An 11-site cross-section survey on the prevalence of nutritional risk, malnutrition (undernutrition) and nutrition support among the diagnosis-related group of elderly inpatients younger than 90 years old with coronary heart disease in North and Central China / 中华临床营养杂志

Objective To investigate the prevalence of nutritional risk,undernutrition and nutritional support among elderly inpatients with coronary heart disease in 11 tertiary A hospitals in China.Methods Records of elderly patients under the age of 90 with coronary heart disease were collected between March 2012 and May 2012 from 11 tertiary A hospitals in China following the direction of diagnosis related group of Beijing government.Results A total of 1 279 consecutive cases were recruited with the average age 74 years old (65-89).The total nutritional risk prevalence was 28.14％ (360/1 279).The prevalence of nutritional risk and nutritional risk score ≥ 5 increased with age.The prevalence of nutritional risk (12.88％ vs.30.08％ vs.42.28％) and nutritional risk scored ≥5 (10.86％ vs.18.61％ vs.27.78％)increased with age.Judging from BMI,most patients were overweight or obese (BMI ≥ 24 kg/m2),accounting for 53.0％ of the total,and prevalence of nutritional risk in this subgroup was 15.12％ (96/635).The prevalence of nutritional risk in patients with normal BMI was 34.24％.The prevalence of undernutrition defined as BMI＜ 18.5 kg/m2 was 4.25％ (51/1 279),among which patients with score ≥ 5 account for 64.7％ (33/51).The prevalence of undernutrition defined as nutritional impairment score =3 was 7.58％ (97/1 279).In patients with nutritional risk,57 were administrated nutrition support (16.6％);in patients without nutritional risk,21 received nutrition support,mostly parenteral nutrition (16 cases,76.2％).In patients with nutritional risk [(79.46± 7.19) years vs.(76.40± 6.16) years],there were statistically significant difference between those who received nutrition support and those who did not in terms of age and the ratio of patients with nutritional risk scored≥5 (35.1％ vs.17.1％) (P =0.001,P=0.002).Conclusions The prevalence of nutritional risk in patients with coronary heart disease was high.The prevalence of undernutrition was low.Prevalence of overweight and obese was high,but there was still nutritional risk in this group of patients.The patients who received nutrition support were older and had high nutritional impairment score,but the indication is not rationale.

Expression and significance of pepsin in lingual tonsil hypertrophy / 中华耳鼻咽喉头颈外科杂志

Objective@#To discuss the relationship between lingual tonsil hypertrophy and laryngopharyngeal reflux.@*Methods@#Ninety-two patients who received throat surgery in Nanfang Hospital between October 2015 and October 2016 were enrolled. Twenty-six healthy volunteers were recruited as normal controls. All participants were assessed with the reflux finding score(RFS) and the size of lingual tonsils were evaluated using a clinical grading system proposed by Friedman under electronic laryngoscope. The score of reflux symptom index(RSI), personal history and medical history were gathered. Biopsy specimens of lingual tonsils were taken from all participants for the immunohistochemical stain of pepsin.SPSS 19.0 software was used for statistical analysis.@*Results@#There were 46.2% (12/26) pepsin-positive and 53.8% (14/26) pepsin-negative volunteers in normal controls. There were 87.0% (80/92) pepsin-positive and 13.0% (12/92) pepsin-negative patients in study group. The severity of lingual tonsil hypertrophy and expression intensity of pepsin in patients were significantly higher in volunteers (Z=-3.636, Z=-5.273, P<0.01). The severity of lingual tonsil hypertrophy was positively associated with the pepsin level in patients (r=0.556, P<0.01). The patients with pepsin-positive expression showed significant correlation between lingual tonsil hypertrophy and the positive rate of RSI and RFS (r=0.258, r=0.225, P<0.05). Analysis of correlated factors indicated that lingual tonsil hypertrophy was associated with smoking (χ2=8.502, P<0.05).@*Conclusions@#The expression of pepsin can be detected in lingual tonsil tissues. The lingual tonsil hypertrophy is closely related to laryngopharyngeal reflux.

