ObjectiveTo investigate the nutritional risk, incidence of malnutrition, and clinical application of nutrition support in hospitalized patients with gastric cancer by the nutritional risk screening (NRS) 2002 score summary table. MethodsFrom June 2009 to February 2010, nutritional risk screen and application of clinical nutritional support were carried out in the hospitalized patients with gastric cancer in this hospital. Nutritional risk was assessed case-by-case according to the severity of illness, nutritional status 〔including body mass index (BMI), recent changes in body weight and eating〕 and patients age. NRS ≥3 was accepted as nutritionally at-risk, while NRS lt;3 no nutritional risk; BMI lt;18.5 kg/m2 (or albumin lt;30 g/L) combined with clinical conditions was judged to be malnourished. Results Three hundreds and eighty-six patients were included, 329 of which completed the NRS2002 screening. One hundred and sixty-five patients (50.15%) were at nutritional risk, while another 164 (49.85%) were no nutritional risk. Malnutrition was found in 57 patients (17.33%). By gender, male malnourished patients and nutritionally at-risk patients were accounting for 16.45% (38/231) and 48.05% (111/231) respectively, while female nutritionally at-risk patients and malnourished patients were accounting for 55.1% (54/98) and 19.39% (19/98) respectively, 72.04% (237/329) of the screened patients accepted clinical nutrition support, among which, 115 patients were at nutritional risk, accounting for 69.70% in that group, and 122 patients were no nutritional risk, accounting for 74.39% in that group. ConclusionsThe incidences of malnutrition and nutritionally at-risk in hospitalized gastric cancer patients are high. And irrationality of clinical nutrition support exists. Evidence-based guidelines are required to improve the nutritional status of support.
Objective To investigate the correlation between MDM2 SNP309 and gastric cancer (GC) risk in Eastern Asian population. Methods Two reviewers independently searched MEDLINE, EMbase and CBM (from January 1st, 1990 to October 23rd, 2012) for case-control studies on the correlation between MDM2 SNP309 and GC risk in Eastern Asian population. Two reviewers independently screen literature, extracted the data, and assessed the methodological quality. Then meta-analysis was performed using RevMan 5.0 software. Results 5 case-control studies were finally included involving 1 621 GC cases and 2 639 controls. The pooled results showed that the variant homozygote (309GG genotype) was significantly associated with an increased risk of GC as compared to wild-type homozygote (309TT genotype: OR=1.54, 95% CI 1.04 to 2.29, P=0.02). Nevertheless, no association was found in comparison of variant heterozygote (309TG genotype) between wild-homozygote (309TT genotype: OR=1.03, 95% CI 0.75 to 1.42, P=0.006). A significantly increased risk of GC was observed for the recessive model (GG vs. TT/TG: OR=1.49, 95% CI 1.20 to 1.84, P=0.07). While in the dominant model (GG/TG vs. TT), non-significant association was observed (OR=1.18, 95% CI 0.84 to 1.65, P=0.001). Conclusion The MDM2 309GG may be significantly associated with an increased risk of GC among Eastern Asians.
A 49-year-old male patient with compartment syndrome of the right leg caused by acute carbon monoxide poisoning was admitted on December 30, 2019. The patient had a 10-year history of chronic nephritis and began dialysis treatment due to renal failure 1 month ago. Emergency surgical decompression for compartment syndrome was performed after admission. Two weeks later, the patient was diagnosed as the novel coronavirus pneumonia caused by 2019 novel coronavirus (2019-nCoV) infection. Then, the patient was transferred to the isolation ward, where he was given anti-infection, anti-virus, expectorant, heat-clearing and detoxifying drugs, bedside dialysis, and nutrition support symptomatic treatment. After 2 weeks of treatment, the patient is getting better, with no fever, cough, wheezing, and other discomfort. Meanwhile, the sensory and motor functions of right lower limb recovered gradually. This case is rare, severe, and difficult to diagnose and treat. It is the first reported case of novel coronavirus pneumonia after orthopedic surgery.
