Fatty liver in dairy cows, which is associated with decreased metabolic function of the liver, develops during times of elevated non-esterified fatty acid （NEFA） concentrations in the blood when the hepatic uptake o...Fatty liver in dairy cows, which is associated with decreased metabolic function of the liver, develops during times of elevated non-esterified fatty acid （NEFA） concentrations in the blood when the hepatic uptake of lipids exceeds the oxidation and secretion of lipids by the liver and then it will cause hepatic accumulation of triglyceride （TG）. The condition is often related to decreased health status, well-being, productivity, and reproductive performance of cows. Prevention of fatty liver in the transition period is always better than any treatments. The nutritional preventative strategies mainly focus either on decreasing the supply of NEFA to liver, and it aims to improve liver function or optimize the capacity then to dispose of NEFA by exporting them as triglycerides in lipoproteins （VLDL）. Good dry cow nutritional programs, combined with excellent feeding management to achieve high levels of dry matter intake throughout the transition period should be the first priority for management. Several different compounds can promote these metabolic actions. The addition of glucose precursors such as glycerol, propyelene glycol, or propionate salts to the feed in the transition diet can modify metabolism in a manner to decrease fatty acid mobilization from adipose tissue and reduce the likelihood of liver TG accumulation. Supplying some other specific nutrients to dairy cows during the transition period may increase rates of NEFA disposal, with resulting effects on performance, though the hepatic capacities for export as triglycerides within VLDL are relatively limited in ruminants. Further studies examining nutritional and management strategies are required to develop new preventive or treatment options that are more practical to reduce the occurrence of fatty liver and its adverse metabolic effects.展开更多
Summary:It has been identified that malnutrition can influence the immune system and time of engraftment,and it's also associated with increased incidence of complications,prolonged length of hospital stays,and tr...Summary:It has been identified that malnutrition can influence the immune system and time of engraftment,and it's also associated with increased incidence of complications,prolonged length of hospital stays,and transplant mortality and morbidity in patients undergoing hematopoietic stem cell transplantation(HSCT),so dynamic nutrition care is highly important.The aim of this study was to better understand the differences between clinical nutrition practices and international recommendations as well as possible barriers to the use of nutrition support in HSCT patients.An evidence-based nutrition support pathway was constructed through a systematic literature review to identify evidence and recommendations relating to the relevant issues.Then,a questionnaire consisting of 28 questions that focused on the 4 topics,namely,assessment and screening for malnutrition,nutrition support interventions,nutrition support in gastrointestinal graft-ver5U5・host disease(GVHD)and neutropenic diet was developed by the study authors and used for data collection.Responses of 18 HSCT centers from 17 provinces were received.General assessment for malnutrition was performed at 72%(13/18)centers.Parenteral nutrition(PN)was given as the first option to HSCT patients in the majority of centers,despite the fact that current guidelines recommend enteral nutrition(EN)over PN.As many as 72%(13/18)of the centers considered a neutropenic diet in the management of HSCT patients,but only one center had a formal neutropenic diet protocol in place for transplant recipients.Criteria for initiating nutrition support in patients with gastrointestinal GVHD were heterogeneous among the centers,and PN was the most widely used technique.The survey results revealed significant heterogeneity with regard to nutrition support practices among the centers,as well as between the practices and the guidelines.Standard nutrition support guidelines or protocols for nutrition support practices were absent in most of the centers.展开更多
基金Supported by National Natural Science Funds (30300259)
文摘Fatty liver in dairy cows, which is associated with decreased metabolic function of the liver, develops during times of elevated non-esterified fatty acid （NEFA） concentrations in the blood when the hepatic uptake of lipids exceeds the oxidation and secretion of lipids by the liver and then it will cause hepatic accumulation of triglyceride （TG）. The condition is often related to decreased health status, well-being, productivity, and reproductive performance of cows. Prevention of fatty liver in the transition period is always better than any treatments. The nutritional preventative strategies mainly focus either on decreasing the supply of NEFA to liver, and it aims to improve liver function or optimize the capacity then to dispose of NEFA by exporting them as triglycerides in lipoproteins （VLDL）. Good dry cow nutritional programs, combined with excellent feeding management to achieve high levels of dry matter intake throughout the transition period should be the first priority for management. Several different compounds can promote these metabolic actions. The addition of glucose precursors such as glycerol, propyelene glycol, or propionate salts to the feed in the transition diet can modify metabolism in a manner to decrease fatty acid mobilization from adipose tissue and reduce the likelihood of liver TG accumulation. Supplying some other specific nutrients to dairy cows during the transition period may increase rates of NEFA disposal, with resulting effects on performance, though the hepatic capacities for export as triglycerides within VLDL are relatively limited in ruminants. Further studies examining nutritional and management strategies are required to develop new preventive or treatment options that are more practical to reduce the occurrence of fatty liver and its adverse metabolic effects.
文摘Summary:It has been identified that malnutrition can influence the immune system and time of engraftment,and it's also associated with increased incidence of complications,prolonged length of hospital stays,and transplant mortality and morbidity in patients undergoing hematopoietic stem cell transplantation(HSCT),so dynamic nutrition care is highly important.The aim of this study was to better understand the differences between clinical nutrition practices and international recommendations as well as possible barriers to the use of nutrition support in HSCT patients.An evidence-based nutrition support pathway was constructed through a systematic literature review to identify evidence and recommendations relating to the relevant issues.Then,a questionnaire consisting of 28 questions that focused on the 4 topics,namely,assessment and screening for malnutrition,nutrition support interventions,nutrition support in gastrointestinal graft-ver5U5・host disease(GVHD)and neutropenic diet was developed by the study authors and used for data collection.Responses of 18 HSCT centers from 17 provinces were received.General assessment for malnutrition was performed at 72%(13/18)centers.Parenteral nutrition(PN)was given as the first option to HSCT patients in the majority of centers,despite the fact that current guidelines recommend enteral nutrition(EN)over PN.As many as 72%(13/18)of the centers considered a neutropenic diet in the management of HSCT patients,but only one center had a formal neutropenic diet protocol in place for transplant recipients.Criteria for initiating nutrition support in patients with gastrointestinal GVHD were heterogeneous among the centers,and PN was the most widely used technique.The survey results revealed significant heterogeneity with regard to nutrition support practices among the centers,as well as between the practices and the guidelines.Standard nutrition support guidelines or protocols for nutrition support practices were absent in most of the centers.
