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1 Asia Pacific Journal of Clinical Nutrition
       Volume 23, 3

         (September 2014)


Abstracts

Contents

Abstract PDF

Mini Review

Childhood obesity in Asia: the value of accurate body
composition methodology

ANDREW P HILLS, NAJAT MOKHTAR, SHARON BROWNIE AND NUALA M BYRNE
Asia Pac J Clin Nutr. 2014;23(3):339-343.

doi: 10.6133/apjcn.2014.23.3.07

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Reviews

Exclusive breastfeeding for six months: the WHO six months recommendation in the Asia Pacific Region
COLIN WILLIAM BINNS AND MI KYUNG LEE
Asia Pac J Clin Nutr. 2014;23(3):344-350.

doi: 10.6133/apjcn.2014.23.3.21

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Effect of L-arginine on immune function: a meta-analysis
KAI KANG, XIAO-LIANG SHU, JING-XIA ZHONG, TING-TING YU AND TAO LEI
Asia Pac J Clin Nutr. 2014;23(3):351-359.

doi: 10.6133/apjcn.2014.23.3.09

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The influence of Mediterranean, carbohydrate and high protein diets on gut microbiota composition in the treatment of obesity and associated inflammatory state
PATRICIA LOPEZ-LEGARREA, NICHOLAS ROBERT FULLER, MARÍA ANGELES ZULET, JOSE ALFREDO MARTINEZ AND IAN DOUGLAS CATERSON
Asia Pac J Clin Nutr. 2014;23(3):360-368.

doi: 10.6133/apjcn.2014.23.3.16

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Effectiveness of traditional Malaysian vegetables (ulam) in modulating blood glucose levels
MOHD FAEZ BACHOK, BARAKATUN-NISAK MOHD YUSOF, AMIN ISMAIL AND AZIZAH ABDUL HAMID
Asia Pac J Clin Nutr. 2014;23(3):369-376.

doi: 10.6133/apjcn.2014.23.3.01

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BRAC’s experience in scaling-up MNP in Bangladesh
KAOSAR AFSANA, MOHAMMAD RAISUL HAQUE, SHAFINAZ SOBHAN AND SHAIMA ARJUMAN SHAHIN
Asia Pac J Clin Nutr. 2014;23(3):377-384.

doi: 10.6133/apjcn.2014.23.3.22

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Original Research Communications

Nutritional Measurement & Methodology

Migrant Asian Indians in New Zealand; prediction of metabolic syndrome using body weights and measures
LJILJANA M JOWITT, LOUISE WEIWEI LU AND ELAINE C RUSH
Asia Pac J Clin Nutr. 2014;23(3):385-393.

doi: 10.6133/apjcn.2014.23.3.06

 

 

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Performance of nutritional screening tools in predicting poor six-month outcome in hospitalised older patients
ELSA DENT, IAN M CHAPMAN, CYNTHIA PIANTADOSI AND RENUKA VISVANATHAN
Asia Pac J Clin Nutr. 2014;23(3):394-399
.

doi: 10.6133/apjcn.2014.23.3.18

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Clinical Nutrition or Feeding Studies

Intra-operative administration of low-dose IV glucose attenuates post-operative insulin resistance
HIROKO FUJINO, SHOKO ITODA, KANAKO ESAKI, MASANORI TSUKAMOTO, SAORI SAKO, KAZUKI MATSUO,
EIJI SAKAMOTO, KUNIO SUWA AND TAKESHI YOKOYAMA
Asia Pac J Clin Nutr. 2014;23(3):400-407.

doi: 10.6133/apjcn.2014.23.3.10

 

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Influence of desflurane on postoperative oral intake compared with propofol
TOMOAKIYATABE, KOICHI YAMASHITA AND MASATAKA YOKOYAMA
Asia Pac J Clin Nutr. 2014;23(3):408-412.

doi: 10.6133/apjcn.2014.23.3.15

 

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An efficacy study on alleviating micronutrient deficiencies through a multiple micronutrient fortified salt in children in South India
MALAVIKA VINOD KUMAR, PRAVEEN K NIRMALAN, JUERGEN G ERHARDT, LAKSHMI RAHMATHULLAH AND SRINIVASA RAJAGOPALAN
Asia Pac J Clin Nutr. 2014;23(3):413-422.

doi: 10.6133/apjcn.2014.23.3.08

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Normal taste acuity and preference in female adolescents with impaired 6-n-propylthiouracil sensitivity
AYAKO NAGAI, MASARU KUBOTA, MIDORI SAKAI AND YUKIE HIGASHIYAMA
Asia Pac J Clin Nutr. 2014;23(3):423-428.

doi: 10.6133/apjcn.2014.23.3.04

 

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Nutritional Status, Dietary Intake, and Body Composition

 

Plasma and tissue free amino acid profiles and their concentration correlation in patients with lung cancer
QIHONG ZHAO, YE CAO, YING WANG, CHUANLAI HU, ANLA HU, LIANG RUAN, QINGLI BO, QIFEI LIU, WENJUN CHEN, FANGBIAO TAO, MIN REN, YONGSHENG GE, ANGUO CHEN AND LI LI

Asia Pac J Clin Nutr. 2014;23(3):429-436.

doi: 10.6133/apjcn.2014.23.3.13

 

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Prevalence of malnutrition in patients admitted to a major urban tertiary care hospital in Hanoi, Vietnam
PHAM THI THU HUONG, NGUYEN THI LAM, NGHIEM NGUYET THU, TRAN CHAU QUYEN, DINH THI KIM LIEN, NGUYEN QUOC ANH, ELIZABETH G HENRY, LAUREN OLIVER, CAROLINE M APOVIAN, THOMAS R ZIEGLER AND CARINE LENDERS
Asia Pac J Clin Nutr. 2014;23(3):437-444
.

doi: 10.6133/apjcn.2014.23.3.19

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Maternal and Clild Nutrition

Growth and anaemia among infants and young children for two years after the Wenchuan Earthquake
CAIXIA DONG, PENGFEI GE, XIAOLAN REN, XIANFENG ZHAO, JIE WANG, HAOQIANG FAN AND SHI-AN YIN
Asia Pac J Clin Nutr. 2014;23(3):445-451.

doi: 10.6133/apjcn.2014.23.3.03

 

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Chinese mothers’ perceptions of their child’s weight and obesity status
SHU CHEN, COLIN W BINNS, BRUCE MAYCOCK, YUN ZHAO AND YI LIU
Asia Pac J Clin Nutr. 2014;23(3):452-458.
doi: 10.6133/apjcn.2014.23.3.14

 

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Effects of a summer program for weight management in obese children and adolescents in Shanghai
QINGYA TANG, HUIJUAN RUAN, YEXUAN TAO, XIAOFEI ZHENG, XIUHUA SHEN AND WEI CAI
Asia Pac J Clin Nutr. 2014;23(3):459-464.
doi: 10.6133/apjcn.2014.23.3.02

 

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Nutritional Epidemiology and Public Health

Estimation of intakes of copper, zinc, and manganese in Japanese adults using 16-day semi-weighed diet records
MAI YAMADA, KEIKO ASAKURA, SATOSHI SASAKI, NAOKO HIROTA, AKIKO NOTSU, HIDEMI TODORIKI, AYAKO MIURA, MITSURU FUKUI AND CHIGUSA DATE
Asia Pac J Clin Nutr. 2014;23(3):465-472.

doi: 10.6133/apjcn.2014.23.3.05

 

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Utility of a web-based weight loss program with auto-extraction of behavioural objectives and recording of daily weight and steps in pre-obese outpatients
YOSHINARI MATSUMOTO, SAWAKO YOSHIUCHI, TAKUMI MIYAUCHI, HUMIKAZU HAYASHI, DAIKI HABU AND YUTAKA KIMURA
Asia Pac J Clin Nutr. 2014;23(3):473-480.

doi:10.6133/apjcn.2014.23.3.17

 

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Iodine status of Taiwanese children before the change in national salt iodization policy: a retrospective study of the nutrition and health survey in Taiwan 2001-2002
KAM-TSUN TANG, WEN-HARN PAN, FAN-FEN WANG, JIUNN-DIANN LIN, GING-SHING WON, WING-KEUNG CHAU,
HONG-DA LIN AND YAO-TE HSIEH
Asia Pac J Clin Nutr. 2014;23(3):481-487.

doi: 10.6133/apjcn.2014.23.3.20

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Nutrigenomics

Association of roasting meat intake with the risk of esophageal squamous cell carcinoma of Kazakh Chinese via affecting promoter methylation of p16 gene
WEIGANG CHEN, CHUNMEI YANG, LAN YANG, CUIHUA QI, SHUXIN TIAN, YUSHENG HAN, YUQIN DOU, YUNGUI
MA, DEAN TIAN AND YONG ZHENG
Asia Pac J Clin Nutr. 2014;23(3):488-497.

doi: 10.6133/apjcn.2014.23.3.11

 

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Clinical Nutrition Practice

 

An improved method of nasojejunal feeding tube placement for patients requiring endoscopic nasobiliarydrainage
XIN-HONG WANG, ZHI-WU LV, BO QU, HUI XING, BING DU AND CHENG-QIAN LV
Asia Pac J Clin Nutr. 2014;23(3):498-503.

doi: 10.6133/apjcn.2014.23.3.12

 

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Future Events

 

Asia Pac J Clin Nutr. 2014;23(3):504.

