禁食记

“给我吃点吧！我都快馋死啦！” “不行，你已经拉肚子了，不能随便吃东西！” 唉，真后悔呀，要不是一时贪嘴吃了太多的螃蟹，我大概也不会急性胃肠炎发作，结果呢，肚子疼就算了，到现也不能吃东西，那些美味佳肴啊!唉……

Clinical investigation of 41 patients with ischemic colitis accompanied by ulcer

AIM: To investigate the relationship among the presence of ulcer lesions, underlying disease, and clinical course in patients with ischemic colitis. METHODS: The subjects were 41 patients (10 male and 31 female; mean age 70 years) with ischemic colitis who were admitted to and received treatment in our hospital from 2000 to 2006. We compared their characteristics and analyzed the mean lengths of admission and fast- ing for 9 patients with ulcer lesions (ulcer group) and 32 without (non-ulcer group). RESULTS: The groups with presence and absence of ulcer differed significantly only in white blood cell (WBC) count. Lengths of fasting and admission were 7.9 d and 17.9 d for the ulcer group and 4.4 d and 10.7 d for the non-ulcer group, respectively, and significantly longer in the ulcer group (P = 0.0057 and 0.0001). There was no correlation between presence of ulcer and presence of underlying diseases. CONCLUSION: Lengths of fasting and admission were significantly longer in patients with ischemic colitis with ulcer than for those without ulcer.

Effect of alternate-day-fasting combined with Lingguizhugan Decoction on blood lipid profiles of hyperlipidemic rats

Objective： To explore the effects of alternate-day-fasting （ADF） therapy combined with Lingguizhugan Decoction （LD）on blood lipid profiles of hyperlipidemic rats. Methods： Rats were randomly assigned into high-fat-diet （HF） group andnormal-diet （ND） group. Hyperlipidemic rats fed with high-fat-diet for 5 weeks were randomly divided into ADF group,alternate-day-fasting with LD （ALG） group and model control （MC） group. The rats in ALG and ADF group weredeprived of food for 24 h every other day for 4 weeks. Rats in ALG group were administrated with LD at fasting day.After 4 weeks of ADF therapy, plasma TC, TG, LDL-c and HDL-c were measured in each group. Expression of miR-143and PPAR-γ protein from adipose was also analyzed. Results： When compared with MC group, after 4 weeks of ADF orcombined ADF and LD therapy, the body weight was evidently reduced in ADF and ALG groups （P = 0.028, P = 0.036by wk 8）. The levels of plasma TC and TG decreased in ADF group and ALG group, which were significantly lower thanthose in MC group （P 〈 0.001, P = 0.045; P 〈 0.001, P = 0.005）. However, the body weight and level of TC and TG inALG group showed non-statistical difference in comparison with ADF group （ALG vs. ADF, P 〉 0.05）. Expression ofmiR-143 and PPAR-γ were higher in MC group than that in NC group （P 〈 0.001）. Compared with MC group,expression of miR-143 and PPAR-γ were significantly decreased in ADF （P = 0.038, P = 0.015） and ALG （P = 0.007, P〈 0.001） groups. When compared with ADF group, expression of miR-143 and PPAR-γ were significantly decreased inALG （P = 0.041, P = 0.046） group. Conclusion： ADF therapy alone not only reduced blood lipids, but also inhibitedmiR-143 and PPAR-γ protein expression in visceral adipose tissue. However, LD couldn’t reduce the levels of bloodlipid profiles more effectively than using ADF alone. Perhaps the effects of LD combined with ADF in the prevention ofhyperlipidemia need further exploration.

Influence of fasting on muscle composition and antioxidant defenses of market-size Sparus macrocephalus

The study was conducted to investigate fasting effects on flesh composition and antioxidant defenses of market-size Sparus macrocephalus. Two hundred fish (main initial weight 580 g) were divided into two groups (control and fasted) and reared in 6 cages. After two weeks of adaptation, group I fasted for 28 d; group II was fed normally as a control. In 3, 7, 14, 21 and 28 d, 6 fish per group were sampled for proximate flesh composition, liver antioxidant enzyme activities and malondialdehyde flesh content analyses. In fasted fish, the reduction of lipid content in muscle occurred after day 3, and, compared to controls, the content of protein decreased from day 14, the activities of liver antioxidative enzymes superoxide dismutase (SOD) and glutathione peroxidase (GPX) increased from day 3, and flesh malondialdehyde levels increased from day 21. Flesh fat reduction shows that fasting may be used as a technique to reduce flesh lipid content in Sparus macrocephalus. However, considering flesh protein loss and the subsequent oxidative stress, the fasting technique should be used with precautions.

