Regulation of ω-3 Fish Oil Emulsion on the SIRS during the Initial Stage of Severe Acute Pancreatitis

The aim of this study was to explore the effects of parenteral supplementation with ω-3 fish oil emulsion （Omegaven） on systemic inflammatory response syndrome （SIRS） during the initial stage of severe acute pancreatitis （SAP）. In a prospective, randomized and controlled trial, 60 patients with SAP were randomized either to treat with conventional therapy （Con group, n=30） or conventional therapy plus intravenous supplementation with ω-3 fish oil emulsion 0.2 g/kg every day （FO group, n=30）. The effects were analyzed by the SIRS-related indexes. The results showed that APACHE-Ⅱ scores in FO group were significantly lower, and the gap increased much farther after the 4th day than those in Con group （P〈0.05）. Fluid equilibrium time became shorter markedly in FO group than in Con group （5.1±2.2 days vs 8.4±2.3 days）. In FO group, SIRS scores were markedly decreased and the SIRS state vanished after the 4th day; Plasma level of TNF-α was significantly reduced, while IL-10 decreased markedly, most prominently between the 4th and 7th day, and the ratio of IL-10/TNF-α raised as compared with Con group （P〈0.05）. During the initial stage of SAP, parenteral supplementation with ω-3 fish oil emulsion could efficiently lower the magnitude and persistence time of the SIRS, markedly retrieve the unbalance of the pro-/anti-inflammatory cytokines, improve severe condition of illness and may provide a new way to regulate the SIRS.

Transgenic Pigs Carrying a Synthesized Fatty Acid Desaturase Gene Yield High Level of ω-3 PUFAs

Polyunsaturated fatty acids （PUFAs） are essential for normal growth in mammals, especially the ω-3 PUFAs, which play important roles in preventing several life-threatening diseases, such as coronary heart disease and diabetes. In this study, we aimed to investigate whether the sFat-1 gene from Caenorhabditis briggsae could be functionally expressed in transgenic pigs, and whether the transgenic could synthesize high quality ω-3 PUFAs endogenously. In this study, a gene construct consisting of CMV promoter and 1.9 kb cDNA of ω-3 fatty acid desaturase gene （sFat-1） from C. briggsae was injected into the male pronucleus of pig embryos by microinjection. The piglets were screened for the transgene by PCR, Southern blot and reverse transcription-PCR analysis. Pigs that give positive results were mated with wild-type pigs to produce the next generation and the transmission of transgene was examined by PCR analysis. Fatty acids compositions of various tissues in the transgenic pigs were then analyzed by gas chromatograph. A total of 878 embryos were transferred into 42 recipients, among which 29 successfully got pregnant and gave birth to a total of 162 piglets, and 8 of them were identified to be transgenic. Fatty acid compositions in the transgenic pigs were altered, and the levels of ω-6：ω-3 ratios were decreased from 14.53 in the control to 2.62 in Fat-1 transgenic pigs. A number of primary sFat-1-transgenic pigs were bred in this study, which lays the foundation for cultivation of new varieties of transgenic pigs.

Effects of ω-3 fatty acids on toll-like receptor 4 and nuclear factor-κB p56 in lungs of rats with severe acute pancreatitis

AIM To determine the effects of ω-3 fatty acids(ω-3FA) on the toll-like receptor 4(TLR4)/nuclear factor κB p56(NF-κBp56) signal pathway in the lungs of rats with severe acute pancreatitis(SAP).METHODS A total of 56 Sprague-Dawley rats were randomly divided into 4 groups: control group, SAP-saline group, SAP-soybean oil group and SAP-ω-3FA group. SAP was induced by the retrograde infusion of sodium taurocholate into the pancreatic duct. The expression of TLR4 and NF-κBp56 in the lungs was evaluated by immunohistochemistry and Western blot analysis. The levels of inflammatory cytokines interleukin-6 and tumor necrosis factor-alpha in the lungs were measured by enzyme-linked immunosorbent assay. RESULTS The expression of TLR4 and NF-κBp56 in lungs and of inflammatory cytokines in serum significantly increased in the SAP group compared with the control group(P < 0.05), but was significantly decreased in the ω-3FA group compared with the soybean oil group at 12 and 24 h(P < 0.05).CONCLUSION During the initial stage of SAP, ω-3FA can efficiently lower the inflammatory response and reduce lung injury by triggering the TLR4/NF-κBp56 signal pathway.

