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OBJECTIVE@#To develop a novel cognitive screening tool for older adults in China.@*METHODS@#"Game-based Cognitive Assessment-3 Minute Version"(G3) was designed and developed based on WeChat mini-program. And its feasibility was analyzed.@*RESULTS@#G3 mini-program contains three one-minute mini digital games and supports users' self-assessment of cognitive functions with instant access to reports. G3 had a good correlation with Montreal Cognitive Assessment Basic (MoCA-B) with Pearson's r =0.611 (P<0.001). Among natural users aged 50 and older (71 179), the G3 initiation and completion rates were 99.55% and 92.28%, respectively. The average time to complete G3 assessments was (278.5±73.73) seconds.@*CONCLUSIONS@#The novel G3 mini-program has good feasibility and usability for older Chinese adults, and can be used for cognitive screening and home self-assessment.
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Estudios de Factibilidad , Pruebas Neuropsicológicas , Cognición , ChinaRESUMEN
Patients with end-stage liver disease after liver transplantation constantly suffer from malnutrition due to primary diseases and transplantation-related factors. Malnutrition will worsen clinical condition of the patients, increase the incidence of complication, length of hospital stay and medical expense after transplantation, and lower the survival rate. Sufficient nutritional support at all stages of liver transplantation is of significance. Accurate assessment of nutritional status and timely intervention are prerequisites for perioperative nutritional treatment in liver transplantation. In this article, the latest nutritional risk screening indexes and evaluation tools, nutritional support methods and other perioperative nutritional intervention measures for liver transplantation were reviewed, aiming to deepen the understanding and cognition of perioperative nutritional therapy for liver transplantation and provide reference for improving nutritional status and clinical prognosis of liver transplant recipients.
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The inconsistency of diagnostic criteria for malnutrition has confused clinicians since the 1980s. After the implementation of disease diagnosis related group payment (DRG) in China's public hospitals, the diagnosis of malnutrition and the correct documentation of nutrition-related diagnosis on the front sheet of medical records are related to the correct classification of the disease group and the medical insurance payment. Therefore, the reliable diagnostic criteria for malnutrition, especially disease-related malnutrition, is urgently needed in clinical practice. In September 2018, The global leadership Iinitiative on malnutrition (GLIM) diagnostic criteria consensus was launched. GLIM aimed to provide the explicit and unified diagnostic criteria for malnutrition in adult hospitalized patients. However, GLIM criteria was based on the voting by nutritional experts and was merely a consensus in nature. The clinical validity of GLIM criteria needs prospective verification, i.e., to demonstrate that patients with malnutrition as per GLIM criteria could have improved clinical outcomes with reasonable nutritional interventions. In November 2020, the article titled Nutritional support therapy after GLIM criteria may neglect the benefit of reducing infection complications compared with NRS 2002 was published on the journal Nutrition. It was the first study comparing nutritional risk screening 2002 (NRS 2002) and GLIM malnutrition diagnostic criteria among Chinese patients for the indication of nutritional support therapy. The clinical effectiveness of the two tools was retrospectively verified as well. Here we discussed the key points of this retrospective study, including the critical research methods, to inform the currently ongoing prospective validation of the GLIM malnutrition diagnostic criteria (the item of reduced muscle mass not included).
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Reasonable nutrition management is important in the long-term care of cancer survivors. It can contribute to reducing the risk of metabolic complications, improving patients' understanding, beliefs, and behavior as regards healthy lifestyles, promoting lifestyle and dietary changes, and positively impacting disease treatment and long-term prognosis. To improve the long-term management of Chinese cancer survivors, reduce medical costs, and maximize clinical benefits and patient outcomes, the Cancer Nutrition Branch of the Chinese Nutrition Society has developed this consensus based on the current cancer patient management and nutritional therapy in China, evidence-based medicine from domestic and foreign publications, as well as expert opinions and experiences in clinical and nutritional fields. Following the Oxford Centre for Evidence-based Medicine (OCEBM) grading system, this consensus provides recommendations for nutritional risk screening, assessment (diagnosis), enteral and parenteral nutrition support, and medical nutrition therapy for cancer survivors, aiming to inform and support the standardized nutritional management of cancer survivors.