 

 

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Childhood obesity in Asia: the value of accurate body composition methodology
ANDREW P HILLS, NAJAT MOKHTAR, SHARON BROWNIE AND NUALA M BYRNE
Childhood obesity, a significant global public health problem, affects an increasing number of low- and middleincome countries, including in Asia. The obesity epidemic has been fuelled by the rapid nutrition and physical activity transition with the availability of more energy-dense nutrient-poor foods and lifestyles of many children dominated by physical inactivity. During the growing years the pace and quality of grow this best quantified by a combination of anthropometric and body composition measures. However, where normative data are available, this has typically been collected on Caucasian children. To better define and characterise overweight and obesity in Asian children, and to monitor nutrition and physical activity interventions, there is a need to increase the use of standardized anthropometric and body composition methodologies. The current paper reports on initiatives facilitated by the International Atomic Energy Agency (IAEA) and outlines future research needs for the prevention and management of childhood obesity in Asia.
Key Words: childhood obesity, Asia, body composition, methodology, stable isotopes
 

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亚洲儿童肥胖:准确的体成分测量方法的价值
儿童肥胖是一个重要的全球性公共健康问题,影响到包括亚洲在内的越来越多的中低收入国家。快速的营养和体育活动的过渡,即更多的高能量密度低营养食物的摄入和许多孩子缺乏体力活动为主的生活方式更加助长了肥胖的流行。在发育期,体格测量和体成分测量相结合是定量生长发育速度和质量最好的方法。然而,可用的规范数据通常是在白人儿童中收集的。为了更好地定义和描述亚洲儿童的超重和肥胖,并监测营养和体育活动的干预措施,有必要增加使用标准化的体格测量和身体成分测量方法。本文报告了国际原子能总署(IAEA)的促进措施,并概述了未来亚洲在儿童肥胖的预防和管理方面的研究需求。
关键词:儿童肥胖、亚洲、体成分、方法、稳定同位素

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Exclusive breastfeeding for six months: the WHO six months recommendation in the Asia Pacific Region
COLIN WILLIAM BINNS AND MI KYUNG LEE
In 2001 the World Health Assembly adopted the infant feeding strategy which included the recommendation for exclusive breastfeeding until 6 months of age with continued breastfeeding while complementary foods are introduced. This recommendation has been endorsed by many national authorities, professional organisations and most countries in the Asia Pacific Region. Reviews by WHO, the US Surgeon General, Agency for Healthcare Research and Quality, US Department of Health and Human Services and others have documented the many benefits of breastfeeding. The introduction of solid foods before six months of age is associated with increased rates of infection, reduced breastmilk production, disruption to the microbiome and possibly obesity. If solids are introduced at around six months (by 26 weeks) there is no evidence of increases in allergic diseases.
Key Words: exclusive, breastfeeding, infancy, morbidity, mortality, dietary advice

 

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纯母乳喂养6 个月:WHO 对亚太地区6 月龄内婴儿的喂养推荐
2011 年的世界卫生大会通过了婴儿哺乳计划,建议6 个月内纯母乳喂养,之后可以配以辅食。此项建议得到了许多国家当局、专业组织和亚洲太平洋地区大多数国家的认可。由WHO、美国公共卫生部、美国卫生保健和质量管理局、美国卫生和公共福利部和其他部门的审议报告指出了母乳喂养的诸多好处。6 月龄之前喂食固体食物会增加感染几率、导致母乳的泌乳量下降、扰乱微生物生存环境、增加肥胖的可能。如果6 月龄左右(26 周龄)添加固体食物,则会降低过敏性疾病的发生。
关键词:单独的、母乳喂养、婴儿期、发病率、致死率、饮食建议

 

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Effect of L-arginine on immune function: a meta-analysis
KAI KANG, XIAO-LIANG SHU, JING-XIA ZHONG, TING-TING YU AND TAO LEI
L-arginine plays an important role in immune regulation by affecting the immune response and inflammation. This meta-analysis was performed to assess whether L-arginine supplementation could improve the outcomes of immune function, and to evaluate the safety of L-arginine supplementation. Four databases (PubMed, EMBASE, Web of Science, the Cochrane Library) for all randomized controlled trials investigating the effects of supplementation with L-arginine published from 1966 to September 2013 were searched. The quality of controlled trials was assessed with the Jadad method. Meta-analyses were performed with fixed- or random-effects models according to heterogeneity of studies. Data from 11 trials involving 321 patients were enrolled. Meta-analysis showed that the L-arginine supplement group had a significantly greater CD4+ T-cell proliferation response (MD 5.03; 95% CI 1.11, 8.95; p<0.05), and that the incidence of infectious complications was lower (OR 0.40; 95% CI 0.17, 0.95; p<0.05) than control.
Key Words: L-arginine, nitric oxide, immune, cytokines, meta-analysis

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L-精氨酸对免疫功能的影响:一项meta 分析
L-精氨酸通过影响机体免疫应答和炎症反应在免疫调节中发挥重要作用。本meta 分析对补充L-精氨酸是否可以改善机体免疫功能的结果进行了评估,同时对补充L-精氨酸的安全性进行了评价。本文检索了四个数据库(PubMed, EMBASE , Web of Science, the Cochrane Library)中自1966 至2013 年9 月发表的有关补充L-精氨酸对免疫功能影响的所有随机对照试验。按照Jadad 评分量表对纳入的随机对照研究进行方法学质量评定,并根据异质性检验的结果,选择使用固定或随机效应模型。最终11 项试验(包括321 名患者)被纳入本次研究。Meta 分析结果显示,与对照组相比,L-精氨酸组CD4+ T 细胞的增殖显著增加(MD 5.03; 95% CI 1.11, 8.95; p<0.05),且感染并发症的发生率降低 (OR 0.40; 95% CI 0.17, 0.95; p<0.05)。
关键词:L-精氨酸、一氧化氮、免疫、细胞因子、meta 分析


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The influence of Mediterranean, carbohydrate and high protein diets on gut microbiota composition in the treatment of obesity and associated inflammatory state
PATRICIA LOPEZ-LEGARREA, NICHOLAS ROBERT FULLER, MARÍA ANGELES ZULET, JOSE ALFREDO MARTINEZ AND IAN DOUGLAS CATERSON
The role of the gut microbiota in understanding the onset and development of obesity is gaining importance. Dietary strategies are the main tool employed to counteract obesity, and nowadays they are focused on a wide range of different aspects of diet and not only on calorie restriction. Additionally, diet is known to be a major factor influencing modification of the gut microbiota. Therefore the influence of both macronutrient and micronutrient content of any dietary strategy to treat obesity on gut bacterial composition should now be taken into consideration, in addition to energy restriction. This review aims to collect the available data regarding the influence of different dietary components on gut microbiota in relation to obesity and inflammatory states in humans. Although more work is needed, specific dietary factors (carbohydrate, protein and Mediterranean foods) have been shown to have an influence on the gut microbiome composition, meaning that there is an opportunity to prevent and treat obesity based on microbiota outcomes.
Key Words: obesity, nutrition, gut microbiota, dietary strategies, inflammation
 

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地中海、碳水化合物和高蛋白饮食在治疗肥胖时对肠道微生物组成的影响和相关炎症状态
肠道微生物的作用在理解肥胖发生和发展的过程越来越重要。膳食策略被用作减肥的一个主要工具,现今,其专注点不仅仅是限制卡路里,而是涉及到膳食的各个方面。此外,饮食是影响肠道微生物组成的一个重要因素。因此,除限制能量摄入之外,治疗肥胖的饮食策略还要考虑到宏观营养和微观营养对肠道微生物组成的影响。本综述的目的旨在收集整理不同的饮食组成对人类肥胖和炎症相关的肠道微生物影响的现有数据。虽然还需要更多的工作,已有证据显示特定的饮食因素(碳水化合物,蛋白质和地中海食物)对肠道微生物的组成
确有影响,意味着有可能通过改变肠道微生物来预防和治疗肥胖。
关键词:肥胖、营养、肠道微生物、饮食计划、炎症
 

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Effectiveness of traditional Malaysian vegetables (ulam) in modulating blood glucose levels
MOHD FAEZ BACHOK, BARAKATUN-NISAK MOHD YUSOF, AMIN ISMAIL AND AZIZAH ABDUL HAMID

Ulam refers to a group of traditional Malaysian plants commonly consumed as a part of a meal, either in the raw form or after a short blanching process. Many types of ulam are thought to possess blood glucose-lowering properties, but relatively little is known on the effectiveness of ulam in modulating blood glucose levels in humans. This review aims to systematically evaluate the effectiveness of ulam in modulating blood glucose levels in humans. A literature review was conducted using multiple databases with no time restriction. Eleven studies were retrieved based on a priori inclusion and exclusion criteria. In these 11 studies, only Momordica charantia, locally known as “peria katak”, was extensively studied, followed by Centella asiatica, locally known as “daun pegaga”, and Alternanthera sessilis, locally known as “kermak putih”. Of the 11 studies, 9 evaluated the effectiveness of M. charantia on blood glucose parameters, and 7 of which showed significant improvement in at least one parameter of blood glucose concentration. The remaining 2 studies reported nonsignificant improvements in blood glucose parameters, despite having high-quality study design according to Jadad scale. None of the studies related to C. asiatica and A. sessilis showed significant improvement in blood glucose-related parameters. Current clinical evidence does not support the popular claim that ulam has glucose-lowering effects, not even for M. charantia. Hence, further clinical investigation is needed to verify the glucose modulation effect of M. charantia, C. asiatica, and A. sessilis.
Key Words: medicinal plants, complementary therapy, diabetes mellitus, blood glucose, clinical trial
 

