison of nutrition indicators and recovery indicators between 2 groups were performed. ResultsThere were no significant differences on levels of count of white blood cell (WBC), serum albumin (ALB), prealbumin (PA), and transferring (TRF) before operation between the 2 groups (P > 0.05). On 3 and 7 days after operation, the levels of ALB, PA, and TRF were all higher in EN group (P < 0.05) besides level of count of WBC. In addition, hospital stay and hospitalization cost were both lower in EN group (P < 0.05), but there was no significant difference on postoperative exhaust time and complication incidence (P > 0.05). ConclusionsEN is a safe, effective, and economical method of nutritional supplements, and it is a preferred method of nutritional support for patients with advanced gastric cancer after operation at prophase, which is worthy to apply widely in clinical.
ObjectiveTo summary the effect of parenteral nutrition combined with enteral nutrition on patients with severe acute pancreatitis. MethodsThe clinical data of 200 patients with severe acute pancreatitis admitted in our hospital in recent 10 years were retrospectively analyzed. Of which 88 cases were treated by traditional nutritional support therapy (traditional nutrition group), the rest of 112 cases of patients with early parenteral nutrition to later period gradually combined with enteral nutrition comprehensive nutritional support strategy (comprehensive nutrition group). ResultsThe APACHEⅡscores and serum level of C-reactive protein (CRP) of patients in comprehensive nutrition group were significantly lower than patients in traditional nutrition group (P < 0.05), while the serum albumin level was significantly higher than that of traditional nutrition group (P < 0.05). In the incidence of complications and mortality, the average length of stay and total cost of comprehensive nutrition group were significantly lower than patients with traditional nutrition group (P < 0.05), the cure rate was significantly higher than that of traditional nutrition group (P < 0.05). ConclusionThe combination of parenteral nutrition and enteral nutrition of nutrition support model not only can shorten the duration of symptoms but also alleviate the burden of patients and reduce complications and mortality.
Forty critical patients with respiratory failure in the intensive care unit were randomly divided into two groups,Group A with administration of parenteral nutritino(PN) and Group B,no parenteral nutrition given.Blood gas analysis and respiratory monitoring showed that the respiratory rate,pH、PaO2、PaCO2 and HCO3- had no marked difference between the two groups.But in Group A there was a slight decrease of Pao2/FiO2 and a marked increase of A-aDO2 and the pulmonary shunt.This study indicates that the content of fat emulsion and hydrocarbon in PN may be the main factor that affects the respiratory function.
ObjectiveTo systematically evaluate short-term efficacy of omega-3(ω-3) polyunsaturated fatty acidsupplemented parenteral nutrition in postoperative gastrointestinal malignancy. MethodsThe literatures published randomized control trials (RCT) were searched in PubMed, Embase, Scopus, Cochrane Library, CNKI, Weipu, and Wanfang Databases. The immune efficacy outcomes ofω-3 polyunsaturated fatty acid-supplemented parenteral nutrition in patients with gastrointestinal malignancy were compared. All the relevant studies were screened and the data were extracted before January 2015. The quality of included literatures was assessed by the risk of bias table provided on Cochrane Library. Statistical analysis was performed by Revman 5.3 software. ResultsSixteen RCTs involving 1019 patients (511 in the study group, 508 in the control group) were enrolled into the analysis. The results of meta analysis:①In the cell immunity:The proportions of CD3, CD4, CD4/CD8 in the study group were significantly higher than those in the control group[CD3:WMD=6.09, 95% CI (2.40, 9.77), P=0.001; CD4:WMD=5.25, 95% CI (3.30, 7.20), P < 0.00001; CD4/CD8:WMD=0.40, 95% CI (0.22, 0.58), P < 0.0001].②In the humoral immunity:The levels of IgA and IgG in the study group were significantly higher than those in the control group[IgA:WMD=0.56, 95% CI (0.36, 0.77), P < 0.00001; IgG:WMD=2.88, 95% CI (0.63, 5.13), P=0.01].③The count of lymphocyte in the study group was significantly higher than that in the control group[WMD=0.27, 95% CI (0.10, 0.43), P=0.002].④In the cytokines:The levels of interleukin-6 and tumor necrosis factor (TNF)-αin the study group were significantly lower than those in the control group[interleukin-6:WMD=-16.75, 95% CI (-25.00, -8.50), P < 0.0001; TNF-α:WMD=-6.25, 95% CI (-10.55, -1.95), P=0.004].⑤The rate of postoperative infective complications in the study group was significantly lower than that in the control group[OR=0.36, 95% CI (0.20, 0.66), P=0.0008]. ConclusionFor postoperative patients with gastrointestinal malignancy, ω-3 polyunsaturated fatty acid-supplemented parenteral nutrition could improve immune function, decrease postoperative inflammatory reaction, and reduce rate of infective complications.
