Pub Date : 2018-12-30DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.06.003
Wenxia Cui, Haiyan Yang, Fenghui Pan, Hui Wang, Weng Zheng, Man Li
Objective To investigate the correlation of serum 25-hydroxy-vitamin D (25-OH-D) with lipid profiles in middle-aged and elderly patients. Methods A total of 284 patients aged over 40 years and admitted in our hospital from May 2016 to May 2017 were selected and divided into four groups according to 25-OH-D levels as the group of normal level which was not less than 30 ng/ml, the group of slight deficiency which was between 20 and 29 ng/ml, the group of moderate deficiency which was between 10 and 19 ng/ml, and the group of severely deficiency which was under 10 ng/ml. Fasting blood draw were taken to detect liver and renal functions, lipids, calcium, phosphorus and 25-OH-D levels. The level of lipids between groups was compared by one-way ANOVA, and the association between lipid profiles and 25-OH-D levels was assessed by Pearson correlation and multiple linear regression. Results The levels of triglyceride (TG), low density lipoprotein cholesterin (LDL-C) and total cholesterol/high density lipoprotein cholesterol (TC/ HDL-C) were significantly higher and the HDL-C levels were significantly lower in the groups of severely deficiency, moderate deficiency and slight deficiency than in the normal group (P=0.035, P=0.015, P=0.013). The levels of serum 25-OH-D were significantly higher in HDL-C≥1.04 mmol/L group than in HDL-C<1.04 mmol/L group (Female P=0.007, male P=0.034). The correlation analysis showed that serum 25-OH-D level was positively associated with HDL-C (female r=0.309, P=0.002, male r=0.241, P=0.002). The multiple linear regression analysis showed that 25-OH-D level was positively correlated with HDL-C, after adjusting age, BMI, liver and kidney function, serum calcium and serum phosphorus (female β=0.259, P=0.047, male β=0.217, P=0.049). Conclusion The incidence of vitamin D deficiency is high in middle-aged and elderly patients, and the level of serum 25-OH-D is positively correlated with HDL-C. Key words: 25-hydroxy vitamin D; Lipid profiles; Middle-aged and elderly people
{"title":"Correlation of serum vitamin D with serum lipid in middle-aged and elderly people","authors":"Wenxia Cui, Haiyan Yang, Fenghui Pan, Hui Wang, Weng Zheng, Man Li","doi":"10.3760/CMA.J.ISSN.1674-635X.2018.06.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2018.06.003","url":null,"abstract":"Objective \u0000To investigate the correlation of serum 25-hydroxy-vitamin D (25-OH-D) with lipid profiles in middle-aged and elderly patients. \u0000 \u0000 \u0000Methods \u0000A total of 284 patients aged over 40 years and admitted in our hospital from May 2016 to May 2017 were selected and divided into four groups according to 25-OH-D levels as the group of normal level which was not less than 30 ng/ml, the group of slight deficiency which was between 20 and 29 ng/ml, the group of moderate deficiency which was between 10 and 19 ng/ml, and the group of severely deficiency which was under 10 ng/ml. Fasting blood draw were taken to detect liver and renal functions, lipids, calcium, phosphorus and 25-OH-D levels. The level of lipids between groups was compared by one-way ANOVA, and the association between lipid profiles and 25-OH-D levels was assessed by Pearson correlation and multiple linear regression. \u0000 \u0000 \u0000Results \u0000The levels of triglyceride (TG), low density lipoprotein cholesterin (LDL-C) and total cholesterol/high density lipoprotein cholesterol (TC/ HDL-C) were significantly higher and the HDL-C levels were significantly lower in the groups of severely deficiency, moderate deficiency and slight deficiency than in the normal group (P=0.035, P=0.015, P=0.013). The levels of serum 25-OH-D were significantly higher in HDL-C≥1.04 mmol/L group than in HDL-C<1.04 mmol/L group (Female P=0.007, male P=0.034). The correlation analysis showed that serum 25-OH-D level was positively associated with HDL-C (female r=0.309, P=0.002, male r=0.241, P=0.002). The multiple linear regression analysis showed that 25-OH-D level was positively correlated with HDL-C, after adjusting age, BMI, liver and kidney function, serum calcium and serum phosphorus (female β=0.259, P=0.047, male β=0.217, P=0.049). \u0000 \u0000 \u0000Conclusion \u0000The incidence of vitamin D deficiency is high in middle-aged and elderly patients, and the level of serum 25-OH-D is positively correlated with HDL-C. \u0000 \u0000 \u0000Key words: \u000025-hydroxy vitamin D; Lipid profiles; Middle-aged and elderly people","PeriodicalId":9877,"journal":{"name":"Chinese Journal of Clinical Nutrition","volume":"26 1","pages":"338-343"},"PeriodicalIF":0.0,"publicationDate":"2018-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43726827","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 : 2018-12-30DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.06.001
Hua Zhong, Wei Chen, L. Fang, K. Yu, Hong Jiang
