Exploring choices of early nutritional support for patients with sepsis based on changes in intestinal microecology

BACKGROUND Sepsis exacerbates intestinal microecological disorders leading to poor prognosis.Proper modalities of nutritional support can improve nutrition,immunity,and intestinal microecology.AIM To identify the optimal modality of early nutritional support for patients with sepsis from the perspective of intestinal microecology.METHODS Thirty patients with sepsis admitted to the intensive care unit of the General Hospital of Ningxia Medical University,China,between 2019 and 2021 with indications for nutritional support,were randomly assigned to one of three different modalities of nutritional support for a total of 5 d:Total enteral nutrition(TEN group),total parenteral nutrition(TPN group),and supplemental parenteral nutrition(SPN group).Blood and stool specimens were collected before and after nutritional support,and changes in gut microbiota,short-chain fatty acids(SCFAs),and immune and nutritional indicators were detected and compared among the three groups.RESULTS In comparison with before nutritional support,the three groups after nutritional support presented:(1)Differences in the gut bacteria(Enterococcus increased in the TEN group,Campylobacter decreased in the TPN group,and Dialister decreased in the SPN group;all P<0.05);(2)different trends in SCFAs(the TEN group showed improvement except for Caproic acid,the TPN group showed improvement only for acetic and propionic acid,and the SPN group showed a decreasing trend);(3)significant improvement of the nutritional and immunological indicators in the TEN and SPN groups,while only immunoglobulin G improved in the TPN group(all P<0.05);and(4)a significant correlation was found between the gut bacteria,SCFAs,and nutritional and immunological indicators(all P<0.05).CONCLUSION TEN is recommended as the preferred mode of early nutritional support in sepsis based on clinical nutritional and immunological indicators,as well as changes in intestinal microecology.

A Study of Immunological Indices for Diagnosis of Chronic Berylliosis

The results of the Be-induced leukocyte migration inhibition test(Be-MIT),the lymphocyte transformation test(LI),the E-rosette formation test(E-RFC),the old tuberculin test(OT),and sero-immunoglobulin(IgG,IgA,IgM)measurements on 13 cases of berylliosis,44 members of the observation group,and 51 members of the contact group are rèported.In the Be-MIT,2 of the berylliosis patients were new cases that had been diagnosed and treated for a long time,and both tested positive(18%).Fourteen patients from the observation group tested positive(32%), and 15 from the contact group tested positive(30%).The 8 cases in the control group tested negative;7 patients from the observation group and 3 of the berylliosis cases tested negative after being treated.The lymphocyte transformation rates of the observation group and the berylliosis group were significantly lower than that of the control group(P<0.01).Both Et-RFC and Ea- RFC contents in the group with berylliosis were much lower than those in the control group(P <0.01).OT tests were performed on 8 berylliosis patients and 10 healthy men.Seven patients showed negative reactions and one showed a positive reaction.All the healthy men showed positive reactions.The IgG and IgA levels of the observation group were significantly higher than those of the control group(P<0.01).The Be-MIT could detect active beryllium disease at an early stage as well as Be-sensitive individuals.This test could be used as a supplementary diagnostic index for the differential diagnosis of berylliosis and for the evaluation of a curative effect.1989 Academic Press,Inc.