简介：Enteralnutritionhasbeenstronglyrecommendedbymajorscientificsocietiesforthenutritionalmanagementofpatientswithacutepancreatitis.Providingsevereacutepancreatitispatientswithenteralnutritionwithinthefirst24-48hofhospitaladmissioncanhelpimproveoutcomescomparedtoparenteralnutritionandnofeeding.Newresearchisfocusinginonwhenandwhattofeedtobestimproveoutcomesforacutepancreatitispatients.Earlyenteralnutritionhavethepotentialtomodulatetheimmuneresponses.Despitethisconsistentevidenceofearlyenteralnutritioninpatientswithacutepancreatitis,clinicalpracticecontinuestovaryduetoindividualclinicianpreference.Achievingtheimmunemodulatingeffectsofenteralnutritionheavilydependonproperplacementofthefeedingtubeandmanaginganytubefeedingassociatedcomplications.Thecurrentarticlereviewstheimmunemodulatingeffectsofenteralnutritionandpro-andprebioticsandsuggestssomepracticaltoolsthathelpimprovethepatientadherenceandtolerancetothetubefeeding.Properselectionofthetypeofthetube,closemonitoringofthetubeforitsplacement,patencyandsecuringitsproperplacementandroutinecheckingthegastricresidualvolumecouldallhelpimprovetheoutcome.Usingpeptide-basedandhighmediumchaintriglyceridesfeedingformulashelpimprovingfeedingtolerance.

简介：Theuseofenteralfeedingaspartofthemanagementofacutepancreatitisdatesbackalmosttwodecades.Thisreviewdescribestheindicationsforandlimitationsofenteralfeedingforthetreatmentofacutepancreatitisusingup-to-dateevidence-baseddata.Asystematicreviewwascarriedouttoanalysecurrentdataontheuseofenteralnutritioninthemanagementofacutepancreatitis.Relevantliteraturewasanalysedfromtheviewpointsofenteralvsparenteralfeeding,earlyvsdelayedenteralnutrition,nasogastricvsnasojejunalfeeding,andearlyoraldietandimmunonutrition,particularlyglutamineandprobioticsupplementation.Finally,currentapplicableguidelinesandtheeffectsoftheseguidelinesonclinicalpracticearediscussed.Thelatestmeta-analysessuggestthatenteralnutritionsignificantlyreducesthemortalityrateofsevereacutepancreatitiscomparedtoparenteralfeeding.Tomaintaingutbarrierfunctionandpreventearlybacterialtranslocation,enteralfeedingshouldbecommencedwithinthefirst24hofhospitaladmission.Also,thesafetyofnasogastricfeeding,whicheasestheadministrationofenteralnutrientsintheclinicalsetting,islikelyequaltonasojejunalfeeding.Furthermore,anearlylow-fatoraldietispotentiallybeneficialinpatientswithmildpancreatitis.Despitetheinitialencouragingresults,thecurrentevidencedoesnotsupporttheuseofimmunoenhancednutrientsorprobioticsinpatientswithacutepancreatitis.

