AIM: To investigate the effect of intensive vs conventional insulin therapy on perioperative nutritional substrates metabolism in patients undergoing radical distal gastrectomy. METHODS: Within 24 h of intensive care ...AIM: To investigate the effect of intensive vs conventional insulin therapy on perioperative nutritional substrates metabolism in patients undergoing radical distal gastrectomy. METHODS: Within 24 h of intensive care unit management, patients with gastric cancer were enrolled after written informed consent and randomized to the intensive insulin therapy (IIT) group to keep glucose levels from 4.4 to 6.1 mmol/L or the conventional insulin therapy (CIT) group to keep levels less than 10 mmol/L. Resting energy expenditure (REE), respiratory quotient (RQ), resting energy expenditure per kilogram (REE/kg), and the lipid oxidation rate were monitored by the indirect calorimeter of calcium citrate malate nutrition metabolism investigation system. The changes in body composition were analyzed by multi-frequency bioimpedance analysis. Blood fasting glucose and insulin concentration were measured for assessment of Homeostasis model assessment of insulin resistance. RESULTS: Sixty patients were enrolled. Compared with preoperative baseline, postoperative REE increased by over 22.15% and 11.07%; REE/kg rose up to 27.22 ± 1.33 kcal/kg and 24.72 ± 1.43 kcal/kg; RQ decreased to 0.759 ± 0.034 and 0.791 ± 0.037; the lipid oxidation ratio was up to 78.25% ± 17.74% and 67.13% ± 12.76% supported by parenteral nutrition solutions from 37.56% ± 11.64% at the baseline; the level of Ln-HOMA-IR went up dramatically (P < 0.05, respectively) on postoperative days 1 and 3 in the IIT group. Meanwhile the concentration of total protein, albumin and triglyceride declined significantly on postoperative days 1 and 3 compared with pre-operative levels (P < 0.05, respectively). Compared with the CIT group, IIT reduced the REE/kg level (27.22 ± 1.33 kcal/kg vs 29.97 ± 1.47 kcal/kg, P = 0.008; 24.72 ± 1.43 kcal/kg vs 25.66 ± 1.63 kcal/kg, P = 0.013); and decreased the Ln-HOMA-IR score (P = 0.019, 0.028) on postoperative days 1 and 3; IIT decreased the level of CRP on postoperative days 1 and 3 (P = 0.017, 0.006); the total protein and albumin concentrations in the IIT group were greater than those in the CIT group (P = 0.023, 0.009). Postoperative values of internal cell fluid (ICF), fat mass, protein mass (PM), muscle mass, free fat mass and body weight decreased obviously on postoperative 7th day compared with the preoperative baseline in the CIT group (P < 0.05, respectively). IIT reduced markedly consumption of fat mass, PM and ICF compared with CIT (P = 0.009 to 0.026). CONCLUSION: There were some benefits of IIT in decreasing the perioperative insulin resistance state, reducing energy expenditure and consumption of proteins and lipids tissue in patients undergoing gastrectomy.展开更多
Background:Control of snail intermediate hosts has been proved to be a fast and efficient approach for interrupting the transmission of schistosomiasis.Some plant extracts have shown obvious molluscicidal activity,and...Background:Control of snail intermediate hosts has been proved to be a fast and efficient approach for interrupting the transmission of schistosomiasis.Some plant extracts have shown obvious molluscicidal activity,and a new compound Luo-Wei,also named tea-seed distilled saponin(TDS),was developed based on the saponins extracted from Camellia oleifera seeds.We aimed to test the molluscicidal activity of 4%TDS against the intermediate host snails in China and Egypt,and evaluate its environmental safety to non-target organisms.Methods:In the laboratory,Oncomelania hupensis,Biomphalaria alexandrina and Bulinus truncatus were exposed to 4%TDS,and the median lethal concentration(LC5o)was estimated at 24,48 and 72 h.In the field,snail mortalities were assessed 1,2,3 and 7 d post-immersion with 2.5 g/m34%TDS and 1,3,7 and 15 d post-spraying with 5 g/m24%TDS.in addition,the acute toxicity of 4%TDS to Japanese quail(Coturnixjaponica),zebrafish(Brachydanio rerio)and freshwater shrimp(Macrobrachium nipponense)was assessed by estimations of LC5o or median lethal dose(LD5o).Results:In the laboratory,the LC5o values of 4%TDS for O.hupensis were 0.701,0.371 and 0.33 mg/L at 24,48 and 72 h,respectively,and 4%TDS showed a 0.33 mg/L 24 h LC5o against B.alexandrina,and a 1.396 mg/L 24 h LCs0 against B.truncatus.Across all study regions,the pooled mortalities of O.hupensis were 72,86,94 and 98%at 1,2,3 and 7 d,following field immersion of 4%TDS at a dose of 2.5 g/m3,and were 69,77,85 and 88%at 1,3,7 and 15 d,following field spraying at 5 g/m2,respectively.4%TDS had moderate toxicity to Japanese quail(7 d LD5o>60 mg/kg)and to shrimp(96 h LCs0=6.28 mg/L;95%CI:3.53-11.2 mg/L),whereas its toxicity to zebrafish was high(96 h LCso--0.15 mg/L;95%CI:0.14-0.17 mg/L).Conclusions:4%TDS is active against O.hupensis,B.alexandrina and B.truncatus under laboratory and field conditions,and it may be a candidate molluscicide of plant origin.展开更多
