Effect of early enteral nutrition on postoperative nutritional status and immune function in elderly patients with esophageal cancer or cardiac cancer

To explore the effect of early enteral nutrition （EN） on postoperative nutritional status, intestinal permeability, and immune 6anction in elderly patients with esophageal cancer or cardiac cancer. Methods： A total of 96 patients with esophageal cancer or cardiac cancer who underwent surgical treatment in our hospital from June 2007 to December 2010 were enrolled in this study. They were divided into EN group （n=50） and parenteral nutrition （PN） group （n=46） based on the nutrition support modes. The body weight, time to first flatus/defecation, average hospital stay, complications and mortality after the surgery as well as the liver function indicators were recorded and analyzed. Peripheral blood samples were collected on the days 1, 4 and 7 after surgery. The plasma diamine oxidase （DAO） activity and D-lactate level were determined to assess the intestinal permeability. The plasma endotoxin levels were determined using dynamic turbidimetric assay to assess the protective effect of EN on intestinal mucosal barrier. The postoperative blood levels of inflammatory cytokines and immunoglobulins were determined using enzyme- linked immunosorbent assay （ELISA）. Results： After the surgery, the time to first flatus/defecation, average hospital stay, and complications were significantly less in the EN group than those in the PN group （P〈0.05）, whereas the EN group had significantly higher albumin levels than the PN group （P〈0.05）. On the 7th postoperative day, the DAO activity, D-lactate level and endotoxin contents were significantly lower in the EN group than those in the PN group （all P〈0.05）. In addition, the EN group had significantly higher IgA, IgG, IgM, and CD4 levels than the PN group （P〈0.05） but significantly lower IL-2, IL-6, and TNF-a levels （P〈0.05）. Conclusions： In elderly patients with esophageal cancer or cardiac cancer, early EN after surgery can effectively improve the nutritional status, protect intestinal mucosal barrier （by reducing plasma endoxins）, and enhance the immune function

Early Enteral Combined with Parenteral Nutrition Treatment for Severe Traumatic Brain Injury:Effects on Immune Function,Nutritional Status and Outcomes

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.

Effect of Early Enteral Nutrition Combined with Probiotics on the Nutritional Status of Patients with Severe Craniocerebral Injury

Objective:To observe the effect of early enteral nutrition combined with probiotics on the nutritional status of patients with severe craniocerebral injury.Methods:Thirty-five patients with severe craniocerebral injury were divided into the study group(17 patients)and the control group(18 patients)according to the method of a randomized numerical table;both groups of patients started enteral nutrition via nasogastric tube within 24–48 hours after admission to the hospital,and probiotics were given in addition to the study group.Hemoglobin,total plasma protein,albumin,prealbumin,cholinesterase,fasting blood glucose,and other indexes were monitored before and early morning after enteral nutrition support,and upper arm circumference(AC),triceps skinfold thickness(TSF),and upper arm muscle circumference(AMC)were measured,and gastrointestinal response and time to first defecation of the patients were observed and compared with GCS score.Results:The hemoglobin,serum albumin,prealbumin,cholinesterase,and total plasma protein levels in the study group were significantly higher and fasting blood glucose levels were significantly lower than those in the control group after treatment(P<0.05).The incidence of reflux and constipation in the study group was lower than that in the control group,and the time to first defecation was shorter than that in the control group(P<0.05).After treatment,AC,TSF,and AMC were higher in the study group than in the control group(P<0.05).GCS scores were significantly higher in both groups after treatment,but the trend was more pronounced in the study group(P<0.05).Conclusion:Compared with simple enteral nutrition,enteral nutrition combined with probiotics can better correct metabolic disorders after heavy craniocerebral injury and improve the nutritional status of patients.

