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Objective:The study was planned to evaluate the clinical utility of microcytic anemia factor (MAF) and low hemoglobin density (LHD%) in the screening of iron deficiency in blood donors.Methods:A total of 400 blood donors, 200 male and 200 female, were randomly admitted to Fujian Blood Center from January1, 2022 to February 28, 2022 by the way of stratified sampling. According to the fourth edition of Diagnostic and therapeutic criteria for hematological diseases, the patients were divided into three groups: normal group (N=299), iron depletion group (ID, n=54) and iron deficient erythropoiesis group (IDE, n=47), Blood routine indexes including hemoglobin (HGB), mean corpuscular volume hemoglobin (MCV), mean corpuscular hemoglobin content (MCH), mean corpuscular hemoglobin concentration (MCHC) and iron metabolism indexes including serum ferritin (SF), serum iron (SI), total iron binding capacity (TIBC), transferrin saturation (TS) and unsaturated iron binding capacity (UIBC) were measured, MAF and LHD% were calculated by formula.One-way ANOVA or Kruskal-Wallis H tests were used to analyze the differences among three groups. Spearman correlation analysis was used to analyze the correlation between MAF and LHD% and iron metabolism indexes.The Receiver Operating Characteristic (ROC) curve was used to evaluated the diagnostic value of MCH, MCHC, MAF and LHD% for iron deficiency in blood donors. Results:MAF in ID group which was 11.81±0.81 were higher than the IDE group which was 10.69±0.95 and lower than the healthy group which was 13.17±1.24, the total difference among the three groups was statistically significant ( F=110.784, P<0.001), the difference between two groups was statistically significant ( P<0.01); LHD% in ID group which was 2.61 (1.87, 3.91)% were lower than the IDE group which was5.60(2.99, 8.02)% and higher than the healthy group which was1.74 (1.22, 2.73)%, the total difference among the three groups was statistically significant ( H=62.166, P<0.001), the difference between two groups was statistically significant ( P<0.01).In 101 iron deficiency blood donors, Spearman correlation analysis showed that MAF was positively correlated with SF, SI and TS ( r=0.426, P<0.01; r=0.547, P<0.01; r=0.566, P<0.01);contrarily, LHD% was negatively correlated with SF, SI and TS ( r=-0.397, P<0.01; r=-0.400, P<0.01; r=-0.479, P<0.01).The areas under the ROC curve of MCH, MCHC, MAF and LHD% diagnostic ID were 0.745, 0.646, 0.819 and 0.646, respectively;the cut-off value of MAF was 12.56, with a sensitivity of 67.90% and a specificity of 83.30%.While the areas under the ROC curve of MCH, MCHC, MAF and LHD% diagnostic IDE were 0.901, 0.834, 0.941 and 0.834, respectively; the cut-off value of MAF was 11.73, with a sensitivity of 87.60% and a specificity of 87.20%. Conclusions:MAF performed a high diagnostic value of iron deficiency, especially IDE, and can be used as a marker in the diagnosis of iron deficiency in blood donors.
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Objective To compare the effectiveness of enteral nutritional emulsion (TPF-D) and enteral nutritional emulsion (TP) in patients with chronic wound and diabetes (CWD). Methods Totally 20 CWD patients in Beijing Jishuitan Hospital from June 2008 to June 2010 were enrolled in this study. Enteral nutritional emulsion (TP) was used for the first 5 days ( TP group) and enteral nutritional emulsion (TPF-D) was used for the second 5 days (TPF-D group). Changes of mean amplitude of glycemic excursions (MAGE), insulin dosage, and prealbumin (PA) were compared between TPF-D group and TP group. The adverse effects and post-operational complications were also observed. Results The every-day MAGE was (2. 56 ±0. 35) mmol/L in TPF-D group, which was significantly lower than that in TP group [ (3.23 ± 0. 42) mmol/L] ( P = 0. 01 ). The mean insulin dosage was (9.6 ± 1.7) U in TPF-D group, which was significantly lower than that in TP group [ ( 12. 2 ± 2. 5 ) U ] ( P =0.03 ). The increase of PA showed no significant difference between TPF-D group [ ( 12.7 ± 3. 3) mg/L] and TP group [ ( 13.4 ± 2. 8 ) mg/L ] ( P = 0. 08 ). No enteral nutrition-related adverse effect or post-operation complication was noted. Conclusion Compared with TP, TPF-D is more suitable for the CWD patients.
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In order to study and appraise the application of artificial dermis in repairing skin defect or organization damage, 20 patients underwent artificial dermis transplantation at the Department of Burn and Plastic Surgery, Beijing Jishuitan Hospital from January 2008 to April 2009 were collected. Patients with skin damage or depth portion organization (tendon, joint and bone appears externally) was perform debridement and artificial dermis transplantation, followed by split thickness autoskin transplantation. The survival of artificial dermis and split thickness autoskin was observed. After transplantation, the depth portion organization of patients were covered efficiently, all grafts survived without obvious scar proliferation. The results demonstrated that the prompt application of artificial dermis can reduce the surgery risk, relieve the surgery to damage, and reduce the scar production in repairing organization damage or depth portion organization expose.