Factors associated with complicated erosive esophagitis: A Japanese multicenter, prospective, cross-sectional study

AIMTo assess the clinical characteristics of patients with complicated erosive esophagitis (EE) and their associated factors.METHODSThis prospective, cross-sectional study included patients diagnosed with EE by upper gastrointestinal endoscopy between October 2014 and March 2015 at 106 Japanese hospitals. Data on medical history, general condition, gastrointestinal symptoms, lifestyle habits, comorbidities, and endoscopic findings were collected using a standard form to create a dedicated database. Logistic regression analysis was used to calculate adjusted odds ratios (aOR) and 95%CI for the association with complicated EE.RESULTSDuring the study period, 1749 patients diagnosed with EE, 38.3% of whom were prescribed proton pump inhibitors (PPIs) were included. Of them, 143 (8.2%) had EE complications. Esophageal bleeding occurred in 84 (4.8%) patients, esophageal strictures in 45 (2.6%) patients, and 14 (0.8%) patients experienced both. Multivariate analysis showed that increased age (aOR: 1.05; 95%CI: 1.03-1.08), concomitant use of psychotropic agents (aOR: 6.51; 95%CI: 3.01-13.61), and Los Angeles grades B (aOR: 2.69; 95%CI: 1.48-4.96), C (aOR: 15.38; 95%CI: 8.62-28.37), and D (aOR: 71.49; 95%CI: 37.47-142.01) were significantly associated with complications, whereas alcohol consumption 2-4 d/wk was negatively associated (aOR: 0.23; 95%CI: 0.06-0.61). Analyzing associated factors with each EE complication separately showed esophageal ulcer bleeding were associated with increased age (aOR: 1.05; 95%CI: 1.02-1.07) and Los Angeles grades B (aOR: 3.60; 95%CI: 1.52-8.50), C (aOR: 27.61; 95%CI: 12.34-61.80), and D (aOR: 119.09; 95%CI: 51.15-277.29), while esophageal strictures were associated with increased age (aOR: 1.07; 95%CI: 1.04-1.10), gastroesophageal reflux symptom (aOR: 2.51; 95%CI: 1.39-4.51), concomitant use of psychotropic agents (aOR: 11.79; 95%CI: 5.06-27.48), Los Angeles grades C (aOR: 7.35; 95%CI: 3.32-16.25), and D (aOR: 20.34; 95%CI: 8.36-49.53) and long-segment Barrett’s esophagus (aOR: 4.63; 95%CI: 1.64-13.05).CONCLUSIONAging and severe EE were common associated factors, although there were more associated factors in esophageal strictures than esophageal ulcer bleeding. Despite the availability and widespread use of PPIs, EE complications are likely to remain a problem in Japan owing to the aging population and high-stress society.

Lymphocytic esophagitis: Still an enigma a decade later

Lymphocytic esophagitis (LE) is a clinicopathologic entity first described by Rubio et al in 2006. It is defined as peripapillary intraepithelial lymphocytosis with spongiosis and few or no granulocytes on esophageal biopsy. This definition is not widely accepted and the number of lymphocytes needed to make the diagnosis varied in different studies. Multiple studies have described potential clinical associations and risk factors for LE, such as old age, female gender and smoking history. This entity was reported in inflammatory bowel disease in the pediatric population but not in adults. Other associations include gastroesophageal reflux disease and primary esophageal motility disorders. The most common symptom is dysphagia, with a normal appearing esophagus on endoscopy, though esophageal rings, webs, nodularities, furrows and strictures have been described. Multiple treatment modalities have been used such as proton pump inhibitors and topical steroids. Esophageal dilation seems to be therapeutic when dysphagia is present along with esophageal narrowing secondary to webs, rings or strictures. The natural history of the disease remains unclear and needs to be better delineated. Overall, lymphocytic esophagitis seems to have a chronic and benign course, except for two cases of esophageal perforation in the literature, thought to be secondary to this entity.

Assessment of negative phototaxis in long-term fasted Glyptocidaris crenularis:a new insight into measuring stress responses of sea urchins in aquaculture

A cost-effective method was designed to measure the behavioral response of negative phototaxis to high-intensity illumination in the sea urchin Glyptocidaris crenularis. Ninety sea urchins were randomly and equally divided into two aquaculture environment groups： a fasted group, which was starved during the experiment, and a fed group. After 10 months, the total mortality of each group was recorded. Then, 15 sea urchins were randomly selected from each group and behavioral responses to high-intensity illumination were investigated for each sea urchin. After the behavioral experiment, body measurements of the trial sea urchins were taken. The results reveal that food deprivation significantly affected test diameter （P〈0.01）, body weight （P〈0.01）, gonad weight （P〈0.0I）, and gut weight （P〈0.01）. Furthermore, food deprivation also affected negative phototaxis behaviors of time to rapid spine movement （P〈0.01）, time to the 1 cm position （P〈0.05）, and walking distance in 300 s （P〈0.01）, but not time to body reaction （P〉0.05）. The mortality rates of fasted and fed urchins were 6.7% and 0%, respectively. The present study provides evidence that food deprivation has a significant effect on phenotypic traits and behavioral responses to high-intensity illumination in the sea urchin G. crenularis. With this method, environmental stressors can be easily detected by measuring proper optional indicators. This study provides a new insight into measuring stress responses of sea urchins in aquaculture. However, further studies should be carried out to understand more environmental factors and to compare this potential behavioral method with immune, physiological, and epidemiological approaches.