Effect of enteral and parenteral nutritional diet intervention on recovery, nutritional status and immune functi on for gastric cancer patients after radical gastrectomy

Objective:To explore the effect of enteral and parenteral nutritional diet intervention on recovery, nutritional status and immune function for gastric cancer patients after radical gastrectomy.Methods:A total of 180 patients with gastric cancer treated in our hospital from January 2016 to December 2017 were selected, and randomly divided into the control group and the observation group by computer, each with 90 cases. Control group received parenteral nutrition intervention, and observation group received enteral and parenteral nutritional diet intervention. Cellular immune function, humoral immune function, nutritional status, and complications occurrence rate were compared between two groups.Results: The levels of cellular immune function between the two groups had no difference before intervention (P>0.05). After intervention, the observation group had higher levels of CD3+, CD4+, and CD4+/CD8+ as well as lower level of CD8+ than those of control group (P<0.05). The IgM, IgA, and IgG levels between the two groups had no difference before treatment (P>0.05), which were decreased after treatment (P<0.05), and were lower in the observation group than those in the control group (P<0.05). The albumin and prealbumin levels between the two groups had no difference before intervention (P>0.05), which were increased after treatment, and were higher in observation group than those in the control group (P<0.05). The incidence of complications in the observation group was significantly lower than that in the control group (P<0.05).Conclusion:The application of enteral and parenteral nutritional diet intervention can promote the recovery, improve the nutritional status and immune function for gastric cancer patients after radical gastrectomy, which has fewer complications.

Effects of enteral nutrition intervention on immune nutritional status and radiation damage in patients with esophageal cancer radiotherapy

Objective: To study the effects of enteral nutrition intervention on immune nutritional status and radiation damage in patients with esophageal cancer radiotherapy. Methods: Patients with esophageal cancer who underwent radiotherapy in West China Hospital, Sichuan University between January and October 2017 were chosen as the research subjects and divided into the experimental group who received enteral nutrition intervention and the control group who received routine intervention. The contents of nutrition indicators and radiation damage markers in serum as well as the contents of immune cells in peripheral blood were determined before radiotherapy and after radiotherapy ended. Results: Compared with those before radiotherapy, serum ALB, PA, TRF and RBP contents as well as peripheral blood Th cell, NK cell, Breg cell and Treg cell contents of experimental group did not change significantly while serum PDGF-BB, TGF-β1, CTGF, TNF-α and SAA contents were significantly higher after radiotherapy;serum ALB, PA, TRF and RBP contents as well as peripheral blood Th cell and NK cell contents of control group were significantly lower while serum PDGF-BB, TGF-β1, CTGF, TNF-α and SAA contents as well as peripheral blood Breg cell and Treg cell contents were significantly higher after radiotherapy;serum ALB, PA, TRF and RBP contents as well as peripheral blood Th cell and NK cell contents of experimental group after radiotherapy were higher than those of control group while serum PDGF-BB, TGF-β1, CTGF, TNF-α and SAA contents as well as peripheral blood Breg cell and Treg cell contents were lower than those of control group. Conclusion: enteral nutrition intervention can improve immune nutritional status and reduce radiation damage in patients with esophageal cancer radiotherapy.

Effects of early enteral nutrition on immune function of severe acute pancreatitis patients

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.

Effect of postoperative early enteral nutrition on clinical outcomes and immune function of cholangiocarcinoma patients with malignant obstructive jaundice

BACKGROUND Most cholangiocarcinoma patients with malignant obstructive jaundice(MOJ)have varying degrees of malnutrition and immunodeficiency preoperatively.Therefore,perioperative nutritional support has important clinical significance in the treatment of cholangiocarcinoma.AIM To investigate the effects of postoperative early enteral nutrition(EEN)on immunity function and clinical outcomes of cholangiocarcinoma patients with MOJ.METHODS This prospective clinical study included 60 cholangiocarcinoma patients with MOJ who underwent surgery.The patients were randomly divided into an experimental group and a control group according to the nutrition support modes.The control group received postoperative total parenteral nutrition(TPN),whereas the experimental group received postoperative EEN and parenteral nutrition(PN;EEN+PN).The clinical outcomes,postoperative immune function,incidences of surgical site infection and bile leakage,intestinal function recovery time,average hospitalization days,and hospitalization expenses of the two groups were assessed on postoperative days(PODs)1,3,and 7.RESULTS The CD3+T,CD4+T,CD8+T,and CD4+T/CD8+T cell count and the immunoglobulin(Ig)G,IgM,and IgA levels in the EEN+PN group were significantly higher than those in the TPN group on PODs 3 and 7(P<0.05),whereas no significant differences in the CD3+T,CD4+T,CD8+T,and CD4+T/CD8+T cell counts and IgG,IgM,and IgA levels before operation and on POD 1 were found between the two groups(P>0.05).The intestinal function recovery time and postoperative hospital stay were shorter(P<0.001 for both)in the EEN+PN group than in the TPN group.The hospitalization expenses of the EEN+PN group were lower than those of the TPN group(P<0.001).However,the incidence of abdominal distension was higher than in the EEN+PN group than in the TPN group(P<0.05).The incidence rates of biliary leakage and surgical site infection were not significantly different between the two groups(P>0.05).CONCLUSION A postoperative EEN program could reduce the incidence of postoperative complications and improve the clinical outcomes and immune functions of cholangiocarcinoma patients with MOJ and is thus beneficial to patient recovery.