简介：AbstractPurpose:To investigate the effect of early enteral nutrition on outcomes of trauma patients in the intensive care unit (ICU).Methods:Clinical data of trauma patients in the ICU of Daping Hospital, China from January 2012 to December 2017 was retrospectively analyzed, including patient age, gender, injury mechanism, injury severity score (ISS), nutritional treatment, postoperative complications (wound infection, abdominal abscess, anastomotic rupture, pneumonia), mortality, and adverse events (nausea, vomiting, abdominal distention). Only adult trauma patients who developed bloodstream infection after surgery for damage control were included. Patients were divided into early enteral nutrition group (<48 h) and delayed enteral nutrition group (control group, >48 h). Data of all trauma patients were collected by the same investigator. Data were expressed as frequency (percentage), mean ± standard deviation (normal distribution), or median (Q1, Q3) (non-normal distribution) and analyzed by Chi-square test, Student's t-test, or rank-sum test accordingly. Multiple logistic regression analysis was further adopted to investigate the significant variables with enteral nutrition.Results:Altogether 876 patients were assessed and 110 were eligible for this study, including 93 males and 17 females, with the mean age of (50.0 ± 15.4) years. Traffic accidents (46 cases, 41.8%) and fall from height (31 cases, 28.2%) were the dominant injury mechanism. There were 68 cases in the early enteral nutrition group and 42 cases in the control group. Comparison of general variables between early enteral nutrition group and control group revealed significant difference regarding surgeries of enterectomy (1.5% vs. 19.0%, p = 0.01), ileum/transverse colon/sigmoid colostomy (4.4% vs. 16.3%, p = 0.01) and operation time (h) (3.2 (1.9, 6.1) vs. 4.2 (1.8, 8.8), p = 0.02). Other variables like ISS (p = 0.31), acute physiology and chronic health evaluation≥20 (p = 0.79), etc. had no obvious difference. Chi-square test showed a much better result in early enteral nutrition group than in control group regarding morality (0 vs. 11.9%, p = 0.03), length of hospital stay (days) (76.8 ± 41.4 vs. 81.4 ± 44.7, p = 0.01) and wound infection (10.3% vs. 26.2%, p = 0.03). Logistic regression analysis showed that the incidence of wound infection was related to the duration required to achieve the enteral nutrition standard (OR = 1.095, p = 0.002). Seventy-six patients (69.1%) achieved the nutritional goal within a week and 105 patients (95.5%) in the end. Trauma patients unable to reach the enteral nutrition target within one week were often combined with abdominal infection, peritonitis, bowel resection, intestinal necrosis, intestinal fistula, or septic shock.Conclusion:Early enteral nutrition for trauma patients in the ICU is correlated with less wound infection, lower mortality, and shorter hospital stay.

简介：AbstractBackground:Feeding intolerance (FI) among intensive care unit (ICU) patients undergoing early continuous enteral nutrition (EN) is related to poor outcomes. This study aimed to explore the prevalence and risk factors of FI in ICU patients.Methods:We retrospectively enrolled 1057 patients who received early continuous EN via a nasogastric tube between January 2014 and August 2019. The prevalence of FI during the first 7 days of ICU stay was calculated, and the risk factors were investigated using multivariate logistic regression analysis.Results:The prevalence of FI during the first 7 days of ICU stay was 10.95%. FI occurred in 159 of 1057 (15.04%) patients on ICU day 2, 114 of 977 (11.67%) patients on ICU day 3, and 86 of 715 (12.03%) patients on ICU day 7. Mechanical ventilation (MV) (odds ratio [OR]: 1.928, 95% confidence interval [CI]: 1.064–3.493, P = 0.03) was an independent risk factor for FI defined by a gastric residual volume (GRV) of 200 mL and/or vomiting, and acute renal failure (OR: 3.445, 95% CI: 1.115–10.707, P = 0.032) was an independent risk factor of FI defined by a GRV of 500 mL and/or vomiting. Continuous renal replacement therapy (CRRT) was an independent predictor regardless of the FI defined by a GRV of 200 mL (OR: 2.064, 95% CI: 1.233–3.456, P = 0.006) or 500 mL (OR: 6.199, 95% CI: 2.108–18.228, P = 0.001) in the ICU patients.Conclusions:FI occurs frequently in early ICU days, especially in patients receiving MV and CRRT. However, further investigation of a consensus definition of FI and risk factors is still warranted in future studies.

简介：Objective:Toexploretheeffectofearlyenteralnutrition(EN)onpostoperativenutritionalstatus,intestinalpermeability,andimmunefunctioninelderlypatientswithesophagealcancerorcardiaccancer.Methods:Atotalof96patientswithesophagealcancerorcardiaccancerwhounderwentsurgicaltreatmentinourhospitalfromJune2007toDecember2010wereenrolledinthisstudy.TheyweredividedintoENgroup(n=50)andparenteralnutrition(PN)group(n=46)basedonthenutritionsupportmodes.Thebodyweight,timetofirstflatus/defecation,averagehospitalstay,complicationsandmortalityafterthesurgeryaswellastheliverfunctionindicatorswererecordedandanalyzed.Peripheralbloodsampleswerecollectedonthedays1,4and7aftersurgery.Theplasmadiamineoxidase(DAO)activityandD-lactatelevelweredeterminedtoassesstheintestinalpermeability.TheplasmaendotoxinlevelsweredeterminedusingdynamicturbidimetricassaytoassesstheprotectiveeffectofENonintestinalmucosalbarrier.Thepostoperativebloodlevelsofinflammatorycytokinesandimmunoglobulinsweredeterminedusingenzyme-linkedimmunosorbentassay(ELISA).Results:Afterthesurgery,thetimetofirstflatus/defecation,averagehospitalstay,andcomplicationsweresignificantlylessintheENgroupthanthoseinthePNgroup(P<0.05),whereastheENgrouphadsignificantlyhigheralbuminlevelsthanthePNgroup(P<0.05).Onthe7thpostoperativeday,theDAOactivity,D-lactatelevelandendotoxincontentsweresignificantlylowerintheENgroupthanthoseinthePNgroup(allP<0.05).Inaddition,theENgrouphadsignificantlyhigherIgA,IgG,IgM,andCD4levelsthanthePNgroup(P<0.05)butsignificantlylowerIL-2,IL-6,andTNF-αlevels(P<0.05).Conclusions:Inelderlypatientswithesophagealcancerorcardiaccancer,earlyENaftersurgerycaneffectivelyimprovethenutritionalstatus,protectintestinalmucosalbarrier(byreducingplasmaendoxins),andenhancetheimmunefunction