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传统马来西亚蔬菜ulam 调节血糖水平的功效
ulam指一组传统的马来西亚植物,无论是生的还是经过短暂的漂烫处理后都是马来西亚人的食物之一。多种ulam被认为具有降血糖的特性,但对ulam调节人体血糖水平的有效性知之甚少。本文旨在系统评估ulam在调节人类血糖水平的功效。不限时间的多个数据库被用于本文文献检索。根据先验的纳入和排除标准检索到11个研究。在这11个研究中,只有苦瓜(当地称为“peria katak”)被广泛研究,其次是积雪草(当地称为“daun pegaga”)和莲子草(当地称为“kermak putih”)。在这11个研究中,有9个研究评估了苦瓜对血糖的影响,其中7个显示至少有1个血糖浓度指标有显著改善。其余2个研究报告血糖没有显著改善,尽管根据Jadad 评分这两项研究属于高质量设计。关于积雪草和莲子草的研究显示对血糖没有显著影响。目前的临床证据不支持ulam,即使是苦瓜,有降低血糖作用这一流行的说法。因此,需要进一步的临床研究来验证苦瓜、积雪草和莲子草对血糖的调节作用。
关键词:药用植物、辅助治疗、糖尿病、血糖、临床试验

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BRAC’s experience in scaling-up MNP in Bangladesh
KAOSAR AFSANA, MOHAMMAD RAISUL HAQUE, SHAFINAZ SOBHAN AND SHAIMA ARJUMAN SHAHIN
Despite progress in health status and achievements in Millennium Development Indicators, Bangladesh presents a gloomy scenario for nutrition. In 2009, BRAC (formerly known as Bangladesh Rural Advancement Committee) has begun to implement a community-based approach of Alive & Thrive with Family Health International 360, aiming to reduce undernutrition among children under two by promoting exclusive breastfeeding and appropriate complementary feeding practices. To address anemia and other micronutrient deficiencies, home-fortification with micronutrient powders (MNP) has been promoted among under-fives across Bangladesh along with the Global Alliance for Improved Nutrition (GAIN). BRAC’s frontline community health workers play a critical role in promoting micronutrient powders with better feeding practices. Over the years, improvements have been observed in the intervention areas: exclusive breastfeeding rose from 49% to 83% of children (0-6 months), 86% of children received complementary feeding at 6-8 months with about two/thirds being fed the recommended number of times; and 70% of children (6-59 months) adhered to MNP use, ie consumption of 1 sachet per day in the past 60 days. However, many challenges are still observed in traditional feeding practices, along with limited skills of community health workers and households’ poor access to quality food, necessitating constant interactions between caregivers, mothers-in-law and fathers with the frontline workers. Maintaining the supply chain of micronutrient powders and a visible and convincing change in nutritional status of children are key success factors. The partnerships between BRAC, GAIN and Renata, the producer of MNP in Bangladesh, have given birth to a home-fortification model that can deliver impact at scale.
Key Words: Infant and young child feeding, micronutrient powder, micronutrient malnutrition, home fortification, BRAC

 

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孟加拉農村發展委員會擴大規模使用微量營養素粉的經驗
儘管健康狀況的進步及千禧年發展指標的成就,孟加拉對於營養仍呈現悲觀的情境。從2009年,孟加拉農村發展委員會(BRAC)開始執行一個社區型的Alive & Thrive with Family Health International 360 計畫,旨在藉由推廣全母乳哺育及餵食適當的副食品,進而降低兩歲以下兒童的營養不良。為了解決貧血及其他微量營養素缺乏,針對有五歲以下兒童的家庭,整個孟加拉與全球營養改善聯盟(GAIN)採用家庭強化微量營養素粉(MNP)。在推動微量營養素粉以達更佳的餵食方法,BRAC 的第一線社區健康工作人員扮演重要的角色。多年來,在介入地區已可看到改善:兒童(0-6個月)的全母乳哺育由49%上升至83%;86%的兒童在6-8個月時開始吃副食品,其中約有2/3餵食達建議次數;70%的兒童(6-59個月)遵守MNP的使用,意即在過去60 天,每天攝取一包。然而,由於社區健康工作人員的技巧有限,加上家戶難以獲得有品質的食物,傳統餵食方法仍然面臨許多挑戰。因此照護者、婆婆/岳母和公公/岳父和第一線工作者間需要持續的互動。維持微量營養素粉的供應鏈,以及兒童營養狀況有看得見且具說服力的改變,將會是成功的關鍵。BRAC、GAIN 及孟加拉微量營養素粉的生產者Renata 間的伙伴關係,讓家庭強化模式得以產生並發揮巨大的影響力。
關鍵字:嬰幼兒餵食、微量營養素粉、微量營養素營養不良、家庭用強化、孟加拉農村發展委員會


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Migrant Asian Indians in New Zealand; prediction of metabolic syndrome using body weights and measures
LJILJANA M JOWITT, LOUISE WEIWEI LU AND ELAINE C RUSH
The aim of this study of Asian Indian migrants in New Zealand was to determine cut-off points for body mass index, waist circumference, waist-to-hip ratio, and waist-to-height ratio that best discriminate for increased risk of type 2 diabetes and cardiovascular disease. One hundred and seventy-five (90F, 85M) Asian Indian volunteers (aged >50 y) were recruited from urban Auckland, New Zealand. Body weight, height and waist and hip circumferences were measured using standard techniques. Waist-to-hip ratio, waist-to-height ratio and body mass index were derived. Total and percent body fat by dual energy X-ray absorptiometry, and fasting glucose, insulin and lipids were measured. Three measures of metabolic risk were determined: the homeostasis model assessment of insulin resistance, the McAuley score for insulin sensitivity and metabolic syndrome by International Diabetes Federation criteria. Body mass index, percent body fat and anthropometric measurements of central adiposity generally did not perform well as indicators of metabolic risk in this high risk population of Asian Indian migrants. Our data support the use of lower ethnic specific body mass index and waist circumference for Asian Indian women and men. The discriminatory power of waist-to-height ratio was similar to that of body mass index. Hence, waist-to-height ratio could be used as a simple screening tool. A recommendation, of a waist-to- height ratio of less than 0.5 that would underpin the simple public health message of “your waist circumference should be less than half your height.”
Key Words: Asian Indians, New Zealand, metabolic syndrome, type 2 diabetes mellitus, waist-to-height ratio
 

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用体重及相关测量指标预测新西兰亚洲印度裔移民的代谢综合症
本研究目的在于确定新西兰亚洲印度裔移民人群的体重指数(BMI),腰围(WC),腰臀比(WHR),和腰围身高比(WHtR)的最佳诊断界值,以甄别该人群中2型糖尿病和心血管疾病的高危人群。本研究从新西兰奥克兰市区征集了170名亚洲印度裔移民志愿者(90名女性,85名男性;年龄>50岁)。体重、身高、腰围和臀围均由标准方法测量。腰臀比、腰围身高比和体重指数由以上原始数据计算得出。采用双能X线吸收法测量了全身体脂总含量和体脂百分比,同时还测量了空腹血糖、胰岛素和血脂。本研究确定了三个代谢风险诊断标准:用动态平衡模型评估胰岛素抵抗,McAuley 评分评估胰岛素敏感性和国际糖尿病联合会的标准诊断代谢综合症。作为诊断亚洲印度裔移民代谢综合症高危人群的指标,体重指数、体脂百分比和中心肥胖人体测量值的总体应用价值表现并不好。我们的数据支持对亚洲印度裔的女性和男性使用低民族特殊性的体重指数和腰围。WHtR 表现出同BMI 相当的甄别能力。因此,WHtR 可以作为一个简单的筛选工具。“腰围身高比低于0.5”这一建议支持简明的公共健康信息:“你的腰围应当小于你身高的一半”。
关键词:亚洲印度裔、新西兰、代谢综合症、2 型糖尿病、腰围身高比


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Performance of nutritional screening tools in predicting poor six-month outcome in hospitalised older patients
ELSA DENT, IAN M CHAPMAN, CYNTHIA PIANTADOSI AND RENUKA VISVANATHAN
Malnutrition is a major problem in hospitalised older people. Many nutrition screening tools are available for malnutrition identification, however little is known about their prognostic ability. This prospective, observational study investigated the prognostic value of three nutritional screening tools in a Geriatric Evaluation and Management Unit: the Geriatric Nutritional Risk Index (GNRI), the Mini Nutritional Assessment (MNA) and the Mini Nutritional Assessment short form (MNA-SF), incorporating either body mass index or calf circumference. Poor six- month outcome was defined as new admission to higher level residential care or mortality at six months post-discharge. Predictive ability of poor outcome was assessed by logistic regression models, adjusting for age, gender, cognition and co-morbidity. Predictive accuracy was determined by area under Receiver Operator Characteristic curves, sensitivity, specificity, predictive values and Youden Index. One hundred and seventy-two consecutive patients with a mean (SD) age=85.2 (6.4) years were included in the study. Malnutrition was identified in 31% of patients using the MNA and was associated with a higher risk of poor six-month outcome when identified by the MNA (OR, 95% CI=3.29, 1.17-9.23) and the GNRI (OR, 95% CI=2.84, 1.31-6.19), but not by the MNA-SF. All screening tools lacked discriminative power for outcome prediction. The MNA and GNRI were useful clinical predictors of poor six-month outcome, although their accuracy of prediction was low. Nutritional screening remains a priority in the routine assessment of hospitalised older people.
Key Words: nutritional status, hospitalisation, aged, malnutrition, epidemiology
 