Objective To explore the relationship between the body weight and the structure and function of the left ventricle in the elderly inpatients, in order to emphasize the importance of body weight in the health management for elderly patients. Methods A total of 152 elderly inpatients meeting the enrollment criteria and providing informed consent were consecutively recruited. The height, body weight, body mass index (BMI), liver and kidney function, glycosylated hemoglobin, blood lipid, blood uric acid and structure and function of left ventricular were measured by anthropometry, biochemical examination and echocardiography respectively. The clinical characteristics, metabolic parameters, structure and function of left ventricular were compared among the low/normal weight, overweight and obesity groups. The correlation between left ventricular diastolic dysfunction (E/A≤0.7) and the metabolic factors was analyzed. Results The incidences of lower/normal weight, overweight and obesity in elderly inpatients were 29.6% (45/152), 52.6% (80/152) and 17.8% (27/152) respectively. Compared with the lower/normal weight group, the level of systolic blood pressure, glycosylated hemoglobin(P=0.005), left atrial diameter(P=0.000), left ventricular posterior wall dimension(P=0.010), left ventricular diastolic diameter(P=0.010), left ventricular mass(P=0.000), relative wall thickness and septal thickness increased significantly in overweight and obesity groups (all P<0.05). A higher proportion of left ventricular diastolic dysfunction was observed in overweight and obesity groups in the patients aging 60-69 years (P=0.028). There was positive correlation between left ventricular diastolic dysfunction and BMI (P=0.022). Conclusions Overweight/obesity increases the risk of left ventricular diastolic dysfunction among elderly inpatients. The body weight management needs to be strengthened in health management for the elderly patients. Key words: Elderly inpatient; Body mass index; Left ventricle; Correlation
{"title":"Correlation of body weight with structure and function of left ventricle in elderly inpatients","authors":"Hua Zhong, Wei Chen, L. Fang, K. Yu, Hong Jiang","doi":"10.3760/CMA.J.ISSN.1674-635X.2018.06.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2018.06.001","url":null,"abstract":"Objective \u0000To explore the relationship between the body weight and the structure and function of the left ventricle in the elderly inpatients, in order to emphasize the importance of body weight in the health management for elderly patients. \u0000 \u0000 \u0000Methods \u0000A total of 152 elderly inpatients meeting the enrollment criteria and providing informed consent were consecutively recruited. The height, body weight, body mass index (BMI), liver and kidney function, glycosylated hemoglobin, blood lipid, blood uric acid and structure and function of left ventricular were measured by anthropometry, biochemical examination and echocardiography respectively. The clinical characteristics, metabolic parameters, structure and function of left ventricular were compared among the low/normal weight, overweight and obesity groups. The correlation between left ventricular diastolic dysfunction (E/A≤0.7) and the metabolic factors was analyzed. \u0000 \u0000 \u0000Results \u0000The incidences of lower/normal weight, overweight and obesity in elderly inpatients were 29.6% (45/152), 52.6% (80/152) and 17.8% (27/152) respectively. Compared with the lower/normal weight group, the level of systolic blood pressure, glycosylated hemoglobin(P=0.005), left atrial diameter(P=0.000), left ventricular posterior wall dimension(P=0.010), left ventricular diastolic diameter(P=0.010), left ventricular mass(P=0.000), relative wall thickness and septal thickness increased significantly in overweight and obesity groups (all P<0.05). A higher proportion of left ventricular diastolic dysfunction was observed in overweight and obesity groups in the patients aging 60-69 years (P=0.028). There was positive correlation between left ventricular diastolic dysfunction and BMI (P=0.022). \u0000 \u0000 \u0000Conclusions \u0000Overweight/obesity increases the risk of left ventricular diastolic dysfunction among elderly inpatients. The body weight management needs to be strengthened in health management for the elderly patients. \u0000 \u0000 \u0000Key words: \u0000Elderly inpatient; Body mass index; Left ventricle; Correlation","PeriodicalId":9877,"journal":{"name":"Chinese Journal of Clinical Nutrition","volume":"26 1","pages":"325-330"},"PeriodicalIF":0.0,"publicationDate":"2018-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42140718","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 : 2018-10-30DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.05.004
Yan Ding, Yinyang Xu, Yi Wang, Qianqian Zhang, Xiaoyi Huang, Zhen Tang, W. Gu, Jianxia Fan, Wen-qiu Yu
Objective To investigate the serum 25-hydroxy vitamin D concentrations and related factors in early pregnancy. Methods Plasma was collected in the first trimester from 23 396 pregnant women to investigate the vitamin D level, and its distribution and differences in different age, body maxx index(BMI) and seasons between primipara and multipara. Preterm birth was used as an indicator of clinical outcomes. Vitamin D concentrations were measured using chemiluminescence microparticle immunoassay. Results 25-hydroxy vitamin D level was 42.0(17.6-76.6)nmol/L in totally 23 396 pregnant women with early pregnancy, and 5% and 95% percentile sites of vitamin D level were 20.2 nmol/L and 70.7 nmol/L respectively. There were 18 170(77.7%) primiparas and 5 226(22.3%) multiparas, with the mean age of 30.0(24.0-38.0) years and BMI of 20.7(16.5-27.6)kg/m2. The number of cases detected in spring (March, April and May), summer(June, July and August), autumn(September, October and November months) and winter(December, January and February) were 5 878, 5 554, 5 974, and 5 990, respectively, and the vitamin D levels were 40.0(29.3, 52.7)nmol/L, 46.2(35.6, 57.2)nmol/L, 43.8(33.1, 54.8)nmol/L and 37.2(26.9, 49.9)nmol/L respectively, with the difference in vitamin D levels statistically significant among the four seasons (P<0.001). According to BMI, all