Usefulness of ω-3 fatty acid supplementation in addition to mesalazine in maintaining remission in pediatric Crohn's disease: A double-blind, randomized, placebo-controlled study

AIM： To assess the value of long-chain w-3 fatty acids （FAs） supplementation in addition to amino-salicylic-acid （5-ASA） in pediatric patients with Crohn＇s disease （CD）. METHODS： Thirty-eight patients （20 males and 18 females, mean age 10.13 years, range 5-16 years） with CD in remission were randomized into two groups and treated for 12 too. Group Ⅰ （18 patients） received 5-ASA （50 mg/kg/d）＋w-3 FAs as triglycerides in gastroresistant capsules, 3 g/d （eicosapentanoic acid, EPA, 400 mg/g, docosahexaenoic acid, DHA, 200 mg/g）. Group Ⅱ （20 patients） received 5-ASA （50 mg/kg/d）＋olive oil placebo capsules. Patients were evaluated for fatty acid incorporation in red blood cell membranes by gas chromatography at baseline 6 and 12 mo after the treatment. RESULTS： The number of patients who relapsed at 1 year was significantly lower in group I than in group Ⅱ （P〈0.001）. Patients in group I had a significant increase in the incorporation of EPA and DHA （P〈0.001） and a decrease in the presence of arachidonic acids. CONCLUSION： Enteric-coated w-3 FAs in addition to treatment with 5-ASA are effective in maintaining remission of pediatric CD.

Effect of ω-3 Polyunsaturated Fatty Acid on Toll-like Receptors in Patients with Severe Multiple Trauma

This study examined the effects of ω-3 polyunsaturated fatty acid（ω-3PUFA） on the expression of toll-like receptor 2（TLR2）,toll-like receptor 4（TLR4） and some related inflammatory factors in peripheral blood mononuclear cells（PBMCs） of patients with early-stage severe multiple trauma.Thirty-two patients who were admitted to the Department of Traumatic Surgery,Tongji Hospital（Wuhan,China） between May 2010 and November 2010,and diagnosed as having severe multiple trauma with a injury severity score（ISS） no less than 16,were enrolled in the study and divided into two groups at random（n=16 in each）：ω-3PUFA group and control group in which routine parenteral nutrition supplemented with ω-3PUFA or not was administered to the patients in two groups for consecutive 7 days.Peripheral blood from these patients was collected within 2 h of admission（day 0）,and 1,3,5 and 7 days after the nutritional support.PBMCs were isolated and used for detection of the mRNA and protein expression of TLR2 and TLR4 by using real-time PCR and flow cytometry respectively,the levels of NF-κB by quantum dots-based immunofluorescence assay,the levels of TNF-α,IL-2,IL-6 and COX-2 by ELISA,respectively.The results showed that the mRNA and protein expression of TLR2 and TLR4 in PBMCs was significantly lower in ω-3PUFA group than in control group 5 and 7 days after nutrition support（both P0.05）.The levels of TNF-α,IL-2,IL-6 and COX-2 were found to be substantially decreased in PBMCs in ω-3PUFA group as compared with control group at 5th and 7th day（P0.05 for all）.It was concluded that ω-3PUFA can remarkably decrease the expression of TLR2,TLR4 and some related inflammatory factors in NF-κB signaling pathway in PBMCs of patients with severe multiple trauma,which suggests that ω-3PUFA may suppress the excessive inflammatory response meditated by the TLRs/NF-κB signaling pathway.

