Pub Date : 2018-02-28DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.01.008
Wenfang Wu
As a new guidance in central venous access device tip placement, electrocardiogram has been widely used in intravenous infusion therapy, reportedly with sound outcome. We wrote this review to help clinical nurses understand and use this approach. Key words: Peripherally inserted central catheter; Electrocardiogram
{"title":"Research progress in electrocardiogram-guided peripherally inserted central catheter placement and tip position","authors":"Wenfang Wu","doi":"10.3760/CMA.J.ISSN.1674-635X.2018.01.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2018.01.008","url":null,"abstract":"As a new guidance in central venous access device tip placement, electrocardiogram has been widely used in intravenous infusion therapy, reportedly with sound outcome. We wrote this review to help clinical nurses understand and use this approach. \u0000 \u0000 \u0000Key words: \u0000Peripherally inserted central catheter; Electrocardiogram","PeriodicalId":9877,"journal":{"name":"Chinese Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46641970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To explore the prognostic value of sarcopenia in patients undergoing pancreaticoduodenectomy. Method Clinicopathologic data and follow-up information of 116 patients undergoing pancreaticoduodenectomy at Renmin Hospital of Wuhan University between March 2011 and August 2016 were collected for statistical analysis. Results Among the 116 patients, the prevalence of sarcopenia was 42.2% (n=49). When compared to the rest of the patients who did not have sarcopenia, the sarcopenia group had longer recovery time [(17.33±6.54)d vs. (13.46±9.32)d, P=0.013] and increased risk of complications (complications in general, 59.2% vs. 38.8%, χ2=4.714, P=0.030; Clavien-Dindo≥3: 26.5% vs. 10.4%, χ2=5.130, P=0.024). Both the Kaplan-Meier survival analysis (P<0.05) and the Cox proportional hazard model (overall survival: hazard ratio=2.285, 95% CI=1.521-3.431; recurrence-free survival, hazard ratio=2.167, 95% CI=1.445-3.248) indicated sarcopenia as the risk factor for poorer overall survival and recurrence-free survival. Conclusions Sarcopenia was an independent predictor of poor prognosis for patients undergoing pancreaticoduodenectomy. Patients with sarcopenia had higher risk of developing complications after surgery and lower overall survival rate and recurrence-free survival rate. Key words: Sarcopenia; Pancreaticoduodenectomy; Complications; Overall survival; Recurrence-free survival
{"title":"The relationship of sarcopenia in patients undergoing pancreaticoduodenectomy with outcome","authors":"Qinmei Cao, Youming Ding, Meng-Kun Chen, Meng-Kun Chen, Bin Wang, Xiaoyan Chen, Kailiang Zhao, Chen Chen","doi":"10.3760/CMA.J.ISSN.1674-635X.2018.01.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2018.01.007","url":null,"abstract":"Objective \u0000To explore the prognostic value of sarcopenia in patients undergoing pancreaticoduodenectomy. \u0000 \u0000 \u0000Method \u0000Clinicopathologic data and follow-up information of 116 patients undergoing pancreaticoduodenectomy at Renmin Hospital of Wuhan University between March 2011 and August 2016 were collected for statistical analysis. \u0000 \u0000 \u0000Results \u0000Among the 116 patients, the prevalence of sarcopenia was 42.2% (n=49). When compared to the rest of the patients who did not have sarcopenia, the sarcopenia group had longer recovery time [(17.33±6.54)d vs. (13.46±9.32)d, P=0.013] and increased risk of complications (complications in general, 59.2% vs. 38.8%, χ2=4.714, P=0.030; Clavien-Dindo≥3: 26.5% vs. 10.4%, χ2=5.130, P=0.024). Both the Kaplan-Meier survival analysis (P<0.05) and the Cox proportional hazard model (overall survival: hazard ratio=2.285, 95% CI=1.521-3.431; recurrence-free survival, hazard ratio=2.167, 95% CI=1.445-3.248) indicated sarcopenia as the risk factor for poorer overall survival and recurrence-free survival. \u0000 \u0000 \u0000Conclusions \u0000Sarcopenia was an independent predictor of poor prognosis for patients undergoing pancreaticoduodenectomy. Patients with sarcopenia had higher risk of developing complications after surgery and lower overall survival rate and recurrence-free survival rate. \u0000 \u0000 \u0000Key words: \u0000Sarcopenia; Pancreaticoduodenectomy; Complications; Overall survival; Recurrence-free survival","PeriodicalId":9877,"journal":{"name":"Chinese Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45010580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-02-28DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.01.010