pregnant women were divided into four groups as BMI<18.5 kg/m2, 18.5 kg/m2≤BMI≤23.9 kg/m2, 24 kg/m2≤BMI≤27.9 kg/m2, BMI≥28 kg/m2, and the levels of 25-hydroxy vitamin D were 43.5(30.9, 56.9)nmol/L, 42.1(30.8, 53.8)nmol/L, 39.9(30.7, 50.4)nmol/L and 39.7(30.7, 49.4)nmol/L respectively with the difference statistically significant among the four groups. The levels of vitamin D detected in pregnant women with age<25 years, 25~29 years, 30~34 years, ≥35 years were 39.1(28.4, 52.3)nmol/L, 41.3(30.1, 52.9)nmol/L, 42.4(31.2, 54.1)nmol/L and 43.8(31.9, 55.7)nmol/L respectively and the difference was statistically significant (P<0.001). The levels of 25- hydroxy vitamin D in primary and multiparas were 41.6(30.2, 52.9)nmol/L and 43.5(32.5, 56.8) nmol/L with the difference statistically significant (P<0.001). Among women of different gestational age during childbirth, the differences in serum 25-hydroxy vitamin D in early pregnancy were not statistically significant(P=0.121). The severe deficiency of vitamin D in early pregnancy was defined as serum level of 25-hydroxy vitamin D less than 5th level. There were statistical differences in the probability of severe vitamin D deficiency of different ages, seasons and BMI between primiparas and multiparas. Conclusions Pregnant women of lower weight, lower age and primiparity have higher incidence of the severe vitamin D deficiency in early trimester of pregnancy. There is significant difference in 25-hydroxy vitamin D level among the different seasons (winter
{"title":"Vitamin D status in early pregancy","authors":"Yan Ding, Yinyang Xu, Yi Wang, Qianqian Zhang, Xiaoyi Huang, Zhen Tang, W. Gu, Jianxia Fan, Wen-qiu Yu","doi":"10.3760/CMA.J.ISSN.1674-635X.2018.05.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2018.05.004","url":null,"abstract":"Objective \u0000To investigate the serum 25-hydroxy vitamin D concentrations and related factors in early pregnancy. \u0000 \u0000 \u0000Methods \u0000Plasma was collected in the first trimester from 23 396 pregnant women to investigate the vitamin D level, and its distribution and differences in different age, body maxx index(BMI) and seasons between primipara and multipara. Preterm birth was used as an indicator of clinical outcomes. Vitamin D concentrations were measured using chemiluminescence microparticle immunoassay. \u0000 \u0000 \u0000Results \u000025-hydroxy vitamin D level was 42.0(17.6-76.6)nmol/L in totally 23 396 pregnant women with early pregnancy, and 5% and 95% percentile sites of vitamin D level were 20.2 nmol/L and 70.7 nmol/L respectively. There were 18 170(77.7%) primiparas and 5 226(22.3%) multiparas, with the mean age of 30.0(24.0-38.0) years and BMI of 20.7(16.5-27.6)kg/m2. The number of cases detected in spring (March, April and May), summer(June, July and August), autumn(September, October and November months) and winter(December, January and February) were 5 878, 5 554, 5 974, and 5 990, respectively, and the vitamin D levels were 40.0(29.3, 52.7)nmol/L, 46.2(35.6, 57.2)nmol/L, 43.8(33.1, 54.8)nmol/L and 37.2(26.9, 49.9)nmol/L respectively, with the difference in vitamin D levels statistically significant among the four seasons (P<0.001). According to BMI, all pregnant women were divided into four groups as BMI<18.5 kg/m2, 18.5 kg/m2≤BMI≤23.9 kg/m2, 24 kg/m2≤BMI≤27.9 kg/m2, BMI≥28 kg/m2, and the levels of 25-hydroxy vitamin D were 43.5(30.9, 56.9)nmol/L, 42.1(30.8, 53.8)nmol/L, 39.9(30.7, 50.4)nmol/L and 39.7(30.7, 49.4)nmol/L respectively with the difference statistically significant among the four groups. The levels of vitamin D detected in pregnant women with age<25 years, 25~29 years, 30~34 years, ≥35 years were 39.1(28.4, 52.3)nmol/L, 41.3(30.1, 52.9)nmol/L, 42.4(31.2, 54.1)nmol/L and 43.8(31.9, 55.7)nmol/L respectively and the difference was statistically significant (P<0.001). The levels of 25- hydroxy vitamin D in primary and multiparas were 41.6(30.2, 52.9)nmol/L and 43.5(32.5, 56.8) nmol/L with the difference statistically significant (P<0.001). Among women of different gestational age during childbirth, the differences in serum 25-hydroxy vitamin D in early pregnancy were not statistically significant(P=0.121). The severe deficiency of vitamin D in early pregnancy was defined as serum level of 25-hydroxy vitamin D less than 5th level. There were statistical differences in the probability of severe vitamin D deficiency of different ages, seasons and BMI between primiparas and multiparas. \u0000 \u0000 \u0000Conclusions \u0000Pregnant women of lower weight, lower age and primiparity have higher incidence of the severe vitamin D deficiency in early trimester of pregnancy. There is significant difference in 25-hydroxy vitamin D level among the different seasons (winter","PeriodicalId":9877,"journal":{"name":"Chinese Journal of Clinical Nutrition","volume":"26 1","pages":"278-283"},"PeriodicalIF":0.0,"publicationDate":"2018-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45720954","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 influence of high-fat diet on liver function and intestinal bacterial community through building rat models. Methods 20 rats of 21 days old were divided into two groups randomly as normal diet group fed with standard chow diet and high-fat group fed with high-fat diet. After 6 weeks, feces of rats in both groups were obtained for 16S rRNA high-through sequencing of the intestinal bacterial community. Results After 6 weeks high-fat diet, total protein (TP)(55.79±3.75, P=0.002), globin (GLB)( 34.9±2.53, P<0.001), albumin (ALB)/GLB (.60±0.02, P<0.001), alkaline phosphatase (ALP)(373.80±63.05, P<0.001), total cholesterol (TC)(1.94±0.23, P<0.001), low density lipoprotein (LDL)(0.76±0.93, P<0.001), LDL/high density lipoprotein (HDL)(1.43±0.22, P<0.001), and triglyceride (TG)(1.48±0.50, P=0.015) increased compared with the normal diet group. Additionally, intestinal bacterial diversity and evenness decreased significantly. The dominant bacteria were Bacteroidetes, Firmicutes, and Proteobacteria, with averaged relative abundances as 56.36%, 35.31%, and 6.61%, respectively. The relative abundances of Bacteroidetes deceased (P=0.007), those of Firmicutes increased (P=0.020), and those of Proteobacteria were kept stable (P=0.928) after a 6-week high-fat diet. Furthermore, the intestinal bacterial community structure changed distinctly between the two groups by 16s rRNA high-through sequencing. Conclusion High-fat diet can lead to change of intestinal bacterial community structure and further result in liver function damnification as well as obesity. Key words: High-through sequencing; 16S rRNA; Rat; Intestinal bacterial community; Liver function
{"title":"Effects of high-fat diet on liver function and intestinal bacterial community in rats","authors":"Shi-yong Zhao, Xianyao Lin, Wen Song, Haishao Chen","doi":"10.3760/CMA.J.ISSN.1674-635X.2018.05.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2018.05.007","url":null,"abstract":"Objective \u0000To investigate the influence of high-fat diet on liver function and intestinal bacterial community through building rat models. \u0000 \u0000 \u0000Methods \u000020 rats of 21 days old were divided into two groups randomly as normal diet group fed with standard chow diet and high-fat group fed with high-fat diet. After 6 weeks, feces of rats in both groups were obtained for 16S rRNA high-through sequencing of the intestinal bacterial community. \u0000 \u0000 \u0000Results \u0000After 6 weeks high-fat diet, total protein (TP)(55.79±3.75, P=0.002), globin (GLB)( 34.9±2.53, P<0.001), albumin (ALB)/GLB (.60±0.02, P<0.001), alkaline phosphatase (ALP)(373.80±63.05, P<0.001), total cholesterol (TC)(1.94±0.23, P<0.001), low density lipoprotein (LDL)(0.76±0.93, P<0.001), LDL/high density lipoprotein (HDL)(1.43±0.22, P<0.001), and triglyceride (TG)(1.48±0.50, P=0.015) increased compared with the normal diet group. Additionally, intestinal bacterial diversity and evenness decreased significantly. The dominant bacteria were Bacteroidetes, Firmicutes, and Proteobacteria, with averaged relative abundances as 56.36%, 35.31%, and 6.61%, respectively. The relative abundances of Bacteroidetes deceased (P=0.007), those of Firmicutes increased (P=0.020), and those of Proteobacteria were kept stable (P=0.928) after a 6-week high-fat diet. Furthermore, the intestinal bacterial community structure changed distinctly between the two groups by 16s rRNA high-through sequencing. \u0000 \u0000 \u0000Conclusion \u0000High-fat diet can lead to change of intestinal bacterial community structure and further result in liver function damnification as well as obesity. \u0000 \u0000 \u0000Key words: \u0000High-through sequencing; 16S rRNA; Rat; Intestinal bacterial community; Liver function","PeriodicalId":9877,"journal":{"name":"Chinese Journal of Clinical Nutrition","volume":"26 1","pages":"293-298"},"PeriodicalIF":0.0,"publicationDate":"2018-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41384547","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 : 2018-10-30DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.05.010
W. Qu, Guofang Wang, Qingqing Li
Objective To understand the present situation and existing problems of the pharmaceutical care of Nutrition Support Pharmacists (NSP) in China and provide reference for pharmaceutical care of NSP. Method Literatures about pharmaceutical care from NSP were retrieved in domestic medical journals from January 2011 to January 2017, and totally 24 articles were analyzed and discussed. Result There were still many problems in NSP, such as the use of Nutritional Risk Screening, and the ratio of glucose/lipid ratio, ratio of non-protein energy to nitrogen ratio, the lack or excess of vitamin and trace elements and the use of insulin and propylene ammonia acyl glutamine in total parenteral nutrition prescription, TPN osmotic pressure and drip time, and the application of glucose and fat milk energy density. Conclusion The pharmaceutical care of NSP starts relatively late, there are still many problems, and the capacity and theoretical level of NSP need to be improved. Key words: Nutrition support pharmacists; Pharmaceutical care; Literature analysis; Total paren-teral nutrition
{"title":"24 published papers from nutrition support pharmacist: a primitive review","authors":"W. Qu, Guofang Wang, Qingqing Li","doi":"10.3760/CMA.J.ISSN.1674-635X.2018.05.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2018.05.010","url":null,"abstract":"Objective \u0000To understand the present situation and existing problems of the pharmaceutical care of Nutrition Support Pharmacists (NSP) in China and provide reference for pharmaceutical care of NSP. \u0000 \u0000 \u0000Method \u0000Literatures about pharmaceutical care from NSP were retrieved in domestic medical journals from January 2011 to January 2017, and totally 24 articles were analyzed and discussed. \u0000 \u0000 \u0000Result \u0000There were still many problems in NSP, such as the use of Nutritional Risk Screening, and the ratio of glucose/lipid ratio, ratio of non-protein energy to nitrogen ratio, the lack or excess of vitamin and trace elements and the use of insulin and propylene ammonia acyl glutamine in total parenteral nutrition prescription, TPN osmotic pressure and drip time, and the application of glucose and fat milk energy density. \u0000 \u0000 \u0000Conclusion \u0000The pharmaceutical care of NSP starts relatively late, there are still many problems, and the capacity and theoretical level of NSP need to be improved. \u0000 \u0000 \u0000Key words: \u0000Nutrition support pharmacists; Pharmaceutical care; Literature analysis; Total paren-teral nutrition","PeriodicalId":9877,"journal":{"name":"Chinese Journal of Clinical Nutrition","volume":"26 1","pages":"314-318"},"PeriodicalIF":0.0,"publicationDate":"2018-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46336539","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 : 2018-10-30DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.05.003
