Effect of glutamine enriched nutrition support on surgical patients with gastrointestinal tumor: a meta-analysis of randomized controlled trials.

BACKGROUND: Associations between glutamine (Gln) enriched nutrition support and surgical patients with gastrointestinal (GI) tumor remain controversy. The purpose of this meta-analysis was to assess the effect of Gln enriched nutrition support on surgical patients with GI tumor in term of relevant biochemical indices, immune indices, and clinical outcomes. METHODS: Six databases were systematically searched to find eligible randomized controlled trials (RCTs) from 1966 to May 2014. When estimated the analysis indexes, the relative risk (RR) was used as the effect size of the categorical variable, while the weighted mean difference (MD) was used as the effect size of a continuous variable. Meta-analysis was conducted with Rev Man 5.2. RESULTS: Thirteen RCTs, involving 1034 patients, were included in the meta-analysis. The analysis showed that Gln enriched nutrition support was more effective in increasing serum albumin (MD: 0.10; 95% confidence interval [CI]: 0.02-0.18; P < 0.05), serum prealbumin (MD: 1.98; 95% CI: 1.40-2.55; P < 0.05) and serum transferring (MD: 0.35; 95% CI: 0.12-0.57; P < 0.05), concentration of IgG (MD: 1.26; 95% CI: 0.90-1.63; P < 0.05), IgM (MD: 0.18; 95% CI: 0.11-0.25; P < 0.05), IgA (MD: 0.22; 95% CI: 0.10-0.33; P < 0.05), CD3 + (MD: 3.71; 95% CI: 2.57-4.85; P < 0.05) and CD4/CD8 ratio (MD: 0.27; 95% CI: 0.12-0.42; P < 0.05). Meanwhile, it was more significant in decreasing the incidence of infectious complications (RR: 0.67; 95% CI: 0.50-0.90; P < 0.05) and shortening the length of hospital stay (MD: -1.72; 95% CI: -3.31--0.13; P < 0.05). CONCLUSIONS: Glutamine enriched nutrition support was superior in improving immune function, reducing the incidence of infectious complications and shortening the length of hospital stay, playing an important role in the rehabilitation of surgical GI cancer patients.

Speciation analysis and the assessment of bioavailability of manganese in phytomedicines by extraction with octanol and determination by flame atomic absorption spectrometry.

Trace elements in phytomedicines are present in the form of metallic complexes. Since n-octanol, a long-chain alkanol, presents a configuration similar to that of carbohydrates and lipids, the lipophilicity and absorptivity of organic medicines may be assessed from their distribution coefficients between octanol and water. This strategy has been used in order to define the species of manganese in a number of phytomedicines and to study the distribution of manganese in decoctions of phytomedicines in the stomach and the intestine. The concentrations of manganese in the original herbal materials and in octanol- and water-soluble fractions were determined by flame atomic absorption spectrometry following mixed acid digestion. The acidities of gastric and intestinal juices, the phytomedical composition and the compatibility of phytomedicines, i.e. the combination of single phytomedicines, greatly affected the manganese complexing ligands and determined the species and bioavailability of manganese. It is concluded that a knowledge of the level of octanol-soluble manganese in a phytomedicine could form the basis of dosage design in order to avoid manganese overload.