Objective To compare glycemic profile between diabetic patients receiving peritoneal dialysis and diabetic patients with normal kidney function, and to investigate the impact of peritoneal dialysis on glycemic control through continuous glucose monitor system(CGMS). Methods 19 diabetic patients with end-stage renal disease receiving regular peritoneal dialysis (DMPD group) and 8 patients with non-diabetic nephropathy receiving regular peritoneal dialysis (PD group) were randomly selected and matched with 20 diabetic patients with normal kidney function (DM group) based on age, gender and 72 hours mean glucose. CGMS were applied on all patients for 72 hours. Glycemic variability parameters were compared among the three groups. Results Peritoneal transport function was positively correlated with mean glucose, glucose standard deviation and mean amplitude of glycemic excursion. Compared with PD group, multiple variation parameters, such as intraday glycemic standard deviation (P<0.001), covariant efficiency (P=0.009) and mean of daily difference (P=0.043), were significantly lower in DMPD group. Though both DMPD and DM group exhibited profile as trough in wee hours and post-prandial hyperglycemia, DMPD had higher glycemic level in wee hours (P<0.001). Conclusion Diabetic patients with end-stage renal disease receiving regular peritoneal dialysis have smaller glucose variability than diabetic patients with normal renal function. Key words: Peritoneal dialysis; Glycemic variability; Peritoneal transport level; Continuous glucose monitor system; Peritoneal glucose exposure
{"title":"Effect of peritoneal dialysis on glycemic variability in patients with diabetes and its clinical implications","authors":"Zi-juan Zhou, Hua Zheng, Wei Li, Ying Ma, Hai-yun Wang, F. Ping, Xuemei Li, Yuxiu Li, Limeng Chen","doi":"10.3760/CMA.J.ISSN.1674-635X.2018.05.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2018.05.001","url":null,"abstract":"Objective To compare glycemic profile between diabetic patients receiving peritoneal dialysis and diabetic patients with normal kidney function, and to investigate the impact of peritoneal dialysis on glycemic control through continuous glucose monitor system(CGMS). Methods 19 diabetic patients with end-stage renal disease receiving regular peritoneal dialysis (DMPD group) and 8 patients with non-diabetic nephropathy receiving regular peritoneal dialysis (PD group) were randomly selected and matched with 20 diabetic patients with normal kidney function (DM group) based on age, gender and 72 hours mean glucose. CGMS were applied on all patients for 72 hours. Glycemic variability parameters were compared among the three groups. Results Peritoneal transport function was positively correlated with mean glucose, glucose standard deviation and mean amplitude of glycemic excursion. Compared with PD group, multiple variation parameters, such as intraday glycemic standard deviation (P<0.001), covariant efficiency (P=0.009) and mean of daily difference (P=0.043), were significantly lower in DMPD group. Though both DMPD and DM group exhibited profile as trough in wee hours and post-prandial hyperglycemia, DMPD had higher glycemic level in wee hours (P<0.001). Conclusion Diabetic patients with end-stage renal disease receiving regular peritoneal dialysis have smaller glucose variability than diabetic patients with normal renal function. Key words: Peritoneal dialysis; Glycemic variability; Peritoneal transport level; Continuous glucose monitor system; Peritoneal glucose exposure","PeriodicalId":9877,"journal":{"name":"Chinese Journal of Clinical Nutrition","volume":"26 1","pages":"261-266"},"PeriodicalIF":0.0,"publicationDate":"2018-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48741808","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 : 2018-08-30DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.04.001
Xiaoxuan Liu, Hongdi Du, Huo Xiaopeng, Hong Jiang
Objective To explore the effect of nurse-led intensive nutritional intervention on nutritional risk, undernutrition and quality of life in hospitalized Alzheimer disease (AD) patients. Methods A total of 170 hospitalized AD patients who met the criteria of the protocol were enrolled and divided randomly into two groups as study group (n=86) and control group (n=84). The two groups received nurse-led intensive nutritional intervention and routine nutritional management respectively for six weeks. Nutritional risk, undernutrition and quality of life were measured by nutritional risk screening 2002 (NRS 2002) and quality of life-Alzheimer disease scale before and after the nutritional intervention. Results There was no significant difference in baseline data between the two groups. The suitable rate of NRS 2002 was 100%. After a 6-week intervention, the prevalence of nutritional risk (41.9% vs. 70.9%, P<0.001) and undernutrition (17.4% vs. 30.2%, P=0.049) decreased significantly in study group. The prevalence of nutritional risk was significantly lower in study group than in control group (41.9% vs. 64.3%, P=0.003). The score of quality of life in study group significantly increased (34.12±5.91 vs. 31.56±6.80, P=0.028) after the intervention, and was significantly higher than that of the control group (34.12±5.91 vs. 31.63±6.22, P=0.030). Conclusion The application of nurse-led intensive nutritional intervention can help to improve the nutritional status and quality of life in hospitalized AD patients. Key words: Alzheimer disease; Inpatients; Nurse-led intensive nutritional intervention; Nutritional risk; Quality of life
