早期康复护理对肠内营养治疗的高血压颅内出血 患者预后的影响

目的：研究早期康复护理对肠内营养治疗的高血压颅内出血患者预后的影响。方法：选取2010 年1 月~2012 年10 月间入 院诊治的高血压颅内出血并应用肠内营养支持治疗的患者120 例,随机分为实验组（60 例）和对照组（60 例）。对照组应用常规护 理办法,实验组在其基础上应用早期康复护理,随访1 年后观察两组患者预后的生活质量情况、GCS（格拉斯哥昏迷指数）评分以 及并发症的发生情况。结果：随访1 年后,实验组的生活质量显著高于对照组（P<0.05）;护理干预前两组患者的GCS 评分无差异, 护理干预后实验组的GCS 评分显著高于对照组（P<0.05）;实验组在肺部感染、下肢静脉血栓、肩手综合征等并发症的发生例数均 显著低于对照组（P<0.05）。结论：针对肠内营养支持治疗的高血压颅内出血患者应用早期康复护理可有效改善患者的昏迷程度、 预防并发症,有助于提高患者的生活质量。     

Maternal and fetal nutrition in south India.

The relation between the nutrition of the mother and that of her baby was assessed in a south Indian community where malnutrition is common and women do not smoke. Unselected mothers and their infants of over 37 weeks'' gestation were studied in two groups: those who paid for their care (150) and a poorer group who did not (172). There were significnat differences between the paying and non-paying groups in maternal triceps skinfold thickness, infant weight, and infant length. Overall there was a significant positive correlation between maternal triceps thickness and infant weight, length, and triceps and subscapular skinfold thickness. The correlation with the infant head circumference was less significant. These findings are further evidence that the nutrition of the mother has an important effect on the nutrition of her baby and that malnutrition is an important reason why Indian babies are lighter than European ones.     

流程管理配合肠内营养对大肠癌手术患者的临床效果

目的:探讨流程管理的护理模式对大肠癌患者术后早期空肠营养的作用,为临床护理提供可借鉴的方法。方法:选择2010年3月-2013年12月在我院接受手术治疗的大肠癌患者93例,随机分为研究组和对照组。其中,研究组51例患者采取流程管理的模式进行空肠营养护理,而对照组42例患者采用基础护理模式。观察并比较两组患者的临床效果及对护理服务的满意度。结果:实施护理干预配合肠内营养支持治疗后,两组患者的营养状况与之前比较均获得明显改善(P0.05);研究组患者的平均住院时间、肠道功能恢复时间、血淀粉酶及尿淀粉酶等各项指标恢复情况均显著优于对照组,差异具有统计学意义(P0.05)。对照组患者对护理服务的满意度为85.71%,研究组患者对护理服务的满意度为100.00%,两组比较差异显著具有统计学意义(P0.05)。结论:流程管理护理配合早期肠内营养能够改善患者术后的营养状况,提高机体免疫功能,而且有利于提高患者对护理服务的满意度,值得推广。     

Profiling of fatty acid methyl esters from the oleaginous diatom Fistulifera sp. strain JPCC DA0580 under nutrition-sufficient and -deficient conditions

The marine oleaginous diatom, Fistulifera sp. strain JPCC DA0580, is a promising candidate for biodiesel production due to its high lipid content. In order to truly evaluate the potential of this strain as biodiesel feedstock as well as the impact of nutrition-deficiency to this strain, the proportion of the lipid fractions and fatty acid methyl ester (FAME) derived from Fistulifera sp. cultured under nutrition-sufficient or -deficient conditions were analyzed. The nutrition deficiency led to the increase of the total lipid content in the form of neutral lipids (NLs) accumulation and the decline of polar lipids compared with nutrition-sufficiency. Meanwhile, the total lipid productivity was not significantly changed under two nutrition conditions while the NL productivity under nutrition-deficient condition was much higher than nutrition-sufficient condition. The major FAME components, C14:0, C16:0, C16:1, and C20:5, contribute to over 90 % of total FAMEs under both nutrition conditions. A lower polyunsaturated FAME level were observed in the nutrition-deficient condition (9.9?±?0.2 %) compared with the nutrition-sufficient condition (19.8?±?1.2 %), suggesting the availability of the nutrition stress on the strain JPCC DA0580 for improvement of fuel quality as well as productivity. The lipid quality estimation based on the FAME profile revealed that the nutrition-deficiency could further improve the lipid quality of both total lipids and NL fraction. In addition, direct infusion ESI-Q-TRAP-MS/MS was carried out for the fractionated NL in order to estimate triacylglycerol (TAG) composition, suggesting a crucial role of the chloroplast in TAG synthesis.     