A Diet with 3% of Energy from a Mixture of Omega-3 Fatty Acids Significantly Increases in Vivo Lipid Peroxidation in Postmenopausal Women

Dietary omega-3 (n - 3) polyunsaturated fatty acids (PUFA) are recommended by public health organizations to reduce the risk of cardiovascular disease, and several epidemiological studies have suggested there is an inverse association between n - 3 intake and human cancers. However, n - 3 are susceptible to an increase in lipid peroxidation in the human body. As part of a crossover dietary intervention study of a diet (20% of energy from fat) with or without an additional 3% of energy from a mixture of n - 3 (with 5.36 g α-linolenic acid and 1.45 g eicosapentaenoic acid and docosahexaenoic acid per 2000 kcal per day), we measured total in vivo lipid peroxidation in healthy postmenopausal women (n = 15). Our results indicated that the diet with 3% of energy from n - 3 significantly increased the urinary concentrations of total polar lipophilic aldehydes and related compounds produced via lipid peroxidation (p α, β-unsaturated hydroxy aldehydes 4-hydroxy-2-trans - hexenal (p trans -decenal (p < 0.05) compared to the diet with less than 1% of energy from n - 3. This is also the first study to document the presence of 4-hydroxy-2-trans -decenal in the urine of individuals consuming n - 3. These results demonstrate that an increase in 3% of energy from dietary n – 3 increases in vivo lipid peroxidation.

ω-3鱼油脂肪乳对脓毒症患者氧化应激指标的影响

目的 探讨ω-3鱼油脂肪乳对脓毒症患者氧化应激指标的影响.方法 40例脓毒症患者随机分为常规TPN组（A组）和ω-3鱼油脂肪乳＋TPN组（B组）,各20例.两组患者均接受等氮、等热量的TPN,B组加用ω-3鱼油脂肪乳2 mL/（kg·d）,共5 d.两组患者于治疗前和治疗后第1、3、6天清晨抽取静脉血进行氧化应激指标检测.结果 A组完成18例,有2例退出; B组完成19例,有1例退出.两组患者在年龄及入ICU 24 h内APACHEⅡ评分方面比较差异无统计学意义（P〉0.05）.B组MDA水平有下降趋势,在治疗后第6天与A组比较差异有统计学意义（P〈0.05）.B组SOD活性、T-AOC水平有上升趋势,在治疗后第3、6天与A组比较差异均有统计学意义（P〈0.05）.B组NO水平有下降趋势,在治疗后第3、6天与A组比较差异均有统计学意义（P〈0.05）.B组GSH-PX活性有上升趋势,在治疗后第6天与A组比较差异有统计学意义（P〈0.01）.结论 ω-3鱼油脂肪乳可以改善脓毒症患者的氧化应激指标.

ω-3鱼油脂肪乳剂对严重创伤患者血白细胞介素-6及肿瘤坏死因子-α的影响

目的:探讨ω-3鱼油脂肪乳剂对严重创伤患者血白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)水平的影响。方法:将29例严重创伤患者随机分为治疗组和对照组,其中,治疗组14例,对照组15例。对照组采用常规治疗,治疗组在常规治疗的基础上加用ω-3鱼油脂肪乳剂。于入院第1、3、5天收集患者血清,放入-50℃冰箱保存,统一用ELISA法检测其中促炎细胞因子IL-6及TNF-α水平,并对两组的结果进行比较。结果:入院后两组患者血IL-6及TNF-α水平均明显升高,但治疗组IL-6、TNF-α升高程度明显低于对照组(P<0.05)。结论:ω-3鱼油脂肪乳剂能抑制严重创伤患者血IL-6及TNF-α水平的上升。