Shao Yawen, B. Yan, L. Ru, He Wenhua, Huaiye Su, W. Qiu
Objective To study the association of maternal calcium supplementation and dietary calcium intake with the preterm birth so that to provide scientific basis for effective intervention of preterm birth. Methods Normal pregnant women who were followed up all through to childbirth in Gansu Provincial Maternity and Child Care Hospital were selected. Multivariate logistic regression was used to evaluate the association of calcium supplementation and intake with preterm birth. Results After confounding factors were adjusted, pregnant women who took calcium supplement for more than 3 months before and/or during pregnancy had the risk of preterm birth reduced by 14% which was dose-responding (OR=0.86, 95% CI=0.77-0.96, P<0.05). Through stratifying by trimesters of pregnancy, it was found that calcium supplement in the third trimester was a protective factor for preterm birth and especially significant in early and very early pregnancy (OR=0.75, 95% CI=0.62-0.92, P<0.05). Through stratifying by dietary calcium intake, pregnant women who took dietary calcium more than 465.55 mg/d had the risk of preterm birth significantly reduced which was shown by the reduction of preterm birth of different degrees, controlled preterm labor and spontaneous premature dilivery (OR=0.66, 95% CI=0.53-0.82, P<0.05). Conclusion Appropriate calcium supplementation or dietary calcium intake before and during pregnancy can reduce the risk of preterm birth, which is especially significant in late pregnancy. Key words: Calcium; Preterm birth; Late pregnancy; Epidemiology
{"title":"Correlations of maternal calcium supplementation and dietary calcium intake with preterm birth","authors":"Shao Yawen, B. Yan, L. Ru, He Wenhua, Huaiye Su, W. Qiu","doi":"10.3760/CMA.J.ISSN.1674-635X.2018.05.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2018.05.003","url":null,"abstract":"Objective \u0000To study the association of maternal calcium supplementation and dietary calcium intake with the preterm birth so that to provide scientific basis for effective intervention of preterm birth. \u0000 \u0000 \u0000Methods \u0000Normal pregnant women who were followed up all through to childbirth in Gansu Provincial Maternity and Child Care Hospital were selected. Multivariate logistic regression was used to evaluate the association of calcium supplementation and intake with preterm birth. \u0000 \u0000 \u0000Results \u0000After confounding factors were adjusted, pregnant women who took calcium supplement for more than 3 months before and/or during pregnancy had the risk of preterm birth reduced by 14% which was dose-responding (OR=0.86, 95% CI=0.77-0.96, P<0.05). Through stratifying by trimesters of pregnancy, it was found that calcium supplement in the third trimester was a protective factor for preterm birth and especially significant in early and very early pregnancy (OR=0.75, 95% CI=0.62-0.92, P<0.05). Through stratifying by dietary calcium intake, pregnant women who took dietary calcium more than 465.55 mg/d had the risk of preterm birth significantly reduced which was shown by the reduction of preterm birth of different degrees, controlled preterm labor and spontaneous premature dilivery (OR=0.66, 95% CI=0.53-0.82, P<0.05). \u0000 \u0000 \u0000Conclusion \u0000Appropriate calcium supplementation or dietary calcium intake before and during pregnancy can reduce the risk of preterm birth, which is especially significant in late pregnancy. \u0000 \u0000 \u0000Key words: \u0000Calcium; Preterm birth; Late pregnancy; Epidemiology","PeriodicalId":9877,"journal":{"name":"Chinese Journal of Clinical Nutrition","volume":"26 1","pages":"272-277"},"PeriodicalIF":0.0,"publicationDate":"2018-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47281879","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 : 2018-10-30DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.05.008
Min Cui, Kang Yu, Chun-wei Li
Objective To explore the relationship between sarcopenia and the risks of falls, osteoporosis, fractures and all-cause mortality among elderly people. Methods This was a meta-analysis of prospective cohort studies. Databases of OVID/Medline, PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI) and Chinese WanFang Database were searched systematically according to the inclusion and exclusion criteria.The literatures related to the relationship between sarcopenia and falls, osteoporosis, fractures and all-cause mortality among elderly people from January 1987 to June 2017 were identified.The quality of the literature was evaluated by the risk assessment tool Newcastle-Ottawa Scale recommended by the Cochrane. Meta-analysis was conducted by RevMan 5.3 and Stata 12.1 software. Results Totally 13 prospective cohort studies including 19 376 subjects and 3 190 outcome events were entered in meta-analysis. The relative risk (RR) for comprehensive adverse outcome events among subjects with sarcopenia was 1.64 times of non-sarcopenia subjects(95% CI=1.51-1.78, P<0.000 01), and the RRs for fall, osteoporosis, fractures and all-cause mortality were 1.60 (95% CI=1.42-1.81, P<0.000 01), 4.85 (95% CI=2.18-10.79, P=0.000 1), 1.59 (95% CI=1.40-1.80, P<0.000 01), 2.08 (95% CI=1.18-3.69, P=0.01) times of non-sarcopenia subjects respectively. Conclusion Sarcopenia increases the risk of falls, fractures, all-cause mortality and comprehensive adverse outcome significantly, suggesting that sarcopenia might be a predictor for adverse outcomes among elderly people. Key words: Sarcopenia; Falls; Osteoporosis; Fractures; Mortality