Caribou (<Emphasis Type="Italic">Rangifer tarandus</Emphasis>) and Inuit Nutrition Security in Canada

Caribou (Rangifer tarandus) has been fundamental to the diet and culture of Arctic Indigenous Peoples for thousands of years. Although caribou populations observe natural cycles of abundance and scarcity, several caribou herds across the Circumpolar North have experienced dramatic declines in recent decades due to a range of interrelated factors. Broadly, the objectives of this study are to examine food and nutrition security in relation to wildlife population and management status across Inuit Nunangat (the Inuit homeland, consisting of four regions across the Canadian Arctic). Specifically, we: (1) characterize the contribution of caribou to Inuit nutrition across northern Canada and (2) evaluate the population and management status of caribou herds/populations harvested by Inuit. Dietary data were derived from the 2007–2008 Inuit Health Survey, which included dietary information for Inuit adults (n?=?2097) residing in thirty-six communities, spanning three regions (the Inuvialuit Settlement Region, Nunavut, and Nunatsiavut) of the Canadian North. Published information regarding the range, abundance, status, and management status of caribou herds/populations was collected through document analysis and was validated through consultation with northern wildlife experts (territorial governments, co-management, and/or Inuit organizations). While caribou contributed modestly to total diet energy (3–11% of intake) across the regions, it was the primary source of iron (14–37%), zinc (18–41%), copper (12–39%), riboflavin (15–39%), and vitamin B12 (27–52%), as well as a top source of protein (13–35%). Restrictions on Inuit subsistence harvest (harvest quotas or bans) are currently enacted on at least six northern caribou herds/populations with potential consequences for country food access for over twenty-five Inuit communities across Canada. A holistic multi-sectorial approach is needed to ensure the sustainability of wildlife populations, while supporting Inuit food and nutrition security in the interim.     

An Assessment of Nutrition Education in Endocrinology Fellowship Programs in the United States

ObjectiveCounseling patients about nutrition significantly improves chronic disease outcomes. Endocrinologists are uniquely positioned to educate patients regarding nutrition. The purpose of this study was to define the current state of nutrition education in endocrinology fellowship programs in the United States and assess the needs for future nutrition training.MethodsEndocrinology program directors were surveyed via an online questionnaire between February and April 2021.ResultsThirty-eight program directors responded (25% response rate) to the survey. Twenty-two (58%) programs offered nutrition education. Existing nutrition education offerings were 1 to 5 total hours (13, 34%), primarily didactic (20, 53%), and often led by registered dietitian nutritionists (15, 39%). Only 3 (8%) programs rated their current nutrition education as extremely effective; 95% of respondents believed that further nutrition education was needed. According to respondents, the ideal nutrition education for endocrine trainees should be 1 to 5 total hours (19, 50%) over multiple sessions (25, 66%), be interactive (24, 63%), and be led by registered dietitian nutritionists (26, 68%). The most important topics for independent practice included diet-related behavior modification (21, 55%), components of a healthful diet (19, 50%), and energy expenditure/intake (18, 47%).ConclusionAlthough the majority of the program directors believe that further nutrition education is needed, almost half of the surveyed programs do not offer such training. Programs that offer nutrition education primarily rely on a didactic format. There is an unmet need for interactive, multidisciplinary nutrition education in these programs.     