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Objective:To explore the scheme of assigning rational scores to the Modified Pediatric Nutritional Risk Screening Tool for children with cerebral palsy(CP) at different Gross Motor Function Classification System(GMFCS) levels.Methods:The clinical data of 360 children with CP hospitalized in the Department of Children′s Rehabilitation, the Third Affiliated Hospital of Zhengzhou University from January to October 2019 were analyzed retrospectively.All the CP children at different GMFCS levels who met the inclusion criteria were subject to nutrition screening and assessment by using the Modified Pediatric Nutritional Risk Screening Tool and the Subjective Global Nutritional Assessment(SGNA) scale.The distribution of malnutrition rates assessed by the SGNA scale among the children at different GMFCS levels was examined.Data between groups were compared by the χ2 test.Children at different GMFCS levels were divided into different subgroups according to the statistical difference.Then, 0 or 1 score was assigned to the Modified Pediatric Nutritional Risk Screening Tool in different subgroups, and different combinations were formed.The nutritional risk screening results of different combinations were evaluated by using the SGNA scale assessment results as a reference. Results:In children with CP, the risk detection rate and incidence rate of malnutrition were 58.1%(209/360) and 36.9%(133/360), respectively.There was no significant difference in the incidence rate of malnutrition between GMFCS Ⅱ and GMFCS Ⅲ, as well as between GMFCS Ⅳ and GMFCS Ⅴ(all P>0.05). Therefore, children with CP were divided into 3 subgroups, namely, group Ⅰ, group Ⅱ to Ⅲ, and group Ⅳ to Ⅴ.Different CP disease scores were given to the Modified Pediatric Nutritional Risk Screening Tool in 3 subgroups, forming 3 different protocols[protocol 1 (0, 0, 1 point); protocol 2(0, 1, 1 point); current protocol (1, 1, 1 point)]. Taking the SGNA scale assessment results as a reference, the sensitivity of protocol 1, protocol 2 and current protocol were 85.7%, 92.5%, and 93.2% respectively.The specificity protocol 1, protocol 2 and current protocol were 81.1%, 78.0%, and 62.6%, respectively.And the Youden indexes of above three protocols were 0.668, 0.705, and 0.558, respectively.The Youden index of protocol 2 was relatively high. Conclusions:The Modified Pediatric Nutritional Risk Screening Tool can effectively identify the risk of malnutrition in children with CP.The scheme of assigning 0 points to children with GMFCS grade Ⅰ and 1 point to children with GMFCS grade Ⅱ to Ⅴ is more reasonable.
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Objective:To explore the characteristics of the changes in risk score for intensive care unit (ICU) patients during hospitalization by the intelligent calculation method, and to provide evidence for the risk prevention.Methods:In this retrospective study, ICU patients of the Fifth Central Hospital in Tianjin from November 3, 2021 to March 28, 2022 were enrolled and divided into ≥ 14 days group, 10-13 days group, 7-9 days group, and 3-6 days group according to the ICU length of stay. Risk scores assessed by the intelligent calculation method of the ICU patients were collected, including nutritional risk screening 2002 (NRS 2002), Caprini score and Padua score. NRS 2002 score for all patients, Caprini score for surgical patients and Padua score for internal medicine patients were selected. Trends in change of each score were compared between patients admitted to ICU 1, 3, 7 (if necessary), 10 (if necessary), and 14 days (if necessary).Results:A total of 138 patients were involved, including 79 males and 59 females, with an average age of (61.71±18.86) years and an average hospital stay of [6.00 (4.00, 9.25)] days. ① in the group with ICU length of stay ≥ 14 days (21 cases): there was no significant change in the NRS 2002 scores of the patients within 10 days, but the NRS 2002 score was significantly decreased in 14 days as compared with 1 day [3.00 (2.50, 3.50) vs. 4.00 (3.00, 5.00), P < 0.05]; both Caprini and Padua score were increased with prolonged hospital stay and compared with 1 day, the scores at the other time points were significantly increased, especially at 14 days [Caprini score: 5.00 (3.25, 7.00) vs. 2.50 (1.25, 5.50), Padua score: 6.00 (6.00, 7.00) vs. 3.00 (1.00, 3.00), both P < 0.05].② in the group with ICU length of stay from 10-13 days (15 cases): with the prolonged hospital stay, there was no significant change in NRS 2002 score, but both Caprini and Padua score were increased at 3, 7, 10 days, especially at 10 days [Caprini score: 3.00 (2.00, 4.75) vs. 2.00 (0.25, 2.75), Padua score: 5.00 (3.50, 6.00) vs. 2.00 (0.50, 4.00), both P < 0.05].