{"title":"Impact of sarcopenia on the risk of falls, osteoporosis, fractures, and all causes of death among elderly people: A Meta-analysis of prospective cohort studies","authors":"Min Cui, Kang Yu, Chun-wei Li","doi":"10.3760/CMA.J.ISSN.1674-635X.2018.05.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2018.05.008","url":null,"abstract":"Objective \u0000To explore the relationship between sarcopenia and the risks of falls, osteoporosis, fractures and all-cause mortality among elderly people. \u0000 \u0000 \u0000Methods \u0000This was a meta-analysis of prospective cohort studies. Databases of OVID/Medline, PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI) and Chinese WanFang Database were searched systematically according to the inclusion and exclusion criteria.The literatures related to the relationship between sarcopenia and falls, osteoporosis, fractures and all-cause mortality among elderly people from January 1987 to June 2017 were identified.The quality of the literature was evaluated by the risk assessment tool Newcastle-Ottawa Scale recommended by the Cochrane. Meta-analysis was conducted by RevMan 5.3 and Stata 12.1 software. \u0000 \u0000 \u0000Results \u0000Totally 13 prospective cohort studies including 19 376 subjects and 3 190 outcome events were entered in meta-analysis. The relative risk (RR) for comprehensive adverse outcome events among subjects with sarcopenia was 1.64 times of non-sarcopenia subjects(95% CI=1.51-1.78, P<0.000 01), and the RRs for fall, osteoporosis, fractures and all-cause mortality were 1.60 (95% CI=1.42-1.81, P<0.000 01), 4.85 (95% CI=2.18-10.79, P=0.000 1), 1.59 (95% CI=1.40-1.80, P<0.000 01), 2.08 (95% CI=1.18-3.69, P=0.01) times of non-sarcopenia subjects respectively. \u0000 \u0000 \u0000Conclusion \u0000Sarcopenia increases the risk of falls, fractures, all-cause mortality and comprehensive adverse outcome significantly, suggesting that sarcopenia might be a predictor for adverse outcomes among elderly people. \u0000 \u0000 \u0000Key words: \u0000Sarcopenia; Falls; Osteoporosis; Fractures; Mortality","PeriodicalId":9877,"journal":{"name":"Chinese Journal of Clinical Nutrition","volume":"26 1","pages":"299-308"},"PeriodicalIF":0.0,"publicationDate":"2018-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49399246","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 : 2018-10-30DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.05.011
Q. Ren
Due to pathophysiological changes, the risk of micronutrient deficiency in geriatric increased. Currently, dietary intake of vitamin A, vitamin B1, vitamin B2, vitamin B12, vitamin C, vitamin E, folic acid, calcium, magnesium, zinc and selenium was still lower than the recommended dietary reference intake in the elderly. Geriatric micronutrient deficiencies may contribute to the decrease of physiological function, immune function and cognitive function. It may also result in frailty and increase the risk of adverse clinical outcomes. The appropriate supplementation of single or multiple micronutrients can improve physiological function, cognitive function, immune function and frailty, meantime, reduce the risk of cardiovascular disease and infection. Given there are still no generally accepted standards on the time and method of intervention, population-based randomized controlled studies are needed to provide the basis for promoting healthy ageing. Key words: Micronutrient; Elderly; Intervention; Function
{"title":"Effect of micronutrient status on geriatric function and clinical outcome","authors":"Q. Ren","doi":"10.3760/CMA.J.ISSN.1674-635X.2018.05.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2018.05.011","url":null,"abstract":"Due to pathophysiological changes, the risk of micronutrient deficiency in geriatric increased. Currently, dietary intake of vitamin A, vitamin B1, vitamin B2, vitamin B12, vitamin C, vitamin E, folic acid, calcium, magnesium, zinc and selenium was still lower than the recommended dietary reference intake in the elderly. Geriatric micronutrient deficiencies may contribute to the decrease of physiological function, immune function and cognitive function. It may also result in frailty and increase the risk of adverse clinical outcomes. The appropriate supplementation of single or multiple micronutrients can improve physiological function, cognitive function, immune function and frailty, meantime, reduce the risk of cardiovascular disease and infection. Given there are still no generally accepted standards on the time and method of intervention, population-based randomized controlled studies are needed to provide the basis for promoting healthy ageing. \u0000 \u0000 \u0000Key words: \u0000Micronutrient; Elderly; Intervention; Function","PeriodicalId":9877,"journal":{"name":"Chinese Journal of Clinical Nutrition","volume":"26 1","pages":"319-322"},"PeriodicalIF":0.0,"publicationDate":"2018-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44227072","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 : 2018-10-30DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.05.002