目的探讨护士主导的强化营养干预对阿尔茨海默病(AD)住院患者营养风险、营养不良及生活质量的影响。方法选取符合方案标准的住院AD患者170例，随机分为研究组(n=86)和对照组(n=84)。两组患者分别接受护士主导的强化营养干预和常规营养管理，为期6周。采用营养风险筛查2002 (NRS 2002)和阿尔茨海默病生活质量量表对营养干预前后的营养风险、营养不足和生活质量进行测量。结果两组患者的基线数据无显著差异。2002年国家标准的适宜率为100%。干预6周后，研究组营养风险患病率(41.9% vs. 70.9%， P<0.001)和营养不良患病率(17.4% vs. 30.2%， P=0.049)显著降低。研究组营养风险发生率明显低于对照组(41.9% vs. 64.3%， P=0.003)。实验组患者干预后生活质量评分显著升高(34.12±5.91比31.56±6.80,P=0.028)，显著高于对照组(34.12±5.91比31.63±6.22,P=0.030)。结论护士主导的强化营养干预有助于改善住院AD患者的营养状况和生活质量。关键词:阿尔茨海默病;住院病人;护士主导的强化营养干预;营养风险;生活质量
{"title":"Effect of nurse-led intensive nutritional intervention on nutritional risk, undernutrition and quality of life in hospitalized patients with Alzheimer disease: A randomized controlled study","authors":"Xiaoxuan Liu, Hongdi Du, Huo Xiaopeng, Hong Jiang","doi":"10.3760/CMA.J.ISSN.1674-635X.2018.04.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2018.04.001","url":null,"abstract":"Objective \u0000To explore the effect of nurse-led intensive nutritional intervention on nutritional risk, undernutrition and quality of life in hospitalized Alzheimer disease (AD) patients. \u0000 \u0000 \u0000Methods \u0000A total of 170 hospitalized AD patients who met the criteria of the protocol were enrolled and divided randomly into two groups as study group (n=86) and control group (n=84). The two groups received nurse-led intensive nutritional intervention and routine nutritional management respectively for six weeks. Nutritional risk, undernutrition and quality of life were measured by nutritional risk screening 2002 (NRS 2002) and quality of life-Alzheimer disease scale before and after the nutritional intervention. \u0000 \u0000 \u0000Results \u0000There was no significant difference in baseline data between the two groups. The suitable rate of NRS 2002 was 100%. After a 6-week intervention, the prevalence of nutritional risk (41.9% vs. 70.9%, P<0.001) and undernutrition (17.4% vs. 30.2%, P=0.049) decreased significantly in study group. The prevalence of nutritional risk was significantly lower in study group than in control group (41.9% vs. 64.3%, P=0.003). The score of quality of life in study group significantly increased (34.12±5.91 vs. 31.56±6.80, P=0.028) after the intervention, and was significantly higher than that of the control group (34.12±5.91 vs. 31.63±6.22, P=0.030). \u0000 \u0000 \u0000Conclusion \u0000The application of nurse-led intensive nutritional intervention can help to improve the nutritional status and quality of life in hospitalized AD patients. \u0000 \u0000 \u0000Key words: \u0000Alzheimer disease; Inpatients; Nurse-led intensive nutritional intervention; Nutritional risk; Quality of life","PeriodicalId":9877,"journal":{"name":"Chinese Journal of Clinical Nutrition","volume":"26 1","pages":"197-201"},"PeriodicalIF":0.0,"publicationDate":"2018-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69987850","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 : 2018-08-30DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.04.002
Yecheng Liu, Lei Guo, Zhi-wei Qi, Jun Xu, Huadong Zhu
Objective To compare the efficacy of two rapid lipid lowering methods as plasma exchange and insulin in the treatment of hyperlipidemic acute pancreatitis. Methods The clinical data of 98 patients with hyperlipidemic acute pancreatitis in Peking Union Medical College Hospital from January 2014 to December 2016 were retrospectively analyzed. All patients were divided into plasma exchange group (n=42) and insulin group (n=56) according to rapid lipid lowering method. Results There were no significant differences in the onset-to-treatment time, the proportion of patients with diabetes, the proportion of patients with pregnancy, the initial triglyceride level, Acute Physiology, Age and Chronic Health Evaluation Ⅱ score and modified CT severity index score score and conditioning-test stimulus interval(CTSI) score between the plasma exchange group and the insulin group (P>0.05). In addition, there were also no significant differences in the incidences of acute respiratory distress syndrome, acute kidney injury, shock and pancreatic abscess, and the proportion of moderate pancreatitis and severe pancreatitis, oral / jejunum nutrition tolerating start time, hospitalization time and mortality between the two groups (P>0.05). The plasma exchange group had significantly less time to achieve the target triglyceride level and to reach normal free fatty acids level than the insulin group [(13.09 ±12.50)h vs. (46.92±20.92)h, t=3.291, P=0.001; (15.75±14.13)h vs.(73.21±38.49)h, t=3.291, P=0.001]. The pancreatic pseudocyst incidence was significantly lower (7.14% vs.23.21%, t=2.120, P=0.034), and the hospitalization cost was significantly higher[(81 794.92±33 719.69)yuan vs. (56 042.43±30 565.34)yuan, t=2.034, P=0.042] in the plasma exchange group than in the insulin group. Conclusions Both plasma exchange and insulin can rapidly lower blood lipids. Plasma exchange has certain advantages over insulin in lipid-lowering, for it is faster, and has lower incidence of pancreatic pseudocyst, thus can be applied in patients whose financial conditions permit. Key words: Acute fat pancreatitis; Plasma exchange; Insulin