③ in the group with ICU length of stay from 7-9 days (23 cases): compared with 1 day, the NRS 2002 score at 3 days and7 days were decreased, but the Caprini and Padua score were increased, especially at 7 days [NRS 2002 score: 2.00 (1.00, 4.00) vs. 2.00 (2.00, 4.00), Caprini score: 3.00 (2.00, 5.50) vs. 2.00 (0.25, 3.00), Padua score: 5.00 (4.00, 6.00) vs. 2.00 (0, 2.00), all P < 0.05]. ④ in the group with ICU length of stay from 3-6 days (79 cases): compared with 1 day, the NRS 2002 score at 3 days was decreased [NRS 2002 score: 2.00 (1.00, 3.00) vs. 2.00 (1.00, 3.00), P < 0.05], Caprini and Padua score were significantly increased [Caprini score: 3.00 (2.00, 4.00) vs. 2.00 (1.00, 3.00), Padua score: 5.00 (4.00, 5.00) vs. 2.00 (1.00, 3.00), both P < 0.05]. Conclusion:Based on dynamic assessment of intelligent calculation methods, the risk of thrombosis in ICU patients increased with hospital length of stay, and the nutritional risk was generally flat or reducing in different hospitalization periods.
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Objective:To investigate the clinical value of nutritional indexes including body mass index (BMI), albumin (ALB), nutrition risk screening 2002 (NRS 2002) and the nutrition risk in critically ill score (NUTRIC) in 28-day prognosis of patients with sepsis related acute kidney injury (AKI).Methods:A prospective cohort study was conducted. Patients with sepsis treated in the emergency intensive care unit (EICU) of China Rehabilitation Research Center from December 1, 2018 to December 1, 2020 were observed for 7 days. Patients with sepsis related AKI were enrolled in this study. The gender, age, BMI, basic diseases, shock, number of affected organs, length of hospital stay, ALB, mechanical ventilation (MV) and vasoactive drug use, sequential organ failure score (SOFA), rapid sequential organ failure score (qSOFA) and acute physiology and chronic health evaluationⅡ(APACHEⅡ) were recorded. The NRS 2002 score and NUTRIC score were calculated. Cox regression model was used to analyze the risk factors of 28-day mortality in patients with sepsis related AKI. The receiver operator characteristic curves (ROC curves) were drawn and the areas under the ROC curves (AUC) were calculated, and the value of BMI, ALB, NRS 2002 score and NUTRIC score was analyzed to predict 28-day mortality in patients with sepsis related AKI. Kaplan Meier survival curves were used to analyze the effects of NRS 2002 score and NUTRIC score stratification on the 28 day prognosis of patients with sepsis related AKI.Results:A total of 140 patients with sepsis related AKI were enrolled, including 73 survival patients and 67 died patients within 28 days. The 28-day mortality was 47.9% (67/140). BMI in the survival group was significantly higher than that in the death group [kg/m 2: 22.0 (19.5, 25.6) vs. 20.7 (17.3, 23.9), P < 0.05], and NRS 2002 score and NUTRIC score were significantly lower than those in the death group [NRS 2002 score: 5 (4, 6) vs. 7 (6, 7), NUTRIC score: 6 (5, 7) vs. 7 (6, 9), both P < 0.05]. The ALB of the survival group was slightly higher than that of the death group, but the difference was not statistically significant. Cox regression analysis showed that NRS 2002 score and NUTRIC score were independent risk factors for 28-day death in patients with sepsis related AKI. ROC curve analysis showed that NUTRIC score had the strongest predictive ability for 28-day death [AUC = 0.785, 95% confidence interval (95% CI) was 0.708-0.850], followed by NRS 2002 score (AUC = 0.728, 95% CI was 0.647-0.800), but there was no significant difference between them. Compared with NRS 2002 score, the predictive ability of BMI and ALB was poor. Kaplan-Meier curve analysis showed that the prognosis of patients with NRS 2002 score≥5 was significantly worse than that of patients with NRS 2002 score < 5 (28-day cumulative survival rate: 42.1% vs. 75.6%, Log-Rank test: 2 = 11.884, P = 0.001), and the prognosis of patients with NUTRIC score≥6 was significantly worse than that of patients with NUTRIC score < 6 (28-day cumulative survival rate: 40.4% vs. 86.1%, Log-Rank test: 2 = 19.026, P = 0.000). Conclusions:Patients with sepsis related AKI have high nutritional risk. Both NRS 2002 score and NUTRIC score have good predictive value for the prognosis of patients with sepsis related AKI, while BMI and ALB have low predictive value. Due to the complex calculation of NUTRIC score, NRS 2002 score may be more suitable for emergency department.
