Nutrient deficiencies are common in patients with inflammatory bowel disease （IBD）. Both total parenteral and enteral nutrition provide important supportive therapy for IBD patients, but in adults these are not usef...Nutrient deficiencies are common in patients with inflammatory bowel disease （IBD）. Both total parenteral and enteral nutrition provide important supportive therapy for IBD patients, but in adults these are not useful for primary therapy. Dietary intervention with omega-3 polyunsaturated fatty acids contained in fish oil may be useful for the care of IBD patients, and recent studies have slyessed the role of PPAR on NFKB activity on the potential beneficial effect of dietary lipids on intestinal function.展开更多
A 76-year-old diabetic man underwent cholecystectomy for gangrenous calculous cholecystitis. His postoperative course was complicated by the development of Candida albicans esophagitis necessitating antifungal therapy...A 76-year-old diabetic man underwent cholecystectomy for gangrenous calculous cholecystitis. His postoperative course was complicated by the development of Candida albicans esophagitis necessitating antifungal therapy, and total parenteral nutrition (TPN) for 15 d. Seven weeks after cholecystectomy, he presented with cholangitis. Endoscopic retrograde cholangiopancreatography (ERCP) demonstrated extrahepatic filling defects. Despite endoscopic extraction of a biliary cast, cholestasis remained unchanged. Oral administration of ursodeoxycholic acid (UDCA), 750 mg/d, resulted in normalization of liver function tests. We, therefore, propose for the f irst time, combined endoscopic plus UDCA treatment for the management of biliary cast syndrome.展开更多
目的探讨儿童和青少年血浆氟含量、每日钙摄入量和血细胞参数的关联。方法本研究基于2013-2016年美国国家健康和营养检查调查(The Ethics Review Board of National Center for Health Statistics,NHANES)数据库,以3684名6~19岁儿童和...目的探讨儿童和青少年血浆氟含量、每日钙摄入量和血细胞参数的关联。方法本研究基于2013-2016年美国国家健康和营养检查调查(The Ethics Review Board of National Center for Health Statistics,NHANES)数据库,以3684名6~19岁儿童和青少年为研究对象,收集数据库中血浆氟含量、每日钙摄入量和血细胞参数信息。使用限制性立方样条分析血浆氟含量、每日钙摄入量与血细胞参数的非线性关系,若存在非线性关系,使用阈值/饱和效应分析法计算最佳拐点;随后利用多重线性回归模型分析三者之间的关联,并分析每日钙摄入量(二分类变量,依据每日钙摄入量的中位数分层)对血浆氟含量与血细胞参数关联的修饰作用。结果血浆氟含量与白细胞计数、血红蛋白含量和血小板计数均无非线性关系(均P_(非线性)>0.05),而与红细胞计数、红细胞比容均存在非线性关系(均P_(非线性)<0.001),调整混杂因素后,血浆氟含量对红细胞计数和红细胞比容效应的最佳拐点分别为0.54和0.31μmol/L;每日钙摄入量与各血细胞参数均无非线性关系(均P_(非线性)>0.05)。调整混杂因素后,血浆氟含量每升高1μmol/L,白细胞计数升高0.49×10^(9)个/L(P=0.009);血浆氟含量与红细胞计数和红细胞比容的关联存在饱和效应:血浆氟含量<0.54μmol/L时,其含量每升高1μmol/L,红细胞计数降低0.46×10^(12)个/L(P<0.001);血浆氟含量<0.31μmol/L时,其含量每升高1μmol/L,红细胞比容降低6.29%(P=0.006);上述关联在血浆氟含量高于最佳拐点后,均无统计学意义(均P>0.05)。依据每日钙摄入量的中位数分层后,在低钙组(每日钙摄入量<0.87 g),血浆氟含量每升高1μmol/L,白细胞计数升高0.77×10^(9)个/L(P=0.001);血浆氟含量<0.54μmol/L时,其含量每升高1μmol/L,红细胞计数降低0.41×10^(12)个/L(P=0.002);血浆氟含量≥0.54μmol/L时,其含量每升高1μmol/L,红细胞计数降低0.47×10^(12)个/L(P<0.001);血浆氟含量<0.31μmol/L时,其含量每升高1μmol/L,红细胞比容降低8.29%(P=0.011);而上述关联在高钙组(每日钙摄入量≥0.87 g)均无统计学意义(均P>0.05)。每日钙摄入量与血浆氟含量对血小板计数存在交互作用(P_(交互)=0.070),血浆氟含量每升高1μmol/L,低钙组血小板计数升高12.68×10^(9)个/L(P=0.013),高钙组血小板计数降低9.05×10^(9)个/L(P=0.035)。结论儿童和青少年血细胞参数与血浆氟含量密切相关,而与每日钙摄入量无直接关联;但不同钙摄入人群中血浆氟含量与血细胞参数关联不同,且每日钙摄入量可修饰血浆氟含量与血小板计数的关联。展开更多