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营养筛查工具在预测住院老年患者六个月预后不良的应用
营养不良是住院老年人最大的问题。许多营养筛查工具可用于营养不良鉴别,但很少有人知道他们的预测力。本前瞻性观察研究调查了在老年医学评估和管理处三个营养筛查工具: 老年营养风险指数(GNRI) , 迷你营养评估(MNA)和迷你营养评估简化版(MNA-SF),结合BMI 或小腿围的预测价值。六个月预后不良定义为出院六个月后以更高层次的居住护理重新入院或者死亡。用Logistic 回归模型评估校正年龄、性别、认知和合并症后,其对预后不良的预测力。用受试者特征工作曲线下面积、灵敏度、特异度、预测值和Youden 指数确定其预测精度。本研究纳入了172 例长期病号,平均年龄为85.2±6.4 岁。用MNA 确诊31%的患者有营养不良,较高的六个月预后不良的风险与用MNA(OR, 95% CI=3.29, 1.17-9.23)和GNRI(OR, 95% CI=2.84, 1.31-6.19)确诊的营养不良与有关,但与MNA-SF 确诊的营养不良无关。所有的筛查工具缺乏对结果预测的分辨别力。MNA 和GNRI 是六个月不良预后有用的临床预测工具,虽然他们的预测精度较低。营养筛查仍然是住院老年人优先的常规评估项目。
关键词:营养状况、住院、老年的、营养不良、流行病学

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Intra-operative administration of low-dose IV glucose attenuates post-operative insulin resistance
HIROKO FUJINO, SHOKO ITODA, KANAKO ESAKI, MASANORI TSUKAMOTO, SAORI SAKO, KAZUKI MATSUO, EIJI SAKAMOTO, KUNIO SUWA
AND TAKESHI YOKOYAMA

Background & Aims: Insulin sensitivity often decreases after surgery in spite of normal insulin secretion, and may worsen the outcome. This post-operative insulin resistance increases according to the magnitude of surgical invasion. However, supplementation of carbohydrates before surgery attenuates the post-operative insulin re-sistance. This study aimed to investigate the effect of intra-operative administration of low-dose glucose on the post-operative insulin resistance. Methods: Patients undergoing maxillofacial surgery were randomly assigned to two groups throughout the surgical procedure: The glucose group receiving acetated Ringer solution with 1.5% glucose and the control group receiving acetated Ringer solution without glucose. Insulin resistance quantified by the mean glucose infusion rate (the glucose infusion rate) was evaluated by glucose clamp using the STG-22TM instrument on the previous day and on the next day of surgery. Blood glucose level was monitored continuously during surgery. In addition, serum insulin, ketone bodies and 3-methylhistidine were measured during periopera-tive period. Results: Patients in the glucose group (n=11) received 0.15±0.06 g/kg/h of glucose during surgery, while patients in the control group (n=11) received no glucose. In both groups, however, the mean blood glucose levels were maintained stable at less than 150 mg/dL during and after surgery. The serum ketone bodies signifi-cantly increased after surgery in the control group (p=0.0035), while it decreased significantly in the glucose group (p=0.043). The reduction rate in the glucose infusion rate was significantly lower in the glucose group, 43.320.7%, than that in the control group, 57.79.3% (p=0.041). Conclusions: Intra-operative small-dose of glucose administration may suppress ketogenesis and attenuate the post-operative insulin resistance without caus-ing hyperglycemia.
Key Words: insulin resistance, glucose clamp, artificial pancreas, ketogenesis, 3-methylhistidine

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术中静脉小剂量给予葡萄糖减弱术后胰岛素抵抗
背景与目的:手术后尽管胰岛素分泌正常,但胰岛素的敏感性往往会降低,这可能会使预后不良。手术后胰岛素抵抗的增加跟手术侵害的程度有关。然而,手术前碳水化合物的补充减弱了手术后胰岛素的抵抗。本研究旨在探讨术中给予低剂量葡萄糖对术后胰岛素抵抗的影响。方法:接受颌面手术的患者根据手术程序被随机分为两个组。葡萄糖组接受含1.5%葡萄糖的醋酸格林溶液,对照组接受不含葡萄糖的醋酸格林溶液。用平均的葡萄糖输注率来量化胰岛素抵抗,分别在手术前一天和手术后第二天用STG-22TM仪器根据葡萄糖钳夹来估计葡萄糖输注率。手术中连续监测血糖水平。另外,围手术期测量血清胰岛素、酮体和3-甲基组氨酸的变化。结果:葡萄糖组患者(11人)在手术中输入葡萄糖0.15±0.06 g/kg/h,对照组患者(11人)没有输入葡萄糖。然而,两组在手术中和手术后血糖平均水平均稳定在低于150 mg/dL。手术后,对照组的血清酮体显著增加(p=0.0035),而葡萄糖组血清酮体显著降低(p=0.043)。葡萄糖组的葡萄糖输注率的降低率(43.320.7%)显著低于对照组(57.79.3%)(p=0.041)。结论:术中小剂量给予葡萄糖能够抑制生酮作用和减轻手术后胰岛素抵抗,而不会导致高血糖症。
关键词:胰岛素抵抗、葡萄糖钳夹、人工胰腺、生酮作用、3-甲基组氨酸

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Influence of desflurane on postoperative oral intake compared with propofol
TOMOAKIYATABE, KOICHI YAMASHITA AND MASATAKA YOKOYAMA
Postoperative oral intake is an important predictor of early postoperative recovery, and anesthesia is known to influence this intake. We compared the influences of desflurane anesthesia and propofol anesthesia on early postoperative oral intake retrospectively. The subjects included a consecutive series of patients who received general anesthesia with propofol or desflurane between June and December 2013. The total amount of calories and proteins taken orally and the incidence of postoperative nausea and vomiting (PONV) on postoperative days (POD) 0, 1, and 2 were collected. A total of 147 patients were analyzed. The desflurane (Des) and the propofol (Pro) groups included 52 and 95 patients, respectively. The incidence of PONV on POD 0, 1, and 2 did not show significant intergroup differences. Total calorie intake on POD 1 and 2 was not significantly different between the 2 groups (1117±508 vs. 1036±549 kcal/day, p=0.39 and 1504±368 vs. 1437±433 kcal/day, p=0.35, respectively). Total amount of protein via oral intake on POD 1 and 2 were not significantly different between the two groups (45.9±21.1 vs. 43.8±22.8 g/day, p=0.60 and 61.3±15.0 vs. 58.9±18.0 g/day, p=0.42, respectively). These findings suggest that desflurane and propofol affect postoperative oral intake in a similar fashion. These results should be confirmed in a future prospective study.
Key Words: postoperative oral intake, postoperative nausea and vomiting, desflurane, propofol, early recovery
 

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地氟醚和异丙酚对术后口腔摄入功能的影响比较
术后口腔摄入功能是术后早期恢复的一个指征,众所周知麻醉影响术后口腔摄入功能。我们回顾性分析比较了地氟醚麻醉和异丙酚麻醉对早期术后口腔摄入功能的影响。受试者为2013 年6 月到12 月间接受过地氟醚或异丙酚的全麻患者。我们收集分析了147 位患者口腔摄入的卡路里和蛋白质总量以及术后(POD)第0、1、2 天的恶心呕吐(PONY)的发生情况。地氟醚组(Des)有52 名患者,异丙酚(Pro)组有95 名患者。在组内PONY 在POD 第0、1 和2天无显著差异。两组间口腔摄入卡路里在POD 第0、1 和2 天的差异不显著(分别是1117±508 vs. 1036±549 kcal/day, p=0.39 和 1504±368 vs. 1437±433 kcal/day, p=0.35)。两组间口腔蛋白质摄入量在POD第0、1和2 天也无显著差异(分别是45.9±21.1 vs. 43.8±22.8 g/day, p=0.60 和 61.3±15.0 vs. 58.9±18.0 g/day, p=0.42)。本研究表明地氟醚和异丙酚对术后口腔摄入功能的影响相似。此结果还需下一步的前瞻性研究来证实。
关键词:术后口服摄入量、术后恶心呕吐、地氟醚、异丙酚、早期恢复

 

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An efficacy study on alleviating micronutrient deficiencies through a multiple micronutrient fortified salt in children in South India
MALAVIKA VINOD KUMAR, PRAVEEN K NIRMALAN, JUERGEN G ERHARDT, LAKSHMI RAHMATHULLAH AND SRINIVASA RAJAGOPALAN
Background: Multiple micronutrient deficiencies are prevalent in India. Objective: The study aims to establish the efficacy of multi-micronutrient fortified salt in addressing multiple micronutrient deficiencies among children compared to nutrition education and no intervention in Tamilnadu. Methods: The study employed a community based randomized controlled trial designed to study the impact of multiple micronutrient salt (micronutrient group) in comparison with nutrition education (education group) and no intervention (control group) on haemoglobin, serum ferritin, soluble transferrin receptor, body iron stores, serum retinol and urinary iodine outcomes over a period of 8 months. The fortified salt contained iron, iodine, vitamin A, vitamin B12 and folic acid. All the children were dewormed at baseline and at the end of the study just before the biochemical measurements. Results: There was a significant improvement in most biochemical parameters studied in the micronutrient group when compared with the control group whereas this was not seen between the education and control. Over 8 months, in the micronutrient group, hemoglobin increased by 0.52 g/dL, retinol by 8.56 μg/dL, ferritin by 10.8μg/L, body iron stores by 1.27 mg and the decrease in the prevalence of retinol deficiency was from 51.6% to 28.1%, anaemia from 46.0% to 32.6%, iron deficiency from 66.9% to 51.3% and iron deficiency anaemia from 35.2% to 31.0%, while the prevalence of all these deficiencies increased or the changes were not significant in the other two groups. Conclusions: Multiple micronutrient fortified salt was able to improve iron and vitamin A status, whereas this was not seen in the nutrition education group.
Key Words: multiple micronutrient fortified salt, micronutrient deficiencies, biochemical assessment, children, India