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简介：TheChildNutritionPrograminvitesallstudentstoparticipateintheschoolbreakfastandlunchprogramatschool.Ourgoalistoimprovethehealthandeducationofstudentsbyprovidingnutritiousmealsthatpromotefoodchoicesforahealthydiet.Failuretoeatbalancedmealsincreasestheriskofillnessincludingobesity,

简介：AseriesofresearchesonthenutritionproblemsinthecultivationofChinesefirseedlingsandplantations,whicharemainlyfocusontheproblemsofseriouslanddegradationinChinesefirplantationsincontradictionwiththerapiddevelopmentoftheplantationsinChina,weresummarized.Twelveyearswastakenandmorethan30piecesofresearchpaperswerepublishedfortheresearches,whichreferstotheproblemsofgrowtheffect,physiologicaleffect,vegetationvariation,biomassaccumulation,n...

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简介：Wepresentthreecasesofself-expandablemetallicstent（SEMS）placementusingaballoonenteroscope（BE）anditsovertube（OT）formalignantobstructionofsurgicallyreconstructedintestine.ABEiseffectivefortheinsertionofanendoscopeintothedeepbowel.However,SEMSplacementisimpossiblethroughtheworkingchannel,becausetheworkingchannelofBEistoosmallandtoolongforthestentdevice.Therefore,weusedatechniqueinwhichtheBEisinsertedasfarasthestenoticarea;thereafter,theBEisremoved,leavingonlytheOT,andthenthestentisplacedbyinsertingthestentdevicethroughtheOT.Inthepresentthreecases,amodificationofthistechniqueresultedinthesuccessfulplacementoftheSEMSforobstructionofsurgicallyreconstructedintestine,andtheprocedureswereperformedwithoutseriouscomplications.Weconsiderthatthepresentprocedureisextremelyeffectiveasapalliativetreatmentfordistalbowelstenosis,suchasinthesurgicallyreconstructedintestine.

简介：Understandingthetransformationofliquidsteeltosolidsteelisthemostfundamentalaspectofcontinuouscasting;however,itremainsacomplexsubjectwithanumberofunresolvedissues.Inthispaper,thefollowingaspectsofmoldoperationwhichgiverisetosub-surfacedefectswillbediscussed;meniscussolidification,surfaceandinterfacialenergies,effectsofgasbubbles,andthedynamicnatureoftheliquidslag-liquidsteelinterface.

简介：Thepaperintroducesrefractoriesforcontinuouscasting,especially,refractoriesforcontinuouscastingforcleansteelinbaosteel.Developingdirectionofrefractoriesforcontinuouscastinghasbeenpointedouttosatisfythenewmetallurgicaloperatingpractice.

简介：TwocharacterizationtheoremsofcontinuousL-domainaregiven.ThenaproblemraisedbyJ.D.LawsonandM.Misloveissolved.