{"title":"Comparison of plasma exchange and insulin in the treatment of hyperlipidemic acute pancreatitis","authors":"Yecheng Liu, Lei Guo, Zhi-wei Qi, Jun Xu, Huadong Zhu","doi":"10.3760/CMA.J.ISSN.1674-635X.2018.04.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2018.04.002","url":null,"abstract":"Objective \u0000To compare the efficacy of two rapid lipid lowering methods as plasma exchange and insulin in the treatment of hyperlipidemic acute pancreatitis. \u0000 \u0000 \u0000Methods \u0000The clinical data of 98 patients with hyperlipidemic acute pancreatitis in Peking Union Medical College Hospital from January 2014 to December 2016 were retrospectively analyzed. All patients were divided into plasma exchange group (n=42) and insulin group (n=56) according to rapid lipid lowering method. \u0000 \u0000 \u0000Results \u0000There were no significant differences in the onset-to-treatment time, the proportion of patients with diabetes, the proportion of patients with pregnancy, the initial triglyceride level, Acute Physiology, Age and Chronic Health Evaluation Ⅱ score and modified CT severity index score score and conditioning-test stimulus interval(CTSI) score between the plasma exchange group and the insulin group (P>0.05). In addition, there were also no significant differences in the incidences of acute respiratory distress syndrome, acute kidney injury, shock and pancreatic abscess, and the proportion of moderate pancreatitis and severe pancreatitis, oral / jejunum nutrition tolerating start time, hospitalization time and mortality between the two groups (P>0.05). The plasma exchange group had significantly less time to achieve the target triglyceride level and to reach normal free fatty acids level than the insulin group [(13.09 ±12.50)h vs. (46.92±20.92)h, t=3.291, P=0.001; (15.75±14.13)h vs.(73.21±38.49)h, t=3.291, P=0.001]. The pancreatic pseudocyst incidence was significantly lower (7.14% vs.23.21%, t=2.120, P=0.034), and the hospitalization cost was significantly higher[(81 794.92±33 719.69)yuan vs. (56 042.43±30 565.34)yuan, t=2.034, P=0.042] in the plasma exchange group than in the insulin group. \u0000 \u0000 \u0000Conclusions \u0000Both plasma exchange and insulin can rapidly lower blood lipids. Plasma exchange has certain advantages over insulin in lipid-lowering, for it is faster, and has lower incidence of pancreatic pseudocyst, thus can be applied in patients whose financial conditions permit. \u0000 \u0000 \u0000Key words: \u0000Acute fat pancreatitis; Plasma exchange; Insulin","PeriodicalId":9877,"journal":{"name":"Chinese Journal of Clinical Nutrition","volume":"26 1","pages":"202-206"},"PeriodicalIF":0.0,"publicationDate":"2018-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69987960","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 : 2018-08-30DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.04.011
Li-Shuang Zhao, Shaomei Wang, Lei Zhao, Zhi-hua Zhang
Objective To observe the effects of two different gauze folding patterns used in local hemostasis after peripherally inserted central catheters (PICC). Methods A total of 152 patients were selected and divided into two groups according to PICC date sequence as control group of 72 patients using 2.0 cm×2.0 cm little gauze to oppress the puncture point and observation group of 80 patients using 1.0 cm×1.5 cm gauze ball made by ourselves to oppress the puncture point. The oozing of the puncture point was observed in patients of the two groups. Results The hemostasis was better in the observation group than in the control group(χ2=15.88, P<0.01). No limb swelling happened to the patients in the observation group(χ2=58.064, P<0.01). There was statistically significant difference in hemostatic effect between the two groups. Conclusion The sterile gauze ball made by ourselves has a good effect on local hemostasis through oppressing the puncture point without any impact on blood circulation of limbs. Key words: Peripherally inserted central catherter; Sterility gauze ball; Local hemostasis
{"title":"Effects of different gauze folding patterns on local hemostasis after peripherally inserted central catheters","authors":"Li-Shuang Zhao, Shaomei Wang, Lei Zhao, Zhi-hua Zhang","doi":"10.3760/CMA.J.ISSN.1674-635X.2018.04.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2018.04.011","url":null,"abstract":"Objective \u0000To observe the effects of two different gauze folding patterns used in local hemostasis after peripherally inserted central catheters (PICC). \u0000 \u0000 \u0000Methods \u0000A total of 152 patients were selected and divided into two groups according to PICC date sequence as control group of 72 patients using 2.0 cm×2.0 cm little gauze to oppress the puncture point and observation group of 80 patients using 1.0 cm×1.5 cm gauze ball made by ourselves to oppress the puncture point. The oozing of the puncture point was observed in patients of the two groups. \u0000 \u0000 \u0000Results \u0000The hemostasis was better in the observation group than in the control group(χ2=15.88, P<0.01). No limb swelling happened to the patients in the observation group(χ2=58.064, P<0.01). There was statistically significant difference in hemostatic effect between the two groups. \u0000 \u0000 \u0000Conclusion \u0000The sterile gauze ball made by ourselves has a good effect on local hemostasis through oppressing the puncture point without any impact on blood circulation of limbs. \u0000 \u0000 \u0000Key words: \u0000Peripherally inserted central catherter; Sterility gauze ball; Local hemostasis","PeriodicalId":9877,"journal":{"name":"Chinese Journal of Clinical Nutrition","volume":"26 1","pages":"254-255"},"PeriodicalIF":0.0,"publicationDate":"2018-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46857493","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 : 2018-08-30DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.04.004