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Objective To study the mechanism of glutamine dipeptide on wound healing after operations on bums. Methods Totally, 30 burned patients were randomly divided into study group and control group (15 cases in each group). All patients received parental nutrition support after operation. Study group patients were supplemented with glutamine dipeptide at a dose of 0. 5 g ·kg-1· d-1. The plasma free hydroxyproline level was measured by a standard amino acid analyzer 1 day before operation and 7 days after operation and the wound healing time was recor- ded. Results The plasma free hydroxyproline levels of both groups were higher than the normal values before opera- tion but without significant difference [control group: (2. 24±0. 84) μg/ml, study group: (2. 32±0.92) jig/ml, normal value: (1.27±0.44) μg/ml]. On the post-operative 7 day, the plasma free hydroxyproline level of study group [ (4. 31±1. 05) ng/ml] was significantly higher than that of control group [ (3. 04±1. 01) μg/ml] (P = 0.002). The wound healing time of study group [ (29. 7±5.3) d] was shorter than that of control group but with- out significant difference [ (33. 3±7.5) d, P = 0. 14 ]. Conclusion The intravenous supplementation of glutamine dipeptide may increase the plasma hydroxyproline level after operation and thus promote wound healing.
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Objective To explore the nutrition risk,undemutrition rates,and nutrirlon support in the hos-pitalized patients with respiratory disorders.Methods Totally 100 hospitalized patients in department of respirato-ry medicine of our hospital from October to December 2008 were enrolled in this study.The nutrition risks were screened on the next day after admission and then two weeks later using Nutrition Risk Screening(NRS2002).Body mass index(BMI)lower than 18.5 ks/m2,serum albumin(sALB)lower than 35 g/L,or pre-ALB was lower than 20 g/L Wag regarded as undemutrition.Results Among all these 100 patients evaluated by NRS2002,59 patients were judged at the risk of malnutrition and 54 patients developed undemutrition two weekB later The nutrition risk and undernutuition rate among non-ambulatory patients were 87.7%and 82.9%,which were signifi-cantly higher than in ambulatory patients(32.2%and 30.5%)(P<0.001).The nutrition risk and undernutu-ition rate were also significantly higher in patients who stayed in the hospital for more than 2 weeks than those for less than 2 weeks(75.0% vs 9.4%and 66.2% vs 21.9%,respectively)(P<0.001).Twenty-two patients received nutritional support.The ratio of parenteral nutrition and enteral nutrition wag 1.2:1.Conclusions NRS2002 can be used in the nutrition assessment in hospitalized patients with respiratory disorders.Non-ambulato-ry and a hospital stay of more than 2 weeks increase the nutritional risk and undemutrition rate.Only a small per-centage of patients receive nutritional support.
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<p><b>OBJECTIVE</b>To explore the influence of glutamine dipeptide on the plasma endotoxin levels in severely burned patients.</p><p><b>METHODS</b>Thirty burned patients with TBSA of 30 - 70% and III degree burn area more than 20% were randomly divided into control (C) and study (S) groups. Glutamine dipeptide powder in dose of 0.5 g/kg/day was given orally in bolus to those patients in S group during 1 - 12 postburn days (PBDs). The plasma levels of glutamine were determined during 1 - 12 PBDs. Simultaneously, the plasma endotoxin level was detected on 1, 3, 6 and 12 PBDs. The wound healing rate at 30 PBD and total hospital stay days were recorded.</p><p><b>RESULTS</b>The plasma glutamine levels at 1 PBD in C and S groups were obviously lower than normal level (659.5 +/- 35 micromol/L), but there was no difference between these two groups (P > 0.05). The plasma glutamine levels in C group was much lower than that in S group at 12 PBD (P < 0.05). The plasma endotoxin concentration on 1 PBD in these two groups increased evidently compared with the normal value (P < 0.05), and there was no difference between the two groups (P > 0.05). The plasma endotoxin level in S group was much lower than that in C group on 3 PBD (P < 0.05). As for the wound healing rate at 30 PBD, it was markedly higher in S group than that in C group (91% vs 85%). On the other hand, the hospital stay days in S group were evidently lower than that in C group (52 vs 67).</p><p><b>CONCLUSION</b>Oral intake of glutamine dipeptide in burn patients could be beneficial to the maintenance of the plasma concentration of glutamine and in decreasing plasma endotoxin level. It would also enhance the wound healing rate at 30 PBD and shorten the hospital stay days.</p>