 

 

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通过复合微量营养素强化盐来缓解印度南部儿童微量营养素缺乏的效果研究
背景:在印度普遍存在多重微量营养素缺乏。目的:本研究的目的是与营养教育干预和无干预相比,确定复合微量营养素强化盐在解决泰米尔纳德邦儿童多重微量营养素缺乏的效果。方法:本研究采用社区为基础的为期8个月的随机对照试验设计,研究复合微量营养素盐(微量营养素组)、营养教育(教育组)和无干预(对照组),对血红蛋白、血清铁蛋白、可溶性转铁蛋白受体、体内铁储存和维生素A和尿碘的影响。强化盐含有铁、碘、维生素A、维生素B12酸。对所有的儿童在基线和研究末期生化测量之前进行驱虫。结果:与对照组相比,微量营养素组的多数生化参数显著改善,然而这种改善在教育组和对照组中未被发现。8个月以后,微量营养素组血红蛋白增加了0.52 g/dL,维生素A增加了8.56 μg/dL,铁蛋白增加了10.8 μg/dL,体内铁储存增加了1.27 mg,维生素A 缺乏症的发生率从51.6%下降到28.1%,贫血的发生率从46.0%下降到32.6%,铁缺乏的发生率从66.9%下降到51.3%,缺铁性贫血的发生率从35.2%下降到31.0%,然而在其它两组未见显著的缺乏增加或改变。结论:复合微量营养素强化盐能够改善铁和维生素A 的状态,然而在营养教育组未见这种改善。
关键词:复合微量营养素强化盐、微量营养素缺乏、生化评估、儿童、印度

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Normal taste acuity and preference in female adolescents with impaired 6-n-propylthiouracil sensitivity
AYAKO NAGAI, MASARU KUBOTA, MIDORI SAKAI AND YUKIE HIGASHIYAMA
This study was conducted to determine the relationship between 6-n-propylthiouracil sensitivity and taste characteristics in female students at Nara Women’s University. Participants (n=135) were screened for 6-npropylthiouracil sensitivity using a taste test with 0.56 mM 6-n-propylthiouracil solution, and the sensitivity was confirmed by an assay for the bitter-taste receptor gene, TAS2R38. Based on the screening results, 33 6-npropylthiouracil tasters and 21 non-tasters were enrolled. The basic characteristics that are thought to influence taste acuity, including body mass index, saliva volume and serum micronutrient concentrations (iron, zinc and copper), were similar between the two groups. In an analysis using a filter-paper disc method, there were no differences in the acuity for four basic tastes (sweet, salty, sour and bitter) between 6-n-propylthiouracil tasters and non-tasters. In addition, the taste preference for the four basic tastes as measured by a visual analogue scale was also comparable between the two groups. This is the first study to demonstrate that 6-n-propylthiouracil nontasters have taste sensitivity for the four basic tastes similar to that in 6-n-propylthiouracil tasters, at least in female adolescents, as measured by the gustatory test using a filter-paper disc method.
Key Words: 6-n-propylthiouracil, TAS2R38, taste acuity, filter-paper method, visual analogue scale

 

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6-N-丙基硫氧嘧啶敏感性受损青少年女性的正常味觉敏感度和味觉偏好
本研究测定了奈良女子大学女生6-N-丙基硫氧嘧啶的敏感性和味觉特征之间的关系。135名参与者的6-N-丙基硫氧嘧啶的敏感性是用0.56毫摩尔6-N-丙基硫氧嘧啶溶液的味觉试验测试进行筛选的,再用苦味受体基因TAS2R38来确认其敏感性。根据筛选结果,33位6-N-丙基硫氧嘧啶尝出者和21位未尝出者入选。那些被认为影响味觉敏感度的基本特征,包括体质指数、唾液量和血清微量元素的浓度(铁、锌和铜)两组之间相似。在使用滤纸片法的分析中, 6--丙基硫氧嘧啶尝出者和未尝出者四种基础味觉(甜、咸、酸和苦)的敏感度没有差异。此外,通过视觉模拟评分测量两组之间四种基础味觉的味觉偏好也相似。首次研究证明:至少在用滤纸片法作为尝味测试的青少年女性中, 6-N-丙基硫氧嘧啶未尝出者与尝出者对四种基础味觉的味觉敏感度相似。
关键词:6-N-丙基硫氧嘧啶、TAS2R38、味觉敏感度、滤纸法、视觉模拟评分


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Plasma and tissue free amino acid profiles and their concentration correlation in patients with lung cancer
QIHONG ZHAO, YE CAO, YING WANG, CHUANLAI HU, ANLA HU, LIANG RUAN, QINGLI BO, QIFEI LIU, WENJUN CHEN, FANGBIAO TAO, MIN REN, YONGSHENG GE, ANGUO CHEN AND LI LI
Variation of plasma free amino acids (PFAAs) is an essential feature of protein metabolic abnormalities in cancer patients. But there still little data about the cancer tissue free amino acid (TFAAs) profiles, including their patterns and correlations with PFAAs. To evaluate the variation in PFAAs and cancer TFAAs in patients with lung cancer, including their patterns and correlations, we investigated the concentrations of free amino acids in lung cancer tissues (n=27), paired lung paracarcinomous tissues (n=27) and plasma (n=27) using an automatic amino acid analyzer after pre-treatment. Within the PFAAs, the concentrations of five amino acids (tryptophan, glycine, citrulline, ornithine and proline) were significantly decreased, while that of phenylalanine was markedly increased compared with control subjects. Within the TFAAs, the concentrations of three amino acids (taurine, glutamic acid and glycine) were increased, while the concentrations of two amino acids (lysine and ornithine) were decreased significantly in lung cancer tissues compared with the paracarcinomous tissues. The amino acid patterns in PFAAs and TFAAs had similar trends, but percentage variations were diverse. Additionally, the concentrations of five amino acids (lysine, phenylalanine, threonine, serine, and alanine) in PFAAs correlated with those in lung cancer TFAAs, but no amino acids in PFAAs were correlated with those in lung paracarcinomous TFAAs. Thus, PFAA profiles may reflect the status of cancer tissues, which may provide more information about the metabolic statuses and prognoses of patients with lung cancer.
Key Words: plasma free amino acids, tissue free amino acids, lung cancer, amino acid pattern, concentration correlations
 

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肺癌病人血浆和组织中游离氨基酸分析以及它们的浓度相关性
肿瘤病人体内血浆游离氨基酸变化是其蛋白质代谢异常的一个基本特征。但是目前很少有研究关注肿瘤组织内部的氨基酸情况,包括它们的模式以及与血浆氨基酸的浓度相关性。为了评价肺癌病人血浆和肿瘤组织中游离氨基酸的变化情况,我们使用氨基酸分析仪测定了27位肺癌肿瘤病人治疗前的血浆、肿瘤组织以及癌旁组织中的游离氨基酸浓度。跟正常人血浆游离氨基酸浓度相比较,我们发现肿瘤病人血浆游离氨基酸浓度中色氨酸、甘氨酸、瓜氨酸、鸟氨酸和脯氨酸显著下降,而蛋氨酸显著上升;与癌旁组织相比,牛磺酸、谷氨酸和甘氨酸浓度显著增加,而赖氨酸和鸟氨酸浓度显著下降。在血浆和组织中游离氨基酸有相似的浓度趋势,但是百分比变化是各异的。另外,我们发现血浆和肺癌组织中的赖氨酸、蛋氨酸、苏氨酸、丝氨酸和丙氨酸有浓度相关性,但是在血浆中和癌旁组织中没有发现一种氨基酸具有浓度相关性。因此,血浆游离氨基酸变化可能反应了肿瘤组织中氨基酸水平,这或许会对肺癌病人未来的代谢状态和预后提供更多信息。
关键词:血浆游离氨基酸、组织游离氨基酸、肺癌、氨基酸模式、浓度相关性
 

