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Objective:To evaluate nutritional status and to analyse risk factors of acute exacerbation of chronic obstructive pulmonary disease (COPD) in the elderly.Methods:Data of elderly hospitalized patients with COPD mainly from 5 grade A, class 3 hospitals (Beijing Hospital, Shanghai Huadong Hospital, Tianjin Nankai hospital, the Second Affiliated Hospital of Medical College of Zhejiang University, Guangzhou First People′s Hospital) from January 2012 to December 2020 were retrospectively analyzed. According to the global initiative for chronic obstructive lung disease criteria (GOLD), elderly COPD patients were divided into acute exacerbation group and stable group. The differences in age, gender, medical history, anthropometry, laboratory examination, nutritional support, results of nutritional risk screening 2002 (NRS2002) and global leadership initiative on malnutrition (GLIM) were compared between the two groups after admission, and the risk factors of acute exacerbation of COPD in the elderly were analyzed by multivariate Logistic regression.Results:A total of 339 elderly patients with COPD aged 65-100 years were included in this study, including 177 cases (52.21%) in acute exacerbation stage. The detection rate of malnutrition in acute exacerbation stage was higher than that in stable stage (51.98% vs 41.98%, P<0.05). The weight, body mass index and grip strength of patients in the acute exacerbation stage were significantly lower than those in the stable period [(55.47±8.42) vs (60.63±9.30) kg, (20.52±4.25) vs (22.39±4.57) kg/m 2, (12.32±4.21) vs (16.59±2.97) kg] (all P<0.05). Spearman correlation analysis showed that the acute exacerbation of elderly patients with COPD was positively correlated with malnutrition ( r=0.443, P<0.001), and negatively correlated with body weight, body mass index and calf circumference ( r=-0.200, -0.214, -0.135, all P<0.05). Multiple Logistic regression analysis showed that acute exacerbation in elderly patients with COPD was only related to malnutrition ( OR=7.799, 95% CI: 4.466-13.622, P<0.001). Conclusions:The incidence of malnutrition in acute exacerbation stage of elderly COPD patients is high. Malnutrition is independently related to acute exacerbation of COPD.
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Teaching in experiments of biology is important for the cultivation of life science talents. In view of the rapid development of life science and the increasing demand for research-oriented talent training, teaching in experiments of biology should set up a variety of learning outcomes: to train experimental skill, to cultivate students' experimental design and operation abilities, and to improve students' scientific thinking and innovative consciousness. We have carried out an educational reform on experimental genetic engineering blended course. In this paper, we introduced our methods of organizing online materials, the curriculum design of the blended course, the implementation details, and a preliminary analysis of teaching effects. We found that experimental genetic engineering blended course could support students' active learning and a learning-centered teaching model. Moreover, it could facilitate students' achievement of improving experimental skills, cultivating a rigorous scientific attitude, professional research quality and academic innovation ability.
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Humanos , Disciplinas das Ciências Biológicas , Currículo , Engenharia Genética , EstudantesRESUMO
Objective:To investigate the association of osteosarcopenia with falls, risk of fracture, malnutrition among middle-aged and elderly adults.Methods:A total of 253 participants dwelling in Guangzhou community aged 40-90 years were included in this cross-sectional study from December 2017 to December 2019.Bone mineral density(BMD)was detected by dual-energy X-ray absorptiometry(DEXA). Body composition was analyzed by a bioelectrical impedance analysis.Handgrip strength and gait speed were examined.The 10-year probability of a major osteoporotic fracture and hip fracture were evaluated by online WHO fracture risk assessment tool( FRAX?). Results:According to diagnostic criteria of AWGS and EWGSOP2, the incidences of osteosarcopenia varied from 5.1% to 7.6%, 5.1% to 11.4% respectively.After the adjustment for age and gender, Logistic regression analysis showed that osteosarcopenia was correlated with falls, risk of fracture and malnutrition.Osteosarcopenia definited by AWGS criteria was strongly correlated with falls( OR=3.27-5.68, P<0.05), osteosarcopenia definited by non-severe sarcopenia criteria was strongly correlated with the risk of hip fracture( OR=1.14-1.15, P<0.05), and fat-free mass index was strongly correlated with osteosarcopenia with different definitions( OR=0.21-0.48, P<0.05). Conclusions:Osteosarcopenia is associated with higher risk of falls, fracture and malnutrition in the Guangzhou community-dwelling middle-aged and elderly adults, and fat-free mass index is an independent risk factor for osteosarcopenia.