ω-3多不饱和脂肪酸对脂多糖诱导的脑损伤新生大鼠的神经保护作用

目的探讨ω-3多不饱和脂肪酸(ω-3 PUFA)对脂多糖(LPS)诱导的脑损伤新生大鼠的神经保护作用。方法将48只3日龄Sprague-Dawley新生大鼠随机分为对照组、LPS组、ω-3 PUFA组和ω-6 PUFA组,每组12只。LPS组、ω-3 PUFA组和ω-6 PUFA组大鼠腹腔注射0.6 mg·kg^(-1)LPS建立脑损伤模型,然后分别立即腹腔注射等容积的生理盐水、ω-3 PUFA和ω-6 PUFA;对照组大鼠腹腔注射等容积的生理盐水。24 h后处死各组大鼠,取海马组织,采用实时荧光定量聚合酶链反应和Western blot法检测各组大鼠海马组织中Toll样受体4(TLR4)、核因子-κB(NF-κB)、肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-1β、IL-6的mRNA和蛋白表达。结果 LPS组、ω-3 PUFA组、ω-6 PUFA组新生大鼠海马组织中TLR4、NF-κB、TNF-α、IL-1β及IL-6 mRNA和蛋白表达均高于对照组(P<0.05);ω-6 PUFA组新生大鼠海马组织中TLR4、NF-κB、TNF-α、IL-1β及IL-6 mRNA和蛋白表达高于LPS组(P<0.05);ω-3 PUFA组新生大鼠海马组织中TLR4、NF-κB、TNF-α、IL-1β及IL-6 mRNA和蛋白表达均低于LPS组和ω-6 PUFA组(P<0.05)。结论ω-3 PUFA能下调大鼠海马组织中TLR4/NF-κB信号通路,减少炎性因子TNF-α、IL-1β、IL-6释放,对LPS所致的脑损伤新生大鼠有神经保护作用。

ω-3鱼油脂肪乳剂对严重创伤患者的临床疗效

目的探讨ω-3鱼油脂肪乳剂对严重创伤患者的疗效。方法将86例严重创伤患者随机分为治疗组和对照组,对照组采用常规治疗,治疗组在常规治疗的基础上加用ω-3鱼油脂肪乳剂。结果治疗组在住ICU时间、住院时间上明显低于对照组(P<0.05)。结论ω-3鱼油脂肪乳剂对严重创伤患者有明显疗效,值得应用。

肠外应用ω-3鱼油脂肪乳对肺挫伤合并肺炎的疗效观察

目的:观察ω-3鱼油脂肪乳对肺挫伤合并肺炎的治疗效果。方法:患者为肺挫伤合并肺炎,均存在呼吸衰竭,氧合指数<300,随机分为鱼油脂肪乳治疗组和对照组,对照组采用机械通气、抗感染、营养支持等常规治疗,治疗组在常规治疗基础上加用ω-3鱼油脂肪乳剂100ml每天一次静脉滴注,疗程5～7天,观察患者住ICU天数、机械通气天数、抗生素使用天数、ARDS发生率,并对两组结果进行比较。结果:治疗组在住ICU天数、机械通气天数、抗生素使用天数、ARDS发生率上明显低于对照组(P<0.05)。结论:ω-3鱼油脂肪乳对肺挫伤合并肺炎的患者有良好的辅助治疗作用,能够有效缩短住ICU天数、机械通气天数、抗生素使用天数,减少ARDS的发生。

