【摘要】 目的 利用人体成分分析仪测定肿瘤化疗患者人体组成,进而探讨肿瘤化疗患者人体成分组成特点及与营养状况的关系。 方法 用人体成分分析仪于2008年4-5月对50例肿瘤化疗患者行人体成分测定并分析。 结果 肿瘤化疗患者人体细胞内液、外液,体内水分、蛋白质、矿物质、骨骼肌含量等成分存在不足,且有30％的肿瘤化疗患者体脂肪含量过剩,40％体脂肪百分比超标。 结论 肿瘤化疗患者由于疾病自身的高消耗,化疗药物对机体的影响,导致摄入不足,营养状况较差,各成分含量均异常。其营养问题应受到重视,并采取积极有效的营养支持以改善营养状况。【Abstract】 Objective To detect the body compositions of patients with carcinoma who had undergone chemotherapy, and to analyze the features of the composition and its relationship with nutritional status. Methods Bioelectrical impedance analyzer was used to measure and analyze the body compositions of 50 patients who was underwent chemotherapy from April to May 2008. Results The compositions such as intracellular and extracellular water, total body water, protein, minerals, skeletal muscle mass were insufficient in patients who had undergone chemotherapy; 30% of the patients had excess body fat, and 40% of the patients′ body fat percent was over standard. Conclusion Because of the high consumption of disease itself and the effects of chemotherapy drugs on the body, the intake of the patients who have undergone chemotherapy is insufficient and the nutritional status is poor. We should actively evaluate their nutritional status and do some effective nutritional supports to improve the nutritional status of patients with carcinoma who have undergone chemotherapy.
Objective To explore the correlations between nutritional markers and pressure injury (PI) in elderly patients with chronic obstructive pulmonary disease (COPD). Methods Retrospective analysis was conducted on elderly patients with COPD and PI who were admitted to the geriatric department of West China Hospital of Sichuan University or Dujiangyan People’s Hospital between January 2020 and December 2021. The blood biochemical indicators mainly including nutritional markers were collected, and their correlations with PI risk factor index Braden score and PI severity index PI stage were analyzed. Results A total of 293 patients with COPD and PI were included. Among the five Braden score groups, the differences in the levels of albumin and prealbumin were statistically significant (P<0.05), and the Braden score was positively correlated with albumin (rs=0.241, P<0.001), prealbumin (rs=0.179, P=0.002), and hemoglobin (rs=0.199, P=0.001). Among the six PI stage groups, the differences in the levels of albumin, globulin, red blood cell count, serum sodium, blood chloride and C-reactive protein were statistically significant (P<0.05), and the PI stage was negatively correlated with albumin (rs=−0.192, P=0.001), and positively correlated with serum sodium (rs=0.139, P<0.001), blood chloride (rs=0.184, P<0.001), and C-reactive protein (rs=0.177, P=0.020). Conclusion When PI risk assessment and severity assessment are performed on elderly COPD patients, it is necessary to pay more attention to nutritional markers and assess whether the patients are at risk of protein malnutrition, which will help to improve the accuracy of PI risk assessment and severity prediction, and effectively improve the efficacy of PI prevention and treatment.
ObjectivesTo evaluate the quality of guidelines on nutrition in liver disease from 2017 to 2019, and to interpret these guidelines so as to provide references for clinical practice.MethodsComputer-assisted literature searches in CNKI, VIP, WanFang Data, Medline (Ovid), The Cochrane Library, PubMed and Medlive databases were performed by two reviewers for guidelines on nutrition in liver disease from January 2017 to July 2019. Two reviewers extracted data and assessed the methodological quality of the included guidelines using AGREE II, separately. Meanwhile, the intraclass correlation coefficient (ICC) was used to assess the degree of consistency.ResultsFour guidelines were included with 2 from China and 2 from Europe. Their average standardised scores in the 6 domains of scope and purpose, stakeholder involvement, rigour of development, clarity, applicability and independence were 79.17%, 71.53%, 78.13%, 85.42%, 61.98% and 43.75%, respectively. The Chinese and European guidelines had similar recommendations for energy and other nutrients, apart from differences in recommendations for protein intake. The European guidelines considered that restricting protein intake was not beneficial for patients with hepatic encephalopathy, while the Chinese guidelines argued that patients with severe hepatic encephalopathy were required to reduce or limit their protein intake.ConclusionsAll 4 guidelines are of average quality and are required to be strengthened in the ‘independence’ domain. Currently, the only consensus on nutrition therapy for liver disease and guidelines on nutrition in end-stage liver disease are available for references in China, with lower quality scores than that of the European guidelines. Therefore, the evidence-based guidelines on nutrition in liver disease should be developed by Chinese national conditions as soon as possible to provide references for clinicians, nurses and clinical nutritionists, enableing them to implement nutrition screening, evaluation, nutritional therapy and follow-up management for patrents with liver disease.
