[Effects of glutamine-enriched enteral nutrition on nutritional status and prognosis of patients with severe head injury].

OBJECTIVE: To investigate the effects of glutamine-enriched enteral nutrition on the nutritional status and prognosis of patients with severe head injury. METHODS: Thirty-three patients with severe head injury were randomly divided into control group (C, 15 cases) and glutamine-enriched group (Gln, 18 cases). Patients in both groups were given routine treatment and enteral nutrition with the same amount of nitrogen and calorie. Patients in Gln group were given glutamine 0.5 g x kg(-1) x d(-1) additionally added into the nutrient fluid. Vital signs and the occurrence of side effects of all patients were observed before and after nutrition support. Venous blood and urine sample of all patients were collected before and 7, 14 days after treatment to determine the parameters of blood, urine routine and hepatorenal function. At the same time points, body mass, skin fold thickness at the region of triceps brachii (TSF), upper arm circumference (AC), upper arm muscle circumference (AMC) and fasting blood glucose of all patients were detected and determined, Glasgow coma scale (GCS) scoring was performed. The length of hospital stay of all patients was recorded. RESULTS: Vital signs and parameters of blood, urine routine and hepatorenal function of patients in 2 groups after nutrition treatment were close to those before treatment. Side effects, such as nausea and diarrhea occurred with spontaneous remission in a few patients. There was no statistical significant difference between 2 groups, and within each group before and after treatment, in respect of body mass and TSF (P > 0.05). Values of AC and AMC of patients in Gln group were obviously higher than those of C group (P < 0.01) on post-treatment day 14. Fasting blood glucose and GCS score of all patients before treatment were close to those on post-treatment day 14 (P > 0.05). Fasting blood glucose and GCS score of patients was respectively lower and higher in Gln group than that in C group on post-treatment day 7 (P < 0.05). Length of hospital stay of patients in Gln group (25 +/- 9) d was obviously shorter than that of C group (33 +/- 12) d (P < 0.05). CONCLUSIONS: Glutamine-enriched enteral nutrition can control the blood glucose level, prevent the loss of lean tissue, improve nutrition status of patients,shorten hospital stay, and accelerate the recovery of patients to some extent.

[Expression and clinical significance of cyclooxygenase-2 in medulloblastoma].

OBJECTIVE: To gain an insight into the possible relationship between the expression of cyclooxygenase-2 (COX-2) and the prognosis of the patients with medulloblastoma. METHODS: COX-2 expression was investigated in 52 medulloblastoma and 10 normal cerebellar tissue specimens by immunohistochemistry. Kaplan-Meier analyses, Log-rank test, and Cox proportional hazard model were used to explore the relationship between the percentage of COX-2 expression and the survival period of patients with medulloblastoma. RESULTS: Positive staining with COX-2 was either moderately or strongly observed in most of the medulloblastoma (51/52). Moreover, COX-2 was expressed not only in tumor cells, but also in the vascular endothelial cells of tumor. No COX-2 immunoreactivity was observed in normal cerebellar tissue. Kaplan-Meier analyses demonstrated that high COX-2 expression (> or = 50% of cells stained positive) correlated with poor survival for the study group as a whole (P < 0.0001). CONCLUSION: Our study provides evidence that COX-2 is expressed in the majority of medulloblastomas and that a potential role of COX-2 inhibitors as an adjuvant therapy for brain tumors may exist.