Hua Zheng, Ying Ma
Glycemic variability is an important indicator for glycemic control and an independent risk factor for cardiovascular events and overall mortality in type 2 diabetes. Hemodialysis patients have greater challenge controling glycemic variability because patients of end-stage renal disease generally have more "brittle" glycemic hemostasis and dialysis itself may cause extra disturbance. In this article, we present an overview on the characteristics, cause, potential damage, and intervention of glycemic variability in hemodialysis patients. Key words: Hemodialysis; Diabetes; Hypoglycemia; Glycemic variability; Dialysis-induced hyperglycemia
{"title":"Glycemic variability in hemodialysis patients: implications, characteristics and interventions","authors":"Hua Zheng, Ying Ma","doi":"10.3760/CMA.J.ISSN.1674-635X.2018.01.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2018.01.010","url":null,"abstract":"Glycemic variability is an important indicator for glycemic control and an independent risk factor for cardiovascular events and overall mortality in type 2 diabetes. Hemodialysis patients have greater challenge controling glycemic variability because patients of end-stage renal disease generally have more \"brittle\" glycemic hemostasis and dialysis itself may cause extra disturbance. In this article, we present an overview on the characteristics, cause, potential damage, and intervention of glycemic variability in hemodialysis patients. \u0000 \u0000 \u0000Key words: \u0000Hemodialysis; Diabetes; Hypoglycemia; Glycemic variability; Dialysis-induced hyperglycemia","PeriodicalId":9877,"journal":{"name":"Chinese Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47537313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-02-28DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.01.002
Song Zhou, Jianning Wang, Mengmei Zhan, Qiuxia Huang
Objective To compare the effects of gastric residual volume (GRV) set at different thresholds on intensive care patients receiving enteral nutrition (EN), so as to inform clinical practice. Methods Controlled clinical trials involving different GRV thresholds in ICU patients undergoing EN were retrieved from multiple electronic databases (including Cochrane Library, PubMed, Ovid Medline, Web of Science, CBM, CNKI, Wanfang Data, and VIP). Quality of the retrieved studies was evaluated for data extraction, and meta-analysis was performed. Results Four randomized controlled trials and one clinically controlled trial were included in the study, with a total of 658 subjects. Results of the meta-analysis suggested no statistically significant difference between the group with GRV threshold≥250 ml and the one with GRV threshold<250 ml in the rates of pneumonia (OR=1.19, 95% CI=0.77-1.82, P=0.43), aspiration (OR=1.59, 95% CI=0.42-6.03, P=0.50), vomiting (OR=1.35, 95% CI=0.48-3.80, P=0.57), reflux (OR=1.29, 95% CI=0.58-2.88, P=0.53), and diarrhea (OR=1.36, 95% CI=0.87-2.13, P=0.17). Nutrient intake and several other outcome measures were unable to be included in the meta-analysis for either the scarcity of studies or inconsistency in the measures adopted, and descriptive analysis was therefore employed instead. Conclusion There was no significant difference between the two groups in terms of complications, but the group with GRV threshold≥250 ml had higher intake of EN. Key words: Enteral nutrition; Intensive care units; Meta-analysis; Gastric residual volume; Complications