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Prevalence of malnutrition in patients admitted to a major urban tertiary care hospital in Hanoi, Vietnam
PHAM THI THU HUONG, NGUYEN THI LAM, NGHIEM NGUYET THU, TRAN CHAU QUYEN, DINH THI KIM LIEN, NGUYEN QUOC ANH, ELIZABETH G HENRY, LAUREN OLIVER, CAROLINE M APOVIAN, THOMAS R ZIEGLER AND CARINE LENDERS
Objectives: To determine the prevalence of malnutrition using anthropometric measures among hospitalized pediatric and adult patients admitted at Bach Mai Hospital, Hanoi, Vietnam. Methods: A one-day cross-sectional survey was used in selected wards (Pediatrics, Surgery, Intensive Care Unit, Renal Diseases, Gastroenterology Diseases, Respiratory Diseases, and Endocrinology). Unavailable patients and those discharged within 24 hours were excluded. Anthropometric data included body weight, height (or length), and mid-upper arm circumference. The type, severity, and prevalence rate of malnutrition were defined based on World Health Organization (WHO) criteria. Results: The sample was hospitalized children and adults: 108 and 571 were children aged 6 months to 18.9 years old and adult patients, respectively. The overall rate of pediatric wasting (weight-for-height ≤-2 SD or BMI ≤-2 SD, kg/m2) was 19.0% (n= 19/100) and that of stunting (height-for-age ≤-2 SD) was 13.9% (n=14/101). Using either the mid-upper arm circumference <11.5 cm or the weight-for-height and weight-for-length ≤-3 SD, the rate of severe wasting among children aged 6-59 months old was 7.0% (n=3/43). None of the children were obese based on weight-for-length, weight-for-height, or BMI. In adults, the prevalence of under-nutrition (BMI<18.5 kg/m2) was 33.3% (n=141/423) while that of obesity (BMI ≥30 kg/m2) was 0.9% (n=4/423). Adults admitted to the Respiratory Diseases ward had the highest prevalence of under-nutrition, 40.9% (n=38/93). Conclusions: The prevalence of malnutrition was high in this cohort of hospitalized patients, particularly in adults, but comparable to other published reports. Obesity was nearly nonexistent in both children and adults.
Key Words: BMI, children, hospital malnutrition, nutrition assessment, Vietnam
 

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越南河内市一个主要三级保健医院收住病人的营养不良发生率
目的:为了解住院病人营养不良的状况,对越南河内市巴赫麦医院的住院儿童和成人采用人体测量法测定营养不良发生率。方法:对儿科病房、外科病房、重症监护室、肾病病房、消化科病房、呼吸科病房以及内分泌科病房的病人进行单日横断面调查。排除无法参与的患者以及24 小时内出院的患者。人体测量数据包括体重、身高(身长)以及上臂围。营养不良的类型、程度以及发生率均遵照WHO 标准。结果:调查对象为108 名6 个月到18.9 岁的儿童和571 名成年病人。儿童消瘦率(体重身高比≤-2 SD 或者 BMI ≤-2 SD, kg/m2) 为 19.0% (n= 19/100),生长迟缓率(身高年龄比)为13.9%(n=14/101)。6-59 月龄的儿童严重消瘦率(上臂围<11.5 cm 或者身高体重比和身高身长比≤-3 SD)为7.0% (n=3/43)。没有一个儿童的身高体重比和身高身长比或者BMI 达到肥胖标准。成人的营养不良(BMI<18.5 kg/m2)率为33.3% (n=141/423),而肥胖 (BMI≥30 kg/m2) 率为 0.9% (n=4/423)。成人中呼吸科营养不良病人较多,为40.9%(n=38/93)。结论:与已发表的报道想比,此项住院病人队列中营养不良率较高,特别是成年人,不管儿童还是成人患者几乎不存在肥胖者。
关键词:BMI、儿童、院内营养不良、营养评估、越南


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Growth and anaemia among infants and young children for two years after the Wenchuan Earthquake
CAIXIA DONG, PENGFEI GE, XIAOLAN REN, XIANFENG ZHAO, JIE WANG, HAOQIANG FAN AND SHI-AN YIN
Background: In order to monitor malnutrition morbidity and anaemic prevalence of infants and young children in rural disaster areas affected by Wenchuan earthquake. Methods: About three months, one year and two years after earthquake (including 77, 102 and 307 children, respectively), by using the questionnaires, information on nutritional and health status of infants and young children aged 6-23 months was collected and evaluated, and anthropometry and haemoglobin concentration were measured. Results: Most of families could not prepare complementary foods for their children so that the children only ate the same meals as adults which resulted in very poor situation in the quantity and quality of complementary food for infants and young children. The main nutritional problems in children included the lack of feeding knowledge in parents; only 10% children could have breast feeding within one hour after delivery, and the basic exclusive breastfeeding was lower. More than 90% children never received nutrient supplements. The malnutrition prevalence was significantly increased two years after the earthquake. The decrease of body weight was rapid (underweight prevalence from 0 at three months to 5.9% after two years), and then a lasting effect resulted in decrease of length shown by stunting prevalence from 6.6% at three months to 10.8% after two years and wasting prevalence from 1.3% at three months to 4.0% after two years. From three months to two years after earthquake, anaemic prevalence markedly increased from 36.5% to 67.5% and the increasing percentage of anaemia was more obvious in girls than boys. Conclusion: The child’s nutritional status continuously worsened and anaemic prevalence was high in areas affected by the earthquake. It is recommended that in the future nutrition interventions should begin immediately.
Key Words: emergency, infants and young children, malnutrition, anaemia, earthquake
 

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中国汶川地震后2 年灾区婴幼儿生长发育和贫血状况
背景:为了监测中国汶川地震灾区婴幼儿营养不良的发病率和贫血的流行情况。方法:在地震后3 个月、1 年和2 年分别调查了77 名、102 名和307 名6-23 个月龄婴幼儿的营养和健康状况,使用问卷收集和评估了相关信息,同时测定了人体测量学指标和血红蛋白浓度。结果:大多数家庭不能够为婴幼儿制作辅食,使这些儿童摄入与成人相同的食物,进食的数量和质量都很差。存在的主要营养问题包括儿童看护人缺乏婴幼儿喂养知识,仅有10%的新生儿出生后1 小时内能吃到母乳,纯母乳喂养率较低。超过90%的儿童从来没有吃过营养素补充剂。地震后2 年,婴幼儿营养不良患病率显著增加。与3 个月时的结果相比较,2 年后低体重率由未检出增加到5.9%,生长迟缓率由6.6%增加到10.8%,消瘦率由1.3%增加到4.0%;贫血患病率也显著增加,由36.5%增加到67.5%,女孩的贫血患病率显著高于男孩。结论:地震灾区婴幼儿营养状况不断恶化,贫血患病率较高。建议尽快采取相应的营养干预措施。
关键词:突发事件、婴幼儿、营养不良、贫血、地震

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Chinese mothers’ perceptions of their child’s weight and obesity status
SHU CHEN, COLIN W BINNS, BRUCE MAYCOCK, YUN ZHAO AND YI LIU
This study recorded maternal perceptions of preschool children’s weight in Chinese mothers living in Australia and China. A survey was undertaken of 1951 mothers living in Chengdu and Wuhan, China and 89 Chinese mothers living in Perth, Australia. All participants were mothers with children aged 2-4 years. The children’s weight and height were measured and their weight status were classified using the International Obesity Task Force 2012 revised international child body mass index cut-offs. The prevalence of overweight or obese in children was 16.7% in China and 8% in Australia. The overall percentages of correct maternal perception of the child’s weight were 35% in underweight children, 69.2% in normal weight children but only 10.8% in overweight/ obese children. Among the overweight/obese children, only 14% in Australia and 10.8% in China were classified as overweight/obese by their mothers. Within the group of underweight children, normal weight mothers (p=0.004) and mothers with older age children (p=0.015) were more likely to correctly classify children’s weight status. A higher percentage of overweight/obese mothers (p=0.002) and mothers who over-estimated her own weight status (p<0.001) have correct perception of the weight status of their overweight/obese children, compared to their counterparts. There was a high prevalence of incorrect maternal perception of preschool children’s weight status in Chinese mothers, especially those with overweight/obese children. To address the obesity epidemic in children, future health promotion programs should put improved efforts to educate parents about obesity and its health consequences in order to reduce misperceptions.
Key Words: children, overweight, obesity, parental perceptions, Chinese
 

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華人媽媽對他們孩子的體重和肥胖狀態的認知
本研究記錄了生活在澳大利亞和中國的華人媽媽對他們的學齡前孩子的體重的看法。有1951位生活在中國成都和武漢的媽媽,以及89位生活在澳洲珀斯的華人媽媽参与了本次调查。所有調查對象都是有2-4歲孩子的母親。調查中測量了孩子的身高和體重,他們的體重狀況用國際肥胖工作組2012年新版的兒童體脂指數界值來劃分。超重和肥胖率在中國孩子中為16.7%,在澳洲華人孩子中為8%。媽媽對孩子體重的正確認知率在低體重孩子中為35%,在正常體重的孩子中為69.2%,但在超重/肥胖孩子中僅有10.8%。在超重/肥胖的孩子中,只有14%的澳洲華人母親和10.8%的中國母親正確地認識到了孩子的超重/肥胖。在低體 重孩子里,正常體重的母親(p=0.004)和有年齡大一些孩子的母親(p=0.015)更有可能正確認識孩子的體重。有更高比例的超重/肥胖的母親(p=0.002),和過高估計了自己體重狀況的母親(p<0.001)能夠正確地意識到孩子的肥胖問題。華人媽媽中對學齡前孩子的體重的錯誤認識率很高,特別是那些有超重/肥胖孩子的媽媽。要解決兒童中的肥胖問題,未來的健康促進項目需要更加努力地教育父母肥胖和肥胖的危害,以減少對肥胖的錯誤認知。
關鍵字:兒童、超重、肥胖、父母的認知、華人
 

