Objective    To observe the intervention effect of combined glutamine and vitamin C on heat apoplexy and enterogenous endotoxemia and its mechanism.     Methods     Forty-eight soldiers at military training in high temperature environment were divided into heat-apoplexy treatment group (n=24) and control group (n=24). Soldiers in heat-apoplexy treatment group were treated with combined glutamine and vitamin C plus routine oral fluid

while those in control group were given routine oral fluid and placebo. Incidence of heat apoplexy

oxidative stress index

plasma endotoxin

ultra-structure of duodenal mucosa and expression of heat shock protein 70 (HSP70) in duodenal mucosa were compared before and after training.     Results    The incidence of heat apoplexy was 8.3% (2/24) and 33.3% (8/24) in heat-apoplexy treatment group and control group

respectively (P0.01). The level of superoxide dismutase (SOD) was higher while the serum level of malondialdehyde (MDA) and endotoxin was lower in heat-apoplexy treatment group than in control group (P0.01). Transmission electron microscopy showed that the villi

orgaelles and endoplasmic reticulum of duodenal mucosa were almost normal in heat-apoplexy treatment group. However

the villi were arranged in disorder with enlarged orgaelles and endoplasmic reticulum of duodenal mucosa in control group. Immunohistochemistry showed that the expression level of HSP70 was significantly higher in heat-apoplexy treatment group than in control group.     Conclusion    Glutamine in combination with vitamin C can provide the energy for the repair of small intestine

increase the protective effect of HSP70 on small intestine

and reduce the incidence of oxidative stress reaction

thus protecting the barrier function of small intestine and decreasing the occurrence of enterogenous endotoxemia. It can thus be used in prevention of heat apoplexy.