Effects of enteral immunonutrition on immune function in patients with multiple trauma

BACKGROUND：Enteral immunonutrition （EIN） refers to addition of some specific nutrients in enteral nutrition （EN）, which can help to increase the immune function, and reduce the inflammatory reaction and septic complications. This study aimed to determine whether EIN can improve the immune function in multiple trauma patients. METHODS：Thirty-two patients with multiple trauma who had been admitted to the general ICU of Changzheng Hospital, Shanghai, from March 2007 to May 2008, were randomly divided into two groups： an enteral immunonutrition group （EIN group, n=16） and an enteral nutrition group （EN group, n=16）. EIN suspension （RuiNeng produced by Sino-Swed Co., Ltd） and ordinary nutrition liquid （RuiSu produced by Sino-Swed Co., Ltd） were given to patients of the EIN group and EN group respectively for at least for 14 days. Peripheral blood lymphocyte count （TLC）, immunoglobulin （IgG, IgM, IgA）, and T-lymphocyte subsets （CD3, CD4, CD8, CD4 / CD8） were detected on the 1st day after grouping, and the 7th day and 14th day after nutritional support. RESULTS： TLC, IgG, IgM, IgA, CD4 and CD4/CD8 ratio were significantly higher in the EIN group on the 7th and 14th day than that on the 1st day （P〈0.05）, and continually increased with a prolonged time of EIN. The parameters of immune function in the EN group on the 7th day didn＇t change significantly compared with those on the 1st day after grouping; on the 14 th day, TLC, IgG, IgM, IgA, CD4 and CD4/CD8 ratio were significantly higher than those on the 1st day after grouping （P〈0.05）, but were significantly lower than those in the EIN group on the 14th day （P〈0.05）. CONCLUSION： Compared with the general formula EN, EIN is more helpful for the recovery of humoral and cellular immune function in the early post-multitraumatic phase.

Effects of comprehensive nutrition support on immune function,wound healing,hospital stay,and mental health in gastrointestinal surgery