A preliminary study on the assessment of swallowing function after supracricoid partial laryngectomy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate a reliable and easy assessment method for swallowing function by evaluating objectively the recovery process of swallowing function in patients six months after supracricoid partial laryngectomy.</p><p><b>METHODS</b>The swallowing function of patients who underwent supracricoid partial laryngectomy was evaluated six months after operation in Nanfang Hospital of Southern Medical University between January 2013 and February 2014 with two methods, the modified barium swallow (MBS) and fiberoptic endoscopic evaluation of swallowing (FEES), combined with modified penetration aspiration scale (MPAS). Furthermore, the feasibility, reliability and accuracy of these two methods were compared.</p><p><b>RESULTS</b>Eleven patients were enrolled. MPAS equals score 1 for solid food, semiliquid food, and liquid food was defined as a criteria of normal swallowing function. By MBS evaluation, the numbers of patients with normal swallowing function were two cases at day 16-30 postoperation, two cases at day 31-45 postoperation, five cases at day 46-90 postoperation, and six cases at day 91-180 postoperation, respectively. By FEES evaluation, the above numbers were three cases, four cases, six cases and eight cases, respectively. When the aspiration was minimal and ejected completely and MPAS was less than or equal to score 4 for solid food, semiliquid food, and liquid food, the gastric tube could be removed. According to this standard, the gastric tube was removed in all cases, and the mean time was (21.7 ± 9.8) days. A good correlation was obtained between these two methods when evaluating solid and semiliquid food, and the Kappa values were 0.802 and 0.844, respectively. However, a little agreement was obtained between these two methods when evaluating liquid food, and the Kappa value was 0.529.</p><p><b>CONCLUSIONS</b>Patients who underwent supracricoid partial laryngectomy could restore good swallowing function in six months after the operation. Both the MBS and FEES are valuable procedures for evaluating objectively the swallowing function in patients after supracricoid partial laryngectomy. The FEES is much better than MBS, because FEES is a simple operation performed alone by otolaryngologists with no radiation.</p>

Multiple factors quantitative analysis on middle ear function in primarily diagnosed patients with nasopharyngeal carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the ways of quantitative and objective evaluation for analyzing the multiple influence factors on middle ear function in the patients with primarily diagnosed NPC, and to analyze the influence factors of middle ear function in the patients with primarily diagnosed nasopharyngeal carcinoma (NPC).@*METHOD@#Three hundred and twenty cases (320 ears) of primarily diagnosed NPC patients were examinated with electric otoscope, acoustic immittance measurement, pure tone audiometry, nasopharynx and middle ear CT or MRI scanning, eustachian tube function examination, and electronic nasopharyngoscope. A series of quantitative methods, as the influence factors including T stage, clinical stage, location, diffusion type and form of tumor, eustachian tube function, pharynx mouth shape, imaging extension (nasal, skull base, pharyngeal recess, parapharyngeal space, tensor veli palatini muscle, levator veli palatini and so on), were used to evaluate the middle ear function. SPSS 13.0 was used to anlyze the single and multiple factors in statistics.@*RESULT@#T stage, clinical stage, location, diffusion type, and form of tumor, pharynx mouth shape, imaging extension (nasal, skull base, pharyngeal recess, parapharyngeal space, tensor veli palatini muscle, levator veli palatini) were the single influence factors on the function of middle ear in primarily diagnosed NPC patients. The gender, age, pathological types, N staging and M staging of NPC patients primarily diagnosed had no effect on middle ear function. The multple factors analysis showed that T stage, tumor location, the function of eustachian tube, tensor veli palatini muscle invasion, and skull base invasion were independent factor of affecting the middle ear function on primarily diagnosed NPC patients.@*CONCLUSION@#In this study, the influence factors of middle ear function with primarily diagnosed NPC were related to T stage, location of tumor, the function of eustachian tube, tensor veli palatini muscle invasion, skull base invasion, otitis media and quantitative criteria. The way of quantitative analysis could be used to evaluate objectively the middle ear function in patients with primarily diagnosed NPC.