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Effects of a summer program for weight management in obese children and adolescents in Shanghai
QINGYA TANG, HUIJUAN RUAN, YEXUAN TAO, XIAOFEI ZHENG, XIUHUA SHEN AND WEI CAI
Objective: To investigate the effects of a combined intervention of diet and physical activity on body composition, resting energy expenditure (REE) and metabolic factors in obese children and adolescents. Methods: Twenty obese children and adolescents aged 7 to 17 years completed a 4-week summer camp program which focussed on personal behaviour, including energy-restricted diets and supervised physical activity. Anthropometry, bioelectrical impedance, ultrasonography (US) for subcutaneous and hepatic fat, and abdominal Magnetic Resonance Imaging assessments were made and blood pressure (BP) recorded before and after the 4-week intervention. Results: 1) Weight loss was 7.2±2.2 kg, with losses of 5.5±2.2 kg and 1.7±1.2 kg in fat mass (FM) and fat free mass (FFM), respectively, with associated reductions in abdominal and hip fat and in the waist/hip circumference ratio and in BP. 2) There were no significant changes in REE or in its ratio with weight. 3) Reductions in uric acid, total cholesterol, triglycerides, LDL cholesterol, HbA1C, insulin, C-Peptide and insulin resistance (HOMA-IR) and the ratio of fatty liver were observed, but not in the inflammatory marker hsCRP. Conclusions: With behavioural intervention during a summer camp, body fat and its distribution were favourably changed, but with some loss of lean mass. However, there were no detectable reductions in REE. Weight management programs which achieve fat loss with maintenance of REE ought to be more sustainable.
Key Words: weight losing summer program, obese of children and adolescents, body composition, resting energy expenditure, biochemical metabolism
 

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上海肥胖儿童青少年减肥夏令营的效果评估
目的:结合身体成分测定、静息能量消耗和代谢因素分析,探讨肥胖儿童青少年进行饮食和运动的综合干预效果。方法:20名7-17岁的肥胖儿童青少年参与并完成了为时四周的夏令营项目。该项目重点关注个体行为,包括饮食限制和运动训练。在项目开始前和结束后分别进行人体学测量、生物电阻抗、腹部超声和核磁共振测定(评估腹部皮下和肝内脂肪),以及血压测定。结果: 1.总体重平均减轻7.2±2.2kg,脂肪质量减少5.5±2.2kg,去脂体质量减少1.7±1.2kg,并分别与腹部和臀部脂肪、腰臀比、血压的减少相关联。2.静息能量代谢测定值与体重矫正后的静息能量代谢值的变化无统计学意义。3.尿酸、总胆固醇、甘油三酯、低密度脂蛋白、糖化血红蛋白、胰岛素、C肽及胰岛素抵抗指标(HOMA-IR)明显降低,脂肪肝的发生率也明显减少,但hsCRP无显著差异。结论:通过四周的减肥夏令营的行为干预,能有效改善体脂肪含量及其分布,也会损失一定量的去脂组织,但静息能量代谢无减少。提示如能延长这种体重管理项目的干预期限,可有效地维持基础能量消耗,使减脂效果更好。
关键词:减肥夏令营、肥胖儿童青少年、体成分、静息能量代谢、 生化代谢
 

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Estimation of intakes of copper, zinc, and manganese in Japanese adults using 16-day semi-weighed diet records
MAI YAMADA, KEIKO ASAKURA, SATOSHI SASAKI, NAOKO HIROTA, AKIKO NOTSU, HIDEMI TODORIKI, AYAKO MIURA, MITSURU FUKUI AND CHIGUSA DATE
Data for the intake of copper, zinc, and manganese in Japanese populations obtained by detailed diet assessment methods and the most recent version of the food composition database in Japan are scarce. Moreover, data on food sources which contribute to the intake of these nutrients in Asian countries, including Japan, are not available. Here, we estimated copper, zinc, and manganese intake and elucidated major food sources of these nutrients in a Japanese population. We collected 16-day diet records from 225 adults aged 30 to 69 years living in 4 areas of Japan. Intakes of copper, zinc, and manganese were estimated using the 16-day diet records and the latest version of the Food Composition Tables in Japan. Mean intakes of copper, zinc, and manganese were 1.2 mg/day, 8.2 mg/day, and 4.9 mg/day for women and 1.4 mg/day, 10.1 mg/day, and 5.1 mg/day for men, respectively. White rice was the largest contributor to the intake of copper, zinc, and manganese, accounting for approximately 20%-30% of the total intake of each.
Key Words: copper, zinc, manganese, dietary intake, Japanese population
 

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用16 天半定量膳食记录估计日本成年人铜、锌和锰的摄入量
通过详细的饮食评估方法和日本最新版的食物成分数据库获得铜、锌和锰摄入量的数据在日本很罕见。另外,亚洲国家(包括日本)也没有这些营养素食物来源的资料。在这里,我们估计了日本人铜、锌和锰的摄入量,并阐明了这些营养素的主要食物来源。我们收集了225 名居住在日本4 个区域,年龄在30-69 岁的成年人16 天的饮食记录。用16 天的饮食记录和日本最新版的食物成分表估计铜、锌和锰的摄入量。铜、锌和锰的平均摄入量分别为:女性1.2 毫克/天、 8.2 毫克/天和 4.9 毫克/天,男性1.4 毫克/天、 10.1 毫克/天和 5.1 毫克/ 天。白米饭是铜、锌和锰摄入量最大的贡献者,约占每个营养素总摄入量的20%~30%。
关键词:铜、锌、锰、饮食摄入、日本人
 

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Utility of a web-based weight loss program with auto-extraction of behavioural objectives and recording of daily weight and steps in pre-obese outpatients
YOSHINARI MATSUMOTO, SAWAKO YOSHIUCHI, TAKUMI MIYAUCHI, HUMIKAZU HAYASHI, DAIKI HABU AND YUTAKA KIMURA
The epidemic of obesity is now a major public health concern in many parts of the world. Face-to-face tailored lifestyle modification therapy is one of the major approaches used for weight loss. However, the lack of time for multiple visits and the lack of resources for administering therapy hinder its implementation. We administered a web-based weight loss program for obese patients from July 2010 to January 2012 that required only 2 personal interviews over 6 months. The program used a system of auto-extraction of behavioural objectives and autorecording of daily weight and number of steps taken. The subjects included 3 obese men (mean age, 35.7±2.3 years; mean body mass index (BMI), 30.4±0.8 kg/m2) and 17 obese women (mean age, 39.3±9.5 years; mean BMI, 28.1±1.8 kg/m2) who volunteered to participate in this weight loss program. Weight loss achieved through this program was significant (mean, 2.7%, p=0.047). Abdominal visceral fat area (VFA) decreased significantly (mean, 12.6%, p=0.017), and the serum cholinesterase and alanine aminotransferase levels improved (mean, 33 U/L, p=0.003; mean, 7 IU/L, p=0.033 respectively). Metabolic syndrome criteria number had a tendency to decrease. Dietary and nutrient intake levels on the food frequency questionnaire improved. Weight loss ratio after 6 months and initial weight loss ratio were strongly significantly correlated. A web-based weight loss program with auto-extraction of behavioural objectives and recording of daily weight and steps can achieve weight loss, as determined by VFA reduction, on low manpower.
Key Words: web-based, weight loss, weight loss program, visceral fat area, obese
 

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适用于肥胖前期门诊病人智能提取减肥目标和记录每日体重及具体实施步骤的网络减肥方案
目前,肥胖是世界上许多地方的一个重要的公共卫生问题。通过面对面地制定个性化生活方式来治疗肥胖是一个非常重要的方法。但是时间和人员的短缺导致此方法难以推广。我们制订了一套针对肥胖病人基于网络的减肥方案,此方案从2010 年7 月到2012 年1 月间开展,期间,6 个月内仅需要与病人会面两次。该方案使用一套可以智能提取减肥目标和智能记录每日体重以每日所采用的步骤。参与此方案的有3 位肥胖男性(平均年龄:35.7±2.3 岁,平均身高体重指数(BMI):30.4±0.8 kg/m2)和17 位肥胖女性(平均年龄:39.3±9.5岁,平均BMI:28.1±1.8 kg/m2),均自愿参与此项方案。在此项方案实施中,体重明显减轻(平均下降2.7%,p=0.047),腹部内脏脂肪面积(VFA)也有显著下降(平均下降12.6%, p=0.017),血清胆碱酯酶和丙氨酸氨基转移酶升高明显(分别为33 U/L,p=0.003; 7 IU/L, p=0.033)。代谢综合征指标也有所下降。有关食物频率问卷调查显示饮食和营养的摄入水平都有所提高。6个月体重降低率和初始体重降低率显著相关。此项可以智能提取减肥目标和记录每天体重及具体实施步骤的网络减肥方案在节约人力资源的情况下,能够有效减轻体重、减少VFA。
关键词:基于网络、减轻体重、减轻体重方案、腹部内脏脂肪面积、肥胖

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Iodine status of Taiwanese children before the change in national salt iodization policy: a retrospective study of the nutrition and health survey in Taiwan 2001-2002
KAM-TSUN TANG, WEN-HARN PAN, FAN-FEN WANG, JIUNN-DIANN LIN, GING-SHING WON, WING-KEUNG CHAU, HONG-DA LIN AND YAO-TE HSIEH
Taiwan was an iodine deficiency area and endemic goiter was common in 1940’s. Mandatory salt iodization started in 1967, and a 1971 survey indicated that goiter rates in children decreased from 21.6% to 4.3%. To understand iodine status before the change of national salt iodization program in 2003, from mandatory to voluntary salt iodization, we retrospectively measured urinary iodine concentrations of samples collected from children in the Nutrition and Health Survey in Taiwan 2001-2002. The median UI level for children aged 6-12 years was 123 μg/L (no differences between males and females). Females aged 10-12 years had the lowest urinary iodine levels. The percentages of this population with urinary iodine levels below 100, 50, and 20 μg/L were 35.2%±1.0%, 4.4%±0.4%, and 0.2%±0.1%, respectively. Older children were more likely to have low urinary iodine levels. People living in different areas of Taiwan had a median urinary iodine levels ranged from 113 μg/L to 164 μg/L (males: 113-153 μg/L; females: 105-174 μg/L), with the highest level in Penghu islands, and the lowest level in the eastern and southern (Southern area 2) areas. According to international criteria, iodine status in 2001-2002 was adequate, comparable to the surveyed goiter rates (4.3%, classified as iodine sufficiency) in 1971, inferring that iodine nutrition remained adequate and stable during this period. The present study is of great importance in documenting the iodine status of Taiwan before the change from mandatory to voluntary salt iodization to serve as a baseline data for future trend analysis in iodine nutrition.
Key Words: thyroid gland, iodine, iodized salt, nutrition surveys, Taiwan
 