基金Supported by The Health Science and Technology Development Project of Shandong, No. 2005HZ024
文摘AIM: To investigate the effect of intensive vs conventional insulin therapy on perioperative nutritional substrates metabolism in patients undergoing radical distal gastrectomy. METHODS: Within 24 h of intensive care unit management, patients with gastric cancer were enrolled after written informed consent and randomized to the intensive insulin therapy (IIT) group to keep glucose levels from 4.4 to 6.1 mmol/L or the conventional insulin therapy (CIT) group to keep levels less than 10 mmol/L. Resting energy expenditure (REE), respiratory quotient (RQ), resting energy expenditure per kilogram (REE/kg), and the lipid oxidation rate were monitored by the indirect calorimeter of calcium citrate malate nutrition metabolism investigation system. The changes in body composition were analyzed by multi-frequency bioimpedance analysis. Blood fasting glucose and insulin concentration were measured for assessment of Homeostasis model assessment of insulin resistance. RESULTS: Sixty patients were enrolled. Compared with preoperative baseline, postoperative REE increased by over 22.15% and 11.07%; REE/kg rose up to 27.22 ± 1.33 kcal/kg and 24.72 ± 1.43 kcal/kg; RQ decreased to 0.759 ± 0.034 and 0.791 ± 0.037; the lipid oxidation ratio was up to 78.25% ± 17.74% and 67.13% ± 12.76% supported by parenteral nutrition solutions from 37.56% ± 11.64% at the baseline; the level of Ln-HOMA-IR went up dramatically (P < 0.05, respectively) on postoperative days 1 and 3 in the IIT group. Meanwhile the concentration of total protein, albumin and triglyceride declined significantly on postoperative days 1 and 3 compared with pre-operative levels (P < 0.05, respectively). Compared with the CIT group, IIT reduced the REE/kg level (27.22 ± 1.33 kcal/kg vs 29.97 ± 1.47 kcal/kg, P = 0.008; 24.72 ± 1.43 kcal/kg vs 25.66 ± 1.63 kcal/kg, P = 0.013); and decreased the Ln-HOMA-IR score (P = 0.019, 0.028) on postoperative days 1 and 3; IIT decreased the level of CRP on postoperative days 1 and 3 (P = 0.017, 0.006); the total protein and albumin concentrations in the IIT group were greater than those in the CIT group (P = 0.023, 0.009). Postoperative values of internal cell fluid (ICF), fat mass, protein mass (PM), muscle mass, free fat mass and body weight decreased obviously on postoperative 7th day compared with the preoperative baseline in the CIT group (P < 0.05, respectively). IIT reduced markedly consumption of fat mass, PM and ICF compared with CIT (P = 0.009 to 0.026). CONCLUSION: There were some benefits of IIT in decreasing the perioperative insulin resistance state, reducing energy expenditure and consumption of proteins and lipids tissue in patients undergoing gastrectomy.
基金the National Science and Technology Pillar Program(grant No.2009BAI78B07 and 2009BAI78B04)National S&T Major Program(grant No.2012ZX10004-220)+3 种基金Shanghai Science and Technology Committee(grant No.11XD1405400)Jjiangsu Provincial Health and Family Planning Commission(grant No.QNRC2016621 and H2018097)Wuxi Municipal Bureau of Science and Technology(grant No.CSE31N1730)Bill&Melinda Gates Foundation.
文摘Background:Control of snail intermediate hosts has been proved to be a fast and efficient approach for interrupting the transmission of schistosomiasis.Some plant extracts have shown obvious molluscicidal activity,and a new compound Luo-Wei,also named tea-seed distilled saponin(TDS),was developed based on the saponins extracted from Camellia oleifera seeds.We aimed to test the molluscicidal activity of 4%TDS against the intermediate host snails in China and Egypt,and evaluate its environmental safety to non-target organisms.Methods:In the laboratory,Oncomelania hupensis,Biomphalaria alexandrina and Bulinus truncatus were exposed to 4%TDS,and the median lethal concentration(LC5o)was estimated at 24,48 and 72 h.In the field,snail mortalities were assessed 1,2,3 and 7 d post-immersion with 2.5 g/m34%TDS and 1,3,7 and 15 d post-spraying with 5 g/m24%TDS.in addition,the acute toxicity of 4%TDS to Japanese quail(Coturnixjaponica),zebrafish(Brachydanio rerio)and freshwater shrimp(Macrobrachium nipponense)was assessed by estimations of LC5o or median lethal dose(LD5o).Results:In the laboratory,the LC5o values of 4%TDS for O.hupensis were 0.701,0.371 and 0.33 mg/L at 24,48 and 72 h,respectively,and 4%TDS showed a 0.33 mg/L 24 h LC5o against B.alexandrina,and a 1.396 mg/L 24 h LCs0 against B.truncatus.Across all study regions,the pooled mortalities of O.hupensis were 72,86,94 and 98%at 1,2,3 and 7 d,following field immersion of 4%TDS at a dose of 2.5 g/m3,and were 69,77,85 and 88%at 1,3,7 and 15 d,following field spraying at 5 g/m2,respectively.4%TDS had moderate toxicity to Japanese quail(7 d LD5o>60 mg/kg)and to shrimp(96 h LCs0=6.28 mg/L;95%CI:3.53-11.2 mg/L),whereas its toxicity to zebrafish was high(96 h LCso--0.15 mg/L;95%CI:0.14-0.17 mg/L).Conclusions:4%TDS is active against O.hupensis,B.alexandrina and B.truncatus under laboratory and field conditions,and it may be a candidate molluscicide of plant origin.