Function of three-dimensional reconstruction of CT scan to the operation of eagle syndrome / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the guiding function of three-dimensional CT scan in the operation of eagle syndrome.@*METHOD@#There were 48 cases of eagle syndrome hospitalized during July 2006 to June 2010 who underwent both three-dimensional reconstruction of CT scan and adem position and lateral X ray film. The images were measured by specialist of radiology department.@*RESULT@#The detail of styloid process is showed more precisely by three-dimensional CT scan, which is able to determine the existence of interrupt, decline, ossification in styloid process. There was significant difference in the measured value (20.83%) between X ray and CT scan (4.16 ± 1.27)cm vs (3.11 ± 0.62)cm, P < 0.05, in 10 cases. We could not touch styloid process in oral approach in 6 cases (12. 5%), which also had diagnostic confliction between X ray and three-dimensional CT scan. Five patients whose styloid process could not be touched during surgery had longer operation time than the other 41 patients.@*CONCLUSION@#Three-dimensional CT has good repeatability, high detailed distinguishability, which is an important basis to diagnose eagle syndrome. When X ray shows prolonged styloid process which can not be palpable in oral, we suggest further three-dimensional CT to avoid unnecessary surgery.

Analysis of correlation between oxidized low density lipoprotein and thrombus precursor protein with acute cerebral infarction / 重庆医学

Objective Dynamic observation of oxidized low density lipoprotein(Ox-LDL) and thrombus precursor protein(TpP) expressed in patients with acute cerebral infarction ,and explore its clinical significance .Methods To detect the Ox-LDL and the plasma TpP level of 44 patients with acute cerebral infarction (ACI)respectively in acute stage and recovery stage ,and the healthy 30 cases (control group)by using enzyme-linked immunosorbent assay (ELISA) method ,and all the ACI cases were scored by the national institutes of health stroke scale (NIHSS) .To analyze the expression of Ox-LDL and plasma TpP in patients with ACI ,and the relationship with the NIHSS score .Results Ox-LDL and plasma TpP in patients with ACI all increased compared with the con-trol group .Ox-LDL and TpP in acute stage were significantly higher than the corresponding recovery stage and the control group , the difference was statistically significant (P0 .05) .The levels of Ox-LDL were positively correla-ted with TpP in ACI group (r=0 .521 ,P<0 .05) .Conclusion The expression of Ox-LDL and plasma TpP in ACI were increased , Ox-LDL and plasma TpP level in ACI varies with changes of clinical course ,and maybe involved in the coordination and the devel-opment process of ACI ;Plasma TpP may be relevant to the seriousness of cerebral infarction ,and may be arguably used as the measurement of ACI patient′s conditions as well as the prognosis estimation .

The relationship between sleep quality and glucose level, diabetic complications in elderly type 2 diabetes mellitus / 中华内科杂志

ObjectiveTo explore the relationship between sleep quality and glucose level,diabetic complications in elderly type 2 diabetes mellitus.Methods A total of 130 hospitalized elderly type 2 diabetes in our hospital were included in the study. Questionnaires and other related clinical data were collected within one week after admission.Patients were divided into two groups:poor-sleeper group and good-sleeper group according to Pittsburgh Sleep Quality Index(PSQI).ResultsSixty percent (78/130) of these patients were poor sleepers. The following parameters differed in the two groups:the duration of diabetes [ (7.9 ± 1.8 ) years vs ( 7.2 ± 1.5 ) years,t =2.318 ],systolic blood pressure [ ( 148 ± 30 ) mm Hg ( 1 mm Hg =0.133 kPa) vs ( 138 ± 23 ) mm Hg,t =2.037 ],fasting plasma glucose (FPG) [ ( 10.7 ± 2.2) mmol/Lvs ( 9.8±1.9)mmol/L,t =2.410],hemoglobin A1c (HbA1c) [(8.6 ±2.2)％ vs (7.8±2.1 ) ％,t =2.068],high-sensitive C-reactive protein (hs-CRP) [ (5.27 ± 2.34) mg/L vs (4.44 ± 1.76)mg/L,t =2.179 ],ratio of diabetic complications ( 61％ vs 32％,x2 ＝ 4.257 ),percentage of depression ( 20％ vs 8％,x2 =3.722 ),score of life quality [ ( 98 ± 19 ) scores vs ( 89 ± 13 ) scores,t ＝ 2.980 ],and proportion of patients treated with insulin (32％ vs 12％,x2 =4.489). All the above parameters were significantly higher in poor-sleeper group than the good-sleeper group (all P value＜ 0.05 ). Multiple correlation analysis showed that the factors affecting sleep quality were FPG,HbA1c,duration of diabetes,diabetic complications,depression,life quality and insulin application (r =0.213,0.257,0.223,0.335,0.422,0.3451,0.231,respectively ; all P value ＜ 0.05 ).By multivariate logistic regression analysis,the followings were found:FPG (β =1.29,P ＜ 0.05 ) and PSQI (β =1.07,P ＜ 0.05 ) were found to be correlated with HbA1c.With increasing of PSQI,FPG,HbA1c,diabetic complications and life quality were changed significantly( all P value ＜ 0.05 ).The indcpcndcnt risk factors of diabetic complications were duration of diabetes ( OR ＝ 1.32,95％ CI 1.01-2.01 ),HbA1c ( OR =2.01,95％ CI 1.63-2.67 ),hs-CRP( OR =1.12,95％ CI 1.08-1.21 ) and PSQI ( OR =1.71,95％ CI 1.58-2.02).ConclusionsElderly type 2 diabetes mellitus are usually poor sleepers. Sleep quality probably affects blood glucoseregulation, and is closely correlated with the occurrence of complications.In addition,poor sleep quality results in poor life quality.