Objective To observe the therapeutic effect of thermosensitive hydrogel containing curcumin-vitamin E (VE) complex (hereinafter referred to as “curcumin-VE hydrogel”) on radiation-induced oral mucositis in mice. Methods Curcumin-VE hydrogel was prepared using the synthesized curcumin-VE complex as the carrier and poloxam as the substrate. The structure of curcumin-VE complex was characterized by Fourier transform infrared spectrometer, the microstructure of curcumin-VE hydrogel was determined by scanning electron microscope, and the gelation temperature was determined by rheometer, gel swelling and degradation were tested and gel adhesion was determined using a universal testing machine. Thirty healthy male BALB/C mice with specific pathogen free grade were randomly divided into three groups, with ten mice in each group. The radiation group and radiation+hydrogel group were modeled by a single high dose of radiation (25 Gy), while the control group had anesthesia but no radiation. The control group and radiation group were given daily feed and water 7 days after radiation. In addition to daily feed and water, the radiation+hydrogel group was given curcumin-VE hydrogel twice a day. The mice were sacreficed on the 8th day after radiation. The weight changes of each group were recorded after radiation. The ulceration area of tongue was measured by toluidine blue. The tongue of mouse were pathologically observed. The activities of superoxide dismutase, catalase (CAT), and glutathione peroxidase and the level of malondialdehyde in tongue tissue were determined. The levels of tumor necrosis factor α (TNF-α), interleukin (IL)-1β and IL-6 in tongue tissue were determined by enzyme linked immunosorbent assay. The distribution and positive expression of phosphorylated histone H2AX (γ-H2AX) and nuclear factor-erythroid 2-related factor 2 were determined by immunohistochemistry. Results Curcumin-VE hydrogel had a porous network structure and the gelation temperature was 30℃, the swelling rate was close to 300%, the gel degradation rate was up to 95% after 48 h, and the adhesion strength was 12.748 kPa. Compared with the radiation group, the weight of mice in the radiation+hydrogel group increased (P<0.05), the ulcer area decreased (P<0.05); the activity of CAT increased (P<0.05); the levels of TNF-α, IL-1β and IL-6 decreased (P<0.05); the expression of γ-H2AX was down-regulated (P<0.05). Conclusion Curcumin-VE hydrogel can delay or weaken the process of radiation-induced oral mucositis by reducing the DNA damage caused by radiation, inhibiting the production of reactive oxygen species, and effectively reducing the level of inflammation in tongue tissue.
ObjectiveTo evaluate the dietary and nutritional status of elderly patients with chronic non-infectious diseases in community hospitals in order to make a reasonable dietary pattern for these patients. MethodsA total of 179 elderly patients with chronic non-infectious diseases in a community hospital of Chengdu from January to September 2014 were collected, and we investigated them on their dietary status and basic personal information. The desirable dietary pattern (DDP) score was adopted to evaluate their dietary and nutritional status. ResultsDDP score of the 179 patients with chronic non-infectious diseases in the community hospital was 91.47, and the dietary quality was relatively good. While the DDP scores of animal food and edible oil exceeded the maximum allowable value, DDP scores of the staple food, fish, eggs, vegetables and fruits were lower than the expected scores. ConclusionIt is suggested that meat and other animal food intake be reduced and replaced by regular intakes of poultry, fish and shrimp, and the intake of staple food, eggs, vegetables, fruits be increased to ensure a balanced diet.