{"title":"Effects of gastric residual volume set at different thresholds on intensive care patients receiving enteral nutrition: a systematic review","authors":"Song Zhou, Jianning Wang, Mengmei Zhan, Qiuxia Huang","doi":"10.3760/CMA.J.ISSN.1674-635X.2018.01.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2018.01.002","url":null,"abstract":"Objective \u0000To compare the effects of gastric residual volume (GRV) set at different thresholds on intensive care patients receiving enteral nutrition (EN), so as to inform clinical practice. \u0000 \u0000 \u0000Methods \u0000Controlled clinical trials involving different GRV thresholds in ICU patients undergoing EN were retrieved from multiple electronic databases (including Cochrane Library, PubMed, Ovid Medline, Web of Science, CBM, CNKI, Wanfang Data, and VIP). Quality of the retrieved studies was evaluated for data extraction, and meta-analysis was performed. \u0000 \u0000 \u0000Results \u0000Four randomized controlled trials and one clinically controlled trial were included in the study, with a total of 658 subjects. Results of the meta-analysis suggested no statistically significant difference between the group with GRV threshold≥250 ml and the one with GRV threshold<250 ml in the rates of pneumonia (OR=1.19, 95% CI=0.77-1.82, P=0.43), aspiration (OR=1.59, 95% CI=0.42-6.03, P=0.50), vomiting (OR=1.35, 95% CI=0.48-3.80, P=0.57), reflux (OR=1.29, 95% CI=0.58-2.88, P=0.53), and diarrhea (OR=1.36, 95% CI=0.87-2.13, P=0.17). Nutrient intake and several other outcome measures were unable to be included in the meta-analysis for either the scarcity of studies or inconsistency in the measures adopted, and descriptive analysis was therefore employed instead. \u0000 \u0000 \u0000Conclusion \u0000There was no significant difference between the two groups in terms of complications, but the group with GRV threshold≥250 ml had higher intake of EN. \u0000 \u0000 \u0000Key words: \u0000Enteral nutrition; Intensive care units; Meta-analysis; Gastric residual volume; Complications","PeriodicalId":9877,"journal":{"name":"Chinese Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48459566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-02-28DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.01.009
Xiao-Ding Liu, B. Ma
Pharmaconutrients refer to macronutrients, micronutrients, microecologics, and nucleotides. Informed by large randomized clinical trials, people have become increasingly prudent in using pharmaconutrients. Critically-ill neurological patients are intensive care patients who have neurological impairment, and therefore command extra caution in using pharmaconutrients. This article reviews the latest studies on the use of pharmaconutrients in this group of patients. Key words: Cerebrovascular diseases; Pharmaconutrients; Glutamine; Neurological impairment
{"title":"A literature review on adverse outcomes resulting from lack of pharmaconutrients in critically-ill neurological patients","authors":"Xiao-Ding Liu, B. Ma","doi":"10.3760/CMA.J.ISSN.1674-635X.2018.01.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2018.01.009","url":null,"abstract":"Pharmaconutrients refer to macronutrients, micronutrients, microecologics, and nucleotides. Informed by large randomized clinical trials, people have become increasingly prudent in using pharmaconutrients. Critically-ill neurological patients are intensive care patients who have neurological impairment, and therefore command extra caution in using pharmaconutrients. This article reviews the latest studies on the use of pharmaconutrients in this group of patients. \u0000 \u0000 \u0000Key words: \u0000Cerebrovascular diseases; Pharmaconutrients; Glutamine; Neurological impairment","PeriodicalId":9877,"journal":{"name":"Chinese Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41391153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-02-28DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.01.001
Tao Zhang, Liang Yu, Shunli Fan, Fei Pan, Dong Zhang, Q. He