Objective To explore the relationship between obstructive sleep apnea hypopnea syndrome ( OSAHS) and airway hyperresponsiveness ( AHR) . Methods 197 subjects suspected for OSAHS were enrolled in the study. They were all performed overnight polysomnogram ( PSG) monitoring and lung function test. Acoording to the results of FEV1% pred, they were performed bronchial provocation test( BPT)or brochial dilation test( BDT) . The relation between apnea hypopnea index ( AHI) and the degree of airway hyperresponsiveness ( AHR, expressed as PD20 -FEV1 ) was evaluated by linear correlation analysis. Results 117 patients were diagnosed as OSAHS, in which 28 cases were complicated with AHR( 3 cases with positive BDT result, 25 cases with AHR) . In 80 non-OSAHS patients, 7 cases were complicated with AHR. Theincidence of AHR was higher in the OSAHS patients compared with the non-OSAHS patients( 23. 9% vs 8. 8% , P lt; 0. 01 ) . AHI of OSAHS patients with AHR was higher than OSAHS patients without AHR[ ( 30. 3 ±5. 1) /h vs ( 23. 7 ±2. 4) /h, P lt;0. 01] . There was a positive correlation between AHI and degree of AHR in OSAHS patients with AHR( r=0. 62, P lt;0. 05, n=25) . Conclusion OSAHS is associated with an increased risk of AHR.
To study the feasibil ity of human adipose derived stem cells (ADSCs) in monolayer culture induced into smooth muscle cells in vitro as seeding cells in vascular tissue engineering. Methods The mononuclear cells in human adipose were separated by collagenase treatment and seeded on culture dishes with the density of 5 × 105/cm2. Cellswere cultured in M-199 plus 10% FBS. When reaching confluence, the cells were subcultured by 0.1% trypsin and 0.02%EDTA treatment, PDGF-BB (50 ng/mL) and TGF-β1 (5 ng/mL) were added at the passage 1 to enhance the smooth muscle cells’ phenotype. Cells were cultured under the inducing medium for 14 days. The morphology of induced cells was observed under the microscope. Cellular immunofluorescence and RT-PCR were used to determine the expression of smooth muscle cell markers of the post-induced cells. Flow cytometry (FACs) was used to examine the positive rate of induced team. Results Cocultured in M-199 media including TGF-β1 and PDGF-BB, the prol iferating capabil ity of the induced cells was significantly downregulated compared with the uninduced cells(P lt; 0.01). The induced cells exhibited “Hill and Valley” morphology, while the uninduced cells were similar to ADSCs of P0 which had the fibroblast-l ike morphology. The results of immunofluorescence indicated that the induced cells expressed smooth muscle (SM) cell- specific markers including α-smooth muscle actin (α-SMA), SM-myosin heavy chain (SM-MHC) and Calponin. The results of RT-PCR revealed that the induced cells also expressed α-SMA, SM-MHC, Calponin and SM-22α.The positive rates of α-SMA, SM-MHC and Calponin in FACs were 3.26% ± 1.31%, 3.55% ± 1.6% and 4.02% ± 1.81%, respectively, before the cells were induced. However, 14 days after the cell induction, the positive rates were 48.13% ± 8.31%, 45.33% ± 10.68% and 39.13% ± 9.42%, respectively. The positive rates in induced cells were remarkably higher than those in uninduced cells(P lt; 0.01). Conclusion The human ADSCs can be induced to express vascular smooth muscle markers, and they are a new potential source of vascular tissue engineering.
【摘要】 目的 评价以问题为基础式学习与病例讨论式学习在“临床风险筛查”培训教学过程中的应用效果。 方法 2010年6月-2011年7月，联合应用两种教学方法对参训医学生进行培训，然后进行临床资料采集、资料整理等实践活动。最后，对学生培训效果进行总结。 结果 共培训医学生50人，并对398例患者进行营养风险筛查。45人（90%）参与者认为此教学方式能激发自身主动学习兴趣，40人（80%）认为通过此次培训能够使学生逐步建立科学研究的思维方式，但有20人（40%）认为短期内采用两种教学方式能够对论文写作、统计学理论和实践等方面能力的提高有促进作用。影响医学生科研能力培训效果的主要因素集中体现在学习任务量的加重、对新教学方法不适应、自学能力三方面。 结论 联合应用问题为基础式学习与病例讨论式学习教学模式，在提高医学生学习主动性、积极性、团队合作及人际沟通能力等方面有优势，但尚存部分问题需要进一步解决。【Abstract】 Objective To explore the effectiveness of problem-based learning (PBL) and case-based study (CBS) in clinical nutritional risk screening training program. Methods All the students were trained by the combination methods of PBL and CBS. Clinical assessment, data collection and the collection of samples were conducted by the students. Finally, the impact of the new teaching strategy was assessed. Results From June 2010 to July 2011, there were a total of 50 students who attended the training program from various departments, and 398 patients were screened for nutritional risk. Forty-five students (90%) thought that this teaching method could inspire their interest in study; 40 students (80%) thought that this teaching method could help them establish a scientific way of thinking. Students who thought this teaching methodology could contribute to their enhancement of writing and statistical skills accounted for only 40 percent of the total enrollment. “High learning burden”, “difficulty in adapting to the new teaching methods” and “the ability of self-study” were the main factors which affected the motivation of students. Conclusions Combined applications of PBL and CBS have advantages in improving students′ learning initiative and enthusiasm, and developing the abilities of team cooperation and interpersonal communication skills. However, there are still some issues that need to be addressed.