ω-3脂肪乳剂减轻重症患者全身性炎性反应综合征的临床疗效观察

目的观察和探讨ω-3脂肪乳剂减轻重症患者全身炎性反应综合征(SIRS)的临床疗效。方法选择安徽省马鞍山市人民医院重症医学科2011年5月～2013年4月收治的SIRS患者96例,随机将所有患者分为实验组和对照组,每组各48例。对照组患者使用普通20%中长链脂肪乳剂500 mL/d治疗;实验组在对照组的基础上再加用ω-3脂肪乳剂100 mL/d静滴治疗,治疗持续1周。治疗前后检测患者的C-反应蛋白(CRP)、降钙素原(PCT)、IL(白介素)-1、IL-6、IL-8、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)水平,并行急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分。结果治疗前两组患者CRP、PCT、IL-1、IL-6、IL-8、ALT和AST水平以及APACHEⅡ评分差异无统计学意义(P>0.05);治疗后,实验组CRP、PCT、IL-1、IL-6、IL-8、ALT和AST水平以及APACHEⅡ评分显著降低,且与对照组相比降低更为明显,差异具有统计学意义(P<0.05)。结论ω-3脂肪乳剂减轻重症患者SIRS的临床效果显著,预后提升明显,值得在临床上进一步推广。

ω-3多不饱和脂肪酸对体外循环下心脏直视手术围术期炎性反应及凝血功能的影响

目的：探讨ω-3多不饱和脂肪酸对体外循环下心脏直视手术围术期患者白细胞介素-6（IL-6）、围术期出血量的影响。方法收集2013年1月至12月收治的需要行心脏手术的患者，分为治疗组及对照组，各15例，治疗组加用ω-3多不饱和脂肪酸（尤文）：0.2g/（kg·d），并分别于Tl：手术开始前；T2：升主动脉阻断后1h；T3：升主动脉开放后30min；T4：升主动脉开放后1h；T5：体外循环结束后2h；T6：手术后6h；T7：手术后12h；T8：手术后24h；T9：手术后48h；T10：手术后72h。收集患者血清，用ELISA法检测IL-6水平。结果自手术开始，IL-6水平明显升高，治疗组IL-6水平明显低于对照组，差异有统计学意义（P〈0.05）。两组患者围术期出血量及输血量差异无统计学意义（P〉0.05）。结论鱼油能减轻心脏手术围术期患者炎性反应，不会引起围术期出血量增多，可安全用于心脏手术围术期。

ω-3鱼油脂肪乳对肝细胞氧化损伤的修复作用及其机制

目的观察ω-3鱼油脂肪乳对肝细胞氧化损伤的修复作用,并探讨其机制。方法体外培养人肝细胞系HL7702细胞。取对数生长期的HL7702细胞分成对照组、模型组和观察组,每组9孔。对照组仅加培养基常规培养;模型组、观察组在培养基中加入500μmol/L过氧化氢(H_2O_2),培养1 h后观察组加入0.5%ω-3鱼油脂肪乳;另设空白对照组,只加培养基,无细胞。各组继续培养4 h后收集细胞,油红O染色观察各组细胞内脂滴变化,CCK-8法测算各组细胞存活率,DCFH-DA荧光探针法检测各组细胞内活性氧簇(ROS),比色法检测各组细胞培养上清液丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST),COD-PAP单试剂比色法检测各组细胞内甘油三酯(TG)、总胆固醇(TC),硫代巴比妥酸法检测各组细胞内丙二醛(MDA),黄嘌呤氧化酶法检测各组细胞内超氧化物歧化酶(SOD),实时荧光定量PCR法检测各组细胞中过氧化物酶体增生物激活受体(PPAR)αmRNA,Western blotting法检测各组细胞中肝型脂肪酸结合蛋白(L-FABP)相对表达量。结果光镜下可见脂滴染为橘红色。对照组组HL7702肝细胞排列紧密,仅见少许橘红色脂滴。模型组肝细胞可见大量橘红色脂滴并伴有脂滴融合现象。观察组肝细胞可见较多橘红色脂滴,但与模型组比较显著减少。对照组、模型组、观察组细胞存活率分别为67.25%±4.68%、71.72%±2.47%、100%。观察组细胞存活率高于模型组(P<0.05),但低于对照组(P<0.05)。与对照组比较,模型组细胞内ROS增高(P<0.05),细胞培养上清液ALT、AST增高(P均<0.05),细胞内TG、TC、MDA增高(P均<0.05),细胞内SOD降低(P<0.05),PPARαmRNA降低(P<0.05),L-FABP相对表达量降低(P<0.05)。与模型组比较,观察组细胞内ROS降低(P<0.05),细胞培养上清液ALT、AST均降低(P均<0.05),细胞内TG、TC、MDA均降低(P均<0.05),细胞内SOD活性增高(P<0.05),PPARαmRNA增高(P<0.05),L-FABP相对表达量增高(P<0.05)。结论ω-3鱼油脂肪乳可修复人肝HL7702细胞氧化损伤,其机制可能与其上调LFABP/PPARα信号通路相关因子的表达、维持肝细胞脂质稳态有关。