Objective To systematically review the safety and efficacy of enhanced recovery after surgery (ERAS) in perioperative management of pancreaticoduodenectomy. Methods A search was performed in databases (including PubMed, EMASE, Cochrane library, Sinomed, Wangfang, VIP, and CNKI) for randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) up to September 2016 on use of ERAS in patients undergoing pancreaticoduodenectomy. After quality evaluation and data extraction, meta-analysis was performed using RevMan 5.3. Results Four RCTs and Twelve NRCTs involving a total of 2 828 patients were included. 1 401 patients were in the ERAS group, and 1 427 in the control group. Meta-analysis results showed that compared with the control group, the ERAS group had shorter length of hospital stay (SMD=-0.36, 95% CI=-0.44--0.28, P 0.05). Conclusion It is reasonably safe and efficacious to adopt ERAS in periopetative management of patients undergoing pancreaticoduodenectomy. Key words: Enhanced recovery after surgery; Pancreaticoduodenectomy; Perioperative; Meta-analysis
{"title":"Systematic review of enhanced recovery after surgery in perioperative management of pancreaticoduodenectomy: a meta-analysis of randomized controlled trials and non-randomized controlled trials","authors":"Tao Zhang, Liang Yu, Shunli Fan, Fei Pan, Dong Zhang, Q. He","doi":"10.3760/CMA.J.ISSN.1674-635X.2018.01.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2018.01.001","url":null,"abstract":"Objective \u0000To systematically review the safety and efficacy of enhanced recovery after surgery (ERAS) in perioperative management of pancreaticoduodenectomy. \u0000 \u0000 \u0000Methods \u0000A search was performed in databases (including PubMed, EMASE, Cochrane library, Sinomed, Wangfang, VIP, and CNKI) for randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) up to September 2016 on use of ERAS in patients undergoing pancreaticoduodenectomy. After quality evaluation and data extraction, meta-analysis was performed using RevMan 5.3. \u0000 \u0000 \u0000Results \u0000Four RCTs and Twelve NRCTs involving a total of 2 828 patients were included. 1 401 patients were in the ERAS group, and 1 427 in the control group. Meta-analysis results showed that compared with the control group, the ERAS group had shorter length of hospital stay (SMD=-0.36, 95% CI=-0.44--0.28, P 0.05). \u0000 \u0000 \u0000Conclusion \u0000It is reasonably safe and efficacious to adopt ERAS in periopetative management of patients undergoing pancreaticoduodenectomy. \u0000 \u0000 \u0000Key words: \u0000Enhanced recovery after surgery; Pancreaticoduodenectomy; Perioperative; Meta-analysis","PeriodicalId":9877,"journal":{"name":"Chinese Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45230679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-02-28DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.01.011
Jiapei Li, Naishi Li
Glucocorticoids are widely used in clinical practice, and abnormal glucose metabolism due to the use of glucocorticoids is prevalent. There has been progress in studies evaluating post-glucocorticoid changes in blood glucose levels using continuous glucose monitoring. This paper reviews glycemic patterns and protocols for insulin treatment of abnormal glucose metabolism following the use of glucocorticoids as shown by continuous glucose monitoring. Key words: Glucocorticoid; Continuous glucose monitoring; Insulin therapy
{"title":"The impact of exogenous glucocorticoids on glucose metabolism as evaluated by continuous glucose monitoring","authors":"Jiapei Li, Naishi Li","doi":"10.3760/CMA.J.ISSN.1674-635X.2018.01.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2018.01.011","url":null,"abstract":"Glucocorticoids are widely used in clinical practice, and abnormal glucose metabolism due to the use of glucocorticoids is prevalent. There has been progress in studies evaluating post-glucocorticoid changes in blood glucose levels using continuous glucose monitoring. This paper reviews glycemic patterns and protocols for insulin treatment of abnormal glucose metabolism following the use of glucocorticoids as shown by continuous glucose monitoring. \u0000 \u0000 \u0000Key words: \u0000Glucocorticoid; Continuous glucose monitoring; Insulin therapy","PeriodicalId":9877,"journal":{"name":"Chinese Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43723781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To investigate the effects of enteral immunonutrition supplemented with omega-3 polyunsaturated fatty acid (ω-3 PUFA) on inflammatory response, intestinal mucosal barrier function and the prognosis in patients with severe traumatic brain injury (sTBI). Methods 122 patients of sTBI hospitalized between January 2015 and