ObjectiveTo investigate the psychology and sleep statuses of liver transplantation recipients during the outbreak of COVID-19.MethodsCluster sampling was used to investigate the patients who underwent liver transplantation in the West China Hospital of Sichuan University from January to February 2020. The psychology and sleep statuses were evaluated by the self-designed questionnaire, State-Trait Anxiety Inventory (SAI), Center for Epidemiological Studies Depression Scale (CES-D), and Pittsburgh sleep quality index (PSQI).ResultsTwenty-seven liver transplantation recipients were included in this study. The questionnaires of the 27 patients were collected. The SAI score was (46.41±8.77); The score of CES-D was (13.11±7.87), there were 2 (7.4%) patients with depression; The PSQI score was (6.44±4.02), there were 7 (25.9%) patients with sleep disorders. The points of anxiety and depression of the patients with different gender, age, education level, marital status, residence, living conditions, primary disease, Child-Pugh classification, whether suffered SARS epidemics, COVID-19 knowledges level, medical insurance, family annual income per capita, and income and expenditure of cash had no significant differences (P>0.05) during the outbreak of COVID-19. However, the points of patients with male or suffered SARS or the family annual income per capita ≥60 000 yuan were higher than those of patients with female or not-suffered SARS or the family annual income per capita <60 000 yuan (P<0.05).ConclusionsAnxiety and sleep disorder of liver transplantation recipients are common during the outbreak of COVID-19, which could not be ignored. Knowledges of COVID-19 should be paid to spread so as to reduce psychological pressure and improve sleep quality.
Objective To evaluate the safety and efficacy of potassium and magnesium supplement with potassium aspartate and magnesium aspartate injection in gastrointestinal surgery patients during absolute fasting．Methods A multicenter randomized controlled clinical trial was conducted in 111 patients after gastrointestinal surgery. For trial group，56 patients were given potassium aspartate and magnesium aspartate injection （Panangin®） in half of the total potassium replenished dose and the rest half of the potassium replenished dose was given in 10% potassium chloride injection．For control group，55 patients were given 10% potassium chloride injection for the total dose of potassium replenished．Such treatments maintained five consecutive days after surgical operation．Clinical observations were performed until patients were discharged from the hospitals．Results Before the intervention，there were no significant differences for the baseline between two groups （P＞0.05）．There was no significant difference for the serum potassium level between two groups （P＞0.05） after intervention．The amount of urinary potassium （mmol/24 h） for patients in the trial group was significantly lower than that in the control group during treatment after operation．The serum magnesium level of control group was much lower than that of control group （P＜0.05）. In the clinical observation process，no drug-related adverse event was observed．Conclusions The supplementary effect of potassium and magnesium for potassium aspartate and magnesium aspartate injection in patients with gastrointestinal surgery during absolute fasting is significant，and superior to potassium chloride injection for potassium supplement．Potassium aspartate and magnesium aspartate injection is a safe and appropriate choice for patients with potassium depletion．
Objective To investigate the feasibility of diagnosis of potential chronic obstructive pulmonary disease (COPD) patients who cannot finish the pulmonary function test via biphasic CT scan. Methods Sixty-seven male individuals aged 43 to 74 (57.0±5.9) years were divided into a COPD group (n=26) and a control group (n=41). All individuals underwent biphasic quantitative CT scan for calculating the proportion of emphysema, functional small airway disease, and normal component of the whole lung and each lobe. Results Based on principle component analysis, two principal components “imaging feature function 1 and imaging feature function 2” were calculated and analyzed by logistic regression, which found that imaging feature function 1 was an independent risk factor of COPD (odds ratio=8.749, P<0.001), and imaging features function 1 could be used to assist the diagnosis of COPD (area under receiver operating characteristic curve=0.843, P<0.001). Conclusion Imaging features function 1 is an independent risk factor for COPD and can assist the diagnosis of COPD.