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Sarcopenia is one of the most common complications of end-stage liver disease (ESLD) and is an independent risk factor for mortality in ESLD patients. Increasing evidence has indicated that nutritional intervention plays an important role in improving the prognosis of ESLD complicated with sarcopenia. Timely identification and early treatment of sarcopenia in ESLD are indispensable for improving patient outcome and quality of life. Accumulating in-depth researches on the pathogenesis and metabolic characteristics of sarcopenia in ESLD patients have provided increasing evidence for the nutritional treatment of sarcopenia in ESLD. Here we reviewed and summarized the research progress regarding the early identification, nutritional risk screening, assessment, and intervention of sarcopenia in ESLD.
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The purpose of value-based healthcare is to effectively control medical costs on the basis of comprehensively improved healthcare quality, which is the key focus of medical system reform in China. Improving information system framework, establishing scientific evaluation methods and transforming medical insurance payment methods are the impetus for value-based healthcare practice in China. "Screening, assessment and intervention" is the critical step in standardized medical nutrition management. In line with the connotation of value-based healthcare, nutritional risk screening aims to improve clinical outcomes. The diagnosis of malnutrition per the Global Leadership Initiative on Malnutrition (GLIM) criteria enables the inclusion into Diagnosis Related Groups (DRGs). Oral nutritional supplement is the preferred medical nutrition treatment for patients at nutritional risk or with malnutrition and insufficient food intake. Standardized application can reduce weight loss, improve clinical outcomes, save medical costs and improve the health and survival of malnourished elderly patients at a lower cost, exemplifying the value-based healthcare model.
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Introducción: La desnutrición intrahospitalaria tiene grandes implicaciones socio-económicas para los países. Sus manifestaciones dependen del grado, tiempo de evolución, déficit ponderal y edad del niño. El objetivo de este estudio es conocer el riesgo nutricional de los pacientes hospitalizados en la Sala de Medicina del Hospital de Especialidades Pediátricas. Métodos: Estudio descriptivo, transversal, pacientes de ambos sexos de 1 mes a 15 años de edad, ingresados a la sala de medicina del Hospital de Especialidades Pediátricas en noviembre de 2014. Se aplicaron dos métodos de tamizaje nutricional, Screening Tool for Assessment of Malnutrition in Paediatrics (STAMP) y Screening Tool for Risk On Nutritionational status and Growth (STRONGKIDS) y se estableció el riesgo nutricional de cada sujeto en estudio. Resultados: 147 pacientes participaron en el estudio. La edad promedio fue de 4,5 años (DE: 4,8), la mayoría eran lactantes (50,3%), con predominio del sexo masculino (56%). Se encontró desnutrición al momento del ingreso en el 12,8% y sobrepeso-obesidad en el 26,6%. STAMP clasificó al 18,3% de la muestra con riesgo nutricional elevado. Dicho método mostró una sensibilidad 57,8% y una especificidad del 87,5%. En cuanto a la prueba de tamizaje STRONGKIDS identificó a un 12,2% con riesgo elevado, con una sensibilidad de 47,3% y especificidad del 92,3%. La concordancia (k) entre STAMP y la evaluación nutricional fue de 0,38 y en el caso de STRONGKIDS fue de 0,41. Conclusiones: Podemos concluir que la prevalencia de desnutrición al momento del ingreso fue del 12,8%. Ambas pruebas de tamizaje nutricional mostraron una buena especificidad (>80%). El riesgo nutricional se correlaciona con las medidas antropométricas principalmente en STRONGKIDS.