Jialu Zhuang, F. Bei, Yishi Qin, Jianhua Sun
Objective To explore the effect of high sn-2 palmitate infant formula (HPIF) on stool frequency and consistency, fatty acids, calcium and magnesium contents in infants. Methods A prospective, double-blind, randomized, controlled clinical study was conducted including 94 healthy mature infants of single birth and appropriate for gestational age, born from June 2013 to December 2014. All eligible infants were enrolled within 21 days after birth. All the infant formula fed subjects were divided randomly into two groups as standard infant formula (IF) group and high sn-2 palmitate infant formula (HPIF) group. Breast-fed infants were enrolled as control group (BF group). All infants were followed up until 90 days old. The growth indexes and defecation status of the three groups were monitored dynamically. Meanwhile, stool fatty acid profile and mineral contents were also detected. Results There was no significant difference in head circumference, body length and body weight among the three groups at enrollment, 42 days and 90 days old. The stool frequency and mushy stool frequency of HPIF and IF groups were significantly lower than that of BF group at 42 days and 90 days old; formed stool frequency was higher in HPIF and IF groups than in BF group. The fecal palmitic acid level in dry feces was significantly higher in HPIF and IF groups than in BF group [(31.1±9.8), (30.9±10.7) vs. (10.8±8.8)mg/g] at 42 days old. At 90 days old, the fecal palmitic acid level in dry feces was significantly lower in HPIF group than in IF group [(24.3±9.8) vs. (29.9±7.9)mg/mg], while was significantly higher in both infant formula fed groups than in BF group [(8.9±8.4)mg/g]. The fecal calcium level in dry feces of HPIF and IF groups were significantly higher than that of BF group [(38.3±14.0), (38.8±15.5) vs. (21.3±13.7)mg/g] at 42 days old. At 90 days old, the fecal calcium level in dry feces of HPIF group was significantly lower than that of IF group [(31.1 ± 11.2) vs. (45.9 ± 16.5)mg/g, dry stool] and significantly higher than that of BF group [(21.5 ± 9.9)mg/g]. The fecal magnesium level was similar between HPIF and IF groups, and significantly higher than that of BF group at 42 days and 90 days old. The fecal calcium level was positively correlated with the content of fecal palmitic acid among three groups (r=0.43, P<0.01). Conclusions Breast milk is the best food for infants. Compared with standard infant formula, feeding with high sn-2 palmitate infant formula can reduce the fecal excretion of calcium and palmitic acid, making it closer to the level of breast-fed infants. Key words: Infant formula; Fatty acids; Palmitic acid; Calcium; High sn-2 palmitate
{"title":"Effect of high sn-2 palmitate infant formula on the excretion of fatty acids, calcium and magnesium in infants","authors":"Jialu Zhuang, F. Bei, Yishi Qin, Jianhua Sun","doi":"10.3760/CMA.J.ISSN.1674-635X.2018.04.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2018.04.004","url":null,"abstract":"Objective \u0000To explore the effect of high sn-2 palmitate infant formula (HPIF) on stool frequency and consistency, fatty acids, calcium and magnesium contents in infants. \u0000 \u0000 \u0000Methods \u0000A prospective, double-blind, randomized, controlled clinical study was conducted including 94 healthy mature infants of single birth and appropriate for gestational age, born from June 2013 to December 2014. All eligible infants were enrolled within 21 days after birth. All the infant formula fed subjects were divided randomly into two groups as standard infant formula (IF) group and high sn-2 palmitate infant formula (HPIF) group. Breast-fed infants were enrolled as control group (BF group). All infants were followed up until 90 days old. The growth indexes and defecation status of the three groups were monitored dynamically. Meanwhile, stool fatty acid profile and mineral contents were also detected. \u0000 \u0000 \u0000Results \u0000There was no significant difference in head circumference, body length and body weight among the three groups at enrollment, 42 days and 90 days old. The stool frequency and mushy stool frequency of HPIF and IF groups were significantly lower than that of BF group at 42 days and 90 days old; formed stool frequency was higher in HPIF and IF groups than in BF group. The fecal palmitic acid level in dry feces was significantly higher in HPIF and IF groups than in BF group [(31.1±9.8), (30.9±10.7) vs. (10.8±8.8)mg/g] at 42 days old. At 90 days old, the fecal palmitic acid level in dry feces was significantly lower in HPIF group than in IF group [(24.3±9.8) vs. (29.9±7.9)mg/mg], while was significantly higher in both infant formula fed groups than in BF group [(8.9±8.4)mg/g]. The fecal calcium level in dry feces of HPIF and IF groups were significantly higher than that of BF group [(38.3±14.0), (38.8±15.5) vs. (21.3±13.7)mg/g] at 42 days old. At 90 days old, the fecal calcium level in dry feces of HPIF group was significantly lower than that of IF group [(31.1 ± 11.2) vs. (45.9 ± 16.5)mg/g, dry stool] and significantly higher than that of BF group [(21.5 ± 9.9)mg/g]. The fecal magnesium level was similar between HPIF and IF groups, and significantly higher than that of BF group at 42 days and 90 days old. The fecal calcium level was positively correlated with the content of fecal palmitic acid among three groups (r=0.43, P<0.01). \u0000 \u0000 \u0000Conclusions \u0000Breast milk is the best food for infants. Compared with standard infant formula, feeding with high sn-2 palmitate infant formula can reduce the fecal excretion of calcium and palmitic acid, making it closer to the level of breast-fed infants. \u0000 \u0000 \u0000Key words: \u0000Infant formula; Fatty acids; Palmitic acid; Calcium; High sn-2 palmitate","PeriodicalId":9877,"journal":{"name":"Chinese Journal of Clinical Nutrition","volume":"26 1","pages":"214-220"},"PeriodicalIF":0.0,"publicationDate":"2018-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49627124","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 : 2018-08-30DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.04.005
jingwen wang, Changwei Liu, Yu Jin, Gang Wang, Weifeng Lu
Objective To investigate the current status of nutritional support in the children with severe traumatic brain injury(TBI), and the influence of nutritional support on the clinical outcomes. Methods A total of 60 children with severe TBI who were admitted to the surgical intensive care unit(SICU) of our hospital from April 2016 to July 2017 were enrolled in this study. The clinical data like gender, age, height, weight, diagnosis and Glasgow coma scale were collected. The children were divided into two groups by actual energy intake: target energy achieved group and unachieved group. Nutritional support indexes including the start time and the way of nutritional support, interruption of enteral nutritional support, predicted target energy value and actual energy intake, incidence of infectious complications, duration of mechanical ventilation, length of SICU stay, length of total hospital stay, total hospital expenses and prognosis were compared between the two groups. Results Among 60 children recruited, 37 (61.6%) were caused by traffic accident, 16 (26.7%) were caused by falling, 7 (11.7%) by other causes. The average duration of SICU were (13.3±8.0) days. 22 (36.7%) children achieved the target energy, while 38(63.3%) failed, and the percentage of actual energy supply was 126% and 65%, respectively (P=0.000). The average age of the target achieved group was younger than that of the target unachieved group [(3.5±2.8)years vs.(6.2±3.9)years, P=0.006], while the duration of the mechanical ventilation was shorter[(2.7±3.9)days vs.(6.8±11.8)days, P=0.014], and the length of hospital stay was shorter[(16.8±7.7)days vs.(19.5±11.6)days , P=0.038]. The total hospital expenses of the target achieved group were lower than the unachieved group [(5.4±4.1)×104 yuan vs.(7.6±5.9)×104 yuan, P=0.024] Conclusions The actual energy intakes of most severe TBI children are less than their target energy. Sufficient energy supply can shorten the length of SICU and hospital stay, and reduce the total hospital expenses. Key words: Traumatic brain injury; Children; Nutritional support
{"title":"Current status of nutritional support and its relationship with clinical outcomes in children with severe traumatic brain injury","authors":"jingwen wang, Changwei Liu, Yu Jin, Gang Wang, Weifeng Lu","doi":"10.3760/CMA.J.ISSN.1674-635X.2018.04.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2018.04.005","url":null,"abstract":"Objective \u0000To investigate the current status of nutritional support in the children with severe traumatic brain injury(TBI), and the influence of nutritional support on the clinical outcomes. \u0000 \u0000 \u0000Methods \u0000A total of 60 children with severe TBI who were admitted to the surgical intensive care unit(SICU) of our hospital from April 2016 to July 2017 were enrolled in this study. The clinical data like gender, age, height, weight, diagnosis and Glasgow coma scale were collected. The children were divided into two groups by actual energy intake: target energy achieved group and unachieved group. Nutritional support indexes including the start time and the way of nutritional support, interruption of enteral nutritional support, predicted target energy value and actual energy intake, incidence of infectious complications, duration of mechanical ventilation, length of SICU stay, length of total hospital stay, total hospital expenses and prognosis were compared between the two groups. \u0000 \u0000 \u0000Results \u0000Among 60 children recruited, 37 (61.6%) were caused by traffic accident, 16 (26.7%) were caused by falling, 7 (11.7%) by other causes. The average duration of SICU were (13.3±8.0) days. 22 (36.7%) children achieved the target energy, while 38(63.3%) failed, and the percentage of actual energy supply was 126% and 65%, respectively (P=0.000). The average age of the target achieved group was younger than that of the target unachieved group [(3.5±2.8)years vs.(6.2±3.9)years, P=0.006], while the duration of the mechanical ventilation was shorter[(2.7±3.9)days vs.(6.8±11.8)days, P=0.014], and the length of hospital stay was shorter[(16.8±7.7)days vs.(19.5±11.6)days , P=0.038]. The total hospital expenses of the target achieved group were lower than the unachieved group [(5.4±4.1)×104 yuan vs.(7.6±5.9)×104 yuan, P=0.024] \u0000 \u0000 \u0000Conclusions \u0000The actual energy intakes of most severe TBI children are less than their target energy. Sufficient energy supply can shorten the length of SICU and hospital stay, and reduce the total hospital expenses. \u0000 \u0000 \u0000Key words: \u0000Traumatic brain injury; Children; Nutritional support","PeriodicalId":9877,"journal":{"name":"Chinese Journal of Clinical Nutrition","volume":"26 1","pages":"221-227"},"PeriodicalIF":0.0,"publicationDate":"2018-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45340619","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 : 2018-08-30DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.04.008