对哮喘儿童而言，母亲往往“有作用”，而非父亲。根据“第三次全国健康与营养检查调查”所做的研究显示，母亲有哮喘史的儿童的风险比母亲无哮喘史的儿童要高（危险比3．71）；此外，母亲发病年龄较早儿童的哮喘风险高于母亲发病年龄...对哮喘儿童而言，母亲往往“有作用”，而非父亲。根据“第三次全国健康与营养检查调查”所做的研究显示，母亲有哮喘史的儿童的风险比母亲无哮喘史的儿童要高（危险比3．71）；此外，母亲发病年龄较早儿童的哮喘风险高于母亲发病年龄较晚的儿童（Journal of Asthma and Allergy，2015，8：51-61，DOI：10．2147／JAA．$80245）。相比之下，父亲一方的任何情况均不具有统计学意义。展开更多
Malnutrition is an independent risk factor for patient morbidity and mortality and is associated with increased healthcarerelated costs.However,a major dilemma exists due to lack of a unified definition for the term.F...Malnutrition is an independent risk factor for patient morbidity and mortality and is associated with increased healthcarerelated costs.However,a major dilemma exists due to lack of a unified definition for the term.Furthermore,there are no standard methods for screening and diagnosing patients with malnutrition,leading to confusion and varying practices among physicians across the world.The role of inflammation as a risk factor for malnutrition has also been recently recognized.Historically,serum proteins such as albumin and prealbumin(PAB)have been widely used by physicians to determine patient nutritional status.However,recent focus has been on an appropriate nutrition-focused physical examination(NFPE)for diagnosing malnutrition.The current consensus is that laboratory markers are not reliable by themselves but could be used as a complement to a thorough physical examination.Future studies are needed to identify serum biomarkers in order to diagnose malnutrition unaffected by inflammatory states and have the advantage of being noninvasive and relatively cost-effective.However,a thorough NFPE has an unprecedented role in diagnosing malnutrition.展开更多
文摘Nutrient deficiencies are common in patients with inflammatory bowel disease （IBD）. Both total parenteral and enteral nutrition provide important supportive therapy for IBD patients, but in adults these are not useful for primary therapy. Dietary intervention with omega-3 polyunsaturated fatty acids contained in fish oil may be useful for the care of IBD patients, and recent studies have slyessed the role of PPAR on NFKB activity on the potential beneficial effect of dietary lipids on intestinal function.
文摘A 76-year-old diabetic man underwent cholecystectomy for gangrenous calculous cholecystitis. His postoperative course was complicated by the development of Candida albicans esophagitis necessitating antifungal therapy, and total parenteral nutrition (TPN) for 15 d. Seven weeks after cholecystectomy, he presented with cholangitis. Endoscopic retrograde cholangiopancreatography (ERCP) demonstrated extrahepatic filling defects. Despite endoscopic extraction of a biliary cast, cholestasis remained unchanged. Oral administration of ursodeoxycholic acid (UDCA), 750 mg/d, resulted in normalization of liver function tests. We, therefore, propose for the f irst time, combined endoscopic plus UDCA treatment for the management of biliary cast syndrome.