Introduction: Malnutrition in hospitalized patients is a prevalent condition and is associated with many adverse outcomes. It depends on the degree, time of evolution, weight deficit and age of the child. There is a direct relationship between nutritional deterioration and longer hospitalization time, causing an increase in the frequency of complications and increased mortality. The objective of this study is to know the nutritional risk of hospitalized patients at Hospital de Especialidades Pediátricas Omar Torrijos Herrera. Methods and materials: Cross-sectional descriptive study with patients evaluated within 48 hours of admission. Patients were aged 1 month or older, both sexes, admitted to the medicine room at Hospital de Especialidades Pediátricas in November 2014. Nutritional risk was assessed by two nutritional screening methods: STAMP and STRONGKIDS. Nutritional status was classified through anthropometrics measurements. The study was approved by the Research Ethics Committee and the signing of the informed consent was required before its inclusion in the study. Results: We evaluated 147 patients aged 4.5 ± 4.8 years, 50.3% were infants and with a predominance of males (56%). The prevalence of malnutrition was 12.8% and for overweight-obesity was 26.6%. STAMP classified 18.3% of patients as high nutritional risk. This method showed a sensitivity of 57.8% and a specificity of 87.5%. Regarding, STRONGKIDS identified 12.2% of patients at high risk, with a sensitivity of 47.3% and specificity of 92.3%. The concordance (k) between STAMP and nutritional evaluation was 0.38 and in the case of STRONGKIDS it was 0.41. Conclusion: The prevalence of malnutrition at the time of admission was 12.8%. STAMP and STRONG KIDS demonstrated high specificity. Nutritional risk is correlated with anthropometric measures mainly in STRONGKIDS. Further studies are required to analyze these tools and nutritional interventions derived from them.
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In the 42 nd and 44 th workshops of CSPEN-nutritional risk-undernutrition-support-outcome-cost effectiveness ratio (NUSOC) multi-center database collaboration group, Jens Kondrup and Henrik Rasmussen described again the application of NRS 2002, the evidence-based basis of NRS 2002 development and the methodology for prospective validation of clinical effectiveness. There is no gold standard for validation. They both considered that malnutrition could be identified as a score of 3 or more for impaired nutritional status in NRS 2002. Although NRS 2002 is simple and easy to be applied, it is not comprehensive enough for malnutrition diagnosis. ASPEN and ESPEN on-line published the Global Leadership (nutritional) Initiative on Malnutrition(GLIM)diagnosis criteria in September 2018. With the gradual implementation of medicare payment based on diagnosis related groups(DRG)in China, the nutritional risk and the malnutrition diagnosis with Chinese version of ICD-10 (2016) code should be recorded in the first page of the medical records. In this terminology interpretations, the terms of nutritional risk screening(NRS 2002.01.016)and malnutrition diagnosis (GLIM-phenotypic criteria 01.028, etiologic criteria 01.029) published in Parenteral and Enteral Nutrition Terminology 2019 are discussed based on the reports given by Kondrup and Rasmussen in Beijing and Zhengzhou.
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@#Objective To analyze the perdictive value of Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) for malnutrition or postoperative complications in children with critical congenital heart disease (CHD). Methods A total of 875 children with critical CHD who were hospitalized in West China Hospital, Sichuan University form August 2019 to February 2021, including 442 males and 433 females with a median age of 30 (12, 48) months, were assessed by STAMP in Health Information System. Clinical data of postoperative complications were collected. Results (1) Based on World Health Organization Z-score as gold standard, 24.5% had malnutrition risk, and 34.3% were diagnosed with malnutrition. According to STAMP, the children were with medium malnutrition risk of 37.9% and high malnutrition risk of 62.1%. There was a statistical difference of incidence rate of malnutrition and detection rate of STAMP malnutrition risk in gender, age, ICU stay or length of mechanical ventilation (P<0.05); (2) with the optimal cut-off point of 5.5 in STAMP for malnutrition, the sensitivity, specificity, positive predictive value, negative predictive value and area under the curve (AUC) were 68.3%, 84.3%, 48.1%, 88.3% and 0.82, respectively; (3) 12.0% of the children were with postoperative complications; (4) with the optimal cut-off point of 5.5 in STAMP for postoperative complications, the sensitivity, specificity, positive predictive value, negative predictive value and AUC were 83.8%, 73.1%, 18.8%, 99.1% and 0.85, respectively. Conclusion Children with critical CHD have a higher incidence of malnutrition risk and postoperative complications. STAMP has a good perdictive value for malnutrition or postoperative complications, however, the sensitivity and specificity of STAMP are affected by the gold standard or the cut-off point.