December 2016 were randomly divided into experimental group (ω-3 PUFA, n=61) and control group (n=61). The serum levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-6 and neuron specific enolase (NSE) were tested with enzyme linked immunosorbent assay. Meanwhile, D-lactate acid and intestinal fat acid binding protein (I-FABP) were evaluated by enzymology spectrophotometer method. After 14 days of treatment, the Glasgow Coma Scale (GCS) scores, Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ scores and prognoses of both groups were compared. Results The serum levels of inflammatory factors (TNF-α and IL-6), intestinal mucosal barrier function indicators (D-lactate acid and I-FABP) and NSE proteins significantly increased after sTBI (P=0.01). Compared with the control group, the experimental group on day 3 had significantly lower serum levels of inflammatory factors [TNF-α: (107.77±19.79)μg/L vs. (151.76±21.65)μg/L, P=0.01; IL-6: (76.85±7.15)μg/L vs. (105.27±10.12)μg/L, P=0.01] and intestinal mucosal barrier function indicators [D-lactate: (69.81±6.32)μg/L vs. (89.80±8.75)μg/L, P=0.03; I-FABP: (40.81±6.73)μg/L vs. (56.60±8.58)μg/L, P=0.01]. On day 7, the experimental group had significantly lower expression of NSE proteins than the control group [(13.63±2.53)μg/L vs. (19.12±3.00)μg/L, P=0.02]. The experimental group received better prognosis compared to the control group on day 14 [GCS scores: (9.74±0.76)vs. (8.44±0.53), P=0.04; APACHE Ⅱ scores: (14.67±1.37)vs. (17.53±1.47), P=0.03]. The experimental group also had fewer days in hospitalization [(19.37±2.27)d vs. (25.42±2.61)d, P=0.01]. Conclusion Enteral immunonutrition supplemented with ω-3 PUFA can effectively regulate the inflammatory response, and reduce impairment to the intestinal mucosal barrier function and damage to neurons in patients with sTBI. Key words: Craniocerebral trauma; Unsaturated fatty acids; Inflammatory response; Intestinal mucosal barrier
{"title":"Effects of enteral immunonutrition supplemented with omega-3 polyunsaturated fatty acid on inflammatory response and intestinal mucosal barrier function in patients with severe traumatic brain injury","authors":"Xiangrong Chen, Cui'e Wang, Baoyuan Xie, Rongrong Zhu, Jinxia Liu, Tian-zao Huang","doi":"10.3760/CMA.J.ISSN.1674-635X.2018.01.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2018.01.003","url":null,"abstract":"Objective \u0000To investigate the effects of enteral immunonutrition supplemented with omega-3 polyunsaturated fatty acid (ω-3 PUFA) on inflammatory response, intestinal mucosal barrier function and the prognosis in patients with severe traumatic brain injury (sTBI). \u0000 \u0000 \u0000Methods \u0000122 patients of sTBI hospitalized between January 2015 and December 2016 were randomly divided into experimental group (ω-3 PUFA, n=61) and control group (n=61). The serum levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-6 and neuron specific enolase (NSE) were tested with enzyme linked immunosorbent assay. Meanwhile, D-lactate acid and intestinal fat acid binding protein (I-FABP) were evaluated by enzymology spectrophotometer method. After 14 days of treatment, the Glasgow Coma Scale (GCS) scores, Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ scores and prognoses of both groups were compared. \u0000 \u0000 \u0000Results \u0000The serum levels of inflammatory factors (TNF-α and IL-6), intestinal mucosal barrier function indicators (D-lactate acid and I-FABP) and NSE proteins significantly increased after sTBI (P=0.01). Compared with the control group, the experimental group on day 3 had significantly lower serum levels of inflammatory factors [TNF-α: (107.77±19.79)μg/L vs. (151.76±21.65)μg/L, P=0.01; IL-6: (76.85±7.15)μg/L vs. (105.27±10.12)μg/L, P=0.01] and intestinal mucosal barrier function indicators [D-lactate: (69.81±6.32)μg/L vs. (89.80±8.75)μg/L, P=0.03; I-FABP: (40.81±6.73)μg/L vs. (56.60±8.58)μg/L, P=0.01]. On day 7, the experimental group had significantly lower expression of NSE proteins than the control group [(13.63±2.53)μg/L vs. (19.12±3.00)μg/L, P=0.02]. The experimental group received better prognosis compared to the control group on day 14 [GCS scores: (9.74±0.76)vs. (8.44±0.53), P=0.04; APACHE