A preliminary study on the effect of rapid recovery model in older adults with acute clinical conditions / 中华老年医学杂志

Objective:To explore the effectiveness of Acute Care of the Elderly(ACE)model and its existing problems in the clinical practice for older adults with acute clinical conditions.Methods:Using the random number table method, a random number sequence was generated, and the patients admitted to the Department of Geriatrics of Shenzhen Nanshan Hospital due to acute diseases From January 2019 to September 2021 were enrolled in the ACE model intervention group(160 cases)and the control group(77 cases)in a 2: 1 ratio.The inclusion criteria were based on disease severity, frailty assessment, and activity of daily living(ADL)assessment.The intervention time was 1-3 weeks.Outcomes of the patients include ADL, hospitalization days, hospitalization expenses, drug proportion, human resource investments, adverse events, 30-day readmission rate, and 1-year mortality.Results:There were no significant difference in baseline indicators such as frailty index and ADL score between the two groups at admission.The ADL score(Barthel index)of the ACE group was significantly improved compared with the control group at discharge(81.71±14.23 vs.70.9±23.89, P<0.001)and at 30 days after discharge(85.84±15.25 vs.68.29±30.91, P<0.001). The hospital cost[(12 735.81±6 541.41)￥ vs.(16 391.54±12 962.34)￥, P=0.002], drug proportion(21.34% vs.28.93 %, P=0.036)and 30-day readmission rate(13.1% vs.23.4%, P=0.037)of the ACE group were significantly lower compared to the control group.The human resource input(32.97±6.72 vs.25.03±5.31, P=0.008)and patient satisfaction(98.23% vs.90.66%, P=0.031)in the ACE group were significantly higher than those of the control group.(4)The incidence of adverse events during hospitalization was significantly lower in the ACE group than in the control group in terms of aspiration(0.63% vs.20.8%, P<0.001), falls(0 vs.10.4%, P<0.001), incontinence dermatitis(0 vs.3.9%, P=0.033), and 1-year mortality(6.3% vs.24.7%, P<0.001). There was no significant difference in the average length of stay(8.98±4.25 vs.10.03±5.32, P=0.101), pressure sores(13.01±4.77 vs.13.27±4.89, P=0.364), DVT risk score(8.53±2.79 vs.8.89±2.76, P=0.340)and medical staff satisfaction(73% vs.80%, P=0.240)between the two groups. Conclusions:The ACE model helps to reduce the disability rate of elderly patients with frailty, adverse events during hospitalization, save drug costs, and improve patient satisfaction.It is worth promoting in geriatric practice, but its localization management details and processes still face many challenges.

Apoptosis of nasopharyngeal carcinoma cells line CNE-2 induced by dihydroartemisinin and its possible mechanism / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#Dihydroartemisinin is a traditional anti-malarial drug, a derivative of the artemisinin, it has anti-tumor activity of a variety of tumor cells. This study investigated the effect of growth inhibition of nasopharyngeal carcinoma cells line CNE-2 induced by dihydroartemisinin and its possible mechanism.@*METHOD@#The effect of DHA on the cell proliferation of CNE-2 was detected by CCK-8 assay with different concentrations and time. The effects of DHA on the cell apoptosis of CNE-2 were detected by Annexin V-FITC assay through flow cytometry and caspase-3 activity assay.@*RESULT@#CCK-8 experimental results show that CNE-2 cell proliferation was suppressed with DHA treatment, as compared with the control group. DHA could induce marked apoptosis in CNE-2 by apoptosis assay, as compared with the control group, The percentages of apoptotic cells increased along with the increase of DHA concentrations in CNE-2; The activity of caspase-3 was increased following DHA treatment in a dose-dependent manner.@*CONCLUSION@#DHA could effectively inhibit proliferation and induce apoptosis of human nasopharyngeal carcinoma cells line CNE-2, the possible mechanism DHA induce apoptosis of CNE-2 cells by upregulating the expression of caspase-3.

The effect of smoking on resting energy expenditure in patients with early diabetic kidney disease / 中华内科杂志

Objective To study the effect of smoking on resting energy expenditure ( REE ) and the relationships among REE, smoking , inflammation and oxidative stress in patients with diabetic kidney disease. Methods A case control study of 31 smokers and 40 non-smokers with early stage of diabetic kidney disease( stage Ⅲ ) were performed to evaluate the chronic effect of smoking on REE. REE/fat free mass( FFM ), biomarkers of oxidative stress malondialdehyde ( MDA ), superoxide dismutase ( SOD ) and inflammation high-sensitivity C-reactive protein (hs-CRP), adiponectin, TNFα were also measured in these subjects. Data were analyzed by Pearson correlation analysis. Results Compared with non-smokers, REE/FFM in smokers group was significantly increased by 15.96% ( P =0.001 ). Pearson analysis showed that smoking was significantly correlated with REE/FFM ( t = 0.395, P = 0.001 ). There were significantly different between smokers and non-smokers in MDA, SOD and hs-CRP ( P＜0.05 ). But no difference between two groups in adiponectin and TNFα ( P ＞ 0.05 ). No significant relationships between REE/FFM and MDA, SOD, hs-CRP, adiponectin, TNFα was found ( P ＞ 0.05 ). Conclusion Chronic smoking can lead to increased REE, arouse oxidative stress and inflammatory in patients with early stage of diabetic kidney disease. However, there is no relationship between increased REE due to smoking and oxidative stress and inflammatory.

Resting energy expenditure in patients with well controlled type 2 diabetes mellitus / 中华临床营养杂志

Objective To investigate the features of resting energy expenditure (REE) in patients with well controlled type 2 diabetes mellitus (T2DM). Methods Totally 45 T2DM patients with stable blood glucose were enrolled. The general conditions, biochemical indicators, measurements of REE ( MREE), and basal energy expenditure (BEE) calculated with Harris-Benedict formula (HBEE) and Owen formula (OBEE) were recorded and compared. Results MREE had no significant difference with HBEE or OBEE in T2DM patients with stable blood glucose (P ＞ 0. 05). Correlation analysis showed that REE was significantly correlated with gender, age, body weight, body height, body surface area, and fat-free mass ( all P ＜ 0.05 ), but was not correlated with body mass index, fat mass, fasting plasma glucose, postprandial plasma glucose, haemoglobin Alc, total cholesterol, triglyceride, total protein, albumin, and haemoglobin (P ＞ 0. 05 ). Multiple regression analysis showed that fat free mass and age had the closest correlation with REE. Conclusions REE does not increase in T2DM patients with well controlled blood glucose. Factors that influence their REE are similar with healthy individuals. Determi nation of REE can provide useful information for the nutrition treatment of T2DM.