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台灣學童在國家食鹽加碘政策變更前的碘營養狀況:台灣2001-2002 營養健康調查之回顧性研究
過去台灣是屬於缺碘地區,地方性甲狀腺腫在1940 年代時十分流行。台灣自1967 年開始實施強制性食鹽加碘以來,學童的甲狀腺腫大率由當時的21.6%降至1971 年的4.3%。為瞭解國家食鹽加碘政策,在2003 年從強制改為自願加碘前的碘營養狀況,我們回顧性檢測2001-2002 台灣學童營養健康調查所收集尿液標本的碘濃度。發現6-12 歲學童的尿碘中位數是123 微克/升(男女沒有差異),當中以10-12 歲女生的尿碘濃度最低。學童尿碘濃度低於100、50 和20微克/升的人口百分比分別是35.2% ± 1.0%、4.4% ± 0.4%和0.2% ± 0.1%,年紀較大的學童尿碘濃度較容易偏低。台灣各地區層的學童尿碘中位數介於113 微克/升至164 微克/升之間 (男生113 - 153 微克/升;女生105 - 174 微克/升),當中最高是澎湖,最低是東部層和南二層。根據國際標準,台灣在2001-2002 年時的碘營養狀況是足夠的,相較於1971 年時的甲狀腺腫大率4.3% (定義為碘足夠),並無多大差別,推測這段期間台灣的碘營養維持正常和穩定。本研究記錄台灣食鹽加碘政策從強制改為自願加碘前的碘營養狀況,提供日後碘營養變化、趨勢分析和比較極為重要的基礎數據。
關鍵字:甲狀腺、碘、加碘鹽、營養調查、台灣

 

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Association of roasting meat intake with the risk of esophageal squamous cell carcinoma of Kazakh Chinese via affecting promoter methylation of p16 gene
WEIGANG CHEN, CHUNMEI YANG, LAN YANG, CUIHUA QI, SHUXIN TIAN, YUSHENG HAN, YUQIN DOU, YUNGUI MA, DEAN TIAN AND YONG ZHENG
Background: Esophageal squamous cell carcinoma (ESCC) incidence is high in Kazak Autonomous Prefecture, Xinjiang, China. Roasting food has been reported to be related with the risk of various cancers and is very popular in the area, and may be related with the risk of ESCC. The promoter methylation inactivation of p16 gene can increase the risk of ESCC. Thus, we want to know whether long-term roasting food is related with the risk of ESCC by effecting the promoter methylation of p16 gene. Materials and Methods: Ninety ESCC patients and 60 healthy subjects were recruited from Kazak Autonomous Prefecture. MassARRAY was used to detect p16 promoter methylation in ESCC tissues, as well as in normal esophageal tissues. The association between the p16 promoter methylation and daily roasting meat intake was examined. Results: Daily roasting meat intake was related with the risk of ESCC (p<0.01) and the mean CpG methylation rates of p16 promoter (p<0.01). In ESCC patients, the mean methylation rates of CpG 11-12 and CpG 33-34-35 were 29.4% and 37.4%, respectively, which was significantly higher than the rates in normal esophageal tissues (16.7% and 12.4%, respectively; p<0.01). The methylation of p16 promoter is also related with daily roasting meat intake (p<0.01) in Kazakh Chinese with ESCC. For the CpG methylation of the p16 promoter in the well, moderately and poorly differentiated ESCC, there are significant differences (p<0.05) for the 19 CpG units in the ESCC and controls. Conclusion: Roasting meat intake was associated with the risk of ESCC via effects on the methylation of p16 promoter. These results suggest roasting food intake should be limited in the diet.
Key Words: esophageal squamous cell carcinoma, p16 promoter methylation, Kazakh Chinese, MassARRAY, roasting
meat

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烤肉摄入通过影响p16 基因启动子甲基化增加中国哈萨克族人患食管鳞状细胞癌的风险
背景: 食管鳞状细胞癌(ESCC)在中国新疆维吾尔自治区伊犁哈萨克自治州有较高的发病率。据报道吃烧烤食物容易患癌,而烧烤食物在该地区非常流行或许增加患ESCC 的风险。p16 基因的启动子甲基化会使该基因失活增加患ESCC 的风险。因此,我们想知道长期食用烧烤食物是否会影响p16 基因的启动子甲基化,进而增加患ESCC 的风险。材料和方法:从哈萨克自治州召集90 名ESCC 患者和60 名健康者,用MassARRAY 技术检测ESCC 组织和正常食管组织的p16 基因启动子甲基化程度。同时调查了p16 基因启动子甲基化与每日食用烤肉的关系。结果: 每日食用烧烤食物会增加患ESCC 风险(p< 0.01)和p16 基因启动子甲基化程度(p<0.01)。在ESCC 患者中, p16 基因启动子中CpG 11-12 和CpG 33-34-35 甲基化率分别是29.4%和37.4%, 高于正常组织中的16.7%和12.4%(p<0.01)。在哈萨克自治州的ESCC 患者中, p16 基因启动子甲基化率与日常烧烤食物食用相关(p<0.01)。在健康人,良性、中性和恶性ESCC 中,p16 基因启动子19 CpG 甲基化也不同(p<0.05)。结论:
烤肉摄入可能影响p16 基因启动子甲基化程度,从而增加患ESCC 的风险。本结果警示在日常的饮食中应该限制食用烧烤食物。
关键词:食管鳞状细胞癌、p16 基因启动子的甲基化、中国哈萨克族、MassARRAY、烤肉

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An improved method of nasojejunal feeding tube placement for patients requiring endoscopic nasobiliarydrainage
XIN-HONG WANG, ZHI-WU LV, BO QU, HUI XING, BING DU AND CHENG-QIAN LV
Objective: To avoid a second endoscopy for nasojejunal feeding tube placement (NFTP) in patients undergoing endoscopic nasobiliary drainage (ENBD), we studied improved NFTP method and compared it to endoscopic method. Methods: Patients with ENBD were divided into two groups. One group (18 patients) received endoscopic NFTP and the other group (26 patients) received improved NFTP. Placement time, physical condition of the patients and complications were recorded. Results: In 18 patients who underwent endoscopic NFTP, NFT was successfully placed on the first attempt in 14 patients with a first placement success rate of 77.8%. NFT was wrongly intubated into the trachea in one patient inducing coughing, and after it was removed, the second placement was successful. The total success rate of endoscopic NFTP was 83.3% with an average placement time of 17.0 minutes. In 26 patients undergoing improved NFTP, all were successfully placed on the first attempt with a success rate of 100%, and an average placement time of 2.55 minutes. In patients with ENBD, the success rate of improved NFTP was significantly higher than endoscopic NFTP (χ2=36.4, p<0.05) with a significantly shorter placement time (t=18.5, p<0.05). Conclusion: For patients with ENBD, improved NFTP method is superior to the endoscopic method as it is more effective, convenient, faster, and cheaper. Additionally it avoids a second endoscopy and has fewer complications, better security and a higher success rate. The improved method is a safer, easier, more effective and practical method of EN and deserves general adoption in clinical work.
Key Words: nasojejunal feeding tube placement, endoscopy, endoscopic nasobiliary drainage, an improved method,
nutrition

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鼻胆管引流患者放置空肠营养管的一种新方法
目的:为避免鼻胆管引流患者放置空肠营养管时二次内镜检查的痛苦,我们研究改进了新的置管方法,并与原有的内镜下空肠营养管置入术的方法进行比较。方法:将需要放置鼻胆管引流的病人分为两组,一组用内镜下空肠营养管置入术18 例,另一组用我们研究改进的新方法放置空肠营养管26 例。记录空肠营养管置入的时间、病人的生理状况及并发症等。结果:内镜下空肠营养管置入术18 例,有14 例一次置管成功,成功率为77.8%,有1 例误入气管病人呛咳,拔出后二次置管成功,总成功率为83.3%,平均置管时间为17 分钟。用我们研究改进的新方法放置空肠营养管26 例,均一次置管成功,成功率为100%,平均置管时间为2.55 分钟。对于鼻胆管引流的患者来说,改进的新方法放置空肠营养管成功率明显高于内镜下空肠营养管置入术(χ2=36.4, p<0.05),操作时间也明显短于后者(t=18.5, p<0.05)。结论:对需要放置鼻胆管引流的病人,我们研究的新方法比内镜下空肠营养管置入术更方便、有效、快速、便宜,而且避免了二次内镜检查的痛苦,并发症少,安全性及成功率高。
该方法对鼻胆管引流患者是一种安全、有效、实用性强的肠内营养置管方法,值得在临床工作中广泛推广。
关键词:鼻空肠喂养管放置、内镜、内镜鼻胆管引流术、一种改进的方法、营养

 

Last Updated: September 2014