Ⅱ scores: (14.67±1.37)vs. (17.53±1.47), P=0.03]. The experimental group also had fewer days in hospitalization [(19.37±2.27)d vs. (25.42±2.61)d, P=0.01]. \u0000 \u0000 \u0000Conclusion \u0000Enteral immunonutrition supplemented with ω-3 PUFA can effectively regulate the inflammatory response, and reduce impairment to the intestinal mucosal barrier function and damage to neurons in patients with sTBI. \u0000 \u0000 \u0000Key words: \u0000Craniocerebral trauma; Unsaturated fatty acids; Inflammatory response; Intestinal mucosal barrier","PeriodicalId":9877,"journal":{"name":"Chinese Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69987570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-02-28DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.01.006
Xin Gong, Chenying Zhu, P. Yu, Xiaoling Xi, Hao Hu, Jianhong Cao
Objective To investigate the nutritional status of patients with heart failure and its effect on all-cause mortality. Methods A total of 351 patients with chronic heart failure, who were consecutively admitted to the East Hospital of Shanghai from March 2013 to November 2015, were put into the heart failure with reduced left ventricular ejection fraction(HFrEF) group. They were compared to 222 controls who were admitted during the same period for preclinical heart failure. After a median follow-up time of 606 days, 108 patients of the HFrEF group died, compared to 11 of the controls. Logistic regression was used to analyze correlations of all-cause mortality with the patients' body mass index (BMI), serum albumin and other factors. Results Compared to the controls, patients with chronic heart failure had lower BMI[(22.71±3.95)kg/m2vs.(24.23±3.66)kg/m2,t=4.331, P=0.000], total cholesterol[(3.81±0.99)mmol/L vs.(4.03±0.96)mmol/L, t=2.638, P=0.009], albumin[(38.18±5.03)g/L vs.(40.18±6.12)g/L, t=3.874, P=0.000] and prealbumin[(187.67±61.83)mg/L vs.(211.94±65.44)mg/L, t=3.937, P=0.000]. Within the HFrEF group, patients with lower BMI had higher mortality (36.0% vs. 22.4%, P=0.008). Logistic regression suggested BMI, age were independent predictors of all-cause death. Conclusions Patients with chronic heart failure had high incidence of malnutrition, and those with BMI<22 kg/m2 had higher risk of mortality. Serum albumin and BMI not only reflected nutritional status of the patients but had significant implications on prognosis. Key words: HFrEF; Nutritional status; All-cause death
{"title":"Correlation between Nutritional Status and Mortality in Patients with Heart Failure","authors":"Xin Gong, Chenying Zhu, P. Yu, Xiaoling Xi, Hao Hu, Jianhong Cao","doi":"10.3760/CMA.J.ISSN.1674-635X.2018.01.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2018.01.006","url":null,"abstract":"Objective \u0000To investigate the nutritional status of patients with heart failure and its effect on all-cause mortality. \u0000 \u0000 \u0000Methods \u0000A total of 351 patients with chronic heart failure, who were consecutively admitted to the East Hospital of Shanghai from March 2013 to November 2015, were put into the heart failure with reduced left ventricular ejection fraction(HFrEF) group. They were compared to 222 controls who were admitted during the same period for preclinical heart failure. After a median follow-up time of 606 days, 108 patients of the HFrEF group died, compared to 11 of the controls. Logistic regression was used to analyze correlations of all-cause mortality with the patients' body mass index (BMI), serum albumin and other factors. \u0000 \u0000 \u0000Results \u0000Compared to the controls, patients with chronic heart failure had lower BMI[(22.71±3.95)kg/m2vs.(24.23±3.66)kg/m2,t=4.331, P=0.000], total cholesterol[(3.81±0.99)mmol/L vs.(4.03±0.96)mmol/L, t=2.638, P=0.009], albumin[(38.18±5.03)g/L vs.(40.18±6.12)g/L, t=3.874, P=0.000] and prealbumin[(187.67±61.83)mg/L vs.(211.94±65.44)mg/L, t=3.937, P=0.000]. Within the HFrEF group, patients with lower BMI had higher mortality (36.0% vs. 22.4%, P=0.008). Logistic regression suggested BMI, age were independent predictors of all-cause death. \u0000 \u0000 \u0000Conclusions \u0000Patients with chronic heart failure had high incidence of malnutrition, and those with BMI<22 kg/m2 had higher risk of mortality. Serum albumin and BMI not only reflected nutritional status of the patients but had significant implications on prognosis. \u0000 \u0000 \u0000Key words: \u0000HFrEF; Nutritional status; All-cause death","PeriodicalId":9877,"journal":{"name":"Chinese Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44905302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-12-30DOI: 10.3760/CMA.J.ISSN.1674-635X.2017.06.009