Jinxia Liu, Xiangrong Chen, Tian-zao Huang, B. Dong, Yuxing Cai
Objective To investigate the effects of enteral immunonutrition supplemented with omega-3 polyunsaturated fatty acid (ω-3 PUFA) on the incidences and severity of ventilator associated pneumonia complications, inflammatory response, and the prognosis in patients with severe traumatic brain injury(sTBI)undergoing ventilator therapy. Methods From January 2015 to June 2017, 64 patients of sTBI were selected and randomly divided into experimental group (ω-3 PUFA, n=32) and control group(n=32). White blood cells (WBC) and the proportion of neutrophils (N%) were evaluated by cell analyzer. Meanwhile, the serum levels of C-reactive protein (CRP) and procalcitonin (PCT) were tested with enzyme linked immunosorbent assay. After 14-days treatment, the Glasgow coma scale (GCS) score, APACHE Ⅱ score, clinical pulmonary infection score (CPIS), pulmonary function and prognoses were also compared between the two groups. Results As compared with the control group, the experimental group had lower incidences of ventilator associated pneumonia(66% vs.56%, P=0.048), reduced degree of lung infection and lower CPIS(8.25±0.60 vs.7.47±0.53); higher lung function indexes[FVC: (2.89±0.19)L vs.(3.46±0.22)L, P=0.010; FEV1: (2.35±0.16)L vs.(2.84±0.24)L, P=0.040; FEV1/FVC %: (49.11±3.34)% vs.(56.00±2.64)%, P=0.038)]; lower serum levels of inflammatory responses [WBC: (11.83±0.74)×109/L vs.(9.51±0.90)×109/L, P=0.029; N%: (79.11±1.51)% vs.(72.71±1.16)%, P=0.041; CRP: (85.15±8.42)mg/L vs.(63.96±5.72)mg/L, P=0.001; PCT: (6.43±0.47)μg/L vs.(4.83±0.39)μg/L, P=0.013]14 days after enteral immunonutrition supplemented with ω-3 PUFA. As compared with the control group, the experimental group received better prognosis with GCS scores increasing(8.69±0.41 vs.9.52±0.59, P=0.038), APACHE Ⅱ scores decreasing(14.74±1.01 vs.12.68±0.89, P=0.049), the time of mechanical ventilation [(13.23±1.17)d vs.(10.88±1.24)d, P=0.024] and the hospitalization days [(23.29±2.45)d vs.(18.42±1.96)d, P=0.012] reduced on the 14th day, mechanical ventilation withdraw rate within 14 days increasing [24/32 (75%) vs.27/32(84%), P=0.030] on the 14th day. Conclusion Enteral immunonutrition supplemented with ω-3 PUFA can effectively reduce the incidence of ventilator associated pneumonia, alleviate the degree of infection and the inflammatory response in patients with sTBI undergoing ventilator therapy possibly improving condition and prognosis, which is worthy of being widely used. Key words: Craniocerebral trauma; Unsaturated fatty acid; Ventilator associated pneumonia; Inflammatory response
{"title":"Effects of enteral immunonutrition supplemented with omega-3 polyunsaturated fatty acid on the incidences of ventilator associated pneumonia complications in patients with severe traumatic brain injury undergoing ventilator therapy","authors":"Jinxia Liu, Xiangrong Chen, Tian-zao Huang, B. Dong, Yuxing Cai","doi":"10.3760/CMA.J.ISSN.1674-635X.2018.05.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2018.05.002","url":null,"abstract":"Objective \u0000To investigate the effects of enteral immunonutrition supplemented with omega-3 polyunsaturated fatty acid (ω-3 PUFA) on the incidences and severity of ventilator associated pneumonia complications, inflammatory response, and the prognosis in patients with severe traumatic brain injury(sTBI)undergoing ventilator therapy. \u0000 \u0000 \u0000Methods \u0000From January 2015 to June 2017, 64 patients of sTBI were selected and randomly divided into experimental group (ω-3 PUFA, n=32) and control group(n=32). White blood cells (WBC) and the proportion of neutrophils (N%) were evaluated by cell analyzer. Meanwhile, the serum levels of C-reactive protein (CRP) and procalcitonin (PCT) were tested with enzyme linked immunosorbent assay. After 14-days treatment, the Glasgow coma scale (GCS) score, APACHE Ⅱ score, clinical pulmonary infection score (CPIS), pulmonary function and prognoses were also compared between the two groups. \u0000 \u0000 \u0000Results \u0000As compared with the control group, the experimental group had lower incidences of ventilator associated pneumonia(66% vs.56%, P=0.048), reduced degree of lung infection and lower CPIS(8.25±0.60 vs.7.47±0.53); higher lung function indexes[FVC: (2.89±0.19)L vs.(3.46±0.22)L, P=0.010; FEV1: (2.35±0.16)L vs.(2.84±0.24)L, P=0.040; FEV1/FVC %: (49.11±3.34)% vs.(56.00±2.64)%, P=0.038)]; lower serum levels of inflammatory responses [WBC: (11.83±0.74)×109/L vs.(9.51±0.90)×109/L, P=0.029; N%: (79.11±1.51)% vs.(72.71±1.16)%, P=0.041; CRP: (85.15±8.42)mg/L vs.(63.96±5.72)mg/L, P=0.001; PCT: (6.43±0.47)μg/L vs.(4.83±0.39)μg/L, P=0.013]14 days after enteral immunonutrition supplemented with ω-3 PUFA. As compared with the control group, the experimental group received better prognosis with GCS scores increasing(8.69±0.41 vs.9.52±0.59, P=0.038), APACHE Ⅱ scores decreasing(14.74±1.01 vs.12.68±0.89, P=0.049), the time of mechanical ventilation [(13.23±1.17)d vs.(10.88±1.24)d, P=0.024] and the hospitalization days [(23.29±2.45)d vs.(18.42±1.96)d, P=0.012] reduced on the 14th day, mechanical ventilation withdraw rate within 14 days increasing [24/32 (75%) vs.27/32(84%), P=0.030] on the 14th day. \u0000 \u0000 \u0000Conclusion \u0000Enteral immunonutrition supplemented with ω-3 PUFA can effectively reduce the incidence of ventilator associated pneumonia, alleviate the degree of infection and the inflammatory response in patients with sTBI undergoing ventilator therapy possibly improving condition and prognosis, which is worthy of being widely used. \u0000 \u0000 \u0000Key words: \u0000Craniocerebral trauma; Unsaturated fatty acid; Ventilator associated pneumonia; Inflammatory response","PeriodicalId":9877,"journal":{"name":"Chinese Journal of Clinical Nutrition","volume":"26 1","pages":"267-271"},"PeriodicalIF":0.0,"publicationDate":"2018-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43457054","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 : 2018-10-30DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.05.005