Cultural Identity and Internationally Adopted Children: Qualitative Approach to Parental Representations

Approximately 30 000 children are adopted across national borders each year. A review of the literature on the cultural belonging of these internationally adopted children shows substantial differences between the literature from English-speaking countries and that from France and Europe in general. The objective of this study is to start from the discourse of French adoptive parents to explore their representations of their child''s cultural belonging and their positions (their thoughts and representations) concerning connections with the child''s country of birth and its culture. The study includes 51 French parents who adopted one or more children internationally. Each parent participated in a semi-structured interview, focused on the adoption procedure and their current associations with the child''s birth country. The interviews were analyzed according to a qualitative phenomenological method, Interpretative Phenomenological Analysis. The principal themes that emerged from our analysis of the interviews made it possible to classify the parents into three different groups. The first group maintained no association with the child''s country of birth and refused any multiplicity of cultural identities. The second group actively maintained regular associations with the child''s country of birth and culture and affirmed that their family was multicultural. Finally, the third group adapted their associations with the child''s birth country and its culture according to the child''s questions and interests. Exploring parental representations of the adopted child enables professionals involved in adoption to provide better support to these families and to do preventive work at the level of family interactions.     

Intra‐ and trans‐generational effects of larval diet on susceptibility to an entomopathogenic fungus,Beauveria bassiana,in the greater wax moth,Galleria mellonella

In addition to nutritional conditions experienced by individuals themselves, those experienced by their parents can affect their immune function. Here, we studied the intra‐ and trans‐generational effects of larval diet on susceptibility to an entomopathogenic fungus, Beauveria bassiana, in the greater wax moth, Galleria mellonella. In the first part of the study, a split‐brood design was used to compare the susceptibility of full sibs raised either on low‐ or on high‐nutrition larval diet. In the second part of the study, a similar experimental design was employed to investigate the effects of maternal and paternal diet as well as their interaction on offspring's susceptibility. In the first part of the study, we found that individuals fed with high‐nutrition diet had higher mortality from infection than individuals fed with low‐nutrition diet. However, diet did not affect post‐infection survival time. Conversely, in the second part of the study, maternal diet was found to have no significant effect on final mortality rate of offspring, but it affected survival time: larvae with high‐nutrition maternal diet survived fewer days after infection than larvae with low‐nutrition maternal diet. Paternal diet had no significant effect on offspring's susceptibility to the fungus, indicating that paternal effects are not as important as maternal effects in influencing immune function in this species. Our findings provide further indication that maternal nutrition affects immune function in insects, and suggest that the direct effects of nutrition on immunity may be different, yet parallel, to those caused by parental nutrition.     

营养干预对局部晚期鼻咽癌患者放化疗期体质量及营养状态的影响

目的:探讨营养干预对局部晚期鼻咽癌患者在放化疗期间的营养状态及体质量的影响。方法:选取我院2015年1月-2019年12月收治的112例鼻咽癌晚期患者,按随机数表法分成营养干预组和对照组各56例,均采用同一放化疗治疗方案,观察组在此基础上给予营养干预。对比两组患者在放化疗治疗期间的生活质量(QOL)评分、营养状态、黏膜损害程度、体质量变化和近期疗效。结果:放射剂量达40Gy时,营养干预组QOL评分≥41分的比例显著高于对照组(P0.05);放疗结束后营养干预组发生Ⅲ级以上的口腔黏膜损害的患者比例显著低于对照组(P0.05);放化疗第4周营养干预组的体质量显著高于对照组(P0.05);放化疗治疗结束后两组原发灶残余比例和淋巴结转移比例比较均无统计学差异(P0.05);放化疗第4、7周营养干预组的血红蛋白(Hb)、总蛋白(TP)和白蛋白(Alb)显著高于对照组(P0.05)。结论:鼻咽癌患者在放化疗期间,营养状况下降明显,营养干预治疗能够有效改善患者的体质量和营养状况,对于患者的后续治疗具有重要意义,应在晚期鼻咽癌的临床治疗中推广营养干预。     

Brief Parenteral Nutrition Accelerates Weight Gain,Head Growth Even in Healthy VLBWs