Hongdi Du, Xiaoxuan Liu, Huo Xiaopeng, Hong Jiang
Objective To investigate the correlation between nutritional status in elderly patients with Alzheimer disease (AD) and self-efficacy of their caregivers. Methods Ninety-two elderly patients with AD and 92 their caregivers were enrolled from a Peking Union Medical College in Beijing from March to October 2017, who were evaluated by the mini nutritional assessment short form (MNA-SF) and the general self-efficacy scale (GSES) respectively for the nutritional status of the AD patients and the self-efficacy of their caregivers, and the correlation between them was analyzed. Results The average MNA-SF score of the AD patients was 7.8±2.5. The incidence of malnutrition risk and malnutrition were 34.8% and 27.2% respectively. The MNA-SF score of the AD patients decreased (F=4.589, P=0.009), and the incidence of malnutrition risk (χ2=7.319, P=0.026) and malnutrition (χ2=7.080, P=0.032) increased significantly with the aggravation of AD. The average self-efficacy score of the caregivers was 2.20±0.45. With the aggravation of AD, the GSES score of the caregivers decreased significantly (F=3.122, P=0.016). There was a positive correlation between the nutritional status of the AD patients and the self-efficacy of their caregivers (r=0.254, P=0.022). Conclusion The nutritional status in elderly patients with AD is positively correlated with the self-efficacy of their caregivers, that is, the higher GSES score of the caregiver is, the better nutritional status of the AD patient has. Key words: Alzheimer disease; Elderly patient; Nutritional status; Caregiver; Self-efficacy
{"title":"Correlation of nutritional status in elderly patients with Alzheimer disease and self-efficacy of their caregivers","authors":"Hongdi Du, Xiaoxuan Liu, Huo Xiaopeng, Hong Jiang","doi":"10.3760/CMA.J.ISSN.1674-635X.2018.04.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2018.04.008","url":null,"abstract":"Objective \u0000To investigate the correlation between nutritional status in elderly patients with Alzheimer disease (AD) and self-efficacy of their caregivers. \u0000 \u0000 \u0000Methods \u0000Ninety-two elderly patients with AD and 92 their caregivers were enrolled from a Peking Union Medical College in Beijing from March to October 2017, who were evaluated by the mini nutritional assessment short form (MNA-SF) and the general self-efficacy scale (GSES) respectively for the nutritional status of the AD patients and the self-efficacy of their caregivers, and the correlation between them was analyzed. \u0000 \u0000 \u0000Results \u0000The average MNA-SF score of the AD patients was 7.8±2.5. The incidence of malnutrition risk and malnutrition were 34.8% and 27.2% respectively. The MNA-SF score of the AD patients decreased (F=4.589, P=0.009), and the incidence of malnutrition risk (χ2=7.319, P=0.026) and malnutrition (χ2=7.080, P=0.032) increased significantly with the aggravation of AD. The average self-efficacy score of the caregivers was 2.20±0.45. With the aggravation of AD, the GSES score of the caregivers decreased significantly (F=3.122, P=0.016). There was a positive correlation between the nutritional status of the AD patients and the self-efficacy of their caregivers (r=0.254, P=0.022). \u0000 \u0000 \u0000Conclusion \u0000The nutritional status in elderly patients with AD is positively correlated with the self-efficacy of their caregivers, that is, the higher GSES score of the caregiver is, the better nutritional status of the AD patient has. \u0000 \u0000 \u0000Key words: \u0000Alzheimer disease; Elderly patient; Nutritional status; Caregiver; Self-efficacy","PeriodicalId":9877,"journal":{"name":"Chinese Journal of Clinical Nutrition","volume":"26 1","pages":"241-244"},"PeriodicalIF":0.0,"publicationDate":"2018-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44556475","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 : 2018-08-30DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.04.009
Shengfang Chen, Chun-li Cui, Haoming Song, Lei Lin