H. Bai, Jianqin Sun, Min Chen, Hua Xie, Dan-feng Xu
Objective To investigate the relationship between calf circumference and skeletal muscle mass, strength and function in the elderly in Shanghai. Methods A total of 401 old people were recruited from physical examination centers in our hospital with the mean age of (71.8±7.4) years, including 202 males and 199 females.Adipose tissue, skeletal muscle mass (SMM) and appendicular skeletal muscle mass (ASM) were measured by bioelectrical impedance analysis. The ASM index (ASM/height2) and SMM index (SMM/height2) were calculated.Muscle function was measured by testing gait speed (m/s). Muscle strength was measured by handgrip strength(HGS) using an electronic hand dynamometer, with the dominant hand gripping for three times and taking the maximum value.Height, weight, right calf circumference and waist circumference were measured. Results Height, weight, ASM, ASM/height2, SMM, SMM/height2 and HGS were significantly higher in men than in women (P<0.01); adipose tissue was significantly higher in women than in men (P<0.05). The age, body mass index, calf circumference, waist circumference and gait speed were not statistically different (P=0.426, P=0.143, P=0.425, P=0.093, P=0.143). There were linear correlations between calf circumference and height, weight, BMI, waist circumference, ASM, ASM/height2, adipose tissue, grip strength, SMM and SMM/height2 (P=0.001, P<0.001, P<0.001, P<0.001, P<0.001, P<0.001, P<0.001, P=0.003, P<0.001, P<0.001). There was no linear correlation between calf circumference and pace and age (P=0.818, P=0.078). Multiple stepwise regression analysis showed that height, BMI, ASM/height2 and SMM were correlated with the calf circumference. Conclusions Skeletal muscle mass and strength are higher in men than in women, while adipose tissue is higher in women than in men. Skeletal musle mass is an important factor affecting the calf circumference. There is a linear correlation between skeletal muscle strength and calf circumference. Key words: Calf circumference; Hand strength; Skeletal muscle mass
{"title":"Relationship between calf circumference and skeletal muscle mass, strength and function in the elderly","authors":"H. Bai, Jianqin Sun, Min Chen, Hua Xie, Dan-feng Xu","doi":"10.3760/CMA.J.ISSN.1674-635X.2018.05.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2018.05.005","url":null,"abstract":"Objective \u0000To investigate the relationship between calf circumference and skeletal muscle mass, strength and function in the elderly in Shanghai. \u0000 \u0000 \u0000Methods \u0000A total of 401 old people were recruited from physical examination centers in our hospital with the mean age of (71.8±7.4) years, including 202 males and 199 females.Adipose tissue, skeletal muscle mass (SMM) and appendicular skeletal muscle mass (ASM) were measured by bioelectrical impedance analysis. The ASM index (ASM/height2) and SMM index (SMM/height2) were calculated.Muscle function was measured by testing gait speed (m/s). Muscle strength was measured by handgrip strength(HGS) using an electronic hand dynamometer, with the dominant hand gripping for three times and taking the maximum value.Height, weight, right calf circumference and waist circumference were measured. \u0000 \u0000 \u0000Results \u0000Height, weight, ASM, ASM/height2, SMM, SMM/height2 and HGS were significantly higher in men than in women (P<0.01); adipose tissue was significantly higher in women than in men (P<0.05). The age, body mass index, calf circumference, waist circumference and gait speed were not statistically different (P=0.426, P=0.143, P=0.425, P=0.093, P=0.143). There were linear correlations between calf circumference and height, weight, BMI, waist circumference, ASM, ASM/height2, adipose tissue, grip strength, SMM and SMM/height2 (P=0.001, P<0.001, P<0.001, P<0.001, P<0.001, P<0.001, P<0.001, P=0.003, P<0.001, P<0.001). There was no linear correlation between calf circumference and pace and age (P=0.818, P=0.078). Multiple stepwise regression analysis showed that height, BMI, ASM/height2 and SMM were correlated with the calf circumference. \u0000 \u0000 \u0000Conclusions \u0000Skeletal muscle mass and strength are higher in men than in women, while adipose tissue is higher in women than in men. Skeletal musle mass is an important factor affecting the calf circumference. There is a linear correlation between skeletal muscle strength and calf circumference. \u0000 \u0000 \u0000Key words: \u0000Calf circumference; Hand strength; Skeletal muscle mass","PeriodicalId":9877,"journal":{"name":"Chinese Journal of Clinical Nutrition","volume":"26 1","pages":"284-287"},"PeriodicalIF":0.0,"publicationDate":"2018-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43356381","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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