BACKGROUND Postoperative patients undergoing gastrointestinal surgery often encounter challenges such as low immune function,delayed wound healing owing to surgical trauma,and increased nutritional demands during recovery.AIM To assess the effect of comprehensive nutritional support program on immune function and wound healing in patients undergoing gastrointestinal surgery.METHODS This retrospective comparative study included 60 patients who underwent gastrointestinal surgery,randomly assigned to either the experimental group(n=30)or the control group(n=30).The experimental group received comprehensive nutritional support,including a combination of enteral and parenteral nutrition,whereas the control group received only conventional comprehensive nutritional support.Evaluation indicators included immune function markers(e.g.,white blood cell count,lymphocyte subsets),wound healing(wound infection rate,healing time),pain score[visual analog scale(VAS)score],and psychological status(anxiety score,depression score)7 days post-surgery)and duration of stay.RESULTS The immune function of patients in the experimental group was significantly better than that in the control group.The white blood cell count was 8.52±1.19×109/L in the experimental group vs 6.74±1.31×109/L(P<0.05).The proportion of CD4+T cells was higher in the experimental group(40.09%±4.91%)than that in the control group(33.01%±5.08%)(P<0.05);the proportion of CD8+T cells was lower(21.79%±3.38%vs 26.29%±3.09%;P<0.05).The CD4+/CD8+ratio was 1.91±0.32 in the experimental group whereas 1.13±0.23 in the control group(P<0.05).The wound infection rate of the experi-mental group was significantly lower than that of the control group(10%vs 30%,P<0.05),and the wound healing time was shorter(10.35±2.42 days vs 14.42±3.15 days,P<0.05).The VAS score of the experimental group was 3.05±1.04,and that of the control group was 5.11±1.09(P<0.05);the anxiety score(Hamilton Anxiety Rating Scale)was 8.88±1.87,and that of the control group was 12.1±3.27(P<0.05);the depression score(Hamilton Depression Rating Scale)was 7.37±1.41,and that of the control group was 11.79±2.77(P<0.05).In addition,the hospitalization time of the experimental group was significantly shorter than that of the control group(16.16±3.12 days vs 20.93±4.84 days,P<0.05).CONCLUSION A comprehensive nutritional support program significantly enhances immune function,promote wound healing,reduces pain,improves psychological status,and shortens hospitalization stays in patients recovering from gastrointestinal surgery.

Effect of immune-enhanced enteral nutrition on inflammatory response and immune function in elderly patients with septic shock

Objective:To investigate the effect of immune-enhanced enteral nutrition on inflammatory response and immune function in elderly patients with severe septic shock.Methods:From September 2016 to October 2018,58 cases of serious septic shock patients treated in our hospital,were randomly assigned to two groups.A group-enteral nutrition emulsion group(n=29);B group-enteral nutrition mixed suspension group(n=29);The admission day,one week,two week after admission,the index data of patients',inflammation and immune were collected.Results:With the increase of admission time,CD4 and CD4/CD8 levels in the two groups were gradually increased and CD8 levels were gradually decreased.At 1 and 2 weeks after admission,CD4 and CD4/CD8 levels in the observation group were higher than those in the control group(P<0.05),and CD8 levels were lower than those in the control group(P<0.05).Each immunoglobulin index of subjects in both groups increased with the increase of admission time.The IgG and IgM levels of subjects in the observation group were higher than those in the control group(P<0.05).IgA levels of subjects in the observation group were higher than those in the control group at 1 and 2 weeks after admission(P<0.05).With the increase of admission time,the c-reactive protein concentration of subjects in the two groups decreased gradually(P<0.05).One week after admission,there was no significant difference in c-reactive protein between the observation group and the control group(P>0.05).C-reactive protein of subjects in the observation group was higher than that in the control group at 2 weeks after admission(P<0.05).With the increase of admission time,the concentration of plasma diamine oxidase(DAO)in the two groups decreased gradually,and the DAO at different time points in each group showed statistical difference(P<0.05).1 week after admission,there was no significant difference in DAO between the observation group and the control group(P>0.05).At 2 weeks after admission,the DAO of subjects in the observation group was higher than that in the control group(P<0.05).Conclusions:Immune-enhancing enteral nutrition is more helpful to control the inflammatory response in patients of serious septic shock,and it's also can modulate the immune function.

Effects of oral nutrition support on nutritional status, immune function and radiation damage in patients with nasopharyngeal carcinoma radiotherapy

Objective:To study the effects of oral nutrition support on nutritional status, immune function and radiation damage in patients with nasopharyngeal carcinoma radiotherapy.Methods:Patients with nasopharyngeal carcinoma who received radiotherapy in West China Hospital between and November January 2017 were selected and randomly divided into the nutrition support group who received oral nutrition support and the normal control group who received routine intervention. The levels of nutrition indicators and radiation damage indicators in serum as well as the contents of immune cells in peripheral blood were determined before radiotherapy and 1 week after end of radiotherapy.Results: Compared with those before radiotherapy, serum ALB, PA, TWEAK, Leptin and Ghrelin levels as well as peripheral blood CD3+CD4+, CD3+CD8+, CD3-CD19+ and CD3-CD56+ immune cell contents of nutrition support group didn't change significantly whereas serum TGF-β1, IL-6, IL-17 and MMP9 levels increased significantly 1 week after end of radiotherapy;serum ALB and PA levels as well as peripheral blood CD3+CD4+, CD3+CD8+, CD3-CD19+ and CD3-CD56+ immune cell contents of normal control group decreased significantly whereas TWEAK, Leptin, Ghrelin, TGF-β1, IL-6, IL-17 and MMP9 levels increased significantly 1 week after end of radiotherapy.Conclusion:Oral nutrition support can avoid the damage of nutritional status and immune function and reduce the radiation damage in patients with nasopharyngeal carcinoma radiotherapy.