Objective To explore the determinants of serum uric acid (UA) levels and the relationship between UA and cardiovascular disease in elderly patients. Methods A cross-sectional design was used. A total of 1 066 elderly patients were consecutively recruited in the study. Anthropometric measurement and lifestyle survey were performed, and serum UA, lipid profile, glucose, homocysteine (Hcy) and superoxide dismutase (SOD) were measured. The determinants of serum UA levels and correlation between UA and cardiovascular disease were analyzed by regression. Results The prevalence of hyperuricemia was 21.9% (25.9% in men and 18.7% in women). Partial correlation analysis showed the level of serum UA was positively correlated with Hcy (r=0.163, P=0.000), body mass index(r=0.128, P=0.004) and triglyceride(r=0.133, P=0.003), and negatively correlated with HDL-C (r=-0.103, P=0.021). After adjustment for potential confounding factors, multivariate analysis showed eGFR (β=-2.044, t=-10.544, P=0.000), gender (β=42.065, t=4.700, P=0.000), Hcy (β=1.367, t=3.714, P=0.000), BMI (β=3.370, t=2.706, P=0.007), TG (β=14.120, t=2.589, P=0.010) and SOD (β=-0.636, t=-3.079, P=0.002) were independent determinants for UA levels in elderly patients. Logistic regression analysis indicated that mild elevation of UA levels was a risk factor of hypertension (OR=1.925, 95% CI=1.124-3.295) in women and OR=1.780(95% CI=1.010-3.136) in men]. High UA levels increased the risk of coronary heart disease in women [OR=1.710 (95% CI=1.157-2.526)], but decreased the risk of ischemic stroke in men [OR=0.524(95% CI=0.335-0.820)]. Conclusions In elderly patients, serum UA levels were affected by renal function, gender, BMI and serum Hcy, TG and SOD. Mildly elevated UA levels increased the risk of hypertension. High UA levels increased the risk of coronary heart disease in women and decreased the risk of ischemic stroke in men. Key words: Elderly patients; Uric acid; Hypertension; Coronary heart disease; Ischemic stroke
{"title":"Determinants of serum uric acid levels and risk for cardiovascular disease in elderly patients","authors":"Shengfang Chen, Chun-li Cui, Haoming Song, Lei Lin","doi":"10.3760/CMA.J.ISSN.1674-635X.2018.04.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2018.04.009","url":null,"abstract":"Objective \u0000To explore the determinants of serum uric acid (UA) levels and the relationship between UA and cardiovascular disease in elderly patients. \u0000 \u0000 \u0000Methods \u0000A cross-sectional design was used. A total of 1 066 elderly patients were consecutively recruited in the study. Anthropometric measurement and lifestyle survey were performed, and serum UA, lipid profile, glucose, homocysteine (Hcy) and superoxide dismutase (SOD) were measured. The determinants of serum UA levels and correlation between UA and cardiovascular disease were analyzed by regression. \u0000 \u0000 \u0000Results \u0000The prevalence of hyperuricemia was 21.9% (25.9% in men and 18.7% in women). Partial correlation analysis showed the level of serum UA was positively correlated with Hcy (r=0.163, P=0.000), body mass index(r=0.128, P=0.004) and triglyceride(r=0.133, P=0.003), and negatively correlated with HDL-C (r=-0.103, P=0.021). After adjustment for potential confounding factors, multivariate analysis showed eGFR (β=-2.044, t=-10.544, P=0.000), gender (β=42.065, t=4.700, P=0.000), Hcy (β=1.367, t=3.714, P=0.000), BMI (β=3.370, t=2.706, P=0.007), TG (β=14.120, t=2.589, P=0.010) and SOD (β=-0.636, t=-3.079, P=0.002) were independent determinants for UA levels in elderly patients. Logistic regression analysis indicated that mild elevation of UA levels was a risk factor of hypertension (OR=1.925, 95% CI=1.124-3.295) in women and OR=1.780(95% CI=1.010-3.136) in men]. High UA levels increased the risk of coronary heart disease in women [OR=1.710 (95% CI=1.157-2.526)], but decreased the risk of ischemic stroke in men [OR=0.524(95% CI=0.335-0.820)]. \u0000 \u0000 \u0000Conclusions \u0000In elderly patients, serum UA levels were affected by renal function, gender, BMI and serum Hcy, TG and SOD. Mildly elevated UA levels increased the risk of hypertension. High UA levels increased the risk of coronary heart disease in women and decreased the risk of ischemic stroke in men. \u0000 \u0000 \u0000Key words: \u0000Elderly patients; Uric acid; Hypertension; Coronary heart disease; Ischemic stroke","PeriodicalId":9877,"journal":{"name":"Chinese Journal of Clinical Nutrition","volume":"26 1","pages":"245-250"},"PeriodicalIF":0.0,"publicationDate":"2018-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47055008","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 : 2018-08-30DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.04.006
Shiwei Liu, Ruixue Duan, Jiaxin Zhang, Yaru Wu, Xin Li, Shenghui Guo, Meimei Wang, Tao Yuan, Z. Shen
Objective To investigate the effects of vaspin on insulin resistants of 3T3-L1 adipocyte through the insulin receptor substrates (IRS)/phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/glucose transporter (Glut) signaling pathway. Methods 3T3-L1 cells cultured by palmitic acid (PA) were used to establish insulin resistance models, which were divided into PA group, PA+ 100 ng/ml vaspin group, PA+ 200 ng/ml vaspin group, PA+ 400 ng/ml vaspin group and PA+ 400 ng/ml vaspin+ wortmannin (PI3K inhibitor) group. Glucose uptake and consumption were assessed by 2-deoxy H3-D-glucose incorporation and glucose oxidase-peroxidase respectively. IRS/PI3K/Akt/Glut signaling pathway was evaluated using reverse transcription polymerase chain reaction and Western blot analysis. Results Compared with PA group, glucose uptake and consumption increased gradually with the increasing of vaspin concentration in other groups (P<0.05). mRNA levels of IRS-1, Akt and Glut 4 increased gradually as vaspin concentration increasing (P<0.05), and the ratios of p-IRS-1 to IRS-1, p-Akt to Akt and Glut 4 protein level also showed the same trends (P<0.05). However, glucose uptake and consumption in PA+ 400 ng/ml vaspin+ wortmannin group were less than that of PA+ 400 ng/ml vaspin group (P<0.05). PA+ 400 ng/ml vaspin+ wortmannin group showed lower mRNA and protein phosphorylation levels of IRS-1, Akt and Glut 4 (P<0.05), and that the ratios of p-IRS-1 to IRS-1, p-Akt to Akt and Glut 4 protein levels decreased (P<0.05). Conclusions Vaspin can improve the insulin sensitivity of 3T3-L1 adipocyte by activating IRS/PI3K/Akt/Glut signaling pathway. Key words: Vaspin; Insulin resistance; 3T3-L1 adipocyte; IRS/PI3K/Akt/Glut