【Abstract】ObjectiveTo investigate the effects of rhGH on hypoalbuminemia in cirrhotic rats after partial hepatectomy. MethodsThirty rats were randomly divided into normal control group (n=6), liver cirrhosis group (LC group, n=6), liver cirrhosis and hepatectomy group (LCH group,n=6), PN (parenteral nutrition) group (n=6， given PN after hepatectomy) and rhGH+PN group (n=6,given rhGH and PN after hepatectomy). Liver function and blood glucose were measured. The expression of ALB mRNA was detected by RTPCR. Liver Ki67 immunohistochemistry was studied. ResultsCompared with PN group, serum ALP was lower; serum ALB and blood glucose were higher in rhGH+PN group. The expression of hepatic ALB mRNA was higher, and hepatic Ki67 labeling index was higher as well in this group. ConclusionrhGH can improve hypoalbuminemia after partial hepatectomy in cirrhotic rats with partial hepatectomy.
Objective To study the manageable methods, effect of early use of enteral nutrition after operations on esophageal cancer patients. Methods By different way of nutritional support after operation, 209 cases of esophageal cancer were divided into two groups in which enteral nutrition（EN） group,146 cases, were managed with early use of nutritional support through intestine and parenteral nutrition（PN） group, 63 cases, were given nutrition by way of veins. Complications, general recovery and blood biochemical criteria after operation between those two groups were compared. Results No cases of anastomotic fistula occurred in the two groups. The incidence of complications in EN group was significantly lower than that in PN group（P〈0.01）, and the occurrence of diarrhea was higher in EN group （P=0. 000）. The time needed for recovery of bowel sounds, anal exsufflation, defecation and hospital stay was shorter and hospital fee lower in EN group than those in PN group（P=0. 000）. The total amount of gastrointestinal and closed thoracic drainages decreased more significantly in EN group （P= 0. 000） and the value of albumin, globulin and total protein was significantly higher also in EN group （P = 0. 000）. But the amount of BUN, creatinine and neutrophil was significantly lower in EN group （P = 0. 000）. Conclusion Early use of enteral nutrition after operation on esophageal cancer is safe, effective and practical, with more significant advantages than those of parenteral nutrition.
ObjectiveTo systematically review the experience of parents caring for preterm infants after discharge from hospital. MethodsWe searched databases including The Cochrane Library, Joanna Briggs Institute Library, PubMed, EMbase, Scopus, ISI Web of Science, PsycINFO, CINAHL, CBM, CNKI and VIP from inception to May 2015, to collect qualitative studies in the experience of parents caring for preterm infants after discharge from hospital. The quality of included studies was evaluated according to JBI Critical Appraisal Tool for qualitative studies in Australia. The results were integrated by integrating methods. ResultsA total of nine studies were included. Thirty-one complete findings were grouped according to their similarities to form seven categories. These categories resulted in two synthesized findings:integration results 1:parents grow in the adaptation of their care giving roles for the preterm infants; integration results 2:they are eager and thankful for support, resource and information in this critical transition period. ConclusionHealth care workers should pay attention to the important influence of premature infants discharged from hospital on their parents. In the adaption period of premature parents, health care workers should give necessary care knowledge skills to guide the parents, to assist them to compete the role of caregivers as soon as possible and promote the healthy growth of premature infants after discharge.
ObjectivesTo systematically review the efficacy and safety of enteral nutrition (EN) for severe acute pancreatitis (SAP) patients within 48 hours after admission.MethodsPubMed, EMbase, The Cochrane Library, CBM, CNKI and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) on early EN (starting within 48 hours after admission) in SAP from inception to October, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using Stata 12.0 software.ResultsA total of 9 RCTs involving 1 074 patients were included. The results of meta-analysis showed that: compared to patients with EN after 48 hours or parental nutrition, the patients given EN within 48 hours after admission had lower mortality (RR=0.53, 95%CI 0.29 to 0.96, P=0.036) and morbidity of multiple organ dysfunction syndrome (MODS) (RR=0.58, 95%CI 0.44 to 0.77, P<0.001). However, no significant differences were found in systemic inflammatory response syndrome (SIRS) (RR=1.00, 95%CI 0.86 to 1.16, P=1.00).Conclusions The current evidence shows that EN within 48 hours after admission can reduce the mortality and morbidity of MODS in SAP patients. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify above conclusions.