Xuanxia Mao, Xiuhua Shen, Wenjing Tang, Kefeng Yang
Objective To investigate the candidate profile and pass rate of the 2016 pilot qualification examination for registered dietitians in Shanghai, and attempt to inform the improvement of the examination. Methods An analysis was conducted on the profiles of all the 193 qualified candidates in the signing-up system of the 2016 pilot examination. Questionnaire surveys were carried out to collect feedback from the candidates on the enrollment requirements of the examination. The pass rates were compared between subgroups divided by age, gender, education, major, workplace (as employee or intern), working years and academic rank. Results 81.3% of the candidates were aged between 20 and 29. Females accounted for 80.3%. The candidates had all received bachelor's degree, 75.6% from full-time undergraduate programs and 96.4% from programs of nutrition. 78.3% of the candidates rated the enrollment requirements of the examination as "reasonable" or "relatively reasonable" . The overall pass rate of the examination was 38.3%. The pass rate of the examinees working or doing internship in hospitals (45%) was significantly higher than that of others (24.5%)(P=0.012). Conclusions The overall pass rate is reasonable. Examinees working or doing internship in hospitals had a higher pass rate than those working in other places. The majority of the candidates had bachelor's degree of nutrition, which is in accordance with the requirement of similar exams in other parts of the world. Key words: Registered dietitian; Examination; Pass rate
{"title":"An analysis on the candidate profile and pass rate of the pilot qualification examination for registered dietitians in Shanghai","authors":"Xuanxia Mao, Xiuhua Shen, Wenjing Tang, Kefeng Yang","doi":"10.3760/CMA.J.ISSN.1674-635X.2017.06.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2017.06.009","url":null,"abstract":"Objective \u0000To investigate the candidate profile and pass rate of the 2016 pilot qualification examination for registered dietitians in Shanghai, and attempt to inform the improvement of the examination. \u0000 \u0000 \u0000Methods \u0000An analysis was conducted on the profiles of all the 193 qualified candidates in the signing-up system of the 2016 pilot examination. Questionnaire surveys were carried out to collect feedback from the candidates on the enrollment requirements of the examination. The pass rates were compared between subgroups divided by age, gender, education, major, workplace (as employee or intern), working years and academic rank. \u0000 \u0000 \u0000Results \u000081.3% of the candidates were aged between 20 and 29. Females accounted for 80.3%. The candidates had all received bachelor's degree, 75.6% from full-time undergraduate programs and 96.4% from programs of nutrition. 78.3% of the candidates rated the enrollment requirements of the examination as \"reasonable\" or \"relatively reasonable\" . The overall pass rate of the examination was 38.3%. The pass rate of the examinees working or doing internship in hospitals (45%) was significantly higher than that of others (24.5%)(P=0.012). \u0000 \u0000 \u0000Conclusions \u0000The overall pass rate is reasonable. Examinees working or doing internship in hospitals had a higher pass rate than those working in other places. The majority of the candidates had bachelor's degree of nutrition, which is in accordance with the requirement of similar exams in other parts of the world. \u0000 \u0000 \u0000Key words: \u0000Registered dietitian; Examination; Pass rate","PeriodicalId":9877,"journal":{"name":"Chinese Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49249452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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