文摘目的探讨儿童和青少年血浆氟含量、每日钙摄入量和血细胞参数的关联。方法本研究基于2013-2016年美国国家健康和营养检查调查(The Ethics Review Board of National Center for Health Statistics,NHANES)数据库,以3684名6~19岁儿童和青少年为研究对象,收集数据库中血浆氟含量、每日钙摄入量和血细胞参数信息。使用限制性立方样条分析血浆氟含量、每日钙摄入量与血细胞参数的非线性关系,若存在非线性关系,使用阈值/饱和效应分析法计算最佳拐点;随后利用多重线性回归模型分析三者之间的关联,并分析每日钙摄入量(二分类变量,依据每日钙摄入量的中位数分层)对血浆氟含量与血细胞参数关联的修饰作用。结果血浆氟含量与白细胞计数、血红蛋白含量和血小板计数均无非线性关系(均P_(非线性)>0.05),而与红细胞计数、红细胞比容均存在非线性关系(均P_(非线性)<0.001),调整混杂因素后,血浆氟含量对红细胞计数和红细胞比容效应的最佳拐点分别为0.54和0.31μmol/L;每日钙摄入量与各血细胞参数均无非线性关系(均P_(非线性)>0.05)。调整混杂因素后,血浆氟含量每升高1μmol/L,白细胞计数升高0.49×10^(9)个/L(P=0.009);血浆氟含量与红细胞计数和红细胞比容的关联存在饱和效应:血浆氟含量<0.54μmol/L时,其含量每升高1μmol/L,红细胞计数降低0.46×10^(12)个/L(P<0.001);血浆氟含量<0.31μmol/L时,其含量每升高1μmol/L,红细胞比容降低6.29%(P=0.006);上述关联在血浆氟含量高于最佳拐点后,均无统计学意义(均P>0.05)。依据每日钙摄入量的中位数分层后,在低钙组(每日钙摄入量<0.87 g),血浆氟含量每升高1μmol/L,白细胞计数升高0.77×10^(9)个/L(P=0.001);血浆氟含量<0.54μmol/L时,其含量每升高1μmol/L,红细胞计数降低0.41×10^(12)个/L(P=0.002);血浆氟含量≥0.54μmol/L时,其含量每升高1μmol/L,红细胞计数降低0.47×10^(12)个/L(P<0.001);血浆氟含量<0.31μmol/L时,其含量每升高1μmol/L,红细胞比容降低8.29%(P=0.011);而上述关联在高钙组(每日钙摄入量≥0.87 g)均无统计学意义(均P>0.05)。每日钙摄入量与血浆氟含量对血小板计数存在交互作用(P_(交互)=0.070),血浆氟含量每升高1μmol/L,低钙组血小板计数升高12.68×10^(9)个/L(P=0.013),高钙组血小板计数降低9.05×10^(9)个/L(P=0.035)。结论儿童和青少年血细胞参数与血浆氟含量密切相关,而与每日钙摄入量无直接关联;但不同钙摄入人群中血浆氟含量与血细胞参数关联不同,且每日钙摄入量可修饰血浆氟含量与血小板计数的关联。
文摘对哮喘儿童而言，母亲往往“有作用”，而非父亲。根据“第三次全国健康与营养检查调查”所做的研究显示，母亲有哮喘史的儿童的风险比母亲无哮喘史的儿童要高（危险比3．71）；此外，母亲发病年龄较早儿童的哮喘风险高于母亲发病年龄较晚的儿童（Journal of Asthma and Allergy，2015，8：51-61，DOI：10．2147／JAA．$80245）。相比之下，父亲一方的任何情况均不具有统计学意义。
文摘Malnutrition is an independent risk factor for patient morbidity and mortality and is associated with increased healthcarerelated costs.However,a major dilemma exists due to lack of a unified definition for the term.Furthermore,there are no standard methods for screening and diagnosing patients with malnutrition,leading to confusion and varying practices among physicians across the world.The role of inflammation as a risk factor for malnutrition has also been recently recognized.Historically,serum proteins such as albumin and prealbumin(PAB)have been widely used by physicians to determine patient nutritional status.However,recent focus has been on an appropriate nutrition-focused physical examination(NFPE)for diagnosing malnutrition.The current consensus is that laboratory markers are not reliable by themselves but could be used as a complement to a thorough physical examination.Future studies are needed to identify serum biomarkers in order to diagnose malnutrition unaffected by inflammatory states and have the advantage of being noninvasive and relatively cost-effective.However,a thorough NFPE has an unprecedented role in diagnosing malnutrition.