Omega-3多不饱和脂肪酸对颈胸腹三切口食管癌切除术后炎症反应的影响研究

目的明确Omega-3多不饱和脂肪酸对颈胸腹三切口食管癌术后炎症反应的影响。方法将44例颈胸腹三切口食管癌手术患者随机分为干预组(21例)和对照组(23例)。术后肠内营养支持方案对照组给予中长链脂肪乳剂,干预组加用Omega-3鱼油脂肪乳剂,其他治疗措施相同。观察患者术后一般情况,检测C-反应蛋白(CRP)、白细胞总数(WBC)、APACHEⅡ评分及血浆白细胞介素-6(IL-6)浓度水平。结果两组患者在术中术后一般情况、WBC、CRP及APACHEⅡ评分上差异均无统计学意义(P>0.05)。Omega-3多不饱和脂肪酸组患者在术后第2天及第3天IL-6低于对照组,差异有统计学意义(P<0.05)。结论在颈胸腹三切口食管癌手术中,Omega-3多不饱和脂肪酸能够有效降低颈胸腹三切口食管癌术后IL-6水平。

Is there a role of lipid-lowering therapies in the management of fatty liver disease?

Atherogenic dyslipidemia is characterized by increased triglyceride-rich lipoproteins and low high-density lipoprotein cholesterol concentrations.It is highly prevalent in non-alcoholic fatty liver disease(NAFLD)and contributes to the increased cardiovascular risk associated with this condition.Alongside insulin resistance it plays an important pathogenetic role in NAFLD/non-alcoholic steatohepatitis(NASH)development and progression.It has been shown that cholesterol-lowering reduces cardiovascular risk more in NAFLD vs non-NAFLD high-risk individuals.This evidence highlights the importance of effective lipid modulation in NAFLD.In this narrative review the effects of the most commonly used lipid-lowering therapies on liver outcomes alongside their therapeutic implications in NAFLD/NASH are critically discussed.Preclinical and clinical evidence suggests that statins reduce hepatic steatosis,inflammation and fibrosis in patients with NAFLD/NASH.Most data are derived from observational and small prospective clinical studies using changes in liver enzyme activities,steatosis/fibrosis scores,and imaging evidence of steatosis as surrogates.Also,relevant histologic benefits were noted in small biopsy studies.Atorvastatin and rosuvastatin showed greater benefits,whereas data for other statins are scarce and sometimes conflicting.Similar studies to those of statins showed efficacy of ezetimibe against hepatic steatosis.However,no significant anti-inflammatory and anti-fibrotic actions of ezetimibe have been shown.Preclinical studies showed that fibrates through peroxisome proliferator-activated receptor(PPAR)αactivation may have a role in NAFLD prevention and management.Nevertheless,no relevant benefits have been noted in human studies.Species-related differences in PPARαexpression and its activation responsiveness may help explain this discrepancy.Omega-3 fatty acids reduced hepatic steatosis in numerous heterogeneous studies,but their benefits on hepatic inflammation and fibrosis have not been established.Promising preliminary data for the highly purified eicosapentaenoic acid require further confirmation.Observational studies suggest that proprotein convertase subtilisin/kexin9 inhibitors may also have a role in the management of NAFLD,though this needs to be established by future prospective studies.