Effects of fasting and preoperative feeding in children

AIM： To investigate whether children should undergo surgery without a long period of fasting after feeding. METHODS： Eighty children with inguinoscrotal disorders （aged 1-10 years） were studied prospectively. They were divided into eight groups that each contained 10 children who were fed normal liquid food （NLF） and a high-calorie diet （HCD） 2, 3, 4 and 5 h before surgery, in two doses at 6-h intervals. NLF was given to four groups and HCD to the other four. In all groups, glucose, prealbumin and cortisol levels in the blood were measured twice： just after oral feeding and just before the operation. After the establishment of adequate anesthesia, gastric residue liquid was measured with a syringe. RESULTS： Blood glucose levels in all patients fed NLF and HCD were high, except in patients inthe HCD-4 group. There was no significant difference in the blood prealbumin levels. There was a significant increase in the blood cortisol levels in the NLF-2 （14.4± 5.7）, HCD-2 （13.2 ± 6.0）, NLF-3 （10.9± 6.4）, and HCD-5 （6.8 ± 5.7） groups （P 〈 0.05）. CONCLUSION： The stress of surgery may be tolerated by children when they are fed up to 2 h before elective surgery.Key words： Cortisol; Diet; Fasting; Food; Glucose; Liquids; Prealbumin

安妮塔·德赛出版新作

安妮塔·德赛是当代最重要的印度英语小说家之一，她的足迹走遍了大半个世界，她的作品则走遍了整个世界。(《世界文学》杂志1999年第3期曾经介绍过她的小长篇《今年夏天咱们去哪儿?》)据2000年1月9日的美国《纽约时报书评》杂志报道。

Effect of Linguizhugan decoction on hyperlipidemia rats with intermittent fasting

OBJECTIVE:To explore the effect of Linguizhugan decoction on hyperlipidemia rats with caloric restriction.METHODS:The hyperlipidemia model of rat was induced by high fat diet for 8 weeks.After the model was established,26 rats were randomly divided into 4 groups:the control group(n=6),the model group(n=6),the intermittent fasting(IF) group(n= 8),and the IF and herbal medicine(IFH) group(n= 6).IF group was applied intermittent fasting every other day.The IFH group was given Linguizhugan decoction every day and intermittent fasting every other day.Blood samples were taken at the end of 16 weeks,and serum ghrelin and lipid was tested.RESULTS:Serum ghrelin in the IF group significantly increased(P<0.01).Serum ghrelin in IFH group was lower than the IF group(P<0.05),but higher than the model group(P<0.01).CONCLUSION:Linguizhugan decoction may play a part in regulation of energy and appetite in hyperlipidemia rats with IF.

Effects of modified Lingguizhugan decoction combined with weekend fasting on metabolic syndrome

OBJECTIVE:To assess the therapeutic effect of weekend fasting and administration of a modified Lingguizhugan decoction on metabolic syndrome(MetS).METHODS:Twenty-one patients with MetS were recruited from the First Affiliated Hospital of Sun Yat-Sen University.Fasting plasma glucose(FPG),30-min and 2-h post-prandial blood glucose(PG),fasting serum insulin(FINS),blood pressure(BP),body mass index(BMI),waist circumference(WC),homeostasis model assessment for insulin resistance index(HOMA-IR),and levels of triglyceride(TG),total cholesterol(TC),low-density lipoprotein-cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C)were tested.Patients were allowed to drink only water and a Chinese herbal decoction during weekends.All samples were tested again after 12 weeks of treatment.RESULTS:FPG,30-min PG,2-h PG,FINS,LDL-C,systolic BP,diastolic BP,BMI,WC,and HOMA-IR de-creased significantly(P<0.05)compared with before treatment.Levels of TG,TC,and HDL-C did not change significantly.CONCLUSION:Weekend fasting improved glucose metabolism,lowered BP,reduced LDL-C levels,BMI,and WC.These data suggest that weekend fasting may be an effective therapy for MetS by protection against coronary atherosclerosis.

The effect of fasting and body reserves on cola tolerance in 2 pit-building insect predators

Pit-building antlions and wormlions are 2 distantly-related insect species, whose larvae construct pits in loose soil to trap small arthropod prey. This convergent evolution of natural histories has led to additional similarities in their natural history and ecology, and thus, these 2 species encounter similar abiotic stress （such as periodic starvation） in their natural habitat. Here, we measured the cold tolerance of the 2 species and examined whether recent feeding or food deprivation, as well as body composition （body mass and lipid content） and condition （quantified as mass-to-size residuals） affect their cold tolerance. In contrast to other insects, in which food deprivation either enhanced or impaired cold tolerance, prolonged fasting had no effect on the cold tolerance of either species, which had similar cold tolerance. The 2 species differed, however, in how cold tolerance related to body mass and lipid content： although body mass was positively correlated with the wormlion cold tolerance, lipid content was a more reliable predictor of cold tolerance in the antlions. Cold tolerance also underwent greater change with ontogeny in wormlions than in antlions. We discuss possible reasons for this lack of effect of food deprivation on both species＇ cold tolerance, such as their high starvation tolerance （being sit-and-wait predators）.