As we know, nutritional support plays a key role in the treatment of severe acute pancreatitis (SAP). Since total parenteral nutrition (TPN) was discovered, the mortality of SAP had been greatly reduced. But researchers recently demonstrated that the prognosis of SAP could be improved by early enteral nutrition (EEN), which has been a priority for nutritional support in patients with SAP. However, implementation of total enteral nutrition is often challenging in the early stage of SAP. If the enteral nutrition is overused, the burden on the gastrointestinal tract will be aggravated. Under such circumstances, the combination of enteral and parenteral nutrition for nutritional support of SAP patients would be a better choice. Therefore, in this study, we compared the efficacy of two enteral nutrition agents: traditional nutritional supplement named Luzhou-Feier powder (LZ-FP) and enteral nutritional suspension (TPF) combined with parenteral nutrition to total parenteral nutrition (TPN) in the treatment of SAP rats. Our analysis revealed that the combination of enteral nutrition and parenteral nutrition was more effective than TPN in SAP. And LZ-FP met the requirements for enteral nutrition of SAP supporting its clinical application in SAP. PRACTICAL APPLICATIONS: Luzhou-Feier powder (LZ-FP) is a traditional Chinese nutritional supplement that was originally developed as a nutritional supplement for infants and is currently used for nutritional support in patients with chronic and consumptive diseases. Our research investigated the effect and its possible mechanisms of LZ-FP as early trophic enteral nutrition in SAP rats and compared it with TPF and TPN which have been used clinically. We found that LZ-FP helped to reduce inflammatory response and improve the intestinal immune barrier of SAP. The curative effect of LZ-FP was comparable to that of TPF. And this effect may be achieved by inducing the secretion of gut hormones. Our research indicates that LZ-FP should be considered as an enteral nutrition preparation for SAP.
BACKGROUND: Whether to provide rhubarb combined with early enteral nutrition (rhubarb/EEN) to patients with severe acute pancreatitis (SAP) remains controversial. This study aimed to systematically explore the efficacy and safety of rhubarb/EEN in SAP patients. METHODS: We performed searches in EMBASE, PubMed, Medline, Cochrane Library, Chinese Biomedicine Literature Database (SinoMed), Chinese Scientific Journal Database (VIP), Chinese National Knowledge Infrastructure (CNKI), and Wanfang datab...
#1Dawid Maduzia(Jagiellonian University Medical College)H-Index: 4
#2Piotr Ceranowicz(Jagiellonian University Medical College)H-Index: 26
Last. Zygmunt Warzecha(Jagiellonian University Medical College)H-Index: 26
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In acute pancreatitis (AP), pancreatic damage leads to local vascular injury, manifesting as endothelial damage and activation, increased vascular permeability, leukocyte rolling, sticking and transmigration to pancreatic tissue as well as activation of coagulation. Previous studies have shown that pretreatment with heparin or acenocoumarol inhibits the development of AP. The aim of the present study was to check the impact of pretreatment with warfarin, an oral vitamin K antagonist, on the deve...
The structurally-related peptides, gastrin and cholecystokinin (CCK), were originally discovered as humoral stimulants of gastric acid secretion and pancreatic enzyme release, respectively. With the aid of methodological advances in biochemistry, immunochemistry, and molecular biology in the past several decades, our concept of gastrin and CCK as simple gastrointestinal hormones has changed considerably. Extensive in vitro and in vivo studies have shown that gastrin and CCK play important roles ...
Acute pancreatitis (AP) is a severe inflammation of the pancreas presented with sudden onset and severe abdominal pain with a high morbidity and mortality rate, if accompanied by severe local and systemic complications. Numerous studies have been published about the pathogenesis of AP; however, the precise mechanism behind this pathology remains unclear. Extensive research conducted over the last decades has demonstrated that the first 24 h after symptom onset are critical for the identification...
Gut hormones have many key roles in the control of metabolism, as they target diverse tissues involved in the control of intestinal function, insulin secretion, nutrient assimilation and food intake. Produced by scattered cells found along the length of the intestinal epithelium, gut hormones generate signals related to the rate of nutrient absorption, the composition of the luminal milieu and the integrity of the epithelial barrier. Gut hormones already form the basis for existing and developin...
BACKGROUND: Enteral nutrition (EN) is more beneficial than parenteral nutrition (PN) in reducing organ failure, infectious complications, and mortality of acute pancreatitis (AP), but its timing is controversial. We attempted to evaluate the safety and clinical outcomes of early EN within 24 hours of admission in patients with AP, especially in predicted severe or severe acute pancreatitis (SAP). METHODS: We searched PubMed, EMBASE Databases, Web of Science, and the Cochrane Library for relevant...
#2Feng Wang(HMU: Harbin Medical University)H-Index: 3
Last. Gang Wang(HMU: Harbin Medical University)H-Index: 14
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In the early stage of acute pancreatitis (AP), abundant cytokines induced by local pancreatic inflammation enter the bloodstream, further cause systemic inflammatory response syndrome (SIRS) by “trigger effect”, which eventually leads to multiple organ dysfunction syndrome (MODS). During SIRS and MODS, the intestinal barrier function was seriously damaged accompanied by the occurrence of gut-derived infection which forms a “second hit summit” by inflammatory overabundance. Gastrointestinal micro...
OBJECTIVE:To explore the therapeutic effect of Bifidobacterium combined with early enteral nutrition in severe acute pancreatitis. PATIENTS AND METHODS:A total of 60 patients with severe acute pancreatitis admitted from November 2012 to November 2016 were retrospectively analyzed. According to the different treatment methods, the patients were divided into Bifidobacterium combined with early enteral nutrition group (experiment group) and early enteral nutrition group (control group). Serum ALB (...
Intestinal mucosal immune barrier dysfunction plays a key role in the pathogenesis of severe acute pancreatitis (SAP). Rhubarb is a commonly used traditional Chinese medicine as a laxative in China. It markedly protects pancreatic acinar cells from trypsin-induced injury in rats. Free total rhubarb anthraquinones (FTRAs) isolated and extracted from rhubarb display the beneficial effects of antibacteria, antiinflammation, antivirus, and anticancer. The principal aim of the present study was to in...
OBJECTIVES:The aim of the study was to observe the role of nucleotide-binding and oligomerization domain (NOD)-like receptors (NLR) in intestinal injury of severe acute pancreatitis (SAP) in rats. METHODS:Severe acute pancreatitis was induced by retrograde infusion of sodium taurocholate into the biliopancreatic duct. Rats were divided into the following 6 groups: sham operation, SAP treated with saline, and SAP treated with interleukin 1β (IL-1β)-converting enzyme inhibitor, killed at 6 or 12 h...