ω-3鱼油脂肪乳在肠内和肠外营养中的应用

综述ω-3鱼油脂肪乳种类、特点及在肠内和肠外营养中的应用。

ω-3PUFAs Prevent MK-801-induced Cognitive Impairment in Schizophrenic Rats via the CREB/BDNF/TrkB Pathway

This study was to determine the protective effect of ω-3 polyunsaturated fatty acids（ω-3PUFAs） on MK-801-induced cognitive impairment in schizophrenia（SZ） rats and the underlying mechanism. A rat model of schizophrenia was induced by MK-801. The cognitive function of rats was assessed using a Morris water maze. The number of hippocampal neurons was measured by Nissl staining. The expression of CREB, p-CREB, BDNF, TrkB, p-TrkB, AKT, p-AKT, ERK, and p-ERK in the hippocampus of rats was detected by Western blotting. The results showed that ω-3PUFAs attenuated MK-801-induced cognitive impairment and hippocampal neurons loss, reversed the injury of the CREB/BDNF/TrkB pathway induced by MK-801, and antagonized MK-801-induced down-regulation of p-AKT and p-ERK in the hippocampus of rats. In conclusion, ω-3PUFAs enhances the CREB/BDNF/TrkB pathway by activating ERK and AKT, thereby increasing the synaptic plasticity and decreasing neuron loss, and antagonizing MK-801-induced cognitive impairment in schizophrenic rats.

ω-3鱼油脂肪乳联合丙氨酰谷氨酰胺在AECOPD机械通气患者营养支持中的应用研究

目的：观察ω-3鱼油脂肪乳联合丙氨酰谷氨酰胺在慢性阻塞性肺疾病急性加重期（acute exacerbation chronic obstructive pulmonary disease,AECOPD）机械通气患者营养支持中的临床疗效。方法 ：64例AECOPD机械通气患者随机分为3组,在机械通气后的第2~11天,分别给予营养支持,A组添加ω-3鱼油脂肪乳及丙氨酰谷氨酰胺,B组添加ω-3鱼油脂肪乳,C组予常规营养支持。观察3组的ICU住院时间、机械通气时间、呼吸机相关肺炎发生率、28 d死亡率等指标。结果：营养支持10 d后A、B、C组的ICU住院时间、机械通气时间、呼吸机相关肺炎发生率差异均有统计学意义（均P〈0.05）,A、B组28 d死亡率较C组下降,但差异无统计学意义（P〉0.05）。结论：ω-3鱼油脂肪乳能有效地减少有创机械通气患者的ICU住院时间及机械通气时间,降低呼吸机相关肺炎发生率,联合丙氨酰谷氨酰胺后效果更佳。

Cytochrome P450 monooxygenase-mediated eicosanoid pathway:A potential mechanistic linkage between dietary fatty acid consumption and colon cancer risk

Human consumption of linoleic acid(LA,18:2ω-6,abundant in vegetable oils)is very high.Animal experiments showed that excessive LA intake increased azoxymethane-induced colon tumorigenesis,however,the impact of excessive LA on colon cancer in human is not conclusive,making it difficult to make dietary recommendations for optimal intake of LA.Understanding the molecular mechanisms of LA on colon tumorigenesis could help to clarify its health effect,and facilitate development of mechanismbased strategies for preventing colon cancer.Recent studies show that the previously unappreciated cytochrome P450 monooxygenase-mediated eicosanoid pathway is upregulated in colon cancer and plays critical roles in its pathogenesis,and could contribute to the effects of dietary LA,as well asω-3 fatty acids,on colon tumorigenesis.In this review,we will discuss recent studies about the roles of cytochrome P450 monooxygenases in fatty acid metabolism and its roles in colonic inflammation and colon cancer,and how this information could help us to clarify the health impacts of dietary fatty acids.