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Objective To analyze the results of infant nutrition monitoring and assess the malnutrition risk in Xi’an area from 2017 to 2019. Methods A total of 837 infants aged 0-3 years who underwent physical examinations in our hospital in Xi’an area between 2017 and 2019 were enrolled. Parents were surveyed to collect basic information and record the conditions of malnutrition (low body weight, growth retardation, and weight loss) in infants. The relationship between the basic information and the detection rate of malnutrition in different years and different infants was analyzed, and the risk of infant malnutrition was evaluated. Results The malnutrition rate of 837 infants was 9.32% (78/837), the low body weight rate was 2.27% (19/837), the growth retardation rate was 6.70% (56/837), and the emaciation rate was 2.51% (21/837). The growth retardation rate, low weight rate and emaciation rate were all related to the annual income of the family and the education level of the mother and parents. The growth retardation rate and the emaciation rate were also related to the age-the younger the age, the lower the growth retardation rate, and the older the age, the lower the emaciation rate. In addition, the growth retardation rate of boys was higher than that of girls, and the difference was statistically significant (P’an area from 2017 to 2019, which are mainly related to the age, the annual family income, and the maternal education level.
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Although binocular vision problems do not appear to be one of the common complications of refractive surgery, the available evidence suggests that these problems can occur after refractive surgery, and preoperative binocular vision status may predict the risk of postoperative binocular vision anomalies.Furthermore, because ophthalmologists usually do not clearly recognize binocular vision, or they do not pay enough attention to it, the existing literature may underestimate the actual prevalence of binocular vision problems after refractive surgery.This paper discusses the existing literature on refractive surgery-related binocular vision anomalies and recommends a screening protocol and risk stratification.It also discusses the expected results of binocular vision testing, the diagnostic criteria for common binocular vision problems, and strategies for treating these anomalies before and after refractive surgery.
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Although binocular vision problems do not appear to be one of the common complications of refractive surgery,the available evidence suggests that these problems can occur after refractive surgery,and preoperative binocular vision status may predict the risk of postoperative binocular vision anomalies.Furthermore,because ophthalmologists usually do not clearly recognize binocular vision,or they do not pay enough attention to it,the existing literature may underestimate the actual prevalence of binocular vision problems after refractive surgery.This paper discusses the existing literature on refractive surgery-related binocular vision anomalies and recommends a screening protocol and risk stratification.It also discusses the expected results of binocular vision testing,the diagnostic criteria for common binocular vision problems,and strategies for treating these anomalies before and after refractive surgery.
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Humanos , China , Neoplasias Esofágicas , Tiempo de Internación , Desnutrición , Tamizaje Masivo , Complicaciones Posoperatorias , Curva ROC , Sensibilidad y EspecificidadRESUMEN
Objective To investigate the incidence of nutritional risk in infants with lower respiratory tract infection, and to compare the effects of different nutritional risks on clinical outcomes, and to provide evi-dence for clinical nutritional management of infantile lower respiratory tract infection. Methods Infants and young children with lower respiratory tract infection who were hospitalized in our hospital from January 2013 to March 2016 were selected as subjects. Nutritional risk screening was performed using the Nutritional Status and Growth Risk Screening Tool ( STRONGkids) . Results A total of 957 infants with lower respiratory tract infec-tions were included in the study. The incidence of high nutrition risk and low and medium nutritional risk were 17. 6％ and 82. 4％, respectively. The clinical cure rate was 68. 5％ and 71. 4％ respectively. The children with pneumonia and bronchitis had high nutritional risk. The incidence rates were 20. 60％ and 4. 87％, respectively, and the difference was statistically significant (χ2=25. 52, P=0. 000) . Time-effect single factor analysis ( Kaplan-Meier method):The hospitalization time for infants with low nutritional risk and high nutri-tional risk was 9. 3 ( 0. 3) d and 13. 3 ( 1. 0) d, respectively. The difference between the two groups was sta-tistically significant. (χ2=28. 33, P=0. 000) , the total hospitalization expenses were 5653. 5 ( 224. 8) yuan and 10079. 5 ( 1755. 8) yuan respectively. The difference between the two groups was statistically significant (χ2=4. 47, P=0. 034) . Multivariate COX regression analysis:High nutritional risk was a risk factor for hospi-talization of hospitalized infants with lower respiratory tract infection ( RR=1. 57, P=0. 024 ) . Conclusion There is a high incidence of high nutritional risk in infants with lower respiratory tract infection. Compared with children with low and moderate nutritional risk, the hospitalization time is longer, the hospitalization cost is in-creased, and the clinical cure rate is lower, which is the risk of clinical outcome. factor. Therefore, it is neces-sary to conduct nutrition risk screening for infants with lower respiratory tract infections, and provide a theoreti-cal basis for clinical nutrition evaluation and nutritional intervention.