Effects of enteral nutrition via jejunostomy catheter on immune response and intestinal mucosal barrier function after radical operation for esophageal cancer

Objective: To study the effects of enteral nutrition via jejunostomy catheter on immune response and intestinal mucosal barrier function after radical operation for esophageal cancer. Methods: A total of 90 patients who were diagnosed with esophageal cancer and received radical operation in Xishui People's Hospital between February 2015 and May 2017 were selected and randomly divided into the EN group who accepted enteral nutrition via jejunostomy catheter and the PN group who received parenteral nutrition. 1 week and 2 weeks after surgery, the expression of immune cell transcription factors in peripheral blood as well as the contents of intestinal mucosal injury markers and inflammatory stress markers in serum were measured. Results: 1 week and 2 weeks after surgery, T-bet expression intensity in peripheral blood of EN group was greatly higher than that of PN group while GATA3, RORγt and Foxp3 expression intensity in peripheral blood as well as DAO, Galectin-1, Galectin-3, Claudin, NE, E, Cor, CRP and CER levels were greatly lower than those of PN group. Conclusion: Enteral nutrition via jejunostomy catheter can improve the immune response and intestinal mucosal barrier function after radical operation for esophageal cancer.

Enteral nutrition and immune modulation of acute pancreatitis

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.

Effects of radical cholecystectomy on nutritional and immune status in patients with gallbladder carcinoma

INTRODUCTION Carcinoma of the gallbladder is the most commonneoplasm in biliary tract,and its incidence has beenrising in recent years.The rate of correct diagnosisin early gallbladder carcinoma has been raised afterthe wide use of CT,ultrasound scans and frozensection examination.Now radical cholecystectomyis advocated as the best management for patientswith early gallbladder carcinoma.In the

RESEARCH OF NUTRITIONAL AND IMMUNE STATUS IN PATIENTS WITH GALLBLADDER CARCINOMA RADICAL CHOLECYSTECTOMY

Objective To inquire the nutritional and immune status in patients with gallbladder carcinoma before and after radical cholecystectomy.Methods The nutritional and immune status in patients with gallbladder carcinoma were assessed in 1 week before surgery, and on 3rd day, 7th day, 14th day and 21st day after operation respectively.Results All of the nutritional parameters but the serum level of iron, TIBC and transfterrin recovered within 3 week after operation. Remarkable decrease of serum IgG, IgA, IgM and C 3, C 4 complement, IL 2, CD 4, CD 4/CD 8 ratio, and the remarkable increase of serum SIL 2R and CD 8( P <0.01) on 3rd day after operation.Conclusion Adequate iron should be supplemented after the radical cholecystectomy for gallbladder carcinoma in the third postoperative week. Radical cholecystectomy with complete resection of the tumor and removal of lymph nodes played the important roles in the recovery of immune function.

Impact of nutritional support on immunity,nutrition,inflammation,and outcomes in elderly gastric cancer patients after surgery