IntroductionWhether parenteral nutrition benefits growth of very low birth weight (VLBW) preterm infants in the setting of rapid enteral feeding advancement is unclear. Our aim was to examine this issue using data from Japan, where enteral feeding typically advances at a rapid rate.MethodsWe studied 4005 hospitalized VLBW, very preterm (23–32 weeks'' gestation) infants who reached full enteral feeding (100 ml/kg/day) by day 14, from 75 institutions in the Neonatal Research Network Japan (2003–2007). Main outcomes were weight gain, head growth, and extra-uterine growth restriction (EUGR, measurement <10^th percentile for postmenstrual age) at discharge.Results40% of infants received parenteral nutrition. Adjusting for maternal, infant, and institutional characteristics, infants who received parenteral nutrition had greater weight gain [0.09 standard deviation (SD), 95% CI: 0.02, 0.16] and head growth (0.16 SD, 95% CI: 0.05, 0.28); lower odds of EUGR by head circumference (OR 0.66, 95% CI: 0.49, 0.88). No statistically significant difference was seen in the proportion of infants with EUGR at discharge. SGA infants and infants who took more than a week until full feeding had larger estimates.DiscussionEven in infants who are able to establish enteral nutrition within 2 weeks, deprivation of parenteral nutrition in the first weeks of life could lead to under nutrition, but infants who reached full feeding within one week benefit least. It is important to predict which infants are likely or not likely to advance on enteral feedings within a week and balance enteral and parenteral nutrition for these infants.     

Successful pregnancy in patient on regular dialysis.

A pregnancy in a patient undergoing regular dialysis treatment was successfully managed. Premature labour occurred at 32 weeks. Fetal nutrition was satisfactory and the infant developed normally and showed no congenital abnormality during 12 months'' observation.     

Pre- and Postnatal Nutritional Histories Influence Reproductive Maturation and Ovarian Function in the Rat

Background

While prepubertal nutritional influences appear to play a role in sexual maturation, there is a need to clarify the potential contributions of maternal and childhood influences in setting the tempo of reproductive maturation. In the present study we employed an established model of nutritional programming to evaluate the relative influences of prenatal and postnatal nutrition on growth and ovarian function in female offspring.

Methods

Pregnant Wistar rats were fed either a calorie-restricted diet, a high fat diet, or a control diet during pregnancy and/or lactation. Offspring then were fed either a control or a high fat diet from the time of weaning to adulthood. Pubertal age was monitored and blood samples collected in adulthood for endocrine analyses.

Results

We report that in the female rat, pubertal timing and subsequent ovarian function is influenced by the animal''s nutritional status in utero, with both maternal caloric restriction and maternal high fat nutrition resulting in early pubertal onset. Depending on the offspring''s nutritional history during the prenatal and lactational periods, subsequent nutrition and body weight gain did not further influence offspring reproductive tempo, which was dominated by the effect of prenatal nutrition. Whereas maternal calorie restriction leads to early pubertal onset, it also leads to a reduction in adult progesterone levels later in life. In contrast, we found that maternal high fat feeding which also induces early maturation in offspring was associated with elevated progesterone concentrations.

Conclusions

These observations are suggestive of two distinct developmental pathways leading to the acceleration of pubertal timing but with different consequences for ovarian function. We suggest different adaptive explanations for these pathways and for their relationship to altered metabolic homeostasis.     

Differentials in fertility among black doctorates

Abstract

The 1978 Contraceptive Prevalence Survey for Guatemala provides an opportunity to examine fertility levels and a number of determinants of fertility for three broad segments of the country: the Department of Guatemala and, in the remainder of the country, the Ladino and Indian populations. While Ladinos had a much higher rate of contraceptive use than did Indians, the two groups had similar birth rates. The lack of difference in fertility appears to be due to the pattern of prolonged breastfeeding among Indians and perhaps to differences in the rate of conception due to nutrition, coital frequency, or other factors.     

Comparaison de la réponse métabolique du petit prématuré alimenté parentéralement,puis au lait maternel de prématurité.