Clinical analysis of primary central nervous system histiocytic sarcoma: one case report / 中华神经科杂志

Objective To provide insight into the clinical manifestation,histopathology characteristics,diagnostic and therapeutic methods of primary histiocytic sarcoma (HS) of central nervous system.Methods The clinical,auxiliary examination and pathological data of one patient with intracranial primary histiocytic sarcoma were presented,and relevant literature were reviewed.Results A 55-year-old female had an 2-month history of hypomnesia and unsteady gait.MRI scans showed multiple mass lesions in brain.Biopsies of the brain lesion showed the tumor cells had polymorphism,and abundant cytoplasm was eosinophilic or clear,with large,pleomorphic nuclei.Immunohistochemically,the tumor cells stained positively with CD45,CD68,CD163,Ki67 and Vimentin,but negatively with pan-cytokeratin,epithelial membrane antigen,CD3,CD20,CD79 a,estrogen receptor,progesterone receptor,Melan-A and glial fibrillary acidic protein.Though she had received radiotherapy,the disease progressed and her consciousness deteriorated within 2 months.Conclusions HS should be considered if multiple or single intracranial unexplained lumps are found and the earliest pathological biopsy is required for early diagnosis.There are no effective therapeutic methods for HS and the prognosis is very poor.

Progress in co-culture and differentiation in adipose-derived stem cells: a review / 生物工程学报

Stem cells can be differentiated into many kinds of somatic cells under defined culture conditions. In addition, the homing possess can be partially imitated by co-culture of stem cells with mature somatic cells. Regarding the importance of clinical application of adipose-derived stem cells (ADSCs), our review first introduced the sources and signs of ADSCs, and then the current knowledge of ADSCs co-culture technology, including drug and chemical induced culture, two-dimensional (2D) and three-dimensional (3D) co-culture, mechanisms of ADSCs differentiation, and application development in recent years in details. Finally, we also addressed prospects of ADSCs.

Predictive value of cholinesterase in the prognosis of gerontal patients with systemic inflammatory response syndrome / 中华急诊医学杂志