BACKGROUND Postoperative rehabilitation of elderly patients with gastric cancer has always been the focus of clinical attention.Whether the intervention by a full-course nutritional support team can have a positive impact on the postoperative immune function,nutritional status,inflammatory response,and clinical outcomes of this special population has not yet been fully verified.AIM To evaluate the impact of full-course nutritional support on postoperative comprehensive symptoms in elderly patients with gastric cancer.METHODS This is a retrospective study,including 60 elderly gastric cancer patients aged 70 years and above,divided into a nutritional support group and a control group.The nutritional support group received full postoperative nutritional support,including individualized meal formulation,and intravenous and parenteral nutrition supplementation,and was regularly evaluated and adjusted by a professional nutrition team.The control group received routine postoperative care.RESULTS After intervention,the proportion of CD4+lymphocytes(25.3%±3.1%vs 21.8%±2.9%,P<0.05)and the level of immunoglobulin G(12.5 G/L±2.3 G/L vs 10.2 G/L±1.8 G/L,P<0.01)were significantly higher in the nutritional support group than in the control group;the changes in body weight(-0.5 kg±0.8 kg vs-1.8 kg±0.9 kg,P<0.05)and body mass index(-0.2±0.3 vs-0.7±0.4,P<0.05)were less significant in the nutritional support group than in the control group;and the level of C-reactive protein(1.2 mg/L±0.4 mg/L vs 2.5 mg/L±0.6 mg/L,P<0.01)and WBC count(7.2×10^(9)/L±1.5×10^(9)/L vs 9.8×10^(9)/L±2.0×10^(9)/L,P<0.01)were significantly lower in the nutritional support group than in the control group.In addition,patients in the nutritional support group had a shorter hospital stay(10.3 d±2.1 d vs 14.8 d±3.6 d,P<0.05)and lower incidence of infection(15%vs 35%,P<0.05)in those of the control group.CONCLUSION The intervention by the nutritional support team has a positive impact on postoperative immune function,nutritional status,inflammatory response,and clinical outcomes in elderly patients with gastric cancer.

Influence of dietary n-3 LC-PUFA on growth, nutritional composition and immune function in marine fish Sebastiscus marmoratus

Abstract A 60-day feeding experiment was conducted to investigate the influence of dietary omega-3 long-chain polyunsaturated fatty acids （n-3 LC-PUFA） on growth, nutritional composition and immune function of marine fish Sebastiscus marmoratus. Five diets containing 3.6, 10.2, 18.2, 26.5, or 37.0 g/kg n-3 LC-PUFA were prepared. The results reveal significant influences of dietary n-3 LC-PUFA on the final weight, weight gain, specific growth rate, feed conversion ratio, and condition factor. As dietary n-3 LC- PUFA increased, weight gain and specific growth rate increased and were significantly higher in groups fed 18.2, 26.5 and 37.0 g/kgthan in groups fed 3.6 and 10.2 g/kg （P〈0.05）; there was no significant difference between groups fed 18.2, 26.5, or 37.0 g/kg （P〉0.05）. With increasing dietary n-3 LC-PUFA, eicosapentaenoic acid and docosahexenoic acid content in muscle and liver increased significantly, immunoglobulin class M content gradually increased from 9.1 to 14.8 Ixg/L, and lysozyme activity content increased from 1 355 to 2 268 U/mL. Broken line model analysis according to weight gain indicated that a dietary n-3 LC-PUFA level of 18.2 g/kg is essential for normal growth at a fat level of 125 g/kg. Therefore, appropriate dietary n-3 LC-PUFA not only promote growth and improve the n-3 LC-PUFA content, but also enhance immune function in S. marmoratus.

Effects of dietary fiber in enteral nutrition on inflammatory reaction, immune response and intestinal mucosal barrier in patients with severe acute pancreatitis