{"title":"Effect and mechanism of Vaspin on insulin resistance of 3T3-L1 adipocytes induced by palmitic acid","authors":"Shiwei Liu, Ruixue Duan, Jiaxin Zhang, Yaru Wu, Xin Li, Shenghui Guo, Meimei Wang, Tao Yuan, Z. Shen","doi":"10.3760/CMA.J.ISSN.1674-635X.2018.04.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2018.04.006","url":null,"abstract":"Objective \u0000To investigate the effects of vaspin on insulin resistants of 3T3-L1 adipocyte through the insulin receptor substrates (IRS)/phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/glucose transporter (Glut) signaling pathway. \u0000 \u0000 \u0000Methods \u00003T3-L1 cells cultured by palmitic acid (PA) were used to establish insulin resistance models, which were divided into PA group, PA+ 100 ng/ml vaspin group, PA+ 200 ng/ml vaspin group, PA+ 400 ng/ml vaspin group and PA+ 400 ng/ml vaspin+ wortmannin (PI3K inhibitor) group. Glucose uptake and consumption were assessed by 2-deoxy H3-D-glucose incorporation and glucose oxidase-peroxidase respectively. IRS/PI3K/Akt/Glut signaling pathway was evaluated using reverse transcription polymerase chain reaction and Western blot analysis. \u0000 \u0000 \u0000Results \u0000Compared with PA group, glucose uptake and consumption increased gradually with the increasing of vaspin concentration in other groups (P<0.05). mRNA levels of IRS-1, Akt and Glut 4 increased gradually as vaspin concentration increasing (P<0.05), and the ratios of p-IRS-1 to IRS-1, p-Akt to Akt and Glut 4 protein level also showed the same trends (P<0.05). However, glucose uptake and consumption in PA+ 400 ng/ml vaspin+ wortmannin group were less than that of PA+ 400 ng/ml vaspin group (P<0.05). PA+ 400 ng/ml vaspin+ wortmannin group showed lower mRNA and protein phosphorylation levels of IRS-1, Akt and Glut 4 (P<0.05), and that the ratios of p-IRS-1 to IRS-1, p-Akt to Akt and Glut 4 protein levels decreased (P<0.05). \u0000 \u0000 \u0000Conclusions \u0000Vaspin can improve the insulin sensitivity of 3T3-L1 adipocyte by activating IRS/PI3K/Akt/Glut signaling pathway. \u0000 \u0000 \u0000Key words: \u0000Vaspin; Insulin resistance; 3T3-L1 adipocyte; IRS/PI3K/Akt/Glut","PeriodicalId":9877,"journal":{"name":"Chinese Journal of Clinical Nutrition","volume":"26 1","pages":"228-234"},"PeriodicalIF":0.0,"publicationDate":"2018-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41791797","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 : 2018-06-30DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.03.011
Zhenlian Wang, Guangming Wan, Luyi Pan
Objective To analyze prevalence and determinants of medical adhesive-related skin injury (MARSI) in peripherally inserted central catheter implanted patients with lung cancer, to create evidence for improved clinical care. Methods A cross-sectional observational study design was adopted. Skin pictures and electronic medical records of 200 lung cancer patients who visited Shanghai Chest Hospital for PICC between June 2017 and September 2017 were analyzed to calculate prevalence of MARSI and identify related factors. Results The prevalence of MARSI was 31.5% (63/200), and mechanical trauma accounted for 50.8% of all cases (32/63). Age, diabetes and anaphylaxis were significantly related to MARSI. Conclusion Analysis of MARSI in PICC implanted patients with lung cancer provided evidence for improved clinical care of such patients. Key words: Peripherally inserted central catheter; Medical adhesive-related; Skin injury
{"title":"Multivariate analysis of medical adhesive-related skin injury in peripherally inserted central catheter implanted patients with lung cancer","authors":"Zhenlian Wang, Guangming Wan, Luyi Pan","doi":"10.3760/CMA.J.ISSN.1674-635X.2018.03.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2018.03.011","url":null,"abstract":"Objective \u0000To analyze prevalence and determinants of medical adhesive-related skin injury (MARSI) in peripherally inserted central catheter implanted patients with lung cancer, to create evidence for improved clinical care. \u0000 \u0000 \u0000Methods \u0000A cross-sectional observational study design was adopted. Skin pictures and electronic medical records of 200 lung cancer patients who visited Shanghai Chest Hospital for PICC between June 2017 and September 2017 were analyzed to calculate prevalence of MARSI and identify related factors. \u0000 \u0000 \u0000Results \u0000The prevalence of MARSI was 31.5% (63/200), and mechanical trauma accounted for 50.8% of all cases (32/63). Age, diabetes and anaphylaxis were significantly related to MARSI. \u0000 \u0000 \u0000Conclusion \u0000Analysis of MARSI in PICC implanted patients with lung cancer provided evidence for improved clinical care of such patients. \u0000 \u0000 \u0000Key words: \u0000Peripherally inserted central catheter; Medical adhesive-related; Skin injury","PeriodicalId":9877,"journal":{"name":"Chinese Journal of Clinical Nutrition","volume":"26 1","pages":"191-194"},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45170426","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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