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Objective:To evaluate the nutritional status of elderly inpatients with heart failure, and to analyze risk factors for malnutrition.Methods:A total of 221 patients with heart failure in our hospital from January 2018 to March 2019 were enrolled in the study.The demographic characteristics and medical record data were collected.All patients received Nutritional Risk Screening 2002(NRS-2002)and a questionnaire survey relating to heart failure.We investigated the effects of risk factors on the detection rate of malnutrition by using Mann-Whitney U test or Chi-square test, and the independent risk factors for malnutrition were analyzed by multivariate Logistic regression analysis.Results:The detection rate of nutritional risk was 45.2% in 221 patients.The detection rate of nutritional risk increased along with lower degree of education and worse cardiac function( P<0.05). The detection rate of nutritional risk was higher in patients with peripheral vascular disease and osteoporosis than in patients without them( P<0.05), and in patients with the increased numbers of complication and drugs( P<0.05). Patients with nutritional risk had a higher degree of frailty and a worse quality of activities of daily living( P<0.05). Multivariate Logistic regression analysis indicated that great age, ejection fraction, B-type natriuretic peptide(BNP), NYHA classification, numbers of drugs and diseases, frailty, low quality of life were independent risk factors for nutritional risk, and Digoxin was the independent protective factor for nutritional risk( P<0.05). Conclusions:The great age, severity of heart failure, numbers of drugs and diseases, frailty, low quality of daily life may be the independent risk factors for nutritional risk in elderly patients with heart failure, and oral Digoxin may be the independent protective factor for nutritional risk.
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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.
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Objective To evaluate the significances of prostate specific antigen (PSA)and alkaline phosphatase(ALP) as a marker of bone formation and tartrate-resistant acid phosphatase 5b (TRACP5b)and pyridinoline cross-linked carboxy-terminal telopeptide of type Ⅰ collagen(ICTP)as markers of bone resorption in predicting therapeutic effect of bone metastasis of prostate cancer patients.Methods Serum levels of PSA,tALP,TRACP5b and ICTP in 57 elderly patients aged 61-90 years with prostate cancer were determined by electrochemiluminescence,colorimetric assay,enzyme linked immunosorbent assays(ELISA)respectively.The correlation between the duration of ADT and the concentrations of each marker index (ln-transformed) was analyzed by Pearson correlation analysis.All prostate cancer patients with bone metastasis were divided into group A (patients without bisphosphonates,n =13),group B (patients with stable bone metastasis and bisphosphonates,n=6) and group C (patients with severe bone metastasis and bisphosphonates,n=8).The concentration of each bone metabolic marker was compared between the three groups.Results Pearson correlation analysis showed that serum concentrations of PSA,ALP and ICTP had no significant correlations with the duration of ADT,but TRACP5b concentration (ln transformed) had a significant positive correlation with the duration of ADT (ln transformed) (R =0.421,P＜ 0.01).The concentrations of PSA,TRACP5b and tALP were increased in group C as compared with group A,but only TRACP5b concentration had a significant difference between group A and C (P＜ 0.05).The concentrations of PSA,tALP,ICTP and TRACP5b were significantly increased in group C as compared with group B (all P＜0.05).Conclusions PSA and bone resorption and formation markers can be excellent monitors of therapeutic effect-relating bone metabolism changes during castration and bisphosphonate treatment in prostate cancer patients with bone metastasis,and TRACP5b may be more sensitive.