简介：Toestablishthemechanismofsurfacechangeinacontinuouspolishingsystem,anidealmathematicalmodelisbuiltbasedonWinkler’shypothesisandthePrestonequation.Thebasicfeaturesofthemodelarethechangeratesinthesurfacepeak–valley(PV)valuesoftheworkpiece,conditioningdiskandpitchlap,ratherthanthespecificsurfaceshapes.Inaddition,anequilibriumstateexistsinthesystem,indicatingthatthesurfacechangeratesareallzero.Underequilibrium,thesurfaceofthelapcouldremainflat,anditisinsensitivetothesurfaceerroroftheworkpiece.Thesecharacteristicslaythetheoreticalfoundationsforhigh-efficiencyandhigh-precisionpolishing.Themethodstoobtainanequilibriumstatewithflatsurfacesarethenproposedandconfirmedexperimentally.High-precisionsurfacesbetterthanλ/10(λ=632.8nm)areconsistentlyproducedexperimentally.

简介：硅(Si)经由钙硅酸盐的申请被供应了到植物到土壤；然而，因为它的低溶解度，钙硅酸盐的高剂量被要求。Nanoparticles能减少Si剂量并且被用于播种沟。这研究调查了液体Si来源的效果，即，高度可溶的硅酸盐(115.2gL1Si和60.5gL1Na2O)并且nanosilica(<200nm)，在Si上，由米饭的举起种，植物木质化，植物C:N:Pstoichiometry，植物生理学，和谷物在greanhousecondistions下面用Oxisol让步。处理包括了nanosilica和可溶的硅酸盐的申请到在0，605，1210，和2420g的Si剂量播种沟哈1。植物举起和处理效果被测量累积，生理的特征，和谷物米饭产出的C和木质素内容，Si，N，和P评估。在标志叶子的硅石身体和非结晶的硅石的免职用扫描电子显微镜学被分析。液体Si的申请在与控制的关系在米饭增加了Si累积47.3%(0g哈1Si)，不管Si，来源使用了。Nanosilica申请增加了叶木质素内容112.7%什么时候与那相比在控制。硅中等影响了网C吸收(增加了1.83%)并且蒸发率(增加了48.3%)；然而，Si影响了既不植物生长也不米饭的谷物产量。这些结果被关於生命或不能生活的应力的缺乏在实验期间在米饭植物解释。就我们的知识而言，在巴西农业，这在植物营养上作为Si化肥和它的效果是nanosilica的使用上的第一份报告。这研究提供米饭植物吸收并且积累nanoparticles的证据；然而，进一步的研究被要求在另外的植物种类调查nanoparticles的使用。

简介：钾(K)在植物影响生理的过程的一个范围并且是控制庄稼生产率和收益质量的一个关键因素。很少信息都不有关切割花植物的功能上的K营养的效果是可得到的。现在的学习被执行调查在K和N营养之间的相互作用，在花数量和毛莨属asiaticusL的质量上。植物与Kfertigation的三个层次被供应(60，120，或180mgKL−；1)不到50mgNL−；1应用，并且在120mgKL−的中间的水平；1，到N应用的三个层次(50，100，或150mgNL−；1)。二最低K治疗和最低N治疗由于更低的发生在花生产为佼佼者倒下茎，在很快扩展花茎的纸巾与局部性的Ca缺乏联系的混乱。有害效果在180mgKL−的供应下面已经以收益质量是明显的；1和50mgNL−；1，并且没在渗透的潜在的、相对的水内容或植物织物的膜稳定性与变化被联系，或与在除在高N申请下面的减少的Ca以外的叶子的矿物质内容的变化。我们的结果建议R的一个低营养的要求。asiaticusL。为K和N，在在K和N的高集中的申请下面的减少的花质量的织物水关系的参与的缺乏，和茎由Ca的减少的可获得性在N和K的高申请下面倒下到花的膨胀织物的正式就职起源。

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简介：在日常生活，人们经常在某些时期重复常规线路。在这篇论文，一个采矿系统被开发经过旅行发现个人的连续线路模式。数个人动人的地位的差异的无异状，采矿系统采用记录的适应GPS数据，五个数据过滤保证clean使数据犯错。采矿系统使用客户机/服务器体系结构保护个人隐私并且减少计算负担。服务者进行主要采矿过程，但是与到recover的不够的信息，真实个人发送。改进顺序的模式采矿的可伸缩性的无异状，一个新奇模式采矿算法，连续线路模式采矿(CRPM)，被建议。这个算法能容忍在真实线路和摘录的不同骚乱经常的模式。基于九个人的旅行表演，那CRPM能更长多于twotimes提取的试验性的结果比传统的线路模式采矿算法发送模式。