Objective To compare the effectiveness of three teaching modes, namely traditional teaching, online teaching, and online and offline blended teaching, in the teaching of the clinical nutrition elective course, and to evaluate the advantages of the online and offline blended teaching mode. Methods A total of 316 students taking the clinical nutrition elective course at Sichuan University in one of the three semesters, Fall 2019-2020, Spring 2019-2020, and Fall 2020-2021, were enrolled as the study population. In the offline group, 69 students used the traditional teaching mode; in the online group, 133 students used the online teaching mode through Chaoxing Xuexitong application; in the online and offline blended teaching group, 144 students used the traditional teaching mode combined with the online teaching. The final exam results and questionnaire satisfaction of the three groups were analyzed and compared. The exam results were presented as median (lower quartile, upper quartile). Results The exam results of the online group [males: 88.0 (85.0, 93.0); females: 91.0 (86.0, 94.0)] and the online and offline blended group [males: 90.0 (83.0, 94.0); females: 91.0 (87.5, 95.0)] were significantly higher than those of the offline group [males: 83.0 (77.0, 89.0); females: 77.5 (67.0, 87.0)] (P<0.001). Compared to the offline teaching mode and online teaching mode, the female students’ satisfaction with the online and offline teaching mode was better (P<0.01). Conclusion The online and offline blended teaching mode can significantly improve students’ performance and learning motivation, and provide a basis for promoting the reform of the clinical nutrition elective course.
Objective To explore the effects of heat-inactivated Lactobacillus gasseri TMC0356 on liver lipid metabolism in rats with metabolic syndrome (MS) and its possible mechanism. Methods Sixty male Sprague-Dawley rats were selected. Rats were randomly divided into 5 groups, including control group, MS model group and three TMC0356 test groups (low-, medium- and high-dose groups). The rats in each group were fed with different diets for 7 days, and the liver was dissected and removed after 15 weeks. The mRNA and protein expression levels of peroxisome hyperbioactive receptor-α (PPAR-α), sterol regulatory element binding protein-1c (REBP-1c), fatty acid synthase (FAS) and carnitine lipoacyltransferase-1 (CPT-1) genes in liver were detected. Results There was no significant difference in the mRNA expression of PPAR-α, SREBP-1c or CPT-1 among the five groups (P>0.05). The mRNA expression of FAS in low-dose TMC0356 test group was lower than that in MS model group (P=0.011), medium-dose TMC0356 test group (P=0.042) and high-dose TMC0356 test group (P=0.009). There was no significant difference in the expression of FAS mRNA between other groups (P>0.05). There was no significant difference in the protein expression of PPAR-α, SREBP-1c or FAS among the five groups (P>0.05). The protein expression of CPT-1 in low-dose TMC0356 test group was higher than that in control group (P=0.033) and high-dose TMC0356 test group (P=0.043). There was no significant difference in the protein expression of CPT-1 between the other groups (P>0.05). Conclusion Heat-inactivated Lactobacillus gasseri TMC0356 may improve the symptoms of metabolic disorder in rats by suppressing appetite, improving insulin resistance, and downregulating the expression of key fat metabolism genes such as FAS and SREBP-1c.
ObjectiveTo systematically evaluate the efficacy of probiotics in preventing antibiotic-associated diarrhea (AAD) in aged people. MethodsPubMed, Web of Science, the Cochrane Database of Systematic Reviews, the Cochrane Controlled Trials Register, CNKI, VIP, and WANFANG electronic databases were searched for studies published, and references of included studies and reviews were screened from database inception to April 2014. Only randomized, controlled trials involving patients older than 65 years were included. Furthermore, only the trials which combined antibiotic administration and probiotic therapy for the prevention of AAD and Jadad score >3 were extracted. ResultsA total of eight articles containing 3 680 subjects (1 843 in the probiotic group, 1 837 people in the control group) met the inclusion criteria. Meta-analysis showed that there was no significant difference in the risk of antibiotic-associated diarrhea (AAD) between probiotics and control groups[RR=0.76, 95%CI (0.51, 1.13), P=0.17]. Further subgroup analysis found that compared with the control group, saccharomyces[RR=1.24, 95%CI (0.70, 2.19), P=0.46], lactobacillus[RR=0.59, 95%CI (0.31, 1.13), P=0.11], multi-probiotics combination[RR=0.58, 95%CI (0.24, 1.41), P=0.23] in the probiotics group were not significantly different. ConclusionThere is no evidence to support that probiotics can reduce the risk of AAD among aged people administrated with antibiotics therapy.