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 opti...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.展开更多
Roof falls in longwall headgate can occur when weak roof and high horizontal stress are present. To prevent roof falls in the headgate under high horizontal stress, it is important to understand the ground response to...Roof falls in longwall headgate can occur when weak roof and high horizontal stress are present. To prevent roof falls in the headgate under high horizontal stress, it is important to understand the ground response to high horizontal stress in the longwall headgate and the requirements for supplemental roof support. In this study, a longwall headgate under high horizontal stress was instrumented to monitor stress change in the pillars, deformations in the roof, and load in the cable bolts. The conditions in the headgate were monitored for about six months as the longwall face passed by the instrumented site.The roof behavior in the headgate near the face was carefully observed during longwall retreat.Numerical modeling was performed to correlate the modeling results with underground observation and instrumentation data and to quantify the effect of high horizontal stress on roof stability in the longwall headgate. This paper discusses roof support requirements in the longwall headgate under high horizontal stress in regard to the pattern of supplemental cable bolts and the critical locations where additional supplemental support is necessary.展开更多
目的对老年痴呆患者使用口服营养补充剂(ONS)的最佳证据进行评价及总结。方法以循证“6S”证据模型为基础,通过计算机检索UpToDate数据库、BMJ Best Practice数据库、国际实践指南注册平台网站、英国卫生与临床优化研究所网站、国际指...目的对老年痴呆患者使用口服营养补充剂(ONS)的最佳证据进行评价及总结。方法以循证“6S”证据模型为基础,通过计算机检索UpToDate数据库、BMJ Best Practice数据库、国际实践指南注册平台网站、英国卫生与临床优化研究所网站、国际指南网、加拿大安大略注册护士协会网、苏格兰学院间指南网、欧洲肠内肠外营养协会网、美国肠内肠外营养协会网、澳大利亚乔安娜布里格斯研究所循证卫生保健中心数据库、Cochrane Library数据库、PubMed数据库、中国生物医学文献数据库中有关老年痴呆患者使用ONS的相关证据,包括临床指南、临床决策、证据总结、系统评价、专家共识和意见、随机对照试验。进行文献质量评价后,提取相关证据,并确定证据分级和推荐级别。结果共纳入12篇文献,包括证据总结1篇、临床指南2篇、系统评价7篇、随机对照试验2篇,总结涉及老年痴呆患者营养风险筛查与评估、ONS的使用原则、ONS的使用方法、ONS制剂的选择、使用ONS的依从性、ONS的应用效果评估方法、ONS的疗效与评价7个方面共19条最佳证据,其中A级推荐证据11条(57.9%)。结论总结老年痴呆患者使用ONS的最佳证据,可为营养不良或存在营养不良风险的老年痴呆患者的营养支持干预提供科学可靠的循证依据。展开更多
基金Supported by Ningxia Natural Science Foundation Project,No.2022AAC03488the National Key Research and Development Program of China,No.2016YFD0400605.
文摘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.
文摘Roof falls in longwall headgate can occur when weak roof and high horizontal stress are present. To prevent roof falls in the headgate under high horizontal stress, it is important to understand the ground response to high horizontal stress in the longwall headgate and the requirements for supplemental roof support. In this study, a longwall headgate under high horizontal stress was instrumented to monitor stress change in the pillars, deformations in the roof, and load in the cable bolts. The conditions in the headgate were monitored for about six months as the longwall face passed by the instrumented site.The roof behavior in the headgate near the face was carefully observed during longwall retreat.Numerical modeling was performed to correlate the modeling results with underground observation and instrumentation data and to quantify the effect of high horizontal stress on roof stability in the longwall headgate. This paper discusses roof support requirements in the longwall headgate under high horizontal stress in regard to the pattern of supplemental cable bolts and the critical locations where additional supplemental support is necessary.
文摘目的对老年痴呆患者使用口服营养补充剂(ONS)的最佳证据进行评价及总结。方法以循证“6S”证据模型为基础,通过计算机检索UpToDate数据库、BMJ Best Practice数据库、国际实践指南注册平台网站、英国卫生与临床优化研究所网站、国际指南网、加拿大安大略注册护士协会网、苏格兰学院间指南网、欧洲肠内肠外营养协会网、美国肠内肠外营养协会网、澳大利亚乔安娜布里格斯研究所循证卫生保健中心数据库、Cochrane Library数据库、PubMed数据库、中国生物医学文献数据库中有关老年痴呆患者使用ONS的相关证据,包括临床指南、临床决策、证据总结、系统评价、专家共识和意见、随机对照试验。进行文献质量评价后,提取相关证据,并确定证据分级和推荐级别。结果共纳入12篇文献,包括证据总结1篇、临床指南2篇、系统评价7篇、随机对照试验2篇,总结涉及老年痴呆患者营养风险筛查与评估、ONS的使用原则、ONS的使用方法、ONS制剂的选择、使用ONS的依从性、ONS的应用效果评估方法、ONS的疗效与评价7个方面共19条最佳证据,其中A级推荐证据11条(57.9%)。结论总结老年痴呆患者使用ONS的最佳证据,可为营养不良或存在营养不良风险的老年痴呆患者的营养支持干预提供科学可靠的循证依据。