Objective:To study the effects of dietary fiber in enteral nutrition on inflammatory reaction, immune response and intestinal mucosal barrier in patients with severe acute pancreatitis. Methods: The patients with severe acute pancreatitis treated in our hospital between February 2015 and February 2018 were selected and randomly divided into two groups. The observation group received basic treatment combined with enteral nutrition containing dietary fiber, and the control group received basic treatment combined with conventional enteral nutrition. The contents of inflammatory cytokines and intestinal mucosal barrier markers in serum, the number of immune cells in peripheral blood as well as the number of intestinal flora in feces were measured respectively before treatment and 7 d after treatment.Results: Interleukin-8 (IL-8), monocyte chemoattractant protein (MCP-1), soluble intercellular adhesion molecule-1 (sICAM-1), soluble triggering receptor expressed on myeloid cells-1 (sTREM1), endotoxin, D-lactic acid and diamine oxidase (DAO) contents in serum, the number of CD8+T cells in peripheral blood as well as the number of enterococcus and enterobacterium in feces of both groups were significantly lower while the number of CD3+T cells, CD4+T cells, CD19+B cells and CD16+CD56+NK cells in peripheral blood as well as the number of bifidobacteria and lactobacillus in feces were significantly higher after treatment, and IL-8, MCP-1, sICAM-1, sTREM1, endotoxin, D-lactic acid and DAO contents in serum, the number of CD8+T cells in peripheral blood as well as the number of enterococcus and enterobacterium in feces of observation group after treatment were significantly lower than those of control group while the number of CD3+T cells, CD4+T cells, CD19+B cells and CD16+CD56+NK cells in peripheral blood as well as the number of bifidobacteria and lactobacillus in feces were significantly higher than those of control group.Conclusion: Dietary fiber in enteral nutrition can alleviate inflammatory reaction, improve immune response and correct intestinal mucosal barrier dysfunction in patients with severe acute pancreatitis.

Effect of postoperative early enteral nutrition support on anti-tumor immune response and inflammatory response process in the elderly patients with esophageal cancer

Objective: To explore the effect of postoperative early enteral nutrition support on anti-tumor immune response and inflammatory response process in the elderly patients with esophageal cancer. Methods: A total of 110 cases of elderly patients with esophageal cancer who underwent radical operation in this hospital between January 2015 and December 2017 were divided into the parenteral nutrition group (n=57) who received parenteral nutrition support and the enteral nutrition group (n=53) who received enteral nutrition support according to the postoperative nutrition intervention methods. The differences in anti-tumor immune response and inflammatory response degree were compared between the two groups of patients immediately after the patients returned to the ward (T0), 48h after nutritional support (T1) and 72h after nutritional support (T2). Results: At T0, there was no statistically significant difference in the contents of Th1/Th2 immune response and Th17/Treg immune response indexes as well as inflammatory mediators in serum between the two groups of patients. At T1 and T2, serum Th1 cytokines IFN-γ and IL-12 contents of enteral nutrition group were higher than those of parenteral nutrition group whereas Th2 cytokines IL-4 and IL-13 contents were lower than those of parenteral nutrition group;serum contents of Th17 cytokines IL-6 and IL-17 as well as Treg cytokines TGF-β and IL-10 were lower than those of parenteral nutrition group;serum inflammatory mediators hs-CRP, PGE and HMGB1 contents were lower than those of parenteral nutrition group. Conclusion: Postoperative early enteral nutrition support can effectively regulate the Th1/Th2 and Th17/Treg immune response balance and inhibit the systemic inflammatory response in elderly patients with esophageal cancer.

Effects of bifidobacterium-containing enteral nutrition intervention on the nutritional status and intestinal flora disturbance in patients with the severe cerebral infarction

Objective:To study the effects of bifidobacterium-containing enteral nutrition intervention on the nutritional status and intestinal flora disturbance in patients with the severe cerebral infarction.Methods:88 patients with severe cerebral infarction who were treated in Deyang Second People's Hospital between March 2014 and October 2016 were collected and divided into control group and observation group according to the random number table, control group received routine enteral nutrition intervention, and the observation group received bifidobacterium-containing enteral nutrition intervention. The nutritional status, intestinal mucosa function and intestinal flora distribution before and after nutritional intervention were compared between the two groups of patients.Results: Before intervention, differences in the nutritional status, intestinal mucosa function and intestinal flora distribution were not statistically significant between two groups of patients. After intervention, peripheral blood levels of nutritional status indexes Hb, TP, ALB, PA and TF in observation group were higher than those in control group;serum levels of intestinal mucosal barrier function indexes DAO and D-lactate were lower than those in control group;the number of bifidobacterium and lactobacillus in feces were larger than those in control group while the number of enterobacteria and enterococcus were smaller than those in control group.Conclusion:Bifidobacterium-containing enteral nutrition intervention can enhance the nutritional status, optimize the intestinal mucosa function and reduce the intestinal flora disturbance in patients with severe cerebral infarction.