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Objective@#To evaluate preoperative nutritional status and inflammatory status by Nutritional Risk Screening-2002 (NRS-2002) and hematologic inflammatory markers in patients with thoracic esophageal squamous cell carcinoma (ESCC), and to explore their effects on long-term survival prognosis.@*Methods@#A total of 113 patients with thoracic ESCC treated by radical resection were grouped for further analysis according to preoperative NRS-2002 score, systemic inflammation score (SIS) and the combination of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio (CNP) score. The progression free survival (PFS) and overall survival (OS) between groups were compared. Multivariate Cox regression analysis was used to determine the independent prognostic factors of patients with thoracic esophageal squamous cell carcinoma, and the interaction analysis of statistically significant factors was carried out.@*Results@#The median PFS was 21 months for all the patients. The 1-year, 3-year and 5-year PFS rates were 69.0%, 25.7% and 23.1%, respectively. Correspondingly, the median OS was 36 months, and the 1-year, 3-year and 5-year OS rates were 95.6%, 46.2% and 29.2%, respectively. Cox univariate analysis showed that T stage, N stage, TNM stage, SIS, CNP score and NRS-2002 score were significantly associated with PFS and OS (all P<0.05), and sex was associated with PFS (P=0.032) in patients with thoracic ESCC. Furthermore, cox multivariate analysis showed that TNM stage (HR=1.570, P=0.039), NRS-2002 score (HR=2.706, P<0.001) and CNP score (HR=1.463, P=0.011) were independent prognosis factors of PFS in patients with thoracic ESCC. In cox model interaction analysis, there was a positive interaction between NRS-2002 score and CNP score (RR=2.789, P<0.001).@*Conclusion@#Preoperative NRS-2002 score combined with CNP score are risk factors for prognosis of patients with thoracic ESCC, which can be used as prognostic indicators.
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Objective@#To explore the effect of nutritional support based on clinical nursing pathway on nutritional status and quality of life among elderly inpatients with Alzheimer disease (AD).@*Methods@#A total of 101 elderly inpatients with AD who met the criteria of the protocol were consecutively enrolled and randomly divided to study group receiving nutritional support based on clinical nursing pathway for two months (n=51) and control group receiving routine nutritional management for 2 months (n=50). Nutritional risk and quality of life were measured by nutritional risk screening 2002 (NRS 2002) and Quality of Life-Alzheimer's Disease Scale (QOL-AD) respectively before and after nutritional support.@*Results@#Baseline data were comparable between the two groups (all P>0.05). After 2-month nutritional support, compared to the control, the incidence of nutritional risk (36.0% vs 17.6%, P=0.037) and undernutrition (26.0% vs 9.8%, P=0.033) decreased significantly in study group. The score of quality of life in study group were significant higher than that of control group (35.73±5.85 vs 30.76±6.14, P=0.023).@*Conclusion@#The nutritional support based on clinical nursing pathway is helpful to improve the nutritional status and quality of life in elderly hospitalized patients with AD.
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Prenatal screening has undergone from simple age screening, serological prenatal screening, multiple serological screening, to combined screening with cell-free fetal DNA in maternal blood (non-invasive prenatal testing, NIPT). prenatal screening plays an important role in the detection and prevention of birth defects, such as chromosomal abnormalities and open neural tube defects(ONTD). With the emergence of NIPT technology, serological test result in prenatal screening has been outgrowth from the functional surrogate of the development status of fetus and placenta to the predictors of pre-eclampsia and fetal growth retardation(FGR). Therefore, large scale screening program will further improve maternal safety and reduce birth defects.