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<p><b>OBJECTIVE</b>To investigate the clinical value of serum total procollagen type 1 aminoterminal propeptide (total P1NP), cross-linked C-terminal telopeptide of type I collagen (β-CTX) and 25(OH)D3 detection in evaluating the risks of fragile hip fracture in elderly patients with osteoporosis.</p><p><b>METHODS</b>Serum levels of total P1NP, β-CTX and 25(OH)D3 was measured in 68 elderly osteoporotic patients with fragile hip fracture and 68 age- and gender-matched osteoporotic controls without fragile hip fracture. In both groups, bone mineral density (BMD) was detected with dual X-ray absorptiometry.</p><p><b>RESULTS</b>The serum levels of total P1NP and β-CTX were significantly higher and 25(OH)D3 level was significantly lower in fragile hip fracture group than in the control group (P<0.05), but the two groups showed no significant difference in lumbar or total hip BMD. Bivariate correlation analysis suggested that in fragile hip fracture group, serum 25(OH)D3 level was positively, while serum total P1NP and β-CTX levels were inversely correlated with lumbar and total hip BMD (P<0.05). In control group, 25(OH)D3 was not related to lumbar or total hip BMD, and serum total P1NP and β-CTX levels were inversely correlated with total hip BMD (P<0.05) but not related to lumbar BMD.</p><p><b>CONCLUSION</b>In osteoporotic elderly patients with close BMD levels, high serum levels of total P1NP and β-CTX and low serum levels of 25(OH)D3 might independently indicate high fragile hip fracture risk, and detection of the three markers can help identify high-risk individuals.</p>
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Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Biomarcadores , Sangue , Densidade Óssea , Calcifediol , Sangue , Colágeno Tipo I , Sangue , Fraturas do Quadril , Sangue , Diagnóstico , Osteoporose , Diagnóstico , Osteoporose Pós-Menopausa , Sangue , Diagnóstico , Peptídeos , Sangue , Pró-Colágeno , SangueRESUMO
Objective To evaluate the significances of prostate specific antigen(PSA),alkaline phosphatase(ALP) as a marker of bone formation,tartrate-resistant acid phosphatase 5b(TRACP5b) and pyridinoline cross-linked carboxy-terminal telopeptide of type Ⅰ collagen(ICTP) as markers of bone resorption in diagnosis of bone metastasis of prostate cancer. Methods Totally 57 elderly patients aged 61-90 years with prostate cancer were divided into groups with bone metastasis(n=27)and without bone metastasis (n=30) according to radionuclide bone imaging,and into progressive(n=18) and limited metastasis groups(n=39) by EOD score.Serum concentrations of PSA,TRACP5b,ALP and ICTP were measured by electrochemiluminescence,colorimetric assay,enzyme-linked immunosorbent assays(ELISA).Sensitivities and specificities were calculated for each marker and the diagnostic values of markers were evaluated by receiver operating characteristic curve (ROC).Resuits The serum levels of PSA,TRACP5b,ALP and ICTP were significantly higher in group with bone metastasis than in group without metastasis (P＜ 0.05).In the progressive bone metastasis group,Gleason score and the concentrations of PSA,ALP,TRACP5b,ICTP were increased as compared with limited metastasis group (P＜ 0.05). In diagnosis of prostate cancer with bone metastasis,the area under ROC curve(AUC) of PSA,TRACP5b,ALP,ICTP were 0.796,0.657,0.762,0.743,respectively.The diagnostic value PSA,ALP and ICTP were comparable,followed by TRACP5b.Using the cut point values of 10.235 μg/L for PSA,4.25 U/L for TRACP5b,116.0 U/L for ALP and 7.6 U/L for ICTP,the sensitivities were 66.7％,59.3％,37％,59.3％ and the specificities were 90％,76.7％,96.7％,80％,respectively.PSA,ALP,ICTP and Gleason score were independent predictors of bone metastasis of prostate cancer,the total coincidence rate of regression model was 84.2％. Conclusions The diagnostic values of PSA,TRACP5b,ALP,ICTP are comparable,the combined and dynamic observation may facilitate early diagnosis of prostate cancer with bone metastasis.