Objective To explore the predictive value of cholinesterase (ChE) in the prognosis of gerontal patients with systemic inflammatory response syndrome. Methods The clinical data of 124 elderly patients with systemic inflammatory response syndrome collected from September 2009 through September 2010 were retrospectively analyzed. All patients were divided into death group and survival group according to the outcome of patients. The cholinesterase ( ChE), albumin, D-Dime, lactic acid and C-reactive protein (CRP) were detected, and the APACHE Ⅱ and GCS scores were documented in the first 24 hours in the ICU. Results There were no significant differences in age, gender, APACHE Ⅱ score and GCS score of patients between death group and survival group ( all P ＞ 0. 05 ), but there were significant differences in lactic acid, D-Dime, albumin, CRP and ChE between two groups ( theP values were 0.011,0.011, 0. 007,0. 008, 0. 000, respectively) . The results of multiple factors regression analysis showed that age, gender,lactic acid, D-Dime, albumin, CRP, APACHE Ⅱ score, and GCS score were not the independent risk factors of prognosis of gerontal patients with SIRS ( the P = 0. 401, 0. 165, 0. 446, 0. 841,0. 615, 0. 120,0. 502, 0. 184, respectively) except ChE ( P = 0. 000) . The receiver operating characteristic curve (ROC) of ChE in the gerontal patients with SIRS showed the area under curve (AUC) = 0.797, SE =0.04, P=0. 000, and the ChE = 103.00 U/L could be a diagnosis point with sensitivity = 0.793, 1-specificity = 0. 258. The correlation analysis showed that the APACHE Ⅱ score, CRP, and albumin were poorly correlated with ChE ( Kendall coefficients were 0. 061, 0. 231, and -0. 090, and theP = 0. 161,0. 000, and 0. 069, respectively ) . Conclusions ChE maybe played a important role in the gerontal patients with SIRS, and could be a predictive index for the prognosis of gerontal patients with systemic inflammatory response syndrome.

Feasibility of modified Epworth sleepiness scale in assessment of obstructive sleep apnea hypopnea syndrome / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the significance of Epworth sleepiness scale(ESS)and modified Epworth sleepiness scale(MESS),and evaluate the feasibility of MESS in assessment of obstructive sleep apnea hypopnea syndrome(OSAHS).METHODS The ESS and MESS of 232 patients with OSAHS was recorded in their first visiting.The scores of ESS and MESS were analyzed with the parameters of polysomnography(PSG). RESULTS Both ESS and MESS can reflect the degree of sleepiness and anoxemia in OSAHS patients,but the MESS was more efficient than ESS.The difference of MESS score between normal group and severe OSAHS group was greater than that of ESS score.CONCLUSION MESS is concerned the living habit of Chinese,and can partly reflect the station of patient with OSAHS.MESS can also be a primary screening method for suspected patients with severe OSAHS.

Vascular Endothelial Growth Factor and Atherosclerosis / 国际脑血管病杂志

Vascular endothelial growth factor (VEGF) has drawn extensive attention from all over the world because of its promising therapeutic prospect. However, recent studies have found that VEGF may promote the occurrence and development of atherosclerosis. The article reviews the molecule characteristics, receptor, expression regulation and function of VEGF, as well as its relationship with atherosclerosis.

Clinical study of wind-warm and pulmonary heat syndrome treated with integrated traditional Chinese and Western medicine / 中西医结合学报

OBJECTIVE: To investigate the clinical effectiveness of Toubiao Qingfei (expelling exterior evil and clearing lung) Decoction (TBQFD) on wind-warm and pulmonary heat syndrome. METHODS: Forty-six subjects were randomized into treatment group and control group. Patients in the control group were treated with Western medicines, while patients in the treatment group were treated with Western medicines and TBQFD. The therapeutic effects and improvement of symptoms in both groups were observed. RESULTS: The durations of fever, cough and absorption of pulmonary inflammatory focus in the treatment group were 1.52, 3.52 and 6.25 days respectively, which were significantly shorter than those in the control group (P<0.05). CONCLUSION: TBQFD can improve the symptoms, such as fever and cough, and can promote the absorption of infection and shorten the clinical course of wind-warm and pulmonary heat syndrome.

Changes of matrix metalloproteinase-3 and urokinase-type plasminogen activator receptor in type 2 diabetes mellitus with macroangiopathy / 中国病理生理杂志

AIM: To investigate the function of matrix metalloproteinase-3 (MMP-3) and urokinase-type plasminogen activator receptor (uPAR) to macroangiopathy in type 2 diabetes mellitus. METHODS: The levels of MMP-3 and uPAR in plasma were determined by ELISA sandwich method in 26 healthy controls and 39 patients with type 2 diabetes mellitus including 15 complication-free cases and 24 with macroangiopathy. RESULTS: The plasma level of uPAR but not MMP-3 was higher in patients without macroangiopathy than that in normal controls (P