The nitrogen retention and plasma amino acid concentration were determined in eight preterm infants (mean birth weight 970 +/- 130 g; mean gestational age 28 +/- 1 weeks) receiving successively total parenteral nutrition and their own mother''s milk. The nitrogen retention during both regimens was comparable to the fetal accretion rate. Plasma amino acid concentrations were lower during the enteral phase of the study than during parenteral nutrition. The metabolic response of small preterm infants is related to the quality of amino acids as well as to the route of intake.     

Haem iron intake in 12-36 month old children depleted in iron: case-control study.

OBJECTIVE: To compare the intakes of haem and non-haem iron in iron depleted and iron replete children. DESIGN: Case-control study. SETTING: Early Childhood Centres and a long day care centre in Sydney, Australia. SUBJECTS: Children aged 12-36 months depleted in iron and controls matched for age and sex. MEAN OUTCOME MEASURES: Iron status by using plasma ferritin concentration. A three day weighed dietary intake record completed by the parents. Risk factors for iron deficiency assessed by questionnaire. RESULTS: Fifty six iron depleted and 68 iron replete children participated. The average daily intake of haem iron was significantly lower in the iron depleted group (t = 2.392, P = 0.018); there was a tendency towards a lower average daily intake of non-haem iron (t = 1.724, P = 0.086) and vitamin C (t = 1.921, P = 0.057) for iron depleted children. Low intake of haem iron (< 0.71 mg/day) was significantly associated with iron depletion with an odds ratio fo 3.0 (P = 0.005). The proportion of iron depleted children who were given whole cows'' milk before 12 months of age was almost double that of iron replete children; multivariate analysis showed that both haem iron intake and age of introduction of cows'' milk were independently associated with iron depletion. CONCLUSIONS: The results of this study show that, in young children in developed countries, a lower haem iron intake is a major risk factor for iron depletion; the introduction of whole cows'' milk before 12 months is further confirmed as a risk factor. Parental education on nutrition should now focus on these two aspects of nutrition for infants and young children.     

Long-term parenteral nutrition

Nineteen patients (11 women and eight men) aged 20-68 received long-term parenteral nutrition, mostly at home, for six to 63 months (mean 19 months). Indications for LTPN were extensive, active Crohn''s disease in three patients, intestinocutaneous fistulas in three, and short-bowel syndrome in the remaining 13 patients. Subclavian or intra-atrial (Broviac) catheters were most commonly used, for which the average life was four and seven months respectively. Complications of long-term parenteral nutrition included pneumothorax in four out of 48 subclavian vein punctures. Catheter-induced thrombosis of central veins was shown by phlebography 17 times in nine patients, and eight episodes of total occlusion occurred. Two of these patients had pulmonary infarction. Nineteen episodes of catheter sepsis occurred in 11 patients, but only one was fatal. Complications related to intestinal disease included intra-abdominal abscesses and intestinal fistulas, and disturbances of liver function. Five patients died, though in only two was death related to long-term parenteral nutrition. One of these patients died from catheter sepsis, the other had subdural haematoma possibly caused by anticoagulant treatment. Eight of the 14 surviving patients still needed parenteral nutrition. All received a disability pension, but six had an acceptable quality of life with almost normal social activities.Despite problems such as difficulties in maintaining standardised infusion programmes, it was concluded that long-term parenteral nutrition at home is practicable and consistent with an acceptable quality of life.     

犬营养代谢病

宠物指人们精心饲养,以供玩赏愉悦的宠爱动物。目前犬类在我国宠物市场发展较为迅速,而且历史非常悠久,其他宠物的饲养规模、普及程度与犬类还相距较远。对国内犬临床疾病情况研究发现,近年来犬营养代谢性疾病发生率逐年升高,广大宠物医师对于此类疾病的关注程度日益加大。本文主要从犬营养代谢病的发病原因、临床较为先进的诊断方法、后期治疗饲养,三个方面进行对犬营养代谢病进行探讨,希望对于宠物市场在我国的发展、临床治疗此类疾病和宠物营养的科学搭配提供指导和帮助。     

Maternal short stature does not predict their children's fatness indicators in a nutritional dual‐burden sample of urban Mexican Maya

The co‐existence of very short stature due to poor chronic environment in early life and obesity is becoming a public health concern in rapidly transitioning populations with high levels of poverty. Individuals who have very short stature seem to be at an increased risk of obesity in times of relative caloric abundance. Increasing evidence shows that an individual is influenced by exposures in previous generations. This study assesses whether maternal poor early life environment predicts her child's adiposity using cross sectional design on Maya schoolchildren aged 7–9 and their mothers (n = 57 pairs). We compared maternal chronic early life environment (stature) with her child's adiposity (body mass index [BMI] z‐score, waist circumference z‐score, and percentage body fat) using multiple linear regression, controlling for the child's own environmental exposures (household sanitation and maternal parity). The research was performed in the south of Merida, Yucatan, Mexico, a low socioeconomic urban area in an upper middle income country. The Maya mothers were very short, with a mean stature of 147 cm. The children had fairly high adiposity levels, with BMI and waist circumference z‐scores above the reference median. Maternal stature did not significantly predict any child adiposity indicator. There does not appear to be an intergenerational component of maternal early life chronic under‐nutrition on her child's obesity risk within this free living population living in poverty. These results suggest that the co‐existence of very short stature and obesity appears to be primarily due to exposures and experiences within a generation rather than across generations. Am J Phys Anthropol 153:627–634, 2014. © 2013 Wiley Periodicals, Inc.     

A Festschrift for Roland L. Weinsier: Nutrition Scientist,Educator, and Clinician1

Roland L. Weinsier, M.D., Dr.P.H., devoted himself to the fields of nutrition and obesity for more than 35 years. He contributed outstanding work related to the treatment of obesity through dietary and lifestyle change; metabolic/energetic influences on obesity, weight loss, and weight regain; body composition changes accompanying weight loss and regain; the health benefits and risks of weight loss; nutrition education for physicians; and nutrition support of sick patients. He served on the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) National Task Force on Prevention and Treatment of Obesity, as Chair of the University of Alabama at Birmingham's Department of Nutrition Sciences, and as Founder and Director of its NIDDK‐funded Clinical Nutrition Research Center. He was a long‐time and active member of NAASO, serving in the roles of Councilor, Publications Committee Chair, Continuing Medical Education Course Director, Public Relations Committee Chair, and Membership Committee Co‐Chair, to name just a few. He was well respected as a staunch defender of NAASO's scientific integrity in these roles. Sadly, Roland Weinsier died on November 27, 2002. He will be missed and remembered by many as a revered and beloved teacher, mentor, healer, and scholar.     

肠内营养在直肠癌术后急性放射性肠炎中的临床应用研究

目的:研究肠内营养在直肠癌术后急性放射性肠炎中的临床应用。方法:选择2012年7月~2013年7月在我院接受治疗的104例直肠癌手术后发生急性放射性肠炎的患者作为研究对象。依照数字法随机分成观察组(51例)和对照组(53例)。对照组予以(半)流质食物,观察组则予以能全力肠内营养支持治疗。分别在治疗前以及治疗后7d测定血生化、营养以及电解质指标。结果:经7d治疗后,观察组的前白蛋白(PA)、白蛋白(Alb)、视黄醇结合蛋白(RBP)及体重(BW)水平均显著高于治疗前以及对照组,C反应蛋白(CRP)显著低于对照组,差异均有统计学意义(均P0.05);但两组治疗后的总蛋白(TP)水平差异无统计学意义(P0.05);两组治疗前后的谷丙转氨酶(ALT)、血清碱性磷酸酶(AKP)、凝血酶原时间(PT)、胆红素(BIL)、尿素氮(BUN)、肌酐(Cr)及血糖(Glu)等血生化指标以及钾离子(K+)、钠离子(Na+)、氯离子(Cl-)、钙离子(Ca2+)等电解质指标的差异均无统计学意义(均P0.05)。结论:通过肠内营养治疗直肠癌手术后发生的放射性肠炎,可改善患者的营养状况,效果显著,值得推广。